Objective:To observe the clinical efficacy of manual reduction combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic thoracolumbar spinal compression fractures through a prospective study.Methods:A total of 124 patients with osteoporotic thoracolumbar compression fractures admitted to Beijing Luoyang Orthopedic Hospital from January 2020 to December 2022 were prospectively selected and randomly divided into a treatment group and a control group, with 62 patients in each group. The control group underwent PVP surgery, while the treatment group underwent PVP surgery after manual reduction. Compare the treatment efficacy, surgical related indicators, pain level, vertebral height and Cobb angle between two groups.Results:The total effective rate of the treatment group was higher than that of the control group: 93.55% (58/62) vs. 80.65% (50/62), and the difference was statistically significant ( P<0.05). The intraoperative fluoroscopy time and single vertebral body surgery time in the treatment group were shorter than those in the control group: (54.87 ± 9.42) s vs. (76.32 ± 10.06) s, (29.51 ± 7.89) min vs. (38.59 ± 8.35) min, with statistical significance ( P<0.01); there was no statistically significant difference in the diffusion coefficient between the two groups of bone cement ( P>0.05). On postoperative 1, 3, and 7 d, the visual analog score (VAS) of the treatment group were lower than those of the control group: (4.43 ± 1.06) points vs. (5.31 ± 1.14) points, (3.16 ± 0.62) points vs. (4.25 ± 0.77) points, (1.28 ± 0.35) points vs. (2.14 ± 0.49) points, with statistical significance ( P<0.01). The incidence of complications in the treatment group was lower than that in the control group: 3.22% (2/62) vs. 12.90% (8/62), and the difference was statistically significant ( P<0.05). The vertebral height of the treatment group was higher than that of the control group at 3 and 6 months after surgery: (23.79 ± 2.16) mm vs. (21.34 ± 2.23) mm, (23.60 ± 2.04) mm vs. (21.22 ± 2.16) mm, and the Cobb angle of the treatment group was lower than that of the control group at 3 and 6 months after surgery: (19.24 ± 2.68)° vs. (21.76 ± 3.00)°, (14.43 ± 2.51)° vs. (17.79 ± 2.64)°, with statistical significance ( P<0.01). Conclusions:In patients with osteoporotic thoracolumbar compression fractures, manual reduction combined with PVP surgery is beneficial for shortening intraoperative fluoroscopy time and surgery time, reducing pain, restoring patient vertebral height, improving Cobb angle, restoring vertebral function, enhancing bone density, and has low treatment costs. It is worth promoting and implementing.

Objective:To observe the clinical efficacy of manual reduction combined with percutaneous vertebroplasty (PVP) in the treatment of osteoporotic thoracolumbar spinal compression fractures through a prospective study.Methods:A total of 124 patients with osteoporotic thoracolumbar compression fractures admitted to Beijing Luoyang Orthopedic Hospital from January 2020 to December 2022 were prospectively selected and randomly divided into a treatment group and a control group, with 62 patients in each group. The control group underwent PVP surgery, while the treatment group underwent PVP surgery after manual reduction. Compare the treatment efficacy, surgical related indicators, pain level, vertebral height and Cobb angle between two groups.Results:The total effective rate of the treatment group was higher than that of the control group: 93.55% (58/62) vs. 80.65% (50/62), and the difference was statistically significant ( P<0.05). The intraoperative fluoroscopy time and single vertebral body surgery time in the treatment group were shorter than those in the control group: (54.87 ± 9.42) s vs. (76.32 ± 10.06) s, (29.51 ± 7.89) min vs. (38.59 ± 8.35) min, with statistical significance ( P<0.01); there was no statistically significant difference in the diffusion coefficient between the two groups of bone cement ( P>0.05). On postoperative 1, 3, and 7 d, the visual analog score (VAS) of the treatment group were lower than those of the control group: (4.43 ± 1.06) points vs. (5.31 ± 1.14) points, (3.16 ± 0.62) points vs. (4.25 ± 0.77) points, (1.28 ± 0.35) points vs. (2.14 ± 0.49) points, with statistical significance ( P<0.01). The incidence of complications in the treatment group was lower than that in the control group: 3.22% (2/62) vs. 12.90% (8/62), and the difference was statistically significant ( P<0.05). The vertebral height of the treatment group was higher than that of the control group at 3 and 6 months after surgery: (23.79 ± 2.16) mm vs. (21.34 ± 2.23) mm, (23.60 ± 2.04) mm vs. (21.22 ± 2.16) mm, and the Cobb angle of the treatment group was lower than that of the control group at 3 and 6 months after surgery: (19.24 ± 2.68)° vs. (21.76 ± 3.00)°, (14.43 ± 2.51)° vs. (17.79 ± 2.64)°, with statistical significance ( P<0.01). Conclusions:In patients with osteoporotic thoracolumbar compression fractures, manual reduction combined with PVP surgery is beneficial for shortening intraoperative fluoroscopy time and surgery time, reducing pain, restoring patient vertebral height, improving Cobb angle, restoring vertebral function, enhancing bone density, and has low treatment costs. It is worth promoting and implementing.

