We propose BioPretext, a multimodal self-supervised learning (SSL) framework that unifies geometric and non-geometric biological signals for orthopedic feature extraction. Unlike conventional approaches that process imaging data independently, BioPretext exploits interactions between structural and functional modalities through cross-modal pretext tasks. The framework employs a dual-branch transformer architecture, where a vision transformer encodes geometric data (e.g., radiographs) and a temporal transformer processes sequential biological signals (e.g., EKG). Both representations are projected into a shared latent space via cross-attention. To improve robustness, two contrastive pretext tasks—signal inversion and time-window masking—are introduced, enabling recovery of corrupted or missing biological signals using geometric context. Extracted features are then integrated through a gated attention mechanism that adaptively weights modality contributions according to task relevance. The framework can replace conventional feature extraction modules in orthopedic AI systems and be readily applied to downstream tasks such as joint kinematics prediction and lesion segmentation. Key innovations include cross-modal SSL optimization, temporal-spatial alignment, and patient-specific dynamic fusion. Implemented with Swin Transformer and Performer backbones, BioPretext is pretrained on unlabeled multimodal datasets and subsequently fine-tuned for orthopedic applications. Experimental results demonstrate superior performance over unimodal SSL approaches, particularly in tasks involving complex interactions between biological and structural data, such as gait analysis and osteoarthritis grading. These findings highlight the potential of BioPretext as a scalable and generalizable framework for multimodal representation learning in orthopedics.

BackgroundMonocytes play a pivotal role in the process of fracture healing, particularly during the early phase. However, the specific functions of their cellular subsets and the alterations that occur in the context of osteoporotic fracture (OPF) remain poorly elucidated.MethodsAn OPF model was established using ovariectomized (OVX) C57BL/6 J mice, with sham-operated mice serving as controls. Subsequent single-cell RNA sequencing (scRNA-seq) analysis was performed to identify and characterize monocyte populations within the early fracture microenvironment.ResultsscRNA-seq analysis revealed that monocytes could be classified into four distinct subsets. Monocytes-1 and monocytes-2 were identified as Ly6C+ monocytes; specifically, monocytes-1 differentiated into M1 macrophages to mediate inflammatory responses, whereas monocytes-2 proliferated and served as a cellular reservoir to support the differentiation of monocytes-1. Monocytes-3 and monocytes-4 exhibited the potential to differentiate into M2 macrophages. Functionally, monocytes-3 primarily constrained the magnitude of inflammatory responses, while monocytes-4 were involved in orchestrating tissue repair processes, such as angiogenesis. In the local bone tissues of OVX mice at the early fracture stage, all monocyte subsets exhibited a tendency toward reduced abundance.ConclusionThis study reveals a high degree of functional heterogeneity among monocyte subsets during early fracture healing. The reduction in monocyte subsets in OVX mice impairs the critical pathological transition from inflammatory responses to tissue repair. This impairment may constitute a partial mechanistic basis for the delayed and compromised healing observed in OPF.

