Nevin Manimala

Zhongguo Gu Shang. 2026 Mar 25;39(3):270-6. doi: 10.12200/j.issn.1003-0034.20250580.

ABSTRACT

OBJECTIVE: To compare clinical efficacy of direct opening with a pointed cone and opening assisted by a honeycomb guide for proximal femoral nail anti-rotation (PFNA) in treating intertrochanteric fractures in elderly.

METHODS: A retrospective analysis was conducted on 76 elderly patients with intertrochanteric fractures of femur treated with PFNA from January 2019 to December 2023, including 34 males and 42 females, aged from 65 to 93 years old with an average of (73.82±4.98) years old. According to the different opening methods at the top of the large rotor, all patients were divided into direct opening group with pointed cone and opening group assisted by honeycomb guide. There were 35 patients direct opening group with pointed cone in pointed cone direct opening group, including 16 males and 19 females, aged from 65 to 91 years old with an average of (73.44±5.12) years old;a sharp cone was used to directly open apex of the greater trochanter, and fluoroscopy was adjusted to the best position after satisfactory fracture reduction. There were 41 patients in opening group assisted by honeycomb guide, including 18 males and 23 females, aged from 65 to 93 years old with an average of (74.15±4.84) years old;at the apex of the large rotor, the positioning needle was adjusted to the optimal position with the assistance of honeycomb guide before opening. Operation time, fluoroscopy frequency, the occurrence of fracture re-displacement during the main screw insertion process, the quality of immediate fracture reduction after operation, fracture healing time, hip joint function at the final follow-up and the failure of internal fixation were compared between two groups.

RESULTS: Seventy-six were successfully followed up from 12 to 18 months (14.5±2.3) months. No internal fixation failures such as withdrawal or cutting of helical blade and fracture of screw occurred in either group. The quality of fracture reduction in opening group assisted by honeycomb guide showed 28 patients with excellent and 13 with acceptable;in direct opening group with pointed cone, the quality was excellent in 13 patients and acceptable in 22 patients;there was statistically significant difference between two groups(P<0.05). Harris hip score of opening group assisted by honeycomb guide was(85.64±7.91) points, which was better than that of direct opening group with pointed cone(82.06±7.52) points, and the difference was statistically significant (P<0.05). There was 1 patient of re-displacement of opening group assisted by honeycomb guide, and 5 patients of re-displacement in direct opening group with pointed cone, there was a statistically significant difference between two groups(P<0.05).

CONCLUSION: Both direct opening with a pointed cone and opening with the assistance of a honeycomb guide in treating intertrochanteric fractures of femur in elderly patients with PFNA could achieve good therapeutic effects. Opening assited with a honeycomb guide is superior to direct opening with pointed cone in avoiding re-displacement of fracture during the process of opening and expanding bone marrow, improving the quality of immediate fracture reduction after operation, and restoring hip joint function.

PMID:41930387 | DOI:10.12200/j.issn.1003-0034.20250580

Zhongguo Gu Shang. 2026 Mar 25;39(3):263-9. doi: 10.12200/j.issn.1003-0034.20221201.

ABSTRACT

OBJECTIVE: To compare clinical efficacy of endoscopic lumbar interbody fusion (Endo-PLIF) and traditional posterior lumbar interbody fusion (PLIF) in treating single-segment lumbar spinal stenosis.

METHODS: From July 2021 to April 2022, 56 patients with lumbar spinal stenosis who underwent lumbar decompression and fusion were included, and divided into observation group and control group according to treatment methods. There were 29 patients in observation group, including 16 males and 13 females;aged from 41 to 65 years old with an average of(53.64±6.34) years;body mass index (BMI) ranged from 10 to 35 kg·m^-2 with an average of (23.38±2.92) kg·m^-2;2 patients with L_3,4, 15 patients with L_4,5, and 12 patients with L₅S₁;treated with Endo-PLIF. There were 27 patients in control group, including 15 males and 12 females;aged from 42 to 60 years old with an average of (55.41±5.82) years;BMI ranged from 12 to 28 kg·m^-2 with an average of (24.20±2.18) kg·m^-2;1 patient with L_3,4, 17 patients with L_4,5, and 9 patients with L₅S₁;treated with PLIF. Operation time, incision length, intraoperative blood loss, postoperative drainage volume, hospital stay, and occurrence of postoperative complications between two groups were compared. Visual analogue scale (VAS) for lower back and lower limb pain and Oswestry Disability index (ODI) at preoperative, 3 days postoperative, 3 months postoperative, and the latest follow-up postoperative were assessed.

