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IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-27 DOI: 10.1016/S1008-1275(24)00087-7
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引用次数: 0
Recurrent spinal subdural hematoma following percutaneous kyphoplasty: A unique case report 经皮椎体后凸成形术后复发性脊柱硬膜下血肿:一份独特的病例报告。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-17 DOI: 10.1016/j.cjtee.2024.08.005
Wen-Hui Liu, Xin-Min Lin, Xin-Yu Lu, Hai Han, Liang-Zhi Zhang, Hai-Xian Lin, Zi-Wen Liu
Spinal intradural (subdural and subarachnoid) hematoma following percutaneous kyphoplasty is an extremely rare complication. In this report, we described a case of 2 episodes of subarachnoid hemorrhage with delayed paralysis after kyphoplasty. A 73-year-old man underwent percutaneous kyphoplasty in our hospital an osteoporotic vertebral fracture at the T12 level. On the 55 h after kyphoplasty for T12 osteoporotic vertebral fracture, he developed paralysis of the lower limbs. An emergency posterior decompression from T8 to L2 was performed. And the subarachnoid hematomas were removed. Postoperatively, the neurological symptoms improved rapidly. However, 2 weeks after the operation, the patient experienced a setback with severe neurological decline (paraplegia with sensory and autonomic dysfunction). An emergency posterior decompression from T5 to L2 was performed. The subarachnoid hematomas were removed. This case reflects the cause and progression of spinal subdural hematoma. Previous literature has debated the best treatment approach for spinal subarachnoid hemorrhage, but the prognosis of patients is heavily dependent on precise symptom evaluation and localization.
经皮椎体后凸成形术后出现脊髓硬膜内(硬膜下和蛛网膜下腔)血肿是一种极为罕见的并发症。在本报告中,我们描述了一例椎体后凸成形术后发生两次蛛网膜下腔出血并伴有延迟性瘫痪的病例。一名 73 岁的男性因 T12 水平骨质疏松性脊椎骨折在我院接受了经皮椎体后凸成形术。在接受椎体后凸成形术治疗 T12 骨质疏松性脊椎骨折 55 小时后,他出现了下肢瘫痪。医生紧急为他进行了从 T8 到 L2 的后路减压术。并清除了蛛网膜下血肿。术后,神经症状迅速好转。然而,术后两周,患者出现了严重的神经功能衰退(截瘫,伴有感觉和自主神经功能障碍)。医生紧急实施了从 T5 到 L2 的后路减压术。蛛网膜下血肿被清除。该病例反映了脊髓硬膜下血肿的病因和进展。以往的文献对脊髓蛛网膜下腔出血的最佳治疗方法存在争议,但患者的预后在很大程度上取决于精确的症状评估和定位。
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引用次数: 0
The construction and application of a trauma limb salvage map in Shaanxi province. 陕西省创伤肢体救治地图的构建与应用。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-15 DOI: 10.1016/j.cjtee.2024.08.004
Meng Wang, Jian-Min Liu, Xing-Bo Dang, Long-Yang Ma, Gong-Liang Du, Wei Hu

Trauma is an important cause of death in young- and middle-aged people. Trauma is comprehensive and includes many surgical specialties, and the surgical techniques of these specialties have long been mature. To reduce the mortality and disability rate of trauma patients, it is necessary to improve trauma management. Trauma has attracted attention in China and trauma treatment and care developed rapidly in recent years. To decrease traumatic mortality and disability rates, our team is committed to building an efficient trauma system in Shaanxi province and has successfully developed a trauma limb salvage map to address the high rates of amputation and disability in patients with limb injuries. This article elaborates on the construction experience of a trauma limb salvage map and its application details in Shaanxi province of China.

创伤是导致中青年死亡的重要原因。创伤的综合性很强,包括很多外科专业,而这些专业的外科技术早已成熟。要降低创伤患者的死亡率和致残率,就必须提高创伤救治水平。近年来,创伤在中国备受关注,创伤治疗和护理发展迅速。为了降低创伤死亡率和致残率,我们的团队致力于建设陕西省高效的创伤救治体系,针对肢体损伤患者截肢率和致残率高的问题,成功开发了创伤肢体救治地图。本文阐述了创伤肢体救治地图的建设经验及其在陕西省的应用细节。
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引用次数: 0
Traumatic cervical tracheal trunk complete rupture combined with cardiac arrest: A case report. 外伤性颈部气管主干完全断裂合并心脏骤停:病例报告
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-08-06 DOI: 10.1016/j.cjtee.2024.08.003
Cheng Yang, Da-Liang Wang, Yang-Lin Du, Qiang-Fei Wang, Yuan Suo, Hui-Jie Yu

Traumatic main bronchus rupture is a relatively rare injury in thoracic trauma, which is extremely critical, with a mortality rate as high as 70% - 80%. The complete rupture and displacement of the traumatic cervical trachea can lead to asphyxia, hypoxia, and cardiac arrest, even death of the patient in a short time. We performed emergency surgery with the support of extracorporeal membrane oxygenation for a case of traumatic cervical tracheal trunk complete rupture and displacement combined with cardiac arrest and achieved a successful rescue. We summarized our experience and found that timely surgical reconstruction of the airway is the key to increasing the traumatic main bronchus rupture survival of patients.