BackgroundGlobal aging has led to a continuous increase in rotator cuff injuries, often accompanied by clinical-related sleep disorders. There is a lack of clinical research on whether preoperative sleep quality affects rapid postoperative recovery; therefore, it is necessary to conduct clinical follow-up studies to explore the relationship between preoperative sleep quality and postoperative rehabilitation, in order to provide rehabilitation guidance for clinical practice.MethodsIn this prospective cohort study, 256 patients who underwent arthroscopic rotator cuff repair (ARCR) at our center from January 2022 to January 2024 were grouped based on the Pittsburgh Sleep Quality Index (PSQI): the high sleep quality group (HSQG, PSQI < 7, n = 120) and low sleep quality group (LSQG, PSQI ≥ 7, n = 136). All patients were given the same rapid rehabilitation protocol. Before the operation and on the 1st, 3rd, 1st week, 1st month, 3rd month, and 6th month after the operation, visual analog scale (VAS) pain scores, Self-Rating Anxiety Scale (SAS) score, Self-Rating Depression Scale (SDS) score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, and patient satisfaction were evaluated. At the same time, the occurrence of adhesions, re-tears, and other complications was recorded.ResultsAll 256 cases successfully completed arthroscopic repair and received complete follow-up. There were no statistically significant differences in baseline data, pain and function scores between the two groups (p > 0.05). Early stage: In the first day, third day and first week after surgery, the VAS, SAS and SDS scores of the HSQG were significantly lower than those of the LSQG (p < 0.05). Mid-term: At 1, 3, and 6 months after surgery, the differences in the above indicators disappeared (p > 0.05). Function: The ASES and Constant-Murley scores of the HSQG were better than those of the LSQG from 1 week to 3 months after surgery (p < 0.05), and there was no difference between the two groups at other time points. Satisfaction: The hospital satisfaction of the HSQG was significantly higher (p < 0.05). Complications: The incidence of LSQG was 5.9%, and that of high sleep quality group was 3.3%. There was no statistically significant difference (p > 0.05).ConclusionMaintaining good sleep quality before surgery can alleviate early postoperative pain, reduce the risk of postoperative anxiety and depression, accelerate functional recovery, and enhance patient satisfaction. It is recommended to incorporate preoperative sleep optimization into the rapid rehabilitation process for rotator cuff injuries to facilitate patients’ rapid postoperative recovery.

Currently, there are practical and technical difficulties in the construction of clinical questions in the development of clinical practice guidelines. Clinicians or guideline developers seldom construct clinical questions based the actual case scenario, leading to some information loss between structured and actual clinical connotation. To overcome this challenge, we proposed a case-guided questions construction approach, and carried out case research and verification in the formulation of the guideline. We found that this method could more efficiently and scientifically assist the formulation of clinical questions, and provide reference for clinicians or guideline developers.

Complications following volar locking plating (VLP) of distal radius fracture (DRF) are frequent. Increasing evidence has shown an inverse relationship between increased surgeon experience and fewer complications in a variety of surgeries, and this study aimed to verify whether this relationship existed when specified in the DRF surgically treated with VLP. Patients with an unstable DRF surgically treated by VLP in our institution between January 2016 and December 2021 were included. Data on complication were obtained by inquiring the medical charts and the follow-up register, also the covariables for adjustment. Surgeon volume was defined by the number of VLP procedures within 12 months preceding index surgery, and its optimal cutoff was determined by constructing the receiver operator characteristic, in which high- or low-volume was dichotomized. The relationship between surgeon volume and risk of complications was investigated using a univariate and multivariate logistic regression model. Five hundred sixty-one patients were enrolled and operated on by 21 surgeons, with a median of 14 for each surgeon. The 1-year complication rate was 13.5%, with tenosynovitis (4.1%), carpal tunnel syndrome (2.7%), and complex regional pain syndrome type 1 (2.3%) being the most common. The optimal cutoff was 8, and 69.2% of patients were operated by high-volume surgeons, with a 7.5% incidence; 30.8% of the patients were operated by low-volume surgeons, with a 27.2% incidence. Low-volume was associated with an increase in the risk of general complications by 4.8 times (95% confidential interval, 2.9-8.2). Subgroup analyses showed that this trend was intensified for AO type C fracture (odds ratio, 5.9), slightly mitigated for type B (odds ratio, 3.7), but not significant for type A. The finding highlighted the need to maintain 8 cases/year to improve the complications of DRFs, and for severe cases, centralized treatment is recommended.

