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 clinical efficacy of digital 3D technology assisted and traditional one-hole split endoscopic surgery for lumbar spinal stenosis with degenerative scoliosis(LSS-DS).Methods Clinical data of 42 patients with LSS-DS who underwent one-hole split endoscopic surgery from January 2022 to December 2023 were retrospectively analyzed.Among them,20 cases were treated with digital 3D technology assisted one-hole split endoscopic surgery(3D group),and 22 cases were treated with traditional one-hole split endoscopic surgery(traditional group).The operation time,intraoperative blood loss,lateral articular surface preservation rate,Visual Analogue Scale(VAS)of lower extremity pain,Oswestry Disability Index(ODI)and modified MacNab criteria at the last follow-up were compared between the two groups.Results Both groups of patients were operated successfully.The operation time of the 3D group and the traditional group was(73.3±24.0)min and(65.7±23.8)min,respectively,with no significant difference(t=1.020,P=0.314).The intraoperative blood loss was(65.3±14.7)ml and(66.7±17.1)ml,respectively,with no significant difference(t=-0.298,P=0.767).The retention rate of lateral articular surface in the 3D group[(88.2±6.3)%]was significantly higher than that in the traditional group[(82.7±4.6)%,t=3.201,P=0.003].One patient in the traditional group had dural tear and was cured after conservative treatment.There were 3 cases of calf muscle venous thrombosis in the 3D group and 4 cases in the traditional group.All the 7 patients were given anticoagulant therapy and appropriately delayed time of ambulation.In the3D group,20 cases were followed up for6-13 months,with a mean of(8.2±2.0)months;in the traditional group,22 cases were followed up for 6-12 months,with a mean of(7.7±1.7)months.According to the modified MacNab criteria,the excellent and good rate was 95.0%(19/20)in the 3D group and 90.1%(20/22)in the traditional group at the last follow-up,and there was no significant difference between the two groups(Z=-0.311,P=0.756).The VAS score and ODI of the two groups were significantly improved at 3 months and 6 months after operation(all P=0.000),but there was no significant difference between the two groups at each time point(P>0.05).Conclusion The short-term efficacy of digital 3D technology assisted one-hole split endoscopic surgery in the treatment of LSS-DS is definite,and the symptoms of patients are significantly improved.

Objective To compare the clinical efficacy of digital 3D technology assisted and traditional one-hole split endoscopic surgery for lumbar spinal stenosis with degenerative scoliosis(LSS-DS).Methods Clinical data of 42 patients with LSS-DS who underwent one-hole split endoscopic surgery from January 2022 to December 2023 were retrospectively analyzed.Among them,20 cases were treated with digital 3D technology assisted one-hole split endoscopic surgery(3D group),and 22 cases were treated with traditional one-hole split endoscopic surgery(traditional group).The operation time,intraoperative blood loss,lateral articular surface preservation rate,Visual Analogue Scale(VAS)of lower extremity pain,Oswestry Disability Index(ODI)and modified MacNab criteria at the last follow-up were compared between the two groups.Results Both groups of patients were operated successfully.The operation time of the 3D group and the traditional group was(73.3±24.0)min and(65.7±23.8)min,respectively,with no significant difference(t=1.020,P=0.314).The intraoperative blood loss was(65.3±14.7)ml and(66.7±17.1)ml,respectively,with no significant difference(t=-0.298,P=0.767).The retention rate of lateral articular surface in the 3D group[(88.2±6.3)%]was significantly higher than that in the traditional group[(82.7±4.6)%,t=3.201,P=0.003].One patient in the traditional group had dural tear and was cured after conservative treatment.There were 3 cases of calf muscle venous thrombosis in the 3D group and 4 cases in the traditional group.All the 7 patients were given anticoagulant therapy and appropriately delayed time of ambulation.In the3D group,20 cases were followed up for6-13 months,with a mean of(8.2±2.0)months;in the traditional group,22 cases were followed up for 6-12 months,with a mean of(7.7±1.7)months.According to the modified MacNab criteria,the excellent and good rate was 95.0%(19/20)in the 3D group and 90.1%(20/22)in the traditional group at the last follow-up,and there was no significant difference between the two groups(Z=-0.311,P=0.756).The VAS score and ODI of the two groups were significantly improved at 3 months and 6 months after operation(all P=0.000),but there was no significant difference between the two groups at each time point(P>0.05).Conclusion The short-term efficacy of digital 3D technology assisted one-hole split endoscopic surgery in the treatment of LSS-DS is definite,and the symptoms of patients are significantly improved.

