With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

OBJECTIVE: To study the relevant factors affecting the occurrence of adjacent vertebral fractures in women with osteoporotic vertebral compression fractures after conservative treatments. METHODS: A total of 98 elderly female patients diagnosed with osteoporotic vertebral compression fractures and treated from January 2020 to January 2022 were retrospectively analyzed. The average age was (73.05±7.38) years old. Based on the follow-up results after two years of injury, the patients were divided into the adjacent vertebral fracture group (24 cases) and the non-adjacent vertebral fracture group (74 cases). The following factors were recorded for each patient:age, initial bone density, follow-up bone density, bone density changes, initial VAS score, degree of fracture compression, presence of old fractures, use of zoledronic acid, use of parathyroid hormone analogs, occurrence of complications, and further compression of the affected vertebrae. Univariate and multivariate Logistic regression analyses were performed to analyze the associated risk factors. RESULTS: Univariate analysis revealed that in elderly women undergoing conservative treatment for osteoporotic vertebral compression fractures, the degree of fracture compression, follow-up bone density, changes in bone density, use of zoledronic acid, and use of parathyroid hormone analogs were statistically significant(P<0.05). Multivariate Logistic regression analysis demonstrated that the degree of fracture compression 95%CI(0.040, 0.571), P=0.005, OR=0.151, changes in bone density 95%CI(1.264, 1 360.732), P=0.036, OR=41.477, and use of parathyroid hormone analogs 95%CI(1.638, 31.625), P=0.009, OR=7.196 were risk factors affecting the occurrence of adjacent vertebral fractures following vertebral compression fractures in elderly women with osteoporosis. CONCLUSION The degree of fracture compression, changes in bone density, and the use of parathyroid hormone analogs are factors influencing the occurrence of adjacent vertebral fractures following vertebral compression fractures in elderly women with osteoporosis. For patients with mild compression fractures (gradeⅠ), conservative treatment can be achieved by intensifying anti-osteoporosis therapy and using parathyroid hormone analogs.
Humans ; Female ; Aged ; Fractures, Compression/etiology* ; Spinal Fractures/therapy* ; Osteoporotic Fractures/therapy* ; Retrospective Studies ; Risk Factors ; Conservative Treatment ; Aged, 80 and over ; Bone Density

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective To investigate the clinical efficacy and safety of Zishen Jianpi Quyu Formula in treating patients with migraine without aura in the postmenstrual period of kidney deficiency and blood stasis type.Methods A total of 104 patients with migraine without aura of kidney deficiency and blood stasis type were randomly divided into the control group and the trial group,with 52 cases in each group.The control group was treated with Flunarizine Hydrochloride Capsules,and the trial group was treated with Zishen Jianpi Quyu Formula on the basis of treatment for the control group.One menstrual cycle constituted a course of treatment,and the treatment covered a total of two courses(eight weeks).The changes of traditional Chinese medicine(TCM)syndrome score,migraine attack frequency,duration of migraine headaches,visual analogue scale(VAS)score of migraine headache intensity,Headache Impact Test-6(HIT-6)score and hemorheology indexes in the two groups before and after treatment were observed.Moreover,the efficacy for TCM syndrome and clinical safety in the two groups were evaluated.Results(1)After two courses of treatment,the total effective rate of the trial group was 90.38%(47/52),and that of the control group was 69.23%(36/52),the intergroup comparison(by chi-square test)showed that the efficacy for TCM syndrome in the trial group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores of the patients in both groups were significantly lower than those before treatment(P＜0.05),and the reduction of TCM syndrome score in the trial group was significantly superior to that in the control group(P＜0.05).(3)After treatment,the migraine attack frequency,duration of migraine headaches,VAS scores of migraine headache intensity in the two groups of patients were significantly improved compared with those before treatment(P＜0.05),and the improvement of migraine headache parameters in the trial group was significantly superior to that in the control group(P＜0.05).(4)After treatment,the HIT-6 score in the two groups was decreased significantly compared with those before treatment(P＜0.05),and the decrease of HIT-6 score in the trial group was significantly superior to that in the control group(P＜0.05).(5)After treatment,hemorheology indexes(including plasma viscosity,whole blood high-shear viscosity,whole blood low-shear viscosity,fibrinogen,and hematocrit)in the two groups were improved compared with those before treatment(P＜0.05),and the improvement of each of hemorheology indexes in the trial group was significantly superior to that in the control group(P＜0.05).(6)During treatment,no serious adverse events occurred in the two groups,which was of high safety.Conclusion Zishen Jianpi Quyu Formula exerts remarkable clinical efficacy in treating patients of migraine without aura in the postmenstrual period of kidney deficiency and blood stasis type.The formula is effective on improving the TCM syndromes and migraine attacks of the patients,achieving the efficacy of milder headache,lower attack frequency and shorter duration,more stability hemorheology indexes and higher safety.

