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Objective: To investigate the frequency of deep vein thrombosis (DVT) in patients aged over 80 years on admission after intertrochanteric femur fracture and to explore the risk factors of DVT., Study Design: Descriptive study. Place and Duration of the Study: Department of Orthopaedics, China-Japan Friendship Hospital, Beijing, China, from 1st January 2019 to 31st December 2022., Methodology: A group of patients aged over 80 years with intertrochanteric fracture were included according to the presence or absence of DVT confirmed by ultrasonography on admission. The patients were divided into the non-DVT and DVT groups. Clinical data were retrospectively compared between the two groups and analysed by multivariate logistic regression to screen risk factors of DVT., Results: A total of 130 patients meeting the inclusion criteria were enrolled, and 37 of them had DVT on admission, with a prevalence of 28.5%, including 25 (67.6%) distal peripheral DVT, 11 (29.7%) proximal central DVT, and 1 (2.7%) mixed DVT. The American Society of Anaesthesiologists (ASA) classification, Charlson comorbidity index, the serum levels of D-dimer, fibrinogen degradation products, albumin, potassium, inorganic phosphorus, and calcium showed significant differences between the two groups (p <0.1). Multivariate analysis identified increased D-dimer (>6.005 mg/L), decreased albumin (<36.45 g/L), and reduced potassium (<3.650 mmol/L) as independent factors for DVT in aged intertrochanteric fracture patients (AIFPs)., Conclusion: A high incidence of DVT was revealed in AIFPs, and elevated D-dimer levels, reduced albumin levels, and reduced potassium concentrations were shown to be correlated to DVT., Key Words: Intertrochanteric fracture, Deep vein thrombosis, Aged patients, Risk factor, Multivariate logistic regression.

The use of natural language interfaces (NLIs) to create charts is becoming increasingly popular due to the intuitiveness of natural language interactions. One key challenge in this approach is to accurately capture user intents and transform them to proper chart specifications. This obstructs the wide use of NLI in chart generation, as users' natural language inputs are generally abstract (i.e., ambiguous or under-specified), without a clear specification of visual encodings. Recently, pre-trained large language models (LLMs) have exhibited superior performance in understanding and generating natural language, demonstrating great potential for downstream tasks. Inspired by this major trend, we propose ChartGPT, generating charts from abstract natural language inputs. However, LLMs are struggling to address complex logic problems. To enable the model to accurately specify the complex parameters and perform operations in chart generation, we decompose the generation process into a step-by-step reasoning pipeline, so that the model only needs to reason a single and specific sub-task during each run. Moreover, LLMs are pre-trained on general datasets, which might be biased for the task of chart generation. To provide adequate visualization knowledge, we create a dataset consisting of abstract utterances and charts and improve model performance through fine-tuning. We further design an interactive interface for ChartGPT that allows users to check and modify the intermediate outputs of each step. The effectiveness of the proposed system is evaluated through quantitative evaluations and a user study.

Objective: To explore the application of minimally invasive percutaneous plate osteosynthesis (MIPPO) the clinical curative effect of treatment of fractures of the distal tibia., Methods: From 2010 June to 2014 June, the application of MIPPO technology combined with LCP (low bend medial distal tibial plates) for treatment of 67 cases of distal tibial fracture patients, to evaluate the healing of fracture, function etc., Results: 67 patients with effective follow-up, time was 6-20 months, mean 15 months. The incision healed in one stage, 3 weeks. The effect of 12-16 weeks to fracture healing standard weight, nomalunion and nonunion cases, no fracture, bone plate and screw loosening, exit and other phenomena. The postoperative function was evaluated according to Johner-Wruch criteria, excellent in 45 cases, good in 16 cases, 6 cases, poor in 0 cases., Conclusion: MIPPO technique combined with LCP (low bend medial distal tibial plates) in treatment of distal tibial fractures in accord with biological osteosynthesis requirements, is a recommendable method to treat fracture extension.

