This study shows a case of a patient with synovial chondromatosis of the hip misdiagnosed as rice body bursitis. The patient complained of pain and limited activity in his left hip. He was diagnosed with synovial chondromatosis of the hip by medical history, physical examination, imaging examination and postoperative pathology. Based on literature review, the characteristics and differential diagnosis of the disease in epidemiology, imaging and pathology were discussed in detail, so as to improve the understanding of the disease and avoid misdiagnosis. He was treated with hip arthroscopy and obtained satisfactory therapeutic effect. The patient was followed up for 1 year without recurrence.

The pelvic incidence (PI) is a key anatomical parameter for vertebral-pelvic sagittal plane stabilization, that is, the angle between the perpendicular to the sacral plate at its midpoint and the line connecting this point to the middle axis of the femoral head, which fully reflects the compensatory ability of the pelvis and it does not change with age, gender and position, but is closely related to race. The measurement result of PI varies with the measurement method. The measurement on the standing lumbosacral lateral radiographs is a classic measurement method, which is easy to operate and has strong practicability. Later, the improved three-dimensional CT measurement and measurement methods on bone specimens are based on this, which reduces the error in X-ray measurement. Early research focused on PI and spine-related diseases. Compared with normal people, a small PI value is likely to cause intervertebral disc degeneration or even herniation, a high PI can cause lumbar spondylolisthesis. The measurement of PI can predict the risk of disc degeneration and lumbar spondylolisthesis progression, providing an important reference for spinal sagittal orthopedic reconstruction. The influence of PI in hip joint diseases cannot be ignored. PI also has a predictive effect on the development of certain hip joint diseases, and has guiding significance for the treatment of diseases. The relationship between PI and hip osteoarthritis, hip dysplasia, femur acetabular impingement, and non-traumatic necrosis of the femoral head was reviewed through literature review. The results showed that the relationship between hip osteoarthritis and PI was still controversial. The higher pelvic incidence was observed in Crowe I patients with hip dysplasia, and the lower PI was observed in patients with femur acetabular impingement. The higher PI was associated with a greater likelihood of femoral head collapse in patients with non-traumatic necrosis of the femoral head.

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Objective: To evaluate preoperative nutritional status and inflammatory status by Nutritional Risk Screening-2002 (NRS-2002) and hematologic inflammatory markers in patients with thoracic esophageal squamous cell carcinoma (ESCC), and to explore their effects on long-term survival prognosis. Methods: A total of 113 patients with thoracic ESCC treated by radical resection were grouped for further analysis according to preoperative NRS-2002 score, systemic inflammation score (SIS) and the combination of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio (CNP) score. The progression free survival (PFS) and overall survival (OS) between groups were compared. Multivariate Cox regression analysis was used to determine the independent prognostic factors of patients with thoracic esophageal squamous cell carcinoma, and the interaction analysis of statistically significant factors was carried out. Results: The median PFS was 21 months for all the patients. The 1-year, 3-year and 5-year PFS rates were 69.0%, 25.7% and 23.1%, respectively. Correspondingly, the median OS was 36 months, and the 1-year, 3-year and 5-year OS rates were 95.6%, 46.2% and 29.2%, respectively. Cox univariate analysis showed that T stage, N stage, TNM stage, SIS, CNP score and NRS-2002 score were significantly associated with PFS and OS (all P<0.05), and sex was associated with PFS (P=0.032) in patients with thoracic ESCC. Furthermore, cox multivariate analysis showed that TNM stage (HR=1.570, P=0.039), NRS-2002 score (HR=2.706, P<0.001) and CNP score (HR=1.463, P=0.011) were independent prognosis factors of PFS in patients with thoracic ESCC. In cox model interaction analysis, there was a positive interaction between NRS-2002 score and CNP score (RR=2.789, P<0.001). Conclusion Preoperative NRS-2002 score combined with CNP score are risk factors for prognosis of patients with thoracic ESCC, which can be used as prognostic indicators.

