Abstract Background: immunonutrition has been introduced and proposed to have positive modulating effects on inflammatory and immune responses in surgical patients. This meta-analysis aimed to assess whether perioperative enteral immunonutrition (EIN) can reduce postoperative complications or reduce inflammatory responses in esophageal cancer (EC) patients undergoing esophagectomy. Methods: PubMed, Embase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of EIN before and/or after surgery in EC patients undergoing esophagectomy were identified. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Results: ten RCTs involving 1,052 patients were included in the meta-analysis, including 573 patients in the EIN group and 479 patients in the enteral nutrition (EN) group. Overall, no significant difference was observed between the two groups in the incidence of postoperative pneumonia, surgical site infection, intra-abdominal abscess, septicemia, and urinary tract infection. No significant incidence of postoperative anastomotic leakage, acute respiratory distress syndrome (ARDS), and in-hospital mortality was found. Conclusions: perioperative enteral immunonutrition did not reduce the incidence of infectious complications and anastomotic leakage in EC patients undergoing esophagectomy, nor did it reduce postoperative CRP and IL-6, but did not increase in-hospital mortality.

Resumen Antecedentes: se ha introducido y propuesto la inmunonutrición para regular activamente la inflamación y la respuesta inmune en pacientes quirúrgicos. El presente metaanálisis fue diseñado para evaluar si la inmunonutrición enteral perioperatoria (EIN, por sus siglas en inglés) puede reducir las complicaciones postoperatorias o la inflamación en pacientes con cáncer de esófago (CE) sometidos a esofagectomía. Métodos: se realizó una búsqueda sistemática en las bases de datos de PubMed, Embase, Web of Science, EBSCO y Cochrane Library. Se evaluó el efecto de la EIN preoperatoria y/o postoperatoria en un ensayo aleatorizado controlado (RCT) en pacientes con cáncer de esófago sometidos a esofagectomía. Dos investigadores buscaron independientemente artículos, extrajeron datos y evaluaron la calidad de los artículos incluidos. Resultados: el metanálisis incluyó diez ensayos controlados aleatorios en los que participaron 1.052 pacientes, de los cuales 573 fueron incluidos en el grupo EIN y 479, en el grupo de nutrición enteral (NE). En general, no hubo diferencia significativa en la incidencia de neumonía postoperatoria, infección del sitio quirúrgico, absceso intraperitoneal, sepsis e infección del tracto urinario entre los dos grupos. No hubo diferencia significativa en la incidencia de fístula anastomótica postoperatoria, síndrome de distrés respiratorio agudo (SDRA) y mortalidad hospitalaria. Conclusión: la inmunonutrición enteral perioperatoria no puede reducir la incidencia de complicaciones infecciosas postoperatorias y fístulas anastomóticas, ni la PCR postoperatoria ni la IL-6. Pero no aumentó la mortalidad hospitalaria.

Abstract Objectives: Abdominal Aortic Aneurysm (AAA) is a complex disease with both genetic and environmental risk factors. This study aimed to examine the potential association of the +276G/T and −420C>G polymorphisms in the resistin gene with AAA susceptibility and progression. Method: We performed a retrospective study involving AAA patients and healthy controls, assessing the distribution of the +276G/T and −420C>G genotypes in both groups. Hardy-Weinberg equilibrium was assessed for both polymorphisms. Logistic regression was used to explore the influence of these genotypes on AAA occurrence and progression, adjusting for relevant confounders. Results: The distribution of +276G/T polymorphism did not significantly differ between AAA patients and controls. Conversely, a significant difference was observed in the genotype distribution of −420C>G polymorphism between the two groups. The CC genotype and CC/CG genotypes of −420C>G polymorphism were found to be associated with an increased risk and progression of AAA. Conclusions: The −420C>G polymorphism, particularly the CC genotype and CC/CG genotypes, might play a substantial role in AAA susceptibility and progression. The present findings underscore the need for further investigations to confirm these associations and fully elucidate the role of the resistin gene in AAA. Objectives (AAA factors 276GT GT 276G T G 420CG CG 420C C Method controls groups HardyWeinberg Hardy Weinberg confounders Results Conversely CCCG Conclusions

