Osteoarthritis （OA）， rheumatoid arthritis （RA）， gouty arthritis （GA）， and intervertebral disc degeneration （IVDD） are the most common bone and joint-related diseases in clinical practice. They can all affect related joints， leading to joint pain， swelling， dysfunction， and other symptoms. The difference is that OA is mainly caused by joint wear and age-related degradation and is manifested as joint pain， stiffness， and limited movement. RA is an autoimmune disease， manifested as joint pain， swelling， morning stiffness， and systemic symptoms. GA is caused by abnormal uric acid metabolism， manifested as acute arthritis， and IVDD is caused by intervertebral disc degeneration. Studies have shown that the mechanism of the occurrence and development of these bone and joint diseases is extremely complex. Pyroptosis is closely related to these bone and joint-related diseases by participating in bone and joint inflammation， cartilage metabolism imbalance， extracellular matrix degradation， and pathological damage of bone and joint. Inhibition of bone and joint-related pyroptosis will effectively prevent and treat bone and joint-related diseases. At the same time， many studies have confirmed that traditional Chinese medicine （TCM） has a prominent curative effect and obvious advantages in the prevention and treatment of bone and joint-related diseases. TCM can reduce the inflammatory reaction of bone and joints， improve the pathological damage of bone and joint diseases， and relieve bone and joint pain by inhibiting pyroptosis. Therefore， this article aims to briefly explain the relationship between pyroptosis and the occurrence and development of bone and joint-related diseases and summarize the latest research reports on the intervention of pyroptosis in the treatment of bone and joint-related diseases by TCM monomers， TCM extracts， and TCM compounds. It offers new ideas for the in-depth study of the pathogenesis and drug treatment of bone and joint diseases and provides a basis for the clinical use of TCM to prevent and treat bone and joint diseases.

Performance appraisal of public hospitals have given a guidance for the development of public hospitals at all levels.A Class A tertiary hospital reviewed the problems in the development of the hospital at the present stage and focused on the following four aspects:①insufficient fine management;②No clear orientation of discipline development;③The bottleneck of the improvement of medical operation efficiency;④New challenges in the reform of payment mode.The tertiary hospital launched a fine management practice in May 2022,in order to solve the problems by taking the Department of Surgery as a pilot area,laying the foundation for fine management through information system construction,improving the efficiency of medical operation through management process optimization,improving the overall competitiveness of disciplines through the construction of sub-specialty and Discipline Alliance and adjusting the performance appraisal index system to play the role of performance incentives.The measures effectively improve the overall capacity and efficiency of hospital medical services and help the hospital to achieve high-quality development.

Purpose/Significance To investigate and analyze the current status and influencing factors of digital health literacy(DHL)of the elderly,and to provide references for relevant departments.Method/Process The eHEALS scale is used to investigate the DHL status of 419 elderly people aged 60 and above in Shanghai through convenience sampling,and the influencing factors are explored through binary logistic regression analysis.Result/Conclusion Low education,smoking,and health anxiety are risk factors,while regular physical exami-nation is protective factor.Relevant departments should focus on the elderly people with lower education,and strengthen research and edu-cation on health examinations,smoking hazards,and the alleviation of anxiety.

【Objective】 To study the effects of different storage temperature and different storage time on the activity of key growth factors in platelet-rich plasma(PRP), and to provide a theoretical basis for maximize the role of PRP in clinical treatment. 【Methods】 PRP was collected by blood cell isolation and apheresis, stored at 22℃ and -80℃, respectively. VEGF, TGF-β and PDGF were detected by ELISA. The content of growth factors in PRP was detected when stored at 22℃for 1, 3 and 5 days, and the growth factors content of PRP stored at 22℃ for 3 days was detected after thrombin activation for 0.5, 1 and 1.5 hours. The content of growth factor in frozen PRP (stored at -80℃ for 30 days after initial 3-days storage at 22℃ ) and fresh PRP (stored at 22℃ for 3 days) was compared. The growth factor content in PRP frozen at - 80℃ for 30, 60 and 180 days, and the growth factor content in PRP frozen at -80℃ for 180 days after repeated freeze-thaw for 1, 2, 3, 5 and 10 times were detected. 【Results】 The growth factor content of apheresis PRP was significantly higher than that of platelet-poor plasma. No statistical difference was noticed in VEGF, TGF-β and PDGF content in PRP at 1, 3 and 5 days stored at 22℃; no statistical difference was noticed in VEGF, TGF-β and PDGF content in PRP stored at 22℃ for 3 days after thrombin activation for 0.5, 1 and 1.5 hours. There was no statistically significant difference in growth factor content between PRP stored at 22℃ for 3 days versus frozen at -80℃ for 30 days after initial 3-days storage at 22℃. No statistical difference was found in VEGF, TGF-β and PDGF contents in frozen PRP repeatedly frozen and thawed for 1 to 10 times. 【Conclusion】 Apheresis PRP can release a large amount of growth factors after activation. Fresh PRP stored at 22℃ for 5 days or frozen at -80℃ for 180 days has no impact on the content of growth factors, and frozen PRP at -80℃ can achieve long-term, effective and safe preservation, which is conducive to multiple use of PRP in treatment.

