Abstract:Objective To investigate the role of myeloid-epithelial-reproductive tyrosine kinase(MerTK)in regulating microglial M1/M2 polarization and neuroinflammation following traumatic brain injury(TBI).Methods A total of 25 male sprague-dawley rats,8 to 10 weeks old,body weight(300±30)g,ranging from 270 to 330 g.Rats were randomly divided into sham group(n=5),TBI group(n=10),TBI+negative control siRNA group(n=5),and TBI+MerTK siRNA group(n=5)by random number table method.In addition to sham operation group,other groups were subjected to controlled cortical impact to establish TBI models.MerTK expression was inhibited via siRNA injection.Quantitative real-time polymerase chain reaction(PCR)was used to measure mRNA levels of CD16(M1 marker)and CD206(M2 marker).Western blot was used to assess MerTK mRNA and protein expression.Immunofluorescence staining was uesd to quantify CD16 and CD206 cells.Modified neurological severity score(mNSS)was used to evaluate neurological function.Brain water content was measured.Results The levels of CD16 mRNA and CD206 mRNA,as well as the levels of MerTK mRNA and MerTK protein expression in the damaged cortex of the rats in the TBI group were higher than those in the sham-operated group at 12 h and 3 d,the differences were statistically significant(P<0.05).After 3 days of surgery,the MerTK protein level in the TBI+MerTK siRNA group was lower than that in the TBI+negative control siRNA group and the TBI group,the difference was statistically significant(P<0.05).The proportion of CD16-positive cells in the TBI+MerTK siRNA group was higher than that in the TBI group,and the proportion of CD206-positive cells was lower than that in the TBI group,the difference was statistically significant(P<0.05).After 3 days of surgery,The mNSS score of rats in TBI+MerTK siRNA group was higher than that of TBI group and TBI+negative control siRNA group,the difference was statistically significant(P<0.05).The degree of brain tissue oedema in TBI+MerTK siRNA group was higher than that of TBI group,the difference was statistically significant(P<0.05).Conclusion MerTK expression in brain tissue after TBI is up-regulated and regulates the M1/M2 balance in microglia,and inhibition of MerTK expression decreases M2 polarisation and increases pro-inflammatory M1-type polarisation,exacerbating cerebral oedema and neurological impairment.

Abstract:Objective To investigate the effect of comprehensive temperature protection on the incidence of adverse reactions in elderly patients undergoing arthroscopic rotator cuff repair for massive rotator cuff tears.Methods A total of 90 patients with massive rotator cuff tears who underwent arthroscopic rotator cuff repair at the General Hospital of Northern Theater Command from January 2016 to January 2022 were selected,including 38 males and 52 females,aged(69.11±2.92)years old,ranging from 65 to 75 years old.Based on perioperative temperature management,patients were divided into warming group and routine group.The routine group received standard intraoperative temperature control,while the warming group received comprehensive temperature protection.The two groups were compared regarding body temperature at different time points[baseline at general anesthesia induction(T0),30 minutes after surgery initiation(T1),60 minutes after surgery initiation(T2),90 minutes after surgery initiation(T3),120 minutes after surgery initiation(T4),and at the end of surgery(T5)],perioperative indicators[intraoperative fluid intake,duration of general anesthesia,perioperative blood loss,intraoperative saline usage,intraoperative urine output,time to general anesthesia recovery,extubation time,post-anesthesia care unit(PACU)stay duration],and adverse events(shivering,agitation,delirium).Results In the warming group,body temperature varied significantly across time points(P<0.05),with T0,T1 being lower than T3,T4,T5,the differences were statistically significant(P<0.05).In the routine group,body temperature also showed significant variation(P<0.05),with T0 and T1 higher than T2,T3,T4,T5,and T2 higher than T3,T4,T5,the differences were statistically significant(P<0.05).No significant difference was observed between the warming and routine groups at T0 and T1(P>0.05).However,the warming group had higher temperatures at T2,T3,T4,T5 compared to the routine group(P<0.05).No significant differences were found in intraoperative fluid intake,duration of general anesthesia,perioperative blood loss,intraoperative saline usage,or urine output between the two groups(P>0.05).The warming group had shorter general anesthesia recovery time,extubation time,and PACU stay duration,the differences were statistically significant(P<0.05).The incidence of shivering,agitation,and delirium was significantly lower in the warming group,the differences were statistically significant(P<0.05).Conclusion Comprehensive temperature protection can reduce the incidence of the incidence of adverse reactions in elderly patients undergoing arthroscopic rotator cuff repair for massive rotator cuff tears.

