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Bone marrow mesenchymal stem cells in treatment of peripheral nerve injury

World Journal of Stem Cells 2024年第8期16卷 799-810页

作者： Xiong-Fei Zou Bao-Zhong Zhang Wen-Wei Qian Florence Mei Cheng department of orthopedic surgery Peking Union Medical College HospitalBeijing 100730China College of Nursing The Ohio State UniversityOhioOH 43210United States

Peripheral nerve injury(PNI)is a common neurological disorder and complete functional recovery is difficult to *** recent years,bone marrow mesenchymal stem cells(BMSCs)have emerged as ideal seed cells for PNI treatment due to their strong differentiation potential and autologous trans-plantation *** review aims to summarize the molecular mechanisms by which BMSCs mediate nerve repair in *** key mechanisms discussed include the differentiation of BMSCs into multiple types of nerve cells to promote repair of nerve *** also create a microenvironment suitable for neuronal survival and regeneration through the secretion of neurotrophic factors,extracellular matrix molecules,and adhesion ***,BMSCs release pro-angiogenic factors to promote the formation of new blood *** modulate cytokine expression and regulate macrophage polarization,leading to ***,BMSCs synthesize and release proteins related to myelin sheath formation and axonal regeneration,thereby promoting neuronal repair and ***,this review explores methods of applying BMSCs in PNI treatment,including direct cell trans-plantation into the injured neural tissue,implantation of BMSCs into nerve conduits providing support,and the application of genetically modified BMSCs,among *** findings confirm the potential of BMSCs in treating ***,with the development of this field,it is crucial to address issues related to BMSC therapy,including establishing standards for extracting,identifying,and cultivating BMSCs,as well as selecting application methods for BMSCs in PNI such as direct transplantation,tissue engineering,and genetic *** these issues will help translate current preclinical research results into clinical practice,providing new and effective treatment strategies for patients with PNI.

关键词： Bone marrow mesenchymal stem cells Peripheral nerve injury Schwann cells Myelin sheath Tissue engineering

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Perioperative and long-term results of ultrasonography-guided single-and multiple-tract percutaneous nephrolithotomy for staghorn calculi

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World Journal of Clinical Cases 2024年第7期12卷 1243-1250页

作者： Rui-Xiang Cheng Ni Dai Yan-Min Wang Pei Qi Fen Chen department of Urology Wuhan Ninth HospitalWuhan 430081Hubei ProvinceChina department of Urinary Pain Wuhan Hankou HospitalWuhan 430000Hubei ProvinceChina Pre-hospital Emergency department Wuhan Puren HospitalWuhan 430081Hubei ProvinceChina department of orthopedic trauma surgery Wuhan Hankou HospitalWuhan 430000Hubei ProvinceChina department of Ultrasound Hubei Provincial Hospital of Integrated Traditional Chinese and Western MedicineWuhan 430015Hubei ProvinceChina

BACKGROUND It is possible that this condition will lead to urosepsis and progressive deterioration of renal function in the absence of surgical *** recent clinical studies have shown that multi-tract percutaneous nephrolithotomy(MPCNL)has a similar stone free rate(SFR)as standard percutaneous nephrolithotomy(S-PCNL).As a result,M-PCNL was also recommended as a treatment option for staghorn *** To examine the perioperative and long-term results of ultrasonography-guided single-and *** This was a retrospective cohort *** March 2021 and January 2022,the urology department of our hospital selected patients for the treatment of staghorn calculi using percutaneous *** primary outcomes were com plication rate and SFR,and the characteristics of patients,operative parameters,laboratory measurements were also *** In total,345 patients were enrolled in the study(186 in the S-PCNL group and 159 in the M-PCNL group).The SFR in the M-PCNL group was significantly higher than that in the S-PCNL group(P=0.033).Moreover,the incidence rates of hydrothorax(P=0.03)and postoperative infection(P=0.012)were higher in the M-PCNL group than in the S-PCNL *** regression analysis demonstrated that post-operative white blood cell count(OR=2.57,95%CI:1.90-3.47,P<0.001)and stone size(OR=1.59,95%CI:1.27-2.00,P<0.001)were associated with a higher overall complication rate in the S-PCNL *** mass index(OR=1.22,95%CI:1.06-1.40,P=0.004)and stone size(OR=1.70,95%CI:1.35-2.15,P<0.001)were associated with increased overall complications in the M-PCNL *** Multiple access tracts can facilitate higher SFR while slightly increasing the incidence of acceptable complications.

