Objective: To analyze the developmental trajectories of clustered health risk behaviors and their association with self-esteem and lonelinesss among junior high school students, so as to provide a reference for formulating comprehensive prevention and control measures of health risk behaviors among adolescents. Methods: In October 2023, 1 165 first year junior high school students from two schools of Jishou City in Hunan Province were selected by convenient sampling method for three follow up surveys (T1:October 2023; T2:April 2024; T3:October 2024). The Adolescent Health Risk Behavior Questionnaire, Rosenberg Self esteem Scale and Loneliness Scale were used to assess health risk behaviors, self esteem and loneliness, respectively. Latent growth curve modeling and latent growth mixture modeling were applied to analyze the developmental trajectories of clustered health risk behaviors among junior high school students. Logistic regression was used to analyze the association of the developmental trajectories of clustered health risk behaviors with self esteem and loneliness among junior high school students. Results: The overall developmental trajectories among junior high school students showed a declining trend (intercept=0.15, slope=-1.65, both P <0.05), with three heterogeneous categories:low risk improvement group ( n =862, 74.0%), moderate risk stable group ( n =260, 22.3%), and high risk deterioration group ( n =43, 3.7%). After adjusting the status of the left behind individuals，using the low risk improvement group as the reference category in multinomial Logistic regression analysis, results indicated that higher loneliness scores among junior high school students increased the risks of belonging to the moderate risk stable group ( OR=1.02, 95%CI =1.00- 1.04 ) and the high risk deterioration group ( OR=1.04, 95%CI =1.00-1.08), while higher self esteem scores reduced the risks of belonging to the moderate risk stable group ( OR=0.93, 95%CI =0.91-0.96) and the high risk deterioration group ( OR=0.88, 95%CI =0.83-0.94) (all P <0.05). Conclusions The overall trend of clustered health risk behaviors among junior high school students gradually improves, and the self esteem and loneliness are significant correlative factors. Targeted intervention measures should be developed for the junior high school students, with a focus on enhancing their self esteem and alleviating loneliness.

Objective:To assess the effects of various leisure hobbies on the ability of daily living(ADL)and the quality of life among older adults in China.Methods:A cross-sectional study was conducted using data from the 4th Chinese Urban and Rural Elderly Living Conditions Sample Survey.We categorized community recreation hobbies into two types: dynamic hobbies, which include walking, playing ball games, dancing, and other physical activities, and static hobbies, which encompass activities that do not require physical exertion, such as reading, watching TV, and drawing.The EuroQol five-dimension scale(EQ-5D)-3L was employed to evaluate the quality of life.Older adults who maintained either dynamic or static hobbies for three consecutive years from 2017 to 2019 were initially screened.The relationship between different types of leisure hobbies and ADL scores, as well as quality of life at various time points, was analyzed using repeated-measures ANOVA.Subsequently, propensity scores were matched based on gender, age, ethnicity, marital status, literacy, and chronic diseases, and five machine learning algorithms were utilized to identify the optimal model for predicting fully independent ADL and EQ-5D effect values.Based on the optimal predictive model, we conducted Shapley Additive Explanations(SHAP)and global analysis.Results:The total number of older adults who participated in the survey over the three consecutive years from 2017 to 2019 was 4 912.Among these, 2 594 individuals maintained the same hobby habits throughout this period, comprising 1 362 males and 1 232 females, with an average age of(70.81±6.71)years.Statistically significant differences in ADL scores and EQ-5D scores were observed between the dynamic and static leisure hobby groups(all P<0.05)across various time points, hobby group classifications, and interaction levels.Older adults engaged in dynamic hobbies exhibited superior ADL functioning and higher EQ-5D scores in comparison to those in the static hobby group, with these differences remaining statistically significant following propensity score matching(all P<0.05).In predicting full ADL independence, the SHAP value for dynamic hobbies ranked second, while for predicting an EQ-5D weighted value of 1, the SHAP value for dynamic hobbies ranked ninth.Overall, the type of dynamic hobby demonstrated a positive trend in its effect on the ability to perform daily activities independently and in achieving an EQ-5D weighted value of 1. Conclusions:In comparison to static hobbies, Chinese older adults who engage in dynamic hobbies exhibit improved daily mobility and a higher quality of life.Furthermore, dynamic hobbies positively influence the capacity for full independence in daily activities, as evidenced by an EQ-5D weighted value of 1.