Abstract:Objective To compare the clinical efficacy of percutaneous minimally invasive fixation with titanium elastic intramedullary nails and open reduction and internal fixation with plates in the treatment of transverse or short oblique clavicle shaft fractures.Methods A total of 174 cases of transverse or short oblique clavicle shaft fractures admitted to Northern Theater Command General Hospital from January 2015 to December 2020 were retrospectively selected,including 110 males and 64 females,aged(46.0±20.4)years,ranging from 18 to 78 years old.According to the different internal fixation methods,the patients were divided into two groups,including 78 cases in the elastic nail group and 96 cases in the plate group.The perioperative status,fracture healing,and postoperative functional results of the two groups were compared.Results Although the patients in the elastic nail group had more intraoperative fluoroscopy times than those in the plate group,the surgical time and incision length were shorter than those in the plate group,and the amount of bleeding was lower than that in the plate group,with statistical significance(P<0.05).The fracture healing time of the elastic nail group was shorter than that of the plate group,and the VAS(visual analogue scale)score was lower than that of the plate group,with statistical significance(P<0.05).There was no statistically significant difference in Constant Murley scores between the two groups(P>0.05).There was also no statistically significant difference in the incidence of complications between the elastic nail group(3/78)and the plate group(4/96,P>0.05).Conclusion Elastic nail intramedullary fixation for clavicle shaft fractures had the advantages of minimal surgical trauma,fast postoperative bone healing,and mild pain.

Abstract:Objective To explore the effect of obucaine hydrochloride gel on sore throat after laryngeal mask ventilation.Methods A total of 60 patients who were admitted to Northern Theater Command Air Force Hospital from January 2023 to December 2023 and scheduled for laryngeal mask general anesthesia were selected as the research objects,with 33 males and 27 females,aged(38.33±9.61)years old,ranging from 26 to 52 years old.They were divided into groups A,B and C according to the random number table method,with 20 cases in each group.Group A was treated with obucaine hydrochloride gel applied to the back of the laryngeal mask ventilation mask.Group B was treated with the same volume of compound lidocaine cream.Group C was treated with paraffin oil.Record the degree of sore throat,pain relief time,incidence of adverse reactions,comfort level and treatment satisfaction of the patients in the three groups at different time points after the operation.Results The sore throat scores of patients in group A at each time point after surgery were significantly lower than those in Group B and group C,the pain relief time was significantly shorter than that in group B and group C,the incidence of postoperative adverse reactions was significantly lower than that in group B and group C,and the satisfaction were significantly higher than those in group B and group C.The differences were all statistically significant(P<0.05).Conclusion Obucaine hydrochloride gel can rapidly alleviate postoperative sore throat symptoms caused by laryngeal masks,shorten the pain relief time,and improve patient satisfaction.However,the occurrence of adverse reactions should be treated with caution.

Abstract:Objective To establish an animal model of acute kidney injury(AKI)by deep hypothermic circulatory arrest(DHCA)in rats.Methods A total of 18 adult male SPF-grade Sprague-Dawley rats were selected,aged(12.6±0.5)weeks old,(ranging from 12 to 13 weeks old),with a body weight of(376.9±13.6)g,ranging from 350 to 400 g.The rats were randomly divided into sham operation group(n=6),cardiopulmonary bypass(CPB)group(n=6),and CPB+DHCA group(n=6)by a random number table.The sham operation group underwent only anesthesia induction,tracheal intubation,and femoral artery/vein and internal jugular vein catheterization,and rectal temperature was maintained above 35℃.The CPB group underwent full-flow perfusion for 90 minutes while rectal temperature was maintained 35℃to 36℃.In the CPB+DHCA group,after initiating CPB,the rats'rectal temperature was lowered below 25℃to induce cardiac arrest.After 30 minutes of circulatory arrest,circulation was restored with gradual flow increase and slow rewarming to 35℃to 36℃,maintaining a total CPB duration of 90 minutes.Postoperatively,the rats surviving beyond 24 hours were euthanized,and arterial blood was collected aseptically via the abdominal aorta to measure creatinine and urea nitrogen levels.Bilateral renal tissues were harvested for sectioning.HE staining was used to observe the tissue morphology and Tunel staining was used to detect the apoptotic cells.Results All the rats in the sham operation and CPB groups survived for 24 hours postoperatively,while one rat in the CPB+DHCA group died within 24 hours.There was no statistically significant difference in the levels of creatinine and urea nitrogen between the sham operation group and the CPB group(P>0.05).The levels of creatinine and urea nitrogen in the CPB+DHCA group were higher than those in the sham operation group and the CPB group,and the differences were statistically significant(P<0.05).The apoptotic index of renal tubular epithelial cells in the CPB+DHCA group was higher than that in the sham operation group and the CPB group,and the difference was statistically significant(P<0.05).Conclusion A standardized 30-minute DHCA protocol successfully establishes a rat AKI model post-DHCA,providing blood and tissue samples for subsequent mechanistic and interventional studies.

