Traumatic fractures place a substantial burden on health-care systems worldwide. Although detailed information about incidence, distribution, and risk factors for traumatic fractures is vital for ...planning and prevention, in China, national data are unavailable. We aimed to do an up-to-date national survey on the population-weighted incidence of traumatic fractures in China.
The China National Fracture Study (CNFS) was a retrospective epidemiological study that recruited a nationally representative sample from eight provinces, 24 urban cities, and 24 rural counties in China using stratified random sampling and the probability proportional to size method. All eligible household members who had lived in their current residence for 6 months or longer were personally interviewed by trained research teams about traumatic fractures of the trunk, arms, or legs (not including the skull, sternum, and ribs) that had occurred in 2014. Telephone surveys were used for participants who were non-contactable after repeated visits. Fracture cases were verified by clinical records, medical history, and radiographs by orthopaedic surgeons and radiologists. We estimated incidence rates for traumatic fractures for the overall population and for subgroups by age and sex, as well as by demographic factors such as ethnic origin, occupation, geographical region, and residency category. We also studied potential associations between fractures and various factors of interest, such as age, ethnic origin, education, smoking, alcohol drinking, sleep time per day, and history of previous fracture. Data were weighted during statistical analysis to ascertain the national incidence rate. This study is registered with the Chinese Clinical Trial Registry, number ChiCTR-EPR-15005878.
Between Jan 19, 2015, and May 16, 2015, 535 836 individuals were selected and invited to participate in the study. Questionnaires from 23 649 (4%) individuals were excluded due to missing items, insufficient responses, or logical errors. Following exclusions, 512 187 (96%) individuals participated in the CNFS, consisting of 259 649 (51%) boys and men and 252 538 (49%) girls and women. Of these individuals, 1763 individuals had experienced traumatic fractures during 2014 (n=1833). The population-weighted incidence rate of traumatic fractures of the trunk, arms, or legs was 3·21 (95% CI 2·83–3·59) per 1000 population in 2014 (3·65, 3·12–4·18 in men and 2·75, 2·46–3·04 in women). For all ages, sleeping less than 7 h per day was identified as a risk factor for traumatic fractures. We identified previous fracture history as a risk factor for adults aged 15 years and older. Alcohol consumption incurred a risk effect for men aged 15 years and older and women aged 15–64 years.
Our results provide detailed information about fracture incidence, distribution, and risk factors, which can now be used as an up-to-date clinical evidence base for national health-care planning and preventive efforts in China and elsewhere. Specific public health policies that focus on decreasing alcohol consumption, prohibiting drunk driving, promoting smoking cessation, and encouraging individuals to obtain sufficient sleep and maintain a healthy bodyweight should be urgently implemented to help reduce the risk of traumatic fractures.
The Hebei Province Medical Science Special Major Projects Research Fund.
Microbial degradation of tylosin (TYL) is a safe and environmentally friendly technology for remediating environmental pollution. Kurthia gibsonii (TYL-A1) and Klebsiella pneumonia (TYL-B2) were ...isolated from wastewater; degradation efficiency of the two strains combined was significantly greater than either alone and resulted in degradation products that were less toxic than TYL. With Polyvinyl alcohol (PVA)-sodium alginate (SA)-activated carbon (AC) used to form a bacterial immobilization carrier, the immobilized bacterial alliance reached 95.9% degradation efficiency in 1 d and could be reused for four cycles, with > 93% degradation efficiency per cycle. In a wastewater application, the immobilized bacterial alliance degraded 67.0% TYL in 9 d. There were significant advantages for the immobilized bacterial alliance at pH 5 or 9, with 20 or 40 g/L NaCl, or with 10 or 50 mg/L doxycycline. In summary, in this study, a bacterial consortium with TYL degradation ability was constructed using PVA-SA-AC as an immobilized carrier, and the application effect was evaluated on farm wastewater with a view to providing application guidance in environmental remediation.
Reduced graphene oxide was prepared by reducing graphene oxide with sodium borohydride, sodium molybdate and hydrochloric acid, which exhibited good electrochemical performance.
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Since ...graphene-based materials have shown great potential in many fields, it is important to explore ultrafast and high-efficient methods to synthesize reduced graphene oxide (rGO) using inexpensive reducing agents under mild conditions. Here, we reported a novel method for the ultrafast chemical reduction of graphene oxide (GO) at room temperature using sodium borohydride (NaBH4), sodium molybdate (Na2MoO4) and hydrochloric acid (HCl). The reduction was carried out within 2 min. A series of characterization results revealed that the obtained reduced graphene oxide has higher reduction degree than that synthesized by NaBH4 alone at high temperature. Moreover, rGO electrode based on the present reducing method exhibited a superior specific capacitance of 139.8 F/g at a current density of 1 A/g, indicating that it can be used as electrode materials for supercapacitors.
