bluuebunny/crossref_metadata_2025_split huggingface dataset:
Current indications for acute total hip arthroplasty in older patients with acetabular fracture: Evidence in 601 patients from 2002 to 2021
Authors: Zhang Bin-Fei , Zhuang Yan , Liu Lin , Xu Ke , Wang Hu , Wang Bo , Wen Hong-Quan , Xu Peng 
Published: January 2023

PurposeOlder patient population with acetabular fractures is increasing rapidly, requiring enhanced recovery. Acute total hip arthroplasty (THA) is a good option for these patients, and it is becoming increasing popular. However, acute THA has different indications in different studies. Therefore, a systematic review is needed to assess and comprehend the indications for acute THA in older patients.MethodsA systematic literature review was conducted to identify a retrospective series or prospective studies in older patients (&gt;60 years) with acetabular fractures. The search timeline was from database construction till December 2021; PubMed, Embase, and Cochrane Library databases were searched. Two trained professional reviewers independently read the full text of documents that met the inclusion criteria and extracted information on the specific methods used and indication information based on the research design.ResultsIn total, there were 601 patients with acetabular fractures aged &gt;60 years from 33 studies were obtained. Twenty-eight studies reported that THA was a feasible treatment option for acetabular fractures in geriatric patients with good outcome. The primary indications were dome impaction, irreducible articular comminution, femoral head injury, and pre-existing osteoarthritis or avascular necrosis. The most common patterns were anterior column and posterior hemitransverse, posterior wall, both columns, and T-type.ConclusionAcute THA is an effective treatment strategy for older patients with acetabular fractures and should be considered when the abovementioned indications are observed on preoperative images. (PROSPERO: CRD42022329555).
The treatment effect of posterior lumbar fusion surgery on patients suffering from lumbar disc herniation concurrent with peroneal nerve paralysis
Authors: Gao Shangju , Li Zhaohui , Li Xiangyu , Rudd Samuel , Wang Haoming , Gao Ze , Ding Wenyuan , Yang Sidong 
Published: January 2023

PurposeThe purpose of this study is to investigate the clinical effect of posterior lumbar fusion surgery on patients who suffer from lumbar disc herniation concurrent with peroneal nerve paralysis.MethodsThe patients suffering from peroneal nerve paralysis and undergoing posterior lumbar fusion surgery between January 2012 and December 2019 were retrospectively reviewed. The data of the identified patients were then collected and processed. All patients were followed up post-operatively after discharge from the hospital. The data was analyzed in terms of Oswestry disability index (ODI), visual analogue scale (VAS) score, and relative lower-limb muscle strength.ResultsA total of 87 patients (52 males and 35 females) aged 54 ± 11 years met the inclusion criteria for this study. These patients stayed in hospital for 16 ± 6 days and were followed up for 81 ± 24 months. Data analysis showed that muscle strength of the tibialis anterior and extensor digitorum significantly recovered at the last follow-up with a grade of 3 (median), compared to grade 0 at admission (p &lt; 0.001). Furthermore, the median VAS score decreased to 1 at the last follow-up from 6 at admission (p &lt; 0.001), and the ODI greatly improved with 10% (median) at the last follow-up, while it was 58% at admission (p &lt; 0.001). The ODI improvement rate was 60% on average at the last follow-up. Multivariate regression analysis regarding the ODI and muscle strength improvement rates showed that advanced age was a risk factor for postoperative recovery.ConclusionsMost of the patients suffering from lumbar disc herniation concurrent with peroneal nerve paralysis can improve after undergoing posterior lumbar fusion surgery, but few can reach full recovery. Advanced age might be a risk factor that affects the prognosis of these patients after surgery.
Nomogram for predicting the distal adding-on phenomenon in severe and rigid scoliosis
Authors: Li Zhongyang , Yang Huiliang , Zhou Chunguang , Xiu Peng , Yang Xi , Wang Lei , Feng Ganjun , Liu Limin , Song Yueming 
Published: January 2023

