BACKGROUND: A growing body of research is exploring the role of antioxidant and anti-inflammatory dietary supplements in the treatment of osteoarthritis, highlighting an increasing emphasis on non-pharmacological interventions. Although more patients are turning to supplements to manage osteoarthritis, their actual effectiveness remains uncertain. OBJECTIVE: This study aims to provide a comprehensive evaluation of the available evidence concerning the efficacy of various dietary supplements in osteoarthritis treatment. SEARCH STRATEGY: We searched PubMed, Embase, Cochrane Library and Web of Science for studies on the use of various dietary supplements in the treatment of osteoarthritis from the creation of each database until Jan 20, 2025. INCLUSION CRITERIA: (1) Research object: osteoarthritis. (2) Intervention measures: patients in the treatment group received dietary supplements, while the control group received placebos. (3) Research type: randomized controlled trials (RCTs). DATA EXTRACTION AND ANALYSIS: Two researchers independently examined the literature and retrieved data based on predefined criteria. The information gathered included the first author, year of publication, sample size, participant demographics, length of the follow-up period, intervention and control measures, and inclusion indications. RCTs comparing dietary supplements to placebo with the pain and function subscales of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) among patients with osteoarthritis were included. The optimal dietary supplement was identified based on the total ranking by summing the surface under the cumulative ranking curve (SUCRA) of these two scores. Furthermore, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to confirm the quality of the evidence. RESULTS: Overall, 23 studies covering 21 dietary supplements and involving 2455 participants met the inclusion criteria. In the WOMAC pain score, the SUCRA of passion fruit peel extract was 91% (mean difference [MD]: -9.2; 95% confidence interval [CI]: [-16.0, -2.3]), followed by methylsulfonylmethane (89%), undenatured type II collagen (87%), collagen (84%), and Lanconone (82%). The SUCRA (99%) of passion fruit peel extract (MD: -41.0; 95% CI: [-66.0, -16.0]) ranked first in terms of the WOMAC function score, followed by Lanconone (95%), collagen (86%), ParActin (84%), and Lactobacillus casei strain Shirota (83%). The top three total rankings are passion fruit peel extract (95.0%), Lanconone (88.5%), and collagen (85.0%). However, the GRADE revealed low evidence quality. CONCLUSION Passion fruit peel extract was the best supplement for improving WOMAC pain and function scores in patients with osteoarthritis, followed by Lanconone and collagen. However, further large-scale, well designed RCTs are required to substantiate these promising findings. Please cite this article as: Chen CS, Wen L, Yang F, Deng YC, Ji JH, Chen RJ, Chen Z, Chen G, Gu JY. Effects of dietary supplements on patients with osteoarthritis: A systematic review and network meta-analysis. J Integr Med. 2025; 23(4): 357-369.
Humans ; Dietary Supplements ; Osteoarthritis/drug therapy* ; Randomized Controlled Trials as Topic

