BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical...BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.展开更多
In clinical dermatology,approximately 15%of patients suffer from nail disorders.Different nail diseases may present with similar clinical manifestations.When clinical diagnosis based on symptoms,dermoscopy,and fungal ...In clinical dermatology,approximately 15%of patients suffer from nail disorders.Different nail diseases may present with similar clinical manifestations.When clinical diagnosis based on symptoms,dermoscopy,and fungal tests is inconclusive,nail biopsy becomes the most critical diagnostic tool.Nail specimens are highly rigid,brittle,and adhere poorly to slide glass,making sectioning challenging and posing significant difficulties for pathology technicians.Limited literature exists on nail histology processing techniques.This paper reviews and consolidates the available literature on nail paraffin sectioning techniques,aiming to provide insights and methods for pathology technicians.展开更多
Background of the Study: Femoral shaft fracture is the most common pediatric injury requiring hospitalization. For children less than 5 years old, non-surgical approach is recommended. For pediatric patients 5 - 14 ye...Background of the Study: Femoral shaft fracture is the most common pediatric injury requiring hospitalization. For children less than 5 years old, non-surgical approach is recommended. For pediatric patients 5 - 14 years old, the most common mode of treatment is flexible intramedullary nailing with a known complication of pain at post-op site, inflammatory reaction/bursitis at the entry site, superficial and deep infection, knee synovitis, knee stiffness, leg length discrepancy, proximal nail migration, angulation or malunion, delayed and non-union, implant breakage. This study aims to present a rare complication of a femoral fracture fixed with flexible intramedullary nail. Methodology: We report the outcome of a 12-year-old male with peri implant fracture of the left femur. He underwent removal of plates and screws and subsequently fixed with flexible intramedullary nails. Patient was followed up at 1, 3, 7, and 10 months post-operatively. Varus-valgus, sagittal angulation, and limb shortening were measured pre- and post-operatively. Complications were recorded on each visit. Results: Pre-operative varus angulation was 10˚, pro-curvatum of 55˚ with limb shortening of 4 cm. Postoperatively, varus was maintained to 10˚ but pro-curvatum was corrected to 4˚ and limb shortening was reduced to 1 cm. However, after 1 month the varus angulation increased to 30˚ while maintaining sagittal pro-curvatum. Limb shortening also increased to 2 cm. New bone formation started to appear along the mechanical axis of the left femur which is apparent at 3 months post-op and pro-curvatum increased to 20˚. At 7 and 10 months post-op no signs of union was noted at the fracture site but the callus formation along the mechanical axis gradually matured and appeared as a new femoral shaft. Conclusion: Formation of new bone in response to unstable flexible intramedullary fixation in pediatric femoral shaft fracture is a very rare complication.展开更多
We investigated the psychological effects of nail treatments on children living in child welfare facilities.We performed a single nail treatment on children living in child welfare facilities.As a result,we found that...We investigated the psychological effects of nail treatments on children living in child welfare facilities.We performed a single nail treatment on children living in child welfare facilities.As a result,we found that feelings of“energy”,“relaxation”,and“comfort”tended to increase more strongly after the treatment than before.Furthermore,these feelings increased even more after the nail treatment.The effects of nail treatments were unrelated to gender or previous nail experience.Furthermore,nail treatments increased communication and interaction with facility staff and other children residing in the facility,promoting self-expression,and,as a result,increasing a sense of accomplishment,acceptance from others,and self-esteem.This suggests that positive emotions persisted even after nail treatments,leading to positive changes in daily life.展开更多
The primary goal of this study is to provide an efficient numerical tool to analyze the seismic performance of nailed walls.Modeling such excavation supports involves complexities due partly to the interaction of supp...The primary goal of this study is to provide an efficient numerical tool to analyze the seismic performance of nailed walls.Modeling such excavation supports involves complexities due partly to the interaction of support with soil and partly because of the amplification of seismic waves through an excavation wall.Consequently,innovative modeling is suggested herein,incorporating the calibration of the soil constitutive model in a targeted range of stress and strain,and the detection of a natural period of complex systems,including soil and structure,while benefiting from Rayleigh damping to filter unwanted noises.The numerical model was achieved by simulating a previous centrifuge test of the excavation wall,manifested at the pre-failure state.Notably,the calibration of the soil constitutive model through empirical relations,which replaces the numerical reproduction of an element test,more accurately simulated the soil-nail-wall interaction.Two factors were crucial to a successful result.First,probing the natural period of the complicated geometry of the model by applying white noises.Second,considering Rayleigh damping to withdraw unwanted noises and thus assess their permanent effects on the model.Rayleigh damping was applied instead of filtering the obtained results.展开更多
Thermal runaway(TR)in lithium-ion batteries(LIBs)involves a complicated multiphysics process with potentially catastrophic consequences,highlighting the importance of investigating effective prevention strategies.This...Thermal runaway(TR)in lithium-ion batteries(LIBs)involves a complicated multiphysics process with potentially catastrophic consequences,highlighting the importance of investigating effective prevention strategies.This study employs a lumped model integrating electrochemical and decomposition reaction kinetics to predict the evolution of the TR of LIBs triggered by axial nail penetration,validated by experimental tests.A computational fluid dynamics(CFD)-based turbulent flow model is further employed to simulate the thermal runaway propagation(TRP)behavior induced by high-temperature gases within the battery module.A parameterized analysis based on numerical simulation is conducted to quantify the impact of thermal insulation material properties on thermal diffusion and heat accumulation within the module.The results indicate that damage to the battery vent significantly increases the risk of sidewall rupture during TR.The incorporation of thermal barriers is essential in the thermal design of battery modules to prevent heat transfer via convection from the thermal exhaust caused by sidewall rupture to adjacent cells.In addition,a reduction in the thermal diffusivity of the thermal barrier material is required to minimize thermal exchange between battery cells.By adopting insulating materials with thermal diffusivity lower than 0.3 mm^(2)/s,the TRP of batteries can be mitigated under non-enclosed conditions.These findings contribute to improved battery safety and inform the development of more effective thermal protection measures and safety standards.展开更多
BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid tre...BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid treatment options to reduce morbidity and mortality.AIM To evaluate and compare the outcomes of CBHA and PFNA in treatment of unstable intertrochanteric fractures.METHODS A comprehensive search was conducted to identify relevant studies discussing the outcomes of using both CBH and PFNA in treatment of unstable intertrochanteric fractures.Studies published up to January 1,2025 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included three studies,all of which were retrospective,involving a total of 240 patients.The follow-up period for participants was at least 12 months.CBHA was associated with significantly higher blood loss compared to PFNA[mean differences(MD):129.14,95%CI(52.51,205.77),P=0.001],though heterogeneity was high(I²=97%).Operative time showed no significant difference initially[MD:6.10,95%CI(-13.34,25.54),P=0.54],but after excluding one study,BHA had longer operative times[MD:21.51,95%CI(18.60,24.41),P<0.00001].Hospital stay and Harris scores showed no significant differences between groups.CBHA facilitated faster progression to weight-bearing[MD:-11.92,95%CI(-22.46,-1.39),P=0.03]and a lower incidence of prosthetic loosening[risk ratio:0.21,95%CI(0.05,0.92),P=0.04].Refracture and thrombus formation rates were comparable between the two groups.CONCLUSION CBHA offers shorter weight-bearing duration and reduced prosthetic loosening but incurs greater blood loss and longer operative times compared to PFNA.Both techniques show comparable functional recovery,hospital stay,refracture,and thrombus risks.Clinical choice should prioritize early mobilization or surgical minimalism,guided by patient needs.Further prospective studies are warranted.展开更多
Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective...Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective cohort study included 45 patients with APRFs treated between February 2019 and October 2022 in our trauma center.Patients were divided into two groups based on the surgical method:20 received RPRIN fixation,and 25 received PCS fixation.Key variables including operation time,fluoroscopic time,blood loss,and postoperative complications were analyzed.Fracture reduction quality was assessed using the Matta score system,and pelvic functional recovery was evaluated using the Majeed score system at the final follow-up.Quantitative variables were compared using the independent sample t test,while categorical variables were analyzed using Chisquare and Fisher’s exact tests.Results The RPRIN group had significantly shorter operation time(36.3±5.6 min vs.49.5±6.9 min,P<0.01),fluoroscopic time(32.0±2.8 s vs.48.4±3.6 s,P<0.01),and less blood loss(20.4±7.6 mL vs.34.0±5.7 mL,P<0.01)than the PCS group.Fracture reduction quality(Matta outcome)and pelvic functional recovery(Majeed outcome)were comparable between the two groups(P>0.05).No significant complications were reported in either group.Conclusions Both RPRIN and PCS are effective for treating APRFs.However,RPRIN offers distinct advantages by reducing operation time,fluoroscopic time,and blood loss,making it a more efficient and less invasive option.Further multicenter studies and biomechanical analyses are warranted to confirm these findings.展开更多
This study examined the positive changes that water-based nail treatments can bring to emotions and behavior in children who do not attend school and use a place for school-refusing children.Children who do not attend...This study examined the positive changes that water-based nail treatments can bring to emotions and behavior in children who do not attend school and use a place for school-refusing children.Children who do not attend school and use a place for school-refusing children were given water-based nail treatments about once a week for three months.In addition,the parents of these children were asked to respond to questions about their children’s daily activities.The results showed that natural communication through nail treatments significantly increased positive emotions.However,continued nail treatments did not reduce the children’s problem behaviors.Some children returned to school,while others continued not attending school.Increased frequency of visits and number of treatments confirmed the promotion of communication.It was suggested that building positive relationships with family and supporters is important for achieving sustained effects from nail treatments.This study showed that nail treatments are a useful tool for promoting positive emotions,self-acceptance,and social skills,and may contribute to the emotional growth and social interest of children who do not attend school.展开更多
Treatment of reverse oblique trochanteric femoral fractures poses a lot of challenges. There have been proponents of intramedullary devices as well as extramedullary devices. We present the results of proximal femoral...Treatment of reverse oblique trochanteric femoral fractures poses a lot of challenges. There have been proponents of intramedullary devices as well as extramedullary devices. We present the results of proximal femoral nailing surgery performed for reverse obliquity intertrochanteric fractures using two proximal lag screws and a nail of 250 mm. There is prospective study of fifty three patients with AO/OTA 31 A-A3 fractures being treated by proximal femoral nailing in our institute after seeking approval from the Hospital ethics board. The quality of the reduction, the operative time, complications and the functional status of the patients were the parameters on which the results were evaluated. The mean Harris hip score was 76.66 (range 70 - 93) and the mean Barthel activity score was 16.21 (range 12 - 20). The average surgical time was 50 minutes and the mean consolidation time was 11.5 weeks. Intramedullary nailing with proximal femoral nails seems to be a good option in the treatment of reverse obliquity intertrochanteric fractures as against the various existing options available for the management.展开更多
Nail connection is widely used in engineering and construction fields.In this study,bamboo nail was proposed as a novel connector for timber assemblies.Penetration depth of bamboo nail into wood was predicted and test...Nail connection is widely used in engineering and construction fields.In this study,bamboo nail was proposed as a novel connector for timber assemblies.Penetration depth of bamboo nail into wood was predicted and tested.The influence of nail parameters(length,radius and ogive radius)on penetration depth were verified.For both tested and predicted results,the penetration depth of bamboo nail increased with the increasing length,radius or ogive radius.In addition,the effect of densification on penetration depth or mechanical properties was evaluated.1.12 g/cm^(3) was a critical density when densification was needed,and further increment of density would decrease the penetration depth of nail.The results of this study manifests that the proposed model is capable to predict the penetration depth of bamboo nail.These findings may provide new insight into efficiently utilization of bamboo resources.展开更多
