Objective To investigate the impact of phase Ⅱ cardiac rehabilitation on the rehabilitation needs and physical activity status of patients after coronary heart disease intervention.Methods A total of 90 patients with coronary heart disease who underwent percutaneous coronary intervention(PCI)in the Coronary Heart Disease Center of the hospital from August 2023 to August 2024 were selected as the research subjects.They were subjected to a 12-week standardized phase Ⅱ cardiac rehabilitation training.General data survey forms,cardiac rehabilitation scales,and the International Physical Activity Questionnaire were used for scale surveys to understand the patients' needs before and after rehabilitation and their weekly physical activity en-ergy expenditure.The cardiopulmonary exercise test gold standard,which reflects exercise capacity through three indicators-maximum oxygen uptake(VO2 max),anaerobic threshold(AT),and metabolic equivalents(MET),were used to compare the physical activity status before and after cardiac rehabilitation.Results Compared with before the implementation,after the implementation of cardiac rehabilitation,the autonomy score in-creased(21.36±1.85 vs.16.73±3.28),the process anxiety(12.60±3.87 vs.14.27±2.12)and outcome anxiety scores(2.31±1.76 vs.4.56±3.56)decreased,the level of low-intensity physical activity decreased[(2 711.62±1 487.09)min/week vs.(3 845.97±2 083.71)min/week],the levels of moderate-intensity[(1 314.67±783.54)min/week vs.(686.22±126.79)min/week],high-intensity[(1 861.33±798.27)min/week vs.(112.00±40.77)min/week],and total physical activity increased[(5 887.62±2 843.54)min/week vs.(4 644.19±2 287.16)min/week].The levels of VO2 max[(28.11±14.28)mL·min-1·kg-1 vs.(23.82±12.34)mL·min-1·kg-1],AT[(16.06±5.41)mL·min-1·kg-1 vs.(13.53±4.56)mL·min-1·kg-1],and MET[(6.89±1.59)mL·min-1·kg-1 vs.(5.78±1.21)mL·min-1·kg-1]all in-creased,with statistically significant differences(P＜0.05).Conclusion Phase Ⅱ rehabilitation after PCI can effectively improve patients' physical activity levels.

Objective:To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer.Methods:From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure.Results:Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status ( P=0.020), undergoing flap transplantation ( P=0.006), and self-esteem level ( P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions:Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

BACKGROUND:Osteoarthritis is a complex disease closely related to metabolic abnormalities.However,previous studies only involved limited blood lipid indicators and did not conduct more comprehensive blood lipid profile analysis.An in-depth exploration of the causal relationship between the seven items of blood lipids and osteoarthritis will not only help understand the pathogenesis of osteoarthritis,but also provide new research directions and clinical basis for its prevention and treatment.OBJECTIVE:To explore the causal relationship between blood lipids and osteoarthritis.METHODS:The genome-wide association analysis statistical data of 7 items of blood lipids and osteoarthritis from the IEU OPEN GWAS database were used to summarize,and significant single nucleotide polymorphisms were used as instrumental variables.The causal relationship between seven items(serum total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,apolipoprotein B,apolipoprotein AI and apolipoprotein A1)of blood lipids and osteoarthritis(osteoarthritis,knee or hip osteoarthritis,knee osteoarthritis and hip osteoarthritis)was determined through two-sample Mendelian randomization analysis.The inverse variance weighting was the main effect,and the MR-Egger regression method and the weighted median method were the supplementary effects.Bonferroni correction and reverse Mendelian randomization analysis could ensure validity.Multivariable Mendelian randomization analysis was used to further eliminate confounding factors.A significant causal relationship between seven items of blood lipids and osteoarthritis was obtained to ensure the robustness of the analysis.Co-localization analysis was used to once again ensure the robustness of the causal relationship and identify significantly influencing gene loci,making the evidence of causality more complete.RESULTS AND CONCLUSION:(1)In the two sample Mendelian randomization analysis,the results from inverse variance weighting indicated negative correlations between osteoarthritis and the following serum lipids:total cholesterol(OR=0.937 2,95%CI=0.885 6-0.991 9,P=0.025),low-density lipoprotein cholesterol(OR=0.959 4,95%CI=0.923 6-0.996 6,P=0.033),high-density lipoprotein cholesterol(OR=0.911 2,95%CI=0.833 5-0.996 2,P=0.04),apolipoprotein B(OR=0.926 7,95%CI=0.887 7-0.967 4,P=0.000 5),and apolipoprotein AI(OR=0.951 2,95%CI=0.911 0-0.993 1,P=0.023).Additionally,total cholesterol(OR=0.892 3,95%CI=0.843 1-0.944 3,P=0.000 08),triglycerides(OR=0.938 5,95%CI=0.884 7-0.995 6,P=0.035),and apolipoprotein B(OR=0.911 6,95%CI=0.865 9-0.959 7,P=0.000 4)were negatively associated with knee or hip osteoarthritis.For knee osteoarthritis specifically,total cholesterol(OR=0.898 3,95%CI=0.841 2-0.959 3,P=0.001),high-density lipoprotein cholesterol(OR=0.881 2,95%CI=0.794 7-0.977 0,P=0.016),and apolipoprotein B(OR=0.919 0,95%CI=0.869 8-0.971 0,P=0.002)also showed negative correlations.Lastly,with respect to hip osteoarthritis,total cholesterol(OR=0.864 5,95%CI=0.797 5-0.937 3,P=0.000 4),low-density lipoprotein cholesterol(OR=0.925 6,95%CI=0.879 5-0.974 1,P=0.003),and apolipoprotein B(OR=0.888 8,95%CI=0.817 6-0.966 3,P=0.005)exhibited negative correlations.No statistically significant differences were found in the reverse Mendelian randomization analysis.(2)In the multivariable Mendelian randomization analysis,the results from inverse variance weighting indicated a negative correlation between high-density lipoprotein cholesterol and osteoarthritis(OR=0.942 7,95%CI=0.896 1-0.991 8,P=0.022).Additionally,total cholesterol(OR=0.799 8,95%CI=0.647 8-0.987 6,P=0.037)and high-density lipoprotein cholesterol(OR=0.865 1,95%CI=0.7781-0.961 9,P=0.007)were also negatively associated with knee osteoarthritis.(3)Colocalization analysis revealed that total cholesterol and low-density lipoprotein were significantly associated with osteoarthritis at single nucleotide polymorphisms rs13107325(H4 posterior probability=99.9%).(4)These findings,using international databases and non-Asian populations,provide valuable insights for early clinical diagnosis,understanding the pathogenesis,and researching prevention and treatment of osteoarthritis in Chinese biomedicine and the Chinese population.

