BACKGROUND:For the treatment of osteochondral lesions of the talus,different treatment methods are adopted according to different types or clinical symptoms,including rehabilitation treatment,surgical treatment and biological agent treatment. Most of the rehabilitation treatment relieved the symptoms and delayed the disease in a short time. In recent years,arthroscopic microfractures,kirschner wire drilling,talus cartilage transplantation,autologous osteochondrocyte transplantation,stem cell transplantation,and biological preparation platelet-rich plasma can achieve good results.OBJECTIVE:To summarize the progress in the treatment of osteochondral lesions of the talus and provide a reference for their clinical treatment. METHODS:Using English search terms "talus,osteochondral lesions of the talus" and Chinese search terms "microfracture,transplantation,platelet-richplasma,stem cell," we searched the PubMed and CNKI databases for related articles published from January 2019 to January 2024. A total of 67 articles were included for comprehensive analysis.RESULTS AND CONCLUSION:(1) There are many ways to treat osteochondral lesions of the talus. Conservative rehabilitation and biological agents can alleviate the condition for Hepple type Ⅰ and Ⅱ lesions. Microfracture or Kirschner wire drilling bone marrow stimulation treatment is used for Hepple type Ⅲ and above and lesion diameter<15 mm,but the long-term efficacy is poor. Replacement and regeneration strategies are used for larger lesions,and transplant failure is the main risk. (2) Biological agent treatment is a new treatment method and is often used in combination therapy. (3) In view of the treatment of osteochondral lesions of the talus,many factors such as the area and location of cartilage injury should be taken into account. The selection of the treatment plan should also take into account the level of medical technology,patient acceptance,economic status and other factor. Personalized combination treatment of various schemes is recommended to achieve good results.

Objective To explore the application effect of isokinetic strength combined with conventional training in the rehabilitation after elbow joint release surgery.Methods A retrospective cohort study was conducted to analyze the clinical data of 82 patients who underwent elective elbow joint release surgery in our hospital from June 2022 to June 2023.They were divided into the control group and the observation group,with 41 cases in each group.Patients in the control group received routine training,while patients in the observation group received isokinetic strength training on the basis of the control group.The elbow joint function,elbow joint range of motion,pain degree,and ability of daily living before and after surgery of patients in the two groups were compared and analyzed.Results Three months after surgery,compared with the control group,the Mayo elbow function score of patients in the observation group were higher(P<0.05),the elbow flexion,extension,forearm supination,and forearm pronation ranges of motion of patients in the observation group were greater(P<0.05),the VAS score of patients in the observation group was lower(P<0.05),the ability of daily living of patients in the observation group was better(P<0.05).Conclusion The application of isokinetic strength combined with conventional training in elbow joint release surgery can promote elbow joint functional recovery,alleviate pain degree,and enhance ability of daily living.

BACKGROUND:For the treatment of osteochondral lesions of the talus,different treatment methods are adopted according to different types or clinical symptoms,including rehabilitation treatment,surgical treatment and biological agent treatment. Most of the rehabilitation treatment relieved the symptoms and delayed the disease in a short time. In recent years,arthroscopic microfractures,kirschner wire drilling,talus cartilage transplantation,autologous osteochondrocyte transplantation,stem cell transplantation,and biological preparation platelet-rich plasma can achieve good results.OBJECTIVE:To summarize the progress in the treatment of osteochondral lesions of the talus and provide a reference for their clinical treatment. METHODS:Using English search terms "talus,osteochondral lesions of the talus" and Chinese search terms "microfracture,transplantation,platelet-richplasma,stem cell," we searched the PubMed and CNKI databases for related articles published from January 2019 to January 2024. A total of 67 articles were included for comprehensive analysis.RESULTS AND CONCLUSION:(1) There are many ways to treat osteochondral lesions of the talus. Conservative rehabilitation and biological agents can alleviate the condition for Hepple type Ⅰ and Ⅱ lesions. Microfracture or Kirschner wire drilling bone marrow stimulation treatment is used for Hepple type Ⅲ and above and lesion diameter<15 mm,but the long-term efficacy is poor. Replacement and regeneration strategies are used for larger lesions,and transplant failure is the main risk. (2) Biological agent treatment is a new treatment method and is often used in combination therapy. (3) In view of the treatment of osteochondral lesions of the talus,many factors such as the area and location of cartilage injury should be taken into account. The selection of the treatment plan should also take into account the level of medical technology,patient acceptance,economic status and other factor. Personalized combination treatment of various schemes is recommended to achieve good results.

