Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Sacroiliac complex injuries are commonly seen in high-energy pelvic fractures. The injuries make a big difference in treatment patterns due to the diverse injury types, posing considerable challenges in formulating optimal treatment strategies, and hence are persistent clinical difficulties in orthopedic trauma. The clinical management of sacroiliac complex injuries presents several key challenges such as a non-negligible rate of missed diagnoses in associated vascular and visceral injuries, absence of standardized protocols for surgical approaches and reduction-fixation strategies across different injury patterns, and ongoing controversies regarding surgical indications and optimal timing for patients combined with concomitant lumbosacral plexus injuries. Currently, no systematic clinical guidelines are available for the diagnosis and treatment of sacroiliac complex injuries both domestically and internationally. To this end, the Pelvic and Acetabular Surgery Group, Orthopedic Branch, China International Exchange and Promotive Association for Medical and Health Care and Orthopedic Physician Branch, Chinese Medical Doctor Association organized a panel of domestic experts in the field to develop the Clinical guideline for the diagnosis and treatment of sacroiliac complex injuries ( version 2025), based on evidence-based medicine and adhering to the principles of scientific rigor, clinical applicability, and innovation. These guidelines provided 11 recommendations covering diagnosis, therapeutic principles and techniques, management protocols for lumbosacral plexus injuries, outcome evaluation, and postoperative rehabilitation pathways, etc., aiming to standardize the clinical management of sacroiliac complex injuries.

Objective To meet the treatment requirements for mitral regurgitation disease,this study designed a novel valve repair system and evaluated its hydrodynamic performance.Methods A mitral regurgitation model was created.The valve repair system was loaded onto the regurgitation model,and pulsatile flow tests and steady backflow leakage tests were conducted.Results The pulsatile flow test results indicated that the percentage of reflux after product implantation was lower than that before implantation under different concentric outputs and reverse pressures.The average cross-valve pressure difference after implantation was less than 5 mmHg.The steady backflow leakage test results showed that as the reverse pressure increased,the leakage amount of the valve repair system after implantation also increased.Conclusion The developed valve repair system exhibits excellent hydrodynamic performance,suggesting the feasibility of its application in the treatment of clinical mitral regurgitation.

OBJECTIVE: To meet the treatment requirements for mitral regurgitation disease, this study designed a novel valve repair system and evaluated its hydrodynamic performance. METHODS: A mitral regurgitation model was created. The valve repair system was loaded onto the regurgitation model, and pulsatile flow tests and steady backflow leakage tests were conducted. RESULTS: The pulsatile flow test results indicated that the percentage of reflux after product implantation was lower than that before implantation under different concentric outputs and reverse pressures. The average cross-valve pressure difference after implantation was less than 5 mmHg. The steady backflow leakage test results showed that as the reverse pressure increased, the leakage amount of the valve repair system after implantation also increased. CONCLUSION The developed valve repair system exhibits excellent hydrodynamic performance, suggesting the feasibility of its application in the treatment of clinical mitral regurgitation.
Hydrodynamics ; Mitral Valve Insufficiency/surgery* ; Mitral Valve/surgery* ; Heart Valve Prosthesis ; Pulsatile Flow ; Heart Valve Prosthesis Implantation

Objective:To study the ultrasonographic manifestations of intercostal muscle and diaphragm involvement in Duchenne muscular dystrophy (DMD) and their correlations with functional status, and to explore the pattern of muscle damage in patients with DMD and the potential role of ultrasonography in assessing disease progression.Methods:A total of 28 patients with DMD who received treatment in the Third Medical Centre of PLA General Hospital from May to December 2023 were prospectively collected as DMD group, and 28 healthy children matched in age and sex were included as controls for a prospective study.Diaphragm thickening fraction (DTF) and intercostal muscle thickening fraction (ICMTF) were measured by B-mode and M-mode ultrasonography, and the muscle gray values were recorded. The differences between groups were compared, and the values of DTF and ICMTF in evaluating the structural and functional changes of respiratory muscle were analyzed.Results:Compared with the control group, the gray value of respiratory muscle was significantly decreased in DMD group, the diaphragm and intercostal muscle were significantly thickened at the end of inspiratory and expiratory periods, DTF was significantly decreased, and ICMTF was significantly increased (all P<0.001). Conclusions:Ultrasound can evaluate the structural changes of respiratory muscle in DMD, so as to clarify the relationship between the structure and function of respiratory muscle in DMD patients.

