Objective:To evaluate the detection rate, anatomical distribution, and influencing factors of bone marrow edema-like signal (BMELS) in the knees of amateur marathon runners.Methods:This was a cross-sectional study. This study publicly recruited amateur marathon runners through the Hangzhou Long-distance Running Association from January 2019 to December 2024. Based on knee magnetic resonance imaging (MRI) results, participants were divided into a BMELS-positive group (BMELS present in at least one knee) and a BMELS-negative group. General clinical information was collected from participants using a questionnaire. All participants underwent a knee MRI scan to screen for the presence of BMELS and to assess its severity. Logistic regression models were used to analyze the associated factors of BMELS in amateur marathon runners, while Spearman′s correlation analysis assessed the correlation between BMELS grade and these factors.Results:A total of 60 subjects (120 knee joints) were enrolled, including 39 males (65%), aged (40.0±8.4) years. Of these, 39 were in the BMELS-positive group, and 21 were in the BMELS-negative group. The BMELS detection rate for the 120 knee joints of these 60 subjects was 53.3% (64/120). BMELS were detected in 43.3%(52/120) of the femur, 34.2% (41/120) of tibia and 17.5% (21/120) of patella. Multivariate logistic regression analysis showed an independent positive correlation between monthly running volume and knee BMELS in amateur marathon runners ( OR=1.007, 95% CI: 1.000-1.013, P=0.035). Spearman′s correlation analysis showed a weak positive correlation between the BMELS grade of the knees and the monthly running volume of amateur marathon runners ( r s=0.360, P=0.005). Conclusions:The detection rate of knee BMELS is high in amateur marathon runners, and they are distributed in a way that is characteristic of the region, with a higher incidence in the medial femoral condyle. In this population, monthly running volume is independently associated with knee BMELS, with a higher grade associated with greater monthly running volume.

Objective Responding to the imperative to modernize vocational education and establish competency-oriented systems,this study investigates the development of on-campus training bases for speech and hearing rehabilitation(SHR)programs within Chinese higher vocational colleges(HVC).It analyzes their functional role and essential compo-nents,and propose a competency-oriented,modular framework for on-campus training based on World Health Organization(WHO)rehabilitation competency framework(RCF),and professional education standards.Methods This research synthesized theories of higher vocational education and practical pedagogy(e.g.,situated learn-ing,experiential learning and constructivism)with analyses of domestic and international SHR educational poli-cies and standards.It examined the strategic importance and essential components(hardware,software,human re-sources,management)of on-campus training bases in the context of higher vocational education.Synthesizing RCF with standards from ASHA(knowledge and skills acquisition,KASA),International Association of Logope-dics and Phoniatrics(IALP),and Teaching Standards for Higher Vocational Schools from Ministry of Education of the People's Republic of China,a core SHR professional competency model tailored for HVC was developed.This model subsequently guided the design of a modular on-campus training curriculum and associated pedagogi-cal approaches.Results On-campus training bases were pivotal platforms that bridge theory and practice,facilitating'teaching-learning-doing'integration within HVC SHR programs.Effective base construction necessitated synergistic integration across four key domains:hardware facilities(meeting specialized acoustic/equipment needs),software resources(case libraries,standard operating procedure and digital tools),'dual-role'human resources and robust manage-ment systems(operations,evaluation,industry-education linkages).Derived from RCF and related standards,a core SHR competency framework was developed,encompassing dimensions such as foundational knowledge and ethics,assessment(audiological;speech-language),intervention(audiological rehabilitation and technology;speech-language),and communication and collaboration.Consequently,eight core training modules were de-signed,including basic operations of hearing testing,introduction to objective hearing testing,preliminary hear-ing aid fitting,application of standardized speech-language assessment tools,simulation of articulation and voice disorder assessment and intervention,simulation of swallowing disorder screening and basic training,comprehen-sive case analysis and rehabilitation plan development,and practice of professional literacy and communication skills;detailing objectives,activities,and resources,and intended for seamless integration with theoretical cours-es and off-campus practicum,establishing a cohesive'curriculum-training-practicum'continuum.Furthermore,a suite of adaptable pedagogical models,including problem-based learning,case-based learning,simulation-based training,project-based learning and the flipped classroom,were recommended for implementing these modules.Conclusion The effective development of on-campus training bases for SHR programs in HVC necessitates establishing a systematic,competency-oriented practical teaching environment.Grounded in RCF,and essential SHR knowl-edge,skills and abilities,this study proposes a framework incorporating eight core training modules and comple-mentary pedagogical models,providing a theoretically grounded,practically applicable blueprint for enhancing the educational quality and substance of these bases within HVC.Successful realization hinges upon the synergis-tic development of the four key elements(hardware,software,human resources,management),deep integration between training activities,the curriculum,and practicum experiences,and the application of innovative pedago-gy to cultivate student potential.

