Objective·To observe the impact of hip synovitis on the long-term outcomes of free vascularized fibular grafting(FVFG)for osteonecrosis of femoral head(ONFH).Methods·Between October 2001 and December 2013,370 patients diagnosed with ONFH(556 hips)underwent FVFG.Preoperative synovitis was assessed using magnetic resonance imaging(MRI)and quantified with the Hip Inflammation MRI Scoring System(HIMRISS).Patients were divided into no synovitis group,moderate synovitis group,and severe synovitis group.Harris hip scores and the incidence of total hip arthroplasty were collected with an average follow-up duration of 90.5 months(range:5-215 months).Hip survival failure(defined as a Harris hip score lower than 80 at the final follow-up or the occurrence of total hip arthroplasty)was calculated.Multivariable Cox regression analysis was adopted to compare the influence of different degrees of synovial inflammation on long-term prognosis.Results·The proportion of hip survival failure was 28.0％in patients without synovitis and 28.5％in those with moderate synovitis,whereas it was significantly higher(60.4％)in patients with severe synovitis.The results of multivariable Cox regression analysis showed that severe synovitis was an independent risk factor for poor prognosis(HR 2.06,95％CI 1.21-3.53)after adjusting for age,gender,education level,marital status,ONFH type,affected side of ONFH,smoking history,baseline Harris hip score and other hip MRI-based covariates(collapse,bone marrow edema,and degeneration).Conclusion·Severe synovitis in patients with ONFH significantly increases the failure rate of hip preservation after FVFG,and the severity of synovitis should be considered in surgical decision-making.

Objective·To observe the impact of hip synovitis on the long-term outcomes of free vascularized fibular grafting(FVFG)for osteonecrosis of femoral head(ONFH).Methods·Between October 2001 and December 2013,370 patients diagnosed with ONFH(556 hips)underwent FVFG.Preoperative synovitis was assessed using magnetic resonance imaging(MRI)and quantified with the Hip Inflammation MRI Scoring System(HIMRISS).Patients were divided into no synovitis group,moderate synovitis group,and severe synovitis group.Harris hip scores and the incidence of total hip arthroplasty were collected with an average follow-up duration of 90.5 months(range:5-215 months).Hip survival failure(defined as a Harris hip score lower than 80 at the final follow-up or the occurrence of total hip arthroplasty)was calculated.Multivariable Cox regression analysis was adopted to compare the influence of different degrees of synovial inflammation on long-term prognosis.Results·The proportion of hip survival failure was 28.0％in patients without synovitis and 28.5％in those with moderate synovitis,whereas it was significantly higher(60.4％)in patients with severe synovitis.The results of multivariable Cox regression analysis showed that severe synovitis was an independent risk factor for poor prognosis(HR 2.06,95％CI 1.21-3.53)after adjusting for age,gender,education level,marital status,ONFH type,affected side of ONFH,smoking history,baseline Harris hip score and other hip MRI-based covariates(collapse,bone marrow edema,and degeneration).Conclusion·Severe synovitis in patients with ONFH significantly increases the failure rate of hip preservation after FVFG,and the severity of synovitis should be considered in surgical decision-making.

Objective:To analyze the epidemiological characteristics and pathogen spectrum of influenza outbreaks in Shaanxi Province from 2014 to 2023 and provide basis reference for strengthening regional influenza prevention and control.Methods:The data were collected from the Public Health Emergency Management Information System of the China Disease Prevention and Control Information System and the China Influenza Surveillance Information System. On-site epidemiological investigation information and etiological test results of influenza network laboratories reported in Shaanxi Province during 2014-2023 were collected, and descriptive analysis was conducted on the time, region, and location distribution of influenza outbreaks. SPSS 25.0 software was used for statistical analysis.Results:A total of 386 influenza outbreaks were reported in Shaanxi from 2014 to 2023, with a total attack rate of 1.81% (14 880/821 001). The epidemic peaks mainly occurred in winter and spring (November to March of the following year), and there was an alternating pattern of epidemic peaks in different years (the early peak was in December, and the late peak was in March of the following year). The epidemic areas were mainly concentrated in the Qinba Mountains of southern Shaanxi (209, 54.15%) and Guanzhong Plain (173, 44.82%). The epidemic places were mainly distributed in primary schools (239, 61.92%), and the differences of epidemic areas and places were statistically significant (all P<0.001). Influenza A(H3N2) viruses were the predominant pathogen in the outbreak (849, 57.76%), and influenza A(H3N2), B (Victoria) lineage and A(H1N1)pdm09 virus alternately dominated the epidemic peak in different years. Conclusions:The peak of influenza outbreaks in Shaanxi Province was winter and spring during 2014-2023. Primary schools in the Qinba Mountains of southern Shaanxi and Guanzhong Plain should be targeted for prevention and control. In the prevention and control programs, close attention should be paid to the changing trend of dominant strains. Effective intervention measures should be targeted to the high-incidence areas and seasons.

Objective:To validate the feasibility of the gamma analysis method in the study of prescription dose conversion between logistic nanodosimetry model (LNDM) and microdosimetric kinetic model (MKM) basing on the Chinese self-developed model LNDM by applying clinical experiences of National Institute of Radiological Science (NIRS).Methods:Physical dose distributions derived from the MKM- and LNDM-based carbon ion treatment plans were compared via the method of gamma analysis under the open-source treatment planning platform matRad. In this way, the prescribed dose conversion factor between the MKM- and LNDM-based treatment plans was obtained. Using water phantoms, the influence of geometric shape, size, depth of target volume (TV), prescribed dose and field setting on the conversion factor was investigated comprehensively. Moreover, preliminary verification of the acquired conversion factor was conducted on the C-shape model and a case of liver cancer patient.Results:The conversion factor depended on the field setting rather than the TV shape. Under the condition of single field, the conversion factor was positively correlated with the size and depth of TV, and the prescribed dose. Moreover, the conversion factor was successfully verified using the C-shape model and the patient with liver cancer, where the gamma passing rates (2%/2 mm) of the physical dose distribution generated by the MKM and LNDM treatment plans were 92.79% and 91.19%, respectively.Conclusions:The conversion factors (f=D LNDM/D MKM) obtained in this study might provide guidance for the prescribed dose setting during the carbon ion treatment planning based on the LNDM. Besides, the gamma analysis method could be used for the study of the prescribed dose conversion between different models.

Objective To investigate whether there is a correlation between the esophageal length of the adult Chinese people and their height, sitting height, sex or age. Methods The length from the upper end of esophagus to the dentate line of the cardia was measured by watching esophageal cavity with endoscope. A total of 613 cases (378 males and 235 females) were studied. Results ① The average length of esophagus was (24.8?2.1)cm for male and (22.8?1.9)cm for female. The difference between male and female was statistically significant (P