With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective To explore the relationship between brain injury related symptom groups and acute stress disorder( ASD). Methods Totally 301 patients with brain injury hospitalized in the Affiliated Hospital of North China University of Technology from March 2017 to March 2018 were recruited. The pa-tients were assessed by Stanford Acute Stress Response Questionnaire ( SASRQ), Brain Trauma Subscale (BIS) and Pittsburgh Sleep Quality Index (PSQI). Results The prevalence of acute stress disorder pa-tients with brain injury was 46. 51% (140/301). The SASRQ score of all patients with brain injury was (70. 78±28. 00). Univariate analysis showed that there were significant differences in age (χ2= 4. 172,P=0. 041),personality type (χ2= 57. 281,P<0. 001),sleep quality ( χ2= 70. 785,P<0. 001),hospitalization frequency (χ2= 43. 547,P<0. 001),depression,obsessive-compulsive and hostile symptoms between pa-tients with and without ASD ( P<0. 05). The scores of depression and obsessive-compulsive symptoms were significantly correlated with SASRQ scores(P<0. 05). The scores of hostility symptoms were significantly cor-related with SASRQ scores except for patients who lost their temper uncontrollably ( r=0. 176-0. 698,P<0. 05). Personality ( OR=0. 243,95% CI=0. 142-0. 415),sleep disorders( OR=0. 072,95% CI=0. 029-0. 178),hospitalization times(OR=0. 129,95%CI=0. 054-0. 306),depressive symptoms( OR=1. 260,95% CI=1. 061-1. 497),obsessive-compulsive symptoms(OR=1. 419,95%CI=1. 239-1. 625) and hostile symp-toms(OR=1. 253,95%CI=1. 058-1. 482) were the influencing factors of ASD in patients with brain injury (P<0. 05). Conclusion The incidence of ASD is higher in patients with brain injury. Personality type,hos-pitalization,sleep quality,depressive symptoms,obsessive-compulsive symptoms and hostile symptoms are the influencing factors,which should be paid more attention.

OBJECTIVE Through researching the ABR threshold, the cochlear morphology and miR-96 expression in the cochlear of BALB/c mice at different month's age, to find out if the miR-96 can regulate the age related hearing loss of BALB/c mice.METHODS ABR testing, AO/PI staining and scanning electron microscope were used to observe the ABR threshold and cochlear morphology of the BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months. Real-time PCR was used to detect the expression of miR-96 in the cochlea of BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months.RESULTS The ABR thresholds of BALB/c mice were (18.5±8.3), (45.8±7.8), and (85.6±15.6) dB SPL separately at the age of 3, 6 and 12 months. At the age of 18 months, no response was observed in the ABR testing with 120 dB SPL acoustic stimulation. In the AO/PI staining, we found that the outer hair cells was apparently lost since the age of 6 months and the loss of hair cells aggravated as the month's age increased. At the age of 12 months, no outer hair cells was left, inner hair cells was lost apparently too. With the scanning electron microscope, we found the changes of deficiency, lodging, fusion, shortening and inversion in the hair cell cilia. And these changes were aggravated as the month's ages increased. At the age of 3 months, the relative expression of miR-96 (2-△CT) was 0.0225±0.0073. The relative expression of miR-96 (2-△CT) in the cochlea were 0.0162±0.0048, 0.0116±0.0048, and 0.0050±0.0014 at the age of 6 months, 12 months and 18 months separately, comparing with the relative expression of miR-96 at the age of 3 months, the differences were significant(P<0.05).CONCLUSION The hearing loss, hair cells loss, and cilia damage aggravated as the month's age increased, but the miR-96 expression in the cochlea decreased. Which suggest that miR-96 might play an important role in the age related hearing loss.

OBJECTIVE To analyze the varieties,causes and preventions of severe complications in OSAHS patients with delayed extubation after surgery.METHODS The clinical dates of 548 OSAHS patients with delayed extubation after surgery were retrospectively analyzed,in order to explore the incidence,reasons,and the prevention and control of severe complications.RESULTS There were 14 cases with severe complications in 548 OSAHS patients,including 1 case of septicemia,one case of nasal alar scar formation,one case of cerebral infarction,2 cases of massive hemorrhage,2 cases of tube dislocation,2 cases of ventilator resistance,2 cases of apnea,3 cases of ventilator-associated pneumonia.All of the14 cases recovered after dealing with the corresponding measures.No dead happened.CONCLUSION The incidence of complications in OSAHS patients with delayed extubation is relatively high.In order to improve the prognosis,more attentions should be paid to the airway care and manipulation in the course of treatment.When the complications happened,corresponding treatments should be done in time.If the patients' respiratory function and airway patency were normal,extubation as early as possible could reduce the incidence of complications.

