To evaluate the features of carotid web (CW) by ultrasonography.

A total of 66 patients with CW were retrospectively enrolled from January 2018 to June 2019 at Xuanwu Hospital, Capital Medical University. All patients were examined by both ultrasonography and CTA, and were divided into either a<50% stenosis group (54 cases) or a ≥50% stenosis group (12 cases). The ultrasonographic characteristics of CW, including the length, thickness, direction (forward or backward to the flow), acute angle between the web and carotid wall, and thrombus between the web and carotid wall were compared between the two groups. The stenosis degrees of carotid artery were compared between patients with and without ischemic stroke.

Forty-two (42/66, 63.6%) patients were diagnosed with CW by initial CDFI examination, of whom 21 (21/66, 31.8%) were diagnosed with ulcerative plaque and 3 (3/66, 4.5%) were diagnosed with carotid dissection at first but confirmed by second examination. There were no differences in the web length, thickness, direction, or thrombus detected between the two groups (P>0.05). The angle between the web and carotid wall in the<50% stenosis group was significantly smaller than that of the ≥50% stenosis group (median angel 39o vs 73o, P=0.002), and the percentage of patients with an angle≤ 60o in the<50% stenosis group was significantly higher than that of the ≥50% stenosis group (74.1% vs 41.7%, P=0.042). The diameter of the residual carotid artery at CW location in the<50% stenosis group was significantly larger and peak systolic velocity was significantly higher in the<50% stenosis group than in the≥50% stenosis group (P<0.001). The stenosis degrees of carotid artery were not statistically different between patients with and without ischemic stroke (P=0.321).

Ultrasonography can be used to evaluate the characteristics of carotid web in 2D and color mode. When the angle between the CW and carotid wall is large, the carotid artery stenosis ≥ 50% is more likely to happen, but carotid artery stenosis is not the main cause of ischemic stroke.

The aim of the present study was to evaluate the efficiency of sling exercise, therapeuticultrasound, therapeuticultrasound and sling exercise in patients to alleviate pain and improve lumbar function with lumbar disc herniation.

Individuals were selected from a list of patients being followed at the department of Rehabilitation in the third hospital of Hebei Medical University. 30 patients who were diagnosed with lumbar disc herniation were collected, the diagnoses were established upon medical history, physical examination, and results of imaging studies. The patients were randomly divided into three groups: therapeuticultrasound group received 14 sessions of ultrasonic therapy to the lumbar region, Sling exercise group received 14 sessions of sling exercise, and therapeuticultrasound and sling exercise group received therapeuticultrasound and sling exercise therapy 14 sessions of therapeuticultrasound to the lumbar region,7 sessions per week, 2 weeks. The VAS and ODI were compared with the assessment of the patients before and at the end of the therapy.

At the end of treatment, three groups VAS scores (F=3.069, P=0.043) and ODI scores (t=12.676, P<0.001) was lower than that at the beginning of treatment (P<0.05), at the end of treatment the VAS scores (F=59.400, P<0.001) and of the ODI scores (t=12.737, P<0.001) of ultrasonic and sling exercise therapy group was lower than the other group, the difference is significantly.

All three groups could reduce pain and improve lumbar function, and the ultrasonic and sling exercise therapy was most effective for lumbar disc herniation treatment in the three groups.

To analyze the treatment of different types of traumatic cerebral infarction in children, and explore its pathogenesis in combination with literature so as to improve the cure rate and reduce disability rate.

The clinical data of 42 cases of traumatic cerebral infarction in children were retrospectively analyzed in The Hospital of 81^st Group Army PLA from January 2015 to December 2019. The diagnosis of traumatic cerebral infarction in children was made by CT scan and MRI scan. According to different conditions, children with traumatic cerebral infarction were classified, and different treatment strategies were selected. Children with lacunar infarction were treated with calcium antagonists and neurotrophic drugs, supplemented by hyperbaric oxygen and exercise rehabilitation. The children of focal cerebral infarction and complex cerebral infarction treated by junior dehydrant and hormone also included the calcium antagonist and nutritional nerve drugs. The therapeutic regimen perhaps adjusted by the evolution of the disease. The children of extensive cerebral infarction underwent emergency cranial decompression, and was treated by reducing intracranial pressure and preventing complications after operation. The treatment results and recovery were observed.

