Objective To analyze the radiological images of osteonecrosis in rare positions in recovered SARS patients, and to study the correlation with the hormone application.Methods The extremities of 41 SARS patients in the recovery stage from June to August in 2003 were examined by using X-ray and 0.5T MR scanner, then the correlation of MR examination results and the application of hormone was analyzed.The mean time interval between the imaging examination and initial hormone application was 88.2 days (66～106 days), the mean maximum hormone (metastab) dose was 392 mg (320-480 mg), and the average medication time was 47.2 days (30-70 days).Results The osteonecrosis of rare positions was revealed in 5 cases involving 11 positions, including bilateral heads of humerus (3), right scaphoid bone (1), right talus (1), bilateral calcaneus (1), and right ischium (1).The main MR manifestation was irregular abnormal signal.Osteonecrosis of right ischium was demonstrated on plain film in only one case.Conclusion MR examination, especially the multi-location scan is necessary in finding the osteonecrosis in SARS patients in the earlier phase.The hormone dose, the medication duration, the sensitivity to hormone, and the difference of individuals are important causes of osteonecrosis.

Objective To analyze the correlation between serum hs -CRP levels and MR Imaging in ischemic cerebrovascu-lar patients.To explore the hs -CRP serum levels in ischemic cerebrovascular patients incidence of early diagnosis and prognosis e-valuation application value.Methods 300 cases of ischemic cerebrovascular disease as the research object were selected from May 2013 to December 2014.The disease is classified into acute cerebral infarction group 100 cases, acute phase of cerebral infarction group 140 cases and transient ischemic attack 60 cases.Among 100 cases of patients with acute cerebral infarction group, in accord-ance with the MR Imaging data, they can be subdivided into three groups.Group A: lacunar infarction group 28 cases; Group B:small area of infarction group 50 cases and group C: large area of infarction group 22 cases.Another 40 healthy physical examination were selected as control group.The hs -CRP serum levels were made correlation analysis with MR Imaging.Results The acute cerebral infarction and transient ischemic attack group serum hs -CRP level difference compared with the control group with statisti-cal significance (p<0.05); The SPSS Spearman correlation analysis result shows that the hs -CRP serum levels and MR Imaging data shown in the infarction area and the body has a direct correlation .Conclusion The ischemic cerebrovascular disease patients se-rum hs-CRP level with MR Imaging have shown increased infarct size and raise.Damage area is bigger, and the corresponding serum hs-CRP levels changes more violently.

ObjectiveTo investigate the protective effect of combination of triptolide and irbesartan on the podocytes in a type 2 diabetic(T2DM) rat model,and evaluate its mechanism.Methods T2DM rats were induced by fed with high-sucrose-high-fat diet combined with a low dose of streptozocin.The rats were randomly divided into 5 groups:normal control group ( NC,n =10),diabetes group ( DM,n =11),triptolide treatment group (DT,n =12),irbesartan treatment group (DI,n =12) and triptolide combined with irbesartan treatment group (DTI,n =13). Ultrastructure of podocytes was observed by electronic microscopy and urinary albumin (UAL) excretion by ELISA was determined after 8 weeks.The expression of nephrin and bone morphogenetic protein-7(BMP-7), connective tissue growth factor (CTGF),transforming growth factor (TGF)β1 mRNA and proteins were detected by immunohistochemistry,real-time PCR and Western blot. Results Increased UAL was significantly attenuated in all treatment groups.Compared to NC group,UAL in DM group was increased significantly (0.45 ± 0.09 vs 6.36 ± 0.87,P ＜ 0.01 ),while decreased in triptolide or irbesartan alone treatment group (2.48 ± 0.37 and 2.68 ±0.42,both P ＜ 0.01 ).Compared with those in control groups,kidney expression of nephrin,BMP-7 mRNA and proteins were downregulated while CTGF, TGFβ1 mRNA and proteins were significantly upregulated in T2DM rats. Triptolide or irbesartan each alone moderately ameliorated albuminuria and podocyte damage.However,their combined usage showed a dramatic therapeutic synergism,manifested by prevention of progressive albuminuria,restoration of the glomerular filtration barrier,reversal of the decline in slit diaphragm proteins,reduction expression of CTGF,TGFβ1,and upregulation of BMP-7.Conclusion Our findings show that triptolide can increase the efficacy of irbesartan,leading to a more effective prevention of kidney disease in T2DM rat model,which may through upregulation of BMP-7 and inhibition the overexpression of CTGF and TGFβ1.

