Objective To investigate the prognostic value of vertebral CT parameters for early fusion sink after transforaminal lumbar interbody fusion(TLIF).Methods The clinical and imaging data of 178 patients with lumbar degenerative diseases treated by TLIF were retrospectively studied.The patients were divided into the sedimentation group(n=57)and the non-sedimentation(n=57)group according to the patient's fusion device settlement 3 months after surgery.The results of general data and CT image parameters were compared between the two groups.Multivariate Logistic regression was used to analyze risk factors of early fusion subsidence,and the prediction efficiency was analyzed.Results The incidence of the early fusion sink was 32.0%.Compared with the non-sedimentation group,the sedimentation group had a higher proportion of patients aged≥60 years,osteoporosis,L5-S1 and intervertebral space height,larger fusion contact area and segmental lordosis angle and lower lumbar CT value(P＜0.05).Logistic regression analysis showed that age≥60 years old,surgical level L5-S1,high intervertebral height and large segmental lordosis angle were independent risk factors for the early fusion after TLIF,while high lumbar CT value was protective factor(P＜0.05).Subject working characteristic curves showed that the area under the curve(AUC)of lumbar CT value,intervertebral height,segmental lordosis angle combined with AUC were higher than those of patients aged≥60 years,surgical segment L5-S1,lumbar CT value,intervertebral height,segmental lordosis angle applied alone(P＜0.05).Conclusion Vertebral CT parameters of lumbar CT value,intervertebral height and segmental lordosis angle have higher predictive value for the early fusion after TLIF,and the combined prediction value of the three parameters is higher.

Objective:To investigate the accuracy and clinical utility of a newly designed acetabular bone defect classification system based on the ischial-gluteal pillar in assessing the severity of acetabular bone defects and guiding hip revision surgery.Methods:A retrospective analysis was conducted on 474 patients who underwent hip revision surgery for prosthetic loosening after total hip arthroplasty at our institution from January 2010 to December 2020, including 296 males and 178 females with a mean age of 70.4±8.9 years (range: 52-86 years). The accuracy of our classification system in guiding surgical procedures was evaluated by comparing preoperative defect classifications with intraoperative findings. Clinical outcomes were evaluated using preoperative and final follow-up Harris hip scores (HHS) and Oxford hip scores (OHS), as well as the incidence of complications.Results:Preoperative classifications included 143 Type I, 192 Type II (Type IIa: 86 cases, Type IIb: 59 cases, Type IIc: 47 cases), 93 Type III (Type IIIa: 54 cases, Type IIIb: 27 cases, Type IIIc: 12 cases), and 46 Type IV cases (Type IVa: 32 cases, Type IVb: 9 cases, Type IVc: 5 cases). Compared with intraoperative findings, classification accuracy was 99.3% for Type I (1 errors), 98.4% for Type II (3 errors), 97.8% for Type III (2 errors), and 97.8% for Type IV (1 misclassified as Type III). The mean follow-up was 5.8±4.4 years (range: 2-12 years). At final follow-up, mean HHS improved from 36.65±10.27 to 91.36±7.53, and mean OHS increased from 11.35±4.36 to 44.6±5.27 with significant difference ( P<0.001). Complications included one Type IV periprosthetic infection, one Type II hip dislocation, one Type I and two Type IV re-revisions (due to femoral loosening or graft resorption), one Type II and one Type III death unrelated to surgery, and one Type I postoperative thigh hematoma. No neurovascular injuries occurred. Conclusions:This novel 3D acetabular bone defect classification system, based on ischial-gluteal pillar integrity, provides accurate preoperative assessment and effectively guides surgical planning. Its application demonstrates favorable mid-term outcomes in hip revision surgery.

