Search

PURPOSE The purpose of this study was to investigate the effects of yoga poses on spinal range of motion, posterior superior iliac spine levels and muscle activity according to pelvic displacement in middle-aged women. METHODS Twenty middle-aged women were selected to normal pelvic displacement group (CON, n=6), anterior pelvic tilt group (APG, n=6) and posterior pelvic tilt group (PPG, n=8). Spinal range of motion, posterior superior iliac spine levels and muscle activity were measured during Yoga poses (Janusirsa asana, parivrrta upavistha konasana, parsva upavistha konasana, virabaddra asana III). RESULTS The following were the main results. Right trunk flexion and pelvic tilt during right janushirasana asana were significantly decreased at APG and PPG compared to CON (p

Purpose: This study aimed to identify the factors that affect intention of retention of hospital nurses by examining correlations between positive psychological capital, job crafting, job satisfaction and intention of retention based on the expanded Job Demand-Resources Model. Methods: A total of 198 nurses with more than 6 months of clinical experience were recruited from a university hospital. Data on positive psychological capital, job crafting, job satisfaction and intention of retention were collected from September to October 2021 using self-report questionnaires. Results: Hierarchical regression analysis demonstrated that the factors affecting hospital nurses' intention to retain were marital status (β=.15, p=.035) in Model 1, positive psychological capital (β=.18, p=.037), and job crafting (β=.29, p=.001) in Model 2, and job satisfaction (β=.55, p<.001) explained by 35% in Model 3. Conclusion: Based on our findings, employer and nursing leaders should provide job satisfaction programs including offering career growth opportunities and building supportive nursing culture for retention among nurses. [ABSTRACT FROM AUTHOR]

The clinical outcome in advanced cancer has improved since the development of targeted therapies and immune checkpoint inhibitors. We can expect better overall survival after a combination treatment with these therapeutic agents. Classical cytotoxic chemotherapeutic agents directly kill tumor cells by destroying the cell structure and DNA of tumor cells or inhibiting their metabolism. Targeted therapy also directly affects tumor cells by inhibiting the cell growth signaling system. Conversely, immune checkpoint inhibitors can enhance immune responses by using the host immune system in the tumor microenvironment, leading to the direct killing of tumor cells. Therefore, immune checkpoint inhibitors are less toxic and have longer response durations. Even in solid tumors with nonimmunogenic backgrounds, cytotoxic chemotherapy or targeted treatment can induce immune responses to place the tumor microenvironment in an immunogenic state. Synergistic anticancer effects can be expected when immune checkpoint inhibitors are added during this state. Moreover, drug resistance may be overcome by combination therapies. If patients with cancer are treated with a combination of these therapeutic agents and the characteristics of each tumor are identified with data from next generation sequencing, personalized treatments can be tailored, making it possible to control cancers as a curable disease just like other benign chronic diseases. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the awareness of child rearing among parents of children in early childhood and to provide fundamental data for parent education programs according to child rearing type. Methods: Q-methodology which provides a method of analyzing the subjectivity of each item was used. Forty Q items which were derived from a literature review and interviews with nurturing mothers were classified into a normal distribution using a 9-point scale. Collected data were analyzed using the QUANAL PC Program. Results: Four types of parents’ child rearing were identified. Type I was named ‘affection-respect type’, type II, ‘concern-rule compliant type’, type III, ‘solicitude-model type’, and type IV, ‘geniality-encouragement type’. Conclusion: For proper growth and development during early childhood, parents should have rational information and awareness of their child rearing type. Results of this study can be used as essential data to develop child rearing education programs according to parents’ child rearing attitude. [ABSTRACT FROM AUTHOR]

Lacan's concept of the Real is one of the core concepts of Lacanian psychoanalytic theory. The Real is not approachable by way of the Symbolic but forms indispensible tie with it by causing it to function with the signifiers to cover over the impossivility of the Real. This concept of the Real should be studied in detail in that it becomes indissoluble with some aspects of the clinic and other cultural domains, including politics. The intent of this paper is to study how the Real is reflected in some phenomena of politics and economics with the help of Karatani's concept of 'transcritique.' Karatani's concept of 'transcritique' is very useful in understanding the relation of the Real and the cultural phenomena because 'transcritique' puts forward the need of the parallax view in approaching the transcendental X existing in the ambiguous Real and surplus value in economics. The transcental X cannot be reduced to any positive factors and can be approached only by way of the parallaw view which forms critical space in between some definite views which are transcended by the parallax view exemplified in 'trnascritique'. Likewise, Lacan's Real can be approached with the parallax view, not being available by way of any one absolute view or standpoint. The impossibility of the Real is defined as antagonism of the Real by Zizek who is regarded as a proselytizer of the Real. Zizek is rather criticial of some postmarxists such as Laclau and Mouffe and a deconstructionist critic, Stavrakakis in that they are too compromising in their interpretations of antagonism of the Real with their focus on discursivity of cultural phenomena, ignoring the hardcore economic aspect of class struggle. Zizek argues that today's global capitalism is extremely inclined toward relentless economic exploitation of the underprivileged countries of the world and antagonism of the Real is manifested in such economic struggles. Therefore in Zizek's view the encounter with the Real and ethical perfomance of the 'event' would be in concrete confrontation with this kind of antagonistic relations not with agnonistic relations as delineated multiculturally in terms of gener, race, and other forms of resistances in the political perspectives of the advocaters of Radical Demoncracy like Laclau and Mouffe. These various arguments in relation to the ambiguous antagonim of the Real prove how the impossibility of the Real causes these different readings among Lacanian scholars and the scholars influenced by Lacan. [ABSTRACT FROM AUTHOR]

Investigation and analysis of the viscosity variation of Saraline-based super lightweight completion fluid (SLWCF) at high pressure and temperature were reported, and the viscosity prediction model was optimized. Viscosity measurements were carried out at temperature and pressure ranging from 298.15 K to 373.15 K, and 0.10 MPa to 4.48 MPa respectively. The data analysis reveals that the reduction of viscosity as a function of temperature may be divided into two regions, i.e. significant viscosity reduction at low temperature and fairly slow viscosity reduction at high temperature; the viscosity of Saraline-based SLWCF is less affected by the changes of pressure. The experimental data were fitted to four different viscosity-temperature-pressure models. The results show that, the modified Mehrotra and Svrcek's and Ghaderi's models are able to satisfactorily predict the viscosity value and measured value and describe the viscosity property at high pressure and temperature. The comparison with the Sarapar-based SLWCF reveals that the viscosity of Sarapar-based SLWCF is more affected by temperature than the Saraline-based SLWCF; pressure seems to have negligible effect on Saraline-based SLWCF viscosity; the modified Mehrotra and Svrcek's and Ghaderi's models are able to give more reliable viscosity predictions for Saraline-based SLWCF than for Sarapar-based SLWCF. Key words: high pressure and temperature, viscosity prediction, super lightweight completion fluid, Saraline synthetic oil, underbalanced perforation

OBJECTIVES The purpose of present study was to analyze the acute effects of exergame on glucose control after glucose ingestion in individuals with pre- and type 2 diabetes. METHODS We enrolled 60 adults with pre-diabetes (Pre-DM, 58.1±9.2 years, n=20) and type 2 diabetes (T2DM, 61.7±9.9 years, n=40). We measured fingertip capillary blood glucose level at 10 min before, 30 min after, 60 min after and 120 min after the 75-g oral glucose tolerance test (OGTT). For the non-exergame control days, participants pursued normal daily activities but refrained from unusual strenuous physical activity. On the exercise days, participants conducted on exergame at 30 min after 75-g OGTT for 30 min. RESULTS Acute exergame reduced the glucose level 60 min, ∆BG30-60 and ∆BG60-120 after glucose ingestion compared to the control trials (p

OBJECTIVES This study aims to investigate the effects of a 24 weeks combined rehabilitation exercise program on the subjective questionnaire, isokinetic muscle function test and dynamic balance test of high tibial osteotomy patients with normal weights and obese individuals. METHODS Sixteen tibial osteotomy patients were recruited in the study. They were divided into two groups(normal weight group[n=8] or obesity weight group[n=8]). A pre-test consisting of subjective questionnaire, isokinetic muscle function test and Y balance test. Using the same test in 12 weeks, 24 weeks after the surgery. All groups completed the rehabilitation exercise program for the duration of 24 weeks. RESULTS The significant interaction was observed between group and time on the involve bilateral flexor strength deficits (p=.045) and the posteromedial reach distance (p=.041). CONCLUSIONS These results suggest that a 24 weeks rehabilitation exercise program is needed after high tibial osteotomy in order to restore the same level of activity as before surgery.

