Objective To study the effect of medial collateral ligament(MCL)release on the squatting motion followling total knee arthroplasty(TKA)and provide reference data for ligament release during knee replacement surgery.Methods Based on CT and MRI images of a volunteer,a three-dimensional(3D)geometric anatomical model of the natural knee joint including bone tissues and major soft tissues was established.A finite element model of the artificial knee joint was established by simulating TKA surgery.The squatting motion after 30％release of the upper end,lower end,and both ends of the MCL was simulated,and motion characteristic data of the knee joint at flexion/extension angles from 0° to 135° were obtained.Results The effects of ligament release at different locations on knee squatting motion varied.After releasing the lower end,the medial translation,posterior translation,superior translation,and adduction of the femur relative to the tibia increased by 13.74％,3.83％,9.74％,and 2.37％,respectively,while the external rotation decreased by 36.8％.After releasing the upper end,the medial translation and posterior translation increased by 10.65％and 10％,respectively,while the superior translation,adduction,and external rotation decreased by 4.52％,33.89％,and 67.1％,respectively.After releasing both ends,the medial translation,posterior translation,and superior translation increased by 14.77％,9.39％,and 22.56％,respectively,while the adduction and external rotation decreased by 15.62％and 47.3％,respectively.Conclusions After MCL released,the medial translation,anterior translation,superior translation,and abduction of the femur relative to the tibia increased,while the external rotation decreased.Releasing the lower end had the least effect on these femoral movements,showing an obvious advantage.

Objective To investigate the status of oral frailty(OF)in patients who underwent chemotherapy for lung cancer,identify key factors influencing OF,and develop a risk prediction model.Methods Using convenience sampling,431 lung cancer inpatient were recruited from three Tier-IIIA hospitals in Jiangsu Province between September and November 2024 as the training cohort.The patients were divided into OF and non-OF groups.Relevant data were compared between the two groups.Multifactorial logistic regression analysis was performed to determine factors that associated with OF,and a risk prediction model was created accordingly.Receiver operating characteristic(ROC)curve analysis was used to predict model performance.In December 2024,additional 185 patients from one other Tier-IIIA hospitals were recruited to validate the developed model.Results The prevalence of OF among lung-cancer patients undergoing chemotherapy was 58.93%.Following listed items were identified as the risk factors of OF(all P<0.05):older in age(OR=3.420),poor education(OR=0.030),brain metastasis(OR=7.880),high nutritional risk screening 2002 score(OR=1.550),elevated C-reactive protein(OR=1.100),and elevated lactate dehydrogenase(OR=1.010).ROC area under the curve(AUC)of the model was 0.860(95%CI:0.830-0.900)in modelling cohort and 0.840(95%CI:0.780-0.900)in validation cohort.Hosmer-Lemeshow goodness-of-fit test yielded χ 2=4.870,P=0.770 for the training set and χ 2=2.770,P=0.950 for the validation set.Conclusion The risk prediction model for OF developed in this study demonstrates a good predictive performance and can facilitate early identification of high-risk patients,thereby providing a scientific basis for clinical interventions.

Objective To explore the identification method,pathogenesis,clinical characteristics and individualized pharmacotherapy of asymptomatic hyperuricemia after renal transplantation.Methods The pharmacist was on duty at the organ transplant outpatient clinic.During this time,they analyzed and sorted out the medications,identified and differentiated a case of asymptomatic hyperuricemia related to spironolactone in a patient who had undergone a renal transplant,and provided comprehensive care throughout the entire process.Results The asymptomatic hyperuricemia in this patient might be associated with spironolactone,and the adverse reactions of the patient were alleviated by pharmacists through optimizing clinical treatment.Up to now,no hyperuricemia occurred.Conclusions Pharmacists are required to collaborate closely with clinicians to establish medication profiles for patients under long-term follow-up and to closely monitor and evaluate drug-related adverse reactions.Additionally,they should assess the renal function and immune status of transplant recipients promptly and formulate individualized treatment plans in order to enhance the long-term survival of both the transplanted kidneys and the recipients.

