Objective To determine the intra-and inter-tester reliability of a dynamometer in assessment of knee joint position senses (JPS).Methods Sixteen healthy volunteers (intra-rater N =6,inter-rater N =10) were examined with regard to intra-and inter-tester reliability of knee JPS by using Biodex System 3 dynamometer,measured by passive replication test,with subjects passively returning to the initial positions at 30°,45° and 60° knee flexion.The absolute error (AE) angle was recorded.Both intra-and inter-tester reliability studies involved two testers.Results The intra-tester reliability of the AE were moderate reliable at 30°,45°and 60° knee flexion,and the values of intra-class correlation coefficients (ICC) were 0.728,0.780 and 0.807,respectively.The values of Pearson's correlation coefficients for inter-tester reliability were 0.676,0.610 and 0.705,respectively (P ＜ 0.05).There was no significant difference between the AE values of dominance and non-dominant knees,test and retest,and in the AE values of 30°,45°and 60° knee flexion (P ＞ 0.05).The 95％ confidence upper limits of all subjects' AE values were less than 3°.Conclusion The major findings of this study suggest that the test-retest reliability of the knee JPS were moderate using Biodex System 3 dynamometer,and selecting a target angle of passive replication test can achieve the same purpose in 30° to 60°knee flexion.The clinical significance should be taken into consideration when the AE changes were greater than 3 degrees.

Objective:To explore role of sodium/chloride transporter member 3 (SLC12A3 ) gene haplotype mutation on Mongolians with essential hypertension (EH) .Methods:A total of 170 EH Mongolians (EH group) and 220 normotensive Mongolians (normotensive group) specimens were collected from Xilin Gol league .Mononucleotide sites (tagSNP) were se-lected using Haploview software ,genotypes were divided using real-time polymerase chain reaction (PCR) and SHESIS on-line analysis software was used to establish haplotype .Results:(1) Body mass index (BMI) ,blood lipids (except high den-sity lipoprotein cholesterol ) and blood pressure of EH group were significantly higher than those of normotensive group , P<0.01;(2) A total of nine tagSNPs were screened from frequent polymorphic mononucleotides (SNPs) of SLC12A3 gene ,and there existed strong linkage disequilibrium (D′> 0.8) in three polymorphic sites (rs2289009 ,rs13306673 and rs7204044 ) .These three polymorphic sites constituted four frequent haplotypes with frequency >3% in total ,and frequen-cy of haplotype GCA in EH group was significantly lower than that of normotensive group (9.4% vs .16.6% ) ,OR=0.52 ,95% CI 0.33~0.84. Conclusion:There is relationship between GCA haplotype of SLC12A3 and hypertension in Mongolians ,individuals with GCA haplotype have a lower risk of hypertension .

Moral injury in the war has been taken seriously since it has been gradually raised as an important military psychological problem.War is not the flavor of a quiet life,nor is it the ideal place to achieve the hero dream.Strong battlefield impact and ethical challenges likely cause moral injury to those innocent soldiers.Based on the American classic war films such as“ Closed Island”,“Born on July 4”,“Field Row” and “Snowden”,this paper mainly expounded the ethical thinking off our causes of moral injury including massacre of the prisoners of war,injustice war,betrayal of the senior officer,and hegemonic government.

With the continuous improvement of people's living standard, more and more people are in pre-diabetes state. Pre-diabetes is the key to the development of diabetes, and early intervention can reduce the incidence of diabetes, and prevent transforming pre-diabetes to diabetes in order to maintain the health status of the patient. By retrieving the Chinese Biomedical Literature Database of nearly five years on pre-diabetes intervention literature, it was found that traditional Chinese medicine interventions in pre-diabetes have a relatively new understanding. Through the traditional Chinese medicine, acupuncture, acupoint massage, and combine traditional Chinese and western medicine, medicinal food, eight brocade etc intervention therapy in patients with pre-diabetes, the occurrence and development of diabetes and its complications can be effectively prevented.

Objective:To explore the effect of intravenous thrombolysis in patients with acute ST segment elevation myocardial infarction (STEAMI) caused by acute occlusion of venous bridging vessels.Methods:The clinical data of a patient with acute STEMI caused by acute occlusion of venous bridge in the North China University of Science and Technology Affiliated Hospital in 2019 was retrospectively analyzed.A 58-year-old male patient underwent coronary artery bypass grafting (CABG) 12 years ago.He was re-admitted to the hospital due to acute inferior ST-segment elevation myocardial infarction for 4 hours.He was given Immediately aspirin 0.3 g chewed, ticagrelor 180 mg orally, heparin 4000 U intravenous injection.Next, he was given 50 mg of recombinant prourokinase intravenous thrombolysis.The successful thrombolysis was judged by observing the relief of chest pain symptoms, the ST segment of ECG falling down and the moving of myocardial enzyme peak.Coronary angiography was performed to observe the pathological changes of coronary artery and Bridge in situ, and further treatment strategies were formulated.Cardiac ultrasound examination was performed to understand the structure and function of the heart.The patients were followed up for 1 year to observe whether there were angina pectoris and cardiovascular events.Results:Thrombolytic therapy was successful at 1 hour.Coronary angiography was performed on the 8th day after acute inferior STEMI.The culprit vessel was ascending aorta great saphenous vein right coronary artery.The whole course was diffuse lesions with a large number of thrombus shadows.In situ, the left main coronary artery was diffuse 60% stenosis, the ostia of anterior descending branch and right coronary artery were completely occluded, and the proximal part of circumflex artery was completely occluded.The patients were given intensive antithrombotic therapy for 14 days, and he got better and was discharged.On the 41st day after acute STEMI, coronary angiography was reexamined.Thrombus shadow in aorta great saphenous vein right coronary artery disappeared.Echocardiography showed that left ventricular diastolic diameter was 53 mm and ejection fraction was 55%.The patient was given improved lifestyle and intensive drug treatment.One year after myocardial infarction, the patient had no angina pectoris and was competent for daily work and life.Conclusion:For patients more than 10 years after CABG, with chronic occlusion of coronary artery in situ, when acute STEMI caused by venous bridge occlusion, intravenous thrombolytic therapy is in line with the principle of early reperfusion treatment and has a good prognosis.

