OBJECTIVE: To evaluate the early effectiveness of transosseous suture fixation in treating recurrent acute patellar dislocation with patellar osteochondral fractures (OCFs). METHODS: A retrospective analysis was conducted on 19 patients with recurrent acute patellar dislocation and patellar OCFs, who underwent transosseous suture fixation between January 2018 and December 2022 and were followed up 2 years. The cohort included 8 males and 11 females, aged 13-21 years (mean, 16.2 years). Patients experienced 2-5 times of patellar dislocation (mean, 3.2 times). The interval from the last dislocation to operation ranged from 3 to 15 days (mean, 9.6 days). Preoperative imaging revealed the intra-articular osteochondral fragments and medial patellofemoral ligament (MPFL) injury. Clinical outcomes were evaluated using the visual analogue scale (VAS) score for pain, the International Knee Documentation Committee (IKDC) score, the Hospital for Special Surgery (HSS) knee score, the Lysholm score, and the Tegner score. Postoperative complications were recorded. During follow-up, the knee X-ray films, CT, and MRI were taken to evaluate fragment healing, displacement, and the morphology and tension of the MPFL reconstruction graft. RESULTS: All incisions healed primarily, and no complication occurred such as infection, joint stiffness, patellofemoral arthritis, or redislocation. Patients were followed up 24-60 months (mean, 43.5 months). At 12 months postoperatively and the last follow-up, significant improvements ( P<0.05) were observed in VAS, Lysholm, IKDC, HSS, and Tegner scores compared to preoperative values. Further improvements were observed at last follow-up compared with the 12 months postoperatively, and the differences were significant ( P<0.05). Imaging studies demonstrated satisfactory osteochondral fragment positioning with stable fixation. At last follow-up, all fragments had healed, and MPFL reconstruction grafts exhibited optimal morphology and tension. No joint adhesion or fragment displacement occurred. CONCLUSION For recurrent acute patellar dislocation with patellar OCFs, transosseous suture fixation proves to be both safe and effective, achieving satisfactory early effectiveness.
Humans ; Male ; Female ; Patellar Dislocation/surgery* ; Adolescent ; Young Adult ; Retrospective Studies ; Patella/surgery* ; Suture Techniques ; Treatment Outcome ; Recurrence ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Follow-Up Studies

Objective:To construct a classification management model on the basis of Kraljic matrix for electrocardiogram(ECG)monitoring equipment in emergency intensive care unit(ICU),so as to explore its application value in the management for ECG monitoring equipment in emergency ICU.Methods:The classification management model on the basis of index for ECG monitoring equipment in emergency ICU was constructed.According to two classification dimensions included the market supply risk and the self-value,an indicator system of classification management,which aimed at strategic materials with high value and high risk,leverage materials with high value and low risk,bottleneck materials with low value and high risk,and conventional materials with low value and low risk,was constructed.A total of fifty-one ECG monitoring equipment in the emergency ICU of The People's Hospital of Longhua of Shenzhen from January to December 2023 were selected,and they were managed respectively by conventional management mode(25 sets)and classification management mode(26 sets)according to different management modes.The standardization level of operation management for equipment,the occurrence of safety risk and the level of management for equipment of the two management modes were compared,and the satisfaction of 30 relative personnel,who used and managed these equipment,for classification management of equipment also were compared.Results:The average values of the percentage of standardization level of normality of equipment operation,disinfection and sterilization,maintenance and fault repair of using classification management mode were respectively(91.58±4.33)%,(92.1±3.28)%,(91.49±3.54)%and(92.58±3.32)%,all of which were higher than those of conventional management mode,and the differences were statistically significant(t=12.537,15.706,14.196,18.946,P<0.05),repsectively.The average incidences of the risk of pressure injury,electrical injury and body fluid extravasation of adopting classification management mode were respectively(2.54±0.87)%,(3.02±0.82)%and(1.29±0.65)%,all of which were lower than those of adopting conventional management mode,and the differences were statistically significant(t=22.825,17.453,24.424,P<0.05),respectively.The satisfaction scores of 30 relative management personnel,who used equipment on the process rationality,system standardization and quality effectiveness,of adopting classification management mode were respectively(94.26±3.54),(92.57±4.36)and(91.87±3.69),all of which were higher than those of conventional management mode,and the differences were statistically significant(t=14.052,13.991,13.551,P<0.05),respectively.The reasonable placement rate,recording rate of standardization,and intact rate of equipment in the 26 equipment by adopting classification management mode were respectively 92.31%,92.31%and 88.46%,all of which were significantly higher than those by adopting conventional management mode,and the differences were statistical significant(x2=12.052,10.398,11.338,P<0.05).Conclusion:The classification management model of ECG monitoring equipment in emergency ICU can increase the management efficiency for the equipment in operating room of hospital,and improve the operation quality of equipment,and enhance the safety of equipment in clinical use,and the standardization of operation management for equipment.

