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Lower limb stress fractures in sport:Optimising their management and outcome

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World journal of Orthopedics 2017年第3期8卷 242-255页

作者： Greg A j Robertson alexander M Wood Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh Edinburgh Department of Orthopaedic Leeds General Infirmary

Stress fractures in sport are becoming increasing more common,comprising up to 10%of all of sporting *** 90%of such injuries are located in the lower *** articles aims to define the optimal management of lower limb stress fractures in the athlete,with a view to maximise return rates and minimise return times to *** planning of this condition is specific to the location of the ***,there remains a clear division of stress fractures by"high"and"low"risk."Low risk"stress fractures are those with a low probability of fracture propagation,delayed union,or non-union,and so can be managed reliably with rest and exercise *** include stress fractures of the PosteroMedial Tibial Diaphysis,Metatarsal Shafts,Distal Fibula,Medial Femoral Neck,Femoral Shaft and Calcaneus."High risk"stress fractures,in contrast,have increased rates of fracture propagation,displacement,delayed and non-union,and so require immediate cessation of activity,with orthopaedic referral,to assess the need for surgical *** include stress fractures of the Anterior Tibial Diaphysis,Fifth Metatarsal Base,Medial Malleolus,Lateral Femoral Neck,Tarsal Navicular and Great Toe *** order to establish the optimal methods for managing these injuries,we present and review the current evidence which guides the treatment of stress fractures in *** this,we note an increased role for surgical management of certain high risk stress fractures to improve return times and rates to *** this,key recommendations are provided for the management of the common stress fracture types seen in the *** case reports are also presented to illustrate the application of sportfocussed lower limb stress fracture treatment in the clinical setting.

关键词： Fractures Lower Limb Sport Management Stress

Alterations in the polysialylated neural cell adhesion molecule and retinal ganglion cell density in mice with diabetic retinopathy

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International journal of Ophthalmology(English edition) 2018年第10期11卷 1608-1615页

作者： Natalia Lobanovskaya Monika jürgenson Anu Aonurm-Helm alexander Zharkovsky Department of Pharmacology Centre of Excellence for Translational Medicine University of Tartu

AIM：To investigate the impact of polysialylated neural cell adhesion molecule（PSA-NCAM）on the survival of retinal ganglion cells（RGCs）in the experimentally induced diabetes in ***：Diabetes was induced in 2.5 months old Swiss Webster mice by intraperitoneal injection of streptozotocin（STZ,90 mg/kg）once daily for two consecutive *** of the proteins of interest in the retinas from diabetic mice at 2mo after diabetes induction was performed using immunohistochemistry and Western blot *** were counted in the wholemounted retinas,and Brn3a marker was ***：Examination of retinas from diabetic mice at 2mo after diabetes induction revealed a considerable reduction in RGC *** experiments also demonstrated a redistribution of PSA-NCAM in the retina of diabetic ***-NCAM immunoreactivity was diminished in the inner part of the retina where RGCs were *** contrast,an enhanced PSA-NCAM immunoreactivity was detected in the outer layers of the ***-NCAM signal was co-localized with glial fibrillary acidic protein immunoreactivity in the Müller cell *** studies have shown that matrix metalloproteinase-9（MMP-9）is responsible for the reduction in PSA-NCAM levels in neuronal *** reduced levels of PSA-NCAM in inner layers（nerve fiber layer,ganglion cell layer）were accompanied by the increased expression of *** contrast,in the outer retinal layers,the expression of MMP-9 was much less ***：MMP-9 induces PSA-NCAM shedding in the inner part of the retina and the decreased level of PSA-NCAM in the inner part of the retina might be,at least in part,responsible for the loss of RGCs in diabetic mice.

