1.Analysis of the disease burden of hypertensive heart disease among individuals aged≥60 years globally and in China from 1990 to 2021
Jiali LI ; Chunzhen REN ; Fan LIU ; Keyan WANG ; Zhijiang BI ; Xiaoxiao ZHAO ; Lixin KE ; Haibo WANG ; Wenxi PENG ; Zhifei WANG ; Qiang ZHANG ; Peng XU ; Yingdong LI ; Xiuxiu DENG ; Xinke ZHAO ; Cuncun LU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(02):281-290
Objective To systematically analyze the characteristics of the disease burden of hypertensive heart disease (HHD) in the elderly (≥60 years) globally and in China from 1990 to 2021, and to predict its future trends from 2022 to 2040, with the aim of providing data support for optimizing comprehensive prevention and control strategies for HHD. Methods Based on the Global Burden of Disease (GBD) 2021 database, the number of prevalent cases and disability-adjusted life years (DALYs) of HHD in the elderly were extracted for the world, China, and five regions categorized by sociodemographic index (SDI). Joinpoint regression was used to analyze the temporal trends of age-standardized prevalence rate and age-standardized DALYs rate of HHD in the elderly. A three-factor decomposition method was applied to evaluate the relative contributions of aging, population growth, and epidemiological changes to the variations in the elderly HHD burden. Additionally, a Bayesian age-period-cohort model was used to predict the elderly HHD burden from 2022 to 2040. Results In 2021, the number of prevalent elderly HHD cases reached 10 283 000 globally and 3 412 400 in China, representing increases of 179.20% and 159.20% respectively, compared with 1990. The DALYs of elderly HHD were 18 812 700 person-years globally and 4 731 400 person-years in China, rising by 76.08% and 29.45% respectively from 1990. Meanwhile, the growth rates of the number of prevalent cases and DALYs of elderly HHD varied across different SDI regions. From 1990 to 2021, the age-standardized prevalence rate of elderly HHD in China, as well as the age-standardized DALYs rate of elderly HHD both globally and in China, showed significant downward trends (all average annual percentage changes<0, all P<0.001). In 2021, the 70-74 years age group accounted for the highest proportion of prevalent cases and DALYs of elderly HHD, both globally and in China. Decomposition analysis revealed that population growth was the dominant factor driving the increase in the elderly HHD burden across all regions. The prediction model results indicated that the number of prevalent cases and DALYs of elderly HHD would continue to rise globally and in China from 2022 to 2040, with the growth rate of the elderly HHD burden in China between 2021 and 2040 expected to exceed the global average. Conclusion Over the past 32 years, although the age-standardized disease rates of elderly HHD have mainly shown a downward trend globally and in China, the absolute number of the disease burden has increased substantially. The projection model indicates a continued upward trajectory, with the growth rate in China higher than the global average. Therefore, there is an urgent need to implement precise prevention and control strategies to effectively mitigate the disease burden of elderly HHD.
