ObjectiveThe full name of vertebroplasty is percutaneous vertebroplasty (PVP). It is a clinical technique that injects bone cement into the diseased vertebral body to achieve strengthening of the vertebra. The research on the safety and efficacy of bone cement is the basis for clinical application. In this study, vertebroplasty is used to evaluate and compare the safety and efficacy of Tecres and radiopaque bone cement in experimental pigs, and to determine the puncture method suitable for pigs and the pre-clinical evaluation method for the safety and efficacy of bone cement. MethodsTwenty-four experimental pigs (with a body weight of 60-80 kg) were randomly divided into an experimental group (Group A) and a control group (Group B). Group A was the Tecres bone cement group, and Group B was the radiopaque bone cement group, with 12 pigs in each group. Under the monitoring of a C-arm X-ray machine, the materials were implanted into the 1st lumbar vertebra (L1) and 4th lumbar vertebra (L4) of the pigs via percutaneous puncture using the unilateral pedicle approach. The animals were euthanized at 4 weeks and 26 weeks after the operation, respectively. The L4 vertebrae were taken for compressive strength testing, and the L1 vertebrae were taken for hard tissue pathological examination to observe the inflammatory response, bone necrosis, and degree of osseointegration at the implantation site. ResultsThe test results of compressive strength between groups A and B showed no significant difference at 4 weeks and 26 weeks after bone cement implantation (P > 0.05). Observation under an optical microscope (×100) revealed that at 4 weeks postoperatively, both groups A and B showed that the bone cement was surrounded by proliferative fibrous tissue, with lymphocyte infiltration around it. The bone cement was combined with bone tissue, the trabecular arrangement was disordered, and osteoblasts and a small amount of osteoid were formed. At 26 weeks postoperatively, bone cement was visible in both groups A and B. The new bone tissue was mineralized, the trabeculae were fused, the trabecular structure was regular and dense with good continuity, and no obvious inflammatory reaction was observed. ConclusionIn experimental pig vertebrae, there were no significant differences observed in the compressive strength, inflammation response, bone destruction, and integration with the bone between Tecres and non-radiopaque bone cement. Both exhibited good biocompatibility and osteogenic properties. It indicates that using vertebroplasty to evaluate the safety and efficacy of bone cement in pigs is scientifically sound.

Objective:To discuss the method for establishing the rat models of irritable bowel syndrome(IBS)by chronic water avoidance stress(WAS)method,and to evaluate its feasibility.Methods:Thirty male Wistar rats were randomly divided into control group(n=10)and model group(n=20).The rats in model group were induced by WAS method for 1 h everyday,lasting for 10 consecutive days;the rats in control group underwent no interventions.After modeling,the general conditions and body weights of the rats in two groups were observed and recorded.The elevated plus maze(EPM)test was used to detect the percentages of the number of open arm entries(OE)and the time spent in open arms(OT)of the rats in two groups;the abdominal withdrawal reflex(AWR)test was used to assess the visceral sensitivity of the rats in two groups;electrocardiography was used to detect the heart rate variability(HRV)of the rats in two groups;electromyography(EMG)of the external oblique muscle was used to detect the colorectal pain sensitivity thresholds of the rats in two groups;multi-channel physiological signal recorder was used to monitor the slow wave frequency of the colon of the rats in two groups.Results:There were no death rats in both groups during the modeling period.After modeling,the rats in model group exhibited poor mental status,reduced spontaneous activity,hypoactivity,disordered and dull fur,irritability,and unclean anal areas;whereas,the rats in control group showed no significant changes in the mental state,spontaneous activity,fur,and perianal area.Compared with control group,the body weight of the rats in model group was significantly decreased(P<0.05).The EPM test results showed that compared with control group,the OE percentage and OT percentage of the rats in model group were significantly decreased(P<0.01).The AWR test results showed that 12 rats in model group scored≥3 points,indicating that the successful rate in creating the visceral pain models was 60%.Compared with control group,the low frequency(LF)signals and the ratio of LF/high frequency(HF)of the rats in model group were significantly increased(P<0.01),and the HF was significantly decreased(P<0.05).The EMG results showed that compared with control group,the coloretal pain sensitivity threshold of the colon of the rats in model group was significantly decreased(P<0.01),and the slow wave frequency of the colon was significantly increased(P<0.01).Conclusion:The WAS method for establishing the rat model of IBS effectively demonstrates the changes in behavior and mental state,increased the visceral sensitivity,accelerated colonic slow wave frequency,and autonomic nervous system imbalance;the WAS method can serve as an effective modeling approach for observing and evaluating the related drugs and interventions on treatment of IBS.

