BACKGROUND:Cannabidiol is effective in ameliorating the body's inflammatory response,but no clear mechanistic studies have been conducted to ameliorate skeletal muscle inflammation induced by exhaustive exercise. OBJECTIVE:To explore the mechanism by which cannabidiol improves skeletal muscle inflammation during exhaustive exercise by using transcriptome sequencing technology. METHODS:Thirty-six Sprague-Dawley rats were randomly divided into six groups:blank control group,exercise coconut oil group,exercise control group,50 mg/kg cannabidiol group,60 mg/kg cannabidiol group,and 70 mg/kg cannabidiol group,with six rats in each group.Except for rats in the blank control group,rats in each group were subjected to swimming exercise for 9 days to produce the exhaustive exercise model.At the end of each swimming exercise,rats in the cannabidiol groups were given 2 mL of fat-soluble cannabidiol at different concentrations(50,60,and 70 mg/kg)by gavage;rats in the exercise coconut oil group were given the same volume of coconut oil by gavage until the end of the exercise on the 9th day;and rats in the blank control group and the exercise control group were not given any special treatment.The levels of inflammatory factors and differentially expressed genes in the skeletal muscle of rats in each group were determined using ELISA and transcriptome sequencing techniques.Differentially expressed genes obtained were subjected to KEGG analysis,and the accuracy of the sequencing data was verified by fluorescence quantitative PCR. RESULTS AND CONCLUSION:The results of ELISA showed that the contents of interleukin-6(P<0.05),tumor necrosis factor-α(P<0.01),interleukin-10 and other inflammatory factors in the exercise group increased significantly compared with the blank control group and the coconut oil group.After cannabidiol intervention,the mass concentrations of interleukin-6 and tumor necrosis factor-α showed a sequential decrease with increasing cannabidiol concentration.By comparing GO and KEGG databases,the functional properties of differentially expressed genes were analyzed,and the results showed that the differentially expressed genes were mainly involved in the tumor necrosis factor signaling pathway and the Toll-like receptor signaling pathway.RT-qPCR results showed that the trends of five randomly selected differentially expressed genes were in agreement with the transcriptome sequencing results.To conclude,cannabidiol can improve skeletal muscle inflammation caused by exhaustive exercise.

Objective To compare the effect of different intensity of neuromuscular training(NMT)on muscle strength and knee joint function of patients after anterior cruciate ligament reconstruction(ACLR).Methods From January,2023 to January,2024,60 ACLR patients in Changhai Hospital were selected,and they received the same intensity of NMT from one to eight weeks after surgery.Eight weeks after surgery,they were randomly divided into low intensity group(n=30)and high intensity group(n=30),and then they received different inten-sities of NMT from nine to 16 weeks after surgery,each training session lasted one hour,with three sessions per week,totaly 48 sessions.The Lysholm score,knee flexor and extensor muscle strength and muscle endurance-were compared at eight weeks and 16 weeks after surgery.Results After group training,the Lysholm score significantly increased in both groups(|t|>13.739,P<0.001),and was higher in the high intensity group than in the low intensity group(t=-2.574,P<0.05);in the high intensity group,the relative peak torque and endurance of the extensor and flexor muscles improved at angular velocities of 60°/s,120°/s and 180 °/s(|t|>2.320,P<0.05);in the low intensity group,the flexor peak torque improved at all the three angular velocities(t>2.177,P<0.05),the extensor peak torque improved at angular velocities of 60°/s and 180°/s(|t|>1.715,P<0.05),and the extensor endurance improved at angular velocity of 60°/s(t=-2.293,P<0.05).However,there was no significant difference in the relative peak torque and endurance of the extensor and flexor muscles at all the three angular velocities(P>0.05).Conclusion Both high and low intensity NMT could improve the muscle strength,muscle endurance and knee joint func-tion.Maybe,high intensity is superior to low intensity.Further verification is still needed.