Objective To observe the effects of Xuanfei Tongfu formula on the prognosis of patients with severe pneumonia.Methods Sixty patients with severe pneumonia admitted to the First People's Hospital of Fuyang District,Hangzhou City from June 1,2022 to April 1,2024 were selected as the research subjects.Patients were divided into control group(31 cases)and observation group(29 cases)by randomly number table method.Upon hospital admission,the control group received conventional Western medicine treatment,while the observation group received Xuanfei Tongfu formula in addition to conventional Western medicine treatment[Rhubarb 8 g(decocted later),Aurantii Fructus Immaturus 12 g,Magnoliae Officinalis Cortex 12 g,Agastache Rugosa 10 g,Tatarian Aster Root 15 g,Natrii Sulfas Exsiccatus 10 g(dissolved in water),decocted to 150 mL each time and taken],once a day for 5 days.Observe the changes of inflammatory indicators such as serum levels of C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6)in both groups before and after treatment.To evaluate the severity indicators of diseases such as acute physiology and chronic health evaluationⅡ(APACHEⅡ)and sequential organ failure assessment(SOFA),as well as the clinical efficacy after treatment.Record the duration of mechanical ventilation,intensive care unit(ICU)length of stay and total hospitalization length of the two groups,calculate the oxygenation index level,and statistically analyze the 28-day survival rate.Results Compared with before treatment,the levels of inflammatory indicators CRP,PCT,and IL-6,as well as the scores of APACHEⅡand SOFA in both groups were significantly lower than those after treatment,the oxygenation index was significantly higher than that before treatment,and the changes in the observation group were more obvious than those in the control group[CRP(mg/L):28±17 vs.50±34,PCT(μg/L):2.0±1.5 vs.4.1±2.7,IL-6(ng/L):52±28 vs.97±61,APACHEⅡscore:12.8±5.1 vs.16.1±6.1,SOFA score:3.9±1.8 vs.6.2±2.7,oxygenation index(mmHg,1 mmHg≈0.133 kPa):302±57 vs.252±85,all P<0.05].Compared with the control group,the observation group exhibited a markedly reduced duration of mechanical ventilation(days:8.3±3.8 vs.11.4±6.4,P<0.05),and a significantly higher total effective rate of clinical efficacy[82.76%(24/29)vs.54.84%(17/31),P<0.05].Conclusion The application of Xuanfei Tongfu formula can effectively enhance the clinical treatment outcomes for severe pneumonia,reduce systemic inflammatory responses,promote organ function recovery,and improve the prognosis of patients.

Severe open tibiofibular fractures account for approximately 28.1% of all open fractures. Among them, Gustilo-Anderson type IIIB/C fractures present significant clinical challenges due to associated bone and soft tissue defects, high infection rates, and risk of amputation. Inadequate preoperative assessment may lead to suboptimal emergency surgical planning or intraoperative complications. Historically, external fixation was often preferred, but this approach has been associated with limitations such as restricted joint mobility, delayed bone union, joint stiffness, and disuse osteoporosis, resulting in poor functional recovery. With advancements of debridement techniques, standardization of antibiotic use, and popularization of early soft tissue coverage, early internal fixation has gained broader acceptance. Nevertheless, controversies persist regarding the choice of fixation method, timing of definitive fixation, use of reamed versus unreamed intramedullary nailing, and necessity of fibular fixation. To standardize the diagnosis and early management of severe open tibiofibular fractures, reduce complication rates, and improve functional recovery, the Society of Microsurgery of the Chinese Medical Association organized a panel of domestic experts to develop the Evidence-based guideline for the diagnosis and early fixation of severe open tibiofibular fractures ( version 2025), using evidence-based methodology. The guidelines provided 12 recommendations covering diagnostic and early fixation strategies of severe open tibiofibular fractures, aiming to provide clinicians with scientifically grounded and standardized guidance.

