The development of traditional Chinese medicine (TCM) diagnosis and treatment has undergone multiple paradigms, evolving from sporadic experiential practices to systematic approaches in syndrome differentiation and treatment and further integration of disease and syndrome frameworks. TCM is a vital component of the medical system, valued alongside Western medicine. Treatment based on syndrome differentiation embodies both personalized treatment and holistic approaches; however, the inconsistency and lack of stability in syndrome differentiation limit clinical efficacy. The existing integration of diseases and syndromes primarily relies on patchwork and embedded systems, where the full advantages of synergy between Chinese and Western medicine are not fully realized. Recently, driven by the development of diagnosis and treatment concepts and advances in analytical technology, Western medicine has been rapidly transforming from a traditional biological model to a precision medicine model. TCM faces a similar need to progress beyond traditional syndrome differentiation and disease-syndrome integration toward a more precise diagnosis and treatment paradigm. Unlike the micro-level precision trend of Western medicine, precision diagnosis and treatment in TCM is primarily reflected in data-driven applications that incorporate information at various levels, including precise syndrome differentiation, medication, disease management, and efficacy evaluation. The current priority is to accelerate the development of TCM precision diagnosis and treatment technology platforms and advance discipline construction in this area.

Objective To explore planning effect of AI-HIP assisted surgical planning system in primary unilateral total hip arthroplasty(THA)and its influence on clinical outcomes.Methods A retrospective analysis was conducted on clinical data of 36 patients who underwent their first unilateral THA from March 2022 to November 2022 and continuously used AI-HIP system(AI-HIP group),including 16 males and 20 females,aged from 43 to 81 years old with an average of(62.2±10.9)years old.According to the matching principle,36 patients who were planned by the traditional template method at the same period were selected as the control group,including 16 males and 20 females,aged from 40 to 80 years old with an average of(60.9±12.1)years old.The accuracy between two groups of prostheses were compared,as well as the combined eccentricity difference between preoperative planning and postoperative practice,lower limb length difference,osteotomy height from the upper edge of the lesser trochanter and top shoulder distance to evaluate planning effect.Harris score and visual analogue scale(VAS)were used to evaluate clinical efficacy.Results Both groups were followed up for 12 to 18 months with an average of(14.5±2.1)months.The complete accuracy and approximate accuracy of acetabular cup and femoral stalk prosthesis in AI-HIP group were 72.2％,100％,58.3％,88.9％,respectively,which were better than 44.4％,83.3％,33.3％,66.7％in control group(P＜0.05).There was no statistical significance in planning of femoral head prosthesis size(P＞0.05).The actual combined eccentricity difference and combined eccentricity difference(practical-planning)in Al-HIP group were 1.0(0.2,2.4)mm and 1.1(-2.1,3.2)mm,respectively;which were better than 3.0(1.4,4.9)mm and 3.5(-1.6,6.5)mm in control group(P＜0.05).There was no significant difference between two groups in actual osteotomy height of the upper margin of the lesser trochanter(P＞0.05).In AI-HIP group,the actual difference of lower extremity length after surgery,the difference of lower extremity length(practical-planning),osteotomy height from the upper margin of lesser trochanter(practical-planning),actual topshoulder distance after surgery,and topshoulder distance(practical-planning)were 1.5(0.2,2.8),1.1(-0.3,2.2),2.1(-2.3,4.1),(15.3±4.1),2.2(-4.8,0.3)mm,respectively;which were better than control group of 2.6(1.3,4.1),2.5(0.3,3.8),5.8(-2.4,7.7),(13.0±4.3),-5.7(-9.4,-2.2)mm(P＜0.05).At final follow-up,there were no significant differences in Harris scores of pain,function,deformity,total scores and VAS between two groups(P＞0.05).The range of motion score was 4.8±0.6 in AI-HIP group,which was higher than that in control group(4.4±0.8)(P＜0.05).Conclusion Compared with traditional template planning,AI-HIP assisted surgical planning system has good accuracy in predicting the prosthetic size of the acetabular cup and femoral stalk,restor-ing joint eccentricity,planning lower limb length,osteotomy height and top shoulder distance on the first unilateral THA,and the clinical follow-up effect is satisfactory.