Abstract:Objective To explore the stability of coronary atherosclerosis plaques guided by optical coherence tomography(OCT)through multivariate analysis.Methods A total of 189 patients with coronary atherosclerotic heart disease(CHD)admitted to our hospital from March 2023 to October 2024 were selected as study subjects,119 males and 70 females,aged(62.61±8.84)years,ranging from 47 to 81 years.They were divided into a stable group(107 cases)and an unstable group(82 cases)based on plaque stability.The baseline data,OCT parameters[eccentricity index(EI),remodeling index(RI),plaque fibrous cap thickness(CD),lipid core/plaque area],and plaque characteristics were compared between the two groups.Multivariate logistic regression analysis was conducted to identify factors influencing plaque stability.Based on the results of the multivariate analysis,a logistic regression model was constructed,and receiver operating characteristic(ROC)curve analysis was used to evaluate the efficacy of each variable and the combined assessment model in assessing plaque stability.Results Elevated C-reactive protein(CRP)(OR=1.583),elevated neutrophil-to-lymphocyte ratio(NLR)(OR=1.632),elevated cystatin C(OR=1.569),elevated EI(OR=1.512),elevated RI(OR=1.605),and elevated lipid core/plaque area(OR=1.652)were risk factors for unstable plaques,while the use of secondary prevention medications(OR=0.586)and decreased CD(OR=0.640)were protective were protective factors for unstable plaques(P<0.05).The area under the curve(AUC)for evaluating unstable plaques ranged from 0.729 to 0.778 for CRP,NLR,CysC,use of secondary prevention medications,EI,RI,CD,and lipid core/plaque area.The AUC value increased to 0.921(95%CI:0.873 to 0.955)when multiple variables were jointly evaluated.Conclusion OCT-guided multivariate analysis can accurately assess plaque stability,providing important evidence for clinical evaluation of plaque stability and guiding subsequent clinical work.

Abstract:Objective To preliminarily evaluate the efficacy of the Xijing JC-V portable extracorporeal membrane oxygenation(ECMO)system in managing blast-induced thoracic trauma in sheep under simulated transport conditions.Methods A total of 14 healthy adult male Small-tailed Han sheep were randomly allocated to either an ECMO group(n=7)or a conventional mechanical ventilation group(n=7).All animals underwent standardized blast injury modeling via a shock tube.Three simulated transport environmental factors were applied:continuous vibration,temperature variations,and confined space.The ECMO group received rapid deployment of the JC-V portable ECMO system with 24 hours of support,while the conventional group received mechanical ventilation only.Oxygenation index and mean arterial pressure(MAP)were measured pre-treatment and at 24 hours post-treatment.Activated clotting time(ACT)and plasma free hemoglobin were monitored during ECMO treatment.Additional hematological parameters(hemoglobin,white blood cell count,platelet count)were recorded in the ECMO group pre-and post-treatment.System deployment time,flow rate performance,and operational reliability were documented.Results The ECMO group demonstrated significantly superior oxygenation index[(354±26)mmHg vs(263±16)mmHg]and MAP[(66±3)mmHg vs(58±2)mmHg]compared to the conventional group(P<0.05).During ECMO treatment,ACT remained stable at 236±21 s with minimal hemolysis(plasma free hemoglobin:0.23±0.02 g/L).No significant differences were observed in hematological parameters pre-versus post-treatment in the ECMO group(P>0.05).The portable ECMO system was successfully deployed within(6.8±0.4)minutes,maintained stable flow rates(2.04 to 2.31 L/min).Conclusion The JC-V portable ECMO system demonstrates effective support and good safety for managing blast-injured sheep under simulated transport environments.

