Objectives:To investigate the clinical efficacy and safety of posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior oblique lumbar interbody fusion(OLIF)+posterior O-arm navi-gated internal fixation in the treatment of patients with degenerative scoliosis.Methods:A retrospective anal-ysis was performed on the 55 patients with degenerative scoliosis who were treated in our hospital between May 2016 and June 2023.According to surgical method,the patients were divided into posterior O-arm navi-gated internal fixation+osteotomy orthopedic group(group A,20 cases)and anterior OLIF+posterior O-arm navi-gated internal fixation group(group B,25 cases).Group A consisted of 8 males and 12 females,aged 47-81(66.4±7.4)years old;Group B consisted of 8 males and 17 females,aged 52-81(67.4±8.2)years old.The pe-rioperative data of the patients were collected,and the visual analogue scale(VAS)score and Oswestry disabil-ity index(ODI)were recorded before operation,at postoperative 1 week and final follow-up to evaluate the clinical efficacy,and full-length spinal X-ray were taken in the standing position at the same time point to measure the coronal Cobb angle,sagittal vertical axis(SVA),lumbar lordosis(LL),intervertebral space height,vertebral fusion rate.The complications were recorded and compared between groups.Results:The patients were followed up for 18-38(26.5±5.3)months in group A and 20-36(24.3±4.2)months in group B,with no statistical difference(P＞0.05).Statistical differences(P＜0.05)were observed between group A and group B in operative time(219.0±25.7min vs 169.4±25.6min),intraoperative blood loss(1087.5±353.1mL vs 672.5±308.6mL),postoperative drainage volume(364.7±22.9mL vs 109.3±25.3mL),postoperative ambulation time(11.0±3.4d vs 6.3±1.8d),and number of blood transfusions(18 vs 8).The VAS scores were 6.2±0.9 points and 1.8±0.8 points in group A at postoperative 1 week and final follow-up respectively,which were 4.4±0.9 and 1.3±0.5 in group B,and group B was lower than group A at the same postoperative time point(P＜0.05).The ODI of group A and group B at postoperative 1 week were(22.8±4.8)％and(19.9±2.9)％,and group B was lower than group A(P＜0.05),while there was no significant difference between the two groups at final follow-up(P＞0.05).At postoperative 1 week and final follow-up,the sagittal SVA of group A was 47.0±1 1.5mm and 43.9±19.7mm,which was 35.2±19.9mm and 30.9±19.9mm in group B,and the sagittal correction in group A was better than that in group B(P＜0.05).There was no statistical difference between the two groups in coronal Cobb angle and LL at postoperative 1 week and final follow-up(P＞0.05).The intervertebral space height of group A was 48.1±8.2mm and 46.1±8.5mm at postoperative 1 week and final follow-up,which was 57.4±5.4mm and 56.3±5.6mm in group B,and group B was better than group A(P＜0.05).There were 2 cases of postoperative cerebrospinal fluid leakage,2 cases of delayed incision healing,1 case of nail and rod fracture,1 case of screw loosening in group A,and the complication rate was 30％(6/20);2 cases in group B had postoperative pain on the anteromedial side of the left thigh,and 2 cases had transient left hip flexion weak-ness,all of which recovered at follow-up,and the complication rate was 16％(4/25).The complication rate was higher in group A than group B(P＜0.05).Both groups had no incision infection or spinal cord injury complications.At final follow-up,the bone graft and fusion device were osseous fusion in both groups.Con-clusions:Both posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior OLIF+posterior O-arm navigated internal fixation can achieve satisfactory clinical efficacy in the treatment of degen-erative scoliosis,the former has better sagittal orthopedic effect,but has the problems of long operative time,large amount of bleeding,long postoperative bed rest,and many complications,while the latter has a similar scoliosis correction,as well as the advantages of minimally invasive,less traumatic,fast recovery and fewer complications,which can provide a new option for the minimally invasive treatment of degenerative scoliosis.