Objective: To explore the risk factors of systemic inflammatory response syndrome (SIRS) in diabetes foot infection (DFI). Methods: A retrospective analysis was conducted on the clinical data of 301 patients admitted to the Ninth Medical Center of the People's Liberation Army General Hospital for DFI from January 2021 to December 2023, including 223 males and 78 females with the age of (63.3±12.0) years. The study population was divided into SIRS group ( n =32) and non-SIRS group ( n =269) based on whether SIRS occurred. Multivariate logistic regression model was used to analyze the risk factors of DFI combined with SIRS. Results: Compared with non-SIRS group, patients in SIRS group were younger [(60.3±8.5) vs (63.7±12.3) years, P =0.047], with lower serum albumin [ M ( Q 1 , Q 3 )] [32.7(29.3, 37.3) vs 36.2(33.6, 39.2) g/L, P =0.003] and hemoglobin [116.0(99.8, 125.3) vs 121.0(111.0, 136.0) g/L, P =0.022], and higher glycosylated hemoglobin [9.8%(8.7%, 11.6%) vs 8.7%(7.4%, 10.6%), P =0.007]; positive rate of diabetes foot history was lower [25.0%(8/32) vs 46.8% (123/269), P =0.019] and the proportion of combined osteomyelitis was higher [90.6% (29/32) vs 46.7% (168/269), P =0.002] in SIRS group. Multivariate logistic regression analysis showed that elevated glycosylated hemoglobin ( OR =1.27,95% CI :1.03-1.58) and osteomyelitis ( OR =4.5,95% CI :1.20-16.86)were risk factors for SIRS. Conclusion: Poor blood glucose control and osteomyelitis are risk factors for DFI complicated with SIRS.

Background: After the Coronavirus disease 2019 (COVID-19) pandemic, international medical services have continued to flourish and reconfigure, leading to the current intense competition among medical institutions. Understanding loyalty in international patients and its related factors may be referenced and used to enhance loyalty among patients visiting a hospital, thereby enhancing the competitiveness of that medical institution., Purpose: This study was designed to explore the significant factors that influence the loyalty of international patients., Methods: The international medical services patient database of a northern medical center was used to extract information on patients who had received services from the international medical center between 2018 and 2022 (n = 3,325). Binary logistic regression analysis was used to calculate the increase in patient loyalty at each quartile, the estimated relative odds ratio (OR) of international patient loyalty, and its 95% confidence interval (CI). Potentially relevant factors controlled in the statistical model included: age, source of information from the unit, and total medical expenses., Results: This study found that the level of international medical service patient loyalty to the target hospital averaged approximately 15.1%. International medical service patient loyalty differed significantly by age group (45-64 years old), using non-internet sources for information, and spending at least 1 million NT dollars on medical expenses (p < .001). The information source used (OR: 1.72; p < .001; 95% CI [1.33, 2.23]) and total medical expenses (OR: 4.56; p < .001; 95% CI [3.49, 5.95]) were identified as significant predictors of loyalty., Conclusions / Implications for Practice: It is hoped the results of this study provide a reference for institutions to promote international medical services, improve international competitiveness, and demonstrate the quality of medical care provided in Taiwan.

Objective: To investigate the midterm and long-term efficacy of flow-diverter device in treating intracranial aneurysms (IAs) and analyze its clinical outcomes in anterior circulation aneurysms and posterior circulation aneurysms. Methods: This is a retrospective case series study. The data of 566 intracranial aneurysm patients (681 aneurysms) treated with the flow-diverter device at Department of Neurosurgery, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University from January 2018 to January 2021 were retrospectively analyzed. There were 205 males and 361 females, with an age ( M (IQR)) of 55 (14) years (range:18 to 77 years). Twelve patients (12 aneurysms) had ruptured aneurysms before surgery, and 75 patients (172 aneurysms) had multiple aneurysms. Preoperative modified Rankin scale (mRS) >2 points in 16 patients.There were 444 patients (552 aneurysms) in the anterior circulation group and 122 patients (129 aneurysms) in the posterior circulation group. Postoperative follow-up was conducted via outpatient visits or telephone calls at 3 to 12 months after the procedure. Baseline aneurysm parameters, surgical information, and imaging and clinical outcomes were collected. Univariate and multivariate Logistic regression analyses were used to identify independent factors associated with long-term incomplete aneurysm occlusion. Results: Intraoperative use of flow diverter-assisted coil embolization was performed in 221 patients (226 aneurysms), and balloon assistance was used in 20 patients (22 aneurysms).The intraoperative rupture rate was 0.5% (3/566), and the intraoperative thrombosis rate was 0.7% (4/566). The in-hospital mortality rate was 1.2% (7/566). Postoperative complications included subarachnoid hemorrhage in 5 patients (0.9%), intracerebral hemorrhage in 2 patients (0.4%), ischemic stroke in 19 patients (3.6%), and transient ischemic attack in 16 patients (3.0%). Imaging follow-up was available for 447 patients (548 aneurysms) with a follow-up duration of (16.7±6.7) months (range:3 to 45 months). Incomplete aneurysm occlusion occurred in 79 patients (95 aneurysms), accounting for 17.3% (95/548). Parent artery stenosis was observed in 63 patients (72 aneurysms), accounting for 13.1% (72/548). Clinical follow-up was available for 530 patients (644 aneurysms) with a follow-up duration of (29.4±11.3) months (range:3 to 54 months). One case of mRS score >2 points was observed in 18 patients, accounting for 3.4% (18/530). Among them, the rate of incomplete occlusion in the anterior and posterior circulation group was 16.9% (76/450) and 19.4% (19/98), respectively, and the rate of parent artery stenosis was 10.9% (49/450) and 23.5% (23/98), respectively; the rate of mRS score>2 points was 2.4% (10/415) and 7.0% (8/115), respectively. Univariate and multivariate Logistic regression analysis showed that aneurysm neck size ( β =0.075, OR =1.08, P =0.028) and coil use ( β =-1.070, OR =0.034, P =0.001) were independent factors influencing long-term aneurysm occlusion. Conclusions: The flow-diverter device demonstrates good safety and efficacy in the midterm and long-term treatment of overall IAs. However, further research is needed to focus on the midterm and long-term treatment outcomes of aneurysms with relatively wide neck and posterior circulation aneurysms.

The urban belt along the Yellow River in Ningxia, located in the middle and upper reaches of the Yellow River, serves as the population and economic center of Ningxia. Quantitatively analyzing the spatiotemporal distribution characteristics of the fraction of vegetation cover （FVC） in this region and its driving factors is of great significance for promoting ecological protection and the construction of a leading area for high-quality development in the Yellow River Basin. In this study, Landsat satellite remote sensing data were utilized to derive the vegetation cover from 2001 to 2020 in the cities along the Yellow River in Ningxia using a pixel-based binary model. The spatial pattern and spatiotemporal changes were analyzed. Additionally, meteorological data and topographic information for the same period in this region were combined. Sen+Mann-Kendall trend analysis, Hurst index, and parameter-optimized geographical detector models were used to analyze the driving factors. The results indicated： ① From 2001 to 2020, there was a significant overall increasing trend in vegetation cover in the urban belt along the Yellow River in Ningxia （ P &lt;0.01）, with a growth rate of 0.25% per annum. The 20-year average FVC was 33.38%, and the vegetation cover was at a relatively low level. In terms of spatial distribution, the vegetation was high in the northeast and low in the southwest, and the main types were very low vegetation coverage and low vegetation coverage. ② During the 20 years, the vegetation condition of the urban belt along the Yellow River in Ningxia had been significantly improved, and the portion of the area with improved vegetation cover accounted for 62.60%, which was much larger than that of the degraded area, and the average coefficient of variation of FVC was 0.098, which was good for the overall stability. ③ The area with H value of FVC less than 0.5 accounted for 66.15%, which showed strong anti-continuance, the area of FVC with improving trend accounted for 34.84%, the area of continuously stable and unchanged area accounted for 7.8%, the area with degrading trend accounted for 52.9%, and the future trend of FVC was uncertain in 9.0% of the area. ④ The analysis of driving factors revealed that land use type was the primary factor influencing the spatial distribution of vegetation cover in the urban belt along the Yellow River in Ningxia. The explanatory power （ Q value） of interactions among various factors was higher than that of individual factors, demonstrating synergistic and nonlinear relationships among them, with no independent relationships. Risk detection showed that each driving factor had its appropriate range for impacting vegetation growth in the study area.

