Search

Background: To explore the advantages of a lateral tibial locking plate combined with Jail screw fixation in the treatment of anterolateral tibial plateau collapse fracture (ATPCF). Methods: A retrospective analysis was conducted on patients with ATPCFs admitted to our hospital from February 2019 to February 2023. Twenty-six patients were successfully included, including 15 males and 11 females, with an average age of 58.6 ± 7.8 years (range 45–68 years). All fractures were Schatzker type II fractures. After fracture reduction and fixation, a lateral locking titanium plate was placed through the anterolateral approach of the tibial plateau, and two screws of appropriate length were placed in the sagittal direction according to the Jail screw technique. Postoperative evaluation indices included surgery time, fracture healing time, the degree of tibial plateau collapse shown by computed tomography (CT) images at 3 days and 1 year after surgery, and the patient's knee range of motion at 1 year after surgery. The effects of fracture reduction and fixation before surgery, 3 days after surgery and 1 year after surgery were evaluated by the Rasmussen radiological score. The Hospital for Special Surgery (HSS) knee score was used to evaluate the knee joint function of patients at 1 year after surgery. Results: The average operation time was 64 ± 6.8 min (range 56–82 min). The fractures healed clinically at 13.8 ± 2.8 weeks (range 12–18 weeks) postoperation. After 15 ± 3.1 months (range 12–19 months) of average follow-up, all the patients were pain-free with a full range of motion and stable knees. At the 1-year postoperative assessment, the CT images showed no secondary collapse of the articular surface, the average knee range of motion was 136.3 ± 2.5° (range, -5° to 135°), the average Rasmussen radiological score was 16.2 ± 0.8 points, and the average HSS knee score was 93.6 ± 3.2 points. Conclusions: The fixation of a anterolateral tibial plateau collapse fracture(ATPCF) using a lateral locking plate and the Jail screw technique has achieved good knee joint function, providing a new option for the treatment of ATPCFs. The clinical efficacy is satisfactory in the short term, avoiding secondary articular surface collapse. [ABSTRACT FROM AUTHOR]

Background: Anterior circulation stroke (ACS) differs from posterior circulation stroke (PCS) in several aspects. We hypothesize that the risk of early neurologic deterioration (END) and its responses to clopidogrel plus aspirin versus aspirin alone may be different between stroke territories., Methods and Results: This was a prespecified post hoc analysis of ATAMIS (Antiplatelet Therapy in Acute Mild to Moderate Ischemic Stroke) trial and included patients with definite infarct location who were classified into ACS and PCS according to stroke territory. Primary outcome was occurrence of END at 7 days, defined as ≥2-point increase in National Institutes of Health Stroke Scale score compared with baseline. We compared the treatment effects of clopidogrel plus aspirin versus aspirin alone in each stroke territory. From 3000 patients, 2431 eligible patients (1780 with ACS [910 assigned into clopidogrel plus aspirin and 870 assigned into aspirin alone] and 651 with PCS [371 assigned into clopidogrel plus aspirin and 280 assigned into aspirin alone]) were included. Median age was 66 years and 35.1% were women. The occurrence of END was higher in ACS than PCS (6.8% versus 3.8%, P =0.007). clopidogrel plus aspirin was associated with lower risk of END in ACS (risk difference [95% CI]: -2.4% [-4.1% to -0.8%], P =0.004), but not in PCS (risk difference [95% CI]: -0.6% [-2.7% to 1.5%], P =0.57). No significant interaction was found ( P =0.69)., Conclusions: Our study demonstrated END was higher in acute mild-to-moderate ischemic stroke with anterior circulation, who derived more benefit from clopidogrel plus aspirin than aspirin alone., Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02869009.