Objective To evaluate the efficacy and safety of enteric-coated metformin hydrochloride capsules(Junlida?)in patients with T2DM and poor glycemic control under lifestyle interventions.Methods In this study,419 patients with T2DM were recruited from 15 research centers from July 2020 to March 2022,and randomly divided into observation(Obs)group(n=209)and control group(Con,n=210)using a multicenter,randomized,double-blind,non-inferiority trial design.Patients in the Obs group were treated with enteric-coated Metformin hydrochloride capsules(Junlida?),and patients in the Con group were treated with Metformin hydrochloride tablets(Glucophage?).The optimal effective dose of 2 g/d was achieved within 4 weeks,and the reasonable dose was maintained until the end of treatment.The treatment period was 24 weeks.HbA1c and its compliance rate,FPG,and body weight were compared between the two groups in full analysis set(FAS)and protocol set(PPS).Safety and adverse events(AE)were evaluated in safety set(SS).Results A total of 414 participants were randomized(207 cases in Obs group and 207 cases in Con group).414 cases in FAS population(207 cases in Obs group and 207 cases in Con group),and 328 cases in PPS population(164 cases in Obs group and 164 cases in Con group),and 414 cases in SS population(207 cases in Obs group and 207 cases in Con group).After treatment,HbA1c,FPG and body weight were lower in both groups(P<0.05)in FAS and PPS.HbA1c compliance rate was not significantly different between the two groups in FAS and PPS(P>0.05).The results of non-inferiority test showed that the lower limit was>-0.4%in both FAS(-0.154,95%CI-0.384～0.069)and PPS(-0.139,95%CI-0.390～0.112),and the Obs group reached non-inferiority end point.The achievement rate,compliance rate,safety index and incidence of AE were not significantly different between the two groups(P>0.05).Conclusions Junlida? demonstrated non-inferiority to Glucophage? in glycemic control and can be safely and effectively used in patients with diabetes.

To formulate an expert consensus on the principles of preoperative hair removal and provide scientific guidance for standardized removal of hair before surgical procedures so as to reduce the incidence of surgical site infections.METHODS Led by the Hospital Management Institute of National Health Commission of the People's Republic of China,this consensus was reached with the joint efforts from the expects of relevant fields such as surgeries,interventional therapies,nursing,and infection prevention and control.The consensus facilitates the classification and evaluation of literatures by following the evidence grade formulated by Oxford Evidence-based Medicine Center and focuses on the association of preoperative hair removal with surgical site infection,it reaches the evidence grade of expert consensus and recommendation intensity by integrating with discussions on meetings and clinical experience of the expects from relevant fields.RESULTS A total of 6 items of consensus were reached by summarizing the latest evidence on the aspects including the indications for preoperative hair removal,tools,range,timing and places.CONCLUSION The consensus,to some extent,make supplements to and complete the exiting regulations and standards.It provides guidance for the medical institutions to carry out the preoperative hair removal.

Objective To study the effect of medial collateral ligament(MCL)release on the squatting motion followling total knee arthroplasty(TKA)and provide reference data for ligament release during knee replacement surgery.Methods Based on CT and MRI images of a volunteer,a three-dimensional(3D)geometric anatomical model of the natural knee joint including bone tissues and major soft tissues was established.A finite element model of the artificial knee joint was established by simulating TKA surgery.The squatting motion after 30％release of the upper end,lower end,and both ends of the MCL was simulated,and motion characteristic data of the knee joint at flexion/extension angles from 0° to 135° were obtained.Results The effects of ligament release at different locations on knee squatting motion varied.After releasing the lower end,the medial translation,posterior translation,superior translation,and adduction of the femur relative to the tibia increased by 13.74％,3.83％,9.74％,and 2.37％,respectively,while the external rotation decreased by 36.8％.After releasing the upper end,the medial translation and posterior translation increased by 10.65％and 10％,respectively,while the superior translation,adduction,and external rotation decreased by 4.52％,33.89％,and 67.1％,respectively.After releasing both ends,the medial translation,posterior translation,and superior translation increased by 14.77％,9.39％,and 22.56％,respectively,while the adduction and external rotation decreased by 15.62％and 47.3％,respectively.Conclusions After MCL released,the medial translation,anterior translation,superior translation,and abduction of the femur relative to the tibia increased,while the external rotation decreased.Releasing the lower end had the least effect on these femoral movements,showing an obvious advantage.

Objective To investigate the status of oral frailty(OF)in patients who underwent chemotherapy for lung cancer,identify key factors influencing OF,and develop a risk prediction model.Methods Using convenience sampling,431 lung cancer inpatient were recruited from three Tier-IIIA hospitals in Jiangsu Province between September and November 2024 as the training cohort.The patients were divided into OF and non-OF groups.Relevant data were compared between the two groups.Multifactorial logistic regression analysis was performed to determine factors that associated with OF,and a risk prediction model was created accordingly.Receiver operating characteristic(ROC)curve analysis was used to predict model performance.In December 2024,additional 185 patients from one other Tier-IIIA hospitals were recruited to validate the developed model.Results The prevalence of OF among lung-cancer patients undergoing chemotherapy was 58.93%.Following listed items were identified as the risk factors of OF(all P<0.05):older in age(OR=3.420),poor education(OR=0.030),brain metastasis(OR=7.880),high nutritional risk screening 2002 score(OR=1.550),elevated C-reactive protein(OR=1.100),and elevated lactate dehydrogenase(OR=1.010).ROC area under the curve(AUC)of the model was 0.860(95%CI:0.830-0.900)in modelling cohort and 0.840(95%CI:0.780-0.900)in validation cohort.Hosmer-Lemeshow goodness-of-fit test yielded χ 2=4.870,P=0.770 for the training set and χ 2=2.770,P=0.950 for the validation set.Conclusion The risk prediction model for OF developed in this study demonstrates a good predictive performance and can facilitate early identification of high-risk patients,thereby providing a scientific basis for clinical interventions.

