Objective To explore the diagnosis and treatment experience of malignant peritoneal mesothelioma by analyzing the clinical characteristics of patients with single center peritoneal mesothelioma.Methods Retrospec-tively analyze the clinical data,including age and treatment regimens,of 99 patients with malignant peritoneal mes-othelioma admitted to Peking Union Medical College Hospital from June 2012 to July 2023.Kaplan-Meier for surviv-al analysis and Logistic and Cox regression were applied to assess the impact of factors like age and treatment regi-mens on survival time.Results The median age of diagnosis for 99 patients with peritoneal mesothelioma was 56 years,of which 82 were pathologically diagnosed.Among them,38 cases(51.4%)underwent tumor cell reduction surgery,and 57 cases(77.0%)underwent systemic or local treatment.The median survival time for all patients was 43 years.The age of diagnosis may affect the prognosis of patients with malignant mesothelioma,and those aged≥65 at the time of diagnosis have a worse prognosis.Conclusions Malignant peritoneal mesothelioma is a rare but invasive malignant tumor with a poor prognosis.There is still a need to develop novo drugs and comprehensive treat-ment strategies.

Objective:To compare the clinical efficacy between fusion with anterior plate and cross screw (APCS) via the anterolateral approach and that with posterior plate (PP) via the posterior approach in ankle arthrodesis.Methods:A retrospective study was conducted to analyze the 64 patients (64 feet) with end-stage ankle arthritis who had been admitted to Department of Foot and Ankle Surgery, Honghui Hospital of Xi'an Jiaotong University from January 2017 to March 2021. They were 24 males and 40 females with an age of (57.7±5.5) years; by the Kellgren-Lawrence staging, 25 cases were in grade Ⅲ and 39 ones in grade Ⅳ. According to the different surgical approaches and internal fixation methods, the patients were divided into a APCS group of 31 cases subjected to the fusion with APCS via the anterolateral approach and a PP group of 33 cases subjected to the fusion with PP via the posterior approach. The clinical efficacy was compared between the 2 groups and between preoperatoion and postoperation in terms of talus center migration (TCM), sagittal talar migration (STM), foot and ankle ability measure (FAAM), and visual analog scale (VAS).Results:There was no statistically significant difference in the preoperative baseline data between the 2 groups of patients, indicating comparability ( P>0.05). In the PP group, the postoperative STM [(4.45±2.21)] mm was significantly smaller than the postoperative one [(7.22±4.22)] mm ( P<0.001). There were no statistically significant differences in the postoperative comparisons of TCM and STM between the 2 groups, in the comparison between postoperative TCM and preoperative TCM in the PP group, or in the comparisons between postoperative and preoperative TCM and STM in the APCS group ( P>0.05). All patients were followed up for (28.1±6.8) months. At the last follow-up, there was no statistically significant difference between the 2 groups in the FAAM life score, FAAM exercise score, or VAS pain score ( P>0.05). The FAAM life score, FAAM motor score, and VAS pain score at the last follow-up were significantly improved in all the patients compared with the preoperative values ( P<0.05). Fusion failure was found in only 1 patient in the APCS group. Conclusion:Both PP and APCS fusion techniques can lead to similarly fine clinical outcomes in ankle arthrodesis, but PP may lead to a significant correction of sagittal talar migration.