Objective:To compare the clinical efficacy of robot-assisted pedicle screw placement with visualization technology and conventional robot-assisted pedicle screw placement, and analyze the accuracy and safety of robot-assisted pedicle screw placement with visualization.Methods:This retrospective study analyzed data from 60 patients (39 males and 21 females) with an average age of 51.03±18.04 years (range 12-78 years) who underwent open spinal pedicle screw fixation surgery for thora columbar diseases at the Orthopedic Department of the First Affiliated Hospital of China Medical University between August 2020 and September 2022. The cases included 25 cases of spinal stenosis, 15 cases of lumbar fractures, 7 cases of thoracic fractures, 3 cases of lumbar spondylolisthesis, and 10 cases of spinal deformities. 30 patients underwent solid pedicle screw placement using robot-assisted visualization technology (visualization group), while the remaining 30 patients received hollow pedicle screw placement using conventional robot-assisted technology (conventional group). After screw placement, "O"-arm X-ray scans were performed for verification, and screw placement accuracy was evaluated based on the Gertzbein-Robbins standard. The study recorded and compared the time required for screw placement, number of fluoroscopy sessions, and perioperative complications between the two groups to provide a comprehensive assessment of surgical outcomes.Results:There were no significant differences in age and gender between the two groups ( P>0.05). In the visualization group, a total of 178 pedicle screws were placed, with 172 screws (96.6%) achieving satisfactory placement, while the conventional group placed 254 pedicle screws, with 240 screws (94.5%) achieving satisfactory placement. The difference in accuracy rates between the two groups was not statistically significant (χ 2=1.087, P=0.297). The visualization group required a mean of 2.60±1.03 fluoroscopy sessions during surgery, significantly less than the conventional group's mean of 5.57±2.12 sessions ( t=-6.860, P=0.001). Moreover, the visualization group had a shorter mean screw placement time of 13.23±3.68 minutes compared to the conventional group's mean of 24.68±15.75 minutes ( t=-3.870, P=0.040). All patients in both groups completed the surgery without postoperative complications such as infection, hematoma, or nerve root injury. Conclusion:The technique of robot-assisted pedicle screw placement with visualization effectively preserves the high precision achieved in conventional robotic surgery. With its advantage of real-time monitoring for screw position, it reduces the intraoperative fluoroscopy times and shortens the screw placement time, thereby further enhancing surgical efficiency.