Objective To construct a risk prediction model for the occurrence of calf muscle vein thrombosis(CMVT)in patients with spontaneous basal ganglia hemorrhage(sBGH)after surgery,and to verify the predictive effect of this model.Methods The surgical patients with sBGH who underwent neurosurgical procedures at the First People's Hospital of Huzhou(First Affiliated Hospital of Huzhou University)from January 2020 to December 2024 were enrolled as study subjects.A total of 345 patients were randomly divided into a modeling group(n=243)and a validation group(n=102).In the modeling group,patients were categorized into CMVT(n=72)and non-CMVT groups(n=171).Collected data included demographics[gender,age,body mass index(BMI)],laboratory indicators[D-dimer,activated partial thromboplastin time(APTT),fibrinogen(Fib),prothrombin time(PT),thrombin time(TT),hypersensitive C-reactive protein(hs-CRP)],and clinical data[hypertension,diabetes,smoking history,preoperative Glasgow coma scale(GCS),preoperative Caprini score,ventricular rupture,hemorrhage volume,surgical approach].Variables with statistical significance in univariate analysis were included in multivariate Logistic regression to identify CMVT risk factors and construct a nomogram model.Model fit was evaluated using the Hosmer-Lemeshow test,and predictive performance was assessed via receiver operator characteristic curve(ROC curve)analysis.Results The analysis of single factors showed that compared with the non-CMVT group,the proportion of male patients in CMVT group was significantly lower[63.9%(46/72)vs.77.8%(133/171)],while age,D-dimer,hs-CRP,Caprini score levels and bleeding volume were significantly higher[age(years):69.00(60.25,75.75)vs.55.00(67.00,74.00),D-dimer(mg/L):1.94(1.02,4.87)vs.0.89(0.48,1.74),hs-CRP(mg/L):21.94(7.50,55.87)vs.10.56(4.62,30.87),Caprini score:5(3,8)vs.3(2,5)].PT and TT were significantly prolonged[PT(s):13.10(12.10,14.13)vs.12.70(12.10,13.50),TT(s):15.25(14.23,16.06)vs.14.70(14.00,15.70)],the proportion of patients with hypertension,diabetes,ventricular rupture,and craniotomy was markedly increased[hypertension:70.8%(51/72)vs.43.9%(75/171),diabetes:25.0%(18/72)vs.7.0%(12/171),ventricular penetration:16.7%(12/72)vs.5.3%(9/171),craniotomy:59.7%(43/72)vs.35.7%(61/171)],GCS score significantly decreased[13(9,14)vs.15(13,15)].All differences were statistically significant(all P<0.05).The multivariate Logistic regression analysis showed that age[odds ratio(OR)=1.053,95%confidence interval(95%CI)was 1.018-1.090],D-dimer(OR=1.194,95%CI was 1.067-1.335),hypertension(OR=2.284,95%CI was 1.085-4.806),diabetes(OR=5.357,95%CI was 1.917-14.973),elevated preoperative Caprini score(OR=1.216,95%CI was 1.066-1.387),and craniotomy(OR=3.359,95%CI was 1.087-10.378)were all independent risk factors affecting the occurrence of CMVT in patients after sBGH(all P<0.05).The linear model was constructed using the aforementioned variables.The Hosmer-Lemeshow test results in the modeling group showedχ2=2.409,P=0.966,indicating good model fit where predicted values showed no significant difference from actual values.ROC curve analysis revealed an area under the curve(AUC)=0.846,95%CI was 0.792-0.899 for the validated model.When the optimal cut-off value was set at 0.538,the model achieved a sensitivity of 70.8%and specificity of 83.0%.In the validation set,the Hosmer-Lemeshow test showedχ2=11.300,P=0.185,indicating good model fit where predicted values showed no significant difference from actual values.ROC curve analysis demonstrated an AUC=0.893,95%CI was 0.832-0.955 for the validated model.At the optimal cut-off value of 0.674,the model achieved a sensitivity of 87.1%,specificity of 80.3%,and an accuracy of 82.4%.Conclusion The risk prediction model has good predictive performance and can provide reference for clinical evaluation of the risk of CMVT in patients with sBGH after surgery.

