BACKGROUND:Minimally invasive spinal surgery has revolutionized the treatment of traumatic thoracolumbar compression fractures. However, rare and potentially serious complications, such as paraspinal compartment syndrome, may still occur. CASE PRESENTATION:A 20-year-old Chinese male soldier sustained a T12 compression fracture and underwent successful minimally invasive percutaneous pedicle screw fixation from T11 to L1. The initial postoperative course was uneventful. On postoperative day 16, he developed severe back pain, serous fluid discharge, and localized paraspinal swelling. This prompted readmission and emergency surgical debridement. Intraoperative findings revealed pale, avascular, and noncontractile paravertebral muscles bilaterally. Pathological examination confirmed skeletal muscle necrosis, establishing the diagnosis of thoracolumbar paravertebral myofascial compartment syndrome. Aggressive management with serial debridements, negative-pressure wound therapy, and appropriate antibiotic therapy led to complete wound healing and full recovery, allowing him to resume military training. CONCLUSION:This case underscores the critical importance of early recognition and prompt surgical intervention in managing paraspinal compartment syndrome. Even in minimally invasive spinal surgery, enhanced intraoperative measures and vigilant postoperative monitoring are necessary to prevent such rare but potentially devastating complications.

STUDY DESIGN/SETTING:A retrospective cohort study. OBJECTIVE:To compare long-term outcomes and complications of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF) with cage-plate constructs (CPC) and stand-alone (SA) cages in treating degenerative cervical spondylosis. SUMMARY OF BACKGROUND DATA:ACDF is commonly used for cervical radiculopathy but may increase adjacent segment degeneration (ASD). CDR has gained popularity by preserving motion and potentially reducing ASD, whereas SA cages offer a simpler alternative to CPC. Despite widespread adoption, further research is needed to clarify the long-term outcomes and associated complications. METHODS:A retrospective analysis was conducted on 1146 patients who underwent cervical surgery between 2009 and 2012 at three Chinese hospitals, grouped into CDR (n=220), CPC-ACDF (n=540), and SA-ACDF (n=386). Primary outcomes included overall success rate and complications. Secondary measures were JOA, VAS, SF-36 scores, and imaging parameters. RESULTS:The CDR group exhibited a significantly higher overall success rate compared with CPC-ACDF and SA-ACDF groups. Dysphagia incidence immediately post-surgery was significantly lower in the CDR and SA-ACDF groups compared with CPC-ACDF. At the final follow-up, implant subsidence was lowest in the CDR group. Radiographic-ASD incidence was significantly lower in the CDR and SA-ACDF groups compared with CPC-ACDF, with SA-ACDF having the lowest rate of symptomatic-ASD. The reoperation occurred in 38 (7.0%) CPC-ACDF, 18 (4.7%) SA-ACDF, and 8 (3.6%) CDR patients. Despite a 65.5% incidence of heterotopic ossification (HO), CDR partially preserved the angular range of motion. Multivariate logistic regression analysis suggested that SA-ACDF and CDR were protective factors against postoperative radiographic-ASD. Conditional nomograms demonstrated good predictive performance for symptomatic-ASD, supported by receiver operating characteristics and calibration curves. CONCLUSION:This study suggests that CDR provides similar clinical outcomes with fewer complications compared with ACDF. However, further research is needed to confirm these findings, particularly considering the variability between different CDR devices and the potential for selection bias.

