Preoperative simulated surgery on 3D model assists osteotomy feasibility verification and surgical guidance for patients with cubitus valgus/varus deformity: a retrospective observational study.

BACKGROUND: As the common delayed complication of supracondylar fractures in children, cubitus valgus/varus deformity might lead to pain and loss of motion of the elbow. The current corrective treatment might not be accurate enough and even contribute to postoperative deformity. This study retrospectively analyzed the clinical value of preoperative simulated surgery on 3D model-assisted osteotomy feasibility verification and surgical guidance for cubitus valgus/varus deformity. METHODS: Seventeen patients were selected from October 2016 to November 2019. Deformities were analyzed from imaging data and 3D models and corrected after the simulated operations. The radiographic evaluation comprised osseous union, carrying angle, and anteversion angle of the distal humerus. The clinical evaluation was performed according to the Hospital for Special Surgery (HSS) scoring system. RESULTS: All patients underwent the operation successfully and had no postoperative deformity. The carrying angle was significantly improved postoperatively (P < 0.001). The anteversion angle of the distal humerus did not change significantly (P > 0.05). The HSS score rose after surgery (P < 0.001). The function of the elbow joint was excellent in seven cases and good in ten cases. CONCLUSION: Simulated surgery on 3D model plays an important role in osteotomy plan and surgical guidance, contributing to good surgical efficacy.

Research progress toward the influence of mosquito salivary proteins on the transmission of mosquito-borne viruses.

Mosquito-borne viruses (MBVs) are a large class of viruses transmitted mainly through mosquito bites, including dengue virus, Zika virus, Japanese encephalitis virus, West Nile virus, and chikungunya virus, which pose a major threat to the health of people around the world. With global warming and extended human activities, the incidence of many MBVs has increased significantly. Mosquito saliva contains a variety of bioactive protein components. These not only enable blood feeding but also play a crucial role in regulating local infection at the bite site and the remote dissemination of MBVs as well as in remodeling the innate and adaptive immune responses of host vertebrates. Here, we review the physiological functions of mosquito salivary proteins (MSPs) in detail, the influence and the underlying mechanism of MSPs on the transmission of MBVs, and the current progress and issues that urgently need to be addressed in the research and development of MSP-based MBV transmission blocking vaccines.

[Simultaneous determination of 22 antibiotics in environmental water samples by solid phase extraction-high performance liquid chromatography-tandem mass spectrometry].

The widespread and frequent use of antibiotics to treat diseases or encourage animal growth has resulted in their persistence and accumulation in water, soil, and sediments. As a typical emerging pollutant in the environment, antibiotics have become an important research focus in recent years. Antibiotics are commonly found at trace levels in water environments. Unfortunately, the determination of various types of antibiotics, all of which exhibit different physicochemical properties, remains a challenging endeavor. Thus, developing pretreatment and analytical techniques to achieve the rapid, sensitive, and accurate analysis of these emerging contaminants in various water samples is an essential undertaking.In this paper, a solid phase extraction-high performance liquid chromatography-tandem mass spectrometry (SPE-HPLC-MS/MS) method for the simultaneous determination of 22 antibiotics including 4 penicillins, 12 quinolones and 6 macrolides in environmental water samples was developed. Based on the characteristics of the screened antibiotics and sample matrix, the pretreatment method was optimized, focusing on the SPE column, pH of the water sample, and amount of ethylene diamine tetra-acetic acid disodium (Na2EDTA) added to the water sample. Prior to extraction, a 200 mL water sample was added with 0.5 g of Na2EDTA and pH-adjusted to 3 using sulfuric acid or sodium hydroxide solution. Water sample enrichment and purification were achieved using an HLB column. HPLC separation was carried out on a C18 column (100 mm×2.1 mm, 3.5 µm) via gradient elution with a mobile phase composed of acetonitrile and 0.15% (v/v) formic acid aqueous solution. Qualitative and quantitative analyses were performed on a triple quadrupole mass spectrometer in multiple reaction monitoring mode using an electrospray ionization source. The results showed correlation coefficients greater than 0.995, indicating good linear relationships. The method detection limits (MDLs) and limits of quantification (LOQs) were in the ranges of 2.3-10.7 ng/L and 9.2-42.8 ng/L, respectively. The recoveries of target compounds in surface water at three spiked levels ranged from 61.2% to 157%, with relative standard deviations (RSDs) of 1.0%-21.9%. The recoveries of target compounds in wastewater at three spiked levels were 50.1%-129%, with RSDs of 1.2%-16.9%. The method was successfully applied to the simultaneous determination of antibiotics in reservoir water, surface water, sewage treatment plant outfall, and livestock wastewater. Most of the antibiotics were detected in watershed and livestock wastewater. Lincomycin was detected in 10 surface water samples, with a detection frequency of 90%, and ofloxacin showed the highest contents (127 ng/L) in livestock wastewater. Therefore, the present method exhibits excellent performance in terms of MDLs and recoveries compared with previously reported methods. The developed method presents the advantages of small water sample volumes, wide applicability, and fast analysis times; thus, it can be considered a rapid, efficient, and sensitive analytical method with excellent potential for monitoring emergency environmental pollution. The method could also provide a reliable reference for formulating antibiotic residue standards. The results provide strong support for and an improved understanding of the environmental occurrence, treatment, and control of emerging pollutants.

