OBJECTIVE: To investigate the feasibility and effectiveness of the novel bone hook combined with finger-guided technique in the treatment of irreducible intertrochanteric femoral fractures in elderly. METHODS: Between January 2021 and August 2023, 23 elderly patients with irreducible intertrochanteric femoral fractures were treated with the novel bone hook combined with finger-guided technique. There were 10 males and 13 females; the age ranged from 68 to 93 years (mean, 76.2 years). The time from injury to operation ranged from 36 to 76 hours (mean, 51.2 hours). According to the classification standard proposed by TONG Dake et alin 2021, there were 10 cases of typeⅠA, 1 case of typeⅠB, 6 cases of type ⅡA, 4 cases of type ⅡB, and 2 cases of type ⅡC. The operation time, intraoperative blood loss, intraoperative fluoroscopy frequences, and quality of fracture reduction were recorded. The fracture healing time and occurrence of postoperative complications were observed during follow-up. At last follow-up, the Harris scoring system was used to evaluate the hip joint function. RESULTS: The operation time was 42-95 minutes (mean, 52.1 minutes). The intraoperative blood loss was 40-420 mL (mean, 126.5 mL). Intraoperative fluoroscopy was performed 14-34 times (mean, 20.7 times). According to the criteria proposed by Chang et al, the quality of fracture reduction was rated as good in 20 cases and acceptable in 3 cases. All patients were followed up 6-20 months (mean, 10.2 months). X-ray film showed that all fractures healed with the healing time of 3.0-5.5 months (mean, 4.0 months). At last follow-up, the Harris score of the hip joint ranged from 82 to 97 points (mean, 90.4 points). Among them, 14 cases were rated as excellent and 9 cases as good. No complication such as coxa vara, cutting of the cephalomedullary nail, nail withdrawal, or nail breakage occurred during follow-up. CONCLUSION The treatment of elderly patients with irreducible intertrochanteric femoral fractures by using the novel bone hook combined with finger-guided technique can achieve high-quality fracture reduction and fixation, and has a good effectiveness.
Humans ; Male ; Female ; Aged ; Aged, 80 and over ; Hip Fractures/diagnostic imaging* ; Fracture Fixation, Internal/instrumentation* ; Fracture Healing ; Treatment Outcome ; Operative Time ; Fracture Fixation, Intramedullary/instrumentation* ; Bone Nails ; Postoperative Complications/epidemiology* ; Feasibility Studies ; Fingers

Objective:To investigate the prognosis and the factors that influence it in patients with non-gastric gastrointestinal stromal tumors (GISTs) who are at low risk of recurrence.Methods:This was a retrospective cohort study. Clinicopathologic and prognostic data from patients with non-gastric GISTs and at low risk of recurrence (i.e., very low-risk or low-risk according to the 2008 version of the Modified NIH Risk Classification), who attended 18 medical centers in China between January 2000 and June 2023, were collected. We excluded patients with a history of prior malignancy, concurrent primary malignancy, multiple GISTs, and those who had received preoperative imatinib. The study cohort comprised 1,571 patients with GISTs, 370 (23.6%) of whom were at very low-risk and 1,201 (76.4%) at low-risk of recurrence. The cohort included 799 (50.9%) men and 772 (49.1%) women of median age 57 (16–93) years. Patients were followed up to July 2024. The prognosis and its influencing factors were analyzed. Receiver operating characteristic curves for tumor diameter and Ki67 were established, and the sensitivity, specificity, area under the curve (AUC) and optimal cut-off value with 95% confidence intervals were calculated. Propensity score matching was implemented using the 1:1 nearest neighbor matching method with a matching tolerance of 0.02.Results:With a median follow-up of 63 (12–267) months, the 5- and 10-year overall survival (OS) rates of the 1,571 patients were 99.5% and 98.0%, respectively, and the 5- and 10-year disease-free survival (DFS) rates were 96.3% and 94.4%, respectively. During postoperative follow-up, 3.8% (60/1,571) patients had disease recurrence or metastasis, comprising 0.8% (3/370) in