BACKGROUND:The prognosis of patients undergoing percutaneous transforaminal endoscopic discectomy is poor,which is related to the lack of functional physical exercise.Conventional rehabilitation methods have limited efficacy,mainly because the rehabilitation methods are relatively single and lack specificity.Therefore,it is necessary to improve the overall functional physical exercise method.OBJECTIVE:To explore the effect of overall functional physical exercise on lumbar biomechanics in patients with lumbar disc herniation who underwent percutaneous transforaminal endoscopic discectomy.METHODS:120 patients who met the percutaneous intervertebral foramen discectomy indication and underwent percutaneous intervertebral foramen discectomy operation in Henan Provincial People's Hospital from April 2021 to September 2022 were selected as study subjects.They were randomly divided into traditional rehabilitation group and overall functional physical exercise group.Patients in the two groups received 8 weeks of traditional rehabilitation and overall functional physical exercise respectively.Before the exercise intervention and after 8 weeks of intervention,the lsoMed2000 isokinetic muscle strength testing system was used to conduct isokinetic muscle strength testing.The Oswestry Disability Index was used to evaluate lumbar spine function.The visual analog scale was used to evaluate the pain level.The anxiety self-rating scale and depression self-report scale were used to assess symptoms of anxiety and depression.After 8 weeks of exercise intervention,the modified Macnab efficacy evaluation standard was used to evaluate the efficacy.RESULTS AND CONCLUSION:(1)Compared with the traditional rehabilitation group,the peak torque and average power of flexion and extensor in the whole functional physical exercise group increased,the peak torque ratio of flexion and extension decreased,Oswestry disability index score,visual analog scale score,self-rating anxiety scale score and self-rating depression scale score decreased,and the excellent and good rate increased 8 weeks after treatment(P＜0.001).(2)It is concluded that compared with the traditional rehabilitation program,overall functional physical exercise after percutaneous intervertebral foramen discectomy in patients with lumbar disc herniation can effectively enhance lumbar biomechanics and function,relieve pain,reduce postoperative bad mood,and improve prognosis,which has high clinical value.

BACKGROUND:The prognosis of patients undergoing percutaneous transforaminal endoscopic discectomy is poor,which is related to the lack of functional physical exercise.Conventional rehabilitation methods have limited efficacy,mainly because the rehabilitation methods are relatively single and lack specificity.Therefore,it is necessary to improve the overall functional physical exercise method.OBJECTIVE:To explore the effect of overall functional physical exercise on lumbar biomechanics in patients with lumbar disc herniation who underwent percutaneous transforaminal endoscopic discectomy.METHODS:120 patients who met the percutaneous intervertebral foramen discectomy indication and underwent percutaneous intervertebral foramen discectomy operation in Henan Provincial People's Hospital from April 2021 to September 2022 were selected as study subjects.They were randomly divided into traditional rehabilitation group and overall functional physical exercise group.Patients in the two groups received 8 weeks of traditional rehabilitation and overall functional physical exercise respectively.Before the exercise intervention and after 8 weeks of intervention,the lsoMed2000 isokinetic muscle strength testing system was used to conduct isokinetic muscle strength testing.The Oswestry Disability Index was used to evaluate lumbar spine function.The visual analog scale was used to evaluate the pain level.The anxiety self-rating scale and depression self-report scale were used to assess symptoms of anxiety and depression.After 8 weeks of exercise intervention,the modified Macnab efficacy evaluation standard was used to evaluate the efficacy.RESULTS AND CONCLUSION:(1)Compared with the traditional rehabilitation group,the peak torque and average power of flexion and extensor in the whole functional physical exercise group increased,the peak torque ratio of flexion and extension decreased,Oswestry disability index score,visual analog scale score,self-rating anxiety scale score and self-rating depression scale score decreased,and the excellent and good rate increased 8 weeks after treatment(P＜0.001).(2)It is concluded that compared with the traditional rehabilitation program,overall functional physical exercise after percutaneous intervertebral foramen discectomy in patients with lumbar disc herniation can effectively enhance lumbar biomechanics and function,relieve pain,reduce postoperative bad mood,and improve prognosis,which has high clinical value.

Objective To evaluates the impact of early application of neuromuscular electrical stimulation(NMES)on muscle strength,clinical outcomes,and long-term quality of life improvements in patients with severe acute pancreatitis(SAP)complicated with acute respiratory distress syndrome(ARDS).Methods A total of 75 patients diagnosed with SAP and ARDS admitted in Department of Critical Care Medicine of our hospital from September 2022 to August 2023 were recruited and then randomly divided into NMES group(n=37)and control group(n=38).After 16 patients were excluded,including 8 died during treatment,3 discharged and 5 received palliative care,there were finally 29 patients in the NMES group and 30 in the control group.Within 48 h after ICU admission,the NMES group received NMES 1 h per day,for 7 d in addition to standard rehabilitation intervention.While,the control group were given conventional interventions for rehabilitation.Assessments at baseline and post-treatment included the incidence of ICU-acquired weakness(ICU-AW),Medical Research Council(MRC)score,duration of mechanical ventilation,lengths of ICU and total hospital stays,and activity,thickness and thickening fraction of the diaphragm.Mortality rates and Barthel index(BI)for self-care ability in 1,3 and 6 months after discharge were recorded for follow-up assessments.Results The NMES group had significantly lower incidence of ICU-AW(P＜0.05),higher upper and lower limb MRC scores and overall MRC score at ICU discharge(P＜0.05),shorter durations of mechanical ventilation,ICU stay,and total hospital stay when compared with the control group(P＜0.05).There was no statistical difference in the BI at 1 month post-discharge between the 2 groups,but the indexes at 3 and 6 months were notably higher in the NMES group than the control group(P＜0.05).No obvious differences were observed between the 2 groups in terms of diaphragm activity,thickness,or thickening scores at enrollment,ICU discharge,or hospital discharge,nor in mortality rates at 1,3,and 6 months after discharge.Conclusion Combined NMES and early rehabilitation therapy can improve muscle strength and reduce length of hospital stay in SAP patients complicated with ARDS,and may enhance long-term quality of life.However,it does not significantly affect diaphragm function or mortality rates.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first reported in China mainland, suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first one reported in China mainland, which suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first reported in China mainland, suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first one reported in China mainland, which suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

OBJECTIVE： To prepare Baicalin-loaded Polyethylene glycol-derivatized phosphatidylethanolamine （BAI@PEG-PE） nanomicelles， and to characterize it and study its cytotoxicity. METHODS： BAI@PEG-PE nanomicelles were prepared by film hydration method and their appearance characteristics were observed. The particle size， polydispersity index， Zeta potential， drug-loading amount and encapsulation efficiency of the nanomicelles were detected. Drug release of BAI raw material and BAI@PEG-PE nanomicelles in pH 7.4 phosphate buffer were compared within 1-84 h. Using coumarin 6 as fluorescent probe， the distribution of PEG-PE nanomicelles in H9c2 cardiomyocytes were observed. H9c2 cardiomyocytes were divided into model group， BAI raw material group and BAI@PEG-PE nanomicelles group. After treated with serum-free DMEM medium containing no or corresponding drugs for 0.5 h， isoproterenol was used to induce cardiomyocyte apoptosis. Nuclear morphology， cell apoptosis rate and protein expression of Bcl-2 and Bax were compared with among 3 groups. RESULTS： Prepared BAI@PEG-PE nanomicelles were uniform globular shape. The particle size was （16.7±0.8） nm， PDI was 0.11±0.01 and Zeta-potential was （－18.4±0.6） mV； drug-loading amount was （7.84±0.65）％， encapsulation efficiency was （85.7±4.9）％ （n＝3）. Accumulative release rate was 76.5％ within 84 h. BAI raw material was released completely within 24 h. PEG-PE nanomicelles could strengthen the intake of coumarin 6 in H9c2 cardiomyocytes， mainly gathering around mitochondria. Compared with model group， the apoptosis morphology of cardiomyocytes were improved significantly in BAI raw material group and BAI@PEG-PE nanomicelles group； apoptosis rate was decreased significantly； protein expression of Bcl-2 was increased significantly； protein expression of Bax was decreased significantly with statistical significance （P＜0.05 or P＜0.01）. Above effects of BAI@PEG-PE nanomicelles group were more significant （P＜0.05 or P＜0.01）. CONCLUSIONS： BAI@PEG-PE nanomicelles are prepared successfully， and show significant sustained-release effect and myocardial targeting， and can prevent cardiomyocyte apoptosis.

Objective: To investigate clinic-pathological characteristics, diagnosis, treatment and prognosis of intravascular large B cell lymphoma (IVLBCL) in China. Methods: Clinical and pathological records were analyzed from 12 IVLBCL patients diagnosed between Jan 2010 to Jun 2016. Kaplan-Meier method was used to estimate overall survival (OS), and univariate analysis was performed to identify prognostic factors. Results: A series of 12 patients with IVLBCL (median age, 53.8 years; range, 32-76 years; 6 males and 6 females) was reviewed. Fever was the most common symptom (10/12), respiratory symptoms (cough, pleural effusion, dyspnea, 50%) and hemophagocytic lymphohistiocytosis (50%) were frequently observed, and only 12 patients had neurological symptom. All patients had elevated lactic dehydrogenase and serum ferritin. International Prognostic Index score was high in 75% of total patients. All patients had extra-nodal involved, pulmonary (6/12) and bone marrow (4/12) were frequently involved. Large lymphoid cells within vessel lumina or sinuses were observed in all patients. These cells were large, with scant cytoplasm, vesicular nuclei, and one or more nucleoli, and the structures of vessels and sinus were reserved. CD20 and CD79a were positive in all cases. 11patients received rituximab combined CHOP regimen chemotherapies, overall response rate (ORR) was 90.1%, and complete response rate was 66.7%. Median survival time and median progression time were not reached after a median follow-up of 20 months. Univariate analysis revealed that no clinical characters were associated with OS. Conclusion As a rare variant of DLBCL, IVLBCL presented with pulmonary involved frequently, and trans-bronchial lung biopsy had good positive rates. Rituximab contained chemotherapy was the backbone for IVLBCL.

Objective To investigate the diagnosis strategy,radiology and clinical pathology feature of craniomaxillofacial primary tumor induced osteomalacia.Methods Twelve cases of craniomaxillofacial primary tumor induced osteomalacia were reviewed,including 5 male and 7 female with a age range from 16 to 69 years.The clinical characteristics,radiology examinations and pathological features were analyzed.Results The craniomaxillofacial primary tumor induced osteomalacia occurred in different ages,with 2 to 30 years of medical history.Seven of the twelve cases were octreotide scintigraphy positive,nine of the twelve cases invaded bone,exhibiting destruction of the adjacent cortex,ten of the twelve showed gingival lesions of local thickening or epulis.The tumor arises from mesenchymal tissue,infiltrating local gingiva and bone trabeeular with spindle like fibroblasts and dental epithelial rests.Conclusions The concealed nature of the tumor induced osteomalacia requires multiple methods to locate the primary tumor and the tumors located in craniomaxillofacial region have unique clinical and pathological features.