ObjectiveTo observe the clinical efficacy and radiographic outcomes of manipulative reduction combined with small splint fixation in the treatment of distal radius fractures. MethodsThe clinical data of 1051 patients with distal radius fractures were retrospectively collected from five hospitals included in the Jiangsu Diagnosis and Treatment Data Platform for Traditional Chinese Medicine（TCM） Dominant Diseases. Propensity score matching at a 1∶4 ratio was applied， resulting in 580 cases selected for final analysis， which comprised 448 patients in the TCM group（manipulative reduction plus small splint fixation） and 132 in the surgical treatment group（open reduction and internal fixation）. Each group was further stratified into type A， B， and C subgroups based on AO fracture classification. Radiographic indicators including palmar tilt， radial inclination， and radial height were compared between groups before treatment and 1 day， 1 week， and 4-6 weeks after treatment， and pain visual analog scale（VAS） scores before treatment and 1 week and 4-6 weeks after treatment were also compared. Wrist joint function was assessed 12 weeks after treatment， using the Dienst wrist function score and the Gartland and Werley（G-W） wrist function score. Additionally， the radiographic indicators at different timepoints and the 12-week wrist function levels were compared between groups across different fracture types. ResultsNo statistically significant difference was observed in radiographic indicators and VAS scores at all timepoints before and after treatment， as well as wrist joint function grades assessed by the Dienst score and the G-W score at 12 weeks after treatment （P＞0.05）. Compared to those before treatment， both groups showed increased palmar tilt， radial inclination， and radial height 1 week and 4-6 weeks after treatment， and decreased VAS scores （P＜0.05）. Compared to those 1 week after treatment， both groups showed a decrease in palmar tilt， an increase in radial inclination and radial height， and a reduction in VAS score 4-6 weeks after treatment（P＜0.05）. In type A and B subgroups， the surgical treatment group had a higher radial inclination than the TCM group 4-6 weeks after treatment， while in the type C subgroup， a higher radial height was shown in the surgical treatment group than in the TCM group 4-6 weeks after treatment（P＜0.05）. In type C subgroup， there was significant difference between groups in the wrist joint function by G-W scores 12 weeks after treatment（P＜0.05）. ConclusionManipulative reduction combined with small splint fixation can maintain fracture alignment and alleviate pain in treating distal radius fractures， which achieves therapeutic outcomes comparable to surgical treatment. It is particularly suitable for type A and B fractures and can be considered an effective treatment option for distal radius fractures.

ObjectiveTo construct an automatic measurement model for palmar tilt and radial inclination suitable for traditional Chinese medicine （TCM） clinical scenarios， and to validate its accuracy and efficiency in TCM manipulative reduction settings. MethodsData on anteroposterior （AP） and lateral X-rays of distal radius fractures were collected from patients admitted to 18 TCM/ integrated TCM and western medicine hospitals in Jiangsu province between September 1st， 2023， and September 1st， 2024， via the Jiangsu Diagnosis and Treatment Big Data Platform for TCM Dominant Diseases. A medical image segmentation framework based on multi-scale feature fusion and edge-awareness was employed， combined with anatomical knowledge specific to TCM orthopedics， to optimize the feature extraction strategy of an artificial intelligence （AI） model. This framework enabled automatic segmentation of fracture regions and measurement of distal radius palmar tilt and radial inclination. The accuracy of the AI model in measuring radial inclination and volar tilt was validated， and the measurement time and average time gain rate of the AI model were compared to those of manual measurement. ResultsA total of 15,444 AP and lateral X-ray images of distal radius fractures were collected， and were divided into a training set （11,144 images， 5066 AP and 6078 lateral）， a validation set （3700 images， 1840 AP and 1860 lateral）， and an independent test set （600 images， 300 AP and 300 lateral） after preprocessing. In the measurement of 300 AP X-rays in the independent test set for radial inclination， when the degree error between AI measurement and manual measurement was ＜3° and ＜5°， AI measurement accuracy was 83% and 93%， respectively. In 300 lateral X-rays in the test set for palmar tilt， when AI measurements had an error of ＜3° and ＜5° compared to manual measurements， corresponding accuracy rate was 78% and 90%， respectively. For 50 X-ray images， AI measurement time was （1.37±0.05） min for radial inclination while manual measurement time was （22.57±2.52） min （P＜0.001）； in terms of palmar tilt， the AI measurement time was （1.33±0.14） min， shorter than （23.70±2.80） min for manual measurement time （P＜0.001）. Average time gain rates for manual and AI measurements were 93.93% and 94.39% respectively. ConclusionAn automatic measurement model for palmar tilt and radial inclination in distal radius fractures has been established， enabling more accurate and efficient assessment as well as providing a tool to support the quantitative evaluation of the efficacy of TCM manipulative reduction and large-sample clinical research.

