Bibliometrics and visualized analysis of research hotspots and current status in clinical management of osteoporotic fractures / 中华内分泌代谢杂志

Objective:Based on Web of Science database, this study aimed to explore the current status, research hotspots and development trends of countries regarding clinical management of osteoporotic fractures using bibliometrics and visualized analysis.Methods:We collected literatures in the field of clinical management of osteoporotic fractures included in Web of Science database, and applied bibliometrics to analyze the publication dates, countries, institutions, journals, authors, highly cited literatures and research hotspots. Visualization was drawn by VOSviewer software.Results:Analysis of the 2 508 articles revealed 3 types of data. (1) The analysis of basic information of the literature showed that: ①The country with the largest number of publications was the United States, which published 672 articles, followed by the United Kingdom and Canada, and China ranked fourth; ②The top three authors in the number of publications were Kanis JA, Cooper C and McCloskey EV respectively; ③The institution with the highest number of publications was the University of Sheffield, UK, followed by the University of Southampton, UK and the University of Toronto, Canada. (2) Network visualization of highly cited literatures showed that 118 highly cited literatures were mainly divided into 5 clusters, which were related to osteoporotic fracture diagnosis, treatment, medication adherence, management consensus and strategies of preventing refracture. (3) Temporal overlay visualization of research hotspots showed that early research mainly focused on traditional therapeutic drugs, and current research hotspots were mainly molecular targeted drugs, trabecular bone score and fracture liaison services.Conclusion:This study shows that the research activity of clinical management of osteoporotic fractures is increasing worldwide, and there is still a huge gap between China and Europe or the United States. Current research hotspots and development trends mainly focus on molecular targeted drugs, osteoporotic fracture treatment concepts, emerging fracture risk assessment tools, and fracture prevention and management models.

Effects of reduction with different anterior and medial cortical supports on stability after intramedullary nailing for unstable intertrochanteric fractures: a biomechanical comparison / 中华创伤骨科杂志

Objective To compare the biomechanical stabilities among different combinations of anterior and medial cortical supports after intramedullary nailing for unstable intertrochanteric fractures.Methods Twenty-seven synthesized femur specimens were used to create models of unstable intertrochanteric fracture of type 31A2.1 according to AO/ASIF classification.They were divided into 9 groups (n =3) according to 9 combinations of anterior and medial cortical supports on the anteroposterior and lateral X-ray films:positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups.After all the fractures were fixated with the newly adapted femoral intertrochanteric nails (FITN),static loadings were applied for tests of fatigue and destruction to investigate the relative displacements and yield loads of the head-neck fragments.Results For the positive-positive,positive-neutral,positive-negative,neutral-positive,neutral-neutral,neutral-negative,negative-positive,negative-neutral,negative-negative groups,the vertical displacements of the head-neck fragments under fatigue loading were respectively 5.33 ±0.58 mm,7.83 ±0.29mm,7.73 ±0.15 mm,8.17 ± 0.29 mm,8.33±1.15 mm,8.83±0.29 mm,9.33±0.58 mm,9.67±1.15 mm and 12.0±1.0 mm,showing significant differences (P ＜ 0.05).The smallest displacement was observed in the positive-positive group,significantly smaller than that in any other groups (P ＜ 0.05).For the above 9 groups,the yield loads were respectively 4,967 ± 153 N,4,467 ± 58 N,3,717 ± 76 N,2,767 ± 58 N,2,533 ± 58 N,2,267 ± 58 N,1,833 ± 58 N,1,667 ± 58 N and 1,333 ± 58 N,showing significant differences between any 2 groups (P ＜ 0.05).In the destruction test,bone interface loosening in the femoral head happened in 2 cases,bone interface loosening in the intertrochanteric zone in 15 cases,split fracture at the zone of distal locking nail in 2 cases,and loosening and breakage of the internal fixator in the distal femur in 8 cases.Conclusions The medial cortical support plays a major role and the anterior cortical support plays a secondary role in the stability of unstable intertrochanteric fracture.In the surgical procedure,surgeons should avoid the medial cortical negative support as much as possible.

