Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.

Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.

BACKGROUND:Mechanical stimulation has been confirmed to promote osteogenic differentiation of bone marrow stromal stem cells,but the mechanism is unknown.Primary cilia are important mechanoreceptors and regulate various signaling pathways such as TGF-β1/BMP-2/SMAD.They are likely to be important targets for mechanical regulation of bone marrow stromal stem cells. OBJECTIVE:To investigate the effect and mechanism of fluid shear stress on osteogenic differentiation of bone marrow stromal stem cells. METHODS:Rat bone marrow stromal stem cells were divided into control group,mechanical stimulation group(fluid shear mechanics intervention by shaking table),mechanical stimulation + IFT88 silencing group(mechanical stimulation + silencing IFT88 expression with siRNA).After 24 hours of intervention,qRT-PCR was utilized to determine the expression of transforming growth factor β1 and bone morphogenetic protein 2.Western blot assay was used to detect the expression of phosphorylated SMAD2/3 protein.Immunofluorescent staining of primary cilia was conducted and morphology was analyzed. RESULTS AND CONCLUSION:Shear stress stimulation could promote the transcriptional activity of transforming growth factor β1 and bone morphogenetic protein 2 genes,and increase the expression of phosphorylated SMAD2/3 protein.After siRNA interfered with primary cilia,this mechanical response effect was significantly reduced.There was a Spearman correlation between the change ratio of the primary cilium area of bone marrow stromal stem cells and the increased ratio of transforming growth factor β1 and bone morphogenetic protein 2 gene transcription.These findings indicate that primary cilia/intraflagellar transport mediates the activation of fluid shear stress-responsive transforming growth factor β1/bone morphogenetic protein 2/SMAD signaling pathway and promotes osteogenic differentiation of bone marrow stromal stem cells.

Objective:To explore the effect of standardized nutrition therapy and nursing in patients with colorectal cancer.Methods:From June 2017 to June 2019, 70 patients with colorectal cancer were selected. They were divided into control group ( n=35) and observation group ( n=35) by random digital table method. The control group was given routine nutrition treatment and nursing, while the observation group was given standardized nutrition treatment plan and nursing. The clinical indexes, nutritional indexes and complications of the two groups were compared, and the immune function before and after operation was compared. Results:The recovery time of bowel sounds, anal exhaust time, defecation time and hospitalization time in the observation group were (3.62±0.64) h, (36.78±11.25) h, (69.74±20.12) h, (15.81±3.57) h, respectively. The control group were (4.08±0.92) h, (44.96±13.83) h, (92.76±19.86) h, (18.83±4.56) h, the difference was statistically significant ( t values were 2.43-4.82, P<0.05 or 0.01). After 7d, the body mass, prealbumin, hemoglobin and serum albumin in observation group were (52.13±5.17) kg, (197.63±39.72) mg/L, (109.74±11.25) g/L, (41.85±5.67) g/L, respectively. The control group were (49.34±4.82) kg, (168.73±32.47) mg/L, (104.06±7.93) g/L, (37.92±4.53), respectively. The difference was statistically significant ( t values were 2.34-3.33, P<0.05 or 0.01). The IgA, IgG, IgM, CD4, CD4/CD8 in the observation group (1.93±0.54) g/L, (11.47±2.35) g/L, (0.96±0.21) g/L, (40.32±5.22)%, 1.68±0.38, the control group were (1.65±0.35) g/L, (9.81±1.69) g/L, (0.81±0.17) g/L, (37.81±4.45)%, 1.49±0.33,The difference was statistically significant ( t values were 2.16-3.39, P<0.05 or 0.01). Conclusions:Standardized nutrition treatment process and nursing can improve the prognosis of colorectal cancer patients, promote the recovery of gastrointestinal function, improve the nutritional status of the body, enhance the immune function of the body.

From September 2017 to February 2018, 650 disabled children and adolescents aged 6-to 17-year-old in Beijing were matched 1∶1 to those in normal physical condition with same age, gender and place of residence. All children and adolescents were investigated for self-injury status in the last year to understand the difference of self-injury incidence between groups. Multivariate unconditional logistic regression model was applied for exploring relevant factors of self-injury of children and adolescents. This study found that the disability, insufficient sleep, difficulty falling asleep, and sleeping late were associated with self-injury of children and adolescents.
Adolescent ; Beijing ; epidemiology ; Child ; Cross-Sectional Studies ; Disabled Children ; statistics & numerical data ; Humans ; Logistic Models ; Self-Injurious Behavior ; epidemiology ; Sleep

From September 2017 to February 2018, 650 disabled children and adolescents aged 6-to 17-year-old in Beijing were matched 1∶1 to those in normal physical condition with same age, gender and place of residence. All children and adolescents were investigated for self-injury status in the last year to understand the difference of self-injury incidence between groups. Multivariate unconditional logistic regression model was applied for exploring relevant factors of self-injury of children and adolescents. This study found that the disability, insufficient sleep, difficulty falling asleep, and sleeping late were associated with self-injury of children and adolescents.

