1.Clinical application of a CT-designed guide plate for targeted injection into the lateral pterygoid muscle
HUANG Min ; OUYANG Shaobo ; YAN Qinyan ; ZENG Yixuan ; LIAO Lan
Journal of Prevention and Treatment for Stomatological Diseases 2025;33(11):932-943
Objective :
To investigate the effectiveness of an extraoral guide plate system targeting the superior and inferior heads of the lateral pterygoid muscle in improving the accuracy of injection therapy for anterior disc displacement (ADD) of the temporomandibular joint (TMJ) with lateral pterygoid myalgia, and to provide a reference for precise clinical treatment.
Methods:
With approval from the institutional medical ethics committee and informed consent from patients, spiral CT scans were performed on seven patients with ADD accompanied or not accompanied by lateral pterygoid myalgia to acquire craniofacial data. Mimics 21.0 software was used to reconstruct three-dimensional craniofacial structures, identify attachment points of the superior and inferior heads of the lateral pterygoid muscle, and design dual injection paths along with a retention system. Personalized templates were fabricated using digital light procession-based 3D printing. Under the guide plate, a single targeted injection of 20 U of botulinum toxin type A (BTX-A) was administered into both the superior and/or inferior heads of the lateral pterygoid muscle. Immediate postoperative CT scans were conducted to compare actual needle placement with preoperative plans. Pain was assessed using the visual analogue scale (VAS) at 3 days and 1, 2, and 4 weeks postoperatively. Joint clicking was recorded at 2 and 4 weeks, and complications were monitored throughout the duration of the study.
Results :
A total of 15 sites in 7 patients were injected into the upper / lower head of the lateral pterygoid muscle under the guidance of the guide plate. Under the guide plate, all of the injections achieved an angular deviation within 2.5° (superior head: 2.49° ± 0.17°, inferior head: 2.31° ± 0.16°) and a needle tip positional deviation within 2 mm [superior head: (1.96 ± 0.25) mm, inferior head: (1.65 ± 0.21) mm]. The significant pain improvement rate (defined as ≥3-point reduction in VAS score) increased from 60% (9/15) at day 3 to 85% (13/15) at 2 weeks post-operation, stabilizing at 86.7% (13/15) at 4 weeks post-operation. Joint clicking improvement rates reached 72% (11/15) at 2 weeks post-operation and 75% (11/15) at 4 weeks post-operation. Regarding safety, only one case of injection site swelling and one case of transient paresthesia were observed; both resolved spontaneously within a short period of time. No neurovascular injury events occurred.
Conclusion
CT-guided guide plate achieves precise targeting design to minimize injection errors in the lateral pterygoid muscle. This technology is effective and safe, and it can provide an anatomically specific and operationally versatile targeted therapy for temporomandibular disorders.
2.Associations between per- and polyfluoroalkyl substance exposure and the prevalence of myopia in adolescents: the mediating role of serum albumin.
Xuewei LI ; Xiaodong CHEN ; Yixuan ZHANG ; Tonglei ZHENG ; Lvzhen HUANG ; Yan LI ; Kai WANG
Environmental Health and Preventive Medicine 2025;30():50-50
BACKGROUND:
The objective of this study was to investigate the potential link between myopia in adolescents and exposure to per- and polyfluoroalkyl substances (PFASs).
METHODS:
This investigation included 1971 subjects with accessible PFAS level data, myopia status, and associated variables from four cycles of the National Health and Nutritional Examination Survey (NHANES). The investigation focused on specific PFAS compounds found in the serum, including perfluorohexane sulfonate (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), and perfluorooctane sulfonic acid (PFOS), chosen for their frequent detection. Owing to the skewed nature of the PFAS level data, the PFAS levels were log-transformed (Ln-PFAS) prior to analysis. Logistic regression, restricted cubic spline modeling, subgroup analysis, and sensitivity analysis were used to examine the associations between exposure to PFASs and the onset of myopia.
RESULTS:
PFOA levels were significantly associated with myopia risk (OR: 1.33; 95% CI: 1.05-1.69; P = 0.019). More specifically, with respect to the first quartile, the second quartile (ORQ2: 1.69; 95% CI: 1.16-2.46; P = 0.007), third quartile (ORQ3: 1.45; 95% CI: 1.03-2.03; P = 0.035), and highest quartile (ORQ4: 1.58; 95% CI: 1.12-2.21; P = 0.010) of participants presented with increased myopia risk. Mediation analysis revealed that PFOA and myopia risk were partially mediated by serum albumin (ALB), with a mediation percentage of 22.48% (P = 0.008). A nonlinear inverted U-shaped relationship was identified between the level of PFOA and myopia risk (P for nonlinearity = 0.005).