Objective To study the relationship between the prevalence of hyperuricemia and thyroid dysfunction. Methods 10 405 active and retired workers aged 21 to 89 years in a Petrochemical Corporation in Ningho area of Zhejiang Province were included. Serum thyroid-stimulation hormone (TSH), free thyroxine thyroid diseases, the prevalence of thyroid dysfunction was 4.2%, 2.9% in male and 7.2% in female. The percentage of subjects with low TSH concentration was 0.4% in male and 0.9% in female,the percentage of TSH subjects,the serum uric acid was significantly increased in subjects with high TSH (P<0.05) and not an independent factor associated with hyperuricemia (OR=1.61 for male and 1.72 for female, P value was less than 0.01 for both). Conclusion The prevalence of hyperuricemia is significantly associated with increased TSH concentration. Overt or subclinical hypothyroidism may be risk factors for hyperuricemia.

Objective: To explore the effects of Buyang Huanwu decoction (BYHWD) on vascular neogenesis and hemorheological parameters following cervical spinal cord injury (SCI). Methods: An acute cervical SCI model was established using 84 female Sprague–Dawley rats. Functional recovery of the rats was evaluated using the forelimb locomotor scale score, forelimb grip strength test, and Basso-Beattie-Bresnahan score. The animals were subsequently euthanized at days 7 and 28 postoperatively. The gross morphology, neuronal survival, and myelin sheath in the injured area were evaluated using hematoxylin and eosin (HE), Nissl, and luxol fast blue (LFB) staining, respectively. Immunofluorescence staining was used to observe CD31 expression 7 days post-injury. Furthermore, the expression of CD31, neuronal nuclear protein (NeuN), and myelin basic protein (MBP) were evaluated 28 days post-injury. Additionally, vascular endothelial growth factor A (VEGFA) and VEGF receptor-2 (VEGFR-2) expression was evaluated using western blotting. Whole-blood viscosity, plasma viscosity, and red blood cell aggregation were measured using a hemorheometer. Results: From postoperative days 3–28, motor function in the BYHWD group began to recover considerably compared to the SCI group. BYHWD effectively restored spinal cord histopathology. In addition, the number of NeuN-positive cells, and fluorescence intensity of CD31at 7 and 28 days and MBP significantly increased in the BYHWD group compared with the SCI group (all P < .05). Moreover, this decoction significantly upregulated the expression of VEGFA and VEGFR-2 (all P < .05). BYHWD improved the hemorheology results (i.e., except erythrocyte aggregation index in the low-dose group), revealing statistically significant differences compared with the SCI group (all P < .05). Conclusion BYHWD effectively promoted angiogenesis, improved hemorheological parameters, and protected neurons and myelin sheaths, ultimately promoting the recovery of neurological function after cervical SCI in rats. These findings suggest that BYHWD promotes vascular neogenesis through the VEGFA/VEGFR-2 pathway.

Objective To explore the protective effect and possible mechanism of Periplaneta americana powder on rats with spinal cord injury.Methods Forty-eight male SD rats were randomly divided into sham operation,saline,Periplaneta americana powder,and Toll-like receptor 4(TLR4)inhibitor groups.Except for the sham operation group,a rat spinal cord hemi-transection injury model was established in the other three groups.The sham operation group received no treatment after the operation,saline and drug groups were subjected to intragastric administration of equal volumes of normal saline and Periplaneta americana powder(630 mg/kg),respectively,and the TLR4 inhibitor group was administered an intraperitoneal injection of TLR4 inhibitor(3 mg/kg).On days 1,3,7,and 14 after the operation,the motor function of rat hind limbs was evaluated by the Basso,Beattie,and Bresnahan(BBB)score.Histopathological changes of the spinal cord were observed by hematoxylin-eosin staining.Changes in the number of neurons were observed by immunohistochemistry.The levels of inflammatory factors IL-1,IL-6,IL-10,and TNF-α were measured by ELISA,and expression of TLR4,myeloid differentiation factor 88(MyD88),and NF-κB p65 was detected by Western Blot.Results Compared with the sham operation group,the BBB score and number of neurons in the saline group were significantly decreased,while the degree of pathological damage,and IL-1,IL-6,TNF-α,TLR4,MyD88,and NF-κB p65 levels were significantly increased(P＜0.05).Compared with the saline group,periplaneta americana powder and TLR4 inhibitor groups showed an increase in BBB scores and the number of neurons,and decreases in the degree of pathological damage and IL-1,IL-6,TNF-α,TLR4,MyD88,and NF-κB p65 levels(P＜0.05).Compared with the TLR4 inhibitor group,the periplaneta americana powder group had better increases in the BBB score,number of neurons and decreases in the degree of pathological damage and expression of IL-1 and TNF-α.Conclusions Periplaneta americana powder reduces the production of inflammatory factors after spinal cord injury by inhibiting the TLR4/MyD88/NF-κB pathway,protects nerves,and promotes motor recovery.

