Inflammation-Responsive Hydrogel Spray for Synergistic Prevention of Traumatic Heterotopic Ossification via Dual-Homeostatic Modulation Strategy.

Traumatic heterotopic ossification (THO) represents one of the most prominent contributors to post-traumatic joint dysfunction, which currently lacks an effective and definitive preventative approach. Inflammatory activation due to immune dyshomeostasis during the early stages of trauma is believed to be critical in initiating the THO disease process. This study proposes a dual-homeostatic modulation (DHM) strategy to synergistically prevent THO without compromising normal trauma repair by maintaining immune homeostasis and inducing stem cell homeostasis. A methacrylate-hyaluronic acid-based hydrogel spray device encapsulating a curcumin-loaded zeolitic imidazolate framework-8@ceric oxide (ZIF-8@CeO2, CZC) nanoparticles (CZCH) is designed. Photo-crosslinked CZCH is used to form hydrogel films fleetly in periosteal soft tissues to achieve sustained curcumin and CeO2 nanoparticles release in response to acidity and reactive oxygen species (ROS) in the inflammatory microenvironment. In vitro experiments and RNA-seq results demonstrated that CZCH achieved dual-homeostatic regulation of inflammatory macrophages and stem cells through immune repolarization and enhanced efferocytosis, maintaining immune cell homeostasis and normal differentiation. These findings of the DHM strategy are also validated by establishing THO mice and rat models. In conclusion, the CZCH hydrogel spray developed based on the DHM strategy enables synergistic THO prevention, providing a reference for a standard procedure of clinical operations.

An Innovative Metal Artifact Reduction Algorithm based on Res-U-Net GANs.

BACKGROUND: During X-ray computed tomography (CT) scans, the metal implants in the patient's body will produce severe artifacts, which reduce the image quality and interferes with the doctor's judgment. Therefore, it is necessary to develop an algorithm for removing metal artifacts in CT images and reconstructing high-quality images. OBJECTIVE: In this article, we proposed a generative adversarial networks (GANs)-based metal artifact reduction algorithm for the image domain, Res-U-Net GANs. This method can effectively suppress noise and remove metal artifacts in CT images. METHODS: Our new approach includes a generator and a discriminator. The generator contains several residual blocks, a U-Net structure and skip connections. And a weighted joint loss function is also used for training. These structures can reduce metal artifacts in images, improve image quality, and restore implant details. RESULTS: We use SSIM, PSNR and RMSE to evaluate the performance of the proposed method. The mean SSIM, PSNR and RMSE of the testing set images are 0.977, 39.044 and 0.011, respectively. And the trained model which is compiled and encapsulated, also show excellent performance in processing clinical data sets, which can remove metal artifacts in clinical CT images. CONCLUSION: We consider that the proposed algorithm can remove metal artifacts in CT images and restore image details, which is very helpful for radiologists.

Starr frame-assisted minimally invasive internal fixation for pelvic fractures: Simultaneous anterior and posterior ring stability.

OBJECTIVE: We aimed to investigate the surgical techniques, efficacy, and safety of Starr frame-assisted minimally invasive internal fixation for simultaneous anterior and posterior ring stability in pelvic fractures. METHODS: The clinical data of 22 patients with anterior and posterior pelvic ring injuries who underwent Starr frame-assisted minimally invasive internal fixation were retrospectively collected. The anterior pelvic ring was fixed with an anterior subcutaneous internal fixator (INFIX), and the posterior pelvic ring was fixed with sacroiliac screws. The operative time, intraoperative blood loss, fluoroscopy times, number of assistants, complications, and weight-bearing time were analyzed. The Matta score was used to evaluate the fracture reduction. The Majeed score was used to evaluate clinical efficacy, and Gibbon's classification was used to estimate the occurrence of sacral nerve injury. RESULTS: All 22 patients were treated with sacroiliac screws for posterior ring injuries, including 12 cases with single sacroiliac screws, nine with two sacroiliac screws, and one with three sacroiliac screws. INFIX was used for all anterior ring fixation, including two screws in seven cases, three screws in 13 cases, and four screws in two cases. The fracture reduction quality was excellent in 15 cases, good in four cases, and moderate in three cases by Matta scores. All patients were followed up for 6-20 (12.5 ± 5.7) months. Callus-formation time based on postoperative X-ray was 3-8 (4.3 ± 1.2) weeks. Weight-bearing time was 3-12 (6.3 ± 2.8) weeks after surgery. At the last follow-up, 15 patients were evaluated as excellent, five as good, and two as fair according to the Majeed score. Gibbons' classification showed that one of the three patients with sacral nerve injury recovered completely and two did not recover. Complications occurred in six patients, including one with internal fixation loosening, two with anterolateral thigh paresthesia, one with malunion, one with nonunion, and one with heterotopic ossification. CONCLUSIONS: Starr frame-assisted minimally invasive internal fixation could stabilize the anterior and posterior pelvic rings simultaneously, overcoming the difficulty of fracture reduction. This technique can help patients with early postoperative weight-bearing and improved functional outcomes, providing a novel modality for the minimally invasive treatment of pelvic ring injuries.

