Objective:To explore the value of using computed tomography(CT)values to distinguish fresh and old fractures vertebral bodies in osteoporotic vertebral compression fractures(OVCF).Methods:Retrospective analysis of clinical data of 101 OVCF patients in our hospital from September 2022 to September 2023.Kappa test for consistency between magnetic resonance imaging(MRI)and vertebral CT values in distinguished fresh or old OVCF.The difference of CT values between fresh,old fractures and adjacent normal vertebral bodies were compared.The diagnostic efficiency was analyed by receiver operating characteristic(ROC)curve.Results:There was a high consistency between vertebral CT values and MRI in the diagnosis of OVCF in fresh and old fractures(Kappa value=0.934).There was a difference in difference of CT values between adjacent normal vertebral bodies and fresh fractures vertebral bodies(P＜0.05).There was a difference in difference of CT values of fresh fractures vertebral bodies and old fractures vertebral bodies(P＜0.05).The ROC curve analysis results showed that,the combined measurement of CT values of fresh and old fractured vertebral bodies has an area under the curve(AUC)of 0.723,which was higher than alone measurement of the CT values of fresh fractured vertebral bodies and old fractured vertebral bodies of 0.536 and 0.610(Z=2.548,2.605,2.841,P＜0.05).Conclusion:CT values of vertebral bodies show high consistency in distinguish fresh and old fractures of OVCF compared to MRI findings,and the diagnostic efficiency of combine detection is relatively high.

Objective:To explore the diagnostic value of conventional computed tomography(CT)combined with enhanced CT scan in bone metastases.Methods:This study was a retrospective observational study,84 suspected bone metastases patients admitted to our hospital from January 2022 to August 2024 were selected,All patients underwent conventional CT and enhanced CT scan and pathological examination,Using pathological examination results as the"gold standard"for diagnosis.The imaging manifestations of bone metastases using conventional CT combined with enhanced CT scan examination were observed;The detection rate and bone metastases types of conventional CT and enhanced CT scan were analyzed;The bone metastases location in different types of malignant tumors were analyzed;The detection results of bone metastases between conventional CT and enhanced CT scan were compared;the diagnostic efficacy of conventional CT and enhanced CT scan alone and in combination for bone metastases were analyzed by Receiver operating characteristic(ROC)curve.Results:The detection rate of osteogenic,osteolytic,cystic and mixed bone metastases by conventional CT combined with enhanced CT scan was supered to that of conventional CT and enhanced CT scan alone(P＜0.05).Bone metastases from lung cancer,breast cancer and other tumors mainly occur in the spine,limbs and ribs,while esophageal cancer,gastric cancer,liver cancer,prostate cancer,thyroid cancer,renal cancer,and nasopharyngeal cancer had relatively fewer bone metastases.The positive detection cases of bone metastases used conventional CT combined with enhanced CT scan were supered to those used conventional CT and enhanced CT scan alone.The sensitivity,specificity and accuracy of conventional CT combined with enhanced CT scan for the diagnosis of bone metastases were 94.00％,94.11％and 94.04％,respectively,and the positive/negative predictive values were 95.91％and 91.42％,respectively.The sensitivity,specificity and accuracy of conventional CT scan were 84.00％,78.78％and 80.95％,respectively,and the positive/negative predictive values were 85.71％and 74.28％,respectively.The sensitivity,specificity and accuracy of enhanced CT were 89.79％,85.71％and 88.09％,respectively.and the positive and negative predictive values were 89.79％and 85.71％,respectively.The diagnostic efficacy of conventional CT combined with enhanced CT scan for bone metastases was significantly better than that of conventional CT and enhanced CT scan alone.Conclusions:Conventional CT combined with enhanced CT scan can significantly improve the diagnostic efficiency of bone metastases,and provide an important basis for clinical treatment.

