BRITISH MEDICAL BULLETIN英国医学公报
BRITISH MEDICAL BULLETIN(英文缩写 BRIT MED BULL),ISSN 0007-1420,eISSN 1471-8391,中文译名:英国医学公报 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 5.841 | Q1 |
| 2022 | 6.700 | Q1 |
| 2023 | 7.400 | Q1 |
| 2024 | 5.200 | Q1 |
| 2025 | 7.500 | Q1 |
BRITISH MEDICAL BULLETIN 最新收录文献
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1. In vivo animal models of Achilles tendon rupture management: a narrative review.
PMID:日期:2026-10-05Acute Achilles tendon rupture is common, and the balance between surgical and non-surgical management remains contested. Much of the mechanistic evidence informing this debate derives from in vivo animal models, which have not previously been appraised together as a class. PubMed/MEDLINE was searched using terms for the Achilles/calcaneal tendon combined with terms for rupture, transection, tenotomy, defect, repair and relevant animal species. Reference lists of included studies and pertinent reviews were hand-searched, supplemented by a grey-literature/web sweep. The search was last updated in June 2026. Given the marked heterogeneity of species, injury model, intervention and outcome measures, findings are synthesized narratively rather than pooled quantitatively or scored against a structured risk-of-bias instrument. Twenty-four in vivo studies (predominantly rat, with mouse, rabbit and one sheep model) were identified. Immobilization angle and duration, rather than repair per se, appear to be dominant determinants of early healing. Biological and pharmacological augmentation strategies generally improve biomechanical properties, with less consistent histological change. Controversies in this literature are of two kinds, substantive and methodological. Direct comparisons of repair versus non-repair are scarce, and reach divergent conclusions once immobilization is accounted for. Reporting of randomization, allocation concealment, blinding and sample-size justification is inconsistent and often absent. Cell- and vesicle-based therapies, engineered scaffolds and lineage-tracing/mechanistic models are actively reshaping this literature. Consensus reference models with standardized transection, repair and immobilization protocols, explicit reporting of ankle angle, duration and method of immobilization, weight-bearing status and timing of mobilization, ARRIVE-compliant reporting, and embedding of biological augmentation within defined management models are needed to strengthen translational value.
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2. Impact of sports participation on genu varum among youth: a systematic review.
PMID:日期:2026-10-03Genu varum occurs more frequently among young male athletes involved in high levels of physical activity, particularly adolescent male soccer players when compared to the general population. This study provides a contemporary examination of the relationship between genu varum and participation in youth sport. A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The literature search was conducted in Web of Science, Scopus, PubMed, Embase, and CINAHL databases. Genu varum is more prevalent among athletes than among age-matched non-athlete controls and has been reported more often in male soccer players, with overloading of the proximal medial tibial growth plate proposed as a possible contributing mechanism. Intercondylar-intermalleolar distance differed in younger age groups with some reporting negative values and some reporting positive values. In recent years, there has been a marked improvement in the methods used to assess lower limb malalignment in young athletes. Clinical measures are simple but lack detail; whole-leg radiographs are increasingly used to capture these details. The lack of longitudinal data examining changes in lower extremity alignment with sports loading during the growth period is an important deficiency of the current research. Long-term follow-up studies are needed to clarify the nature and incidence of genu varum in young athletes, including females. Furthermore, the relationship between genu varum and non-soccer sports should be investigated so the movement and loading characteristics specific to different sports need to be evaluated.
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3. Physeal stress injury and osteochondrosis in the ankle and foot of young athletes.
PMID:日期:2026-07-03Epiphyseal physeal stress injuries (PSIs) and osteochondroses of the foot and ankle in pediatric athletes can result in prolonged absence from activities, surgical intervention or growth arrest, and/or alignment deformities. A systematic review was performed using PRISMA guidelines. Medline, EMBASE and CINAHL electronic databases were searched to identify articles. Clinical studies evaluating the diagnosis and outcomes of PSIs and osteochondrosis of the foot and ankle in pediatric athletes were included. PSIs and osteochondrosis of the foot and ankle require imaging diagnosis often involve the use of radiographs and/or MRI. Conservative treatment is often the initial approach to managing these injuries. These injuries can result in prolonged absence from activity. For injuries that do not resolve with conservative treatment, surgery is often the next step. The timing and type of procedure is variable. Early findings of PSIs or osteochondroses of the foot and ankle may be subtle or inconspicuous on initial radiographs and may require additional imaging workup to ensure appropriate diagnosis. Delayed diagnosis may result in prolonged symptoms and absence from activity and possibly result in growth disturbances. Injury surveillance in all youth sports and activities must include screening for PSIs and osteochondroses to ensure better documentation of incidence among youth. Well-planned prospective longitudinal epidemiological and imaging studies are required to provide more accurate data on the occurrence and natural history of these injuries.
