Abstract:With the popularity of imaging examination and the increase in average life expectancy, the detection rate of pancreatic cystic neoplasm (PCN) is also increasing.Different subtypes of PCN have different risks of malignancy, therefore, accurate stratification of the malignant potential is crucial for providing surveillance plans and making surgical decision.In recent years, many guidelines have identified several imaging features (cyst size, mural nodules, and main pancreatic duct diameter) as risk factors for PCN malignancy.However, the measurement standards for individual feature are not uniform and their diagnostic capabilities are limited; models that integrate multiple features perform poorly in diagnosis.This article reviews the value of imaging risk factors in PCN malignancy prediction and the application of radiomics and artificial intelligence, providing direction for further imaging research and improving the accuracy of preoperative PCN risk stratification.

Abstract:Objective To analyze the incidence and mortality of pancreatic cancer in 2022 globally and in China based on the Global Cancer Statistics 2022 published by the International Agency for Research on Cancer, considering characteristics such as gender, age, and human development index (HDI). Methods Pancreatic cancer data from 185 countries and regions were sourced from the GLOBOCAN 2022 database, and HDI data were compiled based on the Human Development Report 2022 published by the United Nations Development Programme.Cancer data were stratified by age, gender, and HDI to describe the prevalence of pancreatic cancer globally and in China.Pearson correlation analysis was used to evaluate the correlation of standardized incidence rate (SIR), standardized mortality rate (SMR), and mortality-to-incidence ratio (M/I) with HDI. Results In 2022, the number of pancreatic cancer incident cases worldwide was 510 992, ranking 12^th among all cancer incidents, with an SIR of 4.7 per 100 000 (ranking 15^th).The number of pancreatic cancer deaths globally was 467 409, ranking 6^th among all cancer deaths, with an SMR of 4.2 per 100 000 (ranking 9^th).In China, the number of pancreatic cancer incident cases was 118 672 (ranking 10^th among all cancer incidents), accounting for 23.22% of the global pancreatic cancer incidents, with an SIR of 4.4 per 100 000 (ranking13^rd).The number of pancreatic cancer deaths in China was 106 295 (ranking 6^th among all cancer deaths), accounting for 22.74% of the global pancreatic cancer deaths, with an SMR of 3.9 per 100 000 (ranking 8^th).The incidence, mortality, SIR, and SMR in males were higher than those in females both globally and in China.SIR and SMR were positively correlated with HDI (r=0.77 and 0.77, both P＜0.001), while M/I was negatively correlated with HDI (r=-0.43, P＜0.001).The incidence, mortality, SIR and SMR of pancreatic cancer showed an increasing trend with age, and rapidly increased from 45-49 years old. Conclusion The disease burden of pancreatic cancer is serious globally and in China.The incidence and mortality of pancreatic cancer show an upward trend with age, and they are higher in males than in females.HDI is positively correlated with SIR and SMR of pancreatic cancer, while negatively correlated with M/I.

Abstract:Objective To analyze the burden and trends of esophageal cancer in China from 1990 to 2021, and compare them with Japan and South Korea. Methods Based on the global burden of disease 2021 database, the incidence, mortality, and disability-adjusted life years (DALYs) of esophageal cancer and the corresponding age-standardized rates in China from 1990 to 2021 were analyzed and descriptively studied according to different ages and genders, and compared with Japan and South Korea.The estimated annual percentage change and relative variation were used to evaluate the trend of the burden of esophageal cancer.Four risk factors, including smoking, alcohol consumption, low-vegetable diet, and chewing tobacco, were included and the proportions of esophageal cancer DALYs and death burden attributable to each risk factor were analyzed.Breakdown analysis method was used to analyze the contribution of population growth, population aging, and epidemiological changes to the incidence of esophageal cancer.The age-period-cohort model was used to analyze the effect trends of age, period, and birth cohort on the incidence of esophageal cancer.Pearson correlation analysis was used to evaluate the correlation between age-standardized DALYs rate and socio-demographic index (SDI).The number of incident cases and age-standardized incidence rate (ASIR) of esophageal cancer in China over the subsequent 20 years were predicted by autoregressive integrated moving average model. Results In 2021, the number of incident cases, number of deaths, and DALYs of esophageal cancer in China were 320 805, 296 443 and 6 898 666, respectively, with increases of 54.61%, 40.61%, and 17.88% over 1990.In 2021, the ASIR, age-standardized mortality (ASMR), and age-standardized DALYs rate of esophageal cancer in China were 15.04/100 000, 14.13/100 000, and 317.18/100 000, respectively, which were higher than those in Japan (6.22/100 000, 3.81/100 000, and 84.34/100 000, respectively) and South Korea (3.52/100 000, 2.29/100 000, and 50.15/100 000, respectively).The burden of esophageal cancer in males was higher than that in females in the 3 countries.In 2021, smoking and alcohol consumption were the 2 major risk factors for esophageal cancer death in China; the increase in the number of incident cases was mainly caused by population growth and population aging.In addition, the ASIR of esophageal cancer in China increased with age, peaking at 85-89 years old.From 1990 to 2021, SDI was negatively correlated with age-standardized DALYs rate of esophageal cancer in China, Japan, and South Korea.It was predicted that by 2041, the ASIR of esophageal cancer in China would continue to decrease to 9.14/100 000, but the number of incident cases would increase to 398 200. Conclusion The burden of esophageal cancer in China remains substantial.In the future, it will be crucial to strengthen the prevention and control of risk factors such as smoking and alcohol consumption.Additionally, efforts should be made to promote early screening, diagnosis, and treatment, particularly among high-risk populations.

