OBJECTIVE: To observe the clinical efficacy and safety of acupuncture combined with blade needle therapy for knee osteoarthritis (KOA). METHODS: A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. The control group received acupuncture at Neixiyan (EX-LE4)，Dubi (ST35), Yinlingquan (SP9), Liangqiu (ST34), Xuehai (SP10), Yanglingquan (GB34) and Zusanli (ST36) on the affected side, once every other day, 3 times a week. The observation group received blade needle therapy on the basis of the treatment in the control group, once every 3 days, 2 times a week. Both groups were treated for 4 weeks. Before treatment, after 2, 4 weeks of treatment, and after 1 month of treatment completion (in follow-up), the scores of pain visual analogue scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and Lequesne index were observed in the two groups, and the clinical efficacy and safety were evaluated. RESULTS: After 2, 4 weeks of treatment and in follow-up, the pain VAS scores, Lequesne index scores, and pain, stiffness, function scores of WOMAC in both groups were decreased compared with those before treatment (P<0.05), and the VAS scores, Lequesne index scores and pain, function scores of WOMAC in the observation group were lower than those in the control group (P<0.05). The effective response rate in the observation group was 76.7% (23/30), while that in the control group was 70.0% (21/30), there was no statistically significant difference in the effective response rates between the two groups (P>0.05). No adverse reactions were observed in either group. CONCLUSION Acupuncture combined with blade needle therapy could alleviate pain and promote functional recovery in KOA patients, and achieve long-lasting improvements.
Humans ; Osteoarthritis, Knee/physiopathology* ; Acupuncture Therapy/instrumentation* ; Male ; Female ; Middle Aged ; Aged ; Acupuncture Points ; Treatment Outcome ; Adult ; Needles ; Combined Modality Therapy

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To explore the effects of Yiqi Yangyin Tongluo Decoction combined with TCM syndrome differentiation diet on renal function, inflammatory factors, and nutritional status of DN patients with qi-yin deficiency and blood stasis syndrome based on propensity score matching method.Methods:Retrospective clinical studies were carried out. A total of 152 DN patients with qi-yin deficiency and blood stasis syndrome in Dongfang Hospital, Beijing University of Chinese Medicine from January 2022 to January 2024 were selected and divided into an observation group of 83 cases and a control group of 69 cases according to the treatment method. Propensity score matching (PSM) was further adopted to balance the confounding factors before treatment at a ratio of 1:1. Finally, 46 patients in each group were successfully matched. The control group received conventional Western medicine therapy intervention, while the observation group received a combination of Yiqi Yangyin Tongluo Decoction and TCM syndrome differentiation diet treatment on the basis of the control group. Both groups were treated for 3 months. TCM syndrome scores were performed before and after treatment, and t-test was used to detect the levels of SCr, BUN, and β2-MG. ELISA was used to detect the levels of IL-1β, TGF-β1, and TNF-α. Body composition analyzer was used to measure the triceps circumference (AMC) and triceps skinfold thickness (TSF) of the upper arm; the Mini Nutritional Assessment (MNA) was used to assess the risk or status of malnutrition. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate of the observation group was 91.3% (42/46), while that of the control group was 69.7% (32/46). There was a statistical significance in the total effective rate between the two groups ( χ2=4.84, P=0.028). After treatment, the observation group had lower scores of soreness and weakness in the waist and knees, fatigue and weakness, restlessness and heat in the five hearts, and a decrease in the depth of the tongue and dark veins compared to the control group ( t values of 4.23, 3.86, 3.68, 4.62, respectively, P<0.001); serum SCr [(221.53±23.40) mmol/L vs. (261.92±25.48) mmol/L, t=7.92], BUN [(21.74 ± 4.13) mmol/L vs. (25.12 ± 4.50) mmol/L, t=3.75], β2-MG [(2.88 ± 0.71) mg/L vs. (4.54 ± 0.93) mg/L, t=9.62] levels, as well as IL-1β [(47.21 ± 5.48) μg/L vs. (51.92 ± 5.63) μg/L, t=4.07], TGF-β [(67.84 ± 8.03) μg/L vs. (73.29 ± 8.88) μg/L, t=4.75], TNF-α [(29.74 ± 4.13) μg/L vs. (33.12 ± 4.98) μg/L, t=3.54] were lower than those in the control group ( P<0.001); the MNA score (24.89 ± 4.48 vs. 21.02 ± 4.16, t=4.29), AMC [(24.34±2.83) mm vs. (22.19 ± 2.88) mm, t=3.61], TSF [(8.34 ± 2.13) mm vs. (7.12 ± 1.98) mm, t=2.85] were higher than those in the control group ( P<0.001 or P<0.05). During the treatment period, the incidence of adverse reactions in the observation group was 13.0% (6/46), while in the control group it was 8.7% (4/46). There was no statistical significance between the two groups ( χ2=0.45, P=0.503). Conclusion:The combination of Yiqi Yangyin Tongluo Decoction and TCM syndrome differentiation diet can effectively alleviate the clinical symptoms of DN patients, improve their kidney function, enhance their nutritional and health status, and inhibit inflammatory response levels, with good treatment safety.

