1.Association of 24 hour movement behaviors and physical fitness with serum C-reactive protein among female college students
WEN Xinfei, WANG Xiuqiang, WANG Chuanzhi, CHENG Shulin, LIU Jinyan
Chinese Journal of School Health 2026;47(4):579-583
Objective:
To examine the associations between 24 hour movement behavior allocation patterns and physical fitness as well as serum high sensitivity C-reactive protein (hsCRP) levels among female college students, providing evidence for developing personalized health promotion strategies.
Methods:
In September 2025, 48 female college students aged 18-22 years were recruited from a comprehensive university from Shanghai. Continuous 24 hour movement behaviors were monitored using a triaxial accelerometer (ActiGraph GT3X+). Serum hsCRP levels were measured (≥1 000 ng/mL was log grade inflammation), and physical fitness indicators including upper limb muscle strength, vital capacity, and maximal oxygen consumption (VO 2max ) were assessed. Spearman rank correlation analysis was used to evaluate the correlation between variables. Compositional data analysis combined with multiple linear regression was employed to construct isotemporal substitution models, evaluating the effects of substituting 30 minutes of one behavior for another on hsCRP and VO 2max .
Results:
Female college students had the longest average daily sedentary behavior (SB) time (643.2±103.2)min, which was higher than sleep time (452.4±90.0)min, light physical activity (LPA) time (279.0±76.8)min and moderate to vigorous physical activity (MVPA) time (66.0±21.6)min. Correlation analysis revealed that vigorous physical activity (VPA) was positively correlated with hsCRP levels among female college students ( r=0.47, P <0.05). Substituting 30 minutes of MVPA with sleep, SB or LPA significantly reduced predicted hsCRP levels among female college students ( β = -0.90, -0.90, -0.73), replacing 30 minutes of sleep with MVPA significantly increased predicted VO 2max levels ( β =5.12) (all P <0.05). The low grade inflammation group exhibited longer durations of high intensity activity participation and higher mean values for height, body weight, and grip strength compared to the normal group ( t =2.17, 2.52, 2.21, all P <0.05). Within the normal inflammation group, MVPA was positively associated with VO 2max ( β =0.18), while sleep was negatively associated ( β =-0.07) (both P <0.05). In contrast, no statistically significant associations were observed between any activity behavior and VO 2max in the low grade inflammation group (all P >0.05).
Conclusions
MVPA exerts bidirectional effects on the health of female college students. While it enhances cardiorespiratory fitness, it may concurrently elevate chronic low grade inflammation levels. To maximize health benefits, intervention programs focused on increasing MVPA should also give full consideration to the importance of restorative sleep.
2.Vector analysis for evaluating the effect of rotation on myopic astigmatism correction after V4c toric collamer lens implantation
Bo ZHANG ; Wenwen DU ; Hao WANG ; Chenjiu PANG ; Jing YANG ; Shulin WANG ; Zaohe SUN ; Jin LI ; Yuwei GU
Chinese Journal of Experimental Ophthalmology 2025;43(2):144-152
Objective:To evaluate the effect of toric collamer lens (TICL) rotation on myopia combined with astigmatism correction after V4c TICL implantation using standardized vector analysis.Methods:An observational case series study was performed.A total of 152 patients (268 eyes) who underwent V4c TICL implantation for the correction of myopia and myopic astigmatism were enrolled at Henan Eye Hospital from January to December 2021.The preoperative spherical diopter, cylindrical diopter, and spherical equivalent (SE) were -15.00 to -3.25 D, -5.00 to -0.50 D, -16.50 to -3.88 D, respectively.Postoperative TICL vault and axis were measured by anterior segment optical coherence tomography, and postoperative TICL rotation was calculated.Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical diopter, cylindrical diopter, SE, and target astigmatism vector were recorded before and 1 month after surgery.The effectiveness index, safety index, surgically induced astigmatism vector (SIA), margin of error (ME), absolute value of the difference vector |DV|, correction index (CI), and achievement index (IS) were calculated based on the subjective refraction results 1 month after surgery and the cylindrical axis of the V4c TICL.Vector analysis parameters was compared among patients with different preoperative astigmatism, intraoperative TICL fixation, postoperative TICL rotation, and postoperative vault.The correlation between postoperative TICL rotation and TICL fixed angle deviation, postoperative vault, visual acuity and refraction, and vector analysis parameters were evaluated.