Objective:To explore the value of using computed tomography(CT)values to distinguish fresh and old fractures vertebral bodies in osteoporotic vertebral compression fractures(OVCF).Methods:Retrospective analysis of clinical data of 101 OVCF patients in our hospital from September 2022 to September 2023.Kappa test for consistency between magnetic resonance imaging(MRI)and vertebral CT values in distinguished fresh or old OVCF.The difference of CT values between fresh,old fractures and adjacent normal vertebral bodies were compared.The diagnostic efficiency was analyed by receiver operating characteristic(ROC)curve.Results:There was a high consistency between vertebral CT values and MRI in the diagnosis of OVCF in fresh and old fractures(Kappa value=0.934).There was a difference in difference of CT values between adjacent normal vertebral bodies and fresh fractures vertebral bodies(P＜0.05).There was a difference in difference of CT values of fresh fractures vertebral bodies and old fractures vertebral bodies(P＜0.05).The ROC curve analysis results showed that,the combined measurement of CT values of fresh and old fractured vertebral bodies has an area under the curve(AUC)of 0.723,which was higher than alone measurement of the CT values of fresh fractured vertebral bodies and old fractured vertebral bodies of 0.536 and 0.610(Z=2.548,2.605,2.841,P＜0.05).Conclusion:CT values of vertebral bodies show high consistency in distinguish fresh and old fractures of OVCF compared to MRI findings,and the diagnostic efficiency of combine detection is relatively high.

Objective:To explore the diagnostic value of conventional computed tomography(CT)combined with enhanced CT scan in bone metastases.Methods:This study was a retrospective observational study,84 suspected bone metastases patients admitted to our hospital from January 2022 to August 2024 were selected,All patients underwent conventional CT and enhanced CT scan and pathological examination,Using pathological examination results as the"gold standard"for diagnosis.The imaging manifestations of bone metastases using conventional CT combined with enhanced CT scan examination were observed;The detection rate and bone metastases types of conventional CT and enhanced CT scan were analyzed;The bone metastases location in different types of malignant tumors were analyzed;The detection results of bone metastases between conventional CT and enhanced CT scan were compared;the diagnostic efficacy of conventional CT and enhanced CT scan alone and in combination for bone metastases were analyzed by Receiver operating characteristic(ROC)curve.Results:The detection rate of osteogenic,osteolytic,cystic and mixed bone metastases by conventional CT combined with enhanced CT scan was supered to that of conventional CT and enhanced CT scan alone(P＜0.05).Bone metastases from lung cancer,breast cancer and other tumors mainly occur in the spine,limbs and ribs,while esophageal cancer,gastric cancer,liver cancer,prostate cancer,thyroid cancer,renal cancer,and nasopharyngeal cancer had relatively fewer bone metastases.The positive detection cases of bone metastases used conventional CT combined with enhanced CT scan were supered to those used conventional CT and enhanced CT scan alone.The sensitivity,specificity and accuracy of conventional CT combined with enhanced CT scan for the diagnosis of bone metastases were 94.00％,94.11％and 94.04％,respectively,and the positive/negative predictive values were 95.91％and 91.42％,respectively.The sensitivity,specificity and accuracy of conventional CT scan were 84.00％,78.78％and 80.95％,respectively,and the positive/negative predictive values were 85.71％and 74.28％,respectively.The sensitivity,specificity and accuracy of enhanced CT were 89.79％,85.71％and 88.09％,respectively.and the positive and negative predictive values were 89.79％and 85.71％,respectively.The diagnostic efficacy of conventional CT combined with enhanced CT scan for bone metastases was significantly better than that of conventional CT and enhanced CT scan alone.Conclusions:Conventional CT combined with enhanced CT scan can significantly improve the diagnostic efficiency of bone metastases,and provide an important basis for clinical treatment.

Objective To evaluate the relationship between anxiety levels and clinicopathological characteristics in patients with papillary thyroid carcinoma (PTC). Methods Among the patients who underwent surgical treatment in our center from July 2022 to September 2023, 304 patients completed the Hamilton anxiety rating scale (HAM-A) questionnaire. The clinical and pathological characteristics of these patients and their association with anxiety levels were investigated. Results Among the 304 patients, 271 were pathologically confirmed to have PTC. Of the 271 patients, 75 had higher levels of anxiety (according to HAM-A scoring system, a score ≥14 indicates clinically significant anxiety) and were assigned to the anxiety group. Univariate statistical analysis showed that the proportion of patients with elevated thyroid peroxidase antibody (TPOAb) in the anxiety group was higher than that in the non-anxiety group (34.7% vs. 16.8%, P=0.002 4). Moreover, the proportion of patients with multifocal tumors in the anxiety group was also higher than that in the non-anxiety group (33.3% vs. 16.7%, P=0.004 4). Multivariate Logistic regression confirmed that anxiety levels were associated with elevated TPOAb (P=0.005 6) and tumor multifocality (P=0.001 9). Conclusions Anxiety levels may be related to elevated TPOAb and tumor multifocality in PTC patients.