RESUMO Introdução A lesão esportiva é uma lesão comum entre os tenistas profissionais, em comparação com outros esportes. Métodos atualizados de reabilitação podem acelerar a recuperação dos jogadores e garantir um retorno à atividade esportiva. Porém o monitoramento das práticas de reabilitação contemporâneas carece de relatórios atualizados. Objetivo Explorar o monitoramento da função e métodos de recuperação dos jogadores de tênis durante o treinamento de reabilitação após uma lesão. Métodos O tenista foi submetido a capsulotomia artroscópica da articulação do tornozelo esquerdo, remoção de corpo livre e sinovectomia. Foram monitorados a composição corporal do atleta, rotina sanguínea, bioquímica sanguínea, indicadores nutricionais e indicadores fisiológicos. Esses dados foram coletados antes, durante e ao final dos 4 meses (6-10 meses) de reabilitação após a operação. Resultados 1 mês após a operação, o peso e a massa magra diminuíram significativamente, aumentando a porcentagem de gordura corporal; o ritmo cardíaco estático aumentou significativamente (P<0,05). 3 meses após a cirurgia, a massa magra do atleta aumentou significativamente para 43,7 kg, a porcentagem de gordura corporal caiu para 24,5% (P<0,05); a hemoglobina, o ferro sérico, a proteína total e a albumina melhoraram. Na reabilitação durante o mês de outubro, a rotina sanguínea e os índices bioquímicos do sangue foram normais; a frequência cardíaca em repouso, com carga mantida e de recuperação diminuiu significativamente (P<0,05). Conclusão Os tenistas devem começar o monitoramento das funções, treinamento de reabilitação e recuperação nutricional o mais rápido possível após uma cirurgia na articulação do tornozelo. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

ABSTRACT Introduction Sports injury is a common injury among professional tennis players compared to other sports. Updated rehabilitation methods can accelerate players’ recovery and ensure a return to sporting activity. However, contemporary rehabilitation monitoring practices want updated reporting. Objective Monitoring tennis players’ function and recovery methods during rehabilitation training after injury. Methods The tennis player underwent arthroscopic capsulotomy of the left ankle joint, free body removal, and synovectomy. The athlete’s body composition, blood routine, biochemistry, nutritional indices, and physiological indicators were monitored. Data were collected before, during, and at the end of the four months (6-10 months) of rehabilitation after the operation. Results 1 month after the operation, weight and lean mass decreased significantly; body fat percentage increased; static heart rate increased significantly (P<0.05). Three months after surgery, the athlete’s lean mass increased significantly to 43.7 kg; body fat percentage decreased to 24.5% (P<0.05); hemoglobin, serum iron, total protein, and albumin improved; in rehabilitation during October, blood routine and biochemical blood indices were regular; Resting, maintained-load and recovery heart rate decreased significantly (P<0.05). Conclusion Tennis players should begin function monitoring, rehabilitation training, and nutritional recovery as soon as possible after ankle joint surgery. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMEN Introducción La lesión deportiva es una lesión común entre los tenistas profesionales en comparación con otros deportes. Los métodos de rehabilitación actualizados pueden acelerar la recuperación de los jugadores y garantizar la vuelta a la actividad deportiva. Sin embargo, el seguimiento de las prácticas contemporáneas de rehabilitación carece de informes actualizados. Objetivo Explorar el seguimiento de la función y los métodos de recuperación de los tenistas durante el entrenamiento de rehabilitación después de una lesión. Métodos El tenista fue sometido a una capsulotomía artroscópica de la articulación del tobillo izquierdo, a la extracción del cuerpo libre y a la sinovectomía. Se controló la composición corporal del atleta, la rutina sanguínea, la bioquímica sanguínea, los indicadores nutricionales y los indicadores fisiológicos. Estos datos se recogieron antes, durante y al final de los 4 meses (6-10 meses) de rehabilitación tras la operación. Resultados 1 mes después de la operación, el peso y la masa magra disminuyeron significativamente, aumentando el porcentaje de grasa corporal; la frecuencia cardíaca estática aumentó significativamente (P<0,05). 3 meses después de la operación, la masa magra de la atleta aumentó significativamente hasta 43,7 kg, el porcentaje de grasa corporal disminuyó hasta el 24,5% (P<0,05); la hemoglobina, el hierro sérico, la proteína total y la albúmina mejoraron. En el periodo de entrenamiento de rehabilitación en el mes de octubre, la rutina sanguínea y los índices bioquímicos sanguíneos fueron normales; la frecuencia cardíaca en reposo, con carga mantenida y en recuperación disminuyó significativamente (P<0,05). Conclusión Los jugadores de tenis deben comenzar el control de la función, el entrenamiento de rehabilitación y la recuperación nutricional lo antes posible después de la cirugía de la articulación del tobillo. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

