Objective To explore the association between knee torsion and multiple bony abnormali-ties of the lower limb in patients with recurrent patellar dislocation(RPD).Methods The preoperative imaging data of RPD patients treated in our institution between May 2020 and October 2024 were col-lected retrospectively.A total of 238 patients were included in this study,with 83.6%being females.All patients underwent standard hip-knee-ankle CT scans,and lower limb bony structural parameters were reconstructed and measured using Mimics 20.0,focusing on variables such as knee torsion,femo-ral anteversion(FAA),femoral distal torsion angle(DFTA),supratrochlear spur,tibial tuberosity to trochlear groove distance(TT-TG),Caton-Deschamps index,and tibial torsion.Bony abnormalities were categorized based on previously established risk thresholds.Moreover,chi-square tests were em-ployed to compare the composition ratio differences between knee torsion and multiple lower limb osse-ous abnormalities.Results Among all affected knees,the proportion of excessive knee torsion was 33.6%,while in cases with osseous abnormalities,the value was over 40%.Compared with cases of low knee torsion,patients with excessive knee torsion showed significantly higher proportions of FAA(41.3%vs.27.2%,P=0.028),excessive DFTA(60%vs.32.9%,P<0.001),supratrochlear spur(55%vs.38.6%,P=0.016),trochlear dysplasia(93.8%vs.73.4%,P<0.001),excessive TT-TG(68.8%vs.43.7%,P<0.001),and patella alta(50%vs.22.2%,P<0.001).Additionally,95%of knees with excessive torsion exhibited two or more bony risk factors,whereas 55%had four or more bony structural abnormalities,which was significantly higher than those of low knee torsion(55%vs.21.5%,P<0.001).Conclusion In RPD patients,excessive knee torsion is associated with multiple low-er limb bony abnormalities.Moreover,patients with high knee torsion(>12°)are significantly more likely to have multiple bony abnormalities than those with low torsion.Therefore,in surgical decision-making for such patients,lower limb bony abnormalities should be assessed comprehensively.

Objective:To evaluate the clinical outcomes of a large-diameter autograft of 8-strand semitendinosus/gracilis (8S-ST/G) in reconstruction of anterior cruciate ligament (ACL).Methods:A retrospective analysis was conducted of the 56 patients with primary ACL injury who had been treated by the 8S-ST/G autograft technique at Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University between January 2019 and January 2022. The cohort included 42 males and 14 females, with an age of (28.3±7.3) years and a body mass index of (24.4±3.3) kg/m 2. There were 28 left and 28 right knees involved. The preoperative posterior tibial slope measured 14.8°±2.8°. The diameter of 8S-ST/G autograft was (9.3±0.7) mm. The postoperative outcomes documented were knee stability (assessed via KT-1000 arthrometer side-to-side difference, Lachman test, and pivot-shift test), graft maturity, graft roof impingement, and complications. Results:The patients were followed up for (2.4±0.3) years postoperatively. The side-to-side difference decreased significantly from preoperative 6.0 (5.0, 8.0) mm to postoperative 2.0 (0.0, 3.0) mm ( P<0.001). The positive rate of high-grade pivot shift (2+, 3+) reduced significantly from 50.0% (28/56) preoperatively to 3.6% (2/56) postoperatively ( P<0.001). The ACL graft signal grades revealed by the MRI at the final follow-up were grade Ⅰ in 45 cases, grade Ⅱ in 7 cases, and grade Ⅲ in 4 cases. After the 15 patients with their preoperative MRI from other hospitals (showing ACL graft signal of grade I in all) were excluded, the anterior subluxation of lateral compartment (ASLC) and anterior subluxation of medial compartment (ASMC) in the other 41 patients at the final follow-up [(4.8±3.1) mm and 3.0 (2.0, 4.9) mm, respectively] showed no significant differences from the preoperative values [(5.9±3.2) mm and 3.9 (0.0, 6.3) mm, respectively] ( P>0.05). However, in the 30 patients with well-preserved ACL graft signal (grade I), both ASLC and ASMC at the final follow-up [(3.9±2.5) mm and 3.0 (1.5, 4.7) mm] showed significant improvements compared to the preoperative values [(5.5±3.1) mm and 5.1 (2.7, 6.2) mm] ( P<0.05). At the final follow-up, 19.6% (11/56) of the patients showed ACL graft laxity; graft failure occurred in 8.9% (5/56) of the patients, one of whom underwent revision surgery. Second-look arthroscopy revealed concomitant cartilage injuries in 12.5% (7/56) of the patients, cyclops lesions in 3.6% (2/56), and ACL graft impingement in 7.1% (4/56). Conclusion:In the treatment of patients with ACL injury, the 8S-ST/G autograft configuration can significantly improve the stability of the knee joint and graft maturity, but it can not effectively correct the ASLC and ASMC for a subset of patients.

