Objective To explore the efficacy and safety of using a tourniquet in amputation for lower limb gangrene. Methods All patients underwent amputation for lower limb gangrene from January,2009 to June,2023 in Beijing Bo'ai Hospital were reviewed,involving 41 patients with a total of 44 limbs,and they were divided into non-tourniquet group(n=28)and tourniquet group(n=16)according to whether a tourniquet was used during surgery.The am-putation field clearness,surgical bleeding,incision healing,reoperation rate within 30 days post-operation,intra-operative blood pressure and heart rate,and operation time were compared. Results The amputation field was clearer in the tourniquet group(χ2=42.385,P＜0.001),with less bleeding(Z=-2.082,P＜0.05).No tourniquet-related local damages,such as nerve damage and skin injuries,was observed in the limbs using tourniquets.The incidence of grade A of incision healing was not significantly different(χ2=0.028,P=0.624). Conclusion Application of tourniquet can improve the amputation field clearness and reduce bleeding during amputation for lower limb gangrene,without affecting incision healing.

Objective To analyze the impact of different clinical and rehabilitation characteristics on the prognosis of diabetic foot amputees. Methods Related literatures were searched in CNKI,Wanfang Data,PubMed,Cochrane Library and Google Scholar from establishment to August,2024.The literatures were screened and extracted by two researchers independent-ly,the Newcastle-Ottawa Scale(NOS)and the evaluation criteria recommended by Agency for Healthcare Re-search and Quality(US)were used for quality evaluation,and literatures with above medium quality were includ-ed,and a systematic review was conducted. Results A total of 17 articles involving 9 239 subjects were included,in which three were Chinese,and 14 were English.The study designs were case-control study,cohort study and cross-sectional study.They mainly came from the fields of rehabilitation medicine,orthopedics,sports medicine and disability studies,and were published between 1998 to 2023.Clinical and rehabilitation characteristics related to the prognosis of diabetic foot amputees includ-ed amputation level,socioeconomic determinants(educational attainment,economic status,social participation,etc.),psychological states(anxiety,depression,etc.)and physiological factors(age,gender,pain,prosthetic limb usage,and ambulatory capacity,etc.).These different characteristics could affect the quality of life of diabetic foot amputees,and even lead to re-amputation or death. Conclusion Factors of amputation level,socioeconomic status,psychological status and physiological status are impor-tant for poor prognosis in diabetic foot amputees.Controlling the above factors can effectively reduce the re-am-putation rate and mortality,and improve the quality of life in diabetic foot amputees,thus improving their progno-sis,and promoting functional rehabilitation.

ObjectiveTo compare the effect of proprioceptive neuromuscular training methods on pain and motor ability of knee in patients with early knee osteoarthritis (KOA) . MethodsFrom November, 2022 to May, 2023, 60 early KOA patients from Beijing Bo'ai Hospital and community were randomly divided into groups A, B and C, with 20 patients in each group. Group A received proprioceptive neuromuscular facilitation (PNF), group B received neuromuscular exercise (NEMEX), and group C received PNF and NEMEX, for six weeks. They were assessed with Visual Analogue Scale for pain (VAS), angle reappearance test, difference of pre-motor reaction time (VM-VL), active range of motion (AROM) of knee flexion, 10-meter walk test (10MWT), and Knee Injury and Osteoarthritis Outcome Score (KOOS) before and after treatment. ResultsAll the indexes improved in all the groups after treatment (|t| > 2.532, P < 0.05). Among the groups, the VAS score was the least in group A, and then groups C and B; the angle reappearance error was the least in group C, and similar in groups A and B; the VM-VL was the least in groups A and C, followed by group B. ConclusionPNF, NEMEX and PNF+NEMEX can relieve the pain and improve the motor function of knee in patients with early KOA, however, PNF is the most effective on relieving pain, and PNF+NEMEX is the most effective on improving knee function.

ObjectiveTo conduct a systematic review of the susceptibility gene polymorphism sites of primary knee osteoarthritis (PKO). MethodsThe literature on genetic susceptibility and gene polymorphisms of PKO were retrieved from PubMed, Web of Science, CNKI, Wanfang Data, and China Biomedical Literature Database from establishment of the library to December, 2020, and systematically reviewed. ResultsA total of 42 papers on the polymorphism sites of human PKO susceptibility genes were included, involving cellular signaling pathways related to PKO pathogenesis, including inflammatory response, receptor signaling pathway, transcription factor signaling pathway, bone-related signaling pathway, etc. Multiple gene polymorphism sites located in inflammatory factor genes, chemokine genes, Toll-like receptor genes, transcription factor genes, obesity-related genes, and bone-related genes. ConclusionInflammatory factor genes and bone-associated allele polymorphisms are likely to be related to PKO susceptibility.

