Comparison of femoral neck system and cannulated compression screws in the fixation of femoral neck fractures in the elderly patients aged 65 to 75 years old / 中华创伤骨科杂志

Objective:To compare the therapeutic efficacy between femoral neck system (FNS) and cannulated compression screws (CCS) in the fixation of femoral neck fractures in the elderly patients aged 65 to 75 years old.Methods:A retrospective study was conducted to analyze the data of 39 patients aged 65 to 75 years old who had been treated for femoral neck fractures at Department of Trauma Surgery, Hospital Affiliated to Qingdao University from January 2015 to September 2022. The patients were divided into 2 groups according to their internal fixation methods. In the FNS group of 18 cases subjected to FNS fixation, there were 8 male and 10 females with an age of (71.1±2.8) years. In the CCS group of 21 cases subjected to CCS fixation, there were 7 males and 14 females with an age of (70.1±2.9) years. The 2 groups were compared in terms of intraoperative fluoroscopy frequency, surgical time, intraoperative bleeding, hospitalization costs, fracture healing time, internal fixation failure, and Harris hip score, changes in neck shaft angle, and femoral neck shortening at 1 year after surgery.Results:The differences were not statistically significant in the preoperative general data or follow-up time between the 2 groups, indicating comparability ( P>0.05). In the FNS group, the intraoperative fluoroscopy frequency [(15.1±2.3) times] was significantly lower than that in the CCS group [(19.5±3.5) times], the surgical time [(49.2±5.2) minutes] was significantly shorter than that in CCS group [(62.4±11.2) minutes], and the intraoperative bleeding [(74.2±15.6) mL] and hospitalization costs [(39,928.7±1,438.3) yuan] were significantly higher than those in the CCS group [(53.1±17.3) mL and (23,527.9±2,126.3) yuan] (all P<0.05). The difference in fracture healing time was not statistically significant between the 2 groups ( P>0.05). In the FNS group, the decreased neck shaft angle (2.65°±1.66°) and femoral neck shortening (3.9±1.3 mm) were significantly smaller than those in the CCS group [4.18°±2.13° and (6.3±2.5) mm] at 1 year after surgery, and the Harris hip score [(82.2±7.2) points] was significantly higher than that in the CCS group [(76.4±5.9) points] (all P<0.05). Internal fixation failure occurred in 1 case in the FNS group and in 4 cases in the CCS group, respectively, showing no statistically significant difference ( P>0.05). Conclusions:Compared with CCS fixation, FNS fixation may lead to better therapeutic efficacy in patients with femoral neck fracture aged 65 to 75 years old. However, the risk of internal fixation failure should also be taken into consideration.

Efficacy of locking plate internal fixation combined with iliac bone grafting in the treatment of comminuted proximal humeral fracture in the elderly / 中华创伤杂志

