Objective To investigate the clinical effect of elastic fixation of Endobutton plate with loop in the treatment of lower tibiofibular combined injury.Methods A total of 326 patients with lower tibiofibular joint injury combined with ankle fracture underwent surgical treatment from June 2019 to June 2021 were randomly divided into experimental group(163 cases)and control group(163 cases)by using a random number table.The control group was fixed with traditional steel plate screw,and the experimental group was fixed with elastic steel plate with loop Endobutton.Hospitalization and operation related indexes were compared between the two groups.The American Association of Foot and Ankle Surgery Ankle Function Score(AOFAS)was performed on the two groups at 2 and 6 months after surgery,respectively,and the reseparation rate of the lower tibiofibular union was evaluated and compared between the two groups at 6 months after surgery.Results There were no significant differences in operation time,blood loss,incision length,getting out of bed time and hospital stay between experimental group and control group(P＞0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference between the two groups was statistically significant(P＜0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference was statistically significant between the two groups(P＜0.05).The AOFAS scores of control group were(74.5±9.2)and(81.3±4.3)at 2 months and 6 months,respectively,and the excellent and good rate was 76.0％.AOFAS of experimental group were(82.3±5.3)points and(91.2±3.8)points at 2 months and 6 months after surgery,respectively,and the excellent and good rate was 93.2％,the above indexes of experimental group were higher than those of control group,and the difference between the two groups was statistically significant(P＜0.05).Reexamination 6 months after surgery the reseparation rate of lower tibiofibular combination was 12.8％in the control group and 2.4％in the experimental group,and the risk of reseparation in the experimental group was lower than that in the control group,with statistical significance(P＜0.05).Conclusion Elastic fixation using Endobutton plate with loop could be used in the treatment of ankle fracture with distal tibiofibular syndesmosis injury,which has a better effect of traditional internal fixation with plate and screws.

Objective To investigate the clinical effect of elastic fixation of Endobutton plate with loop in the treatment of lower tibiofibular combined injury.Methods A total of 326 patients with lower tibiofibular joint injury combined with ankle fracture underwent surgical treatment from June 2019 to June 2021 were randomly divided into experimental group(163 cases)and control group(163 cases)by using a random number table.The control group was fixed with traditional steel plate screw,and the experimental group was fixed with elastic steel plate with loop Endobutton.Hospitalization and operation related indexes were compared between the two groups.The American Association of Foot and Ankle Surgery Ankle Function Score(AOFAS)was performed on the two groups at 2 and 6 months after surgery,respectively,and the reseparation rate of the lower tibiofibular union was evaluated and compared between the two groups at 6 months after surgery.Results There were no significant differences in operation time,blood loss,incision length,getting out of bed time and hospital stay between experimental group and control group(P＞0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference between the two groups was statistically significant(P＜0.05).The incidence of postoperative complications in experimental group was 2.45％,lower than that in control group(7.98％),and the difference was statistically significant between the two groups(P＜0.05).The AOFAS scores of control group were(74.5±9.2)and(81.3±4.3)at 2 months and 6 months,respectively,and the excellent and good rate was 76.0％.AOFAS of experimental group were(82.3±5.3)points and(91.2±3.8)points at 2 months and 6 months after surgery,respectively,and the excellent and good rate was 93.2％,the above indexes of experimental group were higher than those of control group,and the difference between the two groups was statistically significant(P＜0.05).Reexamination 6 months after surgery the reseparation rate of lower tibiofibular combination was 12.8％in the control group and 2.4％in the experimental group,and the risk of reseparation in the experimental group was lower than that in the control group,with statistical significance(P＜0.05).Conclusion Elastic fixation using Endobutton plate with loop could be used in the treatment of ankle fracture with distal tibiofibular syndesmosis injury,which has a better effect of traditional internal fixation with plate and screws.