RESULTS: Both groups of patients were followed up, the follow-up period for observation group ranged from 4 to 8 months with an average of (7.3±2.2) months, and for control group ranged from 6 to 10 months with an average of (8.1±1.7) months;there was no statistically significant difference between two groups (P>0.05). Operation time, incision length, intraoperative blood loss, postoperative drainage volume and hospital stay of observation group were (140.24±45.39) min, (3.10±0.70) cm, (125.36±25.59) mL, (50.36±15.59) mL and (11.00±2.36) days respectively, while those of control group were (132.56±48.26) min, (10.10±1.00) cm, (258.51±38.25) mL, (155.28±21.34) mL and (18.00±2.58) days respectively;and the differences were statistically significant compared between two groups (P<0.05). VAS and ODI scores of lumbar and leg regions at 3 days, 3 months, and the final follow-up after operation were all improved compared with those of preoperative, and the differences were statistically significant (P<0.05). Moreover, VAS and ODI scores of lumbar and leg regions at each time point after operation in observation group were better than those in control group (P<0.05). At the latest follow-up, there were no cases of screw fracture, loosening, or fusion device withdrawal were found. No nerve root injuries occurred in either group after surgery. In observation group, 1 patient experienced increased leg pain and 1 patient experienced increased leg numbness;1 patient had cerebrospinal fluid leakage, 2 patients had increased leg pain, 1 patient had leg numbness, and 2 patients had incision necrosis in control group;the number of complications in observation group was better than that in control group, and had siginificant difference(P<0.05).

CONCLUSION: Compared with PLIF, Endo-PLIF has satisfactory therapeutic effects. It has advantages of reducing surgical trauma, shortening hospital stay of patients, and effectively improving symptoms.

PMID:41930386 | DOI:10.12200/j.issn.1003-0034.20221201

Zhongguo Gu Shang. 2026 Mar 25;39(3):254-62. doi: 10.12200/j.issn.1003-0034.20240929.

ABSTRACT

OBJECTIVE: To explore clinical efficacy of fixed-platform unicompartmental knee arthroplasty (UKA) with biologic femoral condyle prosthesis in treating medial compartment osteoarthritis of knee joint.

METHODS: A total of 89 patients with medial compartment osteoarthritis of knee joint who were admitted from January 2021 to December 2023 were selected, and divided into biological group and bone cement group according to different treatment methods. There were 45 patients in biological group, including 18 males and 27 females;aged from 54 to 68 years old with an average of (61.42±6.28) years old;the course of disease ranged from 1 to 5 months with an average of (3.74±0.52) months;28 patients with gradeⅡand 17 patients with grade Ⅲ according to Kellgren-Lawrence (K-L) classification;biological femoral head prosthesis was used. There were 44 patients in bone cement group, including 20 males and 24 females;aged from 52 to 69 years old with an average of (61.59±6.18) years old;the course of disease ranged from 0 to 6 months with an average of (3.80±0.49) months;28 patients with grade Ⅱand 16 patients with grade Ⅲ according to K-L classification;bone cement type femoral head prosthesis was used. Operative time, intraoperative blood loss, intraoperative tourniquet usage time, postoperative drainage volume, hospital stay, and complications between two groups were compared. The changes of Oxford University knee score (OKS), Western Ontario and McMaster Universities osteoarthritis index(WOMAC), and knee joint range of motion(ROM) between two groups before operation and after operation at 1, 3, and 6 months, visual analogue scale(VAS) before operation and after operation at 1, 3, 6 and 12 months were used to evaluate pain relief, changes of typeⅠcollagen carboxy-terminal peptideβ-specific sequence (β-CTX), total N-terminal propeptide of typeⅠprocollagen (tPⅠNP), and intact parathyroid hormone (iPTH) between two groups before operation and 6 months after operation were compared between two groups.

