BACKGROUND:The plantarflexor weakness is a common muscle defect in patients with spastic cerebral palsy and Charcot-Marie-Tooth,which clinically manifests abnormal gaits,and the relationship between plantarflexor weakness and abnormal gaits is unclear. OBJECTIVE:To explore the biomechanical behavior of the lower limb under the action of a single factor of plantarflexor weakness to reveal the mechanism of abnormal gait induced by plantarflexor weakness and to provide guidance for the rehabilitation training of patients with plantarflexor weakness. METHODS:A predictive framework of musculoskeletal multibody dynamics in the sagittal plane was established based on OpenSim Moco to predict lower limb joint angles and muscle activation changes during walking in normal subjects.The validity of the framework was verified by combining the inverse kinematics and electromyogram activation time of the experimental data.Reduced isometric muscle forces were used to model plantarflexor weakness and to compare predicted lower extremity joint angles,joint moments,and muscle energy expenditure with normal subjects to analyze the effects of plantarflexor weakness on lower extremity biomechanics. RESULTS AND CONCLUSION:(1)The Moco-based prediction framework realistically predicted the biomechanical changes of the lower limbs during walking in normal subjects(joint angles:normalized correlation coefficient≥0.73,root mean square error≤7.10°).(2)The musculoskeletal model used a small stride support phase to increase the"heel-walking"gait during plantarflexor weakness.When the plantarflexor weakness reached 80%,the muscle energy expenditure was 5.691 4 J/kg/m,and the maximum activation levels of the gastrocnemius and soleus muscles were 0.72 and 0.53,which might cause the plantarflexor weakness patients to be more prone to fatigue when walking.(3)Muscle energy expenditure was significantly higher when the weakness of plantarflexors exceeded 40%,and the joint angles and moments of the lower limbs deteriorated significantly when the weakness of plantarflexors exceeded 60%,suggesting that there may be a"threshold"for the effect of plantarflexor weakness on gait,which may correspond to the point at which health care professionals should intervene in the clinical setting.

Objective To assess the biomechanical differences between the artificial ankle joints INBONE Ⅱ and INFINITY after total ankle arthroplasty(TAA)to provide more scientific and individualized treatment options for patients.Methods A patient-individualized TAA lower extremity MSK MBD model was established using the musculoskeletal(MSK)multibody dynamics(MBD)software AnyBody.The ankle joint contact force,motion,and contact characteristics of artificial ankle joint surfaces were predicted.Results The geometric shape of the articular surface of the artificial ankle had no significant effect on the ankle contact force,but it affected the range of motion and contact characteristics of the articular surface.Compared with INBONE Ⅱ,the coronal plane articular surface arc height of INFINITY was lower,and increased the inversion-eversion and external rotation-internal rotation movements by 7.91%and 2.61%,respectively.Sagittal plane matching was lower,and reduced posterior-anterior and inferior-superior movements by 21.75%and 21.23%,respectively,and medial-lateral movement increased by 49.26%.INFINITY exhibited lower matching with decreases of 18.48%,30.42%,and 26.36%in the medial,lateral,and total joint surface contact areas,respectively.However,the center of the pressure motion trajectory was concentrated on the medial side,while avoiding edge contact stress concentration and reducing the risk of joint dislocation and premature wear of the tibial component.Conclusions The smaller geometric constraints of the INFINITY artificial ankle joint demonstrated better biomechanical performance,thereby promoting improved postoperative ankle joint functional recovery.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To study the levels of individual dose of radiation workers in a steel enterprise in Baotou City from 2018 to 2022, and analyze the main factors affecting the annual dose, and provide basic data for revising relevant standards.Methods:According to the requirements of occupational external exposure personal monitoring standards (GBZ 128-2019), the personal dose monitoring of workers working in a steel enterprise in Baotou City from 2018 to 2022 was carried out, three months for a period, continuous monitoring 4 periods, and the results were analyzed.Results:A total of 1 360 workers from 10 employers within the enterprise were surveyed. The annual doses were in the range of 0.500 - 0.844 mSv, with an average annual individual dose of 0.676 mSv. Especially, the average annual individulal effective dose to workers for safety management and inspection was 0.986 mSv, hiher than 0.698 mSv to rolling workers, pump operators, and continuous casters ( Z = 56.89, P < 0.001). Additionally, female worders working with the radiation generators had a higher average annual individual effective dose of 0.821 mSv, than 0.691 mSv to the male workers who were exposed to sealed sources possibly in many cases as needed, with a statistically significant difference ( Z =-5.53, P < 0.001). Conclusions:The average annual individual effective dose to radiation workers in an iron and steel enterprise in Baotou City meets the requirements of the relevent national standard. The annual dose of women and some workers is relatively high, so the management of radiation workers should be strengthened and the radiation protection measures in the workplace should be improved.

