OBJECTIVE:This study aimed to examine the biomechanical properties of full-length S2 alar-iliac screws combined with posterior iliac transfixion screws for the treatment of unilateral unstable sacral fractures, thereby providing a theoretical foundation for clinical application. METHODS:A 3-dimensional finite element analysis was applied to simulate Tile C1-C3 pelvic injuries, characterized by a unilateral sacral fracture in Denis Zone II combined with fractures of the superior and inferior pubic rami. Three posterior pelvic ring fixation techniques were evaluated: (1) standard S1 screws with S2 alar-iliac screws, (2) full-length S2 screws, and (3) full-length S2 screws combined with posterior iliac transfixion screws. Vertical and rotational stability of the posterior pelvic ring under simulated standing conditions were quantified and compared. Peak stress, vertical displacement of the sacral surface, posterior rotation angle displacement of the sacrum, and stress distribution across the pelvis were recorded and analyzed for each fixation technique. RESULTS:The fixation stability achieved by full-length S2 alar-iliac screws combined with posterior iliac transfixion screws was comparable to that of standard S1 screws with S2 alar-iliac screws. Both techniques demonstrated significantly less vertical displacement and posterior rotational angle of the sacrum compared with single S2 alar-iliac screws (P<0.05). In addition, these methods produced lower peak stress and a more uniform stress distribution. CONCLUSIONS:Full-length S2 alar-iliac screws combined with posterior iliac transfixion screws demonstrated a favorable load-sharing capacity and a reduced risk of implant fatigue. These findings indicate that this fixation method may represent an effective alternative to standard S1 screws with S2 alar-iliac screws for the treatment of unilateral unstable sacral fractures.

ObjectiveThis study provides the first international benchmarking of postoperative hip fracture care in Chinese tertiary hospitals using the UK Fracture Liaison Service (FLS) Key Performance Indicators within a “cascade of care” framework.MethodsThis study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. We conducted a retrospective audit of 2,689 patients aged ≥60 years who received hip fracture surgery in an orthogeriatric co-managed ward from 2016 to 2018. Performance was measured against seven validated FLS KPIs: bone mineral density (BMD) screening, anti-osteoporosis medication initiation, falls risk assessment, rehabilitation provision, follow-up adherence, and secondary fracture incidence at specified time points.ResultsInpatient metrics were excellent: 97.1% (2,610/2,689) underwent BMD screening and 94.0% (2,454/2,610) received bone-protective medication prior to discharge, both exceeding UK benchmarks. Post-discharge follow-up declined sharply: 50.7% (1,363/2,689) at 90 days, 17.7% (477/2,689) at 12–16 weeks, and 9.5% (255/2,689) at 12 months. Secondary fracture rates remained high (11.0–13.4%) across follow-up intervals despite strong treatment initiation. International comparison highlighted strengths in acute inpatient management but exposed deficits in community-based coordination and long-term adherence relative to integrated FLS models.ConclusionThis pioneering international comparison demonstrates that Chinese hospital-centric orthogeriatric co-management delivers outstanding acute care but struggles with sustained secondary fracture prevention due to fragmented healthcare pathways and limited primary care integration. Implementation of dedicated FLS coordinators, digital engagement tools, and structured hospital–community partnerships is essential to build a comprehensive secondary prevention network and reduce long-term fracture risk in China's aging population.

The progressive nature of cardiovascular-kidney-metabolic syndrome (CKM) allows early intervention during stages 0-3. However, the role of the cardiometabolic index (CMI) across CKM stages 0-3 and its potential synergy with depressive symptoms remain unclear. We followed 5,556 CHARLS participants (aged ≥ 45, CKM stages 0-3) for 7 years. Higher CMI and cumulative average CMI (CumCMI) were independently associated with CVD (HR for Q4 vs. Q1: 1.27, P trend = 0.009; HR for high vs. low CumCMI: 1.28, P trend < 0.001). Nonlinear thresholds were 0.47 (CMI) and 2.08 (CumCMI). Among 2,595 participants with complete depressive symptoms data, those with high CumCMI alone (HR = 1.61) or depressive symptoms alone (HR = 1.43) had elevated risk, whereas those with both factors had the highest risk (HR = 2.08). Baseline AUC was 0.651; adding CMI alone yielded no improvement (0.651), whereas adding depressive symptoms alone raised it to 0.657; both together gave 0.657-0.658. However, additive interaction was not statistically significant, and the AUC improvement from adding depressive symptoms to a model already containing CMI was minimal (ΔAUC ≈ 0.007), suggesting that this combined indicator may be more suitable for population-level risk stratification than individual clinical prediction.

