中华创伤杂志最新文献

{"title":"Graded surgery for old thoracolumbar osteoporotic fractures","authors":"Rui Guo, Youhan Wang, Xiaobin Yang, Lingbo Kong, D. Hao, B. He","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.08.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.08.006","url":null,"abstract":"Objective \u0000To investigate the effect of graded surgical treatment according to injury classification on old thoracolumbar vertebral compression fractures (OVCFs). \u0000 \u0000 \u0000Methods \u0000A retrospective case series study was conducted to analyze the clinical data of 238 patients with old thoracolumbar OVCFs admitted to the Honghui Hospital affiliated to the College of Medicine, Xi'an Jiaotong University from February 2013 to November 2016. There were 49 males and 189 females, aged 63-78 years, with an average age of 66.8 years. The bone density T value was (-3.8±0.3)SD. The injured segments were located at T7-T9 in 35 patients, T10-L2 in 171, and L3-L4 in 32. A total of 16 patients had neurological injury, including 14 with grade C and two with grade D according to the American Spinal Injury Association (ASIA) neurological function classification. According to the patient's clinical manifestations and imaging complexity, the patients were assigned with I to V grades for individualized surgical treatment. Among them, 86 patients with grade I were treated with vertebral augmentation; 60 patients with grade II received posterior reduction and internal fixation combined with vertebral augmentation when necessary; 44 patients with grade III were treated with posterior decompression and reduction and internal fixation; 30 patients with grade IV received posterior osteotomy and orthopedic fusion; 18 patients with grade V were treated based on the major symptoms. The visual analogue score (VAS), Oswestry dysfunction index (ODI), vertebral sagittal index, and the American Spinal Injury Association (ASIA) grading before operation and at the last follow-up as well as the postoperative complications were recorded. \u0000 \u0000 \u0000Results \u0000All patients were followed up for 12-38 months with an average of 18.5 months. The VAS of patients with grade I to V improved from preoperative (8.0±0.7)points, (8.1±0.7)points, (8.3±0.89)points, (8.1±0.7)points, (8.2±0.2)points to (2.1±0.8)points, (2.0±0.8)points, (2.2±0.8)points, (2.3±0.8)points, (2.2±0.8)points at the last follow-up (P<0.05); ODI was improved from preoperative 69.5±3.0, 70.1±2.0, 70.3±2.1, 69.9±1.9, 70.0±2.2 to 39.8±2.2, 39.1±2.4, 40.1±2.1, 39.0±2.3, 39.5±2.3 at the last follow-up (P<0.05); the vertebral sagittal index improved from (89.7±2.1)%, (74.4±8.3)%, (75.0±6.7)%, (72.3±5.2)%, (71.1±2.1)% to (85.2±7.4)%, (84.2±5.5)%, (85.1±4.4)%, (86.2±3.5)%, (83.4±1.7)% (P<0.05). For 16 patients with nerve injury, the ASIA grading was improved from preoperative grade C in 14 patients and grade D in two patients to grade D in four patients and grade E in 12 patients at the last follow-up. A total of 11 patients (seven patients with grade I, one with grade II, two with grade IV, and one patient with grade V) had vertebral height loss in the later stage, but only two patients underwent secondary surgery for severe low back pain. \u0000 \u0000 \u0000Conclusions \u0000For obsolete thoracolumbar OVCFs, the concept of graded surgery can effectively guide the t","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"700-707"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47470391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of credibility and repeatability of modified acetabular fracture classification system","authors":"Zhongzheng Wang, Ruipeng Zhang, Yingchao Yin, Ao Li, Shaobo Liang, Y. Zhuang, Z. Hou, Yingze Zhang","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.08.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.08.015","url":null,"abstract":"The Letournel-Judet classification system for acetabular fractures is widely used, but there are still some shortcomings, such as incomplete classification and confusion of classification concepts, which cannot effectively guide the treatment. Professor Hou Zhiyong proposed and elaborated an improved acetabular fracture classification system based on the concept of three columns of acetabulum. However, the credibility and repeatability of the classification still lacked validation from clinical data. In this regard, the author included 463 patients with relatively complete imaging data admitted to Third Hospital of Hebei Medical University and Honghui