Objectives To compared the presentation of research priorities in the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) clinical practice guidelines (CPGs) developed under the guidance of the GRADE working group or its two co-chair, and the Chinese CPGs. Methods This was a methodological empirical analysis. We searched PubMed, Embase, and four Chinese databases (Wanfang, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure and Chinese Biomedical Literature Database) and retrieved nine Chinese guideline databases or Society websites as well as GRADE Pro websites. We included all eligible GRADE CPGs and a random sample of double number of Chinese CPGs, published 2018 to 2022. The reviewers independently screened and extracted the data, and we summarized and analyzed the reporting on the research priorities in the CPGs. Results Of the 135 eligible CPGs (45 GRADE CPGs and 90 Chinese CPGs), 668, 138 research priorities were identified respectively. More than 70% of the research priorities in GRADE CPGs and Chinese CPGs had population and intervention (PI) structure. 99 (14.8%) of GRADE CPG research priorities had PIC structures, compared with only 4(2.9%) in Chinese. And 28.4% (190) GRADE CPG research priorities reflected comparisons between PICO elements, approximately double those in Chinese. The types of research priorities among GRADE CPGs and Chinese CPGs were mostly focused on the efficacy of interventions, and the type of comparative effectiveness in the GRADE research priorities was double those in Chinese. Conclusions There was still considerable room for improvement in the developing and reporting of research priorities in Chinese CPGs. Key PICO elements were inadequately presented, with more attention on intervention efficacy and insufficient consideration given to values, preferences, health equity, and feasibility. Identifying and reporting of research priorities deserves greater effort in the future.

Objectives Clinical practice guideline (CPG) developers conduct systematic summaries of research evidence, providing them great capacity and ability to identify research priorities. We systematically analysed the reporting form and content of research priorities in CPGs related to knee osteoarthritis (KOA) to provide a valuable reference for guideline developers and clinicians.Design A methodological literature analysis was done and the characteristics of the reporting form and the content of the research priorities identified in KOA CPGs were summarised.Data sources Six databases (PubMed, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang and Chinese Biomedical Literature Database) were searched for CPGs published from 1 January 2017 to 4 December 2022. The official websites of 40 authoritative orthopaedic societies, rheumatology societies and guideline development organisations were additionally searched.Eligibility criteria We included all KOA CPGs published in English or Chinese from 1 January 2017 that included at least one recommendation for KOA. We excluded duplicate publications, older versions of CPGs as well as guidance documents for guideline development.Data extraction and synthesis Reviewers worked in pairs and independently screened and extracted the data. Descriptive statistics were used, and absolute frequencies and proportions of related items were calculated.Results 187 research priorities reported in 41 KOA CPGs were identified. 24 CPGs reported research priorities, of which 17 (41.5%) presented overall research priorities for the entire guideline rather than for specific recommendations. 110 (58.8%) research priorities were put forward due to lack of evidence. Meanwhile, more than 70% of the research priorities reflected the P (population) and I (intervention) structural elements, with 135 (72.2%) and 146 (78.1%), respectively. More than half of the research priorities (118, 63.8%) revolved around evaluating the efficacy of interventions. Research priorities primarily focused on physical activity (32, 17.3%), physical therapy (30, 16.2%), surgical therapy (27, 14.6%) and pharmacological treatment (26, 14.1%).Conclusions Research priorities reported in KOA CPGs mainly focused on evaluating non-pharmacological interventions. There exists considerable room for improvement for a comprehensive and standardised generation and reporting of research priorities in KOA CPGs.