To compare the clinical efficacy of vertical double-plate fixation (combining a distal clavicle locking plate and a radial lateral plate) versus clavicular hook plate fixation for unstable distal clavicle fractures. A retrospective analysis was conducted on 37 patients with unstable distal clavicle fractures (Neer II/V) treated at our institution from May 2015 to May 2023. Twenty-one patients underwent open reduction and internal fixation with clavicular hook plates (16 Neer II, 5 Neer V), while 16 patients received vertical double-plate fixation (12 Neer II, 4 Neer V). Postoperative evaluations included: 1) radiographic assessment of fracture healing at 1, 2, 3, and 6 months; 2) Visual Analogue Scale (VAS) pain scores during passive shoulder mobilization at 1, 2, and 4 weeks; and 3) Constant-Murley shoulder function scores and complication rates (incision infection, nonunion, acromial osteolysis, impingement syndrome) at 3, 6 and 12 months. The clavicular hook plate group (mean age 47.96±17.01 years) and vertical double-plate group (mean age 49.47±15.33 years) showed comparable demographics. All patients achieved fracture union within 3–6 months, with no implant displacement. The vertical double-plate group demonstrated significantly lower VAS scores during early rehabilitation (4.6±1.09, 4.05±0.88, 2.8±1.0 vs. 7.25±1.16, 5.9±1.12, 4.75±0.71; P<0.05). At 3, 6 and 12 months, Constant-Murley scores were markedly higher in the vertical double-plate group (84.41±4.48, 92.25±2.47, 94.55 vs. 75.35±5.92, 83.4±3.87, 88.10±2.10; P<0.05). The clavicular hook plate group exhibited higher complication rates: 4 cases of impingement syndrome, 3 of acromial osteolysis, and 5 with limited shoulder mobility—all improving after implant removal. Both techniques effectively achieve fracture union for unstable distal clavicle fractures. However, vertical double-plate fixation offers superior pain control, facilitates earlier functional rehabilitation, improves shoulder functional recovery, and reduces postoperative complications, demonstrating enhanced clinical efficacy compared to hook plate fixation.

Study Design/Setting. A retrospective cohort study. Objective. To compare long-term outcomes and complications of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF) with cage-plate constructs (CPC) and stand-alone (SA) cages in treating degenerative cervical spondylosis. Summary of Background Data. ACDF is commonly used for cervical radiculopathy but may increase adjacent segment degeneration (ASD). CDR has gained popularity by preserving motion and potentially reducing ASD, while SA cages offer a simpler alternative to CPC. Despite widespread adoption, further research is needed to clarify the long-term outcomes and associated complications. Methods. A retrospective analysis was conducted on 1,146 patients who underwent cervical surgery between 2009 and 2012 at three Chinese hospitals, grouped into CDR (n=220), CPC-ACDF (n=540), and SA-ACDF (n=386). Primary outcomes included overall success rate and complications. Secondary measures were JOA, VAS, SF-36 scores, and imaging parameters. Results. The CDR group exhibited a significantly higher overall success rate compared to CPC-ACDF and SA-ACDF groups. Dysphagia incidence immediately post-surgery was significantly lower in the CDR and SA-ACDF groups compared to CPC-ACDF. At the final follow-up, implant subsidence was lowest in the CDR group. Radiographic-ASD incidence was significantly lower in the CDR and SA-ACDF groups compared to CPC-ACDF, with SA-ACDF having the lowest rate of symptomatic-ASD. The reoperation occurred in 38 (7.0%) CPC-ACDF, 18 (4.7%) SA-ACDF, and 8 (3.6%) CDR patients. Despite a 65.5% incidence of heterotopic ossification (HO), CDR partially preserved angular range of motion. Multivariate logistic regression analysis suggested that SA-ACDF and CDR were protective factors against postoperative radiographic-ASD. Conditional nomograms demonstrated good predictive performance for symptomatic-ASD, supported by receiver operating characteristic and calibration curves. Conclusion. This study suggests that CDR provides similar clinical outcomes with fewer complications compared to ACDF. However, further research is needed to confirm these findings, particularly considering the variability between different CDR devices and potential for selection bias.

OBJECTIVE: To put forward a new index of cervical curvature evaluation- relative cervical curvature area, and a new classification of cervical spine was proposed according to the relative cervical curvature area. METHODS: A total of 167 subjects with cervical spondylosis were included in the study. Firstly, 119 subjects were selected to measure C2-C7 lordosis angle by Cobb angle method, Harrison posterior tangent method, and Jackson physiological stress line method, and then their relative cervical curvature area, C1-C7 Cobb angle, C7 slope, and T1 slope were measured. The correlation between relative cervical curvature area and 3 measurement methods and common sagittal parameters was analyzed. According to the angle classification method, we calculated the diagnostic boundary value of the relative cervical curvature area classification, and selected 48 subjects to evaluate its diagnostic efficacy. Finally, 119 subjects were re-evaluated according to the diagnostic threshold and the number of intersections to verify the feasibility of the new classification. RESULTS: The results showed that the relative cervical curvature area index had good intraobserver and interobserver repeatability. Relative cervical curvature area was correlated with Harrison posterior tangent method (r = 0.930), Cobb angle method (r = 0.886), and Jackson physiological stress line method (r = 0.920), and correlated with C1-C7 Cobb angle, C7 slope, and T1 slope. The relative cervical curvature area has a good diagnostic performance for distinguishing patients with lordosis, straightening, and kyphosis. According to the new classification of cervical spine, 119 subjects were divided into 57 simple lordosis, 11 simple straightening, simple kyphosis, 26 S-type, and 21 RS-type. CONCLUSIONS: The relative cervical curvature area uses the area parameter instead of the original angle parameter and distance parameter to incorporate the change of segmental curvature, which makes up for the shortcomings of the Cobb angle method that only evaluates the curvature of 2 vertebrae, and better reflects the cervical curvature. Studies have shown that relative cervical curvature area has good repeatability and diagnostic value, and found that it has a good correlation with common cervical sagittal parameters. The new classification cervical spine makes up for the disadvantage that the angle classification method cannot distinguish between type and RS-type, and initially proposes to use the number of intersections and the relative absolute value area reflect the severity of S-type.