BackgroundThe distal adding-on phenomenon has attracted extensive discussion in the field of spine surgery due to the continual occurrence after scoliosis correction. Previous work has mainly focused on adolescent idiopathic scoliosis (AIS), and a relatively high number of theories for the mechanism of the distal adding-on phenomenon has been proposed for these kinds of patients. Severe and rigid scoliosis, as a special disease form, has a unique etiology, clinical manifestations and internal mechanisms distinct from those of AIS. Given the uniqueness of this disease, the mechanism and causes of the distal adding-on phenomenon have been infrequently studied in depth.ObjectiveTo define clinical and radiological factors associated with distal adding-on in patients with severe and rigid scoliosis.MethodsRadiographic parameters and demographic data of patients with severe and rigid scoliosis were evaluated preoperatively, after posterior instrumentation and fusion surgery, and at the final follow-up via radiographs. According to the appearance of distal adding-on at the final follow-up, the patients were grouped into the Adding-on and the Non-adding-on groups. Various radiological parameters were analyzed in stepwise multivariate logistic regression to identify the variables associated with distal adding-on, which were then incorporated into a nomogram. The predictive performance and calibration of the nomograms for distal adding-on were assessed using C statistics and calibration plots.Results93 patients (21 in the Adding-on and 72 in the Non-adding-on group) were included. The incidence of distal adding-on was 22.6%. The variables associated with distal adding-on were the anterior release, posterior internal distraction, and later posterior spinal fusion (IP) procedure, the posterior vertebral column resection and posterior spinal fusion (PVCR) procedure, postoperative apical vertebral translation (Post-AVT) and preoperative slope of the line linking the pedicles on the concave side of the upper- and lower-end vertebrae (Tan α). Combining these factors, the nomogram achieved a concordance index of 0.92 in predicting distal adding-on and had well-fitted calibration curves.ConclusionsFor patient with a negative Tanα in severe and rigid scoliosis, the risk of distal adding-on tended to increase, and it is recommended to give priority to IP or PVCR. In the final correction, a smaller Post-AVT should not be pursued excessively.
Are testicular sperms superior to ejaculated sperms in couples with previous ART failure due to high rate of fragmented embryos? A retrospective cohort study
Authors: Jiang Ling-Ying , Kong Fei-Fei , Yao Lv , Zhang Fu-Xing , Wang Sha-Sha , Jin Xiao-Ying , Tong Xiao-Mei , Zhang Song-Ying 
Published: January 2023

ObjectiveThe aim was to clarify whether using testicular sperm reduces embryo fragmentation and improves cycle outcomes.MethodsFragmented embryo was defined as an embryo in which fragments account for more than one third of the embryonic surface area. High rate of fragmented embryos was defined by a proportion of fragmented embryos higher than 50%. We recruited infertile couples who had undergone at least one ovarian stimulation cycle using ejaculated sperm but failed to conceive due to high rate of fragmented embryos in each previous cycle. After fully informed consent, the couples agreed to obtain testicular sperm by testicular puncture and use testicular sperm for intracytoplasmic sperm injection (ICSI). The normal fertilization rate, transferable embryo rate, fragmented embryo rate and cycle outcomes were compared between ejaculated sperm group (EJA-sperm group) and testicular sperm group (TESTI-sperm group).ResultsTwenty-two couples who agreed to participate in our study underwent 32 ICSI cycles with ejaculated spermatozoa and 23 ICSI cycles with testicular spermatozoa. Embryo transfers were cancelled in 8 ejaculated cycles and 4 testicular cycles because of no transferable embryos. There were no significant differences in age, normal fertilization rate and high-quality embryo rate between ejaculated and testicular groups. The transferable embryo rate and implantation rate in TESTI-sperm group were significantly higher than those in EJA-sperm group (36.9% vs. 22.0%, p &lt; 0.01; 34.2% vs. 0%, p &lt; 0.001). The fragmented embryo rate in TESTI-sperm group was significantly lower than that in EJA-sperm group (61.2% vs. 75.7%, p &lt; 0.05).ConclusionOur small retrospective cohort study suggests that using testicular sperm may be a recommended option for couples with previous ART failure because of high rate of fragmented embryos. Large samples, multicenter studies or randomized controlled trial (RCT) are needed to further confirm the superiority of testicular sperm.
Fully endoscopic transforaminal discectomy for thoracolumbar junction disc herniation with or without calcification under general anesthesia: Technical notes and preliminary outcomes
Authors: Meng Shengwei , Han Jialuo , Xu Derong , Wang Yan , Han Shuo , Zhu Kai , Lin Antao , Su Kunpeng , Li Yaxiong , Han Xing , Ma Xuexiao , Zhou Chuanli 
Published: January 2023

