BACKGROUND: The achievement of an optimal return to sport (RTS) has remained a key goal after sports-related injuries, with the ongoing debate on the effectiveness of different surgical approaches for anterior cruciate ligament (ACL) rupture. This study aims to assess clinical outcomes and RTS across various surgical methods, such as anatomical single-bundle reconstruction (ASBR), central-axial single-bundle reconstruction (CASBR), and double-bundle reconstruction (DBR). METHODS: A randomized clinical trial was conducted, comprising 191 patients who underwent ACL rupture. These patients were divided into three groups based on the ACL reconstruction techniques they received (ASBR, CASBR, DBR). Over the 2-year follow-up period, the study assessed RTS through four single-hop tests, isokinetic extension tests, and limb asymmetry indices. Postoperative graft status was determined using the signal-to-noise quotient (SNQ), while knee function was evaluated using the International Knee Documentation Committee 2000 (IKDC-2000) score, Lysholm score, Tegner score, and degree of knee laxity. A binary logistic regression model was developed to forecast the factors influencing ideal RTS. RESULTS: DBR (67.63%) and CASBR (58.00%) exhibited higher RTS passing rates compared to ASBR (30.39%; χ2 = 19.57, P <0.05). Quadriceps strength symmetry in the lower limbs was identified as the key determinant of RTS ( χ2 = 17.08, P <0.05). The RTS rate was influenced by SNQs of the graft's tibial site (odds ratio: 0.544) and quadriceps strength of the reconstructed knee joint at 60°/s (odds ratio: 6.346). Notably, the DBR group showed enhanced knee stability, evidenced by superior results in the Lachman test ( χ2 = 13.49, P <0.01), objective IKDC-2000 ( χ2 = 27.02, P = 0.002), and anterior instability test ( χ2 = 9.46, P <0.01). Furthermore, DBR demonstrated superior clinical outcomes based on the Lysholm score (DBR: 89.57 ± 7.72, CASBR: 83.00 ± 12.71, ASBR: 83.21 ± 11.95; F = 10.452, P <0.01) and IKDC-2000 score (DBR: 90.95 ± 7.00, CASBR: 84.64 ± 12.68, ASBR: 83.63 ± 11.41; F = 11.78, P <0.01). CONCLUSION: For patients with ACL rupture, more ideal RTS rate and clinical outcomes were shown in the DBR group than in the ASBR and CASBR groups. Autograft status and quadriceps strength are postively related to RTS. TRIAL REGISTRATION ClinicalTrials.gov (NCT05400460).
Humans ; Anterior Cruciate Ligament Reconstruction/methods* ; Male ; Female ; Adult ; Anterior Cruciate Ligament Injuries/surgery* ; Young Adult ; Return to Sport ; Adolescent ; Anterior Cruciate Ligament/surgery* ; Treatment Outcome

Objective To establish a 103-plex InDel-SNP composite marker amplification system based on Ion Torrent PGM/S5 sequencing platform targeting fragment length less than 175bp,providing an efficient analytical tool for forensic individual identification and paternity identification.Methods Using the human genome GRCh38 as the reference sequence,InDel-SNP composite marker loci suitable for Chinese population were screened from 22 pairs of autosomes and sex chromosomes by using dbSNP database with East Asian population as the target population.Population genetic data of 267 unrelated individuals of Han nationality in Shandong province were investigated,and genetic relationship was verified using 16 real triplet families.Results The 103-plex InDel-SNP composite marker detection system developed in this study,based on the second-generation sequencing platform,exhibits notable features including high sensitivity,excellent stability,strong specificity,and wide applicability to conventional test materials.It effectively enables the determination of typing results for degraded and mixed samples.Conclusion All 16 parent triplet pairs demonstrated adherence to Mendelian inheritance law without any observed allelic dropout or mutation.This detection system holds significant value for forensic individual identification and paternity testing.

