Background: Contemporary techniques for repair of acute anterior cruciate ligament (ACL) rupture have been receiving renewed interest recently because of reports of good outcomes. Methods: A literature search of PUBMED, MEDLINE, EMBASE, and the Cochrane Library was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Only RCTs published in English and comparing clinical outcomes of ACL repair versus reconstruction were included. Outcomes were evaluated using the International Knee Documentation Committee subjective score, Lysholm score, Tegner activity scale, visual analog scale pain score, anterior laxity, Lachman test, hop tests, knee injury and osteoarthritis outcome score, extension deficit, revision rate, and re-rupture rate. Statistical analysis was performed with Review Manager 5.4 and Stata 14.0. Two-tailed P < .05 was considered statistically significant. Results: Four RCTs (with a total of 293 patients) that met the eligibility criteria were included in this review. Over short-term follow-up, none of the studies found significant differences between the repair groups and reconstruction groups with respect to International Knee Documentation Committee, Lysholm, Tegner, visual analog scale, anterior laxity, Lachman test, re-rupture rate, extension deficit, and performance of 3 hop tests (P > .05). In both groups, the hop tests scores were >90%. Conclusion: ACL repair and ACL reconstruction appear to provide comparable short-term outcomes. The low revision rate after primary repair is encouraging. For patients with ACL injury, current repair techniques such as dynamic intraligamentary stabilization and bridge-enhanced ACL repair may be an effective alternative to reconstruction.

Background: Pulmonary cryptococcosis (PC) rarely occurs in immunocompetent children. Case presentation: A 13-year-old boy was admitted to the First Affiliated Hospital of Ningbo University in February 2023 with complaints of cough and chest pain. Physical examination showed slightly moist rales in the right lung. Chest computed tomography (CT) suggested a lung lesion and cavitation. Blood routine test, lymphocyte subsets, immunoglobulin, and complement tests indicated that the immune system was normal. However, the serum cryptococcal antigen test was positive. Next-generation sequencing revealed Cryptococcus infection. The child was diagnosed with PC and was discharged after treating with fluconazole 400 mg. Four months later, chest CT showed that the lung lesion diminished, and reexamination of serum cryptococcal antigen test turned positive. Conclusion: PC should be considered in an immunocompetent child with pulmonary cavities with nonspecific symptoms.

Introduction: Major histocompatibility complex II (MHC-II)-mediated antigen presentation contributes to the pathogenesis of immune thrombocytopenia (ITP). Human leukocyte antigen (HLA)-DRB5 is an MHC-II molecule and this study aims to investigate its role and mechanisms in ITP development. Methods: Guinea pig anti-mouse platelet (PLT) serum-induced ITP mice received tail vein injection of HLA-DRB5 overexpressing adenoviral vector/immune receptor expressed on myeloid cells-1 (IREM-1) monoclonal antibody (mAb). PLT count changes in mice blood were assessed by a hematology analyzer. MHC-II/CD80/CD86 expression in mice blood was measured by quantitative real-time-PCR and immunofluorescence assay. CD8+ T-cell proportion in mice blood was detected by flow cytometry. Results: HLA-DRB5 overexpression exacerbated PLT reduction since the 5th day of the establishment of ITP mice model and enhanced MHC-II/CD80/CD86 expression upregulation as well as CD8+ T-cell ratio elevation in the blood of ITP mice, while its effects were reversed by IREM-1 mAb. Conclusion: HLA-DRB5 overexpression upregulates MHC-II-mediated antigen presentation to CD8+ T cells, thus lowering PLT count in the ITP mice model.

Hemolymphangioma is a rare benign tumor consisting of blood vessels and cystically dilated lymphatics. It occurs in the neck, head, trunk or extremities, chest wall, and gastrointestinal tract. How...

Background: Mycoplasma pneumoniae pneumonia, primarily caused by Mycoplasma pneumoniae , poses a significant burden on pediatric respiratory health, with macrolide‐resistant strains complicating treatment. With macrolide resistance on the rise, alternative treatment options are imperative. Doxycycline has emerged as a promising alternative due to its broad‐spectrum efficacy and favorable safety profile. However, the clinical scenarios for its administration, particularly in macrolide‐resistant Mycoplasma pneumoniae pneumonia in children, have not been extensively explored. Methods: Clinical data of 129 pediatric patients with macrolide‐resistant Mycoplasma pneumoniae pneumonia were retrospectively analyzed. Drug sensitivity testing was performed for one group to confirm the absence of doxycycline resistance, while the other group switched to doxycycline after unsatisfactory effects of macrolide therapy. Clinical response, laboratory parameters, treatment‐emergent adverse events, and cytokine levels were compared between the groups. Results: The group that switched to doxycycline after drug sensitivity testing had notably shorter fever resolution time (3.65 ± 1.24 vs. 3.06 ± 1.15 days), cough relief time (4.82 ± 1.45 vs. 4.13 ± 1.36 days), and a higher chest X‐ray improvement percentage (80.15 ± 5.48% vs. 81.95 ± 4.52%) compared to the unsatisfactory curative effect group. Baseline laboratory parameters, treatment‐emergent adverse events, and baseline cytokine levels showed no significant differences. However, posttreatment, significant differences were observed in IL‐8 (42.16 ± 7.89 vs. 38.83 ± 7.61 pg/mL), IL‐10 (19.35 ± 3.21 vs. 18.14 ± 3.37 pg/mL), and SAA (31.14 ± 5.67 vs. 29.26 ± 3.22 mg/L) between the two groups. Conclusion: Early doxycycline use, particularly after drug sensitivity testing, demonstrated potential clinical efficacy in the treatment of macrolide‐resistant Mycoplasma pneumoniae pneumonia in children.