Objective Responding to the imperative to modernize vocational education and establish competency-oriented systems,this study investigates the development of on-campus training bases for speech and hearing rehabilitation(SHR)programs within Chinese higher vocational colleges(HVC).It analyzes their functional role and essential compo-nents,and propose a competency-oriented,modular framework for on-campus training based on World Health Organization(WHO)rehabilitation competency framework(RCF),and professional education standards.Methods This research synthesized theories of higher vocational education and practical pedagogy(e.g.,situated learn-ing,experiential learning and constructivism)with analyses of domestic and international SHR educational poli-cies and standards.It examined the strategic importance and essential components(hardware,software,human re-sources,management)of on-campus training bases in the context of higher vocational education.Synthesizing RCF with standards from ASHA(knowledge and skills acquisition,KASA),International Association of Logope-dics and Phoniatrics(IALP),and Teaching Standards for Higher Vocational Schools from Ministry of Education of the People's Republic of China,a core SHR professional competency model tailored for HVC was developed.This model subsequently guided the design of a modular on-campus training curriculum and associated pedagogi-cal approaches.Results On-campus training bases were pivotal platforms that bridge theory and practice,facilitating'teaching-learning-doing'integration within HVC SHR programs.Effective base construction necessitated synergistic integration across four key domains:hardware facilities(meeting specialized acoustic/equipment needs),software resources(case libraries,standard operating procedure and digital tools),'dual-role'human resources and robust manage-ment systems(operations,evaluation,industry-education linkages).Derived from RCF and related standards,a core SHR competency framework was developed,encompassing dimensions such as foundational knowledge and ethics,assessment(audiological;speech-language),intervention(audiological rehabilitation and technology;speech-language),and communication and collaboration.Consequently,eight core training modules were de-signed,including basic operations of hearing testing,introduction to objective hearing testing,preliminary hear-ing aid fitting,application of standardized speech-language assessment tools,simulation of articulation and voice disorder assessment and intervention,simulation of swallowing disorder screening and basic training,comprehen-sive case analysis and rehabilitation plan development,and practice of professional literacy and communication skills;detailing objectives,activities,and resources,and intended for seamless integration with theoretical cours-es and off-campus practicum,establishing a cohesive'curriculum-training-practicum'continuum.Furthermore,a suite of adaptable pedagogical models,including problem-based learning,case-based learning,simulation-based training,project-based learning and the flipped classroom,were recommended for implementing these modules.Conclusion The effective development of on-campus training bases for SHR programs in HVC necessitates establishing a systematic,competency-oriented practical teaching environment.Grounded in RCF,and essential SHR knowl-edge,skills and abilities,this study proposes a framework incorporating eight core training modules and comple-mentary pedagogical models,providing a theoretically grounded,practically applicable blueprint for enhancing the educational quality and substance of these bases within HVC.Successful realization hinges upon the synergis-tic development of the four key elements(hardware,software,human resources,management),deep integration between training activities,the curriculum,and practicum experiences,and the application of innovative pedago-gy to cultivate student potential.

