Objective:To investigate the indications and effects of arthroscopic all-inside reconstruction in the treatment of isolated posterior cruciate ligament (PCL) injury.Methods:A retrospective analysis was performed on 47 patients with isolated PCL injury, who underwent arthroscopic all-inside reconstruction in the Third Medical Center of the PLA General Hospital from January 2016 to January 2020. There were 39 males and 8 females, aged 27.14±7.70 years old (range 16-40 years old). The preoperative kneeling-position stress X-ray showed that the degree of tibial posterior displacement was 8-10 mm, which was a complete and isolated Grade II PCL injury. The tibial and femoral tunnels were created through posterior-medial, anteromedial, and anterolateral portals, while the lateral portal to the medial femoral condyle was enlarged to position the tibial tunnel and protect the anterior cruciate ligament. The autologous graft tendon was pulled through the femoral and tibial tunnels secured with an adjustable loop plate. The efficacy was evaluated by evaluating and comparing preoperative and postoperative Lachman test, posterior drawer test, knee range of motion and relaxation, pain visual analogue scale (VAS) and Lysholm score.Results:43 patients were followed up for 35.21±3.88 months (range 12-40 months). The symptoms of knee instability all improved after surgery. At the follow-up of 1 year after surgery, 41 (95%) and 40 (93%) patients showed normal or I-degree laxity in Lachman test and posterior drawer test, respectively. The active range of motion and passive flexion of the knee joint were increased to 90°-110° and 110°-130°, respectively. The Lysholm score was 86.44±4.08 at the first year of follow-up and 90.12±3.33 at the last follow-up with significant difference compared with pre-operations ( P<0.05). The VAS score was 2.07±0.94 at the first year of follow-up and 1.28±0.83 at the last follow-up with significant difference compared with pre-operations ( P<0.05). The Lysholm score and VAS were 90.12±3.33 and 1.28±0.83, which were significantly improved compared to 1-year-follow-up ( P<0.05). Conclusion:Routine kneeling stress X-rays can evaluate the degree of tibial posterior displacement in isolated PCL injuries. With tibial posterior displacement equal to or greater than 10 mm, surgical reconstruction was required. All-inside reconstruction of isolated PCL injury was a safe and minimally invasive surgery to improve symptoms and restore knee functions.

Thrombosis is a key factor that increases the mortality rate of COVID-19 patients and causes long COVID sequelae. Guanxinning Tablet (GXNT), which is composed of Salvia miltiorrhiza and Ligusticum Chuanxiong, has significant antithrombotic activity, but the similarities and differences between its anti-conventional thrombus and microthrombus induced by COVID-19 remain unclear. In this paper, the main active components, potential targets and mechanisms of GXNT in the treatment of thrombus and microthrombus caused by COVID-19 were preliminarily revealed by using anti-platelet experiments in vitro, network pharmacology analysis, molecular docking technology and molecular biology experiments. The results of platelet aggregation and adhesion experiments in vitro showed that GXNT had significant anti-platelet aggregation and adhesion activities in a dose-dependent manner. Using network pharmacology analysis, it was revealed that salvianolic acid B, tanshinone IIA, caffeic acid and ligustrazine in GXNT could resist thrombus and microthrombus caused by COVID-19 through key targets as the high mobility group box 1 protein (HMGB1), tumor necrosis factor (TNF), interleukin 6 (IL6) and AKT serine/threonine kinase 1 (AKT1). HMGB1 signaling pathway is one of its key common mechanisms. Western blot also indicated that GXNT significantly inhibited the expression of HMGB1 protein in platelets. In summary, this paper explores the similarities and differences between the mechanism of GXNT against conventional thrombus and microthrombus caused by COVID-19 and provides drug reference and theoretical basis for clinical prevention and treatment of long COVID sequelae. The animal experiment has been approved by the Experimental Animal Ethics Committee of Tianjin University of Traditional Chinese Medicine (No. TCM-LAEC2023187g1549).

