ObjectiveTo observe the clinical effectiveness and safety of Xiaozhong Zhitong Mixture （消肿止痛合剂） combined with antibiotic bone cement in the treatment of diabetic foot ulcer （DFU） with damp-heat obstructing syndrome. MethodsA total of 72 DFU patients with damp-heat obstructing syndrome were randomly assigned to treatment group （36 cases） and the control group （36 cases）. Both groups received standard treatment and topical antibiotic bone cement for ulcer wounds， while the treatment group received oral Xiaozhong Zhitong Mixture （50 ml per time， three times daily） in additionally. Both groups underwent daily wound dressing changes for 21 consecutive days. Ulcer healing rate， serum levels of tumor necrosis factor-alpha （TNF-α）， interleukin-1 beta （IL-1β）， malondialdehyde （MDA）， superoxide dismutase （SOD）， C-reactive protein （CRP）， and white blood cell （WBC） count were observed before and after treatment， and visual analog scale （VAS） scores for wound pain， traditional Chinese medicine （TCM） syndrome scores， and the DFU Healing Scale （DMIST scale） were also compared. Liver and kidney function were evaluated before and after treatment， and adverse events such as allergic reactions， worsening ulcer pain were recorded. ResultsTotally 35 patients in the treatment group and 33 in the control group were included in the final analysis. The ulcer healing rate in the treatment group was （87.93±9.34）%， significantly higher than （81.82±12.02）% in the control group （P = 0.035）. Compared to pre-treatment levels， both groups showed significant reductions in serum CRP， WBC， MDA， IL-1β， and TNF-α levels， with an increase in SOD level （P＜0.05）. TCM syndrome scores， VAS， and DMIST scores also significantly decreased in both groups （P＜0.05）， with greater improvements in the treatment group （P＜0.05）. No significant adverse reactions were observed in either group during treatment. ConclusionXiaozhong Zhitong Mixture combined with antibiotic bone cement has significant advantages in promoting DFU healing， reducing inflammatory response， and alleviating oxidative stress in DFU patients with damp-heat obstructing syndrome， with good safety for DFU patients with damp-heat obstructing syndrome.

Objective:To investigate the level of rehabilitation exercise adherence in patients undergoing anterior cruciate ligament (ACL) reconstruction within 6 months post-surgery, analyze its trajectory, and provide a reference for clinical nursing interventions.Methods:Using a convenience sampling method, 150 patients who underwent arthroscopic ACL reconstruction at the First Affiliated Hospital of Zhengzhou University from June 2022 to August 2023 were selected. Rehabilitation exercise adherence was assessed monthly from postoperative 1 month (M 1) to 6 months (M 6) using the Orthopedic Functional Exercise Adherence Scale. A latent class growth model was employed to analyze adherence trajectory categories, and Logistic regression was used to identify influencing factors for different adherence trajectories. Results:A total of 144 patients completed follow-up (follow-up rate was 96.00%). Exercise adherence scores gradually declined over the 6 months post-surgery, with scores of (50.30±5.39), (45.92±3.85), (39.48±5.27), (35.83±6.19), (31.85±7.59), and (29.88±7.88) from M 1 to M 6, respectively. The difference in scores across time points was statistically significant ( F=85.467, P<0.01). Three potential categories were identified through the latent class growth model: the moderate-high level rapid decline group ( n=65, 45.14%), the moderate-low level stable group ( n=32, 22.22%), and the moderate-low level slow decline group ( n=47, 32.64%). Logistic regression analysis revealed that gender and age were significant factors influencing adherence trajectory categories ( P<0.05) . Conclusions:Dynamic declines in rehabilitation exercise adherence are common among ACL reconstruction patients, with varying degrees of decline. Gender and age may influence adherence trajectories, suggesting that targeted management strategies could be implemented in clinical practice.

Objective:To investigate the level of rehabilitation exercise adherence in patients undergoing anterior cruciate ligament (ACL) reconstruction within 6 months post-surgery, analyze its trajectory, and provide a reference for clinical nursing interventions.Methods:Using a convenience sampling method, 150 patients who underwent arthroscopic ACL reconstruction at the First Affiliated Hospital of Zhengzhou University from June 2022 to August 2023 were selected. Rehabilitation exercise adherence was assessed monthly from postoperative 1 month (M 1) to 6 months (M 6) using the Orthopedic Functional Exercise Adherence Scale. A latent class growth model was employed to analyze adherence trajectory categories, and Logistic regression was used to identify influencing factors for different adherence trajectories. Results:A total of 144 patients completed follow-up (follow-up rate was 96.00%). Exercise adherence scores gradually declined over the 6 months post-surgery, with scores of (50.30±5.39), (45.92±3.85), (39.48±5.27), (35.83±6.19), (31.85±7.59), and (29.88±7.88) from M 1 to M 6, respectively. The difference in scores across time points was statistically significant ( F=85.467, P<0.01). Three potential categories were identified through the latent class growth model: the moderate-high level rapid decline group ( n=65, 45.14%), the moderate-low level stable group ( n=32, 22.22%), and the moderate-low level slow decline group ( n=47, 32.64%). Logistic regression analysis revealed that gender and age were significant factors influencing adherence trajectory categories ( P<0.05) . Conclusions:Dynamic declines in rehabilitation exercise adherence are common among ACL reconstruction patients, with varying degrees of decline. Gender and age may influence adherence trajectories, suggesting that targeted management strategies could be implemented in clinical practice.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

