Objective:To investigate the necessity of internal fixation of the fibular fracture in the treatment of degree Ⅱ ankle supination-external rotation injury by the Dias-Tachdjian classification in children.Methods:A retrospective study was conducted to analyze the data of 69 children with ankle fracture (degree Ⅱ ankle supination-external rotation injury by the Dias-Tachdjian classification) who had been treated at Department of Orthopedic Trauma, The People's Hospital of Weifang and Department of Pediatric Orthopedics, Tianjin Hospital from January 2015 to October 2021. There were 41 males and 28 females with an age of (10.1±1.4) years, and 37 left and 32 right sides affected. The patients were divided into 2 groups according to whether internal fixation of the fibular fracture was performed. Group A consisted of 21 cases with fibular internal fixation and group B of 48 cases without fibular internal fixation. The preoperative data, operation time and operation expenses were recorded and compared between the 2 groups. At the last follow-up, the anteroposterior and lateral radiographs of bilateral full length lower limbs and ankle joints were taken; the lateral distal tibial angle (LDTA) and the anterior distal tibial angle (ADTA) on the affected side, and the disparity between bilateral ankle tibiotalar angles were measured; ankle function was assessed according to the ankle-hindfoot score of American Association of Foot and Ankle Surgery (AOFAS); the occurrence of premature physeal closure (PPC) was recorded.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (19.5±4.1) months. At the last follow-up, the LDTA on the affected side was 89.6° (87.9°, 90.5°) in group A and 88.6°±1.9° in group B; the ADTA on the affected side was 80.9° (79.0°, 81.4°) in group A and 80.0° (78.6°, 81.2°) in group B; the disparity between bilateral ankle tibiotalar angles was 1.1°±0.5° in group A and 1.2°±0.5° in group B; the AOFAS ankle-hindfoot score was (89.5±5.2) points in group A and 89.0 (87.0, 92.0) points in group B. There was no statistically significant difference between the 2 groups in the above items ( P>0.05). The incidence of PPC was, respectively, 14.3% (3/21) and 14.6% (7/48) in groups A and B, showing no statistically significant difference ( P>0.05). Conclusions:In the treatment of degree Ⅱ ankle supination-external rotation injury in children, internal fixation of the fibular fracture has no significant effect on the imaging angles or the function of the ankle joint. After anatomic reduction of the distal tibia, the fibular fracture can be treated without internal fixation to reduce operational trauma, shorten operation time and reduce operation expenses.

Objective:To study the efficacy of closed reduction with a self-developed T-frame plus robotic navigation in the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children.Methods:A retrospective study was conducted to analyze the data of 67 children with supracondylar fracture of Gartland type Ⅲ who had undergone surgery at The Fifth Hospital of Harbin from January 2023 to March 2024. There were 35 males and 32 females with an age of (5.6±1.2) years. The children were divided into 2 groups according to different surgical methods. The control group (33 cases) was treated by closed reduction and internal fixation with percutaneous K-wire and the study group (34 cases) by closed reduction with a self-developed T-frame plus robotic navigation for internal fixation with percutaneous K-wire. The operation time, anatomical reduction, intraoperative fluoroscopy frequency, intraoperative needle adjustment, Flynn score at the last follow-up and complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All children were followed up for (6.3±2.5) months after surgery. There were no significant differences in operation time, Flynn score at the last follow-up or incidence of complications between the study and the control groups ( P>0.05). The rate of anatomical reduction in the study group (97.1%, 33/34) was significantly higher than that in the control group (54.5%, 18/33), and the intraoperative fluoroscopy frequency [(11.6±2.5) times] and needle adjustment (5.6±1.2) times in the study group were significantly lower than those in the control group [(37.2±2.1) times and (28.7±3.9) times] ( P<0.05). Conclusions:In the treatment of supracondylar humeral fractures of Gartland type Ⅲ in children, our self-developed T-frame can play a good role in fracture reduction and temporary fixation, avoiding iatrogenic secondary injuries caused by freguent reduction and adjustment of needle threading in the course of robotic navigation.