Objective: To analyze the effect of single pigtail bile duct stents without lateral wings bile duct drainage after removal of common bile duct stones in endoscopic retrograde cholangiopancreatography (ERCP). Methods: Patients who underwent ERCP and implantation of a single pigtail bile duct stent for choledocholithiasis in Cholelithic Center of East Hospital Affiliated to Tongji University from January 2019 to September 2023 were retrospectively selected and divided into lateral wingless group (without the lateral wing) and lateral wing group(with the lateral wing) according to whether the lateral wings of the single pigtail bile plastic stents were preserved. The patients were followed up for 1 to 3 months. The stent detachment rate at 2 days, 1 week and 1 month, as well as the incidence of postoperative complications at 1 week and 1 month after ERCP were compared between the two groups. Results: A total of 402 patients were included, including 177 males and 225 females, aged 32-83 (58±12) years. There were 215 cases in the lateral wingless group and 187 cases in the lateral wing group. The stent detachment rate in the lateral wingless group was higher than that in the lateral wing group at 2 days after ERCP [12.6% (27/215) vs 5.9% (11/187), P =0.022]. The stent detachment rate in the lateral wingless was higher than that in the lateral wing group at 1 week after ERCP [87.0% (187/215) vs 25.1% (47/187), P <0.001]. The stent detachment rate in the lateral wing group was higher than that in the lateral wing group at 1 month after ERCP [97.2% (206/215) vs 67.3% (126/187), P <0.001]. The incidence of postoperative complications at 1 week after ERCP revealed no statistical significance between the two groups[(10.7% (23/215) vs 8.6% (16/187), P >0.05]. The incidence of postoperative complications at 1 month after ERCP in the lateral wingless group was lower than that in the lateral wing group [0.9% (2/215) vs 9.6% (18/187), P =0.001]. Conclusion: After the removal of choledocholithiasis with ERCP, bile is drained by a single pigtail bile duct stent with lateral removal, which has a high rate of natural shedding and a low incidence of complications.

Objective: To exlplore the association between the baseline luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio of polycystic ovary syndrome (PCOS) and in vitro fertilisation-embryo transfer outcomes. Methods: This was a retrospective cohort study. A total of 2 868 PCOS patients were enrolled, all of the participants were patients in The First Affiliated Hospital of Anhui Medical University Hospital from October 2015 to October 2021. Propensity score matching (1∶2.5) was conducted to regulate the non-random allocation of patients. Data were extracted from the hospital's medical records. Patients with baseline LH/FSH ratio>2 were deemed as study group, patients with baseline LH/FSH ratio≤2 were deemed as control group. Single factor analysis was applied to compare the differences of pregnancy outcomes between two groups. Results: After propensity score matching (1∶2.5), there were no statistically significant differences in baseline data between the two groups (all P >0.05), indicating that the data were comparable. In the study group, the total dose of gonadotropin (Gn) and duration of Gn were lower than those of the control group ( t =4.989, P <0.001; t =3.267, P =0.001), the rate of in vitro maturation was higher than that of the control group ( χ 2 =4.938, P =0.026), the number of retrieved oocytes and cleavage were higher than those of the control group ( t =-2.305, P =0.021; t =-2.816, P =0.005), but there were no differences in the number and rate of high-quality embryos between the two groups ( t =-1.636, P =0.102; t =-0.123, P =0.902). The incidence of moderate to severe ovarian hyperstimulation syndrome in the study group was significantly higher than that in the control group ( χ 2 =17.277, P <0.001). Regardless of fresh embryo transfer or frozen-thawed embryo transfer cycles, the incidences of gestational diabetes mellitus in the study group were higher than those in the control group ( χ 2 =9.174, P =0.002; χ 2 =4.204, P =0.040) of singleton pregnancy. In the fresh embryo transfer cycle, the clinical pregnancy rate [30.30% (20/66) vs 47.75% (53/111)] and delivery rate [30.30% (20/66) vs 46.85% (52/111)] in the study group were lower than those in the control group ( χ 2 =5.198, P =0.023; χ 2 =4.695, P =0.030). In the frozen-thawed embryo transfer cycle, the delivery rate in the study group was higer than that in the control group [59.41% (423/712) vs 55.04% (1 053/1 913); χ 2 =7.526, P =0.023]. The clinical pregnancy rate and delivery rate of fresh embryo transfer cycle in the study group were significantly lower than those of frozen-thawed embryo transfer cycle ( χ 2 =21.308, P <0.001; χ 2 =20.871, P <0.001), but there were no significant differences in the control group (all P >0.05). Conclusions: PCOS patients with a higher basal LH/FSH ratio are more likely to develop moderate to severe ovarian hyperstimulation syndrome after controlled ovarian stimulation and have a higher incidence of gestational diabetes mellitus. Better pregnancy outcome could be obtained by frozen-thawed embryo transfer.

The wide use of crystalline silicon solar cells in the field of new energy is an important boost for China to achieve the environmental protection goal as soon as possible. However, the production and manufacturing processes of these cells give rise to various occupational hazards at workplace, thus posing health risks to workers. This review provided an overview of production processes of crystalline silicon solar cells, the characteristics of occupational health hazards (productive dust; physical factors, productive toxicant) and proposed occupational protection suggestions.

Objective: To summarize the clinical characteristics of patients with end-stage heart failure who receive heart transplant under extracorporeal membrane oxygenation (ECMO) support. Methods: The clinical data of 12 pediatric patients who received heart transplant with ECMO support in the Seventh Medical Center of Chinese People's Liberation Army General Hospital and Guangdong Provincial People's Hospital, from January 2019 to December 2023 was collected. The data included sex, age, weight, diagnosis, pre-ECMO lactate level, left ventricular ejection fraction (LVEF), vasoactive-inotropic score (VIS), and preoperative ECMO running time. Surgical data included cold ischemia time of the donor heart, cardiopulmonary bypass time, intraoperative use of immunosuppressant, postoperative use of ECMO, duration of postoperative ECMO, rate of successful weaning from ECMO, and survival discharge rate. The paired t -test was performed to compare cardiac function indices before and after left ventricular decompression. Results: The 12 patients ranged in age from 1.1 to 15.8 years, and weighted from 8 to 63 kg. Ten children were diagnosed with dilated cardiomyopathy, one with myocardial underdensification, and one with a novel heterozygous mutation of the SCN5A gene causing overlap syndrome complicated by fatal arrhythmia. Before ECMO, the lactate ranged from 0.6 to>15.0 mmol/L, the LVEF from 6.5% to 43%, and VIS from 3 to 108. Four patients underwent left ventricular decompression supported by preoperative ECMO, and their pulse pressure was significantly increased after decompression ((17.8±2.1) vs. (9.8±1.5) mmHg, 1 mmHg=0.133 kPa, t =11.31, P =0.001), while there was no apparent change in LVEF ((26.8±4.4)% vs. (24.9±4.9)%, t =1.75, P =0.178). A total of 7 children received a second run of ECMO after surgery and 3 of them successfully weaned off ECMO and survived to discharge. In the entire cohort, 10 were successfully weaned from ECMO and 8 survived to discharge. Conclusions: For children with end-stage heart failure supported by ECMO, left ventricular decompression can significantly improve pulse pressure. These patients will eventually require heart transplantation.

The chemical components of Xiaochaihu Granules and absorbed components in rats after oral administration were identified by using ultra performance liquid chromatography-quadrupole orbitrap mass spectrometry(UPLC-Q-Exactive-Orbitrap-MS)and UPLC-triple quadrupole mass spectrometry(UPLC-MS/MS). Separation was performed on a CORTECS UPLC C~+&#95;(18)(2.1 mm×100 mm, 1.6 μm)column with gradient elution using acetonitrile-0.1% formic acid aqueous solution as the mobile phase. Data on the chemical components were collected in positive and negative ion modes and identified based on the retention time, precise molecular weight, fragment ion information in comparison with the reference substance, and literature report. The rat fever model was established by subcutaneous injection of dry yeast. Subsequently, the normal and model rats received oral administration of Xiaochaihu Granules. Blood samples were taken from the orbital vein at different time points after administration, and the plasma was isolated for scanning and identification of absorbed components using the multi reaction monitoring mode(MRM).A total of 112 chemical components were identified in Xiaochaihu Granules, including 63 flavonoids, 31 saponins, 6 organic acids, 4 phenylpropanoids, 3 amino acids and 5 other compounds. Additionally, 18 prototypical components were identified in rat plasma. This study lays the foundation for further study of the therapeutic material and quality control of Xiaochaihu Granules.