Background Symptomatic lumbar disc herniation (LDH) and lumbar isthmic spondylolisthesis (LIS) present significant challenges for military pilots, which may result in grounding if not effectively managed. Surgical treatment for LDH and LIS may offer a pathway to return to flight duty (RTFD), but recent data on this crucial topic is lacking. This study seeks to address this gap by investigating the RTFD outcomes among Chinese military pilots who have undergone lumbar spine surgery for symptomatic LDH and LIS. Methods A retrospective review was conducted on active-duty military pilots who underwent isolated decompressive or fusion procedures at an authorized military medical center from March 1, 2007, to March 1, 2023. The analysis utilized descriptive statistics to examine demographic, occupational, surgical, and outcome data, with a particular focus on preoperative flight status, recommended clearance by spine surgeons, and actual RTFD outcomes and time. Results Among the identified cases of active-duty military pilots with LDH or LIS treated by lumbar surgery ( n = 24), 70.8% (17 of 24) consistently maintained RTFD status without encountering surgical complications or medical issues during the follow-up period. Of the seven pilots who did not RTFD, one retired within a year of surgery, two had anterior cruciate ligament injuries, three had residual radicular symptoms, and one had chronic low back pain. Excluding pilots who retired and did not RTFD for reasons unrelated to their lumbar conditions, the RTFD rate stood at 81.0% (17 of 21). The median time for recommended clearance by spine surgeons was 143.0 days (inter-quartile range, 116.5–196.0), while the median duration for actual RTFD attainment was 221.0 days (inter-quartile range, 182.0–300.0). The median follow-up post-lumbar surgery was 1.7 years (inter-quartile range, 0.4–2.9). Conclusion Most military pilots diagnosed with symptomatic LDH and LIS can continue their careers and regain active-duty flight status following lumbar spine surgery, as reflected by the high RTFD rate. Lumbar spine surgery can successfully alleviate the physical constraints associated with spinal conditions, facilitating the return of military pilots to their demanding profession.

>脊柱融合的理念源始于关节融合技术，即用不动的关节来替代随活动而疼痛的关节。脊柱融合与骨折愈合不同，前者是通过特定的外科技术和材料来实现骨组织终身生物性连接，让“链条式脊柱“变成“柱式脊柱”（并非理想的生理模式脊柱），达到治疗部分脊柱疾病的目的。

The inability of articular cartilage to self-repair following injuries frequently precipitates osteoarthritis, profoundly affecting patients' quality of life. Given the limitations inherent in current clinical interventions, an urgent need exists for more effective cartilage regeneration methodologies. Previous studies have underscored the potential of electrical stimulation in cartilage repair, thus motivating the investigation of innovative strategies. The present study introduces a three-dimensional scaffold fabricated through a composite technique that leverages the synergy between piezoelectricity and biofactors to enhance cartilage repair. This scaffold is composed of polylactic acid (PLLA) and barium titanate (BT) for piezoelectric stimulation and at the bottom with a collagen-coated layer infused with fibroblast growth factor-18 (FGF-18) for biofactor delivery. Designed to emulate the properties of natural cartilage, the scaffold enables controlled generation of piezoelectric charges and the sustained release of biofactors. In vitro tests confirm that the scaffold promotes chondrocyte proliferation, matrix hyperplasia, cellular migration, and the expression of genes associated with cartilage formation. Moreover, in vivo studies on rabbits have illustrated its efficacy in catalyzing the in situ regeneration of articular cartilage defects and remodeling the extracellular matrix. This innovative approach offers significant potential for enhancing cartilage repair and holds profound implications for regenerative medicine. In this study, a three-dimensional composite scaffold with piezoelectric stimulation and synergistic bioactive factors was developed for promoting cartilage repair. Good results were observed in both in vitro and in vivo cartilage repair experiments.