Objective To determine the effect of baicalein on high glucose-induced cardiac fibro-blast pyroptosis based on the nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)/cysteinyl aspartate-specific proteinase-1(Caspase-1)/gasdermin D(GSDMD)pathway.Methods Rat cardiac fibroblasts were grouped into control,high glucose group,low-,medium-and high-dose baicalein(H-,M-and L-baicalein)groups,and H-baicalein+NLRP3 agonist(BMS-986299)group.Except for the control group,all other groups were cultured in DMEM medium containing 40 mmol/L glucose,then 12.5,25 and 50 μmol/L baicalein was added into the medium correspondingly,and 1 μmol/L BMS-986299 was used to treat the H-baicalein+NLRP3 agonist group.Lactate dehydrogenase(LDH)cytotoxicity assay were employed to detect cell cytotoxicity.qRT-PCR and Western blotting were performed to determine the expression of NLRP3,Caspase-1,and GSDMD at mRNA and protein levels.Results High glucose treatment induced more EdU positive cells,higher pyroptotic rate,stronger cytotoxicity,higher Col-Ⅰ and Col-Ⅲ contents,and enhanced mRNA and protein levels of NLRP3,Caspase-1 and GSDMD in comparison to the control group(P＜0.05).The H-baicalein+NLRP3 agonist group had more EdU positive cells(26.85±2.95 cells vs 15.43±1.82 cells,P＜0.05),higher pyroptotic rate[(33.45±4.02)％vs(17.34±2.15)％,P＜0.05],stronger cytotoxicity[(27.94±2.93)％vs(14.13±1.87)％,P＜0.05],and increased contents of Col-Ⅰ(107.58±13.39 ng/ml vs 58.73±8.36 ng/ml,P＜0.05)and Col-Ⅲ(118.43±13.95 ng/ml vs 68.74±8.57 ng/ml,P＜0.05),and enhanced expression of NLRP3,Caspase-1 and GSDMD at both mRNA and protein levels(P＜0.05)when compared with the H-baicalein group.Conclusion Baicalein inhibits high glucose-induced cardiac fibroblast pyroptosis by suppressing NLRP3/Caspase-1/GSDMD pathway.

Objective To investigate the clinical effect of minimally invasive orthopedics combined with Akin surgical segmental osteotomy in the treatment of hallux valgus.Methods Clinical data of hallux valgus patients who underwent minimally invasive orthopedics combined with Akin surgical segmental osteotomy in Wangjing Hospital of China Academy of Chinese Medical Sciences from June 2020 to June 2022 were collected.Hallux valgus angle(HVA),intermetatarsal angle(IMA),distal metatarsal articular angle(DMAA),visual analogue scale(VAS)score,American Orthopedic Foot and Ankle Society(AOFAS)scale score and complications were compared before and after surgery.Results A total of 186 patients with hallux valgus(328 feet)were included in the study.All patients successfully completed the operation and the follow-up period was 6 months.Six months after surgery,HVA,IMA and DMAA were significantly lower than before surgery,VAS score was significantly lower than before surgery,and AOFAS scale score was significantly higher than before surgery(P＜0.05).There were no postoperative complications such as wound infection,delayed union or nonunion of the osteotomy,and metastatic metatarsalgia.Conclusion Minimally invasive orthopedic combined with Akin surgical segmental osteotomy is safe and effective in treatment of hallux valgus,which has the advantages of less injury,good deformity correction and less postoperative complications,and is worthy of clinical application and promotion.

OBJECTIVE To explore the clinical value of metagenomic next generation sequencing(mNGS)in detec-tion of pathogens from the patients with pulmonary infection.METHODS The clinical data were collected from 103 patients with pulmonary infection who were treated in respiratory and critical care medicine department of Gansu Province People's Hospital from Jun.2021 to Jun.2023.The pathogens were detected from all of the patients with the use of mNGS for bronchoalveolar lavage fluid(BALF)and traditional cultures(including sputum culture and BALF culture).The positive rates,consistency,distribution,efficacy and curative effects were observed and sys-tematically compared between the two detection methods.RESULTS Totally 122 strains of bacteria,47 strains of fungi,94 strains of viruses,3 strains of Mycoplasma and 2 strains of Chlamydia were detected from the 103 pa-tients by mNGS,as compared with only 45 strains of bacteria and 20 strains of fungi that were detected by the tra-ditional culture method.The positive rate of detection of pathogens was 89.32％by mNGS,higher than 38.83％of the traditional culture method(P＜0.001).There was certain difference in the distribution of pathogens be-tween the two detection method,the two detection method showed the poor consistency of detection efficacy,and the effect of targeted drug therapy based on the mNGS-detected pathogens was higher than that of the mNGS-negative empirical therapy(P＜0.001).In addition,some of drug resistance genes could be detected by mNGS.CONCLUSIONS The mNGS shows remarkable higher efficacy in detection of the pathogens causing pul-monary infections than the traditional culture method and can detect various types of pathogens.The effect of the targeted drug therapy based on the pathogens detected by mNGS is remarkable.It plays an imorptant role in guid-ing the clinical diagnosis and treatment of the patients with pulmonary infections.