RESULTS: The usage time of hemostatic band during operation and hospital stay in biological group were (54.23±5.69) min and (13.13±1.36) days respectively, while those in bone cement group were (62.11±6.34) min and (10.02±1.27) days respectively;there were statistically significant differences between two groups (P<0.05). There were no statistically significant differences in operation time, intraoperative blood loss, and postoperative drainage volume between two groups (P>0.05). Postoperative OKS and WOMAC scores of biological group at 3 and 6 months were (21.13±2.45), (19.44±1.98), (25.14±2.65), (20.23±2.16) points respectively, which were all lower than those of cement group (24.83±2.57), (23.15±2.46), (29.33±2.98), (24.55±2.67) points;ROM was (119.42±12.57)° and (128.56±13.15)°, which were greater than those of cement group (112.34±12.58)° and (120.44±12.73)°;there were statistically significant differences between two groups (P<0.05). Postoperative VAS of biological group at 1 and 3 months were (2.23±0.24) and (1.92±0.23) respectively, which were higher than those of cement group (1.87±0.21) and (1.67±0.18), and the differences were statistically significant (P<0.05);however, there were no statistically significant differences in postoperative VAS between two groups at 6 and 12 months (P>0.05). At six months after operation, there were no significant differences inβ-CTX, tPⅠNP, and iPTH between two groups (P>0.05). There were no occurrences of implant-related complications such as sterile loosening or radiolucent lines of the prosthesis in both groups.

CONCLUSION: For the treatment of medial compartment osteoarthritis of knee joint with fixed-platform unicompartmental knee arthroplasty (UKA) with biologic femoral condyle prosthesis, bone cement type femoral condyle prosthesis results in less pain in the short term, while biological type femoral condyle prosthesis has a more advantageous long-term effect, which could improve knee joint function. Clinically, the type of prosthesis could be selected based on individual circumstances.

PMID:41930385 | DOI:10.12200/j.issn.1003-0034.20240929

Nurs Open. 2026 Apr;13(4):e70501. doi: 10.1002/nop2.70501.

ABSTRACT

AIM: Shared decision-making (SDM) involves the incorporation of patient preferences, values, and beliefs which yield patient-centered care. This study aims to explore patient engagement in the healthcare decision-making process and its association with the patients’ satisfaction.

DESIGN: A cross-sectional, descriptive correlational design was used.

METHOD: OPTION tool-Arabic version was used to measure the patients’ decision-making level. The Patients’ Satisfaction Questionnaire was used to measure patients’ satisfaction level. Data was analysed using SPSS.

RESULTS: The results showed that patients generally agreed with statements about their engagement in healthcare decision-making, with an overall mean score of 2.03 (SD = 0.08). In contrast, their satisfaction with medical care was neutral, with an overall mean of 2.90 (SD = 0.17), indicating mixed experiences. There was no significant relationship between patient engagement and satisfaction, as correlation and regression analyses showed a very weak, non-significant association (R² = 0.001, p > 0.05). Additionally, demographic variables such as gender, age, marital status, employment, years of infection, and caregiver support showed no statistically significant impact on satisfaction levels.

CONCLUSION: Patient engagement in decision-making was generally agreed upon; however, it did not significantly influence satisfaction with medical care, suggesting that other unmeasured factors may play a more important role in shaping patient satisfaction, and decision-making alone is not sufficient.

PATIENT CONTRIBUTION: Involving patients and the public (PPI) was a key component of this study. From the beginning, patients helped shape the research questions and contributed to designing the study protocol. They also took part in the recruitment process, offering important perspectives on how to engage participants effectively. Additionally, patient representatives reviewed the study materials, providing feedback to improve their clarity and relevance. Lastly, patients were involved in sharing the research outcomes to help make the findings more accessible and understandable to a broader audience.

