OBJECTIVE: To investigate effectiveness of simplified all-arthroscopic Broström technique in treatment of chronic lateral ankle instability in adolescents. METHODS: A clinical data of 21 adolescent patients with chronic lateral ankle instability, who met the selection criteria and were admitted between June 2023 and May 2024, was retrospectively analyzed. There were 18 males and 3 females with an average age of 16.0 years (range, 13-18 years). There were 9 cases of left ankle joint injury and 12 cases of right ankle joint injury. Anterior talofibular ligament (ATFL) injury was diagnosed by arthroscopy in all patients. There were 11 cases of cartilage injury, 5 cases of avulsion fractures, and 6 cases of ankle impingement syndrome. The time from first sprain to operation ranged from 3-60 months (mean, 12.0 months). The ATFL was repaired and the ankle joint stability was restored by simplified all-arthroscopic Broström technique. Visual analogue scale (VAS) score, Tegner score, American Orthopaedic Foot and Ankle Society (AOFAS) score, Karlsson ankle function scale (KAFS) score, Foot and Ankle Outcome Score (FAOS) were used to evaluate ankle pain and function. MRI was used to evaluate the ligament healing. RESULTS: All patients were followed up 8-15 months (mean, 12.6 months). After operation, 1 patient suffered from superficial peroneal nerve injury, 1 patient developed anterior scar impingement on the ankle, 2 patients had superficial wound infection, and 1 patient suffered from sprain again. The VAS score, Tenger score, AOFAS score, KAFS score, and FAOS score significantly improved when compared with the preoperative scores ( P<0.05). MRI examination showed the ligament healing and good tension. CONCLUSION For adolescent patients with chronic lateral ankle instability, using simplified all-arthroscopic Broström technique to repair ATFL can effectively alleviate ankle pain, improve stability, and achieve good effectiveness.
Humans ; Joint Instability/surgery* ; Male ; Adolescent ; Female ; Arthroscopy/methods* ; Ankle Joint/physiopathology* ; Retrospective Studies ; Ankle Injuries/surgery* ; Lateral Ligament, Ankle/injuries* ; Treatment Outcome ; Chronic Disease ; Range of Motion, Articular

BACKGROUND:Several observational studies have found a close relationship between thyroid function levels and sarcopenia,but the causal relationship between thyroid function levels and the onset of sarcopenia is not yet clear. OBJECTIVE:To investigate the causal relationship between thyroid function levels and sarcopenia using a two sample Mendelian randomization method. METHODS:A two sample Mendelian randomization analysis was conducted using genome-wide association study data on thyrotropin,free triiodothyronine,free tetraiodothyronine,subclinical hyperthyroidism,subclinical hypothyroidism,and four related phenotypes of sarcopenia-lefthand grip strength,right hand grip strength,limb lean mass,and gait speed.The inverse-variance weighted method,weighted median method,simple mode method,weighted median estimator method,and MR Egger regression method were used as analysis methods,while heterogeneity test,pleiotropy test,MR-PRESSO,leave-one-out method,funnel plot and other methods were used for sensitivity analysis. RESULTS AND CONCLUSION:Elevated levels of thyroid-stimulating hormone increased left-(β=0.02,SE=0.01,P=0.01)and right-handed grip strength(β=0.02,SE=0.01,P=0.01),an increase in free triiodothyronine decreased left-(β=-0.06,SE=0.02,P=9.5×10-5)and right-handed grip strength(β=-0.07,SE=0.02,P=9.3×10-5),and subclinical hyperthyroidism decreased gait speed(β=-4.4×10-3,SE=1.7×10-3,P=0.01).The sensitivity analysis results were basically consistent with the main analysis results.To conclude,an increase in thyroid-stimulating hormone is a protective factor for sarcopenia,and elevation of free triiodothyronine and subclinical hyperthyroidism may increase the risk of sarcopenia.

Objective:To evaluate the quality of domestic and international nutritional guidelines for inflammatory bowel disease (IBD) from 2013 to 2024 and interpret them, with the aim of providing a reference for clinical practice.Methods:Computer searches were conducted in databases, guideline websites, and professional society websites to collect relevant literature on nutritional guidelines for IBD, with the search period ranging from January 2013 to June 2024. After screening the literature and extracting data, two evaluators independently assessed the quality of the included guidelines, and the drfferences in recommendations between domestic and foreign guidelines were compared.Results:A total of nine adult IBD nutritional guidelines were ultimately included, with the ESPEN guidelines scoring the highest. Domestic guidelines had lower quality scores compared to international guidelines, particularly in terms of rigor and independence. All guidelines recommended nutritional screening and assessment; domestic guidelines recommended the NRS-2002 as a nutritional risk screening tool and the patient-generated subjective global assessment (PG-SGA) as a nutritional status assessment tool, while international guidelines did not generally recommend specific tools. The guidelines were relatively consistent in their recommendations for regular monitoring of micronutrients, energy, protein, and other nutrients, and agreed that there is currently no specific diet that can alleviate IBD.Conclusions:There are differences in genetics and eating habits between domestic IBD and foreign IBD. The nutritional management of IBD patients needs comprehensive evaluation and personalized intervention. Nutritional support should be selected according to the specific conditions during the active period, and healthy diet should be followed during the remission period.

