1.Robot system-assisted versus freehand screw revision for ankylosing spondylitis with lower cervical fractures: a multicenter retrospective study
Shuai LI ; Jiaojiao BAI ; Baorong HE ; Yanzheng GAO ; Wei MEI ; Xinyu LIU ; Yue ZHU ; Qingda LI ; Yukuan LEI ; Lei ZHU ; Zhigang ZHAO ; Yunfei HUANG ; Jinpeng DU ; Mingzhe FENG ; Ningbo CHEN ; Yansheng HUANG ; Xuefang ZHANG ; Zhen CHANG
Chinese Journal of Trauma 2025;41(5):440-448
Objective:To compare the efficacy of robot system-assisted versus freehand screw revision for ankylosing spondylitis (AS) with lower cervical fractures.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 57 patients with AS combined with lower cervical fractures admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Henan Provincial People's Hospital, Zhengzhou Orthopedic Hospital, and Qilu Hospital of Shandong University, including 46 males and 11 females, aged 38-77 years [(65.4±9.5)years]. Injury segments involved C 3 in 7 patients, C 4 in 13, C 5 in 25, C 6 in 10, and C 7 in 2. All the patients underwent revision surgery, among whom, 22 patients were treated with robot system-assisted cervical pedicle screw placement (robot nailing group, with 190 screws), and 35 with freehand cervical pedicle screw placement (freehand nailing group, with 300 screws). The operative duration, intraoperative bleeding volume, frequency of intraoperative fluoroscopy, incision length, and length of hospital stay of the two groups were compared; the time of single nscrew insertion, the number of single nail revisions, the distance between screws and the anterior cortex, the accuracy of screw placement of grade 0 and grade 0+1 were recorded in the two groups. The visual analogue scale (VAS), Japanese Orthopedic Society (JOA) score, neck dysfunction index (NDI), American Spine Injury Association (ASIA) classification before operation, at 3 days, 3 months after operation and at the last follow-up were compared between the two groups. The complication rate was also noted. Results:All the patients were followed up for 12-16 months [(14.3±2.1)months]. The operative duration, intraoperative bleeding volume, and frequency of intraoperative fluoroscopy were (186.4±12.9)minutes, (486.1±68.6)ml, and (3.4±1.3)times in the robot nailing group, which were shorter or less than (206.7±14.4)minutes, (660.3±45.2)ml, and (13.5±3.6)times in the freehand nailing group ( P<0.01). The incision length was (9.4±2.4)cm in the robot nailing group, longer than (5.6±1.2)cm in the freehand nailing group ( P<0.01), and the length of hospital stay was (3.7±0.4)days, shorter than (4.4±1.4)days in the freehand nailing group ( P<0.01). The length of single nail insertion, the number of single nail revision, and the distance between the screws and the front cortex were (6.5±0.4)minutes, (1.1±0.1)times, and (3.5±1.3)mm in the robot nailing group, which were shorter or less than (11.6±0.2)minutes, (1.5±0.2)times, and (12.4±4.7)mm in the freehand nailing group ( P<0.01). The accuracy of the screw placement in the robot nailing group was 90.0% (171/190) and 95.8% (182/190) with level 0 and 0+1 screws, better than 80.0% (240/300) and 89.0% (267/300) in the freehand nailing group ( P<0.05). There was no significant difference in VAS, JOA score, NDI, or ASIA grading between the two groups before operation ( P>0.05). The VAS, JOA, and NDI scores at 3 days after operation were (3.1±0.6)points, (12.1±1.2)points, and (15.6±2.9)points, respectively in the robot nailing group, which were better than (5.0±1.4)points, (11.3±1.1)points and (22.5±3.7)points, respectively in the freehand nailing group ( P<0.05). No statistically significant difference was observed in the ASIA grade between the two groups at 3 days after operation ( P>0.05). There were no significant differences in VAS, JOA, NDI scores, or ASIA grading between the two groups at 3 months after operation and at the last follow-up ( P>0.05). Compared with those before operation, the VAS, JOA, NDI scores, and ASIA grading were significantly improved at 3 days, 3 months after operation and at the last follow-up in the two groups, which were further improved with the passage of time. Two patients in the robot nailing group had pneumonia, with a complication rate of 9% (2/22), while 2 patients in the freehand nailing group had dural sac rupture and cerebrospinal fluid leakage and 3 had lung infection after operation, with a complication rate of 14% (5/35) ( P<0.05). Conclusion:Compared with freehand nailing, the robot system-assisted nailing revision for AS with lower cervical fracture has more advantages in terms of the operative duration, length of hospital stay, intraoperative bleeding volume, frequency of intraoperative fluoroscopy nailing speed and accuracy, screw holding force, early pain relief, function restoration, and complication rate, despite longer surgical incision.
