Fan Liu

Nantong University, Tungchow, Jiangsu, China

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Publications (24)27.38 Total impact

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    ABSTRACT: We performed a meta-analysis to evaluate gender differences of venous thromboembolism (VTE) risk after total hip (THA) and total knee arthroplasty (TKA). We searched PubMed and Web of Knowledge from their beginning to 25 July 2015. Pooled odds ratio (OR) and 95 % confidence interval (CI) for VTE risk were calculated. Twenty studies with 7,892,585 patients were included in our study. The VTE incidence ranged from 0.27 to 61.0 %. The sex ratio (male/female) was 0.623 (3,016,648/4,839,785) in no VTE group versus 0.492 (11,926/24,226) in VTE group. The pooled OR was 1.184 (95 % CI 1.070-1.310; Z = 3.28, P = 0.001). The Begg's test (z = 1.46, P = 0.144) and the Egger's test (t = 0.58, P = 0.571), and the funnel plot suggested there was no significant publication bias. Sensitivity analysis by omitted a study with largest simple size showed the pooled OR was 1.166 (95 % CI 1.051-1.294; Z = 2.91, P = 0.004) by random-effects model. Meta-regression showed VTE risk was not related with THA and TKA incidence (t = 0.35, P = 0.732). Our meta-analysis showed female patients have slightly higher risk of VTE than male patients after THA and TKA.
    No preview · Article · Oct 2015 · Journal of Thrombosis and Thrombolysis
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    ABSTRACT: Patients with diabetes have a high risk of surgical site infection (SSI) after ankle surgery. The aim of the present study was to investigate the efficacy of vacuum-assisted closure (VAC) in the prevention of SSI after ankle surgery compared with the efficacy of standard moist wound care (SMWC). A retrospective study was performed of unstable ankle fractures for surgical fixation in patients with diabetes from January 2012 to December 2014. VAC and SMWC were used for surgical incision coverage. The primary outcome was the incidence of SSI, and the secondary outcomes were the length of hospital stay and crude hospital costs. The data from 76 patients were analyzed, with 22 (28.95%) in the VAC group and 54 (71.05%) in the SMWC group. The incidence of SSI was 4.6% in the VAC group compared with 27.8% in the SMWC group (chi-square 5.076; p = .024), and the crude odds ratio for SSI in the VAC group was 0.124 (95% confidence interval 0.002 to 0.938). The length of hospital stay was lower in the VAC group than in the SMWC group (12.6 ± 2.7 days and 15.2 ± 3.5 days, respectively; t = 3.122, p = .003). The crude hospital costs were also lower in the VAC group than in the SMWC group (Chinese yuan 8643.2 ± 1195.3 and 9456.2 ± 1106.3, respectively; t = 2.839, p = .006). After logistic regression analysis, the adjusted odds ratio for the total SSI rate comparing VAC and SMWC was 0.324 (95% confidence interval 0.092 to 0.804; p = .021). Compared with SMWC, VAC can decrease the SSI rate after ankle surgery in patients with diabetes. This finding should be confirmed by prospective, randomized controlled clinical trials.
    No preview · Article · Oct 2015 · The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons
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    ABSTRACT: One major obstacle in the application of drug delivery systems for cancer chemotherapy is their poor penetration in tumor tissues. Conjugating active ligand moieties to the surface of nanoparticles may be a promising approach for enhancing the tumor accumulation and penetration of nanoparticles. Herein, the cell-penetrating peptide twin-arginine translocation (Tat)-conjugated epirubicin-loaded poly(lactic-glycolic acid) nanoparticles were prepared to achieve deep tumor penetration. The morphology and size of nanoparticles were characterized by scanning electron microscopy and dynamic light scattering, and the biological behaviors of nanoparticles were evaluated. It is demonstrated that Tat-conjugated nanoparticles have a significant improvement in antitumor activity and biodistribution compared with nonconjugated nanoparticles. Importantly, Tat conjugated on the surface of nanoparticles could facilitate the encapsulated drug penetration into deeper tumor tissue. Additionally, Tat-conjugated nanoparticles have good biocompatibility, as demonstrated by hemolytic tests, in vitro cytotoxicity, and histology study. These results suggested that the Tat-conjugated nanoparticles, as a powerful delivery system for chemotherapeutic drug, would have a promising application in human cancer therapy. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci.