BACKGROUND There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail(PFN)and proximal femoral nail antirotation(PFNA)for pertrochanteric femoral fracture...BACKGROUND There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail(PFN)and proximal femoral nail antirotation(PFNA)for pertrochanteric femoral fracture(PFF)in elderly patients.AIM To evaluate both clinical and radiographic outcomes after fixation with PFN and PFNA in an elderly patient population.METHODS One hundred fifty-eight patients older than 65 years with PFF who underwent fixation with either PFN or PFNA were included.Seventy-three patients underwent fixation with PFN,whereas 85 were fixed with PFNA.The mean follow-up was 2.4 years(range,1-7 years).Clinical outcome was measured in terms of operation time,postoperative function at each follow-up visit,and mortality within one year.Radiographic evaluation included reduction quality after surgery,Cleveland Index,tip-apex distance(TAD),union rate,time to union,and sliding distance of the screw or blade.Complications including nonunion,screw cutout,infection,osteonecrosis of the femoral head,and implant breakage were also investigated.RESULTS Postoperative function was more satisfactory in patients who underwent PFNA than in those who underwent PFN(P=0.033).Radiologically,the sliding difference was greater in PFN than in PFNA patients(6.1 and 3.2 mm,respectively,P=0.036).The rate of screw cutout was higher in the PFN group;eight for PFN(11.0%)and two for PFNA patients(2.4%,P=0.027).There were no differences between the two groups in terms of operation time,mortality rate at one year after the operation,adequacy of reduction,Cleveland Index,TAD,union rate,time to union,nonunion,infection,osteonecrosis,or implant breakage.CONCLUSION Elderly patients with PFF who underwent PFNA using a helical blade demonstrated better clinical and radiographic outcomes as measured by clinical score and sliding distance compared with patients who underwent PFN.展开更多
The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedull...The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedullary nails and achieve union with least trauma to the shoulder and the rotator cuff. The multiple elastic screw nails achieve the inherent stability based on the principle of “three point fixation”. We aim to propose that the screw intramedullary nail is an effective implant to facilitate uneventful fracture union, with rapid recovery, low morbidity and low learning curve capable of being replicated in any smaller operative set up.展开更多
Treatment of fragility fractures of the distal tibia in the elderly is demanding because of osteopenic bone quality, the delicate soft tissue cuff and </span></span></span></span><span style...Treatment of fragility fractures of the distal tibia in the elderly is demanding because of osteopenic bone quality, the delicate soft tissue cuff and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">frequent</span></span></span></span></span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> crit</span><span style="font-family:Verdana;">ical circulation. We report the case of two-level tibial pseudarthroses in an</span><span style="font-family:Verdana;"> 83</span></span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">year</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span></span></span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">old woman caused by multiple myeloma successfully stabilized by a long </span><span style="font-family:Verdana;">ankle arthrodesis nail combined with locking compression plate</span> <span style="font-family:Verdana;">osteosynthesis. This case is unique</span></span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> as to our best knowledge</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> herein</span></span></span></span></span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> diaphyseal fractures were </span><span style="font-family:Verdana;">treated for the first time using a technique reported hitherto primarily for</span><span style="font-family:Verdana;"> fragility ankle and pilon fractures.展开更多
Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retr...Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis.展开更多
BACKGROUND Femoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies.Technological advances have led to the latest designs of fully implantable motorized intr...BACKGROUND Femoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies.Technological advances have led to the latest designs of fully implantable motorized intramedullary lengthening nails.The use of these nails has increased over the last few years.AIM To review and critically appraise the literature comparing the outcome of femoral lengthening in children using intramedullary motorized lengthening nails to external fixation.METHODS Electronic databases(MEDLINE,CINAHL,EMBASE,Cochrane)were systematically searched in November 2019 for studies comparing the outcome of femoral lengthening in children using magnetic lengthening nails and external fixation.The outcomes included amount of gained length,healing index,complications and patient reported outcomes.RESULTS Of the 452 identified studies,only two(retrospective and non-randomized)met the inclusion criteria.A total of 91 femora were included.In both studies,the age of patients treated with nails ranged from 15 to 21 years compared to 9 to 15 years for patients in the external fixation group.Both devices achieved the target length.Prevalence of adverse events was less in the nail(60%-73%)than in the external fixation(81%-100%)group.None of the studies presented patient reported outcomes.CONCLUSION The clinical effectiveness of motorized nails is equivalent or superior to external fixation for femoral lengthening in young patients.The available literature is limited and does not provide evidence on patient quality of life or cost effectiveness of the interventions.展开更多
Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current rev...Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current review aims to compare the outcomes of adult tibia fractures treated with solid nails to those treated with hollow nails. Methods: A search on Scopus, PubMed, and Cochrane Library, using three keywords (Outcome, Tibia shaft fractures, Nail) was conducted in April 2023. Results were compiled and two independent reviewers screened and selected eligible articles After removing duplicates, titles and abstracts were read to exclude ineligible studies. Full-text articles of the remaining papers were read to select eligible studies which were further critically appraised to ascertain their methodological quality. The data extracted from the selected papers were synthesized using a combination of pooling of results, tests of statistical difference (t-test and chi-square) and narrative synthesis methods. Results: A total of 2295 articles were obtained from the databases and citation searching. A total of 9 papers were identified as eligible and included in the review. Findings revealed that there is no statistical difference in the outcomes of tibia fractures treated with either solid or hollow nail groups such as duration of surgery (p = 0.541), rate of delayed and non-union (p = 0.342), and rate of surgical site infections (p = 0.395). Conclusion: Intramedullary nailing of tibia shaft fractures with either solid or hollow nails have similar functional outcomes.展开更多
Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was...Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was adopted, and Shenque （神阙 CV 8）, Guanyuan （关元 CV 4）, Zusanli （足三里 ST 36, bilateral）, Pish0 （脾俞 BL 20, bilateral） and Shenshu （肾俞 BL 23, bilateral） were selected. The moxibustion was performed once every other day, 20 min at each time, and moxibustion for ten times was needed. The changes in morphology, flow velocity and pefiloop of nailfold microcirculation were detected by adopting microcirculation detector before moxibustion, after moxibustion for three times, six times, ten times, and on the 15th day after moxibustion, respectively. Results After moxibustion, the abnormal blood capillary morphology of microcirculation gradually turned into normal pattern along with the increase of the number of times of moxibustion, according to the comparison of the number of capillary loop, the diameter of input limb, the diameter of output limb/the diameter of input limb, flow pattern integral, pefiloop integral and total integral with those before moxibustion, the differences were all statistically significant （all P〈0.01）. Conclusion Moxibustion changs the microcirculation of nailfold of body, improves the blood flow pattern, makes the pefiloop status clear, accelerats the blood flow and increases the microcirculation perfusion amount, thus regulating the sub- health status of human body.展开更多
The purpose of this study was to determine perfluoroalkyl substances（PFASs） in human serum, urine, hair and nail from general populations, and to investigate the possibility for human urine, hair and nail used as th...The purpose of this study was to determine perfluoroalkyl substances（PFASs） in human serum, urine, hair and nail from general populations, and to investigate the possibility for human urine, hair and nail used as the biomonitoring sample for PFASs exposure. We detected the concentrations of PFHx A, PFOA, PFNA, PFDA, PFUn DA, PFDo A, PFHx S and PFOS in 39 matched human serum, urine, hair and nail samples from Shenzhen in China. The detection frequency and the median level of PFOS were all higher than that of the other PFASs in four matrices. The median concentration of PFOS in serum, urine, hair, and nail were 9.24 ng/mL, 13.96 ng/L, 0.58 ng/g and 0.63 ng/g, respectively. The results of spearman correlation test indicated that nail was an ideal matrix for biomonitoring PFOS rather than human urine and hair in general populations for the non-invasive sampling.展开更多
AIM To analyze the literature on efficacy of dynamamization vs exchange nailing in treatment of delayed and nonunion femur fractures.METHODS Ultimately, 31 peer-reviewed articles with 644 exchanged nailing patients an...AIM To analyze the literature on efficacy of dynamamization vs exchange nailing in treatment of delayed and nonunion femur fractures.METHODS Ultimately, 31 peer-reviewed articles with 644 exchanged nailing patients and 131 dynamization patients were identified and analyzed. The following key words were inputted in different combinations in order to search the field of publications in its entirety: "nonunion", "delayed union", "ununited", "femur fracture", "femoral fracture", "exchange nailing", "dynaiz(s)ation", "secondary nailing", "dynamic", "static", and "nail revision". The initial search yielded over 150 results, and was refined based on the inclusion criteria: Only studies reporting on humans, non-unions and delayed unions, and the usage of exchange nailing and/or dynamization as a secondary treatment after failed IM nailing. The resulting 66 articles were obtained through online journal access. The results were filtered further based on the exclusion criteria: No articles that failed to report overall union rates, differentiate between success rates of their reported techniques, or articles that analyzed less than 5 patients. RESULTS Exchange nailing lead to fracture union in 84.785% of patients compared to the 66.412% of dynamization with statistically comparable durations until union(5.193 ± 2.310 mo and 4.769 ± 1.986 mo respectively). Dynamically locking exchange nails resulted in an average union time of 5.208 ± 2.475 mo compared to 5.149 ± 2.366 mo(P = 0.8682) in statically locked exchange nails. The overall union rate of the two procedures, statically and dynamically locked exchange nailing yielded union rates of 84.259% and 82.381% respectively. Therefore, there was no significant difference between the different locking methods of exchange nailing for union rate or time to union at a significance value of P < 0.05. The analysis showed exchange nailing to be the more successful choice in the treatment of femoral non-unions in respect to its higher success rate(491/567 EN, 24/57 dynam, P < 0.0001). However, there was no significant difference between the success rates of the two procedures for delayed union fractures(25/27 EN, 45/55 dynam, P = 0.3299). Nevertheless, dynamization was more efficient in the treatment of delayed unions(at rates comparable to exchange nailing) than in the treatment of non-unions.CONCLUSION In conclusion, after examination of factors, dynamization is recommended treatment of delayed femur fractures, while exchange nailing is the treatment of choice for non-unions.展开更多
文摘BACKGROUND In intertrochanteric fractures,the positive medial cortex support reduction is considered to provide a non-anatomical buttress that helps in controlled collapse.AIM To analyze the concept of medial cortical reduction(MCR)and its clinical and radiological association in geriatric intertrochanteric femur fractures.METHODS Geriatric patients who presented with AO/OTA 31A1 and 31A2 femur fractures and treated with proximal femoral nailing between July 2021 and June 2023 were include in this prospective cohort study.Based on the degree of MCR,they were divided into positive,neutral,or negative MCR groups.The demographic baseline characteristics,postoperative radiographic femoral neck-shaft angle and neck length were analyzed at 6,12 and 24 weeks post-surgery.Functional outcomes such as modified Harris Hip Score(HHS)and time to full-weight bearing were also analyzed.RESULTS 47 patients(Male:Famale 35:12)with mean age of 65.8±4.2 years were included in this study.Twenty-two cases had neutral support,nine had negative support,and sixteen had positive support in the medial cortex postoperatively.Baseline characteristics of the three groups were comparable.No significant differences were found in the femur neck length and femur neck-shaft angle changes post-surgery between the groups.The modified HHS was not found to be significant between the groups(P=0.883)as that of the time to full weight bearing(P=0.789).CONCLUSION The type of reduction achieved based on medial cortical alignment does not affect the femur neck length shortening or varus collapse.Future randomized controlled trials are needed to validate the findings noted in the study.
