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.

Objective To establish a standard operating procedure(SOP)for perioperative nursing cooperation in the corneal collagen cross-linking surgery and explore the effect of clinical application in order to improve the quality and efficiency of the management in clinical practice.Methods A research team was established in October 2022 to construct a patient-orientated standard operating procedure for perioperation nursing cooperation in corneal collagen cross-linking surgery.With the before-after control method,170 patients who underwent single eye rapid epithelial-off corneal collagen cross-linking surgery between April 2022 and July 2023 were selected.Totally 85 case form April to October 2022 were assigned into a control group and 85 cases form November 2022 to July 2023 were assigned into a trial group.The control group received a routine perioperative nursing,while the trial group received the standard operating procedure(SOP)for perioperative nursing on the basis of the control group.The two groups were compared in terms of surgical duration,surgical connection duration,perioperative time,surgeon's satisfaction,nurse's job satisfaction and patient's satisfaction.Results The trial group had significantly shorter surgical duration,connection duration and perioperative duration than those of the control group(all P<0.001).The trial group showed significantly higher scores in satisfactions of doctor,nurse and patient in comparison with the control group(all P<0.001).Conclusion The SOP for perioperative nursing cooperation in the corneal collagen cross-linking surgery not only improve the efficiency among the medical team,work quality and services level,but also improve the satisfaction of doctors and patients towards the nursing care and enhance nurse's sense of identity with nursing work.

Objective To establish a standard operating procedure(SOP)for perioperative nursing cooperation in the corneal collagen cross-linking surgery and explore the effect of clinical application in order to improve the quality and efficiency of the management in clinical practice.Methods A research team was established in October 2022 to construct a patient-orientated standard operating procedure for perioperation nursing cooperation in corneal collagen cross-linking surgery.With the before-after control method,170 patients who underwent single eye rapid epithelial-off corneal collagen cross-linking surgery between April 2022 and July 2023 were selected.Totally 85 case form April to October 2022 were assigned into a control group and 85 cases form November 2022 to July 2023 were assigned into a trial group.The control group received a routine perioperative nursing,while the trial group received the standard operating procedure(SOP)for perioperative nursing on the basis of the control group.The two groups were compared in terms of surgical duration,surgical connection duration,perioperative time,surgeon's satisfaction,nurse's job satisfaction and patient's satisfaction.Results The trial group had significantly shorter surgical duration,connection duration and perioperative duration than those of the control group(all P<0.001).The trial group showed significantly higher scores in satisfactions of doctor,nurse and patient in comparison with the control group(all P<0.001).Conclusion The SOP for perioperative nursing cooperation in the corneal collagen cross-linking surgery not only improve the efficiency among the medical team,work quality and services level,but also improve the satisfaction of doctors and patients towards the nursing care and enhance nurse's sense of identity with nursing work.

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 study the clinical characteristics and risk factors of cow's milk protein allergy(CMPA)in infants less than 3 months old in Guangxi District.Methods From July 1 ,2012,to December 30,2014,infants less than 3 months old suspected of CMPA visiting the pediatric outpatient depart-ment of Maternal and Children Hospital of Guangxi Zhuang Autonomous Region were recruited,which included initial diagnosis and being transported from peripheral hospitals.Observation scale was formulated, attending physician screened patients and their senior made a definite diagnosis.All the infants underwent diagnostic algorithms and were followed up constantly.Results A total of 137 cases were divided into aller-gy group(n =51 )and control group(n =86).Two groups shared some common symptoms such as diarrhea, constipation,bloody stool,stomachache,gastroesophageal reflux(GER),indigestion,anorexia,feeding diffi-culties.Between the allergy group and control group the parameters such as feeding patterns (including breast feeding,mix feeding,formula feeding),improper deeding of food supplement,long-term use of antibiotics in neonatal period and parental atopy showed no significant differences(P ﹥0.05).The parameters in neonatal period including GER [20 cases (39.2%)vs.7 cases (8.1 %)],intake of cow's milk formula [51 cases (100%)vs.71 cases (82.6%)],feeding intolerance (including GER)[17 cases (33.3%)vs.1 1 cases (12.8%)],gut infection[8 cases(15.7%)vs.4 cases(4.7%)],transfusion of blood or/and bloody prod-ucts[12 cases(23.5%)vs.1 1 cases(12.8%)]showed statistically significant differences between the aller-gy group and control group(χ2 =19.538,P =0.000;χ2 =9.989,P =0.002;χ2 =8.308,P =0.004;χ2 =4.691 ,P =0.030;χ2 =5.198,P =0.023 ).Conclusion Symptoms of CMPA in infants no more than 3 months old involve mainly digestive system such as diarrhea,bloody stool,GER.Intake of cow milk formula in neonatal period play an important role in triggering CMPA.