Objective To evaluate the reporting quality of randomized controlled trials of TCM treatment of chronic obstructive pulmonary disease based on CONSORT statement and extended version and Jadad scale.To understand the current situation of TCM treatment of COPD RCT and provide reference for future research.Methods PubMed,Embase,Cochrane Controlled Trial Registry,Web of Science,China Journal Full Text Database(CNKI),Wanfang Data,VIP Chinese Journal Service Platform and SinoMed were searched.The retrieval time was from January 2012 to December 2022.CONSORT 2010 statement and extended version and Jadad scale were used to evaluate the quality of the included RCTS.Results A total of 291 literatures(279 Chinese,12 English)were included.In the evaluation of CONSORT declaration,73.47%and 34.69%of all items with reporting rate less than 50%in both English and Chinese respectively.In both English and Chinese,there were 25 and 9 items with reporting rates less than 10%,respectively.The difference in reporting rates of 17 items such as trial registration and outcome index was more than 50%.Evaluating TCM Formulas based on consor-Chm formulas,the reported rates of Chinese and English formulas were poor(<10%)in terms of TCM syndrome type and details of compound intervention measures.In evaluating acupuncture based on the STRICTA list,both Chinese and English reported low rates(<10%)in five aspects,including treatment site and number of needles used.The report rate of moxibustion method based on CONSORT extended version is generally good.According to SPSS25.0,there is a moderate correlation between CONSORT and Jadad(pearson0.419,P<0.01).Conclusion The report quality of TCM treatment of COPD RCTS needs to be further improved,and there are significant problems in text topic,key words,outcome index,blind method,trial registration and other aspects.In the follow-up research,multi-disciplinary talents should be involved and RCT research reports should be regulated strictly in accordance with CONSORT declaration and Jadad scale.This study provides some reference for improving the quality of RCT.

Objective To evaluate the reporting quality of randomized controlled trials of TCM treatment of chronic obstructive pulmonary disease based on CONSORT statement and extended version and Jadad scale.To understand the current situation of TCM treatment of COPD RCT and provide reference for future research.Methods PubMed,Embase,Cochrane Controlled Trial Registry,Web of Science,China Journal Full Text Database(CNKI),Wanfang Data,VIP Chinese Journal Service Platform and SinoMed were searched.The retrieval time was from January 2012 to December 2022.CONSORT 2010 statement and extended version and Jadad scale were used to evaluate the quality of the included RCTS.Results A total of 291 literatures(279 Chinese,12 English)were included.In the evaluation of CONSORT declaration,73.47%and 34.69%of all items with reporting rate less than 50%in both English and Chinese respectively.In both English and Chinese,there were 25 and 9 items with reporting rates less than 10%,respectively.The difference in reporting rates of 17 items such as trial registration and outcome index was more than 50%.Evaluating TCM Formulas based on consor-Chm formulas,the reported rates of Chinese and English formulas were poor(<10%)in terms of TCM syndrome type and details of compound intervention measures.In evaluating acupuncture based on the STRICTA list,both Chinese and English reported low rates(<10%)in five aspects,including treatment site and number of needles used.The report rate of moxibustion method based on CONSORT extended version is generally good.According to SPSS25.0,there is a moderate correlation between CONSORT and Jadad(pearson0.419,P<0.01).Conclusion The report quality of TCM treatment of COPD RCTS needs to be further improved,and there are significant problems in text topic,key words,outcome index,blind method,trial registration and other aspects.In the follow-up research,multi-disciplinary talents should be involved and RCT research reports should be regulated strictly in accordance with CONSORT declaration and Jadad scale.This study provides some reference for improving the quality of RCT.

