Objective:To observe the improving effects of Tuina(Chinese therapeutic massage)plus exercise therapy on joint alignment and walking function in children with genu varum(GV).Methods:Sixty-six children with GV were divided into an exercise therapy group and a Tuina plus exercise therapy group using the random number table method,with 33 cases in each group.Both groups received identical exercise therapy,while the Tuina plus exercise therapy group was additionally offered Tuina manipulation treatment.The intervention course lasted 12 weeks in both groups.Before and after the intervention,the three-dimensional gait analysis was adopted to assess the spatiotemporal parameters,kinematics,and kinetic characteristics of lower-limb joints in children with GV.Results:The GV angle was reduced after intervention in the Tuina plus exercise therapy group(P<0.05),but there was no significant change in the exercise therapy group(P>0.05).After treatment,the Tuina plus exercise therapy group demonstrated a notable decrease in the step length,walking speed,peak forefoot adduction angle,and peak ankle inversion moment(P<0.05),suggesting the correction of the ankle joint's compensatory pathological changes.In the exercise therapy group,the foot progression angle(FPA)and gait deviation index(GDI)increased markedly after the intervention(P<0.05),indicating improved overall kinematic function.Conclusion:The combined use of Tuina manipulations and exercise therapy can produce significant effects in correcting the knee joint's torsion,both coronally(GV angle)and horizontally(ankle inversion moment,FPA,and forefoot adduction angle),while exercise therapy alone can markedly improve the overall kinematic parameters(FPA and GDI).

Objective To assess the motor function of school-aged children with congenital muscular torticollis(CMT),and analyze the spatiotemporal parameters of their walking motion as well as the kinematic parameters of the trunk and lower limbs,so as to explore the potential long-term impact of CMT on the growth and development of children.Methods Using three-dimensional(3D)gait analysis technology,the gait of children with CMT was evaluated in detail and compared with that of normal children.The motion angles and ranges of the trunk,pelvis,hip,knee,and ankle joints,along with spatio-temporal parameters,were analyzed.Thirty-one children with CMT aged 6-12 years were recruited into the torticollis group,and 31 normal children of the same age range were included in the control group.The data of the torticollis group were divided into the healthy side and the affected side based on the side of the torticollis.Statistical analysis was performed among the three groups to calculate the differences in kinematic and spatio-temporal parameters.Results Compared with nomal children of the same age in the control group,significant differences were observed in the affected and unaffected sides of the torticollis group in terms of stride length,gait speed,percentage of support phase time,average ankle inversion angle during the swing phase,average ankle inversion angle during the support phase,average foot orientation angle during the support phase,average ankle internal rotation angle relative to the tibia during the stance phase,average knee valgus angle during the stance phase,average shoulder joint elevation,and shoulder joint height at landing.Specifically,the torticollis group had significantly lower stride length,gait speed,ankle inversion angle,knee valgus angle,and foot eversion angle in both the affected and unaffected sides compared to the control group,while the percentage of support phase time and the internal rotation angle of the foot relative to the tibia during the stance phase were higher than those in the control group.Conclusions For school-aged children with CMT,there are still residual manifestations of overall motor development abnormalities.These abnormalities also affect the non-affected side.Children with CMT have a relatively high risk of developing uneven shoulders,their overall walking efficiency is lower than that of normal children of the same age,and they exhibit lower limb motor abnormalities such as insufficient ankle joint stability.

Objective To investigate the gait characteristics of school-age children with generalised joint hypermobility(GJH).Methods The kinematic and kinetic data of lower extremity joints in 56 children with GJH and 56 healthy children were collected by 3D motion capture system and 3D force plates,and the differences between the two groups were compared and analyzed.Results Kinematics parameters:the mean ankle inversion angle(P=0.000),maximum hip adduction angle(P=0.002)and maximum foot clearance angle(P=0.004)in stance phase decreased in the GJH children group,while the mean foot progression angle(P=0.000),the maximum foot internal rotation angle(P=0.000)in stance phase,and the knee flexion angle(P=0.032)in the middle stance phase increased.Kinetics parameters:the maximum power of knee(P=0.005)and hip(P=0.000)joints and the maximum inversion moment of ankle joints(P=0.009)in stance phase decreased in GJH children group.Temporal and spatial parameters:the step length(P=0.001),walking velocity(P=0.000),and cadence(P=0.000)decreased in GJH children group,while the stance phase percentage(P=0.000),and step width(P=0.000)increased.Conclusions There is a decrease in walking efficiency and balance stability of children with GJH.The line alignment is abnormal in ankle joint.The knee function needs a long-term attention.