Objective:To investigate the mechanism by which formononetin combined with platelet-rich plasma (PRP) enhances the proliferation and differentiation of osteoblasts.Methods:Rat osteoblasts ROS17/2.8 were cultured in vitro and treated with formononetin (10, 20, 40 μmol/L) combined with PRP. Cells were also intervened with G15 (a G protein-coupled estrogen receptor inhibitor) and Super-TDU [a Yes-related protein (YAP) inhibitor]. Cell proliferation viability was detected using the cell counting kit-8 (CCK-8) assay; alkaline phosphatase (ALP) activity was measured using an ALP assay kit; protein expression of G protein-coupled estrogen receptor (GPER) and p-YAP was detected by Western blot; and YAP subcellular distribution was analyzed by fluorescence assay.Results:Formononetin (20 μmol/L) synergistically enhanced the PRP-induced proliferation and ALP activity of osteoblasts (all P<0.05). Compared with the control group, formononetin significantly up-regulated GPER protein expression and down-regulated p-YAP protein expression (all P<0.01), with the most pronounced effects observed at 20 μmol/L. Formononetin (20 μmol/L) induced nuclear accumulation of YAP protein in osteoblasts. Pretreatment with G15 or Super-TDU reversed the synergistic effect of formononetin on PRP, and both the cell proliferation rate and ALP activity were lower than those in the PRP+ formononetin group (all P<0.01). Conclusions:Formononetin enhances the PRP-induced proliferation and differentiation of osteoblasts through the GPER/YAP signaling pathway.

Objective:To study the distribution characteristics of current patients with Kashin-Beck disease (KBD) in Molidawa Daur Autonomous Banner (referred to as Morin Banner), and provide suggestions for service management.Methods:Information of KBD current patients in Morin Banner was collected from January 1, 2018 to June 30, 2024 using the "KBD Current Patient Survey System" provided by the Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention. A descriptive study method was used to analyze the basic information and clinical data of current patients.Results:As of June 30, 2024, a total of 6 223 KBD current patients were reported in Morin Banner, and the patients were distributed in 15 townships (towns). There was a statistically significant difference in the prevalence rate of KBD among different townships (towns, χ 2 = 3 069.01, P < 0.001). The minimum age of the KBD current patients was 27 years old, and the maximum was 98 years old, mainly concentrated in the age range of 45 - 74 years old, accounting for 95.7% (5 954/6 223). There was a significant difference in the prevalence rate of KBD among different age groups (χ 2 = 5 912.76, P < 0.001). The male to female ratio was 1.00∶1.14 (2 910 ∶ 3 313), and there was a statistically significant difference in prevalence rate of KBD between genders(χ 2 = 44.38, P < 0.001). The KBD current patients mainly had a primary school education, married, and farmers, accounting for 59.2% (3 685/6 223), 89.8% (5 590/6 223), 93.2% (5 802/6 223), respectively; and the clinical grading of patients is mainly degree Ⅰ. There was a statistically significant difference in the rate of limb disability among patients with different clinical grades (χ 2 = 64.26, P < 0.001). The rate of limb disability in males was higher than that in females (χ 2 = 10.36, P = 0.001). Conclusions:The KBD current patients in Morin Banner are distributed in various township (town), with middle-aged and elderly famers being the main ones. It is necessary to strengthen monitoring of KBD, and pay attention to personalized treatment and management of KBD current patients.