Objective To explore early postoperative gait characteristics and clinical outcomes after total knee arthroplasty(TKA).Methods From February 2023 to July 2023,26 patients with unilateral knee osteoarthritis(KOA)were treated with TKA,including 4 males and 22 females,aged from 57 to 85 years old with an average of(67.58±6.49)years old;body mass in-dex(BMI)ranged from 18.83 to 38.28 kg·m-2 with an average of(26.43±4.15)kg·m-2;14 patients on the left side,12 pa-tients on the right side;according to Kellgren-Lawrence(K-L)classification,6 patients with grade Ⅲ and 20 patients with grade Ⅳ;the courses of disease ranged from 1 to 14 years with an average of(5.54±3.29)years.Images and videos of standing up and walking,walking side shot,squatting and supine kneeling were taken with smart phones before operation and 6 weeks after operation.The human posture estimation framework OpenPose were used to analyze stride frequency,step length,step length,step speed,active knee knee bending angle,stride length,double support phase time,as well as maximum hip flexion angle and maximum knee bending angle on squatting position.Western Ontario and McMaster Universities(WOMAC)arthritis index and Knee Society Score(KSS)were used to evaluate clinical efficacy of knee joint.Results All patients were followed up for 5 to 7 weeks with an average of(6.00±0.57)weeks.The total score of WOMAC decreased from(64.85±11.54)before op-eration to(45.81±7.91)at 6 weeks after operation(P＜0.001).The total KSS was increased from(101.19±9.58)before opera-tion to(125.50±10.32)at 6 weeks after operation(P＜0.001).The gait speed,stride frequency and stride length of the affected side before operation were(0.32±0.10)m·s-1,(96.35±24.18)steps·min-1,(0.72±0.14)m,respectively;and increased to(0.48±0.11)m·s 1,(104.20±22.53)steps·min-1,(0.79±0.10)m at 6 weeks after operation(P＜0.05).The lower limb support time and active knee bending angle decreased from(0.31±0.38)sand(125.21±11.64)° before operation to(0.11±0.04)s and(120.01±13.35)° at 6 weeks after operation(P＜0.05).Eleven patients could able to complete squat before operation,13 patients could able to complete at 6 weeks after operation,and 9 patients could able to complete both before operation and 6 weeks after operation.In 9 patients,the maximum bending angle of crouching position was increased from 76.29° to 124.11° before operation to 91.35° to 134.12° at 6 weeks after operation,and the maximum bending angle of hip was increased from 103.70° to 147.25° before operation to 118.61° to 149.48° at 6 weeks after operation.Conclusion Gait analysis technology based on artificial intelligence image recognition is a safe and effective method to quantitatively identify the changes of pa-tients'gait.Knee pain of KOA was relieved and the function was improved,the supporting ability of the affected limb was im-proved after TKA,and the patient's stride frequency,stride length and stride speed were improved,and the overall movement rhythm of both lower limbs are more coordinated.

Objective:To evaluate the feasibility and safety of PT Scope (short for intelligent pressure and temperature controlled flexible ureteroscopy)combined with Thulium laser in the intracavitary treatment of upper urinary tract stones.Methods:A retrospective analysis was conducted on the clinical data of 13 patients with upper urinary tract stones who were treated with PT Scope combined with Thulium laser lithotripsy in Sun Yat-Sen Memorial Hospital from February to April 2024. There were 7 males and 6 females. The patients had a mean age of (46±10) years old, with an accumulated stone diameter of (25.8±13.3) mm. There were 7 cases of lower calyx stones (53.8%), and 3 cases of concomitant ureteral stones (23.1%).Four patients (30.8%) had positive preoperative urine cultures, and six patients (46.2%) had leukocyte counts greater than 100 cells/μl in their urine tests. The Thulium laser power was set at 45 W (1.5 J at 30 Hz, 0.3 J at 150 Hz). The renal pelvic pressure threshold was set at 30 mmHg (1 mmHg=0.133 kPa), and the temperature threshold at 43 ℃. Postoperatively, double J stents were placed for 2 to 4 weeks.Results:All 13 patients successfully completed the surgery. The median operative time was 30 (25, 90) minutes. The intraoperative average renal pelvic pressure in these 13 patients ranged from 8 mmHg to 24 mmHg, and the average renal pelvic temperature ranged from 25 ℃ to 34 ℃. Postoperatively, 1 patient experienced a fever (38.0 ℃) and 2 patients required analgesic treatment due to postoperative pain. There were no other intraoperative or postoperative complications. The median postoperative hospital stay was (1.5±0.8) days. The stone-free rate of 1 month was 84.6%(11/13).Conclusions:PT Scope combined with Thulium laser could effectively control renal pelvic pressure and temperature, achieve a high stone-free rate, and have a low complication rate. It is a safe and effective treatment for upper urinary tract stones.

