Objective:To investigate the clinical efficacy of minimally invasive bone plate technology combined with interlocking intramedullary nail fixation in the treatment of Schatzker type V-VI tibial plateau fractures.Methods:This study is a prospective randomized controlled trial involving 102 patients with Schatzker type V-VI tibial plateau fractures admitted to the First People's Hospital of Yuhang District from November 2020 to October 2023. The patients were randomly divided into a control group ( n = 48) and a study group ( n = 54) using the random number table method. The study group received treatment with minimally invasive plate technology combined with interlocking intramedullary nail fixation, while the control group underwent double bone plate fixation through medial and lateral knee incisions. Surgical outcomes and bone healing were compared between the two groups. All participants were followed up for 1 year after surgery, during which knee joint function was assessed at 1, 6, and 12 months using the Hospital for Special Surgery knee score and balance ability was evaluated using the Berg Balance Scale. The incidence of postoperative complications was also compared between the two groups. Results:The study group had significantly shorter surgical time [(69.38 ± 12.64) minutes], intraoperative blood loss [(165.20 ± 17.58) mL], and fracture healing time [(14.51 ± 3.02) weeks] compared with the control group [(91.24 ± 15.18) minutes, (222.19 ± 20.47) mL, (17.04 ± 4.11) weeks, t = 7.93, 15.13, 3.51, all P < 0.05]. At 1, 6, and 12 months after surgery, the Berg Balance Scale scores in the study group were (44.55 ± 4.01), (49.31 ± 3.67), and (53.11 ± 3.18), respectively. These scores were significantly higher than those in the control group [(40.27 ± 3.98), (45.65 ± 3.16), (48.26 ± 3.20), t = -5.40, -5.36, -7.65, all P < 0.05]. At 1, 6, and 12 months after surgery, the Hospital for Special Surgery knee scores in the study group were (68.29 ± 4.25), (76.37 ± 5.25), (83.31 ± 5.01) respectively. These scores were significantly higher than those in the control group [(63.57 ± 4.14), (72.08 ± 4.50), (80.05 ± 4.57), t = -5.67, -4.40, -3.42, all P < 0.05]. There was no significant incidence in the incidence of complications between the study and control groups [12.96% (7/54) vs. 18.75% (9/48), P > 0.05]. Conclusions:The use of minimally invasive bone plate technology combined with interlocking intramedullary nail fixation for the treatment of Schatzker type V-VI tibial plateau fractures has demonstrated significant short-term clinical results, including reduced intraoperative blood loss, shorter fracture healing time, and improved recovery of joint function after surgery.

Objective:To investigate the clinical efficacy of minimally invasive bone plate technology combined with interlocking intramedullary nail fixation in the treatment of Schatzker type V-VI tibial plateau fractures.Methods:This study is a prospective randomized controlled trial involving 102 patients with Schatzker type V-VI tibial plateau fractures admitted to the First People's Hospital of Yuhang District from November 2020 to October 2023. The patients were randomly divided into a control group ( n = 48) and a study group ( n = 54) using the random number table method. The study group received treatment with minimally invasive plate technology combined with interlocking intramedullary nail fixation, while the control group underwent double bone plate fixation through medial and lateral knee incisions. Surgical outcomes and bone healing were compared between the two groups. All participants were followed up for 1 year after surgery, during which knee joint function was assessed at 1, 6, and 12 months using the Hospital for Special Surgery knee score and balance ability was evaluated using the Berg Balance Scale. The incidence of postoperative complications was also compared between the two groups. Results:The study group had significantly shorter surgical time [(69.38 ± 12.64) minutes], intraoperative blood loss [(165.20 ± 17.58) mL], and fracture healing time [(14.51 ± 3.02) weeks] compared with the control group [(91.24 ± 15.18) minutes, (222.19 ± 20.47) mL, (17.04 ± 4.11) weeks, t = 7.93, 15.13, 3.51, all P < 0.05]. At 1, 6, and 12 months after surgery, the Berg Balance Scale scores in the study group were (44.55 ± 4.01), (49.31 ± 3.67), and (53.11 ± 3.18), respectively. These scores were significantly higher than those in the control group [(40.27 ± 3.98), (45.65 ± 3.16), (48.26 ± 3.20), t = -5.40, -5.36, -7.65, all P < 0.05]. At 1, 6, and 12 months after surgery, the Hospital for Special Surgery knee scores in the study group were (68.29 ± 4.25), (76.37 ± 5.25), (83.31 ± 5.01) respectively. These scores were significantly higher than those in the control group [(63.57 ± 4.14), (72.08 ± 4.50), (80.05 ± 4.57), t = -5.67, -4.40, -3.42, all P < 0.05]. There was no significant incidence in the incidence of complications between the study and control groups [12.96% (7/54) vs. 18.75% (9/48), P > 0.05]. Conclusions:The use of minimally invasive bone plate technology combined with interlocking intramedullary nail fixation for the treatment of Schatzker type V-VI tibial plateau fractures has demonstrated significant short-term clinical results, including reduced intraoperative blood loss, shorter fracture healing time, and improved recovery of joint function after surgery.

