Objective To analyze the evidence of risk factors and health and rehabilitation intervention strategies for lower back inju-ries in adult golfers. Methods A thematic search method was employed,retrieving literature related to low back pain in adult golfers from PubMed,Web of Science,EBSCO,Scopus,the Cochrane Library,CNKI,VIP and Wanfang Data,with publica-tion dates ranging from inception to April 1st,2024.Authors,country,publication time,study subjects,risk fac-tors for low back pain and intervention strategies were extracted from the literature for systematic review. Results Nine English articles from the United States,Australia,South Korea,Portugal and South Africa were included,involving 237 golfers,three survey studies,one prospective cohort study,five randomized controlled trial(RCT)and quasi-RCT articles were enrolled.The study subjects included adult professional and amateur golfers.The primary risk factors were excessive repetition of non-standard golf swinging movements resulting in excessive lumbar torsion and overuse of the lumbar musculature;abnormal activation patterns of the rectus abdominis,erec-tor spinae and latissimus dorsi muscles;and functional limitation of the trunk and hip joints,causing excessive lumbar compensation during the swinging motion.Health and rehabilitation intervention strategies included the comprehensive application of electromyography and ultrasound biofeedback technologies with a focus on screen-ing the lumbar weak muscle groups and swinging actions,optimizing training load,and standardizing swinging technical movements;strengthening functional training of the trunk and hip joints;and enhancing strength train-ing of the abdominal and core muscle groups,as well as the deep muscle groups. Conclusion The risk factors for low back pain in adult golfers are primarily associated with excessive repetition of im-proper golf swing techniques,insufficient strength in the abdominal and core muscle groups,and functional limi-tations of the trunk and hip joints.Key intervention strategies include optimizing training load using electromyog-raphy and ultrasound biofeedback techniques,standardizing swing techniques,enhancing trunk and hip joint functional training,and strengthening waist,abdominal,core and deep muscle group strength training.The imple-mentation of these strategies helps to reduce the risk of low back pain in golfers,enhance athletic performance,and promote physical and mental health.

Objective:To evaluate the accuracy of the domestic "Skywalker" surgical robot in implementing personalized lower limb alignment reconstruction scheme in total knee arthroplasty (TKA) and the short-term clinical outcome of robotic assisted TKA.Methods:From September 2020 to January 2021, the data of patients who received surgical robot assisted TKA in 5 clinical centers in China (Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Southwest Hospital affiliated to Third Military Medical University, The Affiliated Hospital of Qingdao University, The First Affiliated Hospital of Chongqing Medical University and Yantai Yuhuangding Hospital, and Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine was the group leader) were prospectively collected and retrospectively analyzed. There were 24 males and 82 females with an average age of 67.6±7.3 years, (range 45-80 years); Average body mass index 26.42±4.31 kg/m 2, all the operation were performed by "Skywalker" surgical robot system according to preoperative design based on CT. The operation time, intraoperative blood loss, hospitalization days and postoperative complications were recorded, and the imaging indexes including hip-knee-ankle (HKA), lateral distal angle of femur (LDFA) and medial proximal angle of tibia (MPTA) measured before and after the operation, implant model indexes (preoperative planning implant model and postoperative implant model) and short-term clinical efficacy indexes [Western Ontario and McMaster Universities (WOMAC) osteoarthritis index] pain score, stiffness score, joint function score, total score and SF-12 score before and 3 months after the operation) were compared. Results:The average follow-up period was 109.60±9.80 d, (range 95-143 d). The average operation time of 106 patients was 105.30±23.22 min; The average intraoperative blood loss was 141.70±58.33 ml; The average length of hospitalization was 5.82±2.80 d. One patient had ischemic stroke after operation, and one patient had abnormal liver function after operation. According to the judgment of the investigator, all of them were not related to the operation. The actual angle error is the difference between the preoperative planning angle and the postoperative measurement angle. The absolute error of 99.1% (105/106) of the HKA angle was within 3°, 90.8% (69/76) of LDFA, 98.7% (75/76) of the MPTA. In 45 patients in one center where data were available, the actual implant models used in all patients were consistent with the preoperative planning size, and there were only differences in version selection such as Asian condyle. WOMAC pain score, joint function score, total score was improved from 7.34±2.85, 25.10±9.85, 34.75±13.02 to 3.34±2.66, 14.68±9.64, 18.66±13.49 before and after operation, respectively, which were statistically significant ( P<0.001) and SF-12 physiological score and psychological score were improved form 27.24±6.42, 30.68±8.26 to 38.83±5.74, 39.36±7.85 before and after operation, respectively, which were statistically significant ( t=7.33, P<0.001; t=4.53, P=0.043). Conclusion:Domestic surgical robot system "Skywalker" can assist the surgeon to achieve accurate and personalized reconstruction of lower limb alignment and achieve satisfactory short-term clinical outcomes. The long-term clinical outcomes of personalized reconstruction and survival rate of implant still need to be further studied.

