Objective:To investigate the correlation between serum visfatin level and the risk of relapse after radiofrequency ablation in patients with atrial fibrillation(AF).Methods:The clinical data of 1 120 patients with AF who were admitted to the First Affiliated Hospital of Xinjiang Medical University and treated with radiofrequency ablation from June 2020 to December 2021 were retrospectively analyzed, and the general data as well as the results of preoperative and postoperative 12 months 24 h echocardiography and laboratory test index were collected. Followed up for 12 months, the patients′recurrence of AF was observed, and the changes of preoperative and postoperative 12 months echocardiography and laboratory test index were compared between the patients with and without recurrence of AF; the risk factors affecting the recurrence of AF after radiofrequency ablation were analyzed by Logistic regression analysis, the correlation of visfatin level and the recurrence of radiofrequency ablation was analyzed by Pearson test.Results:The results of Logistic regression analysis showed that the patients′ age ( OR = 2.344), body mass index ( OR = 2.090), persistent AF ( OR = 3.655), hypertension ( OR = 3.529 ), coronary artery disease ( OR = 4.035), preoperative left atrial diameter (LAD) ( OR = 3.644 ), visfatin level ( OR = 2.136 ) and postoperative 12 months LAD ( OR = 2.046), left atrial volume index(LAVI) ( OR = 2.237), atrial natriuretic polypeptide (ANP) ( OR = 3.600), visfatin ( OR = 3.699), and highly sensitive C-reactive protein (hs-CRP) ( OR = 3.586) levels at 12 months postoperatively were risk factors for recurrence in AF patients ( P<0.05). In the recurrence group, there were no statistical differences in LAD, LAVI, ANP, visfatin, and hs-CRP levels at 12 months postoperatively compared with preoperative levels ( P>0.05). The results of Pearson test showed that there was a positive correlation between AF recurrence and visfatin level after radiofrequency ablation ( r = 0.420, P = 0.013). Conclusions:There are many factors affecting AF recurrence after radiofrequency ablation in patients with AF, the common ones are age, left heart enlargement, hs-CRP level, etc. Meanwhile, high level of visfatin before and after surgery is also an important factor of AF recurrence.

This study explored the ideas and methods of acupuncture for Guillain-Barré Syndrome （GBS） with the core principle of “to treat flaccidity， select the yangming （阳明） channel only”. The main pathological mechanism of GBS is deficiency of qi and blood in the yangming channel， malnutrition of all sinews， diminished spleen and stomach function leading to the production of pathogenic damp-heat qi， which obstructs the meridians， and gradually affects the liver and kidneys， consuming essence and damaging blood. Concurrently， dysfunction of the dumai （督脉） pivotal mechanism and lack of moisture in sinews and vessels result in symptoms such as skin numbness， paralysis， and muscle wastage. In clinical diagnosis and treatment， a combination of syndrome and channel differentiation is taken. Treatment primarily focuses on acupoints of yangming channel， aiming to supplement qi and blood， and acupoints of du mai are combined to open the vessel and fill the marrow. Specific acupoints are selected based on syndrome differentiation， providing comprehensive regulation to promote harmonization of qi and blood， relieve meridians， and the smooth generation and circulation of whole body fluids. This， in turn， enhances the strength of muscles and bones， and fosters a robust and freely moving body.

Objective:To evaluate the calf muscle cross-sectional area (CSA) and fat fraction (FF) in amateur marathon runners based on T 2WI-Flex fat-suppression sequence and iterative decomposition of water and fat with echo asymmetrical and least-squares estimation quantitation sequence (IDEAL-IQ) technique, and to explore the correlation between them and age, body mass index (BMI), running age, speed exercise, and monthly exercise. Methods:From September to November 2022, 37 amateur marathon group (marathon group) and 12 healthy volunteers (control group) who did not often exercise were recruited in Shijiazhuang. T 2WI-Flex fat-suppression sequence and IDEAL-IQ sequence were performed on all subjects. The anterior group of the right calf (tibialis anterior, extensor hallucis longus, extensor digital longus), external group of the calf (peroneus longus, peroneus brevis), soleus, medial head and lateral head of the gastrocnemius were delineated along the edge of the muscle contour as regions of interest, and the CSA and FF values of the muscles were obtained. Twelve subjects matched with the clinical data of the control group were selected from the marathon group (marathon matched group), and the differences in CSA and FF were compared by independent sample t test or Mann-Whitney U test. Spearman correlation analysis was used to evaluate the correlation between CSA and FF values of the right calf and running-related indicators including age, BMI, running age, speed exercise, and monthly exercise in 37 amateur marathon runners. Results:The CSA of the right calf soleus muscle in the marathon matched matched group was larger than that in the control group ( t=-2.09, P=0.048). There was no significant difference in CSA of other calf muscles between the two groups ( P>0.05). The FF values of the right calf anterior group, the outer group, the soleus muscle, the medial head and the lateral head of the gastrocnemius muscle in the marathon matched group were lower than those in the control group ( P<0.05). The BMI of 37 amateur marathon runners was positively correlated with the CSA and FF values of the anterior group, the outer group, the soleus, the medial head and the lateral head of the gastrocnemius muscle (CSA: r=0.628, 0.468, 0.680, 0.566, 0.615, respectively, all P<0.05; FF value: r=0.395, 0.567, 0.631, 0.482, 0.516, respectively, all P<0.05). The FF values of the anterior group, the outer group, the soleus, the medial head and the lateral head of the gastrocnemius muscle were negatively correlated with monthly exercise ( r=-0.337, -0.405, -0.437, -0.338, -0.446, respectively, all P<0.05). Conclusions:Long-term running training can reduce the FF value of each calf muscle group, and the FF value of calf muscles is negatively correlated with the amount of running each month. Long-term running training has the greatest effect on the CSA of soleus muscle.