关键词： diabetic retinopathy matrix metalloproteinase-9 polysialylated neural cell adhesion molecule retinal ganglion cells

Parametric study on smoothed particle hydrodynamics for accurate determination of drag coefficient for a circular cylinder

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Water Science and Engineering 2017年第2期10卷 143-153页

作者： Maziar Gholami Korzani Sergio A. Galindo-Torres alexander Scheuermann David j. Williams School of Civil Engineering The University of Queensland St Lucia Brisbane QLD 4072 Australia School of Mathematics and Physics The University of Queensland St Lucia Brisbane QLD 4072 Australia

Simulations of two-dimensional(2D) flow past a circular cylinder with the smoothed particle hydrodynamics(SPH) method were conducted in order to accurately determine the drag coefficient. The fluid was modeled as a viscous liquid with weak compressibility. Boundary conditions,such as a no-slip solid wall, inflow and outflow, and periodic boundaries, were employed to resemble the physical problem. A sensitivity analysis, which has been rarely addressed in previous studies, was conducted on several SPH parameters. Hence, the effects of distinct parameters, such as the kernel choices and the domain dimensions, were investigated with the goal of obtaining highly accurate results. A range of Reynolds numbers(1-500) was simulated, and the results were compared with existing experimental data. It was observed that the domain dimensions and the resolution of SPH particles, in comparison to the obstacle size, affected the obtained drag coefficient significantly. Other parameters, such as the background pressure, influenced the transient condition, but did not influence the steady state at which the drag coefficient was determined.

关键词： Smoothed particle hydrodynamics Drag coefficient Reynolds number Sensitivity analysis Viscous flow

Double negative T cells,a potential biomarker for systemic lupus erythematosus

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Precision Clinical Medicine 2020年第1期3卷 34-43页

作者： jessy j.alexander alexander jacob Anthony Chang Richard j.Quigg james N.jarvis Department of Pathology University of ChicagoChicagoIL 60637USA Departments of Medicine PediatricsJacobs School of Medicine and Biomedical Sciences and GeneticsGenomics&Bioinformatics ProgramUniversity at BuffaloBuffaloNY 14203USA

Systemic lupus erythematosus(SLE)is an autoimmune disease that is a challenge to diagnose and *** is an urgent need for biomarkers to help define organ involvement,and more effective therapies.A unique population of T cells,the CD3^(+)CD4^(−)CD8^(−)(DNeg)cells,is significantly increased in lupus *** cases(53%)of pediatric SLE patients had elevated DNeg cells in their peripheral blood,which correlated with kidney function(R^(2)=0.54).Significant infiltration of DNeg cells was observed in both adult and pediatric lupus kidneys by *** the first time,this study provides direct evidence that DNeg cells facilitate kidney injury in preclinical 8-week-old MRL/lpr lupus *** lupus mice,the increase in DNeg cells tracked with worsening disease and correlated with kidney function(R^(2)=0.85).Our results show that DNeg cells per se can cause kidney dysfunction,increase in number with increase in disease pathology,and could serve as a potential biomarker.

关键词： CD3^(+)CD4^(−)CD8^(−)T cells glomerulonephritis inflammation lupus

Return to sport following tibial plateau fractures: A systematic review

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World journal of Orthopedics 2017年第7期8卷 574-587页

作者： Greg A j Robertson Seng j Wong alexander M Wood Edinburgh Orthopaedic Trauma Unit Royal Infirmary of Edinburgh Orthopaedic Department Leeds General Infirmary

AIM To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for different treatment *** A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, MEDLINE, PEDro, Scopus, SPORTDiscus and Web of Science was performed in january 2017 using the keywords "tibial", "plateau", "fractures", "knee", "athletes", "sports", "non-operative", "conservative", "operative", "return to sport". All studies which recorded return rates and times to sport following tibial plateau fractures were included. RESULTS Twenty-seven studies were included: 1 was a randomised controlled trial, 7 were prospective cohort studies, 16 were retrospective cohort studies, 3 were case series. One study reported on the outcome of conservative management(n = 3); 27 reported on the outcome of surgical management(n = 917). Nine studies reported on Open Reduction Internal Fixation(ORIF)(n = 193), 11 on Arthroscopic-Assisted Reduction Internal Fixation(ARIF)(n = 253) and 7 on Frame-Assisted Fixation(FRAME)(n = 262). All studies recorded "return to sport"rates. Only one study recorded a "return to sport" time. The return rate to sport for the total cohort was 70%. For the conservatively-managed fractures, the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME was 52%. The return rate for ARIF was found to be significantly greater than that for ORIF(OR 3.22, 95%CI: 2.09-4.97, P < 0.001) and for FRAME(OR 4.33, 95%CI: 2.89-6.50, P < 0.001). No difference was found between the return rates for ORIF and FRAME(OR 1.35, 95%CI: 0.92-1.96, P = 0.122). The recorded return time was 6.9 mo(median), from a study reporting on *** Return rates to sport for tibial pl

