PURPOSE: Bone cement-reinforced fenestrated pedicle screws (FPSs) have been widely used in the internal fixation and repair of the spine with osteoporosis in recent years and show significant improvement in fixation strength and stability. However, compared with conventional reinforcement methods, the advantages of bone cement-reinforced FPSs remain undetermined. This article compares the effects of fenestrated and conventional pedicle screws (CPSs) combined with bone cement in the treatment of osteoporosis. METHODS: A clinical control study of FPSs and CPSs combined with bone cement reinforcement in osteoporotic vertebral internal fixation was performed using the database PubMed, Embase, Cochrane Library, CNKI, the Wanfang, and the China Biomedical Literature Service System. Two evaluators screened the relevant literature in strict accordance with the inclusion criteria (diagnosis of participants, type of clinical study, treatment with FPS and CPS, and outcome indicators) and exclusion criteria (duplicate literature and missing or incorrect data) and independently conducted data extraction and quality evaluation. Clinical control studies of direct comparison between FPS and CPS combined with bone cement reinforcement in patients who were definitively diagnosed with thoracolumbar fractures or spinal degenerative diseases were included. Quality evaluation was conducted using the Cochrane risk bias evaluation tool for randomized controlled studies and using the Newcastle-Ottawa scale for retrospective case-control studies. RevMan software (version 5.3) was used for the meta-analysis to compare the clinical efficacy, radiological results, and related complications of the 2 methods. RESULTS: A total of 13 articles were included, including 7 randomized controlled studies and 6 retrospective case-control studies. There were 909 patients in these studies, 451 in the FPS and polymethyl methacrylate (FPS & PMMA) group and 458 in the CPS and polymethyl methacrylate (CPS & PMMA) group. The results of the meta-analysis showed that there was no significant difference between the 2 groups in operation time, hospital stay, visual analogue score, Japanese orthopaedic association score, Oswestry disability index score, Cobb angle, vertebral body deformation index and fusion rate (p > 0.05). The mean difference of intraoperative bleeding volume was -10.45, (95% confidence intervals (CI) (-16.92, -3.98), p = 0.002), the mean difference of loss height of the anterior edge of the vertebral body after surgery was -0.69 (95% CI (-0.93, -0.44), p < 0.001), and the relative risk (RR) of overall complication rate was 0.43 (95% CI (0.27, 0.68), p < 0.001), including the RR of bone cement leakage rate was 0.57 (95% CI (0.39, 0.85), p = 0.005). The screw loosening rate (RR = 0.26, 95% CI (0.13, 0.54), p < 0.001) of the FPS group was significantly lower than that of the CPS group. CONCLUSION The existing clinical evidence shows that compared with the CPS combined with bone cement, the use of FPS repair in the internal fixation of an osteoporotic vertebral body can reduce the amount of intraoperative bleeding, be more conducive to maintaining the height of the vertebral body, and significantly reduce the incidence of postoperative complications such as bone cement leakage and screw loosening.
Humans ; Pedicle Screws ; Bone Cements ; Spinal Fractures/surgery* ; Osteoporotic Fractures/surgery* ; Fracture Fixation, Internal/instrumentation*

Objective:To evaluate the therapeutic efficacy,safety,and factors influencing overall survival(OS)in patients with newly dia-gnosed acute myeloid leukemia(unfit AML)treated with venetoclax(VEN)plus low-dose cytarabine(LDAC)treatment regimen.Methods:In this study,we retrospectively analyzed clinical data from 33 patients with unfit AML treated with VEN plus LDAC at the Affiliated Hospital of Jiangsu University between December 2019 and January 2024.The efficacy and survival outcomes of this regimen were assessed.Results:Thirty-three patients(median age:72 years)were enrolled,including 29 with de novo AML and four with secondary AML.The median follow-up duration was 781 days,with a median OS and progression-free survival(PFS)of 467 days(range:104-812 days)and 395 days(range:104-637 days),respectively.After induction chemotherapy,the overall response rate(ORR)was 69.7%,with a composite rate of complete response(CR)and CR with incomplete blood count recovery(CRi)reaching 36.4%.Morphologic leukemia-free state(MLFS)and partial re-mission(PR)were observed in 3%and 30.3%of patients,respectively.The median number of treatment cycles was three(range:1-6.5).Treatment-related adverse events were primarily hematological,with high rates of grade 3-4 hematologic toxicities.Kaplan-Meier analysis revealed significant associations between survival and ECOG performance status,TP53 mutation status,treatment cycles,and response(P<0.05).Univariate and multivariate Cox regression analyses identified treatment cycles as an independent risk factor for OS(P<0.05).Con-clusions:The VEN plus LDAC regimen demonstrated feasibility and efficacy in patients with newly diagnosed AML;initial response and con-tinuous treatment were associated with favorable survival.

