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 evaluate the diagnostic value of intestinal tissue metagenomic next-generation sequencing (mNGS) in severe diarrhea following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Sixteen patients who developed severe diarrhea or hematochezia after haploidentical allo-HSCT at the First Affiliated Hospital of Fujian Medical University (June 2023–August 2024) were enrolled. All underwent gastrointestinal endoscopy and mNGS for microbial detection. Clinical, endoscopic, pathological, and microbiological data were analyzed to evaluate the diagnostic value of mNGS and treatment outcomes following targeted therapy.Results:The study included 16 patients (12 males, 4 females; median age 32.5 years, range 3–60 years). Diarrhea occurred a median of 3.93 months post-transplant (range 1.63–10.40 months). Stool cultures were negative except for one case with Candida. One patient tested positive for Clostridium difficile antigen. Endoscopy revealed mucosal congestion, edema, erosion, and bleeding, with focal inflammation on pathology. mNGS detected pathogens in 87.5% (14/16) of cases, including mixed infections in 78.5% (11/14). Common pathogens were Klebsiella pneumoniae, Enterococcus faecium, Escherichia coli, Rhizopus microsporus, EBV, and CMV. Targeted treatment adjustments led to symptom improvement in 87.5% of patients.Conclusion:Allo-HSCT patients are prone to infectious diarrhea due to immunosuppression. Molecular analysis of endoscopic biopsy tissues using mNGS can accurately identify pathogens, guide targeted therapy, and improve clinical outcomes.

Objective To analyze the current status and emerging technology trends in domestic medical drainage tube patents,so as to explore possible factors for low patent conversion rates.Methods Patents associated with"drainage tube","medical drainage tube","surgical drainage tube"and related terms were retrieved from the National Intellectual Property Administration Database and the Innojoy Patent Search Engine,covering the period from 2010 to 2020.Screening and visual analysis were conducted using Excel and SPSS 27.0.Results A total of 2 895 relevant patents were identified,comprising 2 489 utility model patents,367 invention patents and 39 design patents.The number of patent applications demonstrated a year-on-year growth trend,with a higher concentration in eastern coastal regions and provinces housing numerous top-tier hospitals and medical institutions.Approximately 49.26％of the patents filed by individuals were affiliated with hospitals,universities,or enterprises.Innovation hotspots included the design,functionality,performance,and safety aspects of drainage tubes and probes.Of the patents,72.61％were invalid,and 61.73％had a survival period of three years or less.Only 5.15％were commercially utilized through transfers,pledges,or licensing.Conclusion Domestic patent applications for medical drainage tubes have seen rapid growth,with a focus on enhancing tube structures such as sleeves,balloons,drainage holes,and threaded designs.However,the unsatisfactory situation of patent conversion and operation have been mainly limited by factors such as weak core technology of patents,insufficient awareness of achievements conversion,poor operation of patent conversion mechanism,insufficient market promotion,and insufficient integration of industry,academia,and research.To address this issue,enhancing intellectual property protection,revitalizing valid patents,and expanding transformation channels would benefit patients and facilitate hospitals'high-quality development,injecting new vitality into the health industry.