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[13]).Written informed consent was obtained from each subject.Results:At 1 month postoperatively, the mean safety and efficacy indices were 1.27 and 1.29, respectively.There was no statistically significant difference between the predicted SE of (-0.11±0.13)D and the postoperative SE of (-0.07±0.52)D ( t=-0.994, P=0.321).UCVA, BCVA and cylinder diopter in the operative eyes were all improved after surgery compared to before surgery and the differences were statistically significant ( t=17.854, 5.446, -25.634; all P<0.001).The rotation of V4c TICL was 0° to 25°, with a mean of (5.41±4.35)°, which was positively correlated with the V4c TICL fixed angle deviation ( rs=0.461, P<0.001), negatively correlated with postoperative cylindrical diopter and positively correlated with postoperative UCVA, |DV| and SIA ( r=-0.360, 0.191, 0.205, 0.142; all P<0.05).Vector analysis between groups showed that vault, SIA and |DV| were higher and CI and IS were lower in low astigmatism group than in high astigmatism group ( Z=-3.017, -13.569, -2.793, -2.761, -4.779; all P<0.05).V4c TICL rotation and |DV| were lower in low fixation angle difference group than in high fixation angle difference group ( Z=-7.865, -2.080; both P<0.05).Preoperative cylindrical diopter, intraoperative V4c TICL fixed angle deviation, SIA and |DV| were lower in low rotation group than in high rotation group ( Z=-2.104, -4.578, -2.456, -2.090; all P<0.05).There were no statistically significant differences in the TICL rotation or in each vector between patients with different vault after the surgery (all P>0.05). Conclusions:V4c TICL implantation can achieve good results for the correction of myopia and myopic astigmatism.There is a slight difference between the fixation axis and the target axis of V4c TICL, which affects the rotation of V4c TICL and |DV|.Postoperative V4c TICL rotation is related to TICL fixed angle deviation, postoperative UCVA, SIA, |DV| and postoperative cylindrical diopter.Postoperative vault has no significant effect on TICL rotation and differences in each vector.
3.Analysis of Chemical Components of Yin-Qiao-Qing-Re Tablets by UPLC-Q-TOF-MS/MS and GC-MS
Zerong CAI ; Yumei HU ; Wenjun LIU ; Shulin WANG ; Xinyu KONG ; Yifan YANG ; Mengyu QIAN ; Li-ang CAO ; Zhenzhong WANG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(9):1198-1212
OBJECTIVE The non-volatile and volatile chemical components in Yin-Qiao-Qing-Re Tablets were analyzed sepa-rately using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS)and Gas Chromatography Mass Spectrometry(GC-MS).METHODS The non-volatile components were analyzed using a Waters ACQUITY UPLC BEH C18 column(2.1 mm×100 mm,1.7 μm),with a mobile phase consisting of 0.1%formic acid aqueous solution(A)and acetonitrile(B)for gradient elution,a flow rate of 0.35 mL·min-1,an injection volume of 5 μL,and a column temperature of 30 ℃;the volatile components were analyzed using an Agilent SH-I-5MS column(5%Phenyl Methyl Silox,30 m×250 μm,0.25 μm);the procedure was temperature-programmed,with an injection volume of 1 μL,a split ratio of 10∶1,a flow rate of 1.0 mL·min-1,and an inlet temperature of 200 ℃.RESULTS A total of 134 non-volatile chemical components and 23 volatile components were analyzed and identified from Yin-Qiao-Qing-Re Tablets,among which 49 compounds were confirmed through comparison with reference stand-ards.The non-volatile components mainly include 27 flavonoids,21 organic acids,15 lignans,14 iridoids,12 phenylethanoid glyco-sides,11 saponins,10 alkaloids,5 terpenes,4 amino acids,3 phenylpropanoids,3 nucleosides,3 xanthones,3 phenolic glycosides,2 chromones and 1 carbohydrate.The volatile components mainly include 11 monoterpenes,5 alcohols and phenols,3 alkenes,2 ke-tones,1 ester,and 1 hydrocarbon.CONCLUSION This study rapidly identifies the chemical components of Yin-Qiao-Qing-Re Tablets,laying a preliminary foundation for research on the pharmacodynamic substances of Yin-Qiao-Qing-Re Tablets and the im-provement of quality control standards.
