Objective:To evaluate the early-to-mid-term efficacy of supramalleolar osteotomy (SMO) in the treatment of traumatic ankle arthritis secondary to peri-ankle fracture.Methods:A retrospective study was conducted to analyze the clinical data of 29 patients who had been treated for traumatic ankle arthritis secondary to old peri-ankle fracture by SMO from March 2018 to March 2023 at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital. There were 14 males and 15 females, 39.0 (25.0, 49.0) years in age. Types of old fracture: 4 lower tibiofibular fractures, 19 ankle fractures, and 6 pilon fractures. Surgery was conducted for 16 cases and conservative treatment for the remaining 13 cases. The interval between the old fracture and the current surgery was 10.0 (2.0, 19.5) years. The clinical efficacy was evaluated using the ankle-hindfoot score of American Association of Foot and Ankle Surgery (AOFAS), foot function index (FFI), and visual analog scale (VAS) pain score. Imaging analysis was conducted and imaging comparisons were made between pre-surgery and post-surgery in terms of tibial anterior surface (TAS) angle, tibial lateral surface (TLS) angle, talar tilt (TT) angle, and changes in modified Takakura staging. Complications were recorded. Surgical satisfaction was investigated at the final follow-up.Results:The 29 patients were followed up for 17.0 (14.0, 23.5) months. The AOFAS ankle-hindfoot score [(84.2±9.6) points], FFI [7.0 (3.0, 10.9) points], VAS pain score [2.0 (1.0, 3.0) points], and TAS angle [90.84° (86.70°, 92.50°)] at the final follow-up for all patients were significantly better than the pre-surgery values [(68.0±16.7) points, 20.9 (6.1, 29.1) points, 5.0 (2.0, 8.0) points, and 78.63° (74.30°, 85.00°)] (all P<0.05). At the final follow-up, the ankle arthritis grading did not show any significant change ( P>0.05) and there were no significant differences in TT angle or TLS angle between pre-surgery and post-surgery ( P>0.05). Incision failed to heal in 1 case, incision healing was delayed in 3 cases, and ankle arthritis progressed on imaging in 6 cases. As for patient self-assessed satisfaction, 23 cases felt very satisfactory, 4 cases quite satisfactory, and 2 cases common, giving an overall satisfaction rate of 93.1% (27/29). Conclusions:SMO has led to good early-to-mid-term efficacy in the treatment of traumatic ankle arthritis secondary to peri-ankle fracture, showing obvious pain relief and functional improvement after correction of the ankle joint alignment, limited postoperative complactions and a high rate of patient satisfaction.

OBJECTIVE To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)after COVID-19 epidemic so as to offer help for early clinical diagnosis and treatment.METHODS The clinical data that were collected from the MPP patients who were treated in the fever clinic of the First Medical Center of Chinese PLA General Hospital from Jul.2023 to Aug.2024 were retrospectively analyzed.The results of laboratory tests for the different age groups of patients complicated with other pathogens were statistically analyzed.RESULTS Of totally 161 MPP patients who were enrolled in the study,78(48.85％)were male,and 83(51.55％)were fe-male;the average age was(32.98±14.35)years old,and the patients aged between 20 and 40 years old accoun-ted for 43.48％(70 cases).The enrolled patients were divided into the simple MPP group with 92(57.14％)ca-ses and the MPP+mixed group with 69(42.86％)cases according to the result of etiological test of sputum;the patients of MPP+mixed group were divided into the MPP+bacteria group with 42(60.87％)cases,the MPP+fungi group with 10(14.49％)cases,and the MPP+viruses group with 17(24.64％)cases.There was significant difference in the age among the groups(P＜0.05);there were no significant differences in the sex,white blood cell counts and percentage of mononuclear cells among the groups,the percentage of lymphocytes was highest in the simple MPP group,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were highest in the MPP+bacteria group,and there were significant differences(P＜0.05).All of the patients were divided into three groups:the ≤20-year-old group the＞20-40-year old group and the＞40-year-old group.There were no sig-nificant differences in the white blood cell counts,percentage of lymphocytes,percentage of mononuclear cells and IL-6 level among the three groups,and the CRP level was highest in the＞20-40-year old group(P=0.025).Ran-dom forest model analysis showed that the weight of CRP was highest(22.65％)among the clinical characteristics of the MPP patients,which played a key role in construction of model.As for other factors,the weight of age was 17.02％,the percentage of lymphocytes 15.34％,the white blood cells counts 14.86％,the percentage of mono-nuclear cells 14.39％,the IL-6 13.61％,the gender 2.13％.CONCLUSION MPP maintains common among the patients aged less than 40 years old after the COVID-19 epidemic,nearly half of the patients are complicated with the infections of other pathogens,and CRP is more helpful for the clinical diagnosis and treatment of the MPP in early stage.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.

