BACKGROUND:The plateau environment affects the immune function and metabolic status of patients with osteomyelitis,leading to acceleration or complication of the disease process.The construction of effective and stable animal models of chronic osteomyelitis is essential for experimental studies of chronic osteomyelitis.OBJECTIVE:To establish a sheep model of chronic osteomyelitis in plateau regions for toxicity assessment and therapeutic research.METHODS:Fifteen healthy sheep were selected in this study.Sodium morrhuate and Staphylococcus aureus suspension were injected into the medullary cavity of the middle segment of the tibia to establish the chronic osteomyelitis model.General observation,body mass and temperature monitoring,blood infection index detection,radiological scoring,and microbial culture were performed for evaluation and analysis.RESULTS AND CONCLUSION:(1)Local tissue swelling and lameness of the affected leg were observed in all sheep in the early stage after modeling,accompanied by varying degrees of anorexia.A slight decrease in body mass was observed in sheep 1 week after modeling,while no significant changes in body temperature were observed.(2)The erythrocyte sedimentation rate significantly accelerated 4 days after modeling(P<0.05)and gradually returned to normal levels after 1 month.The white blood cell count showed a significant increase within 4 days after modeling and returned to normal after 1 week.The level of C-reactive protein increased significantly after modeling(P<0.05)and remained significantly higher than normal until the end of the experiment(P<0.05).(3)Fifteen sheep exhibited typical radiological manifestations of osteomyelitis,including unclear boundaries,irregular osteolytic lesions,and low-density bright absorption areas with interspersed necrotic bone fragments of increased and uneven density.Different degrees of periosteal reaction were observed in the cortex near the lesion.(4)Thirteen sheep were cultured for a single strain of Staphylococcus aureus,while two sheep were cultured for Staphylococcus aureus and Escherichia coli.These findings indicate that a reliable chronic osteomyelitis animal model of sheep tibia can be successfully established in plateau regions by injecting an appropriate amount of Staphylococcus aureus suspension into the medullary cavity of sheep,combined with local implantation of foreign cotton thread and sodium morrhuate.

Objective:To analyze the current preparation and usage situation of first-aid drugs in the rescue vehicles in children's medical institutions, and provide references for optimizing the list of emergency drugs.Methods:First-aid drug lists in the rescue vehicles of 12 children's medical institutions from 11 provinces and municipalities in China were collected through questionnaire surveys, and the drugs as well as their quantities were compared. The existing problems in the use of first-aid drugs in the 12 medical institutions were investigated by on-site interviews. The usage information of first-aid drugs in the rescue vehicles of the General Surgery and Cardiology Department of Shanxi Children's Hospital from May 2022 to April 2023 was collected through the hospital information center, and usage frequency and dosage per patient of the drugs were calculated. Descriptive statistical analysis was conducted on the collected data.Results:The first-aid drug lists in 12 hospitals were various, including 7 to 22 kinds of drugs and involving a total of 23 drugs. These mainly included vasoactive drugs, cardiotonic drugs, antiarrhythmic drugs, antiangina and anti-ischemic drugs for the heart, antispasmodic drugs, diuretics, dehydrating drugs, sedative-hypnotic drugs, and glucocorticoids, all of which were injections. The drugs that were included in all the lists of 12 hospitals were epinephrine, dopamine, dexamethasone, furosemide, and atropine. The drug lists of different rescue vehicles throughout the hospital were the same in 4 hospitals, while the lists varied among departments based on their specific clinical needs in the other 8 hospitals. None of the 12 hospitals had a first-aid drug usage manual. The on-site interview results showed that, the existing problems about drug preparation and use in rescue vehicles mainly involved the following 6 aspects: drug types, quantities, labels, storage, procurement, and usage. In Shanxi Children's Hospital, the types and quantities of first-aid drugs in rescue vehicles of General Surgery Department and Cardiology Department were the same. There were 6 and 9 kinds of drugs were used in the 2 departments during rescue operations, respectively. The drugs that were never used in either department included promethazine, lidocaine, diazepam, phenobarbital, raceanisodamine, sodium bicarbonate, atropine, glucose, and calcium gluconate.Conclusions:The phenomenon of unreasonable kinds and quantities of first-aid drugs in the rescue vehicles existed in the children's medical institutions, and the drugs provided did not fully match the actual clinical needs. There was an urgent need for preparation guidelines and usage manuals of first-aid drugs that were suitable for children's medical institutions to enhance the scientificity of drug supply and the correctness of usage.

