PURPOSE: The rapid development of winter sports requires investigation on injuries in Chongli district, Zhangjiakou city, one of the ski sites of the 2022 Winter Olympics. Careful evaluation is required to observe which injuries are caused under what circumstances, and then we can make corresponding preventive measures and recommendations based on the results. METHODS: In this retrospective study, the data of injury cases at ski resorts in China (Chongli district) and Japan were analyzed to provide a reference for the ongoing injury prevention at ski resorts. We collected data on injuries at Wanlong and Fulong ski resorts in Chongli district during the 2017-2018 and 2018-2019 ski seasons. We referred to the skiing injury report issued in February 2020 of a nationwide ski safety statistical service - Japan Ski Safety Association. The causes of injury and specific injured body parts were analyzed based on the data of Chinese and Japanese ski resorts. Statistical significance has been calculated using the Chi-square test. RESULTS: During the 2019-2020 ski season in Japanese ski resorts, the number of reported injuries per 10,000 skiers was 0.93, of which 457 (17.3%) were over 50 years old, accounting for a large proportion of injuries, meanwhile in Chongli ski resort, the injury rate of skiers aged 50 and over was 7.1%. The knee joint (23.7% at Wanlong ski resort and 28.4% in Japanese ski resorts) was the most injured body part among Chongli and Japanese skiers. Among snowboarders, shoulder joint injury (17.7% in Japanese ski resorts) was the most common, and injury on hands and fingers (16.3% in Wanlong ski resorts) was the most common. Head injury rates are similar in Chongli, China and Japanese ski resorts (8.2% and 8.7%, respectively). CONCLUSION Our analysis demonstrated that injury data recorded among young skiers was higher in Chinese ski resorts (Chongli district) than that in Japanese ski resorts, and elderly skiers made up a larger proportion of skiing injuries in Japanese resorts. Thus, according to our research, the protection of knee joints, shoulder joints, and hands and fingers should be taken seriously. It should pay attention to the teaching of ski poles (for finger protection), and use protective devices such as knee pads, helmets, etc.
Aged ; Humans ; Middle Aged ; Retrospective Studies ; Athletic Injuries/prevention & control* ; Skiing/injuries* ; Japan/epidemiology* ; China/epidemiology*

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

Objective: To evaluate the efficacy within the first 24 h post extracorporeal membrane pulmonary oxygenation (ECMO) and the impact of early efficacy on the prognosis of adult patients with fulminant myocarditis (FM). Methods: This retrospective case analysis study included hospitalized patients (age≥18 years) who were diagnosed with fulminant myocarditis from November 2016 to May 2021 in the First Affiliated Hospital of Zhengzhou University. Patients were divided into survival or non-survival groups according to treatment outcomes. The age, sex, treatments, drug use, ECMO use, clinical and laboratory data (before and 24 h after the use of ECMO) were analyzed. The change rate of clinical and laboratory data after 24 h use of ECMO was calculated to find differences between two groups. Multivariate logistic regression was used to analyze the related factors with in-hospital death and complication between the two groups. Results: A total of 38 FM patients treated with ECMO were included. There were 23 cases (60.5%) in the survival group, aged (39.6±13.7) years, and 17 (73.9%) cases were female. The total ECMO time was (134.4±71.3)h. There were 15 cases (39.5%) in non-survival group, aged (40.0±15.8) years, and there were 12(80.0%) female, the ECMO time was (120.1±72.4) h in this group. The proportion of tracheal intubation and continuous renal replacement therapy in the survivor group and dosage of norepinephrine within 24 h after ECMO implantation were significantly less than in non-survival group (all P<0.05). There was no significant difference in all efficacy related biochemical indexes between two groups before ECMO use. The levels of lactic acid, procalcitonin, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase-MB, cardiac troponin I and N-terminal B-type natriuretic peptide prosoma were significantly less in survival group than in non-survival group at 24 h after the use of ECMO (all P<0.05). Results of multivariate logistic regression analysis showed that the higher 24 h change rate of creatinine (OR=0.587, 95%CI 0.349-0.986, P=0.044) and creatine kinase-MB (OR=0.177, 95%CI 0.037-0.841, P=0.029) were positively correlated with reduced risk of in-hospital mortality. The central hemorrhage and acute kidney injury in survival group were less than in non-survivor group (P<0.05). Conclusions: After 24 h early use of ECMO in FM patients, the improvement of various efficacy related biochemical test indexes in the survival group was better than that in the non-survival group. Faster reduction of creatine kinase-MB and creatinine values within 24 h ECMO use is positively correlated with reduced risk of in-hospital mortality in adult patients with FM.
Adolescent ; Adult ; Extracorporeal Membrane Oxygenation/methods* ; Female ; Hospital Mortality ; Humans ; Middle Aged ; Myocarditis/therapy* ; Retrospective Studies ; Treatment Outcome ; Young Adult