OBJECTIVE To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia(MPP)after COVID-19 epidemic so as to offer help for early clinical diagnosis and treatment.METHODS The clinical data that were collected from the MPP patients who were treated in the fever clinic of the First Medical Center of Chinese PLA General Hospital from Jul.2023 to Aug.2024 were retrospectively analyzed.The results of laboratory tests for the different age groups of patients complicated with other pathogens were statistically analyzed.RESULTS Of totally 161 MPP patients who were enrolled in the study,78(48.85％)were male,and 83(51.55％)were fe-male;the average age was(32.98±14.35)years old,and the patients aged between 20 and 40 years old accoun-ted for 43.48％(70 cases).The enrolled patients were divided into the simple MPP group with 92(57.14％)ca-ses and the MPP+mixed group with 69(42.86％)cases according to the result of etiological test of sputum;the patients of MPP+mixed group were divided into the MPP+bacteria group with 42(60.87％)cases,the MPP+fungi group with 10(14.49％)cases,and the MPP+viruses group with 17(24.64％)cases.There was significant difference in the age among the groups(P＜0.05);there were no significant differences in the sex,white blood cell counts and percentage of mononuclear cells among the groups,the percentage of lymphocytes was highest in the simple MPP group,the levels of C-reactive protein(CRP)and interleukin-6(IL-6)were highest in the MPP+bacteria group,and there were significant differences(P＜0.05).All of the patients were divided into three groups:the ≤20-year-old group the＞20-40-year old group and the＞40-year-old group.There were no sig-nificant differences in the white blood cell counts,percentage of lymphocytes,percentage of mononuclear cells and IL-6 level among the three groups,and the CRP level was highest in the＞20-40-year old group(P=0.025).Ran-dom forest model analysis showed that the weight of CRP was highest(22.65％)among the clinical characteristics of the MPP patients,which played a key role in construction of model.As for other factors,the weight of age was 17.02％,the percentage of lymphocytes 15.34％,the white blood cells counts 14.86％,the percentage of mono-nuclear cells 14.39％,the IL-6 13.61％,the gender 2.13％.CONCLUSION MPP maintains common among the patients aged less than 40 years old after the COVID-19 epidemic,nearly half of the patients are complicated with the infections of other pathogens,and CRP is more helpful for the clinical diagnosis and treatment of the MPP in early stage.

OBJECTIVE To summarize the clinical characteristics and diagnosis and treatment experiences in dealing with non-severe Chlamydia psittaci pneumonia.METHODS The clinical data were collected from 34 patients who were diagnosed with non-severe C.psittaci pneumonia through quantitative polymerase chain reactiong(qPCR)for sputum in fever clinic of the First Medical Center of Chinese PLA General Hospital from Mar.2023 to Mar.2024 and were retrospectively analyzed.The clinical characteristics and treatment outcomes were evaluated.RESULTS The average age of the patients was(44.82±13.74)years old,the ratio of male to female was 1∶1.83;all of the patients had fever;major symptoms were cough(70.59％),pharyngodynia(44.12％),and flu-like symptoms(41.18％);82.35％of the patients had the history of contact with poultry.The C-reactive pro-tein(CRP)level,interleukin-6(IL-6),systemic inflammatory response index(SIRI)and aggregate index of sys-temic inflammation(AISI)were higher among the patients aged no less than 44 years old than among the patients less than 44 years old(P＜0.05);the percentage of lymphocytes of the patients aged no less than 44 years old was lower than that of the patients aged less than 44 years old(P＜0.05).As for the imaging findings,73.53％of the patients had consolidation shadows,26.47％had ground-glass opacities,and 32.35％involved both lungs.All of the patients received quinolones or tetracyclines for treatment of 7-14 days and all symptoms relieved.CT reexami-nated 1 month after the treatment showed that 55.88％of the cases had complete absorption of pulmonary infec-tious lesions,and 35.29％had partial absorption.CONCLUSIONS The patients with non-severe Chlamydia psitta-ci pneumonia are characterized by the history of contact with poultry,fever complicated with respiratory tract symptoms,rise of inflammatory markers(more significant among patients of advanced age)and lower lobe con-solidation shadow/ground-glass opacities.Early identification and standardized treatment may facilitate the favora-ble treatment outcomes.

