Redox potential in human semen: Validation and qualification of the MiOXsys assay

Seminal oxidative stress (OS) is a major contributing factor to male infertility. Semen analysis cannot identify reactive oxygen species (ROS), which can be measured using a chemiluminescence assay. Measurement of redox potential provides a more comprehensive assessment of OS, although the test has yet to be fully validated. This study aimed to validate the MiOX^sys analyser for measuring static oxidation–reduction potential (sORP). Results demonstrated that duplicate measurements must be taken, sensors must be batch tested, and sockets should be regularly changed to avoid inconsistency in measurement. Measurement of sORP using MiOX^sys exhibited good reproducibility across different operators (p = 0.469), analysers (p = 0.963) and days (p = 0.942). It is not affected by mechanical agitation (p = 0.522) or snap freezing and thawing (p = 0.823). The stability of sORP over time requires further verification, particularly in samples with high initial sORP. Measurement is temperature sensitive between 2 and 37°C, significantly increasing with increasing temperature (p = 0.0004). MiOX^sys is a more stable assay for assessing OS than chemiluminescence methods and permits greater flexibility for sample handling. MiOX^sys could be implemented to complement semen analysis as part of routine diagnostic testing for male infertility and may be useful in identifying contributing factors to idiopathic infertility.     

Dorsal Chopart’s fracture dislocation – A rare injury

A rare case of Dorsal Chopart’s fracture dislocation after a fall from height is presented. It combines the features of pure dorsal Chopart’s dislocation and the longitudinal swivel variant described by Main and Jowett presenting as dorsomedial fracture dislocation of the medial three fourths of the navicular, crushing the lateral one fourth. The possible mechanism of injury has been described. It has been successfully treated with closed reduction and percutaneous k-wire fixation. At two-year follow-up the patient was asymptomatic, back to his moderately active work.     

Contralateral prophylactic mastectomy: A narrative review of the evidence and acceptability

The uptake of contralateral prophylactic mastectomy (CPM) has increased steadily over the last twenty years in women of all age groups and breast cancer stages. Since contralateral breast cancer is relatively rare and the breast cancer guidelines only recommend CPM in a small subset of patients with breast cancer, the drivers of this trend are unknown. This review aims to evaluate the evidence for and acceptability of CPM, data on patient rationales for choosing CPM, and some of the factors that might impact patient preferences. Based on the evidence, future recommendations will be provided. First, data on contralateral breast cancer risk and CPM rates and trends are addressed. After that, the evidence is structured around four main patient rationales for CPM formulated as questions that patients might ask their surgeon: Will CPM reduce mortality risk? Will CPM reduce the risk of contralateral breast cancer? Can I avoid future screening with CPM? Will I have better breast symmetry after CPM? Also, three different guidelines regarding CPM will be reviewed. Studies indicate a large gap between patient preferences for radical risk reduction with CPM and the current approaches recommended by important guidelines. We suggest a strategy including shared decision-making to enhance surgeons’ communication with patients about contralateral breast cancer and treatment options, to empower patients in order to optimize the use of CPM incorporating accurate risk assessment and individual patient preferences.     

Neglected medial swivel dislocation of talonavicular joint with calcaneus,cuboid and 5th metatarsal fractures – A case report

Talonavicular dislocation is a rare injury. Isolated medial or lateral talonavicular dislocations without disruption of subtalar joint are known as medial or lateral swivel dislocations respectively, both being extremely rare. We describe a rare case of neglected medial swivel dislocation with concomitant calcaneus, cuboid and 5th metatarsal fracture, which was managed with open reduction and fixation of talonavicular joint with k-wires and an external distractor. At 1 year follow up the patient was mobilizing full weight bearing without any pain or deformity, the radiographs showing well located talonavicular joint and healed calcaneus, cuboid and 5th metatarsal fractures. This is the first reported case of medial swivel talonavicular dislocation with associated calcaneum, cuboid and 5th metatarsal fracture to the best of our knowledge. This case report highlights the importance of maintaining high level of suspicion for diagnosing midfoot injuries in a polytraumatized patient as well as need of accurate and timely reduction of dislocation for good functional outcome.Level of clinical evidenceLevel 4.     

