OBJECTIVE:To analyze the learning curve of robot-assisted percutaneous placement of acetabular anterior column screws. METHODS:Between January 2021 and January 2024, 30 patients undergoing robot-assisted percutaneous acetabular anterior column screw placement performed by the same surgeon were enrolled, including 21 males and 9 females, aged from 27 to 65 years old with a mean of (45.2±17.6) years old, with a disease course ranging from 1 to 9 days with a mean of (1.1±5.3) days. According to the chronological order of surgery, the patients were divided into an early group, a middle group, and a late group, with 10 cases in each group. The number of screws graded as excellent, good, and poor was recorded in each group. Fluoroscopy times, screw planning time, guide wire adjustment times, and total operation time were compared among groups. The learning curve was analyzed using curve regression. RESULTS:All procedures was successfully completed in all three groups, without intraoperative or postoperative complications. Postoperative coronal CT showed that in the early group, excellent/good screws were 8/2;in the middle group, excellent/good screws were 9/1;in the late group, excellent/good screws were 9/1. All screws were graded as excellent or good (26/4), without cortical perforation or poor grade screws. There was no significant difference in the proportion of excellent and good screws among the three groups (P>0.05). Fluoroscopy times, screw planning time, guide wire adjustment times, and total operation time:the differences were statistically significant between the early group and the middle group, and between the early group and the late group (P<0.05), while no significant difference was found between the middle group and the late group(P>0.05). Curve regression showed that fluoroscopy times, screw planning time, guide wire adjustment times, and total operation time for robot-assisted percutaneous antegrade anterior column screw placement gradually decreased progressively with increasing surgical experience and reached a plateau after approximately 15 cases. CONCLUSION:The learning curve of robot-assisted percutaneous acetabular anterior column screw placement is relatively steep, and surgical performance tends to stabilize after about 15 cases.

Objective To systematically evaluate the accuracy of robot-assisted placement of various types of pelvic channel screws, compare the precision difference between short screws and trans-cortical screws, and analyze the influencing factors of screw malposition. Methods A retrospective analysis was conducted on 283 patients with pelvic fractures who underwent robot-assisted pelvic screw placement at Gansu Provincial Hospital from January 2021 to October 2025. There were 167 males and 116 females, with a mean age of (46.5±18.1) years. Patients were divided into eight groups according to screw type: S1 trans-cortical (33), S1 short (54), S2 trans-cortical (23), S2 short (39), antegrade anterior column (78), retrograde anterior column (67), antegrade LC-II (36), and retrograde LC-II (16). Screw accuracy was assessed by postoperative pelvic CT using the Smith grading system. The Chi-squared test or Fisher's exact test was used for group comparisons. Results The overall accuracy rate (Smith grade 0) was 98.6% (341/346). The combined accuracy of short screws (98.9%, 92/93) was significantly higher than that of trans-cortical screws (96.4%, 54/56, P =0.035). Univariate analysis revealed that screw type ( P =0.035) and BMI≥30 kg/m² (P=0.031) were associated with screw malposition, while age≥60 years ( P =0.639), sex ( P =0.556), and fracture type ( P =0.643) showed no significant association. All malpositioned screws were Smith grade I (cortical breach ≤2 mm). The excellent-good rate of Majeed score at 6 months postoperatively was 91.4% (85/93) in the short screw group and 85.7% (48/56) in the trans-cortical screw group ( P =0.097). Conclusion Robot-assisted pelvic channel screw placement demonstrates excellent overall accuracy. Short screws achieve significantly higher precision than trans-cortical screws, and BMI≥30 kg/m² is associated with an increased risk of malposition. When biomechanical fixation strength is satisfied, preferential use of short screws is recommended to reduce the risk of malposition, though larger prospective studies are needed for confirmation.

