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Systematic review of dynamization vs exchange nailing for delayed/non-union femoral fractures

World Journal of Orthopedics 2018年第7期9卷 92-99页

作者： Jacob E vaughn ronit v shah Tarek Samman Jacob Stirton Jiayong Liu Nabil A Ebraheim College of Medicine and Life Sciences University of Toledo Department of Orthopedic Surgery University of Toledo Medical Center

AIM To analyze the literature on efficacy of dynamamization vs exchange nailing in treatment of delayed and nonunion femur *** Ultimately, 31 peer-reviewed articles with 644 exchanged nailing patients and 131 dynamization patients were identified and analyzed. The following key words were inputted in different combinations in order to search the field of publications in its entirety: "nonunion", "delayed union", "ununited", "femur fracture", "femoral fracture", "exchange nailing", "dynaiz(s)ation", "secondary nailing", "dynamic", "static", and "nail revision". The initial search yielded over 150 results, and was refined based on the inclusion criteria: Only studies reporting on humans, non-unions and delayed unions, and the usage of exchange nailing and/or dynamization as a secondary treatment after failed IM nailing. The resulting 66 articles were obtained through online journal access. The results were filtered further based on the exclusion criteria: No articles that failed to report overall union rates, differentiate between success rates of their reported techniques, or articles that analyzed less than 5 patients. RESULTS Exchange nailing lead to fracture union in 84.785% of patients compared to the 66.412% of dynamization with statistically comparable durations until union(5.193 ± 2.310 mo and 4.769 ± 1.986 mo respectively). Dynamically locking exchange nails resulted in an average union time of 5.208 ± 2.475 mo compared to 5.149 ± 2.366 mo(P = 0.8682) in statically locked exchange nails. The overall union rate of the two procedures, statically and dynamically locked exchange nailing yielded union rates of 84.259% and 82.381% respectively. Therefore, there was no significant difference between the different locking methods of exchange nailing for union rate or time to union at a significance value of P < 0.05. The analysis showed exchange nailing to be the more successful choice in the treatment of femoral non-unions in respect to its higher succ

关键词： Non-union Delayed union Dynamization Femoral fracture Exchange nailing

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p53 balances between tissue hierarchy and anarchy

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Journal of Molecular Cell Biology 2019年第7期11卷 553-563页

作者： Gabriela Koifman ronit Aloni-Grinstein varda Rotter Department of Molecular Cell Biology the Weizmann Institute of ScienceRehovot 7610001Israel Department of Biochemistry and Molecular Genetics Israel Institute for Biological ResearchNess ZionaIsrael

Normal tissues are organized in a hierarchical model,whereas at the apex of these hierarchies reside stem cells (SCs) capable of self-renewal and of producing differentiated cellular progenies,leading to normal development and ***,tumors are organized in a hierarchical manner,with cancer SCs residing at the apex,contributing to the development and nourishment of tumors .p53,the well-known 'guardian ofthe genome',possesses various roles in embryonic development as well as in adult SC life and serves as the ‘guardian of tissue hierarchy’.Moreover,p53 serves as a barrier for dedifferentiation and reprogramming by constraining the cells to a somatic state and preventing their conversion to *** the contrary,the mutant forms of p53 that lost theirtumor suppressor activity and gain oncogenic functions serve as 'inducers oftissue anarchy' and promote cancer *** this review,we discuss these two sides ofthe p53 token that sentence a tissue either to an ordered hierarchy and life or to anarchy and death.A better understanding of these processes may open new horizons for the development of new cancer therapies.

关键词： p53 stem cell gain of function cancer stem cells adult stem cells embryonic development tissue hierarchy

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