The coinfection of respiratory viruses and bacteria is a major cause of morbidity and mortality worldwide, despite the development of vaccines and powerful antibiotics. As a macromolecule that is difficult to absorb in the gastrointestinal tract, a homogeneous polysaccharide from Houttuynia cordata (HCPM) has been reported to exhibit anti-complement properties and alleviate influenza A virus (H1N1)-induced lung injury; however, the effects of HCPM without in vitro antiviral and antibacterial activities on more complicated pulmonary diseases resulting from viral-bacterial coinfection remains unclear. This study established a representative coinfection murine pneumonia model infected with H1N1 (0.2 LD₅₀) and methicillin-resistant Staphylococcus aureus (MRSA, 10⁷ CFU). HCPM significantly improved survival rate and weight loss, and ameliorated gut-lung damage and inflammatory cytokine production. Interestingly, the therapeutic effect of HCPM on intestinal damage preceded that in the lungs. Mechanistically, HCPM inhibited the overactivation of the intestinal complement (C3a and C5a) and suppressed the activation of the NLR family pyrin domain-containing 3 (NLRP3) pathway, which contributes to the regulation of the Treg/Th17 cell balance in the gut-lung axis. The results indicate the beneficial effects of an anti-complement polysaccharide against viral-bacterial coinfection pneumonia by modulating crosstalk between multiple immune regulatory networks.

Objective:To explore the application value of pterygium excision(PE)combined with autologous limbal stem cell transplantation(LSCT)in the treatment of pterygium.Methods:The clinical data of 125 patients with pterygium admitted to Yucheng County People's Hospital from Feb 2021 to Feb 2023 were retrospectively analyzed.The patients were divided into two groups according to the surgical method,with 58 patients undergoing PE combined with amniotic membrane transplantation as the control group and 67 patients undergoing PE combined with LSCT as the observation group.The surgical-related indicators and postoperative complications were compared between the two groups,as well as the pre-and post-operative visual acuity,corneal parameters[corneal astigmatism,corneal fluorescein staining(FL)score],tear secretion function[tear film breakup time(BUT),Schirmer test].Results:The operation time,corneal wound healing time,regression time of hyperemia and edema,and suture removal time in the observation group were shorter than those in the control group(P＜0.01).The visual acuity level in the observation group was higher than that in the control group at 7 days,1 month,and 3 months after surgery(P＜0.05).The corneal astigmatism degree and FL score in the observation group were lower than those in the control group at 1 month and 3 months after surgery,while BUT and Schirmer test were higher than those in the control group(P＜0.05).There was no significant difference in the total incidence of complications between the two groups after surgery(P＞0.05).Conclusion:The combined treatment of PE and LSCT for pterygium is effective,which can accelerate the recovery process after surgery,improve corneal morphology and tear secretion function,enhance visual acuity,and ensure surgical safety.

