ObjectiveQi deficiency and phlegm dampness syndrome is a common type of clinical traditional Chinese medicine（TCM） syndrome. However， there is no standard， scientific， and accurate report on the construction of animal models of Qi deficiency and phlegm dampness syndrome. This study aims to construct a mouse model of Qi deficiency and phlegm dampness syndrome by using a multi-factor composite modeling method and to evaluate the model. MethodsTwenty-one C57BL/6 mice were randomly divided into three groups with seven mice in each group， which were the normal group， model group， and Shenling Baizhusan （SLBZ） group. The control group was fed with ordinary diet and kept in a normal environment. The model group and SLBZ group were fed with a high-fat diet in a high-humidity environment. Swimming with heavy weights until exhaustion and gavage with cold water or lard were used to establish the mouse model of Qi deficiency and phlegm dampness syndrome. In order to test the syndrome by prescription， mice in the SLBZ group were treated with SLBZ for 14 days after model construction. The exhaustive swimming time， body weight， serum lipid levels， tongue changes， "Qi deficiency and phlegm dampness" assessment scale score， and cecal index of mice in each group were measured. The feces of each group of mice were sent for metagenomics and metabolome sequencing， and the changes in intestinal flora and metabolites were analyzed. ResultsAfter the modeling of Qi deficiency and phlegm dampness syndrome， the exhaustive swimming time of mice was obviously shortened （P<0.01）. The serum total cholesterol， low density lipoprotein cholesterol， and non-high density lipoprotein cholesterol of mice were significantly increased （all P<0.01）. The tongue of mice was significantly different from that of the normal group， and the score of the assessment scale was significantly higher than that of the control group （P<0.01）. Cecal index decreased significantly （P<0.01）. The serum lipid level， tongue image， assessment scale score， and cecal index were reversed in the SLBZ group. Metagenomic and metabolome sequencing results showed that intestinal flora and fecal metabolites were significantly changed in mice with Qi deficiency and phlegm dampness syndrome. Akkermansia_muciniphila， Faecalibaculum_rodentium， Eubacterium_plexicaudatum， Eubacterium sp 14_2， Candida glabrata， Romboutsia_ilealis， Turicibacter sp TS3， and other bacteria had significant changes， and the expressions of intestinal metabolites such as chenodeoxycholic acid， choline， L-phenylalanine betaine， and 2-phenylbutyric acid were significantly changed. Related metabolic pathways such as linoleic acid metabolism， primary bile acid biosynthesis， lysine degradation， arginine biosynthesis， and alpha-linolenic acid metabolism were affected. ConclusionThe Qi deficiency and phlegm dampness model of mice can be constructed by the multi-factor composite modeling method of high-fat diet feeding， high-humidity environment feeding， exhaustive swimming with heavy weight， and intragastric administration with cold water or lard. The blood lipid level， tongue change， score of "Qi deficiency and phlegm dampness assessment scale"， cecal index， and changes in related intestinal flora and metabolites of mice can be used as key indicators for model evaluation.

Objective:To investigate the management options for loop plate cutting of the tibial cortex during reconstruction of the anterior cruciate ligament (ACL) by the all-inside technique.Methods:From January 2022 to December 2024, a total of 13 patients with ACL injury who underwent all-inside reconstruction with tibial lateral loop plate cutting of the cortex and immediate revision for ACL injuries at Department of Sports Medicine, the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed (cut group). There were 5 males and 8 females with an average age of 28.7±9.1 years (range, 17-39 years). During the revision, a transverse tunnel was drilled at the distal end of the tibial tunnel, and the loop plate was fixed to the lateral tibial cortex through the transverse tunnel. Matched by gender, age, and side, the patients who underwent ACL reconstruction with all-inside loop steel without cutting the tibial cortex during the same period (the uncut group) were selected as the control group at a ratio of 1∶2, including 10 males and 16 females, aged 29.1±9.3 years (range, 17-39 years). The visual analogue scale (VAS), Tegner score, International Knee Documentation Committee (IKDC) and Lysholm score for knee pain before and after surgery were compared between the two groups, and bone tunnel enlargement was assessed using the Peyrache grading scale.Results:All patients were successfully operated and followed up for 13.1±2.5 months and 13.3±2.6 months, respectively. The Lysholm scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 35.44±15.69, 75.21±16.77, and 93.47±18.56 respectively, while those of the uncut group were 37.81±17.33, 71.45±15.82, and 91.05±19.54. The Lysholm scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Lysholm scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Lysholm scores between the two groups before and after surgery ( P>0.05). The IKDC scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 39.12±14.28, 69.52±15.36, and 84.24±17.91 respectively, while those of the uncut group were 37.46±11.55, 72.81±17.73, and 87.62±18.52. The IKDC scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the IKDC scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the IKDC scores between the two groups before and after surgery ( P>0.05). The Tegner scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 1.61±1.11, 3.59±1.66, and 5.59±1.79 respectively, while those of the non-cutting group were 1.57±1.05, 3.47±1.51, and 5.41±1.63. The Tegner scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Tegner scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Tegner scores between the two groups before and after surgery ( P>0.05). According to Peyrache's grading criteria, 7 cases in the cutting group had femoral side bone tunnel enlargement and 8 cases had tibial side bone tunnel enlargement; 12 cases in the non-cutting group had femoral side bone tunnel enlargement and 15 cases had tibial side bone tunnel enlargement, with no statistically significant differences (χ 2=0.205, P=0.650; χ 2=0.053, P=0.818). At the last follow-up, there were 2 cases of Lachman grade I in the cutting group and 3 cases in the non-cutting group, 1 case of joint stiffness in the cutting group and 2 cases in the non-cutting group. None of the patients in the two groups had vascular nerve injury, deep vein thrombosis, or intra-articular infection. Conclusion:The method of drilling a transverse tunnel at the distal end of the outer opening of the tibial tunnel and fixing the loop plate to the lateral tibial cortex through the transverse tunnel, along with cutting the tibial cortex, can improve the knee joint function.

