extension

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  • 文章类型: Journal Article
    指定的蚕(AntheraeamylittaD.)在Smilipal生物圈保护区(SBR)中发现,由四个生态群组成。这项研究检查了来自四个生态群体的八个民族的遗传学(莫代尔,Nalia,Bogai和Jata)使用RAPD和ISSR标记。RAPD引物产生127条条带,其中116个多态性区域中有41个的PIC值高于0.45。ISSR标记将PIC数据值分配给127个多态性位点中的57个。聚类分析揭示了生态种群之间的遗传差异,用标记将生态种群分成几组。低睾丸和高遗传多样性表明这些个体处于不同的水平。如果没有提供足够的保护,SBR中设计的生态物种灭绝的风险增加。这项研究表明,RAPD+ISSR标记的组合使用可以改善该技术在基因组信息有限的情况下识别不同疾病的结果。
    Designated silkworms (Antheraea mylitta D.) are found in the Smilipal Biosphere Reserve (SBR) and consist of four ecological groups. This study examined the genetics of eight ethnic groups from four ecological groups (Modal, Nalia, Bogai and Jata) using RAPD and ISSR markers. The RAPD primer produced 127 bands, of which 41 out of 116 polymorphic regions had a PIC value above 0.45. ISSR markers assigned PIC data values to 57 of 127 polymorphic sites. Cluster analysis revealed genetic differences between ecological populations, with markers separating ecological populations into groups. Low testicles and high genetic diversity indicate that these individuals are at different levels. If adequate protection is not provided, the risk of extinction of ecospecies designed in SBR increases. This study shows that the combined use of RAPD + ISSR markers can improve the results of the technology in identifying different diseases in situations where genomic information is limited.
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  • 文章类型: Journal Article
    背景:腰椎的生理运动是肌肉骨骼保健专业人员感兴趣的话题,因为异常运动被认为与腰椎不适有关。许多研究人员已经描述了腰椎的运动范围,但是只有少数人提到了屈伸过程中每个节段的特定运动模式,主要包括矢状旋转中的节段起始序列。然而,仍然缺乏对生理运动的适当定义。对于下颈椎,描述了年轻健康个体在屈伸运动中分段贡献的一致模式,从而定义了颈椎的生理运动。
    目的:本研究旨在通过确定健康男性参与者在最大屈伸期间每个椎骨矢状旋转的节段贡献序列来定义腰椎生理运动模式。
    方法:对11名健康男性参与者进行了两次摄影记录,18-25岁,没有脊柱问题的历史,与2周的间隔(时间点T1和T2)。使用图像识别软件通过绘制每个个体片段的片段旋转与片段L1至S1的累积旋转的关系来识别每个个体的片段贡献序列中的特定模式。通过测试T1与T2确定个体间变异性。第二位研究人员通过重新评估30个椎间序列来测试组内相关系数。
    结果:在研究屈曲期间的摄影记录图时,未发现一致的模式。在扩展过程中发现了一个更一致的模式,尤其是在最后阶段。它包括L3L4中的旋转峰值,然后是L2L3中的峰值,最后,在L1L2。该模式存在于所有记录的71%(15/21)中;64%(7/11)的参与者在两个时间点具有一致的模式。腰椎的节段贡献顺序不如颈椎一致,可能是由于刻面方向的差异造成的,椎间盘,骨盆的过度突出,和肌肉招募。
    结论:在64%(7/11)的录音中,在无症状的年轻男性参与者中,在上腰椎伸展的最后阶段发现了一致的运动模式.腰椎生理运动是一个广义的概念,受多种因素影响,这还不能在一个坚定的定义中捕捉到。
    背景:ClinicalTrials.govNCT037227;https://clinicaltrials.gov/ct2/show/NCT037227。
    RR2-10.2196/14741。
    BACKGROUND: Physiological motion of the lumbar spine is a topic of interest for musculoskeletal health care professionals since abnormal motion is believed to be related to lumbar complaints. Many researchers have described ranges of motion for the lumbar spine, but only few have mentioned specific motion patterns of each individual segment during flexion and extension, mostly comprising the sequence of segmental initiation in sagittal rotation. However, an adequate definition of physiological motion is still lacking. For the lower cervical spine, a consistent pattern of segmental contributions in a flexion-extension movement in young healthy individuals was described, resulting in a definition of physiological motion of the cervical spine.