OBJECTIVE: To review the clinical characteristics of patients with traumatic spinopelvic dissociation (SPD) and explore the diagnostic and therapeutic methods. METHODS: A clinical data of 22 patients with SPD who underwent surgical treatment between March 2019 and August 2024 was retrospectively analyzed. There were 13 males and 9 females, with an average age of 35.5 years (range, 14-61 years). The causes of injury included falling from height in 16 cases, traffic accidents in 5 cases, and compression injury in 1 case. Sacral fractures were classified based on morphology into "U" type (9 cases), "H" type (7 cases), "T" type (4 cases), and "λ" type (2 cases). According to the Roy-Camille classification, there were 4 cases of type Ⅰ, 12 cases of type Ⅱ, 2 cases of type Ⅲ, and 4 cases of type Ⅳ. The Cobb angle was (35.7± 22.0)°. Sixteen patients were accompanied by lumbosacral trunk and cauda equina nerve injury, which was classified as grade Ⅱ in 5 cases, grade Ⅲ in 5 cases, and grade Ⅳ in 6 cases according to the Gibbons grading. The time from injury to operation was 2-17 days (mean, 5.7 days). Based on the type of sacral fracture and sacral nerve injury, 6 cases were treated with closed reduction and minimally invasive percutaneous sacroiliac screw fixation, 16 cases were treated with open reduction and lumbar iliac fixation (8 cases)/triangular fixation (8 cases). Among them, 11 patients with severe fracture displacement and kyphotic deformity leading to sacral canal stenosis or bony impingement within the sacral foramen underwent laminectomy and sacral nerve decompression. X-ray films and CT were reviewed during followed-up. The Matta score was used to evaluate the quality of fracture reduction. At last follow-up, the Majeed score was used to assess the functional recovery, and the Gibbons grading was used to evaluate the nerve function. RESULTS: All operations were successfully completed. All patients were followed up 8-64 months (mean, 20.4 months). Two patients developed deep vein thrombosis of the lower limbs, 2 had incision infections, and 1 developed a sacral pressure ulcer; no other complications occurred. Radiological examination showed that the Cobb angle was (12.0±6.8)°, which was significantly different from the preoperative one ( t=6.000, P<0.001). The Cobb angle in 16 patients who underwent open reduction was (14.9±5.5)°, which was significantly different from the preoperative one [(46.8±13.9)° ] ( t=8.684, P<0.001). According to the Matta scoring criteria, the quality of fracture reduction was rated as excellent in 8 cases, good in 7 cases, fair in 5 cases, and poor in 2 cases, with an excellent and good rate of 68.2%. Bone callus formation was observed at the fracture site in all patients at 12 weeks after operation, and bony union achieved in all cases at last follow-up, with a healing time ranging from 12 to 36 weeks (mean, 17.6 weeks). At last follow-up, the Majeed score was rated as excellent in 7 cases, good in 10 cases, fair in 4 cases, and poor in 1 case, with an excellent and good rate of 77.3%. One patient experienced a unilateral iliac screw breakage at 12 months after operation, but the fracture had already healed, and there was no loss of reduction. Among the 16 patients with preoperative sacral nerve injury, 11 cases showed improvement in nerve function (6 cases) or recovery (5 cases). CONCLUSION SPD with low incidence, multiple associated injuries, and high incidence of sacral nerve injury, requires timely decompression of the sacral canal for symptomatic sacral nerve compression, fractures reduction, deformities correction, and stable fixation.
Humans ; Adult ; Female ; Male ; Retrospective Studies ; Middle Aged ; Spinal Fractures/diagnostic imaging* ; Adolescent ; Sacrum/diagnostic imaging* ; Fracture Fixation, Internal/methods* ; Young Adult ; Pelvic Bones/surgery* ; Treatment Outcome ; Bone Screws

OBJECTIVE: To compare the registration accuracy of cone beam computed tomography (CBCT) images while registering to virtual craniodentofacial patients based on soft tissue and the dentition registration method. METHODS: Virtual dentofacial patients out of 13 selected participants who needed CBCT scanning were established by impression with a registered-block impression (RBI) based on digital dental images, three-dimensional (3D) facial images and maxillofacial CBCT images. CBCT images were processed in the Mimics software program, establishing the craniofacial virtual patients based on CBCT images (CCTs). Registration between virtual patients from RBI and CCT, using the soft tissue in lower half face (STE) and dentition (DTN) as the reference area, respectively, forming two kinds of virtual craniofacial patients based on digital dental images, 3D facial images and skeletal images of CBCT (hiding the soft tissue and dental casts from CBCT). Three-dimensional deviation analysis was performed in the upper half face and lower half face of facial images from CBCT between two kinds of virtual craniodentofacial patients and compared with 3D facial images from RBI and recorded as root mean square error (RMSE). Paired-t test was used to compare the deviations of RMSEs between the upper and lower half of the face and the upper half of the face of facial images from CCT, respectively, between the two kinds of virtual craniodentofacial patients based on STE and DTN methods. RESULTS: Paired-t tests showed that there was no statistically significant difference between the upper and lower half faces of facial images from CCT between STE and DTN (P>0.05), but the deviation of RMSEs of the upper half face of facial images from CCT in STE was smaller than those in DTN [(1.696±0.420) mm vs. (1.752±0.424) mm, P < 0.01]. CONCLUSION The registration accuracy of CBCT registered in virtual craniodentofacial patients using soft tissue as the reference area was higher.
Humans ; Cone-Beam Computed Tomography/methods* ; Imaging, Three-Dimensional/methods* ; Male ; Face/anatomy & histology* ; Female ; Adult ; Image Processing, Computer-Assisted/methods* ; Young Adult ; User-Computer Interface

