Volume 105 · Issue 25 · 2025

Testosterone plays a crucial impact on male growth and development, sexual function, muscle mass, and mental health. In recent years, the role of testosterone in regulating energy metabolism via multiple targets has increasingly drawn attention. It can not only enhance insulin sensitivity but also promote lipolysis, thus offering novel insights into the prevention and treatment of diabetes mellitus, fatty liver, and obesity. Timely testosterone supplementation in adult male patients with type 2 diabetes mellitus and obesity may bring significant metabolic benefits.

In recent years, hip arthroscopy has made great progress and has been extended to the treatment of intra-articular or periarticular diseases. However, the complex structure of the hip joint, high technical operation requirements and relatively long learning curve have hindered the popularization and development of hip arthroscopy in China. Therefore, on the one hand, it is necessary to promote the research and training of standardized techniques for the diagnosis of hip disease and the treatment of arthroscopic surgery, so as to improve the safety, effectiveness and popularization of the technology. On the other hand, our organization proactively leverages cutting-edge digitalization and intelligentization technologies, including medical image digitalization, medical big data analytics, artificial intelligence, surgical navigation and robotic control, virtual reality, telemedicine, and 5G communication technology. We conduct a range of innovative research and development initiatives such as intelligent-assisted diagnosis of hip diseases, digital preoperative planning, surgical intelligent navigation and robotic procedures, and smart rehabilitation solutions. These efforts aim to facilitate a digitalization and intelligentization leap in technology and continuously enhance the precision of diagnosis and treatment. In conclusion, standardization promotes the homogenization of diagnosis and treatment, while digitalization and intelligentization facilitate the precision of operations. The synergy of the two lays the foundation for personalized diagnosis and treatment and continuous innovation, ultimately driving the rapid development of hip arthroscopy technology.

The chondrolabral junction is defined as the cartilage of the transition zone on the acetabulum within 5 mm of the labral attachment point. Chondrolabral junction injury can lead to limitation of hip movements such as flexion and rotation, and may cause clinical problems such as pain, hip instability, and secondary joint degeneration. This article summarizes studies on the outcomes of arthroscopic surgery for chondrolabral junction injuries, comparing the surgical efficacy and prognostic differences among various types of chondrolabral junction lesions. The analysis of chondrolabral junction injuries and the assessment of their predictive value provide a reference for the development of surgical protocols and postoperative rehabilitation plans.

The outside-in longitudinal capsulotomy is an emerging and appealing technique in hip arthroscopy. This technique has its unique features in portal establishment and capsular incision, differing from the traditional inter-portal capsulotomy. Although its clinical use is becoming increasingly popular, there is no consensus in clinical practice. The Hip Joint and Spine Group of the Sports Medicine Branch of the Chinese Medical Association and Hip joint Group of the Sports Medicine Branch of the Chinese Medical Doctor Association initiated this project to reach an expert consensus using a modified Delphi method through literature analysis and expert discussion. This consensus finally gives 14 recommendations covering the definition, indications, key step of capsulotomy, capsular management, postoperative rehabilitation and the advantages and disadvantages of this technique, aiming to provide guidance and reference for the standardized application of the outside-in longitudinal capsulotomy.

Neurovascular compression is the primary etiology of classical trigeminal neuralgia. Microvascular decompression can achieve clinical cure by relieving the compression of responsible blood vessels on the trigeminal nerve. However, secondary trigeminal neuralgia caused by primary neurological diseases such as multiple sclerosis and tumors, as well as idiopathic trigeminal neuralgia with unclear etiology, exhibit distinct pathogenesis, diagnostic criteria, and treatment principles compared to classical trigeminal neuralgia. Due to the lack of standardized diagnostic and therapeutic guidelines for these types of trigeminal neuralgia internationally, clinical practice often faces issues such as unclear diagnosis and classification, poor treatment outcomes, and frequent complications, which have drawn significant attention from experts. Therefore, the Specialized Committee on Neurorestoratology of Chinese Medical Doctor Association, Specialized Committee on Peripheral Nerve Surgery of Chinese Medical Doctor Association, and International Association of Neurorestoratology, in collaboration with experts from neurosurgery and painology departments across 25 domestic medical centers, systematically developed 19 recommendations based on the latest medical evidence and multidisciplinary clinical experience. These recommendations address diagnosis, differential diagnosis, imaging examinations, pharmacological treatment, and surgical interventions, aiming to standardize the clinical management of trigeminal neuralgia.