外伤性主支气管破裂是胸部创伤中较为罕见的损伤,病情极其危重,死亡率高达 70% - 80%。外伤性颈部气管完全破裂和移位可导致窒息、缺氧和心跳骤停,甚至在短时间内导致患者死亡。我们在体外膜肺氧合的支持下对一例外伤性颈部气管主干完全断裂移位合并心跳骤停的患者实施了急诊手术,并取得了成功的抢救。我们总结经验发现,及时手术重建气道是提高外伤性主支气管断裂患者存活率的关键。
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引用次数: 0
An experimental study of a novel external fixator based on universal joints for the rapid initial stabilization of mandibular comminuted fractures 基于万向接头的新型外固定器用于快速初步稳定下颌骨粉碎性骨折的实验研究
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-09 DOI: 10.1016/j.cjtee.2024.06.002
Zhi-Qiang Hu , Tai-Qiang Dai , Lu Zhao , Xun Li , Xu Gong , Hao Jia , Hai-Tao Kong , Bo-Lei Cai , Shi-Ping Chang , Lei Tian
<div><h3>Purpose</h3><p>Shaping and assembling contemporary external fixators rapidly for the severe mandibular fractures remains a challenge, especially in emergency circumstance. We designed a novel external fixator that incorporates universal joints to provide the stabilization for mandibular comminuted fractures. This study aims to confirm the efficacy of this novel external fixator through biomechanical tests <em>in vitro</em> and animal experiments.</p></div><div><h3>Methods</h3><p><em>In vitro</em> biomechanical tests were conducted using 6 fresh canine with mandibular defect to simulate critical comminuted fractures. Three mandibles were stabilized by the novel external fixator and other mandibles were fixed by 2.5 mm reconstruction plates. All fixed mandibles were subjected to loads of 350 N on the anterior regions of teeth and 550 N on the first molar of the unaffected side. The stability was evaluated based on the maximum displacement and the slope of the load-displacement curve. In animal experiments, 9 beagles with comminuted mandibular fractures were divided into 3 groups, which were treated with the novel external fixation, reconstruction plate, and dental arch bar, respectively. The general observation, the changes in animals’ weight, and the surgical duration were recorded and compared among 3 groups. The CT scans were performed at various intervals of 0 day (immediately after the surgery), 3 days, 7 days, 14 days, 21 days, and 28 days to analyze the displacement of feature points on the canine mandible and situation of fracture healing at 28 days. The statistical significance was assessed by the two-way analysis of variance test followed by the Bonferroni test, enabling multiple comparisons for all tests using GraphPad Prism10.1.0 (GraphPad Inc, USA).</p></div><div><h3>Results</h3><p>The outcomes of the biomechanical tests indicated that no statistically significant differences were found in terms of the maximum displacement (<em>p</em> = 0.496, 0.079) and the slope of load displacement curves (<em>p</em> = 0.374, 0.349) under 2 load modes between the external and internal fixation groups. The animal experiment data showed that there were minor displacements of feature points between the external and internal fixation groups without statistic difference, while the arch bar group demonstrated inferior stability. The CT analysis revealed that the best fracture healing happened in the internal fixation group, followed by the external fixation and arch baring at 28 days after fixation. The external fixation group had the shortest fixation duration (25.67 ± 3.79) min compared to internal fixation ((70.67 ± 4.51) min, <em>p</em> < 0.001) and arch baring ((42.00 ± 3.00) min, <em>p</em> = 0.046).</p></div><div><h3>Conclusion</h3><p>The conclusion of this study highlighted the efficacy and reliability of this novel external fixator in managing mandibular fractures rapidly, offering a viable option for the initial stabilization of comm
目的为严重下颌骨骨折快速塑形和组装现代外固定器仍是一项挑战,尤其是在紧急情况下。我们设计了一种新型外固定器,其中包含万向关节,可为下颌骨粉碎性骨折提供稳定。本研究旨在通过体外生物力学测试和动物实验证实这种新型外固定器的功效。方法使用 6 只下颌骨缺损的新鲜犬进行体外生物力学测试,模拟严重粉碎性骨折。三个下颌骨用新型外固定器固定,其他下颌骨用 2.5 毫米重建板固定。所有被固定的下颌骨都承受了牙齿前部 350 牛顿的载荷,未受影响一侧的第一磨牙承受了 550 牛顿的载荷。根据最大位移和载荷-位移曲线的斜率来评估稳定性。在动物实验中,9 只下颌骨粉碎性骨折的小猎犬被分为 3 组,分别接受新型外固定物、重建钢板和牙弓杆的治疗。记录并比较 3 组的一般观察结果、动物体重变化和手术时间。分别在术后 0 天、3 天、7 天、14 天、21 天和 28 天进行 CT 扫描,分析犬下颌骨特征点的移位情况以及 28 天时骨折愈合的情况。结果生物力学测试结果表明,外固定组和内固定组在 2 种载荷模式下的最大位移(p = 0.496,0.079)和载荷位移曲线斜率(p = 0.374,0.349)差异无统计学意义。动物实验数据显示,外固定组和内固定组的特征点位移较小,无统计学差异,而弓形杆组的稳定性较差。CT 分析显示,内固定组的骨折愈合情况最好,其次是外固定组和固定后 28 天的弓形条组。与内固定((70.67 ± 4.51)分钟,p < 0.001)和弓形固定((42.00 ± 3.00)分钟,p = 0.046)相比,外固定组的固定时间最短(25.67 ± 3.79)分钟。
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引用次数: 0
A serial case study of the combined use of intraoperative CT and surgical navigation system for the removal of small foreign bodies in the maxillofacial region 联合使用术中 CT 和手术导航系统清除颌面部小异物的系列病例研究
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-05 DOI: 10.1016/j.cjtee.2024.07.005
Dong-Yang Ma , Shu-Meng Zhang , Chao-Yuan Pang , Wen-Kai Zhang , Bing-Wu Wang