Objective To investigate the mechanism and protective effect of Humanin(HN)on rotenone(Rot)-induced toxic damage for dopamine neurons.Methods The Rot-poisened PC12 cell model was constructed,and the control group,the Rot poisening group,the HN pretreated Rot poisening group,and the HN treatment group were set up.ELISA was used to detect the content of HN inside and outside of Rot-infected cells,CCK-8 assay was used to detect cell viability,and ATP detection kit was used to detect the intracellular ATP content.Dichloro-dihydro-fluorescein diacetate(DCFH-DA)assay was used to detect the level of reactive oxygen species(ROS)in cells.Western blotting was performed to detect the expression level of mitochondrial autophagy regulatory proteins Pink1,Parkin,p62,LC3,mitochondrial biogenesis regulatory protein PGC1α,division/fusion regulatory proteins OPA1,MFN2,DRP1,p-DRP1 and antioxidant stress regulatory proteins Keap1 and Nrf2.HBAD-mcherry-EGFP-LC3 adenovirus transfected cells was used to observed the number of autophagosomes and autophagolysosomes.Results The results showed that the intracellular concentration of HN in PC12 in the Rot poisening group was significantly higher than that in the control group(P＜0.05);Compared with the control group,the Rot poisening group had significantly decreased activity of PC12 cells,decreased ATP content and increased production of ROS.After the poisen of Rot in PC12 cells,the expression of Pink1 and p-Parkin,the ratio of LC3Ⅱ/LC3Ⅰ and the expression of p-DRP1 in mitochondrial fusion protein was increased,while the expression of p62,the expression of mitochondrial biogenesis protein PGC1 α,mitochondrial fusion proteins MFN2 and OPA1,and antioxidant stress proteins Keap1 and Nrf2 were decreased(all P＜0.05).The number of autophagosomes and autophagolysosomes in PC12 cells in the Rot poisening group was higher than that in the control group(P＜0.05),and HN pretreatment(20 μmol/L)could significantly improve the changes mentioned above caused by Rot poisening(P＜0.05).Conclusion HN ameliorates Rot-induced toxic damage for dopamine neurons by inhibiting mitophagy and mitochondrial division and promoting mitochondrial biogenesis and fusion,and anti-oxidative stress.

OBJECTIVE To construct the quantitative evaluation system of regional clinical pharmacists’ professional ability， and provide reference for the evaluation of regional clinical pharmacists’ professional ability. METHODS Twenty-one experts from 18 hospitals in Chongqing were consulted to construct a professional ability index system for clinical pharmacists. TOPSIS model was used to calculate and obtain the expert authority index （EI）， and the weighted averaging method was used to construct the judgment matrix. Analytic hierarchy process （AHP） was used to calculate the weights of all indicators for establishing a quantitative evaluation system of regional clinical pharmacists’ professional ability according to the weights of each item. RESULTS The results of TOPSIS showed that the EI range was 0.010-0.100， and the relative authority of experts was distinguished and measured effectively. The results of AHP showed that the judgment matrix of the quantitative evaluation system met the requirements of consistency test （consistency test index CR＜0.1）. Finally， a quantitative evaluation system for regional clinical pharmacists’ professional ability was established， including 6 sub-objective items （basic ability， clinical practice ability， coordination and communication ability， publicity ability， scientific research and teaching ability， continuous improvement ability） and 25 index items （such as educational background， professional title， clinical pharmacy working years， daily theoretical skills assessment， information ability level， medication education， etc.）. CONCLUSIONS A quantitative evaluation system of regional clinical pharmacists’ professional ability has been established. Our study provides a theoretical reference for the quantitative evaluation and optimal management of regional clinical pharmacists.

