Objective:To explore the efficacy and safety of negative-pressure wound therapy (NPWT) in treating infected wounds in orthopedic trauma patients.Methods:China National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Data Knowledge Service Platform, PubMed, Web of Science, Cochrane Library, and CINAHL were searched for randomized controlled trials (RCT) and cohort studies examining the impact of NPWT on wound healing in orthopedic trauma infections. The retrieval time was from the establishment of the databases to October 2024. RevMan 5.4 software was used for Meta-analysis. The patients were divided into two groups according to different treatment methods: the intervention group, treated with NPWT, and the control group, treated with conventional treatment. The observed indicators included clinical efficacy, wound healing quality, length of hospital stay, wound healing time, incidence of complications, secondary surgery rate, and duration of antibiotic use. Publication bias analysis was performed on the observed indicators through Begg and Egger tests.Results:A total of 13 studies were included, comprising 11 RCT and 2 cohort studies, involving a total of 3 538 patients, with 1 762 in the intervention group and 1 776 in the control group. The meta-analysis results indicated that the intervention group had better clinical efficacy ( OR=7.08, 95% CI 5.31, 9.45, P<0.01), higher wound healing quality ( MD=4.15, 95% CI 3.99, 4.32, P<0.01), shorter length of hospital stay ( MD=-13.38, 95% CI -14.39, -12.38, P<0.01), shorter wound healing time ( MD=-8.11, 95% CI -10.22, -6.00, P<0.01), lower incidence of complications, lower secondary surgery rate ( OR=0.22, 95% CI 0.09, 0.57, P<0.01), and shorter duration of antibiotic use ( MD=-7.61, 95% CI -8.06, -7.16, P<0.01) when compared with the control group. No significant publication bias was observed in the aforementioned indicators ( P>0.05). Conclusion:Compared with the conventional treatment, NPWT can enhance the clinical efficacy and wound healing quality of infected wounds in orthopedic trauma patients, shorten length of hospital stay and wound healing time, reduce the incidence of complications and secondary surgery rates, and shorten the duration of antibiotic use.

OBJECTIVE: To investigate the technical key points and effectiveness of ultrasonic bone scalpel-assisted anterior controllable antedisplacement and fusion (ACAF) for treating cervical ossification of the posterior longitudinal ligament (OPLL). METHODS: Between June 2022 and December 2024, 11 OPLL patients underwent ultrasonic bone scalpel-assisted ACAF. The cohort included 8 males and 3 females, aged 49-74 years (mean, 56.7 years). The OPLL classification included 5 cases of mixed-type, 4 cases of segmental-type, and 2 cases of continuous-type cases. Ossification involved 2-5 spinal segments (mean, 3.2). Disease duration ranged from 2 to 18 months (mean, 6.2 months). The operation time, intraoperative blood loss, and complications were recorded. Pain improvement was assessed using the visual analogue scale (VAS) score, and neurological function was evaluated using Japanese Orthopaedic Association (JOA) score. Postoperative cervical CT and MRI were performed to measure spinal canal encroachment rate, spinal canal area, and spinal cord sagittal diameter. RESULTS: All operations were successfully completed. The operation time ranged from 174 to 360 minutes (mean, 255.9 minutes). The intraoperative blood loss ranged from 170 to 530 mL (mean, 345.9 mL). The C ₅ nerve root palsy occurred in 1 patient. No cerebrospinal fluid leakage, aggravated spinal cord injury, or recurrent/superior laryngeal nerve injuries occurred. All patients were followed 3-12 months (mean, 7.2 months). At last follow-up, VAS scores significantly decreased and JOA scores significantly increased compared to preoperative values ( P<0.05). According to the JOA improvement rate, the effectiveness was rated as excellent in 2 cases, good in 8, and fair in 1, with an excellent and good rate of 90.9%. Radiological re-examination revealed no implant loosening, screw breakage, or aggravated spinal stenosis. Postoperative spinal canal encroachment rate significantly decreased, while spinal canal area and spinal cord sagittal diameter significantly increased compared to preoperative measurements ( P<0.05). CONCLUSION For the treatment of cervical OPLL via ACAF, the intraoperative application of ultrasonic bone scalpel-assisted osteotomy enables precise vertebral groove creation and mobilization of the vertebra-ossification complex, thereby enhancing surgical safety and achieving satisfactory short-term effectiveness.
Humans ; Middle Aged ; Male ; Female ; Ossification of Posterior Longitudinal Ligament/diagnostic imaging* ; Aged ; Cervical Vertebrae/diagnostic imaging* ; Spinal Fusion/instrumentation* ; Treatment Outcome ; Ultrasonic Surgical Procedures/instrumentation* ; Operative Time

