Zhongguo gu shang = China journal of orthopaedics and traumatology最新文献

{"title":"[Heterogeneous population characteristics of short-term changes in severe osteoporosis].","authors":"Mengjie Wu, Xinghua Xiang, Wei Yang, Jiaxu Han, Yaxin Tian, Dezhi Tang, Xuetong Bai","doi":"10.12200/j.issn.1003-0034.20260367","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20260367","url":null,"abstract":"<p><strong>Objective: </strong>To explore heterogeneous population characteristics of short-term symptom scores and bone mineral (BMD) density changes in patients with severe osteoporosis (OP), in order to provide a basis for early identification of patient differences and design of subsequent research based on real-world clinical data.</p><p><strong>Methods: </strong>Observational data of 257 patients with severe OP who met inclusion criteria from March 2020 to October 2021 were included. At the 3-month follow-up point, the symptom score changes and BMD changes were used to define \"significant change\" and \"non-significant change\" classification labels respectively. XGBoost(eXtreme Gradient Boosting) algorithm was employed to construct a change classification model. Combined with SHAP(Shapley Additive exPlanations) interpretation algorithm and rule extraction technology, feature analysis was conducted on the two types of short-term change heterogeneous populations.</p><p><strong>Results: </strong>Based on the change classification model, a total of 17 decision rules were extracted. The rules for changes in short-term symptom scores and BMD were mainly composed of compound conditions, clearly presented the characteristics of \"significant change\" group under the interaction of multiple baseline factors. ① Rules for symptom score changes. The composite interaction characteristics of the combined features of blood pressure parameters (systolic blood pressure≤124.5 to 149.5 mmHg, diastolic blood pressure>78 mmHg) with the symptom items such as \"weakness in waist and knees\" ≤ 3.5 points, \"difficulty in bearing weight\"≤3.5 points, \"leg cramps\">2.5 points, and \"back pain\">3.5 points were highlighted. These characteristics were also influenced by factors such as age, body mass index (BMI), and baseline BMD. ② Rules for BMD changes. The core of this rule was the interaction window between age (55.5 to 63.5 years old) and specific intervals of baseline BMD T/Z values (T value≤-2.85 or -3.15<Z value≤-1.85), covering the high pulse pressure difference pattern where systolic blood pressure was>126.5 mmHg and diastolic blood pressure was≤69.5 mmHg. Both types of rules involved the interaction of multiple factors such as age, disease duration, and baseline BMD levels.</p><p><strong>Conclusion: </strong>The short-term variability in severe OP patients has identifiable composite characteristics. The changes in symptom scores serve as an effective indicator reflecting the overall recovery status of body and functions of muscles and bones in the early stage. Although the changes in BMD are relatively less, when combined with age, bone mass baseline, and blood pressure patterns, they could provide early clues for individualized monitoring and intervention adjustments. These characteristics make up for the early differences which are easily overlooked in long-term evaluations, providing a highly differentiated and refined reference for clinical decision-making.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 9","pages":"910-7"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application of osteoclast-inhibitory strategy based on RANKL/OPG signaling pathway in hip-preserving treatment of osteonecrosis of the femoral head].","authors":"Guoyuan Sun, Handong Chen, Jiaxiang Gao, Yake Wang, Fengrui Liu, Yaxing Duan, Weiguo Wang, Qidong Zhang","doi":"10.12200/j.issn.1003-0034.20260007","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20260007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore application effect of osteoclast inhibition based on nuclear factor-κB receptor activator ligand(RANKL)/osteoprotegerin(OPG) signaling pathway in hip preservation treatment of femoral the head necrosis (ONFH), and to compare therapeutic efficacy differences between osteoclast inhibition combined with core decompression and simple core decompression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixty-four patients with Association Research Circulation Osseous(ARCO) stageⅠ-Ⅱ ONFH who underwent unilateral core decompression treatment from January 2021 to June 2024 were selected, and were divided into experimental group and control group based on intervention method and propensity score matching method. There were 32 patients in experimental group, including 21 males and 11 females;aged from 26 to 61 years old with an average of (48.9±6.8) years old;body mass index(BMI) ranged from 18.5 to 30.7 kg·m&lt;sup&gt;-2&lt;/sup&gt; with an average of (23.0±4.1) kg·m&lt;sup&gt;-2&lt;/sup&gt;;10 patients were hormone-related and 22 patients were alcohol-related;3 patients were stageⅠand 29 patients were stageⅡaccording to ARCO grading;core decompression combined with osteoclast inhibition were performed. There were 32 patients in control group, including 21 males and 11 females;aged from 27 to 61 years old with an average of (49.2±6.4) years old;BMI ranged from 18.2 to 30.5 kg·m&lt;sup&gt;-2&lt;/sup&gt; with an average of (22.5±4.3) kg·m&lt;sup&gt;-2&lt;/sup&gt;;10 patients were hormonal origin and 22 patients were alcoholic origin;3 patients were stageⅠand 29 patients were stageⅡaccording to ARCO grading;core decompression treatment was performed. At 12 months after operation, visual analogue scale (VAS), Harris hip score, classification of bone marrow edema (edema, E0-E3), and fibrosis stage (fibrosis, F0-F2) , the levels of serum RANKL and OPG, as well as RANKL/OPG ratio between two groups were compared;and the incidence of adverse reactions between two groups were compared.