Objectives:To investigate the clinical efficacy of bilateral mini-open Wiltse approach transforami-nal lumbar interbody fusion(MO-TLIF)in the treatment of degenerative lumbar diseases in the elderly.Meth-ods:A retrospective analysis was conducted on 62 elderly patients with single-segment degenerative lumbar diseases who underwent MO-TLIF or minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)inthe First Affiliated Hospital of Naval Medical University between September 2017 and August 2020.Among them,37 were male and 25 were female,aged 68.0±5.5 years.The patients were divided into the MO-TLIF group(32 cases)and the MIS-TLIF group(30 cases).There were no statistically significant differences between the two groups in terms of gender ratio,age,body mass index(BMI),surgical segment,disease duration,or follow-up time(P＞0.05).The differences between the two groups were compared in terms of operative time,in-traoperative blood loss,intraoperative fluoroscopy,postoperative wound drainage,time to ambulation,hospital stay,complications,and fusion rate.The visual analogue scale(VAS),lumbar Japanese Orthopedic Association(JOA)scores,and Oswestry disability index(ODI)before surgery,at 3 months postoperatively,and at the final follow-up were recorded and compared.Results:The two groups of patients all successfully completed the surgery without significant surgery-related complications.There were no statistically significant differences be-tween the MO-TLIF and MIS-TLIF groups in terms of intraoperative blood loss(80.3±25.1mL vs.72.3±21.8mL),postoperative wound drainage volume(30.7±10.2mL vs.29.3±9.0mL),or hospital stay(5.4±0.9d vs.5.4±0.8d)(P＞0.05).Compared with the MIS-TLIF group,the MO-TLIF group had shorter operative time(90.8±8.8min vs.98.3±8.0min,P=0.001)and fewer number of intraoperative fluoroscopy(4.7±0.7 times vs.7.2±1.4 times,P＜0.001).Both groups showed significant improvement in low back pain VAS score,lumbar JOA score,and ODI at postoperative 3 months and final follow-up compared with preoperative values(P＜0.001),but there were no statistically significant differences between the two groups at the same time points(P＞0.05).At the fi-nal follow-up,no internal fixation-related complications such as screw or rod breakage were observed in both groups,and all the cases achieved bone fusion.Conclusions:Bilateral MO-TLIF can achieve good therapeutic outcomes in treating single-segment degenerative lumbar diseases,which can reduce intraoperative fluoroscopy frequency and shorten operative time comparing with MIS-TLIF.

Objectives:To investigate the clinical efficacy of bilateral mini-open Wiltse approach transforami-nal lumbar interbody fusion(MO-TLIF)in the treatment of degenerative lumbar diseases in the elderly.Meth-ods:A retrospective analysis was conducted on 62 elderly patients with single-segment degenerative lumbar diseases who underwent MO-TLIF or minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)inthe First Affiliated Hospital of Naval Medical University between September 2017 and August 2020.Among them,37 were male and 25 were female,aged 68.0±5.5 years.The patients were divided into the MO-TLIF group(32 cases)and the MIS-TLIF group(30 cases).There were no statistically significant differences between the two groups in terms of gender ratio,age,body mass index(BMI),surgical segment,disease duration,or follow-up time(P＞0.05).The differences between the two groups were compared in terms of operative time,in-traoperative blood loss,intraoperative fluoroscopy,postoperative wound drainage,time to ambulation,hospital stay,complications,and fusion rate.The visual analogue scale(VAS),lumbar Japanese Orthopedic Association(JOA)scores,and Oswestry disability index(ODI)before surgery,at 3 months postoperatively,and at the final follow-up were recorded and compared.Results:The two groups of patients all successfully completed the surgery without significant surgery-related complications.There were no statistically significant differences be-tween the MO-TLIF and MIS-TLIF groups in terms of intraoperative blood loss(80.3±25.1mL vs.72.3±21.8mL),postoperative wound drainage volume(30.7±10.2mL vs.29.3±9.0mL),or hospital stay(5.4±0.9d vs.5.4±0.8d)(P＞0.05).Compared with the MIS-TLIF group,the MO-TLIF group had shorter operative time(90.8±8.8min vs.98.3±8.0min,P=0.001)and fewer number of intraoperative fluoroscopy(4.7±0.7 times vs.7.2±1.4 times,P＜0.001).Both groups showed significant improvement in low back pain VAS score,lumbar JOA score,and ODI at postoperative 3 months and final follow-up compared with preoperative values(P＜0.001),but there were no statistically significant differences between the two groups at the same time points(P＞0.05).At the fi-nal follow-up,no internal fixation-related complications such as screw or rod breakage were observed in both groups,and all the cases achieved bone fusion.Conclusions:Bilateral MO-TLIF can achieve good therapeutic outcomes in treating single-segment degenerative lumbar diseases,which can reduce intraoperative fluoroscopy frequency and shorten operative time comparing with MIS-TLIF.

