bluuebunny/crossref_metadata_2025_split huggingface dataset:
Better PROMs and higher return-to-sport rate after modular bicompartmental knee arthroplasty than after total knee arthroplasty for medial and patellofemoral compartment osteoarthritis
Authors: Deng Wang , Shao Hongyi , Tang Hao , Tang Qiheng , Wang Zhaolun , Yang Dejin , Zhou Yixin 
Published: January 2023

BackgroundTheoretical advantages of bicompartmental knee arthroplasty (BKA) over total knee arthroplasty (TKA) for bicompartmental (medial combined with patellofemoral) osteoarthritis (OA) are still unclear. This study aimed to compare patient-reported outcome measures (PROMs) and return-to-sport (RTS) rate between modular BKA and TKA in early follow-up.MethodsTwenty-five consecutive modular BKA cases with a minimum 2-year follow-up were matched with 50 TKA cases at 1:2 ratio. Demographic data and preoperative functional scores, including the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Scores (KSSs), were analyzed to ensure comparability. Postoperative WOMAC score, KSS, range of motion (ROM), Forgotten Joint Score-12 (FJS-12), and RTS rates were compared. Operative time and blood loss were also analyzed.ResultsSignificant differences in the WOMAC-function (median 97.1 vs. 89.7, p &lt; 0.001) and KSS-function (median 90.0 vs. 80.0, p = 0.003) scores were identified between the BKA and TKA groups. ROM was significantly greater in the BKA group than in the TKA group (median 125.0° vs. 120.0°, p = 0.004), in addition to the FJS-12 (median 89.6 vs. 53.1, p &lt; 0.001). The overall RTS rate was significantly higher in the BKA group than in the TKA group (71.6% vs. 56.5%, p = 0.039). Operative time was significantly longer in the BKA group than in the TKA group (median 105.0 vs. 67.5 min, p &lt; 0.001), but blood loss was similar (median 557.6 vs. 450.7 ml, p = 0.334).ConclusionModular BKA demonstrated better functional recovery, better joint perception, and higher RTS rate than TKA; thus, modular BKA can be a good alternative for bicompartmental OA.
Influence on emergency digit replantation and outcome assessment after COVID-19 virus nucleic acid testing normalization
Authors: Zhang Kunqi , Zhang Rui , Li Shanyu , Liu Shenghe , Wang Feiyan , Xu Jia , Kang Qinglin 
Published: January 2023

ObjectiveThe study aims to compare the implementation and prognosis of emergency digit replantation surgery before and after normalized corona virus disease 2019 (COVID-19) nucleic acid testing for patients taking emergency operation and to explore the influence of normalized COVID-19 nucleic acid testing on replantation surgery.MethodNormalized COVID-19 nucleic acid testing for patients taking emergency operation has been carried out since 1 August 2021 at our hospital, which means each patient who needs emergency surgical treatment has to obtain either positive or negative results of COVID-19 nucleic acid before entering the operating room. This research reviewed and compared the prognosis of the injured extremity that had emergency severed digit replantation between June and September 2021, at the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, and analyzed the impact of normalized COVID-19 nucleic acid testing on the outcome of the replanted fingers of different severity using disability of arm-shoulder-hand (DASH) and hand injury severity scoring (HISS) scoring systems.ResultsA total of 54 cases with 74 severed replanted phalanges were included replanted by the research group between 1 August and 30 September 2021, without any COVID-19 suspected/confirmed case detected. Compared with previous period (1 June to 31 July, 2021), although the interval between emergency visits and emergency replantation did increase significantly after normalized COVID-19 nucleic acid testing [(3.83 ± 0.94) to (1.77 ± 0.67) h, P &lt; 0.05], we observed no significant difference in the improvement rate of the DASH scoring of the disabled upper extremity 3-month postoperatively (P = 0.538) nor in the complication rate (P = 0.344). Moreover, there was no significant difference in the improvement rate of the DASH scoring of the disabled upper extremity 3-month postoperatively in patients with different traumatic severities before and after normalized COVID-19 nucleic acid testing (moderate P = 0.269, severe P = 0.055, major P = 0.149).ConclusionDespite the preoperative delay, the policy of COVID-19 nucleic acid testing normalization does not have explicit influence on the short-term outcomes of emergency digit replantation surgery. With this evidence, microsurgeons could pay attention to the patients' anxiety and spend more effort in comforting them during the prolonged preoperative wait. These insights may have implications for other emergency department resource management whenever a social crisis occurs.
Application of femoral nerve block combined with modified swelling anesthesia in high ligation and stripping of great saphenous vein
Authors: Chen Xiaobin , Liu Zhenwen , Zhou Binbin , Fan Zuyou , Zhao Hu , Lin Chen 
Published: January 2023