Objective:To analyze the effect of Excel tabular nutrition assessment management combined with mental awareness intervention in patients with chronic renal failure.Methods:Using the convenient sampling method, a total of 90 patients with chronic renal failure who were treated in Department of Nephrology of Huai'an Second People's Hospital in Jiangsu Province from January to December 2020 were selected. They were divided into the control group and the research group by computer random number method, with 45 cases in each group. The control group was given routine nursing and mental awareness intervention, while the research group was given Excel tabular nutrition assessment management on the basis of the control group. Self-Rating Anxiety Scale (SAS) , Self-Rating Depression Scale (SDS) , Mindful Attention Awareness Scale (MAAS) and Kidney Disease Quality of Life Short Form (KDQOL-SFTM) were respectively used to evaluate the level of adverse psychology, mental awareness and quality of life of patients in two groups. The levels of nutritional indicators, adverse psychological mood, mental awareness and quality of life were compared between the two groups.Results:SAS score and SDS score of the two groups after intervention were lower than before intervention, and that of the research group was lower than the control group. The MAAS score of the two groups after intervention was higher than before, and that of the research group was higher than the control group. Quality of life scores in both groups were higher than before intervention and those of the research group were higher than the control group, and the differences were statistically significant ( P<0.05) . Conclusions:The application of Excel tabular nutrition assessment management combined with mental awareness intervention in patients with chronic renal failure can relieve negative emotions of patients, improve their mental awareness and improve their quality of life.

ObjectiveTo investigate the effect of different cytopathological grading standards on the efficiency of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic cancer. MethodsRelated clinical data and pancreatic cytopathological results were collected from 256 patients with pancreatic space-occupying lesions who underwent EUS-FNA in The First Affiliated Hospital of Anhui Medical University from May 2011 to March 2019, and the influencing factors for the diagnostic efficiency of EUS-FNA were analyzed based on surgical pathology and follow-up results. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of different cytopathological grading standards in the diagnosis of pancreatic cancer. ResultsA total of 67 patients who were lost to follow-up were excluded, and a total of 189 patients were included in the study. According to the Papanicolaou cytopathological standard, there were 47 cases of heterotypic cells, 25 cases of suspected cancer cells, 20 cases of cancer cells, and 97 cases without tumor cells based on EUS-FNA. A total of 133 patients were confirmed to have pancreatic cancer by postoperative pathology and follow-up results, among whom 52 had no tumor cells, 36 had heterotypic cells, 25 had suspected cancer cells, and 20 had cancer cells based on cytopathological results. EUS-FNA had a true positive rate of 6090% (81 patients) and a false negative rate of 39.10% (52 patients) in the diagnosis of pancreatic cancer; for the 56 patients without pancreatic cancer, EUS-FNA had a false positive rate of 19.64% (11 patients) and a true negative rate of 80.36% (45 patients). EUS-FNA had an area under the ROC curve of 0.643 (95% confidence interval: 0.561-0.724) in the diagnosis of pancreatic cancer. In combination with different cytopathological grading standards and with the diagnostic criteria of “the identification of heterotypic cells or suspected cancer cells or cancer cells was considered positive”, “the identification of suspected cancer cells or cancer cells was considered positive”, and “the identification of cancer cells was considered positive”, the results showed that the diagnostic criteria of “the identification of heterotypic cells or suspected cancer cells or cancer cells was considered positive” improved the efficiency of EUS-FNA in the diagnosis of pancreatic cancer, with a sensitivity of 50.38% and a specificity of 75.00%. Among the 189 patients, 13 (6.88%) experienced complications after EUS-FNA, which included hyperamylasemia and abdominal pain. ConclusionThe combination of different cytopathological grading standards can help improve the efficiency of EUS-FNA in the diagnosis of pancreatic cancer.