    OBJECTIVE: This study aimed to define the lumbar spines\' physiological motion pattern by determining the sequence of segmental contribution in sagittal rotation of each vertebra during maximum flexion and extension in healthy male participants.
    METHODS: Cinematographic recordings were performed twice in 11 healthy male participants, aged 18-25 years, without a history of spine problems, with a 2-week interval (time point T1 and T2). Image recognition software was used to identify specific patterns in the sequence of segmental contributions per individual by plotting segmental rotation of each individual segment against the cumulative rotation of segments L1 to S1. Intraindividual variability was determined by testing T1 against T2. Intraclass correlation coefficients were tested by reevaluation of 30 intervertebral sequences by a second researcher.
    RESULTS: No consistent pattern was found when studying the graphs of the cinematographic recordings during flexion. A much more consistent pattern was found during extension, especially in the last phase. It consisted of a peak in rotation in L3L4, followed by a peak in L2L3, and finally, in L1L2. This pattern was present in 71% (15/21) of all recordings; 64% (7/11) of the participants had a consistent pattern at both time points. Sequence of segmental contribution was less consistent in the lumbar spine than the cervical spine, possibly caused by differences in facet orientation, intervertebral discs, overprojection of the pelvis, and muscle recruitment.
    CONCLUSIONS: In 64% (7/11) of the recordings, a consistent motion pattern was found in the upper lumbar spine during the last phase of extension in asymptomatic young male participants. Physiological motion of the lumbar spine is a broad concept, influenced by multiple factors, which cannot be captured in a firm definition yet.
    BACKGROUND: ClinicalTrials.gov NCT03737227; https://clinicaltrials.gov/ct2/show/NCT03737227.
    UNASSIGNED: RR2-10.2196/14741.
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  • 文章类型: Journal Article
    背景:虽然PRISMA2020声明旨在指导原始系统评价的报告,更新的系统评价,和实时系统评价(LSR),其解释和阐述文件指出,可能需要解决更新的系统审查和LSR的其他考虑因素。本文报告了为LSR开发PRISMA2020声明扩展的协议。方法:我们将遵循EQUATOR网络的指导制定健康研究报告指南。我们将回顾文献,以确定PRISMA2020清单中需要修改的可能项目,以及需要添加的新项目。然后,我们将调查不同利益相关方团体的代表,了解他们对PRISMA2020清单拟议修改的意见。我们将总结,present,并在网上会议上讨论调查结果,旨在就LSR扩展的内容达成共识。然后我们将起草清单,每个项目的解释和阐述,和PRISMA2020扩展的流程图。然后,我们将与利益相关者代表分享这些初始文件,以获得最终反馈和批准。讨论:我们预计针对LSR的PRISMA2020扩展将使LSR作者受益,编辑,和LSR的同行评审员,以及LSR的不同用户,包括指南开发人员,政策制定者,医疗保健提供者,病人,和其他利益相关者。
    Background: While the PRISMA 2020 statement is intended to guide the reporting of original systematic reviews, updated systematic reviews, and living systematic reviews (LSRs), its explanation and elaboration document notes that additional considerations for updated systematic reviews and LSRs may need to be addressed. This paper reports the protocol for developing an extension of the PRISMA 2020 statement for LSRs. Methods: We will follow the EQUATOR Network\'s guidance for developing health research reporting guidelines. We will review the literature to identify possible items of the PRISMA 2020 checklist that need modification, as well as new items that need to be added. Then, we will survey representatives of different stakeholder groups for their views on the proposed modifications of the PRISMA 2020 checklist. We will summarize, present, and discuss the results of the survey in an online meeting, aiming to reach consensus on the content of the LSR extension. We will then draft the checklist, explanation and elaboration for each item, and flow diagram for the PRISMA 2020 extension. Then, we will share these initial documents with stakeholder representatives for final feedback and approval. Discussion: We anticipate that the PRISMA 2020 extension for LSRs will benefit LSR authors, editors, and peer reviewers of LSRs, as well as different users of LSRs, including guideline developers, policy makers, healthcare providers, patients, and other stakeholders.
