Objective:To analyze the application value of three-dimensional computed tomography (3-D CT) reconstruction technique in the evaluation of related predictive parameters of osteoporotic hip fractures.Methods:From February 2014 to March 2019, 106 patients with hip fracture who underwent dual-energy X-ray bone density test of T≤ -2.5 SD on the hip were analyzed retrospectively. There were 58 males and 48 females; Age 73.50±5.59 years old (range, 65-88 years old); Height 170.12±7.43 cm (range, 152-187 cm); Weight (69.26±11.85) kg (range, 37-94 kg); Body mass index 23.60±2.37 kg/m 2 (range, 18.3-28.9 kg/m 2); There were 32 cases of femoral neck fractures, 68 cases of intertrochanteric fractures and 6 cases of subtrochanteric fractures. Anatomic parameters of the hip were the cortical thickness index (CTI), hip axis length (HAL), and femoral offset (FO). The above-mentioned predictive parameters of the hip fractures were measured based on X-ray and 3-D CT reconstruction images. Comparison of the two methods were analyzed using paired t test, liner Pearson analysis, and Bland-Altman analysis. Pearson analysis was used to evaluate correlation between CTI, HAL, and FO and T value. Results:106 cases were compared and analyzed with the measured values of X-ray and 3-D CT reconstruction images according to the preset measurement scheme. The mean value of CTI measured by conventional X-ray measurement method was 0.31±0.05, and the mean value of CTI measured by 3-D CT reconstruction images was 0.31±0.05. The result was not statistically significant ( t=0.938, P=0.35). The mean values of HAL, FO measured by conventional X-ray measurement method were 123.35±12.74 mm, 43.99±2.81 mm, and the mean values of HAL, FO measured by 3-D CT reconstruction images were 121.11±14.51 mm, 40.73±3.11 mm. The results were statistically different ( t=2.578, 18.502; all P< 0.05). The Bland-Altman results showed that there was no difference in the consistency of the two measurement methods for CTI while the measurement results of HAL, FO were quite different. CTI and HAL showed strong correlations with the T scores respectively ( r=0.784, -0.748; P< 0.001). Conclusion:Based on 3-D CT reconstruction technique, accurate measurement of related predictive parameters of osteoporotic hip fractures can be realized, which provides theoretical basis for the evaluation of osteoporotic hip fractures in the elderly and the formulation of accurate rehabilitation treatment plan.

Objective:To investigate the application value of computer-assisted preoperative planning (CAPP) in the treatment of AO/OTA type-C distal femoral fractures.Methods:A retrospective analysis was conducted on 150 patients with AO/OTA type-C distal femur fractures from January 2010 to December 2021 using the less invasive stabilization system-distal femur (LISS-DF). Patients were divided into a non-CAPP group and a CAPP group based on whether computer-assisted preoperative planning was utilized. The non-CAPP group included 81 patients (56 males, 25 females) with an age range of 39 to 67 years (mean 54.9±5.8 years), consisting of 22 type-C1 fractures, 35 type-C2 fractures, and 24 type-C3 fractures. The CAPP group comprised 69 patients (50 males, 19 females) with an age range of 45 to 63 years (mean 53.9±4.6 years), including 18 type-C1 fractures, 28 type-C2 fractures, and 23 type-C3 fractures. The study recorded the time of preoperative planning and compared the surgical duration, intraoperative blood loss, times of fluoroscopy intraoperatively, and hospital stay length between the two groups. At the last follow-up, knee function was evaluated using the Hospital for Special Surgery (HSS) knee score and pain was assessed using the visual analogue scale (VAS).Results:The preoperative planning time of CAPP was 22.5±3.4 min (range, 17-31 min). There were statistically significant differences between non-CAPP group and CAPP group in terms of surgical duration (non-CAPP, 110.9±7.7 min; CAPP, 94.4±6.3 min), intraoperative blood loss (non-CAPP, 299.3±34.2 ml; CAPP, 224.1±22.0 ml), times of fluoroscopy intraoperatively (non-CAPP, 11.3±3.1; CAPP, 6.7±2.2), and hospital stay length (non-CAPP, 12.8±3.2 d; CAPP, 6.4±1.9 d) ( P<0.001). All patients were followed up, with the CAPP group having a follow-up duration of 17.7±3.3 months and the non-CAPP group having 18.1±3.7 months. Both groups of patients achieved clinical healing of fractures. The healing time for fractures in the CAPP group and the non-CAPP group were 13.9±1.1 weeks and 14.0±1.3 weeks, respectively, with no statistically significant difference ( t=0.699, P=0.490). At the last follow-up, the average HSS score and VAS score of the patients in the CAPP group were 86.6±3.4 points and 0.9±0.4 points, which were both better than those of the non-CAPP group 79.2±5.1 points and 1.3±0.5 points ( P<0.001). No patients in either group experienced complications related to delayed fracture healing, nonunion, or internal fixation failure. Conclusion:When using LISS -DF steel plate to treat complex distal femoral fractures, CAPP can assist the operator in efficiently and accurately completing preoperative design. Compared with traditional preoperative planning, it can reduce surgical time, surgical trauma, and achieve more satisfactory postoperative outcomes.

OBJECTIVE To synthesize a polymer PEI-ss-PEG2000-DSPE containing disulfide bond and to prepare as cationic micelle(P-ss-PD) based on branched polyethyleneimine(PEI). To investigate the ability of P-ss-PD micelle to reduce cytotoxicity and improve the transfection efficiency of antisense oligonucleotide(ASO) in human breast cancer cell lines, and to study the anti-tumor effect of P-ss-PD micelle in nude mice. METHODS PEI-ss-PEG2000-DSPE was synthesized by grafting PEG2000-DSPE onto branched PEI with disulfide bond as a connecting arm. P-ss-PD micelle was prepared by ethanol injection method and P-ss-PD/ASO nanocomplex was obtained by combining P-ss-PD micelle with ASO. The particle size and zeta potential of P-ss-PD/ASO nanocomplex at various mass ratios were determined by laser particle size analyzer. Agarose gel retardation assay was used to investigate the binding degree of P-ss-PD/ASO nanocomplex and determine the optimal mass ratio. At the same time, the reduction responsive ability of P-ss-PD micelle was investigated. The cytotoxicity of P-ss-PD micelle was detected by CCK8 kit. The transfection efficiency of P-ss-PD micelle was investigated by flow cytometry and high content cell imaging analysis system in MDA-MB-231 cells. The anti-tumor effect of P-ss-PD micelle was investigated by tumor-bearing nude mice models. RESULTS When the mass ratio was 300∶1, the particle size of P-ss-PD/ASO nanocomplex was the smallest and had a good stability. The average particle size was (58.90 ± 4.08)nm, the average zeta potential was (16.80 ± 1.23)mV, and the morphology was uniform spherical. P-ss-PD/ASO nanocomplex had the reduction responsive ability and could release ASO under highly reductive conditions.In vitro, compared with unmodified branched PEI, the cytotoxicity of P-ss-PD micelle was significantly reduced and the transfection efficiency was significantly increased.In vivo, the tumor growth inhibition rate of P-ss-PD/ASO nanocomplex in tumor-bearing nude mice was more than 50%. CONCLUSION The P-ss-PD micelle prepared in this study is a kind of low toxicity and high transfection efficiency non-viral vector, which has the characteristics of reduction responsive releasing, and shows a promising application in ASO drug delivery.