Objective To explore the application effect of isokinetic strength combined with conventional training in the rehabilitation after elbow joint release surgery.Methods A retrospective cohort study was conducted to analyze the clinical data of 82 patients who underwent elective elbow joint release surgery in our hospital from June 2022 to June 2023.They were divided into the control group and the observation group,with 41 cases in each group.Patients in the control group received routine training,while patients in the observation group received isokinetic strength training on the basis of the control group.The elbow joint function,elbow joint range of motion,pain degree,and ability of daily living before and after surgery of patients in the two groups were compared and analyzed.Results Three months after surgery,compared with the control group,the Mayo elbow function score of patients in the observation group were higher(P<0.05),the elbow flexion,extension,forearm supination,and forearm pronation ranges of motion of patients in the observation group were greater(P<0.05),the VAS score of patients in the observation group was lower(P<0.05),the ability of daily living of patients in the observation group was better(P<0.05).Conclusion The application of isokinetic strength combined with conventional training in elbow joint release surgery can promote elbow joint functional recovery,alleviate pain degree,and enhance ability of daily living.

Objective To investigate the effect of a three-tier delirium care management process in patients with acute stroke in neurology intensive care unit(NICU).Methods A total of 50 patients with acute stroke admitted to the NICU of the Fourth Hospital of Changsha from May to September 2021 were assigned to the control group.The patients in the control group received routine NICU nursing care to prevent delirium.Another 50 patients with acute stroke admitted to the NICU from December 2021 to April 2022 were assigned to the trial group.They were managed with the three-tier delirium nursing management process on top of the routine NICU nursing care for the control group.The incidence of ICU delirium(DICU),duration of DICU,length of stay in NICU and the incidence of delirium-related adverse events were compared between the two groups.The degree of delirium and cognitive function before and after the intervention were compared between the two groups as well.Results The trial group had significantly shorter duration of DICU and NICU stay(both P<0.05)and lower incidence rate of delirium-related adverse events(P<0.05)compared to the control group.After the intervention,the trial group showed significantly lower scores on the intensive care delirium screening checklist(ICDSC)and significantly higher scores of cognitive function compared to those of the control group(both P<0.05).Conclusion The three-tier delirium nursing management process can lower the occurrence of delirium in NICU patients with acute stroke,shorten the NICU stay,reduce the safety risk in nursing,and improve the cognitive function.

Glyceryl phenylbutyrate(GPB)serves as a long-term management medication for Ornithine transcarbamylase deficiency(OTCD),effectively controlling hyperammonemia,but there is a lack of experience in using this medicine in China.This article retrospectively analyzes the case of a child diagnosed with OTCD at Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine,including a review of related literature.After diagnosis,the patient was treated with GPB,followed by efficacy follow-up and pharmacological monitoring.The 6-year and 6-month-old male patient exhibited poor speech development,disobedience,temper tantrums,and aggressive behavior.Blood ammonia levels peaked at 327 μmol/L;urine organic acid analysis indicated elevated uracil levels;cranial MRI showed extensive abnormal signals in both cerebral hemispheres.Genetic testing revealed de novo mutation in the OTC gene(c.241T＞C,p.S81P).Blood ammonia levels were approximately 43,80,and 56 μmol/L at 1,2,and 3 months after starting GPB treatment,respectively.During treatment,blood ammonia was well-controlled without drug-related adverse effects.The patient showed improvement in developmental delays,obedience,temperament,and absence of aggressive behavior.

Objective To establish an ideal modeling method for diarrhea predominant irritable bowel syndrome(IBS-D)with anxiely and depression in rats,and to provide a basis for the clinical study of IBS-D.Methods 60 rats were used in this study.(1)At first,20 rats were randomly divided into blank,3%acetic acid enema,4%acetic acid enema,and 5%acetic acid enema groups.After the modeling and observation period,the diarrhea status and the degree of colon injury caused by different modeling concentrations were observed by diarrhea related index and colon histopathology.(2)After the optimal modeling concentration was assessed,40 rats were randomly divided into control(a),acetic acid enema(b),acetic acid+binding(c),and acetic acid+binding+tail clip(d)groups and correspondingly treated for 8 days.After the treatments,the general condition,diarrhea-related index,open field test(OFT)score,and colonic histopathology of rats were evaluated.Results(1)Compared with the blank group,the fecal trait score of 4%acetic acid enema group was increased on days 1 to 3 after intervention(P＜0.001),and gradually decreased on days 4 to 7 after intervention.After 1 week,there was no significant difference between the fecal trait score and that of the blank group(P＞0.05).Body weight was lower(P＜0.01),fecal water content was higher(P＜0.001).Compared with blank group,body weight of the 5%acetic acid enema group was decreased(P＜0.001),the fecal trait score and diarrhea index were increased(P＜0.01).No significant difference was found between 3%acetic acid enema and blank groups.The pathological colon tissue showed that,compared with the blank group,the mucosal structure of the 4%acetic acid enema group was complete with a small amount of inflammatory cell infiltration,and the pathological tissue score showed no significant difference(P＞0.05),whereas the 5%acetic acid enema had a medium to large amount of inflammatory cell infiltration,and the pathological tissue score was increased(P＜0.01).(2)Compared with group a,group b had lower body weight(P＜0.001),and higher fecal trait score,fecal water content and diarrhea index(P＜0.01).Compared with a and b groups,the body weight of c and d groups was lower(P＜0.001),the fecal traits score,fecal water content,and diarrhea index were increased(P＜0.01),and the colon running time was decreased(P＜0.01).Compared with group c,Fecal water content in group D was higher(P＜0.001).In the OFT score,compared with a and b groups,the OFT distance,standing times,and upright times in c and d groups were lower(P＜0.05).Compared with c,the OFT distance,standing times,and upright times in d group were lower(P＜0.05).The pathological tissue of colon showed that the mucosal structure of the four groups was complete,and there were different degrees of inflammatory cell infiltration.The pathological tissue scores of groups c and d were higher than those of groups a and b(P＜0.05).Conclusions The 4%acetic acid concentration is appropriate for IBS-D modeling.After superposition and binding,the IBS-D diarrhea and internal hypersensitivity characteristic state can be better simulated.After superposition of a tail clip,the IBS-D model of liver stagnation and spleen deficiency can be established successfully.

