OBJECTIVE:To compare the clinical efficacy and radiological results of arthroscopic all-inside technique and traditional technique in anterior cruciate ligament reconstruction.METHODS:Databases such as CNKI,WanFang,VIP,PubMed,Web of Science,Embase,and Cochrane Library were searched for literature on all-inside technique and traditional technique in anterior cruciate ligament reconstruction.The search time was from the establishment of each database to September 2024.Meta-analysis was conducted on the included literature.RESULTS:(1)A total of 17 articles were included in the meta-analysis,with 631 patients in the all-inside technique reconstruction group and 626 patients in the traditional technique reconstruction group.The earliest time for the last follow-up was half a year after surgery,and the latest was 5 years after surgery.Most follow-up period was 2 years.(2)Meta-analysis results showed that compared with traditional anterior cruciate ligament reconstruction,the all-inside technique had a thicker graft during anterior cruciate ligament reconstruction[mean difference(MD)=0.20,95％confidence interval(CI)(0.09,0.31),P=0.000 5],smaller postoperative maximum diameter[standardized mean difference(SMD)=-3.64,95％CI(-6.00,-1.28),P=0.002]and volume[SMD=-3.69,95％CI(-5.37,-2.00),P＜0.000 1]of the tibial tunnel,and higher International Knee Documentation Committee subjective scores[MD=2.41,95％CI(0.49,4.32),P=0.01]and Lysholm scores[MD=1.11,95％CI(0.42,1.8),P=0.002]2 years after surgery.However,the operation time was relatively longer[MD=10.06,95％CI(4.71,15.4),P=0.000 2],and the knee stability was poorer after 2 years[SMD=0.3,95％CI(0.04,0.55),P=0.02].No significant differences were found between the two groups in the following aspects:the subjective scores of the International Knee Documentation Committee at 6 months and 1 year postoperatively[MD=-0.05,95％CI(-1.96,1.83),P=0.96;MD=0.51,95％CI(-1.17,2.19),P=0.55];the difference in anterior laxity of bilateral knees at 1 year postoperatively[SMD=-0.02,95％CI(-0.3,0.27),P=0.9];the Lysholm score at 6 months postoperatively[MD=0.87,95％CI(-0.15,1.89),P=0.09];the objective score of the International Knee Documentation Committee at the last follow-up[RR=0.95,95％CI(0.86,1.06),P=0.37];the American Knee Society Score at the last follow-up[MD=0.33,95％CI(-0.55,1.21),P=0.47];the Tegner score at the last follow-up[MD=0.05,95％CI(-0.11,0.22),P=0.53];the negative rate of the pivot shift test at the last follow-up[RR=0.92,95％CI(0.83,1.01),P=0.09];the postoperative revision rate at the last follow-up[RR=2.2,95％CI(0.98,4.92),P=0.05];and the result of the single-leg hop test at the last follow-up[MD=-0.06,95％CI(-4.99,4.86),P=0.98].CONCLUSION:There were no significant differences in most functional outcome scores and the position of the tibial tunnel between the all-inside technique and the traditional technique after anterior cruciate ligament reconstruction.The all-inside technique was more favorable in terms of subjective International Knee Documentation Committee scores and Lysholm scores at 2 years postoperatively.Meanwhile,the knee joint was more stable 2 years after anterior cruciate ligament reconstruction using the traditional technique.In addition,it was found that the graft was thicker during the all-inside technique,while the diameter and volume of the tibial tunnel were smaller postoperatively,with more bone tissue preserved.Nevertheless,the operation time of the all-inside technique was longer.