PURPOSE: To retrospectively analyze the clinical outcomes of meniscus repair with simultaneous anterior cruciate ligament (ACL) reconstruction and explore the causes of failure of meniscus repair. METHODS: From May 2013 to July 2018, the clinical data of 165 patients who were treated with meniscus surgery and simultaneous ACL reconstruction, including 69 cases of meniscus repair (repair group) and 96 cases of partial meniscectomy (partial meniscectomy group) were retrospectively analyzed. The exclusion criteria were as follows: (1) ACL rupture associated with fracture, collateral ligament injury, or complex ligament injury; (2) a history of knee surgery; or (3) a significant degree of osteoarthritis. The 69 patients in the repair group were divided into the non-failure group (62 cases) and the failure group (7 cases) depending on the repair effect. Postoperative outcomes of the repair group and the partial meniscectomy group were compared. General conditions and postoperative outcomes of the failure group and the non-failure group were compared. During the median follow-up period of 28 months (range, 4 - 65 months) after the second arthroscopy, postoperative outcomes of seven patients in the failure group were summarized. SPSS 25.0 statistical software was used for statistical analysis. A p value less than 0.05 was considered statistically significant. RESULTS: Seven patients in the failure group who underwent the second arthroscopy were followed up for (30 ± 17.4) months and their postoperative outcomes were summarized. Compared with the partial meniscectomy group, the International Knee Documentation Committee scores of patients in the repair group improved significantly (p = 0.031). Compared with the non-failure group, more patients in the failure group were younger than 24 years (p = 0.030). The median follow-up period was 39.5 months. All patients recovered well after subsequent partial meniscectomy and relieved clinical symptoms. Visual analog scale scores decreased significantly (p = 0.026), and the International Knee Documentation Committee and Lysholm scores improved significantly (p = 0.046 for both). CONCLUSION The failure rate of meniscus repair in this study was 10.1% (7/69), all of which were medial meniscus tears. However, the surgical outcomes of ACL reconstruction were not affected, and there might be a role for graft protection. Therefore, meniscus retears can be successful treated by performing subsequent partial meniscectomy in patients with repair failure.
Anterior Cruciate Ligament Injuries/surgery* ; Anterior Cruciate Ligament Reconstruction ; Humans ; Menisci, Tibial/surgery* ; Meniscus ; Retrospective Studies

Osteoarthritis (OA) is one of the most common geriatric motor system diseases in the clinical practice. Aging, whose hallmark is cellular senescence, is an important factor leading to the occurrence and development of OA, but its exact role in the pathological development of OA is not completely clear. Studies have proved that targeting senescence can effectively treat aging-related diseases. In this study, the heterozygous mouse model of Cdkn2a-e (Luc-2A-tdTomato-2a-CreerT2-Wpre-PA)1 was established by the CRISPR/ Cas9 technique. The expression of Cdkn2a (p16, p16INK4a), a classical marker of senescence, can be traced in vivo in mice. We then utilized anterior cruciate ligament transection (ACLT) to induce OA in Cdkn2a mice, and we hope to verify the relationship between aging and the occurrence and development of OA and visualize aging changes during OA development through the mice model. In this study, 10-12 weeks old Cdkn2a mice were randomly divided into no surgery control group, sham operation group and ACLT group. OA model was constructed in mice by ACLT operation. After surgery for 4 weeks, animals were collected for fluorescence imaging detection in vivo, which showed that local fluorescence expression of Cdkn2a increased in knee joints of mice in the ACLT group four weeks after surgery (P < 0. 05) . The Safranin O-Fast Green Staining of mouse knee tissue sections showed degeneration of the knee cartilage in the ACLT group at 4 weeks after surgery (P < 0. 05) . Immunohistochemical staining of Cdkn2a was performed on the knee tissue of mice. Compared with the other two groups, Cdkn2a staining on the cartilage surface of the knee tissue of mice in the ACLT group was deeper. The results showed that the OA model induced by surgery showed local aging, which further verified the relationship between aging and OA. At the same time, the Cdkn2a tracer mouse model can reflect the aging progress of mice in vivo, with combination of imaging examinations, so that the occurrence and progress of the relationship between aging and OA can be observed in real time. This heterozygous mouse model of Cdkn2a-e(Luc-2A-tdTomato-2a-CreerT2-Wpre-PA) 1 is not only useful for mechanism research of aging and OA diseases, but also beneficial for finding more potential therapy targets to OA and aging.

