Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Objective:To investigate the effects of transepithelial photorefractive keratectomy (TransPRK) and femtosecond small incision lenticule extraction (SMILE) on corneal biomechanics measured by the Ocular Response Analyzer in the early postoperative period.Methods:A cohort study was conducted.The right eyes of 56 patients who underwent TransPRK and 52 patients who underwent SMILE in Dalian Medical University Affiliated Dalian Third People's Hospital from November 2020 to June 2021 were continuously included.The postoperative follow-up was 3 months.The central corneal thickness (CCT) and keratometry (Km) were measured 1 month and 3 months after surgery.The corneal-compensated intraocular pressure (IOPcc), corneal resistance factor (CRF), corneal hysteresis (CH), and 19 repeatable mechanical infrared signal waveform parameters measured by the Ocular Response Analyzer were recorded before the surgery, 1 month and 3 months after the surgery, respectively.The measurement indexs at different time points between two groups were compared.This study adhered to the Declaration of Helsinki and the study protocol was approved by the Ethics Committee of Dalian Medical University Affiliated Dalian Third People's Hospital (No.2019-KT-010). Written informed consent was obtained from each patient before surgery.Results:There was no significant difference in CCT, Km, and IOPcc between the two groups at 1 month and 3 months after the surgery (all at P>0.05). In both groups, CRF, CH, p1area, p2area, p1area1, p2area1, w1, w2, w11, w21, h1, h2, h11, h21, dive1, dive2 and mslew1 were decreased, while path1, path2, path11, and aplhf were increased at 1 month after the surgery compared with before surgery, showing statistically significant differences (all at P<0.05). In both groups, CRF, CH, p1area, p2area, p1area1, p2area1, w1, w2, w11, w21, h1, h2, h11, h21, dive1 decreased, while path1, path2, path11, and aplhf were increased at 3 months after the surgery in comparison with before surgery, showing statistically significant differences (all at P<0.05). In SMILE group, the dive2 were decreased at 3 months after the surgery compared with before surgery, and the difference was statistically significant ( P<0.01). At 1 month after the surgery, p1area, p2area, p1area1, p2area1, w1, w2, w11, w21, dive1 and dive2 were higher, while CH, path1, path2, and path11 were smaller in TransPRK group than in SMILE group, showing statistically significant differences between them (all at P<0.05). At 3 months after the surgery, p1area, p2area, p1area1, p2area1, w1, w2, w11, w21, h2, h21, dive1 and dive2 were higher, while path1, path2, and path11 were smaller in TransPRK group than in SMILE group, showing statistically significant differences between them (all at P<0.05). Conclusions:Corneal biomechanics are weakened after both TransPRK and SMILE.In the early postoperative period, the mechanical infrared waveform parameters measured by the Ocular Response Analyzer are better after TransPRK than after SMILE.

Objective:To investigate correlations between blood lipid levels and clinical characteristics of patients with psoriasis vulgaris (PsV) in Fujian province.Methods:Totally, 245 PsV patients were enrolled from Department of Dermatology of the First Affiliated Hospital of Fujian Medical University from March 2019 to March 2022, and 250 gender-, age-, and body mass index-matched health checkup examinees served as controls. Their biochemical indicators, such as blood lipids, liver function, and kidney function, were evaluated. Clinical data, such as disease courses, involvement of specific sites, history of smoking and alcohol consumption, and family history of psoriasis, were collected from the PsV patients, and correlations between these clinical data and dyslipidemia were analyzed. Measurement data were compared using t test or Mann-Whitney U test, and enumeration data were compared using chi-square test. Results:There were 122 (50.8%) patients with dyslipidemia in the PsV group and 94 (37.6%) in the control group, and the prevalence of dyslipidemia significantly differed between the two groups ( χ2 = 7.48, P = 0.006). The prevalence of hypo-high-density lipoprotein cholesterolemia was significantly higher in the PsV group (29.8%) than in the control group (18.8%; χ2 = 8.15, P = 0.004). The PsV group showed significantly decreased serum levels of total cholesterol (4.5[3.9, 5.2] mmol/L), high-density-lipoprotein cholesterol (1.1[1.0, 1.3] mmol/L), and apolipoprotein A1 (1.2[1.1, 1.4] g/L) compared with the control group (4.9[4.3, 5.4] mmol/L, 1.3[1.1, 1.5] mmol/L, 1.3[1.2, 1.5] g/L, respectively; all P < 0.001). The proportions of males, patients with a history of alcohol consumption, and patients with involvement of the palmoplantar sites were significantly higher in the PsV patients with dyslipidemia (92.6%, 13.1%, 13.8%, respectively) than in those without dyslipidemia (70.7%, 6.0%, 5.0%, respectively; all P < 0.001). Multifactorial logistic regression analysis showed that "male" and "BMI ≥ 25 kg/m 2" were independent risk factors for dyslipidemia in the PsV patients ( OR [95% CI]: 3.94 [1.74, 9.74], 3.18 [1.71, 6.09], respectively), and "involvement of the palmoplantar sites" was independently associated with increased risk of hyperlipidemia ( OR [95% CI]: 3.38 [1.18, 11.01]) . Conclusion:The prevalence of dyslipidemia was higher in PsV patients than in healthy populations, and PsV patients being males, having BMI ≥ 25 kg/m 2 and with involvement of palmoplantar sites may be prone to develop lipid metabolism disorders.

Objective To investigate the current perioperative management of geriatric hip fractures in China.Methods The survey was performed between 15th to 21st of November,2017.An electric questionnaire was delivered to the orthopedic surgeons attending the 12th International Congress of Chinese Orthopedic Association (COA) and the orthopedic fellows attending grand round at Department of Orthopaedic Trauma,Beijing Jishuitan Hospital.The questionnaire addressed the current perioperative management of geriatric hip fractures (≥ 65 years) at the departments where the participants worked,covering preoperative examination and preparation,postoperative rehabilitation and multidisciplinary collaboration.Results 171 valid questionnaires were collected for this study.Of the 171 orthopedic surgeons from 28 provinces in China,106 (62.0％) came from a tertiary hospital and 65 (38.0％) from a secondary hospital.In 74.3％ (127/171) of the hospitals,more than 100 geriatric hip fractures were treated annually.63.2％ (108/171) of the hospitals treated 100 to 500 cases annually,5.9％ (10/171) 500 to 1,000 cases and 5.3％ (9/171) more than 1,000 cases.Multidisciplinary collaboration was not established in most hospitals (71.9％,123/171) for geriatric hip fractures.Pulmonary function test (61.4％,105/171),Holter (38.0％,65/171) and ambulatory blood pressure monitoring (53.8％,92/171) were indicated as routine preoperative investigations.In 56.3 ％ (96 / 171) of the hospitals,traction was performed before operation.In 80.1％ (137 / 171) of the hospitals,the interval between admission to surgery was more than 48h for the patients.In 36.3％ (62/171)of the hospitals,patients were allowed to ambulate within one week after surgery.In 4.1％ (7/171) of the hospitals,patients were allowed full weight-bearing within one week after surgery.Conclusion Significant gaps exist in perioperative management of geriatric hip fractures between current practice in China and worldwide guidelines and consensus.