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.

AIM:To explore the way and mecha-nism of cell death induced by Fructus Akebiae in non-small cell lung cancer(NSCLC)cells.METH-ODS:CCK-8,Hochest33342/PI staining,and colony formation experiments were used to detect cell via-bility and proliferation.Western blot was used to detect the expression of cell death-related proteins ATG5,HMGB1,GPX4,apoptosis-related proteins,and PI3K-Akt signaling pathway-related proteins.Flow cytometry was used to detect the apoptosis rate.DCFH-DA fluorescent probes were used to de-tect the levels of total intracellular ROS under a flu-orescence microscope.RESULTS:Fructus Akebiae significantly inhibited the cell viability and prolifera-tion of human NSCLC cells(P＜0.05).The expression of apoptosis-related proteins BAX,Cleaved cas-pase3,and Cleaved caspase9 in NSCLC cells was sig-nificantly increased(P＜0.05),while p-PI3K,p-Akt,and BCL2 were markedly decreased(P＜0.05).Fruc-tus Akebiae was found to clearly increase the apop-tosis rate and the levels of total intracellular ROS(P＜0.05).The antioxidant NAC significantly reversed apoptosis,ROS production and regulation of PI3K-Akt pathway related proteins induced by Fructus Akebiae(P＜0.05).CONCLUSION:Fructus Akebiae in-duces apoptosis via regulating ROS-mediated PI3K-Akt signaling pathway in non-small cell lung cancer cells.