OBJECTIVE:This paper collects relevant literature on blood flow restriction training combined with resistance training,and analyzes the different effects of blood flow restriction training combined with resistance training on athletes'muscle-related indexes and specialized abilities in accordance with the paradigm of systematic evaluation and Meta-analysis,aiming to provide data support for athletes to utilize blood flow restriction training in their training practices. METHODS:Chinese and foreign databases(CNKI,WanFang,PubMed,Web of Science,SPORTDiscus)were searched to collect randomized controlled trials on the effects of blood flow restriction training combined with resistance training on limb circumference,muscle mass,muscle strength,and specialized ability of college athletes from January 1st,2000 to October 12th,2023.At least two researchers evaluated the quality of the included literature using the Cochrane Collaboration risk of bias assessment tools and criteria.Heterogeneity tests,data merging,subgroup analyses,forest plotting,and sensitivity analyses were performed using RevMan 5.4,and funnel plots with publication bias evaluation and sensitivity analyses were performed.The evaluation indexes were limb circumference,muscle thickness,muscle strength and specialized ability,and subgroup analyses were performed for different specialized athletic abilities. RESULTS:(1)A total of 18 randomized controlled trials with 403 subjects were included,and according to the Cochrane Collaboration's risk of bias assessment tool,the quality of literature in the included literature was grade A in 16 articles and grade B in 2 articles.(2)Comparing the effects of blood flow restriction training combined with resistance training and resistance training,there was no significant difference between the two groups in terms of limb circumference[standardized mean difference(SMD)=0.03,95%confidence interval:-0.16-0.21,P=0.78],and a significant difference between the two groups in terms of muscle thickness(SMD=0.14,95%CI:0.01-0.27,P=0.03)and muscle strength(SMD=0.37,95%CI:0.14-0.60,P=0.001).(3)Subgroup analyses of the indicators of specialized capacity indicated that there was high heterogeneity in the analyzed results of distance metrics(I2=73%)and time metrics(I2=55%),which was analyzed as a possible reason due to the differences in testing methods and assessment of metrics'significance in the studies;there was no heterogeneity(I2=0%)in the analyzed results of power metrics;blood flow restriction training combined with resistance training had a significant effect on distance metrics(P<0.01).(4)The results of the combined effect showed the effect of blood flow restriction training combined with resistance training vs.resistance training for specialized ability(P=0.41),suggesting that there is no significant effect of different training methods on specialized ability. CONCLUSION:Both blood flow restriction training combined with resistance training and resistance training can promote muscle thickness,muscle strength and specialized ability in college athletes.Meanwhile,blood flow restriction training combined with resistance training has a more significant effect on muscle thickness,muscle strength and some specialized abilities compared with resistance training.Therefore,blood flow restriction training can be scientifically and rationally integrated into specialized training,so as to achieve a better training effect by integrating the differentiated physiological stimuli to the muscles.However,due to the small number of included studies and other possible limitations,more high-quality,multi-sport type and sex randomized trials need to be included in the future to confirm this.

OBJECTIVE:To compare the clinical efficacy and radiological results of arthroscopic all-inside technique and traditional technique in anterior cruciate ligament reconstruction.METHODS:Databases such as CNKI,WanFang,VIP,PubMed,Web of Science,Embase,and Cochrane Library were searched for literature on all-inside technique and traditional technique in anterior cruciate ligament reconstruction.The search time was from the establishment of each database to September 2024.Meta-analysis was conducted on the included literature.RESULTS:(1)A total of 17 articles were included in the meta-analysis,with 631 patients in the all-inside technique reconstruction group and 626 patients in the traditional technique reconstruction group.The earliest time for the last follow-up was half a year after surgery,and the latest was 5 years after surgery.Most follow-up period was 2 years.