Objective   To investigate the correlation between osteoporotic femoral head and neck fractures and changes in cortical thickness, diameter, area and the morphology of the femoral head and neck, so as to elucidate the pathogenesis of femoral neck fractures.   Methods   65 dry femoral specimens were collected, with 30 osteoporosis and 35 normal specimens. CT scanning and digital reconstruction were performed to analyze the thickness of bone cortex, the diameter and area of the femoral head and neck. The ratio of the diameter and area of each part was calculated, and morphological changes of bone tissue were observed under scanning electron microscopy.   Results   Compared with the normal group, the thickness of the medial and lateral cortex at the junction of the femoral head and neck and the medial cortex at the middle of femoral neck in the osteoporosis group were lower, the ratio of the maximum diameter of the femoral head to the diameter at the middle of the femoral neck was significantly higher in the osteoporosis group. In addition, the ratio of the maximum cross-sectional area of the femoral head to the basal area significantly increased in the osteoporosis group. The arrangement of bone lamella was irregular in the bone cortex, with loose structures and disordered arrangement of bone trabecula in the osteoporosis group. Conclusions   In osteoporosis, bone cortex at the junction of the femoral head and neck and medial cortex at the middle of the femoral neck are relatively weak, and femoral head is larger and neck is smaller in shape. Loose bone plates and disordered trabecular arrangement appeared in the femoral neck, which may be the morphological basis for the occurrence of osteoporotic femoral neck fractures. 

Objective    To collect the imaging data of axillary artery and its branches by combining computed tomography angiography (CTA), and to supplement the classification and variation of axillary artery branches, so as to provide reference for clinical axillary structure and axillary artery injury.    Methods   The image data of 100 patients with CTA of left upper limb and axilla were randomly collected from Xiangya Hospital of Central South University. After 3D reconstruction by GE AW4.6 workstation, the course, branch type and variation of axillary artery were observed The whole segment length, branch segment length and internal diameter of each segment were measured and statistically analyzed.   Results   The axillary artery classification can be divided into 7 types according to the number of branches from the main trunk: type I: accounting for 7%, type II: 24%, type III: 18%, type IV: 29%, type V: 11%, type VI: 9%, type VII: 2%. There were 5 types according to the origin of blood vessels: type I: accounting for 1.8%, type II: 2.9%, type III: 2.4%, type IV: 6%, type V: 0.5%, no origin variation accounted for 86.4%. There were 7 types according to the first-level branches from the common trunk,  type I: accounting for 16%, type II: 5%, type III: 2%, type IV: 2%, type V: 1%, type VI: 1%, type VII: 12%, no co-common trunk variation accounted for 61%.   Conclusions   There are many variation types of axillary artery branches. CTA images can clearly and directly reflect the course, branch type and variation of axillary artery. The imaging data of axillary artery branches and variation are supplemented and improved, so as to provide reference for the establishment of a new blood supply pathway for clinical axillary vascular injury.

