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1.
Chin J Traumatol ; 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34509352

RESUMO

Intertrochanteric fractures have become a severe public health problem in elderly patients. Proximal femoral nail anti-rotation (PFNA) is a commonly used intramedullary fixation device for unstable intertrochanteric fractures. Pelvic perforation by cephalic screw is a rare complication. We reported an 84-year-old female who fell at home and sustained an intertrochanteric fracture. The patient underwent surgery with PFNA as the intramedullary fixation device. Routine postoperative examination revealed medial migration of the helical blade that eventually caused pelvic perforation. We performed a cemented total hip arthroplasty as the savage procedure. At the latest follow-up 12 months after total hip arthroplasty, the patient had no pain or loosening of the prosthesis in the left hip. Pelvic perforation should be considered when choosing PFNA as the intramedullary fixation device, especially in patients with severe osteoporosis wherein the helical blade can be easily inserted during the operation. The lack of devices to avoid oversliding of the helical blade in PFNA is an unreported cause of this complication and should be considered in such cases.

2.
Chin Med J (Engl) ; 134(5): 532-538, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33560666

RESUMO

BACKGROUND: Models to predict mortality in trauma play an important role in outcome prediction and severity adjustment, which informs trauma quality assessment and research. Hospitals in China typically use the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) to describe injury. However, there is no suitable prediction model for China. This study attempts to develop a new mortality prediction model based on the ICD-10-CM lexicon and a Chinese database. METHODS: This retrospective study extracted the data of all trauma patients admitted to the Beijing Red Cross Emergency Center, from January 2012 to July 2018 (n = 40,205). We used relevant predictive variables to establish a prediction model following logistic regression analysis. The performance of the model was assessed based on discrimination and calibration. The bootstrapping method was used for internal validation and adjustment of model performance. RESULTS: Sex, age, new region-severity codes, comorbidities, traumatic shock, and coma were finally included in the new model as key predictors of mortality. Among them, coma and traumatic shock had the highest scores in the model. The discrimination and calibration of this model were significant, and the internal validation performance was good. The values of the area under the curve and Brier score for the new model were 0.9640 and 0.0177, respectively; after adjustment of the bootstrapping method, they were 0.9630 and 0.0178, respectively. CONCLUSIONS: The new model (China Mortality Prediction Model in Trauma based on the ICD-10-CM lexicon) showed great discrimination and calibration, and performed well in internal validation; it should be further verified externally.


Assuntos
Classificação Internacional de Doenças , Ferimentos e Lesões , Pequim , China , Humanos , Valor Preditivo dos Testes , Estudos Retrospectivos
3.
World J Emerg Med ; 12(1): 18-23, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33505545

RESUMO

BACKGROUND: A pandemic of coronavirus disease (COVID-19) has been declared by the World Health Organization (WHO) and caring for critically ill patients is expected to be at the core of battling this disease. However, little is known regarding an early detection of patients at high risk of fatality. METHODS: This retrospective cohort study recruited consecutive adult patients admitted between February 8 and February 29, 2020, to the three intensive care units (ICUs) in a designated hospital for treating COVID-19 in Wuhan. The detailed clinical information and laboratory results for each patient were obtained. The primary outcome was in-hospital mortality. Potential predictors were analyzed for possible association with outcomes, and the predictive performance of indicators was assessed from the receiver operating characteristic (ROC) curve. RESULTS: A total of 121 critically ill patients were included in the study, and 28.9% (35/121) of them died in the hospital. The non-survivors were older and more likely to develop acute organ dysfunction, and had higher Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores. Among the laboratory variables on admission, we identified 12 useful biomarkers for the prediction of in-hospital mortality, as suggested by area under the curve (AUC) above 0.80. The AUCs for three markers neutrophil-to-lymphocyte ratio (NLR), thyroid hormones free triiodothyronine (FT3), and ferritin were 0.857, 0.863, and 0.827, respectively. The combination of two easily accessed variables NLR and ferritin had comparable AUC with SOFA score for the prediction of in-hospital mortality (0.901 vs. 0.955, P=0.085). CONCLUSIONS: Acute organ dysfunction combined with older age is associated with fatal outcomes in COVID-19 patients. Circulating biomarkers could be used as powerful predictors for the in-hospital mortality.