Objective:To explore the effect of case-based learning (CBL) based on WeChat platform in orthopedics practice teaching.Methods:A total of 101 orthopedic interns in The First Affiliated Hospital of Navy Medical University Hongkou Campus were randomly divided into two groups, with 50 interns in experimental group and 51 interns in control group. The experimental group conducted CBL based on WeChat platform for teaching, and the control group adopted traditional teaching method for teaching. At the end of the internship, the teaching effect on the interns was assessed by the "department graduation examination" and "questionnaire survey". The examination included basic theoretical knowledge and case analysis. Questionnaire survey included active preparation before class, teaching methods, class participation and discussion, interest in class and teaching effect. SPSS 17.0 was used for statistical analysis.Results:The total scores of the examinations, theoretical test and case analysis of the interns in the experimental group [(83.58±5.68) points, (49.98±3.71) points, (33.60±2.28) points, respectively] were better than those of the interns in the control group [(80.28±6.04) points, (48.20±4.12) points, (32.08±2.06) points, respectively], with statistical significance ( P < 0.05). The results of the questionnaire survey showed that the interns in the experimental group were significantly more satisfied with the teaching than those in the control group in such aspects as active preparation before class, teaching methods, class participation and discussion, class interest, class effect and satisfaction, and the differences in active preparation, participation and interest were statistically different ( P < 0.05). Conclusion:In the process of orthopedics practice teaching, the teaching method of CBL based on WeChat platform can mobilize the enthusiasm and participation of students, and can improve the clinical teaching effect of orthopedics, which is worthy of promotion and application in practice teaching.

Objective:To investigate the knee joint pain during running and its contributing factors among sailors on a long oceangoing voyage through questionnaire, so as to provide evidence for future preventive measures.Methods:After four months of voyage, a questionnaire survey was conducted on the knee joint pain during running and its contributing factors among sailors in the background of long oceangoing vessel protection operation. The questionnaire collected data regarding age, height, weight, body mass index (BMI), physical exercise history, knee joint pain history, single running duration, running frequency, running shoes, and warm-up before running. The runners were divided into two groups, namely knee joint pain group (pain group) and no knee joint pain group (painless group). The differences of the pain contributing factors between the two groups were compared.Results:In total, 122 valid questionnaires returned, 68 in the pain group and 54 in the painless group. The incidence rate of knee joint pain was 55.7 %. There was no statistically significant difference in age, height, weight, BMI, physical exercise history, running frequency, and running shoes between the two groups ( P>0.05). There were statistically significant differences in knee joint pain history, single running duration, and warm-up before running between the two groups ( P<0.05). Conclusion:Knee joint pain during running is common among sailors on a long oceangoing voyage. The knee injury is closely related to the history of knee pain, too long single running time, and no warm-up before running. It is suggested that sailors pay attention to quadriceps exercise, warm-up before running, and scientific planning of running on the long oceangoing voyage.

Objective:To investigate the knee joint pain during running and its contributing factors among sailors on a long oceangoing voyage through questionnaire, so as to provide evidence for future preventive measures.Methods:After four months of voyage, a questionnaire survey was conducted on the knee joint pain during running and its contributing factors among sailors in the background of long oceangoing vessel protection operation. The questionnaire collected data regarding age, height, weight, body mass index (BMI), physical exercise history, knee joint pain history, single running duration, running frequency, running shoes, and warm-up before running. The runners were divided into two groups, namely knee joint pain group (pain group) and no knee joint pain group (painless group). The differences of the pain contributing factors between the two groups were compared.Results:In total, 122 valid questionnaires returned, 68 in the pain group and 54 in the painless group. The incidence rate of knee joint pain was 55.7 %. There was no statistically significant difference in age, height, weight, BMI, physical exercise history, running frequency, and running shoes between the two groups ( P>0.05). There were statistically significant differences in knee joint pain history, single running duration, and warm-up before running between the two groups ( P<0.05). Conclusion:Knee joint pain during running is common among sailors on a long oceangoing voyage. The knee injury is closely related to the history of knee pain, too long single running time, and no warm-up before running. It is suggested that sailors pay attention to quadriceps exercise, warm-up before running, and scientific planning of running on the long oceangoing voyage.