Objective To compare the surgical outcomes of the sequence of screw and rod placement for Lenke type 5C adolescent idiopathic scoliosis(AIS).Methods Lenke type 5C AIS patients who underwent posterior orthopedic fusion and fixation in our hospital from Jan.2013 to Dec.2020 were recruited.Based on surgical sequences,22 cases were assigned to bilateral group(after bilateral screw placement,orthopedics was performed on the convex side and then on the concave side),and 20 cases were assigned to convex group(screws placed on the convex side and performed orthopedics,followed by the concave side).The operation-related indicators(including operation time),imaging parameters,quality of life scores were compared between the 2 groups before and 2 years after surgery.Complications of the 2 groups were analyzed.Results The operation time in the bilateral group was significantly longer than that in the convex group([232.8±13.1]min vs[198.4±16.5]min,P＜0.01).At the last follow-up 2 years after operation,the Cobb angle and its correction rate in the convex group were better than those in the bilateral group([8.0±2.3]° vs[9.9±3.2]°,P=0.03;[81.9±5.4]%vs[77.8±5.8]%,P=0.02).The rate of pedicle screw breach rate was 5.4%(17/312)in the bilateral group and 1.4%(4/280)in the convex group,with significant difference(P＜0.01).At the last follow-up 2 years after operation,the treatment satisfaction of quality of life assessment of the bilateral group was 4.61±1.38,and that of the convex group was 4.50±1.44,but there was no significant difference between the 2 groups(P＞0.05).There were no abnormal electrophysiological monitoring or operation-related complications in the 2 groups.Conclusion For Lenke type 5C AIS,the convex side of pedicle screw placement and orthopedics followed by concave side of pedicle screw placement and orthopedics can achieve better surgical effect.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

Objective To explore the MRI images and clinical characteristics of right ventricular outflow tract obstruction(RVOTO)in hypertrophic cardiomyopathy(HCM)patients.Methods The clinical and imaging data of 30 patients with RVOTO and 55 randomly selected patients with simple left ventricular outflow tract obstruction(LVOTO)were retrospectively analyzed,and the data between the two groups were statistically analyzed.Results The N-terminal pro-B type natriuretic peptide(NT-proBNP)value,the average thickness of left ventricular basal end diastolic anterior wall and anterior septum,the proportion of"scallop sign"on imaging,and the mass percentage of myocardial late gadolinium enhancement(LGE)in RVOTO group were significantly higher than those in LVOTO group(P<0.01).Conclusion RVOTO is the result of multiple factors,including the thickening of interventricular septum,as well as the right ventricular free wall.When the"scallop sign"appears in MRI examinations of HCM patients,it is necessary to be highly vigilant for the presence of RVOTO.

Post-stroke depression is a common complication after stroke,which seriously affects the quality of life and clinical prognosis of stroke patients.Acupuncture therapy for post-stroke depression has been proven effective.This article reviewed recent clinical studies on acupuncture therapy for post-stroke depression from the perspectives of pure acupuncture therapy,electroacupuncture therapy,head acupuncture therapy,auricular acupuncture therapy,and comprehensive therapy.The acupoint selection focused on the Governor Vessel,combined with the acupoints of the bladder meridian,liver meridian and pericardium meridian.The comprehensive therapy combined acupuncture with Chinese materia medica,moxibustion,music therapy and rehabilitation training is currently the main treatment approach.Further analysis on the shortcomings of the field could provide references for clinical protocols and mechanism research of acupuncture therapy for post-stroke depression.

Objective To explore the MRI images and clinical characteristics of right ventricular outflow tract obstruction(RVOTO)in hypertrophic cardiomyopathy(HCM)patients.Methods The clinical and imaging data of 30 patients with RVOTO and 55 randomly selected patients with simple left ventricular outflow tract obstruction(LVOTO)were retrospectively analyzed,and the data between the two groups were statistically analyzed.Results The N-terminal pro-B type natriuretic peptide(NT-proBNP)value,the average thickness of left ventricular basal end diastolic anterior wall and anterior septum,the proportion of"scallop sign"on imaging,and the mass percentage of myocardial late gadolinium enhancement(LGE)in RVOTO group were significantly higher than those in LVOTO group(P<0.01).Conclusion RVOTO is the result of multiple factors,including the thickening of interventricular septum,as well as the right ventricular free wall.When the"scallop sign"appears in MRI examinations of HCM patients,it is necessary to be highly vigilant for the presence of RVOTO.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

Post-stroke depression is a common complication after stroke,which seriously affects the quality of life and clinical prognosis of stroke patients.Acupuncture therapy for post-stroke depression has been proven effective.This article reviewed recent clinical studies on acupuncture therapy for post-stroke depression from the perspectives of pure acupuncture therapy,electroacupuncture therapy,head acupuncture therapy,auricular acupuncture therapy,and comprehensive therapy.The acupoint selection focused on the Governor Vessel,combined with the acupoints of the bladder meridian,liver meridian and pericardium meridian.The comprehensive therapy combined acupuncture with Chinese materia medica,moxibustion,music therapy and rehabilitation training is currently the main treatment approach.Further analysis on the shortcomings of the field could provide references for clinical protocols and mechanism research of acupuncture therapy for post-stroke depression.