Objective:To investigate the effects of different intensity of lighting on normal refractive development and form deprivation myopia (FDM) in guinea pigs.Methods:A total of 108 healthy 3-week-old guinea pigs were divided into normal refractive development guinea pigs ( n=54) and FDM guinea pigs ( n=54). FDM models were prepared in FDM animals by occlusion of the left eyes using an opaque mask, and the bilateral eyes were open in the normal refractive development guinea pigs.The guinea pigs were randomized to low (20 lx), normal(300 lx), and high intensity-lighting (5 000 lx) groups with a 12-hour light/12-hour dark cycle for 6 consecutive weeks under LED light.The ocular biometry was performed in a two-week interval.Axial length (AL) and dilated diopter were measured by A-scan ultrasonography and retinoscopy, respectively, and were compared after different lighting durations, and the change trends of them in normal refractive development and FDM guinea pigs were evaluated. Results:The AL values were not significantly different among low, normal and high intensity-lighting groups ( Fgroup=0.365, P=0.697), and the AL was gradually prolonged over the lighting duration ( Ftime=353.750, P<0.001). The diopters showed a statistically significant difference among different intensity-lighting groups ( Fgroup=3.576, P=0.034). The diopter in high intensity-lighting for 4 weeks was (+ 2.75±2.15) D, which was significantly higher than (0.41±3.07) D in the normal refrective development guinea pigs ( P<0.001). In the FDM guinea pigs, both AL and diopter were not significantly different among low, normal and high intensity-lighting groups ( Fgroup=0.105, P=0.900; Fgroup=0.973, P=0.387), and significant differences were seen in AL and diopter among three groups ( Ftime=408.302, 27.407; both at P<0.001). The diopter in FDM eyes of low intensity-lighting for 2 weeks was (+ 2.35±1.95) D, which was higher than (+ 1.90±0.97) D before lighting, with no statistically significant difference between them ( P>0.05). The AL was shortest and the AL change was smallest in normal refractive development guinea pigs of high intensity-lighting group.The diopter change in FDM guinea pigs of the low intensity-lighting group was significantly smaller than that in the normal intensity-lighting group ( P<0.001), with a transient hyperopia drift. Conclusions:The 5 000 lx lighting can slow down the development toward myopia in the normal refractive development eyes, and 20 lx lighting tends to delay the progression FDM eyes with a hyperopic shift after lighting for 2 weeks.