Objective:To investigate changes of CD4+T/CD8+T ratio in children with mycoplasma pneumoniae pneumonia(MPP)at different ages and to predict outcome.Methods:A total of 150 children aged 1～12 with MPP admitted to The Second People's Hospital of Hefei from March 2021 to September 2023 were selected as study group,and were divided into improved group(n=112)and deteriorated group(n=38)according to clinical outcomes after treatment.According to age,patients were divided into in-fant group(≤3 years old)38 cases,preschool group(4～6 years old)57 cases,school age group(>6 years old)55 cases.General information,biochemical test indicators and other related data were collected,CD4+T/CD8+T was calculated,and statistical analysis was performed by SPSS23.0 software.Through univariate and multifactor Logistics regression analysis,changes of CD4+T/CD8+T and other indicators in MPP children of different ages were compared,and independent factors affecting outcome of MPP children were screened.ROC curve was used to analyze efficacy of selected independent influencing factors in predicting outcome of MPP children of different ages.Log-binomial model was used to analyze risk effect of age on CD4+T/CD8+T and different outcomes in MPP children.Dose-response relationship between CD4+T/CD8+T and risk of disease progression in MPP children was analyzed by Logistic regression model combined with restricted cubic spline(RCS)model.P<0.05 was statistically significant.Results:CRP,IgA,IgG,IgM and CD8+T were the highest in infant group,followed by preschool group,the lowest in school-age group(P<0.05),CD4+T and CD4+T/CD8+T were the lowest in infant group,followed by preschool group,and the highest in school-age group(P<0.05).MPP children with≤3 years old accounted for the lowest proportion of improvement(18.76%)and the worst improvement,followed by MPP children with 4～6 years old,MPP children with>6 years old accounted for the highest proportion of improvement(43.75%),and the best im-provement(P<0.001).Improvement of children with disease course≤7 days was significantly better than disease course>7 days(P<0.001).CRP,DD,ESR,LDH,IgA,IgG,IgM and CD8+T levels in children with MPP deterioration were significantly higher than children with MPP improvement(P<0.001),and CD4+T and CD4+T/CD8+T levels were significantly lower than children with MPP im-provement(P<0.001).Multi-factor Logistics regression analysis showed that age,IgA,IgG,IgM and CD4+T/CD8+T were independent influencing factors for outcome of MPP children(P<0.05).ROC curve analysis showed that when cut-off value was 1.50,AUC of CD4+T/CD8+T to predict outcome of MPP children was 0.86(95%CI:0.75～0.94),sensitivity and specificity were 83.76%and 84.60%,respectively.Log-binomial model showed that MPP children with CD4+T/CD8+T≤1.50%had the highest risk of worsening out-come.Risk scores before and after adjustment were 2.05(1.41～3.75),2.07(1.46～3.88)and 2.14(1.50～4.02)times of those in im-provement group.School-age children with CD4+T/CD8+T>1.50%had the lowest risk of worsening,and risk before and after adjust-ment was 1.07(1.00～1.87),1.13(1.04～1.98),1.18(1.07～2.01)times higher than improved group.RCS model analysis of relation-ship between CD4+T/CD8+T and different outcomes in MPP children showed that regardless of whether confounders were adjusted,CD4+T/CD8+T was negatively correlated with outcome of MPP children.Conclusion:CD4+T/CD8+T in MPP children of different ages is significantly different.CD4+T/CD8+T is the lowest in infant group,followed by preschool group,and the highest in school-age group.CD4+T/CD8+T in children with worsening MPP is significantly lower than improved MPP,and CD4+T/CD8+T is negatively correlated with outcome of MPP children,which has certain value in predicting outcome of MPP children.

Approximately 30%-40% of epilepsy patients do not respond well to adequate anti-seizure medications (ASMs), a condition known as pharmacoresistant epilepsy. The management of pharmacoresistant epilepsy remains an intractable issue in the clinic. Its early prediction is important for prevention and diagnosis. However, it still lacks effective predictors and approaches. Here, a classical model of pharmacoresistant temporal lobe epilepsy (TLE) was established to screen pharmacoresistant and pharmaco-responsive individuals by applying phenytoin to amygdaloid-kindled rats. Ictal electroencephalograms (EEGs) recorded before phenytoin treatment were analyzed. Based on ictal EEGs from pharmacoresistant and pharmaco-responsive rats, a convolutional neural network predictive model was constructed to predict pharmacoresistance, and achieved 78% prediction accuracy. We further found the ictal EEGs from pharmacoresistant rats have a lower gamma-band power, which was verified in seizure EEGs from pharmacoresistant TLE patients. Prospectively, therapies targeting the subiculum in those predicted as "pharmacoresistant" individual rats significantly reduced the subsequent occurrence of pharmacoresistance. These results demonstrate a new methodology to predict whether TLE individuals become resistant to ASMs in a classic pharmacoresistant TLE model. This may be of translational importance for the precise management of pharmacoresistant TLE.
Epilepsy, Temporal Lobe/diagnosis* ; Animals ; Drug Resistant Epilepsy/drug therapy* ; Electroencephalography/methods* ; Rats ; Anticonvulsants/pharmacology* ; Neural Networks, Computer ; Male ; Humans ; Phenytoin/pharmacology* ; Adult ; Disease Models, Animal ; Female ; Rats, Sprague-Dawley ; Young Adult ; Convolutional Neural Networks