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4. Current concepts and management of insertional Achilles tendinopathy and calcific insertional Achilles tendinopathy.
PMID:日期:2026-07-03Insertional Achilles tendinopathy (IAT) accounts for ~20%-25% of all Achilles tendinopathy presentations. Diagnosis is primarily clinical, supported by weight-bearing radiographs, ultrasound, and magnetic resonance image. At the molecular level, activation of the mammalian target of rapamycin (mTOR) pathway, reactive oxygen species (ROS), nuclear factor kappa B (NF-κB)-mediated inflammation, and aberrant tenocyte differentiation drives entheseal degeneration, and, in calcific insertional Achilles tendinopathy (CIAT), dystrophic calcification. Genetic susceptibility modulates individual risk. A narrative literature review was conducted, searching PubMed, Embase, and the Cochrane Library for studies addressing the epidemiology, clinical presentation, imaging, pathophysiology, genetics, and treatment of IAT and CIAT, prioritizing randomized controlled trials, systematic reviews, and meta-analyses, to March 2026. Insertional and calcific Achilles tendinopathy markedly impair athletic performance and quality of life. Modified eccentric loading and extracorporeal shock wave therapy have better evidence-based outcomes. There is genetic susceptibility. Management of IAT and CIAT requires a structured, staged approach. There is a lack of high-level evidence base for operative management. mTOR pathway activation drives chondral metaplasia and dystrophic calcification in CIAT; oxidative stress Nicotinamide adenine dinucleotide phosphateoxidase/mitochondrial reactive oxygen species (ROS) and NF-κB signalling are parallel, interacting mechanisms that are targetable pharmacologically. The modified Zadek calcaneal osteotomy is effective for appropriately selected CIAT patients, even without excision of intratendinous calcific deposits. High-quality comparative trials across all treatment domains are a priority. Tissue engineering strategies for enthesis regeneration represent a promising direction for the future.
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5. Modeling inflammation and inflammatory diseases in organoids.
PMID:日期:2026-07-03Organoids are 3D cellular structures that self-establish from stem cells and faithfully recapitulate key features of the tissue of interest. Organoids have emerged as powerful tools for disease modeling by maintaining pathology- and patient-specific characteristics, offering a highly valuable substitute for traditional cellular and animal models that often lack translational accuracy to model complex in vivo disease conditions. Despite its strong power, organoid cultures do not reconstruct the in vivo inflammatory microenvironment and thus do not maintain the imposed inflammatory state, making it challenging to model inflammation-linked diseases. PubMed was used as database and source of information. Organoids represent powerful tools to unravel disease mechanisms and eventually screen and identify new therapeutic approaches. Organoid models represent reliable but still reductionist representations of the in vivo tissue/organ, lacking the complex cell composition. Co-cultures with microenvironmental cell types or nearby impacting signaling factors are required to recapitulate the full disease phenotype, including the inflammatory state of the tissue. To obtain more representative inflammatory disease research models, exposure of organoids to inflammatory stimuli such as cytokines and co-cultures with immune cells or microbiota are being established. Implementation of advanced cellular complexity and inflammation in organoid models will enable the study of inflammatory disease-driving mechanisms in an accurate and relevant setting, and result in advanced clinical translation of research findings.
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6. Ulnar variance in youth sport.