Observation of the therapeutic effect of Tongyuan needling combined with jingyu herb-separated moxibustion on recurrent implantation failure of kidney deficiency and blood stasis / 中国针灸

OBJECTIVES@#To observe the therapeutic effect of Tongyuan needling combined with jingyu herb-separated moxibustion on the patients with recurrent implantation failure (RIF) of kidney deficiency and blood stasis undergoing frozen embryo transfer of the conventional hormone replacement therapy cycle.@*METHODS@#Sixty RIF of kidney deficiency and blood stasis patients who planned for frozen embryo transfer were randomly divided into a combined treatment group (30 cases) and a western medication group (30 cases). In the western medication group, the conventional hormone replacement therapy was performed for endometrial preparation during transfer cycle. On the basis of treatment as the western medication group, in the combined treatment group, Tongyuan needling combined with jingyu herb-separated moxibustion was adopted. Regarding tongyuan needling, the acupoint prescription for Tongdu Tiaoshen (promoting the governor vessel and regulating the spirit, e.g. Dazhui [GV 14], Ganshu [BL 18], Shenshu [BL 23] and back-shu points) and that for Yinqi Guiguan (conducting qi back to the primary, e.g. Zhongwan [CV 12], Qihai [CV 6], Guanyuan [CV 4] and front-mu points) were selected. Acupuncture was delivered at these two prescriptions alternatively each time. After acupuncture, the herb-separated moxibustion (in which, the herbal powder was prepared with the modified Yangjing Zhongyu decoction for cultivating the kidney essence and promoting pregnancy) was operated at Shenque (CV 8). This combined therapy was delivered once every two days, 3 sessions a week till the day of embryo transfer. The pregnancy outcomes (positive rate of human chorionic gonadotropin [β-HCG] and clinical pregnancy rate) were compared between the two groups, as well as the TCM syndrome score, serum estradiol (E2) and progesterone (P) levels, endometrial thickness and type, endometrial blood flow index (pulsatility index [PI], resistance index [RI]) before and after treatment.@*RESULTS@#After treatment, the clinical pregnancy rate of the combined treatment group was 40.0% (12/30), higher than that of the western medication group (16.7%, 5/30, P<0.05); and the difference in the positive rate of β-HCG was not significant statistically between the two groups (P>0.05). After treatment, the serum levels of E2 and P were elevated (P<0.05), the endometrial thickness was thickened (P<0.05); the scores of TCM syndrome, and the levels of PI and RI were reduced (P<0.05) when compared with those before treatment in the two groups. The proportion of type A endometrium increased compared with that before treatment in the combined treatment group (P<0.05). Except the levels of E2 and P, the above indexes in the combined treatment group were superior to the western medication group (P<0.05).@*CONCLUSIONS@#On the basis of frozen embryo transfer of conventional hormone replacement cycle, the intervention of Tongyuan needling combined with jingyu herb-separated moxibustion can effectively relieve the clinical symptoms, increase the endometrial blood flow and its thickness, and improve the endometrial receptivity, thereby ameliorate pregnancy outcomes in RIF patients of kidney deficiency and blood stasis.

Discussion on the chemical compositions and treatment mechanism of sepsis of Sonchus arvensis L. by network pharmacology / 药学实践杂志

Objective To explore the effective constituents from Sonchus arvensis L. and the potential mechanism in treating sepsis by network pharmacology. Methods The chemical ingredients reported in the literature were taken as research objects and Swiss Target Prediction database was used to collect the identify the potential targets of those ingredients. The GeneCards, OMIM and TTD databases were applied to screen the sepsis related molecular targets. The cross targets were obtained and used to construct the active ingredient-disease target network. In addition, the targets were also imported into STRING database to construct a PPI network. Finally, GO and KEGG enrichment analysis were performed on the target genes to predict the mechanism via DAVID database. Results 71 components from S. arvensis L. were obtained, which corresponded to 579 potential drug targets. There were 3437 related targets of sepsis. S. arvensis L. and sepsis shared 272 common targets. The results showed that 1366 terms were found by GO function enrichment, including 245 molecular functions (MF), 1002 biological processes (BP), and 119 cell composition (CC), The KEGG enrichment analysis suggested that 166 signaling pathways were involved. Conclusion The study revealed that TNF, AKT1, IL-6, IL-1β, TP53 and some other targets might be affected by potentially active ingredients of S arvensis L. such as linoleic acid, linolenic acid and oleic acid to regulate the expression of steroids, sphingolipids hormones as well as epidermal factors and chemokines in treating sepsis.

