Objective:To compare arthroscopic versus open Brostr?m-Gould repair of the anterior talofibular ligament (ATFL) in the treatment of chronic ankle instability (CAI) in young men undergoing high intensity exercise.Methods:A retrospective study was conducted to analyze the 61 young male patients with CAI undergoing high-intensity exercise who had been treated at Department of Trauma and Orthopedics, 947th Army Hospital of Chinese People’s Liberation Army from January 2016 to July 2020. Their age was (25.9±2.7) years and their disease duration (13.9±2.8) months. According to their different treatment methods, they were divided into an arthroscopic group ( n=26) in which their ATFL was repaired by arthroscopic Brostr?m-Gould surgery and a Brostr?m-Gould group ( n=35) in which their ATFL was repaired by open Brostr?m-Gould surgery. The 2 groups were compared in terms of operation time and intraoperative bleeding, as well as the ankle-hindfoot scores of American Orthopaedic Foot & Ankle Society (AOFAS), Karlsson ankle functional (KAF) scores and visual analogue scale (VAS) pain scores at postoperative 3, 6, 12, and 24 months. Results:There were no significant differences in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). The operation time [(35.8±3.9) min] and intraoperative bleeding [(6.6±2.6) mL] in the arthroscopic group were significantly less than those in the Brostr?m-Gould group [(52.1±4.6) min and (16.1±4.0) mL] ( P < 0.05). The AOFAS ankle-hindfoot scores and KAF scores in the arthroscopic group were significantly higher than those in the Brostr?m-Gould group at postoperative 3 and 6 months, but the AOFAS ankle-hindfoot score and KAF score at postoperative 24 months were significantly lower than those in the Brostr?m-Gould group ( P < 0.05). There was no statistically significant difference in AOFAS ankle-hindfoot score or KAF score between the 2 groups at postoperative 12 months, as well as in VAS pain scores at postoperative 3, 6, 12, and 24 months between the 2 groups ( P > 0.05). Conclusions:In young men undergoing high intensity exercise, compared with open Brostr?m-Gould surgery, arthroscopic Brostr?m-Gould surgery may lead to better clinical outcomes in a short-term (3 months after surgery). However, open Brostr?m-Gould surgery may result in better long-term efficacy than arthroscopic Brostr?m-Gould surgery (24 months after surgery).

Objective:To compare arthroscopic versus open Brostr?m-Gould repair of the anterior talofibular ligament (ATFL) in the treatment of chronic ankle instability (CAI) in young men undergoing high intensity exercise.Methods:A retrospective study was conducted to analyze the 61 young male patients with CAI undergoing high-intensity exercise who had been treated at Department of Trauma and Orthopedics, 947th Army Hospital of Chinese People’s Liberation Army from January 2016 to July 2020. Their age was (25.9±2.7) years and their disease duration (13.9±2.8) months. According to their different treatment methods, they were divided into an arthroscopic group ( n=26) in which their ATFL was repaired by arthroscopic Brostr?m-Gould surgery and a Brostr?m-Gould group ( n=35) in which their ATFL was repaired by open Brostr?m-Gould surgery. The 2 groups were compared in terms of operation time and intraoperative bleeding, as well as the ankle-hindfoot scores of American Orthopaedic Foot & Ankle Society (AOFAS), Karlsson ankle functional (KAF) scores and visual analogue scale (VAS) pain scores at postoperative 3, 6, 12, and 24 months. Results:There were no significant differences in the preoperative general data between the 2 groups, indicating comparability ( P > 0.05). The operation time [(35.8±3.9) min] and intraoperative bleeding [(6.6±2.6) mL] in the arthroscopic group were significantly less than those in the Brostr?m-Gould group [(52.1±4.6) min and (16.1±4.0) mL] ( P < 0.05). The AOFAS ankle-hindfoot scores and KAF scores in the arthroscopic group were significantly higher than those in the Brostr?m-Gould group at postoperative 3 and 6 months, but the AOFAS ankle-hindfoot score and KAF score at postoperative 24 months were significantly lower than those in the Brostr?m-Gould group ( P < 0.05). There was no statistically significant difference in AOFAS ankle-hindfoot score or KAF score between the 2 groups at postoperative 12 months, as well as in VAS pain scores at postoperative 3, 6, 12, and 24 months between the 2 groups ( P > 0.05). Conclusions:In young men undergoing high intensity exercise, compared with open Brostr?m-Gould surgery, arthroscopic Brostr?m-Gould surgery may lead to better clinical outcomes in a short-term (3 months after surgery). However, open Brostr?m-Gould surgery may result in better long-term efficacy than arthroscopic Brostr?m-Gould surgery (24 months after surgery).