Hospital affiliated to Xi'an Jiaotong University Medical College in the past five years. Four trauma orthopedists classified the patients according to the modified classification method of acetabular fracture. After two months, the original sequence of imaging data was disrupted and re-classified by the same trauma orthopedists. The consistency of the classification was evaluated by Kappa test and compared with Letournel-Judet classification. The results showed that credibility and repeatability of the modified classification were higher than Letournel-Judet classification, suggesting the feasibility of clinical application. \u0000 \u0000 \u0000Key words: \u0000Hip fractures; Acetabulum; Modified acetabular fracture classification","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"763-768"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41628663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between direct anterior approach and posterolateral approach in hip arthroplasty for elderly patients with femoral neck fractures","authors":"Ruixia Zhu, Gongyin Zhao, Liangliang Wang, Shijie Jiang, Nanwei Xu, Jiao Xiaojun, Yuji Wang","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.08.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.08.010","url":null,"abstract":"Objective \u0000To compare the efficacy of direct anterior approach (DAA) and posterolateral approach (PA) in hip arthroplasty for elderly patients with femoral neck fractures. \u0000 \u0000 \u0000Methods \u0000A retrospective case-control study was conducted to analyze the clinical data of 67 elderly patients with femoral neck fractures admitted to Second People's Hospital of Changzhou City, Affiliated Hospital of Nanjing Medical University from July 2015 to December 2017. There were 25 males and 42 females, aged 60-90 years [(76.1±7.6)years]. There were 31 patients with right femoral neck fracture and 36 with left femoral neck fracture, all of whom underwent operations within 72 hours after injury. There were 18 patients with type III and 49 with type IV according to Garden typing. All patients were treated with total hip arthroplasty. Direct anterior approach (DAA) was performed in 36 patients (DAA group) and posterior approach (PA) was performed in 31 patients (PA group). The operation time, intraoperative blood loss, postoperative drainage, recessive blood loss, total blood loss, the time when the patients got out of bed, and hospitalization time were compared between the two groups. Visual analogue scale (VAS) and Harris score were used to evaluate hip joint function one month after operation. The complications of the two groups were recorded. \u0000 \u0000 \u0000Results \u0000All patients were followed up for 3-6 weeks, with an average of one month. The operation time of DAA group was longer than that of PA group [(75.0±10.5)minutes vs. (54.0±11.4)minutes] (P 0.05). DAA group had shorter durations in terms of the time when patients got out of bed [(23.7±18.1)hours vs. (35.1±22.5)hours] (P 0.05). Intraoperative and postoperative complications included femoral periprosthetic fracture in three patients, lateral femoral nerve injury in two patients and severe anemia requiring blood transfusion in two patients in DAA group. In the PA group, there was one patient with deep venous thrombosis of the lower extremity at one month after operation, two patients with posterior dislocation of the hip, four patients with periprosthetic fracture and four patients with severe anemia requiring blood transfusion (P>0.05). \u0000 \u0000 \u0000Conclusion \u0000For femoral neck fracture in the elderly, compared with PA hip arthroplasty, DAA hip arthroplasty has less bleeding, earlier time to get out of bed and shorter hospital stay, with satisfactory short-term results. \u0000 \u0000 \u0000Key words: \u0000Femoral neck fractures; Hip arthroplasty, replacement, hip; Recessive blood loss","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"730-735"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44409049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy comparison of pedicle screw with vertebroplasty or intermediate screw for osteoporotic thoracolumbar compression fractures","authors":"Bolong Zheng, D. Hao, Liang Yan, Zheng-wei Xu, Simin He, Xiaobin Yang, B. He","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.08.