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  • 文章类型: Journal Article
    本研究旨在确定这一现状,决定因素,以及农民采用气候智能型畜牧业生产实践的挑战。采用三阶段抽样技术选择研究地点和233个样本农户受访者。数据主要使用预先测试的结构化问卷收集。还进行了关键的线人访谈和焦点小组讨论,以补充家庭调查数据。描述性统计和有序逻辑回归模型用于分析定量数据。结果表明,采用最多的做法是堆肥(85.41%)和粪肥管理(70.39%),而采用最少的技术是沼气生产(3.86%)和轮作放牧(22.32%)。抽样农民的收养状况也被归类为低(19.74%),中等(67.81%),和高采纳者(12.45%)。良种成本高,使用粪肥作燃料,自由放牧,缺乏信息和意识是采用气候智能型牲畜生产技术的主要制约因素。结果还表明,教育,放牧的土地,总牲畜饲养量,和推广代理接触对智能牲畜生产技术的采用做出了显著和积极的贡献,而与水源的距离对气候智能型牲畜生产实践的采用状况影响不大,并且具有负面影响。该研究表明,利益相关者的合作和加强推广服务对于气候智能型畜牧业生产的最大利益具有重要意义。
    This study aimed to identify the status, determining factors, and challenges in adopting climate smart livestock production practices by farmers. Three-staged sampling techniques were used to select the research sites and 233 sample farmer household respondents. Data were collected mainly using a pre-tested structured questionnaire. Key informant interviews and focus group discussions were also conducted to complement the household survey data. Descriptive statistics and an ordered logistic regression model were applied to analyze the quantitative data. The result revealed that the most adopted practices were composting (85.41%) and manure management (70.39%) while the least adopted technologies were biogas generation (3.86%) and rotation grazing (22.32%). The adoption status of the sampled farmers was also categorized into low (19.74%), medium (67.81%), and high adopter (12.45%). The high cost of improved breed, use of manure for fuel, free grazing, lack of information and awareness were the major constraints to adopting the climate smart livestock production technologies. The result also revealed that education, grazing land, total livestock holding, and extension agent contact contributed significantly and positively to the adoption of smart livestock production technology, while the distance from the water source had an insignificant and negative effect on the adoption status of climate smart livestock production practices. The study suggests the relevance of the cooperation of stakeholders and strengthening extension services for the maximum benefits of climate smart livestock production.
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  • 文章类型: Journal Article
    腰肌包括手部的4个固有肌肉,并且涉及掌指关节(MCPJ)的屈曲和近端指间和远端指间关节的伸展。本研究的目的是探讨该指标的腰椎肌的解剖学力学,中间,戒指,和小手指。
    我们评估了25具尸体手臂,并测量了MCPJ与指尖之间的距离,MCPJ和腰肌之间的距离,以及MCPJ和最近端腰椎肌起源之间的距离。通过这些测量,我们计算了所需的力,插入比(近端长度,中间,和远端指骨除以MCPJ到插入距离),和肌肉长度。
    我们发现所有手指之间的力明显不同,除了食指和无名指的比较(P=.34)。此外,我们发现大多数手指之间的肌肉长度明显不同,除了食指和中指之间的比较(P=0.24),食指和无名指(P=.20)。插入率无显著差异。
    我们的研究表明,所有手指的腰肌运动功能的解剖学力学相似。这可能进一步意味着所有手指的运动都同样精确,从而导致彼此协调,因此,足够的手功能。
    IV.
    UNASSIGNED: The lumbrical muscles comprise 4 intrinsic muscles of the hand and are involved in flexion of the metacarpophalangeal joint (MCPJ) and extension of the proximal interphalangeal and distal interphalangeal joints. The purpose of this study was to investigate the anatomical mechanics of the lumbrical muscles of the index, middle, ring, and small fingers.
