1.Research on the mechanism of neutrophil extracellular trap-related genes mediating the onset of oral squamous cell carcinoma and their prognostic markers
YU Haoyang ; ZHANG Rui ; SONG Hongquan
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(4):349-366
Objective:
To investigate the prognostic significance and biological functions of neutrophil extracellular traps (NETs) related genes in oral squamous cell carcinoma (OSCC).
Methods:
A total of 333 transcriptome datasets and 6 single-cell sequencing datasets of OSCC were retrieved from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Based on 69 NETs related gene sets, univariate Cox and Lasso-Cox regression were used to construct a prognostic risk model for OSCC. The model's efficacy was evaluated through Kaplan-Meier analysis and receiver operating characteristic (ROC) curves, and risk scoring and nomogram analysis were conducted. Further, the relationship between NETs risk scores and angiogenesis, epithelial-mesenchymal transition (EMT), and cell cycle was explored. Enrichment analysis was performed to annotate the functional characteristics of relevant pathways. Kaplan-Meier analysis was employed to screen for prognostic key genes. Candidate targets were validated through drug prediction and molecular docking assays. Single-cell RNA sequencing was utilized to characterize the expression profile of the key gene cathepsin G (CTSG) within the tumor microenvironment (TME). Using pan-cancer and OSCC related data retrieved from the TCGA database, we analyzed the differences in CTSG expression between tumor tissues and normal tissues. Subsequently, immunohistochemical staining experiments were performed on tissue microarrays to validate its expression at the protein level.
Results:
A prognostic risk model based on six NETs related genes (F3, AKT1, CTSG, VNN3, MPO, and IL17A) was successfully established. Patients in the high-risk group exhibited significantly shorter overall survival (OS) (P < 0.000 1). The area under the ROC curve (AUC) of the established model for predicting 1-, 3-, and 5-year overall survival (OS) rates was 0.718, 0.820, and 0.805, respectively. The NETs related risk score was identified as an independent prognostic factor (P < 0.001), with the constructed nomogram demonstrating good calibration. The NETs related risk score correlated with angiogenesis (r = ˗0.20,, P < 0.001), EMT (r = 0.17, P < 0.01), G1/S phase transition (r = 0.11, P < 0.05), and G2/M phase transition (r = 0.17, P < 0.01). GSEA(gene set enrichment analysis)revealed that the high-risk group was significantly enriched in pathways including basal cell carcinoma, whereas the low-risk group exhibited significant enrichment in pathways such as alpha-linolenic acid metabolism (P < 0.05). Kaplan-Meier analysis revealed that patients with low expression of CTSG had a poorer prognosis (P < 0.001). Molecular docking assays demonstrated a stable binding interaction between CTSG and glutathione (binding energy: -7.4 kcal/mol). Single-cell RNA sequencing analysis further showed that CTSG was highly expressed in mast cell subsets but weakly expressed in malignant cells (P < 0.001). TCGA pan-cancer analysis revealed that CTSG is underexpressed in multiple cancer tissues, including OSCC (P < 0.05). Immunohistochemical staining confirmed that CTSG protein expression was lower in tumor tissues than in paracancerous tissues (P < 0.01).
Conclusion
The NETs related prognostic model established in this study exhibits robust predictive performance. CTSG was identified as a key prognostic gene, thereby providing a novel biomarker and potential therapeutic target for prognostic evaluation and targeted therapy of OSCC.
2.Expert consensus on the application of nasal cavity filling substances in nasal surgery patients(2025, Shanghai).
Keqing ZHAO ; Shaoqing YU ; Hongquan WEI ; Chenjie YU ; Guangke WANG ; Shijie QIU ; Yanjun WANG ; Hongtao ZHEN ; Yucheng YANG ; Yurong GU ; Tao GUO ; Feng LIU ; Meiping LU ; Bin SUN ; Yanli YANG ; Yuzhu WAN ; Cuida MENG ; Yanan SUN ; Yi ZHAO ; Qun LI ; An LI ; Luo BA ; Linli TIAN ; Guodong YU ; Xin FENG ; Wen LIU ; Yongtuan LI ; Jian WU ; De HUAI ; Dongsheng GU ; Hanqiang LU ; Xinyi SHI ; Huiping YE ; Yan JIANG ; Weitian ZHANG ; Yu XU ; Zhenxiao HUANG ; Huabin LI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2025;39(4):285-291
This consensus will introduce the characteristics of fillers used in the surgical cavities of domestic nasal surgery patients based on relevant literature and expert opinions. It will also provide recommendations for the selection of cavity fillers for different nasal diseases, with chronic sinusitis as a representative example.
