Chinese Journal of Traumatology最新文献

{"title":"Scrotal reconstruction using anterolateral thigh flap in a pediatric patient: A case report.","authors":"Shi Gao, Haiqiong Chen, Guoqiang Zhao","doi":"10.1016/j.cjtee.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.05.002","url":null,"abstract":"<p><p>Avulsion injury of genitalia is rare, particularly in pediatric patients. The reconstruction of necrotic scrotal tissue presents a significant challenge. This case report describes a pediatric patient who experienced complete avulsion of the left inguinal, scrotal, and penile regions, accompanied by multiple pelvic fractures, and the scrotal tissue subsequently became necrotic. We performed scrotal reconstruction using a pedicled anterolateral thigh flap and fixed both testes. Postoperatively, the scrotum had a satisfactory appearance, with no significant reduction in testicular size compared to age-matched peers, indicating a successful repair.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prehospital care: Lessons learned from 311 mortalities at level I trauma center.","authors":"Parvez Mohi Ud Din Dar, Supreet Kaur, Anand Kumar Katiyar, Pratyusha Priyadarshani, Subodh Kumar, Amit Gupta, Sushma Sagar","doi":"10.1016/j.cjtee.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.02.011","url":null,"abstract":"<p><strong>Purpose: </strong>Trauma, a leading cause of disability and death globally, underscores the critical importance of timely medical intervention, particularly within the \"golden hour\" following trauma. Yet, in low-middle-income countries, the absence or fledgling state of emergency medical systems (EMS) exacerbates mortality rates. This study aims to retrospectively analyze mortalities at a level 1 trauma center in India, comparing patients who received prehospital care with those who did not.</p><p><strong>Methods: </strong>Conducted at a level 1 trauma center in India from April 2019 to April 2020, this retrospective observational study included trauma patients who died during hospitalization. Exclusions comprised (1) patients deceased upon arrival, (2) patients receiving cardiopulmonary resuscitation, and (3) non-trauma deaths. Demographics, clinical profiles, causes of death, and transportation methods were scrutinized. Data encompassed patient transport details, clinical assessments, interventions, length of stay, and causes of death. Statistical analysis was performed using SPSS 14, with statistical significance set at p < 0.05.</p><p><strong>Results: </strong>Among 55,277 trauma patients, 311 mortalities were recorded. Most were male (n=267, 83.9%), aged 21-40 years (n=133, 42.8%), with blunt trauma being the predominant cause (97.4%). The majority of patients had road traffic injuries (n=180, 57.9%) and falls (n=95, 30.5%). Threatened airway (n=144, 46.3%), tachycardia (n=159, 51.2%), and hypotension (n=74, 23.8%) were common on patients' arrival. Traumatic brain injuries (70.4%) prevailed. Private vehicles transported 46.6% of patients, while only 7.0% arrived within the golden hour. Although patients who received prehospital care experienced delayed hospital arrival, they exhibited higher oxygen saturation and systolic blood pressure.</p><p><strong>Conclusion: </strong>Augmentation of prehospital care and EMS infrastructure in low-resource settings is crucial to mitigating trauma mortality. Although prehospital care delayed hospital arrival, it positively impacted physiological parameters and potentially improved patient outcomes. This study underscores the imperative of timely interventions and comprehensive EMS development to address the global trauma burden effectively.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for the prediction of traumatic intracranial abnormalities in the elderly: Development and validation.","authors":"Apisorn Jongjit, Thara Tunthanathip","doi":"10.1016/j.cjtee.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.03.003","url":null,"abstract":"<p><strong>Purpose: </strong>Traumatic brain injury is a major public health issue and a leading cause of death and disability among the elderly. As a result, traumatic intracerebral abnormalities (tICA) are now frequently diagnosed using cranial computed tomography (cCT), which has led to an overuse of this investigation. The present study aimed to develop and validate the nomogram for predicting tICA in the elderly.