To assess the clinical curative effect of bundling bone fragments with double figure-of-eight suture in bony mallet finger.

A retrospective analysis was performed on 24 patients (24 fingers) with chronic bony mallet finger who underwent surgery at the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital from June 2021 to May 2023. During the procedure, bundling bone fragment with double figure-of-eight suture was performed on the base of the distal phalanx. After removal of the Kirschner wire at postoperative 6 weeks, the flexion and extension of the affected finger were gradually strengthened, the range of motion (ROM) and the total active range of motion (TAM) of the finger were recorded. Finger function was evaluated according to the TAM system of the American Association of Hand Surgeons.

A total of 24 patients were enrolled, including 14 males and 10 females, and the age ranged from 16 to 54 years old. According to the Wehbe and Schneider classification, there were 5 cases of type Ia, 5 cases of type Ib, 8 cases of type IIa, 4 cases of type IIb, 1 cases of type Ⅲa, and 1 cases of type Ⅲb. The range of time from injury to operation was 21 days to 64 days. All incisions healed well, with no broken nail and no shedding nail. Mallet finger deformities were all corrected postoperatively, and all fractures healed well. All the 24 cases were followed, and the follow-up period was 6.0 to 9.3 months. At the last follow-up, the mean active ROM of the distal interphalangeal joint of the injured finger was 28.5°~39.2° [31.5° (31.1°, 33.7°)], and the mean active ROM of the distal interphalangeal joint of the healthy finger was 30.6°~40.2° [31.8° (32.°1, 35.2°)]. There was no significant difference in ROM between the injured finger and the healthy finger (Z=-3.92, P=0.724). The TAM of the injured finger was 229.4°~238.5° [232.2° (230.8°, 234.5°)], and that of the healthy finger was 230.2°~241.3° [234.1° (233.5°, 235.7°)]. There was no significant difference in TAM between the injured finger and the healthy finger (Z=-1.84, P=0.314). According to the evaluation criteria of the TAM system, 21 cases had excellent outcomes, and 3 had good outcomes, and the rate of excellent and good outcomes was 100%.

Satisfactory therapeutic outcomes for bony mallet finger deformity can be achieved by bundling bone fragment with double figure-of-eight suture, and it is an effective and practical method.

To explore the role of Vaspin in the progression of osteoarthritis (OA) by analyzing the serum levels of Vaspin in patients with knee OA of different severity.

All OA patients received a preoperative X-ray examination (antero-posterior and lateral radiographs in weight loading), and the Kellgren-Lawrence (K-L) grade of knee OA was assessed. A total of 30 mild knee OA (MKOA) patients (K/L score≤2) and 70 severe knee OA (SKOA) patients (K/L score≥3) were included in this study, and their blood samples were collected to separate serum. Vaspin levels in serum from all patients were detected using enzyme-linked immunosorbent assay (ELISA). Vaspin levels were compared between patients with different disease severity and between patients with different body mass index (BMI). The relationship of serum Vaspin with disease activity indices, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), was evaluated. Unconditioned Logistic regression analysis was performed to assess which clinical or laboratory index is an independent risk factor for disease severity in OA.

Serum Vaspin concentrations were significantly higher in SKOA patients than in MKOA patients (P=0.011). Serum Vaspin levels were significantly higher in OA patients with a BMI≥28 than in those with a BMI<24 (P=0.027). Serum Vaspin levels were positively correlated with CRP, but not ESR, in OA patients (R=0.36, P<0.01 and R=0.20, P=0.11, respectively). Vaspin level was identified to be an independent risk factor for disease severity in OA.

Abnormal expression of Vaspin may be involved in the development and progression of OA, and Vaspin may be a related molecule between obesity and OA and could be useful for monitoring the activity and progression of OA.

To study the effect of using gap balance technique versus measuring osteotomy technique in total knee arthroplasty on postoperative knee joint function, lower extremity alignment changes, and intraoperative osteotomy parameters in patients with knee osteoarthritis.

