Abstract:

[Objective] To explore the occurrence characteristics and risk factors of bone stress injuries (BSI) in recruits of an army

training base. [Methods] The recruits were randomly selected from a training base of the army from 2021 to 2023. The data were collected

through questionnaire survey and inspection, and their epidemiological characteristics were summarized and analyzed. [Results] A total of

11 627 valid questionnaires were collected, among which 1 626 recruits were diagnosed with BSI (14.0%), including 1 010 cases of tibia in-

jury, accounted for 62.1%. As results of univariate comparison, the injured group proved significantly higher than the uninjured group in

terms of the proportion of female [n, male/female, (1 583/43) vs (9 981/190), P=0.047], age [(21.3±2.4) y vs (21.1±2.0) y, P=0.002], BMI

[(22.6±2.5) kg/m² vs (22.4±2.3) kg/m², P=0.004], smoking [n, yes/no, (679/947) vs (3 625/6 379), P<0.001], PSQI score [(4.6±2.8) vs (2.3±

2.3), P<0.001] and previous sports injury before joining the army [n, yes/no, (173/1453) vs (618/9383), P<0.001], while the former was infe-

rior to the latter in terms of diet [n, good/fair/poor, (5 048/4 033/920) vs (533/829/264), P<0.001], sleep [n, excellent/good/fair/poor, (6 063/

2 782/1 026/130) vs (724/575/271/56), P<0.001], exercise habits [n, never/occasionally/often, (673/2 611/6 717) vs (259/577/790), P<0.001], foot arch [n, normal/abnormal, (8 938/1 063) vs (1 394/232), P<0.001], ligament relaxation score [n, <3/≥3, (8 397/1 604) vs (1 320/

306), P=0.005], scores of 3 000 m running [n, excellent/good/fair, (1 140/4 756/4 105) vs (127/576/923), P<0.001] and sit-ups [n, excellent/

good/fair/poor, (2 473/3 604/3 479/445) vs (320/522/644/140), P<0.001]. Regarding binary multivariate logistic regression analysis, male

(OR=0.630, P<0.05), good diet (OR=0.786, P<0.05), non-injury before enlistment (OR=0.747, P<0.05) were the protective factor of BSI oc-

currence, whereas higher PSQI score (OR=1.335, P<0.05), less exercise before joining the army (OR=1.440, P<0.05), abnormal foot arch

(OR=1.176, P<0.05) and poor performance at 3 000 m running (OR=1.460, P<0.05) were the independent risk factor for the injury. [Conclusion] The incidence of bone stress injury was 14.0%, with highest involved site of the tibia . Gender, diet quality, exercise injury before

military service, exercise habits before military service, PSQI score, foot arch shape and 3 000 m running performance could be used as risk

assessment indicators of bone stress injury.

Abstract:[Objective] To explore the effect of functional training prescription on preventing military training injury in army recruits.[Methods] A total of 59 army recruits were included in the study, and randomly divided into two groups, including 24 men in the trial groupand 35 men in the control group. The trial group added 6-week functional training prescription in the routine training, while the controlgroup implemented the routine training program. The functional assessment tests and blood biochemical tests were performed before and af-ter the trial, and the differences between and within the groups were compared. [Results] A total of 8 soldiers were injured during the trial,including 1 in the trial group and 7 in the control group. After intervention, the proportion of functional movement screen (FMS) score ≤14in the trial group was significantly reduced from 82.6% to 8.7%, and the difference was significant compared with the control group (P＜0.001). After intervention, many functional indexes were improved in both groups, among which the improvement of FMS, left and right Ybalancetest (YBT) and landing buffer was statistically significant (P＜0.05). After intervention, all indexes of the trial group were better thanthose of the control group. Of them, the FMS score [(17.3±1.8) vs (3.6±1.9), P＜0.001] and YBT score on the right side [(107.8±7.8) vs(103.5±8.0), P=0.048] proved significantly better in the trail group than those in the control group. In terms of blood tests, there were no sig-nificant changes in hemoglobin (HB) in both groups after intervention, while hematocrit (HCT) decreased slightly, which in control groupwere statistically significant (P＜0.05). The changes of serum urea (BU), creatine kinase (CK), serum cortisol (SC) and blood testosterone(BT) in the trial groups were statistically significant (P＜0.05), while BT change was no significant difference in the control group. However,BT/SC decreased in both groups, which was statistically significant in control group (P＜0.05). [Conclusion] Local fatigue of lower limbs is the main cause of military training injuries in army recruits. Functional training prescriptions based on lower limb fascia release and func-tional strength training do effectively reduce the risk of training injury.