The secretion of growth hormone progressively decreases with advancing age, and some of the elderly develop age-related growth hormone deficiency. Physiological concentration of growth hormone is crucial for the regulation of material metabolism and the maintenance of organ and systemic functions in adults. Clinically, adult growth hormone deficiency manifests as a complex constellation of symptoms including obesity, fatty liver, sarcopenia, osteoporosis, diminished sexual function, reduced physical performance, and depression, which are partially analogous to the clinical phenotypes of aging. For patients with clearly identified causes or those with age-related growth hormone deficiency, physiological doses of growth hormone supplementation therapy can significantly improve the aforementioned symptoms. Consequently, adult growth hormone deficiency is considered as one of the endocrine causes for certain aging symptoms. Currently, clinicians have insufficient awareness of this issue. Age-related growth hormone deficiency should logically be an integral part of adult growth hormone deficiency, yet it has not received sufficient clinical attention and emphasis. The Pubertal Development and Gonadal Disorders Committee from Chinese Aging Well Association and Society of Endocrinology and Metablic Disease, China National Health Association organized 34 domestic experts from fields including endocrinology, nutrition, geriatric medicine, and sports medicine. Based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for clinical evidence levels, they formulated expert consensus and proposed coping strategies centered around key scientific issues related to growth hormone therapy for anti-aging, including the target population for treatment, treatment risks and benefits, and the duration of treatment courses. By integrating the evaluation opinions from the Delphi method, 16 recommendation statements aiming to standardize the application of growth hormone therapy on anti-aging were finally determined. And in response to various issues in the field of growth hormone anti-aging therapy, the future research directions have been proposed.

To evaluate the clinical efficacy of a modified outside-in longitudinal capsulotomy using the indirect head of the rectus femoris (IHRF) as an anatomical landmark in arthroscopic treatment of femoroacetabular impingement (FAI) and acetabular labral tears.

Clinical data of 59 patients with FAI and labral tears undergoing hip arthroscopy at the First Hospital of Jilin University from June 2021 to May 2023 were retrospectively analyzed. The patients were divided into two groups based on surgical approach: 34 patients underwent capsulotomy using the iliocapsularis muscle as a landmark (iliocapsularis group), while 25 patients underwent IHRF-guided capsulotomy (IHRF group). Both groups received standardized procedures, including acetabuloplasty, labral repair, and cam osteoplasty. The clinical parameters (surgical time, traction time, complications), functional scores [visual analog scale (VAS) of pain, modified Harris Hip Score (mHHS), Hip Outcome Score (HOS), International Hip Outcome Tool-12 (iHOT-12), Hip Disability and Osteoarthritis Outcome Score (HOOS-12)], and radiographic outcomes [α angle, lateral center-edge angle (LCEA), Tönnis grade] were compared preoperatively and at final follow-up between the two groups.

No significant differences in baseline demographics (gender, age, body mass index) were observed between the groups (all P>0.05). The IHRF group demonstrated shorter surgical time [(70.6±8.8) vs (86.2±7.4) minutes] and traction time [(35.2±5.8) vs (44.6±5.3) minutes] when compared to those in the iliocapsularis group (both P<0.05). All patients were followed-up for at least 12 months. Postoperatively, both groups exhibited significant improvements in VAS, mHHS, HOS, iHOT-12, and HOOS-12 scores (all P<0.05). Complication rates were comparable between the IHRF and iliocapsularis group [4.0%(1/25) vs 5.9%(2/34), P=0.911]. Radiographically, alpha angles decreased significantly in both groups (iliocapsularis group: 60.7°±3.2° vs 40.1°±3.1°; IHRF group: 59.9°±4.1° vs 39.9°±1.9°, both P<0.05), with no intergroup differences in alpha angle, LCEA, or Tönnis grade at the final follow-up (all P>0.05). ​

Arthroscopic longitudinal capsulotomy guided by the IHRF as an anatomical landmark offers comparable efficacy to the iliocapsularis-based approach for FAI and labral tears, with advantages in procedural efficiency and precision.