目的 运用网络药理学和实验验证探讨补肾痹通方治疗膝骨关节炎(KOA)的作用机制.方法 运用中药系统药理学数据库与分析平台获取补肾痹通方的有效成分与作用靶点,运用GeneCards、OMIM、PharmGkb、TTD、DrugBank数据库检索KOA疾病相关靶点,将药物和疾病靶点取交集,将获得的有效成分及相关靶点导入Cytoscape软件,绘制"补肾痹通方-有效成分-KOA作用靶点"的网络图,筛选关键有效成分,将潜在靶点导入STRING数据库绘制蛋白质-蛋白质相互作用网络图.筛选补肾痹通方治疗KOA的核心靶点,进行GO富集与KEGG注释分析.选取人软骨细胞设置对照组、损伤组、给药组,对照组正常培养,损伤组和给药组在含白细胞介素(IL)-1β(10ng/ml)DMEM/F12培养基中培养,给药组给予0.444 7 μg/ml补肾痹通方药液.培养24 h后,观察三组细胞形态,采用酶联免疫吸附试验检测炎症因子水平,qRT-PCR与免疫印迹法检测三组软骨修复因子的表达.结果 共筛选出补肾痹通方有效成分186个,主要为槲皮素、木犀草素、山柰酚等,主要通过TNF、MMP1、CXCL2、IL1B等关键靶点和PI3K/Akt、T细胞受体、Toll样受体、低氧诱导因子-1、TNF、IL-17等信号通路发挥作用,涉及氧化应激反应、细胞凋亡、炎症反应等生物过程.显微镜下可见,损伤组细胞数量减少,给药组细胞数量增加.损伤组肿瘤坏死因子-α(TNF-α)、IL-1β、IL-6水平高于对照组,转化生长因子-β(TGF-β)、胰岛素样生长因子-1(IGF-1)、碱性成纤维细胞生长因子(BFGF)水平及SOX9、COL2A1基因和蛋白的表达水平均低于对照组(P＜0.05).给药组TNF-a、IL-1 β、IL-6水平低于损伤组,TGF-β、IGF-1、BFGF及SOX9、COL2A1基因和蛋白的表达水平均高于损伤组(P＜0.05).结论 补肾痹通方可能通过缓解炎症细胞浸润并参与SOX9、COL2A1调控来促进损伤软骨细胞修复.

目的:探讨补肾生骨汤调节miR-135b-5p/Runt相关基因2(RUNX2)信号轴对股骨头无菌性坏死(ONFH)大鼠的影响.方法:将SD大鼠随机分为假手术(Sham)组、ONFH组、低/中/高剂量补肾生骨汤(0.13,0.26,0.52 g/mL,L/M/H-补肾生骨汤)组、H-补肾生骨汤+miR-135b-5p agomir 组、H-补肾生骨汤+agomir-NC组,采用液氮冷冻法制备ONFH大鼠模型;苏木精-伊红(HE)染色观察股骨头组织病理改变;检测血浆中纤维蛋白原(FIB)、血管内皮生长因子(VEGF)、一氧化氮合成酶(NOS)、骨钙素(BGP)水平;RT-qPCR仪、Western Blot法分别检测股骨头组织中miR-135b-5p、RUNX2表达水平;双荧光素酶实验分析miR-135b-5p与RUNX2的靶向关系.结果:与Sham组比较,ONFH组股骨头组织发生区域性缺损,骨小梁稀疏、行走不规则,空骨陷窝增多明显;血浆中FIB表达升高,VEGF、NOS、BGP表达降低(P＜0.05);经L/M/H-补肾生骨汤干预后,上述情况均改善,且经H-补肾生骨汤干预改善更明显;在H-补肾生骨汤干预的基础上增加miR-135b-5p agomir干预后,H-补肾生骨汤干预的改善作用被削弱.与Sham组比较,ONFH组股骨头组织中miR-135b-5p表达升高,RUNX2表达降低(P＜0.05);经H-补肾生骨汤干预后,miR-135b-5p表达降低,RUNX2表达升高(P＜0.05);在H-补肾生骨汤干预的基础上增加miR-135b-5p agomir干预后,miR-135b-5p表达升高,RUNX2表达降低(P＜0.05).双荧光素酶实验结果显示,miR-135b-5p与RUNX2存在靶向关系.结论:补肾生骨汤能促进ONFH大鼠股骨头组织修复,可能与下调miR-135b-5p进而靶向上调RUNX2有关.

Review question / Objective: Clinical practice guideline development group systematic summary of research evidence, so they have the most capacity and energy to identify research priorities. We systematically evaluated the reporting form and content of research priorities in clinical practice guidelines (CPGs) related to knee osteoarthritis (KOA). Information sources: We searched 6 databases including PubMed, Embase, VIP Database for Chinese Technical Periodicals, Wanfang, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. In addition, The official websites of 40 authoritative orthopedic societies, rheumatology societies and guideline development organizations were additionally searched.