To systematically evaluate the accuracy of robot-assisted sacroiliac screw placement, compare the precision difference between short screws and trans-cortical (through-and-through) screws, and analyze factors associated with screw malposition. A retrospective analysis was conducted on 149 patients with pelvic fractures who underwent robot-assisted sacroiliac screw placement at Gansu Provincial Hospital from January 2021 to October 2025. A total of 149 sacroiliac screws (93 short, 56 trans-cortical) were included. Screw accuracy was assessed by postoperative pelvic CT using the Smith grading system. Functional outcomes were evaluated by Majeed score at 6 months. Univariate analysis was used to explore risk factors for malposition, but results are presented as exploratory due to the limited number of events. The overall accuracy rate was 98.0

Percutaneous pelvic channel screw fixation is a key technique for the minimally invasive treatment of pelvic ring injuries. Robotic-assisted systems aim to improve accuracy and reduce radiation, but direct comparative studies across platforms are lacking. This systematic review and meta-analysis primarily compares robot-assisted versus conventional fluoroscopy-guided pelvic channel screw placement, with a secondary narrative comparison of technical differences across TiRobot, Mazor X, and ROSA platforms. We systematically searched PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, and CBM databases up to April 2026. Comparative studies of robot-assisted versus conventional fluoroscopy-guided pelvic channel screw placement in adult pelvic ring injury patients were included. Primary outcomes were screw accuracy (Gras classification) and radiation exposure. Secondary outcomes included operative time, functional recovery (Majeed score), complications, and cost. No direct head-to-head studies comparing different robotic platforms for pelvic screw placement were identified; therefore, platform comparisons are primarily narrative and indirect, with spine surgery data presented as hypothesis-generating only. Risk of bias was assessed using ROBINS-I and RoB-2, and evidence was graded using the GRADE system. Fifteen studies (1,247 patients, 2,893 screws) were included. Primary meta-analysis showed that robot-assisted placement significantly improved screw accuracy (excellent/good rate: 98.2

OBJECTIVE:To explore medium and long term efficacy of oblique lateral interbody fusion (OLIF) in treating lumbar specific infection. METHODS:From October 2017 to January 2021, 24 patients with lumbar specific infection were treated by OLIF combined with vertebral screw internal fixation, including 15 males and 9 females, aged from 27 to 61 years old with an average of (43.0±15.0) years old;the courses of disease ranged from 6 to 24 months with an average of (14.0±7.0) months;7 patients with L2-L3, 12 patients with L3-L4 and 5 patients with L4-L5;19 patients with tuberculosis infection and 5 patients with brucella infection. The amount of intraoperative blood loss, operative time and complications were recorded, and erythrocyte sedimentation rate(ESR), C-reactive protein (CRP), visual analogue scale (VAS), Japanese Orthopaedic Association(JOA) score and American Spinal Injury Association (ASIA) rating were compared before and one month after opertaion. RESULTS:All patients were followed up from 9 to 24 months with an average of (13.0±6.0) months. Operative time was (132.5±21.4) min, and intraoperative blood loss was (227.3±43.1) ml. ESR and CRP were decreased from (82.34±18.62) mmol·h-1 and (53.08±21.84) mg·L-1 before operation to (33.52±17.31) mmol·h-1 and (15.48±8.36) mg·L-1 at one month after operation, respectively (P<0.05). VAS was decreased from (7.52±1.36) before opertaion to (1.74±0.87) at one month after operation (P<0.05). JOA was increased from (17.86±3.95) before operation to (24.72±3.19) at one month after operation (P<0.05). Four patients had neurological symptoms before operation, and were classified to grade D according to ASIA classification, who were recovered to grade E at 1 month after operation. One patient was suffered from psoas major muscle injury after operation, and returned to normal at 3 weeks. One patient was suffered from abdominal distension and difficulty in defecation, and relieved after gastrointestinal decompression and enema. No complications such as abdominal organ injury and poor wound healing occurred in all patients. CONCLUSION:OLIF combined with vertebral screw internal fixation is a new minimally invasive surgical method for the treatment of lumbar specific infection, especially the lesion located on the middle lumbar vertebra. It has advantages of less trauma, short operation time, less blood loss, convenient operation, complete removal of the lesion, safety and effectiveness, and has good medium-and long-term efficacy for lumbar specific infection.