In 42 cases of traumatic cerebral infarction in children, 35 cases (83.3%) were good recovery, 4 cases (9.5%) were moderate disability, 2 cases (4.8%) were severe disability, 1 case (2.4%) died, and no vegetative state. The good recovery rate of lacunar infarction was 100%, that of focal cerebral infarction was 62.5%, that of mixed cerebral infarction was 60%, and that of extensive cerebral infarction was 50%.

It is of great significance to improve the therapeutic effect and prognosis of children with traumatic cerebral infarction to adopt different treatment schemes for different types of cerebral infarction.

To characterize the patients with supratentorial hypertensive intracerebral hemorrhage (ICH) in the Tibetan Plateau over an altitude of 4000 meters.

A total of 68 cases with supratentorial hypertensive ICH were retrospectively included in Ali Regional People’s Hospital from January 2017 to September 2018. The clinical and laboratory data were collected. A simple linear correlation analysis was applied to analyze the correlation between the amount of bleeding and sex, age, nationality, time from onset , systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), serum triglyceride (TG), and cholesterol. According to computed tomography (CT) findings, 68 cases were divided into the basal ganglia ICH group (33 cases) and the lobar ICH group (35 cases). The characteristics between two groups were analyzed using t-test or χ² test.

The data of sex, age, nationality, time from onset, SBP, DBP, Hb, TG, and cholesterol of 68 cases on admission did not show any definitive correlation with the hematoma volumes (P＞0.05). The SBP and DBP of patients in the basal ganglia ICH group were significantly higher than that in the lobar ICH group, respectively [(184.9±28.5) mmHg vs (164.6±24.4) mmHg; (113.0±18.1) mmHg vs (103.0±18.4) mmHg] (t=0.499, 0.486; P=0.002, 0.033).

The relevant factors of hematoma volumes in patients with ICH in plateau area were not yet clear. Diastolic and systolic blood pressure of patients in the basal ganglia ICH group was higher than that in those in lobar ICH group.

To compare the efficacy evaluation of electrospun composite biomaterials and a porcine small intestine submucosa mesh for hernia repair.

A randomized, single-blind, controlled multicenter trial was performed in 3 hospitals in Shanghai. Eligible adult patients with primary unilateral reducible groin hernias were randomly assigned (1∶1) to electrospun composite biomaterials (experimental group) or porcine small intestine submucosa (control group) mesh groups. Patients were treated with the tARB technique and assessed at 1,3 and 6 months after the surgery. The primary endpoint was hernia recurrence. The secondary endpoints were postoperative complications including groin pain and operative site infections.

172 patients were assigned to experimental (n=86) and control (n=86) groups. At 6 months follow-up, postoperative complications occurred in 5 patients (5/86, 5.95%) and 2 (2/86, 2.35%) patients in the control and experimental groups, respectively (P>0.05). There was no significant difference in VAS or SVS score between the two groups.

We demonstrate that electrospun composite biomaterial mesh can be used as a ideal choice for inguinal hernia repair. Electrospun composite biomaterial has the characteristics of low recurrence rate, absorbability and long-term comfort.It can be further applied in clinical practice in the future.

Pancreaticoduodenectomy(PD)remains one of the most complicated hepatobiliary operations. The development of minimally invasive surgery for PD has always been an hot spot. Laparoscopic pancreaticoduodenectomy(LPD) has not been widespread carried out due to its difficulty and long learning curve. LPD accounts for 9% of all PD, according to the National Cancer Data base. Compared with laparoscopic surgery, robotic surgery system has significant advantages in the field of minimally invasive PD, including stereotactic amplified vision, filtering hand tremor and simulating the wrist. The article would review the surgical techniques and notes, which could provide clinical reference for other surgeons.