Objective To evaluate preoperative nutritional status and inflammatory status by Nutritional Risk Screening?2002 ( NRS?2002 ) and hematologic inflammatory markers in patients with thoracic esophageal squamous cell carcinoma ( ESCC), and to explore their effects on long?term survival prognosis.Methods A total of 113 patients with thoracic ESCC treated by radical resection were grouped for further analysis according to preoperative NRS?2002 score, systemic inflammation score ( SIS) and the combination of neutrophil?to?lymphocyte ratio and platelet?to?lymphocyte ratio (CNP) score. The progression free survival (PFS) and overall survival ( OS) between groups were compared. Multivariate Cox regression analysis was used to determine the independent prognostic factors of patients with thoracic esophageal squamous cell carcinoma, and the interaction analysis of statistically significant factors was carried out. Results The median PFS was 21 months for all the patients. The 1?year, 3?year and 5?year PFS rates were 69.0%, 25.7% and 23.1%, respectively. Correspondingly, the median OS was 36 months, and the 1?year, 3?year and 5?year OS rates were 95.6%, 46.2% and 29.2%, respectively. Cox univariate analysis showed that T stage, N stage, TNM stage, SIS, CNP score and NRS?2002 score were significantly associated with PFS and OS (all P＜0.05), and sex was associated with PFS ( P＝0.032) in patients with thoracic ESCC. Furthermore, cox multivariate analysis showed that TNM stage ( HR＝1.570, P＝0.039), NRS?2002 score ( HR＝2.706, P＜0.001) and CNP score (HR＝1.463, P＝0.011) were independent prognosis factors of PFS in patients with thoracic ESCC. In cox model interaction analysis, there was a positive interaction between NRS?2002 score and CNP score ( RR＝2.789, P＜0.001). Conclusion Preoperative NRS?2002 score combined with CNP score are risk factors for prognosis of patients with thoracic ESCC, which can be used as prognostic indicators.

Objective To evaluate preoperative nutritional status and inflammatory status by Nutritional Risk Screening?2002 ( NRS?2002 ) and hematologic inflammatory markers in patients with thoracic esophageal squamous cell carcinoma ( ESCC), and to explore their effects on long?term survival prognosis.Methods A total of 113 patients with thoracic ESCC treated by radical resection were grouped for further analysis according to preoperative NRS?2002 score, systemic inflammation score ( SIS) and the combination of neutrophil?to?lymphocyte ratio and platelet?to?lymphocyte ratio (CNP) score. The progression free survival (PFS) and overall survival ( OS) between groups were compared. Multivariate Cox regression analysis was used to determine the independent prognostic factors of patients with thoracic esophageal squamous cell carcinoma, and the interaction analysis of statistically significant factors was carried out. Results The median PFS was 21 months for all the patients. The 1?year, 3?year and 5?year PFS rates were 69.0%, 25.7% and 23.1%, respectively. Correspondingly, the median OS was 36 months, and the 1?year, 3?year and 5?year OS rates were 95.6%, 46.2% and 29.2%, respectively. Cox univariate analysis showed that T stage, N stage, TNM stage, SIS, CNP score and NRS?2002 score were significantly associated with PFS and OS (all P＜0.05), and sex was associated with PFS ( P＝0.032) in patients with thoracic ESCC. Furthermore, cox multivariate analysis showed that TNM stage ( HR＝1.570, P＝0.039), NRS?2002 score ( HR＝2.706, P＜0.001) and CNP score (HR＝1.463, P＝0.011) were independent prognosis factors of PFS in patients with thoracic ESCC. In cox model interaction analysis, there was a positive interaction between NRS?2002 score and CNP score ( RR＝2.789, P＜0.001). Conclusion Preoperative NRS?2002 score combined with CNP score are risk factors for prognosis of patients with thoracic ESCC, which can be used as prognostic indicators.