ABSTRACT Sarcopenia, a concept reflecting the loss of skeletal muscle mass, was reported to be associated with the prognosis of several tumors. However, the prognostic value of sarcopenia in patients with renal cancer remains unclear. We carried out this metaanalysis and systematic review to evaluate the prognostic value of sarcopenia in patients with renal cell carcinomas. We comprehensively searched PubMed, Embase, and Cochrane Library from inception to December 2018. Hazard ratio (HR) and 95% confidence interval (CI) were pooled together. A total of 5 studies consisting of 771 patients were enrolled in this quantitative analysis, 347 (45.0%) of which had sarcopenia. Patients with sarcopenia had a worse OS compared with those without sarcopenia (HR=1.76; 95%CI, 1.35-2.31; P <0.001). In the subgroup of patients with localized and advanced/metastatic diseases, sarcopenia was also associated with poor OS (HR=1.48, P=0.039; HR=2.14, P <0.001; respectively). With a limited sample size, we did not observe difference of PFS between two groups (HR=1.56, 95% CI, 0.69-3.50, P=0.282). In the present meta-analysis, we observed that patients with sarcopenia had a worse OS compared with those without sarcopenia in RCC. Larger, preferably prospective studies, are needed to confirm and update our findings.

This work reports the formation of nanoprous Pd with tunable pore size and high stability by dealloying Pd30Cu40Ni10P20 metallic glass. The results show that lower dealloying temperature results in smaller pore size while the dealloying duration does not cause distinct change in the porous structure, even at an ambient dealloying temperature. The glassy structure and the multiple components in the precursor alloy are attributed to the hindered diffusion of Pd atoms and a slow coarsening rate of the nanoprous structure. The fully dealloyed porous sample with the smallest average pores size of 10 nm exhibit much higher catalytic activity when compare with the commercial Pd/C catalysts while the specimen with an average pores size of 13 nm shows the highest catalytic stability among the fully dealloyed alloys.

ABSTRACT Objective: miR-483-5p has been identified as a miRNA oncogene in certain cancers. However, its role in prostate cancer has not been sufficiently investigated. In this study, we investigated the role of miR-483-5p in prostate cancer and examined RBM5 regulation by miR-483-5p. Material and methods: Expression levels of miR-483-5p were determined by quantitative real-time PCR. The effect of miR-483-5p on proliferation was evaluated by MTT assay, cell invasion was evaluated by trans-well invasion assays, and target protein expression was determined by western blotting in LNCaP, DU-145, and PC-3 cells. Luciferase reporter plasmids were constructed to confirm the action of miR-483-5p on downstream target gene RBM5 in HEK-293T cells. Results: we observed that miR-483-5p was upregulated in prostate cancer cell lines and tissues. A miR-483-5p inhibitor inhibited prostate cancer cell growth and invasion in DU-145 and PC-3 cells. miR-483-5p directly bound to the 3' untranslated region (3'UTR) of RBM5 in HEK-293T cells. RBM5 overexpression inhibited prostate cancer cell growth and invasion in LNCaP cells. Enforced RBM5 expression alleviated miR-483-5p promotion of prostate cancer cell growth and invasion in LNCaP cells. Conclusion: The present study describes a potential mechanism underlying a miR-483-5p/RBM5 link that contributes to prostate cancer development.

