Objective To investigate the effect of continuous passive motion(CPM) and rehabilitation on flexion of the shoulder after intensive burn.Methods 36 patients with intensive burn on upper limb(including the skin around axilla fossa) were divided randomly into CPM group(n=19) and control group(n=17).The CPM group received both routine rehabilitation and continuous passive motion treatment,and the control group only underwent routine rehabilitation treatment.Their ranges of active or passive motion were assessed.Results There was a significant improvement both in the CPM group and the control group after treatment(P<0.01),but the CPM group improved more(P<0.05).Conclusion CPM can improve the efficacy of the routine rehabilitation on flexion of the shoulder after intensive burn.

Objective To observe the effect of ankle-foot orthosis(AFO)on the activities of daily living(ADL)and walking ability of patients with low lumbar spinal cord injury.Methods29 cases with low lumbar spinal cord injury were trained by systematic rehabilitation.According to patients' condition,static AFO or dynamic AFO were assembled for them.All patients were evaluated with Modified Barthel Index(MBI)and Functional Independence Measure(FIM)before and after training,and the walking distances were also measured.ResultsAfter AFO dressed,the ADL scores of patients increased,especially walking ability increased significantly(P<0.05).Of 29 patients,26 cases had outdoor walking ability,3 cases had domestic walking ability.ConclusionSelecting different kinds of AFO according to condition of individual can help patients with low lumbar spinal cord injury to reconstruct their walking ability and improve ability of self-management.

Trauma registration is an important tool to record the process and timeline in the treatment of trauma patients. The operation of trauma database is of great significance for reducing the mortality of patients, promoting the construction of trauma treatment system, and providing reference for policy-making. Trauma registration system has been established in the United States, United Kingdom, Germany and other developed countries for many years. However, the domestic system is still at an initial stage, and there are problems like data deficiencies, data incoherence, no item of complications, no treatment data after discharge and limits of human and financial resources. Therefore, there is room for improvements in terms of personnel fixation, financial support and continuous data monitoring should be further improved. In this study, the authors summarize the traum registration system from aspects of basic situation both at home and abroad, data analysis, clinical value, operation mechanism and challenges so as to provide important data for clinical researches.

Objective:To explore and compare early postoperative clinical outcomes between dynamic and classical superior capsular reconstruction for the treatment of irreparable post-superior massive rotator cuff tears (MIRCTs).Methods:29 patients with MIRCTs treated with autologous fascia dynamic SCR (14) and classical SCR (15) at Department of Sports Medicine of the First Affiliated Hospital of Army Medical University from September 2019 to March 2022 were retrospectively analyzed on preoperative and final follow-up pain visual analogue scale (VAS), Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score, range of motion (ROM), acromiohumeral distance (AHD), Sugaya classification and Goutallier classification.Results:All 29 patients were followed up with an average follow-up time of 36.50±8.18 months for dynamized SCR and 29.33±9.15 months for classical SCR, respectively. There was no significant difference between the two groups in terms of gender, age, course of disease and preoperative AHD ( P>0.05). At the final follow-up, there was no significant difference in the degree of improvement in forward flexion (81.79°±36.14° vs. 69.00°±40.19°, t=0.899, P=0.377), abduction [87.50°(71.25°, 122.50°) vs. 80.00°(45.00°, 95.00°), Z=-1.400, P=0.172] and internal rotation [5.00°(5.00°, 6.00°) vs. 4.00°(1.00°, 6.00°), Z=-0.871, P=0.400]; external rotation improved significantly in the dynamic SCR group compared to classical SCR group [37.50°(30.00°, 41.25°) vs. 25.00°(15.00°, 30.00°), Z=-2.285, P=0.019]. Although both groups showed clinical improvements, no significant difference was found between the dynamic SCR group and the classical SCR group on VAS [4.00(3.75, 5.00) vs. 4.00(3.00, 5.00), Z=-0.029, P=0.949], ASES score (50.99±7.98 vs. 46.47±13.73, t=1.074, P=0.293), Constant-Murley score [62.50(54.00, 69.50) vs. 56.00(47.00, 62.00), Z=-1.956, P=0.112] and UCLA score (20.21±3.53 vs. 18.40±3.87, t=1.315, P=0.199). At the final follow-up, patients in the dynamic SCR group had a higher degree of improvement in AHD (3.66±2.22 mm vs. 2.00±1.75 mm, t=2.247, P=0.033). There was no significant difference in Sugaya grading between the two groups at the final follow-up ( Z=-0.370, P=0.747). As for the degree of improvement in Goutallier's grading, there was an improvement in the dynamic SCR group at the final follow-up versus the preoperative period ( Z=-2.101, P=0.036), while there was no significant difference in the degree of improvement in the classical SCR group at the final follow-up versus the preoperative period ( Z=-0.700, P>0.05). Conclusion:Both dynamic SCR and classical SCR for MIRCTs significantly improved shoulder function. Significant improvements in external rotation, AHD and Goutallier grading were observed in the dynamic SCR group compared to the classical SCR group.