Objective:To analyze the intercomparision result of personal dose monitoring and gross alpha/beta detection capability between the disease control and prevention institutions at provincial, municpal and county levels during 2022-2024, in order to provide a reference for radiation detection capability and policy making of these institutions in China.Methods:Data on personal dose monitoring and gross alpha/beta detection, obtanied from the 2022-2024 radiation detection capability intercomparison between the disease control and prevention institutions at different levels, were recorded. Both the qualification rates (including excellence) and excellence rates of all the institutions at all evels from 2022 to 2024 were analyzed using SPSS 22.0.Results:From 2022 to 2024, the number of participating institutions at all levels showed an overall upward trend, increasing from 262 to 430, with particularly notable growth at the municipal level. In the 2024 gross α/β detection capability intercomparison, the non-qualification rate in municipal-level institutions was significantly higher than in county-level institutions ( χ2=10.53, P < 0.05). The qualification rate (including excellence) of the municipal-level gross alpha/beta detection in 2022 and 2024 were lower than in 2023( χ2=29.93, P < 0.01). Among all regions, the 2024 personal dose monitoring intercomparison result showed that the qualification rate (including excellence) in East China was higher than in Southwest and Northwest China ( χ2=15.62, P <0.01). East China also outperformed Northwest China ( χ2=16.21, P <0.01). In the 2022 gross alpha/beta detection capability intercomparison, the qualification rate (including excellent performance) in East China and South China was higher than in Northwest China ( χ2=23.76, 11.22, P<0.01). Overall, East China showed relatively higher qualification rate in intercomparison result of both personal dose monitoring and radiation detection (including excellence), while Northwest China showed lower qualification rates (including excellence). Conclusions:Although the radiation detection capability of disease control and prevention institutions at all levels has improved in recent years, there are still insufficience of detection capabilities at some municipal- and county-level laboratories and even unbalance between different regionas. Policy support should prioritize underdeveloped areas, such as municipal- and county-level institutions and the Northwest, and enhance the technical proficiency and quality management of laboratory personnel.

Mass vaccination represents a highly effective strategy for accelerating disease control while simultaneously reducing incidence and mortality rates. By developing comprehensive plans and standards for mass vaccination, it is feasible to optimize resource allocation and swiftly enhance vaccination coverage, thereby preventing, controlling, or interrupting outbreaks or epidemics of specific infectious diseases. To standardize the mass vaccination process and establish a population immunity barrier in an orderly, efficient, and safe manner, a panel of experts was convened to develop the Recommendations on Mass Vaccination. These recommendations are grounded in the requirements of relevant policies and regulations in China, as well as the insights gained from the mass vaccination campaign for COVID-19 vaccines conducted in the country. The recommendations outline the system requirements pertaining to initiation conditions, departmental coordination, responsibilities, mobilization, operational specifications, and responses to vaccine reactions, among other aspects of mass vaccination implementation, so as to serve as a reference for future mass vaccination initiatives and the formulation of related policies.

Pelvic fractures, the most severe bone trauma, account for approximately 3% of all fractures. As they are caused by high-energy injuries, their rates of mortality and disability are high. Over the past two centuries, the treatment strategies for these fractures have evolved from conservative therapy to open reduction and plate fixation, then to closed reduction and percutaneous screw fixation, and recently to screw fixation assisted by artificial intelligence. In the past 40 years, constant progress has been made in the treatment of pelvic fractures. It is generally acknowledged that a personalized treatment plan should be formulated based on each patient's age, fracture type, comorbidities, functional requirements and other factors when an appropriate treatment mode is chosen. The primary aim of treatment is to accelerate functional recovery, decrease the rate of disability after injury, and improve the quality of daily life of the patient. This paper reviews the treatment history of pelvic fractures, discusses the advantages and disadvantages of current treatment options, and looks ahead to future prospects, aiming to offer valuable references for related clinical practice.