Purpose

The removal of small foreign bodies embedded within the deep soft tissues of the maxillofacial region is a complex and challenging task for maxillofacial surgeons. The purpose of this study was to explore the efficacy of the combination of intraoperative CT and surgical navigation for the removal of small foreign objects in the maxillofacial region.

Methods

A serial case study was conducted involving all consecutive patients who underwent surgical removal of small foreign bodies in the maxillofacial region. The combination of intraoperative CT and a surgical navigation system was used at a single medical institution from January 2018 to December 2022. Comprehensive data, including patient demographics, characteristics of the foreign bodies, previous surgical interventions, duration of the surgical procedure, and removal success rate were collected for this study. Relevant data were recorded into Microsoft Excel sheet and analyzed using SPSS version 22.0.

Results

Nine patients (6 males and 3 females) were included in this study, with an average age of 37 years. Each patient had previously undergone an unsuccessful removal attempt utilizing conventional surgical methods based on preoperative CT imaging or C-arm guidance at a local healthcare facility. Four patients also experienced unsuccessful attempts with preoperative CT image-based navigation systems. However, by employing the combined approach of intraoperative CT and surgical navigation, the foreign bodies were successfully removed in all 9 patients. The mean duration of the surgical procedure was 59 min, and the average size of the foreign bodies was approximately 26 mm³. Postoperative follow-up exceeding 6 months revealed no complications.

Conclusion

The combined use of a surgical navigation system and intraoperative CT represents a potent and effective strategy for the precise localization and subsequent removal of small foreign bodies from the soft tissue structures of the maxillofacial region. This integrative approach appears to increase the success rate of surgical interventions in such cases.

目的对于颌面外科医生来说,取出埋藏在颌面部深层软组织内的小异物是一项复杂而具有挑战性的任务。本研究的目的是探讨术中 CT 和手术导航相结合对颌面部小异物取出的疗效。方法对所有接受颌面部小异物取出手术的连续患者进行了连续病例研究。从 2018 年 1 月到 2022 年 12 月,在一家医疗机构中结合使用了术中 CT 和手术导航系统。本研究收集了包括患者人口统计学特征、异物特征、既往手术干预、手术持续时间和取出成功率在内的综合数据。相关数据记录在 Microsoft Excel 表格中,并使用 SPSS 22.0 版进行分析。结果本研究共纳入 9 名患者(6 男 3 女),平均年龄为 37 岁。每位患者都曾在当地医疗机构根据术前 CT 成像或 C 臂引导尝试过传统手术方法,但均未成功。有四名患者在术前使用基于 CT 图像的导航系统时也经历过失败。然而,通过采用术中 CT 和手术导航相结合的方法,所有 9 名患者都成功取出了异物。手术的平均时间为 59 分钟,异物的平均大小约为 26 立方毫米。结论联合使用手术导航系统和术中 CT 是精确定位和随后清除颌面部软组织结构中的小异物的有效策略。这种综合方法似乎提高了此类病例的手术成功率。
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引用次数: 0
Internal iliac artery ligation as a damage control method in hemodynamically unstable pelvic fractures: A systematic review of the literature 髂内动脉结扎作为血流动力学不稳定骨盆骨折的损伤控制方法:文献系统回顾
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-05 DOI: 10.1016/j.cjtee.2024.07.004
Hui Li, Tao Ai, Guang-Bin Huang, Jun Yang, Gong-Bin Wei, Jin-Mou Gao, Ping He, Xue-Mei Cao, Ding-Yuan Du

Purpose

Internal iliac artery ligation (IIAL) has been used as a damage control procedure to treat hemodynamically unstable pelvic fracture for many years. However, there is ongoing debate regarding the effectiveness and safety of this hemostatic method. Therefore, we performed a systematic literature review to assess the efficacy and safety of IIAL for pelvic fracture hemostasis.

Methods

Three major databases, PubMed, Embase, and Google Scholar, were searched to screen eligible original studies published in English journals. Two reviewers independently read the titles, abstracts, and full texts of all literature. Articles were included if they reported the use and effects of IIAL.

Results

A total of 171 articles were initially identified, with 22 fully meeting the inclusion criteria. Among the analyzed cases, up to 66.7% of patients had associated abdominal and pelvic organ injuries, with the urethra being the most frequently injured organ, followed by the bowel. The outcomes of IIAL for achieving hemostasis in pelvic fractures were found to be satisfactory, with an effective rate of 80%. Hemorrhagic shock was the leading cause of death, followed by craniocerebral injury. Notably, no reports of ischemic complications involving the pelvic organs due to IIAL were found.

