The antibacterial and antialgal enhancement of the hydroquinone acrylamide polyurethane coating based on microphase separation.

The undesirable and inevitable adhesion of marine organisms on submerged surfaces has seriously affect the environment, economy and society, so emerging and promising strategies for antifouling are required. Here, the novel and environmental strategy of the antibacterial and antialgal materials was proposed for the application of the antifouling coating without releasing harmful substances. The environment-friendly antifouling agent, the capsaicin derivative N-(2,5-dihydroxy-4-acrylamide meth-ylbenzyl)acrylamide (PHABA), was modified to the molecular chain of the polyurethane. The best tensile strength was up to 23.5 MPa of PUP-25% and the elongation at break was 415% of PUP-25%. The excellent wear resistance (300 wear cycles) and chemical solution resistance (H2SO4, NaOH, and NaCl solutions) revealed the applicability of the coating. PHABA would migrate to the surface of the polyurethane coating with time and enhanced the antibacterial and antialgal properties of the coating. PUP-25% prevented more than 90% of bacterial and algal adhesion, indicating the potential application of the antifouling coating.

Plate augmentation and hybrid bone grafting are effective treatments for atrophic nonunion of the femur with the original intramedullary nail retained in situ.

The purpose of this study is to evaluate the efficacy of plate augmentation and hybrid bone grafting for treating atrophic nonunion of the femur with original intramedullary nail retained in situ.In this study, 36 patients with atrophic nonunion of the femur who underwent surgery using the technique of plate augmentation and a hybrid bone grafting while retaining the original intramedullary nail in situ in Xi'an Honghui Hospital from January 2019 to December 2021 were enrolled. 28 patients who met the inclusion and exclusion criteria were ultimately included in the study. These 28 patients, consisting of 20 males and 8 females with a mean age of 38 years, were evaluated based on factors such as operation time, intraoperative blood loss, the average hospitalization days. Additionally, the results and function of these patients were evaluated by union time, Wu's scores of limb function and incidence of serious complications.All 28 patients achieved bone union at the 12 month follow-up, with an average follow-up time of 14.6 ± 4.2 months.The average operation time was 68.3 ± 11.2 min, and the average intraoperative blood loss was 140 ± 22.6 ml. Patients were hospitalized for an average of 5.8 ± 1.1 days. Full clinical and radiological bone union was achieved on average at 5.1 ± 1.9 months. The mean value of Wu's scores at the 12 month follow-up was significantly higher than before the operation. Limb function was excellent in 27 patients and good in one patient at the 12 month follow-up. However, five patients experienced the lower limb vein thrombosis, including one deep vein thrombosis and four lower limb intermuscular vein thromboses. One patient had a superficial infections of the surgical incision site, while three patients reported pain and numbness where their iliac bone graft was extracted at the 12 month follow-up. The technique of plate augmentation and hybrid bone grafting, combined with retaining the original intramedullary nail in situ has been shown to be a safe, effective, simply and standardizable practice for treating atrophic femoral nonunion with an intact original IMN fixation.

Research progress of bionic intramedullary nail of proximal femur based on "lever-fulcrum balance and reconstruction" theory in the treatment of senile intertrochanteric femoral fractures / 国际外科学杂志

Femoral intertrochanteric fracture is one of the common types of fractures in the elderly. With the general improvement of medical and living standards, the number of elderly people is increasing, and the problem of osteoporosis has also become relatively prominent. Therefore, low violence can usually cause fractures in this area of the elderly, which has a significant negative impact on the quality of life of elderly patients. With the further development of medical technology and internal fixation materials, the emergence of proximal femoral nail antirotation(PFNA) has greatly improved the treatment effect of femoral intertrochanteric fractures in elderly patients. However, with the increasing number of patients treated, internal fixation failures have gradually been reported. In recent years, proximal femoral biomimetic intramedullary nail(PFBN) has been reported to have good clinical efficacy. Therefore, this article mainly elaborates on the theoretical basis, design characteristics, biomechanics, and clinical efficacy research of PFBN, providing more reference for the clinical treatment of femoral intertrochanteric fractures in elderly patients in the future.

Hydralazine represses Fpn ubiquitination to rescue injured neurons via competitive binding to UBA52 / 药物分析学报

A major impedance to neuronal regeneration after peripheral nerve injury(PNI)is the activation of various programmed cell death mechanisms in the dorsal root ganglion.Ferroptosis is a form of pro-grammed cell death distinguished by imbalance in iron and thiol metabolism,leading to lethal lipid peroxidation.However,the molecular mechanisms of ferroptosis in the context of PNI and nerve regeneration remain unclear.Ferroportin(Fpn),the only known mammalian nonheme iron export protein,plays a pivotal part in inhibiting ferroptosis by maintaining intracellular iron homeostasis.Here,we explored in vitro and in vivo the involvement of Fpn in neuronal ferroptosis.We first delineated that reactive oxygen species at the injury site induces neuronal ferroptosis by increasing intracellular iron via accelerated UBA52-driven ubiquitination and degradation of Fpn,and stimulation of lipid peroxidation.Early administration of the potent arterial vasodilator,hydralazine(HYD),decreases the ubiquitination of Fpn after PNI by binding to UBA52,leading to suppression of neuronal cell death and significant ac-celeration of axon regeneration and motor function recovery.HYD targeting of ferroptosis is a promising strategy for clinical management of PNI.

