With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

With the great development of medical education reform,clinical competency has become the requirements and goal of talent training in Medical Imaging in medical universities within and beyond China.The aim of this article is to review the role of non-standardized assessment at raising students'clinical competency in the course of Diagnostic Medical Imaging in our university.To achieve the goal of reinforcing student's thought of medical imaging and their clinical competency,building up high-quality educational evaluation system,strengthening the teaching faculty,facilitating the combination of theory teaching and practice teaching,improving the practice ability and the awareness of services after their formal induction,and therefore cultiva-ting effective and practical medical imaging talents for our nation.

Objective:To study the effects of breastfeeding within 2 weeks after birth on late-onset sepsis in very low birth weight infants (VLBWI).Methods:From July 2018 to June 2019, clinical data of VLBWI (birth weight <1 500 g) born in our hospital were retrospectively reviewed. According to the proportion of breastfeeding volume in total feeding volume within 2 weeks after birth, the infants were assigned into high-proportion breastfeeding group (breastfeeding >50%), low-proportion breastfeeding group (breastfeeding ≤50%) and formula group. The incidences of late-onset sepsis among the three groups were compared using the chi-square test or Fisher's exact probability method. Logistic regression was used to analyze the effects of breastfeeding within 2 weeks after birth on late-onset sepsis.Results:The incidences of late sepsis in high-proportion breastfeeding group, low-proportion breastfeeding group and formula group were 0.4% (1/216), 8.1% (5/62) and 8.0% (2/25), respectively ( P<0.001). Logistic regression analysis showed that compared with the high-proportion breastfeeding group, the low-proportion breastfeeding group ( OR=17.844, 95% CI 2.005~158.775) and the formula group ( OR=23.261, 95% CI 1.916~282.350) had increased risks of late-onset sepsis. Conclusions:For VLBWI, high proportion breastfeeding (breastfeeding >50%) within 2 weeks after birth may reduce the risk of late-onset sepsis.

Objective:To study the trends and ranges of blood pressure in extremely premature infants (EPIs) during the first 7 days after birth.Methods:From January 2016 to December 2020, EPIs born in our hospital were retrospectively analyzed. Their blood pressure were monitored using umbilical arterial catheters and no patients needed anti-hypotension treatment. The clinical data of the infants and their mothers, blood pressure data during the first 7 days after birth, clinical outcomes and complications were collected. The trends of blood pressure in untreated EPIs were analyzed and the blood pressure ranges of EPIs of different gestational ages (GA) were established.Results:A total of 145 cases of EPIs were included and their systolic pressure, diastolic pressure and mean blood pressure showed upward trends during 2~168 h after birth ( P<0.001). The diastolic pressure increased significantly within 24 h after birth ( P<0.05), systolic pressure and mean blood pressure increased significantly within 72 h after birth ( P<0.05). Blood pressure increased with age and GA. Conclusions:The blood pressure of EPIs will increase spontaneously during 7 days after birth. The ranges of blood pressure are measured for infants with different GA to provide clinical evidence for blood pressure management of EPIs during early postnatal period.

Objective:To study the effect of oropharyngeal colostrum administration on salivary secretory IgA (sIgA) levels in extremely/very low birth weight preterm infants fed by gastric tube.Methods:Preterm infants with birth weight <1 500 g ( n=90) hospitalized in neonatal intensive care unit of the Affiliated Shenzhen Maternity & Child Healthcare Hospital of Southern Medical University from August 2020 to January 2021 were enrolled as research subjects. They were assigned into observation group and control group. The observation group accepted oropharyngeal administration of colostrum before being fed by gastric tube once every 3 hours for 7 days. The control group was given normal saline before each feeding. Other nursing interventions were consistent with the observation group. Saliva samples were collected at the 2 hour and 7 day after birth and the levels of slgA were tested. SPSS 26.0 statistical software was applied to analyse the data. Results:A total of 81 preterm infants completed this study. The content of salivary sIgA in observation group (42 cases) on 7 day after birth were significantly higher than those on the 2 hour after birth [15.4 (0.6, 106.7) μg/ml vs. 0.6 (0.0, 5.3) μg/ml] ( P<0.05). There was no statistically significant difference between the sIgA levels in the saliva of the control group (39 cases) at the 7 postnatal day and 2 hour after birth [0.0 (0.0, 1.4) μg/ml vs. 0.0 (0.0, 5.2) μg/ml] ( P>0.05). The content of salivary sIgA in observation group were significantly higher than those in control group on the 7 day after birth, the difference was statistically significant ( P<0.05). The salivary sIgA levels in the observation group were negatively correlated with the starting time of oropharyngeal administration of colostrum ( r=-0.330, P<0.05), and positively correlated with the total number of oropharyngeal administration of colostrum ( r=0.388, P<0.05). Conclusions:Oropharyngeal colostrum administration can improve the levels of salivary sIgA of extremely/very low birth weight preterm infants fed by gastric tube.