Conclusion

IIAL has a good effect in treating hemodynamically unstable pelvic fracture without the risk of pelvic organ ischemia. This procedure should be considered a priority for hemodynamically unstable pelvic fracture patients with abdominal organ injuries.

目的多年来,髂内动脉结扎术(IIAL)一直被用作治疗血流动力学不稳定的骨盆骨折的损伤控制手术。然而,关于这种止血方法的有效性和安全性一直存在争议。因此,我们进行了一项系统性文献综述,以评估 IIAL 用于骨盆骨折止血的有效性和安全性。方法:我们检索了 PubMed、Embase 和 Google Scholar 三大数据库,筛选出符合条件的发表在英文期刊上的原创研究。两名审稿人独立阅读了所有文献的标题、摘要和全文。结果共初步筛选出 171 篇文章,其中 22 篇完全符合纳入标准。在分析的病例中,多达66.7%的患者伴有腹部和盆腔器官损伤,其中尿道是最常见的损伤器官,其次是肠道。IIAL对骨盆骨折止血的效果令人满意,有效率为80%。失血性休克是死亡的主要原因,其次是颅脑损伤。结论 IIAL 在治疗血流动力学不稳定的骨盆骨折方面效果良好,且无骨盆器官缺血的风险。对于血流动力学不稳定且伴有腹腔脏器损伤的骨盆骨折患者,应优先考虑这种手术。
{"title":"Internal iliac artery ligation as a damage control method in hemodynamically unstable pelvic fractures: A systematic review of the literature","authors":"Hui Li,&nbsp;Tao Ai,&nbsp;Guang-Bin Huang,&nbsp;Jun Yang,&nbsp;Gong-Bin Wei,&nbsp;Jin-Mou Gao,&nbsp;Ping He,&nbsp;Xue-Mei Cao,&nbsp;Ding-Yuan Du","doi":"10.1016/j.cjtee.2024.07.004","DOIUrl":"10.1016/j.cjtee.2024.07.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Internal iliac artery ligation (IIAL) has been used as a damage control procedure to treat hemodynamically unstable pelvic fracture for many years. However, there is ongoing debate regarding the effectiveness and safety of this hemostatic method. Therefore, we performed a systematic literature review to assess the efficacy and safety of IIAL for pelvic fracture hemostasis.</p></div><div><h3>Methods</h3><p>Three major databases, PubMed, Embase, and Google Scholar, were searched to screen eligible original studies published in English journals. Two reviewers independently read the titles, abstracts, and full texts of all literature. Articles were included if they reported the use and effects of IIAL.</p></div><div><h3>Results</h3><p>A total of 171 articles were initially identified, with 22 fully meeting the inclusion criteria. Among the analyzed cases, up to 66.7% of patients had associated abdominal and pelvic organ injuries, with the urethra being the most frequently injured organ, followed by the bowel. The outcomes of IIAL for achieving hemostasis in pelvic fractures were found to be satisfactory, with an effective rate of 80%. Hemorrhagic shock was the leading cause of death, followed by craniocerebral injury. Notably, no reports of ischemic complications involving the pelvic organs due to IIAL were found.</p></div><div><h3>Conclusion</h3><p>IIAL has a good effect in treating hemodynamically unstable pelvic fracture without the risk of pelvic organ ischemia. This procedure should be considered a priority for hemodynamically unstable pelvic fracture patients with abdominal organ injuries.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 5","pages":"Pages 288-294"},"PeriodicalIF":1.8,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000762/pdfft?md5=baf39e90eba1df71efed5ca7247d451b&pid=1-s2.0-S1008127524000762-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The cytochrome P4501A1 (CYP1A1) inhibitor bergamottin enhances host tolerance to multidrug-resistant Vibrio vulnificus infection 细胞色素 P4501A1 (CYP1A1) 抑制剂佛手柑素能增强宿主对多重耐药弧菌感染的耐受性。
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-03 DOI: 10.1016/j.cjtee.2024.07.003
<div><h3>Purpose</h3><p><em>Vibrio vulnificus</em> (<em>V. Vulnificus</em>) infection is characterized by rapid onset, aggressive progression, and challenging treatment. Bacterial resistance poses a significant challenge for clinical anti-infection treatment and is thus the subject of research. Enhancing host infection tolerance represents a novel infection prevention strategy to improve patient survival. Our team initially identified cytochrome P4501A1 (CYP1A1) as an important target owing to its negative modulation of the body's infection tolerance. This study explored the superior effects of the CYP1A1 inhibitor bergamottin compared to antibiotic combination therapy on the survival of mice infected with multidrug-resistant <em>V. Vulnificus</em> and the protection of their vital organs.</p></div><div><h3>Methods</h3><p>An increasing concentration gradient method was used to induce multidrug-resistant <em>V. Vulnificus</em> development. We established a lethal infection model in C57BL/6J male mice and evaluated the effect of bergamottin on mouse survival. A mild infection model was established in C57BL/6J male mice, and the serum levels of creatinine, urea nitrogen, aspartate aminotransferase, and alanine aminotransferase were determined using enzyme-linked immunosorbent assay to evaluate the effect of bergamottin on liver and kidney function. The morphological changes induced in the presence of bergamottin in mouse organs were evaluated by hematoxylin and eosin staining of liver and kidney tissues. The bacterial growth curve and organ load determination were used to evaluate whether bergamottin has a direct antibacterial effect on multidrug-resistant <em>V. Vulnificus</em>. Quantification of inflammatory factors in serum by enzyme-linked immunosorbent assay and the expression levels of inflammatory factors in liver and kidney tissues by real-time quantitative polymerase chain reaction were performed to evaluate the effect of bergamottin on inflammatory factor levels. Western blot analysis of IκBα, phosphorylated IκBα, p65, and phosphorylated p65 protein expression in liver and kidney tissues and in human hepatocellular carcinomas-2 and human kidney-2 cell lines was used to evaluate the effect of bergamottin on the nuclear factor kappa-B signaling pathway. One-way ANOVA and Kaplan-Meier analysis were used for statistical analysis.</p></div><div><h3>Results</h3><p>In mice infected with multidrug-resistant <em>V. Vulnificus</em>, bergamottin prolonged survival (<em>p</em> = 0.014), reduced the serum creatinine (<em>p</em> = 0.002), urea nitrogen (<em>p</em> = 0.030), aspartate aminotransferase (<em>p</em> = 0.029), and alanine aminotransferase (<em>p</em> = 0.003) levels, and protected the cellular morphology of liver and kidney tissues. Bergamottin inhibited interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α expression in serum (IL-1β: <em>p</em> = 0.010, IL-6: <em>p</em> = 0.029, TNF-α: <em>p</em> = 0.025) and inhibited the protein ex
