OBJECTIVE: To retrospectively assess the advantages of the modified Uhl technique in the treatment of Colles' fracture guided by the principles of Chinese osteosynthesis (CO) concept. METHODS: A retrospective study was conducted on 358 patients with Colles' fracture treated with the modified Uhl technique of closed reduction and percutaneous pin between January 2016 and June 2021. Out of these, 120 eligible cases were selected and categorized into two groups according to different surgical methods:the closed reduction and percutaneous pin group, and the open reduction group. Sixty-eight patients in the closed reduction and percutaneous pin group were treated with the modified Uhl technique, while fifty-two patients in the open reduction group were treated with open reduction and internal fixation using plates. The modified Sarmiento imaging score, Gartland-Werley wrist score, operation time, hospital stay, and treatment costs between the two groups were compared at a 6-month postoperative follow-up. RESULTS: There were no significant differences in terms of gender, age, affected side, injure factors, time of injury to surgery, Sarmiento imaging score, and Gartland-Werley wrist joint score (P>0.05). The closed reduction and percutaneous pin group exhibited an operation time of (35.88±14.11) minutes, hospitalization stay of (9.78±2.48) days, and treatment costs of (16 074.91±1 964.48) yuan, while the open reduction group demonstrated comparatively longer operation time of (65.48±14.26) minutes, hospitalization stay of (15.88±2.00) days, and treatment costs of (20 451.27±1 760.22) yuan (P<0.01). CONCLUSION The modified Uhl technique presents notable advantages in the management of Colles' fracture, including reliable fixation, less trauma, shorter operation time, less pain, shorter hospital stay, and cost-effectiveness. This technique exhibits promising potential for broader clinical application. However, it is important to note that the pin could potentially damage tendons, and in cases of Colles' fractures with osteoporosis and comminuted fragments, additional techniques may be required for reliable fixation.
Humans ; Retrospective Studies ; Colles' Fracture/surgery* ; Fracture Fixation, Internal ; Fractures, Comminuted ; Hospitalization

OBJECTIVE: To evaluate the safety and accuracy of Renaissance robot navigation system in minimally invasive surgery for thoracolumbar fracture. METHODS: The clinical data of patients with thoracolumbar fracture who underwent posterior minimally invasive pedicle screw internal fixation from July 2016 to July 2019 was retrospectively analyzed. And the patients were divided into robot group and artificial group. Robot navigation assisted screw placement was used in robot group, and traditional unarmed screw placement was used in artificial group. There were 20 patients in robot group, including 13 males and 7 females, aged from 23 to 69 years old with an average of(45.05±11.81)years old, one case was T₁₁ fracture, 2 cases were T₁₂, 10 cases were L₁, 6 cases were L₂ and 1 case was L₃. There were 20 patients in artificial group, including 11 males and 9 females, aged from 26 to 65 years old with an average of(43.40±11.22)years old, 2 cases were T₁₁ fractures, 7 cases were T₁₂, 10 cases were L₁, and 1 case was L₃. The numbers of fluoroscopy, operation time and intraoperative blood loss were observed. The screw position was evaluated by Neo method. RESULTS: A total of 126 screws were implanted in robot group and 124 screws were implanted in artificial group. The operation time, fluoroscopy times, intraoperative blood loss were(115.75±14.26) min, (7.95±0.89) times and (132.50±29.36) ml in robot group and (129.50±10.50) min, (14.40±2.56) times and(182.50±23.14) ml in artificial group, respectively, there was significant difference between the groups(P<0.05). According to Neo classification method, there were 122 screws at grade 0, 4 screws at grade 1 in robot group, and there were 108 screws at grade 0, 9 screws at grade 1 and 7 screws at grade 2 in artificial group. The accuracy of the robot group was better than that of artificial group(P<0.05). CONCLUSION Compared with free hand screw placement, Renaissance robot navigation system can effectively improve the accuracy of pedicle screw placement, reduce the number of fluoroscopy times and intraoperative blood loss, thereby improving the safety of operation.
Adult ; Aged ; Female ; Fracture Fixation, Internal/methods* ; Humans ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Pedicle Screws ; Retrospective Studies ; Robotics ; Spinal Fusion ; Young Adult