BackgroundTo analyze and explore the clinical efficacy of ultrasound guided femoral nerve block combined with modified swelling anesthetic solution in high ligation and stripping of the great saphenous vein.Methods90 patients with varicose great saphenous vein of lower limbs undergoing high ligation and stripping of great saphenous vein were randomly divided into group A (femoral nerve block combined with modified swelling anesthesia), group B (simple swelling anesthesia) and group C (epidural anesthesia), with 30 patients in each group. The serum CRP level, operation duration, intraoperative blood loss, postoperative hospitalization time, total hospitalization cost, postoperative VAS score, preoperative and postoperative VCSS score, intraoperative mean arterial pressure and heart rate, postoperative related complications, and patients, satisfaction with diagnosis and treatment were compared among the three groups.ResultsThere was no significant difference in operation duration, intraoperative blood loss, postoperative complications, and preoperative and postoperative VCSS scores among the three groups (P &gt; 0.05). The postoperative hospitalization time, postoperative VAS score and total hospitalization cost of patients in group A and B were lower than those in group C, and the postoperative hospitalization time and postoperative VAS score in group A were more significant (P &lt; 0.05). Compared with group B, the fluctuation range of intraoperative mean arterial pressure and heart rate, and postoperative serum CRP level in group A and C were lower, especially in group A (P &lt; 0.05). The three groups of patients were followed up regularly after surgery. The results showed that the number of postoperative complications in group A was lower than that in the other two groups (P &lt; 0.05), and the postoperative complications of the three groups were effectively relieved after symptomatic treatment (dressing change, anti-infection, taking drugs to improve circulation, etc.). The satisfaction of patients in group A was significantly higher than that in groups B and C (P &lt; 0.05).ConclusionsUltrasound guided femoral nerve block combined with modified swelling anesthetic solution applied in high ligation and stripping of the great saphenous vein can significantly improve postoperative inflammatory stress reaction of patients, effectively ensure the safety and reliability of surgical progress, help to improve analgesia effect and accelerate physical rehabilitation, and has short hospitalization time, low medical cost, and high satisfaction of patients' diagnosis and treatment, which is worthy of widespread clinical promotion and reference.
Prognostic and clinicopathological value of the geriatric nutritional risk index in gastric cancer: A meta-analysis of 5,834 patients
Authors: He Liang , Li Ying , Qu Linlin , Zhang Fan 
Published: January 2023

BackgroundRecent studies have explored the prognostic value of the geriatric nutritional risk index (GNRI) in patients with gastric cancer (GC), but the results are controversial. We aimed to systemically identify the association between the GNRI and prognosis in GC using a meta-analysis.MethodsThe databases of PubMed, Web of Science, Cochrane Library, and Embase were searched until September 25, 2022. Pooled hazard ratios and the corresponding 95% confidence intervals (CIs) were used to estimate the prognostic value of the GNRI in GC. Odds ratios (ORs) and 95% CIs were used to assess the correlation between the GNRI and clinicopathological characteristics of GC.ResultsTen studies including 5,834 patients with GC were included in this meta-analysis. The merged results indicated that a low pretreatment GNRI was associated with inferior overall survival (hazard ratio = 1.21, 95% CI = 1.12–1.30, P &lt; 0.001) and worse cancer-specific survival (hazard ratio = 2.21, 95% CI = 1.75–2.80, P &lt; 0.001) for GC. Moreover, a low GNRI was significantly associated with an advanced pathological stage (OR = 2.27, 95% CI = 1.33–3.85, P = 0.003), presence of adjuvant chemotherapy (OR = 1.25, 95% CI = 1.01–1.55, P = 0.040), and tumor location in the lower stomach (OR = 1.33, 95% CI = 1.06–1.65, P = 0.012) in GC. However, there was no significant association between GNRI and sex, tumor differentiation, or lymph node metastasis in patients with GC.ConclusionOur meta-analysis identified that the pretreatment GNRI level was a significant prognostic factor for patients with GC. A low GNRI is associated with worse overall survival and inferior cancer-specific survival in patients with GC.
Effect of cervical suspensory traction in the treatment of severe cervical kyphotic deformity
Authors: Shengfa Pan , Hongyu Chen , Yu Sun , Fengshan Zhang , Li Zhang , Xin Chen , Yinze Diao , Yanbin Zhao , Feifei Zhou 
Published: January 2023