目的:弧菌(V. Vulnificus)感染的特点是发病迅速、病情恶化和治疗困难。细菌耐药性给临床抗感染治疗带来了巨大挑战,因此成为研究的主题。增强宿主感染耐受性是提高患者生存率的一种新型感染预防策略。由于细胞色素 P4501A1 (CYP1A1)对机体感染耐受性的负向调节作用,我们的团队最初将其确定为一个重要靶点。本研究探讨了 CYP1A1 抑制剂佛手柑素与抗生素联合疗法相比,对感染耐多药弧菌小鼠的存活率及其重要器官保护的卓越效果:方法:采用浓度梯度递增法诱导耐多药弧菌发育。我们在 C57BL/6J 雄性小鼠中建立了致死感染模型,并评估了佛手柑素对小鼠存活率的影响。我们在 C57BL/6J 雄性小鼠中建立了轻度感染模型,并使用酶联免疫吸附法测定了血清中肌酐、尿素氮、天门冬氨酸氨基转移酶和丙氨酸氨基转移酶的水平,以评估佛手柑素对肝肾功能的影响。通过对肝脏和肾脏组织进行苏木精和伊红染色,评估了小鼠器官在佛手柑素作用下的形态学变化。利用细菌生长曲线和器官负荷测定来评估佛手柑素是否对耐多药弧菌有直接的抗菌作用。通过酶联免疫吸附试验对血清中的炎症因子进行定量,并通过实时定量聚合酶链反应对肝脏和肾脏组织中炎症因子的表达水平进行检测,以评估佛手柑素对炎症因子水平的影响。用 Western 印迹分析肝脏和肾脏组织以及人肝细胞癌-2 和人肾-2 细胞系中 IκBα、磷酸化 IκBα、p65 和磷酸化 p65 蛋白的表达,以评估小青柑素对核因子卡巴-B 信号通路的影响。统计分析采用了单因素方差分析和卡普兰-梅耶分析:结果:在感染耐多药弧菌的小鼠中,佛手柑素延长了存活时间(p = 0.014),降低了血清肌酐(p = 0.002)、尿素氮(p = 0.030)、天冬氨酸氨基转移酶(p = 0.029)和丙氨酸氨基转移酶(p = 0.003)水平,并保护了肝脏和肾脏组织的细胞形态。佛手柑素能抑制血清中白细胞介素(IL)-1β、IL-6 和肿瘤坏死因子(TNF)-α 的表达(IL-1β:p = 0.010,IL-6:p = 0.029,TNF-α:p = 0.025),并抑制肝脏(IL-1β:p = 0.010,IL-6:p = 0.011,TNF-α:p = 0.037)和肾脏(IL-1β:p = 0.016,IL-6:p = 0.011,TNF-α:p = 0.008)组织中炎症因子 IL-1β、IL-6、TNF-α 的蛋白表达。佛手柑素不影响耐多药弧菌的增殖,也不影响小鼠腹腔灌洗液(p = 0.225)、肝脏(p = 0.186)或肾脏(p = 0.637)中的细菌量:结论:佛手柑素能增强小鼠对耐多药弧菌感染的耐受性。结论:佛手柑素能增强小鼠对耐多药弧菌感染的耐受性,该研究可为弧菌的新型临床治疗策略的开发提供参考和指导。
{"title":"The cytochrome P4501A1 (CYP1A1) inhibitor bergamottin enhances host tolerance to multidrug-resistant Vibrio vulnificus infection","authors":"","doi":"10.1016/j.cjtee.2024.07.003","DOIUrl":"10.1016/j.cjtee.2024.07.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;&lt;em&gt;Vibrio vulnificus&lt;/em&gt; (&lt;em&gt;V. Vulnificus&lt;/em&gt;) infection is characterized by rapid onset, aggressive progression, and challenging treatment. Bacterial resistance poses a significant challenge for clinical anti-infection treatment and is thus the subject of research. Enhancing host infection tolerance represents a novel infection prevention strategy to improve patient survival. Our team initially identified cytochrome P4501A1 (CYP1A1) as an important target owing to its negative modulation of the body's infection tolerance. This study explored the superior effects of the CYP1A1 inhibitor bergamottin compared to antibiotic combination therapy on the survival of mice infected with multidrug-resistant &lt;em&gt;V. Vulnificus&lt;/em&gt; and the protection of their vital organs.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;An increasing concentration gradient method was used to induce multidrug-resistant &lt;em&gt;V. Vulnificus&lt;/em&gt; development. We established a lethal infection model in C57BL/6J male mice and evaluated the effect of bergamottin on mouse survival. A mild infection model was established in C57BL/6J male mice, and the serum levels of creatinine, urea nitrogen, aspartate aminotransferase, and alanine aminotransferase were determined using enzyme-linked immunosorbent assay to evaluate the effect of bergamottin on liver and kidney function. The morphological changes induced in the presence of bergamottin in mouse organs were evaluated by hematoxylin and eosin staining of liver and kidney tissues. The bacterial growth curve and organ load determination were used to evaluate whether bergamottin has a direct antibacterial effect on multidrug-resistant &lt;em&gt;V. Vulnificus&lt;/em&gt;. Quantification of inflammatory factors in serum by enzyme-linked immunosorbent assay and the expression levels of inflammatory factors in liver and kidney tissues by real-time quantitative polymerase chain reaction were performed to evaluate the effect of bergamottin on inflammatory factor levels. Western blot analysis of IκBα, phosphorylated IκBα, p65, and phosphorylated p65 protein expression in liver and kidney tissues and in human hepatocellular carcinomas-2 and human kidney-2 cell lines was used to evaluate the effect of bergamottin on the nuclear factor kappa-B signaling pathway. One-way ANOVA and Kaplan-Meier analysis were used for statistical analysis.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;In mice infected with multidrug-resistant &lt;em&gt;V. Vulnificus&lt;/em&gt;, bergamottin prolonged survival (&lt;em&gt;p&lt;/em&gt; = 0.014), reduced the serum creatinine (&lt;em&gt;p&lt;/em&gt; = 0.002), urea nitrogen (&lt;em&gt;p&lt;/em&gt; = 0.030), aspartate aminotransferase (&lt;em&gt;p&lt;/em&gt; = 0.029), and alanine aminotransferase (&lt;em&gt;p&lt;/em&gt; = 0.003) levels, and protected the cellular morphology of liver and kidney tissues. Bergamottin inhibited interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α expression in serum (IL-1β: &lt;em&gt;p&lt;/em&gt; = 0.010, IL-6: &lt;em&gt;p&lt;/em&gt; = 0.029, TNF-α: &lt;em&gt;p&lt;/em&gt; = 0.025) and inhibited the protein ex","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 5","pages":"Pages 295-304"},"PeriodicalIF":1.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000750/pdfft?md5=7d7b6b24fda2023f231b875abf634c03&pid=1-s2.0-S1008127524000750-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Posterior-only fixation in pelvic fractures: Is it sufficient in lateral compression injuries? 骨盆骨折的单纯后固定:对于侧向压缩伤是否足够?
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-03 DOI: 10.1016/j.cjtee.2024.07.002
Sameer Aggarwal, Sandeep Patel, Lav Mehta, Mohak Kataria, Vishal Kumar, Prasoon Kumar

