ObjectiveTo evaluate the efficacy and safety of Janus kinase （JAK） inhibitors combined with Chinese herbal medicine （CHM） in treating rheumatoid arthritis （RA）. MethodsClinical data from 169 RA patients were retrospectively collected. Among them， 71 cases received JAK inhibitors as the control group， while 98 cases received JAK inhibitors plus CHM as the observation group， both treated for 24 weeks. The rheumatoid factor （RF）， cyclic citic peptide antibody （anti-CCP）， erythrocyte sedimentation rate （ESR）， C-reactive protein （CRP）， and white blood cell count （WBC） were recorded before and after treatment. Databases including CNKI， Wanfang， VIP， PubMed and Web of Science were searched from inception till August 31st， 2025 for randomized controlled trials （RCTs） on the combined use of JAK inhibitors and CHM for RA. The methodological quality of the included studies was evaluated using the risk of bias assessment tool. Meta-analyses were performed for RF， anti-CCP， ESR， CRP， 28-joint disease activity score （DAS28）， overall clinical effective rate， and incidence of adverse events. Sensitivity analysis were also performed. ResultsThe retrospective study demonstrated that after treatment， ESR， CRP， and anti-CCP levels decreased in the observation group， while ESR and CRP levels decreased in the control group （P＜0.05）. Moreover， ESR and RF levels in the observation group were lower than those in the control group （P＜0.05）. A total of 9 RCTs involving 770 patients were included in the meta-analysis. The results indicated that the JAK inhibitors plus CHM group was superior to the JAK inhibitors group in reducing RF （MD=-8.97， 95%CI -15.01 to -2.94， P=0.004）， CRP （MD=-3.34， 95%CI -3.82 to -2.86， P＜0.001）， ESR （MD=-5.33， 95%CI -7.98 to -2.69， P＜0.001）， and DAS28 score （MD=-0.54， 95%CI -0.74 to -0.34， P＜0.001）， as well as in improving the overall clinical effective rate （OR=4.53， 95%CI 2.55 to 8.03， P＜0.001）. No statistically significant differences were observed between groups in anti-CCP levels （SMD=-2.08， 95%CI -4.41 to 0.24， P=0.080） or incidence of adverse events （OR=0.93， 95%CI 0.55 to 1.57， P=0.790）. ConclusionThe combination of JAK inhibitors and CHM demonstrates remarkable efficacy in treating RA， contributing to improved disease activity and reduced inflammatory markers with a favorable safety profile.

Objective To investigate the prevalence of thyroid nodules in the physical examination population in Mianyang region and analyze its association with metabolic syndrome. Methods A retrospective study was conducted on 9 978 individuals who underwent health examinations at our hospital from January 2024 to May 2025. Thyroid examinations were performed using color Doppler ultrasound to analyze the prevalence of thyroid nodules in this population. Clinical data of all subjects were collected, and logistic regression analysis was employed to assess the association between metabolic syndrome and the risk of thyroid nodule development. Results The prevalence of thyroid nodules in the physical examination population of Mianyang region was 17.98% (1 794/9 978). The logistic regression results showed that after adjusting for gender, age, BMI, occupation, consumption of non-iodized salt, staying up late, daily sleep duration, anxiety, and depression, metabolic syndrome (OR=6.593, 95% CI: 3.961-10.975) was associated with thyroid nodules (P<0.05). Conclusion The prevalence of thyroid nodules among the physical examination population in the Mianyang area is 17.98%, and metabolic syndrome remains associated with the risk of thyroid nodules after effectively controlling for confounding factors.