ObjectiveThis study aimed to investigate a new noninvasive traction method on the treatment of severe cervical kyphotic deformity.MethodsThe clinical data of patients with severe cervical kyphosis (Cobb &gt; 40°) treated in Peking University Third Hospital from March 2004 to March 2020 were retrospectively summarized. 46 cases were enrolled, comprising 27 males and 19 females. Fifteen patients underwent skull traction, and 31 patients underwent suspensory traction. Among them, seven used combined traction after one week of suspensory traction. Bedside lateral radiographs were taken every two or three days during traction. The cervical kyphosis angle was measured on lateral radiographs in and extended position at each point in time. The correction rate and evaluated Japanese Orthopedic Association (JOA) scoring for the function of the spinal cord were also measured. The data before and after the operation were compared with paired sample t-test or Wilcoxon signed-rank test.ResultsNo neurological deterioration occurred during the skull traction and the cervical suspensory traction. There were 12 patients with normal neurological function, and the JOA score of the other 34 patients improved from 11.5 ± 2.8 to 15.4 ± 1.8 at the end of follow up (P &lt; 0.05). The average kyphotic Cobb angle was 66.1° ± 25.2, 28.7° ± 20.1 and 17.4° ± 25.7 pre-traction, pre-operative, and at the final follow-up, respectively (P &lt; 0.05). The average correction rate of skull traction and suspensory traction was 34.2% and 60.6% respectively. Among these, the correction rate of patients with simple suspensory traction was 69.3%. For patients with a correction rate of less than 40% by suspensory traction, combined traction was continued, and the correction rates after suspensory traction and combined traction were 30.7% and 67.1% respectively.ConclusionsPre-correction by cervical suspensory traction can achieve good results for severe cervical kyphotic deformity, with no wound and an easy process. Combined traction is effective for supplemental traction after suspensory traction.
Clinical study to assess influence of immediate provisionalization and various implant morphologies on implant stability: A prospective clinical study
Authors: Qi Meiyao , Deng Shiyong , Tan Zhen 
Published: January 2023

IntroductionThe aim of this study was to evaluate the influence of different implant morphologies and immediate provisionalization options on the change of implant stability.Methods94 Patients were randomized to receive implants from Straumann® BL/Straumann® BLT/Astra OsseoSpeed® TX, meanwhile having the same opportunity to receive healing abutment or immediate provisionalization. Implant stability quotient (ISQ) and marginal bone loss (MBL) were recorded at following timepoints. Parametric statistic was used for data analysis.ResultsData showed that ISQ and MBL values of conical/straight/straight with micro-thread neck implants had no significant difference.DiscussionImmediate provisionalization options could move the dip point of ISQ values ahead or delayed around one week, which were also relevant to implant systems. MBL values were proved to be unaffected by both two factors mentioned above.
Evaluation of femoral head bone quality by Hounsfield units: A predictor of implant failure for intertrochanteric fractures after intramedullary nail fixation
Authors: Fan Jixing , Lv Yang , Xu Xiangyu , Zhou Fang , Zhang Zhishan , Tian Yun , Ji Hongquan , Guo Yan , Yang Zhongwei , Hou Guojin 
Published: January 2023

