Objective:To explore the risk factors of quality of life(QoL)being below normal levels in patients undergo-ing total knee arthroplasty(TKA)at 6 months after surgery,and to construct a nomogram prediction model.Method:Two-hundred and sixty-seven patients who underwent TKA at Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)from April 2021 to October 2022 were selected.Clini-cal data were collected on admission and within 6 months after surgery.According to the QoL assessment at 6 months after surgery,they were divided into a high-quality group(n=136)and a non-high-quality group(n=131).LASSO regression was used to screen the predictors,and multivariate Logistic regression was established to construct the predictive model of QoL of TKA patients at 6 months after surgery.Receiver operating character-istic curve(ROC curve),calibration curve and decision curve were drawn to evaluate its predictive value.Result:A total of 131(49.06%)patients had lower QoL than normal 6 months after TKA.LASSO regression selected age,surgical side,education level,duration of knee osteoarthritis(KOA),perioperative recovery,and visual analog scale(VAS)during preoperative rest as predictors.Multivariate logistic regression analysis showed that age(OR,1.08;95%CI,1.01-1.15),duration of KOA(OR,1.13;95%CI,1.05-1.22),VAS during preoperative rest(OR,1.94;95%CI,1.20-3.15),and perioperative rehabilitation(OR,0.42;95%CI,0.18-0.97)were independent risk factors for lower than normal QoL in TKA patients at 6 months after surgery(P<0.05).Statistically significant indicators in multivariate logistic regression analysis were includ-ed in the nomogram model,which underwent internal validation.The area under the ROC curve was 0.829(95%CI,0.779-0.879),indicating good predictive ability of the model.The calibration curve showed good consistency between the predicted probability and the actual probability.The decision curve analysis showed that this model is clinically applicable.Conclusion:Age,duration of KOA,VAS during preoperative rest,and perioperative rehabilitation are indepen-dent predictors of lower-than-normal QoL in TKA patients at 6 months after surgery,and the nomogram mod-el based on the above indicators had good predictive performance.

BACKGROUND:A large number of articles have reported the effect and mechanism of platelet-rich plasma and hydrogel in the treatment of spinal cord injury,but few articles have summarized their treatment strategies for spinal cord injury. OBJECTIVE:To summarize the pathological process of spinal cord injury and the strategies of repairing spinal cord injury with platelet-rich plasma and hydrogel alone and in combination. METHODS:PubMed and CNKI databases were searched for articles published from inception to March 2024 by computer.The Chinese search terms were"spinal cord injury,platelet-rich plasma,hydrogel."The English search terms were"spinal cord injury,spinal cord,platelet-rich plasma,hydrogel,angiogenesis,neuralgia,combination therapy."Articles were screened according to inclusion and exclusion criteria,and 128 articles were finally included for review and analysis. RESULTS AND CONCLUSION:(1)The classification of platelet-rich plasma is complex and diverse,and the effects of platelet-rich plasma in the repair treatment of spinal cord injury are various,but they all show certain positive effects,that is,they can promote axon regeneration,stimulate angiogenesis,and treat neuropathic pain and so on.(2)The effect of platelet-rich plasma is mainly due to the growth factors contained in platelet-rich plasma.(3)There are many types of hydrogels,which mainly play the role of filling,simulating extracellular matrix,carrying drugs and biological products,and carrying cells as scaffolds in the repair treatment of spinal cord injury.(4)Compared with single therapy,combination therapy of platelet-rich plasma and hydrogel can promote nerve regeneration and spinal cord function recovery more effectively.

Objective To explore the causal association between immune cells and allergic rhi-nitis using Mendelian randomization(MR)approach.Methods GWAS data for 731 types of im-mune cells and allergic rhinitis were obtained from genome-wide association study(GWAS)databas-es.A two-sample bidirectional MR analysis was conducted,with the inverse-variance weighted(IVW)method as the primary analytical approach,and the weighted median method,MR-Egger re-gression,simple mode method,and weighted mode method as supplementary approaches.Sensitivity analyses,including heterogeneity tests,pleiotropy tests,and the leave-one-out method,were per-formed.Bonferroni correction was applied to the preliminary results to enhance their reliability and rigor.Results The two-sample forward MR analysis revealed correlations between 67 immune cell phenotypes and allergic rhinitis.After Bonferroni correction,four immune cell phenotypes were finally identified.Among them,the expression of CD3 on CD39-positive activated CD4 regulatory T cells(OR=0.953,95％CI,0.931 to 0.978,P＜0.001,Padj=0.007),the expression of herpesvirus entry mediator(HVEM)on CD45RA-negative CD4+T cells(OR=0.965,95％CI,0.948 to 0.983,P＜0.001,Padj=0.008),and the percentage of human leukocyte antigen class DR(HLA-DR)-high-expressing monocytes among leukocytes(OR=0.929,95％CI,0.885 to 0.974,P=0.002,Padj=0.157)were protective factors for allergic rhinitis.In contrast,the percentage of transitional B cells among B cells(OR=1.094,95％CI,1.032 to 1.161,P=0.003,Padj=0.183)was a risk factor for allergic rhinitis.The reverse MR analysis showed no causal relationship between allergic rhinitis and the four immune cell phenotypes.Conclusion The two-sample forward MR analysis confirms a caus-al link between immune cells and allergic rhinitis.MR analysis has the advantages of reducing con-founding factor interference and avoiding reverse causation,providing a theoretical basis for in-depth research on immune mechanisms,sensitive biomarkers,and drug treatment targets of allergic rhinitis.

