Objective To investigate the associations of circulating inflammatory proteins and risk of psoriasis by using a two-sample Mendelian randomization (MR) approach. Methods Based on the genome-wide association study (GWAS) of inflammatory proteins and psoriasis, genetic variants associated with circulating inflammatory proteins were selected as instrumental variables (IVs), and genetic association data of psoriasis were extracted. The inverse-variance weighted method was used as the primary MR method, with statistical power analysis conducted to evaluate the test power. MR-Egger regression, weighted median, maximum likelihood, and MR Pleiotropy RESidual Sum and Outlier (PRESSO) tests were used to evaluate the influence of horizontal pleiotropy on the MR association estimates. Additionally, as sensitivity analysis, a GWAS of psoriasis from the FinnGen database was used as a replication dataset to evaluate the robustness of the results. Results A total of 558 single nucleotide polymorphisms associated with 74 inflammatory proteins were included. After False Discovery Rate (FDR) corrections, genetically predicted circulating levels of C-X-C motif chemokine ligand 9 (CXCL9) [odds ratio (OR)=1.76, 95% confidence interval (CI) (1.46, 2.11), P=2.31×10?9], C-C motif chemokine ligand 19 (CCL19) [OR=1.41, 95%CI (1.22, 1.62), P=2.97×10?6], and tumor necrosis factor-beta (TNFB) [OR=1.31, 95%CI (1.13, 1.52), P=3.56×10?4] were found to be significantly associated with an increased risk of psoriasis. Sensitivity analyses yielded similar results. Statistical power analysis indicated that the power to detect these associations was greater than 99%. Conclusion Genetically predicted circulating CXCL9, CCL19, and TNFB levels are positively associated with risk of psoriasis.
Objective To investigate the short-term effectiveness of proximal tibial lateral raft plate combined combined with or without Jail screw fixation in the treatment of tibial plateau collapse fractures involved posterior-lateral column. MethodsA retrospective analysis was performed on 106 patients (106 knees) with tibial plateau collapse fracture involved posterior-lateral column admitted between January 2016 and January 2021. According to the combination with Jail screw fixation or not, patients were divided into control group (treated by lateral raft plate without Jail screw fixation, 52 cases) and study group (treated by lateral raft plate with Jail screw fixation, 54 cases). There was no significant difference between the two groups in terms of gender, age, affected knee side, cause of injury, Schatzker classification, Tscherne-Gotzen classification, time from injury to operation, and preoperative lateral tibial plateau posterior slope angle (PSA), tibial plateau varus angle (TPVA), Rasmussen anatomical score (P>0.05). The operation time, cumulative fluoroscopy time, intraoperative blood loss, hospitalization stay, fracture healing time, complications, and lateral tibial plateau PSA, TPVA, Rasmussen anatomical score detected by X-ray films and CT before operation and at 1 year after operation of the two groups were recorded and compared. The number of cases of articular surface collapse in the two groups was recorded at 1 year after operation, and the effectiveness was evaluated by American Special Surgery Hospital (HSS) score. ResultsAll patients were followed up 12-32 months (mean, 19.5 months). There was no significant difference between the two groups in operation time, cumulative fluoroscopy time, intraoperative blood loss, hospitalization stay, and fracture healing time (P>0.05). There were 2 patients (3.7%) in the study group and 3 patients (5.8%) in the control group with superficial wound infection, which were cured after debridement and dressing change. There was no significant difference in the incidence between the two groups (χ2=0.252, P=0.616). There was no complication such as vascular and nerve injury, internal fixation failure, nonunion or malunion of fracture, and deep vein thrombosis of lower limbs in both groups. At 1 year after operation, 9 cases (17.3%) in the control group had joint collapse of 2-3 mm, while only 2 cases (3.7%) in the study group had joint collapse, showing significant difference (χ2=5.271, P=0.022). At 1 year after operation, the PSA, TPVA, and Rasmussen anatomical scores of the two groups were significantly improved when compared with preoperative ones (P<0.05); the differences of pre- and post-operative PSA, TPVA, Rasmussen anatomical score, and postoperative HSS score in the study group were significantly better than those in the control group (P<0.05). ConclusionThe lateral raft plate combined with or without Jail screw fixation can achieve satisfactory short-term effectiveness in the treatment of tibial plateau collapse fractures involved posterior-lateral column. Combined with Jail screw, it can enhance the fixation and avoid the occurrence of secondary articular surface collapse, which can be used as a better choice.
The spine is one of the most common sites for bone metastases from malignant tumors, and its incidence is increasing year by year. It often leads to severe pain, pathological fractures, nerve compression, and spinal cord dysfunction, seriously affecting the quality of life of patients. The comprehensive treatment of spinal metastases with both traditional Chinese and Western medicine has shown significant efficacy, especially in improving clinical symptoms, promoting postoperative recovery as soon as possible, and enhancing the quality of life. Based on the latest research progress at home and abroad and from the perspective of clinical application, this guideline, grounded in evidence-based medical evidence, has formed 25 recommendations covering treatment objectives, efficacy evaluation, rational selection of traditional Chinese medicine, treatment plans, and postoperative rehabilitation. It provides diagnostic and therapeutic suggestions for orthopedic oncologists, oncologists, radiologists, pain specialists, and other professionals engaged in traditional Chinese medicine, Western medicine, or integrated traditional Chinese and Western medicine, as well as specialized nurses.