Objective:From the perspective of policy tools,it aimed to explore the policy focuses for promoting the high-quality development of compact county medical communities.Methods:It utilized content analysis method to encode and quantify the policy texts of county medical community.Results:A total of 107 policy documents on the construction of county medical community were screened,and 319 codes were obtained.The classification statistics showed that authoritative tools accounted for 34.80%,persuasive tools accounted for 30.41%,capacity-building tools accounted for 15.99%,system transformation tools accounted for 11.60%,and incentive tools accounted for 7.21%.Conclusion:The policy tools for building county medical communities in China are becoming increasingly diversified,but the strategies for using these tools still need to be strengthened.The government should gradually change the application strategy of authoritative tools and persuasive tools,further strengthen the supervision function of the government,and increase the intensity of policy publicity and guidance.At the same time,policies should strengthen the effective utilization of capacity-building tools,system transformation tools,and incentive tools,so as to establish the long-term mechanism of compact county medical communities,form scientific effective sustainable incentive mechanism,and promote the developmint in healthy,long and sustainable cooperative direction.

Objective:To review the literature on improving patients′medical experience, analyze the current research status in this field, and provide references for enhancing patients′medical experience.Methods:A search was conducted for studies related to improving patients′medical experience published from January 2015 to November 2024 in eight databases, including CNKI and Web of Science. Using software CiteSpace 6.4.R1 and VOSviewer 1.6.19 to analyze publication trends, keyword clustering, existing problems in the process of improving patients′medical experience, and the measures taken.Results:6 507 articles were included, of which 4 452 were in English (68.4%) and 2 055 were in Chinese (31.6%). The annual number of publications showed a nearly linear growth trend ( R2 = 0.983 9). The clustering analysis results indicated that domestic and international research mainly focused on patient-centered diagnostic and treatment systems, behaviors, services, and environments. Existing studies revealed that there were still problems such as long waiting times for appointments and consultations (292 articles), uneven distribution of medical resources (198 articles), and poor doctor-patient communication (155 articles). To improve patients′medical experience, the following intervention measures were proposed: accelerating the medical reform process and strengthening government responsibilities (169 articles); enhancing service concepts and innovating service models (363 articles); optimizing the consultation process and simplifying medical procedures (221 articles); improving the consultation environment and optimizing the facilities in the consultation area (181 articles); and integrating technological advantages to cover the entire medical process (346 articles). Conclusions:Research on improving patients' medical experience was increasingly attracting the attention of more and more scholars. Issues such as low service efficiency, unbalanced resource allocation, and poor doctor-patient communication need to be given special attention. In the future, it is recommended to enhance the experience of patients′ medical experience by strengthening policy and institutional guarantees, accelerating the construction of information technology, improving doctor-patient communication skills and humanistic care, and enhancing the capacity of primary medical services.

In this study,the carboxylated magnetic beads were coupled with bivalent nanobodies a-gainst porcine epidemic diarrhea virus(PEDV)M protein to construct immunomagnetic beads(IM-NBs-Ⅱ),The capture and enrichment function of IMNBs-Ⅱ was verified by using PEDV propaga-ted in Vero cells.A one-step RT-qPCR detection method for PEDV was established by combining the characteristics of IMNBs-Ⅱ with the detection advantages of reverse transcription fluorescence quantitative polymerase chain reaction(RT-qPCR).Specific analysis found that this method has no cross reactivity with swine fever virus,porcine reproductive and respiratory syndrome virus,por-cine parvovirus,porcine circovirus,indicating that it has good specificity.Sensitivity analysis re-vealed that the detection sensitivity of the RT-qPCR based on IMNBs-Ⅱ was increased 10 times compared to traditional RT-qPCR methods.Detection of the clinical samples confirm that the RT qPCR method based on IMNBs-Ⅱ is suitable for rapid and accurate detection of clinical feces and tissue samples.The method established in this study effectively avoids contamination issues during nucleic acid extraction,simplifies experimental procedures,and saves detection time,which pro-vides a method for efficient detection of PEDV.

