AIM:To evaluate the effect of differ-ent frequencies 0.01%atropine eye drops on the ocular surface in adolescent myopia control.METH-ODS:A total of 84 adolescent patients with myopia were recruited for this study.They were randomly assigned to receive 0.01%atropine eye drops at dif-ferent frequencies(morning group,evening group,morning and evening group).During the treatment period,ocular and systemic adverse reactions were observed,spherical equivalent refraction(SER)and axial length(AX)were examined.Additionally,ocu-lar surface disease index(OSDI)questionnaire was obtained,tear meniscus height(TMH),non-inva-sive first tear film break-up time(NifBUT),non-inva-sive average tear film break-up time(NiaBUT),and meibomian gland atrophy score(MaS)were mea-sured by Keratograph 5M.RESULTS:During the 6-month treatment with 0.01%atropine eye drops,all adverse reaction symptoms were relatively mild and infrequent.Only one case of systemic reaction was reported,with temporary xerostomia.Six pa-tients reported discomfort such as ocular itching and dryness.The ocular reactions of photophobia and blurred near vision were slightly more com-mon in the morning and combined morning-eve-ning groups compared to the evening group,but there were no significant differences among the three groups(P>0.05).Compared to baseline,there were significant differences in SER and AX among the three groups after six months of treatment(P<0.05).Compared to baseline,no significant differ-ences were observed in the Morning group after six months of treatment in terms of OSDI score(P=0.656),TMH value(P=0.362),NifBUT(P=0.510),Ni-aBUT(P=0.700),and MaS(P=0.846).Similarly,no significant changes were found in the Evening group regarding OSDI score(P=0.429),TMH value(P=0.462),NifBUT(P=0.462),NiaBUT(P=0.598),and MaS(P=0.351).Additionally,in the Morning and evening group,no significant changes were de-tected in OSDI score(P=0.457),TMH value(P=0.748),NifBUT(P=0.197),NiaBUT(P=0.070),and MaS(P=0.802)after six months of treatment.CON-CLUSION:After six months of using 0.01%atropine eye drops with different frequencies in adolescent myopia control,there was no significant impact on the ocular surface.

OBJECTIVE: To investigate the impact of bone mass and volume of low-density zones beneath the tibial plateau on the maximum von Mises stresses experienced by the cartilage and meniscus in the knee joint. METHODS: The study included one healthy adult volunteer, from whom CT scans were obtained, and one patient diagnosed with knee osteoarthrisis (KOA), for whom X-ray films were acquired. A static model of the knee joint featuring a low-density zone was established based on a normal knee model. In the finite element analysis, axial loads of 1 000 N and 1 800 N were applied to the weight-bearing region of the upper surface of the femoral head for model validation and subsequent finite element studies, respectively. The maximum von Mises stresses in the femoral cartilage, as well as the medial and lateral tibial cartilage and menisci, were observed, and the stress percentage of the medial and lateral components were concurrently analyzed. Additionally, HE staining, as well as alkaline magenta staining, were performed on the pathological specimens of patients with KOA in various low-density regions. RESULTS: The results of model validation indicated that the model was consistent with normal anatomical structures and correlated with previous calculations documented in the literature. Static analysis revealed that the maximum von Mises stress in the medial component of the normal knee was the lowest and increased with the advancement of the hypointensity zone. In contrast, the lateral component exhibited an opposing trend, with the maximum von Mises stress in the lateral component being the highest and decreasing as the hypointensity zone progressed. Additionally, the medial component experienced an increasing proportion of stress within the overall knee joint. HE staining demonstrated that the chondrocyte layer progressively deteriorated and may even disappear as the hypointensity zone expanded. Furthermore, alkaline magenta staining indicated that the severity of microfractures in the trabecular bone increased concurrently with the expansion of the hypointensity zone. CONCLUSION The presence of subtalar plateau low-density zone may aggravate joint degeneration. In clinical practice, it is necessary to pay attention to the changes in the subtalar plateau low-density zone and actively take effective measures to strengthen the bone status of the subtalar plateau low-density zone and restore the complete biomechanical function of the knee joint, in order to slow down or reverse the progression of osteoarthritis.