OBJECTIVE: To define a safe distance range from the LC-Ⅱ screw trajectory to the apex of the greater sciatic notch based on pelvic CT measurements, and to clinically assess the feasibility of using this range under iliac oblique view combined with iliac tangential view fluoroscopy to guide screw insertion. METHODS: CT scans of 104 normal pelvises collected between January 2022 and February 2025 were analyzed. There were 52 males and 52 females, with a median age of 45.8 years (range, 19-76 years). The RadiAnt DICOM Viewer software was used to reconstruct coronal, sagittal, and axial sections of the potential LC-Ⅱ screw trajectory. The maximum safety distance (Dmax) and the optimal safety distance (Dopt) from this trajectory to the greater sciatic notch were measured on the coronal and sagittal views. A retrospective analysis was conducted on 21 patients with LC-Ⅱ type pelvic fractures treated with the LC-Ⅱ screws fixation. And the screws were placed within the pre-defined safe distance under guidance from the iliac oblique view and iliac tangential view. Postoperative CT scans were obtained to evaluate the accuracy of screw placement. RESULTS: Radiographic measurements from the 104 cases showed that Dmax ranged from 1.87 to 3.87 cm (mean, 2.79 cm), and Dopt ranged from 1.01 to 2.92 cm (mean, 1.84 cm). Both Dmax and Dopt were significantly greater in the males than in the females ( P>0.05). No significant difference was found between the left and right sides within the same gender ( P>0.05). All 21 patients successfully underwent fracture reduction and fixation, with a total of 23 LC-Ⅱscrews implanted. According to the Lonstein grading system, the screw placement accuracy was rated as excellent in 16 screws, good in 3, fair in 3, and poor in 1, with an excellent and good rate of 82.6%. CONCLUSION Utilizing a CT-defined safe distance range from the screw trajectory to the greater sciatic notch, and adhering to this range under iliac oblique view combined with iliac tangential view fluoroscopy, enables the accurate and precise placement of LC-Ⅱ screws.
Humans ; Male ; Female ; Middle Aged ; Bone Screws ; Adult ; Tomography, X-Ray Computed/methods* ; Aged ; Ilium/surgery* ; Pelvic Bones/diagnostic imaging* ; Fracture Fixation, Internal/instrumentation* ; Retrospective Studies ; Fluoroscopy ; Fractures, Bone/diagnostic imaging* ; Young Adult

Objective:To explore the efficacy and safety of negative-pressure wound therapy (NPWT) in treating infected wounds in orthopedic trauma patients.Methods:China National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Data Knowledge Service Platform, PubMed, Web of Science, Cochrane Library, and CINAHL were searched for randomized controlled trials (RCT) and cohort studies examining the impact of NPWT on wound healing in orthopedic trauma infections. The retrieval time was from the establishment of the databases to October 2024. RevMan 5.4 software was used for Meta-analysis. The patients were divided into two groups according to different treatment methods: the intervention group, treated with NPWT, and the control group, treated with conventional treatment. The observed indicators included clinical efficacy, wound healing quality, length of hospital stay, wound healing time, incidence of complications, secondary surgery rate, and duration of antibiotic use. Publication bias analysis was performed on the observed indicators through Begg and Egger tests.Results:A total of 13 studies were included, comprising 11 RCT and 2 cohort studies, involving a total of 3 538 patients, with 1 762 in the intervention group and 1 776 in the control group. The meta-analysis results indicated that the intervention group had better clinical efficacy ( OR=7.08, 95% CI 5.31, 9.45, P<0.01), higher wound healing quality ( MD=4.15, 95% CI 3.99, 4.32, P<0.01), shorter length of hospital stay ( MD=-13.38, 95% CI -14.39, -12.38, P<0.01), shorter wound healing time ( MD=-8.11, 95% CI -10.22, -6.00, P<0.01), lower incidence of complications, lower secondary surgery rate ( OR=0.22, 95% CI 0.09, 0.57, P<0.01), and shorter duration of antibiotic use ( MD=-7.61, 95% CI -8.06, -7.16, P<0.01) when compared with the control group. No significant publication bias was observed in the aforementioned indicators ( P>0.05). Conclusion:Compared with the conventional treatment, NPWT can enhance the clinical efficacy and wound healing quality of infected wounds in orthopedic trauma patients, shorten length of hospital stay and wound healing time, reduce the incidence of complications and secondary surgery rates, and shorten the duration of antibiotic use.