Objective:To compare the parameters for infra-acetabular screw placement between men and women using a digital Chinese anatomical model of the pelvis and acetabulum.Methods:The normal pelvic CT data were collected from the 163 adult patients who had been admitted to the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2021. There were 61 males and 102 females with an age of 53.0 (45.0, 60.0) years. Mimics 21.0 software was used to reconstruct the three dimensional pelvis which was then imported into Autodesk maya 2022 software before the model was flattened. Polygonal modeling tools were used to create a cylinder to simulate an infra-acetabular screw for length and angle measurements of the screw. The diameters of the infra-acetabular screws were measured by axial fluoroscopy in Mimics 21.0 software. The maximum diameters and maximum lengths of the infra-acetabular bone channel were compared between males and females, and the angles between the axis of the infra-acetabular screw and the anterior pelvic plane and the median sagittal plane were also compared between genders.Results:The maximum diameters of the left and right infra-acetabular corridors were 5.24 (4.26, 6.38) mm and 5.04 (4.50, 6.57) mm in males, and 3.99 (3.81, 4.51) mm and 3.89 (3.65, 4.90) mm in females; the maximum lengths of the left and right infra-acetabular corridors were (98.43±4.42) mm and (98.01±5.08) mm in males and 87.73 (84.22, 90.98) mm and 87.51 (84.59, 90.15) mm in females. The left and right angles between the infra-acetabular screw axis and the median sagittal plane were -0.98°±4.79° and -1.08°±4.91° in men, and 6.20° (3.34°, 11.16°) and 6.44° (3.77°, 11.85°) in women. The differences in the above data between men and women were statistically significant ( P<0.05). There was no statistically significant difference between men and women in the angle between the infra-acetabular screw axis and the anterior pelvic plane ( P>0.05). Conclusions:The length and diameter of the infra-acetabular corridor in males are greater than those in females, the angle between the infra-acetabular corridor and the sagittal plane in males is smaller than that in females, and the infra-acetabular corridor in males is more parallel to the sagittal plane. Therefore, the fluoroscopy angle should be adjusted for males to reduce the difficulty in screw placement when an infra-acetabular screw is placed during surgery.

Objective:To analyze the clinical characteristics and treatment methods of the patients who suffered from ice and snow sports injuries in Xinjiang in winter so that useful information can be provided for medical service for ice and snow sports.Methods:A retrospective study was conducted to analyze the clinical data of 147 patients who had sought medical attention for ice and snow sports injuries at Department of Orthopaedics, Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine from November 2018 to March 2022. The basic information, injury site, injury type, injury cause, length of hospitalization, and treatment methods of the patients were classified and statistically analyzed. The χ2 test was used to compare the injury site and type in patients of different ages, and the nonparametric Kruskal-Wallis test to compare the length of hospitalization in patients of different ages. Results:Of the 147 patients, 73 were males and 74 females with an age of (27.8±15.6) years. The top 3 injury sites were the lower limb (36.91%, 55/149), the upper limb (31.54%, 47/149), and the head and face (14.77%, 22/149). The top 3 injury types were fractures (61.90%, 91/147), skin and soft tissue lesions (14.97%, 22/147), and ligament lesions (10.20%, 15/147). The main causes for injury were fall (58.50%, 86/147), sprain (20.41%, 30/147), and bruise (19.73%, 29/147). Of the 91 patients with fractures, 55 (60.44%, 55/91) underwent surgical treatment, and 32 (35.16%, 32/91) closed reduction and plaster/brace external fixation. Eight of the 22 patients with soft tissue lesions (36.36%, 8/22) and 7 of the 15 patients with ligament lesions (46.67%, 7/15) underwent surgical treatment. The length of hospitalization for the 147 patients was 6.0 (4.0, 9.0) d. The differences in injury site and injury type were statistically significant between different age groups of patients, and the length of hospitalization was significantly different between different age groups of fracture patients ( P<0.05). Conclusions:Young people are the population who suffered from the most injuries due to ice and snow sports in winter in Xinjiang. Injury sites, injury types, and lengths of hospitalization varied with different age groups. Fractures were the most common type of injury. The participants of ice and snow sports should be fully aware that ice and snow sports are highly risky and thus avoid high-risk movements. Doctors should consider the patient's age, injury site, and injury type comprehensively when they formulate specific diagnostic and treatment schemes.

