ObjectiveTo explore the possible mechanism of Qishao Tongbi Capsule （芪芍通痹胶囊， QTC） in the treatment of intervertebral disc degeneration （IDD）. MethodsSeventy-five rats were randomly divided into control group， model group， low-dose QTC group， high-dose QTC group， high-dose QTC +agonist group， with 15 rats in each group. Except for the control group， all other groups were subjected to a fibrous ring puncture to prepare an IDD model. After modeling， rats in low-dose QTC group and high-dose QTC group were given QTC at doses of 0.2 and 0.8 g/（kg·d） by gavage， respectively. Rats in high-dose QTC+ agonist group was given QTC at 0.8 g/（kg·d） and SKL2001 solution at 10 mg/（kg·d） by gavage. The control group and model group were given 10 ml/（kg·d） distilled water by gavage. All treatments were given once a day for 4 consecutive weeks. After treatment， X-ray and magnetic resonance imaging （MRI） were used to detect IDD degree. Hematoxylin-eosin （HE） staining and Safranin O-Fast Green staining were used to observe the morphological changes of the intervertebral disc tissue. Immunohistochemical staining was performed to examine the levels of proteoglycan， type Ⅱ collagen （COL Ⅱ）， and matrix metalloproteinase-3 （MMP-3） in the intervertebral disc tissue. Western blotting was used to detect the extracellular matrix （ECM）-related proteins （proteoglycan， COL Ⅱ， MMP-3， MMP-9， MMP-13）， aging-related proteins （P53， P21， P16）， apoptosis related proteins， including B-cell lymphoma/leukemia 2 （BCL-2）， BCL-2 related X protein （BAX）， Cleaved Caspase-3， and Wnt/β-catenin pathway related proteins such as Wnt3a， glycogen synthase kinase-3β （GSK-3β） and β-catenin in the intervertebral disc nucleus pulposus （NP） tissue. Reverse Transcription Quantitative Polymerase Chain Reaction （RT-qPCR） was used to assess the mRNA expression of Wnt3a， GSK-3β， and β-catenin in intervertebral disc tissue. ResultsCompared with the model group， rats in the low-dose QTC group and high-dose QTC group exhibited improved DHI， decreased Pfirmann grading， and alleviated IDD. The structural integrity of the NP and annulus fibrosus increased， and the number of the NP increased. The levels of proteoglycan， COL Ⅱ， BCL-2 and GSK-3β increased， while the levels of MMP-3， MMP-9， MMP-13， P53， P21， P16， BAX， Cleaved Caspase-3， Wnt3a and β-catenin protein decreased. The mRNA expression of Wnt3a and β-catenin mRNA decreased， while GSK-3β mRNA expression increased （P＜0.05）. Compared with the low-dose QTC group， the high-dose QTC group showed further improvements in DHI， decrease in Pfirrmann grading （P＜0.05）， and greater alleviation of IDD. The structural integrity of NP and annulus fibrosus was further enhanced， and the number of NP cells further increased. The levels of proteoglycan， COL Ⅱ， BCL-2 and GSK-3β were higher， while the levels of MMP-3， MMP-9， MMP-13， P53， P21， P16， BAX， Cleaved Caspase-3， Wnt3a and β-catenin were lower. The mRNA expression of Wnt3a and β-catenin decreased， while GSK-3β mRNA expression increased （P＜0.05）. Compared with the high-dose QTC group， the high-dose QTC +agonist group showed a decrease of DHI， an increase of Pfirmann grading （P＜0.05）， significant aggravation of IDD， reduction in structural integrity of the NP and annulus fibrosus， a decrease of NP cell count， lower levels of proteoglycan， COL Ⅱ， BCL-2 and GSK-3β， and higher levels of MMP-3， MMP-9， MMP-13， P53， P21， P16， BAX and Cleaved Caspase-3. Additionally， GSK-3β mRNA expression decreased （P＜0.05）. ConclusionQTC can inhibit NP cell aging， apoptosis， and ECM degradation in IDD rats， and its therapeutic effect may be mediated through the inhibition of the Wnt/β-catenin pathway.

