Clinical symptoms of COVID-19 pneumonia in children: A protocol for systematic review and meta-analysis.

BACKGROUND: This meta-analysis aimed to compare the clinical symptoms of COVID-19 pneumonia in children. METHODS AND ANALYSIS: Electronic databases including PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI) database, Wanfang Database, and Chinese Biomedical Literature Database (CBM) were searched from its inception to June 21, 2020. We only included studies that reported clinical symptoms of COVID pneumonia in children. Quality of the included studies was assessed by 2 authors. Pooled results were summarized by STATA 12.0 software.The heterogeneity was measured by I2 tests (I2 < 50 indicates little heterogeneity, I2≥50 indicates high heterogeneity). Publication bias was performed by funnel plot and statistically assessed by Begg test (P > .05 as no publication bias). RESULTS: Results will be shown as figures or tables. CONCLUSION: Our study aims to systematically present the clinical symptoms of COVID-19 pneumonia patients in children, so as to further provide guidance for clinical management.

Overcoming resistance to anti-PD-1 immunotherapy in lymphoepithelioma-like carcinoma: A case report and review of the literature.

OBJECTIVES: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small-cell lung cancer with no established treatment protocols. Immunotherapy is rarely used as a second-line choice in patients with advanced LELC, and more cases of this condition should be presented. MATERIALS AND METHODS: We present a patient with advanced primary pulmonary LELC overcoming the resistance to second-line anti-programmed death-1 (PD-1) immunotherapy. We also review the literature to summarize the current immunotherapy landscape of this rare disorder. RESULTS AND CONCLUSION: The LELC patient progressed after first-line chemotherapy, was treated by immunotherapy alone and progressed again. To overcome the developed resistance to immunotherapy, chemotherapy with nedaplatin plus paclitaxel in addition to nivolumab was administered and a progression-free survival (PFS) of 5 months was achieved. It was also observed that the blood levels of neuron-specific enolase may act as an efficacy biomarker in LELC. Patients with this rare disorder resistant to anti-PD-1 immunotherapy might benefit from therapy based on PD-1 inhibition; this is a future avenue of research.

Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture.

PURPOSE: To compare the outcomes of contracture release by arthroscopic versus open surgical approach in patients with external snapping hip (ESH) caused by gluteal muscle contracture (GMC). METHODS: Medical records of patients with ESH due to GMC who underwent open surgery (n = 44) or arthroscopic surgery (n = 48) between October 2008 and October 2014 were reviewed. Patients were followed up at 1, 3, 12, and 24 months postoperatively. Operation time, incision length, postoperative pain, postoperative complication rate, and recurrence rate were compared between the 2 groups. Hip adduction, and Harris Hip Scores (HHS) at 1 and 2 years postoperatively were compared between the groups and with preoperative data. RESULTS: Mean operation time did not differ between the 2 groups (p>0.05). The arthroscopic surgery group had smaller incisions (p<0.05), less postoperative pain (p<0.05), lower complication rates (p<0.05) than did the open surgery group. The recurrence rates were similar for the 2 groups (p>0.05). Hip adduction, and HHS 1 year and 2 years postoperatively were significantly better postoperatively than they had been preoperatively for both groups (all p<0.01), and were similar for the 2 groups (all p>0.05). CONCLUSIONS: Arthroscopic release of contracture tissue is a safe and effective approach for the treatment of ESH caused by GMC, with the advantages of small scars, less postoperative pain, fewer complications compared with open surgery.

Arthroscopic Repair of Chronic Tears of the Anterior Horn of the Lateral Meniscus That Includes Covering the Lesion With an Infrapatellar Pedicle Fat Flap.