Evidence and risk indicators of non-random sampling in clinical trials in implant dentistry: A systematic appraisal.

AIM: Analysis of distribution of p-values of continuous differences between test and controls after randomization provides evidence of unintentional error, non-random sampling, or data fabrication in randomized controlled trials (RCTs). We assessed evidence of highly unusual distributions of baseline characteristics of subjects enrolled in clinical trials in implant dentistry. MATERIALS AND METHODS: RCTs published between 2005 and 2020 were systematically searched in Pubmed, Embase, and Cochrane databases. Baseline patient data were extracted from full text articles by two independent assessors. The hypothesis of non-random sampling was tested by comparing the expected and the observed distribution of the p-values of differences between test and controls after randomization. RESULTS: One-thousand five-hundred and thirty-eight unique RCTs were identified, of which 409 (26.6%) did not report baseline characteristics of the population, and 671 (43.6%) reported data in forms other than mean and standard deviation and could not be used to assess their random sampling. Four-hundred and fifty-eight trials with 1449 baseline variables in the form of mean and standard deviation were assessed. The study observed an over-representation of very small p-values [<.001, 1.38%, 95% confidence interval (CI) 0.85-2.12 compared to the expected 0.10%, 95% CI 0.00-0.26]. No evidence of over-representation of larger p-values was observed. Unusual distributions were present in 2.38% of RCTs and more frequent in non-registered trials, in studies supported by non-industry funding, and in multi-centre RCTs. CONCLUSIONS: The inability to assess random sampling due to insufficient reporting in 26.6% of trials requires attention. In trials reporting suitable baseline data, unusual distributions were uncommon, and no evidence of data fabrication was detected, but there was evidence of non-random sampling. Continued efforts are necessary to ensure high integrity and trust in the evidence base of the field.

Is subfibular ossicle excision necessary in the modified Brostr?m procedure for chronic lateral ankle instability? / 中华创伤骨科杂志

Objective:To investigate the effect of subfibular ossicle excision on the clinical efficacy of Brostr?m procedure for chronic lateral ankle instability (CLAI).Methods:From March 2014 to December 2018, 76 patients were treated by the modified Brostr?m procedure using the suture anchor technique for CLAI at Department of Foot & Ankle Surgery, Wuhan Fourth Hospital. Of them, 33 had subfibular ossicles (SFO group) and 43 did not (NSFO group). In the SFO group, there were 19 males and 14 females, aged (28.4±8.6) years; in the NSFO group, there were 21 males and 22 females, aged (27.8±7.4) years. Subfibular ossicles were excised in the SFO group. The 2 groups were compared in terms of American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and visual analogue scale (VAS) pain scores at preoperation and the final follow-up.Results:The 2 groups were comparable due to insignificant differences between them in their preoperative general data ( P>0.05). All the patients were followed up for 24 to 72 months (average, 28 months). The AOFAS ankle-hindfoot scores improved significantly from 54.5±3.4 to 95.7±2.1 in the SFO group and significantly from 56.2±2.7 to 95.2±2.4 in the NSFO group at the final follow-up; the VAS scores reduced significantly from 5.7±1.8 to 1.6±1.4 in the SFO group and significantly from 5.7±1.6 to 1.7±1.2 in the NSFO group at the final follow-up (all P<0.05). No significant differences were found between the 2 groups in terms of AOFAS or VAS scores at the final follow-up ( P>0.05). Conclusion:Since the modified Brostr?m procedure plus subfibular ossicle excision may result in similar good clinical efficacy as merely the modified Brostr?m procedure may for the CLAI patients without subfibular ossicle, subfibular ossicle excision should be suggested for the CLAI patients with subfibular ossicle.

Bovine-Derived Xenografts Immobilized With Cryopreserved Stem Cells From Human Adipose and Dental Pulp Tissues Promote Bone Regeneration: A Radiographic and Histological Study.

Adipose tissue-derived stem cells (ADSCs) and dental pulp stem cells (DPSCs) have become promising sources for bone tissue engineering. Our study aimed at evaluating bone regeneration potential of cryopreserved ADSCs and DPSCs combined with bovine-derived xenografts with 10% porcine collagen. In vitro studies revealed that although DPSCs had higher proliferative abilities, ADSCs exhibited greater mineral depositions and higher osteogenic-related gene expression, indicating better osteogenic differentiation potential of ADSCs. After applying cryopreserved ADSCs and DPSCs in a critical-sized calvarial defect model, both cryopreserved mesenchymal stem cells significantly improved bone volume density and new bone area at 2, 4, and 8 weeks. Furthermore, the combined treatment with ADSCs and xenografts was more efficient in enhancing bone repair processes compared to combined treatment with DPCSs at all-time points. We also evaluated the sequential early bone healing process both histologically and radiographically, confirming a high agreement between these two methods. Based on these results, we propose grafting of the tissue-engineered construct seeded with cryopreserved ADSCs as a useful strategy in accelerating bone healing processes.