OBJECTIVE To prepare Arg-Gly-Asp（RGD）-modified doxorubicin （DOX）-loaded “core-shell” nanoparticles （RGD@DOX-LPNs）， characterize the nanoparticles， and investigate their antitumor effects. METHODS RGD@DOX-LPNs were prepared using the nanoprecipitation method. Their morphology was examined by visual inspection and electron microscopy. Particle size， polydispersity index （PDI）， and Zeta potential were determined， and differential scanning calorimetry （DSC） and X-ray diffraction （XRD） were employed. Encapsulation efficiency （EE）， drug loading （DL）， and stability were evaluated. The in vitro release kinetics， mucus diffusion， and tumor cell uptake [tracked using coumarin 6 （COU）] were investigated. The in vivo tissue distribution and gastrointestinal retention [labeled with 11-chloro-1， 1′-dipropyl-3， 3， 3′， 3′-tetramethyl-10， 12- trimethyleneindotricarbocyanine iodide （IR780）] were investigated. Using 4T1 tumor-bearing mice as the experimental subjects， the effects of the prepared formulation on tumor volume， tumor weight， and cell apoptosis rate were evaluated. RESULTS RGD@DOX-LPNs presented as orange transparent liquid with uniform and near-spherical particles. The particle size was （159.67± 8.02） nm， PDI was 0.15±0.06， and Zeta potential was （－19.70±0.79） mV. After modification with RGD， the thermal absorption peak and crystalline diffraction peak of DOX disappeared. EE and DL of RGD@DOX-LPNs were （72.65±4.37）% and （4.62± 0.38）% ， respectively. No obvious changes in appearance， particle size， or EE were observed after storage at 4 ℃ and 25 ℃ for 7 days. The cumulative drug release at 4 h was approximately 73%， which was lower than that of free DOX（almost completely released within 1 h）. The amount of COU in the first segmental mucus layer of COU-LPNs was significantly lower than that in the corresponding segment of RGD@COU- LPNs， whereas it was significantly higher in the 2nd to 5th segmental mucus layers compared to RGD@COU-LPNs （P＜0.01）. Cellular uptake of RGD@COU-LPNs was significantly higher than that of COU-LPNs（P＜0.05）. The isolated tissue fluorescence intensity of RGD@IR780-LPNs was stronger than that of IR780-LPNs， indicating better small intestinal retention. Compared with free DOX and unmodified nanoparticles （DOX-LPNs）， RGD@DOX-LPNs exhibited a higher tumor inhibition rate of 65.74%， significantly reduced tumor volume and weight， and increased apoptosis rate（P＜0.01）. CONCLUSIONS RGD@DOX-LPNs are successfully prepared with sustained release properties， which can improve gastrointestinal mucus retention， enhance cellular uptake of DOX， and have potent antitumor activity against breast cancer.

Objective To observe the clinical efficacy of therapy focusing on regulating spleen and stomach for the treatment of acoustic hypersensitivity(AH),which also named as auditory hyperaesthesia,and to explore the relevant factors influencing the efficacy.Methods From January 2018 to December 2023,the patients admitted to the outpatient department of otolaryngology-head and neck surgery of the First Affiliated Hospital of Guangzhou University of Chinese Medicine and diagnosed as AH with complete medical data were included as study subjects.Follow-up through telephone or network was carried out for those patients who with uncertain prognosis.The changes in the pre-and post-treatment scores of Indicators of Acoustic Hypersensitivity Severity(IAHS)were used as the reference index for efficacy evaluation,and the cure rate and effective rate were used as the efficacy analysis indexes for statistical analysis.And then the efficacy of traditional Chinese medicine(TCM)medical care combined with health care focusing on regulating spleen and stomach for the treatment of AH was evaluated.Furthermore,multivariate logistic regression was used to explore the relevant factors influencing the efficacy of AH.Results A total of 298 cases of AH patients meeting the inclusion criteria were collected,among which 151 cases(50.67%)were cured,22 cases(7.38%)were markedly effective,75 cases(25.17%)were effective,and 50 cases(16.78%)were ineffective,with a total effective rate of 83.22%(248/298).The univariate analysis results showed that eight factors(including post-treatment lifestyle score,range of lifestyle adjustment,severity of AH,duration of the disease,presence of tinnitus,presence of hearing drop,presence of vertigo,and age)had an influence on the efficacy,and the differences were statistically significant(P<0.05 or P<0.01).However,the factors of gender,occupation,education level,and history of noise exposure had no influence on the efficacy(P>0.05).The multivariate binary logistic regression analysis showed that five factors,namely post-treatment lifestyle score,range of lifestyle adjustment,severity of AH,presence of vertigo and duration of the disease,had a significant correlation with the cure rate of AH(P<0.05 or P<0.01),and four factors,namely post-treatment lifestyle score,severity of AH,range of lifestyle adjustment and age,had a significant correlation with the effective rate of AH(P<0.05 or P<0.01).Conclusion The method of TCM medical care and health care focusing on regulating spleen and stomach exerts a better efficacy for AH patients.And the lifestyle,severity of AH,duration of the disease,age,and presence of vertigo are the relevant factors affecting the outcomes,which is worthy of further in-depth study.