</p><p><strong>Methods: </strong>This was a retrospective cohort study. The study population consisted of patients who met the following inclusion criteria: (1) aged ≥60 years, as defined by the World Health Organization; (2) admitted to a tertiary referral hospital between January 2015 and December 2022; and (3) underwent cCT scanning upon admission. Patients were excluded if (1) patients' images were unavailable or (2) patients died in the emergency department before hospitalization. The total data was divided into the development cohort (2015-2019, n=2052) to develop the nomogram and the validation cohort (2020-2022, n=310) to test the predictability as temporal validation. Binary logistic regression was used in the construction of the nomogram.</p><p><strong>Results: </strong>There were 2362 patients in the entire cohort. Positive CT scan rates among the elderly amount to 21.3%. Multivariable analysis identified the following factors significantly associated with traumatic intracranial hematoma in the elderly: use of aspirin (odds ratio (OR)=4.49, 95% confidence interval (CI) 3.08-6.54), warfarin usage (OR=6.88, 95% CI 2.99-15.8), traffic accidents (OR=1.98, 95% CI 1.46-2.68), Glasgow coma scale 9-12 (OR=3.24, 95% CI 1.66-6.35), amnesia (OR=1.65, 95% CI 1.17-2.33), nausea or vomiting (OR=12.5, 95% CI 5.56-28.07), seizure (OR=11.42, 95% CI 3.33-39.22), motor weakness (OR=65.45, 95% CI 18.68-229.29), and bleeding per nose or ear (OR=24.81, 95% CI 10.57-14.58). The predictability of the nomogram demonstrated sensitivity, specificity, and an area under the receiver operating characteristic curve of 0.833, 0.788, and 0.889, respectively.</p><p><strong>Conclusion: </strong>According to the temporal validation, the nomogram had an outstanding performance for tICA prediction in the elderly. In the future, the prediction tool will assist clinicians in making judgments and balancing the rate of cCT in clinical practice.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of optimal screws positions for internal fixation of femoral neck fracture: A simulation study based on femoral neck safe zone.","authors":"Hua Guo, Quanwei Bao, Li Qiao, Yuntong Zhang, Shuogui Xu, Jianghong Wu","doi":"10.1016/j.cjtee.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.07.001","url":null,"abstract":"<p><strong>Purpose: </strong>It is often difficult for surgeons to accurately implant the cannulated screws for fixing femoral neck fractures under C-arm fluoroscopy. Our simulation study attempts to help surgeons identify the optimal positions of screws on anteroposterior and lateral radiographs.</p><p><strong>Methods: </strong>Softwares were used for 3-dimensional reconstruction and cross-sections construction of 60 femoral necks. The contours of all cross-sections along the axis of the femoral neck were stacked to identify a safe zone for screws placement. A simulation experiment was carried out with 3 circles of diameter 6.5 mm in the safe zone. The absolute and relative positions of every screw in the anteroposterior radiographs and lateral radiographs were measured.</p><p><strong>Results: </strong>The morphologies of the safe zones for screws placement were anteriorly flat ellipses. The best dispersion was obtained with the inverted triangle shape in this zone: the inferior was positioned near the lower 1/10 on the anteroposterior view and near the anterior 3/5 on the lateral view. The anterosuperior and posteriosuperior screws were positioned near the upper 1/5 and 1/4, respectively, on the anteroposterior view, and near the anterior 1/10 and posterior 1/5, respectively, on the lateral view.</p><p><strong>Conclusion: </strong>Simulated screws implantation demonstrates the distribution characteristics of screws in anteroposterior and lateral radiographs. This can help decrease the risk of perforation and iatrogenic injury.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Interposition of acellular amniotic membrane at the tendon to bone interface would be better for healing than overlaying above the tendon to bone junction in the repair of rotator cuff injury\" [Chinese J Traumatol 28 (2025) 187-192].","authors":"Jiang-Tao Wang, Chun-Bao Li, Jia-Ting Zhang, Ming-Yang An, Gang Zhao, Yu-Jie Liu","doi":"10.1016/j.cjtee.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.09.001","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The positioning of cephalon medullary nailing correlated with hidden blood loss during the perioperative period in patients with intertrochanteric fractures: A retrospective study.","authors":"Yao Chen, Shaobo Zhang, Ziqi Liu, Jiashan Li","doi":"10.1016/j.cjtee.