Objectives:To explore the urban-rural differences in the association between the Life's Essential 8(LE8)scores and the risk of new-onset cardiometabolic diseases(CMD)among adult Chinese.Methods:A total of 4 719 adults aged 18 years or older without CMD from the China Health and Nutrition Survey(CHNS)cohort from 2009 to 2015 were enrolled,including 1 909 in urban areas and 2 810 in rural areas.CMD included myocardial infarction,stroke,and diabetes.The LE8 score included diet,physical activity,sleep,nicotine exposure,body mass index(BMI),non-high-density lipoprotein cholesterol(non-HDL-C),blood glucose,and blood pressure.The score of each LE8 factor ranged from 0 to 100 points,and the average of the sum of the eight scores was the final score.The final LE8 score was divided into a low group(<67.5 points),a medium group(67.5-77.5 points),and a high group(>77.5 points)according to the tertile of the final LE8 score.There were 780,564,and 565 cases in the low,medium,and high LE8 score groups in urban areas,respectively.There were 838,934,and 1 038 cases in the low,medium,and high LE8 score groups in rural areas.The primary outcome was the number of participants newly diagnosed with diabetes,stroke,and/or myocardial infarction during the follow-up period.The Cox proportional hazards regression model was used to analyze the urban-rural difference in the association between LE8 and the risk of new-onset CMD.Results:The total cardiovascular health LE8 scores in rural areas was higher than that in urban residents(72.9 points vs.70.2 points,P<0.01).During the average follow-up period([5.86±0.74]years),there were 176 new cases of CMD,including 67 cases in urban areas and 109 cases in rural areas.Multivariate Cox analysis showed that in the fully adjusted model,compared with the urban-higher group,the rural-lower group(HR=1.65,95%CI:1.27-2.15,P=0.001)had the greatest increased risk of new CMD,followed by the urban-lower group(HR=1.49,95%CI:1.01-2.21,P=0.046),the rural-middle group(HR=1.42,95%CI:1.06-1.90,P=0.020),and the rural-higher group(HR=1.16,95%CI:1.01-1.33,P=0.032).Multivariable Cox regression results showed that in urban areas,compared with those with LE8 scores≥70 points,those with LE8 scores<70 points and with unfavorable BMI score(HR=2.70,95%CI:1.51～4.84,P<0.01),blood glucose scores(HR=2.09,95%CI:1.24-3.51,P<0.01),and blood pressure score(HR=3.73,95%CI:1.69-8.24,P<0.01)faced increased risk of CMD;in rural areas,compared with≥70 points group,<70 points group with unfavorable BMI score(HR=3.92,95%CI:2.43-6.30,P<0.01),non-HDL-C score(HR=2.96,95%CI:1.94-4.52,P<0.01),blood glucose score(HR=2.59,95%CI:1.71-3.94,P<0.01)and blood pressure score(HR=1.85,95%CI:1.18-2.92,P<0.01)faced increased risk of CMD.The risk of CMD associated with BMI,blood glucose,and non-HDL-C scores<70 points was higher in rural areas than in urban areas.Conclusions:Although rural residents have slightly higher LE8 scores than urban residents,the risk of CMD associated with lower LE8 scores is particularly significant in rural areas.Strengthening the monitoring and primary prevention of cardiovascular health among rural residents is of great significance to reduce the burden of CMD in China.