Abstract:Objective To investigate the influencing factors of long-term mortality in patients with acute myocardial infarction (AMI). Methods The data of AMI patients hospitalized in Department of Cardiovasology of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan.2007 to Dec.2018 were collected.The patients who survived in the hospital were followed up, and the influencing factors and their predictive value for long-term mortality were analyzed by Cox survival analysis and receiver operating characteristic (ROC) curve. Results A total of 4 868 patients with AMI were included, of which 261 died in hospital and 1 081 were lost to follow-up.A total of 3 526 patients were followed up.Advanced age, diabetes mellitus, smoking, and elevated serum creatinine, lipoprotein(a) and troponin were independent risk factors for long-term mortality in AMI patients.For every 1-year increase in the age of onset, the risk of long-term mortality increased by 7.5% (hazard ratio ［HR］=1.075, 95% confidence interval ［CI］ 1.064-1.086, P＜0.001).The long-term mortality risk of smokers with AMI was 1.261 times that of non-smokers (HR= 1.261, 95% CI 1.023-1.555, P＜0.05).The long-term mortality risk of diabetes patients with AMI was 1.307 times that of non-diabetes patients (HR=1.307, 95% CI 1.073-1.592, P＜0.01).Primary percutaneous coronary intervention (PCI) or elective PCI, use of statins, use of β-blockers, and elevated hematocrit were protective factors for long-term mortality.The risk of long-term mortality in patients treated with primary PCI or elective PCI was reduced by 46.9% and 54.8%, respectively (HR=0.531, 95% CI 0.398-0.707, P＜0.001; HR=0.452, 95% CI 0.353-0.580, P＜0.001), reduced by 39.2% in patients treated with statins (HR=0.608, 95% CI 0.408-0.906, P＜0.05), and reduced by 17.7% in patients treated with β-blockers (HR=0.823, 95% CI 0.678-0.998, P＜0.05).ROC curve analysis results showed that except for age (area under curve ［AUC］=0.773), the predictive value of serum creatinine, lipoprotein(a), hematocrit, and troponin for long-term mortality was relatively low in AMI patients (AUC=0.636, 0.564, 0.667, and 0.524). Conclusion Primary PCI or elective PCI and use of statins or β-blockers can improve the long-term prognosis of patients with AMI, while advanced age, diabetes mellitus, and smoking may increase the risk of long-term mortality.