2.Efficacy Mechanism of Xianlian Jiedu Prescription Against Colorectal Cancer Recurrence vias Regulating Angiogenesis
Yanru XU ; Lihuiping TAO ; Jingyang QIAN ; Weixing SHEN ; Jiani TAN ; Chengtao YU ; Minmin FAN ; Changliang XU ; Yueyang LAI ; Liu LI ; Dongdong SUN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):79-87
ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer (CRC) and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit, followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group, low-dose Xianlian Jiedu prescription (XLJDP-L) group (6.45 g·kg-1·d-1), medium-dose Xianlian Jiedu prescription (XLJDP-M) group (12.9 g·kg-1·d-1), high-dose Xianlian Jiedu prescription (XLJDP-H) group (25.8 g·kg-1·d-1), and 5-fluorouracil (5-FU) group (1×10-3 g·kg-1·d-1). The mice were euthanized after 14 days of continuous intervention, and recurrent tumor tissue was harvested. Hematoxylin and eosin (HE) staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry (IHC) was employed to assess the expression of proliferating cell nuclear antigen (Ki67), vascular endothelial growth factor (VEGF), and platelet-endothelial cell adhesion molecule (CD31) in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 (ANG-2), VEGF, phosphorylated-protein kinase B (p-Akt), protein kinase B (Akt), phosphorylated-phosphatidylinositol 3-kinase (p-PI3K), and phosphatidylinositol 3-kinase (PI3K) in recurrent tumor tissue. ResultsBefore treatment, there were no statistical differences in tumor volume, tumor weight, and body mass among the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group compared to the model group, indicating model stability. After treatment, compared with those in the model group, the tumor volume and tumor weight in the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly reduced (P<0.01), showing dose dependency. Meanwhile, there were no significant differences in body weight among the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group, tumor tissue in the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group had loosely arranged cells, increased intercellular spaces, small and shriveled nuclei, light staining, fewer mitotic figures and atypical nuclei, and increased necrotic areas. IHC showed that compared with those of the model group, the positive rates of Ki67, VEGF, and CD31 in the recurrent tumor tissue of the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly reduced (P<0.01) in a dose-dependent manner. Western blot results showed that compared with those of the model group, the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L, XLJDP-M, and XLJDP-H groups and the 5-FU group were significantly downregulated (P<0.05, P<0.01), and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner (P<0.05, P<0.01). ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2, VEGF, and CD31.
3.Plasma Metabolomic Analysis of Colorectal Cancer Patients with Spleen-Qi Deficiency and Damp-heat Stasis-toxin Syndrome Based on UPLC-Q-Exactive-Orbitrap-MS
Siting MENG ; Lihuiping TAO ; Dong ZHANG ; Qinchang ZHANG ; Yiping FAN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):130-137
ObjectiveTo observe and analyze the plasma metabolite differences among colorectal cancer patients with spleen-qi deficiency, damp-heat stasis-toxin syndrome(SRYD), non-spleen-qi deficiency, damp-heat stasis-toxin syndrome(non-SRYD), and normal human beings(Normal), aiming to identify unique metabolites specific to SRYD colorectal cancer patients and their potential biomarkers. MethodsBased on the diagnostic criteria of SRYD and non-SRYD colorectal cancer, 30 patients were included, including 10 patients with SRYD colorectal cancer and 20 patients with non-SRYD colorectal cancer, while 10 individuals were recruited for the Normal group. Metabolome sequencing of plasma from the three groups was performed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS). Multivariate statistical analysis were performed by principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA), and the intergroup differential metabolites were identified based on variable importance in the projection(VIP) value>1 and t-test P<0.05. And pathway enrichment analysis based on Kyoto Encyclopedia of Genes and Genomes(KEGG) was performed to explore the metabolites and metabolic pathways specific to SRYD colorectal cancer patients. ResultsMetabolome sequencing results showed some differences in metabolic profiles between the groups. A total of 111 plasma differential metabolites were found in the SRYD group and the Normal group, of which 31 were up-regulated and 80 were down-regulated, mainly including stearoyl lysophosphatidylcholine, indole-3-acrylic acid, and dehydroepiandrosterone sulfate(P<0.05). The non-SRYD group exhibited 97 differentially expressed metabolites compared to the Normal group, with 36 up-regulated and 61 down-regulated, mainly including stearoyl lysophosphatidylcholine, sphingosine, and palmitoyl lysophosphatidylcholine(P<0.05). And the SRYD group exhibited 19 differentially expressed metabolites compared to the non-SRYD group, of which 5 were up-regulated and 14 were down-regulated, mainly including dihydrosphingosine, palmitic acid, and linoleoylethanolamide(P<0.05). The significant differential metabolites were subjected to KEGG analysis to obtain significantly enriched metabolic pathways in each group, and the results showed that 11 metabolic pathways such as primary bile acid synthesis, cholesterol metabolism and bile secretion were differential signaling pathways specific to SRYD colorectal cancer. Further retrieval of the above key signaling pathways showed that bile acids were up-regulated in both bile secretion and primary bile acid synthesis pathways, and there was a trend of up-regulation of glycochenodeoxycholic acid, taurochenodeoxycholic acid, and chenodeoxycholic acid. ConclusionPrimary bile acid synthesis, cholesterol metabolism, and bile secretion-related pathways may be differential signaling pathways specific to SRYD colorectal cancer, and bile acid is a core molecule in the metabolic pathway, which can serve as potential biomarkers closely related to the development and progression of SRYD colorectal cancer.