Objective To assess the effectiveness of the evaluation of military physical function(EMPF)system in predicting the occurrence of military training injuries among new recruits to provide scientific guidance and methodological choice for military training.Methods A total of 527 new recruits from 5 grassroots units from July 2016 to February 2018 were selected for the study.The recruits underwent EMPF testing,and their military training injuries were monitored over a 2-year follow-up period.Those who sustained injuries during training were divided into injury group(n=163),while the remaining recruits were placed in healthy group(n=364).The predictive ability of the total EMPF score for training injuries was assessed using the receiver operating characteristic curve(ROC),and the correlation between the total EMPF score,individual test scores,and military training injuries were analyzed using binary logistic regression.Results The total EMPF score of new recruits in injury group(19.52±1.97)was significantly lower than that of healthy group(24.31±1.54)(P<0.001),which also demonstrated a high diagnostic value in predicting the risk of military training injuries,with an area under the curve(AUC)of ROC of 0.971(P<0.001).A cut-off value of 22 scores was found to have the highest accuracy in predicting future training injuries,with an odds ratio(OR)of 25.63,sensitivity of 0.939,specificity of 0.879,positive likelihood ratio of 7.76,and a post-test probability of 0.67.Binary logistic regression analysis revealed that 6 EMPF tests,including holding the ball over and leaning back,bending forward and touching the ground with the ball,lunge squat and twist,swallow balance with holding the ball afterward,vertical jump,and respiratory pattern assessment,were negatively associated with the risk of military training injuries(P<0.0001).Conclusion The EMPF system can effectively predict the risk of military training injuries,with military personnel whose total EMPF score is less than 22 being at higher risk of sustaining such injuries.

GPR126, also known as ADGRG6, is one of the most deeply studied aGPCRs. Initially, GPR126 was thought to be a receptor associated with muscle development and was primarily expressed in the muscular and skeletal systems. With the deepening of research, it was found that GPR126 is expressed in multiple mammalian tissues and organs, and is involved in many biological processes such as embryonic development, nervous system development, and extracellular matrix interactions. Compared with other aGPCRs proteins, GPR126 has a longer N-terminal domain, which can bind to ligands one-to-one and one-to-many. Its N-terminus contains five domains, a CUB (complement C1r/C1s, Uegf, Bmp1) domain, a PTX (Pentraxin) domain, a SEA (Sperm protein, Enterokinase, and Agrin) domain, a hormone binding (HormR) domain, and a conserved GAIN domain. The GAIN domain has a self-shearing function, which is essential for the maturation, stability, transport and function of aGPCRs. Different SEA domains constitute different GPR126 isomers, which can regulate the activation and closure of downstream signaling pathways through conformational changes. GPR126 has a typical aGPCRs seven-transmembrane helical structure, which can be coupled to Gs and Gi, causing cAMP to up- or down-regulation, mediating transmembrane signaling and participating in the regulation of cell proliferation, differentiation and migration. GPR126 is activated in a tethered-stalk peptide agonism or orthosteric agonism, which is mainly manifested by self-proteolysis or conformational changes in the GAIN domain, which mediates the rapid activation or closure of downstream pathways by tethered agonists. In addition to the tethered short stem peptide activation mode, GPR126 also has another allosteric agonism or tunable agonism mode, which is specifically expressed as the GAIN domain does not have self-shearing function in the physiological state, NTF and CTF always maintain the binding state, and the NTF binds to the ligand to cause conformational changes of the receptor, which somehow transmits signals to the GAIN domain in a spatial structure. The GAIN domain can cause the 7TM domain to produce an activated or inhibited signal for signal transduction, For example, type IV collagen interacts with the CUB and PTX domains of GPR126 to activate GPR126 downstream signal transduction. GPR126 has homology of 51.6%-86.9% among different species, with 10 conserved regions between different species, which can be traced back to the oldest metazoans as well as unicellular animals.In terms of diseases, GPR126 dysfunction involves the pathological process of bone, myelin, embryo and other related diseases, and is also closely related to the occurrence and development of malignant tumors such as breast cancer and colon cancer. However, the biological function of GPR126 in various diseases and its potential as a therapeutic target still needs further research. This paper focuses on the structure, interspecies differences and conservatism, signal transduction and biological functions of GPR126, which provides ideas and references for future research on GPR126.