Objective:To evaluate the early-to-mid-term efficacy of supramalleolar osteotomy (SMO) in the treatment of traumatic ankle arthritis secondary to peri-ankle fracture.Methods:A retrospective study was conducted to analyze the clinical data of 29 patients who had been treated for traumatic ankle arthritis secondary to old peri-ankle fracture by SMO from March 2018 to March 2023 at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital. There were 14 males and 15 females, 39.0 (25.0, 49.0) years in age. Types of old fracture: 4 lower tibiofibular fractures, 19 ankle fractures, and 6 pilon fractures. Surgery was conducted for 16 cases and conservative treatment for the remaining 13 cases. The interval between the old fracture and the current surgery was 10.0 (2.0, 19.5) years. The clinical efficacy was evaluated using the ankle-hindfoot score of American Association of Foot and Ankle Surgery (AOFAS), foot function index (FFI), and visual analog scale (VAS) pain score. Imaging analysis was conducted and imaging comparisons were made between pre-surgery and post-surgery in terms of tibial anterior surface (TAS) angle, tibial lateral surface (TLS) angle, talar tilt (TT) angle, and changes in modified Takakura staging. Complications were recorded. Surgical satisfaction was investigated at the final follow-up.Results:The 29 patients were followed up for 17.0 (14.0, 23.5) months. The AOFAS ankle-hindfoot score [(84.2±9.6) points], FFI [7.0 (3.0, 10.9) points], VAS pain score [2.0 (1.0, 3.0) points], and TAS angle [90.84° (86.70°, 92.50°)] at the final follow-up for all patients were significantly better than the pre-surgery values [(68.0±16.7) points, 20.9 (6.1, 29.1) points, 5.0 (2.0, 8.0) points, and 78.63° (74.30°, 85.00°)] (all P<0.05). At the final follow-up, the ankle arthritis grading did not show any significant change ( P>0.05) and there were no significant differences in TT angle or TLS angle between pre-surgery and post-surgery ( P>0.05). Incision failed to heal in 1 case, incision healing was delayed in 3 cases, and ankle arthritis progressed on imaging in 6 cases. As for patient self-assessed satisfaction, 23 cases felt very satisfactory, 4 cases quite satisfactory, and 2 cases common, giving an overall satisfaction rate of 93.1% (27/29). Conclusions:SMO has led to good early-to-mid-term efficacy in the treatment of traumatic ankle arthritis secondary to peri-ankle fracture, showing obvious pain relief and functional improvement after correction of the ankle joint alignment, limited postoperative complactions and a high rate of patient satisfaction.

Objective:To evaluate the early efficacy of local application of tranexamic acid on the osteotomy surface during hallux valgus surgery in reducing postoperative occult blood loss and thus postopera-tive swelling.Methods:The data of 40 cases with hallux valgus osteotomy admitted to the Department of Foot and Ankle Surgery of Jishuitan Hospital from July 11,2022 to October 8,2022,including 5 males and 35 females were retrospectively analyzed.According to the inclusion and exclusion criteria,32 cases were finally divided into 16 cases in the observation group(application of tranexamic acid)and 16 cases in the control group(no application of tranexamic acid).The observation group was paired with the con-trol group one by one in accordance with the operation style,and the change in the anterior and posterior diameter of the first metatarsal head,the change in the circumferential diameter of the foot,the length of the first metatarsal midline and the length of the plumbline of the foot measured by postoperative CT were compared between the two groups before and after surgery,in order to evaluate the degree of swelling around the incision after the surgery.The first metatarsal midline and plumb line were measured by reference to the two auxiliary lines that intersect the soft tissue border in the sesamoid bone position to measure the rotation angle of the first metatarsal.A total of three clinicians completed the measurements of these two line segments and interobserver comparisons were performed.Results:By interobserver com-parison,the consistency of the length of the midline of the first metatarsal and the plumbline measured by CT was high and could be considered a reliable measurement.After the paired t-test,there was no statis-tical difference in the amount of changes in the anteroposterior diameter of the first metatarsal before and after surgery between the observation and control groups(P＞0.05),and the amount of changes in the circumferential diameter of the foot before and after surgery was smaller in the observation group than in the control group,which was statistically significant(P＜0.05);the length of the midline of the first metatarsal and the plumbline of the foot measured by CT after surgery was smaller in the observation group than in the control group,which was statistically significant(P＜0.05).Conclusion:Local ap-plication of tranexamic acid on the osteotomy surface during hallux valgus osteotomy can relieve postopera-tive swelling to some extent,which may be related to the fact that tranexamic acid reduces occult blood loss in the postoperative period.

