Research progress on the effect of fluorosis on nervous system and its mechanism / 中华地方病学杂志

Fluorosis is an endemic disease caused by prolonged exposure to excessive fluoride and is considered a serious public health problem in many countries. In recent years, the damage of chronic fluorosis to the central nervous system has attracted extensive attention from scholars at home and abroad. The mechanisms of neurotoxicity caused by fluorosis include oxidative stress, inflammatory reaction, autophagy, neurotransmitters and related enzymes, changes in neural signaling pathways, abnormal neuronal energy metabolism of neurons, cell apoptosis, etc., causing permanent damage to human brain structure, impaired learning ability, memory dysfunction and behavioral problems. This article reviews the effects of fluorosis on the nervous system and related mechanisms, and provides a reliable basis for prevention and treatment of fluorosis.

Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (version 2022) / 中华创伤杂志

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Potential use of 3D-printed graphene oxide scaffold for construction of the cartilage layer.

BACKGROUND: Three-dimensional (3D) printing involves the layering of seed cells, biologically compatible scaffolds, and biological activity factors to precisely recapitulate a biological tissue. Graphene oxide (GO), a type of micro material, has been utilized as a small molecule-transport vehicle. With the proliferation of GO, the biocompatibility of chondrocytes in a microenvironment constructed by 3D printed scaffolds and GO is innovative. Accordingly, we speculate that, as a type of micro material, GO can be used with 3D scaffolds for a uniform distribution in the cartilage layer. RESULTS: A qualitative analysis of the chondrocyte-proliferation potential revealed that the culture of 3D printing with a 10% GO scaffold was higher than that of the other groups. Meanwhile, the progress of cell apoptosis was activated. Through scanning electron microscopy, immunofluorescence, and in vivo research, we observed that the newborn cartilage matrix extended along the border of the cartilage and scaffold and matured. After an analysis with immunohistochemical staining with aggrecan and collagen I, the cartilage following the 3D-printed scaffold was thinner than that of the 3D-printed GO scaffold. Furthermore, the collagen I of the cartilage expression in treatment with the GO scaffold was significant from week 2 to 6. CONCLUSIONS: The findings indicate that a 3D-printed GO scaffold can potentially be utilized for the construction of a cartilage matrix. However, the optimum concentration of GO requires further research and discussion.

CT evaluation of cervical pedicle in a Chinese population for surgical application of transpedicular screw placement.

The lower cervical pedicle size differs between the Chinese and the non-Chinese population. Knowledge of pedicle dimensions and surface landmarks is crucial for the safe placement of screws, but few quantitative data concerning the lower cervical pedicle using CT scan and multiplanar reformations (MPR) in a Chinese population exist. The aim of this study was to evaluate lower cervical pedicle (C3-C7) dimensions in a Chinese population by computed axial tomography for surgical application. The dimensions of the pedicles (C3-C7) were determined in 60 patients from CT images of cervical spinal lesions. Measurements of pedicle height, width, pedicle axis length, effective length, and two angles of the pedicles, the distances from the projection point of the pedicle axis to the lateral edge of the lateral mass and to the inferior edge of the superior facet were measured. The smallest outer pedicle width was found at C3 among the female and C4 among the male. This measurement was significantly different between male and female patients in the outer pedicle width (P < 0.05; independent samples t test) at C3 and C4. The mean values of the outer pedicle width ranged from 5.4 to 6.7 mm in males, and 4.4 to 6.3 mm in females. The projection point of the pedicle axis in the lateral-superior area of the cervical lateral mass was the most important. There were significant correlations (P < 0.01; Kendall's W test) between the vertebral level and both pedicle angles (PTA and PSA). The smallest pedicle transverse angle was at C7 in males and females. The cervical spinal cord or vertebral artery may be at risk of injury if the angulation of the screw insert is over-medial or over-lateral in the transverse plane. Therefore, preoperative CT evaluation of pedicle transverse angle is very important. Considering the amount of variation among individuals, our data on CT measurements of pedicle in a Chinese population in conjunction with evaluation of the results of preoperative CT may enhance the safety of transpedicular screw fixation in the lower cervical spine.

Treatment of complex proximal tibia fractures with less invasive stabilization system / 中国矫形外科杂志

[Objective]To summarize results of treating complex proximal tibia fractures with less invasive stabilization system(LISS),and to explore the concept and technology of LISS.[Method]From January 2004 to March 2006,39 cases of complex proximal tibia fractures were treated with less invasive stabilization system,including 26 male and 13 female.The mean age of the patients was 34.8 years(range 22 to 54 years).According to the AO/OTA fracture classification,there were 19 cases in type 41-A3,12 cases in type 41-C2,4 cases in type 41-C3,4 cases in proximal type 42.Seven cases were open fractures and were classified as 3 grade Ⅰ,4 grade Ⅱ open fracture according to the system of Gustilo.Eleven patients were multitraumatic patients.[Result]All the cases were followed up for averaging 15.6 months(10～21 months).The mean operation time was 75 min(60～130 min).All fractures healed,the averaging healing time was 13 weeks(11～16weeks).The averaging blood lost was 300 ml(170～500 ml).The postoperative alignment of 33 fractures was satisfactory,5 cases had 6?～ 8 ?valgus auglation,one case had 5?varus auglation in coronal plane.The mean time of weight bearing was 14.2 weeks(11～18 weeks).The range of movement was 100?～120?.All the cases had no infection,breakage of screws and plates,failed fixation and so on.According to HSS scores system,there were 26 excellent cases,7 good cases,5 fair cases,1 poor case,the excellent and good rate was 84.6%.[Conclusion]Less invasive stabilization system,providing stable fixation and optimizing early bone union and functional rehabilitation,is a realistic therapy in treatment of complex proximal tibia fractures.Exact comprehension of LISS concept and procedure,adjustment according to cases,are very important to assure satisfactory results.