Anterior cruciate ligament (ACL) injury is one of the common sports injuries. Anterior cruciate ligament reconstruction (ACLR) is the mainstream treatment for ACL injury, aiming to regain normal anatomical structure and stability of the knee joint and promote the patient's return to sports. Under the guidance of the concept of enhanced recovery after surgery, early weight-bearing rehabilitation (EWB) is an important factor affecting patient function and quality of life. However, there is no consensus on whether EWB rehabilitation can be performed after ACL surgery. This study aims to explore the safety and feasibility of EWB after ACL surgery. The study implemented a gradual EWB rehabilitation program in the experimental group, including weight-shifting training, balance training, and gait training on the affected lower limb, and assessed wound healing and stability of the knee joint. The study found that EWB after ACLR is safe and feasible. EWB rehabilitation not only does not pose a negative effect on the patient's knee pain, swelling, wound healing, and stability, but also helps to improve knee active flexion and quality of life faster and better. The EWB program in this study is simple, safe, and effective, and it provides strong theoretical guidance and practical demonstration for accelerated rehabilitation after ACLR.

This study aimed to improve Knee Osteoarthritis (KOA) therapy by evaluating the knowledge framework and investigating research trends in inflammatory mechanisms. Conducting a thorough search on July 31, 2023, using the Science Citation Index Expanded of the Web of Science Core Collection, we identified 1,083 articles authored by 6,159 individuals from 3,610 institutions across 299 countries. China led in productivity with 377 papers, followed by the United States (253) and Japan (60). The University of California System (20 publications), Guangzhou University of Science and Technology (19), Duke University (18), and Shanghai Jiao Tong University (18) were the top institutions. Notably, the USA and Southern Medical University China held significant centrality in countries and institutions, respectively. Among 1,084 co-occurring keywords, "expression", "rheumatoid arthritis", "articular cartilage", "F kappa b", and "Synovial fluid" emerged as highly correlated topics. Analyzing inflammatory mechanisms in KOA through visualization tools offers insights into the knowledge framework, aiding in identifying future trends for better pain control. The study employed CiteSpace, VOS Viewer, and Tableau to analyze research hotspots and frontiers in inflammation mechanisms in KOA. It focused on essential signaling pathways in articular cartilage, synovial membrane, subchondral bone, and synovial fluids of OA patients and animal models, along with potential therapeutic reagents. Future exploration of the interaction between mechanisms can elucidate key factors in different pathways and the efficacy of injection therapy on inflammation.

We sought to investigate effects of aerobic exercise in women with preeclampsia history. 42 women were enrolled. After 16 weeks, we found improvement in endothelial function index and oxidative stress biomarkers in the exercise group. Moreover, the change of endothelial function index was significantly associated with the change of total antioxidant capacity in the exercise group. Our findings showed aerobic exercise improved exercise capacity, endothelial function and oxidative stress in formerly preeclamptic women, and favorable modification of oxidative stress might be a vital pathway of endothelial function's melioration in those women, which deserves further exploration.

目的:探讨骨科康复一体化模式在康复治疗学专业学生实习带教中的应用效果.方法:将60名康复治疗学专业实习生,随机分为对照组(n=30)和观察组(n=30).对照组采用传统带教方法带教,观察组采用基于骨科康复一体化治疗模式的带教方法带教.2组的带教内容均为肌肉骨骼康复学,比较2组教学效果.结果:观察组学生的理论考核、操作考核成绩均显著高于对照组(P＜0.05).观察组学生在学习积极性、对知识和技能的掌握程度、自主学习能力、沟通表达能力方面的自我评价亦显著高于对照组(P＜0.05).同样观察组学生对学习过程、学习效果的满意程度也显著高于对照组(P＜0.05).结论:与传统带教方法相比,基于骨科康复一体化模式的带教方法能够有效地提高教学质量,发挥学生的主观能动性,值得推广应用.

This paper reports an analysis of the bioinformatics and medical informatics literature with the objective to identify upcoming trends that are shared among both research fields to derive benefits on proprioception for their future. This paper summarizes global research hot topics of proprioception recently based on qualitative evidence from bibliometrics. The research of proprioception is becoming more mature. Domestic scholars can further study proprioception in vision, balance, and other field, and constantly improve the research level in this field in China.

