BACKGROUND: The correlation between the morphological structure of the patellofemoral joint (PFJ) and the severity of knee joint osteoarthritis (KOA) remains uncertain. This study aims to investigate the correlation between the severity of knee joint osteoarthritis and the alignment of patellofemoral and patellar height on radiographs. METHODS: This multi-center, retrospective study analyzed the magnetic resonance imaging (MRI) scans and anteroposterior radiographs of 534 adult outpatients with KOA. To evaluate the radiographic severity of KOA, anteroposterior radiographs of the knee and the Kellgren-Lawrence (K-L) grade were used. Knee MRI scans were used to measure the patellar length ratio (PLR), sulcus angle (SA), lateral patellar tilt angle (LPTA), and the distance between tibial tuberosity and trochlear groove (TT-TG). We examined the association between the configuration of the PFJ, arrangement, and harshness of the KOA. Information on participants' demographics, such as age, sex, side, height, and weight, was collected. A chi-squared test was used for the correlation of radiographic severity of KOA with sex and the affected side. Spearman correlation was used for patellofemoral alignment or morphology and the radiographic severity of lateral KOA. Multiple linear regression models were used for the association between LPTA, SA, TT-TG, and severity of KOA after accounting for demographic variables. RESULTS: The study comprised of 534 patients; of these, 339 (63%) were female. A total of 586 knees were evaluated in this study. Age showed a strong positive correlation with KOA severity ( r  = 0.516, P <0.01), whereas LPTA showed a strong negative correlation ( r  = -0.662, P <0.01). Additionally, SA ( r  = 0.616, P <0.05), and TT-TG showed a strong positive correlation ( r  = 0.770, P <0.01) with tibiofemoral osteoarthritis (TFOA) severity. Multiple linear regression analysis indicated that knee osteoarthritis severity (β = -2.946, P <0.001) and side (β = -0.839, P  = 0.001) was associated with LPTA; knee osteoarthritis severity (β = 5.032, P <0.001) and age (β = -0.095, P <0.001) was associated with SA; knee osteoarthritis severity (β = 2.445, P <0.001), sex (β = -0.326, P  = 0.041), body mass index (β = -0.061, P  = 0.017) and age (β = -0.025, P <0.001) was associated with TT-TG. CONCLUSION Radiographic severity of KOA was positively associated with age, SA, and TT-TG but negatively associated with LPTA.
Humans ; Female ; Male ; Osteoarthritis, Knee/pathology* ; Middle Aged ; Retrospective Studies ; Aged ; Patellofemoral Joint/pathology* ; Magnetic Resonance Imaging ; Adult ; Patella/pathology* ; Radiography

As a major category of occupational hazards in China, physical factors are widely distributed in various industries and affect a large number of workers. The list and diagnostic criteria of occupational diseases caused by physical factors are important basis for occupational disease diagnosis and protection of occupational health rights and interests for occupational populations. This article compares the differences in the list of occupational diseases caused by physical factors at home and abroad, analyzes the problems in the current list of occupational diseases caused by physical factors and related diagnostic standards in China, and puts forward relevant suggestions for further adjusting the list of occupational diseases caused by physical factors, formulating and revising relevant diagnostic standards for occupational diseases, providing reference for improving the classification and catalogue of occupational diseases in China in the future.