4.Plasma Metabolomic Analysis of Colorectal Cancer Patients with Spleen-Qi Deficiency and Damp-heat Stasis-toxin Syndrome Based on UPLC-Q-Exactive-Orbitrap-MS
Siting MENG ; Lihuiping TAO ; Dong ZHANG ; Qinchang ZHANG ; Yiping FAN ; Haibo CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):130-137
ObjectiveTo observe and analyze the plasma metabolite differences among colorectal cancer patients with spleen-qi deficiency, damp-heat stasis-toxin syndrome(SRYD), non-spleen-qi deficiency, damp-heat stasis-toxin syndrome(non-SRYD), and normal human beings(Normal), aiming to identify unique metabolites specific to SRYD colorectal cancer patients and their potential biomarkers. MethodsBased on the diagnostic criteria of SRYD and non-SRYD colorectal cancer, 30 patients were included, including 10 patients with SRYD colorectal cancer and 20 patients with non-SRYD colorectal cancer, while 10 individuals were recruited for the Normal group. Metabolome sequencing of plasma from the three groups was performed by ultra-performance liquid chromatography-quadrupole-electrostatic field orbitrap mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS). Multivariate statistical analysis were performed by principal component analysis(PCA) and partial least squares-discriminant analysis(PLS-DA), and the intergroup differential metabolites were identified based on variable importance in the projection(VIP) value>1 and t-test P<0.05. And pathway enrichment analysis based on Kyoto Encyclopedia of Genes and Genomes(KEGG) was performed to explore the metabolites and metabolic pathways specific to SRYD colorectal cancer patients. ResultsMetabolome sequencing results showed some differences in metabolic profiles between the groups. A total of 111 plasma differential metabolites were found in the SRYD group and the Normal group, of which 31 were up-regulated and 80 were down-regulated, mainly including stearoyl lysophosphatidylcholine, indole-3-acrylic acid, and dehydroepiandrosterone sulfate(P<0.05). The non-SRYD group exhibited 97 differentially expressed metabolites compared to the Normal group, with 36 up-regulated and 61 down-regulated, mainly including stearoyl lysophosphatidylcholine, sphingosine, and palmitoyl lysophosphatidylcholine(P<0.05). And the SRYD group exhibited 19 differentially expressed metabolites compared to the non-SRYD group, of which 5 were up-regulated and 14 were down-regulated, mainly including dihydrosphingosine, palmitic acid, and linoleoylethanolamide(P<0.05). The significant differential metabolites were subjected to KEGG analysis to obtain significantly enriched metabolic pathways in each group, and the results showed that 11 metabolic pathways such as primary bile acid synthesis, cholesterol metabolism and bile secretion were differential signaling pathways specific to SRYD colorectal cancer. Further retrieval of the above key signaling pathways showed that bile acids were up-regulated in both bile secretion and primary bile acid synthesis pathways, and there was a trend of up-regulation of glycochenodeoxycholic acid, taurochenodeoxycholic acid, and chenodeoxycholic acid. ConclusionPrimary bile acid synthesis, cholesterol metabolism, and bile secretion-related pathways may be differential signaling pathways specific to SRYD colorectal cancer, and bile acid is a core molecule in the metabolic pathway, which can serve as potential biomarkers closely related to the development and progression of SRYD colorectal cancer.