Neoadjuvant Chemotherapy Is Effective in Those Infected With SARSCoV-2: The Real-World Experience of a Large Chinese Breast Cancer Center / 한국유방암학회지

Purpose@#During the major shift in China's policies on coronavirus disease 2019 (COVID-19), many residents will be infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) over a short period, including a few patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Moreover, it is unknown whether this comorbidity affects the efficacy of NAC for breast cancer and the patient's psychological state and quality of life (QOL). This study aims to answer these questions. @*Methods@#The clinical data of 2,793 patients with breast cancer who received NAC at The Affiliated Hospital of Qingdao University were retrospectively collected. The infected and non-infected groups were divided according to whether they were infected with COVID-19 during NAC. Propensity score matching was used to reduce patient selection bias. The effectiveness, psychological well-being, and QOL of the two groups were compared. @*Results@#No discernible differences were observed in the pathological complete response rates (p = 0.307) and major histological responses rate (p = 0.398) between the infected and non-infected groups. Following the full course of NAC, the Functional Assessment of Cancer Treatment General (p < 0.001) and Functional Assessment of Cancer Therapy for Breast Cancer (p < 0.001) were lower in the infected group than the non-infected group, the Hospital Anxiety and Depression Scale (HADS) anxiety scale (p < 0.001) and HADS depression scale (p < 0.001) were considerably higher in the infected group than the non-infected group. @*Conclusion@#With timely treatment and effective medical management, SARS-CoV-2 does not appear to affect the efficacy of NAC; however, it can significantly affect the QOL of patients and increase their psychological distress. Therefore, in addition to a timely assessment of the efficacy of NAC, it is necessary to dynamically understand the patient's psychological state and QOL.

Reliability of ICF dysfunction combination in rehabilitated inpatients / 中国现代医生

@#Objective To explore the inter-rater and within-rater reliability of the 30 categories of the International Classification of Functioning Disability,and Health(ICF)dysfunction set(ICF generic-30 set)in clinical function assessment,to provide a basis for its clinical application.Methods Ninety patients from the Neurorehabilitation Department of the First People's Hospital of Suqian City were enrolled in this study.All patients were evaluated by the same functional evaluator's ICF dysfunction combination at the two time points of admission and discharge for the internal reliability analysis of the evaluator.Thirty patients in the neurorehabilitation department were randomly selected to be evaluated by two ICF function evaluators at the same time to conduct test-retest reliability analysis among evaluators.The internal consistency of the Cronbach's α coefficient test scale,and the intra-group correlation coefficient(ICC)test inter-rater reliability and within-rater reliability.Results The Cronbach's α coefficients of the combination of ICF dysfunction,physical function and activity,and participation in the two subscales were 0.941,0.717,and 0.942,respectively.The inter-rater reliability analysis showed that the ICC of the total score of the scale and the total scores of physical function and activity and participation in the two subscales were 0.998,0.971,0.999(P<0.01),and the inter-rater reliability good;the internal reliability analysis of the evaluator showed that the total score of the scale and the total scores of physical function and activity and participation in the two subscales were 0.988,0.917,0.991(P<0.01),except that b640 sexual function is not applicable,and b130 energy Harmony drive function ICC is 0.558,b280 pain ICC is 0.409,ICC of other combination items is 0.838-0.986(P<0.01),the evaluator's internal reliability is good;90 patients'ICF dysfunction combination scale has 30 categories.The comparison between admission and discharge was statistically significant except that b640 was not applicable for sexual function(P<0.05).Conclusion The combination of ICF dysfunction has good internal consistency and inter-evaluator and intra-evaluator reliability in the functional evaluation of patients in neurorehabilitation department.

Anterolateral or Posteromedial Plate-Assisted Intramedullary Nailing for Fixation of Proximal Third Tibia Fractures: A Biomechanical Study / 医用生物力学

Objective To study the stability of plate-assisted intramedullary nailing for fixing proximal third tibiafractures, compare and observe biomechanical characteristics of anterolateral or posteromedial plate-assisted intramedullary nailing after fixation of proximal third tibia fractures. Methods Eight artificial tibia of 4th-generation sawbones were divided into two groups based on location of the assisted plate, namely, anterolateral plate group and posteromedial plate group, with 4 specimens in each group. Each two locking bolts were fixed to theintramedullary nail proximally and distally, and each three bicortical screws were fixed to the plate proximally and distally. The specimens were osteotomized with a 10-mm defect which located 0. 5 cm to the proximal locking bolt of intramedullary nail or 5-6 cm distally to the knee joint line, in order to simulate an AO/ OTA 41-A2 type proximal third tibia fracture after fixation of intramedullary nail. After osteotomy was finished, axial compression test, three point bending test, cyclic loading and overstress test were conducted by mechanical testing machine. The results of axial stiffness and three-point stiffness between two groups were compared and analyzed. Results Axial compression test showed that the average axial stiffness in posteromedial plate group was lower than that in anterolateral plate group, but no significantly statistical differences were found between the two groups. Three point bending test showed that the average bending stiffness in posteromedial plate group was significantly higher than that in anterolateral plate group when stimulating either varus stress (plate located at pressure side of the fracture, t = 3. 679, P<0. 05) or valgus stress (plate located at tension side of the fracture, t = 8. 975, P<0. 05). Conclusions Plate-assisted intramedullary nailing for fixation of proximal third tibia fractures can minimize the angulation malalignment, improve the stability of nailed proximal tibial fragment and allow the early weight bearing. Both anterolateral and posteromedial plate-assisted intramedullary nail can provide satisfactory axial stability for proximal third tibia fractures, while posteromedial plate-assisted intramedullary nail shows better bending stability than anterolateral plate in countering varus or valgus stress deformity. This study provides an essential basis for clinical decision making about plate-assisted intramedullary nailing for fixing proximal third tibia fractures.

