BACKGROUND:As the end bearing joint of the human body,the ankle joint bears the top-down pressure of the body,which leads to the ankle joint is easy to be damaged in the movement,can induce functional ankle instability,which negatively affects daily life.The study of lower extremity biomechanics in patients with functional ankle instability during counter movement jump is of great significance for scientific training,prevention of ankle injury,and clinical rehabilitation after injury. OBJECTIVE:To investigate the kinetics and kinematics of lower limbs in the longitudinal jumping of functional ankle instability population. METHODS:From March to September 2023,15 male patients with functional ankle instability and 15 healthy people,aged 22-28 years old,were recruited in Soochow University.All subjects completed counter movement jump experiment.Vicon infrared high-speed motion capture system and Kistler three-dimensional force measuring table were used to simultaneously collect the lower limb kinematics and kinetics indexes of the two groups of subjects at the take-off stage of counter movement jump,the instant off the ground,the initial landing moment and the peak moment of vertical ground reaction force. RESULTS AND CONCLUSION:(1)At the instant off the ground,the affected side of the functional ankle instability group showed smaller knee internal rotation moment(P=0.020)and smaller ankle internal rotation moment(P=0.009)compared with the affected side of the healthy control group.(2)At the moment of landing,the affected side of the functional ankle instability group showed a smaller hip flexion angle than the affected side of the healthy control group(P=0.039).Compared with the healthy control group,functional ankle instability group showed smaller hip abduction angle(P=0.022),smaller knee varus angle(P=0.010),larger knee external rotation angle(P=0.021),smaller ankle varus angle(P=0.004),and smaller external ankle rotation angle(P=0.008).(3)At the peak of vertical ground reaction force,functional ankle instability group showed a smaller ankle varus angle than healthy control group(P=0.044).(4)The results showed that the lower limb biomechanical characteristics of the patients with functional ankle instability were abnormal compared with the healthy people during counter movement jump,which mainly showed the changes of the kinematics and kinetics indexes of the lower limb joints in the sagittal plane and the frontal plane at the moment of lift-off and landing.These changes reflect that people with functional ankle instability adopt rigid take-off and landing patterns when performing counter movement jump,tend to transfer the load of the affected ankle joint to other joints of the lower limb,and show compensatory phenomenon of the healthy lower limb.Therefore,detection and correction of abnormal biomechanical features should be a part of rehabilitation training for those with functional ankle instability.

BackgroundSchool bullying is a serious social issue. Non-suicidal self-injury （NSSI） is a highly prevalent behavior among adolescents with depression and is also becoming a great matter of concern. Previous studies have proved a very close correlation among school bullying， experiential avoidance， family functioning， and NSSI behavior. However， there is a considerable lack of research on the moderating role of family functioning in the relationship between school bullying and experiential avoidance in adolescents with depression in China. ObjectiveTo explore the mediating role of experiential avoidance in the relationship between school bullying and NSSI in adolescents with depressive disorder， and the moderating role of family functioning in the relationship between school bullying and experiential avoidance， so as to provide references for formulating intervention strategies for NSSI in adolescents with depressive disorder. MethodsFrom January to December 2024， 318 consecutive adolescent patients fulfilling the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for depression and attending the outpatient department of Weifang Mental Health Center were selected. All respondents completed the Delaware Bullying Victimization Scale-Student （DBVS-S）， Acceptance and Action Questionnaire-II （AAQ-II）， Family Assessment Device （FAD）， and Behavioral Questionnaire in the Adolescent Non-suicidal Self-injury Assessment Questionnaire （ANSAQ）. Pearson correlation was used to examine the relationship among variables. SPSS Process Macro v4.1 package program was utilized to seek the mediating and moderating effects. ResultsData were collected from 306 valid respondents （96.23%）. In adolescent with depressive disorder， DBVS-S score was positively correlated with both the behavioral questionnaire score in the ANSAQ and the AAQ-II score （r=0.357， 0.558， P<0.01）. AAQ-II score was positively correlated with the behavioral questionnaire score in the ANSAQ （r=0.380， P<0.01）. Experiential avoidance partially mediated the relationship between school bullying and NSSI in adolescents with depressive disorder， and the mediating effect value was 0.142 （95% CI： 0.081~0.204）. Family functioning moderated the relationship between school bullying and experiential avoidance， and the moderated mediation value was 0.096 （95% CI： 0.042~0.165）. ConclusionMediation is found from school bullying to NSSI behavior through experiential avoidance in adolescents with depressive disorder， and family functioning plays a moderating role in the relationship between school bullying and experiential avoidance.

