Three-dimensional printed patient-specific instrumentation (3D-PSI) provides a precise and individualized treatment solution for unicompartmental knee arthroplasty (UKA). Currently, this technology is being applied in clinical practice and has demonstrated certain potential. Compared to conventional instrumentation (CI), 3D-PSI offers a broader range of indications, higher-quality preoperative planning, shorter surgical time, a smoother learning curve, more precise osteotomy and prosthesis placement, and better postoperative functional recovery. However, it still has limitations in the rotational alignment of the tibial component. Additionally, the higher cost for patients and increased hospital equipment investment make it less beneficial for surgeons already proficient in CI techniques. Further reliable evidence is needed to compare 3D-PSI with computer navigation and robotic technologies. This review summarizes the advantages and limitations of 3D-PSI assisted UKA and compares 3D-PSI with different auxiliary technologies.

Objective To investigate the correlation between brain iron content and cognitive function in patients with Alzheimer's disease(AD),and to assess the diagnostic value of iron deposition in AD using quantitative susceptibility mapping(QSM)technology.Methods Forty-three patients with AD who visited the Second Affiliated Hospital of Xinjiang Medical University between January 2024 and December 2024,and 42 healthy controls matched for gender and age were enrolled in the study.Comprehensive clinical data were collected from all participants.All subjects underwent brain MRI scans using a Philips Ingenia CX 3.0T magnetic resonance imaging system,including both QSM and conventional cranial MRI sequences.The acquired QSM images were post-processed and normalized using the STISuite software package,and the iron content in predefined regions of interest was quantified using ITK-SNAP.All participants also underwent neuropsychological assessments.Differences in regional brain iron content between AD patients and healthy controls were analyzed and compared.Spearman's correlation coefficient was calculated to evaluate the relationship between iron levels in the frontal cortex,basal ganglia,and hippocampus and cognitive performance.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic accuracy of iron deposition in differentiating AD patients from healthy controls.Results(1)Compared with the control group,the magnetic susceptibility values in the basal ganglia and hippocampus of the AD group showed statistically significant differences(P<0.01),with higher values observed in the AD group.No statistically significant difference was found in the susceptibility values of the frontal cortex between the AD group and the control group(P>0.05).(2)In the AD group,the susceptibility values of the left caudate nucleus and left hippocampus tail were negatively correlated with the MMSE scores(P<0.05).Additionally,the susceptibility values of the left caudate nucleus,left putamen,left hippocampus,and left hippocampus tail were negatively correlated with the MOCA scores(P<0.05).(3)The area under the curve(AUC)for diagnosing AD based on the left caudate nucleus was 0.758(95%CI:0.649-0.867),for the left putamen it was 0.719(95%CI:0.606-0.831),and for the left hippocampus tail it was 0.640(95%CI:0.518-0.763).Conclusions(1)The iron content in certain brain regions of AD patients is elevated compared to that in healthy controls,particularly in the basal ganglia and hippocampus.(2)The iron concentration in the brains of AD patients,especially in the left caudate nucleus,left putamen,left hippocampus,and hippocampal tail,is negatively correlated with cognitive function.Higher iron levels are associated with more severe cognitive impairment,suggesting that iron accumulation may serve as a potential biomarker for assessing disease severity.(3)Iron deposition in the left caudate nucleus and left putamen demonstrates certain diagnostic value for AD and holds promise as an imaging marker for the auxiliary diagnosis of the disease.

Objective To investigate the correlation between brain iron content and cognitive function in patients with Alzheimer's disease(AD),and to assess the diagnostic value of iron deposition in AD using quantitative susceptibility mapping(QSM)technology.Methods Forty-three patients with AD who visited the Second Affiliated Hospital of Xinjiang Medical University between January 2024 and December 2024,and 42 healthy controls matched for gender and age were enrolled in the study.Comprehensive clinical data were collected from all participants.All subjects underwent brain MRI scans using a Philips Ingenia CX 3.0T magnetic resonance imaging system,including both QSM and conventional cranial MRI sequences.The acquired QSM images were post-processed and normalized using the STISuite software package,and the iron content in predefined regions of interest was quantified using ITK-SNAP.All participants also underwent neuropsychological assessments.Differences in regional brain iron content between AD patients and healthy controls were analyzed and compared.Spearman's correlation coefficient was calculated to evaluate the relationship between iron levels in the frontal cortex,basal ganglia,and hippocampus and cognitive performance.Receiver operating characteristic(ROC)curves were constructed to assess the diagnostic accuracy of iron deposition in differentiating AD patients from healthy controls.Results(1)Compared with the control group,the magnetic susceptibility values in the basal ganglia and hippocampus of the AD group showed statistically significant differences(P<0.01),with higher values observed in the AD group.No statistically significant difference was found in the susceptibility values of the frontal cortex between the AD group and the control group(P>0.05).(2)In the AD group,the susceptibility values of the left caudate nucleus and left hippocampus tail were negatively correlated with the MMSE scores(P<0.05).Additionally,the susceptibility values of the left caudate nucleus,left putamen,left hippocampus,and left hippocampus tail were negatively correlated with the MOCA scores(P<0.05).(3)The area under the curve(AUC)for diagnosing AD based on the left caudate nucleus was 0.758(95%CI:0.649-0.867),for the left putamen it was 0.719(95%CI:0.606-0.831),and for the left hippocampus tail it was 0.640(95%CI:0.518-0.763).Conclusions(1)The iron content in certain brain regions of AD patients is elevated compared to that in healthy controls,particularly in the basal ganglia and hippocampus.(2)The iron concentration in the brains of AD patients,especially in the left caudate nucleus,left putamen,left hippocampus,and hippocampal tail,is negatively correlated with cognitive function.Higher iron levels are associated with more severe cognitive impairment,suggesting that iron accumulation may serve as a potential biomarker for assessing disease severity.(3)Iron deposition in the left caudate nucleus and left putamen demonstrates certain diagnostic value for AD and holds promise as an imaging marker for the auxiliary diagnosis of the disease.