Objective To clarify the traditional Chinese medicine(TCM)constitution and TCM patterns in patients with recurrent spontaneous abortion(RSA)in Foshan area,and explore the correlation between them.Methods Totally 310 RSA patients were selected,and tongue,facial photos,and pulse diagnosis data were collected using the traditional Chinese medicine physical fitness four diagnosis instrument.The data was used to analyze the distribution and correlation of TCM constitution and TCM patterns of RSA patients in Foshan area.Results The top four constitution are Qi stagnation constitution,phlegm dampness constitution,Yin deficiency constitution,and Qi deficiency constitution,with kidney deficiency type being the most common among TCM patterns.People with Qi deficiency and Yang deficiency constitutions are prone to the syndrome of weak Qi and blood.People with yin deficiency constitution are prone to blood heat syndrome type.People with phlegm dampness and dampness heat constitution are prone to the syndrome of spleen and kidney deficiency.People with blood stasis constitution are prone to developing blood stasis syndrome types.Conclusion The TCM constitution and TCM patterns in Foshan area are obvious.TCM constitution is closely related to traditional TCM patterns,and different constitutions may affect the onset and clinical symptoms of RSA patients.

【Objective】 To analyze the related factors affecting perioperative blood transfusionin patients undergoing totalhysterectomy, explorethe effective measures to reduce allogeneic blood transfusion and provide data for the establishment of clinical blood transfusion single-disease evaluation index of total hysterectomy. 【Methods】 747 cases of total hysterectomy from three grade-A tertiary general hospitals and onematernal and child health care hospitalin Dalian wereselected, and divided into transfusion group(n=69)and non-transfusion(n=678). Detailed information was collected and analyzed, including patient demographics, operation information, blood routine before operation, postoperative recovery and transfusion volume. 【Results】 9.2%(69/747)of total hysterectomy patients received blood transfusion, with per capita red blood usageof(0.4±2.1)U. The age, operative time, volume of intra-operationbleeding, pre-operationhemoglobin(Hb) level, length ofhospital stay, types and days of antibiotics use between transfusion group and non-transfusion groupwere (49.7±9.1)vs(53±9.5)years old, (182.7±83.5)vs(119.5±64.8)min, (603±650)vs(160±173)mL, (96±26)vs(124±18)g/L, (9.3±4.8)vs(7.3±3.9)days, (2.2±1.1)vs(1.6±0.7)kinds, (6.0±3.9)vs (4.4±2.2)days, respectively, showing significant differences(P<0.05). Transfusion volumewas associated with volume of intra-operation bleeding (r=0.004), operative time (r=0.002) and Hb level of pre-operation(r=-0.022). 【Conclusion】 Blood management of patients undergoingtotal hysterectomy should be strengthened to reduce the incidence of allogeneic blood transfusion and improve patient outcomes by raising the pre-operation Hb level, shortening the operative time and reducing the volume of intra-operation bleeding.

OBJECTIVETo investigate characteristics and the differences of the anatomical parameters of the proximal femur of the developmental dysplasia of the hip (DDH).

METHODSA total of 38 patients(47 hips) diagnosed as DDH with CT scan data and the pelvis radiograph from January 2012 to December 2014 in China-Japan Union Hospital of Jilin University were retrospectively analyzed. All the hips were divided into 3 groups according to Crowe classification method. Thirty normal hips were selected as controls who admitted at the same time. CT data of the patients were imported into Mimics 17.0. The three-dimensional models of the proximal femur were then reconstructed, and the following parameters were measured: neck-shaft angle, neck length, offset, height of the centre of femoral head, height of the isthmus, height of greater trochanter, the medullary canal diameter of isthmus (Di), the medullary canal diameter 10 mm above the apex of the lesser trochanter (DT+ 10), the medullary canal diameter 20 mm below the apex of the lesser trochanter (DT-20), and then DT+ 10/Di, DT-20/Di and DT+ 10/DT-20 were calculated.Variance discrepancy analysis was used to compare the difference among the four groups, and LSD method was used to compare the difference between either two groups.

