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Retrospective study.

A retrospective study was conducted to clarify the prognostic factors of postoperative for cervical spine fractures patients with ankylosing spondylitis (AS).

Now the high probability of cervical fractures in patients with AS is unanimously recognized. Fractures mostly occur in the lower cervical spine and two-thirds of patients are accompanied by spinal cord injury. But there are few studies on treatment of AS patients with cervical fracture and it is unclear whether the surgical method, timing of surgery, basic treatment of AS, and different doses of steroids therapy have an impact on the prognosis. Thus, this study aims to evaluate the impact of perioperative factors on the prognosis of traumatic cervical fractures in surgical patients with AS.

Preoperative and postoperative spinal cord function were assessed according to the Japanese Orthopaedic Association (JOA) Scores and Improvement rate were calculated. The neck pain severity were rated using a visual analogue scale (VAS) reoperative steroid application as soon as possible.

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Retrospective cohort study.

The purpose of this study was to utilize the National Readmission Database to determine the national estimates of complication and 90-day readmission rates associated with cervical spinal fusion in adult patients with rheumatoid arthritis (RA).

RA patients who undergo cervical spine surgery are known to be at high risk for readmissions, which are costly and may not be reimbursed by Medicare.

The National Readmission Database was queried for adults (>18 years) diagnosed with RA undergoing cervical spine fusion. #link# Patient, operative, and hospital factors were assessed in bivariate analyses. Independent risk factors for readmissions were identified using stepwise multivariate logistic regression.

From 2013 to 2014, a total of 5597 RA patients (average age 61.5 ± 11.2 years, 70.9% female) underwent cervical spine fusion. A total of 691 (12.3%) patients were readmitted within 90 days (). Index inpatient complications included dysphagia (readmitted 7.9% vs. non-readmitted 5.1%; P = 0.003), urinary tract infection (UTI) (8.8% vs. 3.7%; P < 0.001), respiratory-related complications (7.6% vs. 3.4%; P < 0.001), and implant-related complications (5.4% vs. 2.7%; P < 0.001). see more demonstrated the following as the strongest independent predictors for 90-day readmission intraoperative bleeding (odds ratio [OR] 3.6, P = 0.001), inpatient Deep Vein Thrombosis (DVT) (OR 4.1, P = 0.004), and patient discharge against medical advice (OR 33.5, P = 0.001).

Readmission rates for RA patients undergoing cervical spine surgery are high and most often due to postoperative infection (septicemia, UTI, pneumonia, wound). Potential modifiable factors which may improve outcomes include minimizing intraoperative blood loses, postoperative DVT prophylaxis, and discharge disposition.

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3.Lung cancer always ranks first in the number of cancer deaths every year, accounting for 18.4% of total cancer deaths in 2018. Metastasis is the main cause of death in lung cancer patients. The identification of bioactive components of traditional Chinese medicine is very important for the development of novel reagents against non-small cell lung cancer (NSCLC). Rosthorin A has originated from Rabdosia rosthornii (Diels) Hara which excerpts from 'Chinese materia medica', and is known to have 'clear heat phlegm' properties in the folk. Little is known about the biological functions and mechanisms of Rosthorin A in cancer cells at present. The role of EMT in metastasis of a tumor cell is self-evident. Slug is an important EMT inducer, which is related to the development of lung cancer. Cell growth, clone assay, cell migration, cell invasion, and protein expression, and NSCLC transplanted tumor growth were performed in A549, H1299, and H1975 cells. Rosthorin A significantly inhibited the growth of NSCLC cells, it could prolong the survival of nude mice. Rosthorin A inhibited the migration and invasion of A549, H1299, and H1975 cells. Rosthorin A up-regulated E-cadherin expression level and down-regulated the expression of β-catenin, N-cadherin, vimentin, Slug, and Twist. Rosthorin A could promote the expression of E-cadherin and inhibit the development of EMT by downregulating Slug, to inhibit the development and metastasis of NSCLC cells. In summary, Rosthorin A could be used as a promising candidate for the treatment of NSCLC patients with recurrence and metastasis.

To demonstrate the efficacy of a protocol combining surgical excision and high-dose-rate brachytherapy for treatment of keloids.

The authors performed a unicentric retrospective cohort study between 2013 and 2018. The minimum follow-up was 12 months. All patients treated for keloids at the authors' institution were included. Extralesional excision was performed with placement of a brachytherapy sheath under the skin. The total dose of irradiation was 18 Gy. The postoperative results were evaluated for aesthetic and functional outcomes with a validated scale, as well as the presence or absence of recurrence.

Fifteen patients were lost to follow-up. Thirty-eight patients with 67 keloids were included. The control rate was 94%. The aesthetic and functional outcomes were considered good in 62% of cases. The main limitation of the study was the small patient population.

Extralesional excision combined with postoperative high-dose-rate brachytherapy seems to be one of the most effective invasive protocols to treat and prevent keloids.

Extralesional excision combined with postoperative high-dose-rate brachytherapy seems to be one of the most effective invasive protocols to treat and prevent keloids.