OBJECTIVE: To compare the efficacy between vesselplasty and percutanous kyphoplasty (PKP) in the treatment of Kümmell disease. METHODS: The clinical data of patients with Kümmell disease from July 2018 to December 2019 were retrospectively analyzed. According to the different therapeutic methods, the patients were divided into vesselplasty group and PKP group. There were 20 patients in vesselplasty group, including 2 males and 18 females, aged from 54 to 83 years with an average of (67.40±7.44)years, 1 case of T₁₀ fracture, 3 cases of T₁₂ fracture, 9 cases of L₁ fractures, 5 cases of L₂ fractures and 2 cases of L₃ fractures. There were 20 patients in PKP group, including 3 males and 17 females, aged from 56 to 81 with an average of(67.20±7.01) years, 2 cases of T₁₀ fracture, 1 case of T₁₁ fracture, 6 cases of T₁₂ fracture, 10 cases of L₁ fracture and 1 case of L₃ fracture. Visual analogue scale(VAS), Cobb angle, anterior vertebral height were recorded before operation, 1 day after operation and 1 year after operation. Oswestry Disability Index(ODI) was recorded before operation, 1 month after operation and 1 year after operation. And bone cement leakage rate was compared between two groups after operation. RESULTS: All the patient were followed up for more than 1 year. In vesselplasty group, VAS score was 1.20±0.41, ODI was(13.50±3.10)%, Cobb angle was(17.20±3.12)° and anterior vertebral height was(20.20±1.35) mm at 1 year after operation. In PKP group, VAS score was 1.15±0.40, ODI was (13.20±3.00)%, Cobb angle was (17.10±3.19)° and anterior vertebral height was (20.10±1.37) mm at 1 year after operation. These index was significantly better than pre-operation through intra-group comparison(P<0.05), and there was no statistically difference between the two groups(P>0.05). There were 20 cases (20 vertebrae) in vesselplasty group, of which 1 case had bone cement leakage at the upper endplate, with a leakage rate of 5%(1/20). In PKP group, there were 20 cases (20 vertebrae), 3 cases of upward endplate leakage(3/7), 1 case of downward endplate leakage(1/7), 1 case of leakage to the front of the vertebral body(1/7), 2 cases of leakage to the side of the vertebral body(2/7), with a leakage rate of 35% (7/20). The difference between two groups was statistically significant(P<0.05). CONCLUSION Vesselplasty in the treatment of Kümmell disease can better reduce leakage rate of bone cement and reduce complications.
Bone Cements ; Female ; Fractures, Compression/surgery* ; Humans ; Kyphoplasty/methods* ; Male ; Osteoporotic Fractures/surgery* ; Retrospective Studies ; Spinal Fractures/surgery* ; Spondylosis ; Treatment Outcome ; Vertebroplasty

Objective To investigate the effect of different concentrations of Echinococcus multilocularis secretion antigen (Em-sAg) on the phenotype and function of mouse bone marrow-derived dendritic cells (BMDCs) induced by lipopolysaccharide (LPS). Methods The bone marrow precursor cells isolated from the mouse bone marrow cavity were stimulated by mouse recombinant granulocyte-macrophage colony-stimulating factor (GM-CSF) to form BMDCs, and then cell morphology was observed under an inverted microscope. After the purity of BMDCs was identified by flow cytometry, BMDCs were divided into control group, positive control group (LPS 1 μg/ml), LPS+3 mg/ml Em-sAg group, LPS+1.5 mg/ml Em-sAg group, LPS+0.75 mg/ml Em-sAg group, and LPS+0.375 mg/ml Em-sAg group. Flow cytometry was used to measure the expression of BMDC surface molecules (CD80, CD86, and MHC-Ⅱ molecules) in each group, and ELISA was used to measure the expression level of the cytokine IL-12p70. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results Observation under an inverted microscope showed that after 8-10 days of culture, the cells had burr-like protrusions and were in a state of complete suspension. Flow cytometry showed that the positive rate of CD11c was above 70% and most of the cultured cells were identified as BMDCs based on this. Flow cytometry further showed that compared with the control group, the LPS group had significant increases in the cell molecules CD80, CD86, and MHC-Ⅱ on surface (all P < 0.05); compared with the LPS group, the LPS+3 mg/ml Em-sAg group, the LPS+1.5 mg/ml Em-sAg group, the LPS+0.75 mg/ml Em-sAg group, and the LPS+0.375 mg/ml Em-sAg group had a significant reduction in CD80 ( F =34.870, P < 0.001), while there were no significant reductions in CD86 and MHC-Ⅱ( P > 0.05). ELISA showed that there was a significant difference in the level of IL-12 p70 between groups ( F =73.140, P < 0.05); compared with the control group, the LPS group had a significant increase in the expression level of IL-12p70 after stimulation ( P < 0.05); compared with the positive control group, the LPS+3 mg/ml Em-sAg group, the LPS+1.5 mg/ml Em-sAg group, the LPS+0.75 mg/ml Em-sAg group, and the LPS+0.375 mg/ml Em-sAg group had a significant reduction in the expression level of IL-12p70 ( P < 0.05), and the degree of reduction in the pro-inflammatory factor IL-12p70 increased with the increase in the concentration of Em-sAg. Conclusion Different concentrations of Em-sAg can inhibit LPS-induced maturity of BMDCs and the expression of the pro-inflammatory cytokine IL-12p70.