Objective To evaluate perioperative fluid infusion strategies in retroperitoneal tumor patients.Method Data of 89 retroperitoneal tumor patients in Peking University People's Hospital and Peking University International Hospital were collected and devided into intraoperative minor haemorrhage group (761 ml) and massive haemorrhage group (4 813 ml),including postoperative fluid treatment,input and output volume,serum brain natriuretic peptide level and postoperation complications.Results Fluid input on the 1st day after operation,the 2nd day,the 3rd day respectively were (7 565 ±4 757),(3 869 ± 727),(3 289 ± 897),(3 096 ± 567) ml in the minor haemorrhage group,and (13 927 ± 5 612),(5 192 ± 1 274),(3 786 ± 1 137),(3 797 ± 719) ml in the massive haemorrhage group (t =-4.637,-3.117,-2.460,-2.982,P =0.04,0.048,0.36,0.038).BNP level respectively were (33 ±25),(82 ±66),(116 ± 54),(145 ± 75) ng/ml in the minor haemorrhage;respectively,(70 ± 65),(165 ± 153),(256 ± 220),(442 ± 412) ng/ml in the massive haemorrhage group (t =-4.637,-3.117,-2.460,-2.982,P =0.041,0.038,0.046,0.04).The accumulative percentage of negative fluid balance was 100％ in 3 days after operation.Acute kidney injury (AKI),cardiac,respiratory events,major intraabdominal complications deep venous thrombosis developed in minor and massive haemorrhage group were 4.7％,7.1％,4.7％,14.3％,9.5％ vs.25.1％,27.6％,46.8％,10.6％,17.0％ respectively (x2 =2.89,5.89,19.96,0.044,0.674,P=0.049,0.015,0.001,0.834,0.412).Conclusions Multiple goals directed fluid strategy leads to a better outcome by decreasing the AKI rate.BNP level could be used as a goal marker in fluid treatment.

Objective To study the influence of resolving phlegm and relaxing bowels decoction(Huatan Tongfu decoction)on plasma tissue type plasminogen activator(t-PA),plasminogen activator inhibitor(PAI)and homocysteine(Hcy)in patients with acute cerebral infarction. Methods With randomized and controlled clinical research,78 inpatients from 2010 to 2012 in Traditional Chinese Medicine(TCM)Department of Beijing Chaoyang Hospital,Capital Medical University were chosen,including 40 patients in observation group and 38 patients in control group. The patients in control and observation groups were treated by conventional treatment,and additionally the patients in observation group received Huatan Tongfu decoction(ingredients:Trichosanthis 30 g,Arisaema with bile 6 g,Magnolia bark 10 g,Fried rice sprout 15 g),and the rhubarb decoction was made alone,each 20 mL decoction containing crude drug 6 g. 1-4 days after the beginning of the study,the two decoctions were mixed,and the patients took the lukewarm mixture orally twice daily(once 1/2 the dosage);5-12 days after the start of the study, the patients took 200 mL lukewarm mixed decoction daily,being divided into 2 times to administer,and according to the patient defecation situation,the dosage of rhubarb decoction was adjusted individually,the therapeutic course being 12 days. The t-PA,PAI and Hcy were detected before treatment and on the 7th day after treatment. TCM syndrome scores(phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome)were recorded before and on the 12th day after treatment,and the scores of National Institute of Health Stroke Scale(NIHSS)were recorded at the same time. Results Before treatment,the differences in t-PA,PAI,Hcy levels and NIHSS score and phlegm syndrome,fire-heat syndrome and sthenic-fu syndrome scores were not statistically significant;all the indicators improved significantly after treatment compared with those before treatment,and the changes in observation group were more remarkable〔t-PA(mg/L):13.03±2.15 vs. 12.95±2.16,PAI(mg/L):23.64±9.07 vs. 26.81±10.00, Hcy(μmol/L):9.13±1.15 vs. 11.52±3.17,phlegm syndrome:9.16±1.71 vs. 11.17±2.89,fire-heat syndrome:7.51±1.59 vs. 8.81±2.26, sthenic-fu syndrome:0.61±0.87 vs. 1.19±1.14, NIHSS score:5.70±3.16 vs. 5.90±2.97〕. Conclusion The mechanism of Huatan Tongfu decoction in treatment of patients with acute cerebral infarction accompanied by TCM syndromes of phlegm heat and sthenic-fu may be related to the reduction of plasma PAI and Hcy levels,protection of vascular endothelium and promotion of fibrinolysis,thereby the decoction can improve the clinical efficacy.