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.08.008","url":null,"abstract":"Objective \u0000To compare the efficacy of pedicle screw with vertebroplasty (PSV) or intermediate screw (PSIS) for osteoporotic thoracolumbar compression fractures. \u0000 \u0000 \u0000Methods \u0000A retrospective case control study was conducted to analyze the clinical data of 141 patients with osteoporotic thoracolumbar vertebral compression fractures admitted to Honghui Hospital, College of Medicine, Xi'an Jiaotong University from January 1, 2012 to December 31, 2015. There were 59 males and 82 females, aged 60-75 years, with an average age of 65.4 years. All the fractures had bone mineral density (BMD) T value 15 degrees or anterior column compression > 40%. There were 65 patients with thoracic vertebral fractures (T10-T12) and 76 with lumbar vertebral fractures (L1-L4). Among all patients, 68 received PSV treatment (PSV group) and 73 received fixed PSIS treatment (PSIS group). The operation time, intraoperative blood loss, visual analogue scale (VAS), anterior height ratio, central height ratio, and segmental kyphosis angle at 3 days, 3 months, 6 months, 1 year and 2 years after operation were compared between the two groups. The complications were recorded. \u0000 \u0000 \u0000Results \u0000All patients were followed up for 25-31 months, with an average of 27.9 months. There were no significant differences in operation time and intraoperative blood loss between the two groups (P>0.05). VAS at each time point of postoperative follow-up was significantly lower than those before operation in both groups (P 0.05). Anterior height ratios of PSV group were higher than those of PSIP group at postoperative 3 months, 6 months, 1 year and 2 years (P<0.05) [(95.2±5.2) vs. (92.6±7.1), (93.8±5.2) vs. (91.4±3.2), (93.3±4.9) vs. (91.2±5.1), (92.6±5.5) vs. (90.1±4.7)]. The central height ratios of PSV group were higher than those of PSIP group at postoperative 6 months, 1 year and 2 years [(91.4 ±6.9) vs. (88.9±7.2), (90.8±7.4) vs. (88.4±5.9), (90.1±7.6) vs. (87.1±7.2)](P<0.05). Segmental kyphosis angle of PSV group was lower than that of PSIP group at postoperative 3 months, 6 months, 1 year and 2 years [(2.9±0.4)° vs. (3.2±0.9)°, (3.0±0.5)° vs. (3.2±0.3)°, (3.1±0.7)° vs. (3.4±0.4)°, (3.1±0.4)° vs. (3.4±0.7)°](P<0.05 or 0.01). Bone cement leakage from screws occurred in two patients in PSV group and three patients in PSIS group. Cement leakage occurred in the injured vertebra in four patients of PSV group, with no any symptom. In PSIS group, two patients suffered from one side rod breakage at 9 months and 1 year after surgery, respectively. CT showed sound bone healing, without any further management. \u0000 \u0000 \u0000Conclusion \u0000For osteoporotic thoracolumbar compression fractures, PSV can attain similar pain relief compared with PSIS, but the former is more conducive to reducing the loss of anterior and middle column height and correcting kyphosis deformity. \u0000 \u0000 \u0000Key words: \u0000Osteoporotic fractures; Spinal fractures; Bone cement","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"716-722"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46268076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary clinical application of anterior anatomical reduction plate fixation for atlantoaxial dislocation","authors":"Quan-jin Zang, Xijing He, Haopeng Li, Kai Cao, Ting Zhang, Jun Dong, Jiantao Liu","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.08.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.08.004","url":null,"abstract":"Objective \u0000To evaluate the preliminary clinical effect of anterior anatomical reduction plate fixation on the treatment of atlantoaxial dislocation. \u0000 \u0000 \u0000Methods \u0000A retrospective case series study was conducted to analyze the 13 patients with atlantoaxial dislocation admitted to the second affiliated hospital of Xi'an Jiaotong University from January 2016 to December 2017. There were eight males and five females, aged 20-57 years, with an average age of 42 years. All patients received transoropharyngeal reconstruction and atlantoaxial anterior anatomical reduction plate fixation, 12 of which underwent the surgery for the first time but one had the revision surgery. The operation time and intraoperative bleeding were recorded. The angle of the clivus axis was measured, and the reduction of the atlantoaxial spine and the fusion of bone graft were observed. The neurological function was evaluated by Japanese Orthopedic Association (JOA) score and the improvement rate of spinal cord function was calculated. The complications were also recorded. \u0000 \u0000 \u0000Results \u0000All