Aim To investigate the effect of high-fat diet on the tight junction function injury of Sertoli cells through the NF-κB/NLRP3 signaling pathway in mice and to explore the underlying mechanism.Methods Male C57BL/6J mice were fed with high-fat or normal diet for five months.The body and gonadal organ weight of mice were measured,and their indices were calculated.The sperm concentration,the sperm viabili-ty,the testicular histomorphology and the expression levels of tight junction proteins ZO-1,Occludin and Claudin-11 were measured.TM4 cells were treated with palmitic acid(PA)for 24 h.Cell viability was detected by CCK-8 method.Then,TM4 cells were di-vided into different groups treated with PA(0,50,100,200 and 300 μmnol·L-1),and the expression lev-els of tight junction proteins ZO-1,Occludin and Clau-din-11 were detected by Western blot.The tight junc-tion permeability of TM4 cells were detected by transepithelial electrical resistance(TEER)and FITC-dextran.The expression levels of mRNA and proteins for the NF-κB/NLRP3 pathway-related factors were de-tected by RT-qPCR and Western blot.Results The results from animal experiments showed that high-fat diet increased body weight and seminal vesicle weight of mice,and decreased testicular index,epididymal in-dex,sperm concentration and sperm motility of mice.High-fat diet also caused testicular tissue structure damage and down-regulated the expression levels of tight junction proteins ZO-1 and Occludin,without af-fecting the expression of Claudin-11.In vitro,PA sig-nificantly down-regulated the expression levels of ZO-1,Occludin and Claudin-11 in TM4 cells,increased the cell permeability,as well as up-regulated the mRNA and protein expression levels of NLRP3/NF-κB signa-ling pathway-related factors in TM4 cells.Conclusions High-fat diet can impair the function of tight junction of testicualr Sertoli cells,and the machanism may be related to the activation of the NF-κB/NLRP3 signaling pathway,resulting in Sertoli cell inflammation in mice.

Objective:To compare the benefits and prognostic risks of unilateral lobectomy (with or without isthmusectomy) or total (or near-total) thyroidectomy for primary foci of unilateral papillary thyroid cancer (PTC) patients with ipsilateral lateral cervical lymph node metastasis (LLNM) , so as to find out the optimal surgery for these patients.Methods:A total of 505 unilateral PTC patients with ipsilateral LLNM who underwent initial surgical treatment at the Thyroid Surgery Department of Zhejiang Cancer Hospital from Feb. 2012 to Jan. 2020 were retrospectively reviewed. The patients were divided into unilateral lobectomy group ( n=314) and total thyroidectomy group ( n=191) according to the extent of resection of primary foci. Then 177 pairs of cases were screened out after eliminating the potential confounding bias between the two groups by using propensity score matching (PSM) , analyzing the differences in clinical outcomes such as recurrence-free survival (RFS) , overall survival (OS) , hospitalization costs, and postoperative complications between the two groups. Results:After PSM, the postoperative complication rate was 37.3% ( n=66) in the total thyroidectomy group and 3.4% ( n=6) in the unilateral lobectomy group. The complication was mainly characterized by temporary hypoparathyroidism (HP) . Although the difference in length of hospitalization between the two groups was not statistically significant ( P=0.792) , patients in the unilateral lobectomy group used less surgical time ( P<0.001) , had lower hospitalization and surgical costs ( P<0.0001) , and took a relatively smaller dose of levothyroxine (L-T4) one month after the operation ( P<0.0001) , as compared with the total thyroidectomy group. Univariate analysis showed that the number of LLNM total lymph node metastasis (LNM) rate, LLNM rate, and T stage were significant risk factors for relapse. Multi-factor regression analysis indicated that T-staging was a risk factor for recurrence. After a median follow-up of 60 (3-138) months, 19 patients (10.7%) in the unilateral lobectomy group and 11 patients (6.2%) in the total thyroidectomy group recurred, with no statistical difference between the two groups ( P=0.133) . The OS curve displayed no significant difference between the unilateral lobectomy and total thyroidectomy groups ( P=0.740) . Conclusion:For unilateral PTC patients with ipsilateral LLNM without other high-risk features, unilateral lobectomy could be a better option.