To compare the clinical efficacy of arthroscopic augmented repair of rotator cuff injuries using artificial dermis (Pelnac) versus acellular allogeneic dermis, and to provide evidence for graft selection in clinical practice.

Clinical data of 39 patients with rotator cuff injuries treated in the orthopaedics department of Guangzhou Red Cross Hospital affiliated to Jinan University, from June 2021 to May 2025 were retrospectively analyzed. Inclusion criteria: tendon retraction distance ≥three centimetres, the preoperative Goutallier grade (fatty infiltration of the rotator cuff muscles) ≥grade two; no local osseous lesions, tolerant of patch augmentation, good cognitive function, and good compliance. Exclusion criteria: osteoarthritis, humeral head fracture, Bankart lesion, nerve palsy history, unauthorized use of drugs affecting efficacy or receipt of other treatments during the treatment period, end-stage malignant tumors. According to patch type, the patients were divided into an artificial dermis (Pelnac) group ( artificial group) (n=20) and the acellular allogeneic dermis group (acellular dermis group) (n=19). All the patients underwent a double-row anchor suture plus patch-covering procedure. T test, chi square test, and Mann-Whitney U test were used to compare shoulder range of motion, visual analogue scale (VAS) score, Constant-Murley score, and tendon thickness between the two groups.

There were no statistically significant differences in baseline data between the two groups (all P>0.05). Before treatment, no statistically significant differences were found in any observed indicators between the two groups (P>0.05). After treatment, shoulder range of motion and Constant-Murley score were significantly improved in both groups compared with those before treatment (all P<0.05), while VAS score was significantly decreased (Z=-3.983, -3.879, both P<0.05). After treatment, Constant-Murley scores were 77±6 in the artificial group and 76±4 in the acellular dermis group, VAS scores were 1.0 (1.0, 2.0) and 1.0 (1.0, 2.0) repectivley, as well as tendon thickness (8.4±0.6) mm and (8.3±0.8) mm repectivley. There was no statistically significant difference between the two groups in (all P>0.05). No statistically significant difference was found in postoperative shoulder range of motion between the two groups (all P>0.05).

Both artificial dermis (Pelnac) and acellular allogeneic dermis patches achieved favorable efficacy in augmented repair of rotator cuff injuries.

To evaluate the clinical efficacy and complications of arthroscopic tension band wiring with Kirschner wires for coronoid process fractures combined with mini-incision repair of lateral collateral ligament injuries in the treatment of varus posteromedial rotatory instability (VPMRI) of the elbow.

This was a retrospective case-control study. Between March 2019 and September 2022, a total of 20 patients with cubitusvarus and posteromedial rotatory instability who were treated at Xuzhou Renci Hospital were enrolled. Patients with pre-existing elbow stiffness were excluded. The cohort comprised nine males and 11 females, with four left and 16 right elbow injuries. All the patients underwent arthroscopic Kirschner wire tension band fixation for the coronoid fracture combined with a small-incision repair of the lateral collateral ligament injury.Observation indicators included operation time, intraoperative blood loss, elbow range of motion (flexion, extension, internal rotation, external rotation), the visual analogue scale (VAS) for pain, and the Mayo elbow performance score (MEPS). Complications (heterotopic ossification, joint stiffness, nerve injury, skin irritation), patient satisfaction, and fracture healing were recorded. Paired t tests were used for statistical comparisons.

All the patients were followed up for (16±5) months. The mean age was (30±12) years. The mean operation time was (85±11) min, and the mean intraoperative blood loss was (56±10) ml. At the final follow-up, the elbow range of motion [flexion (137.3±8.6)°, extension (-1.5±2.8)°, internal rotation (84.3±5.3)°, external rotation (82.3±8.3)°] showed significant improvement compared to preoperative values [(61.3±10.1)°, (-16.5±7.5)°, (43.1±9.8)°, (40.3±6.5)°] (t=25.622, 8.379, 16.538, 17.817, all P<0.05). The final MEPS was 97±4 significantly higher than the preoperative score of 42±7 (t=30.509, P=0.001). The final VAS score was 1.3±0.6, significantly lower than the preoperative score of 7.1±1.3 (t=18.116, P=0.001).