patients were followed up for 10-30 months [(14.2±5.0)months]. The operation time was 150-285 minutes [(216.8±36.7)minutes]. The intraoperative blood loss was 50-130 ml [(80.5±19.7)ml]. The slope axis angle was (113.2±9.1)° before operation and (145.8±6.7)° after operation, with an average increase of 32.6° (P<0.01). Anatomical reduction was obtained in nine patients, and partial reduction in four patients. At the last follow-up, the atlantoaxial fusion was obtained in all patients, and the healing time was (4.6±1.1)months. Postoperative neurological symptoms were improved compared with those before operation. The JOA score was improved from preoperative (8.7±1.7)points to postoperative (14.3±1.2)points, with an average increase of 5.6 points (P<0.01). The average improvement rate of spinal cord function was 69%. Except for one patient with cerebrospinal fluid leakage, there were no complications such as spinal cord, nerve, blood vessel injury or wound infection after operation. \u0000 \u0000 \u0000Conclusions \u0000Anterior atlantoaxial anatomical reduction plate fixation can effectively restore the dislocated atlantoaxial joint, restore slope axis angle, improve bone fusion rate, and improve nerve function. It can be used as an alternative or supplement to posterior fixation. \u0000 \u0000 \u0000Key words: \u0000Atlas; Axis; Dislocations; Internal fixators; Anatomical plate","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"686-692"},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44612515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of basic fibroblast growth factor in epidermal stem cells differentiating into neural stem cells in rats","authors":"Zheng-wei Xu, D. Hao, Liang Dong, Tuan-jiang Liu, Hua Guo, B. He","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.006","url":null,"abstract":"Objective \u0000To investigate the effect of basic fibroblast growth factor (bFGF) on the differentiation of epidermal stem cells(ESCs) into nerve cells in rats. \u0000 \u0000 \u0000Methods \u0000The epidermal basal layer tissue of newborn SD rats (1-3 days) were isolated and obtained. ESCs were digested and isolated by rapid attachment to a substrate, and the morphology of ESCs was observed under an inverted microscope. ESCs were cultured with Keratinocytes serum-free medium (K-SFM). The ESCs were grouped and treated according to the density including Group A: 0.1×107/ml, Group B: 0.3×107/ml, Group C: 0.5×107/ml, Group D: 0.1×106/ml, and each group was added bFGF (20 ng/ml). The changes of cell morphology were observed and counted for seven days. The changes of cell markers Nestin and NSE were detected by immunohistochemistry. \u0000 \u0000 \u0000Results \u0000The ESCs of SD rat were isolated successfully. After bFGF induction, the numbers of cells with morphological changes in Groups A and B were larger than those in other two groups in the first 6 days (P<0.05), and the number in Group A was the largest on the seventh day (P<0.05). On the third day, Group C had the largest number of cells with changes based on the comparison within the group. There was no change in cell morphology in Group D. Immunohistochemistry showed positive Nestin and NSE. \u0000 \u0000 \u0000Conclusion \u0000The bFGF helps induce the differentiation of ESCs into nerve cells, which is associated with the cell density. \u0000 \u0000 \u0000Key words: \u0000Fibroblast growth factors; Stem cells; Cell differentiation; Nerve cells","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"612-617"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46677521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Related issues on mechanism and clinical application of stem cell transplantation for spinal cord injury","authors":"B. He","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.003","url":null,"abstract":"Spinal cord injury is often accompanied by the loss of sensory, motor and autonomic nerve function below the spinal cord injury area. It has poor prognosis and often leads to life-long disability, even death. To date, there is no effective treatment for radical functional repair of spinal cord injury. Stem cells are a class of cells with the potential to differentiate into neurons, which can play a therapeutic role through remedying or replacing the damaged neurons, secreting neurotrophic factors, inhibiting local inflammatory response. A variety of stem cells are commonly used in transplantation, but they have their own advantages and disadvantages. The main methods of