To compare the efficacy of the "double-strand inverted V-shape" vs the "single-strand looped" suture techniques to treat acetabular labral injuries under hip arthroscopy.

In this study, clinical data of patients diagnosed with femoroacetabular impingement admitted to the Department of Sports Medicine, Orthopedic Medicine Division, the Chinese PLA General Hospital from June 2018 to July 2022 were collected and analyzed retrospectively. Patients were divided into the "double-strand inverted V-shape" (double-strand) and the "single-strand looped" (single-strand) groups based on the surgical suture method for the injured labrum. The two groups were compared in terms of the labral injury extent, number and cost of anchors, and preoperative and postoperative outcomes using the visual analog scale (VAS) for pain, modified Harris Hip score (mHHS), and International Hip Outcome Tool (iHOT-12) scores.

Fifty-eight patients were included, with 30 in the double-strand group, 20 males and 10 females, aged (37.8±10.2) years, and 28 in the single-strand group, 18 males and 10 females, aged (39.3±12.6) years. All patients underwent surgery successfully, and the patients in the double-strand group and single-strand group were followed-up for [M(Q₁, Q₃)] [36.0(24.0, 36.0) and 30.0(24.0, 36.0) months, respectively. The extent of labral injury 3.5 (3.0, 4.0) vs 2.0 (1.5, 2.4) h], the number of anchors [4.0 (4.0, 4.3) vs 3.0 (3.0, 4.0) pins], and the cost of the anchors [7 084 (6 916, 8 603) vs 5 061 (5 061, 6 748) yuan] in the double-strand group were all higher than those of the single-strand group (all P<0.001), but the number of anchors/injury extent [1.2 (1.1, 1.3) vs. 1.5 (1.5, 2.0) pins/h] and anchor cost/injury extent[2 092 (1 949, 2 305) vs. 2 531 (2 531, 3 374) yuan/h] were lower (both P<0.001). There was no statistical significance in the differences of preoperative and postoperative VAS, mHHS, and iHOT scores between the double-strand group and the single-strand group, as well as in the differences of the changes in VAS, mHHS, and iHOT scores before and after surgery (all P>0.05).

The "double-strand inverted V-shape" suture technique for acetabular labral injuries under hip arthroscopy can achieve clinical outcomes similar to the "single-strand looped" suture technique while reducing anchor use and costs under same injury extent, and providing better economic benefits.

To explore the clinical effect of puncture-based limited incision capsulotomy under hip arthroscopy in the treatment of femoroacetabular impingement (FAI).

A retrospective analysis was conducted on the data of patients with FAI who underwent hip arthroscopy surgery at Cangzhou Central Hospital from January 2020 to January 2023. All patients were divided into two groups based on capsular management during hip arthroscopy: the T-shaped capsulotomy group (TS group) and the puncture limited capsulotomy group (PL group). The TS group underwent traditional T-shaped capsulotomy via an outside-in approach, while the PL group received cannula-guided puncture and limited longitudinal capsulotomy via an inside-out approach. By comparing the incidence of postoperative complications, total surgical time (TOT), capsule suturing time (CST), CST/TOT, visual analog scale (VAS) pain score, modified Harris hip joint score (mHHS), nonarthritic hip score (NAHS), and international hip outcome tool-12 (iHOT-12) during preoperative and postoperative period at 6 months and 1 year follow-up between TS and PL group, the clinical efficacy in the two groups was evaluated.

A total of 82 patients were enrolled in this study, 30 males and 52 females with a mean age of (46.0±11.9) years; there were 32 cases (32 hips) in TS group and 50 cases (50 hips) in PL group. The TOT[(62.2±7.9) vs (50.2±7.2)min], CST[17.0(15.0, 22.8) vs 9.0(7.8, 10.0) min], and CST/TOT ratios [29.0%(22.5%, 34.8%) vs 17.5%(14.8%, 21.0%)] in TS group were all significantly higher than those in PL group (all P<0.001). Complication incidence rate in the TS and PL group was comparable [15.6% (5 cases) vs 14.0% (7 cases), P=0.840]. There was no significant differences in preoperative VAS, mHHS, NAHS, and iHOT-12 scores between the TS and PL group (all P>0.05). Both groups demonstrated progressive pain VAS reduction at 6 months and 1 year after the operation (all P<0.05 within groups), with the PL group exhibiting lower 6-month VAS (P<0.05). Functional scores (mHHS, NAHS, iHOT-12) improved progressively at 6 months and 1 year after the operation in both groups (all P<0.05 within groups). At 6 months, the PL group showed superior functional scores (all P<0.05), but no inter-group differences remained at 1 year (all P>0.05).