This study analyzed the efficacy and safety of arthroscopic outside-in repair of the anterior horn of the lateral meniscus that includes covering the lesion with an infrapatellar pedicle fat flap in patients with chronic tears. This retrospective study reviewed 87 patients with chronic tears of the anterior horn of the lateral meniscus who underwent arthroscopic outside-in repair, which included covering the lesion with an infrapatellar pedicle fat flap (group A, n=45) or not (group B, n=42). The 2 groups were similar in terms of age, sex, body mass index, and disease duration. Patient results were assessed with Tegner, Lysholm, and visual analog scale scores; healing criteria; magnetic resonance imaging; and complication rates. Mean follow-up was 38.2 months. Tegner and Lysholm scores improved postoperatively in both groups (all P<.01) and were similar for the 2 groups (all P>.05). Visual analog scale scores were reduced postoperatively in both groups (P<.01) and similar for the 2 groups (P>.05). Healing rates and complication rates did not differ between the 2 groups (all P>.05), but healing on magnetic resonance imaging was better in group A than group B (P<.05). The repair of chronic tears of the anterior horn of the lateral meniscus can lead to good clinical outcomes and a satisfactory success rate. Covering the repair site with an infrapatellar pedicle fat flap may improve meniscal healing and does not increase the complication rate. [Orthopedics. 2018; 41(3):e360-e364.].

Comparison of arthroscopic versus open surgery on external snapping hip caused by gluteal muscle contracture.

PURPOSE: To compare the outcomes of contracture release by arthroscopic versus open surgical approach in patients with external snapping hip (ESH) caused by gluteal muscle contracture (GMC). METHODS: Medical records of patients with ESH due to GMC who underwent open surgery (n = 44) or arthroscopic surgery (n = 48) between October 2008 and October 2014 were reviewed. Patients were followed up at 1, 3, 12, and 24 months postoperatively. Operation time, incision length, postoperative pain, postoperative complication rate, and recurrence rate were compared between the 2 groups. Hip adduction, and Harris Hip Scores (HHS) at 1 and 2 years postoperatively were compared between the groups and with preoperative data. RESULTS: Mean operation time did not differ between the 2 groups (p>0.05). The arthroscopic surgery group had smaller incisions (p<0.05), less postoperative pain (p<0.05), lower complication rates (p<0.05) than did the open surgery group. The recurrence rates were similar for the 2 groups (p>0.05). Hip adduction, and HHS 1 year and 2 years postoperatively were significantly better postoperatively than they had been preoperatively for both groups (all p<0.01), and were similar for the 2 groups (all p>0.05). CONCLUSIONS: Arthroscopic release of contracture tissue is a safe and effective approach for the treatment of ESH caused by GMC, with the advantages of small scars, less postoperative pain, fewer complications compared with open surgery.

[Treatment of type IV Pipkin fracture through transtrochanteric approach with trochanteric osteotomy].

OBJECTIVE: To summarize the short-term effectiveness of type IV Pipkin fracture through transtrochanteric approach with trochanteric osteotomy. METHODS: Between January 2007 and January 2010, 15 cases of type IV Pipkin fracture were treated through transtrochanteric approach with trochanteric osteotomy. There were 9 males and 6 females with an average age of 42.5 years (range, 27-55 years). The causes of fractures included traffic accident (12 cases), falling from height (2 cases), and heavy pound injury (1 case). The time from injury to hospitalization was 4 hours to 7 days (mean, 2.3 days). All patients had limitation of activity in the injured hips. The X-ray films and CT three-dimensional reconstruction indicated posterior dislocation of the hip joints and fractures of the femoral head and acetabulum, with no fracture of femoral neck. The locations of the femoral head fractures were under the round ligament in 9 cases and above the round ligament in 6 cases. Complications were treated firstly in all patients. The time from hospitalization to operation ranged from 2 to 10 days (mean, 4.5 days). RESULTS: All patients got primary wound healing with no early complication. All the patients were followed up 12-48 months with an average of 26 months. All osteotomies and acetabular fractures healed within 6 to 8 weeks. All patients achieved healing of femoral head fracture after 6-10 months. Mild heterotopic ossification occurred in 2 cases at 3 months after operation which were left untreated; and necrosis of the femoral head occurred in 1 case at 8 months after operation, was treated by total hip arthroplasty. At last follow-up, the flexion of the injuried hips ranged from 60 to 120 degrees (mean, 92.5 degrees). Based on Thompson et al. scoring scales, the results were excellent in 5 cases, good in 7 cases, fair in 2 cases, and poor in 1 case; the excellent and good rate was 80%. CONCLUSION: Treatment of type IV Pipkin fracture through transtrochanteric approach with trochanteric osteotomy can provide good visualization and protection of the blood supply of the femoral head.