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ABSTRACT: PURPOSE: The purpose of this study was to assess the effects of operative and non-operative treatment on clavicle fractures. METHOD: Relevant clinical trials on the operative and non-operative treatment for clavicle fractures were retrieved through searching the databases MEDLINE, Embase, OVID and the Cochrane Central Register of Controlled Trials up to December 2011. The quality of the included studies was assessed by two authors. A meta-analysis was carried out on homogeneous studies. Five studies involving 633 clavicle fractures were included. RESULTS: The differences in nonunion [risk ratio (RR) 0.12, 95 % confidence interval (CI) 0.05-0.29], malunion (RR 0.11, 95 % CI 0.04-0.29) and neurological complications (RR 0.45, 95 % CI 0.25-0.81) were statistically significant between operative and non-operative treatment. There was no statistically significant difference in delayed union (RR 0.78, 95 % CI 0.31-1.95). CONCLUSION: Operative treatment is better than non-operative treatment, but decisions should be made in accordance with specific conditions for clinical application.
International Orthopaedics 05/2013; · 2.03 Impact Factor
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European Journal of Pediatric Surgery 07/2012; · 0.81 Impact Factor
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ABSTRACT: Despite improvements in surgical techniques and implant design in orthopedic surgery, implantation-associated infections are still a challenging problem for surgeons. In 2006, trace quantities of human β-defensin 3 (hBD-3) were found in human bone tissue and bone cells. Human β-defensin 3 is a 45-amino-acid peptide that is considered the most promising class of defensin antimicrobial peptides and may help in the prevention and treatment of implantation-associated infections. Studies of the effectiveness of hBD-3 against Staphylococcus aureus showed that hBD-3 was more potent at low concentrations than other antibiotics. The effect of hBD-3 on S aureus biofilms has not been reported. We studied the effect of hBD-3, vancomycin, and clindamycin on S aureus biofilms and on the survival of the bacteria in the biofilms.Staphylococcus aureus biofilms were examined with confocal scanning laser microscopy. Staining with LIVE/DEAD BacLight viability stain (Molecular Probes Europe BV, Leiden, The Netherlands) differentiated between live and dead bacteria within the biofilms, and extracellular polymeric substances (slime) from the biofilms was evaluated after staining with calcofluor white (Sigma Chemical Company, Rocky Hill, New Jersey). Human β-defensin 3 and clindamycin reduced the S aureus biofilm area. Human β-defensin 3 was significantly more effective against bacteria from the S aureus biofilms than was clindamycin. Vancomycin did not reduce the S aureus biofilm area.
Orthopedics 01/2012; 35(1):e53-60. · 2.66 Impact Factor
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ABSTRACT: Migration of metallic foreign body into the cerebral circulation is rarely seen. Most of the cases reported were due to gunshot wounds and shotgun wounds to the neck and face. When the foreign body is near the great vessel, it must be removed immediately or will cause complications. This study reported a case of delayed metallic foreign body embolus to the ophthalmic artery resulting from an injury to the right neck, which arose from the presence of metallic emboli to the cerebral circulation.
Chinese medical journal 03/2011; 124(5):790-2. · 0.86 Impact Factor
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ABSTRACT: The aim of the study was to explore the feasibility of the Ca-P coating titanium alloy plate to be used as the vancomycin drug-delivery system by biomimetic coating technology. Through the X-ray diffraction study, the main components of the coatings were identified as octocalcium phosphate. The in vitro vancomycin release, bacteriostasis activity to Staphylococcus aureus (S. aureus), the scanning electron microscope (SEM) image and osteoblast adhesion and proliferation test of vancomycin-loaded Ca-P coating plate were evaluated. The bacteriostatic activity of the vancomycin-loaded Ca-P coating plate showed a continuous drug release and had an inhibitory effect on the growth of the S. aureus. In vitro osteoblast culture results showed that the Ca-P coating plate loaded with or without the vancomycin both obviously promoted the osteoblast attachment. It was suggested that the vancomycin-loaded Ca-P coating may be compounded in the surface of the internal fixators to reduce the incidence of the implant-associated infection.
