Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

Objective:To evaluate the safety and efficacy of digital technology-assisted debridement and bone and soft tissue reconstruction in the treatment of chronic osteomyelitis of the tibia.Methods:This retrospective study analyzed clinical data from 38 patients (26 males, 12 females; mean age 45.61±18.36 years, range 16-83 years) with chronic post-traumatic osteomyelitis complicated by soft tissue defects in the tibia, treated at the Department of Orthopaedics, Fourth Medical Center of PLA General Hospital between June 2021 and June 2023. There were 18 cases of traffic accidents, 6 cases of high-altitude falls, 6 cases of heavy objects and 6 cases of low-energy falls. Lesion sites: 12 cases in the upper segment of the tibia, 12 cases in the middle segment, and 14 cases in the lower segment. According to the Cierny-Mader classification, there were 24 cases of type III and 14 cases of type IV. Before the operation, the "3D point cloud technology" was used to plan the debridement range of bone and soft tissue. During the operation, the optical navigation system was used to monitor the debridement range in real time. The flap was designed by combining "Reading Tablet Treasure" with CT angiography, and the amount of bone graft was predicted by AI algorithm. The surgical method adopted is the Masquelet technique, namely thorough debridement, bone cement occupation and soft tissue repair in the first stage, and bone reconstruction in the second stage. Comparing the calculated bone defect amount and soft tissue defect area before the operation with the actual measured values after debridement. The cure rate of infection was evaluated by using the McKee bone infection treatment criteria after the operation. The visual analogue scale (VAS) for pain, lower extremity functional scale (LEFS), and self-rating anxiety scale (SAS) were used to evaluate the improvement of the quality of life of postoperative patients.Results:38 patients were followed up with a mean follow-up of 13.53±2.37 months. 37 patients' infections were effectively controlled, and 1 patient had a recurrence of infection, with an effectiveness rate of 97% for the treatment of McKee's infections. The preoperative calculated bone defect amount and soft tissue defect area were 51.05±26.31 cm 3 and 68.42±43.45 cm 2 respectively, and the actual measured values after debridement during the operation were 51.66±26.35 cm 3 and 68.82±43.76 cm 2 respectively. There was no statistically significant difference before and after the operation ( P>0.05). The interval between the first and second stage surgeries was 10.36±1.61 weeks, and all flaps survived after the first stage surgery. Two months after the operation, one case had recurrent osteomyelitis. After palliative treatment, sinus tracts were formed at the infection site. At the 12-month regular dressing change follow-up, there were still purulent secretions in the sinus tracts. There was no recurrence of infection after primary debridement in 37 cases, and the bone grafts healed. The bone healing time was 3.58±0.97 months. The postoperative VAS, LEFS, and SAS scores were 1.00±0.91, 66.68±7.91, and 34.30±4.29, respectively, which were significantly improved compared with the preoperative scores of 7.54±1.52, 21.22±4.29, and 52.70±6.74, respectively, and the difference was statistically significant ( P<0.05). Conclusions:The application of digital technology to precisely design the debridement range of bone and soft tissue, and the real-time holographic visualization monitoring of the debridement range during the operation can achieve precise debridement of bone and soft tissue and personalized and precise repair of soft tissue defects. It is a safe and effective technique for the treatment of chronic osteomyelitis of the tibia.

[This corrects the article DOI: 10.1016/j.apsb.2021.08.015.].

Osteosarcoma is a kind of bone tumor with highly proliferative and invasive properties, a high incidence of pulmonary metastasis and a poor prognosis. Chemotherapy is the mainstay of treatment for osteosarcoma. Currently, there are no molecular targeted drugs approved for osteosarcoma treatment, particularly effective drugs for osteosarcoma with pulmonary metastases. It has been reported that fibroblast activation protein alpha (FAPα) is upregulated in osteosarcoma and critically associated with osteosarcoma progression and metastasis, demonstrating that FAPα-targeted agents might be a promising therapeutic strategy for osteosarcoma. In the present study, we reported that the FAPα-activated vinblastine prodrug Z-GP-DAVLBH exhibited potent antitumor activities against FAPα-positive osteosarcoma cells in vitro and in vivo. Z-GP-DAVLBH inhibited the growth and induced the apoptosis of osteosarcoma cells. Importantly, it also decreased the migration and invasion capacities and reversed epithelial-mesenchymal transition (EMT) of osteosarcoma cells in vitro and suppressed pulmonary metastasis of osteosarcoma xenografts in vivo. Mechanistically, Z-GP-DAVLBH suppressed the AXL/AKT/GSK-3β/β-catenin pathway, leading to inhibition of the growth and metastatic spread of osteosarcoma cells. These findings demonstrate that Z-GP-DAVLBH is a promising agent for the treatment of FAPα-positive osteosarcoma, particularly osteosarcoma with pulmonary metastases.