    UNASSIGNED: We evaluated 25 cadaver arms and measured the distance between the MCPJ and fingertip, the distance between the MCPJ and lumbrical muscle insertion, and the distance between the MCPJ and the most proximal lumbrical muscle origin. With these measurements we calculated the needed force, insertion ratio (length of the proximal, middle, and distal phalanx divided by the MCPJ to insertion distance), and lumbrical muscle length.
    UNASSIGNED: We found that the force was significantly different between all fingers, except for the comparison of the index and ring finger (P = .34). In addition, we found that muscle length was significantly different between most the fingers, except for the comparison between the index and middle fingers (P = .24), and index and ring fingers (P = .20). There was no significant difference in insertion ratio.
    UNASSIGNED: Our study suggests that the anatomical mechanics for the motor function of the lumbrical muscles are similar in all fingers. This could further imply that movements are equally precise in all fingers resulting in coordination with one another and, therefore, adequate hand function.
    UNASSIGNED: IV.
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  • 文章类型: Journal Article
    可以使用不同的内镜评分系统来评估溃疡性结肠炎(UC)的严重程度。然而,大多数与疾病程度无关。
    我们的研究旨在比较PanMay评分与内镜Mayo(MES)的预测价值,溃疡性结肠炎内镜严重程度指数(UCEIS),和都柏林评分在预测UC长期结局中的作用。
    这项回顾性研究纳入了至少3年随访前接受结肠镜检查的连续UC患者。
    PanMayo,MES,UCEIS,对参与者的Dublin评分和基线临床和人口统计学特征进行评估.终点是需要新型生物治疗的疾病发作,结肠切除术,和住院。使用基线临床活动对患者进行分层。
    250名患者中大约62.8%处于临床缓解期。在这些患者中,PanMayo,MES,都柏林评分与临床耀斑风险呈正相关。MES评分随临床发作而增加。PanMayo得分(>12分),但不是MES得分,与需要新的生物启动和生物升级有关。此外,需要新型生物治疗的缓解期患者的Dublin和UCEIS评分趋势相似.结肠切除术风险与PanMayo和Dublin评分相关。
    联合内镜评估疾病范围和严重程度可以更准确地预测UC患者的预后。除了现有的评分系统外,还可以使用PanMayo评分,从而导致更准确的检查。
    UC内镜评分不评估延伸性。我们的研究旨在分析PanMayo评分的预测价值。根据250名患者,结果表明,PanMayo评分可以更准确地预测UC的长期疾病结局。
    UNASSIGNED: Different endoscopic scoring systems for assessing ulcerative colitis (UC) severity are available. However, most of them are not correlated with disease extent.
    UNASSIGNED: Our study aimed to compare the predictive value of the PanMay score versus the endoscopic Mayo (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and Dublin score in predicting long-term outcomes of UC.
    UNASSIGNED: This retrospective study enrolled consecutive UC patients who underwent colonoscopy before at least a 3-year follow-up.
    UNASSIGNED: The PanMayo, MES, UCEIS, and Dublin scores and the baseline clinical and demographic characteristics of the participants were assessed. Endpoints were disease flare that required novel biological therapy, colectomy, and hospitalization. Patients were stratified using baseline clinical activity.
    UNASSIGNED: Approximately 62.8% of the 250 enrolled patients were in clinical remission. In these patients, the PanMayo, MES, and Dublin scores were positively associated with the risk of clinical flare. The MES score increased with clinical flare. The PanMayo score (>12 points), but not the MES score, was associated with the need for novel biological initiation and biological escalation. Furthermore, the Dublin and UCEIS scores of patients in remission who need novel biological treatment had a similar trend. Colectomy risk was associated with PanMayo and Dublin scores.
    UNASSIGNED: The combined endoscopic assessment of disease extent and severity can be more accurate in predicting outcomes among patients with UC. PanMayo score can be utilized in addition to the existing scoring systems, thereby leading to a more accurate examination.
    UNASSIGNED: UC endoscopic scores do not assess extension. Our study aimed to analyze the predictive value of the PanMayo score. Based on 250 patients, results showed that the long-term disease outcomes of UC could be predicted with the PanMayo score more accurately.