Objective:To compare the efficacy between locking plate internal fixation combined with iliac bone graft and separate locking plate internal fixation in the treatment of comminuted proximal humeral fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 42 elderly patients with comminuted proximal humeral fracture admitted to Affiliated Hospital of Qingdao University from January 2018 to January 2020. There were 20 males and 22 females, aged 65-75 years [(69.5±8.5)years]. According to Neer classification, there were 26 patients with three-part fracture and 16 with four-part fracture. Eighteen patients were treated by locking plate internal fixation combined with autologous iliac bone grafting (bone grafting group), and 24 patients were treated by locking plate internal fixation alone (non-bone grafting group). The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization time, and fracture healing time were documented. Shoulder joint range of motion (forward flexion, extension, internal rotation and external rotation) and degree of humeral head height loss were measured at 1, 6, 12 months after operation and at the last follow-up. The Neer score and visual analogue score (VAS) of shoulder joint were evaluated at 12 months after operation and at the last follow-up. The complications were observed.Results:All patients were followed up for 12-24 months [(18.5±3.8)months]. There were no significant differences in operation time, intraoperative blood loss, postoperative drainage volume and hospitalization time between the two groups (all P>0.05). The fracture healing time in bone grafting group was (3.1±0.7)months, shorter than (4.2±0.9)months in non-bone grafting group ( P<0.05). In the two groups, the postoperative shoulder joint range of motion and degree of humeral head height loss increased significantly over time (all P<0.05). At 1, 6, 12 months after operation and at the last follow-up, the shoulder forward flexion range of motion in bone grafting group was (136.2±7.4)°, (139.3±6.9)°, (146.6±6.1)° and (148.4±4.7)°, higher than that in non-bone grafting group [(134.5±6.7)°, (136.5±7.0)°, (137.9±9.2)° and (138.3±7.9)°]; the shoulder extension range of motion in bone grafting group was (37.1±6.3)°, (40.5±4.4)°, (43.1±3.1) ° and (46.6±4.2)°, higher than that in non-bone grafting group [(35.5±4.6)°, (37.9±5.1)°, (41.3±2.5)° and (43.9±3.1)°]; the shoulder internal rotation range of motion in bone grafting group was (50.5±3.2)°, (54.1±5.6)°, (56.6±4.2)° and (58.9±3.6)°, higher than that in non-bone grafting group [(46.9±5.1)°, (50.3±4.2)°, (53.5±2.7)° and (55.4±5.1)°]; the shoulder external rotation range of motion in bone grafting group was (52.2±3.6)°, (55.6±4.3)°, (58.7±4.4)° and (60.2±5.6)°, higher than that in non-bone grafting group [(50.1±4.7)°, (52.6±5.7)°, (55.3±3.2)° and (57.3±4.1)°] ( P<0.05 or 0.01). At 1, 6, 12 months after operation and at the last follow-up, the degree of humeral head height loss in bone grafting group was (0.8±0.1)mm, (1.1±0.2)mm, (1.4±0.3)mm and (1.6±0.3)mm, smaller than that in non-bone grafting group [(1.1±0.2)mm, (1.4±0.3)mm, (1.7±0.6)mm and (2.0±0.5)mm] ( P<0.05 or 0.01). In the two groups, the postoperative shoulder joint range of motion and degree of humeral head height loss increased significantly over time (all P<0.05). There was no significant difference in Neer score of shoulder joint between the two groups before operation ( P<0.05). At 1, 6, 12 months after operation and at the last follow-up, the Neer score of shoulder joint in bone grafting group was (80.2±5.4)points, (82.1±5.0)points, (85.4±5.8) points and (90.3±4.6)points, higher than that in non-bone grafting group [(75.6±5.1)points, (80.4±5.5)points, (83.5±2.2)points and (87.4±4.8)points] ( P<0.05 or 0.01). There was no significant difference in VAS between the two groups before operation, at 1, 6, 12 months after operation or at the last follow-up (all P>0.05). The complication rate was 11.1% (2/18) in bone grafting group and was 20.8% (5/24) in non-bone grafting group ( P<0.05). Conclusions:For comminuted proximal humeral fractures in the elderly, locking plate internal fixation combined with autogenous iliac bone grafting can accelerate fracture healing, improve shoulder joint range of motion, promote functional recovery, and reduce complications in comparison with locking plate internal fixation alone.

A comparative clinical investigation of tibial plateau fractures managed with double reverse traction reducers / 中华骨科杂志

Objective:To evaluate the clinical outcomes of internal fixation using double reverse traction reducers in the treatment of tibial plateau fractures.Methods:This study retrospectively examined the medical records of 48 patients who underwent surgical intervention for tibial plateau fractures at the Affiliated Hospital of Qingdao University between January 2021 and September 2022. The cohort, aged between 35 to 68 years (mean: 53.0±7.9 years), included 23 males and 25 females. Fractures were classified according to the Schatzker system, with 9 type III, 23 type IV, 11 type V, and 5 type VI fractures recorded. Patients were divided into two groups based on the surgical approach: the minimally invasive group underwent treatment with double reverse traction reducers for reduction and internal fixation in 24 cases, while the open group received conventional open reduction and internal fixation in 24 cases. Comparative parameters included operation duration, intraoperative blood loss, hospital stay, early postoperative knee mobility, and weight-bearing timelines. Postoperative radiographic images were appraised using the Rasmussen imaging score, and knee functionality was assessed at the final follow-up with the Hospital for Special Surgery (HSS) score and the International Knee Documentation Committee (IKDC) score.Results:The preoperative general data were statistically indifferent between groups ( P>0.05). All patients were followed for 13.5±4.3 months (range, 9.5-24 months). In the minimally invasive group, operative time was 88.96±19.04 minutes, intraoperative blood loss was 65±32 ml, and hospital stay was 11.8±3.9 days. Early postoperative knee joint activity commenced at 8.96±2.84 days, significantly earlier compared to the open group, which recorded 178.63±67.75 minutes of surgery, 114.16±65.05 ml blood loss, a 15.3±4.8 days hospital stay, and 16.83±4.09 days to knee joint movement. The difference was statistically significant ( P<0.05). No significant variation was observed in the time to bone healing between the minimally invasive group at 12.6±3.8 weeks and the open group at 13.21±4.98 weeks ( P>0.05). Rasmussen imaging criteria revealed 21 excellent and 3 good outcomes in the minimally invasive group, and 19 excellent and 5 good in the open group, with no statistical significance in the excellent-good rate differentiation ( P>0.05). Bone healing occurred within 3.2±0.8 months (range, 2.5-6.0 months), with 79% (19/24) in the minimally invasive group and 75% (18/24) in the open group achieving healing within 3 months. The open group had one incidence of superficial skin infection, and one patient in the minimally invasive group developed deep vein thrombosis (DVT); no other related complications were documented. Conclusion:Minimally invasive treatment of tibial plateau fractures using double reverse traction reducers offers significant benefits, including reduced surgical time, minimal blood loss, less soft tissue trauma, and enhanced joint function recovery. This approach is particularly advantageous in managing complex tibial plateau fractures compared to traditional open reduction and internal fixation methods.