Objective To investigate the gait characteristics of school-age children with generalised joint hypermobility(GJH).Methods The kinematic and kinetic data of lower extremity joints in 56 children with GJH and 56 healthy children were collected by 3D motion capture system and 3D force plates,and the differences between the two groups were compared and analyzed.Results Kinematics parameters:the mean ankle inversion angle(P=0.000),maximum hip adduction angle(P=0.002)and maximum foot clearance angle(P=0.004)in stance phase decreased in the GJH children group,while the mean foot progression angle(P=0.000),the maximum foot internal rotation angle(P=0.000)in stance phase,and the knee flexion angle(P=0.032)in the middle stance phase increased.Kinetics parameters:the maximum power of knee(P=0.005)and hip(P=0.000)joints and the maximum inversion moment of ankle joints(P=0.009)in stance phase decreased in GJH children group.Temporal and spatial parameters:the step length(P=0.001),walking velocity(P=0.000),and cadence(P=0.000)decreased in GJH children group,while the stance phase percentage(P=0.000),and step width(P=0.000)increased.Conclusions There is a decrease in walking efficiency and balance stability of children with GJH.The line alignment is abnormal in ankle joint.The knee function needs a long-term attention.

Objective To assess the motor function of school-aged children with congenital muscular torticollis(CMT),and analyze the spatiotemporal parameters of their walking motion as well as the kinematic parameters of the trunk and lower limbs,so as to explore the potential long-term impact of CMT on the growth and development of children.Methods Using three-dimensional(3D)gait analysis technology,the gait of children with CMT was evaluated in detail and compared with that of normal children.The motion angles and ranges of the trunk,pelvis,hip,knee,and ankle joints,along with spatio-temporal parameters,were analyzed.Thirty-one children with CMT aged 6-12 years were recruited into the torticollis group,and 31 normal children of the same age range were included in the control group.The data of the torticollis group were divided into the healthy side and the affected side based on the side of the torticollis.Statistical analysis was performed among the three groups to calculate the differences in kinematic and spatio-temporal parameters.Results Compared with nomal children of the same age in the control group,significant differences were observed in the affected and unaffected sides of the torticollis group in terms of stride length,gait speed,percentage of support phase time,average ankle inversion angle during the swing phase,average ankle inversion angle during the support phase,average foot orientation angle during the support phase,average ankle internal rotation angle relative to the tibia during the stance phase,average knee valgus angle during the stance phase,average shoulder joint elevation,and shoulder joint height at landing.Specifically,the torticollis group had significantly lower stride length,gait speed,ankle inversion angle,knee valgus angle,and foot eversion angle in both the affected and unaffected sides compared to the control group,while the percentage of support phase time and the internal rotation angle of the foot relative to the tibia during the stance phase were higher than those in the control group.Conclusions For school-aged children with CMT,there are still residual manifestations of overall motor development abnormalities.These abnormalities also affect the non-affected side.Children with CMT have a relatively high risk of developing uneven shoulders,their overall walking efficiency is lower than that of normal children of the same age,and they exhibit lower limb motor abnormalities such as insufficient ankle joint stability.

Objective:To observe the improving effects of Tuina(Chinese therapeutic massage)plus exercise therapy on joint alignment and walking function in children with genu varum(GV).Methods:Sixty-six children with GV were divided into an exercise therapy group and a Tuina plus exercise therapy group using the random number table method,with 33 cases in each group.Both groups received identical exercise therapy,while the Tuina plus exercise therapy group was additionally offered Tuina manipulation treatment.The intervention course lasted 12 weeks in both groups.Before and after the intervention,the three-dimensional gait analysis was adopted to assess the spatiotemporal parameters,kinematics,and kinetic characteristics of lower-limb joints in children with GV.Results:The GV angle was reduced after intervention in the Tuina plus exercise therapy group(P<0.05),but there was no significant change in the exercise therapy group(P>0.05).After treatment,the Tuina plus exercise therapy group demonstrated a notable decrease in the step length,walking speed,peak forefoot adduction angle,and peak ankle inversion moment(P<0.05),suggesting the correction of the ankle joint's compensatory pathological changes.In the exercise therapy group,the foot progression angle(FPA)and gait deviation index(GDI)increased markedly after the intervention(P<0.05),indicating improved overall kinematic function.Conclusion:The combined use of Tuina manipulations and exercise therapy can produce significant effects in correcting the knee joint's torsion,both coronally(GV angle)and horizontally(ankle inversion moment,FPA,and forefoot adduction angle),while exercise therapy alone can markedly improve the overall kinematic parameters(FPA and GDI).