Objectives:To explore the risk factors related to the prolonged postoperative length of hospital stay(LOS)in patients after spinal tuberculosis lesion removal and fusion with internal fixation,and to construct a nomogram prediction model,so as to provide a theoretical basis for the enhanced recovery management of spinal tuberculosis patients.Methods:The clinical data of 142 patients with spinal tuberculosis who underwent lesion removal and fusion with internal fixation in the Department of Orthopedics of the Affiliated Hospital of Zunyi Medical University between December 2018 and June 2023 were retrospectively analyzed.The patients were randomly divided into modeling group(n=96)and validation group(n=46)in a 2∶1 ratio.Setting the postoperative LOS＞21d as the outcome variable for prolonged LOS,and taking age,gender,alcohol history,smoking history,hypertension,coronary heart disease,diabetes,anemia,postoperative hypoproteinemia,spinal cord injury,tuberculosis in other parts,bone destruction,blood transfusion,removal time of drainage,postoperative complications,operative time,blood loss,preoperative American Society of Anesthesiologists(ASA)score,postoperative ASA score,surgical incision length,pus formation,chemotherapy before surgery,and chemotherapy regimens as independent variables to develop univariate logistic regression model.The risk factors screened after univariate analysis were included for multivariate logistic regression model to determine the independent risk factors for LOS＞21d after lesion removal and fusion with internal fixation in patients with spinal tuberculosis and to construct a predictive model for risk factors.The area under the curve(AUC)of receiver operating characteristics(ROC)curve was used to assess the the differentiation of the model;Calibration curve was used to assess the calibration situation of the model;Decision curve analysis(DCA)was used to assess the clinical value and influence of the model on actual decision-making process.Data of validation group was applied to draw ROC curve and calibration curve for external verification.Results:Univariate and multivariate analyses revealed that age(OR=1.040,95%CI:1.011-1.069),tuberculosis at other sites(OR=2.867,95%CI:1.157-7.106),and preoperative ASA score(OR=1.543,95%CI:1.015-2.347)were the independent risk factors for prolonged postoperative hospitalization in patients with spinal tuberculosis after lesion removal and fusion with internal fixation.The AUC of ROC curves of modeling group and validation group were 0.767(95%CI:0.671-0.863)and 0.720(95%CI:0.569-0.871),respectively,suggesting the predictive model had good predictive efficiency.The results of the calibration curve analysis demonstrated that the actual curve roughly resembled the ideal curve,and DCA curve revealed that the nomogram had superior clinical benefits.Conclusions:The spinal tuberculosis patients who are at older age,combined with other sites of tuberculosis,and with high preoperative ASA score are prone to prolonged LOS after lesion removal and fusion with internal fixation,and the risk prediction nomogram model developed accordingly has great predictive efficiency.

BACKGROUND:Interleukin-8 is an important cytokine that has been found to play an important role in bone regeneration through multiple pathways. OBJECTIVE:To comprehensively review the action mechanism of interleukin-8 effects on bone regeneration to provide ideas for the following studies on interleukin-8. METHODS:By searching the China National Knowledge Infrastructure database for articles published from January 1999 to February 2023 and PubMed database for articles published from January 1985 to February 2023 reporting the role of interleukin-8 in bone-associated cells and vascularisation.Chinese and English search terms were"interleukin-8,bone repair,bone metabolism,mesenchymal stem cells,osteoblasts,osteoclasts,vascularization".The initial review yielded 508 articles in English and Chinese,and a total of 51 articles were included for review and analysis according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:According to the existing research,interleukin-8 can promote bone cell regeneration and assist bone healing through multiple pathways,which is mainly divided into three aspects:(1)Promote the proliferation and differentiation of bone cells such as mesenchymal stem cells and osteoblasts,and promote the development of cells in the direction of promoting bone healing;(2)interleukin-8 can promote angiogenesis and provide sufficient nutrition and oxygen for bone tissue,thus further improving the quality and stability of bone healing.(3)The appearance of interleukin-8 facilitates the expression of hypoxia-inducible factor-1α,vascular endothelial growth factor,and matrix metalloproteinase,which can create a microenvironment conducive to bone regeneration,thus promoting the regeneration and repair of bone tissue.In summary,interleukin-8 plays an important role in bone healing by promoting osteoblast proliferation and differentiation,facilitating angiogenesis and improving the mechanical properties of bone regeneration,as well as influencing bone metabolism through osteoclasts,mesenchymal stem cells,and other action sites.