From October 2019 to May 2021, 81 patients with knee osteoarthritis who underwent unilateral total knee arthroplasty at Xing'anmeng People's Hospital were included, of which 30 underwent femoral osteotomy using the gap balance technique (using a novel femoral measurement locator; experimental group), and 51 underwent femoral osteotomy using the combined technique of measuring osteotomy and gap balance (control group). The operation time, intraoperative parameters (the amount of osteotomy of the lateral tibial plateau, the amount of osteotomy of the distal femur, the amount of osteotomy of the posterior medial condyle of the femur, the amount of osteotomy of the posterior lateral condyle of the femur, and the thickness of the spacer) were compared between the two groups. Posterior knee pain visual analogue scale (VAS) score, knee range of motion, knee society score (KSS), Western Ontario MacMaste (WOMAC) score, and related imaging parameters were also compared.

The osteotomy of the posterior medial condyle of the femur (9.0±0.98 vs 9.7±01.0, t=-3.212, P=0.002) was less and the thickness of the spacer (8.2±0.6 vs 9.4±1.1, t=-4.939, P=0.001) was thinner in the experimental group than in the control group. The KSS (74.8±13.7 vs 66.9±14.5) and WOMAC score (32.9±7.8 vs 38.9±8.1) at the 1-month follow-up were significantly better in the experimental group (P<0.05), suggesting a faster recovery of knee joint function. There was no significant difference in KSS or WOMAC score at 6 months, 1 year, and last follow up after operation between the two groups (P>0.05). The plateau angle was significantly corrected in both groups after operation (P<0.05), but there was no significant difference in the femoral-tibial angle or tibial plateau angle between the two groups after surgery (P>0.05).

The use of the new femoral measuring locator for gap balance osteotomy in total knee arthroplasty can achieve ideal flexion gap balance and reduce the amount of osteotomy on the posterior medial condyle of the femur, and the short-term postoperative knee joint function recovery is better.

To compare the incidence of anterior femoral notching in total knee arthroplasty (TKA) using the anterior versus posterior reference system, and to investigate the reason of anterior femoral notching by calculating the cutting error caused during osteotomy by the oscillation of saw blade through the guide-slot.

Patients who underwent TKA for primary osteoarthritis between September 2015 and December 2020 were enrolled in this study. The patients were divided into either an anterior reference group or a posterior reference group according to the femoral component sizing method used. The incidence of anterior femoral notching was compared between the two groups according to the Tayside classification on postoperative lateral X-ray images of the knee joint. The height and depth of the slot as well as the thickness and the cutting length of saw blade were measured. The maximum oscillatory amplitude of blade and the maximum cutting depth of the anterior cortex were calculated using the measured value of the slot height, slot depth and saw blade thickness.

A total of 195 patients (239 knees) were enrolled in the study with 107 and 132 knees in the anterior and posterior reference groups, respectively. There was no significant difference between the two groups in the incidence of general anterior femoral notching (26.2% vs 18.9%, χ²=1.789, P=0.181) or the incidence of severe anterior femoral notching (Tayside grades Ⅲ and Ⅳ; 4.7% vs 6.1%, χ²=0.221, P=0.638). The maximum oscillatory amplitude of blade and the maximum cutting depth of the anterior cortex at a cutting length of 5 cm were 2.98 mm and 0.75 mm in the anterior reference group and 3.15 mm and 0.80 mm in the posterior reference group, respectively.

The anterior reference system does not seem to be definite advantages over the posterior reference system in avoiding anterior femoral notching during TKA. The reason may be the special design of the femoral prosthesis of the posterior reference system. The cutting error caused by the oscillation of saw blade in the guide-slot during osteotomy and other factors may play an important role in leading to anterior femoral notching.

To measure the bone mineral density of infants and toddlers aged 0-3 in Shijingshan district of Beijing.

A total of 6297 infants and toddlers aged 0-3 years who received physical examination at Peking University Shougang Hospital from January 2015 to February 2020 were selected, of whom there were 3306 boys and 2991 girls. Bone mineral density was measured by quantitative ultrasound. The results were then analyzed statistically.

