Objective To investigate the initiation of fracture repair and regulation on molecular level.Methods Literature concernedfracture repair and effects of correlative factors in the process in recent years was reviewed. The initiation in the process of fracture repair and the effects of the correlative factor were summarized to probe into effective methods to intervene. Results During fracture repair, the initiation had particular character and the correlative factors were concerned with the process. Conclusion The correlative factors regulate the initiation of fracture repair on molecular level.
【摘要】 目的 探讨重型颅脑损伤的死亡原因。方法 对2002年1月—2010年1月收治的54例重型颅脑损伤死亡患者,其受伤原因、受伤至入科时间、损伤时间、临床表现、治疗情况等临床资料进行回顾性分析。结果 原发或继发性颅脑损伤严重、严重的合并伤和术后并发症是死亡的重要因素。结论 重型颅脑损伤患者死亡的原因是多方面的,对此类患者须采取综合救治措施,以降低其死亡率。
Objective To review the research progress in transplantation of the skeletal muscle myoblast. Methods The recentlypublished articles concernedwith the myoblast transplantation were reviewed, including myoblast culture, modified transplant methods, preparation of the recipient, scaffold choice, and aninfluence of the recipient’s immunity on the transplantation. How to improve the efficiency of the myoblast transplantation was also discussed. Results The techniques of the myoblast transplantation were improved and transplantation efficiency was increased. 〖WTHZ〗Conclusion The transplantation of the skeletal muscle myoblast has a great potential value in clinical practice and a promising future in its clinical application.
In clinical, manually scoring by technician is the major method for sleep arousal detection. This method is time-consuming and subjective. This study aimed to achieve an end-to-end sleep-arousal events detection by constructing a convolutional neural network based on multi-scale convolutional layers and self-attention mechanism, and using 1 min single-channel electroencephalogram (EEG) signals as its input. Compared with the performance of the baseline model, the results of the proposed method showed that the mean area under the precision-recall curve and area under the receiver operating characteristic were both improved by 7%. Furthermore, we also compared the effects of single modality and multi-modality on the performance of the proposed model. The results revealed the power of single-channel EEG signals in automatic sleep arousal detection. However, the simple combination of multi-modality signals may be counterproductive to the improvement of model performance. Finally, we also explored the scalability of the proposed model and transferred the model into the automated sleep staging task in the same dataset. The average accuracy of 73% also suggested the power of the proposed method in task transferring. This study provides a potential solution for the development of portable sleep monitoring and paves a way for the automatic sleep data analysis using the transfer learning method.
OBJECTIVE: To present a surgical choice for nonunion and bone defect. METHODS: From November 1994 to October 1997, 17 cases of nonunion of fracture and massive bone defect were treated by autogenous iliac bone and fibular bone with vascular anastomosis. Of 17 cases, there were 10 cases of nonunion of bone fracture, 7 cases of bone defect following tumor resection (4 cases of benign and 3 cases of malignant). Autogenous fibular bone grafting with vascular anastomosis, ranging from 12 cm to 29 cm in length, were employed in 12 cases; autogenous iliac bone grafting, ranging from 7 cm x 3 cm to 9 cm x 5 cm in size, were utilized in the other 5 cases. All of 17 cases were followed up for 10 months to 5 years, 3 years and 7 months in average, and were evaluated from clinical manifestation. RESULTS: Bone union was achieved in 10 cases of nonunion of fracture after bone grafting, bony refilling of the bone defect was observed in 4 cases due to benign tumor and 1 case due to malignant tumor. The other 2 cases of malignant tumor died from lung metastasis of the tumor 10 months and 12 months after bone grafting, respectively. CONCLUSION: Bone grafting is an effective surgical option in treatment of nonunion of fracture and bone defect.
