Objective:To evaluate the effect of electroacupuncture (EA) on ionotropic purinergic receptor 4 (P2X4R)/nuclear factor-kappa B (NF-κB) signaling pathway during spinal cord injury (SCI) in rats.Methods:Thirty-six clean-grade healthy adult female Sprague-Dawley rats, weighing 210-250 g, were divided into 3 groups ( n=12 each) using a random number table method: sham surgery group (S group), SCI group, and SCI+ EA treatment group (SCI+ EA group). The SCI model was established by the Allen′s method in anesthetized animals. In group S, only the spinous processes and vertebral laminae were resected, but the spinal cord was not injured. On the 7th day after developing the model, EA of Jiaji, Dazhui, and Mingmen lasting 30 min was performed once a day for 7 consecutive days, with a depth of 2 mm, intensity of 12-15 mV, frequency of 2 Hz, in SCI+ EA group. The mechanical paw withdraw threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before developing the model and 3, 7, 14, 21 and 28 days after developing the model, and the motor function was assessed using the Basso-Beattie-Bresnahan (BBB) score. The recovery of motor function was assessed using footprint analysis at 28 days after developing the model. After the final behavioral testing, the rats were sacrificed, and spinal cord tissues were harvested to observe the pathological changes of the spinal cord tissues using hematoxylin-eosin staining, to detect the expression of P2X4R and phosphorylated NF-κB p65 (p-NF-κB p65) (by immunohistochemical analysis and Western blot) and to determine contents of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6 (by enzyme-linked immunosorbent assay). Results:Compared with the baseline measured at 1 day before developing the model, the MWT and BBB scores were significantly decreased and the TWL was shortened at each time point after developing the model in SCI group and SCI+ EA group ( P<0.05). Compared with S group, the MWT and BBB scores were significantly decreased and the TWL was shortened at each time point after developing the model, the expression of P2X4R and p-NF-κB p65 in spinal cord tissues was up-regulated, and the contents of TNF-α, IL-1β and IL-6 were increased in SCI group ( P<0.05). Compared with SCI group, the MWT and BBB scores were significantly increased and the TWL was prolonged at 14, 21 and 28 days after developing the model, the expression of P2X4R and p-NF-κB p65 in spinal cord tissues was down-regulated, and the contents of TNF-α, IL-1β and IL-6 were decreased ( P<0.05), and the pathological damage of spinal cord tissues was alleviated and footprints were reduced in SCI+ EA group. Conclusions:The mechanism by which EA alleviates SCI may be related to the inhibition of the activation of the P2X4R/NF-κB signaling pathway and the reduction in the inflammatory response in rats.

Objective:To design and develop a cone-beam CT imaging system for small animals with continuously adjustable spatial resolution.Methods:The imaging system used an X-ray source with a focal spot size of 30 μm and a flat panel detector with a pixel size of 100 μm. On this premise, a " stepping-focusing-rotating" image acquisition mode was proposed, in which the " focusing" and " stepping" systems were sequentially embedded in the " rotating" system. In this acquisition mode, the X-ray source and flat panel detector were relatively stationary to form the " focusing" system. When the " stepping" system accurately transported the object to the scanning position, the " focusing" system could achieve adjustable spatial resolution by making linear motion around the object to be scanned according to different experimental requirements. Finally the " rotating" system achieve high-quality imaging.Results:The variable spatial resolution of small animal CBCT ranges from 35.7 μm to 71.4 μm, and the FOV ranges from 39.6 mm to 108.0 mm. The conversion time for the limit spatial resolution is 19.125 s, which allowed accurate 3D reconstruction of normal mice at different resolutions with high reproducibility.Conclusions:A cone-beam CT suitable for small animals has been developed, whose spatial resolution and FOV can be adjusted arbitrarily within a certain range, which can meet the different imaging requirements in rodent experiments.

Objective:To investigate the clinical efficacy of perforator-based bilobed flaps in the treatment of stage 4 pressure ulcers.Methods:This retrospective observational study included 29 patients (21 males, 8 females) with stage 4 pressure ulcers admitted to the Department of Burn and Plastic Surgery and Wound Repair at Xuzhou First People's Hospital from August 2021 to May 2023. The patients' ages ranged from 12 to 82 (61.3±15.7) years. For ischial tuberosity pressure ulcers, reconstruction was performed using a posterior femoral bilobed flap based on the first perforator of the deep femoral artery, combined with a small gluteus maximus muscle flap. Sacrococcygeal pressure ulcers were repaired using a bilobed flap based on the superior or inferior gluteal artery perforator. Post-operative follow-up lasted for 2-36 months, during which flap survival and complications were assessed.Results:All the 29 bilobed flaps were successfully rotated and provided for adequate coverage without the need for pedicle division or perforator vessel dissection. Primary healing was achieved in 26 cases, with suture removal occurring two weeks post-operatively. Three patients experienced partial wound dehiscence and marginal necrosis due to post-operative pressure, which healed after two weeks of debridement and dressing changes. During follow-up for 2-36 months, no pressure ulcer recurrence was observed. The flaps demonstrated excellent survival, with soft texture, good elasticity, and adequate blood supply. The donor sites healed with only linear scars, and no severe complications were reported.Conclusion:Bilobed flaps based on artery perforators demonstrate excellent clinical outcomes in the treatment of stage 4 pressure ulcers.