Humans ; Finite Element Analysis ; Knee Joint/physiology* ; Tibia/anatomy & histology* ; Cartilage, Articular/physiology* ; Menisci, Tibial/physiopathology* ; Tomography, X-Ray Computed ; Osteoarthritis, Knee/diagnostic imaging* ; Weight-Bearing ; Bone Density ; Adult ; Stress, Mechanical ; Male ; Middle Aged ; Biomechanical Phenomena ; Female

BACKGROUND:Non-traumatic necrosis of the femoral head is a difficult joint disease,and preserving one's own femoral head is of great significance for young patients.Currently,there is a lack of regular and unified functional exercise plans.OBJECTIVE:To investigate the effect of hip abductor muscle exercise on the three-dimensional gait and collapse rate of patients with non-traumatic femoral head necrosis,and to provide theoretical basis for effective rehabilitation of patients with non-traumatic femoral head necrosis.METHODS:Totally 81 non-traumatic and non-surgical patients with femoral head necrosis(81 hips)admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2020 to June 2022 were included.Patients were randomly divided into a control group(n=40)and a hip abductor muscle exercise group(n=41).The control group received routine physical therapy and medication treatment.The hip abductor muscle exercise group underwent hip abductor muscle exercise on the basis of the control group.The gait status(hip joint range of motion,step length difference,and ground contact time difference)of two groups of patients was evaluated using the Tecnobody balance assessment system before and 12 weeks after treatment.The BIODEX-S4 isokinetic muscle strength testing system was used to test the peak force distance of hip abduction isokinetic muscle strength.Gluteus medius width ratio was compared between two groups.The collapse rate was compared between two groups of patients 1 year after treatment.RESULTS AND CONCLUSION:(1)There was no statistically significant difference between the hip abductor muscle exercise group and the control group in terms of age,gender,side profile,body mass index,and etiology(P＞0.05).(2)Before treatment,there was no significant statistical difference in the range of motion of the affected hip joint between the two groups(P＞0.05).After treatment,the range of motion of the affected hip joint in both groups improved compared to before treatment(P＜0.05),and the range of motion of the affected hip joint in the hip abductor muscle exercise group was significantly higher than that in the control group(P＜0.05).(3)Before treatment,there was no significant statistical difference in the step length and touchdown time between the two groups(P＞0.05).12 weeks after treatment,the difference in step length and touchdown time between the two groups decreased compared to before treatment(P＜0.05),and the difference in step length and touchdown time between the hip abductor muscle exercise group after treatment was significantly greater than that of the control group(P＜0.05).(4)Before treatment,there was no significant statistical difference in gluteus medius width ratio between the two groups(P＞0.05).12 weeks after treatment,the gluteus medius width ratio of both groups increased compared to that before treatment(P＜0.05),and the gluteus medius width ratio of the hip abductor muscle exercise group was significantly higher than that of the control group(P＜0.05).(5)At 1 year after treatment,the comparison of femoral head collapse rates between the two groups showed significant statistical significance(P＜0.05),and that in the hip abductor muscle exercise group(22％)was significantly lower than that in the control group(45％).(6)It is concluded that exercise of the hip abductor muscle effectively enhances hip joint function,improves gait,and reduces the rate of femoral head collapse in patients with non-traumatic femoral head necrosis.It is recommended to use hip abductor muscle exercise as one of the basic methods for hip preservation in non-traumatic femoral head necrosis.