Objective:To analysis of the latent profiles and influencing factors of body image in patients with postoperative oral cancer.Methods:From July 2024 to March 2025, a total of 332 patients with primary oral cancer confirmed by pathology, aged ≥18 years, and undergoing oral cancer surgery at Hunan Cancer Hospital were selected using simple random sampling and cluster sampling. Among them, 25 were female and 307 were male. The body image scale and the Rosenberg self-esteem scale were used to investigate the patients. The main indicators included the total scale scores and scores on various dimensions of body image, such as appearance evaluation and health focus, with particular attention to satisfaction with facial appearance and oral function.The correlation between self-esteem and body image was analyzed, and differences in scores were compared based on gender, age, self-esteem level, and surgical procedure.Results:Among the 332 patients, 93.4% (310/332) were married, and 6.6% (22/332) were unmarried, divorced, or widowed. A total of 84.3% (280/332) underwent flap transplantation surgery, while 15.7% (52/332) did not. The body image distress in the 332 patients could be categorized into a body image adaptation group [80.12% (266/332)] and a body image disorder group [19.88% (66/332)]. Unmarried/divorced/widowed status ( P=0.020), undergoing flap transplantation ( P=0.006), and self-esteem level ( P<0.001) were identified as influencing factors for postoperative body image disorder in oral cancer patients. Conclusions:Given the varying levels of body image concerns among oral cancer patients, healthcare providers can implement targeted, personalized nursing interventions based on their distinct categories and influencing factors.