Objective:To investigate the influencing factors of enlarged perivascular space (PVS) in relapsing-remitting multiple sclerosis (RRMS) patients and their relationship with cognitive function.Methods:Twenty-seven individuals with RRMS (RRMS group) and 27 healthy controls (healthy control group) who presented to the Department of Neurology, the Sixth Medical Center of People′s Liberation Army General Hospital from July 2022 to November 2024 underwent cognitive function assessments. PVS volume fractions, lesion volumes, and brain volumes were calculated using FreeSurfer, FSL, and other relevant softwares. Group differences in PVS volume fractions, lesion volumes, brain volumes, and cognitive function assessments were compared. Furthermore, correlations between PVS volume fractions and lesion volumes, brain volumes, and cognitive function assessments were analyzed within the RRMS group.Results:Compared with the healthy control group, the RRMS group exhibited significantly higher PVS volume fractions in white matter (PVS_w) (3.14‰±0.29‰ vs 2.91‰±0.30‰, t=2.877, P=0.006) and PVS volume fractions in deep gray matter (PVS_d) (2.25‰±0.10‰ vs 2.17‰±0.09‰, t=2.681, P=0.010), indicating an enlargement of the PVS. Compared with the healthy control group, the RRMS group showed a significant decrease in both white matter volumes [297.3 (274.3, 340.2) ml vs (324.2 (311.0, 350.0) ml, U=-2.085, P=0.037] and deep grey matter volumes [40.2 (34.9, 43.6) ml vs 42.7 (40.2, 44.8) ml, U=-2.292, P=0.022]. Compared with the healthy control group, the RRMS group showed significantly lower scores in cognitive function assessments ( P<0.05). Univariate analysis showed that PVS_w in the RRMS group was significantly positively correlated with age ( r=0.486), white matter lesion volumes ( r=0.437) and deep gray matter lesion volumes ( r=0.394;all P<0.05); PVS_d was also significantly positively correlated with white matter lesion volumes ( r=0.418) and deep gray matter lesion volumes ( r=0.480; both P<0.05). Multiple linear regression analysis showed that age ( B=0.011,95% CI 0.004-0.017), white matter lesion volumes ( B=0.026,95% CI 0.011-0.040) and deep gray matter lesion volumes ( B=0.401,95% CI 0.032-0.771) in the RRMS group were significantly positively correlated with PVS_w, while white matter lesion volumes ( B=0.007,95% CI 0.001-0.014) and deep gray matter lesion volumes ( B=0.204,95% CI 0.029-0.380) were significantly positively correlated with PVS_d (both P<0.05). Univariate analysis showed that immediate memory score in the RRMS group was significantly negatively correlated with PVS_d ( r=-0.428), and was significantly positively correlated with education level ( r=0.471), deep gray matter volumes ( r=0.530) and total brain volumes ( r=0.389; all P<0.05); short-term delayed memory score in the RRMS group was significantly negatively correlated with age ( r=-0.390), PVS_w ( r=-0.417) and white matter lesion volumes ( r=-0.438), and was significantly positively correlated with gender ( r=0.393), white matter volumes ( r=0.478), deep gray matter volumes ( r=0.579) and total brain volumes ( r=0.602;all P<0.05); verbal fluency test score in the RRMS group was significantly negatively correlated with PVS_d ( r=-0.409) and was significantly positively correlated with education level ( r=0.419) and total brain volumes ( r=0.400;all P<0.05). Multiple linear regression analysis revealed that PVS_d ( B=-5.572, 95% CI -11.513--0.368) and brain volumes ( B=0.012, 95% CI 0.001-0.023) in the RRMS group were both significant predictors of immediate recall score, while PVS_d ( B=-14.203,95% CI -27.514--0.891) was an independent predictor of verbal fluency test score (all P<0.05). Conclusions:The PVS is enlarged in individuals with RRMS compared with the healthy controls, and increased lesion volumes may be a significant predictor. Furthermore, enlarged PVS in the deep gray matter may be a significant predictor of impairment of verbal memory and verbal function in individuals with RRMS.

