OBJECTIVE: To investigate the effectiveness of spring ligament repair combined with subtalar arthroereisis (STA) and the Kidner procedure for treating children's flexible flatfoot with painful accessory navicular. METHODS: A retrospective analysis was conducted on clinical data from 45 children (45 feet) aged 7-14 years with flexible flatfoot and painful accessory navicular who met the selection criteria and were treated between February 2018 and May 2022. Among them, 23 cases (23 feet) were treated with spring ligament repair combined with STA and Kidner procedure (observation group), while 22 cases (22 feet) received STA with Kidner procedure alone (control group). Comparison of baseline data between the two groups including gender, age, affected side, preoperative visual analogue scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, talonavicular coverage angle (TCA), talus-first metatarsal angle (T1MT), talus-second metatarsal angle (T2MT), talus first plantar angle (Meary angle), calcaneal inclination angle (Pitch angle) showed no significant differences ( P>0.05). The following parameters were recorded and compared between the two groups: operation time, intraoperative blood loss, incision length, hospital stay, time to full weight-bearing, and complication rates. Foot pain and functional recovery were assessed using the VAS score and AOFAS score preoperatively and at last follow-up. Radiographic measurements including TCA, T1MT, T2MT, Meary angle, and Pitch angle were analyzed by comparing preoperative to last follow-up values. RESULTS: Both groups of patients successfully completed the surgery without any procedure-related complications such as vascular, neural, or tendon injury. The operation time in the observation group was significantly longer than that in the control group ( P<0.05). There was no significant difference between the two groups in terms of intraoperative blood loss, incision length, hospital stay, or time to full weight-bearing ( P>0.05). All patients were followed up 23-47 months (mean, 33.7 months). In the control group, 1 patient experienced discomfort during walking, attributed to screw irritation in the sinus tarsi, which resolved after 2-3 months of rehabilitation. None of the remaining patients developed complications such as sinus tarsi screw loosening, peroneal tendon contracture, or wound infection. At last follow-up, the observation group showed significantly better improvements in radiographic parameters (TCA, T1MT, T2MT, Meary angle, Pitch angle) and greater reductions in VAS and AOFAS scores compared to the control group ( P<0.05). CONCLUSION The combined procedure of spring ligament repair, STA, and Kidner procedure for children's flexible flatfoot with painful accessory navicular demonstrates significant improvements in foot appearance, arch collapse correction, and pain relief. This technique offers technical simplicity, minimal intraoperative complications, and satisfactory clinical outcomes.
Humans ; Flatfoot/surgery* ; Child ; Retrospective Studies ; Adolescent ; Male ; Female ; Treatment Outcome ; Tarsal Bones/abnormalities* ; Subtalar Joint/surgery* ; Ligaments, Articular/surgery* ; Orthopedic Procedures/methods* ; Foot Diseases

Objective:To address the critical issue of missing dynamic border molding information in edentulous direct digital impression technology, this study explores innovative digital solutions and conducts preliminary application validation.Methods:Based on the myostatic line theory, a methodology was established: intraoral scanner (IOS) high-frequency video was utilized to dynamically capture functional molding data of soft tissues, integrated with a self-developed mobility gradient recognition algorithm to achieve dynamic threshold segmentation between the muscle dynamic zone and myostatic zone, termed "optical digital molding technology". Ten edentulous patients with well-fitting complete dentures, treated at the Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2024 to December 2024, were enrolled. The standard deviation between the muscle static line (generated by mobility gradient algorithm with thresholds of 0.3-0.7 mm) and the denture border curve was analyzed to optimize the dynamic threshold, followed by single-case clinical validation.Results:Among the mobility thresholds of 0.3-0.7 mm, the 0.5 mm threshold yielded the smallest standard deviation between the myostatic line and denture border. Clinical validation demonstrated that dentures designed with this threshold exhibited no displacement during dynamic functional tests, with marginal sealing meeting clinical standards.Conclusions:The optical digital border molding technique for edentulous soft tissue boundaries translates the myostatic line theory into quantifiable parameters for the first time. Based on data from 10 cases, a mobility threshold of 0.5 mm is recommended for clinical application.