Fetuin-A is an immunomodulator and a potential therapeutic option in BMP4-dependent heterotopic ossification and associated bone mass loss.

Heterotopic ossification (HO) is the abnormal formation of bone in extraskeletal sites. However, the mechanisms linking HO pathogenesis with bone mass dysfunction remain unclear. Here, we showed that mice harboring injury-induced and BMP4-dependent HO exhibit bone mass loss similar to that presented by patients with HO. Moreover, we found that injury-induced hyperinflammatory responses at the injury site triggered HO initiation but did not result in bone mass loss at 1 day post-injury (dpi). In contrast, a suppressive immune response promoted HO propagation and bone mass loss by 7 dpi. Correcting immune dysregulation by PD1/PDL1 blockade dramatically alleviated HO propagation and bone mass loss. We further demonstrated that fetuin-A (FetA), which has been frequently detected in HO lesions but rarely observed in HO-adjacent normal bone, acts as an immunomodulator to promote PD1 expression and M2 macrophage polarization, leading to immunosuppression. Intervention with recombinant FetA inhibited hyperinflammation and prevented HO and associated bone mass loss. Collectively, our findings provide new insights into the osteoimmunological interactions that occur during HO formation and suggest that FetA is an immunosuppressor and a potential therapeutic option for the treatment of HO.

Design and Validation of a Smile-Necklace Plate for Treating Inferior Patellar Pole Avulsion Fractures: A Review and Hypothesis.

The patella's inferior pole transmits force generated by contraction of the quadriceps muscle to the tibial tuberosity through the attached patellar ligament, thus completing knee extension. Therefore, fractures of the patella's inferior pole disrupt the coherence of mechanical transmission in the lower extremities. There appears to be no consensus among trauma centers regarding the treatment of infrapatellar pole fractures, primarily because there is no consistent design or application of internal fixation for this type of fracture. We designed a new internal implant similar to the smile necklace based on our previous study. This smile-necklace plate (SNP) has the advantage of both plate fixation and tension-band wiring fixation, permitting early rehabilitation, especially in osteoporotic comminuted infrapatellar pole fractures. Finite element analysis helped verify the biomechanical advantages of the SNP in comparison with existing studies. Hence, this novel implant is a promising treatment option for inferior pole patellar fractures.

Exosomes Secreted from circZFHX3-modified Mesenchymal Stem Cells Repaired Spinal Cord Injury Through mir-16-5p/IGF-1 in Mice.

BACKGROUND: Spinal cord injury (SCI) is a devastating neurological event that leads to severe motor and sensory dysfunction. Exosome-mediated transfer of circular RNAs (circRNAs) was associated with SCI, and exosomes have been reported to be produced by mesenchymal stem cells (MSCs). This study is designed to explore the mechanism of exosomal circZFHX3 on LPS-induced MSCs injury in SCI. METHODS: Exosomes were detected by transmission electron microscope and nanoparticle tracking analysis. CD9, CD63, CD81, and TSC101, B-cell lymphoma-2 (Bcl-2), Bcl-2 related X protein (Bax), Cleaved caspase 3, and Insulin-like growth factor 1 (IGF-1) protein levels were measured by western blot assay. CircZFHX3, microRNA-16-5p (miR-16-5p), and IGF-1 level were detected by real-time quantitative polymerase chain reaction (RT-qPCR). Cell viability and apoptosis were detected by Cell Counting Kit-8 (CCK-8) and flow cytometry assay. Levels of IL-1ß, IL-6, and TNF-α were assessed using Enzyme-linked immunosorbent assays (ELISA). ROS, LDH, and SOD levels were measured by the special kits. The binding between miR-16-5p and circZFHX3 or IGF-1 was predicted by Starbase and DianaTools and then verified by a dual-luciferase reporter and RNA Immunoprecipitation (RIP) assays. The biological role of exosomal circZFHX3 on SCI mice was examined in vivo. RESULTS: CircZFHX3 and IGF-1 were decreased, and miR-16-5p was increased in SCI mice. Also, exosomal circZFHX3 boosted cell viability and repress apoptosis, inflammation, and oxidative stress in LPS-treated BV-2 cells in vitro. Mechanically, circZFHX3 acted as a sponge of miR-16-5p to regulate IGF-1 expression. Exosomal circZFHX3 reduced cell injury of SCI in vivo. CONCLUSIONS: Exosomal circZFHX3 inhibited LPS-induced BV-2 cell injury partly by regulating the miR-16-5p/ IGF-1 axis, hinting at a promising therapeutic strategy for the SCI treatment.