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  • 文章类型: Journal Article
    创建SPIRIT-TCM扩展2018是为了指导中药(TCM)临床试验方案的设计和报告。本研究旨在调查癌症护理研究相关领域与该指南的一致性程度。
    对2019年1月以来以中英文发表的中医癌症试验方案进行范围审查。五大学术数据库(MEDLINE,EMBASE,CINAHL,中部,和中国国家知识基础设施)进行了搜索。通过描述性分析评估与2018年SPIRIT-TCM扩展的一致性。
    确定了53项中医癌症治疗试验方案,包括23个针灸,26中草药(CHM),和4个太极拳/气功(TCQ)干预措施。大多数清单项目的一致性较低,特别是在质量控制和安全报告方面,剂量,中医诊断模式,西医和中医干预之间可能的相互作用,和中医相关的结果评估。
    尽管SPIRIT-TCMExtension2018指南是通过广泛的Delphi咨询制定的,已发表的中医癌症治疗临床试验方案与指南的一致性较低.进一步的研究是必要的,以了解低的协调率和如何科学的报告可以提高在中医癌症护理研究。
    UNASSIGNED: The SPIRIT-TCM Extension 2018 was created to guide the design and reporting of Traditional Chinese Medicine (TCM) clinical trial protocols. This study aims to investigate the extent of concordance with this guideline in the relevant field of cancer care research.
    UNASSIGNED: A scoping review of TCM cancer trial protocols published in English and Chinese since January 2019 was conducted. Five major academic databases (MEDLINE, EMBASE, CINAHL, CENTRAL, and China National Knowledge Infrastructure) were searched. Concordance with the SPIRIT-TCM Extension 2018 was assessed by descriptive analysis.
    UNASSIGNED: Fifty-three TCM cancer care trial protocols were identified, comprising 23 acupuncture, 26 Chinese herbal medicine (CHM), and 4 Tai Chi/Qigong (TCQ) interventions. The majority of the checklist items had a low rate of concordance, especially in the reporting of quality control and safety, dosage, TCM diagnostic patterns, possible interactions between Western Medicine and TCM interventions, and TCM-related outcome assessments.
    UNASSIGNED: Although the SPIRIT-TCM Extension 2018 guideline was established through extensive Delphi consultation, there are low rates of concordance between published TCM cancer care clinical trial protocols with the guideline. Further research is necessary to understand the low rate of concordance and how scientific rigors of reporting can be improved in TCM cancer care research.
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  • 文章类型: Journal Article
    大量的研究人员和从业人员的工作集中在为养蜂中的寄生Varroa破坏螨开发新的化学控制方法上。其中一个结果是开发和测试“甘油-草酸”混合物,以长时间放置在菌落中,标签外使用其他合法杀螨剂草酸。关于这种方法的大多数分发工作是由从业人员领导的,并在非学术期刊上发表。强调从业人员和科学家之间缺乏有效的伙伴关系,以及美国养蜂的延期任务可能失败。这里,我们总结了从业者主导的研究,我们可以找到并与美国东南部的商业养蜂人合作,以测试这些从业者开发的“毛巾-草酸-甘油”输送系统。我们的研究,使用2017年蜂蜜流之间的129个商业菌落,分为4个治疗组,在暴露于草酸-甘油商店毛巾的菌落中,没有减少Varroa寄生的效果。我们强调我们的结果与从业者分发的结果之间的差异,至少在东南部,以及未能扩展到支持从事研究的从业者。
    A significant amount of researcher and practitioner effort has focused on developing new chemical controls for the parasitic Varroa destructor mite in beekeeping. One outcome of that has been the development and testing of \"glycerol-oxalic acid\" mixtures to place in colonies for extended periods of time, an off-label use of the otherwise legal miticide oxalic acid. The majority of circulated work on this approach was led by practitioners and published in nonacademic journals, highlighting a lack of effective partnership between practitioners and scientists and a possible failure of the extension mandate in beekeeping in the United States. Here, we summarize the practitioner-led studies we could locate and partner with a commercial beekeeper in the Southeast of the United States to test the \"shop towel-oxalic acid-glycerol\" delivery system developed by those practitioners. Our study, using 129 commercial colonies between honey flows in 2017 split into 4 treatment groups, showed no effectiveness in reducing Varroa parasitism in colonies exposed to oxalic acid-glycerol shop towels. We highlight the discrepancy between our results and those circulated by practitioners, at least for the Southeast, and the failure of extension to support practitioners engaged in research.