Humans
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Nasal Cavity/surgery*
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Nasal Surgical Procedures
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China
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Consensus
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Sinusitis/surgery*
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Dermal Fillers
3.Research progress on ferritinophagy in cancer intervention
Weihua ZHENG ; Zihang WANG ; Long XUA ; Caiyan AN ; Yali YAN ; Yu ZHANG ; Hongquan WANG ; Junjing ZHANG
Chinese Journal of Hepatobiliary Surgery 2025;31(7):549-552
Ferroptosis is an iron-dependent cell death modality triggered by the accumulation of lipid peroxides and is closely linked to tumor pathogenesis. Ferritinophagy refers to the selective autophagic degradation of ferritin, releasing intracellular stored iron to maintain iron metabolic homeostasis. This process is also significantly associated with tumor-targeted interventions. This review systematically elucidates the mechanisms of ferroptosis and ferritinophagy, their roles in tumor progression, and the therapeutic potential of pharmacologically induced ferritinophagy in anticancer strategies.
4.Finite element analysis of application of variable angle screws in posterolateral tibial plateau fractures
Zhenghui HU ; Wen ZHANG ; Hongquan HENG ; Weizhi REN ; Chenying WU ; Zenghui GU ; Jian PENG ; Liubing LI ; Wei XU
Chinese Journal of Tissue Engineering Research 2025;29(27):5735-5742
BACKGROUND:During the treatment of posterolateral tibial plateau fractures through the fibular head approach,the gap between the fibular head and the lateral plateau cannot accommodate the posterior placement of a plate for all patients.OBJECTIVE:To analyze,via finite element analysis,the differences in fixation strength resulting from varying the angles and quantities of horizontal arm variable angle screws in the plate during the treatment of posterolateral tibial plateau fractures through the fibular head approach.METHODS:A finite element model was established based on CT images of the knee to ankle joints of a 30-year-old healthy adult male volunteer.The models were divided into two categories:posteriorly placed group and non-posteriorly placed group based on whether the lateral locking compression plate was posteriorly placed.The posteriorly placed group was further subdivided into groups A-D based on the offset angle of the two variable angle screws(0°,5°,10°,and 15°).The non-posteriorly placed group was subdivided into groups E and F based on offset angles(0° and 15°).Finite element analysis was used to evaluate the von Mises stress distribution,maximum von Mises stress,and compressive displacement under loads of 250,500,and 750 N,exploring the mechanical differences between the groups.RESULTS AND CONCLUSION:(1)Finite element analysis results showed that under a 750 N load,the maximum compressive displacement trend of the internal fixation device was D<B=C=F<A<E.The trend for maximum von Mises stress was B<C<A<D<F<E.The trend for maximum compressive displacement on the bone was C=D<B<A<F<E,and for maximum von Mises stress,it was B<C<A<F<D<E.The displacement and stress trends for the six models were similar under loads ranging from 250 N to 750 N.(2)These results suggest that for posterolateral tibial plateau fractures fixed through the fibular head approach,posterior placement of the plate should aim to accommodate two screws.If only one screw can be fixed during surgery,variable angle screws should be offset in the range of 0-15° to increase the probability of securing two screws.
5.Molecular classification of head and neck squamous cell carcinoma based on hypoxia-related genes and clinical significance of STC2
ZHU Jianing ; WANG Tiantian ; ZHANG Rui ; SONG Hongquan
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(5):345-358
Objective :
To construct a molecular classification system for head and neck squamous cell carcinoma (HNSCC) utilizing hypoxia-related gene (HAG) expression profiles, and to comprehensively examine the clinicopathological significance and biological functions of the hypoxia gene stanniocalcin 2 (STC2) in HNSCC.
Methods :
Transcriptomic data and clinical information of 546 HNSCC samples were obtained from The Cancer Genome Atlas (TCGA) database, and based on the expression profiles of 200 HRGs, HNSCC was classified subclasses using non-negative matrix factorization (NMF). HNSCC was classified into three subclasses (C1, C2, and C3), and the molecular characteristics and prognostic differences of the subclasses were assessed by comparing the tumor mutation load, functional enrichment analysis, drug sensitivity, and clinical features among the subclasses. LASSO-Cox regression was used to screen prognosis-related genes and construct prognostic models. Using oral squamous cell carcinoma (OSCC)-related data in the TCGA database, we analyzed the expression differences of STC2 in OSCC and control samples, and detected the mRNA and protein expression of STC2 in oral squamous carcinoma samples using qRT-PCR and immunohistochemistry. We knocked down STC2 in CAL-27 cells and verified the knockdown efficiency by qRT-PCR and Western blot. CCK-8 assay and cell scratch assay were used to assess the effect of STC2 on cell proliferation and migration ability.