transplantation include subarachnoid injection, intravenous injection and intralesional injection. This article reviews the types of stem cells, the methods of stem cell transplantation, the time of transplantation, the therapeutic effect and the possible mechanism so as to provide reference for the basic and clinical research of stem cell therapy for spinal cord injury. \u0000 \u0000 \u0000Key words: \u0000Spinal cord injuries; Stem cells; Cell transplantation","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"593-596"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42763729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress in mechanism, diagnosis and treatment of neurogenic bowel dysfunction after spinal cord injury","authors":"Chengjie Wu, Yong Ma, Yang Guo, Zheng Suyang, Pan Yalan, Pengcheng Tu, Guihua Xu","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.007","url":null,"abstract":"Neurogenic bowel dysfunction (NBD) manifested as constipation and fecal incontinence often occurs after spinal cord injury (SCI). NBD affects patients' quality of life and is an urgent clinical problem to be solved. The mechanism of NBD is related to central and autonomic nervous system dysfunction, intestinal nervous system dysfunction, changes in intestinal microorganism composition and abnormal content of neurotransmitters. The evaluation method of NBD is mainly based on scoring and imaging, which lacks unified criteria, and the treatment method for NBD is the combination of traditional Chinese and Western medicine. The author summarizes the mechanism, evaluation method, treatment and nursing of NBD in order to provide new insight into these aspects to improve clinical efficacy. \u0000 \u0000 \u0000Key words: \u0000Spinal cord injuries; Neurogenic bowel; Quality of life","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"618-624"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46714786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors of proximal deep venous thrombosis in patients with fractures","authors":"Jianping Sun, Kun Zhang, Pengfei Wang, H. Xue, Liang Sun, Shuguang Liu, Binfei Zhang, Zhong Li, Hua Lin","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.008","url":null,"abstract":"Objective \u0000To investigate the clinical characteristics and risk factors of perioperative deep venous thrombosis(DVT) in fracture patients. \u0000 \u0000 \u0000Methods \u0000A retrospective case control study was conducted to analyze the clinical data of 147 patients with DVT diagnosed by color Doppler ultrasound or lower extremity deep venography from July 2015 to November 2017 in Honghui Hospital Affiliated to Xi'an Jiaotong University College of Medicine. The patients were divided into proximal thrombosis group (including the popliteal vein) and distal thrombosis group according to the involvement site with the popliteal vein as reference. The proximal thrombosis group (56 patients) included 31 males and 25 females, aged 38-89 years, with an average age of 67.8 years. There were three patients with pelvic and acetabular fractures, 39 with hip fractures, 10 with femoral shaft fractures, three with periarticular fractures, and one with tibia and fibula fracture. According to the site of involvement, four patients had proximal vein thrombosis, and the other 52 patients had proximal combined with distal thrombosis. There were 44 patients with left thrombosis and 12 with right thrombosis. Thrombosis at femoral vein and above was found in 20 patients (7 with external iliac vein thrombosis), and thrombosis at popliteal vein was found in 36 patients. The distal thrombosis group (91 patients) consisted of 51 males and 40 females, aged 21-92 years, with an average of 63.6 years. There were 12 patients with pelvic and acetabular fractures, 39 with hip fractures, four with femoral shaft fractures, 16 with fractures surrounding knee joint, 12 with tibia and fibula fractures, and eight with ankle joint fractures. There were 43 patients with left thrombosis and 48 with right thrombosis. The gender, age, fracture location, time from injury to operation, operation time, blood transfusion rate, thrombus side, D-dimer level before and after operation, and internal medical diseases were compared between the two groups. The risk factors with statistical significance were screened for multivariate Logistic regression analysis. \u0000 \u0000 \u0000Results \u0000In proximal thrombosis group, 70% (39/56) had hip fracture and 18% (10/56) had femoral shaft fracture, while 