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

Objective To explore the correlation of traditional Chinese medicine(TCM)syndrome elements with language function and activities of daily living(ADL)in patients suffering post-stroke aphasia(PSA).Methods Ninety-eight PSA patients hospitalized at the College of Rehabilitation Medicine,Fujian University of Traditional Chinese Medicine from April 2023 to April 2024 were selected.The language function,TCM syndrome elements,and their correlations were analyzed.Results(1)Among PSA patients,males outnumbered females.PSA patients exhibited different performances on various aphasia-related scales,with language impairments mainly concentrated in naming and spontaneous speech.(2)The distribution of TCM syndrome elements varied in PSA patients with different age groups.In the age group＜50 years old,qi obstruction(100.00%),phlegm syndrome(100.00%),and dampness syndrome(100.00%)were predominant.In the age group of 50-59 years old,phlegm syndrome(100.00%)and yang hyperactivity syndrome(96.30%)were predominant.In the age group of 60-69 years old,phlegm syndrome(100.00%)and yang hyperactivity syndrome(96.15%)were also predominant.In the age group of 70-79 years old,qi deficiency syndrome(100.00%)was predominant.In the age group of 80-89 years old,syndromes such as qi insecurity,qi obstruction,qi deficiency,phlegm,yang hyperactivity,blood stasis,wind stirring,and blood cold were concentrated(all 100.00%).However,there were no statistically significant differences in the distribution of TCM syndrome elements among various age groups(P＞0.05).(3)The distribution of deficiency and excess syndrome elements varied in PSA patients with different genders.Among deficiency syndrome elements,yang hyperactivity,qi deficiency,and yin deficiency were predominant in males,while yang hyperactivity,qi deficiency,and blood deficiency were predominant in females.Among excess syndrome elements,phlegm syndrome,qi obstruction,and dampness syndrome were predominant in males,while phlegm syndrome,qi obstruction,and qi stagnation syndrome were predominant in females.However,there were no statistically significant differences in the distribution of deficiency and excess syndrome elements between genders(P＞0.05).(4)After controlling the factors of age group and gender,partial correlation analysis of syndrome elements and language function showed that among the disease-location syndrome elements,spontaneous naming(r=-0.588,P=0.027)and sematic cued naming(r=-0.558,P=0.038)in the Boston Naming Test(BNT)were negatively correlated with the large intestine;among the disease-nature syndrome elements,BNT sematic cued naming(r=0.821,P＜0.001)was positively correlated with qi sinking,while BNT spontaneous naming was negatively correlated with blood heat(r=-0.544,P=0.044)and was positively correlated with fluid depletion(r=0.860,P=0.028);BNT recognitive naming was positively correlated with external wind(r=0.966,P=0.034);errors in BNT sematic cued naming were negatively correlated with qi sinking(r=-0.540,P=0.005);the Modified Barthel Index(MBI)was positively correlated with essence deficiency(r=0.572,P=0.021).Conclusion The TCM syndrome elements of phlegm,qi block,yang hyperactivity,and qi deficiency are commonly seen in PSA patients.There is a certain correlation of language function and ADL with TCM syndrome elements in PSA patients.

Objective To investigate the drivers,stakeholders,core tasks,and differentiated development models of digital transformation in Chinese hospitals,develop a hospital digital transformation model,and propose advancement pathways.Methods Leveraging ROCCIPI theory,socio-technical systems theory,and social network theory,a multiple case study approach was employed to analyze four representative Chinese hospitals,examining the driving factors,social network relationship,and core tasks of digital transformation.Results Hospital digital transformation is a complex process driven by regulations,opportunities,and capabilities,requiring efficient collaboration among stakeholders focused on patient services,clinical operations,hospital management,and security.It identified three development models-ecology-oriented,regional integration,and grassroots enhancement—based on the distinct characteristics of the hospitals.A theoretical model for digital transformation in four Chinese hospitals was developed,along with proposed pathways and strategies.Conclusion It presents a digital transformation model and advancement pathways for hospitals through multiple case analyses,addressing the limited perspectives of existing research and providing a reference for practice.

Objective To investigate the drivers,stakeholders,core tasks,and differentiated development models of digital transformation in Chinese hospitals,develop a hospital digital transformation model,and propose advancement pathways.Methods Leveraging ROCCIPI theory,socio-technical systems theory,and social network theory,a multiple case study approach was employed to analyze four representative Chinese hospitals,examining the driving factors,social network relationship,and core tasks of digital transformation.Results Hospital digital transformation is a complex process driven by regulations,opportunities,and capabilities,requiring efficient collaboration among stakeholders focused on patient services,clinical operations,hospital management,and security.It identified three development models-ecology-oriented,regional integration,and grassroots enhancement—based on the distinct characteristics of the hospitals.A theoretical model for digital transformation in four Chinese hospitals was developed,along with proposed pathways and strategies.Conclusion It presents a digital transformation model and advancement pathways for hospitals through multiple case analyses,addressing the limited perspectives of existing research and providing a reference for practice.