Objective:To discuss the clinical effect of the modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures in the treatment of middle and lower facial sagging.Methods:The clinical data of patients with middle and lower facial sagging treated in Hangzhou Yichao Medical Aesthetics Clinic from February 2021 to February 2023 were retrospectively analyzed. The operation was performed using barbed sutures to progressively reduce tension and suspend sutures of the superficial musculoaponeurotic system (SMAS) and the skin and subcutaneous tissue. The skin tissue flap was separated from the superficial layer of SMAS with temporal hairline to peri-auricular incision. Firstly, the sagging SMAS and the zygomatic fat pad were fixed to the deep temporal fascia by purse-string suture with barbed sutures, and then the sagging skin and subcutaneous tissue were progressively fixed to the corresponding SMAS at multiple points to the incision direction to improve the middle and lower facial relaxation and reduce the incision tension as much as possible. The nasolabial groove of the patients was scored (0-4) before surgery and 12 months after surgery to evaluate the surgical effect. The higher the score, the more serious the nasolabial groove depression was. Meanwhile, the postoperative recovery, complications and satisfaction of the patients were observed and followed up. SPSS 26.0 software was used to analyze the data. Preoperative and postoperative nasolabial groove scores were represented by Mean±SD, and paired t-test was used for comparison. P<0.05 was considered statistically significant. Results:A total of 23 patients were included, including 4 males and 19 females. They ranged in age from 42 to 68, with an average age of 54.0. All patients showed varying degrees of middle and lower facial relaxation and nasolabial groove deepening. Nasolabial groove score was (3.6±0.5) points. One patient had mild hematoma on the second day after surgery, which subsided after suction and compression, then the facial swelling basically subsided about 7 days after the operation. After 12-17 months of follow-up (mean 13.2 months), the middle and lower facial relaxation and nasolabial depression of 23 patients were significantly improved. No serious complications such as facial nerve injury occurred in all patients, and postoperative scars were not obvious. The nasolabial groove score at 12 months after the operation was (2.0±0.6) points, which was significantly lower than that before the operation ( t=14.81, P<0.001). The patient satisfaction rate was 95.7%(22/23). Conclusion:The modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures avoids deep dissection, and has simple operation, low complications, fast recovery. The relaxation of middle and lower face can be significantly improved, and the long-term effect is stable.

Objective:To evaluate the therapeutic efficacy,safety,and factors influencing overall survival(OS)in patients with newly dia-gnosed acute myeloid leukemia(unfit AML)treated with venetoclax(VEN)plus low-dose cytarabine(LDAC)treatment regimen.Methods:In this study,we retrospectively analyzed clinical data from 33 patients with unfit AML treated with VEN plus LDAC at the Affiliated Hospital of Jiangsu University between December 2019 and January 2024.The efficacy and survival outcomes of this regimen were assessed.Results:Thirty-three patients(median age:72 years)were enrolled,including 29 with de novo AML and four with secondary AML.The median follow-up duration was 781 days,with a median OS and progression-free survival(PFS)of 467 days(range:104-812 days)and 395 days(range:104-637 days),respectively.After induction chemotherapy,the overall response rate(ORR)was 69.7%,with a composite rate of complete response(CR)and CR with incomplete blood count recovery(CRi)reaching 36.4%.Morphologic leukemia-free state(MLFS)and partial re-mission(PR)were observed in 3%and 30.3%of patients,respectively.The median number of treatment cycles was three(range:1-6.5).Treatment-related adverse events were primarily hematological,with high rates of grade 3-4 hematologic toxicities.Kaplan-Meier analysis revealed significant associations between survival and ECOG performance status,TP53 mutation status,treatment cycles,and response(P<0.05).Univariate and multivariate Cox regression analyses identified treatment cycles as an independent risk factor for OS(P<0.05).Con-clusions:The VEN plus LDAC regimen demonstrated feasibility and efficacy in patients with newly diagnosed AML;initial response and con-tinuous treatment were associated with favorable survival.