Objectives: To analyze the rules of acupoint selection in treatment of cancer-related insomnia with acupuncture and moxibustion by data mining technology., Methods: The articles of cancer-related insomnia treated with acupuncture and moxibustion were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, WOS, Cochrane, and Embase databases, from the inception of each database to January 5, 2024. The prescription database of acupuncture and moxibustion for cancer-related insomnia was established. The descriptive analysis was conducted on the use frequency, meridian tropism and distribution of acupoints. Using SPSS Modeler 18.0 Apriori algorithm, the association rules of acupoint prescriptions were analyzed. With Cytoscape3.9.1 software used, the complex network diagram was plotted, and the cluster analysis of high-frequency acupoints was performed by SPSS26.0 software., Results: Forty-one articles were included, and 67 prescriptions were extracted with 89 acupoints involved, and the total use frequency was 447 times. The top 4 acupoints of the high use frequency were Baihui (GV20), Sanyinjiao (SP6), Shenmen (HT7) and Shenting (GV24). The included meridians were the governor vessel, the spleen meridian, the bladder meridian, the conception vessel, the heart meridian and the stomach meridian. The selected acupoints were mostly distributed on the head, the neck and and the upper and lower limbs. The special acupoints of the high use frequency included the five- Shu points, the crossing points and yuan -primordial points. Regarding acupoint combination, GV24, SP6, HT7, and GV20 were highly correlated. The three effective clusters were categorized among the top 12 acupoints of the high use frequency., Conclusions: In treatment of cancer-related insomnia with acupuncture and moxibustion, the principle focuses on supporting the healthy qi , eliminating pathogens, regulating yin and yang , promoting the circulation of the governor vessel for regulating the spirit, and tranquilizing the mind. The core acupoint prescription may includes GV24, SP6, HT7 and GV20；combined with Zusanli (ST36) and Yintang (GV4 + ) to enhance the therapeutic effect.

Objectives: To study the diagnosis, treatment, and complications of hypophosphatemic rickets (HR) in children, explore effectiveness evaluation indicators for the disease, and understand the pattern in height growth among these patients., Methods: A retrospective analysis of the initial clinical data and five-year follow-up data of 85 children with HR treated at Children's Hospital of Nanjing Medical University from January 2008 to December 2022., Results: Among the 85 children with HR, there were 46 males (54%) and 39 females (46%). The age at initial diagnosis ranged from 6 months to 13 years and 9 months, with a median age of 2.75 years. The average height standard deviation score was -2.0±1.1. At initial diagnosis, children exhibited reduced blood phosphate levels and elevated alkaline phosphatase (ALP), with 99% (84/85) presenting with lower limb deformities. The positive rate for PHEX gene mutations was 93% (55/59). One year post-treatment, there was a significant reduction in ALP levels and the gap between the lower limbs ( P <0.05). The fastest height growth occurred in the first year after treatment, at 8.23 cm/year, with a peak height velocity (PHV) phase lasting about two years during puberty. The height increased by 9-20 cm in male children during the PHV stage and 10-15 cm in female children. Major complications included nephrocalcinosis and hyperparathyroidism. The incidence rate of nephrocalcinosis in the first year after treatment was 55% (22/40), which increased with the duration of the disease ( P <0.001); an increased urinary phosphate/creatinine ratio was positively associated with a higher risk of nephrocalcinosis ( OR =1.740, P <0.001). The incidence of hyperparathyroidism in the first year after treatment was 64% (27/42)., Conclusions: For children presenting with lower limb deformities, short stature, and slow growth, early testing for blood levels of phosphate, calcium, and ALP, along with imaging examinations of the lower limbs, can aid in the early diagnosis of HR. Genetic testing may be utilized for definitive confirmation when necessary. ALP combined with improvements in skeletal deformities and annual height growth can serve as indicators of therapeutic effectiveness for HR. Compared to normal children, children with HR demonstrate a lower height increase during the PHV phase, necessitating close follow-up and timely adjustment of treatment plans Citation:Chinese Journal of Contemporary Pediatrics, 2024, 26(7): 677-682 .

This study reports on three patients with Shwachman-Diamond syndrome (SDS) who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the First Affiliated Hospital of Zhejiang University School of Medicine. Based on relevant literature, the clinical manifestations and genetic mutation characteristics of SDS were summarized, and the efficacy and timing of allo HSCT for such patients were explored. Three SDS patients were all male, with transplant ages of 32, 33, and 32 years old, respectively. All three patients were diagnosed in childhood. Case 1 presented with anemia as the initial clinical manifestation, which gradually progressed to a decrease in whole blood cells; Case 2 and 3 both present with a decrease in whole blood cells as the initial clinical manifestation. Case 1 and 3 have intellectual disabilities, while case 3 presents with pancreatic steatosis and chronic pancreatitis. All three patients have short stature. Three patients all detected heterozygous mutations in the SBDS: c.258+2T>C splice site. The family members of the three patients have no clinical manifestations of SDS. All three patients were treated with a reduced dose pre-treatment regimen (Fludarabine+Busulfan+Me-CCNU+Rabbit Anti-human Thymocyte Globulin). Case 1 and case 2 underwent haploid hematopoietic stem cell transplantation, while case 3 underwent unrelated donor hematopoietic stem cell transplantation. Case 1 was diagnosed with myelodysplastic syndrome transforming into acute myeloid leukemia before transplantation, but experienced early recurrence and death after transplantation; Case 2 is secondary implantation failure, dependent on platelet transfusion; Case 3 was removed from medication maintenance treatment after transplantation, and blood routine monitoring was normal.

Atmospheric precipitation samples were collected in 2018, 2019, and 2021 in Beijing to study the concentrations and changes of the main metal elements and water-soluble ions； the wet deposition fluxes of heavy metals, water-soluble ions, dissolved inorganic nitrogen, and sulfur in the atmospheric precipitation and their impacts on the ecological environment； and the scavenging mechanisms of the typical precipitation to atmospheric pollutants during the study period. The results showed that the precipitation in Beijing during the study period was mostly neutral or alkaline, and the frequency of acid rain occurrence was very low, only accounting for 3.06%. The total concentrations of major metal elements in 2018, 2019, and 2021 were （4 787.46 ±4 704.31）, （7 663.07 ±8 395.05）, and （2 629.13 ±2 369.51） μg·L -1 , respectively. The total equivalent concentrations of ions in 2018, 2019, and 2021 were （851.68 ±649.16）, （973.98 ±850.94）, and （644.31 ±531.16） μeq·L -1 , respectively. The interannual changes in major metal elements and ions followed the order of 2019 &gt; 2018 &gt; 2021. The seasonal average total concentrations of major metal elements in spring, summer, autumn, and winter were （9 624.25 ±7 327.92）, （4 088.67 ±5 710.14）, （3 357.68 ±3 995.64）, and （6 203.19 ±3 857.43） μg·L -1 , respectively, and the seasonal average total equivalent concentrations of ions in spring, summer, autumn, and winter were （1 014.71 ±512.21）, （729.83 ±589.90）, （724.35 ±681.40）, and （1 014.03 ±359.67） μeq·L -1 , respectively, all presenting the order of spring &gt; winter &gt; summer &gt; autumn. NO 3 - and SO 4 2- were the main acid-causing ions in precipitation, whereas NH 4 + and Ca 2+ were the main acid-neutralizing ions. The wet deposition fluxes of the heavy metal Cd were very low [（0.05 ±0.01） mg·（m 2 ·a） -1 ], only accounting for （0.13 ±0.04）% of the total wet deposition fluxes of main metal elements； however, its soil safety years were 291 years, significantly lower than those of other heavy metals, displaying that its ecological risk was relatively the highest. The total wet precipitation flux of water-soluble ions NH 4 + , Ca 2+ , NO 3 - , and SO 4 2- accounted for （85.72 ±2.18）% of the wet precipitation flux of total ions, suggesting that their comprehensive impact on the ecological environment might have been higher. DIN wet deposition flux was mainly characterized by NH 4 + -N, which had a positive impact on the ecological environment in summer. SO 4 2- -S wet deposition flux was higher in summer, so its positive impact on the ecological environment was also greater. The scavenging effects of atmospheric precipitations to pollutants from the air were impacted by various factors, and the synergism effects of these factors could directly influence the scavenging mechanisms of precipitation to pollutants.