Objective    To discuss the safety and feasibility of no chest tube (NCT) after thoracoscopic pneumonectomy. Methods    The online databases including PubMed, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP, China Biology Medicine disc (CBMdisc) were searched by computer from inception to October 2020 to collect the research on NCT after thoracoscopic pneumonectomy. Two reviewers independently screened the literature, extracted the data, and evaluated the quality of the included studies. The RevMan 5.3 software was used for meta-analysis. Results    A total of 17 studies were included. There were 12 cohort studies and 5 randomized controlled trials including 1 572 patients with 779 patients in the NCT group and 793 patients in the chest tube placement (CTP) group. Meta–analysis results showed that the length of postoperative hospital stay in the NCT group was shorter than that in the CTP group (SMD=–1.23, 95%CI –1.59 to –0.87, P<0.000 01). Patients in the NCT group experienced slighter pain than those in the CTP group at postoperative day (POD)1 (SMD=–0.97, 95%CI –1.42 to –0.53, P<0.000 1), and POD2 (SMD=–1.10, 95%CI –2.00 to –0.20, P=0.02), while no statistical difference was found between the two groups in the visual analogue scale of POD3 (SMD=–0.92, 95%CI –1.91 to 0.07, P=0.07). There was no statistical difference in the 30-day complication rate (RR=0.93, 95%CI 0.61 to 1.44, P=0.76), the rate of postoperative chest drainage (RR=1.51, 95%CI 0.68 to 3.37, P=0.31) or the rate of thoracocentesis (RR=2.81, 95%CI 0.91 to 8.64, P=0.07) between the two groups. No death occurred in the perioperative period in both groups. Conclusion    It is feasible and safe to omit the chest tube after thoracoscopic pneumonectomy for patients who meet the criteria.

BACKGROUND: Bioabsorbable materials have shown obvious advantages in clinical application for more than ten years, and have been widely used in many biomedical fields. OBJECTIVE: To review characteristics of bioabsorbable materials and their application in orthopedics. METHODS: The articles published in Wanfang, CNKI, VIP, and PubMed databases were searched by computer. The key words were “bioabsorbable materials, bioabsorbable metal materials, bioabsorbable inorganic materials, polymer materials, biocomposites” in Chinese, and “bioabsorbable/bioabsorbable material, metal material, polymer material, biocomposites” in English. RESULTS AND CONCLUSION: Absorbable metal materials have good mechanical properties. The corrosion mechanism of polymer materials is clear, which can predict the corrosion behavior and corrosion rate in vivo and in vitro, but its load-bearing performance is not as good as that of absorbable metal materials. After certain treatment, bioceramics have good biocompatibility, bone conductivity and osseointegration, but they are brittle and difficult to be formed. Biocomposites have the properties of component materials, and can also obtain new properties that single component materials do not have, so it has a wide application prospect.

Autoimmune pancreatitis (AIP) is an autoimmune-mediated abnormal chronic inflammatory disorder and is often misdiagnosed as pancreatic neoplastic lesions. With in-depth studies of this disease in recent years, it has been taken seriously by hepatobiliary physicians and surgeons. This article summarizes the clinical features, diagnostic criteria, and treatment methods for autoimmune pancreatitis at the present stage, so as to provide clinicians with diagnosis and treatment experience to reduce clinical misdiagnosis.

OBJECTIVE: To evaluate the clinical effects of tranexamic acid in arthroscope for femoroacetabular impingement. METHODS: Totally 34 patients (34 hips) with femoroacetabular impingement underwent hip arthroscopy from June 2016 to December 2018, were randomly divided into two groups named as tranexamic acid group and control group, 17 patients in each group. In TXA group, there were 10 males and 7 females, aged from 20 to 49 years old with an average of (32.1±7.6) years old;15 mg/kg TXA was intravenous drops before operation incision performed at 10 min. In control group, there were 11 males and 6 females, aged from 20 to 49 years old with an average of (30.9±6.2) years old;100 ml normal saline was intravenous drops before operation incision performed at 10 min. Introopertaive and total bloodloss between two groups were compared. Visual analogue scale (VAS) at 3 and 7 days after opertaion were used to evaluate pain relief of hip joint. Modified Harris Hip Score(mHHS) of hip joint at 3, 6, 9 and 12 weeks after oeprtaion were applied to evaluate clinical effects. RESULTS: All patients were obtained follow up over 12 weeks. Incision healed well without infection and deep vein thrombosis. There were no statistical difference in opertaion time bewteen two groups( CONCLUSION Preoperative application of tranexamic acid could effectively reduce blood loss in arthroscopy for femoroacetabular impingement, thereby improving surgical field of vision, reducing difficulty of surgical operation, which could promote early and rapid rehabilitation of hip function.
Adult ; Aged ; Arthroscopes ; Arthroscopy ; Blood Loss, Surgical ; Female ; Femoracetabular Impingement/surgery* ; Hip Joint/surgery* ; Humans ; Male ; Middle Aged ; Tranexamic Acid ; Treatment Outcome ; Young Adult