    No preview · Article · Sep 2015 · Journal of Pharmaceutical Sciences
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    ABSTRACT: In this meta-analysis, we aimed to assess glycosylated hemoglobin (HbA1c) level and lower extremity amputation (LEA) risk in patients with diabetes. Systematic computerized searches of the PubMed and Web of Knowledge were performed. We compared HbA1c level between groups with LEA and without LEA by meta-analysis; we also examined the dose-response relationship between HbA1c level and LEA risk. Sixteen studies were included in the meta-analysis. Eleven studies with 43 566 patients compared HbA1c between groups with and without LEA. The mean HbA1c (%) ranged from 8.3 to 12.5 in the group with LEA and from 7.4 to 11.3 in the group without LEA. The pooled weighted mean difference was 1.110 (95% confidence interval = 0.510-1.709; Z = 3.63, P = .008). The funnel plot was symmetrical, and Begg's test (z = 0.00, P = 1.000) and Egger's test (t = -0.02, P = .984) suggested no significant publication bias. Six studies with 109 933 patients included in the dose-response meta-analysis. The LEA incidence ranged from 0.3% to 14.6% between different HbA1c levels. Dose-response meta-analysis showed statistically significant association between HbA1c and LEA risk (χ(2) = 65.51, P = .000). In linear model, the odds ratio for LEA incidence was 1.229 (95% confidence interval = 1.169-1.292) for every 1% HbA1c increase. In the spline model, the odds ratio of LEA risk increased with HbA1c levels, especially when HbA1c ranged from 5% to 9%. Our meta-analysis indicates that high level of HbA1c is an important risk factor for LEA in patients with diabetes. This evidence supports the strategy for lowering glucose levels to reduce amputation in patients with diabetes. © The Author(s) 2015.
    No preview · Article · Jun 2015 · The International Journal of Lower Extremity Wounds
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    ABSTRACT: Accumulating evidence has shown that miR-196a plays an important role in tumorigenesis and tumor progression in various types of cancer. miRNA profiling studies have suggested that miR-196a is highly overexpressed in breast cancer. However, the functional mechanism of miR-196a in breast cancer remains unclear. In the present study, we first showed that the expression of miR-196a was significantly upregulated in human breast cancer samples and breast cancer cell lines. Using a loss-of-function approach, we showed that the downregulation of miR-196a inhibited the proliferation of breast cancer cells in vitro and in vivo. Ubiquitin-conjugating enzyme E2C (UBE2C) gene as a cellular proto-oncogene, which was overexpressed and positively correlated with miR‑196a expression in breast cancer tissues, was identified as a direct target of miR-196a. Moreover, in order to investigate whether miR-196a regulated cell growth in breast cancer cells by targeting UBE2C, rescue studies were performed in breast cancer cells. The restoration of UBE2C by transfecting UBE2C cDNA in anti-miR-196a-tranfected breast cancer cells rescued the suppression of cell proliferation. In conclusion, the present study showed that miR-196a promoted cell proliferation by targeting UBE2C in breast cancer. Thus, miR-196a may be a potential oncogene in breast cancer and a promising therapeutic target in breast cancer treatment.
    No preview · Article · Jun 2015 · Oncology Reports
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    ABSTRACT: Schwann cell plays an important role in the recovery of peripheral nerve injury, since it is involved in directing and providing physical support to regrow axons by building characteristic bands, and creating an axonal growth microenvironment by secreting neurotrophic factors. Thus, substantial attention has been devoted to investigate various biocompatible biomaterials for promoting Schwann cells proliferation. The distinguished properties of graphene have attracted more attention since of their mechanical and biocompatible features. To the best of our knowledge, the biological applications of graphene against Schwann cells remain unexplored. In this study, we prepared the graphene oxide (GO) and reduced graphene oxide (rGO) coated substrate for evaluation the promotion Schwann cells proliferation. The properties of GO and rGO were characterized by atomic force microscopy, the morphology of the GO and rGO coated substrate were observed by the optical microscopy. CCK-8 kit was conducted to evaluate the proliferation of Schwann cells. The cytoskeleton of Schwann cells was analyzed by phalloidin and Hoechst staining. Furthermore, the expression and secretion of NGF, BDNF and CNTF were investigated. The graphene-based materials will effectively enhance the repair of peripheral nerve injury through promoting Schwann cells proliferation.