目的 探讨胰岛素样生长因子-1(IGF-1)过表达的骨髓间充质干细胞(BMSCs)对白细胞介素1β(IL-1β)诱导的软骨细胞损伤的影响及相关机制.方法 慢病毒转染构建IGF-1过表达的BMSCs,使用倒置显微镜观察细胞形态,流式细胞仪鉴定骨髓间充质干细胞表面抗原表达,实时定量PCR和 Western blot法检测IGF-1 mRNA及蛋白表达情况.将IGF-1慢病毒转染的BM-SCs、空载体慢病毒转染的BMSCs、BMSCs分别与5 ng/mL IL-1β诱导的大鼠软骨细胞共同培养24 h后,CCK-8检测软骨增殖情况;Tunel法检测软骨细胞凋亡率;Western blot法检测Bcl-2相关X蛋白(Bax)、B淋巴细胞瘤-2(Bcl-2)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)、细胞色素C(Cytc)蛋白表达;酶联免疫吸附试验(ELISA)检测细胞提取液中IL-1β、白细胞介素6(IL-6)和肿瘤坏死因子-α(TNF-α)水平.结果 IGF-1过表达的BMSCs提高IL-1β处理的软骨细胞增殖活性,抑制IL-1β诱导的软骨细胞凋亡,并降低细胞提取液中IL-1β、IL-6和TNF-α水平(P＜0.05),下调软骨细胞中Bax、Caspase-3、Cytc等凋亡蛋白的表达水平,上调抗凋亡蛋白Bcl-2的表达水平(P＜0.05).结论 IGF-1过表达的骨髓间充质干细胞可抑制IL-1β诱导的软骨细胞凋亡及炎性因子的表达,提高软骨细胞增殖活性.

骨质疏松症（OP）是一种全身性骨骼疾病，是老年人群常见的骨科疾患，较高的发病率、致残致死率、治疗费用等问题给患者家庭带来了较大的影响，丝氨酸/苏氨酸蛋白激酶（AMPK）/雷帕霉素靶蛋白（mTOR）信号通路对细胞的代谢和凋亡有重要意义。中药单体或中药复方能够通过AMPK/mTOR信号通路影响相关因子表达防治OP，但具体机制尚未完全阐明。该文就AMPK/mTOR通路对成骨细胞和破骨细胞的作用以及中医药在其中的调节作用问题进行综述，为下一步的OP防治工作提供新的视角和思路。

Osteonecrosis of the femoral head（ONFH）is a severe disabling orthopedic disease with a complex mechanism and an irreversible course.The primary treatment strategy is to relieve discomfort through symptomatic treatment,and final treatment strategy is a total hip replacement.Despite satisfactory surgical results and mature technology,there are also non-negligible drawbacks associated with the procedure.The development of modern treatment technology has enabled physicians to diagnose and treat patients early.On this basis,scholars from the department of orthopedics are actively researching head-preserving techniques.In Chinese medicine,avascular necrosis of femoral head is considered "bone erosion" and "bone paralysis" and has not been completely overcome despite the advancement of orthopedic treatment.The progression ofa osteonecrosis and bone destruction is a one-way process,and Chinese medicine is well-equipped to treat this condition.In addition to significantly improving patients’ quality of life and reducing their financial burden,Chinese medicine has successfully delayed joint replacement surgery.There is an increase in social acceptance and patient satisfaction.It has attracted the attention of scholars and is recommended in the guidelines as a treatment method with high clinical and social values.

骨关节炎(osteoarthritis,OA)是一种临床上常见的慢性退行性关节疾病.核因子-κB(nuclear factor-κB,NF-κB)信号通路参与机体的免疫应答、炎症反应、细胞分化、细胞凋亡等多种生物过程,与OA的发生发展关系密切.中药在改善OA症状方面疗效显著,而中药治疗OA的作用机制与抑制NF-κB信号通路的异常激活关系密切.本文概述了NF-κB信号通路,探讨了NF-κB信号通路与OA的关系,对中药基于NF-κB信号通路治疗OA作用机制的研究进展进行了综述.