Objective:To investigate the changes in serum levels of interleukin-1β (IL-1β) and hypoxia-inducible factor-2α (HIF-2α) in patients with intracranial aneurysms before and after surgery, and their relationship with clinical prognosis.Methods:A prospective research method was used, a total of 120 patients with intracranial aneurysms who underwent endovascular embolization treatment in Xi'an NO.9 Hospital from December 2019 to December 2022 were selected as the study subjects. According to the prognosis after one-year follow-up, they were divided into poor prognosis group and good prognosis group. The general data of the two groups and the changes of serum IL-1β and HIF-2α levels before and after surgery were compared and analyzed. The changes of serum IL-1β and HIF-2α before and after surgery in patients with intracranial aneurysms and their relationship with the prognosis of patients were analyzed.Results:Among the 120 patients, 98 (81.67%) had a good prognosis and 22 (18.33%) had a poor prognosis. The proportion of large and wide necked aneurysms in the poor prognosis group was higher than that in the good prognosis group: 40.91% (9/22) vs. 10.20% (10/98), 45.45% (10/22) vs. 20.41%(20/98), with statistical significant differences ( P<0.05). On postoperative day 7, the serum levels of IL-1 β and HIF-2 α in the poor prognosis group were higher than those in the good prognosis group: (62.58 ± 6.12) ng/L vs. (56.95 ± 5.33) ng/L, (101.62 ± 10.55) ng/L vs. (92.70 ± 7.82) ng/L, with statistical significant differences ( P<0.05). Multivariate Logistic regression analysis showed that the size of aneurysms, including giant aneurysms, wide necked aneurysms, and high levels of serum IL-1β and HIF-2α 7 d after surgery, were independent risk factors for clinical prognosis in patients with intracranial aneurysms ( P<0.05). The working characteristic curve of the subjects was drawn, and the results showed that serum IL-1β and HIF-2α had certain predictive value for the clinical prognosis of intracranial aneurysm patients 7 d after surgery, but their sensitivity was relatively low. The parallel experiment method was used to jointly predict the samples. The results showed that the area under the curve for predicting the clinical prognosis of intracranial aneurysm patients with serum IL-1β and HIF-2α at 7 d after surgery was 0.867, with sensitivity and specificity of 86.40% and 74.50%, respectively, indicating high predictive value. Conclusions:The levels of serum IL-1β and HIF-2α are significantly elevated in patients with intracranial aneurysms after surgery, and are closely related to their clinical prognosis, which can help predict the clinical prognosis of intracranial aneurysm patients.

Acute pancreatitis(AP),one of the most common acute abdominal conditions in clinical practice,is typically self-limiting.However,approximately 20%of cases progress to severe acute pancreatitis,characterized by persistent systemic inflammatory response syndrome and multiple-organ dysfunction syndrome,with a high mortality rates.The pathogenesis of AP involves complex pathophysiological processes,and in recent years,the role of oxidative stress(OS)in AP has garnered increasing attention.OS refers to an imbalance between reactive oxygen species production and antioxidant capacity following endogenous or exogenous stimuli,which can lead to pancreatic cell injury,exacerbation of inflammatory responses,and organ dysfunction.Notably,antioxidants have demonstrated efficacy in reducing OS-induced pancreatic damage and multi-organ dysfunction in animal models.This article reviews current molecular mechanisms of OS in AP,its role in disease progression and recent advances in antioxidant-based therapeutic strategies for AP.

Acute pancreatitis(AP),one of the most common acute abdominal conditions in clinical practice,is typically self-limiting.However,approximately 20%of cases progress to severe acute pancreatitis,characterized by persistent systemic inflammatory response syndrome and multiple-organ dysfunction syndrome,with a high mortality rates.The pathogenesis of AP involves complex pathophysiological processes,and in recent years,the role of oxidative stress(OS)in AP has garnered increasing attention.OS refers to an imbalance between reactive oxygen species production and antioxidant capacity following endogenous or exogenous stimuli,which can lead to pancreatic cell injury,exacerbation of inflammatory responses,and organ dysfunction.Notably,antioxidants have demonstrated efficacy in reducing OS-induced pancreatic damage and multi-organ dysfunction in animal models.This article reviews current molecular mechanisms of OS in AP,its role in disease progression and recent advances in antioxidant-based therapeutic strategies for AP.