Abstract:

Abstract:[Objective] To investigate the risk factors of anterior cruciate ligament injury (ACLI) caused by vault training and the effectof postoperative rehabilitation training. [Methods] A retrospective study was done on the patients who underwent arthroscopic ACL recon-struction for ACLI due to vault training in The 940th Hospital, Joint Logistics Support Force of PLA from October 1, 2019 to October 31,2022. The data regarding their general information, injury status, follow-up and re-training data were compared. [Results] A total of 356patients with knee joint injury caused by vault training were included into this study, including 117 patients with knee joint injury causedby vault training I, 158 patients with knee joint injury caused by vault training II and 81 patients with knee joint injury caused by vaulttraining III. The VAS score, Lysholm score and ROM were significantly improved in the patients after operation compared with those preop-eratively (P＜0.05). However, there were no significant differences in the main evaluation parameters, including different age, different mili-tary ranks, different time periods after injury and different injury subjects (P＞0.05). During the follow-up, 99 (27.8%) of the 356 patientsreached the standard of re-training, and it took an average of 16 months to recover to the state of re-training. [Conclusion] Vault training is an important cause of ACLI. Although the patients are well recovered in clinic state, the recovery period after injury is long and the re-train-ing rate is low.

Abstract:[Objective] To compare the clinical effect of non-fluoroscopy (NFS) arthroscopic acetabuloplasty versus conventional fluoroscopy (FS) counterpart for treatment of pincer femoroacetabular impingement (P-FAI). [Methods] A retrospective analysis was performedon 70 patients who were underwent hip arthroscopy for P-FAI in Department of Orthopedics, PLA General Hospital from October 2021 toFebruary 2023. According to the preoperative doctorpatient communication, 35 patients underwent a line-like acetabuloplasty under NFSarthroscopy, while other 35 patients underwent conventional FS arthroscopic acetabuloplasty. The documents regarding to perioperative period, follow-up and images were compared between the two groups. [Results] All patients in both groups had the arthroscopic procedure performed successfully without serious complications, such as injury of important blood vessels and nerves. The NFS group proved significantlysuperior to the FS group in terms of operative time [(110.1±14.8) min vs (128.5±22.5) min, P＜0.001] and intraoperative fluoroscopy times[(0.9±0.9) times vs (2.9±1.4) times, P＜0.001], although there were no significant differences in intraoperative blood loss, incision healing andhospital stay between the two groups (P＞0.05). All patients in both groups were followed up for more than 12 months, with an average of(26.4±5.5) months. At the last follow-up, VAS scores significantly decreased (P＜0.05), while mHHS and iHOT scores significantly increasedin both groups (P＜0.05). There were no statistically significant differences in VAS, mHHS and iHOT scores between the two groups beforesurgery (P＞0.05). At the last followup, the NFS group was greater than the FS group in terms of VAS and mHHS scores, and the former wasless than the latter in IHOT-12 scores, whereas all of the differences in abovementioned parameters proved not statistically significant between the two groups (P＞0.05). In terms of imaging, the lateral center-edge angle (LCEA) and acetabular index (AI) in both groups significantly improved at the last follow-up compared with those before surgery (P＜0.05), whereas which were not significantly different betweenthe two groups at any time points accordingly (P＞0.05). [Conclusion] Both non-fluoroscopy and conventional fluoroscopy arthroscopic acetabuloplasty do achieve good clinical results, with no significant differences between the two methods, but the former does save operationtime and reduce the impact of radiation on health.

