Zhou Xiang

West China School of Medicine, Hua-yang, Sichuan, China

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Publications (58)66.2 Total impact

  • Z Xu, X Duan, X Yu, H Wang, X Dong, Z Xiang
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    ABSTRACT: To determine the accuracy of MRI versus ultrasound for Morton's neuroma. A search was undertaken for clinical studies published in any language in PubMed up to the date of December 2013. Studies assessing the accuracy of the ultrasound or MRI for the diagnosis of Morton's neuroma were included. Data were pooled for meta-analysis. Study selection, data collection, and extraction were performed independently by two authors. Meta-disc 1.4 and Revman 5.2 software were applied for statistical analysis. The study included 12 studies; 217 patients underwent MRI and 241 underwent ultrasound examinations. There appeared greater diagnostic accuracy for ultrasound than MRI for the diagnosis of Morton's neuroma (ultrasound sensitivity 90%, specificity 88%, positive likelihood ratio 2.77, negative likelihood ratio 0.16 versus MRI sensitivity 93%, specificity 68%, positive likelihood ratio 1.89, negative likelihood ratio 0.19). The available evidence suggests that ultrasound can provide better accuracy for the diagnosis of Morton's neuroma than MRI. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
    Clinical Radiology 11/2014; · 1.66 Impact Factor
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    ABSTRACT: Vascularization of engineered bone tissue is critical for ensuring its survival after implantation, and it is the primary factor limiting its clinical use. A promising approach is to prevascularize bone grafts in vitro using endothelial progenitor cells (EPC) derived from peripheral blood. Typically EPC cells are added together with mesenchymal stem cells (MSC) that differentiate into osteoblasts. One problem with this approach is how to promote traditional tissue engineering bone survival with a minimally invasive approach method. Here we examined the effectiveness of administering to stimulate the release of peripheral blood stem cells. Cells were isolated by Ficoll density gradient centrifugation and identified as EPC and MSC based on morphology, surface markers, and functional analysis. EPC and MSC were co-cultured in several different ratios, and cell morphology and tube formation were assessed by microscopy. Expression of osteogenesis and vascularization markers was quantified by ELISA, PCR, histochemical and immunofluorescence staining. Increasing the proportion of EPC in the co-culture system led to greater tube formation and greater expression of endothelial cell marker CD31. An EPC:MSC ratio of 75:25 gave the highest expression of osteogenesis and angiogenesis markers. Co-cultures adhered to a three-dimensional scaffold of strontium-doped calcium polyphosphate and proliferated well. Our findings show that co-culturing peripheral blood-derived EPC and MSC may prove useful for generating prevascularized bone tissue for clinical use.
    Tissue Engineering Part A 10/2014; · 4.07 Impact Factor
  • International Journal of Surgery 10/2014; · 1.65 Impact Factor
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    ABSTRACT: To investigate the specific microRNA (miRNA) in osteogenic and chondrogenic differentiations of C3H10Tl/2 cells. C3H10Tl/2 cells were induced to differentiate into osteoblasts and chondrocytes. Specific miRNA more than 2 fold change and 2 average normalized probe signal between C3H10Tl/2 and C3H10Tl/2-derived osteoblast, and' between C3Hl0Tl/2 and C3H10Tl/2-derived chondrocytes were screened out by miRNA microarray, and verified by real-time fluorescence quantitative PCR (RT-qPCR). Alkaline phosphatase expression of osteogenic induced group was significantly higher than that of control group at 7 days after induced (P < 0.05). RT-qPCR results showed the expressions of Runx2, serine protease (Sp7), collagen type I, and osteopontin (OPN) genes were significantly increased at 7, 14, and 21 days after induced when compared with before induced (P < 0.05). Western blot results showed the expressions of Runx2, Sp7, collagen type I, and OPN proteins of osteogenic induced group were significantly higher than those of control group at 21 days after induced (P < 0.05). The expressions of SOX9, collagen type II, Aggrecan, and Has2 were significantly increased at 5, 10, and 15 days after induced when compared with before induced (P < 0.05). The expressions of SOX9, collagen type 2, Aggrecan, and Has2 proteins of chondrogenic induced group were significantly higher than those of control group at 15 days after induced (P < 0.05). Totally, 10 osteogenic and 3 chondrogenic miRNA more than 2 fold change and 2 average normalized probe signal were screened out by miRNA microarray. RT-qPCR results of these specific miRNAs were similar to microarray results except miR-455-3p. Specific miRNAs are screened out by microarray and it is a good foundation for the future study on miRNA functional verification and target gene prediction.