(2)Meta-analysis results showed that compared with traditional anterior cruciate ligament reconstruction,the all-inside technique had a thicker graft during anterior cruciate ligament reconstruction[mean difference(MD)=0.20,95％confidence interval(CI)(0.09,0.31),P=0.000 5],smaller postoperative maximum diameter[standardized mean difference(SMD)=-3.64,95％CI(-6.00,-1.28),P=0.002]and volume[SMD=-3.69,95％CI(-5.37,-2.00),P＜0.000 1]of the tibial tunnel,and higher International Knee Documentation Committee subjective scores[MD=2.41,95％CI(0.49,4.32),P=0.01]and Lysholm scores[MD=1.11,95％CI(0.42,1.8),P=0.002]2 years after surgery.However,the operation time was relatively longer[MD=10.06,95％CI(4.71,15.4),P=0.000 2],and the knee stability was poorer after 2 years[SMD=0.3,95％CI(0.04,0.55),P=0.02].No significant differences were found between the two groups in the following aspects:the subjective scores of the International Knee Documentation Committee at 6 months and 1 year postoperatively[MD=-0.05,95％CI(-1.96,1.83),P=0.96;MD=0.51,95％CI(-1.17,2.19),P=0.55];the difference in anterior laxity of bilateral knees at 1 year postoperatively[SMD=-0.02,95％CI(-0.3,0.27),P=0.9];the Lysholm score at 6 months postoperatively[MD=0.87,95％CI(-0.15,1.89),P=0.09];the objective score of the International Knee Documentation Committee at the last follow-up[RR=0.95,95％CI(0.86,1.06),P=0.37];the American Knee Society Score at the last follow-up[MD=0.33,95％CI(-0.55,1.21),P=0.47];the Tegner score at the last follow-up[MD=0.05,95％CI(-0.11,0.22),P=0.53];the negative rate of the pivot shift test at the last follow-up[RR=0.92,95％CI(0.83,1.01),P=0.09];the postoperative revision rate at the last follow-up[RR=2.2,95％CI(0.98,4.92),P=0.05];and the result of the single-leg hop test at the last follow-up[MD=-0.06,95％CI(-4.99,4.86),P=0.98].CONCLUSION:There were no significant differences in most functional outcome scores and the position of the tibial tunnel between the all-inside technique and the traditional technique after anterior cruciate ligament reconstruction.The all-inside technique was more favorable in terms of subjective International Knee Documentation Committee scores and Lysholm scores at 2 years postoperatively.Meanwhile,the knee joint was more stable 2 years after anterior cruciate ligament reconstruction using the traditional technique.In addition,it was found that the graft was thicker during the all-inside technique,while the diameter and volume of the tibial tunnel were smaller postoperatively,with more bone tissue preserved.Nevertheless,the operation time of the all-inside technique was longer.

This article summarized Professor Rao Xiangrong's experience in the diagnosis and treatment of obesity-related nephropathy.According to Rao,this disease belongs to congenital deficiency and acquired malnutrition,and diet,labor and leisure are out of proportion,resulting in dryness and heat in the middle energizer,excess of yang-ming or concomitant deficiency of the shao-yin,or blood stasis and phlegm obstruction,and blood circulation is out of proportion.In the later stage,turbidity,toxicity,phlegm,and blood stasis coexist.The syndrome belongs to the same disease of middle and lower energizer.Treatment should clear away heat and dryness in the middle energizer,clear phlegm and dampness,remove blood stasis and eliminate turbidity.The prescriptions of modified Yunü Decoction,Dahuang Huanglian Xiexin Decoction,Qingzhong Decoction should be used,with good efficacy.

Objective:To investigate the disease burden, clinical characteristics and independent risk factors affecting in-hospital outcomes of children with congenital heart disease (CHD) combined with heart failure (HF) in China.Methods:(1) Descriptive study: based on the global burden of disease study 2021, available data on children under 15 years of age with CHD and HF in China from 1990 to 2021 were collected. The prevalence and trends in different age subgroups (<1 year, 1-<2 years, 2-<5 years, 5-<10 years, 10-<15 years) were analyzed, and the annual percentage change (EAPC) was estimated using linear regression. (2) Retrospective cohort study: a total of 1 062 children with CHD and HF from a multicenter study on pediatric HF in China were included. The children were divided into two groups:<2 years group and 2-<18 years group. Data on demographics, clinical features, diagnosis, treatments, and in-hospital