Objective:To investigate the value of 99Tc m-hydrazinonicotinamide (HYNIC)-prostate specific membrane antigen(PSMA) SPECT/CT imaging in biochemical recurrence of prostate cancer (PCa). Methods:From January 2018 to March 2023, 112 patients with biochemical recurrence of PCa (age (72.6±6.1) years) who underwent 99Tc m-HYNIC-PSMA SPECT/CT imaging in Henan Provincial People′s Hospital were retrospectively analyzed. According to the level of prostate specific antigen (PSA), patients were divided into 0.2 μg/L2 μg/L group. According to the Gleason score, patients were divided into Gleason score≥8 group and Gleason score <8 group. The detection rate between groups was analyzed by χ2 test, and the difference of the PSA level between groups was compared by Mann-Whitney U test. Results:PSMA imaging was positive in 77 cases and negative in 35 cases, with the detection rate of 68.8%(77/112). The detection rates of local recurrence, lymph node metastasis, bone metastasis and lung metastasis were 8.9%(10/112), 43.8%(49/112), 28.6%(32/112) and 0.9%(1/112), respectively. The detection rates of 0.2 μg/L2 μg/L groups were 44.7%(21/47), 8/12 and 90.6%(48/53), respectively ( χ2=24.44, P<0.001). The detection rates of Gleason score ≥8 group and <8 group were 76.4%(55/72) and 55.0%(22/40) ( χ2=5.47, P=0.032); the PSA level between the two groups was statistically different (3.11(0.75, 5.91) and 0.84(0.44, 2.92) μg/L; z=-2.99, P=0.003). Of the patients with PSMA positive imaging, 84.4%(65/77) changed their treatment regimen and 15.6%(12/77) continued to observe or maintain the original treatment plan. Of the patients with PSMA negative imaging, 40.0%(14/35) changed the treatment plan, 51.4%(18/35) continued to observe or maintain the original treatment plan, and 8.6%(3/35) discontinued the original treatment because no tumor metastasis was found. Conclusion:99Tc m-HYNIC-PSMA SPECT/CT imaging can provide reference for the lesion detection, treatment decision-making and follow-up observation of biochemical recurrence of PCa.

The aqueous two-phase system (ATPS) is an all-aqueous system fabricated from two immiscible aqueous phases. It is spontaneously assembled through physical liquid-liquid phase separation (LLPS) and can create suitable templates like the multicompartment of the intracellular environment. Delicate structures containing multiple compartments make it possible to endow materials with advanced functions. Due to the properties of ATPSs, ATPS-based drug delivery systems exhibit excellent biocompatibility, extraordinary loading efficiency, and intelligently controlled content release, which are particularly advantageous for delivering drugs in vivo. Therefore, we will systematically review and evaluate ATPSs as an ideal drug delivery system. Based on the basic mechanisms and influencing factors in forming ATPSs, the transformation of ATPSs into valuable biomaterials is described. Afterward, we concentrate on the most recent cutting-edge research on ATPS-based delivery systems. Finally, the potential for further collaborations between ATPS-based drug-carrying biomaterials and disease diagnosis and treatment is also explored.

OBJECTIVE: To summarize the progress of clinical diagnosis and treatment of diabetic Charcot neuroarthropathy (CNO) of foot and ankle to provide reference for clinical treatment. METHODS: The research literature on diabetic CNO of foot and ankle at home and abroad was widely reviewed, and the stages and classification criteria of CNO were summarized, and the treatment methods at different stages of the disease course were summarized. RESULTS: CNO is a rapidly destructive disease of bone and joint caused by peripheral neuropathy, which leads to the formation of local deformities and stress ulcers due to bone and joint destruction and protective sensory loss, which eventually leads to disability and even life-threatening. At present, the modified Eichenholtz stage is a commonly used staging criteria for CNO of foot and ankle, which is divided into 4 stages by clinical and imaging manifestations. The classification mainly adopts the modified Brodsky classification, which is divided into 6 types according to the anatomical structure. The treatment of diabetic CNO of foot and ankle needs to be considered in combination with disease stage, blood glucose, comorbidities, local soft tissue conditions, degree of bone and joint destruction, and whether ulcers and infections are present. Conservative treatment is mainly used in the active phase and surgery in the stable phase. CONCLUSION The formulation of individualized and stepped treatment regimens can help improve the effectiveness of diabetic CNO of foot and ankle. However, there is still a lack of definitive clinical evidence to guide the treatment of active and stable phases, and further research is needed.
Humans ; Ankle ; Ulcer/complications* ; Arthropathy, Neurogenic/therapy* ; Ankle Joint ; Diabetes Mellitus ; Diabetic Foot/therapy*

