THE ISOKINETIC MUSCLE ASYMMETRY OF THE THIGH AT 1 YEAR AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WAS SIGNIFICANTLY ASSOCIATED WITH GAIT ASYMMETRY

Objective: To study the correlation between muscle strength asymmetry and gait asymmetry in 1 year after （Anterior Cruciate Ligament Reconstruction， ACLR）. Methods: Twenty-five ACLR patients were enrolled in the Department of Sports Medicine, Peking University Third Hospital. Data of isokinetic muscle strength test one year after ACLR were collected. The concentric and eccentric strength of extensor and flexor muscles at 60°/s, 180°/s and 300°/s on the uninjured side and the injured side were measured respectively, and the peak value of muscle strength was analyzed. The three dimensional motion information and ground reaction force during gait were collected, and the peaks of three dimensional joint angle and moments during gait stance phase were calculated by inverse dynamics analysis. The paired-samples T test was used to analyze the difference of gait parameters and isokinetic muscle strength peaks. Spearman correlation analysis was used to study the correlation between bilateral asymmetry index of isokinetic muscle strength and gait asymmetry index. Results: One year after ACLR, the isokinetic muscle strength peaks of the flexor and extensor muscles on the injured side were significantly lower than those on the uninjured side【60°/s extensor concentric, the injured side: (1.22 ± 0.4)Nm·kg-1, uninjured side: (1.73 ± 0.42)Nm·kg-1, bilateral difference: (-0.5 ± 0.39)Nm·kg-1, P \u3c 0.01; 60°/s flexor concentric, injured side: (0.84 ± 0.19)Nm·kg-1, uninjured side: (1.05 ± 0.23)Nm·kg-1, bilateral difference: (-0.21 ± 0.14)Nm·kg-1, P \u3c 0.01】. Compared with the uninjured side, the injured side showed insufficient knee extension at the time of maximum knee extension during stance phase 【injured side: (5.25 ± 4.17) °, uninjured side: (2.24 ± 3.11) °, bilateral difference: (3.01 ± 2.44) °, P \u3c 0.01】, and the peak extension moment decreased significantly 【injured side: (0.1 ± 0.09) Nm·kg-1·m-1, (0.15 ± 0.07) Nm·kg-1·m-1, (-0.05 ± 0.06) Nm·kg-1·m-1, P \u3c 0.01】. One year after ACLR, the asymmetry of 180°/s isokinetic extensor concentric strength was significantly correlated with the asymmetry of peak flexion moment (R = 0.449, P = 0.024). The asymmetry of 60°/s isokinetic extensor concentric strength was significantly correlated with the asymmetry of peak internal rotation moment (R = 0.421, P = 0.036). One year after ACLR, asymmetries of 180°/s, 300°/s isokinetic extensor concentric strength and 60°/s isokinetic flexor eccentric strength were significantly correlated with peak asymmetries during stance phase. Conclusion: There is a significant correlation between isokinetic muscle strength asymmetry of knee and gait asymmetry. This study suggests that ACLR patients still need regular rehabilitation training to improve muscle strength and motor function 1 year after ACLR, so as to reduce the risk of reinjury and secondary injury

The experience of long-stay patients in a forensic psychiatric hospital in China: a qualitative study

open access articleBackground Long stay in forensic psychiatric hospitals is common in patients who are defined as “not criminally responsible on account of mental disorder”. However, little is known about how these patients experience and perceive the long stay within these settings. The aim of this study is to explore the perception and needs of long-stay patients in forensic psychiatric hospitals in China. Methods In-depth semi-structured interviews were conducted with 21 participants who had lived in the forensic psychiatry hospital for more than 8 years. We used thematic analysis strategies to analyse the qualitative data. Results Participants’ perceptions clustered seven themes: hopelessness, loneliness, worthlessness, low mood, sleep disturbances, lack of freedom, and lack of mental health intervention. Conclusions The views and opinions expressed by long-stay patients showed that psychological distress is prevailing in forensic psychiatric hospitals. Adequate and effective care and mental health interventions are recommended to be tailored for their special needs

Association between gut microbiota, microbial network, and immunity in pregnancy with a focus on specific bacterial clusters

BackgroundThe community characteristics of the gut microbiota are not well defined and are not as widely studied as the functions of individual bacteria. This study aims to investigate the community composition of intestinal flora in women of childbearing age by conducting cluster analysis of gut microbiota and analyzing the relationship between different clusters and immune status.MethodsA total of 45 women of childbearing age were recruited in the study, including 15 non-pregnant women and 30 women in late pregnancy, and stool samples were collected twice during the third trimester, specifically at 32 weeks and at full term. The gut microbiota data was analyzed using 16S rRNA amplicon sequencing. Partitioning Around Medoids algorithm was employed to assess microbial clustering patterns. Microbial network for each cluster was performed and plasm cytokines were measured to analyze the relationship between specific genera and immune state in clusters.ResultsThere were three distinct clusters of intestinal community composition in women of childbearing age. Cluster 1 (PAM_1) was characterized by a high abundance of Bacteroides, while cluster 2 (PAM_2) showed higher levels of Bifidobacterium and Blautia, along with a significantly increased Firmicutes to Bacteroidota ratio. Cluster 3 (PAM_3) displayed a high abundance of Escherichia-shigella. PAM_1 was the most dominant cluster in non-pregnant women, and this dominant cluster was also one of the main in late pregnancy. At full term, the majority of subjects retained the same cluster as at 32 weeks, while a few experienced a shift. The microbial correlation networks differed across the three clusters, with PAM_1 exhibiting higher modularity and fewer connections. Analysis of the correlation between genera and plasma cytokines showed significant differences in their associations with cytokines between pregnancy and nonpregnancy within the same cluster, and the same genera had different effects in different clusters.ConclusionWomen of childbearing age exhibit three distribution patterns of gut microbiota, and the intestinal clusters reshaped during late pregnancy in a small population. Different clusters may have diverse immunomodulatory effects in different physiological states. When studying the gut microbiome during pregnancy, it is crucial to consider the cluster differences within healthy women