Objective:To explore the potential categories of psychological distress in spousal caregivers of stroke patients and differences in quality of life between categories, in order to provide a theoretical basis for early clinical identification and provision of individualized and targeted interventions for psychological distress in spousal caregivers of stroke patients and improvement of their quality of life.Methods:A total of 207 spouse caregivers of stroke patients hospitalized in three class 1-Grade A hospitals in Yinchuan city of Ningxia Hui Autonomous Region, who met the inclusion and exclusion criteria were selected from December 2020 to July 2021 by convenience sampling method as study subjects. The general information questionnaire, Kessler Psychological Distress Scale, and the Mos 36-Item Short from Health Survey were used for a cross-sectional survey.Results:A total of 203 spousal caregivers of stroke patients were finally investigated, 46 males and 157 females with a age of (58.65 ± 9.66) years. Psychological distress among spousal caregivers of stroke patients was categorized into 3 potential categories:no distress group (40%, 81/203), listlessness group (45%, 91/203) and helplessness and restlessness group (15%, 31/203). The psychological distress subgroup was a factor influencing the quality of life of spousal caregivers of stroke patients ( t=-10.03, P<0.05), explaining 33.0% of the variance in quality of life. Conclusions:Psychological distress in spousal caregivers of stroke patients is significantly heterogeneous. Those in the helplessness and restlessness group have the lowest quality of life and should be given focused attention and early intervention.

Objective A recombinant plasmid for CRISPR interference(CRISPRi)that incorporates dCas9 from Streptococcus pyogenes was constructed to investigate the function of Coxiella burnetii genes through a prompt,simple method.Methods A single guide RNA(sgRNA)sequence targeting C.burnetii dotB was integrated into a recombinant plasmid,which was then transformed into C.burnetii using electroporation.Next,dCas9 expression was induced with dehydrated tetracycline(aTC)to inhibit the transcription of dotB.Results The results demonstrated that dCas9 can be expressed normally in the CRISPRi system through aTC induction.Suppression of dotB was observed at the transcriptional and translational levels.In addition,the intracellular reproduction of C.burnetii significantly decreased after the suppression of dotB expression.Conclusion Silencing technology for the C.burnetii gene based on CRISPRi was established in this study,providing support for studying the biological functions of C.burnetii genes.

Objective:To explore the relationship between psychological distress and intimacy in stroke patients and the mediating effect of different dyadic coping style, to provide theoretical guidance for improving the intimate relationship of stroke patients.Methods:A convenient sampling method was used to select 203 patients with stroke who visited the General Hospital of Ningxia Medical University, the People's Hospital of Ningxia Hui Autonomous Region and the Department of Neurology of Yinchuan First People's Hospital from December 2020 to July 2021 as the survey objects. The general information questionnaire, Kessler Psychological Distress Scale, Quality of Relationship Index and Dyadic Coping Inventory were used to investigate patients.Results:The scores of psychological distress, intimate relationship, positive dyadic coping and negative dyadic coping were 19.33 ± 7.46, 32.75 ± 6.79, 86.25 ± 13.22, and 16.46 ± 4.08, respectively. Correlation analysis showed that psychological distress was negatively correlated with intimate relationship and positive dyadic coping ( r=-0.195, -0.204, both P<0.01), psychological distress was positively correlated with negative dyadic coping ( r=0.229, P<0.01). The mediating effect of positive dyadic coping and negative dyadic coping on psychological distress and intimate relationship was 35.87% and 53.26%, respectively. Conclusions:The psychological distress indirectly affects the intimate relationship of stroke patients through positive dyadic coping and negative dyadic coping. Health care workers can guide patients to actively cope with the disease and encourage couples to strengthen communication, so as to enhance the intimacy of couples and promote their physical and mental health development.