5.Analysis of reoperation causes in unilateral biportal endoscopy for treating lumbar degenerative diseases
Yuquan LIU ; Guangpeng LI ; Xiang LI ; Bin ZHU ; Weiyang ZUO ; Haining TAN ; Ning LIU ; Qi FEI ; Haibo SUN ; Tianqi FAN ; Yong YANG ; Lingjia YU
International Journal of Surgery 2025;52(2):108-113
Objective:To analyze the reoperation rate and causes during the early adoption phase of unilateral biportal endoscopy (UBE).Methods:The clinical data of 180 patients who underwent UBE performed by a single surgeon at Beijing Friendship Hospital, Capital Medical University from October 2021 to June 2023 were retrospectively analyzed. Clinical and imaging data of patients who underwent reoperation were collected to analyze the causes of reoperation, and the clinical efficacy of the reoperations was also followed up. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used before and after treatment. Results:A total of 180 patients who underwent UBE were included in this study, of which 6 patients underwent reoperation, and the reoperation rate was 3.33%. Among them, 3 cases occurred in the first 90 surgeries and the other 3 occurred in the subsequent 90 surgeries. The causes of reoperation were as follows: recurrent lumbar disc herniation at the same segment postoperatively in 2 cases, insufficient decompression in 2 cases, disc herniation following isolated decompression in 1 case, and immediate postoperative perianal numbness in 1 case. The time between the initial surgery and reoperation ranged from 0 to 187 days, with an average of 63.3 days. The average follow-up time after reoperation was 18.3 months. The visual analogue scale (VAS) and Oswestry disability index (ODI) scores of the patients at the last follow-up were significantly improved compared with those before operation (VAS score of low back pain: 5.2 ± 1.7 before operation, 1.2 ± 0.8 at the last follow-up, P<0.001; VAS score of leg pain: 7.2 ± 1.5 before operation, 1.2 ± 1.2 at the last follow-up, P<0.001; ODI score: 67.3 ± 5.7 before operation, 20.2 ± 8.2 at the last follow-up, P<0.001). The postoperative modified MacNab scores were generally satisfactory (4 cases were rated as excellent, accounting for 66.7%; 2 cases were rated as good, accounting for 33.3%). Except for one patient who experienced dural injury during open revision surgery, there were no serious complications such as nerve damage. Conclusions:In the early stages of UBE surgery, recurrent lumbar disc herniation and inadequate decompression are the primary reasons for reoperation, typically occurring within the first three months postoperatively. Reoperation does not significantly increase the risk of nerve injury. Enhanced early postoperative follow-up is recommended. For symptomatic patients, a second surgery with thorough decompression can yield satisfactory treatment outcomes.
6.Exploring the Components and Mechanism of Shenbai Jiedu Decoction in Treating CRA Carcinogenesis Based on LC-MS and Network Pharmacology
Li LIU ; Qiuying YAN ; Xiaoxuan FAN ; Minmin FAN ; Liu LI ; Huiping TAO-LI ; Shuchen CHANG ; Haibo CHENG ; Dongdong SUN
Journal of Nanjing University of Traditional Chinese Medicine 2024;40(8):771-784
OBJECTIVE To identify the chemical components of Shenbai Jiedu Decoction(SBJDD),a traditional Chinese medi-cine(TCM)prescription clinically used for the treatment of colorectal adenoma(CRA),and explore the potential mechanism of SBJDD preventing and treating CRA carcinogenesis.METHODS An ultra-high performance liquid chromatography-time of flight-mass spectrometry(UPLC-Q-TOF-MS)method was established to detect the chemical components in the decoction of SBJDD and the plas-ma samples of rats after administration with SBJDD.Based on the network pharmacological method,SBJDD was screened for the poten-tial active ingredients at different stages of CRA carcinogenesis,and the mechanism of the anti-cancer effect of SBJDD was explored.In vitro experiments were also carried out to verify the mechanism of anti-colorectal cancer(CRC)action of SBJDD.RE-SULTS The detection data of UPLC-Q-TOF-MS showed that 152 components were found from SBJDD water extraction.41 chemical compounds were identified in plasma samples from rats administrated with SBJDD.Network pharmacology analysis indicated that during the CREI stage,the potential active ingredients in SBJDD,including epiberberine,and kushenol H,might affect target proteins such as PIK3CA,MAPK3 and PIK3CB.This,in turn,can influence signaling pathways like PI3K-AKT and Ras signaling pathways,and regulate biological processes like protein phosphorylation,and