BACKGROUND: In vivo and in vitro experiments have demonstrated that polyetheretherketone (PEEK) polymer is the best cervical fusion cage material due to its good biocompatibility, elastic modulus similar to human bone, and satisfactory plasticity and hardness.OBJECTIVE: To assess the outcomes of polyetheretherketone (PEEK) cage filled with nano-artificial bone following anterior cervical discectomy and fusion (ACDF) in patients with cervical spondylotic myelopathy.METHODS: In total 17 patients with cervical spondylotic myelopathy were collected from the Department of Orthopedics, First Affiliated Hospital of Harbin Medical University between May 2007 and September 2009. There were 12 males and 5 females,averaging 55 (range 42-67) years of age. All patients underwent ACDF using PEEK cage filled with nano-artificial bone. Patients'neurological functions were assessed on the basis of Japanese Orthopaedic Association (JOA) scoring system. The distance between the midpoint of the upper end plate and lower end plate was measured as interboby height. Radiographs with the neck in lateral flexion and extension were obtained to evaluate fusion results.RESULTS AND CONCLUSIONS: Seventeen patients with cervical spondylotic myelopathy participated in the final analysis.Almost all patients had symptomatic improvement. Within postoperative several days, muscle strength of lower limb was increased, and limb was more flexible after surgery than prior to surgery. At 3 months after surgery, JOA scores were significantly increased compared to prior to surgery, the operated segments were stable and disc space height was satisfactory. In addition, no complications were found, and all cases achieved solid fusion, as confirmed by radiographs. These findings suggest that the immediate stability of the operated segments can be obtained by anchoring PEEK cage, and the nano-artificial bone-filled PEEK cage is safe, simple, and with relatively few complications. It is therefore a good choice for patients with cervical spondylotic myelopathy.

Objective To evaluate the safety and efficacy of the human acellular nerve allograft (hANG)for nerve repair in the clinical setting,and report the early outcomes of bridging digital nerve defect with the hANG. Methods Four patients with 5 digital nerve injuries were included in this pilot study.The nerves defect ranged from 10-20 mm and were bridged with the hANG(manufactured by Zhongda Medical Equipment Co.,Ltd,Guangzhou,China).Four digital nerve acute injuries in 3 patients were repaired with hANG primarily,while the nerve in another patient was reconstructed secondarily.The procedure was performed under a 10-manifying operating microscope.The nerve stumps were debrided until the normal fascicles could be seen.hANG was inserted between the proximal and distal stumps and end-to-end neurorrhaphy was performed with 9-0 sutures.Postoperative cares included dressing change and administration of antibiotics.No immunosuppressants had been used.The follow-up time ranged from 1 to 3 months.The wound and blood sample were examined for the safety of hANG.The nerve function Wag evaluated according to the scoring system proposed by the Nerve Injuries Committee of the British Medical Research Council. Results All wounds healed primarily.The adverse effects,such as rejection,allergy,infection,and toxicity to the liver and kidney were absent.The results of blood biochemistry test were within the normal range.The injured nerve achieved good functional recovery.In 2 cages,the 2 point discrimination(2PD)was 8mm(S3~+,excellent). Conclusion Based on the short term follow-up,using hANG to repair digital nerve defect as long as 20mm was safe,and the nerve functional recovery is pretty good.