Publications by authors named "Shan Ou"

42 Publications

Traumatic Brain Injury and Risk of Dementia and Alzheimer's Disease: A Systematic Review and Meta-Analysis.

Neuroepidemiology 2021 Nov 24. Epub 2021 Nov 24.

Introduction: Previous studies have investigated the potential role of traumatic brain injury (TBI) in subsequent development of dementia and Alzheimer's disease (AD) but reported inconsistent results. We aim to determine the association between TBI and subsequent occurrence of dementia and AD.

Methods: We performed a systematic search in PubMed and Web of Science for studies that quantitatively investigated the association between TBI and risk of dementia and AD and were published on or before September 21, 2021. A random-effect model was used to combine the estimates.

Results: Twenty-five eligible articles were included in this meta-analysis. The results suggested that TBI was associated with an increased risk of dementia (pooled odds ratio [OR] = 1.81, 95% confidence interval [CI] = 1.53 - 2.14). However, no association was observed between TBI and Alzheimer's disease (pooled OR = 1.02, 95% CI = 0.91 - 1.15). In the subgroup analysis, TBI with loss of consciousness was not associated with risk of dementia (pooled OR = 0.96, 95% CI = 0.84 - 1.09). Besides, Asian ethnicity, male gender, and mean age of the participants less than 65 were associated with a higher risk of dementia.

Conclusion: Our study suggests an increased risk of dementia among individuals with TBI, highlighting the need for more intensive medical monitoring and health education in individuals with TBI. Biological mechanisms linking TBI and the development of dementia are needed in future studies.
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http://dx.doi.org/10.1159/000520966DOI Listing
November 2021

Effects of propofol and inhalational anesthetics on the optic nerve sheath diameter in patients undergoing surgery in the steep Trendelenburg position: a systematic review and meta-analysis.

Ann Palliat Med 2021 10;10(10):10475-10485

Department of Anesthesiology, Chengdu First People's Hospital, Chengdu, China.

Background: Optic nerve sheath diameter (ONSD) is recognized as a surrogate indicator of intracranial pressure (ICP) during surgery. Due to the requirements of surgery, the adjustment to the steep Trendelenburg position and the establishment of CO2 pneumoperitoneum can lead to an increase in ICP, resulting in an increase in the ONSD. Anesthetic agents have different impacts on cerebral blood volume and ICP. The aim of this study was to evaluate the effects of propofol and inhalational anesthetics on the ONSD based on data from randomized controlled trials (RCTs).

Methods: The electronic databases of PubMed, EMBASE, Ovid MEDLINE, the Cochrane Library, and other databases were searched systematically using specified keywords from their inception to June 2021. The Chi-square test and I2 test were used to evaluate the heterogeneity across the studies. The weighted mean difference (WMD) with 95% confidence interval (CI) were adopted to analyze continuous data.

Results: A total of 379 patients from 7 studies were involved in this meta-analysis. There were borderline significant differences in the ONSD atT2 between propofol and the control group: T2 (WMD =-0.15, 95% CI: -0.31, -0.00, P=0.005). There were significant differences at T3 (WMD =-0.23,95% CI: -0.42, -0.05, P =0.013) and T4 (WMD  =-0.18, 95% CI: -0.29, -0.07, P =0 .001). After statistical verification, there was no significant difference in the ONSD at T1 between the 2 groups: T1 (WMD =-0.08, 95% CI: -0.26, 0.10, P =0 .368). There were also no significant differences in mean arterial pressure (MAP) (P=0.654, 0.445, 0.698, and 0.562, respectively) and end tidal CO2 (ETCO2) (P=0.081, 0.506, 0.126, and 0.983, respectively) at T1, T2, T3 and T4 between propofol and inhalational anesthetics.

Discussion: The findings in the present study indicated that the ONSD during propofol anesthesia was significantly lower than that during inhalational anesthesia after adopting the Trendelenburg position and CO2 pneumoperitoneum. These analysis results suggest that propofol anesthesia may help to minimize changes in ICP compared to inhalational anesthetics.
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http://dx.doi.org/10.21037/apm-21-2363DOI Listing
October 2021

Metabolites Identification of Chemical Constituents From the Eggplant ( L.) Calyx in Rats by UPLC/ESI/qTOF-MS Analysis and Their Cytotoxic Activities.

Front Pharmacol 2021 15;12:655008. Epub 2021 Jul 15.

Department of Medicinal Chemistry and Natural Medicine Chemistry, College of Pharmacy, Harbin Medical University, Harbin, China.

Eggplant ( L.) Calyx is a medicinal and edible traditional Chinese medicine with anti-inflammatory, anti-oxidant, and anti-cancer properties. However, the pharmacodynamic components and metabolic characteristics remain unclear. Amide and phenylpropanoid were the two main constituents, and four amides, including -trans--coumaroyltyramine (), -trans--coumaroyloctopamine (), -trans--coumaroylnoradrenline (), -trans-feruloyloctopamine (), and a phenylpropanoid neochlorogenic acid () were selected. In this study, these five representative compounds showed cytotoxic activities on A549, HCT116, and MCF7 cells. In addition, the metabolites of from the eggplant calyx in rats were identified. In total, 23, 37, 29, and 17 metabolites were separately characterized in rat plasma, urine, feces, and livers, by UPLC/ESI/qTOF-MS analysis. The metabolism of amides and phenylpropanoid was mainly involved in hydroxylation, methylation, glucuronidation, or sulfation reactions. Two hydroxylated metabolites ( and ) were clearly identified by comparison with reference standards. Rat liver microsome incubation experiments indicated that P450 enzymes could hydroxylate , and the methylation reaction of the 7-hydroxyl was also observed. This is the first study on the metabolism of these compounds, which lays a foundation for follow-up studies on pharmacodynamic evaluations and mechanisms.
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http://dx.doi.org/10.3389/fphar.2021.655008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8320773PMC
July 2021

Head Injury and Amyotrophic Lateral Sclerosis: A Meta-Analysis.

Neuroepidemiology 2021 Feb 23:1-9. Epub 2021 Feb 23.