Objective: To investigate the correlation of early incubator temperature fluctuation on intraventricular hemorrhage (IVH) in very/extremely-low birth weight infants (E/VLBW). Methods: From July 2015 to September 2016, 270 patients of hospitalized E/VLBW were included in this study. Temperature changes including incubator temperature and abdominal temperature within 72 hours after admission and routine clinical data were collected,the E/VLBW were divided into IVH group and non-IVH group, as well as the occurrence and grading of IVH. Chi-square test, t test and nonparametric test and logistic regression analysis were used to explore the effect of early incubator temperature fluctuations in E/VLBW on IVH. Results: Of the 270 V/ELBW studied, the incidence of IVH was 24.4% (66/270) , severe IVH(grade Ⅲ and Ⅳ) was 5.2% (14/270) . Univariate analysis showed that in addition to common IVH risk factors such as gestational age, body weight, 1/5 min Apgar score, sex, delivery, hyperglycemia, prenatal steroid and mechanical ventilation, fluctuations of body temperature and incubator temperature were relevant for IVH in E/VLBW (P<0.05) . Logistic regression analysis of the above relevant risk factors showed fluctuations of temperature (OR=1.10) was also an independent risk factor for IVH in E/VLBW(P<0.05) , in addition to sex(OR=0.42) , 1 min Apgar score (OR=0.71) , and hyperglycemia (OR=3.67) . Conclusion Fluctuation of incubator temperature is an independent risk factor for IVH in V/ELBWI. During centralized nursing and nursing operations, the operating time should be shortened as much as possible to reduce the number of fluctuations of incubators and body temperature to reduce the incidence of IVH and improve the quality of life.

Objective To investigate the effect of the courses of image diagnostics on clinical pro-bation period via the combination of PBL and multimedia network teaching model. Methods 126 under-graduates from the department of medical image (Grade 2011 and 2012) were selected as teaching subjects, and PBL combined with multimedia network teaching was adopted in the teaching of the course of medical imaging diagnosis. After class we implemented a questionnaire survey, and let the students write learning experience. Statistical analysis was conducted by using SSPS 13.0 to reflect the teaching participation in the students' questionnaire and a. summary analysis of the learning experience of the students was also made. Results 123 valid questionnaires were collected. 94.31%(116 people) of students were active participants in these courses, 90.25%(111 people) of the students thought they could actively communicate in teaching, and 43% (110 people) of the students thought they got fully prepared before class. 123 articles in accor-dance with the requirements of experience were received; most students took positive attitude to the active influence the teaching methods had brought; some student pointed out that the teaching method had the disadvantages such as too much time to prepare, too much information, and so on. Conclusions The com-bination of PBL and multimedia network teaching has preliminary results. It is a novel model that is available for teaching image diagnostics on clinical probation period.

Objective To evaluate the clinical effect of Kangai injection combined with transcatheter arterial chemoembolization (TACE) in the treatment of hepatic cancer.Methods We searched CBM,CNKI,WanFang and VIP,clinical studies of Kangai injection combined with TACE in the treatment of hepatic cancer were included and compared.The methodological quality of included studies was assessed and Meta analysis was performed by Rev Man 5.2 software.Results 9 studies involving 595 patients were included.Meta analysis results indicated that the difference of effective rate was significant [RR =1.32,95 ％ CI(1.10,1.58),P =0.003] ; The quality of life improvement rate also had significant difference[RR =1.85,95％ CI(1.42,2.41),P ＜ 0.000 01].Conclusion Kangai injection combined with TACE in the treatment of hepatic cancer can get extra benefits compared with TACE alone.It can improve the curative effect,significantly improve the quality of life.

Objective To investigate the premature infants′ pain operation during their hospitalization and thus provide evidence for the necessity of premature infants pain management. Methods Using the method of convenient sampling, we prospectively collected data of all painful procedures performed on 111 premature infants who recruited from admission to discharge in a Neonatal Intensive Care Unit in Shenzhen. The pain of premature infant was evaluated by premature infant pain profile ( PIPP ) . Results During hospitalization, 111 premature infants were exposed to 8 258 painful operations, with each preterm having (74. 4 ± 18. 22) times and averagely (3. 72 ± 1. 53) times each day. Below 1 500 g birth weight infants and equal and beyond 1 500 g birth weight infants were exposed to a median of 153 and 46 painful procedures, respectively. Among those painful procedures, 3M Transparent Dressing removal was the most frequently pain operation performed on preterm neonates, and peripheral arterial puncture, plantar blood sampling, and subcutaneous injection were top three reasons caused most pain. Conclusions Premature infants, particularly very/extremely low birth weight infants ( VLBWI/ELBWI ) , are exposed to numerous invasive painful procedures. It is necessary to train health-care workers to enhance their pain management ability, thereby to reduce the adverse effects of pain stimuli to the premature infants.