Objective:To investigate the effect of temozolomide on autophagy of human glioma cells, and the inhibition of autophagy induced pyrocytosis on the proliferation of human glioma cells.Methods:2-64 μ mol/L of temozolomide was used to treat glioma U251 cells cultured in vitro. MTT assay was used to detect cell viability, MDC staining was used to detect autophagic vesicles in cells, cloning assay was used to detect cell proliferation, RT qPCR was used to detect the expression level of pyroptosis related mRNA in cells, Western blot was used to detect the expression of autophagy related proteins and pyroptosis related proteins in cells, and the relationship between autophagy and pyroptosis was detected by adding autophagy inhibitors.Results:Temozolamide could induce autophagy of human glioma cells, and significantly induce tumor cells to pyroptosis, thereby inhibiting the proliferation of tumor cells; RT qPCR results showed that caspase-1, GSDMD, IL-1 after temozolomide administration compared with the normal group β, the mRNA expression levels of IL-18 and NLRP3 increased significantly; Western blot results showed that Cleaved-caspase-1, Cleaved-N-terminalGSDMD, IL-1 β、IL-18 and NLRP3 protein were up-regulated; The incidence of pyroptosis decreased after the addition of autophagy inhibitors.Conclusion:Temozolamide can induce autophagy of human glioma cells, and then lead to pyroptosis, which plays an inhibitory role in proliferation.

Objective:To explore the impact of weekend hospitalization on total hospitalization expenses for elderly patients with hip fracture under the geriatric orthopedic co-management.Methods:A retrospective analysis was conducted to analyze the clinical data of elderly patients with hip fracture who had been hospitalized for surgical treatment at Beijing Jishuitan Hospital from May 2015 to December 2020. They were divided into 2 groups based on their admission date. Group A was admitted from Monday to Thursday while Group B from Friday to Sunday. The general demographic data, diagnostic information, comorbidities, hospitalization expenses of the patients were collected. The differences in total hospitalization expenses, hospitalization time, rate of surgery within 48 hours and rate of hospital mortality between the 2 groups were analyzed by rank sum test, chi square test, correlation analysis, and multiple linear regression.Results:A total of 6,075 patients with hip fracture were included in this study, including 1,675 males and 4,400 females with a median age of 80 (74, 85) years. There were 3,935 ones in group A and 2,140 ones in group B. The total hospitalization expenses for group A was 58,160.52 (49,215.45, 72,748.94) yuan, insignificantly lower than those for Group B [58,412.90 (49,163.58, 72,712.61) yuan] ( P>0.05). The rate of surgery within 48 hours for group A was 75.8% (2,984/3,935), significantly higher than that for group B [49.3% (1,054/2,140)]. The hospitalization time for group A was 5 (4, 7) days, significantly less than that for group B [5 (4, 7) days] ( P<0.05). There was no significant difference in the rate of hospital mortality between the 2 groups ( P>0.05). Multiple linear regression analysis showed that total hospitalization expenses were significantly higher for patients admitted on weekends, hospitalization time was positively correlated with total hospitalization expenses, and total hospitalization expenses were significantly lower for the patients undergoing surgery within 48 hours ( P<0.05). Conclusion:Admission on weekends can increase total hospitalization expenses, prolong hospitalization time, and reduce rate of surgery within 48 hours for elderly patients with hip fracture.

Objective:To explore the clinical characteristics of paroxysmal kinesigenic dyskinesia (PKD) secondary to pseudohypoparathyroidism (PHP), so as to improve the clinicians′ understanding of the disease.Methods:The clinical data of 2 cases of PKD secondary to PHP in Beijing Tiantan Hospital, Capital Medical University from June 2022 to October 2022 were summarized, and the related literature was reviewed to analyze the pathogenesis, clinical manifestations, laboratory examination and imaging characteristics of the disease, as well as its treatment and prognosis.Results:Ten cases of PKD secondary to PHP were previously reported. A total of 12 cases (including these 2 cases) were included in the study, of which 7 were males (7/12) and 5 were females (5/12). The onset age was 8-23 years. The clinical manifestations of the disease included paroxysmal limb torsion, limb stiffness, limb tremor, throwing movements, and dance like movements. There were 3 cases (3/12) who had seizure at the same time. Ten cases (10/12) were induced by exercise, while 2 cases (2/12) were not mentioned the inducing factor. Eleven cases (11/12) with paroxysmal symptoms lasting less than 2 minutes can be relieved automatically. Only 1 case had a family history. Laboratory examination of all patients showed low calcium, high phosphorus and significant elevation of parathyroid hormone. The head CT scans of 10 cases (10/12) showed multiple intracranial calcifications. There were 9 cases (9/12) alone received the supplementation of calcium and active vitamin D, while 3 cases (3/12) were additionally treated with antiepileptic drugs. All cases had good prognosis.Conclusions:PHP is a rare cause of secondary PKD. A small number of patients can have seizures at the same time. Most patients have a good prognosis after receiving calcium and active vitamin D supplementation.