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Study DesignCohort study.PurposeThis study primarily aimed to evaluate the serum levels of tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-4 in patients with lumbar radiculopathy 1 and 12 months after microdiscectomy.Overview of LiteratureLumbar radiculopathy is possibly caused by inflammatory changes in the nerve root. The intraneural application of pro-inflammatory cytokines induces behavioral signs associated with pain. Anti-inflammatory cytokine treatment effectively reduces hyperalgesia.MethodsThe role of TNF-α and IL-4 in long-lasting lumbar radiculopathy was addressed. A total of 262 patients were recruited from Anqing Hospital, Anhui Medical University. During inclusion at 1 and 12 months, serum concentrations of TNF-α and IL-4 were analyzed by enzyme-linked immunosorbent assay, and pain intensity was reported on a 0–10 cm visual analog scale (VAS).ResultsSixty six patients had VAS <3 and 196 patients had VAS ≥3. Serum concentrations of pro-inflammatory TNF-α and anti-inflammatory IL-4 in patients with lumbar radiculopathy related to disc herniation were measured at 1- and 12-month follow-up. TNF-α decreased in both VAS groups with time. In contrast, IL-4 increased in both groups at 1 month and then decreased gradually until month 12. The changes in serum levels of TNF-α and IL-4 over time between the VAS ≥3 and VAS <3 groups were significantly different.ConclusionsChronic lumbar radiculopathy may be associated with high level of pro-inflammatory substances, such as TNF-α, in serum after disc herniation, and elevated anti-inflammatory cytokine in patients with lumbar radiculopathy may indicate a favorable outcome.

Hip fracture incidence rates in Hefei, China, over a period of 1 year (2010) were assessed. The aim of this study was to investigate the incidence and epidemiology of hip fracture in Hefei and compare it with other populations. All the hip fracture records were obtained from the Hefei Hospital Discharge Register for the entire population ≥50 years of age and restricted to cervical or trochanteric types. The incidence of hip fracture was standardized to the 2010 World population. A total of 1518 (aged ≥50) hip fractures (628 in men, 890 in women) were recorded during the study period. The age-adjusted incidence rate for 1 year was 144/100,000 (95 % CI = 135-153/100,000) for women and 97/100,000 (95 % CI = 85-109/100,000) for men. The standardized incidence rate against the 2010 World population was 151.7/100,000 for women and 98.2/100,000 for men. The mean age of patients with a hip fracture was 74.5 ± 10.1 years for women and 71.9 ± 11.9 years for men. The overall female to male ratio of hip fracture was 1.48:1 for hip fracture incidence and 1.54:1 for standardized incidence. Simple fall accounted for 85 % hip fractures in total cases. Hefei has a lower incidence of hip fracture compared with Beijing and other countries from the five continents in recent studies, but a higher incidence than those cities in north-east China in the early 1990s. The inequality incidence in different geographic areas could be due to the urbanization or life expectancy of the population, but further investigation needs to be done to confirm this hypothesis. We also found a higher incidence in women than in men. Simple fall may be the main mechanism of injury for hip fracture.

Study design: A retrospective hospital-based study. Objectives: To describe the epidemiologic features of traumatic spinal cord injury (TSCI) in Anhui Province. Setting: Two hospitals within Anhui Province, China. Methods: We retrospectively reviewed the hospital records on all patients with TSCI, admitted between 1 January 2007 and 31 December 2010 (n ¼ 761). Variables included age, gender, occupation, neurological level, severity of injury, cause and treatment. Results: Seven hundred and sixty-one cases of TSCI were identified. Five hundred and eighty eight were males (77.3%) and 173 were females (22.7%), with a mean age of 45 years (s.d. ¼ 13, range from 5 to 87). Fall from height was the leading cause of injury (52.6%), followed by transport (21.2%). The neurological lesion levels were cervical (46.3%), lumbosacral (33.3%) and thoracic (20.4%). Conclusion: Prevention strategies for TSCI should target 30-60 age group, males, farmers and fall from height. The results of this study will serve as a basis for further studies on TSCI. The prevention strategies and treatment should be designed according to the injury features. Epidemiologic studies identify high-risk groups and provide useful information for prevention efforts. It is, therefore, imperative to conduct epidemiologic studies of TSCI in order to formulate corresponding intervention strategies to epidemiological features. In this study, we outlined the epidemiological features of TSCI, which included age, gender, cause, occupation, neurological level and severity of injury at admission, treatment and so on. The results of this study will serve as a base for design prevention strategies and epidemiological studies in order to reduce the number of patients with TSCI.

BackgroundTibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach.MethodsRetrospective analysis was performed in patients with tibial shaft fractures that were treated with IMN through a SP or IP approach between 01/01/2014 and 31/12/2016. The clinical and functional outcomes of the knee were assessed with the Hospital for Special Surgery (HSS) Knee Score. Secondary outcomes included the operation time and intraoperative blood loss.ResultsA total of 50 patients/fractures (26 IP and 24 SP) with a minimum follow-up of 15 months were evaluated. All fractures were OTA 42. No significant differences were found between the two groups in age, gender, side of fractures, operation time, intra-operative blood loss, and follow-up time. No significant difference was seen in HSS score (P = 0.62) between them. Sub analysis of all the HSS components scores revealed no significant differences between pain (P = 0.57), the stand and walk (P = 0.54), the need for walking stick (P = 0.60) and extension lag (P = 0.60). The other HSS components showed full scores (IP 10 vs. SP 10) in both approaches, including muscle force, flexion deformity and stability components. The range of motion (ROM) component score was superior in the IP group (P = 0.04) suggesting a higher ROM.ConclusionsBoth SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.