Objective To analyze the changing trends and attributable risk factors of low back pain disease burden in Chinese population from 1990 to 2023,and to predict the related disease burden of low back pain in 2030.Methods Based on the 2023 Global Burden of Disease(GBD)study database,the incidence,prevalence,years lived with disability(YLDs),and characteristics and trends of risk factors among Chinese individuals with low back pain from 1990 to 2023 were analyzed,the age and gender differences in disease burden were assessed,and the disease burden in 2030 was jointly predicted by autoregressive integrated moving average model and age-period-cohort model.Results From 1990 to 2023,the number of incident cases,the number of prevalent cases,and YLDs in Chinese low back pain population showed an upward trend,from 29.989 1 million cases,68.636 3 million cases,and 7.732 4 million person-years to 41.383 6 million cases,95.324 0 million cases,and 10.635 9 million person-years,respectively.The incidence rate,prevalence rate,and YLDs rate increased from 2 543.31 per 100 000,5 820.89 per 100 000,and 655.77 per 100 000 to 2 892.65 per 100 000,6 663.01 per 100 000,and 743.43 per 100 000 respectively.However,the age-standardized incidence rate,age-standardized prevalence rate,and age-standardized YLDs rate showed a downward trend,from 2 859.73 per 100 000,6 636.60 per 100 000,and 740.83 per 100 000 to 2 164.80 per 100 000,4 929.78 per 100 000,and 551.92 per 100 000,respectively.The burden of low back pain in women was significantly higher than that in men and increased with age(peak at 50 to 59 years old).Attribution analysis showed that smoking,occupational factors,and high body mass index(BMI)were the main factors leading to the increase of YLDs,and there was a gender difference.The tow model showed that the age-standardized incidence rate,the age-standardized prevalence rate,and the age-standardized YLDs rate for low back pain would decrease year by year from 2023 to 2030.Conclusion The disease burden of low back pain in China shows that from 1990 to 2023,the burden of low back pain in the Chinese population has been increasing year by year.Smoking,occupational factors,and high BMI are the main risk factors.Interventions targeting these controllable risk factors are crucial for reducing the disease burden.It is expected that by 2030,the disease burden of low back pain is expected to decrease,although the absolute burden will remain high.Greater attention should be paid to the middle-aged and elderly population,especially the female population,who bear a heavier disease burden.Targeted interventions,such as weight control and smoking cessation management,should be actively implemented against these controllable risk factors.
Objective:To compare the early effectiveness and safety of mini open endoscopy assisted anterior cervical discectomy and fusion (MOEA-ACDF) versus traditional ACDF in the treatment of cervical spondylotic myelopathy (CSM). Methods:A retrospective analysis was conducted on the clinical data of 60 patients with CSM admitted between January 2022 and January 2023 who met the selection criteria, including 30 cases each undergoing MOEA-ACDF and traditional ACDF. Except for age and height of the adjacent vertebral body (HAVB), no significant difference was observed between groups ( P>0.05) in the gender, body mass index, disease duration, surgical segment, preoperative visual analogue scale (VAS) scores for neck/upper limb pain, neck disability index (NDI), Japanese Orthopaedic Association (JOA) score, and C 2-7 Cobb angle. The operation time, postoperative drainage volume, and occurence of complications, as well as VAS scores for neck/upper limb pain, NDI, JOA score and its improvement rate, C 2-7 Cobb angle, HAVB, and bone graft fusion status (Bridwell classification) at the surgical segment were recorded and compared between groups. Results:Both groups completed the operations successfully. The MOEA-ACDF group exhibited significantly longer operation time compared to the ACDF group ( P<0.05), and no significant difference was found in the postoperative drainage volume between groups ( P>0.05). Postoperatively, only 1 case in the MOEA-ACDF group developed subcutaneous ecchymosis in the neck, while the incidence of complications showed no significant difference between groups ( P>0.05). All patients were followed up 12-28 months (mean, 17.6 months). Over time, both groups demonstrated gradual improvement in NDI, VAS scores for neck/upper limb pain, and JOA scores ( P<0.05). At 1, 3, and 6 months, as well as at last follow-up, no significant difference was observed in all indicators between groups ( P>0.05). At last follow-up, the improvement rates of JOA scores in the two groups reached 90% (27/30), with no significant difference in the grading of improvement between groups ( P>0.05). Imaging re-examination revealed increased C 2-7 Cobb angle and HAVB in both groups postoperatively ( P<0.05), but no significant changes over time ( P>0.05). At 1 month after operation and last follow-up, no significant difference was observed in C 2-7 Cobb angle between groups ( P>0.05). Regarding the HAVB, ACDF group demostrated superior outcomes compared to MOEA-ACDF groups ( P<0.05). Both groups achieved bone graft fusion, and no significant difference between groups was observed in Bridwell classification at 6 months or last follow-up. During follow-up, no failure of internal fixation, sinking or displacement of cage, degeneration of adjacent segment was found. Conclusion:MOEA-ACDF has good early effectiveness in the treatment of CSM, and can effectively improve the height and physiological curvature of cervical spine, which is equivalent to the traditional ACDF.
