OBJECTIVE: To explore the effectiveness of arthroscopic release of elbow joint assisted by medial small incision ulnar nerve release in the treatment of non-traumatic elbow stiffness. METHODS: The clinical data of 15 patients with non-traumatic elbow stiffness treated with arthroscopic release of elbow joint assisted by medial small incision ulnar nerve release between April 2019 and September 2023 were retrospectively analyzed. There were 6 males and 9 females with an average age of 46 years ranging from 34 to 56 years. The causes included rheumatoid arthritis in 3 cases, gouty arthritis in 2 cases, loose bodies in 3 cases, and elbow osteoarthritis in 7 cases. There were 4 cases with ulnar neuritis and 3 cases with synovial osteochondromatosis. The duration of elbow stiffness ranged from 6 to 18 months, with an average of 10 months. The operation time and intraoperative blood loss were recorded. The effectiveness was evaluated by visual analogue scale (VAS) score, range of elbow motion (maximum flexion, maximum extension, and total flexion and extension), Mayo score, and Hospital for Special Surgery (HSS) elbow score. RESULTS: The operation time was 60-90 minutes, with an average of 65 minutes, and the intraoperative blood loss was 40-100 mL, with an average of 62 mL. All patients were followed up 13-18 months, with an average of 14 months. There was no complication such as vascular and nerve injury, poor wound healing, collateral ligament injury, elbow joint space narrowing, osteophyte proliferation, or loose body formation around the joint. At last follow-up, the elbow range of motion (maximum flexion, maximum extension, and total flexion and extension), VAS score, and Mayo score significantly improved when compared with those before operation ( P<0.05). The HSS elbow score was 85-95, with an average of 92; 12 cases were excellent, 3 cases were good, and the excellent and good rate was 100%. CONCLUSION Arthroscopic release of elbow joint assisted by medial small incision ulnar nerve release is an effective way to treat non-traumatic elbow stiffness, which has the advantages of small trauma, short operation time, and good effectiveness. It can carry out early elbow rehabilitation training and significantly improve elbow function.
Humans ; Male ; Female ; Arthroscopy/methods* ; Adult ; Middle Aged ; Elbow Joint/physiopathology* ; Retrospective Studies ; Range of Motion, Articular ; Treatment Outcome ; Ulnar Nerve/surgery* ; Operative Time

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective To explore the clinical value of complement 1q(C1q),mannose-binding lectin(MBL)and complement 5a(C5a)in the early diagnosis and disease monitoring of diabetic kidney disease(DKD),as well as their relationship with renal tubular injury.Methods A total of 232 patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Kailuan General Hospital from December 2020 to December 2021 were selected in this study.Patients were divided into the simple diabetes mellitus(SDM)group(n=50)and the DKD group(n=182)based on urinary albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).The DKD group was further divided into the low-risk diabetic nephropathy(LDKD)group(n=90),the moderate-risk diabetic nephropathy(MDKD)group(n=55)and the high-risk diabetic nephropathy(HDKD)group(n=37)according to the risk of chronic kidney disease progression.Forty healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group(NC group).The DKD group was divided into the Q1-Q4 groups based on the quartile levels of NAG/Ucr according to the severity of renal tubular injury from mild to severe.General biochemical indicators,as well as the levels of C1q,MBL and C5a in each group were detected.Spearman correlation analysis was used to analyze the correlation between C1q,MBL,C5a and glomerular and tubular injury indexes.Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of the progression risk of DKD and the degree of renal tubular injury.Results The levels of systolic blood pressure,diastolic blood pressure,triglycerides(TG),serum creatinine(Scr),uric acid(UA),UACR,NAG/Ucr,C1q,MBL and C5a were higher in the DKD group than those in the SDM group and the NC group.The levels of TC,LDL-C,ApoB and HbA1c were higher than those in the NC group,while the level of HDL-C was lower than that in the NC group.The levels of TC,LDL-C,HbA1c and NAG/Ucr were higher in the SDM group than those in the NC group,while the level of HDL-C was lower than that in the NC group(P＜0.05).Among different progression risk groups of DKD,the levels of C1q were higher in the HDKD group than those in the SDM