1.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
2.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
3.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
4.Analysis of Incidence and Risk Factors for Periprosthetic Fracture after Total Knee Arthroplasty in South Korea from 2010 to 2020Based on National Registry Data
Jisu PARK ; Tae Woo KIM ; Min Ki KIM ; Jiyu SUN ; Kee Jeong BAE ; Moon Jong CHANG ; Chong Bum CHANG ; Seung-Baik KANG
Clinics in Orthopedic Surgery 2025;17(3):408-416
Background:
Periprosthetic fracture (PPF) is a troublesome complication as it utilizes substantial healthcare resources. Recent studies about the epidemiology of PPF after total knee arthroplasty (TKA) are still lacking, and there is limited national-level analysis focusing on the comorbid chronic conditions as risk factors of PPF. This study used national registry data from South Korea and aimed to investigate the epidemiology of PPF following TKA between 2010 and 2020 and identify which comorbidities contributed to the risk of PPF.
Methods:
Using Health Insurance Review and Assessment (HIRA) service data in South Korea, the incidence of PPF after TKA between 2010 and 2020 was evaluated and stratified by age and sex. Medical comorbidities were evaluated as possible risk factors for PPF using Cox regression analysis.
Results:
PPF occurred in 14,429 patients, accounting for 2.37% of total TKA patients. The prevalence of PPF by sex was 2.50% in women and 1.64% in men. The PPF rate was 2.82% in under 60 years, 2.25% in 60 to 69 years, 2.42% in 70 to 79 years, 2.29% in 80 to 89 years, and 2.12% in over 90 years. Among 17 analyzed comorbidities, 11 were found to be associated with PPF after TKA. Severe liver disease (hazard ratio [HR], 1.303), hemiplegia (HR, 1.244), and dementia (HR, 1.206) were the top 3 risk factors.Although osteoporosis, pulmonary disease, peptic ulcer, and diabetes showed relatively low HRs than these top 3 factors, the incidence rates were higher.
Conclusions
PPF occurred in 2.37% of TKA patients in South Korea from 2010 to 2020. PPF rate was higher in women. To prevent PPF after TKA, proper patient management and education should be emphasized, particularly in patients with severe liver disease, hemiplegia, and dementia.
5.Quality Evaluation of Zhuye Shigao Granules and Its Therapeutic Effect on Mice with Cold-dampness Pestilence Attacking Lung Syndrome
Haihong LI ; Jiaqi SHEN ; Liwen LIANG ; Ziqi YANG ; Yuting YANG ; Shuyun LIANG ; Zhiliang SUN ; Jiannan LI ; Guangzhi CAI ; Jiyu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(15):182-190
ObjectiveTo establish a quality evaluation method for Zhuye Shigao granules(Zhuye Shigaotang) based on fingerprint and determination of index components, and to investigate the therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome. MethodsThe fingerprint of Zhuye Shigao granules was established by high performance liquid chromatography(HPLC), and the methods for determination of total calcium, orientin, isoorientin, ginsenosides Rg1, Re and Rb1 and other 2 index components were established. Fifty ICR mice were randomly divided into the blank group, model group, Zhuye Shigao granules low, medium and high dose groups(9.3, 18.6, 37.2 g·kg-1·d-1), with 10 mice in each group. In addition to the blank group, the model mice with cold-dampness pestilence attacking lung syndrome was prepared by nasal drip of lipopolysaccharide combined with cold-dampness environment. Each administration group was given the corresponding liquid by gavage according to the dose, while the blank group and model group were given the same volume of normal saline by gavage. Then, the body temperature and organ index of mice in each group were measured, hematoxylin-eosin(HE) staining was used to investigate the lung tissue injury of mice in each group, and enzyme-linked immunosorbent assay(ELISA) was used to detect the changes of tumor necrosis factor-α(TNF-α), interleukin(IL)-lβ, IL-6, IL-10 levels in serum and lung tissue, as well as immunoglobulin(Ig)A and IgM levels in serum. ResultsThe fingerprint similarity of 10 batches of Zhuye Shigao granules was>0.950, and 20 common