Objective: To investigate the effect of exosomes loaded with Lycium barbarum miRNA (Lb-miR2911) on spermatogenic function recovery in non-obstructive azoospermia (NOA) rats through cross-regulation of the Wnt/β-catenin signaling pathways., Methods: We established an NOA model in 30 four-week-old male SD rats by intraperitoneal injection of busulfan. At 5 weeks after modeling, we equally randomized the rats into a model control group (MC，untreated), an Lb-miR2911EXO group (Lb-miR2911EXO ，treated by intratesticular injection of Lb-miR2911-loaded exosomes), and a sham group (Shame，treated by intratesticular injection of exosomes-empty drug), with another 10 male SD rats taken as normal controls（NC）. We observed the uptake and metabolic changes of Lb-miR2911 in the testis tissue of the rats by RNA FISH at 2 and 6 weeks after treatment, detected cell proliferation, spermatogenesis and gene expressions of the Wnt/β-catenin signaling pathways in the testis tissue by Transcriptome sequencing analysis combined with Western blot and RT-PCR at 12 weeks, evaluated the recovery of the spermatogenic function based on the testis tissue morphology and sperm quality, and assessed the organ toxicity of Lb-miR2911 in the tissue and organs of the rats based on histomorphological analysis and the levels of serum TNF-α, IL-1β, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT) and other relevant indicators., Results: After 12 weeks of treatment, histomorphological analysis showed regular arrangement of spermatogenic cells at all levels in the testis tissue, with a large number of mature sperm in the tubular lumen, and with significantly higher Johnsen scores, testis weight, testicular index, sperm concentration and sperm motility in the Lb-miR2911EXO than in the sham group (all P< 0.05). Compared with the model controls, the Lb-miR2911EXO group exhibited remarkably down-regulated gene expression of DACT3 (P< 0.05), up-regulated expressions of DVL2 and β-catenin (P< 0.05), elevated levels of p-DVL2 and β-catenin (nucleus) proteins (P< 0.05), increased expressions of cell proliferation-related genes CCND1, CCNE1 and CCNE2 (P< 0.05) and spermatogenesis-related genes DMC1, CCR6, JAM2 and KLC3 (P< 0.05). No pathological changes were observed in the lung, liver and kidney tissues of the rats, or in the levels of serum TNF-α, IL-1β, AST, ALT, creatinine and urea nitrogen in the rats treated with Lb-miR2911EXO compared with the normal controls (P > 0.05)., Conclusion: Lb-miR2911-loaded exosomes promote spermatogenic function recovery in NOA rats through cross-regulation of the DACT3, Wnt and β-catenin signaling pathways.

This study utilized a prospective, large-sample, multi-center, and registered key specialty approach of hospitals to monitor the application of Reduning Injection. A total of 100 249 adolescent patients aged 14 years and below who received Reduning Injection were monitored, resulting in 83 cases of adverse events, with 76 of them being classified as adverse drug reaction(ADR). The calculated incidence rate of ADR for Reduning Injection was 0.076%, indicating a very rare ADR. The main symptoms of ADR were pruritus, diarrhea, abdominal pain, vomiting, high fever, dyspnea, convulsion, and chills. All ADR cases were reported for the first time, including three new ADR cases and 73 known ADR cases. The categories of ADR was general ADR. All ADR was mild in severity. There were more males than females in ADR patients. One patient had a history of ADR, and the drug causing ADR was buprofen. The largest number of ADR cases occurred when the dosage of Reduning injection was 5-10 mL. The dropping speed was 30 drops or less per min, and the solvent type was 5% glucose injection. The most common manifestation of ADR patients was pruritus, followed by diarrhea, abdominal pain, vomiting, high fever, dyspnea, convulsions, and chills. 72 patients(94.74% of ADR patients) discontinued the drug, and three patients(3.95% of ADR patients) were given oxygen inhalation. 47 cases(61.84% of ADR patients) were treated with medication, of which dexamethasone was the most used(24 cases, 46.15% of ADR patients). 76 ADR patients were cured or improved. ADRs are more likely to occur when diagnosed with acute bronchitis by western medicine and cough by traditional Chinese medicine(TCM), TCM syndrome type is wind heat syndrome, and the combination medicine is ambroxol hydrochloride and bromhexine hydrochloride injection, ascorbic acid/vitamin C injection. This result provides an evidence-based safety basis for active pharmacovigilance of Reduning Injection in adolescents aged 14 years and below.

Programmed death-ligand 1 (PD-L1) is important in maintaining central and peripheral immune tolerance in normal tissues, mediating tumor immune escape and keeping the balance between anti- and pro-inflammatory responses. Inflammation plays an important role in inflammatory lung diseases. This article reviews the research progress and potential clinical value of PD-L1 in inflammatory lung diseases, including acute lung injury, chronic obstructive pulmonary disease, asthma and idiopathic pulmonary fibrosis.

Objective: To investigate the surgical treatment effect and prognostic factors of hilar cholangiocarcinoma. Methods: This is an ambispective cohort study. From August 2005 to December 2022,data of 510 patients who diagnosed with hilar cholangiocarcinoma and underwent surgical resection at the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University were retrospectively collected. In the cohort,there were 324 males and 186 females,with an age of ( M (IQR)) 63(13)years (range:25 to 85 years). The liver function at admission was Child-Pugh A (343 cases,67.3%) and Child-Pugh B (167 cases,32.7%). Three hundred and seventy-two(72.9%) patients had jaundice symptoms and the median total bilirubin was 126.3(197.6) μmol/L(range: 5.4 to 722.8 μmol/L) at admission. Two hundred and fourty-seven cases (48.4%) were treated with percutaneous transhepatic cholangial drainage or endoscopic nasobiliary drainage before operation. The median bilirubin level in the drainage group decreased from 186.4 μmol/L to 85.5 μmol/L before operation. Multivariate Logistic regression was used to identify the influencing factors for R0 resection,and Cox regression was used to construct multivariate prediction models for overall survival(OS) and disease-free survival(DFS). Results: Among 510 patients who underwent surgical resection,Bismuth-Corlett type Ⅲ-Ⅳ patients accounted for 71.8%,among which 86.1% (315/366) underwent hemi-hepatectomy,while 81.9% (118/144) underwent extrahepatic biliary duct resection alone in Bismuch-Corlett type Ⅰ-Ⅱ patients. The median OS time was 22.8 months, and the OS rates at 1-,3-,5-and 10-year were 72.2%,35.6%,24.8% and 11.0%,respectively. The median DFS time was 15.2 months,and the DFS rates was 66.0%,32.4%,20.9% and 11.0%,respectively. The R0 resection rate was 64.5% (329/510), and the OS rates of patients with R0 resection at 1-,3-,5-and 10-year were 82.5%, 48.6%, 34.4%, 15.2%,respectively. The morbidity of Clavien-Dindo grade Ⅲ-Ⅴ complications was 26.1%(133/510) and the 30-day mortality was 4.3% (22/510). Multivariate Logistic regression indicated that Bismuth-Corlett type Ⅰ-Ⅲ ( P =0.009), hemi-hepatectomy and extended resection ( P =0.001),T1 and T2 patients without vascular invasion (T2 vs. T1: OR =1.43 (0.61-3.35), P =0.413;T3 vs. T1: OR =2.57 (1.03-6.41), P =0.010;T4 vs. T1, OR =3.77 (1.37-10.38), P <0.01) were more likely to obtain R0 resection. Preoperative bilirubin,Child-Pugh grade,tumor size,surgical margin,T stage,N stage,nerve infiltration and Edmondson grade were independent prognostic factors for OS and DFS of hilar cholangiocarcinoma patients without distant metastasis. Conclusions: Radical surgical resection is necessary to prolong the long-term survival of hilar cholangiocarcinoma patients. Hemi-hepatectomy and extended resection,regional lymph node dissection and combined vascular resection if necessary,can improve R0 resection rate.

Objectives: To investigate the risk factors for diabetic ketoacidosis (DKA) in children/adolescents with type 1 diabetes mellitus (T1DM) and to establish a model for predicting the risk of DKA., Methods: A retrospective analysis was performed on 217 children/adolescents with T1DM who were admitted to General Hospital of Ningxia Medical University from January 2018 to December 2021. Among the 217 children/adolescents,169 cases with DKA were included as the DKA group and 48 cases without DKA were included as the non-DKA group. The risk factors for DKA in the children/adolescents with T1DM were analyzed, and a nomogram model was established for predicting the risk of DKA in children/adolescents with T1DM., Results: For the 217 children/adolescents with T1DM, the incidence rate of DKA was 77.9% (169/217). The multivariate logistic regression analysis showed that high levels of random blood glucose, hemoglobin A1c (HbA1c), blood ketone body, and triglyceride on admission were closely associated with the development of DKA in the children/adolescents with T1DM ( OR =1.156, 3.20310 15 , 20.131, and 9.519 respectively; P <0.05). The nomogram prediction model had a C -statistic of 0.95, with a mean absolute error of 0.004 between the risk of DKA predicted by the nomogram model and the actual risk of DKA, indicating that the model had a good overall prediction ability., Conclusions: High levels of random blood glucose, HbA1c, blood ketone body, and triglyceride on admission are closely associated with the development of DKA in children/adolescents with T1DM, and targeted intervention measures should be developed to reduce the risk of DKA.