Quadrilateral plate fractures of the acetabulum: Classification, approach, implant therapy and related research progress.

The quadrilateral plate (QP) is an essential structure of the inner wall of the acetabulum, an important weight-bearing joint of the human body, which is often involved in acetabular fractures. The operative exposure, reduction and fixation of QP fractures have always been the difficulties in orthopedics due to the special morphological structure and anatomical features of the QP. Fortunately, there have been many effective methods and instruments developed for QP exposure, reduction and fixation by virtue of the combined efforts of numerous orthopedists. At the same time, each method presents with its own advantages and disadvantages, resulting in different prognoses. It is necessary to have a thorough understanding of the anatomy, radiology and fixation techniques of the QP in terms of patient prognosis optimization. In this paper, the anatomical features, definition and classification of QP, operative approach selection, implant internal fixation methods and efficacy were reviewed.

[Comparison of femoral neck system and inverted triangle cannulated screws fixations in treatment of Pauwels typle â ¢ femoral neck fractures].

OBJECTIVE: To compare the effectiveness of the femoral neck system (FNS) and inverted triangle cannulated screws (ITCS) for the treatment of Pauwels type Ⅲ femoral neck fractures. METHODS: The clinical data of 59 patients with Pauwels type Ⅲ femoral neck fractures treated between May 2019 and November 2020 were retrospectively analysed. The patients were divided into FNS group (28 cases) and ITCS group (31 cases) according to the different internal fixation. There was no significant difference in gender, age, affected side, body mass index, cause of injury, smoking history, alcohol abuse history, Pauwels angle, Garden classification, AO/Orthopaedic Trauma Association (AO/OTA) classification, and time from injury to operation between the two groups ( P>0.05). The operation time, incision length, intraoperative blood loss, extra assisted reduction procedures (Kirschner wire prying reduction or open reduction), hospitalization stay, and early complications were recorded and compared between the two groups. Garden index and Haidukewych score were used to evaluate fracture reduction. Fracture healing time, lateral thigh irritation, time of partial or total weight-bearing postoperatively, shortening length and degree of femoral neck, change of caput-collum-diaphysis (CCD) angle (the difference of CCD angle between immediate after operation and last follow-up), incidence of osteonecrosis of femoral head and revision surgery were recorded and compared between the two groups. Hip joint function were evaluated by Harris score. RESULTS: The operation time of FNS group was significantly shorter than ITCS group, and the incision length was significantly longer than ITCS group ( P<0.05). There was no significant difference in intraoperative blood loss, assisted reduction, Garden index, Haidukewych score, and hospitalization stay between the two groups ( P>0.05). All the incisions healed by first intention. There were 2 deep vein thrombosis in the FNS group and 1 pulmonary infection and 1 deep vein thrombosis in the ITCS group. No significant difference was found in the incidence of early postoperative complications (7.1% vs. 6.5%) between the two groups ( P=1.000). Patients in both groups were followed up 3-14 months, and there was no significant difference in follow-up time between the two groups ( t=-0.553, P=0.582). The fracture healing time, Harris score, and the partial weight-bearing time after operation of the FNS group were significantly better than those of the ITCS group ( P<0.05). However, there was no significant difference in total weight-bearing time between the two groups ( Z=-1.298, P=0.194). No lateral thigh irritation was found in the FNS group, while 10 patients in the ITCS group had lateral thigh irritation, and the incidence between the two groups (0 vs. 32.3%) was significant ( P=0.001). At last follow-up, the shortening length and degree of femoral neck and the change of CCD angle in FNS group were significantly less than those in ITCS group ( P<0.05). There was no patient with osteonecrosis of femoral head or reoperation in the FNS group, while 4 patients in the ITCS group underwent reoperation (including 2 cases of osteonecrosis of the femoral head). However, the incidences (0 vs. 6.5%; 0 vs.12.9%) between the two groups were not significant ( P=0.493; P=0.114). CONCLUSION: Using FNS to treat Pauwels type Ⅲ femoral neck fracture is simple as well as able to reduce the shortening of the femoral neck and the change of the CCD angle. Also, FNS is conducive to the recovery of hip joint function, which should be considered as a new choice for the treatment of young femoral neck fracture patients.