OBJECTIVE To screen potential adverse drug event （ADE） signals for the treatment of multiple sclerosis （MS） with ofatumumab， and to provide reference for the safe use of drugs in clinical practice. METHODS Using “ofatumumab” and the trade name “Kesimpta” as the search keywords， adverse event （AE） reports related to ofatumumab included in FDA Adverse Event Reporting System database from January 2009 to December 2023 were screened， and their reason contained the “multiple sclerosis”； ADE signal mining and analysis were conducted by reporting odds ratio method and proportional reporting ratio method. RESULTS A total of 21 759 eligible AE reports were selected， involving 62 449 AE cases； 27 system organ classes included general diseases and various reactions at the site of administration （15 021 cases）， neurological diseases （9 668 cases）， infectious and invasive diseases （5 967 cases）， injury， poisoning and surgical complications （4 952 cases）， musculoskeletal and connective tissue disorders （4 647 cases）. A total of 21 759 AE reports correspond to 606 ADE signals， including 234 ADE positive signals. A total of 107 ADE positive signals were not included in drug instruction of ofatumumab， including flu-like diseases， nasopharyngitis， cough， urinary tract infection， sore throat， insomnia， runny nose， anemia， hair loss， atrial fibrillation， and thrombocytopenia， etc. CONCLUSIONS In the process of using ofatumumab for MS， sufficient attention should be paid to ADE included in drug instructions. The ADE with strong signal strength screened in this study should also be paid special attention to， such as flu-like diseases， hemocytopenia， temperature intolerance， optic neuritis， and moyamoya disease. The increased risk of infection， cardiovascular disease， and potential damage to the respiratory and spiritual systems caused by ofatumumab can not be ignored.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To analyze the risk factors of neck pain in fighter pilots . Methods Cluster random sampled fighter pilots were investigated by a cross-sectional survey .The questionnaire included daily neck pain ,as well as such exposure factors as personal general conditions ,life styles and flight traing styles .The subjects with daily neck pain were constituted to the neck pain group and those without daily neck pain were selected as the control group .The differences in age ,body mass index ,lifestyle and training styles were compared between two groups .Then the risk factors were analyzed by a Logistic regression model . Results Data of 429 fighter pilots were validated and were analyzed .The prevalence of daily neck pain was 30 .1% .The differences on the proportions of age over 35 yr ,sleep disorders ,improper measures against annoyance ,sedentary habit ,more than 4 hours of consumer electronics watching per day ,more than 2 hours of sustained monitor watching frequently , mattress too hard , long-term flight , vibration influence in flight , insufficient protection measures against +Gzload ,and no massage relaxation after flight showed statistically significance between two groups (χ2＝5 .662～32 .128 , P＜0 .05) .Totally 6 latent risk factors of neck pain were concerned by Logistic regression model .The descending risk orders of the factors were the age over 35 yr (OR＝11 .397) ,sleep disorders (OR ＝ 3 .013 ) , improper measures against annoyance (OR ＝ 2 .758 ) , awkward neck posture during flight (OR＝2 .618) ,watching consumer electronics more than 4 hours per day (OR＝2 .192) and continuously watching monitor more than 2 hours frequently (OR＝1 .899) . Conclusions The prevalence of daily neck pain in fighter pilots was comparatively high .Life styles effectively influence the invasion of neck pain in fighter pilots according to the study .Insufficient work and rest alternation and unreasonable emotion regulation would be the important risk factors to the daily neck pain in fighter pilots .