Abstract:Objective Explore the proliferative effect of platelet-rich plasma(PRP)from human umbilical cord blood at different concentrations on human umbilical cord-mesenc hymal stem cells(hUC-MSCs)and the optimal concentration for proliferation.Methods Umbilical cords of full-term healthy pregnant and lying-in women were collected.hUC-MSCs were isolated and cultured by the tissue block culture method.Collect umbilical cord blood.Isolate PRP by the two-step centrifugation method and activate it.The concentration of transforming growth factor-β1 in platelet-rich plasma is measured by enzyme-linked immunosorbent assay,which represents the PRP concentration.According to the PRP concentration,the samples are divided into 7 groups:0 pg/ml group,500 pg/ml group,1 000 pg/ml group,1 500 pg/ml group,2 000 pg/ml group,2 500 pg/ml group,and 3 000 pg/ml group.Inoculate hUC-MSCs,Measure the absorbance using thecell counting kit-8 kit every 24 hours.Statistically analyze the proliferative effect of PRP at different concentrations on hUC-MSCs and the optimal concentration for proliferation.Results On the 4th day of culture,the absorbance values in the 1 000 pg/ml and 1 500 pg/ml groups were higher than those in the 0 pg/ml group,the differences were statistically significant(P<0.05).The absorbance value in the 3 000 pg/ml group was lower than that in the 0 pg/ml group,the difference was statistically significant(P<0.05).On the 5th,6th,and 7th days,the absorbance values in the 500 pg/ml,1 000 pg/ml,1 500 pg/ml,and 2 000 pg/ml groups were all higher than those in the 0 pg/ml group.Among these,the 1500 pg/ml group exhibited the highest absorbance value,the differences were statistically significant(P<0.05).The absorbance values in the 2 500 pg/ml and 3 000 pg/ml groups were lower than those in the 0 pg/ml group,the differences were statistically significant(P<0.05).Conclusion PRP derived from source of human umbilical cord blood promotes the proliferation of hUC-MSCs,the optimal concentration to promote the proliferation of hUC-MSCs was 1 500 pg/ml.

Abstract:Objective To investigate the value of serum lactate dehydrogenase(LDH)and soluble triggering receptor expressed on myeloid cells-1(sTREM-1)in predicting postoperative pulmonary infection in patients with chronic subdural hematoma(CSDH).Methods A total of 200 patients who underwent CSDH drilling and drainage in Yuncheng Central Hospital were selected from May 2019 to May 2022.According to whether pulmonary infection occurred after the operation.There were 149 males and 51 females,aged 67.62±7.59 years,ranging from 60 to 75 years.They were divided into non-infection group(n=100)and infection group(n=100).The patients in the infection group were divided into mild group(n=42),moderate group(n=37)and severe group(n=21)according to the occurrence of pulmonary infection.General data such as gender,age,smoking history,drinking history,diabetes,hypertension,heart disease,and pulmonary disease were collected.Serum C-reactive protein(CRP),procalcitonin(PCT),white blood cell count,LDH,and sTREM-1 levels were measured.Multivariate Logistic regression analysis was used to analyze the risk factors of pulmonary infection after CSDH.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum LDH and sTREM-1 levels for pulmonary infection.Results Multivariate logistic regression analysis showed that serum LDH and sTREM-1 were independent risk factors for CSDH postoperative pulmonary infection(P<0.05).The levels of serum LDH and sTREM-1 in the moderate group and the severe group were higher than those in the mild group,and the severe group was higher than the moderate group,the difference was statistically significant(P<0.05).ROC curve showed that the area under the ROC curve of serum LDH,sTREM-1 and their combination in predicting pulmonary infection after CSDH operation was 0.786(95%CI:0.724 to 0.848),0.777(95%CI:0.714 to 0.840)and 0.909(95%CI:0.871 to 0.948),respectively.The sensitivity of LDH,sTREM-1 and their combination in predicting pulmonary infection after CSDH operation was 61.00%,76.00%and 77.00%,respectively,and the specificity was 86.00%,68.00%and 90.00%,respectively.The combined predictive value was better than that of LDH and sTREM-1 alone(P<0.05).Conclusion Serum LDH and sTREM-1 are independent risk factors for postoperative pulmonary infection in CSDH patients,which can be used as biomarkers to predict postoperative pulmonary infection in CSDH patients,and the combined prediction efficiency of serum LDH and sTREM-1 is higher.