Objective To compare the effect of different intensity of neuromuscular training(NMT)on muscle strength and knee joint function of patients after anterior cruciate ligament reconstruction(ACLR).Methods From January,2023 to January,2024,60 ACLR patients in Changhai Hospital were selected,and they received the same intensity of NMT from one to eight weeks after surgery.Eight weeks after surgery,they were randomly divided into low intensity group(n=30)and high intensity group(n=30),and then they received different inten-sities of NMT from nine to 16 weeks after surgery,each training session lasted one hour,with three sessions per week,totaly 48 sessions.The Lysholm score,knee flexor and extensor muscle strength and muscle endurance-were compared at eight weeks and 16 weeks after surgery.Results After group training,the Lysholm score significantly increased in both groups(|t|>13.739,P<0.001),and was higher in the high intensity group than in the low intensity group(t=-2.574,P<0.05);in the high intensity group,the relative peak torque and endurance of the extensor and flexor muscles improved at angular velocities of 60°/s,120°/s and 180 °/s(|t|>2.320,P<0.05);in the low intensity group,the flexor peak torque improved at all the three angular velocities(t>2.177,P<0.05),the extensor peak torque improved at angular velocities of 60°/s and 180°/s(|t|>1.715,P<0.05),and the extensor endurance improved at angular velocity of 60°/s(t=-2.293,P<0.05).However,there was no significant difference in the relative peak torque and endurance of the extensor and flexor muscles at all the three angular velocities(P>0.05).Conclusion Both high and low intensity NMT could improve the muscle strength,muscle endurance and knee joint func-tion.Maybe,high intensity is superior to low intensity.Further verification is still needed.

Objective To explore the application value of improving the operation method of the coaxial microcatheter system to increase the recanalization rate of long-segment occluded blood vessels in the lower extremity arteries.Methods Eleven patients with long-segment occlusion of the lower extremity arteries were selected.Firstly,the angiographic catheter was sent to about 3-4 cm proximal to the occluded segment to provide support and direction control of the coaxial microcatheter system.Then,the microcathe-ter was sent to about 1 cm proximal to the occluded segment through the angiographic catheter,and the microguide wire was sent to the occluded segment,making the tip of the guide wire closely adhere to the occluded segment.The guide wire was fixed by using the guide wire controller to ensure that the guide wire in the blood vessel was always about 1 cm exposed outside the microcatheter.Meanwhile,the microcatheter and the microguide wire were rotated to make the tip form a"spring"shape similar to that of a pipe-line dredging machine,so that the coaxial microcatheter system could pass through the occluded segment of the blood vessel in this shape.After confirmed that the microcatheter had entered the lumen of the distal outflow tract blood vessel,the subsequent interven-tional treatment was completed according to the conventional method.Results Eleven patients with long-segment occluded blood vessels in the lower extremity arteries were successfully treated with improving the operation method of the coaxial microcatheter system to dredge the occluded segment,and completed the interventional treatment of the affected limb blood vessels without vascu-lar rupture,vascular bleeding or arterial dissection.Conclusion Using the improved operation method of the coaxial microcatheter system to dredge the long-segment occluded blood vessels of the lower extremity arteries is simple,safe and has a high success rate,which is worthy of clinical promotion.