Objective To explore the correlation between serum inflammatory indicators and short-term prognosis in patients with single-segment lumbar intervertebral disc protrusion(LDH)treated by transforaminal endoscopic discectomy(TELD).Methods From January 2015 to June 2022,137 patients with single-segment LDH received TELD treatment.The levels of serum inflammatory factors such as C-reactive protein(CRP),white blood cell count(WBC),erythrocyte sedimentation rate(ESR),and procalcitonin(PCT)of the patients before the operation and 3 days after the operation,as well as surgical data such as anesthesia methods,operation time,and blood loss were collected.The time for patients to resume work was collected,and the pain relief and functional recovery of the patients were evaluated by using the Visual Analogue Scale(VAS)and the Oswestry Disability Index(ODI).Pearson or Spearman rank correlation analysis was used to explore the correlations between demographic characteristics,inflammatory indicators,surgical data and short-term prognosis.Results The average time for patients to return to work was(3.55±2.13)months.There were statistically significant differences in the pain and functional scores at each time point compared with those at the previous time point(P＜0.05).The CRP,WBC and PCT of the patients after the operation were significantly increased compared with those before the operation,and the difference was statistically significant(P＜0.05).The levels of CRP and PCT in patients 3 days after surgery were significantly positively correlated with VAS 6 months after surgery.The duration of symptoms and the CRP level 3 days after surgery were significantly positively correlated with ODI 6 months after surgery.BMI was significantly positively correlated with the time to return to work(P＜0.05).Conclusion There is a certain correlation between the levels of serum inflammatory indicators in patients with single-segment LDH treated with TELD and the short-term prognosis.The increase of CRP and PCT 3 days after the operation may affect the rehabilitation process of the patients.

OBJECTIVE To optimize the optimum processing technology of vinegar-processed Artemisiae Argyi Folium(AAF),and analyze the difference of index components and analgesic activity before and after processing.METHODS The method for the determination of total flavonoids and total terpenes in AAF was established with eupatilin and Santamarine as control substances,re-spectively.The HPLC-VWD method was established for the simultaneous determination of 6-Methoxytricin,Santamarine,eupatilin and Artemisolide in AAF.Box-Behnken design-response surface method was used to optimize the processing technology of vinegar-processed AAF,with the content of total flavonoids,total terpenes and four active ingredients as the index,and the amount of rice vin-egar,moistening time,processing temperature and processing time as the factors.The quantitative analysis was combined with hierar-chical cluster analysis(HCA),principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)to evaluate the difference of index components before and after processing.The analgesic activity before and after processing was investigated using pain mice induced by formalin.RESULTS The optimum processing parameters of vinegar-processed AAF were 16%rice vinegar dosage,moistening time 50 min,processing temperature 160℃and processing time 12 min.There were significant differences in the content of index components before and after processing.The analgesic activity of vinegar-processed AAF was signifi-cantly better than that of AAF.CONCLUSION The optimized processing technology is stable and feasible,which can provide scien-tific basis for standardizing production of vinegar-processed AAF.