ObjectiveTo evaluate the feasibility, safety, and outcomes of percutaneous endoscopic transforaminal discectomy (PETD) for thoracolumbar junction disc herniation (TLDH) with or without calcification.MethodsThis study included 12 patients diagnosed with TLDH with or without calcification who met the inclusion criteria and underwent surgery for PETD from January 2019 to December 2021. The mean patient age, operation time, hospitalization time, time in bed, and complications were recorded. Patients were followed up for at least 9 months. Visual analog scale (VAS) scores for low-back and leg or thoracic radicular pain and modified Japanese Orthopedic Association score (m-JOA) scores were preoperatively evaluated, at 1 day and 3, 6, and 12 months postoperatively or at last follow-up. The modified MacNab criteria were used to evaluate clinical efficacy at 12 months postoperatively or at last follow-up.ResultsThe mean patient age, operation time, hospitalization time, and time in bed were 53 ± 13.9 years, 101.3 ± 9.2 min, 4.5 ± 1.3 days, and 18.0 ± 7.0 h, respectively. The mean VAS scores of low-back and leg or thoracic radicular pain improved from 5.8 ± 1.5 and 6.5 ± 1.4 to 2.0 ± 0.9 and 1.3 ± 0.5, respectively (P &lt; 0.05). The m-JOA score improved from 7.5 ± 1.2 to 10.0 ± 0.7 (P &lt; 0.05). The overall excellent–good rate of the modified MacNab criteria was 83.3%. No severe complications occurred.ConclusionFully endoscopic transforaminal discectomy and ventral decompression under general anesthesia is a safe, feasible, effective, and minimally invasive method for treating herniated discs with or without calcification at thoracolumbar junction zone.
Septic arthritis with osteomyelitis due to Salmonella enterica serotype Dublin: A case series
Authors: Jiang Boyi , Xu Hong , Zhou Zongke 
Published: January 2023

BackgroundSeptic arthritis with osteomyelitis due to Salmonella enterica serotype Dublin is rare. We reviewed and analyzed cases of septic arthritis with osteomyelitis due to Salmonella enterica serotype Dublin seen at our institution.MethodsThe medical records of all patients diagnosed with Salmonella septic arthritis and/or Salmonella osteomyelitis during 2017–2022 were included. We reviewed the diagnosis, medical history, clinical management, and outcome of all cases.ResultsFive patients with Salmonella septic arthritis or Salmonella osteomyelitis were identified during the 5-year study period. They were all male; the median age was 53 years (range 15–56). Only one was immunodeficient. All five patients were infected at the hip joint and ipsilateral femur, while two suffered bilateral hip septic arthritis with femoral osteomyelitis. Salmonella Dublin was isolated from the hip joint fluid of all patients. Four presented with fever and constitutional signs within four weeks of symptom onset. Four had positive blood cultures, and only one patient had gastrointestinal symptoms. Four patients underwent surgical debridement as the primary surgical plan, and two underwent secondary two-stage exchange after primary surgical debridement failure. The last patient had a two-stage exchange directly as the first surgical treatment. All patients received intravenous antimicrobial therapy for a median duration of 6 (range 4–12) weeks and oral antimicrobial therapy for a median duration of 4 (range 4–6) weeks. All patients had a median duration of follow-up of 12 months (range 9–25), and none had evidence of recurrence of infection.ConclusionsSeptic arthritis due to Salmonella Dublin remains rare. It frequently occurs with ipsilateral femur osteomyelitis adjacent to the infected hip joint in our cases. Surgical debridement or two-stage exchange, along with 4–12 weeks of effective intravenous and followed by 4–6 oral antimicrobial therapy, could successfully eradicate the infection.
A pulmonary nodule mislocated in “dorsal” segment due to tri-lobed left lung
Authors: Lyu Xiaohong , Xu Yuan , Qin Yingzhi , Ma Dongjie , Liu Hongsheng 
Published: January 2023