文摘In clinical dermatology,approximately 15%of patients suffer from nail disorders.Different nail diseases may present with similar clinical manifestations.When clinical diagnosis based on symptoms,dermoscopy,and fungal tests is inconclusive,nail biopsy becomes the most critical diagnostic tool.Nail specimens are highly rigid,brittle,and adhere poorly to slide glass,making sectioning challenging and posing significant difficulties for pathology technicians.Limited literature exists on nail histology processing techniques.This paper reviews and consolidates the available literature on nail paraffin sectioning techniques,aiming to provide insights and methods for pathology technicians.
文摘Background of the Study: Femoral shaft fracture is the most common pediatric injury requiring hospitalization. For children less than 5 years old, non-surgical approach is recommended. For pediatric patients 5 - 14 years old, the most common mode of treatment is flexible intramedullary nailing with a known complication of pain at post-op site, inflammatory reaction/bursitis at the entry site, superficial and deep infection, knee synovitis, knee stiffness, leg length discrepancy, proximal nail migration, angulation or malunion, delayed and non-union, implant breakage. This study aims to present a rare complication of a femoral fracture fixed with flexible intramedullary nail. Methodology: We report the outcome of a 12-year-old male with peri implant fracture of the left femur. He underwent removal of plates and screws and subsequently fixed with flexible intramedullary nails. Patient was followed up at 1, 3, 7, and 10 months post-operatively. Varus-valgus, sagittal angulation, and limb shortening were measured pre- and post-operatively. Complications were recorded on each visit. Results: Pre-operative varus angulation was 10˚, pro-curvatum of 55˚ with limb shortening of 4 cm. Postoperatively, varus was maintained to 10˚ but pro-curvatum was corrected to 4˚ and limb shortening was reduced to 1 cm. However, after 1 month the varus angulation increased to 30˚ while maintaining sagittal pro-curvatum. Limb shortening also increased to 2 cm. New bone formation started to appear along the mechanical axis of the left femur which is apparent at 3 months post-op and pro-curvatum increased to 20˚. At 7 and 10 months post-op no signs of union was noted at the fracture site but the callus formation along the mechanical axis gradually matured and appeared as a new femoral shaft. Conclusion: Formation of new bone in response to unstable flexible intramedullary fixation in pediatric femoral shaft fracture is a very rare complication.
基金This study received a research grant from the Hoyu Science Foundation in 2023.
文摘We investigated the psychological effects of nail treatments on children living in child welfare facilities.We performed a single nail treatment on children living in child welfare facilities.As a result,we found that feelings of“energy”,“relaxation”,and“comfort”tended to increase more strongly after the treatment than before.Furthermore,these feelings increased even more after the nail treatment.The effects of nail treatments were unrelated to gender or previous nail experience.Furthermore,nail treatments increased communication and interaction with facility staff and other children residing in the facility,promoting self-expression,and,as a result,increasing a sense of accomplishment,acceptance from others,and self-esteem.This suggests that positive emotions persisted even after nail treatments,leading to positive changes in daily life.
基金supported by the International Institute of Earthquake Engineering and Seismology(IIEES) as technical project No.760
文摘The primary goal of this study is to provide an efficient numerical tool to analyze the seismic performance of nailed walls.Modeling such excavation supports involves complexities due partly to the interaction of support with soil and partly because of the amplification of seismic waves through an excavation wall.Consequently,innovative modeling is suggested herein,incorporating the calibration of the soil constitutive model in a targeted range of stress and strain,and the detection of a natural period of complex systems,including soil and structure,while benefiting from Rayleigh damping to filter unwanted noises.The numerical model was achieved by simulating a previous centrifuge test of the excavation wall,manifested at the pre-failure state.Notably,the calibration of the soil constitutive model through empirical relations,which replaces the numerical reproduction of an element test,more accurately simulated the soil-nail-wall interaction.Two factors were crucial to a successful result.First,probing the natural period of the complicated geometry of the model by applying white noises.Second,considering Rayleigh damping to withdraw unwanted noises and thus assess their permanent effects on the model.Rayleigh damping was applied instead of filtering the obtained results.