Abstract:[Objective] To compare the clinical outcomes of posterior cruciate ligament (PCL) reconstruction by all-inside and conven-tional arthroscopic techniques. [Methods] A retrospective study was performed on 74 patients who underwent arthroscopic PCL reconstruc-tion from July 2016 to July 2021. According to doctor-patient discussion, 31 patients received all-inside PCL reconstruction with autoge-nous semitendinosus tendon graft (the all-inside group), while the other 43 patients underwent conventional arthroscopic PCL reconstruc-tion with allogeneic tendon graft (the routine group). The perioperative, follow-up and imaging data of the two groups were compared. [Results] The all-inside group proved significantly superior to the routine group in terms of total incision length [(7.1±1.3) cm vs (10.3±2.4)cm, P＜0.001], the walking time [(3.4±2.1) days vs (5.6±3.2) days, P＜0.001], early complication rate (3.2% vs 9.3%, P=0.043) and hospitalstay [(7.4±1.8) days vs (10.3±3.6) days, P＜0.001]. In addition, the all-inside group resumed full weight-bearing activities significantly earli-er than the routine group [(93.6±11.7) days vs (128.4±12.4) days, P＜0.001]. The VAS score, Lysholm score, IKDC grade, knee flexion-ex-tension ROM, posterior drawer test and backward Lachman test significantly improved in both groups over time (P＜0.05). The all-insidegroup was significantly better than the routine group in terms of knees ROM [(124.4±3.6)° vs (116.5±3.2)°, P＜0.001; (138.7±3.6)° vs(132.6±5.8)°, P＜0.001], Lysholm score [(124.4±3.6) vs (116.5±3.2), P＜0.001; (138.7±3.6) vs (132.6±5.8), P＜0.001] and IKDC grades 3months postoperatively and at the latest follow-up. Regarding imaging, the all-inside group was also significantly better than the routinegroup in femoral tunnel variation [case, reduced/no change/enlargement, (23/8/0) vs (13/27/3), P＜0.001]. [Conclusion] The all-inside ar-throscopic PCL reconstruction is superior in term of clinical consequence to the conventional arthroscopic PCL reconstruction for this liga-ment rupture.

Abstract:[Objective] To analyze and discuss the teaching situation of arthroscopic surgery, and to provide basis for improving theteaching outcomes. [Methods] From August 2021 to August 2023, a total of 79 progressive students who had studied arthroscopy in ourCenter's Orthopedics Department were enrolled into this study. Using questionnaire survey, theory test and practical test to collect data,stratified univariate comparison and multi-factor logistic regression analysis were conducted to search the influencing factors of teaching ef-fect. [Results] There were 77 males and 2 females in this survey. Of them, 52 (65.8%) were satisfied with the clinical teaching of arthrosco-py, while 27 (34.2%) were dissatisfied. In term of univariate comparison, the satisfied group was significantly higher than the dissatisfiedgroup regarding to the number of clinically managed beds, the number of operations, the number of practical exercises, the performance ofpractical exercise assessment and the self-satisfaction score, which all proved statistically significant (P＜0.05). As results of multi-factor lo-gistic regression analysis, the actual performance (OR=92.734, 95%CI 2.489~3 455.071, P=0.014), self-satisfaction (OR=27.195, 95%CI1.193~618.352, P=0.038) and the number of practical exercises (OR=15.789, 95%CI 1.672~149.055, P=0.016) were positive influencingfactors of teaching satisfaction. [Conclusion] Appropriately increasing the number of practical exercises to improve the performance of prac-tical exercises and stimulate students' interest in learning and gain satisfaction may be helpful to improve the overall effect of clinical teach-ing of arthroscopy.