PMID:41928053 | DOI:10.1002/nop2.70501

Environ Monit Assess. 2026 Apr 3;198(4):403. doi: 10.1007/s10661-026-15245-w.

ABSTRACT

Rapid urbanization puts additional strain on traditional livestock systems, but the spatial dynamics of urban/peri-urban grazing in South Asia remain largely unknown. This study examines practices, socioeconomic effects, and stakeholder acceptance via surveys conducted with 100 graziers and 50 non-graziers in the semiarid region of Multan, Pakistan. The results indicate clear spatial divergence. Urban areas face significantly elevated public health hazards, deterioration of green belts, and spatial limitations that concentrate livestock among middle-income groups, whereas peri-urban systems exhibit inequities in land access that benefit small ruminants and exhibit bimodal income distributions. Urban graziers like young cattle for rapid turnover and exhibit heightened confidence for expansion, in contrast to peri-urban stakeholders who foresee a reduction due to urban sprawl. Perceptions of non-graziers markedly differ, highlighting zoonotic and environmental concerns in contrast to cultural advantages and waste recycling. Findings necessitate cohesive policies that safeguard grazing lanes, create peripheral market centers, and improve veterinary services to maintain livelihoods during urban transitions.

PMID:41928044 | DOI:10.1007/s10661-026-15245-w

J Math Biol. 2026 Apr 3;92(4):62. doi: 10.1007/s00285-026-02387-1.

ABSTRACT

The widely used incompatible insect technique based on Wolbachia for the control of mosquito-borne diseases might be limited in field since high temperature has an adverse effect on some Wolbachia, which reduces its density in mosquitoes and induces incomplete cytoplasmic incompatibility (CI) when the larval habitats experience large temperature fluctuations. By analyzing a model of delay differential equations, we identify a threshold CI intensity, below which the infected male release would not reduce but instead increase the stable adult population level, a phenomenon called suppression paradox, which caused by the overcompensation effect of adult mosquitoes increasing when larval density decreases. For Aedes albopictus mosquitoes in Guangzhou, our simulations predict that paradox would occur if CI intensity is no more than 0.6094. Besides, to reduce at least $80\%$ of the wild adult mosquitoes in the peak season within 8 weeks, we find that the CI intensity should be no less than 0.96, and the least release ratio is sensitive to the CI intensity.

PMID:41928035 | DOI:10.1007/s00285-026-02387-1

Environ Geochem Health. 2026 Apr 2;48(6):277. doi: 10.1007/s10653-026-03176-x.

ABSTRACT

Extensive soil contamination with polycyclic aromatic hydrocarbons (PAHs), particularly naphthalene and benzo(a)pyrene, poses serious threats to agricultural productivity and ecological health. This study aimed to evaluate the synergistic effects of foliar-applied selenium nanoparticles (SeNP) and aged cellulose-derived biochar (CBC) on PAH immobilization and spinach growth in contaminated soils. A controlled pot experiment was conducted, and comparative analysis among treatments was performed using adsorption isotherm modelling, physicochemical characterization of biochar (FTIR and mineral phase analysis), PAH quantification by GC-MS, elemental analysis by ICP-OES, and statistical evaluation of plant physiological and biochemical parameters. Results revealed that aging of CBC enhanced surface functional group formation and transformed mineral phases from Mg₂SiO₄ and MgO to more stable forms such as MgCO₃, Ca, and SiO₂. During PAH adsorption, the relative contribution of mineral components decreased while non-mineral functional groups played a dominant role, reflected by a shift from Freundlich to Langmuir isotherm behavior. The combined application of foliar SeNP and aged CBC significantly improved antioxidant enzyme activities, photosynthetic performance, and PAH sequestration in root cell walls and vacuoles, thereby reducing naphthalene and benzo(a)pyrene uptake and toxicity. Overall, the integrated strategy of SeNP and aged CBC demonstrated enhanced PAH immobilization and improved plant resilience, providing a sustainable approach for remediation of contaminated agricultural soils and protection of food security.

PMID:41928033 | DOI:10.1007/s10653-026-03176-x

Aesthetic Plast Surg. 2026 Apr 2. doi: 10.1007/s00266-026-05802-6. Online ahead of print.