Abstract:Objective To evaluate the long-term efficacy of tumor necrosis factor-α(TNF-α) inhibitor (TNFi) in the treatment of ankylosing spondylitis (AS) complicated with osteoporosis (OP) and the impact on bone metabolism, bone density, and inflammatory factors. Methods The data of 158 patients with AS and OP, who were admitted to Department of Rheumatology and Immunology of The First Affiliated Hospital of Naval Medical University (Second Military Medical University) from Jan.1, 2010 to Dec.31, 2017, were retrospectively collected.The patients were divided into bisphosphonate group (n=54), TNFi group (n=58), and TNFi＋bisphosphonate group (n=46) according to the treatment methods.All patients were treated with calcium combined with calcitriol as the background treatment.After 5 years of treatment, Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) scores were evaluated, and inflammatory indexes, bone metabolism markers, and bone mineral density were detected. Results After 5 years of treatment, the BASDAI and BASFI scores, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), TNF-α, and interleukin-17A of the TNFi＋bisphosphonate group and TNFi group were significantly lower than those before treatment (all P＜0.05); in the bisphosphonate group only ESR and CRP were significantly lower than those before treatment (both P＜0.05), and the other inflammatory indexes and BASDAI and BASFI scores showed no significant changes (all P＞0.05).The bone mineral density of the 3 groups after 5 years of treatment was significantly higher than that before treatment (all P＜0.05), and the bone mineral density of the TNFi＋bisphosphonate group was significantly higher than that of the other 2 groups (both P＜0.05).After 5 years of treatment, the levels of parathyroid hormone (PTH), procollagen type 1 N-terminal propeptide (P1NP) and β-C-terminal telopeptide of type Ⅰ collagen (β-CTX) in the TNFi＋bisphosphonate group and bisphosphonate group were significantly decreased compared with those before treatment (all P＜0.05), while the levels of N-terminal midfragment of osteocalcin (N-MID) and 25-hydroxy-vitamin D (25VitD) were significantly increased (all P＜0.05); in the TNFi group only PTH and P1NP levels were significantly decreased (both P＜0.05), while β-CTX, N-MID and 25VitD levels showed no significant differences (all P＞0.05). Conclusion Long-term use of TNFi in patients with AS and OP can effectively reduce disease activity, improve physical function, decrease the level of inflammatory factors, alleviate abnormal bone metabolism, and increase bone mineral density; and the combined use of TNFi and bisphosphonates has better efficacy.

Abstract:Objective To observe the morphology of maxillary sinus floor septa using cone beam computed tomography (CBCT), and to analyze its relationships with gender, age, and maxillary sinus volume. Methods Totally 375 patients (750 maxillary sinuses) who underwent CBCT were retrospectively selected from Department of Stomatology of The First Affiliated Hospital of Naval Medical University (Second Military Medical University).The DICOM file data of CBCT images were fed into Mimics 22.0 software to reconstruct 3-dimensional images of maxillary sinuses, and the occurrence, position, and height of maxillary sinus floor septa were observed and the volume of maxillary sinus was measured.The relationships of the maxillary sinus floor septum incidence with gender, age, and maxillary sinus volume were analyzed. Results Of the 750 maxillary sinuses 130 showed sinus floor septa, with incidence of 17.3%.The incidence rates of maxillary sinus floor septa in males and females were 18.5% (63/340) and 16.3% (67/410), respectively, with no significant difference (P=0.431).The incidence rates of maxillary sinus floor septa in the age groups of 18-30 years, 31-45 years, 46-60 years, and ＞60 years were 12.7% (29/228), 16.5% (32/194), 23.1% (36/156), and 19.2% (33/172), respectively, with no significant difference (P=0.058).The incidence rates of maxillary sinus floor septa in the groups with maxillary sinus volumes of 0-10 cm³, 11-20 cm³, and ＞20 cm³ were 7.1% (14/196), 19.9% (54/271), and 21.9% (62/283), respectively, with a significant difference (P=0.001).A total of 168 maxillary sinus floor septa were detected, of which 24 (14.3%) were located in the anterior part of the maxillary sinus, 84 (50.0%) in the middle part, and 60 (35.7%) in the posterior part.The heights of the maxillary sinus floor septa in the anterior, middle, and posterior parts of the maxillary sinus were (5.75±1.84), (9.08±3.77), and (6.41±1.76) mm, respectively, with a significant difference (P＜0.001). Conclusion The detection rate of maxillary sinus floor septa increases with the expansion of the maxillary sinus volume.CBCT can provide accurate information about the position and size of the maxillary sinus floor septa, providing a basis for clinical maxillary sinus floor elevation surgery.

Abstract:Objective To analyze the transcriptome data of Zika virus (ZIKV)-infected human neuroblastoma cells SH-SY5Y by bioinformatics method, and to identify the potential genes involved in the pathogenic mechanism of ZIKV. Methods SH-SY5Y cells were infected with ZIKV.The total RNA was extracted and the differentially expressed genes (DEGs) were screened by transcriptome sequencing.Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to predict the biological processes, molecular functions, and signaling pathways mainly involved in the DEGs, and the results were verified by quantitative polymerase chain reaction (qPCR). Results A total of 259 DEGs were identified, including 172 up-regulated genes and 87 down-regulated genes.GO functional enrichment analysis showed that the DEGs were mainly related to extracellular matrix, response to stimulus, antimicrobial humoral response, and developmental process.KEGG pathway enrichment analysis revealed that the DEGs were predominantly associated to inflammatory reaction and immune response.The qPCR validation results of DEGs were basically consistent with the transcriptome sequencing results. Conclusion The expression of genes involved in extracellular matrix, response to stimulus, and regulation of inflammatory reaction is significantly altered in SH-SY5Y cells after ZIKV infection, suggesting that ZIKV may cause neurological lesions by remodeling the extracellular matrix and regulating inflammatory reaction.

