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 compare the anti-thymic atrophy effects of petroleum ether(PEE), ethyl acetate(EAE), n-butanol(BE) and water extract(WE) fractions from root tubers of Tetrastigma hemsleyanum Diels et. Gilg based on mice thymic atrophy model established by intraperitoneal injection of PolyI:C to preliminarily investigate the mechanisms of its effects. METHODS One hunderd ICR mice were randomly divided into 10 groups: control group, model group, low- and high-dose groups of the four extract fractions, with 10 mice in each group. The control group and model group were given equal volume of purified water and gavaged for 10 d. Starting on the 9th day, PolyI:C solution of 16 mg·kg−1 was injected intraperitoneally for 2 consecutive days, except for the control group, which was injected intraperitoneally with physiological saline. Samples of thymics were weighed and and visceral index was calculated, blood samples were taken for analysis of IL-2, TNF-α and WBC, thymic histopathology was analyzed using hematoxylin-eosin staining, Western blotting was performed to detect the expression of TNF-α, p-NF-κB and NF-κB. RESULTS Compared with the model group, all groups of extracts could enhance the thymus weight and thymus index, as well as the cortex and medulla area ratio and the number of thymic corpuscles in 1 mm2 of medulla to different degrees, and at the same time, significantly reduce the level of TNF-α in plasma, evidently inhibited the phosphorylation of NF-κB, and reduced the protein expression of TNF-α, and each of them having distinct advantages and disadvantages. Peripheral blood white blood cell, lymphocyte absolute count and lymphocyte percentage were elevated in the low-dose WE group, low-dose EAE group and high dose PEE group, IL-2 levels were significantly elevated in the low-dose WE group and high dose BE group, and these effects were particularly well demonstrated. CONCLUSION Four extracts from root tubers of Tetrastigma Hemsleyanum Diels et. Gilg can improve morphological changes and atrophy of the thymus tissue in different degrees, regulate of peripheral blood leukocyte imbalance in post-modeling mice, it may be related to the inhibition of PolyI:C-induced phosphorylation of the NF-κB and reduction of protein expression of pro-inflammatory factors.

Mechanical thrombectomy is a minimally invasive interventional method. Embolization device is too close to the blood vessel wall and venous valve in clinical applications, and it can cause blood vessel damage when it is sucked into the lumen. Embolization device is easy to cause hemolysis. Optimal design can reduce the damage to red blood cells, but it cannot be completely avoided; Shedding emboli can complicate the pulmonary artery. The clinical application studies of mechanical thrombectomy devices in the world was reviewed, including 74 experimental studies and 166 clinical application studies. The current status and causes of vascular injury, hemolysis and pulmonary embolism caused by mechanical thrombectomy were analyzed. This paper aims to make recommendations for the optimization of mechanical thrombectomy devices.

Objective To investigate the influence of thrombus entrance shape, suction rate and blood flow velocity on thrombus aspiration of rotary cutting and suctioned thrombectomy devices, so as to provide theoretical support for the design and optimization of such devices. Methods Three models with different thrombus entrance shapes (‘L’-style, ‘8’-style and ‘0’-style) were established to study the influence of thrombus entrance shape on the thrombectomy; different suction rates (75, 100, 125, 150 mL/min) and different blood flow velocities (0-10 cm/s, at interval of 1 cm/s) were set to discuss how the suction rate and blood flow velocity affected the thrombectomy based on ‘8’-style thrombus entrance. Results The thrombus could not be aspirated evenly in ‘L’-style model, and there was no significantly difference in aspiration between ‘8’ -style model and ‘0’-style model. But the ‘8’-style model was better than ‘0’-style model in lateral thrombus suction. The suction rate that was greater than 100 mL/min provided a limited effect on improvement of thrombectomy effect. The best suction effect was reached when blood flow velocity was less than 1 cm/s, and the effect of thrombectomy was decreasing gradually with blood flow velocity increasing. Conclusions The thrombus entrance shape, suction rate and blood flow velocity had a great impact on thrombectomy greatly. A wide and short thrombus entrance shape, an appropriate increase of suction rate and decrease of blood flow velocity would contribute significantly to the improvement of thrombectomy effect. These results can be used as guidance for the optimal design of rotary cutting and suctioned thrombectomy devices.