2.Comparative efficacy of navigation system and orthopedic robot-assisted nail placement in the treatment of lower cervical fracture and dislocation
Xinnan CHENG ; Shuai LI ; Jiaojiao BAI ; Qingda LI ; Yukuan LEI ; Lei ZHU ; Zhen CHANG ; Zhigang ZHAO ; Yunfei HUANG ; Mingzhe FENG ; Liang YAN ; Hua HUI ; Lingbo KONG ; Baorong HE
Chinese Journal of Trauma 2025;41(2):148-156
Objective:To compare the clinical efficacy of navigation system and orthopedic robot-assisted nail placement in the treatment of lower cervical fracture and dislocation.Methods:A retrospective cohort study was conducted to analyze the clinical data of 49 patients with fracture and dislocation of the lower cervical spine who were admitted to Honghui Hospital, Xi′an Jiaotong University School of Medicine from May 2021 to October 2022, including 38 males and 11 females, aged 29-61 years [(39.3±7.3)years]. Injury segments involved C 3 in 12 patients, C 4 in 11, C 5 in 8, C 6 in 9 and C 7 in 9. Twenty-one patients were treated with S8 navigation system (navigation group, 84 screws), and 28 with TINAVI orthopedic robot (robot group, 112 screws). The two groups were compared in terms of the total surgical duration, single screw placement time, total screw placement time, distance between the screw and the anterior cortex, incision length, intraoperative radiation dose, intraoperative blood loss and length of hospital stay. The height of intervertebral space, Cobb angle, sliding distance between vertebral bodies and American Spinal Injury Association (ASIA) grade were assessed before surgery and at 3 days after surgery. Visual analogue scale (VAS), Japanese Orthopedic Association (JOA) score and neck dysfunction index (NDI) before surgery, at 3 days, 3 months after surgery and at the last follow-up were compared. The accuracy of screw placement, intraoperative invasion rate of adjacent facet joints and rate of postoperative complications (infection, screw loosening, etc.) were evaluated. Results:All the patients were followed up for 12-16 months [(13.6±1.9)months]. In the navigation group, the total surgical duration, distance from the screw to the anterior cortex and the intraoperative radiation dose were (236.2±30.6)minutes, (2.0±0.2)mm and (374.3±90.3)mGy respectively, which were significantly shorter or less than those in the robot group [(278.4±20.7)minutes, (10.6±2.9)mm and (448.4±77.9)mGy] ( P<0.01). The single screw placement time, total screw placement time, incision length and intraoperative blood loss were (3.5±0.4)minutes, (23.9±0.5)minutes, (9.1±2.4)cm and (422.2±30.4)ml respectively, which were significantly longer or more than those in the robot group [(2.6±0.2)minutes, (17.9±0.7)minutes, (6.6±2.6)cm and (360.3±56.3)ml] ( P<0.01). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). No significant differences were observed in the height of the intervertebral space, Cobb angle, sliding distance between the vertebral bodies and ASIA grade between the two groups ( P>0.05). At 3 days after surgery, the height of intervertebral space, Cobb angle, sliding distance between vertebral bodies and ASIA grade in both groups were significantly improved when compared with those before surgery ( P<0.05 or 0.01). There were no significant differences in VAS, JOA scores or NDI between the two groups before surgery, at 3 days, 3 months after surgery and at the last follow-up ( P>0.05). The VAS, JOA scores and NDI in both groups were gradually improved at 3 days, 3 months and at the last follow-up after surgery when compared with those before surgery ( P<0.05). There was no significant difference in the accuracy of screw placement of levels 0 and 0+1 between the two groups ( P>0.05). No significant difference in the intraoperative invasion rate of adjacent facet joints between the two groups was found ( P>0.05). There were no serious complications such as infection or screw loosening after surgery in both groups. Conclusions:For lower cervical fracture and dislocation, although there are more advantages in total surgical duration, screw holding force and radiation control regarding the navigation system, and more outstanding performance in screw placement efficiency, incision length and intraoperative blood loss regarding the orthopedic robot, both of them can effectively rebuild the cervical structure, improve neurological function, relieve postoperative pain, improve screw placement accuracy and reduce facet joint injury and serious complications. Selection of the best auxiliary screw placement system should comprehensively consider patients′ conditions and the experience of the surgical team.
