Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.

Objective:To investigate the efficacy of arthroscopic ligament augmentation repair in the treatment of chronic lateral ankle instability.Methods:The clinical data of 65 patients with chronic lateral ankle instability who received treatment at Shangluo Central Hospital from October 2019 to October 2022 were retrospectively analyzed. The clinical data were divided into three groups based on treatment methods: the mini-open group ( n = 15), in which patients underwent arthroscopy-assisted small incision lateral ligament repair; the arthroscopy group ( n = 15), in which patients received total ankle arthroscopic ligament augmentation repair; and the non-surgical group ( n = 35), in which patients were treated conservatively. The American Orthopedic Foot and Ankle Score (AOFAS) value, the Tegner Activity Scale (TAS) score, Visual Analog Scale (VAS) score, the time to achieve full weight-bearing, and the time to return to sports were compared among all groups. Results:After treatment, AOFAS value and the TAS score increased in all three groups compared with pre-treatment levels, while the VAS value decreased in all groups. All differences were statistically significant ( t = 6.53, 7.45, 6.58, 6.50, 7.62, 6.52, 6.80, 7.50, 6.49, all P < 0.01). There were no significant differences in AOFAS value, TAS score, and VAS score among the three groups (all P > 0.05). The time to achieve full weight-bearing in the arthroscopy group was 6.6 (5.5, 9.0) weeks, which was shorter than the 7.4 (6.0, 9.0) weeks in the mini-open group and the 9.4 (7.6, 12.0) weeks in the non-surgical group. These differences were statistically significant ( H = 7.98, P = 0.001). The proportion of patients returning to sports in the arthroscopy group was 80% (12/15), which was higher than the 66% (10/15) in the mini-open group and the 28% (10/35) in the non-surgical group. These differences were statistically significant ( χ2 = 30.78, P = 0.025). The time to return to sports in the arthroscopy group was 12.1 (9.5, 15.0) weeks, which was shorter than the 14.6 (12.0, 18.2) weeks in the mini-open group and the 16.1 (13.2, 19.0) weeks in the non-surgical group. These differences were statistically significant ( H = 8.90, P = 0.001). Conclusions:Ankle arthroscopic ligament augmentation repair for the treatment of chronic lateral ankle instability is safe and shows better clinical efficacy, making it a viable option for clinical practice.

Objective:To investigate the efficacy of arthroscopic ligament augmentation repair in the treatment of chronic lateral ankle instability.Methods:The clinical data of 65 patients with chronic lateral ankle instability who received treatment at Shangluo Central Hospital from October 2019 to October 2022 were retrospectively analyzed. The clinical data were divided into three groups based on treatment methods: the mini-open group ( n = 15), in which patients underwent arthroscopy-assisted small incision lateral ligament repair; the arthroscopy group ( n = 15), in which patients received total ankle arthroscopic ligament augmentation repair; and the non-surgical group ( n = 35), in which patients were treated conservatively. The American Orthopedic Foot and Ankle Score (AOFAS) value, the Tegner Activity Scale (TAS) score, Visual Analog Scale (VAS) score, the time to achieve full weight-bearing, and the time to return to sports were compared among all groups. Results:After treatment, AOFAS value and the TAS score increased in all three groups compared with pre-treatment levels, while the VAS value decreased in all groups. All differences were statistically significant ( t = 6.53, 7.45, 6.58, 6.50, 7.62, 6.52, 6.80, 7.50, 6.49, all P < 0.01). There were no significant differences in AOFAS value, TAS score, and VAS score among the three groups (all P > 0.05). The time to achieve full weight-bearing in the arthroscopy group was 6.6 (5.5, 9.0) weeks, which was shorter than the 7.4 (6.0, 9.0) weeks in the mini-open group and the 9.4 (7.6, 12.0) weeks in the non-surgical group. These differences were statistically significant ( H = 7.98, P = 0.001). The proportion of patients returning to sports in the arthroscopy group was 80% (12/15), which was higher than the 66% (10/15) in the mini-open group and the 28% (10/35) in the non-surgical group. These differences were statistically significant ( χ2 = 30.78, P = 0.025). The time to return to sports in the arthroscopy group was 12.1 (9.5, 15.0) weeks, which was shorter than the 14.6 (12.0, 18.2) weeks in the mini-open group and the 16.1 (13.2, 19.0) weeks in the non-surgical group. These differences were statistically significant ( H = 8.90, P = 0.001). Conclusions:Ankle arthroscopic ligament augmentation repair for the treatment of chronic lateral ankle instability is safe and shows better clinical efficacy, making it a viable option for clinical practice.

Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.

Objective:To explore the effect of diet safety management based on swallowing function classification in perioperative period of elderly patients with hip fractures, so as to provide basis for improving perioperative food safety and shortening hospitalization time of patients with hip fracture.Methods:A total of 68 elderly patients with hip fractures in the First Medical Center of PLA General Hospital from December 2020 to August 2021 were selected and divided into experimental group and control group according to even and odd-number of admission number, each group contained 34 patients. The control group was given routine diet nursing and food safety education. The experimental group was given graded diet safety management according to the swallowing function evaluation results. The incidence of aspiration and length of hospital stay were compared between the two groups.Results:The incidence of chocking during hospitalization was 5.1% (78/1 517) in the control group and 1.2% (17/1 402) in the experimental group, and the difference was statistically significant ( χ2=35.73, P<0.01). The incidence of choking in the control group was 0.7% (11/1 517), and 0.4% (5/1 402) in the experimental group, and the difference was not statistically significant ( χ2=1.82, P>0.05). There was no significant difference in hospitalization time between the two groups, 10 (8,12) in the control group and 9 (8,11) in the experimental group ( Z=-1.33, P>0.05). Conclusions:The implementation of diet safety management based on swallowing function classification in elderly patients with hip fractures can reduce the incidence of coughing. Evaluation of swallowing function should be included in the evaluation of hip fractures in the elderly.