BACKGROUND:Non-traumatic necrosis of the femoral head is a difficult joint disease,and preserving one's own femoral head is of great significance for young patients.Currently,there is a lack of regular and unified functional exercise plans.OBJECTIVE:To investigate the effect of hip abductor muscle exercise on the three-dimensional gait and collapse rate of patients with non-traumatic femoral head necrosis,and to provide theoretical basis for effective rehabilitation of patients with non-traumatic femoral head necrosis.METHODS:Totally 81 non-traumatic and non-surgical patients with femoral head necrosis(81 hips)admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2020 to June 2022 were included.Patients were randomly divided into a control group(n=40)and a hip abductor muscle exercise group(n=41).The control group received routine physical therapy and medication treatment.The hip abductor muscle exercise group underwent hip abductor muscle exercise on the basis of the control group.The gait status(hip joint range of motion,step length difference,and ground contact time difference)of two groups of patients was evaluated using the Tecnobody balance assessment system before and 12 weeks after treatment.The BIODEX-S4 isokinetic muscle strength testing system was used to test the peak force distance of hip abduction isokinetic muscle strength.Gluteus medius width ratio was compared between two groups.The collapse rate was compared between two groups of patients 1 year after treatment.RESULTS AND CONCLUSION:(1)There was no statistically significant difference between the hip abductor muscle exercise group and the control group in terms of age,gender,side profile,body mass index,and etiology(P＞0.05).(2)Before treatment,there was no significant statistical difference in the range of motion of the affected hip joint between the two groups(P＞0.05).After treatment,the range of motion of the affected hip joint in both groups improved compared to before treatment(P＜0.05),and the range of motion of the affected hip joint in the hip abductor muscle exercise group was significantly higher than that in the control group(P＜0.05).(3)Before treatment,there was no significant statistical difference in the step length and touchdown time between the two groups(P＞0.05).12 weeks after treatment,the difference in step length and touchdown time between the two groups decreased compared to before treatment(P＜0.05),and the difference in step length and touchdown time between the hip abductor muscle exercise group after treatment was significantly greater than that of the control group(P＜0.05).(4)Before treatment,there was no significant statistical difference in gluteus medius width ratio between the two groups(P＞0.05).12 weeks after treatment,the gluteus medius width ratio of both groups increased compared to that before treatment(P＜0.05),and the gluteus medius width ratio of the hip abductor muscle exercise group was significantly higher than that of the control group(P＜0.05).(5)At 1 year after treatment,the comparison of femoral head collapse rates between the two groups showed significant statistical significance(P＜0.05),and that in the hip abductor muscle exercise group(22％)was significantly lower than that in the control group(45％).(6)It is concluded that exercise of the hip abductor muscle effectively enhances hip joint function,improves gait,and reduces the rate of femoral head collapse in patients with non-traumatic femoral head necrosis.It is recommended to use hip abductor muscle exercise as one of the basic methods for hip preservation in non-traumatic femoral head necrosis.

AIM:To evaluate the effect of differ-ent frequencies 0.01%atropine eye drops on the ocular surface in adolescent myopia control.METH-ODS:A total of 84 adolescent patients with myopia were recruited for this study.They were randomly assigned to receive 0.01%atropine eye drops at dif-ferent frequencies(morning group,evening group,morning and evening group).During the treatment period,ocular and systemic adverse reactions were observed,spherical equivalent refraction(SER)and axial length(AX)were examined.Additionally,ocu-lar surface disease index(OSDI)questionnaire was obtained,tear meniscus height(TMH),non-inva-sive first tear film break-up time(NifBUT),non-inva-sive average tear film break-up time(NiaBUT),and meibomian gland atrophy score(MaS)were mea-sured by Keratograph 5M.RESULTS:During the 6-month treatment with 0.01%atropine eye drops,all adverse reaction symptoms were relatively mild and infrequent.Only one case of systemic reaction was reported,with temporary xerostomia.Six pa-tients reported discomfort such as ocular itching and dryness.The ocular reactions of photophobia and blurred near vision were slightly more com-mon in the morning and combined morning-eve-ning groups compared to the evening group,but there were no significant differences among the three groups(P>0.05).Compared to baseline,there were significant differences in SER and AX among the three groups after six months of treatment(P<0.05).Compared to baseline,no significant differ-ences were observed in the Morning group after six months of treatment in terms of OSDI score(P=0.656),TMH value(P=0.362),NifBUT(P=0.510),Ni-aBUT(P=0.700),and MaS(P=0.846).Similarly,no significant changes were found in the Evening group regarding OSDI score(P=0.429),TMH value(P=0.462),NifBUT(P=0.462),NiaBUT(P=0.598),and MaS(P=0.351).Additionally,in the Morning and evening group,no significant changes were de-tected in OSDI score(P=0.457),TMH value(P=0.748),NifBUT(P=0.197),NiaBUT(P=0.070),and MaS(P=0.802)after six months of treatment.CON-CLUSION:After six months of using 0.01%atropine eye drops with different frequencies in adolescent myopia control,there was no significant impact on the ocular surface.

