Objective To evaluate the clinical efficacy of arthroscopic treatment with anchor fixation for Segond fractures.Methods A total of 29 patients with Segond fractures treated with arthroscopic evaluation and anchor fixation technique between January 2011 and December 2015 were included in this retrospective case series study.There were 17 males and 12 females,with an average age of 41 years (range,27-62 years).Among the patients with Segond fractures,there were 20 patients combined with anterior cruciate ligament (ACL) rupture,three with posterior cruciate ligament (PCL) rupture,seven with medial collateral ligament (MCL) lesion,six with lateral collateral ligament (LCL) rupture,12 with meniscus lesion,and two with tibial plateau fracture.The time duration from injury to operation was 5-14 days (mean,7 days).The operation time and intraoperative blood loss volume were recorded.The postoperative pain,complications,knee joint stability,and fracture healing were observed.The pain was evaluated using numerical rating scale (NRS).Drawer test,Lachman test,lateral stress test,and Lysholm scores were performed to assess the knee function before and after operation.Results The operation time was 40-125 minutes (mean,85 minutes),and intraoperative blood loss was 10-30 ml (mean,15 ml).All patients were followed up for 12-18 months (mean,14 months).Two weeks after operation,the pain was not obvious,with NRS of 0-1.One patient had deep venous thrombosis one week after operation,and recovered after vascular intervention therapy.Other patients had no infection,deep vein thrombosis or other postoperative complications.The results of drawer test,Lachman test,and lateral stress test were negative in all patients,which indicated good knee joint stability.All patients were seen bone union,with the healing rate of 100％.The preoperative Lysholm scores were 35-62 points [(52.0 ± 4.2) points],and the scores one year after operation were 86-95 points [(91.9 ± 1.4) points] (P ＜ 0.05).Conclusion Arthroscopic treatment with anchor fixation has advantages of minor trauma,little hemorrhage,high fracture healing rate and good function recovery,and hence is an effective surgical treatment for Segond fractures.

Objective:To investigate the clinical effect of transcranial direct current stimulation (tDCS) in treating incomplete cervical spinal cord injury, and to explore the possibility of a relationship between the expression of long chain non-coding RNA (LncRNA) and neurological recovery after such injury.Methods:Forty-six patients suffering from incomplete cervical spinal cord injury were randomly divided into a tDCS group and a control group, each of 23. The American Spinal Cord Injury Association (ASIA) standard, a functional independence scale (FIM) and the modified Barthel index (MBI) were used to evaluate functional changes before and after 8 weeks of treatment. The neurophysiological evaluations of the spinal cord injury were in terms of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs). The expression of the LncRNA-MALAT1, MIAT, GPNMB, LILRB4 and SCD1 genes was quantified before and after the intervention. The relationship between the expression of LncRNA and MBI was then further explored.Results:The average central motor conduction time (CMCT) of the MEPs and the average central conduction time (CTT) of SEPs in the tDCS group were significantly lower than those before treatment and significantly faster than those of the control group after the treatment. The relative expression levels of LncRNA-MALAT1 and MIAT in the tDCS group were significantly higher than those before treatment and among the control group after the intervention. However, no significant differences were observed in the average expression of the LncRNA-GPNMB, LILRB4 or SCD1 genes. After tDCS the relative expression levels of LncRNA-MALAT1 and MIAT were positively and significantly correlated with MBI scores.Conclusions:tDCS can promote the recovery of motor and sensory functions after incomplete cervical spinal cord injury. The underlying mechanism may lie in the up-regulation of LncRNA-MALAT1 and MIAT expression.