    08/2014; 28(8):1009-16.
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    ABSTRACT: Repair of load-bearing bone defects remains a challenge in the field of orthopaedic surgery. In the current study, a surface microstructured porous titanium (STPT) successively treated with H2O2/TaCl5 solution and simulated body fluid was used to repair the critical-sized segmental bone defects in rabbit femur, and non-treated porous titanium (NTPT) and porous biphasic calcium phosphate ceramics (PBCP) were used as control, respectively. A 15 mm long implant was positioned in the femoral defect and stabilized by a plate and screws fixation. After implantation into the body for 1, 3 and 6 months, X-ray observation confirmed that porous titanium groups (NTPT and STPT) provided better mechanical support than PBCP group at the early stage. However, there was no obvious difference in the formed bony callus between PBCP and STPT groups in the later stage, and they both showed better shape of bony callus than NTPT group. Micro-CT and histomorphometric analysis for the samples of 6-month implantation demonstrated that more new bone formed in the inner pores of PBCP and STPT groups than that in NTPT group. Moreover, the biomechanical tests revealed that STPT group could bear larger compressive load than NTPT and PBCP groups, almost reaching the level of the normal rabbit femur. STPT exhibited the enhanced repairing effect on the critical-sized segmental bone defect in rabbit femur, meaning that it could be an ideal material for the repair of large bone defect in load-bearing site.
    Journal of Materials Science Materials in Medicine 03/2014; · 2.14 Impact Factor
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    ABSTRACT: This meta-analysis was conducted to investigate whether helical blade implant system had advantages in terms of cut-out rate when compared to screw implant system for trochanteric fractures of elderly population. The databases of MEDLINE, Cochrane Library and OVID were searched from inception to September 2013, and all randomized controlled trials comparing outcomes between helical blade system and screw system in treating trochanteric fractures were selected. Three researchers assessed the methodological quality and extracted data of the enrolled studies independently. Data were analysed using Review Manager 5.1 version. Six studies including 759 patients were involved. Results revealed that compared with screw group, blade group had similar outcomes of "centre-centre" position (95 % CI 0.89-1.06, P = 0.48) and tip-apex distance (95 % CI-0.08 to 1.31, P = 0.08). Cut-out and other complications were also comparable between the two groups (95 % CI 0.34-1.54, P = 0.41; 95 % CI 0.73-1.32, P = 0.90). Operation time and fluoroscopy time of blade group were significantly less than that of screw group (95 % CI -5.13 to -3.70, P < 0.00001; 95 % CI -32.50 to -27.07, P < 0.00001). Outcome of post-operative function was similar between two groups (95 % CI 0.94-1.15, P = 0.45). Blade group required less operation time and fluoroscopy time than that of screw group treating trochanteric fractures in the elderly, but the differences observed could be biased due to grouping and other limitations. Outcomes of cut-out complication, other complications, position of implant and post-operative function were similar between two groups.
    European Journal of Orthopaedic Surgery & Traumatology 02/2014; · 0.18 Impact Factor
  • Weili Fu, Zhou Xiang
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    ABSTRACT: To review the research progress of the co-culture system for constructing vascularized tissue engineered bone. The recent literature concerning the co-culture system for constructing vascularized tissue engineered bone was reviewed, including the selection of osteogenic and endothelial lineages, the design and surface modification of scaffolds, the models and dimensions of the co-culture system, the mechanism, the culture conditions, and their application progress. The construction of vascularized tissue engineered bone is the prerequisite for their survival and further clinical application in vivo. Mesenchymal stem cells (owning the excellent osteogenic potential) and endothelial progenitor cells (capable of directional differentiation into endothelial cell) are considered as attractive cell types for the co-culture system to construct vascularized tissue engineered bone. The culture conditions need to be further optimized. Furthermore, how to achieve the clinical goals of minimal invasion and autologous transplantation also need to be further studied. The strategy of the co-culture system for constructing vascularized tissue engineered bone would have a very broad prospects for clinical application in future.