Objective Toinvestigatethethrombusclinicalcurativeeffectandpracticalvalueintreatmentofdeepveinthrombosis (DVT)byusingmodifiedaspirationcatheter.Methods Atotalof35patientswhometthediagnosticcriteriaofDVTwererandomly assignedintoexperimentalandcontrolgroups.Afterasufficientpreoperativepreparation,thepatientsweredividedintotheexperimentalgroup (n=18,usingmodifiedaspirationcatheterwithsubsequenturokinasethrombolysisandconventionalanticoagulationtherapy)andthe controlgroup [n=17,usingthe8Fvascularsheaths (COOK,USA)duringtheprocedure,subsequenturokinasethrombolysisand conventionalanticoagulationtherapy].Thepatencyofvessels,theperimeterdifferenceandthecomplicationweredocumented.Theresultswere comparedbetweenthetwogroups.Results Inexperimentalgroup,thrombusremovalofgradeⅣ (removalratelessthan0%)was 0%in0case,gradeⅢ (removalratelessthan50%)was5.56%in1case,gradeⅡ (removalrategreaterthan50%)was94.44%in ncontrolgroup,thrombusremovalofgradeⅣwas23.53%in4cases,gradeⅢwas52.94%in9cases,gradeⅡwas23.53%in4cases. Thedifferencesofthelegcircumferenceoftheaffectedextremitiesat15cmaboveandbelowthekneejointattimeofdischargewere alllessthanthoseatadmission.Thedifferencesinbothpreoperativeandpostoperativedatabetweenthetwogroupswerestatistically significant(bothP<0.05).Noseriouscomplicationswerefoundintwogroups.Conclusion UsingmodifiedaspirationcathetertreatingDVTisa safeandeffectivemethod,whichhashighsuctionefficiencyandfewcomplications.Therefore,itisworthytoberecommended. 17casesI.

Objective To explore the clinical application of a new laryngeal mask in implantation of tracheal stent.Methods The new laryngeal masks were implanted under general anesthesia for 20 patients with tracheal or primary bronchus stenosis.The oxygen was continuously supplied from its side hole,and the stents were subsequently implanted from the tail hole.Results By using the new laryngeal masks under general anesthesia,all of 20 patients were successfully and leisurely implanted the tracheal stent.After the operation,the dyspnea symptoms were significantly improved,and there was no complication.Conclusion Stent implantation by using the new laryngeal mask under general anesthesia will provide a safe and effective treatment for tracheal stenosis.

Objective To investigate the combined use of osteoarthritis treatment effect of lornoxicam and peptide drugs.Methods 260 patients with osteoarthritis treated in our hospital from May 2014 to June 2016 were selected, were randomly divided into study group and control group, each group of 130 cases.The patients in the control group were treated with sodium hyaluronate and lornoxicam, the study group was given bone peptide on the basis of the control group. The pain scores, knee function and adverse reactions were compared between the two groups.Results There was no significant difference in VAS and WOMAC scores between the two groups before treatment; after treatment, the improvement of VAS and WOMAC score in the study group was better than that in the control group (P<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups. Conclusion Sodium hyaluronate, bone peptide, lornoxicam and other drugs in the treatment of patients with osteoarthritis clinical efficacy is obvious, and fewer adverse reactions.

The article reviewed the research progress of ligustilide in recent years and elaborated its pharmacological functions and mechanisms in detail,especially in ischemic brain injury.Its mechanism includes reducing cerebral infarct volumes and improving neurobehavioral deficits,anti-oxidant and anti-apoptosis,antithrombotic activity,calcium channel blockers function,and effect on erythropoietin.Other pharmacological effects of ligustilide including inhibiting vascular smooth muscle cell proliferation,anti-inflammatory and analgesic effects,effects on LPS-induced endotoxic shock,inhibiting constriction effect,suppression of the central nervous system,and ameliorating the memory impairment induced by scopolamine and so on,are also introduced.Ligustilide has potential pharmacological value,which provides a reference for its further research and development.

Objective: To examine the effects of RS on serum cholesterol and expression of genes associated with cholesterol metabolism in rat liver for understanding its mechanism. Method: Eighteen rats were randomly assigned to three groups, six rats each. They were fed with chemical purified normal diet (control group), low RS (15%Hi-maize 1043) diet and high RS (30%Hi-maize 1043) diet respectively. Six weeks later, serum cholesterol and short chain fatty acid (SCFA) in the cecum were measured. Likewise, hepatic cholesterol 7?-hydroxylase, LDL receptor, and SR-B1 mRNA levels were measured by realtime PCR. Results: Hepatic cholesterol 7a-hydroxylase, LDL receptor, SR-B1 mRNA levels and cecal acetate, propionate and n-butyrate concentrations in the high RS group were significantly higher than those in the control group (P