IgA nephropathy（IgAN）is the most common primary glomerular disease，characterized by the deposition of IgA in the glomerular mesangial area. IgAN is a progressive disease with a protracted and relapsing course. Approximately 50%~75% of adult IgAN patients experience renal function deterioration and eventually progress to end-stage kidney disease（ESKD）within 20 years after diagnosis. Among patients with onset in childhood，about 30% ultimately progress to ESKD after 20 years of long-term follow-up. In recent years，numerous studies have continuously explored important signaling pathways and key molecules in its pathogenesis. This review introduces the therapeutic advances in IgAN，aiming to provide better treatment options for clinicians.

Objective:To identify the incidence and prevalence of inflammatory bowel disease (IBD) in the northern Chinese population of Jinan, Shangdong Province, along with its temporal trends from 2005 to 2022.Methods:By utilizing the data from the Jinan basic medical insurance system, a population-based IBD cohort was constructed. This facilitated the computation of both the incidence and prevalence rates of IBD, alongside their temporal trends throughout the 2005 to 2022 timeframe. The 95% confidence intervals were estimated using poisson regression.Results:The overall incidence rate of IBD showed a yearly increasing trend, with age-standardized incidence rates rising from 0.03/100 000 in 2005 to 5.39/100 000 in 2022. The age-standardized incidence rate of ulcerative colitis (UC) increased from 0.03/100 000 in 2005 to 4.97/100 000 in 2022. The age-standardized incidence rate of Crohn's disease (CD) rose from 0.05/100 000 in 2011 to 0.44/100 000 in 2022. The crude prevalence of IBD increased from 0.60/100 000 in 2005 to 32.39/100 000 in 2022. Specifically, the crude prevalence of UC increased from 0.60/100 000 in 2005 to 31.44/100 000 in 2022, while the crude prevalence of CD increased from 0.05/100 000 in 2011 to 1.19/100 000 in 2022.Conclusions:Analysis of recent medical insurance data reveals a continuous uptrend in both the incidence and prevalence of IBD in Jinan, a northern city in China. This underscores the urgent need for enhanced medical resources and healthcare guaruntee to ensure the well-being of individuals afflicted with IBD.

Hearing loss is the most prevalent disabling disease. Cochlear implantation（CI） serves as the primary intervention for severe to profound hearing loss. This consensus systematically explores the value of genetic diagnosis in the pre-operative assessment and efficacy prognosis for CI. Drawing upon domestic and international research and clinical experience, it proposes an evidence-based medicine three-tiered prognostic classification system（Favorable, Marginal, Poor）. The consensus focuses on common hereditary non-syndromic hearing loss（such as that caused by mutations in genes like GJB2, SLC26A4, OTOF, LOXHD1） and syndromic hereditary hearing loss（such as Jervell & Lange-Nielsen syndrome and Waardenburg syndrome）, which are closely associated with congenital hearing loss, analyzing the impact of their pathological mechanisms on CI outcomes. The consensus provides recommendations based on multiple round of expert discussion and voting. It emphasizes that genetic diagnosis can optimize patient selection, predict prognosis, guide post-operative rehabilitation, offer stratified management strategies for patients with different genotypes, and advance the application of precision medicine in the field of CI.
Humans ; Cochlear Implantation ; Prognosis ; Hearing Loss/surgery* ; Consensus ; Connexin 26 ; Mutation ; Sulfate Transporters ; Connexins/genetics*

