The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi， impaired qi transformation， and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology， chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi， blood， and essence， while "stagnation" refers to the accumulation of phlegm， turbid dampness， and blood stasis. These two components interact reciprocally， forming a vicious cycle where deficiency leads to stagnation， and stagnation further damages the healthy qi. In the early stage of mild myelosuppression， chemotoxicity begins to accumulate in the bone marrow， leading to qi consumption， blood deficiency， yin injury， and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression， the accumulation of toxicity causes qi sinking， exhaustion of essence， and marrow depletion， along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation， with an emphasis on assessing the severity of the condition， balancing deficiency and excess， and achieving both symptomatic relief and root cause resolution.

OBJECTIVE: The relationship between fish consumption and stroke is inconsistent, and it is uncertain whether this association varies across predicted stroke risks. METHODS: A cohort study comprising 95,800 participants from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project was conducted. A standardized questionnaire was used to collect data on fish consumption. Participants were stratified into low- and moderate-to-high-risk categories based on their 10-year stroke risk prediction scores. Hazard ratios ( HRs) and 95% confidence intervals ( CIs) were estimated using Cox proportional hazard models and additive interaction by relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (SI). RESULTS: During 703,869 person-years of follow-up, 2,773 incident stroke events were identified. Higher fish consumption was associated with a lower risk of stroke, particularly among moderate-to-high-risk individuals ( HR = 0.53, 95% CI: 0.47-0.60) than among low-risk individuals ( HR = 0.64, 95% CI: 0.49-0.85). A significant additive interaction between fish consumption and predicted stroke risk was observed (RERI = 4.08, 95% CI: 2.80-5.36; SI = 1.64, 95% CI: 1.42-1.89; AP = 0.36, 95% CI: 0.28-0.43). CONCLUSION Higher fish consumption was associated with a lower risk of stroke, and this beneficial association was more pronounced in individuals with moderate-to-high stroke risk.
Humans ; China/epidemiology* ; Male ; Female ; Stroke/etiology* ; Middle Aged ; Prospective Studies ; Incidence ; Aged ; Animals ; Fishes ; Risk Factors ; Diet ; Seafood ; Adult ; Cohort Studies

OBJECTIVE: To compare clinical efficacy of intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy in treating moderate to severe hallux valgus (HV). METHODS: A retrospective analysis was conducted on clinical data of 42 patients with moderate to severe HV admitted from January 2022 to December 2022. According to different incisions, the patients were divided into medial incision group with 22 patients (22 feet) and intermetatarsal incision group with 20 patients (20 feet). In medial incision group, there were 3 males and 19 females, aged from 40 to 69 years old with an average of (55.0±11.4) years old;body mass index (BMI) ranged from 21 to 29 kg·m-2 with an average of (25.2±2.1) kg·m-2;the courses of disease ranged from 8 to 16 years with average of (12.0±2.2) years;11 patients with moderate deformity and 11 patients with severe deformity. In transplantar incision group, there were 3 males and 17 females, aged from 39 to 68 years old with an average of (53.0±7.5) years old;BMI ranged from 20 to 28 kg·m^-2 with an average of (24.8±1.9) kg·m^-2;the courses of disease ranged from 9 to 17 years with an average of (14.0±3.1) years;9 patients with moderate deformity and 11 patients with severe deformity. Hallux valgus angle (HVA) and the first-second intermetatarsal angle (IMA), American Orthopaedic Foot and Ankle Society (AOFAS) forefoot scores and complications between two groups before operation and 12 months after operation were observed and compared. RESULTS: All patients were successfully completed the surgery and were followed up for 12 to 15 months with an average of (13.52±1.65) months. There were no statistically significant difference in HVA and IMA between two groups before operation and 12 months after operation (P>0.05). AOFAS forefoot scores of medial incision group before operation and 12 months after operation were (45.0±6.8) and (86.0±6.7) respectively, and those of transmetatarsal incision group were (46.0±7.4) and (83.0±7.5) respectively. Postoperative AOFAS forefoot scores between two groups at 12 months were statistically significant compared with those of before operation (P<0.01). According to AOFAS forefoot scores, 8 patients got excellent result, 14 good in medial incision group;while 6 excellent and 14 good in transplantar incision group. At 12 months, postoperative AOFAS forefoot score of functional score of in medial incision group(38.0±2.5), was better than that in transplantar incision group (34.0±2.2), and the difference was statistically significant (P<0.05). One patient in medial incision group occurred HV deformity, mild numbness occurred in 3 toes in transplantar incision group, and 3 patients were dissatisfied with scar. No complications such as infection, nonunion of bones or ischemic necrosis of metatarsal heads occurred in either group. CONCLUSION Both intermetatarsal incision and lateral soft tissue release of medial incision combined with Scarf osteotomy can effectively treat moderate to severe HV. The functional recovery after medial incision is better than that after intermetatarsal incision.
Humans ; Male ; Female ; Hallux Valgus/physiopathology* ; Middle Aged ; Osteotomy/methods* ; Adult ; Aged ; Retrospective Studies ; Treatment Outcome ; Metatarsal Bones/surgery*