Objective:To investigate the prevalence and determinants of dry eye syndrome among civil aviation flight attendants.Methods:Data from 1 201 civil aviation flight attendants across 6 airlines, along with their eye examination and general health records from the previous year, were collected and analyzed between January and March 2024. A self-designed questionnaire was designed to assess risk factors to dry eye syndrome. The severity of dry eye syndrome of these civil aviation flight attendants was assessed using the Ocular Surface Disease Index (OSDI) scale before they were grouped based on OSDI scores. The Fatigue Assessment Scale and Pittsburgh Sleep Quality Index were used to evaluate levels of fatigue and sleep quality. Multivariable Logistic regression was employed to identify factors associated with the severity of dry eye syndrome.Results:A total of 1 201 flight attendants were enrolled in this study. Questionnaires were distributed to all the participants, and 1 021 valid responses were collected, yielding a response rate of 85.0%. All flight attendants experienced dry eye syndrome. Among these cases, 657 cases were classified as moderate and 364 as severe. Logistic regression analysis showed that flying hours in the previous year ( OR=1.001, 95% CI: 1.001-1.002), a history of eyelid disease ( OR=2.059, 95% CI: 1.311-3.232), fatigue ( OR=2.438, 95% CI: 1.633-3.640), use of preservative-containing eye drops ( OR=3.034, 95% CI: 1.800-5.113), use of artificial tears ( OR=2.431, 95% CI: 1.544-3.827), use of contact lenses ( OR=2.095, 95% CI: 1.381-3.179), refractive progression of <-0.50 D ( OR=3.102, 95% CI: 1.955-4.920) and -0.50 to <-1.00 D ( OR=3.846, 95% CI: 1.845-8.018), sleep scale scores of 6-10 ( OR=1.940, 95% CI: 1.258-2.993), 11-15 ( OR=2.730, 95% CI: 1.564-4.768), and 16-21 ( OR=6.010, 95% CI: 1.752-20.614) were determinants of the severity of dry eye syndrome. Conclusions:Dry eye symptoms are generally severe among civil aviation flight attendants. Priority should be given to monitoring sleep quality and fatigue levels, with particular emphasis on individuals exceeding 713 flying hours in the previous year for early detection of dry eye syndrome.

Objective To explore the feasibility of using the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein in retroperitoneal laparoscopic left adrenalectomy(RLLA).Methods 116 patients who had RLLA carried out in our hospital between January 2021 and December 2023 were chosen.They were separated into the experimental group(RLLA with the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein)and the control group[conventional three-layer method anatomic retroperitoneal laparoscopic adrenalectomy(RLA)],with 58 cases in each group.The clinical data of the two groups were compared,and the intraoperative and postoperative 24 h clinical indicators,stress indicators,immune function,and complications were evaluated.Results RLLA was successfully completed in two groups,and no cases were converted to open surgery.The operation time,time for searching the central vein,retention time of the drainage tube and postoperative hospital stay in the experimental group were significantly shorter than those in the control group.The intraoperative blood loss and postoperative drainage volume were significantly less than those in the control group,the differences were all statistically significant(P<0.05);There was no statistically significant difference in the recovery time of gastrointestinal function between the two groups of patients after surgery(P>0.05).There were no statistically significant differences in preoperative inflammatory factors,stress indicators and immune function indicators between the two groups of patients(P>0.05).The white blood cell(WBC),C-reaction protein(CRP)and interleukin-6(IL-6)of the two groups of patients 24 hours after the operation were significantly higher than those before the operation,but the experimental group was significantly lower than the control group,the differences were statistically significant(P<0.05).The malondialdehyde(MDA)of the two groups of patients 24 hours after the operation was significantly higher than that before the operation,while the superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px)were significantly lower than those before the operation,and the MDA in the experimental group was significantly lower than that in the control group,and the SOD and GSH-Px were significantly higher than those in the control group(P<0.05).The levels of CD4+and CD4+/CD8+in experimental groups of patients 24 hours after the operation were significantly decreased than those before the operation,and the levels of CD3+,CD4+and CD4+/CD8+in the experimental group were significantly higher than those in the control group.The differences were statistically significant(P<0.05).There was no statistically significant difference in CD8+between the two groups of patients 24 hours after surgery(P>0.05).The number of cases with intraoperative blood pressure fluctuations in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Neither peritoneal injury,renal pedicle vascular injury or retroperitoneal hematoma occurred during or after the operation in the two groups of patients.Conclusion In RLLA,using the left inferior phrenic vein as an anatomical landmark and prioritizing the dissection of the central adrenal vein is feasible,which can improve surgical indicators,reduce stress response and immune response,and have clinical application value.