Objective:Based on the data from the 2023 Global Burden of Disease (GBD) study, the changing trends of the disease burden of neck pain and its demographic characteristics in China from 1990 to 2023 was systematically evaluated, in order to provide evidence for the formulation of neck pain prevention and control strategies. Methods:Data on the incidence, prevalence, years lived with disability (YLDs), and their age-standardized rates of neck pain in China were extracted from the GBD 2023 database. A descriptive analysis was conducted by stratifying data by gender and age. The Joinpoint regression model was used to analyze the temporal trends of age-standardized incidence, prevalence, and YLDs rates, and the average annual percentage change (AAPC) was calculated. Results:From 1990 to 2023, the number of incident cases, prevalent cases, and YLDs of neck pain in China increased by 66.08%, 83.06%, and 80.49%, respectively, while the age-standardized rates showed relatively small fluctuations overall (rate of change<1.2%). The incidence, prevalence, and YLDs rates in females were higher than those in males, and the age-standardized YLDs rate in females showed a continuous upward trend (AAPC=0.067%, P<0.05). The disease burden of neck pain gradually increased with age, being most concentrated in middle-aged, elderly, and advanced-age populations. Joinpoint regression analysis revealed that the age-standardized incidence, prevalence, and YLDs rates exhibited multi-stage changes, with a common upward phase from 2005 to 2009 and a slight decline after 2021. Conclusion:The increase in the absolute burden of neck pain in China is mainly driven by population aging. Priority should be given to focusing on female, middle-aged, and elderly populations, and early intervention should be strengthened to reduce long-term disability burden.
Acute isolated meniscal injury is a common sports-related knee injury in clinical practice.In June 2024,the American Academy of Orthopaedic Surgeons(AAOS)released the latest Clinical Practice Guideline for the Management of Acute Isolated Meniscal Pathology.Based on rigorous evidence-based methodology,the guideline provides systematic recommendations regarding physical examination,imaging evaluation,and both non-operative and operative management strategies,classifying these recommendations according to the strength of evidence.This article aims to interpret the key points in the diagnosis and management of acute isolated meniscal injury,to inform clinical practice and guide future research.
Objective To summarize recent research advances of hydrogels for the treatment of osteonecrosis of the femoral head(ONFH).Methods The literature on hydrogels for treatment of ONFH at home and abroad in recent years was extensively reviewed,and the fundamental research and clinical application were summarized and analyzed.Results In the field of fundamental research,functionalized hydrogels(including thermosensitive,oxygen-controlled release,and ion-doped types)demonstrate significant advantages in achieving targeted delivery,controlled release,and microenvironment regulation.Particularly,the development of novel material systems,such as composite scaffold systems,gene-activated hydrogels,and engineered exosomes,has further enhanced treatment precision and biological efficacy.In terms of clinical application,the materials like recombinant human fibroblast growth factor 2(rhFGF-2)gelatin hydrogels have been validated in multiple trials,showing promising joint preservation rates and bone regeneration capabilities.This opens a promising new clinical pathway for hip-preserving treatment of ONFH.Among these,hydrogel-based multilevel composite scaffolds represent the most promising materials for clinical translation.Conclusion Hydrogel systems,by synergistically regulating osteogenesis,angiogenesis,and immunomodulation,and leveraging the unique advantages of functionalized materials in precise drug control and microenvironment regulation,have evolved into advanced platforms for the comprehensive treatment of ONFH.Among them,rhFGF-2 gelatin hydrogels,with their remarkable clinical efficacy,offer a new strategy of significant translational value for hip-preserving therapy.