4.Optimization of the Extraction Process of Changyan Heji Ⅱ Based on UPLC-Q-TOF-MS/MS Combined with Response Surface Method and Principal Component Analysis
Shulin WANG ; Jing SHANG ; Wenjun LIU ; Zerong CAI ; Mengyu QIAN ; Xiaoxin HU ; Liang CAO ; Zhenz-hong WANG ; Wei XIAO
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(4):501-512
OBJECTIVE To establish a extraction process of Changyan Heji Ⅱ(CYHJ-Ⅱ)based on UPLC-Q-TOF-MS/MS technology combined with response surface analysis,and to optimize the extraction process.METHODS The chemical components in CYHJ-Ⅱ were qualitatively analyzed by UPLC-Q-TOF-MS/MS technology,and the chemical components with good linear relation-ship in mass spectrometry response were selected as process investigation indicators;the extraction process parameters(water addition amount,extraction time and soaking time)were investigated by Box-Behnken design;the comprehensive score was obtained by princi-pal component analysis(PCA),and the optimal process was determined by the comprehensive score combined with response surface a-nalysis.RESULTS Through qualitative analysis,110 components were inferred and identified from CYHJ-Ⅱ,including 2 organic acids,82 flavonoids,13 terpenoids,and 13 alkaloids.Based on the results of qualitative analysis,48 index components with good lin-ear relationships were derived by UPLC-Q-TOF-MS/MS combined with Masshunter mass spectrometry data analysis software.PCA was performed and the comprehensive score was calculated.Response surface analysis was performed with the comprehensive score as an indicator.The optimal extraction process obtained by combining the response surface prediction results and actual production was:soaking for 45 min,8 times the amount of solvent,2 extractions,each time for 120 min.CONCLUSION This study provides a new idea for the investigation of the extraction process of traditional Chinese medicine compound prescriptions and expands a new method for the development of traditional Chinese medicine compound prescriptions.
5.Methodological correlation and efficacy analysis of the detection of hepatitis B virus surface antigen in clinical laboratory
Haixia WANG ; Shulin ZHANG ; Yingying ZHAO ; Yangfan FENG ; Weipeng DU ; Jingyi LIANG ; Jiawei LI
Chinese Journal of Immunology 2025;41(7):1772-1776,1781
Objective:To explore the evaluation and relationship of hepatitis B virus(HBV)surface antigen(HBsAg)in clinical laboratory in different detection systems,further scientifically and reasonably to explain the test results for serving clinical practices.Methods:During the period from June 2021 to July 2022,100 425 specimens of patients with screened,suspected and confirmed HBV infections were collected from the clinical departments(mainly infectious hepatology)of Nanyang Central Hospital.Detection methodology included quantitative(electrochemiluminescence and chemiluminescence),qualitative(gold standard),semi-quantita-tive(ELISA),and highly sensitive HBV-DNA(RT-PCR)methods,and then analyzed the strengths and weaknesses and closeness be-tween each methodology.The relationship between the two Roche HBsAg detection systems was analyzed by correlation analysis.The HBsAg efficacy analysis was validated using Cut/Off value setting and detection limit,which in turn analyzed the distribution of false-positive and false-negative reporting models.Results:Detection results for low-and medium-concentration HBsAg showed a correla-tion between the electrochemical luminescence semi-quantitative method and ELISA method.ELISA method still had advantages in terms of sensitivity and specificity when detecting HBsAg,and there were no significant differences compared to domestic and interna-tional HBsAg quantitative detection systems.Performance validation conducted in accordance with the CNAS-GL038 document showed that the minimum detection limit for HBsAg calculated using the ELISA method in this laboratory was 0.1 U/ml.When the ROC curve Cut/Off value was set to 0.105,the area under the curve was the largest(AUC=0.986).Based on Roche's semi-quantitative electroche-miluminescence detection and patient medical history,in the common reporting model for hepatitis B five-item detection using ELISA method,HBsAg false positives occurred most frequently when HBsAg was positive alone,and HBsAg occurred most frequently in the false positive range when the OD value was less than 0.5.In ELISA method for detecting HBsAg,as the OD value increased from 0.01 to 0.10,the number of false-negative results also increased.Roche Elecsys HBsAg Ⅱ Quant Ⅱ and Elecsys HBsAg Ⅱ testing systems exhibited good linearity under certain conditions,with a ratio of approximately 1/0.18.In Elecsys HBsAg Ⅱ Quant Ⅱ detection sys-tem,the test results of HBsAg samples diluted 400 times were highly consistent with the original test results with a coefficient of deter-mination R2=0.993 8.Conclusion:There was a certain relationship between various detection systems of HBsAg at a suitable concen-tration.The detection of HBsAg by ELISA can meet the needs of clinical detection.