3.Analysis of peripheral blood monocyte subsets in chronic myelomonocytic leukemia: a single-center study
Lin WANG ; Minming LI ; Jiaojiao BAI ; Chengxin DENG ; Ping WU ; Chengwei LUO ; Peilong LAI ; Jianyu WENG ; Xin DU
Chinese Journal of Hematology 2025;46(10):952-957
Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.
4.Summary of the best evidence for foot offloading care to prevent diabetic foot recurrence
Yan WAN ; Qing JIA ; Jiaojiao BAI
Chinese Journal of Nursing 2025;60(16):2033-2039
Objective To retrieve,screen,and integrate evidence related to foot offloading care for preventing the recurrence of diabetic foot,and provide a reference for clinical nursing practice.Methods According to the"6S"pyramid model of evidence-based resources,relevant domestic and foreign databases and professional websites were systematically searched for the literature on foot offloading care to prevent the recurrence of diabetic foot.The retrieval time limit was from the establishment of the database to January 2025.Totally 2 researchers independently evaluated the quality of the literature,and the evidence was extracted from the literature that met the quality standards.Results A total of 14 pieces of the literature were included,including 8 guidelines,4 expert consensuses,1 evidence summary,and 1 systematic review.A total of 36 pieces of evidence were summarized from 4 dimensions,including foot pressure assessment,local pressure adjustment,daily foot offloading behaviors,and offloading prevention health education.Conclusion This study summarizes the best evidence of foot offloading care for the prevention of diabetic foot recurrence,which is scientific and comprehensive,and it can provide an evidence-based basis for clinical practice.It is recommended to apply the evidence according to specific clinical scenarios and the personalized characteristics of patients to better improve the clinical outcomes of patients.
5.Correlation among sensory information processing, self-regulation abilities and clinical symptoms in children with autism spectrum disorder
Jiaojiao REN ; Jing QI ; Qian ZHANG ; Ruibei BAI ; Hong GAO ; Zhaohui WANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(4):323-327
Objective:To explore the correlation among sensory information processing, self-regulation abilities, and clinical symptoms in children with autism spectrum disorder (ASD).Methods:From December 1, 2023 to May 1, 2024, a total of 73 ASD children aged 3-7 years old meeting the inclusion criteria were recruited, and they were divided into mild group ( n=20), moderate group ( n=26), and severe group ( n=27) based on clinical symptoms.The sensory processing and self-regulation checklist (SPSRC) was used to assess sensory processing and self-regulation abilities. Clinical symptoms of ASD were assessed by the social responsiveness scale (SRS), the autism behavior checklist (ABC), and the childhood autism rating scale (CARS). Statistical analysis was conducted by SPSS 25.0 software, including Chi-square test, one-way ANOVA, and Pearson correlation analysis. Results:Abnormal rates of sensory processing across the six domains in ASD children were as follows: auditory (31.51%, 23/73), visual (32.88%, 24/73), tactile (32.88%, 24/73), gustatory/olfactory (32.88%, 24/73), vestibular (24.66%, 18/73), and proprioception (27.40%, 20/73).Abnormal rates of self-regulation abilities across the three domains were as follows: physiological state (38.36%, 28/73), emotional regulation (49.32%, 36/73), and adaptability (31.51%, 23/73).The severe group showed higher abnormal rates in SPSRC domains compared to the moderate and mild groups (all P<0.05). Total scores of each SPSRC domain were negatively correlated with total scores of SRS, ABC, and CARS ( r=-0.648--0.236, all P<0.05). Conclusion:The more severe the impairment in sensory processing and self-regulation abilities in ASD children, the more severe their clinical symptoms. Improving sensory processing and self-regulation abilities may contribute to the rehabilitation of children with ASD.