OBJECTIVE：To establish the content determin ation method of ferulic acid ，verbascoside，ligustilide and astragaloside in Shengyu decoction lyophilized powder. METHODS ：HPLC method was adopted to determine 4 components in 3 batches of lyophilized powder. The determination of ferulic acid ，verbascoside and ligustilide was performed on Inertsil ODS-SP C 18 column with mobile phase consisted of methanol- 0.1％ phosphoric acid （gradient elution ）at the flow rate of 1.0 mL/min；detector was diode array detector ；detection wavelength was set at 330 nm；column temperature was 30 ℃，the sample size was 10 μL. The determination of astragaloside was performed on Kromasil C 18 column with mobile phase consisted of acetonitrile-water （32∶68，V/ V）；detector was evaporative light scattering detector ；the drift tube temperature wa s 100 ℃，the carrier gas （air）flow rate was 2.5 L/min at the flow rate of 1.0 mL/min；column temperature was 30 ℃，the sample size was 10 μL. RESULTS：The linear ranges of ferulic acid ，verbascoside，ligustilide and astragaloside were 0.050 15-10.03 μg（r＝0.999 8），0.067 80-13.56 μg（r＝ 0.999 9），0.057 30-11.46 μg（r＝0.999 5），1.128-11.28 μg（r＝0.999 3），respectively. The detection limits were 2.12×10－4，1.30× 10－3，8.02×10－4，1.09×10－3 μg，respectively. The limit of quantification were 7.43×10－4，3.87×10－3，2.34×10－3，3.36×10－3 μg， respectively. RSDs of precision ，stability（12 h）and reproducibility tests were all lower than 2％（n＝6）. Average recovery rates were 99.6％（RSD＝0.83％，n＝6），100.9％（RSD＝1.07％，n＝6），98.8％（RSD＝0.84％，n＝6）and 101.3％（RSD＝0.99％， n＝6），respectively. The contents of ferulic acid ，verbascoside，ligustilide and astragaloside in 3 batches of samples were 1.225-1.248， 0.413-0.424， 0.325-0.332， 0.394-0.404 mg/g， respectively （RSDs among batches were lower than 1.5％ ）. CONCLUSIONS：Established method is stable ，reproducible，rapid and accurate for the content determination of ferulic acid ， verbascoside， ligustilide and astragaloside in Shengyu

OBJECTIVE: Electroacupuncture has been commonly used in clinical practice for pain after total knee arthroplasty, but its effects and safety remain controversial. The efficacy and safety of electroacupuncture in the treatment of pain after total knee arthroplasty were systematically evaluated. METHODS: PubMed, Embase, Cochrane Library, SinoMed, CNKI, VIP and Wanfang databases were searched to collect randomized controlled trials on electroacupuncture in the treatment of pain after total knee arthroplasty from inception to December 31, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was performed by RevMan 5.3 software. RESULTS: (1) A total of six studies involving 304 patients were included. (2) The results of meta-analysis showed that compared with control group, the experimental group had significantly lower visual analogue scale scores at 3 days [MD=-0.67, 95%CI(-1.01 to-0.33), P < 0.001], 7 days [MD=-0.60, 95%CI (-0.88 to-0.33), P < 0.001), 14 days [MD=-0.97, 95%CI(-1.74 to-0.21), P < 0.05) and end point of clinical trial (MD=-0.67, 95%CI(-1.04 to-0.30), P < 0.001), respectively, after total knee arthroplasty. There were no significant differences in visual analogue scale scores at 1 day after total knee arthroplasty [MD=-0.12, 95%CI(-0.64, 0.40), P >0.05). (3) The incidence of postoperative vertigo was significantly lower in the trial group than that in the control group [OR=0.28, 95%CI(0.10, 0.78), P < 0.05]. (4) The incidence of postoperative vomiting was not significantly different between the trial and control groups [OR=0.83, 95%CI(0.37, 1.87), P > 0.05]. CONCLUSION: Electroacupuncture has obvious advantages in the treatment of pain after total knee arthroplasty, which can significantly relieve the pain reaction of patients at 3, 7, 14 days and the end point of clinical trial, and can reduce the incidence of postoperative vertigo, but it cannot reduce the incidence of postoperative vomiting and pain at 1 day after total knee arthroplasty. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.