Objectives:To explore the urban-rural differences in the association between the Life's Essential 8(LE8)scores and the risk of new-onset cardiometabolic diseases(CMD)among adult Chinese.Methods:A total of 4 719 adults aged 18 years or older without CMD from the China Health and Nutrition Survey(CHNS)cohort from 2009 to 2015 were enrolled,including 1 909 in urban areas and 2 810 in rural areas.CMD included myocardial infarction,stroke,and diabetes.The LE8 score included diet,physical activity,sleep,nicotine exposure,body mass index(BMI),non-high-density lipoprotein cholesterol(non-HDL-C),blood glucose,and blood pressure.The score of each LE8 factor ranged from 0 to 100 points,and the average of the sum of the eight scores was the final score.The final LE8 score was divided into a low group(<67.5 points),a medium group(67.5-77.5 points),and a high group(>77.5 points)according to the tertile of the final LE8 score.There were 780,564,and 565 cases in the low,medium,and high LE8 score groups in urban areas,respectively.There were 838,934,and 1 038 cases in the low,medium,and high LE8 score groups in rural areas.The primary outcome was the number of participants newly diagnosed with diabetes,stroke,and/or myocardial infarction during the follow-up period.The Cox proportional hazards regression model was used to analyze the urban-rural difference in the association between LE8 and the risk of new-onset CMD.Results:The total cardiovascular health LE8 scores in rural areas was higher than that in urban residents(72.9 points vs.70.2 points,P<0.01).During the average follow-up period([5.86±0.74]years),there were 176 new cases of CMD,including 67 cases in urban areas and 109 cases in rural areas.Multivariate Cox analysis showed that in the fully adjusted model,compared with the urban-higher group,the rural-lower group(HR=1.65,95%CI:1.27-2.15,P=0.001)had the greatest increased risk of new CMD,followed by the urban-lower group(HR=1.49,95%CI:1.01-2.21,P=0.046),the rural-middle group(HR=1.42,95%CI:1.06-1.90,P=0.020),and the rural-higher group(HR=1.16,95%CI:1.01-1.33,P=0.032).Multivariable Cox regression results showed that in urban areas,compared with those with LE8 scores≥70 points,those with LE8 scores<70 points and with unfavorable BMI score(HR=2.70,95%CI:1.51～4.84,P<0.01),blood glucose scores(HR=2.09,95%CI:1.24-3.51,P<0.01),and blood pressure score(HR=3.73,95%CI:1.69-8.24,P<0.01)faced increased risk of CMD;in rural areas,compared with≥70 points group,<70 points group with unfavorable BMI score(HR=3.92,95%CI:2.43-6.30,P<0.01),non-HDL-C score(HR=2.96,95%CI:1.94-4.52,P<0.01),blood glucose score(HR=2.59,95%CI:1.71-3.94,P<0.01)and blood pressure score(HR=1.85,95%CI:1.18-2.92,P<0.01)faced increased risk of CMD.The risk of CMD associated with BMI,blood glucose,and non-HDL-C scores<70 points was higher in rural areas than in urban areas.Conclusions:Although rural residents have slightly higher LE8 scores than urban residents,the risk of CMD associated with lower LE8 scores is particularly significant in rural areas.Strengthening the monitoring and primary prevention of cardiovascular health among rural residents is of great significance to reduce the burden of CMD in China.

Objective:To investigate the clinical curative effect of hyperbaric oxygen（HBO）combined with total arthroscopy in the treatment of popliteal cyst.Methods:From June 2015 to January 2020，the clinical data of 85 patients with popliteal cyst who received total arthroscopic minimally invasive surgery in Department of Orthopedics，Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Department of Adult Orthopedics，Xinhua Hospital Chongming Branch were collected. According to different treatments，patients were divided into observation group（ n=45）and control group（ n=40）. The control group received total arthroscopic minimally invasive surgery while the observation group was additionally treated by hyperbaric oxygen therapy. Visual analogue scale（VAS）was used to evaluate the pain during the 72 hours after operation. Postoperative ambulation time and length of hospital stay were also recorded. Lysholm scoring system was used to evaluate knee function. The therapeutic efficacy was assessed by Rauschning-Lindgren grading. All the patients were followed up for one year to record the recurrence of cysts. Results:After treatment，the postoperative ambulation time and length of hospital stay of the observation group were obviously reduced compared with those of the control group，and its VAS score was lower than that of the control group，with significant statistical differences（ P<0.05）. The Lysholm scores of the two groups seven days after treatment were significantly higher than that before treatment，and the Lysholm score of the observation group markedly was higher than that of the control group after treatment，with significant statistical difference（ P<0.05）. After treatment，the total effective rate of the observation group（93.3%）was remarkably higher than that of the control group（77.5%），with significant statistical difference（ P<0.05）. The recurrence rate of popliteal cyst in the observation group（6.7%）was significant different from that in the control group（17.5%）（ P<0.05）. Conclusion:HBO combined with total arthroscopic minimally invasive surgery in the treatment of popliteal cyst has the advantages of small incision，light pain，rapid recovery，which can quickly restore the function of knee joint with low recurrence rate and significant curative effect.