Objective To explore the association of serum cytokine levels with disease activity in patients with dermatomyositis (DM) and clinically amyopathic dermatomyositis (CADM),especially their association with skin lesions and interstitial lung disease (ILD).Methods Enzyme-linked immunosorbent assay (ELISA) and cytometric beads array (CBA)were performed to detect the serum levels of interleukin (IL)-2,IL-4,IL-6,IL-10,IL-17A,IL-18,tumor necrosis factor (TNF) and interferon (IFN)-γin 40 patients with DM or CADM,as well as in 16 health checkup examinees (healthy control group).Then,the association of serum cytokine levels with skin lesions,inflammatory biomarkers and severity of ILD was analyzed.Results The patients with DM/CADM showed significantly higher serum levels of IL-6 (37.8 ±45.8 pg/ml),IL-10 (16.1 ± 7.2 pg/ml) and IL-18 (492.0 ± 193.1 pg/ml) compared with the healthy controls (12.0 ± 2.7 pg/ml,7.7 ± 1.4 pg/ml,191.1 ± 39.2 pg/ml,respectively,all P ＜ 0.001),and there were no significant differences in the serum levels of the other 5 cytokines between the above 2 groups.The serum level of IL-6 was significantly higher in patients with elevated erythrocyte sedimentation rate (ESR) than in those with normal ESR (49.7 ± 46.8 pg/ml vs.29.1 ± 45.4 pg/ml,P =0.008).The patients with raised C-reactive protein (CRP) levels showed significantly higher serum levels of IL-6 (68.7 ± 59.7 pg/ml) and IL-18 (635.1 ± 232.8 pg/ml) compared with those with normal CRP levels (IL-6:30.6 ± 40.3 pg/ml,P =0.013;IL-18:440.2 ± 164.7 pg/ml,P =0.020).Moreover,the patients with elevated levels of lactate dehydrogenase (LDH) showed significantly higher serum levels of IL-10 (18.4 ± 6.9 pg/ml),IL-17A (19.6 ±6.7 pg/ml) and IL-18 (529.4 ± 197.2 pg/ml) compared with those with normal LDH levels (IL-10:10.7 ±4.8 pg/ml,P ＜ 0.001;IL-17A:11.4 ± 6.6 pg/ml,P =0.001;IL-18:404.9 ± 158.0 pg/ml,P =0.037).No significant difference in the cytokine levels was observed between the patients with elevated creatine kinase (CK) levels and those with normal CK levels.The patients with Gottron's papules/sign showed significantly higher serum levels of IL-18 (513.7 ± 187.2 pg/ml) compared with those without Gottron's papules/sign (297.1 ± 140.4 pg/ml,P ＜ 0.05).The serum levels of IL-10 and IL-18 were significantly higher in the patients with DM/CADM complicated by ILD (18.0 ± 6.7 pg/ml,552.3 ± 192.8 pg/ml,respectively) than in those without ILD (11.6 ± 6.5 pg/ml,351.4 ± 101.0 pg/ml,respectively,both P =0.001).Conclusion Serum levels of IL-6,IL-10 and IL-18 are highly associated with inflammatory biomarkers,skin lesions and ILD in patients with DM/CADM.

The paper introduces the definition of smart phone,operating mobile communication network and hidden danger about safety,and definition and advantages of SSL VPN,states the application of SSL VPN technology in the direct network report of epidemic situation information of infectious diseases combining with SSL VPN technology and remote connection,analyzes the work principle and specific operation process,achieves safety login to the China Information System for Disease Prevention and Control with smart phones,and completes normal business data processing.