Objective To clarify the clinical application of the disease terms"subchondral insufficiency fracture of the knee(SIFK)"and"osteonecrosis of the knee(ONK)",and to review the research progress on this pathological condition.Methods The research literature in the field of SIFK and ONK both domestically and internationally in recent years was widely reviewed,and the research progress of SIFK and ONK was summarized from the aspects of the current conceptual frameworks,etiological factors and pathogenic mechanisms,clinical and imaging manifestations,therapeutic approaches,and prognostic outcomes.Results The exact etiology of SIFK remains controversial,and its specific pathogenesis has not been fully elucidated.Subchondral fracture has been identified as the primary pathological feature of this disease entity.SIFK predominantly affects the females over 65 years old,presenting with sudden onset of severe and persistent pain.MRI serves as the gold standard for diagnosis of early-stage SIFK.The characteristic MRI findings include bone marrow edema-like signals and a subchondral low-signal line in the affected femoral condyle.Generally,if bone morphology is preserved without subchondral bone collapse,conservative management is typically the first-line treatment approach.Surgical intervention should be considered if there is no clinical or radiographic improvement after 3 to 4 months of conservative therapy.Conclusion Considering the pathological features of bone specimens,adopting the SIFK for ONK demonstrates greater appropriateness in diagnosis and management of these disorders.Early diagnosis and management are important for improving the prognosis of SIFK patients.
Objective:To analyze the changing trends in the burden of gout disease attributable to high body mass index (BMI) and impaired kidney function in China from 1990 to 2023, and predict the burden of gout disease attributable to high BMI and impaired kidney function in China from 2024 to 2035, to provide a scientific basis for gout prevention and control. Methods:Based on the 2023 Global Burden of Disease (GBD) study data, this study analysed the characteristics of the burden of gout attributable to high BMI and impaired kidney function by gender and age group. It employed the Joinpoint regression model to examine trends in the age-standardized disability-adjusted life years (DALYs) rate and utilized the autoregressive integrated moving average (ARIMA) model to predict the disease burden trend from 2024 to 2035. Results:From 1990 to 2023, the age-standardized DALYs rate for gout attributable to high BMI in China increased (1990: 3.79 per 100 000, 95% UI: 2.15 per 100 000-6.24 per 100 000; 2023: 7.34 per 100 000, 95% UI: 4.22 per 100 000-11.39 per 100 000). Joinpoint analysis results showed that from 1990 to 2023, the age-standardized DALYs rate for gout attributable to high BMI in China exhibited an overall upward trend [average annual percent change (AAPC) for males=2.12%, 95% CI: 2.02%-2.22%; AAPC for females=1.92%, 95% CI: 1.79%-2.04%, both P<0.05]. For gout attributable to impaired kidney function, the age-standardized DALYs rate showed a slow overall increase in males, while the change in females was not significant (AAPC for males=0.36%, 95% CI: 0.27%-0.45%, P<0.05; AAPC for females=0.11%, 95% CI: -0.11%-0.33%). According to the ARIMA model predictions, by 2035, the age-standardized DALYs rates of gout attributable to high BMI in males and females and attributable to impaired kidney function in females were projected to stabilize at 10.85 per 100 000, 3.48 per 100 000, and 1.75 per 100 000, respectively. In contrast, the age-standardized DALYs rate of gout attributable to impaired kidney function in males was predicted to continue rising until 2035, reaching an estimated 5.98 per 100 000. Conclusion:The disease burden of gout associated with high BMI and impaired kidney function continues to worsen in China. The age-standardized DALYs rate for gout attributable to impaired kidney function in males is projected to continue rising until 2035. Therefore, there is an urgent need to improve population-wide BMI management strategies and enhance medical support for patients with kidney diseases, with targeted interventions prioritized among specific groups such as middle-aged obese individuals and middle-aged and elderly patients with kidney diseases.