Glioma is a highly aggressive malignant tumor of the central nervous system that necessitates active treatment through surgery,radiotherapy,and chemotherapy.However,the prognosis of high-grade gliomas[World Health Organization(WHO)classification of central nervous system tumorsgrade Ⅲ-Ⅳ]remains poor,thus new treatment strategies are urgently needed.Oncolytic virus(OV)therapy is a kind of immunotherapy that can specifically infect and effectively kill tumor cells while activating anti-tumor immunity.The oncolytic herpes simplex virus(oHSV)is expected to emerge as a new adjuvant treatment for glioma due to its unique advantages.This article reviews the current understanding of oHSV,the anti-tumor mechanism of OV,the current clinical research status of oHSV targeted therapy for glioma,the research progress of oHSV collaborative anti-tumor strategy,and the existing problems in oHSV anti-glioma research,aiming to provide valuable insights for the treatment of glioma.

Objective To explore the effects of the training the trainers model in the quality control circle training.Methods According to the training the trainers model, 27 nurses were involved as trainers and received quality control circle training by 6 mentors from 2013 to 2015. The training capacity of trainers and the training effect of the target group were assessed before and after training. The lasting effect after training were evaluated.Results The self-assessment score of 6 trainers′ training capacity after training (4.30±0.54) was significantly higher than before training (1.41±0.50) (t=-19.98, P<0.01). The self-assessment score of 189 circle members′ training capacity after training ( 27. 51 ± 4. 19 ) was significantly higher than before training (20.52±4.56) (t=-18.722, P<0.01). The percentage of nursing staff participating in the quality control circle significantly increased from 2.8% to 12.4% after the whole process (χ2=226.378, P<0.01).Conclusions The training the trainers model is effective in improving training capacity of trainers in quality control circle training and increasing effects of quality control circle training among target nurses and is an effective model in training quality control circle on nurses.

Objective:To investigate the impact of non-alcoholic fatty liver disease (NAFLD) on the incidence of type 2 diabetes mellitus (T2DM) in an elderly population.Methods:A rural elderly population of Kunshan city, Jiangsu Province were used as the research subject. Prior diabetes mellitus, heavy alcohol consumption and incomplete data were excluded from prospective cohort study analysis. Annual physical examination and follow-up were conducted from 2007 to 2016. T2DM onset, death and loss to follow-up visits were observed as the research subject end points. According to the baseline physical examination results, the study subjects were divided into NAFLD and control groups, and further baseline data of both groups were analyzed whether there were match. The cumulative incidence rate of T2DM were statistically analyzed and compared between the two groups. Simultaneously, the relationship between the two groups of various indexes and the newly developed T2DM were analyzed using Kaplan-Meier. The variables with P < 0.1 were selected and incorporated into the Cox proportional hazard regression model. The impact of NAFLD on the incidence of T2DM was analyzed in an elderly population. Results:At baseline, there were statistically significant differences in the distribution of age, sex, waist circumference, body mass index, systolic blood pressure, diastolic blood pressure, direct bilirubin, blood urea nitrogen and triglycerides between NAFLD and non-NAFLD groups. However, fasting blood glucose, serum creatinine, total bilirubin, total cholesterol, low density lipoprotein cholesterol and high-density lipoprotein cholesterol had no statistically significant differences between the two groups. After nine years of follow-up, 207 newly developed T2DM cases, 52 NAFLD cases and 155 control group were selected as the study subjects. The cumulative incidence rates were 4.25%, 10.34%, and 3.55%, respectively. Kaplan-Meier analysis result showed that there were statistically significant differences in the cumulative incidence rates between the two groups from five-year. NAFLD had increased the T2DM risk in an elderly population by approximately 2.14 times (2.14 CI: 1.132 ~ 4.047) at five-year, and then had increased year by year thereafter. Univariate analysis showed that T2DM risk was 2.76 times higher in NAFLD than non-NAFLD groups (95% CI: 2.015 ~ 3.777). After adjustment for gender, age, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, serum creatinine, triglyceride, total cholesterol, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol, T2DM risk ratio was 1.68 times higher in NAFLD than control groups (95% CI: 1.163 ~ 2.425). Conclusion:NAFLD is an independent long-term risk factor for the T2DM onset in an elderly population.