The Fourth Department, State Key Laboratory of Trauma, Burn and Combined Injuries, Institute for Traffic Medicine, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, China,

Background: Prior studies have suggested that head injury might be a potential risk factor of amyotrophic lateral sclerosis (ALS). However, the association has not been well established. We aimed to provide a synopsis of the current understanding of head injury's role in ALS.

Methods: We performed a systematic search in PubMed for observational studies that quantitatively investigated the association between head injury and ALS risk published before April 10, 2020. We used a random-effects model to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: Fourteen eligible articles including 10,703 cases and 2,159,324 controls were selected in current meta-analysis. We found that head injury was associated with an increased risk of ALS (OR = 1.38, 95% CI: 1.20-1.60) and the association was slightly stronger concerning severe head injury and ALS risk (OR = 1.69, 95% CI: 1.27-2.23). Considering the number of head injuries (N) and ALS risk, the association was weak (OR = 1.23, 95% CI: 1.10-1.37, N = 1; OR = 1.29, 95% CI: 0.89-1.86, N ≥ 2). In addition, a strong association with ALS risk was found in individuals who suffered head injury <1 year (OR = 4.05, 95% CI: 2.79-5.89), and when the time lag was set at 1-5, 5-10, and >10 years, the pooled OR was 1.13, 1.35, and 1.10, respectively.

Conclusion: This meta-analysis indicates that head injury, especially severe head injury, could increase ALS risk. Although a strong association is found between head injury <1 year and ALS risk in the current study, this result suggests a possibility of reverse causation.
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http://dx.doi.org/10.1159/000510987DOI Listing
February 2021

Trauma and amyotrophic lateral sclerosis: a systematic review and meta-analysis.

Amyotroph Lateral Scler Frontotemporal Degener 2021 05 11;22(3-4):170-185. Epub 2021 Jan 11.

The Eighth Department, State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, China.

: Trauma especially head trauma is considered a potential risk factor of amyotrophic lateral sclerosis (ALS), but their association has not been well established. We aimed to determine the association of prior trauma with ALS risk. This study was performed according to the Meta-Analysis of Observational Studies in Epidemiology guideline to assess related literatures, and a random-effects model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Twenty-nine eligible articles involving 18,390 cases and 6,519,391 controls were included in this meta-analysis. The results showed that trauma was associated with an increased risk of ALS (pooled OR = 1.51, 95% CI: 1.32-1.73). Besides, patients with trunk trauma, head trauma and lower limb trauma had an increased risk of ALS, whereas no evidence suggested that upper limb trauma and spine trauma could increase ALS risk. Considering the number of traumatic events, the association between trauma and ALS risk was significant for patients with repeated trauma events (pooled OR = 1.21, 95% CI: 1.07-1.38). The results showed that individuals with a history of trauma within 5 years were more likely to be diagnosed with ALS (pooled OR = 1.84, 95% CI: 1.56-2.17). Importantly, both old trauma and very old trauma were found to be associated with an increased risk of ALS (pooled OR = 1.24, 95% CI: 1.12-1.38; pooled OR = 1.28, 95% CI: 1.10-1.49; respectively). This meta-analysis indicated that trauma could increase ALS risk, which may be applied for the clinicians to tailor targeted treatment regimens and make prophylactic strategies for ALS in traumatic patients.
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http://dx.doi.org/10.1080/21678421.2020.1861024DOI Listing
May 2021

SNHG10 Promotes Cell Proliferation and Migration in Gastric Cancer by Targeting miR-495-3p/CTNNB1 Axis.

Dig Dis Sci 2021 08 12;66(8):2627-2636. Epub 2020 Sep 12.

Department of Gastroenterology, The Sixth People's Hospital of Chongqing, Chongqing, 400000, China.

Background: Long non-coding RNAs have been acknowledged as the crucial regulators in the progression of human cancers, including gastric cancer (GC). Small nucleolar RNA host gene 10 (SNHG10) has been identified as an oncogene in several cancer types. Nonetheless, it is unclear whether SNHG10 exerts functions in GC cells.

Aims: The aims of the current study were to explore the function and underlying mechanism of SNHG10 in GC.

Methods: The expression levels of SNHG10, miR-495-3p and catenin beta 1 (CTNNB1) were detected by RT-qPCR. Loss-of-function assays, including CCK-8, colony formation assay, flow cytometry analysis and transwell assays, were conducted to verify the effect of SHNG10 on the proliferation, apoptosis, migration and invasion of GC cells. Mechanism experiments were performed to identify the downstream molecular mechanism of SNHG10.

Results: SNHG10 was expressed at a high level in GC cells. Knockdown of SNHG10 inhibited the proliferation, migration and invasion of GC cells. Silencing of SNHG10 led to the downregulation of core factors of WNT signaling pathway. Knockdown of SNHG10 could decline the expression of CTNNB1 through sequestering miR-495-3p.

Conclusions: SNHG10 promotes the procession of GC through targeting miR-495-3p/CTNNB1 and activating WNT signaling pathway.
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http://dx.doi.org/10.1007/s10620-020-06576-wDOI Listing
August 2021

Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis.

J Int Med Res 2020 Aug;48(8):300060520926075

Department of Anaesthesiology, Chengdu First People's Hospital, Chengdu, Sichuan Province, China.

Objective: To evaluate the efficacy and safety of the addition of local infiltration analgesia (LIA) to adductor canal block (ACB) for pain control after primary total knee arthroplasty (TKA).

Methods: Two reviewers independently searched for potentially relevant published studies using electronic databases, including PubMed® (1966 to June 2019), Embase® (1974 to June 2019) and Web of Science (1990 to June 2019). The results were pooled using the random-effects model to produce standard mean differences for continuous outcome data and odds ratio for categorical outcome data.

Results: A total of three randomized controlled trials (RCTs) and three non-RCTs were included for data extraction and meta-analysis. There were significant differences between the two groups regarding the postoperative pain score on postoperative day (POD) 0 and POD 1. The cumulative opioid consumption in the ACB plus LIA groups was significantly lower than that in the ACB groups on POD 0 and POD 1. No significant differences were found in terms of postoperative range of motion or length of hospitalization.