The mean Z value of bone mineral density in 6297 infants and toddlers was -0.99; the mild deficiency rate was 14.2% (911/6297), moderate deficiency rate was 11.6% (750/6297), severe deficiency rate was 19.9% (1268/6297), and the total deficiency rate was 46.5% (2929/6297). The bone mineral density of girls was significantly lower than that of boys. The deficiency rate of girls was 56.9% (1702/2991), which was significantly higher than that of boys (37.1%, 1227/3306). The mild deficiency, moderate deficiency and severe deficiency rates of girls were also all higher than those of boys. The bone mineral density was the lowest in the 4-6 months group, followed by 0-3 months. After 6 months of age, the bone mineral density increased gradually with age. The deficiency rate was the highest too in the 4-6 months group.

There is a high rate of low bone mineral density in infants and toddlers aged 0-3 years in Shijingshan district of Beijing, which is related to gender and age.

To report the clinical outcomes of recurrent patellar dislocation (RPD) patients after medial patellofemoral ligament reconstruction (MPFLR) combined with tibial tubercle osteotomy (TTO), to evaluate the impact of preoperative J sign severity on postoperative residual graft laxity correction, and to identify the predisposing factors of high grade J sign.

A total of 165 adult consecutive RPD patients who underwent MPFL reconstruction and TTO at the Orthopedic Department of Peking University Shougang Hospital and were followed for more than 2 years were analyzed retrospectively in this study. All the patients were classified into three groups based on the severity of pre-operative knee J sign: grade 1+, grade 2+, and grade 3+. Computed tomography (CT) examination was performed in all patients at 0° extension of the knee, and true lateral X-ray films of the knee were obtained at 20° flexion. The patellar laxity index measured by patellar glide test (PGT) under anesthesia and the radiographic parameters (tibial tuberosity-trochlear groove distance, patellar height, trochlear groove classification, patella trochlear-groove distance, femoral anteversion angle, tibial external angle, and knee rotational angle), as well as the pre/postoperative knee functional scores including International Knee Documentation Committee (IKDC) score, Kujala score, and Lysholm score, were assessed. Furthermore, the postoperative residual J sign and surgical failure rate were compared among the three groups at the final follow-up.

Totally, 138 (83.6%, 138/165) patients participated in the final follow up. The average follow-up duration was (38.2±5.9) months (range, 36~45 months), and most of the patients (97.1%, 134/138) did not suffer from RPD during the follow-up period except for 4 patients in the grade 3+ group. Seventeen patients had grade 3+ J sign, 24 had grade 2+, and 97 had grade1+ preoperatively. There was no significant difference among the three groups in age, gender, injury side, time from injury to surgery, follow-up duration, and preoperative knee function scores (P＞0.05). At the final follow-up, the patellar laxity index was (36.4±19.6) % in the grade 3+ J sign group, (23.5±8.1)% in the grade 2+ group, and (22.9±9.8)% in the grade 1+ group; there was a significant difference in the patellar laxity index among the three groups (P＜0.05). The patella trochlear-groove distance in the grade 3+, grade 2+, and grade 1+ groups was (-1.7±8.2) mm, (-6.6±8.0) mm, and (9.4±7.4) mm, respectively; there was a significant difference among three groups (P＜0.05). The femoral anteversion angle in the grade 3+, grade 2+, and grade 1+ groups was (28.2±11.6)°, (20.4±12.6)°, and (19.6±10.7)°, respectively; there was a significant difference in the femoral anteversion angle among the three groups (P＜0.05). The tibial external angle in the grade 3+, grade 2+, and grade 1+ groups was (30.4±20.0)°, (16.5±17.5)°, and (19.8±16.2)°, respectively; there was a significant difference in the tibial external angle among the three groups (P＜0.05). The knee rotational angle in the grade 3+, grade 2+, and grade 1+ groups was (14.6±5.4)°, (8.3±3.9)°, and (9.2±5.2)°, respectively; there was a significant difference in the knee rotational angle among the three groups (P＜0.05). The three groups had no significant difference in patellar height or trochlear groove classification (P＞0.05). The IKDC, Kujala, and Lysholm scores were (77.2±6.1), (76.1±3.3), and (84.7±5.6) in the grade 3+group, (87.3±8.7), (84.4±4.8), and (91.6±8.0) in the grade 2+group, and (86.4±6.5), (85.3±1.2), and (93.1±4.3) in the grade 1+group, respectively; all were significantly improved compared with the preoperative scores (P＜0.05).The failure rate in the grade 3+ group was 23.5%, which was significantly higher compared with those in the grade 2+ (0%) group and grade 1+ group (0%) (P＜0.05). The odds ratio of high grade J sign (3+) with patella trochlear-groove distance was 1.44, that with femoral anteversion angle was 1.37, and that with knee rotational angle was 1.24 (P＜0.05).

