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Neural Regeneration Research 2025年第7期20卷 2108-2115页

作者： Yuhui Kou Zongxue Jin Yusong Yuan Bo Ma Wenyong Xie Na Han Department of trauma and orthopedics Peking University People’s HospitalBeijingChina National Center for trauma Medicine Peking University People’s HospitalBeijingChina Key Laboratory of trauma and Neural Regeneration(Peking University) Ministry of EducationBeijingChina trauma Medicine Center Peking University People’s HospitalBeijingChina Department of orthopedics China-Japan Friendship HospitalBeijingChina

FK506(Tacrolimus)is a systemic immunosuppressant approved by the *** and Drug ***506 has been shown to promote peripheral nerve regeneration,however,its precise mechanism of action and its pathways remain *** this study,we established a rat model of sciatic nerve injury and found that FK506 improved the morphology of the injured sciatic nerve,increased the numbers of motor and sensory neurons,reduced inflammatory responses,markedly improved the conduction function of the injured nerve,and promoted motor function *** findings suggest that FK506 promotes peripheral nerve structure recovery and functional regeneration by reducing the intensity of inflammation after neuronal injury and increasing the number of surviving neurons.

关键词： FK506 inflammation motor neurons nerve regeneration neuron peripheral nerve injury sensory neurons

Comparison between direct repair and humana cellular nerve allografting during contralateral C7 transfer to the upper trunk for restoration of shoulder abduction and elbow flexion

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Neural Regeneration Research 2019年第12期14卷 2132-2140页

作者： Liang Li Wen-Ting He Ben-Gang Qin Xiao-Lin Liu Jian-Tao Yang Li-Qiang Gu Department of orthopedic trauma and Microsurgery the First Affiliated Hospital of Sun Yat-sen University

Direct coaptation of contralateral C7 to the upper trunk could avoid the interposition of nerve grafts. We have successfully shortened the gap and graft lengths, and even achieved direct coaptation. However, direct repair can only be performed in some selected cases, and partial procedures still require autografts, which are the gold standard for repairing neurologic defects. As symptoms often occur after autografting, human acellular nerve allografts have been used to avoid concomitant symptoms. This study investigated the quality of shoulder abduction and elbow flexion following direct repair and acellular allografting to evaluate issues requiring attention for brachial plexus injury repair. Fifty-one brachial plexus injury patients in the surgical database were eligible for this retrospective study. Patients were divided into two groups according to different surgical methods. Direct repair was performed in 27 patients, while acellular nerve allografts were used to bridge the gap between the contralateral C7 nerve root and upper trunk in 24 patients. The length of the harvested contralateral C7 nerve root was measured intraoperatively. Deltoid and biceps muscle strength, and degrees of shoulder abduction and elbow flexion were examined according to the British Medical Research Council scoring system;meaningful recovery was defined as M3–M5. Lengths of anterior and posterior divisions of the contralateral C7 in the direct repair group were 7.64 ± 0.69 mm and 7.55 ± 0.69 mm, respectively, and in the acellular nerve allografts group were 6.46 ± 0.58 mm and 6.43 ± 0.59 mm, respectively. After a minimum of 4-year follow-up, meaningful recoveries of deltoid and biceps muscles in the direct repair group were 88.89% and 85.19%, respectively, while they were 70.83% and 66.67% in the acellular nerve allografts group. Time to C5/C6 reinnervation was shorter in the direct repair group compared with the acellular nerve allografts group. Direct repair facilitated the restorati

关键词： nerve regeneration contralateral C7 nerve root transfer nerve graft brachial plexus avulsion injury direct repair human acellular nerve allograft shoulder function elbow function nerve transfer phrenic nerve accessary nerve neural regeneration

Contralateral C7 transfer combined with acellular nerve allografts seeded with differentiated adipose stem cells for repairing upper brachial plexus injury in rats

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Neural Regeneration Research 2019年第11期14卷 1932-1940页

作者： Jian-Tao Yang Jin-Tao Fang Liang Li Gang Chen Ben-Gang Qin Li-Qiang Gu Department of Microsurgery & orthopedic trauma the First Affiliated Hospital of Sun Yat-sen University