Conclusion: ACB plus LIA significantly reduced the postoperative pain score on POD 0 and POD 1 compared with isolated ACB. In addition, ACB plus LIA was associated with a significant reduction in opioid consumption during the early postoperative period.
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http://dx.doi.org/10.1177/0300060520926075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557703PMC
August 2020

Genetic polymorphisms in complement receptor 1 gene and its association with HBV-related liver disease: A case-control study.

Gene 2019 Mar 5;688:107-118. Epub 2018 Dec 5.

Department of Clinical Laboratory, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China. Electronic address:

Background: Several investigators have reported that complement receptor 1 (CR1) likely play a role in the pathogenesis of tumors, autoimmune and inflammatory diseases. However, the association of genetic polymorphisms of CR1 with risk of hepatitis B virus (HBV)-related liver disease remains unexplored.

Methods: In a case-control study of 399 HBV-related liver disease patients and 227 healthy controls, we genotyped two SNPs in CR1 (rs3811381 and rs2274567) and assessed their associations with risk of HBV-related liver disease.

Results: No significant differences were observed in the frequency distribution of genotypes or alleles between CR1 rs3811381 and rs2274567 polymorphisms in patients and controls. However, stratification analysis indicated that these two CR1 polymorphisms may contribute to the risk of HBV- hepatocellular carcinoma (HCC) and chronic hepatitis B (CHB) in subgroups of males, alcohol drinkers and nonsmokers. Further, our results showed that the rs3811381 polymorphism may contribute to HBV-HCC risk in subgroups of older and younger subjects, while the G allele, AG and the combined AG + GG genotypes of rs2274567 may be risk factors for HBV-HCC in younger subjects. In addition, our results indicated that subjects who carried the rs3811381 G allele and the rs2274567 AG genotype were at decreased risk of HBV- liver cirrhosis (LC) in subgroups of females.

Conclusions: Our results support the hypothesis that the CR1 gene rs3811381 and rs2274567 polymorphisms may contribute to HBV-HCC and HBV-CHB risk, particularly in subgroups of males, alcohol drinkers, nonsmokers, while these two CR1 polymorphisms were found to associate with decreased risk of HBV-LC, particularly in females. Further validation of these results is warranted.
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http://dx.doi.org/10.1016/j.gene.2018.11.082DOI Listing
March 2019

[Application of SNP-array technology in the genetic analysis of pediatric patients with growth retardation].

Zhonghua Yi Xue Yi Chuan Xue Za Zhi 2017 Jun;34(3):321-326

Central Laboratory for Genetic and Metabolic Diseases, Maternal and Child Health Care Hospital of Guangxi Zhuang Autonomous Region, Institute of Birth Defect Control and Prevention of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530012, China.

Objective: To explore the value of single nucleotide polymorphism array (SNP-array) for the analysis of pediatric patients with growth retardation.

Methods: One hundred eighty one children with growth retardation were enrolled. DNA was extracted from peripheral samples from the patients, and whole genome copy number variations (CNVs) were detected using Illumina Human Cyto SNP-12. All identified CNVs were further analyzed with reference to databases including ClinGen, ClinVar, DECIPHER, OMIM and DGV as well as comprehensive review of literature from PubMed to determine their pathogenicity.

Results: Forty seven patients (26%) with abnormal CNVs were detected, which included 12 known microdeletions/microduplications syndrome (26%), 10 pathogenic non-syndromic CNVs (21%), 3 numerical chromosome aberrations (6%), 3 unbalanced translocations (6%), 4 pathogenic mosaicisms (9%) and 15 cases with unknown clinical significance (32%). After excluding obvious numerical and/or structural chromosomal abnormalities, this study has detected 15 pathogenic microdeletions/microduplications sized 5 Mb or less, which may be missed by routine chromosomal karyotyping. In addition, there were 3 cases with loss of heterozygoisty (LOH) containing known or predicted imprinting genes as well as 2 cases with suspected parental consanguinity.

Conclusion: SNP-array technology is a powerful tool for the genetic diagnosis of children with growth disorders with advantages of high resolution and improved accuracy.
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http://dx.doi.org/10.3760/cma.j.issn.1003-9406.2017.03.002DOI Listing
June 2017

A rare occurrence of two large de novo duplications on 1q42-q44 and 9q21.12-q21.33.

Gene 2016 Dec 31;594(1):59-65. Epub 2016 Aug 31.

Laboratory of Genetics and Metabolism, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region; Guangxi Birth Defects Prevention and Control Institute, Nanning 530003, Guangxi, People's Republic of China; Department of Laboratory Medicine, Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, United States; Claritas Genomics, Cambridge, MA 02139, United States. Electronic address:

De novo partial distal 1q trisomy is uncommon and mostly occurs in combination with monosomy of another chromosome due to a parental translocation. Distal 1q trisomy co-occurring with another de novo duplication on a separate chromosome is extremely rare. Here, we reported a patient carrying two large de novo interstitial duplications including a 20Mb duplication at 1q42-q44 and a 14.2Mb duplication at 9q21.12-q21.33. The patient presented with features of pre- and postnatal growth retardation, low birth weight, failure to thrive, developmental delay and frequent infection. Her dysmorphic features included macrocephaly, prominent forehead, triangular face, wide fontanelle, hypertelorism, flat nasal bridge, tented mouth, micrognathia, protruding and low-set ears, slender limbs with toe-walking appearance. In addition, she presented with subdural hematoma. The clinical presentations of this patient are mostly consistent with those of distal 1q trisomy syndrome or 9q interstitial duplication. The interstitial 1q trisomy may have contributed to the macrocephaly, prominent forehead and limb abnormalities of our patient. Either or both de novo duplications could have contributed to the features of growth retardation, developmental delay and dysmorphic features including hypertelorism, low-set ears and abnormal nose/nasal bridge.
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http://dx.doi.org/10.1016/j.gene.2016.08.042DOI Listing
December 2016

The epidemiology of traumatic brain injury in civilian inpatients of Chinese Military Hospitals, 2001-2007.