MPFL reconstruction combined with TTO is effective for most of RPD patients during the 2-year follow-up period except for patients with preoperative high grade J sign (grade 3+). However, the morbidity of postoperative positive residual patellar J sign was 26% and the positive J sign might increase the laxity of the patella. Preoperative high grade patellar J sign may lead to postoperative residual graft laxity and even failure, and high grade J sign appears to be associated with increased patella trochlear-groove distance, femoral anteversion angle, and tibial external angle.

As an important non-operative treatment, new biological agents represented by platelet rich plasma have achieved specific results in the treatment of knee osteoarthritis and received great attention. However, at present, the application of platelet rich plasma in knee osteoarthritis lacks high level research, the preparation, usage, and indication selection lack unified standards, and the mechanism of action on articular cartilage is not completely clear, which has caused some controversy on the clinical application of platelet rich plasma. Based on the existing research, this article will describe the current situation of platelet rich plasma from six aspects: mechanism of action, indication selection, preparation, optimal use, perioperative management, and clinical efficacy, and discuss its future development.

Knee osteoarthritis is a common degenerative disease among middle and old aged people. The expert consensus on stepwise treatment of knee osteoarthritis was established in 2018, in which a staging system and matched therapeutic regimens have been provided. In our opinion, surgical treatment is more characteristic of steps compared with non-surgical treatment which can be throughout the process of management of knee osteoarthritis. So we put forward the concept of stepwise surgical treatment of knee osteoarthritis, which contains four steps (arthroscopic knee surgery, osteotomy around the knee, partial knee arthroplasty, and total knee arthroplasty) based on the extent of anatomy preservation in the knee, aiming to achieve individualization, precision, minimal invasiveness, and intellectualization during the management of knee osteoarthritis and try to perform the step-down surgery.

To evaluate the efficacy of extracorporeal shock wave therapy (ESWT) in the treatment of osteoarthritis of the knee with flexion deformity (FD).

A retrospective study was conducted in patients who were diagnosed with osteoarthritis of the knee with FD and treated with conservative therapyat the Civil Aviation General Hospital from January 2021 to December 2021. A total of 57 patients were enrolled in this study, and they were divided into either an ESWT group or a non-EWST group. Age, gender, disease course, body mass index, Kellgren-Lawrence (K-L) grade, and Knee Society Score (KSS), Western Ontario and McMaster University (WOMAC) osteoarthritis index, Visual Analogue Scale (VAS) score, FD, and range of motion (ROM) before operation, immediately after operation, and 3 months after operation were recorded. Two independent samples t-test or rank-sum test was used to compare age, gender, disease course, body mass index, K-L grade. Repeated measures ANOVA was used to compare KSS, WOMAC, VAS, FD, and ROM.

KSS, VAS, WOMAC, FD and ROM at 3 months after operation in the EWST group were 121.63±9.25, 3.74±0.26, 37.50±1.44, 10.79±4.74, and 124.05±1.38, respectively, which were significantly better than corresponding preoperative values (91.63±10.41, 6.11±0.26, 51.63±0.97, 15.37±0.56, and 110.00±3.37, respectively, P＜0.05). VAS, FD, and ROM at 3 months after operation were statistically better in the ESWT group than in the non-ESWT group (4.79±0.28, 13.34±4.65, and 119.21±2.24, respectively, P＜0.05).

ESWT is an effective treatment to relieve pain and improve joint function, ROM, and FD in patients with osteoarthritis of the knee with FD, which is better than traditional physical treatment.