peaks were calibrated. Seven of them were identified, including peak 11(isoorientin), peak 12(orientin), peak 14(apioside liquiritin), peak 15(liquiritin), peak 17(apioside isoliquiritin), peak 19(isoliquiritin) and peak 20(liquiritigenin). The results of quantitative analysis showed that the content range of each index component in 10 batches of Zhuye Shigao granules was as follows:Total calcium of 9.978-11.294 mg·g-1, isoorientin of 0.033-0.041 mg·g-1, orientin of 0.046-0.055 mg·g-1, ginsenoside Rg1+ginsenoside Re of 0.748-0.762 mg·g-1, ginsenoside Rb1 of 0.151-0.197 mg·g-1, liquiritin of 1.106-1.366 mg·g-1, glycyrrhizic acid of 0.904-1.182 mg·g-1. Compared with the blank group, the body temperature of mice in the model group was significantly increased, the organ indexes of liver, lung and spleen were significantly decreased, the organ index of thymus was significantly increased, HE staining of lung tissue showed infiltration of inflammatory cells, a small amount of serous exudation was observed in the alveoli, and lung tissue was damaged. After the intervention of Zhuye Shigao granules, the pathological changes were improved compared with the model group. The expression levels of IL-1β, IL-6 and TNF-α were significantly increased, the expression level of IL-10 was significantly decreased in serum and lung tissue. The levels of IgA and IgM in serum were significantly decreased(P<0.01). Compared with the model group, the body temperature, the organ indexes and immune factor levels in serum and lung tissue of mice in the Zhuye Shigao granules medium and high dose groups were significantly reduced(P<0.05, P<0.01). ConclusionIn this study, the quality evaluation of Zhuye Shigao granules was carried out based on fingerprint combined with determination of index components, and the fingerprint of four herbs(Lophatheri Herba, Ophiopogonis Radix, Pinelliae Rhizoma and Glycyrrhizae Radix et Rhizoma) in this formula and the determination of 8 index components were established. The therapeutic effect of Zhuye Shigao granules on mice with cold-dampness pestilence attacking lung syndrome may be related to inhibiting inflammatory response and mediating immune regulation.
6.Secondary aesthetic restoration of tetracycline-stained teeth with incongruous gingival margins by digitally guided precision crown lengthening: a case report and literature review
LING Huiling ; SUN Jiyu ; REN Wei ; YUE Li ; RUAN Yifeng ; QIN Ziqi ; GAN Xueqi
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(9):784-791
Objective:
To evaluate the clinical efficacy of digitally guided precision crown lengthening in secondary aesthetic rehabilitation cases, and to provide a clinical reference for digitally guided crown lengthening procedures and secondary aesthetic restorations.
Methods:
We present a case of a patient with tetracycline-stained teeth, partial detachment of anterior resin veneers, and gingival margin discrepancies. The patient underwent digitally guided precision crown lengthening followed by secondary aesthetic rehabilitation. Multimodal data, including intraoral, facial, and CBCT scans, were integrated to construct a four-dimensional virtual patient model (incorporating teeth, face, bone, and occlusion) for surgical planning and 3D-printed guide fabrication. Secondary aesthetic restoration was performed after achieving stable post-surgical outcomes. Based on this case, we conducted a detailed analysis and reviewed relevant literature on crown lengthening in secondary aesthetic rehabilitation.
Results:
The gingival contour of the anterior teeth exhibited significant improvement, with enhanced symmetry and stable gingival margin positioning that closely matched the preoperative design. The crown lengthening procedure demonstrated high precision, and the final outcome was aesthetic and functional. Literature review indicated that secondary restorations frequently present challenges such as gingival contour discrepancies and inflammation. Aesthetic crown lengthening in the anterior region should optimize both soft and hard tissue morphology to meet aesthetic standards, with digital technology improving procedural accuracy.