Objective:To evaluate the detection rate, anatomical distribution, and influencing factors of bone marrow edema-like signal (BMELS) in the knees of amateur marathon runners.Methods:This was a cross-sectional study. This study publicly recruited amateur marathon runners through the Hangzhou Long-distance Running Association from January 2019 to December 2024. Based on knee magnetic resonance imaging (MRI) results, participants were divided into a BMELS-positive group (BMELS present in at least one knee) and a BMELS-negative group. General clinical information was collected from participants using a questionnaire. All participants underwent a knee MRI scan to screen for the presence of BMELS and to assess its severity. Logistic regression models were used to analyze the associated factors of BMELS in amateur marathon runners, while Spearman′s correlation analysis assessed the correlation between BMELS grade and these factors.Results:A total of 60 subjects (120 knee joints) were enrolled, including 39 males (65%), aged (40.0±8.4) years. Of these, 39 were in the BMELS-positive group, and 21 were in the BMELS-negative group. The BMELS detection rate for the 120 knee joints of these 60 subjects was 53.3% (64/120). BMELS were detected in 43.3%(52/120) of the femur, 34.2% (41/120) of tibia and 17.5% (21/120) of patella. Multivariate logistic regression analysis showed an independent positive correlation between monthly running volume and knee BMELS in amateur marathon runners ( OR=1.007, 95% CI: 1.000-1.013, P=0.035). Spearman′s correlation analysis showed a weak positive correlation between the BMELS grade of the knees and the monthly running volume of amateur marathon runners ( r s=0.360, P=0.005). Conclusions:The detection rate of knee BMELS is high in amateur marathon runners, and they are distributed in a way that is characteristic of the region, with a higher incidence in the medial femoral condyle. In this population, monthly running volume is independently associated with knee BMELS, with a higher grade associated with greater monthly running volume.

Objective To explore the construction of a core competency framework and content for higher vocational speech-lan-guage-hearing rehabilitation technology programs based on World Health Organization rehabilitation competency framework(RCF). Methods Utilizing RCF and integrating the educational objectives for higher vocational speech-language-hearing reha-bilitation programs outlined by the Ministry of Education in 2022,as well as the technical documents from the In-ternational Association of Logopedics and Phoniatrics and the American Speech-Language-Hearing Association,this study analyzed the professional activities in speech-language-hearing rehabilitation technology to construct a competency framework based on RCF and give details in the specific content of each domain. Results The competency for speech-language-hearing rehabilitation technology encompassed seven domains:core val-ues,beliefs,practice,professionalism,learning and development,management and leadership,and research.Each domain was subdivided into specific competency elements and professional activities. Conclusion Establishing a higher vocational education system for speech-language-hearing rehabilitation technology based on RCF will help to set educational objectives,and construct curriculum systems,so that to cultivate practi-tioner who meet social needs and possess comprehensive professional skills and competencies.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective:To evaluate the acute effects of different foot-strike patterns of running on knee cartilage in amateur marathon runners using the T 2* mapping technique. Methods:From November 2021 to February 2022, 29 amateur marathon runners were recruited in Hangzhou. The gait analysis was performed to determine their landing patterns, then the runners were divided into the fore-foot strike (FFS) group (11 cases) and the rear-foot strike (RFS) group (18 cases). The MRI of the knee joint of the dominant leg was performed before and 30 min after running, and the volume, thickness, and T 2* value of each division of knee cartilage were measured. Independent samples t-tests were used to compare the differences in baseline data before running between the groups, and paired samples t-tests were used to compare the differences before and after running within the groups. Results:The difference in knee cartilage volume and thickness between the FFS and RFS groups before running was not statistically significant ( P>0.05), and the T 2* value of the femur medial posterior in the RFS group was higher than that of the FFS group ( t=-2.47, P=0.020). Compared with pre-running, cartilage thickness of the tibia lateral posterior decreased in the FFS group after running ( t=-2.96, P=0.016), and cartilage thickness of the tibia lateral posterior and patella lateral central decreased in the RFS group ( t=-3.25, -3.02, P=0.004, 0.007). Cartilage volume of the tibia lateral posterior decreased in the FFS group after running ( t=-2.58, P=0.030), and the cartilage volume of the patella lateral central decreased in the RFS group ( t=-2.74, P=0.013). The differences in T 2* values of cartilage in each region before and after running were not statistically significant in the FFS group ( P>0.05), whereas in the RFS group, the cartilage T 2* values in the femur medial posterior, femoral trochanter central, femoral trochanter lateral, femur lateral central, tibia lateral anterior, tibia medial posterior, tibia medial central, and tibia medial anterior decreased ( P<0.05). Conclusions:After running, FFS showed changes in morphology and biochemical composition only in some subregions of tibial cartilage, whereas most of the femoral cartilage, patellar cartilage, and tibial cartilage regions were altered by RFS. The RFS pattern introduces greater acute changes in cartilage in the knee joint.

