1.Protective effects of selenium on azathioprine hepatotoxicity in mice
Chengchun SUN ; Cheng YUAN ; Junwen HAO
Chinese Pharmacological Bulletin 1987;0(02):-
The changes of alanine amino-transferase (ALT) in plasma, glutathione (GSH) in the whole blood, the malondialdehyde(MDA) and glutathione peroxidase (GSH-Px) in the liver's tissue in mice were studied in the group with azathioprine (Aza) 10 mg?kg-1?d-1 and in the group with Aza mixed selenium (Se) 1 mg ?kg-1?d-l for 1 and 2 weeks. The results showed that in the Aza group, the levels of ALT, MDA increased and that of GSH, GSH-Px decreased significantly at 1 wk and 2 wk. But in the Se group the levels of ALT, MDA decreased and that of GSH, GSH-Px increased significantly, which approached the nor-mal level. The hepatocytes degeneration and necrosis were observed by light microscope in Aza group but not in Se group. The results indicated that Se had protective effects on Aza hepa-totoxicity in mice.
2.Effect of minimally invasive transpedicular bone grafting additional vertebral pedicle screw fixation in the treatment of thoracolumbar fracture
Xiaobin LI ; Junwen CHENG ; Zhikang ZHOU ; Bin DONG
Chinese Journal of Primary Medicine and Pharmacy 2015;(6):899-901
Objective To explore the effect of minimally invasive transpedicular bone grafting additional ver -tebral pedicle screw fixation in the treatment of thoracolumbar fracture .Methods 60 patients with thoracolumbar fracture were randomly divided into the observation group and the control group ,30 cases in each group .The control group received traditional open inter vertebral four nail pedicle screw fixation combined with posterolateral bone graft fusion for treatment while the observation group was treated by minimally invasive transpedicular bone grafting addi -tional vertebral pedicle screw fixation ,to analyze the clinical effects .Results The imaging parameters of postopera-tion[the sagittal index(1.9 ±7.1)°,Cobb's angle(4.2 ±3.5)°,change of vertebral body height (90.2 ±6.5)%]in the observation group were significantly better than those of the control group (t=6.78,6.80,7.02,all P<0.05). The imaging parameters 3 months after operation[the sagittal index(4.9 ±3.2)°,Cobb's angle(7.0 ±2.7)°,change of vertebral body height (87.6 ±4.1)%] in the observation group were significantly better than those of the control group(t=6.78,6.80,7.02,all P<0.05).The operation time,incision length,bleeding volume,postoperative drain-age,postoperative hospital stay of the observation group were (141.9 ±14.2)min,(10.8 ±1.7)cm,(105.7 ±12.3)mL, (5.6 ±4.1)mL,(6.6 ±1.1)d,respectively,which were significantly better than those of the control group (t=7.72,7.89,5.68,all P<0.05).Conclusion Minimally invasive transpedicular bone grafting additional vertebral pedicle screw fixation has a significant effect in the treatment of thoracolumbar fractures ,which is safe and reliable .
3.The early-term clinical efficacy of titanium trabecular metal acetabular components produced by E-beam technology in total hip arthroplasty
Wenjun CHENG ; Wusheng KAN ; Qiong ZHENG ; Junwen WAN ; Haijun XU ; Zhihong XIAO
Chinese Journal of Orthopaedics 2014;(8):816-823
Objective To explore the early-term efficacy of porous titanium trabecular metal acetabular (TTM) compo-nents produced by E-beam technology in total hip arthroplasty(THA). Methods From May 2012 to JUN 2013, nineteen primary THA patients (20 hips) were devided into observation group of porous TTM acetabular prosthesis produced by E-beam technology and control group of Pinnacle acetabular prosthesis. TTM group had nine patients (10 hips), including 7 males and 2 females, with the mean age of 61.0 years. Pinnacle group had ten patients (10 hips), including 6 males and 4 females, with the mean age of 58.6 years. The patients were followed up at the 6,12,24 weeks after operation. X-rays were taken at the follow-ups. Acetabular compo-nent stability and osseointegration were assessed through radiograph. Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Osteoarthritis index were recorded before and after operation to evaluate clinical effects of surgery. Results In TTM group, the Harris score improved from 48.2 ± 5.5 preoperatively to 89.5 ± 4.0 postoperatively, SF-36 scores from 329.1 ± 86.7 to 763.8 ± 15.1, and WOMAC index from 18.8 ± 11.0 to 1.3 ± 0.9. No cases suffered aseptic loosening and migration. After 24 weeks, There was no significant difference regarding Harris scores system,SF-36 Heath Survey Questionnaire and WOMAC Os-teoarthritis index between two groups. In TTM group, two hips had a radiolucent line postoperatively, which occurred in 2 and 3 zone. The lines were disappeared 24 weeks later. Conclusion In THA, the initial stability of TTM produced by E-beam tech-nology was fine, which can facilitate bone ingrowth in early stage. However, the long-term follow-up effect still needs to be con-firmed.