CONCLUSION
Our findings suggest a potential link between exposure to PFOA and the likelihood of myopia development in young individuals and a mediating effect of serum ALB on this relationship. Notably, PFOA was identified as a key PFAS significantly contributing to the observed link between PFAS exposure and myopia risk. The potential threat of PFOA to myopia should be examined further.
Humans
;
Fluorocarbons/adverse effects*
;
Myopia/blood*
;
Adolescent
;
Male
;
Female
;
Prevalence
;
Environmental Exposure/adverse effects*
;
Nutrition Surveys
;
Environmental Pollutants/adverse effects*
;
United States/epidemiology*
;
Alkanesulfonic Acids/blood*
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Caprylates/blood*
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Serum Albumin/metabolism*
;
Child
;
Sulfonic Acids
3.A cisplatin prodrug-based self-assembling ozone delivery nanosystem sensitizes radiotherapy in triple-negative breast cancer.
Tianyue XU ; Dan ZHENG ; Meixu CHEN ; Linlin SONG ; Zhihui LIU ; Yan CHENG ; Yujie ZHAO ; Liwen HUANG ; Yixuan LI ; Zhankun YANG ; Cong LI ; Biao DONG ; Jing JING ; Hubing SHI
Acta Pharmaceutica Sinica B 2025;15(5):2703-2722
Lacking therapeutic targets highlights the crucial roles of chemotherapy and radiotherapy in the clinical management of triple-negative breast cancer (TNBC). To relieve the side effects of the chemoradiotherapy combination regimen, we design and develop a self-assembled micelle nanosystem consisting of perfluorocarbon chain-modified cisplatin prodrug. By incorporating perfluorodecalin, this nanosystem can effectively carry ozone and promote irradiation-derived reactive oxygen species (ROS) production. By leveraging the perfluorocarbon sidechain, the nanosystem exhibits efficient internalization by TNBC cells and effectively escapes from lysosomal entrapment. Under X-ray irradiation, ozone-generated ROS disrupts the intracellular redox balance, thereby facilitating the release of cisplatin in a reduction-responsive manner mediated by reduced glutathione. Moreover, oxygen derived from ozone decomposition enhances the efficacy of radiotherapy by alleviating tumor hypoxia. Notably, the combination of irradiation with ozone-loaded cisplatin prodrug nano system synergistically prompts antitumor efficacy and reduces cellular/systemic toxicity in vitro and in vivo. Furthermore, the combo regimen remodels the tumor microenvironment into an immune-favored state by triggering immunogenic cell death and relieving hypoxia, which provides a promising foundation for a combination regimen of immunotherapy. In conclusion, our nanosystem presents a novel strategy for integrating chemotherapy and radiotherapy to optimize the efficacy and safety of TNBC clinical treatment.
4.Augmentation of PRDX1-DOK3 interaction alleviates rheumatoid arthritis progression by suppressing plasma cell differentiation.
Wenzhen DANG ; Xiaomin WANG ; Huaying LI ; Yixuan XU ; Xinyu LI ; Siqi HUANG ; Hongru TAO ; Xiao LI ; Yulin YANG ; Lijiang XUAN ; Weilie XIAO ; Dean GUO ; Hao ZHANG ; Qiong WU ; Jie ZHENG ; Xiaoyan SHEN ; Kaixian CHEN ; Heng XU ; Yuanyuan ZHANG ; Cheng LUO
Acta Pharmaceutica Sinica B 2025;15(8):3997-4013
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent inflammation and joint damage, accompanied by the accumulation of plasma cells, which contributes to its pathogenesis. Understanding the genetic alterations occurring during plasma cell differentiation in RA can deepen our comprehension of its pathogenesis and guide the development of targeted therapeutic interventions. Here, our study elucidates the intricate molecular mechanisms underlying plasma cell differentiation by demonstrating that PRDX1 interacts with DOK3 and modulates its degradation by the autophagy-lysosome pathway. This interaction results in the inhibition of plasma cell differentiation, thereby alleviating the progression of collagen-induced arthritis. Additionally, our investigation identifies Salvianolic acid B (SAB) as a potent small molecular glue-like compound that enhances the interaction between PRDX1 and DOK3, consequently impeding the progression of collagen-induced arthritis by inhibiting plasma cell differentiation. Collectively, these findings underscore the therapeutic potential of developing chemical stabilizers for the PRDX1-DOK3 complex in suppressing plasma cell differentiation for RA treatment and establish a theoretical basis for targeting PRDX1-protein interactions as specific therapeutic targets in various diseases.