Objective:To observe the pronunciation of consonants among children with developmental speech sound disorder and explore the correlation between mispronounced consonants and short-term memory so as to determine the pathogenesis of the disorder.Methods:Thirty-six children with developmental speech sound disorder and aged 4 to 13 years were evaluated. Their pronunciation of consonants at the phoneme and lexical levels was tested to record the error types and error rate. Twelve of the children were then randomly chosen to form a voice disorder group. Another 10 healthy counterparts constituted a control group. The short-term memory of both groups was assessed and any correlation between pronunciation and short-term memory was analyzed.Results:The children with a developmental speech sound disorder differed significantly from the controls in terms of the numbers of errors in articulating blade-alveolar, blade-palatal and velar consonants. On the phoneme level, the highest substitution error rate occurred when pronouncing lingua-palatal consonants (42.86%), followed by supradental consonants (32%). The highest distortion and non-acquisition error rates were with blade-palatal consonants (14%) and lingua-palatal consonants (9.5%). On the vocabulary level, the highest substitution, distortion, ellipsis and non-acquisition error rates appeared when pronouncing lingua-palatal and velar consonants, velar and blade-palatal consonants, supradental consonants as well as blade-palatal consonants. Significant differences were found between the phoneme and lexical levels in the substitution of supradental and blade-palatal consonants as well as in the ellipsis of blade-alveolar consonants. They were moderately associated with pronunciation level. There was, however, no significant difference in working memory span between the two groups, and no significant correlation was observed between working memory span and pronunciation level.Conclusion:The mispronunciation of consonants by children with developmental speech disorders is higher at the lexical than at the phoneme level. They mainly substitute lingua-palatal and velar consonants and elide supradental consonants, which may be related to short-term memory span.

BACKGROUND:Traumatic spinal cord injury primarily relies on scale assessment and imaging examinations in clinical practice.However,there are limitations in predicting the prognosis of the injury.Therefore,the use of metabolomics technology for biomarker screening is significant for estimating the extent of damage,injury and recovery,as well as developing new therapies. OBJECTIVE:To characterize the metabolic features of patients with traumatic spinal cord injury using metabolomics technology and explore potential biomarkers and disrupted metabolic pathways. METHODS:Serum and urine samples were collected from 20 patients with traumatic spinal cord injury(observation group)and 10 healthy subjects(control group).Metabolites were analyzed and multivariate statistical analysis was then performed for data processing to screen differential metabolites.Metabolic pathway enrichment was performed using MetaboAnalyst software.Logistic regression was applied to construct a biomarker combination model,and its relationship with the American Spinal Injury Association grading was analyzed. RESULTS AND CONCLUSION:Significant differences in 160 and 73 metabolites were detected in the serum and urine samples of the two groups,respectively.Pathway enrichment analysis showed evident disturbances in lipid metabolism after traumatic spinal cord injury,including sphingolipid,arachidonic acid,α-linolenic acid,and arachidonic acid metabolism,as well as glycerophospholipid and inositol phosphate biosynthesis.The combination of two identified biomarkers,telmisartan and quercetin glycoside,showed a correlation with the American Spinal Injury Association grading in both serum and urine levels.Thus,metabolomics technology provides assistance in further understanding the pathological mechanisms of traumatic spinal cord injury and screening therapeutic targets.The identified metabolic biomarker combination may serve as a reference for assessing the severity of traumatic spinal cord injury.

OBJECTIVE To investigate the improvement effects and possible mechanism of Phyllanthus emblica water extracts on lipid metabolism disorder and insulin resistance （IR） in diabetic model rats. METHODS IR model of male SD rats was established and randomly divided into model group， positive control group， P. emblica water extracts high-dose， medium-dose and low-dose groups， and another blank group was set up， with 10 rats in each group. P. emblica water extracts high-dose， medium- dose and low-dose groups were given P. emblica water extract diluent at the doses of 800， 400 and 200 mg/kg respectively； positive control group was given pioglitazone solution 2.7 mg/kg； blank group and model group were given the same volume of normal saline， by intragastrical administration， once a day， for consecutive 4 weeks. The general state of rats was observed， and the body mass and the levels of serum lipid metabolism indexes [triacylglycerol （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）] were measured； fasting insulin of serum （FINS）， insulin resistance index （IRI） and insulin sensitivity index （ISI） were measured and calculated by enzyme-linked immunosorbent assay （ELISA）. The pathological morphology of liver tissue was observed by hematoxylin-eosin staining； the expression of glycogen in the liver was observed by periodic acid-Schiff staining， and the staining area was calculated； the protein expressions of peroxisome proliferator-activated receptor γ （PPARγ）， nuclear factor κB（NF-κB） and AMP-activated protein kinase （AMPK） were detected by Western blot. RESULTS Compared with blank group， the rats in the model group had obvious symptoms of polydipsia， polyphagia and polyuria， and the serum levels of TC， TG， LDL-C， FINS and IRI were significantly increased （P＜0.05）， while ISI was significantly reduced （P＜ 0.05）； the structure of hepatic lobule was obviously disordered， the liver cells were deformed and enlarged， and there were many lipid deposits and fat vacuoles； PAS staining area of glycogen was significantly reduced（P＜0.05）； the protein expression levels of PPARγ and p-AMPK were significantly decreased （P＜0.05）， while the protein expression level of NF-κB was significantly increased （P＜0.05）. Compared with model group， the mental state of rats， liver histopathological morphology and glycogen expression were improved significantly in P. emblica water extracts high-dose and medium-dose groups； the levels of the above indicators were significantly reversed（P＜0.05）. CONCLUSIONS P. emblica water extracts may improve glucose and lipid metabolism disorders， liver function and IR in IR model rats， and regulate IR by activating the PPARγ/AMPK/NF-κB signaling pathway.