Abstract:Objective To detect the expression of translationally-controlled tumor protein 1 (TPT1) in renal cell carcinoma (RCC) and to explore its role in RCC. Methods Microarray dataset GSE15641 (including 23 normal kidney tissue samples and 32 RCC tissue samples) was downloaded from the Gene Expression Omnibus, and differentially expressed genes between RCC tissue and normal kidney tissue were screened using R 4.3.0 software.The TPT1 expression in RCC tissue and adjacent non-tumor tissue of 90 patients diagnosed and treated at Affiliated Hospital of Nantong University, as well as in human RCC cells (769-P, 786-O, ACHN, and Caki-1) and human embryonic kidney 293 cell (HEK293) was detected by quantitative polymerase chain reaction (qPCR) and Western blotting.The relationship between TPT1 expression and clinical pathological characteristics of RCC patients was analyzed by χ² test.The clinical data of 522 RCC patients were derived from The Cancer Genome Atlas, and the correlation between TPT1 expression and prognosis of RCC patients was analyzed by receiver operating characteristic (ROC) curve and Kaplan-Meier survival curve.After in vitro transfection of TPT1 small interfering RNA (siRNA) and its negative control (NC) into 786-O and Caki-1 cells, the TPT1 expression was detected by qPCR and Western blotting; the proliferation, migration, and invasion were detected by cell counting kit 8 assay, scratch assay, and Transwell assay, respectively; and the expression of apoptosis-related proteins was detected by Western blotting. Results TPT1 expression was significantly upregulated in the RCC tissue and cells compared with the normal kidney tissue and HEK293 cells (all P＜0.05).The RCC patients with low TPT1 expression levels had significantly smaller tumor size and lower metastasis rate than those with high TPT1 expression levels (both P＜0.05).The ROC curve analysis results indicated that TPT1 had high diagnostic value for RCC (area under curve was 0.856 9, 95% confidence interval was 0.804 5-0.909 3, P＜0.001).The Kaplan-Meier survival analysis results showed that the overall survival of RCC patients in the low TPT1 expression group was significantly longer than that in the high TPT1 expression group (P=0.018 4).In the cell experiment, compared with the siRNA NC group, the proliferation activity, scratch healing rate, and invading transmembrane cell number of 786-O and Caki-1 cells were significantly decreased after transfection with TPT1 siRNA (all P＜0.01); the expression levels of B-lymphoma gene 2 (Bcl-2) and matrix metalloproteinase-9 were significantly decreased, while the expression of Bcl-2 associated X protein was significantly increased (all P＜0.05). Conclusion TPT1 is involved in the progression of RCC and may be a potential therapeutic target for RCC.

Abstract:Objective To mine valid information in public databases through bioinformatics analysis and machine learning models and to identify candidate genes related to preeclampsia, so as to improve the accuracy of early diagnosis and provide targets for pathogenesis, diagnosis and treatment research. Methods The RNA-seq datasets of placental tissue samples of preeclampsia patients and healthy pregnant women were retrieved from the Gene Expression Omnibus, and the gene expression matrix was obtained after data download, quality control, comparison and quantification through bioinformation analysis.The differentially expressed genes were screened by DESeq2 1.38.3, the enrichment pathway was determined using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes, the co-expression network was constructed using weighted gene co-expression network analysis (WGCNA), and the machine learning prediction model was established by random forest algorithm. Results A total of 49 common differentially expressed genes were screened from placental tissue samples of 156 pregnant women (70 preeclampsia patients and 86 healthy pregnant women) in 4 datasets and they were significantly enriched in extracellular regions, positive regulation pathway of follicle-stimulating hormone secretion, hormone activity pathway, and cytokine-cytokine receptor interaction pathway, etc.The 49 differentially expressed genes were categorized into 7 co-expression modules by WGCNA, and key modules highly related to preeclampsia were identified.Six candidate key genes (fms related receptor tyrosine kinase 1 ［FLT1］, pappalysin 2 ［PAPPA2］, protein phosphatase 1 regulatory inhibitor subunit 1C ［PPP1R1C］, myosin ⅦB ［MYO7B］, long intergenic non-protein coding RNA 2009 ［LINC02009］, and inhibin subunit α ［INHA］) were screened.The random forest model based on these 6 key genes had good predictive value for preeclampsia (area under curve was 0.978). Conclusion Preeclampsia may be associated with genes for hormone secretion, immune response, angiogenic factors, pregnancy-associated plasma proteins, and inhibin, and these genes may be candidate diagnostic markers of preeclampsia.