the very low-risk group and 4.7% (57/1,201) in the low-risk group. In the low-risk group, recurrence or metastasis occurred in 5.5% (25/457) of patients with duodenal GISTs, 3.9% (25/645) of those with small intestinal GISTs, 9.2% (6/65) of those with rectal GISTs, and 10.0% (1/10) of those with colonic GISTs. Among the 60 patients with metastases, 56.7% (34/60) of the metastases were located in the abdominal cavity, 53.3% (32/60) in the liver, and 3.3% (2/60) in bone. During the follow-up period, 13 patients (0.8%) died of disease. Receiver operating characteristic curves were plotted for tumor diameter and Ki67 and assessed using the Jordon index. This showed that the difference in DFS between the two groups was statistically significant when the cutoff value for tumor diameter was 3.5 cm (AUC 0.731, 95% CI: 0.670–0.793, sensitivity 77.7%, specificity 64.1%). Furthermore, the difference in DFS between the two groups was statistically significant when the cutoff value for Ki67 was 5% (AUC 0.693, 95% CI: 0.624–0.762, sensitivity 60.7%, specificity 65.3%). Multifactorial analysis revealed that tumor diameter ≥3.5 cm, Ki67 ≥5%, and R1 resection were independent risk factors for DFS in patients with non-gastric GISTs at low risk of recurrence (all P<0.05). Furthermore, age >57 years, Ki67 ≥5%, and R1 resection were also independent risk factors for OS in patients with non-gastric GISTs at low risk of recurrence (all P<0.05). We also grouped the patients according to whether they had received postoperative adjuvant treatment with imatinib for 1 or 3 years. This yielded 137 patients in the less than 1-year group, 139 in the 1-year plus group; and 44 in both the less than 3 years and 3-years plus group. After propensity score matching for age, tumor diameter, Ki67, and resection status, the differences in survival between the two groups were not statistically significant (all P>0.05). The 10-year DFS and OS were 87.5% and 95.5%, respectively, in the group treated with imatinib for less than 1 year and 88.5% and 97.8%, respectively, in the group treated for more than 1 year. The 10-year DFS and OS were 89.6% and 92.6%, respectively, in the group treated with imatinib for less than 3 years and 88.0% and 100.0%, respectively, in the group treated with imatinib for more than 3 years. Conclusion:The overall prognosis of primary, non-gastric, low recurrence risk GISTs is relatively favorable; however, recurrences and metastases do occur. Age, tumor diameter, Ki67, and R1 resection may affect the prognosis. For some patients with low risk GISTs, administration of adjuvant therapy with imatinib for an appropriate duration may help prevent recurrence and improve survival.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.

Oral diseases,such as periodontitis,salivary gland diseases,and oral cancers,significantly challenge health conditions due to their detrimental effects on patient's digestive functions,pronunciation,and esthetic demands.Delayed diagnosis and non-targeted treatment profoundly influence patients'prognosis and quality of life.The exploration of innovative approaches for early detection and precise treatment represents a promising frontier in oral medicine.Exosomes,which are characterized as nanometer-sized extracellular vesicles,are secreted by virtually all types of cells.As the research continues,the complex roles of these intracellular-derived extracellular vesicles in biological processes have gradually unfolded.Exosomes have attracted attention as valuable diagnostic and therapeutic tools for their ability to transfer abundant biological cargos and their intricate involvement in multiple cellular functions.In this review,we provide an overview of the recent applications of exosomes within the field of oral diseases,focusing on inflammation-related bone diseases and oral squamous cell carcinomas.We characterize the exosome alterations and demonstrate their potential applications as biomarkers for early diagnosis,highlighting their roles as indicators in multiple oral diseases.We also summarize the promising applications of exosomes in targeted therapy and proposed future directions for the use of exosomes in clinical treatment.