Objective To investigate the correlation between serum homocysteine(Hcy) ,folic Acid ,vitamin B12 ,ferritin levels and cerebral infarction ,and provide a new way for prevention and treatment of cerebral infarction .Methods Forty -eight hospital‐ized patients with ischemic cerebrovascular disease who were in the neurology ward department of the hospital from April 2012 to November 2014 were enrolled in the study as cerebral infarction group .Meanwhile ,30 healthy elderly patients were recruited ran‐domly as a healthy control group during the same period .There was no significant difference in sex and age between the two groups .People with other diseases were excluded .Hospitalized patients were diagnosed within 24 -72 hours and received CT and MRI scan and other related auxiliary examination after being admitted to hospital .All these patients underwent plasma Hcy ,folic acid ,vitamin B12 ,ferritin level tests which were determined by using chemiluminescence and radioimmunoassay .SPSS17 .0 statistical software was used for statistical analysis ,and the correlation between Hcy ,folic acid ,vitamin B12 ,ferritin and cerebral infarction were analyzed .Results The plasma Hcy and ferritin levels in cerebral infarction group were higher than those in control group ,and the difference is significant(P<0 .05) .Meanwhile ,folic acid ,vitamin B12 levels in cerebral infarction group were lower than those in control group and the difference was significant(P<0 .05) .There were significant differences in levels of Hcy ,folic acid ,vitamin B12 ,ferritin between groups of different cerebral infarction levels .Conclusion Detections of serum Hcy ,folic acid ,vitamin B12 and ferritin could be of important clinical value in cerebral infarction .

Objective To investigated the clinical application effects of autonomous copper wire-ECG positioning technology on PICC in very low birth weight infants (VLBWI).Methods The study investigated 54 VLBWI who needed PICC and were hospitalized in the neonatal medical center of Huai′an maternity and child health care hospital in 2015. The participants were divided into the intervention group ( n=27) and the control group ( n=27) using random number table. The intervention group used the autonomous copper wire -ECG positioning technology by observing the changes of typical P-wave while the control group used the conventional locating method. PICC indwelling time, location accuracy, and the incidence of related complications were compared between the two groups according to the gold standard of postoperative chest X-ray. Results The location accuracy for the intervention group was significantly higher than the accuracy for the control group (92.6% vs 66. 7%;χ2=5.594, P<0.05). However, PICC indwelling time for the intervention group had little difference compared to the control group [(20.85±12.5) d vs (22.33±10.0) d; t=0.481,P>0.05] . The incidence of complications also had limited difference between the two groups since there were 4 cases of related complications for the intervention group and 6 cases for the control group (χ2=0.123,P>0.05) . Conclusions The autonomous copper wire-ECG positioning technology should be further developed and applied to the population of VLBWI because of its high accuracy and operability.

Objective To observe the effect of shallow suction of endotracheal in ventilated neonates . Methods Eighty-six infants, from June 2012 to March 2013, were divided into observation group and control group using the random number table .The 40 infants in control group were used for traditional suction;the 46 infants in observation group were used for Shallow suction .The difference of interval time of suctions , trachea mucosal injury , frequency of artificial airway block , changes of heart rate and SpO 2 were compared between the two groups .Results The total times of sputum suction were 296 in observation group and 252 in control group . In observation group , the frequency of SpO 2 below 85% among infants was 5 times, which was less than 33 times in control group.The difference was significant (χ2 =27.44, P <0.05).The time of suction was (8.10 ±1.36)s in observation group and (12.50 ±1.46)s in control group, and the difference was significant (t=2.650, P<0.05).The frequency of trachea mucosal injury was 12 times in control group, compared to 0 in observation group, which was significantly different (χ2 =14.410,P <0.05).However, there was no obvious difference in heart rate , interval time between suctions and artificial airway block (χ2/t =1.217, 0.761,0.003,P>0.05).Conclusions The shallow suction of endotracheal is benefit in shortening the suction time, decreasing the frequency of hypoxemia , reducing the influence of airway and the mucosal injury , compared with traditional suction .Thus, we recommend that the shallow suction is worthy to being widely used in clinical interventions .