Brain Inj 2015 27;29(7-8):981-8. Epub 2015 Apr 27.

Department of Neurosurgery, Chengdu Military General Hospital of People's Liberation Army , Chengdu, Sichuan , PR China and.

Primary Objective: To investigate the epidemiology of TBI in Chinese inpatients.

Research Design: Civilian inpatients of Chinese military hospitals diagnosed with TBI between 2001-2007 were identified using ICD-9-CM codes.

Methods And Procedures: Demographic characteristics, admission time, injury cause, injury severity, length of stay and outcomes were compared between ICD-9-CM diagnosis groups.

Main Outcomes And Results: In total, 203 553 civilian patients with TBI (74.86% male, 25.14% female) were identified from >200 Chinese military hospitals. TBI diagnoses increased by a mean of 4.67% each year. Admission peaked during the third quarter of the year and October annually. The leading causes of TBI were motor vehicle-traffic (51.41%), falls (21.49%) and assaults (15.77%). TBI was categorized by abbreviated injury scale score as mild in 36.64%, serious in 20.13%, severe in 26.81% and critical in 15.68% of inpatients. The mean length of stay was 17.8 ± 24.1 days. Recovery rate was 93.06% and mortality was 4.14%.

Conclusions: The epidemiological data may contribute to the development of effective, targeted strategies to prevent TBI.
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http://dx.doi.org/10.3109/02699052.2014.989405DOI Listing
June 2016

Operative Treatment of Terrible Triad of the Elbow via Posterolateral and Anteromedial Approaches.

PLoS One 2015 24;10(4):e0124821. Epub 2015 Apr 24.

Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, China.

The aim of the study was to explore the clinical outcome of posterolateral and anteromedial approaches in treatment of terrible triad of the elbow. The study involved 12 patients with closed terrible triad of the elbow treated by posterolateral and anteromedial approaches between January 2010 and June 2012. The mechanism of injury included fall from height in 9 patients and traffic accident in 3. According to O'Driscoll classification for fractures of the ulnar coronoid, there were 11 patients with type Ⅰ and 1 with type Ⅱ fractures. According to Mason classification for fractures of the radial head, there were 3 patients with type Ⅰ, 7 with type Ⅱ and 2 with type Ⅲ fractures. All patients were followed up for 12-27 months (average 15.5 months), which showed no pain or severe pain in all patients except for 2 patients with mild pain. At the last follow-up, the mean flexion was for 125°(range, 90°-140°), the mean extension loss for 20°(range, 0°-70°), the mean pronation for 66°(range, 20°-85°) and the mean supination for 60°(range, 30°-85°). The bony union time was 8-14 weeks (average 11 weeks) and the elbows were stable in flexion-extension and varus-valgus in all patients. The elbows maintained a concentric reduction of both the ulnotrochlear and the radiocapitellar articulation. Mild heterotopic ossification of the elbow occurred in 3 patients at 6 months after operation and mild degenerative change in 1 patient at 18 months after operation. The Broberg and Morrey elbow performance score was 82 points (range, 58-98 points). The results were excellent in 6 patients, good in 4, fair in 1 and poor in 1, with excellence rate of 83.3%. The results showed that the combined posterolateral and anteromedial approaches can facilitate the reduction and fixation of terrible triad of the elbow. Repair of radial head, coronoid, medial and lateral collateral ligaments can sufficiently restore the elbow stability, allow early postoperative motion and enhance the functional recovery.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0124821PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409296PMC
January 2016

Walking speed in elderly outpatients depends on the assessment method.

Age (Dordr) 2014 6;36(6):9736. Epub 2014 Dec 6.

Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands.

Walking speed is shown to be an important indicator of the health status and function in older adults and part of the comprehensive geriatric assessment in clinical practice. The present study aimed to assess the influence of different assessment methods on walking speed and its association with the key aspects of poor health status, i.e., the presence of low cognitive performance and cardiopulmonary disease. In 288 community-dwelling elderly (mean age 82.2 ± 7.1 years) referred to a geriatric outpatient clinic, walking speed was assessed with the 4-m, 10-m, and 6-min walking tests. The mean walking speed assessed with the 10-m walking test was higher compared to the 4-m and 6-min walking tests (mean difference (95% CI) 0.11 m/s (0.10; 0.13) and 0.08 m/s (0.04; 0.13), respectively). No significant difference was found in the walking speed assessed with the 4-m compared to the 6-min walking test (mean difference (95% CI) -0.03 m/s (-0.08; 0.03)). ICCs showed excellent agreement of the 4-m with the 10-m walking test and fair to good agreement of the 6-min with the 4-m as well as 10-m walking test. The presence of low cognitive performance was negatively associated with walking speed, with the highest effect size for the 4-m walking test. The presence of cardiopulmonary disease was negatively associated with walking speed as well, with the highest effect size for the 6-min walking test. In conclusion, in the clinically relevant population of elderly outpatients, walking speed and its interpretation depends on the assessment method, which therefore cannot be used interchangeably in clinical practice.
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http://dx.doi.org/10.1007/s11357-014-9736-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259093PMC
June 2015

Comparison of three fixations for tibial plateau fractures by biomechanical study and radiographic observation.

Int J Surg 2015 Jan 18;13:292-296. Epub 2014 Nov 18.

Institute of Digitized Medicine, Wenzhou Medical College, Wenzhou 325035, China.

Aim: The aim of this study was to compare the fixation effects of three fixation devices for tibial plateau fracture (AO/OTA classification 41 A1).

Methods: Sixteen human cadaver tibial specimens were randomly divided into four groups. An A1 fracture model was established. The fractures were subsequently fixed by axial controlled intramedullary nail, external fixation and steel plate fixation. Each specimen was subjected to axial compression, torsion test and three-point bending test. Then a rat model was used to evaluate the therapeutic effect of these three fixations by evaluation of callus formation time and healing time.

Results: It was found that the axial controlled intramedullary nail group obtained superior biomechanical properties of resistance ability of bending, torsional and axial compressive, compared with external fixation and steel plate group. In animal experiments, the axial controlled intramedullary nail group had a significant shorter callus occurrence and healing time than steel plate and external fixator group.