6.Correlation among sensory information processing, self-regulation abilities and clinical symptoms in children with autism spectrum disorder
Jiaojiao REN ; Jing QI ; Qian ZHANG ; Ruibei BAI ; Hong GAO ; Zhaohui WANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(4):323-327
Objective:To explore the correlation among sensory information processing, self-regulation abilities, and clinical symptoms in children with autism spectrum disorder (ASD).Methods:From December 1, 2023 to May 1, 2024, a total of 73 ASD children aged 3-7 years old meeting the inclusion criteria were recruited, and they were divided into mild group ( n=20), moderate group ( n=26), and severe group ( n=27) based on clinical symptoms.The sensory processing and self-regulation checklist (SPSRC) was used to assess sensory processing and self-regulation abilities. Clinical symptoms of ASD were assessed by the social responsiveness scale (SRS), the autism behavior checklist (ABC), and the childhood autism rating scale (CARS). Statistical analysis was conducted by SPSS 25.0 software, including Chi-square test, one-way ANOVA, and Pearson correlation analysis. Results:Abnormal rates of sensory processing across the six domains in ASD children were as follows: auditory (31.51%, 23/73), visual (32.88%, 24/73), tactile (32.88%, 24/73), gustatory/olfactory (32.88%, 24/73), vestibular (24.66%, 18/73), and proprioception (27.40%, 20/73).Abnormal rates of self-regulation abilities across the three domains were as follows: physiological state (38.36%, 28/73), emotional regulation (49.32%, 36/73), and adaptability (31.51%, 23/73).The severe group showed higher abnormal rates in SPSRC domains compared to the moderate and mild groups (all P<0.05). Total scores of each SPSRC domain were negatively correlated with total scores of SRS, ABC, and CARS ( r=-0.648--0.236, all P<0.05). Conclusion:The more severe the impairment in sensory processing and self-regulation abilities in ASD children, the more severe their clinical symptoms. Improving sensory processing and self-regulation abilities may contribute to the rehabilitation of children with ASD.