Objective:To study the distribution characteristics of current patients with Kashin-Beck disease (KBD) in Molidawa Daur Autonomous Banner (referred to as Morin Banner), and provide suggestions for service management.Methods:Information of KBD current patients in Morin Banner was collected from January 1, 2018 to June 30, 2024 using the "KBD Current Patient Survey System" provided by the Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention. A descriptive study method was used to analyze the basic information and clinical data of current patients.Results:As of June 30, 2024, a total of 6 223 KBD current patients were reported in Morin Banner, and the patients were distributed in 15 townships (towns). There was a statistically significant difference in the prevalence rate of KBD among different townships (towns, χ 2 = 3 069.01, P < 0.001). The minimum age of the KBD current patients was 27 years old, and the maximum was 98 years old, mainly concentrated in the age range of 45 - 74 years old, accounting for 95.7% (5 954/6 223). There was a significant difference in the prevalence rate of KBD among different age groups (χ 2 = 5 912.76, P < 0.001). The male to female ratio was 1.00∶1.14 (2 910 ∶ 3 313), and there was a statistically significant difference in prevalence rate of KBD between genders(χ 2 = 44.38, P < 0.001). The KBD current patients mainly had a primary school education, married, and farmers, accounting for 59.2% (3 685/6 223), 89.8% (5 590/6 223), 93.2% (5 802/6 223), respectively; and the clinical grading of patients is mainly degree Ⅰ. There was a statistically significant difference in the rate of limb disability among patients with different clinical grades (χ 2 = 64.26, P < 0.001). The rate of limb disability in males was higher than that in females (χ 2 = 10.36, P = 0.001). Conclusions:The KBD current patients in Morin Banner are distributed in various township (town), with middle-aged and elderly famers being the main ones. It is necessary to strengthen monitoring of KBD, and pay attention to personalized treatment and management of KBD current patients.

Objective:To investigate the mechanism by which formononetin combined with platelet-rich plasma (PRP) enhances the proliferation and differentiation of osteoblasts.Methods:Rat osteoblasts ROS17/2.8 were cultured in vitro and treated with formononetin (10, 20, 40 μmol/L) combined with PRP. Cells were also intervened with G15 (a G protein-coupled estrogen receptor inhibitor) and Super-TDU [a Yes-related protein (YAP) inhibitor]. Cell proliferation viability was detected using the cell counting kit-8 (CCK-8) assay; alkaline phosphatase (ALP) activity was measured using an ALP assay kit; protein expression of G protein-coupled estrogen receptor (GPER) and p-YAP was detected by Western blot; and YAP subcellular distribution was analyzed by fluorescence assay.Results:Formononetin (20 μmol/L) synergistically enhanced the PRP-induced proliferation and ALP activity of osteoblasts (all P<0.05). Compared with the control group, formononetin significantly up-regulated GPER protein expression and down-regulated p-YAP protein expression (all P<0.01), with the most pronounced effects observed at 20 μmol/L. Formononetin (20 μmol/L) induced nuclear accumulation of YAP protein in osteoblasts. Pretreatment with G15 or Super-TDU reversed the synergistic effect of formononetin on PRP, and both the cell proliferation rate and ALP activity were lower than those in the PRP+ formononetin group (all P<0.01). Conclusions:Formononetin enhances the PRP-induced proliferation and differentiation of osteoblasts through the GPER/YAP signaling pathway.