关键词： Tibial Plateau Fracture Knee Return Sport Rate Time

Failed biliary cannulation: Clinical and technical outcomes after tertiary referral endoscopic retrograde cholangiopancreatography

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World journal of Gastroenterology 2011年第45期17卷 4993-4998页

作者： Michael P Swan Michael j Bourke Stephen j Williams Sina alexander Alan Moss Rick Hope David Ruppin Department of Gastroenterology and Hepatology Westmead Hospital

AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS: Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP. RESULTS: Fifty-one patients (35 female; mean age: 62.5 years; age range: 40-87 years) with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis (45%) or pancreatic malignancy (18%). Successful biliary can- nulation was 100%. The precut needle knife sphincterotomy (NKS) rate was 27.4%. Complications occurred in 3.9% (post-ERCP pancreatitis). An identif iable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 nave pa-pilla patients (female 61%; mean age: 59.9 years; age range: 18-94 years) who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate (100% vs 98%) or postERCP pancreatitis (3.1% vs 3.9%). Precut NKS use was more frequent (27.4% vs 12.7%) (P = 0.017). CONCLUSION: Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures.

关键词： Failed endoscopic retrograde cholangiopancreatography Failed biliary cannulation Unsuccessful biliary cannulation Tertiary referral endoscopic retrograde cholangiopancreatography Needle knife sphincterotomy Biliary cannulation Precut sphincterotomy Post endoscopic retrograde cholangiopancreatography pancreatitis

A critical examination of compound stability predictions from machine-learned formation energies

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npj Computational Materials 2020年第1期6卷 858-868页

作者： Christopher j.Bartel Amalie Trewartha Qi Wang alexander Dunn Anubhav jain Gerbrand Ceder Department of Materials Science&Engineering University of CaliforniaBerkeleyBerkeleyCA 94720USA Energy Technologies Area Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA Materials Sciences Division Lawrence Berkeley National LaboratoryBerkeleyCA 94720USA

Machine learning has emerged as a novel tool for the efficient prediction of material properties,and claims have been made that machine-learned models for the formation energy of compounds can approach the accuracy of Density Functional Theory(DFT).The models tested in this work include five recently published compositional models,a baseline model using stoichiometry alone,and a structural *** testing seven machine learning models for formation energy on stability predictions using the Materials Project database of DFT calculations for 85,014 unique chemical compositions,we show that while formation energies can indeed be predicted well,all compositional models perform poorly on predicting the stability of compounds,making them considerably less useful than DFT for the discovery and design of new *** critically,in sparse chemical spaces where few stoichiometries have stable compounds,only the structural model is capable of efficiently detecting which materials are *** nonincremental improvement of structural models compared with compositional models is noteworthy and encourages the use of structural models for materials discovery,with the constraint that for any new composition,the ground-state structure is not known a *** work demonstrates that accurate predictions of formation energy do not imply accurate predictions of stability,emphasizing the importance of assessing model performance on stability predictions,for which we provide a set of publicly available tests.