Non-alcoholic fatty liver disease(NAFLD) is a chronic metabolic condition with rapidly increasing incidence, becoming a public health issue of worldwide concern. Studies have shown that farnesoid X receptor(FXR)-based modulation of downstream targets can improve liver function and metabolic status in the patients with NAFLD and may be a potential drug target for treating this di-sease. Great progress has been achieved in the development of drugs targeting FXR for the treatment of NAFLD. A number of studies have explored the traditional Chinese medicine and their active ingredients for the treatment of NAFLD via FXR considering the high safety and efficacy and mild side effects. This paper systematically describes the mechanism of traditional Chinese medicines in the treatment of NAFLD via FXR and the downstream targets, aiming to provide precise targets for the drug development and clinical treatment of NAFLD.

Objective: To investigate the levels of serum surface active protein D (SP-D) and clara cell protein (CCl6) in workers exposed to black silica dust, and analyze its influencing factors. Methods: From July to September 2021, 174 workers in 37 positions exposed to silica dust in 5 ferrous metal foundry were investigated by cross-sectional research method. The exposure concentration of silica dust workers was obtained through occupational health field investigation and detection, and the general situation of the study subjects was obtained through questionnaire survey and peripheral blood was collected. Double antigen sandwich enzyme-linked immunosorbent assay (ELISA) was used to detect the concentrations of SP-D and CC16 in serum of workers. The mean values were compared by one-way ANOVA, and the influencing factors of SP-D and CC16 concentrations in serum were analyzed by ordered multiple logistic regression. Results: The time-weighted average concentration (C-TWA) of 174 workers exposed to silica dust (respirable dust) ranged from 0.09 mg/m(3)~3.58 mg/m(3), and the C-TWA overstandard rate of dust exposed workers was 32.18% (56/174) , with differences among workers in different positions (χ(2)=28.85, P <0.001) . The highest concentration of silica dust was (0.82±0.11) mg/m(3). Using C-TWA<50% OEL occupational exposure limit (OEL) as reference, serum SP-D concentration in workers with ≥50% OEL was increased ( OR =4.95, 95% CI : 1.86~13.17, P =0.001) , while CC16 concentration was decreased ( OR =0.15, 95% CI : 0.05~0.40, P <0.001) ; Serum CC16 concentration decreased in workers exposed to silica dust C-TWA≥OEL ( OR =0.46, 95% CI : 0.28~0.98, P =0.043) . Compared with those with low occupational health literacy, the serum SP-D concentration of workers with high occupational health literacy decreased ( OR =0.48, 95% CI : 0.25~0.92, P =0.027) and CC16 concentration increased ( OR =2.09, 95% CI : 1.10-3.97, P =0.024) . Conclusion: When no abnormality was found in the physical examination of workers, the serum SP-D and CC16 concentration levels changed, and the change was related to the concentration of workers exposed to silica dust.

Some information and records about musk (She, ) and river deer (Zhang, /) can be found in local chronicles or documents in Guizhou. They were taken as the same species in terms of a medicinal animal. The records for their living areas in Guizhou were neither clear nor in detail in the Ming Dynasty, but were specific in the Qing Dynasty and more concise in the period of the Republic of China. The living areas for musk and river deer reduced from the Ming Dynasty to the Republic of China. Such change was believed to be the result of the natural environment and the social factors as well, such as the reclamation of mountain areas in Guizhou, the reduction of forests, and the demand and resulting exorbitant prices that led to excessive hunting.

Objectives: To study the value of serum fibroblast growth factor 23 (FGF23) in the diagnosis of hypophosphatemic rickets in children., Methods: A total of 28 children who were diagnosed with hypophosphatemic rickets in Children's Hospital of Nanjing Medical University from January 2016 to June 2021 were included as the rickets group. Forty healthy children, matched for sex and age, who attended the Department of Child Healthcare of the hospital were included as the healthy control group. The serum level of FGF23 was compared between the two groups, and the correlations of the serum FGF23 level with clinical characteristics and laboratory test results were analyzed. The value of serum FGF23 in the diagnosis of hypophosphatemic rickets was assessed., Results: The rickets group had a significantly higher serum level of FGF23 than the healthy control group ( P <0.05). In the rickets group, the serum FGF23 level was positively correlated with the serum alkaline phosphatase level ( r s =0.38, P <0.05) and was negatively correlated with maximum renal tubular phosphorus uptake/glomerular filtration rate ( r s =-0.64, P <0.05), while it was not correlated with age, height Z-score, sex, and parathyroid hormone ( P >0.05). Serum FGF23 had a sensitivity of 0.821, a specificity of 0.925, an optimal cut-off value of 55.77 pg/mL, and an area under the curve of 0.874 in the diagnosis of hypophosphatemic rickets ( P <0.05)., Conclusions: Serum FGF23 is of valuable in the diagnosis of hypophosphatemic rickets in children, which providing a theoretical basis for early diagnosis of this disease in clinical practice.

Objective: To observe the short-term efficacy, long-term efficacy and safety of acupuncture for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)., Methods: Forty-two patients with CP/CPPS were randomly divided into an acupuncture group (21 cases, 1 case dropped off) and a sham acupuncture group (21 cases). The patients in the acupuncture group were treated with acupuncture at bilateral Zhongliao (BL 33), Huiyang (BL 35), Shenshu (BL 23) and Sanyinjiao (SP 6); the needling depth of Zhongliao (BL 33) and Huiyang (BL 35) was 60 to 80 mm, while Shenshu (BL 23) and Sanyinjiao (SP 6) was directly punctured of 30 mm. The patients in the sham acupuncture group were treated with acupuncture at non-acupoints, including points 2 cm next to Shenshu (BL 23), Zhongliao (BL 33) and Huiyang (BL 35), and the midpoint of the connecting line between the spleen meridian and the kidney meridian. All the non-acupoints were treated with directly puncture of 2 to 3 mm. The needles were left for 30 min in both groups, once every other day in the first four weeks, three times a week, and twice a week in the next four weeks, totally 20 treatments. Before treatment, after treatment and in follow-up of 24 weeks after treatment completion, the National Institutes of Health-chronic prostatitis symptom index (NIH-CPSI) score and urinary flow rate were observed in both groups; the clinical efficacy and safety were evaluated., Results: Compared with those before treatment, the pain and discomfort scores, urination symptoms scores, quality of life scores and total scores of NIH-CPSI in both groups were reduced after treatment in the two groups ( P <0.01), while each item score and total score of NIH-CPSI in the acupuncture group were reduced in follow-up ( P <0.01, P <0.05). After treatment and in follow-up, each item score and total score of NIH-CPSI in the acupuncture group were lower than those in the sham acupuncture group ( P <0.05, P <0.01). After treatment, the maximum and average urinary flow rates in the acupuncture group were higher than those before treatment ( P <0.05), and the average urinary flow rate in the acupuncture group was higher than that in the sham acupuncture group ( P <0.05). The total effective rate was 75.0% (15/20) in the acupuncture group, which was higher than 42.9% (9/21) in the sham acupuncture group ( P <0.05). No significant adverse reactions were observed in the two groups, and there was no significant difference in the incidence of adverse reactions between the two groups ( P >0.05)., Conclusion: Acupuncture could effectively alleviate the clinical symptoms, improve quality of life, and has a sustained, safe and reliable therapeutic effect in patients with CP/CPPS.

Objective: To explore the association between gallbladder adenomyomatosis (GA) and occult pancreaticobiliary reflux (OPBR). Methods: A total of 81 patients with GA who underwent cholecystectomy in Shanghai East Hospital from December 2020 to January 2022 were enrolled, including 48 cases of fundal type, 28 cases of segmental type and 5 cases of diffuse type. Patient's intraoperative bile was coltected and tested for amylase. According to gallbladder bile amylase level, patients were divided into OPBR group (bile amylase>110 U/L) and the control group (bile amylase≤110 U/L). Results: Among 81 patients, 32 were male and 49 were female, and aged (49.1±13.2) years; there were 66 cases in control group, including 27 males and 39 females, and aged (50.0±12.9)years; there were 15 patients in the OPBR group, including 5 males and 10 females, and aged (45.1±14.2) years. In terms of the clinical features of the two groups, there was no significant difference (all P >0.05), except for a significant increase in biliary amylase in the OPBR group compared with the control group ( P <0.001). However, the incidence of OPBR was significantly different in the three types of GA, with a lower incidence of OPBR in the fundal type (10.4%, 5/48) than in the segmental type (28.6%, 8/28) and diffuse type (2/5) ( P =0.038). In addition, segmental GA was more likely to be combined with gallbladder stones (85.7%, 24/28) than fundal GA (58.3%, 28/48) and diffuse GA (3/5) ( P =0.031). Univariate and multivariate logistic regression analyses showed OPBR [ OR (95% CI )=3.410 (1.010 to 11.513), P =0.048] and combined gallbladder stones [ OR (95% CI )=2.974 (1.011 to 8.745), P =0.048] indepenclently correlated with segmental and diffuse GA. Conclusions: The incidence of OPBR is higher in segmental and diffuse GA, and gallstones and OPBR are independently associated with the occurrence of segmental and diffuse GA. These results suggest that OPBR may be the initiating factor for the occurrence and carcinogenesis of segmental and diffuse GA.

Objective: To explore the predictive value of controlling nutritional status (CONUT) score and dialysis age for peritoneal dialysis-associated peritonitis (PDAP). Methods: This study was a follow-up study. Patients with end-stage renal disease who received peritoneal dialysis (PD) for the first time in the Department of Nephrology, the Third Affiliated Hospital of Suzhou University from January 2010 to December 2020 were enrolled in the study. Patients were divided into non-peritonitis group, mono group (only once PDAP occurred in one year) and frequent group (twice or more PDAP occurred in one year) according to the occurrence and frequency of PDAP during follow-up. The demographic, clinical and laboratory data of patients were collected, and the body mass index and CONUT score were recorded after half a year. Cox regression analysis was used to screen the relevant factors, and receiver operating characteristic (ROC) curve was used to analyze the predictive value of CONUT score and dialysis age for PDAP. Results: A total of 324 PD patients were included, with 188 males (58.0%) and 136 females (42.0%), and aged［ M （ Q 1 ， Q 3 ）］48 (37, 60) years old. The follow-up time was 33 (19, 56) months. PDAP occurred in 112 patients (34.6%), including 63 patients (19.4%) in mono group and 49 patients (15.1%) in frequent group. Multivariate Cox regression analysis showed that half-year CONUT score ( HR =1.159, 95% CI : 1.047-1.283, P =0.004) was a risk factor for PDAP, and the baseline CONUT score ( HR =1.194, 95% CI: 1.012-1.408, P =0.036) was a risk factor for frequent peritonitis. The area under ROC curve of baseline CONUT score combined with dialysis age in predicting PDAP and frequent peritonitis was 0.682 (95% CI : 0.628-0.733) and 0.676 (95% CI : 0.622-0.727), respectively. Conclusion: CONUT score and dialysis age have certain predictive value for PDAP, and the predictive value of combined diagnosis is higher, which may be used as a potential predictor for PDAP in PD patients.

Objective: To investigate the effect of moxibustion on the proteins related with apoptosis and nuclear transcription factor kappa B (NF-κB) in hippocampus of diabetic rats with cognitive impairment (CI), so as to explore its mechanism underlying improvement of learning-memory ability., Methods: Thirty SD rats were randomly divided into normal, model and moxibustion groups ( n =10 rats/group). The diabetic model was established by i.p. injection of streptozotocin solution (25 mg·kg -1 ·d -1 ), followed by high-fat diet raising for 4 weeks, and the CI model was confirmed by Morris water maze test. The rats in the moxibustion group were given moxibustion at "Shenting" (GV24), "Baihui" (GV20) and "Dazhui" (GV14) for 20 min each time, the treatment was conducted 6 times a week for 4 weeks. The learning-memory ability was detected by Morris water maze test, the random blood glucose of rats was measured by glucometer and test strips. The protein and mRNA expression levels of Bcl-2, Bax, Caspase-3 and NF-κB p65 in hippocampus were detected by Western blot and quantitative real-time PCR, separately., Results: After modeling, the random blood glucose, escape latency, and the expression levels of Bax, Caspase-3 and NF-κB p65 proteins and mRNAs in the model group were significantly increased, while the expression levels of Bcl-2 protein and mRNA were decreased ( P <0.001， P <0.01, P <0.05) in comparison with the normal group. Following the treatment, the modeling induced increase of blood glucose, escape latency, and the expression levels of Bax, Caspase-3 and NF-κB p65 proteins and mRNAs, as well as decrease of Bcl-2 protein and mRNA expression levels were reversed ( P <0.05, P <0.01, P <0.001)., Conclusion: Moxibustion can improve learning-memory ability in diabetic rats with cognitive impairment, which may be related to its function in regulating the expression levels of hippocampal Bcl-2, Bax, Caspase-3 and NF-κB.

Objective: To study the correlation between ceramic and chronic obstructive pulmonary disease (COPD), and explore its related risk factors. Methods: In January 2021, five representative ceramic enterprises were selected from Chancheng District, Nanhai District, Gaoming District and Sanshui District of Foshan City. The ceramic workers who came to Chancheng Hospital of Foshan First People's Hospital for physical examination from January to October 2021 were selected as the research objects, and 525 people were included. Conduct questionnaire survey and pulmonary function test. Logistic regresion was performed to analyze the influencing facters of COPD among ceramic workers. Results: The subjects were (38.51±1.25) years old, 328 males and 197 females, and the detection rate of COPD was 9.52% (50/525). The incidence of respiratory symptoms such as dyspnea, chronic cough, wheezing and chest tightness, the detection rates of abnormal lung age, abnormal lung function and COPD in males were higher than those in females ( P <0.05). The logistic regression analysis showed that male, age, working years, smoking status and family history of COPD were the risk factors for COPD among ceramic workers ( P <0.05) . Conclusion: The ceramic workers are the high risk population of COPD. We should do a good job in health education, and do a regular physical examination to find the changes of lung function in time, and prevent the occurrence of COPD as soon as possible.

Objective: To investigate the difference in sensitivity between X-ray and three-dimensional reconstruction of computed tomography (3D-CT) for the diagnosis of distal fibular avulsion fracture, and the radiographic presentation of the ossicle., Methods: From January to October 2018, 92 patients with distal fibular avulsion fracture were visited for surgical treatment in Department of Sports Medicine, Peking University Third Hospital, and 60 cases were finally enrolled according to the inclusion and exclusion criteria. Intraoperative detection was regarded as the gold standard, and the diagnostic sensitivity of preoperative ankle X-ray and 3D-CT for the distal fibular avulsion fractures was statistically determined. The ossicle maximum diameter as well as the degree of its displacement were also measured. On 3D-CT, the distance from the ossicle center point to the anterior fibular tuberosity (a), the distance to the fibular tip (b), and the a/b value was used to present the ossicle displacement., Results: Among the 60 patients, 36 and the 52 patients were correctly detected by X-ray and 3D-CT, respectively, and the sensitivities was 60.0% and 86.7%, respectively ( P =0.004). The mean diameter of the ossicle on X-ray and 3D-CT was (9.2±3.9) mm and (10.5±3.2) mm, respectively. The mean distance from the ossicle center to the anterior fibular tuberosity (a) was (17.5±3.6) mm and the mean distance to the fibular tip (b) was (17.4±4.8) mm, with mean a/b values of 1.1±0.7. The intraclass correlation coefficients (ICC) for each measurement ranged from 0.891-0.998 with a high degree of consistency., Conclusion: Compared with X-ray, 3D-CT has higher sensitivity in diagnosing distal fibular avulsion fractures, can help clinicians evaluate ossicle's location and choose surgical methods, and is recommended to be performed in patients with suspected distal fibula avulsion fractures in clinical practice.

With the approach of untargeted metabolomics and correlation analysis, this study aimed to explore the mechanism of Aurantii Fructus from Lingnan region in alleviating dryness by analyzing the different effects of raw Aurantii Fructus(RAF) and processed Aurantii Fructus(PAF) on fecal endogenous metabolism in normal rats. Eighteen Sprague-Dawley(SD) rats were randomly divided into a control group(C), an RAF group(10 g·kg~(-1)), and a PAF group(10 g·kg~(-1)). After seven days of administration, the effects of RAF and PAF on dryness-related indexes were compared, including water intake, fecal water content, salivary secretion, the expression of AQP5, VIP, and 5-HT in the submandibular gland, as well as the expression of AQP3, VIP, and 5-HT in the colon. The fecal samples in each group were determined by LC-MS. Multivariate statistical analysis and Pearson correlation coefficient were used for screening the differential metabolites and metabolic pathways in alleviating dryness of RAF. The results indicated that both RAF and PAF showed certain dryness, and the dryness of RAF was more significant. Moreover, PAF could alleviate dryness of RAF to a certain extent by reducing the water intake, fecal water content, and the expression of AQP3, VIP, and 5-HT in the colon and increasing the salivary secretion and the levels of AQP5, VIP, and 5-HT in the submandibular gland. According to the analysis of fecal metabolomics, 99 and 58 metabolites related to dryness were found in RAF and PAF respectively, where 16 of them played an important role in alleviating dryness of RAF. Pathway analysis revealed that the mechanism of PAF in alleviating dryness of RAF was presumably related to the regulation of riboflavin metabolism, purine metabolism, arginine biosynthesis, pyrimidine metabolism, alanine metabolism, aspartate metabolism, glutamate metabolism, and retinol metabolism pathways. This study suggested that PAF might alleviate dryness of RAF by affecting the metabolic levels of the body, which provides a new basis for further clarifying the processing mechanism of PAF.