基金the Faraday Institution’s SafeBatt(https://www.safebatt.ac.uk/)project[grant numbers:EP/S003053/1,FIRG061]DSIT and the Royal Academy of Engineering,under the Chair in Emerging Technologies Scheme(CiET1718/59)。
文摘Thermal runaway(TR)in lithium-ion batteries(LIBs)involves a complicated multiphysics process with potentially catastrophic consequences,highlighting the importance of investigating effective prevention strategies.This study employs a lumped model integrating electrochemical and decomposition reaction kinetics to predict the evolution of the TR of LIBs triggered by axial nail penetration,validated by experimental tests.A computational fluid dynamics(CFD)-based turbulent flow model is further employed to simulate the thermal runaway propagation(TRP)behavior induced by high-temperature gases within the battery module.A parameterized analysis based on numerical simulation is conducted to quantify the impact of thermal insulation material properties on thermal diffusion and heat accumulation within the module.The results indicate that damage to the battery vent significantly increases the risk of sidewall rupture during TR.The incorporation of thermal barriers is essential in the thermal design of battery modules to prevent heat transfer via convection from the thermal exhaust caused by sidewall rupture to adjacent cells.In addition,a reduction in the thermal diffusivity of the thermal barrier material is required to minimize thermal exchange between battery cells.By adopting insulating materials with thermal diffusivity lower than 0.3 mm^(2)/s,the TRP of batteries can be mitigated under non-enclosed conditions.These findings contribute to improved battery safety and inform the development of more effective thermal protection measures and safety standards.
文摘BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid treatment options to reduce morbidity and mortality.AIM To evaluate and compare the outcomes of CBHA and PFNA in treatment of unstable intertrochanteric fractures.METHODS A comprehensive search was conducted to identify relevant studies discussing the outcomes of using both CBH and PFNA in treatment of unstable intertrochanteric fractures.Studies published up to January 1,2025 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included three studies,all of which were retrospective,involving a total of 240 patients.The follow-up period for participants was at least 12 months.CBHA was associated with significantly higher blood loss compared to PFNA[mean differences(MD):129.14,95%CI(52.51,205.77),P=0.001],though heterogeneity was high(I²=97%).Operative time showed no significant difference initially[MD:6.10,95%CI(-13.34,25.54),P=0.54],but after excluding one study,BHA had longer operative times[MD:21.51,95%CI(18.60,24.41),P<0.00001].Hospital stay and Harris scores showed no significant differences between groups.CBHA facilitated faster progression to weight-bearing[MD:-11.92,95%CI(-22.46,-1.39),P=0.03]and a lower incidence of prosthetic loosening[risk ratio:0.21,95%CI(0.05,0.92),P=0.04].Refracture and thrombus formation rates were comparable between the two groups.CONCLUSION CBHA offers shorter weight-bearing duration and reduced prosthetic loosening but incurs greater blood loss and longer operative times compared to PFNA.Both techniques show comparable functional recovery,hospital stay,refracture,and thrombus risks.Clinical choice should prioritize early mobilization or surgical minimalism,guided by patient needs.Further prospective studies are warranted.
基金supported by Clinical Application-oriented Medical Innovation Foundation from National Clinical Research Center for Orthopedics,Sports Medicine&Rehabilitation and Jiangsu China-Israel Industrial Technical Research Institute Foundation(No.2021-NCRC-CXJJ-ZH-24)National Key R&D Plan of the 14th Five-Year Plan(No.2022YFC2504303).
文摘Objective To compare the clinical outcomes of retrograde pubic ramus intramedullary nail(RPRIN)and percutaneous cannulated screw(PCS)in the treatment of anterior pelvic ring fractures(APRFs).Methods This retrospective cohort study included 45 patients with APRFs treated between February 2019 and October 2022 in our trauma center.Patients were divided into two groups based on the surgical method:20 received RPRIN fixation,and 25 received PCS fixation.Key variables including operation time,fluoroscopic time,blood loss,and postoperative complications were analyzed.Fracture reduction quality was assessed using the Matta score system,and pelvic functional recovery was evaluated using the Majeed score system at the final follow-up.Quantitative variables were compared using the independent sample t test,while categorical variables were analyzed using Chisquare and Fisher’s exact tests.Results The RPRIN group had significantly shorter operation time(36.3±5.6 min vs.49.5±6.9 min,P<0.01),fluoroscopic time(32.0±2.8 s vs.48.4±3.6 s,P<0.01),and less blood loss(20.4±7.6 mL vs.34.0±5.7 mL,P<0.01)than the PCS group.Fracture reduction quality(Matta outcome)and pelvic functional recovery(Majeed outcome)were comparable between the two groups(P>0.05).No significant complications were reported in either group.Conclusions Both RPRIN and PCS are effective for treating APRFs.However,RPRIN offers distinct advantages by reducing operation time,fluoroscopic time,and blood loss,making it a more efficient and less invasive option.Further multicenter studies and biomechanical analyses are warranted to confirm these findings.
基金supported by a research grant from the Hoyu Science Foundation in 2023.
文摘This study examined the positive changes that water-based nail treatments can bring to emotions and behavior in children who do not attend school and use a place for school-refusing children.Children who do not attend school and use a place for school-refusing children were given water-based nail treatments about once a week for three months.In addition,the parents of these children were asked to respond to questions about their children’s daily activities.The results showed that natural communication through nail treatments significantly increased positive emotions.However,continued nail treatments did not reduce the children’s problem behaviors.Some children returned to school,while others continued not attending school.Increased frequency of visits and number of treatments confirmed the promotion of communication.It was suggested that building positive relationships with family and supporters is important for achieving sustained effects from nail treatments.This study showed that nail treatments are a useful tool for promoting positive emotions,self-acceptance,and social skills,and may contribute to the emotional growth and social interest of children who do not attend school.
文摘Treatment of reverse oblique trochanteric femoral fractures poses a lot of challenges. There have been proponents of intramedullary devices as well as extramedullary devices. We present the results of proximal femoral nailing surgery performed for reverse obliquity intertrochanteric fractures using two proximal lag screws and a nail of 250 mm. There is prospective study of fifty three patients with AO/OTA 31 A-A3 fractures being treated by proximal femoral nailing in our institute after seeking approval from the Hospital ethics board. The quality of the reduction, the operative time, complications and the functional status of the patients were the parameters on which the results were evaluated. The mean Harris hip score was 76.66 (range 70 - 93) and the mean Barthel activity score was 16.21 (range 12 - 20). The average surgical time was 50 minutes and the mean consolidation time was 11.5 weeks. Intramedullary nailing with proximal femoral nails seems to be a good option in the treatment of reverse obliquity intertrochanteric fractures as against the various existing options available for the management.
