ObjectiveTo investigate the lower limb muscle synergy patterns during jumping in patients after anterior cruciate ligament reconstruction (ACLR). MethodsFrom March to November, 2022, 23 patients after ACLR were enrolled as observation group, and 24 healthy ones matched in height, body mass and exercise level were recruited as control group at Wuhan Sports University. Surface electromyography (sEMG) data of lower limb muscles were collected during a single-leg vertical jump task. Non-negative matrix factorization was applied for synergy analysis. The number of synergies, variance accounted for, synergy structure (muscle weight) and activation coefficient were extracted. ResultsThree types of muscle synergy patterns were identified on the affected side and contralateral side of the observation group, and the control group. For Synergy 1, the weight of biceps femoris was higher on both the affected and contralateral sides than in the control group (P < 0.01); the weight of semitendinosus was higher on the affected side than on the contralateral side (P < 0.05). For Synergy 2, the weight of lateral gastrocnemius and soleus were higher on both sides of the observation group than in the control group (P < 0.05). For Synergy 3, the weight of gluteus maximus was lower on the affected side than on the contralateral side and in the control group (P < 0.05); the weight of tibialis anterior was higher on the affected side than on the contralateral side and in the control group (P < 0.001); the weight of vastus lateralis was lower on the contralateral side than on the affected side and in the control group (P < 0.001). In the observation group, the peak activation time and stop time of Synergy 3 were delayed bilaterally (P < 0.05). ConclusionPatients after ACLR exhibit altered structural and temporal characteristics of lower limb muscle synergy during jump task. The hamstrings show increased participation during the pre-activation phase, and calf muscles undertake more stabilizing functions during the landing phase.

Objectives:To assess the impact of intravascular ultrasound(IVUS)guidance for drug-eluting stent(DES)implantation on the long-term outcomes in coronary artery disease(CAD)patients with chronic kidney disease(CKD).Methods:A retrospective study was conducted on 1 800 CAD and CKD patients who underwent coronary DES implantation at Nanjing First Hospital from January 2018 to December 2022.Patients were divided into IVUS-guided group(IVUS group,n=333)and angiography-guided group(angiography group,n=1 467).Propensity score matching(PSM)was performed at a 1:2 ratio to adjust for differences in baseline clinical and angiographic characteristics between the two groups.Major adverse cardiovascular events(MACE),including cardiac death,target vessel myocardial infarction,and clinically driven target vessel revascularization,were evaluated over a 2-year follow-up.Cox proportional hazards regression was performed to identify independent predictors of MACE.Results:After propensity score matching,333 patients in the IVUS group were matched with 666 patients in the angiography group.Following matching,there were no significant differences in clinical characteristics and angiographic data between the two groups(all P>0.05).Regarding procedural data,IVUS group had a higher number of stents implanted,longer total stent length,larger average stent diameter,more frequent use of post-dilation balloons,larger post-dilation balloon diameter,and greater contrast agent usage(all P<0.05).MACE rate was significantly higher in the angiography group than that in the IVUS group(23.9%vs.18.0%,P=0.037).The difference was mainly attributed to a higher rate of cardiac death in the angiography group(16.1%vs.10.8%,P=0.013).Additionally,patients in angiography group had a significantly higher all-cause mortality rate compared to IVUS group(19.7%vs.13.8%,P=0.022).Multivariate cox regression analysis showed that IVUS guidance(HR=0.73,95%CI:0.55-0.99,P=0.042)was an independent protective factor,while hypertension(HR=1.60,95%CI:1.13-2.26,P=0.008),type 2 diabetes(HR=1.56,95%CI:1.19-2.05,P=0.001),acute coronary syndrome(HR=1.92,95%CI:1.12-3.30,P=0.018),and moderate to severe calcification(HR=1.55,95%CI:1.18-2.04,P=0.002)were independent risk factors for MACE at 2 years after DES implantation in CKD patients.Conclusions:Patients with CAD and CKD,IVUS-guided DES implantation is associated with a reduced risk of MACE and all-cause mortality at 2 years post-procedure compared to coronary angiography-guided implantation.