Journal of Materials Science Materials in Medicine 03/2011; 22(4):989-95. · 2.32 Impact Factor
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ABSTRACT: We prospectively compared the effects of an antibiotic-impregnated cement spacer and an antibiotic irrigating metal spacer in the treatment of infections after total hip arthroplasty (THA) to determine a better method for 2-stage revision of infected THA. We used a uniform protocol of a 3-month spacer interval and specific local and systemic antibiotic therapies. The clinical outcome was determined by assessing operation time, blood loss during spacer implantation, hospital stay and time in bed, and joint function. The patients were followed for a mean 61.4 months (range, 24-94 months). Antibiotic-impregnated cement spacers had a higher rate of infection control than antibiotic irrigating metal spacers (96.2% vs 76%, respectively; P<.01), with no recurrence of infections or implant loosening. Patients receiving antibiotic-impregnated cement spacers had a shorter operation time (2.42±0.65 vs 3.34±0.36 hours metal spacers; P<.01), less blood loss (1085.48±279.49 vs 1964.78±469.23 mL metal spacers; P<.01), a shorter hospital stay (24.53±4.72 days vs 51.36±3.46 days metal spacers; P<.01), and better function before the second step of the 2-stage revision (Harris Hip Score, 88.16±6.94 vs 79.54±6.48 metal spacers; P<.05), and they were free from long-term irrigation. Compared with the antibiotic irrigating metal spacer, the antibiotic-impregnated cement spacer is characterized by higher infection control rate, better joint function recovery before the second operation, shorter operation time, and less blood loss, with no continuous irrigation required.
Orthopedics 03/2011; 34(3):172. · 2.66 Impact Factor
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ABSTRACT: A catastrophic earthquake struck Wenchuan region of West China on May 12, 2008 and caused more than 69 225 deaths. This study was to analyze injury characteristics and treatment of the seismic patients based on Chinese Trauma Databank, which will be helpful for improvement of future medical rescue in potential disasters.
Based on inpatients'medical records of seismic patients admitted into 11 hospitals, data were registered with Trauma Database System Version 3.0. Patients'general information, causes, clinical characteristics and treatment of injuries were studied.
Main causes for seismic injuries were blunt strike (68.2%), crush/burying (18.7%) and slip/falling (11.5%). Slip/falling was the main cause for spinal injuries and accounted for 19.1%, which was higher than the percentage for other body part. Extremity injuries accounted for 54.8% of all injuries. Fractures accounted for 53.1%. Lower extremity fracture accounted for 70.1% of lower extremity injury and spinal fracture accounted for 85.9% of spinal injury. The proportion of spinal injuries with AIS larger than or equal to 4 was higher than that of other injured locations except for the abdomen. Debridement and suturation for single injury and multiple injury patients accounted for 64.7% and 42.9% of their operations respectively.
Blunt strike, crush/burying and slip/falling are the main causes for seismic injuries. The most frequently injured site is extremity. The main injury type is fracture, especially for the lower extremities and the spine. Multiple injury patients were mainly treated by operation, including debridement and suturation, closed reduction and external fixation, etc.
Chinese Journal of Traumatology (English Edition) 10/2010; 13(5):297-303.
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ABSTRACT: In pedicle screw fixation, the heads of monoaxial screws need to be directed in the same straight line to accommodate the rod placement by backing out during operation, which decreases the insertional torque and internal fixation strength. While polyaxial screws facilitate the assembly of the connecting rod, but its ball-in-cup locking mechanism reduces the static compressive bending yield strength as compared with monoaxial screws. Our study aimed to assess the mechanical performance of a modified pedicle screw.
In this study, the tail of the screw body of the modified pedicle screw was designed to be a cylinder-shaped structure that well matched the inner wall of the screw head and the screw head only rotated around the cyclinder. Monoaxial screws, modified screws and polyaxial screws were respectively assembled into 3 groups of vertebrectomy models simulated by ultra high molecular weight polyethylene (UHMWPE) blocks. This model was developed according to a standard for destructive mechanical testing published by the American Society for Testing Materials (ASTM F1717-04). Each screw design had 6 subgroups, including 3 for static tension, load compression and torsion tests, and the rest for dynamic compression tests. In dynamic tests, the cyclic loads were 25%, 50%, and 75% of the compressive bending ultimate loads respectively. Yield load, yield ultimate load, yield stiffness, torsional stiffness, cycles to failure and modes of failure for the 3 types of screws were recorded. The results of modified screws were compared with those of monoaxial and polyaxial screws.
In static tests, results of bending stiffness, yield load, yield torque and torsional stiffness indicated no significant differences between the modified and monoaxial screws (P > 0.05), but both differed significantly from those of polyaxial screws (P < 0.05). In dynamic compression tests, both modified and monoaxial screws showed failures that occurred at the insertion point of screw body into the UHMWPE block, while the polyaxial screw group showed screw body swung up and down the screw head because of loosening of the ball-in-cup mechanism.
The modified screw is well-designed and biomechanically improved. And it can provide sufficient stability for segment fixation as monoaxial screws.
Chinese Journal of Traumatology (English Edition) 08/2010; 13(4):222-8.