Objective: To explore whether long-term potentiation(LTP) induced by brain-derived neurotrophic factor(BDNF) of hippocampus is involved in the process of maternal separation(MS) leading to impaired cognitive function of offspring in adolescence. Methods: The newborn CD-1 mice were randomly divided into maternal separation group(MS group) and control group(CON group). Mice in MS group were separated from the mother mice for 3 h every day from postnatal day 4 to 21 while no intervention was taken in the CON group. The spatial learning and memory ability was assessed using Morris water maze at the age of 3 months. Western blot and real-time quantitative PCR were used to detect the levels of BDNF and BDNF mRNA in the hippocampus. LTP of the hippocampal CA3-CA1 neural pathway was recorded using electrophysiological techniques. Results: Compared with CON group, the latency and distance of Morris water maze in maternal separation group were significantly longer(P<0.01). The percentage of time and distance in target quadrant during the memory phase in MS group were obviously lower than those in control group(P<0.05). The results of WB and Real-time quantitative PCR in MS group showed that the levels of BDNF and BDNF mRNA in MS group apparently decreased(P<0.05). Compared with CON group, MS group showed a significantly lower LTP in CA3-CA1 neural pathway(P<0.01). Conclusion The certain intensity of maternal separation can impair learning and memory function in young CD-1 male mice, which may be associated with decreased expression of BDNF and impaired LTP in the hippocampus.

Objective: To investigate the effects of embryonic inflammation on the hippocampal synaptosomal-associated protein 25(SNAP-25) level and cognitive function in middle-aged. Methods: During gestational days 15-17, the CD-1 maternal mice received a daily intraperitoneal injection of lipopolysaccharides(LPS, 50 μg/kg) or the equal volume of normal saline, and the corresponding offspring were regarded as LPS group and CON group respectively. At the age of young(3-month-old) and middle-aged(15-month-old), the spatial learning and memory ability was assessed using Morris water maze(MWM), and the expression of hippocampal SNAP-25 protein was detected by immunohistochemical method and Western blot. Results: Compared with the 3-month CON group, the 15-month CON group had longer swimming distance(P<0.01), lower swimming distance percentage(P<0.01) in the target quadrant, and higher hippocampal subregions(CA1, CA3, DG) SNAP-25 levels(P<0.01). The same results were obtained in 15-month LPS group compared with 15-month CON group in learning and memory phase(P<0.05), and higher hippocampal subregions(CA1, DG) SNAP-25 levels(P<0.01). Pearson correlation analysis indicated that the hippocampal CA1 and CA3 subregions SNAP-25 level was positively correlated with the swimming distance, but negatively correlated with the percentage of swimming distance in the target quadrant. Conclusion Embryonic inflammation can accelerate the impairment of spatial learning and memory and the increase of hippocampal CA1 and CA3 subregions SNAP-25 protein in middle-aged CD-1 mice, and there may be a correlation between them.