OBJECTIVE: To investigate the correlation between postoperative driving pressure (DP) and the prognosis of lung transplantation, and to further evaluate the value of early DP monitoring in lung transplantation. METHODS: A observational study was conducted. The patients after lung transplantation who admitted to the intensive care unit (ICU) of Wuxi People's Hospital from February 1, 2022 to February 1, 2023 were collected. They were divided into low DP group (DP≤15 cmH₂O, 1 cmH₂O ≈ 0.098 kPa) and high DP group (DP > 15 cmH₂O) according to DP within 2 hours after operation. The clinical data including general information, primary disease, chronic diseases, cardiopulmonary function, laboratory indicators, intraoperative condition, postoperative lactic acid (Lac) and ventilator parameters were collected. Primary outcomes included 28-day and 90-day survival, and secondary outcomes included occurrence of primary graft dysfunction (PGD), duration of extracorporeal membrane oxygenation (ECMO), duration of mechanical ventilation, weaning of mechanical ventilation, and length of ICU stay. The general data and observations between the two groups were compared. Kaplan-Meier curve analysis was conducted to analyze the situation of mechanical ventilation and 90-day survival. Receiver operator characteristic curve (ROC curve) was used to evaluate the predictive ability of DP for failed weaning of mechanical ventilation and 90-day death. The dose-response relationship between DP and 90-day death risk was determined by restricted cubic spline model. Univariate analysis was performed using Cox proportional hazards model. RESULTS: A total of 101 patients were enrolled, with 68 patients (67.3%) in the low DP group and 33 patients (32.7%) in the high DP group. No statistically significant difference in general information, chronic diseases, primary diseases, cardiopulmonary function, laboratory indicators, intraoperative conditions, and postoperative Lac between the two groups was found. Compared with the low DP group, the patients in the high DP group had higher inspiratory pressure (Pinsp) and incidence of PGD with grade 3 at 24 hours after operation [Pinsp (cmH₂O): 21.0±0.6 vs. 20.0±0.7, PGD with grade 3 at 24 hours: 60.6% (20/33) vs. 39.7% (27/68), both P < 0.05], longer duration of ECMO, duration of mechanical ventilation, and the length of ICU stay [duration of ECMO (hours): 37 (21, 109) vs. 22 (14, 43), duration of mechanical ventilation (days): 3.1 (1.8, 10.7) vs. 1.9 (1.1, 3.2), length of ICU stay (days): 6 (3, 13) vs. 4 (3, 5), all P < 0.05], and lower successful weaning rate of mechanical ventilation [81.8% (27/33) vs. 95.6% (65/68), P < 0.05). The 28-day and 90-day survival rates in the high DP group were significantly higher than those in the low DP group [28-day: 69.7% (23/33) vs. 86.8% (59/68), 90-day: 63.6% (21/33) vs. 83.8% (57/68), both P < 0.05]. Kaplan-Meier curve showed that the patients in the low DP group were weaned and extubated earlier than high DP group, and the cumulative situation of weaning was better (Log-Rank test: χ ² = 14.054, P < 0.001), and the 90-day cumulative survival rate in the low DP group was significantly higher than that in the high DP group (Log-Rank test: χ ² = 4.791, P = 0.029). ROC curve analysis showed that the area under ROC curve (AUC) of DP for predicting 90-day death was 0.664 [95% confidence internal (95%CI) was 0.540-0.787, P = 0.017], and the AUC for predicting failed weaning of mechanical ventilation was 0.794 (95%CI was 0.667-0.921, P = 0.004). Results of restricted cubic spline model analysis showed that the 90-day death risk continued to increase with the DP < 18 cmH₂O; when DP≥18 cmH₂O, elevated DP did not continue to increase the 90-day death risk, showing a plateau effect. Univariate analysis showed that DP was independent risk factors of 90-day death, and the death risk increased by 9.3% for every 1 cmH₂O increase in DP [hazard ratio (HR) = 1.093, 95%CI was 1.007-1.186, P = 0.033]. CONCLUSIONS DP is an independent risk factor of death after lung transplantation, and early postoperative DP may be used as a predictor of failed weaning of mechanical ventilation and 90-day death after lung transplantation.
Humans ; Lung Transplantation ; Prognosis ; Respiration, Artificial ; Intensive Care Units ; Postoperative Period ; Pressure ; Primary Graft Dysfunction/epidemiology* ; Transplant Recipients ; Female ; Extracorporeal Membrane Oxygenation ; Male ; ROC Curve ; Middle Aged