signal transduction.During the CRA stage,the potential active ingredi-ents from SBJDD,such as 3,7-dihydroxycoumarin,palmatine,and kushenol A,might affect target proteins such as AKT and EGFR.This can regulate the negative regulation of apoptotic process,and positive regulation of cell proliferation,and modify HIF-1,and Rap1 signaling pathways.During the progression of CRA carcinogenesis,potential active ingredients such as 3,7-dihydroxycouma-rin may interact with TP53,and impact the PI3K-AKT,and Thyroid hormone signaling pathways to regulate biological processes,in-cluding positive regulation of transcription from RNA polymerase Ⅱ promoter,and negative regulation of apoptotic process.In the CRC stage,core ingredients like p-coumaric acid may bind with proteins such as PRKCB.This binding may impact the signaling pathways that negatively affect EGFR tyrosine kinase inhibitor resistance,and PI3K-AKT signaling pathways.Additionally,it may regulate bio-logical processes,including negative regulation of apoptotic process,signal transduction,and protein phosphorylation.In vitro experi-ment results indicated that SBJDD inhibited the proliferation of HT29 cells and suppressed the expression of EGFR and PKC proteins.CONCLUSION The UPLC-Q-TOF-MS method is established to effectively separate the chemical constituents in SBJDD,which are mainly composed of alkaloids,organic acids and flavonoids components.Components from SBJDD dock with different targets during the carcinogenesis process of CRA and regulate cancer-related signaling pathways to exert therapeutic effects.
7.Early vocabulary development in Mandarin children with cochlear implantation
Jinming LI ; Min WANG ; Jianfen LUO ; Ruijie WANG ; Xiuhua CHAO ; Zhaomin FAN ; Haibo WANG ; Lei XU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(7):696-704
Objective:To investigate the development of receptive and expressive vocabulary in Mandarin-speaking children with cochlear implants (CI) during the first year after CI activation.Methods:A total of 827 children (411 boys and 416 girls) who were implanted CI before 2.5 years of age from October 2019 to December 2022 in the Department of Auditory Implantation, Shandong Provincial ENT Hospital were included in this study. The Infant Checklist of the Mandarin Early Vocabulary Inventory (EVI) was used to assess the quantity and content of receptive and expressive vocabulary at the time of CI activation and at the 1st, 3rd, 6th, 9th, 12th months post-activation. SPSS 22.0 was used to describe the receptive and expressive vocabulary of CI children at the first year after activation.Results:During the first year after CI activation, CI children′s receptive and expressive vocabulary consistently increased with the CI usage. The average number of receptive vocabulary and expressive vocabulary respectively increased from 0 to 178, and from 0 to 97. At the first year of post-activation, the number of receptive and expressive vocabulary of CI children were superior to that of hearing-age matched typical-hearing children, but fell behind of that of chronological age matched typical-hearing children. In terms of lexical categories, receptive and expressive vocabulary was acquired in the following order: nouns, verbs, adjectives, and pronouns. Among the top 50 words that CI children could express, nouns were the most common, then followed by verbs, adjectives, and pronouns. Father′s education level can significantly and positively predictethe receptive vocabulary of CI children at the first year post-activation. At the first year after CI activation, the 10th, 25th, 50th, 75th, and 90th percentiles were 113, 149, 178, 202, 223 for the receptive vocabulary, and 9, 37, 97, 148, 188 for expressive vocabulary.Conclusion:For Mandarin speaking children with CI, the receptive and expression vocabulary continuely increased within the first year after CI activation. The ability to grasp receptive vocabulary precedes the ability to express expressive vocabulary. Compared to hearing-age matched typical-hearing children, CI children showed faster rate of the vocabulary growth, and earlier and more frequently verb expression. However, it still larged behind that of chronological age matched hearing normal children. CI children respectively understood and expressed nouns and verbs the first. In children with CI, the first concepts understood and expressed were nouns and verbs. Among the first 50 words expressed, nouns were the most numerous, and the age at which verbs were acquired was earlier than that for hearing-age matched typical-hearing children.
