Objective To explore the effect of peripheral nerve electrical stimulation on axon regeneration after spinal cord injury (SCI) in rats. Methods Nighty-two healthy Sprague-Dawley rats were randomly divided into blank control group (n=12), control group (n=40) and experimental group (n=40). All groups were suffered NYU impaction to prepare T8 SCI models, the control group and the experimental group implanted stimulating electrode on the sciatica nerve. The experimental group received electric intervention in addition. They were evaluated with BBB score one day, one week, two weeks, four weeks and eight weeks after modeling; and with motor evoked potentials (MEP) one week, two weeks, four weeks and eight weeks after modeling. Morphological changes and the expression of neurofilament pro-tein (NF)-200 and glial fibers acid protein (GFAP) were observed by HE staining and immunohistochemistry one week, two weeks, four weeks and eight weeks after modeling. Results There was no significant difference in BBB scores among three groups (P>0.05) in all the time points except eight weeks (P<0.05). There was no significant difference in the amplitudes and latencies among three groups one week after modeling (P>0.05), however, there was significant difference two weeks, four weeks and eight weeks after modeling (P<0.05). All the groups showed syringomyelia and glial scar formation one week, two weeks, four weeks and eight weeks after modeling. There was no sig-nificant difference in NF-200 axon count among three groups one week after modeling (P>0.05), but was different two weeks, four weeks and eight weeks after modeling (P<0.05). There was no significant difference in GFAP area count among three groups in all the time points (P>0.05). Conclusion Implantable peripheral nerve electrical stimulation can improve conduction function and motor function in rats with SCI. And it may promote axonal regeneration of the injured segments.

Objective To compare the short-term effects of myocapsular flap repair through minimal posterior approach in Hip arthroplasty with traditional posterior approach in hip arthroplasty in elderly femoral neck fractures. Methods From August 2007 to may 2009, a total of 126 femoral neck fracture patients were randomly divided into two groups, with 63 patients treated with myocapsular flap repair through minimal posterior approach (the modified group), and 63 patients treated with traditional posterior approach (the traditional group). Fifty-eight patients underwent the first-ever total hip replacement and 68 patients underwent artificial double-acting femoral head replacement. Eighty-four cases were inserted with cemented implants and 42 cases with uncemented. Data of incision length, operation time, blood loss volume, drainage amount, blood transfusion volumes were recorded separately. Postoperative complications related to the surgery and hip joint function were also documented. Function of hip joint was scored with Harris scale. All data were statistically analyzed. Results Five patients died within 1 year of surgery, and 4 patients dropped out. All the remained 117 patients were followed up for 12 - 24 months. There were no significant difference in age, type of fracture and artificial the incision length in the modified group was significantly shorter than that in the traditional group([ 10. 5 ± 2. 4 ]cm vs [ 17. 2 ± 3.6 ] cm, t = 3. 012, P = 0. 004). The average operating time was significantly shorter in the modified group compared to the traditional group (t = 2. 455, P = 0. 038). Blood loss, drainage amount, blood transfusion volumes in the modified group were less than those in the traditional group( t = 3.211,2. 986 and 3. 352 ,Ps ＜ 0. 01, respectively). Conclusion Myocapsular flap repair through minimal posterior approach in Hip arthroplasty is a reasonable, mini invasive technique for hip replacement in older with a less blood loss and shorter operating time.fractures

Objective To evaluate the relationship of diurnal variation of antidiuretic hormone (ADH) with urinary output,serum osmolality and blood pressure in spinal cord injury (SCI) patients. MethodsThe study was prospective,random and contrastive. Twenty complete SCI patients (two females and 18 males,Complete SCI group) and ten healthy controls (two females and eight males,control group) were studied. Urinary output and osmolality in the day time (8:00-20:00) and at night (20:00-8:00) were recorded. Blood samples for the measurement of serum osmolality and ADH were drawn at 14:00 and 2:00. Results There was very significant difference in regard of urinary output between day time and night time in complete SCI Group and control Group ( P 0.05). However,ADH level increased in the healthy Group at night,with a very significant difference ( P