Objective:To investigate the clinical and pathological characteristics, treatment and prognosis of endometriosis (EM)-associated ovarian mesonephric-like adenocarcinoma (MLA).Methods:Clinical and pathological data were collected from nine patients diagnosed with EM-associated ovarian MLA at the Obstetrics and Gynecology Hospital of Fudan University between January 2022 and December 2024. Histological slides were re-reviewed, immunohistochemical examination and molecular testing were performed, and patient follow-up was conducted.Results:(1) Clinical characteristics: the median age of the nine patients was 54 years (range: 38-69 years). All patients presented with a pelvic mass; five cases also reported abdominal pain. Tumor location included five cases in the right ovary, two in the left ovary, and two involving both ovaries. International Federation of Gynecology and Obstetrics (FIGO) staging showed 3 cases at stage Ⅰ, 4 at stage Ⅱ, and 2 at stage Ⅲ. (2) Pathological features: gross examination revealed mixed solid-cystic masses with solid areas appearing gray-white or yellow-brown; the median maximum tumor diameter was 9.0 cm (range: 2.6-13.0 cm). Microscopically, tumors exhibited various architectural patterns, including tubular, glandular, papillary, slit-like, sex cord-like, glomeruloid, and solid structures, with tubular and glandular patterns being most common. Tumor cells demonstrated mild to moderate nuclear atypia. Of the 11 tumor foci in the 9 cases, 8 showed coexistence of MLA with other tumor components, such as endometrioid carcinoma, borderline endometrioid or borderline seromucinous tumors. In 1 case of MLA mixed with a borderline endometrioid tumor, both components exhibited squamous metaplasia. Immunohistochemistry showed variable expression of GATA-binding protein 3, thyroid transcription factor-1, CD 10, and calretinin, with positive rates of 9/11, 8/11, 5/11, and 3/6, respectively. Two tumor foci (2/11) exhibited focal expression of estrogen receptor and progesterone receptor. All cases displayed wild-type p53 expression. Molecular testing via next-generation sequencing in five patients revealed pathogenic mutations in the KRAS gene (5/5), with 3 cases (3/5) harboring additional pathogenic mutations in other genes. (3) Treatment and prognosis: all patients underwent surgery, supplemented by chemotherapy and (or) targeted therapy. Five patients underwent comprehensive staging surgery, four received cytoreductive surgery, and one patient received targeted therapy. The median follow-up duration was 7 months (range: 2-27 months). Three patients (3/9) experienced recurrence, and no deaths were reported during the follow-up period. Conclusions:EM-associated ovarian MLA demonstrates diverse morphological patterns and frequently coexists with other tumor types. Accurate diagnosis relies on an integrated evaluation of histomorphology, immunohistochemistry, and molecular testing. The primary treatment for EM-associated ovarian MLA is surgery, followed by adjuvant chemotherapy. Patients harboring pathogenic KRAS p.G12C mutations may benefit from targeted therapies. Ovarian MLA is an aggressive tumor, prone to recurrence in the short term, and has a poor prognosis.

Objective:To investigate the clinical and pathological characteristics, treatment and prognosis of endometriosis (EM)-associated ovarian mesonephric-like adenocarcinoma (MLA).Methods:Clinical and pathological data were collected from nine patients diagnosed with EM-associated ovarian MLA at the Obstetrics and Gynecology Hospital of Fudan University between January 2022 and December 2024. Histological slides were re-reviewed, immunohistochemical examination and molecular testing were performed, and patient follow-up was conducted.Results:(1) Clinical characteristics: the median age of the nine patients was 54 years (range: 38-69 years). All patients presented with a pelvic mass; five cases also reported abdominal pain. Tumor location included five cases in the right ovary, two in the left ovary, and two involving both ovaries. International Federation of Gynecology and Obstetrics (FIGO) staging showed 3 cases at stage Ⅰ, 4 at stage Ⅱ, and 2 at stage Ⅲ. (2) Pathological features: gross examination revealed mixed solid-cystic masses with solid areas appearing gray-white or yellow-brown; the median maximum tumor diameter was 9.0 cm (range: 2.6-13.0 cm). Microscopically, tumors exhibited various architectural patterns, including tubular, glandular, papillary, slit-like, sex cord-like, glomeruloid, and solid structures, with tubular and glandular patterns being most common. Tumor cells demonstrated mild to moderate nuclear atypia. Of the 11 tumor foci in the 9 cases, 8 showed coexistence of MLA with other tumor components, such as endometrioid carcinoma, borderline endometrioid or borderline seromucinous tumors. In 1 case of MLA mixed with a borderline endometrioid tumor, both components exhibited squamous metaplasia. Immunohistochemistry showed variable expression of GATA-binding protein 3, thyroid transcription factor-1, CD 10, and calretinin, with positive rates of 9/11, 8/11, 5/11, and 3/6, respectively. Two tumor foci (2/11) exhibited focal expression of estrogen receptor and progesterone receptor. All cases displayed wild-type p53 expression. Molecular testing via next-generation sequencing in five patients revealed pathogenic mutations in the KRAS gene (5/5), with 3 cases (3/5) harboring additional pathogenic mutations in other genes. (3) Treatment and prognosis: all patients underwent surgery, supplemented by chemotherapy and (or) targeted therapy. Five patients underwent comprehensive staging surgery, four received cytoreductive surgery, and one patient received targeted therapy. The median follow-up duration was 7 months (range: 2-27 months). Three patients (3/9) experienced recurrence, and no deaths were reported during the follow-up period. Conclusions:EM-associated ovarian MLA demonstrates diverse morphological patterns and frequently coexists with other tumor types. Accurate diagnosis relies on an integrated evaluation of histomorphology, immunohistochemistry, and molecular testing. The primary treatment for EM-associated ovarian MLA is surgery, followed by adjuvant chemotherapy. Patients harboring pathogenic KRAS p.G12C mutations may benefit from targeted therapies. Ovarian MLA is an aggressive tumor, prone to recurrence in the short term, and has a poor prognosis.