Comparative study of allicin-containing quadruple therapy vs. bismuth-containing quadruple therapy for the treatment of Helicobacter pylori infection: a prospective randomized study.

BACKGROUND: Bismuth has antimicrobial activity and can improve the efficacy of triple Helicobacter pylori (H. pylori) therapy. Allicin added to conventional therapy for H. pylori infection also improves H. pylori eradication rates. Thus, this study aims to evaluate and compare the efficacy, safety and tolerability of allicin-containing quadruple therapy and bismuth-containing quadruple therapy and to investigate the factors that affect the eradication rates. METHODS: Two hundred twenty H. pylori-infected patients were included and randomly (1:1) assigned to 14-day quadruple therapy: ilaprazole (5 mg bid), doxycycline (100 mg bid), and furazolidone (100 mg bid) with an allicin soft capsule (40 mg of DATS tid) (IDFA) or colloidal bismuth tartrate (220 mg of elemental bismuth bid) (IDFB). Eradication was confirmed by urea breath tests. Symptom improvement, adverse events, and adherence were assessed by a questionnaire. RESULTS: In the intention-to-treat and per-protocol analysis, the eradication rates for IDFA and IDFB groups were 87.5% (70/80) vs. 86.3% (69/80, P = 0.815) and 91.9% (68/74) vs. 91.8% (67/73, P = 0.980) as first-line therapies; 83.3% (25/30) vs. 83.3% (25/30, P = 1) and 89.3% (25/28) vs. 88.9% (24/27, P = 1) as second-line therapies. Symptom improvement rates were 96.1% and 97.0% for IDFA and IDFB (P = 1). The adverse event rates were 10.9% in IDFA and 14.5% in IDFB groups (P = 0.418). Nausea occurred frequently in IDFB than IDFA (1.8% vs. 8.2%, P = 0.030). Smoking and sharing utensils significantly affected the efficacy. CONCLUSION: Allicin-containing quadruple therapy might be regarded as a promising alternative to bismuth-containing quadruple therapy in H. pylori eradication.

The effects of periacetabular osteotomy in the treatment of borderline developmental dysplasia of the hip / 中华骨科杂志

Objective:To investigate the effects of periacetabular osteotomy (PAO) in treating borderline developmental dysplasia of the hip (DDH).Methods:The patients with borderline DDH [lateral center-edge angle (LCEA): 18°-25°) who received PAO with follow-up duration for more than 2 years from January 2011 to January 2018 in our hospital were retrospectively analyzed. The patients in the control group were matched on a 1∶2 ratio based on gender, age, body mass index (BMI) and follow-up duration. There were 66 patients in the 0°≤LCEA<10° group and 66 patients in the 10°≤LCEA<18° group. The LCEA, anterior center-edge angle (ACEA), T?nnis angle, femoral head extrusion index, femoro-epiphyseal acetabular roof (FEAR) index, femoral anteversion angle, West Ontario and McMaster University (WOMAC) index and International Hip Outcome Tool (iHOT-12) were compared among the three groups before operation and the last follow-up.Results:In the preoperative 18°≤LCEA<25° group, three of 33 patients (9.1%) had LCEA, because the only imaging feature suggested acetabular dysplasia, while other parameters were evaluated within the normal range. There were 17 patients with ACEA <20° (51.5%), 24 patients (72.7%) with T?nnis angle >10°, 12 patients (36.4%) with ACEA <20° and T?nnis angle >10°. The positive rate of posterior wall signs in the 18°≤LCEA<25° group (72.7%) was lower than that in the 10°≤LCEA<18° group (77.3%) and the 0°≤LCEA<10° group (90.9%) with statistically significant difference (χ 2=6.417, P=0.040) at preoperation. The positive rate of cross sign (27.3%) and ischial spine sign (48.5%) in the 18°≤LCEA<25° group were higher than those in the 10°≤LCEA<18° group (10.6% and 18.2%, respectively, χ 2=7.002, P=0.030) and the 0°≤LCEA<10° groups (9.1% and 13.6%, respectively, χ 2=16.497, P<0.001). The FEAR index in the 18°≤LCEA<25° group (3.7±8.0) lower than that in the 10°≤LCEA<18° group (4.3±7.9) and the 0°≤LCEA<10° group (11.0±8.8) with significant difference ( F=12.703, P<0.001). In the 18°≤LCEA<25° group, postoperative LCEA increased from 20.4°±1.8° to 37.8°±7.1°, ACEA increased from 18.3°±7.8° to 36.3°±6.3°. T?nnis angle decreased from 12.7°±6.2° to -5.6°±9.2°, the femoral head extrusion index decreased from 22.9%±6.7% to 10.7%±12.2%, the WOMAC index decreased from 20.1±13.4 to 6.0±6.3, and the iHOT-12 score increased from 50.2±19.9 to 90.0±13.7. The above difference before and after surgery was statistically significant ( P<0.05). At the last follow-up, the WOMAC score in the 18°≤LCEA<25° group was 6.0±6.3, wich was less than 10°≤LCEA<18° group (9.3±9.6) and 0°≤LCEA<10° group (12.0±16.0) ( F=6.515, P=0.002). The iHOT-12 score in the 18°≤LCEA<25° group was 90.0±13.7, which was greater than 10°≤LCEA<18° group (77.7±17.3) and 0°≤LCEA<10° group (78.1±20.5) ( F=15.833, P<0.001). Conclusion:After 2 years follow-up, PAO significantly improved bone coverage of femoral head and hip function in patients with borderline DDH. Before surgery, we should pay attention to the comprehensive evaluation of different radiological parameters of the acetabulum, to make better preoperative planning.