关键词： Single-tract percutaneous nephrolithotomy Multiple-tract percutaneous nephrolithotomy Staghorn calculi Ultrasonography

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Solitary Osteogenic Exostosis of the Femur Revealed by Recurring Acute Distal Thigh Pain: About a Case

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Open Journal of Pediatrics 2024年第4期14卷 719-726页

作者： Thierno Saïdou Barry Mohamed Lamine Sadou Sacko Balla Keita Sory Sidimé Moussa Condé Daniel Agbo-Panzo Pediatric surgery department Donka National Hospital (HND) of the University Hospital of Conakry Gamal Abdel Nasser University of Conakry (UGANC) of Guinea Conakry Guinea orthopedic and trauma surgery department Donka National Hospital (HND) of the Conakry University Hospital Conakry Guinea

Introduction: Solitary exostoses are the most common benign tumors of the fertile metaphyses of the long bones of children. Their radiological diagnosis of metaphyseal bone growth must be confirmed on pathological examination. These tumors can remain asymptomatic for a long time and reveal themselves during a particularly vascular complication. The objective of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of these tumors. Patient and Observation: We report the case of a 15-year-old adolescent girl, with no particular pathological history, received in the pediatric surgery department of the Donka National Hospital (HND) of the Conakry University Hospital for recurrent acute painful swelling of the lower third of the left thigh in an afebrile context accompanied by lameness and stopping school for a few days (2 - 3 days). The symptoms appear to have evolved over the past 3 years and after physical activities. It regresses with rest, analgesics and non-steroidal anti-inflammatory drugs. The notion of trauma and sickle cell disease was not reported in the patient's clinical history. It is the persistence of the symptomatology which motivates the said consultation. On palpation, a small hard mass is noted at the expense of the internal metaphysis of the left distal femur. Deep palpation of this area causes a tingling sensation and during rapid mobilization of the knee. The remainder of the orthopedic examination was unremarkable. Standard x-ray of the femur shows a bony growth with a pointed tip from the distal metaphysis of the left femur. On surgical exploration, we noted a wedge-shaped exostosis oriented towards the vastus medialis muscle. Histological examination of the surgical specimen confirms osteogenic exostosis. There is no recurrence after 2 years. Conclusion: The distal femoral metaphysis is the most common location of solitary osteochondromas in children. Their definitive diagnosis requires the histology of

关键词： Osteogenic Exostosis Osteochondromas Fertile Long Bone Metaphyses Child

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Knee Osteoarthritis Progression after Distal Femur Closing Wedge Osteotomy

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Open Journal of orthopedics 2024年第4期14卷 187-199页

作者： Ferdinand Nyankoué Mebouinz Khalifa Fall Kennedy Muluem Justine Raphaela Nyekel Moustapha Niane Alioune Badara Gueye Daniel Handy Eone Charles Valerie Kinkpé department of surgery and Specialties The Faculty of Medicine and Biomedical Sciences The University of Yaound&#233 I Yaound&#233 Cameroon department of orthopedic and trauma surgery Cheikh Anta Diop University of Dakar Dakar Senegal department of surgery and Specialties The Faculty of Medicine and Pharmaceuticals Sciences The University of Douala Douala Cameroon

Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.