Objective    To explore the radiologic anatomical characteristics of the relative position between acromion and humerus head, as well as the clinical application in the treatment of proximal humerus fractures with intramedullary nailing.    Methods    A total of 105 standard shoulder joint images under X-ray were selected. The supraglenoid tubercles was defined as point A, the subglenoid tubercles as point B, the apex of the superior lateral aspect of anatomical neck of humerus as point C, the anteroinferior aspect of anatomical neck of humerus as point D, and the outermost edge of the acromion as point E, the intersection of the axis of the humerus shaft and the cortex of the humerus head as point F, and the outermost edge of the greater tuberosity of humerus as point H. The line was drawn parallel to the axis of the humerus shaft through point E and point H respectively. The line perpendicular to the axis of the humerus shaft was drawn through point F. The two points of intersection were point G and I. Lines AB, CD, EF, EG, FG, GI, HI, EI were measured respectively. The humeral neck shaft angle (∠α) and the angle between line EF and line FG (∠β) were measured respectively. And the acromial projection index (API, FG/FI×100%) was calculated. The morphology of acromion and its relative position with the axis of the humerus shaft in the sagittal plane were observed. The correlation among the above measurements were analyzed by Spearman correlation. The gender difference was analyzed by t-test. The difference in anatomical parameters among three types of the morphology of acromion was analyzed by ANOVA test.   Results   The age was negatively related with HI, AB was positively related with CD, GI and HI, CD was positively related with AB, EG, GI and HI, ∠β was positively related with EG, GI, and negatively related with EF, FG and API, API was positively related with EF, FG and negatively related with EG, GI, HI and ∠β. The AB, CD, GI and HI of the male were longer than those of the female, the ∠β of the male was larger than that of the female, and the API of the male was smaller than that of the female, with statistical difference (P≤0.05). Except for the type I, acromion generally crossed the axis of the humerus shaft in type II and III. There was no significant difference in anatomical parameters among the three types of acromion (P>0.05).    Conclusions   The difficulty of intramedullary nailing placement in the humerus is closely related to the API. The larger the humerus head, the smaller the acromion projection index, and the easier it is to insert the nail. The male have a larger humeral head size than female, so it may be easier to insert intramedullary nail in male. Compared to the type I acromion, it may be more difficult in inserting the nail for the type II and III.

Objective   To compare the implantation safety of the first and second sacral alar-iliac screw (S1AIS, S2AIS) for fixation of sacroiliac joint through radiological anatomy.    Methods   CT data of 80 normal adult pelvic were selected, with 40 cases for each gender, aged (45.1±6.3) years old. By simulating the SAIS fixation method using CT digital reconstruction technology to measure the insertable range, nail path length and width of S1AIS and S2AIS on the 3D reconstruction of pelvic. Φ6.5 mm and Φ8.0 mm screws were implanted respectively on the left and right sides of 30 3D printed pelvic models. The implantation results were observed.    Results    The length and width of the nail path in S1AIS and S2AIS were similar (P>0.05), and there were no breaches of nail path in Φ6.5mm SAIS. However, the insertable range and the nail path length on the sacral side [(234.56±10.06) mm2, (40.97±2.81) mm] of S2AIS were smaller than those of S1AIS [(307.55±10.42) mm2, (42.16±3.06) mm, P<0.05], and the breach rate of the sacral posterior lateral cortex of Φ8.0 mm S2AIS (30%) was higher than that of Φ8.0 mm S1AIS (3%) (P<0.05).    Conclusions    S1AIS has a larger insertable range, fewer breaches of the sacral posterior lateral cortex and a longer nail path length on the sacral side compared to S2AIS, indicating that S1AIS has higher implantation safety than S2AIS in fixation of sacroiliac joint.

Objective   To analyze the difference of bone thickness of normal paranasal sinuses and explore its significance for the global osteitis scoring scale(GOSS) of chronic rhinosinusitis.   Methods   A total of 39 patients who received sinus CT examination in the Department of Otolaryngology, Head and Neck Surgery of our hospital from January 2023 to March 2024 were collected. The bone thickness of maxillary sinus, bilateral anterior ethmoid sinus, bilateral posterior ethmoid sinus, bilateral posterior frontal sinus and bilateral anterior sphenoid sinus were measured respectively. The difference of bone thickness of paranasal sinus was analyzed and the 95% confidence interval of every sinus was evaluated.   Results   The average bone thickness of the posterior lateral wall of maxillary sinus was (1.35±0.17) mm, that of the anterior ethmoid sinus was (0.82±0.08) mm, that of the posterior ethmoid sinus was (0.80±0.06) mm, and that of the posterior frontal sinus was (1.22±0.21) mm. The mean bone thickness of the anterior wall of bilateral sphenoid sinus was (0.81±0.11) mm. There were statistically significant differences in bone thickness of paranasal sinus in all groups (F=134.6, P<0.05). Multiple comparisons showed the bone thickness of posterior lateral wall of maxillary sinus and posterior wall of frontal sinus was thicker (P<0.05), while there was no statistical differences in the bone thickness of the walls of the anterior ethmoid sinus, posterior ethmoid sinus and sphenoid sinus (P>0.05).   Conclusions  The bone thickness of normal paranasal sinuses was different, maxillary and frontal sinuses were thicker while ethmoid and sphenoid sinuses were thinner. This difference may lead to overestimate the bone thickening of maxillary sinuses, frontal sinuses and underestimate the bone thickening of ethmoid and sphenoid sinuses in CRS.

