BACKGROUND:Clinical studies suggest that both bone quality and excessive crown-to-implant ratio are factors that affect the success rate of implant surgery,but there is no consensus on how large the crown-to-implant ratio under each bone quality will affect the prognosis of implant repair.OBJECTIVE:To analyze the stress and strain of bone tissue around implant restorations with different crown-to-implant ratios under different bone types after stress loading using three-dimensional finite element method.Combined with the Frost bone mechanics regulation system theory,the physiological limits of bone strain were observed for each bone type within a certain range of crown to implant ratios.METHODS:Cone beam CT data were selected from a patient to establish solid bone block models with four different bone types(class Ⅰ bone:cortical bone thickness 3 mm+dense cancellous bone,class Ⅱ bone:cortical bone thickness 2 mm+relatively dense cancellous bone,class Ⅲ bone:cortical bone thickness 1 mm+relatively low-density cancellous bone,class Ⅳ bone:cortical bone thickness 1 mm+low-density cancellous bone).Implant restorations with five different crown-to-implant ratios(1,1.5,2,2.5,and 3)were created on each bone block model,for a total of 20 models.Vertical and oblique forces were applied to the dental crown to observe the von Mises stress values,strains,and displacement of the cortical and cancellous bones,as well as the degree of implant displacement.RESULTS AND CONCLUSION:(1)In the class Ⅰ bone model,when the crown-to-implant ratio reached 3 under oblique loading,the cortical bone strain exceeded the physiological limit.In the class Ⅱ bone model,under oblique loading,when the crown-to-implant ratio reached 2.5,the cortical bone strain exceeded the physiological limit.In the class Ⅲ bone model,under oblique loading,cortical bone exceeded the physiological limit when the crown-to-implant ratio reached 2.5,while cancellous bone reached the critical physiological limit at 1.In the class Ⅳ bone model,under oblique loading,when the crown-to-implant ratio reached 1.5,2,2.5,and 3,the cortical bone strain exceeded the physiological limit.In the class Ⅳ bone model,all five crown-to-implant ratios of cancellous bone exceeded physiological limits.(2)Under vertical load,the cancellous bone strain exceeded the physiological limit when the crown-root ratio reached 1,2,2.5,and 3 in the class Ⅲ bone model,and when the cancellous bone strain of the five crown-root ratios in the class Ⅳ bone model exceeded the physiological limit.(3)Under oblique or vertical load,the implant displacement of the 20 groups of models did not exceed 100 μm.(4)From the perspective of biomechanics,when patients with insufficient bone height choose implant restoration,the crown-root ratio that class Ⅰ bone can tolerate is up to 2.5 times,the crown-root ratio that class Ⅱ bone can tolerate is up to 2 times,and the crown-root ratio that class Ⅲ and class Ⅳ bones can tolerate is up to 1 times due to excessive strain of cancellous bone;but the crown-root ratio that cortical bone in class Ⅲ bone can tolerate is up to 2 times.Whether class Ⅲ bone can tolerate implant restoration with a high crown-root ratio and whether cancellous bone can tolerate higher strains needs further study.

BACKGROUND:Clinical studies suggest that both bone quality and excessive crown-to-implant ratio are factors that affect the success rate of implant surgery,but there is no consensus on how large the crown-to-implant ratio under each bone quality will affect the prognosis of implant repair.OBJECTIVE:To analyze the stress and strain of bone tissue around implant restorations with different crown-to-implant ratios under different bone types after stress loading using three-dimensional finite element method.Combined with the Frost bone mechanics regulation system theory,the physiological limits of bone strain were observed for each bone type within a certain range of crown to implant ratios.METHODS:Cone beam CT data were selected from a patient to establish solid bone block models with four different bone types(class Ⅰ bone:cortical bone thickness 3 mm+dense cancellous bone,class Ⅱ bone:cortical bone thickness 2 mm+relatively dense cancellous bone,class Ⅲ bone:cortical bone thickness 1 mm+relatively low-density cancellous bone,class Ⅳ bone:cortical bone thickness 1 mm+low-density cancellous bone).Implant restorations with five different crown-to-implant ratios(1,1.5,2,2.5,and 3)were created on each bone block model,for a total of 20 models.Vertical and oblique forces were applied to the dental crown to observe the von Mises stress values,strains,and displacement of the cortical and cancellous bones,as well as the degree of implant displacement.RESULTS AND CONCLUSION:(1)In the class Ⅰ bone model,when the crown-to-implant ratio reached 3 under oblique loading,the cortical bone strain exceeded the physiological limit.In the class Ⅱ bone model,under oblique loading,when the crown-to-implant ratio reached 2.5,the cortical bone strain exceeded the physiological limit.In the class Ⅲ bone model,under oblique loading,cortical bone exceeded the physiological limit when the crown-to-implant ratio reached 2.5,while cancellous bone reached the critical physiological limit at 1.In the class Ⅳ bone model,under oblique loading,when the crown-to-implant ratio reached 1.5,2,2.5,and 3,the cortical bone strain exceeded the physiological limit.In the class Ⅳ bone model,all five crown-to-implant ratios of cancellous bone exceeded physiological limits.(2)Under vertical load,the cancellous bone strain exceeded the physiological limit when the crown-root ratio reached 1,2,2.5,and 3 in the class Ⅲ bone model,and when the cancellous bone strain of the five crown-root ratios in the class Ⅳ bone model exceeded the physiological limit.(3)Under oblique or vertical load,the implant displacement of the 20 groups of models did not exceed 100 μm.(4)From the perspective of biomechanics,when patients with insufficient bone height choose implant restoration,the crown-root ratio that class Ⅰ bone can tolerate is up to 2.5 times,the crown-root ratio that class Ⅱ bone can tolerate is up to 2 times,and the crown-root ratio that class Ⅲ and class Ⅳ bones can tolerate is up to 1 times due to excessive strain of cancellous bone;but the crown-root ratio that cortical bone in class Ⅲ bone can tolerate is up to 2 times.Whether class Ⅲ bone can tolerate implant restoration with a high crown-root ratio and whether cancellous bone can tolerate higher strains needs further study.

