The expert consensus on the clinical treatment of herpes zoster with fire needling was developed, and the commonly used fire needling treatment scheme verified by clinical research was selected to form a standardized diagnosis and treatment scheme for acute herpes zoster and postherpetic neuralgia (PHN), so as to answer the core problems in clinical application. The consensus focuses on patients with herpes zoster, and forms recommendations for 9 key clinical issues, covering simple fire needling and TCM comprehensive therapy based on fire needling, including fire needling combined with cupping, fire needling combined with Chinese herb, fire needling combined with cupping and Chinese herb, fire needling combined with filiform needling, fire needling combined with moxibustion, and provides specific recommendations and operational guidelines for various therapies.
Humans ; Herpes Zoster/therapy* ; Acupuncture Therapy/instrumentation* ; Consensus ; Clinical Protocols

Objective:To investigate the prognostic effect of femoral resection on patients with soft tissue sarcoma of the thigh with cortical bone involvement.Methods:This retrospective study included patients with soft tissue sarcoma of the thigh diagnosed and treated in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to December 2021. Patients were divided into two groups based on whether femoral resection and reconstruction were performed with 20 in the resection group and 86 in the non-resection group. Propensity score matching (PSM) was used to control confounding variables. Overall Survival, recurrence free survival, metastasis free survival, and postoperative functional outcomes were compared between groups before and after PSM. Cox proportional hazards regression was used to identify risk factors for death, recurrence, and metastasis.Results:Before PSM, the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 46.7% and 36.7% in the resection group, compared to 69.7% and 60.3% in the non-resection group without significant differences ( P>0.05). However, the 5-year metastasis-free survival (MFS) rate was significantly lower in the resection group (40.0%) compared to the non-resection group (73.1%) ( P=0.021). After PSM, the 5-year OS, RFS, and MFS in the resection group were 46.7%, 36.7%, and 35.9%, respectively, compared to 45.0%, 39.4%, and 67.7% in the non-resection group, with no significant differences ( P>0.05). The median postoperative MSTS functional score after PSM was significantly lower in the resection group 23(18, 25) points than in the non-resection group 26.5(24.3, 27.8) points ( U=43.000, P=0.007). Multivariate Cox regression analysis identified grade III histology ( HR=3.794, P=0.002) and tumor involvement angle around the femur greater than 180° ( HR=2.729, P=0.030) as independent risk factors for death. Age over 55 years ( HR=4.185, P=0.015), tumor diameter greater than 8 cm ( HR=4.290, P=0.014), and involvement of the intermuscular compartment ( HR=3.794, P=0.017) were associated with increased risk of local recurrence. Grade III histology ( HR=3.848, P=0.006) and involvement of the intermuscular compartment ( HR=2.500, P=0.045) were associated with distant metastasis. Conclusion:For patients with thigh soft tissue sarcoma involving femoral cortex involvement but no medullary cavity invasion, bone resection did not improve survival, recurrence or metastasis compared with patients in non-resection group. A relatively more conservative surgical approach may be advisable to preserve limb function without compromising oncological prognosis.

Objective:To investigate the prognostic effect of femoral resection on patients with soft tissue sarcoma of the thigh with cortical bone involvement.Methods:This retrospective study included patients with soft tissue sarcoma of the thigh diagnosed and treated in the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to December 2021. Patients were divided into two groups based on whether femoral resection and reconstruction were performed with 20 in the resection group and 86 in the non-resection group. Propensity score matching (PSM) was used to control confounding variables. Overall Survival, recurrence free survival, metastasis free survival, and postoperative functional outcomes were compared between groups before and after PSM. Cox proportional hazards regression was used to identify risk factors for death, recurrence, and metastasis.Results:Before PSM, the 5-year overall survival (OS) and recurrence-free survival (RFS) rates were 46.7% and 36.7% in the resection group, compared to 69.7% and 60.3% in the non-resection group without significant differences ( P>0.05). However, the 5-year metastasis-free survival (MFS) rate was significantly lower in the resection group (40.0%) compared to the non-resection group (73.1%) ( P=0.021). After PSM, the 5-year OS, RFS, and MFS in the resection group were 46.7%, 36.7%, and 35.9%, respectively, compared to 45.0%, 39.4%, and 67.7% in the non-resection group, with no significant differences ( P>0.05). The median postoperative MSTS functional score after PSM was significantly lower in the resection group 23(18, 25) points than in the non-resection group 26.5(24.3, 27.8) points ( U=43.000, P=0.007). Multivariate Cox regression analysis identified grade III histology ( HR=3.794, P=0.002) and tumor involvement angle around the femur greater than 180° ( HR=2.729, P=0.030) as independent risk factors for death. Age over 55 years ( HR=4.185, P=0.015), tumor diameter greater than 8 cm ( HR=4.290, P=0.014), and involvement of the intermuscular compartment ( HR=3.794, P=0.017) were associated with increased risk of local recurrence. Grade III histology ( HR=3.848, P=0.006) and involvement of the intermuscular compartment ( HR=2.500, P=0.045) were associated with distant metastasis. Conclusion:For patients with thigh soft tissue sarcoma involving femoral cortex involvement but no medullary cavity invasion, bone resection did not improve survival, recurrence or metastasis compared with patients in non-resection group. A relatively more conservative surgical approach may be advisable to preserve limb function without compromising oncological prognosis.