Objective To investigate the epidemiological features and changing trends of disease burden of spinal cord injury(SCI)in China from 1990 to 2023,conduct decomposition analysis of disease burden changes,and provide evidence for SCI prevention and control.Methods Based on the 2023 Global Burden of Disease(GBD)study data,indicators including incidence and years lived with disability(YLDs)were used to analyze the status and changing trends of SCI disease burden in China from 1990 to 2023.The Gupta decomposition framework was applied to quantify the contributions of population growth,population aging,age-specific incidence rate changes,and disease severity changes to YLDs growth.Results In 2023,the number of SCI incidence cases in China was 232 700 cases,representing a 43.6％increase compared to 1990.From 1990 to 2023,the age-standardized YLDs rate of SCI decreased,while the age-standardized incidence rate showed an overall upward trend:it increased year by year from 1990 to 2015,declined briefly after 2015,and rose again from 2020.The disease burden of SCI in males was higher than in females.The age distribution of disease burden showed a shift toward older age groups,with incidence rates increasing with age among middle-aged and elderly populations.Falls were the main cause of SCI in China.Compared with 1990,YLDs in males and females increased by 48.58％and 41.72％respectively in 2023.The proportions of male growth attributed to population growth,population aging,age-specific incidence rate changes,and disease severity changes were 22.79％,22.69％,34.99％,and-31.88％,while those for females were 23.82％,26.30％,21.99％,and-30.40％.Conclusion From 1990 to 2023,population aging made a substantial contribution to the growth of SCI disease burden in China.The primary factor driving the growth of SCI disease burden differed by gender.Clinical interventions that mitigate disease severity represent a key strategy for addressing the rapid growth of SCI disease burden.
Objective To review the research progress and application prospects of Kartogenin(KGN)in cartilage repair and tissue engineering.Methods Through a literature review,the mechanisms of KGN in cartilage repair,biomaterial composite strategies,and the resulting repair effectivenes were sorted out.Results KGN regulates multiple signaling pathways to induce mesenchymal stem cells differentiation into chondrocytes,maintain chondrocyte phenotypes,inhibit chondrocyte senescence,and promote the secretion of extracellular matrix.KGN also forms high-efficiency scaffolds with various materials,suitable for tissue engineering scaffolds of different anatomical sites and defect types,and exhibits significant cartilage regenerative effectiveness in vitro and small animal models.Conclusion Overall,KGN shows great application potential in cartilage tissue engineering.However,clinical translation still faces many challenges,which represents a key direction for future research.
Objective:To analyze the current status and temporal trends of the disease burden of osteoarthritis (OA) in China from 1990 to 2023, stratified by anatomical sites (knee, hip, hand, and other), utilizing data from the 2023 Global Burden of Disease (GBD) study, and to explore the site-specific heterogeneity of disease burden attributed to high body mass index (BMI), providing a scientific basis for formulating precision prevention and control strategies. Methods:Based on the GBD 2023 database, data on the incidence, prevalence, and years lived with disability (YLDs), as well as their corresponding age-standardized rates of OA in China from 1990 to 2023, were collected and stratified by gender, age, and anatomical site (knee, hip, hand, and other). A log-linear regression model was employed to calculate the estimated annual percentage change (EAPC) to analyze temporal trends. Additionally, the population attributable fraction (PAF) was used to quantify the contribution of high BMI to OA across different sites and to analyze the heterogeneity of this attribution. Results:In 2023, the disease burden of OA in China increased. In terms of anatomical distribution, knee OA constituted the heaviest burden, with 115.0032 million prevalent cases, accounting for approximately 65.78% of the total. Attribution analysis showed that knee OA was slightly more affected by high BMI than hip OA, and the PAF increased significantly over time. In 2023, the PAFs for knee and hip OA in females (29.49% and 28.57%, respectively) were substantially higher than those in 1990 (19.10% and 18.38%). A similar upward trend was observed in males (26.65% and 25.92% in 2023). Regarding attribution differences, female PAF levels were consistently higher than those of males across all years and sites. Hand OA exhibited the fastest growth rate, with the EAPC of its age-standardized YLDs rate reaching 1.64%, far exceeding that of knee OA (0.43%). Demographically, all burden indicators were higher in females than in males. Hand OA demonstrated an intergenerational cumulative effect. The difference in YLDs rates between 2023 and 1990 widened with age, reaching 123.29 per 100 000 in the >95 years old group, highlighting the severe challenges posed by population aging. Conclusion:From 1990 to 2023, the disease burden of OA in China continued to rise. Knee OA remains the heaviest burden category and is significantly driven by high BMI, whereas hand OA shows the fastest growth trend. Prevention and control strategies should focus on weight management for knee and hip OA, while prioritizing the prevention and care of hand OA in the elderly population.
