BACKGROUND:Inter-limb asymmetry is a common phenomenon observed during human growth and development.Prolonged specialized training can lead to specific adaptations in inter-limb asymmetry among athletes.OBJECTIVE:To review the formation causes,manifestations,and impacts of inter-limb asymmetry on sports performance,and provide an overview of the relevant assessment methods and intervention strategies.METHODS:A literature search was conducted in the CNKI,WanFang,PubMed,and Web of Science databases from their inception to September 2024.The search terms included"asymmetry,asymmetries,asymmetric,asymmetrical,imbalance,strength,power,force,jump,sprint,athletic performance,anthropometry,injury"in English and Chinese.After excluding duplicate publications,irrelevant content,and conference papers,a total of 131 articles were finally included for analysis.RESULTS AND CONCLUSION:(1)Inter-limb asymmetry can be influenced by various factors including genetics,task demands,training regimens,injuries,fatigue,and limb preference.These factors lead to being primarily manifested in anatomical structure,strength performance,and task-specific asymmetry.(2)An increase in inter-limb asymmetry can result in impaired performance in bilateral in-phase symmetric movements.However,the relationship between increased inter-limb asymmetry and bilateral out-of-phase symmetric movements remains unclear and requires further investigation.(3)Training interventions have been shown to effectively mitigate inter-limb asymmetry,with unilateral training demonstrating superior outcomes compared with bilateral training.The choice of training methods and content should be tailored to meet the specific demands of the sport.(4)To further clarify the relationship between inter-limb asymmetry and athletic performance,it is recommended that future research adopt the concept of"task specificity"in inter-limb asymmetry.This includes standardizing study designs,selecting sensitive testing methods and indicators,unifying calculation methods to provide more high-quality evidence,and establishing categorized warning threshold standards for inter-limb asymmetry in different sports.

BACKGROUND:Inter-limb asymmetry is a common phenomenon observed during human growth and development.Prolonged specialized training can lead to specific adaptations in inter-limb asymmetry among athletes.OBJECTIVE:To review the formation causes,manifestations,and impacts of inter-limb asymmetry on sports performance,and provide an overview of the relevant assessment methods and intervention strategies.METHODS:A literature search was conducted in the CNKI,WanFang,PubMed,and Web of Science databases from their inception to September 2024.The search terms included"asymmetry,asymmetries,asymmetric,asymmetrical,imbalance,strength,power,force,jump,sprint,athletic performance,anthropometry,injury"in English and Chinese.After excluding duplicate publications,irrelevant content,and conference papers,a total of 131 articles were finally included for analysis.RESULTS AND CONCLUSION:(1)Inter-limb asymmetry can be influenced by various factors including genetics,task demands,training regimens,injuries,fatigue,and limb preference.These factors lead to being primarily manifested in anatomical structure,strength performance,and task-specific asymmetry.(2)An increase in inter-limb asymmetry can result in impaired performance in bilateral in-phase symmetric movements.However,the relationship between increased inter-limb asymmetry and bilateral out-of-phase symmetric movements remains unclear and requires further investigation.(3)Training interventions have been shown to effectively mitigate inter-limb asymmetry,with unilateral training demonstrating superior outcomes compared with bilateral training.The choice of training methods and content should be tailored to meet the specific demands of the sport.(4)To further clarify the relationship between inter-limb asymmetry and athletic performance,it is recommended that future research adopt the concept of"task specificity"in inter-limb asymmetry.This includes standardizing study designs,selecting sensitive testing methods and indicators,unifying calculation methods to provide more high-quality evidence,and establishing categorized warning threshold standards for inter-limb asymmetry in different sports.

Objective To construct a prediction model for the population with hypertension and diabetes to assess the risk of chronic kidney disease (CKD), and to provide a scientific basis for formulating targeted CKD prevention and control measures. Methods Based on physical examination data from community residents aged 60 years and above in Nanjing in 2022, 10 221 patients with hypertension and diabetes were selected as the study subjects. Variables associated with CKD prevalence were screened using univariate analysis, and further variable selection was performed using LASSO regression. Finally, a CKD risk prediction model was constructed based on logistic regression. The model's performance was evaluated using the ROC curve and calibration curve. Results The prevalence rate of CKD in the study population was 22.71%, with a mean age of 71.66 years. LASSO regression identified seven variables associated with CKD: age, blood urea nitrogen (BUN), hemoglobin, uric acid, triglyceride-glucose (TyG) index, urine protein-to-creatinine ratio (UPCR), and medical insurance type. The final logistic regression model incorporated six variables: age [OR=1.067 (95% CI: 1.058-1.076)], BUN [OR=1.377 (95% CI: 1.338-1.418)], hemoglobin [OR=0.992 (95% CI: 0.989-0.995)], uric acid [OR=1.004 (95% CI: 1.003-1.004)], TyG index [OR=1.445 (95% CI: 1.324-1.577)], and self-payment medical insurance [OR=1.732 (95% CI: 1.542-1.945)]. The model had an AUC of 0.759 (95% CI: 0.747-0.770) and a Brier score of 0.140 (95% CI: 0.136-0.145), indicating good predictive performance. The calibration curve showed good agreement between the predicted risk and the observed value. Conclusion The constructed LASSO-logistic regression risk prediction model in this study can effectively assess the risk of CKD in elderly individuals aged 60 years and above with hypertension and diabetes, providing a basis for early identification of high-risk individuals and the formulation of targeted CKD prevention and control measures.