    No preview · Article · Jun 2015 · Journal of Biomaterials and Tissue Engineering
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    ABSTRACT: Objective To explore the toxicity and biological activity of cobalt nanoparticles on the osteoclasts. Analyze the relationship between cobalt nanoparticles and osteolysis.Methods Monocyte-macrophages (RAW 264.7) was cultured in vitro, osteoclast-like cells were induced by lipopolysaccharides (LPS). After RAW 264.7 was induced for 24 h, Methyl Thiazolium Tetrazolium (MTT) biological toxicity test of osteoclast-like cell was preceded using Cobalt nanoparticles (set 4 concentrations: 10, 20, 50, 100 μM) and cobalt chloride (set 4 concentrations: 10, 20, 50, 100 μM) at 2, 4, 8, 24 and 48 h respectively. The relative expression of mRNA of CA II and Cat K after RAW 264.7 induction was determined by Q-PCR.ResultsmRNA relative expression of CA II, Cat K were reduced at multiple concentrations both cobalt nanoparticles and cobalt chloride, and was time and concentration dependent, cobalt nanoparticles are more significant than cobalt chloride group. But when the cobalt nanoparticles concentration is in 10–50 μM, the mRNA relative expression of CA II, Cat K increased.Conclusion Cobalt nanoparticles have biological toxicity. At multiple concentrations, the differentiation and proliferation of osteoclasts was inhibited, but when the concentration of cobalt nanoparticles is in 10–50 μM, it has been strengthened.
    No preview · Article · May 2015 · Orthopaedic Surgery
  • Hao Zhou · Qinglin Han · Fan Liu
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    ABSTRACT: Cobalt or chromium alloys are the most common clinical materials of prosthesis and there have been some investigators at home and abroad have done related researches about the genotoxic effects of cobalt and chromium ions and nanoparticles. People have certain understanding about the mechanism of production of ions as well as their influence on cells. However, chromium or cobalt nanoparticles genotoxicity related research is still in its preliminary stage. In each stage, the mechanisms, from creating of the particles, through entering cells, until finally causing genotoxic, are still contained many problems to be solved. This article reviews the research progress in mechanisms of production and genotoxic effects of cobalt, chromium ions and nanoparticles.
    No preview · Article · Apr 2015 · Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi
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    ABSTRACT: The aim of this study was to compare the efficacy of vacuum assisted closure (VAC) with standard moist wound care (SMWC) in surgical site infection after ankle surgery. A prospective cohort was performed among patients with surgical site infection after ankle surgery between 2012 and 2013. The follow-up period was three month, and the efficacy end point was complete wound closure rate. Ninety-four patients were analyzed, with 61 patients in the VAC group and 33 in the SMWC group. The complete wound closure rate in the VAC group was higher than that in the SMWC group at 3 month follow up (90.2% Vs. 72.7%, p = 0.028). The median time to complete wound closure was 31 days (95% CI 20.2-41.8) for VAC, and 63 days (95% CI 46.9-79.1) for SMWC (χ(2) = 4.023, p = 0.045). In the superficial infection subgroup, the median times to complete wound closure were 20 days (95% CI 14.2-35.1) in the VAC group and 42 days (95% CI 35.4-69.4) in SMWC group (χ(2) = 4.331, p = 0.041). In the deep subgroup, the median times to complete wound closure were 46 days (95% CI 28.2-65.9) in the VAC group and 75 days (95% CI 43.2-79.6) in SMWC group (χ(2) = 6.475, p = 0.026). Our result showed that vacuum assisted closure was more effective than standard moist wound care in surgical site infection after ankle surgery. Copyright © 2015 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.
