Abstract Background The reduction in irreducible extracapsular hip fractures has always been controversial. Here, we present a new minimally invasive reduction technique and compare it with limited open reduction (LOR) to treat irreducible extracapsular hip fractures. Methods From January 2016 to January 2018, our institution treated 653 patients with extracapsular hip fractures by intramedullary fixation. Among them, 525 cases got a successful closed reduction. The other 128 were irreducible and reduced by percutaneous reduction with double screwdrivers (PRDS) or LOR. There were 66 cases in the PRDS group while 62 in the LOR group. All fractures were classified using the Evans-Jensen classification. In addition, the differences in incision length, blood loss, fluoroscopic number, operation time, inpatient time, weight training time, Harris score, and complications were analyzed. Results The incision length was 8.4 ± 1.4 cm in the PRDS group and 15.3 ± 3.0 cm in the LOR group, respectively ( p < 0.05); blood loss was equal to 151 ± 26 and 319 ± 33 ml, respectively ( p < 0.05); fluoroscopic number was 14 ± 3 and 8 ± 2, respectively ( p < 0.05); operation time was 44 ± 9 and 73 ± 11 min, respectively ( p < 0.05); inpatient time was 6.2 ± 1.7 and 8.4 ± 2.2 days, respectively ( p < 0.05); weight training time after the operation was 4.5 ± 1.5 and 10.7 ± 1.8 days, respectively ( p < 0.05); and the excellent rate of Harris score was 92.4% and 88.7%, respectively ( p > 0.05). There was no significant difference in complication incidence between the two groups ( p > 0.05). Conclusions The PRDS group presented better clinical effects for managing irreducible extracapsular hip fractures than the LOR. Therefore, the PRDS technique could be the first reduction choice for patients with irreducible fractures.
Acoustic characteristics of classical opera singing differ considerably between the Western and the Chinese cultures. Singers in the classical Peking opera tradition are specializing on one out of a limited number of standard roles. Audio and electroglottograph signals were recorded of four performers of the Old Man roel and four performers of the Colorful Face role. Recordings were made of the singers' speech and when they sang recitatives and songs from their repertoires. Sound pressure level, fundamental frequency and spectrum characteristics were analyzed. Histograms showing the distribution of fundamental frequency showed marked peaks for the songs, suggesting a scale tone structure. Some of the intervals between these peaks were similar to those used in Western music. Vibrato rate was about 3.5 Hz, i.e., considerably slower than in Western classical singing. Spectra of vibrato-free tones contained unbroken series of harmonic partials sometimes reaching up to 17000 Hz. LTAS curves showed no trace of a singer's formant cluster. However, the Colourful Face role singers' LTAS showed a marked peak near 3300 Hz, somewhat similar to that found in Western pop music singers. The mean LTAS slope between 700 and 6000 Hz decreased by about 3 dB/octave per dB of equivalent sound level.
Background Bone transport technique is widely used for the management of large segmental bone defects. However, several reasons may prevent its successful completion, such as poor osteogenesis, docking site nonunion, severe chronic pain and psychological problems. We used sequential nailing technique to solve these problems. The objective of this study was to analyze the clinical effects of our modified technique for the management of large segmental bone defects after trauma. Methods Twenty-three patients using bone transport combined with sequential nailing technique in our institution from June 2011 to June 2020 were included and analyzed retrospectively. There were 15 males and eight females. The age ranged from 19 to 64 years. There were eight cases suffering from basic medical diseases. The initial injury was open in 14 patients. Seven cases encountered femoral defects and 16 for tibia. The main reasons for sequential nailing technique were docking site nonunion (nine cases), poor osteogenesis (five cases), severe chronic pain (five cases) and psychological problems (four cases). The residual bone defects after removing the external fixator, operation plans, complications and follow-up time were recorded. Bone defect healing was evaluated by Paley score. Results The mean residual bone defects were (2.9 ± 1.9) cm. The mean time in external fixator was (9.5 ± 3.4) months. The average follow-up time was (23 ± 3) months. With respect to complications, two cases suffered from nonunion again and were treated by bone graft with augmented plate fixation. No infection recurrence was found in these cases. The excellent and good rate of bone defect healing was 91.3%. Conclusion Bone transport combined with sequential nailing technique could shorten the external fixation time, overcome the inconvenience of the external frame to patients, eliminate chronic pain and be easy for patients to accept. Patients using this modified technique achieved high satisfaction.