RESULTSThe parameters of neck-shaft angle of DDH with Crowe I, Crowe II-III, Crowe IV and the control group were (131.8°±7.1°), (131.7°±6.5°), (122.8°±11.4°) and (131.8°±5.9°), respectively; the parameters of neck-shaft angle of DDH with Crowe IV was smaller than that of DDH with Crowe I, Crowe II-III and control group (all P<0.05). The parameters of the neck length of DDH with Crowe IV ((44.6±6.6) mm) was smaller than that of DDH with Crowe I ((48.6±6.7) mm), Crowe II-III ((50.4±4.7) mm) (all P<0.05). There is no statistic difference in the offset among the groups (F=2.392, P>0.05). The parameters of the height of greater trochanter of DDH with Crowe IV ((12.1±6.1) mm) was bigger than that of DDH with Crowe I ((8.9±7.2) mm), Crowe II-III ((7.5±3.3) mm) and control group ((6.1±3.9) mm) (all P<0.05). The parameters of the height of the centre of femoral head of DDH with Crowe I, Crowe II-III, Crowe IV were (39.6±6.5) mm, (39.1±4.2) mm, (38.8±8.6) mm, which were smaller than that of the control group ((46.5±6.2) mm) (all P<0.05). The parameters of Di of DDH with Crowe I, Crowe II-III, Crowe IV and the control group were (9.9±2.2) mm, (8.3±1.8) mm, (8.7±1.7) mm and (10.1±1.4) mm; the parameters of Di of DDH with Crowe II-III and Crowe IV were smaller than that of the control group (all P<0.05). The parameters of DT+ 10 ((17.2±5.3) mm) and DT-20 ((12.2±3.0) mm) of DDH with Crowe IV were smaller than that of DDH with Crowe I ((25.2±3.4) mm, (17.1±2.3) mm) and Crowe II-III ((21.9±4.2) mm, (16.3±3.2) mm) (all P<0.05). The parameter of the height of the isthmus of DDH with Crowe IV ((94.1±19.7) mm) was smaller than that of DDH with Crowe I ((106.2±13.8) mm), Crowe II-III ((108.8±10.5) mm) and control group ((116.5±10.6) mm), respectively (P=0.010, 0.008, 0.000). The parameters of DT+ 10/Di (2.0±0.4) and DT-20/Di (1.4±0.2) of DDH with Crowe IV were smaller than that of DDH with Crowe I (2.6±0.5, 1.8±0.3), Crowe II-III (2.7±0.60, 1.9±0.3) (all P<0.05).

CONCLUSIONSComparing to DDH with Crowe I-III and control group, DDH with Crowe IV has a dramatic change in the intramedullary and extramedullary parameters. The isthmus and the great trochanter are higher and there is apparent narrowing of the medullary canal around the level of the lesser trochanter.

Adult ; Analysis of Variance ; Case-Control Studies ; Femur ; abnormalities ; diagnostic imaging ; Hip Dislocation, Congenital ; classification ; diagnostic imaging ; Hip Joint ; diagnostic imaging ; Humans ; Retrospective Studies ; Tomography, X-Ray Computed

In recent years,stem cell research has been developing quickly in biological science.As the key of regenerative medicine,stem cell therapy becomes another innovative treatment following drug therapy and surgery.In vivo stem cell tracking,including optical imaging,radionuclide imaging and MRI,can trace the viability,distribution and function of engrafted cells.Multimodal imaging integrates two or more types of imaging techniques to obtain the combined advantages of each technology,and therefore is able to accurately and effectively trace stem cell in vivo,hopefully promoting its clinical transformation.This paper reviews the application of multimodal imaging in stem cell research.