Agitation during the recovery period after general anesthesia is a common complication after pediatric surgery,which can lead to accidents and other serious complications.Esketamine is a high-affinity noncompetitive inhibitor of N-methyl-D-aspartate(NMDA)receptors,which has both anesthetic and analgesic effects,and can be used as an adjunct drug to sedation for endotracheal intubation under general anesthesia and perioperative anesthesia.This article reviews the current research progress of esketamine in the treatment of agitation during recovery period in order to provide reference for clinical reduction of the occurrence of agita-tion in children during recovery period.

Tongxie Yaofang， also known as Baizhu Shaoyaosan， was first recorded in Danxi's Experiential Therapy （《丹溪心法》） by ZHU Danxi in the Yuan dynasty. It is composed of Atractylodis Macrocephalae Rhizoma， Paeoniae Radix Alba， Citri Reticulatae Pericarpium， and Saposhnikoviae Radix， and serves as the representative prescription for the treatment of painful diarrhea. It has the functions of tonifying the spleen， emolliating the liver， relieving pain， and checking diarrhea， and is mainly used in the treatment of gastrointestinal diseases such as irritable bowel syndrome （IBS） and ulcerative colitis （UC）. In addition， it is effective in treating gastrointestinal disorders with mental and psychological abnormalities， as well as obstinate anorexia in children， depression syndrome， and respiratory diseases. Experimental research and clinical practice have shown that Tongxie Yaofang has multi-component， multi-pathway， and multi-target characteristics in the treatment of diseases. The mechanism of Tongxie Yaofang in treating diseases is mainly attributed to anti-inflammation， immune function regulation， intestinal hypersensitivity improvement， emotion regulation， etc. Monoterpene glycosides， flavonoids， chromones， lactones， and other components contained play an important therapeutic role. The research on the systems biology of Tongxie Yaofang， such as metabolomics， proteomics， and network pharmacology， provides a scientific basis for clarifying its mechanism of action and expanding its clinical application. However， there are still some problems to be solved， such as difficulty in combining diseases and syndromes and lack of in-depth systematic research. Through the retrieval and collation of relevant literature， this paper systematically reviewed the material basis， pharmacological effects， and systems biology research of Tongxie Yaofang， aiming to lay a foundation for in-depth research on its mechanism in treating diseases and rational application in clinical practice.

ObjectiveTo explore the brain mechanism of repetitive transcranial magnetic stimulation (rTMS) on dysfunction after stroke using functional magnetic resonance imaging (fMRI). MethodsLiteratures about the functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke were retrieved in PubMed, Web of Science, CNKI and Wanfang data from establishment to June 1st, 2021. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature screening, and data extraction were performed by two researchers. ResultsA total of 14 randomized controlled trials were finally enrolled. They were of high or very high quality. They mainly involved the therapeutic effect and imaging mechanisms of rTMS on dysfunction after stroke. ConclusionrTMS could change the excitability of the cerebral cortex and the effective connections between brain regions after stroke, promote the reorganization of brain function, and achieve the recovery of post-stroke dysfunction.

Objective     To investigate the perioperative clinical effects and follow-up results of minimally invasive coronary artery bypass grafting (MICS CABG) versus conventional coronary artery bypass grafting (CABG) in thoracotomy. Methods     The patients who received off-pump CABG in Beijing Anzhen Hospital from January 2017 to October 2021 were collected. Among them, the patients receiving MICS CABG performed by the same surgeon were divided into a minimally invasive group, and the patients receiving median thoracotomy were into a conventional group. By propensity score matching, preoperative data were balanced. Perioperative and postoperative follow-up data of the two groups were compared. Results     A total of 890 patients were collected. There were 211 males and 28 females, aged 60.54±9.40 years in the minimally invasive group, and 487 males and 164 females, aged 62.31±8.64 years in the conventional group. After propensity score matching, there were 239 patients in each group. Compared with the conventional group, patients in the minimally invasive group had longer operation time, shorter drainage duration, less drainage volume on the first postoperative day, shorter postoperative hospital stay, and lower rate of positive inotropenic drugs use, while there was no statistical difference in the mean number of bypass grafts, ICU stay, ventilator-assisted time, blood transfusion rate or perioperative complications (P>0.05). During the median follow-up of 2.25 years, there was no statistical difference in major adverse cardiovascular and cerebrovascular events, including all-cause death, stroke or revascularization between the two groups (P>0.05). Conclusion    Reasonable clinical strategies can ensure perioperative and mid-term surgical outcomes of MICS CABG not inferior to conventional CABG. In addition, MICS CABG has the advantages in terms of postoperative hospital stay, postoperative drainage volume, and rate of positive inotropic drugs use.