The application of immunosuppressants has significantly reduced the incidence rate of rejection reaction after liver transplantation， but the clinical efficacy of immunosuppressants is greatly affected by individual differences between patients. This article systematically reviews the recent research advances in the interaction between immunosuppressants and gut microbiota， with a focus on the regulatory role and mechanism of intestinal microflora communities on the efficacy of immunosuppressants. Studies have shown that intestinal microbiome is one of the key factors influencing the efficacy of immunosuppressive therapy after liver transplantation. This review aims to provide a theoretical basis for in-depth research in this field and provide new insights for developing individualized immunosuppressive treatment regimens based on the regulation of intestinal microflora.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

OBJECTIVE To analyze the characteristics of imported malaria cases in West China Hospital of Sichuan University in recent years and to provide reference for the prevention and control of imported infectious diseases.METHOD A retrospective analysis of 62 cases of imported malaria from abroad reported in West China Hospital of Sichuan University from 2012 to 2023 were retrospectively analyzed.RESULTS From 2012 to 2023,62 cases of imported malaria were reported,including 49 cases(79.03％)of falciparum malaria,10 cases(16.13％)of vivax malaria,and 3 cases(4.84％)of ovale malaria.Among the imported malaria cases,9 cases were severe malaria,with 8(16.33％,8/49)severe cases caused by falciparum malaria,of which 6 cases(75.00％,6/8)were cere-bral malaria.The cases were mainly Chinese citizens and young-to-middle-aged adults,with the highest concentra-tion in the 40-49 age group(37.10％,23/62).There were more males than females,with a male-to-female sex ratio of 11.4∶1;the predominant occupation was worker(38.71％,24/62).The primary region of importation was Africa(90.32％,56/62).There was importation throughout the year,with no distinct seasonal distribution pattern.Two of the admitted cases died(severe cases of falciparum malaria,which developed into cerebral malari-a),while the rest were improved and discharged from the hospital after standardized treatment.CONCLUSIONS Cases of imported malaria from abroad are characterized by Chinese nationality,males,young adults and workers.The type of malaria is mainly falciparum malaria,and the prognosis for most cases is relatively good.It is necessary to strengthen the construction of joint prevention and control systems and other long-term mechanisms,and to continuously and scientifically implement various strategies and measures to prevent the re-emergence of malaria through imported ca-ses,in order to avoid the occurrence of secondary cases resulting from imported infections.

To explore the cultivation path of excellent physicians in regional medical universities, a horizontal integration of clinical courses was performed to construct a curriculum centered on systemic diseases. Clinical courses adopted bedside rotation teaching with small class (30-40 students, 3-4 students/group). A comprehensive approach was designed and implemented, covering overall framework, organizational guarantee, teaching arrangement, teaching method, and assessment system. The effectiveness of the reform was evaluated through the comprehensive exams during the basic stage and national clinical medicine proficiency test. Despite no significant differences in the basic stage, the national clinical medicine proficiency test scores of the C2E class with teaching reform increased continuously from 2017 to 2020. The theoretical examination score of the C2E class was higher than that of regular classes 1 in 2017, 2019, and 2020. With continuous optimization, the skill examination score of the C2E class was significantly higher than that of regular class 1 in 2020. These findings highlight the effectiveness of the teaching reform and provide a foundation for the teaching reform of large class in five-year clinical medicine programs.