Conclusion: The axial controlled intramedullary nail fixation has a superior biomechanical characteristic and fixation effect for tibial plateau fractures than steel plate and external fixator.
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http://dx.doi.org/10.1016/j.ijsu.2014.11.013DOI Listing
January 2015

Clinical efficacy of simple decompression versus anterior transposition of the ulnar nerve for the treatment of cubital tunnel syndrome: A meta-analysis.

Clin Neurol Neurosurg 2014 Nov 11;126:150-5. Epub 2014 Aug 11.

Department of Orthopedics, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou 325027, China.

Objectives: The aim of this study was to evaluate the clinical efficacy of simple decompression (SD) versus anterior transposition (AT) of the ulnar nerve for the treatment of cubital tunnel syndrome.

Methods: Seven public databases (PubMed, MEDLINE and EMBASE, Springer, Elsevier Science Direct, Cochrane Library and Google scholar) were searched from 1971 to December 2013. The overall odds ratios (OR) and their 95% confidence intervals (CI) were pooled to compare the clinical outcomes. Subgroup analysis was performed based on the region, study type, Jadad score, type of AT, and follow-up duration. Meta-analysis was conducted by using Rev. Man 5.1 and Stata 11.0 software.

Results: Finally, we included 13 studies involved 1009 (500 patients receiving SD and 509 patients receiving AT) patients with cubital tunnel syndrome. The overall estimate (OR=0.91, 95% CI=0.67-1.23, P=0.536) indicated that there was no significantly statistical difference between the clinical outcomes of patients treated with SD and AT. Meanwhile, subgroup analyses by region, study type, Jadad score, type of AT and follow-up duration showed the consistent results with the overall estimate. In addition, we found that the incidence of complications in patients treated by SD was significantly lower than that in patients treated by AT (OR=0.32, 95% CI=0.17-0.60, P=0.05).

Conclusions: In conclusion, although SD had equivalent clinical outcomes with AT for the treatment of cubital tunnel syndrome, SD should be preferred due to having lower incidence of complications.
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http://dx.doi.org/10.1016/j.clineuro.2014.08.005DOI Listing
November 2014

An extended anterolateral approach for posterolateral tibial plateau fractures.

Knee Surg Sports Traumatol Arthrosc 2015 Dec 13;23(12):3750-5. Epub 2014 Sep 13.

Traumatic Center, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China.

Purpose: The best approach for treating posterolateral tibial plateau fractures remains controversial. The clinical results of an extended anterolateral approach on such fractures are discussed in this study.

Methods: Between 2010 and 2011, ten patients with posterolateral tibial plateau fracture were treated using an extended anterolateral approach with a proximal tibial locking compression plate. The epidemiological data, operation details, and clinical outcomes over 26.4 ± 2.3 months (range 24-30 months) of follow-up were prospectively collected and analyzed.

Results: The average surgical duration was 91.5 ± 18.7 min (range 80-130 min). An anatomic reduction rate of 90 % (9/10) was observed although one patient with a lateral comminuted fracture and dislocation presented a 2-mm joint surface depression postoperatively. The average fracture healing time was 10.6 ± 1.8 weeks (range 8-14 weeks), with an average hospital for special surgery knee score of 95.3 ± 6.5 points (range 80-100 points), an average knee flexion of 119.8° ± 17.2° (range 95°-140°) and an average knee extension of 2.1° ± 2.1° (range 0°-6°). No complications were found.

Conclusions: The extended anterolateral approach with a proximal tibial compression plate offers direct and complete surgical exposure and may provide an effective method for the surgical treatment of posterolateral tibial plateau fractures.

Level Of Evidence: Therapeutic, Level IV.
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http://dx.doi.org/10.1007/s00167-014-3304-yDOI Listing
December 2015

A time course study about gene expression of post-thermal injury with DNA microarray.

Int J Dermatol 2015 Jul 29;54(7):757-64. Epub 2014 Jul 29.

Department of Neurosurgery, General Hospital of Chengdu Military Command, Chengdu, Sichuan.

Background: Burn injury is one of the most common and devastating forms of trauma in daily life. However, the exact sequence of events after burn injury remains unknown.

Objective: This study aims to investigate gene expression alterations after burn injury.

Methods: Microarray data set GSE8056 was downloaded from the Gene Expression Omnibus (GEO) database, including 12 samples, equally distributed in four groups: normal skin tissue as control and damaged tissues 1-3 days after burn (early period); 4-7 days after burn (middle period); and more than 7 days after burn (late period). Packages in R language were utilized to pre-process the data and filter out the differentially expressed genes (DEGs). Functional annotation of all three groups of DEGs was conducted by using clusters of orthologous groups analysis. The DEGs shared by all three groups were picked out and analyzed with STRING to set up a protein-protein interaction network. CFinder was chosen to implement module analysis, and expression analysis systematic explorer was then adopted to reveal the dysfunctional pathways for each module.

Results: A total of 727, 782, and 445 DEGs were identified in the early, middle, and late period after burn, and 234 DEGs were identified as continually differentially expressed throughout all time periods, including genes encoding proinflammatory cytokines, such as interleukin (IL)-6, IL-8, and IL-1β, and genes associated with cell proliferation. Three modules associated with cell proliferation and inflammatory responses were generated from the protein-protein interaction network.

Conclusion: Our findings are beneficial for understanding the progression of the wound healing response after burn.
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http://dx.doi.org/10.1111/ijd.12534DOI Listing
July 2015

[Analysis of chromosomal abnormalities and a report of eight new karyotypes among children in genetic counseling].

Zhongguo Dang Dai Er Ke Za Zhi 2014 Jul;16(7):725-8

Genetic and Metabolic Center Laboratory, Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning 530003, China.

Objective: To study the relationship between abnormal karyotypes and clinical phenotypes among children in genetic counseling in Guangxi Zhuang Autonomous Region, China.