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 02/2014; 28(2):179-85.
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    ABSTRACT: Abstract With the evergrowing number of people who work in visual display terminal, the work-related musculoskeletal disorders of the upper body are believed to be an important problem all over the world. The forearm support,which can keep the forearm and wrist in biomechanical posture, is a possible protective factor of the development of upper body syndrome. This meta-analysis examines the efficacy of forearm support in reducing upper body syndrome. The Cochrane Library, EMBASE, Ovid, Science direct, Springer-link, Google Scholar, CNKI database, Wanfang database were searched from inception until May 29th 2013. Studies relevant were included after the screen of title, abstract and the full text. Impact of bias was assessed independently by two authors.Four studies that met all the inclusion criteria were included finally. The combined results based on all studies suggested that statistically the forearm support had a unconspicuous effect on upper body syndrome (OR = 0.70, 95% CI: 0.49, 1.02).The result of subgroup suggested that forearm support have a significant effect on neck or shoulder syndrome (OR = 0.70, 95% CI: 0.43, 1.14) and the effect on upper extremity syndrome(OR = 0.76, 95% CI: 0.49, 1.19) is not significant. This meta-analysis suggested that the forearm support had statistically unconspicuous effect on preventing upper body syndrome on the whole.
    Archives of Environmental and Occupational Health 01/2014; · 0.47 Impact Factor
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    ABSTRACT: To evaluate the effectiveness and safety of endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR) using a meta-analysis of data from randomized controlled trials. Electronic searches of the Cochrane Register of Controlled Trials (CENTRAL, Issue 11 of 12, Nov 2012), PUBMED (1980 to Dec 2012), and EMBASE (1980 to Dec 2012) were used to identify randomized controlled trials that evaluated endoscopic vs open methods for treatment of carpal tunnel syndrome. Studies to be used were independently identified by two researchers. The methodological quality of the studies was assessed by the Cochrane Collaboration tool for assessing risk of bias. Fifteen randomized controlled trials involving 1,596 hands were included. Based on the Cochrane Collaboration tool for assessing risk of bias, four studies were rated as high quality, five studies were rated as moderate quality, and six were rated as low quality. Our meta-analysis indicated that ECTR resulted in better recovery of pinch strength, earlier time of return to work, but a higher rate of reversible nerve problems (including neurapraxia and numbness) than OCTR. ECTR also resulted in a lower rate of irreversible nerve damage (P > 0.05), wound problems (including wound infection, wound hematoma and wound dehiscence) and reflex sympathetic dystrophy (P > 0.05) compared with OCTR. Our meta-analysis revealed no obvious statistical differences in relief of symptoms (pain and paraesthesia), recovery of grip strength and reoperation rate. Our meta-analysis of available randomized controlled trials demonstrated that ECTR and OCTR were similar in relief of symptoms, but ECTR resulted in better recovery of function and earlier return to work and was safer than OCTR.
    Archives of Orthopaedic and Trauma Surgery 01/2014; · 1.36 Impact Factor
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    ABSTRACT: EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Analyze the latest innovations in biomaterial scaffolds for the repair and regeneration of osteochondral defects. 2. Discuss the design and manufacture of biomaterial scaffolds. 3. Compare the advantages and disadvantages of stratified and nonstratified scaffolds. 4. Review the latest fixation methods of scaffolds in vivo. Due to their good biocompatibility and mechanical integrity, tissue engineering scaffolds have become a principal method of repair and regeneration of osteochondral defects. To improve their intrinsic properties, control their degenerative times, and enhance their cell adhesion and differentiation, numerous scaffold architectures and formation methods have been developed and tested, but the ideal scaffold design is still controversial. Moreover, scaffold fixation has a significant influence on repair and regeneration after implantation. The authors analyzed relative studies to address the latest scaffold designs, including biphasic scaffold, multilayered scaffold, and continuous nonstratified scaffold, and this article compares their advantages and disadvantages. In addition, the authors introduce a novel modified method for scaffold fixation known as magnetic fixation. Both stratified and nonstratified scaffolds can repair osteochondral defects, but continuous nonstratified scaffolds are more biomimetic compared with the native osteochondral structures, and they lead to a better regeneration of hyaline-like cartilage and structured bone tissue. Therefore, the authors suggest continuous nonstratified scaffolds are an effective option for treating osteochondral defects.