Objectives:To investigate the clinical efficacy and safety of posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior oblique lumbar interbody fusion(OLIF)+posterior O-arm navi-gated internal fixation in the treatment of patients with degenerative scoliosis.Methods:A retrospective anal-ysis was performed on the 55 patients with degenerative scoliosis who were treated in our hospital between May 2016 and June 2023.According to surgical method,the patients were divided into posterior O-arm navi-gated internal fixation+osteotomy orthopedic group(group A,20 cases)and anterior OLIF+posterior O-arm navi-gated internal fixation group(group B,25 cases).Group A consisted of 8 males and 12 females,aged 47-81(66.4±7.4)years old;Group B consisted of 8 males and 17 females,aged 52-81(67.4±8.2)years old.The pe-rioperative data of the patients were collected,and the visual analogue scale(VAS)score and Oswestry disabil-ity index(ODI)were recorded before operation,at postoperative 1 week and final follow-up to evaluate the clinical efficacy,and full-length spinal X-ray were taken in the standing position at the same time point to measure the coronal Cobb angle,sagittal vertical axis(SVA),lumbar lordosis(LL),intervertebral space height,vertebral fusion rate.The complications were recorded and compared between groups.Results:The patients were followed up for 18-38(26.5±5.3)months in group A and 20-36(24.3±4.2)months in group B,with no statistical difference(P＞0.05).Statistical differences(P＜0.05)were observed between group A and group B in operative time(219.0±25.7min vs 169.4±25.6min),intraoperative blood loss(1087.5±353.1mL vs 672.5±308.6mL),postoperative drainage volume(364.7±22.9mL vs 109.3±25.3mL),postoperative ambulation time(11.0±3.4d vs 6.3±1.8d),and number of blood transfusions(18 vs 8).The VAS scores were 6.2±0.9 points and 1.8±0.8 points in group A at postoperative 1 week and final follow-up respectively,which were 4.4±0.9 and 1.3±0.5 in group B,and group B was lower than group A at the same postoperative time point(P＜0.05).The ODI of group A and group B at postoperative 1 week were(22.8±4.8)％and(19.9±2.9)％,and group B was lower than group A(P＜0.05),while there was no significant difference between the two groups at final follow-up(P＞0.05).At postoperative 1 week and final follow-up,the sagittal SVA of group A was 47.0±1 1.5mm and 43.9±19.7mm,which was 35.2±19.9mm and 30.9±19.9mm in group B,and the sagittal correction in group A was better than that in group B(P＜0.05).There was no statistical difference between the two groups in coronal Cobb angle and LL at postoperative 1 week and final follow-up(P＞0.05).The intervertebral space height of group A was 48.1±8.2mm and 46.1±8.5mm at postoperative 1 week and final follow-up,which was 57.4±5.4mm and 56.3±5.6mm in group B,and group B was better than group A(P＜0.05).There were 2 cases of postoperative cerebrospinal fluid leakage,2 cases of delayed incision healing,1 case of nail and rod fracture,1 case of screw loosening in group A,and the complication rate was 30％(6/20);2 cases in group B had postoperative pain on the anteromedial side of the left thigh,and 2 cases had transient left hip flexion weak-ness,all of which recovered at follow-up,and the complication rate was 16％(4/25).The complication rate was higher in group A than group B(P＜0.05).Both groups had no incision infection or spinal cord injury complications.At final follow-up,the bone graft and fusion device were osseous fusion in both groups.Con-clusions:Both posterior O-arm navigated internal fixation+osteotomy orthopedic surgery and anterior OLIF+posterior O-arm navigated internal fixation can achieve satisfactory clinical efficacy in the treatment of degen-erative scoliosis,the former has better sagittal orthopedic effect,but has the problems of long operative time,large amount of bleeding,long postoperative bed rest,and many complications,while the latter has a similar scoliosis correction,as well as the advantages of minimally invasive,less traumatic,fast recovery and fewer complications,which can provide a new option for the minimally invasive treatment of degenerative scoliosis.