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Pulmonary embolism after shoulder surgery:Is it a real threat?

World Journal of Methodology 2025年第1期15卷 42-50页

作者： Charalampos Pitsilos Pericles Papadopoulos Panagiotis Givissis Byron Chalidis 2^(nd)orthopaedic department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 54635Greece 1^(st)orthopaedic department Aristotle University of ThessalonikiSchool of MedicineThessaloniki 57010Greece

Pulmonary embolism(PE)is a rare but devastating complication of shoulder *** from increased morbidity and mortality rates,it may significantly impair postoperative recovery and functional *** frequency accounts for up to 5.7%of all shoulder surgery procedures with a higher occurrence in women and patients older than 70 *** is most commonly associated with thrombophilia,diabetes mellitus,obesity,smoking,hypertension,and a history of *** usually occurs secondary to upper or lower-extremity deep vein thrombosis(DVT).However,in rare cases,the source of the thrombi cannot be *** for PE following shoulder surgery remains a topic of debate,and the standard of care does not routinely require prophylactic medication for DVT *** ambulation and elastic stockings are important preventative measures for DVT of the lower extremity and medical agents such as aspirin,low-molecular-weight heparin,and vitamin K antagonists are indicated for high-risk patients,long-lasting operations,or concomitant severe acute respiratory syndrome coronavirus 2 *** most common symptoms of PE include chest pain and shortness of breath,but PE can also be asymptomatic in patients with intrinsic tolerance of *** with DVT may also present with swelling and pain of the respective *** treatment of PE includes inpatient or outpatient anticoagulant therapy if the patient is hemodynamically unstable or stable,*** instability may require transfer to the intensive care unit,and cardiovascular arrest can be implicated in fatal *** important issue for patients with PE in the postoperative period after shoulder surgery is residual stiffness due to a delay in rehabilitation and a prolonged hospital *** physiotherapy and range-of-motion exercises do not adversely affect the prognosis of PE and are highly recommended to preserve shoulder mobility and function.

关键词： Pulmonary embolism Venous thromboembolism Shoulder surgery Shoulder arthroscopy Shoulder arthroplasty

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Liposomes as versatile agents for the management of traumatic and nontraumatic central nervous system disorders:drug stability,targeting efficiency,and safety

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Neural Regeneration Research 2025年第7期20卷 1883-1899页

作者： Mingyu Zhang Chunyu Xiang Renrui Niu Xiaodong He Wenqi Luo Wanguo Liu Rui Gu department of Orthopedic surgery China-Japan Union Hospital of Jilin UniversityChangchunJilin ProvinceChina

Various nanoparticle-based drug delivery systems for the treatment of neurological disorders have been widely ***,their inability to cross the blood–brain barrier hampers the clinical translation of these therapeutic *** are nanoparticles composed of lipid bilayers,which can effectively encapsulate drugs and improve drug delivery across the blood–brain barrier and into brain tissue through their targeting and ***,they can potentially treat traumatic and nontraumatic central nervous system *** this review,we outlined the common properties and preparation methods of liposomes,including thin-film hydration,reverse-phase evaporation,solvent injection techniques,detergent removal methods,and microfluidics ***,we comprehensively discussed the current applications of liposomes in central nervous system diseases,such as Alzheimer's disease,Parkinson's disease,Huntington's disease,amyotrophic lateral sclerosis,traumatic brain injury,spinal cord injury,and brain *** studies related to liposomes are still in the laboratory stage and have not yet entered clinical ***,their application as drug delivery systems in clinical practice faces challenges such as drug stability,targeting efficiency,and ***,we proposed development strategies related to liposomes to further promote their development in neurological disease research.

关键词： Alzheimer's disease amyotrophic lateral sclerosis brain tumors central nervous system Huntington's disease liposome drug delivery neurological disorders Parkinson's disease spinal cord injury traumatic brain injury

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Surgical site soft tissue thickness as a predictor of complications following arthroplasty

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World Journal of Methodology 2025年第2期15卷 62-73页

作者： Kevin A Wu Faheem Pottayil Crystal Jing Ankit Choudhury Albert T Anastasio department of orthopaedic surgery Duke University HospitalDurhamNC 27710United States department of orthopaedic surgery Medical College of Georgia at Augusta UniversityAugustaGA 30912United States department of orthopaedic surgery Medical College of WisconsinMilwaukeeWI 53226United States

Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative *** research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty,particularly infections,across procedures such as total knee,hip,shoulder,and ankle *** studies have indicated that increased STT is associated with a higher risk of complications,including infection and wound healing *** assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instru-mental in guiding preoperative planning to optimize outcomes in arthroplasty *** measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthro-plasty surgery.