Abstract:Prevention and treatment of military training injuries has always been the focus of attention in the field of military medicine.In order to improve the research level of military training injury prevention and treatment in China, the author selected the research institu-tions of military training injury prevention and treatment in foreign armies with Pubmed database as the main literature search source, andfound that the research institutions of military training injury prevention and treatment in foreign armies were mainly distributed in Ameri-ca, Europe and Australia, and concentrated in the United States. Since the establishment of the Defense Safety Oversight Council (DSOC) in2003, the military training injury research institutions of various military services and local colleges and universities in the United Stateshave gradually increased, mainly concentrated in the medical centers of various military services and military research institutes (centers)of local colleges and universities, and the research results mainly focused on the physical fitness assessment of soldiers, mental health sta-tus before and after training, and physical fatigue monitoring during training. Through combing and integrating the results of foreign militarytraining injury research institutions, it can provide reference for our military training injury prevention and control research in terms of in-creasing investment and support for military training injury research, strengthening military-civilian linkage and interdisciplinary integra-tion research, and accelerating the construction of prevention and control system.

Abstract:Modern military and sports training generally puts higher demands on soldiers and athletes, but it also increases the risk ofbone stress injuries (BSI) and female athlete triad (FAT). BSI is a common injury in sports and military training, with a risk factor related tolow energy availability. The female athlete triad is a comprehensive syndrome with low energy availability as the core and involving nutri-tion, reproductive and skeletal systems. This review aims to explore the relationship between BSI and FAT in depth, with the issue of energyavailability during exercise throughout this study. By elaborating on the correlation between the pathogenesis and energy availability of FATand BSI, this review aims to enhance the understanding of these two diseases and promote better prevention and rehabilitation strategies toensure the bone health of female athletes and soldiers.

Abstract:Due to the high intensity of military training, the complexity of training courses and the relatively high risk of injury, mili-tary training injuries have been in a state of high incidence for a long time, and have become an important cause of non-combat injuries,which have a huge impact on soldiers' daily life. In order to explore the impact of risk factors and preventive recommendations on the pre-vention and treatment of military training injuries, 13 major risk factors including gender, age, BMI, smoking, nutrition, balance, flexibility,psychology, strength, overtraining, sleep, drugs, and joint motion were screened out according to previous research results, and the currentresearch status of risk factors and preventive recommendations for military training injuries was sorted out. This paper systematically ex-pounds the implementation of corresponding preventive measures in military training, which can significantly reduce the risk of injury inmilitary training, improve the safety and effect of training, and provide reference for the future research on the prevention and treatment ofmilitary training injuries.

Abstract:Anterior cruciate ligament (ACL) tear is more common in people who exercise, especially in young people. Due to thechange of intraarticular environment and joint mechanics, the rupture of this ligament can lead to symptoms such as knee pain, instabilityand mobility dysfunction, which will bring long-term negative effects to patients. It is worth noting that many studies have shown that ACLrupture can cause synovial inflammation, chondrocyte injury and cartilage matrix degradation, and finally lead to posttraumatic osteoarthri-tis (PTOA). The causes of these changes in the articular cavity may be closely related to the changes in the articular cavity environment af-ter ACL tear. Therefore, based on the changes in the intraarticular environment after ACL rupture, this paper mainly analyzes the influenceof the changes in the intraarticular environment before and after surgery on the prognosis of patients, and provides a reliable scientific basisfor the predicating PTOA after ACL rupture.