outcomes were analyzed. Mann-Whitney U test and chi-square test were used for group comparisons.Multivariable Logistic regression was applied to identify factors influencing outcomes (in-hospital mortality and adverse cardiovascular events). Results:(1) From 1990 to 2021, the number of children with CHD and HF in China increased from 333 000 (95% uncertainty interval ( UI) 271 000-405 000) to 368 000 (95% UI 296 000-459 000), a growth of 10.8% (95% UI 5.0%-16.6%). Concurrently the prevalence rate increased from 104.5 (95% UI 85.1-127.3) per 100 000 to 142.0 (95% UI 114.0-176.8) per 100 000, a growth of 35.9% (95% UI 28.7%-43.0%), with an EAPC of 1.5% (95% CI 1.2%-1.8%). Although the number of cases in the<1 year and 1-<2 years groups decreased by 41.0% and 25.6%, respectively, the prevalence in all age groups showed an upward trend:<1 year EAPC 0.6% (95% CI 0.5%-0.7%); 1-<2 years EAPC 0.9% (95% CI 0.8%-1.0%); 2-<5 years EAPC 1.2% (95% CI 1.0%-1.4%); 5-<10 years EAPC 1.5% (95% CI 1.2%-1.8%); 10-<15 years EAPC 2.1% (95% CI 1.9%-2.3%). (2) The multicenter study revealed that among 1 062 hospitalized children, 528 (49.7%) were male and 534 (50.3%) were female, with the age at admission of 5.4 (2.2,18.2) months. The majority of the children (77.9%, 827/1 062) were under 2 years of age, whereas 22.1% (235/1 062) were aged between 2-<18 years. Children with complex congenital heart defects accounted for the highest proportion (48.6%, 516/1 062), while those with isolated CHD made up 31.5% (335/1 062). Statistically significant differences were observed in several variables in demographics, clinical features, diagnosis, treatments, and outcomes between the two age groups (all P<0.05). The use of renin-angiotensin-aldosterone system inhibitors (41.1%, 436/1 062) and beta-blockers (8.7%, 92/1 062) was lower in hospitalized children with CHD and HF. Logistic regression identified complex CHD ( OR=7.73, 95% CI 2.24-26.63; OR=3.17, 95% CI 1.92-5.23), pulmonary hyperperfusion ( OR=2.15, 95% CI 1.01-4.18; OR=2.00, 95% CI 1.35-2.97), left ventricular ejection fraction<55% ( OR=2.13, 95% CI 1.08-4.21; OR=2.80, 95% CI 1.45-5.56), arterial oxygen partial pressure ( OR=0.99, 95% CI 0.98-0.99; OR=0.99, 95% CI 0.98-0.99), and serum calcium levels ( OR=0.31, 95% CI 0.17-0.58; OR=0.42, 95% CI 0.28-0.62) as independent risk factors for in-hospital mortality and cardiovascular events. Conclusions:The disease burden of CHD combined with HF in China has shown a continuous upward trend from 1990 to 2021, with higher growth rates in older age groups. Complex CHD, pulmonary hyperperfusion, left ventricular ejection fraction <55%, arterial oxygen partial pressure, and serum calcium concentration are independent risk factors for in-hospital mortality and cardiovascular events.

This article summarized Professor Rao Xiangrong's experience in the diagnosis and treatment of obesity-related nephropathy.According to Rao,this disease belongs to congenital deficiency and acquired malnutrition,and diet,labor and leisure are out of proportion,resulting in dryness and heat in the middle energizer,excess of yang-ming or concomitant deficiency of the shao-yin,or blood stasis and phlegm obstruction,and blood circulation is out of proportion.In the later stage,turbidity,toxicity,phlegm,and blood stasis coexist.The syndrome belongs to the same disease of middle and lower energizer.Treatment should clear away heat and dryness in the middle energizer,clear phlegm and dampness,remove blood stasis and eliminate turbidity.The prescriptions of modified Yunü Decoction,Dahuang Huanglian Xiexin Decoction,Qingzhong Decoction should be used,with good efficacy.

Objective:To investigate the disease burden, clinical characteristics and independent risk factors affecting in-hospital outcomes of children with congenital heart disease (CHD) combined with heart failure (HF) in China.Methods:(1) Descriptive study: based on the global burden of disease study 2021, available data on children under 15 years of age with CHD and HF in China from 1990 to 2021 were collected. The prevalence and trends in different age subgroups (<1 year, 1-<2 years, 2-<5 years, 5-<10 years, 10-<15 years) were analyzed, and the annual percentage change (EAPC) was estimated using linear regression. (2) Retrospective cohort study: a total of 1 062 children with CHD and HF from a multicenter study on pediatric HF in China were included. The children were divided into two groups:<2 years group and 2-<18 years