OBJECTIVETo investigate the changes in circulating plasmacytoid dendritic cells (pDCs) in patients with chronic hepatitis B (CHB) during the course of treatment with pegylated-interferon alfa-2s (peg-IFNa-2a) and to determine the correlations with therapeutic response.

METHODSForty-one patients with CHB who were receiving peg-IFNa-2a antiviral treatment for 48 weeks were enrolled in the study.Expression of the Toll-like receptor 9 (TLR9) on and frequency and functionality of the pDCs were analyzed at treatment weeks 0, 2, 12, 24, 36 and 48.

RESULTSAll patients exhibited an initially rapid decrease in the numbers of circulating pDCs and showed CpG-induced endogenous IFNa production within the first 2 weeks of treatment.Subsequently, all responders displayed a continuous increase in pDC numbers as well as functionality, both of which peaked around week 12 of treatment; in addition, these treatment responses were accompanied by significantly increased levels of type 1 T helper cytokines (P less than 0.05), which did not occur in the non-responders.

CONCLUSIONpDCs are involved in the initial therapeutic immune response stimulated by peg-IFNa-2a treatment.Recovery of blood pDC number and functionality may represent a predictor of favorable response to peg-IFNa-2a antiviral treatment in patients with CHB.

According to the common standard of ethic review for clinical research , it is equal to each kind of research program whether western medicine or Traditional Chinese Medicine .It should be reviewed the ethic and scientific issues in the same time .However, on account of the two majority characteristics of Traditional Chinese Medicine , it would be concerned more evidence , such as the safety data before clinic , the syndrome differentiation and treatment of target disease , drug combination , dosage and course of treatment , the methods of outcome meas-urement, admixture of the drug, the selection of control drug including placebo and so on .

Objective To investigate whether a novel long-acting tumor necrotic factor (TNF) antagonist (soluble TNF receptor:IgG Fc [sTNFR:IgG-Fc]) can protect hepatocyte damage against liver failure caused by drugs in immunity-induced cirrhotic rats.Methods Wistar rats were repeatedly sensitized by human serum albumin (HSA) emulsified in complete freud adjuvant.The blood was collected at day 10 after the final sensitization.If anti-albumin antibody was positive,the rats were intravenously injected with HSA twice a week.After six weeks,liver cirrhosis was induced by immunity.All the model rats were divided into three groups with 15 each.Liver failure was induced with D-galactosamine/ lipopolysaccharide (LPS) intraperitoneal injection in the rats with liver cirrhosis in model group.The rats in pretreatment group were intraperitoneally injected with long-acting soluble TNF receptor p55 18 h before D-galactosamine/LPS injection.The control group were injected with 0.9％ sodium chloride.General condition,survival rate,liver function and pathological changes were all examined.Serum levels of interleukin (IL)-6,IL-22 and intrahepatic level of IL-6 were detected by enzyme linked immunosorbent assay (ELISA).The activity of Caspase 3 in hepatocyte lysis solution was measured by spectrophotography.Real-time polymerase chain reaction (PCR) was used to detect mRNA expressions of proliferating cell nuclear antigen (PCNA),bcl-2,bax and IL-22 receptor.Data were analyzed by variance analysis among groups.Results Rats in model group were dispirited with poor response after 12 hours and only 3 survived,compared with soluble TNF receptor p55 pre-treated group rats,in which all survived (P=0.029 8) with flexible response.Serum alanine aminotransferase levels in these two groups were (6 533± 360) and (105 ± 7) U/L,respectively.Hepatic regenerative nodule developed massive or submassive necrosis with septal fibrosis in model group,whereas soluble TNF receptor p55 alleviated the inflammatory and necrosis reaction of hepatic tissue.Serum IL-6 levels in model group and pretreatment group were (842.0±12.9) and (91.9±1.6) pg/mL,respectively (F=380.30,P＜0.01).Intrahepatic levels of IL-6 in these two groups were (26.2±1.2) and (11.1±0.8) pg/mL,respectively (F=176.90,P＜0.01),and serum IL-22 levels were (167.0±27.8) and (988.0±109.6) pg/mL,respectively (F=37.91,P＜0.01).Hepatic Caspase-3 activity was reduced by almost 60％ by soluble TNF receptor p55 pretreatment (F=303.70,P＜0.01) and bax expression reduced by 22％ (F=108.80,P＜0.01),while bcl-2 and PCNA expressions were up-regulated by 3.6-folds and 23.0-folds,respectively (F=115.60,P＜0.01; F=594.20,P＜0.01).Conclusions Long acting soluble TNF receptor p55 could improve survival rate,liver function and reduce inflammatory reaction of rats with liver failure induced by drugs on the basis of liver cirrhosis caused by immunity,which indicates that this drug may process a potential therapeutic value.