Objective To construct a LASSO-logistic regression model for the risk of complications of cardiopulmonary resuscitation(CPR)based on clinical data and relevant parameters of external chest compression and to provide a reference for the prevention of com-plications of cardiopulmonary resuscitation.Methods One hundred cardiac arrest survivor patients admitted to Shijiazhuang Circular Chemical Industrial Park Hospital from April 2020 to May 2023 were selected and divided into complication and non-complication groups according to complications.The clinical data,chest compression-related parameters of the 2 groups were compared,and LASSO regression was used to initially screen the influencing factors of CPR complications.Logistic regression was used to analyze the influencing factors of CPR complications,and Nomogram was drawn to predict the risk of CPR complications.Results LASSO regression screening showed that the coefficients of body mass index,thoracic anteroposterior diameter,rescuer education level,and rescuer gender were compressed.When λ was 1.786,the number of influencing factors was minimized,and the model performance was excellent.At this time,seven predic-tive variables including rescuer identity,rescuer CPR training,application of air mattress,application of decompression pad,compression depth,compression duration,and strict control of fluid volume were selected to achieve the best selection of influencing factors.Logistic regression analysis showed that rescuer being a nurse,rescuer having received CPR training,application of air mattress bed,application of decompression pad,and strict control of fluid volume were related protective factors for CPR complications,while compression depth and compression duration were related risk factors for CPR complications(P＜0.05).The nomogram diagram of the logistic prediction model for CPR complication risk showed that its C-index was 0.932,indicating good discrimination,and the calibration curve fitted well with the ideal curve.The constructed prediction model had good consistency with the actual observed results.Conclusion CPR complications included sternal fractures,lung contusions,and rib fractures.The risk closely relates to the rescuer,the rescuer's CPR training,the appli-cation of air mattress bed,the application of decompression pad,the depth of compression,the duration of compression,and the strict con-trol of fluid volume.

Objective To explore the clinical,radiological,and arthroscopic outcomes of anterior cru-ciate ligament(ACL)reconstruction combined with posterior tibial slope(PTS)reducing osteotomy in patients with increased PTS and excessive anterior tibial subluxation(ATS)due to primary ACL inju-ry.Methods This retrospective study included patients who underwent ACL reconstruction between 2016 and 2022 in our department.The inclusion criteria were PTS≥15° and ATS≥6 mm,and all pa-tients received ACL reconstruction combined with PTS reducing osteotomy with a follow-up of more than 2 years.Before and after the operation,they were assessed KT-1000 side-to-side difference(KT SSD),pivot shift grade,Lachman test,anterior tibial subluxation of the medial and lateral compart-ments(ASMC and ASLC),magnetic resonance imaging(MRI),and arthroscopic findings of associat-ed injuries.Moreover,graft laxity was defined as graft laxity observed on MRI or arthroscopy,KT SSD>3 mm,or pivot>1+,while graft failure was defined as graft rupture on MRI or arthroscopy,KT SSD>5 mm,or pivot>2+.Meanwhile,clinical outcomes were compared preoperatively and post-operatively,and graft status and associated injuries were described.Results A total of 30 patients were included,with an average age of 31 years,and 23%of female.The inter-observer reliability for mea-surements of PTS and ATS was greater than 0.80.Compared to preoperative values,postoperative PTS(18.2° vs.6.8°,P<0.001),KT SSD(7.8 mm vs.1.2 mm,P<0.001),ASLC(7.5 mm vs.4.5 mm,P=0.002),and ASMC(5.0 mm vs.2.7 mm,P=0.034),all showed significant improvements.In addi-tion,the proportion of patients with postoperative pivot grade of 2+to 3+(73.3%vs.6.7%,P<0.001)and Lachman grades Ⅱ-Ⅲ(70%vs.3.3%,P<0.001)reduced significantly.At the last follow-up,the incidence of graft laxity was 20%,and that of the graft failure was 13.3%.Among all pa-tients,1 patient(3.3%)had graft roof impingement or cyclops lesion,and 3(10%)suffered from concomitant cartilage injury,with 4(13.3%)undergoing intercondylar notchplasty due to intercondylar notch hyperplasia.However,no complications related to osteotomy,such as infection,non-union,or fixation failure,were observed.Conclusion Over a follow-up period of at least 2 years,for primary ACL injury patients with steep PTS and excessive ATS,combined ACL reconstruction with PTS reduc-ing osteotomy improves knee stability,but significantly reduces PTS,the incidence of severe pivot grade,anterior tibial subluxation in both medial and lateral compartments,and delays the occurrence of graft laxity and failure.

