Objective To observe the clinical effect of myofascial release on treatment of patients with chronic tention headache. Methods A total of 100 patients with chronic tention headache, admitted to our hospital from January 2012 and January 2014 and met the inclusion criteria, were chosen in our study; According to the will of the patients, they were divided into treatment group (n=50) using myofascial release and control group (n=50) with traditional massage. The treatment time was 30 min per day for 5 days as a therapeutic cycle, interval for 2 days to continue the next cycle, and they received treatment for a total of 8 weeks. The headache index, syndrome improvement, changes of headache times and headache impact scale-6 scores were recorded and analyzed;the clinical efficacies of these two treatment methods were compared. Results The treatment efficacy of treatment group was significantly better as compared with that of control group in the aspects of total effective rate (96%vs. 76%, x2=4.757, P=0.004), changes of headache index (11.11±10.28 vs. 19.37±10.56, t=3.963, P=0.000), changes of headache times at three months after treatment (12.06±5.86 vs. 15.35±6.02, t=2.770, P=0.007) and changes of headache impact-6 scores (44.58±6.50 vs. 52.81±8.02, t=5.637, P=0.000). Conclusion Myofacial release has better efficacy than traditional massage in treating chronic tention headache; the method of myofacial release is simple and easy to apply, with good value of clinical applications.

Objective: To explore the feasibility and the value of CT enterography (CTE) in the quantitative evaluation of Crohn's disease (CD). Methods: Retrospectively analyzed 49 patients diagnosed as CD by clinical, enteroscopy, pathology, and imaging from April 2016 to June 2017 in Zhongnan Hospital of Wuhan University. All patients underwent routine enteroscopy and standardized CTE. The interval between the two examinations was less than 2 weeks. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured at intervals. The ESR ranged from 2.0 to 97.0 mm/1 h, with an average of (30.6±26.5) mm/1 h, CRP from 0.3 to 143.3 mg/L, and a median of 27.7 mg/L. CD patients were classified into inactive, mild and moderate-severe according to Crohn's disease simplified endoscopic activity score(SES-CD) after enteroscopy. CTE evaluated the site of lesion, the thickness and enhanced patterns of the most severe lesions of the bowel wall, mural enhanced CT value in the portal vein phase, ΔCT value, stenosis, perienteric inflammation, mesenteric hypervascularity (comb sign), enlarged lymph nodes, abdominal abscesses, fistulas, etc. The Chi-square test was used to compare the differences of enhanced patterns among different groups. ANOVA (Analysis of Variance) was used to compare the differences in bowel wall thickness, plain CT values, mural enhanced CT value in the portal vein phase and ΔCT values among different groups. The correlation between CTE parameters and SES-CD or laboratory data was analyzed by Pearson (normal distribution data) or Spearman (skewed distribution data). Results: SES-CD ranged from 1 to 15, with an average of 5.1±2.6. Among 49 cases, 13 were inactive, 19 were mild, and 17 were moderate-severe. There were 25 cases of intestinal obstruction or stenosis, including 24 cases in the active group and 1 case in the non-active group, and the difference was statistically significant (χ²=13.3, P<0.01). The short diameter of lymph nodes was more than 10 mm in 7 patients, all of them were active patients; 32 cases were mesenteric hypervascularity, manifested as "comb sign" , among them, 28 cases were active and 4 cases were non-active, and the difference was statistically significant (χ²=9.3, P<0.01). Perienteric inflammation was manifested in 30 cases, including 27 cases in the active group and 3 cases in the non-active group, and the difference was statistically significant (χ²=10.8, P<0.01). The enhanced patterns of thickened bowel wall in the non-active was dominated by C and D types, while A and B types was mainly in the active group, and the difference was statistically significant (P<0.05); There were significant differences in bowel wall thickness, mural enhanced CT value in the portal vein phase and ΔCT values between different groups (P<0.05), however, the difference of plain CT values between different groups was not significant (P>0.05). Bowel wall thickness, mural enhanced CT value in the portal vein phase and ΔCT values were all moderately correlated with SES-CD (r were 0.564, 0.585, 0.533, respectively; P all <0.01). Bowel wall thickness was positively correlated with ESR and CRP(r were 0.542, 0.452, respectively; P all <0.01). Mural enhanced CT value in the portal vein phase and ΔCT values were not correlated with ESR or CRP (P>0.05). Conclusion The bowel wall thickness, mural enhanced CT value in the portal vein phase and the ΔCT value can be used to accurately assess the activity of CD lesions.