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  • 文章类型: Journal Article
    在美国对农业伤害和死亡进行监测一直是一个持续的挑战,许多病例超出了国家和地方监测系统的标准。在这项研究中,捕获-再捕获分析用于估算2016年至2020年印第安纳州致命农业伤害的数量.还提供了非致命伤害的有限分析。此分析是可能的,因为两个公开可用的数据集包含事件描述,并具有足够的案例匹配细节。第一个数据集包括PurdueExtension发布的年度农业死亡报告中发布的印第安纳州致命和非致命农业伤害摘要列表。第二个数据源是AgInjuryNews,收集新闻媒体和其他公开来源发布的农业伤害和死亡报告。捕获-再捕获分析的结果估计,每年在印第安纳州,普渡大学延期错过了18%的致命事件,而AgInjuryNews错过了大约60%。AgInjuryNews每年约有3起致命事件被普渡大学扩展所遗漏。非致命事件的分析受到以下事实的限制:两个数据源仅包括极其严重和/或与死亡有关的非致命伤害。普渡大学扩建计划估计会错过22%,而AgInjuryNews估计会错过25%的非致命性农业伤害,符合该狭窄定义。虽然捕获-再捕获分析仅提供真实伤害率的估计,这些结果提供了证据,表明普渡大学的监测记录了该州大多数农业死亡人数。AgInjuryNews已经能够识别普渡大学遗漏的案件,这项研究在量化此数据源中发现的媒体报道与扩展监视有何不同方面迈出了重要的一步。这项研究还强调了非致命伤害监测的持续局限性,以及公开数据可以帮助研究人员填补监测空白的方式。
    Conducting surveillance of agricultural injuries and fatalities in the United States has been an ongoing challenge, with many cases falling outside the criteria of national and local surveillance systems. In this research, capture-recapture analysis was used to estimate the number of fatal agricultural injuries in Indiana between 2016 and 2020. A limited analysis of non-fatal injuries is also provided. This analysis was possible because of two publicly available datasets containing incident descriptions with sufficient detail for case matching. The first dataset consisted of summary lists of fatal and nonfatal agricultural injuries in Indiana published in annual agricultural fatality reports produced by the Purdue Extension. The second data source was AgInjuryNews, which gathers reports of agricultural injuries and fatalities published in news media and other publicly available sources. Results of the capture-recapture analysis estimate that, every year in Indiana, the Purdue Extension misses 18% of fatal incidents and AgInjuryNews misses approximately 60%. AgInjuryNews identifies approximately 3 fatal incidents per year that are missed by Purdue Extension. Analysis of nonfatal incidents was limited by the fact that both data sources only included nonfatal injuries that were extremely severe and/or connected to a fatality. The Purdue Extension is estimated to miss 22% and AgInjuryNews is estimated to miss 25% of nonfatal agricultural injuries meeting that narrow definition. While capture-recapture analysis only provides estimates of true injury rates, the results provide evidence that Purdue Extension\'s surveillance captures most agricultural fatalities in the state. AgInjuryNews has been able to identify cases missed by Purdue, and this research takes an important step forward in quantifying how media reports found in this data source differ from extension surveillance. This research also highlights the continuing limitations in the surveillance non-fatal injuries and the ways in which publicly available data can aid researchers in filling gaps in surveillance.
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  • 文章类型: Journal Article
    肱骨干骨折是骨科医生治疗的常见损伤。这项研究的目的是评估移位的肱骨干骨干骨折,并描述与非移位或最小移位的骨折线延伸到肱骨近端干骨干区域的发生率和特征。
    所有肱骨干骨干骨折位于肱骨干远端三分之二的成人患者,在2007年至2020年期间在单一一级创伤机构接受治疗,进行了回顾性鉴定。包括202例肱骨干骨折203例。根据AO/OTA分类对骨折类型进行分类,并在X线片上评估骨折线延伸到近端骨干处区域。患者人口统计学,管理细节,和影像学结果来自电子病历的审查.