    Orthopedics 11/2013; 36(11):868-73. · 1.05 Impact Factor
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    ABSTRACT: The limited repair potential of articular cartilage, which hardly heals after injury or debilitating osteoarthritis, is a clinical challenge. The aim of this work was to develop a novel type I collagen (Col)/glycosaminoglycan (GAGs)-porous titanium biphasic scaffold (CGT) and verify its ability to repair osteochondral defects in an animal model with bone marrow stem cells (bMSCs) in the chondral phase. The biphasic scaffold was composed of Col/GAGs as chondral phasic and porous titanium as subchondral phasic. Twenty-four full-thickness defects through the articular cartilage and into the subchondral bone were prepared by drilling into the surface of the femoral patellar groove. Animals were assigned to one of the three groups: 1) CGT with bMSCs (CGTM), 2) only CGT, and 3) no implantation (control). The defect areas were examined grossly, histologically and by micro-CT. The most satisfied cartilage repairing result was in the CGTM group, while CGT alone was better than the control group. Abundant subchondral bone formation was observed in the CGTM and CGT groups but not the control group. Our findings demonstrate that a composite based on a novel biphasic scaffold combined with bMSCs shows a high potential to repair large osteochondral defects in a canine model.
    Materials science & engineering. C, Materials for biological applications. 10/2013; 33(7):3951-7.
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    ABSTRACT: To investigate the protocols of combined culture of human placenta-derived mesenchymal stem cells (HPMSCs) and human umbilical vein endothelial cells (HUVECs) from the same and different individuals on collagen material,to provide the. Under voluntary contributions, HPMSCs were isolated and purified from human full-term placenta using collagenase IV digestion and lymphocyte separation medium, and confirmed by morphology methods and flow cytometry, and then passage 2 cells were cultured under condition of osteogenic induction. HUVECs were isolated from fresh human umbilical vein by collagenase I digestion and subcultured to purification, and cells were confirmed by immunocytochemical staining of von Willebrand factor (vWF). There were 2 groups for experiment. Passage 3 osteoblastic induced HPMSCs were co-cultured with HUVECs (1:1) from different individuals in group A and with HUVECs from the same individual in group B on collagen hydrogel. Confocal laser scanning microscope was used to observe the cellular behavior of the cell-collagen composites at 1, 3, 5, and 7 days after culturing. Flow cytometry showed that HPMSCs were strongly positive for CD90 and CD29, but negative for CD31, CD45, and CD34. After induction, alizarin red, alkaline phosphatase, and collagenase I staining were positive. HUVECs displayed cobble-stone morphology and stained positively for endothelial cell marker vWF. The immunofluorescent staining of CD31 showed that HUVECs in the cell-collagen composite of group B had richer layers, adhered and extended faster and better in three-dimension space than that of group A. At 7 days, the class-like microvessel lengths and the network point numbers were (6.68 +/- 0.35) mm/mm2 and (17.10 +/- 1.10)/mm2 in group A, and were (8.11 +/- 0.62) mm/mm2 and (21.30 +/- 1.41)/mm2 in group B, showing significant differences between the 2 groups (t = 0.894, P = 0.000; t = 0.732, P = 0.000). Composite implant HPMSCs and HUVECs from the same individual on collagen hydrogel is better than HPMSCs and HUVECs from different individuals in integrity and continuity of the network and angiogenesis.
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 08/2013; 27(8):916-22.