This study investigated the effects of visfatin on the structure and the immunity levels in the small intestine of LPS-induced rats. Forty Wistar male and female SPF rats were randomly and equally divided into four groups: the saline (control), vistfatin, lipopolysaccharide (LPS), and visfatin+LPS co-stimulated. The functions of visfatin in the intestinal mucosal immunity were investigated by examining the variation of tissue structure, inflammation and immunity-related proteins in the intestine of immunologically stressed rats using HE staining, ELISA, immunohistochemistry and Western Blot. The results showed that, when compared with the control group, the visfatin-treated group showed a decrease in the intestinal villus height and width, and a significant increase in the levels of IL-6 and TNF-ð as well as Immunoglobulin A (IgA) positive cells. Additionally, when compared with the LPS-treated group, the visfatin+LPS co-stimulated group showed a decrease in the villus height and width as well as the levels of IL-6 and TNF-ð, and an increase in IgA levels, implying a shrinking response to LPS injection. All the results suggest that, under normal physiological conditions, visfatin disturbs the body's homeostasis and causes intestinal villus atrophy by increasing IgA expression. While under immune response conditions, LPS acts as an exogenous antigen to promote visfatin against LPS-induced inflammation by decreasing the expression of IgA. Under immune stress conditions, visfatin as an exogenous stimulus promotes the immune response by regulating the protein levels of IL-6, TNF-ð and IgA.

Este estudio investigó los efectos de la visfatina sobre la estructura y los niveles de inmunidad en el intestino delgado de ratas inducidas por lipopolisacáridos (LPS). Cuarenta ratas Wistar se dividieron aleatoriamente e igualmente en cuatro grupos: solución salina (control), vistafin, LPS y visfatina + LPS co-estimuladas. Las funciones de la visfatina en la inmunidad de la mucosa intestinal se investigaron mediante el examen de variación de la estructura del tejido, la inflamación y las proteínas relacionadas con la inmunidad en el intestino de ratas estresadas inmunológicamente; usando tinción HE, ELISA, inmunohistoquímica y Western Blot. Los resultados mostraron que, en comparación con el grupo control, el grupo tratado con visfatina presentó una disminución en la altura y ancho de las vellosidades intestinales, y un aumento significativo en los niveles de IL-6 y TNF-ð, así como inmunoglobulina A (IgA células positivas). Además, al comparar este grupo con el grupo tratado con LPS- el grupo visfatina + LPS co-estimulado mostró una disminución en la altura y ancho de las vellosidades, así como en los niveles de IL-6 y TNF-ð, y un aumento en los niveles de IgA, lo que implica reducción de una respuesta a la inyección LPS. Todos los resultados sugieren que, en condiciones fisiológicas normales, la visfatina perturba la homeostasis del cuerpo y provoca la atrofia de las vellosidades intestinales mediante el aumento de la expresión de IgA. Mientras que bajo condiciones de la respuesta inmune, LPS actúa como un antígeno exógeno para promover visfatina contra la inflamación inducida por LPS por la disminución de la expresión de IgA. En condiciones de estrés inmunológico, la visfatina como estímulo exógeno promueve la respuesta inmune mediante la regulación de los niveles de proteína de IL-6, TNF-ð e IgA.