基金This work was financially supported by the National Natural Science Foundation of China(No.32071700).
文摘Nail connection is widely used in engineering and construction fields.In this study,bamboo nail was proposed as a novel connector for timber assemblies.Penetration depth of bamboo nail into wood was predicted and tested.The influence of nail parameters(length,radius and ogive radius)on penetration depth were verified.For both tested and predicted results,the penetration depth of bamboo nail increased with the increasing length,radius or ogive radius.In addition,the effect of densification on penetration depth or mechanical properties was evaluated.1.12 g/cm^(3) was a critical density when densification was needed,and further increment of density would decrease the penetration depth of nail.The results of this study manifests that the proposed model is capable to predict the penetration depth of bamboo nail.These findings may provide new insight into efficiently utilization of bamboo resources.
文摘BACKGROUND There are few studies in the literature comparing the clinical outcomes and radiographic results of proximal femoral nail(PFN)and proximal femoral nail antirotation(PFNA)for pertrochanteric femoral fracture(PFF)in elderly patients.AIM To evaluate both clinical and radiographic outcomes after fixation with PFN and PFNA in an elderly patient population.METHODS One hundred fifty-eight patients older than 65 years with PFF who underwent fixation with either PFN or PFNA were included.Seventy-three patients underwent fixation with PFN,whereas 85 were fixed with PFNA.The mean follow-up was 2.4 years(range,1-7 years).Clinical outcome was measured in terms of operation time,postoperative function at each follow-up visit,and mortality within one year.Radiographic evaluation included reduction quality after surgery,Cleveland Index,tip-apex distance(TAD),union rate,time to union,and sliding distance of the screw or blade.Complications including nonunion,screw cutout,infection,osteonecrosis of the femoral head,and implant breakage were also investigated.RESULTS Postoperative function was more satisfactory in patients who underwent PFNA than in those who underwent PFN(P=0.033).Radiologically,the sliding difference was greater in PFN than in PFNA patients(6.1 and 3.2 mm,respectively,P=0.036).The rate of screw cutout was higher in the PFN group;eight for PFN(11.0%)and two for PFNA patients(2.4%,P=0.027).There were no differences between the two groups in terms of operation time,mortality rate at one year after the operation,adequacy of reduction,Cleveland Index,TAD,union rate,time to union,nonunion,infection,osteonecrosis,or implant breakage.CONCLUSION Elderly patients with PFF who underwent PFNA using a helical blade demonstrated better clinical and radiographic outcomes as measured by clinical score and sliding distance compared with patients who underwent PFN.
文摘The debate continues over the management of diaphyseal fractures of the humerus. There are a variety of extramedullary as well as intramedullary implants. We aim to propose a technique of passing the screw intramedullary nails and achieve union with least trauma to the shoulder and the rotator cuff. The multiple elastic screw nails achieve the inherent stability based on the principle of “three point fixation”. We aim to propose that the screw intramedullary nail is an effective implant to facilitate uneventful fracture union, with rapid recovery, low morbidity and low learning curve capable of being replicated in any smaller operative set up.
文摘Treatment of fragility fractures of the distal tibia in the elderly is demanding because of osteopenic bone quality, the delicate soft tissue cuff and </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">frequent</span></span></span></span></span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> crit</span><span style="font-family:Verdana;">ical circulation. We report the case of two-level tibial pseudarthroses in an</span><span style="font-family:Verdana;"> 83</span></span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">- </span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">year</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span></span></span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;">old woman caused by multiple myeloma successfully stabilized by a long </span><span style="font-family:Verdana;">ankle arthrodesis nail combined with locking compression plate</span> <span style="font-family:Verdana;">osteosynthesis. This case is unique</span></span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> as to our best knowledge</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> herein</span></span></span></span></span><span><span><span><span><span style="font-family:""><span style="font-family:Verdana;"> diaphyseal fractures were </span><span style="font-family:Verdana;">treated for the first time using a technique reported hitherto primarily for</span><span style="font-family:Verdana;"> fragility ankle and pilon fractures.
文摘Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis.
基金Supported by Children’s Hospital Charity and Industry(Nuvasive,CA,United States),No.5431.
文摘BACKGROUND Femoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies.Technological advances have led to the latest designs of fully implantable motorized intramedullary lengthening nails.The use of these nails has increased over the last few years.AIM To review and critically appraise the literature comparing the outcome of femoral lengthening in children using intramedullary motorized lengthening nails to external fixation.METHODS Electronic databases(MEDLINE,CINAHL,EMBASE,Cochrane)were systematically searched in November 2019 for studies comparing the outcome of femoral lengthening in children using magnetic lengthening nails and external fixation.The outcomes included amount of gained length,healing index,complications and patient reported outcomes.RESULTS Of the 452 identified studies,only two(retrospective and non-randomized)met the inclusion criteria.A total of 91 femora were included.In both studies,the age of patients treated with nails ranged from 15 to 21 years compared to 9 to 15 years for patients in the external fixation group.Both devices achieved the target length.Prevalence of adverse events was less in the nail(60%-73%)than in the external fixation(81%-100%)group.None of the studies presented patient reported outcomes.CONCLUSION The clinical effectiveness of motorized nails is equivalent or superior to external fixation for femoral lengthening in young patients.The available literature is limited and does not provide evidence on patient quality of life or cost effectiveness of the interventions.