Automatic removal algorithm of electrooculographic artifacts in non-invasive brain-computer interface based on independent component analysis / 生物医学工程学杂志

The non-invasive brain-computer interface (BCI) has gradually become a hot spot of current research, and it has been applied in many fields such as mental disorder detection and physiological monitoring. However, the electroencephalography (EEG) signals required by the non-invasive BCI can be easily contaminated by electrooculographic (EOG) artifacts, which seriously affects the analysis of EEG signals. Therefore, this paper proposed an improved independent component analysis method combined with a frequency filter, which automatically recognizes artifact components based on the correlation coefficient and kurtosis dual threshold. In this method, the frequency difference between EOG and EEG was used to remove the EOG information in the artifact component through frequency filter, so as to retain more EEG information. The experimental results on the public datasets and our laboratory data showed that the method in this paper could effectively improve the effect of EOG artifact removal and improve the loss of EEG information, which is helpful for the promotion of non-invasive BCI.

Optimization of xylose fermentation for ethanol production by Candida shehatae HDYXHT-01 / 生物工程学报

Plackett-Burman (PB) design and central composite design (CCD) were applied to optimize of xylose fermentation for ethanol production by Candida shehatae HDYXHT-01. The PB results showed that (NH4)2SO4, KH2PO4, yeast extract and inoculum volume were the main affecting factors. With ethanol productivity as the target response, the optimal fermentation was determined by CCD and response surface analysis (RSM). The optimal fermentation conditions were (NH4)2SO4 1.73 g/L, KH2PO4 3.56 g/L, yeast extract 2.62 g/L and inoculum volume 5.66%. Other fermentation conditions were xylose 80 g/L, MgSO47H20 0.1 g/L, pH 5.0 and 250 mL flask containing 100 mL medium and cultivated at 30 degrees C for 48 h and the agitation speed was 140 r/min. Under this fermentation conditions, ethanol productivity was 26.18 g/L, which was 1.15 times of the initial.

Long-term effects of vascularized pisiform transfer for Kienb(o)ck's disease / 中华骨科杂志

Objective To evaluate the long-term efficacy of vascularized pisiform transfer for patients with Kienb(o)ck's disease in Lichtman stages Ⅲ-Ⅳ. Methods Eleven patients were reviewed to analyze results after lunate resection and vascularized pisiform transfer for Lichtman stages Ⅲ and Ⅳ. There were six men and five women. Age ranged from 20 to 67 years with a average of 41.0±14.3 years. According to Lichtman stage. There were 4 cases in stage Ⅲa, 5 cases in stage Ⅲb, and 2 cases in stage Ⅳ. Assessment criteria included subjective assessment of pain, visual analogue scale (VAS), range of motion (ROM), grip power,Cooney wrist score and radiographic changes on each follow-up visit. The radiographic changes including pis iform bone location, shape, sclerosis change, osteoarthritis, carpal height ratio, Nattrass index, Radioscaphoid angle and ulnar variance were recorded. Results The follow-up periods of all of cases were 61-202 months,with an average of 104.1 months. Pain had improved in 10 patients and disappeared in 7 cases. The VAS score was 2.2±1.9 at follow-up visit. Range of motion of injured wristw as only 65.3% of opposite side. Grip power was 84.3% of the contralateral hand. According to Cooney score, the results were excellent in 1 case, good in 7cases, fair in 2 cases and poor in 1 case, with the excellent and good rate of 72.7%. Radiologically, 8 cases had normal position of the pisiform bone, 2 had volar displacement and 1 had ulnar displacement which leaded to widen scaphopisiform space. Six pisiform bones had normal trabecular structure, three had degenerative changes. Bone sclerosis was seen in 2 cases and osteoarthritis was found in 3 patients. Compared with radiographic parameter before surgery, carpal height ratio and Nattrass index significantly lowered and radioscaphoid angle significantly increased. Conclusion Lunate resection and vascularized pisiform transfer is an effective method for Kienb(o)k′s disease in stages Ⅲ-Ⅳ. Although carpal collapse appeared postoperatively,the results show high patient satisfaction and good function after vascularized bone transplantation.