The present study was to investigate the effects of visfatin on the morphological structure and function of the rat uterus during inflammation. The expression and distribution of visfatin, morphological structure, eosinophils (EOS), myeloperoxidase (MPO) and cytokines in the uterus of the LPS-induced rat were studied using hematoxylin-eosin staining (HE), immunohistochemical methods, western blots and enzyme-linked immunosorbent assay (ELISA). The present study showed that visfatin positive cells dispersed widely in the uterus, and strong positive staining was observed mainly in the cell cytoplasm. Compared with saline group, in visfatin group, more uterine glands were found, EOS increased, and the difference was significant (P<0.05), MPO reduced, and the difference was significant (P<0.01). In addition, visfatin was able to increase the secretion of IL-1b, IL-6, and TNF-a (P<0.01). Compared with LPS group, in vifatin+LPS group, the uterine glands of the lamina propria increased, the myometrium became thinner, the number of EOS and MPO reduced obviously, but the difference was not significant (P>0.05), and after LPS stimulated body, visfatin decrease the level of IL-1b, IL-6, TNF-a (P<0.01). The above results suggest that visfatin could affect the morphological structure of rat uterus; Visfatin could modulate the inflammatory response in rats' uterus by regulating the quantity of inflammatory cells, such as EOS and MPO, and the level of inflammatory cytokines, such as IL-1b, IL-6, TNF-a.

El objetivo del presente estudio fue investigar los efectos de la visfatina sobre la estructura morfológica y la función del útero de la rata durante la inflamación. Se estudiaron la expresión y distribución de la visfatina, la estructura morfológica, eosinófilos, mieloperoxidasa y citoquinas en el útero de rata mediante la tinción de H&E, métodos inmunohistoquímicos, Western blots y ELISA. El estudio mostró que las células visfatina positivas se dispersan ampliamente en el útero, junto a una fuerte tinción positiva, principalmente en el citoplasma de la célula. En comparación con el grupo control, en el grupo visfatina, se encontraron más glándulas uterinas, se observó un aumento de EOS y la diferencia fue significativa (p<0,05), MPO reducida siendo esta diferencia también significativa (p<0,01). Además, la visfatina fue capaz de aumentar la secreción de IL-1b, IL-6 y TNF-a (P<0,01). En comparación con el grupo LPS, visfatina+grupo LPS, las glándulas uterinas de la lámina propia aumentaron, se observó un miometrio más delgado, y número reducido de EOS y MPO, sin embargo, la diferencia no fue significativa (P>0,05). Después de estímulo LPS en el cuerpo, se registró un nivel menor de visfatina en IL-1b, IL-6, TNF-a (P<0,01). Los resultados anteriores sugieren que visfatina podría afectar a la estructura morfológica del útero de rata. Además, podría modular la respuesta inflamatoria en el útero mediante la regulación de la cantidad de células inflamatorias, tales como EOS y MPO.

PURPOSE: To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT). MATERIALS AND METHODS: We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia. RESULTS: The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%. CONCLUSION: Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes.

The histological changes in the spleen and the immunohistochemical expression of visfatin in lipopolysaccharide-stimulated piglets are reported to examine the relation between visfatin and inflammation. The results are as follows: (1) After LPS treated, the spleen displayed thicker capsules and trabecula, the thinner periarterial lymphatic sheath, and the more expandable splenic sinusoid, with an increase in the number of splenic nodules, lymphocytes, ellipsoids of the marginal zone, red blood cells and macrophagocytes. (2) Visfatin-positive cells were mainly distributed in the red pulp of the spleen, with less in splenic nodules and periarterial lymphatic sheath. In the LPS-treated group, the signal intensity and quantity of the visfatin-positive cells were significantly higher in the red pulp and the ellipsoids of the spleen (P<0.01), whereas lower in the periarterial lymphatic sheath. These results indicate that LPS stimulation induces inflammation, causing the histological changes of the piglet spleen and activating humoral immune response. Moreover, variation of visfatin in the spleen suggests that lymphocytes and macrophages are the potent source of visfatin which participates in the humoral immune response in the inflammation.