Objective:To observe the effects of electroacupuncture at "Shenting", "Benshen" and "Baihui" acupoints on the mechanical pain threshold and JAK/PI3K/TRPV1 pathway in the trigeminal ganglion of rats with trigeminal neuralgia model; To explore the related mechanism.Methods:Totally 36 male SD rats were divided into sham-operation group, model group and electroacupuncture group using random number table method, with 12 rats in each group. Except for the sham-operation group, rats in the model group and electroacupuncture group were modeled by infraorbital nerve chronic constriction injury. In the electroacupuncture group, electroacupuncture was performed at "Shenting", "Benshen" and "Baihui" 14 days after surgery, 20 min every day, once every other day, and every 3 times for 1 course of treatment with an interval of 2 d between each course of treatment. A total of 2 courses of treatment were performed. VonFrey fiber wire was used to measure the mechanical pain threshold of rat whisker pads. HE staining was used to observe the morphology and structure of trigeminal ganglion of rats in each group. Immunohistochemistry and Western blot method were used to observe the protein expressions of JAK, PI3K and TRPV1 in trigeminal ganglion of rats, and the serum level of IL-6 was detected in the serum of rats by ELISA.Results:Compared with the model group, the pain threshold of the electroacupuncture group increased significantly ( P<0.05), and the infiltration of inflammatory cells and demyelination in the trigeminal nerve ganglion decreased, and the positive expressions of JAK, PI3K, and TRPV1 in the trigeminal ganglion decreased ( P<0.05 or P<0.01), the protein expressions of JAK2, PI3K, and TRPV1 decreased ( P<0.05 or P<0.01), and the serum IL-6 level decreased ( P<0.01). Conclusions:Electroacupuncture at "Shenting", "Benshen" and "Baihui" may play an analgesic role by regulating IL-6 levels and inhibiting the activation of JAK/PI3K/TRPV1 signaling pathway.

Objective:To explore the risk factors of quality of life(QoL)being below normal levels in patients undergo-ing total knee arthroplasty(TKA)at 6 months after surgery,and to construct a nomogram prediction model.Method:Two-hundred and sixty-seven patients who underwent TKA at Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital)from April 2021 to October 2022 were selected.Clini-cal data were collected on admission and within 6 months after surgery.According to the QoL assessment at 6 months after surgery,they were divided into a high-quality group(n=136)and a non-high-quality group(n=131).LASSO regression was used to screen the predictors,and multivariate Logistic regression was established to construct the predictive model of QoL of TKA patients at 6 months after surgery.Receiver operating character-istic curve(ROC curve),calibration curve and decision curve were drawn to evaluate its predictive value.Result:A total of 131(49.06%)patients had lower QoL than normal 6 months after TKA.LASSO regression selected age,surgical side,education level,duration of knee osteoarthritis(KOA),perioperative recovery,and visual analog scale(VAS)during preoperative rest as predictors.Multivariate logistic regression analysis showed that age(OR,1.08;95%CI,1.01-1.15),duration of KOA(OR,1.13;95%CI,1.05-1.22),VAS during preoperative rest(OR,1.94;95%CI,1.20-3.15),and perioperative rehabilitation(OR,0.42;95%CI,0.18-0.97)were independent risk factors for lower than normal QoL in TKA patients at 6 months after surgery(P<0.05).Statistically significant indicators in multivariate logistic regression analysis were includ-ed in the nomogram model,which underwent internal validation.The area under the ROC curve was 0.829(95%CI,0.779-0.879),indicating good predictive ability of the model.The calibration curve showed good consistency between the predicted probability and the actual probability.The decision curve analysis showed that this model is clinically applicable.Conclusion:Age,duration of KOA,VAS during preoperative rest,and perioperative rehabilitation are indepen-dent predictors of lower-than-normal QoL in TKA patients at 6 months after surgery,and the nomogram mod-el based on the above indicators had good predictive performance.

