ABSTRACT
Objective:To investigate the effect of cranioplasty with polyetheretherketone (PEEK) after craniectomy in patients with traumatic brain injury (TBI).Methods:A retrospective case series study was used to analyze the clinical data of 85 TBI patients undergone craniectomy admitted to Renji Hospital, Shanghai Jiaotong University School of Medicine from February 2017 to April 2021, including 57 males and 28 females, aged 7-70 years [(40.8±15.5)years]. Patients′ Glasgow Coma Scale (GCS) was 6-15 points [15 (13, 15)points]. All patients underwent PEEK cranioplasty as scheduled. The extended Glasgow Outcome Scale (GOSE) was used to evaluate the neurological function before, at 3 and 6 months after operation. After excluding 33 patients with preoperative GOSE score of 8 points, 52 patients with preoperative GOSE score less than 8 points were analyzed on the degree of GOSE improvement. Patients′ satisfaction with PEEK repair was evaluated through telephone interviews at 6 months postoperatively. The incidence of complications were observed during hospitalization and within 6 months postoperatively.Results:All patients were followed up for 6-7 months [6 (6, 7)months]. The GOSE was 6 (5, 8)points before operation, 6 (5, 8)points at 3 months after operation, and 7 (5, 8)points at 6 months after operation. There was no significant difference in GOSE at 3 months after operation and before operation ( P>0.05), but it was significantly increased at 6 months after operation when compared to the preoperative level ( P<0.05). With regards to GOSE, there were 10 patients with mild amelioration but 42 with no amelioration at 3 months after operation, while 4 patients with significant amelioration and 31 with no amelioration were observed at 6 months after operation ( P<0.05). For PEEK repair, Patients′ satisfaction was very high in 43 patients, high in 33, general in 7 and poor in 2. A total of 25 patients had postoperative complications during hospitalization and within 6 months postoperatively, with the incidence of complications of 29%. Specifically, there was 1 patient with wound infection, 1 new epilepsy, 8 epidural hemorrhage, 13 subcutaneous effusion, 1 subcutaneous effusion, severe infection and material exposure, and 1 severe infection, new-onset epilepsy and subcutaneous effusion. Repair materials were removed in 2 patients due to multiple complications; other patients obtained alleviation via treatment, without affect on their daily life. Conclusion:PEEK cranioplasty following craniectomy for TBI patients can improve prognosis, attain high satisfaction and has low incidences of postoperative infection and exposure of repair materials.
ABSTRACT
The prevalence of child and adolescent growth and mental-behavior related diseases are increasing,and the pathogcnesis are complex.Twins are excellent natural resources for complex chronic diseases research as they share the maternal intrauterine environment,born at the same time and share the same family environment in early years,which could benefit the adjust ment of confounding factors,such as age,genetic factors and early family environmental factors.Birth cohort with twin families involved could be more effective in exploring the genetic and environmental factors for complex chronic diseases at the very beginning of life.This paper summarizes the objective,content,progress,strengths and potential problems of Wuhan Twin Birth Cohort,with emphasis on the overall design and progress of the study.
ABSTRACT
The prevalence of child and adolescent growth and mental-behavior related diseases are increasing,and the pathogcnesis are complex.Twins are excellent natural resources for complex chronic diseases research as they share the maternal intrauterine environment,born at the same time and share the same family environment in early years,which could benefit the adjust ment of confounding factors,such as age,genetic factors and early family environmental factors.Birth cohort with twin families involved could be more effective in exploring the genetic and environmental factors for complex chronic diseases at the very beginning of life.This paper summarizes the objective,content,progress,strengths and potential problems of Wuhan Twin Birth Cohort,with emphasis on the overall design and progress of the study.