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.

Objective To explore the application value of 320-slice spiral CT myocardial perfusion technique in the evaluation of cardiac function in patients with coronary artery disease.Methods 24 patients with known reversible myocardial ischemia with coro-nary heart disease and 13 cases of normal were detected by 320-slice spiral CT myocardial perfusion scan in resting and after dobu-tamine-induced stress,measured the values of cardiac function indexes(ESV、EDV、SV、EF)in resting and after dobutamine-induced stress respectively,the results were analyzed by paired t test and independent sample t test,when the P value is less than 0.05,con-sidered statistically significant or correlation.Results The values of cardiac function indexes (ESV,EDV,SV)between the resting and after dobutamine-induced stress were significantly different except EF value in normal group.But only the EF value was signifi-cantly different in CHD,the rest values of cardiac function indexes(ESV,EDV,SV)no significant difference.Each corresponding value of cardiac function indexes in resting and after dobutamine-induced stress was significantly different between the CHD and the normal.Conclusion The dobutamine-induced stress myocardial perfusion with 320-slice spiral CT can judge the impaired degree of cardiac function in patients with myocardial ischemia,provide the basis for comprehensive evaluation of coronary artery disease and its prognosis.

Objective To investigate the treatment effect of the proximal humeral internal locking system (PHIL()S) on the elderly patients with displaced proximal humeral fractures.MethodsFrom Feb 2004 to Mar 2007, 36 patients (mean age: 72.2 years) with proximal humeral fractures were treated with PHILOS plate fixation which included 14 cases with 2-part, 17 cases with three-part and 5 cases with four-part fractures according to Neer classification.Operation time,intraoperative blood loss, blood transfusion, perioperative complications and function evaluation of the operated shoulder joint were calculated with 14.5 months follow-up at average.Results The average operation time and blood loss were (61.5± 11.6) min and ( 165.2±91.2) ml, respectively. 1 case with accidents of blood vessel and 1 case with pneumonia were found without neurovascular injuries. All fractures were radiographically healed in an average of 3-5 months.No necrosis of humeral head appeared and 30 (83.3％) cases were excellent or good according to Neer scoring system. Two part fracture and early operation ( within 3 days after operation) might improve the postoperative function of shoulder joint, but the patient's age, gender and ASA score were not statistically with Neer score.Conclusions PHILOS plate fixation is a suitable procedure for displaced proximal humeral fractures via stable fixation and early rehabilitation, especially for elderly patients combined with osteoporosis.

Objective To observe the pathologic type and degree of traumatic recurrent anterior dislocation of the shoulder by means of arthroscopy and discuss clinical results of modified Bristow method and arthroscopic Bankart reconstruction so as to provide refeFences for selecting operation methods.Methods A retrospective study was done off 62 patients(62 shoulders,44 males and 18 females.at av-erage age of 39.8 years.ranging from 21 to 67 years)with anterior recurrent dislocation of shoulder (mean duration of 87 months)admitted into our hospital from July 1997 to Oetcher 2007.All patients un-derwent preoperative arthroscopic examination that showed pathologic changes including injury of shoulder and humerus head,Bankart injury severity and laxitas of humerus glenoid ligament of articular capsule,which were used as referenee of surgical procedures.Modified Bristow's method or arthroscopic suture anchor Bankart reconstruction were performed according to arthroscopic results(pathologic change).The patients were assessed with the University of California at Los Angeles(UCLA)shoulder rating scale.Results There were 45 patients treated with modified Bristow,s method and 17 with arthroscopic suture anchor Bankart reconstruction.The follow.uD for mean 64.2 months showed that pre-and post-operative mean UCLA scores were(22.6±4.4)points and(29.8±4.2)points respectively(P＜0.01),the mean forward flexion(136.8±14.2)°and(156.6±17.8)°respectively(P＜0.01)and the mean ex-ternal rotation in 90°abduction(52.5±16.4)°and(72.4±11.3)°(P＜0.01).There were no redis-location at final follow-up,but there were 6 patients(9.6%)with positive apprehension test.Of all,60 patients(97%)returned to their pre-injury.work. Conclusions Observation of pathologic change of surgical procedure.Both modified Bristow's method and arthruscopic Bankart reconstruction are good methtxts for treatment of recurrent anterior shoulder dislocation under conditions of successful management of pathologic change of shoulder, restoration of normal anatomic structure of shoulder ioint and strict indi-cation control.