Objective To investigate the causal association between bronchial asthma and bone mineral density at different sites using a two-sample Mendelian randomization (MR) approach. Methods Summary data for exposure factors and outcome were obtained from different genome-wide association studies.Single nucleotide polymorphisms strongly associated with bronchial asthma were selected as instrumental variables,and those in linkage disequilibrium were excluded.The inverse-variance weighted (IVW) method was used as the primary method for MR analysis,complemented by weighted median,simple mode,weighted mode,and MR-Egger regression methods.Sensitivity analyses were conducted to assess the stability of the results. Results The random-effects model of IVW analysis showed that heel bone mineral density (OR=0.986;95% CI,0.974 to 0.998;P=0.023) as the outcome dataset had a reverse causal effect with bronchial asthma,while lumbar spine bone mineral density (OR=1.031;95% CI,0.984 to 1.081;P=0.195),femoral neck bone mineral density (OR=1.014;95% CI,0.973 to 1.057;P=0.505),and forearm bone mineral density (OR=1.011;95% CI,0.935 to 1.094;P=0.775) as outcome datasets showed no causal effect with bronchial asthma.The MR-Egger intercept test results indicated that the P-values for the intercepts of lumbar bone mineral density,femoral neck bone mineral density,forearm bone mineral density,and calcaneal bone mineral density were all over 0.05,suggesting no horizontal pleiotropy and relatively stable results. Conclusion MR analysis reveals a reverse causal effect between bronchial asthma and heel bone mineral density,suggesting that clinicians should strengthen the monitoring of heel bone mineral density in patients with bronchial asthma to timely detect and intervene osteoporosis.

Background and objective Chronic cough after pulmonary resection is one of the most common complications,which seriously affects the quality of life of patients after surgery.Therefore,the aim of this study is to explore the risk factors of chronic cough after pulmonary resection and construct a prediction model.Methods The clinical data and postoperative cough of 499 patients who underwent pneumonectomy or pulmonary resection in The First Affiliated Hospital of University of Science and Technology of China from January 2021 to June 2023 were retrospectively analyzed.The patients were randomly divided into training set(n=348)and validation set(n=151)according to the principle of 7:3 randomization.According to whether the patients in the training set had chronic cough after surgery,they were divided into cough group and non-cough group.The Mandarin Chinese version of Leicester cough questionnare(LCQ-MC)was used to assess the severity of cough and its impact on patients'quality of life before and after surgery.The visual analog scale(VAS)and the self-designed numerical rating scale(NRS)were used to evaluate the postoperative chronic cough.Univariate and multivariate Logistic regression analysis were used to analyze the independent risk factors and construct a model.Receiver operator characteristic(ROC)curve was used to evaluate the discrimination of the model,and calibration curve was used to evaluate the consistency of the model.The clinical application value of the model was evaluated by decision curve analysis(DCA).Results Multivariate Logistic analysis screened out that preoperative forced expiratory volume in the first second/forced vital capacity(FEV1/FVC),surgical procedure,upper mediastinal lymph node dissection,subcarinal lymph node dissection,and postoperative closed tho-racic drainage time were independent risk factors for postoperative chronic cough.Based on the results of multivariate analysis,a Nomogram prediction model was constructed.The area under the ROC curve was 0.954(95％CI:0.930-0.978),and the cut-off value corresponding to the maximum Youden index was 0.171,with a sensitivity of 94.7％and a specificity of 86.6％.With a Bootstrap sample of 1000 times,the predicted risk of chronic cough after pulmonary resection by the calibration curve was highly consistent with the actual risk.DCA showed that when the preprobability of the prediction model probability was be-tween 0.1 and 0.9,patients showed a positive net benefit.Conclusion Chronic cough after pulmonary resection seriously af-fects the quality of life of patients.The visual presentation form of the Nomogram is helpful to accurately predict chronic cough after pulmonary resection and provide support for clinical decision-making.