ABSTRACT

BACKGROUND: Trapezius hypertrophy is a significant aesthetic concern among women. Botulinum toxin has emerged as a potential treatment option for this condition. In this study, we conducted a prospective, randomized, double-blind trial to evaluate the effectiveness and safety of letibotulinumtoxinA specifically for women.

METHODS: We conducted a prospective study between July 2022 and June 2023, recruiting 20 patients seeking treatment for trapezius hypertrophy. LetibotulinumtoxinA (Botulax®) was used as the neurotoxin. The patients were randomized into group A (n = 10, 40 units) and group B (n = 10, 80 units). Each group received different doses of toxin at 10 injection points along the trapezius muscle.

RESULTS: We analyzed the contour changes in two groups and calculated the average area before and after treatment. After 12 weeks post-treatment, both groups demonstrated a decrease in the trapezius area with statistically significant differences (p = 0.011, p = 0.005). The median satisfactory score was 4, indicating a moderate level of satisfaction in both groups. No statistically significant differences or complications were observed between the groups.

CONCLUSION: LetibotulinumtoxinA for trapezius hypertrophy demonstrated efficacy with no differences between two experimental groups. Aesthetic concerns were addressed, enhancing shoulder and neck appearance with a high degree of satisfaction.

LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:41927997 | DOI:10.1007/s00266-026-05802-6

Eur Radiol. 2026 Apr 2. doi: 10.1007/s00330-026-12520-9. Online ahead of print.

NO ABSTRACT

PMID:41927981 | DOI:10.1007/s00330-026-12520-9

Eur Radiol. 2026 Apr 2. doi: 10.1007/s00330-026-12494-8. Online ahead of print.

ABSTRACT

OBJECTIVES: Sentinel lymph node (SLN) biopsy remains the standard for axillary staging in early-stage breast cancer, though ongoing clinical investigations are exploring the omission of axillary procedures in specific subgroups. This study assessed whether axillary ultrasonography (US) and MRI can predict SLN involvement and developed a predictive tool to identify patients who may safely forgo axillary surgery.

MATERIALS AND METHODS: We retrospectively analyzed 8114 patients with cT1-T2N0 invasive breast cancer across three cancer centers in China. All patients underwent preoperative axillary US and/or MRI. Multivariate logistic regression identified independent predictors of SLN metastases, which were used to construct a predictive model. The model was validated using a 70:30 training-validation split and visualized through a nomogram. Subgroup analyses evaluated the risk of SLN involvement among patients with negative imaging findings.

RESULTS: SLN metastases were observed in 2545 patients (31.37%), with clinical T2 stage, lymphovascular invasion, Ki-67 ≥ 20%, ER + /HER2- subtype, and positive findings on US or MRI independently associated with SLN involvement (p < 0.001). Among 2282 patients with negative US and MRI findings, the SLN metastasis rate was 16.39%. The multivariable predictive model integrating imaging findings with clinicopathologic variables demonstrated good performance, with an AUC of 0.775 (95% CI: 0.750-0.801) in the training set and 0.759 (95% CI: 0.740-0.778) in the validation set. Notably, omission of axillary surgery would miss nodal metastases in 17.4% of patients eligible for CDK4/6 inhibitors.

CONCLUSION: Preoperative US and MRI are valuable for identifying low-risk patients. The prediction model may help select early-stage breast cancer patients for whom axillary surgery can be safely omitted while minimizing undertreatment risks for adjuvant therapies.

KEY POINTS: Question Can preoperative axillary ultrasound and MRI reliably stratify lymph node metastasis risk in patients with early-stage breast cancer? Findings A multivariate nomogram developed from 8,114 patients showed consistent predictive accuracy for axillary metastasis (AUC: 0.775 in training; 0.759 in validation cohort). Clinical relevance This model supports individualized axillary management by identifying patients who may safely avoid axillary surgery while preserving accurate nodal risk stratification for adjuvant systemic therapy and radiotherapy decision-making.

PMID:41927980 | DOI:10.1007/s00330-026-12494-8