BACKGROUND: This study aimed to explore the effect of a nanomaterial-based miR-320a inhibitor sustained release system in trauma-induced osteonecrosis of the femoral head (TIONFH). METHODS: The miR-320a inhibitor-loaded polyethylene glycol (PEG)- Poly(lactic-co-glycolic acid) (PLGA)- Poly-L-lysine (PLL) nanoparticles were constructed using the double emulsion method. The TIONFH rabbit model was established to observe the effects of miR-320a inhibitor nanoparticles in vivo. Hematoxylin–eosin staining and microcomputed tomography scanning were used for bone morphology analysis. Bone marrow mesenchymal stem cells (BMSCs), derived from TIONFH rabbits, were used for in vitro experiments. Cell viability was determined using the MTT assay. RESULTS: High expression of miR-320a inhibited the osteogenic differentiation capacity of BMSCs in vitro by inhibiting the expression of the osteoblastic differentiation markers ALP and RUNX2. MiR-320a inhibitor-loaded PEG-PLGA-PLL nanoparticles were constructed with a mean loading efficiency of 1.414 ± 0.160%, and a mean encapsulation efficiency of 93.45 ± 1.24%, which released 50% of the loaded miR-320a inhibitor at day 12 and 80% on day 18. Then, inhibitor release entered the plateau. After treatment with the miR-320a inhibitor nanoparticle, the empty lacunae were decreased in the femoral head tissue of TIONFH rabbits, and the osteoblast surface/bone surface (Ob.S/BS), osteoblast number/bone perimeter (Ob.N/B.Pm), bone volume fraction, and bone mineral density increased. Additionally, the expression of osteogenic markers RUNX2 and ALP was significantly elevated in the TIONFH rabbit model. CONCLUSION The miR-320a inhibitor-loaded PEG-PLGA-PLL nanoparticle sustained drug release system significantly contributed to bone regeneration in the TIONFH rabbit model, which might be a promising strategy for the treatment of TIONFH.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Hemophilic arthritis(HA),caused by recurrent bleeding,can seriously affect patient quality of life and consumes extensive social and medical resources.There is thus a need to establish an animal model of HA for research;however,this is limited by ethical requirements.Here we review the recent literature and summarize research progress into animal models of HA at home and abroad,from the aspects of species selection,modeling method,histopathology,and imaging evaluation method.Species selection includes rodents such as mice,New Zealand rabbits,beagles,miniature pigs,and crab-eating macaques.Modeling method comprise gene knockout trauma models,gene knockout spontaneous models,and injection models.Among these,the gene knockout spontaneous model closely mimics the pathological process of spontaneous bleeding and concurrent arthritis in human HA,making it more relevant to human HA.However,due to high modeling costs,phenotypic instability,and low survival rates,this model is not the preferred choice for animal experimental studies.In contrast,gene knockout trauma models exhibit characteristics such as short modeling time,strong stability,and high success rates,thus being widely utilized in animal experimental research.Evaluation of HA models involves various imaging method including MRI,micro-CT,MSKUS/PD,in addition to various gross scoring method.By reviewing the progress of HA model research,more experimental evidence is provided for investigating the pathogenesis and validating the efficacy of HA treatments,thereby compensating for the lack of clinical data,particularly in the field of traditional Chinese medicine therapy.