Objective: Electrospun nanofibers exhibit potential as scaffolds for articular cartilage tissue regeneration. This study aimed to fabricate electrospun polycaprolactone (PCL)/silk fibroin (SF) composite nanofiber scaffolds and to explore performance of the scaffolds for articular chondrocyte regeneration.Methods: By altering material composition and preparation methods, three types of nanofiber scaffolds were effectively fabricated, including randomly oriented PCL (RPCL) nanofiber scaffold, randomly oriented PCL/SF (RPCL/SF) nanofiber scaffold, and aligned PCL/SF (APCL/SF) nanofiber scaffold. Physiochemical analyses were performed to determine mechanical properties and surface hydrophilicity of the nanofiber scaffolds. In vitro studies were conducted to investigate performance of the scaffolds on articular chondrocyte proliferation, gene expression and glycosaminoglycan secretion. Cytoskeleton staining was used to observe the arrangement of chondrocytes along the direction of the fibers and their elongation along the fiber arrangement.Results: The physicochemical analysis demonstrated that the APCL/SF nanofiber scaffold exhibited improved mechanical properties and surface hydrophilicity compared to the RPCL and RPCL/SF nanofiber scaffolds. Furthermore, the in vitro cell culture studies confirmed that the APCL/SF nanofibers could significantly promote articular chondrocyte proliferation, type II collagen (COL-II) gene expression, and glycosaminoglycan secretion compared to the RPCL and RPCL/SF nanofiber scaffolds. Additionally, cytoskeletal staining displayed that the APCL/SF nanofiber scaffold promoted the elongation of articular chondrocytes in the direction of parallel fiber alignment.Conclusion: The APCL/SF nanofiber scaffold exhibited promising potential as a composite scaffold for articular cartilage regeneration.

目的:通过脊柱单侧双通道内镜技术(UBE)治疗椎间孔型腰椎间盘突出(ILDH)的临床研究,设计了一种基于椎间孔区三维解剖结构的超远外侧入路(FFLB)并评价其临床应用价值.方法:回顾性分析2020年1月至2022年1月收治的12例ILDH患者的临床资料.男4例,女8例;年龄26～68岁,平均(46.5±11.8)岁;体重指数21.1～27.8 kg/m2,平均(25.04±1.94)kg/m2;记录手术时间、住院时间,对比分析手术前后的疼痛视觉模拟评分(VAS)、日本骨科协会(JOA)评分、直腿抬高角度、MRI矢状位和轴位椎间孔距离.结果:所有患者手术顺利完成,手术时间40～90 min,平均(67±15)min.术后随访时间6～13个月,平均(7.5±2.2)个月.术后即刻、术后3个月和术后6个月的腰腿痛VAS评分均低于术前,JOA评分高于术前,差异有统计学意义(P＜0.05);直腿抬高角度大于术前,差异有统计学意义(P＜0.05);MRI轴位椎间孔内孔、正中央、外孔前后距离均大于术前,差异有统计学意义(P＜0.05);MRI矢状位椎间孔上区和下区的椎间孔内孔、正中央、外孔前后距离均大于术前,差异有统计学意义(P＜0.05).结论:FFLB增加了操作器械的外展角,方便椎间孔内外操作.准确的初始定位和清晰的三维解剖结构为治疗ILDH提供了新选择.

