Objective:To investigate the impact of antenatal corticosteroid (ACS) exposure on neonatal outcomes in late preterm infants.Methods:This retrospective cohort study analyzed 406 late preterm infants (gestational age 34 +0-36 +6 weeks) born at Tongji University Affiliated Dongfang Hospital between January 2021 and June 2024. Participants were divided into ACS-exposed ( n=254) and control ( n=152) groups. Maternal characteristics, neonatal profiles, and outcomes [respiratory disorders (respiratory distress syndrome, respiratory failure, bronchopulmonary dysplasia), neonatal hypoglycemia, and early-onset sepsis] were compared. And they were stratified by plurality (154 twins, 252 singletons) and gestational age (96 at 34 +0-34 +6 weeks; 111 at 35 +0-35 +6 weeks; 199 at 36 +0-36 +6 weeks), the effects of ACS exposure on neonatal outcomes were analyzed. Late preterm infants were also divided into affected ( n=13) and unaffected ( n=393) groups according to whether they had respiratory disorders, and the risk factors of respiratory disorders were analyzed. Statistical methods included independent t-test, Mann-Whitney U, Chi-square test, and multivariate logistic regression. Results:The ACS-exposed group exhibited significantly higher rates of assisted reproductive technology conception [53.1% (135/254) vs. 37.5% (57/152), χ2=9.37], twin pregnancy [43.3% (110/254) vs. 28.9% (44/152), χ2=6.84], cesarean delivery [83.5% (212/254) vs. 66.4% (101/152), χ2=15.66], and neonatal intensive care unit admission than those in the control group [59.1% (150/254) vs. 40.8% (62/152), χ2=12.61] (all P<0.05). No significant differences emerged between ACS-exposed and control groups in respiratory disorders [3.1% (8/254) vs. 3.3% (5/152), χ2=0.01], early-onset sepsis [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71], or neonatal hypoglycemia [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71] (all P>0.05). Stratified analyses by plurality or gestational age strata revealed no significant differences in respiratory disorders, early-onset sepsis or neonatal hypoglycemia between ACS-exposed and control groups (all P>0.05). Multivariate logistic regression identified ACS exposure as non-protective against respiratory disorders ( OR=0.37, 95% CI: 0.10-1.39, P=0.144), with maternal glucose metabolism disorders (pre-gestational/gestational diabetes) as a risk factor ( OR=5.26, 95% CI: 1.57-17.71, P=0.007) and higher gestational age as protective ( OR=0.34, 95% CI: 0.15-0.78, P=0.012). Conclusions:ACS administration at 34 +0-36 +6 weeks demonstrated no significant benefits for preventing respiratory disorders in late preterm infants and did not increase risks of hypoglycemia or early-onset sepsis. Maternal glucose dysregulation and lower gestational age elevate respiratory morbidity risk in this population.

Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

Objective:To explore the clinical efficacy of autologous platelet-rich plasma (PRP) in the treatment of acute injury to the anterior talofibular ligament (ATFL).Methods:A retrospective study was conducted to analyze the data of 96 patients who had been admitted to Department of Orthopedic Trauma Repair, The Nanhua Hospital Affiliated to Hengyang Medical School for acute ATFL injuries of grades Ⅰ & Ⅱ from January 2022 to December 2023. They were divided into 2 groups according to their different treatments. In the PRP group subjected to local PRP injection combined with conservative treatment, there were 49 patients (28 males and 21 females), with an age of (32.5±6.5) years. In the conservative group subjected to traditional conservative treatment, there were 47 patients (24 males and 23 females), with an age of (30.5±5.3) years. The 2 groups were compared in terms of visual analog scale (VAS) pain scores, talar anterior translations, Karlsson scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores before and 6 months after treatment.Results:No statistically significant differences were observed in the baseline characteristics between the 2 groups before treatment, indicating comparability ( P>0.05). All patients were followed up for (9.1±1.7) months. In both groups, the VAS pain scores significantly decreased after treatment than the pre-treatment ones, the talar anterior translations significantly reduced after treatment than the pre-treatment ones, and the AOFAS and Karlsson scores significantly increased after treatment than the pre-treatment ones ( P < 0.05). After 6 months of treatment, the talar translation distance [(2.5±0.4) mm], AOFAS ankle hind foot score [(91.7 ± 4.0) points], and Karlsson score [(93.0±3.5) points] in the PRP group were significantly better than those in the conservative group [(6.1±0.9) mm, (87.1±4.3) points, (89.0±4.0) points]( P < 0.05). Conclusion:In the treatment of acute ATFL injury, PRP therapy demonstrates good clinical efficacy, for it can significantly reduce pain, promote functional recovery, and improve joint stability.

