目的:探討后路椎弓根螺釘固定在地震傷胸腰椎骨折中的應用及優點。方法:對19例胸腰椎骨折的地震傷患者行后路椎弓根螺釘內固定術。結果:本組病例的手術時間70～115分鐘,平均出血量約280mL,兩例病員術中出血超過400mL進行輸血,復位椎體前緣高度由術前平均57.5%恢復到術后平均93.6%,后突角由術前平均21°矯正到術后平均3°,術后3～7天轉往外地繼續治療,Frankel分級平均提高0.4。結論:后路椎弓根螺釘固定具有省時、節約醫療資源、提高救治效率、減輕患者痛苦的優點,尤其適用于大批傷病員的緊急救治。
Objective To investigate the expression of miR-92a in breast cancer tissues and whether it can influence the migration and invasion ability of breast cancer cells through kruppel-like factor 4 (KLF4). Methods ① The expressions of miR-92a and KLF4 mRNA in cancer tissues and adjacent tissues were detected by qRT-PCR in 122 breast cancer patients who were operated in our hospital from May 2017 to October 2019. ② The expression of miR-92a in MCF-7 breast cancer cells was up-regulated or knocked out. Cell survival rate was detected by MTT assay, cell migration ability was detected by scratch assay, cell invasion ability was detected by Transwell assay, and the relative expression levels of KLF4, E-cadherin (E-cad), and N-cadherin (N-cad) proteins were detected by Western blotting. ③ The targeting relationship between miR-92a and KLF4 was detected by dual luciferase reporter gene assay. Results ① The relative expression levels of miR-92a and KLF4 mRNA in cancer tissues were higher than those in adjacent tissues (P<0.05). ② The up-regulation of miR-92a expression had no effect on the survival rate of MCF-7 breast cancer cells, but the migration and invasion ability of cells were enhanced (P<0.05). The knockdown of miR-92a expression decreased the survival rate of MCF-7 breast cancer cells and the ability of cell migration and invasion (P<0.05). ③ The miR-92a and KLF4 had a direct targeting relationship, up-regulation of miR-92a expression increased the relative expression levels of KLF4 and N-cad proteins, while decreased the relative expression level of E-cad protein (P<0.05). After knockout of miR-92a expression, the relative expression levels of KLF4 and N-cad proteins were decreased, while the relative expression level of E-cad protein was increased (P<0.05). Conclusion The miR-92a is highly expressed in breast cancer cells, and knockout of miR-92a expression can inhibit KLF4 signaling pathway and reduce the migration and invasion ability of breast cancer cells.
目的 探討經傷椎椎弓根螺釘內固定治療胸腰椎骨折的臨床療效。 方法 2008年5月－2010年12月，選擇38例胸腰椎骨折患者，采用椎弓根螺釘固定傷椎及相鄰上下椎體。其中男28例，女10例；年齡21～65歲，平均36.5歲。骨折部位：胸8 1例，胸9 2例，胸10 4例，胸11 8例，胸12 7例，腰1 10例，腰2 4例，腰3 2例。受傷至手術時間3～7 d，平均4.5 d。對患者手術前后椎體高度、矢狀面后凸Cobb角、神經功能Frankel分級變化等指標進行測量并隨訪。 結果 術后患者切口均Ⅰ期愈合。38例獲隨訪12～18個月，平均15個月。骨折均獲得骨性融合，無釘棒斷裂、無死亡或神經損傷加重患者。術后神經功能Frankel分級較術前有明顯改善（P＜0.05）。術后X線片復查示傷椎高度恢復達90%以上，外形正常；CT復查示椎管內有效矢狀徑恢復滿意，椎管前方無明顯骨性壓迫，傷椎椎體骨愈合良好。術后1、12個月時傷椎前、后緣高度及后凸Cobb角均較術前顯著改善（P＜0.05）；術后12個月隨訪椎體高度無丟失。 結論 經傷椎椎弓根釘復位、減壓、內固定治療胸腰椎骨折具有創傷小、固定節段少、脊柱穩定性好、能有效矯正及預防脊柱后凸畸形等優點。
Objective To conduct a systematic bibliometric analysis of recent research on robot-assisted orthopedic surgery, in order to reveal the research trends, hotspots, main contributors, and future development directions in this field. Methods On August 27, 2024, WoSCC (Web of Science Core Collection Database) was searched and relevant literature on robot-assisted orthopedic surgery from 2003 to 2023 was included. Excel 2016, VOSviewer (version 1.6.10), and CiteSpace (version 6.2.R6) were used for data collection and analysis. Results The total citation frequency of 1718 retrieved literature was 28978 times, with an average citation frequency of 16.87 times per article. The total citation frequency of articles in 2019 was the highest (4330 times), and the publication volume in 2023 was the highest (315 articles). Among the top 5 countries in terms of publication volume, the United States had the highest publication volume and total citation frequency, while China ranked second in terms of publication volume, but had the lowest average citation frequency per article. Analysis of cooperation between countries showed that the United States, China, Germany, and other countries had the most cooperation. Babar Kayani’s articles were cited the most frequently. Among the top 10 institutions in terms of publication volume, the Hospital for Special Surgery (United States) had the highest publication volume, the Pennsylvania State System of Higher Education (United States) had the highest total citation frequency for publications, and the average citation frequency of each article published by the University of Pittsburgh (United States) was the highest. The dynamic evolution of research hotspots suggested that early research mainly focused on the combination of traditional surgical techniques and navigation, while in recent years, research had mainly focused on computer-aided surgery, augmented reality, and medical robotics technology. Conclusions In recent years, significant progress has been made in the research of robot-assisted orthopedic surgery, with the United States taking a leading position in this field and having extensive global cooperation. Research hotspots show that with the continuous development of computer-aided surgery, augmented reality, and robotics technology, the field of orthopedic surgery is evolving towards more precise, individualized, and minimally invasive directions.