BACKGROUND:Osteoarthritis is a complex disease closely related to metabolic abnormalities.However,previous studies only involved limited blood lipid indicators and did not conduct more comprehensive blood lipid profile analysis.An in-depth exploration of the causal relationship between the seven items of blood lipids and osteoarthritis will not only help understand the pathogenesis of osteoarthritis,but also provide new research directions and clinical basis for its prevention and treatment.OBJECTIVE:To explore the causal relationship between blood lipids and osteoarthritis.METHODS:The genome-wide association analysis statistical data of 7 items of blood lipids and osteoarthritis from the IEU OPEN GWAS database were used to summarize,and significant single nucleotide polymorphisms were used as instrumental variables.The causal relationship between seven items(serum total cholesterol,triacylglycerol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,apolipoprotein B,apolipoprotein AI and apolipoprotein A1)of blood lipids and osteoarthritis(osteoarthritis,knee or hip osteoarthritis,knee osteoarthritis and hip osteoarthritis)was determined through two-sample Mendelian randomization analysis.The inverse variance weighting was the main effect,and the MR-Egger regression method and the weighted median method were the supplementary effects.Bonferroni correction and reverse Mendelian randomization analysis could ensure validity.Multivariable Mendelian randomization analysis was used to further eliminate confounding factors.A significant causal relationship between seven items of blood lipids and osteoarthritis was obtained to ensure the robustness of the analysis.Co-localization analysis was used to once again ensure the robustness of the causal relationship and identify significantly influencing gene loci,making the evidence of causality more complete.RESULTS AND CONCLUSION:(1)In the two sample Mendelian randomization analysis,the results from inverse variance weighting indicated negative correlations between osteoarthritis and the following serum lipids:total cholesterol(OR=0.937 2,95%CI=0.885 6-0.991 9,P=0.025),low-density lipoprotein cholesterol(OR=0.959 4,95%CI=0.923 6-0.996 6,P=0.033),high-density lipoprotein cholesterol(OR=0.911 2,95%CI=0.833 5-0.996 2,P=0.04),apolipoprotein B(OR=0.926 7,95%CI=0.887 7-0.967 4,P=0.000 5),and apolipoprotein AI(OR=0.951 2,95%CI=0.911 0-0.993 1,P=0.023).Additionally,total cholesterol(OR=0.892 3,95%CI=0.843 1-0.944 3,P=0.000 08),triglycerides(OR=0.938 5,95%CI=0.884 7-0.995 6,P=0.035),and apolipoprotein B(OR=0.911 6,95%CI=0.865 9-0.959 7,P=0.000 4)were negatively associated with knee or hip osteoarthritis.For knee osteoarthritis specifically,total cholesterol(OR=0.898 3,95%CI=0.841 2-0.959 3,P=0.001),high-density lipoprotein cholesterol(OR=0.881 2,95%CI=0.794 7-0.977 0,P=0.016),and apolipoprotein B(OR=0.919 0,95%CI=0.869 8-0.971 0,P=0.002)also showed negative correlations.Lastly,with respect to hip osteoarthritis,total cholesterol(OR=0.864 5,95%CI=0.797 5-0.937 3,P=0.000 4),low-density lipoprotein cholesterol(OR=0.925 6,95%CI=0.879 5-0.974 1,P=0.003),and apolipoprotein B(OR=0.888 8,95%CI=0.817 6-0.966 3,P=0.005)exhibited negative correlations.No statistically significant differences were found in the reverse Mendelian randomization analysis.(2)In the multivariable Mendelian randomization analysis,the results from inverse variance weighting indicated a negative correlation between high-density lipoprotein cholesterol and osteoarthritis(OR=0.942 7,95%CI=0.896 1-0.991 8,P=0.022).Additionally,total cholesterol(OR=0.799 8,95%CI=0.647 8-0.987 6,P=0.037)and high-density lipoprotein cholesterol(OR=0.865 1,95%CI=0.7781-0.961 9,P=0.007)were also negatively associated with knee osteoarthritis.(3)Colocalization analysis revealed that total cholesterol and low-density lipoprotein were significantly associated with osteoarthritis at single nucleotide polymorphisms rs13107325(H4 posterior probability=99.9%).(4)These findings,using international databases and non-Asian populations,provide valuable insights for early clinical diagnosis,understanding the pathogenesis,and researching prevention and treatment of osteoarthritis in Chinese biomedicine and the Chinese population.

Objective:To compare percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction in the treatment of radial neck fractures in children.Methods:A retrospective study was conducted to analyze the 96 children with radial neck fracture who had been admitted to Department of Orthopedics, Children's Hospital of Anhui Province from January 2020 to January 2023. They were 51 boys and 45 girls with an age of (7.0±2.5) years. By the Judet classification, there were 74 cases of type Ⅲ and 22 cases of type IV. Twenty-one cases were treated with percutaneous Kirschner wiring after ultrasound-guided reduction (Kirschner wire group) while 75 cases with elastic intramedullary nailing after ultrasound-guided reduction (intramedullary nail group). The surgical time, fluoroscopy frequency, fracture healing time, and incidence of complications were compared between the 2 groups. Their postoperative X-ray films were evaluated according to the Métaizeau criteria, and elbow joint function was evaluated according to the Steel and Gtrham scoring at the last follow-up.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The 96 pediatric patients were followed up for (10.6±4.2) months after surgery. The surgical time [(18.5±2.6) minutes] and fluoroscopy frequency [4.0 (3.0, 4.0) times] in the Kirschner wire group were significantly less than those in the intramedullary nail group [(30.9±2.7) minutes, 8.0 (7.0, 9.0) times] ( P<0.05). There was no statistically significant difference in fracture healing time, good and excellent rate of postoperative reduction by the Métaizeau criteria, good and excellent rate of elbow joint function by the Steel and Gtrham scoring at the last follow-up, or incidence of complications ( P>0.05). Conclusion:In the treatment of radial neck fractures in children, both ultrasound-guided percutaneous Kirschner wiring and elastic intramedullary nailing after ultrasound-guided reduction can lead to similar therapeutic effects, but the former can shorten surgical time, reduce intraoperative fluoroscopy frequency, and spare a secondary surgery.