目前,临床上腰椎结核的手术治疗多采用经前路、经后路、前后联合入路等[1-2]. 2012 年Silvestre等报道了斜外侧椎间融合术(oblique lateral interbody fusion, OLIF),该术式以手术时间短、出血量少、创伤小等优点已被广泛应用于腰椎退行性变的治疗,并取得满意的疗效[3-4] . 此前作者采用单纯斜外侧椎间融合术联合椎体螺钉治疗腰椎结核,亦取得了满意的随访效果[5] . 但由于当时手术经验欠缺,高位腰椎结核若采用此术式,术中存在第 11、12 肋骨阻挡术区的情况,增加了手术难度,因此未纳入高位腰椎结核患者. 随着手术技术的提高及经验的积累,我院采用改良斜外侧椎间融合术联合椎体螺钉治疗高位腰椎结核,报道如下.

目的 探讨不同手术时机对胸腰椎骨折伴完全性脊髓损伤疗效的影响.方法 48 例胸腰椎骨折伴完全性脊髓损伤患者,按照手术时机不同分为A组(29 例)和B组(19 例).A组患者伤后24 h内行急诊手术治疗,B组患者伤后 3～5 d行手术治疗.比较两组患者手术时间、术中出血量、术后神经功能恢复情况.结果 A组患者手术时间(191.6±35.1)min长于B组的(156.4±23.6)min,术中出血量(968.5±114.3)ml多于B组的(468.8±85.8)ml,差异均具有统计学意义(P<0.05).48例患者均得到随访,随访时间 13～23 个月,平均随访时间 18 个月.所有患者植骨均融合,内固定位置良好,无松动、断裂情况.末次随访时,A组有 4 例由术前的A级恢复为B级,好转率为 13.8%(4/29);B组有 2 例由术前的A级恢复为B级,好转率为10.5%(2/19).两组患者术后神经功能好转率比较差异无统计学意义(P>0.05).结论 对于胸腰椎骨折伴完全性脊髓损伤患者,早期手术会增加术中出血量,延长手术时间,增加手术风险,且对于术后神经功能恢复情况无显著效果,因此需先行对症支持治疗、处理基础疾病、改善一般情况后,再行手术治疗.

Objective: This research aimed to investigate the curative effect of oblique lateral interbody fusion (OLIF) in the treatment of lumbar tuberculosis. Methods: A total of 32 patients, including 18 males and 14 females (29-58 years old, with the mean age of 47) who were admitted to our hospital from October 2016 to June 2020 and treated with oblique lateral interbody fusion combined with vertebral screw internal fixation, were retrospectively collected. The segmental distribution of lesions was L 2 - L 3 16 cases, L 3 -L 4 11 cases and L 4 -L 5 5 cases. At first, preoperative antituberculous drug treatment was standardized for 2-4 weeks. Furthermore, intraoperative blood loss, operation time, postoperative complications, ESR, CRP, VAS, JOA and ASIA scores were recorded before and after surgery and at the last follow-up. In addition, antituberculous drug therapy was regulated continuously after surgery. Results: All patients were followed up for 12-17 months, with an average of 14 months. ① The average operation time was (132.5±21.4) min, and the intraoperative blood loss was (227.3±43.1) ml. ② Preoperative ESR was (74.56±15.43) mmol/h, and CRP was (43.21±19.37) mg/L. Seven days after surgery, ESR was (42.37±19.26) mmol/h, and CRP was (22.51±18.42) mg/L. In the last follow-up, ESR was (9.25±4.13) mmol/h, and CRP was (8.17±3.21) mg/L. They have statistically significant differences before surgery, seven days after the surgery and in the last follow-up (P<0.05). ③ The average VAS score before surgery was (7.21±1.40) points, the average JOA score was (18.24±4.13) points, the average VAS score seven days after surgery was (2.23±1.32) points, the average JOA score was (24.72±3.19) points, and the average VAS score in the last follow-up was (1.63±0.54) points. JOA score was (27.72±2.61). They have statistically significant differences before surgery, seven days after the surgery and in the last follow-up (P<0.05) ④Six patients had neurologic symptoms with ASIA grade D before surgery, 2 patients recovered to Grade E seven days after surgery, and the remaining 4 patients also recovered to grade E in the last follow-up. Besides, 26 patients were graded as Grade E before surgery, seven days after surgery and in the last follow-up. ⑤ After surgery, 1 patient suffered psoas major muscle damage, which was manifested as reduced hip flexion strength of the lower extremity, and returned to normal three weeks later. Apart from that, none of the patients had complications such as abdominal organ injury and poor wound healing. Conclusion: OLIF is a new minimally invasive method for treating lumbar tuberculosis, with short operation time, less blood loss, convenient operation, thorough removal of lesions, and good long-term follow-up effect. It is worthy of promotion and application.