Methods: We studied 601 children who visited Guangxi Zhuang Autonomous Region Women and Children Care Hospital for genetic counseling between January 2009 and July 2012. Blood samples were cultured routinely for karyotype analysis with G banding as well as clinical analysis.

Results: Out of 601 patients, 329 (54.7%) had chromosomal abnormalities, and 8 new abnormal human karyotypes were found. Among 329 children with abnormal karyotypes, 317 (96.4%) had an abnormal number of chromosomes, and 12 (3.6%) had abnormal chromosomal structure. Abnormal karyotypes were clinically manifested by Down's syndrome (74.5%), growth retardation (10.9%), and mental retardation (3.0%).

Conclusions: Eight rare abnormal karyotypes were found in the study, providing new resources for the genetic studies and etiological analysis of growth retardation, mental retardation, gonadal dysgenesis, and multiple congenital anomalies in children.
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July 2014

Human beta-defensin-3 for the diagnosis of periprosthetic joint infection and loosening.

Orthopedics 2014 Apr;37(4):e384-90

In this study, the difference in expression of human beta-defensin-3 in periprosthetic tissue and cancellous bone was observed in the periprosthetic tissue and cancellous bone of patients in the periprosthetic joint infection group, the aseptic loosening group, and the spacer treatment group as well as the synovial membrane and ilium of the normal control group. Hematoxylin and eosin staining of the synovial tissue showed different levels of neutrophil infiltration in all groups except for the normal control group. Immunofluorescence staining of periprosthetic tissue and cancellous bone showed the most positive cells expressing human beta-defensin-3 and the largest mean optical density in the periprosthetic joint infection group, followed by the aseptic loosening group, the spacer treatment group, and the normal control group, with a significant difference in comparison between the periprosthetic joint infection group and the other 3 groups (P<.01). White blood cell count, erythrocyte sedimentation rate, and C-reactive protein level were highest in the periprosthetic joint infection group, whereas no difference was found between the other 3 groups. Taken together, high levels of human beta-defensin-3 protein expression were found in the periprosthetic tissue and cancellous bone of patients with periprosthetic joint infection and aseptic loosening, but there are differential expressions of human beta-defensin-3, and this may provide a new marker for the differential diagnosis of infection and loosening of the artificial joint.
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http://dx.doi.org/10.3928/01477447-20140401-61DOI Listing
April 2014

Genistein alleviates radiation-induced pneumonitis by depressing Ape1/Ref-1 expression to down-regulate inflammatory cytokines.

Cell Biochem Biophys 2014 Jul;69(3):725-33

The aim of the study was to investigate the role of genistein in alleviating radiation-induced pneumonitis(RIP) through down-regulating levels of the inflammatory cytokines by inhibiting the expression of apurinic/apyrimidinic endonuclease 1/redox factor-1 (Ape1/Ref-1). Fifty female C57BL/6J mice (8 weeks old) were randomly divided into a control group, a pure irradiation (IR) group and a genistein + IR group. At the four time points after IR, hematoxylin, and Masson’s trichrome stainings were used to examine the pathological changes and collagen fiber deposition. Flow cytometry was used to detect reactive oxygen system (ROS) changes, EMSA was used to estimate the nuclear factor kappa B (NF-κB) transcriptional activities and an ELISA assay was used to measure the levels of TGF-β1, IL-1β, TNF-α, and IL-6 in the serum and bronchoalveolar lavage fluid (BALF) 2 weeks after IR.The pathological detection results showed acute inflammatory/fibrinoid exudation of the thoracic tissue after IR,which was significantly alleviated with genistein. The IR inducedan APE1 protein expression increase and NF-jB was effectively suppressed by genistein (P < 0.05). The induction of the inflammatory cytokines TGF-β1, IL-1β,TNF-α, and IL-6 by IR were in turn inhibited in the serum and BALF of the genistein-pretreated mice (P < 0.05). In addition, the ROS production was significantly boosted in the A549 cells after IR, which could be down-regulated by the pretreatment of genistein. The results demonstrate that genistein alleviates RIP by attenuating the inflammatory response in the initiation of RIP. A possible target of genistein is the Ape1/ref-1, which regulates key inflammatory cytokines by activating the NF-κB.
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http://dx.doi.org/10.1007/s12013-014-9859-xDOI Listing
July 2014

Open reduction and internal fixation of posterolateral tibial plateau fractures through fibula osteotomy-free posterolateral approach.

J Orthop Trauma 2014 Sep;28(9):513-7

*Department of Orthopedics, Wenzhou Medical College-Affiliated Yiwu Central Hospital, Yiwu, China; †Department 8, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, People's Republic of China; ‡Department of Anesthesiology, General Hospital of Chengdu Military Command, Chengdu, People's Republic of China; §Department of Orthopedics, The Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, China; and ‖Institute of Digital Medicine, Wenzhou Medical College, Wenzhou, China.

Objective: To evaluate the outcome of patients with posterolateral tibial plateau fractures after open reduction and internal fixation with a fibula osteotomy-free posterolateral approach.

Design: Retrospective chart and operation note review.

Setting: A medical college-affiliated tertiary hospital.

Materials And Methods: A retrospective chart and radiographic review of posterolateral tibial plateau fractures treated with a posterolateral approach between January 2006 and July 2010 was performed. The primary (ie, the total Rasmussen function score) and secondary (ie, the postoperative infection, knee deformity, and complications) outcomes were analyzed.

Results: A total of 32 patients were identified for this study. Patients were followed for an average of 18.2 months (range, 12-36 months); the total Rasmussen function score was 24.8 ± 2.9 points. The results were rated as excellent (≥27 points) in 19 patients, good (20-26 points) in 11, and fair (10-19 points) in 2 patients. No wound infections, screw loosening or implant fracture, and nonunion, deformity, or fracture redisplacement were seen. Stretch injury of the common peroneal nerve was found in 1 patient, who obtained recovery 2 months after additional conservative management.

Conclusions: Adequate open reduction and internal fixation with a fibula osteotomy-free posterolateral approach can attain a satisfactory clinical outcome for patients with posterolateral tibial plateau fractures.

Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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http://dx.doi.org/10.1097/BOT.0000000000000047DOI Listing
September 2014

Meta-analysis of the outcomes of intramedullary nailing and plate fixation of humeral shaft fractures.

Int J Surg 2013 28;11(9):864-8. Epub 2013 Aug 28.

Department 8, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, PR China. Electronic address:

Objective: The purpose of this study is to compare the outcomes of intramedullary nailing and plate fixation in the treatment of humeral shaft fractures using meta-analysis.

Methods: PubMed, MEDLINE, EMBASE, the Cochrane Controlled Clinical Trials Register (CCTR) databases were searched for studies that investigated the efficacy of intramedullary nailing and plate fixation in the management of humeral shaft fractures. Delayed healing rate, nonunion, postoperative infection and radial nerve paralysis were key outcomes of interest. Data were searched within the time period of July 1990 through September 2012. The statistical software RevMan 5.0 was used to analyze the statistical significance of the results.

Results: Total 459 cases of patients in 10 literature, including 231 cases of plate group and 228 cases of the intramedullary nailing groups were collected. The results of meta-analysis showed that delayed healing rate of humeral shaft fractures was lower in plate fixation compared with intramedullary nailing (RR = 2.64, 95% CI (1.08, 6.49), P < 0.05). No statistically significant difference in nonunion, postoperative infections, radial nerve paralysis and other complications was identified between nailing and plate fixation groups (P > 0.05).

Conclusions: In general, the effect size of intramedullary nailing may be comparable to that of plate fixation in the terms of nonunion, postoperative infections, radial nerve paralysis. The only slightly difference was identified in the event of delayed healing rate.
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http://dx.doi.org/10.1016/j.ijsu.2013.08.002DOI Listing
July 2014

[Cytogenetic analysis of 105 new human abnormal karyotypes].

Yi Chuan 2013 Jul;35(7):885-9

Guangxi Zhuang Autonomous Region Women and Children Care Hospital, Nanning, China.

To analyze the genetic effect of the abnormal chromosome karyotype, we summarized and studied the clinical data of the new abnormal karyotypes diagnosed at the Guangxi Zhuang Autonomous Region Women and Children Care Hospital from January 2009 to July 2012. The samples were cultured routinely for the karyotype analysis using G banding and C banding. Chromosomal aberrations were named according to the International System for Human Cytogenetic Nomenclature (ISCN 2009). Among tested samples, 105 new human abnormal karyotypes were identified (86 reciprocal translocation, 10 chromosomal inversion, six derivative chromosome, one duplication, one isochromosome, one partial trisomy and monosomy). The results suggest that chromosomal abnormalities were a major cause of miscarriage, infertility, congenital abnormalities, mental retardation and amenorrhea in humans.
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http://dx.doi.org/10.3724/sp.j.1005.2013.00885DOI Listing
July 2013

Dendritic development of hippocampal CA1 pyramidal cells in a neonatal hypoxia-ischemia injury model.

J Neurosci Res 2013 Sep 20;91(9):1165-73. Epub 2013 May 20.

Department of Neurobiology, College of Basic Medical Sciences, Chongqing Key Laboratory of Neurobiology, Third Military Medical University, Chongqing, China.

It is believed that neonatal hypoxia-ischemia (HI) brain injury causes neuron loss and brain functional defects. However, the effect of HI brain injury on dendritic development of the remaining pyramidal cells of the hippocampus and the reaction of contralateral hippocampal neurons require further studies. The Morris water maze and Golgi-Cox staining were used to evaluate the learning and memory and dendritic morphology of pyramidal cells. The results of Golgi-Cox staining showed CA1 pyramidal neurons of HI injury models with fewer bifurcations and shorter dendrite length than the naive control group. The density of dendritic spines of hippocampal CA1 pyramidal neurons was significantly lower in the HI brain injury group than in controls. With respect to hippocampal function, the HI brain injury group presented cognitive deficits in the reference memory task and probe trail. In the HI group, the pyramidal cells of left hippocampus that did not experienced ischemia but did experience hypoxia had more complex dendrites and higher density of spine than the HI injury side and control. The functional implementation of injured hippocampus might depend mainly on the hypertrophy of contralateral hippocampus after HI brain injury. Corticosterone can partially prevent the hippocampal pyramidal cells from HI injury and reduce the difference of the bilateral hippocampus pyramidal cells, but there was no improvement in learning and memory.
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http://dx.doi.org/10.1002/jnr.23247DOI Listing
September 2013

Operative versus non-operative treatment for clavicle fracture: a meta-analysis.

Int Orthop 2013 Aug 5;37(8):1495-500. Epub 2013 May 5.

Department 8, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, 400042, People's Republic of China.

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.
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http://dx.doi.org/10.1007/s00264-013-1871-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3728389PMC
August 2013

Effect of cervical sympathetic block on cerebral vasospasm after subarachnoid hemorrhage in rabbits.

Acta Cir Bras 2013 Feb;28(2):89-93

Department of Anesthesiology, People's Hospital of Guizhou Province, China.

Purpose: Cerebral vasospasm (CVS) is a major complication after subarachnoid hemorrhage (SAH) induced by the rupture of intracranial aneurysms. The aim of the present study was to investigate the effect and mechanism of cervical sympathetic block on cerebral vasospasm of the rabbits after SAH.

Methods: After successful modeling of cervical sympathetic block, 18 healthy male white rabbits were randomly divided into three groups (n=6), ie, sham operation group (Group A), SAH group (Group B) and SAH with cervical sympathetic block group (Group C). Models of delayed CVS were established by puncturing cisterna magna twice with an injection of autologous arterial blood in Groups B and C. A sham injection of blood through cisterna magna was made in Group A. 0.5 ml saline was injected each time through a catheter for cervical sympathetic block after the first injection of blood three times a day for 3 d in Group B (bilateral alternating). 0.5 ml of 0.25% bupivacaine was injected each time through a catheter for cervical sympathetic block after the first injection of blood three times a day for 7 d in Group B. 2 ml venous blood and cerebrospinal fluid were obtained before (T1), 30 min (T2) and 7 d (T3) after the first injection of blood, respectively, and conserved in a low temperature refrigerator. Basilar artery value at T1, T2 and T3 was measured via cerebral angiography. The degree of damage to nervous system at T1 and T3 was recorded.