Objective To construct a LASSO-logistic regression model for the risk of complications of cardiopulmonary resuscitation(CPR)based on clinical data and relevant parameters of external chest compression and to provide a reference for the prevention of com-plications of cardiopulmonary resuscitation.Methods One hundred cardiac arrest survivor patients admitted to Shijiazhuang Circular Chemical Industrial Park Hospital from April 2020 to May 2023 were selected and divided into complication and non-complication groups according to complications.The clinical data,chest compression-related parameters of the 2 groups were compared,and LASSO regression was used to initially screen the influencing factors of CPR complications.Logistic regression was used to analyze the influencing factors of CPR complications,and Nomogram was drawn to predict the risk of CPR complications.Results LASSO regression screening showed that the coefficients of body mass index,thoracic anteroposterior diameter,rescuer education level,and rescuer gender were compressed.When λ was 1.786,the number of influencing factors was minimized,and the model performance was excellent.At this time,seven predic-tive variables including rescuer identity,rescuer CPR training,application of air mattress,application of decompression pad,compression depth,compression duration,and strict control of fluid volume were selected to achieve the best selection of influencing factors.Logistic regression analysis showed that rescuer being a nurse,rescuer having received CPR training,application of air mattress bed,application of decompression pad,and strict control of fluid volume were related protective factors for CPR complications,while compression depth and compression duration were related risk factors for CPR complications(P＜0.05).The nomogram diagram of the logistic prediction model for CPR complication risk showed that its C-index was 0.932,indicating good discrimination,and the calibration curve fitted well with the ideal curve.The constructed prediction model had good consistency with the actual observed results.Conclusion CPR complications included sternal fractures,lung contusions,and rib fractures.The risk closely relates to the rescuer,the rescuer's CPR training,the appli-cation of air mattress bed,the application of decompression pad,the depth of compression,the duration of compression,and the strict con-trol of fluid volume.

Objective:To evaluate the clinical outcomes of a large-diameter autograft of 8-strand semitendinosus/gracilis (8S-ST/G) in reconstruction of anterior cruciate ligament (ACL).Methods:A retrospective analysis was conducted of the 56 patients with primary ACL injury who had been treated by the 8S-ST/G autograft technique at Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University between January 2019 and January 2022. The cohort included 42 males and 14 females, with an age of (28.3±7.3) years and a body mass index of (24.4±3.3) kg/m 2. There were 28 left and 28 right knees involved. The preoperative posterior tibial slope measured 14.8°±2.8°. The diameter of 8S-ST/G autograft was (9.3±0.7) mm. The postoperative outcomes documented were knee stability (assessed via KT-1000 arthrometer side-to-side difference, Lachman test, and pivot-shift test), graft maturity, graft roof impingement, and complications. Results:The patients were followed up for (2.4±0.3) years postoperatively. The side-to-side difference decreased significantly from preoperative 6.0 (5.0, 8.0) mm to postoperative 2.0 (0.0, 3.0) mm ( P<0.001). The positive rate of high-grade pivot shift (2+, 3+) reduced significantly from 50.0% (28/56) preoperatively to 3.6% (2/56) postoperatively ( P<0.001). The ACL graft signal grades revealed by the MRI at the final follow-up were grade Ⅰ in 45 cases, grade Ⅱ in 7 cases, and grade Ⅲ in 4 cases. After the 15 patients with their preoperative MRI from other hospitals (showing ACL graft signal of grade I in all) were excluded, the anterior subluxation of lateral compartment (ASLC) and anterior subluxation of medial compartment (ASMC) in the other 41 patients at the final follow-up [(4.8±3.1) mm and 3.0 (2.0, 4.9) mm, respectively] showed no significant differences from the preoperative values [(5.9±3.2) mm and 3.9 (0.0, 6.3) mm, respectively] ( P>0.05). However, in the 30 patients with well-preserved ACL graft signal (grade I), both ASLC and ASMC at the final follow-up [(3.9±2.5) mm and 3.0 (1.5, 4.7) mm] showed significant improvements compared to the preoperative values [(5.5±3.1) mm and 5.1 (2.7, 6.2) mm] ( P<0.05). At the final follow-up, 19.6% (11/56) of the patients showed ACL graft laxity; graft failure occurred in 8.9% (5/56) of the patients, one of whom underwent revision surgery. Second-look arthroscopy revealed concomitant cartilage injuries in 12.5% (7/56) of the patients, cyclops lesions in 3.6% (2/56), and ACL graft impingement in 7.1% (4/56). Conclusion:In the treatment of patients with ACL injury, the 8S-ST/G autograft configuration can significantly improve the stability of the knee joint and graft maturity, but it can not effectively correct the ASLC and ASMC for a subset of patients.

