For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Background: and Purpose The optimal management of patients with acute basilar artery occlusion (BAO) is uncertain. We aimed to evaluate the safety and efficacy of endovascular thrombectomy (EVT) compared to medical management (MM) for acute BAO through a meta-analysis of randomized controlled trials (RCTs). Methods: We performed a systematic review and meta-analysis of RCTs of patients with acute BAO. We analyzed the pooled effect of EVT compared to MM on the primary outcome (modified Rankin Scale [mRS] of 0–3 at 3 months), secondary outcome (mRS 0–2 at 3 months), symptomatic intracranial hemorrhage (sICH), and 3-month mortality rates. For each study, effect sizes were computed as odds ratios (ORs) with random effects and Mantel-Haenszel weighting. Results: Four RCTs met inclusion criteria including 988 patients. There were higher odds of mRS of 0-3 at 90 days in the EVT versus MM group (45.1% vs. 29.1%, OR 1.99, 95% confidence interval [CI] 1.04–3.80; P=0.04). Patients receiving EVT had a higher sICH compared to MM (5.4% vs. 0.8%, OR 7.89, 95% CI 4.10–15.19; P<0.01). Mortality was lower in the EVT group (35.5% vs. 45.1%, OR 0.64, 95% CI 0.42–0.99; P=0.05). In an analysis of two trials with BAO patients and National Institutes of Health Stroke Scale (NIHSS) <10, there was no difference in 90-day outcomes between EVT versus MM. Conclusion In this systematic review and meta-analysis, EVT was associated with favorable outcome and decreased mortality in patients with BAO up to 24 hours from stroke symptoms compared to MM. The treatment effect in BAO patients with NIHSS <10 was less certain. Further studies are of interest to evaluate the efficacy of EVT in basilar occlusion patients with milder symptoms.

Objective:To evaluate the value of CT angiography (CTA) for vertebral artery (VA) injury in the transverse foramen region of cervical vertebra.Methods:The clinical and CTA imaging data of 56 patients with cervical spine trauma in People's Hospital of Yuxi City from January 2016 to December 2019 were retrospectively analyzed. To observe the VA were or not injuried and their degrees, and the relationship between fracture in transverse foramen region and injured of the VA by applying post processing techniques such as volume reconstruction (VR), image fusion, curved planar reconstruction (CPR), multi-planar reconstruction (MPR), vascular analysis and so on.Results:There were 35 cases in the positive group of transverse perforation stenosis among the 56 patients, and 21 cases in the negative group. There were 19 cases injuried the VA in the positive group of stenosis, but just 5 cases′VA were injuried in the negative group of stenosis, with statistically significant differences ( P<0.05). The risk of VA injuried caused by different degrees of transverse perforation stenosis in the positive stenosis group was statistically significant ( P<0.05). The VA damaged distribution were: 3 cases in V1 segment, 16 cases in V2 segment, 5 cases in V3 segment. The degree of luminal stenosis were: 9 cases of mild stenosi, 7 cases of moderate stenosis, 5 cases of severe stenosis, and 3 cases of luminal occlusion. Conclusions:The CTA of VA can clearly show its anatomical route, degree of injury, range and its adjacent relationship with the fracture end of the transverse foramina of cervical vertebra, which can provide evidences of objective and reliable imaging for spinal surgeons to assess their conditions and select the treatment plans.

Suture broken, knot slipping and tissue tearing are the main reasons of wound closure failure in clinical operation. Based on this, we simulated the suturing and healing operation by using a biological materials testing machine and investigated the tensile properties before and after knotting, relaxation property and friction property of three common sutures: silk, polyglactin 910 and polypropylene. Results show that the tensile property decreased after knotting. The tensile strength of polyglactin 910 and elongation of polypropylene were the largest. During the relaxation process, the sutures relaxed the most in the first 2 hours. The relaxation from less to more was: polyglactin 910, silk and polypropylene. Coating or monofilament could obviously reduce the surface roughness of sutures, and thus reduce the friction force of the suture-suture interface. The friction force of the suture-suture interface increased with the increasing load but did no change with the increasing velocity. The results can provide an important theoretical basis for the optimizations of suture design and knotting operation.
Friction ; Materials Testing ; Polyglactin 910 ; Polypropylenes ; Silk ; Suture Techniques ; Sutures ; Tensile Strength

The large force applied by laparoscopic grasper during clamping operation can cause tissue damage and induce various complications. In this research, the security of graspers with different radii of curvature and teeth were evaluated by using experimental investigation, finite element simulation and tissue damage assessment method based on compression tests with rabbit large intestines models. Results showed that the most serious tissue damages appeared in areas that were in contact with the jaw edges, which were the regions of stress concentration. The increase in radii of curvature of the edges or teeth could alleviate the tissue damages. The results could provide basic data for choosing and designing noninvasive graspers.