Although arthroscopic tension band fixation of coronoid fractures combined with mini-open lateral collateral ligament repair for VPMRI is technically demanding, it allows early postoperative rehabilitation and reduces complications.

To identify preoperative muscle compositions of operated and contralateral sides and examine the association with postoperative walking and chair-raising outcomes after unilateral total hip arthroplasty (THA).

This retrospective study included 305 patients who underwent unilateral primary THA due to femoral head necrosis or hip osteoarthritis from January 2022 to December 2023. Exclusion criteria were: a history of long-term bedridden, prior hip surgery history on the operative side, hip dysplasia, severe complications after THA, incomplete imaging or functional data. A total of 133 patients were included in this study. Bilateral total muscle area index (TMI), normal attenuation muscle area index (NAMI) and fat infiltration (FI) of hip muscles were examined on a preoperative axial CT image. Six-meter walking test (6mWT) and five times sit-to-stand test (5-STST) were conducted at three-month follow-up. Paired t test or Wilcoxon rank sum test were used to compare the differences between bilateral muscle compositions. Pearson correlation coefficients were calculated to determine the factors associated with 6mWT and 5-STST results. Factors with P<0.1 in the univariate analysis were included in multivariate linear regression analysis.

Preoperatively, TMI was significantly higher on the contralateral side of gluteus maximus (t=-10.700, P<0.001), gluteus medius (Z=-3.407, P=0.001), iliopsoas (t=-6.839, P<0.001), and rectus femoris (t=-6.327, P<0.001) compared with the operative side. In terms of muscle quality, NAMI was significantly higher and FI was significantly lower on the contralateral side of gluteus maximus (NAMI: t=-12.359, P<0.001, FI: Z=-8.774, P<0.001), gluteus medius (NAMI: t=-8.213, P<0.001, FI: Z=-8.241, P<0.001), gluteus minimus (NAMI: t=-5.110, P<0.001, FI: Z=-7.063, P<0.001), iliopsoas (NAMI: t=-9.010, P<0.001, FI: Z=-7.587, P<0.001), piriformis (NAMI: Z=-5.841, P<0.001, FI: Z=-6.569, P<0.001), and rectus femoris (NAMI: t=-6.835, P<0.001, FI: Z=-4.500, P<0.001) compared with the operative side. In multivariate regression analysis, age (B=0.123, P<0.001) and contralateral gluteus minimus FI (B=5.948, P=0.013) were independently positively associated with 5-STST time. Contralateral gluteus maximus TMI (B=-0.438, P=0.001) was independently negatively associated with 5-STST time. Age (B=-0.006, P<0.001) and contralateral iliopsoas FI (B=-1.178, P<0.001) were independently negatively associated with 6mWT speed. Contralateral gluteus minimus TMI (B=0.047, P=0.025) was independently positively associated with 6mWT speed.

The preoperative muscle qualities of gluteus maximus, gluteus minimus and iliopsoas on the non-operative side were significantly associated with postoperative gait and sit-to-stand abilities at the three-month follow-up.

To analyze the epidemiological characteristics of hip fractures in the Mindong region over a 10-year period and provide evidence for prevention and control strategies in coastal aging areas.