Objectives:This study aims to explore the clinical significance of lateral pelvic sentinel lymph node biopsy (SLNB) using indocyanine green (ICG) fluorescence navigation in laparoscopic lateral pelvic lymph node dissection (LLND) and evaluate the accuracy and feasibility of this technique to predict the status of lateral pelvic lymph nodes (LPLNs).Methods:The clinical and pathological characteristics, surgical outcomes, lymph node findings and perioperative complications of 16 rectal cancer patients who underwent SLNB using ICG fluorescence navigation in laparoscopic LLND in the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during April 2017 and October 2022 were retrospectively collected and analyzed. The patients did not receive preoperative neoadjuvant radiotherapy and presented with LPLNs but without LPLN enlargement (MRI showed the maximum short axes of the LPLNs were ≥5 mm and <10 mm at first visit).Results:All 16 patients were successfully performed SLNB using ICG fluorescence navigation in laparoscopic LLND. Three patients underwent bilateral LLND and 13 patients underwent unilateral LLND. The lateral pelvic sentinel lymph nodes (SLNs) were clearly fluorescent before dissection in 14 patients and the detection rate of SLNs for these patients was 87.5%. Lateral pelvic SLN metastasis was diagnosed in 2 patients and negative results were found in 12 patients by frozen pathological examinations. Among the 14 patients in whom lateral pelvic SLNs were detected, the dissected lateral pelvic non-SLNs were all negative. All dissected LPLNs were negative in two patients without fluorescent lateral pelvic SLNs. The specificity, sensitivity, negative predictive value, and accuracy was 85.7%, 100%, 100%, and 100%, respectively.Conclusions:This study indicates that lateral pelvic SLNB using ICG fluorescence navigation shows promise as a safe and feasible procedure with good accuracy. This technique may replace preventive LLND for locally advanced lower rectal cancer.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Objectives:This study aims to explore the clinical significance of lateral pelvic sentinel lymph node biopsy (SLNB) using indocyanine green (ICG) fluorescence navigation in laparoscopic lateral pelvic lymph node dissection (LLND) and evaluate the accuracy and feasibility of this technique to predict the status of lateral pelvic lymph nodes (LPLNs).Methods:The clinical and pathological characteristics, surgical outcomes, lymph node findings and perioperative complications of 16 rectal cancer patients who underwent SLNB using ICG fluorescence navigation in laparoscopic LLND in the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during April 2017 and October 2022 were retrospectively collected and analyzed. The patients did not receive preoperative neoadjuvant radiotherapy and presented with LPLNs but without LPLN enlargement (MRI showed the maximum short axes of the LPLNs were ≥5 mm and <10 mm at first visit).Results:All 16 patients were successfully performed SLNB using ICG fluorescence navigation in laparoscopic LLND. Three patients underwent bilateral LLND and 13 patients underwent unilateral LLND. The lateral pelvic sentinel lymph nodes (SLNs) were clearly fluorescent before dissection in 14 patients and the detection rate of SLNs for these patients was 87.5%. Lateral pelvic SLN metastasis was diagnosed in 2 patients and negative results were found in 12 patients by frozen pathological examinations. Among the 14 patients in whom lateral pelvic SLNs were detected, the dissected lateral pelvic non-SLNs were all negative. All dissected LPLNs were negative in two patients without fluorescent lateral pelvic SLNs. The specificity, sensitivity, negative predictive value, and accuracy was 85.7%, 100%, 100%, and 100%, respectively.Conclusions:This study indicates that lateral pelvic SLNB using ICG fluorescence navigation shows promise as a safe and feasible procedure with good accuracy. This technique may replace preventive LLND for locally advanced lower rectal cancer.

Objective:To evaluate the association between septic shock and tracheal injury in the intensive care unit (ICU) patients with invasive ventilation.Methods:This was a prospective single-centre cohort study. Patients who underwent invasive mechanical ventilation at the Department of Anesthesia Critical Care Medicine of the Second Hospital of Hebei Medical University from May 31, 2020 to March 5, 2022 were selected. The general characteristics of patients, reasons for ICU admission, vital signs, laboratory test results, Acute Physiology and Chronic Health Evaluation Ⅱ scores, Charlson Comorbidity Index, size of endotracheal tube, presence or absence of septic shock, oxygenation index, duration of intubation, consumption of norepinephrine and epinephrine, and tracheal injury scores at the time of extubation were recorded. Univariate linear regression analysis was used to identify the risk factors for tracheal injury, followed by adjustment using multivariate linear regression analysis.Results:Ninety-seven patients were ultimately included, and the average age was (56.6±16.5) yr, with 64.9% being male. The results of adjusted linear regression showed that septic shock was associated with tracheal injury scores ( β=2.99, 95% confidence interval 0.70-5.29). Subgroup analysis revealed a stronger correlation with a duration of intubation≥8 days ( P=0.013). Conclusions:Patients with septic shock exhibit significantly higher tracheal injury scores compared with those without septic shock, suggesting that septic shock may serve as an independent risk factor for tracheal injury.

Objective:To evaluate the association between septic shock and tracheal injury in the intensive care unit (ICU) patients with invasive ventilation.Methods:This was a prospective single-centre cohort study. Patients who underwent invasive mechanical ventilation at the Department of Anesthesia Critical Care Medicine of the Second Hospital of Hebei Medical University from May 31, 2020 to March 5, 2022 were selected. The general characteristics of patients, reasons for ICU admission, vital signs, laboratory test results, Acute Physiology and Chronic Health Evaluation Ⅱ scores, Charlson Comorbidity Index, size of endotracheal tube, presence or absence of septic shock, oxygenation index, duration of intubation, consumption of norepinephrine and epinephrine, and tracheal injury scores at the time of extubation were recorded. Univariate linear regression analysis was used to identify the risk factors for tracheal injury, followed by adjustment using multivariate linear regression analysis.Results:Ninety-seven patients were ultimately included, and the average age was (56.6±16.5) yr, with 64.9% being male. The results of adjusted linear regression showed that septic shock was associated with tracheal injury scores ( β=2.99, 95% confidence interval 0.70-5.29). Subgroup analysis revealed a stronger correlation with a duration of intubation≥8 days ( P=0.013). Conclusions:Patients with septic shock exhibit significantly higher tracheal injury scores compared with those without septic shock, suggesting that septic shock may serve as an independent risk factor for tracheal injury.