Objective To explore the CT imaging features of solid pseudo- papillary tumor of pancreas (SPTP) and the diagnostic value of dual-enhanced scanning in SPTP. Methods CT imaging data of 38 cases with SPTP confirmed by surgical pathology were retrospectively analyzed, among whom there were 20 cases who had underwent dual-phases enhanced scanning and 18 cases who had underwent three-phases enhanced, the CT imaging features of the tumors,enhancement degree and the enhancement peak phase of tumors′solid composition were observed. Results All the tumors were single.Tumor located in the head of pancreas in 14 cases, in the neck in 4 cases,in the body in 8 cases, in the tail in 7 cases, in the body-tail of border in 4 cases,and 1 case in the head-neck of border.The size of tumors was 2.4+7.8 cm;tumor of 12 cases was solid mainly,of 24 cases was solid and cystic,and of 2 cases was cystic mainly. Enhancement was uneven. The solid composition showed mild-to-moderate reinforcement, and the enhanced peak stage was in portal vein phase or delay phase.Conclusions There are some characteristics in CT imaging findings of SPTP, CT imaging combined with clinical characteristics can make an accurate diagnosis before operation. The diagnosis accuracy of SPTP with MSCT through dual- phases enhancement scaning and the three- phases enhancement shows no difference,and the former scaning technology can reduce the received effective radiation dose of patients and improve the efficiency of examining.It is worth of promoting.

Objective To analyze the CT imaging features of pulmonary sclerosing haemangioma(PSH),so as to improve the level of the diagnosis of this disease.Methods Retrospectively analyzed the Multi-slice spiral computed tomography(MSCT) imaging data of 13 cases of PSH with who confirmed by surgical pathology,all cases were performed CT with non-enhanced scaning and enhanced.Results 13 patients' average age was 42 years old,including 10 female,accounted for 76.92％ (10/13).All the nodules or masses of the 13 cases were single,long diameter was 0.6-5.0cm,all tumors presented as round or oval shaped,clear boundary.1 case with calcifications in 13 cases,2 cases with air meniscus sign,and 2 cases with halo sign around.Contrast-enhanced:10 cases were enhanced homogeneously,3 cases were enhanced heterogeneously and with vessel marginating sign,1 case of lymph node was enlargement in mediastinal.Conclusion PSH mainly more shows at middle-aged women,it has relative characteristic of CT imaging within non-enhanced scaning and enhanced.Therefore,a comprehensive analysis of these CT features can help to improve the accuracy of diagnosis.

Objective To explore the suitable delayed time of MSCT mesenteric venography and to probe the value of different post-processing methods.Methods 49 patients with abdominal pain (group A)underwent MSCT mesenteric venography with a delayed time of 15-20 s after the arterial phase,and the CT showed the mesenteric vein(MV)was normal.Meanwhile,other 49 ones with abdominal pain (group B)underwent conventional biphasic CT with a delay-time of 35 s after arterial phase.The CT value and diameter of superior mesenteric vein between two groups were compared,and the grading,scoring and display of mesenteric vein with different post-processingmethods were assessed.Results The diameters of SMV were (10.52±2.19)mm in group A and (9.88±2.60)mm in group B,exhibiting no statistically significant difference (P >0.05);Meanwhile the average attenuations of SMV were (1 96.55±40.59)HU in group A and (1 64.32± 28.35)HU in group B,exhibiting a statistically significant difference (P<0.05).In addition,the display ability and scoring of mesenteric vein and its branches on volume rendering (VR)in group A were better than those in group B (P <0.05).VR was better in display of the vascular space distribution than maximum intensity projection (MIP)and sliding thin slab maximum intensity projection (STS-MIP),the STS-MIP was better in display of tiny blood vessels than VR and MIP,and the curved planner reformation (CPR)was superior in display of vascular lumen and the relationship with adjacent structures.Conclusion The image quality of mesenteric vein with the delayed time of 1 5-20 s after arterial phase is superior to that with delayed time of 35 s,and different advantages of the post-processing methods are showed in display of MV.

A cadmium column reduction-azo dyes spectrophotometric method based on micro sequential injection lab-on-valve was established for the determination of total nitrogen in seawater. The experimental parameters were optimized, and the interference experiment was carried out. The results showed that the interference of the main components and salinity in sea water could be eliminated by using a series of standard solution prepared by national standard seawater with certain salinity. The concentration of total nitrogen in seawater was linear with the absorbance in the range of 0 . 03-1 . 00 mg/L with a correlation coefficient of 0. 9993. When determining the national standard seawater at nitrogen concentration of 0. 20 mg/L, the relative standard deviation (RSD) was 4. 9%, the detection limit was 0. 010 mg/L, and the recoveries were 99. 5%-101 . 1%. There were not significance differences between the results of this method and national standard method in the t-test analysis. The method is suitable for the determination of total nitrogen in seawater.