4.Low calorie parenteral nutrition in the elderly abdominal surgical patients
Aiqun CHENG ; Xiang LI ; Yongqiang WENG ; Weiping LI ; Junwen ZHOU ; Yiqun ZHOU ; Enzhao LUO
Chinese Journal of General Surgery 2001;0(08):-
ObjectiveTo determine the appropriate method of parenteral nutritional(PN) treatment in the elderly abdominal surgical patients. Methods48 operative and 33 nonoperative patients who were put in fasting state received parenteral nutrition for 5 days. The calorie supplied by nonprotein nutrition was 20kcal?kg1?d1 and the protein was 0.8~1.25g?kg1?d1. ResultsPN treatment could maintain the normal plasma protein level and had no influence on the liver and renal function. No side effects or metabolism disorders were noted in this series. ConclusionsLow calorie PN can be safely used in the elderly abdominal surgical patients.
5.Efficacy of fast-track surgery combined with standard rehabilitation training in elderly patients after total hip arthroplasty
Yu CAI ; Huajun ZHOU ; Wenjun CHENG ; Junwen WANG ; Wei ZUO ; Wusheng KAN
Chinese Journal of Orthopaedic Trauma 2016;18(8):673-678
Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P > 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P > 0.05).There were no complications in the experiment group while there were 14 complications (31.1%) in the control group,showing a significant difference (P < 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.
6.Risk factors and nursing countermeasures of nerve damage caused by thoracolumbar burst fractures
Hongyun HAN ; Benrang JIA ; Junwen CHENG
Chinese Journal of Modern Nursing 2016;22(25):3571-3574,3575
Objective To explore the risk factors of nerve damage caused by thoracolumbar burst fractures and put forward targeted nursing interventions so as to provide references for improving the prognosis of patients with thoracolumbar burst fractures. Methods We recruited 375 patients with thoracolumbar burst fractures of Department of Orthopedics in Yuncheng Central Hospital. The clinical data were collected with a self-made questionnaire related to risk factors of nerve damage caused by thoracolumbar burst fractures. The data were analyzed with the methods of descriptive statistics and logistic regression analysis using SPSS 19.0 statistical software.Results The major reasons of nerve damage caused by thoracolumbar burst fractures included traffic accidents (43.64%), falls from great heights (29.09 %). Logistic regression analysis showed that the risk factors of nerve damage caused by thoracolumbar burst fractures involved old age ( OR=1. 63, P<0. 01 ) , damaged segments of T12/L1(OR=20.95, P<0.01), rear ligament complex damage (OR=6.72, P<0.01), intraspinal space-occupying (OR=6.58, P<0.01). Besides, the protective factors of nerve damage caused by thoracolumbar burst fractures included the level of knowledge mastery on self-rescue of fractures ( OR=0.52, P<0.01) and self-rescue measures of fractures (OR=0.21, P<0.01).Conclusions The thoracolumbar burst fracture easily caused nerve damage with many influencing factors. In addition to carrying out well perioperative nursing service for patients with thoracolumbar burst fractures in clinic, it is important to provide health education on knowledge related to self-rescue of fractures for the public through an internet platform so as to reduce the occurrence of nerve damage and improve the prognosis of patients.