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    ABSTRACT: Porous titanium with appropriate surface treatments can be osteoinductive. To investigate the effect of surface treatments of porous titanium on the attachment and differentiation of mesenchymal stem cells (MSCs), two kinds of surface microstructured porous titaniums, H2O2/TaCl5 treated one (HTPT), and H2O2/TaCl5 and subsequent simulated body fluid (SBF) treated one (STPT) were fabricated, and non-treated one (NTPT) was used as control. The morphology, specific surface area (SSA), pore distribution and mechanical strength of these materials were characterized respectively, and the results showed that H2O2/TaCl5 treatment led to a significant increase in both SSA and micropores of HTPT, and the further SBF immersion resulted in the formation of a layer of bone-like apatite on the surface of STPT. Although the surface treatments had a little negative impact on the compressive strength and elasticity modulus of porous titanium, the mechanical strength of HTPT or STPT was enough for the bone defect repair of the load-bearing sites. The protein adsorption and cell adhesion experiments confirmed that the microstructured surface notably enhanced porous titanium's protein binding capacity and promoted MSCs adhesion on the surface. More importantly, cell differentiation experiments proved that the microstructured surface evidently elevated the osteoblastic gene expressions of MSCs compared to NTPT. The enhanced biological effect by the surface treatments was more robust on STPT. Therefore, our results suggest that the microstructured surface has great potential for promoting MSCs differentiation towards osteoblasts, giving excellent support for the osteoinduction of porous titanium with appropriate surface treatments.
    Journal of Materials Science Materials in Medicine 06/2013; · 2.14 Impact Factor
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    ABSTRACT: OBJECTIVES: Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are treatment choices for end-stage shoulder osteoarthritis. The decision of whether to use TSA or HA is controversial. The objective of this study was to compare the effects of TSA and HA for shoulder osteoarthritis. METHODS: We conducted a search for clinical studies that had been published in any language in December 2012 or before. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and several other databases. Randomized and quasi-randomized controlled clinical studies that evaluated different methods were included. At least two review authors independently performed the study selection, data collection, and data extraction. The software Revman 5.1 was used for the statistical analysis. RESULTS: This study included 4 clinical trials. Two of the trials were published clinical trials, and the other 2 clinical trials were presented as unpublished abstracts. A total of 146 patients with 153 shoulders were included in the trials. Compared with HA, TSA presents with a higher UCLA shoulder scale (MD 3.10, 95% CI 1.13-5.08) and a higher ASES (MD 10.17, 95% CI 1.40-18.87). There was no significant difference between TSA and HA for revision (RR 0.35, 95% CI 0.10-1.19), WOOS (MD 9.10, 95% CI -2.72 to 20.92), and incidence of instability (RR 0.88, 95% CI 0.19-3.98). HA had a lower operation time (MD 39.00, 95% CI 17.05-60.95). CONCLUSION: The available evidence suggests that TSA is more effective than HA for patients with shoulder arthritis.
    Seminars in arthritis and rheumatism 06/2013; · 4.72 Impact Factor
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    ABSTRACT: Anterior cervical discectomy and fusion is a standard treatment for symptomatic cervical disc disease, but pseudarthrosis and accelerated adjacent-level disc degeneration may develop. Cervical disc arthroplasty was developed to preserve the kinematics of the functional spinal unit. Trials comparing arthroplasty with anterior cervical discectomy and fusion have shown unclear benefits in terms of clinical results, neck motion at the operated level, adverse events, and the need for secondary surgical procedures. Only randomized clinical trials were included in this meta-analysis, and the search strategy followed the requirements of the Cochrane Library Handbook. Two reviewers independently assessed the methodological quality of each included study and extracted the relevant data. Twenty-seven randomized clinical trials were included; twelve studies were Level I and fifteen were Level II. The results of the meta-analysis indicated longer operative times, more blood loss, lower neck and arm pain scores reported on a visual analog scale, better neurological success, greater motion at the operated level, fewer secondary surgical procedures, and fewer such procedures that involved supplemental fixation or revision in the arthroplasty group compared with the anterior cervical discectomy and fusion group. These differences were significant (p < 0.05). The two groups had similar lengths of hospital stay, Neck Disability Index scores, and rates of adverse events, removals, and reoperations (p > 0.05). The meta-analysis revealed that anterior cervical discectomy and fusion was associated with shorter operative times and less blood loss compared with arthroplasty. Other outcomes after arthroplasty (length of hospital stay, clinical indices, range of motion at the operated level, adverse events, and secondary surgical procedures) were superior or equivalent to the outcomes after anterior cervical discectomy and fusion. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
    The Journal of Bone and Joint Surgery 03/2013; 95(6):555-61. · 3.23 Impact Factor
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    ABSTRACT: In this study, porous titanium was treated by a hydrogen peroxide solution with (HT) or without (HO) tantalum chloride at a low temperature to endow its bioactivity. The microstructure, film stability and in vitro and in vivo bioactivity of HT-treated and HO-treated porous titanium were investigated, and the non-treated one was used as control. After HT treatment, a well-crystallized titania nanoparticle film consisting of anatase phase with good film stability was formed on the surface of porous titanium, and the tantalum element appeared in the film, while the HO-treated porous titanium surface showed a dual structure with well-aligned nanorods as an outer layer and condensed nanoparticles as an inner layer consisting of a mixture of well-crystallized anatase and rutile phases. In vitro bioactivity assessment showed that both HT- and HO-treated porous titanium possessed high apatite-forming ability. More importantly, after implantation in the dorsal muscles of dogs, the HT- and HO-treated implants induced ectopic bone formation in its inner pores after 5 months, while the non-treated one did not. The present study showed that HT-treated porous titanium possessed good film stability and bioactivity to be used as bone repair materials in clinic under load-bearing conditions.