The hip arthroscopy technique of puncture-based limited incision capsulotomy for treating FAI demonstrates favorable clinical outcomes, significantly reduces operative time, enhances surgical efficiency, and does not increase the incidence rate of surgical complications.

To analyze the effect and mechanisms of tigecycline on the proliferation of liver cancer cells in mouse model.

Human hepatocellular carcinoma G2 (HepG2), human hepatocellular carcinoma 7 (Huh7), human hepatocellular carcinoma 3B (Hep3B) and Mahler′s human hepatocellular carcinoma 97 high metastatic (MHCC97H) were divided into 6 groups respectively: group T0 (without tigecycline), group T1 (1.25 μmol/L tigecycline), group T2 (2.50 μmol/L tigecycline), group T3 (5.00 μmol/L tigecycline), group T4 (10.00 μmol/L tigecycline), and group T5 (20.00 μmol/L tigecycline). The proliferation capabilities of each group were compared after 48 hours of treatment (cell survival rate, the experiment was repeated 3 times). Based on the results of the effect of tigecycline on the proliferation ability of liver tumor cells, the mRNA and protein levels of ferroptosis-related genes [Acyl-CoA synthetase long chain family member 4 (ACSL4), glutathione peroxidase 4 (GPX4), and solute vector family member 11 (SLC7A11) ] in HepG2 and Hep3B cells in groups T0, T2 and T3 were detected (the experiment was repeated 3 times). Based on the results of the effects of tigecycline on the genes and protein levels of ACSL4, GPX4, and SLC7A11 in HepG2 and Hep3B, HepG2 and Hep3B cells were divided into 4 groups respectively: group T0, group T3, group T3F [5.00 μmol/L tigecycline combined with 10.00 μmol/L Ferrostatin-1 (Fer-1)] and group T3P [5.00 μmol/L tigecycline combined with 10.00 μmol/L ACSL4 specific inhibitor (PRGL493)], to compare the ACSL4 protein levels and cell proliferation abilities among different groups (cell survival rate, the experiment was repeated 3 times). HepG2 or Hep3B cell suspensions were subcutaneously injected into BALB/c nude mice to construct the subcutaneous tumor-bearing model of liver tumors in nude mice. On the 6th day, the mice were randomly divided into 3 groups (5 mice in each group for the HepG2 and Hep3B cell liver tumor nude mouse models): group N (no treatment), group TIG (treated with 100 mg/kg tigecycline), and group TP (treated with 100 mg/kg tigecycline combined with 0.5 mg/kg PRGL493). The effects of tigecycline on the proliferation of liver tumor cells in vivo and the ACSL4 protein in tumor tissues were detected, and the mechanism by which tigecycline inhibits the proliferation of liver tumor cells was analyzed.

The survival rates of HepG2, Huh7, Hep3B, and MHCC97H cells in T1, T2, T3, T4, and T5 groups were all lower than that of T0 group (all P<0.05); in both HepG2 and Hep3B cells, there was no statistically significant difference in the mRNA levels of ACSL4, GPX4, and SLC7A11, or in the protein levels of GPX4 and SLC7A11 between the T3 and T0 groups (all P>0.05). However, the ACSL4 protein levels of HepG2 and Hep3B cells in T3 group were all higher than that of T0 group (all P<0.05). The ACSL4 protein levels of HepG2 and Hep3B cells in T3F and T3P groups were lower than that of T3 group (all P<0.05), and the cell survival rates of HepG2 and Hep3B cells in T3F and T3P groups were higher than that of T3 group(all P<0.05). The tumor volumes of nude mouse subcutaneous tumor models in TIG group on the 21st day were lower than that of N group(all P<0.05). The tumor volumes of nude mouse subcutaneous tumor models in TP group were higher than that of TIG group (all P<0.05).

Tigecycline inhibits the proliferation of liver cancer cells, and its mechanism may be related to promoting ACSL4-mediated ferroptosis.