Abstract:Objective To explore the value of Wells score and D-dimer combined with thromboelastography(TEG)in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicated with pulmonary embolism.Methods A total of 130 AECOPD patients admitted to the First Affiliated Hospital of Guangxi University of Science and Technology from January 2022 to June 2023 were selected,including 68 males and 62 females,aged(49.45±2.18)years old,with an age range of 20 to 78 years old.According to the results of CT pulmonary angiography,patients were divided into a pulmonary embolism group(n=35)and a non pulmonary embolism group(n=95).The Wells score,D-dimer levels,and TEG parameters[Coulation reaction time(R-time),time of clot formatior(K-time),Comprehensive coagulation index(CI value),maximum amplitude(MA ralue)]were compared between the pulmonary embolism group and the non pulmonary embolism group,and the predictive value of Wells score,D-dimer,TEG,and their combination for AECOPD complicated with pulmonary embolism were analyzed.Results Wells score and D-Dimer content in pulmonary embolism group were higher than those in non pulmonary embolism group;R-time in pulmonary embolism group was lower than that in non pulmonary embolism group;K-time,CI value,MA value in pulmonary embolism group were higher than those in non pulmonary embolism group,the differences were statistically significant(P<0.05).The Well score,D-dimer,TEG and the combination of three tests predicting AECOPD with pulmonary embolism by receiver operator characteristic curve showed that the predictive value of Wells score,D-dimer combined with TEG was higher(P<0.05).Conclusion Wells score,D-dimer combined with TEG in patients with AECOPD complicated with pulmonary embolis can improve the predictive value.

Abstract:Objective To explore the Analysis of drinking patterns and risk factors for ascites in patients with alcoholic cirrhosis.Methods A total of 115 male patients with alcoholic cirrhosis,aged(57.56±8.71)years old,ranging from 34 to 77 years old,were selected from the General Hospital of Northern Theater Command between May 2023 and October 2024.Using questionnaires and medical record reviews,the presence of ascites upon admission was recorded.Drinking patterns and clinical data were compared between patients with and without ascites,and logistic regression analysis was performed to identify relevant risk factors affecting the occurrence of ascites in patients with alcoholic cirrhosis.Results Multivariate logistic regression analysis showed that drinking tea after alcohol consumption was independently associated with a reduced risk of ascites in patients with alcoholic cirrhosis,as was living in urban areas(P<0.05).Conclusion Drinking tea after consuming alcohol is independently associated with a reduced risk of ascites in patients with alcoholic cirrhosis.Additionally,residing in urban areas is also independently associated with a reduced risk of ascites in these patients.

Abstract:Objective To investigate the application of 915 MHz microwave therapy combined with neuromuscular control training in the treatment of ankle training injury.Methods Collect 108 undergraduate indoor patients with ankle joint injuries caused by training from the General Hostipal of Northem Theater Command between October 2020 and October 2023.There were 101 males and 7 females,age(24.66±3.69)years old,ranging from 18 to 50 years old.Using the random number method,all patients were randomly assigned to the experimental group and the control group,with 54 people in each group.Two groups were given a routine training injury treatment plan,with routine rehabilitation training after the acute phase.The control group received daily neuromuscular control training in addition to basic rehabilitation training,while the experimental group received 915 MHz microwave therapy after the acute phase on top of the control groupCompare the clinical outcomes,pain levels,ankle proprioception,ankle stability,serum inflammatory factors,and adverse reactions between two groups.Results The VAS scores for the experimental group were lower than those of the control group;both the active and passive reduction error angles were lower than those of the control group;the CAIT scores were higher than those of the control group;the levels of sICAM-1,SVCAM-1,and TNF-α were all lower than those of the control group,the difference was statistically significant(P<0.05).Comparison of the incidence of adverse reactions between the two groups,there was no statistically significant difference(P>0.05).Conclusion Combining 915 MHz microwave treatment and neuromuscular control training can significantly improve the analgesic effect of ankle training injuries,and enhance the dynamic stability of ankle joint.The mechanism of combined intervention is closely related to the inhibition of inflammatory response,which is suitable for clinical application.