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.

Inducing the degradation of KRAS represents a novel strategy to combat cancers with KRAS mutation. In this study, we identify ubiquitin-specific protease 2 (USP2) as a novel deubiquitinating enzyme of KRAS in multiple myeloma (MM). Specifically, we demonstrate that gambogic acid (GA) forms a covalent bond with the cysteine 284 residue of USP2 through an allosteric pocket, inhibiting its deubiquitinating activity. Inactivation or knockdown of USP2 leads to the degradation of KRAS, resulting in the suppression of MM cell proliferation in vitro and in vivo. Conversely, overexpressing USP2 stabilizes KRAS and partially abrogates GA-induced apoptosis in MM cells. Furthermore, elevated USP2 levels may be associated with poorer prognoses in MM patients. These findings highlight the potential of the USP2/KRAS axis as a therapeutic target in MM, suggesting that strategically inducing KRAS degradation via USP2 inhibition could be a promising approach for treating cancers with KRAS mutations.

Background and Aims:Stenting and plain old balloon angioplasty (POBA) remain the primary treatments for femoropopliteal in-stent restenosis (ISR). These approaches demonstrate good short-term patency;however,ISR frequently recurs due to continuous stimulation of the vascular intima by the stent. With advancements in endovascular technology,excimer laser ablation (ELA) combined with drug-coated balloons (DCB) offers a novel strategy for treating ISR. This study investigated the safety and efficacy of ELA combined with DCB for complex femoropopliteal ISR.Methods:The clinical data of 69 patients with femoropopliteal ISR treated with interventional procedures between June 2020 and June 2022 were retrospectively analyzed. Among them,27 patients underwent ELA combined with DCB treatment (ELA+DCB group),and 42 patients underwent POBA combined with DCB treatment (POBA+DCB group). Relevant clinical variables were compared between the two groups.Results:No significant differences were observed in baseline characteristics between the two groups (all P>0.05). True lumen re-entry was achieved in all 69 patients. The procedural success rates for the ELA+DCB and POBA+DCB groups were 92.6％ (25/27) and 90.5％ (38/42),respectively,with no statistically significant difference (P>0.05). Intraoperative adverse events were comparable between groups (all P>0.05). Logistic regression analysis indicated that thrombus in the target lesion was an independent risk factor for distal embolization during ELA+DCB (HR=24.695,95％ CI=1.061-574.904,P=0.046). Ankle-brachial index (ABI) values immediately after the procedure and at 1 and 6 months postoperatively showed no significant differences between the two groups (all P>0.05). However,the ELA+DCB group demonstrated superior ABI outcomes at 12,18,and 24 months postoperatively (all P<0.05). There were no significant differences in all-cause mortality or amputation rates postoperatively (both P>0.05). Kaplan-Meier analysis showed that the ELA+DCB group had higher 2-year freedom from target lesion revascularization (81.5％ vs. 57.1％,P=0.044) and 2-year patency rates (77.8％ vs. 52.4％,P=0.031) compared to the POBA+DCB group. ROC curve analysis identified a laser tube diameter/reference vessel diameter (TD/RVD) ratio cutoff value of 0.47 (AUC=0.825,95％ CI=0.619-1.000) for predicting 2-year patency after ELA plus DCB treatment,with a specificity of 66.7％. Cox regression analysis revealed that postoperative antithrombotic therapy (HR=0.033,95％ CI=0.002-0.661,P=0.026),≥2 tibial arteries recanalized (HR=0.022,95％ CI=0.001-0.808,P=0.038),and TD/RVD ≥ 0.47 (HR=0.002,95％ CI=0.000-0.403,P=0.022) were independent factors associated with improved 2-year patency after ELA plus DCB treatment.Conclusion:For complex femoropopliteal ISR,ELA combined with DCB does not show significant advantages in safety compared to POBA combined with DCB,but it provides superior long-term efficacy. Intraoperative management and postoperative antithrombotic therapy may influence the mid-to long-term outcomes of ELA combined with DCB for treating complex femoropopliteal ISR.