    No preview · Article · Mar 2015 · International Journal of Surgery (London, England)
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    ABSTRACT: Objective Evidence shows obesity is an important risk factor for knee osteoarthritis (OA). However, the dose-response relationship between body mass index (BMI) and knee OA risk is unclear. The purpose of the current study is to establish a nonlinear dose-response relationship between BMI and risk of knee OA.Methods The electronic database of PubMed, Web of Science, and translating research into practice (TRIP) database were searched. Observational studies for BMI and knee OA risk were included. Restricted cubic splines and generalized least-squares regression methods were used to model a potential curvilinear relationship and to make a dose-response meta-analysis.ResultsA total of 12 studies were included in the meta-analysis. A non-linear dose-response association between BMI and risk of knee OA was significant (P = 0.001). The relative risks were 1.59 (95% CI: 1.34-1.81), 3.55 (95% CI: 2.51-5.11), and 7.45 (95% CI: 4.19-13.13) when BMI was at the point of 25, 30, and 35 kg/m2 compared with reference (22.5 kg/m2, the median value of the lowest category), respectively. Non-linear dose-response association was also significant in male and female subgroup. In male subgroup, the relative risks were 1.39 (95% CI: 0.99-1.92), 3.41 (95% CI: 2.07-5.48), and 5.71 (95% CI: 3.12-9.95) when BMI was at the point of 25, 30, and 32.5 kg/m2 compared with reference, respectively. In female subgroup, the relative risks were 1.72 (95% CI: 1.51-1.99), 3.51 (95% CI: 2.65-4.51), and 4.72 (95% CI: 3.25-6.91) compared with reference when BMI was at the point of 25, 30, and 32.5 kg/m2 compared with reference, respectively. Modest publication bias was found in the meta-analysis. However, sensitivity analysis showed a high stability for the result.Conclusions The meta-analysis indicated that knee OA risk increased almost exponentially according with the increase of body mass index. Knee OA prevention will benefit from weight control.
    No preview · Article · Oct 2014 · Obesity
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    Qinglin Han · Fan Liu · Youlang Zhou
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    ABSTRACT: Heparanase (HPSE) is a type of endoglycosidase that decomposes the heparan sulfate (HS) lateral chains of heparan sulfate proteoglycans (HSPGs), releases related growth factors and participates in angiogenesis and bone formation. HPSE is expressed in osteoblasts and is involved in fracture healing. However, the role of HPSE in osteogenic differentiation requires in-depth investigation. To investigate the expression of HPSE in the osteogenic differentiation of rat marrow stromal cells (MSCs), the protein and mRNA expression levels of HPSE on days 0, 1, 3, 7, 10, 14 and 21 of osteogenic differentiation of MSCs in 2- and 10-month-old rats were detected using western blotting and reverse transcription-polymerase chain reaction (RT-PCR), respectively. From the third day of osteogenic differentiation onwards, all HPSE protein and mRNA expression levels in 2-month-old rats were significantly increased compared with basal levels (days 0 and 1; P<0.05). The protein and mRNA expression levels reached a peak on days 10 and 14, respectively, followed by a gradual decline. The same pattern was observed in 10-month-old rats; however, when compared with with basal levels, the differences were not statistically significant (P>0.05). The protein and mRNA levels of HPSE in the 2-month-old rats were significantly higher compared with the respective levels in the 10-month-old rats (P<0.05). HPSE is involved in the osteogenic differentiation of rat MSCs. The protein and mRNA expression levels of HPSE in aged rats are weaker compared with those in young rats, which may be related to the declined osteogenic differentiation ability.
    Full-text · Article · Jun 2013 · Experimental and therapeutic medicine
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    Ran Tao · Yue Lu · Hua Xu · Zhen-Yu Zhou · You-Hua Wang · Fan Liu
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    ABSTRACT: Objective: To compare two internal fixation devices clinically in stabilisation of intertrochanteric femur fractures. Methods: Eighty-seven patients were randomised upon their admission to the hospital using a sealed envelope method. Forty-five were treated with proximal femur nail antirotation (PFNA) and 42 with reverse less invasive stabilisation system (LISS). The perioperative data were recorded and compared in relation to fracture type. Results: In each type of fractures, no significant differences were found with respect to the blood loss, the quality of reduction, the time to bony healing, and the Harris hip score between the 2 groups. The mean duration of surgery was significantly longer in reverse LISS group than in PFNA group. Conclusion: Both the PFNA and the reversed LISS are effective in the treatment of different types of intertrochanteric femur fractures. PFNA is superior to reverse LISS in terms of surgical time, weight-bearing, and perhaps fluoroscopy time.