A single-center retrospective study was conducted using data from newly diagnosed hip fracture inpatients admitted to MinDong Hospital between January 2015 and December 2024. Inclusion criteria: diagnoses of femoral neck fracture, intertrochanteric fracture, and related hip fractures. Exclusion criteria: pathological fractures (e.g., tumor metastasis, severe osteoporosis-excluded bone diseases), old fractures, periprosthetic fractures after hip fracture surgery, and patients with missing critical information (age, sex, fracture type). Data collected included patient demographics (gender, age, age stratification, season, occupation, resident type, geographical characteristics, patient source), clinical information (fracture site and types, classification, surgical approach, hospitalization duration). Stratified statistical analysis was performed by year, age, and season. Non-normally distributed measurement data are presented as M (P₂₅, P₇₅), with comparisons among multiple groups using the Kruskal-Wallis test. Categorical data are presented as n (%), with intergroup comparisons using the chi-square test or Fisher’s exact test; annual trends were analyzed using the trend chi square test.

A total of 5 320 patients were enrolled, accounting for 6.2% of orthopedic inpatients, with an average annual growth rate of 10.1%. The proportion of female patients was 58.7% and showed an increasing trend from 54.0% to 64.1% (χ²=22.59, P=0.007). The median age of patients was 75 years, with elderly patients aged ≥80 years accounting for 35.4%; the proportion of patients aged >90 years increased from 4.2% in 2015 to 8.6% in 2023. Rural patients accounted for 68.9%, while the proportion of urban residents significantly increased (χ²=24.28, P=0.004). Coastal patients outnumbered mountainous area patients, but no significant difference in annual changes was observed (χ²=25.59, P>0.05). Winter was the peak incidence season (27.4%), with statistically significant differences in seasonal distribution among elderly patients (χ²=29.789, P=0.01). The surgical rate increased from 81.7% to 91.5% (P<0.001), and the proportion of joint replacement rose from 32.2% to 47.1% (χ²=68.13, P<0.001). The average length of hospital stay shortened from a maximum of 17 days to 11 days (H=371.22, P<0.001), and the median postoperative hospital stay decreased from 9 days to 7 days (H=908.54, P<0.001).

Hip fractures in the Mindong region grew rapidly, characterized by female predominance, high incidence in the elderly, and seasonal variation. This highlights the need to strengthen seasonal fall prevention, optimize perioperative management, and standardize anti-osteoporosis treatment.

To investigate the current status of social support, positive coping, psychological resilience and caregiver burden among older caregivers of elderly patients after hip fracture surgery and to analysis latent profiles of caregiver burden.

A convenience sampling method was used to select 234 older caregivers of elderly patients who underwent hip fracture surgery and admitted to the Orthopedics Center of Foshan Hospital of Traditional Chinese Medicine from February to October 2025. Inclusion criteria: age≥60 years old, family caregivers of elderly patients who spent the longest time providing care and undertook the primary caregiving responsibilities during hospitalization (care duration≥four hours per day), able to communicate effectively and understand the questionnaire. Exclusion criteria: presence of severe illness or impaired consciousness, having experienced a major stressful event within the past six months, having an employment relationship with the patient or receiving remuneration, currently participating in other studies. The investigation was conducted using a general information questionnaire, the social support appraisals scale, the simplified coping style questionnaire, the Conner-davidson resilience scale and the Zarit caregiver burden scale. Pearson correlation analysis were used to verify the correlations; a mediation model was used to examine the mediating effects of positive coping and psychological resilience on the relationship between social support and caregiver burden among older caregivers of elderly patients after hip fracture surgery. Latent profile analysis was used to investigate the heterogeneity in caregiver burden.

Among older caregivers of elderly patients after hip fracture surgery, positive coping (β=-0.115, P<0.001) and psychological resilience (β=-0.058, P<0.001) of older caregivers demonstrated significant individual mediating effects between social support and caregiver burden; positive coping and psychological resilience also showed a significant chain mediating effect between social support and caregiver burden (β=-0.074, P<0.001). The latent profile analysis of the caregiver burden could be divided into four groups: severe caregiver burden group (11.1%), moderate caregiver burden group (33.3%), moderate personal burden-mild responsibility burden group (30.3%), and mild caregiver burden group (25.2%).