Objective To evaluate the results and complications of hip arthroplasty performed as a salvage procedure after the failed treatment of intertrochanteric hip fractures in elderly patients. Methods Between 2004 and 2009,10 patients were treated with hip arthroplasty after the failed treatment of intertrochanteric fracture.There were six females and four males,at mean age of 75.7 years ( range,68-84 years).The initial treatment of fractures included dynamic hip screw (DHS) fixation in three cases,dynamic condyle screw (DCS) fixation in one,proximal femur fixation with reconstruction interlocking nail in three and conservative treatment without internal fixation in three.The failed procedures included avascular necrosis in four cases,cephalic implant cutting in three,nonunion in two and malunion associated with osteoarthritis in one.Joint hip replacement was performed except for pre-operative infection.Harris score at follow-up was recorded and prosthesis position was evaluated by imaging. Results Six patients were treated with total hip arthroplasty with a cemented cup (three patients) and an uncemented cup ( three patients) and four with a bipolar hemiarthroplasty.A long-stem implant was used in 5 of the 10 hips.The average duration of follow-up was 4.6 years (2-7 years).The mean duration of surgery was 128 minutes and mean blood loss was 764 ml.The mean Harris hip score increased from 37 preoperatively to 85 postoperatively.The functional results were satisfactory.One 84-year-old patient with the implant intact died 2 years postoperatively from a brain hemorrhage. Conclusions Hip arthroplasty is an effective salvage procedure after the failed treatment of intertrochanteric fractures in elderly patient.Most patients have better pain relief and functional improvements in spite of technical difficulties than primary arthroplasty.In the meantime,attention should be paid to patients with poor bone quality,bone loss,or articular cartilage damage.

Objective To summarize the perioperative characters of femoral neck fractures in patients aged at over 80 years by analyzing the surgical treatment procedures. Methods A retrospective study was done on data of patients with femoral neck fractures treated surgically from June 2000 and June 2008. There were 25 males and 36 females, at average age of 83.4 years (80-94 years). Of all, there were 53 patients with fresh fractures including six with type Garden Ⅰ or Ⅱ fractures and 47 with type Garden Ⅲ or Ⅳ fractures, eight with old fractures ( all type Garden Ⅳ). Fifty-one patients (84%) were accompanied with preexisted internal medical or neurological diseases. Six patients with type Garden Ⅰ or Ⅱ fractures were treated with cannulated screw fixation (CSF). Among 55 patients with type Garden Ⅲ or Ⅳ fractures inclu-ding 47 fresh fractures and 8 old ones, 53 patients were treated by hip hemiarthroplasty (HHA) but the other two by cemented total hip arthroplasty (THA) because of preexisting hip osteoarthritis. Results The average operation duration and blood loss were 51 minutes and 50 ml in CSF group, 81 minutes and 180 ml in HHA group, 105 minutes and 350 ml in THA group. Fifteen patients (25%) had postoperative com-plications, mostly hypotension, cardiac insufficiency and atrial fibrillation, accounting for 12%. Postoperative hemoglobin was decreased by 11.9%, 17.1% and 18. 1% on average respectively in CSF group, HHA group and THA group, and postoperative albumin decreased by 10.8%, 18. 1% and 20.2% on average respectively in CSF group, HHA group and THA group. There were 17 patients (28%) with hemoglobin below 100 g/L and four (7%) with albumin below 30 g/L after operation. Conclusions The patients aged ≥80 years with femoral neck fractures are usually accompanied with preexisted internal medical or neurological diseases and have high risk in operation. Adequate preoperative preparation and active prevention and treatment of perioperative complications are important for successful operation and good postoperative results.

The effects of the pulsed electromagnetic fields (PEMFs) of different intensity on bone mineral density (BMD) and biomechanical properties of rabbits' femur had been studied. Twenty-seven female white big ear rabbits were randomly divided into three groups. The magnetic groups were fed in 15 Hz PEMFs, which pulse duration was set to be 5 ms (6 h x d(-1)), the magnetic intensity was 10 x 10(-4) T and the other was 20 x 10(-4) T. Control group were just fed in coils, and the instrument of PEMFs was powered off. After six weeks, by examine BMD and biomechanical properties of the rabbits' femur, the effects of these PEMFs were studied. Compared with control group, the values of BMD, maximum load and structural rigidity of magnetic group were significantly increased (P < 0.05). In addition, there was significant increase in values of BMD and structural rigidity in group 10 x 10(-4) T in comparison with group 20 x 10(-4) T (P < 0.05). PEMFs is effective in improving BMD and biomechanical properties. The experiment indicated that there was evident "window-effect" during the treatment by PEMFs. It is favorable to the treatment and prevention of osteoporosis.
Animals ; Biomechanical Phenomena ; Bone Density ; physiology ; radiation effects ; Dose-Response Relationship, Radiation ; Electromagnetic Fields ; Female ; Femur ; metabolism ; physiology ; Osteoporosis ; prevention & control ; Rabbits ; Random Allocation