Objective:To investigate the accuracy and clinical utility of a newly designed acetabular bone defect classification system based on the ischial-gluteal pillar in assessing the severity of acetabular bone defects and guiding hip revision surgery.Methods:A retrospective analysis was conducted on 474 patients who underwent hip revision surgery for prosthetic loosening after total hip arthroplasty at our institution from January 2010 to December 2020, including 296 males and 178 females with a mean age of 70.4±8.9 years (range: 52-86 years). The accuracy of our classification system in guiding surgical procedures was evaluated by comparing preoperative defect classifications with intraoperative findings. Clinical outcomes were evaluated using preoperative and final follow-up Harris hip scores (HHS) and Oxford hip scores (OHS), as well as the incidence of complications.Results:Preoperative classifications included 143 Type I, 192 Type II (Type IIa: 86 cases, Type IIb: 59 cases, Type IIc: 47 cases), 93 Type III (Type IIIa: 54 cases, Type IIIb: 27 cases, Type IIIc: 12 cases), and 46 Type IV cases (Type IVa: 32 cases, Type IVb: 9 cases, Type IVc: 5 cases). Compared with intraoperative findings, classification accuracy was 99.3% for Type I (1 errors), 98.4% for Type II (3 errors), 97.8% for Type III (2 errors), and 97.8% for Type IV (1 misclassified as Type III). The mean follow-up was 5.8±4.4 years (range: 2-12 years). At final follow-up, mean HHS improved from 36.65±10.27 to 91.36±7.53, and mean OHS increased from 11.35±4.36 to 44.6±5.27 with significant difference ( P<0.001). Complications included one Type IV periprosthetic infection, one Type II hip dislocation, one Type I and two Type IV re-revisions (due to femoral loosening or graft resorption), one Type II and one Type III death unrelated to surgery, and one Type I postoperative thigh hematoma. No neurovascular injuries occurred. Conclusions:This novel 3D acetabular bone defect classification system, based on ischial-gluteal pillar integrity, provides accurate preoperative assessment and effectively guides surgical planning. Its application demonstrates favorable mid-term outcomes in hip revision surgery.

Objective To investigate the prognostic value of vertebral CT parameters for early fusion sink after transforaminal lumbar interbody fusion(TLIF).Methods The clinical and imaging data of 178 patients with lumbar degenerative diseases treated by TLIF were retrospectively studied.The patients were divided into the sedimentation group(n=57)and the non-sedimentation(n=57)group according to the patient's fusion device settlement 3 months after surgery.The results of general data and CT image parameters were compared between the two groups.Multivariate Logistic regression was used to analyze risk factors of early fusion subsidence,and the prediction efficiency was analyzed.Results The incidence of the early fusion sink was 32.0%.Compared with the non-sedimentation group,the sedimentation group had a higher proportion of patients aged≥60 years,osteoporosis,L5-S1 and intervertebral space height,larger fusion contact area and segmental lordosis angle and lower lumbar CT value(P＜0.05).Logistic regression analysis showed that age≥60 years old,surgical level L5-S1,high intervertebral height and large segmental lordosis angle were independent risk factors for the early fusion after TLIF,while high lumbar CT value was protective factor(P＜0.05).Subject working characteristic curves showed that the area under the curve(AUC)of lumbar CT value,intervertebral height,segmental lordosis angle combined with AUC were higher than those of patients aged≥60 years,surgical segment L5-S1,lumbar CT value,intervertebral height,segmental lordosis angle applied alone(P＜0.05).Conclusion Vertebral CT parameters of lumbar CT value,intervertebral height and segmental lordosis angle have higher predictive value for the early fusion after TLIF,and the combined prediction value of the three parameters is higher.

Objective To analyze the biomechanical characteristics of the landing movements of com-petitive aerobics athletes,compare the laterality between their dominant and non-dominant limbs,and to explore the primary factors influencing landing stability.Methods Taking 26 female aerobics athletes in universities as the research objects,their kinematics and kinetics data of double-leg vertical land-ing with the height of 40 cm were simultaneously recorded.A comparison was made between the two limbs in terms of joint angles at initial contact,range of motion(ROM)of joint,ground reaction force(GRF),load-rate,the displacement and envelope area of the center of pressure(COP).The symmetry index(SI),reflecting laterality,was computed,and a multiple stepwise regression analysis was conduct-ed to examine the correlation between parameter asymmetry and COP envelope area.Results Compared with the non-dominant limbs,the dominant limbs had significantly greater knee external rotation and hip abduction angle at initial contact(P<0.05),significantly greater ROM of the ankle and hip flexion-extension and hip adduction-abduction,and smaller ROM of ankle rotation during landing(P<0.05).Moreover,the peak knee extension moment of the dominant limbs was significantly higher than the non-dominant limbs(P<0.01).The SI of vertical load rate and peak knee extension moment were signif-icantly positively correlated with the COP envelope area(P<0.05).In addition,the SI of vertical load rate,peak knee extension moment and knee rotation angle could explain 83.6%of the difference in the COP envelope area.Conclusion There is laterality between the dominant and non-dominant limb of competitive aerobics athletes during landing:the greater laterality of the load rate and peak knee ex-tension moment,the worse the landing stability.Furthermore,the SI of vertical load rate,peak knee extension moment,and knee rotation angle can be used as predictors of the landing stability.