OBJECTIVE To establish the fingerprint of Huatan qushi huoxue decoction （HQHD），and to explore the effects of processing and decoction methods on its components. METHODS Using salvianolic acid B as reference ，HPLC fingerprints of 10 batches of single and mixed decoction of crude drugs ，single and mixed decoction of processed products （original formula referred to 8 ingredients were crude drugs ；processed formula referred to processed products of Alisma orientale ，Salvia miltiorrhiza ， Curcumae Radix and Bupleuri Radix ，and crude drugs of other ingredients ；single decoction referred to the mixing of each ingredient after being decocted separately ；mixed decoction refers to decocting after mixing all ingredients ）were stablished by Similarity Evaluation System of Chromatographic Fingerprints of Traditional Chinese Medicine （2012 edition）. The similarity evaluation，common peak identification and attribution ，chemical pattern recognition analysis were also carried out. RESULTS There were 37 common peaks in each fingerprint of 10 batches of single and mixed decoction of crude drugs ，single and mixed decoction of processed ，the similarities with control fingerprint were higher than or close to 0.950. Nine common peaks were identified，i.e. rutin （peak 12），hesperidin（peak 13），salvianolic acid B （peak 16），quercetin（peak 20），silybin（peak 22）， luteolin（peak 23），autrantio-obtusin（peak 29），23-acetylalismol C （peak 34），saikosaponin b 2（peak 35）；decoction pieces of 8 ingredients all contributed to the fingerprints of HQHD. Principal component analysis （PCA）showed that the 4 kinds of HQHD samples were grouped into one category ，respectively. The clustering result of partial least squares-discriminant analysis was consistent with that of PCA. Corresponding components of peak 1，15，17，18 and 36，salvianolic acid B and luteolin m ay be the differential markers of the quality for mixed decoction samples of crude drugs and processed products ； corresponding components of peak 1，7，17-19，salvianolic acid B and hesperidin may be the differential markers of the quality for single decoction samples of crude drugs and processed products；corresponding components of peak 1，17-19，36， salvianolic acid B and luteolin may be the differential markers of the quality for single decoction and mixed decoction samples of crude drugs ；corresponding components of peak 7，17-19，21， hesperidin，salvianolic acid B ，rutin，luteolin and autrantio-obtusin may be the differential markers of the quality for single decoction and mixed decoction samples of processed products. CONCLUSIONS The established fingerprint of HQHD is stable and reliable. The quality differential components of different decoction samples are luteolin ，hesperidin，etc. The quality differential components of samples processed or not are rutin ，hesperidin，autrantio-obtusin，etc.

The incidence rate of nonalcoholic fatty liver disease (NAFLD) is gradually increasing, and NAFLD has become the most important chronic liver disease in China. At present, the pathogenesis of NAFLD has not been fully elucidated and there are still no effective drugs. From the perspectives of pathogenesis, noninvasive diagnosis, and drug action and efficacy, this article introduces the research advances in metabolomics regarding endogenous small molecule metabolites in NAFLD, so as to provide new ideas and methods for further exploration of NAFLD.

Adenosine monophosphate-activated protein kinase (AMPK) is a critical enzyme for energy and metabolic regulation and can effectively maintain the homeostasis of energy and metabolism in cells and the body, and thus it plays an important role in both health and diseases. Current studies have shown that AMPK can regulate inflammatory response in the body through various cytokines and signaling pathways such as nuclear factor-kappa B (NF-κB), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) and has become a potential therapeutic target for a variety of inflammatory diseases. In acute pancreatitis, abnormal activation of trypsin can cause the injury and necrosis of tissue cells, release various inflammatory factors including NF-κB, TNF-α, and IL-6, and induce systemic inflammatory response, leading to organ injury or acute inflammatory disease. Recent studies indicate that the activation of AMPK can alleviate the inflammatory damage of acute pancreatitis. Therefore, AMPK and its signaling pathway may become potential therapeutic targets for acute pancreatitis.

Objective To explore the real user experiences of patients with PICC catheter for PICC maintenance network in Shandong province.Methods Descriptive phenomenological methodology was adopted in this study.A semi-structured interview was conducted with 18 patients of PICC-line maintained in different hospitals from PICC maintenance network in Shandong province.We analysed the data by Colaizzi's phenomenological research method.Results The experiences of patients with PICC catheter for PICC maintenance network in Shandong province contain positive and negative aspects.The positive aspects were convenient medical treatment,cooperation in various level hospitals,progress of basic hospitals,and enthusiastic services;the negative aspects were personnel shortage,different levels of nurses and imperfect supporting system.Conclusions Patients with PICC maintenance network possessed positive experience,but the accessibility of PICC maintenance network should be further enhanced,specialized development should be promoted.Meanwhile,for the questions proposed by patients,some measures should be taken to improve the overall PICC maintenance service from various level hospitals in Shandong province and make the experience of patients better.These measures include strengthening the standardized training and quality control of PICC,improving the supporting system,and promoting the implementation of continuous nursing mode in the primary hospitals.