Objective To analyze the risk factors of neck pain in fighter pilots . Methods Cluster random sampled fighter pilots were investigated by a cross-sectional survey .The questionnaire included daily neck pain ,as well as such exposure factors as personal general conditions ,life styles and flight traing styles .The subjects with daily neck pain were constituted to the neck pain group and those without daily neck pain were selected as the control group .The differences in age ,body mass index ,lifestyle and training styles were compared between two groups .Then the risk factors were analyzed by a Logistic regression model . Results Data of 429 fighter pilots were validated and were analyzed .The prevalence of daily neck pain was 30 .1% .The differences on the proportions of age over 35 yr ,sleep disorders ,improper measures against annoyance ,sedentary habit ,more than 4 hours of consumer electronics watching per day ,more than 2 hours of sustained monitor watching frequently , mattress too hard , long-term flight , vibration influence in flight , insufficient protection measures against +Gzload ,and no massage relaxation after flight showed statistically significance between two groups (χ2＝5 .662～32 .128 , P＜0 .05) .Totally 6 latent risk factors of neck pain were concerned by Logistic regression model .The descending risk orders of the factors were the age over 35 yr (OR＝11 .397) ,sleep disorders (OR ＝ 3 .013 ) , improper measures against annoyance (OR ＝ 2 .758 ) , awkward neck posture during flight (OR＝2 .618) ,watching consumer electronics more than 4 hours per day (OR＝2 .192) and continuously watching monitor more than 2 hours frequently (OR＝1 .899) . Conclusions The prevalence of daily neck pain in fighter pilots was comparatively high .Life styles effectively influence the invasion of neck pain in fighter pilots according to the study .Insufficient work and rest alternation and unreasonable emotion regulation would be the important risk factors to the daily neck pain in fighter pilots .

Objective To study the effects of Shuanghuanglian Oral Solution (only for children) on general condition, body weight, food intake, growth and development, blood routine and pathologic changes of SD weanling rats; To provide experimental references for clinical safe medication.Methods SD weanling rats were randomly divided into control group,Shuanghuanglian (only for children) Oral Solution low-, medium- and high-dose group according to body mass, with 30 rats in each group. Each administration group was given corresponding amount of Shuanghuanglian Oral Solution (only for children) concentrated ointment for gavage, once a day, for 33 d. The toxicity of the rats during dosing period and recovery period (medicine withdrawal 25 d) was observed.Results There were no significant differences in general condition, individual development, organ mass and coefficient, and internal fixation and pathological findings of rats in administration groups during dosing period and recovery period. The body mass and food intake of female and male rats in the Shuanghuanglian Oral Solution high-dose group were lower than those in the control group. The blood routine test during dosing period showed that the lymphocyte ratio of female rats and male rats in Shuanghuanglian Oral Solution high-dose group decreased significantly, neutrophil ratio increased significantly, and then returned to normal level in recovery period.Conclusion Shuanghuanglian Oral Solution (only for children) concentrated ointment has no toxic effect on the whole body organs and tissues of juvenile rats, and the safety is good.

Objective To investigate the prevalence of daily neck pain (DNP) and fly-related neck pain(FNP) in fighter pilots and to estimate how neck symptoms influenced operational flying in fighter pilots,so as to provide elementary data for further investigation of risk factors and preventive measure.Methods Two hundred and thirty three fighter pilots,including 94 high-performance fighter pilots and 139 conventional fighter pilots,were surveyed on self-reported prevalence of DNP and FNP in past 1-yr.The pilots were grouped into with DNP and healthy groups by prevalence of DNP,and the FNP prevalence was compared between these two groups.The prevalences of DNP and FNP were compared between high-performance fighter pilots and conventional fighter pilots.Pilots also described how FNP influenced operational flying.Results Among all pilots,32.6％ had experienced DNP,59.7％ had experienced FNP and 17.2％ had experienced frequent FNP.DNP pilots had statistically higher FNP and frequent FNP prevalence than healthy pilots (x2=41.665,54.669,P＜0.01).Comparing with conventional fighter pilots,high performance fighter pilots had no statistically different DNP and FNP prevalence,but had statistically different frequent FNP prevalence(x2 =7.753,P＜0.01).Among the pilots with FNP,18.7％ reported neck pain impacted flying endurance,20.1％ reported impacted ability of concentration or stamina,37.4％ reported impacted ability of observation or target searching,59.7％ reported impacted agile operation or high G maneuvers.Among high performance fighter pilots with FNP,67.8％ reported restricted air combat maneuvers resulted from FNP.Conclusions Prevalence of daily neck pain and fly-related neck pain are considerably high in fighter pilots.Pilots with daily neck pain are more easily to experience fly-related neck pain,indicating that their neck functions are steadily weakened and require prompt and effective intervention.High performance fighter pilots are more easily to experience frequent fly-related neck pain.The fly-related neck pain affects operational flying in many ways.Those findings highlight the stricter demand of neck function for high performance fighter pilots and the necessary support to air service.