The positive coping and psychological resilience among older caregivers of elderly patients after hip fracture surgery act as a chain-mediating factor between social support and caregiver burden, and their caregiver burden is heterogeneous. Medical staff can develop tailored training programs on age-friendly care based on the latent profile analysis of the caregiver burden and the relationships between various variables, in order to alleviate the challenges of aged care.

To investigate the clinical application of a deep-learning model based on six-degree-of-freedom (6DOF) lower-limb gait kinematics for bedside prediction of fall risk in hospitalized older adults.

This cross-sectional study enrolled 207 hospitalized older adults (65 to 93 years) from the orthopedic wards of Guangdong Provincial People’s Hospital. Inclusion criteria: age≥60 years, clear consciousness, and the ability to walk independently for at least 10 m. Patients unable to complete gait testing due to severe trauma or acute complications were excluded. Lower-limb 6DOF gait kinematic data were collected using a motion-capture system. According to the Morse fall scale (MFS), participants were categorized into low-, medium-, and high-risk groups. Gait time-series data were transformed into two-dimensional gait maps and analyzed using an attention-enhanced one-dimensional convolutional neural network (1D-CNN). Model performance was evaluated using accuracy, precision, recall, and F1 score, and further assessed with receiver operating characteristic (ROC) curves and confusion matrix analysis.

A total of 207 participants were included, comprising 59 high-risk, 72 medium-risk, and 76 low-risk individuals. On the independent test set (n=41), the model achieved an accuracy of 0.878, precision of 0.874, recall of 0.897, and an F1 score of 0.882. The recall for the high-risk group reached 1.000, indicating no missed high-risk fallers. ROC analysis demonstrated good discriminative ability across different risk levels.

The attention-enhanced 1D-CNN model based on 6DOF gait kinematics can effectively stratify fall risk in hospitalized older adults with high predictive performance and clinical interpretability. This approach provides an objective bedside tool for fall-risk screening in hospital settings.

To observe the clinical effect of Taohong Siwu decoction in the treatment of knee osteoarthritis, and explore its mechanism bysystems pharmacology.

A total of 60 patients with knee osteoarthritis admitted to Foshan Jianxiang Bone Injury Hospital from July 2023 to July 2024 were randomly enrolled, excluding those with poor compliance or comorbid severe cardiovascular and cerebrovascular diseases, rheumatic diseases, etc. They were randomly divided into treatment group and control group with 30 cases in each group. The treatment group was given Taohong Siwu decoction combined with extracorporeal shock wave therapy, while the control group was given oral celecoxib combined with extracorporeal shock wave therapy. Visual analogue scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) of knee joint were followed up after one and two months of treatment. T test was employed to compare the therapeutic efficacy between the two groups. Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) was used to search and screen the active components and target of Taohong Siwu decoction. GeneCards and Online Mendelian Inheritance in Man (OMIM) Database were used to screen the targets of knee osteoarthritis disease. The intersection of the active component target of Taohong Siwu decoction and the target of knee osteoarthritis disease was selected by R software, and Venn diagram was drawn. The visualization network diagram of traditional Chinese medicine active ingredient-disease target was obtained by using the software of Cytoscape. Protein-protein interaction (PPI) of active ingredient disease target protein interaction was obtained through online string platform. Finally, gene ontology (Go) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were carried out, and then the obtained main active components were molecular docking with the core target protein, and the docking results were further visualized.

After one and two months of treatment, VAS score and WOMAC score of the two groups were lower than those before treatment, the differences were statistically significant (t=-3.24, -1.87, -5.69, -1.56, all P<0.05); compared with the control group, the VAS score and WOMAC score of the treatment group decreased more significantly after treatment, and the differences were statistically significant (t=-5.21, -6.41, -3.01, -3.69, all P<0.05). Forty compounds were screened from Taohong Siwu decoction, which could act on 120 therapeutic targets, such as serine/threonine kinase 1 (AKT1), Jun proto-oncogene (JUN), mitogen-activated protein kinase1 (MAPK1), and participate in the regulation of tumor necrosis factor, interleukin-17 and other signal pathways.