To explore the treatment of superficial incision dehiscence after abdominal surgery by Z-plasty combined with negative-pressure wound therapy.

A retrospective study was performed on seven patients with superficial abdominal incision dehiscence from October 2018 to February 2019. All patients were given systemic antibiotics and nutrition support. link2 During the first stage, surgical debridement with negative-pressure wound therapy was performed. link3 Local Z-plasty was performed in the second stage.

The incision healed well in all patients, and no infection or necrosis occurred in the flaps. During the follow-up of 7.3 months (range, 5-10 months), no incision rupture or redehiscence occurred.

Surgical debridement, negative-pressure wound therapy, and Z-plasty can be used to treat superficial abdominal incision dehiscence and achieve good therapeutic effect and prognosis. Z-plasty can be used as an alternative to direct suture of incisions because of its simplicity and excellent results.

Surgical debridement, negative-pressure wound therapy, and Z-plasty can be used to treat superficial abdominal incision dehiscence and achieve good therapeutic effect and prognosis. Z-plasty can be used as an alternative to direct suture of incisions because of its simplicity and excellent results.

Conjoined twins are a rare congenital anomaly. If separation of the conjoined organs is feasible, reconstruction of the skin and tissue defects is a challenge for the plastic surgeon. This article describes the use of opposing triangle flaps in the separation of three different kinds of conjoined twins.

Plastic surgeons measured each conjoined area and designated the vertical length as a and the width as b. The length of the base of the opposing triangle flap was calculated to match a, and the height of the triangle to match b.

After detailed calculations and careful surgery, the area of the opposing triangle flaps nearly covered the areas exposed after separation, and the three conjoined twins achieved primary closure of their wounds. The pygopagus and ischiopagus twins recovered uneventfully. The omphalopagus twins developed a wound infection, but after daily wound care, the twins recovered within a week.

With precise calculations, the opposing triangle flap is a feasible and effective method for defect closure after separation of conjoined twins in certain cases. Clinicians may prefer this technique because it avoids the complications and second surgery necessitated by tissue expanders.

With precise calculations, the opposing triangle flap is a feasible and effective method for defect closure after separation of conjoined twins in certain cases. Clinicians may prefer this technique because it avoids the complications and second surgery necessitated by tissue expanders.Stalled healing in chronic wounds is a challenging problem for providers and remains multifactorial in etiology. Older adults with insulin-dependent diabetes are at very high risk. In this case report, two patients with large nonhealing wounds were considered for treatment with daily jet lavage irrigation in an attempt to remove the inflammatory products of their respective chronic wounds and eliminate the persisting biofilm bacteria. Several attempts were made to reduce treatments to two to three times per week, and negative-pressure wound therapy was initiated in both cases only to see the return of inflammation and necrosis of the wound bed. In both cases, the daily jet lavage irrigation was successful in creating a granulating wound bed that slowly healed over many months. One patient died with an open sacral pressure injury, and the other patient died 4 months after complete healing of a large heel pressure injury. The interesting observation is the necessity of daily high-intensity wound irrigation to correct the chronic infectious process. Diabetic chronic wounds in high-risk older adults are recalcitrant to standard wound treatments, and providers should consider daily jet lavage wound irrigation to deal with this problem.

To evaluate the effectiveness of electric stimulation (ES) for diabetic foot ulcer (DFU) treatment.

The authors searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases for randomized clinical trials published through March 2019 that compared the efficacy of ES and standard wound care (SWC) versus SWC alone for DFU treatment. The outcomes were pooled using a random-effects model.

Of the 145 randomized clinical trials initially identified, seven studies (with a total of 274 patients) met the inclusion criteria. The percentage decrease in ulcer area at 4 weeks was significantly greater in patients treated with ES and SWC than SWC alone (standardized mean difference, 1.09; 95% confidence interval, 0.62-1.57; P < .001). The ulcer healing rate at 12 weeks was also significantly faster in the ES group (risk difference, 0.19; 95% confidence interval, 0.06-0.32; P = .005). Subgroup analysis showed comparable efficacies with different waveforms (monophasic vs biphasic).

Electrical stimulation appears to be an effective adjunctive therapy for accelerating DFU healing.

Electrical stimulation appears to be an effective adjunctive therapy for accelerating DFU healing.

The Support Surface Standards Initiative (S3I) has evolved with the goal of standardizing language and performance evaluation of support surfaces. There is a consumer need for education about support surface standards to transfer new information with clinical relevance.

To develop a framework for meaningful dialogue through consensus building that drives value-based purchasing, propose a clinically relevant path for understanding how to apply data from the standards into critical interprofessional analysis and support surface selection, and navigate the first tier of a process targeted as an educational initiative within the Standards Committee.

The authors purposively sampled the S3I Tissue Integrity Group with a semi-structured qualitative survey to identify the essential components of support surfaces standard performance testing. A two-phase interview and review process was implemented within the larger S3I group to achieve consensus on content for knowledge transfer, with a threshold of 80% agreement within the Standards Committee.