8.Clinical analysis of 50 patients with abnormal pulsatile tinnitus in sigmoid sinus
Li LI ; Yuechen HAN ; Pengcheng SUN ; Na HU ; Yanyan MAO ; Zhiqiang HOU ; Haibo WANG ; Zhaomin FAN
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2024;59(8):792-796
Objective:To analyze the disease characteristics, diagnosis and treatment methods of venous pulsatile tinnitus treated by intervention of sigmoid sinus.Methods:Fifty patients (from Shandong Provincial ENT Hospital, Shandong University between February 2014 and July 2020) with venous pulsatile tinnitus treated by sigmoid sinus surgery were analyzed retrospectively. The tinnitus characteristics, imaging findings, surgical methods, intraoperative findings and postoperative tinnitus changes were recorded. The patients were followed up for 6-12 months. The sign rank sum test was used to analyze the difference in tinnitus grading before and after surgery. There were 50 patients with unilateral venous pulsatile tinnitus, including 49 females and 1 male. The age ranged from 17 to 67 years, with a median age of 44 years. There were 45 cases of right tinnitus and 5 cases of left tinnitus. The degree of tinnitus before operation was grade Ⅱ or above, including 4 cases of gradeⅡ, 11 cases of grade Ⅲ, 22 cases of grade Ⅳ and 13 cases of grade Ⅴ.Results:Thirty-seven cases were cured, 8 cases were ineffective (no change in tinnitus), 3 cases were markedly effective (tinnitus grade decreased by 3 in 2 cases, 4 in 1 case), and 2 cases were effective (tinnitus grade decreased by 1). The difference of tinnitus grade before and after operation was statistically significant ( Z=-5.70, P<0.05). Temporal bone CT showed 36 cases of sigmoid diverticulum (including 17 cases with sigmoid sinus dehiscence), 12 cases of sigmoid sinus dehiscence and 2 cases of absence of the temporal bone cortex abutting to sigmoid sinus. Thirty-five cases were performed with closure of sigmoid sinus diverticulum, 4 cases were performed with resurfacing of the sigmoid plate, 5 cases were performed with narrowing of sigmoid sinus, 4 cases were performed with simple opening of pre sigmoid mastoid air chamber, 1 case of opening was performed with pre sigmoid mastoid air chamber combined with narrowing of sigmoid sinus, and 1 case was performed with opening of pre sigmoid mastoid air chamber combined with closure of sigmoid sinus diverticulum. Conclusions:Venous pulsatile tinnitus is common in women. The common causes may be sigmoid sinus wall abnormalities such as sigmoid sinus diverticulum and perisigmoid bone defect. Imaging examinations are helpful for diagnosis. Venous pulsatile tinnitus can be treated with surgery.