6.Vector analysis for evaluating the effect of rotation on myopic astigmatism correction after V4c toric collamer lens implantation
Bo ZHANG ; Wenwen DU ; Hao WANG ; Chenjiu PANG ; Jing YANG ; Shulin WANG ; Zaohe SUN ; Jin LI ; Yuwei GU
Chinese Journal of Experimental Ophthalmology 2025;43(2):144-152
Objective:To evaluate the effect of toric collamer lens (TICL) rotation on myopia combined with astigmatism correction after V4c TICL implantation using standardized vector analysis.Methods:An observational case series study was performed.A total of 152 patients (268 eyes) who underwent V4c TICL implantation for the correction of myopia and myopic astigmatism were enrolled at Henan Eye Hospital from January to December 2021.The preoperative spherical diopter, cylindrical diopter, and spherical equivalent (SE) were -15.00 to -3.25 D, -5.00 to -0.50 D, -16.50 to -3.88 D, respectively.Postoperative TICL vault and axis were measured by anterior segment optical coherence tomography, and postoperative TICL rotation was calculated.Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), spherical diopter, cylindrical diopter, SE, and target astigmatism vector were recorded before and 1 month after surgery.The effectiveness index, safety index, surgically induced astigmatism vector (SIA), margin of error (ME), absolute value of the difference vector |DV|, correction index (CI), and achievement index (IS) were calculated based on the subjective refraction results 1 month after surgery and the cylindrical axis of the V4c TICL.Vector analysis parameters was compared among patients with different preoperative astigmatism, intraoperative TICL fixation, postoperative TICL rotation, and postoperative vault.The correlation between postoperative TICL rotation and TICL fixed angle deviation, postoperative vault, visual acuity and refraction, and vector analysis parameters were evaluated.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2021[13]).Written informed consent was obtained from each subject.Results:At 1 month postoperatively, the mean safety and efficacy indices were 1.27 and 1.29, respectively.There was no statistically significant difference between the predicted SE of (-0.11±0.13)D and the postoperative SE of (-0.07±0.52)D ( t=-0.994, P=0.321).UCVA, BCVA and cylinder diopter in the operative eyes were all improved after surgery compared to before surgery and the differences were statistically significant ( t=17.854, 5.446, -25.634; all P<0.001).The rotation of V4c TICL was 0° to 25°, with a mean of (5.41±4.35)°, which was positively correlated with the V4c TICL fixed angle deviation ( rs=0.461, P<0.001), negatively correlated with postoperative cylindrical diopter and positively correlated with postoperative UCVA, |DV| and SIA ( r=-0.360, 0.191, 0.205, 0.142; all P<0.05).Vector analysis between groups showed that vault, SIA and |DV| were higher and CI and IS were lower in low astigmatism group than in high astigmatism group ( Z=-3.017, -13.569, -2.793, -2.761, -4.779; all P<0.05).V4c TICL rotation and |DV| were lower in low fixation angle difference group than in high fixation angle difference group ( Z=-7.865, -2.080; both P<0.05).Preoperative cylindrical diopter, intraoperative V4c TICL fixed angle deviation, SIA and |DV| were lower in low rotation group than in high rotation group ( Z=-2.104, -4.578, -2.456, -2.090; all P<0.05).There were no statistically significant differences in the TICL rotation or in each vector between patients with different vault after the surgery (all P>0.05). Conclusions:V4c TICL implantation can achieve good results for the correction of myopia and myopic astigmatism.There is a slight difference between the fixation axis and the target axis of V4c TICL, which affects the rotation of V4c TICL and |DV|.Postoperative V4c TICL rotation is related to TICL fixed angle deviation, postoperative UCVA, SIA, |DV| and postoperative cylindrical diopter.Postoperative vault has no significant effect on TICL rotation and differences in each vector.