Objective:To investigate the application value of flexible traction suspension (FTS) strategy in pure single-incision laparoscopic distal gastrectomy (PSILDG).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 12 patients who underwent PSILDG in The Second Affiliated Hospital of Army Medical University from November 2021 to March 2024 were collected. There were 8 males and 4 females, aged (53±14)years. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absolute numbers. Results:(1) Intraoperative conditions. All 12 patients underwent PSILDG with FTS strategy successfully, with the operation time of (260±31) minutes, the volume of intraoperative blood loss of 103.3(37.5,150.0)mL, the length of surgical incision of (3.9±0.6)cm. There was no intra-operative special circumstance or complication. (2) Postoperative conditions. Results of histopatho-logical examination showed that among the 12 patients, there were 10 cases of adenocarcinoma, 1 case of signet ring cell carcinoma, and 1 case of high-grade intraepithelial neoplasia. The distance of the proximal tumor margin was 2.8(2.0,3.4)cm, the distance of distal margin was 5.9(5.0,7.5)cm, the tumor diameter was (2.3±1.0)cm, and the number of lymph node dissected was 34±10. On the post-operative first day, all 12 patients had a visual analog score of 1.0. The time to postoperative removal of gastric tube was 1.25(1.00,1.75)days, the time to postoperative first intake of liquid food was 2.00(1.00,2.00)days, the time to postoperative first out-of-bed activity was 1.67(1.00,2.00)days, the time to postoperative first flatus was 2.40(2.00,3.00)days, the time to postoperative first bowel movement was 3.50(2.00,5.00)days, the duration of postoperative hospital stay was (7.10±1.40) days, and the satisfaction score for the abdominal wall incision was 20.6±2.7. No patient experien-ced postopera-tive complications. (3) Follow-up. All 12 patients completed a 30-day follow-up after surgery, with no complication or need for secondary surgery.Conclusion:Application of FTS strategy in PSILDG is safe and feasible.

Objective:To investigate the application value of flexible traction suspension (FTS) strategy in pure single-incision laparoscopic distal gastrectomy (PSILDG).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 12 patients who underwent PSILDG in The Second Affiliated Hospital of Army Medical University from November 2021 to March 2024 were collected. There were 8 males and 4 females, aged (53±14)years. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M( Q1, Q3). Count data were described as absolute numbers. Results:(1) Intraoperative conditions. All 12 patients underwent PSILDG with FTS strategy successfully, with the operation time of (260±31) minutes, the volume of intraoperative blood loss of 103.3(37.5,150.0)mL, the length of surgical incision of (3.9±0.6)cm. There was no intra-operative special circumstance or complication. (2) Postoperative conditions. Results of histopatho-logical examination showed that among the 12 patients, there were 10 cases of adenocarcinoma, 1 case of signet ring cell carcinoma, and 1 case of high-grade intraepithelial neoplasia. The distance of the proximal tumor margin was 2.8(2.0,3.4)cm, the distance of distal margin was 5.9(5.0,7.5)cm, the tumor diameter was (2.3±1.0)cm, and the number of lymph node dissected was 34±10. On the post-operative first day, all 12 patients had a visual analog score of 1.0. The time to postoperative removal of gastric tube was 1.25(1.00,1.75)days, the time to postoperative first intake of liquid food was 2.00(1.00,2.00)days, the time to postoperative first out-of-bed activity was 1.67(1.00,2.00)days, the time to postoperative first flatus was 2.40(2.00,3.00)days, the time to postoperative first bowel movement was 3.50(2.00,5.00)days, the duration of postoperative hospital stay was (7.10±1.40) days, and the satisfaction score for the abdominal wall incision was 20.6±2.7. No patient experien-ced postopera-tive complications. (3) Follow-up. All 12 patients completed a 30-day follow-up after surgery, with no complication or need for secondary surgery.Conclusion:Application of FTS strategy in PSILDG is safe and feasible.