Objective This study investigated lower limb biomechanics and lateral asymmetry during the continuous vertical jump(CVJ)landing process in individuals with unilateral functional ankle instability(FAI)and compared these characteristics with those of healthy individuals.Methods Fourteen males with unilateral FAI were selected as the experimental group,and 14 males without ankle joint injury were matched to the control group.Both the groups performed 30 CVJ landing tasks.Lower limb kinematic and kinetic characteristics during the 1st,15th,and 30th CVJ landings were synchronously collected using Vicon and Kistler equipment,and a 2×3 mixed analysis of variance was adopted for the data.Results In the execution of CVJ landing tasks,patients with FAI demonstrated no significant differences in the kinematic and kinetic characteristics of the affected limbs compared with healthy controls.However,a greater degree of lateral asymmetry was observed in the FAI group,particularly in the symmetry index(SI)of the vGRF peak.Despite the increase in the number of jump landings and consequent increase in fatigue levels,which led to adjustments in lower limb movement patterns,these adjustments did not appear to have a significant impact on the biomechanical characteristics and asymmetry of the affected limb in patients with FAI.Conclusions This study provides a theoretical basis for the prevention of recurrent ankle sprains in patients with FAI,as well as rehabilitation training prior to their return to sports.These findings underscore the importance of addressing lower limb asymmetry in the rehabilitation training of patients with FAI to reduce the risk of potential long-term injuries.When formulating rehabilitation plans for patients with FAI,particular attention should be paid to the correction of lower limb asymmetry with consideration of biomechanical adaptability under different states to achieve a more comprehensive rehabilitation outcome.

Objective:To investigate the prevalence of cataract and its risk factors in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and Han and Kazak people aged 50 years old and over in Emin County, Tacheng area, Xinjiang.Methods:A cross-sectional study was conducted.An epidemiological survey on the prevalence of cataract among people aged 50 years old and over was performed by the Department of Ophthalmology of North China University of Science and Technology Affiliated Hospital in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and Emin County from October 2015 to June 2018.The basic sampling units (BSUs) were divided according to the administrative regions, with about 1 000 people in each administrative region.With a population exceeding 1 500, sample units would be divided into more than two BSUs according to the population.Xinjiang Tacheng area was divided into 240 BSUs, and 12 BSUs were selected by random number table method for inspection.With the lens opacity classification system Ⅱ (LOCS Ⅱ) as the diagnostic standard, the prevalence rate of cataract in different nationalities and different ages in this area was evaluated, and the relationship between age, nationality, sex, hypertension, diabetes, smoking, hyperlipidemia, coronary heart disease, ultraviolet irradiation time and the prevalence rate of cataract was analyzed.This study protocol was approved by the Ethics Committee of the Jiu Shi Hospital of Xinjiang Production and Construction Corps (No.SW-201501-04).Results:The prevalence rate of cataract among people aged 50 and over in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and Emin County was 76.34%.The prevalence rate of cataract in 50-<60-year-old group, 60-<70-year-old group, 70-<80-year-old group and ≥80-year-old group was 23.30%, 77.40%, 89.60% and 100.00%, respectively.There were significant differences in the prevalence among people between different ages, different nationalities, with and without hypertension, with and without diabetes, with and without hyperlipidemia (all at P<0.01). There was no significant difference in the prevalence among people between different sexes, with and without coronary heart disease, smoking or not, different ultraviolet irradiation time (all at P>0.05). Multiple logistic regression analysis showed that age (50-<60 years old: [ OR=39.93, 95% CI: 20.77-76.77; 60-<70 years old: OR=3.81, 95% CI: 2.05-7.08; 70-<80 years old: OR=1.72, 95% CI: 0.92-3.22]), hypertension ( OR=1.54, 95% CI: 1.13-2.11) and hyperlipidemia ( OR=1.41, 95% CI: 1.10-2.03) were independent risk factors for cataract. Conclusions:The incidence of cataract in the Jiu Shi Hospital of Xinjiang Production and Construction Corps and people aged 50 and over in Emin County is higher than that in other parts of China, in which age, hypertension and hyperlipidemia are independent risk factors for cataract.

