To summarize Professor GAO Shuzhong's clinical experience in treating idiopathic tinnitus with a combination of acupuncture and Chinese meteria medica. It is believed that idiopathic tinnitus is mostly caused by weak lungs and spleen， kidney essence deficiency， liver constraint transforming into fire， and binding constraint of heart qi. Treatment advocates the combination of acupuncture and Chinese meteria medica in clinical practice. Acupuncture treatment mainly focus on the method of opening the orifices by syndrome identification in combination with Ermen （TE 21）， Tinggong （SI 19）， Tinghui （GB 2）， Shenmai （BL 62） to regulate qi and blood， and supporting with Baihui （GV 20）， Yintang （EX-HN 3）， Taichong （LR 3）， and Yanglingquan （GB 34） to soothe the liver， resolve constraint， and calm the mind. Oral administration of Chinese medicinal prescription usually includes modified Yiqi Congming Decoction （益气聪明汤） and Tongqi Powder （通气散）， and the external administration of Chinese medicinal prescription can apply self-prescribed Wenqing Powder （温清散） to navel moxibustion.

Objective: To investigate the association between dietary quality and overweight / obesity among primary school students, so as to provide a basis for the prevention and control of childhood obesity. Methods: In September 2022, third-grade students from six primary schools in Ningbo City, Zhejiang Province were selected by a random cluster sampling method. Data on gender, age, height, and weight were collected through questionnaire surveys and physical examinations. Body mass index (BMI) was calculated, and overweight and obesity were determined using gender- and age-specific BMI cut-off points. The Chinese dietary quality questionnaires was administered to assess the intake of health-promoting and restricted foods over the past 24 hours, thereby evaluating overall dietary quality. A multivariate logistic regression model was used to analyze the association between dietary quality and overweight / obesity among primary school students. Results: A total of 1 375 primary school students were included, comprising 722 (52.51%) boys and 653 (47.49%) girls, with a mean age of (8.47±0.30) years. Among them, 165 (12.00%) were overweight and 171 (12.44%) were obese. The score for health-promoting foods was (4.29±2.27) points. The median score of restricted foods was 2.00 (interquartile range, 3.00) points. The total dietary quality score was (10.84±2.42) points. Multivariable logistic regression analysis indicated that the restricted food score was positively associated with overweight (OR=1.073, 95%CI: 1.002-1.148), while the total dietary quality score was negatively associated with overweight (OR=0.911, 95%CI: 0.851-0.976). However, no statistically significant associations were observed between the health-promoting food score and overweight or obesity (both P>0.05), nor between the restricted food score or total dietary quality score and obesity (both P>0.05). Conclusion A higher intake of restricted foods was associated with an increased risk of overweight, while a better dietary quality was associated with a decreased risk of overweight among primary school students.

OBJECTIVE: To investigate short-term effectiveness of robot-assisted fracture reduction and fixation combined with arthroscopic exploration for posterolateral depressed tibial plateau fractures. METHODS: Between January 2022 and January 2024, 8 patients with posterolateral depressed tibial plateau fractures (Schatzker type Ⅲ) were treated using robot-assisted fracture reduction and fixation combined with arthroscopic exploration, with simultaneous treatment of concomitant ligament or meniscus tears. There were 3 males and 5 females with an average age of 54.1 years (range, 42-68 years). Injury mechanisms included traffic accidents (3 cases) and falls (5 cases). The time from injury to operation ranged from 2 to 4 days (mean, 3.1 days). Operation time, intraoperative blood loss, hospital stay duration, visual analogue scale (VAS) score for pain, and complications were recorded. Fracture healing and knee Rasmussen scores were assessed radiographically, while knee function was evaluated using range of motion and Hospital for Special Surgery (HSS) scores. RESULTS: All operations were successfully completed. The operation time was 108-129 minutes (mean, 120.1 minutes). The intraoperative blood loss was 10-100 mL (mean, 41.3 mL). The hospital stay duration was 4-7 days (mean, 5.6 days). All incisions healed by first intention without complication such as peroneal nerve injury, vascular damage, or infection. All patients were followed up 32-48 weeks (mean, 40 weeks). Radiographic follow-up confirmed that the knee Rasmussen scores rated as excellent in 8 patients and all fractures healed with the healing time of 12-16 weeks (mean, 13.5 weeks). The VAS score for pain was 2-4 (mean, 2.8) at discharge and improved to 0 at 1 month after operation. The knee range of motion was 80°-110° (mean, 96.1°) at discharge and increased to 135°-140° (mean, 137.9°) at 1 month after operation. At 3 months after operation, the HSS score was 91-94 (mean, 92.8), all graded as excellent. No severe complication, including implant failure, occurred during follow-up. CONCLUSION For posterolateral depressed tibial plateau fractures, the minimally invasive approach combining robot-assisted fracture reduction and fixation with arthroscopic exploration demonstrates multiple advantages, including shorter operation time, reduced intraoperative blood loss, excellent wound healing, fewer complications, and rapid recovery of knee function. This technique achieves satisfactory short-term effectiveness, while its long-term effectiveness requires further evaluation.
Humans ; Male ; Tibial Fractures/surgery* ; Female ; Middle Aged ; Adult ; Arthroscopy/methods* ; Minimally Invasive Surgical Procedures/methods* ; Fracture Fixation, Internal/methods* ; Aged ; Treatment Outcome ; Robotic Surgical Procedures/methods* ; Operative Time ; Range of Motion, Articular ; Fracture Healing ; Length of Stay ; Tibial Plateau Fractures