Taohong Siwu decoction can effectively relieve the symptoms of knee osteoarthritis, which may be related to the characteristics of multi-target and multi-channel regulation.

To establish a mechanical friction model between human skin and surgical drapes, verify the mechanical feasibility of the perineal-post-free traction technique in the Trendelenburg position, clarify its adaptability to patients with different body weights and analyze the safe angles, so as to provide a mechanical basis for clinical application.

(1) In vitro experiment: fresh porcine skin was used to simulate human skin. A friction coefficient tester was employed to measure the friction coefficient between porcine skin and surgical drapes under pressures of 40 mmHg and 80 mmHg, with five porcine skin specimens per group and three repeated measurements for each specimen. (2) In vivo experiment: 30 patients scheduled for hip arthroscopy using the perineal-post-free traction technique who voluntarily signed informed consent forms and met the inclusion were enrolled. The patients with history of previous hip surgery were excluded. The actual traction force and Trendelenburg angle at 10 mm of hip joint distraction were measured, the friction coefficient between skin and surgical drapes was calculated, and the consistency between in vitro and in vivo data was compared. (3) Group analysis: Patients were divided into a low-weight group (<60 kg), a medium-weight group (60–79 kg), and a high-weight group (≥80 kg). The trends of friction coefficient and angle in each group were analyzed. Statistical analysis was performed using SPSS 26.0 software. One-way analysis of variance or independent-samples t test was used for intergroup comparisons, and P<0.05 was considered statistically significant.

(1) In vitro experiment: The mean friction coefficients between porcine skin and surgical drapes under 40 mmHg and 80 mmHg were 0.371 and 0.433, respectively. The friction coefficient was positively correlated with increasing pressure (t=-3.1165, P=0.0143). (2) In vivo experiment: Thirty patients were included, consisting of 23 males and seven females. Age were from 16 to 66 years, (35±13) years on average; body weight were from 48 to 100 kg, (72±13) kg on average . The traction force ranged from 44.30 to 87.70 kg, (59.4±11.3) kg on average, the Trendelenburg angle ranged from 5.3° to 14.3°, ( 9.9±2.8)°on average, and the friction coefficient ranged from 0.43 to 1.18, 0.70±0.22 on average. (3) The applicable Trendelenburg angles for patients with low, medium, and high body weights using the perineal-post-free traction technique are 10°, 13°, and 15°, respectively.

At a Trendelenburg angle of 10° to 15°, the frictional force between skin and surgical drapes can counteract the lower-extremity traction force and ensure safe distraction of the hip joint space. For patients of different body weights, the minimum safe angle should be used to reduce complications, and a smaller body weight requires a larger angle. The findings provide important references for positioning in related orthopedic surgeries.

Non-traumatic osteonecrosis of the femoral head (NT-ONFH) is a common hip joint disease with a complex pathogenesis closely related to lipid metabolism disorders, oxidative stress, and alcohol toxicity. Acetaldehyde dehydrogenase 2 (ALDH2), a key enzyme in alcohol metabolism in humans, can lead to the accumulation of acetaldehyde or other aldehydes in the body due to reduced enzyme activity caused by gene mutations, which may further promote the occurrence and development of NT-ONFH. Studies have confirmed a significant association between ALDH2 gene polymorphisms and the onset of NT-ONFH. Individuals carrying mutant alleles (e.g., ALDH2*2) exhibit reduced alcohol metabolism capacity, making them more susceptible to microcirculatory dysfunction in the femoral head, osteoblast apoptosis, and abnormal differentiation of bone marrow mesenchymal stem cells, which accelerates the progression of osteonecrosis. This article systematically summarized the current research status on the impact of ALDH2 and its gene mutations on NT-ONFH, elucidated the underlying mechanisms at the cellular and animal experimental levels, and summarized factors related to disease progression as well as potential drugs and therapeutic targets identified in recent studies. Additionally, it analyzed the limitations and shortcomings of existing research and prospects future research directions, aiming to provide a theoretical basis for further revealing the pathogenesis of NT-ONFH and developing novel therapeutic strategies.