Abstract:Objective To explore the feasibility of using ultrasound monitoring of the lower uterine segment during labor in trial of labor after cesarean(TOLAC).Methods A total of 164 multiparous women who met the criteria for TOLAC and requested TOLAC were selected from the General Hospital of Northern Theater Command from July 2021 to December 2023 as the TOLAC group,aged(33.04±4.56)years old,ranging from 23 to 42 years old.Another 164 primiparous women who underwent vaginal trial of labor during the same period were selected as the control group,aged(32.70±4.38)years old,ranging from 23 to 42 years old.Both groups underwent high-frequency ultrasound measurement of the lower uterine segment muscle thickness during labor.The delivery outcomes and maternal and neonatal outcomes were compared between the two groups.The thickness of the lower uterine segment muscle during and between contractions was measured and compared in the successful delivery cases of both groups.The thickness of the lower uterine segment muscle during contractions in different stages of labor was also compared between the successful delivery cases of both groups.Results There were no statistically significant differences between the TOLAC group and the control group in terms of postpartum blood loss,postpartum hemorrhage rate,neonatal weight,neonatal Apgar score,and neonatal admission to the intensive care unit(P＞0.05).The TOLAC group had a lower rate of successful vaginal delivery and shorter gestational weeks compared with the control group(P＜0.05).In both groups,the thickness of the lower uterine segment muscle during contractions was significantly less than that between contractions in successful delivery cases(P＜0.05).There was no statistically significant difference in the change of lower uterine segment muscle thickness during and between contractions between the successful delivery cases of the TOLAC group and the control group(P＞0.05).In the TOLAC group,the thickness of the lower uterine segment muscle was significantly different during the latent phase,active phase,and second stage of labor in successful delivery cases(P＜0.05).Similarly,in the control group,the thickness of the lower uterine segment muscle was significantly different during the latent phase,active phase,and second stage of labor in successful delivery cases(P＜0.05).The thickness of the lower uterine segment muscle during the latent phase,active phase,and second stage of labor was significantly lower in the successful delivery cases of the TOLAC group compared with the control group(P＜0.05).Conclusion High-frequency transabdominal ultrasound can be used to dynamically monitor the lower uterine segment during TOLAC and can help identify women with poor uterine scar healing in advance.

Abstract:Objective To explore the analysis of clinical outcomes of critically ill pregnant women and their perinatal infants.Methods A total of 573 critically ill pregnant women admitted to the General Hospital of the Northern Theater Command from January 2019 to December 2023 were selected.Aged(29.10±5.60)years old,ranging from 14 to 44 years old.The clinical outcomes of critically ill pregnant women and their perinatal infants were statistically analyzed,and the disease data of pregnant women were collected.Logistic regression analysis was used to explore the impact of the disease conditions of pregnant women on the clinical outcomes of critically ill pregnant women and their perinatal infants.Results There were 573 critically ill pregnant women,556 survived and 17 died.There were 416 live births and 157 stillbirths among the perinatal infants.The proportion of pregnant women with gestational hypertension among the survivors was higher than that among the deceased,and the proportions of aortic dissection and amniotic fluid embolism were lower than those among the deceased.The differences were statistically significant(P＜0.05).Logistic regression analysis showed that the presence of amniotic fluid embolism was an independent risk factor for the death of critically ill pregnant women.The risk of death for critically ill pregnant women with gestational hypertension is lower than that of pregnant women without gestational hypertension.(P＜0.05).The proportion of perinatal infants with congenital heart disease and placental abruption among the survivors was lower than that among the deceased,and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that placental abruption and congenital heart disease were independent risk factors for the death of perinatal infants(P＜0.05).Conclusion The presence of amniotic fluid embolism is an independent risk factor for the death of critically ill pregnant women.The risk of death for critically ill pregnant women with gestational hypertension is lower than that of pregnant women without gestational hypertension.and placental abruption and congenital heart disease are independent risk factors for the death of perinatal infants.

Abstract:Objective To investigate the clinical efficacy of high tibial osteotomy(HTO)combined with arthroscopic debridement of the knee joint in the treatment of varus knee osteoarthritis.Methods A total of 115 patients with varus knee osteoarthritis admitted to the Second Hospital of Tangshan from January 2022 to June 2023,including 51 males and 64 females,aged(56.57±5.92)years old and ranging from 45 to 65 years old.Based on the surgical approach,patients were divided into the HTO group(n=65)and HTO combined with arthroscopic group(n=50).The HTO group was treated with HTO,and the HTO combined with arthroscopic group was treated with HTO combined with arthroscopic debridement of the knee joint.The perioperative indicators were recorded and compared between the two groups,including surgical duration,intraoperative blood loss,length of hospital stay,time to weight-bearing ambulation and healing time of the osteotomy site.The Hospital for Special Surgery(HSS)score,Lysholm score,visual analogue scale(VAS)score,medial proximal tibial angle(MPTA),and femoral-tibial angle(FTA)before the operation,6 months after the operation and 12 months after the operation were recorded and compared between the two groups.The occurrence of complications in the two groups were observed.Results There were no statistically significant differences in perioperative indicators between the two groups(P＞0.05).Before the surgery,there were no statistically significant differences between the two groups in HSS score,Lysholm score,VAS score(P＞0.05).At 6 and 12 months after the operation,HSS score,Lysholm score,VAS score of the two groups were higher than those before the operation,moreover,the HSS score and Lysholm score in the HTO combined with arthroscopy group were higher than those in the HTO group,and the differences were statistically significant(P＜0.05).At 6 and 12 months after the operation,the pain VAS score of the two groups were lower than that before the operation,and the VAS score of the HTO combined with arthroscopy group was lower than that in the HTO group,and the differences were statistically significant(P＜0.05).Before the operation,6 months after the operation and 12 months after the operation,there were no statistically significant differences in MPTA and FTA between the two groups(P＞0.05).At 6 months and 12 months after the operation,the MPTA of the two groups was higher than that before the operation,and the FTA of the two groups was lower than that before the operation,and the differences were statistically significant(P＜0.05).No obvious complications occurred in the two groups.Conclusion Compared with HTO alone,HTO combined with arthroscopic debridement of the knee joint can significantly improve knee function,reduce knee pain,and achieve similar correction of lower limb alignment in patients with varus knee osteoarthritis.