    Preview · Article · Feb 2013 · The Scientific World Journal
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    ABSTRACT: Peroxisome proliferator-activated receptor-γ (PPAR-γ) has been found to play an essential role in cell proliferation, but whether it was involved in Schwann cells differentiation has never been studied. We have found in sciatic nerve injury that expression of PPAR-γ decreases mainly in Schwann cells, and it was also increased in differentiated Schwann cells. Further, activated PPAR-γ by the endogenous ligand 15 d-PGJ(2) increased expressions of PPAR-γ level and Schwann cell differentiation, and this effect may be protected by its antagonist GDW9662. These results indicate that PPAR-γ could promote Schwann cell differentiation, which plays an important role in peripheral nerve injury and regeneration.
    No preview · Article · Nov 2011 · Journal of Molecular Neuroscience
  • Qing-lin Han · You-hua Wang · Fan Liu
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    ABSTRACT: To investigate the effect of timing of surgery on clinical results and perioperative complications in pediatric patients with Gartland III type supracondylar humeral fractures without neurovascular compromise. Eighty-six consecutive children treated surgically at our hospital from April 2005 to June 2007 for displaced supracondylar humeral fractures were reviewed. All these patients were treated by the same group of doctors. The children were divided into two groups: early if treated within 12 hours after injury and delayed if treated later than that. Perioperative complications and clinical results, especially for open surgery, were compared between the two groups. Forty pediatric patients underwent surgery in the early group and 46 in the delayed group. There were no significant differences between the two groups in perioperative complications such as pin tract infection, iatrogenic nerve injury, compartment syndrome and conversion to open surgery. For open surgery, both the clinical results and perioperative complications were not affected by delaying for more than 12 hours after injury. However, blood loss and operation time were greater in the early than in the delayed group, possibly due to relatively more edema. Delay in surgery, regardless of whether it is closed or open, for more than 12 hours after injury does not influence the perioperative complications and clinical results for displaced supracondylar humeral fractures in children. However early open reduction and pinning may increase intra-operative blood loss and take longer.
    No preview · Article · Nov 2011 · Orthopaedic Surgery
  • Qing-lin Han · You-hua Wang · Fan Liu
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    ABSTRACT: To evaluate the clinical effects of surgical treatment for open dislocation of talus. From June 2001 to July 2008,the complete data of 11 patients with open dislocations of talus were retrospectively analyzed, including 8 males and 3 females with an average age of 39.5 years (ranged 19 to 52). According to Gustilo typing, type I was in 2 cases, type II in 6 cases, type III A in 2 cases, type III B in 1 case. Five cases were tibial astragaloid joint dislocation in which 3 cases associated with subtalar joint dislocation, 4 cases were subtalar joint dislocation and 2 cases were total dislocation of talus. Among them, 8 dislocations associated with talus fractures. All patients were treated with debridement, open reduction, internal fixation with K-wires or screws and external fixation with plaster or external fixator within 8 hours after injury. External fixations were removed at 6 weeks after operation. Partial weight bearing was permitted only when X-rays indicated bony healing. Clinical effects were evaluated according to AOFAS system and X-ray films during follow-up. The mean time of follow-up was 13.8 months(ranged 10 to 15 months). Eight patients with fractures obtained bone healing in 4-7 months with an average of 4.3 months. No infection of wound or deep tissue was found. At final follow-up, talus necrosis was in 2 cases and traumatic arthritis was in 2 cases. The AOFAS score was 71.3 +/- 8.6, among the total, the pain, function, alignment was respectively (32.4 +/- 7.1), (31.0 +/- 15.7), (7.6 +/- 2.3) scores. Complete debridement may avoid infection in treating open dislocation of talus, early reduction and fixation is a key point during treatment.