Objective:To investigate the self-care contribution and binary coping level of spouse caregivers for middle-aged and young stroke patients and explore the relationship between the two, in order to improve the quality of self-care contribution of spouse caregivers to middle-aged and young stroke patients.Methods:A cross-sectional survey was conducted among 200 middle-aged and young stroke patients ′ spouse caregivers in the People ′s Hospital of Xinjiang Uygur Autonomous Region from January to June 2023 by the general data questionnaire, the Caregiver Contribution to Self-care of Stroke Patient Scale, the Dyadic Coping Inventory. The correlation between self-care contributions and binary coping strategies of spousal caregivers was analyzed, and the factors that affect their self-care contributions were screened. Results:Finally, 192 middle-aged and young stroke patients ′ spouse caregivers were included, including 70 males and 122 females, aged 18-59 years old. The total score of self-care contribution of spousal caregivers of middle-aged and young stroke patients was (75.43 ± 6.80) points, and the total score of binary coping was (117.12 ± 9.59) points, both of which were positively correlated ( r=0.691, P<0.05). Hierarchical regression analysis showed that after controlling for the influence of general data, binary coping could explain 28.4% variation in the self-care contribution of spouse caregivers of middle-aged and young stroke patients ( P<0.05). Conclusions:The duality coping level positively predicts the quality of spouse caregivers ′ self-care contribution to middle-aged and young stroke patients. Medical staff should assess the dual coping level of middle-aged and young stroke patients and their spouses, and carry out targeted dual intervention measures to improve the quality of caregivers' contribution to stroke patients ′ self-care.

Objective To investigate the clinical characteristics and immunotherapy effect of myelin oligodendrocyte glycoprotein antibody(MOG-Ab)-associated disorders(MOGAD)onset with spinal cord injury.Methods Clinical data of 2 children with MOGAD onset with spinal cord injury were retrospectively analyzed.Results The first symptoms of 2 children were both lower limbs fatigue.After testing the full-length MOG-Ab in both serum and CSF and MRI scanning,they were diagnosed as MOGAD onset with spinal cord injury.The clinical symptoms were relieved after hormone impact treatment,and the range of abnormal signals were reduced by reexamination.After discharge,the patient was followed up for more than 5 months,and the clinical symptoms were cured without recurrence.Conclusions MOGAD onset with spinal cord injury is a rare disease type.Its early clinical manifestations may be neck,back and waist discomfort,gradually aggravated limb weakness,urination and defecation dysfunction.Imaging examination shows abnormal signals of multi-segmental spinal cord,and MOG-Ab could be detected in CSF and peripheral blood.Early identification and diagnosis and timely application of hormone impact treatment can help to quickly relieve clinical symptoms and improve prognosis.

Healthcare professionals should be aware that genital mycoplasma infections are common in clinical practice, which are mainly caused by Mycoplasma hominis (Mh), Ureaplasma urealyticum (UU) and Mycoplasma genitalium (Mg). Mh and UU can colonize the urogenital tract of healthy individuals and are associated with bacterial vaginosis, urethritis, pelvic inflammatory disease, infertility and preterm birth; while Mg may cause urethritis, cervicitis, endometritis and pelvic inflammatory disease, bringing more threat to reproductive health in women. Mh and UU can be detected by culture on special media, while isolating Mg and subtyping UU require molecular biological techniques. Currently, there are no unified guidelines for the screening and treatment of genital mycoplasmas infections worldwide. The article reviews the progress of screening, diagnosis and treatment strategies for mycoplasma infections in female genital tract, aiming to provide a reference for clinical management of this conditon.