OBJECTIVE: To assess the impacts of electroacupuncture (EA) on the gait, oxidative stress, inflammatory reaction, and protein degradation in the rats of denervated skeletal muscle atrophy, and explore the potential mechanism of EA for alleviating denervated skeletal muscle atrophy. METHODS: Forty male SD rats, 8 weeks old, were randomly assigned to a sham-surgery group, a model group, an EA group, and a p38 MAPK inhibitor group, with 10 rats in each group. The right sciatic nerve was transected to establish a rat model of denervated skeletal muscle atrophy in the model group, the EA group and the p38 MAPK inhibitor group. In the sham-surgery group, the nerve was exposed without transection. One day after successful modeling, the rats in the EA group received EA at "Huantiao" (GB30) and "Zusanli" (ST36) on the right side, using a continuous wave with a frequency of 2 Hz and current intensity of 1 mA, for 15 min in each session, EA was delivered once a day, 6 times a week. In the p38 MAPK inhibitor group, the rats received the intraperitoneal injection with SB203580 (5 mg/kg), once a day, 6 times a week. The intervention was composed of 3 weeks in each group. After the intervention completion, the CatWalk XT 10.6 animal gait analysis system was used to record the gait parameters of rats. The wet weight ratio of the gastrocnemius muscle was calculated after the sample collected. Using HE staining, the fiber morphology and cross-sectional area of the gastrocnemius muscle were observed; ELISA was employed to measure the content of interleukin (IL)-6, IL-1β, and tumor necrosis factor (TNF)-α in the gastrocnemius muscle; the biochemical hydroxyamine method was adopted to detect the content of superoxide dismutase (SOD) and malondialdehyde (MDA) in the gastrocnemius muscle; with immunohistochemistry and Western blot used, the expression of p38 mitogen-activated protein kinase (p38 MAPK), phosphorylated (p)-p38 MAPK, muscle atrophy F-box gene (Atrogin-1), muscle RING finger 1 (Murf-1), nuclear factor E2-related factor 2 (Nrf2), and heme oxygenase-1 (HO-1) was detected in the gastrocnemius muscle. RESULTS: Compared to the sham-surgery group, in the model group, the standing duration, the swing time and the step cycle were increased (P<0.001), the footprint area of the maximum contact time, the print area, the average intensity of the maximum contact time, the average intensity, the swing speed, and the step length were decreased (P<0.001); the wet weight ratio of gastrocnemius muscle and fiber cross-sectional area were reduced (P<0.001); the content of IL-6, IL-1β, TNF-α and MDA in gastrocnemius muscle elevated (P<0.001), and that of SOD reduced (P<0.001); the positive and protein expression of p-p38 MAPK, Atrogin-1 and Murf-1 elevated (P<0.001) and that of Nrf2 and HO-1 dropped (P<0.001). When compared with the model group, in the EA group and the p38 MAPK inhibitor group, the standing duration, the swing time and the step cycle decreased (P<0.01), the footprint area of the maximum contact time, the print area, the average intensity of the maximum contact time, the average intensity, the swing speed, and the step length increased (P<0.01); the wet weight ratio of gastrocnemius muscle and fiber cross-sectional area were improved (P<0.01, P<0.05); the content of IL-6, IL-1β, TNF-α and MDA in gastrocnemius muscle dropped (P<0.05, P<0.01), and that of SOD elevated (P<0.01, P<0.05); the positive and protein expression of p-p38 MAPK, Atrogin-1 and Murf-1 dropped (P<0.01, P<0.05) and that of Nrf2 and HO-1 increased (P<0.01, P<0.05). CONCLUSION Electroacupuncture may alleviate skeletal muscle atrophy in denervated skeletal muscle atrophy rats by mediating the p38 MAPK activity, thereby suppressing oxidative stress, inflammatory reaction, and protein degradation.
Animals ; Electroacupuncture ; Male ; Rats ; p38 Mitogen-Activated Protein Kinases/genetics* ; Rats, Sprague-Dawley ; Muscular Atrophy/metabolism* ; Muscle, Skeletal/metabolism* ; Humans ; Signal Transduction ; Superoxide Dismutase/genetics* ; Tumor Necrosis Factor-alpha/genetics* ; Oxidative Stress ; MAP Kinase Signaling System ; Acupuncture Points