ObjectiveTo explore the expression levels of long non-coding RNA （lncRNA） H19 and microRNA-22-3p （miR-22-3p） in the serum of patients with acute myocardial infarction （AMI） and their diagnostic value for AMI. MethodsA total of 176 AMI patients were selected as the experimental group and were divided into ST-segment elevation myocardial infarction （STEMI） group （n=95） and non-ST-segment elevation myocardial infarction （NSTEMI） group （n=81） based on their medical history and electrocardiogram. Meanwhile， 156 patients with negative angiography during the same period were selected as the control group （CON group）. The relative expression levels of lncRNA H19 and miR-22-3p in the serum of the two groups were detected by real-time fluorescence quantitative polymerase chain reaction. The diagnostic value of miR-22-3p and lncRNA H19 in AMI was evaluated by receiver operating characteristic curve （ROC） analysis. The levels of serum cardiac troponin I （cTnI）， creatine kinase （CK）， creatine kinase MB isoenzyme （CK-MB）， and high-sensitivity C-reactive protein （CRP） were detected in all study subjects. Spearman correlation analyses were used to evaluate the correlations between lncRNA H19 and miR-22-3p and cTnI， CK， CK-MB and CRP. ResultsCompared with the control group， the expression level of lncRNA H19 was upregulated and the expression level of miR-22-3p was downregulated in the AMI group （all P<0.01）； compared with the NSTEMI group， the expression level of lncRNA H19 was upregulated and the expression level of miR-22-3p was downregulated in the STEMI group （P<0.01）. The areas under the ROC curves （AUC） for the diagnosis of AMI by miR-22-3p， lncRNA H19 and their combination were 0.555， 0.977， and 0.983， respectively. lncRNA H19 was positively correlated with cTnI， CK， CK-MB and CRP （P<0.05）， and negatively correlated with left ventricular ejection fraction （LVEF） （P<0.001）； miR-22-3p was negatively correlated with cTnI， CK and CRP， and positively correlated with LVEF （P<0.05）. ConclusionThe expression level of lncRNA H19 is elevated and the expression level of miR-22-3p decreased in AMI patients， and their levels may have potential value as an auxiliary biomarker for AMI diagnosis and cardiac function assessment.

OBJECTIVE: To compare the effectiveness of arthroscopic outside-in release for gluteal muscle contracture (GMC) in supine position versus lateral decubitus position. METHODS: The clinical data of 34 GMC patients meeting selection criteria between January 2022 and May 2023 were retrospectively analyzed. Arthroscopic contracture band release was performed in the lateral decubitus position (lateral group, n=14) or the supine position (supine group, n=20). No significant difference ( P>0.05) was observed between groups in baseline data, including gender, age, body mass index, preoperative GMC functional quantitative score, modified Harris hip score (mHHS), visual analogue scale (VAS) pain score, and hip flexion/adduction range of motion (ROM). The total operation time, release procedure time, non-release procedure time, intraoperative blood loss, hospital stay, and postoperative complications were recorded and compared. Functional outcomes (GMC functional quantitative score, mHHS score, VAS score, hip flexion/adduction ROM) were evaluated preoperatively and at 3, 12, and 24 months postoperatively. RESULTS: All incisions healed by first intention without major vascular or neurological complications. In the lateral group, 3 patients developed patchy bruising on bilateral buttocks and posterior thighs at 3 days after operation, which resolved after 2 weeks of ice packs and ultrasonic therapy. The supine group demonstrated significantly shorter total operation time, non-release procedure time, hospital stay, and reduced intraoperative blood loss versus the lateral group ( P<0.05). No significant difference was found in release procedure time ( P>0.05). All patients were followed up 24 months. Both groups showed significant improvements ( P<0.05) in mHHS score, GMC functional quantitative score, VAS score, and hip adduction/flexion ROM at all postoperative timepoints compared to preoperative values, with no significant intergroup differences ( P>0.05). CONCLUSION Both surgical positions effectively improve hip function in GMC patients. However, the supine position offers significant advantages over the lateral decubitus position in operation time, anesthesia management, intraoperative blood loss control, and reduced hospital stay.
Humans ; Male ; Female ; Arthroscopy/methods* ; Retrospective Studies ; Buttocks/surgery* ; Adult ; Range of Motion, Articular ; Supine Position ; Treatment Outcome ; Middle Aged ; Contracture/surgery* ; Muscle, Skeletal/surgery* ; Young Adult ; Operative Time ; Hip Contracture/surgery* ; Patient Positioning/methods*