Comparison of acute shortening-lengthening and antibiotic calcium sulfate-loaded bone transport for the treatment of segmental tibial defects after trauma / 国际外科学杂志

Objective:To compare the clinical effects of acute shortening-lengthening technique with antibiotic calcium sulfate-loaded bone transport technique for the treatment of segmental tibial defects after trauma.Methods:The clinical data of 58 patients with large tibial defects treated by Ilizarov technique in Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from May 2014 to December 2019 were retrospectively analyzed. Thirty patients were treated by acute shortening-lengthening (group A), and they were divided into those who were successful in one-time shortening during operation (group A1) and those who needed gradual shortening after operation (group A2) according to different shortening conditions. And 28 patients by antibiotic calcium sulfate-loaded bone transport (group B). The external fixation time (EFT) and external fixation index (EFI) of the two groups were compared. Bone defect healing and limb functions were evaluated according to the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria. Complications were compared by Paley classification. The measurement data of normal distribution were expressed as ± s, and t-test was used for comparison between groups; the count data were expressed as n(%), and the chi-square test, Fisher exact probability method or Mann-Whitney U test were used for comparison between groups. Results:Patients were followed for(27.5±5.1)months. There was no significant difference in EFT, EFI, bone defect healing and limb functions between the two groups( P>0.05). The incidence of Grade-Ⅱ[41.2% (7/17)], Grade-Ⅲ [47.1% (8/17)] pin-tract infection in group A1 and Grade-Ⅱ[46.2% (6/13)], Grade-Ⅲ pin-tract [53.8% (7/13)] in group A2 was significantly higher than those in group B[14.3% (4/28)], [17.9% (5/28)] ( P<0.05). The number of complications per capita in group A1 [(1.4±0.3) times/case] and in group A2 [(1.5±0.3) times/case]was significantly higher than that in group B [(1.1±0.5) times/case]. Conclusions:Patients can be cured successfully by both acute shortening-lengthening and bone transport techniques. Compared with acute shortening-lengthening group, the complication incidence in antibiotic calcium sulfate-loaded bone transport group was lower, especially, the infection-related complications. Therefore, antibiotic calcium sulfate-loaded bone transport technique has a greater application prospect in patients with large segmental bone defects caused by infection or osteomyelitis.

Therapeutic effect of sural neurocutaneous flap combined with antibiotic-impregnated calcium sulfate and autologous iliac bone graft of chronic calcaneal osteomyelitis / 国际外科学杂志

Objective:To analyze the therapeutic effect of sural neurocutaneous flap combined with antibiotic-impregnated calcium sulfate and autogenous iliac bone graft of chronic calcaneal osteomyelitis.Methods:A retrospective analysis was peformed in 29 patients with chronic calcaneal osteomyelitis treated with sural neurocutaneous flap combined with antibiotic-impregnated calcium sulfate and autogenous iliac bone graft in the Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from April 2013 to January 2020. There were 19 males and 10 females, with the age of (45.38±12.85) years, ranged from 22 to 67 years. The course of disease was (16.00±6.96) months, ranged from 6 to 36 months. The skin defect area was (41.9±15.9) cm 2, ranged from 11.8 to 86.8 cm 2. The causes of injury: 18 cases of high fall, 6 cases of traffic accidents, 3 cases of heavy rolling, the remaining 2 cases were machine strangulation and sharp stab wounds. The inflammatory markers [white blood cell (WBC), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), C reactive protein (CRP)] and bone healing time were recorded before operation, 2, 4, 8 weeks and 6 months after operation. During the follow-up period, the flap texture, survival were observed, and the ankle-posterior foot function recovery was evaluated by the American Association of Foot and Ankle Surgery (AOFAS) score were observed before and after the operation, and the incidence of complications were recorded. The measurement data were expressed as mean±standard deviation ( ± s), and the t-test was used for inter-group comparison; the levels of WBC, ESR, PCT and CRP at different time points before and after operation were compared by repeated measurement ANOVA, and the LSD t-test was used for pairwise comparison. Results:All the 29 patients were followed up for (14.51±6.10) months, ranged from 6 to 30 months. All the flaps survived without abrasion, ulceration, or skin protrusion, and all patients could walk normally with shoes. There were 28 cases of stage I bone healing, with an average of (5.87±2.07) months, ranged from 3 to 12 months. The inflammatory indexes was significantly decreased at different time points after operation ( P<0.05). There was no significant difference between 6 months and 8 weeks after operation ( P>0.05), while there was significant difference at other time points ( P<0.05). The ankle-posterior foot score of AOFAS at 6 months after treatment was significantly higher than that before treatment (83.44±7.93 vs 55.37±8.07), the differences was statistically significant ( P<0.05). The clinical efficacy of foot function recovery was excellent in 12 cases, good in 15 cases and fair in 2 cases among 29 patients .The excellent and good rate was 93.1% (27/29). One patient recurred 1 month after operation and was re-implanted with antibiotic-loaded calcium sulfate mixed autogenous iliac bone after debridement, no recurrence was found. The total complication rate was 31.0%, but there was no significant impact on the patient's life in the later period. All patients returned to daily life and work. Conclusion:The treatment of chronic calcaneal osteomyelitis with sural neurocutaneous flap combined with antibiotic-impregnated calcium sulfate and autogenous iliac bone graft can effectively control infection, reconstruct calcaneal and soft tissue structure, promote functional recovery of affected limb, and ultimately improve the patient′s quality of life.