Objective:To investigate the effects of circular RNA (circRNA) BICD2 (circ-BICD2) on glutamine metabolism, cell proliferation, migration, invasion and apoptosis of oral squamous cell carcinoma (OSCC) cells and to further explore the possible mechanism.Methods:OSCC cells were purchased from Shanghai Institute of Cellular Cells, Chinese Academy of Sciences. Samples of OSCC tissues and corresponding adjacent tissues were collected from 35 OSCC patients who underwent surgical resection at the First Affiliated Hospital of Zhengzhou University from January 2016 to January 2018. Real-time quantitative PCR (RT-qPCR) and western blot were performed to detect the expression levels of circ-BICD2, miR-296-5p and transgelin2 (TAGLN2) in OSCC tissues and cells. Bioinformatics, dual luciferase report experiment and RNA immunoprecipitation (RIP) experiment were used to determine the targeting relationship between circ-BICD2 and miR-296-5p, miR-296-5p and TAGLN2. According to different transfection oligonucleotides or plasmids, CAL27 and SCC9 cells were divided into si-NC group (transfection si-NC), si-circ-BICD2 group (transfection si-circ-BICD2), si-circ-BICD2+anti-miR-NC group (transfected with si-circ-BICD2 and anti-miR-NC), si-circ-BICD2+anti-miR-296-5p group (transfected with si-circ-BICD2 and anti-miR-296-5p), miR-NC group (transfected with miR-NC), miR-296-5p group (transfected with miR-296-5p mimic), miR-296-5p+pcDNA (transfected with miR-296-5p mimic and pcDNA) and miR-296-5p+TAGLN2 group (transfected with miR-296-5p mimic and pcDNA-TAGLN2). Cell counting kit 8(CCK-8), colony formation experiment, flow cytometry, Scratch healing test and Transwell experiment were applied to detect OSCC cell viability, number of colonies, cycle distribution, apoptosis rate, migration rate and invasive cell numbers. Glutamine (gln) consumption, α-ketoglutaric acid (α-KG) production and adenosine triphosphate (ATP) concentration were also detected by the kit. The expression of cyclinD1 and Glutamine hydrolase (GLS1) proteins of CAL27 and SCC9 cells in each of the groups were detected by western blot. Twelve four-week-old clean BALB/c female nude mice were injected with a single-cell suspension of SCC9 cells into the axillary skin to establish a transplanted tumor model. Twelve transplanted tumor model mice were divided into sh-circ-BICD2 group and sh-NC group. Mice were sacrificed by cervical dislocation at 32 days after injection, the tumors were removed and the tumor weight was tested.Results:The expressions of circ-BICD2 (2.54±0.74) and TAGLN2 (1.86±0.15) were increased ( P<0.05), while the expression of MiR-296-5p was decreased in OSCC tissues ( P<0.05). Cell viability, clone formation numbers, migration rate, invasive cell numbers, S phase cell ratio, glu consumption, α-KG production, ATP concentration, expression of cyclinD1 and GLS1 proteins of OSCC cells were significantly reduced after interference with circ-BICD2 expression. The apoptosis rate, the proportion of cells in G0-G1 phase and the expression of miR-296-5p were significantly increased ( P<0.05). Inhibiting the expression of miR-296-5p coulld reverse the effect of interfering with circ-BICD2 on OSCC cell proliferation, migration, invasion, apoptosis and glutamine metabolism ( P<0.05). After overexpression of miR-296-5p, cell viability, clone formation red number, migration rate, number of invasive cells, S phase cell ratio, glu consumption, α-KG production, ATP concentration and expressions of cyclinD1, GLS1 and TAGLN2 proteins in OSCC cells were significant decrease. The rate of apoptosis and the proportion of cells in G0-G1 phase were significantly increased ( P<0.05). Compared with overexpression of miR-296-5p, cell viability, clone formation red number, migration rate, number of invasive cells, S phase cell ratio, glu consumption, α-KG production, ATP concentration, cyclinD1, GLS1 and TAGLN2 proteins in OSCC cells after overexpression of miR-296-5p and TAGLN2 were significantly increased, and the apoptosis rate and the proportion of cells in the G0-G1 phase were significantly decreased ( P<0.05). Compared with the sh-NC group, the tumor weights of mice in the sh-circ-BICD2 group were significantly reduced ( P<0.05). Conclusions:Circ-BICD2 was highly expressed in OSCC cells. Interfering with circ-BICD2 could inhibit the proliferation, migration and invasion of OSCC cells, glutamine metabolism and tumor growth and promote cell apoptosis, which might be relate to the regulation of miR-296-5p/TAGLN2 molecular axis.