BACKGROUND:Heterotopic ossification is a dynamic growth process.Diverse heterotopic ossification subtypes have diverse etiologies or induction factors,but they exhibit a similar clinical process in the intermediate and later phases of the disease.Acquired heterotopic ossification produced by trauma and other circumstances has a high incidence. OBJECTIVE:To summarize the molecular biological mechanisms linked to the occurrence and progression of acquired heterotopic ossification in recent years. METHODS:The keywords"molecular biology,heterotopic ossification,mechanisms"were searched in CNKI,Wanfang,PubMed,Embase,Web of Science,and Google Scholar databases for articles published from January 2016 to August 2022.Supplementary searches were conducted based on the obtained articles.After the collected literature was screened,131 articles were finally included and summarized. RESULTS AND CONCLUSION:(1)The occurrence and development of acquired heterotopic ossification is a dynamic process with certain concealment,making diagnosis and treatment of the disease difficult.(2)By reviewing relevant literature,it was found that acquired heterotopic ossification involves signaling pathways such as bone morphogenetic protein,transforming growth factor-β,Hedgehog,Wnt,and mTOR,as well as core factors such as Runx-2,vascular endothelial growth factor,hypoxia-inducing factor,fibroblast growth factor,and Sox9.The core mechanism may be the interaction between different signaling pathways,affecting the body's osteoblast precursor cells,osteoblast microenvironment,and related cytokines,thereby affecting the body's bone metabolism and leading to the occurrence of acquired heterotopic ossification.(3)In the future,it is possible to take the heterotopic ossification-related single-cell osteogenic homeostasis as the research direction,take the osteoblast precursor cells-osteogenic microenvironment-signaling pathways and cytokines as the research elements,explore the characteristics of each element under different temporal and spatial conditions,compare the similarities and differences of the osteogenic homeostasis of different types and individuals,observe the regulatory mechanism of the molecular signaling network of heterotopic ossification from a holistic perspective.It is beneficial to the exploration of new methods for the future clinical prevention and treatment of heterotopic ossification.(4)Meanwhile,the treatment methods represented by traditional Chinese medicine and targeted therapy have become research hotspots in recent years.How to link traditional Chinese medicine with the osteogenic homeostasis in the body and combine it with targeted therapy is also one of the future research directions.(5)At present,the research on acquired heterotopic ossification is still limited to basic experimental research and the clinical prevention and treatment methods still have defects such as uncertain efficacy and obvious side effects.The safety and effectiveness of relevant targeted prevention and treatment drugs in clinical application still need to be verified.Future research should focus on clinical prevention and treatment based on basic experimental research combined with the mechanism of occurrence and development.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.

Objective:To compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol (PEG) electrolyte powder for colonoscopy bowel preparation.Methods:A total of 283 randomized patients from 9 centers in China taking OSS ( n=143) or PEG ( n=140) using two-day split bowel preparation regimen received colonoscopy and assessment. The primary index was the bowel preparation success rate [global Boston bowel preparation scale (BBPS)≥ 6 by independent assessment center]. Secondary indices included BBPS global and segmental scores, investigator satisfaction (5-point Likert scale) with the quality of bowel preparation, patient satisfaction assessed by questionnaires, and patient tolerance assessed by Sharma scale. Compliance and safety were compared between the two groups. Results:The bowel preparation success rates were 100.0% for OSS and 99.3% for PEG [adjusted difference 0.7% (95% CI: -5.3% - 6.7%), P<0.001 for non-inferiority]. The BBPS global score in OSS group was significantly higher than that in PEG group (8.1 VS 7.7, P<0.001). The segment BBPS scores were also higher in OSS group than those in PEG group for all 3 segments (right colon: 2.4 VS 2.3, P=0.002; transverse colon: 2.8 VS 2.7, P=0.018; left colon: 2.8 VS 2.7, P=0.007). Investigator Likert score in the OSS group was significantly higher than that in the PEG group (2.6 VS 2.3, P<0.001). There was no significant difference in compliance between OSS and PEG, except for the second dose (90.9% VS 82.6%, P=0.039). There was no significant difference in patient satisfaction, Sharma score or proportion of patients with tolerance-related symptoms between the two groups. Safety was comparable between the two groups, and all adverse events were mild to moderate. Conclusion:OSS has comparable efficacy with PEG, with higher BBPS scores in all segments, better investigator satisfaction, better compliance in split dose, and comparable patient tolerance and safety.

Objective To evaluate FIB-NLR,a combined neutrophil-lymphocyte ratio (NLR) and fibrinogen concentration (FIB) in predicting the prognosis of gastrointestinal stromal tumors (GIST).Methods Data of 79 GIST patients who underwent surgery from Jun 2010 to Dec 2014 were retrospectively analyzed.Patients were divided into 3 groups:NLR ＜ 2.30 and FIB ＜ 3.85 g/L were defined as group 0,NLR≥2.30 and FIB ＜3.85 g/L or NLR ＜2.30 and FIB≥3.85 g/L as group 1,NLR≥2.30 and FIB≥3.85 g/L as group 2.The clinicopathological features of the three groups and the 5-year recurrence-free survival rate after surgery were compared.Results FIB concentration and NLR were significantly correlated with NIH risk grade and tumor size in GIST patients (x2 =9.517,12.41 1,6.081,20.067,all P ＜ 0.05).FIB-NLR was closely related to tumor size,tumor risk and tumor mitosis (x2 =14.406,12.514,28.225,all P ＜ 0.05).Survival analysis showed that high FIB predicts lower 5-year recurrence-free survival rate,it was 87.4％ for group 0,60.8％ for group 1,21.1％ for group2,x2 =29.617,P＜0.000).Conclusion FIB-NLR independently predicts the prognosis of gastrointestinal stromal tumors.