Objective To explore whether butorphanol tartrate as an adjuvant of ropivacaine for brachial plexus block can reduce the incidence of rebound pain after brachial plexus block.Methods Based on sample size calculation,174 patients undergoing upper limb bone surgery were included in this study and randomized into three groups using statistical software:butorphanol tartrate compound local anesthetic(group B1),brachial plexus block with 0.25%ropivacaine 20 mL(including adjuvant butorphanol 1mg);intravenous butorphanol group(group B2),brachial plexus block with 0.25%ropivacaine 20 mL,in addition,1mg of butorphanol was administered i.v;control(group C),only 0.25%ropivacaine 20ml for brachial plexus block.The patients were visited the day before operation,and the basic information of the patients was obtained.At the same time,the Douleur Neuropathique 4 questions(DN4)was used to evaluate whether there were neuropathic components(DN4≥4)in the site to be operated on,and the Numerical rating scale(NRS)was introduced to the patients,and the preoperative NRS value was obtained.30 minutes before the operation,the same anesthesiologist with rich experience in nerve block completed the ultrasound-guided brachial plexus block(interscalene approach),and tested whether the block effect was perfect.After entering the operating room,the patients were given general anesthesia,and the duration of operation,vital signs during operation,dosage of analgesics and whether or not using tourniquet were recorded.After the operation,the patients were sent to the postanesthesia care unit,and then sent to the ward when the patients reached the standard of leaving the room.Distribute pain diaries to patients and their families and instruct them to fill in relevant matters.The patients were followed up at 0 h,6 h,12 h,18 h,24 h and 36 h after operation to obtain the NRS value at each time point after operation,the time when the block disappeared and the highest NRS value within 12 hours,the first use of rescue analgesics,the use of postoperative analgesics,postoperative adverse events and the quality of patient recovery.Results The incidence of rebound pain was 31.6%in B1,48.2%in B2,and 54.4%in C.The pairwise comparison showed statistical difference between B1 and C(P<0.05).Rebound pain score in the three groups was B1 group0.05).There were no statistical differences in the duration of motor block,sensory block duration,duration of analgesia,time to first request for rescue analgesia,and QoR-15 recovery quality score(P>0.05).There was no statistical difference in the incidence of postoperative adverse effects among the three groups(P>0.05).Conclusion This study found that brachial plexus block with 1mg butorphanol tartrate as an adjuvant for ropivacaine reduced the incidence of rebound pain and rebound pain scores after upper limb orthopedic surgery and reduced postoperative opioid consumption.

The integration of science and education is not only an important strategy for promoting social progress and technological development,but also a modern form of higher education aiming at cultivating innovative talents.Conducting scientific research training for undergraduate medical students is one of the important ways to cultivate their innovative abilities and comprehensive qualities.Our team proposed a"teaching,science,and ideology trinity"teaching model to comprehensively cultivate students' scientific research comprehensive abilities under the value orientation of ideological and political education by or-ganically integrating molecular biology experimental teaching with the scientific research training of under-graduate medical students.In this teaching activity,taking the experiment of gene polymorphism as an example,our team selected students with research potential from the whole grade and divided them into 4 project groups that were instructed by 4 teachers.The students were trained in the whole process of scien-tific research,including topic selection,project writing,experimental designing,application for research ethics,and project summary.Our team has always adhered to student-contentedness of educational con-cepts to stimulate students' intrinsic motivation throughout the teaching process.Students are the design-ers and implementers of the project,and teachers are only guides and promoters of learning.After this training,students not only became familiar with the writing and implementation of scientific research pro-jects,but also improved their literature reading,experimental designing,experimental skills,and prob-lem-solving abilities.More importantly,this teaching activity also cultivated students' awareness of re-search ethics and academic moral standards.