Objective To investigate the current status of knowledge-attitude-practice of cardiac rehabilitation in patients undergoing coronary artery bypass grafting(CABG) and analyze its influencing factors. Methods From July to November 2022, 288 patients with CABG in the coronary heart disease surgery center of Beijing Anzhen Hospital Affiliated to Capital Medical University were conveniently included, and general information questionnaire and cardiac rehabilitation knowledge and practice questionnaire were used to investigate the general situation and the level of knowledge-attitude-practice of cardiac rehabilitation in patients with coronary heart disease. Results A total of 290 questionnaires were sent out in this study, and 288 were effectively collected, with an effective recovery rate of 99.31%. The total score of the questionnaire was (106.81±13.35), and the total score rate was 62.83%, including the knowledge questionnaire scoring (39.34±9.13), belief questionnaire scoring (32.86±3.39) and behavior questionnaire scoring (34.61±3.54). The scoring rates of knowledge, attitude and practice questionnaire were 46.28%, 82.15% and 76.91%, respectively. Multiple linearregression analysis showed that patients who lived in rural areas, had education background of primary school or below, were farmers, had public health insurance, and had no previous coronary intervention, had lower levels of knowledge-attitude-practice of cardiac rehabilitation (P < 0.05). Conclusion The knowledge-attitude-practice of cardiac rehabilitation, especially the level of knowledge, in patients with CABG is needed to be improved. The factors that affect the level of knowledge-attitude-practice of cardiac rehabilitation in this population are diversified, suggesting that individual cardiac rehabilitation guidance should be implemented according to different people and local conditions, and diversified cardiac rehabilitation models should be established to improve the long-term and compliance of cardiac rehabilitation.

Objective:To investigate the clinical phenotype and prognosis among different genotypes of progressive familial intrahepatic cholestasis(PFIC) by cases analysis.Methods:The PFIC cases diagnosed at Beijing Children′s Hospital from 2015 to 2022 were collected, and the clinical phenotypic characteristics, treatment and prognosis were compared and analyzed.Results:A total of 628 cases of cholestatic liver disease were diagnosed, and 26 cases of PFIC were found, accounting for 4.1%.The number of PFIC 2 were the most, 14(53.8%)cases; three(11.5%) cases were PFIC 1; five(19.2%)cases were PFIC 3; while two(7.7%) cases were PFIC 4 and PFIC 6, respectively, and there was no case of PFIC 5.Type 1, 2, 4, and 6 had early onset ages(2 days to 21 months), while type 3 had a wide range of onset ages(8 to 145 months). The symptoms included jaundice(96.2%), pruritus(42.3%), and mucosal bleeding(15.4%). All three cases of type 1 had extrahepatic manifestations of diarrhea and malnutrition.Two cases of type 3 were found to have end-stage liver disease.Cases of PFIC 3 had increased serum γ-glutamyltransferase(97.2-439.5 U/L), while those of other types were normal.The bile acids were all increased(10.1-599.6 μmol/L). Abdominal ultrasound mainly showed liver enlargement(80.8%)and enhanced echogenicity of liver parenchyma(73.1%), enlargement of the spleen(61.5%). Ultrasound liver elastography ranged from 6.3 kPa to 23.1 kPa, there were 21(80.8%) cases ≥9 kPa.Among 26 cases, one case was lost to follow-up, and 11 cases were effective by oral medication alone.Fourteen children were still suffering from relapse or progress after drug treatment: four cases received liver transplantation (three cases had a good prognosis and one case died), two cases received biliary drainage, six cases were still taking drugs orally, and two cases died without active intervention in disease progress.Conclusion:Type 2 is the most common type in PFIC.The onset of most cases is in infancy.Jaundice, pruritus and hepatosplenomegaly are common clinical manifestations, and extrahepatic manifestations can be seen in type 1 cases.Type 3 cases can start with end-stage liver disease.Bile acid of all cases are increased.Except for type 3, the serum γ-glutamyltransferase of cases are normal.Oral medication has certain effects on some cases, but more than half progress, and some need biliary diversion or liver transplantation.