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both of groups were followed up, and follow-up period for experimental group for 12 to 14 months with an average of (12.9±0.9) months, and for control group for 12 to 14 months with an average of (12.7±0.7) months, there was no statistically significant difference between two groups (&lt;i&gt;P&lt;/i&gt;&lt;0.05). At 12 months after operation, serum RANKL level and RANKL/OPG ratio in experimental group were(570.8±125.6) pg·mL&lt;sup&gt;-1&lt;/sup&gt; and(1.83±0.51) respectively, which were lower than those in control group [(681.5±82.1) pg·mL&lt;sup&gt;-1&lt;/sup&gt; and (2.21±0.49)], and the differences were statistically significant (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The scores for bone marrow edema and fibrosis in experimental group were both lower than those before operation, and were even lower than those in control group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). VAS and Harris scores of experimental group were (2.13±0.82) and (85.8±9.80), which were better than those of control group (2.83±1.13) and (79.2±9.10), and the differences were statistical","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 9","pages":"862-9"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Construction and validation of Cox proportional hazards model for the risk of hip failure after hip-preserving treatment for osteonecrosis of the femoral head].","authors":"Yongqi Xia, Shaoyi Guo, Wang Deng, Yunfeng Zhang, Mingxue Chen, Yixin Zhou, Dejin Yang","doi":"10.12200/j.issn.1003-0034.20250866","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250866","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore risk factors influencing the failure of hip preservation surgery for osteonecrosis of the femoral head (ONFH), construct and validate Cox proportional hazards model for predicting the risk of postoperative failure, and present it visually as a nomogram.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 156 patients (34 patients with bilateral lesions, 190 hips) who underwent modified core decompression surgery or multi-hole titanium cage implantation for ONFH from August 2017 to December 2023. Baseline data and follow-up information of patients were compared:(1) Demographic data, included gender, age, body mass index(BMI), and causes of ONFH. (2) Clinical scoring, modified Harris hip score (mHHS) and visual analogue scale (VAS) for pain were evaluated.(3) Imaging indicators, included ARCO staging, JIC classification, modified Kerboul angle, lateral center-edge angle (LCEA), femoral neck-shaft angle(NSA), and α angle. (4) Laboratory tests, included platelets(PT), total cholesterol(TC), triglycerides(TG), low-density lipoprotein (LDL), high-density lipoprotein(HDL), apolipoprotein-A1(Apo-A1), apolipoprotein-B(Apo-B), prothrombin time(PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and D-dimer(D-d). (5) Surgical and postoperative data, inculded surgical method, postoperative time limit for weight-bearing restriction, use of calcium supplements/anti-osteoporosis drugs after surgery, and exposure to postoperative risk factors. The imaging endpoint was defined as postoperative radiological collapse of femoral head (progressing to stage 3B or higher according to ARCO classification), and clinical endpoint was defined as undergoing total hip arthroplasty (THA). Correlations between all above variables and two types of postoperative failure outcomes were examined and analyzed by Univariate Cox regression analysis, variables with &lt;i&gt;P&lt;/i&gt;&lt;0.1 were included in backward stepwise regression multivariate model to screen out independent risk factors and construct a nomogram. The discrimination of model was evaluated by area under the curve(AUC) of time-dependent receiver operator characteristic(ROC) curve and C-index. The accuracy was assessed by drawing calibration curve. The clinical practicability was evaluated by decision curve analysis(DCA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All 190 hips were followed up for a period of 33.00 (21.00, 51.00) months. There were 67 hips (35.26%) with imaging failure and 32 hips (16.84%) with clinical failure. The results of univariate Cox regression analysis showed 9 variables associated with imaging failure were BMI, preoperative LDL, whether AVN CAGE was implanted, preoperative ARCO stage, JIC classification, modified Kerboul angle, PT, FIB, and postoperative restricted weight-bearing time(&lt;i&gt;P&lt;/i&gt;&lt;0.1);preoperative JIC classification, APTT, and FIB variables were related to clinical failure (&lt;i&gt;P&lt;/i&gt;&lt;0.1). The results of multivariate analy","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 9","pages":"870-9"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of clinical efficacy of absorbable rods combined with hollow compression screws in the treatment of comminuted fractures of talar body].","authors":"Liangzhi Gong, Jieyuan Zhang, Mingjie Tang, Lei Wang, Xin Ma, Zhongmin Shi","doi":"10.12200/j.issn.1003-0034.20250974","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250974","url":null,"abstract":"<p><strong>Objective: </strong>To explore clinical efficacy of absorbable rods combined with hollow compression screws in treating comminuted fractures of talar body.