Objective To analyze the temporal trends of gout disezse burden in China from 1990 to 2021,and construct an age-period-cohort(APC)model to explore the independent effects of age,period,and birth cohort on epidemiological indicators,and predict the future burden of gout disease in China from 2022 to 2035.Methods Data on gout disease burden in China during 1990-2021 were extracted from the Global Burden of Disease(GBD)2021 database.Joinpoint regression analysis was used to assess temporal trends.The APC model was applied to evaluate the age,period and cohort effects on prevalence risk and disability-adjusted life years(DALYs).A Bayesian age-period-cohort(BAPC)model was employed to project the age-standardized prevalence rate(ASPR)and age-standardized DALY rate(ASDR)of gout in China from 2022 to 2035.Results From 1990 to 2021,the incidence,prevalence and DALYs of gout in China all increased substantially,with overall rising trends in the age-standardized incidence rate(ASIR),ASPR and ASDR.Compared with 1990,the incidence,prevalence and DALYs in 2021 increased by 160.45%,181.12%,and 175.93%,respectively,while their age-standardized rates increased by 23.74%,26.48%and 25.89%.Joinpoint regression analysis revealed that average annual percentage changes(AAPCs)of 0.73%for ASIR,0.82%for ASPR and 0.80%for ASDR during 1990-2021.In 2021,the number of cases and DALYs reached their peaks in males aged 55-59 years and females aged 65-69 years.Both prevalence and DALY rates increased steadily with age,with marked rises starting at age 30 in men and age 40 in women.Overall,males showed higher prevalence,DALYs and corresponding rates than those of females across all age groups.APC model results indicated that the age effect,period effect and cohort effects on prevalence and DALY rates presented an overall upward tread.Decomposition analysis showed that population aging contributed the most to the increase in incidence and DALYs from 1990 to 2021.BAPC projections suggested that by 2035,the ASPR and ASDR of gout in China reached 890.50 per 100,000 and 27.26 per 100,000,respectively.Conclusion The ASPR and ASDR of gout in China are projected to continue increasing from 2022 to 2035.Targeted public health strategies for high-risk populations are urgently needed to reduce the growing burden of gout.

BACKGROUND:There are still great controversies in the etiology,clinical manifestations,diagnosis and treatment of pigmented villonodular synovitis.Bibliometric and visualization studies on pigmented villonodular synovitis can clarify the research development context and point out the direction for future research.OBJECTIVE:To analyze the global research status,hotspot,and trend of pigmented villonodular synovitis.METHODS:All publications related to pigmented villonodular synovitis from 1995 to 2023 were retrieved from Web of Science and CNKI.Citespace and bibliometrics were used to analyze the clustering,co-occurrence,and emergent words of all articles.The Web of Science database adopts subject headings plus free words for retrieval,while the CNKI database retrieves through subject headings.Finally,986 English articles and 599 Chinese articles were included.RESULTS AND CONCLUSION:(1)The United States has an absolute leading position in research in this field,ranking first in the number of published papers,H index,and cited times.China ranks the 4th in the total volume of published articles and 12th in the H index.The quality of published articles and international cooperation still need to be improved.(2)Cluster analysis of pigmented villonodular synovitis studies showed that the top five clusters were radiotherapy,soft tissue sarcoma,rheumatoid arthritis,magnetic resonance imaging,and diagnosis.(3)The key words that continued to emerge until 2023 were colony-stimulating factor 1,giant cell tumor of tendon sheath,case report,chromosome translocation,radiotherapy,expression,and kinase.(4)Based on keyword analysis and co-citation analysis,it is found that the research on the clinical characteristics of pigmented villonodular synovitis,the development of new colony-stimulating factor 1 inhibitors,and the application of colony-stimulating factor 1 inhibitors in the treatment process are current research hotspots.(5)Combining thematic evolution with the analysis of current research hotspots,based on clarifying the etiology,pathogenesis,and clinical characteristics of pigmented villonodular synovitis,improving the diagnostic accuracy of pigmented villonodular synovitis,enhancing the precision of treatment,and reducing the recurrence rate after treatment will be key issues that require focus in the future.

Objective To investigate the clinical effect of minimally invasive orthopedics combined with Akin surgical segmental osteotomy in the treatment of hallux valgus.Methods Clinical data of hallux valgus patients who underwent minimally invasive orthopedics combined with Akin surgical segmental osteotomy in Wangjing Hospital of China Academy of Chinese Medical Sciences from June 2020 to June 2022 were collected.Hallux valgus angle(HVA),intermetatarsal angle(IMA),distal metatarsal articular angle(DMAA),visual analogue scale(VAS)score,American Orthopedic Foot and Ankle Society(AOFAS)scale score and complications were compared before and after surgery.Results A total of 186 patients with hallux valgus(328 feet)were included in the study.All patients successfully completed the operation and the follow-up period was 6 months.Six months after surgery,HVA,IMA and DMAA were significantly lower than before surgery,VAS score was significantly lower than before surgery,and AOFAS scale score was significantly higher than before surgery(P＜0.05).There were no postoperative complications such as wound infection,delayed union or nonunion of the osteotomy,and metastatic metatarsalgia.Conclusion Minimally invasive orthopedic combined with Akin surgical segmental osteotomy is safe and effective in treatment of hallux valgus,which has the advantages of less injury,good deformity correction and less postoperative complications,and is worthy of clinical application and promotion.