Objective:To investigate the impact of antenatal corticosteroid (ACS) exposure on neonatal outcomes in late preterm infants.Methods:This retrospective cohort study analyzed 406 late preterm infants (gestational age 34 +0-36 +6 weeks) born at Tongji University Affiliated Dongfang Hospital between January 2021 and June 2024. Participants were divided into ACS-exposed ( n=254) and control ( n=152) groups. Maternal characteristics, neonatal profiles, and outcomes [respiratory disorders (respiratory distress syndrome, respiratory failure, bronchopulmonary dysplasia), neonatal hypoglycemia, and early-onset sepsis] were compared. And they were stratified by plurality (154 twins, 252 singletons) and gestational age (96 at 34 +0-34 +6 weeks; 111 at 35 +0-35 +6 weeks; 199 at 36 +0-36 +6 weeks), the effects of ACS exposure on neonatal outcomes were analyzed. Late preterm infants were also divided into affected ( n=13) and unaffected ( n=393) groups according to whether they had respiratory disorders, and the risk factors of respiratory disorders were analyzed. Statistical methods included independent t-test, Mann-Whitney U, Chi-square test, and multivariate logistic regression. Results:The ACS-exposed group exhibited significantly higher rates of assisted reproductive technology conception [53.1% (135/254) vs. 37.5% (57/152), χ2=9.37], twin pregnancy [43.3% (110/254) vs. 28.9% (44/152), χ2=6.84], cesarean delivery [83.5% (212/254) vs. 66.4% (101/152), χ2=15.66], and neonatal intensive care unit admission than those in the control group [59.1% (150/254) vs. 40.8% (62/152), χ2=12.61] (all P<0.05). No significant differences emerged between ACS-exposed and control groups in respiratory disorders [3.1% (8/254) vs. 3.3% (5/152), χ2=0.01], early-onset sepsis [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71], or neonatal hypoglycemia [1.6% (4/254) vs. 1.3% (2/152), χ2=0.71] (all P>0.05). Stratified analyses by plurality or gestational age strata revealed no significant differences in respiratory disorders, early-onset sepsis or neonatal hypoglycemia between ACS-exposed and control groups (all P>0.05). Multivariate logistic regression identified ACS exposure as non-protective against respiratory disorders ( OR=0.37, 95% CI: 0.10-1.39, P=0.144), with maternal glucose metabolism disorders (pre-gestational/gestational diabetes) as a risk factor ( OR=5.26, 95% CI: 1.57-17.71, P=0.007) and higher gestational age as protective ( OR=0.34, 95% CI: 0.15-0.78, P=0.012). Conclusions:ACS administration at 34 +0-36 +6 weeks demonstrated no significant benefits for preventing respiratory disorders in late preterm infants and did not increase risks of hypoglycemia or early-onset sepsis. Maternal glucose dysregulation and lower gestational age elevate respiratory morbidity risk in this population.

Objective To investigate the risk factors of severe complications of elderly patients with pancreaticoduodenectomy (PD). Methods The clinical data of 399 elderly patients with PD and 65 years or more (65-91years) including 76 cases with 75 years or more （19.0%） in this hospital from January 2016 to December 2020, were retrospectively analyzed. Less Barthel index score was used to indicate lower activities of daily living. The risk factors of severe complications after PD were analyzed by binary Logistic regression and predictive model was established. Receiver operating characteristic (ROC) curve was used to verify the predictive efficiency of model. Results A total of 224 cases were found postoperative complications from 399 elderly PD cases with the rate 56.14% including 187 (46.87%) cases of mild complications and 37 (9.27%) cases of severe complications. Age ≥75 years (OR=2.78, P<0.05), combined with hypertension (OR=4.20, P<0.05) and less Barthel index score (OR=0.96, P<0.05) were independent risk factors for severe complications after PD in elderly patients. The risk prediction model of severe postoperative complications of PD was constructed using 6 indexes including age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time, and the fit of regression equation 0.93. ROC curve analysis showed that area under curve (AUC) was 0.76, the sensiti-vity 65%, and the specificity 76%. Conclusions Age 75 years or more, hypertension and low activities of daily living would be independent risk factors for severe complications after PD in elderly patients. The risk model constructed by age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time had certain predictive efficacy for severe complications after PD in elderly patients.