Jiuwei Xifeng Granules have become a Chinese patent medicine in the market. Because the formula contains Os Draconis, a top-level protected fossil of ancient organisms, the formula was to be improved by replacing Os Draconis with Ostreae Concha. To evaluate whether the improved formula has the same effectiveness and safety as the original formula, a randomized, double-blind, parallel-controlled, equivalence clinical trial was conducted. This study enrolled 288 tic disorder(TD) of children and assigned them into two groups in 1∶1. The treatment group and control group took the modified formula and original formula, respectively. The treatment lasted for 6 weeks, and follow-up visits were conducted at weeks 2, 4, and 6. The primary efficacy endpoint was the difference in Yale global tic severity scale(YGTSS)-total tic severity(TTS) score from baseline after 6 weeks of treatment. The results showed that after 6 weeks of treatment, the declines in YGTSS-TSS score showed no statistically significant difference between the two groups. The difference in YGTSS-TSS score(treatment group-control group) and the 95%CI of the full analysis set(FAS) were-0.17[-1.42, 1.08] and those of per-protocol set(PPS) were 0.29[-0.97, 1.56], which were within the equivalence boundary [-3, 3]. The equivalence test was therefore concluded. The two groups showed no significant differences in the secondary efficacy endpoints of effective rate for TD, total score and factor scores of YGTSS, clinical global impressions-severity(CGI-S) score, traditional Chinese medicine(TCM) response rate, or symptom disappearance rate, and thus a complete evidence chain with the primary outcome was formed. A total of 6 adverse reactions were reported, including 4(2.82%) cases in the treatment group and 2(1.41%) cases in the control group, which showed no statistically significant difference between the two groups. No serious suspected unexpected adverse reactions were reported, and no laboratory test results indicated serious clinically significant abnormalities. The results support the replacement of Os Draconis by Ostreae Concha in the original formula, and the efficacy and safety of the modified formula are consistent with those of the original formula.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Double-Blind Method ; Drugs, Chinese Herbal/therapeutic use* ; Tic Disorders/drug therapy* ; Treatment Outcome

In view of the problem of slow development of intensive care medicine in Xizang, the research team made full use of the national partner assistance to Xizang, gathered resources across all cities in Xizang, and formed a national academic platform for critical care medicine in plateau areas. Adhering to the academic orientation with hemodynamics as the main topic, critical care ultrasound as the bedside dynamic monitoring and evaluation method, and blood flow-oxygen flow resuscitation as the core connotation, we have achieved the goals of improving the critical care talent echelon throughout Xizang, driving the overall progress of intensive care medicine in Xizang, making a figure in China, and focusing on training of top-notch talents.

Pharmacokinetics of traditional Chinese medicine(TCM)is a discipline that adopts pharmacokinetic research methods and techniques under the guidance of TCM theories to elucidate the dynamic changes in the absorption,distribution,metabolism and excretion of active ingredients,active sites,single-flavour Chinese medicinal and compounded formulas of TCM in vivo.However,the sources and components of TCM are complex,and the pharmacodynamic substances and mechanisms of action of the majority of TCM are not yet clear,so the pharmacokinetic study of TCM is later than that of chemical medicines,and is far more complex than that of chemical medicines,and its development also confronts with challenges.The pharmacokinetic study of TCM originated in the 1950s and has experienced more than 70 years of development from the initial in vivo study of a single active ingredient,to the pharmacokinetic and pharmacodynamic study of active ingredients,to the pharmacokinetic study of compound and multi-component of Chinese medicine.In recent years,with the help of advanced extraction,separation and analysis technologies,gene-editing animals and cell models,multi-omics technologies,protein purification and structure analysis technologies,and artificial intelligence,etc.,the pharmacokinetics of TCM has been substantially applied in revealing and elucidating the pharmacodynamic substances and mechanisms of action of Chinese medicines,research and development of new drugs of TCM,scientific and technological upgrading of large varieties of Chinese patent medicines,as well as guiding the rational use of medicines in clinics.Pharmacokinetic studies of TCM have made remarkable breakthroughs and significant development in theory,methodology,technology and application.In this paper,the history of the development of pharmacokinetics of TCM and the progress of cutting-edge research was reviewed,with the aim of providing ideas and references for the pharmacokinetics of TCM and related research.