Objective To analyze the current status and trends in the burden of musculoskeletal diseases in China from 1990 to 2023,providing evidence-based support for formulating and optimizing prevention and control strategies for musculoskeletal diseases in China.Methods Based on the 2023 Global Burden of Disease(GBD)study database,the study integrated incidence,prevalence,disability-adjusted life years(DALYs),and age-standardized rates of musculoskeletal diseases in the Chinese population from 1990 to 2023,stratified by gender and age.The proportional contribution to all-cause prevalence was calculated,and regression models were constructed using Joinpoint software to assess temporal trends.Results In 2023,the five major musculoskeletal diseases collectively accounted for approximately 25.0％of all-cause prevalence in China.Among these,osteoarthritis contributed the most(11.68％),followed by low back pain(6.89％)and neck pain(3.52％).Gout(1.28％)and rheumatoid arthritis(0.36％)had relatively lower contributions.From 1990 to 2023,the overall burden of the five major musculoskeletal diseases remained substantial,with heterogeneous temporal patterns across diseases.Stratified by age and gender,the five diseases exhibited low levels during childhood and adolescence,increased significantly in middle and older adulthood,and peaked in the elderly.Except for gout,the burden of the other four diseases was higher in females than in males across most age groups.The scale of each disease varied considerably.Osteoarthritis showed the most significant increase in prevalence,with prevalent cases increasing from 53.766 8 million to 161.7424 million,and the age-standardized DALYs rate rising by 16.19％.Gout showed the fastest growth in disease burden,with age-standardized DALYs rates rising from 19.88/100 000 to 25.14/100 000(a 26.46％increase).Although low back pain showed a decline,it remained a major source of disability over the long term,with the age-standardized DALYs rate decreasing from 740.83/100 000 to 551.92/100 000(a 25.49％decrease).Neck pain remained generally stable with a age-standardized DALYs rate increase of 1.18％.The age-standardized incidence rate of rheumatoid arthritis increased by 19.41％,and the age-standardized DALYs rate decreased by 8.38％.Conclusion Over the past 30 years,the burden of musculoskeletal diseases in China has shown a persistent upward trend with significant gender and age disparities.Future prevention and control strategies should place greater emphasis on early identification and proactive interventions,advocating for more targeted comprehensive measures for high-risk populations.Concurrently,efforts must be made to enhance standardized diagnosis and treatment capabilities at the primary care level,alongside strengthening continuous rehabilitation management.
Objective To review the research on tibial tunnel positioning techniques in posterior cruciate ligament(PCL)reconstruction to provide references for clinical practice.Methods Relevant literature on tibial tunnel positioning techniques in PCL reconstruction was extensively reviewed,and summarized.Their advantages,disadvan-tages,and clinical outcomes were compared.Results The position of the tibial tunnel is crucial to the prognosis of PCL reconstruction.The commonly used tibial tunnel positioning techniques include transtibial anteromedial anatomical reconstruction,transtibial anterolateral anatomical reconstruction,Inlay technique,and modified tibial low tunnel reconstruction.Recent studies have shown that there is no significant difference in clinical function scores between anterolateral and anteromedial reconstructions,but the former is associated with greater postoperative posterior tibial translation,which may lead to poor knee joint stability in the long-term follow-up.Compared with other techniques,the Inlay technique is more invasive and is generally not the first clinical choice.In contrast to anteromedial reconstruction,modified tibial low tunnel reconstruction can reduce graft wear.But,studies have demonstrated no significant difference in clinical outcomes between the two techniques.In addition,the modified tibial low tunnel reconstruction is a non-anatomical reconstruction method.Studies have indicated that the degree of posterior tibial translation after non-anatomical reconstructions is greater than that after anatomical reconstruction.Whether the knee joint stability can be guaranteed after non-anatomical reconstruction remains unclear,so the advantages of this technique need to be further investigated.Conclusion Different tibial positioning techniques have their own merits and demerits.At present,there is no clear evidence that any technique has absolute advantages.Surgeons should make a choice based on their own specific conditions and the patient's specific situation.