Objective:To correlate the expression of interleukin-6 (IL-6), CD40 ligand (CD40L), and soluble triggering receptor expressed on myeloid cells 1 (sTREM-1) with regulatory T lymphocyte (Treg)/helper T lymphocyte 17 (Th17) in children with immune thrombocytopenic purpura (ITP) and to assess their combined diagnostic value.Methods:A retrospective study was conducted involving 80 children with ITP (ITP group) and 80 healthy children undergoing routine health screenings (control group) at Jinhua Central Hospital from February 2023 to February 2024. The levels of IL-6, CD40L, and sTREM-1, along with the Treg/Th17 ratio, were compared between the two groups and among children with different degrees of ITP severity. The correlations between IL-6, CD40L, and sTREM-1 and the severity of ITP, as well as the Treg/Th17 ratio were analyzed. Additionally, the diagnostic value of the combined tests was evaluated.Results:The levels of IL-6, CD40L, and sTREM-1 in the ITP group were (46.53 ± 8.69) ng/L, (6.51 ± 1.51), and (18.76 ± 3.72) ng/L, respectively. These values in the ITP group were significantly higher than those in the control group [(11.72 ± 1.58) ng/L, (4.31 ± 1.25), (8.07 ± 1.34) ng/L, t = 35.25, 10.04, 24.18, all P < 0.001]. The Treg/Th17 ratio in the ITP group was (1.34 ± 0.41), which was significantly lower than that in the control group [(13.56 ± 2.87), t = 37.70, P < 0.001]. In children with severe ITP, the levels of IL-6, CD40L, and sTREM-1 were (56.39 ± 11.70) ng/L, (9.62 ± 1.78), and (24.72 ± 4.81) ng/L, respectively. For those with moderate ITP, the levels were (45.41 ± 8.27) ng/L, (6.38 ± 1.40), and (17.69 ± 3.56) ng/L, respectively. In children with mild ITP, the levels were (37.04 ± 6.32) ng/L, (5.11 ± 1.32), and (14.50 ± 3.04) ng/L. The Treg/Th17 ratio in children with mild ITP was (0.95 ± 0.26), which was significantly lower than that in the moderate (1.37 ± 0.40) and severe (2.88 ± 0.56) groups. All differences were statistically significant among the three groups ( F = 23.98, 42.57, 37.15, 122.23, all P < 0.001). The levels of IL-6, CD40L, and sTREM-1 were positively correlated with the severity of ITP ( r = 0.565, 0.542, 0.538) and negatively correlated with the Treg/Th17 ratio ( r = -0.572, -0.536, -0.532), with all correlations being statistically significant (all P < 0.001). The receiver operating characteristic curve analysis indicated that the area under the curve values for the individual diagnoses of IL-6, CD40L, and sTREM-1 were 0.779, 0.750, and 0.763, respectively. In contrast, the area under the curve value for the combined diagnosis was 0.951, which was greater than that for each individual marker ( Z = 1.924, 2.137, 2.015, P = 0.037, 0.026, 0.031). Conclusions:The levels of IL-6, CD40L, and sTREM-1 in children with ITP are substantially correlated with the severity of ITP and the Treg/Th17 ratio, demonstrating notable diagnostic efficacy for ITP. Notably, the combination of IL-6, CD40L, and sTREM-1 greatly enhances diagnostic value.

Objective:To identify the incidence and prevalence of inflammatory bowel disease (IBD) in the northern Chinese population of Jinan, Shangdong Province, along with its temporal trends from 2005 to 2022.Methods:By utilizing the data from the Jinan basic medical insurance system, a population-based IBD cohort was constructed. This facilitated the computation of both the incidence and prevalence rates of IBD, alongside their temporal trends throughout the 2005 to 2022 timeframe. The 95% confidence intervals were estimated using poisson regression.Results:The overall incidence rate of IBD showed a yearly increasing trend, with age-standardized incidence rates rising from 0.03/100 000 in 2005 to 5.39/100 000 in 2022. The age-standardized incidence rate of ulcerative colitis (UC) increased from 0.03/100 000 in 2005 to 4.97/100 000 in 2022. The age-standardized incidence rate of Crohn's disease (CD) rose from 0.05/100 000 in 2011 to 0.44/100 000 in 2022. The crude prevalence of IBD increased from 0.60/100 000 in 2005 to 32.39/100 000 in 2022. Specifically, the crude prevalence of UC increased from 0.60/100 000 in 2005 to 31.44/100 000 in 2022, while the crude prevalence of CD increased from 0.05/100 000 in 2011 to 1.19/100 000 in 2022.Conclusions:Analysis of recent medical insurance data reveals a continuous uptrend in both the incidence and prevalence of IBD in Jinan, a northern city in China. This underscores the urgent need for enhanced medical resources and healthcare guaruntee to ensure the well-being of individuals afflicted with IBD.