Antibiotic-loaded calcium sulfate-autologous iliac bone combined with sural neurocutaneous flap for one-stage treatment of chronic calcaneus osteomyelitis plus skin and soft tissue defects / 中华创伤骨科杂志

Objective:To investigate the clinical effects of antibiotic-loaded calcium sulfate-autologous iliac bone combined with sural neurocutaneous flap in the one-stage treatment of chronic calcaneus osteomyelitis plus skin and soft tissue defects.Methods:From January 2013 to September 2019, 48 patients were admitted to Department of Orthopedic Trauma, Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University for chronic calcaneal osteomyelitis complicated with skin and soft tissue defects. They were divided into 2 groups according to different bone grafts. In group A of 26 patients treated at one stage by antibiotic-loaded calcium sulfate-autologous iliac bone combined with sural neurocutaneous flap, there were 16 males and 10 females with an age of (45.0±11.7) years and an area of skin defect of (56.0±16.7) cm 2. In group B of 22 patients treated at one stage by simple autologous iliac bone combined with sural neurocutaneous flap, there were 13 males and 9 females with an age of (43.6±9.6) years and an area of skin defect of (53.8±16.2) cm 2. The volume of the ilium harvested, fracture healing time, infection control, donor site complications, pain score of visual analogue scale (VAS) and function recovery of the ankle were compared between the 2 groups. Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The 48 patients were followed up for (15.3±6.0) months. Group A had a significantly smaller volume of the ilium harvested [(67.3±14.1) cm 3] than group B [(90.7±23.5) cm 3], a significantly lower rate of donor site complications [3.8% (1/26)] than group B [31.8% (7/22)], significantly lower VAS pain scores at 6, 12, 24, 48 and 72 hours than group B, and significantly lower WBC count, erythrocyte sedimentation rate and C-reactive protein at 2, 4, 8 weeks after operation than group B (all P<0.05). There was no statistically significant difference between the 2 groups in the infection control rate [96.2% (25/26) versus 77.3% (17/22)], the fracture healing time [(6.2±1.9) months versus (6.4±2.1) months], or the ankle-hindfoot score of AOFAS (The American Orthopaedic Foot and Ankle Society) (83.9±7.2 versus 82.5±8.7) at 6 months after operation (all P>0.05). Conclusion:In one-stage treatment of chronic calcaneal osteomyelitis complicated with skin and soft tissue defects, compared with simple autologous iliac bone combined with sural neurocutaneous flap, antibiotic-loaded calcium sulfate-autologous iliac bone combined with sural neurocutaneous flap can reduce the volume of the ilium harvested, pain score of VAS, and incidence of donor site complications, and improve the recovery of inflammatory indicators, leading to fine clinical effects.

Comparison of bone transport technique combined with bone grafting plus internal fixation versus simple bone transport technique for large segmental bone defects at lower limbs after trauma / 中华创伤骨科杂志

Objective:To compare the clinical efficacy between bone transport technique combined with bone grafting plus internal fixation and simple bone transport technique in the treatment of large segmental bone defects at lower limbs after trauma.Methods:A retrospective study was conducted to analyze the clinical data of 42 patients with large segmental bone defects at lower limbs after trauma who had been treated at Department of Trauma Orthopaedics, Honghui Hospital Affiliated to Medicine College, Xi'an Jiaotong University from September 2015 to September 2019. The patients were divided into 2 groups according to the different methods of repairing bone defects. In group A of 18 patients subjected to bone transport combined with bone grafting plus internal fixation, there were 11 males and 7 females with an age of (35.2±10.3) years, and 12 tibial defects and 6 femoral defects; in group B of 24 patients subjected to simple bone transport, there were 15 males and 9 females with an age of (37.3±9.4) years, and 17 tibial defects and 7 femoral defects. The external fixation time (EFT), external fixation index (EFI), total cure time and complications were recorded and compared between the 2 groups. At the last follow-up, the Ennecking score for limb functional recovery (score/total score 30) and Self-rating Anxiety Scale (SAS) were used to evaluate respectively the functional recovery of the limbs and postoperative anxiety.Results:The 2 groups were comparable because there was no significant difference between them in preoperative general data or follow-up time ( P>0.05). There was no statistically significant difference in the number of surgeries between the 2 groups ( P>0.05). The EFT [(5.9±1.5) months], EFI [(0.45±0.09) months/cm], total treatment time [(16.2±2.4) months], Ennecking score for limb functional recovery (87.0%±8.6%), SAS score [(43.2±9.0) points], and complications per capita [(0.4±0.2) times/case] in group A were significantly better than those in group B [(15.3±4.2) months, (1.19±0.28) months/cm, (19.7±3.5) months, (77.3%±9.2%), (58.2±9.3) points, and (1.2±0.5) times/case] (all P<0.05). Conclusion:In the treatment of large segmental bone defects at lower limbs, compared with simple bone transport technique, bone transport technique combined with bone grafting plus internal fixation has advantages of shorter external fixation time and overall cure time, a lower rate of complications, and better functional recovery of the limbs.