5.Wendan Decoction ameliorates metabolic phenotypes in rats with metabolic syndrome and phlegm syndrome by modulating the gut microbiota-bile acid axis.
Kaiyue HUANG ; Jingxin QI ; Wenqian LUO ; Yixuan LIN ; Meimei CHEN ; Huijuan GAN
Journal of Southern Medical University 2025;45(6):1174-1184
OBJECTIVES:
To investigate the therapeutic mechanism of Wendan Decoction for phlegm syndrome in rats with metabolic syndrome (MS).
METHODS:
Forty Wistar rats were randomly divided into normal control group (n=8) and 3 phlegm syndrome model groups (induced by high-fat, high-sugar, and high-salt feeding and a single-dose intraperitoneal STZ injection; n=24) treated with daily gavage of saline, Wendan Decoction (3.6 g/kg), or metformin (0.1 g/kg) for 4 weeks. General conditions and glucose and lipid metabolism parameters of the rats were monitored, and serum LPS, liver histopathology, hepatic expressions of FXR, CYP7A1 and FGFR4 and ileal expressions of FXR and FGF15 were examined. Gut microbiota structure was analyzed using 16S rDNA sequencing, and serum bile acids were quantified with UHPLC-MS/MS.
RESULTS:
The rat models of phlegm syndrome exhibited severe hepatic steatosis and necrosis, increased body weight, abdominal circumference, Lee's index, FBG, FINS, HOMA-IR, TG, TC, LDL and LPS, and decreased HDL level. The abundance of Bacteroidetes, Megamonas, and Bacteroides in gut microbiota increased while Firmicutes, Lachnospiraceae_NK4A136_group, isohyodeoxycholic acid, and glycohyodeoxycholic acid decreased significantly; hepatic FXR and FGFR4 expressions and ileal FXR and FGF15 expressions decreased while hepatic CYP7A1 expression increased significantly in the rat models. Treatment with Wendan Decoction effectively alleviated hepatic pathology, reduced body weight and abdominal circumference, improved glucose and lipid metabolic profiles and gut microbiota structure, and reversed the changes in hepatic and ileal protein expressions. Correlation analysis revealed that Firmicutes and Lachnospiraceae_NK4A136_group were positively correlated while Bacteroidetes, Megamonas and Bacteroides were negative correlated with the levels of isohyodeoxycholic acid and hyodeoxycholic acid.
CONCLUSIONS
Wendan Decoction can significantly improve metabolic profiles in rats with phlegm syndrome of MS possibly by regulating the intestinal flora-bile acid axis to modulate the intestinal flora structure and maintain bile acid homeostasis via the FXR signaling pathway.
Animals
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Gastrointestinal Microbiome/drug effects*
;
Metabolic Syndrome/microbiology*
;
Bile Acids and Salts/metabolism*
;
Rats, Wistar
;
Drugs, Chinese Herbal/therapeutic use*
;
Rats
;
Male
;
Fibroblast Growth Factors/metabolism*
;
Liver/metabolism*
;
Cholesterol 7-alpha-Hydroxylase/metabolism*
;
Receptors, Cytoplasmic and Nuclear/metabolism*
6.ALKBH5 exacerbates psoriatic dermatitis in mice by promoting angiogenesis.