Emergent foot and ankle surgery in the epidemic of COVID-19 / 中华创伤骨科杂志

Objective:To report our experience in the emergent foot and ankle surgery in the epidemic of COVID-19.Methods:The data of 18 patients with acute foot and ankle injury were reviewed who had been admitted to the Department of Foot and Ankle Surgery, Wuhan Fourth Hospital from 20th January, 2020 to 26th February, 2020. They were 11 men and 7 women, aged from 18 to 70 years (average, 42.5 years). There were 5 cases of acute open injury and 13 ones of acute closed injury. COVID-19 infection was diagnosed or suspected in 5 cases but not in the other 13 cases. Emergency operation was carried out for 2 patients with open injury plus COVID-19 infection and one with complicated pilon fracture plus COVID-19 infection, one of whom received secondary operation. One patient with closed fracture of the left calcaneus plus COVID-19 infection was hospitalized from emergency department for secondary surgery, and another with closed fracture of the right lateral malleolus was referred to the isolation ward after emergency plaster fixation. Of the 10 patients with closed injury but without COVID-19 infection, 3 received conventional secondary surgery after admission and the others conservative treatment at the outpatient department. Recorded were COVID-19 infections in the patients after admission and in the medical staff. The measures taken and experience in control and prevention of COVID-19 infection after outbreak of the epidemic were reviewed.Results:Of the 11 patients who had been hospitalized for foot and ankle injury in emergency, 5 were definitely diagnosed of or suspected of COVID-19 infection and 6 free of COVID-19 infection. During hospitalization, COVID-19 infection was confirmed in the 5 cases and no COVID-19 infection occurred in the other 6 patients. No COVID-19 infection occurred in the medical staff; no cross infection was observed between the patients and the medical staff.Conclusions:Reasonable strategies are advised to balance the foot and ankle surgery and epidemic prevention. A simplified management is not advised for all the cases. The operative procedures in emergent foot and ankle surgery should be optimized in line with the epidemic control and prevention principles to facilitate functional rehabilitation for the patients.

Research on the determination of emodin in Xiaoyan granulas / 国际中医中药杂志

Objective:To establish a method for the determination of emodin in Xiaoyan granulas by high performance liquid chromatography (HPLC). Methods:Took inertsil ODS-3 (250 mm × 4.6 mm, 5 μm) as the chromatographic separation the mobile phase was acetonitrile-0.1% phosphoric acid (80:20), the detection wavelength was 254 nm, the flow rate was 1.0 ml/min, and the column temperature was at 40 ℃.Results:The linear range of emodin was 0.034 6-0.432 0 μg ( r=0.999 9). The average recovery was 94.02% ( RSD=1.29%, n=6). Conclusions:This method is simple, accurate, which could be used repeatedly and can be used as the emodin determination method for Xiaoyan granulas.

Effects of shooting position on X-ray evaluation index of developmental hip dysplasia / 中华骨科杂志