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 investigate the management options for loop plate cutting of the tibial cortex during reconstruction of the anterior cruciate ligament (ACL) by the all-inside technique.Methods:From January 2022 to December 2024, a total of 13 patients with ACL injury who underwent all-inside reconstruction with tibial lateral loop plate cutting of the cortex and immediate revision for ACL injuries at Department of Sports Medicine, the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed (cut group). There were 5 males and 8 females with an average age of 28.7±9.1 years (range, 17-39 years). During the revision, a transverse tunnel was drilled at the distal end of the tibial tunnel, and the loop plate was fixed to the lateral tibial cortex through the transverse tunnel. Matched by gender, age, and side, the patients who underwent ACL reconstruction with all-inside loop steel without cutting the tibial cortex during the same period (the uncut group) were selected as the control group at a ratio of 1∶2, including 10 males and 16 females, aged 29.1±9.3 years (range, 17-39 years). The visual analogue scale (VAS), Tegner score, International Knee Documentation Committee (IKDC) and Lysholm score for knee pain before and after surgery were compared between the two groups, and bone tunnel enlargement was assessed using the Peyrache grading scale.Results:All patients were successfully operated and followed up for 13.1±2.5 months and 13.3±2.6 months, respectively. The Lysholm scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 35.44±15.69, 75.21±16.77, and 93.47±18.56 respectively, while those of the uncut group were 37.81±17.33, 71.45±15.82, and 91.05±19.54. The Lysholm scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Lysholm scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Lysholm scores between the two groups before and after surgery ( P>0.05). The IKDC scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 39.12±14.28, 69.52±15.36, and 84.24±17.91 respectively, while those of the uncut group were 37.46±11.55, 72.81±17.73, and 87.62±18.52. The IKDC scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the IKDC scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the IKDC scores between the two groups before and after surgery ( P>0.05). The Tegner scores of the cutting group before surgery, 6 months after surgery, and 1 year after surgery were 1.61±1.11, 3.59±1.66, and 5.59±1.79 respectively, while those of the non-cutting group were 1.57±1.05, 3.47±1.51, and 5.41±1.63. The Tegner scores of both groups 6 months and 1 year after surgery were higher than those before surgery, and the Tegner scores 1 year after surgery were higher than those 6 months after surgery, with statistically significant differences ( P<0.05). There were no statistically significant differences in the Tegner scores between the two groups before and after surgery ( P>0.05). According to Peyrache's grading criteria, 7 cases in the cutting group had femoral side bone tunnel enlargement and 8 cases had tibial side bone tunnel enlargement; 12 cases in the non-cutting group had femoral side bone tunnel enlargement and 15 cases had tibial side bone tunnel enlargement, with no statistically significant differences (χ 2=0.205, P=0.650; χ 2=0.053, P=0.818). At the last follow-up, there were 2 cases of Lachman grade I in the cutting group and 3 cases in the non-cutting group, 1 case of joint stiffness in the cutting group and 2 cases in the non-cutting group. None of the patients in the two groups had vascular nerve injury, deep vein thrombosis, or intra-articular infection. Conclusion:The method of drilling a transverse tunnel at the distal end of the outer opening of the tibial tunnel and fixing the loop plate to the lateral tibial cortex through the transverse tunnel, along with cutting the tibial cortex, can improve the knee joint function.

AIM:To explore the way and mecha-nism of cell death induced by Fructus Akebiae in non-small cell lung cancer(NSCLC)cells.METH-ODS:CCK-8,Hochest33342/PI staining,and colony formation experiments were used to detect cell via-bility and proliferation.Western blot was used to detect the expression of cell death-related proteins ATG5,HMGB1,GPX4,apoptosis-related proteins,and PI3K-Akt signaling pathway-related proteins.Flow cytometry was used to detect the apoptosis rate.DCFH-DA fluorescent probes were used to de-tect the levels of total intracellular ROS under a flu-orescence microscope.RESULTS:Fructus Akebiae significantly inhibited the cell viability and prolifera-tion of human NSCLC cells(P＜0.05).The expression of apoptosis-related proteins BAX,Cleaved cas-pase3,and Cleaved caspase9 in NSCLC cells was sig-nificantly increased(P＜0.05),while p-PI3K,p-Akt,and BCL2 were markedly decreased(P＜0.05).Fruc-tus Akebiae was found to clearly increase the apop-tosis rate and the levels of total intracellular ROS(P＜0.05).The antioxidant NAC significantly reversed apoptosis,ROS production and regulation of PI3K-Akt pathway related proteins induced by Fructus Akebiae(P＜0.05).CONCLUSION:Fructus Akebiae in-duces apoptosis via regulating ROS-mediated PI3K-Akt signaling pathway in non-small cell lung cancer cells.

Objective To measure the abdominal muscle composition of maintenance dialysis patients using quantitative computed tomography(QCT)and to analyze its relationship with abdominal aortic calcification(AAC).Methods The abdominal CT data of 193 maintenance dialysis patients were analyzed retrospectively and their clinical data were collected.The abdominal muscle composi-tion,including muscle area and muscle fat area,was measured at the middle level of L3 vertebral by QCT.The abdominal aortic calcifica-tion scores(AACs)were calculated using the Agatston method.The groups were grouped according to the quartiles of AACs,and differences in muscle area,muscle fat area and their associated variables were compared between the four groups.The relationship between abdominal muscle composition and AAC was assessed using Spearman rank correlation analysis and partial correlation analysis.Results AACs were positively correlated with age,male,dialysis age,diabetes,hypertension,and abdominal muscle fat area(r=0.555,0.172,0.192,0.348,0.335,0.358,all P<0.05),while no significant correlation was found with abdominal muscle area.A partial correlation analysis controlling for age,sex,dialysis age,hypertension and diabetes showed that AACs were still positively correlated with abdominal muscle fat area(r=0.183,P=0.012).Conclusion Abdominal muscle fat area in maintenance dialysis patients is positively associ-ated with the degree of AAC,and high abdominal muscle fat area is a risk factor for AAC.Enhanced muscle exercise may prevent the risk of vascular calcification in dialysis patients.