Objective:To investigate the influence of preoperative thyroid dysfunction on the 30-day postoperative mortality and complications in elderly patients with hip fracture.Methods:A retrospective analysis was conducted of the 349 elderly patients with hip fracture who had been admitted to Department of Orthopedic Trauma, Beijing Luhe Hospital Affiliated to Capital Medical University from January 2018 to December 2019. They were 108 males and 241 females, with an average age of 76.3 years (from 60 to 104 years). There were 190 femoral intertrochanteric fractures and 159 femoral neck fractures. By the preoperative level of thyroid function, the patients were divided into a normal function group of 290 cases and a dysfunction group of 59 cases. The 2 groups were compared in terms of hospital stay, mortality and incidence of complications within 30 days postoperation.Results:In this cohort, the rate of 30-day postoperative mortality was 3.4%(12/349) and the incidence of 30-day postoperative complications 14.6%(51/349). The 2 groups were comparable because there was no significant difference between them in the preoperative general data except for the preoperative comorbidity of coronary heart disease ( P>0.05). In the dysfunction group, the hospital stay averaged (10.2±6.9) d, the rate of 30-d postoperative mortality 1.7%(1/59) and the incidence of 30-day postoperative complications 16.9%(10/59), which were insignificantly different from those in the normal function group [(10.7±7.5) d, 3.8%(11/290) and 14.1%(41/290), respectively] ( P> 0.05). Conclusion:Since preoperative thyroid dysfunction does not affect the 30-day postoperative mortality and postoperative complications in the elderly patients with hip fracture but no definite thyroid disease, routine thyroid function screening is not recommended for them.

As patients undergoing orthopedic surgery are a high-risk group for venous thromboembolism (VTE), clinical guidelines suggest anticoagulant drugs for VTE prophylaxis during perioperative period. Global antithrombotic guidelines vary in recommendations for anticoagulant drugs, but there is a general consensus in favor of using low-molecular-weight heparin (LMWH) as the first choice for prophylaxis, followed by unfractionated heparin, fondaparinux, warfarin, aspirin, and other direct oral anticoagulants (DOACs). Of them, aspirin is an inexpensive, widely used antiplatelet drug with limited complications and clear efficacy in prevention of myocardial infarction, stroke, and certain specific cancers. It was also used early for venous thromboembolism prophylaxis in orthopedic patients after surgery. Clinical experience of orthopedic physicians in North America has shown the effectiveness of aspirin in VTE prevention over several decades so that aspirin continues to be used to this day, but its use for VTE prophylaxis is less common in Europe and Asia. Historically, the role and efficacy of aspirin in VTE prevention have been the subjects of considerable controversy, for the early and recent research findings contradict each other, and recommendations conflict in different guidelines. This review focuses on the advancements in clinical evidence and guideline recommendations regarding the use of aspirin for VTE prophylaxis in major orthopedic surgeries.

Objective To compare arthroscopic double-row bridging suture and minimally invasive locking plate system in the treatment of simple avulsion fracture of humeral greater tuberosity.Methods A retrospective study was conducted of the 93 patients with avulsion fracture of humeral greater tuberosity who had been treated at Orthopaedic Center,Beijing Luhe Hospital from January 2012 to December 2016.Of them,38 were treated by arthroscopic double-row bridging suture (ADRB) and 55 by open reduction and internal fixation with minimally invasive locking plate system (MIPS).Regular X-ray follow-ups were carried out at 3,6 and 12 months postoperatively and every 6 months afterwards.Surgical time,range of motion (ROM) of the shoulder,American Shoulder and Elbow Surgeons (ASES) score,Visual Analogue Scale (VAS) and complications were recorded preoperatively and at the last follow-up.Results The patients of the arthroscopy and plate groups were comparable because there were no significant differences in the preoperative general data between them (P ＞ 0.05).The average follow-up time for the 93 patients was 35.9months (from 12 to 60 months).The operation time for the arthroscopy group (97.0 ± 20.1 min) was significantly longer than that for the plate group (67.5 ± 19.0 min) (P ＜ 0.05).At the last follow-up,anteflexion lift (152.6° ± 12.9°),abduction lift (154.0° ± 13.5°) and internal rotation angle at 90° (57.7° ±12.2°) in the arthroscopy group were significantly better than those in the plate group (134.9° ± 17.8°,129.5° ± 18.6° and 50.8° ± 12.9°,respectively) (P ＜ 0.05).At the last follow-up,the ASES scores for the arthroscopy and plate groups were 88.5 ± 7.6 and 85.1 ± 11.3,respectively,showing no statistically significant difference (P ＞ 0.05);the VAS scores for the 2 groups were 1.5 ± 1.2 and 2.2 ± 1.5 respectively,showing a statistically significant difference between the 2 groups (P ＜ 0.05).There was no significant difference between the2 groups in improvement of ASES scores (P ＞ 0.05).Ninety fractures healed after 3 months while 3 fractures in the arthroscopy group did after 6 months.In the plate group,7 patients developed shoulder stiffness 3 to 6 months after surgery and 3 ones reported pain during abduction.Conclusions Both ADRB and MIPS are an effective treatment for simple avulsion fracture of humeral greater tuberosity.MIPS fixation needs shorter surgical time while ADRB leads to better postoperative shoulder ROM.