Objective To investigate the effect of treadmill running with different intensities on type Ⅱ collagen (Col2) of knee joint articular cartilages in rats.Methods A total of 48 adult Sprague-Dawley rats were randomly divided into a control (C) group,a low-intensity exercise (L) group,a moderate-intensity exercise (M)group and a high-intensity exercise (H) group,each of 12.Rats in three exercises groups were regularly trained on treadmill at low,moderate,and high intensities respectively.Eight weeks later,all the animals were sacrificed.The right tibial plateau samples were collected to observe collagen fibers under polarizing light microscopy,and the collagen Ⅱ content were examined using immunohistochemistry.The mRNA expression of biglycan (BGN),fibromodulin (FMOD) and Col2 was tested using the quantitative real-time reverse transcription-polymerase chain reaction.Results Compared with group C,collagen fibers in group L and M exhibited almost the same organization,whereas,alteration in organization and shape of collagen fibers was found in group H.Significantly lower content of type Ⅱ collagen was found in group H than that in group C.In comparison with group C,group L had significantly higher gene expression of Col2,whereas group H had significantly higher BGN mRNA expression.Conclusion Low-or moderate-intensity treadmill running appears to have beneficial effect on articular cartilages to maintain its integrity.Highintensity exercises induce lower content and disorder of type Ⅱ collagen in articular cartilages,but the self-healing of cartilage may still exist.

Objective To investigate the effect of cyclic tensile stress (CTS) on the metabolism inand apoptosis of rat chondrocytes.Methods Primary rat chondrocytes were cultured on a Bioflex plate for one day and then stretched cyclically for 24 hours at a frequency of 0.5 Hz using a Flexcell-5000T apparatus.The cells were divided into 5 groups according to their stretching ratio:0％ (the control group),2％,6％,10％ and 14％.After the stretching,Col Ⅱ,Aggrecan,MMP-13 and ADAMTS-5 mRNA were measured using qPCRs,and the NO and PGE2 levels were measured using ELISA kits.Moreover,TUNEL staining and Annexin V-FITC/PI were used to analyze the apoptosis of chondrocytes.Results Compared with the control group,the average levels of Col Ⅱ and Aggrecan mRNAdecreasedin 10％ and 14％ groups [(0.738±0.11) and (0.58±0.13),(0.75±0.11) and (0.55±0.09)].In those groups,the MMP-13 [(2.47±0.47) and (2.88±0.36)] and ADAMTS-5 mRNA level [(2.39±0.33) and (2.75±0.49)],the NO [(6.96±0.96) and (8.28±0.82)] and PGE2 level [(6.83±0.66) and (7.15±0.71)] had increased significantly.In the 6％ group the average levels of Col Ⅱ(1.76±0.30) and Aggrecan mRNA (1.93±0.14)of 6％ group were significantly higher than the control group,but the NO level of the former (3.07±0.20) was significantly lower than the control group (3.89 ± 0.33).The apoptosis rate of chondrocytesin 2％ and 6％ groups were (0.065±0.013) and (0.063 ± 0.147),without significant differences to that of the control group (0.045 ± 0.008).However,compared with the control group,apoptosis in the 10％ and 14％ groups [(0.135 ±0.026) and (0.184±0.020)] increased significantly.Conclusion The effect of cyclic tensile stress on chondrocyte metabolism and apoptosis was magnitude-dependent.Ten percent and 14％ CTS can increase the catabolism and apoptosis of chondrocytes.Ten percent and 14％ strain can increase the catabolism and apoptosis of chondrocytes.Cyclic 6％ strain can increase the anabolism of chondrocytes,but 2％ strain has no impact on metabolism or apoptosis.