To retrospectively analyze the clinical efficacy of arthroscopy combined with medial high biplanar tibial osteotomy in the treatment of medial compartment knee osteoarthritis.

From August 2018 to January 2022, 28 patients (29 knees) with medial compartment knee osteoarthritis were successfully followed up under the concept of enhanced recovery after arthroscopic exploration combined with high medial tibial osteotomy at Shougang Hospital, Peking University, including 3 males (3 knees) and 25 females (26 knees). Their average age was (57.8±6.2) years (range, 45~71 years). The visual analogue scale (VAS), HSS knee score, Lysholm score, and knee range of motion (ROM) were used to evaluate the postoperative efficacy. Preoperative and postoperative standard anteroposterial-lateral radiographs were used to measure tibiofemoral angle (FTA) and medial proximal tibia angle (MPTA) to record the range of motion of the knee at 3 months after operation. The occurrence of complications was recorded. Paired t test was used for statistical analysis, and P＜0.01 was considered statistically significant.

The patients were followed up for 8~48 months, with an average of (25.8±12.8) months. Arthroscopic examination revealed 29 knees combined with other injuries, including meniscus tear (29 knees), articular cartilage injury (29 knees), stenosis of intercondylar fossa (9 knees), cartilage free body (6 knees), etc. The varus deformity was effectively corrected after operation. VAS score [(6.28±0.649) vs (1.52±0.509)], HSS score [(62.34±4.125) vs (89.48±2.544)], Lysholm score [(57.17±3.855) vs (79.93±4.200)], FTA [(183.87±1.604)° vs (174.85±0.834)°], MPTA [(83.39±0.997)° vs (89.99±1.372)°], and the range of motion of the knee joint [(105±7.559)° vs (126.90±4.100)° were significantly improved 3 months after operation compared with those before operation (P＜0.01). During the follow-up period, 1 case had wound infection 3 months after operation, and the wound healed after debridement and VSD treatment. No failure of internal fixation was observed, and no nonunion of osteotomy site was found.

Arthroscopic exploration combined with high tibial osteotomy can effectively correct the force line of the affected limb, relieve pain symptoms, and timely detect other structural injuries in the joint, as well as take intervention measures simultaneously representing a safe and effective method for the treatment of medial compartment knee osteoarthritis.

To investigate the effect of medial unicompartmental knee arthroplasty (UKA) on lateral compartment degeneration in medial compartment osteoarthritis of the knee.

We retrospectively analyzed 67 patients (69 knees) with medial knee osteoarthritis treated with medial mobile bearing UKA at the Orthopedic Department of Xiangyang First People's Hospital from March 2019 to March 2022. There were 14 men (14 knees) and 53 women (55 knees), and they ranged in age from 52~82 years,with a mean age of 67 years. There were 35 cases with left knee lesions, 30 cases with right knee lesions, and 2 cases with bilateral knee lesions, with a medical history of 0.5 to 10 years. The patients' intraoperative prosthesis placement angles were measured, and changes in Oxford Knee Score (OKS), Hospital for Special Surgery Knee Function Score (HSS), and Western Ontario and McMaster Universities Arthritis Index (WOMAC) before operation and at postoperative follow-up were compared, and whether the patients had painful symptoms on the lateral side of the knee, narrowing or loss of the lateral compartment joint space, and subchondral sclerosis on the frontal and lateral views of the knee was recorded. The Kellgren-Lawrance grading criteria were applied for osteoarthritis grading.

All patients were followed up for 6-36 months. At the last follow-up, the patients' HSS score and OKS score were significantly higher than those before surgery, and the OWOMAC index was significantly lower than that before surgery. In ten cases, UKA femoral prosthesis was placed in the internal reversal position, and seven patients had lateral knee pain symptoms at the follow-up, among which six showed narrowing or loss of the lateral compartment joint space on the lateral knee radiographs and subchondral sclerosis changes. UKA femoral prosthesis was placed in the standard position in 48 cases, three patients had painful symptoms in the lateral knee, but no significant changes were seen in the lateral radiographs of the knee on review. In five of these patients, the lateral radiographs of the knee showed narrowing or loss of the lateral compartment space and subchondral sclerosis.