Objective:To establish a digital anatomical model of the pelvic and compare the differences in morphological parameters of the infra-acetabular screw safety channel between men and women.Methods:A retrospective analysis was performed on the pelvic data of 106 normal adults who underwent plain pelvic CT scan for non-pelvic disorders diseases in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2022 to December 2022, including 56 males and 50 females, aged 50.58±11.22 years (range, 21-68 years). Use reverse reconstruction software to reconstruct the pelvis and import it into Autodesk maya 2022 software to level the model. Use polygonal modeling tools to simulate the insertion of infra-acetabular screws and measure the length of the screw, the screw insertion angle, and the distance between the needle entry point and the apex of the iliopubic eminence. Measure the diameter of the infra-acetabular screw through axial fluoroscopy; measure the needle entry area, narrow area and needle exit area in Mimics 21.0 software; compare the differences in the above indicators between men and women.Results:The maximum diameters of male and female infra-acetabular screws were 4.82±1.07 mm and 3.93±0.65 mm respectively; the maximum lengths were 97.74±93.8 mm and 88.23±4.55 mm respectively; the angles with the sagittal plane were -1.33°±4.96°and 7.29°±6.20° respectively; the needle insertion areas were 314.83±4.79 mm 2 and 198.29±78.70 mm 2 respectively, the narrow areas were 75.61±19.00 mm 2 and 47.33±13.34 mm 2 respectively, and the needle exit areas were 400.52±88.86 mm 2 and 268.27±120.71 mm 2 respectively; the differences between male and female were statistically significant ( P<0.05). The infra-acetabular screw insertion points for men and women are respectively 9.39±1.44 mm and 9.68±1.41 mm inside the iliopubic eminence apex, and 8.87±1.22 mm and 9.28±1.56 anterior to the iliopubic eminence apex; the angles between the infra-acetabular screw and the anterior pelvic plane were 52.69°±7.38°and 52.32°±1.24°respectively; the differences were not statistically significant ( P>0.05). When the screw diameter was 3.5 mm, 88% (49/56) of men and 76% (38/50) of women have corridor in the pelvis for screws to pass through, and the difference was not statistically significant (χ 2=2.375, P=0.123). But when the screw diameter was 4.5 mm, 59% (33/56) of men and 20% (10/50) of women have corridor in the pelvis for screws to pass through, and the difference was statistically significant (χ 2=16.603, P<0.001). Conclusion:There are large individual differences in infra-acetabular corridor parameters. The length, diameter, needle entry area, narrow area and needle exit area of the infra-acetabular screw in men are larger than those in women, while the angle with the sagittal plane in men is smaller than that in women. There is no significant difference between men and women in the distance between the insertion point of the infra-acetabular screw and the iliopubic eminence and the angle between the screw and the anterior pelvic plane. There was no significant difference in the pass rate of screws with a diameter of 3.5 mm between males and females in the acetabular canal, while the pass rate of screws with a diameter of 4.5 mm was higher than that of females.

Objective To study the clinical efficacy of two-stage bone transport combined with induced membrane technique in the treatment of post-traumatic tibial osteomyelitis.Methods A retrospective study was conducted of the 14 patients with post-traumatic tibial osteomyelitis who had been treated by two-stage bone transport combined with induced membrane technique from February 2009 to August 2015.They were 12 males and 2 females,aged from 26 to 59 years (average,40.4 years).By the Cierny & Mader classification,they all belonged to type Ⅳ.Their disease course ranged from 6 to 30 months,averaging 15.3 months.The number of their previous operations ranged from 2 to 6 times,averaging 3.3 times.In the first stage of operation,tibial extended external fixation was installed according to preoperative design,followed by early debridement and extensive removal of osteomyelitis lesion.The length of bone defect after resection of osteomyelitis lesion was from 4 to 18 cm (average,8.5 cm).10％ vancomycin-contained polymethyl methacrylate (PMMA) bone cement was molded and placed in the bone defects.In the second stage of operation,the PMMA-induced membrane was opened to remove the PMMA bone cement,the bone marrow was drilled through and the induced membrane was then sutured up.Tibial osteotomy was conducted at an appropriate part.The average interval between the first and second stages was from 4 to 7 weeks (average,4.8 weeks).The clinical efficacy was evaluated according to the Paley criteria at final follow-ups.Complications were recorded.Results All the patients were followed up for 15 to 50 months (17.5 months).No relapse of osteomyelitis occurred.The total treatment time ranged from 11 to 19 months,with an average of 14.7 months.The total time for external fixation was from 10 to 18 months,averaging 13.2 months.The external fixator indexes ranged from 31 to 75 day/cm,with an average of 48.5 day/cm.According to Paley criteria at final follow-ups,the clinical efficacy was excellent in 11 and good in 3 cases.Pin tract infection occurred in 9 patients,mal-alignment after removal of external fixation in 6,and malunion or nonunion at the docking site in 5.Conclusions Two-stage bone transport combined with induced membrane technique can cure thoroughly post-traumatic tibial osteomyelitis.Its operation procedures are simple but effective.