Objective To explore the relationship between epstein-barr viral(EBV)load and T lymphocyte subsets distribution in peripheral blood of children with systemic lupus erythematosus(SLE)and its synergistic effect on liver injury.Methods A total of 212 children with SLE admitted to the Xinjiang Uygur Autonomous Region Children's Hospital from October 2021 to September 2023 were selected as the study subjects.The SLE disease activity index(SLEDAI)score was divided into active group(n=58)and inactive group(n=154).The clinical data and laboratory indexes of the two groups were compared.The curve relationship between EBV load and T lymphocytes was analyzed by local weighted scatterplot smoothing(LOWESS)method.According to the occurrence of liver injury,212 children with SLE were divided into two groups(n=166)without liver injury and(n=46)with liver injury.The clinical data of the two groups were compared.Multifactor Logistics regression analysis was used to screen the influencing factors of liver injury in SLE children.Restricted cubic spline(RCS)model was used to analyze the relationship between EBV load,T lymphocytes and liver injury.The unconditioned Logistic regression model was used to analyze the interaction between EBV load and T lymphocytes on liver injury.Results Compared with the inactive group,the active group had younger age(t=9.265),higher hormone dosage(t=2.369),decreased ALB,CD4+,CD4+/CD8+levels(t=4.870,3.463,5.820),and increased EBV load,CD3+,CD8+levels(t=40.830,12.719,5.048),and the differences were statistically significant(all P<0.05).LOWESS analysis showed that EBV load had a nonlinear relationship with CD3+,CD4+,CD8+and CD4+/CD8+.The proportion of children with liver injury who had a disease course of≤3 months,EBV load,CD3+and CD8+levels,and the proportion of active children were lower than those without liver injury(t/χ2=10.749～30.378);the levels of ALB,CD4+and CD4+/CD8+indexes were higher than those without live injury(t=13.561,3.117,13.204),and the differences were statistically significantly(all P<0.05).Multivariate Logistic regression analysis showed that disease duration≤3 months,EBV load,CD3+,ALB,CD4+/CD8+and active SLE were influential factors for liver injury in SLE children(Wald χ2=1.020～1.932,all P<0.05).The results of RCS model analysis showed that EBV load,CD3+and CD8+were positively correlated with liver injury in SLE children,and CD4+,CD4+/CD8+were negatively correlated with liver injury in SLE children.Interaction analysis results showed that EBV load≥450 IU/ml had a multiplicative and additive interaction with CD3+≥60%,CD4+<30%,CD8+≥37%and CD4+/CD8+<0.94,and the risk of liver injury in SLE children was higher when the two factors co-existed.Conclusion There is a nonlinear relationship between EBV load in peripheral blood of SLE children and CD3+,CD4+,CD8+and CD4+/CD8+.Peripheral blood EBV load and abnormal expression of CD3+,CD4+,CD8+and CD4+/CD8+are all factors affecting liver injury in children with SLE,and there is a multiplicative and additive interaction between the above factors.