Background and objectives:Hip fractures, often termed the "last fracture in life," are associated with a 20-30% one-year postoperative mortality and about 50% of survivors endure permanent disability and loss of independence. Early, accurate risk prediction enables timely preventive measures and individualized care, reducing incidence. However, older adults frequently present with mobility limitations, multiple chronic comorbidities, and heterogeneous hospital resources, leading to missing clinical or imaging data. Consequently, developing hip-fracture risk models robust to incomplete data is essential to improve generalizability, feasibility, and clinical decision-making in resource-constrained settings. Materials and methods:We retrospectively analyzed 1,287 elderly clinical records from Beijing Jishuitan Hospital, Capital Medical University, including 643 patients with hip fractures and 644 controls without fractures. Baseline variables showed notable between-group differences in sex, age, fracture history, hemoglobin levels, and bone mineral density (BMD). A global machine learning model was developed using complete-case data, with performance evaluated by accuracy and the area under the receiver operating characteristic curve (AUC). To address the frequent problem of modular missing data, we further proposed a progressive fusion model (MMPro-HIP). This model integrates features from multiple modalities stepwise, allowing for robust prediction despite incomplete information. Results:The global model reached an accuracy of 84.67% and an AUC of 0.8064. Key predictors included age, sex, BMD, and cholesterol, with the section modulus within BMD emerging as an important but previously underutilized factor. The MMPro-HIP model achieved superior performance on the independent test set, with an accuracy of 90.94% and an AUC of 0.9423. By capturing cross-modal interactions, this approach outperformed the global model. Ablation experiments confirmed the contribution of demographic variables (79.06%) and BMD measures (-6.71%) to predictive accuracy. Conclusion:MMPro-HIP showed favorable predictive performance for hip fracture risk assessment in older adults with incomplete clinical data in this single-center retrospective cohort. BMD contributed the largest performance gain, while basic demographic information alone still provided useful baseline stratification. These findings suggest that progressive multimodal fusion with residual correction may be a practical strategy for structured clinical prediction under modular missingness, although external validation is still needed.

Objective: To evaluate the safety and efficiency of deep brain stimulation (DBS) in the treatment of primary cervical dystonia (CD) and to compare the difference between the STN (subthalamic nucleus)-DBS and GPi (Globus Pallidus internus)-DBS. Study Design: Experimental study. Place and Duration of the Study: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China, from January 2012 to December 2021. Methodology: This study analysed the effects of DBS on 34 patients with primary cervical dystonia (CD) based on the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). It included 15 STN-DBS and 19 GPi-DBS cases, with TWSTRS scores collected at baseline and the final follow-up. Stimulation parameters and adverse events were also recorded. Results: The mean follow-up time was 42.77 +/- 27.46 months. A significant improvement in TWSTRS total scores was observed in all patients (p <0.001), with no significant difference between STN-DBS and GPi-DBS groups (p = 0.481). The amplitude of stimulation in the GPi group was found to be higher than that in the STN group (p <0.001). Adverse events included one case of electrode breakage in the STN-DBS group, mild dyskinesias in 14 patients (twelve from the STN-DBS group and two from the GPi-DBS group), and other stimulation-related complications in four patients (one from the STN-DBS group and three from the GPi-DBS group). All stimulation-related complications were manageable with parameter adjustments. Conclusion: DBS can significantly improve the symptoms of primary CD patients, with no significant difference in outcomes between STN-DBS and GPi-DBS. It has a good long-term therapeutic effect and surgical safety.