OBJECTIVE: To assess the effectiveness of supramalleolar osteotomy (SMOT) as a therapeutic intervention for varus-type ankle arthritis, while also examining the associated risk factors that may contribute to treatment failure. METHODS: The clinical data of 82 patients (89 feet) diagnosed with varus-type ankle arthritis and treated with SMOT between January 2016 and December 2020 were retrospectively analyzed. The patient cohort consisted of 34 males with 38 feet and 48 females with 51 feet, with the mean age of 54.3 years (range, 43-72 years). The average body mass index was 24.43 kg/m ² (range, 20.43-30.15 kg/m ²). The preoperative tibial anterior surface angle (TAS) ranged from 77.6° to 88.4°, with a mean of 84.4°. The modified Takakura stage was used to classify the severity of the condition, with 9 feet in stage Ⅱ, 41 feet in stage Ⅲa, and 39 feet in stage Ⅲb. Clinical functional assessment was conducted using the Maryland sore, visual analogue scale (VAS) score, and psychological and physical scores in Health Survey 12-item Short From (SF-12). Radiology evaluations include TAS, talar tilt (TT), tibiocrural angle (TC), tibial medial malleolars (TMM), tibiocrural distance (TCD), tibial lateral surface angle (TLS), and hindfoot alignment angle (HAA). The results of clinical failure, functional failure, and radiology failure were statistically analyzed, and the related risk factors were analyzed. RESULTS: The operation time ranged from 45 to 88 minutes, with an average of 62.2 minutes. No complication such as fractures and neurovascular injuries was found during operation. There were 7 feet of poor healing of the medial incision; 9 pin tract infections occurred in 6 feet using external fixator; there were 20 cases of allograft and 3 cases of autograft with radiographic bone resorption. Except for 1 foot of severe infection treated with bone cement, the remaining 88 feet were primary healing, and the healing area was more than 80%. All patients were followed up 24-82 months, with an average of 50.2 months. Maryland score, VAS score, SF-12 psychological and physiological scores, and TAS, TC, TLS, TCD, TT, TMM, HAA, and Takakura stage were significantly improved at last follow-up ( P<0.05). Postoperative clinical failure occurred in 13 feet, functional failure in 15 feet, and radiology failure in 23 feet. Univariate analysis showed that obesity, TT>10°, and Takakura stage Ⅲb were risk factors for clinical failure, HAA≥15° and Takakura stage Ⅲb were risk factors for functional failure, and TT>10° was risk factor for radiographic failure ( P<0.05). Further logistic regression analysis showed that TT>10°, HAA≥15°, and TT>10° were risk factors for clinical failure, functional failure, and radiographic failure, respectively ( P<0.05). CONCLUSION SMOT is effective in the mid- and long-term in the treatment of varus-type ankle arthritis, but it should be used with caution in patients with obesity, severe hindfoot varus, severe talus tilt, and preoperative Takakura stage Ⅲb.
Male ; Female ; Humans ; Middle Aged ; Ankle ; Ankle Joint/surgery* ; Retrospective Studies ; Osteoarthritis/surgery* ; Osteotomy/methods* ; Risk Factors

Objective:To observe the curative effects of triplane intra-articular osteotomy in the treatment of malunion of calcaneal intra-articular fracture.Methods:The 16 patients were retrospectively analyzed who had been admitted to Foot and Ankle Surgery Department, Honghui Hospital from January 2016 to December 2019 for malunion of calcaneal intra-articular fracture. They were 12 males and 4 females, with an average age of 43.4 years (from 31 to 58 years). The left side was affected in 10 cases and the right side in 6 cases. All malunions were type Yu Ⅱ (compressed bone fragments on the posterior articular surface) and treated with triplane intra-articular osteotomy. The curative effects were assessed by comparing the radiological parameters, American Orthopaedic Foot and Ankle Surgery Society (AOFAS) ankle-hindfoot score, pain visual analog scale (VAS) and psychological and physical scores in Health Survey 12-item Short Form (SF-12) between preoperation and the final follow-up.Results:All the patients were followed up for 20 to 60 months (average, 42.9 months); the bone healing time was 10 to 14 weeks (average, 11.5 weeks). At the final follow-up, their B?hler angle (25.7°±2.3°), Gissane angle (117.1°±5.8°), Meary angle (2.9°±1.3°), talocalcaneal angle (31.3°±3.0°), hindfoot alignment angle (3.9°±1.8°), ankle height [(82.3±2.6) mm], calcaneus height [(56.9±2.4) mm], calcaneus width [(41.4±2.1) mm], AOFAS ankle-hindfoot score [(82.3±7.3) points], median VAS score [3 (2, 3) points], SF-12 psychological score [(46.6±3.6) points], and SF-12 physiological score [(43.6±3.5) points] were significantly improved than the preoperative values [8.4°±2.7°, 137.5°±9.3°, 8.3°±4.3°, 24.6°±3.7°, -4.6°±3.2°, (76.1±3.1) mm, (53.8±3.0) mm, (50.2±2.2) mm, (51.9±7.7) points, 6 (6, 7) points, (37.5±3.8) points, and (31.0±2.6) points] (all P<0.01) Conclusion:In the treatment of type Yu Ⅱ malunion of calcaneal intra-articular fracture, triplane osteotomy can anatomically reduce the bone fragments of collapsed posterior articular surface, reshape the normal anatomy of the calcaneus, and preserve the subtalar joint, leading to positive short- and mid-term follow-up effects.