OBJECTIVE: To conduct a comprehensive analysis of proximal humeral anatomical characteristics in the Chinese population utilizing three-dimensional reconstruction technology, thereby establishing an evidence base for the enhancement of shoulder hemiarthroplasty procedures and the development of domestically manufactured prostheses. METHODS: The study cohort comprised 30 patients (60 shoulders) presenting with cervicoscapular pain between July 2023 and June 2025, with equal gender distribution (15 males and 15 females); age distribution ranged from 20 to 75 years (mean, 53.7 years). Data acquisition was performed via high-resolution CT imaging (technical parameters: slice thickness 0.625 mm, voltage 120 kV, current 150 mA, matrix 512×512). Subsequently, CT datasets were processed in DICOM format using Mimics17.0 software for three-dimensional reconstruction, followed by quantitative assessment via Imageware12.0 software to evaluate key proximal humeral parameters: humeral head dimensions (coronal diameter, sagittal diameter, surface curvature diameter, thickness), angular measurements [neck-shaft angle, retroversion angle (retroversion angle 1 was the angle between the humeral head axis and the line connecting the medial and lateral condyles, and retroversion angle 2 was the angle between the humeral head axis and the tangent of the trochlea)], and positional metrics (medial offset, posterior offset). Statistical analysis incorporated Pearson correlation coefficients to determine parameter relationships, with comparative evaluations conducted across demographic variables including gender, height, body mass, and age. RESULTS: Quantitative analysis yielded the following measurements: humeral head coronal diameter (41.8±3.6) mm, sagittal diameter (39.1±4.1) mm, surface curvature diameter (44.9±4.6) mm, thickness (17.2±1.8) mm, neck-shaft angle (128.4±4.2)°, retroversion angle 1 (16.9±8.9)°, retroversion angle 2 (21.4±11.3)°, medial offset (3.8±1.7) mm, and posterior offset (5.1±1.6) mm. Correlation analysis demonstrated the most pronounced positive relationship between humeral head surface curvature diameter and thickness ( r=0.966, P=0.001), with additional significant positive correlations observed between surface curvature diameter and coronal diameter ( r=0.842, P=0.001), posterior offset and retroversion angle 1 ( r=0.766, P=0.001), and coronal diameter and thickness ( r=0.727, P=0.001). Demographic analysis revealed significantly greater dimensions in males compared to females for humeral head surface curvature diameter, coronal diameter, sagittal diameter, and thickness ( P<0.05), with these parameters demonstrating progressive increases corresponding to height ( P<0.05). With the exception of neck-shaft angle, all parameters exhibited a positive correlation with body mass. No significant age-related differences were detected across parameters ( P>0.05). CONCLUSION The proximal humeral morphology in the Chinese population exhibits substantial variability, necessitating optimization of prosthetic designs based on population-specific anatomical metrics to enhance the efficacy of personalized clinical interventions.
Humans ; Middle Aged ; Male ; Female ; Aged ; Imaging, Three-Dimensional/methods* ; Adult ; Tomography, X-Ray Computed/methods* ; Humerus/diagnostic imaging* ; Shoulder Joint/surgery* ; Hemiarthroplasty/methods* ; Humeral Head/anatomy & histology* ; Young Adult ; Clinical Relevance

OBJECTIVE: To summarize the research progress on knee laxity of biomechanics and prevention and treatment after posterior cruciate ligament (PCL) reconstruction. METHODS: The domestic and international literature on the prevention and treatment of knee laxity after PCL reconstruction in recent years was extensively reviewed and analyzed. RESULTS: Different degrees of knee laxity often occur after PCL reconstruction, which can lead to poor prognosis in patients. The causes are associated with a variety of factors, including abnormal graft remodeling (such as differences in healing time and biomechanics among different types of grafts), tunnel position deviation (such as graft wear caused by the "killer turn" effect), and mechanical factors in postoperative rehabilitation (such as improper early weight-bearing and range of motion). These factors may promote graft elongation, increase early posterior tibial translation, and thereby induce knee laxity. CONCLUSION While PCL reconstruction improves knee stability, it is crucial to focus on and prevent postoperative knee laxity. However, current surgical methods are limited by factors such as graft characteristics, surgical technique flaws, and rehabilitation protocols, and thus can not fully correct the issue of abnormal postoperative laxity. Surgical techniques and treatment strategies still need further improvement and optimization to enhance patients' postoperative outcomes and quality of life.
Humans ; Joint Instability/surgery* ; Posterior Cruciate Ligament Reconstruction/adverse effects* ; Posterior Cruciate Ligament/surgery* ; Knee Joint/physiopathology* ; Biomechanical Phenomena ; Range of Motion, Articular ; Postoperative Complications/prevention & control* ; Knee Injuries/surgery*