Application of 3D printing technology combined with locking plate fixation in femoral shaft fracture of patients with femoral deformity / 国际外科学杂志

Objective:To analyze the therapeutic effect of 3D printing technology combined with locking plate fixation on femoral shaft fracture in patients with femoral deformity.Methods:The clinical data of 33 patients with femoral shaft fracture with femoral deformity who met the inclusion criteria and underwent locking plate fixation in the Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from June 2014 to December 2020 were retrospectively analyzed. The patients were divided into 3D printing group ( n=18) and control group ( n=15) according to whether 3D printing was performed before operation. The 3D printing group including 11 males and 7 females with an age of (46.78±13.76) years.The control group including 9 males and 6 females with an age of (48.20±14.27) years.The operation time, intraoperative blood loss, fracture healing time and complications of the two groups were recorded. Visual analogue scale (VAS) scores of pain were evaluated before and 6, 12, 24, 48 and 72 h after operation. According to the Harris hip score, the Hospital for Special Surgery (HSS) knee score and The MOS 36-item short-from Health Survey (SF-36), the hip and knee function and quality of life of the patients before and 12 months after injury were evaluated. The measurement data were represented as mean±standard deviation( ± s), and the comparison between groups was conducted using the t-test; the comparison of count data between groups was conducted by Chi-square test or Fisher exact probability. Results:The operation time, intraoperative blood loss, and incidence of complications in the 3D printing group were (91.50±9.07) min, (191.11±16.01) mL, and 0(0/18), respectively, and those in the control group were (118.07±14.19) min, (270.27±17.59) mL, and 26.7% (4/15), the differences between the two groups were statistically significant ( P <0.05). The pain VAS scores of the 3D printing group were significantly better than those of the control group at 6, 12, 24, 48, and 72 h after operation ( P<0.05). There were no differences in fracture healing time and preoperative pain VAS between the two groups( P>0.05). There were no significant differences in hip function, knee function and quality of life scores between the two groups before injury and 12 months after injury( P>0.05). Conclusion:In the treatment of femoral shaft fractures in patients with femoral deformity with locking plate fixation, the application of 3D printing technology can be used for preoperative design and plate preshaping, which can shorten the operation time, reduce the amount of intraoperative blood loss, reduce the VAS of pain and the incidence of complications, improve the satisfaction of surgery, and provide a new option for the treatment of femoral shaft fractures in patients with femoral deformity.

Effect of internal structures on the accuracy of 3D printed full-arch dentition preparation models in different printing systems

PURPOSE@#. The objective of this study was to investigate how internal structures influence the overall and marginal accuracy of full arch preparations fabricated through additive manufacturing in different printing systems. @*MATERIALS AND METHODS@#. A full-arch preparation digital model was set up with three internal designs, including solid, hollow, and grid. These were printed using three different resin printers with nine models in each group. After scanning, each data was imported into the 3D data processing software together with the master cast, aligned and trimmed, and then put into the 3D data analysis software again to compare the overall and marginal deviation whose results are expressed using root mean square values and color maps. To evaluate the trueness of the resin model, the test data and reference data were compared, and the precision was evaluated by comparing the test data sets. Color maps were observed for qualitative analysis. Data were statistically analyzed by one-way analysis of variance and Bonferroni method was used for post hoc comparison (α = .05). @*RESULTS@#. The influence of different internal structures on the accuracy of 3D printed resin models varied significantly (P < .05). Solid and grid models showed better accuracy, while the hollow model exhibited poor accuracy. The color maps show that the resin models have a tendency to shrink inwards. @*CONCLUSION@#. The internal structure design influences the accuracy of the 3D printing model, and the effect varies in different printing systems. Irrespective of the kind of printing system, the printing accuracy of hollow model was observed to be worse than those of solid and grid models. [J Adv Prosthodont 2023;15:145-54]

Cangxi Tongbi Capsules promote chondrocyte autophagy by regulating circRNA＿0008365/miR-1271/p38 MAPK pathway to inhibit development of knee osteoarthritis / 中国中药杂志