Health equity can narrow the health gap between different groups and enable citizens to enjoy fair health services. Clinical practice guideline makers have been paying more and more attention to health equity, and exploring and applying the consideration to the development of corresponding guidelines. However, existing clinical practice guideline development gives little consideration to the structured and systematic construction of health equity, and the guidance for future guidelines is limited. This paper aims to put forward methodological suggestions for in-depth consideration of health equity in clinical practice guideline development, withthe hope of providing reference for guideline developers.

Knee osteoarthritis (KOA) is a prevalent joint disorder characterized by articular cartilage degeneration and apoptosis. This research was aimed to demonstrate effects of calcitonin (CT) on apoptosis and Bcl-2 in KOA articular chondrocytes. In vitro cellular experiments were conducted using articular chondrocytes obtained from KOA patients, with a portion of the cells undergoing passaging and proliferation culture. The remaining cells were rolled into control group (normal chondrocytes), KOA group (chondrocytes from arthritis joints), and CT group (chondrocytes from arthritis joints treated with CT). Control and KOA groups were treated with an equivalent amount of saline solution. Apoptosis and Bcl-2 protein expression levels were assessed in each group to evaluate the impact of CT on articular chondrocytes. It was revealed that proliferation rate of human chondrocytes decreased with increasing passage number, and the exponential growth phase was shorter. After day 6, the proliferation rate drastically increased, exhibiting an exponential growth trend. Relative to KOA group, the CT group demonstrated a notable reduction in apoptosis of articular chondrocytes ( P <0.05). Bcl-2 protein level was greatly upregulated in CT group ( P < 0.05). In short, CT can inhibit apoptosis of articular chondrocytes and promote Bcl-2 expression, thereby contributing to the stability and survival of articular chondrocytes. In summary, CT has a positive effect on apoptosis and Bcl-2 expression in KOA articular chondrocytes.

Purpose The optimal method for achieving proper graft tension during patellofemoral ligament reconstruction is a topic of debate. In the past, a digital tensiometer was used to simulate the knee structure, and a tension of approximately 2N was identified as suitable for restoring the patellofemoral track. However, it is unclear whether this tension level is sufficient during the actual surgery. The objective of this study was to verify the efficacy of graft tension using a digital tensiometer for medial patellofemoral ligament (MPFL) reconstruction and to conduct a mid-term follow-up. Methods The study enrolled 39 patients who had experienced recurrent patellar dislocation. Preoperative computed tomography scans and X-rays confirmed patellar instability, patellar tilt angle patellar congruence angle and the history of dislocation and patellar apprehension test. Knee function was evaluated using preoperative and postoperative Lysholm and Kujala scores. Results The study included 39 knees, comprising 22 females and 17 males, with an average age of 21.10 ± 7.26. The patients were followed up for at least 24 months through telephone or face-to-face questionnaires. All patients had a preoperative history of ≥2 patellar dislocations, none of which were surgically treated. During surgery, all patients underwent isolated MPFL reconstruction and lateral retinacula release. The mean Kujala and Lysholm scores were 91.28 ± 4.90 and 90.67 ± 5.15, respectively. The mean PTA and PCA were 11.5 ± 2.63 and 2.38 ± 3.58, respectively. The study found that a tension of approximately 27.39 ± 5.57N (14.3–33.5N) was required to restore the patellofemoral track in patients with recurrent patellar dislocation. No patients required reoperation during the follow-up period. Overall, 36 out of 39 patients (92.31%) reported no pain when completing daily activities at the last follow-up. Conclusion In conclusion, a tension level of approximately 27.39 ± 5.57N is necessary to restore normal patellofemoral relationships during clinical practice, which indicates that using a tension of 2N is too low. The use of a tensiometer during patellofemoral ligament reconstruction is a more accurate and reliable surgical procedure for treating recurrent patellar dislocation.