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ABSTRACT: Multiple sclerosis (MS) is the most common demyelination disease of central nervous system (CNS). The deterioration of the disease is characterized by the axonal loss with defective remyelination. Progesterone can promote the remyelination, but whether it exerts beneficial effect on treatment of MS still remains unclear. Olig1 protein is a key regulator in the remyelination, when the intracellular sublocalization plays an import role too. We observed the effect of progesterone on experimental autoimmune encephalomyelitis (EAE) in rats by injecting the progesterone after the neurological behavioral deficits were shown up. The results showed no continuous increase of the nervous function score from day 10 after injection (p<0.05). Electron microscopy and LFB staining found prominent increase of OD value of normal myelin in the brain from day 6 after injection (p<0.05). Olig1 protein was localized almost completely in the cytoplasm of Olig1-positive cells from normal rats' brain. In EAE rats, the Olig1 protein has been translocated to the nucleus of 32.17% of Olig1-positive cells, which was increased to 68.52% after injection with progesterone at day 6 after injection (p<0.01). The results indicate that the progesterone is beneficial to attenuating neurological behavioral deficits, for it can promote more successful remyelination of EAE with aid of the nucleus-sublocalized Olig1 protein.
Neuroscience Letters 04/2010; 476(1):42-5. · 2.11 Impact Factor
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ABSTRACT: To analyze the characteristics and causes of motorcycle accidents in China from 2000 to 2005.
We collected data on possession of motorcycles and automobiles, number of traffic crashes, casualty and economic loss from 2000-2005 Statistic Annual Report of Traffic Management Bureau, Ministry of Public Security of China. The data was processed statistically by SPSS 11.0 software package.
During 6 years, the number of motorcycle accidents were up to 122,300 in 2003, which was the highest, and then gradually decreased. However, the casualty had the tendency of consistent increase, for example, the motorcycle accidents resulted in 26,200 deaths and 157,500 injuries in 2005. The mortality per 10, 000 motorcycles and the ratio of deaths to injuries were lower than those of automobiles, but the mortality per 100 motorcycle accidents was significantly higher than that of automobiles (P less than 0.01).
China has attached great importance to the management of traffic safety, which is beneficial to control and reduce traffic accidents in recent years. However, the casualty keeps increasing annually. Therefore, it is urgent to strengthen the management of motorcycles, promote the education of motorcyclists, take effective traffic measures and improve the first-aid system of traffic injuries.
Chinese Journal of Traumatology (English Edition) 09/2008; 11(4):243-6.
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ABSTRACT: To analyze characteristics and causes of road crash and injuries in China from 2003 to 2005.
The data of road crash in 2003-2005 were collected to study the characteristics including total vehicle number, occurrence rates of traffic accidents and serious traffic accidents so as to discuss the causes and characteristics of road crash in China.
From 2003 to 2005, the numbers of traffic accidents, injuries and deaths as well as the mortality rates per 100,000 persons and per 10,000 vehicles declined in China. Until 2005, the total number of traffic accidents decreased to 450,000 and deaths to 99,000, with the mortality rate per 10,000 vehicles being 7.6 persons. While the drivers and passengers accounted for 33.2% and 26.6% of death casualties respectively in 2005. Most traffic accidents were caused by drivers, especially those with driving experience less than 3 years. Traffic accidents occurred on suburban roads accounted for 60%. The mortality rate of the traffic accidents per 100 km on the first grade road ranked the highest. The mortality rate of the traffic accidents on expressways ranked the highest, with continual increase of death and injury.
At present, the increase trend of traffic accidents and casualties in China has been slowed down to some extent and shows a declining tendency, but the situation is far away from being optimistic. In order to cut down the number of traffic accidents and casualties, we should pay more attention to training and managing drivers with less than three driving years and those driving buses. Strict prevention measures should be laid on traffic accidents on first grade roads, expressways and suburban roads as well as the enhancement on improving first-aid system.
Chinese Journal of Traumatology (English Edition) 03/2008; 11(1):3-7.
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Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology 01/2008; 15(12):936-7.
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ABSTRACT: Non-bioartificial liver has been applied to clinic for quite a long time, but the reported efficacy has been very different. The aim of this study was to compare the efficacy and safety of hemoperfusion adsorption, plasma exchange and plasma exchange plus hemoperfusion adsorption in treatment of severe viral hepatitis.
Seventy-five patients with severe viral hepatitis were treated with hemoperfusion adsorption therapy (24 cases), plasma exchange therapy (17 cases) and plasma exchange plus hemoperfusion adsorption therapy (34 cases). The data of liver function, renal function, blood routine test, prothrombin time (PT) and prothrombin activity (PTa) pre- and post-therapy were analyzed.