Objective:To compare the analgesic effects of naborphine and desorine after surgery for supracondylar fracture of humerus in children.Methods:Eighty-seven children with supracondylar fracture of humerus who received surgical treatment in Zhoushan Hospital of Traditional Chinese Medicine between January 2019 and January 2020 were included in this study. They were randomly assigned to receive postoperative analgesia either with dezocine (control group, n = 44) or naborphine (observation group, n = 43). The postoperative agitation score, postanesthetic recovery score, postoperative visual analogue scale score, and adverse reactions were determined between the two groups. Results:The heart rate and mean arterial pressure at the time of extubation were (102 ± 7) beats/min and (83 ± 6) mmHg respectively in the observation group, which were significantly lower than those in the control group [(115 ± 8) beats/min, (92 ± 7) mmHg, t = 6.214, 8.283, P < 0.05]. In the observation group, the postoperative agitation score was (4.45 ± 0.34) points, (5.02 ± 0.38) points, and (3.65 ± 0.39) points, at the time of spontaneous eye opening, at the time of extubation and at 30 minutes after extubation respectively, which were significantly lower than those in the control group [(5.31 ± 0.48) points, (5.75 ± 0.35) points, (4.12 ± 0.37) points, t = 6.392, 7.194, 7.382, all P < 0.05]. At 30 min, 3 h and 6 h after surgery, the visual analogue scale scores in the observation group were significantly lower than those in the control group ( t = 5.345, 6.124, 7.553, P < 0.05). The time to return to spontaneous breathing, the time to spontaneous eye opening and the time to extubation in the observation group were (7.32 ± 4.17) min, (11.65 ± 3.32) min, (12.13 ± 2.41) min, respectively, which were significantly shorter than those in the control group [(10.34 ± 4.15) min, (14.43 ± 3.18) min, (15.16 ± 2.23) min, t = 7.216, 5.382, 7.319, all P < 0.05]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [6.97% (3/43) vs. 27.27% (12/44), χ2 = 6.280, P < 0.05]. Conclusion:Naborphine for analgesia after surgery for supracondylar fracture of humerus in children can effectively reduce the incidence of agitation during the recovery period, enhance postoperative analgesic effect, and lower the incidence of reverse reactions.

Objective To investigate the endoscopic ultrasound (EUS) features of distal biliary stricture (DBS), and to provide a clinical basis for the evaluation of DBS by EUS. Methods Related clinical data were collected from 175 patients with DBS who underwent EUS examination in The First Affiliated Hospital of Anhui Medical University from April 2016 to March 2020 to analyze their clinical manifestation, laboratory examination results, imaging findings, and EUS findings, and the patients were followed up to summarize the EUS features of DBS. The chi-square test was used for comparison of categorical data between groups, and the t -test was used for comparison of continuous data between groups. Results Among the 175 patients with DBS, 85(48.57%) had benign DBS and 90(51.43%) had malignant DBS. Compared with the patients with benign DBS, the patients with malignant DBS had a significantly longer length of stricture on EUS (14.1±3.0 mm vs 7.9±3.0 mm, t =13.358, P < 0.001) and significantly higher incidence rates of the characteristic changes on EUS such as hypoechoic space-occupying lesions in lumen (57.8% vs 34.1%, χ 2 =9.843, P =0.002), peripheral lymph node enlargement (26.7% vs 12.9%, χ 2 =5.147, P =0.023), and pancreatic duct dilatation (51.1% vs 28.2%, χ 2 =9.532, P =0.002). EUS combined with magnetic resonance cholangiopancreatography had a sensitivity of 70.6% in the diagnosis of benign DBS and a sensitivity of 92.2% in the diagnosis of malignant DBS. Conclusion The characteristic EUS features of DBS, such as long length of stricture, hypoechoic lesion, peripheral lymph node enlargement, and pancreatic duct dilatation, may help with the differential diagnosis of DBS in clinical practice.