关键词： stability critical solids

Effect of 5-FU on modulation of disarrangement of immune-associated cytokines in experimental acute pancreatitis

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World journal of Gastroenterology 2009年第16期15卷 2032-2037页

作者： Xiao-Li Chen Sang-Zhu Ciren Hui Zhang Li-Geng Duan alexander j Wesley Department of General Surgery The Huaxi Hospital Medical Center University of Sichuan Chengdu 610041 China Department of Surgery Transplantation Division University of Cincinnati Medical Center Cincinnati OH 45267-0558 United States

AIM： To investigate the effects of 5-Fluorouracil （5-FU） on modulation of pro-inflammatory and anti-inflammatory cytokines in acute pancreatitis and the mechanism of it in the treatment of acute pancreatitis. METHODS： Male Sprague Dawley rats were assigned to 3 Groups： Group A, sham operated rats as controls （n = 7）; Group B, acute pancreatitis induced by ductal injection with 5% sodium cholate at a volume of 1.0 mL/kg without any other treatment; Group C, after the pancreatitis was induced as in Group B, the rats were injected intravenously with 5-FU 40 mg/kg. The animals in Groups B and C were killed at 2, 6 and 24 h after operation （n = 7）, and blood samples were taken for measurement of tumor necrosis factor-α （TNF-α）, interleukin-1 （IL-1）, interleukin-6 （IL-6）（by bioassay）, and interleukin-10 （IL-10）, transforming growth factor-β （TGF-β）（by ELISA）. The wet weight of pancreatic tissue, serum amylase levels and white blood cells were also measured. RESULTS： Four rats in Group B and one in Group C died after pancreatitis was induced. Both pro-inflammatory cytokines （TNF-α, IL-1, IL-6） at the 2 and 6 h period and the anti-inflammatory cytokines （IL-10, TGF-β） at 24 h increased significantly （P 〈 0.05） in rats of Group B. After treatment with 5-FU, TNF-α, IL-1, and IL-6 in serum of rats of Group C were inhibited at 2 and 6 h after operation （P 〈 0.05）, and IL-IO, TGF-13 were inhibited at 24 h compared to Group B （P 〈 0.05）. Obvious improvements in the severity of the acute pancreatitis, including the amylase levels, wet weight of pancreatic tissue and neutrophil counts, were also observed after treatment with 5-FU. CONCLUSION： 5-FU is an anti-metabolic and immunosuppressive agent which can minimize the abnormal immune o/tokine response and relieve the pathophysiological disorders associated with experimental acute pancreatitis.

关键词： Pancreatitis Cytokines Systemic inflammatory response syndrome 5-Fluorouracil

Patients without hepatocellular carcinoma progression after transarterial chemoembolization benefit from liver transplantation

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World journal of Gastroenterology 2007年第5期13卷 761-767页

作者： Aiman Obed alexander Beham Kerstin Püllmann Heinz Becker Hans j Schlitt Thomas Lorf Department of Surgery University of Regensburg Regensburg 93053Germany 不详 Department of Surgery University of Goettingen Goettingen 37073 Germany

AIM： To assess the outcome of patients, who underwent transarterial chemoembolization （TACE） for hepatocellular carcinoma （HCC） and subsequently liver transplantation （OLT） irrespective of tumor size when no tumor progression was observed. METHODS： Records, imaging studies and pathology of 84 patients with HCC were reviewed. Ten patients were not treated at all, 67 patients had TACE and 35 of them were listed for OLT. Tumor progression was monitored by ultrasound and AFP level every 6 wk. Fifteen patients showed signs of tumor progression without transplantation. The remaining 20 patients underwent OLT. Further records of 7 patients with HCC seen in histological examination after OLT were included. RESULTS： The patients after TACE without tumor progression underwent transplantation and had a median survival of 92.3 too. Patients, who did not qualify for liver transplantation or had signs of tumor progression had a median survival of 8.4 mo. The patients without treatment had a median survival of 3.8 mo. Independent of International Union Against Cancer （UICC） stages, the patients without tumor progression and subsequent OLT had longer median survival. No significant difference was seen in the OLT treated patients if they did not fulfill the Milan criteria. CONCLUSION： Selection of patients for OLT based on tumor progression results in good survival. The evaluation of HCC patients should not only be based on tumor size and number of foci but also on tumor progression and growth behavior under therapy.

关键词： Liver transplantation Hepatocellularcarcinoma