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on clinical data of 13 patients with comminuted talar body fractures who received absorbable rod-assisted hollow compression screw treatment from July 2023 to January 2025. There were 11 males and 2 females;aged from 27 to 64 years old;7 patients caused by falling down, 4 patients caused by traffic accidents, and 2 patients caused by heavy objects;the time from injury to medical consulatation was 1 to 6 hours;8 patients involved fractures of the posterior tubercle of the talar body, 4 patients involved fractures of the lateral tubercle of the talar body, and 1 patient involved both lateral tubercle and posterior tubercle of talar body. The time of fracture healing and occurrence of complications were recorded. Clinical efficacy were evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Hawkins ankle joint function score, and visual analogue scale(VAS) for pain.</p><p><strong>Results: </strong>All 13 patients were performed successfully without intraoperative complications. Postoperative follow-up was completed for all patients, with a median duration of 18 months(ranged from 6 to 28 months). Primary wound healing was achieved in all patients, and no postoperative complications, such as surgical site infection or delayed wound healing occurred. AOFAS ankle-hindfoot score increased from 44 to 63 and 55 to 76 at 3 and 6 months postoperatively, respectively, to 62 to 95 at the latest follow-up. At the latest follow-up, according to AOFAS ankle-hindfoot score, 4 patients were excellent, 6 patients were good, and 3 patients were fair. VAS was decreased from 6 to 8 before operation, 5 to 6 at 3 months, and 2 to 4 at 6 months after operation, and 1 to 2 points at the latest follow-up. At the latest follow-up, Hawkins ankle function score ranged from 7 to 14 points, with 4 patients got excellent result, 5 patients good, and 4 patients fair. There were 2 patients with traumatic arthritis and 1 patient with mild numbness in the sole of foot.</p><p><strong>Conclusion: </strong>The concurrent application of absorbable rods and hollow compression screws in the surgical management of comminuted talar body fractures has demonstrated favorable short-and medium-term clinical outcomes. This technique facilitates fracture union, enhances functional recovery, and is associated with a low complication rate. These findings support its consideration as a viable surgical option for this challenging injury.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 9","pages":"895-902"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case report of talus bone erosion caused by asymptomatic hyperuricemia].","authors":"Huina Zhuang, Juan Li","doi":"10.12200/j.issn.1003-0034.20250744","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250744","url":null,"abstract":"","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 9","pages":"941-2"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of tranexamic acid on blood loss control in patients undergoing primary total knee arthroplasty].","authors":"Shuai Yu, Di Jia, Jiawei Liu, Ya Ding, Bin Zhu, Gong Cheng, Hongliang Wang, Guangfeng Sun","doi":"10.12200/j.issn.1003-0034.20250125","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250125","url":null,"abstract":"<p><p>Total knee arthroplasty (TKA) is an important surgical method for treating advanced knee osteoarthritis(KOA). It could effectively restore knee joint function and relieve pain. However, perioperative blood loss may cause postoperative anemia, increase the demand for blood transfusion, and thereby affect the prognosis of patients and increase medical burden. Tranexamic acid (TXA), as an anti-fibrinolytic agent, plays a significant role in controlling blood loss during perioperative period of TKA. TXA mainly works by competitively inhibiting the binding of plasminogen to fibrin, thereby preventing fibrin degradation. This reduces the amount of blood loss during and after operation, lowers blood transfusion rate, and does not affect patient's coagulation function. Studies have confirmed that TXA could significantly reduce blood loss during perioperative period of TKA. Whether administered systemically, topically, or in combination, it could effectively decrease total blood loss and the rate of blood transfusion, without increasing the risk of adverse events such as thromboembolism, and has good safety. However, the administration route and dosage of TXA have significant impacts on therapeutic effect. At present, the optimal regimen still needs to be explored. Routes such as intravenous administration and intra-articular administration each have their own characteristics, and the dosage selection should take into account factors such as the patient's weight and surgical conditions. Currently, the research focus on the safety of TXA in high-risk patients (such as those with a history of thrombosis), the optimization of individualized dosing strategies, and its combined application with other hemostasis techniques. In general, TXA is an effective auxiliary measure for blood management during the perioperative period of TKA, which can improve patient prognosis and save medical costs. However, its long-term effects and applicability in specific populations still require more high-quality research to verify.