关键词： Soft-tissue thickness Arthroplasty Surgical complications Total knee arthroplasty Total hip arthroplasty Total shoulder arthroplasty Total ankle arthroplasty Preoperative assessment Wound healing Infection risk

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Femoral neck stress fracture and medial tibial stress syndrome following high intensity interval training: A case report and review of literature

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World Journal of Clinical Cases 2022年第23期10卷 8323-8329页

作者： Dawn Suwanie Tan Fiona Millicent Cheung Dekai Ng Tin Lung Alan Cheung department of orthopaedic surgery International Orthopaedic ClinicSingapore329563Singapore

BACKGROUND Femoral and tibial stress injuries are commonly found in long distance running *** fractures have rarely been reported in athletes performing high intensity interval training(HIIT)*** objective of this study was to report a case of a patient who presented with medial tibial stress syndrome and femoral neck stress fracture after performing HIIT *** SUMMARY A 26 year old female presented with bilateral medial tibial *** had been performing HIIT exercise for 45 min,five times weekly,for a seven month *** tibial pain was gradual in onset,and was now severe and worse on exercise,despite six weeks of *** resonance imaging(MRI)revealed bilateral medial tibial stress *** she was taking norethisterone for birth control,a dual energy X-ray absorbitometry scan was performed which demonstrated normal bone mineral density of her lumbar spine and femoral *** was managed conservatively with analgesia and physiotherapy,but continued to exercise against medical *** presented again six months later with severe right hip *** of her right hip demonstrated an incomplete stress fracture of her subtrochanteric *** symptoms resolved with strict rest and *** HIIT may cause stress injury of the tibia and femur in young individuals.

关键词： High intensity interval training Medial tibial stress syndrome Femoral neck stress fracture Exercise Fracture Case report

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Paeoniflorin,the Main Monomer Component of Paeonia lactiflora,Exhibits Anti-inflammatory Properties in Osteoarthritis Synovial Inflammation

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Chinese Journal of Integrative Medicine 2024年第5期30卷 433-442页

作者： CHEN Pu ZHOU Jun RUAN An-min MA Yu-feng WANG Qing-fu department of orthopaedic surgery Beijing University of Chinese Medicine Third Affiliated HospitalBeijing 100029China department of orthopaedic surgery Guangdong Provincial Hospital of Chinese MedicineGuangzhou 510120China department of orthopaedic surgery Beijing Longfu HospitalBeijing 100010China

Objective:To explore the mechanism of paeoniflorin(PF)on osteoarthritis(OA)synovial inflammation from network pharmacology to experimental ***:Targets of OA were constructed by detecting the database of network database platforms(Therapeutic Target database,Drug Bank and Gene Cards),and the targets of PF were constructed by Pub Chem and Herbal Ingredients'Targets *** Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis of these co-targeted genes were conducted via Database for Annotation,Visualization,and Integrated Discovery(DAVID)database,and protein-protein interaction(PPI)networks were conducted via the search tool for the retrieval of interacting genes(STRING)*** counting kit-8(CCK-8)assay was performed to assess the potential toxicity of PF on human OA fibroblast-like synoviocytes(FLS),quantitative real-time polymerase chain reaction(q PCR),enzyme-linked immunosorbent assay(ELISA)and Western blot were used to verify the potential mechanism of PF in synovial ***:Twenty-six co-targeted genes were *** enrichment results showed that these co-targeted genes were most likely localized in the cytoplasm,and the biological processes mainly involved'cellular response to hypoxia''lipopolysaccharide(LPS)-mediated signaling pathway'and'positive regulation of gene expression'.KEGG pathway analysis indicated that these co-targeted genes may function through pathways associated with'hypoxia-inducible factor-1(HIF-1)signaling pathway'and'tumornecrosis factor(TNF)signaling pathway'.The PPI network showed that the top 3 hub genes were TP53,TNF,and *** docking results showed that PF was well docking with ***-8 showed no potential toxicity of 10,20 and 50μmol/L PF on human OA *** PF significantly decreased the expression levels of interleukin-1β,interleukin-6,TNF-αmatrix metalloproteinase 13(MMP13),and a disintegrin and metalloproteinase with thrombospondin motifs 5(ADAMTS5)and TNF

关键词： paeoniflorin osteoarthritis synovial inflammation tumor necrosis factor-α network pharmacology Paeonia lactiflora

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Anterolateral rotatory instability in vivo correlates tunnel position after anterior cruciate ligament reconstruction using bone-patellar tendon-bone graft

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World Journal of Orthopedics 2017年第12期8卷 913-921页