OBJECTIVE: To observe the clinical efficacy of the simple expansion of the spinal canal decompression, decompression plus hydroxyapatite/polyamide artificial lamina reconstruction, and decompression plus titanium mesh reconstruction in the treatment of spinal canal stenosi. METHODS: A total of 39 patients with lumbar spinal stenosis (with or without disc herniation, spondylolisthesis less than I degree), who received therapy of surgery from January, 2011 to January, 2012, were retrospectively analyzed. All patients were divided into 3 groups: a laminectomy surgery alone group (group A, n=15), a decompression plus hydroxyapatite/polyamide artificial lamina reconstruction group (group B, n=14), and a laminectomy decompression plus reconstruction with titanium mesh group (group C, n=10). Intraoperative situation, the postoperative excellent rate and JOA score were analyzed. RESULTS: The duration and blood loss in surgery in group A was much less than that in the group B and C (P<0.05), but there was no statistical significance between the group B and C. The postoperative excellent rate in three groups were similar in 3 months (P>0.05). Twelve months after the surgery, the group B and C showed advantage over the group A (P<0.05). JOA scores in 3 and 12 months after the surgery were all greater than that before the surgery (P<0.05). There was no difference in excellent rates in 3 groups in 3 months after the operation (P>0.05); the group B and C showed advantage over the group A in 12 months after the operation (P<0.05). No serious complications were related to the surgery in the 3 groups. Imaging changes were not significant difference. CONCLUSION The decompression plus hydroxyapatite/polyamide artificial lamina reconstruction and the decompression plus titanium mesh reconstruction show advantages in long-term effect over the simple vertebral canal decompression.
Decompression, Surgical ; Humans ; Intervertebral Disc Displacement ; surgery ; Laminectomy ; Laminoplasty ; Reconstructive Surgical Procedures ; Retrospective Studies ; Spinal Canal ; surgery ; Spinal Fusion ; Spinal Stenosis ; surgery ; Titanium ; Treatment Outcome

Objective:To explore the change trend of disease burden in laryngeal cancer attributable to smoking in China from 1990 to 2019.Methods:Based on data from the 2019 Global Burden of Disease Study database, the changes of death cases, mortality, disability adjusted life years (DALY) and DALY rate of laryngeal cancer attributable to smoking among people with different gender and age in China from 1990 to 2019 were analyzed. Joinpoint software was used to evaluate the annual percentage change (APC) and average annual percentage change (AAPC) of attributable mortality and DALY rate. The change trend of laryngeal cancer death attributable to smoking and DALY was analyzed.Results:From 1990 to 2019, the mortality rate and DALY rate of laryngeal cancer attributable to smoking in China showed an overall upward trend (AAPC of mortality was 1.6%, P < 0.05;AAPC of DALY rate was 1.26%, P < 0.05). In 2019, 75.64% of laryngeal cancer deaths in China were attributable to smoking, with 15 336 attributable deaths, 1.08/100 000 attributable mortality rates, 376 143 person-year attributable DALY and 26.45/100 000 attributable DALY rates, respectively. The population attributable fraction, death number, mortality rate, DALY and DALY rate of laryngeal cancer attributable to smoking in males were higher than those in females. In China, the number of laryngeal cancer deaths and DALY attributable to smoking peaked in the age group of 50-69 years old, and the attributable mortality and DALY rate peaked in the age group of ≥70 years old. Conclusions:The disease burden of laryngeal cancer attributable to smoking is high in China from 1990 to 2019, and there are differences in gender and age.

The overall health condition of patients significantly affects the diagnosis,treatment,and prognosis of endodontic diseases.A systemic consideration of the patient's overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy,as well as selecting appropriate therapeutic approaches.This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence,aiming to provide general guidance on clinical procedures,improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Objective:The study aimed to investigate the effects of exercise on the expression of ferroptosis-related proteins and the associated mechanisms in a post-traumatic stress disorder(PTSD)model induced by transient foot shock.Methods:Thirty-five male C57BL/6J mice(8 weeks old)were randomly divided into three groups:Control group,PTSD group,and Exe+PTSD group.PTSD model mice were established by foot-shock and PTSD behaviors were assessed using a fear conditioning box.Iron distribution areas were detected by Fe3+staining.Western Blot analysis were performed to determine the expression level of ferroptosis-related proteins in the mice.Results:Compared to the control group,the freezing time and Fe3+distribution areas in the cortex and hippocampus were significantly increased in the mice with PTSD(P＜0.05).The levels of ferroportin1(FPN1),glutathione peroxidase 4(GPX4),and brain-derived neurotrophic factor(BDNF)proteins were significantly decreased(P＜0.05),while the expression of high mobility group box 1(HMGB1)protein was significantly elevated(P＜0.05).Exercise significantly reduced freezing time and Fe3+accumulation in the cortex and hippocampus(P＜0.05),and it also up-regulated the expression of FPN1,GPX4,and BDNF proteins(P＜0.05),while down-regulating HMGB1 expression compared to the PTSD group(P＜0.05).Conclusion:This study demonstrates that PTSD induces the ferroptosis-related pathway in mice,and exercise can inhibit iron accumulation and reverse the expression of ferroptosis-related proteins induced by PTSD,there-by alleviating PTSD-like behavior in mice.