ObjectiveTo investigate the material basis and mechanism of Arnebia euchroma against hepatocarcinoma by network pharmacology， and to verify the potential targets of A. euchroma against hepatocarcinoma by molecular docking and experiments. MethodThe main active ingredients of A. euchroma were collected by retrieving the literature through China National Knowledge Network （CNKI） and Traditional Chinese Medicine System Pharmacology Database and Analysis Platform（TCMSP）. The active ingredients were screened out by FAFDrug4 platform according to the pharmacokinetics （ADME） properties of the drugs. The screening compounds and liver cancer targets were collected by using several databases and analyzed by drawing Venn diagrams. The protein-protein interaction （PPI） network was constructed by Cytoscape and STRING database. DAVID database was used to perform Gene Ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis of key targets. Autodock was used to perform molecular docking of targets on core pathways. Cell counting kit-8 （CCK-8） experiment was carried out to validate the activities of five naphthoquinones. Based on the predicted results in the H22 tumor-bearing mouse model， the key targets of isovalerylshikonin against hepatocarcinoma were verified by hematoxylin-eosin （HE） staining， enzyme-linked immunosorbent assay （ELISA）， and Western blot assay. ResultFifty-five active ingredients and 34 targets of active ingredients against hepatocarcinoma were screened out. The active molecules with high degree values in the “drug-active ingredient-target-disease” network were mainly naphthoquinones. PPI network obtained several core targets of A. euchroma against hepatocarcinoma. Twenty-two pathways were screened out by KEGG analysis， mainly involving phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， vascular endothelial growth factor （VEGF）， tumor necrosis factor （TNF）， and other signaling pathways. The results of molecular docking showed that the five naphthoquinones had a good affinity with the targets of the PI3K/Akt signaling pathway. The results of CCK-8 and animal experiments showed that the lipid-soluble component isovalerylshikonin had good anti-cancer potential， and the high-dose group reduced the serum levels of VEGF and alpha fetoprotein （AFP） levels and elevated interferon-γ （IFN-γ） level （P<0.05， P<0.01）. The high-dose group also down-regulated phosphorylate（p）-Akt （Ser473） and B-cell lymphoma （Bcl）-2 protein expressions and up-regulated Bcl-2-antagonist of cell death （Bad） protein expression （P<0.01）. ConclusionA. euchroma can inhibit hepatocarcinoma cell proliferation and tumor angiogenesis and induce cancer cell apoptosis through the PI3K/Akt signaling pathway， which provides ideas and clues for the subsequent in-depth investigation of its specific mechanism.