Objective:To investigate the changes in serum levels of interleukin-1β (IL-1β) and hypoxia-inducible factor-2α (HIF-2α) in patients with intracranial aneurysms before and after surgery, and their relationship with clinical prognosis.Methods:A prospective research method was used, a total of 120 patients with intracranial aneurysms who underwent endovascular embolization treatment in Xi'an NO.9 Hospital from December 2019 to December 2022 were selected as the study subjects. According to the prognosis after one-year follow-up, they were divided into poor prognosis group and good prognosis group. The general data of the two groups and the changes of serum IL-1β and HIF-2α levels before and after surgery were compared and analyzed. The changes of serum IL-1β and HIF-2α before and after surgery in patients with intracranial aneurysms and their relationship with the prognosis of patients were analyzed.Results:Among the 120 patients, 98 (81.67%) had a good prognosis and 22 (18.33%) had a poor prognosis. The proportion of large and wide necked aneurysms in the poor prognosis group was higher than that in the good prognosis group: 40.91% (9/22) vs. 10.20% (10/98), 45.45% (10/22) vs. 20.41%(20/98), with statistical significant differences ( P<0.05). On postoperative day 7, the serum levels of IL-1 β and HIF-2 α in the poor prognosis group were higher than those in the good prognosis group: (62.58 ± 6.12) ng/L vs. (56.95 ± 5.33) ng/L, (101.62 ± 10.55) ng/L vs. (92.70 ± 7.82) ng/L, with statistical significant differences ( P<0.05). Multivariate Logistic regression analysis showed that the size of aneurysms, including giant aneurysms, wide necked aneurysms, and high levels of serum IL-1β and HIF-2α 7 d after surgery, were independent risk factors for clinical prognosis in patients with intracranial aneurysms ( P<0.05). The working characteristic curve of the subjects was drawn, and the results showed that serum IL-1β and HIF-2α had certain predictive value for the clinical prognosis of intracranial aneurysm patients 7 d after surgery, but their sensitivity was relatively low. The parallel experiment method was used to jointly predict the samples. The results showed that the area under the curve for predicting the clinical prognosis of intracranial aneurysm patients with serum IL-1β and HIF-2α at 7 d after surgery was 0.867, with sensitivity and specificity of 86.40% and 74.50%, respectively, indicating high predictive value. Conclusions:The levels of serum IL-1β and HIF-2α are significantly elevated in patients with intracranial aneurysms after surgery, and are closely related to their clinical prognosis, which can help predict the clinical prognosis of intracranial aneurysm patients.

BACKGROUND:The plateau environment affects the immune function and metabolic status of patients with osteomyelitis,leading to acceleration or complication of the disease process.The construction of effective and stable animal models of chronic osteomyelitis is essential for experimental studies of chronic osteomyelitis.OBJECTIVE:To establish a sheep model of chronic osteomyelitis in plateau regions for toxicity assessment and therapeutic research.METHODS:Fifteen healthy sheep were selected in this study.Sodium morrhuate and Staphylococcus aureus suspension were injected into the medullary cavity of the middle segment of the tibia to establish the chronic osteomyelitis model.General observation,body mass and temperature monitoring,blood infection index detection,radiological scoring,and microbial culture were performed for evaluation and analysis.RESULTS AND CONCLUSION:(1)Local tissue swelling and lameness of the affected leg were observed in all sheep in the early stage after modeling,accompanied by varying degrees of anorexia.A slight decrease in body mass was observed in sheep 1 week after modeling,while no significant changes in body temperature were observed.(2)The erythrocyte sedimentation rate significantly accelerated 4 days after modeling(P<0.05)and gradually returned to normal levels after 1 month.The white blood cell count showed a significant increase within 4 days after modeling and returned to normal after 1 week.The level of C-reactive protein increased significantly after modeling(P<0.05)and remained significantly higher than normal until the end of the experiment(P<0.05).(3)Fifteen sheep exhibited typical radiological manifestations of osteomyelitis,including unclear boundaries,irregular osteolytic lesions,and low-density bright absorption areas with interspersed necrotic bone fragments of increased and uneven density.Different degrees of periosteal reaction were observed in the cortex near the lesion.(4)Thirteen sheep were cultured for a single strain of Staphylococcus aureus,while two sheep were cultured for Staphylococcus aureus and Escherichia coli.These findings indicate that a reliable chronic osteomyelitis animal model of sheep tibia can be successfully established in plateau regions by injecting an appropriate amount of Staphylococcus aureus suspension into the medullary cavity of sheep,combined with local implantation of foreign cotton thread and sodium morrhuate.

