AIM:To investigate the effects of puerarin(PU)on fecal metabolomics in atherosclerosis(AS)model mice.METHODS:Apolipoprotein E gene knockout(ApoE-/-)mice were fed a high-fat,high-cholesterol diet to es-tablish an AS model.The mice were randomly divided into control,model,and PU treatment groups,with five mice in each group.Body weight changes were recorded weekly.After 12 weeks,plasma inflammatory cytokines,lipid profiles,and aortic plaque area were measured,and fecal metabolomic analysis was performed using untargeted metabolomics.RE-SULTS:(1)The high-fat,high-cholesterol diet successfully induced the AS model,with significant increases in body weight(P<0.01),plasma levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-1β(P<0.01),as well as higher levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),and triglycerides(TG),and reduced levels of high-density lipoprotein cholesterol(HDL-C)(P<0.01).The plaque area in both the whole aorta and the aortic sinus was significantly increased(P<0.01).(2)PU treatment significantly reduced body weight(P<0.05)and inflammatory cytokine levels(P<0.01),and improved lipid metabolism disorders.Specifically,TC,TG,and LDL-C lev-els significantly decreased(P<0.05 or P<0.01),while HDL-C levels significantly increased(P<0.01).In addition,the plaque area in both the whole aorta and the aortic sinus was significantly reduced in the PU-treated group(P<0.01).(3)Metabolomic analysis showed that PU regulated the levels of L-valine,L-phenylalanine,and L-histidine,restoring abnor-mal amino acid metabolism pathways.Additionally,PU downregulated abnormal levels of phosphatidylcholine and ce-ramide,promoting lipid metabolism balance.PU also modulated bile acid metabolism and oxidative stress mechanisms,improving purine and pyrimidine metabolism and related energy metabolism pathways.CONCLUSION:PU significantly ameliorates metabolic abnormalities in AS mouse models by regulating lipid metabolism,amino acid metabolism,bile acid metabolism,and gut microbiota-related metabolic pathways.

AIM:To investigate the effects of puerarin(PU)on fecal metabolomics in atherosclerosis(AS)model mice.METHODS:Apolipoprotein E gene knockout(ApoE-/-)mice were fed a high-fat,high-cholesterol diet to es-tablish an AS model.The mice were randomly divided into control,model,and PU treatment groups,with five mice in each group.Body weight changes were recorded weekly.After 12 weeks,plasma inflammatory cytokines,lipid profiles,and aortic plaque area were measured,and fecal metabolomic analysis was performed using untargeted metabolomics.RE-SULTS:(1)The high-fat,high-cholesterol diet successfully induced the AS model,with significant increases in body weight(P<0.01),plasma levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-1β(P<0.01),as well as higher levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),and triglycerides(TG),and reduced levels of high-density lipoprotein cholesterol(HDL-C)(P<0.01).The plaque area in both the whole aorta and the aortic sinus was significantly increased(P<0.01).(2)PU treatment significantly reduced body weight(P<0.05)and inflammatory cytokine levels(P<0.01),and improved lipid metabolism disorders.Specifically,TC,TG,and LDL-C lev-els significantly decreased(P<0.05 or P<0.01),while HDL-C levels significantly increased(P<0.01).In addition,the plaque area in both the whole aorta and the aortic sinus was significantly reduced in the PU-treated group(P<0.01).(3)Metabolomic analysis showed that PU regulated the levels of L-valine,L-phenylalanine,and L-histidine,restoring abnor-mal amino acid metabolism pathways.Additionally,PU downregulated abnormal levels of phosphatidylcholine and ce-ramide,promoting lipid metabolism balance.PU also modulated bile acid metabolism and oxidative stress mechanisms,improving purine and pyrimidine metabolism and related energy metabolism pathways.CONCLUSION:PU significantly ameliorates metabolic abnormalities in AS mouse models by regulating lipid metabolism,amino acid metabolism,bile acid metabolism,and gut microbiota-related metabolic pathways.

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.

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 explore the differences in scapular motion and shoulder function between patients suffering from rotator cuff tears(RCT)with and without type Ⅲ scapular dyskinesis(SD).Meth-ods Between September 2021 and March 2023,sixteen patients suffering from rotator cuff tears with SD(SD group)and 17 counterparts without SD(non-SD group)were recruited from the Sports Hospital of the General Administration of Sport of China.Their scapular motion was assessed by measuring three parameters in the X-rays,including scapular spine line(LSS),scapular upward rotation angle(SU-RA),and coracoid upward shift distance(CUSD).Moreover,their shoulder range of motion in flexion,abduction and external rotation were recorded,and further evaluated using the Pain Visual Analog Scale(VAS)and American Shoulder and Elbow Surgeons Score(ASES).Results No significant differenc-es were found between the two groups in the average score of SURA,CUSD and LSS at 0°～30° shoul-der abduction,or in that of CUSD and LSS at 60°～90°shoulder abduction.However,the average SU-RA score of the SD group at 60°～90°shoulder abduction was significantly greater than the other group(P<0.05).The shoulder ranges of motion during active flexion,abduction and external rotation were significantly smaller in the SD group than in the non-SD group(P<0.05).Moreover,the average VAS score in the SD group was significantly higher than the non-SD group(P<0.05),while the average ASES score was significantly lower than the latter group(P<0.05).Conclusions RCT patients type III SD exhibits greater scapular upward rotation during shoulder abduction compared to those without SD.Moreover,the former patients suffer from more severe pain and have worse shoulder range of motion and functional performance than the latter.