Objective:To explore the value of Hong′s single-stitch duct to mucosa pancreaticoenterostomy(HSDMP) in laparoscopic pancreaticoduodenectomy(LPD).Methods:The perioperative clinical data of 300 patients undergoing LPD admitted to the Second Department of Hepatobiliary Surgery in the First Hospital of Jilin University from April 2015 to March 2019 were retrospectively analyzed. The patients were categorized into pancreatic fistula group( n=43) and non pancreatic fistula group( n=257). according to the presence or absence of postoperative pancreatic fistula. Among them, pancreaticojejunostomy was performed with HSDMP in 210 patients, and 90 patients underwent traditional pancreaticoenterostomy. Univariate and multivariate logistic regression were used to analyze the risk factors for the development of pancreatic fistula after LPD, and the difference on the time of pancreaticojejunostomy and the incidence of postoperative pancreatic fistula were compared between HSDMP and traditional pancreaticojejunostomy. Results:Univariate analysis showed that the differences on BMI, abdominal operation history, pancreatic texture, and pancreatic duct diameter were statistically significant compared with non-pancreatic fistula group (all P value <0.05). Multivariate logistic regression showed that BMI ( OR1.180, 95% CI1.047-1.338, P=0.008) and pancreatic texture( OR=0.375, 95% CI 0.135-0.861, P=0.036) were independent risk factors for pancreatic fistula after LPD. Compared with traditional pancreaticojejunostomy, HSDMP was associated with shorter anastomosis time and low incidence of postoperative pancreatic fistula, but there was no statistical significance between the two groups. Conclusions:The independent risk factors for pancreatic fistula are high BMI and soft pancreatic texture. Compared with traditional pancreaticojejunostomy, HSDMP does not prolong LPD time and increase the incidence of postoperative pancreatic fistula.

Objective:To explore an assay that can concisely, rapidly, and accurately quantify the amount of chimeric antigen receptor (CAR)-T cells in the bone marrow or peripheral blood of patients after CAR-T cell immunotherapy by morphological analysis and flow cytometry assay, providing timely and accurate feedback for clinical treatment.Methods:We analyzed the CAR-T cell detection results in peripheral blood and bone marrow of 256 patients who received CAR-T cell immunotherapy in the Department of Hematology, Affiliated Hospital of Xuzhou Medical University from August 2016 to August 2021. All 256 patients survived more than one month after CAR-T cell infusion. Among them, there were 118 patients with multiple myeloma, 68 patients with acute lymphoblastic leukemia, and 70 patients with lymphoma. The morphological characteristics, positive rate and detection rate of CAR-T cell in peripheral blood and bone marrow were analyzed by morphological methods. The positive rate and detection rate of CAR-T in peripheral blood and bone marrow were analyzed by flow cytometry protein L detection. χ 2 test was used to comprehensively analyze the difference between the detection rate of the combined analysis of the two methods and the detection rate of the single method. Results:CAR-T cells have significant morphological characteristics, and there are obvious morphological differences from normal lymphocytes. The detection rates of CAR-T cells in peripheral blood or bone marrow by morphological methods and flow cytometry were 88.28%(226/256) and 79.29% (203/256), respectively. When the two methods were combined, the detection rate of CAR-T cells can reach 99.22%, with statistically significant difference comparing to that of single method( P<0.05). Through the analysis of the detection results of peripheral blood at different time points, it was found that the average detection rates of morphology and flow cytometry in 118 patients with multiple myeloma were 9.50% and 10.23% on the 7th day, and 13.50% and 15.19% respectively on the 15th day. On the 21st day, the average detection rates of morphology and flow cytometry were 8.00% and 10.07%, respectively. The average detection rates of morphology and flow cytometry in 68 patients with acute lymphoblastic leukemia were 12.00% and 11.22% on the 7th day, and 21.00% and 23.10% respectively on the 15th day. On the 21st day, the average detection rates of morphology and flow cytometry were 13.50% and 10.91%, respectively. The average detection rates of morphology and flow cytometry in 70 lymphoma patients were 7.50% and 10.35% on the 7th day, and 9.00% and 10.35% respectively on the 15th day. The average detection rates of morphology and flow cytometry at 21 days were 6.50% and 5.69%, respectively. The number of CAR-T cells in samples from patients with different diseases reached a peak around the 15th day. Conclusion:The detection rate of CAR-T cells from peripheral blood or bone marrow was significantly higher with the combination of the 2 methods compared to the single method.