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.

新冠病毒感染疫情严重威胁着世界各国人民的生命健康。目前，对病毒感染的防治研究主要集中在抑制病毒与分子受体的结合上。AXL作为新发现的严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）受体，在协助病毒感染人体呼吸系统中发挥着重要作用，是未来临床干预的潜在靶点。本研究对已发表的单细胞测序数据进行整理和分析，发现AXL在年轻人肺细胞中的表达水平明显高于老年人。人胚肺二倍体成纤维细胞（2BS）是衰老研究的公认细胞株。本文采用2BS细胞构建复制性细胞衰老模型，发现年轻细胞中AXL的蛋白水平明显高于衰老细胞，据此推测年轻人感染的风险可能更高，需要注意防护。我们发现一种羊栖菜褐藻多糖硫酸酯组分（SFW-3）可显著下调年轻2BS细胞中AXL的表达水平，表明SFW-3具有一定的抗SARS-CoV-2感染的研究价值，同时表明2BS细胞株也可作为潜在的SARS-CoV-2体外感染模型。
Humans ; SARS-CoV-2 ; Sargassum/metabolism* ; Diploidy ; Sulfates/metabolism* ; COVID-19 ; Polysaccharides/pharmacology* ; Lung

Objective To compare the biomechanical effects of contiguous three-level cervical Hybrid surgery[anterior cervical discectomy and fusion (ACDF) + cervical disc arthroplasty ( CDA)] and three-level ACDF. Methods The finite element model of C1-T1 cervical-thoracic spine was developed based on CT data. Three models were simulated by the implantation of Prestige LP and Zero-P prostheses, including two Hybrid models (AFA, Prestige LP implanted at C3-4 and C5-6 segments and Zero-P implanted at C4-5 segment; FAF, Zero-P implanted at C3-4 and C5-6 segments and Prestige LP implanted at C4-5 segment) and three-level ACDF model(FFF). The changes in range of motion (ROM) of adjacent levels during flexion, extension, lateral bending and axial rotation, the overall ROM, as well as the intradiscal pressure ( IDP) and facet contact force ( FCF) of adjacent levels were compared. Results The ROM in adjacent levels and the overall ROM of the AFA modelwere closer to the intact model, and the maximum increases in the ROM of the adjacent levels for the FAF and FFF models were 15. 0% and 23. 4% , respectively. For AFA, FAF and FFF models, the maximum increases in the maximum IDP of adjacent levels were 19. 0% , 66. 7% , 147. 6% , and the maximum increases in FCF were 17. 4% , 55. 7% , 80. 1% , respectively. Conclusions This study provides biomechanical basis for three-level cervical Hybrid surgery in treating patients with the contiguous three-level cervical degenerative disc disease.

Reconstructing three-dimensional (3D) models from two-dimensional (2D) images is necessary for preoperative planning and the customization of joint prostheses. However, the traditional statistical modeling reconstruction shows a low accuracy due to limited 3D characteristics and information loss. In this study, we proposed a new method to reconstruct the 3D models of femoral images by combining a statistical shape model with Laplacian surface deformation, which greatly improved the accuracy of the reconstruction. In this method, a Laplace operator was introduced to represent the 3D model derived from the statistical shape model. By coordinate transformations in the Laplacian system, novel skeletal features were established and the model was accurately aligned with its 2D image. Finally, 50 femoral models were utilized to verify the effectiveness of this method. The results indicated that the precision of the method was improved by 16.8%-25.9% compared with the traditional statistical shape model reconstruction. Therefore, the method we proposed allows a more accurate 3D bone reconstruction, which facilitates the development of personalized prosthesis design, precise positioning, and quick biomechanical analysis.
Imaging, Three-Dimensional/methods* ; Tomography, X-Ray Computed/methods* ; Femur/surgery* ; Models, Statistical ; Lower Extremity