Objective To compare the short-term effectiveness of repairing distal tibiofibular syndesmosis with metal screws and absorbable screws. Methods A retrospective analysis was performed on the clinical data of 63 patients with ankle fracture combined with injury of the distal tibiofibular syndesmosis admitted between January 2017 and January 2020. Among them, 31 patients were treated with absorbable screw fixation of the distal tibiofibular syndesmosis (research group) and 32 patients were treated with metal screw fixation of the distal tibiofibular syndesmosis (control group). There was no significant difference in gender, age, cause of injury, surgical side, time from injury to operation, fracture type, preoperative visual analogue scale (VAS) score, and American Orthopaedic Foot & Ankle Society (AOFAS) score between the two groups (P>0.05). The operation time and fracture healing time were recorded and compared between the two groups. X-ray film was taken to evaluate the effect of ankle joint reduction and fixation. Olerud-Molander ankle fracture efficacy score (short for OM score), AOFAS score, and VAS score were used to evaluate the effectiveness. Results There was no significant difference in operation time between the two groups (t=−0.683, P=0.497). In the control group, 1 case of delayed healing and 1 case of poor healing occurred in the lateral incision after operation, which healed after dressing change; the rest of the patients had primary healing of the incision. Patients in both groups were followed up 12-24 months, with an average of 13.8 months. In the control group, 1 patient with fracture of pronation and external rotation walked with full weight bearing after removing the metal screw of the distal tibiofibular syndesmosis at 8 weeks after operation, the anatomical plate of the lateral malleolus was broken, and the lateral malleolus was fixed again and recovered after 5 months; 1 patient had mild ankle pain after operation, and the pain disappeared after removing the metal screw of the distal tibiofibular syndesmosis at 8 weeks. No complication such as nerve and blood vessel injury occurred in all patients. There was no significant difference in fracture healing time between the two groups (t=−1.128, P=0.264). The AOFAS and VAS scores significantly improved in both groups at 12 months after operation (P<0.05). There was no significant difference between the two groups in the OM scores, and the difference of AOFAS and VAS scores between before and after operation (P>0.05). Conclusion Using absorbable screws to repair the distal tibiofibular syndesmosis can effectively restore the ankle acupoint structure, prevent ankle instability, and restore good ankle function. There is no significant difference in effectiveness between absorbable screws and metal screws, and there is no need for secondary operation to remove screws.
Objective To evaluate the effectiveness of open reduction and medial-lateral double plate internal fixation for type C distal humeral fractures. Methods Between June 2002 and January 2009, 32 patients with distal humeral intra-articular fractures were treated. There were 19 males and 13 females, aged 19-70 years (mean, 43.3 years). The fracture was caused by fall ing in 7 cases, by traffic accident in 15 cases, by fall ing from height in 5 cases, by crush injury in 4 cases, and by machine injury in 1 case. The time from injury to operation was 8 hours-7 days (mean, 3.3 days). Of 32 patients, 1 had open fracture and 31 had closed fracture; 5 patients compl icated by injury of ular nerve. According to AO/Association for the Study of Internal Fixation (AO/ASIF) classification, there were 9 cases of type C1, 16 of type C2, and 7 of type C3. Open reduction and medial-lateral double plate internal fixation were performed through posterior midl ine approach in 8 cases and through medial-lateral two-incision approaches in 24 cases. Results All incisions healed by first intention. The 32 cases were followed up 11-24 months (mean, 14 months). The X-ray films showed that all fractures healed at 3-6 months (mean, 3.8 months). According to Aitken et al. scoring system, the results were excellent in 22 cases, good in 6 cases, fair in 3 cases, and poor in 1 case with an excellent and good rate of 87.5%. In 5 patients with injury of ular nerve, 4 cases completely recovered at 6 months and 1 case still showed some symptoms after 1 year. Conclusion Treatment of type C distal humeral fractures with open reduction and medial-lateral double plate internal fixation can get good cl inical results.
ObjectiveTo explore the surgical method and its clinical efficacy for complicated proximal ulnar fracture. MethodsFrom February 2006 to July 2014, 22 patients with complicated proximal ulnar fracture were treated by open reduction with internal fixation. There were 17 males and 5 females with an average age of 32 years. According to AO classification, there were 4 cases of type C1, 13 of type C2, and 5 of type C3. Among the, there were 4 cases combined with posterior elbow dislocation, 2 cases combined with anterior elbow dislocation, and there were 2 Monteggia Ⅳ cases. Nineteen cases were close fractures, and the other 3 were open fractures. Nerve and vessel injury was not found in all cases. The time before operation was 7 to 12 days, with an average of 8 days. All patients were treated with open reduction and internal fixation. Mayo standard for evaluation of elbow joint was used to evaluate the therapeutic effect after operation. ResultsAll the patients were followed up from 8 to 18 months, with an average of 14 months. All fractures were completely healed. The healing time ranged from 12 to 30 weeks averaging 16 weeks. No failure of internal fixation occurred; no elbow anchyloses or instability occurred. The range of motion of elbow joint was between 120° and 140°, with an average of 135°. Mayo elbow score showed that 16 cases were excellent, 4 good, and 2 fair with an excellent and good rate of 90.9%. ConclusionEarly surgical treatment and rehabilitative training can facilitate satisfactory effects on complicated proximal ulnar fracture.