43% (39/91) had hip fracture and 4% (4/91) had femoral shaft fracture in distal thrombosis group (P 0.05). Logistic regression analysis showed that hip fracture and femoral shaft fracture, left lower limb, blood transfusion, high D-dimer level before and after operation were risk factors for proximal thrombosis. \u0000 \u0000 \u0000Conclusions \u0000Proximal venous thrombosis is often combined with distal venous thrombosis. Hip fracture, femoral shaft fracture, left lower limb, blood transfusion, preoperative and postoperative high D-dimer levels have significant effects on proximal thrombosis. \u0000 \u0000 \u0000Key words: \u0000Venous thrombosis; Fractures, bone; Risk factors","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"625-630"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44439119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of polylactic-co-glycolic acid/graphene oxide nanofibers combined with brain derived neurotrophic factor on spinal cord injury repair","authors":"Su Pan, Zhiping Qi, Shuang Zheng, Yue Ma, Chuan Fu, Weijian Kong, Shuangqi Yu, Xiaoyu Yang, Zhuo Zhang","doi":"10.3760/CMA.J.ISSN.1001-8050.2019.07.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1001-8050.2019.07.004","url":null,"abstract":"Objective \u0000To investigate the effect of polylactic-co-glycolic acid (PLGA)/graphene oxide (GO) nanofibers combined with brain derived neurotrophic factor (BDNF) on neural stem cells (NSCs) proliferation and differentiation as well as on the spinal cord injury repair. \u0000 \u0000 \u0000Methods \u0000PLGA/GO nanofibers were manufactured and absorbed with BDNF, and the microstructure of PLGA/GO nanofibers was observed by scanning electron microscope. The loading efficiency and release curve of BDNF on PLGA/GO nanofibers were measured by ELISA. NSCs were implanted on the surface of PLGA/GO and PLGA/GO/BDNF nanofibers. The absorbance values of each group were measured by MTT method, and the expression of Tuj-1 was observed by immunofluorescence and PCR. A total of 30 female SD rats were divided into control group (n=10), PLGA/GO group (n=10) and PLGA/GO/BDNF group (n=10) according to random number table. T9 spinal cord tissue was cut by Venus scissors to establish spinal cord hemisection injury model of rats. PLGA/GO and PLGA/GO/BDNF nanofibers were implanted onto the surface of injury site. BBB score was used to assess the motion functional recovery of the rats at 1, 7, 14 and 28 days after operation. Immunofluorescence staining of neuron specific nucleoprotein (NeuN) and glial fibrillary acidic protein (GFAP) were performed to observe the expressions of neurons and astrocytes at the injured site respectively one month after injury. \u0000 \u0000 \u0000Results \u0000The PLGA/GO nanofibers showed an irregular smooth fiber-like structure, and the average fiber diameter was (987.5±176.3)nm. NSCs could differentiate into neurons on the nanofibers. The result of ELISA showed loading rate of BDNF on PLGA/GO nanofibers was about 47.5%. The release curve showed that BDNF was first released about 30% on the first day and then about 60% on the 21st day. The results of MTT and PCR showed that optical density value and Tuj-1 gene expression in the PLGA/GO/BDNF group were significantly higher than those in the PLGA/GO group (P<0.05). The animal experiment results showed that the BBB score of PLGA/GO/BDNF group was (15.3±0.7)points at 28 days after injury, which was significantly higher than that of the injury control group [(11.8±0.8)points] and that of PLGA/GO group [(12.7±0.8)points] (P<0.05). Immunofluorescence results showed that the expression of NeuN in PLGA/GO/BDNF group was 13.7±2.2, significantly higher than that in injury control group (4.3±2.9)(P<0.05), and the expression of GFAP in PLGA/GO group was (25.6±4.3)% significantly lower than that in injury control group [(38.5±6.2)%] and PLGA/GO group [(36.7±7.3)%](P<0.05). \u0000 \u0000 \u0000Conclusion \u0000PLGA/GO nanofibers combined with BDNF can effectively promote the proliferation and neuron differentiation of NSCs in vitro and repair spinal cord injury in vivo through orthotopic transplantation at the injury site. \u0000 \u0000 \u0000Key words: \u0000Spinal cord injuries; Neural stem cells; Brain-derived neurotrophic factor; Polylactic-co-glycolic acid/graphene oxide","PeriodicalId":10161,"journal":{"name":"Chinese Journal of Trauma","volume":"35 1","pages":"597-604"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45153935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}