Objective To analyze the correlation between high signal intensity of infrapatellar fat pad(IPFP)and symptoms and structural changes of osteoarthritis of the knee in patients with osteoarthritis of the knee based on image digitization.Methods Imaging and clinical data of patients with knee osteoarthritis(KOA)were retrospectively analyzed.The differences in knee osteoarthritis symptoms and structural changes in patients with different IPFP high signal intensities were compared,and the relationship between IPFP high signal intensity changes and knee osteoar-thritis symptoms as well as structural changes was also analyzed.Results A total of 219 patients(268 knees)were collected and completed imaging measurements and evaluations,and the median IPFP high signal intensity(27.40％)was used to compare the groups.The IPFP high signal intensity ≥ 27.40％group had a significantly higher degree of tibial cartilage damage,changes in knee angle,pain,and total scores on the osteoarthritis index(western ontario and mcMaster).universities osteoarthritis index(WOMAC)were significantly higher than those in the IPFP high signal intensity＜27.40％group,with a statistically significant difference(P＜0.05);IPFPF high signal inten-sity changes were associated with knee pain,joint line convergence angle,JLCA,and knee joint angle.Angle(JLCA),knee kellgren-Lawrence(KL)classification,and the degree of femoral and tibial cartilage damage were significantly positively correlated(P＜0.05).Conclusion In patients with KOA,there is a significant correlation between IPFP high signal intensity changes and knee pain symptoms as well as structural changes,which may be an important factor influencing the progression of KOA.

AIM: To investigate the effects of 0.01% atropine eye drops on macular blood flow density and retinal thickness in children with different degrees of myopia. METHODS: This was a prospective case-control study. Sixty-four patients (112 eyes) diagnosed with myopia for the first time with 0.01% atropine eye drops before and 6 months after medication were investigated with the uncorrected distance visual acuity (UCVA), axial length (AL), spherical equivalent (SE), macular ganglion cell-inner plexiform layer thicknes (mGCIPL) using slit lamp examination and optical coherence tomography (OCT), vascular density in the macular area and the area of the avascular in the fovea using optical coherence tomography angiography (OCTA) . Changes in various indicators before and after medication were compared. RESULTS: Compared with before medication, the AL of the three groups of myopia patients increased significantly (P<0.01), the difference in low to moderate myopia group was significantly smaller than that in high myopia group. Compared with before medication, SE increased in all three groups of myopia patients, yet there was no statistically significant difference in the low - grade myopia group (P>0.05). The difference was statistically significant between the moderate myopia group and the high myopia group (P< 0.01). Compared with before medication, there was no change in intraocular pressure (IOP) among the three groups of myopic patients (P>0.05). After 6 months of medication, the central circle macular vessel density (cCVD) increased in the low myopia group and moderate myopia group (P<0.01), there was no statistically significant difference in the high myopia group (P>0.05). Before and after medication, there was no significant difference in outer circle macular vessel density (oCVD), inner circle macular vessel density (iCVD), and whole circle macular vessel density (wCVD) among the three myopia groups (P>0.05). The increase in mGCIPL was statistically significant in the low myopia group (P<0.01), but there was no statistically significant difference in the moderate myopia and high myopia groups (P>0.05). There was no significant difference in foveal avascular zone (FAZ) among the three myopia groups before and after medication (P>0.05). There was no correlation between CVD, AL, and SE in the three myopia groups (P>0.01). There was a low correlation between CVD and mGCIPL in the low myopia group (r=0.442, P<0.05), there was no correlation between CVD and mGCIPL in the moderate myopia and high myopia groups (P >0.01). CONCLUSION: 0.01% atropine can significantly reduce the rate of axial and refractive growth in children with low to moderate myopia, increase the density of central macular vessels, and increase the thickness of mGCIPL in children with low to moderate myopia.