Objective To analyze the trends in the burden of osteoporosis-related disease in China and worldwide from 1990 to 2023,and to further estimate the attributable burden of key determinants,so as to inform the formulation of prevention and control strategies for osteoporosis.Methods Based on the 2023 Global Burden of Disease(GBD)study database,the data on mortality,disability adjusted life years(DALYs),years lived with disability(YLDs),and years of life lost(YLLs)attributable to low bone mineral density(LBMD)among individuals aged 40 years and older in China and globally from 1990 to 2023 were collected.Metrics focused primarily on age-standardized rates,and data were stratified by age group and gender.Joinpoint regression models were employed to estimate the annual percentage change(APC)and average annual percentage change(AAPC)to assess trends in the burden.An age-period-cohort analysis was conducted to characterize age,period,and birth cohort effects.Additionally,the Das Gupta decomposition method was applied to decompose the changes in the number of LBMD-attributable deaths in China from 1990 to 2023,quantifying the contributions of population growth,population aging,and changes in age-specific mortality rates.Results From 1990 to 2023,DALYs rates and YLLs rates attributable to LBMD showed an overall decreasing trend in both China and the world.DALYs rates declined from 311.54/100 000 to 268.55/100 000 in China and from 288.85/100 000 to 265.11/100 000 globally.In China,the YLDs rate increased from 170.42/100 000 to 197.91/100 000,whereas the global YLDs rate remained relatively stable.The burden of LBMD-related disease was consistently higher in women than in men.Falls were the leading cause of LBMD-attributable deaths and DALYs,followed by road injuries,while other types of injuries accounted for a relatively small proportion.Gupta decomposition showed that the number of LBMD-attributable deaths increased by 62.88％in men and 138.25％in women,primarily driven by population growth(contributing 108.33％in men and 138.98％in women)and population aging(contributing 42.26％in men and 70.59％in women),while changes in age-specific mortality rates offset the increase by 87.72％in men and 71.32％in women.Conclusion From 1990 to 2023,the mortality burden attributable to LBMD in China has decreased overall,but the disability burden has continued to rise,suggesting a shift in osteoporosis-related disease burden from lethality toward disability.Falls are the main attributable cause,and the burden is particularly high among older adults and women.Strengthening bone mineral density screening,fall prevention,and secondary fracture prevention and management is essential to reduce the long-term health losses associated with osteoporosis.
Objective:To explore the diagnostic efficacy of electrochemical detection of synovial fluid leukocyte esterase (LE) based on glucosyl ester for periprosthetic joint infection (PJI) in rabbits. Methods:The enzyme kinetic parameters of the LE-catalyzed reaction based on glucosyl esters were determined electrochemically, and the charge-LE concentration relationship was plotted. Forty-eight healthy New Zealand rabbits were randomly divided into a sham-operation group (blank group), a knee joint metal prosthesis implantation group (control group), and a knee joint metal prosthesis implantation with PJI group (experimental group), with 16 rabbits in each group. The experimental group underwent intra-articular injection of 1×10 5 CFU/mL Staphylococcus aureus suspension at 7 days after right knee joint prosthesis implantation. The control group underwent intra-articular injection of 1 mL of sterile saline at 7 days after right knee joint prosthesis implantation. The blank group underwent right knee joint capsule incision and suture, followed by intra-articular injection of 1 mL of sterile saline 7 days later. The general condition of the animals was observed after operation. At 28 days after operation, imaging examination, microbiological examination, hematological test, and electrochemical detection of synovial fluid LE were performed. The area (AUC) under the receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity of LE-based detection of PJI. Results:The Michaelis constant of the enzymatic reaction of LE catalyzing glucosyl ester was 7.335 mmol/L, and the maximum reaction rate of the enzymatic reaction was 63.750 μmol·L -1·min -1. The calibration curve regression equation for the charge difference (ΔQ)-LE concentration was C (LE)=0.7115ΔQ-14.75, with a determination coefficient R 2 of 0.988 4 (95% CI: 0.5698, 0.8532, P<0.001). All animals survived to the end of the experiment. During the period, the experimental group showed signs of joint infection, and the microbiological test results were all positive. The other two groups had no related infection manifestations and the tests were negative. Imaging examination showed that the experimental prosthesis was stable in position, soft tissue swelling around the joint and mild deformation in the joint. There was no obvious swelling in the soft tissue around the joints in the other two groups, and the joints were in good alignment. Synovial fluid and hematological tests revealed that the experimental group exhibited significantly higher levels of LE, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), white blood cell count (WBC), neutrophil count (Neu), and monocytes count (Mon) compared to both the control group and the blank group ( P<0.05). Notably, ESR and Mon levels were significantly higher in the control group compared to the blank group ( P<0.05). The mentioned indicators, with an AUC>0.9 ( P<0.05), possess good diagnostic value for PJI. Among them, CPR and Neu exhibit the highest sensitivity, reaching 93.8%, while LE, ESR, and Mon demonstrate the highest specificity, reaching 100%. Conclusion:Both synovial fluid LE and hematological testing exhibit good diagnostic efficacy in the rabbit PJI model, with the method based on electrochemical quantitative detection of glucose-based esters for LE demonstrating higher specificity, sensitivity, and accuracy.