Objective@#To explore the impacts of the imaging positions on the sagittal tilt of the pelvis and the imaging parameters of the hip joint.@*Methods@#From December 2015 to October 2016, a total of 78 female DDH patients (DDH group) who received Bernese periarticular osteotomy were enrolled, aged 28.41±9.91 years (range 18-49 years) with 135 hips. There were 21 cases on one side and 57 cases on both sides. Another 26 female volunteers without spinal and hip disease were enrolled as the control group, aged 23.54±5.58 years (range 18-49 years) with 52 hips. X-ray films of the anterior and posterior pelvis were performed in both groups. The pelvic sagittal tilt was evaluated by measurement (pubic symphysis to sacrococcygeal distance, PSSC), with lateral center-edge angle of Wiberg (LCEA), Tönnis angle (TA), and Sharp angle (angle of Sharp, SA) assessed the degree of hip dysplasia and assessed the horizontal positional relationship between the femoral head and the acetabulum using tear drop distance (TD). All data were measured twice by two measurers independently. The correlation between hip parameters and X-ray position was analyzed.@*Results@#The average PSSC in the supine and standing positions of the control group were 53.73±16.22 mm and 36.45±14.21 mm, respectively with significant difference-17.28±8.07 mm (t=-10.913, P=0.000). The PSSC of the supine and standing positions of the DDH group were 56.76±13.54 mm and 48.62±15.44 mm, respectively with significant difference-8.13±13.02 mm (t=-5.516, P=0.000). The PSSC of the standing DDH group was larger than that in the control group. There was no significant difference in the PSSC between the two groups in the supine position. Furthermore, there were no significant difference in the supine and standing PSSC between the unilateral and bilateral DDH patients (P>0.05). In the control group, the hip in supine and standing position, LCEA averaged 30.33°±4.69° and 29.70°±3.83° (P>0.05), and TA averaged 4.05°±3.51° and 4.36°±3.07° (P>0.05), respectively. SA averaged 40.53°±4.34° and 41.79°±3.16° (P>0.05), and TD averaged 6.80±0.98 mm and 6.65±1.30 mm (P>0.05), respectively. In the DDH group, the hip in supine and standing positions, LCEA averaged 3.07°±12.07° and 1.69°±12.11° (P<0.05), and TA averaged 22.62°±9.31° and 23.82°±9.45° (P>0.05), respectively. SA averaged 48.01°±4.68° and 48.49°±4.74° (P>0.05), respectively, and TD averaged 10.51±3.51 mm and 10.93±4.23 mm (P>0.05), respectively.@*Conclusion@#From supine to standing, the pelvis backward is the main trend in sagittal plane. In standing, the pelvis of female DDH patients is forward contrast with normal women. There was no difference in pelvic tilt between unilateral and bilateral DDH patients. Female DDH patients from the supine to standing, hip coverage decreased, while the femoral head appeared horizontally outward. The hip joint of DDH patients is unstable.

Effects of shooting position on X?ray evaluation index of developmental hip dysplasia / 中华骨科杂志

Objective To explore the impacts of the imaging positions on the sagittal tilt of the pelvis and the imaging pa?rameters of the hip joint. Methods From December 2015 to October 2016, a total of 78 female DDH patients (DDH group) who received Bernese periarticular osteotomy were enrolled, aged 28.41±9.91 years (range 18-49 years) with 135 hips. There were 21 cases on one side and 57 cases on both sides. Another 26 female volunteers without spinal and hip disease were enrolled as the control group, aged 23.54±5.58 years (range 18-49 years) with 52 hips. X?ray films of the anterior and posterior pelvis were per?formed in both groups. The pelvic sagittal tilt was evaluated by measurement (pubic symphysis to sacrococcygeal distance, PSSC), with lateral center?edge angle of Wiberg (LCEA), T?nnis angle (TA), and Sharp angle (angle of Sharp, SA) assessed the degree of hip dysplasia and assessed the horizontal positional relationship between the femoral head and the acetabulum using tear drop dis?tance (TD). All data were measured twice by two measurers independently. The correlation between hip parameters and X?ray posi?tion was analyzed. Results The average PSSC in the supine and standing positions of the control group were 53.73±16.22 mm and 36.45±14.21 mm, respectively with significant difference-17.28±8.07 mm (t=-10.913, P=0.000). The PSSC of the supine and standing positions of the DDH group were 56.76± 13.54 mm and 48.62± 15.44 mm, respectively with significant difference -8.13±13.02 mm (t=-5.516, P=0.000). The PSSC of the standing DDH group was larger than that in the control group. There was no significant difference in the PSSC between the two groups in the supine position. Furthermore, there were no significant differ?ence in the supine and standing PSSC between the unilateral and bilateral DDH patients (P＞0.05). In the control group, the hip in supine and standing position, LCEA averaged 30.33°±4.69°and 29.70°±3.83°(P＞0.05), and TA averaged 4.05°±3.51°and 4.36°± 3.07°(P＞0.05), respectively. SA averaged 40.53°±4.34°and 41.79°±3.16°(P＞0.05), and TD averaged 6.80±0.98 mm and 6.65± 1.30 mm (P＞0.05), respectively. In the DDH group, the hip in supine and standing positions, LCEA averaged 3.07°±12.07°and 1.69°±12.11°(P<0.05), and TA averaged 22.62°±9.31°and 23.82°±9.45°(P＞0.05), respectively. SA averaged 48.01°±4.68°and 48.49°±4.74°(P＞0.05), respectively, and TD averaged 10.51±3.51 mm and 10.93±4.23 mm (P＞0.05), respectively. Conclusion From supine to standing, the pelvis backward is the main trend in sagittal plane. In standing, the pelvis of female DDH patients is forward contrast with normal women. There was no difference in pelvic tilt between unilateral and bilateral DDH patients. Female DDH patients from the supine to standing, hip coverage decreased, while the femoral head appeared horizontally outward. The hip joint of DDH patients is unstable.