Objective:To compare the safety and accuracy between robotic-assisted screw placement and free-hand screw placement in adolescent idiopathic scoliosis (AIS) surgery.Methods:The clinical data of 69 AIS patients underwent posterior spinal scoliosis orthomorphia from December 2021 to October 2023 in Beijing Chaoyang Hospital, Capital Medical University were retrospectively analyzed. Among them, 37 patients underwent robot-assisted screw placement (robot group), and 32 patients underwent fluoroscopy-assisted free-hand screw placement (free-hand group). The basic information of surgery (operation time, intraoperative blood loss, intraoperative radiation exposure time, postoperative hospital stay and postoperative complications), screw placement indexes (single screw placement time and accuracy of screw placement) and imaging indexes (main curve correction rate, kyphotic change and lumbar lordosis change) were compared between two groups. The ln curve regression analysis method was used to evaluate the learning curve of robot-assisted screw placement therapy for AIS.Results:A total of 716 screws were placed in 32 patients of free-hand group, and 766 screws in 37 patients of robot group. The operation time, intraoperative radiation exposure time, single screw placement time and accuracy of screw placement in robot group were significantly higher than those in free-hand group: (272.30 ± 67.98) min vs. (221.66 ± 67.32) min, (149.81 ± 57.21) s vs. (116.03 ± 63.10) s, (497.97 ± 51.74) s vs. (381.47 ± 46.58) s and 97.91% (750/766) vs. 91.48% (655/716), and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in intraoperative blood loss, postoperative hospital stay, incidence of neurological complications, incidence of incision infection and number of screw between two groups ( P>0.05). There were no statistical differences in the main curve correction rate, kyphotic change and lumbar lordosis change between two groups ( P>0.05). When the fitting degree was the highest ( R2 = 0.729, P<0.01), the fitting equation was y = - 50.93ln x + 634.7 ( x was the number of operation, and y was the single screw placement time), and the number of vertices was 12 cases. The robot group was divided into three subgroups according to the order of surgery, subgroup A consisted of 12 patients who underwent the surgery from first to twelfth, subgroup B consisted of 12 patients who underwent the surgery from thirteenth to twenty-fourth, and subgroup C consisted of 13 patients who underwent the surgery from twenty-fifth to thirty-seventh. Among them, the single screw placement time in subgroup A was significantly longer than that in subgroup B and subgroup C: (560.92 ± 35.03) s vs. (465.75 ± 21.20) and (469.62 ± 24.94) s, and there was statistical difference ( P<0.05); there was no statistical difference between subgroup B and subgroup C ( P>0.05). Conclusions:Robot-assisted screw placement for AIS can effectively improve the accuracy of screw placement without affecting deformity correction, but it can increase screw placement time, operation time and radiation exposure time. A smooth learning curve is obtained after performing 12 procedures.

BACKGROUND:Research on physical activity and executive function continues to emerge,but no scholars have used visual tools to explore the dynamic evolution path of research topics in this field.OBJECTIVE:To explore the dynamic evolution process of research topics in the field of physical activity and executive function using bibliometrics methos,so as to clarify their development status and changes in knowledge structure.METHODS:The Web of Science database was searched by the search formula:TS=("Physical activity"AND"Executive function*")OR TS=(Exercise AND"Executive function*").According to the inclusion and exclusion criteria,4 386 relevant documents were selected as content,and SciMAT software was used for visual analysis.RESULTS AND CONCLUSION:The field of physical activity and executive function is booming,with more and more in-depth research and more room for future development.This field can be divided into four directions:executive function,children,the elderly,and intervention,and forms 11 main evolutionary paths.Topics such as"motor skills,""lifestyle,""aerobic exercise,"and"interventions"are likely to be the focus of future research,with the"adolescent"and"elderly"groups being the focus of research in this area.