Results:
Based on HRGs expression profiles, HNSCC was categorized into three subclasses (C1, C2, and C3). Subclass C1 had moderate hypoxic activity and good prognosis; subclass C2 had the highest hypoxic activity, poor prognosis, and poor sensitivity to CTLA-4 inhibitors (P<0.05); subclass C3 had the lowest hypoxic activity and moderate prognosis, and STC2 belonged to subclass C3. The frequency of cyclin-dependent kinase inhibitor 2A (CDKN2A), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), and tumor protein p53 (TP 53) mutations was higher in HNSCC. C1 genomic gain and deletion burden were significantly higher than C3 subclass (P<0.05) and C2 genomic gain than C3 subclass (P<0.05). The C2 subclass was significantly enriched in hypoxia-associated pathways, such as glycine metabolism and base excision repair (P<0.05). The C1, C2, and C3 subclasses were significantly positively correlated in terms of sex (male) (Cramer’s V=0.15), radiation exposure (Cramer’s V=0.12), medication (Cramer’s V=0.18), and pathological grading (G1/G2) (Cramer’s V=0.25) (P<0.05). Nine prognosis-related genes were screened by LASSO-Cox regression, among which high expression of STC2 was positively correlated with poorer overall survival (OS) in HNSCC patients (P<0.01). Bioinformatics analysis showed that STC2 mRNA expression was higher in OSCC than in normal controls (P<0.05). qRT-PCR and immunohistochemistry confirmed that both mRNA and protein expression of STC2 were significantly upregulated in OSCC tissues and cells (P<0.01). In vitro experiments showed that STC2 expression was knocked down to approximately 80% in CAL-27 cells (P<0.001), and the STC2 knockdown group had a reduced value-added rate (P<0.001) and a reduced percentage of scratch closure (P<0.05) compared with the control group.
Conclusion
We successfully constructed a molecular typing system for HNSCC based on the expression profiles of HRGs and categorized HNSCC into three subclasses with significant prognostic differences, among which the C2 subclass had the highest hypoxic activity and the poorest prognosis. STC2 was highly expressed in HNSCC and suggested a poor prognosis, demonstrating that it may be a potential target for HNSCC treatment.
6.Effect and prognosis of thoracolumbar fracture combined with incomplete spinal cord injury on male sexual function
Gao SI ; Yuexin WANG ; Daole HU ; Guojin HOU ; Zhongwei YANG ; Yan GUO ; Zhishan ZHANG ; Hongquan JI ; Fang ZHOU ; Yun TIAN ; Yang LYU
Chinese Journal of Orthopaedics 2025;45(9):552-560
Objective:To investigate the effects of thoracolumbar vertebral fracture with incomplete spinal cord injury on male sexual function and postoperative prognosis.Methods:A retrospective review was conducted on data from 144 male patients with thoracolumbar vertebral fractures and incomplete spinal cord injuries treated between May 2009 and May 2021 in the Department of Traumatology and Orthopedics at Peking University Third Hospital. Patients ranged in age from 19 to 55 years (mean: 38.6±10.6 years) and underwent posterior incision and reduction internal fixation. The International Index of Erectile Function-5 (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the International Spinal Cord Injury Male Sexual Function Basic Data Set were used for sexual function evaluation. Based on the American Spinal Injury Association (ASIA) Spinal Cord Injury classification, changes in neurological and sexual function were assessed at the pre-injury stage, 3 months post-injury, 2 years postoperatively, and at the final follow-up. Factors influencing sexual dysfunction and recovery were analyzed. Spearman correlation analysis was used to identify factors affecting sexual function injury and recovery.Results:A total of 117 patients were included in the final analysis. Follow-up duration ranged from 26.2 to 161.7 months (mean: 74.6±40.5 months). After injury, ASIA grades were distributed as follows: 43 patients with grade B, 41 with grade C, and 33 with grade D. At the 2-year follow-up, 30 patients were grade E, 63 grade D, 19 grade C, and 5 grade B. Improvement in ASIA classification was observed in 90.6% (106/117) of patients: 79 improved by one grade, 27 by two grades, 8 remained unchanged, 1 worsened by one grade, and 2 worsened by two grades. Mean IIEF-5 scores were 19.5±6.4 pre-injury, 8.7±8.0 at 3 