Objective   To investigate the morphological features of the inferior fascicle of the anterior-inferior tibiofibular ligament (AITFL) and classify the anatomical features, so as to provide reference for the precise anatomy of the tibiofibular joint and the surgical repair of the ankle ligament.   Methods   100 adult lower limbs were dissected and the characteristics of the AITFL were noted. The length, origin and insertion widths of the inferior fascicle were measured with a digital vernier caliber, while angles (α) between the inferior fascicle and the horizontal plane were examined with a protractor.   Results   (1)The AITFL was divided into four types according to the relation between the AITFL and the inferior fascicle: typeⅠ, the inferior fascicle was separated from the rest of the ligament by a gap in 11cases; typeⅡ, the inferior fascicle was not completely separated from the rest of the ligament by a gap, with its origin or insertion attachment continuing with AITFL in 32 cases; type Ⅲ, the inferior fascicle was separated from the rest of the ligament by a gap and possessed its own origin and insertion attachments in 19 cases; type Ⅳ, the inferior fascicle could not be separated from the AITFL in 38 cases. (2) There was no statistical significance in the types between male and female (c2=7.052, P=0.070). The lengths, origin and insertion widths of the inferior fascicle and α were (23.39±5.93) mm, (8.38±4.23) mm, (6.95±4.13) mm and (29.02±10.90), respectively.     Conclusions  The classification of AITFL in this experiment is a supplement to previous studies. The AITFL is a potential factor causing ankle joint injury. We should pay attention to the variation characteristics of the AITFL when treating the ankle injury by arthroscopy, so as to reduce complications and improve the surgical effect. 

Objective    To investigate the effect and mechanism of Bmal1 overexpression on C2C12 myoblasts proliferation and differentiation.   Methods   Bmal1 was overexpressed in C2C12 myoblasts by lentivirus-mediated stable transfection. The expression levels of mRNA and protein of some myogenic regulatory factors were determined by RT-qPCR or Western blot assay. Transcriptome sequence analysis and its related experiments were used to explore the expression of Wnt signaling pathway and cell cycle regulators in C2C12 myoblasts after overexpression of Bmal1 during the differentiation process. Subsequently, Wnt signaling pathway was blocked by inhibitor XAV939. The effects of XAV939 on C2C12 myoblasts after overexpression of Bmal1 were observed using corresponding experiments.   Results   Overexpression of Bmal1 promoted the proliferation of myoblasts cultured in growth medium. The S-phase fraction of total cells (SPF) and Proliferation Index (PI) of myoblasts increased. Compared with the blank control group and negative control group, the ratio of EdU positive cells and nuclear translocation of β-catenin were increased in C2C12 myoblasts after overexpression of Bmal1. Overexpression of Bmal1 significantly promoted myogenic differentiation and myotube fusion. The mRNA and protein expression levels of MyoD, myogenin, and Myh3 were up-regulated in a time-dependent manner in C2C12 myoblasts after overexpression of Bmal1. Cluster analysis and related experiments supported that the expression of the relative factors of Wnt signaling pathway and cell cycle was up-regulated during the proliferation and differentiation of Bmal1-overexpressed C2C12 myoblasts. XAV939(5μmol/L) treatment inhibited the Bmal1 overexpression-induced the up-regulated expression of Tcf1 and c-Jun. Continuous XAV939 treatment suppressed myotube fusion and down-regulated the expression of MyoD, myogenin, and Myh3 in Bmal1-overexpressed C2C12 myoblasts.  Conclusions Bmal1 may serve as a potential target for skeletal muscle injury repair. Overexpression of Bmal1 enhances myoblasts proliferation and differentiation by enhancing Wnt signaling pathway.