Tibial plateau fractures are difficult to treat and more likely complicated by subsequent surgical site infection (SSI). There is limited information about its characteristics and related risk ...factors for SSI. This study was designed as a prospective and multicentre one to address this issue. From July to 15 November in 2014, 235 patients with tibial plateau fractures were treated by open reduction and internal fixation (ORIF) and followed up with complete data. Twelve patients (5·1%, 12/235) developed SSI, with 2·1% for deep SSI and 3·0% for superficial SSI. Most of them (10/12) occurred during the hospital stays. The median occurrence time was 6 days after operation (range, 2–26 days). We use univariate and multivariate logistic regression models to investigate the potential risk factors. In the univariate analysis, open fracture, prolonged preoperative stay, smoking habitus and preoperative abnormal neutrophil (NEUT) count were significant risk factors for SSI occurrence. However, in multivariate analysis, only open fracture (OR, 3·31; 95%, 1·06–1·84) and current smoking status (OR, 5·68; 95% CI, 1·56–20·66) remained significant. We recommend that smoking cessation programme is introduced at the time of admission to the hospital and elaborative evaluation of fracture severity and soft‐tissue damage is performed with an aim of reducing the risk of post‐operative SSI.
The aim of this study was to investigate the presence of preoperative DVT following spinal fracture and the association between the presence of DVT and risk factors. Ultrasonography and blood ...analyses were performed preoperatively in patients diagnosed with spinal fracture between October 2014 and December 2018. Univariate analyses were performed on the data of demographics, comorbidities, location of injury, spinal cord injury (SCI) grading and laboratory biomarkers. The receiver operating characteristic (ROC) curve analysis was employed to obtain the optimal D-dimer cut-off value for diagnosis. In total, 2432 patients with spinal fractures were included, among whom 108 (4.4%) patients had preoperative DVTs. The average interval between fracture and initial diagnosis of DVT was 4.7 days (median, 2 days), ranging from 0 to 20 days; 78 (72.2%) were diagnosed within 7 days after injury and 67 (62.0%) within 3 days; 19 (17.5%) patients had proximal vein involved and 89 (82.4%) presented in distal veins. Multivariate logistic regression suggested six risk factors independently correlated to DVT, including delay to DUS (in each day) (odds ratio OR = 1.11), ASA class III-IV (OR = 2.36), ASIA grade (A/B) (OR = 2.36), ALB < 3.5 g/dL (OR = 2.08), HDL-C < 1.1 mmol/L (OR = 1.68) and D-Dimer > 1.08 µg/ml (OR = 2.49).
Nitric oxide (NO) has attracted significant attention as a stellar molecule. Presently, the study of NO has penetrated every field of life science, and NO is widely distributed in various tissues and ...organs. This review demonstrates the importance of NO in both male and female reproductive processes in numerous ways, such as in neuromodulation, follicular and oocyte maturation, ovulation, corpus luteum degeneration, fertilization, implantation, pregnancy maintenance, labor and menstrual cycle regulation, spermatogenesis, sperm maturation, and reproduction. However, the mechanism of action of some NO is still unknown, and understanding its mechanism may contribute to the clinical treatment of some reproductive diseases.
The production of graphene oxide with less acid is beneficial to reduce the costs and lower the impact on the environment, but it is still a great challenge. In this work, a relatively simple, safe ...method for synthesizing graphene oxide with much less acid (decrease ∼40%) is proposed. With assistance of the heat absorbed from environment and reaction system, the temperature of reaction system of low acid can be well controlled. More interestingly, the graphite can be completely oxidized into graphite oxide by using much less acid, with lowering the production of high-concentration aqueous waste acid (> 1 mol/L, decrease ∼40%). A series of characterizations show that the prepared graphene oxide has similar yield and functional groups compared with that of using the conventional method. This work provides a safe and environmentally friendly choice for the large-scale production of graphene oxide and its derivative materials.
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Graphene oxide was synthesized by using much less concentrated sulfuric acid. The graphite can be completely oxidized into graphite oxide, with lowering the production of high-concentration aqueous waste acid (> 1 mol/L, decrease ∼40%).
Background
This study aims to quantitatively summarize risk factors associated with heterotopic ossification after total hip arthroplasty.
Methods
The computerized and additional manual searches were ...performed in Medline, Embase, CNKI, and Cochrane central database (all through March 2014) for potential studies. Studies eligible had to meet the quality assessment criteria by Newcastle–Ottawa Scale and to evaluate the risk factors for heterotopic ossification after total hip arthroplasty. Two reviewers independently extracted the relevant data and any disagreement was solved by consensus. Stata11.0 was used to perform all the statistical analyses.