Objective:To discuss the clinical effect of the modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures in the treatment of middle and lower facial sagging.Methods:The clinical data of patients with middle and lower facial sagging treated in Hangzhou Yichao Medical Aesthetics Clinic from February 2021 to February 2023 were retrospectively analyzed. The operation was performed using barbed sutures to progressively reduce tension and suspend sutures of the superficial musculoaponeurotic system (SMAS) and the skin and subcutaneous tissue. The skin tissue flap was separated from the superficial layer of SMAS with temporal hairline to peri-auricular incision. Firstly, the sagging SMAS and the zygomatic fat pad were fixed to the deep temporal fascia by purse-string suture with barbed sutures, and then the sagging skin and subcutaneous tissue were progressively fixed to the corresponding SMAS at multiple points to the incision direction to improve the middle and lower facial relaxation and reduce the incision tension as much as possible. The nasolabial groove of the patients was scored (0-4) before surgery and 12 months after surgery to evaluate the surgical effect. The higher the score, the more serious the nasolabial groove depression was. Meanwhile, the postoperative recovery, complications and satisfaction of the patients were observed and followed up. SPSS 26.0 software was used to analyze the data. Preoperative and postoperative nasolabial groove scores were represented by Mean±SD, and paired t-test was used for comparison. P<0.05 was considered statistically significant. Results:A total of 23 patients were included, including 4 males and 19 females. They ranged in age from 42 to 68, with an average age of 54.0. All patients showed varying degrees of middle and lower facial relaxation and nasolabial groove deepening. Nasolabial groove score was (3.6±0.5) points. One patient had mild hematoma on the second day after surgery, which subsided after suction and compression, then the facial swelling basically subsided about 7 days after the operation. After 12-17 months of follow-up (mean 13.2 months), the middle and lower facial relaxation and nasolabial depression of 23 patients were significantly improved. No serious complications such as facial nerve injury occurred in all patients, and postoperative scars were not obvious. The nasolabial groove score at 12 months after the operation was (2.0±0.6) points, which was significantly lower than that before the operation ( t=14.81, P<0.001). The patient satisfaction rate was 95.7%(22/23). Conclusion:The modified rhytidectomy technique with biplanar progressive tension-reducing and suture suspension using barbed sutures avoids deep dissection, and has simple operation, low complications, fast recovery. The relaxation of middle and lower face can be significantly improved, and the long-term effect is stable.

Objective To evaluate the association between metabolic syndrome and colorectal carcino-ma. Methods A total of 900 patients with colorectal carcinoma from 2013 to 2016 in Qianfoshan Hospital Af-filiated to Shandong University were selected as the case group and 1774 non-colorectal carcinoma participants from health management center as the control group. Logistic regression model was used to identify the relation-ship between metabolic syndrome and colorectal carcinoma. Results Compared with the controls (27. 0％), metabolic syndrome was more prevalent among cases (35. 4％). The difference was statistically significant (χ2 = 20. 33,P < 0. 01). Multivariate logistic regression analyses showed that metabolic syndrome as an entity increased colorectal carcinoma risk (OR = 1. 38,95％ CI:1. 08-1. 75,χ2 = 17. 68,P < 0. 01). Subjects with 2 and 3 or more components of the metabolic syndrome had an increased risk of colorectal carcinoma,and the ORs of colorectal carcinoma were 1. 37 and 1. 60,respectively. Gender-specific patterns were also observed in the association between metabolic syndrome,component and colorectal carcinoma (χ2 = 5. 40,P = 0. 02;χ2 =8. 66,P < 0. 01). Conclusion Metabolic syndrome is associated with the occurrence of colorectal carcinoma. An increasing trend in risk of colorectal carcinoma with the number of metabolic syndrome components is observed.

Objective To evaluate the viability of adipocytes after they are subjected to different compressive stress in vitro for improvement of autologous fat graft and its clinical application.Methods Fat grafts were harvested from healthy patients who underwent liposuction for body contouring.Then the fat grafts were randomly divided into 5 experimental groups,including control group without any compressive stress,and continuous compressive stress groups (0,25,50,75,and 100 kPa),and the glucose transport test was performed at days 1,2,3 and 4.An MTT assay was also performed after 4 days with continuous compressive stress in each group with the same experimental protocol for control.Routine histological examination was done in all groups to examine possible structural destruction after compressive stress.Results As compared with the control group,the glucose transport test showed transported glucose concentration decreased with an increase in compressive stress in all of the other four groups (P＜0.01),and this effect would increase with action time.MTT assay showed absorbance (A492nm) also decreased with an increase in compressive stress in four days (P＜0.05),the similar fndings of MTT assay on the viability of fat grafts in all five groups and correlated with the glucose transport test (r=0.838,P＜0.01).Histology showed significantly distorted and fractured adipocytes and cell injury rate was to raise with an increase in compressive stress.Conclusions Our study demonstrates the harmful effect on the viability of fat grafts with an increase in compressive stress and therefore we should reduce this effect in clinical application of fat grafts.