 Objective    To compare effects of two commonly used Rho kinase inhibitors, Fasudil and Y27632, on promoting cutaneous nerve regeneration.    Methods    Firstly, 15 Sprague Dawley rats were used to establish a clamp-induced injury model on the saphenous nerve. They were then divided into the control, Fasudil and Y27632 groups, and intraperitoneal given DMSO, Fasudil （40 mg/kg） or Y27632 （40 mg/kg）, respectively, once a day for 7 days after surgery. Then, the regenerated axons within the saphenous nerve were evaluated. Secondly, perforator flaps were harvested on the back of 15 ICR mice, which were equally divided into the above-mentioned three groups with drugs administered accordingly. 30 days later, axons within the flaps were quantitatively analyzed. Finally, the rat embryonic dorsal root ganglias （DRG） were collected and cultured in PDMS molds to establish an in vitro axotomy model, which were then divided into the above-mentioned three groups and treated accordingly. The length of regenerated DRG axons was measured after 3 days. One-way analysis of variance was used to process the data.   Results   One week after saphenous nerve injury, the density of new axons in the control, Fasudil and Y27632 groups was （43.2±6.5）%, （55.8±5.2）% and （68.0±2.3） %, respectively. The axon density of the Y27632 group was significantly higher than those of the other 2 groups （P<0.01）. One month after flap surgery, the nerve density of the distal cross-section of the flap in the control, Fasudil and Y27632 was （1.1±1.1）‰, （2.8±0.5）‰ and （6.0±0.9）‰, respectively. The nerve density of the flap in the Y27632 group was significantly higher than the other 2 groups （P<0.001）. 3 days after DRG axotomy, the expression of SPRR1a, ATF3, c-JUN, GAP43, RhoA and ROCK2 significantly increased. The length of the regenerated axons and the area of growth cones of DRG in the control, Fasudil and Y27632 groups were （1916±132） μm and （40±7） μm2, （2302±134） μm and （55±7） μm2, and （2662±112） μm and （79±5） μm2, respectively. The length of the regenerated axons and the area of growth cones of DRG in the Y27632 group were significantly larger than that of the other 2 groups （P<0.05）.   Conclusions Y27632 is more capable than Fasudil to promote DRG growth cone expansion and repair after cutaneous nerve injury, and is very suitable for promoting sensory recovery after skin flap surgery.

Objective    To explore the effect of exosomes derived from platelet-rich plasma (PRP-Exo) on wound healing rate and vascularization in the early stage of wound repair in rats.    Methods    PRP-Exo was extracted from the whole blood of 6 healthy volunteers. 40 rats were randomly divided into model group and PRP-Exo group, with 20 rats in each group. A full-thickness skin defect model was established. PRP-Exo group was injected with 200 μg of PRP-Exo, once per day. On the day of modeling (0 d) and on 3, 7, 11, 14, 17, and 20 days after modeling, photos of the wounds in each group were taken to analyze the wound contraction rate. HE and Masson staining were used to observe histopathological changes. Immunohistochemistry was used to detect the expression of CD31, α-smooth muscle actin (α-SMA), and Janus kinase 2 (JAK2). HUVEC was divided into the control group (normal culture), the PRP-Exo group (50 μg/mL PRP-Exo), and the PRP-Exo+AG490 group (50 μg/mL PRP-Exo+20 μmol/L AG490). CCK-8, scratch and angiogenesis were used to detect cell proliferation, migration and angiogenesis ability. While WB was used to detect molecules related to the JAK2/ signal transducer and activator of transcription 3 (STAT3) signaling pathway and the expression of vascular endothelial growth factor (VEGF).   Results    Compared with the model group, the wound contraction rate on 7, 11, and 14 days, epidermal thickness and length of new epithelial tissue on 7 day, number of microvessels, and expression levels of α-SMA and JAK2 were increased in the PRP-Exo group (P<0.05). Compared with the control group, the ability of cell proliferation, migration, angiogenesis and the expression of p-JAK2, p-STAT3 and VEGF were increased in PRP-Exo group (P<0.05). Compared with the PRP-Exo group, the ability of proliferation, migration, angiogenesis and the expression of p-JAK2, p-STAT3 and VEGF were decreased in PRP-Exo+AG490 group (P<0.05).    Conclusions    PRP-Exo enhances wound vascularization and promotes wound healing in rats through the JAK2/STAT3 signaling pathway.