4.
J Cardiothorac Surg ; 15(1): 167, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32646474

RESUMO

BACKGROUND: Chest blunt trauma (CBT) and the resultant rib fractures often lead to thoracic collapse. The purpose of this study was to explore the effect of displacement of the rib fracture and thoracic collapse on the thoracic volume by using normal chest CT data. METHODS: In this retrospective study, seven consecutive normal participants were selected from our hospital between June and July 2018. Normal thoracic models were reconstructed, followed by simulation of lateral fractures through the 4th to 9th ribs under three collapse modes with 1-5 cm of collapse. The thoracic collapse models (n = 630) were reconstructed using 3Dmax 2014. We calculated the thoracic volume and reduction percentage for each thoracic collapse model. Linear regression-based comparisons of thoracic volume reductions were performed. RESULTS: In all three collapse modes, the degree of the collapse was linearly correlated with the mean thoracic volume reduction. The reduction percentage in the posterior collapse mode was higher than that in the anterior collapse mode (P < 0.001). The largest volume reductions in the anterior, posterior, and simultaneous collapse models were in the 6th rib fracture model (P < 0.001), 8th rib fracture model (P < 0.001), and 7th rib fracture model (P < 0.001), respectively. CONCLUSIONS: The influences of rib fracture displacement and collapse on the thoracic volume in the 6th through 8th ribs are critical in lateral rib fractures. For patients with 6th to 8th rib fractures and posterior rib collapse, surgical intervention to restore thoracic volume may be more essential.


Assuntos
Fraturas das Costelas/diagnóstico por imagem , Cavidade Torácica/diagnóstico por imagem , Cavidade Torácica/patologia , Ferimentos não Penetrantes/diagnóstico por imagem , Adulto , Simulação por Computador , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Estudos Retrospectivos , Fraturas das Costelas/etiologia , Fraturas das Costelas/cirurgia , Tomografia Computadorizada por Raios X , Ferimentos não Penetrantes/complicações
5.
Chin Med J (Engl) ; 133(11): 1268-1275, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32404692

RESUMO

BACKGROUND: We aimed to describe and analyze the pre-hospital emergency medical service (EMS) in Beijing and provide information for the government and medical institutions to optimize EMS. METHODS: We collected all pre-hospital emergency data in Beijing from 2008 to 2017. The chief complaint in each case was classified according to the Medical Priority Dispatch System (MPDS). The sites' administrative districts were determined through geo-encoding of addresses and then classified into four functional regions. We analyzed the demand for EMS, emergency response times (ERT), and disease spectrum for Beijing as a whole, and for each functional region. RESULTS: A total of 4,192,870 pre-hospital EMS cases met the inclusion criteria, with a significant increase (P < 0.001) of 51.60% from 2008 to 2017. EMS demand was positively associated with population (r = 0.946, P < 0.001). The pre-hospital EMS demand rate was 1907.05 in 2008 and 2172.23 in 2017 per 100,000, with no significant change (P = 0.57). ERT increased significantly (P = 0.001), from 19.18 min in 2008 to 24.51 min in 2016. According to MPDS classifications, the demand for pre-hospital care increased for 14 diseases, remained stable for 19, and decreased for only 1 disease. Cases of injury-related disease increased significantly from approximately 90,000 in 2017, accounting for 20% of all pre-hospital EMS cases, and the demand rate decreased in the core region but increased in the sub-urban regions. Cases of heart problems and stroke/transient ischemic attack also increased significantly in the four functional regions, with the highest demand rate in the Core Functional Region. CONCLUSIONS: More resources and effort should be devoted to pre-hospital EMS according to the increased pre-hospital EMS demand and prolonged ERT in Beijing over our 10-year study period. Changes in disease spectrum and differences between functional regions should also be considered.


Assuntos
Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Emergências , Hospitais , Humanos , Estudos Retrospectivos
6.
Mater Sci Eng C Mater Biol Appl ; 110: 110640, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32204074