Conclusion
Precision crown lengthening effectively addresses gingival margin discrepancies in secondary aesthetic rehabilitation, ensuring stable gingival positioning and superior aesthetic outcomes. This approach is particularly suitable for cases with high aesthetic demands.
7.Analytic method of the characteristics of acupuncture manipulation based on ultrasound imaging
Jie CHEN ; Jun ZHAO ; Yuhe WEI ; Yang BAI ; Jiyu HE ; Ziyi CHEN ; Liming SUN ; Lei WANG ; Jingli LI ; Yanan ZHANG ; Yan SHEN ; Chong SU
China Medical Equipment 2024;21(10):10-18
Objective:To construct an analytic method aimed at the characteristics of the commonly method of supplementing and pouring of acupuncture based on the analysis and modeling of ultrasound images around acupoint region in the process of acupuncture.Methods:A total of 7 healthy subjects who underwent physical examination in Beijing Zhongguancun Hospital from June,2022 to June,2023 were selected,and their Kongzui acupoints were acupunctured by 10 acupuncturists with associate senior title as 4 kinds of acupuncture manipulations included reinforcing by twisting and rotating(RFTR),reducing by twisting and rotating(RDTR),reinforcing by lifting and thrusting(RFLT),and reducing by lifting and thrusting(RDLT).The B-ultrasound diagnostic device was used to collect the images of muscle and fascial tissue below the acupoint,so as to construct the model of images.The definition of virtual acupuncture point was adopted to study the regulation of perturbation of subcutaneous tissue that was caused after the skin was acupunctured by needle.The change regulation of the virtual acupuncture point of muscle bundle below skin at Zuikong acupoint of subjects was analyzed.Results:The difference value of average absolution value between peak and trough of the trajectory of virtual acupuncture point of twisting and rotating was 0.066±0.045,and the average value of amplitude of this method was less than that(0.428±0.276)of lifting and thrusting method,and the twisting and rotating method was uniform and symmetrical,and there was difference between two kinds of acupuncture methods.The characteristics of computer graphics was used to qualify the work effect of lifting and thrusting,and reinforcing and reducing,which showed the heavy insertion and light lifting of RFLT,and showed heavy lifting and light insertion of RDLT,thus distinguished the two methods[(RFLT)and(RDLT)].Conclusions:The ultrasound imaging and computer graphics can be used to analyze the regularity of the common"reinforcing and reducing"method of acupuncture and moxibustion.
8.Time series analysis of air pollution and asthma outpatient visits in Hefei
Xiaofeng WU ; Xinmiao SUI ; Shu SUN ; Jiyu CAO
Journal of Public Health and Preventive Medicine 2022;33(1):37-42
Objective To explore the relationship between the outpatient visits for adult asthma and air pollution in a tertiary hospital in Hefei. Methods The number of outpatient visits for asthma in a tertiary hospital in Hefei from 2014 to 2020 was collected. The air pollutant data was obtained through the Hefei Air Monitoring Station, and the meteorological indicators of the same period were collected through the China Meteorological Network. The R statistical software was used to establish a generalized additive model to analyze the lag effect of air pollution on the number of outpatient visits for asthma. Results From 2014 to 2020, there were 7 220 asthma outpatients in the tertiary hospital in Hefei, including 3104 males and 4 116 females, 3 798 patients in warm season, and 3 422 patients in cold season. During the period, the average concentrations of SO2, NO2, CO, O3, PM10, and PM2.5 were 11.9μg/m3, 40.1μg/m3, 0.9 mg/m3, 87.3μg/m3, 81.3μg/m3, and 55.7μg/m3, respectively. The results of the single-pollutant model showed that every 10μg/m3 increase in SO2 concentration increased the risk of asthma by 0.74% (95%CI: 0.22%-1.29%), and the effect was the greatest on Lag2 day. NO2 increased the risk of asthma by 0.31% (95%CI: 0.13%-0.49%), with the greatest effect on Lag0 day. The analysis of the dual pollutant model found that whereas the effect of SO2 decreased after the incorporation of NO2, the effect increased after the incorporation of CO, O3, PM10, or PM2.5, respectively. The effect of NO2 on asthma decreased after the incorporation of SO2, whereas the effect on asthma increased after the inclusion of CO, PM10, or PM2.5. Stratified analysis of cold and warm seasons showed that the effect of NO2 on asthma was the greatest in lag0 in cold season. The effect of SO2 was higher in cold season than in warm season, and it was the highest in lag2. The gender stratification analysis showed that the effects of SO2 and NO2 on male asthma were higher than those on females. Conclusion From 2014 to 2020, the increase of SO2 and NO2 concentrations in Hefei is positively correlated with the risk of asthma in the outpatient department of a tertiary hospital. The effect has a certain lag. It is of great significance to formulate relevant preventive measures for the occurrence and attack of asthma.