关键词： Knee Osteoarthritis Progression Osteotomy Distal Femur

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Effect of tubastatin A on NLRP3 inflammasome activation in macrophages under hypoxia/ reoxygenation conditions

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World Journal of Emergency Medicine 2024年第4期15卷 289-296页

作者： Hao Li Chang Liu Ying Cui Panpan Chang Wei Chong department of Emergency Medicine the First Hospital of China Medical UniversityShenyang 110001China trauma Medicine Center Peking University People's HospitalBeijing 100871China Key Laboratory of trauma and Neural Regeneration Peking UniversityBeijing 100871China National Center for trauma Medicine of China Beijing 100871China

BACKGROUND:There are currently no effective drugs to mitigate the ischemia/reperfusion injury caused by fluid resuscitation after hemorrhagic shock(HS).The aim of this study was to explore the potential of the histone deacetylase 6(HDAC6)-specific inhibitor tubastatin A(TubA)to suppress nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)inflammasome activation in macrophages under hypoxia/reoxygenation(H/R)***:The viability of RAW264.7 cells subjected to H/R after treatment with different concentrations of TubA was assessed using a cell-counting kit-8(CCK8)***,2.5μmol/L TubA was used with RAW264.7 cells under H/R ***264.7 cells were divided into three groups,namely the control,H/R,and TubA *** levels of reactive oxygen species(ROS)in the cells were detected using fluorescence *** protein expression of HDAC6,heat shock protein 90(Hsp90),inducible nitric oxide synthase(iNOS),NLRP3,gasdermin-D(GSDMD),Caspase-1,GSDMD-N,and Caspase-1 p20 was detected by western *** levels of interleukin-1β(IL-1β)and IL-18 in the supernatants were detected using enzyme-linked immunosorbent assay(ELISA).RESULTS:HDAC6,Hsp90,and iNOS expression levels were significantly higher(P<0.01)in the H/R group than in the control group,but lower in the TubA group than in the H/R group(P<0.05).When comparing the H/R group to the control group,ROS levels were significantly higher(P<0.01),but significantly reduced in the TubA group(P<0.05).The H/R group had higher NLRP3,GSDMD,Caspase-1,GSDMD-N,and Caspase-1 p20 expression levels than the control group(P<0.05),however,the TubA group had significantly lower expression levels than the H/R group(P<0.05).IL-1βand IL-18 levels in the supernatants were significantly higher in the H/R group compared to the control group(P<0.01),but significantly lower in the TubA group compared to the H/R group(P<0.01).CONCLUSION:TubA inhibited the expression of HDAC6,Hsp90,and iNOS in macrophages

关键词： Hemorrhagic shock Hypoxia/reoxygenation Macrophage NLRP3 Tubastatin A

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Irisin-loaded electrospun core-shell nanofibers as calvarial periosteum accelerate vascularized bone regeneration by activating the mitochondrial SIRT3 pathway

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Regenerative Biomaterials 2024年第1期3卷 44-57页

作者： Xi Hua Mingzhuang Hou Lei Deng Nanning Lv Yong Xu Xuesong Zhu Huilin Yang Qin Shi Hao Liu Fan He department of Orthopaedics The First Affiliated Hospital of Soochow UniversitySoochow UniversitySuzhou 215006China Orthopaedic Institute Suzhou Medical CollegeSoochow UniversitySuzhou 215000China department of orthopedics Suzhou Wuzhong People’s HospitalSuzhouJiangsu Province 215128China department of orthopedic surgery Lianyungang Clinical College of Xuzhou Medical UniversityLianyungang 222003China