Background LncRNA prostate cancer-associated transcript 6 (PCAT6) has been reported to be dysregulated in several cancers and is associated with tumor progression. Here, we have performed a meta-analysis to assess the general prognostic role of PCAT6 in malignancies. Methods Four public databases (Embase, Pubmed, Web of Science, Cochrane Library) were used to identify eligible studies, then data was extracted and associations between prognostic indicators and clinical characteristics were combined to estimate hazard ratio (HR) or odds ratio (OR) with a 95% confidence interval (CI). Publication bias was measured using the Begg's test, and the stability of the combined results was measured using sensitivity analysis. Subsequently, results were validated using Gene Expression Profiling Interactive Analysis (GEPIA) and the National Genomics Data Center (NGDC). Results Ten studies were considered eligible for inclusion. In total, 937 patients and eight types of cancer were included. Our results revealed that overexpression of PCAT6 was significantly associated with a shorter OS (HR = 1.82; 95% CI, [1.40, 2.38]; P < 0.0001) and progression-free survival (PFS) (HR = 1.66; 95% CI, [1.22, 2.25]; P < 0.0001) in cancer patients, and that PCAT6 overexpression was significantly associated with individual tumor clinicopathological parameters, including TNM stage (OR = 0.29; 95% CI, [0.09, 0.94]; P = 0.04), gender (OR = 1.84; 95% CI, [1.31, 2.59]; P = 0.0005), and whether the tumor was metastatic (OR = 5.02; 95% CI, [1.36, 18.57]; P = 0.02). However, PCAT6 overexpression was not correlated with patient age and tumor differentiation. PCAT6 expression was significantly up-regulated in four types of cancer, which was validated using the GEPIA cohort. Combining OS and disease-free survival (DFS) of these four types of cancer revealed a shorter OS and DFS in patients with PCAT6 overexpression. PCAT6 expression in various types of cancer was also validated in NGDC. A total of eight cancers were analyzed and PCAT6 was highly expressed in all eight cancers. Further functional predictions suggest that PCAT6 is correlated with tumor prognosis, and that PCAT6 may be useful as a new tumor-specific marker. Conclusions LncRNA PCAT6 is highly expressed in multiple cancer types and its upregulation was significantly associated with patient prognosis and poorer clinical features, thereby suggesting that PCAT6 may be a novel prognostic factor in multiple cancer types.

The incidence of lower back pain caused by intervertebral disc degeneration (IDD) is gradually increasing. IDD not only affects the quality of life of the patients, but also poses a major socioeconomic burden. There is currently no optimal method for delaying or reversing IDD, mainly due to its unknown pathogenesis. MicroRNAs (miRNAs/miRs) participate in the development of a number of diseases, including IDD. Abnormal expression of miRNAs in the intervertebral disc is implicated in various pathological processes underlying the development of IDD, including nucleus pulposus (NP) cell (NPC) proliferation, NPC apoptosis, extracellular matrix remodeling, inflammation and cartilaginous endplate changes, among others. The focus of the present review was the advances in research on the involvement of miRNAs in the mechanism underlying IDD. Further research is expected to identify markers for early diagnosis of IDD and new targets for delaying or reversing IDD.