Diabetic peripheral neuropathy （DPN） is one of the common complications of diabetes. The disease has a long course with nerve pain and other symptoms， seriously affecting the quality of life of patients. DPN is related to high glucose in vivo， inflammation， oxidative stress， apoptosis， and autophagy， involving phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， nuclear factor-κB （NF-κB）， mitogen-activated protein kinase （MAPK）， and other signaling pathways. At present， the treatment of DPN mainly focuses on symptomatic treatments such as blood glucose control and neurotrophic therapy， but the effect is not ideal. Therefore， it is particularly important to select a reasonable and effective drug to prevent and treat DPN. In recent years， Chinese medicine has played an important role in the treatment of DPN. Many studies have explored the mechanism of Chinese medicine in the treatment of DPN， and it has been found that some Chinese medicine monomers and compounds can regulate signaling pathways to prevent and treat DPN. This paper reviewed the research results of signaling pathways involved in DPN and the regulation of related pathways by Chinese medicine， aiming to provide references for the clinical treatment of DPN.

OBJECTIVE: To investigate the short-term effectiveness of ultrasound-guided closed reduction by Kirschner wire provocation technique in the treatment of Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents. METHODS: Between May 2019 and May 2022, 41 patients with Salter Harris types Ⅰ and Ⅱ distal tibial epiphyseal fractures were admitted, all of whom had periosteal entrapment on preoperative MRI, and 38 cases (92.7%) were confirmed to have periosteal entrapment by intraoperative ultrasound. There were 24 males and 14 females, the age ranged from 6.8 to 15.7 years, with an average of 10.7 years; and there were 20 cases of Salter Harris type Ⅰ and 18 cases of type Ⅱ. The time from injury to operation was 22-76 hours, with an average of 28.4 hours. The preoperative imaging examination showed excellent alignment in 4 cases, good in 20 cases, and poor in 14 cases. The ultrasound guided Kirschner wire provocation technique for closed reduction and percutaneous Kirschner wire internal fixation were performed. The operation time, intraoperative fluoroscopy frequency, fracture healing time, and complications were recorded. Anteroposterior and lateral X-ray films of the affected ankle joint were taken before operation, at 3 months after operation, and at last follow-up to observe the healing of the fracture, and anteroposterior X-ray films of the whole length of both lower limbs were taken to evaluate the alignment of the force lines of the affected limbs. The range of motion (ROM), visual analogue scale (VAS) score, and American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score were used to evaluate ankle function. The mechanical lateral distal tibia angle (mLDTA) and the anatomic anterior distal tibia angle (aADTA) were measured. RESULTS: The operation time ranged from 17 to 52 minutes, with an average of 22.6 minutes, and the intraoperative fluoroscopy frequency ranged from 3 to 11 times, with an average of 4.2 times. X-ray examination during operation and at 2 days after operation showed that anatomical reduction was achieved. All patients were followed up 10-24 months, with an average of 16.4 months. All fractures healed in 6.1-7.2 weeks, with an average of 6.3 weeks; no fracture displacement occurred, and the patients recovered to their pre-injury level of motion at 6 months after operation. Needle tail irritation occurred in 2 cases at 4 weeks after operation, and they recovered after symptomatic treatment. During the follow-up, there was no serious complication such as incision deep infection, bone nonunion, delayed union, and malunion. At last follow-up, the patients' alignment were all excellent, and the difference was significant when compared with preoperative one ( Z=-7.471, P<0.001). The VAS score, AOFAS ankle-hindfoot score, dorsiflexion-plantar flexion ROM, varus-valgus ROM, mLDTA, and aADTA significantly improved at 3 months after operation and last follow-up when compared with preoperative ones ( P<0.05). CONCLUSION Ultrasound-guided closed reduction by Kirschner wire provocation technique for treating Salter-Harris types Ⅰ and Ⅱ periosteal entrapment of distal tibial epiphyseal fractures in children and adolescents is minimally invasive and safe.
Male ; Female ; Child ; Humans ; Adolescent ; Tibia ; Bone Wires ; Treatment Outcome ; Fractures, Bone/surgery* ; Fracture Fixation, Internal/methods* ; Ultrasonography, Interventional ; Retrospective Studies ; Tibial Fractures/surgery*