Background and Aims:Stenting and plain old balloon angioplasty (POBA) remain the primary treatments for femoropopliteal in-stent restenosis (ISR). These approaches demonstrate good short-term patency;however,ISR frequently recurs due to continuous stimulation of the vascular intima by the stent. With advancements in endovascular technology,excimer laser ablation (ELA) combined with drug-coated balloons (DCB) offers a novel strategy for treating ISR. This study investigated the safety and efficacy of ELA combined with DCB for complex femoropopliteal ISR.Methods:The clinical data of 69 patients with femoropopliteal ISR treated with interventional procedures between June 2020 and June 2022 were retrospectively analyzed. Among them,27 patients underwent ELA combined with DCB treatment (ELA+DCB group),and 42 patients underwent POBA combined with DCB treatment (POBA+DCB group). Relevant clinical variables were compared between the two groups.Results:No significant differences were observed in baseline characteristics between the two groups (all P>0.05). True lumen re-entry was achieved in all 69 patients. The procedural success rates for the ELA+DCB and POBA+DCB groups were 92.6％ (25/27) and 90.5％ (38/42),respectively,with no statistically significant difference (P>0.05). Intraoperative adverse events were comparable between groups (all P>0.05). Logistic regression analysis indicated that thrombus in the target lesion was an independent risk factor for distal embolization during ELA+DCB (HR=24.695,95％ CI=1.061-574.904,P=0.046). Ankle-brachial index (ABI) values immediately after the procedure and at 1 and 6 months postoperatively showed no significant differences between the two groups (all P>0.05). However,the ELA+DCB group demonstrated superior ABI outcomes at 12,18,and 24 months postoperatively (all P<0.05). There were no significant differences in all-cause mortality or amputation rates postoperatively (both P>0.05). Kaplan-Meier analysis showed that the ELA+DCB group had higher 2-year freedom from target lesion revascularization (81.5％ vs. 57.1％,P=0.044) and 2-year patency rates (77.8％ vs. 52.4％,P=0.031) compared to the POBA+DCB group. ROC curve analysis identified a laser tube diameter/reference vessel diameter (TD/RVD) ratio cutoff value of 0.47 (AUC=0.825,95％ CI=0.619-1.000) for predicting 2-year patency after ELA plus DCB treatment,with a specificity of 66.7％. Cox regression analysis revealed that postoperative antithrombotic therapy (HR=0.033,95％ CI=0.002-0.661,P=0.026),≥2 tibial arteries recanalized (HR=0.022,95％ CI=0.001-0.808,P=0.038),and TD/RVD ≥ 0.47 (HR=0.002,95％ CI=0.000-0.403,P=0.022) were independent factors associated with improved 2-year patency after ELA plus DCB treatment.Conclusion:For complex femoropopliteal ISR,ELA combined with DCB does not show significant advantages in safety compared to POBA combined with DCB,but it provides superior long-term efficacy. Intraoperative management and postoperative antithrombotic therapy may influence the mid-to long-term outcomes of ELA combined with DCB for treating complex femoropopliteal ISR.