Se presentan los cambios histológicos en el bazo y la expresión inmunohistoquímica de visfatin en lechones estimulados mediante lipopolisacáridos (LPS) con el objetivo de estudiar la relación entre visfatin e inflamación. Los resultados fueron los siguientes: (1) Después del tratamiento por LPS se observaron en el bazo cápsulas más gruesas y trabéculas, una vaina linfática periarterial más delgada, y más sinusoides esplénicos expandible, con un aumento en el número de nódulos esplénicos, linfocitos, elipsoides de la zona marginal, como también un aumento de las células rojas de la sangre y los macrofagocitos. (2) Las células visfatina-positivas se distribuyeron principalmente en la pulpa roja del bazo, con una cantidad menor en los nódulos esplénicos y la vaina linfática periarterial. En el grupo tratado con LPS, la intensidad de la señal y número de células positivas fueron significativamente mayor en la pulpa roja y los elipsoides del bazo (P<0,01), mientras que estas fueron menores en la vaina linfática periarterial. Estos resultados indican que la estimulación con LPS induce la inflamación provocando cambios histológicos del bazo de los lechones y la activación de la respuesta inmune humoral. Por otra parte, la variación de visfatin en el bazo sugiere que los linfocitos y los macrófagos son una fuente potente de visfatin en la respuesta inmune humoral de la inflamación.

Our research aimed to look into the clinical traits and genetic mutations in sporadic non-syndromic anodontia and to gain insight into the role of mutations of PAX9, MSX1, AXIN2 and EDA in anodontia phenotypes, especially for the PAX9. Material and Methods The female proband and her family members from the ethnic Han families underwent complete oral examinations and received a retrospective review. Venous blood samples were obtained to screen variants in the PAX9, MSX1, AXIN2, and EDA genes. A case-control study was performed on 50 subjects with sporadic tooth agenesis (cases) and 100 healthy controls, which genotyped a PAX9 gene polymorphism (rs4904210). Results Intra-oral and panoramic radiographs revealed that the female proband had anodontia denoted by the complete absence of teeth in both the primary and secondary dentitions, while all her family members maintained normal dentitions. Detected in the female proband were variants of the PAX9 and AXIN2 including A240P (rs4904210) of the PAX9, c.148C>T (rs2240308), c.1365A>G (rs9915936) and c.1386C>T (rs1133683) of the AXIN2. The same variants were present in her unaffected younger brother. The PAX9 variations were in a different state in her parents. Mutations in the MSX1 and EDA genes were not identified. No significant diferences were found in the allele and genotype frequencies of the PAX9 polymorphism between the controls and the subjects with sporadic tooth agenesis. Conclusions These results suggest that the association of A240P with sporadic tooth agenesis still remains obscure, especially for different populations. The genotype/phenotype correlation in congenital anodontia should be verified.

OBJECTIVE: The features of earthquake-related head injuries may be different from those of injuries obtained in daily life because of differences in circumstances. We aim to compare the features of head traumas caused by the Sichuan earthquake with those of other common head traumas using multidetector computed tomography. METHODS: In total, 221 patients with earthquake-related head traumas (the earthquake group) and 221 patients with other common head traumas (the non-earthquake group) were enrolled in our study, and their computed tomographic findings were compared. We focused the differences between fractures and intracranial injuries and the relationships between extracranial and intracranial injuries. RESULTS: More earthquake-related cases had only extracranial soft tissue injuries (50.7% vs. 26.2%, RR=1.9), and fewer cases had intracranial injuries (17.2% vs. 50.7%, RR = 0.3) compared with the non-earthquake group. For patients with fractures and intracranial injuries, there were fewer cases with craniocerebral injuries in the earthquake group (60.6% vs. 77.9%, RR = 0.8), and the earthquake-injured patients had fewer fractures and intracranial injuries overall (1.5 + 0.9 vs. 2.5 +1.8; 1.3 + 0.5 vs. 2.1 + 1.1). Compared with the non-earthquake group, the incidences of soft tissue injuries and cranial fractures combined with intracranial injuries in the earthquake group were significantly lower (9.8% vs. 43.7%, RR = 0.2; 35.1% vs. 82.2%, RR = 0.4). CONCLUSION: As depicted with computed tomography, the severity of earthquake-related head traumas in survivors was milder, and isolated extracranial injuries were more common in earthquake-related head traumas than in non-earthquake-related injuries, which may have been the result of different injury causes, mechanisms and settings.

