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.

Objectives:To investigate the effect of concentrated growth factor(CGF)on the repairation of damaged intervertebral disc annulus in rats.Methods:First,4 adult Sprague-Dawley(SD)female rats were se-lected,6-7 weeks old,weight 200-250g,blood was collected from the rats'abdominal veins after anesthesia and processed through centrifugation to isolate CGF.Then 36 adult SD female rats were selected from the same batch rats,and were randomly assigned into three groups of control group,surgery group,and CGF group,with 12 rats per group.In the blank group,only the L4/5 discs were exposed and no other treatment was done.In the control group,only the L4/5 discs were exposed and no other treatment was done.The surgery group had a disc puncture performed at the L4/5 level to induce disc rupture;In the CGF group,after modeling,membrane was made with CGF to cover over the annulus fibrosus defect.Postoperative care included standard antiseptic and analgesic treatments.At 4 and 6 weeks postoperatively,tissues from the L4/5 level were harvested for morphological assessment via hematoxylin and eosin(HE)and type n collagen im-munohistochemistry staining.Results:Postoperatively at both 4 and 6 weeks,with the preservation of the nu-cleus pulposus's integrity,the surgery group demonstrated pronounced annulus fibrosus damage at the L4/5 disc compared to the control group.In contrast,the CGF group showed a significant decrease in annulus fibrosus damage relative to the surgery group.HE staining of disc sections revealed that the CGF group had markedly improved annulus fibrosus healing compared to the surgery group.The immunohistochemistry of typeⅡ collagenase protein of intervertebral disc in each group at 6 weeks after operation indicated that the dam-age of fibrous ring in the surgery group was more serious than that in the other two groups,and the expres-sion of type Ⅱ collagenase protein was concentrated in the damaged site.Compared with the surgery group,the annulus fibrosus damage was lighter in the CGF group,and the expression of type Ⅱ collagenase protein was also concentrated in the damaged site.Conclusions:CGF can effectively promote the repair of damaged intervertebral disc annulus fibrosus.

The healing process of skin wounds caused by severe mechanical trauma and chronic diseases(e.g.,diabetic foot ulcers)is often accompanied by tissue injury,microbial infection,intense inflammatory reactions,hypertrophic scars,and other complications.Microneedles have been widely used to facilitate wound healing in recent years.According to their different modes of action,microneedle formulation can be categorized into five types:solid microneedles,hollow microneedles,coated microneedles,soluble microneedles,and hydrogel microneedles.This paper reviews the preparation methods and characteristics of microneedles,and summarizes their roles in hemostasis,bacteriostasis,anti-inflammation,enhancement of collagen deposition,and angiogenesis,in the hope of providing some reference for future research and development.

Objectives:To investigate the effect of concentrated growth factor(CGF)on the repairation of damaged intervertebral disc annulus in rats.Methods:First,4 adult Sprague-Dawley(SD)female rats were se-lected,6-7 weeks old,weight 200-250g,blood was collected from the rats'abdominal veins after anesthesia and processed through centrifugation to isolate CGF.Then 36 adult SD female rats were selected from the same batch rats,and were randomly assigned into three groups of control group,surgery group,and CGF group,with 12 rats per group.In the blank group,only the L4/5 discs were exposed and no other treatment was done.In the control group,only the L4/5 discs were exposed and no other treatment was done.The surgery group had a disc puncture performed at the L4/5 level to induce disc rupture;In the CGF group,after modeling,membrane was made with CGF to cover over the annulus fibrosus defect.Postoperative care included standard antiseptic and analgesic treatments.At 4 and 6 weeks postoperatively,tissues from the L4/5 level were harvested for morphological assessment via hematoxylin and eosin(HE)and type n collagen im-munohistochemistry staining.Results:Postoperatively at both 4 and 6 weeks,with the preservation of the nu-cleus pulposus's integrity,the surgery group demonstrated pronounced annulus fibrosus damage at the L4/5 disc compared to the control group.In contrast,the CGF group showed a significant decrease in annulus fibrosus damage relative to the surgery group.HE staining of disc sections revealed that the CGF group had markedly improved annulus fibrosus healing compared to the surgery group.The immunohistochemistry of typeⅡ collagenase protein of intervertebral disc in each group at 6 weeks after operation indicated that the dam-age of fibrous ring in the surgery group was more serious than that in the other two groups,and the expres-sion of type Ⅱ collagenase protein was concentrated in the damaged site.Compared with the surgery group,the annulus fibrosus damage was lighter in the CGF group,and the expression of type Ⅱ collagenase protein was also concentrated in the damaged site.Conclusions:CGF can effectively promote the repair of damaged intervertebral disc annulus fibrosus.