RESUMO

Hydrogen (H2) is one of the major biodegradation products of magnesium (Mg) alloys implanted for bony fracture healing and reconstruction; H2 thus plays a significant role in the regulation of local microenvironment and the biology of resident cells. The interactions between the H2 and the local cells are of great interest, and a full understanding of the effect of H2 on bone marrow mononuclear cells (BMMCs) would accelerate the development of effective strategies for successful bony healing. This study investigates how H2, with different concentrations and durations, regulates the osteoclastogenesis of mouse BMMCs. First, using H2 with five concentrations (0%, 2%, 25%, 50% and 75%) and three durations (5, 7 and 10 days), the osteoclastogenesis of mouse BMMCs in these H2 conditions were measured using TRAP staining, F-actin ring formation assay, pit formation assay and RT-qPCR analysis. Based on these findings, the proliferation assay, apoptosis assay, western blot analysis and ELISA assay of BMMCs after osteoclast induction were performed. The findings showed that H2 (especially the 50% and 75% H2) obviously inhibited the osteoclast formation, function and osteoclast-related genes expression of osteoclast-induced BMMCs; additionally, H2 (50%) was found to reduce the proliferation, promote the apoptosis and inhibit the expression of osteoclast-related proteins of BMMCs with the presence of osteoclast-induced medium. Therefore, H2 significantly inhibited the osteoclastogenesis of mouse BMMCs, which may become a new therapeutic agent for anti-bony resorption and open new avenues for the translational research of Mg alloys.


Assuntos
Células da Medula Óssea/citologia , Hidrogênio/farmacologia , Leucócitos Mononucleares/citologia , Osteogênese/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Células da Medula Óssea/efeitos dos fármacos , Células da Medula Óssea/metabolismo , Proliferação de Células/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Leucócitos Mononucleares/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Osteoclastos/citologia , Osteoclastos/efeitos dos fármacos , Osteoclastos/metabolismo
7.
BMJ Open ; 8(12): e023347, 2018 12 04.
Artigo em Inglês | MEDLINE | ID: mdl-30518584

RESUMO

INTRODUCTION: The implementation of first aid processes for patients with trauma in China faces significant challenges. These challenges include long response times of prehospital first aid services, lack of information exchange between prehospital first aid services and in-hospital emergency services, lack of a professional rescue team in the majority of hospitals, and lack of standardised training for prehospital and in-hospital emergency personnel. The purpose of the trial is to guide the establishment of an urban trauma treatment system in China, highlight the construction of a trauma treatment system tailored to the Chinese context and improve levels of medical treatment by selecting approximately 100 counties across China as pilots to establish a regional trauma treatment system. METHODS AND ANALYSIS: A cluster-randomised controlled trial will be performed in 98 county-level research institutes. Included research institutes will be randomised into an experimental group and a control group. Patients in both experimental and control groups will receive basic treatments. A trauma treatment team will be established in the experimental group. The primary outcome measure is in-hospital mortality rate of patients. The secondary outcome measures include mortality rate of patients within 30 days after trauma attack and within 30 days after discharge, the time between arrival in the institution and receiving consultation, and the time from admission to the start of surgery. The effects of establishment of trauma treatment teams on the treatment of severe trauma will be evaluated in all counties. ETHICS AND DISSEMINATION: The procedures have been approved by The Medical Ethics Committee of Peking University People's Hospital (No.2017PHB098-01) and conform to the Declaration of Helsinki. Data will be collected and analysed in accordance with participant privacy laws and regulations. Results will be disseminated through policy briefs, workshops, peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER: NCT03363880; Pre-results.


Assuntos
Primeiros Socorros , Equipe de Assistência ao Paciente/organização & administração , Regionalização da Saúde/organização & administração , Ferimentos e Lesões/cirurgia , China , Análise por Conglomerados , Acesso aos Serviços de Saúde/organização & administração , Mortalidade Hospitalar , Humanos , Taxa de Sobrevida , Estudos de Tempo e Movimento , Ferimentos e Lesões/mortalidade
8.
Chin J Traumatol ; 21(1): 30-33, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29429777

RESUMO

PURPOSE: To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. METHODS: In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People's Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases. Evaluation was based on Sartiento's modification of the Gartland and Werley score. Efficacy was assessed with wrist pain as the focus. RESULTS: The wrist function scores of the surgical group were better than nonoperative groups. There was no significant difference in wrist function scores between the dorsal splint group and the bivalve cast group. The ulnar wrist pain incidence had no significant difference in surgical and nonoperative groups. The displace rate in dorsal splint group was higher than other groups. CONCLUSION: The overall effect of surgical treatment of distal radius fracture is better than nonoperative treatment. The ulnar wrist pain incidence has no significant difference in these groups. Dorsal splint fixation is more prone to displace than bivalve cast fixation.