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 9","pages":"954-8"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Imaging study on the safety of freehand lumbar pedicle screw placement based on the cat's eye segmentation of X-ray films].","authors":"Jintao Xi, Rui Peng, Xiaozhen Wang, Xiongwei Wang, Yang Wang, Yiliang Zhu, Qilin Lu","doi":"10.12200/j.issn.1003-0034.20250735","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250735","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the safety of manual lumbar pedicle screw placement based on the position of the cat's eye (pedicle projection) on X-ray films.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 150 patients with lumbar spine disorders from December 2022 to June 2024 were enrolled and classified into three types according to the cat's eye position on AP X-rays:type A (the lateral edge of the cat's eye extends beyond the lateral edge of the vertebral body); type B (the lateral edge of the cat's eye largely coincides with the lateral edge of the vertebral body);and type C (the lateral shadow of the pedicle is located at the medial edge of the pedicle). Patients were divided into two groups:the imaging-guided simulation group (90 patients, 30 each in types A, B, and C) and the imaging review group (60 patients, 20 each in types A, B, and C). All patients underwent screw insertion at the intersection of the inferior third of the transverse process and the lateral edge of the articular process. In the imaging-guided simulation group, the lumbar spine was divided into three regions from medial to lateral on AP X-rays;the screw direction was adjusted so that the tip of the screw tract corresponded to these three regions on the virtual projection, and CT analysis was performed to evaluate accuracy and determine whether the medial wall of the pedicle or the lateral edge of the vertebral body was penetrated. The imaging review group included 60 patients with lumbar pedicle screw placements;their AP and lateral X-ray images as well as postoperative CT data were analyzed to quantify the number of screws at corresponding positions and assess effectiveness via postoperative CT evaluation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the imaging-guided simulation study, the rate of successful screw placement in zone 3 for type A patients was 96.67% (29/30), significantly higher than that in zone 1 50%(15/30) and zone 2 86.67%(26/30), with a statistically significant difference(&lt;i&gt;P&lt;/i&gt;&lt;0.05);In type B cat's eyes, the placement rates of screws in zone 1 and zone 2 were 90.00% (27/30) and 93.33% (28/30), respectively, significantly higher than those in zone 3 70% (21/30), with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05);In type C cat's eyes, the placement rate in zone 1 was 90.00% (27/30), superior to that in zone 2 63.33%(19/30) and zone 3 40%(12/30), also showing a statistically significant difference(&lt;i&gt;P&lt;/i&gt;&lt;0.05). Imaging analysis revealed that among patients with type A cats eyes, screw placements were in zone 1(3 cases), zone 2 (10 cases), and zone 3 (7 cases);the placement rates in zones 2 and 3 were 90% (9/10) and 100% (7/7), respectively, significantly higher than that in zone 1 33.3%(1/3), with a statistically significant difference (&lt;i&gt;P&lt;/i&gt;&lt;0.05). For patients with type B cat's eyes, the placement rates in zones 1 and 2 were both 100% (5/5) and 100% (12/12), significantly higher than that in zone 3 33.3%(1/3), with a statistica","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"770-7"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on the role of exosomal miRNA in spinal cord injury and intervention by traditional Chinese medicine].","authors":"Yanjun Zhang, Long Yang, Tiefeng Guo, Yandong Liu, Pingyi Ma, Linzhao Luo, Xinfeng Liu","doi":"10.12200/j.issn.1003-0034.20250308","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20250308","url":null,"abstract":"<p><p>Spinal cord injury (SCI) remains a significant challenge in modern medicine due to its complex pathophysiological mechanisms, the irreversibility of damage, and limited treatment options. Recent studies have shown that microRNAs (miRNAs) transported by exosomes play a crucial role in the occurrence, progression, and outcomes of SCI. This article systematically reviews the functional mechanisms of exosomal miRNAs in SCI, with a particular focus on elucidating the unique advantages and molecular mechanisms by which Traditional Chinese Medicine (TCM) intervenes in SCI through an integrated \"multi-component, multi-target, multi-pathway\" approach that modulates miRNA networks. The content encompasses the biogenesis of exosomal miRNAs and their regulatory roles in various pathological processes post-SCI, including the inflammatory microenvironment, axonal regeneration, cell apoptosis, and vascular