7.Treatment of tibial plateau fractures involving external posterior condyle collapse with 3D printed osteotomy guide plate combined with "Jail" screw technique
Jing JIAO ; Yucheng HUANG ; Fei XIAO ; Wenjun CHENG ; Shilei WU ; Chunbao YANG ; Juchuan JIA ; Junwen WANG
Chinese Journal of Orthopaedics 2022;42(18):1204-1211
Objective:To investigate the clinical efficacy of 3D printed osteotomy guide plate combined with "Jail" screw technique in the treatment of tibial plateau fractures involving external posterior condylar collapse.Methods:From January 2016 to January 2021, 41 patients (22 males and 19 females) with tibial plateau fractures involving external posterior condylar collapse were treated with 3D printed osteotomy guide plate combined with "Jail" screw technique and followed up. The age was 47.4±11.5 years (range, 22-69 years). According to Schatzker fracture type, 18 cases were type IV, 14 cases were type V and 9 cases were type VI. All fractures were closed, and 12 of them were complicated with lateral meniscus injury, but none of them were complicated with nerve and vascular injury. The time from injury to operation was 7.2±3.4 d (range, 4-17 d). All patients underwent 3D CT scanning and digital modeling before operation. According to the modeling results, a 1∶1 solid size fracture model was made by 3D printing, and the osteotomy guide plate and the "Jail" screw preset guide plate were designed. During the operation, the tibial lateral condyle osteotomy was performed with customized osteotomy guide plate. After reduction, the fixation of the fracture was performed with the preset guide plate using "Jail" screw. Postoperative fracture reduction was evaluated according to Rasmussen score, and knee function was evaluated by Hospital for Special Surgery (HSS) score.Results:All the 41 patients were followed up for 15.2±5.8 months (range, 6-26 months). Immediate postoperative radiographs showed good fracture reduction, and the average healing time was 14.1±1.2 weeks (range, 12-17 weeks). One year after operation, the Rasmussen score of knee joint was 17.4±1.6 points (range, 13-19 points), of which 31 cases were excellent, 8 cases were good, and 2 cases were fair, with an excellent/good rate of 95% (39/41). HSS scores was 87.3±5.6 points (range, 68-95 points), including 30 excellent cases, 10 good cases and 1 fair case, with an excellent/good rate of 98% (40/41). The range of motion of knee joint was 126.8°±3.8°. At the last follow-up, no serious complications such as common peroneal nerve injury, popliteal vascular injury, postoperative infection, or internal fixation failure occurred.Conclusion:3D printed osteotomy guide plate combined with "Jail" nail placement technique is an effective method for tibial plateau fractures involving external posterior condylar collapse, and the postoperative treatment results are satisfactory. The use of customized osteotomy guide plate is more accurate and less damaging. The use of "Jail" screw preset guide plate can ensure more accurate screw placement.
8.Minimally invasive robot-assisted treatment of tibial plateau fractures of Schatzker types Ⅱ and Ⅲ that can be indirectly reduced
Fei XIAO ; Wenping HE ; Junwen WANG ; Jing JIAO ; Ming CHEN ; Yucheng HUANG ; Keke CHENG ; Tianrun LEI
Chinese Journal of Orthopaedic Trauma 2024;26(7):604-610
Objective:To explore the advantages of minimally invasive internal fixation assisted by an orthopedic robot in the treatment of tibial plateau fractures of Schatzker types Ⅱ and Ⅲ that can be indirectly reduced.Methods:A retrospective study was conducted of the 18 patients who had been treated for tibial plateau fractures of Schatzker types Ⅱ and Ⅲ at Department of Orthopaedics, The Fourth Hospital of Wuhan from December 2019 to December 2021. They were 12 males and 6 females with an age of (45.2±9.6) years. All fractures were closed. Of them, 6 were complicated with an avulsion fracture at the insertion point of the anterior cruciate ligament, 1 with tear of the medial collateral ligament, and 8 with tear of the lateral meniscus. All patients were treated with minimally invasive internal fixation using the "fence" screw technique after indirect reduction assisted by an orthopedic surgical robot. Those combined with avulsion fracture of the anterior cruciate ligament and meniscus tear underwent one-stage arthroscopic surgery, while those combined with tear of the medial collateral ligament underwent one-stage open repair. The fracture reduction was evaluated according to the Rasmussen radiological scoring system, and the knee joint function evaluated using the American Hospital for Special Surgery (HSS) scoring system.Results:All the 18 patients were fully followed up for (10.6±1.9) months. The X-ray films immediately after surgery showed good fracture reduction. The fractures healed after (11.3±1.2) weeks. At 6 months after surgery, the Rasmussen knee score was (16.8±1.0) points, giving 5 excellent and 13 good cases; the HSS score was (93.2±3.0) points, giving 17 excellent and 1 good cases. By the last follow-up, no serious complications occurred, such as common peroneal nerve injury, popliteal vascular injury, postoperative infection, or internal fixation failure.Conclusion:Since minimally invasive internal fixation assisted by an orthopedic robot can lead to fine clinical efficacy for tibial plateau fractures of Schatzker types Ⅱ and Ⅲ, this technique can be widely applied in clinical practice.