作者： Yasutaka Tashiro Ken Okazaki Koji Murakami Hirokazu Matsubara Kanji Osaki Yukihide Iwamoto Yasuharu Nakashima department of orthopaedic surgery University of Pittsburgh department of orthopaedic surgery Kyushu University

AIM To quantitatively assess rotatory and anterior-posterior instability in vivo after anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone(BTB) autografts, and to clarify the influence of tunnel positions on the knee *** Single-bundle ACL reconstruction with BTB autograft was performed on 50 patients with a mean age of 28 years using the trans-tibial(TT)(n = 20) and trans-portal(TP)(n = 30) techniques. Femoral and tibial tunnel positions were identified from the high-resolution 3 D-CT bone models two weeks after surgery. Anterolateral rotatory translation was examined using a Slocum anterolateral rotatory instability test in open magnetic resonance imaging(MRI) 1.0-1.5 years after surgery, by measuring anterior tibial translation at the medial and lateral compartments on its sagittal images. Anterior-posterior stability was evaluated with a Kneelax3 *** A total of 40 patients(80%) were finally followed up. Femoral tunnel positions were shallower(P < 0.01) and higher(P < 0.001), and tibial tunnel positions were more posterior(P < 0.05) in the TT group compared with the TP group. Anterolateral rotatory translations in reconstructed knees were significantly correlated with the shallow femoral tunnel positions(R = 0.42, P < 0.01), and the rotatory translations were greater in the TT group(3.2 ± 1.6 mm) than in the TP group(2.0 ± 1.8 mm)(P < 0.05). Side-to-side differences of Kneelax3 arthrometer were 1.5 ± 1.3 mm in the TT, and 1.7 ± 1.6 mm in the TP group(N.S.). Lysholm scores, KOOS subscales and reinjury rate showed no difference between the two *** Anterolateral rotatory instability significantly correlated shallow femoral tunnel positions after ACL reconstruction using BTB autografts. Clinical outcomes, rotatory and anterior-posterior stability were overall satisfactory in both techniques, but the TT technique located femoral tunnels in shallower and higher positions, and tibial tunnels in more p

关键词： Anterior cruciate ligament Patellar tendon Bone-patellar tendon-bone Rotatory instability Magnetic resonance imaging Tunnel position Anatomic Singlebundle

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Brachioradialis tendon transfer and palmaris longus tendon graft for thumb avulsion:A case report and review of literature

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World Journal of Clinical Cases 2025年第4期13卷 48-55页

作者： Pierre Curings Sonia Ramos-Pascual Kinga Michalewska Nicolas Gibert Lionel Erhard Mo Saffarini AlexisNogier department of Hand surgery Clinique TrenelSainte-Colombe 69560France Medical Research ReSurg SANyon 1260VaudSwitzerland department of Hand surgery Hand and Upper Limb Surgical InstituteVilleurbanne 69100France department of orthopaedics Clinique TrenelSainte-Colombe 69560France

BACKGROUND Thumb replantation following complete traumatic avulsion requires complex techniques to restore function,especially in cases of avulsion at the level of the metacarpophalangeal joint(MCP I)and avulsion of the flexor pollicis longus(FPL)at the musculotendinous *** treatments include direct tendon suture or tendon transfer,most commonly from the ring *** optimize function and avoid donor finger complications,we performed thumb replantation with flexion restoration using brachioradialis(BR)tendon transfer with palmaris longus(PL)tendon *** SUMMARY A 20-year-old left-handed male was admitted for a complete traumatic left thumb amputation following an accident while sliding from the top of a *** patient presented with skin and bone avulsion at the MCP I,avulsion of the FPL tendon at the musculotendinous junction(zone 5),avulsion of the extensor pollicis longus tendon(zone T3),and avulsion of the thumb’s collateral arteries and *** patient was treated with two stage thumb *** first intervention consisted of thumb replantation with MCP I arthrodesis,resection of avulsed FPL tendon and implantation of a silicone tendon *** second intervention consisted of PL tendon graft and BR tendon ***-up at 10 months showed good outcomes with active interphalangeal flexion of 70°,grip strength of 45 kg,key pinch strength of 15 kg and two-point discrimination threshold of 4 *** Flexion restoration after complete thumb amputation with FPL avulsion at the musculotendinous junction can be achieved using BR tendon transfer with PL tendon graft.