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.03.002","url":null,"abstract":"<p><strong>Purpose: </strong>Hidden blood loss (HBL) during the perioperative period significantly impacts postoperative recovery and complications, yet it is frequently disregarded. This study aimed to investigate the effects of tip-apex distance (TAD) and calcar-referenced tip-apex distance (calTAD) on HBL in the treatment of intertrochanteric fractures utilizing proximal femoral nail antirotation (PFNA). The study also seeks to evaluate the possible decrease in HBL subsequent to PFNA treatment by optimizing nail positioning.</p><p><strong>Method: </strong>A historical cohort study was conducted from January 2020 to December 2022. Patients diagnosed with unilateral acute closed femoral intertrochanteric fracture and who underwent PFNA internal fixation surgery met the inclusion criteria, and were grouped according to the value of calTAD and TAD. The participants were divided into low TAD group (TAD<20 mm) and high TAD group (TAD≥20 mm); low calTAD group (calTAD<7.625 mm) and high calTAD group (calTAD≥7.625 mm), respectively. The primary outcome measures were intraoperative blood loss (including HBL, overt blood loss, and total blood loss). Continuous data were analyzed using an independent sample t-test or Mann-Whitney U test, and categorical data were analyzed using the Pearson Chi-square test. Univariate analysis was used to evaluate the association between various indicators and perioperative HBL. A stepwise multiple linear regression analysis model was used to determine the independent factors affecting perioperative HBL. A p value less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 131 patients were initially included, of which 80 were assigned to the calTAD group (with 61 in the high calTAD group and 19 in the low calTAD group), and 80 were assigned to the TAD group (with 34 in the high TAD group and 46 in the low TAD group). The average HBL for the low TAD group was 772.85 mL, whereas for the high TAD group it was 919.68 mL (p>0.05). The average HBL for the low calTAD group was 611.42 mL, whereas for the high calTAD group it was 904.97 mL (p<0.05). Subsequent analysis revealed that the patient's height, preoperative hemoglobin levels, changes in hemoglobin and hematocrit levels from pre- to post-surgery, and calTAD are independent risk factors influencing HBL.</p><p><strong>Conclusion: </strong>In summary, our investigation revealed a significant correlation between the positioning of nails in PFNA and HBL during the perioperative period. By optimizing the placement of the cephalic nail, specifically by ensuring a calTAD of less than 7.625 mm, a significant decrease in HBL can be attained. Additionally, we identified that height, preoperative hemoglobin, differences in preoperative and postoperative hemoglobin and hematocrit, and the positioning of the cephalic nail were independent risk factors for HBL.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The observational chart for traumatic limb swelling enhances diagnostic accuracy for osteofascial compartment syndrome.","authors":"Zhi-Wei Yang, Zhao-Di Wang, Jun-Sheng Yang, Liang-Cheng Tong, Lei Zhao, Wei Dai, Kun Pang, Ying Li","doi":"10.1016/j.cjtee.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.08.004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;To evaluate the diagnostic accuracy of the observational chart for traumatic limb swelling (OCTLS) for osteofascial compartment syndrome (OCS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a descriptive-longitudinal study. Data of 316 patients who underwent surgical treatment for tibial fractures in our department from January 2015 to December 2023 were collected. Patients with Gustilo type II or higher open fractures, vascular injury, or bilateral fractures were excluded from the study. Two groups of double-blinded investigators independently assessed patients for the presence of OCS using 2 distinct diagnostic methods. Three senior orthopedic trauma surgeons evaluated patients with post-fracture calf swelling for OCS and the need for fasciotomy based on clinical signs and their extensive clinical experience. Subsequently, fasciotomy was performed according to their judgment, followed by postoperative examination of muscle and soft tissue conditions. Additionally, a follow-up evaluation was conducted to assess for complications such as ischemic muscle contracture. Another 3 trained researchers used OCTLS to grade swelling severity and determine the need for fasciotomy. The final diagnostic gold standard of OCS was determined by referring to whether there was escape of muscles at fasciotomy and/or color change in the muscles or muscle necrosis intraoperatively, and neurological abnormality or contracture at the last follow-up. The results of the 2 diagnostic methods were compared with the final diagnostic result. Kappa consistency