Objective To investigate the difference of matrix stiffness in different regions of tibial plateau in osteoarthritis (OA) and its effects on morphology of the cartilage and mitochondria. Methods The tibial plateau cartilage specimens of OA were obtained for nanoindentation test, transmission electron microscopy and histological analysis. The stiffness of cartilage matrix in different regions of OA tibial plateau was detected by nano-indentation. The morphology of cartilage mitochondria in different regions was observed by transmission electron microscopy, and the changes of mitochondrial plane area, shape and ridge volume density were quantitatively analyzed. Cartilage injury in different regions of OA tibial plateau was observed by histological staining. Results The cartilage of OA tibial plateau showed regional heterogeneity, and the cartilage and mitochondria on medial side of varus knee OA were more severe, and the matrix stiffness was higher. The OA scores were positively correlated with matrix stiffness. There was also a significant correlation between OA scores and mitochondrial morphology: the higher OA scores, the larger and rounder mitochondrial plane area, and the lower cristae volume density. Conclusions The differences of tibial plateau revealed the correlation between cartilage matrix stiffness, OA scores and mitochondrial morphological parameters. The increased cartilage matrix stiffness may be the main cause of chondrocyte mitochondrial injury, and further aggravate the progression of OA.

Objective To understand the pathogenic epidemiological status quo among populations with respiratory tract infectious in Nanjing area.Methods The IgM antibody detection reagent kit against 9 kinds of respiratory tract pathogen was used to conduct the IgM antibody detection in 25 057 patients with respiratory tract infection in the Affiliated Nanjing Hospital of Nanjing Medical University,Affiliated Children's Hospital of Nanjing Medical University and Nanjing General Hospital of Nanjing Military Region from May 2013 to April 2015.Results A total of 8 575 cases(34.22％) of pathogen positive were detected out,in which Pneumonia mycoplasma (MP) antibody had the highest positive rate (23.77％);followed by respiratory syncytial virus (RSV,5.19 ％),adenovirus (ADV,4.56 ％),Parainfluenza virus type 1,2 and 3 (PIVS,4.02 ％) and influenza B virus (INFB,2.28％).The seasonal distribution of RSV,ADV and PIVS was significant and had high onset in winter and spring,but low onset in summer and autumn.Infants and young children had maximal positive cases in preschool period,which were 5 274 cases;as a whole,MP IgM antibody positive rate was gradually decreased with the age increase.Conclusion MP is the main pathogen causing respiratory tract infections in Nanjing area,followed by RSV.The pathogenic infection has a correlation with the age group,moreover which demonstrates the seasonal epidemic trend.

Objective To evaluate the clinical efficacy of total hip arthroplasty (THA) with no femoral shortening oste?otomy for unilateral CroweⅣ developmental dysplasia of hip. Methods From October 2007 to January 2010, 32 patients with CroweⅣdevelopmental dysplasia of hip in one side underwent THA, including 20 females and 12 males, with an average age of 49.4 ± 9.7 years (range, 23-60 years). There were 15 cases as normal and 17 as mild developmental dysplasia of hip in the other side. The THA were performed with requisite soft tissue release and direct leverage using an elevator but with no femoral shorten?ing osteotomy. The patients' satisfaction, Harris hip score, bilateral leg?length discrepancy and pelvic obliquity was used to assess the clinical results. Results All of patient were followed up for 1-6 years, average 4.0 ± 1.5 years. No loosening or failure of component occurred by the end of follow?up. The Harris hip score was improved from preoperative 36.5±10.3 (20-63) to 89.8± 4.9 (80-97), and the excellent and good rate was 100% (excellent 16 cases, good 16 cases). The satisfactory rate was 93.8%(30/32). The leg?length discrepancy of the bilateral sides and the pelvic obliquity was corrected gradually and the gait returns to normal. Nine cases have valgus knee after THA and 4 cases of them felt uncomfortable after long?distance walk. Femoral nerve injury occurred in 2 cases. All of cases recovered after 1 and 3 months respectively. No infection and dislocation oc?curred. Conclusion THA with no femoral shortening osteotomy can achieve good clinical results in patients with unilateral CroweⅣdevelopmental dysplasia of hip. The discrepancy of leg?length will be diminished with the correction for pelvic obliquity.