Assuntos
Fraturas do Rádio/terapia , Punho/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Consolidação da Fratura , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas do Rádio/fisiopatologia , Adulto Jovem
9.
Disaster Med Public Health Prep ; 12(3): 411-414, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29198239

RESUMO

BACKGROUND: On August 12, 2015, a hazardous chemical explosion occurred in the Tianjin Port of China. The explosions resulted in 165 deaths, 8 missing people, injuries to thousands of people. We present the responses of emergency medical services and hospitals to the explosions and summarize the lessons that can be learned. METHODS: This study was a retrospective analysis of the responses of emergency medical services and hospitals to the Tianjin explosions. Data on injuries, outcomes, and patient flow were obtained from the government and the hospitals. RESULTS: A total of 46 ambulances and 143 prehospital care professionals were dispatched to the scene, and 198 wounded were transferred to hospitals by ambulance. More than 4000 wounded casualties surged into hospitals, and 798 wounded were admitted. Both emergency medical services and hospitals were quick and successful in the early stage of the explosions. The strategy of 4 centralizations (4Cs) for medical services management in a mass casualty event was successfully applied. CONCLUSIONS: The risk of accidental events has increased in recent years. We should take advantage of the lessons learned from the explosions and apply these in future disasters. (Disaster Med Public Health Preparedness. 2018; 12: 411-414).


Assuntos
Serviços Médicos de Emergência/estatística & dados numéricos , Explosões/estatística & dados numéricos , Fatores de Tempo , Vazamento de Resíduos Químicos/estatística & dados numéricos , China , Serviços Médicos de Emergência/métodos , Humanos , Incidentes com Feridos em Massa/estatística & dados numéricos , Estudos Retrospectivos , Capacidade de Resposta ante Emergências/estatística & dados numéricos , População Urbana
10.
Neural Regen Res ; 10(10): 1690-5, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26692871

RESUMO

Although several surgical procedures exist for treating cubital tunnel syndrome, the best surgical option remains controversial. To evaluate the efficacy of anterior subcutaneous transposition of the ulnar nerve in patients with moderate to severe cubital tunnel syndrome and to analyze prognostic factors, we retrospectively reviewed 62 patients (65 elbows) diagnosed with cubital tunnel syndrome who underwent anterior subcutaneous transposition. Preoperatively, the initial severity of the disease was evaluated using the McGowan scale as modified by Goldberg: 18 patients (28%) had grade IIA neuropathy, 20 (31%) had grade IIB, and 27 (42%) had grade III. Postoperatively, according to the Wilson & Krout criteria, treatment outcomes were excellent in 38 patients (58%), good in 16 (25%), fair in 7 (11%), and poor in 4 (6%), with an excellent and good rate of 83%. A negative correlation was found between the preoperative McGowan grade and the postoperative Wilson & Krout score. The patients having fair and poor treatment outcomes had more advanced age, lower nerve conduction velocity, and lower action potential amplitude compared with those having excellent and good treatment outcomes. These results suggest that anterior subcutaneous transposition of the ulnar nerve is effective and safe for the treatment of moderate to severe cubital tunnel syndrome, and initial severity, advancing age, and electrophysiological parameters can affect treatment outcome.

11.
Chin Med J (Engl) ; 128(10): 1301-5, 2015 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-25963348

RESUMO

BACKGROUND: This study aimed to evaluate the effects of standard rescue procedure (SRP) in improving severe trauma treatments in China. METHODS: This study was conducted in 12 hospitals located in geographically and industrially different cities in China. A standard procedure on severe trauma rescue was established as a general rule for staff training and patient treatment. A regional network (system) efficiently integrating prehospital rescue, emergency room treatments, and hospital specialist treatments was built under the rule for information sharing and improving severe trauma treatments. Treatment outcomes were compared between before and 1 year after the implementation of the SRP. RESULTS: The outcomes of a total of 74,615 and 12,051 trauma cases were collected from 12 hospitals before and after the implementation of the SRP. Implementation of the SRP led to efficient cooperation and information sharing of different treatment services. The emergency response time, prehospital transit time, emergency rescue time, consultation call time, and mortality rate of patients were 24.24 ± 4.32 min, 45.69 ± 3.89 min, 6.38 ± 1.05 min, 17.53 ± 0.72 min, and 33.82% ± 3.87% (n = 441), respectively, before the implementation of the standardization and significantly reduced to 10.11 ± 3.21 min, 22.39 ± 4.32 min, 3.26 ± 0.89 min, 3.45 ± 0.45 min, and 20.49% ± 3.11%, separately (n = 495, P < 0.05) after that. CONCLUSIONS: Staff training and SRP can significantly improve the efficiency of severe trauma treatments in China.