Objective:To address the critical issue of missing dynamic border molding information in edentulous direct digital impression technology, this study explores innovative digital solutions and conducts preliminary application validation.Methods:Based on the myostatic line theory, a methodology was established: intraoral scanner (IOS) high-frequency video was utilized to dynamically capture functional molding data of soft tissues, integrated with a self-developed mobility gradient recognition algorithm to achieve dynamic threshold segmentation between the muscle dynamic zone and myostatic zone, termed "optical digital molding technology". Ten edentulous patients with well-fitting complete dentures, treated at the Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2024 to December 2024, were enrolled. The standard deviation between the muscle static line (generated by mobility gradient algorithm with thresholds of 0.3-0.7 mm) and the denture border curve was analyzed to optimize the dynamic threshold, followed by single-case clinical validation.Results:Among the mobility thresholds of 0.3-0.7 mm, the 0.5 mm threshold yielded the smallest standard deviation between the myostatic line and denture border. Clinical validation demonstrated that dentures designed with this threshold exhibited no displacement during dynamic functional tests, with marginal sealing meeting clinical standards.Conclusions:The optical digital border molding technique for edentulous soft tissue boundaries translates the myostatic line theory into quantifiable parameters for the first time. Based on data from 10 cases, a mobility threshold of 0.5 mm is recommended for clinical application.

Objective To explore the correlation between serum inflammatory indicators and short-term prognosis in patients with single-segment lumbar intervertebral disc protrusion(LDH)treated by transforaminal endoscopic discectomy(TELD).Methods From January 2015 to June 2022,137 patients with single-segment LDH received TELD treatment.The levels of serum inflammatory factors such as C-reactive protein(CRP),white blood cell count(WBC),erythrocyte sedimentation rate(ESR),and procalcitonin(PCT)of the patients before the operation and 3 days after the operation,as well as surgical data such as anesthesia methods,operation time,and blood loss were collected.The time for patients to resume work was collected,and the pain relief and functional recovery of the patients were evaluated by using the Visual Analogue Scale(VAS)and the Oswestry Disability Index(ODI).Pearson or Spearman rank correlation analysis was used to explore the correlations between demographic characteristics,inflammatory indicators,surgical data and short-term prognosis.Results The average time for patients to return to work was(3.55±2.13)months.There were statistically significant differences in the pain and functional scores at each time point compared with those at the previous time point(P＜0.05).The CRP,WBC and PCT of the patients after the operation were significantly increased compared with those before the operation,and the difference was statistically significant(P＜0.05).The levels of CRP and PCT in patients 3 days after surgery were significantly positively correlated with VAS 6 months after surgery.The duration of symptoms and the CRP level 3 days after surgery were significantly positively correlated with ODI 6 months after surgery.BMI was significantly positively correlated with the time to return to work(P＜0.05).Conclusion There is a certain correlation between the levels of serum inflammatory indicators in patients with single-segment LDH treated with TELD and the short-term prognosis.The increase of CRP and PCT 3 days after the operation may affect the rehabilitation process of the patients.

OBJECTIVE To optimize the optimum processing technology of vinegar-processed Artemisiae Argyi Folium(AAF),and analyze the difference of index components and analgesic activity before and after processing.METHODS The method for the determination of total flavonoids and total terpenes in AAF was established with eupatilin and Santamarine as control substances,re-spectively.The HPLC-VWD method was established for the simultaneous determination of 6-Methoxytricin,Santamarine,eupatilin and Artemisolide in AAF.Box-Behnken design-response surface method was used to optimize the processing technology of vinegar-processed AAF,with the content of total flavonoids,total terpenes and four active ingredients as the index,and the amount of rice vin-egar,moistening time,processing temperature and processing time as the factors.The quantitative analysis was combined with hierar-chical cluster analysis(HCA),principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)to evaluate the difference of index components before and after processing.The analgesic activity before and after processing was investigated using pain mice induced by formalin.RESULTS The optimum processing parameters of vinegar-processed AAF were 16%rice vinegar dosage,moistening time 50 min,processing temperature 160℃and processing time 12 min.There were significant differences in the content of index components before and after processing.The analgesic activity of vinegar-processed AAF was signifi-cantly better than that of AAF.CONCLUSION The optimized processing technology is stable and feasible,which can provide scien-tific basis for standardizing production of vinegar-processed AAF.