group. Data on demographics, clinical features, diagnosis, treatments, and in-hospital outcomes were analyzed. Mann-Whitney U test and chi-square test were used for group comparisons.Multivariable Logistic regression was applied to identify factors influencing outcomes (in-hospital mortality and adverse cardiovascular events). Results:(1) From 1990 to 2021, the number of children with CHD and HF in China increased from 333 000 (95% uncertainty interval ( UI) 271 000-405 000) to 368 000 (95% UI 296 000-459 000), a growth of 10.8% (95% UI 5.0%-16.6%). Concurrently the prevalence rate increased from 104.5 (95% UI 85.1-127.3) per 100 000 to 142.0 (95% UI 114.0-176.8) per 100 000, a growth of 35.9% (95% UI 28.7%-43.0%), with an EAPC of 1.5% (95% CI 1.2%-1.8%). Although the number of cases in the<1 year and 1-<2 years groups decreased by 41.0% and 25.6%, respectively, the prevalence in all age groups showed an upward trend:<1 year EAPC 0.6% (95% CI 0.5%-0.7%); 1-<2 years EAPC 0.9% (95% CI 0.8%-1.0%); 2-<5 years EAPC 1.2% (95% CI 1.0%-1.4%); 5-<10 years EAPC 1.5% (95% CI 1.2%-1.8%); 10-<15 years EAPC 2.1% (95% CI 1.9%-2.3%). (2) The multicenter study revealed that among 1 062 hospitalized children, 528 (49.7%) were male and 534 (50.3%) were female, with the age at admission of 5.4 (2.2,18.2) months. The majority of the children (77.9%, 827/1 062) were under 2 years of age, whereas 22.1% (235/1 062) were aged between 2-<18 years. Children with complex congenital heart defects accounted for the highest proportion (48.6%, 516/1 062), while those with isolated CHD made up 31.5% (335/1 062). Statistically significant differences were observed in several variables in demographics, clinical features, diagnosis, treatments, and outcomes between the two age groups (all P<0.05). The use of renin-angiotensin-aldosterone system inhibitors (41.1%, 436/1 062) and beta-blockers (8.7%, 92/1 062) was lower in hospitalized children with CHD and HF. Logistic regression identified complex CHD ( OR=7.73, 95% CI 2.24-26.63; OR=3.17, 95% CI 1.92-5.23), pulmonary hyperperfusion ( OR=2.15, 95% CI 1.01-4.18; OR=2.00, 95% CI 1.35-2.97), left ventricular ejection fraction<55% ( OR=2.13, 95% CI 1.08-4.21; OR=2.80, 95% CI 1.45-5.56), arterial oxygen partial pressure ( OR=0.99, 95% CI 0.98-0.99; OR=0.99, 95% CI 0.98-0.99), and serum calcium levels ( OR=0.31, 95% CI 0.17-0.58; OR=0.42, 95% CI 0.28-0.62) as independent risk factors for in-hospital mortality and cardiovascular events. Conclusions:The disease burden of CHD combined with HF in China has shown a continuous upward trend from 1990 to 2021, with higher growth rates in older age groups. Complex CHD, pulmonary hyperperfusion, left ventricular ejection fraction <55%, arterial oxygen partial pressure, and serum calcium concentration are independent risk factors for in-hospital mortality and cardiovascular events.

Objective:To explore the psychological experience and demand of parents of children with delayed recovery after congenital heart disease surgery.Methods:This study adopted phenomenological research methods from qualitative research. Using the purposive sampling method, parents of postoperative delayed recovery children with congenital heart disease who met the inclusion criteria were selected as the research objects from October to November 2019 at Fuwai Hospital, Chinese Academy of Medical Sciences. Semi-structured interviews were conducted with the parents of the children, and the data were analyzed by Colaizzi 7-step analysis method.Results:Finally, 13 parents of children with delayed recovery after congenital heart disease surgery were included. According to the interview results, four themes were extracted, which were negative psychological experience of parents of children with delayed recovery, positive psychological experience and expectation change of parents, heavy economic burden of parents and diversified needs of parents.Conclusions:During the delayed recovery period, psychological experience of parents is complex and their needs are diverse. The nursing staff should identify and pay attention to the causes of the negative psychological experience of the parents of the children, timely channel their negative emotions and strengthen the positive psychological experience in many aspects. They can assist parents to seek social help to reduce physical and mental pressure and meet the diverse needs of parents by providing high-quality nursing services and multi-channel information support.