Objective    To investigate the mechanism of mulberry aqueous extract promoting chondrogenic differentiation of bone marrow mesenchymal stem cells (BMSC).    Methods   BMSCs were extracted by the whole bone marrow adherent method. The CCK8 assay was used to detect the proliferation of BMSCs induced by mulberry aqueous extract on cells. RT-qPCR was used to test miRNAs in BMSCs treated by mulberry aqueous extract. Biological information prediction and the dual luciferase reporter gene validated that MMP14 was regulated by rno-miR-139. RT-qPCR and WB were used to detect the effect of rno-miR-139 mimic and inhibitor on MMP14 expression. siMMP14 transfected BMSCs to detect the expression of Sox9. Immunohistochemistry was used to detect rno-miR-139 regulate chondrogenic differentiation of BMSCs in ectopic transplantation in vivo.   Results    The mulberry aqueous extract effectively promoted the chondrogenic differentiation of BMSCs. The downregulation of rno-miR-139 targeted the upregulation of MMP14 and promoted the expression of Sox9. The downregulated rno-miR-139 lead to upregulating Sox9 and Collagen II in ectopic cartilage differentiation of BMSCs in vivo.    Conclusions   Mulberry aqueous extract inhibits rno-miR-139 by upregulating MMP14 to promote chondrogenic differentiation of BMSCs.

Objective    To explore and develop animal-derived functional cosmetic raw materials, pig umbilical cord extracts were tested for protein concentration, subjected to metabolomics and proteomics analysis, and their efficacy on hair follicle cells, animal hair follicle cycles, and androgenetic alopecia (AGA) models was studied.    Methods   The protein concentration and metabolomic analysis of porcine umbilical cord extract were carried out, and the evaluation of the efficacy of the hair follicle cycle and the efficacy of mouse hair follicle cycle was completed by establishing a mouse hair follicle cycle model and treating mice with different concentrations of porcine umbilical cord extract and tracking the skin color, hair follicle changes and hair diameter of mice, and analyzing the histological morphology of mouse hair follicles. The histomorphology of hair follicles in mice was analyzed, the levels of androgen receptor and Dickkopf-related protein 1 (DKK1) were detected, and the changes of skin blood flow were tracked to complete the efficacy evaluation of the androgenetic alopecia model.   Results    (1) The protein concentration of pig umbilical cord extract extracted by patented extraction technology was (7.45±1.23) mg/ml; (2) The number of proteins and peptides of pig umbilical cord extract, the number of available proteins: (187±12), the number of peptides: (696±44) (n=3); (3) The hair diameter of the back hair follicles of mice increased after treatment with porcine umbilical cord extract; (4) The number of hair follicles entering the growth phase increased significantly after the porcine umbilical cord extract was applied to the dorsal skin of mice (15-90 μg/mL), and the size and number of hair follicles gradually increased；(5) After the umbilical cord extract was applied, the hair coverage of the back skin increased, the hair bulb of hair follicles increased, the expression of AR and DKK1 decreased, and the blood flow increased.   Conclusions   (1) Porcine umbilical cord extract contains abundant and diverse small molecule metabolites, a variety of proteins, polypeptides and other substances; (2) Porcine umbilical cord extract can promote the thickening of hair follicles in mice, and accelerate the transition from telogen phase to growth phase; (3) Umbilical cord extract can improve the average blood perfusion in the area of hair loss and inhibit the miniaturization of hair follicles caused by androgenetic alopecia by inhibiting the expression of AR and DKK1.