Objective:To investigate the status of vertebral compression fracture (VCF) in elderly patients with osteoporosis and analyze its influencing factors.Methods:A total of 222 elderly patients with osteoporosis admitted to Department of Spinal Surgery in Affiliated Hospital of Zunyi Medical University from March 2019 to March 2023 were selected as the research objects by the convenient sampling method, and clinical data of the patients were collected. Patients were divided into VCF group ( n=98) and non-VCF group ( n=124) based on whether or not VCF occurred. Logistic regression was used to analyze the influencing factors of VCF in elderly patients with osteoporosis. Results:The incidence of VCF in 222 elderly patients with osteoporosis was 44.1% (98/222). The results of Logistic regression analysis showed that a history of falls ( OR=2.968, 95% CI: 1.154-7.736, P=0.024), no history of osteoporosis drug treatment ( OR=4.707, 95% CI: 1.525-14.531, P=0.007), body mass index>24.0 kg/m 2 ( OR=4.586, 95% CI: 2.071-10.158, P<0.001), lower bone density T values ( OR=3.221, 95% CI: 2.194-4.731, P<0.001) and low albumin ( OR=0.828, 95% CI: 0.752-0.913, P<0.001) were risk factors for VCF in elderly patients with osteoporosis. Conclusions:The incidence of vertebral compression fracture is high in elderly patients with osteoporosis, among which a history of falls, no history of osteoporosis drug treatment, body mass index greater than 24 kg/m 2, lower bone density T-values and low albumin are the main influencing factors that affect the occurrence of vertebral compression fracture in elderly patients with osteoporosis. Clinical medical staff should pay attention to these risk factors, identify the risk of fractures in elderly patients early and take targeted intervention measures.

Objective:To investigate the association between relative mitochondrial DNA copy number (mtDNA-CN) and coal-burning-borne endemic fluorosis (abbreviated as coal-burning-borne fluorosis).Methods:From June 2018 to March 2019, using cross-sectional study, 482 patients with coal-burning-borne fluorosis were selected as the case group in Bijie City, a typical coal-burning-borne fluorosis area of Guizhou Province; meanwhile, 212 healthy individuals from Changshun County, a non-coal-burning-borne fluorosis area in Guizhou Province, were selected as the control group. Questionnaire survey and physical examination were used to collect general condition such as basic information and living habits of the two groups, peripheral venous blood samples were collected, and real-time fluorescence quantitative PCR was used to detect the relative mtDNA-CN in peripheral blood. The correlation between relative mtDNA-CN and coal-burning-borne fluorosis was analyzed by binary and unordered multi-class logistic regression.Results:There were significant differences in the body mass index (BMI), and the distribution of gender rario, marital status and education level between the control group and the case group ( t = 7.91, χ 2 = 5.11, 13.33, 34.32, P < 0.05). The relative mtDNA-CN in the control group was higher than that in the case group [median (quartile): 202 (138, 292) vs 131 (96, 217), Z = - 7.80, P < 0.001]. The results of binary logistic regression analysis [odds ratio (95% confidence interval)] showed that educational level [primary school: 0.572 (0.377 - 0.868), junior high school and above: 0.292 (0.174 - 0.493)], relative mtDNA-CN [131 - < 217: 0.265 (0.144 - 0.488), ≥217: 0.183 (0.100 - 0.335)] and BMI [1.222 (1.142 - 1.307)] were the influencing factors for the risk of coal-burning-borne fluorosis( P < 0.05). In subgroups with different BMI and educational levels, the relative mtDNA-CN was significantly negatively correlated with the risk of coal-burning-borne fluorosis( Ptrend < 0.05), and there was no interaction between mtDNA-CN and BMI and educational levels ( Pinteraction > 0.05). The results of unordered multi-class logistic regression analysis showed that the relative mtDNA-CN were significantly negatively correlated with the risk of dental fluorosis and skeletal fluorosis ( Ptrend < 0.05). Conclusion:The higher the relative mtDNA-CN, the lower the risk of coal-burning-borne fluorosis, suggesting that mtDNA-CN may be a potential biomarker of coal-burning fluorosis.