Objective:To explore the effective way to improve the protection efficiency of intellectual property rights of medical institutions in the field of biomedicine by building an efficient patent pre-examination management system, so as to promote the transformation of achievements.Methods:Through literature review, case analysis and combined with the actual examination situation of the intellectual property protection center, the study analyzed and summarized the characteristics of long R&D cycle, rapid technology iteration, multidisciplinary intersection in the field of biomedicine, and the necessity of hospitals to carry out patent pre-examination work.Results:The pre-examination awareness of scientific researchers in medical institutions was weak, the drafting of application documents was not standardized, and the patent achievements were out of touch with the market.Conclusions:To accelerate intellectual property conversion of innovation achievements, innovation management strategies should be implemented: standardized processes, pre-evaluation, professional team support, process control and talent cultivation.

BACKGROUND:It has been shown that Gushukang affects bone metabolism by regulating nucleotide and amino acid metabolism and immune mechanisms.Current research on the mechanism of Gushukang in the treatment of osteoporosis primarily focuses on osteoblast regulation and requires further improvement from the perspective of osteoclasts. OBJECTIVE:To investigate the mechanism by which Gushukang interferes with osteoclasts in the treatment of osteoporosis using RAW264.7 cells as the research model. METHODS:Twenty-four 8-week-old female Sprague-Dawley rats were randomly divided into four groups(n=6 per group):the three experimental groups were given 1,2 and 4 g/kg osteoporosis solution by gavage(2 times per day),and the control group was given an equal amount of distilled water by gavage(2 times per day).After 7 days of intragastric administration,aortic blood samples were extracted to collect serum samples using centrifugation,and serum samples from the same groups were combined to obtain the low-,medium-,and high-concentration Gushukang-containing and normal sera for the subsequent experiments.(1)RAW264.7 cells were cultured in six groups:normal serum was added to the control group;low,medium,and high concentration groups were added with low,medium,and high concentrations of Gushukang-containing serum,respectively;ML385,a nuclear factor erythroid 2-related factor 2(Nrf2)inhibitor was given in the Nrf2 inhibitor group;and t-BHQ,a Nrf2 activator,was added in the Nrf2 activator group.Cell viability was detected using the cell counting kit-8 assay.(2)The 3rd generation RAW 264.7 cells were cultured and divided into five groups:the blank control group was added with normal serum,the osteoclast group was added with receptor activator of nuclear factor κB ligand(RANKL),and the low-,medium-,and high-concentration groups were added with low-,medium-,and high-concentration Gushukang-containing serum based on the addition of RANKL.Tartrate-resistant acid phosphate staining was performed after 5 days of culture.(3)RAW264.7 cells were cultured and divided into five groups:blank control group was cultured with normal serum,osteoclast group cultured with normal serum and RANKL,high concentration+osteoclast group cultured with RANKL+high concentration Gushukang-containing serum,osteoclast+Nrf2 agonist group cultured with RANKL+t-BHQ,and high concentration+osteoclast+Nrf2 inhibitor group cultured with RANKL+high concentration Gushukang-containing serum+ML385.Western blot assay and determination of reactive oxygen content were performed after 5 days of culture. RESULTS AND CONCLUSION:The cell counting kit-8 results indicated that Gushukang-containing serum,NRF2 inhibitor or agonist had no significant effect on RAW264.7 cell viability.Tartrate-resistant acid phosphate staining results demonstrated that Gushukang-containing serum exhibited a concentration-dependent inhibitory effect on osteoclast differentiation.Western blot analysis and determination of reactive oxygen species revealed that compared with the blank control group,Nrf2 protein expression was decreased in the osteoclast group(P<0.05),while c-Fos and NFATc1 protein expression and reactive oxygen species content were elevated(P<0.05);compared with the osteoclast group,Nrf2 protein expression was elevated and reactive oxygen species content was decreased in the high-concentration+osteoclast group,osteoclast+Nrf2 agonist group,and high-concentration+osteoclast+Nrf2 inhibitor group(P<0.05),while c-Fos and NFATc1 protein expression was decreased in the high concentration+osteoclast group and osteoclast+Nrf2 agonist group(P<0.05);compared with the high concentration+osteoclast group,Nrf2 protein expression was decreased(P<0.05)and reactive oxygen species content was elevated(P<0.05)in the high concentration+osteoclast+Nrf2 inhibitor group.To conclude,Gushukang reduces reactive oxygen species production by activating Nrf2,thereby inhibiting downstream of the c-Fos/NFATc1 pathway and suppressing osteoclast differentiation.