7.Robot system-assisted versus freehand screw revision for ankylosing spondylitis with lower cervical fractures: a multicenter retrospective study
Shuai LI ; Jiaojiao BAI ; Baorong HE ; Yanzheng GAO ; Wei MEI ; Xinyu LIU ; Yue ZHU ; Qingda LI ; Yukuan LEI ; Lei ZHU ; Zhigang ZHAO ; Yunfei HUANG ; Jinpeng DU ; Mingzhe FENG ; Ningbo CHEN ; Yansheng HUANG ; Xuefang ZHANG ; Zhen CHANG
Chinese Journal of Trauma 2025;41(5):440-448
Objective:To compare the efficacy of robot system-assisted versus freehand screw revision for ankylosing spondylitis (AS) with lower cervical fractures.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 57 patients with AS combined with lower cervical fractures admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Henan Provincial People's Hospital, Zhengzhou Orthopedic Hospital, and Qilu Hospital of Shandong University, including 46 males and 11 females, aged 38-77 years [(65.4±9.5)years]. Injury segments involved C 3 in 7 patients, C 4 in 13, C 5 in 25, C 6 in 10, and C 7 in 2. All the patients underwent revision surgery, among whom, 22 patients were treated with robot system-assisted cervical pedicle screw placement (robot nailing group, with 190 screws), and 35 with freehand cervical pedicle screw placement (freehand nailing group, with 300 screws). The operative duration, intraoperative bleeding volume, frequency of intraoperative fluoroscopy, incision length, and length of hospital stay of the two groups were compared; the time of single nscrew insertion, the number of single nail revisions, the distance between screws and the anterior cortex, the accuracy of screw placement of grade 0 and grade 0+1 were recorded in the two groups. The visual analogue scale (VAS), Japanese Orthopedic Society (JOA) score, neck dysfunction index (NDI), American Spine Injury Association (ASIA) classification before operation, at 3 days, 3 months after operation and at the last follow-up were compared between the two groups. The complication rate was also noted. Results:All the patients were followed up for 12-16 months [(14.3±2.1)months]. The operative duration, intraoperative bleeding volume, and frequency of intraoperative fluoroscopy were (186.4±12.9)minutes, (486.1±68.6)ml, and (3.4±1.3)times in the robot nailing group, which were shorter or less than (206.7±14.4)minutes, (660.3±45.2)ml, and (13.5±3.6)times in the freehand nailing group ( P<0.01). The incision length was (9.4±2.4)cm in the robot nailing group, longer than (5.6±1.2)cm in the freehand nailing group ( P<0.01), and the length of hospital stay was (3.7±0.4)days, shorter than (4.4±1.4)days in the freehand nailing group ( P<0.01). The length of single nail insertion, the number of single nail revision, and the distance between the screws and the front cortex were (6.5±0.4)minutes, (1.1±0.1)times, and (3.5±1.3)mm in the robot nailing group, which were shorter or less than (11.6±0.2)minutes, (1.5±0.2)times, and (12.4±4.7)mm in the freehand nailing group ( P<0.01). The accuracy of the screw placement in the robot nailing group was 90.0% (171/190) and 95.8% (182/190) with level 0 and 0+1 screws, better than 80.0% (240/300) and 89.0% (267/300) in the freehand nailing group ( P<0.05). There was no significant difference in VAS, JOA score, NDI, or ASIA grading between the two groups before operation ( P>0.05). The VAS, JOA, and NDI scores at 3 days after operation were (3.1±0.6)points, (12.1±1.2)points, and (15.6±2.9)points, respectively in the robot nailing group, which were better than (5.0±1.4)points, (11.3±1.1)points and (22.5±3.7)points, respectively in the freehand nailing group ( P<0.05). No statistically significant difference was observed in the ASIA grade between the two groups at 3 days after operation ( P>0.05). There were no significant differences in VAS, JOA, NDI scores, or ASIA grading between the two groups at 3 months after operation and at the last follow-up ( P>0.05). Compared with those before operation, the VAS, JOA, NDI scores, and ASIA grading were significantly improved at 3 days, 3 months after operation and at the last follow-up in the two groups, which were further improved with the passage of time. Two patients in the robot nailing group had pneumonia, with a complication rate of 9% (2/22), while 2 patients in the freehand nailing group had dural sac rupture and cerebrospinal fluid leakage and 3 had lung infection after operation, with a complication rate of 14% (5/35) ( P<0.05). Conclusion:Compared with freehand nailing, the robot system-assisted nailing revision for AS with lower cervical fracture has more advantages in terms of the operative duration, length of hospital stay, intraoperative bleeding volume, frequency of intraoperative fluoroscopy nailing speed and accuracy, screw holding force, early pain relief, function restoration, and complication rate, despite longer surgical incision.