    No preview · Article · Jul 2011 · Zhongguo gu shang = China journal of orthopaedics and traumatology
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    ABSTRACT: Controversy persists concerning the preferred treatment of peritrochanteric femoral fractures. The purpose of the present study was to evaluate the mid-term outcomes of the newly developed implants - proximal femoral nail antirotation (PFNA) for the stabilisation of this type of fracture. Between April 2006 and March 2008, 169 patients with peritrochanteric femoral fractures were treated with PFNA. As many as 26 patients were excluded from the study. According to the Orthopaedic Trauma Association (OTA) classification system, the remaining 143 fractures were classified as 19 cases of AO/OTA 31A1 fractures, 83 cases of 31A2 fractures, 28 cases of 31A3 fractures and 13 cases of 31A combined with proximal 32 fracture or separate proximal 32 fracture. The mean age of these patients was 67 years (range, 20-93 years). The operative time, the overall fluoroscopy time, the duration of hospitalisation and the surgical complications were noted. Patients were followed up for a mean of 21 months (range, 12-36 months). Functional outcomes were assessed according to the Harris hip scoring system. Fifteen patients (10%) required open reduction. The mean duration of surgery (from the beginning of close reduction to wound closure) was 72 min with a range between 45 and 170 min. The mean fluoroscopy time was 164 s with a range between 92 and 396 s. The mean time of hospital stay was 15 days. Postoperative X-rays showed a good or acceptable reduction in 134 cases (94%), and an ideal implant position in 131 cases (92%). There were 12 (8%) postoperative complications. All patients except one healed their fractures without any implant-specific complication (bending, breaking of the implant, cut out of the PFNA blade, femoral head penetration of the blade or ipsilateral fractures of the femoral shaft at the tip of the implant). The average time to bone healing was 16 weeks (range, 12-25 weeks). At the time of the latest follow-up, 106 patients (74%) were restored to their preoperative mobility. The mean Harris hip score was 84 points (range, 46-100 points). A total of 106 patients (74%) had an excellent or good outcome. According to the patients and/or their caregivers, outcome was described as satisfactory in 120(84%) of the 143 patients, and 36(90%) of the 40 patients, who were more than 80 years old. The results suggest that PFNA is a very effective and safe method in the treatment of different patterns of peritrochanteric femoral fractures. The fixation is adequate to maintain reduction over time even in osteoporotic bones.
    Preview · Article · Aug 2010 · Injury
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    Ya-ke Liu · Hua Xu · Fan Liu · Ran Tao · Jun Yin
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    ABSTRACT: To investigate the effects of serum cobalt ion concentration on the liver, kidney and heart in mice. Forty 4-week-old male ICR mice were randomly divided into four groups (n = 10 in each group) as follows: Group 1 (HD), high-dose cobalt chloride group (3.28 mg/kg/day); Group 2 (MD), medium-dose cobalt chloride group (1.64 mg/kg/day); Group 3 (LD), low-dose group cobalt chloride group (0.82 mg/kg/day); and Group 4 (NC), normal control group (vehicle). Cobalt chloride and normal saline were given by intraperitoneal injection once per day for 3 weeks. The body weights of the mice were recorded every 3 days to ensure the correct doses of cobalt chloride. Blood samples for testing were taken at day 4, week 1, week 2 and week 3. Serum cobalt ion concentrations were measured in all samples whereas other serum biochemical variables, including aspartate aminotransferase (AST), aspartate aminotransferase (ALT), blood urea nitrogen (BUN), creatinine (Cr), and creatine kinase (CK) were evaluated at week 1, 2 and 3. After killing the mice at week 3, the heart, liver and kidney were collected for pathological evaluation. Serum cobalt ion concentration was different between the groups. High-dose cobalt chloride significantly increased AST, ALT and CK concentrations, the concentrations increasing in parallel with treatment duration. Pathological evaluation showed that high-dose cobalt chloride had toxic effects on the heart and liver; however no significant effect was apparent in the kidney. High-dose cobalt ion concentration in serum has toxic effects on the heart and liver, but no significant effect on the kidney in mice.