Objective:To investigate the effect of nourishing yin and tonifying yang method on inflammatory response and bone metabolism in patients with T2DM complicated with osteoporosis (OP).Methods:A randomized controlled trial. From January 2022 to December 2023,80 patients with T2DM and OP in our hospital were selected as the observation objects, and they were divided into two groups by random number table method, with 40 cases in each group.On the basis of conventional treatment, the control group chewed vitamin D calcium chewable tablets, and the observation group added nourishing yin and tonifying yang Chinese medicine.Both groups were treated for 6 months. TCM syndrome scores were performed before and after treatment ;the levels of fasting blood glucose (FPG), 2 hPG and HbA1c were detected by intelligent blood glucose monitor;the levels of serum neutrophils and lymphocytes were detected by automatic blood analyzer, and the neutrophil/lymphocyte ratio (NLR) was calculated;the levels of serum IL-1β and TNF-α were detected by automatic chemiluminescence analyzer, the levels of type I procollagen amino terminal propeptide (PINP), type I collagen carboxy terminal peptide β special sequence (β-CTX) and 25-hydroxy vitamin D3 [25-(OH)D3] were detected by ELISA;Bone mineral density (BMD) was detected by bone mineral density detector. The adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate was 92.5 %(37/40) in the observation group and 75.0 % (30/40) in the control group,the difference between the two groups was statistically significant ( χ2=4.50, P=0.034).After treatment, the scores of soreness and weakness of waist and knees, soreness and pain of waist and back, clear and long urine, pale tongue and white coating in the observation group were lower than those in the control group ( t=3.11, 3.75, 3.51, 3.74, P<0.01);the levels of serum FPG, 2 hPG and HbA1c in the observation group were lower than those in the control group ( t=3.11,3.20,3.39, P<0.01).The levels of serum NLR (2.63 ± 0.68 vs. 3.24 ± 0.79, t=3.70), IL-1β [(81.65 ± 8.30) ng/L vs. (89.03 ± 8.98) ng/L, t=3.82] and TNF-α [(35.14 ± 5.11) μg/L vs. (39.96 ± 5.38) μg/L, t=4.11] in the observation group were lower than those in the control group ( P<0.01). After treatment, the levels of PINP [(29.83 ± 3.92) ng/L vs. (34.02 ± 4.03) ng/L, t=4.71] and β-CTX [(21.30 ± 3.95 ) ng/L vs. (25.32 ± 4.18) ng/L, t=4.42] in the observation group were lower than those in the control group ( P<0.01), the levels of 25-(OH)D3 [(42.86 ± 5.12) μg/L vs. (38.08 ± 4.55) μg/L, t=4.41] and BMD [(0.90 ± 0.18) g/cm 3vs. (0.78 ± 0.16) g/cm 3, t=3.15] were higher than those in the control group ( P<0.01).During the treatment, the incidence of adverse reactions was 12.5% (5/40) in the observation group and 10.0 % (4/40) in the control group,there was no significant difference between the two groups ( χ2=0.13, P=0.723). Conclusion:The method of nourishing yin and tonifying yang can effectively improve the TCM syndromes of T2DM patients with OP, reduce the levels of blood glucose and inflammatory factors, improve bone metabolism, improve clinical efficacy and have good treatment safety.

Objective:To evaluate the quality of domestic and international nutritional guidelines for inflammatory bowel disease (IBD) from 2013 to 2024 and interpret them, with the aim of providing a reference for clinical practice.Methods:Computer searches were conducted in databases, guideline websites, and professional society websites to collect relevant literature on nutritional guidelines for IBD, with the search period ranging from January 2013 to June 2024. After screening the literature and extracting data, two evaluators independently assessed the quality of the included guidelines, and the drfferences in recommendations between domestic and foreign guidelines were compared.Results:A total of nine adult IBD nutritional guidelines were ultimately included, with the ESPEN guidelines scoring the highest. Domestic guidelines had lower quality scores compared to international guidelines, particularly in terms of rigor and independence. All guidelines recommended nutritional screening and assessment; domestic guidelines recommended the NRS-2002 as a nutritional risk screening tool and the patient-generated subjective global assessment (PG-SGA) as a nutritional status assessment tool, while international guidelines did not generally recommend specific tools. The guidelines were relatively consistent in their recommendations for regular monitoring of micronutrients, energy, protein, and other nutrients, and agreed that there is currently no specific diet that can alleviate IBD.Conclusions:There are differences in genetics and eating habits between domestic IBD and foreign IBD. The nutritional management of IBD patients needs comprehensive evaluation and personalized intervention. Nutritional support should be selected according to the specific conditions during the active period, and healthy diet should be followed during the remission period.