Objective:To analyze the clinical data of patients with end-stage ankle and hindfoot ar-thropathy who underwent tibiotalocalcaneal(TTC)arthrodesis by the same surgeon,explore the short-and mid-term clinical results,complications and functional improvement,and discuss the clinical progno-sis and precautions of TTC arthrodesis.Methods:Retrospective analysis was made on the clinical data of 40 patients who underwent TTC arthrodesis by the same surgeon from March 2011 to December 2020.In this study,23 males and 17 females were included,with an average age of(49.1±16.0)years.All the patients underwent unilateral surgery.The clinical characteristics,imaging manifestations,main diagno-sis and specific surgical techniques of the patients were recorded.The clinical outcomes were evaluated by comparison of the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score and visual analogue scale(VAS)between pre-operation and at the last follow-up.The fusion healing time,symptom improvement(significant improvement,certain improvement,no improvement or deterioration)and postoperative complications were also recorded.Results:The median follow-up time was 38.0(26.3,58.8)months.The preoperative VAS score was 6.0(4.0,7.0),and the AOFAS score was 33.0(25.3,47.3).At the last follow-up,the median VAS score was 0(0,3.0),and the AOFAS score was 80.0(59.0,84.0).All the significantly improved compared with their preoperative corre-sponding values(P＜0.05).There was no wound necrosis or infection in the patients.One patient suf-fered from subtalar joint nonunion,which was syphilitic Charcot arthropathy.The median bony healing time of other patients was 15.0(12.0,20.0)weeks.Among the included patients,there were 25 cases with significant improvement in symptom compared with that preoperative,8 cases with certain improve-ment,4 cases with no improvement,and 3 cases with worse symptoms than that before operation.Con-clusion:TTC arthrodesis is a reliable method for the treatment of the end-stage ankle and hindfoot ar-thropathy.The function of most patients was improved postoperatively,with little impact on daily life.The causes of poor prognosis included toe stiffness,stress concentration in adjacent knee joints,nonunion and pain of unknown causes.

Objective To investigate the imaging features of intestinal schwannoma(IS)in order to improve the diagnostic ability of the disease.Methods The clinical and imaging data of 14 patients with surgically and pathologically confirmed IS were retrospectively analyzed,including the location,size,morphology,nature,growth pattern,CT density,MRI signal,PET/CT metabolism and other characteristics of the tumors.Results Of the 14 IS cases,the lesions of 3 cases were located in the duodenum,2 cases in the cecum,8 cases in the colon and 1 case in the rectum.The lesions were all round or oval,with an average maximum diameter of(2.4±1.1)cm.The lesions were solid in 13 cases,extraluminal growth in 10 cases,cystic degeneration in 1 case and myxoid degeneration in 1 case.Chronic inflammatory lymph nodes were seen around the diseased intestines in 9 cases,and the short diameter of lymph nodes was greater than 5 mm in 6 cases.All 14 cases of IS showed low attenuation on plain CT scan,and progressive enhancement after contrast injection,including 1 case of mild enhancement,2 cases of moderate enhancement,and 11 cases of obvious enhancement.Two cases of IS showed low signal intensity on T1WI,slightly high signal intensity on T2WI,significantly high signal intensity on DWI,and obvious progressive enhancement after contrast injection on MRI.Two cases of IS showed high metabolism on 18F-FDG-PET/CT,and the SUVmax was 9.4 and 8.8,respectively.Conclusion The imaging findings of IS were characteristic to a certain extent.They mainly manifested as solid nodules or masses derived from the intestinal submucosa,with uniform attenuation or signal intensity,obvious progressive enhancement after contrast injection,obvious hypermetabolism on 18F-FDG-PET/CT,and slightly larger homogeneous lymph nodes were common around the lesions.

Strong cation exchange mediums have been widely applied in protein purification.In this work,the strong cation exchange chromatography medium was prepared by coupling small molecular ligands through allyl activation commonly used in agarose-based media.The matrix based on the macroporous microspheres was a copolymer of glycidyl methacrylate and ethylene glycol dimethacrylate.The effects of reaction factors on the ligand density were detailedly investigated.The ligand density in the prepared medium was controlled in the range of 0.126-0.370 mol/L(wet gel).Its adsorption performance was evaluated with lysozyme as a model protein.The static binding capacity was in the range of 37.0-81.0 g/L.The maxium dynamic binding capacity reached 37.7 g/L and the maximum lysozyme recovery was 98.97%.The strong cation exchange medium obtained here showed low non-specific adsorption and high separation efficiency on lysozyme.This strong cation exchange medium showed a great potential in rapid protein purification.