Objective To observe the effect of different Nasointestinal feeding tube catheterization techniques on patients with ICU brain dysfunction.Methods Totally 51 patients were divided into the traditional blind intubation group(26 cases)and the ultrasound guided group(25 cases)according to the random number table.The efficacy of catheterization was evaluated using first catheterization success rate,final catheterization success rate,catheterization time,and complications.Results The ultrasound guided catheterization group has a higher success rate for the first catheterization compared to the traditional blind insertion group;There was no statistically significant difference in general information,final catheterization success rate,catheterization time,and incidence of complications between the two groups.Conclusion The two kinds of nasogastric tube placement techniques are safe and effective in patients with ICU brain dysfunction,ultrasound guided catheterization can improve the success rate of first catheterization and have better efficiency.

Based on the summary of overview, occurrence, and evaluation tools of scan-associated anxiety, this article introduces the research progress of scan-associated anxiety influencing factors from the aspects of demography, disease factors and doctor-patient relationship. This article also sorts out the effect of psychological support, video intervention, virtual reality technology and relaxation therapy on scan-associated anxiety, so as to provide a reference for the management of scan-associated anxiety in cancer patients.

Objective:To explore the status quo of symptom management self-efficacy based on patient reported outcomes of nasopharyngeal carcinoma patients and analyze its related factors.Methods:From January to April 2021, 230 patients with nasopharyngeal carcinoma who were treated in Zhejiang Cancer Hospital were selected as the study subject by convenient sampling. The General Information Questionnaire and Patient-Reported Outcome Measurement Information System-Self-Efficacy for Managing Symptoms (PROMIS-SEMSX) were used to investigate. Single factor analysis and multiple linear regression analysis were used to explore the influencing factors of symptom management self-efficacy in patients with nasopharyngeal carcinoma.Results:A total of 230 questionnaires were distributed, 220 were recovered, and 205 were valid. The score of symptom management self-efficacy of patients with nasopharyngeal carcinoma was (97.74±20.00) , which was above the middle level, and the lowest score dimension was confidence, which was (23.52±5.91) . Multiple linear regression showed that gender, education level, medical expense payment method, economic level, tumor stage, course of disease, tumor recurrence and metastasis were the influencing factors of symptom management self-efficacy of nasopharyngeal carcinoma patients ( P<0.05) . A total of 41.5% of the total variation was explained. Conclusions:The self-efficacy of symptom management in patients with nasopharyngeal carcinoma needs to be improved. The medical and nursing staff should focus on the patients with low educational level, heavy economic burden, late tumor, recurrence and metastasis, and focus on providing specific health guidance to alleviate their discomfort symptoms during treatment, and improve their self-efficacy of symptom management.

Objective:To translate the Efficacy of Self-Efficacy for Managing Symptoms (SEMSX) based on the Patient-Reported Outcomes Measurement Information System (PROMIS) into Chinese, and to test the reliability and validity of the scale among Chinese patients with nasopharyngeal carcinoma.Methods:The English version of PROMIS-SEMSX was translated into Chinese according to the FACIT translation method. The reliability and validity of the scale were evaluated. From January to April in 2021, the convenient sampling method was adopted to select 205 patients with nasopharyngeal cancer in Zhejiang Cancer Hospital for investigation.Results:The Chinese version of PROMIS-SEMSX scale consisted of 28 items in 4 dimensions, which were consistent with confidence level(with 7 items), symptom management(with 5 items), the impact of symptoms on life(9 items), seeking and understanding support(7 items). The calibration correlation validity was 0.935. The total Cronbach α coefficient of the scale was 0.966, and the half-reliability of the total scale was 0.891. The Cronbach α coefficient of each dimension was 0.910-0.938, and the total retest reliability coefficient of the scale was 0.757.Conclusions:The Chinese version of PROMIS-SEMSX has good reliability and validity in patients with nasopharyngeal carcinoma, and provides a new tool for patients with nasopharyngeal carcinoma to evaluating self-efficacy symptom management.