Objective:To investigate the clinical curative effect of hyperbaric oxygen（HBO）combined with total arthroscopy in the treatment of popliteal cyst.Methods:From June 2015 to January 2020，the clinical data of 85 patients with popliteal cyst who received total arthroscopic minimally invasive surgery in Department of Orthopedics，Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and Department of Adult Orthopedics，Xinhua Hospital Chongming Branch were collected. According to different treatments，patients were divided into observation group（ n=45）and control group（ n=40）. The control group received total arthroscopic minimally invasive surgery while the observation group was additionally treated by hyperbaric oxygen therapy. Visual analogue scale（VAS）was used to evaluate the pain during the 72 hours after operation. Postoperative ambulation time and length of hospital stay were also recorded. Lysholm scoring system was used to evaluate knee function. The therapeutic efficacy was assessed by Rauschning-Lindgren grading. All the patients were followed up for one year to record the recurrence of cysts. Results:After treatment，the postoperative ambulation time and length of hospital stay of the observation group were obviously reduced compared with those of the control group，and its VAS score was lower than that of the control group，with significant statistical differences（ P<0.05）. The Lysholm scores of the two groups seven days after treatment were significantly higher than that before treatment，and the Lysholm score of the observation group markedly was higher than that of the control group after treatment，with significant statistical difference（ P<0.05）. After treatment，the total effective rate of the observation group（93.3%）was remarkably higher than that of the control group（77.5%），with significant statistical difference（ P<0.05）. The recurrence rate of popliteal cyst in the observation group（6.7%）was significant different from that in the control group（17.5%）（ P<0.05）. Conclusion:HBO combined with total arthroscopic minimally invasive surgery in the treatment of popliteal cyst has the advantages of small incision，light pain，rapid recovery，which can quickly restore the function of knee joint with low recurrence rate and significant curative effect.

Objective:To investigate the clinical efficacy of minimally invasive surgery combined with hyperbaric oxygen in the treatment for moderate to severe carpal tunnel syndrome.Methods:The clinical data of 86 patients with moderate to severe carpal tunnel syndrome admitted to the Department of Adult Orthopedics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Orthopedics Department of the Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from March 2016 to December 2019 were retrospectively analyzed. According to the treatment method, they were divided into observation group ( n=42) and control group ( n=44). The control group was treated with modified Okutsu method of endoscopic carpal tunnel release (ECTR), and the observation group was given hyperbaric oxygen on the basis of the treatment in the control group. The clinical efficacy of the two groups three months after operation was assessed by using carpal tunnel syndrome evaluation criteria, and their excellent and good recovery rates were compared. The median nerve sensory conduction velocity (SCV), motor nerve conduction velocity (MCV), sensory nerve action potential (SNAP) amplitude, and motor nerve distal motor latency (DML) of the two groups were measured by electromyography before operation, and 14 d, 30 d, and 90 d after operation. The disabilities of arm, shoulder, and hand (DASH) questionnaire was used to evaluate the upper-extremity function of the two groups before operation, and 14 d, 30 d, and 90 d after operation, and the pinch strength and grip strength of the two groups before operation, and 14 d, 30 d and 90 d after operation were measured by Jamar Pinch Gauge and Jamar Hand Dynamometer. Results:After three months of follow-up, the excellent and good recovery rate of the observation group (85.71%) was significantly higher than that of the control group (70.45%), with a significant statistical difference ( P<0.05). The DASH scores of the observation group were significantly lower than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). The SCV and MCV of the observation group were significantly faster than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). The DMLs of the observation group were significantly shorter than those of the control group at 14 d, 30 d, and 90 d after operation, while the SNAPs were significantly bigger than those of the control group ( P<0.05). The grip strength and pinch strength of the observation group were significantly stronger than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). Conclusion:Modified Okutsu method of ECTR combined with postoperative hyperbaric oxygen treatment can improve the clinical excellent and good recovery rate of carpal tunnel syndrome, which can enhance the electrophysiological function of their median nerves, and their daily functioning, to provide reference for treating chronic injuries caused by carpal tunnel syndrome and other peripheral nerve entrapment syndromes.