Objective:To explore the value of amide proton transfer-weighted (APTw) imaging and intravoxel incoherent motion (IVIM) imaging for diagnosing and evaluating the pathological differentiation of cervix squamous cell carcinoma (CSCC).Methods:This study was a diagnostic trial. Totally 56 patients pathologically diagnosed with CSCC at the First Hospital of Lanzhou University from October 2021 to October 2022 were retrospectively collected, as the CSCC group. And 36 female healthy volunteers who underwent physical examinations at the First Hospital of Lanzhou University from October 2021 to October 2023 were recruited as the control group. CSCC patients were divided into well-moderately differentiated ( n=34) and poorly differentiated groups ( n=22). The region of interest was placed in the lesions of CSCC group and normal cervical stroma of control group, and the quantitative parameters for asymmetric magnetization transfer ratio (MTR asym) of APTw imaging and pure diffusion coefficient (D), false diffusion coefficient (D *) and perfusion fraction (f) for IVIM were obtained. The independent sample t test was used to compare the differences in quantitative parameters between the two groups, the logistic regression model was used to establish combined parameters for the quantitative parameters with statistical significance between the two groups. The receiver operator characteristic curve was used to evaluate the diagnostic efficacy of single quantitative parameters and combined parameters to distinguish the CSCC group from the control group, and the well-moderately differentiated group from the poorly differentiated group in CSCC patients. The area under the curve (AUC) was compared using the DeLong test. Results:There were significant differences in MTR asym, D and f between CSCC group and control group ( t=-9.79, 10.09, 11.35, P<0.001). Also, significant differences were found for MTR asym and D between the well-moderately differentiated and poorly differentiated group ( t=4.11, -3.76, P<0.001). There was no significant difference in other quantitative parameters ( P>0.05). When comparing the CSCC group and control group, the AUC (95% CI) of MTR asym, D, f and combined parameter (MTR asym+D+f) were 0.887 (0.804-0.944), 0.940 (0.871-0.979), 0.968 (0.909-0.993), 0.995 (0.950-1.000). The AUC of the combined parameter was higher than those of MTR asym and D, with statistical significance ( Z=3.07, 2.06, P=0.002, 0.040). When comparing the well-moderately differentiated and poorly differentiated group, the AUC (95% CI) of MTR asym, D, and combined parameter (MTR asym+D) were 0.789 (0.660-0.887), 0.775 (0.644-0.876), 0.852 (0.731-0.932). There was no significant difference between each two AUCs ( P>0.05). Conclusion:The quantitative parameters of APTw and IVIM imaging can be used to diagnose and preliminarily evaluate the pathological differentiation of CSCC. Joint parameters can improve the diagnostic efficiency of CSCC.

Objective To systematically review whether mirror therapy(MT)intervention can effectively improve upper extremity motor function and activities of daily living(ADL)in stroke patients;whether its improvement is affected by pa-tients'age and disease course;and whether MT's influencing factors,such as intervention period,time,and fre-quency,have a dosage effect on upper extremity motor function and ADL. Methods Seven databases were searched,including Embase,Web of Science,PubMed,Cochrane Library,Wanfang data,VIP and CNKI from establishment to April,2023,and randomized controlled trials of MT for upper extremity motor function and ADL in stroke patients were screened.Quality assessment was performed using Physiothera-py Evidence Database(PEDro).Meta-analysis was performed using RevMan 5.4.1,and network meta-analysis was performed using R software,reticulated meta-analysis tables and cumulative probability tables were drawn for ranked comparisons,and funnel plots were drawn to test for publication bias of the outcome indicators using Stata 17.0 software.GRADE was used to evaluate the quality of evidence for the outcome indicators. Results A total of 13 papers(532 patients)were included.The PEDro score ranged from 6 to 8.Most of the literature did not report the blinding completely or did not implement allocation concealment,which might have some limita-tions.MT could improve the scores of Fugl-Meyer Assessment-Upper Extremities(n = 466,MD = 6.05,95%CI 3.44～8.66,P<0.001),Barthel index(n = 230,MD = 9.95,95%CI 6.23～13.68,P<0.001)and Functional Inde-pendence Measure(n = 147,MD = 4.17,95%CI 2.61～5.72,P<0.001)in stroke patients.Network meta-analysis showed that MT was more effective in upper limb motor function intervention for stroke patients aged 40 to 59 years with a disease course less than three months;and an intervention period less than four weeks,single inter-vention time less than 30 minutes,intervention duration daily more than 30 minutes and intervention twice daily might optimize the effects on upper limb motor function. Conclusion MT is effective on upper limb motor function and ADL in stroke patients,and the effect on upper limb mo-tor function is affected by the age and disease course of the patients,as well as the period,time and frequency of intervention.