Objective:By comparing the clinical data and follow-up data of patients with coronary heart disease combined with chronic kidney disease who choose different ways of revascularization for the first time when do PCI revascularization therapy again. To investigate the effect of coronary artery bypass grafting on revascularization for the first time in patients.Methods:A retrospective analysis of clinical data of 358 patients with coronary heart disease combined with chronic kidney disease who received revascularization PCI from January 2008 to December 2017 was made. All the patients were divided into CABG group(75 cases) and PCI group(283 cases) for clinical characteristics and prognosis comparison. According to the occurrence of major adverse cardiovascular events, Cox regression was carried out to establish a risk prediction model. Results:Compared with the patients in the two groups, the ratio of current smoking(17.33% vs. 33.57%, P=0.006) and hospitalized patients with recurrent acute myocardial infarction(28.00% vs. 40.64%, P=0.045) were decreased in CABG group, the ratio of triple-vessel disease(82.67% vs. 55.12%, P<0.001) and road via femoral artery(49.33% vs. 24.03%, P<0.001) were significantly increased in the CABG group, the Gensini score[136.00(100.75, 164.00) vs. 53.00(39.00, 74.00), P<0.001] and contrast agent dosage [300(200, 400)ml vs. 200(200, 300)ml, P<0.001] were significantly higher in CABG group, but the incidence of MACCE was significantly lower in CABG group than in PCI group (40.00% vs. 57.60%, χ2=7.571, P=0.0059). According to the Cox regression of MACCE events, it was found that CABG ( RR=0.586, 95% CI: 0.396-0.867, P=0.007) and higher glomerular filtration rate( RR=0.988, 95% CI: 0.980-0.997, P=0.007) were the protective factors, white blood cell elevation( RR=1.100, 95% CI: 1.020-1.187, P=0.013) and the application of renin-angiotensin-aldosterone system inhibitor( RR=1.380, 95% CI: 1.016-1.875, P=0.039) were independent risk factors. Conclusion:Patients with coronary heart disease combined with chronic kidney disease can benefit from CABG for the first time in revascularization, when they were confronted with PCI revascularization again.

Objective:To investigate the clinical value of totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization for portal hypertension com-plicated with splenic aneurysm.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 17 patients with portal hypertension complicated with splenic aneurysm who were admitted to 2 medical centers (15 cases in Shenzhen University General Hospital and 2 cases in Wuhan First Hospital) from January 2013 to May 2020 were collected. There were 7 males and 10 females, aged (59±14)years. All patients underwent totally laparoscopic exoclusion of splenic artery aneurysm combined with pericardial devascularization. Observation indicators : (1) surgical and postoperative conditions; (2) complications; (3) follow-up. Follow-up was conducted by out-patient examiantion and telephone interview to detect the effect of exclusion of arterial tumor, and blood re-flow, portal vein thrombosis and survival of patients 3 months after operation. The follow-up was up to December 2020. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Results:(1) Surgical and postoperative conditions. All 17 patients successfully completed the operation, without perioperative death. The operation time, volume of intraoperative blood loss of 17 patients were (181±30)minutes, 187(range, 90?420)mL. The white blood cell count, red blood cell count, hemoglobin, serum albumin were (9±4)×10 9/L, (3.5±0.9)×10 12/L, (86±17)g/L, (36±7)g/L on the postoperative day 3. Time to postoperative abdominal drainage tube removal and duration of post-operative hospital stay were (7±4)days and (11±4)days. (2) Complications. All 17 patients had ascites after surgery, which were improved after oral treatment with diuretics. There was no complication such as intra-abdominal hemorrhage, gastrointestinal fistula, pleural effusion, infection, abscess formation, fever and vascular embolism. (3) Follow-up. All the 17 patients were followed up for 28.6(range, 7.0?84.0)months. During the follow-up, the splenic aneurysm cavity of all patients was completely isolated, no blood re-flow and no portal vein thrombosis was observed, and no patient died. Conclusion:Totally laparoscopic exclusion of splenic artery aneurysm combined with pericardial devascularization is safe and feasible in the treatment of portal hypertension complicated with splenic aneurysm.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

Metabolic reprogramming is a hallmark of cancer, including lung cancer. However, the exact underlying mechanism and therapeutic potential are largely unknown. Here we report that protein arginine methyltransferase 6 (PRMT6) is highly expressed in lung cancer and is required for cell metabolism, tumorigenicity, and cisplatin response of lung cancer. PRMT6 regulated the oxidative pentose phosphate pathway (PPP) flux and glycolysis pathway in human lung cancer by increasing the activity of 6-phospho-gluconate dehydrogenase (6PGD) and α-enolase (ENO1). Furthermore, PRMT6 methylated R324 of 6PGD to enhancing its activity; while methylation at R9 and R372 of ENO1 promotes formation of active ENO1 dimers and 2-phosphoglycerate (2-PG) binding to ENO1, respectively. Lastly, targeting PRMT6 blocked the oxidative PPP flux, glycolysis pathway, and tumor growth, as well as enhanced the anti-tumor effects of cisplatin in lung cancer. Together, this study demonstrates that PRMT6 acts as a post-translational modification (PTM) regulator of glucose metabolism, which leads to the pathogenesis of lung cancer. It was proven that the PRMT6-6PGD/ENO1 regulatory axis is an important determinant of carcinogenesis and may become a promising cancer therapeutic strategy.