7.Clinical efficacy of membrane-induced technique combined with antibiotic cement-coated plate in the treatment of chronic osteomyelitis of the distal femur
Xianjie ZHU ; Xiaoliang TAO ; Shulin WANG ; Xiaohua WANG ; Dong SUN
Chinese Journal of Orthopaedics 2025;45(20):1305-1312
Objective:o evaluate the clinical efficacy of the induced membrane technique combined with an antibiotic-impregnated bone cement-coated plate fixation in the treatment of chronic osteomyelitis of the distal femur.Methods:A retrospective study was performed on patients diagnosed with chronic osteomyelitis of the distal femur, who received the induced membrane technique combined with an antibiotic-impregnated bone cement-coated plate fixation at Southwest Hospital from November 2016 to December 2022. All patients underwent a two-stage surgical protocol. Stage I involved thorough debridement, placement of antibiotic-impregnated bone cement spacers, and internal fixation with antibiotic-impregnated bone cement-coated plates. Stage II comprised internal fixation for the repair and reconstruction of bone defects. Intraoperatively, microbial culture, antibiotic susceptibility testing, and pathological examination were conducted on bone tissue lesion samples to guide targeted anti-infective therapy. Postoperatively, laboratory markers including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), along with clinical manifestations (e.g., incision drainage, redness, fever, and pain), were monitored to exclude infection recurrence. Infection control was ultimately confirmed by intraoperative frozen section analysis during the second stage. Additionally, bone healing was evaluated via X-ray of the affected limb every month after the second-stage surgery, and lower limb function was assessed using the final knee range of motion (ROM) and the lower extremity function scale (LEFS).Results:A total of 104 patients met the inclusion criteria, including 70 males and 34 females, with a mean age of 35.2±12.13 years. Thirty-seven patients were diagnosed with chronic hematogenous osteomyelitis (CHO) and 67 with post-traumatic osteomyelitis (PTOM). The mean follow-up was 25.48±6.61 months (range, 12-38 months). After the first-stage surgery, infection recurred in 6 CHO and 15 PTOM patients, requiring repeated debridement. Two CHO patients experienced infection recurrence after second-stage reconstruction, which was successfully controlled with further staged treatment. Five PTOM patients developed nonunion after second-stage bone grafting but ultimately achieved bone union after revision surgery. At final follow-up, CRP levels were 4.45±4.23 mg/L (CHO) and 5.16±4.26 mg/L (PTOM), and ESR levels were 5.47±7.42 mm/h (CHO) and 8.51±8.72 mm/h (PTOM), all significantly lower than preoperative values (CRP: CHO 68.31±65.61, PTOM 42.71±80.46; ESR: CHO 52.18±34.29, PTOM 45.87±39.13; all P<0.05). All patients ultimately achieved bone union. One PTOM patient with a preoperative rupture of the knee extensor mechanism had limited improvement in ROM (15° preoperatively vs. 12° at 4-year follow-up). In the remaining patients, knee ROM at final follow-up was significantly improved (CHO: 101.38°±43.73°, PTOM: 94.28°±43.94°) compared with preoperative values (CHO: 57.17°± 4.53°, PTOM: 39.61°±52.61°; all P<0.05). The final LEFS scores were 72.18±9.51 (CHO) and 71.66±10.25 (PTOM). Conclusion:The findings of this study demonstrate that the combination of the "Chongqing Technique" and the "Membrane-Induced Technique" is effective in eradicating chronic osteomyelitis of the distal femur, promoting bone healing, and restoring satisfactory knee joint function.