ObjectiveTo systematically investigate the registration status, methodology and reporting quality of the systematic review protocols for animal experiment registered on PROSPERO platform.MethodsSystematic review protocols of animal experiments registered on PROSPERO platform were searched up to December 31st, 2019. Two reviewers independently screened literature, extracted data, and performed a descriptive analysis of the methodological quality and reporting characteristics of the included studies.ResultsA total of 351 protocols from 50 countries were included, involving 22 diseases. The intervention measures were primarily "pharmaceutical chemicals". Only approximately 1/3 of the studies reported the search strategy from at least one database, approximately half of the studies were prepared to report heterogeneity analysis and publication bias, and only approximately 1/3 of the studies were prepared to report sensitivity analysis.ConclusionsThe quantity of systematic reviews of animal experiments registered on the PROSPERO platform is increasing annually, however, there are still some limitations in the methodology and reporting quality.
ObjectiveTo systematically review the relationship between frailty and risk of orthostatic hypotension.MethodsPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect studies on the association between frailty and orthostatic hypotension from inception to July 7th, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by RevMan 5.3 software.ResultsFive cross-sectional studies involving 8 671 patients were included. The results of meta-analysis showed that prefrailty (OR=1.04, 95%CI 0.99 to 1.09, P=0.11) and frailty (OR=1.02, 95%CI=0.92 to 1.13, P=0.70) were not associated with orthostatic hypotension. The results of subgroup analysis showed that differences of sample size (<500 or ≥500), using different frailty assessment tools (Fried scale, clinical frailty scale, and frailty index), different regions (Europe, Asia, and America) and different sources of studied subjects (hospitals and communities), the risk of orthostatic hypotension were not increased with frailty.ConclusionsCurrent evidence shows that frailty does not increase the risk of orthostatic hypotension. Due to limited quality and quantity of included studies, the above conclusions are needed to be validated by more high-quality studies.
ObjectiveTo systematically review the dose-response relationship between body mass index (BMI) and all-cause mortality in the elderly with frailty.MethodsPubMed, EMbase, Web of Science, CNKI, VIP, WanFang Data, and CBM databases were electronically searched to collect cohort studies on the association of BMI and mortality in frail adults from inception to November 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; Stata 15.0 software was then used to analyze the dose-response analysis of BMI and mortality by restricted cubic spline function and generalized least squares method.ResultsA total of 4 cohort studies involving 12 861 frail adults were included. Meta-analysis results showed that compared with normal BMI, the frail elderly who were overweight (HR=0.80, 95%CI 0.74 to 0.88, P<0.001) and obese (HR=0.89, 95%CI 0.79 to 1.00, P=0.047) had lower all-cause mortality. The results of dose-response meta-analysis showed that there was a non-linear relationship between BMI and all-cause mortality in the elderly with frailty (P value for nonlinearity was 0.035), for which the elderly with frailty had a BMI nadir of 27.5-31.9 kg/m2. For linear trends, and when BMI was less than 27.5 kg/m2, the risk of all-cause death was reduced by 4% for every 1 kg/m2 increase in BMI (RR=0.96, 95%CI 0.90 to 1.03, P=0.320), when BMI was greater than 27.5 kg/m2, the risk of all-cause death increased by 4% for every 1 kg/m2 increase in BMI (RR=1.04, 95%CI 1.03 to 1.05, P<0.001).ConclusionsThere is a paradox of obesity and a significant nonlinear relationship between BMI and all-cause mortality in the frailty elderly, with the lowest all-cause mortality in the frailty elderly at BMI 27.5-31.9 kg/m2. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusions.
Based on the PRISMA 2009 checklist, the study analyzed current status and reporting quality of systematic reviews of animal experiments, and consulted experts in relevant fields to form an initial entry pool of reporting checklists for systematic reviews of animal experiments in traditional Chinese medicine (PRISMA-ATCM). Then, the initial entry pool was improved through 2 rounds of Delphi expert consultation. Finally, the items were revised through the consensus meeting, and the final PRISMA-ATCM was formed. Of the 27 items on the PRISMA checklist, 12 were revised and expanded, specifically relating to TCM interventions and animal characteristics. The publication of the PRISMA-ATCM will improve the transparency and standardization of systematic reviews of animal experiments in Chinese medicine.