Objective To investigate the impact of body mass index(BMI)on the perioperative outcomes and prognosis in patients with clear cell renal cell carcinoma(ccRCC)undergoing robot-assisted partial nephrectomy(RAPN),so as to provide reference for optimizing clinical management strategies.Methods The clinical data of 745 ccRCC patients undergoing RAPN at our hospital during 2014 and 2023 were retrospectively analyzed.Patients were categorized into three groups according to preoperative BMI:normal weight(18＜BMI＜24,n=202),overweight(24＜BMI＜28,n=428),and obese(BMI≥28,n=115).Baseline characteristics,surgical parameters,postoperative complications,pre-and post-operative estimated glomerular filtration rate(eGFR),and overall survival(OS)were compared among the groups.Multivariate regression analyses were performed to adjust potential confounders.Results Among baseline characteristics,only the gender distribution differed significantly among the three groups(P=0.009).Multivariate analysis showed that gender had no significant effects on reoperation,transfusion,operation time,intraoperative blood loss,or postoperative renal function.The median follow-up was 32(12,55)months.Compared with the normal-weight group,the obese group had longer operation time[140.0(115.0,170.0)min vs.160.0(125.0,190.0)min,P=0.009]and greater intraoperative blood loss[50.0(50.0,100.0)mL vs.100.0(50.0,150.0)mL,P=0.003].No statistically significant differences were observed among the three groups in pre-and post-operative eGFR,overall complication rate,long-term follow-up eGFR,or OS(P＞0.05).Conclusion RAPN provides comparable surgical benefits across BMI categories in patients with ccRCC;however,obese patients may experience increased operation time and blood loss.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective:To explore the effects of diversified teaching combined with the affective-cognitive theory in neurology clerkship instruction.Methods:We enrolled 406 medical students on clerkship at the affiliated hospitals of Sun Yat-sen University from November 2023 to April 2024. They were randomly assigned by cluster to either observation group ( n=164) or control group ( n=242). The observation group received a diversified teaching model that selected context-appropriate teaching methods based on clinical scenarios, while using the affective-cognitive theory to optimize instructional pathways. The control group received traditional teaching. The effectiveness of teaching was evaluated through an objective structured clinical examination (OSCE; maximum score, 10 points) and a questionnaire survey. SPSS 22.0 was used to perform Mann-Whitney U test, chi-square test, and multiple linear regression analysis. NVivo 12.0 was employed to process open-ended questions. Results:In the OSCE, the observation group had a significantly higher mean score than the control group [9 (8, 10) points vs. 8 (7, 9) points, Z=-6.10, P<0.001]. The distribution difference across different score ranges between the two groups was also statistically significant ( Z=-5.94, P<0.001). Stratified analyses by sex and neurological theory test score demonstrated significantly higher mean scores in the observation group than in the control group ( P<0.001). The multiple linear regression analysis indicated an independent positive correlation between the novel teaching model and OSCE score ( P<0.001). The results of the questionnaires revealed that in the observation group, 98.57% reported that they were satisfied with the teaching model, and 90.72% reported that they accomplished the core teaching objectives; core competencies including knowledge and skills, communication and collaboration, and professionalism were improved; additionally, the participants of the observational group highly endorsed the practical content, the logical structure and richness of instruction, and the active classroom learning environment. Conclusions:The diversified teaching model integrated with the affective-cognitive theory significantly improves proficiency in core clinical skills across different groups of neurology clerks.