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 compare the efficacy of O-arm navigation-assisted and freehand posterior pedicle screw fixation in the treatment of ankylosing spondylitis (AS) associated with lower cervical fractures in adults.Methods:A retrospective cohort study was conducted to analyze the clinical data of 29 adult AS patients with lower cervical fractures admitted to Zhengzhou Orthopedic Hospital from June 2020 to September 2024, including 22 males and 7 females, aged 35-72 years [(52.3±11.1)years]. Injured segments involved C 5~6 in 6 patients, C 6 in 8, C 6~7 in 8, and C 7 in 7. Accirdubg to AO classification, the fracture was classified as type B3 in 22 patients and type C in 7. All the patients underwent posterior cervical pedicle screw fixation, among whom 15 patients were treated with navigation-assisted screw placement (navigation screw placement group, with 120 screws) and 14 with freehand technique (freehand screw placement group, with 112 screws). The two groups were compared in terms of the operative time, intraoperative blood loss, and postoperative drainage volume. The accuracy of screw placement, penetration rate of the pedicle cortex and fracture healing time were evaluated in the two groups. The Cobb angle before surgery and at 3 days after surgery and American Spinal Injury Association (ASIA) classification before surgery and at the last follow-up were recorded in the two groups. The visual analogue scale (VAS) score, Japanese Orthopedic Association (JOA) score and neck dysfunction index (NDI) before surgery, at 1 week, 3 months after surgery and at the last follow-up were compared between the two groups. The incidence of postoperative complications was also investigated. Results:All the patients were followed up for 6-57 months [(29.3±14.1)months]. The operation duration, intraoperative blood loss, and postoperative drainage volume were (166.0±31.4)minutes, (256.7±70.7)ml, and (91.0±14.4)ml in the navigation screw placement group, which were shorter or less than (219.29±31.7)minutes, (342.1±60.7)ml, and (123.2±20.7)ml in the freehand screw placement group ( P<0.01). The accuracy of screw placement in the navigation screw placement group was 98.3% (118/120) and penetration rate of the pedicle cortex was 5.8% (7/120), which were both superior to 89.3% (100/112) and 18.8% (21/112) in the freehand screw placement group ( P<0.01). No significant difference was detected in fracture healing time between the two groups ( P>0.05). There were no significant differences in the Cobb angle before surgery and at 3 days after surgery, as well as in the ASIA grading before surgery and at the last follow-up between the two groups ( P>0.05). The Cobb angle and ASIA classification at 3 days after surgery and at the last follow-up were improved compared with those before surgery ( P<0.05). Before surgery, at 1 week, 3 months after surgery, and at the last follow-up, the VAS scores were 8.0(7.0, 9.0)points, 4.0(3.0, 4.0)points, 2.0(1.0, 2.0)points, and 0.0(0.0, 1.0)points in the navigation screw placement group, which were not significantly different from 8.0(7.0, 9.0)points, 4.0(3.0, 4.0)points, 1.5(1.0, 2.0)points, and 0.0(0.0, 1.0)points in the freehand screw placement group ( P>0.05); the JOA scores were (7.5±1.4)points, (10.9±1.2)points, (13.2±1.5)points, and (15.7±1.0)points in the navigation screw placement group, which were not significantly different from (7.2±2.8)points, (10.1±3.2)points, (11.8±3.8)points, and (14.1±4.3)points in the freehand screw placement group ( P>0.05); the NDI were 48.0(44.0, 56.0)%, 30.0(30.0, 34.0)%, 18.0(16.0, 22.0)%, 8.0(6.0, 10.0)% in the navigation screw placement group, which were not significantly different from 44.0(40.0, 52.0)%, 30.0(29.0, 34.5)%, 17.0(16.0, 20.0)%, and 8.0(5.5, 10.0)% in the freehand screw placement group ( P>0.05). The VAS scores, JOA scores, and NDI were improved at 1 week, 3 months after surgery, and at the last follow-up in both groups, compared to those before surgery and they were gradually improved with the passage of the follow-up time ( P<0.05). One patient in the navigation screw placement group developed postoperative pulmonary infection and recovered after symptomatic treatment, with an incidence of complications 7% (1/15). Two patients in the freehand screw placement group had postoperative cerebrospinal fluid leakage and dural rupture and recovered after symptomatic treatment, with an incidence of complications 14% (2/14). Throughout the follow-up period, no complications such as screw breakage, implant loosening, or loss of correction were found in either group. Conclusion:Compared with freehand screw placement, the O-arm navigation system-assisted posterior pedicle screw fixation in the treatment of AS associated with lower cervical fractures in adults demonstrates significant advantages, including reduced operative time, decreased intraoperative blood loss and postoperative drainage volume, improved accuracy of screw placement, and reduced penetration rate of the pedicle cortex.