    Biomedical Materials 02/2013; 8(2):025006. · 2.92 Impact Factor
  • Weili Fu, Zhou Xiang
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    ABSTRACT: To review the research progress of the seed cells, scaffolds, growth factors, and the prospects for clinical application of the intervertebral disc regeneration. The recent literature concerning the regeneration strategies and tissue engineering for treatment of degenerative intervertebral disc disease was extensively reviewed and summarized. Seed cells based on mesenchymal stem cells (MSCs) and multiple-designed biomimetic scaffolds are the hot topic in the field of intervertebral disc regeneration. It needs to be further investigated how to effectively combine the interactions of seed cells, scaffolds, and growth factors and to play their regulation function. The biological regeneration of intervertebral disc would have a very broad prospects for clinical application in future.
    Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery 02/2013; 27(2):227-32.
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    ABSTRACT: Background. The purpose of this meta-analysis was to find out whether the proximal femoral nail was better than the dynamic hip screw in the treatment of trochanteric fractures with respect to operation time, blood transfusion, hospital stay, wound complications, number of reoperation, and mortality rate. Methods. All randomized controlled trials comparing proximal femoral nail and dynamic hip screw in the treatment of trochanteric fractures were included. Articles and conference data were extracted by two authors independently. Data was analyzed using RevMan 5.1 version. Eight trials involving 1348 fractures were retrieved. Results. Compared with DHS fixation, PFN fixation had similar operation time (95% CI: -15.28-2.40, P = 0.15). Blood loss and transfusion during perioperative time were also comparable between the two fixations (95% CI: -301.39-28.11, P = 0.10; 95% CI: -356.02-107.20, P = 0.29, resp.). Outcomes of hospital stay (95% CI: -0.62-1.01, P = 0.64), wound complication (95% CI: 0.66-1.67, P = 0.82), mortality (95% CI: 0.83-1.30, P = 0.72), and reoperation (95% CI: 0.61-1.54, P = 0.90) were all similar between the two groups. Conclusion. PFN fixation shows the same effectiveness as DHS fixation in the parameters measured.