BACKGROUND:Existing studies have preliminarily summarized the potential association between muscle activity of the affected lower limb and gait stability during walking in patients undergoing anterior cruciate ligament reconstruction.However,there are some issues such as incomplete observation of muscle categories,incomplete observation of walking action phases,and failure to consider synergistic effects among multiple muscle groups,which urgently require further improvement in this study.OBJECTIVE:To monitor muscle synergy information of the affected leg during walking in patients undergoing anterior cruciate ligament reconstruction and to analyze the association between muscle synergy information and gait stability.METHODS:Twenty-four male patients aged(21.66±4.09)years undergoing anterior cruciate ligament reconstruction,were recruited.Electromyographic and center of pressure data were collected from the affected lower limb during walking.A non-negative matrix decomposition algorithm was used to extract the number of muscle synergic elements from the affected leg,the time spent in peak activation of each muscle synergic element,and the muscle relative weight indexes.Correlation analysis was then performed with the center of pressure indexes.RESULTS AND CONCLUSION:Six types of muscle synergies were identified in the affected leg.The number of muscle synergic elements showed no significant correlation with the distance and speed of lateral displacement of the center of pressure.Regarding the peak activation time of muscle synergic elements,synergic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.413,P=0.045)and a significant negative correlation with the lateral displacement velocity of the center of pressure(r=-0.470,P=0.020).The activation time of the remaining types of muscle synergic elements was not significantly related with patient's gait stability indices.In terms of muscle relative weights,the rectus femoris muscle of synergistic element 1 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.592,P=0.005)and a significant negative correlation with the lateral displacement speed of the center of pressure(r=-0.529,P=0.014).Additionally,the relative weight of the biceps femoris muscle of synergistic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.428,P=0.037).To conclude,the central system in patients undergoing anterior cruciate ligament reconstruction regulates the synergistic muscle activity of the affected leg during walking to enhance gait stability in two primary ways:by prolonging the activation time of the muscle synergists during the dominant loading response period and enhancing the activation of the quadriceps muscle,in order to enhance the control of eccentric contractions of the knee joint during the landing of the affected leg and improve the stability of the knee joint;and by increasing the activation of the biceps femoris muscle during the loading response period,which increases the degree of knee flexion and enhances the lower limb's cushioning function during the landing of the affected leg.

BACKGROUND:Existing studies have preliminarily summarized the potential association between muscle activity of the affected lower limb and gait stability during walking in patients undergoing anterior cruciate ligament reconstruction.However,there are some issues such as incomplete observation of muscle categories,incomplete observation of walking action phases,and failure to consider synergistic effects among multiple muscle groups,which urgently require further improvement in this study.OBJECTIVE:To monitor muscle synergy information of the affected leg during walking in patients undergoing anterior cruciate ligament reconstruction and to analyze the association between muscle synergy information and gait stability.METHODS:Twenty-four male patients aged(21.66±4.09)years undergoing anterior cruciate ligament reconstruction,were recruited.Electromyographic and center of pressure data were collected from the affected lower limb during walking.A non-negative matrix decomposition algorithm was used to extract the number of muscle synergic elements from the affected leg,the time spent in peak activation of each muscle synergic element,and the muscle relative weight indexes.Correlation analysis was then performed with the center of pressure indexes.RESULTS AND CONCLUSION:Six types of muscle synergies were identified in the affected leg.The number of muscle synergic elements showed no significant correlation with the distance and speed of lateral displacement of the center of pressure.Regarding the peak activation time of muscle synergic elements,synergic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.413,P=0.045)and a significant negative correlation with the lateral displacement velocity of the center of pressure(r=-0.470,P=0.020).The activation time of the remaining types of muscle synergic elements was not significantly related with patient's gait stability indices.In terms of muscle relative weights,the rectus femoris muscle of synergistic element 1 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.592,P=0.005)and a significant negative correlation with the lateral displacement speed of the center of pressure(r=-0.529,P=0.014).Additionally,the relative weight of the biceps femoris muscle of synergistic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.428,P=0.037).To conclude,the central system in patients undergoing anterior cruciate ligament reconstruction regulates the synergistic muscle activity of the affected leg during walking to enhance gait stability in two primary ways:by prolonging the activation time of the muscle synergists during the dominant loading response period and enhancing the activation of the quadriceps muscle,in order to enhance the control of eccentric contractions of the knee joint during the landing of the affected leg and improve the stability of the knee joint;and by increasing the activation of the biceps femoris muscle during the loading response period,which increases the degree of knee flexion and enhances the lower limb's cushioning function during the landing of the affected leg.