Objective:To understand the current situation of the ability to screen health information of the elderly in rural areas and analyze its influencing factors, so as to provide a basis for taking targeted measures.Methods:A cross-sectional survey was adopted, and rural elderly people in Yonghe Town, Dahu Town and Dayao Town of Liuyang City, Hunan Province were selected as the survey subjects by the convenience sampling method. The investigation was conducted using the general information Questionnaire, the Health Information Discrimination Ability Scale, the filial Piety Expectation Scale and the two-way Social Support Scale.Results:A total of 228 questionnaires were distributed, and 215 valid questionnaires were retrieved, with an effective recovery rate of 94.30%. Among the 215 rural elderly people surveyed, 86 were male and 129 were female. The ability to discriminate health information was (69.19 ± 13.41) points, the expectation of filial piety was (37.67 ± 6.12) points, and the two-way social support was (46.82 ± 8.11) points. The ability of rural elderly people to discriminate health information was positively correlated with filial piety expectations and two-way social support ( r = 0.340, 0.456; both P<0.01). The results of hierarchical regression analysis showed that educational level, filial piety expectations and two-way social support were the influencing factors of the current status of health information discrimination ability of rural elderly people ( t values were 2.60 to 5.35, all P<0.05). Conclusions:The ability of discriminating health information of the elderly in rural areas is affected by the educational level, filial piety expectation and two-way social support. The health information of rural elderly people with low education level should be screened and targeted, so as to enrich their cultural life and combine education with fun. Actively build a filial piety culture to promote children′s attention to their parents. In addition to providing social support for the elderly, we should promote their interpersonal and social communication and exert their self-value, so as to improve the health information screening ability of the elderly in rural areas.

Objective To explore the cardiovascular protective effect of dapagliflozin on patients with heart failure with preserved ejection fraction(HFpEF)complicated with type 2 diabetes mellitus(T2DM).Methods Patients with HFpEF complicated with T2DM were divided into treatment group and control group according to cohort method.The control group was given 0.5 g of metformin hydrochloride tablet orally twice a day,while the treatment group was given 10 mg of dapagliflozin tablet orally once a day on the basis of treatment in the control group.Patients in both groups were continuously treated for 6 months.The clinical efficacy after treatment and blood glucose indicators[fasting blood glucose(FBG),2 hours postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1 c)],echocardiographic left ventricular parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular remodeling index(LVRI),left ventricular mass index(LVMI)]and serum N-terminal pro-brain natriuretic peptide(NT-proBNP),serum myocardial fibrosis indicators[matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1)]before and after treatment were compared between both groups,and the safety evaluation was performed.Results Seventy-five cases in treatment group and 72 cases in control group were included.After treatment,the total effective rates in treatment group and control group were 93.33％(70 cases/75 cases)and 81.94％(59 cases/72 cases),respectively(P＜0.05).After treatment,the levels of FBG,2 h PBG,HbA1c,LVEF and LVEDD revealed no statistical differences between treatment group and control group(all P＞0.05).After treatment,LVRI values in treatment group and control group were(2.17±0.41)and(2.54±0.46)g·mL-2;LAMI values were(102.47±10.32)and(113.84±15.52)g·m-2;serum NT-proBNP levels were(652.38±208.26)and(993.24±302.69)pg·mL-1;MMP-9 levels were(142.52±21.67)and(168.73±25.88)mg·L-1;TIMP-1 levels were(3.68±0.84)and(3.12±0.91)μg·L-1,respectively(all P＜0.05).The total incidence rates of adverse reactions in treatment group and control group were 14.67％(11 cases/75 cases)and 12.50％(9 cases/72 cases),respectively(P＞0.05).Conclusion Dapagliflozin can improve ventricular remodeling and enhance cardiac function in patients with HFpEF complicated with T2DM,and it has a significant cardiovascular protective effect.