Objective To investigate the experience in diagnosis and treatment of elderly patients with hip fractures during the epidemic period of Coronavirus Disease 2019 (COVID-19). Methods During the epidemic period of COVID-19, totally 58 elderly patients with hip fractures were treated in our hospital from February to April 2020 under the guidance of the National and Shanghai government's standards for prevention and control of COVID-19 as well as patients' conditions. Among the 58 patients, there were 39 cases of intertrochanteric fractures and 19 cases of femoral neck fractures, and 48 cases were treated by operation and 10 cases by conservative treatment. Results Among the 58 elderly patients with hip fractures, 46 cases had normal body temperature, 12 cases had more than 37.3 ℃ of body temperature, and their suspected possibility of COVID-19 was excluded after investigation. A total of 48 patients with surgical treatments had good wound healing, and all of them recovered and discharged smoothly. Conclusion In the condition of fully consideration on the medical safety and benefits of patients during the epidemic period of COVID-19, the combination of various prevention and control measures can ensure that the elderly patients with hip fractures are treated well.

Context Adiponectin (APN) is reported to be correlated closely with autonomic nervous function in different clinical settings. Heart rate recovery (HRR) is a noninvasive and readily obtainable indicator, which reflects the coordinated interplay between parasympathetic reactivation and sympathetic withdrawal. Objective This study aimed to investigate the relationship between serum APN and HRR in polycystic ovarian syndrome (PCOS) women. Design Eighty-nine PCOS women were enrolled and divided into two groups. Women with HRR values slower than 12 beats were defined as Blunted HRR Group. APN levels were compared between Blunted HRR Group and Normal HRR Group. Multivariate logistic regression analysis and multiple linear regression analysis were performed to determine which clinical variables were independently associated with HRR and APN levels, respectively. Results Twenty-three women were categorized into Blunted HRR Group, in which APN level was significantly lower than Normal HRR Group. Age, body mass index, hypertension, and APN were independent factors of attenuated HRR in PCOS women. Meanwhile, multiple linear regression analysis showed age, dyslipidemia, and homeostasis model assessment-insulin resistance (HOMA-IR) were closely associated with APN levels in PCOS women. Conclusions Our findings suggested that decreased APN concentration was closely associated with HRR blunt in PCOS women. Further studies are needed to explore the underlying interactions between APN and autonomic nervous function.

目的 探讨膝关节骨肉瘤切除伴肿瘤型假体置换术后影响患者功能的因素.方法 采用问卷调查法调查2019年1月到2020年8月在我院骨科接受膝关节骨肉瘤切除伴肿瘤型假体置换术后患者20例,应用骨与软组织肿瘤术后功能重建评估系统[5](MSTS)评估患者术后功能,同时采集患者的一般人口学特征信息如性别、身高、文化程度等,以及临床评估资料如康复治疗、并发症、股四头肌肌力等.采用单因素和多因素线性回归分析影响术后功能的因素.结果 术后功能得分为(22.4±5.3)分;膝关节活动度为(97.3±14.0)度;术后日常生活能力得分为(94.5±7.1)分.单因素分析发现并发症(t=5.094,P<0.05)、术后时间(t=-2.890,P<0.05)、肿瘤部位(t=2.077,P<0.05)和康复治疗(t=-3.009,P<0.05)是影响术后功能的因素;多因素研究发现并发症(t=-2.827,P<0.05)、术后时间(t=2.173,P<0.05)和康复治疗(t=2.442,P<0.05)是术后功能的独立影响因素.结论 并发症、康复治疗和术后时间是膝关节骨肉瘤患者肿瘤型假体置换术后功能的主要影响因素.减少并发症和开展康复治疗可以促进术后功能恢复.