Objective To explore the clinical characteristics and treatment scheme of patients with spinal infection caused by Prevotella intermedia(P.intermedia).Methods Clinical diagnosis and treatment processes of a patient with spinal infection caused by P.intermedia admitted to the spinal surgery department of a hospital were summa-rized,and relevant literature was retrieved from database for reviewing.Results The patient,a 50 year old male,was admitted to the hospital due to"lumbago pain complicated with pain in double lower extremities for 2 months".The lesion tissue was taken for metagenomic next-generation sequencing(mNGS)detection,which detected P.in-termedia,and the patient was diagnosed with P.intermedia spondylitis.After treatments with open lesion clea-rance,tube rinsing+autologous bone transplantation fusion internal fixation,intravenous drip of ceftriaxone sodium and metronidazole,as well as metronidazole rinsing,infection was under control.A total of 16 available papers were retrieved,together with this case,a total of 17 patients were included,with 7 males and 10 females.The main risk factors were diabetes and history of corticosteroid use(35.3％).The most common invasion sites were lumbar ver-tebra(n=12)and thoracic vertebra(n=6).13 cases were positive for pathogen culture,3 cases were positive for molecular detection,and 1 case was positive for staining microscopy.17 patients received anti-anaerobic bacteria treatment,with 14 cases receiving combined surgical treatment.One case died,with a mortality of 5.9％;5 cases had partial neurological impairment,with a disability rate of 29.4％.The survival rate of patients who received treatment of anti-anaerobic bacteria combined with surgery was 92.8％,3 patients only with anti-anaerobic bacteria treatment but without surgery were all cured.Conclusion P.intermedia is an opportunistic pathogeanic bacteria which often causes infection in immunocomprised individuals and is prone to be misdiagnosed.It is recommended to perform mNGS detection to identify the pathogen as early as possible and seize the opportunity for treatment to reduce mortality.

Objective To investigate the clinical characteristics of female migraine patients with patent foramen ovale(PFO)and design a risk prediction model for PFO in female migraine patients(migraineur patients PFO risk prediction model,MPRPM).Methods Female migraine patients who visited Zhongshan Hospital,Fudan University from Jun 1,2019 to Dec 31,2022 were included.Preoperative information and follow-up results after discontinuation of medication were collected.Patients were divided into PFO-positive and PFO-negative groups based on transesophageal echocardiography results.A multivariate Logistic regression model and a random forest model were constructed,and the random forest model was validated multidimensionally.Key features were selected based on the mean decrease accuracy(MDA)to construct MPRPM.Results A total of 305 female patients were included in the study,with 204 patients in the PFO-positive group and 101 patients in the PFO-negative group.Multivariate Logistic regression analysis showed that age at migraine onset,attack frequency,severe impact on life during attacks,exercise-related headaches,menstruation-induced headaches,aura migraines,and a history of cryptogenic stroke were predictive factors for PFO positivity.The random forest model effectively predicted the incidence of PFO in female migraine patients,with an AUC of 0.895(95%CI:0.847-0.943).MPRPM demonstrated a sensitivity of 71.6%and specificity of 91.1%(AUC:0.862,95%CI:0.818-0.906,P<0.001).The optimal cut-off value was 2.5 points.Patients correctly classified by the model showed a higher rate of symptom improvement compared to incorrectly classified patients(94.3%vs.82.0%,P=0.023).Conclusion We identified predictive factors for PFO in migraine patients.MPRPM can provide guidance in the diagnostic process and therapeutic decision-making for female migraine patients,assist in patient triage,and reduce the healthcare burden.

Objective To analyze the impact of mini plate and cannulated screw internal fixation on joint function recovery in patients with posterior malleolus fracture.Methods A total of 150 patients with posterior malleolus fractures,treated at our hospital from March 2021 to June 2023,were included in this study.They were divided into two groups using the odd-even number method.The control group consisted of 75 patients who underwent cannulated screw internal fixation,while the study group comprised 75 patients who received mini plate internal fixation.Clinical indicators,ankle range of motion,ankle function,and health status were compared and analyzed between the two groups.Additionally,levels of inflammatory factors,postoperative complications,and clinical efficacy were assessed.Results In terms of operation time and intraoperative blood loss,there was no statistically significant difference between the two groups(P＞0.05).However,the study group exhibited shorter ambulation days,fracture healing time,and hospitalization days compared to the control group(P＜0.05).Moreover,the study group demonstrated significantly improved ankle dorsiflexion,ankle plantar flexion,foot varus and foot valgus range of motion compared to the control group(P＜0.05).Additionally,higher AOFAS score and KPS score were observed in the study group as compared to the control group(P＜0.05).Furthermore,levels of IL-6,IL-8 and CRP were lower in the study group than in the control group(P＜0.05).The incidence of postoperative complica-tions was also lower in the study group than in the control group(P＜0.05).Conclusion Mini plate internal fixa-tion for posterior malleolus fracture yields ideal outcomes by promoting improvement in clinical indicators and ankle range of motion while effectively enhancing ankle function,reducing inflammatory reaction as well as minimizing postoperative complications.