The scarcity of native periosteum poses a significant clinical barrier in the repair of critical-sized bone *** challenge of enhancing regenerative potential in bone healing is further compounded by oxidative stress at the fracture ***,the introduction of artificial periosteum has demonstrated its ability to promote bone regeneration through the provision of appropriate mechanical support and controlled release of proosteogenic *** this study,a poly(L-lactic acid)(PLLA)/hyaluronic acid(HA)-based nanofibrous membrane was fabricated using the coaxial electrospinning *** incorporation of irisin into the core-shell structure of PLLA/HA nanofibers(PLLA/HA@Irisin)achieved its sustained *** vitro experiments demonstrated that the PLLA/HA@Irisin membranes exhibited favorable *** osteogenic differentiation of bone marrow mesenchymal stem cells(BMMSCs)was improved by PLLA/HA@Irisin,as evidenced by a significant increase in alkaline phosphatase activity and matrix ***,PLLA/HA@Irisin significantly enhanced the mitochondrial function of BMMSCs via the activation of the sirtuin 3 antioxidant *** assess the therapeutic effectiveness,PLLA/HA@Irisin membranes were implanted in situ into critical-sized calvarial defects in *** results at 4 and 8 weeks post-surgery indicated that the implantation of PLLA/HA@Irisin exhibited superior efficacy in promoting vascularized bone formation,as demonstrated by the enhancement of bone matrix synthesis and the development of new blood *** results of our study indicate that the electrospun PLLA/HA@Irisin nanofibers possess characteristics of a biomimetic periosteum,showing potential for effectively treating critical-sized bone defects by improving the mitochondrial function and maintaining redox homeostasis of BMMSCs.

关键词： periosteum irisin mitochondrial function critical-sized bone defect redox homeostasis

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Indocyanine green:The guide to safer and more effective surgery

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World Journal of Gastrointestinal surgery 2024年第3期16卷 641-649页

作者： Pietro Fransvea Maria Michela Chiarello Valeria Fico Maria Cariati Giuseppe Brisinda Emergency surgery and trauma Center Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy department of surgery Azienda Sanitaria Provinciale di CosenzaCosenza 87100Italy department of surgery Azienda Sanitaria Provinciale di CrotoneCrotone 88900Italy department of Abdominal and Endocrine Metabolic Medical and Surgical Sciences Fondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy

In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal *** authors present an interesting review on the use of indocyanine green fluo-rescence in different aspects of abdominal *** also highlight future perspectives of the use of indocyanine green in mini-invasive ***-cyanine green,used for fluorescence imaging,has been approved by the Food and Drug Administration and is safe for use in *** can be administered in-travenously or *** its advent,there have been several advance-ments in the applications of indocyanine green,especially in the surgical field,such as intraoperative mapping and biopsy of sentinel lymph node,measurement of hepatic function prior to resection,in neurosurgical cases to detect vascular anomalies,in cardiovascular cases for patency and assessment of vascular ab-normalities,in predicting healing following amputations,in helping visualization of hepatobiliary anatomy and blood vessels,in reconstructive surgery,to assess flap viability and for the evaluation of tissue perfusion following major trauma and *** these reasons,the intraoperative use of indocyanine green has become common in a variety of surgical specialties and transplant ***-lorectal surgery has just lately begun to adopt this technique,particularly for perfusion visualization to prevent anastomotic *** regular use of in-docyanine green coupled with fluorescence angiography has recently been pro-posed as a feasible tool to help improve patient *** the best available data,it has been shown that routine use of indocyanine green in colorectal surgery reduces the rates of anastomotic *** use of indocyanine green is proven to be safe,feasible,and effective in both elective and emergency ***,additional robust evidence from larger-scale,high-quality studies is essential before incorporating indocyanine g

关键词： Indocyanine green Colorectal surgery Fluorescence-guided surgery Gastrointestinal surgery Hepato-biliary surgery Pancreatic surgery Surgical oncology

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A Polyvinyl Alcohol/Acrylamide Hydrogel with Enhanced Mechanical Properties Promotes Full-Thickness Skin Defect Healing by Regulating Immunomodulation and Angiogenesis Through Paracrine Secretion

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Engineering 2024年第6期37卷 138-151页