Bladder tumor within inguinal bladder hernia is rare. This article reports a case of a male patient who was admitted to hospital due to gross hematuria，accompanied by lower abdominal pain when straining to urinate for two months. Physical examination revealed a irreducible mass in the left inguinal region. Ultrasound and MRI examinations suggested an inguinal bladder hernia complicated by multiple bladder lesions. Cystoscopy revealed extensive tumors，and pathological examination indicated high-grade urothelial carcinoma with carcinoma in situ. PET-CT confirmed pelvic lymph node metastasis. The patient underwent three cycles of neoadjuvant therapy followed by laparoscopic radical cystectomy combined with hernia repair. There was no evidence of recurrence of the hernia or tumor after one year of follow-up.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective To evaluate the effect of pneumatic logistics transport system(PTS)on the trans-portation efficiency of the transferred samples and the accuracy of the results.Methods The transportation speed,temperature and humidity change of PTS were analyzed by temperature and humidity transmitter.Anti-coagulant samples containing disodium ethylenediaminetetraacetate(EDTA-K2),sodium citrate,lithium hepa-rin and samples containing inert separation gel coagulant were selected.and used respectively for complete blood cell analysis,prothrombin time(PT),activated partial prothrombin time(APTT),troponin T(TnT)and other myocardial markers,as well as the detection of items such as glucose(Glu)and lactate dehydrogen-ase(LDH).According to the transfer mode,they were divided into the manual transfer group and the PTS transfer group,and according to the number of PTS transfers,they were divided into the one-time transfer group,the three-time transfer group and before transfer(control).The differences among each group were statistically analyzed,and 1/3 allowable total error(1/3TEa)was adopted as the criterion for determining the clinical application value.Results There was no statistically significant difference in the changes of tempera-ture and humidity during the transportation process of PTS compared with manual transportation(P＞0.05),but it was significantly faster than manual transportation in terms of transportation time(P＜0.05).Com-pared with before transfer,the differences between the PT,APTT,Glu and LDH items in the one-time trans-fer group and the three-time transfer group were statistically significant(P＜0.01),and their deviations were all much greater than 1/3TEa.However,in the plasma samples,compared with before transport,there were statistically significant differences in Glu and LDH between the one-time transfer group and the three-time transfer group(P＜0.05),but the deviations were all less than 1/3TEa.For the items of TnT,red blood cell count and hematocrit,compared with before transfer,there were statistically significant differences between some groups of the one-time transfer group and the three-time transfer group(P＜0.05),but the deviations were all less than 1/3TEa.Conclusion PTS can significantly improve the transportation efficiency of sam-ples,but it significantly affects the detection of Glu and LDH in plasma samples,which can be improved by u-sing serum sample transportation instead.In addition,PTS also affects the detection of PT and APTT,and it is not recommended to use PTS to transport coagulation specimen.