Clinical symptoms of patients improved after treatment. The levels of aminotransferase, total bilirubin, direct bilirubin decreased significantly after 3 therapies (P<0.05 or P<0.01). PT, the level of total serum protein decreased significantly and PTa increased significantly after plasma exchange therapy and plasma exchange plus hemoperfusion adsorption therapy (P<0.05 or P<0.01). The side effects were few and mild in all patients.
Three therapies were effective in the treatment of severe viral hepatitis. Plasma exchange therapy and plasma exchange plus hemoperfusion adsorption therapy are better than hemoperfusion adsorption therapy.
World Journal of Gastroenterology 04/2004; 10(8):1218-21. · 2.47 Impact Factor
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ABSTRACT: To evaluate the clinical efficacy and safety of middle mode artificial liver-plasma pheresis in treatment of severe hepatitis.
Seventeen patients with severe hepatitis were treated with plasma pheresis. The results of liver function, renal function, blood routine, prothrombin time (PT), prothrombin time activity (PTa) before and after the treatment were analyzed. All patients were observed closely.
Symptoms of patients treated with plasma pheresis were improved, and the total effective rate reached 58.8 percent, but the survival rate was only 11.8 percent. Compared with those before the therapy, there were significant differences in aminotransferase, total bilirubin, direct bilirubin, PT, PTa and total protein level after treatment (P<0.05 or P<0.01). The side-effects were mild.
Middle artificial liver is effective in the treatment of severe hepatitis.
Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue 02/2004; 16(1):6-8.
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ABSTRACT: The primary comparative analysis between the host genetic factors and their relationships with clinical phenotype of 20 pairs of HBV infected and high risk twins.
Zygosity of twins was diagnosed by STR microsatellite polymorphism analysis. To identify the serological model and exclude the evidence of coinfection with other virus, we detected HAV, HBV, HCV, HDV, HEV serological markers by electrochemiluminescence method. HBV DNA level was detected by Lightcycler Fluorescent Quantitative system and Liver function (ALT, AST, TBil) was detected by HITACHI7250 Biochemistry Detection System. The data was analysis by Fisher's exact test to comparatively analyze among the monozygotic twins (MZ), dizygotic twins (DZ) and control groups.
The significant difference was found in the concordance rate of disease, concordance of clinical phenotype and serological patterns of HBV infection between the MZ and DZ twins (P < 0.05), it was also found between MZ and control groups (P < 0.05), but not between DZ and control groups (P > 0.05). No significant difference in the concordance of other HBV infection markers was observed (P > 0.05). Concordance of clinical phenotype may be related to patients' age and antivirus therapy. Injection with the HBIg and initiative vaccination right after birth can prevent twins with high risk to infection to be victims.
The significant difference was found in the concordance rate, concordance of clinical phenotype and serological patterns between MZ and control groups, it was also found between MZ and DZ groups, which is correspond to the opinion of the high concordance of MZ and indicated the host genetic factors may play role in influencing the clinical phenotype, while other factors such as the vaccination may have an effect on the clinical phenotype in some extent.
Zhonghua yi xue za zhi 02/2004; 84(3):189-93.
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Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology 10/2003; 11(9):571, 576.
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ABSTRACT: ObjectiveA catastrophic earthquake struck Wenchuan region of West China on May 12, 2008 and caused more than 69 225 deaths. This study was to analyze injury characteristics and treatment of the seismic patients based on Chinese Trauma Databank, which will be helpful for improvement of future medical rescue in potential disasters.Methods
Based on inpatients' medical records of seismic patients admitted into 11 hospitals, data were registered with Trauma Database System Version 3.0. Patients' general information, causes, clinical characteristics and treatment of injuries were studied.ResultsMain causes for seismic injuries were blunt strike (68.2%), crush/burying (18.7%) and slip/falling (11.5%). Slip/falling was the main cause for spinal injuries and accounted for 19.1%, which was higher than the percentage for other body part. Extremity injuries accounted for 54.8% of all injuries. Fractures accounted for 53.1%. Lower extrem-ity fracture accounted for 70.1% of lower extremity injury and spinal fracture accounted for 85.9% of spinal injury. The proportion of spinal injuries with AIS=4 was higher than that of other injured locations except for the abdomen. Debridement and suturation for single injury and multiple injury patients accounted for 64.7% and 42.9% of their operations respectively.Conclusion
Blunt strike, crush/burying and slip/falling are the main causes for seismic injuries. The most frequently injured site is extremity. The main injury type is fracture, especially for the lower extremities and the spine. Multiple injury patients were mainly treated by operation, including debridement and suturation, closed reduction and external fixation, etc.
Chinese Journal of Traumatology (English Edition) 13(5):297-303.