With the continuous increase in transportation activities, the transportation sector has become an important source of global greenhouse gases. In 2019, road vehicles accounted for nearly three-quarters of the CO 2 emissions of the entire transportation sector and will be the key to achieving carbon peaks in the transportation sector. At the same time, air pollutants emitted by road vehicles are also one of the threats to the environment and human health. Based on the long-range energy alternatives planning system (LEAP) model, we constructed the baseline (BAU) scenario, low-carbon (LC) scenario, and enhanced low-carbon (ELC) scenario for the development of the road transport sector in Lanzhou from 2015 to 2040 and simulated energy consumption and emission co-reduction of greenhouse gases and pollutants under policies and measures. The results showed that the energy consumption and CO 2 emissions of the LC scenario will peak in 2026, whereas those in the ELC scenario will peak in 2020. In these two scenarios, pollutant emissions such as NO x , CO, HC, PM 2.5 , and PM 10 began to decline sharply between 2015 and 2017, and the downward trend will slow down gradually around 2023. Based on the feasibility of measures and the cost of abatement, the LC scenario can be used as a road vehicle carbon peak scenario in Lanzhou. In this scenario, the reduction rates of energy consumption, CO 2 , NO x , CO, HC, PM 2.5 , and PM 10 emissions will reach -24.17%, -26.57%, -55.38%, -65.91%, -72.87%, -76.66%, and -77.18% compared with those under the BAU scenario by 2040. At present, the road vehicles in Lanzhou City should focus on structural optimization measures such as clean-energy use of public transportation, electrification of small passenger cars, and phasing out old cars, as well as vigorously promoting low-carbon travel and improving energy efficiency accompanying the development of automotive technology. These efforts will effectively control CO 2 and pollutant emissions by road vehicles, and carbon peaks will be achieved as soon as possible. In addition, it is necessary to pay attention to the changes in vehicle types during the implementation of these measures, which most contribute CO 2 and various pollutants, in order to make the measures more targeted by changing the number or the market share of new energy of focused vehicle types.

Purpose: To evaluate the effects of total parenteral nutrition and octreotide on pediatric patients with chylous ascites post-operative., Methods: Four patients were diagnosed with chylous ascites from Nov 2009 to Nov 2012. Total parenteral nutrition and octreotide was administered to 2 patients, while the other two only received fasting and total parenteral nutrition. All patients had persistent peritoneal drainage, with the quantity and quality of drainage fluid observed daily., Results: Two patients who received somatostatin therapy completely recovered within 7d without any recurrence while on a normal diet. The other two patients who only received fasting and total parenteral nutrition was cured 24-30 d after therapy., Conclusion: Total parenteral nutrition along with octreotide can relieve the symptoms and close the chyle leakage in patients with chylous ascites rapidly. It seems to be an effective therapy available for the treatment of chylous ascites., (Copyright AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.)

Purpose: Ovarian germ cell tumors are rare in childhood. The goal of the study is to provide information that may help guide the evaluation and surgical management of future children with ovarian tumors., Methods: A retrospective review of patients with ovarian germ cell tumors between January 1990 and January 2010 was performed., Results: 137 patients were included with a median age of 9.5 years. Teratomas were found most frequently (mature: 78, immature: 6), followed by yolk sac tumors (n = 51), dysgerminoma (n = 1) and embryonal carcinoma (n = 1). Abdominal pain (81.8%) and abdominal distension (58.4%) were the most common symptoms. Twenty-six infants were found prenatally. Twenty-one patients presented torsion of the ovary. Alpha-feto-protein levels were elevated in all pure yolk sac tumors, two immature teratomas and one embryonal carcinoma. Most patients (84) were Stage I, 16 were Stage II, 23 Stage III, and four Stage IV. All patients with mature and immature teratomas (grade 1) underwent surgery alone. Surgery + chemotherapy were conducted in 55 other patients. The surgical procedures consisted of salpingo-oophorectomy (n = 68), oophorectomy (n = 21) and ovarian-sparing tumorectomy (n = 48). Sixteen patients gave up the treatment and died. Excluding this subset, 5-year relapse-free survival and overall survival was 93.4% and 98.3%, respectively. No recurrences were observed in any patients., Conclusion: Ovarian germ cell tumors have an excellent prognosis. With accurate staging, complete resection, and adjuvant chemotherapy, patients should be expected to have excellent survival rates. Preservation of ovarian tissue should be considered whenever safe and feasible, however, this needs to be confirmed by studies on larger numbers of patients.