9.The modified Bikini approach used for fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate
Zhenhua ZHU ; Qiguang MAI ; Tao LI ; Haibo XIANG ; Yuhui CHEN ; Jianwen LIAO ; Shicai FAN
Chinese Journal of Orthopaedic Trauma 2024;26(3):194-201
Objective:To investigate the effectiveness of the modified Bikini approach in the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate.Methods:A retrospective study was conducted to analyze the data of 54 patients with acetabular fracture who had been treated at Department of Trauma Orthopedics, Orthopedic Medical Center, The Third Hospital Affiliated to Southern Medical University from May 2017 to June 2021. The patients were divided into 2 groups based on different surgical approaches: an observation group [26 cases, 6 males, 20 females; aged 40.0 (29.8, 46.8) years] treated with fixation with an integrated wing-shaped anatomical locking plate through the modified Bikini approach, and a control group [28 cases, 10 males, 18 females; aged 34.5 (24.0, 43.5) years] treated with fixation with an integrated wing-shaped anatomical locking plate through the lateral-rectus approach. The incision length, operation time, intraoperative bleeding, length of hospital stay, quality of postoperative fracture reduction, visual analog scale (VAS) for pain, hip function, Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) were compared between the 2 groups.Results:The differences in the preoperative general data between the 2 groups were not statistically significant, indicating comparability ( P>0.05). There were no statistically significant differences between the 2 groups either in terms of incision length, operation time, intraoperative bleeding, or hospital stay ( P>0.05). The 2 groups were not significantly different in the excellent/good rate of fracture reduction [100.0% (26/26) versus 92.9% (26/28)], VAS at 1 month postoperation [2.0(1.0, 3.0) versus 2.0(1.0, 3.0)], or the modified Merle d'Aubigné and Postel hip score at 12 months postoperation [13.5(12.3, 14.8) versus. 14.0(13.0, 15.0)] ( P>0.05). However, the VSS [4.50(4.00, 6.00)] and POSAS (29.85±10.05) at 12 months postoperation in the observation group were significantly lower than those in the control group [6.50(5.00, 8.25) and 37.11±11.75] ( P<0.05). Conclusion:In the fixation of acetabular fracture with an integrated wing-shaped anatomical locking plate, the modified Bikini approach can not only achieve as fine early clinical efficacy as the lateral-rectus approach, but also demonstrate the aesthetic advantages of smaller incision scar and more hidden incision.
10.The effects of treadmill training with different intensities on tendon-bone healing in rats after anterior cruciate ligament reconstruction
Ting LIANG ; Liang ZHU ; Xuliang ZHAO ; Haibo ZHAO ; Fan JIANG ; Tengbo YU
Chinese Journal of Orthopaedic Trauma 2024;26(10):890-898
Objective:To investigate the effects of treadmill training with different intensities on tendon-bone healing in rats after anterior cruciate ligament (ACL) reconstruction.Methods:Of the 99 adult male Sprague-Dawley (SD) rats used for this study, 90 were randomly selected to undergo ACL reconstruction with autologous caudal tendon. Two weeks after the surgical reconstruction, the 90 SD rats were randomized into a low-intensity group (group L, n=30) subjected to treadmill training at a speed of 12 m/min, a moderate-intensity group (group M, n=30) subjected to treadmill training at a speed of 18 m/min, and a free group (group C, n=30) subjected to free activities in the cage as a model control. The other 9 rats were set as a blank control (group N, n=9) subjected to no treatment at all. The treadmill training started at the end of 2 weeks after surgical reconstruction. Hematoxylin-eosin (HE), micro-CT analysis, mechanical testing, real-time quantitative polymerase chain reaction (qPCR) and western blot analysis were used to evaluate the quality of tendon-bone healing. Results:There were no significant differences in the areas of femoral and tibial lateral bone tunnels or the total bone volume ratio (BV/TV) between the 3 groups 2 weeks after surgery ( P > 0.05). At 4 weeks and 8 weeks after surgery, the areas of lateral tibial bone tunnel and lateral femoral tunnel in groups C, M and L showed a decreasing trend ( P < 0.05) while the BV/TV of lateral femoral tunnel and the BV/TV of lateral tibial tunnel in groups C, M and L showed an increasing trend ( P < 0.05). At 8 weeks after surgery, HE staining showed that the tendon-bone healing was the most mature in group L, followed by group M, and the least mature in group C, showing statistically significant differences ( P < 0.05). The stiffness and maximum failure load showed an increasing trend from group C to group M to group L to group N. The stiffness in group M and the stiffness and maximum failure load in groups N and L were significantly higher than those in group C ( P < 0.05). The relative mRNA expression levels of osteopontin (OPN) and collagen type Ⅱ alpha 1 chain gene (COL2 α 1), as well as the protein expression levels of osteocalcin, OPN, and COL2 α 1, showed an increasing trend from group C to group M to group L, showing significant differences between pairwise comparisons ( P < 0.05). Conclusions:Treadmill training starting at the end of 2 weeks after surgery is beneficial to tendon-bone healing and improves the biomechanical strength of the tendon-bone complex. Low-intensity mechanical stimulation is more conducive to new bone formation and collagen fiber remodeling in the tendon-bone complex.

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