OBJECTIVE:To compare the clinical efficacy of the minimally invasive technique and the open method in the treatment of irreducible unilateral subaxial cervical facet joint dislocation (SCFD).METHODS:From March 2015 to September 2018, 62 patients with unilateral SCFD were studied. The cases were divided into 2 groups based on different surgery strategies. Thirty-one patients were enrolled in the minimally invasive surgery (MIS) group, and 31 patients were enrolled in the open surgery group. The duration of prone position operation, blood loss, and total hospitalization costs were recorded. The clinical effects were evaluated using visual analogue scale scores, the Oswestry Disability Index, and Japanese Orthopedic Association scores at each follow-up. In addition, the segmental Cobb angle and intervertebral height were recorded and compared.RESULTS:The amount of intraoperative blood loss, prone position operation duration, and total hospital costs in the MIS group were significantly lower than in the open surgery group. The visual analogue scale, Oswestry Disability Index, and Japanese Orthopedic Association scores of the 2 groups significantly improved after the operation. A satisfactory fusion rate was obtained in both groups, and the segmental Cobb angle and intervertebral height scores in both groups improved significantly.CONCLUSIONS:Minimally invasive reduction had equal clinical efficacy to posterior open surgery. However, MIS was less invasive and had lower costs. Therefore, it is a potential option in the treatment of SCFD.

BackgroundNeck pain (NP) is a common musculoskeletal disorder among fighter pilots and has become a rising concern due to its detrimental impact on military combat effectiveness. The occurrence of NP is influenced by a variety of factors, but less attention has been paid to the association of NP with demographic, occupational, and cervical sagittal characteristics in this group. This study aimed to investigate the prevalence and risk factors of NP in Chinese male fighter pilots using a questionnaire and cervical sagittal measurements.MethodsDemographic and flight-related data, as well as musculoskeletal pain information, were gathered from Chinese male fighter pilots via a self-report questionnaire. Cervical sagittal parameters were measured and subtypes were classified using standardized lateral cervical radiographs. Differences in various factors between the case and control groups were analyzed using t-tests or chi-square tests. Binary logistic regressions were conducted to explore potential risk factors contributing to NP. Predictors were presented as crude odds ratios (CORs) and adjusted odds ratios (AORs), along with their respective 95% confidence intervals (CIs).ResultsA total of 185 male fighter pilots were included in this cross-sectional study. Among them, 96 (51.9%) reported experiencing NP within the previous 12 months. The multivariate regression analysis revealed that continuous flight training (AOR: 4.695, 95% CI: 2.226–9.901, p < 0.001), shoulder pain (AOR: 11.891, 95% CI: 4.671–30.268, p < 0.001), and low back pain (AOR: 3.452, 95% CI: 1.600–7.446, p = 0.002) were significantly associated with NP.ConclusionThe high 12-month prevalence of NP among Chinese male fighter pilots confirms the existence of this growing problem. Continuous flight training, shoulder pain, and low back pain have significant negative effects on pilots’ neck health. Effective strategies are necessary to establish appropriate training schedules to reduce NP, and a more holistic perspective on musculoskeletal protection is needed. Given that spinal integrated balance and compensatory mechanisms may maintain individuals in a subclinical state, predicting the incidence of NP in fighter pilots based solely on sagittal characteristics in the cervical region may be inadequate.

夏科氏关节炎(Charcot arthropathy),又称作神经性关节炎,多数是由于糖尿病、脊髓空洞症、脊髓创伤、麻风病、慢性酒精中毒等因素,夏科氏关节炎常累及肩关节,导致骨质破坏,肩关节不稳和抬举功能障碍.造成肩关节周围神经功能障碍,脊髓空洞症是导致肩关节夏科氏关节炎的常见原因[1],发生肩关节反复脱位,骨关节退变与破坏.

A meta-analysis research was executed to appraise the consequence of intrawound vancomycin powder (IWVP) in orthopaedic surgery (OPS) as surgical site wound infection (SSWI) prophylaxis. Inclusive literature research till March 2023 was carried out and 2756 interconnected researches were revised. Of the 18 picked researches enclosed 13 214 persons with OPS were in the used researches' starting point, 5798 of them were utilising IWVP, and 7416 were control. Odds ratio (OR) in addition to 95% confidence intervals (CIs) were used to appraise the consequence of the IWVP in OPS as SSWI prophylaxis by the dichotomous approaches and a fixed or random model. IWVP had significantly lower SSWIs (OR, 0.61; 95% CI, 0.50-0.74, P < .001), deep SSWIs (OR, 0.57; 95% CI, 0.36-0.91, P = .02), and superficial SSWIs (OR, 0.67; 95% CI, 0.46-0.98, P = .04) compared with control in persons with OPS. IWVP had significantly lower SSWIs, deep SSWIs, and superficial SSWIs compared with control in persons with OPS. However, when interacting with its values, caution must be taken and more research is needed to confirm this finding.