    203例肱骨干骨干骨折,11.8%(n=24)的主要骨折线未移位或移位最小。这包括所有近端第三交界骨干骨干骨折的43.7%(n=7),10.7%(n=16)的所有中段骨干骨折,和所有远端第三骨干骨折的2.6%(n=1)。近端骨折延伸的患者,平均而言,老年人(61.7岁对44.4岁,p<0.001),女性比例更高(75%对45.5%,p<0.01)与无骨折近端延伸的患者相比。近端延伸骨折均为闭合性骨折(n=24),更常见的是低能量下降(87.5%对35.2%,p<0.001),更常见的是螺旋型骨折(62.5%对17.2%)。近端延伸骨折更常非手术治疗(58.3%对42.1%,p<0.01),但发现非手术治疗后的骨不连发生率(17.6%对8.1%)高于没有近端延伸的骨折.所有经手术治疗的近端干phy端延伸骨折均用固定结构固定,以实现近端骨折线范围的固定。最常进入肱骨头和颈部。对于骨不连的患者,还进行了肱骨头近端固定的手术管理,包括近端延伸线的持续透明度,在非手术治疗失败后。平均随访时间为35.5周(范围:0-607周)。
    在肱骨干骨干骨折的情况下,近端骨折线延长并不少见。在计划手术治疗这些损伤时,检测和考虑这种有时微妙的发现很重要。
    UNASSIGNED: Humeral shaft fractures are common injuries treated by orthopaedic surgeons. The purpose of this study is to evaluate displaced diaphyseal humerus fractures and describe the incidence and characteristics associated with non or minimally displaced fracture line extension into the proximal metadiaphyseal region of the humerus.
    UNASSIGNED: All adult patients with diaphyseal humeral shaft fractures located within the distal two-thirds of the humeral shaft, treated at a single level I trauma institution between 2007 and 2020, were retrospectively identified. 202 patients with 203 fractures of the humeral shaft were included. Fracture patterns were classified according to AO/OTA classification and fracture line extension into the proximal metadiaphyseal region was evaluated on radiographs. Patient demographics, management details, and radiographic outcomes were obtained from review of the electronic medical record.
    UNASSIGNED: Of 203 diaphyseal humerus fractures, 11.8 % (n = 24) had non or minimally displaced proximal extension of their main fracture line. This included 43.7 % (n = 7) of all proximal third junction diaphyseal fractures, 10.7 % (n = 16) of all middle third diaphyseal fractures, and 2.6 % (n = 1) of all distal third diaphyseal fractures. Patients with proximal fracture extension were, on average, older (61.7 versus 44.4 years, p < 0.001), and a higher percentage were female (75 % versus 45.5 %, p < 0.01) compared to patients without fracture proximal extension. Fractures with proximal extension were all closed fractures (n = 24), were more often sustained from low-energy fall (87.5 % versus 35.2 %, p < 0.001), and were more often spiral type fractures (62.5 % versus 17.2 %). Fractures with proximal extension were more often treated non-operatively (58.3 % versus 42.1 %, p < 0.01), but were found to have a higher rate of nonunion after non-operative treatment (17.6 % versus 8.1 %) compared to fractures without proximal extension. All operatively treated fractures that had proximal metaphyseal extension were secured with a fixation construct to achieve fixation proximal to the extent of the fracture line, most often into the humeral head and neck. Operative management with proximal fixation into the humeral head was also pursued for a patient with nonunion, including persistent lucency of the proximal extension line, after failed non-operative treatment. Mean follow-up was 35.5 weeks (range: 0-607 weeks).
    UNASSIGNED: Proximal fracture line extension in the setting of diaphyseal humerus fractures is not uncommon. Detection and consideration of this sometimes subtle finding is important when planning to treat these injuries operatively.
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