Objective To construct a risk prediction model for the occurrence of calf muscle vein thrombosis(CMVT)in patients with spontaneous basal ganglia hemorrhage(sBGH)after surgery,and to verify the predictive effect of this model.Methods The surgical patients with sBGH who underwent neurosurgical procedures at the First People's Hospital of Huzhou(First Affiliated Hospital of Huzhou University)from January 2020 to December 2024 were enrolled as study subjects.A total of 345 patients were randomly divided into a modeling group(n=243)and a validation group(n=102).In the modeling group,patients were categorized into CMVT(n=72)and non-CMVT groups(n=171).Collected data included demographics[gender,age,body mass index(BMI)],laboratory indicators[D-dimer,activated partial thromboplastin time(APTT),fibrinogen(Fib),prothrombin time(PT),thrombin time(TT),hypersensitive C-reactive protein(hs-CRP)],and clinical data[hypertension,diabetes,smoking history,preoperative Glasgow coma scale(GCS),preoperative Caprini score,ventricular rupture,hemorrhage volume,surgical approach].Variables with statistical significance in univariate analysis were included in multivariate Logistic regression to identify CMVT risk factors and construct a nomogram model.Model fit was evaluated using the Hosmer-Lemeshow test,and predictive performance was assessed via receiver operator characteristic curve(ROC curve)analysis.Results The analysis of single factors showed that compared with the non-CMVT group,the proportion of male patients in CMVT group was significantly lower[63.9%(46/72)vs.77.8%(133/171)],while age,D-dimer,hs-CRP,Caprini score levels and bleeding volume were significantly higher[age(years):69.00(60.25,75.75)vs.55.00(67.00,74.00),D-dimer(mg/L):1.94(1.02,4.87)vs.0.89(0.48,1.74),hs-CRP(mg/L):21.94(7.50,55.87)vs.10.56(4.62,30.87),Caprini score:5(3,8)vs.3(2,5)].PT and TT were significantly prolonged[PT(s):13.10(12.10,14.13)vs.12.70(12.10,13.50),TT(s):15.25(14.23,16.06)vs.14.70(14.00,15.70)],the proportion of patients with hypertension,diabetes,ventricular rupture,and craniotomy was markedly increased[hypertension:70.8%(51/72)vs.43.9%(75/171),diabetes:25.0%(18/72)vs.7.0%(12/171),ventricular penetration:16.7%(12/72)vs.5.3%(9/171),craniotomy:59.7%(43/72)vs.35.7%(61/171)],GCS score significantly decreased[13(9,14)vs.15(13,15)].All differences were statistically significant(all P<0.05).The multivariate Logistic regression analysis showed that age[odds ratio(OR)=1.053,95%confidence interval(95%CI)was 1.018-1.090],D-dimer(OR=1.194,95%CI was 1.067-1.335),hypertension(OR=2.284,95%CI was 1.085-4.806),diabetes(OR=5.357,95%CI was 1.917-14.973),elevated preoperative Caprini score(OR=1.216,95%CI was 1.066-1.387),and craniotomy(OR=3.359,95%CI was 1.087-10.378)were all independent risk factors affecting the occurrence of CMVT in patients after sBGH(all P<0.05).The linear model was constructed using the aforementioned variables.The Hosmer-Lemeshow test results in the modeling group showedχ2=2.409,P=0.966,indicating good model fit where predicted values showed no significant difference from actual values.ROC curve analysis revealed an area under the curve(AUC)=0.846,95%CI was 0.792-0.899 for the validated model.When the optimal cut-off value was set at 0.538,the model achieved a sensitivity of 70.8%and specificity of 83.0%.In the validation set,the Hosmer-Lemeshow test showedχ2=11.300,P=0.185,indicating good model fit where predicted values showed no significant difference from actual values.ROC curve analysis demonstrated an AUC=0.893,95%CI was 0.832-0.955 for the validated model.At the optimal cut-off value of 0.674,the model achieved a sensitivity of 87.1%,specificity of 80.3%,and an accuracy of 82.4%.Conclusion The risk prediction model has good predictive performance and can provide reference for clinical evaluation of the risk of CMVT in patients with sBGH after surgery.