Purpose: Anastomotic leakage (AL) is a serious postoperative complication after colorectal cancer surgery, and accurate preoperative prediction remains challenging. This study aimed to develop and validate a magnetic resonance imaging (MRI)–based radiomics nomogram for the preoperative prediction of AL. Methods: A total of 146 patients with colorectal cancer, including 11 with AL, were retrospectively enrolled and randomly divided into training and validation cohorts at a 7:3 ratio. Clinical variables and preoperative MRI-based radiomic features were analyzed. A clinical model was constructed using logistic regression. Radiomic features were selected using the least absolute shrinkage and selection operator method to develop a radiomics model, from which a radiomic score was calculated. A combined radiomics nomogram integrating the radiomic score and significant clinical factors was subsequently established. Model performance was evaluated using receiver operating characteristic curve analysis in both cohorts. Results: The clinical model achieved an area under the curve (AUC) of 0.766 in the training cohort and 0.583 in the validation cohort. The radiomics model demonstrated improved discrimination, with AUCs of 0.822 and 0.800, respectively. The combined radiomics nomogram showed the best predictive performance, yielding AUCs of 0.869 in the training cohort and 0.858 in the validation cohort. Conclusion The proposed MRI-based radiomics nomogram demonstrates good predictive performance for postoperative anastomotic leakage and may serve as a useful tool for preoperative risk stratification in patients with colorectal cancer.

Objective:To explore the effective way to improve the protection efficiency of intellectual property rights of medical institutions in the field of biomedicine by building an efficient patent pre-examination management system, so as to promote the transformation of achievements.Methods:Through literature review, case analysis and combined with the actual examination situation of the intellectual property protection center, the study analyzed and summarized the characteristics of long R&D cycle, rapid technology iteration, multidisciplinary intersection in the field of biomedicine, and the necessity of hospitals to carry out patent pre-examination work.Results:The pre-examination awareness of scientific researchers in medical institutions was weak, the drafting of application documents was not standardized, and the patent achievements were out of touch with the market.Conclusions:To accelerate intellectual property conversion of innovation achievements, innovation management strategies should be implemented: standardized processes, pre-evaluation, professional team support, process control and talent cultivation.

Objective:To investigate the correlation and influencing factors between sarcopenia and cardiac structure and function in elderly inpatients.Methods:A total of 945 elderly patients, aged 60 years and older, were recruited from the Geriatrics Department at Xuanwu Hospital.Sarcopenia was assessed, while cardiac structure and function were evaluated through echocardiography and NT-proBNP measurements.Results:Patients were classified into two groups: a sarcopenia group(n=185, 19.6%)and a non-sarcopenia group(n=760, 80.4%).Compared to the non-sarcopenia group, the sarcopenia group exhibited a reduction in left atrial diameter(LAD), left ventricular end-diastolic diameter(LVEDD), left ventricular mass(LVM), stroke volume(SV), and cardiac output(CO)(all P<0.05).In contrast, NT-proBNP levels were significantly elevated in the sarcopenia group( P<0.001).Multivariate logistic regression analysis identified older age( OR=1.080, P<0.001)and elevated NT-proBNP( OR=1.001, P<0.001)as independent risk factors for sarcopenia.Conversely, higher LAD( OR=0.858, P<0.001)and LVM( OR=0.988, P=0.002)were recognized as independent protective factors.Additionally, NT-proBNP demonstrated a negative correlation with handgrip strength( r=-0.241, P<0.001), gait speed( r=-0.215, P<0.001), SPPB score( r=-0.270, P<0.001), and appendicular skeletal muscle mass(ASM)( r=-0.208, P<0.001), while exhibiting a positive correlation with the 5-time chair stand test( r=0.169, P<0.001).LVM was positively correlated with handgrip strength( r=0.213, P<0.001)and ASM( r=0.456, P<0.001).Furthermore, LAD was positively correlated with handgrip strength( r=0.071, P=0.029)and ASM( r=0.305, P<0.001). Conclusions:Notably, significant differences exist in cardiac structure and function between elderly patients with sarcopenia and those without.Furthermore, indicators related to sarcopenia are correlated with alterations in cardiac structure and function.