AIM: To investigate the association of osteoprotegerin ( OPG) gene single nucleotide polymor-phisms (SNPs), 163A/G (rs3102735) and 245T/G (rs3134069), with susceptibility to rheumatoid arthritis (RA) in Chinese Han population .METHODS:A total of 205 patients with RA and 171 healthy control subjects were enrolled into this study.Genotyping was performed by polymerase chain reaction-based restriction fragment length polymorphism and subsequently confirmed by DNA sequencing .Odds ratio ( OR) and 95%confidence intervals ( CI) were calculated for the risk genotypes and alleles .RESULTS: OPG gene polymorphisms 163A/G and 245T/G were conformed to the Hardy-Weinberg equilibrium .The statistical differences in the genotypes of AA , AG and GG at 163A/G locus were found in RA and controls.The G allele was associated with an increased risk of RA , with OR of 1.219 (95%CI:1.066~2.339).No significant difference was observed between RA group and control group with respect to genotypic and allelic frequencies of OPG gene 245T/G (P>0.05).CONCLUSION:The OPG gene 163A/G SNP may be associated with RA susceptibility , and G allele may be the risk factor for developing RA .

Objective:To study the influences of sucrose,citric acid and sodium bicarbonate on the adhesion of 3 kinds of adhesives.Methods:60 extracted tooth and 60 zirconia blocks (3 mm × 3 mm × 3 mm) were randomly divided into 3 groups (n =20),namely PULPDENT group,3M ESPE RelyxTM Veneer group and RelyxTM Luting group.Then,the samples of each group fell into 4 subgroups(n=5),namely subgroup A for artificial saliva,subgroup B for 10％ sucrose,subgroup C for 0.2％ citric acid,and subgroup D for 0.03 ％ sodium bicarbonate.After completing the adhesion of the specimens with corresponding adhesives,the specimens of subgroups A,B,C and D were submerged into artificial saliva(the control),sucrose,citric acid and sodium bicarbonate solutions for 2 times/day and 5 min/time,respectively.For the rest of time,all the specimens were submerged in artificial saliva.3 months later,shear bond strength of the specimens was tested,the fracture surface was observed under SEM,20 × microscope,and the fracture model was observed by stereoscopic microscope.SPSS 17.0 software was adopted for statistical analysis of the data.Results:The bond strength of PULPDENT,3M ESPE RelyxTM Veneer groups were higher than that of RelyxTM Luting group(P ＜ 0.05);the bond strength of subgroups B,C and D was lower than that of subgroup A(P ＜0.05);and the difference between the remaining groups was not statistically significant(P ＞0.05).SEM observation displayed that in group RelyxTM Luting,subgroups B,C and D showed increased crack depth,width and length when compared with subgroup A;there was no obvious difference between the remaining groups and the control group;in groups PULPENT,3M ESPE RelyxTM Veneer and RelyxTM Luting,all samples in their subgroups showed interface failure.Conclusion:Compared with PULPDENT and 3M ESPE RelyxTM Veneer adhesive,RelyxTM Luting is more susceptible to the influence of sucrose,citric acid and sodium bicarbonate,so it is not suitable for bonding zirconia blocks.

Total mesorectal excision(TME)and complete mesoclic excision (CME)concepts make people aware of membrane integrity;the effect of endoscopic magnification and the hemostatic effect of ultrasonic scalpel,surgical field of view clearly,to further understand the structure of the membrane,which proposed the surgical anatomy of the membrane.This article describes the surgical membrane anatomy from the colorectal membrane of the embryonic development and membrane anatomical features that guide laparoscopic colorectal surgery.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.