Hemophilia B is a genetic disorder caused by coagulation factor Ⅸ(FⅨ) deficiency, mainly manifesting as joint, muscle and deep tissue bleeding. Hemophilia pseudotumor is a mass formed by soft tissue liquefaction and necrosis caused by repeated bleeding. Most pseudotumors occur in the bone and muscle. We report a case of hemophilia B with pseudotumor formation in the pelvis and abdomen, where lesion location is relatively rare. After active and effective hemostasis, the patient's hematuria symptom gradually improved. This case suggests that early and timely hemostatic treatment is crucial for patients with hemophilia.

OBJECTIVE：To investigate the effects of curcumin on bone metabolism balance in ovariectomized osteoporosis model rats ，and to investigate its potential mechanism. METHODS ：Totally female Wistar rats were randomly divided into blank group（group A ），model group （group B ），estradiol group [group C （positive control ），estradiol valerate 50 μg（/ kg·d）]， curcumin low-dose ，medium-dose and high-dose groups [group D-F ，55，110，165 μg（/ kg·d）]，with 15 rats in each group. Except for group A ，other rats were ovariectomized to establish osteoporosis model. After modeling ，group A and B were given normal saline intrgastrically ，and administration groups were given relevant medicine intrgastrically 30 mL/kg，once a day ，for consecutive 12 weeks. The contents of serum bone metabolism markers [BALP ，CBF-α1，CTX-Ⅰ，PINP and OC] were determined by ELISA. The bone mineral density （BMD）and trabecular structure indexes [relative bone volume fraction （BV/TV），trabecular number （Tb.N），trabecular thickness （Tb.Th），connectivity density （Conn. D ），trabecular separation （Tb.Sp）and structure model index （SMI）] were determined by micro CT imaging system. The mRNA and protein expression of OPG and RANKL in hypothalamus and femur were determined by RT-PCR and Western blotting assay. RESULTS ：Compared with group A ，the contents of serum bone metabolism markers ，BMD，BV/TV，Tb.N，Tb.Th，Conn.D，mRNA and protein expression of OPG were decreased significantly in group B ，while Tb.Sp ，SMI，mRNA and protein expression of RANKL were increased significantly @qq.com （P＜0.05）. Compared with group B ，the contents of serum bone metabolism markers ，BMD，BV/TV，Tb.N，Tb.Th，Conn.D，mRNA and protein expression of OPG were increased significantly in administration groups ；Tb.Sp，SMI，mRNA and protein expression of RANKL were decreased significantly ，in a dose-dependent manner among curcumin groups （P＜0.05 or P＜0.01）. CONCLUSIONS ：Curcumin can improve the level of bone metabolism，increase BMD ，improve the trabecular microstructure and inhibit bone absorption in ovariectomized osteoporosis model rats. Its mechanism may be related to the regulation of OPG/RANKL signaling pathway.

Objective ThispaperpresentedaninvestigationonthesimilaritiesanddifferencesintheclinicalfeaturesandCTfindings betweenallogeneichematopoieticstem celltransplantation (allo-HSCT)inducedandnon-transplantinducedair-leaksyndromes (ALS)inpatientssufferingfromhematopathy,toimprovetheunderstandingofALSinpatientswithhematopathy.Methods Retrospective analysesandcomparisonsofclinicaldataandCTimageswereconductedbetweenGroupA (12patientswithALSafterallo-HSCT) andGroupB (26patientswithnon-transplant-relatedALS).A M annG W hitney U testwasperformedtoevaluatethemeasurementdata, andthe χ 2testor Fisher exacttestwasconductedtoexaminetheenumerationdata.Differencethresholdsof P＜0.05from bothsides weretakentobethedeterminantforstatisticalsignificance.Results TheincidenceratesofALSinpatientswithhematopathyafter anallo-HSCTwerefoundtobesignificantlyhigherthanthoseinpatientsonwhomsuchtransplantshadnotbeenperformed(1.84%. vs.0.06%),P＜0.001.SymptomsofdyspneaweremuchmorefrequentlyobservedingroupAcomparedtogroupB (7/12vs1/26), P＜0.01;whereasthedifferencesforthesymptomsofchesttightness,chestpain,andpharyngalgia werenotadequateintermsofstatistical significance,P＞0.05.IngroupA,theoccurrencesofALSsecondarytolongonsetnon-infectionpulmonarycomplications(LONIPC) associatedwithchronicgraft-versus-hostdisease(cGVHD)werefoundin8/12patients,whereastheoccurrencesin15/26patients weresecondarytopulmonaryinfectioningroupB,P＜0.01.Therewerenostatisticallysignificantdifferencesinage,gender,BMI, backgroundblooddisease,basictreatmentcounts,CTtype,treatmentmethodsandCTdisappearancetimelengthbetweenthetwo groups,P＞0.05.Conclusion Thereweredifferencesintheincidencerates,basiclungdiseasesandclinicalsymptomsbetweenallo-HSCT inducedandnon-transplantinducedALSinpatientssufferingfromhematopathy.Hematopathy-associatedALSwascommoninyoung adultswithlankypostures,patientswithleukemiaasback-grounddisease,patientswithahistoryofchemotherapyandpatientswith pulmonarydiseases.Thecommonsymptomsofpatients with hematopathy-associated ALS were chesttightness and chest pain,andpatients’overallprognosisweregood,meanwhileCT manifestationsweremainlycharacterizedbymixedpulmonary interstitialemphysema(PIE)+pneumomediastinum (PM)andsimplepneumothorax (PT).