Objective To investigate the short-term efficacy of ultrasound-guided argon-helium knife cryoablation for the treatment of advanced non-small cell lung cancer with supraclavicular lymph node metastases.Methods A total of 14 patients with advanced non-small cell lung cancer complicated by supraclavicular lymph node metastases were treated with ultrasound-guided argon-helium knife cryoablation on the basis of intravenous chemotherapy or targeted therapy.The short-term therapeutic effect and adverse reactions were analyzed.Results All the 14 patients were successfully treated with argon-helium knife cryoablation under ultrasound guidance.The overall effective rate was 78.6％,and the local compression symptoms of the patients were improved.The scores evaluated by the QLQ-C30 scale were improved when compared with preoperative values.The postoperative fever and local pain of puncture site,which were the common accompanying symptoms of argon-helium knife cryoablation,were relieved or disappeared within a few days after symptomatic treatment.Conclusion Ultrasound-guided argon-helium knife cryoablation is an effective method for local palliative treatment of advanced non-small cell lung cancer with supraclavicular lymph node metastases,which can monitor the real-time changes of lesion and evaluate the therapeutic effect in the treatment course.The clinical symptoms can be relieved within a short time after treatment,and the quality of life of patients will also be improved.

Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8％ of which were gram-positive bacteria and 51.2％ were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2％),Escherichia coli (20.7％),Klebsiella (13.7％),Enterococcus (7.2％),and Staphylococcus aureus (6.6％).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0％,≥36.8％ and ≥56.8％ of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5％ of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4％ and 19.9％ in 2015 to 25.7％ and 26.6％ in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9％ and 73.2％ respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7％ and 22.9％ in 2015 to 18.5％ and 14.7％ in 2021,respectively.The prevalence of PRSP was 1.5％ in the isolaets from adults and and 0.8％ in the isolates from children.Less than 3.0％ of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1％ and 81.0％,respectively.The prevalence of MRSA was relatively stable,28.5％ in 2015 and 28.0％ in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.

Objective To investigate the distribution and antimicrobial resistance of bacterial isolates from blood samples in the hospitals participating in China Antimicrobial Surveillance Network (CHINET) from 2015 to 2021.Methods Bacterial strains isolated from blood samples were collected from 52 medical centers participating in CHINET from 2015 to 2021 for analysis of bacetrial distribution and antimicrobial resistance.Results A total of 153591 isolates were collected,48.8％ of which were gram-positive bacteria and 51.2％ were gram-negative bacteria.The top five bacterial strains were coagulase negative Staphylococcus (28.2％),Escherichia coli (20.7％),Klebsiella (13.7％),Enterococcus (7.2％),and Staphylococcus aureus (6.6％).Compard to female patients,male patients showed lower proportion of E.coli and higher proportions of other bacterial species in all the bacterial isolaets from blood samples.The proportions of Streptococcus pneumoniae and Salmonella in all the bacterial isolaets from blood samples were higher in children compared to adults.Enterobacterales species showed various resistance rates to antimicrobial agents.Overall,≥58.0％,≥36.8％ and ≥56.8％ of E.coli strains were resistant to cefotaxime,gentamicin and levofloxacin respectively over the 7-year period.However,less than 2.5％ of the E.coli strains were resistant to carbapenems.K.pneumoniae showed higher resistance rates to imipenem and meropenem than other Enterobacterales species.During the 7-year period,the prevalence of imipenem-resistant and meropenem-resistant K.pneumoniae increased