Objective:To evaluate the effect of ultrasound-guided adductor canal block with bupivacaine liposome on analgesia in elderly patients undergoing total knee arthroplasty.Methods:This was a prospective study. Sixty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, regardless of gender, aged 65-83 yr, weighing 50-80 kg, scheduled for elective unilateral total knee arthroplasty under subarachnoid anesthesia from April 2023 to January 2024 in Zhengzhou Orthopaedic Hospital, were divided into 2 groups ( n=30 each) using a random number table method: bupivacaine liposome group (LB group) and ropivacaine group (R group). Ultrasound-guided adductor canal block was performed at 30 min before subarachnoid anesthesia, bupivacaine liposome diluent 20 ml (133 mg) was injected in LB group, and 0.5% ropivacaine 20 ml was injected in R group. Patient-controlled intravenous analgesia was performed after operation, and tramadol was used for rescue analgesia when the visual analogue scale (VAS) score ≥3. VAS scores at rest and during activity were recorded at 8, 12, 24, 48 and 72 h after surgery. The time to the first pressing analgesia pump and rescue analgesia were recorded within 72 h after surgery. The quadriceps muscle strength was measured at 1 day before surgery and 12, 24, 48 and 72 h after surgery. The knee joint range of motion was assessed at 1 day before surgery and 24, 48 and 72 h after surgery. Patient′s satisfaction with analgesia was recorded at 72 h after surgery. The adverse reactions within 72 h after surgery were also recorded. Results:Compared with R group, VAS scores at rest and during activity were significantly decreased at 12, 24, 48 and 72 h after surgery, the time to the first pressing analgesia pump was prolonged, the rate of rescue analgesia after surgery was decreased, the score for the patient′s satisfaction with analgesia was increased, the knee joint range of motion was increased ( P<0.05), and no significant change was found in the quadriceps muscle strength and incidence of adverse reactions in LB group ( P>0.05). Conclusions:Ultrasound-guided adductor canal block with bupivacaine liposome provides better analgesia than ropivacaine in elderly patients undergoing total knee arthroplasty.

Objective:To summarize the prenatal ultrasound features of fetal cleidocranial dysplasia (CCD) and provide references for clinical consultation.Methods:A retrospective analysis was conducted on the prenatal ultrasound features, genetic testing results, and prognosis of a CCD fetus diagnosed at Qingdao Women and Children's Hospital in June 2023. Relevant literature on CCD was retrieved from the CNKI, Yiigle, Wanfang, and PubMed databases including cases confirmed by genetic testing or postnatal clinical phenotype and imaging with relatively complete prenatal ultrasound information. The prenatal ultrasound features of CCD fetuses were summarized using descriptive statistical analysis.Results:(1) In this case, prenatal ultrasound at 25 weeks of gestation indicated widened cranial sutures with clear near-field intracranial structures, absence of the nasal bone, shortened and rigid bilateral clavicles, and mildly shortened bilateral femurs and humeri. Chromosomal karyotyping and chromosomal microarray analysis showed no abnormalities, but whole exome sequencing detected a RUNX2 gene mutation, leading to a diagnosis of CCD combined with the ultrasound phenotype. At 36 weeks of gestation, the mother experienced premature rupture of membranes and delivered a male infant vaginally. Bedside X-rays indicated bilateral wet lungs and bilateral clavicular dysplasia in the newborn. Telephone follow-up at 9 months showed no abnormalities in growth and development. (2) Literature review: Thirteen cases from 13 articles were included, along with this case, totaling 14 CCD fetuses. The main ultrasound phenotypes of CCD fetuses were clavicular dysplasia (12/14), incomplete cranial ossification (10/14), absence of the nasal bone (8/14), and shortening of the femur (12/14). Other ultrasound phenotypes included scapular dysplasia, short ribs, and increased interocular distance. Conclusion:Clavicular dysplasia and incomplete cranial ossification are the most specific signs of fetal CCD, while absence of the nasal bone and mild femoral shortening are secondary features of CCD.