Objective To investigate the value of gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)enhanced MRI and T1 mapping for evaluating vessels encapsulating tumor clusters(VETC)caused by hepatocellular carcinoma(HCC).Methods Totally 112 cases of HCC confirmed by surgical pathology were retrospectively enrolled and categorized into positive group(n=46)and negative group(n=66)based on the presence or absence of VETC.Gd-EOB-DTPA enhanced MRI features and T1 mapping parameters were compared between groups.Multivariate logistic regression analysis was used to identify independent risk factors for HCC VETC,and a combined nomogram model was developed.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the efficacy of the identified independent risk factors and nomogram model for predicting HCC VETC.Results The maximum diameter of HCC,incidence of non-smooth tumor margin,prevalence of peritumoral hypo-intensity on hepatobiliary phase(HBP),as well as T1 value of HBP(T1post)in positive group were all higher,while the change rate of T1 value(ΔT1％)in positive group was lower than those in negative group(all P＜0.05).The increased maximum diameter,non-smooth margin,peritumoral hypo-intensity on HBP and low ΔT1％were all independent risk factors for HCC VETC(all P＜0.05),with AUC for predicting HCC VETC of 0.680,0.675,0.686 and 0.752,respectively.The nomogram model developed based on the combination of the above factors showed sensitivity of 78.79％,specificity of 71.74％and AUC of 0.839 for predicting HCC VETC.Conclusion Gd-EOB-DTPA enhanced MRI combined with T1 mapping could be used to effectively predict HCC VETC.

This study aims to delve into the influences and underlying mechanisms of Banxia Xiexin Decoction(BXD) on the proliferation, apoptosis, invasion, and migration of colon cancer cells. Firstly, the components of BXD in blood were identified by UPLC-MS/MS, and subsequently the content of these components were determined by HPLC. Then, different concentrations of BXD were used to treat both the normal intestinal epithelial cells(NCM460) and the colon cancer cells(HT29 and HCT116). The cell viability and apoptosis were examined by the cell counting kit-8(CCK-8) and flow cytometry, respectively. Western blot was employed to determine the expression of the apoptosis regulators B-cell lymphoma-2(Bcl-2) and Bcl-2-associated X(Bax). The cell wound healing assay and Transwell assay were employed to measure the cell migration and invasion, respectively. Additionally, Western blot was employed to determine the expression levels of epithelial-mesenchymal transition(EMT)-associated proteins, including epithelial cadherin(E-cadherin), neural cadherin(N-cadherin), and vimentin. The protein and mRNA levels of the factors in the poly(ADP-ribose) glycohydrolase(PARG)/poly(ADP-ribose) polymerase 1(PARP1)/nuclear factor kappa-B p65(NF-κB p65) signaling pathway were determined by Western blot and RT-qPCR, respectively. The results demonstrated that following BXD intervention, the proliferation of HT29 and HCT116 cells was significantly reduced. Furthermore, BXD promoted the apoptosis, enhanced the expression of Bcl-2, and suppressed the expression of Bax in colon cancer cells. At the same time, BXD suppressed the cell migration and invasion and augmented the expression of E-cadherin while diminishing the expression of N-cadherin and vimentin. In addition, BXD down-regulated the protein and mRNA levels of PARG, PARP1, and NF-κB p65. In conclusion, BXD may inhibit the malignant phenotypes of colon cancer cells by mediating the PARG/PARP1/NF-κB signaling pathway.
Colonic Neoplasms/pathology* ; Drugs, Chinese Herbal/pharmacology* ; Phenotype ; Signal Transduction/drug effects* ; Cell Proliferation/drug effects* ; Apoptosis ; Cell Movement/drug effects* ; Neoplasm Invasiveness ; HCT116 Cells ; Proto-Oncogene Proteins c-bcl-2/biosynthesis* ; Humans ; Poly (ADP-Ribose) Polymerase-1 ; Glycoside Hydrolases ; bcl-2-Associated X Protein ; NF-kappa B p50 Subunit