Robot-assisted technology has developed rapidly in modern medicine in recent years, demonstrating significant clinical value particularly in the diagnosis and treatment of complex conditions such as developmental dysplasia of the hip (DDH). Existing research indicates that when applied to various hip surgeries, this technology can enhance the accuracy of preoperative planning and, to some extent, reduce the risk of complications. In the treatment of DDH, the primary advantages of robot-assisted technology include precise localization of the surgical site, optimization of prosthesis placement, improved postoperative hip range of motion, reduction of lower limb length discrepancy, lower revision rates, promotion of postoperative rehabilitation, and maintenance of stable long-term outcomes. At the same time, as this technology becomes more widely adopted, the issues it raises regarding patient privacy protection, liability determination, and social ethics cannot be overlooked, and relevant laws and regulations still require further refinement. This article reviewed research progress in robot-assisted treatment for DDH, summarized its clinical advantages, analyzed current technical challenges as well as legal and ethical issues, and outlined future development directions. It aimed to provide guidance for overcoming key technical bottlenecks, enhancing clinical application standards, and expanding related research, thereby offering patients more precise and efficient treatment options.

The meniscal posterior root maintains knee stability. When torn, the circular structure of the meniscus is disrupted, with function similar to total meniscectomy, can induce osteoarthritis (OA). Therefore, early diagnosis and treatment of meniscal posterior root tear are crucial. Currently, the repair techniques for medial meniscus posterior root tear (MMPRT) are progressively transitioning from traditional transtibial pull-out repair toward reversed suture anchor technique. Combining these with biological augmentation agents such as platelet-rich plasma (PRP) may improve clinical outcomes. This review aimed to enhance clinicians’ understanding of the early diagnosis and treatment of posterior meniscus root tears by discussing the anatomy and biomechanics of the posterior root, injury mechanisms, clinical manifestations, imaging characteristics, and treatment options. By doing so, it sought to promote timely and appropriate treatment strategies to preserve articular cartilage function to the greatest extent and improve patients’ long-term quality of life.

To explore the practical value of integrating the dynamic indicator limits derived from national clinical laboratory quality specifications with Six Sigma in driving the continuous improvement of quality indicators across the total testing process in medical laboratories.

Data of 15 quality indicators from the clinical laboratory of a tertiary hospital between 2023 and 2025 were analyzed. Using the 2023 national quality specifications as the baseline and the 2025 specifications as the evaluation standard, 8 quality indicators requiring improvement were included. Based on the root causes of errors, they were divided into process-dependent (n=5) and operation-dependent (n=3) indicators. A dynamic benchmarking management strategy was adopted to implement a stepwise PDCA cycle of "benchmarking, reaching the standard, and setting a new standard," and the improvement effects during 2023 to 2025 were evaluated.

By 2025, the process-dependent indicators improved significantly: Error rates for specimen type, container, and collection volume decreased substantially, with corresponding σ values increasing to 5.4σ (P＜0.01)、5.3σ (P＜0.001)、5.3σ (P＜0.01), respectively. The σ value for the IQC CV failure rate rose to 6.0σ (P＜0.001), and the σ value for the incorrect laboratory report rate increased to 5.3σ (P＜0.001). Among the operation-dependent indicators, the σ values for the blood culture contamination rate and specimen hemolysis rate improved to 4.6σ (P＜0.001) and 4.7σ (P＜0.05), respectively, while the improvement in the anticoagulated specimen coagulation rate was not statistically significant.

The dynamic benchmarking management strategy combined with Six Sigma metrics, through stepwise goal setting and focusing on indicators requiring improvement, can significantly enhance the quality level of the total testing process, with the intervention effect on process-dependent indicators.