BACKGROUND:Photoresponsive nanomaterials offer the combined advantages of nanomaterials and the unique benefits of light responsiveness.They find extensive applications in biomedical fields like tissue regeneration,biological imaging,disease diagnosis,drug delivery,and targeted therapy,making them a research hotspot in the field of functional materials.OBJECTIVE:To summarize the advantages and research progress of photoresponsive nanomaterials in bone tissue regeneration.METHODS:CNKI and PubMed databases were searched using the main English search terms"light-responsive,photoresponsive,nanomaterials,bone defect,bone regeneration,osteogenesis,osseointegration"and main Chinese search terms"light-responsive,nanomaterials,bone defect,bone regeneration,osseointegration."Relevant literature was selected based on inclusion and exclusion criteria,resulting in the inclusion of 59 articles for review.RESULTS AND CONCLUSION:The surface morphology of photoresponsive nanomaterials can promote bone tissue regeneration by directly modulating the gene expression and biological behavior of osteoblasts and indirectly regulating immune-related cells behavior.Photoresponsive nanomaterials can be utilized for photothermal and photodynamic antibacterial purposes to facilitate the repair of infectious bone defects.Mild photothermal stimulation generated by photoresponsive nanomaterials can effectively enhance osteogenesis by upregulating the expression and functionality of osteogenic-related genes and proteins.Photoresponsive nanomaterials can produce electrons under light exposure,thereby achieving non-invasive promotion of bone tissue regeneration by modulating local cellular potential changes.Drug release systems based on photoresponsive nanomaterials can undergo structural changes under specific light sources to promote drug release,providing targeted therapeutic strategies for bone tissue regeneration.

BACKGROUND:Photoresponsive nanomaterials offer the combined advantages of nanomaterials and the unique benefits of light responsiveness.They find extensive applications in biomedical fields like tissue regeneration,biological imaging,disease diagnosis,drug delivery,and targeted therapy,making them a research hotspot in the field of functional materials.OBJECTIVE:To summarize the advantages and research progress of photoresponsive nanomaterials in bone tissue regeneration.METHODS:CNKI and PubMed databases were searched using the main English search terms"light-responsive,photoresponsive,nanomaterials,bone defect,bone regeneration,osteogenesis,osseointegration"and main Chinese search terms"light-responsive,nanomaterials,bone defect,bone regeneration,osseointegration."Relevant literature was selected based on inclusion and exclusion criteria,resulting in the inclusion of 59 articles for review.RESULTS AND CONCLUSION:The surface morphology of photoresponsive nanomaterials can promote bone tissue regeneration by directly modulating the gene expression and biological behavior of osteoblasts and indirectly regulating immune-related cells behavior.Photoresponsive nanomaterials can be utilized for photothermal and photodynamic antibacterial purposes to facilitate the repair of infectious bone defects.Mild photothermal stimulation generated by photoresponsive nanomaterials can effectively enhance osteogenesis by upregulating the expression and functionality of osteogenic-related genes and proteins.Photoresponsive nanomaterials can produce electrons under light exposure,thereby achieving non-invasive promotion of bone tissue regeneration by modulating local cellular potential changes.Drug release systems based on photoresponsive nanomaterials can undergo structural changes under specific light sources to promote drug release,providing targeted therapeutic strategies for bone tissue regeneration.

Promoting wound healing is a common clinical challenge faced by surgeons, with a variety of repair method and materials currently available for clinical use. In recent years, with the continuous development of disciplines such as tissue engineering, regenerative medicine, and materials science, research on wound repair materials has progressed rapidly. This article will organize the classification, advantages and disadvantages, and the latest advancements in the preparation processes of wound repair materials. It will also discuss the current challenges faced by wound repair materials and future research directions, with the aim of providing a reference for related studies in wound repair.