Objective:To explore the clinical outcomes of intraoperative fluoroscopy on femoral tunnel placement in treating professional snow sports athletes with anterior cruciate ligament (ACL) injury.Methods:A retrospective case series study was used to analyze the clinical data of 13 professional snow sports athletes with ACL injury treated in the National Institute of Sports Medicine, General Administration of Sport of China from January 2016 to January 2019. There were 5 males and 8 females, aged 16-27 years [(18.5±3.0)years]. Intraoperative lateral fluoroscopy combined with quadrant method was performed for the accurate femoral tunnel placement in single-bundle ACL reconstruction by using autologous hamstring tendon in all patients. KT1000 side-to-side difference (KT1000-ssd), pivot shift test, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Marx activity scale and maximum extension and flexion resistance ratio of the involved and uninvolved knee were compared before operation (or before injury) and at 3, 6, 12 and 24 months after operation. Whether returning to the field, time taken in returning to the field and re-injury were recorded at each follow-up visit. ACL graft signal intensity ratio (SIR) in MRI of the involved knee was evaluated at postoperative 24 months.Results:All patients were followed up for 24-33 months [(25.8±2.7)months]. There were 7 patients with KT1000-ssd degree I, 5 with degree II and 1 with degree III before operation, compared to 12 patients with KT1000-ssd degree 0 and 1 with degree I at 3 and 6 months after operation and 13 patients with KT1000-ssd degree 0 at 12 and 24 months after operation. The pivot shift test was grade I in 8 patients and grade II in 5 before operation, compared to 11 patients with degree 0 and 2 with degree I at 3 months after operation and 12 patients with degree 0 and 1 with degree I at 6, 12 and 24 months after operation. IKDC subjective score was (68.0±4.3)points, (84.7±7.9)points, (94.6±3.3)points and (96.5±1.8)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, IKDC subjective score was significantly improved compared to the preoperative (48.3±25.0)points (all P<0.01). The Lysholm score was (63.4±6.6)points, (80.1±6.5)points, (93.8±4.6)points and (96.5±2.4)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the Lysholm score was significantly improved compared to the preoperative (47.5±29.4)points (all P<0.01). The Marx activity scale was (7.4±0.5)points, (13.8±0.7)points, (14.6±0.8)points and (15.0±0.7)points at postoperative 3, 6, 12 and 24 months, respectively, significantly lower than (16.0±0.0)points before the injury (all P<0.01). The maximum extension resistance ratio of the involved and uninvolved knee was 0.60±0.10, 0.85±0.08, 0.91±0.06 and 0.97±0.04 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum extension resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.57±0.18 (all P<0.01).The maximum flexion resistance ratios of involved and uninvolved knee were 0.64±0.09, 0.82±0.06, 0.89±0.04 and 0.94±0.06 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum flexion resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.60±0.12 (all P<0.01). Thirteen athletes returned to the field within 12 months after operation with the time taken in returning to the field ranging from 5-12 months [(8.7±1.9)months]. There was no ACL re-injury at postoperative 24 months. The ACL graft SIR in MRI of the involved knee was 1.80±0.20 at postoperative 24 months. Conclusion:Intraoperative fluoroscopy on femoral tunnel placement in the treatment of professional snow sports athletes with ACL injury can significantly improve the knee joint stability, subjective function, sports performance and muscle strength within 6 months, and can help them return to the field within 12 months, and accelerates graft healing.

