A rare complication of pelvic perforation by an excessive medial slide of the helical blade after treatment of an intertrochanteric fracture with proximal femoral nail anti-rotation: A case report and literature review.

Intertrochanteric fractures have become a severe public health problem in elderly patients. Proximal femoral nail anti-rotation (PFNA) is a commonly used intramedullary fixation device for unstable intertrochanteric fractures. Pelvic perforation by cephalic screw is a rare complication. We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture. The patient underwent surgery with PFNA as the intramedullary fixation device. Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation. We performed a cemented total hip arthroplasty as the savage procedure. At the latest follow-up of 12 months after total hip arthroplasty, the patient had no pain or loosening of the prosthesis in the left hip. Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device, especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation. The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.

Effects of surgical and nonoperative treatment on wrist function of patients with distal radius fracture.

PURPOSE: To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. METHODS: In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People's Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento's modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus. RESULTS: The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups. CONCLUSION: The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.

Respiratory Function Tolerance of Rats with Vaying Degrees of Thoracic Volume Reduction.

OBJECTIVE: To compare the effects of respiratory function on different degrees of reduced thoracic volume and evaluate the tolerance of rats with reduced thoracic volume, and to assess the feasibility of thoracic volume as a measure of the severity of rib fractures. METHODS: A total of 24 10-week-old female Sprague-Dawley (SD) rats were randomly divided into four groups (n = 6 in each group) according to the displacement degree of bilateral rib fractures (2, 4, 6, and 8 mm). The respiratory function of the rats（Tidal volume, Inspiration time, Expiration time, Breath rate, Minute volume, Peak inspiration flow) measured via whole-body barometric plethysmography before and after operation for 14 consecutive days. Respiratory function parameters of each group were analyzed. Chest CT scans were performed before and 14 days after operation, after that we reconstructed three-dimensional of the thoracic and lung and measured their volumes by computer software. We calculated the percentage of thoracic and lung volume reduction after operation. RESULTS: At the 14th day after the operation, the decline of thoracic volume rates of in the 2, 4, 6, and 8 mm groups were 5.20%, 9.01%, 16.67%, and 20.74%, respectively. The 8 mm group showed a significant reduction in lung volume. The postoperative tidal volumes were lower in each of the groups than the baseline values before the operation. The tidal volume of the 2 mm group gradually recovered after the operation and returned to a normal level (1.54 ± 0.07 mL) at 14th day after the operation. The tidal volume of the 4, 6, and 8 mm groups recovered gradually after the operation, but did not return to baseline level at the 14th day. In particular, the tidal volume of the 8 mm group was significantly lower than that of the other groups during the 14 days (1.23 ± 0.12 mL, p < 0.05). There were no significant changes in the inspiratory and expiratory times, peak inspiratory and expiratory flows, respiratory rate, and minute ventilation during the 14 days after the operation in each group. CONCLUSIONS: Displaced rib fractures lead to thoracic collapse and reduced thoracic volume, which can affect tidal volume in rats. The greater the decrease of thoracic volume, the more obvious the decrease of early tidal volume. The thoracic volume can be used as an objective parameter to evaluate the severity of multiple rib fractures. Early operation to restore thoracic volume may improve early respiratory function. Decreased thoracic volume affected respiratory function and can be compensated and recovered in the long term.

Red meat consumption and risk for dyslipidaemia and inflammation: A systematic review and meta-analysis.

Aim: The study (PROSPERO: CRD42021240905) aims to reveal the relationships among red meat, serum lipids and inflammatory biomarkers. Methods and results: PubMed, EMBASE and the Cochrane databases were explored through December 2021 to identify 574 studies about red meat and serum lipids markers including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP) or hypersensitive-CRP (hs-CRP). Finally, 20 randomized controlled trials (RCTs) involving 1001 people were included, red meat and serum lipid markers and their relevant information was extracted. The pooled standard mean difference (SMD) was obtained by applying a random-effects model, and subgroup analyses and meta-regression were employed to explain the heterogeneity. Compared with white meat or grain diets, the gross results showed that the consumption of red meat increased serum lipid concentrations like TG (0.29 mmol/L, 95% CI 0.14, 0.44,P<0.001), but did not significantly influence the TC (0.13 mmol/L, 95% CI -0.07, 0.33, P = 0.21), LDL-C (0.11 mmol/L, 95% CI -0.23, 0.45, P = 0.53), HDL-C (-0.07 mmol/L, 95% CI -0.31, 0.17, P = 0.57),CRP or hs-CRP (0.13 mmol/L, 95% CI -0.10, 0.37,P = 0.273). Conclusion: Our study provided evidence to the fact that red meat consumption affected serum lipids levels like TG, but almost had no effect on TC, LDL-C, HDL-C and CRP or hs-CRP. Such diets with red meat should be taken seriously to avoid the problem of high lipid profiles. Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO], identifier [CRD42021240905].

Assessment of thoracic volume changes after the collapse of lateral rib fractures based on chest computed tomography data: computer simulation and a multiple variable linear regression analysis.