INTRODUCTION: There is no consensus on whether cardiopulmonary reserve affects the risk of gravity-induced loss of consciousness (G-LOC) or almost loss of consciousness (A-LOC). Few previous studies have used cardiopulmonary exercise testing (CPET) to assess cardiopulmonary reserve function (CPRF) of fighter aviators. We compared CPET-related parameters in G-LOC/A-LOC and non-G-LOC/A-LOC fighter aviators to explore the effect of cardiopulmonary reserve function on G tolerance. METHODS: A total of 264 male fighter aviators with more than 500 h of flight experience participated in the study, all of whom underwent CPET and human centrifuge testing. We divided the aviators into two groups based on whether they experienced G-LOC/A-LOC during the human centrifuge test and compared the CPET parameters between the two groups. RESULTS: A total of 37 aviators (14%) experienced G-LOC/A-LOC. There were no significant differences in age (26.65 ± 4.30 vs. 26.01 ± 4.95), height (173.68 ± 4.21 vs. 173.55 ± 3.37), weight (69.51 ± 6.22 vs. 69.63 ± 6.01), or body mass index (23.06 ± 2.11 vs. 23.11 ± 1.82) between the two groups. Forced vital capacity (FVC) (4.95 ± 0.87 vs. 4.65 ± 0.79) and forced expiratory volume in 1 s (FEV1) divided by FVC (FEV1/FVC) (79.88 ± 7.24 vs. 83.72 ± 9.24) of pulmonary function of the G-LOC/A-LOC group was significantly lower than that of the non-G-LOC/A-LOC group. There was no significant difference in CPET-related parameters between the two groups. DISCUSSION: In conclusion, FEV1/FVC may be a factor affecting aviators’ G-LOC/A-LOC, meaning aviators with slightly lower ventilation are more likely to experience G-LOC/A-LOC. However, oxygen uptake and exercise blood pressure, oxygen pulse, etc., may not be the main factors influencing G-LOC/A-LOC. Lan X, Zhu W, Du J, Wang J, Yang M, Xu Y, Cao Y. High G tolerance and cardiopulmonary reserve function in healthy air force aviators. Aerosp Med Hum Perform. 2023; 94(12):911–916.

Background:Surgically treated anterior cruciate ligament (ACL) injuries may be a waivable condition and allow return to full flight status, but waivers are based on expert opinion rather than recent published data. The purpose of this study was to evaluate return to flight after anterior cruciate ligament reconstruction (ACLR) in male military aircrews with ACL injuries and to identify factors that affect flight clearance.Method:A single-center retrospective review was conducted by the authors for all active-duty aircrew who underwent ACLR at an authorized military medical center from January 2010 to December 2019. Demographic characteristics, occupational information, surgical data, and flight readiness evaluation outcomes were collected. Based on the final medical evaluation, subjects were divided into a qualified group (N = 64) and a disqualified group (N = 9), and the difference in data collected between the two groups was then analyzed to identify factors affecting flight clearance.Results:A total of 73 patients underwent successful ACLR with a mean age of 31.6 ± 5.6 years. Non-contact injury was the main type of ACL injury, accounting for 84.9% of the total injuries. 55 cases (75.3%) occurred during daily sports activities and 18 (24.7%) during military training. 64 of the 73 crewmembers (87.7%) were able to return to flight at their last follow-up evaluation. The preoperative interval time (PIT) was significantly less in the qualified group than in the disqualified group (P = 0.002). Patients who underwent ACLR within three months were more likely to return to flying than those who underwent the procedure three months later (97.4% vs. 76.5%, P = 0.010). The incidence of failure to return to flight duty was significantly higher in aircrews with ACL injuries combined with meniscal injuries than in aircrews with isolated ACL injuries (21.4% vs. 0.0%, P = 0.017).Conclusion:ACLR appears to be safe for military aircrew suffering ACL injuries with or without meniscal injury, and return to flight status is the most likely outcome for the majority of postoperative pilots. Prolonged PIT, PIT > 3 months, and ACL injury combined with meniscus injury had a negative impact on postoperative flight readiness.