Objective To develop a Nomogram prediction model for post-stroke delirium (PSD) in patients with acute stroke and to verify the effectiveness of the prediction model. Methods A total of 400 patients with acute stroke,admitted to the Department of Neurology in our hospital between June 2022 and March 2023,were retrospectively included in the study as the training group. Independent risk factors for PSD were identified by Logistic regression analysis. A calibration model was constructed to evaluate the consistency of the model. The area under ROC curve (AUC) was used to evaluate the accuracy of the prediction model. Between April and July 2023,172 patients with acute stroke were selected,as the validation group,for external validation of the model. Results The incidence of PSD was found at 27.50％ in the training group and 26.74％ in the validation group. A Nomogram prediction model was constructed with the five predictors:cerebrovascular interventional surgery,hypersensitive C-reactive protein,smoking,National Institutes of Health Stroke Scale (NIHSS) score and age. The calibration curve was found close to the ideal curve with an AUC at 0.797 for the training group,and the risk prediction corresponding to the maximum Youden index was 0.554 with a predicted threshold of 134.63. The calibration curve of the validation group was also found close to the ideal curve,with an AUC of 0.844. Conclusion The nomogram prediction model for PSD in patients with acute stroke demonstrates a good risk prediction value for risk assessment,which can help medical staff to effectively predict the risk for PSD in patients with acute stroke and to take corresponding measures in prevention of PSD.

Objective To develop a Nomogram prediction model for post-stroke delirium (PSD) in patients with acute stroke and to verify the effectiveness of the prediction model. Methods A total of 400 patients with acute stroke,admitted to the Department of Neurology in our hospital between June 2022 and March 2023,were retrospectively included in the study as the training group. Independent risk factors for PSD were identified by Logistic regression analysis. A calibration model was constructed to evaluate the consistency of the model. The area under ROC curve (AUC) was used to evaluate the accuracy of the prediction model. Between April and July 2023,172 patients with acute stroke were selected,as the validation group,for external validation of the model. Results The incidence of PSD was found at 27.50％ in the training group and 26.74％ in the validation group. A Nomogram prediction model was constructed with the five predictors:cerebrovascular interventional surgery,hypersensitive C-reactive protein,smoking,National Institutes of Health Stroke Scale (NIHSS) score and age. The calibration curve was found close to the ideal curve with an AUC at 0.797 for the training group,and the risk prediction corresponding to the maximum Youden index was 0.554 with a predicted threshold of 134.63. The calibration curve of the validation group was also found close to the ideal curve,with an AUC of 0.844. Conclusion The nomogram prediction model for PSD in patients with acute stroke demonstrates a good risk prediction value for risk assessment,which can help medical staff to effectively predict the risk for PSD in patients with acute stroke and to take corresponding measures in prevention of PSD.

Aim To explore the effects of putative receptor protein related to ATI (APJ) homodimer on the behaviors-the proliferation, migration and tube formation of human umbilical vein endothelial cells (HU-VECs). Methods HUVECs at logarithmic growth stage were randomly divided into PBS, Apelin-13 + TM1 (APJ monomer group) and Apelin-13 + PBS group (APJ homodimer group). Western blot and Matrix-Assisted Laser Desorption/Ionization Time of Fligh Mass Spectrometry (MALDI-TOF MS) were used to detect the expression of APJ and APJ homodimer in HUVECs, respectively. Real-Time Cell Analyzers (RT-CA) was used to detect the concentration of the maximum effect of Apelin-13. Cell viability was detected by CCK-8. The cell migration ability was detected by scratch test, and the number of tubes formed on matri-gel that made artificial basement membrane was counted. Results Western blot and MALDI-TOF MS showed that APJ and APJ homodimer were expressed in HUVECs. The EC50 of Apelin-13 was 2.26 x 10