Peptide-based radiopharmaceuticals targeting integrin α5β1 show promise for precise tumor diagnosis and treatment. However, current peptide-based radioligands that target α5β1 demonstrate inadequate in vivo performance owing to limited tumor retention. The use of PEGylation to enhance the tumor retention of radiopharmaceuticals by prolonging blood circulation time poses a risk of increased blood toxicity. Therefore, a PEGylation strategy that boosts tumor retention while minimizing blood circulation time is urgently needed. Here, we developed a PEGylation-enabled peptide multidisplay platform (PEGibody) for PR_b, an α5β1 targeting peptide. PEGibody generation involved PEGylation and self-assembly. [⁶⁴Cu]QM-2303 PEGibodies displayed spherical nanoparticles ranging from 100 to 200 nm in diameter. Compared with non-PEGylated radioligands, [⁶⁴Cu]QM-2303 demonstrated enhanced tumor retention time due to increased binding affinity and stability. Importantly, the biodistribution analysis confirmed rapid clearance of [⁶⁴Cu]QM-2303 from the bloodstream. Administration of a single dose of [¹⁷⁷Lu]QM-2303 led to robust antitumor efficacy. Furthermore, [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 exhibited low hematological and organ toxicity in both healthy and tumor-bearing mice. Therefore, this study presents a PEGibody-based radiotheranostic approach that enhances tumor retention time and provides long-lasting antitumor effects without prolonging blood circulation lifetime. The PEGibody-based radiopharmaceutical [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 shows great potential for positron emission tomography imaging-guided targeted radionuclide therapy for α5β1-overexpressing tumors.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Bladder tumor within inguinal bladder hernia is rare. This article reports a case of a male patient who was admitted to hospital due to gross hematuria，accompanied by lower abdominal pain when straining to urinate for two months. Physical examination revealed a irreducible mass in the left inguinal region. Ultrasound and MRI examinations suggested an inguinal bladder hernia complicated by multiple bladder lesions. Cystoscopy revealed extensive tumors，and pathological examination indicated high-grade urothelial carcinoma with carcinoma in situ. PET-CT confirmed pelvic lymph node metastasis. The patient underwent three cycles of neoadjuvant therapy followed by laparoscopic radical cystectomy combined with hernia repair. There was no evidence of recurrence of the hernia or tumor after one year of follow-up.

Objective To analyze the risk factors for death in children with interruption of aortic arch (IAA) and ventricular septal defect (VSD) after one-stage radical surgery. Methods A retrospective analysis was performed on patients with IAA and VSD who underwent one-stage radical treatment in the First Hospital of Hebei Medical University from January 2006 to January 2017. Cox proportional hazards regression model was used to analyze the risk factors for death after the surgery. Results A total of 152 children were enrolled, including 70 males and 82 females. Twenty-two patients died with a mean age of 30.73±9.21 d, and the other 130 patients survived with a mean age of 37.62±11.06 d. The Cox analysis showed that younger age (OR=0.551, 95%CI 0.320-0.984, P=0.004), low body weight (OR=0.632, 95%CI 0.313-0.966, P=0.003), large ratio of VSD diameter/aortic root diameter (VSD/AO, OR=2.547, 95%CI 1.095-7.517, P=0.044), long cardiopulmonary bypass time (OR=1.374, 95%CI 1.000-3.227, P=0.038), left ventricular outflow tract obstruction (LVOTO, OR=3.959, 95%CI 1.123-9.268, P=0.015) were independent risk factors for postoperative death. Conclusion For children with IAA and VSD, younger age, low body weight, large ratio of VSD/AO, long cardiopulmonary bypass time and LVOTO are risk factors for death after one-stage radical surgery.

Objective: To compare the clinical efficacy of anterior column reconstruction using single or double titanium mesh cage (TMC) after total en bloc spondylectomy (TES) of thoracic and lumbar spinal tumors. Methods: A retrospective cohort study was performed involving 39 patients with thoracic or lumbar spinal tumors. All patients underwent TES, followed by anterior reconstruction and screw-rod instrumentation via a posterior-only procedure. Twenty-two patients in group A were treated with a single TMC to reconstruct the anterior column, whereas 17 patients in group B were reconstructed with double TMCs. Results: The overall follow-up is 20.5 ± 4.6 months. There is no significant difference between the 2 groups regarding age, sex, body mass index, tumor location, operative time, and intraoperative blood loss. The time for TMC placement was significantly shortened in the double TMCs group (5.2 ± 1.3 minutes vs. 15.6 ± 3.3 minutes, p = 0.004). Additionally, postoperative neural complications were significantly reduced with double TMCs (5/22 vs. 0/17, p = 0.046). The kyphotic Cobb angle and mean intervertebral height were significantly corrected in both groups (p ≤ 0.001), without obvious loss of correction at the last follow-up in either group. The bone fusion rates for single TMC and double TMCs were 77.3% and 76.5%, respectively. Conclusion Using 2 smaller TMCs instead of a single large one eases the placement of TMC by shortening the time and avoiding nerve impingement. Anterior column reconstruction with double TMC is a clinically feasible, and safe alternative following TES for thoracic and lumbar tumors.