To investigate the mechanism by which Cangxi Tongbi Capsules promote chondrocyte autophagy to inhibit knee osteoarthritis(KOA) progression by regulating the circRNA＿0008365/miR-1271/p38 mitogen-activated protein kinase(MAPK) pathway. The cell and animal models of KOA were established and intervened with Cangxi Tongbi Capsules, si-circRNA＿0008365, si-NC, and Cangxi Tongbi Capsules combined with si-circRNA＿0008365. Flow cytometry and transmission electron microscopy were employed to determine the level of apoptosis and observe autophagosomes, respectively. Western blot was employed to reveal the changes in the protein levels of microtubule-associated protein light chain 3(LC3)Ⅱ/Ⅰ, Beclin-1, selective autophagy junction protein p62/sequestosome 1, collagen Ⅱ, a disintegrin and metalloproteinase with thrombospondin motifs 5(ADAMTS-5), and p38 MAPK. The mRNA levels of circRNA＿0008365, miR-1271, collagen Ⅱ, and ADAMTS-5 were determined by qRT-PCR. Hematoxylin-eosin staining was employed to reveal the pathological changes of the cartilage tissue of the knee, and enzyme-linked immunosorbent assay to measure the levels of interleukin-1β(IL-1β) and tumor necrosis factor-alpha(TNF-α). The chondrocytes treated with IL-1β showed down-regulated expression of circRNA＿0008365, up-regulated expression of miR-1271 and p38 MAPK, lowered autophagy level, increased apoptosis rate, and accelerated catabolism of extracellular matrix. The intervention with Cangxi Tongbi Capsules up-regulated the expression of circRNA＿0008365, down-regulated the expression of miR-1271 and p38 MAPK, increased the autophagy level, decreased the apoptosis rate, and weakened the catabolism of extracellular matrix. However, the effect of Cangxi Tongbi Capsules was suppressed after interfering with circRNA＿0008365. The in vivo experiments showed that Cangxi Tongbi Capsules dose-dependently inhibited the p38 MAPK pathway, enhanced chondrocyte autophagy, and mitigated articular cartilage damage and inflammatory response, thereby inhibiting the progression of KOA in rats. This study indicated that Cangxi Tongbi Capsules promoted chondrocyte autophagy by regulating the circRNA＿0008365/miR-1271/p38 MAPK pathway to inhibit the development of KOA.

Effect of task-driven group workshop learning method in Nursing Education of Mongolian undergraduate nursing students / 中国实用护理杂志

Objective:To explore the effect of task-driven group workshop learning method on teaching satisfaction degree and practical ability in Mongolian medical nursing students.Methods:From September 2018 to January 2020, using convenient sampling method, a total of 38 Mongolian undergraduate nursing students of grade 2016 of Mongolian Medical College of Inner Mongolia Medical University were recruited as control group to receive traditional method, and the teaching practice activities were arranged after the main content was completed. Another 39 students of grade 2017 were recruited as observational group to receive task-driven group workshop learning method. The preparation of teaching practice tasks will run through all stages of teaching. The differences of students′ achievement, teaching satisfaction and autonomous learning ability between the two groups were compared.Results:The grade of observational group was 84.81 ± 3.45, higher than 76.16 ± 3.59 of the control group , which had significant difference ( t=-5.35, P<0.05). The score of teaching satisfaction of observational group was 82.00 ± 11.62, higher than 70.94 ± 6.65 in the control group, which had significant difference ( t=-5.10, P<0.05). The dimensions of information ability, cooperation ability and total score of the Autonomous Learning Ability Scale in observational group scored 39.28 ± 6.46, 24.54 ± 3.45, 98.13 ± 14.58, which were higher than 36.18 ± 5.46, 22.39 ± 3.59, 91.37 ± 11.47 in the control group, which had significant difference ( t=-2.27, -2.67, -2.26, all P<0.05). Conclusions:The task-driven group workshop learning method can improve the study result and the satisfaction of teaching, it can also improve the information ability and cooperation ability in Mongolian medical nursing students, which is worthy of reference in nursing teaching.

Efficacy comparison of femoral neck dynamic system and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients / 中华创伤杂志

Objective:To compare the clinical efficacy of femoral neck system (FNS) and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 76 young and middle-aged patients with femoral neck fracture admitted to Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2018 to September 2020, including 45 males and 31 females, aged 23-63 years [(49.5±8.2)years]. Garden classification of the fracture was 25 patients with type II, 34 with type III and 17 with type IV. Pauwels classification of the fracture was 16 patients with type I, 31 with type II and 29 with type III. A total of 40 patients were treated with cannulated screw fixation (cannulated screw group) and 36 patients with FNS fixation (FNS group). Operation time, frequency of fluoroscopy, length of hospital stay, weight-bearing time and bone union time were compared between the two groups. Hip function was assessed by Harris hip score at 6, 12 months after operation. The incidence of postoperative complications was observed.Results:All patients were followed up for 12-20 months [(15.2±1.7)months]. The frequency of fluoroscopy [(13.4±1.9)times], weight-bearing time [(11.1±1.9)weeks] and bone union time [(13.8±1.6)weeks] in FNS group were lower or shorter than those in cannulated screw group [(18.2±2.6)times, (15.7±1.6)weeks, (14.6±1.6)weeks] (all P<0.05 or 0.01). There were no significant differences in operation time, length of hospital stay and Harris hip score at 6, 12 months after operation between the two groups (all P>0.05). No postoperative infection occurred in both groups. In cannulated screw group, there were 4 patients with femoral neck shortening, 3 with deep venous thrombosis, 2 with internal fixation loosening, 2 with nail withdrawal and 1 with fracture non-union, showing the incidence of complications of 30% (12/40). In FNS group, there was 2 patients with femoral neck shortening, 1 with deep vein thrombosis and 1 with internal fixation loosening, showing the incidence of complications of 11% (4/36) ( P<0.05). Conclusion:For femoral neck fracture in the young and middle-aged patients, both FNS and cannulated screw fixation can obtain satisfactory efficacy, but FNS has the advantages of decreased frequency of intraoperative fluoroscopy, early weight bearing, reduced time to bone union and low incidence of complications.