作者： Peng Wang Liping Qian Huixin Liang Jianhao Huang Jing Jin Chunmei Xie Bin Xue Jiancheng Lai Yibo Zhang Lifeng Jiang Lan Li Qing Jiang State Key Laboratory of Pharmaceutical Biotechnology Division of Sports Medicine and Adult Reconstructive SurgeryDepartment of Orthopedic SurgeryNanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing UniversityNanjing 210008China Jiangsu Engineering Research Center for 3D Bioprinting Nanjing 210008China Institute of Medical 3D Printing Nanjing UniversityNanjing 210093China Centre for Experimental Animals Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing UniversityNanjing 210008China College of Aeroplane Engineering Nanjing University of Aeronautics and AstronauticsNanjing 210016China National Laboratory of Solid State Microstructures Department of PhysicsNanjing UniversityNanjing 210093China department of Chemical Engineering Stanford UniversityStanfordCA 94305USA department of orthopedic surgery The Second Affiliated Hospital Zhejiang University School of MedicineOrthopedic Research Institute of Zhejiang UniversityKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang ProvinceHangzhou 310009China

Hydrogel-based tissue-engineered skin has attracted increased attention due to its potential to restore the structural integrity and functionality of ***,the mechanical properties of hydrogel scaffolds and natural skin are substantially ***,we developed a polyvinyl alcohol(PVA)/acrylamide based interpenetrating network(IPN)hydrogel that was surface modified with polydopamine(PDA)and termed *** Dopa-gel exhibited mechanical properties similar to native skin tissue and a superior ability to modulate paracrine ***,a tough scaffold with tensile resistance was fabricated using this hydrogel by three-dimensional *** results showed that the interpenetration of PVA,alginate,and polyacrylamide networks notably enhanced the mechanical properties of the *** modification with PDA endowed the hydrogels with increased secretion of immunomodulatory and proangiogenic *** an in vivo model,Dopa-gel treatment accelerated wound closure,increased vascularization,and promoted a shift in macrophages from a proinflammatory M1 phenotype to a prohealing and anti-inflammatory M2 phenotype within the wound ***,the focal adhesion kinase(FAK)/extracellular signal-related kinase(ERK)signaling pathway may mediate the promotion of skin defect healing by increasing paracrine secretion via the ***,proangiogenic factors can be induced through Rho-associated kinase-2(ROCK-2)/vascular endothelial growth factor(VEGF)-mediated paracrine secretion under tensile stress *** together,these findings suggest that the multifunctional Dopa-gel,which has good mechanical properties similar to those of native skin tissue and enhanced immunomodulatory and angiogenic properties,is a promising scaffold for skin tissue regeneration.

关键词： Polyvinyl alcohol/acrylamide hydrogel Mechanical property enhancement Paracrine effect Skin regeneration Signaling pathways

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Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

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Neural Regeneration Research 2024年第5期19卷 1126-1132页

作者： Hengxing Zhou Yongfu Lou Lingxiao Chen Yi Kang Lu Liu Zhiwei Cai David BAnderson Wei Wang Chi Zhang Jinghua Wang Guangzhi Ning Yanzheng Gao Baorong He Wenyuan Ding Yisheng Wang Wei Mei Yueming Song Yue Zhou Maosheng Xia Huan Wang Jie Zhao Guoyong Yin Tao Zhang Feng Jing Rusen Zhu Bin Meng Li Duan Zhongmin Zhang Desheng Wu Zhengdong Cai Lin Huang Zhanhai Yin Kainan Li Shibao Lu Shiqing Feng department of orthopedics The Second HospitalCheeloo College of MedicineShandong UniversityShandongChina department of orthopedics Shandong University Center for OrthopedicsQilu HospitalCheeloo College of MedicineShandong UniversityShandongChina department of orthopedics Tianjin Medical University General HospitalInternational Science and Technology Cooperation Base of Spinal Cord InjuryTianjin Key Laboratory of Spine and Spinal CordTianjinChina Faculty of Medicine and Health The Back Pain Research TeamSydney Musculoskeletal HealthThe Kolling InstituteUniversity of SydneySydneyNSWAustralia department of Spine surgery Honghui HospitalXi’an Jiaotong UniversityXi’anShaanxi ProvinceChina department of Burns and Plastic surgery The Fourth Medical Center of Chinese PLA General HospitalBeijingChina Faculty of Medicine and Health School of Health SciencesUniversity of SydneyNSWAustralia Sydney Spine Institute BurwoodSydneyNSWAustralia Laboratory of Epidemiology Tianjin Neurological InstituteDepartment of NeurologyTianjin Medical University General Hospital&Tianjin Neurological InstituteKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous SystemMinistry of Education and Tianjin CityTianjinChina department of orthopedics Henan Provincial People’s HospitalZhengzhouHenan ProvinceChina department of Spinal surgery The Third Hospital of Hebei Medical UniversityShijiazhuangHebei ProvinceChina department of orthopedics The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan ProvinceChina department of Spine surgery Zhengzhou Orthopedics HospitalZhengzhouHenan ProvinceChina department of orthopedic surgery and orthopedic Research Institute West China HospitalSichuan UniversityChengduSichuan ProvinceChina department of orthopedics Xinqiao HospitalArmy Medical UniversityChongqingChina department of orthopedics The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina department of Spinal surgery Shengj

traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even *** has the largest population of patients with traumatic spinal cord *** studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been *** the best of our knowledge,no national-level study of treatment status and economic burden has been *** retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national *** included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of *** epidemiological and clinical features,treatment status,and total and daily costs were *** in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression *** percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent *** 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 *** total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 ho

关键词： China clinical features costs epidemiology methylprednisolone sodium succinate methylprednisolone retrospective study traumatic spinal cord injury treatment

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Three-dimensional analysis of age and sex differences in femoral head asphericity in asymptomatic hips in the United States

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World Journal of orthopedics 2024年第8期15卷 754-763页

作者： Mahad M Hassan Aliya G Feroe Brenton W Douglass Andrew E Jimenez Benjamin Kuhns Charles F Mitchell Robert L Parisien Daniel A Maranho Eduardo N Novais Young-Jo Kim Ata M Kiapour department of orthopedic surgery University of MinnesotaMinneapolisMN 55454United States department of orthopedic surgery TRIA Orthopaedic CenterBloomingtonMN 55122United States department of orthopedic surgery Boston Children’s HospitalBostonMA 02115United States department of orthopedic surgery Mayo ClinicRochesterMN 55901United States department of Orthopaedics and Rehabilitation Yale School of MedicineNew HavenCT 06510United States department of orthopedic surgery American Hip Institute Research FoundationDes PlainesIL 60018United States department of orthopedic surgery Mount SinaiNew YorkNY 10029United States department of Biomechanics Medicineand Rehabilitation of the Locomotor SystemRibeirao Preto Medical SchoolUniversity of São PauloRibeirao Preto 14048-900São PauloBrazil

BACKGROUND The sphericity of the femoral head is a metric used to evaluate hip pathologies and is associated with the development of osteoarthritis and femoral-acetabular *** To analyze the three-dimensional asphericity of the femoral head of asymptomatic pediatric *** hypothesized that femoral head asphericity will vary significantly between male and female pediatric hips and increase with age in both *** Computed tomography scans were obtained on 158 children and adolescents from a single institution in the United States(8-18 years;50%male)without hip *** femoral measurements including the femoral head diameter,femoral head volume,residual volume,asphericity index,and local diameter difference were used to evaluate femoral head *** In both sexes,the residual volume increased by age(P13 years)in females,there were no sex-differences in residual volume and aspherity *** were no age-related changes in mean diameter difference in both sexes(P=0.07)with no significant sex-differences across different age groups(P=0.06).In contrast,there were significant increases in local aspherity(maximum diameter difference)across whole surface of the femoral head and all quadrants except the inferior regions in males(P=0.03).There were no sex-differences in maximum diameter difference at any regions and age group(P>0.05).Increased alpha angle was only correlated to increased mean diameter difference across overall surface of the femoral head(P=0.024).CONCLUSION There is a substantial localized asphericity in asymptomatic hips which increases with age *** 2D measured alpha angle can capture overall asphericity of the femoral head,it may not be sensitive enough to represent regional asphericity patterns.

关键词： Hip Femoral head Sphericity Skeletal growth Sex differences

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