PMID:日期:2026-07-03Ulnar variance is a radiographic measurement that describes the relative heights of the distal ulna and radius. Youth athletes who repetitively load their wrist can develop stress injury at the distal radial physis, which may alter longitudinal growth resulting in positive ulnar variance (PUV). This dynamic bony relationship may predilect athletes for wrist pain and/or ulnar-sided pathology; however, the prevalence and clinical significance of ulnar variance in youth athletes is not completely understood. PubMed, CINAHL, EMBASE, and SPORTDiscus were queried in November 2025 without time constraints. Ulnar variance is best measured in skeletally immature athletes on posteroanterior radiographs using Hafner's method. Youth athletes exhibit more PUV values on average than non-athlete predicted norms. Its magnitude is not significantly associated with training volume or wrist pain. Positive ulnar variance is a potential end stage of stress injury to the radial growth plate complex. Symptomatic PUV becomes clinically meaningful and may warrant surgical intervention in select cases. Reported prevalence of PUV in youth athletes varies widely across studies (0%-50%), reflecting substantial heterogeneity in the existing literature. Inconsistent associations of ulnar variance with multiple anthropometric variables, biological data, and training characteristics prevent clear delineation between the effects of genetics vs repetitive mechanical stress to the distal radial physis on its development. Treatment of symptomatic PUV remains controversial. Body composition may uniquely impact ulnar variance magnitude. Distal radial physis stress injury, rather than PUV, may be a primary driver of wrist pain. Newer prospective investigations incorporating dynamic imaging techniques are warranted to evaluate ulnar variance under physiologic weight-bearing conditions. Future work should include athletes from multiple upper extremity weight-bearing sports (gymnastics, cheerleading, diving, and wrestling) across all levels of participation to better account for the effects of training exposure on ulnar variance. Serial radiographic evaluation may also help define the relationship between progressive PUV and the development of wrist pain and dysfunction.
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7. Boosting early bone healing by freeze-dried bovine leukocyte-platelet rich fibrin and nanohydroxyapatite in rabbit: histopathological, molecular, and Raman spectroscopy analysis.
PMID:日期:2026-07-03Globally, millions suffer from bone fractures every year, with substantial clinical consequences. Intervention is crucial when healing mechanisms are ineffective. Leukocyte-platelet rich fibrin (L-PRF), by its rapid, simple, and cost-effective preparation methodology alongside a calcium phosphate-based compound such as nanohydroxyapatite may favorably impact clinical practice. A critical-sized radius bone defect was produced in 25 White New Zealand rabbits divided into five groups (n = 5 per group) including untreated, autograft, nanohydroxyapatite scaffold, bovine lyophilized L-PRF, and nanohydroxyapatite and L-PRF simultaneously. The defects were evaluated 7 days postsurgery by histopathological, molecular, and Raman spectroscopy evaluations. Platelet and growth factor content of lyophilized L-PRF powder stimulate cell proliferation and differentiation, and extracellular matrix production. Nanohydroxyapatite scaffold and lyophilized L-PRF powder could effectively enhance early bone regeneration. While the autograft group was expected to perform best, as the gold standard of repair, the lyophilized L-PRF group performed best in some indicators of extracellular matrix production, such as matrix-to-mineral ratio and carbonate-to-phosphate ratio. Nanohydroxyapatite scaffold played as a mechanical strength provider and had a lesser role in stimulating biological repair responses, in the short term, while L-PRF significantly enhanced cell proliferation and differentiation and extracellular matrix production by releasing osteogenic factors. The long-term effects of lyophilized L-PRF on bone repair, duration of platelet growth factor release from L-PRF, injecting fresh L-PRF at periodic intervals, and using lyophilized L-PRF alongside other bone-stimulating scaffolds should be addressed in future studies.
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8. Genetic susceptibility to aseptic loosening following total hip and knee arthroplasty: a systematic review of candidate-gene and genome-wide association studies.