Osteoarthritis (OA) is a common degenerative disease of the motor system with a high morbidity and disability rate. The pathogenesis of OA is not clear at present. Previous studies believe that the pathogenesis of OA is mainly related to trauma factors, while recent studies have shown that metabolic factors, including abnormal cholesterol metabolism, are also closely related to OA. The treatment of OA is mainly symptomatic treatment at the early stage and surgical treatment at the late stage, and there is no specific drug. Previously, BNTA, a small molecule drug with cartilage protective effects, has been shown to have a good effect on OA caused by trauma, but its effect on OA caused by high cholesterol remains unclear. In order to explore the therapeutic effect of BNTA on OA caused by high cholesterol and its mechanism, the OA model of rats was constructed by adopting high cholesterol diets, and paraffin sections of knee joints were taken for histological evaluation. Lipid accumulation in chondrocytes of rats was assessed by oil red O staining. The expression of genes and proteins related to anabolism, catabolism and cholesterol metabolism in chondrocytes was assessed by RT-qPCR, immunofluorescence and immunohistochemistry. The results showed that BNTA could alleviate OA pathological manifestations and improve the OARSI (Osteoarthritis Research Society International) score in the OA model of high cholesterol rats. In rat chondrocytes, BNTA can promote the expression of anabolism-related genes col2, sox9 and acan, inhibit the expression of catabolism-related genes mmp13 and adamts5, and improve the lipid accumulation caused by high cholesterol in rat chondrocytes. BNTA can up-regulate Insig1 expression in rat chondrocytes and the OA model of high cholesterol rats. This study confirmed that high cholesterol can aggravate OA in vivo and in vitro, and can increase lipid accumulation in rat chondrocytes. Taken together, BNTA can alleviate OA phenotypes induced by high cholesterol and improve abnormal lipid accumulation in chondrocytes, possibly by inhibiting cholesterol biosynthesis in cells by upregulating Insig1, thereby alleviating abnormal lipid accumulation.

Objective:To study the effect of sedimentary type Limonitum on hemostatic indexes in blood and metal ions in serum of rats with hemorrhage. Method:The hemorrhagic rat models were established by warfarin sodium. The experimental animals were divided into control group，model group，powder group and water decoction group. On day 15 from drug administration， the contents of 6-keto prostaglandin F_1α（6-keto-PGF_1α），thromboxane B₂（TXB₂），arachidonic acid（AA），endothelin 1（ET-1），platelet activating factor（PAF），P-selectin（PS），and Ca²⁺ in the whole blood of rats in each group were determined by enzyme-linked immunosorbent assay（ELISA）. The contents of Na，Mg，K，Ca，Fe，Al，Li，Be，Ti，V，Cr，Mn，Co，Ni，Cu，Zn，As，Sr，Cd，Sn，Sb，Ba，and Pb in serum samples were determined by inductively coupled plasma optical emission spectrometer（ICP-OES） and inductively coupled plasma mass spectrometry（ICP-MS）. Result:Compared with the model group，the content of 6-keto-PGF_1α was reduced in the powder group and water decoction group （P<0.05），and the contents of TXB₂，AA，ET-1，PAF，PS，Ca²⁺ were significantly increased（P<0.01），with a positive and beneficial regulatory effect. In the powder group， 10 kinds of metal elements in serum of rats were significantly and positively regulated： Na，K，Ca，Fe，Li，Ti，V，Co，Cu，and Zn（P<0.05，P<0.01）. In the water decoction group， 10 metal elements with significant positive regulation were as follows： Na，K，Ca，Fe，Li，V，Ni，Cu，Zn，and Sr（P<0.05，P<0.01）. In addition，the content of Cr（P<0.01） in the powder group and Cr（P<0.01），Pb（P<0.05） in the water decoction group were significantly reduced. Conclusion:The powder and water decoction of sedimentary type Limonitum had definite and positive intervention effect on warfarin hemorrhage model rats，which could play a coagulation role by enhancing the vasoconstriction ability，promoting the activation of platelets，and increasing the platelet aggregation rate and blood viscosity. The metal elements such as Na，K，Ca，Fe，Li，Ti，V，Co，Cu，Zn，Ni and Sr may be the material basis for sedimentary type Limonitum to exert hemostatic effect. According to the above indicators，the intervention effect of powder group and decoction group was basically the same.

