Obiective:To explore the surgical technique of arthroscopic reconstruction of the anterior cruciate ligament (ACL) combined with anterior lateral ligament (ALL) using the hamstring tendon graft through the femoral tunnel, and evaluate the clinical efficacy before and after surgery.Methods:Retrospective analysis of clinical data of 20 patients with ACL combined with ALL rupture admitted to Qinhuangdao First Hospital of Hebei Medical University from October 2020 to July 2022. All patients received arthroscopic reconstruction of ACL combined with ALL using the hamstring tendon graft through the femoral tunnel. The Lysholm knee joint score, International Knee Documentation Committee (IKDC) score, and Lachman test were evaluated using a questionnaire survey, and objective evaluations were performed using a knee joint activity measurement instrument and a KT-2000 measurement instrument before and 1 year after surgery. Compare the Lysholm knee joint score, IKDC score, Lachman test grade, knee flexion and extension range of motion, and tibia anterior and posterior relaxation before and after surgery. The measurement data were represented by mean ± standard deviation ( ± s), and t-test was used for comparison before and after surgery. The comparison of paired grade data before and after surgery was conducted using Wilcoxon test. Results:All 20 patients underwent surgery successfully, and all patients were followed up for an average follow-up time of (12.2±1.4) months, with a surgical time of 60-90 minutes. Postoperative MRI examination of the knee joint showed good graft fixation and no common complications such as knee stiffness, infection, deep vein thrombosis, and neurovascular injury. At the last follow-up, the knee joint flexion and extension activities of 20 patients were normal, with 2 patients weakly positive for Lachman test I; the Lysholm knee joint score and IKDC score increased from preoperative (44.6±1.7) points and (54.2±2.0) points to final follow-up (87.5±1.3) points and (89.6±1.0) points, respectively. The knee joint flexion and extension range of motion increased from preoperative (35.0±1.5)°to final follow-up (134.2±2.5)°, and the knee joint stability and function score improved significantly compared to preoperative, and the difference was statistically significant ( P<0.05); bend the knee 90°, KT-2000 measures the difference in tibial relaxation decreased from preoperative (11.9±1.0) mm to final follow-up (1.9±0.3) mm. The results showed that the stability of the knee joint was significantly improved compared to before surgery, and the difference before and after surgery was statistically significant ( P<0.05). Conclusions:The surgical technique of arthroscopic reconstruction of ACL and ALL using a single bundle of hamstring tendon graft under knee arthroscopy is safe and effective, and can restore the stability of knee joint rotation in patients. The clinical subjective and objective functional scoring indicators for short-term follow-up after surgery are satisfactory.

Objective To improve the recognition and knowledge of autosomal dominant polycystic kidney disease (ADPKD) related male infertility through investigation for MRI characteristics of this disease. Methods Fourteen patients confirmed with ADPKD related obstructive azoospermia were retrospectively analyzed. All patients referred to clinic with male infertility, and obstructive azoospermia were additionally confirmed by laboratory tests and clinical examination. Subsequent abdominopelvic MR examinations were performed to comfirm obstructive factors and obstructive location. All patients were performed an abdominopelvic MR examination including non-enhanced and enhanced MR. MR imaging characteristics were analyzed and summarized by two experienced radiologists. Results MRI results for all cases were classified into 4 groups:10 cases with bilateral polycystic kidneys and bilateral seminal vesicle cysts, 2 cases with bilateral polycystic kidneys, polycystic liver and bilateral seminal vesicle cysts, 1 case with bilateral polycystic kidneys, polycystic liver and absence of bilateral seminal vesicles, 1 case with bilateral cystic kidneys, bilateral seminal vesicle cysts as well as Müllerian duct cyst. A wide range of coronal T2WI scan was necessary to observe cystic lesions in both liver and bilateral kidneys as well as abnormal changes in pelvis. The obstructive sites in all cases were located in level from ejaculatory duct to seminal vesicle. Bilateral seminal vesicle cysts presented as significantly dilated glandular ducts of seminal vesicles, in which flocculence or nodular sediment can be found. Conclusion Male infertility caused by ADPKD-related deferential duct obstrution is characterized by bilateral polycystic kidney disease and Seminal vesicle ejaculatory duct obstruction in MRI, which can be combined with other abnormalities.

Objective: To analyze the current nutritional composition of commonly consumed prepackaged foods among children in Chengdu and to provide a scientific basis for health education among children and adolescents. Methods: Based on the 3 day and 24 hour dietary data of children aged 6-12 in Chengdu of the Southwest China Childhood Nutrition and Growth Cohort from 2021 to 2022, the nutritional information of prepackaged foods was collected by combining offline and online methods. All foods were classified step by step, and the nutrient content of each 100 g or 100 mL food was counted and graded. Results: A total of 1 902 children s prepackaged foods in 23 sub categories of 10 major categories were investigated. Nuts and seeds, snack foods, instant foods and other dairy products had higher total energy(2 476, 2 027, 1 728, 1 816 kJ/100 g), with the nutrient reference value percentage(NRV%) exceeding 20%. Fish, poultry, meat, eggs and their products had the highest protein content(22.8 g/ 100 g ) with an NRV% of 38%, nuts and seeds had the highest fat content(47.5 g/100 g) with an NRV% of 79%, confectionery and jelly had the highest carbohydrate content(82.1 g/100 g) with an NRV% of 27%, and seasoning flour products had the highest sodium content with an NRV% up to 118%. Seasoning flour products and instant foods were mostly high sodium, high fat and high carbohydrate food. Baked and puffed foods were almost high fat and high carbohydrate. Fish, poultry, meat, eggs, beans and their products were rich in protein but mostly high in sodium. Beverages and cold drinks were low in other nutrients except carbohydrate. Conclusion The nutrient content of various prepackaged foods commonly consumed by children in Chengdu are quite different. Most of the foods consumed by children are high sodium, high fat and/or high carbohydrate. Nutrition education should be strengthened to help children choose healthy foods.