This study aimed to investigate surgeons′ subjective perceptions of handedness effects on hip arthroscopy through questionnaire surveys, and to evaluate the objective outcomes of handedness effects by retrospective research. The questionnaire targeted hip joint surgeons from the Chinese Society of Sports Medicine, while the clinical review analyzed 175 consecutive hip arthroscopy procedures (from January 2019 tp December 2021) performed by a single right-handed surgeon at Shandong University Second Hospital. Of the patients, there were 83 males and 92 females with a mean age of (38.0±13.0) years. The patients were divided into dominant-hand (n=86) and non-dominant-hand (n=89) groups for comparison of operative parameters and outcomes. The survey (159 participants with a response rate of 100%) revealed that 82.39% (131/159) perceived superior proficiency with dominant hand, 61.64% (98/159) of the surgeons believed that the dominant hand for operation could yield better early results, while 50.94% (81/159) reported equivalent long-term results. Clinical data demonstrated superior median fluency scores [4.0(4.0, 5.0) vs 3.0(3.0, 4.0), P<0.001] and shorter operation time [(95.4±15.6) vs (111.4±19.6) minutes, P<0.001] in dominant-hand procedures. However, no significant difference was found in surgical accuracy or 1-year postoperative outcomes between the two groups (all P>0.05). The findings indicate that while surgeons′ non-dominant hand use may compromise surgical fluency and operation time, it does not significantly affect surgical accuracy or clinical outcomes.

The clinical data and prognosis of 6 patients with systemic light chain amyloidosis-related peripheral neuropathy admitted to Huashan Hospital Affiliated to Fudan University from June 2019 to January 2024 were analyzed retrospectively, and discussed.The patients were from 48 to 70 (58±9) years, including 4 males and 2 females. Among the initial symptoms, 4 cases had both lower limb sensory abnormalities, 1 case had both upper limb numbness, pain, weakness, 1 case had swallowing disorders, 5 cases had pain and autonomic symptoms, 6 cases had weight loss, 6 cases had heart involvement, mainfested as chest tightness, shortness of breath, and 3 patients had kidney involvement, manifested as asymptomatic proteinuria. Four cases had light chain type λ, 1 case had λ+κ and i case had κ. Five cases underwent lumbar puncture with protein cell separation and CSF protein was (1.00±0.21) g.Electrophysiological examination was performed in all 6 patients, suggesting multiple peripheral nerve damage involving motor and sensory nerves and mainly axonal involvement.Four cases (4/5) had positive intestinal biopsies; 1 (1/3) cases had positive nerve biopsy; 1 (1/1) case had positive skin biopsy and 1 (0/1) had negative fat biopsy; 5 (0/5) had bone marrow biopsy, with negative Congo red staining. All 6 patients underwent chemotherapy, with only 1 improving, 3 experiencing gradually worsening symptoms, and 2 dying. Multiple peripheral nerve axonal damage and autonomic nerve involvement are characteristics of systemic light chain amyloidosis peripheral neuropathy.

This study reports a novel case of acute promyelocytic leukemia (APL) characterized by a tripartite fusion gene, NUP98::RARG::LINE-L2a, formed by the rearrangement of nucleoporin 98 (NUP98), retinoic acid receptor gamma (RARG), and long interspersed nuclear element L2a (LINE-L2a). The molecular mechanism underlying the patient′s resistance to all-trans retinoic acid (ATRA) is also investigated. The 32-year-old male was admitted to Shandong Provincial Hospital Affiliated to Shandong First Medical University with complaints of "a 10-day cough and newly detected leukocytosis for one day". He was initially diagnosed with acute myeloid leukemia (AML) and bronchitis. Fundus hemorrhage was observed on physical examination. Coagulation tests showed elevated D-dimer and prolonged prothrombin time. Bone marrow smears showed 92% abnormal promyelocytes, and flow cytometry indicated an APL immunophenotype. However, the PML::RARA fusion gene formed by the promyelocytic leukemia (PML) gene and the retinoic acid receptor α gene (RARA) was negative by genetic testing, but identified by transcriptome sequencing as the NUP98:: RARG:: LINE-L2a tripartite fusion gene positive.. The patient responded poorly to ATRA-based induction therapy. Upon identifying the tripartite fusion gene, the treatment was switched to idarubicin combined with cytarabine chemotherapy. The patient achieved complete remission and subsequently underwent allogeneic hematopoietic stem cell transplantation. At the most recent follow-up of 16 months post-transplantation(May 2025), the patient remained in continuous remission. Sequence and fusion protein structural analyses revealed that the tripartite fusion leads to truncation of the ligand-binding domain of RARG gene, which is the key molecular mechanism underlying ATRA resistance.