文摘Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current review aims to compare the outcomes of adult tibia fractures treated with solid nails to those treated with hollow nails. Methods: A search on Scopus, PubMed, and Cochrane Library, using three keywords (Outcome, Tibia shaft fractures, Nail) was conducted in April 2023. Results were compiled and two independent reviewers screened and selected eligible articles After removing duplicates, titles and abstracts were read to exclude ineligible studies. Full-text articles of the remaining papers were read to select eligible studies which were further critically appraised to ascertain their methodological quality. The data extracted from the selected papers were synthesized using a combination of pooling of results, tests of statistical difference (t-test and chi-square) and narrative synthesis methods. Results: A total of 2295 articles were obtained from the databases and citation searching. A total of 9 papers were identified as eligible and included in the review. Findings revealed that there is no statistical difference in the outcomes of tibia fractures treated with either solid or hollow nail groups such as duration of surgery (p = 0.541), rate of delayed and non-union (p = 0.342), and rate of surgical site infections (p = 0.395). Conclusion: Intramedullary nailing of tibia shaft fractures with either solid or hollow nails have similar functional outcomes.
基金Supported by General program of National Natural Science Foundation of China:81373742,81674062Special program of social development and medical health of science and technology projects in Taiyuan:12016925
文摘Objective To explore the mechanism of moxibustion for people in sub-health status. Methods Thirty-nine young and middle-aged sub-health volunteers were enrolled, including 13 males and 26 females. Mild moxibustion was adopted, and Shenque （神阙 CV 8）, Guanyuan （关元 CV 4）, Zusanli （足三里 ST 36, bilateral）, Pish0 （脾俞 BL 20, bilateral） and Shenshu （肾俞 BL 23, bilateral） were selected. The moxibustion was performed once every other day, 20 min at each time, and moxibustion for ten times was needed. The changes in morphology, flow velocity and pefiloop of nailfold microcirculation were detected by adopting microcirculation detector before moxibustion, after moxibustion for three times, six times, ten times, and on the 15th day after moxibustion, respectively. Results After moxibustion, the abnormal blood capillary morphology of microcirculation gradually turned into normal pattern along with the increase of the number of times of moxibustion, according to the comparison of the number of capillary loop, the diameter of input limb, the diameter of output limb/the diameter of input limb, flow pattern integral, pefiloop integral and total integral with those before moxibustion, the differences were all statistically significant （all P〈0.01）. Conclusion Moxibustion changs the microcirculation of nailfold of body, improves the blood flow pattern, makes the pefiloop status clear, accelerats the blood flow and increases the microcirculation perfusion amount, thus regulating the sub- health status of human body.
基金funded by the National Natural Science of Foundation of China(Nos.21537001 and 21407033)the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB14010100)
文摘The purpose of this study was to determine perfluoroalkyl substances（PFASs） in human serum, urine, hair and nail from general populations, and to investigate the possibility for human urine, hair and nail used as the biomonitoring sample for PFASs exposure. We detected the concentrations of PFHx A, PFOA, PFNA, PFDA, PFUn DA, PFDo A, PFHx S and PFOS in 39 matched human serum, urine, hair and nail samples from Shenzhen in China. The detection frequency and the median level of PFOS were all higher than that of the other PFASs in four matrices. The median concentration of PFOS in serum, urine, hair, and nail were 9.24 ng/mL, 13.96 ng/L, 0.58 ng/g and 0.63 ng/g, respectively. The results of spearman correlation test indicated that nail was an ideal matrix for biomonitoring PFOS rather than human urine and hair in general populations for the non-invasive sampling.
文摘AIM To analyze the literature on efficacy of dynamamization vs exchange nailing in treatment of delayed and nonunion femur fractures.METHODS Ultimately, 31 peer-reviewed articles with 644 exchanged nailing patients and 131 dynamization patients were identified and analyzed. The following key words were inputted in different combinations in order to search the field of publications in its entirety: "nonunion", "delayed union", "ununited", "femur fracture", "femoral fracture", "exchange nailing", "dynaiz(s)ation", "secondary nailing", "dynamic", "static", and "nail revision". The initial search yielded over 150 results, and was refined based on the inclusion criteria: Only studies reporting on humans, non-unions and delayed unions, and the usage of exchange nailing and/or dynamization as a secondary treatment after failed IM nailing. The resulting 66 articles were obtained through online journal access. The results were filtered further based on the exclusion criteria: No articles that failed to report overall union rates, differentiate between success rates of their reported techniques, or articles that analyzed less than 5 patients. RESULTS Exchange nailing lead to fracture union in 84.785% of patients compared to the 66.412% of dynamization with statistically comparable durations until union(5.193 ± 2.310 mo and 4.769 ± 1.986 mo respectively). Dynamically locking exchange nails resulted in an average union time of 5.208 ± 2.475 mo compared to 5.149 ± 2.366 mo(P = 0.8682) in statically locked exchange nails. The overall union rate of the two procedures, statically and dynamically locked exchange nailing yielded union rates of 84.259% and 82.381% respectively. Therefore, there was no significant difference between the different locking methods of exchange nailing for union rate or time to union at a significance value of P < 0.05. The analysis showed exchange nailing to be the more successful choice in the treatment of femoral non-unions in respect to its higher success rate(491/567 EN, 24/57 dynam, P < 0.0001). However, there was no significant difference between the success rates of the two procedures for delayed union fractures(25/27 EN, 45/55 dynam, P = 0.3299). Nevertheless, dynamization was more efficient in the treatment of delayed unions(at rates comparable to exchange nailing) than in the treatment of non-unions.CONCLUSION In conclusion, after examination of factors, dynamization is recommended treatment of delayed femur fractures, while exchange nailing is the treatment of choice for non-unions.