Objective:To investigate the clinical efficacy of minimally invasive surgery combined with hyperbaric oxygen in the treatment for moderate to severe carpal tunnel syndrome.Methods:The clinical data of 86 patients with moderate to severe carpal tunnel syndrome admitted to the Department of Adult Orthopedics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Orthopedics Department of the Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from March 2016 to December 2019 were retrospectively analyzed. According to the treatment method, they were divided into observation group ( n=42) and control group ( n=44). The control group was treated with modified Okutsu method of endoscopic carpal tunnel release (ECTR), and the observation group was given hyperbaric oxygen on the basis of the treatment in the control group. The clinical efficacy of the two groups three months after operation was assessed by using carpal tunnel syndrome evaluation criteria, and their excellent and good recovery rates were compared. The median nerve sensory conduction velocity (SCV), motor nerve conduction velocity (MCV), sensory nerve action potential (SNAP) amplitude, and motor nerve distal motor latency (DML) of the two groups were measured by electromyography before operation, and 14 d, 30 d, and 90 d after operation. The disabilities of arm, shoulder, and hand (DASH) questionnaire was used to evaluate the upper-extremity function of the two groups before operation, and 14 d, 30 d, and 90 d after operation, and the pinch strength and grip strength of the two groups before operation, and 14 d, 30 d and 90 d after operation were measured by Jamar Pinch Gauge and Jamar Hand Dynamometer. Results:After three months of follow-up, the excellent and good recovery rate of the observation group (85.71%) was significantly higher than that of the control group (70.45%), with a significant statistical difference ( P<0.05). The DASH scores of the observation group were significantly lower than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). The SCV and MCV of the observation group were significantly faster than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). The DMLs of the observation group were significantly shorter than those of the control group at 14 d, 30 d, and 90 d after operation, while the SNAPs were significantly bigger than those of the control group ( P<0.05). The grip strength and pinch strength of the observation group were significantly stronger than those of the control group at 14 d, 30 d, and 90 d after operation ( P<0.05). Conclusion:Modified Okutsu method of ECTR combined with postoperative hyperbaric oxygen treatment can improve the clinical excellent and good recovery rate of carpal tunnel syndrome, which can enhance the electrophysiological function of their median nerves, and their daily functioning, to provide reference for treating chronic injuries caused by carpal tunnel syndrome and other peripheral nerve entrapment syndromes.

Objective:To investigate the clinical efficacy of hyperbaric oxygen (HBO) therapy combined with arthroscopic minimally invasive treatment on sports traumatic ankle arthritis (STAA) during perioperative period.Methods:The clinical data of 138 patients with STAA admitted to the Department of Adult Orthopedics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Orthopedics Department of Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to January 2020 were collected. According to the treatment methods adopted, they were divided into 3 groups, 46 cases were treated with conventional surgery (group A), 43 cases were treated with arthroscopic minimally invasive treatment (group B), and 49 cases received HBO (HBO was started 3 days before the operation and restarted the second day after the operation) combined with arthroscopic minimally invasive treatment (group C). The clinical efficacies in the 3 groups of patients were observed. The Mcguire scores and the scores of visual analogue scale (VAS) for pain before and after operation were recorded. The postoperative ankle function recovery time, postoperative recovery treatment time, postoperative joint swelling and pain symptoms subsiding time, as well as the operation time, intraoperative blood loss, and length of hospital stay, were recorded.Results:After treatment, the Mcguire scores of the patients in group B and C were significantly higher than those of the group A, and the VAS scores were significantly reduced; after treatment, the Mcguire scores of the patients in group C were significantly higher than that of the group B, and the VAS scores was significantly reduced, with significantly statistical differences ( P<0.05, or P<0.01). After treatment, the total effective rates of the group B (86.0%) and the group C (95.9%) were significantly higher than that of the group A (71.7%), and the total effective rate of the group C was significantly higher than that of the group B, all were with significantly statistical differences ( P<0.05, or P<0.01). The operation time, intraoperative blood loss, and length of hospital stay of the group B and C were significantly lower than those of the group A ( P<0.05, or P<0.01); the length of hospital stay of the patients in the group C was significantly lower than that of the patients in the group B ( P<0.05), but their operation time and intraoperative blood loss were no significant difference ( P>0.05). The postoperative pain subsiding time, postoperative joint function recovery time, and postoperative recovery treatment time of the patients in the group B and C were significantly lower than those of the patients in the group A ( P<0.05, or P<0.01); the postoperative pain subsiding time, postoperative joint function recovery time, and postoperative recovery treatment time of the patients in the group C were significantly lower than those of the patients in the group B, with significantly statistical differences ( P<0.05). Conclusion:HBO combined with arthroscopic minimally invasive treatment on STAA can significantly improve the clinical efficacy and help restore ankle joint function.