The patient, a 74-year-old female, was admitted to the Sino-Japanese Friendship Hospital of Jilin University on September 20, 2024 due to "pain and numbness in the left upper limb with weakened strength". Physical examination palpated neck and subclavicular masses, ultrasound, CT and MRI examination were performed, and brachial plexus masses were found, and schwannoma was to be excluded. Based on the above examination results, "mass resection" was performed considering brachial plexus schwannoma. The postoperative pathology was dedifferentiated liposarcoma, and the dedifferentiation was divided into atypical neurofibroma with undetermined malignant potential. The patient was older and no other treatment was performed after tumor resection; Follow-up until 5 months postoperatively (March 2025), the tumor recurred and no follow-up treatment was performed.

Acetabular cartilage exfoliation (ACD) is a special type of acetabular cartilage injury that often appears as a concomitant injury in femoroacetabular impingement syndrome (FAI). The incidence of ACD is high and can adversely affect the prognosis of FAI patients. Therefore, how to treat ACD has become a key problem in the field of hip sports injury. At present, the traditional methods of treating acetabular cartilage injury, including simple cleaning, microfracture, grinding and drilling, have not reached a unified consensus in the treatment of ACD. This review will focus on the etiology, diagnosis, existing treatment modalities and prognosis of ACD, in order to provide ideas and evidence for better treatment of ACD.

Hip arthroscopy has important diagnostic and therapeutic value for hip joint diseases. The vigorous development and widespread application of hip arthroscopy pose new challenges to perioperative anesthesia management. At present, both general anesthesia and intraspinal anesthesia can meet the needs of hip arthroscopic surgery, but the choice of anesthesia method needs to comprehensively consider the patient's basic condition, surgical complexity and postoperative rehabilitation needs. Multimodal analgesia is still the mainstream strategy of perioperative analgesia in hip arthroscopy, among which combined intraarticular drug injection or local infiltration anesthesia has good clinical application prospect because of its simple operation and few adverse reactions. This paper systematically analyzes the clinical value and limitation of different anesthesia modes in hip arthroscopic surgery, discusses the feasible scheme to optimize perioperative analgesia management, and prospects the future development direction, aiming to provide feasible basis for optimizing anesthesia management and implementing ERAS strategy in hip arthroscopic surgery.

ANKRD26-associated thrombocytopenia (ANKRD26-RT) is an autosomal dominant thrombocytopenia caused by a mutation in the 5' untranslated region of the ANKRD26 gene. Because the disease is relatively rare, clinicians and laboratory personnel lack awareness of it, and it is often misdiagnosed, misdiagnosed and improperly treated. In recent years, with the application of genetic testing technology and hematopoietic stem cell transplantation, the diagnosis and treatment of ANKRD26-RT is steadily improving. This article reviews the pathophysiological mechanism, clinical characteristics, diagnosis and treatment strategies of ANKRD26-RT and the susceptibility to hematological malignant tumors, aiming to improve people's understanding of this disease.

Various tumor treatment options not only prolong the survival of tumor patients, but also attract much attention to the cardiovascular adverse events caused by them. Atherosclerosis is an important manifestation of cardiovascular toxicity. Different treatments promote the formation of atherosclerosis through various ways, among which endothelial cell damage caused by oxidative stress is the most common predisposing factor. This article reviews the atherosclerosis associated with tumor therapy and its possible mechanisms.

Continuous glucose monitoring (CGM) has gradually become a useful tool for assessing and quantifying the quality of blood glucose control in recent years, and there are many advantages in non-insulin treatment of type 2 diabetes mellitus (T2DM), such as improving blood glucose and blood glucose fluctuations. The use of CGM in patients with T2DM is rapidly expanding, but the clinical evidence for the use of CGM in non-insulin-treated patients with T2DM is very limited.