Objective To provide a comprehensive review of the surgical methods for repairing post-epicanthoplasty deformity,aiming to offer a reference for clinical decision-making in selecting appropriate techniques.Methods Relevant research literature concerning the repair of post-epicanthoplasty deformities was extensively reviewed.The background,clinical applications,and current challenges of these reconstructive procedures were summarized and analyzed.Results Post-epicanthoplasty deformities are not uncommon,and with evolving aesthetic standards,the demand for medial canthal reconstruction is increasing.The primary surgical techniques reported in the literature include the V-Y advancement flap,the reverse skin-redraping method,and the reverse Z-plasty.In recent years,the application of orbicularis oculi myocutaneous flaps has become more prevalent.While most of these procedures yield satisfactory outcomes,they still face certain limitations,particularly in addressing challenges related to scar management,individual patient variations,and the precise control of medial canthal morphology.Conclusion When clinically addressing post-epicanthoplasty deformities,surgeons must select the most suitable surgical method based on a comprehensive assessment of the patient's specific condition and various contributing factors.An individualized approach is crucial to achieving the optimal aesthetic and functional outcomes.
Objective To summarize the current research progress of finger flexion deformity caused by forearm flexor muscle lesions,providing a reference for clinical diagnosis and treatment.Methods The domestic and international literature about finger flexion deformity caused by forearm flexor muscle lesions was extensively reviewed.A summary analysis was conducted from the etiology and pathogenesis,diagnosis and differential diagnosis,and treatment methods.Results The three types of forearm flexor pathology leading to finger flexion deformity include Volkmann's contracture,pseudo-Volkmann's contracture,and congenital flexor muscle lesions with different pathogenesis.The diagnosis is mainly based on the patient's medical history,clinical features,and imaging examinations,with attention paid to differential diagnosis.Currently,conservative treatment for such deformities is not very effective,and surgical treatment is mainly adopted.According to the causes and severity,options such as resection of the contracture band,resection of contracture band,release of compressed muscle(tendon),and flexor origin muscle sliding surgery,could be performed to correct hand deformities and restore hand function,and thus resulting in favorable outcomes.Conclusion Volkmann's contracture,pseudo-Volkmann's contracture,and congenital flexor muscle lesions causing finger flexion deformity have different causes and pathogenesis,which can be distinguished by carefully inquiring about the medical history,the clinical characteristics of the three,and imaging examinations,thereby selecting appropriate treatment methods.
Objective:To explore the effectiveness of arthroscopic-assisted closed reduction and internal fixation with absorbable screws in the treatment of Hawkins type Ⅱ talar neck fractures. Methods:A retrospective analysis was conducted on the clinical data of 31 patients with closed Hawkins type Ⅱ talar neck fractures between October 2021 and July 2023, all of whom were treated with arthroscopic-assisted closed reduction and internal fixation with absorbable screws. There were 18 males and 13 females with an average age of 35.9 years (range, 17-61 years). Causes of injury included sports injuries in 26 cases and impact injuries in 5 cases. The time from fracture to operation was 3-5 days (mean, 3.7 days). During follow-up, ankle pain and function were assessed using the visual analogue scale (VAS) score and the American Orthopaedic Foot & Ankle Society Ankle-Hindfoot Score (AOFAS-AHS), while radiological examinations were used to evaluate the quality of fracture reduction and healing. Results:All operations were successfully completed, and all incisions healed by first intention. All patients were followed up 12-16 months (mean, 13.0 months). One patient experienced persistent pain, limping, and joint dysfunction postoperatively, which returned to normal after symptomatic treatment. At 3 months after operation and last follow-up, the VAS scores were 2.7±0.9 and 1.3±0.8, respectively; the AOFAS-AHS were 74.5±4.7 and 90.9±3.6, respectively. There were significant differences in VAS score and AOFAS-AHS between different time points ( P<0.05). At last follow-up, all fractures healed, and the internal fixation was secure. No complication such as talar necrosis, subtalar joint stiffness, wound infection, or screw irritation occurred during follow-up. Conclusion:Arthroscopic-assisted closed reduction and internal fixation with absorbable screws for Hawkins type Ⅱ talar neck fractures has the advantages of minimal trauma, precise screw placement, few complications, and avoiding secondary screw removal, with satisfactory effectiveness.