test, paired χ&lt;sup&gt;2&lt;/sup&gt; test (McNemar test), and receiver operating characteristic curve were used to evaluate the diagnostic efficacy of the 2 diagnostic methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 316 patients, 211 were finally included in the study, including 160 males and 51 females, with an average follow-up time of (14.5 ± 2.7) months. Among the 211 patients with tibial fracture-associated swelling, 42 were definitively diagnosed with OCS. Based on clinical symptoms and signs judgment, among the 65 fasciotomy patients, 38 were confirmed as correct, while among the 146 non-fasciotomy patients, 4 developed ischemic muscle contractures. Based on the OCTLS for assessment, fasciotomy was correctly recommended in 36 out of 43 cases, while 6 out of 168 non-fasciotomy patients developed OCS. Compared to the use of the gold standard, clinical signs judgment showed moderate consistency (McNemar's test p &lt; 0.001, Kappa = 0.618, p &lt; 0.001), whereas OCTLS demonstrated strong agreement (McNemar's test p = 1.000, Kappa = 0.808, p &lt; 0.001). Receiver operating characteristic analysis revealed higher diagnostic accuracy for OCTLS (area under curve = 0.908, 95% CI: 0.843 - 0.972) compared to clinical signs judgment (area under curve = 0.872, 95% CI: 0.812 - 0.933). OCTLS achieved superior accuracy (93.8% vs. 85.3%, χ&lt;sup&gt;2&lt;/sup&gt; = 8.221, p &lt; 0.001) and a lower fasciotomy rate (20.4% vs. 30.8%, χ&lt;sup&gt;2","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual cutting-based morphological differences in osteoarthritic and healthy knees: Implications for total knee arthroplasty prosthesis design.","authors":"Bin Yu, Yu Zhang, Dongdong Cao, Jinchang Han, Weiyong Wu, Chao Zhang, Aifeng Liu","doi":"10.1016/j.cjtee.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.08.003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;End-stage knee osteoarthritis (OA) patients are the primary candidates for total knee arthroplasty (TKA). However, most morphological refinements of TKA prosthesis are based on anatomical data from the knees of healthy individuals. This study aimed to determine whether differences exist in key bony morphological characteristics of the distal femur and proximal tibia between osteoarthritic knees and healthy knees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective cross-sectional observational study with a case-control design. Patients who were aged ≥50 years, had no history of trauma, fracture, or surgery in the studied knee, and had no obvious knee flexion contracture were included in this study by CT scans. Patients who met the American College of Rheumatology clinical criteria for knee OA were included in the study group. Kellgren-Lawrence grade III or IV knees were studied (for bilateral cases, the more severely affected knee was chosen). Patients who presented with unilateral knee pain or trauma were included in the control group, with CT scans from the opposite (asymptomatic) knee used for analyzing. The studied knee had a Kellgren-Lawrence grade of 0 or I and showed no abnormalities upon physical examination. Archived knee CT scans from 160 patients were divided into 2 groups: the study group (80 moderate-to-severe OA knees) and the control group (80 healthy knees). After 3-dimensional reconstruction and virtual cutting using a CT workstation, 13 morphological parameters of the distal femur and proximal tibia were compared between the 2 groups using independent-samples t-tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No significant group differences in the femoral anteroposterior dimension (p = 0.797), height of the lateral femoral condyle (p = 0.268), posterior condylar angle (p = 0.240), tibial anteroposterior dimension (p = 0.536), or tibial lateral anteroposterior dimension (p = 0.702) were observed. However, the femoral mediolateral dimension (p = 0.002), distal femoral aspect ratio (femoral mediolateral dimension/femoral anteroposterior dimension) (p &lt; 0.001), height of the femoral trochlear groove (p &lt; 0.001), height of the medial femoral condyle (p &lt; 0.001), tibial mediolateral dimension (p = 0.001), proximal tibial aspect ratio (tibial mediolateral dimension/tibial anteroposterior dimension) (p = 0.004), tibial medial anteroposterior dimension (p = 0.005), and tibial asymmetry ratio (tibial medial anteroposterior dimension/tibial lateral anteroposterior dimension) (p = 0.006) were all significantly greater in the study group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Knees with moderate-to-severe OA are significantly wider than healthy knees, and OA is a risk factor for increased tibial platform asymmetry. When refining the morphological parameters of TKA prostheses, the specific bony morphological characteristics of OA knees should be taken into account to reduce the potential risk of femoral or tibial compone","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative laboratory markers as predictors of early spinal surgical site infections: A retrospective cohort study.","authors":"Tianhong Chen, Renxin Chen, Hongliang Zhang, Qinyu Feng, Lin Cai, Jingfeng Li","doi":"10.1016/j.cjtee.