group and the LDKD group.The levels of MBL and C5a were higher in the MDKD group than those in the SDM group and the LDKD group,and the level of MBL was higher in the LDKD group than that in the SDM group(P＜0.05).After grouping according to the quartile levels of NAG/Ucr,the levels of TC,ApoB,HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q4 group than those in the Q1 group.The levels of TC,ApoB,Scr,UACR,C1q and C5a were significantly higher than those in the Q2 group,and the levels of UACR and C5a were significantly higher than those in the Q3 group.The levels of HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q3 group than those in the Q1 group.The level of UACR was higher in the Q2 group than that in the Q1 group(all P＜0.05).The Spearman correlation analysis showed that C1q,MBL and C5a were positively correlated with UACR and NAG/Ucr,and negatively correlated with eGFR(all P＜0.05).The ordinal Logistic regression analysis showed that elevated levels of MBL,C5a,NAG/Ucr,Scr and systolic blood pressure were independent influencing factors of progression risk in DKD patients.Elevated levels of C5a,HbA1c and UACR were independent influencing factors of renal tubular injury in DKD patients.Conclusion C1q and C5a can be used to monitor middle and late DKD and tubular injury,and C5a is an independent risk factor for DKD progression and tubular injury.MBL can be used to screen for early DKD and is also an independent risk factor for its progression.

Objective To explore the clinical value of complement 1q(C1q),mannose-binding lectin(MBL)and complement 5a(C5a)in the early diagnosis and disease monitoring of diabetic kidney disease(DKD),as well as their relationship with renal tubular injury.Methods A total of 232 patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Kailuan General Hospital from December 2020 to December 2021 were selected in this study.Patients were divided into the simple diabetes mellitus(SDM)group(n=50)and the DKD group(n=182)based on urinary albumin/creatinine ratio(UACR)and estimated glomerular filtration rate(eGFR).The DKD group was further divided into the low-risk diabetic nephropathy(LDKD)group(n=90),the moderate-risk diabetic nephropathy(MDKD)group(n=55)and the high-risk diabetic nephropathy(HDKD)group(n=37)according to the risk of chronic kidney disease progression.Forty healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group(NC group).The DKD group was divided into the Q1-Q4 groups based on the quartile levels of NAG/Ucr according to the severity of renal tubular injury from mild to severe.General biochemical indicators,as well as the levels of C1q,MBL and C5a in each group were detected.Spearman correlation analysis was used to analyze the correlation between C1q,MBL,C5a and glomerular and tubular injury indexes.Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of the progression risk of DKD and the degree of renal tubular injury.Results The levels of systolic blood pressure,diastolic blood pressure,triglycerides(TG),serum creatinine(Scr),uric acid(UA),UACR,NAG/Ucr,C1q,MBL and C5a were higher in the DKD group than those in the SDM group and the NC group.The levels of TC,LDL-C,ApoB and HbA1c were higher than those in the NC group,while the level of HDL-C was lower than that in the NC group.The levels of TC,LDL-C,HbA1c and NAG/Ucr were higher in the SDM group than those in the NC group,while the level of HDL-C was lower than that in the NC group(P＜0.05).Among different progression risk groups of DKD,the levels of C1q were higher in the HDKD group than those in the SDM group and the LDKD group.The levels of MBL and C5a were higher in the MDKD group than those in the SDM group and the LDKD group,and the level of MBL was higher in the LDKD group than that in the SDM group(P＜0.05).After grouping according to the quartile levels of NAG/Ucr,the levels of TC,ApoB,HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q4 group than those in the Q1 group.The levels of TC,ApoB,Scr,UACR,C1q and C5a were significantly higher than those in the Q2 group,and the levels of UACR and C5a were significantly higher than those in the Q3 group.The levels of HbA1c,Scr,UACR,C1q and C5a were significantly higher in the Q3 group than those in the Q1 group.The level of UACR was higher in the Q2 group than that in the Q1 group(all P＜0.05).The Spearman correlation analysis showed that C1q,MBL and C5a were positively correlated with UACR and NAG/Ucr,and negatively correlated with eGFR(all P＜0.05).The ordinal Logistic regression analysis showed that elevated levels of MBL,C5a,NAG/Ucr,Scr and systolic blood pressure were independent influencing factors of progression risk in DKD patients.Elevated levels of C5a,HbA1c and UACR were independent influencing factors of renal tubular injury in DKD patients.Conclusion C1q and C5a can be used to monitor middle and late DKD and tubular injury,and C5a is an independent risk factor for DKD progression and tubular injury.MBL can be used to screen for early DKD and is also an independent risk factor for its progression.