Objective To predict the potential mechanism of Yifei Sanjie prescription in the treatment of lung adenocarcinoma based on network pharmacology,and to verify one of the key signal pathways,Janus protein tyrosine kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3),by cell experiments in vitro.Methods To screen the main active components and potential action targets of Yifei Sanjie prescription,with traditional Chinese medicine system pharmacological database(TCMSP).To search and retrieve the main targets of lung adenocarcinoma,with human genetic database(GeneCards)and online human Mendelian genetic database(OMIM).To obtain the intersection targets by screening and apply Wayne diagram,then analysis the topology and establish the traditional Chinese medicine-active compound-target network diagram by using of Cytoscape 3.7.2 software.To construct the protein-protein interaction(PPI)network,with the protein-protein interaction platform(STRING)and Cytoscape3.7.2 software.To analyze the functional enrichment of gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG),with the Metascape database.To carry out the molecular docking verification by using of Vina1.2.3 software.Using CCK-8 method to detect the effect of Yifei Sanjie prescription on cell activity.Using the cell scratch test to observe the effect on cell migration.And using Western blot method to test the expression of p-STAT3,STAT3,p-JAK2,JAK2 and VEGF-A.Results 94 active components,329 related drug targets and 1358 lung adenocarcinoma targets were obtained from Yifei Sanjie prescription,among which,150 of them intersected.PPI network visualization analysis shows that the potential key targets of Yifei Sanjie prescription in the treatment of lung adenocarcinoma are protein kinase B1(AKT1),β-actin(ACTB),tumor suppressor gene p53(TP53),serum albumin(ALB),caspase-3(CASP3)and vascular endothelial growth factor A(VEGFA).KEGG enrichment analysis screened 138 related signal pathways,indicating that JAK/STAT signaling pathway may play a key role in the treatment of lung adenocarcinoma with Yifei Sanjie prescription.Molecular docking results showed that quercetin,luteolin,and ursolic acid had good binding activities with JAK2 and STAT3.The cell experiment showed that compared with the blank group,Yifei Sanjie prescription could significantly inhibit the activity of A549 cells,inhibit the migration of A549 cells,and decrease the expression of p-JAK2/JAK2,p-STAT3/STAT3 and VEGF-A protein.In addition,Colivelin,an activator of JAK2/STAT3 pathway,could reverse the effect of Yifei Sanjie prescription on the expression of A549 related proteins.Conclusion Yifei Sanjie prescription has the characteristics of multi-component,multi target and multi pathway in the treatment of lung adenocarcinoma,and its mechanism may be related to the down-regulation of p-JAK2,p-STAT3 and VEGF-A protein expression,thereby inhibiting cell proliferation and migration.

Polyurethane (PUR) plastics is widely used because of its unique physical and chemical properties. However, unreasonable disposal of the vast amount of used PUR plastics has caused serious environmental pollution. The efficient degradation and utilization of used PUR plastics by means of microorganisms has become one of the current research hotspots, and efficient PUR degrading microbes are the key to the biological treatment of PUR plastics. In this study, an Impranil DLN-degrading bacteria G-11 was isolated from used PUR plastic samples collected from landfill, and its PUR-degrading characteristics were studied. Strain G-11 was identified as Amycolatopsis sp. through 16S rRNA gene sequence alignment. PUR degradation experiment showed that the weight loss rate of the commercial PUR plastics upon treatment of strain G-11 was 4.67%. Scanning electron microscope (SEM) showed that the surface structure of G-11-treated PUR plastics was destroyed with an eroded morphology. Contact angle and thermogravimetry analysis (TGA) showed that the hydrophilicity of PUR plastics increased along with decreased thermal stability upon treatment by strain G-11, which were consistent with the weight loss and morphological observation. These results indicated that strain G-11 isolated from landfill has potential application in biodegradation of waste PUR plastics.
Plastics/metabolism* ; Polyurethanes/chemistry* ; RNA, Ribosomal, 16S ; Bacteria/genetics* ; Biodegradation, Environmental

Existing traditional Chinese medicine (TCM)-related databases are still insufficient in data standardization, integrity and precision, and need to be updated urgently. Herein, an Encyclopedia of Traditional Chinese Medicine version 2.0 (ETCM v2.0, http://www.tcmip.cn/ETCM2/front/#/) was constructed as the latest curated database hosting 48,442 TCM formulas recorded by ancient Chinese medical books, 9872 Chinese patent drugs, 2079 Chinese medicinal materials and 38,298 ingredients. To facilitate the mechanistic research and new drug discovery, we improved the target identification method based on a two-dimensional ligand similarity search module, which provides the confirmed and/or potential targets of each ingredient, as well as their binding activities. Importantly, five TCM formulas/Chinese patent drugs/herbs/ingredients with the highest Jaccard similarity scores to the submitted drugs are offered in ETCM v2.0, which may be of significance to identify prescriptions/herbs/ingredients with similar clinical efficacy, to summarize the rules of prescription use, and to find alternative drugs for endangered Chinese medicinal materials. Moreover, ETCM v2.0 provides an enhanced JavaScript-based network visualization tool for creating, modifying and exploring multi-scale biological networks. ETCM v2.0 may be a major data warehouse for the quality marker identification of TCMs, the TCM-derived drug discovery and repurposing, and the pharmacological mechanism investigation of TCMs against various human diseases.