Objective To investigate the function of the glutamic-oxaloacetic transaminase 2(GOT2)gene in acute myeloid leukemia cells.Methods ShRNAs targeting at GOT2 were constructed to suppress GOT2 expression in the THP-1 human monocytic leukemia cell line.GOT2 mRNA level was measured by RT-qPCR,and GOT2 protein ex-pression was measured by Western blot.Intracellular free amino acid level was quantified using colorimetric assays.The impact of GOT2 knockdown in THP-1 cell function was evaluated through cell viability(CCK-8 assay)and ap-optosis(flow cytometry).Results After GOT2 knockdown,both GOT2 mRNA and protein were significantly de-creased in THP-1 cells(P＜0.05).Compared to the control group,GOT2 knockdown did not affect intracellular glutamate levels(P＞0.05),but led to a marked decrease in aspartate level(P＜0.05).GOT2 knockdown signifi-cantly impaired THP-1 cell viability,inhibited cell proliferation(P＜0.05)and promoted apoptosis(P＜0.05).Conclusions Down regulation of GOT2 significantly decreases intracellular aspartate level in acute myeloid leukemia cells,impairs cellular viability and induces apoptosis,which suggests that GOT2 may play a key role in the regula-tion of amino acid metabolism in acute myeloid leukemia.

Objective To investigate the effect of PIAS3 on glucose fluctuation-induced oxidative stress and mito-chondrial dysfunction in rat cardiomyocytes.Methods H9c2 were cultured in vitro,and divided into normal glucose control group(Control),mannitol-induced osmotic pressure control group(MG),constant high glucose group(HG),intermittent hyperglycemia group(IHG),IHG+siRNA NC group,and IHG+PIAS3 siRNA group.Cell proliferation was assessed using CCK-8 assay.LDH release,MDA and GSH levels,as well as SOD activity,were detected using corresponding kits.Mitochondrial membrane potential was evaluated via JC-1 staining combined with flow cytometry.ROS levels in cells and mitochondria were determined using DCFH-DA and MitoSOX staining,re-spectively.Protein expression of PI3K,p-PI3K,AKT,and p-AKT was analyzed by Western blot.Results Com-pared with the control group,intermittent hyperglycemia promoted oxidative stress and mitochondrial dysfunction,significantly upregulated PIAS3 expression(P＜0.001)and downregulated p-PI3K and p-AKT protein levels(P＜0.001).Knockdown of PIAS3 significantly alleviated oxidative stress and mitochondrial dysfunction induced by glucose fluctuations,and increased p-PI3K and p-AKT protein levels(P＜0.001).Conclusions Knockdown of PIAS3 may alleviate glucose fluctuation-induced oxidative stress and mitochondrial dysfunction in ratcardiomyocytes by activating the PI3K/AKT signaling pathway.