Objective To investigate and evaluate the safety and effectiveness of the Chimney technique in mitral valve reoperation. Methods The clinical data of mitral valve reoperation patients who underwent Chimney surgery in Wuhan Asia Heart Hospital from 2019 to 2021 were retrospectively analyzed. Results A total of 26 patients were collected, including 7 males and 19 females, aged 27-67 (53.46±11.18) years. All patients had previous mitral valve surgery, including 23 mitral valve replacements and 3 mitral valve repairs. All patients received Chimney technique using the ideal artificial sized mitral valve, and 1 patient died of neurological complications in hospital. The cardiopulmonary bypass time and the aortic cross-clamping time were 231.11±77.05 min and 148.50±52.70 min, respectively. The mean diameter of the implanted mitral valve prosthesis was 29.08±0.68 mm, which was statistically different from pre-replacement valve prosthesis size of 26.69±0.77 mm (P＜0.001). The mean transvalvular pressure gradient of the prosthetic mitral valve measured on postoperative echocardiography was 14.77±5.34 mm Hg, which was statistically different from preoperative value of 20.92±9.83 mm Hg (P=0.005). Conclusion The Chimney technique is safe and effective for reoperation in patients with small mitral annuli, which can not only reduce the risk of reoperation, but also obtain larger prosthetic valve implants with good hemodynamic characteristics and clinical outcomes.

OBJECTIVE To investigate the current situation of pharmaceutical clinic service in medical institutions in China and provide experience and suggestions for promoting the development of pharmaceutical clinics. METHODS Questionnaire survey was used to investigate the development of pharmaceutical clinics in medical institutions of 31 provinces （autonomous regions and municipalities directly under the central government） in March to April 2023， and the descriptive analysis was conducted. The regression analysis was carried out for the influential factors of pharmaceutical clinic service. RESULTS A total of 1 368 questionnaires were distributed in this survey and 1 304 valid questionnaires were collected with the effective response rate of 95.32%. A total of 463 medical institutions carried out pharmaceutical clinic service， the rate of which was 35.51% （463/1 304）； the rates of pharmaceutical clinics in tertiary， secondary， primary and other medical institutions were 52.80%， 17.18% and 5.88%， respectively. The frequency of opening pharmaceutical clinics was 3.17 days per week on average， with an average of 5.99 visiting pharmacists in each medical institution. Among the visiting pharmacists， clinical pharmacists accounted for the vast majority （88.68%， 2 459/2 773）. There were various categories of pharmaceutical clinics， including joint clinics and pharmacist-independent clinics； among pharmacist-independent clinics， pharmaceutical specialty/specialty disease clinics were the main ones， accounting for 89.72% of the total number of pharmaceutical clinics. The value of pharmacists in pharmaceutical clinics was manifested in various forms， among which the proportion of medical institutions charging pharmaceutical clinics was 10.80%. The main experiences in developing pharmaceutical clinics were to attach importance to discipline construction and personnel training. The main difficulties in developing pharmaceutical clinics were low compensation levels and a shortage of talent.The number of clinical pharmacists， the number of visiting pharmacists in pharmaceutical clinics and additional compensation were positively correlated with the amount of pharmaceutical clinic services（P＜0.05）. CONCLUSIONS In recent years， pharmaceutical clinics have made significant progress； in the future， it is still necessary to further strengthen discipline construction and talent cultivation， pay attention to the value embodiment of pharmacists， to promote the healthy development of pharmaceutical clinics.

BACKGROUND:Osteoarthritis is a chronic degenerative disease of skeletal muscle,and the incidence of osteoarthritis is increasing yearly,but its pathogenesis is not clear.The commonly used drugs for osteoarthritis include non-steroidal anti-inflammatory drugs and glucocorticoid.Adverse drug reactions to these drugs can reduce patient compliance and ultimately affect the efficacy of treatment.Active ingredients in Chinese medicine are closely scrutinized for their safety and other characteristics. OBJECTIVE:Through reviewing the research progress in the effect of active ingredients of traditional Chinese medicine on osteoarthritis-related signaling pathways,to provide ideas and theoretical basis for the research,development,and application of new drugs in the prevention and treatment of osteoarthritis. METHODS:CNKI,WanFang,VIP,PubMed,and GeenMedical were searched for relevant literature in the last 10 years.The key words were"OA,osteoarthritis,traditional Chinese medicine,active ingredients of traditional Chinese medicine,chondrocyte,inflammation,signal pathways,mechanism"in Chinese and English.We excluded the irrelevant repetitive and older literature,and finally included 63 articles for further review. RESULTS AND CONCLUSION:The active ingredients of traditional Chinese medicine regulate the levels of inflammatory factors,promote the proliferation and differentiation of chondrocytes,regulate the apoptosis of chondrocytes,and delay the degeneration of chondrocytes through Wnt/β-catenin,NK-ΚB,P38 MAPK,PI3K/AKT,JAK2/STAT3 and other signaling pathways,thus slowing the progression of osteoarthritis.