ObjectiveTo investigate the histological features as well as the factors influencing liver disease progression in Chinese patients with chronic hepatitis C (CHC). MethodsA total of 102 CHC patients who underwent percutaneous liver biopsy between August 2007 and May 2010 were recruited. Age, gender, body mass index (BMI) and transmission route of recruited patients were recorded. Serum levels of alanine transaminase (ALT) and aspartate transaminase (AST), HCV genotypes, HCV viral load and liver histological changes were detected. Statistical analysis was done by t test and Logistic regression. ResultsThe serum levels of ALT and AST in CHC patients with histological activity index (HAI) ≥4 were much higher, while platelet (PLT) counts were lower than those with HAI ＜4(t=2.209, 2. 298 and 2. 565, respectively; all P＜0.05). Likewise, in patients with F≥3, the serum levels of ALT and AST as well as the mean age and the duration of infection were significantly elevated compared with F ＜ 3 group ( t = 3.497, 2. 758, 2. 340 and 2. 570,respectively; all P＜0. 05), while PLT counts were much lower (t = 2. 761, P=0. 007). The unvariate predictors for HAI≥4 were female, ALT＞1 × upper limits of normal (ULN), AST level,F≥3, HCV RNA≥6 lgIU/mL and PLT counts. By mutivariate analysis, the Ishak stage score was the only independent predictor for HAI≥4 (OR 3.098, 95％CI 1.884-5. 092; P＜0.01). Finally,the univariate predictors for F≥3 were age, BMI≥24 kg/m2 , ALT＞1 × ULN, AST level, HAI≥4,PLT counts and duration of infection≥ 15 years. Multivariate analysis revealed that age (OR 1. 074,95％CI 1.006-1. 146; P=0.033), ALT level (OR 1. 035, 95％CI 1.015－1.055; P＜0.01), ASTlevel (OR 0. 969, 95％CI 0. 948－0. 990; P=0. 005), the duration of infection ≥15 years (OR 37. 215, 95％CI 5. 816－238. 127; P＜0.01) and HAI≥4 (OR 1. 939, 95％CI 1. 426－2. 636; P＜0.01) were independent predictors for F≥ 3. ConclusionAge, ALT level, AST level, duration of infection≥15 years, HAI≥4 are independent predictors for liver fibrosis.

Objective To explore the therapeutic effect on the prevention of eccyesis by optimizing fallopian tube to be pregnant.Methods Three hundred and seventy-nine patients with infertility were divided into two groups:control group with 187 patients received the combined optimized treatment,and study group with 192 patients received the combined optimized treatment and optimizing fallopian tube to be pregnant.All patients received the hysterosalpingography uterosalpingography(HSU)whik the patients of the study group received the ultraphonic monitor for the.dominant follicle besides for 6 ovulatory cycle.Results There were intrauterine gestation 59 patients(31.55%,59/187),eccyesis 20 patients(10.70%,20/187)and infertility 108 patients(57.75%,108/187)in control group while there were intrauterine gestation 83 patients(43.23%,83/192),eccyesis 10 patients(5.21%,10/192)and infertility 99 patients (51.56%,99/192)in study group.The intrauterine gestation rate in study group was higher than that in control group(P<0.05),and the eccyesis rate was lower than that in control group(P<0.05).But there was no significant difference in the infertility rate between two groups(P＞0.05).The eccyesis rate in fallopian tube unsmooth was higher than that in salpingemphraxis and fallopian tube canalization respectively[12.59%(18/143),2.63%(2/76),2.70%(2/74),P<0.05].Conclusion Selecting the optimizing fallopian tube by HSU and monitoring the dominant follicle by ultraphonic to guide pregnancy can let the dominant follicle grow and conceive in the optimizing fallopian tIlbe,and this treatment can raise the intrauterine gestation rate and decrease the cause of eccyesis.