This study aims to characterize subsequent fractures in a cohort of older adults undergoing hip fracture surgery in China, and to evaluate the risk factors associated with the subsequent fractures. In this retrospective cohort study, we collected 3-year postoperative follow-up data for older patients (aged 60 years and above) who were admitted and underwent surgery for hip fractures at a single center in Beijing, China, from 2016 to 2018. The patients were categorized into two groups: those who experienced a subsequent fracture during three years post-surgery and those who did not. Within three years post-surgery, 63.7

Sarcopenia is a clinical syndrome characterized by progressive and widespread reductions in muscle mass and strength, mainly manifested by loss of muscle strength and somatic dysfunction, leading to a corresponding increased risk of falls, disability, and even death in the elderly. This study intended to explore the role and mechanism of IRE1α-XBP1 pathway in regulating ferroptosis in age-related sarcopenia. A mouse model of age-related sarcopenia was constructed to assess muscle function and mass. HE staining and Sirius red staining were used to observe the histopathological and morphological changes in skeletal muscle tissue, muscle fibre cross-sectional area (CSA) was determined, and immunofluorescence staining was used to detect IRE1α-XBP1 pathway proteins and 4-Hydroxynonenal (4-HNE). C2C12 cells were induced by using D-gal. Cell proliferation was detected by CCK-8, myotube diameter was observed and measured, apoptosis and ROS levels were detected by flow cytometry. Tissue and cellular iron content and oxidative stress-related indexes were detected by kits, pro-inflammatory and ferroptosis-related factors were detected by RT-qPCR, and IRE1α-XBP1 pathway proteins and 4-HNE were detected by Western blot. Activation of the IRE1α-XBP1 pathway was observed in sarcopenia mouse model, and 4μ8c, an RNase-specific inhibitor of IRE1α, effectively ameliorated the signs of aging and pathological manifestations of sarcopenia in mice. Pharmacological inhibition of the IRE1α-XBP1 pathway attenuated ferroptosis in muscle tissue of SAMP8 mice. Inhibition of IRE1α-XBP1 pathway ameliorated D-gal-induced C2C12 myotube damage and ferroptosis, and ferroptosis inducer reversed the ameliorative effects of 4μ8c on C2C12 cell ferroptosis phenotype and myotube damage. Pharmacological Inhibition of IRE1α-XBP1 pathway ameliorates age-related sarcopenia by attenuating ferroptosis in SAMP8 mice.

ABSTRACT Objective The periprosthetic fractures occur frequently in modern society, and Vancouver type B fractures have the highest incidence. Surgical treatment of fractures was necessary; however, the traditional operations have obvious disadvantages. This study aimed to explore the clinical efficacy of a novel technique—minimally invasive percutaneous plate osteosynthesis (MIPPO) combined with noncontact bridging plate for periprosthetic fracture (NCB.PP) for treating Vancouver type B femoral periprosthetic fractures. Methods The clinical data of 24 patients with Vancouver type B femoral periprosthetic fractures who were admitted between October 2018 and January 2023 were retrospectively analyzed. Fourteen were male and 10 were female; the average age was 74.82 ± 12.11 years (range 65–93 years). All patients underwent biological hip arthroplasty, including 14 total hip replacements and 10 hemi‐arthroplasties. All patients were injured by falls, and the average time from injury to hip replacement was 17.16 ± 7.17 months (range 7–34 months). According to Vancouver classification, 7, 14, and 3 patients were type B1, B2, and B3 fractures, respectively. Both MIPPO and NCB.PP were employed for fracture reduction and fixation for all patients. All patients were followed up for 18 months continuously. The operation duration, intraoperative blood loss, number of bicortical screws at the proximal end of the fracture, postoperative complications, fracture healing rate, and time of fractures were recorded for all the patients. The clinical efficacy was assessed using the Harris Hip Score. Results The average operation duration was 83.33 ± 12.16 min (range 60–150 min), the average intraoperative blood loss was 448.14 ± 186.24 mL (range 300–750 mL), and the average number of bicortical screws at the proximal end of the fracture was 3.62 ± 0.57 (range 3 ± 5). The fracture healing rate was 91.67%, and the average healing time was 7.83 ± 1.24 months (6–18 months). The average Harris Hip Score in the last follow‐up was 73.75 ± 12.62 (range 45 ± 95). No cases of reduction loss, internal fixation failure, prosthesis dislocation, or renovation were reported. Two cases of superficial wound infection, three cases of postoperative pulmonary infection, and three cases of postoperative urinary tract infectionwere successfully treated with targeted interventions. Conclusion MIPPO combined with NCB.PP for treating Vancouver type B femoral periprosthetic fractures can shorten the operation duration, reduce intraoperative blood loss, alleviate iatrogenic surgical trauma, provide sufficient internal fixation strength, facilitate fracture healing, and stabilize the prosthesis effectively, and can be recommended for clinical use.