Objective To investigate the mechanism of nootkatone(NKT)in mitigating depression-like behavior caused by blast traumatic brain injury(TBI).Methods The rat bTBI depression-like model was established by simulating the shock wave parameters of blast overpressure(BOP of 60 kPa,90 kPa,and 120 kPa)with a biological shock wave tube.After 14 days of exposure,we evaluated the depression-like behavior of rats using the tail suspension test and forced swimming test.We identified that the BOP(120 kPa)condition caused the most noticeable depressive behavior and used this condition for subsequent experiments.Thirty male SD rats were randomly divided into sham operation group,bTBI group(BOP of 120 kPa),and bTBI+NKT group[at 1 d after exposure to BOP of 120 kPa,giving NKT 10 mg/(kg·d)orally for 14 days],10 in each group.After 14 days of exposure,the depression-like behavior of rats was evaluated by tail suspension test and forced swimming test.The expression levels of protein kinase A(PKA),phosphorylated cyclic adenosine monophosphate effector binding protein(pCREB),and brain-derived neurotrophic factor(BDNF)in the hippocampus of rat were determined by Western blotting.Immunohistochemistry was used to detect the generation of proliferating cell nuclear antigen(PCNA)-labeled neurons in the hippocampal dentate gyrus(DG).Results BOP of 90 kPa can cause depression-like in rats and BOP of 120 kPa can cause the most noticeable depressive behavior(P<0.05).Therefore,we selected the BOP exposure of 120 kPa for subsequent experiments.After 14 days of BOP exposure,compared with sham operation group,the immobility time of tad suspension test in bTBI group was prolonged(P<0.05),the latency of for ced swimming test was shortened,the immobility time was prolonged(P<0.05),the expression levels of PKA,pCREB and BDNF protein in hippocampus were lowered(P<0.05),and the number of PCNA-labeled neurons in hippocampal DG area was reduced(P<0.05);compared with the bTBI group,the immobility time of tail suspension test in bTBI+NKT group was shortened(P<0.05),the latency of forced swimming test was prolonged,the immobility time was shortened(P<0.05),the expression levels of PKA,pCREB and BDNF protein in hippocampus were increased(P<0.05),and the number of PCNA-labeled neurons in hippocampal DG area was increased(P<0.05).Conclusions Early treatment with NKT can improve depression-like behavior in mild bTBI rats.The mechanism may be related to the up-regulation of the PKA-CREB-BDNF signaling pathway and increased expression levels of pCREB and BDNF in the hippocampus,which results in increased neuron numbers in the DG region of the hippocampus.

Objective To explore the current status of H.pylori infection in the natural population of Sanya City,analyze its influencing factors,and provide a reference basis for the prevention and control of H.pylori infection.Methods A total of 677 residents from four districts of Sanya City were selected by overall stratified random sampling method,and were subjected to urea 14C breath test and questionnaire survey to calculate the positive rate of H.pylori in the natural population and analyze the influencing factors of H.pylori infection.Results A total of 606 residents were included,and the number of H.pylori positive detections was 261,with a positive detection rate of 38.5％.Among them,different ethnicity,marital status,smoking,eating vegetables and fruits,and literacy level were associated with H.pylori infection(P＜0.05);gender,age,BMI,alcohol consumption,drinking water source,betel quid chewing,and the number of cohabitants were not significantly associated with H.pylori infection(P＞0.05).Family infection was an independent risk factor for H.pylori infection in the natural population of Sanya City,and Li ethnicity,frequent consumption of fruits and vegetables,and college and higher education level were independent protective factors for H.pylori infection in the natural population of Sanya City.Conclusion The rate of H.pylori infection in the natural population of Sanya City is lower than the national average.Consuming more fruits and vegetables and improving the awareness of hygiene protection are conducive to the prevention of H.pylori infection;and the promotion of the family and related members with the same examination and treatment is important to avoid aggregation of infection within the family.