Objective:To investigate the current status and influencing factors of barriers to going out among elderly patients with chronic obstructive pulmonary disease (COPD), and to provide a reference for implementing targeted preventive measures.Methods:Elderly COPD patients from the People's Hospital of Xinjiang Uygur Autonomous Region were selected between January and May 2024 by convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, Scale on Barriers to Going Out for the Elderly, Perceived Isolation Scale and COPD Assessment Test (CAT).Results:A total of 270 questionnaires were distributed, with 250 valid responses, the effective response rate was 92.6%. Among the 250 elderly COPD patients, there were 124 males and 126 females, with age distributions: 116 patients aged 60-69 years, 94 aged 70-79 years, and 40 aged ≥80 years. The total score for Scale on Barriers to Going Out for the Elderly was (20.01 ± 4.09). The score on barriers to going out in elderly COPD patients were positively correlated with the Perceived Isolation Scale and CAT scores ( r = 0.456 and 0.625, both P <0.05). Multiple linear regression analysis revealed that age, oxygen therapy, exercise habits,Perceived Isolation Scale, and CAT score classification were the main influencing factors for barriers to going out ( t values were -2.85 to 8.93, all P<0.05), explaining 63.0% of the total variance. Conclusions:The level of barriers to going out in elderly COPD patients is moderate-to-high level. Healthcare professionals should emphasize the assessment of barriers to going out, closely monitor high-risk groups, and develop and implement interventions to prevent such barriers.

AIM To study the chemical constituents from ethyl acetate fraction of Balanophora harlandii Hook.f.and their tyrosinase inhibitory activity.METHODS Separation and purification were performed using silica gel,MCI,ODS,Sephadex LH-20 and semi-preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The monophenolase inhibitory activity was determined by the tyrosinase-catalyzed oxidation of L-tyrosine.RESULTS Twenty-four compounds were isolated and identified as sesamin(1),methyl caffeate(2),quercetin(3),5,7-dihydroxychromanone(4),methyl 3,4-dihydroxybenzoate(5),esculetin(6),kaempferol(7),naringenin(8),pyrogallic acid(9),pinosylvin(10),methyl propionate(11),caffeic acid(12),saccharinol(13),ferulic acid(14),trans-p-hydroxycinnamic acid(15),cinnamic acid(16),vanillic acid(17),vanillin(18),4-hydroxyacetophenone(19),4-hydroxybenzaldehyde(20),apigenin(21),(-)-isolariciresinol(22),(-)-secoisolariciresinol(23)and meso-2,3-di(3′,4′-methylenedioxybenzyl)butane-1,4-diol(24).The IC50 values of compounds 3,5,7,8,19,and 20 ranged from(0.246 5±0.028 3)to(1.278 2±0.021 3)mmol/L.CONCLUSION Compounds 1-9、11、15、17-21、24 are isolated from this plant for the first time,and 1,6,9,17-19,24 are first isolated from genus Balanophora.Compounds 3、5、7、8、19 and 20 have tyrosinase inhibitory activity.