PurposeThe aim of present study is to evaluate the femoral head bone quality by Hounsfield units and its relationship to the occurrence of implant failure for intertrochanteric fractures after intramedullary nail fixation.MethodsThis retrospective study assessed 160 intertrochanteric fractures treated with intramedullary fixation. Patients with and without implant failure were divided into failure and control groups, respectively. The demographic information, femoral head Hounsfield unit (HU) value, the reduction quality, status of posteromedial support and position of the screw/blade were collected and compared. The logistic regression analyses were performed to evaluate risk factors of implant failure in intertrochanteric fractures after intramedullary nail fixation.ResultsOf the patients, 15 (9.38%) suffered from implant failure after intramedullary fixation. The mean HU value of femoral head was much lower in the failure group than the control group (133.25 ± 34.10 vs. 166.12 ± 42.68, p = 0.004). And the univariate analyses showed that A3 fracture and poor reduction quality were associated with implant failure (p &lt; 0.05). After adjustment for confounding variables, the multivariable logistic regression analyzes showed that femoral head HU value (odds ratio [OR], 0.972; 95% CI, 0.952–0.993; p = 0.008) and poor reduction quality (OR, 7.614; 95% CI, 1.390–41.717; p = 0.019) were independent influencing factors for implant failure.ConclusionThe femoral head HU value was significantly correlated with the incidence of implant failure and can be used as an independent factor to predict implant failure for intertrochanteric fractures after intramedullary fixation.
Treatment of avulsion fracture of posterior cruciate ligament tibial insertion by minimally invasive approach in posterior medial knee
Authors: Guo Huihui , Zhao Yao , Gao Liang , Wang Chen , Shang Xianbo , Fan Haitao , Cheng Wendan , Liu Chang 
Published: January 2023

ObjectiveThe study aims to explore the feasibility and clinical effect of posterior minimally invasive treatment of cruciate ligament tibial avulsion fracture.MethodsPosterior knee minimally invasive approach was used to treat avulsion fracture of posterior cruciate ligament (PCL) tibia in 15 males and 11 females. The length of the incision, intraoperative blood loss, operation time, postoperative hospital stay, residual relaxation, and fracture healing time were analyzed to evaluate the curative effect, learning curve, and advantages of the new technology. Neurovascular complications were recorded. During the postoperative follow-up, the International Knee Joint Documentation Committee (IKDC), Lysholm knee joint score, and knee joint range of motion were recorded to evaluate the function.ResultsAll 26 patients were followed up for 18–24 months, with an average of 24.42 ± 5.00 months. The incision length was 3–6 cm, with an average of 4.04 ± 0.82 cm. The intraoperative blood loss was about 45–60 ml, with an average of 48.85 ± 5.88 ml. The operation time was 39–64 min, with an average of 52.46 ± 7.64 min. The postoperative hospital stay was 2–5 days, with an average of 2.73 ± 0.87 days. All incisions healed grade I without neurovascular injury. All fractures healed well with an average healing time of 9.46 ± 1.33 weeks (range, 8–12 weeks). The Lysholm score of the affected knee was 89–98 (mean, 94.12 ± 2.49) at 12-month follow-up. The IKDC score was 87–95 with an average of 91.85 ± 2.19, and the knee range of motion was 129–148° with an average of 137.08 ± 5.59°. The residual relaxation was 1–3 mm, with an average of 1.46 ± 0.65 mm.ConclusionThis minimally invasive method provides sufficient exposure for internal fixation of PCL tibial avulsion fractures without the surgical complications associated with traditional open surgical methods. The process is safe, less invasive, and does not require a long learning curve.
Debridement without bone grafting prevents osteolytic lesions progression in revision THAs with prosthesis revised
Authors: Kong Keyu , Li Fupeng , Qiao Hua , Chang Yongyun , Hu Yi , Li Huiwu , Zhang Jingwei 
Published: January 2023