9.Comparison of Gamma 3 U-blade system and Gamma 3 nails in treatment of elderly patients with osteoporotic unstable femoral intertrochanteric fracture
Shilei WU ; Jing JIAO ; Yucheng HUANG ; Fei XIAO ; Keke CHENG ; Wenjun CHENG ; Junwen WANG
Chinese Journal of Orthopaedic Trauma 2022;24(3):258-261
Objective:To compare the short-term therapeutic effects of Gamma 3 U-Blade system and Gamma 3 nails in the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture.Methods:The data of 70 elderly patients with osteoporotic unstable intertrochanteric fracture were retrospectively analyzed who had been admitted to the Department of Orthopedics, Wuhan Fourth Hospital from June 2018 to December 2020. They were divided into 2 groups according to their treatments. In the U-Blade group of 35 cases subjected to fixation with Gamma 3 U-Blade system, there were 14 males and 21 females with an age of (77.7 ± 4.8) years; in the Gamma 3 nail group of 35 cases subjected to fixation with Gamma 3 nails, there were 14 males and 21 females with an age of (79.3 ± 5.2) years. The 2 groups were compared in terms of operation time, intraoperative blood loss, apex distance, fracture union time, postoperative complications, timed up and go (TUG) at postoperative 2 weeks, 3 months and 6 months, and hip function at postoperative 9 months.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). There was no significant difference either in operation time, intraoperative blood loss or apex distance between the 2 groups ( P>0.05). The fracture union time [(12.0 ± 0.2) weeks] and Harris hip score at postoperative 9 months [90 (90, 91)] in the U-Blade group were insignificantly different from those in the Gamma 3 nail group [(12.0 ± 0.3) weeks and 91 (89, 91)] ( P>0.05). The rate of implant-related complications in the U-Blade group [0% (0/35)] was significantly lower than that in the Gamma 3 nail group [17.1% (6/35)] and the TUGs at postoperative 2 weeks and 3 months [(80.2 ± 3.6) s and 45 (43, 49) s] in the former were significantly shorter than those in the latter [(89.3 ± 4.2) s and 56 (54, 59) s] ( P<0.05). Conclusion:In the treatment of elderly patients with osteoporotic unstable intertrochanteric fracture, compared with traditional Gamma 3 nails, Gamma 3 U-Blade system can reduce implant-related complications and facilitate early recovery of walking ability.
10.Internal fixation for tibial plateau fractures involving anteromedial margin caused by hyperextension varus injury
Yucheng HUANG ; Jing JIAO ; Wenjun CHENG ; Xin WANG ; Junwen WANG
Chinese Journal of Orthopaedic Trauma 2017;19(10):833-839
Objective To report the operative procedures and clinical outcomes of open reduction and internal fixation for the treatment of tibial plateau fractures involving anteromedial margin caused by hyperextension varus injury.Methods From December 2013 to December 2015,11 patients with tibial plateau fracture involving anteromedial margin caused by hyperextension varus injury were treated at our department.They were 6 males and 5 females with a mean age of 42.3 years (range,from 19 to 65 years).Simple medial column fracture happened in 2,fractures of medial and lateral columns in 4,fractures of medial and posterior columns in 3,and 3-column fractures in 2 cases.The cortical bone fractures of anteromedial margin were fixated by open reduction and internal fixation using self-clipped joint line plating.Bone grafting was conducted if necessary.Results The 9 patients were followed up for an average of 17.6 months (range,from 12 to 30 months).All the fractures healed.The average time for radiographic bony union and full weight bearing was 11.4 weeks (range,from 9 to 14 weeks) and 16.1 weeks (range,from 14 to 19 weeks),respectively.On average,the Rasmussen's radiological grading scored 16.9 (range,from 14 to 18)immediately after operation;the Hospital for Special Surgery scores of all the patients at 12 months postoperatively averaged 89.1 (range,from 75 to 94),yielding an excellent to good rate of 92.3%.The average range of motion of the affected knee was from 2.3° to 125.1°.There were significant differences in both tibial plateau angle and posterior slope angle on radiography between preoperation and postoperation (P < 0.05).There were no significant differences in either tibial plateau angle or posterior slope angle on radiography between immediate postoperation and 12 months postoperation (P > 0.05).Partial incision necrosis occurred postoperatively in one case which was uneventfully healed after wound management.One case complicated with preoperative common peroneal nerve injury reported dorsal sense of numbness which was healed after administration of neurotrophic drugs.No screw loosening,plate breakage or fixation failure was found during follow-ups.Conclusions It is difficult to treat the tibial plateau fractures involving anterumedial margin caused by hyperextension varus injury.Internal fixation with joint line plating is an appropriate treatment for this fracture pattern,leading to satisfactory clinical outcomes.