OBJECTIVE: To investigate the effectiveness of hip arthroscopy in the treatment of patients with femoroacetabular impingement (FAI) syndrome combined with ligamentum teres injury. METHODS: A retrospective analysis was conducted on 23 patients (23 hips) with Cam-type FAI syndrome combined with ligamentum teres injury who met the selection criteria between April 2022 and May 2024. The cohort included 12 males and 11 females, with a mean age of 29.16 years (range, 16-57 years). According to Tönnis classification, there were 5 cases of grade 0, 10 cases of grade Ⅰ, and 8 cases of grade Ⅱ in hip osteoarthritis. The disease duration ranged from 6 to 24 months, with an average of 12 months. Under hip arthroscopy, hypertrophic synovium and the damaged ligamentum teres were debrided, while the torn labrum and cartilage were repaired, and femoral head-neck osteoplasty was performed to eliminate impingement, restore the normal morphology of the acetabulum and femoral head-neck, and suture the joint capsule. Acetabular lateral center-edge angle (LCEA) and α angle (reflecting the degree of non-sphericity at the femoral head-neck junction) were measured before and after operation, and the modified Harris hip score (mHHS), the International Hip Outcome Tool-12 (IHOT-12), and the visual analogue scale (VAS) score for pain were evaluated. RESULTS: The operation was successfully completed in all patients. The incisions healed by first intention after operation, and there was no perioperative complications such as iatrogenic cartilage injury, fracture, infection, neurovascular traction injury, or lower extremity venous thrombosis. All the 23 patients were followed up 12-24 months, with an average of 14.6 months. The pain of hip joint significantly relieved, and the function of hip joint improved; no complication such as joint stiffness, joint instability, and osteonecrosis of the femoral head occurred. The α angle, VAS score, mHHS score, and IHOT-12 score at last follow-up were significantly better than those before operation ( P<0.05); there was no significant difference in LCEA compared to preoperative value ( P>0.05). CONCLUSION Hip arthroscopy is a safe and effective treatment for patients with FAI syndrome combined with ligamentum teres injury, which can achieve satisfactory effectiveness.
Humans ; Femoracetabular Impingement/complications* ; Arthroscopy/methods* ; Adult ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adolescent ; Treatment Outcome ; Young Adult ; Hip Joint/surgery* ; Acetabulum/surgery* ; Round Ligaments/surgery* ; Range of Motion, Articular

OBJECTIVE: To summarize research progress on enhanced recovery after posterior cruciate ligament (PCL) reconstruction, clarify the core contradictions, effective intervention methods, and evaluation shortcomings in current clinical practice, and provide theoretical support for optimizing clinical rehabilitation strategies. METHODS: Relevant domestic and international literature in recent years was systematically searched. The key technologies and challenges for enhanced recovery after PCL reconstruction were analyzed from three aspects: the core issues of enhanced recovery after PCL reconstruction, treatment strategies, and the post-reconstruction effectiveness evaluation system. RESULTS: Enhanced recovery after PCL reconstruction mainly faces two core problems. First, there is a balance dilemma between graft tendon protection and knee joint function recovery: the tensile capacity of the graft tendon is weak in the early postoperative period, so excessive weight-bearing easily leads to relaxation, while overly conservative immobilization causes muscle atrophy and joint adhesion. Second, the return-to-sport rate is significantly affected by injury type and treatment method: patients with combined multiple ligament or meniscus injuries have a much lower return-to-sport rate than those with isolated PCL injury, and the risk of return-to-sport failure is higher. Current research mainly promotes rehabilitation from two aspects: physical therapy and surgical technology. Physical therapy runs through the perioperative period: preoperatively, muscle strength training, swelling control, and maintenance of joint range of motion are used to optimize surgical conditions; postoperatively, phased intervention is implemented. Surgical technology focuses on minimally invasive and anatomical approaches: arthroscopic surgery reduces injury, double-bundle reconstruction and internal tension-relief technology improve stability, and modified tunnel positioning and special surgical methods avoid the risk of "Killer Turn". Postoperative functional evaluation adopts multi-dimensional indicators: subjective evaluation relies on scales such as Lysholm and International Knee Documentation Committee (IKDC); objective evaluation assesses stability through Telos stress test and posterior drawer test; imaging evaluation takes MRI as the core; psychological evaluation is assisted by the Tampa scale of kinesiophobia-11 (TSK-11). However, there are obvious shortcomings, such as the lack of PCL-specific evaluation tools. CONCLUSION Enhanced recovery after PCL reconstruction requires the integration of precise surgery, individualized rehabilitation, and comprehensive subjective and objective evaluation. In the future, biomaterials and digital technologies should be integrated to optimize the full-cycle management of PCL reconstruction, thereby improving functional recovery and the effect of return to sports.
Humans ; Posterior Cruciate Ligament Reconstruction/rehabilitation* ; Posterior Cruciate Ligament/injuries* ; Recovery of Function ; Knee Joint/physiopathology* ; Knee Injuries/rehabilitation* ; Return to Sport ; Enhanced Recovery After Surgery ; Tendons/transplantation* ; Arthroscopy