Clinical characteristics, treatment, and prognosis of 74 2019 novel coronavirus disease patients in Hefei: A single-center retrospective study.

ABSTRACT: Since December 2019, pneumonia caused by a novel coronavirus (SARS-CoV-2), namely 2019 novel coronavirus disease (COVID-19), has rapidly spread from Wuhan city to other cities across China. The present study was designed to describe the epidemiology, clinical characteristics, treatment, and prognosis of 74 hospitalized patients with COVID-19.Clinical data of 74 COVID-19 patients were collected to analyze the epidemiological, demographic, laboratory, radiological, and treatment data. Thirty-two patients were followed up and tested for the presence of the viral nucleic acid and by pulmonary computed tomography (CT) scan at 7 and 14 days after they were discharged.Among all COVID-19 patients, the median incubation period for patients and the median period from symptom onset to admission was all 6 days; the median length of hospitalization was 13 days. Fever symptoms were presented in 83.78% of the patients, and the second most common symptom was cough (74.32%), followed by fatigue and expectoration (27.03%). Inflammatory indicators, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) of the intensive care unit (ICU) patients were significantly higher than that of the non-ICU patients (P < .05). However, 50.00% of the ICU patients had their the ratio of T helper cells to cytotoxic T cells (CD4/CD8) ratio lower than 1.1, whose proportion is much higher than that in non-ICU patients (P < .01).Compared with patients in Wuhan, COVID-19 patients in Anhui Province seemed to have milder symptoms of infection, suggesting that there may be some regional differences in the transmission of SARS-CoV-2 between different cities.

Robot-assisted vs freehand cannulated screw placement in femoral neck fractures surgery: A systematic review and meta-analysis.

BACKGROUND: Several studies have reported that medical robot-assisted method (RA) might be superior to conventional freehand method (FH) in orthopedic surgery. Yet the results are still controversial, especially in terms of femoral neck fractures surgery. Here, 2 methods were assessed based on current evidence. METHODS: Electronic databases including Cochrane Library, PubMed, Web of Science. and EMBASE were selected to retrieved to identify eligible studies between freehand and RAs in femoral neck fractures, with 2 reviewers independently reviewing included studies as well as collecting data. RESULTS: A total of 5 studies with 331 patients were included. Results indicated that 2 surgical methods were equivalent in terms of surgical duration, Harris score, fracture healing time, fracture healing proportion and complications, while RA showed clinical benefits in radiation exposure, intraoperative bleeding, total drilling times, and screw parallelism. CONCLUSIONS: Current literature revealed significantly difference between 2 techniques and suggested that RA might be beneficial for patients than freehand method.

RNA Sequencing Evidences the Prevention of Oxidative Stress is Effective in Injury-Induced Heterotopic Ossification Treatment.

Heterotopic ossification is a bona fide bone formation outside the normal skeleton. Traumatic injury and genetic mutations are the important risk factors of HO. Both injury-induced HO and hereditary HO severely affect human life quality. However, there were no effect therapies treating HO. Here, we performed the RNA-sequencing assay to examine dynamic process during HO initiation and development. Moreover, we found that oxidation-reduction process were significantly dysregulated following HO formation. Further, we characterized that Nuclear factor erythroid 2-related factor 2 (NRF2) expression conferred antioxidant property in macrophages and then helped chondrocytes formation. Instead, 3-Nitrotyrosine is expressed by T-lymphocytes, but not macrophages, causing deficient adaptive immunity. Inhibition of NRF2 markedly alleviated HO. Finally, we identified that PI3K/AKT signaling pathway is responsible for whole HO process, but ERK signaling is activated only in early stage. ERK pathway blockade effectively prevented HO. These findings revealed that oxidative stress induced by early immune response can be targeted in HO treatment.

Development and validation of a predictive nomogram for postoperative osteonecrosis of the femoral head with cannulated screws fixation.