Nerve grafting has always been necessary when the contralateral C7 nerve root is transferred to treat brachial plexus injury. Acellular nerve allograft is a promising alternative for the treatment of nerve defects, and results were improved by grafts laden with differentiated adipose stem cells. However, use of these tissue-engineered nerve grafts has not been reported for the treatment of brachial plexus injury. The aim of the present study was to evaluate the outcome of acellular nerve allografts seeded with differentiated adipose stem cells to improve nerve regeneration in a rat model in which the contralateral C7 nerve was transferred to repair an upper brachial plexus injury. Differentiated adipose stem cells were obtained from Sprague-Dawley rats and transdifferentiated into a Schwann cell-like phenotype. Acellular nerve allografts were prepared from 15-mm bilateral sections of rat sciatic nerves. Rats were randomly divided into three groups: acellular nerve allograft, acellular nerve allograft + differentiated adipose stem cells, and autograft. The upper brachial plexus injury model was established by traction applied away from the intervertebral foramen with micro-hemostat forceps. Acellular nerve allografts with or without seeded cells were used to bridge the gap between the contralateral C7 nerve root and C5–6 nerve. Histological staining, electrophysiology, and neurological function tests were used to evaluate the effect of nerve repair 16 weeks after surgery. Results showed that the onset of discernible functional recovery occurred earlier in the autograft group first, followed by the acellular nerve allograft + differentiated adipose stem cells group, and then the acellular nerve allograft group;moreover, there was a significant difference between autograft and acellular nerve allograft groups. Compared with the acellular nerve allograft group, compound muscle action potential, motor conduction velocity, positivity for neurofilament and S100, diameter o

关键词： nerve regeneration peripheral nerve injury brachial plexus injury contralateral C7 nerve root acellular nerve adipose stem cells Schwann cells tissue engineering nerve nerve grafting nerve defect neural regeneration

Factors predicting sensory and motor recovery after the repair of upper limb peripheral nerve injuries

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Neural Regeneration Research 2014年第6期9卷 661-672页

作者： Bo He Zhaowei Zhu Qingtang Zhu Xiang Zhou Canbin Zheng Pengliang Li Shuang Zhu Xiaolin Liu Jiakai Zhu Department of Microsurgery and orthopedic trauma the First Affiliated Hospital of Sun Yat-sen University

OBJECTIVE： To investigate the factors associated with sensory and motor recovery after the repair of upper limb peripheral nerve injuries. DATA SOURCES： The online PubMed database was searched for English articles describing outcomes after the repair of median, ulnar, radial, and digital nerve injuries in humans with a publication date between 1 January 1990 and 16 February 2011. STUDY SELECTION： The following types of article were selected：（1） clinical trials describ- ing the repair of median, ulnar, radial, and digital nerve injuries published in English; and （2） studies that reported sufficient patient information, including age, mechanism of injury, nerve injured, injury location, defect length, repair time, repair method, and repair materials. SPSS 13.0 software was used to perform univariate and multivariate logistic regression analyses and to in- vestigate the patient and intervention factors associated with outcomes. MAIN OUTCOME MEASURES： Sensory function was assessed using the Mackinnon-Dellon scale and motor function was assessed using the manual muscle test. Satisfactory motor recovery was defined as grade M4 or M5, and satisfactory sensory recovery was defined as grade S3＋ or S4. RESULTS： Seventy-one articles were included in this study. Univariate and multivariate logistic regression analyses showed that repair time, repair materials, and nerve injured were inde- pendent predictors of outcome after the repair of nerve injuries （P 〈 0.05）, and that the nerve injured was the main factor affecting the rate of good to excellent recovery. CONCLUSION： Predictors of outcome after the repair of peripheral nerve injuries include age, gender, repair time, repair materials, nerve injured, defect length, and duration of follow-up.

关键词： nerve regeneration peripheral nerve injury outcome predictors nerve repair upperlimb univariate analysis prognosis 863 Program neural regeneration

Missed posterior shoulder dislocation and McLaughlin lesion after an electrocution accident

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Chinese Journal of traumatology 2012年第6期15卷 376-378页

作者： Fabio Rodia Angelo Ventura Georgios Touloupakis Emmanouil Theodorakis Marco Ceretti cto trauma and orthopedic hospital RomeItaly

Posterior shoulder dislocation is a rare event that may occur after a direct trauma, an epileptic seizure, electric shock or electroconvulsive therapy. In more than 50% of the cases, posterior dislocations are missed on initial evaluation and often misdiagnosed as frozen shoul- ders with unfortunate consequences. We present the case of a missed posterior suhluxation and reverse Hill Sachs lesion （McLaughlin lesion） in a 40-year-old woman caused by anelectric shock of 240 V. The patient underwent sur- gery in our institute two weeks after the injury. The humeralhead was reduced and the reverse Hill Sachs lesion was filled by demineralized bone matrix allograft with osteoinductive factors. Tendons were repaired and a temporaneous artrodesis was performed. At the final follow up of 12 months, we obtained a Costant Score of 93 and the patient returned to her previous daily activities.

