Objective:To analyze the relevant factors of knee joint cartilage injury in patients with anterior cruciate ligament rupture and construct a nomogram prediction model.Methods:The clinical data of 160 patients with unilateral anterior cruciate ligament rupture who underwent surgical treatment from March 2020 to February 2023 at Tianjin 272 Hospital and the Ninety-Eighty-Third Hospital of the People′s Liberation Army Joint Logistics Support Force were retrospectively analyzed. The patients were divided into injured group (97 cases) and non injured group (63 cases) based on whether there was concurrent knee joint cartilage injury. The optimal cutoff values of each factor were analyzed by the receiver operating characteristic (ROC) curve. Using a multiple Logistic regression model to analyze the independent risk factors of knee joint cartilage injury in patients with anterior cruciate ligament rupture; construct a nomogram model for predicting knee joint cartilage injury in patients with anterior cruciate ligament rupture. The internal validation of the nomogram model was validated using calibration curves, and the predictive performance of the nomogram model is evaluated using decision curves.Results:The body mass index (BMI), rate of meniscus injury, number of sprains and injury time in injured group were significantly higher than those in non injured group: (24.15 ± 2.52) kg/m 2 vs. (22.84 ± 3.13) kg/m 2, 77.32% (75/97) vs. 17.46% (11/63), (2.64 ± 0.90) times vs. (1.17 ± 0.64) times, (19.15 ± 3.77) d vs. (12.92 ± 3.14) d, and there were statistical differences ( P<0.05). The ROC curve analysis results show that the optimal cutoff values for BMI, number of sprains and injury time were 22.9 kg/m 2, once and 16 d, respectively. BMI (>22.9 kg/m 2), meniscus injury (with), number of sprains (>1 time) and injury time (>16 d) were independent risk factors for knee joint cartilage injury in patients with anterior cruciate ligament rupture, and they were also predictive factors for building nomogram model. The internal validation results show that the nomogram model predicts a C-index of 0.819 (95% CI 0.715 to 0.883) for patients with anterior cruciate ligament rupture complicated by knee cartilage injury. The consistency between the observed values and the predicted values was good. The nomogram model predicts a threshold of over 0.14 for knee joint cartilage injury in patients with anterior cruciate ligament rupture, and the clinical net benefits provided by the column chart model were higher than BMI, meniscus injury, number of sprains and injury time. Conclusions:This study constructs a nomogram model based on BMI, meniscus injury, number of sprains, and injury time to predict knee joint cartilage injury in patients with anterior cruciate ligament rupture. The model has good predictive value for knee joint cartilage injury in patients with anterior cruciate ligament rupture, and can be used to identify high-risk patients who are prone to knee joint cartilage injury in patients with anterior cruciate ligament rupture.

Background and Aims:Severe and multiple complications significantly affect the survival of patients after pancreaticoduodenectomy(PD).Previous studies have primarily focused on improving anastomosis techniques to reduce postoperative fistulas,with limited research on anatomical approaches to decrease complications and improve patient outcomes.This article summarizes our team's experience in applying curettage and suction dissection method in PD and analyzes its safety and clinical efficacy. Methods:The clinical data from patients undergoing elective PD in the Department of Hepatobiliary Surgery of Inner Mongolia Medical University Hospital from January 2021 to June 2023 were retrospectively collected.Patients using the curettage and suction dissection method were designated as the observation group,while those using traditional anatomical techniques were served as the control group.The observation group utilized the Peng's multifunctional operational dissector(PMOD),whereas the control group used conventional electrotome and ultrasonic scalpel during operation.The main clinical variables between the two groups were compared,and factors affecting postoperative survival of patients were also analyzed. Results:A total of 169 patients were included,with 59 in the observation group and 110 in the control group.No significant differences in baseline characteristics were found between the groups(all P＞0.05).The observation group exhibited more nerve infiltration during surgery than the control group(64.41％vs.39.09％,P=0.002),but had significantly shorter operative time(236 min vs.330 min,P＜0.01).There were no significant differences in lymph node metastasis,blood loss,or vascular infiltration between the two groups(all P＞0.05).The incidence of postoperative pancreatic fistula was significantly lower in the observation group than that in the control group(16.9％vs.40.0％,P=0.002).No significant differences were noted between the groups in terms of reoperation rate within one month,postoperative hospitalization duration,bile leakage,bleeding,infection,delayed gastric emptying or survival(all P＞0.05).Multivariate Logistic regression analysis identified smoking,tumor nerve infiltration,and delayed gastric emptying as independent risk factors affecting survival(all P＜0.05). Conclusion:Using curettage and suction dissection method with PMOD in PD is safe and feasible.It is simpler,less invasive,and results in shorter operative time compared to traditional method,indirectly reducing postoperative complications.Its clinical efficacy is reliable,suggesting potential for broader application in clinical practice.