PMID:日期:2026-07-03Aseptic loosening is the leading cause of revision after total hip (THA) and knee (TKA) arthroplasty, accounting for 33%-50% of revisions. Variable individual susceptibility suggests genetic contributions. Five databases searched to 9 June 2026. Studies reporting genetic associations with aseptic loosening or osteolysis in THA/TKA were included. Quality was assessed via Q-Genie. Pooled odds ratios (random-effects) were computed for loci with ≥3 independent studies (TNF-α -308G > A, IL-6 -174G > C). Meta-analysis for MMP-1 rs5854 was not possible because of insufficient replication. Twenty-six studies (7419 participants) examined THA or mixed cohorts; none studied TKA alone. Seventeen gene loci were implicated (cytokines, bone remodelling, matrix degradation, etc.). Pooled analysis: TNF-α -308G > A OR 1.94 (95% CI 1.28-2.93; I2 = 38%; 3 studies); IL-6 -174G > C OR 1.61 (95% CI 1.07-2.42; I2 = 51%; 3 studies). IL-1RN VNTR 498 bp allele conferred ~ 4-fold risk in atopic patients. Variants in RANK, KREMEN2, OPG, SFRP1, TIRAP, and BCL2 were also associated. GNAS1 and CALCA showed no association. Quality was low to moderate. No genome wide association studies (GWAS) was identified. Evidence is dominated by small, single-centre, candidate-gene studies in Caucasian THA cohorts, with heterogeneity in surgery, implants, and phenotype definitions. IL1RN-atopy interaction enables pre-surgical screening. IL-6 genotyping may personalize monitoring. Biobank-registry linkage now permits adequately powered GWAS. A well-powered GWAS using registry-biobank linkage; independent replication of RANK/OPG/Wnt and IL1RN findings; first TKA-specific genetic studies; standardized phenotype definitions.
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9. Diagnostic accuracy of clinical examination versus MRI for meniscal tears: a systematic review and meta-analysis.
9. 临床检查与MRI对半月板撕裂的诊断准确性：系统综述和荟萃分析PMID:日期:2026-07-03Meniscal tears are a common cause of knee morbidity and a frequent indication for arthroscopy. Whether clinical examination, magnetic resonance imaging (MRI), or both should be the first-line diagnostic test remains contested. We searched PubMed, CINAHL Complete, Medline, and Web of Science for paired-design studies in adults in which every patient underwent both composite clinical examination and MRI, with arthroscopy as the reference standard. Ten studies (1643 knees) met our inclusion criteria. Risk of bias was assessed with QUADAS-2; estimates were pooled with a random-effects model. For medial meniscal tears, MRI achieved pooled sensitivity of 90% and specificity of 91%; composite clinical examination achieved 85% sensitivity and 95% specificity. For lateral meniscal tears, MRI yielded 81% sensitivity and 82% specificity; composite clinical examination yielded 75% sensitivity and 93% specificity. Whether composite clinical examination is interchangeable with MRI as a first-line test; reduced MRI specificity in degenerative meniscal lesions and osteoarthritic knees; and the operator-dependence of clinical examination and the lack of a standardized composite-examination protocol. Composite clinical examination by an experienced clinician retains diagnostic value alongside MRI. Paired-design synthesis with arthroscopic verification gives less biased estimates of comparative accuracy than unpaired designs. Standardization of composite clinical examination protocols; consistent reporting of examiner experience; stratification of MRI accuracy by field strength and pulse sequence; and cost-effectiveness evaluation of clinical-examination-first diagnostic pathways.
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10. Indirect calculation of metabolic power in soccer: a critical analysis of a popular model.
PMID:日期:2026-07-03The Global Positioning System (GPS)-based metabolic power model for soccer, proposed by di Prampero and applied by Osgnach, rests on a fixed energy cost (EC) of running of 4.6 J·kg-1·m-1 and a biomechanical equivalence between accelerated level and constant-speed uphill running. A narrative review was conducted via PubMed, Scopus, and Web of Science using terms like metabolic power, EC of running, GPS soccer, sprint biomechanics, equivalent slope, and running economy (2005-2025). Running EC is relatively speed-independent across submaximal velocities typical of football (~6-18 km·h-1). The geometric principle underlying the accelerated-to-inclined running equivalence is accepted, and GPS metabolic power provides a useful metric for relative load comparisons. A universal fixed EC ignores interindividual variability (~20%), fatigue, surfaces, and drag. The equivalence model has vector orientation inconsistencies, employs the imprecise term 'equivalent mass', and derives its postural reference from sprint-start conditions unrepresentative of match-play accelerations (~2-4 m·s-2). Validation studies show systematic underestimations of 29%-85% relative to indirect calorimetry. Refinements exist but remain unimplemented in most commercial platforms. Individually calibrated EC values, inertial measurement unit integration, and hybrid models combining GPS kinematics with cardiorespiratory data are promising. Force-velocity profiling offers a biomechanically grounded alternative for individual sprint characterization. Priorities include calorimetric validation under match conditions; player-specific EC models incorporating fatigue, surface, and role; implementing model updates in commercial software; and comparing alternative load metrics for injury-risk prediction.