目的 研究二苯乙烯苷(tetrahydroxy stilbene-2-o-β-d-glycoside,TSG)对氧化应激导致的骨质疏松的保护作用,并初步探讨相关机制.方法 不同浓度TSG预处理MC3T3-E124 h,200μM H2O2处理24 h,实验分组:①空白对照组;②H2O2处理组;③H2O2+TSG 1μM处理组;④H2O2+TSG 10μM处理组;⑤H2O2+NAC 1mM处理组,通过CCK-8检测细胞活性;RT-PCR检测细胞中TCF及其下游基因(AXIN2、ALP、OPG)、FoxO3a及其下游基因(GADD45、CAT)的mRNA表达;Western blot检测细胞中β-catenin、FoxO3a蛋白表达情况.30只9周龄BALB/c雌性小鼠,随机分为5组:①基础组:标记为C;②假手术组+溶剂组:标记为J;③去卵巢模型组+溶剂组:标记为MC;④去卵巢模型组+TSG(40 mg/ml):标记为T;⑤去卵巢模型组+雌激素:标记为E.术后7 d开始给药,共90 d,每天给药40 mg/kg小鼠体质量,取血清用于检测活性氧自由基(reactive oxygen species,ROS)水平;HE染色用于小鼠骨组织形态学评价;RT-PCR检测骨组织中FoxO3a、TCF及其下游基因的mRNA表达.结果 不同浓度TSG预处理后,细胞活性降低现象得到改善;Western-blot结果提示,H2O2作用可以提高FoxO3a蛋白表达,不同浓度TSG预处理后,FoxO3a蛋白表达下降;去卵巢小鼠血清中ROS水平升高(P<0.01);T组可以明显改善血清中ROS水平(P<0.05);HE染色结果提示,去卵巢小鼠骨量减少,骨小梁数量减少,间距增大,给予TSG处理后,骨小梁数量及间距有不同程度改变.RT-PCR结果提示,在细胞层面及小鼠去卵巢OP模型中,氧化应激可上调FoxO3a及其下游基因的mRNA表达,下调TCF及其下游基因的表达(P<0.01),给予不同浓度TSG预处理后,FoxO3a、TCF及其下游基因的表达得到改善(P<0.05).结论 氧化应激可以导致成骨前体细胞MC3T3-E1死亡增加,导致小鼠骨量减少,TSG可以通过调控WNT/FoxO3a信号通路来抑制氧化应激介导骨质疏松的发生.

Objective:To explore the clinical diagnostic features and the causes of misdiagnosis of Keegan′s disease.Methods:3 patients with Keegan's disease treated in Orthopedics Department of Air Force Medical Center Affiliated to Air Force Medical University from March 2018 to December 2020 were selected. Their diagnosis, differential diagnosis and outcomes were analyzed, and the relevant literatures were reviewed.Results:There were 3 patients, 1 male and 2 females, aged 36, 36 and 47 years old, respectively. All the patients had restricted abduction of the right shoulder without obvious inducement, and lateral soreness when lifting the right upper arm. The muscle strength of deltoid muscle and biceps brachii of the right upper limb was significantly reduced, with no symptoms and signs of spinal cord damage and paresthesia. There were typical selective "high spots" in MRI T2WI, and clear neurological damage of the deltoid and biceps in electrophysiology, in line with all the clinical features of Keegan′s disease. With conservation treatment, all patients began to get better 2 to 3 weeks and recovered 11 to 13 weeks after onset.Conclusion:Shoulder abductor dysfunction without paresthesia is a typical clinical feature of Keegan′s disease.

目的:分析脑膜补片联合大骨瓣减压术治疗颅脑损伤的临床应用效果.方法:选择东部战区总医院淮安医疗区2014年1月—2020年1月收治的65例重度颅脑损伤患者作为研究对象,采用随机数表法分成对照组32例和观察组33例.对照组患者进行标准化大骨瓣减压术治疗,观察组患者进行脑膜补片联合大骨瓣减压术治疗.比较两组患者预后情况、并发症.结果:观察组患者预后情况良好率高于对照组,差异有统计学意义(Z=2.742,P=0.006<0.05).观察组患者并发症率低于对照组差异有统计学意义(χ2=5.669,P=0.017<0.005).结论:脑膜补片联合大骨瓣减压术治疗颅脑损伤能明显减少患者术后并发症发生情况,改善预后,建议使用.