Recently, injectable dual-crosslinked (DC) hydrogel scaffolds have attracted many attentions as a class of excellent bone regeneration biomaterials with in-situ tunable functions. However, the design of injectable DC hydrogels with cell behavior-compatible network structure and mechanical property remains a bottleneck. Herein, based on the in-situ gelling method, we constructed an injectable CMCS/PEG+SA/CaCl2 (CPSC) chemical/physical DC hydrogel scaffold with tunable softness/hardness mechanical properties and good biocompatibility. The formation mechanism and properties of the CPSC hydrogel scaffold were investigated by FTIR, XRD, rheometry, and mechanical testing. It is found that proper softness/hardness mechanical properties can be obtained by adjusting the secondary network structure of the hydrogel. The CPSC hydrogel scaffold prepared under optimal conditions can effectively promote cell infiltration, nutrient transport, and the osteogenic differentiation of rat bone mesenchymal stem cells (rBMSCs). The in vivo experiments show that the rBMSCs-loaded injectable CPSC hydrogels with appropriate mechanical properties can effectively promote bone reconstruction. This study has provided important guidance for the construction of injectable DC hydrogels with adjustable softness/hardness to promote osteogenesis for bone defect repair.

Short term results of the change of center of rotation (COR) after Bryan cervical disc replacement (CDR) have been reported. However, there is a lack of long-term studies focusing on the COR and its influences on facet joint degeneration. To evaluate the long-term clinical and radiographic results of Bryan CDR, and to explore the influence of deviated COR on facet joint degeneration at index level. It is a retrospective follow up study conducted in China. Eighty-three consecutive patients who received single-level Bryan CDR were retrospectively reviewed. Clinical evaluation included Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), and Odom’s scale. Radiographic evaluation underwent before surgery, at early follow-up (3 months) and last follow-up (10 years). The radiographic parameters included range of motion (ROM), location of COR presented by the coordinates (COR-x, COR-y), and facet joint degeneration score. Correlation analysis was conducted between changes of COR and facet joint degeneration score. Fifty-nine patients were included, with an average age of 44.6 ± 7.4 years. The mean follow-up time was 135.7 ± 12.4 (120–155) months. JOA score, NDI and Odom’s scale showed significant improvements at last follow-up. The ROM was well preserved through follow-up. 33 patients (55.9

Hip fracture, increasing exponentially with age, is osteoporosis's most severe clinical consequence. Intertrochanteric fracture, one of the main types of hip fracture, is associated with higher mortality and morbidity. The current research hotspots lay in improving the treatment effect and optimizing the secondary stability after intertrochanteric fracture surgery. Cortex buttress reduction is a widely accepted method for treating intertrochanteric fracture by allowing the head-neck fragment to slide and rigidly contact the femoral shaft's cortex. Medial cortical support is considered a more effective option in treating young patients. However, osteo-degenerations features, including bone weakness and cortical thickness thinning, affect the performance of cortex support in geriatric intertrochanteric fracture treatment. Literature focusing on the age-specific difference in cortex performance in the fractured hip is scarce. We hypothesized that this osteo-19 degenerative feature affects the performance of cortex support in treating intertrochanteric fractures between the young and the elderly. We established twenty models for the old and the young with intertrochanteric fractures and performed static and dynamic simulations under one-legged stance and walking cycle conditions. The von Mises stress and displacement on the femur, proximal femoral nail anti-rotation (PFNA) implant, fracture plane, and the cutting volume of cancellous bone of the femur were compared. It was observed that defects in the anterior and posterior cortical bone walls significantly increase the stress on the PFNA implant, the displacement of the fracture surface, and cause a greater volume of cancellous bone to be resected. We concluded that ensuring the integrity and alignment of the anterior and posterior cortical bones is essential for elderly patients, and sagittal support is recommended. This finding suggests that the treatment method for intertrochanteric fracture may differ, considering the patient's age difference.