8.Comparative efficacy of navigation system and orthopedic robot-assisted nail placement in the treatment of lower cervical fracture and dislocation
Xinnan CHENG ; Shuai LI ; Jiaojiao BAI ; Qingda LI ; Yukuan LEI ; Lei ZHU ; Zhen CHANG ; Zhigang ZHAO ; Yunfei HUANG ; Mingzhe FENG ; Liang YAN ; Hua HUI ; Lingbo KONG ; Baorong HE
Chinese Journal of Trauma 2025;41(2):148-156
Objective:To compare the clinical efficacy of navigation system and orthopedic robot-assisted nail placement in the treatment of lower cervical fracture and dislocation.Methods:A retrospective cohort study was conducted to analyze the clinical data of 49 patients with fracture and dislocation of the lower cervical spine who were admitted to Honghui Hospital, Xi′an Jiaotong University School of Medicine from May 2021 to October 2022, including 38 males and 11 females, aged 29-61 years [(39.3±7.3)years]. Injury segments involved C 3 in 12 patients, C 4 in 11, C 5 in 8, C 6 in 9 and C 7 in 9. Twenty-one patients were treated with S8 navigation system (navigation group, 84 screws), and 28 with TINAVI orthopedic robot (robot group, 112 screws). The two groups were compared in terms of the total surgical duration, single screw placement time, total screw placement time, distance between the screw and the anterior cortex, incision length, intraoperative radiation dose, intraoperative blood loss and length of hospital stay. The height of intervertebral space, Cobb angle, sliding distance between vertebral bodies and American Spinal Injury Association (ASIA) grade were assessed before surgery and at 3 days after surgery. Visual analogue scale (VAS), Japanese Orthopedic Association (JOA) score and neck dysfunction index (NDI) before surgery, at 3 days, 3 months after surgery and at the last follow-up were compared. The accuracy of screw placement, intraoperative invasion rate of adjacent facet joints and rate of postoperative complications (infection, screw loosening, etc.) were evaluated. Results:All the patients were followed up for 12-16 months [(13.6±1.9)months]. In the navigation group, the total surgical duration, distance from the screw to the anterior cortex and the intraoperative radiation dose were (236.2±30.6)minutes, (2.0±0.2)mm and (374.3±90.3)mGy respectively, which were significantly shorter or less than those in the robot group [(278.4±20.7)minutes, (10.6±2.9)mm and (448.4±77.9)mGy] ( P<0.01). The single screw placement time, total screw placement time, incision length and intraoperative blood loss were (3.5±0.4)minutes, (23.9±0.5)minutes, (9.1±2.4)cm and (422.2±30.4)ml respectively, which were significantly longer or more than those in the robot group [(2.6±0.2)minutes, (17.9±0.7)minutes, (6.6±2.6)cm and (360.3±56.3)ml] ( P<0.01). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). No significant differences were observed in the height of the intervertebral space, Cobb angle, sliding distance between the vertebral bodies and ASIA grade between the two groups ( P>0.05). At 3 days after surgery, the height of intervertebral space, Cobb angle, sliding distance between vertebral bodies and ASIA grade in both groups were significantly improved when compared with those before surgery ( P<0.05 or 0.01). There were no significant differences in VAS, JOA scores or NDI between the two groups before surgery, at 3 days, 3 months after surgery and at the last follow-up ( P>0.05). The VAS, JOA scores and NDI in both groups were gradually improved at 3 days, 3 months and at the last follow-up after surgery when compared with those before surgery ( P<0.05). There was no significant difference in the accuracy of screw placement of levels 0 and 0+1 between the two groups ( P>0.05). No significant difference in the intraoperative invasion rate of adjacent facet joints between the two groups was found ( P>0.05). There were no serious complications such as infection or screw loosening after surgery in both groups. Conclusions:For lower cervical fracture and dislocation, although there are more advantages in total surgical duration, screw holding force and radiation control regarding the navigation system, and more outstanding performance in screw placement efficiency, incision length and intraoperative blood loss regarding the orthopedic robot, both of them can effectively rebuild the cervical structure, improve neurological function, relieve postoperative pain, improve screw placement accuracy and reduce facet joint injury and serious complications. Selection of the best auxiliary screw placement system should comprehensively consider patients′ conditions and the experience of the surgical team.