Objective:To observe any effect of early-stage body weight-supported treadmill training on the progression of osteoporosis after a stroke.Methods:Sixty stroke survivors with osteoporosis were randomly divided into a treatment group and a control group, each of 30. Both groups were given routine medication including Miacalcic, α-D3 and Fosamax, along with standard rehabilitation training. The treatment group was additionally subjected to body weight-supported treadmill training. The bone mineral density (BMD), serum osteoprotegerin (OPG) and serum NF-κ B ligand receptor activator (RAKNL) levels were measured for both groups before and after 3, 6 and 12 months of treatment.Results:The average BMD, OPG and RAKNL levels and the RANKL/OPG ratio in both groups improved with treatment. After 3, 6 and 12 months of treatment, all four average indicators were superior to those of the control group at the same time points.Conclusion:Body weight-supported treadmill training can significantly retard the development of osteoporosis.

Objective To study the correlation between the clinical characteristics of HCC patients with different phenotype circulating tumor cells in the peripheral blood.Methods 77 patients with HCC and 21 patients with benign liver diseases treated at Zhujiang Hospital of Southern Medical University from April 2015 to December 2016 were retrospectively studied.The CanPatrolTM System was adoptedto detect epithelial-mesenchymal phenotype CTCs in the peripheral blood.This study aimed to clarify whether the epithelial-mesenchymal phenotype CTCs were specifically originated from the tumorand to investigate the correlation between CTCs and the clinical features of the patients.Results Using epithelial and mesenchymal markers,the CTCs were divided into three subtypes:epithelial,mesenchymal and mixed CTCs.No epithelial-mesenchymal phenotype CTCs were detected in patients with benign liver diseases.The positivity rates of epithelial,mixed and mesenchymal CTCs in the peripheral blood of 77 patients with HCC were 37.7％ (29/77),74.0％ (57/77) and 50.6％ (39/77),respectively.The positivity rates of epithelial-mesenchymal phenotype CTCs in patients with HCC were significantly higher than the group of patients with benign liver diseases (P ＜ 0.05).The positivity rates of epithelial CTCs were significantly correlated with AFP,number of tumor and portal vein tumor thrombus (P ＜ 0.05).The positivity rates of mixed CTCs were significantly correlated with portal vein tumor thrombus,tumor differentiation and BCLC stage (P ＜ 0.05).The positivity rates of mesenchymal CTCs were significantly correlated with tumor size,portal vein tumor thrombus,tumor differentiation and BCLC stage (P ＜ 0.05).Conclusions The positivity rates of epithelial,mixed and mesenchymal CTCs were closely related to different aspects of clinical characteristics of patients with HCC.These CTCs may serve as indicatorsto evaluatethe progress of HCC.

Objective To explore the clinical results of total knee arthroplasty (TKA) in the treatment of knees with bony ankylosis in extension.Methods From June 2000 to June 2007,10 patients had knees with bony ankylosis in extension were treated with TKA,including 4 males and 6 females,with an average age of 49 years (range,29 to 63 years).The primary diseases were as follows:ankylosing spondylitis in 3 cases,rheumatoid arthritis in 2 cases,hemophilic arthritis in 1 care,traumatic arthritis in 3 cases and pyogenic arthritis in 1 case.The range of motion (ROM) was 0° in all knees,and the average HSS (the Hospital for Special Surgery) score before operation was 32.5±10.26.Two patients underwent bilateral TKA,and 8 underwent unilateral TKA.Results All patients were followed up for 3 to 10 years (average,5.3 years).The average HSS score was improved to 87.75±6.45 at the last follow-up,and there was significant difference compared with that before operation (t=18.668,P=0.000).The average ROM was improved to 97.08°±11.57°at the last follow-up,and there was remarkable difference compared with that before operation (t=29.063,P=0.000).The postoperative complications included cutaneous necrosis in 2 cases,deep venous thrombosis of lower limb in 1 case,periprosthetic fracture in 1 case,and deep prosthetic infection in 1 case who underwent revised TKA later.The postopertative X-ray showed no looseness of the prostheses.Conclusion TKA through medial parapatellar approach,with dissection of the rectus femoris,secondary osteotomy and soft tissue balance intraoperatively is effective in the treatment of knees with bony ankylosis in extension,which can correct the ankylosed knee deformitis successfully.Combining with the correct rehabilitation exercise,it is possible to improve significantly the function of knee and life quality in these patients.

ObjectiveTo observe the clinical effect of acupuncture plus ice excitation on dysphagia in stroke patients.Methods60 stroke patients with dysphagia were divided randomly into treatment group (n=30) and control group (n=30). The treatment group received acupuncture plus ice excitation, while the control group only received acupuncture. The course was 4 weeks.ResultsThe curative effect showed that the total effective rate was 96.67% in the treatment group with recovery in 23 cases, improvement in 6 cases, and uselessness in 1 case, while the total effective rate was 73.33% in the control group with recovery in 17 cases, improvement in 5 cases, and uselessness in 8 cases (χ2=6.435, P＜0.05).ConclusionAcupuncture plus ice excitation had a good effect on dysphagia in stroke patients.