Long non-coding RNAs (lncRNAs) have been previously researched in ankylosing spondylitis (AS). Nevertheless, there are few studies of lncRNAs and mRNAs associated with the pathogenesis of AS. Differentially expressed lncRNAs (DElncRNAs) and mRNAs (DEmRNAs) between AS and normal samples were assessed using the R limma package. DOSE packages and 'clusterProfiler' were exploited for gene enrichment analysis. The functional association of proteins and protein interactions was assessed using the STRING database. To investigate the important genes and subnetworks in the protein-protein interaction network, the MCODE plug-in in the Cytoscape software was utilized. The gene mRNA was examined via reverse transcription-quantitative PCR. In total, 152 DEmRNAs and 204 DElncRNAs were observed between normal and AS samples. A total of 68 candidate genes related to DElncRNA were identified. These candidate genes were enriched in 30 cellular component terms, 22 molecular functions, 83 biological processes, 9 Kyoto Encyclopedia of Genes and Genomes, and 36 disease ontology pathways. NONHSAG037054.2 was the most related lncRNA to genes, and GABPA was the most connected gene to lncRNA in AS. The NCBI/GenBank accession number of the lncRNA NONHSAG037054.2 was not found because it is not included in NCBI. The information of lncRNA NONHSAG037054.2 can be found at the website (http://www.noncode.org/show_gene.php?id=NONHSAG037054 and https://www.genecards.org/cgi-bin/carddisp.pl?gene=ACAP2-IT1). In total, 13 microRNAs (miRNAs) and 46 miRNAs associated with NONHSAG037054.2 and GABPA, respectively, were found. A total of 173 RNA-binding protein genes were associated with both NONHSAG037054.2 and GABPA. In addition, GABPA was downregulated in AS samples, suggesting it may have diagnostic value in AS. In conclusion, NONHSAG037054.2 and GABPA are associated with AS. GABPA was downregulated in AS, and it could serve as a novel diagnostic factor for AS.

Background and objectivesPneumonia portrays a critical health concern in geriatrics. Geriatric pneumonia can lead to changes on other complications, in which hypoalbuminemia is a common complication. However, few studies have looked at the impact of pneumonia on the course of hypoalbuminemia and predicting. This study aims to predicting hypoalbuminemia in geriatric pneumonia and non-pneumonia patients and exploring the clinical difference between the two groups.Materials and methodsThis retrospective study enrolled 42 pneumonia patients group and 76 non-pneumonia patients group. The indicators difference of different groups were analyzed, then a mutual information-grey relational coefficient gradual fusion model was constructed to predict hypoalbuminemia in the future by the indicators of vital signs, N-Terminal Pro-Brain Natriuretic Peptide, blood routine examination and urine routine examination at admission. Through the sensitivity analysis of model, we analysed the important of four examines in patients with and without pneumonia.ResultsThe predicted accuracy of our gradual fusion model was 0.954, which improve the prediction accuracy by nearly 17.6% compared with the classical machine learning method. The AUC of gradual fusion model was 0.96 and 0.9 in hypoalbuminemia patients with and without pneumonia. The sensitivity analysis of gradual fusion model showed blood routine examine was most important to predict hypoalbuminemia in patients with pneumonia, while urine routine examine was most important to predict hypoalbuminemia in non-pneumonia patients.ConclusionThe changes in the blood of patients with hypoalbuminemia combined with pneumonia were more significant than that of patients with hypoalbuminemia alone, which was characterized by abnormal excretion due to low protein. We suggested doctors should pay more attention to blood routine results when preventing hypoalbuminemia in patients with pneumonia and pay more attention to urine routine examine results when preventing hypoalbuminemia in patients without pneumonia.