Objective:To explore the potential categories of resourcefulness in primary caregivers of stroke patients and analyze the differences in the characteristics of different types of caregivers, so as to provide basis for clinical construction of effective intervention plans.Methods:The 308 primary caregivers of stroke patients who met the research standards in the Department of Neurology of General Hospital of Ningxia Medical University, People′s Hospital of Ningxia Hui Autonomous Region, the First People′s Hospital of Yinchuan from December 2020 to August 2021 were selected as the research objects by convenient sampling method.The general information questionnaire, Resourcefulness Scale and Social Support Revalued Scale were used for cross-sectional investigation.Results:The resourcefulness of the primary caregivers of stroke patients were divided into 2 potential categories: low resourcefulness group (62.7%, 193/308) and high resourcefulness group (37.3%, 115/308). Uni-variate analysis showed that there were differences between potential categories: age and education level of stroke patients, whether there was long-term medication history, number of other chronic diseases, had there been any complications due to illness, age, education level and occupation of caregivers, average daily care duration, family relations, and social support ( χ2 values were -3.34 - 23.62, all P<0.05). Logistic regression analysis showed that social support and education level of caregivers were the influencing factors of caregiver resourcefulness ( P<0.05). Conclusions:The resourcefulness in the primary caregivers of stroke patients has certain characteristics. Clinically, targeted intervention measures should be formulated according to the different types of caregiver resourcefulness characteristics of caregivers and their influencing factors to improve the caregiver resourcefulness of stroke patients.

Objective:To construct a conceptual framework of burnout among primary caregivers of stroke patients based on grounded theory.Methods:According to the characteristics of age, gender, relationship with patients, length of care and other characteristics of purpose sampling method, from December 2021 to March 2022, 31 primary caregivers of stroke patients were selected for semi-structured interviews in two second-class hospitals, a first-class hospitals and a community health service station in Wuzhong city and Yinchuan city. The data were analyzed in procedural grounded theory method.Results:A total of 29 primary categories and 9 secondary categories were formed. The conceptual framework of burnout among primary caregivers of stroke patients was finally established, which consisted of four main categories (role burnout, physical burnout, psychological burnout and social burnout) and a core category (burnout of primary caregivers of stroke patients).Conclusions:The conceptual framework of burnout among primary caregivers of stroke patients constructed in this study elaborates the connotation of burnout of primary caregivers of stroke patients from four aspects, which can provide a basis for the development of assessment tools and the formulation of intervention measures in the future.

OBJECTIVE: To investigate the clinical efficacy of acrylic cement (PMMA) mixed with calcium sulfate combined with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic fracture (OVCF). METHODS: The clinical data of 191 patients with OVCF treated with PKP from January 2020 to March 2021 were retrospectively analyzed. Among them, 82 patients with 94 vertebral bodies were treated with PMMA mixed with calcium sulfate as the observation group, and 109 patients with 125 vertebral bodies were treated with pure PMMA as the control group. Among the 82 patients in the observation group, there were 16 males and 66 females, with a mean age of (75.35±11.22) years old, including 36 thoracic vertebrae and 58 lumbar vertebrae. In the control group, there were 109 patients, 22 males and 87 females, with an average age of (74.51±9.21) years old, including 63 thoracic vertebrae and 62 lumbar vertebrae. The visual analog scale (VAS) before operation and 1 day, 3 months and 1 year after operation were calculated. The Oswestry disability index (ODI), Cobb's angle, vertebral body height and the probability of postoperative bone cement leakage were used to analyze the efficacy of the two groups. RESULTS: All the patients were followed up for more than one year. Compared with the control group, there was no significant difference in operation time, bleeding volume and bone cement injection volume between the two groups(P>0.05), while the leakage rate of bone cement was significantly lower in the observation group (P<0.05). In addition, there was no significant difference in VAS, ODI, Cobb angle, and vertebral body height between the two groups before operation, and 1 day, 3 months, and 1 year after operation (P>0.05), but each index was improved compared with that before operation (P<0.05). CONCLUSION PMMA mixed with calcium sulfate has equivalent efficacy in treating OVCF than PMMA alone, but can effectively reduce the probability of cement leakage.
Female ; Male ; Humans ; Aged ; Aged, 80 and over ; Middle Aged ; Polymethyl Methacrylate ; Calcium Sulfate/therapeutic use* ; Osteoporotic Fractures/surgery* ; Bone Cements/therapeutic use* ; Kyphoplasty ; Retrospective Studies ; Lumbar Vertebrae/surgery*