[目的]介绍斜外侧椎间融合术治疗腰椎结核的手术技术和初步结果.[方法] 2018年10月—2020年6月,本院骨科收住腰椎结核患者13例,采用斜外侧椎间融合术治疗.取侧卧位,经腹外斜肌、腹内斜肌、腹横肌进入腹膜外间隙,抵达腰椎侧方,清除病灶,取髂骨植骨,最后行椎体钉内固定.[结果]手术时间平均(132.51±21.40) min,术中出血量(227.32±43.14)ml.术后7d,血沉(elythocyte sedimentation late,ESR)、C反应蛋白(C-reactive protein,CRP)、VAS评分(visual analogue scale,VAS)均较术前显著改善,差异均有统计学意义(P＜0.05).术后患者神经功能改善,无明显并发症.[结论]斜外侧椎间融合术治疗腰椎结核是一种新的微创手术方式,具有创伤小、手术时间短、出血量少、病灶清除彻底、安全有效的优点.

Background . Staples closure technology has been widely used in total knee arthroplasty (TKA) and achieved good results. In recent years, a new type of material called skin closure tape (SCT) has been applied to TKA which also showed good treatment results. However, since it is still not clear yet which one is better, this paper collects literatures for statistical analysis so as to provide evidence for the use of SCT in TKA. Methods . The comparative study on effects between SCT and staples is reviewed after the primary release of TKA in PubMed, the Cochrane library, and the EMBASE database up to March 2019. The two researchers independently screened the literature and evaluated the quality of the literature using bias risk tools. Results . A total of four studies (3330 knees) have been included in our meta-analysis. For the main point, the results show that the SCT can reduce readmission rates compared to staples (RR 0.68, 95% CI 0.49–0.95,P=0.03), with no significant difference in complications (RR 0.85, 95% CI 0.27–2.64,P=0.77). Secondly, the results suggest that although there is no significant difference in removal time between the two groups, the SCT can reduce pains, save time and costs, and have a better cosmetic effect. Conclusions . Our study indicates SCT as a closure method with fewer complications and faster speed compared with staples. Nevertheless, the cost and pain need to be further confirmed because of the small sample size included in this study.

目的:探讨术前肌肉注射纳布啡对老年单侧全髋关节置换术或半关节置换术患者术后疼痛的影响.方法:选取2016年10月至2017年4月在甘肃省人民医院行单侧全髋节置换术或半髋关节置换术的60例老年患者,按照入院时间分为对照组和观察组,各30例.观察组于手术前一天晚上8点肌注纳布啡,对照组给予氯化钠安慰剂.观察比较两组视觉模拟评分(VAS评分)、生活质量自我评分、情绪自我评分及睡眠状况自我评分的情况.结果:观察组患者视觉模拟评分在术后30分钟、2小时、6小时、12小时低于对照组(P<0.05).术后24小时及术后48小时观察组生活质量自我评分、情绪自我评分及睡眠质量自我评分优于对照组(P<0.05).结论:术前肌注盐酸纳布啡可缓解老年患者髋关节置换术后的疼痛,还可提高患者术后生活质量、睡眠质量,稳定情绪.

Objective: To investigate the effect of preoperative nalbuphine intramuscular injection on postoperative pain in elderly patients who received total hip replacement or hemiarthroplasty. Methods: A total of 60 elderly patients who received total hip or hemi-hip arthroplasty during October 2016 to April 2017 in Gansu Provincial Hospital were included in the study. They were randomized into the control group and the nalbuphine group. The nalbuphine group received intramuscular nalbuphine injection at 8: 00 pm in the day before the day for operation, while the control group was given placebo. We observed and recorded the visual analogue score (VAS) at 30 minutes (T1), 2 hours (T2), 6 hours (T3) and 12 hours (T4) after surgery and meanwhile recorded quality of life and postoperative adverse reaction at day 1 after admission, one day before operation, 24 hours after operation and 48 hours after operation. Results: Compared with the control group, the nalbuphine group had lower visual analogue sores and higher quality of life scores at each time observed. No significant adverse reaction happened in both of the two groups. Conclusion: Nalbuphine pretreatment is useful for postoperative pain management of elder patients who receive hip arthroplasty.