BackgroundBone defects in revision total hip arthroplasties (rTHAs) caused by osteolysis are routinely treated with autografts or allografts, despite their various disadvantages. Currently, little is known about the prognosis of ungrafted cavities with complete debridement following prosthetic revision in rTHAs with component loosening, as few reports have focused on the application of debridement without bone grafting in osteolytic lesions that do not compromise structural stability in revision THAs with revised components.MethodsIn this study, 48 patients receiving rTHAs with components revised for aseptic loosening with osteolysis between 2015 and 2019 were included. Anteroposterior and lateral radiographs of hips before and after revision surgery and last follow-up were compared to measure whether the size of the debrided osteolytic cavity without bone graft had changed.ResultsIn total, 48 patients with 59 osteolytic lesions were enrolled. The mean follow-up period was 3.33 years (range 2–6 years). None of the 59 cavities had progressed at the last follow-up, and 11 (18.6%) regressed. Two patients underwent re-revision according to dislocation during follow-up.ConclusionIn rTHAs with revised components, osteolytic lesions that do not influence structural stability could be debrided without grafting to avoid the disadvantages of grafting. Debridement and component revision are sufficient to prevent the progression of osteolytic lesions during surgery, without having adverse effects on the short-to mid-term prognosis.
Monitoring of postoperative neutrophil-to-lymphocyte ratio, D-dimer, and CA153 in: Diagnostic value for recurrent and metastatic breast cancer
Authors: Ren Zhiyao , Yang Jing , Liang Jiahui , Xu Yunfeng , Lu Guanda , Han Yanxun , Zhu Jie , Tan Husheng , Xu Tao , Ren Min 
Published: January 2023

ObjectiveThis stydy aims to assess the value of monitoring of postoperative neutrophil-to-lymphocyte ratio (NLR), D-dimer, and carbohydrate antigen 153 (CA153) for diagnosis of breast cancer (BC) recurrence and metastasis.Materials/MethodsA cohort of 252 BC patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University between August 2008 and August 2018 were enrolled in this retrospective study. All patients were examined during outpatient follow-ups every 3 months for 5 years postoperation and every 6 months thereafter. Recurrence or metastasis was recorded for 131 patients but not for the remaining 121. Retrospective analysis of hematological parameters and clinicopathological characteristics allowed comparison between the two groups and evaluation of these parameters for the recurrent and metastatic patients.ResultsLymph node metastasis, higher tumor node metastasis (TNM) staging, and higher histological grade correlated with BC recurrence and metastasis (p &lt; 0.05). Statistical differences were found in absolute neutrophil count (ANC), absolute lymphocyte count (ALC), CEA, CA153, D-dimer, NLR, platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) between the recurrent and metastatic and control groups (p &lt; 0.05). Logistic regression analysis showed that CA153, D-dimer, NLR, and TNM staging were risk factors for BC recurrence and metastasis (p &lt; 0.05). Combined values for the NLR, D-dimer, and CA153 had good diagnostic values, giving the highest area under the curve (AUC) of 0.913. High NLR, D-dimer, and CA153 values were significantly associated with recurrence and metastasis at multiple sites, lymph node metastasis, and higher TNM staging (p &lt; 0.05). Patients with high CA153 were more likely to have bone metastases (p &lt; 0.05), and those with high D-dimer were prone to lung metastasis (p &lt; 0.05). With the increasing length of the postoperative period, the possibility of liver metastases gradually decreased, while that of chest wall recurrence gradually increased (p &lt; 0.05).ConclusionMonitoring postoperative NLR, D-dimer, and CA153 is a convenient, practical method for diagnosing BC recurrence and metastasis. These metrics have good predictive value in terms of sites of recurrence and metastasis and the likelihood of multiple metastases.
An ingested metallic wire migrating from stomach to pancreas treated by laparoscopic surgery: A case report
Authors: Hao Fulong , Feng Qingbo , Li Jiaxin , Wu Hong 
Published: January 2023

IntroductionForeign bodies inside the pancreas are rare and usually occur after the ingestion of sharp objects such as a fish bone, a sewing needle, or a toothpick. Furthermore, an ingested metallic wire migrating from stomach to pancreas is very rare.Case PresentationWe report a 36-year-old woman who was admitted to our hospital with “3-day history of dull progressive epigastric pain.” Computed tomography of the abdomen revealed a linear, high-density body between the stomach wall and the pancreas. During the operation, a linear, hard, metallic wire was found in the adhesive tissue between the gastric antrum and the pancreatic body. The operation was uneventful, and the patient recovered well.ConclusionThe case of a foreign body inside the pancreas caused by a metallic wire is very rare. Radiological examinations play a vital role in the diagnosis of metallic wire ingestion. Metallic wire ingestion can be treated with laparoscopic surgery, both technically and safely.