ObjectiveTo demonstrate the long-term effect of Yishi Therapy for primary tinnitus and analyze the factors affecting the effectiveness. MethodsWe conducted long-term follow-ups of primary tinnitus cases treated with Yishi Therapy during 1 January 2017 to 30 June 2023 by face-to-face， online and telephone between 1 July 2023 and 31 January 2024， to understand the final regression of primary tinnitus and lifestyle changes. We retrospectively analysed the basic data of patients before treatment， and statistically analysed the recovery rate and overall effective rate of tinnitus treated by the Yishi Therapy， and the factors affecting the effectiveness such as lifestyle， age， duration of disease， gender， tinnitus location， severity of tinnitus， accompanying symptoms and complications on the overall effective rate. ResultsA total of 496 cases of primary tinnitus completed follow-ups successfully， and the total Tinnitus Evaluation Questionnaire （TEQ） at follow-up was significantly lower than that before treatment （P＜0.001）. Among the 496 cases， 101 （20.36%） cases cured， 189 （38.10%） cases showed significant improvement， 116 （23.39%） cases were effective， 90 （18.15%） cases were ineffective， and the overall effect rate was 81.85% （406/496）. At follow-up， the score of lifestyle was higher than that before treatment （P＜0.001）. Grouped by the score of lifestyle at follow-up， the effective rates of better lifestyle group and poor lifestyle group were 97.53% （237/243） and 66.80% （169/253）， respectively， with statistical significance （P＜0.001）. Grouped by the mean value of the difference in lifestyle scores before and after treatment， the effective rates of the group with greater lifestyle adjustment and the group with smaller adjustment were 97.55% （239/245） and 66.53% （167/251）， respectively， and the differences were statistically significant （P＜0.001）. Binary logistic regression showed that the better lifestyle， the greater lifestyle adjustment and the severity of tinnitus were positively correlated with the total effective rate of tinnitus （P＜0.001）， while older and hearing loss were negatively correlated with the total effective rate of tinnitus （P＜0.05）. ConclusionYishi Therapy on primary tinnitus shows good long-term effect， lifestyle， severity of tinnitus， hearing loss or not， age are the relevant factors affecting the efficacy of tinnitus， lifestyle is the main factor affecting clinical efficacy.

Objective:To evaluate the teaching effect of multi-disciplinary integrated training program on the open comprehensive training room to improve the post competency of medical imaging students.Methods:A total of 122 residential students of five-year medical imaging from Batch 2014 of The First Affiliated Hospital of Chengdu Medical College were divided into experimental group and control group. The experimental group carried out the multi-disciplinary open comprehensive training program, and the control group carried out open-ended exercises. The comprehensive discipline theory examination, assessment of clinical thinking and comprehensive skill appraisal, and satisfaction questionnaire results were compared between the two groups. SPSS 23.0 was used for t test. Results:①Comprehensive discipline theory examination scores were higher in experimental group than the control group [(80.33±3.70) vs. (74.56±5.09)], with statistical differences ( P<0.05). ②Experimental group scored higher in clinical thinking and comprehensive skills than the control group did, and the difference was statistically significant [(87.58±3.15) vs. (74.52±3.66), P<0.05]. ③The questionnaire investigation showed that the experimental group students did better in improving autonomous learning ability, expression ability, the team cooperation ability, the ability to find and fix problems and the degree of self-esteem than control group, with statistically significant differences ( P<0.05). Conclusion:The multi-disciplinary open comprehensive training program has a good effect on optimizing the open-ended exercises. Students' knowledge of multi-disciplinary comprehensive theoretical knowledge and imaging skills have been improved, and the ability of teamwork, problem-solving ability, self-learning ability and innovation ability required by the core competence of the profession have been developed and improved, which meets the modern medical treatment of education "to create an educational platform of medical education collaboration and multi-disciplinary integration, and to cultivate students' innovative and autonomous learning."