Objective:To investigate the risk factors of pleural effusion after spinal separation surgery for patients with spinal metastatic tumors.Methods:A total of 427 patients with spinal metastatic tumors from January 2014 to January 2022 in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively analyzed. There were 252 males and 175 females, with an average age of 59±12 years (range, 15-87 years). All patients underwent separation surgery. Based on the chest CT within 1 month after surgery, the volume of pleural effusion was measured individually by reconstruction software. Pleural effusion was defined as small volume (0-500 ml), moderate volume (500-1 000 ml), and large volume (above 1 000 ml). Baseline data and perioperative clinical outcomes were compared between the groups, and indicators with statistically significant differences were included in a binary logistic regression analysis to determine the independent risk factors for the development of pleural effusion after isolation of spinal metastatic cancer. Receiver operating characteristic (ROC) curves were conducted to calculate the area under the curve (AUC) for each independent risk factor.Results:All patients successfully completed the operation. Among the 427 patients, there were 35 cases of large pleural effusion, 42 cases of moderate pleural effusion, and 350 cases of small pleural effusion. There were significant differences in tumor size (χ 2=9.485, P=0.013), intraoperative blood loss ( Z=-2.503, P=0.011), blood transfusion ( Z=-2.983, P=0.003), preoperative total protein ( Z=2.681, P=0.007), preoperative albumin ( Z=1.720, P= 0.085), postoperative hemoglobin ( t=2.950, P=0.008), postoperative total protein ( Z=4.192, P<0.001), and postoperative albumin ( t=2.268, P=0.032) in the large pleural effusion group versus the small and moderate pleural effusion group. Logistic regression analysis showed that decreased preoperative albumin ( OR=0.89, P=0.045) and metastases located in the thoracic spine ( OR=4.01, P=0.039) were independent risk factors for the occurrence of large pleural effusion after separation surgery. The ROC curve showed that the AUC and 95% CI for preoperative albumin, lesion location, and the combined model were 0.637 (0.54, 0.74), 0.421 (0.36, 0.48), and 0.883 (0.81, 0.92). The combined predictive model showed good predictive value. Conclusion:The volume of pleural effusion can be measured individually and quantitatively based on chest CT. Decreased preoperative albumin and metastases located in the thoracic spine are independent risk factors for the occurrence of large pleural effusion after separation surgery. The combined prediction of the two factors has better predictive efficacy.

Promoting wound healing is a common clinical challenge faced by surgeons, with a variety of repair method and materials currently available for clinical use. In recent years, with the continuous development of disciplines such as tissue engineering, regenerative medicine, and materials science, research on wound repair materials has progressed rapidly. This article will organize the classification, advantages and disadvantages, and the latest advancements in the preparation processes of wound repair materials. It will also discuss the current challenges faced by wound repair materials and future research directions, with the aim of providing a reference for related studies in wound repair.

Objective: This meta-analysis aims to refine the understanding of the optimal choice between different cage shapes in transforaminal lumbar interbody fusion (TLIF) by systematically comparing perioperative data, radiological outcomes, clinical results, and complications associated with banana-shaped and straight bullet cages. Methods: A meticulous literature search encompassing PubMed, Embase, Scopus, Web of Science, China Knowledge Network, and Wanfang Data was executed up to October 5, 2023. Inclusion criteria focused on studies comparing banana-shaped and straight bullet cages in TLIF. The quality of included studies was assessed using appropriate tools such as the Newcastle-Ottawa Scale (NOS) for nonrandomized studies. Rigorous evaluations were performed for radiographic outcomes, including disc height (DH), segmental lordosis (SL), lumbar lordosis (LL), subsidence, and fusion rates. Clinical outcomes were meticulously evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI), and complications. Results: The analysis incorporated 7 studies, involving 573 patients (297 with banana-shaped cages, 276 with straight cages), all with NOS ratings exceeding 5 stars. No statistically significant differences were observed in operative time, blood loss, or hospitalization between the 2 cage shapes. Banana-shaped cages exhibited greater changes in DH (p = 0.001), SL (p = 0.02), and LL (p = 0.01). Despite statistically higher changes in ODI for straight cages (26.33, p < 0.0001), the actual value remained similar to banana-shaped cages (26.15). Both cage types demonstrated similar efficacy in VAS, complication rates, subsidence, and fusion rates. Conclusion Although banana-shaped cages can excel in restoring DH, SL, and LL, straight bullet cages can provide comparable functional improvements, pain relief, and complication rates.

Objective: This meta-analysis aims to refine the understanding of the optimal choice between different cage shapes in transforaminal lumbar interbody fusion (TLIF) by systematically comparing perioperative data, radiological outcomes, clinical results, and complications associated with banana-shaped and straight bullet cages. Methods: A meticulous literature search encompassing PubMed, Embase, Scopus, Web of Science, China Knowledge Network, and Wanfang Data was executed up to October 5, 2023. Inclusion criteria focused on studies comparing banana-shaped and straight bullet cages in TLIF. The quality of included studies was assessed using appropriate tools such as the Newcastle-Ottawa Scale (NOS) for nonrandomized studies. Rigorous evaluations were performed for radiographic outcomes, including disc height (DH), segmental lordosis (SL), lumbar lordosis (LL), subsidence, and fusion rates. Clinical outcomes were meticulously evaluated using visual analogue scale (VAS), Oswestry Disability Index (ODI), and complications. Results: The analysis incorporated 7 studies, involving 573 patients (297 with banana-shaped cages, 276 with straight cages), all with NOS ratings exceeding 5 stars. No statistically significant differences were observed in operative time, blood loss, or hospitalization between the 2 cage shapes. Banana-shaped cages exhibited greater changes in DH (p = 0.001), SL (p = 0.02), and LL (p = 0.01). Despite statistically higher changes in ODI for straight cages (26.33, p < 0.0001), the actual value remained similar to banana-shaped cages (26.15). Both cage types demonstrated similar efficacy in VAS, complication rates, subsidence, and fusion rates. Conclusion Although banana-shaped cages can excel in restoring DH, SL, and LL, straight bullet cages can provide comparable functional improvements, pain relief, and complication rates.