Methods to address metal artifacts in post-processed CT images – A do-it-yourself guide for orthopedic surgeons

Computed tomography (CT) scans are often used for postoperative imaging in orthopedics. In the presence of metallic hardware, artifacts are generated, which can hamper visualization of the CT images, and also render the study ineffective for 3-D printing. Various solutions are available to minimize metal artifacts, and radiologists can employ these before or after processing the CT study. However, the orthopedic surgeon may be faced with situations where the metal artifacts were not addressed. To counter such problems, we present three do-it-yourself (DIY) techniques that can be used to manage metal artifacts.     

3种抗肿瘤有毒蒙药的研究进展

随着社会发展和生活水平的提高,恶性肿瘤已经成为影响人类健康的重大疾病之一。有毒蒙药在治疗疾病及救治疑难杂症中具有重要作用。多种有毒蒙药有一定的抗肿瘤作用,且有着良好的治疗效果,但由于其本身的毒性,使其在临床上的应用受到很大的限制。蒙医在实践中不断摸索出有毒蒙药的多种减毒方法,如采用配伍、炮制等减毒手段进行处理,以达到降低毒性、提高疗效的作用。通过对3种代表性有毒蒙药斑蝥Mylabris、草乌Aconiti Kusnezoffii Radix、瑞香狼毒Stellerae Chamaejasmes Radix的抗肿瘤作用、毒性机制及减毒策略进行综述,为其临床用药及新药开发提供依据。     

人工骨和自体骨在复杂跟骨骨折异形钢板内固定术中的病例对照研究

目的 :比较人工骨与自体骨在复杂跟骨骨折异形钢板内固定术中的临床疗效。方法:自2015年4月至2019年4月收治60例复杂跟骨骨折患者行切开复位异形钢板内固定术治疗,按照植骨材料不同分为试验组和对照组,每组30例。试验组男21例,女9例;年龄18～71(36.85±7.42)岁;SandersⅢ型19例,SandersⅣ型11例;采用人工骨植入。对照组男23例,女7例,年龄20～69(37.26±7.38)岁;SandersⅢ型18例,SandersⅣ型12例;采用自体骨植入。比较两组患者手术时间、术中出血量、术后切口干燥时间、愈合时间及并发症情况,比较术前及术后3个月B?hler角及Gissane角变化情况,采用Maryland评分评价患足功能恢复情况。结果:两组患者术后均获得随访,时间3～15(10.15±2.67)个月。试验组手术时间、术中出血量分别为(89.32±12.43) min、(101.64±5.13) ml,对照组分别为(112.45±13.82) min、(119.01±5.26) ml,两组比较差异有统计学意义(P0.05);两组术后切口干燥时间、愈合时间、并发症比较差异无统计学意义(P0.05)。试验组术前、术后3个月B?hler角分别为(14.19±2.47)°、(34.52±4.41)°,对照组分别为(14.08±2.35)°、(33.67±4.36)°;试验组术前及术后3个月Gissane角分别为(90.16±6.43)°、(131.45±9.83)°,对照组分别为(90.11±6.37)°、(130.87±9.24)°;两组术后3个月B?hler角、Gissane角与术前比较差异有统计学意义(P0.05);但两组术后3个月B?hler角、Gissane角比较差异无统计学意义(P0.05)。末次随访时,两组Maryland评分各项目评分、总分及优良率比较差异无统计学意义(P0.05)。结论:在复杂跟骨骨折异形钢板内固定术中,采用人工骨和自体骨在促进骨折恢复方面效果相当,且术后切口干燥时间、愈合时间及并发症发生情况相近,但使用人工骨可减少术中出血量,缩短手术时间。