Objective:To observe the effect of abdominal electroacupuncture(EA)on intestinal function in patients with constipation after stroke. Methods:A total of 100 patients with post-stroke constipation were divided into an observation group and a control group by the random number table method,with 50 cases in each group.The control group was treated with oral lactulose,10 mL each time,3 times a day,for 2 consecutive weeks.The observation group was treated with additional abdominal EA at Tianshu(ST25),Fushe(SP13),and Daheng(SP15)on the basis of oral lactulose,30 min for needle retention each time,once a day,for 2 consecutive weeks.The total effective rate after treatment,constipation symptom score,the score of patient assessment of constipation quality of life scale(PAC-QOL),serum motilin(MTL)level,and the score of mini-mental state examination(MMSE)were compared between the two groups. Results:After 2 weeks of treatment,the total effective rate was 93.5%in the observation group and 76.1%in the control group,and the difference between the two groups was statistically significant(P<0.05).The constipation symptom score,PAC-QOL score,MMSE score,and MTL level changed significantly after treatment in both groups(P<0.05).After treatment,the constipation symptom score and PAC-QOL score in the observation group were lower than those in the control group,while the MMSE score and MLT level were higher than those in the control group,and the differences between the two groups were statistically significant(P<0.05). Conclusion:On the basis of oral lactulose,EA at abdominal points can significantly improve the intestinal and cognitive function of stroke patients simultaneously.

OBJECTIVE： To optimize the processing technology of fried Radix Paeoniae， and to provide reference for quality control of the processed products. METHODS： The content of paeoniflorin in fried Radix Paeoniae was determined by HPLC. The determination was performed on Agilent ZORBAX SB-C18 column with mobile phase consisted of acetonitrile-0.05 mol/L potassium dihydrogen phosphate solution （15 ∶ 85， V/V） at the flow rate of 1.0 mL/min. The column temperature was 30 ℃， and detection wavelength was set at 230 nm. The sample size was 10 μL. The appearance character of fried Radix Peaoniae were investigated by appearance color， crosssection color， hardness and smell. Taking the comprehensive score of appearance character and paeoniflorin content as evaluation index， the dosage， stir-frying temperature and stir-frying time were investigated. According to the results of single factor test， Box-Behnken response surface methodology was used to optimize above 3 factors. The optimized processing technology was validated. RESULTS： The linear range of paeoniflorin were 0.02-4.15 mg/mL （r＝0.999 9）； precision， stablity， repeatability and sample recovery rate meet the requirements. The optimal technology of fried Radix Paeoniae included the dosage of 374.60 g， frying temperature of 101.61 ℃， frying time of 20 min. Under optimal technology， comprehensive score of fried Radix Paeoniae ranged 97.39-98.82 in 6 times of parallel verification tests （RSD＝0.54％）， which was close to predicted value 98.18. The color of fried Radix Paeoniae was slightly deeper than Radix Paeoniae， which was crisp and fragrant. CONCLUSIONS： The optimized processing technology of fried Radix Paeoniae is stable and feasible， and is suitable for the preparation of the processed products.

Objective To observe the clinical efficacy of electroacupuncture in treating herpes zoster.Method Ninety patients with herpes zoster were randomized into treatment group 1, treatment group 2, and a control group, 30 cases in each group. Treatment group 1 was intervened by surround needling at Ashi points (deep needling, by 33 mm) plus electroacupuncture; treatment group 2 was by surround needling at Ashi points (superficial needling by 16 mm) plus electroacupuncture; the control group was by oral administration of Valacyclovir Hydrochloride tablets plus Vitamin B1. After 10-day treatment, the blister-breaking time, crust-forming time, and the time of falling-off of the crust, and Visual Analogue Scale (VAS) were observed, and the clinical efficacies were compared.Result The recovery rate and total effective rate were respectively 73.3% and 93.3% in treatment group 1, versus 46.7% and 86.7% in treatment group 2, and 33.3% and 63.3% in the control group. The recovery rate of treatment group 1 was significantly different from that of treatment group 2 and the control group (P<0.01,P<0.05). The total effective rates of treatment group 1 and 2 were both significantly different from that of the control group (P<0.01,P<0.05). The blister-breaking time, crust-forming time, and crust falling-off time of treatment group 1 were significantly different from that of treatment group 2 and the control group (P<0.01,P<0.05). The crust-forming time and falling-off time of treatment group 2 were significantly different from that of the control group (P<0.05). The VAS scores were markedly changed after the intervention in the three groups (P<0.01). After the treatment, the VAS scores of treatment group 1 and 2 were significantly different from that of the control group (P<0.01). The VAS score of treatment group 1 was markedly different from that of treatment group 2 after the treatment (P<0.05).Conclusion Electroacupuncture is an effective method in treating herpes zoster, while deep surround needling at Ashi points plus electroacupuncture can effectively inhibit the development of blisters, promote crust-forming, release the neural pain, and reduce the incidence of postherpetic neuralgia.