BACKGROUND: Chest blunt trauma (CBT) and the resultant rib fractures often lead to thoracic collapse. The purpose of this study was to explore the effect of displacement of the rib fracture and thoracic collapse on the thoracic volume by using normal chest CT data. METHODS: In this retrospective study, seven consecutive normal participants were selected from our hospital between June and July 2018. Normal thoracic models were reconstructed, followed by simulation of lateral fractures through the 4th to 9th ribs under three collapse modes with 1-5 cm of collapse. The thoracic collapse models (n = 630) were reconstructed using 3Dmax 2014. We calculated the thoracic volume and reduction percentage for each thoracic collapse model. Linear regression-based comparisons of thoracic volume reductions were performed. RESULTS: In all three collapse modes, the degree of the collapse was linearly correlated with the mean thoracic volume reduction. The reduction percentage in the posterior collapse mode was higher than that in the anterior collapse mode (P < 0.001). The largest volume reductions in the anterior, posterior, and simultaneous collapse models were in the 6th rib fracture model (P < 0.001), 8th rib fracture model (P < 0.001), and 7th rib fracture model (P < 0.001), respectively. CONCLUSIONS: The influences of rib fracture displacement and collapse on the thoracic volume in the 6th through 8th ribs are critical in lateral rib fractures. For patients with 6th to 8th rib fractures and posterior rib collapse, surgical intervention to restore thoracic volume may be more essential.

[Nitrogen Removal from Mature Landfill Leachate via Denitrification-Partial Nitritation-ANAMMOX Based on a Zeolite Biological Aerated Filter].

A combined process of denitrification-partial nitritation-ANAMMOX based on a zeolite biological aerated filter (ZBAF) was applied to treat mature landfill leachate. We investigate the partial nitritation characteristics of the ZBAF and the nitrogen removal performance as well as the carbon removal performance of the combined process. Results showed that, based on the selective inhibition of nitrite oxidizing bacteria (NOB) by free ammonia (FA), the ZBAF could successfully achieve stable and efficient partial nitrification of mature landfill leachate, with an average nitrite accumulation rate (NAR) of 93.8% and a maximum nitrite production rate (NPR) of 1.659 kg·(m3·d)-1. After adding 700 mg·L-1 glucose to the influent, due to the synergistic effect of denitrification and anammoxidation, the combined process achieved its best nitrogen removal performance at a reflux ratio of 2.0 and hydraulic retention time (HRT) of 2.2 days. The average ammonia removal efficiency (ARE), total nitrogen removal efficiency (NRE), total nitrogen removal loading rate (NRR), and average chemical oxygen demand (COD) removal efficiency were 97.2%, 90.0%, 0.585 kg·(m3·d)-1, and 45.3%, respectively. Furthermore, the NRR of the anaerobic ammonium oxidation (ANAMMOX) process (NRRANA) reached 1.268 kg·(m3·d)-1. High-throughput sequencing technology was used to analyze the microbial community structure in each device. Results showed that denitrifiers (Paracoccus and Comamonas), ammonia-oxidizing bacteria (AOB) (Nitrosomonas), and ANAMMOX bacteria (Candidatus Kuenenia and Candidatus Anammoxoglobus) were the dominant bacteria in the UASB, ZBAF, and ANAMMOX reactor, respectively, which corresponded to the stable nitrogen removal performance of the combined process.

Three-dimensional printed navigational template for localizing small pulmonary nodules: A case-controlled study.

BACKGROUND: Localization of small pulmonary nodules is an inevitable challenge for the thoracic surgeon. This study aimed to investigate the accuracy of three-dimensional (3D) printing technology for localizing small pulmonary nodules, especially ground-glass nodules (GGNs). METHODS: This study enrolled patients with peripheral small pulmonary nodules (≤ 2 cm) who required preoperative localization. In the comparison period, patients underwent both computed tomography-guided (CT-G) and 3D-printing template guided (3D-G) localization to compare the accuracies of the two methods. In the testing period, the 3D-printing technique was implemented alone. The 3D-printing physical navigational template was designed based on data from perioperative CT images. Clinical data, imaging data, surgical data, and evaluation index were collected for further analysis. The learning curve of the 3D-printing localization technique was assessed using cumulative sum (CUSUM) analysis and multiple linear regression analysis. RESULTS: In the comparison period (n = 14), the success rates of CT-G and 3D-G were 100% and 92.9% (P = 0.31), respectively; in the testing period (n = 23), the success rate of 3D-G was 95.6%. The localization times of CT-G, 3D-G (comparison), and 3D-G (testing) were 23.6 ± 5.3, 19.3 ± 6.8, and 9.8 ± 4.6 minutes, respectively. The CUSUM learning curve was modeled using the equation: Y = 0.48X2 - 0.013X - 0.454 (R2 = 0.89). The learning curve was composed of two phases, phase 1 (the initial 20 patients) and phase 2 (the remaining 17 patients). CONCLUSIONS: 3D printing localization has adequate accuracy and is a feasible and accessible strategy for use in localizing small pulmonary nodules, especially in right upper lobe. The use of this technique could facilitate lung nodule localization prior to surgery.

Pressure effect on structural and vibrational properties of Y-substituted BiFeO3.

The structural and vibrational properties of 5% Y-substituted BiFeO3 under pressure have been investigated using synchrotron x-ray diffraction (SXRD) and Raman scattering measurements. At a pressure below 30.3 GPa, distinct changes in the Raman spectra and SRXD pattern show evidence for one pressure-induced structural transition from the polar rhombohedral R3c phase to the nonpolar orthorhombic Pnma phase commencing at 3.6 and completed at 7.2 GPa, where there is a region of phase coexistence between the R3c and Pnma phases. At a higher pressure of 40.8 GPa, another phase transition from orthorhombic to cubic is observed accompanied by the insulator-metal transition. Our data do not suggest the pressure-induced re-entrance of ferroelectricity in the model multiferroic Bi0.95Fe0.05O3 in the pressure range studied.