Objective To analyze the correlation between the morphology of tibial intercondylar eminence and non-contact anterior cruciate ligament (ACL) injury, and provide a theoretical basis for the prevention and risk identification of ACL injury. Methods A retrospective analysis was conducted on the knee radiographs of 401 patients admitted to the Chengdu Second People’s Hospital between January 2017 and October 2021, including 219 males and 182 females. Non-contact rupture of ACL was observed in 180 patients and confirmed by arthroscopy or surgery, while the remained 221 patients were confirmed to have normal ACL by physical examination and MRI. The heights of medial and lateral tibial intercondylar eminence and the width of tibial intercondylar eminence of the 401 patients were measured, and the risk factors of ACL injury were analyzed. Results The height of medial tibial intercondylar eminence was lower and the width of tibial intercondylar eminence was smaller in male patients with ACL fracture than those in the male control group with statistical significance (P<0.05). Logistic regression analysis showed that a narrow width of tibial intercondylar eminence was a risk factor of ACL injury in males (P<0.05). The receiver operating characteristic (ROC) curve showed that the diagnostic threshold was 11.40 mm, the area under the curve (AUC) was 0.851 [95% confidence interval (CI) (0.797, 0.896)], the sensitivity was 72.81%, and the specificity was 84.76%. The height of medial tibial intercondylar eminence was lower and the width of tibial intercondylar eminence was smaller in female patients than those in the female control group with statistical significance (P<0.05). Logistic regression analysis showed that both a low height of medial tibial intercondylar eminence and a narrow width of tibial intercondylar eminence were risk factors of ACL injury in females (P<0.05). For the width of medial tibial intercondylar eminence, the ROC curve showed that the diagnostic threshold was 8.30 mm, and the AUC was 0.684 [95%CI (0.611, 0.751)], the sensitivity and specificity were 63.64% and 72.41%, respectively; for the height of medial tibial intercondylar eminence, the diagnostic threshold was 11.30 mm, and the AUC was 0.699 [95%CI (0.627, 0.756)], the sensitivity was 89.39%, and the specificity was 47.41%. Conclusions The reduced width of tibial intercondylar eminence is a risk factor and effective predictor of non-contact ACL injury in males. Both the reduced height of the medial tibial intercondylar eminence and the reduced width of tibial intercondylar eminence are risk factors and may be predictors for non-contact ACL injury in females.
Objective To systematically review the risk factors of tic disorder (TD) in children. Methods Databases including PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP, and WanFang Data were electronically searched to collect observational studies on children with TD from inception to June 29th 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 32 studies involving 556 560 children were included. The results of meta-analysis showed that the risk factors for TD were as follows: male (OR=2.23, 95%CI 1.08 to 4.61, P=0.03), premature delivery (OR=1.66, 95%CI 1.04 to 2.64, P=0.03), low birth weight (OR=1.27, 95%CI 1.07 to 1.50, P=0.005), history of neonatal jaundice (OR=7.46, 95%CI 1.15 to 48.42, P=0.04), other adverse factors in the perinatal period (OR=2.74, 95%CI 1.89 to 3.98, P<0.000 01), poor eating habits (OR=2.11, 95%CI 1.52 to 2.93, P<0.000 01), long-term viewing of electronic products (OR=2.22, 95%CI 1.31 to 3.75, P=0.003), history of febrile convulsions (OR=2.43, 95%CI 1.21 to 4.86, P=0.01), recurrent respiratory infection (OR=2.63, 95%CI 1.49 to 4.64, P=0.000 8), chronic tonsillitis (OR=2.01, 95%CI 1.31 to 3.09, P=0.001), rhinopathy (OR=1.77, 95%CI 1.35 to 2.31, P<0.000 1), attention deficit hyperactivity disorder (ADHD) (OR=5.32, 95%CI 3.77 to 7.51, P<0.000 01), decreased blood iron content (OR=3.68, 95%CI 1.56 to 8.67, P=0.003), family history of TD (OR=6.33, 95%CI 3.20 to 12.53, P<0.000 01), family history of mental illness (OR=2.39, 95%CI 2.03 to 2.83, P<0.000 01), maternal mental disorder during pregnancy (OR=2.49, 95%CI 1.99 to 3.11, P<0.000 01), alcohol drinking during pregnancy (OR=1.40, 95%CI 1.09 to1.79, P=0.007), smoking or passive smoking during pregnancy (OR=1.84, 95%CI 1.68 to 2.01, P<0.000 01), and corporal punishment (OR=3.57, 95%CI 1.52 to 8.34, P=0.003). Parity (second birth and above) (OR=0.41, 95%CI 0.25 to 0.68, P=0.000 6) was a protective factor for tic disorder. Conclusions Current evidence shows that the incidence of TD is related to gender, family history of mental illness, maternal life habits during pregnancy, perinatal history, chronic respiratory diseases, abnormal trace elements, and strict education methods, etc. Moreover, parity is a protective factor for the occurrence of TD. Due to the limited quantity and quality of included studies, more high-quality studies are required to verify the above conclusions.