目的 调查随时间推移,内侧开放楔形胫骨高位截骨术(open-wedge high tibial osteotomy,OWHTO)术后矫形角度是否丢失,并确定哪些因素与其相关.方法 回顾性研究2018年5月至2020年10月期间于新疆医科大学附属中医医院进行OWHTO的患者,共纳入40例(45膝)患者,男15例,女25例;平均年龄为(55.4±11.86)岁.测量患者术前、术后、术后1年时的髋-膝-踝角(hip-knee-ankle angle,HKA)、胫骨近端内侧角(medial proximal tibial angle,MPTA)、关节线会聚角(joint line convergence angle,JLCA)、胫骨后倾角(posterior tibial slope,PTS)及 Caton指数;比较患者术前、术后1年的西安大略和麦克马斯特大学骨关节炎指数(western Ontario and McMaster universities osteoarthritis index,WOMAC)和美国膝关节协会(American knee society,AKS)评分.结果 术后患者均获13～28个月随访,平均随访(18.7土7.54)个月.HKA由术前(-8.00±3.17)°矫正至术后3 d(2.56±2.61)°,术后1年为(1.66±2.89)°;术前及术后3 d、1年组间比较差异有统计学意义(P＜0.05).JLCA由术前(2.54±1.43)°变化至术后 3 d(2.54±1.94)°,术后 1 年为(2.38土 1.60)°;PTS 由术前(7.81±5.05)°变化至术后 3 d(6.98±4.71)°,术后 1年为(8.34±4.83)°;JLCA与PTS组间比较,差异均无统计学意义(P＞0.05).以术后3 d同术后1年相比,HKA变化大于1.为界,分为变化组和不变组,对于术前JLCA和术后PTS进行比较,组间差异均无统计学意义(P＞0.05).结论 在OWHTO病例中,约49％的病例在1年的随访中显示矫形角度丢失＞1 °,但未发现与其相关的影响因素.

目的 探讨血清血小板衍生生长因子(PDGF)、成纤维细胞生长因子2(FGF-2)水平与膝骨关节炎患者病情严重程度的相关性.方法 选取2020 年7 月—2023 年1 月新疆医科大学第四附属医院骨二科诊治膝骨关节炎患者105 例作为关节炎组,依据严重程度分为轻中度亚组62 例和重度亚组43 例;同时纳入健康体检者102 例作为健康对照组.采用PCR法检测PDGF基因rs974819 位点、FGF-2 基因rs2922979 位点多态性并进行测序鉴定;采用双抗体夹心酶联免疫吸附法检测血清PDGF水平,酶联免疫吸附法检测血清FGF-2 水平;多因素Logistic回归分析影响膝骨关节炎患者病情严重程度的因素.结果 健康对照组和关节炎组 PDGF 基因 rs974819 位点、FGF-2 基因rs2922979 位点上均检出GG型、GC型、CC型3 种基因型,关节炎组携带CC型基因型及C等位基因占比显著高于健康对照组(PDGF:χ2/P =41.726/<0.001,54.382/<0.001;FGF-2:χ2/P =65.987/<0.001,88.988/<0.001),C等位基因可能是膝骨关节炎的易感基因.关节炎组血清 PDGF、FGF-2 水平低于健康对照组(t/P = 11.715/<0.001、22.079/<0.001).重度亚组血清PDGF、FGF-2 水平低于轻中度亚组(t/P =6.525/<0.001、8.304/<0.001),IL-17、TNF-α水平高于轻中度亚组(t/P =6.032/<0.001、8.952/<0.001).血清PDGF、FGF-2 高是膝骨关节炎患者病情进展为重度的保护因素[OR(95%CI)=0.849(0.753～0.957)、0.834(0.747～0.931)].结论 随膝骨关节炎患者疾病严重程度增加,血清PDGF、FGF-2 水平降低,PDGF基因rs974819 位点、FGF-2 基因rs2922979 位点的C等位基因可能是膝骨关节炎的易感基因.