BACKGROUND:At present,open reduction and internal fixation and minimally invasive needle aspiration are commonly used in patients with Sanders types Ⅱ and Ⅲ calcaneal fractures.However,there is little comparison between the clinical efficacy of the two methods and high-level clinical evidence is still available. OBJECTIVE:To compare the curative effect of Sanders types Ⅱ and Ⅲ calcaneal fractures treated by three-dimensional digital model-assisted minimally invasive needle penetration and tarsal sinus incision and manual reduction and internal fixation with steel plate. METHODS:From January 2021 to October 2022,80 patients with Sanders types Ⅱ and Ⅲ calcaneal fractures who were treated in the Department of Orthopedics,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province were randomly divided into control group(40 cases)and observation group(40 cases).The control group was treated with manual reduction and internal fixation with steel plate through the traditional tarsal sinus incision,while the observation group was treated with a three-dimensional digital model assisted with minimally invasive needle penetration fixation.The operation time,blood loss,hospitalization time and fracture healing time of the two groups were recorded.The changes in Maryland score,AO-FAS score,pain visual analog scale score,quality of life score(SF-36 score),and imaging parameters(B?hler angle,Gissane angle,calcaneal length,width and height)were observed before and 12 months after operation in the two groups.The complications during the follow-up were recorded. RESULTS AND CONCLUSION:(1)Operation time,blood loss,hospitalization time and fracture healing time in the observation group were lower than those in the control group(all P<0.05).(2)The Maryland score,AO-FAS score,SF-36 score,B?hler angle,Gissane angle,calcaneal length and height of the two groups after treatment were significantly higher than those before treatment(all P<0.05).Visual analog scale score and calcaneal width were significantly lower than those before treatment(all P<0.05).(3)After 12 months of follow-up,the incidence of complications in the observation group was lower than that in the control group(all P<0.05).(4)In conclusion,the treatment of Sanders types Ⅱ and Ⅲ calcaneal fractures with three-dimensional digital model-assisted minimally invasive needle penetration fixation can significantly improve the operation time,bleeding volume and other perioperative indicators,and can reduce the occurrence of multiple complications.The recovery of ankle function,relief of pain symptoms,and improvement of quality of life are equivalent to traditional therapy.

Objective:To explore the risk factors for atrial fibrillation(AF)in elderly Chinese patients with severe valvular heart disease(VHD).Methods:This was a cross-sectional study and consecutively enrolled 978 elderly patients with severe VHD diagnosed in 18 Class A tertiary hospitals across the country from September 2021 to March 2022, including 322(32.9%)patients with concurrent AF.Clinical and echocardiographic data were collected to analyze the risk factors for AF.Results:Among VHD patients, compared with the non-AF group, the AF group was older, had a higher female ratio, higher diastolic blood pressure, higher proportions with cerebrovascular disease and chronic kidney disease, lower serum low density lipoprotein cholesterol and higher serum creatinine, amino-terminal A-type natriuretion peptide and glycosylated hemoglobin.As for echocardiographic parameters, the left atrial diameter was larger, the left ventricular end-diastolic diameter, interventricular septum thickness, and left ventricular posterior wall thickness were smaller in the AF group than in the non-AF group.All of the differences were statistically significant(all P<0.05). The results of multivariate Logistic regression analysis showed that the left atrial anteroposterior diameter increased( OR=1.166, P<0.01), the left ventricular end-diastolic diameter decreased( OR=0.929, P<0.01), and advanced age( OR=1.051, P<0.05)was an independent risk factor for elderly VHD patients with concurrent AF. Conclusions:In elderly patients with severe VHD, advanced age, an increased left atrial anteroposterior diameter, and a decreased left ventricular end-diastolic diameter were independently associated with AF.Therefore, evaluation of cardiac structure and regular follow-up should be performed in elderly patients with severe VHD for early intervention to reduce the incidence of AF.

Microplastics refer to plastic particles with a diameter of less than 5 mm. Because of their wide distribution in the environment, it has gradually become one of the environmental hot issues of global concern in recent years. Microplastics are characterized by small particle size and strong adsorption. Existing studies have confirmed the biotoxic effects of microplastics in marine organisms and in experimental animals, suggesting their potential harm to human health. However, there have been few studies on the effects of microplastics on human health, and the research results have been inconsistent. Therefore, by summarizing the recent domestic and foreign studies about human exposure to microplastics as well as their potential effects on human body, this paper provides ideas and theoretical basis for further exploring the effects of microplastics on human health and related mechanisms.