Objective   To investigate the self-assembly capacity of lipoaspirates as an engineering module in constructing large-volume engineered adipose tissue and to evaluate its maximum survival depth for maintaining cell viability.    Methods    The engineered tissue volume was scaled up from less than 1 mL to 27 mL with structural optimization, and the self-assembly capability and structural stability post-expansion were assessed. Additionally, the presence of hypoxia- or nutrient deficiency-induced necrosis in the tissue core under static culture conditions was analyzed.   Results    Lipoaspirates as an engineering module successfully self-assembled into a morphologically stable adipose flap in a 27 mL large-volume construct. However, limited by substance diffusion in static culture, nutrient penetration depth remained below 10 mm within 72 hours, with cell viability and metabolic activity decreasing with depth. Beyond 6 mm, both parameters dropped significantly, indicating near-complete necrosis.    Conclusions   Lipoaspirates enable rapid construction of 27 mL engineered adipose tissue, but its cell survival depth is limited to less than 10 mm due to diffusion constraints, highlighting the need for optimized culture strategies to enhance deep-layer cell viability.

Objective   To explore the mechanism of Resolvin D1 in the treatment of intracranial  hemorrhage by using network pharmacology and molecular docking techniques. Methods The target information related to RvD1 and intracranial hemorrhage was obtained from five databases: PubChem, TargetNet, Stitch, Disgenet and GeneCards. Then, the protein interaction analysis and core target screening were carried out using String database and Cytoscape software. The enrichment analysis of Go and KEGG was performed at the same time, and finally the molecular docking experiment was conducted for verification. Results A total of 115 RvD1-related target genes and 1705 intracranial hemorrhage    targets were obtained, and there were 60 overlapping genes among them. The PPI network  analysis results showed a complex network of 60 nodes and 554 edges. The top 10 core targets were IL6, IL1B, TNF, IL10, TLR4, IFNG, STAT3, CD4, MMP9, and CCL2. Molecular docking test showed that RvD1 has strong binding affinity for these target proteins. Conclusions In the treatment of intracranial hemorrhage, RvD1 may affect the inflammatory response and protein binding process by regulating multiple target genes, and plays a role in multiple signaling pathways. 

Objective    To investigate the role and mechanism of Spastin phosphorylation in the neurites growth and branch formation of hippocampal neurons.   Methods    Co-IP and immunofluorescence co-localization were used to analyze the interaction between Spastin and F-actin and whether their binding was regulated by phosphorylation modification. Spastin and its phosphorylation mutants were transfected into cultured COS1 cells and rat hippocampal neurons, and immunofluorescence was used to visualize F-actin and neurites.   Results   Co-IP results showed that Spastin interacted with F-actin, and the binding of Spastin to F-actin was enhanced by dephosphorylation at S210 site of Spastin and weakened by phosphorylation modification, which was statistically different from that of the Spastin wild-type group (P<0.05). Immunofluorescence showed that over-expression of Spastin promoted microfilament polymerization, dephosphorylation of S210 further promoted microfilament polymerization, and phosphorylation of S210 inhibited microfilament polymerization, which was statistically different from that of the wild-type group of Spastin (P<0.05). Analysis of neurites outgrowth showed that over-expression of Spastin enhanced elongation and branching of neurites, which was further enhanced by dephosphorylation of S210, and inhibited by phosphorylation of S210, which was statistically different from that of the wild-type group of Spastin (P<0.05).  Conclusions   Phosphorylation modification of Spastin at S210 site remodels the microfilament cytoskeleton by inhibiting the binding of Spastin to F-actin, thereby regulating neurite outgrowth and branch formation.