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective To investigate the sagittal correction effect and clinical efficacy of multisegment Smith-Peterson osteotomy (SPO) and single-segment pedicle subtraction osteotomy (PSO) in the treatment of old osteoporotic vertebral compression fracture (OVCF)combined with kyphosis.Methods A retrospective case control study was conducted to analyze the clinical data of 24 patients with old OVCF combined with kyphosis admitted to Traditional Chinese Medical Hospital of Xiaoshan from February 2014 to July 2016.There were 10 males and 14 females,aged 58-72 years,with an average of 65.6 years.Thirteen patients were treated with multi-segment SPO (Group A),six of whom underwent two-segment SPO and seven underwent three-segment SPO.Eleven patients were treated with single-segment PSO (Group B).The operation time,intraoperative bleeding volume,the number of cases using cementreinforced nail track,postoperative drainage,hospitalization time and postoperative complications were compared between the two groups.Cobb angle,sagittal vertical axis (SVA),thoracic kyphosis angle (TK) and lumbar lordosis angle (LL) of kyphosis deformity were measured before operation,after operation and at the last follow-up.Oswestry Dysfunction Index (ODI) and Visual Analogue Scale (VAS) were used to evaluate the clinical efficacy at the last follow-up.Results All patients were followed up for 6-24 months,with an average of 15.4 months.The operation time of Group A was (198.1 ± 27.3)minutes,while that of Group B was (237.6 ± 36.1)minutes (P ＜ 0.05).The amount of intraoperative bleeding in Group A was (1 256.2 ± 389.4) ml,while that in Group B was (1 525.6 ±457.1)ml (P ＜ 0.05).Two patients in Group A and five patients in Group B were treated with cement-reinforced nail track (P ＜ 0.05).There was no significant difference in drainage and hospitalization time between the two groups (P ＞ 0.05).Three patients in Group A and one patient in Group B had cerebrospinal fluid leakage (P ＜ 0.05).The postoperative SVA was (1.4 ± 0.7) cm in Group A and (-1.1 ± 0.6) cm in Group B (P ＜ 0.05).No significant differences were found between the two groups in Cobb angle,TK and LL of kyphosis (P ＞ 0.05).There was no significant difference in SVA,Cobb angle,TK and LL between the two groups at the last follow-up (P ＞ 0.05).There was no significant difference in ODI and VAS between the two groups after operation and at the last follow-up (P ＞ 0.05).No complications such as spinal cord injury,embolism caused by cement leakage,extraction or rupture of pedicle screw occurred in either group.Conclusion For old osteoporotic vertebrae compressed fractures combined with kyphosis,multi-segment SPO and single-segment PSO can achieve good sagittal correction and clinical efficacy.Single-segment PSO has better correction effect and lower incidence of cerebrospinal fluid leakage,yet accompanied with disadvantages of overcorrection,screw loosening,longer operation time and more blood loss.

BACKGROUND:Adipose-derived mesenchymal stem cells are gaining widespread interest in the Achil es tendon tissue engineering and regeneration, and an enabling environment (oxygen concentration) for cellinduction and differentiation is particularly necessary.
OBJECTIVE:To co-culture adipose-derived mesenchymal stem cells with primary tenocytes in standard culture condition (20%O 2 tension) and in an atmosphere of reduced oxygen (2%O 2 tension) in order to determine whether the two conditions differ in their effect on tenogenic differentiation.
METHODS:Tenocytes were isolated via serial expansion in culture from several Sprague-Dawley rats’ Achil es tendons. Adipose-derived mesenchymal stem cells were purchased. After one passage, adipose-derived mesenchymal stem cells were indirectly co-cultured with tenocytes in standard culture condition (20%O 2 tension) and in an atmosphere of reduced oxygen (2%O 2 tension). Col agen 1, col agen 3, Tenomodulin, Thrombospondin-4, Scleraxis levels were compared for each culture condition at 7, 14 and 21 days fol owing co-culturing. Immunofluorescence staining was performed to evaluate production of col agen 1 and Thrombospondin-4.
RESULTS AND CONCLUSION:Fol owing indirect co-culturing, hypoxic differentiated adipose-derived mesenchymal stem cells expressed higher levels of tendon-related genes and proteins than normoxic controls, which suggest that oxygen levels can significantly affect tenogenic differentiation, and hypoxia is advantageous for efficient differentiation of adipose-derived mesenchymal stem cells in vitro for tendon tissue engineering.