8.Clinical laboratory testing and molecular epidemiological characterization of influenza A virus in a hospital in Henan Province from 2016-2024
Haixia WANG ; Yue WU ; Jingjing CAI ; Yingying ZHAO ; Yangfan FENG ; Qing CHEN ; Kai DU ; Shulin ZHANG ; Xuedong ZHANG
Chinese Journal of Laboratory Medicine 2025;48(9):1185-1193
Objective:To investigate the methodological differences in the detection, the inflammatory markers and the pathogenic epidemiological characteristics of influenza A virus in clinical laboratories, in order to provide more diagnostic and epidemiological data for diagnosis and prevention for children with influenza A.Methods:A retrospective cross-sectional study was conducted to collect 96 731 patients with suspected influenza A from January 2016 to October 2024 in Nanyang City Center Hospital from the Clinical Laboratory Testing Information System, including 5 731 patients with confirmed influenza A, aged 5.2 (2.8, 43.7) years old. We analyzed the distribution of influenza A patients from age and mixed infections, the relationship between patient age and positive detection rate by restricted cubic spline (RCS), analyzed differences in testing methods used Kappa consistency testing and receiver operating characteristic (ROC) curves, established a model of inflammatory markers by logistic regression, as well as developed a prediction model and also the mutation of the hemagglutinin (HA) sequence of the influenza A subtype H3N2 virus using evolutionary tree analysis.Results:RCS analysis showed an inverted 'S' shaped non-linear relationship between the positive detection rate of influenza A and the age groups of the patients. Among the mixed infections, 1.43%(1 352/94 867) of the cases were combined with Mycoplasma pneumoniae infection. The Kappa values of reverse transcription PCR (RT-PCR) and serological indirect immunofluorescence assay (IFA) for detecting influenza A in nasopharyngeal swabs and alveolar lavage fluid in clinical laboratories were 0.632 and 0.809, respectively, and those of magnetic particle chemiluminescence assay were 0.614 and 0.668, respectively, and the area under curves in ROC curve of IFA and RT-PCR were 0.869 and 0.792, respectively. The inflammatory indexes were usually elevated in severe children compared with mild children. By binary logistic regression model analysis, neutrophil-to-lymphocyte ratio, D-dimer/fibrinogen and prognosis nutrition index were the risk factors and serum amyloid A/C reactive protein ratio was the protective factor for severe children with influenza A, and the OR values of the above factors were 1.760, 7.076, 1.045, and 0.719, respectively, and P<0.01. By the Bayesian Interdiction Criterion, the optimal seasonal autoregressive moving average mixed model for influenza A epidemics was ARIMA (1, 1, 1) (2, 1, 2) 12 with the highest prediction accuracy of 98.63%. The seven strains of H3N2 all belonged to the same isoforms, with nucleotide similarity of the HA gene ranging from 99.5% to 99.9%, and the glycosylation site, receptor-binding site, and the conserved amino acid residue Glycosylation sites, receptor binding sites and conserved amino acid residues remained unchanged. HA sequence analysis showed that the prevalent strains in Nanyang had undergone mutation to different degree compared with the vaccine strains. Conclusion:Scientific and rational testing and characteristic inflammatory markers in the clinical laboratory are of great clinical value in the diagnosis of children with severe influenza A. At the same time, the epidemiological monitoring of influenza A variants should be strengthened.
9.Alterations in individual differential structural covariance networks of cognitive emotion regulation in young, first-episode and drug-naive patients with major depressive disorder
Meiling GU ; Qiuyu LYU ; Shulin FANG ; Jiayue HE ; Daifeng DONG ; Xiang WANG
Chinese Journal of Neurology 2025;58(4):396-403
Objective:To investigate the alterations in the brain structural network properties related to cognitive emotion regulation strategies in young, first-episode and drug-naive (FEDN) patients with major depressive disorder (MDD).Methods:One hundred and twelve young patients who were diagnosed with FEDN MDD were enrolled in the Second Xiangya Hospital of Central South University between October 2019 and October 2023, and 143 healthy controls (HC) were recruited for reference during the same period. Clinical data and T 1 structural images of high-resolution magnetic resonance imaging were collected from all participants, and the cognitive emotion regulation was assessed using the Chinese version of the Cognitive Emotion Regulation Questionnaire (CERQ-C). The brain structural alterations related to cognitive emotion regulation strategies were explored using whole-brain voxel-based morphometry (VBM) group analysis and individual differential structural covariance network (IDSCN) analysis. Partial correlation analysis was performed between the IDSCN anomalous structural concatenated edge and subdimensions of the CERQ-C. Results:The scores on the sub-dimension of negative cognitive emotion regulation (self-condemnation, rumination, catastrophization, blaming others) in the young FEDN MDD patients in CERQ-C were significantly higher than those in HC (14.28±2.30 vs 12.45±2.00, t=6.501, P<0.001;14.40±2.97 vs 11.31±2.93, t=7.934, P<0.001;12.19±3.75 vs 7.59±2.58, t=10.553, P<0.001;10.26±3.00 vs 8.74±2.89, t=3.916, P<0.001; respectively). There was no statistically significant difference in the VBM group analysis (all P>0.05). However, IDSCN single sample t test results showed significant group differences between the left orbitofrontal inferior gyrus and the left supplementary motor area, the left orbitofrontal middle gyrus and the bilateral precuneus, and the left superior temporal gyrus and the bilateral hippocampus (all P<0.05). With controlling for age, sex, and other factors, partial correlation analysis results showed that the left orbital inferior frontal gyrus-left supplementary motor area connection in patients with MDD was positively correlated with the self-condemnation and acceptance scores of the CERQ-C ( r=0.226, P=0.027; r=0.216, P=0.035), while negatively correlated with the score of blaming others ( r=-0.252, P=0.013). Additionally, connections between the right hippocampus and left superior temporal gyrus were significantly associated with the scores on catastrophization subdimension of the CERQ-C ( r=0.229, P=0.025). Conclusion:Due to its sensitivity to individualized analyses, the IDSCN analysis found that abnormal topological property changes were mainly manifested in the limbic system, the sensorimotor system, and the default network in young FEDN MDD patients, and were linked to their negative cognitive emotion regulation strategies, even though the VBM group analysis did not yield any significant results.