    The Scientific World Journal 01/2013; 2013:805805. · 1.22 Impact Factor
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    ABSTRACT: BACKGROUND: Radial head fractures are the most common type of elbow fracture and can severely affect the function of the elbow. There is uncertainty and controversy about when surgery is indicated as well as what type of surgical intervention is best. OBJECTIVES: To assess the effects of surgical interventions for treating radial head fractures in adults. We aimed to compare surgical versus non-surgical treatment, and different methods of surgical intervention. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (May 2012), the Cochrane Central Register of Controlled Trials (The Cochrane Library; 2012 Issue 4), MEDLINE (1946 to May 2012), EMBASE (1980 to 2012 Week 19) and trial registers (November 2011). No language restrictions were applied. SELECTION CRITERIA: All randomised and quasi-randomised controlled trials evaluating surgical interventions for treating radial head fractures. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, assessed risk of bias and extracted data. Where appropriate, results were pooled. MAIN RESULTS: We included three randomised controlled trials, involving a total of 251 participants. All three trials were at high risk of performance bias reflecting the fact that surgeons could not be blinded. One trial was at low risk of selection bias but was undermined by a high attrition bias, in part resulting from post-randomisation exclusions. There were incomplete details of methodology for the other two trials, which usually resulted in unclear risk of bias judgements.Two trials compared radial head replacement with open reduction and internal fixation (ORIF) for treating Mason type III radial head fractures. The trial authors reported outcomes at a mean of 2.8 years and 15 months respectively. There were significant differences between the two groups in favour of radial head replacement in the Broberg and Morrey elbow scores (92.1 versus 72.4, mean difference (MD) 19.70; 95% confidence interval (CI) 15.64 to 23.76; one trial, 45 participants), excellent or good Broberg and Morrey elbow scores (33/36 versus 16/31, risk ratio (RR) 1.88; 95% CI 1.27 to 2.77; two trials), and overall adverse events (6/36 versus 15/31, RR 0.33; 95% CI 0.14 to 0.77; two trials). No statistically significant difference was found between the two groups in any of the reported individual adverse events.One trial compared biodegradable pins with standard metal screws in treating radial head fractures of AO-classification 21 B2. The two types of fixation devices yielded similar results, with no significant between-group differences in the Broberg and Morrey scores (93.3 versus 90.9, MD 2.40; 95% CI -0.10 to 4.90), excellent or good Broberg and Morrey elbow scores (72/74 versus 56/61, RR 1.06; 95% CI 0.97 to 1.15), and adverse events (13/82 versus 16/82, RR 0.81; 95% CI 0.42 to 1.58) at two-year follow-up. AUTHORS' CONCLUSIONS: Only tentative conclusions can be drawn from the available evidence in this review. Compared with ORIF, there was some evidence that radial head replacement had better elbow function and fewer adverse events for Mason type III radial head fractures in the short term. However, the evidence is of low quality and it is unknown whether these results would apply in the longer term or more generally. Using biodegradable implants may be as good as metallic implants for fixation of some usually more stable fractures but more evidence is needed to confirm this. There is a need for good quality evidence for addressing the areas of uncertainty for the surgical treatment of radial head fractures.
    Cochrane database of systematic reviews (Online) 01/2013; 5:CD008987. · 5.94 Impact Factor
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    ABSTRACT: Many studies have shown that calcium phosphate ceramics (CP) have osteoconductive and osteoinductive properties; however, the exact mechanism of bone induction has not yet been reported. This study was performed to investigate if destroying immunological function will influence osteogenesis, to explain the mechanism which is unclear. In this study, twenty C57BL/6 mice were divided into two groups (n = 10), in group 1, a hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) ceramic was implanted into both the left and right leg muscles of each mouse; in group 2, ten mice experienced lethal irradiation, then were injected bone marrow (BM) cells from green fluorescent protein (GFP) transgenic mice by tail veil, after bone marrow transplantation (BMT), heart, liver, spleen, lung, kidney, and muscle were harvested for biological analysis, after the GFP chimera model was established successfully, the same HA/β-TCP ceramic was implanted into both leg muscles of each mouse immediately after irradiation. 45 and 90 days after implantation, the ceramics of the two groups were harvested to perform with hematoxylin and eosin (HE) and immunohistochemistry (IHC) staining; the results showed that there was no bone formation in group 2, while new bone tissues were detected in group 1. Our findings suggest that the BM cell from GFP transgenic mice is a good biomarker and it could set a good platform for chimera model; it also shows that BM cell is one of cell resources of bone induction, and destruction of immune function will impede osteoinduction by CP. Overall, our results may shed light on clear mechanism study of bone induction in the future.
    Applied Surface Science 12/2012; 262:200–206. · 2.54 Impact Factor

Publication Stats

156 Citations
66.20 Total Impact Points


  • 2014
    • West China School of Medicine
      Hua-yang, Sichuan, China
  • 2006–2013
    • Sichuan University
      • • National Engineering Research Center for Biomaterials
      • • Department of Orthopedic Surgery
      Chengdu, Sichuan Sheng, China