Abstract:Objective To explore the influence of the size and quality of uterine fibroids on the outcome of cesarean myomectomy(CM).Methods A total of 387 patients with uterine fibroids who underwent cesarean section were selected from the Northern Theater Command General Hospital between January 2012 and December 2022,aged(32.5±3.6)years old,ranging from 29 to 36 years old.Patients were divided into two groups based on their surgical methods:the CM group(n=162)and the cesarean section group(n=225).The CM group underwent combined cesarean section and myomectomy,while the cesarean section group underwent only a cesarean section.Clinical data,fibroid conditions,and surgical outcomes were compared between the CM group and the cesarean section group.The study also compared patients with the longest fibroid diameter reaching 5 cm(small myoma group),5 cm but not 10 cm(medium myoma group),or reached 10 cm(large myoma group),as well as those with fibroid masses less than 250 g(low quality group),250 g but not 500 g(medium quality group),or reached 500 g(high quality group),focusing on the surgical outcomes of the CM group.Results The proportion of nulliparous women,those with a history of abdominal surgery,and those with multiple fibroids in the CM group was higher than that in the cesarean section group.The longest diameter of fibroids in the CM group was also greater than that in the cesarean section group,with statistically significant differences(P＜0.05).There were no statistically significant differences in the incidence of pregnancy complications or postoperative complications between patients in the CM group and the cesarean section group(P＞0.05).Patients in the CM group had longer surgical times,estimated intraoperative blood loss,hospital stays,and transfusion rates compared to those in the cesarean section group,with statistically significant differences(P＜0.05).Comparing patients with small myoma group,medium myoma group,and large myoma group,there were statistically significant differences in the quality of removed fibroids,postoperative hemoglobin levels,surgical time,estimated intraoperative blood loss,hospital stay,transfusion status,and postoperative complication rates(P＜0.05).Comparing patients with low quality group,medium quality group,and high quality group,there were statistically significant differences in postoperative hemoglobin levels,estimated intraoperative blood loss,hospital stay,transfusion status,and postoperative complication rates(P＜0.05).Conclusion Cesarean section and myomectomy are safe and effective without increasing postoperative risk.

Abstract:Objective To investigate the prognostic value of the neutrophil-to-lymphocyte ratio(NLR)in patients with ruptured ectopic pregnancy.Methods A total of 143 ectopic pregnancy patients admitted to the The First Hospital of China Medical University from June 2019 to June 2023 were selected,aged(30.32±5.02)years old,ranging from 18 to 45 years old.The rupture group(n=63)and non-rupture group(n=80)were divided according to whether the rupture occurred.Blood routine examination results were collected upon admission,and NLR values were calculated to analyze their relationship with rupture occurrence and prognosis.Perform logistic regression analysis to determine whether NLR is a predictor,and draw an receiver operator characteristic(ROC)curve to evaluate its predictive performance.Results Logistic regression identified NLR as a risk factor for rupture.ROC curve analysis showed that NLR could be used as a predictor of ectopic pregnancy rupture.Conclusion The elevation of NLR is closely related to the rupture of ectopic pregnancy and can be used as a predictive indicator.