months post-injury, and 17.5±7.1 at 2 years postoperatively, with statistically significant differences ( F=123.247, P<0.001). Differences between 3 months post-injury vs. pre-injury and 2 years postoperatively vs. 3 months post-injury were statistically significant ( P<0.05). Mean PEDT scores were 5.3±3.1 pre-injury, 6.9±5.2 at 3 months post-injury, and 6.4±5.1 at 2 years postoperatively, with statistically significant differences ( F=17.014, P<0.001). The difference between 3 months post-injury and pre-injury was statistically significant ( P<0.05), but not between 2 years postoperatively and 3 months post-injury ( P>0.05). At the 2-year follow-up, 96 patients had their IIEF-5 classification restored to pre-injury levels, 85 restored PEDT classifications, and 83 restored both. Post-injury ASIA classification was positively correlated with a decrease in IIEF-5 score and an increase in PEDT score at 3 months post-injury ( P<0.05). Injury segment was positively correlated with the decrease in IIEF-5 score ( P<0.05). Time from injury to surgery showed a positive correlation with increased PEDT score at 3 months ( P<0.05). Post-injury ASIA grade, injury segment, time to surgery, age, intraoperative decompression, and spinal cord function recovery all showed significant correlations with changes in IIEF-5 and (or) PEDT scores at 2 years postoperatively ( P<0.05). According to the International Spinal Cord Injury Male Sexual Function Basic Data Set, the proportion of patients willing to discuss sexual issues increased from 29.9% at 3 months post-injury to 47.9% at 2 years postoperatively ( P<0.05). The proportion of patients with absent or diminished psychogenic erections remained stable (48.7% vs. 48.9%, P>0.05), while those with normal reflexive erections increased from 34.2% to 65.0% ( P<0.05). Conclusion:Thoracolumbar fractures with incomplete spinal cord injury result in reduced erectile function and increased incidence of premature ejaculation. The degree of spinal cord injury and the level of the injured segment are strongly correlated with the extent of sexual dysfunction. At the 2-year postoperative follow-up, 70.9% of patients had recovered sexual function to pre-injury levels.
7.Correlation of fetal rectal ampulla abdominal diameter with gestational age and establishment of reference values in low-risk fetuses at 18~40 weeks of pregnancy
Yuqi ZHANG ; Kesong ZHOU ; Shiquan ZHANG ; Lei TANG ; Enxiu XIE ; Hongquan LIAO ; Tao YANG
The Journal of Practical Medicine 2025;41(6):882-888
Objective To examine the correlation between fetal rectal ampulla diameter and gestational age,and to establish reference value ranges for low-risk fetuses between 18 and 40 weeks of gestation in Yibin region.Methods A total of 1,103 low-risk singleton pregnant women between 18 and 40 weeks of gestation were recruited from five hospitals in Yibin City(the Second People's Hospital,the First People's Hospital,the Fifth People's Hospital,the Maternal and Child Health Hospital of Yibin City,and the Maternal and Child Health Hospital of Cuiping District)for routine level Ⅰ,Ⅱ,and Ⅲ prenatal ultrasound screening from October 2022 to March 2024.Fetal rectal ampulla diameters,including anteroposterior diameter,transverse diameter,and area,were measured using prenatal ultrasound.The normality of these measurements was assessed using the Shapiro-Wilk test.Scatter plots depicting the relationship between fetal rectal ampulla diameter parameters and gestational age were generated using the"Overlap Scatter Plot"function in SPSS.Percentiles were calculated using the"Explore"function in SPSS,with reference value ranges described by P5,P10,P50,P90,and P95.Results The visual-ization rate of the fetal rectal ampulla diameter was 55%at 18~20 weeks of gestation,100%at 21~37 weeks,and 96%at greater than 37 weeks.The fetal rectal ampulla diameter exhibited a significant positive correlation with gestational age(r=0.925~0.949,P<0.01).Conclusions Prenatal ultrasound measurement of fetal rectal ampulla diameter demonstrates a robust correlation with gestational age.The reference intervals for the rectal ampulla diameter of low-risk fetuses between 18 and 40 weeks of gestation,established in this study,may offer valuable theoretical guidance for prenatal diagnosis of fetal rectal and anal abnormalities in Yibin region.