Magnetic, geochemical characterization and health risk assessment of road dust in Xuanwei and Fuyuan, China.

As an accumulation of solid organic and inorganic pollutant particles on outdoor ground surfaces, road dust is an important carrier of heavy metal contaminants and can be a valuable medium for characterizing urban environmental quality. Because the dusts can be an important source of atmospheric particles and take impact on human health, the aim of this study described in detail the mineralogical characteristics, morphology, and heavy metal content of road dust from Xuanwei and Fuyuan, locations with high lung cancer incidence. Our results show that the average concentrations of heavy metals in road dust were higher than their background values. Higher concentrations of heavy metals were found in the magnetic fractions (MFs) than in the non-magnetic fractions (NMFs). Magnetic measurements revealed high magnetic susceptibility values in the road dust samples, and the dominant magnetic carrier was magnetite. The magnetic grains were predominantly pseudo-single domain, multi-domain, and coarse-grained stable single domains (coarse SSD) in size. SEM/XRD analysis identified two groups of magnetic particles: spherules and angular/aggregate particles. Hazard index (HI) values for adults exposure to road dust samples, including MF, Bulk, and NMF, in both areas were lower or close to safe levels, while HI values for childhood exposure to magnetic fractions in both areas were very close or higher than safe levels. Cancer risks from road dust exposure in both areas were in the acceptable value range.

[Contrast-enhanced CT for the diagnosis of extracapsular spread by head and neck cancers: a systematic review and meta analysis].

PURPOSE: This study aimed to assess the diagnostic efficacy of contrast-enhanced CT in the screening of extracapsular spread by head and neck cancers. METHODS: Electronic databases, including MEDLINE, EMBASE,CBM,CNKI and SciencePaper Online were searched electronically. Hand-searching was also performed. QUADAS-2 was used by two independent reviewers to assess the methodological quality, and data extraction of included studies was delivered. Meta analysis was conducted via MetaDisc1.4 and STATA 11.0. RESULTS: A total of 8 studies involving 639 participants were included. All studies were retrospective, 1 had high risk of bias, and the remaining had unclear risk of bias. Meta analysis showed that when screening extracapsular spread, contrast-enhanced CT had a pooled sensitivity of 0.67, pooled specificity of 0.84, area under curve of 0.83. CONCLUSIONS: Contrast-enhanced CT is a good tool for diagnosing extracapsular spread by head and neck cancers.

Sinus tarsus mini incision approach with percutaneous reduction and fixation for Sanders Ⅱ、 Ⅲ calcaneal fractures / 中华骨科杂志

Objective To explore the methods and clinical effect of the sinus tarsus mini incision approach with percutaneous fixation technique in the treatment of Sanders Ⅱ,Ⅲ calcaneus fractures.Methods From January 2015 to May 2016,the clinical data of 64 cases with Sanders Ⅱ,Ⅲ calcaneus fractures who were treated by sinus tarsus mini incision approach with percutaneous reduction and fixation were analyzed retrospectively.The average age was 46.64±10.51 years (range,25-68) and 49 patients were males and 15 patients were females.According to Sander's classification,39 patients were Sanders Ⅱ and 25 were Sanders Ⅲ fracture.Calcaneal varus was corrected and the length,width and height of bone were reduced by sinus tarsus mini incision approach with percutaneous fixation technique.Calcaneal fracture was treated by calcaneal bone plate combined with percutaneous screw fixation.Complications and operation procedure were recorded post-operation.Anteroposterior,lateral and axial views of preoperative and postoperative X-ray and CT scan were taken to assess the classification,restoration and intertion status of fracture.Radiological assessment was performed using B(o)hler's angle and Gissane's angle.Functional outcome was assessed using the Maryland foot score (MFS).Results All of the sixty-four patients were followed up for 12-18 months (average,14.80± 2.03).After surgery,only 4 cases of superficial necrosis of the incision were found,and the incisions were all healed and no infection occurred after surgery.No tendon tenosynovitis was seen after surgery.There were no fracture displacement,internal fixation failure,and fracture deformity healing cases.The mean time of bone union was 9.44±1.38 weeks (8-12 weeks) without fracture deformity healing case.The mean time of bone union was 9.17±1.16 weeks for the 23 cases with bone graft.For the 41 cases without bone graft,the bone healing average time was 9.91 ± 1.62 weeks,and there is no statistically difference between cases with and without bone graft (t=1.936,P=0.061).B(o)hler's angle was 6.625°±4.904° (range,-5°-15°) preoperative,and improved to 31.031°± 4.660° (range,24°-40°),which had statistically significant difference (t=-28.863,P=0.000).Gissane's angle was from preoperative 76.094°±12.981° (range,55°-105°) to 127.328°±6.486° (range,115°-140°) at the time of the latest follow-up,and the difference had statistically significant (t=-28.246,P=0.000).Maryland Score:excellent 30 cases (22 cases of type Ⅱ,8 cases of type Ⅲ),good 27 cases (15 of type Ⅱ,12 of type Ⅲ),fair 7 cases (2 of type Ⅱ,5 of type Ⅲ).The overall good rate was 89.06％ (57/64).Conclusion The tarsal sinus minimally invasive small incision reduction and internal fixation combined with percutaneous reduction and fixation technique in the treatment of ealcaneal fractures,exerts the advantages of small trauma,clear surgical exposure for reduction,reliable fixation,and low incision complications,which is applicable to treat the Sanders Ⅱ,Ⅲ calcaneal fractures.