Assuntos
Serviços Médicos de Emergência/normas , Ferimentos e Lesões , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Adulto Jovem
12.
Zhongguo Gu Shang ; 28(3): 226-9, 2015 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-25936191

RESUMO

OBJECTIVE: To analyze effects of fracture of processus styloideus ulnae on prognosis in the treatment of distal radial fracture of type C according to AO classification. METHODS: This was a retrospective case-control study, and the information was got ten through case evaluation and follow-up, including sex, age, patient satisfaction, Gartland & Werley score and radiographic score. There were 76 patient treated with open reduction and plate fixation in People's Hospital Affiliated to Peking University from July 2006 to July 2011. All the patients were divided into two groups: no combination with fracture of processus styloideus ulnae (group A, 56 cases), combination with fracture of processus styloideus ulnae (group B, 20 cases). The patients in group A and B were treated with open reduction and internal fixation; however the fracture of processus styloideus ulnae was not fixed. The indexes such as clinical data, bone grafting, joint movement, Gartland & Werley score and radiographic score were compared between two groups. RESULTS: The ulnaris pain of patients in group B was more obvious than that in group A. The local VAS, palmar and dorsal flexion degree of wrist joint, motion VAS, patients satisfaction score, radial and ulnar deviation degree, pronation and supination of forearm degree, Gartland & Werley score and radiographic score were separately 0.1 ± 0.1, (51.1 ± 1.9)°, (60.2 ± 1.9)°, 0.6 ± 0.1 (23.1 ± 0.9)°, (28.7 ± 1.3)° (81.5 ± 2.6)°, (68.2 ± 2.7)° 1.9 ± 0.3, 89.6 ± 12.3 in group A; and separately 0.3 ± 0.3, (51.4 ± 2.3)°, (66.6 ± 1.7)°, 0.5 ± 0.2, (24.5 ± 2.0)°, (26.9 ± 1.8)°, (80.3 ± 2.5)°, (70.3 ± 3.7)°, 1.2 ± 0.4, 92.5 ± 7.5 in group B; there were no statistical differences in above indexes between two groups. CONCLUSION: Whether the distal radial fracture with a concomitant unrepaired ulnar styloid fracture or not exerts no influence on mainly outcomes including function, radiography and motion of the wrist.


Assuntos
Placas Ósseas , Fixação Interna de Fraturas/métodos , Fraturas do Rádio/cirurgia , Fraturas da Ulna/cirurgia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
13.
Neural Regen Res ; 10(1): 71-8, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25788923

RESUMO

The clinical effects of 2-mm small gap sleeve bridging of the biological conduit to repair peripheral nerve injury are better than in the traditional epineurium suture, so it is possible to replace the epineurium suture in the treatment of peripheral nerve injury. This study sought to identify the regeneration law of nerve fibers in the biological conduit. A nerve regeneration chamber was constructed in models of sciatic nerve injury using 2-mm small gap sleeve bridging of a biodegradable biological conduit. The results showed that the biological conduit had good histocompatibility. Tissue and cell apoptosis in the conduit apparently lessened, and regenerating nerve fibers were common. The degeneration regeneration law of Schwann cells and axons in the conduit was quite different from that in traditional epineurium suture. During the prime period for nerve fiber regeneration (2-8 weeks), the number of Schwann cells and nerve fibers was higher in both proximal and distal ends, and the effects of the small gap sleeve bridging method were better than those of the traditional epineurium suture. The above results provide an objective and reliable theoretical basis for the clinical application of the biological conduit small gap sleeve bridging method to repair peripheral nerve injury.

14.
Neural Regen Res ; 10(1): 79-83, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25788924

RESUMO

Repair techniques for short-distance peripheral nerve defects, including adjacent joint flexion to reduce the distance between the nerve stump defects, "nerve splint" suturing, and nerve sleeve connection, have some disadvantages. Therefore, we designed a repair technique involving intraoperative tension-free application of a nerve elongator and obtained good outcomes in the repair of short-distance peripheral nerve defects in a previous animal study. The present study compared the clinical outcomes between the use of this nerve elongator and performance of the conventional method in the repair of short-distance transection injuries in human elbows. The 3-, 6-, and 12-month postoperative follow-up results demonstrated that early neurological function recovery was better in the nerve elongation group than in the conventional group, but no significant difference in long-term neurological function recovery was detected between the two groups. In the nerve elongation group, the nerves were sutured without tension, and the duration of postoperative immobilization of the elbow was decreased. Elbow function rehabilitation was significantly better in the nerve elongation group than in the control group. Moreover, there were no security risks. The results of this study confirm that the use of this nerve elongator for repair of short-distance peripheral nerve defects is safe and effective.