Expression and identification of recombinant chimeric CARDS of Mycoplasma pneumoniae / 中国人兽共患病学报

We expressed multi-epitope chimeric protein of CARDS toxin protein of Mycoplasma pneumonia (Mp) in prokaryotic cells,and purified and investigated its immunoreactivity.A recombinant multi-epitope chimeric gene including ten critical epitopes was connected by linker and cloned into prokaryotic expression vector pET-28a(+),and transformed into E.coli BL21(DE3) cells for expression under induction of IPTG.The antigenicity of expressed recombinant protein was identified with 6 × His monoclonal antibody and human positive serum by Western blot.The recombinant expression vector pET-CARDS was constructed and the about 30 kDa recombinant chimeric protein expressed in BL21(DE3) successfully.Western blot analysis showed that it can react respectively with 6 × His monoclonal antibodies and human positive serum.This study showed that the chimeric CARDS protein has an obvious immunoreactivity and a potential to be a new antigen for the diagnosis of Mp infection.

A clinical analysis of Weixuening granule combined with prednisone for treatment of patients with primary immune thrombocytopenia / 中国中西医结合急救杂志

Objective To observe the clinical efficacy of Weixuening granule combined with prednisone for treatment of patients with primary immune thrombocytopenia (ITP) and its impact on platelet-associated antibodies(PAIgG, PAIgM, PAIgA). Methods Sixty patients with ITP were randomly divided into a observation group (30 cases, Weixuening granule combined with prednisone) and a control group (30 cases, prednisone therapy alone), 3 months constituting a therapeutic course. The clinical effects, platelet count (PLT) and PAIgG, PAIgM, PAIgA of two groups were observed after two courses of treatment. The time of withdrawing prednisone, relapse rate in 1 year and adverse reactions were also monitored. Results The total effective rate of the observation group was higher than that of the control group [90.00%(27/30) vs. 73.33%(22/30), P0.05). Conclusions The combined use of Weixuening granule and prednisone for treatment of patients with primary ITP is more effective than administration of prednisone alone;the adverse reactions are less in combined therapy group. Possibly, the better therapeutic effect of combined therapy is related to the decrease of platelet-associated antibodies and increase of the platelet generation.

Rectal and perianal inflammatory myofibroblastic tumor: report of 3 cases / 中华普通外科杂志

Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.

Analysis of Survival and Functional Outcome after Nerve-Sparing Surgery with Extraperitoneal Lateral Lymphadenectomy for Lower Rectal Carcinoma / 中国普外基础与临床杂志

Objective To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%(28/173); the coupled group was 9.6%(21/219), P

Radical resection of rectal cancer with autonomic nerve preserving and the postoperative urinary and sexual function / 中国普通外科杂志

Objective To evaluate the effect on postoperative urinary and sexual function of the radical operation with autonomic nerve preserving for mid low rectal cancer.[WT5”HZ]Method [WT5”BZ]Radical operation with autonomic nerve preserving was performed on 188 cases of rectal cancer. Nerves were fully preserved in 98 cases of Dukes A stage,one or both side nerves preserved in 78 cases of stage B, only S 3,4 nerve preserved in 12 cases of stage C.[WT5”HZ]Result [WT5”BZ]The postoperative voluntary micturition developed at 8 5 days for Dukes A; 9 0 days for stage B; and 16 8 days for stage C. Erection and ejaculation remained in Dukes A, in 96% and 100%;stage B, in 47 4% and 50%;stage C, in 0 and 0. The local recurrence after the operation accounted for 12 8%(24/188), among them Dukes A,B,C were 4 1%,21 9%, and 33 3% respectively.The 5 year survival rate were 77 6%,52 6% and 33 3% respectively.[WT5”HZ]Conclusion [WT5”BZ]The radical operation with autonomic nerve preserving for rectal cancer effects a better life quality not at the expense of local recurrence and reduction of 5 year survival rate.