Background This study aimed to investigate the positional consistency between the guidewire and the screw in spinal internal fixation surgery. Methods This study involved 64 patients who underwent robot-assisted thoracic or lumbar pedicle screw fixation surgery. Guidewires were inserted with the assistance of the Tirobot. Either cannulated screws or solid screws were inserted. Guidewire and screw accuracy was measured using CT images based on the Gertzbein and Robbins scale. The positional consistency between guidewire and screw was evaluated based on the fused CT images, which could graphically and quantitatively demonstrate the consistency. The consistency was evaluated based on a grading system that considered the maximum distance and angulation between the centerline of the guidewire and the screw in the region of the pedicle. Results A total of 322 screws were placed including 206 cannulated ones and 116 solid ones. Based on the Gertzbein and Robbins scale, 97.5% of the guidewires were grade A, and 94.1% of the screws were grade A. Based on our guidewire-screw consistency scale, 85% in cannulated group, and 69.8% in solid group, were grade A. Both solid and cannulated screws may alter trajectory compared to the guidewires. The positional accuracy and guidewire-screw consistency in the solid screw group is significantly worse than that in the cannulated screw group. The cortical bone of the pedicle has a positive guide effect on either solid or cannulated screws. Conclusion The pedicle screws may alter trajectory despite the guidance of the guidewires. Solid screws show worse positional accuracy and guidewire-screw consistency compared with cannulated screws. Trial registration The study was retrospectively registered and approved by our center’s institutional review board.

This study aimed to investigate the effectiveness of tract-specific diffusion tensor imaging (DTI) metrics in identifying the responsible segments for neurological dysfunction in cervical spondylotic myelopathy (CSM). The study encompassed nineteen participants diagnosed with CSM, including 10 males and 9 females. Additionally, a control group consisting of ten healthy caregivers (5 males and 5 females) were recruited with no symptoms and no compressions on magnetic resonance imaging (MRI). All participants underwent a comprehensive physical examination, MRI assessment, and DTI examination conducted by a senior chief physician. Several parameters were collected from the MR images, including the aspect ratio (defined as the anteroposterior diameter / the transverse diameter of the corresponding segment’s spinal cord), transverse ratio (defined as the transverse diameter of the corresponding segment's spinal cord / the transverse diameter of the spinal cord at C2/3), and T2 high signal of the spinal cord. Furthermore, quantitative DTI metrics, such as axial diffusivity (AD), mean diffusivity (MD), radial diffusivity (RD), and fractional anisotropy (FA), were calculated using automatic region-of-interest (ROI) analysis for both whole spinal cord column and dorsal column. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic efficacy of the aspect ratio, transverse ratio, and DTI parameters. The area under the curve (AUC), sensitivity, and specificity were calculated. Intraoperative spinal cord electrophysiological examination was performed as the objective measure of spinal cord function during surgery. As determined by electrophysiological examination, neurological dysfunction was found in 2 patients due to C3/4 compression, in 10 patients due to C4/5 compression, in 6 patients due to C5/6 compression, and in 1 patient due to C6/7 compression. The modified Japanese Orthopedic Association scale (mJOA) was 12.71 ± 1.55 in the CSM group, with 4.87 ± 0.72 for sensory nerve function and 5.05 ± 1.35 for motor nerve function. For the control group, none of the volunteers had neurological dysfunction. T2 high signal was found at the most stenotic segment in 13 patients of the CSM group. Considering all the cervical segments, the aspect ratio (AUC = 0.823, P = 0.001, Sensitivity = 68.42

BackgroundTo assess the accuracy of robot-assisted Magerl screw placement and explore the factors affecting the accuracy.MethodsA retrospective analysis of patients who underwent robot-assisted Magerl screw placement was performed. The accuracy of Magerl screw placement was evaluated according to the Gertzbein and Robbins scale.Results47 Magerl screws were placed in 24 consecutive patients. 32 Magerl screws were narrower than the C2 isthmus height and 26 of them were grade A. 15 Magerl screws were wider than the C2 isthmus height and all of them were grade B. Temporary fixation after decompression and a smaller difference between the C2 isthmus height and screw diameter were associated with a higher probability of cortical breach.ConclusionThe accuracy of robot-assisted Magerl screw placement was excellent. Temporary fixation after decompression and a smaller difference between the C2 isthmus height and screw diameter increased the risk of cortical breach.