Kaempferol,a natural flavonoid compound,can be extracted from various traditional Chinese medicine,fruits and vegetables.It possesses effective physiological activity,low toxicity and low side effects.It has been revealed by the research results that kaempferol exhibits obvious preventive and inhibitory effects on many common cancers,such as colon cancer,breast cancer,leukemia,etc..The anti-tumor effects are mainly exerted by blocking cell cycle,inhibiting invasion and migration,inducing cell apoptosis and autophagy,and inhibiting aerobic glycolysis of tumors.Meanwhile,the combination of kaempferol and many drugs can produce synergistic anti-tumor and sensitizing effects.The nano-preparation of kaempferol has significant curative effect in the treatment of tumor,which indicates that kaempferol has a good clinical application prospect.In this work,the pharmacological research progress for anti-tumor effect of kaempferol in recent years was reviewed.This article aims to provide theoretical basis and research ideas for further research of kaempferol.

Objective:To compare the short-term effect of the arthroscopic reconstruction of anterior cruciate ligament (ACL) by femoral tunnel positioning through the tendon incision (TI) technique and anteromedial (AM) technique.Methods:Between December 2015 and March 2017, 176 patients with ACL injuries underwent arthroscopic ACL reconstruction at the First Affiliated Hospital of USTC were analyzed. According to the method of localization of femoral tunnel, they were divided into two groups: TI group (localization of femoral tunnel by TI for reconstruction of ACL) and AM group (localization of femoral tunnel by AM for reconstruction of ACL). There were 87 patients in the TI group (63 males and 24 females) with an age of 32.8±9.4 years (range, 19-51 years) and a body mass index (BMI) of 24.8±6.3 kg/m 2 (range, 18.1-31.7 kg/m 2), including 9 obese patients (BMI>28 kg/m 2). There were 89 patients in the AM group (59 males and 30 females) with an age of 36.7±13.0 years (range, 17-56 years) and a BMI of 25.7±5.8 kg/m 2 (range, 18.9-31.6 kg/m 2), including 11 obese patients. To evaluate whether the drill was in contact with the articular surface of the medial condyle of the femur, whether the anterior angle of the medial meniscus was damaged, the sagittal and coronal angles of the femoral tunnel and the total length of the femoral tunnel. The anterior drawer test, Lachmann test, pivot shift test, knee flexion angle (KFA), Lysholm score, International Knee Documentation Committee (IKDC) score and the incidence of postoperative complications were compared between the two groups. At the same time, the time of taking out tendon, operation time, hospital stay and recovery time were compared between two groups of obese people. Results:In the TI group, the guide pin could reach all areas of the medial wall of the lateral femoral condyle from the inferior cartilage edge to the top of the intercondylar fossa, the drill bit had no contact with the medial femoral condyle (MFC), and the anterior angle of the medial meniscus was not damaged. In AM Group, 3 cases of MFC and 1 case of anterior horn of medial meniscus were injured in order to get the best position of femoral tunnel. The angle of femoral tunnel in sagittal plane (50.2°±3.2°) and coronal plane (46.1°±5.8°) in experimental group was notably larger than that in control group (45.6°±5.4°, 38.3°±4.7°), the difference was statistically significant ( P<0.05). However, there was no significant difference in the length of femoral tunnel between the two groups (38.2±3.2 mm and 37.7±2.5 mm, P>0.05). All patients were followed up for an average of 8.3±2.1 (range, 3-12) months. The positive rates of anterior drawer test, Lachmann test and pivot shift test were not significantly different between the two groups at 3, 6, 9 and 12 months after operation ( P>0.05). The KFA, Lysholm and IKDC scores in both groups were significantly increased after operation ( P<0.05), but there was no significant difference of above indexes between the two groups ( P>0.05). The overall complication rate in AM group (14.6%, 13/89) was significantly higher than that in TI group (6.9%, 6/87), the difference was statistically significant ( P<0.05). Additionally, the tendon harvesting (15.0±0.2 min vs. 26.0±0.2 min, P<0.05) and operation time (2.0±0.3 h vs. 3.0±0.4 h, P<0.05) were significantly shortened among obese patients in experimental group compared with those in control group. Conclusion:The TI technique demonstrates comparable effectiveness to the AM technique in ACL reconstruction through femoral tunnel positioning, with the added advantage of safer femoral tunnel localization. This approach minimizes the risk of iatrogenic injuries to the articular cartilage of the medial condyle of the femur and the anterior horn of the medial meniscus. Furthermore, the TI technique reduces tendon removal time, particularly beneficial for obese patients.