BACKGROUND: Osteonecrosis of the femoral head (ONFH) remains a major complication of femoral neck fractures. Early interventions require preliminary prediction and detection. In this study, we aimed to evaluate the perioperative variables of postoperative ONFH in femoral neck fracture patients with closed reduction and cannulated screw fixation. We also established and validated an individualized nomogram for the prediction of postoperative ONFH. METHODS: We included 470 patients with ONFH from two hospitals [First Affiliated Hospital of University of Science and Technology of China (n=360) and Southern Branch of the First Affiliated Hospital of the University of Science and Technology of China (n=110)]. We evaluated the prognostic value of multiple perioperative variables using a Cox regression model in the training cohort. We developed a nomogram for the prediction of ONFH using a logistic regression model. We assessed the performance of this nomogram in a validation cohort and evaluated its clinical value. RESULTS: Of the 470 patients who met the inclusion criteria, 141 (30.0%) developed postoperative ONFH. We found alcohol use [odds ratio (OR), 1.743, 95% confidence interval (CI), 1.042-2.901, P=0.033], cerebrovascular disease (OR, 5.357, 95% CI, 2.318-13.13, P<0.001), interval to surgery (OR, 5.273, 95% CI, 2.724-10.43, P<0.001), Garden classification (OR, 23.17, 95% CI, 6.812-145.3, P<0.001), Garden index (OR, 5.935, 95% CI, 2.670-14.184, P<0.001), interval to partial weight-bearing (OR, 0.053, 95% CI, 0.006-0.296, P=0.002), and six-month Harris hip score (OR, 0.856; 95% CI, 0.792-0.919, P<0.001) were independent predictors of postoperative development of ONFH. Based on these variables, we developed a nomogram that showed good discrimination in both the training [area under the curve (AUC) =0.865] and the validation cohort (AUC =0.877). The favorable performance of this nomogram was also confirmed in the validation cohort. CONCLUSIONS: We developed and validated an easy-to-use nomogram for predicting postoperative ONFH. This nomogram can aid decision-making of intraoperative interventions and postoperative rehabilitation plans for patients, surgeons, and osteo-rehabilitative physicians.

Early complications of preoperative external traction fixation in the staged treatment of tibial fractures: A series of 402 cases.

BACKGROUND: Different external skeletal fixators have been widely used in preoperative traction of high-energy tibial fractures prior to a definitive surgical treatment. However, the early complications associated with this staged treatment for traction and soft tissue injury recovery have rarely been discussed. AIM: To analyze the early complications associated with preoperative external traction fixation in the staged treatment of tibial fractures. METHODS: A total of 402 patients with high-energy tibial fractures treated using preoperative external traction fixation at a Level 1 trauma center from 2014 to 2018 were enrolled in this retrospective study. Data regarding the demographic information, Tscherne soft tissue injury, fracture site, entry point placement, and duration of traction were recorded. Procedure-related complications such as movement and sensation disorder, vessel injury, discharge, infection, loosening, and iatrogenic fractures were analyzed. RESULTS: The mean patient age was 42.5 (18-71) years, and the mean duration of traction was 7.5 (0-26) d. In total, 19 (4.7%) patients presented with procedure-related complications, including technique-associated complications in 6 patients and nursing-associated complications in 13. Differences in the incidence of complications with respect to sex, affected side, soft tissue injury classification, and fracture sites were not observed. However, the number of complications due to hammer insertion was significantly reduced than those due to drill insertions (2.9% vs 7.4%). CONCLUSION: We found a low incidence of early complications related to the fixation. Furthermore, the complications were not significantly associated with the severity of the soft tissue injury and fracture site. Although relatively rough and more likely to cause pain, the number of complications associated with hammer insertion was significantly smaller than that of complications associated with drill insertion.

IL-1ß promotes osteogenic differentiation of mouse bone marrow mesenchymal stem cells via the BMP/Smad pathway within a certain concentration range.