injury. It provides a detailed summary of how active TCM components and compound formulas target specific miRNAs to regulate corresponding signaling pathways, thereby exerting synergistic and integrated effects across multiple aspects such as inhibiting inflammatory responses, reducing apoptosis, and promoting axonal regeneration and revascularization. Despite some progress in SCI research, numerous challenges persist, including the complexity of regulatory mechanisms, difficulties in clinical translation, and shortcomings in delivery technologies. Building on this, the article points out future directions for the integrated treatment of SCI combining traditional Chinese and Western medicine, explores the application prospects of nano-drug delivery systems in enhancing the delivery efficiency and therapeutic specificity of TCM, and provides a theoretical basis and conceptual reference for in-depth exploration of miRNA-targeted therapy and the modernization of TCM research. In conclusion, with the continuous advancement of integrated Chinese and Western medicine research, more effective treatment options for SCI patients are anticipated, ultimately improving their quality of life and prognosis.</p>","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"849-56"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of clinical outcomes between robot-assisted and conventional percutaneous pedicle screw fixation for lumbar fractures based on the AO classification].","authors":"Haiping Cai, Wenbin Xu, Chang Ge, Liqun Duan, Xi Chen, Wenzhi Zhang, Xiuwu Guo","doi":"10.12200/j.issn.1003-0034.20251014","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20251014","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the short-term efficacy of robot-assisted percutaneous pedicle screw fixation versus traditional percutaneous pedicle screw fixation in treating lumbar vertebral fractures, and to evaluate the differences in surgical benefits for different types of stable fractures based on AO classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 47 patients with single-segment lumbar vertebral fractures admitted between January 2023 and December 2024. Patients were classified by AO type as stable fractures (A1/A2:22 cases) or unstable fractures (A3/B1-B2:25 cases);by surgical approach as robot-assisted percutaneous group (robot group) or conventional percutaneous group (traditional group). Among stable fractures, the robot group comprised 10 cases and the conventional group 12 cases;among unstable fractures, the robot group included 11 cases and the conventional group 14 cases. Perioperative parameters (operational time, intraoperative blood loss, postoperative hospitalization duration), visual analogue scale(VAS), Oswestry disability index(ODI), and anterior vertebral height(AVH) were compared between the two groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All patients were followed up for 12 months. In stable fractures, the robot group exhibited significantly lower intraoperative blood loss (23.50±7.47) mL compared to the conventional group (32.50±9.65) mL (&lt;i&gt;P&lt;/i&gt;=0.026), whereas no statistically significant differences were observed in operative time, postoperative hospitalization duration, VAS, ODI, and AVH scores at different time points before and after surgery between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). In unstable fractures, the robot group demonstrated superior surgical duration (64.09±11.36) min, intraoperative blood loss (27.73±12.92) mL, and postoperative hospitalization time (5.91±1.45) days compared to the conventional group (77.86±18.78) min, (46.79±20.34) mL, and (7.64±2.02) days, respectively, with all differences being statistically significant (&lt;i&gt;P&lt;/i&gt;&lt;0.05). On day 1 postoperatively, the VAS in the robotic group was (2.27±0.79) scores, significantly lower than that of the conventional group (3.43±0.94) scores (&lt;i&gt;P&lt;/i&gt;=0.003), although no statistically significant difference was observed between the two groups at the 12 month after surgery (&lt;i&gt;P&lt;/i&gt;=0.159). The ODI at day 1 and 12 months postoperatively were (26.55±6.56) and (8.27±2.10) respectively in the robot group, both significantly better than those of the conventional group (41.64±12.11) and (13.57±4.03), respectively (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The AVH measurements at day 1 and 12 months postoperatively were (2.41±0.56) cm and (2.22±0.55) cm in the robot group, significantly higher than those of the conventional group (2.02±0.31) cm and (1.87±0.30) cm, respectively(&lt;i&gt;P&lt;/i&gt;&lt;0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;For unstable lumbar fractures(A3/B1-B2), robot-assisted percutaneous pedicle screw fixation provides superior ","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"762-9"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current clinical application status and decision making of internal fixation for lumbar spine].","authors":"Liang Yu, Liujun Zhao","doi":"10.12200/j.issn.1003-0034.20260714","DOIUrl":"https://doi.org/10.12200/j.issn.1003-0034.20260714","url":null,"abstract":"","PeriodicalId":23964,"journal":{"name":"Zhongguo gu shang = China journal of orthopaedics and traumatology","volume":"39 8","pages":"757-61"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}