BackgroundThe left lung has two lobes and one fissure, while the right lung has three lobes and two fissures. Accessory fissures are usually found in imaging examinations and autopsies; however, finding an actual accessory lobe is rare.Case presentationIn a lung nodule resection surgery, a 68-year-old male patient was found with three lobes and two fissures in his left lung. The lung nodule was misdiagnosed as being located in the lower lobe because the accessory fissure was misregarded as the oblique fissure. The lung nodule was found in the upper lobe, and this anatomical variation changed the surgical plan. The pathology of the lung nodule was granulomatous inflammation with caseous necrosis with the positive antacid stain. The patient was eventually diagnosed with tuberculosis.Literature reviewCases involving the lung accessory fissure and lung accessory lobe variants were reviewed. In 10 autopsy and dissection studies, the incidence of accessory fissure in the left lung was 13.5% (79/587, ranging from 2.7% to 50.0%), and in the right lung, it was 7.3% (42/575, ranging from 3.1% to 30.4%). The incidence of accessory lobes in the left lung was 2.0% (11/547, ranging from 0.0% to 7.4%), and in the right lung was 2.6% (14/539, ranging from 0.0% to 17.4%). The incidence of accessory fissures in bilateral lungs identified by chest x-ray or computed tomography ranged from 7.3% to 32.0%. Three surgical case reports inferred accessory lobes, including a left upper lobectomy, left lung transplantation, and an open thoracotomy.ConclusionThis is the first clinical case report that shows that lung accessory lobe caused the mislocation of a lung nodule. Therefore, radiologists and surgeons should be aware of the possibility of an accessory lobe in the lung.
Application of the 3D-MRI on post-operative graft assessment in adolescent patients with ACL reconstruction: A minimal 2-year follow-up
Authors: Wang Xiaona , Qi Yansong , Bao Huricha , Xu Yongsheng 
Published: January 2023

BackgroundThe purpose of the present study was to assess the prognostic morphological changes of the reconstructed hamstring auto-grafts by using reconstructed three-dimensional MRI (3D-MRI) in adolescent patients with ACLR.Methods22 adolescent patients (less than 17 years old) were retrospective included between January 1, 2018, and October 31, 2020, in our department. The patients were divided into 2 subgroups: subgroup A (&lt;14 years old) and subgroup B (≥14 years old). 3D-MRI was used to detect the total cross-sectional area (TCA) and long-to-short axis (LSA) ratio of the reconstructed ACL graft at the proximal, mid-point, and distal regions. The minimal follow-up was 2 years.ResultsThe averaged follow-up of subgroup A and B was 37.8 ± 5.6 and 37.6 ± 6.5 months, respectively. Comparing to the initial graft (ACLR operation), the TCA of reconstructed ACL was increased by 30.6% on average, and the TCAs at proximal, mid-point, and distal regions were increased by 56.4%, 50.0%, and 17.7%, respectively, inner-group comparisons showed that the TCAs of the 3 region in subgroup A were all increased at the follow-up (P = 0.002) (P &lt; 0.001) (P &lt; 0.001), however, only increased mid-point (P = 0.024) and distal TCAs (P &lt; 0.001) were found in subgroup B. Comparing to the native ACL, the proximal LSA ratio in subgroup A was comparable, while it was lower in subgroup B than the native ACL (P = 0.004), the distal LSA ratios in the 2 subgroups were both lower than the native ACL (P = 0.004) (P = 0.006).Conclusions3D-MRI assessment can exactly identify the morphological changes of the graft in adolescent patients with ACLR, the TCA of the constructed ACL was increased compared to the initial graft, however, the LSA ratio was still lower than the native ACL. Younger adolescent patients may have a better potential on the ligamentization after ACLR than the older adolescent patients.
Therapeutic effect of postoperative adjuvant transcatheter arterial chemoembolization based on the neutrophil-to-lymphocyte ratio
Authors: Feng Guo-Ying , Shi Zheng-Rong , Zhao Yu-Fei , Chen Kai , Tao Jie , Wei Xu-Fu , Cheng Yu 
Published: January 2023