Objective To test the differences in diffusion properties?namely fractional anisotropy (FA) and apparent diffusion coefficient(ADC)?between amateur marathon runners and healthy volunteers′thigh muscles using diffusion tensor imaging (DTI) at rest. Methods Thirty amateur marathon runners(Group A) and 20 healthy volunteers (Group B) were recruited. All were males and their age was between 28 to 53 years. All subjects underwent both thigh DTI examination. DTI parameters FA and ADC were evaluated in thigh muscles(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, adductor longus, adductor magnus, biceps femoris long head, semitendinosus and semimembranosus)in all subjects. We tested the differences in diffusion properties between GroupA and B using independent sample t test. Results The average FA value of the thigh muscles measured in Group A was (0.24 ± 0.03), which was significantly lower than that in Group B=(0.27±0.03)(t=5.164,P<0.01). The average ADC value of the thigh muscles measured in Group A was (1.74±0.10)×10?3mm2/s, which was significantly higher than that in Group B=(1.70±0.09)×10?3mm2/s (t=2.060,P<0.05). The FA value of Group A was lower than that of Group B in the rectus femoris, vastus lateralis, vastus medialis, biceps femoris long head, semitendinosus and semimembranosus (P<0.05). The ADC value of Group A was higher than that of Group B in the vastus intermedius, vastus medialis and biceps femoris long head(P<0.05). Conclusions In the absence of positive findings from conventional MRI, DTI technique can non?invasively assess the subtle changes in the bilateral thigh muscles of amateur marathon runners at rest in the early stage of microscopic molecular level, providing important imaging evidence for early changes in skeletal muscle caused by marathon.

Objective: To test the differences in diffusion properties-namely fractional anisotropy (FA) and apparent diffusion coefficient(ADC)-between amateur marathon runners and healthy volunteers′ thigh muscles using diffusion tensor imaging (DTI) at rest. Methods: Thirty amateur marathon runners(Group A) and 20 healthy volunteers (Group B) were recruited. All were males and their age was between 28 to 53 years. All subjects underwent both thigh DTI examination. DTI parameters FA and ADC were evaluated in thigh muscles(rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, adductor longus, adductor magnus, biceps femoris long head, semitendinosus and semimembranosus)in all subjects. We tested the differences in diffusion properties between GroupA and B using independent sample t test. Results: The average FA value of the thigh muscles measured in Group A was (0.24±0.03), which was significantly lower than that in Group B=(0.27±0.03)(t=5.164,P<0.01). The average ADC value of the thigh muscles measured in Group A was (1.74±0.10)×10^-3mm²/s, which was significantly higher than that in Group B=(1.70±0.09)×10^-3mm²/s (t=2.060,P<0.05). The FA value of Group A was lower than that of Group B in the rectus femoris, vastus lateralis, vastus medialis, biceps femoris long head, semitendinosus and semimembranosus (P<0.05). The ADC value of Group A was higher than that of Group B in the vastus intermedius, vastus medialis and biceps femoris long head (P<0.05). Conclusions In the absence of positive findings from conventional MRI, DTI technique can non-invasively assess the subtle changes in the bilateral thigh muscles of amateur marathon runners at rest in the early stage of microscopic molecular level, providing important imaging evidence for early changes in skeletal muscle caused by marathon.