Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To compare the imaging quality and metabolic quantitative parameters of pulmonary nodules between Q. Flex whole information five-dimensional (5D) and conventional three-dimensional (3D) PET/CT imaging for clinical evaluation.Methods:Fifty-four patients (30 males, 24 females, age: 60(42, 75) years; 78 solid pulmonary nodules (maximum diameter≤3 cm) with abnormal uptake of 18F-FDG) from Tianjin Cancer Hospital Airport Hospital between June 2022 and August 2022 were enrolled in this retrospective study. All patients underwent 5D scanning and 3D, 5D reconstruction. Image quality scores, signal-to-noise ratio (SNR), SUV max, SUV mean and metabolic tumor volume (MTV) of pulmonary nodules of 5D group and 3D group were evaluated and compared with χ2 test and Wilcoxon signed rank test. Correlation of quantitative parameters between 2 groups were analyzed by using Spearman rank correlation analysis. Results:Thirty-five of 78(45%) pulmonary nodules with image quality score≥4 were found in 5D group, which were more than those in 3D group (22/78(28%); χ2=4.67, P=0.031). Meanwhile, SNR, SUV max, SUV mean, and MTV were significantly positively correlated between the 2 groups ( rs values: 0.86, 0.86, 0.85, and 0.95, all P<0.001). SNR, SUV max and SUV mean of pulmonary nodules in 5D group were significantly higher than those in 3D group, which were 37.46(18.42, 62.00) vs 32.72(16.97, 54.76) ( z=-4.07, P<0.001), 9.71(5.48, 13.82) vs 8.96(4.82, 12.63) ( z=-3.05, P<0.001) and 6.30(3.39, 8.94) vs 5.61(2.99, 7.63)( z=-4.07, P<0.001) respectively. MTV of pulmonary nodules in 5D group was significantly lower than that in 3D group, which was 1.72(0.66, 2.74) cm 3vs 1.98(1.06, 4.63) cm 3 ( z=-7.13, P<0.001). Quantitative parameters of lower lung field and nodules with maximum diameters of >10 mm and ≤20 mm based on 5D scanning changed most significantly compared with those based on 3D scanning ( z values: from -5.23 to -2.48, all P<0.05). Conclusion:Q. Flex 5D PET significantly improves the quantitative accuracy of SUV and MTV of pulmonary nodules, and the improvement of image quality is substantial without increasing the radiation dose, which has clinical practical value.

BACKGROUND:Lateral retinacular release is effective to treat anterior knee pain, but it has not been confirmed through the parameters of the knee joint. OBJECTIVE: To analyze the relevant parameters on the axial X-ray films of the patela before and after lateral retinacular release and then to find out the efficient parameters for patelofemoral joint disorders on the axial X-ray film of the patela, which are of most clinical significance. METHODS: Fifty patients with anterior knee pain were included randomly who admitted at the Department of Joint Surgery, Affiliated Hospital of Jining Medical University from February 2009 to December 2013, including 45 cases of Outerbridge I-III undergoing arthroscopic lateral retinacular release+articular cartilage repair and 5 cases of Outerbridge IV undergoing lateral retinacular release+knee joint surface replacement. RESULTS AND CONCLUSION:After lateral retinacular release, the congruence angle, patelofemoral index and tilt angle were al reduced significantly (P < 0.05 orP < 0.01), but there was no change in the lateral patelofemoral angle (P > 0.05). The patelar trajectory restored to the corresponding central position of the femoral condyle, and meanwhile, no joint hematoma, deep vein thrombosis and patelar subluxation occurred. These findings indicate that the lateral retinacular release is of great significance for treatment of anterior knee pain induced by lateral patelofemoral compression.

BACKGROUND: As the preliminary experiment for gene therapy in intervertebral disc degeneration, this study aims to construct a recombinant plasmid containing fluorescent pAAV-hSOX9-IRES-tdTomato for adeno-associated virus packaging, in a broader attempt to lay the foundation for late experiments in vitro and in vivo.OBJECTIVE: To construct human SOX9 gene overexpressing adeno-associated virus, pAAV-hSOX9-IRES-tdTomato, packaging. METHODS: The plasmid pAAV-IRES-tdTomato and plasmid pUC57-hSOX9 were connected into pAAV-hSOX9-IRES-tdTomato by enzyme digestion method. The adeno-associated virus was packaged with plasmid co-transfections method. The recombinant pAAV-hSOX9-IRES-tdTomato was transfected into 293AAV cell by calcium phosphate transfection. The purification and drop of adeno-associated virus was tested by determination of biological titer. RESULTS AND CONCLUSION: The results of BLAST sequence comparison analysis showed that, pAAV-hSOX9-IRES-tdTomato exactly matched the synthetic gene sequence hSOX9. The titer is 1×107 TU/mL. Human gene SOX9 recombinant adenoviruses, pAAV-hSOX9-IRES-tdTomato, have been constructed successfully.

Objective To explore.the effect of operative treatment for more than 70-year-old patients with osteoporotic hip fracture,and analyze the clinical feature,perioperative management and choices of operative treatment.Methods One hundred and fifty-nine patients of more than 70-year-old with osteoporotic hip fracture were operated from June 2007 to October 2010.Fracture type:38 cases with intertrochanteric fracture while femoral neck fracture in 121 cases.Results One hundred and thirty-five cases were followed up after operation ranging from 3 to 43 months.There were 2 cases by proximal femur nail internal fixation,13 cases by proximal femur locked plate internal fixation,15 cases by dynamic hip screwinternal fixation,48 cases by bipolar femoral head arthroplasty and 57 cases by total hip arthroplasty.The Harris scores of various surgical method above respectively were 100.0％ (2/2),76.9％ ( 10/13 ),80.0％(12/15),89.6％ (43/48),96.5％ (55/57).Conclusions The operation plays an important role in the treatment of elderly osteoporotic hip fracture,having so many advantages as earlier mobilization,less complications and better life quality.But it is important to pay attention to perioperative management and choose reasonable surgical approach according to classification of fracture.

Objective To investigate the effects of captopril on structure and function of sciatic nerve in diabetic rats. Methods Streptozotocin induced diabetic male Sprague Dawley rats were treated with 0.1% captopril in drinking water for 12 weeks, then advanced glycation end products (AGEs), cAMP content, and the nerve conduction velocity of sciatic nerve in diabetic rats were measured, morphometric quantitative analysis and ultrastructure of sural nerve were also performed. Results Captopril reduced accumulation of AGEs, restored synthesis of cAMP in sciatic nerve, improved nerve conduction velocity partialy, and ameliorated morphology abnormalities in myelin nerve fibre. Conclusion These findings suggest that captopril may exert a therapeutic effects on diabetic peripheral neuropathy.