UKA for medial compartment osteoarthritis of the knee is clinically effective in the short term, and poor intraoperative femoral prosthesis placement accelerates lateral compartment degeneration.

To investigate the effects of tranexamic acid (TXA) on blood loss, venous thromboembolism (VTE), and cardio-cerebral embolism in elderly patients with intertrochanteric fracture.

A retrospective analysis was performed on 411 elderly patients with intertrochanteric fracture who received proximal femoral nail anti-rotation internal fixation from January 2017 to January 2021 at Civil Aviation General Hospital. According to whether TXA was used perioperatively or not, the patients were divided into a hemostatic group (265 cases) and a non-hemostatic group (146 cases). The hemostatic group was given an intravenous infusion of 1 g/100 ml TXA before intraoperative skin resection and after operation. In contrast, TXA and similar hemostatic drugs were not used in the non-hemostatic group. Intraoperative latent and dominant blood loss, total blood loss, transfusion rate, hemoglobin (Hb) and hematocrit (Hct) at 1, 2, 3, 7, and 14 d after surgery, activated partial thrombin time (APTT), fibrinogen (FIB), and D-dimer (DD) at 3, 7, and 14 d after surgery, and the incidence of VTE, cardio-cerebral embolism, and mortality at 3 months after surgery were compared between the two groups.

Intraoperative latent and dominant blood loss, total blood loss, and transfusion volume in the hemostatic group [(586.73±130.08) ml, (204.37±45.31) ml, (791.09±175.39) ml, and (263.89±93.91) ml, respectively] were significantly lower than those in the non-hemostatic group [(733.23±168.14) ml, (260.98±59.85) ml, (994.21±227.99) ml, and (383.67±207.51) ml, respectively; P＜0.05]. Hb level at 2, 3, 7, and 14 d after surgery in the hemostatic group [(87.99±11.04) g/L, (95.32±7.79) g/L, (99.87±7.55) g/L, and (108.68±8.09) g/L, respectively] was significantly higher than that in the non-hemostatic group [(85.25±9.30) g/L, (92.12±7.07) g/L, (97.16±6.78) g/L, and (105.25±6.88) g/L, respectively; P＜0.05], and Hct level at 3d after surgery in the hemostatic group [(28.98±2.96)%] was significantly higher than that in the non-hemostatic group [(27.47±2.70)%; P＜0.05]. There were no significant differences in postoperative APTT, FIB, DD, blood transfusion rate, or the incidence of VTE, cardio-cerebral embolism, and mortality between the two groups (P＞0.05).

Perioperative use of TXA can effectively reduce intraoperative blood loss and blood transfusion in elderly patients with intertrochanteric fracture while not increasing the incidence of VTE and did not increase the risk of cardio-cerebral embolism.

To explore the effect of calcium carbonate D3 tablets combined with leuprorelin on sex hormones and bone metabolism in girls with central precocious puberty (CPP).

A total of 146 girls with precocious puberty who visited Wuxi Children's Hospital from January 2019 to January 2021 were included in this study and divided into either a control group or a study group. The control group was treated with leuprorelin alone, and the study group was given leuprorelin plus calcium carbonate D3 tablets. Growth index, sex hormone levels, sex gland volume, and bone metabolism were compared between the two groups.

The 12-month growth rate (GV) and predicted adult height (PAH) in the study group were significantly higher than those in the control group (P＜0.05). Peak follitropin beta (PFSH) , lutropin alpha (PLH), and estradiol (E2) in the study group were signifiancely lower than those in the control group at 3 months after treatment (P＜0.05). Ovarian volume, uterine volume, and follicle diameter in the study group were significantly lower than those of the control group after 12 months of treatment (P＜0.05). Blood calcium (Ca) and vitamin D [25-(OH)] were significantly higher and osteocalcin (Ost) and type I collagen carboxyl terminal peptide (β-CTX) were significantly higher in the study group than in the control group (P＜0.05) after 12 months of treatment. The total incidence of adverse reactions did not differ significantly between the study group and the control group (8.22% vs 6.85%, respectively, P＞0.05).