Objective:To study the clinical efficacy and impact on quality of life of the first administration of different doses of 131iodine ( 131I) therapy in patients with differentiated thyroid cancer (DTC) after surgical resection. Methods:A total of 97 DTC patients who underwent elective surgical resection at Hongqi Hospital Affiliated to Mudanjiang Medical University from June 2022 to June 2024 were selected and divided into a high-dose group ( n = 49) and a low-dose group ( n = 48) based on their first postoperative treatment with different doses of 131I. All patients underwent DTC endoscopic thyroidectomy. The high-dose group received > 150 - 200 mCi 131I treatment after surgery, while the low-dose group received 100 - 150 mCi 131I treatment after surgery. Both groups of DTC patients were followed up for 12 months. A comparison was conducted between the two groups regarding the success rate of clearing residual thyroid tissue (referred to as thyroid clearance), disease-free survival rate, recurrence rate, incidence of adverse reactions, and changes in quality of life before and after treatment. Results:There was no statistically significant difference in the success rate of thyroid clearance between the two groups of DTC patients (χ 2 = 1.43, P = 0.232). The disease-free survival rate of DTC patients in the low-dose group was higher than that in the high-dose group (χ 2 = 4.86, P = 0.027), and the recurrence rate was lower than that in the high-dose group (χ 2 = 4.86, P = 0.027). The incidence of adverse reactions in DTC patients in the low-dose group was lower than that in the high-dose group (χ 2 = 4.59, P = 0.032). The scores of the short form 36 health survey (SF-36) of both groups of DTC patients after treatment were higher than those before treatment ( P < 0.05), and the SF-36 scores of DTC patients in the low-dose group were higher than those in the high-dose group after treatment ( P < 0.001). The scores of the thyroid cancer specific quality of life (THYCA-QoL) of both groups of DTC patients after treatment were lower than those before treatment ( P < 0.05), and the THYCA-QoL scores of DTC patients in the low-dose group were lower than those in the high-dose group after treatment ( t = 4.48, P < 0.001). Conclusions:The initial treatment effect of different doses of 131I after DTC surgical resection is comparable, but the low-dose 131I can improve the disease-free survival rate, reduce adverse reactions, and improve the quality of life of patients, which is worthy of clinical practice.

Objective To investigate the value of gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)enhanced MRI and T1 mapping for evaluating vessels encapsulating tumor clusters(VETC)caused by hepatocellular carcinoma(HCC).Methods Totally 112 cases of HCC confirmed by surgical pathology were retrospectively enrolled and categorized into positive group(n=46)and negative group(n=66)based on the presence or absence of VETC.Gd-EOB-DTPA enhanced MRI features and T1 mapping parameters were compared between groups.Multivariate logistic regression analysis was used to identify independent risk factors for HCC VETC,and a combined nomogram model was developed.Receiver operating characteristic(ROC)curve was plotted,and the area under the curve(AUC)was calculated to evaluate the efficacy of the identified independent risk factors and nomogram model for predicting HCC VETC.Results The maximum diameter of HCC,incidence of non-smooth tumor margin,prevalence of peritumoral hypo-intensity on hepatobiliary phase(HBP),as well as T1 value of HBP(T1post)in positive group were all higher,while the change rate of T1 value(ΔT1％)in positive group was lower than those in negative group(all P＜0.05).The increased maximum diameter,non-smooth margin,peritumoral hypo-intensity on HBP and low ΔT1％were all independent risk factors for HCC VETC(all P＜0.05),with AUC for predicting HCC VETC of 0.680,0.675,0.686 and 0.752,respectively.The nomogram model developed based on the combination of the above factors showed sensitivity of 78.79％,specificity of 71.74％and AUC of 0.839 for predicting HCC VETC.Conclusion Gd-EOB-DTPA enhanced MRI combined with T1 mapping could be used to effectively predict HCC VETC.

Objective To investigate the application effect of cold snare endoscopic mucosal resection(CS-EMR)in the treatment of 6 to 9 mm colorectal small polyps.Methods A total of 82 patients with small colonic polyps in our hospital from March 2022 to August 2023 were collected and divided into the observation group(45 cases received CS-EMR)and the control group[37 cases received hot snare endoscopic mucosal resection(HS-EMR)]according to different surgical methods.The clinical efficacy,polyp resection status,complete polyp resection rate,perioperative indicators and occurrence of complications were compared between the two groups.Results Follow-up for 1 month after operation,the effective rate of treatment in the observation group was higher than that in the control group(P<0.05).There was no statistically significant difference in the polyp resection status or perioperative indicators between the two groups(P>0.05).There was no statistically significant difference in the complete polyp resection rates of patients with different pathological types or total complete resection rate between the two groups(P>0.05).The incidence of delayed bleeding and endoscopic hemostasis rate in the observation group were lower than those in the control group(P<0.05).Conclusion The complete resection rate of 6～9 mm colorectal polyps through CS-EMR was comparable to that of HS-EMR,and CS-EMR has a better efficacy and lower risk of perioperative bleeding,along with higher safety.