Based on the actual situation of rapid increase in obesity prevalence and the current lack of a professional weight loss and bariatric surgery treatment platform in Macao, coupled with the continouous rise in the obesity population, the further development and refine-ment of obesity treatment methods has become particularly urgent. Against this backdrop, the authors conduct an in-depth discussion to analyze how Macao, leveraging its unqiue geographical location and favorable policy advantages within the broader context of collaborative development in the Guangdong-Hong Kong-Macao greater bay area, can actively explore future development paths and potential challenges in the fields of bariatric and metabolic medicine and surgery, with the aim to provide a robust reference for advancing related medical technologies in Macao, thereby enhancing the overall level of obesity treatment in the region.

Objective To examine the level of sperm flagellar tubulin glycosylation(Gly-Tubulin)in asthenospermia patients(AP)and discuss its significance.Methods According to the principle of inclusion and exclusion criteria,108 patients treated in the Department of Andrology in Xinjiang Uygur Autonomous Region Maternal and Child Health Hospital from June 2021 to May 2022 were rolled in this study.According to the results of semen examine,they were divided into group AP(n=74),and normal control(NC)group(n=34).Colleced the clinical date of both group,such as the age,the sterility period.The levels of sex hormones were detected by chemiluminescence method.The glycosylated Tubulin levels of the sperm were detected by Western blot and immunofluorescence was used for localization analysis,and the relationship between the Gly-Tubulin of sperm flagellar and asthenospermia was analyzed by Multivariate Logistic regression analysis.Results Compared to NC group,the sterility period of group AP was prolong(3.98±0.30 vs 0.78±0.08),the percent of forward sperm motility was decreased(18.55±0.97 vs 46.24±1.89)and the expression level of Gly-Tubulin in the sperm flagellar was decreased(0.64±0.11 vs 1.00±0.00),the differences with statistical significance(t=62.038,χ2=14.394,3.148,all P＜0.05).There were no significant differences in follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradiol(E2),testosterone,semen volume,sperm concentration and total sperm between the two groups(t/χ2=0.043～1.503,all P>0.05).Multivariate Logistic regression analysis showed that the percent of forward sperm motility and the sperm flagellar Gly-Tubulin expression level were independent risk factors for male asthenospermia(Wald χ2=4.406,7.492,P<0.05).Conclusion Abnormal level of Gly Tubulin in sperm flagella may be closely related to the occurrence and development of asthenospermia.

Objective Explored the clinical efficacy and mechanism of improved CO2 fractional laser on treatment for refractory wounds.Methods A total of 122 patients with refractory wounds who were admitted to the hospital from May 2022 to May 2024 were selected and randomly divided into a conventional group(conventional dressing change treatment+photodynamic therapy+conventional CO2 fractional laser treatment)and an improved group(conventional dressing change treatment+photodynamic therapy+improved CO2 fractional laser treatment)by lottery,with 61 cases in each group.The serum C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)levels,the number of wound bacteria before treatment and after 1,2,and 3 weeks of treatment were compared between the two groups.The wound healing rates after 1,2,and 3 weeks of treatment were compared between the two groups.The clinical efficacy of the two groups was compared.The levels of wound exudate basic fibroblast growth factor(bFGF)and angiopoietin-1(Ang-1)before treatment and after 1,2,and 3 weeks of treat-ment were compared.The adverse reactions of the two groups were compared.Results Repeated measures analy-sis of variance showed that there were an interaction effect between groups and over time in the serum CRP and ESR levels,the number of wound bacteria in both groups(P<0.05).There were no significant differences in the serum CRP and ESR levels and the number of wound bacteria between the two groups before treatment(P>0.05).The serum CRP and ESR levels and the number of wound bacteria in the improved group were lower than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).Repeated measures analysis of variance showed that there was an interaction effect between groups and over time in the wound healing rates of both groups(P<0.05).The wound healing rates in the improved group were higher than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).The total clinical effective rate of the improved group was higher than that of the conventional group(P<0.05).Repeated measures analysis of variance showed that there was an inter-action effect between groups and over time in the levels of bFGF and Ang-1 in wound exudates of both groups(P<0.05).There was no significant difference in the levels of bFGF and Ang-1 in wound exudates between the two groups before treatment(P>0.05).The levels of bFGF and Ang-1 in wound exudates in the improved group were higher than those in the conventional group after 1,2,and 3 weeks of treatment(P<0.05).There were no signifi-cant differences in the incidence of pain,pruritus and rash between the two groups(P>0.05).Conclusions In the treatment of refractory wounds,the combination of improved CO2 fractional laser and photodynamic therapy could promote the secretion of wound exudate growth factors,inhibit wound bacterial growth and inflammatory response,accelerate wound healing,and improve clinical efficacy,with high safety.The mechanism of action is related to the promotion of wound exudate growth factor secretion.