关键词： Shoulder dislocation Electric injuries Bone matrix

MicroRNA-584-5p/RUNX family transcription factor 2 axis mediates hypoxia-induced osteogenic differentiation of periosteal stem cells

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World Journal of Stem Cells 2023年第10期15卷 979-988页

作者： Jia-Jia Lu Xiao-Jian Shi Qiang Fu Yong-Chuan Li Lei Zhu Nan Lu Department of orthopedic trauma Surgery Shanghai Fourth People’s HospitalSchool of MedicineTongji UniversityShanghai 200001China Department of orthopedic trauma Surgery Shanghai Changzheng HospitalShanghai 200001China Department of orthopedic trauma Haimen People’s Hospital of Jiangsu ProvinceNantong 226100Jiangsu ProvinceChina

BACKGROUND The hypoxic environment during bone healing is important in regulating the differentiation of periosteal stem cells(PSCs)into osteoblasts or chondrocytes;however,the underlying mechanisms remain *** To determine the effect of hypoxia on PSCs,and the expression of microRNA-584-5p(miR-584-5p)and RUNX family transcription factor 2(RUNX2)in PSCs was modulated to explore the impact of the miR-584-5p/RUNX2 axis on hypoxiainduced osteogenic differentiation of *** In this study,we isolated primary mouse PSCs and stimulated them with hypoxia,and the characteristics and functional genes related to PSC osteogenic differentiation were *** expressing miR-584-5p and RUNX2 were established to determine PSC osteogenic *** Hypoxic stimulation induced PSC osteogenic differentiation and significantly increased calcified nodules,intracellular calcium ion levels,and alkaline phosphatase(ALP)activity in *** differentiation-related factors such as RUNX2,bone morphogenetic protein 2,hypoxia-inducible factor 1-alpha,and ALP were upregulated;in contrast,miR-584-5p was downregulated in these ***,upregulation of miR-584-5p significantly inhibited RUNX2 expression and hypoxia-induced PSC osteogenic ***2 was the target gene of miR-584-5p,antagonizing miR-584-5p inhibition in hypoxia-induced PSC osteogenic *** Our study showed that the interaction of miR-584-5p and RUNX2 could mediate PSC osteogenic differentiation induced by hypoxia.

关键词： Periosteal stem cell Osteogenic differentiation RUNX family transcription factor 2 MiroRNA-584-5p

Is two-stage reimplantation effective for virulent pathogenic infection in a periprosthetic hip? A retrospective analysis

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World Journal of orthopedics 2015年第9期6卷 712-718页

作者： Yong-Cheol Yoon Devendra Lakhotia Jong-Keon Oh Jun Gyu Moon Kumar Prashant Won Yong Shon orthopedic trauma Division Gachon University Gil Hospital Department of orthopedic Surgery Korea University College of MedicineGuro Hospital

AIM: To investigate the effectiveness of two-stage reimplantation using antibiotic-loaded bone cement(ALBC) and the risk factors associated with failure to control periprosthetic joint infection(PJI).METHODS: We retrospectively reviewed 38 consecutive hips managed using two-stage reimplantation with ALBC. The mean follow-up period was 5.4 years(range: 2.5-9 years). RESULTS: The causative pathogens were isolated from 29 patients(76%), 26 of whom were infected with highly virulent organisms. Sixteen patients(42%) underwent at least two first-stage debridements. An increased debridement frequency correlated significantly with high comorbidity(P < 0.001), a lower preoperative Harris hip score(HHS; P < 0.001), antimicrobial resistance, and gram-negative and polymicrobial infection(P = 0.002). Of the 35 patients who underwent two-stage reimplantation, 34 showed no signs of recurrence of infection. The mean HHS improved from 46 ± 12.64 to 78 ± 10.55 points, with 7(20%), 12(34%), 11(32%)and 5(14%) patients receiving excellent, good, fair and poor ratings, respectively. CONCLUSION: The current study demonstrated that two-stage reimplantation could successfully treat PJI after hip arthroplasty. However, the ability of ALBC to eradicate infection was limited because frequent debridement was required in high-risk patients(i.e., patients who are either in poor general health due to associated comorbidities or harbor infections due to highly virulent, difficult-to-treat organisms). Level of evidence: Level Ⅳ.