Objective To investigate the application of magnetic resonance imaging (MRI) fluid-attenuated inversion recovery vascular hyperintensities (FVH) for the diagnosis of transient ischemic attack (TIA). Methods Consecutive 218 inpatients for TIA from May 2011 to July 2013 were reviewed with gender, age, cardiovascular risk factors, TIA or a history of stroke, TIA duration, and calculate the ABCD2 scores. All patients accepted MRI and MRA within 24 hours of symptom onset. FVH positive patients would follow up MRI and MRA within 7 days. All the patients were followed up in 90 days. Results FVH was identified in 45 patients (21%), 15 cases of them was found diffusion weighted imaging (DWI) hyperintensities on the same sides. The prevalence of atrial fibrillation (AF, P<0.001), DWI positive (P= 0.010) and arterial occlusive lesions (AOL, P=0.003) were more in the FVH positive patients than in the negative ones, while the duration of symptoms was shorter (P=0.010). Multivariate Logistic regression analysis showed that AF (OR=7.17, 95% CI: 2.71-18.4), AOL (OR=4.93, 95% CI: 3.53-12.6) and hemiplegic (OR=2.84, 95% CI: 1.21-7.42) independently associated with FVH. 7 days after the onset, FVH was not found in 15 patients (65%, transient FVH), in whom the prevalence of AF was more (P=0.020), and AOL was less (P<0.001). A total of 197 patients (90%) were successfully followed up. In the FVH-positive patients, 5 cases developed into recurrent TIA and 6 into ischemic stroke (IS), focused on the the same sides of FVH; while the FVH-negative patients, 2 cases developed into recurrent TIA and 5 into IS. COX proportional hazard analysis showed that FVH (HR=3.64, 95% CI: 1.08-12.6) and AOL (HR=3.82, 95% CI: 1.07-15.8) independently associated with the recurrence of TIA or IS. Conclusion FVH can be helpful for the diagnosis of TIA and predictions for recurrent TIA or IS after a TIA.

Objective To explore the influence of pelvis obliquity in lateral position to acetabular component orientation during total hip arthroplasty (THA),and the method to correct.Methods Fifty patients (62 hips) were performed THA with posterolateral incision in lateral position by the same team.The patients were randomized and divided into experimental group (EX,with 25 cases,34 hips) and control group (CON,with 25 cases,28 hips).In EX group,the acetabular components were placed by means of the gradienter and plumb correcting technique during THA.While in CON group,the acetabular components were placed by traditional method during THA.The acetabular abduction angles were measured postoperatively,and compared between the two groups.Results The average obliquity of pelvis was-1.647°±4.512°in EX group when putting the patient in lateral position before correcting.Through the application of gradienter and plumb,the average abduction angle of acetabular component was 42.685°±3.355° postoperatively,with the difference of 1.962°±1.515° compared with the preoperative angles.And in CON group,the average abduction angle of acetabular component was 44.534°±4.844° postoperatively,with the difference of 4.244°±3.042°.The difference of abduction angle in CON group was much higher than that in EX group (P＜0.05).Conclusion The pelvic obliquity when putting the patient under lateral position will affect the surgeons'judgments of placing acetabular component during THA,furthermore,lead to inconsistency among the abduction angles obtained preoperatively,intraoperatively and postoperatively.By applying the correcting method with gradienter and plumb,the discrepancy can reduce obviously between the abduction angle measured postoperatively and that of measured during operation comparing with traditional method.

Objective To evaluate the diagnostic value of tracking movement of normal patellar using volume scan on sensation 320 CT. Method Data of dynamic scans of 30 knees was collected using the motor function of 320 CT and retrospectively analyzed. The data of movement of the patellorfemoral joint was obtained during flexion (from 0° to 120°) within 10-sec by 320 CT from all volunteers. The 3D coordinate of the center of patella was recorded to investigate the dispose relation of patellofemoral joint.Result With the knee angle changed from 0° to 90°, the patella moved rapidly along the Y-axis direction ( sagittal plane) down about (53.87 ± 0. 45 ) mm, and then entered the plateau phase with little change.When the knee flexion reached 10°-30° ,the patellar movement along the X-axis reached the largest range of (2. 31 ±0. 52)-(3.36 ± 0. 43 ) mm, and subsequently moved to the opposite lateral direction with the maximum about (8. 53 ± 0. 44 ) mm at 120°. In the Z axis, the track initially showed plateau, and then presented a rapidly downward trend after 30°. The patellar tracking is like an outward arc during the whole knee flexion. Conclusion The motor functional imaging of 320 CT can pinpoint the patelar tracking in a fast, painless way.