Objective To compare the outcomes of surgical treatment of ankle fracture with or without repair of deltoid ligament(DL) rupture.Methods Between March 2009 and December 2015,75 patients were treated surgically at Department of Foot and Ankle Surgery,Honghui Hospital for ankle fracture with DL rupture.Of them,the DL rupture was repaired in 20(repair group) and not in 54(non-repair group).The 2 groups were compared in terms of pre- and post-operative medial clear space(MCS),rate of radiological MCS malreduction(MCS>5mm),rate of surgical failure,the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score and visual analogue scale(VAS).The outcomes of AO/OTA types B and C were also compared between the 2 groups.Results The 2 groups were compatible due to insignificant differences in their preoperative general data and follow-up time(46.9±22.5 months versus 56.3±23.9 months)(P>0.05).The MCSs after operation(3.3±0.3 mm) and at the last follow-up(3.2±0.3mm) in the repair group were significantly shorter than those in the non-repair group(3.8±1.0mm and 3.8±1.2mm)(P<0.05).The rate of radiological MCS malreduction in the repair group(0) was significantly lower than that in the non-repair group(20.4%)(P<0.05).There were no significant differences between the 2 group in rate of surgical failure(0 versus 7.4%),AOFAS ankle-hindfoot score(88.0±5.8 versus 85.9±8.7) or VAS(1.2±0.8 versus 1.6±1.6)(P>0.05).The rate of radiological MCS malreduction for AO/OTA type C ankle fracture in the non-repair group was significantly higher than those for AO/OTA types B and C in the repair group and AO/OTA type B in the non-repair group(P<0.05).Conclusion Surgical repair of the DL rupture may help decrease the rate of postoperative MCS malreduction,especially for AO/OTA type C ankle fractures.

Objective: This study was designed to evaluate the impact of a schoolbased child sexual abuse (CSA) prevention education on knowledge and skills of schoolaged children in a rural area of China, and to provide a reference for conducting CSA prevention program in the rural area in the future. Methods: Three hundred and sixtyfive schoolage children, recruited from grade 2-5 in 2 rural schools of northeast China, were assigned to a CSA prevention education group or a control group by class. CSA prevention education was implemented by school teachers. Questionnaire surveys were conducted before and after the intervention. To evaluate intervention impact on students’ knowledge and skills, ttest was used to compare scores increment in knowledge and skills between intervention group and the control group. Results: The findings showed that scores in CSA prevention knowledge and skills among children in both groups was significantly improved after intervention. The increment of knowledge and skill scores in intervention group was 3.49 and 1.99, respectively, significantly higher than that of control group(1.05 and 1.11). Conclusion The present study shows that school CSA prevention education is helpful to improve children’s knowledge and skills of personal safety in the rural area. Schoolbased CSA prevention education methods and evaluation methods needs to be further improved.

Objective To investigate the prevalence of psychological violence against children by parents and to explore possible influencing factors.Methods In two primary schools from a city,located in the northeast part of China,1 164 parents of the pupils from grade 1 to 6,were anonymously surveyed by a self-administered questionnaire,to analyze the situation of psychological violence and influencing factors.Results Of the 1 164 parents,78.1％ reported that they practised psychological violence towards their children.Compared with girls,boys were more psychologically maltreated by their parents (81.3％ vs.74.7％,P＜0.01).Data from the multivariate logistic regression analysis indicated that following factors increased the risk of psychological violence against children:child being male (OR=1.684);initiated by the mother (OR=1.640),parents experiences of psychologically violent victimization (OR=2.064) during their childhood,supportive or tolerant attitudes towards corporal punishment (OR=2.618) from the parents,low awareness of the harmfulness of psychological violence against children (OR=1.666) of the parents,and lower social economic status (OR=1.745) of the family,etc.Conclusion Psychological violence experienced by the parents appeared very common.Prevention programs on psychological violence should be strengthened to increase the awareness of parents on this serious problem.