OBJECTIVE: To analyze characteristics and related factors of the plantar pressure during the level walking and single leg standing in the chronic ankle instability (CAI) individuals. METHODS: From April 2019, 75 CAI individuals and 40 healthy individuals were enrolled in this study. Both of the static and dynamic plantar pressure were measured during six times level walking and three times single leg standing testing. The data including peak force, time to peak force in various foot contact areas and the time to boundary (TTB) and velocity of center of pressure (COP) were measured and compared between the affected side and the unaffected side and between the CAI cases and the healthy individuals. The correlations between the plantar pressure and the gender, Beighton score, affected side and body mass index (BMI) were analyzed. RESULTS: The characteristics of plantar pressure distribution in the CAI individuals included: (1) During the level walking, the affected side showed the similar pressure contribution as the unaffected side (P>0.05). While compared with healthy individuals, there was a significantly higher peak force in the 5th metatarsal area (t=-3.86, P=0.03) of the affected side, lower peak force in the 1st (t=2.99, P=0.02), 2nd metatarsal head areas (t=2.09, P=0.01) of the affected side, medial hindfoot areas of both sides (affected, t=2.33, P=0.01; unaffected, t=3.74, P=0.02) and toes areass of both sides (affected, t=2.23, P=0.01; unaffected, t=3.28, P=0.02) and a delay to peak force in the 4th metatarsal head area (t=3.33, P=0.01) of the affected side. (2) During the single leg standing, the CAI individuals showed significantly worse balance control in the anterior/posterior direction (P < 0.05) and lateral/medial direction (P < 0.05) compared with the healthy controls, and the affected side had more severe balance control deficit in the lateral/medial direction (P < 0.05). (3) The women (P < 0.05) and the individuals with higher Beighton scores (P < 0.05) showed worse balance control deficit in the lateral/medial direction. CONCLUSION CAI individuals showed significantly a more lateral shifted plantar distribution during the level walking compared with the healthy individuals and the tendency was worse on the affected sides, and showed worse balance control in the anterior/posterior direction and lateral/medial direction during the single leg standing. The women and those with generalized ligament laxity showed significantly worse balance control.
Ankle ; Ankle Joint ; Case-Control Studies ; Female ; Foot ; Humans ; Joint Instability

OBJECTIVE: To make a retrospective analysis of the situation and process of treating skiers' injuries in the medical station of the Wanlong ski resort in Chongli and the nearest treatment hospital, and to provide a basis for the establishment and optimization of the treatment process between the medical station of the Winter Olympics ski resort and the nearest treatment hospital, and to gain experience for medical security of mass skiing. METHODS: The data of all ski injuries in Chongli District were collected from the medical station of the Wanlong ski resort during the 2018-2019 snow season (November 2018 to April 2019) and the nearest treatment hospital during two periods (March 2019, and November 2019 to January 2020). The differences of injury causes, injury types, injury sites, and treatment effects of the injured skiers were analyzed. RESULTS: A total of 755 cases of ski injuries were recorded in the medical station of Wanlong ski resort, the estimated incidence of injury was 2.02‰ per day. The nearest treatment hospital treated a total of 838 injured skiers from different ski resorts in Chongli District in the two periods. In the records of the ski resort medical station, the main causes of injury were technical defects and turnovers (53.6%). Knee joint injury rate was the highest (18.7%), followed by head and neck (12.9%) and lower limb (11.9%). The number of injuries on intermediate roads was the highest (40.0%), the greatest number of injuries (81.2%) occurred when the age of skiing was less than 5 years. In the records of the nearest treatment hospital, the injury types were fracture or fissure fracture, contusion and trauma, and muscle and soft tissue injury, accounting for 30.5%, 27.4%, and 21.2% respectively. 9.6% of the injured took the snow field ambulance to the hospital, and 50% of them suffered from fractures or fissure fractures. CONCLUSION The injury rate of skiing in the 2018-2019 snow season of the Wanlong ski resort in Chongli was higher than that reported by foreign literature. Severe trauma (including severe fractures and concussions) could occur and patients needed to be transferred to the nearest hospital for treatment. The ski resort medical station and the nearest treatment hospital should be strengthened with adequate medical staff and equipment, and promote cooperation in the timely referral of seriously injured patients, the organization and construction of ski patrols and the medical security of large-scale competitions, thus playing an important role in forming a grassroots network of medical security and treatment system for skiing.
Athletic Injuries/therapy* ; Child, Preschool ; Hospitals ; Humans ; Retrospective Studies ; Seasons ; Skiing

OBJECTIVE: To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers. METHODS: The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared. RESULTS: A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen. CONCLUSION In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.
Athletic Injuries/epidemiology* ; Humans ; Lower Extremity ; Retrospective Studies ; Skiing ; Trauma Centers