Objective:To investigate the diagnostic value of synthetic MRI methods in the differentiation of benign and malignant breast lesions.Methods:Clinical and imaging data of 93 breast patients confirmed by pathology in the Second Affifiliated Hospital of Xi′an Jiaotong University from May 2019 to April 2020 were analyzed retrospectively. All patients underwent synthetic MRI technique, and the quantitative parameters of T 1, T 2, and proton density (PD) values were measured. Independent samples t-test and Wilcoxon test were used to compare the differences in clinical and imaging characteristics between the benign and malignant breast lesions. ROC curve was used for the comparison of the diagnostic efficacy of the quantitative parameters in differentiating malignant from benign breast lesions. Results:Of the 93 patients with breast lesions, 62 cases were malignant and 31 cases were benign. The quantitative T 2 values for benign and malignant lesions were 103 (93, 126)ms and 83 (77, 90)ms respectively, and the quantitative PD values were 87.7 (72.7, 96.7)pu and 73.5(63.3, 79.4)pu respectively. There were statistically significant differences between benign and malignant lesion( P<0.05). Taking quantitative T 2 values of 90.5 ms and PD values of 84.8 pu as the cut-off value, the area under the ROC curve in differentiating benign from malignant breast lesions were 0.87 and 0.75, accuracy values were 80.6% and 78.5%, specificity values were 87.1% and 54.8%, sensitivity values were 77.4% and 90.3% respectively. Conclusion:Synthetic MRI methods can be applied in the examination of breast lesions and has the potential to be an effective diagnostic method for the differential diagnosis between benign and malignant lesions of breast.

Objective: To investigate the prevalence of degenerative knee osteoarthritis and the relationship between osteoporosis and knee osteoarthritis. Methods: A community-based cross-sectional study was conducted and stratified sampling method was used to select the sample. The permanent residents over 18 years old in Beijing were selected, and self-developed questionnaires were used by face-to-face interview including the disease condition and possible relative factors. The effect of osteoporosis on knee osteoarthritis was analyzed after controlling the effect of gender, age, BMI, waist-hip ratio, education level, nature of work, intensity of work, physical exercise by the Logistic regression model. Results: Among the 783 subjects, 53 cases of knee degenerative osteoarthritis were found, with the prevalence rate was 6.77% and the prevalence rate of 95%CI was 5.01%, 8.53%. The prevalence rates of <45 years old group, 45-59 year-old group and ≥60-year-old group were 2.54%, 7.02% and 16.67% respectively, and the difference was statistically significant (χ²=36.284, P=0.000). After controlling the other factors, osteoporosis had an independent effect on knee osteoarthritis with OR value of 3.56 (95%CI: 1.76, 7.18). Conclusion The older the age, the higher the prevalence of degenerative knee arthritis, and there is a correlation between osteoporosis and degenerative knee arthritis.

Objective To investigate the serum level of carboxy-terminal telopeptide of type I collagen (ICTP) and explore its correlation with MMP-2 and MMP-9 in patients with coronary artery disease (CHD). Methods A total of 103 CHD patients treated in our hospital between October, 2013 and May, 2014 were enrolled, including 39 with stable angina pectoris (SAP), 39 with unstable angina (UA), and 25 with acute myocardial infarction (AMI), with 38 non-CHD volunteers as the control group. The serum levels of ICTP, MMP-2, and MMP-9 were detected in all the subjects using enzyme-linked immunosorbent assay (ELISA). Results No significant difference in serum levels of MMP-2, MMP-9, or ICTP was found between the control and SAP groups or between UA and AMI groups (P>0.05), but the latter two groups had significantly higher serum levels of MMP-2, MMP-9, and ICTP than the former two groups (P<0.05). Serum ICTP level was found to negatively correlated with the fibrotic area and positively with the lipid component in the plaques (P<0.05). Regression analysis revealed significant positive correlations of serum ICTP with MMP-2 and MMP-9 (P<0.05). Conclusions An elevated serum ICTP level is indicative of the presence of unstable plaques in CHD patients. Serum ICTP is more strongly correlated with MMP-2 than with MMP-9, and can be used as a non-invasive marker for assessing vulnerable plaques in patients with acute coronary syndrome.

Objective To investigate the serum level of carboxy-terminal telopeptide of type I collagen (ICTP) and explore its correlation with MMP-2 and MMP-9 in patients with coronary artery disease (CHD). Methods A total of 103 CHD patients treated in our hospital between October, 2013 and May, 2014 were enrolled, including 39 with stable angina pectoris (SAP), 39 with unstable angina (UA), and 25 with acute myocardial infarction (AMI), with 38 non-CHD volunteers as the control group. The serum levels of ICTP, MMP-2, and MMP-9 were detected in all the subjects using enzyme-linked immunosorbent assay (ELISA). Results No significant difference in serum levels of MMP-2, MMP-9, or ICTP was found between the control and SAP groups or between UA and AMI groups (P>0.05), but the latter two groups had significantly higher serum levels of MMP-2, MMP-9, and ICTP than the former two groups (P<0.05). Serum ICTP level was found to negatively correlated with the fibrotic area and positively with the lipid component in the plaques (P<0.05). Regression analysis revealed significant positive correlations of serum ICTP with MMP-2 and MMP-9 (P<0.05). Conclusions An elevated serum ICTP level is indicative of the presence of unstable plaques in CHD patients. Serum ICTP is more strongly correlated with MMP-2 than with MMP-9, and can be used as a non-invasive marker for assessing vulnerable plaques in patients with acute coronary syndrome.