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective:To explore the clinical value of syndecan-1 (SDC1), asymmetric dimethylarginine (ADMA) assessment in the early diagnosis and course monitoring of patients with type 2 diabetic kidney disease (DKD).Methods:This is a cross-sectional study. A total of 232 patients with type 2 diabetes admitted to the Department of Endocrinology of Kailuan General Hospital from December 2020 to December 2021 were included. The general biochemical indexes, SDC1 and ADMA were detected. According to urinary albumin/creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR), patients were divided into simple diabetes group (50 cases) and DKD group (182 cases). According to the risk of progression of DKD, the DKD group was further divided into low-progression diabetic nephropathy (LDKD) subgroup (90 cases), medium-progression diabetic nephropathy(MDKD)subgroup (55 cases), and high-progression diabetic nephropathy(HDKD) subgroup (37 cases). Forty healthy people undergoing physical examination during the same period in our hospital were selected as the healthy control group. According to the quartile value of N-acetyl-β-D-glucosaminase/urinary creatinine (NAG/Ucr), the DKD group was divided into Q1- Q4 subgroups, with 45, 45, 46 and 46 cases, respectively. Spearman correlation was used to analyze the correlation between SDC1, ADMA and glomerular and renal tubule injury indexes in DKD patients. Multifactor ordered Logistic regression was used to analyze the influencing factors of the progression risk of DKD and renal tubular injury. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic performance of SDC1 and ADMA for DKD. Results:The levels of systolic blood pressure, diastolic blood pressure, triglyceride (TG), serum creatinine (Scr), uric acid (UA), NAG/Ucr, SDC1 and ADMA in DKD group were higher than those in SDM group and healthy control group (all P<0.05). The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), and hemoglobin A1c (HbA 1c) in DKD group were higher than those in healthy control group, and the level of high density lipoprotein cholesterol (HDL-C) was lower than that in healthy control group (all P<0.05). The SDC1 level in HDKD subgroup was higher than that in SDM group and LDKD subgroup, and the ADMA level was higher than that in SDM group and lower than that in LDKD subgroup (all P<0.05). SDC1 level in MDKD subgroup was higher than that in SDM group and LDKD subgroup, ADMA level was higher than that in SDM group, but lower than that in LDKD subgroup (all P<0.05).The levels of SDC1 and ADMA in LDKD subgroup were higher than those in SDM group (all P<0.05). The levels of TC, AporB, HbA 1c, Scr, UACR and SDC1 in NAG/Ucr Q4 subgroup were higher than those in Q1 subgroup, the levels of Scr, UACR and SDC1 were higher than those in Q2 subgroup, and the levels of HbA 1c, Scr, UACR and SDC1 in Q3 subgroup were higher than those in Q1 subgroup (all P<0.05). Spearman correlation analysis showed that SDC1 was positively correlated with UACR, NAG/Ucr ( r=0.757, 0.566, all P<0.05),and was negatively correlated with eGFR ( r=-0.337, P<0.05). ADMA was positively correlated with UACR, NAG/Ucr ( r=0.197, 0.142, all P<0.05). Multifactor ordered Logistic regression analysis showed that SDC1, NAG/Ucr and Scr were the independent influencing factors of progression risk in DKD patients ( OR=2.043, 1.067, 1.047, 0.660, 1.394, all P<0.05), while SDC1, HbA 1c and ACR were the independent influencing factors of renal tubule injury in DKD patients ( OR=1.177, 1.193, 1.002,all P<0.05). ROC curve showed that the area under the curve (AUC) of SDC1 for DKD diagnosis was 0.979, the sensitivity was 92.31%, and the specificity was 92.22%, while the AUC of ADMA for DKD diagnosis was 0.745, the sensitivity was 81.32%, and the specificity was 60.00%. The AUC, sensitivity and specificity of the combined diagnosis of DKD were 0.981, 90.66% and 95.66%. Conclusions:SDC1 is an independent risk factor of DKD progression and tubular injury in DKD patients, which can be used to diagnose early DKD and monitor the progression of DKD. ADMA is suitable for early screening of DKD.