8.Clinical Efficacy of Shaoqi Yijia Prescription in the Treatment of Hashimoto's Thyroiditis with Liver Depression and Spleen Deficiency in the Non-Hypothyroidism Stage and Its Effect on Serum Inflammatory Factors
Zhidan ZHANG ; Jian BU ; Hongquan SHEN ; Hongping WANG ; Liping CHEN ; Jie WANG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(8):1087-1093
OBJECTIVE To observe the clinical efficacy of Shaoqi Yijia Prescription in the treatment of Hashimoto's thyroiditis(HT)with liver depression and spleen deficiency in the non-hypothyroidism stage and its effect on serum inflammatory factors.METHODS A total of 74 patients with Hashimoto's thyroiditis of liver depression and spleen deficiency type in the non-hypothyroid-ism stage who were treated in Putuo District Central Hospital in Shanghai from June to August 2024 were selected and randomly divided into the observation group and the control group with 37 cases in each group(2 cases dropped out in each group).The control group was treated with oral selenium yeast tablets,and the observation group was treated with Shaoqi Yijia Prescription,both for 12 weeks.The traditional Chinese medicine(TCM)syndrome scores,Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD)and fatigue self-assessment scale(FSAS)scores were evaluated before and after treatment;the thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb)and serum inflammatory factors interleukin 4(IL-4),IL-6,IL-10,TNF-α and IFN-γ levels were detected before and after treatment in the two groups of patients.RESULTS After treatment,the total score of TCM syndrome and the scores of epigastric or hypochondrium pain,abdominal distension,poor appetite,depression or irritability,and frequent sighs in the observation group were significantly reduced(P<0.05,P<0.01),and the total score of the observation group was better than that of the control group(P<0.01);after treatment,the serum TPOAb level of the observation group was significantly re-duced(P<0.05),the serum TPOAb level of the control group did not change significantly(P>0.05),and the serum TgAb and TPO-Ab levels of the observation group were better than those of the control group(P<0.05);after treatment,the HAMA and HAMD scores of the observation group were significantly reduced(P<0.01),and the HAMA,HAMD and FSAS scores of the observation group were better than those of the control group(P<0.05);after treatment,the serum IL-4 and IL-10 levels of the observation group were in-creased(P<0.05),and the IL-6,IFN-γ and TNF-α levels were decreased compared with those before treatment(P<0.05).The se-rum IL-4,IL-6 and IL-10 levels of the observation group were significantly different from those of the control group(P<0.05).CONCLUSION Shaoqi Yijia Prescription can alleviate the clinical symptoms of patients with Hashimoto's thyroiditis of liver depres-sion and spleen deficiency type in the non-hypothyroid period,and improve anxiety and depression,which may be related to improving the body's inflammatory response.
9.Correlation of fetal rectal ampulla abdominal diameter with gestational age and establishment of reference values in low-risk fetuses at 18~40 weeks of pregnancy
Yuqi ZHANG ; Kesong ZHOU ; Shiquan ZHANG ; Lei TANG ; Enxiu XIE ; Hongquan LIAO ; Tao YANG
The Journal of Practical Medicine 2025;41(6):882-888
Objective To examine the correlation between fetal rectal ampulla diameter and gestational age,and to establish reference value ranges for low-risk fetuses between 18 and 40 weeks of gestation in Yibin region.Methods A total of 1,103 low-risk singleton pregnant women between 18 and 40 weeks of gestation were recruited from five hospitals in Yibin City(the Second People's Hospital,the First People's Hospital,the Fifth People's Hospital,the Maternal and Child Health Hospital of Yibin City,and the Maternal and Child Health Hospital of Cuiping District)for routine level Ⅰ,Ⅱ,and Ⅲ prenatal ultrasound screening from October 2022 to March 2024.Fetal rectal ampulla diameters,including anteroposterior diameter,transverse diameter,and area,were measured using prenatal ultrasound.The normality of these measurements was assessed using the Shapiro-Wilk test.Scatter plots depicting the relationship between fetal rectal ampulla diameter parameters and gestational age were generated using the"Overlap Scatter Plot"function in SPSS.Percentiles were calculated using the"Explore"function in SPSS,with reference value ranges described by P5,P10,P50,P90,and P95.Results The visual-ization rate of the fetal rectal ampulla diameter was 55%at 18~20 weeks of gestation,100%at 21~37 weeks,and 96%at greater than 37 weeks.The fetal rectal ampulla diameter exhibited a significant positive correlation with gestational age(r=0.925~0.949,P<0.01).Conclusions Prenatal ultrasound measurement of fetal rectal ampulla diameter demonstrates a robust correlation with gestational age.The reference intervals for the rectal ampulla diameter of low-risk fetuses between 18 and 40 weeks of gestation,established in this study,may offer valuable theoretical guidance for prenatal diagnosis of fetal rectal and anal abnormalities in Yibin region.