15.
Neural Regen Res ; 10(1): 90-4, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25788926

RESUMO

Electrical stimulation has been shown to accelerate and enhance nerve regeneration in sensory and motor neurons after injury, but there is little evidence that focuses on the varying degrees of fibrosis in the delayed repair of peripheral nerve tissue. In this study, a rat model of sciatic nerve transection injury was repaired with a biodegradable conduit at 1 day, 1 week, 1 month and 2 months after injury, when the rats were divided into two subgroups. In the experimental group, rats were treated with electrical stimuli of frequency of 20 Hz, pulse width 100 ms and direct current voltage of 3 V; while rats in the control group received no electrical stimulation after the conduit operation. Histological results showed that stained collagen fibers comprised less than 20% of the total operated area in the two groups after delayed repair at both 1 day and 1 week but after longer delays, the collagen fiber area increased with the time after injury. Immunohistochemical staining revealed that the expression level of transforming growth factor ß (an indicator of tissue fibrosis) decreased at both 1 day and 1 week after delayed repair but increased at both 1 and 2 months after delayed repair. These findings indicate that if the biodegradable conduit repair combined with electrical stimulation is delayed, it results in a poor outcome following sciatic nerve injury. One month after injury, tissue degeneration and distal fibrosis are apparent and are probably the main reason why electrical stimulation fails to promote nerve regeneration after delayed repair.

16.
Neural Regen Res ; 10(1): 95-8, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25788927

RESUMO

Human acellular nerve allografts have a wide range of donor origin and can effectively avoid nerve injury in the donor area. Very little is known about one-stage reconstruction of digital nerve defects. The present study observed the feasibility and effectiveness of human acellular nerve allograft in the reconstruction of < 5-cm digital nerve defects within 6 hours after injury. A total of 15 cases of nerve injury, combined with nerve defects in 18 digits from the Department of Emergency were enrolled in this study. After debridement, digital nerves were reconstructed using human acellular nerve allografts. The patients were followed up for 6-24 months after reconstruction. Mackinnon-Dellon static two-point discrimination results showed excellent and good rates of 89%. Semmes-Weinstein monofilament test demonstrated that light touch was normal, with an obvious improvement rate of 78%. These findings confirmed that human acellular nerve allograft for one-stage reconstruction of digital nerve defect after hand injury is feasible, which provides a novel trend for peripheral nerve reconstruction.

17.
Beijing Da Xue Xue Bao Yi Xue Ban ; 46(5): 766-70, 2014 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-25331402

RESUMO

OBJECTIVE: To investigate the surgical treatment results of implant failure after clavicular fracture open reduction and internal fixation (ORIF). METHODS: Fifteen cases from Jan. 2005 to Jan. 2013 were treated surgically according to fracture classification, time of implant failure and implant type. The fracture union, shoulder function and pain were evaluated postoperatively. RESULTS: All the patients had full follow-up for 5 to 101 months (mean: 43.8 months). All the fractures were united well. The constant scores to assess the shoulder function were 82 to 100 (mean: 93.3 in the fracture side) and were 85 to 100 (mean: 96.7 in the uninjured side); statistically significant difference of the constant scores between the two sides was found (P=0.02). Eight cases did not have shoulder pain in the fracture side, while the other 7 cases had mild pain, The visual analogue scale (VAS) scores to evaluate shoulder pain were 1 to 3 in the fracture side, which were statistically different from those in the uninjured side (P=0.03). CONCLUSION: Implant instability causes early implant failure after clavicular fracture ORIF and re-fixation with stable implant is effective. Fracture nonunion leads to late implant failure, and bridging fixation using locking plate associated with bony autograft with iliac crest is a successful method to treat atrophy clavicular nonunion. Surgical treatment can bring good results.