Rotator cuff injury often leads to shoulder pain and dysfunction. For the injured rotator cuff tendon without continuous interruption, conservative treatment is often used. However, the shoulder is used frequent in daily life, which makes that the rotator cuff injury generally shows gradual aggravation and eventually progresses to complete tear due to poor blood supply of the rotator cuff tendon tissue and weak repair ability. In order to reverse the pathophysiological changes after rotator cuff injury and promote the repair of injured rotator cuff tendon, a series of conservative treatments for rotator cuff injury have been explored. Extracorporeal shock wave therapy (ESWT) is one of the representative treatments, but its molecular biological mechanism in promoting rotator cuff repair is still unclear. Therefore, the authors review the progress of ESWT for rotator cuff injury from aspects of the molecular biological mechanism and clinical application status, so as to provide a reference for future researches and clinical application of ESWT.

The spatiotemporal distribution of growth factors in bone tissue-engineered repair and reconstruction is critical. Growth factors can be used in bone tissue engineering through different encapsulation methods. Different encapsulation methods make growth factors have different release kinetics. At present, the common physical entrapment, easily degradable carrier and simple spatial structure usually result in poor sustained release of growth factors by burst release. The optimization of release methods of growth factors enables their release at different times and spaces in a biomimetric manner, which is conducive to improving the effect of tissue repair and avoiding the adverse effects of excessive factors. Starting from the necessity of spatiotemporal sustained release of growth factors, the authors summarize growth factors can attain spatiotemporal sustained release by being directly immobilized on the surface of the carrier, encapsulated in the carrier, encapsulated in the microparticles and encapsulated in the carrier by the microparticles and review the spatiotemporal sustained release of growth factors in different encapsulation methods, so as to provide a reference for optimizing spatiotemporal release of growth factor in bone tissue engineering.

Objective:To develop an information system for testing radiological protection that can interface with National Radiation Health Information Platform/Medical Radiation Monitoring Subsystem and to improve the testing efficiency.Methods:Complying with the relevant national regulations and standards, the analysis was carried out of demand investigation and system modeling. An information system for testing radiological protection was established using B/S architecture, comprising three modules such as testing, audit and system management. The users at four levels were set of administrator, inspector, auditor and report issuer.Results:Based on test result, the developed information system has been shown to realize the informatization of the whole process from filling, auditing, issuing, issuing of the testing report to data uploading, with improved testing efficiency.Conclusions:The developed information system for testing radiological protection can improve the testing efficiency, and can be successfully interfaced with the National Radiation Health Information Platform/Medical Radiation Protection Monitoring Subsystem.

Coal workers' pneumoconiosis（CWP）is one of the most common occupational diseases. The pathogenesis of CWP remains unclear and effective therapeutic drug is not exist. Therefore，looking for CWP-related biomarkers have become a focus of research. In recent years，intensive studies have been carried out on the pathogenesis of CWP，such as inflammatory response，alveolar epithelial cell injury，extracellular matrix remodeling，epigenetics，oxidative stress and immune dysfunction. It has been found that some biomarkers were related to CWP，such as high mobility group protein 1，nucleotide-binding oligomerization domain-like receptor family protein 3，surfactant protein，mucoprotein 5B，osteopontin，aminin，DNA methylation，microRNA，long noncoding RNA，cytochrome b-245-alpha polypeptide and cluster of differentiation，and others. These biomarkers are helpful for early screening，monitoring efficacy and pathogenesis research of CWP. However，it is necessary to further explore biomarkers with high sensitivity and specificity and conduct prospective clinical value evaluation to better guide the prevention and treatment of CWP .