BACKGROUND:As tissue engineering brings new hope to the worldwide problem of articular cartilage repair,the construction of light-curing 3D printed hydrogel scaffolds with biomimetic composition is of great significance for cartilage tissue engineering. OBJECTIVE:To construct a biomimetic methacryloylated hyaluronic acid/acellular Wharton's jelly composite hydrogel scaffold by digital light processing 3D printing technology,and to evaluate its biocompatibility. METHODS:Wharton's jelly was isolated and extracted from human umbilical cord,then decellulated,freeze-dried,ground into powder,and dissolved in PBS to prepare 50 g/L acellular Wharton's jelly solution.Methylallylated hyaluronic acid was prepared,lyophilized and dissolved in PBS to prepare 50 g/L methylallylated hyaluronic acid solution.Acellular Wharton's jelly solution was mixed with methacrylyacylated hyaluronic acid solution at a volume ratio of 1:1,and was used as bio-ink after adding photoinitiator.Methylacrylylated hyaluronic acid hydrogel scaffolds(labeled as HAMA hydrogel scaffolds)and methylacrylylated hyaluronic acid/acellular Wharton's jelly gel scaffolds(labeled as HAMA/WJ hydrogel scaffolds)were prepared by digital light processing 3D printing technology,and the microstructure,swelling performance,biocompatibility,and cartilage differentiation performance of the scaffolds were characterized. RESULTS AND CONCLUSION:(1)Under scanning electron microscope,the two groups of scaffolds showed a three-dimensional network structure,and the fiber connection of HAMA/WJ hydrogel scaffold was more uniform.Both groups achieved swelling equilibrium within 10 hours,and the equilibrium swelling ratio of HAMA/WJ hydrogel scaffold was lower than that of HAMA hydrogel scaffold(P＜0.05).(2)CCK-8 assay showed that HAMA/WJ hydrogel scaffold could promote the proliferation of bone marrow mesenchymal stem cells compared with HAMA hydrogel scaffold.Dead/live staining showed that bone marrow mesenchymal stem cells grew well on the two groups of scaffolds,and the cells on the HAMA/WJ hydrogel scaffolds were evenly distributed and more cells were found.Phalloidine staining showed better adhesion and spread of bone marrow mesenchymal stem cells in HAMA/WJ hydrogel scaffold than in HAMA.(3)Bone marrow mesenchymal stem cells were inoculated into the two groups for chondrogenic induction culture.The results of qRT-PCR showed that the mRNA expressions of agglutinoglycan,SOX9 and type Ⅱ collagen in the HAMA/WJ hydrogel scaffold group were higher than those in the HAMA hydrogel scaffold group(P＜0.05,P＜0.01).(4)These findings indicate that the digital light processing 3D bioprinting HAMA/WJ hydrogel scaffold can promote the proliferation,adhesion,and chondrogenic differentiation of bone marrow mesenchymal stem cells.

As a potential vectored vaccine,Newcastle disease virus(NDV)has been subject to various studies for vaccine development,while relatively little research has outlined the immunomodulatory effect of the virus in antigen presentation.To elucidate the key inhibitory factor in regulating the interaction of infected dendritic cells(DCs)and T cells,DCs were pretreated with the NDV vaccine strain LaSota as an inhibitor and stimulated with lipopolysaccharide(LPS)for further detection by enzyme-linked immunosorbent assay(ELISA),flow cytometry,immunoblotting,and quantitative real-time polymerase chain reaction(qRT-PCR).The results revealed that NDV infection resulted in the inhibition of interleukin(IL)-12p40 in DCs through a p38 mitogen-activated protein kinase(MAPK)-dependent manner,thus inhibiting the synthesis of IL-12p70,leading to the reduction in T cell proliferation and the secretion of interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),and IL-6 induced by DCs.Consequently,downregulated cytokines accelerated the infection and viral transmission from DCs to T cells.Furthermore,several other strains of NDV also exhibited inhibitory activity.The current study reveals that NDV can modulate the intensity of the innate?adaptive immune cell crosstalk critically toward viral invasion improvement,highlighting a novel mechanism of virus-induced immunosuppression and providing new perspectives on the improvement of NDV-vectored vaccine.

Objective To analyze the symmetry characteristics of gait dynamics,kinematics,and spatial and temporal parameters in children with mild leg length discrepancy(LLD)and evaluate the likely influence or risk of LLD on children's growth to provide a theoretical basis for early assessment and intervention.Methods Using a modified conventional three-dimensional model,31 markers were placed on the body surface of each subject to collect the gait parameters and calculate the symmetry index(SI).The spatial distance of the ipsilateral markers between the anterior superior iliac spine-external knee-external ankle in the standing position was recorded as the leg length.Then,59 children with leg length difference in the range of 0.5 cm