Purpose: Lateral compression (LC) injuries account for more than two-thirds of all pelvic fractures. The goal of surgical treatment is to provide adequate stability and early mobilization. The consensus on posterior fixation of such injuries is strong in the literature; however, the necessity of anterior ring fixation is not clear. Therefore, this study was formulated to determine the practicability of posterior-only fixation in LC injuries.

Methods: Between March 2015 and May 2020, all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study. Demographic data, co-morbidities, treatment, types of surgical fixation, concomitant injuries and surgeries, surgical complications, length of hospital stay, injury to weight bearing duration, and follow-up period were documented. Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire. Non-normally distributed data were presented as median (Q1, Q3) and normally distributed data were presented as mean ± SD. Spearman's rank correlation coefficient was used for correlation analysis.

Results: A total of 25 patients were included, with a mean age of 29.8 years. All patients were managed operatively with posterior-only fixation. The median Majeed score was 90 (76, 95). The median physical component summary score was 69.37 (38.75, 85.62). The median mental component summary score was 63.95 (39.25, 87.87). There was no significant difference compared to population norms of both physical component summary and mental component summary. Injury to weight bearing time correlated significantly (p = 0.002) with Majeed score as well as SF-36 score (p = 0.044). No other variable had a significant association with outcomes.

Conclusion: Posterior-only fixation is sufficient for fixing LC injuries with up to 80% of cases having good to excellent functional outcomes. However, comparative studies with larger sample sizes are needed for further validation.