Results
Fourteen studies involving 6468 cases with total hip arthroplasty and 1939 heterotopic ossification (HOs) (30.0 %) were eligible and included in this meta-analysis. Our meta-analysis identified the significant increased risk factors for HO were male gender odds ratio (OR) 2.11; 95 % confidence interval (CI) 1.80–2.48), cemented implant (OR 1.48; 95 % CI 1.00–2.17), bilateral operations (OR 1.74; 95 % CI 1.24–2.45), ankylosing spondylitis (OR 1.90; 95 % CI 1.07–3.37) and ankylosed hip (OR 9.85; 95 % CI 2.61–37.24). Rheumatoid arthritis was protective for the development of HO (OR 0.51; 95 % CI 0.33–0.80). The other variables including age, use of NSAIDs, femoral neck fracture, previous hip fracture, hypertrophic osteoarthritis and osteophytes were identified not as the risk factors for development of HO (
P
> 0.05).
Conclusion
Patients involved with the above-mentioned medical conditions should be carefully paid close attention by surgeons to reduce HO after total hip arthroplasty.
Level of evidence
Level II, meta-analysis.
Tibetan pigs were thought to have good performances of rough feeding tolerance, which may be related to the gut microbiota. This study was conducted to investigate the changes of colonic microbiota ...contribute to fiber utilization in Tibetan pigs fed alfalfa supplementation diet compared with basal diet, and verified whether the microbial community in Tibetan pigs fed alfalfa diet was beneficial to utilize fiber using
in vitro
fermentation. A total of 40 Tibetan pigs were allocated into two groups and fed with a corn-soybean meal basal diet (CD) or a 50% alfalfa supplementation diet (AD) for 42d. Our results showed pigs fed CD diet improved carcass weight compared to pigs fed AD diet (
p
< 0.05), yet reduced the bacterial diversity (
p
< 0.05). Tibetan pigs fed CD diet increased certain pathogenic bacteria (
Streptococcus
) abundance (FDR < 0.05). Alfalfa consumption increased fiber-degrading bacteria abundance (
UCG-005, Rikenellaceae_RC9_gut_group, Prevotellaceae_UCG-003, Alloprevotella, Marvinbryantia,
and
Anaerovibrio
) in the colonic digesta (FDR < 0.05) and improved concentrations of acetate, propionate, butyrate, and total SCFA in colonic content (
p
< 0.05). Higher fermentation capacity of fecal microbiota from pig fed AD diet was verified by
in vitro
fermentation. Collectively, our results indicated that alfalfa supplementation in diets improved the abundance of fiber-degrading bacteria and SCFA production in the hindgut of Tibetan pig, as well as enhanced the fermentation capacity of fecal microbiota.
The literature lacks population-based epidemiologic studies on the incidence and risk factors for traumatic foot fractures. The purpose of this study was to update information concerning the ...incidence of foot fractures in China and to identify associated risk factors.
All the data on foot fractures were available from the China National Fracture Survey (CNFS), which was conducted between January and May in 2015. A total of 8 provinces, 24 urban cities and 24 rural counties in China were selected, using stratified random sampling and the probability proportional to size method. Individuals who had lived in their current residence for 6 months or longer were personally interviewed about any foot fracture that had occurred in 2014. Questionnaires were completed by every participant for data collection and quality control was accomplished by our research team members. The information included age, gender, height, weight, ethnic group, education, occupation, smoking, alcohol consumption, sleeping time per day, dietary habits and others. Fracture was initially identified by patients' self report and further confirmed by their providing medical records.
A total of 512187 individuals participated in the CNFS. There were 201 patients with foot fractures in 2014. Mean age at the time of fracture was 45.4 years. The incidence rate of foot fractures was 39.2 (95%CI: 33.8-44.7)/100000/year. Fall and traffic accident were the most common causes for foot fractures and over 60% of these occurred at home or on the road. Alcohol consumption, history of previous fracture and average sleep time <7h/d were identified as independent risk factors for foot fractures both in males and females. Cigarette smoking was identified as a significant risk factor for foot fracture in males. For females, BMI >24 kg/m2 was a risk factor whilst living in the west region was associated with a lower incidence rate of foot fracture.
The present study shows an incidence of 39.2/100000/year of foot fractures in China. Specific public health policies focusing on decreasing alcohol consumption and encouraging individuals to obtain sufficient sleep should be implemented. Females with a higher BMI should focus more on foot health care, especially in those with history of previous fracture.
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