Chengfang ZHANG ; Fei LI ; Bao CHAI ; Jian JIANG ; Yinlian ZHANG ; Xuemei LI ; Jingyu ZHANG ; Yuqiong HUANG ; Zilin JIN ; Yixuan Wang WAN ; Suwen LIU ; Nan YU ; Hongxiang CHEN
Frontiers of Medicine 2025;19(4):653-664
Psoriasis is a chronic inflammatory skin disease, and its pathogenesis is largely modulated by abnormal angiogenesis. Previous research has indicated that AlkB homolog 5 (ALKBH5), an important demethylase affecting N6-methyladenosine (m6A) modification, plays a role in regulating angiogenesis in cardiovascular and eye diseases. Our present study found that ALKBH5 was upregulated and co-localized with cluster of differentiation 31 (CD31) in the skin of IMQ group compared with control group. ALKBH5-deficient mice decreased IMQ-induced psoriatic dermatitis and exhibited histological improvements, including decreased epidermal thickness, hyperkeratosis, numbers of dermal capillary vessels and inflammatory cell infiltration. ALKBH5-KO mice alleviated angiogenesis in psoriatic lesions by downregulating the protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway. Additionally, the expression of ALKBH5 was significantly upregulated in IL-17A-induced human umbilical vein endothelial cells (HUVECs), which further promoted the expression of angiogenesis-related cytokines and endothelial cell proliferation. Cell proliferation and angiogenesis were suppressed in ALKBH5 knockdown group, whereas ALKBH5 overexpression promoted these processes. The regulation of angiogenesis in HUVECs by ALKBH5 was facilitated through the AKT-mTOR pathway. Collectively, ALKBH5 plays a pivotal role in psoriatic dermatitis and angiogenesis, which may offer a new potential targets for treating psoriasis.
Animals
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Psoriasis/chemically induced*
;
Mice
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Humans
;
Neovascularization, Pathologic/genetics*
;
Human Umbilical Vein Endothelial Cells/metabolism*
;
AlkB Homolog 5, RNA Demethylase/genetics*
;
Proto-Oncogene Proteins c-akt/metabolism*
;
TOR Serine-Threonine Kinases/metabolism*
;
Cell Proliferation
;
Mice, Knockout
;
Disease Models, Animal
;
Signal Transduction
;
Male
;
Skin/blood supply*
;
Mice, Inbred C57BL
;
Angiogenesis
7.Inhibitory effect of safranal on proliferation,migration and phenotypic transformation of vascular smooth muscle cells of rats induced by high glucose in vitro
Yixuan GAO ; Peng WANG ; Silong ZHANG ; Ruijuan GAO ; Yingfang MA ; Keke ZHANG ; Dan FENG ; Zongqi HUANG ; Ketao MA ; Li LI ; Junqiang SI
Journal of Jilin University(Medicine Edition) 2025;51(4):948-957
Objective:To discuss whether safranal affects the proliferation,migration,and phenotypic transformation of the vascular smooth muscle cells(VSMCs)in a high-glucose environment and to clarify the function of safranal in the prevention and treatment of diabetic(DM)vascular complications.Methods:The SD rats were selected as experimental subjects;primary VSMCs were cultured from rat thoracic aortas and divided into control group,25 mmol·L-1 high glucose(HG)group,HG+20 μmol·L-1 safranal group,HG+40 μmol·L-1 safranal group,and HG+80 μmol·L-1 safranal group.The cells in control group received no treatment;the cells in 25 mmol·L-1 HG group were pretreated with 25 mmol·L-1 HG;the cells in HG+20,40,and 80 μmol·L-1 safranal groups were further treated with 20,40,and 80 μmol·L-1 safranal respectively for 48 h on the basis of 25 mmol·L-1 HG group.Cell counting kit-8(CCK-8)method was used to determine the appropriate concentration of safranal and detect the viabilities of the VSMCs in various groups;cell scratch healing assay was used to detect the scratch healing rates of the VSMCs in various groups;Transwell chamber assay was used to detect the numbers of the migration VSMCs in various groups;immunofluorescence method was used to detect the fluorescence intensities of alpha-smooth muscle actin(α-SMA)and rabbit anti-osteopontin(OPN)in the VSMCs in various groups;Western blotting method was used to detect the expression levels of OPN,α-SMA,and proliferating cell nuclear antigen(PCNA)in the VSMCs in various groups.Results:Under microscope,on the 4th day of in vitro culture,the spindle-shaped or triangular cells crawled out from the edge of the thoracic aorta tissue blocks,with long spindle being the most common morphology.On the 14th,the cells gradually covered the bottom of the dish;when cell density reached 80%-90%,the characteristic"hills and valleys"growth pattern appeared.Third-generation cells were taken for immunofluorescence identification;immunofluorescence staining