目的:侧压伤(LC)占骨盆骨折总数的三分之二以上。手术治疗的目的是提供足够的稳定性和早期活动能力。文献中对此类损伤的后路固定达成了强烈共识,但前路环形固定的必要性并不明确。因此,本研究旨在确定 LC 损伤中单纯后路固定的实用性:方法:2015 年 3 月至 2020 年 5 月期间,在一家一级创伤中心收治并进行手术的所有 LC 型骨盆环骨折患者均纳入本横断面观察性研究。研究记录了患者的人口统计学数据、并发症、治疗方法、手术固定类型、并发伤和手术、手术并发症、住院时间、受伤至负重时间以及随访时间。采用Majeed评分和SF-36问卷对功能结果和生活质量进行评估。非正态分布数据以中位数(Q1、Q3)表示,正态分布数据以均数±标清表示。相关分析采用斯皮尔曼等级相关系数:共纳入 25 名患者,平均年龄为 29.8 岁。所有患者均接受后路固定手术治疗。Majeed评分中位数为90(76,95)。躯体部分汇总得分的中位数为 69.37(38.75,85.62)。精神部分总分的中位数为 63.95(39.25,87.87)。与人群标准相比,体能部分和心理部分的得分均无明显差异。受伤至负重时间与马吉德评分和 SF-36 评分显著相关(p = 0.002),与 SF-36 评分也显著相关(p = 0.044)。其他变量均与结果无明显关联:结论:单纯后路固定足以固定LC损伤,高达80%的病例可获得良好至卓越的功能预后。结论:单纯后路固定足以固定 LC 损伤,高达 80% 的病例可获得良好至卓越的功能预后,但还需要样本量更大的比较研究来进一步验证。
{"title":"Posterior-only fixation in pelvic fractures: Is it sufficient in lateral compression injuries?","authors":"Sameer Aggarwal, Sandeep Patel, Lav Mehta, Mohak Kataria, Vishal Kumar, Prasoon Kumar","doi":"10.1016/j.cjtee.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.07.002","url":null,"abstract":"<p><strong>Purpose: </strong>Lateral compression (LC) injuries account for more than two-thirds of all pelvic fractures. The goal of surgical treatment is to provide adequate stability and early mobilization. The consensus on posterior fixation of such injuries is strong in the literature; however, the necessity of anterior ring fixation is not clear. Therefore, this study was formulated to determine the practicability of posterior-only fixation in LC injuries.</p><p><strong>Methods: </strong>Between March 2015 and May 2020, all patients with LC type pelvic ring fractures who were admitted and operated upon in a single level 1 trauma center were included in this cross-sectional observational study. Demographic data, co-morbidities, treatment, types of surgical fixation, concomitant injuries and surgeries, surgical complications, length of hospital stay, injury to weight bearing duration, and follow-up period were documented. Functional outcome and quality of life were assessed using Majeed score and SF-36 questionnaire. Non-normally distributed data were presented as median (Q<sub>1</sub>, Q<sub>3</sub>) and normally distributed data were presented as mean ± SD. Spearman's rank correlation coefficient was used for correlation analysis.</p><p><strong>Results: </strong>A total of 25 patients were included, with a mean age of 29.8 years. All patients were managed operatively with posterior-only fixation. The median Majeed score was 90 (76, 95). The median physical component summary score was 69.37 (38.75, 85.62). The median mental component summary score was 63.95 (39.25, 87.87). There was no significant difference compared to population norms of both physical component summary and mental component summary. Injury to weight bearing time correlated significantly (p = 0.002) with Majeed score as well as SF-36 score (p = 0.044). No other variable had a significant association with outcomes.</p><p><strong>Conclusion: </strong>Posterior-only fixation is sufficient for fixing LC injuries with up to 80% of cases having good to excellent functional outcomes. However, comparative studies with larger sample sizes are needed for further validation.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A study of the impact of traffic investment on traffic fatalities in China, 2004 – 2020 2004-2020 年中国交通投资对交通死亡事故的影响研究
IF 1.8 4区 医学 Q2 ORTHOPEDICS Pub Date : 2024-07-03 DOI: 10.1016/j.cjtee.2024.07.001
Li-Lu Sun, Shan Liu, Tian Lan, Xi-Ping Zou

Purpose

Road traffic injuries (RTIs) have been one of the most serious public health problems in China. The purpose of this study was to investigate the extent to which traffic investment affects traffic fatalities in China as well as regional differences.

Methods

The cohort study analyzed the correlation between traffic investment and traffic fatalities, incorporating additional factors such as economic conditions, road infrastructure, population density, and lighting. The selected variables included the number of traffic fatalities, traffic investment, urban per capita road area, urban road length, road mileage, urban road lighting, population size, and per capita gross domestic product. Relevant data between 2004 and 2020 were collected for an analysis using a fixed effect regression model. A p < 0.05 is considered statistically significant. To reduce the heterogeneity caused by regional differences, the provinces were divided into 6 groups according to administrative districts, and the clustering standard error analysis was carried out.