9.Analysis of peripheral blood monocyte subsets in chronic myelomonocytic leukemia: a single-center study
Lin WANG ; Minming LI ; Jiaojiao BAI ; Chengxin DENG ; Ping WU ; Chengwei LUO ; Peilong LAI ; Jianyu WENG ; Xin DU
Chinese Journal of Hematology 2025;46(10):952-957
Objective:To evaluate the clinical value of peripheral blood monocyte subset analysis in the diagnosis and treatment of chronic myelomonocytic leukemia (CMML) .Method:We retrospectively enrolled 51 patients newly diagnosed with CMML at Guangdong Provincial People's Hospital between June 1, 2020, and December 31, 2024, according to the WHO 2022 diagnostic criteria. Twenty-three patients with other myeloid neoplasms (excluding CMML) and peripheral monocytosis (absolute count ≥0.5×10 9/L and percentage ≥10%) were included as the control group. All patients underwent bone marrow aspiration for examinations including bone marrow smears, biopsies, cytogenetics, and gene mutation analysis to establish a definitive diagnosis. Concurrently, flow cytometry was used to determine the proportions of peripheral blood monocyte subsets: classical (MO1, CD14 +CD16 -) , intermediate (MO2, CD14 +CD16 +) , and non-classical (MO3, CD14 lowCD16 +) . Differences between the groups were compared, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves. Result:Among the 51 CMML patients, the proportion of the peripheral blood MO1 subset was significantly higher than that in patients with other myeloid neoplasms ( P=0.027) , whereas there were no significant differences in the MO2 and MO3 subsets (all P>0.05) . Further analysis revealed that 43 (84.31%) of the CMML patients met the WHO diagnostic threshold for the MO1 subset (≥94%) , while the remaining 8 patients did not; 46 patients (90.20%) had MO3 subset proportions below the threshold proposed by Hudson (≤1.13%) , while the remaining 5 patients were above this threshold. In-depth analysis showed that among the 8 patients who did not meet the WHO criteria, 7 were experiencing inflammation. Similarly, all 5 patients who did not meet the Hudson criteria were in an inflammatory state. Subsequent ROC curve analysis of this cohort identified a cut-off value for the MO1 subset of 97.55% [Area Under the Curve (AUC) =0.661, P=0.027], which aligns with the WHO criteria. Conclusion:Peripheral blood monocyte subset analysis, particularly MO1 subset analysis, can effectively assist in CMML diagnosis, but exclusion of inflammatory conditions is required.
10.Summary of the best evidence for foot offloading care to prevent diabetic foot recurrence
Yan WAN ; Qing JIA ; Jiaojiao BAI
Chinese Journal of Nursing 2025;60(16):2033-2039
Objective To retrieve,screen,and integrate evidence related to foot offloading care for preventing the recurrence of diabetic foot,and provide a reference for clinical nursing practice.Methods According to the"6S"pyramid model of evidence-based resources,relevant domestic and foreign databases and professional websites were systematically searched for the literature on foot offloading care to prevent the recurrence of diabetic foot.The retrieval time limit was from the establishment of the database to January 2025.Totally 2 researchers independently evaluated the quality of the literature,and the evidence was extracted from the literature that met the quality standards.Results A total of 14 pieces of the literature were included,including 8 guidelines,4 expert consensuses,1 evidence summary,and 1 systematic review.A total of 36 pieces of evidence were summarized from 4 dimensions,including foot pressure assessment,local pressure adjustment,daily foot offloading behaviors,and offloading prevention health education.Conclusion This study summarizes the best evidence of foot offloading care for the prevention of diabetic foot recurrence,which is scientific and comprehensive,and it can provide an evidence-based basis for clinical practice.It is recommended to apply the evidence according to specific clinical scenarios and the personalized characteristics of patients to better improve the clinical outcomes of patients.

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