BACKGROUND:Numerous studies have explored the effects of physical activity on the hippocampus,but the relationship between physical activity and the human hippocampus remains controversial and confusing.Therefore,it is necessary to sort out the relevant research in the field of physical activity and hippocampal tissue.OBJECTIVE:To explore the dynamic evolution process of research topics in the field of physical activity and hippocampus,clarify the development status and changes in knowledge structure,and provide directions for further research through bibliometrics.METHODS:The Web of Science database was searched by the search formula:TS=("physical exercise"AND hippocampus)OR TS=("physical activity"AND hippocampus)OR TS=("exercise"AND hippocampus).According to the inclusion and exclusion criteria,3 225 relevant documents were selected as content.SciMAT software was used for visual analysis.RESULTS AND CONCLUSION:(1)The field of physical activity and hippocampal tissue is booming,with more and more in-depth research and more room for future development.(2)This field can be divided into four directions:"messenger RNA,"behavior,""environment"and"cognitive function,"and forms 7 main evolutionary paths.(3)Topics such as"neurotrophic factors,""aerobic exercise"and"cognitive impairment"are likely to be the focus of future research.(4)This research field focuses on the elderly population,and the use of different model mice to explore the mechanism of physical activity on the hippocampus has promoted further research in this field.

Objective To explore the diagnosis,treatment and prognostic factors of urachal carcinoma(UrC),aiming to provide reference for the standardized diagnosis and treatment of this disease.Methods A retrospective analysis was conducted on the clinical data of 75 UrC patients confirmed with postoperative pathology treated in our hospital during Mar.2010 and Mar.2023.All patients underwent surgical treatment,and 35 received postoperative chemotherapy.Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors.Kaplan-Meier curves were adopted to calculate the cumulative survival rates and overall survival(OS).Results Among the 75 patients,the male to female ratio was 2.8∶1 and the mean age was(58.4±2.2)years.Median follow-up was 60 months and median OS was 48 months.The 3-year survival rate was 67.3％and the 5-year survival rate was 38.8％.There were 19 cases(25.3％)of CK7 positive,60 cases(80.0％)of Sheldon stage Ⅲ and above,and 26 cases(34.7％)of postoperative recurrence.CK7 positive(P=0.001),Sheldon staging Ⅲ+Ⅳ(P=0.005)and postoperative recurrence(P=0.003)were independent prognostic factors.Conclusion Urachal carcinoma is a rare malignant tumor in males with occult onset.CK7 positive,Sheldon staging and postoperative recurrence were independent prognostic factors of this disease.

Objective To explore the relationship between serum CysC,KIM-1 and acute kidney injury(AKI)and prognosis in patients with renal cell carcinoma after laparoscopic nephron sparing surgery(LNSS).Methods A total of 62 patients with renal cell carcinoma who underwent LNSS in our hospital were collected.Serum CysC and KIM-1 levels were detected by immunoturbidimetry and enzyme-linked immunosorbent assay,respectively.According to whether AKI occurred and recurrence after surgery,the patients were divided into the non-AKI group(n=34)and AKI group(n=28),as well as the good prognosis group(n=45)and poor prognosis group(n=17).Univariate and multivariate Logistic regression were used to analyze the influencing factors of AKI and poor prognosis.The predictive value of CysC and KIM-1 for AKI and poor prognosis was analyzed by the receiver operating characteristic(ROC)curve.Results There were significant differences in gender,hypertension,diabetes,operation time,glomerular filtration rate(GFR),renal artery occlusion time and KIM-1 level between the non-AKI group and AKI group(P＜0.05).There were significant differences in tumor diameter,grade,lymph node metastasis,CysC and KIM-1 level between the good prognosis group and poor prognosis group(P＜0.05).Multivariate Logistic regression showed that gender,diabetes,GFR,renal artery occlusion time and KIM-1 level were independ-ent risk factors for AKI while GFR was an independent protective factor for AKI(P＜0.05);tumor diameter,serum CysC and KIM-1 level were independent risk factors for poor prognosis(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of KIM-1 for predicting AKI was 0.687;The AUC of CysC and KIM-1 for predicting poor prognosis were 0.829 and 0.871,respectively.Conclusion Serum KIM-1 is an independent risk factor for AKI after LNSS in patients with renal cell carcinoma,and serum CysC and KIM-1 are independent risk factors for poor prognosis.