Objective To analyze the prevalence and influencing factors of sarcopenia in patients with tracheotomy and construct a prediction model,so as to provide reference for the prevention and early intervention of sarcopenia in patients.Methods A total of 162 patients who underwent tracheotomy at Zhejiang Rehabilitation Medical Center/The Affiliated Rehabilitation Hospital of Zhejiang Chinese Medical University from January 2023 to December 2024 were selected as subjects.According to the diagnosis criteria for sarcopenia,the patients were divided into sarcopenia group(n=141)and non-sarcopenia group(n=21).Statistical analysis was conducted on demographic data and clinical indicators of both groups.Multivariate Logistic regression model was employed to identify risk factors for developing sarcopenia in patients undergoing tracheotomy,followed by the construction of a predictive model.Results There were significant differences in age,tracheotomy time,total protein,globulin levels,and hemoglobin levels between two groups(P＜0.05).Multivariate Logistic regression analysis showed that tracheotomy duration,low globulin levels,and low hemoglobin levels were independent risk factors for developing sarcopenia in patients undergoing tracheotomy.A risk prediction model constructed using these three indicators,area under the receiver operating characteristic curve was 0.939,with a sensitivity of 89.4％and a specificity of 85.7％.Conclusion Sarcopenia has a high prevalence in patients with tracheotomy,and the model based on tracheotomy time,low globulin level and low hemoglobin level has high value in predicting the risk of sarcopenia in patients with tracheotomy.

Objective To analyze the prevalence and influencing factors of sarcopenia in patients with tracheotomy and construct a prediction model,so as to provide reference for the prevention and early intervention of sarcopenia in patients.Methods A total of 162 patients who underwent tracheotomy at Zhejiang Rehabilitation Medical Center/The Affiliated Rehabilitation Hospital of Zhejiang Chinese Medical University from January 2023 to December 2024 were selected as subjects.According to the diagnosis criteria for sarcopenia,the patients were divided into sarcopenia group(n=141)and non-sarcopenia group(n=21).Statistical analysis was conducted on demographic data and clinical indicators of both groups.Multivariate Logistic regression model was employed to identify risk factors for developing sarcopenia in patients undergoing tracheotomy,followed by the construction of a predictive model.Results There were significant differences in age,tracheotomy time,total protein,globulin levels,and hemoglobin levels between two groups(P＜0.05).Multivariate Logistic regression analysis showed that tracheotomy duration,low globulin levels,and low hemoglobin levels were independent risk factors for developing sarcopenia in patients undergoing tracheotomy.A risk prediction model constructed using these three indicators,area under the receiver operating characteristic curve was 0.939,with a sensitivity of 89.4％and a specificity of 85.7％.Conclusion Sarcopenia has a high prevalence in patients with tracheotomy,and the model based on tracheotomy time,low globulin level and low hemoglobin level has high value in predicting the risk of sarcopenia in patients with tracheotomy.

Objective To discuss the treatment of tibial plateau posterior column fractures via the posteromedial approach which dissects the medial head of the gastrocnemius muscle.Methods From July 2013 to September 2016,7 patients were treated at Department of Orthopaedics and Trauma,The First Affiliated Hospital to Dalian Medical University by surgery via the posteromedial approach dissecting the medial head of the gastrocnemius muscle for tibial plateau posterior column fractures.They were 6 men and one woman,aged from 38 to 61 years (49.3 years on average).According to AO/OTA classification,4 cases belonged to type 41-B3.3,one to type 41-B3.1,one to type 41-C3.3 and one to type 41-C3.1.According to the three-column classification,3 cases were categorized into three-column fracture,2 cases into fracture of both medial and posterior columns,and 2 cases into simple posterior column fracture.Of the posterior column fractures,5 had the medial posterior column split and the lateral column collapsed,and 2 had the medial posterior column split.According to Schatzker classification,5 cases were categorized into type Ⅳ,one into type Ⅴ and one into type Ⅵ.Fracture reduction was assessed according to the Rasmussen criteria postoperation.The knee function was assessed at final follow-ups using The Hospital for Special Surgery (HSS) scoring system.The postoperative complications were documented.Results Insertion rupture of the posterior cruciate ligament was found in one case,lateral meniscus injury in 2 cases,and tibial external dislocation combined with bone fragment incarceration into the lateral femoral condyle in one case.All the lesions were repaired.All the incisions were healed at the first stage.No major neurovascular injuries were found.The 7 patients were followed up for 8 to 12 months (mean,11.4 months).Bony union was achieved in all after 12 to 16 weeks (mean,14.3 weeks).The postoperative Rasmussen reduction scores averaged 17.7 points.The average tibial plateau tilt angle was 9.5°postoperatively and 10.8° at final follow-ups;the average tibial plateau varus angle was 86.7° postoperatively and 87.3° at final follow-ups.The HSS knee scores at final follow-ups averaged 91.4 points.No significant reduction loss,implants loosening,infection or malunion was observed at final follow-ups.Conclusion The posterior medial approach which dissects the medial head of the gastrocnemius muscle is a safe and practical one for treatment of tibial plateau posterior column fractures,because it can well expose the posterior column of the entire tibial plateau so that is beneficial to the anatomical reduction of the fracture and placement of implants,leading to fine short-term curative effect.

Objective To explore the relationship between MRI signal intensity in pallidum and levels of total bilirubin in neonatal hy-perbilirubinemia. Methods From July, 2014 to October, 2015, sixty neonates were divided into three groups according to the levels of total serum bilirubin (TSB), that were group I (TSB 17.1~34.2μmol/L, n=16), group II (TSB>34.2~340μmol/L, n=34), and group III (TSB>340μmol/L, n=10). They were screened with 3.0 T MRI, and the T1WI signal intensity of bilateral pallidum was measured. Results The bi-lateral signal intensity was higher in group III than in group II and group I. There was positive correlation between signal intensity and TSB levels. Conclusion The MRI signal intensity in pallidum may help for diagnosis of neonatal bilirubin encephalopathy.