AimTo evaluate the feasibility of the preoperative neutrophil-to-lymphocyte ratio (NLR) as an index to guide postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with liver cancer.MethodsWe recruited a total of 166 patients with liver cancer who underwent surgery alone or surgery plus PA-TACE between January 2013 and June 2017 and compared the 1, 2, and 3-year recurrence-free survival (RFS) and overall survival (OS) between patients with high and low NLRs, surgery and surgery plus PA-TACE groups, and relevant subgroups using the Kaplan–Meier method. We also evaluated the independent factors affecting the prognosis of liver cancer after surgery using a Cox risk ratio model and correlation between NLR levels and high-risk recurrence factors of liver cancer with logistic regression analysis.ResultsThe 1, 2, and 3-year RFS rates were all significantly higher in the low-NLR group compared to the high-NLR group (P &lt; 0.05). However, the 1, 2, and 3-year OS rates were similar in the low- and high-NLR groups (P &gt; 0.05). After propensity score matching, the 1, 2, and 3-year RFS and OS rates were significantly better in patients treated with surgery plus PA-TACE compared with surgery alone (P &lt; 0.05). The 1, 2, and 3-year RFS and OS rates were also significantly better in the surgery plus PA-TACE subgroup compared with the surgery-alone subgroup in the high-NLR group (P &lt; 0.05), but there was no significant difference in RFS or OS between the surgery plus PA-TACE and surgery-alone subgroups at 1, 2, and 3 years in the low-NLR group (P &gt; 0.05). Multivariate analysis in the high-NLR group showed that a poorly differentiated or undifferentiated tumor was an independent risk factor for postoperative RFS. Multiple tumors were an independent risk factor for postoperative OS (P &lt; 0.05), while PA-TACE was an independent protective factor for postoperative RFS and OS (P &lt; 0.05). In the low-NLR group, AFP &gt; 400 µg/L was an independent risk factor for postoperative OS (P &lt; 0.05). Multivariate logistic regression indicated that patients with a maximum tumor diameter of &gt;5 cm were at increased risk of having high NLR levels compared to patients with a maximum tumor diameter of &lt;5 cm (P &lt; 0.05).ConclusionPA-TACE can improve the prognosis of patients with a high preoperative NLR (≥2.5), but has no obvious benefit in patients with low preoperative NLR (&lt;2.5). This may provide a reference for clinical selection of PA-TACE.
Arteriovenous fistulas in the craniocervical junction region: With vs. without spinal arterial feeders
Authors: Song Zihao , Ma Yongjie , Wang Yinqing , He Chuan , Li Guilin , Zhang Peng , Hong Tao , Sun Liyong , Hu Peng , Ye Ming , Zhang Hongqi 
Published: January 2023

ObjectiveArteriovenous fistulas (AVFs) in the craniocervical junction (CCJ) region are a rare occurrence with special clinical manifestations. This study retrospectively reviewed patients with CCJ AVFs treated at our neurosurgical center, aiming to enhance the understanding of CCJ AVFs.MethodsA total of 113 patients with CCJ AVFs treated at our neurosurgical center between January 2013 and December 2020 were enrolled. They were grouped as patients with CCJ AVFs with spinal arterial feeders (n = 20) and patients with CCJ AVF without spinal arterial feeders (n = 93). Clinical presentation, angiographic characteristics, intraoperative findings, and treatment outcomes were analyzed.ResultsThe patients’ median age was 55 years (IQR 47.5–62 years). The proportion of males in the group without spinal arterial feeders was significantly higher (p = 0.001). Subarachnoid hemorrhage (SAH) was the most common clinical presentation, especially in the group with spinal arterial feeders (p &lt; 0.001). There were significant differences in AVF type, fistula location, and direction of the venous drainage between the two groups (p &lt; 0.001). Intervention embolization combined with microsurgery was more common in treating AVFs with spinal arterial feeders (p = 0.006). Spinal arterial feeders did not affect the outcome (p = 0.275).ConclusionsSAH was the most common presentation of CCJ AVFs in this study. Microsurgery and interventional embolization were optional treatment strategies. The angioarchitecture of CCJ AVFs was essential for selecting treatment strategies.
Satisfactory short-term outcomes of totally laparoscopic ileostomy reversal compared to open surgery in colorectal cancer patients
Authors: Xu Zheng , Luo Shou , Su Hao , Liang Jianwe , Liu Qian , Wang Xishan , Jin Weisen , Zhou Haitao 
Published: January 2023

BackgroundRecently, totally laparoscopic (TLAP) surgery has suggested its potential on ileostomy reversal. This study aimed to compare the short-term outcomes between TLAP and traditional open ileostomy reversal.Patients and methodsFrom September 2016 to September 2021, 107 eligible patients underwent TLAP (n = 48) or open (n = 59) loop ileostomy reversal were retrospectively enrolled. Surgical parameters, postoperative recovery and complications were identified and compared between TLAP technique vs. open surgery.ResultsThe operation time and estimated blood loss showed no obvious difference between TLAP and open group. However, TLAP reversal significantly decreased the incision length (4.5cm vs. 6cm, P &lt; 0.001). Furthermore, patients underwent TLAP surgery showed quicker first ground activities (1 day vs. 2 days, P &lt; 0.001), faster first flatus passage (2 days vs. 3 days, P = 0.004) and shorter postoperative stay (5 days vs. 7 days, P = 0.007). More importantly, postoperative complications were significantly reduced after TLAP reversal (3 cases vs. 10 cases, P = 0.026). Further logistic regression analyses also indicated the TLAP technique was associated with lower incidence of complications (OR=3.316, CI, 1.118–9.835; P = 0.031).ConclusionsTLAP surgery is competitive in promoting postoperative recovery as well as reducing complications compared to the traditional open ileostomy reversal.