Abstract:[Objective] To observe and detect the osteogenic capacity of allogenic cortical bone anchors implanted into the humeralhead in mice. [Methods] A total of 54 C57BL6/J mice were randomly divided into two groups, 27 mice were used for preparing allogenic cor-tical bone anchors, while another 27 mice were used as receptors for allograft cortical bone anchors. Three animals were sacrificed for tissueobservation and immunohistochemical detection at 1 week, 2 weeks, 4 weeks, 6 weeks, 8 weeks and 10 weeks after implantation, additional-ly, for Mcro-CT at 1, 4 and 10 weeks respectively. [Results] In term of histological observation, trabecular bone gradually increased aroundallogenic cortical bone anchors after implantation, while the allogenic cortical bone anchor was gradually absorbed, with new bone growinginto the interior of allogenic cortical bone anchors. Micro-CT showed that the trabecular volume increased significantly with the time of 1, 4and 10 weeks [(0.20±0.37) mm3, (0.27±0.35) mm3, (0.34±0.38) mm3, P=0.001]. Immunohistochemical assays showed that with time of 1, 2, 4,6, 8 and 10 weeks after implantation, osteocalcin (OCN) [(0.48±0.05), (0.65±0.05), (0.64±0.06), (0.68±0.11), (0.73±.03), (0.72±0.03), P=0.004], TGF-β1 [(0.49±0.02), (0.58±0.02), (0.64±0.02), (0.67±0.01), (0.72±0.01), (1.07±0.07), P＜0.001], andc-Jun N-terminal kinase(1JNK1) [(0.51±0.02), (0.63±0.01), (0.65±0.01), (0.68±0.07), (0.71±0.10), (0.83±0.19), P=0.022] significantly increased in term of opticaldensity (OD) values. [Conclusion]The biological properties of mouse allogenic cortical bone anchors can be verified by implantation into hu-merus head, and the osteogenic capacity of the allogenic cortical bone anchors in host bone is proved to be good.

Abstract:[Objective] To utilize bioinformatics methods to screen for differentially expressed genes (DEGs) associated with ankylosingspondylitis (AS) in the Gene Expression Omnibus database (GEO), aiming to provide new biological targeting strategies for the clinical diag-nosis and treatment of AS. [Methods] Datasets GSE41038 and GSE39340 were downloaded from the GEO database. After data processing,DEGs related to AS were selected. Functional enrichment and pathway analyses were then performed on these DEGs. Subsequently, the pro-tein-protein interaction (PPI) network of the identified genes was constructed using the online database (Search Tool for Retrieval of Interact-ing Genes, STRING) and visualized using Cytoscape software. [Results] A total of 433 DEGs were identified between AS patients andhealthy individuals, with 276 upregulated and 157 downregulated. GO analysis revealed that these DEGs were mainly involved in positiveregulation of T cell activation and collagen-containing extracellular matrix. KEGG enrichment results were primarily associated with NFkappaB signaling pathway and TNF signaling pathway. Using the STRING database, a protein interaction network was constructed, with Cy-toscape identified the top 10 genes with the highest connectivity, including CASP3, CD36, CXCR4, EGFR, FGF10, IL-1β, MMP1, MMP3,SELL and TLR2. [Conclusion] In this study, the potential mechanism of AS was analyzed by bioinformatics method, and 10 important mole-cules were screened, which may be the potential key genes and biological markers of AS.