Traditional Chinese medicine(TCM)plays a unique role in preventive treatment of disease,treatment of chronic disease and recovery.Integrating modern science and technology and methods to carry out integrated and innovative research will help to bring the value of traditional Chinese medicine into full play.In recent years,with the rapid development of digital therapeutics such as artificial intelligence and wearable devices,digital therapeutics have emerged.Under the guidance of TCM theory,TCM integrates digital therapeutics technology methods,personalized treatment of patients through advanced program-driven software or combined with hardware devices,and improves patient compliance,gives full play to the advantages of TCM.This paper uses CiteSpace to visualize the research hotspots of digital therapeutics,combined with the literature and the website data of the Food and Drug Administration and the National Medical Products Administration,to sort out the application of digital therapeutics in the prevention,treatment and recovery of diseases,analyze the key technologies and core theories in the current application of digital therapeutics.And taking TCM pentatotherapy,kinesiatrics and aromatherapy as examples,this paper discusses the application forms of digital therapeutics under the guidance of TCM theory,and provides a preliminary paradigm for TCM digital therapeutics.

Objective:To explore the feasibility and preliminary effectiveness of case-based learning (CBL) teaching based on network resources in standardized residency training for nuclear medicine.Methods:Open network resources of CBL curriculum (13 sessions in total) were used to perform the collective teaching of 21 residents who received training in our professional base, with a total of 61 person-times. The residents received the test on objective questions before class, immediately after class, and at 1 week after class (7-10 days) to assess the learning effect of residents at these time points, and an evaluation form of teaching effectiveness was used after each class to assess the teaching effect. SPSS 23.0 was used to perform a one-way analysis of variance.Results:As for the test score of objective questions, there were 61 valid scores before class, 61 valid scores immediately after class, and 51 valid scores at 1 week after class (7-10 days), with a mean score of (49.43±13.37), (84.43±14.44), and (80.88±10.04), respectively (with 100 points as the total score), which showed a significant difference ( F=105.80, P<0.01). As for the evaluation of teaching effectiveness, a total of 61 valid forms were received, and the results of "very satisfied, satisfied, fairly good, and dissatisfied" accounted for 34.4% (21/61), 52.5% (32/61), 9.84% (6/61), and 3.28% (2/61), respectively, with an overall satisfaction rate (very satisfied+satisfied) of 86.9% (53/61). Conclusion:It is feasible and effective to make full use of network resources to carry out CBL teaching in standardized residency training for nuclear medicine, which has achieved a good preliminary effect.

Objective:To analyze the effect of problem-based learning (PBL) combined with case-based learning (CBL) and clinical pathway (CP) teaching methods in standardized residency training in department of hepatobiliary surgery.Methods:A total of 64 residents who received the standardized residency training in the Department of Hepatobiliary Surgery in Shaanxi Provincial People's Hospital from July 2018 to July 2019 were selected and divided into the observation group and the control group. The control group used PBL + CBL teaching methods, while the observation group adopted PBL + CBL + CP teaching methods. The after-department examination scores and the teaching cognition scores of the two groups were compared. SPSS 15.0 was used for t-test and Chi-square test. Results:The after-department examination scores of the two groups were compared. Compared with the control group, the examination scores of professional theories, case analysis and operation skills in the observation group were significantly higher, and the difference was statistically significant ( t = 6.98, 7.85, 7.01, P < 0.05). In terms of recognition of teaching, the observation group was significantly higher than the control group, and the difference was statistically significant ( t = 9.14, P < 0.05). Conclusion:The PBL + CBL + CP teaching is conducive to the comprehensive and systematic mastery of knowledge and the rapid establishment of scientific clinical thinking. It has a strong scientific and systematic nature and is worthy of promotion.