Objective To address the lack of unified group standards,inconsistent rehabilitation service processes,and waste of rehabilitation resources in the field of traumatic spinal cord injury(TSCI)rehabilitation in China,a standardized rehabilitation specifications for TSCI was established based on the 2017 expert consensus,the latest evidence-based medical evidence,and the International Classification of Functioning,Disability and Health(ICF)framework.Methods Led by the China Rehabilitation Research Center and funded by the National Key Research and Development Program of China and the Capital Health Research and Development of Special Funds,this guideline was developed by experts from multiple renowned domestic institutions,drawing on international experience and combining it with clinical practice in China.Results Rehabilitation Guidelines and Specifications for Traumatic Spinal Cord Injury(2025 Edition)clarifies the terminology and definitions of TSCI and specifies standards for the entire process,including pre-hospital first aid,emergency management,clinical diagnosis,acute phase clinical treatment,rehabilitation assessment,and rehabilitation therapy.It details rehabilitation protocols such as physical therapy(motor therapy),occupational therapy,vocational rehabilitation,social rehabilitation,and psychological rehabilitation.Furthermore,it provides specific rehabilitation management strategies for common complications involving the respiratory system,bowel,bladder,cardiovascular system,as well as pain,spasticity,and pressure injuries.Conclusion This guideline is applicable to medical and health institutions at all levels involved in the diagnosis and treatment of TSCI.Early,accurate,and standardized rehabilitation treatment can effectively reduce disability rates,restore limb function,and improve patients' quality of life.The formulation of this guideline provides a significant basis for the standardized treatment and rehabilitation of TSCI patients in China.
Objective To analyze the trends in the disease burden of fall-related fractures among elderly Chinese from 1990 to 2023,and to examine the disparities by age,gender,and fracture site,in order to inform the development of targeted strategies for the prevention of such fractures.Methods Data on the incidence,prevalence,and years lived with disability(YLDs)of fall-related fractures among elderly Chinese from 1990 and 2023 was sourced from the 2023 Global Burden of Disease(GBD)study.The disease burden across age groups,genders,and fracture sites was assessed.Furthermore,temporal trends by these strata were analyzed using Joinpoint 5.4.0.0 software.Results From 1990 to 2023,the average annual percent changes in the age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized years of life lost rate(ASYR)for fall-related fractures among elderly Chinese were 1.81％,1.03％,and 0.83％,respectively.In China,the disease burden of fall-related fractures among the elderly increased with advancing age,and the rate of this increase accelerated in older age groups.Females had higher values than males in terms of ASIR,the rates of increase for all burden measures were greater in males.Fall-related fractures among the elderly Chinese can be classified into 12 sites,among which hip fracture had the highest ASIR,with values of 538.15 and 963.57 per 100 000 in 1990 and 2023,respectively.Fractures of the patella,tibia,fibula,or ankle had the highest ASPR and ASYR.Their ASPR were14 836.73 and 19 727.74 per 100 000 in 1990 and 2023,respectively,and ASYR were 740.84 and 989.54 per 100 000,respectively.Conclusion The increasing and heterogeneous burden of fall-related fractures among elderly Chinese calls for targeted management strategies,in addition to enhanced osteoporosis prevention,that address the distinct risks by gender,age,and fracture site.
Objective To summarize the research in tissue regeneration and engineered scaffold materials for the prevention and treatment of lymphedema.Methods The recent domestic and international literature about lymphangiogenesis-related factors,stem cells,and tissue engineered scaffold materials for the prevention and treatment of lymphedema was extensively reviewed and summarized,and the progress of tissue engineered scaffold materials in prevention and treatment of lymphedema was emphatically introduced.Results Lymphangiogenesis-related factors,stem cells,and tissue engineered scaffold materials utilize two main strategies to prevent and treat lymphedema:promoting lymphatic network regeneration in vivo and constructing functional lymphatic tissues for transplantation in vitro.Conclusion Tissue regeneration and engineered scaffold materials provide new approaches for the prevention and treatment of lymphedema.Although innovative developments have been made,most are still at the basic research stage,and clinical translation remains a challenge.