OBJECTIVE: To determine the features of earthquake-related pelvic crush fractures versus non-earthquake fractures with digital radiography and multidetector row computed tomography. METHODS: One hundred and sixty-seven survivors with pelvic crush fractures in the 2008 Sichuan earthquake were entered in our study as the earthquake-related group (139 underwent digital radiography, 28 underwent multidetector row computed tomography); 70 victims with non-earthquake pelvic fractures were enrolled into this study as the non-earthquake group (54 underwent digital radiography, 16 underwent multidetector row computed tomography). Data were reviewed retrospectively between groups, focusing on anatomic distributions, status of pelvic bone fractures, numbers of pelvic bones involved, and classification of pelvic ring fractures according to the Tile classification system. RESULTS: Pelvic fractures occurred more frequently in the pubis in the earthquake-related group than in the non-earthquake group (135/167, 81% vs. 48/70, 69%). In addition, comminuted fractures were more common in the earthquake-related group than in the non-earthquake group (55/167, 33% vs. 10/70, 14%). Multiple fractures were less common in the earthquake-related group than in the non-earthquake group (81/167, 49% vs. 46/70, 66%). Regarding the classification of pelvic ring fractures, Type C predominantly composed of subtype C3 occurred more frequently (64/167, 38% vs. 12/70, 17%), and Type A was less common in the earthquake-related group than in the non-earthquake group (31/167, 19% vs. 23/70, 32%). All differences were statistically significant (p<0.05). No difference was found in Type B fractures between the groups (72/167, 43% vs. 35/70, 50%). CONCLUSION: Earthquake-related pelvic crush fractures can be characterized by a high incidence of pelvic fractures occurring in the pubis, comminuted fractures, and Type C fractures predominantly composed by subtype C3, despite a low incidence of multiple fractures.

PURPOSE: Massive earthquakes are harmful to humankind. This study of a historical cohort aimed to investigate the difference between earthquake-related crush thoracic traumas and thoracic traumas unrelated to earthquakes using a multi-detector Computed Tomography (CT). METHODS: We retrospectively compared an earthquake-exposed cohort of 215 thoracic trauma crush victims of the Sichuan earthquake to a cohort of 215 non-earthquake-related thoracic trauma patients, focusing on the lesions and coexisting injuries to the thoracic cage and the pulmonary parenchyma and pleura using a multi-detector CT. RESULTS: The incidence of rib fracture was elevated in the earthquake-exposed cohort (143 vs. 66 patients in the non-earthquake-exposed cohort, Risk Ratio (RR) = 2.2; p<0.001). Among these patients, those with more than 3 fractured ribs (106/143 vs. 41/66 patients, RR=1.2; p<0.05) or flail chest (45/143 vs. 11/66 patients, RR=1.9; p<0.05) were more frequently seen in the earthquake cohort. Earthquake-related crush injuries more frequently resulted in bilateral rib fractures (66/143 vs. 18/66 patients, RR= 1.7; p<0.01). Additionally, the incidence of non-rib fracture was higher in the earthquake cohort (85 vs. 60 patients, RR= 1.4; p<0.01). Pulmonary parenchymal and pleural injuries were more frequently seen in earthquake-related crush injuries (117 vs. 80 patients, RR=1.5 for parenchymal and 146 vs. 74 patients, RR = 2.0 for pleural injuries; p<0.001). Non-rib fractures, pulmonary parenchymal and pleural injuries had significant positive correlation with rib fractures in these two cohorts. CONCLUSIONS: Thoracic crush traumas resulting from the earthquake were life threatening with a high incidence of bony thoracic fractures. The ribs were frequently involved in bilateral and severe types of fractures, which were accompanied by non-rib fractures, pulmonary parenchymal and pleural injuries.