Channel bone grafting in treatment of postoperative atrophic nonunion of clavicular fracture / 中华创伤骨科杂志

Objective:To evaluate the clinic efficacy of channel bone grafting [preservation of the sclerotic bone at the broken nonunion ends and fixation with limited contact dynamic compression plate (LC-DCP)] in the treatment of postoperative atrophic nonunion of middle clavicular fracture.Methods:The 41 patients were retrospectively analyzed who had been treated at Department of Orthopaedics and Traumatology, Xi'an Hong-Hui Hospital for atrophic nonunion after internal fixation of middle clavicular fracture from June 2015 to December 2019. They were 23 males and 18 females, with a mean age of 47.6 years (from 28 to 63 years). The left side was affected in 25 cases and the right side in 16 cases. The time interval between initial fracture surgery and nonunion surgery averaged 18.5 months (from 9 to 40 months). Thirty-six cases had undergone one operation and 5 cases 2 operations before admission. The length of bone defect was measured during operation. All nonunions were treated with construction of a graft channel, iliac bone graft and LC-DCP internal fixation above the clavicle. The upper limb function of the affected side was evaluated by the Disabilities of Arm, Shoulder and Hand (DASH) 12 months after operation.Results:The 41 patients were followed up for an average of 13.6 months (from 12 to 15 months). A bone defect ≤2.0 cm was found in 25 cases and that >2.0 cm in 16 ones. Nonunion healed in all patients after an average time of 14 weeks (from 12 to 16 weeks). One patient reported continuous pain in the donor area after operation and the other developed deep venous thrombosis at the right lower limb. The DASH upper limb scores at 12 months after operation averaged 14.7.Conclusion:Channel bone grafting is a feasible clinical treatment of postoperative atrophic nonunion of middle clavicular fracture, because it preserves the sclerotic bone at the broken nonunion ends, reduces the amount of iliac bone graft and leads to fine clinic efficacy.

Comparison of cannulated screwing versus plating in combination with interlocking intramedullary nailing for ipsilateral discontinuous fractures of tibial shaft and plateau / 中华创伤骨科杂志

Objective:To compare the clinical effects between cannulated screwing and plating in combination with interlocking intramedullary nailing for the treatment of ipsilateral discontinuous fractures of the tibial shaft and plateau.Methods:A retrospective analysis was performed of the clinical data of 34 patients who had been treated for ipsilateral discontinuous fractures of the tibial shaft and plateau at Department of Orthopedics and Trauma, Honghui Hospital Affiliated to Xi′an Jiaotong University from January 2015 to January 2020. There were 17 males and 17 females, aged from 26 to 60 years (average, of 43.6 years). The left side was affected in 18 cases and the right side in 16. The patients were divided into 2 groups according to their internal fixation methods: a cannulated screw group of 16 cases treated with cannulated screwing and intramedullary nailing and a plate group of 18 cases treated with plating and intramedullary nailing. The 2 groups were compared in terms of operation time, intraoperative blood loss, incision length, tibial plateau collapse, consumables cost, hospital stay, fracture healing time, weight-bearing time, range of knee motion, reduction of tibial plateau fracture by Rasmussen radiology, Lysholm knee function score at the last follow-up and complications.Results:There was no significant difference in the preoperative general data between the 2 groups, showing the 2 groups were comparable ( P>0.05). All the 34 patients were followed up for 12 to 28 months (average, 17.4 months). There was no significant difference either in operation time, hospital stay, tibial plateau healing time, tibial fracture healing time, weight-bearing time or range of knee motion between the 2 groups ( P>0.05). In the cannulated screw group, the intraoperative blood loss [(89.4 ± 14.5) mL] and consumables cost [(2.0 ± 0.2) ten thousand yuan] were significantly less than those in the plate group [(120.8 ± 22.1) mL and (2.6 ± 0.4) ten thousand yuan], the incision length [(4.1 ± 0.8) cm] was significantly shorter than that in the plate group [(7.1 ± 0.9) cm], and the Lysholm knee function score at the last follow-up [(89.8 ± 4.5) points] was significantly lower than that in the plate group [(93.0 ± 4.2 points] (all P<0.05). The difference was statistically significant between the 2 groups in the quality of tibial plateau reduction ( P<0.05). The postoperative tibial plateau collapse in the plate group [0.5 (0, 2) mm] was insignificantly less than that in the cannulated screw group [1.0 (0, 2) mm] ( P>0.05). In the cannulated screw group, one tibial shaft fracture did not achieve union after operation and deep vein thrombosis occurred in 2 cases after operation; in the plate group, 2 cases suffered from delayed wound healing, one from delayed fracture healing, one from deep venous thrombosis of lower extremity, and one from knee discomfort which was relieved after removal of internal fixation. Conclusions:In the treatment of ipsilateral discontinuous fractures of tibial shaft and plateau, both cannulated screwing and plating in combination with interlocking intramedullary nailing can achieve good clinical effects. Although plating in combination with intramedullary nailing lead to more severe trauma and higher costs, it is conducive to improving the reduction quality of the tibial plateau and postoperative functional recovery of the knee joint.