Results

Overall, there has been a significant improvement in road safety in China from 2004 to 2020, but some regions show an increase in traffic fatalities. The model reveals that traffic investment is significantly and positively correlated with the number of traffic fatalities. Holding all other factors constant, each 10,000 yuan increase in transport investment was associated with an average increase of 0.22 road traffic fatalities. In the analysis of regional differences, there was a significant positive correlation between traffic investment and traffic fatalities in the Northwest region and an increase of 10,000 yuan leads to an increase of 0.47. There was a significant negative correlation between road mileage, urban road lighting system, and population and traffic fatalities. For example, holding other factors constant, a 10,000 km reduction in road length would increase the number of traffic deaths by 45.56. The model results of urban per capita road area, urban road length, per capita gross domestic product, and the explained variables showed that p > 0.100, which was not statistically significant.

Conclusions

Therefore, traffic investments are essential for governments to develop measures to enhance road safety and reduce the risk of road fatalities. Adjusting traffic road investment and other covariates is conducive to improving traffic safety and reducing the risk of road fatalities. The road safety situation in different regions of China varies greatly. Local governments should consider the actual conditions to provide better road safety configuration policies.
目的道路交通伤害(RTI)一直是中国最严重的公共卫生问题之一。本研究旨在调查交通投资对中国交通事故死亡人数的影响程度以及地区差异。方法该队列研究分析了交通投资与交通事故死亡人数之间的相关性,并纳入了经济条件、道路基础设施、人口密度和照明等其他因素。所选变量包括交通事故死亡人数、交通投资、城市人均道路面积、城市道路长度、道路里程、城市道路照明、人口数量和人均国内生产总值。收集了 2004 年至 2020 年的相关数据,采用固定效应回归模型进行分析。P < 0.05 为具有统计学意义。为减少地区差异带来的异质性,将各省按行政区域分为 6 组,并进行聚类标准误差分析。结果总体而言,2004 年至 2020 年,中国道路交通安全状况显著改善,但部分地区交通事故死亡人数有所增加。模型显示,交通投资与交通事故死亡人数呈显著正相关。在其他因素不变的情况下,交通投资每增加 1 万元,道路交通死亡人数平均增加 0.22 人。从地区差异分析,西北地区交通投资与交通事故死亡人数呈显著正相关,每增加 1 万元,交通事故死亡人数增加 0.47 人。道路里程、城市道路照明系统、人口与交通死亡事故之间存在明显的负相关关系。例如,在其他因素不变的情况下,道路长度每减少 1 万公里,交通死亡人数将增加 45.56 人。城市人均道路面积、城市道路长度、人均国内生产总值和被解释变量的模型结果显示,P > 0.100,不具有统计学意义。调整交通道路投资和其他协变量有利于提高交通安全性,降低道路死亡风险。中国不同地区的道路安全形势差异很大。地方政府应考虑实际情况,提供更好的道路安全配置政策。
{"title":"A study of the impact of traffic investment on traffic fatalities in China, 2004 – 2020","authors":"Li-Lu Sun,&nbsp;Shan Liu,&nbsp;Tian Lan,&nbsp;Xi-Ping Zou","doi":"10.1016/j.cjtee.2024.07.001","DOIUrl":"10.1016/j.cjtee.2024.07.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Road traffic injuries (RTIs) have been one of the most serious public health problems in China. The purpose of this study was to investigate the extent to which traffic investment affects traffic fatalities in China as well as regional differences.</div></div><div><h3>Methods</h3><div>The cohort study analyzed the correlation between traffic investment and traffic fatalities, incorporating additional factors such as economic conditions, road infrastructure, population density, and lighting. The selected variables included the number of traffic fatalities, traffic investment, urban per capita road area, urban road length, road mileage, urban road lighting, population size, and per capita gross domestic product. Relevant data between 2004 and 2020 were collected for an analysis using a fixed effect regression model. A <em>p</em> &lt; 0.05 is considered statistically significant. To reduce the heterogeneity caused by regional differences, the provinces were divided into 6 groups according to administrative districts, and the clustering standard error analysis was carried out.</div></div><div><h3>Results</h3><div>Overall, there has been a significant improvement in road safety in China from 2004 to 2020, but some regions show an increase in traffic fatalities. The model reveals that traffic investment is significantly and positively correlated with the number of traffic fatalities. Holding all other factors constant, each 10,000 yuan increase in transport investment was associated with an average increase of 0.22 road traffic fatalities. In the analysis of regional differences, there was a significant positive correlation between traffic investment and traffic fatalities in the Northwest region and an increase of 10,000 yuan leads to an increase of 0.47. There was a significant negative correlation between road mileage, urban road lighting system, and population and traffic fatalities. For example, holding other factors constant, a 10,000 km reduction in road length would increase the number of traffic deaths by 45.56. The model results of urban per capita road area, urban road length, per capita gross domestic product, and the explained variables showed that <em>p</em> &gt; 0.100, which was not statistically significant.</div></div><div><h3>Conclusions</h3><div>Therefore, traffic investments are essential for governments to develop measures to enhance road safety and reduce the risk of road fatalities. Adjusting traffic road investment and other covariates is conducive to improving traffic safety and reducing the risk of road fatalities. The road safety situation in different regions of China varies greatly. Local governments should consider the actual conditions to provide better road safety configuration policies.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 380-388"},"PeriodicalIF":1.8,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Chinese Journal of Traumatology
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