Objective To study the biomechanical performance of proximal femoral nailing antirotation (PFNA) in the treatment of femoral intertrochanteric fracture involving the lateral wall using finite element analysis and the significance of the lateral wall.Methods A healthy senior volunteer,male,80 years of age,was recruited for this study.The CT data of his proximal femur were used to establish a three-dimensional finite element model of proximal femur by software Mimics17.0 and Geomagic Stusio.After the intertrochanteric fracture of AO-type 31-A1.2 was simulated together with coronal displacement of the lateral wall fracture,it was assembled with PFNA into the three-dimensional finite element model.Finite element analysis was performed on the femoral head,neck,fracture ends,lateral wall,and internal components of the model to observe the stress values of various parts of the model under the same load,with different degrees of fracture reduction (no displacement,anterior displacement of 5％,10％,15％ and 20％,posterior displacement of 5％,10％,15％ and 20％) and with or without the lateral wall.Results The stress values for internal components at the femoral head,neck,fracture ends,main nail with anatomical reduction of fracture ends and integrity of the lateral wall were 0.40 MPa,30.05 MPa,74.35 MPa and 121.68 MPa,respectively.The respective stress values of the above with lateral wall fracture were 0.82 MPa,47.32 MPa,151.92 MPa and 266.88 MPa,increased by about 100％.With every horizontal reduction loss increased by 5％ forward or backward,the stress exerting on the corresponding spots would see a 10％ progressive growth,plus 20％ lateral wall fracture and reduction loss.The stress of the main nail (468.43 MPa) was thrice that (121.68 MPa) of the stress posing on the complete lateral wall with the fracture ends 100％ reduced.Conclusions When PFNA is used in the treatment of femoral intertrochanteric fractures involving the lateral wall,stresses on the internal components may be doubled.Loss of coronal reduction may lead to the most significant increase in stress on the bonding site between the main nail and screw blade.

Objective: To investigate the effects of 25-hydroxyvitamin D3[25(OH) D3,D3] on NLRP3 inflammasome activation and inflammatory response of bone marrow mesenchymal stem cells (BMSCs) from diabetic rats. Methods: BMSCs were isolated from diabetic rats and identified by immunocytochemical staining. The cells were divided into diabetic control group (without D3 treatment),low concentration group(treated with 1 × 10-5 mmol /L of D3),intermediate concentration group(treated with 1 × 10-4 mmol /L of D3),and high concentration group(treated with 1 × 10-3 mmol /L of D3) (n = 10),BMSCs from normal rats were used as the normal control group(without D3 treatment). Inflammation-related proteins including NLRP3 in BMSCs were examined by western blot analysis. Results: The cultured cells expressed biomarkers of BMSCs. VDR expression in normal control,diabetic control and low concentration groups was less than that in intermediate concentration and high concentration groups(P ＜ 0. 05). Compared with all diabetc groups,normal control group expressed less NF-κB,NLRP3,ASC,Caspase-1,IL-1β,IL-18 and IL-6(P ＜ 0. 05). Additionally,diabetic control and low concentration groups showed stronger expression of NF-κB,NLRP3,ASC,Caspase-1,IL-1β,IL-18 and IL-6 than intermediate concentration and high concentration groups(P ＜ 0. 05). Conclusion: 25-(OH)2-D3 can inhibit the activation of NLRP3 in BMSCs and suppress the inflammatory response of BMSCs from the diabetic rats.

Objective To compare the curative effects of Pauwels cannulated screws (PCS) and DHS-blade plus anti-rotation screw +anti-rotation screw(DHSA +AS) in the treatment of Pauwels type Ⅲ femoral neck fractures.Methods From December 2013 to December 2015,46 patients with fresh Pauwels type Ⅲ femoral neck fracture were treated with internal fixation at our department.They were divided into 2 groups according to different fixation methods.In the DHSA + AS group of 25 patients,13 were male and 12 female,with an average age of 49.2 ± 8.2 years,and there were 3 cases of Garden type Ⅱ,4 cases of Garden type Ⅲ and 18 cases of Garden type Ⅳ.In the PCS Group of 21 patients,11 were male and 10 female,with an average age of 48.7 ± 6.2 years,and there were 2 cases of Garden type Ⅱ,6 cases of Garden type Ⅲ and 13 cases of Garden type Ⅳ.The 2 groups were compared in terms of operation time,intraoperative blood loss,reduction quality,hospital stay,union time,postoperative complications and Harris hip score.Results DHSA + AS group needed significantly longer operation time (54.0 ± 7.3 minutes) and incurred significantly more intraoperative blood loss (102.3 ± 10.5 mL) than PCS group (46.3 ± 5.4 minutes & 77.4 ±9.1 mL,respectively) (P ＜ 0.05).There were no significant differences between the 2 groups in reduction quality,hospital stay,or union time (P ＞ 0.05).DHSA + AS group and PCS group obtained an average follow-up of 14.1 ± 1.6 months and 13.7 ± 1.2 months,respectively.For DHSA + AS group and PCS group,the rate of postoperative complications was respectively 12.0％ (3/25) versus 4.8％ (1/91),and the Harris hip score at the last follow-up respectively 83.6 ± 5.4 versus 85.1 ± 5.5,showing no significant differences between the 2 groups (P ＞ 0.05).Conclusions DHSA + AS and PCS are both suitable internal fixation options for patients with Pauwels type Ⅲ femoral neck fracture when reduction is fine.Compared with DHSA + AS,PCS may need less operation time and incur less intraoperative blood loss.