Objectives:To assess the efficacy of cord blood-assisted haploid peripheral blood stem cell transplantation (haplo-cord-PBSCT) versus unrelated donor peripheral blood stem cell transplantation (UD-PBSCT) in the treatment of malignant hematological diseases.Methods:A retrospective analysis was performed on one hundred and four patients with malignant hematological diseases who underwent haplo-cord-PBSCT and fifty-two patients who underwent UD-PBSCT at Xiangya Hospital of Central South University between January 2016 and December 2021.Results:①The median implantation time for neutrophils in the haplo-cord-PBSCT and UD-PBSCT groups was 13 (9–22) days and 13 (10–24) days, respectively ( P=0.834), whereas the median implantation time for platelets was 15 (7–103) days and 14 (8-38) days, respectively ( P=0.816). The cumulative implantation rate of neutrophils at 30 days after transplantation in the haplo-cord-PBSCT group and the UD-PBSCT group was 100% ( P=0.314), and the cumulative platelet implantation rate at 100 days after transplantation was 95.2% (95% CI 88.3% - 98.1% ) and 100% ( P=0.927), respectively. 30 days after transplantation, both groups of patients achieved complete donor chimerism, and no umbilical cord blood stem cells were implanted. ②The cumulative incidence rates of grade Ⅱ-Ⅳ acute GVHD within 100 days after transplantation in the haplo-cord-PBSCT group and the UD-PBSCT group were 29.1% (95% CI 20.1% –38.1% ) and 28.8% (95% CI 17.2% –41.6% ( P=0.965), respectively. The cumulative incidence rates of grade Ⅲ/Ⅳ acute GVHD were 7.8% (95% CI 3.6% –14.0% ) and 9.6% (95% CI 3.5% –19.5% ) ( P=0.725). The cumulative incidence rates of 2-year chronic GVHD in the haplo-cord-PBSCT group and the UD-PBSCT group were 45.3% (95% CI 36.1% -56.1% ) and 35.1% (95% CI 21.6% –44.1% ), respectively ( P=0.237). The cumulative incidence rates of severe chronic GVHD at 2 years after transplantation were 13.6% (95% CI 7.6% -21.3% ) and 12.9% (95% CI 5.1% -24.3% ), respectively ( P=0.840). ③The 2-year CIR after transplantation in the haplo-cord-PBSCT group and UD-PBSCT group were 12.8% (95% CI 7.0% –20.5% ) and 10.0% (95% CI 3.6% –20.2% ), respectively ( P=0.341), and the NRM were 14.7% (95% CI 8.4% –22.6% ) and 16.2% (95% CI 7.4% –28.0% ), respectively ( P=0.681). ④The 2-year OS rates in the haplo-cord-PBSCT and UD-PBSCT groups after transplantation were 82.2% (95% CI 74.8% –90.3% ) and 75.5% (95% CI 64.2% -88.7% ), respectively ( P=0.276). The 2-year DFS rates were 69.9% (95% CI 61.2% –79.8% ) and 73.8% (95% CI 62.4% -87.3% ), respectively ( P=0.551). The 2-year rates of GVHD-free/recurrence-free survival (GRFS) were 55.3% (95% CI 44.8% -64.8% ) and 64.7% (95% CI 52.8% –79.3% ), respectively ( P=0.284) . Conclusion:The findings of this study indicate that haplo-cord-PBSCT and UD-PBSCT have comparable efficacy and safety in the treatment of malignant hematological diseases and can be used as an alternative treatment options.