Objective:To investigate the effects of psychosocial factors on early puberty and its sex specific differences.Methods:Bengbu Yuhui Longitudinal Study of Children Development Cohort, consisting of 1 162 students in grades 1-3 (524 girls) and their parents, was established in April 2021 in Bengbu, Anhui Province. The parents were surveyed by questionnaire to collect the information about their children's 56 items of psychosocial factor exposures, including 5 dimensions: major life events, early life adversity, interpersonal/relational conflict, family economic status and daily life troubles. Pubertal growth and physical examinations were conducted by trained professionals at baseline, the 1 st (May 2022), 2 nd (October 2022), 3 rd (May 2023), and 4 th (October 2023) follow-up surveys. In this study, the pubertal development status data were from the 4 th follow-up examination. Fianally, the valid data on pubertal development of 1 105 children were obtained, including the data from 510 girls (46.15%). Multinomial logistic regression model was used to analyze the association between psychosocial factors and early puberty, and the final predictors of early puberty were explored by using four models [least absolute shrinkage and selection operator (LASSO), multiple logistic regression, ridge regression, and Bayesian]. Results:The detection rates of early puberty in boys and girls were 13.60% and 16.30%, respectively. The median of intra-group absolute correlation of psychosocial factor exposure (0.042-0.066) was generally higher than that of inter-group among girls (0.031-0.059), while no similar diference was found among boys. LASSO model showed that moving house, being raised by someone other than parents, sexual abuse, peer conflict, high monthly household income, and high exposure to electronics on school days were predictors of early puberty in girls, while moving house and high monthly household income were the predictors of early puberty in girls in all four models (LASSO, multiple logistic regression, ridge regression, and Bayesian). Among boys, only a transient loss from family was a predictor of early puberty.Conclusion:Early puberty in children can be predicted by psychosocial factors, and there are gender-specific differences.

Hemodialysis patients exhibit compromised immune function and require long-term repeated vascular punctures as therapeutic approach,the risk of infection increases.Hospital-associated infection in hemodialysis de-partment(center)happens from time to time,which has already become a concern for the medical community,patients and social media.This paper outlines the task origin of China's"Standard for infection prevention and control in hemodialysis department(center)"(WS/T854-2025),the compilation basis and explanations for its key content,feasibility and implementation recommendations,as well as the clarifications on common issues encoun-tered during its promotion and enforcement.

Objective:In the context of the current serious investigation and punishment of scientific research dishonesty cases by various levels of management departments and institutions, and the strong emphasis on scientific research integrity construction, this paper analyzes the current situation and shortcomings of the protection of the legitimate rights and interests of the involved parties, and explores methods, paths, and countermeasures to strengthen and improve the protection of the rights and interests of the involved parties.Methods:Through policy learning, literature review, case analysis, and expert consultation, we conducted in-depth analysis of the problems and deficiencies in the current protection mechanism. Based on problem-solving and addressing weaknesses, we proposed targeted and feasible countermeasures and suggestions.Results:The current protection mechanism for medical research dishonesty cases had insufficient coverage, specialization, and effectiveness in terms of laws and regulations, institutional functions, rights protection, and relief feedback. Targeted measures should be taken from top-level design, program optimization, psychological and social support, management function expansion, and evaluation system improvement.Conclusions:The current laws and regulations, operational mechanisms, channels, and functions related to the protection of involved objects are weak or lacking to varying degrees, and urgently need to be highly valued at all levels to accelerate the improvement of the investigation and handling of medical research dishonesty cases and the protection mechanism for involved objects.

Objective:To construct a framework for evaluating the quality of health economic evaluation methodology based on the pragmatic clinical trial.Methods:An evaluation framework was constructed based on existing quality evaluation tools for health economic evaluation other quality evaluation tools.The weights of each item in the framework were determined by the Delphi method,and the weighted average was calculated using the expert authority coefficient.Results:A total of 23 experts were consulted,and the expert authority coefficients were 0.88 and 0.90,respectively.The results of the Wilcoxon signed-rank test showed no statistically signifi-cant differences among the expert opinions in two rounds(P＞0.05).Finally,a framework with 3 dimensions and 8 items was estab-lished.Conclusion:The evaluation framework has high scientificity and reliability.