from 21.4％ and 19.9％ in 2015 to 25.7％ and 26.6％ in 2021,respectively.However,carbapenems still maintained good antibacterial activity against other Enterobacterales,associaetd with lower resistance rates.In the 7-year period,Acinetobacter baumannii showed a dwonward trend in the resistance rates to imipenem and meropenem,but remained 72.9％ and 73.2％ respectively in 2021.The prevalence of imipenem-resistant and meropenem-resistant P.aeruginosa decreased from 26.7％ and 22.9％ in 2015 to 18.5％ and 14.7％ in 2021,respectively.The prevalence of PRSP was 1.5％ in the isolaets from adults and and 0.8％ in the isolates from children.Less than 3.0％ of the Enterococcus faecium and Enterococcus faecalis strains were resistant to vancomycin,teicolanin,or linezolid.The prevalence of methicillin-resistant S.aureus (MRSA) and coagulase negative Staphylococcus (MRCNS) was 32.1％ and 81.0％,respectively.The prevalence of MRSA was relatively stable,28.5％ in 2015 and 28.0％ in 2021.Conclusions Coagulase negative Staphylococcus,E.coli and K.pneumoniae were the main bacterial species isolated from blood samples in the hospitals participaing in the CHINET from 2015 to 2021.Significant sex and age differences were found in the distribution of bcterial isolates from blood samples.The overall resistance rates of the top bacetrial strains from blood samples to antimicrobial agents showed a downward trend.Ongoing surveillance of antimicrobial resistance for the isolates from blood samples is still essential for prescribing rational antimicrobial therapies and curbing bacterial resistance.

OBJECTIVE: To evaluate the short-term efficacy of proximal fibula osteotomy in the treatment of knee osteoarthritis, and to analyze the effect of osteotomy on the tension of the lateral knee soft tissue of patients and verify the reliability of the Arch string theory. METHODS: A total of 71 patients with varus knee osteoarthritis from December 2019 to March 2022 were included, 3 patients dropped out, and 68 patients completed all trials, collected 27 males and 41 females, aged from 51 to 79 years old, with an average of (68.0±7.0 ) years old. The follow-up time ranged from 4 to 12 weeks, with an average of (3.76±1.94) weeks. After admission, the patient underwent Proximal fibula osteotomy, and the tension of lateral knee soft tissue, visual analogue scale (VAS) of pain, the western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and other indicators were recorded before surgery and 1 month after surgery in the weight-bearing state. RESULTS: According to the VAS, the curative effect of a single index was evaluated by referring to the score before and after treatment by Bao Zongzhao. Thirty seven cases were markedly effective, 27 cases were effective, and 4 cases were ineffective. After surgery, 3 patients presented with weakness of dorsalis pedis extension and 1 presented with paresthesia of dorsalis pedis, which disappeared after symptomatic treatment . The VAS and WOMAC score at 1 month after operation were lower than those before operation, and the differences were statistically significant(P<0.001). The tension of lateral knee soft tissue 1 month after operation was lower than that before operation, and the difference had statistical significance(P<0.001). CONCLUSION Proximal fibula osteotomy is safe and effective in the treatment of varus knee osteoarthritis in the short term. One month after osteotomy, the tension of lateral knee soft tissue increases under weight-bearing state, but the long-term changes still need further observation and follow-up.
Male ; Female ; Humans ; Middle Aged ; Aged ; Osteoarthritis, Knee/surgery* ; Fibula/surgery* ; Reproducibility of Results ; Tibia/surgery* ; Knee Joint/surgery* ; Osteotomy ; Treatment Outcome ; Retrospective Studies

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female ; Humans ; Adolescent ; SARS-CoV-2 ; Smell ; COVID-19/complications* ; Cross-Sectional Studies ; COVID-19 Vaccines ; Incidence ; Olfaction Disorders/etiology* ; Taste Disorders/etiology* ; Prognosis