Objective:To analyze the risk factors affecting regional lymph node metastasis in salivary gland mucoepidermoid carcinoma (MEC) and to establish a nomogram model for individually predicting lymph node metastasis in salivary gland MEC.Methods:The clinical data of 2 152 patients with salivary gland MEC from 1975 to 2020 were collected from the Surveillance, Epidemiology, and End Results (SEER) database of the National Cancer Institute. The collected data were divided into training cohort (1 506 cases) and validation cohort (646 cases) according to the ratio of 7∶3. Single-factor regression and multi-factor logistic regression were used to screen factors related to local lymph node metastasis in salivary gland MEC, with constructing of a nomogram. Calibration curve, receiver operating characteristic (ROC) curve, area under the ROC curve (AUC) and decision curve analysis were used to evaluate model performance in the validation cohort and the total cohort. Statistical tests were performed using SPSS (26.0) and R (4.3.0) software.Results:Multivariate logistic regression results showed that M stage [ OR(95% CI):12.360(3.295-46.365), P=0.014], pathological grade Ⅱ、Ⅲ、Ⅳ[ OR(95% CI): 1.956(1.329-2.879), 9.654(6.309-14.772), 9.298(6.072-14.238), P<0.001], T staging T2, T3, T4[ OR(95% CI): 1.706(0.932-3.124), 3.021(1.790-5.096), 3.311(1.925-5.695), P<0.001], and gender [ OR(95% CI):0.759(0.593-0.972), P=0.029] were independent factors affecting local lymph node metastasis in salivary gland MEC. Through verification in the validation cohort and the total cohort, the AUC values were greater than 0.8, and the calibration curve was close to the perfect reference line, proving that the constructed nomogram model had good specificity and sensitivity for predicting local lymph node metastasis in salivary gland MEC. Conclusion:M stage, pathological grade, T stage, and gender are risk factors for predicting regional lymph node metastasis and the established-nomogram has good predictive performance for local lymph node metastasis in salivary gland MEC.

Objective:To establish and validate a radiomics nomogram based on MR for predicting cervical lymph node metastasis in laryngeal cancer.Methods:One hundred and seventeen patients with laryngeal cancer who underwent MR examinations and received open surgery and neck dissection between January 2016 and December 2019 were included in this study. All patients were randomly divided into a training cohort ( n=89) and test cohort ( n=28) using computer-generated random numbers. Clinical characteristics and MR were collected. Radiological features were extracted from the MR images. Enhanced T1 and T2WI were selected for radiomics analysis, and the volume of interest was manually segmented from the Huiyihuiying radiomics cloud platform. The variance analysis (ANOVA) and the least absolute shrinkage and selection operator (LASSO) algorithm were used to reduce the dimensionality of the radiomics features in the training cohort. Then, a radiomic signature was established. The clinical risk factors were screened by using ANOVA and multivariate logistic regression. A nomogram was generated using clinical risk factors and the radiomic signature. The calibration curve and receiver operator characteristic (ROC) curve were used to confirm the nomogram′s performance in the training and test sets. The clinical usefulness of the nomogram was evaluated by decision curve analysis (DCA). Furthermore, a testing cohort was used to validate the model. Results:The radiomics signature consisted of 21 features, and the nomogram model included the radiomics signature and the MR-reported lymph node status. The model showed good calibration and discrimination. The model yielded areas under the ROC curve (AUC) in the training cohort, specificity, and sensitivity of 0.930, 0.930 and 0.875. In the test cohort, the model yielded AUC, specificity and sensitivity of 0.883, 0.889 and 0.800. DCA indicated that the nomogram model was clinically useful.Conclusion:The MR-based radiomics nomogram model may be used to predict cervical lymph node metastasis of laryngeal cancer preoperatively. MR-based radiomics could serve as a potential tool to help clinicians make an optimal clinical decision.