Objective:To explore the changes in early postpartum pelvic floor muscle strength following the implementation of the new labor process.Methods:This retrospective cohort study selected 1 834 primiparous women with singleton, full-term pregnancies who delivered at Peking University First Hospital from February 2011 to March 2016 and had a pelvic floor re-examination 6-8 weeks postpartum. Out of these, 738 cases who followed the old labor process before 2014 were categorized as the old process group, and 1 096 cases who followed the new labor process after 2014 were categorized as the new process group. Basic data, childbirth information, and postpartum pelvic floor muscle strength of the two groups were compared. Data were statistically analyzed using t-test, Chi-square test, Mann-Whitney U test, Wilcoxon rank-sum test, and ordered multicategory logistic regression to assess the impact of the new and old labor process and other factors on pelvic floor muscle strength. Results:The total duration of labor, as well as the duration of the first, second, and third stages of labor, were longer in the new process group than in the old process group [549.0 min (360.0-768.0 min) vs. 482.5 min (328.0-635.0 min), 465.0 min (297.5-672.5 min) vs. 420.0 min (285.0-555.0 min), 42.0 min (24.0-74.0 min) vs. 27.0 min (18.0-45.0 min), with Z-value of－5.72,－3.95, and－9.28, all P<0.05). The rates of vaginal delivery and labor analgesia were higher in the new process group [72.1% (790/1 096) vs. 67.2% (496/738), χ2=7.41; 67.4% (739/1 096) vs. 53.4% (394/738), χ2=36.82; both P<0.05]. There were no statistically significant differences in the comparison of Class Ⅰ and Class Ⅱ muscle strength grades between the two groups (all P>0.05). Conclusion:There was no significant decline in early postpartum pelvic floor muscle strength following the implementation of the new labor process standards.

BACKGROUND: Previous studies have shown that lymph node metastasis only occurs in some mixed ground-glass nodules (mGGNs) which the pathological results were invasive adenocarcinoma (IAC). However, the presence of lymph node metastasis leads to the upgrading of tumor-node-metastasis (TNM) stage and worse prognosis of the patients, so it is important to perform the necessary evaluation before surgery to guide the operation method of lymph node. The aim of this study was to find suitable clinical and radiological indicators to distinguish whether mGGNs with pathology as IAC is accompanied by lymph node metastasis, and to construct a prediction model for lymph node metastasis. METHODS: From January 2014 to October 2019, the patients with resected IAC appearing as mGGNs in computed tomography (CT) scan were reviewed. All the lesions were divided into two groups (with lymph node metastasis or not) according to their lymph node status. Lasso regression model analysis by applying R software was used to evaluate the relationship between clinical and radiological parameters and lymph node metastasis of mGGNs. RESULTS: A total of 883 mGGNs patients were enroled in this study, among which, 12 (1.36%) showed lymph node metastasis. Lasso regression model analysis of clinical imaging information in mGGNs with lymph node metastasis showed that previous history of malignancy, mean density, mean density of solid components, burr sign and percentage of solid components were informative. Prediction model for lymph node metastasis in mGGNs was developed based on the results of Lasso regression model with area under curve=0.899. CONCLUSIONS Clinical information combined with CT imaging information can predict lymph node metastasis in mGGNs.
Humans ; Lymphatic Metastasis ; Lung Neoplasms ; Adenocarcinoma ; Lymph Nodes ; Social Group

Objective: To analyze the current nutritional composition of commonly consumed prepackaged foods among children in Chengdu and to provide a scientific basis for health education among children and adolescents. Methods: Based on the 3 day and 24 hour dietary data of children aged 6-12 in Chengdu of the Southwest China Childhood Nutrition and Growth Cohort from 2021 to 2022, the nutritional information of prepackaged foods was collected by combining offline and online methods. All foods were classified step by step, and the nutrient content of each 100 g or 100 mL food was counted and graded. Results: A total of 1 902 children s prepackaged foods in 23 sub categories of 10 major categories were investigated. Nuts and seeds, snack foods, instant foods and other dairy products had higher total energy(2 476, 2 027, 1 728, 1 816 kJ/100 g), with the nutrient reference value percentage(NRV%) exceeding 20%. Fish, poultry, meat, eggs and their products had the highest protein content(22.8 g/ 100 g ) with an NRV% of 38%, nuts and seeds had the highest fat content(47.5 g/100 g) with an NRV% of 79%, confectionery and jelly had the highest carbohydrate content(82.1 g/100 g) with an NRV% of 27%, and seasoning flour products had the highest sodium content with an NRV% up to 118%. Seasoning flour products and instant foods were mostly high sodium, high fat and high carbohydrate food. Baked and puffed foods were almost high fat and high carbohydrate. Fish, poultry, meat, eggs, beans and their products were rich in protein but mostly high in sodium. Beverages and cold drinks were low in other nutrients except carbohydrate. Conclusion The nutrient content of various prepackaged foods commonly consumed by children in Chengdu are quite different. Most of the foods consumed by children are high sodium, high fat and/or high carbohydrate. Nutrition education should be strengthened to help children choose healthy foods.