Objective:To investigate the clinical efficacy of hyperbaric oxygen (HBO) therapy combined with arthroscopic minimally invasive treatment on sports traumatic ankle arthritis (STAA) during perioperative period.Methods:The clinical data of 138 patients with STAA admitted to the Department of Adult Orthopedics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Orthopedics Department of Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to January 2020 were collected. According to the treatment methods adopted, they were divided into 3 groups, 46 cases were treated with conventional surgery (group A), 43 cases were treated with arthroscopic minimally invasive treatment (group B), and 49 cases received HBO (HBO was started 3 days before the operation and restarted the second day after the operation) combined with arthroscopic minimally invasive treatment (group C). The clinical efficacies in the 3 groups of patients were observed. The Mcguire scores and the scores of visual analogue scale (VAS) for pain before and after operation were recorded. The postoperative ankle function recovery time, postoperative recovery treatment time, postoperative joint swelling and pain symptoms subsiding time, as well as the operation time, intraoperative blood loss, and length of hospital stay, were recorded.Results:After treatment, the Mcguire scores of the patients in group B and C were significantly higher than those of the group A, and the VAS scores were significantly reduced; after treatment, the Mcguire scores of the patients in group C were significantly higher than that of the group B, and the VAS scores was significantly reduced, with significantly statistical differences ( P<0.05, or P<0.01). After treatment, the total effective rates of the group B (86.0%) and the group C (95.9%) were significantly higher than that of the group A (71.7%), and the total effective rate of the group C was significantly higher than that of the group B, all were with significantly statistical differences ( P<0.05, or P<0.01). The operation time, intraoperative blood loss, and length of hospital stay of the group B and C were significantly lower than those of the group A ( P<0.05, or P<0.01); the length of hospital stay of the patients in the group C was significantly lower than that of the patients in the group B ( P<0.05), but their operation time and intraoperative blood loss were no significant difference ( P>0.05). The postoperative pain subsiding time, postoperative joint function recovery time, and postoperative recovery treatment time of the patients in the group B and C were significantly lower than those of the patients in the group A ( P<0.05, or P<0.01); the postoperative pain subsiding time, postoperative joint function recovery time, and postoperative recovery treatment time of the patients in the group C were significantly lower than those of the patients in the group B, with significantly statistical differences ( P<0.05). Conclusion:HBO combined with arthroscopic minimally invasive treatment on STAA can significantly improve the clinical efficacy and help restore ankle joint function.

BACKGROUND:Fracture healing in diabetic patients is usual y unsatisfactory because of hormones and metabolic disorder, and an eventual multiple organ dysfunction resulting from high blood glucose. OBJECTIVE:To dynamical y observe the changes of cytokines during the fracture healing process in diabetic rats before and after insulin treatment. METHODS:A total of 120 Sprague-Dawley rats were included in this study. Of them, 90 rats intravenously injected with 5%tetraoxypyrimidine to induce rat models of diabetes were randomized into insulin treatment and diabetes groups, respectively. The remaining 30 rats were intravenously injected with equal volume of saline and selected as control group. The next day, blood glucose was determined. Healing at 1, 4, and 8 weeks after fracture were observed by the X-ray film. Biomechanical strength of the injured right tibia was measured at 4, 6, and 8 weeks after modeling. Cytokines in the osteotylus were determined by immunohistochemical staining and in situ hybridization technique. RESULTS AND CONCLUSION:The X-ray films showed that the speed of fracture healing in the diabetes group was slower than insulin treatment and control groups. Biomechanical strength of the osteotylus in the diabetes group was significantly decreased compared with the insulin treatment and control groups. However, there were no significant differences in above-mentioned parameters between the control and insulin treatment groups. Bone morphogenetic protein 2, basic fibroblast growth factor, transforming growth factor-beta, and vascular endothelial growth factor were widely expressed in the osteotylus and their expressions in diabetes group were significantly lower and slower than those in the control and insulin treatment groups. There was no statistical difference between control and insulin treatment groups. These results indicate that osteotylus formation speed, biomechanical strength, and growth factor expressions at the fracture site in diabetes rats were decreased compared with normal rats. Insulin treatment can enhance cytokine levels at the fracture site, thereby promoting the osteoblast proliferation and fracture healing.

Objective To explore the effect of orthopedic sub-discipline rotation mode in the postgraduate orthopaedic education. Meth-ods Randomly selected orthopaedic postgraduate students from grade 2011 and grade 2012 (30 students each grade). Students from grade 2011 went through the traditional teaching mode,and students from grade 2012 adopted 2 months of rotation in each sub-discipline. The clini-cal examination results and teaching satisfaction of the two groups were analyzed. Results The clinical examination results and teaching sat-isfaction of students from the two grades showed statistically differences (P<0. 05). Conclusion Orthopaedic sub-discipline rotation teach-ing mode improved the postgraduates in different ways such as orthopaedic theoretical knowledge, clinical skills, case analysis and so on. Meanwhile,the new teaching mode can get students more satisfied.