Abstract:An ideal ionizing radiation biomarker should be able to quickly, conveniently and accurately assess the radiation dose received by individuals, and can predict the effect of radiation-induced damage.Radiation dose assessment based on gene or molecular expression profiles is a research focus in the field of radiation biodosimetry.Non-coding RNA and proteomics have the characteristic of high-throughput that allows for rapid and real-time detection, making them highly potential for radiation biodosimetry research.This paper summarizes the research progress of non-coding RNA and proteins as potential radiation biomarkers in recent years, and also reviews their influencing factors and application scenarios.

Abstract:Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in China.When HCC is diagnosed, most patients have been at the middle or advanced stage and have lost the chance of radical resection.In recent years, the roles of targeted therapy, immunotherapy, and radiotherapy have become increasingly prominent in the treatment of unresectable HCC.Although HCC is sensitive to radiation, the clinical value of radiotherapy is often underestimated due to the low tolerance of liver to radiation.With the development of radiotherapy technology, radiotherapy has been widely used in unresectable HCC.Patients can gain more survival benefits whether treated with radiotherapy alone or in combination with other treatments.This review focuses on the application and progress of radiotherapy and its combination therapy in unresectable HCC.

Abstract:Ankylosing spondylitis is a refractory autoimmune disease, and heterotopic ossification is one of the most important pathological features.The mechanism of heterotopic ossification in ankylosing spondylitis involves many aspects, including ossification-related genes, ossification-related factors, ossification-related cells, ossification signaling pathways, and mechanical stress.This article elaborates the pathogenesis of heterotopic ossification in ankylosing spondylitis from different aspects of multiple channels, pathways, targets, and factors, hoping to provide reference for expanding clinical and basic research and in-depth understanding of ankylosing spondylitis.

Abstract:Objective To study the splenic injuries caused by high-altitude falling and underwater explosion and the 2-dimensional ultrasound and contrast-enhanced ultrasound (CEUS) characteristics. Methods Twenty-three healthy Beagle dogs were divided into high-altitude falling group (n=13) and underwater explosion group (n=10).Free-fall high-platform device and gram-grade trinitrotoluene were used to simulate high-altitude falling injury and underwater explosion injury in Beagle dogs, respectively.Ultrasound examination of the spleen was performed immediately after injury, with follow-up examinations every hour.CEUS examination was performed in surviving dogs.Spleen specimens were taken from deceased dogs after injury to observe gross injuries.Pathological changes in tissue morphology and cell apoptosis were observed by hematoxylin-eosin (H-E) staining. Results In the high-altitude falling model, 6, 2, 1, and 1 dogs died in the 6 m, 7 m, 8 m, and 9 m groups, respectively; in the underwater explosion model, 1 and 4 dogs died in the buoyancy and frogman groups, respectively.Two-dimensional ultrasound examination of the high-altitude falling model showed spleen rupture (disruption of splenic parenchymal structure), perisplenic fluid accumulation, subcapsular hematoma, intrasplenic hematoma, increased splenic vein echo, and uneven splenic parenchymal echo.Two-dimensional ultrasound examination of the underwater explosion model showed increased splenic vein echo and uneven splenic parenchymal echo, which were less serious compared with the high-altitude falling model.CEUS results indicated 4 major contrast patterns in both models.The Beagle dogs with type Ⅰ (large focal contrast defect), type Ⅱ (diffuse contrast defect), or type Ⅲ (no contrast agent entry into the splenic vein) contrast patterns all had splenic rupture after injury.H-E staining results showed true splenic rupture, diffuse intrasplenic hemorrhage, splenic hematoma/ecchymosis, subcapsular hematoma/ecchymosis, and venous congestion after spleen injury, which were consistent with the 2-dimensional ultrasound findings. Conclusion High-altitude falling causes more serious spleen injuries in Beagle dogs compared with underwater explosions.Routine ultrasound performs well in diagnosing typical splenic injuries, while CEUS has advantages in evaluating atypical splenic injuries and has good predictive ability for delayed splenic rupture.