Vascular calcification is an active and complex pathological process regulated by several factors. Vascular calcification is closely related to the incidence and mortality of the cardiovascular disease, chronic kidney disease and other diseases, which affects multiple organs and systems, thus affecting people's health. Therefore, more and more attention is paid to vascular calcification. At present, the pathogenesis and clinical practice of vascular calcification have been continuously improved, which mainly includes calcium and phosphorus imbalance theory, vascular smooth muscle cell transdifferentiation theory, bone homeostasis imbalance theory, epigenetic regulation theory, inflammation theory, extracellular matrix theory, new cell fate theory and so on. However, there are still many unsolved problems. Since the occurrence and development of vascular calcification affect multiple organs and systems, this expert consensus gathered clinicians and basic research experts engaged in the study of vascular calcification in order to summarize the progress of various disciplines related to vascular calcification in recent years. The purpose of this consensus is to systematically summarize the latest research progress, treatment consensus and controversy of vascular calcification from the aspects of epidemiology, pathogenesis, prevention and treatment, so as to provide theoretical basis and clinical enlightenment for in-depth research in this field.

Vascular calcification is the crucial factor of high cardiovascular disease morbidity and mortality in patients with chronic kidney disease (CKD), which causes a huge medical and economic burden. It is urgent to explore its pathogenesis and intervention methods. CKD-associated vascular calcification is an ectopic osteogenesis process actively regulated by multiple cells. Vascular smooth muscle cells (VSMCs) undergo osteogenic differentiation in a pro-calcification environment, and secrete matrix vesicles to form calcium and phosphorus crystal deposition sites, which are key events in the development of CKD-associated vascular calcification. This article reviews the new mechanism and technology of CKD-associated vascular calcification and discusses the role of the myokine Irisin in CKD-associated vascular calcification.

Objective: To investigate the feasibility of reducing the iodine delivery rate (IDR) of coronary CT angiography(CCTA)with 100 kVp to 60% of 120 kVp standard. Methods: A total of 205 patients (105 males and 100 females, aged from 23 to 87 years) underwent CCTA due to suspected coronary artery disease in Department of Radiology of Peking University Third Hospital from February to July 2022 were enrolled. Those patients were divided into five subgroups according to their body weight: <50 kg, 50 to 59 kg, 60 to 69 kg, 70 to 79 kg and ≥ 80 kg, respectively. All the cases were scanned with 100 kVp tube voltage and combined with mixed iterative reconstruction technology KARL 3D. The IDR injection protocol was set to 60% of the 120 kVp IDR standard (10% lower than the guideline), and the IDR of each group was 0.9, 1.0, 1.1, 1.3 and 1.4 gI/s, respectively. The CT attenuations (CT value) and noise (SD value) of the aortic root, proximal left anterior descending branch and the distal segments of the right coronary artery, the signal-to-noise ratio (SNR) and contrast noise ratio (CNR) of proximal left anterior descending branch and the distal segments of the right coronary artery, the whole subjective image quality scores of the coronary artery, and effective dose (ED) of CCTA in the five groups were compared. The One-way ANOVA or Kruskal-walls test was used for statistical analysis. Results: There was no significant difference in CT attenuations and noise of aortic root, proximal left anterior descending and the distal segments of the right coronary artery, SNR and CNR of proximal left anterior descending branch and the distal segments of the right coronary artery, and subjective image quality scores among the five groups (all P >0.05). The difference of the dosage of contrast medium and ED among the five groups were statistically significant (all P <0.05). The dosage of contrast medium in the five groups were 30, 34, 38, 43 and 48 ml, and the ED in the five groups was 2.24 (1.88, 2.56), 2.62 (2.24, 3.17), 2.70 (2.48, 3.20), 4.13 (3.85, 4.40) and 4.44 (4.01, 5.02) mSv, respectively. Conclusion: It is feasible to reduce the IDR injection protocol of coronary CT angiography with 100 kVp to 60% of the standard injection protocol with 120 kVp, which is worthy of promotion.

Objective: To observe the effect of Huayu Tongluo (resolving stasis and promoting collateral circulation) moxibustion combined with intradermal needling on depressive symptoms, quality of life and cognitive impairment in patients with mild to moderate depression after cerebral infarction on the basis of western medicine treatment., Methods: Fifty patients with mild to moderate depression after cerebral infarction were randomly divided into an acupuncture combined with western medication group (group A, 25 cases) and a western medication group (group B, 25 cases). In the group B, paroxetine hydrochloride tablets were taken orally, 20 mg after breakfast, once a day, and the dose could be adjusted to the maximum 40 mg/d according to the patients' condition, for 4 weeks totally. On the basis of the treatment in the group B, the group A was treated with Huayu Tongluo moxibustion, namely aconite cake-separated moxibustion at Baihui (GV 20) and suspended moxibustion at Dazhui (GV 14) and Shenting (GV 24), combined with intradermal needling at Shenmen (HT 7), Jianshi (PC 5), Zusanli (ST 36), etc. Huayu Tongluo moxibustion was performed 6 times a week, and intradermal needling was performed 3 times a week，for 4 weeks totally. In the two groups, the scores of Hamilton depression scale (HAMD), stroke specific quality of life scale (SS-QOL) and mini mental state examination (MMSE) were observed before and after treatment, and the clinical efficacy and safety were compared., Results: After treatment, the HAMD score in the each group was decreased compared with that before treatment ( P <0.05), and that in the group A was lower than the group B ( P <0.05); after treatment, the SS-QOL score in the group A and MMSE score in the two groups were increased compared with those before treatment ( P <0.05), and the SS-QOL score in the group A was higher than the group B ( P <0.05). The total effective rate was 88.0% (22/25) in the group A, which was higher than 60.0% (15/25) in the group B ( P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (4.0% [1/25] vs 16.0%[4/25], P >0.05)., Conclusion: On the basis of the treatment of western medication paroxetine hydrochloride tablets, Huayu Tongluo moxibustion combined with intradermal needling therapy can effectively improve the depressive symptoms, quality of life and cognitive impairment of patients with mild to moderate depression after cerebral infarction.

Objective: To retrospectively analyze the clinical features and treatment outcomes of patients with diabetic foot ulcers (DFU), and to investigate the effect of controlling nutritional status (CONUT) scores on the amputation risks and hospital length-of-stay of DFU patients., Methods: A total of 357 DFU inpatients admitted to the Department of Endocrinology, PLA Strategic Support Force Characteristic Medical Center between January 1, 2016 and December 31, 2018 were enrolled and analyzed retrospectively. Based on their CONUT scores, the patients were divided into 3 groups, a normal nutritional status group consisting of patients with CONUT scores 0-1 ( n =100), a mild malnutrition group consisting of patients with CONUT scores 2-4 scores ( n =164), and a moderate-to-severe malnutrition group consisting of patients with CONUT scores≥5 ( n =93). According to whether they underwent amputation, patients were divided into an amputation group ( n =110) and a non-amputation group ( n =247). The clinical characteristics, amputation rate, and hospital length-of-stay were compared between groups with different CONUT scores. Logistic regression was conducted to analyze the independent risk factors of amputation., Results: The total amputation rate of DFU patients was 30.6%. Among all amputations, the major amputation (above-the-ankle amputation) rate was 1.8%, and the minor amputation rate was 98.2%. The amputation rate in patients with mild and moderate-to-severe malnutrition were 1.5 and 3.0 times higher than those in the normal nutritional status group, respectively. Logistic regression analysis showed that the moderate-to-severe nutritional status (5-12 scores), white blood cell, Wagner classification and ankle-brachial index were independent risk factors for amputation., Conclusion: CONUT score is closely associated with amputations in DFU patients. Improving the nutritional status of patients in the early stage could reduce the risk of amputation., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)