Assuntos
Clavícula/cirurgia , Fixação Interna de Fraturas , Fraturas Ósseas/cirurgia , Placas Ósseas , Humanos , Dor , Procedimentos Cirúrgicos Reconstrutivos
18.
Beijing Da Xue Xue Bao Yi Xue Ban ; 46(5): 777-81, 2014 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-25331404

RESUMO

OBJECTIVE: To evaluate the current condition of urban road traffic injuries (RTIs) according to Beijing Emergency Medical Center (BEMC) from Jan. 1, 2004 to Dec. 31, 2010, analyze the social characteristics and explore the possible methods for prevention and improvement. METHODS: Using data from the Beijing Emergency Medical Center, we collected 19 550 victims who were involved in RTIs in Beijing from Jan. 1, 2004 to Dec. 31, 2010. The personal information, time of the injury event, road user type and striking vehicle type, as well as the site and severity of injury, were analyzed using Excel 2007 and SPSS 17.0 software with ANOVA of variance and Chi-squared tests. RESULTS: The annual rate of RTIs was 120.0 per 100 000 people in Beijing, and the mortality rate was about 4.97 per 100 000 people. Male victims were more than female victims (11 737 persons vs. 7 618 persons).The mean age was (72.92 ± 5.67) years. Overall, RTIs in all the age groups happened in October commonly, and were inclined to daytime, especially at noon. But different age groups had their special hour distribution features of RTIs. Traffic collisions occurred most frequently in pedestrians and cyclists (7 588,38.81%;3 790,19.39%). Majorities of victims presented with head injuries and lower-limb injuries(8 343,42.68%; 6 828,34.93%). These collisions included car striking accidents (11 490, 58.77%). And most of the older adults were classified as medium in severity (11 718, 59.94%). CONCLUSION: The prevention and treatment of RTIs, should focus on targeted prevention solutions and standardized pre-hospital rescue, according to specific population, time interval and vehicle usage.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Idoso , China/epidemiologia , Cidades , Traumatismos Craniocerebrais/epidemiologia , Serviços Médicos de Emergência , Feminino , Hospitais , Humanos , Traumatismos da Perna/epidemiologia , Masculino
19.
Beijing Da Xue Xue Bao Yi Xue Ban ; 46(2): 254-7, 2014 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-24743816

RESUMO

OBJECTIVE: To study clinical-related characteristics of sociology of postoperative distal radius fracture patients. METHODS: A multi-center retrospective research was conducted on the information of the case evaluation and follow-up, including the patients' gender, age, habits, history of chronic diseases, conditions of fracture, length of hospital stay and treatments. The epidemiology data were analyzed with SPSS15.0. RESULTS: Of the entire 143 patients, 52 were male (average age: 41), and 91 were female (average age: 61). The different gender and age groups had significant distinction in the characteristics of injury. The length of hospital stay was influenced by the energy of injury. CONCLUSION: To reduce the damage or incidence of distal radius fracture, we should avoid falling, strengthen protection awareness, treat internal medicine diseases or osteoporosis and so on. The knowledge of characteristics of sociology and injury of distal radius fracture is beneficial to the prevention and treatment.


Assuntos
Fraturas do Rádio/epidemiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos
20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 45(5): 704-7, 2013 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-24136262

RESUMO

OBJECTIVE: To observe the clinical outcome after the surgical treatment of the deltoid ligament injury associated with ankle fractures. METHODS: From January 2005 to December 2009, 16 deltoid ligament ruptures associated with ankle fractures were repaired. According to the AO/OTA system, 2 cases belonged to fracture A, 8 to B, and 6 to C. Radiographs, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores and visual analogue scale (VAS) were used for the outcome measurements. RESULTS: The 16 patients were followed up for 30 to 84 months,with the mean follow-up of 47 months. All wounds healed at the first stage. The mean time of bone union was 12.8 weeks (range: 10-14 weeks). The mean AOFAS ankle-hindfoot score in the last follow-up was 93 points (range: 85-100 points). The mean score of VAS was 0.94 points (range: 0-2 points). CONCLUSION: Surgical treatment of ankle fractures associated with deltoid ligament rupture can achieve satisfactory outcomes, but it is important to decide the operation indication.


Assuntos
Fraturas do Tornozelo , Fraturas Ósseas/cirurgia , Ligamentos Articulares/lesões , Adulto , Idoso , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Humanos , Ligamentos Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Ruptura , Técnicas de Sutura , Resultado do Tratamento , Adulto Jovem
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