Objective: To analyze the genotypes, amino acid vatiations and molecular epidemiological characteristics of respiratory syncytial virus (RSV) infection in pediatric patients in Gansu province for the future research. Methods: A total of 4 556 respiratory tract specimens were colleted from pediatric patients under 10 years of age in five cities in Gansu from 2012 to 2017. These specimens were tested for RSV and its subtypes.The coding region of the RSV G gene was amplified using reverse transcription-polymerase chain reaction (RT-PCR) and sequenced for RSV positive specimens. Sequences were edited using DNA Star software. Sequence alignment and phylogenetic trees were built by MEGA 6.0 software. Results: Out of 4 556 specimens, 1 135 (24.91%) were positive for RSV, totally 216 G protein sequences were obtained. RSV A isolates were clustered into three genotypes: NA1、NA3 and ON1. The nucleotides and amino-acid homology was 84.9%-100% and 77.3%-100%, respectively. The nucleotides and amino-acid homology between this study and prototype long strain was 81.2%-83.3% and 74.1%-88.0%. RSV B isolates were clustered into only BA9 one genotypes. The nucleotides and amino-acid homology was 97.7%-100% and 95.8%-100%, respectively. The nucleotides and amino-acid homology between this study and prototype CH18537 strain was 84.9%-85.7% and 77.9%-80.1%. Conclusions The genetic characteristics and the amino-acid changes were analyzed systematically using data of RSV G gene collected from 2012 to 2017 in Gansu province in this study. These data were used for analyses of the etiology, control and prevention of RSV infection.

Objective To observe the influence of tea pigment on myocardial contractility,electrocardiogram(ECG) and heart rate in exsomatized toads under the condition of myocardialischemia.Methods Sixty toads were divided into the normal exsomatized toad heart group(A) and myocardial ischemia toad heart(B).Then the group A was re-divided into the Ringer's solution group (A1),tea pigment low dose(200 mg/L) group(A2) and the high dose(400 mg/L) group(A3);the group B was re-divided into the pituitrin model group(B1),pituitrin + tea pigment low dose(200 mg/L) group(B2) and high dose(400 mg/L) group(B3).The BL-420S biological function experiment system was used to record the myocardial contractile force and ECG change curve of exsomatized toad.Results Compared with the group A1,the myocardial contractility in the group A3 was obviously increased(P＜0.05),the difference in the group A2 had no statistical significance(P＞0.05);the QRS peak value of ECG and heart rate had no statistically significant difference(P＞0.05);compared with the group A1,the myocardial contractility,ECG QRS peak value and heart rate in the group B1 were significantly decreased(P＜0.05);compared with the group B1,the myocardial contractility,ECG QRS peak value and heart rate in the group B2 and B3 were significantly increased(P＜0.05).Conclusion Tea pigment can obviously improve the decrease of the exsomatized toad cardiac activity caused by myocardial ischemia.

Objective To compare the anatomical differences of tibia osteotomy between Han and Uygur populations and to analysis their compatibility with imported prosthesis component.Methods Two hundred patients (400 knees) were selected from the outpatients and healthy volunteers of the non-knee joint disease from September 1,2012 to December 1,2014,with 86 men (172 knees) and 114 women (228 knees).The average age is 44.64-10.8 years (range 21-68 years old).According to the populations,the subjects were divided into Han group and Uygur group.Furthermore,each group was divided into male subgroup and female subgroup.A full-length CT scan of the lower limb was conducted to reconstruct the knee joint in the workstation.The tibial osteotomy was simulated in total knee arthroplasty.The transverse diameter of the tibial cross section,the longitudinal depth of the medial platform and the depth of the lateral platform were measured.The front and back diameter and aspect ratio of the osteotomy were calculated.There parameters were compared between the Han and Uygur groups.Five mm tolerance range method was used to analysis the cover rate of the following three kinds of commercially imported prosthesis,namely Depuy,Link and Zimmer.Results The mean value of the tibial cross section were 72.3±4.3 mm,50.7±3.1 mm,47.8±3.0 mm,49.3±2.9 mm and 0.682±0.021 in Han group,while those were 74.5±4.8 mm,51.4±3.0 mm,48.6±2.8 mm,50.0±2.9 mm and 0.672±0.020 in Uygur group,respectively.Except the aspect ratio,the average value of each parameter in Uygur group was greater than that in the Han group with statistically significant differences between the two populations.The cover rate of the three kinds of prosthesis tibial component were 53.0％,37.0％ and 40.0％ for Han group,but 61.0％,43.0％ and 42.5％ for Uygur group.Depuy prosthesis was fit for the Uygur population better.Conclusion The geometry and anatomy of proximal tibia in Chinese showed significant difference between Han and Uygur populations.The mean covering rates of the imported tibial components were low in the dimensions of the resected surface.We can improve the prosthesis and the matching degree by adjusting the parameters or increasing the model set.