Objective:To analyze the current preparation and usage situation of first-aid drugs in the rescue vehicles in children's medical institutions, and provide references for optimizing the list of emergency drugs.Methods:First-aid drug lists in the rescue vehicles of 12 children's medical institutions from 11 provinces and municipalities in China were collected through questionnaire surveys, and the drugs as well as their quantities were compared. The existing problems in the use of first-aid drugs in the 12 medical institutions were investigated by on-site interviews. The usage information of first-aid drugs in the rescue vehicles of the General Surgery and Cardiology Department of Shanxi Children's Hospital from May 2022 to April 2023 was collected through the hospital information center, and usage frequency and dosage per patient of the drugs were calculated. Descriptive statistical analysis was conducted on the collected data.Results:The first-aid drug lists in 12 hospitals were various, including 7 to 22 kinds of drugs and involving a total of 23 drugs. These mainly included vasoactive drugs, cardiotonic drugs, antiarrhythmic drugs, antiangina and anti-ischemic drugs for the heart, antispasmodic drugs, diuretics, dehydrating drugs, sedative-hypnotic drugs, and glucocorticoids, all of which were injections. The drugs that were included in all the lists of 12 hospitals were epinephrine, dopamine, dexamethasone, furosemide, and atropine. The drug lists of different rescue vehicles throughout the hospital were the same in 4 hospitals, while the lists varied among departments based on their specific clinical needs in the other 8 hospitals. None of the 12 hospitals had a first-aid drug usage manual. The on-site interview results showed that, the existing problems about drug preparation and use in rescue vehicles mainly involved the following 6 aspects: drug types, quantities, labels, storage, procurement, and usage. In Shanxi Children's Hospital, the types and quantities of first-aid drugs in rescue vehicles of General Surgery Department and Cardiology Department were the same. There were 6 and 9 kinds of drugs were used in the 2 departments during rescue operations, respectively. The drugs that were never used in either department included promethazine, lidocaine, diazepam, phenobarbital, raceanisodamine, sodium bicarbonate, atropine, glucose, and calcium gluconate.Conclusions:The phenomenon of unreasonable kinds and quantities of first-aid drugs in the rescue vehicles existed in the children's medical institutions, and the drugs provided did not fully match the actual clinical needs. There was an urgent need for preparation guidelines and usage manuals of first-aid drugs that were suitable for children's medical institutions to enhance the scientificity of drug supply and the correctness of usage.

Anterior cruciate ligament(ACL)injury is caused by strong violence,which can destabilize the knee joint,cause joint cartilage degeneration,meniscus injury,and in severe cases,develop osteoarthropathy.The gold standard for the treatment of ACLR injuries at this stage is arthroscopic anterior cruciate ligament recon-struction(ACLR).In clinical practice,the LARS(Ligament advanced reinforcement system)artificial ligament made of polyethylene terephthalate(PET)as the material has a good effect in the short and medium term,but the long-term biological healing between the graft and the host bone is poor,and the real"ligamentization"requirement of the postoperative graft cannot be met.Coating-modified modification of artificial ligaments can improve their hydrophilicity and biocompatibility,which in turn can promote the healing of graft-bone tunnels.Tendon bone healing is a bone-derived progressive process from indirect insertion to direct insertion,which takes a relatively long time and is closely related to the prognosis and early rehabilitation effect of patients.This article reviews the progress of superficial modification of artificial ligaments to promote ACLR tendon bone healing.

Objective:To understand the prevalence of insufficient physical activity among adults aged ≥18 years in China and to explore the influencing factors.Methods:The China Chronic Disease and Risk Factor Surveillance was conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method was used to select permanent residents aged ≥18 years. A questionnaire including Global Physical Activity Questionnaire was used to collect information about the participants' demographic characteristics and physical activity through face-to-face interview. A total of 183 769 participants completed the survey. After complex data weighting, the prevalence of insufficient physical activity, occupation, transportation, and leisure-time physical activity time was analyzed. Multivariate logistic regression models were used to analyze the influencing factors related to insufficient physical activity.Results:The prevalence of insufficient physical activity among adults aged ≥18 years was 22.3% (95% CI: 20.9%-23.7%) in China in 2018, with males [24.4% (95% CI: 23.0%-25.8%)] significantly higher than females [20.2% (95% CI: 18.6%-21.8%)]. Adults aged 70 years and above [28.4% (95% CI: 26.9%-29.9%)] were significantly higher than adults in other age groups, followed by adults aged 18-29 years [26.4% (95% CI: 24.4%- 28.3%)] and 30-39 years [23.4% (95% CI: 21.5%-25.3%)], and tended to increase with increasing education and total sedentary behavior time ( P<0.001). The weekly occupation, transportation, and leisure-time physical activity time appeared 958.6 (95% CI: 911.4-1 005.8) minutes, 234.5 (95% CI: 224.7- 244.2) minutes, and 88.6 (95% CI: 83.5-93.7) minutes, respectively. Multivariate logistic regression analysis showed that males, adults living in rural areas or northern China, ≥70 years, with junior high school education, an annual household income per capita <6 000 yuan and institutional/clerical/ technical occupation and longer total sedentary behavior time were related to a higher prevalence of insufficient physical activity. Conclusions:In China, over one-fifth of the adults had lower physical activity levels. Adults who are male, young adults, more educated, institutional/clerical/technical occupation, and with more extended total sedentary behavior are the populations that need to be focused on to promote physical activity-related health.