Middle-aged and elderly patients with femoral neck fracture often suffer from basic diseases. Conservative treatment will significantly increase the incidence of complications. At present, surgical treatment is mostly advocated. Internal fixation is one of the effective treatment methods for middle-aged and elderly patients with femoral neck fracture. It has the advantages of improving hip joint function, accelerating patient recovery, and improving patient quality of life. At present, there are many choices of internal fixation in the world, each has its own advantages and disadvantages, and there is no unified standard. Different surgical methods can be selected according to various factors such as fracture type, patient′s physical condition and surgical auxiliary technology. This article reviews the clinical progress of internal fixation for femoral neck fractures in middle-aged and elderly patients from four aspects: the characteristics of femoral neck fractures in middle-aged and elderly patients, common internal fixation methods, 3D printing guide plate auxiliary technology and artificial intelligence auxiliary technology.

Objective:To explore the influence of deviation of the bolt in femoral neck system (FNS) on the short-term outcomes in young and middle-aged patients with displaced femoral neck fracture.Methods:A retrospective analysis was conducted of the 114 young and middle-aged patients with displaced femoral neck fracture who had been treated with FNS at Department of Orthopaedics, Suzhou Municipal Hospital from December 2019 to January 2023. Based on the postoperative measurements of the deviation of the bolt tip to the central axis of the femoral head and neck (W), the patients were divided into a central group (W≤20%) and a deviation group (W>20%). In the central group of 63 cases, there were 27 males and 36 females with a mean age of (46.4±8.0) years. In the deviation group of 51 cases, there were 20 males and 31 females with a mean age of (45.1±9.8) years. The 2 groups were compared in terms of weight-bearing time, fracture healing time, tip-apex distance, degree of femoral neck shortening, Harris Hip Score and EuroQol five-dimensional questionnaire-5L (EQ-5D-5L) utility value at the last follow-up, as well as complications and revision surgeries.Results:There was no statistically significant difference in the preoperative general information, auxiliary reduction or quality of fracture reduction between the 2 groups, showing comparability between groups ( P>0.05). There was no significant difference in the partial weight-bearing time between the 2 groups ( P>0.05). In the central group, the full weight-bearing time [15.0 (14.0, 16.0) weeks] and fracture healing time [14.0 (12.0, 15.0) weeks] were significantly shorter than those in the deviation group [16.0 (15.0, 19.0) weeks; 15.0 (13.0, 17.0) weeks], the tip-apex distance [(21.4±3.4) mm] was significantly shorter than that in the deviation group [(23.5±2.7) mm], the Harris Hip Score [(90.6±6.1) points] and EQ-5D-5L utility value [0.9 (0.8, 0.9)] at the last follow-up were significantly higher than those in the deviation group [(87.7±6.2) points; 0.9 (0.8, 0.9)], and the incidences of moderate and severe femoral neck shortening [25.4% (16/63)], avascular necrosis of the femoral head [0 (0/63)] and revision surgery [0 (0/63)] were significantly lower than those in the deviation group [66.7% (34/51), 7.8% (4/51), 9.8% (5/51)] (all P< 0.05). Conclusion:A closer positioning of the FNS bolt to the central axis of the femoral head and neck favors satisfactory short-term outcomes and a lower revision surgery rate in young and middle-aged patients with displaced femoral neck fracture.

Bone defects caused by trauma, infection, tumor and other factors is a thorny problem in orthopedic clinic, and promoting bone repair and regeneration is the key and difficult point of treatment. In addition to autologous bone grafting, artificial bone materials are often used for large bone defects. β-tricalcium phosphate has good biocompatibility, bone conduction and bone induction properties, and has been studied deeply because of its excellent drug delivery performance and has shown broad application prospects. In this paper, the author will summarize the research progress of β-tricalcium phosphate composites loaded with different drugs in the treatment of bone defects caused by trauma, infection and tumor.

The placement of the flexible ureteroscopic sheath during lithotripsy may injure the ureter. We have developed a double-tube flexible ureteral access sheath. Thirteen patients with renal calculi were treated with double-tube and flexible sheath in one stage. CT examination of 13 cases showed that the ureter was normal. The double-tube flexible ureteral access sheath makes the operation of sheathing easy, safe and effective.