10.Clinical efficacy of membrane-induced technique combined with antibiotic cement-coated plate in the treatment of chronic osteomyelitis of the distal femur
Xianjie ZHU ; Xiaoliang TAO ; Shulin WANG ; Xiaohua WANG ; Dong SUN
Chinese Journal of Orthopaedics 2025;45(20):1305-1312
Objective:o evaluate the clinical efficacy of the induced membrane technique combined with an antibiotic-impregnated bone cement-coated plate fixation in the treatment of chronic osteomyelitis of the distal femur.Methods:A retrospective study was performed on patients diagnosed with chronic osteomyelitis of the distal femur, who received the induced membrane technique combined with an antibiotic-impregnated bone cement-coated plate fixation at Southwest Hospital from November 2016 to December 2022. All patients underwent a two-stage surgical protocol. Stage I involved thorough debridement, placement of antibiotic-impregnated bone cement spacers, and internal fixation with antibiotic-impregnated bone cement-coated plates. Stage II comprised internal fixation for the repair and reconstruction of bone defects. Intraoperatively, microbial culture, antibiotic susceptibility testing, and pathological examination were conducted on bone tissue lesion samples to guide targeted anti-infective therapy. Postoperatively, laboratory markers including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), along with clinical manifestations (e.g., incision drainage, redness, fever, and pain), were monitored to exclude infection recurrence. Infection control was ultimately confirmed by intraoperative frozen section analysis during the second stage. Additionally, bone healing was evaluated via X-ray of the affected limb every month after the second-stage surgery, and lower limb function was assessed using the final knee range of motion (ROM) and the lower extremity function scale (LEFS).Results:A total of 104 patients met the inclusion criteria, including 70 males and 34 females, with a mean age of 35.2±12.13 years. Thirty-seven patients were diagnosed with chronic hematogenous osteomyelitis (CHO) and 67 with post-traumatic osteomyelitis (PTOM). The mean follow-up was 25.48±6.61 months (range, 12-38 months). After the first-stage surgery, infection recurred in 6 CHO and 15 PTOM patients, requiring repeated debridement. Two CHO patients experienced infection recurrence after second-stage reconstruction, which was successfully controlled with further staged treatment. Five PTOM patients developed nonunion after second-stage bone grafting but ultimately achieved bone union after revision surgery. At final follow-up, CRP levels were 4.45±4.23 mg/L (CHO) and 5.16±4.26 mg/L (PTOM), and ESR levels were 5.47±7.42 mm/h (CHO) and 8.51±8.72 mm/h (PTOM), all significantly lower than preoperative values (CRP: CHO 68.31±65.61, PTOM 42.71±80.46; ESR: CHO 52.18±34.29, PTOM 45.87±39.13; all P<0.05). All patients ultimately achieved bone union. One PTOM patient with a preoperative rupture of the knee extensor mechanism had limited improvement in ROM (15° preoperatively vs. 12° at 4-year follow-up). In the remaining patients, knee ROM at final follow-up was significantly improved (CHO: 101.38°±43.73°, PTOM: 94.28°±43.94°) compared with preoperative values (CHO: 57.17°± 4.53°, PTOM: 39.61°±52.61°; all P<0.05). The final LEFS scores were 72.18±9.51 (CHO) and 71.66±10.25 (PTOM). Conclusion:The findings of this study demonstrate that the combination of the "Chongqing Technique" and the "Membrane-Induced Technique" is effective in eradicating chronic osteomyelitis of the distal femur, promoting bone healing, and restoring satisfactory knee joint function.


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