Abstract:[Objective] To present the surgical technique and preliminary clinical outcomes of double shallow patellar tunnels and su-ture loops fixation for medial patellofemoral ligament reconstruction. [Methods] From January 2021 to January 2022, 30 patients with patel-lar dislocation were treated with abovementioned MPFL reconstruction. After location on the medial edge of the patella, two guide pins withtail holes were transversely drilled into the opposite side. Two shallow tunnels 5mm in depth were created by a cannulated drill 4.5 in diam-eter over the guide pins. Use a guide pin with a tail hole, leading PDS suture was introduce into each bone tunnel. Then, using the leadingPDS, two suture loops was induced into both bone tunnels. As the tendon graft was placed into two suture loops, the suture ends were tight-ened simultaneously to fit tendon graft into the shallow tunnels and fixed with knots. The tendon graft was led under the deep fascia to thefemoral incision, the femoral tunnel was made, the graft was introduced, and an interference screw was inserted to fix the reconstructed MP-FL in appropriate tension. [Results] All the patients had MPFL reconstructed successfully without serious complications, and were followedup for 12 to 24 months. Compared with those preoperatively, knee range of motion (ROM) [(63.3±18.2)°, (121.4±4.7)°, P＜0.001], VAS score[(6.4±0.9), (1.9 ±0.5), P＜0.001], IKDC scores [(38.2±6.5), (79.9±5.3), P＜0.001], patellar tilt [(23.7±4.2)°, (12.1±3.2)°, P＜0.001] and patel-lar congruency angle [(18.9±3.1)°, (-5.5±1.3)°, P＜0.001] are improved significantly at the last follow-up. [Conclusion] Reconstruction ofmedial patellofemoral ligament with double shallow tunnels and double suture loops fixation did reduce iatrogenic trauma and achieve goodclinical consequences for patella dislocation or subluxation.

Abstract:[Objective] To investigate the clinical outcomes of cluster nursing in preventing laryngeal irritation after anterior cervicalsurgery. [Methods] A retrospective study was conducted on 172 patients who underwent anterior cervical surgery in our hospital. Of them,83 patients who were admitted from July 2022 to November 2022 received routine nursing, while other 89 patients admitted from December2022 to April 2023 received cluster nursing. The Bazaz dysphagia grade, swallowing quality of life (SWAL-QOL) and general comfort ques-tionnaire (GCQ) were compared between the two groups. [Results] All patients in both groups were successfully operated on without seriouscomplications. The cluster group proved significantly superior to the routine group 2 days and 5 days after surgery in terms of Bazaz dyspha-gia grade [none/mild/medium/severe, (49/23/12/5) vs (41/18/14/10), P=0.004; (80/7/2/0) vs (50/18/10/5), P=0.015], SWALQOL score[(56.1±7.9) vs (50.6±10.0), P=0.014; (60.1±5.9) vs (52.3±9.8), P=0.001], and GCQ score [(93.3±7.1) vs (89.3±10.4), P=0.003; (96.1±3.4) vs(93.5±7.5), P=0.002]. In addition, the former was also significantly better than the latter in term of incidence of throat irritation [case (%), 6(6.7) vs 17 (20.0), P=0.001]. [Conclusion] The intervention of cluster nursing after anterior cervical surgery is beneficial to prevent throat ir-ritation and improve patients' experience to medical service.

Abstract:[Objective] To explore the effect of self-efficacy intervention on kinetophobia in revision reconstruction of the anterior cru-ciate ligament due to military training injury. [Methods] Sixty patients with kinesophobia in revision reconstruction of anterior cruciate liga-ment (ACL) due to military training injury were included into this study from May 2022 to October 2023. Among them, 30 patients admittedfrom February to October 2023 were given self-efficacy intervention (intervention group) on the basis of routine care, while other 30 pa-tients admitted between May 2022 and January 2023 received routine care (routine group). The numeric rating scale (NRS) scores for pain,Tampa Scale of Kinesiophobia (TSK-17) and general self-efficacy scale (GSES) were compared between the two groups. [Results] At admis-sion, there were no significant differences in pain NRS, TSK-17 and GSES scores between the two groups (P＞0.05). Compared with those atadmission, the pain NRS, TSK-17 and GSES scores significantly improved in both groups at discharge (P＜0.05). At discharge, the interven-tion group proved significantly superior to the routine group in terms of NRS [(2.2±0.8), (2.7±0.7), P=0.006], TSK-17 [(30.8±2.8), (33.3±1.8), P＜0.001] and GSES scores [(32.9±2.5), (27.7±2.4), P＜0.001]. [Conclusion] Self-efficacy intervention can significantly reduce pain,reduce kinesiophobia and promote functional recovery in ACL revision reconstruction due to military training injury.

Abstract:髋关节发育不良，髋关节置换，肢体延长