Objective:To summarize the clinical characteristics of children with severe pneumonia requiring mechanical ventilation due to human Boca virus infection.Methods:Clinical data of children with severe human Boca virus pneumonia required mechanical ventilation who were admitted to the emergency intensive care unit at Beijing Children's Hospital Affiliated to Capital Medical University from October 2022 to June 2023 were retrospectively analyzed.Results:A total of ten children with human Boca virus pneumonia required mechanical ventilation were included,including seven males with a median age of 21.5(10.0-42.0) months and six children less than two years old.Six patients were admitted to hospital in the fall of 2022 and four were in the summer of 2023.All cases had cough,wheezing and fever.The wheezes could be heard in all patients admitted to hospital for physical examination.Respiratory sounds were reduced in six cases,and moist crackles were heard in two cases.Two patients had thrush.One patient with bronchial lavage culture showed streptococcus pneumoniae and staphylococcus aureus.One patient had human herpesvirus type 6 infection on day 5 of the course of disease,and one child had rhinovirus.There was no evidence of co-infection in the remaining five cases.All patients were given mechanical ventilation for respiratory failure,and the median mechanical ventilation time was 85 (46-165) hours.Each patient was examined by bronchoscope for 1-3 times.Bronchoscopy manifested endobronchial inflammation,mucosal swelling,increased secretions (10/10),mucous thrombus formation (8/10) and scattered necrotic epithelium (4/10).All patients were discharged after improvement and the median length of administration was 9 (6-14) days.Conclusion:Human Boca virus is one of the important pathogens of severe pneumonia in children,with severe cough,wheezing and feve,which can lead to endobronchial trachea inflammation,easy to form mucous embolus and mucosal necrosis.In severe cases,mechanical ventilation and bronchoscopy are required,and most of them have good prognosis.

Objective To carry out rigid-body inverse dynamics modelling and analysis of a self-designed 6RSS parallel bio-inspired masticatory robot.Methods Firstly,the functions of kinematic variables including translational/rotational velocities and accelerations were derived for rigid-body inverse dynamics modelling.Secondly,the rigid-body inverse dynamics model was established with the Newton-Euler's law.Finally,the chewing motion trajectories of the oral health volunteers were tracked and numerical calculations were carried out in the case where the robot was subjected to a chewing reaction force.Results Numerical calculations showed that the driving torque and the constraint force of the robot peaked when the chewing reaction force was at its maximum.Conclusion The external force has a large impact on the inverse dynamics of the robot,and theoretical references are provided for the motion control and optimal design of the robot.[Chinese Medical Equipment Journal,2024,45(3):16-22]

Objective:To investigate the postoperative renal function and oncologic outcomes of cystic renal cell carcinoma with partial nephrectomy,and to compared the single-center data on surgical out-comes with the Surveillance,Epidemiology,and End Results(SEER)database.Methods:This was a retrospective study that included the patients with cystic renal cell carcinoma who underwent partial ne-phrectomy in the Department of Urology,Peking University Third Hospital(PUTH)from 2010 to 2023.The clinical data and depicting baseline characteristics were collected.Renal dynamic imaging and the Chinese Coefficients for Chronic Kidney Disease Epidemiology Collaboration(C-CKD-EPI)formulae were used to calculate the estimated glomerular filtration rate(eGFR).The renal function curves over time were then plotted,and the patients were followed-up to record their survival status.Cases of cystic renal cell carcinoma in the SEER database between 2000 and 2020 were included,propensity score matching(PSM)was performed to balance the differences between SEER cohort and PUTH cohort,and the cancer-specific survival(CSS)curves for both groups were plotted and statistical differences were calcu-lated by the Kaplan-Meier method.Results:A total of 38 and 385 patients were included in the PUTH cohort and SEER cohort,respectively,and 31 and 72 patients were screened in each cohort after PSM.Of the baseline characteristics,only tumor size(P=0.042)was found to differ statistically between the two groups.There was no statistically significant difference between the two cohorts in terms of CSS after PSM(P=0.556).The median follow-up time in the SEER cohort was 112.5(65,152)months and a 10-year survival rate of 97.2％,while the PUTH cohort had a median follow-up of 57.0(20,1 172)months and a 10-year survival rate of 100.0％.There was no statistically significant difference between eGFR determined by preoperative renal dynamic imaging and the results of the C-CKD-EPI formulae based on creatinine estimation(P=0.073).There was a statistically significant difference in eGFR among the preoperative,short-term postoperative,and long-term postoperative(P＜0.001),which was characterized by the presence of a decline in renal function in the short-term postoperative period and the recovery of renal function in the long-term period.Conclusion:Partial nephrectomy for cystic renal cell carcinoma is safe and feasible with favorable renal function and oncologic outcomes.