The speech intelligibility index (SII) theory objectively assesses speech intelligibility, and the frequency-importance function (FIF), which reflects the relative importance of various frequency bands to speech intelligibility for various languages, occupies the central part of the theory. However, the FIF has not been examined for tonal Chinese Mandarin speech. In this study, considering the characteristics of Mandarin speech, 50 phonemically-balanced one-syllable words were selected as the speech stimuli from the speech corpus "A Method for Calculating Articulation Index (GB/T 15508-1995)", which meets the National Standards of China, and the 1/3 octave FIF was measured and computed with the Fletcher's method. The results show that spectrum regions with frequencies 2000-4000 Hz are more important in Chinese speech than those in English speech. The results predicted by SII model with the new FIF fit the result of human psychophysical studies well, which indicate that the new FIF model is effective and appropriate for assessing the intelligibility of Mandarin speech even when a steady-state noise masker is co-presented. [Supported by the NSFC 60435010; 60535030; 60605016; 30670704]
BACKGROUND Surgical managements were recommended for unstable distal clavicle fracture owing to the high incidence of nonunion. The present study compared the efficacy of anatomical locking plate with versus without additional suture anchor fixation for the treatment of unstable Neer type II distal clavicle fractures. MATERIAL AND METHODS Between January 2013 to January 2015, 28 consecutive patients with unstable Neer type II fractures were treated by using anatomical locking plate with or without additional suture anchor fixation. The patients were divided into anatomical locking plate group (group A) and anatomical locking plate combined with suture anchor group (group B) according to the surgical method. The operative-related parameters such as operation time, blood loss, length of hospitalization, union time, functional outcomes (Constant score, UCLA score and DASH score) and CC distance were compared. RESULTS The mean follow-up period of the 28 patients was 19.60 months (21.80 versus 18.39 months, respectively). No statistical differences in general and peri-operative parameters were found between 2 groups. The group B had significant higher Constant score than group A (P=0.004, 91.67 versus 83.10). While no statistical differences were reached in the UCLA score and DASH score between 2 groups (P=0.112 and 0.163, respectively). The group A had longer CC distance than group B (11.67 versus 8.94 mm), while no statistic difference was found (P=0.067). CONCLUSIONS For the treatment of acute unstable Neer type II distal clavicle fractures, both surgical methods could offer satisfactory outcome. However, anatomical locking plate combined with additional suture anchor fixation had a better functional and radiographic outcome than that without additional suture anchor fixation.
Abstract How to deal with large tibial bone defects is still controversial. The purpose of this research was to compare the semi-focal bone transport (SFBT) technique with traditional bone transport (TBT) technique for treating such patients. Sixty-two patients were included and retrospectively analyzed. In all cases, after radical debridement large tibial bone defects remained. Patients were treated by the SFBT or TBT technique. The distraction, consolidation duration and complications were recorded by the patients’ medical files. Based on the Association for the Study and Application of Methods of Ilizarov (ASAMI) standard, the bone and functional results were evaluated. The mean bone defect size was 7.7 ± 1.6 cm and 7.5 ± 2.1 cm for SFBT and TBT patients. The mean external fixation index (EFI) was 1.51 ± 0.14 months/cm and 1.89 ± 0.25 months/cm for SFBT and TBT patients ( p < 0.05), respectively. With respect to bone and function results, there was no significant differences between the two groups ( p > 0.05). The mean number of complications per patient was 1.1 ± 0.6 and 1.6 ± 0.7 for SFBT and TBT patients ( p < 0.05). Compared to the traditional bone transport technique, patients using the semi-focal bone transport technique achieved better clinical effects, including shorter EFI and less complications. Therefore, the SFBT technique could be a new option for patients with large tibial bone defects.
Despite improvements in surgical techniques and implant design in orthopedic surgery, implantation-associated infections are still a challenging problem for surgeons. In 2006, trace quantities of human β-defensin 3 (hBD-3) were found in human bone tissue and bone cells. Human β-defensin 3 is a 45-amino-acid peptide that is considered the most promising class of defensin antimicrobial peptides and may help in the prevention and treatment of implantation-associated infections. Studies of the effectiveness of hBD-3 against Staphylococcus aureus showed that hBD-3 was more potent at low concentrations than other antibiotics. The effect of hBD-3 on S aureus biofilms has not been reported. We studied the effect of hBD-3, vancomycin, and clindamycin on S aureus biofilms and on the survival of the bacteria in the biofilms.Staphylococcus aureus biofilms were examined with confocal scanning laser microscopy. Staining with LIVE/DEAD BacLight viability stain (Molecular Probes Europe BV, Leiden, The Netherlands) differentiated between live and dead bacteria within the biofilms, and extracellular polymeric substances (slime) from the biofilms was evaluated after staining with calcofluor white (Sigma Chemical Company, Rocky Hill, New Jersey). Human β-defensin 3 and clindamycin reduced the S aureus biofilm area. Human β-defensin 3 was significantly more effective against bacteria from the S aureus biofilms than was clindamycin. Vancomycin did not reduce the S aureus biofilm area.
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