Objective: To compare the clinical effects of endoscopic thyroidectomy using a modified gasless transsubclavian approach and the traditional neck approach for unilateral papillary thyroid carcinoma (cN0). Methods: The clinical data of 135 patients with cN0 papillary thyroid carcinoma who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from October 2020 to November 2022 were retrospectively analyzed. There were 37 males and 98 females, aging (43.2±8.8) years (range: 21 to 59 years). There were 51 cases using the modified gasless transsubclavian approach (TS group) and 84 cases using the traditional neck approach (TN group). Comparative analyses were performed between the operative results of the 2 groups by t-test, Wilcoxon rank sum test, and χ² test. Results: All endoscopic operations were successfully completed without conversion to the traditional neck approach. Compared to the TN group, the TS group had a longer operation time (M(IQR)) (73.5 (22.5) minutes vs. 90.0 (30.0) minutes, Z=-5.831, P<0.01), more postoperative drainage (60 (25) ml vs. 95 (45) ml, Z=-6.275, P<0.01), higher hospitalization costs (22 687 (3 488) yuan vs. 26 652 (2 431) yuan, Z=-6.944, P<0.01), and a higher rate of parathyroid autotransplantation (15.5% (13/84) vs. 60.8% (31/51), χ²=29.651, P<0.01). There was no significant difference in the total exposure rate of the central compartment, postoperative hospitalization time, the number of dissected lymph nodes, the number of metastatic lymph nodes, C-reactive protein ratio before and after operation, and preoperative and postoperative parathyroid hormone (all P>0.05). Conclusions: Endoscopic thyroidectomy using the modified gasless transsubclavian approach is safe for cN0 papillary thyroid carcinoma, with longer operating time, more postoperative drainage, higher hospitalization costs, and moredifficulty in preserving the inferior parathyroid gland in situ compared to traditional open surgery.

Objective:To investigate the curative effect of decompression with reserved superficial temporal artery for treatment of severe traumatic brain injury (sTBI).Methods:A retrospective case-control study was conducted to analyze the clinical data of 265 patients with sTBI who underwent decompressive craniectomy in Shaanxi Provincial People's Hospital from July 2016 to December 2019. Among them, 152 were males and 113 were females, with the age of 33-72 years [(50.1±12.8)years]. On admission, the Glasgow Coma Score (GCS) was 3-8 points [(5.7±1.4)points]. A total of 135 patients were treated with reserved superficial temporal artery decompression after admission (observation group) and 130 patients were treated with conventional decompression without deliberately preserving the superficial temporal artery (control group). The amount of intraoperative scalp bleeding, scalp healing time, cerebrospinal fluid incision leakage, healing degree and postoperative craniocerebral CT angiography (CTA) were compared between the two groups.Results:All patients were followed up for 7-15 days [(12.4±2.5)days]. The amount of intraoperative scalp bleeding was (15.4±4.5)ml in observation group and (65.2±4.7)ml in control group ( P<0.01). The healing time was (7.1±1.1)days in observation group and (9.5±2.3)days in control group ( P<0.01). There were 5 patients (3.7%) with cerebrospinal fluid incision leakage in observation group compared to 21 patients (16.2%) in control group ( P<0.01). There were 114 patients with Grade A healing in observation group compared to 91 patients in control group ( P<0.05). Based on the postoperative craniocerebral CTA, the superficial temporal artery was intact and the blood supply was normal in observation group, while the main trunk of the superficial temporal artery was disconnected from the zygomatic arch segment and the blood supply was incomplete in control group. Conclusions:For patients with sTBI, decompressive craniectomy with reserved superficial temporal artery can promote the healing of the scalp. Moreover, keeping the superficial temporal artery can significantly reduce the amount of bleeding during operation, reduce postoperative scalp healing time and incidence of cerebrospinal fluid incision leakage and assist cerebral blood perfusion.