As a kind of class II medical device, medical optical radiation protective eyewears should meet the requirements of safety and effectiveness. In this study, the evaluation system of medical optical radiation protective eyewears is established. Combined with the medical device registration unit division guidelines, the classification method of medical optical radiation protective eyewears is given. Medical optical radiation protective eyewears are not only assembled spectacles, but also have special optical radiation protection performance. The performance evaluation method of medical optical radiation protective eyewears and the evaluation method of shelf life for medical optical radiation protective eyewears are given.
Radiation Protection

Objective:To compare the post-operative outcomes between extended lateral approach and L-shaped lateral approach in surgical treatment of Sanders type III intra-articular calcaneal fractures.Methods:A retrospective case-control study was made on clinical data of 34 patients with fresh Sanders type III intra-articular calcaneal fractures hospitalized in Langfang Hospital of Traditional Chinese Medicine from October 2014 to October 2017. There were 33 males and 1 female, with the age of 18-56 years [(42.5±9.4)years]. All fractures were fresh. Seventeen patients were fixed by the extended lateral approach (extended approach group) and seventeen patients by L-shaped lateral approach (L-shaped approach group). Operation duration, intraoperative bleeding volume, length of hospital stay, one-stage wound healing rate and complication rate were observed. B?hler and Gissane angle were measured before operation, one week after operation and 12 months after operation. American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale was applied to evaluate function recovery.Results:There were no significant differences between groups in operative time and intraoperative bleeding volume ( P>0.05). There were significant differences between extended approach group and L-shaped approach group in length of hospital stay [(15.7±4.0)days vs.(22.4±9.6)days], one-stage wound healing rate [88%(15/17) vs. 47%(8/12)] and postoperative complication rate [12%(2/17) vs. 47%(8/17)] ( P<0.05). The B?hler and Gissane angles did not differ significantly between groups before operation and one week and 12 months after operation ( P>0.05). At postoperative 12 months, the B?hler and Gissane angles were improved from preoperative (8.2±6.0)°, (85.3±10.5)° to (23.9±6.1)° and (119.3±6.2)° respectively in extended approach group, and those from preoperative (9.4±3.9)°, (85.5±7.1)° to (25.8±3.7)° and (122.2±5.6)° respectively in L-shaped approach group (all P>0.05). At 12 months after operation, the AOFAS score was (86.9±7.5)points in extended approach group, with the excellent and good rate of 88%; and was (83.3±12.5)points in L-shaped approach group, with the excellent and good rate of 76% ( P>0.05). While the score of hindfoot joint activity in extended approach group was (5.8±0.7)points, significantly higher than (3.4±1.0)points in L-shaped approach group ( P<0.05). Conclusion:For Sanders III intraarticular calcaneal fractures, compared with L-shaped approach group, plate fixation via extended approach can promote fracture healing, shorten hospital stay, reduce incidence of complications and facilitate function recovery of subtalar joint.

Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.

Objective To observe the influence of Shenmai injection for the postoperative infection and related serum indexes of patients with breast cancer,in order to provide evidence for the prevention of patients'postoperative infection.Methods 90 patients with breast cancerwere selected as the study object,and all the patients were randomly divided into control group(conventional postoperative treatment group)45 cases and observation group (conventional treatment and Shenmai injection group)45 cases,then the postoperative infection rates,inflammatory indexes and immune indexes before the treatment and after the treatment at different time were compared .Results The total postoperative infection rate of observation group was one case (2.22%),and it had no obviously difference compared with four cases (8.89%) of control group,the inflammatory indexes including PCT, TNF-α, IL-6 and hs-CRP at first,third and seventh day after the treatment were all lower than those of control group ,the immune indexes including CD3 +、CD4 +、CD8 +及 CD3 +CD4 +were all better than those of control group ( all P<0.05 ) .Conclusion The Shenmai injection can effectively control the postoperative infection rate of patients with breast cancer,and it also plays active improvement role for the infection related indexes.

Objective To explore the effect of iliac bone flap combined with cancellous bone graft in the treatment of traumatic avascular necrosis of the femoral head (TFHIN). Methods The patients were treated with iliac bone flap and cancellous bone graft. The operation time, intraoperative blood loss, fracture healing time, follow-up time and the postoperative complications were recorded.The degree of hip movement (flexion, external rotation, internal rotation, abduction and adduction) was recorded;the hip functions of patients with different stages were analyzed;the long-term curative effect of postoperative was analyzed. Results The operation time was (68.36 ± 6.81) min, intraoperative blood loss was(93.65 ± 10.42)ml, fracture healing time was(4.31 ± 1.25)months, follow-up time was 35-62 (48.92 ± 2.61)months, and the postoperative complication was 1.42%(3/212).The scores of hip function were significantly improved in each postoperative stage, joint flexion, external rotation, internal rotation, abduction and adduction range was significantly expanded: (94.86 ± 12.37)° vs. (118.24 ± 15.25)°, (32.07 ± 10.34)° vs. (43.64 ± 10.82)°, (28.33 ± 9.61)° vs. (33.41 ± 11.85)°, (19.44 ± 8.37)° vs. (24.36 ± 7.65)°, and the differences were statistically significant (P<0.05). At the last follow-up, the total excellent and good rate of hip function recovery was 88.74%(205/231).The stability rate of imaging was 80.09%(185/231). Conclusions In patients with TFHIN, treatment with the iliac bone flap pedicled with cancellous bone could the blood pressure of the femoral head, restore the blood supply to the damaged site, participate in the bone induction, and improve the hip movement and function,which has a good effect.