Abstract:Objective To investigate the distribution of bone contusions in the knee joint after acute anterior cruciate ligament(ACL)rupture following non-contact sports injuries.Methods A total of 186 patients who underwent ligament reconstruction surgery for complete anterior cruciate ligament rupture were selected from the General Hospital of the Northern Theater Command from January 2023 to May 2024,After excluding the criteria,101 patients remained.There were 100 males and 1 female,aged(25.96±4.61)years old,ranging from 18 to 37 years old.The presence of bone contusions in the lateral tibial plateau(LTP),medial tibial plateau(MTP),lateral femoral condyle(LFC),and medial femoral condyle(MFC)was recorded separately.Bone contusions in LTP,LFC or both were defined as lateral bone contusions,and bone contusions in MTP,MFC or both were defined as medial bone contusions,and the relationship between the location and severity of bone contusions was compared.Results Among the 101 cases,had one contusion were 9 cases(LTP were 5 cases,MFC were 2 cases,LFC was 1 cases,and MTP was 1 case),had two contusions were 42 cases(LTP+LFC were 33 cases,LTP+MTP were 7 cases,and LFC+MTP were 2 cases),had three contusions were 34 cases(LTP+LFC+MTP were 25 cases,LTP+LFC+MFC were 6 cases,and LTP+MFC+MTP were 3 cases),and had four contusions were 16 cases(LTP+LFC+MTP+MFC were 16 cases).The proportion of lateral bone contusions[97.0％(98/101)]was higher than that of medial bone contusions[61.4％(62/101)],the difference was statistically significant(P＜0.05).The severity of bone injuries on the inner and outer sides of the knee joint also showed a statistically significant difference(P＜0.05).Conclusion Lateral bone contusions are more common and more severe than medial in patients with non-contact anterior cruciate ligament rupture.

Abstract:Objective To investigate the effects of mechanical cervical ripening on pregnancy outcomes in pregnant women with Group B Streptococcus(GBS)infection.Methods A total of 80 Full-term pregnancy with GBS,full term pregnant women who had a positive GBS test and vaginal delivery after induction of labor were collected in the Northern Theater General Hospital from January 2020 and December 2022.Aged(29.96±3.73)years old,ranging from 23 to 37 years old.Among them,40 pregnant women who successfully induced labor with a disposable cervical dilatation balloon were the balloon group,and oxytocin was used as the oxytocin group for a total of 40 cases.Comparison of the laboratory infection indicators(white blood cell count,C-reactive protein,and procalcitonin),cervical ripeness,delivery time,and the incidence of complications between the two groups of puerpera.Comparison of the newborns and neonatal laboratory infection indicators(white blood cell count,Creactive protein,procalcitonin,and GBS positive in blood culture)after induction of labor between the two groups of puerpera.Results The C-reactive protein level in the balloon group was higher than that in the oxytocin group,the difference was statistically significant(P＜0.05).The cervical ripening status in the balloon group was better than that in the oxytocin group,the difference was statistically significant(P＜0.05).The causes labor time and first stage of labor duration in the balloon group was shorter than that in the oxytocin group,the difference was statistically significant(P＜0.05).The postpartum hemorrhage rate in the balloon group was lower than that in the oxytocin group,the difference was statistically significant(P＜0.05).The rates of meconium-stained amniotic fluid,fetal distress,fever during labor,postpartum hemorrhage,and puerperal disease in the balloon group were lower than those in the oxytocin group,with no statistically significant difference(P＞0.05).The rates of neonatal pneumonia,jaundice,sepsis,and Apgar score at 1 minute after birth in the balloon group were also lower than those in the oxytocin group,the difference was not statistically significant(P＞0.05).The comparison of white blood cell counts,C-reactive protein,procalcitonin,and positive blood culture for GBS in the newborns of women who underwent full-term induction with oxytocin and balloon showed no statistically significant difference(P＞0.05).Conclusion The use of disposable cervical dilatation balloon to mechanically promote cervical ripening did not lead to adverse outcomes for pregnant women and newborns.It can improve the effectiveness of induction of labor at term without increasing the probability of infection.

Abstract:Objective To explore the current situation of kineshobia and its influencing factors in patients after total knee arthroplasty.Methods A total of 354 patients who underwent total knee arthroplasty and were admitted to the First Affiliated Hospital of China Medical University from December 2020 to December 2023 were selected,including 68 males and 286 females,with an age of(65.78±7.49)years old,ranging from 55 to 75 years old.Binary logistic regression was used to analyze the influencing factors of kinesophobia in patients.According to the scores of the tampa scale for kinesiophobia(TSK),they were divided into the non-kinesia group(n=265,TSK≤37 points)and the kinesia group(n=89,TSK＞37 points).Results 89 patients suffered from kineshobia after the operation.The results of binary logistic regression analysis showed that high monthly household income,high hospital for special surgery scale score,and high activities of daily living scale score are independent protective factors,while high numeric rating scale score and high self-rating anxiety scale score are independent risk factors.Conclusion The incidence of kinesiophobia in patients after total knee arthroplasty in this study is high.The occurrence of kinesiophobia is mainly affected by family monthly income level,pain degree,knee joint function,daily life self-care ability and anxiety.