To evaluate the safety and efficacy of oral double-balloon enteroscopy for small intestinal bezoars with obstruction, the clinical, endoscopic, imaging, pathological and surgical data of patients with small intestinal bezoars and obstruction treated in Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from December 2021 to March 2023 were retrospectively analyzed. A total of 5 patients, all female, aged 52-83 years, were included. The clinical manifestation was mainly digestive tract obstruction. The diameter of bezoars was 30-50 mm. Three were located in the jejunum, one in the proximal ileum, and one at the jejuno-ileal junction. Three cases were diagnosed as having small intestinal bezoars by imaging examination before operation. All 5 patients achieved technical success. Four patients achieved clinical success, the symptoms of obstruction were completely relieved, and 1 patient was partially relieved due to malignant obstruction. No obvious complication occurred in 5 patients after operation. The follow-up time was 15-790 days, and there was no recurrence. The results showed that oral double-balloon enteroscopy for small intestinal bezoars was safe and effective, providing a new treatment for patients with small intestinal bezoars except for surgery.

The ninth edition of TNM staging for lung cancer has been announced at the 2023 World Lung Cancer Congress and implemented from January 1, 2024. The focus of the ninth TNM staging change is dividing N2 into N2a and N2b, as well as M1c into M1c1 and M1c2. Although the T staging has not changed, it has played an important role in verifying the eighth edition of the T staging. The subdivision of stage N2 has led some patients with ⅢA of the eighth edition to experience ascending or descending stages, which will more accurately help to assess the condition and prognosis of patients with mediastinal lymph node metastasis, as well as the design of related clinical studies. Modifying the M1c staging will help define oligometastasis and explore new treatment models in the future. The ninth edition of the TNM staging system provides a more detailed division of different tumor loads, but there is no clear explanation for the staging of lung cancer after neoadjuvant therapy. Further data analysis is needed, and it is expected to be answered in the tenth edition of TNM staging.

Objective To observe the value of spectral CT multi-parameter imaging for preoperative predicting lymph node metastasis(LNM)of gastric cancer.Methods Totally 136 patients with gastric adenocarcinoma were retrospectively enrolled.The patients were further divided into LNM group(n=74)and non-LNM group(n=62)according to postoperative pathological findings of lymph nodes status.Clinical data,conventional CT findings and spectral CT parameters were compared between groups.Factors being significant different between groups were included in multivariate logistic regression analysis to screen independent predictors of gastric cancer LNM.Clinical+conventional CT model(model 1),spectrum CT model(model 2)and combined model(model 3)were constructed based on the above independent predictors,respectively.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of each model for preoperative predicting LNM of gastric cancer.Results CT-N stage,CT-T stage,70,100 and 140 keV CT valuestumor at arterial phase(AP),arterial enhancement fraction(AEF)and normalized iodine concentration at venous phase(NICVP)were all independent predictors of gastric cancer LNM(all P＜0.05).AUC of model 3 was 0.846,higher than that of model 1 and model 2(AUC=0.767,0.774,Z=-0.368,-2.373,both P＜0.05)for preoperative predicting LNM of gastric cancer,while the latter two were not significantly different(Z=-0.152,P=0.879).Conclusion Spectral CT multi-parameter imaging could effectively predict LNM of gastric cancer preoperatively.

Objective:To explore the impact of social support, self-efficacy, and neurological function on disease acceptance in stroke patients.Methods:From September 2022 to February 2023, convenience sampling was used to select 322 stroke patients from Shanghai Hospital of Traditional Chinese Medicine and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine as participants. The survey was conducted using the General Information Questionnaire, Perceived Social Support Scale (PSSS), Stroke Self-Efficacy Questionnaire (SSEQ), Acceptance of Illness Scale (AIS), and National Institute of Health Stroke Scale (NIHSS) .Results:The AIS, PSSS, SSEQ, and NIHSS scores of stroke patients were (21.88±10.66), (52.64±13.80), (73.92±28.91), and (5.37±3.64), respectively. Social support of patients had a positive impact on disease acceptance ( P<0.01). Self-efficacy partially mediated the relationship between social support and disease acceptance, with indirect effects accounting for 48.84% of the total effect. The second half of the mediating effect of "social support→self-efficacy→disease acceptance" (self-efficacy→disease acceptance) was regulated by neurological function ( β=-0.020, P<0.01) . Conclusions:Medical and nursing staff can increase patients' social support, enhance their self-efficacy, and strengthen targeted interventions for patients with high levels of neurological deficits, thereby improving their disease acceptance.