Calcium carbonate D3 tablets combined with leuprorelin can effectively improve the growth and development of CPP girls, inhibit the development of the gonads, and help regulate bone metabolism.

To investigate the effect of paricalcitol combined with ciracalcet on the micro-inflammatory state and alkaline phosphatase (ALP) and parathyroid hormone (iPTH) levels in patients with uremic secondary hyperparathyroidism (SHPT).

A total of 80 SHPT patients with uremia treated at Yijishan Hospital from June 2019 to December 2020 were selected, and the patients were randomly divided into a combination group (n=40) and a control group (n=40) using the random number table method. The control group was treated with paricalcitol alone, and the combination group was treated with paricalcitol combined with cinacalcet. The treatment lasted for 12 weeks in both groups. The therapeutic effects and the changes in calcium and phosphorus levels, micro-inflammation indicator levels, ALP, iPTH, and parathyroid gland volume between before treatment and 12 weeks after treatment were compared between the two groups.

After 12 weeks of treatment, the total treatment effective rate in the combination group was significantly higher than that of the control group (92.5% vs 75.0%, P＜0.05). Blood calcium, blood phosphorus, and calcium phosphorus product in both groups decreased after treatment when compared with the values before treatment (P＜0.05 for all), but the decreasing trend was more obvious in the combination group than in the control group (P＜0.05 for all). Serum levels of interleukin-6, tumor necrosis factor-α, and C reactive protein (CRP) decreased in both groups when compared with those before treatment (P＜0.05 for all), but the decreasing trend was more obvious in the combination group (P＜0.05 for all). Serum ALP and iPTH levels were both lower than those before treatment in the two groups (P＜0.05 for all), but iPTH was significantly lower in the combination group than in the control group [(326.59±38.39) pg/ml vs (483.21±46.56) pg/ml, P＜0.05]. After 12 weeks of treatment, the volume of the parathyroid glands was lower than that before treatment in both groups (P＜0.05 for both), and the volume of the parathyroid glands in the combination group was significantly smaller than that of the control group [(0.79±0.14) mm³ vs (1.08±0.19) mm³, P＜0.05].

Paricalcitol combined with cinacalcet has a significant therapeutic effect on uremic SHPT, which reduces the micro-inflammatory state of the patients and the levels of ALP and iPTH, as well as the volume of the parathyroid glands.

To evaluate the effect of the antidepressant duloxetine on bone metabolism in patients with depression by comparing the blood concentration of bone turnover markers.

From September 2020 to February 2022, 49 patients with depressive disorder (patient group) and 49 sex- and age-matched healthy controls (normal group) were recruited at the Department of Clinical Psychology of Wuxi Hospital of Traditional Chinese Medicine and the Department of Clinical Psychology of Wuxi Mental Health Center. Blood concentrations of bone transformation markers including C-terminal cross-linking telopeptide of type I collagen (β-CTX) and N-terminal propeptide of type I procollagen (P1NP) were detected by electrochemiluminescence immunoassay. Comparisons were performed between the patient group and the normal group, and between patients before and after treatment with duloxetine.

At baseline, β-CTX (pg/ml) was significantly higher in the patient group than in the normal group [321.1 (189.4) vs 210.4 (103.5), t=-3.59, P=0.001], but there was no significant difference in P1NP (P＞0.05). After treatment, β-CTX increased significantly from 321.1 (189.4) to 475.3 (192.4) in the patient group (P=0.001); P1NP increased from 49.9(19.8) to 54.5(27.6), but there was no significant difference.

Bone resorption in patients with depression is higher than that in healthy people, and it is more obvious after treatment with duloxetine, which may increase the risk of fracture.

To investigate the diagnostic value of knee cross-sectional CT measurements of tibial tuberosity-trochlear groove (TT-TG) distance, patellar tilt angle, and patellar deviation angle for patellar dislocation.

From 2013 to 2016, 153 patients with patellar dislocation and 151 controls at Peking University Third Hospital were analyzed retrospectively. TT-TG distance, patellar tilt angle, and patellar deviation angle were measured on axial CT images. The performance of TT-TG distance, patellar tilt angle, and patellar deviation angle in predicting patellar dislocation was assessed by the receiver operating characteristic (ROC) curve analysis.