Objective:To analyze the research status and development trend of pediatrician competence in China and abroad, for reference in promoting the pediatrician competence research in the country.Methods:Literature review on pediatric resident′s competency was made using CNKI, WanFang and PubMed databases, ranging from their establishment up to December 25, 2019. A descriptive statistical analysis was made on the literatures′ publication year, publication area, research object and application area among others, using Excel 2019 and EndnoteX8.Results:A total of 199 Chinese documents and 262 English documents were finally retrieved. From 2009, the number of publications increased year by year, of which the Pediatrics has topped the rest, followed by Academic Medicine and Chinese Journal of Medical Education Research. The publishing institutions were mostly universities and affiliated hospitals, among which the Children′s Hospital of Chongqing Medical University topped the rest. The keyword of the highest frequency was education and the researches focus on the competency application and modelling. Conclusions:The pediatric healthcare system is paying greater attention on competence researches, but China has not yet established an appropriate pediatric resident competency model fitting local conditions. Meanwhile, the researches are plagued by such setbacks as excessive concentration of resources, simple methods and lack of empirical studies. It is recommended to broaden the explorations in this regard so as to identify pediatric resident competency development models fitting China′s conditions.

Objective ToMeasureofleftventricularregionalsystolicfunctioninpatientswithcirrhosisby2DGSTItechnology.To exploretheclinicalvalueofleftventricularsystolicfunctionindifferentChildGPughgradedlivercirrhosispatientsanditscorrelation withthedegreeoflivercirrhosis.Methods Toselecting60casesoflivercirrhosispatientsincirrhosisgroup.AccordingtotheChildGPugh classification,thepatientsinA,BandCgradesweredividedintoA,BandCgroups.Toselecting30outpatientswithphysicalexaminations, whoseageandgendermatchedwithcirrhosispatientsatthesameperiodasnormal/controlgroup.Measuredtheconventionalindexes, andanalysedtwoGdimensionaldynamicimagesoftwoGchamber,threeGchamber,fourGchamberviewofapical.Thedifferencesinstrain indexandrelatedparametersbetweenthecirrhosisgroupsandthenormalcontrolgroupwerecompared.Results (1)Betweenliver cirrhosisgroupandcontrolgroup,therewerestatisticaldifferencesinheartrate,interventricularseptumthicknessandleftventricular enddiastolicvolume(P＜0.05).leftventricularejectionfraction wassignificantlylowerintheChildCgroupthanintheChild A groupandtheChildBgroup(P＜0.05),andwassignificantlyhigherintheChildBgroupthanthecontrolgroup(P＜0.05).Withthe increaseofChildGPughscoreinlivercirrhosisgroup,interventricularseptumthickness,leftatrialanteroposteriordiameter,leftventricular enddiastolicdiameterandleftventricularenddiastolicvolumeweregraduallyincreasing.Therewerestatisticallysignificantdifferences betweensomegroups(P＜0.05);(2)Longitudinalsystolicpeakstrainofeachsegmentofleftventricularwallwasgenerallylowerin thelivercirrhosisgroupthanthecontrolgroup,andthestrainin bothgroupsshowedincreasingtrendfromthebasaltotheapical segments.There werestatisticallysignificantdifferences between partialsegment(P＜0.05);(3)WiththeincreaseofChildGPugh scoreincirrhosisgroup,longitudinalsystolicpeakstrainofthe leftventricularwallgraduallydecreased.ChildCgroupcomparedwithothergroups,theleftventricularlongitudinalstrainaverage valuedifferencewasstatisticallysignificant(P＜0.05).Therewerestatisticallysignificantdifferencesinpartialsegmentbetweenthe othergroups(P＜0.05).Conclusion (1)2DGSTItechnologycanbesensitiveandreliabletodetectsubGclinicalmyocardialregional systolicdysfunctioninpatientswithcirrhosis;(2)LeftventricularsystolicfunctionisnegativelycorrelatedwithChildGPughgradein patientswithlivercirrhosis.

Delirium is an acute cognitive impairment syndrome. The incidence of delirium in intensive care unit (ICU) is higher than that in general wards which is an independent risk factor of clinical outcomes of ICU patients. At present, there is no unified standards in assessment instrument for ICU delirium in China which has influences on early diagnosis and assessment by medical staff and makes the incidence of ICU delirium high. This paper reviewed the research progress of assessment instrument for ICU delirium at home and abroad so as to provide a basis for assessment of ICU patients with delirium in China.