Polycystic ovary syndrome (PCOS) is associated with an increased risk of cardiovascular disease in women. Hyperhomocysteinemia (H-Hcy) is closely relat ed to arterial stiffness (AS) in patients with cardiovascular disease. This study aimed to investigate the relationship between serum homocysteine(Hcy) level and brachial-ankle pulse wave velocity (baPWV) in Chinese women with PCOS. A total of 124 PCOS women were enrolled and divided into two groups according to their baPWV values: normal, baPWV < 1400 cm/s and high AS, baPWV ≥ 1400 cm/s. Univariate analysis was performed to investigate the relative factors for baPWV, and multiple regression analysis was used to evaluate the association of Hcy with baPWV. The group with high AS (n = 35) had higher Hcy levels than the other group (n = 89; P < 0.05). Moreover, univariate analysis revealed that serum Hcy was positively correlated with baPWV (r = 0.133, P < 0.01). In multiple regression analysis, the age-adjusted serum Hcy level was positively correlated with baPWV (β = 0.201, P < 0.01). It remained positively associated with baPWV (β = 0.145, P < 0.01) after further adjustments for age, BMI, PCOS duration, systolic blood pressur e, and homeostasis model assessment-insulin resistance as well as several other factors correlated with baPWV. Our results demonstrated that H-Hcy was significantly and independen tly related to elevated baPWV, suggesting that Hcy might play a role in the pathologic process of AS in women with PCOS. Further researches with more subjects are needed to explore whether Hcy would be a promising biomarker for the stratification management of PCOS women.

目的:探讨非特异性颈腰痛患者心理压力、社会支持程度与疼痛强度、病程的相关性.方法:采用横断面研究方法,对203例非特异性颈腰痛患者进行问卷调查,采用“疼痛数字分级法、社会支持评定量表和中文版知觉压力量表”,数据使用Spearman相关性分析和等级Logistic回归进行统计分析.结果:患者的疼痛强度、心理压力、社会支持平均得分分别是(3.9±1.9)分、(24.9±7.4)分、(36.9±8.1)分;相关性分析结果显示,疼痛强度与心理压力有轻度正相关(r=0.351,P=0.015),与社会支持有中度负相关(r=-0.405,P=0.06);疼痛病程与心理压力有轻度正相关(r=0.302,P=0.031).结论:非特异性颈腰痛患者的疼痛强度和病程与心理压力和社会支持程度之间存在相关性,通过缓解心理压力,提高社会支持度,有助于提高颈腰痛的综合诊治水平,形成生理-心理-社会的三维防治体系.

随着心身医学的研究发展,当今大部分疾病可归属到心身疾病范畴,且处于高发状态.我国提出了“首诊在基层”的服务模式,但全科医学尚处于发展阶段,基层卫生服务中全科医生存在医疗水平参差不齐的问题,其岗位胜任能力有待提高,在心身疾病诊疗能力层面尤为明显.通过心身医学与全科医学相结合,可以提升全科医生对心身疾病的认知应对能力,改善全科医生的岗位胜任能力不足现状,同时促进社区居民精神卫生健康,充分体现全科医生“健康守门人”的作用.本文阐述了目前国内全科医学起步晚、需求高的发展现状,总结归纳了国内外对心身医学的认知,揭示出我国精神卫生资源供不应求的现象.笔者根据我国存在心身疾病临床诊断率低,全科医生缺乏相关的心理干预技术,缺乏适合中国国情的诊断评估标准等问题,认为应从多角度进行促进,从政府部门制定相关政策、完善全科医生的院校教育和培训体系及结合本土中医全科特色方面,提出了增强全科医生心身疾病诊疗能力的三点建议.心身医学和全科医学相结合符合当前我国医疗服务发展需求,通过强化全科医生在首诊中的心身疾病认知与应对能力,对于提升基层医疗卫生服务能力,控制医保费用,减少患者与社会的经济负担,具有显著的促进意义,从而更好实现“健康2030”的目标.

目的 探讨抗CD19嵌合抗原受体(CAR)修饰的T细胞(CAR-T)制备阶段Nalm-6细胞的免疫表型及PD-1 mRNA水平变化.方法 将30株急性淋巴细胞白血病(ALL)细胞株Nalm-6细胞分为空白组(不作任何处理)、对照组(转染空白CD19质粒pVAX1)、CD19组(转染CD19真核质粒pVAX1-F),每组各10株.CCK-8细胞增殖实验检测Nalm-6细胞增殖率,倒置显微镜观察Nalm-6细胞转染后细胞形态,流式细胞仪检测Nalm-6细胞免疫表型及PD-L1、PD-1 mRNA水平.结果 转染24、36 h时,CD19组Nalm-6增殖率低于对照组与空白组,差异有统计学意义(P<0.05).空白组Nalm-6细胞间隙分明,排列较稀疏;对照组Nalm-6细胞出现少量聚集,排列较密,有粘连现象;CD19组Nalm-6细胞出现大量聚集,排列紧密,有团状现象.CD19组CD19表达量低于对照组与空白组,差异有统计学意义(P<0.05).各组CD22表达量比较,差异无统计学意义(P>0.05).Nalm-6细胞CD19表达随着共培养时间延长增高,而CD22表达无显著变化.CD19组PD-1、PD-L1 mRNA水平低于空白组与对照组,差异有统计学意义(P<0.05).结论 CAR-T细胞制备阶段Nalm-6细胞中,CD19表达上调、PD-1 mRNA水平下降,不能显著抑制肿瘤细胞的增殖能力.