Objective:To assess the value of S-Detect and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of Breast Imaging Reporting and Data System(BI-RADS) 4 breast lesions.Methods:A total of 104 breast lesions in 100 patients diagnosed as BI-RADS category 4 by conventional ultrasound were prospectively enrolled, and all of them were received S-Detect and CEUS examination at the same time. Taking pathology as the gold standard, ROC curve was constructed to compare the diagnostic efficacy of conventional ultrasound, S-Detect, CEUS and their combination.Results:Among the 104 BI-RADS category 4 breast lesions, 63 were benign and 41 were malignant. The sensitivities of conventional ultrasound, S-Detect, CEUS and S-Detect combined with CEUS were 73.17%, 87.80%, 87.80%, 90.24%; the specificities were 57.14%, 60.32%, 68.25%, 77.78%; the positive predictive values were 52.63%, 59.02%, 64.29% and 72.55%; the negative predictive values were 76.60%, 88.37%, 89.59% and 92.45%; the accuracies were 63.46%, 71.15%, 75.96% and 82.69%; and the areas under the ROC curve (AUC) were 0.652, 0.741, 0.780 and 0.840. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of S-Detect and CEUS diagnosis were improved compared with conventional ultrasound. The AUC of combined diagnosis was higher than that of S-Detect, CEUS alone, and the differences were statistically significant(all P<0.05). The AUC of CEUS was higher than that of conventional ultrasound, and the difference was statistically significant ( P<0.05). There were no significant differences in AUC between any two of other groups (all P>0.05). Conclusions:The combined application of S-Detect and CEUS could achieve complementary advantages, which is of great significance for the differential diagnosis of benign and malignant in BI-RADS 4 breast lesions.

Objective:To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of malignant endometrial lesions.Methods:A total of 142 patients with endometrial lesions who underwent contrast-enhanced ultrasound examination in Beijing Tiantan Hospital, Capital Medical University from January 2019 to September 2021 were selected. The endometrial lesions were divided into benign group (including endometrial hyperplasia and endometrial polyps) and malignant group (endometrial cancer) according to the pathological results of surgery, and the differences of contrast enhancement patterns between benign group and malignant group were compared. The sensitivity, specificity of CEUS in the diagnosis of endometrial cancer were calculated, and the Kappa value was calculated with the initial enhancement time earlier than or equal to the muscularity or the peak time earlier than the muscularity as the diagnostic index for the diagnosis of endometrial malignant lesions. The sensitivity, specificity, and Kappa value of CEUS in the diagnosis of endometrial cancer and endometrial cancer with thickness ≥10 mm were calculated.Results:A total of 108 patients underwent surgery with clear pathological results, including 66 patients in the benign lesion group and 42 patients in the malignant lesion group. The thickness of malignant lesions was significantly larger than that of benign lesions, and the difference was statistically significant( t=4.039, P<0.05), but there was no significant difference of hemodynamic parameters between the two groups ( P>0.05). The initial enhancement time, peak time and peak intensity of benign lesions were significantly different from those of malignant lesions(all P<0.05). The sensitivity, specificity, and Kappa value of CEUS in the diagnosis of endometrial cancer were 64.3%, 100% and 0.668, respectively. The sensitivity, specificity and Kappa value of CEUS in the diagnosis of endometrial carcinoma with lesion thickness ≥10 mm were 75.0%, 100% and 0.795, respectively. Conclusions:For the diagnosis of endometrial lesions, especially the malignant endometrial lesions with thickness and diameter greater than or equal to 10mm, there is a high diagnostic coincidence rate between CEUS and pathological diagnosis, and endometrial malignant lesions have more specific CEUS manifestations.

Objective:To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on therapy-related leukemia (TRL).Methods:The clinical data of 14 patients with TRL who received allo-HSCT in Aerospace Central Hospital from April 2012 to February 2020 were retrospectively analyzed, and the therapeutic efficacy and survival status were also analyzed.Results:Of the 14 patients, 5 were males and 9 were females; the median age was 35 years old (12-59 years old). There were 12 patients with acute myeloid leukemia, 1 patient with chronic lymphocytic leukemia/small cell lymphoma, and 1 patient with acute lymphoblastic leukemia. At the time of transplantation, 4 patients achieved bone marrow complete remission, 3 patients achieved bone marrow partial remission, and the remaining 7 patients had no remission. Five patients received HLA-matched sibling transplantation, 9 patients received haplotype transplantation, and they all received myeloablative pretreatment schemes. All 14 patients were successfully implanted; the median engraftment time of granulocyte was 16 d (10-24 d), and the median engraftment time of platelet was 13 d (10-34 d). Grade Ⅰ-Ⅱ acute graft-versus-host disease (GVHD) occurred in 7 patients, chronic GVHD occurred in 6 patients, and grade Ⅲ intestinal GVHD occurred in 2 patients. The median follow-up time was 32 months (4-97 months). Among 14 patients, 5 patients died.Conclusion:The allo-HSCT can improve the prognosis and long-term survival rate of TRL patients.