Rotational osteotomy on the base of femoral neck in treating osteonecrosis of the femoral head / 中华骨科杂志

Objective To report the short-term outcomes of the rotational osteotomy on the base of femoral neck in treating osteonecrosis of femoral head.Methods Ten patients (10 hips) with osteonecrosis of femoral head underwent the rotational osteotomy on the base of femoral neck between March 2014 and October 2016.There were 9 males and 1 female.The average age was 29.6 years,ranging from 18 to 42 years.There were 4 patients in right side and 6 in left side.The Association Research Circulation Osseous (ARCO) Stage was from ⅡB to ⅢC (2 cases of ⅡB,2 cases of ⅡC,1 case of ⅢA,1 case of ⅢB,4 cases of ⅢC).The following main procedures were involved in the treatment:surgical hip dislocation,the extension of retinacular soft-tissue flap to protect the main blood supply of the femoral head,anterior or posterior rotational (60°-90°) of femoral head after femoral neck osteotomy.We used three compress cannulated screws to fix the femoral neck osteotomy.The postoperative Harris hip scores (HHS),Western Ontario and McMaster College (WOMAC) score,pelvic A-P view and lateral hip view radiographic characteristics were analyzed to assess the short-term outcomes.Results The average follow-up duration was 16.3 months (7-36 months).No progressive femoral head collapse was observed in 6 patients at the last follow-up.The average post-operative intact ratio was 42.90％± 10.07％.The HHS improved from 80.00±14.93 to 86.83±6.11 (4 cases improved,1 case with no change and 1 case decreased slighdy).The WOMAC score decreased from 16.00±14.53 to 9.00±3.85 (1 cases increased,1 case with no change and 4 case decreased).The remaining 4 cases,however,had the progression of the femoral head collapse.The average post-operative intact ratio was 16.57％±6.57％.The HHS decreased from 77.75±14.66 to 60.75±17.54 (1 case improved slightly and 3 cases decreased).The WOMAC score increased from 12.75±5.06 to 22.50±8.81 (4 cases increased).Conclusion The rotational osteotomy on the base of femoral neck not only shifts the necrosis area away from weight-bearing region but also improves the post-operative intact ratio.Patients with ARCO stage ⅡB-ⅢB may achieve remission of symptoms and improvement of hip function by this surgical technique.However,for patients with ⅢC stage,we should conduct preoperative design to make sure whether the surgery is worth doing or not.Some patients may suffer from post-operative progression collapse of the femoral head.

Evaluating oral epithelial dysplasia classification system by near-infrared Raman spectroscopy.

Until now, the classification system of oral epithelial dysplasia is still based on the architectural and cytological changes, which relies on the observation of pathologists and is relatively subjective. The purpose of present research was to discriminate the oral dysplasia by the near-infrared Raman spectroscope, in order to evaluate the classification system. We collected Raman spectra of normal mucosa, oral squamous cell carcinoma (OSCC) and dysplasia by near-infrared Raman spectroscope. The biochemical variations between different stages were analyzed by the characteristic peaks in the subtracted mean spectra. Gaussian radial basis function support vector machines (SVM) were used to establish the diagnostic models. At the same time, principal component analysis (PCA) and linear discriminant analysis (LDA) were used to verify the results of SVM. Raman spectral differences were observed in the range between 730~1913 cm-1. Compared with normal mucosa, high contents of protein and DNA in oral dysplasia and OSCC were observed. There were no significant or gradual variation of Raman peaks among different dysplastic grades. The accuracies of comparison between mild, moderate, severe dysplasia with OSCC were 100%, 44.44%, 71.15%, which elucidated the low modeling ability of support vector machines, especially for the moderate dysplasia. The analysis by PCA-LDA could not discriminate the stages, either. Combined with support vector machines, near-infrared Raman spectroscopy could detect the biochemical variations in oral normal, OSCC and dysplastic tissues, but could not establish diagnostic model accurately. The classification system needs further improvements.