Results: There was no significant difference in diameter of basilar artery at T1 among three groups. The diameters of basilar artery at T2 and T3 of Groups B and C were all smaller than that in Group A, which was smaller than Group C, with a significant difference. There was no significant difference in NO and NOS in plasma and cerebrospinal fluid among three groups. The NO and NOS contents at T2 and T3 of Groups B and C were all lower than Group A; Group C was higher than Group B, with a significant difference. The nerve function at T3 of Groups B and C were all lower than Group A and that of Group C higher than Group B, with a significant difference.

Conclusion: Cervical sympathetic block can relieve cerebral vasospasm after subarachnoid hemorrhage and increase NO content and NOS activity in plasma and cerebrospinal fluid to promote neural functional recovery.
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http://dx.doi.org/10.1590/s0102-86502013000200001DOI Listing
February 2013

BDNF expression with functional improvement in transected spinal cord treated with neural stem cells in adult rats.

Neuropeptides 2013 Feb 6;47(1):1-7. Epub 2012 Sep 6.

Institute of Neuroscience, Kunming Medical College, Kunming 650031, China.

Neural stem cells (NSC) could promote the repair after spinal cord transection (SCT), the underlying mechanism, however, still keeps to be defined. This study reported that NSC grafts significantly improved sensory and locomotor functions in adult rats with SCT in acute stage after injury. NSC could survive; differentiate towards neurons or glia lineage in vitro and vivo. Biotin dextran amine (BDA) tracing showed that little CST regeneration in the injury site, while SEP was recorded in NSC engrafted rats. Immunohistochemistry and Real time PCR confirmed that engrafted NSC expressed BDNF and increased the level of BDNF mRNA in injured site following transplantation. The present data therefore suggested that the functional recovery following SCT with NSC transplantation was correlated with the expression of BDNF, indicating the usage of BDNF with NSC transplantation in the treatment of SCI following injury.
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http://dx.doi.org/10.1016/j.npep.2012.06.001DOI Listing
February 2013

Treatment of unstable posterior pelvic ring fracture with percutaneous reconstruction plate and percutaneous sacroiliac screws: a comparative study.

J Orthop Sci 2012 Sep 19;17(5):580-7. Epub 2012 Jul 19.

Department of Orthopedics, Central Hospital of Yiwu City, Yiwu, Zhejiang Province, China.

Objective: The aim of this study is to compare the clinical effects of percutaneous reconstruction plate and percutaneous sacroiliac screws in treatment of unstable posterior pelvic ring fracture.

Methods: Fifty-eight patients with unstable posterior pelvic ring fracture treated with two methods from March 2002 to October 2007 were enrolled in the study and divided into two groups according to two kinds of internal fixation: percutaneous reconstruction plate (20 males and 9 females, at mean age 37.3 ± 11.3 years) and percutaneous sacroiliac screws (21 males and 8 females, at mean age 39.3 ± 10.4 years). Causes of injury included traffic accident in 38 patients, fall from height in 17, and crush in 3. The correlative data of operation duration, number of X-ray exposures, intraoperative bleeding volume, length of incision, Majeed postoperative functional evaluation, and postoperative complications were analyzed statistically.

Results: All 58 patients were followed up for 12-36 months (mean duration 21.3 months). There was statistical difference for operation duration, number of X-ray exposures, size of incision, and intraoperative bleeding volume between the two groups. Majeed postoperative functional evaluation indicated excellent and good rates of 86.1% for percutaneous reconstruction plate and 88.2% for percutaneous sacroiliac screws.

Conclusions: The clinical effect of the two methods is similar in treatment of Tile C pattern posterior pelvic ring fracture. However, the percutaneous reconstruction plate has lower risk of damaging nerves and blood vessels than the percutaneous sacroiliac screws. Moreover, intraoperative fluoroscopy is rarely performed.
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http://dx.doi.org/10.1007/s00776-012-0257-1DOI Listing
September 2012

Cystic adventitial disease of popliteal artery in a boy younger than 6 years old.

Eur J Pediatr Surg 2012 Dec 7;22(6):475-8. Epub 2012 Jul 7.

Department II of Orthopedics, Children's Hospital of Chongqing Medical University, Chongqing, China.

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http://dx.doi.org/10.1055/s-0032-1313347DOI Listing
December 2012

Treatment of unstable sacral fractures with percutaneous reconstruction plate internal fixation.

Acta Cir Bras 2012 May;27(5):338-42

Department of Orthopedics, Central Hospital of Yiwu City, China.

Purpose: To study the effects of percutaneous reconstruction plate internal fixation in the treatment of unstable sacral fractures.

Methods: Percutaneous reconstruction plate internal fixation was applied on 21 cases of unstable sacral fracture (15 males and six females, at age range of 16-65 years, mean 38.3 years) including four cases of Denis Zone I, 14 cases of Zone II and three cases of Zone III. In operation, an arc incision (about 3-5 cm long) was made along the iliac crest on the outside border of posterior superior iliac spine (PSIS) on both sides, and then the plate was transported from the wounded side to the opposite one through the subcutaneous tunnel.

Results: The mean incision length, operation time, intraoperative blood loss was 4.3 cm, 45.2 min, and 160.8 ml respectively. All these patients were followed up for 12-33 months (average 16.3 months), which showed no incision infection, intraoperative neurovascular injury, internal fixation loose or breakage, disunion, or obvious lower limb length inequality. The function result was rated as excellent in six cases, good in 12 and fair in 3, with excellence rate of 85.7%, according to the Majeed scoring system.

Conclusion: Percutaneous reconstruction plate internal fixation is an ideal surgical approach to unstable sacral fractures, as it is easy, safe, causing less trauma and fewer complications, and conducive to quicker recovery.
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http://dx.doi.org/10.1590/s0102-86502012000500010DOI Listing
May 2012
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