Objective: To investigate the effect of nucleophosmin 1 (NPM1) mutant A on TGF-β1-induced K562 cell proliferation and AKT phosphorylation. Methods: K562 cells were infected with Ad5-NPM1 to create an NPM1 over-expression cell model. NPM1 levels were determined by ELISA and Western blot analysis. The levels of AKT and P-AKT were determined by Western blot. MTT was used to measure the proliferation of K562 cells. Results: NPM1 protein levels in K562 cells increased in an Ad5-NPM1-MOI-dependent manner. Cell proliferation and NPM1 levels in the supernatant were significantly increased in K562 cells infected with Ad5-NPM1-30 and Ad5-NPM1-100 compared to those infected with Ad5-vector-100 (P<0.01). Treatment with (10 ng/mL) TGF-β1 increased P-AKT levels, but not total AKT levels in K562 cells. TGF-β1-induced phosphorylation of AKT was significantly increased by infection of K562 cells with Ad5-NPM1-100. No significant differences were found in total AKT levels among all groups. TGF-β1 (10 ng/mL) treatment also in-creased the proliferation of K562 cells. TGF-β1-induced K562 cell proliferation was significantly increased by infection with Ad5-NPM1-100 (P<0.01). Conclusions: NPM1 improves TGF-β1-induced cell proliferation by up-regulating AKT phosphorylation levels.

Objective To compare the effects of smoking and non smoking on postoperative pain of laparoscopic cholecystectomy. Methods Sixty patients having underwent selective laparoscopic cholecystectom were divided into smoking group and non smoking group by random digits table with 30 cases each. In smoking group, 14 cases quitted smoking within 1 week before operation. The Fagerstrom test of nicotine dependence (FTND) was evaluated before operation in smoking group, and FTND ≥ 6 scores was in 11 cases. The visual analog score (VAS), Bruggrmarm comfort score (BCS), sedation-agitation score (SAS), immediately, 15 min, and 30 min after entering postanesthesia care unit (PACU) and leaving PACU was evaluated. The operation time, anesthesia time, wake up time, extubation time, PACU time, using rate of remedial measures and untoward reaction were recorded. Results There were no statistical differences in operation time, anesthesia time, wake up time, extubation time, SAS and incidence of untoward reaction between 2 groups (P>0.05). The PACU time and using rate of remedial measures in smoking group were significantly higher than those in non smoking group:(39.7 ± 5.1) min vs. (31.3 ± 6.1) min and 30.0% (9/30) vs. 0, and there were statistical differences (P<0.05). The VAS immediately, 15 min and 30 min after entering PACU and leaving PACU in smoking group was significantly higher than that in non smoking group: (2.90 ± 0.85) scores vs. (1.00 ± 0.83) scores, (2.70 ± 0.47) scores vs. (0.73 ± 0.69) scores, (2.60 ± 0.56) scores vs. (1.13 ± 0.73) scores, (2.23 ± 0.57) scores vs. (1.13 ± 0.73) scores; and the BCS was significantly lower than that in non smoking group:(1.80 ± 0.61) scores vs. (2.90 ± 0.99) scores, (1.90 ± 0.31) scores vs. (2.87 ± 1.00) scores, (2.10 ± 0.31) scores vs. (2.47 ± 0.82) scores, (2.17 ± 0.38) scores vs. (2.47 ± 0.82) scores, and there were statistical differences (P<0.05). The VAS immediately after entering PACU in patients of FTND ≥ 6 scores was significantly higher than that in patients of FTND<6 scores:(3.6 ± 0.7) scores vs. (2.5 ± 0.7) scores, the BCS was significantly lower than that in patients of FTND <6 scores:(1.5 ± 0.5) scores vs. (2.0 ± 0.6) scores, and there were statistical differences (P<0.05). The VAS immediately after entering PACU in patients of non- quit smoking was significantly higher than that in patients of quit smoking: (3.4 ± 0.7) scores vs. (2.4 ± 0.6) scores, and there were statistical differences (P<0.05). Conclusions Smokers have more severe postoperative pain in laparoscopic cholecystectomy and higher postoperative opioid requirement than nonsmokers. Quit smoking before surgery will reduce postoperative pain and related complications. Appropriate increase of analgesic drugs can prevent postoperative pain in patients with smoking.

Heatstroke is a critical disease which usually catches in the hot environment in summer and abundant exercise that could bring about multiple organ dysfunction.The process of the occurrence and development of heatstroke includes of the compensatory phase,acute reaction stage and decompensation stage.The recent researches have shown that the mechanism of liver injury induced by heatstroke might be related to the direct action of heat,mitochondrial dysfunction in liver cells and cascade of inflammatory response,and each link promoted each other,finally caused liver injury.In addition,a cascade of inflammatory responses in the hepatic sinusoid might play a predominant role in liver injury induced by heatstroke.This paper aims to review the mechanism of liver damage caused by heatstroke in terms of the physiology and pathology,so as to provide perspectives for clinical prevention and treatment of liver injury.