Objective: To explore the risk factors for mortality in nonagenarians with femoral neck fractures and clarity the relationships between risk factors and postoperative mortality., Methods: For this retrospective study, a total of 197 patients with consecutive isolated nonpathologic hip fractures undergoing hemiarthroplasty were recruited. There were 64 males and 133 females with an age range of 70 years or above. They were divided into three age groups: A, 70-79 years; B, 80-89 years; and C, ≥ 90 years. A retrospective chart review was conducted to compare these groups in terms of age, gender, nutritional status, blood albumin, total lymphocyte count, hemoglobin levels at admission, comorbidities, American Society of Anesthesiologists (ASA) rating of operative risk and time period between injury and surgery., Results: Among them, 14 patients died within 1 year. There was one in-hospital death and 13 patients died during follow-ups. The mortality rates of groups A, B and C were (n = 3, 3.9%), (n = 5, 7.2%) and (n = 6, 24.0%). The ASA scores were III (n = 9) and IV (n = 4). And 13 patients had a preoperative blood albumin level < 35 g/L while 11 patients showed a preoperative lymphocyte count level < 1 500 cells/ml. The mortality rates were similar in groups A and B but were significantly lower than that of group C., Conclusion: The nonagenarians have a significantly higher mortality. And lower lymphocyte count, nonagenarian, > 2 comorbidities, high ASA score, low blood albumin level and low hemoglobin levels at admission are significant factors for assessing 1-year mortality in elders with femoral neck fractures.

Objective: Glucocorticoid is the main cause of non-traumatic avascular necrosis of femoral head. To explore the changes of reactive oxygen species (ROS) in the bone microvascular endothelial cells treated with glucocorticoid so as to investigate the pathogenesis of steroid-induced avascular necrosis of femoral head., Methods: The cancellous bone of femoral head was harvested from voluntary donators undergoing total hip arthroplasty, and then the bone microvascular endothelial cells were isolated by enzyme digestion. The cells at passage 3 were cocultured with different concentrations of hydrocortisone (0, 0.03, 0.10, 0.30, and 1.00 mg/mL) for 24 hours. MTT assay was used for the inhibitory rate of cell proliferation, flow cytometry for apoptosis rate, and fluorescence probe for the production of ROS and xanthine oxidase (XOD)., Results: At 2-3 days primary culture, the cells were spindle and arranged like cobbles and they reached confluence after 1 week. The inhibitory rates of cell proliferation in 0.03, 0.10, 0.30, and 1.00 mg/mL groups were 20.22% +/- 2.97%, 22.94% +/- 4.52%, 43.98% +/- 3.35%, and 78.29% +/- 3.85%, respectively; and 2 high-concentration groups (0.30 and 1.00 mg/mL groups) were significantly higher (P < 0.05) than 2 low-concentration groups (0.03 and 0.10 mg/mL groups). The apoptosis rates in 0, 0.03, 0.10, 0.30, and 1.00 mg/mL groups were 0.10% +/- 0.01%, 0.23% +/- 0.02%, 1.83% +/- 0.04%, 6.34% +/- 0.11%, and 15.33% +/- 0.53%, respectively; 2 high-concentration groups (0.30 and 1.00 mg/mL groups) were significantly higher (P < 0.05) than 0 mg/mL group. In 0, 0.30, and 1.00 mg/mL groups, the ROS levels were 57.35 +/- 7.11, 120.47 +/- 15.68, and 166.15 +/- 11.57, respectively, and the XOD levels were 0.017 9 +/- 0.000 9, 0.028 3 +/- 0.0017, and 0.067 7 +/- 0.0041, respectively; there were significant differences in the levels of ROS and XOD among 3 groups (P < 0.05)., Conclusion: Increasing of ROS production in bone microvascular endothelial cells can be induced by high concentration glucocorticoid, and it can result in cell injury.