with VSMC-specific marker α-SMA showed positive expression of α-SMA protein in the primarily cultured VSMCs.The CCK-8 assay results showed that compared with control group,the cell viability of the cells in 160 μmol·L-1 safranal group was significantly decreased(P<0.01),indicating toxic damage to the cells.Under the conditions of safranal concentrations at 20,40,and 80 μmol·L-1 respectively,after 48 h intervention on VSMCs,no significant adverse effect on cell viability was observed;considering both the effect and toxicity of safranal,these three concentrations were used in subsequent cell experiments.After 48 h intervention,compared with control group,the activity of the VSMCs in 25 mmol·L-1 HG group was increased(P<0.001);compared with 25 mmol·L-1 HG group,the activities of the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were gradually decreased(P<0.05).The cell scratch healing assay and Transwell assay results showed that after 48 h intervention,the scratch healing rate of the VSMCs in 25 mmol·L-1 HG group was significantly higher than that in control group(P<0.01),and the number of transmembrane cells through the Transwell chamber was significantly increased(P<0.05);compared with 25 mmol·L-1 HG group,the scratch healing rates of the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were gradually decreased(P<0.05),and the number of transmembrane cells was decreased(P<0.05).The immunofluorescence staining results showed that compared with control group,the fluorescence intensity of α-SMA protein in the VSMCs in 25 mmol·L-1 HG group was significantly weakened(P<0.001),while the fluorescence intensity of OPN protein was significantly enhanced(P<0.001);compared with 25 mmol·L-1 HG group,the fluorescence intensities of α-SMA protein in the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were gradually increased(P<0.05),and the fluorescence intensities of OPN were gradually weakened(P<0.05).The Western blotting method results showed that compared with control group,the expression level of α-SMA protein in the VSMCs in 25 mmol·L-1 HG group was decreased(P<0.05),and the expression levels of PCNA and OPN proteins were increased(P<0.01);compared with 25 mmol·L-1 HG group,the expression level of α-SMA protein in the VSMCs in HG+20,40,and 80 μmol·L-1 safranal groups were increased(P<0.05),and the expression levels of PCNA and OPN proteins were decreased(P<0.05).Conclusion:Safranal can inhibit the proliferation,migration,and phenotypic transformation of the VSMCs induced by high glucose.
8.Latent class analysis of the behavioral lifestyle of diabetic patients in community diabetes based on the perspective of lifestyle medicine
Yixuan ZHANG ; Tianyuan FENG ; Yifei GAO ; Meixiang HUANG ; Luyi GUO
Journal of Public Health and Preventive Medicine 2024;35(5):28-32
Objective To explore the latent class and influencing factors between different behavioral lifestyles in community patients with diabetes, to classify the population and reveal the behavioral lifestyle characteristics of different types of diabetes, and to provide a scientific basis for active health management of diabetes, the identification of high-risk groups and maximization of the effect of intervention measures. Methods From June to August 2022, a behavioral and lifestyle follow-up survey was conducted on 1 179 diabetes patients with electronic health records from 18 community health service centers in Pingshan District, Shenzhen. The latent class analysis (LCA) method was used to cluster the life and behavior style of the study subjects, and the disordered multi-classification logistic regression was used to analyze the influencing factors of each class. Results The LCA results showed that there were three latent classes of community diabetes patients: “overweight and obese group” (28.4%), “balanced diet group” (30.8%), and “vegetarian but persistent exercise group” (40.8%). Logistic regression analysis results showed that age, total cholesterol , LDL , fasting blood glucose, comorbidities, and hypertension history affected the latent classes of behavioral lifestyle in diabetic patients in the community (P<0.05). Conclusion The behavioral lifestyle of community diabetes patients has obvious classification characteristics and obvious differentiation in terms of eating behavior. Doctors and health managers can issue corresponding lifestyle medicine prescriptions and formulate corresponding active health management measures to prevent the occurrence of risk factors related to diabetes patients in advance and formulate personalized intervention measures.