Backgroud Psychological disorders, including depression, fear of falling, and cognitive disorders, are common among elderly patients with hip fractures. The effectiveness of a co-management care model in elderly hip fracture patients has been established, but its impact on those with psychological disorders remains unclear. Objective This study aims to investigate the effects of a co-management care model on elderly hip fracture patients with psychological disorders. Methods This study conducted a post-hoc analysis of a quasi-experiemental trial. The intervention group received collaborative care from orthopedic and geriatric departments in Beijing hospital, while the control group received standard orthopedic-led management in five other hospitals. The primary outcomes included three follow-up assessments within one year, focusing on changes in quality of life from admission. Repeated measurement linear regression models were used to compare differences between the groups, adjusting for potential confounding factors. Results The study included 2,071 patients with hip fractures: 1,110 in the intervention group and 961 in the control group. Over half of the patients experienced one or more psychological disorders, primarily fear of falling and cognitive disorders. The intervention had no significant effect on patients with depressive states. Patients with cognitive disorder can benefit from a co-management care model. The co-management care model may have a unfavorable effect on patients with high fear of falling. Additionally, it did not impact the quality of life in patients with concurrent depression, higher fear of falling, and cognitive disorder. Conclusion The co-management care model can improve quality of life for elderly hip fracture patients with cognitive disorder. Long-term health education for elderly hip patients should be strengthened, especially those with high fear of falling.

Objective To investigate the correlation between interleukin(IL) -1 family, classical inflammatory markers and pulmonary function in patients with stable chronic obstructive pulmonary disease(COPD). Methods Forty-five patients with stable COPD who visited the outpatient clinic or ward of the Department of Geriatrics,Beijing Jishuitan Hospital,Capital Medical University,from July 2021 to December 2022 were selected for a prospective cross-sectional survey to collect gender,age,smoking history and smoking index,underlying disease information,and serum IL-1 family(IL-1α,IL-1β,IL-18),IL-6,IL-8,TNF-α detection and pulmonary function tests. Results Multivariate regression analysis found that IL-18 was independently correlated with forced expiratory volume in the first second(FEV1) predicted value(FEV1%),IL-18 and age were independently associated with the single-breath diffusing lung capacity of carbon monoxide(DLCO),IL-18 was independently related to the improvement rate of FEV1. Conclusion IL-18 level in stable COPD was significantly correlated with pulmonary ventilation function,pulmonary diffusion capacity and FEV1 improvement rate,which suggesting that IL-18 may play an important role in the development of the disease at this stage and can be used as the good monitoring indicators for the evaluation of stable COPD.

Low back pain influences people of every age and is one of the major contributors to the global cost of illness. Intervertebral disc degeneration (IVDD) is a major contributor to low back pain, but its pathogenesis is unknown. Recently, ferroptosis has been shown to have a substantial role in modulating IVDD progression. However, the function of ferroptosis-related long non-coding RNAs (lncRNAs) has rarely been reported in IVDD. Consequently, the research was conducted to explore the ferroptosis-related lncRNA signature in the IVDD occurrence and development. We analyzed two datasets (GSE167199 and GSE167931) archived in the NCBI Gene Expression Omnibus (GEO) public database. We screened differentially expressed genes (DEGs) and differentially expressed lncRNAs (DELncs) in these datasets using the limma package. Ferroptosis-related genes (FRGs) were derived from the FerrDb V2 website and the intersection of DEGs and FRGs was considered as differentially expressed ferroptosis-related genes (DFGs). These genes were then subjected to Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis. Correlations between DFGs and DELncs were shown by Pearson test to determine differential expression of ferroptosis-related lncRNAs. The Pearson test showed that CPEB1-HTR2A-AS1 and ACSL3-DNAJC27-AS1 pairs had correlation coefficients over 0.9. Twenty ferroptosis-related lncRNAs were identified and validated in IVDD. Eight of these lncRNAs were upregulated in IVDD nucleus pulposus cells, including HTR2A-AS1, MIF-AS1, SLC8A1-AS1, LINC00942, DUXAP8, LINC00161, LUCAT1 and LINC01615. Twelve were downregulated in IVDD nucleus pulposus cells, including DNAJC27-AS1, H19, LINC01588, LINC02015, FLNC1, CARMN, PRKG1-AS1, APCDD1L-DT, LINC00839, LINC00536, LINC00710 and LINC01535. Eighteen of the 20 lncRNAs (excluding H19 and LUCAT1) were identified as ferroptosis-related lncRNAs for the first time and verified in IVDD. We have identified a ferroptosis-related lncRNA signature involved in IVDD and revealed a close relationship between CPEB1 and HTR2A-AS1, and between ACSL3 and DNAJC27-AS1. Our findings indicate that ferroptosis-related lncRNAs are a new target set for the early detection and therapy of IVDD.