Objective To analyze the current status of exercise and exercise self-efficacy (ESE) and its influencing factors in middle-aged and elderly patients with high blood pressure, and to provide a basis for the intervention of patients with hypertension in the community. Methods The stratified random sampling method was used to select 546 patients with hypertension who had received hypertension management for one year in the community. The general condition, exercise condition, and ESE scores were collected using survey questionnaires. Chi-square test was applied to analyze the difference of exercise efficacy score among different characteristic objects, and analysis of regression method was applied to analyze the influencing factors of exercise self-efficacy. Results A total of 546 people were surveyed in this study, of which 67.03% of hypertension patients participated in exercise. The main exercise program was walking healthily (87.43%). A total of 262 people (47.99%) had strong performance on ESE score, while 284 people (52.01%) had weak self-efficacy. The univariate unconditional logistic regression analysis found that there were significant differences in the distribution of educational level, family monthly income, years of hypertension, whether they received the guidance from family doctors, whether they exercised and whether they warmed up before exercise (P<0.05). The multivariate unconditional logistic regression analysis showed that educational level of junior high school and low average monthly household income were the risk factors affecting exercise efficacy, and the guidance of family doctors, exercise, and hypertension less than 5 years were the protective factors affecting exercise efficacy. Conclusion The exercise self-efficacy of middle-aged and elderly patients with hypertension in this community is at a medium level, and family doctors should carry out targeted interventions based on influencing factors to improve exercise self-management ability.

As a rare Chinese medicinal material， Paridis Rhizoma is mainly distributed in Yunnan， Guangxi， and Guizhou in southwestern China， with the effect of clearing heat and detoxifying， alleviating edema and relieving pain， cooling liver and tranquilizing mind. It is particularly effective for injuries from falls， fractures， contusions and strains， snake bites， cold wind-induced convulsion， and other diseases， which has been used for more than 2 000 years. According to modern research， polyphyllin Ⅱ， one of the main active components of Paridis Rhizoma， belongs to diosgenin in structure. It has the anti-tumor， anti-inflammatory， antiviral， antibacterial， immune-regulating， antioxidant， and multidrug resistance-reversing activities， showing good application prospect. Especially， the anti-tumor effect of polyphyllin Ⅱ has attracted wide attention， and the mechanism is inhibiting proliferation， migration， and invasion of tumor cells， inducing cell cycle arrest， apoptosis， and autophagy， suppressing angiogenesis， and modulating tumor microenvironment. However， the pharmacokinetic results show that polyphyllin Ⅱ has low bioavailability in vivo due to the low solubility， poor absorption， unsatisfactory distribution， and slow metabolism， which limit the clinical application. In recent years， there has been an explosion of research on the adverse reactions of polyphyllin Ⅱ， such as the strong hemolytic activity and obvious cytotoxicity to liver， kidney， myocardium and cardiovascular cells. Thus， papers were retrieved from "CNKI"， "VIP"， "Wanfang Data"， "PubMed"， "Web of Science"， and "Elsevier SD" with "Paris saponin Ⅱ"， "Polyphyllin Ⅱ" as the main keywords， and the pharmacological activities and mechanisms， pharmacokinetics， and adverse reactions were summarized. The findings are expected to serve as a reference for the in-depth research， development， and utilization of polyphyllin Ⅱ.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.