Objective   To investigate the changes of biomechanical response of anterior cruciate ligament (ACL) in KOA rats.   Methods   The left hind limb was immobilized for 3 weeks to establish a rat model of early knee osteoarthritis, after success of model was confirmed by Saffron-O and Fast Green staining, two groups of anterior cruciate ligaments were dissected for macroscopic mechanical testing by multi-scale micro-mechanical loading system. The changes of microscopic components were determined by histological staining. The microstructure was observed by two-photon microscopy.    Results    The results of Saffron-O and Fast Green staining showed early pathological changes of cartilage in KOA after 3 weeks of left hind limb fixation. HE staining showed that anterior cruciate ligament was infiltrated by inflammatory cells in early KOA, ligaments in an inflammatory environment. The macroscopic mechanical test indicated that stiffness, low tensile modulus, and high tensile modulus of ACL changed in early arthritis. The initial slope of compensatory side was higher than that of the right anterior cruciate ligament in the normal group. The microstructure observation confirmed that ACL was disordered after arthritis, and the arrangement direction of collagen fibers was disordered.    Conclusions    These results indicate that the changes of mechanical properties of ACL of KOA induced by joint braking are mainly characterized by an increase of tissue stiffness, which may be related to inflammatory infiltration of ligament tissue and the changes of microscopic collagen fiber structure.

Objective   To compare the biomechanical stability of three different internal fixation methods by constructing an effective finite element model of the coronoid process fracture of the ulna. The diversity in the injury mechanism of Regan-Morrey Type II fracture of the coronoid process of the ulna makes it difficult to establish a unified surgical standard in clinical treatment.   Methods    After establishing a finite element model of the coronoid process fracture of the ulna using three-dimensional finite element modeling software, models of post-operative internal fixation with a T-shaped plate (A), an L-shaped plate (B), and tension screws (C) were created using related finite element software. These models were then subjected to loading analysis in a simulated supine position.   Results   Under the same loading conditions, the maximum displacement at the fracture line and the average displacement of nodes on the fracture line of the Regan-Morrey Type II fracture of the coronoid process were in the order C>B>A.    Conclusions    The use of a T-shaped plate for internal fixation of the Regan-Morrey Type II fracture of the coronoid process of the ulna demonstrates good biomechanical stability, followed by the L-shaped plate and tension screws.

Objective    To compare retrospectively the efficacy of small incision and traditional open repair combined with early accelerated rehabilitation in the treatment of acute Achilles tendon rupture.   Methods   Patients with acute Achilles tendon rupture were divided into a small incision group (n=22) and an open group (n=23) for surgical treatment. All patients underwent early accelerated rehabilitation. Postoperative Achilles Tendon Rupture Score (ATRS), Visual Analog Scale (VAS) score, imaging examination, incidence of secondary injury, Achilles tendon re-rupture rate, operation time, hospitalization time, return to sports time and patient satisfaction were analyzed.    Results    The ATRS of the small incision group was higher than that of the open group 3 months after surgery. There was no significant difference in the postoperative VAS score and ATRS 12 months after surgery between the two groups. In the small incision group and the open group, 1/1 case had superficial tissue infection and 1/3 had deep tissue infection. No re-rupture cases were found in the imaging examination of the two groups 1 year after surgery. The patients with "high satisfaction" of the small incision group was higher than that of the open group.   Conclusions   Based on the early accelerated rehabilitation program, both small incision and traditional open repair can achieve better therapeutic effects for patients, but the patients in the small incision group have higher postoperative satisfaction with the incision and faster postoperative recovery. Therefore, small incision repair technology combined with early accelerated rehabilitation program can be used as a feasible choice for surgical treatment of acute Achilles tendon rupture.

Adolescent lumbar disc herniation (ALDH) has a different pathogenesis compared to adults and is often associated with spinal morphological abnormalities. These abnormalities include lumbosacral transitional vertebrae (LSTV), facet joint asymmetry, spinopelvic-pelvic sagittal alignment, spinous process obliquity, irregular endplate morphology, and scoliosis,among others. They may affect the biomechanics of the lumbosacral region and increase disc stress, leading to early disc degeneration and the development of ALDH. However, the specific pathological mechanisms are not yet clear. This review explores the relationship between these structural abnormalities and ALDH, aiming to provide a new perspective on understanding the pathogenesis of ALDH, and to offer scientific evidence and future research directions for its prevention and treatment.