9.The association between vitamin intake and the progression of metabolic dysfunction-associated fatty liver disease
Renling YAO ; Yixuan ZHU ; Rui HUANG ; Jie LI
The Journal of Practical Medicine 2024;40(6):820-826
Objective There is a Few studies explored the association between vitamin intake and meta-bolic dysfunction-associated fatty liver disease(MAFLD),while the existing results were still contradictory.This study aimed to investigate the association between dietary vitamins and all-cause mortality as well as fibrosis risk in patients with MAFLD.Methods The data were extracted from the third National Health and Nutrition Examination Surveys 1988-1994.Dietary vitamins was assessed using a 24 h diet recall,including vitamin A,vitamin B6,vitamin B12,vitamin C,vitamin D,thiamin,riboflavin,folic acid and α-tocopherol.The non-alcoholic fatty liver disease fibrosis score(NFS)<-1.455 was considered as non-advanced fibrosis,while NFS≥-1.455 was considered as advanced fibrosis.Results A total of 3844 MAFLD participants were included in this study.The median time of follow-up was 310 months.1739 participants(45.3%)were deceased during the follow-up.The intake of thiamin,riboflavin,α-tocopherol,VB6,and VB12 were significantly higher in patients with NFS-determined non-advanced fibrosis(P<0.05).After adjusting,a significantly lower risk of fibrosis was found in patients with the highest quartile(>11.5 mg/d)of α-tocopherol intake compared to the lowest intake group(P = 0.031).Compared to the lowest quartile group,the risk of mortality was reduced by 0.34 folds in the group consuming the highest quartile amount(>130 mg/d)of VC(HRs:0.66,95%CI:0.51~0.85,P = 0.001).Conclusions More α-tocopherol intake reduced fibrosis grade in MAFLD patients.VC intake may reduce all-cause mortality in patients with MAFLD.
10.Effect of three-dimensional spatial distribution of necrotic and support areas on outcomes of fibular support for hip preservation
Xinwei YUAN ; Yixuan HUANG ; Hongzhong XI ; Mingbin GUO ; Jianbin MAI ; Guangquan SUN ; Xin LIU ; Bin DU
Chinese Journal of Tissue Engineering Research 2024;28(18):2789-2794
BACKGROUND:The distribution of the necrotic area plays an important role in hip preservation treatment.At present,there are few studies on whether the difference in the three-dimensional spatial distribution of osteonecrosis of the femoral head affects the clinical outcome of fibular support. OBJECTIVE:To explore the relationship between the spatial distribution and clinical outcome at the sites of osteonecrosis of the femoral head and fibular support using CT three-dimensional reconstruction so as to provide a basis for optimizing the applicable conditions of fibular support and improving the hip preservation effect of fibular support. METHODS:Eighty patients with osteonecrosis of the femoral head who were treated with fibular support for hip preservation from January 2010 to January 2021 were selected as the study subjects according to the inclusion criteria.They were followed up for at least 2 years.According to the clinical outcome,the patients were divided into the successful hip preservation group(n=55)and the failure hip preservation group(n=25).3D reconstruction was performed according to the preoperative and postoperative CT images of the patients.According to the three-column theory,the femoral head was divided into outer nine areas,middle nine areas and inner nine areas(L1-9,C1-9,and M1-9)to explore the spatial distribution of necrotic area of the femoral head and fibular support area and its relationship with clinical outcome. RESULTS AND CONCLUSION:(1)Before operation,the necrotic area of the femoral head was mainly distributed in L1,L2,L4,L5,C1,C2,C4,and C5(the upper and middle part of the anterior part of the outer ninth area and the middle part of the middle ninth area).After operation,the fibular support area was mainly distributed in L5,L6,C5,and C6(the middle and lower part of the outer ninth area and the middle and lower part of the middle ninth area).(2)There were significant differences in the distribution of osteonecrosis of the femoral head between the successful hip preservation group and the failure hip preservation group in L8(the posterior middle part of the outer ninth area),C3(the anterior lower part of the middle ninth area),C6(the lower middle part of the middle part of the inner ninth area)and M2(the anterior middle part of the inner ninth area)(P<0.05).There was a significant difference in the distribution of fibular support in L5 and L6(middle and lower part of outer nine)(P<0.05).Among them,the L8 region could be used as an independent predictor of hip preservation failure in fibular support surgery.The area under the curve of the L8 single factor prediction model was 0.698[95%CI(0.575,0.822)];the sensitivity was 76%,and the specificity was 63.6%.(3)It turns out,when the necrotic area involves L8,C3,C6,and M2,especially L8,the failure of fibular support may increase,and when the fibular support involves L5 and L6,the effect of hip preservation is often not ideal.


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