Objective To investigate the safety and feasibility of the modified terminal cannula ileostomy in laparoscopic anus-preserving operation of low rectal cancer (RC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 15 patients who underwent laparoscopic radical resection of RC + terminal cannula ileostomy in the Subei People's Hospital of Jiangsu Province between September 2016 and June 2017 were collected.The patients underwent laparoscopic low anterior resection of RC,intra-abdominal sigmoid colon-rectum end-to-end anastomosis after extracting tumor specimens,and terminal cannula ileostomy in vitro.Observation indicators:(1) intraoperative situations:operation time,time of cannula ileostomy,volume of intraoperative blood loss,number of lymph node dissected,surgical margin;(2) postoperative situations:time to initial anal exsufflation,recovery time of defecation,time of tube removal,closing time of stoma,postoperative complications,duration of hospital stay;(3) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the anastomotic leakage-related complications up to December 2017.Measurement data with normal distribution were represented as (x)±s.Results (1) Intraoperative situations:all the 15 patients underwent successful laparoscopic radical resection of RC + terminal cannula ileostomy,without conversion to open surgery and death.The operation time,time of cannula ileostomy,volume of intraoperative blood loss and number of lymph node dissected were respectively (170 ± 34) minutes,(23 ± 4) minutes,(59 ± 27)mL and (13 ± 5) per case.No residual cancer cells were found in resection margins.(2) Postoperative situations:time to initial anal exsufflation and recovery time of defecation in 15 patients were respectively (6± 1) days and (7 ± 1) days.The stoma was automatically closed after tube removal,and time of tube removal and closing time of stoma after tube removal were respectively (23 ± 2) days and (3 ± 1) days.The incidence of postoperative complications was 1/15.One patient with catheterization-related complications was improved by strengthening dressing and antibiotic use,and the stoma was healed at 8 days after tube removal.There was no anastomotic leakage-related complications and death.The duration of hospital stay was (15±3) days.(3) Followup situations:all the 15 patients were followed up for 6-12 months.During the follow-up,there were no anastomotic leakage-related complications and death.Conclusion The modifyied terminal cannula ileostomy is safe and feasible,and is also an ideal surgical method for preventing anastomotic leakage in the laparoscopic anuspreserving operation of low RC.

OBJECTIVETo compare the clinical outcomes of embryos selected using time-lapse microscopy and traditional morphological method in IVF/ICSI cycles and evaluate the clinical value of time-lapse microscopy in early embryo monitoring and selection.

METHODSe retrospectively analyzed the clinical data of 139 IVF/ICSI cycles with embryo selection based on time-lapse monitoring (TLM group, n=68) and traditional morphological method (control group, n=71). The βHCG-positive rate, clinical pregnancy rate and embryo implantation rate were compared between the 2 groups. Subgroup analysis was performed in view of female patients age and the fertilization type.

RESULTSThe βHCG-positive rate, clinical pregnancy rate and implantation rate were 66.2%, 61.8% and 47.1% in TLM group, significantly higher than those in the control group (47.9%, 43.7% and 30.3%, respectively; P<0.05). Compared with patients below 30 years of age, patients aged between 31 and 35 years benefited more from time-lapse monitoring with improved clinical outcomes. time-lapse monitoring significantly increased the βHCG-positive rate, clinical pregnancy rate and implantation rate for patients undergoing IVF cycles, but not for those undergoing ICSI or TESA cycles.

CONCLUSIONSCompared with those selected using traditional morphological method, the embryos selected with time-lapse microscopy have better clinical outcomes, especially in older patients (31-35 years of age) and in IVF cycles.

Embryo Implantation ; Embryo Transfer ; Female ; Humans ; Microscopy ; methods ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

The aim of the study was to select a suitable pelletisation aid of valsartan immediate-release pellets in the extrusion process and optimized the formulation. The properties of the pellets with five excipients which were microcrystalline cellulose(MCC), low-substituted hydroxypropyl cellulose(L-HPC), crospovidone(PVPP), pregelatinized starch(PCS)and k-carrageenan were evaluated and compared by the single factor test. And the pelletisation aids were chosen preliminary. The properties of the pellets with MCC, L-HPC, k-carrageenan respectively were evaluated and compared and k-carrageenan was determined as the most appropriate pelletisation aid. The Box-Behnken design was employed to optimize the formulation. The optimised formulation was k-carrageenan 16. 98 g, HPMC-E5 2. 03 g, SLS 0. 26 g. The yield and aspect ratio of pellets was 91. 23% and 1. 14, respectively. And there was no significant difference between observed and predictive responses. The results showed k-carrageenan pellets owned properties of a high yield, acceptable sphericity and fast drug release.