Inflammatory factors play an important role in the process of fracture healing. The influence of interleukin (IL)-1ß, a key inflammatory factory, on new bone formation has been controversial. The aim of the present study was to investigate whether IL-1ß affects the osteogenic differentiation of mouse bone marrow mesenchymal stem cells (MBMMSCs), and examined its effective concentration range and molecular mechanism of action. MBMMSC proliferation in the presence of IL-1ß was observed using a Cell-Counting Kit-8 assay, and the effect of IL-1ß on MBMMSC apoptosis was examined via flow cytometry. Alkaline phosphatase assay, Alizarin Red staining and quantitative assays were performed to evaluate the osteogenic differentiation of MBMMSCs. The expression levels of osteogenic differentiation markers were detected using reverse transcription-quantitative PCR (RT-qPCR). It was demonstrated that within a concentration range of 0.01-1 ng/ml, IL-1ß promoted osteogenic differentiation of MBMMSCs and did not induce apoptosis. Furthermore, RT-qPCR results indicated that IL-1ß increased osteogenic gene expression within this concentration range. Moreover, Western blotting results identified that the bone morphogenetic protein/Smad (BMP/Smad) signaling pathway was significantly activated by IL-1ß under osteogenic conditions. Therefore, the present results suggested that within a certain concentration range, IL-1ß promoted osteogenic differentiation and function of MBMMSCs via the BMP/Smad signaling pathway.

Tibial intramedullary nailing in the lateral decubitus position: Technical notes and preliminary clinical outcomes.

BACKGROUND: Traditional intramedullary nailing (IMN) for tibial shaft fractures through an infrapatellar approach is typically performed in the supine position and requires a specially designed operative table and an experienced assistant throughout the surgery. We attempted to perform IMN for tibial fractures in the lateral decubitus position to make the process easier both for surgeons and radiographers. METHODS: A total of 36 tibial IMN procedures were performed with the patient in the lateral position from May 1, 2014 to April 30, 2016. The technical feasibility and early results were evaluated. RESULTS: The mean time to complete the nailing procedure during surgery was 78.4 ±â€Š1.1 min. The mean intraoperative time for fluoroscopy was 36.7 ±â€Š1.1 min. No radiographic angular malalignment or bone non-union was reported. No surgical site infections or other surgery-related complications occurred in our series. CONCLUSION: Tibial IMN through an infrapatellar approach in the lateral decubitus position may be a valuable alternative as it simplifies the procedure for both surgeons and radiographers. This technique is highly effective for surgical operation and fluoroscopy compared to traditional supine position. This technique also seems to provide satisfactory clinical and radiographic outcomes in our preliminary clinical outcomes.

Diagnosis of Klippel-Trenaunay syndrome and extensive heterotopic ossification in a patient with a femoral fracture: a case report and literature review.

BACKGROUND: Klippel-Trenaunay syndrome (KTS) is a rare complex vessel malformation syndrome characterized by venous varicosities, capillary malformations, and limb hypertrophy. However, extensive heterotopic ossification (HO) secondary to this syndrome is extremely rare. CASE PRESENTATION: We report the case of a patient with previously undiagnosed KTS and extensive HO who presented with a femoral fracture secondary to a motor vehicle accident. Extensive ossification, which leads to compulsive contracture deformity and dysfunction of the leg, was distributed on the flexor muscle side, as revealed by the radiograph. The diagnosis was finally established by combining imaging and histological analysis with classical clinical symptoms. Amputation was performed at the fracture site proximal to the infected necrotic foci. Open management of the fracture was challenging owning to the pervasive ossification and tendency for excessive bleeding. Gene sequencing analysis showed homozygous mutation of FoxO1 gene. CONCLUSIONS: Definitive diagnosis of a combination of KTS and extensive HO requires detailed imaging analysis and pathologic evidence. Mutation of the FoxO1 gene, which regulates bone formation by resistance to oxidative stress in osteoblasts, is a potential factor in the microenvironment of malformed vessels caused by KTS.

Community quarantine strategy against coronavirus disease 2019 in Anhui: An evaluation based on trauma center patients.

OBJECTIVE: The objective of our study was to introduce community quarantine strategy against coronavirus disease 2019 (COVID-19) in Anhui and evaluate the effectiveness of community quarantine based on trauma center (TC) patients. METHOD: The structure of community quarantine strategy was illustrated. Distribution of injuries among patients in two TCs between January 24, 2020 and February 24, 2020 was described. Multiple linear regression was used to analyze the correlation between the distribution of Injuries in TCs and the number of COVID-19-associated cases. RESULTS: A total of 757 TC patients in the two hospitals were enrolled. The number of traffic injuries and outdoor injuries showed a significant decrease in the early stage and began to increase on February 17. The number of indoor injuries neither decreased nor increased. Multiple linear regression analysis revealed a significant correlation between COVID-19-associated cases and traffic and outdoor injuries. CONCLUSION: From the perspective of the injuries in TCs, community quarantine strategy was effectively implemented and significantly slowed the outbreak of COVID-19 in Anhui. However, the implementation and maintenance of the strategy is costly and requires the participation of the entire population.