The research status of active,active-passive hybrid and passive nasal endoscopic surgical robots was introduced,and the shortcomings of the current nasal endoscopic surgical robots were analyzed in structural design,high cost,big size and lack of haptic feedback mechanism.It's pointed out the emphases of the future nasal endoscopic surgical robots included intelligence,miniaturization,new type of materials and low cost.[Chinese Medical Equipment Journal,2024,45(3):95-102]

Objective To explore the in vitro and in vivo antimicrobial activity of pinaverium bromide(PVB)against Staphylococcus epidermidis(S.epidermidis).Methods S.epidermidis isolated from blood specimens of hospitalized patients in a hospital in Changsha from January to December 2022 were collected.Susceptibility test of S.epidermidis to PVB was performed using broth microdilution method and disc diffusion method.The time-and concentration-dependent antimicrobial activity of PVB were determined by time-killing assay.Ultrastructural chan-ges in bacteria after PVB treatment was observed by transmission electron microscope.The inhibitory and clearance effects of PVB on S.epidermidis biofilm were detected by crystal violet staining test.The combined antimicrobial effect of PVB and antimicrobial agents was studied through microdilution checkerboard technique.A skin abscess infection model was constructed to detect the in vivo antimicrobial activity of PVB.Results Antimicrobial suscepti-bility testing results showed that the minimum inhibitory concentration(MIC)and minimum bactericidal concentra-tion(MBC)of PVB against the standard strains RP62A and ATCC 12228 were 8 and 16 μg/mL,respectively;The MIC and MBC of clinical strains of S.epidennidis were 4-8 μg/mL and 8-16 μg/mL,respectively.Disc diffu-sion method results showed that compared with the untreated control group(0.60±0)cm,0.2 mg PVB treatment showed a significant inhibitory zone([2.26±0.09]cm;t=45.34,P＜0.001),and the diameter of inhibitory zone increased with the increase of PVB dosage.The time-killing curves indicated PVB had bactericidal activity,which enhanced with increased concentration and action duration.Transmission electron microscope observed that PVB could significantly damage the normal structure of S.epidermidis,leading to bacterial edema and lysis.In addition,at the concentration of 1 × MIC,PVB could significantly inhibit the formation of S.epidermidis biofilm,reducing the amount of biofilm formation(A570nm)from(2.30±0.18)to(0.47±0.11;t=14.85,P＜0.001).Meanwhile,PVB at the concentration of 1 × MIC could effectively destroy the formed biofilm,reducing the amount of biofilm from(2.64±0.10)to(1.77±0.30;t=4.76,P=0.009).The combination of PVB with amikacin and gentamicin exhibited synergistic antimicrobial activity,with synergistic inhibitory indexes of 0.50 and 0.31,respectively.Ani-mal models showed that 10 mg/kg body weight of PVB could reduce the area of abscesses from(68.83±10.68)mm2 to(35.50±10.58)mm2(t=6.52,P＜0.001),and reduce the amount of viable bacteria in abscesses from(6.11±0.55)lg(CFU/abscess)to(3.60±0.34)lg(CFU/abscess)(t=3.08,P=0.014).Hematoxylin-eosin staining revealed that the infiltration of inflammatory cells in skin abscesses in the PVB treatment group reduced significantly compared with the control group,tending to be normal.Conclusion PVB exhibits effective in vitro and in vivo an-timicrobial effect against S.epidermidis,which can be used as an alternative for the treatment of S.epidermidis-related infections.