Objective To investigate the characteristics of cognitive inhibition in children with hearing impairment and the impact of different types of materials on their cognitive inhibition.Methods From June,2024 to January,2025,21 children with hearing impairment from Liaocheng Special Education School and 20 typically developing children from Guotun Town Central Primary School in Yanggu County,Liao-cheng were randomly selected.A directed forgetting task was used in a mixed experimental design.The experi-mental procedure was presented using Eprime 3.0,and recall performance was recorded through paper-and-pen-cil tests.Results Three children with hearing impairment and two typically developing children were dropped down.The children with hearing impairment scored significantly lower on recall tasks than the typically developing children(F=13.545,P<0.001).In the typically developing children,recall performance under the memory condition was sig-nificantly lower than under the forgetting condition(P<0.001).In the children with hearing impairment,there was no significant difference in recall performance between the memory condition and the forgetting condition(P>0.05).Regardless of whether the materials were letters or figures,all the children showed significantly high-er recall scores under the forgetting condition compared to the memory condition(P<0.01).Conclusion Children with hearing impairment exhibit weaker cognitive inhibition compared to typically developing chil-dren.The type of materials doesn't impact individuals'cognitive inhibition performance.

Objective:To understand the current status of oral frailty in elderly diabetic patients and analyze its influencing factors.Methods:A convenience sampling method was used to select elderly diabetic patients hospitalized at Henan Cancer Hospital and Henan Provincial People's Hospital from October 2023 to May 2024. The general information questionnaire, Oral Frailty Index-8 (OFI-8) , Short Form of Health Literacy Dental Scale (HeLD-14) , Nutritional Risk Screening 2002 (NRS 2002) , and the Diabetes Distress Scale (DDS) were used to collect data. Binary Logistic regression analysis was used to examine the influencing factors of oral frailty in elderly diabetic patients.Results:A total of 235 questionnaires were distributed, and 220 valid questionnaires were returned, with an effective response rate of 93.62% (220/235) . The incidence of oral frailty in elderly diabetic patients was 46.82% (103/220) . The binary Logistic regression analysis showed that glycated hemoglobin, dry mouth, remaining teeth, nutritional risk, oral health literacy, and diabetes distress were significant influencing factors for the occurrence of oral frailty in elderly diabetic patients ( P<0.05) . Conclusions:The current status of oral frailty in elderly diabetic patients is concerning. Healthcare providers should pay attention to the oral health status of elderly diabetic patients and provide targeted nursing interventions and recommendations based on the influencing factors of oral frailty, in order to reduce its occurrence.

Objective:To analyze the burden and trends of noncommunicable chronic disease(NCD) attributable to metabolic factors in China from 1990 to 2021.Methods:Data from the Global Burden of Diseases(GBD) 2021 database were utilized to describe changes in mortality and disability-adjusted life years(DALYs) of NCD in China from 1990 to 2021. Stratified analyses were conducted by age, sex, sociodemographic index(SDI), and related risk factors. Statistical analyses and predictions were conducted using the age-period-cohort model and the Nordpred model.Results:In 2021, the age-standardized mortality rate and age-standardized DALYs rate of NCD attributable to metabolic factors in China were 227.56 per 100 000 and 4 829.39 per 100 000, respectively. Their average annual percentage changes were -0.76%( P<0.001) and -0.77%( P<0.001). Overall, the burden decreased progressively with higher SDI levels. Analysis using the age-period-cohort model indicated reduced birth cohort and period effects for metabolic factor-attributable NCD, while age effects rose significantly. The minimum relative risk( RR) value was observed in the 15-19 age group( RR=0.01), and the maximum RR value occurred in the 95-99 age group( RR=996.86). The overall rising mortality trend indicated that age effects are the predominant driver at present. Projections estimate that by 2046, deaths from metabolic factor-attributable NCD in China will reach 8 189 563, with an age-standardized mortality rate of 236.95 per 100 000. Conclusions:China continues to face a substantial burden of NCD linked to metabolic factors, with older adults, males, and individuals with hypertension, diabetes, and prediabetes identified as key populations requiring targeted interventions.