Objective To evaluate the clinical efficacy and safety of short-segment pedicle screw fixation combined with vertebroplasty for the treatment of thoracolumbar osteoporotic compression fractures.Methods A retrospective case control study was conducted on 63 patients with fresh thoracic or lumbar osteoporotie compression fractures who were surgically treated from January 2010 to December 2013.There were 26 males and 37 females,with age of 63-87 years [(76.3 ± 5.7) years].According to the surgical method,the patients were assigned to simple vertebroplasty group (Group A),short-segment pedicle screw fixation group (Group B),and short-segment pedicle screw fixation group combined with vertebroplasty group (Group C),with 21 cases in each group.Length of hospital stay,operation time,and blood loss were recorded.The visual analog scale (VAS),anterior vertebral body height,angle of the kyphotic deformity,and complications before operation,immediately after operation,3 months after operation,and at the last follow up were compared among three groups.Complications of each group were recorded.Results The hospital stay,operation time,and blood loss in Group C were significantly higher than those in Group A (P ＜ 0.05),but there were no significant differences between Group B and Group C (P ＞ 0.05),except for a longer operation time in Group C.The pre-operative VAS showed no significant difference among three groups (P ＞ 0.05).However,the mean VAS in Groups A,B and C at the last follow up were 1.0(0.0,2.0)points,1.0(0.0,2.0)points,0.0(0.0,1.0)points,respectively.The VAS in Group C was significantly lower than that in Group B or A (P ＜ 0.05).The mean anterior vertebral body height and angle of the kyphotic deformity in Group C had no significant difference from that in Group A or B before operation and immediately after operation (P ＞ 0.05).At the last follow up,the mean anterior vertebral body height and angle of the kyphotic deformity in Groups A,B and C were (68 ±14.7)％,(72.3 ±9.0)％,(81.5 ±5.6)％ and (10.6 ±3.9)°,(10.7 ±5.0)°,(7.4 ± 5.0) °,respectively.The loss of anterior vertebral body height and angle of the kyphotic deformity correction in Group C were significantly less than that in Group A or B (P ＜ 0.05).Superficial infection was found in Groups B (n =2) and C (n =1),and the infection was cured after antibiotic therapy and dress change.Bone cement leakage was found in Groups A (n =8) and C (n =5),with no nerve compression.Internal fixation failure was seen in Group B (n =3),and the implant was removed directly.Conclusion Short-segment pedicle screw fixation combined with vertebroplasty can effectively reduce the loss of anterior vertebral body height and angle of the kyphotic deformity and hence enhance the clinical efficacy.

Objective:To evaluate the efficacy of anteromedial extensile approach in the treatment of complicated closed pilon fractures classified as type AO/OTA C2 or C3 . Methods:Twenty‐three patients ,who suffered from complicated closed pilon fractures of distal tibia(25 lesions) ,underwent open reduction and internal fixation with anteromedial extensile approach . Among the 23 patients , there were 18 males and 5 females , with mean age of (43 .7 ± 9 .0 ) years . According to AO classification ,there were 11 lesions of type C2 and 14 lesions of type C3 .Operating time ,blood loss ,time of fracture healing , situation of complications ,and American Orthopedic Foot&Ankle Society(AOFAS) score were recorded ,so as to analyze the safety ,the indication ,and the pros and cons of this approach . Results:The average operating time was (119 .6 ± 23 .6)min . The intraoperative blood loss was (168 ± 64 .4) mL .And the time of fracture healing was (12 .5 ± 5 .4)weeks .The AOFAS scores were 81 .9 ± 18 .2 and 79 .9 ± 19 .5 at 12 month and 24 month after surgery ,respectively .Four cases of complications were observed , and there was no patient with invalid internal fixation . Conclusion:During the surgical treatment of complicated closed pilon fractures ,the anteromedial extensile approach allows complete access to the medial and lateral column of distal tibia and the articular surface ,so that the incidence rate of soft tissue complications was low and the clinical efficacy was satisfactory .