关键词： Brachioradialis tendon transfer Flexor pollicis longus Palmaris longus tendon graft Replantation Thumb amputation Thumb avulsion Case report

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Management of achilles tendon injury: A current concepts systematic review

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World Journal of Orthopedics 2015年第4期6卷 380-386页

作者： Vivek Gulati Matthew Jaggard Shafic Said Al-Nammari Chika Uzoigwe Pooja Gulati Nizar Ismail Charles Gibbons Chinmay Gupte department of orthopaedic surgery Chelsea and Westminster Hospital department of orthopaedic surgery Imperial College

Achilles tendon rupture has been on the rise over recent years due to a variety of reasons. It is a debilitating injury with a protracted and sometimes incomplete recovery. Management strategy is a controversial topic and evidence supporting a definite approach is limited. Opinion is divided between surgical repair and conservative immobilisation in conjunction with functional orthoses. A systematic search of the literature was performed. Pubmed, Medline and EmB ase databases were searched for Achilles tendon and a variety of synonymous terms. A recent wealth of reporting suggests that conservative regimens with early weight bearing or mobilisation have equivalent or improved rates of re-rupture to operative regimes. The application of dynamic ultrasound assessment of tendon gap may prove crucial in minimising re-rupture and improving outcomes. Studies employing functional assessments have found equivalent function between operative and conservative treatments. However, no specific tests in peak power, push off strength or athletic performance have been reported and whether an advantage in operative treatment exists remains undetermined.

关键词： orthopaedic surgery Achilles tendon injury Sports injury Tendon rupture Conservative management

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Inflammasome links traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1644-1664页

作者： Gabriela Seplovich Yazan Bouchi Juan Pablo de Rivero Vaccari Jennifer C.Munoz Pareja Andrew Reisner Laura Blackwell Yehia Mechref Kevin K.Wang J.Adrian Tyndall Binu Tharakan Firas Kobeissy department of surgery Morehouse School of MedicineAtlantaGAUSA department of Neurobiology Center for NeurotraumaMultiomics&Biomarkers(CNMB)Neuroscience InstituteMorehouse School of MedicineAtlantaGAUSA department of Neurological surgery and the Miami Project to Cure Paralysis University of Miami Miller School of MedicineMiamiFLUSA Division of Pediatric Critical Care Department of PediatricsUniversity of Miami Miller School of MedicineMiamiFLUSA department of Pediatrics Emory UniversityAtlantaGAUSA department of Neurosurgery Children’s Healthcare of AtlantaAtlantaGAUSA department of Chemistry and Biochemistry Texas Tech UniversityLubbockTXUSA Morehouse School of Medicine AtlantaGAUSA

traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.

关键词： Alzheimer's disease caspase-1 chronic traumatic encephalopathy inflammasomes neurodegeneration neuroinflammation NLRP1 NLRP3 pyroptosis tauopathy traumatic brain injury

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Impact of time between meniscal injury and isolated meniscus repair on post-operative outcomes:A systematic review

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World Journal of Clinical Cases 2025年第7期13卷 39-45页

作者： Kashif Javid Xavier Akins Nicole G Lemaster Amer Ahmad Austin V Stone department of orthopaedic surgery and Sports Medicine University of KentuckyLexingtonKY 40504United States

BACKGROUND Meniscal tears are one of the most common knee *** the diagnosis of a meniscal tear has been made,there are several factors physicians use to guide clinical *** influence of time between injury and isolated meniscus repair on patient outcomes is not well *** this relationship is important as it may influence clinical decision-making and can add to the preoperative patient education *** hypothesized that increasing the time from injury to meniscus surgery would worsen postoperative *** To investigate the current literature for data on the relationship between time between meniscus injury and repair on patient *** PubMed,Academic Search Complete,MEDLINE,CINAHL,and SPORTDiscus were searched for studies published between January 1,1995 and July 13,2023 on isolated meniscus *** criteria included concomitant ligament surgery,incomplete outcomes or time to surgery data,and *** demographics,time to injury,and postoperative outcomes from each study were abstracted and *** Five studies met all inclusion and exclusion *** were 204(121 male,83 female)patients *** of five(60%)studies determined that time between injury and surgery was not statistically significant for postoperative Lysholm scores(P=0.62),Tegner scores(P=0.46),failure rate(P=0.45,P=0.86),and International Knee Documentation Committee scores(P=0.65).Two of five(40%)studies found a statistically significant increase in Lysholm scores with shorter time to surgery(P=0.03)and a statistically significant association between progression of medial meniscus extrusion ratio(P=0.01)and increasing time to *** Our results do not support the hypothesis that increased time from injury to isolated meniscus surgery worsens postoperative ***-making primarily based on injury interval is thus not recommended.

关键词： Meniscus Meniscal Meniscus repair Meniscectomy Patient reported outcomes Postoperative outcomes Time to surgery Injury interval

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