Abstract:Objective To develop a military identity scale and to evaluate its reliability and validity. Methods The theoretical and structural models of the scale were determined based on literature review and interviews. An item pool was established, test items were compiled, and the basic items were formed after revision by experts. Several servicemen were selected. Sample 1 was used for item analysis and exploratory factor analysis, and sample 2 was used for confirmatory factor analysis and internal consistency test. The reliability of the scale was tested by Cronbach’s α coefficient and split-half reliability. The construct validity was tested by correlation analysis and confirmatory factor analysis. The military job burnout scale was used as criteria to test the criterion validity. Results The scale finally included 23 items in 4 factors (cognition, affection, sense of adaptation, and efficacy), which explained 54.087% of the total variance. The Cronbach’s α coefficient of the scale was 0.925, and the Cronbach’s α coefficients of the 4 factors were 0.843, 0.899, 0.854, and 0.835, respectively. The split-half reliability of the scale was 0.873, and the split-half reliability of the 4 factors was 0.812, 0.882, 0.870, and 0.821, respectively. The scale had good construct validity (the goodness of fitting χ²/df was 1.978, the comparative fit index was 0.927, the growth fitting index was 0.928, the Tucker-Lewis index was 0.916, the root mean square error of approximation was 0.055, and the goodness of fit index was 0.896). Conclusion The military identity scale developed in this study has good validity and reliability, and can be used to evaluate the identity of servicemen in China.

Abstract:Objective To investigate the risk factors of pharyngocutaneous fistula (PCF) after total laryngectomy for hypopharyngeal cancer. Methods The clinical data of 89 hypopharyngeal cancer patients, who underwent total laryngectomy in The Affiliated Cancer Hospital of Nanjing Medical University from Jan.2009 to Dec.2019, were retrospectively analyzed.The patients were divided into PCF group and non-PCF group.The risk factors of PCF related to patient, disease, and treatment were analyzed. Results Among the 89 patients, 20 cases had postoperative PCF and 69 had no PCF.The overall incidence of PCF was 22.5%.Univariate analysis showed that the proportions of patients with diabetes mellitus (P=0.031), preoperative chemoradiotherapy (P=0.021), preoperative hypoalbuminemia (P=0.008), postoperative hypoalbuminemia (P=0.002), and flap repair (P=0.034) in the PCF group were significantly higher than those in the non-PCF group.Multivariate logistic regression analysis showed that postoperative albumin level was an independent protective factor for PCF (odds ratio=0.174, 95% confidence interval 0.048-0.626, P=0.007). Conclusion The hypopharyngeal cancer patients with diabetes mellitus, perioperative hypoalbuminemia, or preoperative chemoradiotherapy are more likely to develop PCF after total larynegctomy.

Abstract:Objective To reduce the mechanical impact caused by postoperative creep and relaxation of tendon grafts by pre-setting high-strength sutures using suture weaving. Methods Fresh pig tendo calcaneus specimens were used to prepare 30 anterior cruciate ligament tendon grafts, and they were randomly divided into control group, 2-strand suture implantation group, and 4-strand suture implantation group, with 10 tendon grafts in each group.The control group were not given suture implantation in the tendon grafts, and the 2- and 4-strand suture implantation groups were pre-set 2 and 4 strands of high-strength No.2 sutures, respectively.The tendon grafts in each group were subjected to 1, 100, 500, 1 000, 1 500, 2 000, 2 500, and 3 000 fatigue tests in turn, and the relaxation was recorded.Finally, the tendon grafts in each group were pulled to failure at a constant rate of 5 cm/min, and the traction force when the relaxation reached 5 mm, i.e.the failure load, was recorded. Results The relaxation of tendon grafts after each fatigue test was significantly lower in the 2- and 4-strand suture implantation groups than that in the control group, and the relaxation was significantly lower in the 4-strand suture implantation group than that in the 2-strand suture implantation group (all P＜0.05).The failure loads of tendon grafts were significantly higher in the 2- and 4-strand suture implantation groups than that in the control group, and the failure load was significantly higher in the 4-strand suture implantation group than that in the 2-strand suture implantation group (all P＜0.05). Conclusion Pre-setting high-strength sutures in tendon grafts by suture weaving can effectively improve the mechanical properties of tendon grafts.

Abstract: