OBJECTIVE: To screen the population for acupuncture treatment of neck pain, using functional magnetic resonance imaging (fMRI) technology and based on machine learning algorithms. METHODS: Eighty patients with neck pain were recruited. Using FPX25 handheld pressure algometer, the tender points were detected in the areas with high-frequent onset of neck pain and high degree of acupoint sensitization. Acupuncture was delivered at 4 tender points with the lowest pain threshold, once every two days; and the treatment was given 3 times a week and for 2 consecutive weeks. The amplitude of low-frequency fluctuation (ALFF) of the brain before treatment was taken as a predictive feature to construct support vector machine (SVM), logistic regression (LR), and K-nearest neighbors (KNN) models to predict the responses of neck pain patients to acupuncture treatment. A longitudinal analysis of the ALFF features was performed before and after treatment to reveal the potential biological markers of the reactivity to the acupuncture therapy. RESULTS: The SVM model could successfully distinguish high responders (48 cases) and low responders (32 cases) to acupuncture treatment, and its accuracy rate reached 82.5%. Based on the SVM model, the ALFF values of 4 brain regions were identified as the consistent predictive features, including the right middle temporal gyrus, the right superior occipital gyrus, and the bilateral posterior cingulate gyrus. In the patients with high acupuncture response, the ALFF value in the left posterior cingulate gyrus decreased after treatment (P<0.05), whereas in the patients with low acupuncture response, the ALFF value in the right superior occipital gyrus increased after treatment (P<0.01). The longitudinal functional connectivity (FC) analysis found that compared with those before treatment, the high responders showed the enhanced FC after treatment between the left posterior cingulate gyrus and various regions, including the bilateral Crus1 of the cerebellum, the right insula, the bilateral angular gyrus, the left medial superior frontal gyrus, and the left middle cingulate gyrus (GRF: corrected, voxel level: P<0.05, mass level: P<0.05). In contrast, the low responders exhibited the enhanced FC between the left posterior cingulate gyrus and the left Crus2 of the cerebellum, the left middle temporal gyrus, the right posterior cingulate gyrus, and the left angular gyrus; besides, FC was reduced in low responders between the left posterior cingulate gyrus and the right supramarginal gyrus (GRF: corrected, voxel level: P<0.05, mass level: P<0.05). CONCLUSION This study validates the practicality of pre-treatment ALFF feature prediction for acupuncture efficacy on neck pain. The therapeutic effect of acupuncture on neck pain is potentially associated with its impact on the default mode network, and then, alter the pain perception and emotional regulation.
Humans ; Neck Pain/physiopathology* ; Acupuncture Therapy ; Female ; Male ; Adult ; Middle Aged ; Machine Learning ; Magnetic Resonance Imaging ; Young Adult ; Brain/physiopathology* ; Acupuncture Points ; Aged

Objective To investigate the risk factors for AHRE after dual-chamber pacemaker im-plantation in elderly patients without history of atrial fibrillation.Methods A retrospective analy-sis was conducted on 159 elderly patients receiving implantation of cardiac dual-chamber pace-makers in the Chinese PLA General Hospital from January 2018 to December 2020.Based on oc-currence of AHRE or not,they were divided into an AHRE group(73 cases)and a non-AHRE group(86 cases).Cox proportional hazards analysis were performed to analyze the survival and risk factors of AHRE.Results Heart failure(HR=2.134,95％CI:1.212-3.758,P=0.009),his-tory of stroke/transient ischemic attack/thromboembolism(HR=2.378,95％CI:1.293-4.375,P=0.005),atrial sensing amplitude＜2.0 mV(HR=2.258,95％CI:1.307-3.900,P=0.004),NT-proBNP＞900 ng/L(HR=1.740,95％CI:1.024-2.955,P=0.040),and eGFR＜60 ml/(min·1.73 m2)(HR=2.118,95％CI:1.227-3.655,P=0.007)were independent risk factors for new-onset AHRE in elderly patients after dual-chamber pacemaker implantation.Conclusion For elderly patients without history of atrial fibrillation after cardiac dual-chamber pacemaker implan-tations,the occurrence of AHRE is significantly associated with multiple risk factors such as heart failure,history of stroke/transient ischemic attack/thromboembolism,eGFR＜60 ml/(min·1.73 m2),atrial sensing amplitude＜2.0 mV,and NT-proBNP＞900 ng/L.

Reduced or interrupted blood flow is an important pathological and physiological process in femoral head necrosis,so understanding the blood flow of the femoral head can help better understand the progression of femoral head necrosis.With the continuous development and improvement of imaging technology,the technical methods for detecting the blood flow of the femoral head are gradually being widely applied,allowing clinical physicians to better understand the blood flow situation of patients with femoral head necrosis.However,at present,the prognosis prediction of femoral head necrosis still mainly revolves around factors such as the area and angle of femoral head necrosis.Therefore,this article explores imaging techniques covering studies such as femoral head vascular imaging or blood flow perfusion parameters,summarizes their application research progress in femoral head necrosis blood flow assessment,and aims to provide more objective basis for exploring the prevention and prognosis of femoral head necrosis from the perspective of femoral head blood flow.

Objective:To provide theoretical basis for exploring risk factors for injuries and formulating preventive measures by studying the epidemiological characteristics of injuries in specific populations based on the pre-hospital emergency data.Methods:A retrospective analysis was conducted on injury cases of children and adolescents treated by the Zhengzhou Emergency Medical Rescue Center（120）over the past five years.Analyzed factors related to injuries such as age，gender，injury type，location of call，and time of call.Results:Over the past five years，there were a total of 22 160 pre-hospital emergency injury patients in Zhengzhou，including 22 059 cases whose information were complete.The median age was 13（2，17）years-old，with the highest proportion being 13-18 years-old，accounting for 11 515 cases（52.5%）.The top three types of injuries were trauma 10 094（45.8%），followed by traffic accidents 9 465（42.9%），and poisoning 2 080（9.4%）.Trauma mainly occurred from 17:00 to 22:00，traffic injuries mainly occurred from 17:01 to 20:00，12:01 to 15:00，and 07:01 to 08:00，while poisoning mainly occurred from 20:01 to 03:00 the next day.Trauma was most common in May，September，and November，and least common in January to March；traffic injuries were most common from June to August，and least common from December to February；there was no significant difference in the distribution of poisoning by month.The main call locations for injuries were residential areas，roads，recreational places，and schools.Conclusion:Pre-hospital emergency data of injury patients can supplement research data on injuries.The injury among children and adolescents requires attention from society and families.

Reduced or interrupted blood flow is an important pathological and physiological process in femoral head necrosis,so understanding the blood flow of the femoral head can help better understand the progression of femoral head necrosis.With the continuous development and improvement of imaging technology,the technical methods for detecting the blood flow of the femoral head are gradually being widely applied,allowing clinical physicians to better understand the blood flow situation of patients with femoral head necrosis.However,at present,the prognosis prediction of femoral head necrosis still mainly revolves around factors such as the area and angle of femoral head necrosis.Therefore,this article explores imaging techniques covering studies such as femoral head vascular imaging or blood flow perfusion parameters,summarizes their application research progress in femoral head necrosis blood flow assessment,and aims to provide more objective basis for exploring the prevention and prognosis of femoral head necrosis from the perspective of femoral head blood flow.

Objective:To provide theoretical basis for exploring risk factors for injuries and formulating preventive measures by studying the epidemiological characteristics of injuries in specific populations based on the pre-hospital emergency data.Methods:A retrospective analysis was conducted on injury cases of children and adolescents treated by the Zhengzhou Emergency Medical Rescue Center（120）over the past five years.Analyzed factors related to injuries such as age，gender，injury type，location of call，and time of call.Results:Over the past five years，there were a total of 22 160 pre-hospital emergency injury patients in Zhengzhou，including 22 059 cases whose information were complete.The median age was 13（2，17）years-old，with the highest proportion being 13-18 years-old，accounting for 11 515 cases（52.5%）.The top three types of injuries were trauma 10 094（45.8%），followed by traffic accidents 9 465（42.9%），and poisoning 2 080（9.4%）.Trauma mainly occurred from 17:00 to 22:00，traffic injuries mainly occurred from 17:01 to 20:00，12:01 to 15:00，and 07:01 to 08:00，while poisoning mainly occurred from 20:01 to 03:00 the next day.Trauma was most common in May，September，and November，and least common in January to March；traffic injuries were most common from June to August，and least common from December to February；there was no significant difference in the distribution of poisoning by month.The main call locations for injuries were residential areas，roads，recreational places，and schools.Conclusion:Pre-hospital emergency data of injury patients can supplement research data on injuries.The injury among children and adolescents requires attention from society and families.

Objective To investigate the risk factors for AHRE after dual-chamber pacemaker im-plantation in elderly patients without history of atrial fibrillation.Methods A retrospective analy-sis was conducted on 159 elderly patients receiving implantation of cardiac dual-chamber pace-makers in the Chinese PLA General Hospital from January 2018 to December 2020.Based on oc-currence of AHRE or not,they were divided into an AHRE group(73 cases)and a non-AHRE group(86 cases).Cox proportional hazards analysis were performed to analyze the survival and risk factors of AHRE.Results Heart failure(HR=2.134,95％CI:1.212-3.758,P=0.009),his-tory of stroke/transient ischemic attack/thromboembolism(HR=2.378,95％CI:1.293-4.375,P=0.005),atrial sensing amplitude＜2.0 mV(HR=2.258,95％CI:1.307-3.900,P=0.004),NT-proBNP＞900 ng/L(HR=1.740,95％CI:1.024-2.955,P=0.040),and eGFR＜60 ml/(min·1.73 m2)(HR=2.118,95％CI:1.227-3.655,P=0.007)were independent risk factors for new-onset AHRE in elderly patients after dual-chamber pacemaker implantation.Conclusion For elderly patients without history of atrial fibrillation after cardiac dual-chamber pacemaker implan-tations,the occurrence of AHRE is significantly associated with multiple risk factors such as heart failure,history of stroke/transient ischemic attack/thromboembolism,eGFR＜60 ml/(min·1.73 m2),atrial sensing amplitude＜2.0 mV,and NT-proBNP＞900 ng/L.

BACKGROUND:Up to now,there is no literature on the relationship between blood laboratory tests and the course of nontraumatic osteonecrosis of femoral head in different stages.It is necessary to further explore and analyze so as to better clarify the influencing factors of nontraumatic osteonecrosis of femoral head. OBJECTIVE:To analyze the relationship between blood laboratory indicators and the course of nontraumatic osteonecrosis of the femoral head by the Association Research Circulation Osseous(ARCO),thus exploring the influencing factors of blood laboratory indicators on the course of nontraumatic osteonecrosis of the femoral head. METHODS:This study used a retrospective study design.A total of 2 103 patients with osteonecrosis of the femoral head were retrieved from Wangjing Hospital of China Academy of Chinese Medical Sciences database,and 1 075 patients with nontraumatic osteonecrosis of the femoral head were ultimately included based on inclusion and exclusion criteria.Patient age,gender,body mass index,and blood laboratory test results were collected.Blood laboratory tests included low-density lipoprotein,total cholesterol,triglycerides,high-density lipoprotein,apolipoprotein β,apolipoprotein α1,uric acid,total protein quantitative,alkaline phosphatase,activated partial thromboplastin time,prothrombin time,prothrombin time International Normalized Ratio,prothrombin time activity,fibrinogen quantitative,coagulation time of thrombin,D-dimer,total iron binding capacity,and platelet count.The indicators of patients with different age groups and different ARCO stages were compared,and multiple Logistic regression analysis was applied to explore the influencing factors of ARCO stages in osteonecrosis of the femoral head. RESULTS AND CONCLUSION:(1)There were statistical differences in total cholesterol,uric acid,prothrombin time,prothrombin time International Normalized Ratio,and D-dimer among ARCO stages in the young group(P<0.05).Among young patients in ARCO stage II,total cholesterol levels were higher than those in ARCO stage III(P<0.05).Uric acid levels in ARCO stage IV were higher than those in ARCO stage II and III(P<0.05).Prothrombin time and prothrombin time International Normalized Ratio were shorter in ARCO stage IV and II than in ARCO stage III(P<0.05).D-dimer levels were higher in ARCO stage III and IV than in ARCO stage II(P<0.05).(2)There were statistically significant differences in high-density lipoprotein,coagulation time of thrombin,and D-dimer among ARCO stages in the middle-aged group(P<0.05).Among middle-aged patients in ARCO stage IV,high-density lipoprotein levels were higher than those in ARCO stages II and III(P<0.05).Coagulation time of thrombin was shorter in ARCO stage IV than in ARCO stage III(P<0.05).D-dimer levels were higher in ARCO stages IV than in ARCO stages II and III(P<0.05).(3)The uric acid,activated partial thromboplastin time,D-dimer,and platelet count in the elderly group showed statistically significant differences(P<0.05).The uric acid level in ARCO stage IV was higher than that in ARCO stage II and III patients in the elderly group(P<0.05),while the activated prothrombin time in ARCO stage II patients was shorter than that in ARCO stage III patients in the elderly group(P<0.05).The D-dimer level in ARCO stage III and IV patients was higher than that in ARCO stage II patients in the elderly group(P<0.05).The platelet count in ARCO stage IV was lower than that in ARCO stage III patients in the elderly group(P<0.05).(4)Multiple logistic regression analysis showed that total cholesterol and platelet count may be protective factors for course of nontraumatic osteonecrosis of the femoral head,while D-dimer,uric acid,overweight,and young and middle age may be risk factors for course of nontraumatic osteonecrosis of the femoral head.(5)It is indicated that total cholesterol,high-density lipoprotein,uric acid,prothrombin time,prothrombin time International Normalized Ratio,and D-dimer are statistically significant among patients with different ARCO stages.Total cholesterol and platelet count may be protective factors for the course of nontraumatic osteonecrosis of the femoral head,while D-dimer,uric acid,overweight,and middle-aged and young age groups may be hazard factors for the course of nontraumatic osteonecrosis of the femoral head.

ObjectiveTo explore the effect of grain-sized moxibustion at "Zhongwan （RN12）" "Tianshu （ST25）" and "Shangjuxu （ST37）" on the colon tissue of mice with ulcerative colitis （UC）， and to analyze the potential mechanism. MethodsForty C57BL/6 male mice were randomly divided into blank group， model group， moxibustion group and mesalazine group， with 10 mice in each group. In all the groups except for the blank group， UC mouse model was prepared by freely drinking 3% sodium dextran sulfate solution. After successful modeling， the moxibustion group was treated with grain-sized moxibustion at Zhongwan， Tianshu and Shangjuxu ， 3 cones per acupoint， 30 s of each cone. The mesalazine group was given 300 mg/kg of mesalazine enteric-coated tablet solution by gavage. The blank group and the model group were only fixed by grasping without any intervention. Each group was intervened once a day for 7 consecutive days. The general condition of mice in each group was observed， and the disease activity index （DAI） score was evaluated. The colon length， intestinal weight and colon mucosal injury score were detected. The contents of serum intercellular adhesion molecule-1 （ICAM-1）， interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） were detected by ELISA. The pathological changes of colon tissue were observed by HE staining. The mRNA and protein expressions of non-receptor tyrosine protein kinase 2 （JAK2）， signal transducer and activator of transcription 3 （STAT3） and suppressor of cytokine signaling 3 （SOCS3） in colon tissue of mice were detected by real-time fluorescence quantitative PCR and immunohistochemistry， respectively. The mean fluorescence intensity of JAK2 and SOCS3 in colon tissue of mice was detected by immunofluorescence double staining. ResultsCompared to the blank group， the mice in the model group had unclean perianal area， unformed stool， destroyed colonic mucosal morphology， shortened body weight and colon length， increased DAI score， intestinal weight index， colonic mucosal injury and pathological score， serum ICAM-1， IL-6 and TNF-α levels， increased mRNA and protein expression of JAK2 and STAT3 in colon tissue， and decreased mRNA and protein expression of SOCS3 （P＜0.01）. Compared to those in the model group， the perianal area of mice in the moxibustion group and the mesalazine group was improved， and the colonic mucosal morphology was more complete； body weight and colon length increased， while DAI score， intestinal weight index， colonic mucosal injury and pathological score， serum ICAM-1， IL-6 and TNF-α levels decreased， with decreased mRNA and protein expression of JAK2 and STAT3 in colon tissue， and increased SOCS3 mRNA and protein expression （ P＜0.01 or P＜0.05 ）. There was no significant difference in any index between the moxibustion group and the mesalazine group. ConclusionGrain-sized moxibustion at "Zhongwan"， "Tianshu" and "Shangjuxu" can improve the damage of colon mucosa in UC model mice， and the mechanism may be related to the key factors regulating JAK2 / STAT3 signaling pathway based on SOCS3.

Objective:To investigate the impacts of atrial high-rate episodes (AHRE) on the risks of new onset of atrial fibrillation and all-cause mortality in elderly patients over 90 years old after cardiac dual-chamber pacemaker implantation.Methods:This study was a retrospective study. Patients aged 90 years and above who were implanted with cardiac dual-chamber pacemakers and followed up in the People′s Liberation Army General Hospital from January 2017 to June 2022 were enrolled and divided into AHRE≥6 h group and AHRE<6 h group according to the onset time of AHRE. The primary endpoint was new onset of atrial fibrillation, and the secondary endpoints were all-cause mortality and cardiovascular mortality. Kaplan-Meier survival curve was poltted, and log-rank test was used to compare the differences in the incidence of new onset of atrial fibrillation, all-cause death and cardiovascular death between AHRE≥6 h and AHRE<6 h groups. Multivariate Cox survival analysis was used to investigate the factors affecting new onset of atrial fibrillation, all-cause death and cardiovascular death in elderly patients aged 90 years and above with dual-chamber pacemaker implantation.Results:A total of 169 patients were enrolled, aged (93.95±3.28) years, including 18 females (11%). The median follow-up time was 28.9 months. There were 87 and 82 patients in AHRE≥6 h group and AHRE<6 h group, respectively. Kaplan-Meier survival curve analysis showed that the incidence of new onset of atrial fibrillation (log-rank P<0.001), all-cause death (log-rank P=0.004) and cardiovascular death (log-rank P=0.026) in AHRE≥6 h group was significantly higher than that in AHRE<6 h group.After adjusting for traditional risk factors, multivariate Cox survival analysis showed that AHRE≥6 h was an independent risk factor for new onset of atrial fibrillation ( HR=4.046, 95% CI 2.402-6.814, P<0.001) and all-cause mortality ( HR=1.668, 95% CI 1.119-2.487, P=0.012) in elderly patients over 90 years old with cardiac dual-chamber pacemaker implantation. However, AHRE≥6 h had no effect on cardiovascular mortality ( P>0.05). Anemia ( HR=3.098, 95% CI 1.342-7.153, P=0.008) and heart failure with reduced ejection fraction ( HR=3.028, 95% CI 1.181-7.763, P=0.021) were both independently associated with cardiovascular mortality. Conclusions:AHRE is common in cardiac dual-chamber pacemakers recipients aged 90 years and above, and AHRE≥6 h can be used as a predictor of new onset of atrial fibrillation or all-cause mortality in these patients.