Objective:To compare the therapeutic effects of different inhaled medications on patients with frequent cough in chronic obstructive pulmonary disease (COPD), including changes in symptoms and acute exacerbation.Methods:This study was based on the RealDTC study, and the study subjects were stable COPD patients from the Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University from December 2016 to March 2023. The demographic characteristics, smoking status, history of biofuel exposure, history of acute exacerbation in the past year, lung function, COPD Assessment Test (CAT) score, modified British Medical Research Council Respiratory Difficulty Questionnaire (mMRC) score, and inhalation medication regimen of the patients were collected. Patients with frequent cough are defined as having a cough score of ≥2 in the first item of the CAT score. According to the type of inhaled medication, patients with frequent cough are divided into l long-acting muscarine anticholinergic (LAMA), long-acting β2 agonists (LABA)+ LAMA, inhaled corticosteroids (ICS)+ LABA, and ICS+ LABA+ LAMA groups. At the 6th month follow-up, CAT scores were collected and symptom control was evaluated, including minimum clinical improvement (MCID) (defined as a decrease of ≥2 points from baseline in CAT scores at the 6th month) and improvement in cough symptoms (defined as a decrease of ≥1 point from baseline in cough scores). During a one-year follow-up, the number of acute exacerbations was evaluated. The relationship between different inhaled medications and prognosis in patients with frequent cough in COPD was evaluated using multivariate logistic regression analysis.Results:A total of 653 patients with frequent cough in COPD were included, with a CAT score of (16.4±6.1) and a cough score of 3(2, 3). After 6 months of follow-up, 403 patients (61.7%) achieved MCID, and 394 patients (60.3%) had improved cough symptoms; During a one-year follow-up, 227 patients (34.8%) experienced acute exacerbation. After receiving inhalation medication treatment, the CAT scores and cough scores of four groups of patients with frequent cough, namely LAMA, LABA+ LAMA, ICS+ LABA, and ICS+ LABA+ LAMA, decreased compared to before treatment (all P<0.05). There was a statistically significant difference in the proportion of △CAT score, MCID, and acute exacerbation among the four groups of LAMA, LABA+ LAMA, ICS+ LABA, and ICS+ LABA+ LAMA (all P<0.05), while there was no statistically significant difference in the proportion of △cough score and cough score reduction ≥1 point (all P>0.05). The results of multivariate logistic regression analysis showed that compared with patients treated with LAMA or ICS+ LABA drugs, patients with frequent cough in COPD treated with LABA+ LAMA or ICS+ LABA+ LAMA drugs were more likely to achieve MCID and less likely to experience acute exacerbation (all P<0.05). Conclusions:Compared with LAMA or ICS+ LABA, patients with frequent cough in COPD who receive LABA+ LAMA or ICS+ LABA+ LAMA drug treatment are more likely to improve symptoms and have a lower risk of acute exacerbation.

Objective:To explore the impact of sleep disorders on the therapeutic effects of different inhaled medications in patients with chronic obstructive pulmonary disease (COPD).Methods:A prospective observational study was conducted on 393 patients with stable COPD who visited the Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University from December 2020 to September 2021. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of patients with chronic obstructive pulmonary disease, and patients were divided into a non sleep disorder group and a sleep disorder group. The Berlin questionnaire was used to assess the risk of obstructive sleep apnea syndrome (OSAS) in patients, and the hospital anxiety and depression questionnaire (HADS) was used to assess the presence of anxiety and depression in patients. The improvement of symptoms [minimum clinically significant difference (MCID)] and the deterioration of symptoms [clinical significant symptom deterioration (CID)] within six months of patient follow-up were evaluated. The moderate to severe acute exacerbation of the patient was recorded during the one-year follow-up period. The clinical characteristics of two groups of patients were compared, and multiple regression analysis was used to evaluate the relationship between sleep quality and the prognosis of chronic obstructive pulmonary disease, as well as the impact of sleep disorders on the treatment efficacy of different inhaled drugs.Results:The average age of 393 patients with chronic obstructive pulmonary disease was (62.9±8.3)years old, with a median percentage of forced expiratory volume in the first second (FEV 1%) of 53.7%(30.7%) and a mean PSQI score of (5.7±3.4)points. 