Objective To explore the application effect of multimodal somatosensory exercise based on artificial intelligence technology in home rehabilitation exercise for elderly patients with chronic obstructive pulmonary dis-ease(COPD),so as to promote COPD patients to participate in home rehabilitation exercise.Methods Using the convenient sampling method,80 elderly patients with COPD admitted to the Department of Respiratory Medicine of a tertiary A hospital in Urumqi from November 2023 to February 2024 were selected as the research subjects.Ac-cording to the random number table method,they were divided into a control group and an experimental group,with 40 cases in each group.The control group adopted the traditional exercise training method,and the experimental group adopted the multi-modal somatosensory movement based on artificial intelligence technology for exercise in-tervention,with 5 times a week,and the intervention was implemented for 12 weeks.The pulmonary function index,modified Medical Research Council scale score,physical fitness level,Chronic Obstructive Pulmonary Disease As-sessment Test scale score and exercise compliance of the 2 groups were compared before intervention and 12 weeks after intervention.Results 77 patients completed the study,with 39 in the experimental group and 38 in the control group.The forced vital capacity,forced expiratory volume in one second,forced expiratory volume in one second to forced vital capacity ratio,physical fitness level and exercise compliance of the experimental group were higher than those of the control group,while the modified British Medical Research Council scale score and Chron-ic Obstructive Pulmonary Disease Assessment Test score were lower than those of the control group.The differences were statistically significant(P＜0.05).Conclusion Somatosensory exercise based on artificial intelligence technology can improve the lung function of the patients with COPD,improve the exercise compliance and physical fitness in-dicators of elderly patients and improve the quality of life of the patients.

Aim To identify the underlying target of bullatine A(BA)against rheumatoid arthritis(RA)u-sing limited proteolysis-small molecule mapping(LiP-SMap)drug target proteomics and to provide a scientif-ic basis for clinical application of Aconiti brachypodi Radix in the treatment of RA.Methods LiP-SMap drug target proteomics was employed to perform bioin-formatics analysis for comparing and validating the dif-ferential protein expression after BA intervention.A collagen-induced arthritis(CIA)model was estab-lished in DBA/1 mice using bovine type Ⅱ collagen.The mice were then divided into the CIA model group,methotrexate-positive control group(MTX group),and BA groups(10 mg·kg-1 and 20 mg·kg-1)based on their clinical scores.After drug intervention,the thera-peutic efficacy against RA was assessed by joint index scores and foot thickness measurements.Histopatholog-ical changes in the arthritic joints of CIA mice were e-valuated using hematoxylin and eosin(HE)staining.Enzyme-linked immunosorbent assay(ELISA)was employed to detect inflammatory cytokines interleukin-17(IL-17)and total IgG and IgG3 anti-collagen-spe-cific antibodies levels from the serum of CIA mice.Flow cytometry was used to detect the expression levels of intracellular Th17 cells(IL-17+CD4+T cells)and Th1 cells(IFN-γ+CD4+T cells).Fluorescent quanti-tative PCR was performed to detect the expression of genes related to differential proteins.Results The proteomic analysis identified Serpinb1a as a protein with strong binding affinity to BA,and KEGG enrich-ment analysis indicated IL-17 signaling pathway was a crucial pathway of BA in against RA.BA treatment significantly reduced clinical scores and foot thickness,improved local arthritis symptoms in CIA mice,and al-leviated inflammatory cell infiltration into arthritic joints(P＜0.05).Differential protein validation re-sults showed that BA had strong affinity with Serpinb1a(-5.92 kJ·mol-1)and downregulated the expres-sion of Serpinb1a mRNA.Furthermore,the administra-tion of BA markedly reduced serum IL-17 A levels from CIA mice,inhibited the expression of intracellular IL-17 A and IFN-γ cytokines in splenic CD4+T cells(P＜0.05),and significantly downregulated the transcrip-tional expression of IL-17F(P＜0.05).Conclusion BA exhibits therapeutic effects on collagen-induced arthritis,and its mechanism of action may involve the regulation of Serpinb1a and the IL-17 signaling path-way.