目的 观察中医传统功法联合康复治疗对脑卒中恢复期患者轻度抑郁、焦虑及日常生活活动能力(Activity of Daily Living Scale,ADL)功能恢复的影响,为脑卒中后出现轻度抑郁、焦虑的群体提供新的治疗方法,改善其功能,提高其日常生活能力.方法 选取60例有抑郁、焦虑的脑卒中恢复期患者,将其随机分为观察组30例及对照组30例,所有患者均进行脑卒中后常规康复治疗、康复护理以及健康教育,而观察组在对照组基础上再进行每天1次、每次20 min的传统功法(放松功)训练,连续训练8周.在治疗前、治疗后应用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD),汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA),巴塞尔指数(Barthel),Fugl-Meyer上、下肢运动功能评估量表(Fugl-Meyer Assessment,FMA).结果 治疗8周后,两组的HAMD、HAMA评分均比治疗前降低(均P＜0.05),观察组低于对照组(P＜0.05);Barthel指数评分、FMA评分均比治疗前提高(均P＜0.05),观察组高于对照组(P＜0.05);观察组的HAMD、HAMA量表减分率比对照组明显(P＜0.05);观察组HAMD量表中的"抑郁情绪、早醒、工作兴趣减退感、现实解体、全身性症状、能力减退感、绝望感"项目的改善比对照组明显(P＜0.05);观察组HAMA量表中的"焦虑体验、紧张感、失眠"项目的改善比对照组明显(P＜0.05).结论 传统功法(放松功法)结合康复治疗对脑卒中恢复期患者的抑郁、焦虑不良情绪以及日常生活活动能力的改善有效且效果比单纯的康复治疗明显.

目的:观察腰椎稳定性训练对慢性非特异性下背痛患者疼痛、腰椎功能及多裂肌横截面积、腹横肌厚度的影响。方法:共招募25例慢性非特异性下背痛患者作为研究对象，均给予腰椎稳定性训练。于治疗前、治疗2个月后对患者疼痛程度、腰椎功能及腰椎多裂肌横截面积、腹横肌厚度等进行检测。结果:25例患者经2个月腰椎稳定性训练后，发现其疼痛评分[(1.88±1.09)分]、Oswestry腰椎功能障碍指数(10.24±5.72)以及腰椎屈曲范围[(6.28±6.18)cm]等均较治疗前明显改善( P<0.05)；并且入选患者左、右侧多裂肌横截面积[分别为(10.20±3.43)cm 2和(10.29±3.24)cm 2]及腹横肌厚度[分别为(3.18±0.95)cm和(3.26±0.94)cm]亦显著优于治疗前水平( P<0.05)。 结论:腰椎稳定性训练能有效缓解慢性非特异性下背痛患者疼痛，增强腰椎活动功能，同时还能增加腰椎多裂肌横截面积及腹横肌厚度，该疗法值得在非特异性下背痛患者中推广、应用。