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.08.002","url":null,"abstract":"<p><strong>Purpose: </strong>To screen laboratory markers with predictive value in early spinal surgical site infections (SSI) that are diagnosed within 30 days postoperatively.</p><p><strong>Methods: </strong>Patients who underwent surgical treatment for internal spinal fixation between March 2022 and March 2023 in our hospital were retrospectively studied. The inclusion criteria were aged >18 years, undergoing internal fixation surgery, complete medical records with >30 days of postoperative follow-up, diagnosis was made within 30 days postoperatively, and an informed consent form was obtained. The exclusion criteria were abnormal white blood cell count or neutrophil percentage in the preoperative blood routine and combined diseases that may affect the C-reactive protein (CRP) or procalcitonin (PCT) values, including lower respiratory tract infection, renal insufficiency, and liver disease. We collected patients' personal information, surgical information, and blood laboratory data, including CRP, PCT, lymphocyte-neutrophil ratio, platelet-neutrophil ratio, and routine blood tests on preoperative and postoperative days 3, 5, and 7, from these patients. These data were statistically analyzed to determine which laboratory markers were statistically significant. The diagnostic value and optimal diagnostic threshold of these laboratory markers were further determined by receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>A total of 106 patients were enrolled in this study, of whom 8 patients were diagnosed with early SSI. A total of 4 laboratory markers were screened, namely, CRP on postoperative day 7 (optimal diagnostic threshold of ≥64.1 mg/L, sensitivity of 100%, specificity of 76.5%, area under the curve (AUC) of 0.908), PCT on postoperative day 7 (optimal diagnostic threshold of ≥0.2 ng/mL, sensitivity of 87.5%, specificity of 94.1%, AUC of 0.967), lymphocyte count on postoperative day 5 (optimal diagnostic threshold of ≤0.67 × 10⁹/L, sensitivity of 50%, specificity of 95.9%, AUC of 0.760), and lymphocyte count on postoperative day 7 (optimal diagnostic threshold of ≤1.32 × 10⁹/L, sensitivity of 87.5%, specificity of 55.1%, AUC of 0.721).</p><p><strong>Conclusion: </strong>We concluded that CRP and PCT levels on postoperative day 7 and lymphocyte counts on postoperative days 5 and 7 are useful markers in screening for early spinal SSI.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TIM-3, a potential target for sepsis therapy.","authors":"Shaowen Huang, Xiaofei Huang, Xifeng Feng, Rui Wang, Fengying Liao, Di Liu, Jianhui Sun, Huacai Zhang, Anyong Yu, Ling Zeng","doi":"10.1016/j.cjtee.2025.08.001","DOIUrl":"https://doi.org/10.1016/j.cjtee.2025.08.001","url":null,"abstract":"<p><p>Immune dysregulation is one of the leading causes of mortality in patients with sepsis. T cell immunoglobulin and mucin domain-containing protein 3 (TIM-3), a negative costimulatory molecule, is pivotal for immune regulation during sepsis. The effects of TIM-3 appear to be bidirectional: in the early stages of sepsis, upregulation of TIM-3 may help attenuate inflammation, whereas its sustained overexpression in later stages and ligand binding promotes immune apoptosis or exhaustion, which suppresses immune responses. Furthermore, TIM-3 synergizes with other immune checkpoint molecules (e.g., programmed cell death receptor-1), exacerbates immunosuppression, and increases the risk of secondary infections. Blocking the TIM-3 signaling pathway can restore immune cell function and may be a novel therapeutic strategy for sepsis. Although TIM-3 holds promise as both a biomarker and a therapeutic target, its mechanisms are complex and may vary across disease stages, which necessitates further research to optimize targeted interventions. Future studies should focus on elucidating the dynamic signaling pathways of TIM-3, developing combination immunotherapies, and conducting clinical trials to validate its safety and efficacy in sepsis treatment.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}