Objective:To explore the relationship between children's intelligence and urinary fluoride in Suojia Township of Miao, Yi and Hui Nationalities (referred to as Suojia Township), a coal-burning-borne endemic fluorosis area in Guizhou Province.Methods:In April 2019, 173 children aged 10 to 13 years old were selected from three schools in Suojia Township. According to whether they had dental fluorosis, the children were divided into case group ( n = 104) and control group ( n = 69). Middle segment urine samples of the children were collected and urinary fluoride level was determined by the method of ion-selective electrode. Combined Raven's Test-the Rural in China (CRT-RC2) was used for children's intelligence quotient (IQ) test. Linear regression analysis was used to observe the association between urinary fluoride and IQ, and the results were expressed by regression coefficient ( β) and 95% confidence interval ( CI). Results:Urinary fluoride level of case group was higher than that of control group [(2.14 ± 1.78) vs (1.53 ± 0.98) mg/L], and IQ was lower than that of control group [(92.33 ± 11.68) vs (100.38 ± 11.87) points], and the differences were statistically significant ( t = 2.58, 4.41, P < 0.05). The linear regression equation of urinary fluoride ( X) and IQ ( Y) of case group was Y = 96.99 - 2.86 X. For every 1 mg/L increase in urinary fluoride level, IQ decreased by 2.86 points ( β = - 2.86, 95% CI: - 5.48 - - 0.24). Conclusion:Long-term exposure to fluoride pollution from coal burning may damage children's intelligence, and children's IQ decreases with increase of fluoride level in urine.

Objective:To investigate the relationship between gene polymorphism of osteoprotegerin (OPG) and coal-burning endemic fluorosis in Guizhou Province.Methods:In 2018 and 2019, a case-control study was conducted in Bijie City, a typical coal-burning endemic fluorosis area in Guizhou Province, and 260 cases of coal-burning endemic fluorosis patients were selected as case group. According to the "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008), the case group was divided into severe group (130 cases) and mild group (130 cases). At the same time, 130 cases without dental fluorosis and skeletal fluorosis symptoms were chosen as control group in Changshun County, a non-coal-burning endemic fluorosis area in Guizhou Province. Whole blood genomic DNA was extracted, and real-time fluorescence quantitative PCR with TaqMan-MGB probe was utilized to type the OPG gene rs2460985, rs2073618, rs6469804 and rs6993813 four single nucleotide polymorphism (SNP) loci of all samples, and genetic model analysis was performed to compare the frequency distribution of its alleles, genotypes and constructed haplotypes in control, mild and severe groups. Results:By Hardy-Weinberg equilibrium test, the genotype frequencies of the four SNP loci all reached genetic balance in control, mild and severe groups ( P > 0.05). There was a statistically significant difference in the genotype frequency of OPG gene rs6469804 locus among the three groups (χ 2 = 10.615, P < 0.05), and the difference in the genotype frequency of this locus between the control group and the severe group was statistically significant (χ 2 = 6.784, P < 0.05). The results of genetic model analysis showed that in comparison between the control group and the severe group, the optimal genetic model of rs6469804 locus was the overdominant genetic model, the frequency distribution of genotypes AA + GG and AG in the control group and the severe group was statistically significant [odds ratio ( OR) = 1.94, 95% confidence interval ( CI): 1.16 - 3.23, P < 0.05], genotype AG was a risk factor for coal-burning endemic fluorosis. In comparison between the control group and the mild group, the optimal genetic model of rs2073618 locus was the recessive genetic model, the frequency distribution of genotypes GG + GC and CC in the control group and the mild group was statistically significant ( OR = 3.17, 95% CI: 1.08 - 9.30, P < 0.05), genotype CC was a risk factor for coal-burning endemic fluorosis. In comparison between the control group and the mild group, haplotypes C-C-G-T and T-G-A-C were risk factors for coal-burning endemic fluorosis (adjusted OR = 2.41, 1.98, 95% CI: 1.29 - 4.50, 1.22 - 3.23, P < 0.05); in comparison between the control group and the severe group, haplotype T-G-A-C was a risk factor for coal-burning endemic fluorosis (adjusted OR = 1.87, 95% CI: 1.14 - 3.07, P < 0.05). Conclusion:OPG gene rs6469804 locus genotype AG and rs2073618 locus genotype CC may be risk factors for coal-burning endemic fluorosis.