Structured exercise is shown to be one of the most effective lifestyle interventions for women with polycystic ovary syndrome (PCOS). Anti-Müllerian hormone (AMH) has been proposed as a marker of ovarian dysfunction, and oxidative stress plays an important role in the development of PCOS. We sought to investigate whether there was any effect of aerobic exercise on AMH levels and oxidative stress in Chinese PCOS women. Thirty-eight PCOS women were enrolled and divided into two groups. The exercise group carried out a 12-week exercise program, while the control group maintained their normal lifestyle. All women underwent blood tests and cardiopulmonary exercise tests (CPETs) at enrollment and at 12-week follow-up. At baseline, there was no statistically significant difference between the two groups in clinical characteristics, AMH, oxidative biomarkers, and CPET parameters. After 12 weeks, body mass index (BMI) and cardiovascular fitness indexes of the exercise group were improved. We also found a decrease in AMH (P = 0.021) and malondialdehyde (MDA) (P = 0.002) and an increase in superoxide dismutase (SOD) (P = 0.009) and total antioxidant capacity (TAC) (P = 0.012) in the exercise group, while there was no change in the control group. Moreover, the change of AMH was positively associated with the change of MDA (r = 0.23, P = 0.003) in the exercise group. Our findings demonstrated that 12 weeks of aerobic exercise produced beneficial effects on BMI, cardiovascular fitness, AMH, and oxidative stress in PCOS women. Favorable modification of oxidative stress might thus be an effective method for improvement of AMH in these women, which deserves further exploration in the future.

目的 为了解上海某区产科床位和产科人员的现状,对区内医疗机构的产科服务能力做出客观评价,为区内产科资源调整提供科学依据.方法 对区内产科相关医疗机构的床位使用、人力资源和助产服务情况进行调查.结果 2013-2017年区内平均出生人口数为7 306人;近5年区内医疗机构产科床位使用率有2年持续在91％以上;区内年均分娩量在5 600左右,每年约有2 200名的户籍孕产妇在外区分娩;2016-2017年产科医师平均助产效率为173.39％,助产士的平均助产效率为79.87％;危重孕产妇的发生率为0.22％,抢救成功率为98.38％,2017年度产科门诊医师的每天门诊量为47.34人次,剖宫产率为39.09％.结论 产科资源布局应作调整;加强产科队伍建设.

Hyperhomocysteinemia is an independent risk factor for cardiovascular impairment in hypertension. Oxidative stress is important in the molecular mechanisms associated with hypertension, but there are few studies focusing on the comparison of oxidative stress biomarkers in hypertensive patients with or without hyperhomocysteinemia. The study included 50 newly diagnosed hypertensive patients with hyperhomocysteinemia, 50 newly diagnosed hypertensive patients without hyperhomocysteinemia, and 50 age-matched healthy controls. Serum levels of malondialdehyde, nitric oxide, 8-isoprostane-F2(?), superoxide dismutase, catalase, and glutathione peroxides were compared. Levels of malondialdehyde and 8-isoprostane-F2(?) were higher in both hypertensive groups than in the control group (8.3 +/- 1.8mol/L vs. 6.5 +/- 1.3mol/L vs. 4.3 +/- 1.2mol/L, P<0.05; 23.5 +/- 12.1pg/mL vs. 17.4 +/- 10.3pg/mL vs. 13.9 +/- 7.5pg/mL, P<0.05), while levels of superoxide dismutase and catalase were lower in both hypertensive groups than in the control group (120.5 +/- 13.7U/mL vs. 131.3 +/- 18.2U/mL vs. 149.1 +/- 14.6U/mL, P<0.05; 23.8 +/- 7.4U/mL vs. 24.6 +/- 9.2U/mL vs. 33.5 +/- 8.2U/mL, P<0.05). In hypertensive subgroups, serum malondialdehyde levels were higher in the hyperhomocysteinemia group than the other group (8.3 +/- 1.8mol/L vs. 6.5 +/- 1.3mol/L; P<0.05), and superoxide dismutase activities were lower in the hyperhomocysteinemia group than the other group (120.5 +/- 13.7U/mL vs. 131.3 +/- 18.2U/mL; P<0.05). Moreover, in hypertensive patients, homocysteine levels were significantly correlated with malondialdehyde (r=0.39, P<0.01), 8-isoprostane-F2? (r=0.47, P<0.05), superoxide dismutase (r=-0.51, P<0.01), and catalase (r=-0.51, P<0.05), respectively. Our findings demonstrated oxidative stress was more severe in hypertensive patients with hyperhomocysteinemia than those hypertensive patients without it. Besides, there were strong relationships between homocysteine activities and oxidative/antioxidative parameters, which indicated that homocysteine might aggravate the oxidative stress in hypertension to produce contributory effects on cardiovascular impairment.