Objective:To investigate the effects of psychosocial factors on early puberty and its sex specific differences.Methods:Bengbu Yuhui Longitudinal Study of Children Development Cohort, consisting of 1 162 students in grades 1-3 (524 girls) and their parents, was established in April 2021 in Bengbu, Anhui Province. The parents were surveyed by questionnaire to collect the information about their children's 56 items of psychosocial factor exposures, including 5 dimensions: major life events, early life adversity, interpersonal/relational conflict, family economic status and daily life troubles. Pubertal growth and physical examinations were conducted by trained professionals at baseline, the 1 st (May 2022), 2 nd (October 2022), 3 rd (May 2023), and 4 th (October 2023) follow-up surveys. In this study, the pubertal development status data were from the 4 th follow-up examination. Fianally, the valid data on pubertal development of 1 105 children were obtained, including the data from 510 girls (46.15%). Multinomial logistic regression model was used to analyze the association between psychosocial factors and early puberty, and the final predictors of early puberty were explored by using four models [least absolute shrinkage and selection operator (LASSO), multiple logistic regression, ridge regression, and Bayesian]. Results:The detection rates of early puberty in boys and girls were 13.60% and 16.30%, respectively. The median of intra-group absolute correlation of psychosocial factor exposure (0.042-0.066) was generally higher than that of inter-group among girls (0.031-0.059), while no similar diference was found among boys. LASSO model showed that moving house, being raised by someone other than parents, sexual abuse, peer conflict, high monthly household income, and high exposure to electronics on school days were predictors of early puberty in girls, while moving house and high monthly household income were the predictors of early puberty in girls in all four models (LASSO, multiple logistic regression, ridge regression, and Bayesian). Among boys, only a transient loss from family was a predictor of early puberty.Conclusion:Early puberty in children can be predicted by psychosocial factors, and there are gender-specific differences.

Objective To explore the cardiovascular protective effect of dapagliflozin on patients with heart failure with preserved ejection fraction(HFpEF)complicated with type 2 diabetes mellitus(T2DM).Methods Patients with HFpEF complicated with T2DM were divided into treatment group and control group according to cohort method.The control group was given 0.5 g of metformin hydrochloride tablet orally twice a day,while the treatment group was given 10 mg of dapagliflozin tablet orally once a day on the basis of treatment in the control group.Patients in both groups were continuously treated for 6 months.The clinical efficacy after treatment and blood glucose indicators[fasting blood glucose(FBG),2 hours postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1 c)],echocardiographic left ventricular parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular remodeling index(LVRI),left ventricular mass index(LVMI)]and serum N-terminal pro-brain natriuretic peptide(NT-proBNP),serum myocardial fibrosis indicators[matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1)]before and after treatment were compared between both groups,and the safety evaluation was performed.Results Seventy-five cases in treatment group and 72 cases in control group were included.After treatment,the total effective rates in treatment group and control group were 93.33％(70 cases/75 cases)and 81.94％(59 cases/72 cases),respectively(P＜0.05).After treatment,the levels of FBG,2 h PBG,HbA1c,LVEF and LVEDD revealed no statistical differences between treatment group and control group(all P＞0.05).After treatment,LVRI values in treatment group and control group were(2.17±0.41)and(2.54±0.46)g·mL-2;LAMI values were(102.47±10.32)and(113.84±15.52)g·m-2;serum NT-proBNP levels were(652.38±208.26)and(993.24±302.69)pg·mL-1;MMP-9 levels were(142.52±21.67)and(168.73±25.88)mg·L-1;TIMP-1 levels were(3.68±0.84)and(3.12±0.91)μg·L-1,respectively(all P＜0.05).The total incidence rates of adverse reactions in treatment group and control group were 14.67％(11 cases/75 cases)and 12.50％(9 cases/72 cases),respectively(P＞0.05).Conclusion Dapagliflozin can improve ventricular remodeling and enhance cardiac function in patients with HFpEF complicated with T2DM,and it has a significant cardiovascular protective effect.