10.Effect and prognosis of thoracolumbar fracture combined with incomplete spinal cord injury on male sexual function
Gao SI ; Yuexin WANG ; Daole HU ; Guojin HOU ; Zhongwei YANG ; Yan GUO ; Zhishan ZHANG ; Hongquan JI ; Fang ZHOU ; Yun TIAN ; Yang LYU
Chinese Journal of Orthopaedics 2025;45(9):552-560
Objective:To investigate the effects of thoracolumbar vertebral fracture with incomplete spinal cord injury on male sexual function and postoperative prognosis.Methods:A retrospective review was conducted on data from 144 male patients with thoracolumbar vertebral fractures and incomplete spinal cord injuries treated between May 2009 and May 2021 in the Department of Traumatology and Orthopedics at Peking University Third Hospital. Patients ranged in age from 19 to 55 years (mean: 38.6±10.6 years) and underwent posterior incision and reduction internal fixation. The International Index of Erectile Function-5 (IIEF-5), the Premature Ejaculation Diagnostic Tool (PEDT), and the International Spinal Cord Injury Male Sexual Function Basic Data Set were used for sexual function evaluation. Based on the American Spinal Injury Association (ASIA) Spinal Cord Injury classification, changes in neurological and sexual function were assessed at the pre-injury stage, 3 months post-injury, 2 years postoperatively, and at the final follow-up. Factors influencing sexual dysfunction and recovery were analyzed. Spearman correlation analysis was used to identify factors affecting sexual function injury and recovery.Results:A total of 117 patients were included in the final analysis. Follow-up duration ranged from 26.2 to 161.7 months (mean: 74.6±40.5 months). After injury, ASIA grades were distributed as follows: 43 patients with grade B, 41 with grade C, and 33 with grade D. At the 2-year follow-up, 30 patients were grade E, 63 grade D, 19 grade C, and 5 grade B. Improvement in ASIA classification was observed in 90.6% (106/117) of patients: 79 improved by one grade, 27 by two grades, 8 remained unchanged, 1 worsened by one grade, and 2 worsened by two grades. Mean IIEF-5 scores were 19.5±6.4 pre-injury, 8.7±8.0 at 3 months post-injury, and 17.5±7.1 at 2 years postoperatively, with statistically significant differences ( F=123.247, P<0.001). Differences between 3 months post-injury vs. pre-injury and 2 years postoperatively vs. 3 months post-injury were statistically significant ( P<0.05). Mean PEDT scores were 5.3±3.1 pre-injury, 6.9±5.2 at 3 months post-injury, and 6.4±5.1 at 2 years postoperatively, with statistically significant differences ( F=17.014, P<0.001). The difference between 3 months post-injury and pre-injury was statistically significant ( P<0.05), but not between 2 years postoperatively and 3 months post-injury ( P>0.05). At the 2-year follow-up, 96 patients had their IIEF-5 classification restored to pre-injury levels, 85 restored PEDT classifications, and 83 restored both. Post-injury ASIA classification was positively correlated with a decrease in IIEF-5 score and an increase in PEDT score at 3 months post-injury ( P<0.05). Injury segment was positively correlated with the decrease in IIEF-5 score ( P<0.05). Time from injury to surgery showed a positive correlation with increased PEDT score at 3 months ( P<0.05). Post-injury ASIA grade, injury segment, time to surgery, age, intraoperative decompression, and spinal cord function recovery all showed significant correlations with changes in IIEF-5 and (or) PEDT scores at 2 years postoperatively ( P<0.05). According to the International Spinal Cord Injury Male Sexual Function Basic Data Set, the proportion of patients willing to discuss sexual issues increased from 29.9% at 3 months post-injury to 47.9% at 2 years postoperatively ( P<0.05). The proportion of patients with absent or diminished psychogenic erections remained stable (48.7% vs. 48.9%, P>0.05), while those with normal reflexive erections increased from 34.2% to 65.0% ( P<0.05). Conclusion:Thoracolumbar fractures with incomplete spinal cord injury result in reduced erectile function and increased incidence of premature ejaculation. The degree of spinal cord injury and the level of the injured segment are strongly correlated with the extent of sexual dysfunction. At the 2-year postoperative follow-up, 70.9% of patients had recovered sexual function to pre-injury levels.


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