No significant difference was found between the two groups in age, sex, knee size, height, weight, Insall-Salvati index, femoral width, or tibial width. The mean TT-TG distance, patellar tilt angle, and patellar deviation angle in the patellar dislocation group were 19.4 mm, 27.5°, and 42.8°, respectively, which were significantly greater than those of the control group (12.2 mm, 11.5°, and 15.6°, respectively). ROC curve analysis suggested that TT-TG distance, patellar tilt angle, and patellar deviation angle could be efficient to diagnose patellar dislocation. All the three measurements had good value in diagnosing patellar dislocation, with the area under the curve values greater than 0.85, and their optimal cutoff values were 15.9, 20.8°, and 31.1°, respectively.

TT-TG distance, patellar tilt angle, and patellar deviation angle have high value in diagnosing patellar dislocation.

To compare the range of motion and functional scores of distal radius intraarticular fractures in elderly patients after conservative and volar locking plate surgery.

A total of 75 patients with intra-articular fractures of the distal radius treated at Peking University Shougang Hospital from January 2017 to December 2019 were retrospectively studied. Among them, 33 patients were treated by manual reduction and plaster external fixation, and 42 patients were treated by volar locking plate surgery. The efficacy of the two groups was evaluated by wrist motion and Disabilities of the Arm, Shoulder and Hand (DASH) score at 12 months after treatment.

The parameters of range of motion in the conservative group were the following: dorsiflexion, (60.7±7.2)°; palmar flexion, (53.6±10.5)°; pronation, (83.9±8.9)°; supination, (83.8±7.7)°; radial deviation, (23.2±8.1)°; ulnar deviation, (36.2±7.8)°; DASH score, 11.1±9.4; the corresponding parameters in the operation group were (58.2±9.4)°, (50.1±10.0)°, (83.1±8.8)°, (83.9±8.4)°, (22.8±7.0)°, (37.5±7.4)°, and (9.8±10.8). There was no significant difference in these parameters between the two groups (P＞0.05).

Both conservative treatment and volar locking plate surgery are effective in the treatment of intra-articular fractures of the distal radius in the elderly. There is no significant difference between the two. The appropriate treatment should be selected according to the specific conditions of patients.

To investigate the anatomic feasibility and simulation effect of sacroiliac screw implanted from the front of the ilium (SIS-FI).

Pelvis CT data for 80 healthy adults (40 males and 40 females) collected from Imaging Department database of Wuxi No. 9 People's Hospital from January 2019 to May 2020 were analyzed retrospectively. Anatomic parameters of screw channel were measured by CT digital reconstruction technique to simulate SIS-FI fixation. Under the control of an aiming device, taking 6 mm backward from 2 o'clock or 10 o'clock of the posterior edge of the acetabulum as the entry point, and the base of the superior facet of S1 as the exit point, SIS-FIs with a diameter of 6.5 mm and 7.3 mm respectively, and a length of 90 mm were implanted on the two sides of the 40 3D printed models of the pelvis (1∶1). The implantation of screw was observed.

The entry point was located at the position of (5.78±1.35) mm horizontally backward from the posterior edge of the acetabulum and (2.48±0.50) mm vertically downward from the upper edge of the acetabulum. The upward angle between the central axis of the channel and the line parallel to the superior endplate of S1 was (42.99±5.16)°, and the inward angle between the central axial of the channel and the longitudinal axis of the human trunk was (43.79±2.83)°. The length of the screw channel was (102.55±7.64) mm, the minimum width was (16.55±1.77) mm, and the minimum height was (18.78±1.44) mm. All the implanted screws were located within the channel, but screws in one case were longer and penetrated a little behind the posterior part of the channel.

At least one screw with a diameter of 6.5-7.3 mm and a length of 85-95 mm for SIS-FI can be implanted into the pelvis of Chinese. SIS-FI implanted with the aid of an aiming device has high accuracy. However, its clinical value needs further study.