9.Retrospective analysis of adverse reactions and related factors of resin cement dentin adhesive
FU Xinliang ; SUN Jiyu ; ZHU Zhuoli ; GAN Xueqi
Journal of Prevention and Treatment for Stomatological Diseases 2022;30(7):491-498
Objective:
To investigate the adverse reactions of resin cement used for dentin bonding and its influencing factors.
Methods:
Patients with dental defects treated with resin cement dentin adhesive for direct composite resin repair or full crown indirect repair were selected as the research objects. The occurrence and causes of adverse reactions, such as dental pulp lesions, soft tissue adverse reactions, and restoration loosening and falling off 7 days, 1 month, 3 months, 6 months, and 1 year after treatment, were analyzed retrospectively.
Results :
Among the 14 776 teeth of 5 971 patients who used resin cement dentin adhesive, 580 cases (3.93%) had adverse reactions. Univariate analysis showed that the incidence of adverse events was highest in teeth with the "full crowns (fixed partial dentures)" restoration type at 7 days, 1 month, and 12 months after treatment. At 7 days after treatment, the incidence of adverse events was the highest in teeth with a preparation depth of "near pulp after preparation". At 7 days and 3 months after treatment, the incidence of adverse events was the highest in teeth with " dentin conditioner-adhesive-resin" treatment of the bonding surface. Multivariate analysis indicated that pulp perforation and pulp capping after tooth preparation were risk factors for adverse events 7 days after treatment (OR=2.610), and the “dentin primer-adhesive-resin” bonding surface treatment method was a protective factor for adverse events 7 days and 3 months after treatment (OR<1).
Conclusion
affect the occurrence of adverse events. pulp perforation, and pulp capping after tooth preparation, and self-etching bonding may contribute to adverse reactions.
10.Nanomedicines for the treatment of rheumatoid arthritis: State of art and potential therapeutic strategies.
Qin WANG ; Xianyan QIN ; Jiyu FANG ; Xun SUN
Acta Pharmaceutica Sinica B 2021;11(5):1158-1174
Increasing understanding of the pathogenesis of rheumatoid arthritis (RA) has remarkably promoted the development of effective therapeutic regimens of RA. Nevertheless, the inadequate response to current therapies in a proportion of patients, the systemic toxicity accompanied by long-term administration or distribution in non-targeted sites and the comprised efficacy caused by undesirable bioavailability, are still unsettled problems lying across the full remission of RA. So far, these existing limitations have inspired comprehensive academic researches on nanomedicines for RA treatment. A variety of versatile nanocarriers with controllable physicochemical properties, tailorable drug release pattern or active targeting ability were fabricated to enhance the drug delivery efficiency in RA treatment. This review aims to provide an up-to-date progress regarding to RA treatment using nanomedicines in the last 5 years and concisely discuss the potential application of several newly emerged therapeutic strategies such as inducing the antigen-specific tolerance, pro-resolving therapy or regulating the immunometabolism for RA treatments.


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