    Preview · Article · May 2010 · Orthopaedic Surgery
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    ABSTRACT: To compare the immediate stability of different fixation techniques for the direct repair of spondylolytic defects in the pars interarticularis. Eight fresh-frozen and thawed calf cadaveric lumbar spines were used for mechanical testing. A modified Scott, screw-rod-hook, screw-rod construct fixation and Buck techniques were applied to calf lumbar spines in which bilateral spondylolytic defects had been created in the L(4) vertebra. The multidirectional flexibility of each specimen was measured under flexion/extension, right/left lateral bending, and right/left axial rotation. After creating a pars interarticularis defects at L(4), the range of movement (ROM) at both the L(3)-L(4) and L(4)-L(5) levels were increased under all loading conditions. Each fixation technique significantly increased stability and almost restored intervertebral rotation mobility to normal levels. Under flexion-extension, the screw-rod-hook and screw-rod construct techniques of fixation provided more rotational stability than did the other two techniques (P < 0.05). The screw-rod-hook, screw-rod construct and Buck techniques also provided more flexion/extension stability than the modified Scott technique. The current study has shown that the ROM at the involved and upper adjacent level of spondylolysis is greater than in the intact spine. All four fixation techniques accorded with spinal biomechanical principles and restored intervertebral rotation displacements under flexion, rotation and bending loads to the intact condition. The screw-rod-hook and screw-rod construct fixation techniques provided more stability than did the modified Scott and Buck techniques, and are therefore good prospects for direct repair.
    Preview · Article · Feb 2010 · Orthopaedic Surgery
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    ABSTRACT: To discuss the classification, management and outcome of fractures of the ulnar coronoid process. Retrospective analysis was carried out in 31 patients (19 men and 12 women of average age 29.8 years [range, 18-52 years]) with fractures of the ulnar coronoid process. The fractures were classified into four major groups based on the extent of injury to the ulnar coronoid process, the state of the anterior bundle of the ulnar collateral ligaments (UCL) and elbow stability. A fracture of the coronoid process less than halfway up was defined as type I (eleven cases); of the middle of the coronoid process with injury of the UCL as type II (nine cases); of the base of coronoid process with dislocation of the elbow joint, sometimes with injury of the UCL, as type III (six cases); and severe comminuted fracture of the coronoid process with elbow instability as type IV (five cases). We chose treatment according to the type of injury. Follow-up was 18-72 months (average 28.6 months). All patients achieved fracture union without inflammation, neural injuries or elbow instability. One type III and two type IV patients had traumatic osteoarthritis, and two type III and two type IV developed heterotopic ossification. There was a statistically significant difference between the ranges of movement of the two-side joints in type IV. We choose conservative treatment for type I fractures unless the bone fragment affected movement of the elbow joint, in which case we chose operative treatment so that elbow stability was not affected. Type II and type III fractures with elbow instability were reduced by internal fixation and the ligament repaired or reconstructed. In type IV cases, bone reconstruction was necessary to recover elbow stability. Proper post-operative rehabilitation can decrease the occurrence of traumatic osteoarthritis.
    Preview · Article · Nov 2009 · Orthopaedic Surgery
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    ABSTRACT: The purpose of present study was to evaluate the role of LISS after a large series of patients in whom a fracture around the knee had been treated with this uniform technique. Between April 2004 and September 2006, 210 patients with a total of 216 fractures around the knee were treated with LISS, all at the Affiliated Hospital to Nantong University. Patients were followed for a mean of 27 months (range 12-42 months). 26 patients were excluded from the study. The remaining 184 patients with a total of 189 fractures of either distal femur (85 cases) or proximal tibia (104 cases) were available for analysis. The mean age of these patients was 49 years (range 18-82 years). Immediate postoperative X-rays showed the alignment of bone and joint was satisfactorily maintained with LISS in all cases and an ideal implant position in 176 cases (93%). All cases healed the fracture without non-union. The mean time to union was 15 weeks (range 12-27 weeks) for the femoral and 16 weeks (range 12-27 weeks) for the tibia fractures. Functional assessment was performed using HSS (hospital for special surgery) score. At the time of the latest follow-up, 158 patients (86%) had an excellent or good outcome. Overall, 3 patients were subject to a salvage operative procedure due to implant failure. Three cases underwent secondary bone graft for open fractures. Superficial and deep infection was found each in one patient and both were treated successfully. Hardware prominence irritation was found in 2 patients. LISS was removed in 27 patients after bone healing, and this procedure was neither less invasive nor easy as imagined. The results indicate the LISS system is perfect but by no means unique in the treatment of the fractures around the knee. The fixation is adequate enough to maintain alignment and obtain union with a low incidence of complications even in patients with osteoporotic bone. We firmly believe favourable results can be achieved when this device is combined with correct indications as well as skillful techniques.
    Preview · Article · Jul 2009 · Injury