Aim To explore the protective effect of icariin on the damage of tight junctional function of Sertoli cells in naturally aging mice and the related mechanism.Methods 15-month-old C57BL/6J male mice were randomly divided into three groups:aging model group,low-dose and high-dose icariin treatment group(5 and 20 mg·kg-1).Another 1-month-old C57BL/6J male mice were considered as adult control group(n=10).The mice in adult control group and aging model group were given the vehicle(0.5％sodi-um carboxymethyl cellulose solution)by intragastric administration,while the mice in icariin-treated groups were given different concentrations of icariin,respec-tively.After continuous administration of icariin for three months,the testes and epididymis were immedi-ately removed,weighed,and the organ index was calcu-lated.Sperm viability and sperm concentration in epi-didymis were measured.The morphological changes of testes were observed by HE staining.The ultrastructur-al changes of tight junctions of Sertoli cells were ob-served by transmission electron microscopy.The ex-pression levels of tight junction-related proteins ZO-1,Occludin,and Claudin11 of testicular Sertoli cells were detected by Western blot.The expression and localiza-tion of ZO-1,Occludin,Raptor,Rictor,p-70S6K,and p-rps6 were detected by immunofluorescence.Results Compared with the aging model group,icariin signifi-cantly increased testicular weight and its index,and ep-ididymal index,improved sperm viability and increased sperm concentration in naturally aging mice.In addi-tion,icariin improved the degeneration of testicular morphology and the damage of ultrastructure of Sertoli cell tight junction with aging.Furthermore,Western blot results showed that icariin up-regulated the expres-sion of ZO-1 and Occludin,but had no significant effect on the expression of Claudin 11.Immunofluorescence assay showed that icariin up-regulated the expression of Rictor,and down-regulated the expression of p-70S6K,p-rps6 and Raptor.Conclusions Icariin improves the tight junction damage of Sertoli cells in naturally aging mice,and its mechanism may be related to restoring the balance between mTORC1 and mTORC2.

Objective To evaluate the value of radiomics models and comprehensive models based on multiparametric magnetic resonance imaging(mpMRI)in predicting the expression of human epidermal growth factor receptor 2(HER2)in bladder cancer(BCa).Methods A total of 76 pathologically confirmed BCa patients undergoing pelvic mpMRI during Jan.2022 and Nov.2024 at the Affiliated Zhongda Hospital of Southeast University were retrospectively included.After the volume of interest(VOI)was sketched,7 modal features were obtained,including T2WI,DWI,DCE,T2WI+DWI,T2WI+DCE,DWI+DCE,and T2WI+DWI+DCE,which were analyzed with logistic regression to obtain the predictive values.After that,the best sequences were screened with receiver operating characteristic(ROC)curves,and then combined with support vector machine,logistic regression,K-nearest neighbor,plain Bayes and adaptive enhancement,to construct the radiomics prediction models.Logistic regression analysis was used to screen the predictors of high HER 2 expression and to construct a comprehensive prediction model and a nomogram.Finally,decision curve analysis(DCA)was used to quantify the clinical benefits.Results Among the radiomics models based on the T2WI+DWI+DCE sequence,the AdaBoost model demonstrated the best predictive performance,with area under the ROC curve(AUC)being 0.863(95％CI:0.807-0.920)in the training set and 0.716(95％CI:0.601-0.830)in the validation set.Based on radiomics features and clinical imaging characteristics,logistic regression analysis identified tumor pedicle and risk group as the predictors of high HER2 expression.The comprehensive prediction model based on the two factors achieved the AUC of 0.869(95％CI:0.772-0.965)in the training set and 0.875(95％CI:0.712-0.986)in the validation set.Conclusion The radiomics model based on the T2WI+DWI+DCE sequence has high accuracy in predicting HER2 expression,outperforming single-sequence models.The nomogram based on the comprehensive prediction model has high clinical decision-making efficacy and is useful for non-invasive identification of HER2 expression.