186 cases (47.3%) of patients had sleep disorders. Compared with patients in the non sleep disorder group, patients in the sleep disorder group had a higher proportion of middle school education and below, lower FEV 1 and FEV 1/forced vital capacity (FVC), higher baseline COPD Assessment Test (CAT), modified Medical Research Council (mMRC) and Clinical COPD Questionnaire (CCQ) scores, and a higher proportion of comorbid anxiety (all P<0.05). Compared with patients without sleep disorders, patients with sleep disorders had a lower incidence of MCID ( P=0.030) and a higher incidence of CID ( P=0.005). During the one-year follow-up period, patients with sleep disorders experienced a higher proportion of moderate to severe acute exacerbation ( P=0.001), severe acute exacerbation ( P=0.003), and frequent acute exacerbation ( P=0.009). The results of multiple regression analysis showed that patients with sleep disorders had a lower likelihood of developing MCID ( OR: 0.288, 95% CI: 0.145-0.379, P<0.001), and an increased risk of developing CID ( OR: 3.150, 95% CI: 2.011-4.388, P<0.001) and acute exacerbation ( OR: 1.659, 95% CI: 1.162-2.368, P=0.005). Compared with patients using long-acting muscarinic antagonist (LAMA) or inhaled corticosteroids (ICS)+ long-acting β2-agonist (LABA), patients in the sleep disorder group who used LABA+ LABA were more likely to develop MCID ( OR: 1.420, 95% CI: 1.021-2.751, P=0.010; OR: 1.976, 95% CI: 1.123-2.227, P=0.023). Conclusions:Compared with patients without sleep disorders, COPD patients with sleep disorders have a lower likelihood of symptom improvement, and a higher risk of symptom deterioration and acute exacerbation.Patients with COPD with sleep disorders are more likely to achieve symptom improvement by using LABA+ LAMA.

Objective To investigate the effects of Licorice chalcone A(LCA)on proliferation,migration,invasion and antioxidant capacity of human glioma U87 cells and its mechanism.Methods Glioma U87 cells cultured in vitro were divided into 4 groups,blank control group(conventional culture)and experimental-L,-M,-H groups(5,10,20 μmol·L-1 LC A).Cell proliferation capacity was detected by cell counting kit-8,cell clonogenesis ability was detected by clonogenesis assay,cell migration ability was detected by scratch assay,and cell invasion ability was detected by Transwell assay.Colorimetric assay was used to detect total glutathione(T-GSH),malondialdehyde(MDA)and superoxide dismutase(SOD),and Western blotting was used to detect the protein expression levels of phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt).Results The cell proliferation activities of blank control group and experimental-L,-M,-H groups were(90.20±2.17)％,(79.06±1.57)％,(66.13±2.11)％and(49.52±1.82)％;cell clone formation rates were(76.83±2.30)％,(42.33±2.09)％,(17.71±1.84)％and(12.12±1.97)％;12 h cell mobility rates were(34.92±2.24)％,(27.90±1.89)％,(18.76±1.14)％and(14.87±0.82)％;24 h cell mobility rates were(50.37±2.61)％,(39.43±2.56)％,(21.11±2.33)％and(18.32±2.39)％;the number of perforated cells were 120.39±4.16,79.95±3.83,45.67±3.55 and 18.14±2.85;T-GSH levels were(71.43±2.39),(58.51±2.91),(49.43±2.78)and(35.44±2.76)μmol·L-1;MDA levels were(4.14±0.91),(7.23±1.75),(9.20±1.56)and(11.37±1.90)nmol·mL-1;SOD levels were(41.44±2.10),(35.43±2.91),(28.56±2.32)and(20.62±2.05)U·mg-1;the relative expression levels of p-Akt were 1.27±0.03,1.06±0.02,0.89±0.01 and 0.60±0.02,respectively.The above indexes were statistically significant between experimental-L,-M,-H groups and blank control group(all P＜0.01).Conclusion LCA can inhibit the proliferation,migration,invasion and induce oxidative damage of glioma U87 cells,and its mechanism may be related to the down-regulation of p-Akt protein expression in PI3K/Akt signaling pathway.