The preferred treatment for adrenal functional tumors is laparoscopic surgical resection. However, in recent years, various ablation techniques have gradually been applied in the treatment of adrenal tumors. This report presents the successful diagnosis and treatment experience of 4 aldosterone-producing adenomas and 1 cortisol-secreting adenoma treated with a combined cold and hot ablation system at Xi’an Daxing Hospital from Dec. 2023 to Dec. 2024, providing a new treatment approach for clinical exploration.

Objective To investigate the impact of body mass index(BMI)on the perioperative outcomes and prognosis in patients with clear cell renal cell carcinoma(ccRCC)undergoing robot-assisted partial nephrectomy(RAPN),so as to provide reference for optimizing clinical management strategies.Methods The clinical data of 745 ccRCC patients undergoing RAPN at our hospital during 2014 and 2023 were retrospectively analyzed.Patients were categorized into three groups according to preoperative BMI:normal weight(18＜BMI＜24,n=202),overweight(24＜BMI＜28,n=428),and obese(BMI≥28,n=115).Baseline characteristics,surgical parameters,postoperative complications,pre-and post-operative estimated glomerular filtration rate(eGFR),and overall survival(OS)were compared among the groups.Multivariate regression analyses were performed to adjust potential confounders.Results Among baseline characteristics,only the gender distribution differed significantly among the three groups(P=0.009).Multivariate analysis showed that gender had no significant effects on reoperation,transfusion,operation time,intraoperative blood loss,or postoperative renal function.The median follow-up was 32(12,55)months.Compared with the normal-weight group,the obese group had longer operation time[140.0(115.0,170.0)min vs.160.0(125.0,190.0)min,P=0.009]and greater intraoperative blood loss[50.0(50.0,100.0)mL vs.100.0(50.0,150.0)mL,P=0.003].No statistically significant differences were observed among the three groups in pre-and post-operative eGFR,overall complication rate,long-term follow-up eGFR,or OS(P＞0.05).Conclusion RAPN provides comparable surgical benefits across BMI categories in patients with ccRCC;however,obese patients may experience increased operation time and blood loss.

Objective:To explore the effects of diversified teaching combined with the affective-cognitive theory in neurology clerkship instruction.Methods:We enrolled 406 medical students on clerkship at the affiliated hospitals of Sun Yat-sen University from November 2023 to April 2024. They were randomly assigned by cluster to either observation group ( n=164) or control group ( n=242). The observation group received a diversified teaching model that selected context-appropriate teaching methods based on clinical scenarios, while using the affective-cognitive theory to optimize instructional pathways. The control group received traditional teaching. The effectiveness of teaching was evaluated through an objective structured clinical examination (OSCE; maximum score, 10 points) and a questionnaire survey. SPSS 22.0 was used to perform Mann-Whitney U test, chi-square test, and multiple linear regression analysis. NVivo 12.0 was employed to process open-ended questions. Results:In the OSCE, the observation group had a significantly higher mean score than the control group [9 (8, 10) points vs. 8 (7, 9) points, Z=-6.10, P<0.001]. The distribution difference across different score ranges between the two groups was also statistically significant ( Z=-5.94, P<0.001). Stratified analyses by sex and neurological theory test score demonstrated significantly higher mean scores in the observation group than in the control group ( P<0.001). The multiple linear regression analysis indicated an independent positive correlation between the novel teaching model and OSCE score ( P<0.001). The results of the questionnaires revealed that in the observation group, 98.57% reported that they were satisfied with the teaching model, and 90.72% reported that they accomplished the core teaching objectives; core competencies including knowledge and skills, communication and collaboration, and professionalism were improved; additionally, the participants of the observational group highly endorsed the practical content, the logical structure and richness of instruction, and the active classroom learning environment. Conclusions:The diversified teaching model integrated with the affective-cognitive theory significantly improves proficiency in core clinical skills across different groups of neurology clerks.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.