Comparison of double mini locking plate and anatomical locking plate in the treatment of comminuted olecranon fracture / 国际外科学杂志

Objective:To compare the efficacy of double mini locking plate and anatomical locking plate in the treatment of comminuted olecranon fracture.Methods:The clinical data of 46 patients who underwent comminuted olecranon fracture in the Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2017 to May 2020 were analyzed retrospectively. Among them, 21 cases were treated with double mini locking plate (double plate group) and 25 cases with anatomical locking plate (single plate group). The operation time, patient satisfaction, range of motion, return to work time, soft tissue stimulation to remove internal fixation, Mayo elbow performance score (MEPS), disabilities of arm, shoulder and hand score (DASH) of the two fixation methods were statistically compared. Measurement data with normal distribution were represented as ( ± s), and comparison between groups was conducted using the t test. Comparison between groups of count data was conducted using the chi-square test or Fisher exact probability. Results:All 46 patients were followed up for to (19.17±2.79) months. All fractures healed after operation. There was no significant difference in operation time, range of motion, patient satisfaction, MEPS and DASH scores among the two groups( P>0.05). The time of returning to work was (8.47±2.13) weeks in the double plate group and (9.78±1.98) weeks in the single plate group, and the difference was statistically significant ( P< 0.05). There were 9 cases of internal fixation due to soft tissue stimulation, 1 cases in double plate group and 8 cases in single plate group, and the difference was statistically significant ( P<0.05). Conclusions:Compared with anatomical locking plate, the treatment of olecranon fracture with double mini locking plate can effectively reduce soft tissue stimulation and promote patients to return to work early, and the operation time is not significantly prolonged, and the biomechanical advantage is obvious, the clinical effect is satisfactory and the postoperative function is good, so it is an effective treatment.

Comparison of our modified hybrid bone transport technique and conventional bone transport technique in treatment of distal tibial osteomyelitis with bone defects involving the articular surface / 中华创伤骨科杂志

Objective:To introduce our modified hybrid bone transport technique using hindfoot arthrodesis nails combined with antibiotic-loaded calcium sulfate by comparison with conventional bone transport in the treatment of distal tibial osteomyelitis with bone defects involving the articular surface.Methods:The clinical data of 34 patients were retrospectively analyzed who had been treated at Department of Orthopaedics, Honghui Hospital for distal tibial osteomyelitis with bone defects involving the articular surface from September 2014 to September 2019. They were divided into 2 groups according to their way of repairing bone defects. In the modified group of 14 cases subjected to the treatment using the modified hybrid bone transport technique, there were 9 males and 5 females, with an age of (39.4±7.3) years. In the conventional group of 20 cases subjected to the treatment using conventional bone transport technique, there were 12 males and 8 females, with an age of (41.2±6.6) years. The external fixation time (EFT), external fixation index (EFI), self-rating anxiety scale (SAS) were recorded and compared between the 2 groups. Healing of bone defects and function were evaluated at the last follow-up according to the criteria of Association for the Study and Application of the Method of Ilizarov (ASAMI) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-posterior foot score, respectively. Complications were recorded according to the Paley classification.Results:There was no significant difference in the general data between the modified group and the conventional group, showing they were comparable ( P>0.05). Thirty-four patients were followed up for 18 to 32 months (average, 27 months) after operation. The modified group had significantly shorter EFT [(3.9±1.6) months] than the conventional group [(9.8±2.2) months], and significantly lower EFI [(0.48±0.09) months/cm] than the conventional group [(1.42±0.32) months/cm] ( P<0.05). The SAS [(48.1±4.7) points] in the modified group was significantly lower than that in the conventional group [(61.2±6.2) points], and the number of complications per capita in the former [(0.8±0.4)/case] was significantly smaller than that in the latter [(1.42±0.32)/case] ( P<0.05). There were no significan differences in the healing of bone defects or AOFSA ankle-posterior foot score ( P>0.05). In the modified group and the conventional group, respectively, 13 versus 12 patients were satisfied while 1 versus 8 patients unsatisfied, 1 versus 8 patients had grade-Ⅱ infection while 13 versus 12 patients did not, and 1 versus 9 patients had grade-Ⅲ infection while 13 versus 11 patients did not. There were significant differences between the 2 groups in the above indexes (all P<0.05). Conclusion:In the treatment of distal tibial osteomyelitis with bone defects involving the articular surface, compared with conventional bone transport technique, our modified hybrid bone transport technique using hindfoot arthrodesis nails combined with antibiotic-loaded calcium sulfate may lead to better clinical efficacy due to the advantages of shorter external fixation time, lower external fixation index and fewer complications.