Objective:To evaluate the feasibility of a six-step suspension technique for endoscopic lateral neck dissection (LND) through the chest-breast approach in patients with papillary thyroid carcinoma (PTC).Methods:This is a retrospective case series study.Clinical data of 81 PTC patients who underwent endoscopic LND via the chest-breast approach using the six-step suspension method at the Department of Thyroid Surgery, Shenzhen People′s Hospital were collected from January 2022 to October 2024. The cohort consisted of 15 male and 66 female patients, with age of (35.2±10.2)years (range:8.5 to 65.0 years). Key variables, including LND duration, total operative time, postoperative hospital stay, details of lymph node metastasis, postoperative complications, and follow-up data were recorded and analyzed.Results:The duration of LND was (131.8±42.2)minutes (range: 65 to 275 minutes), and the total operative time was (195.5±49.6)minutes (range: 110 to 390 minutes). The postoperative hospital stay was (4.8±1.5)days(range:3 to 15 days). The number of dissected lateral cervical lymph nodes was 32.7±10.1 (range: 11 to 54). The maximum tumor diameter was (16.1±10.1)mm(range:2 to 30 mm), while the maximum size of metastatic lymph nodes was (16.7±6.2)mm(range:7 to 30 mm). The positivity rate was 24.7% (841/3 410) in the lateral cervical+central lymph node and 16.1% (427/2 646) in the lateral cervical lymph node. Postoperative lymphatic leakage occurred in 2 patients, both of whom were successfully treated conservatively. No other significant complications were reported. During the postoperative follow-up period, which lasted for (18.3±7.4) months (range: 1.1 to 34.4 months), the mean postoperative serum thyroglobulin (Tg) level ( M(IQR)) was 0.05 (0.50) μg/L (range: 0.01 to 7.90 μg/L), with 86.4% of patients showing a Tg ≤1.00 μg/L. Through imaging evaluations, no evidence of residual disease or recurrence was detected. Conclusion:Endoscopic LND via the chest-breast approach, utilizing the six-step suspension method, maybe a feasible and effective technique with promising clinical outcomes.

Traditional treatment modalities for thalassemia include regular blood transfusions and allogenic hematopoietic stem cell transplantation(allo-HSCT).In recent years,autologous transplantation of gene-modified hematopoietic stem cells has emerged as a new curative strategy for transfusion-dependent thalassemia(TDT),which has the potential to replace conventional treatments,and provide lifelong benefits for patients.There are two existing technical approaches for gene therapy of β-thalassemia:gene addition,which involves transducing exogenous β-globin genes into hematopoietic stem cells(HSCs),and gene editing,which utilizes CRISPR-Cas9 or other editing systems to re-activate the expression of γ-globin gene.This article summarizes the marketed products and research progress in clinical trials,aiming to analyze the respective advantages and limitations of these two approaches,and discusses the effectiveness and safety of current gene therapies for β-thalassemia,as well as the future directions for associated technologies,including ex vivo HSC expansion with maintenance of stemness and vector-mediated in vivo gene modification.In terms of clinical translational medicine,this article provides in-depth insights into promising solutions for contemporary challenges confronted in clinical trials,including process development challenges,clinical trial conduct,regulatory approval processes,commercialization and payment systems.

Objective:To study the influence of methyltransferases like 3(METTL3)on the radiosensitivity of oral squamous cell carcinoma cells(OSCCs).Methods:The apoptosis level of OSCCs CAL27,SCC9 and SCC15 treated with X-ray radiation doses of 2,4 and 8 Gy respectively was compared by flow cytometry,the expression of methylated gene RNA and protein in the cells were examined by qRT-PCR and Western blot.m6A in the cells was quantified by LC/LC-MS method.qRT-PCR and Western blot were used to investigate the expression of methylated gene RNA and protein in the cells.Flow cytometry was used to examine the cell apoptosis level of CAL27 and SCC15 cells treated with METTL3 overexpression and knockdown respectively.The clone forma-tion of CAL27 and SCC15 cells after knockdown and overexpression of target genes followed by radiation treatment was observed by clonogenic assays.Results:The apoptosis rate of all the cell lines increased with the increase dose of radiation at each dose,CAL27 cells showed the highest and SCC15 showed the lowerst apoptosis rate.The RNA and protein expression levels of METTL3 in CAL27 were significantly lower than those of SCC15.m6A quantification showed that the methylation modification in CAL27 cells was lower than that in SCC15.The expression of METTL3 was increased in CAL27 and SCC15 cells after radiation treatment.Knockdown of METTL3 increaced the apoptosis rate and decreased the clonogenesity,overession of METTL3 the decreaced the ap optosis rate and increased the clonogenecity of the cells.Conclusion:Regulation of METTL3 can affect the radiotherapy sensitivity of OSCCs,METTL3 may become a new target for radiosensitization of OSCCs.