关键词： Two-stage reimplantation Periprosthetic infection Antibiotic-loaded bone cement Debridement

Direct anterior approach hip arthroplasty:How to reduce complications-A 10-years single center experience and literature review

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World Journal of orthopedics 2022年第4期13卷 388-399页

作者： Fabrizio Rivera Luca C Comba Alessandro Bardelli Department of orthopedic trauma SS Annunziata HospitalSavigliano 12038Italy Department of orthopedic trauma Universitàdegli Studi di TorinoTorino 10124Italy

BACKGROUND The direct anterior approach for total hip arthroplasty(DAA-THA)is increasing in popularity due to some advantages such as less surgical trauma,minimal dissection of soft tissues,shorter rehabilitation times,faster return to daily activities,lower incidence of *** the other hand,the literature reports a high rate of intraoperative complications,with many different rates and complication types in the published *** To analyze our complications comparing results with the literature;to report measures that we have taken to reduce complications *** All DAA-THA patients with one year minimum follow up who were operated at a single high-volume centre,between January 2010 and December 2019 were included in this retrospective *** surgeries were performed using cementless short anatomical or straight stems and press fit ***’followup was performed,at 6 wk,3 mo,then annually post-surgery with clinical and radiological *** outcomes were stem revision for aseptic loosening and all-cause stem *** outcome was intra-operative and post-operative complications *** A total of 394 patients underwent DDA-THA from January 2010 and December 2019,for a total of 412 hips;twelve patients lost to follow-up and one patient who died from causes not related to surgery were excluded from the *** average age at the time of surgery was 61 years(range from 28 to 78 years).Mean follow-up time was 64.8 mo(range 12-120 mo).Seven stems were *** cortical perforation,one trochanteric and lateral cortical wall intraoperative fracture,one diaphyseal fracture,three clinically symptomatic early subsidence and one late aseptic *** also observed 3 periprosthetic fractures B1 according to the Vancouver *** minor complications not requiring stem revision were 5 un-displaced fractures of the calcar region treated with preventive cerclage,one early infection,one case of late pos

关键词： Hip arthroplasty Direct anterior approach Short hip stem Minimally invasive surgery Complications

Advancement in utilization of magnetic resonance imaging and biomarkers in the understanding of schizophrenia

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World Journal of Clinical Cases 2025年第1期13卷 11-15页

作者： Aidan K Tirpack Danyaal G Buttar Mandeep Kaur Department of Psychiatry Campbell University School of Osteopathic MedicineBuies CreekNC 27506United States Department of Psychiatry and Behavioral Health Mercyhealth Hospital and Trauma CenterJanesvilleWI 53548United States

Historically,psychiatric diagnoses have been made based on patient’s reported symptoms applying the criteria from diagnostic and statistical manual of mental *** utilization of neuroimaging or biomarkers to make the diagnosis and manage psychiatric disorders remains a distant *** have been several studies that examine brain imaging in psychiatric disorders,but more work is needed to elucidate the complexities of the human *** this editorial,we examine two articles by Xu et al and Stoyanov et al,that show developments in the direction of using neuroimaging to examine the brains of people with schizo-phrenia and *** et al used magnetic resonance imaging to examine the brain structure of patients with schizophrenia,in addition to examining neurotransmitter levels as *** et al used functional magnetic resonance imaging to look at modulation of different neural circuits by diagnostic-specific scales in patients with schizophrenia and *** two studies provide crucial evidence in advancing our understanding of the brain in prevalent psychiatric disorders.

关键词： Schizophrenia Magnetic resonance imaging Biomarkers Neurotransmitters Psychiatric disorders

Dislocation of primary total hip arthroplasty:Analysis of risk factors and preventive options

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World Journal of orthopedics 2024年第6期15卷 501-511页

作者： Dario Regis Mattia Cason Bruno Magnan Department of orthopedic and trauma Surgery Integrated University HospitalVerona 37126VenetoItaly

Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint ***,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic *** is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical *** most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of ***,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the *** spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after *** options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.

关键词： Dislocation Total hip arthroplasty Revision surgery Review Risk factors Complication