目的 回顾性分析中前中柱垫高、后路截骨矫形钉棒固定治疗脊柱结核临床疗效,并评价该技术的安全性、合理性及其手术适应症.方法 自2015年1月至2017年5月,我院收治脊柱结核患者共30例,男16例,女14例;年龄16-70岁(平均40岁);病史12-96个月(平均52个月);术前脊柱结核病灶位于颈胸段椎体2例,胸椎8例,胸腰段6例,腰椎14例,其中累及一个椎体8例, 2个椎体20例,2个椎体以上2例.术前后凸Cobb角45.864±10.536°;30例患者有脊髓损伤,根据Frankel分级:A级3例,B级5例,C级16例,D级6例.结果 所有患者均获得随访12~36个月,平均22.5个月.手术时间200~260分钟,平均220分钟.术中出血量400~1260,平均569mL;术前后凸 Cobb角 45.864±10.536°,术后Cobb角10.364±4.564°,术前椎体前缘高度 1.386±0.350cm,术后椎体前缘高度 2.164±0.325cm,手术前后统计有明显差异(P<0.01);术前椎体后缘高度2.375±0.256cm,术后椎体后缘高度2.182±0.423cm,手术前后统计有明显差异(P<0.01);术后末期随访患者Frankel分级:A级6例,B级3例,C级2例,D级2例, E级1例.围手术期内脑脊液漏1例,结核复发2例,伤口愈合不良3例.结论 脊柱前中柱垫高、后路截骨矫形钉棒固定治疗脊柱结核取得良好效果,创伤小,手术出血量少,并发症少,应用范围广泛,是一种安全有效治手术方法,治疗脊柱结核值得推广应用.

脊柱畸形个体差异大、治疗过程复杂、手术难度高、风险大,一直以来都是脊柱骨科医师面临的巨大挑战.而目前,将3D打印技术应用于脊柱畸形矫形,正在成为一种新的思路,本文在简单介绍3D打印技术的基础上,将从疾病诊断、手术相关应用、个体化支具制作等3方面综述3D打印技术在脊柱矫形中的应用现状,同时总结目前所存在的主要问题,展望3D打印技术在脊柱畸形矫形领域的发展远景.

目的 分析骨科创伤及术后下肢肿胀的临床治疗效果,以提高临床防治水平.方法 选取60例2015年3月-2016年9月在该院治疗的骨科创伤及术后下肢肿胀患者,分为研究组(30例)与对照组(30例),研究组给予中药桔术四物汤治疗,对照组给予甘露醇与复方丹参治疗,比较两组临床治疗效果.结果 研究组治疗显效17例,有效11例,总有效率为93.33％.对照组显效12例,有效8例,总有效率为66.67％,比较差异有统计学意义(P＜0.05).研究组的不良反应明显较少(P＜0.05).结论 中药桔术四物汤应用于骨科创伤及下肢肿胀治疗,能够有效缓解患者临床症状,增强关节活动度,临床疗效显著.

目的 研究枸杞叶漱口液对牙菌斑的抑制作用.方法 ①使用85%的乙醇,加热回流法反复提取3次,使用旋转蒸发仪进行浓缩,获得枸杞叶总浸膏;②取适量枸杞叶浸膏配制成0.5%的枸杞叶漱口液;③选取8名志愿者,依据随机双盲、自身对照的原则,每位受试者分别先后含漱生理盐水(阴性对照组)、高露洁漱口液(阳性对照组)、枸杞叶漱口液(实验组).测试前彻底清洁口腔,每种漱口液测试周期为4d,期间停止一切口腔清洁措施.4d后,采用改良Qiugley-Hein菌斑指数记录法,记录PI值.中间间隔1周,再使用另一种漱口液,直至3种漱口液测试完.最后比较3组菌斑数.结果 实验组和阳性对照组菌斑数均高于阴性对照组,差异有统计学意义(P<0.01);且实验组与阳性对照组的菌斑数,差异无统计学意义(P>0.05).结论 枸杞叶漱口液具有良好的清除牙菌斑的作用.