The gradual progression of the"team-based"medical talent aid initiative in Tibet has prompted our hospital to respond to the national call by dispatching medical team members to the Tibetan Medicine Hospital in Biru County,Naqu City,Tibet Autonomous Region for short-term flexible assistance.This paper takes short-term counterpart support work as a case study to analyze the implementation,challenges and achievements of the aid efforts,and proposes recommendations for a sustainable development mechanism for future assistance initiatives.During the counterpart support period,the medical team members built upon a unique foundation of Tibetan medicine and pharmacology,actively explored specialty construction,promoted appropriate technologies,and initiated remote consultations.Achievements were made in disease diagnosis and treatment processes,enhance-ment of medical technology,and talent cultivation.

This article introduces the connotation of feedback-seeking behavior, analyzes the influencing factors of feedback-seeking behavior of medical students from personal factors, feedback provider situation, hospital organizational environment and social culture and summarizes intervention strategies for feedback-seeking behavior from the perspectives of medical students, teachers and society, so as to provide a basis and guidance for constructing feedback-training programs for medical students, thereby ensuring medical quality and patient safety.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

We describe a case of fetal sacrococcygeal teratoma detected by ultrasound at 14 gestational weeks. The tumor was classified as "type Ⅰ" by ultrasonography combined with MRI. The cystic part accounted for over 60% of the mass before 26 weeks and ruptured spontaneously at 28 weeks. The size of the tumor was 12.8 cm×9.7 cm×12.3 cm at 36 +5 gestational weeks. A female newborn was born through cesarean section at 37 weeks of gestation and had the tumor removed surgically on the postnatal day 4. Postoperative follow-up showed that the neonate had a good prognosis without physiological dysfunction.

Objective:To conduct a clinical study on acupuncture combined with hyperbaric oxygen and medication in the treatment of sudden deafness，and observe the curative effect.Methods:A total of 228 patients with sudden deafness admitted to the Department of Rehabilitation Medicine of Shaanxi Provincial People’s Hospital from January 2019 to January 2021 were randomly divided into treatment group（ n=121）and control group（ n=107）. The control group received acupuncture and medication therapy，while the treatment group received hyperbaric oxygen therapy on the basis of the control group. Before observing the efficacy，each group was treated for seven times. Results:The marked response rate of the treatment group was 68.6%，and the overall response rate was 85.1%；while the marked response rate of the control group was 57.9%，and the overall response rate was 71.0%. There were statistically significant differences between the two groups（ P<0.05）. Conclusion:Hyperbaric oxygen combined with acupuncture and medication is more effective than using acupuncture and medication alone in the treatment of sudden deafness.

Objective:To conduct a clinical study on acupuncture combined with hyperbaric oxygen and medication in the treatment of sudden deafness，and observe the curative effect.Methods:A total of 228 patients with sudden deafness admitted to the Department of Rehabilitation Medicine of Shaanxi Provincial People’s Hospital from January 2019 to January 2021 were randomly divided into treatment group（ n=121）and control group（ n=107）. The control group received acupuncture and medication therapy，while the treatment group received hyperbaric oxygen therapy on the basis of the control group. Before observing the efficacy，each group was treated for seven times. Results:The marked response rate of the treatment group was 68.6%，and the overall response rate was 85.1%；while the marked response rate of the control group was 57.9%，and the overall response rate was 71.0%. There were statistically significant differences between the two groups（ P<0.05）. Conclusion:Hyperbaric oxygen combined with acupuncture and medication is more effective than using acupuncture and medication alone in the treatment of sudden deafness.

We describe a rare case of fetal mediastinal capillary hemangioma presenting as pleural effusion and a huge pleural occupying lesion during late pregnancy. The patient was admitted at 36 +3 weeks of gestation, with a fetal chest occupying lesion for 11 days. Routine prenatal ultrasound and MRI indicated right pleural effusion and a huge chest occupying lesion in the fetus. The woman was administered oxytocin and delivered a live baby boy at 36 +5 weeks of gestation. The baby was diagnosed as mediastinal hemangioma by postnatal CT, angiography and 3D reconstruction and was discharged after oral propranolol treatment. However, he was readmitted one month after birth due to "pneumonia and tachypnea". After multidisciplinary consultation, the baby underwent a right-side thoracic mediastinal mass resection, and a mediastinal capillary hemangioma was confirmed by pathology. The child continued taking propranolol orally and received regular follow-up and rehabilitation after the operation up to 7 months old, by which time no obvious abnormalities were found.