Objectives:To explore the CT classification and evaluation methods of thoracoabdominal folded deformity in ankylosing spondylitis(AS).Methods:A retrospective analysis was conducted on 31 patients with AS thoracolumbar kyphosis who underwent thoracolumbar CT examinations between July 2017 and January 2024.There were 28 males and 3 females,with an average age of 45.0±8.9 years.The thoracoabdominal folded angle(TAFA)and the distances between xiphoid process and the superior edge of the pubic symphysis(XP)were measured on the mid-sagittal plane of thoracolumbar CT.The global kyphosis(GK),thoracic kypho-sis(TK),and lumbar lordosis(LL)Cobb angle and sagittal vertical axis(SVA)were measured on the full-length lateral radiograph of the spine.According to the effect of sagittal lumbar physiological curvature on the change of abdominal volume,a CT classification of AS thoracoabdominal folded deformity was innovatively classified into three types,type Ⅰ when there was physiological lordosis in the lumbar spine,type Ⅱ when the physiological curvature of the lumbar spine became straight,and type Ⅲ when there was lumbar kyphosis deformity.According to TAFA,type Ⅲ patients were divided into two subtypes:TAFA＞90° was subtype A,and TAFA ≤90° was subtype B.Five trained spinal surgeons independently evaluated and classified the clini-cal data of patients(with a 10d interval),and used Kendall's W-test to analyze the consistency of multiple observation results.Using one-way analysis of variance to compare the differences in the above measurement parameters between different types.Results:Among the 31 patients,there were 5 cases of thoracoabdominal folded deformity type Ⅰ,8 cases of type Ⅱ,12 cases of type Ⅲ A,and 6 cases of type ⅢB.The Kendall's W consistency coefficient for inter-observer classification was 0.954(P＜0.001).The average GK,TK,LL,SV A,TAFA,and XP of patients were 83.7°±29.9°,48.7°±21.3°,-13.9°±25.3°,22.8±14.9cm,128.1°±50.5°,and 16.8±8.9cm,respectively;The Kendall's W consistency coefficients between the different groups'measurement values of TAFA and XP were 0.946(P＜0.001)and 0.979(P＜0.001),respectively;There were significant differ-ences in TAFA and XP pairwise comparisons between different subtypes(P＜0.001).Conclusions:CT imaging classification can objectively evaluate the thoracoabdominal folded deformity in AS,and the distance between the xiphoid process and pubic symphysis and the TAFA are important indicators for evaluating the thoracoab-dominal folded deformity in AS.

Objective To collect and analyze outpatient prescription data for exogenous cough treatment from a hospital in Shenzhen,and to identify the characteristics and medication patterns of traditional Chinese medicine(TCM).Methods This study collected prescriptions from a hospital in Shenzhen for exogenous cough treatment in January 2024.R language for data mining were used to analyze the medication frequency,clustering patterns,and association rules in the treatment of exogenous cough by TCM and to explore the medication patterns and the usage of classic formulas in TCM for this condition.Results A total of 451 outpatient prescriptions for exogenous cough were include,the top ten most frequently used herbs were Licorice,Bitter almond,Bellflower,Ephedra,Tangerine peel,Stemonae radix,Tuckahoe,Pinellia ternata,Nepeta,Bulb of thunberg fritillary.Cluster analysis and association rules revealed that San'ao decoction,Kikyodon soup,and Zhisou powder were commonly prescribed,targeting lung function,dispersing wind,and resolving phlegm to effectively alleviate cough symptoms.Significant differences in medication usage were observed across different syndrome types.For the wind cold attacking lung pattern,the core herbs were warm in nature and focused on dispersing with acrid-warm properties.Conversely,the treatment of wind heat attacking the lung pattern typically involved cold-natured herbs,with a primary focus on clearing and draining lung heat.Stratification by age revealed that the pediatric group often used drugs with mild properties,such as Stemona and Shegan.The young adult group tended to be prescribed cold-natured drugs like Forsythia and Hogfonnel Root.The middle-aged and elderly group preferred warming and tonifying drugs such as Japanese Catnip and Perilla frutescens.Conclusion The TCM treatment of exogenous cough primarily focuses on releasing the exterior and dispersing the lung.Due to the region's subtropical monsoon climate and temperature fluctuations physicians flexibly modified classical formulas such as San'ao decoction and Zhisou powder according to individual constitutions and symptom patterns.This targeted,syndrome-based approach effectively disperses the lung qi,stops cough and transforms phlegm,and alleviates cough.

Objective:To evaluate the effect of electroacupuncture (EA) on ionotropic purinergic receptor 4 (P2X4R)/nuclear factor-kappa B (NF-κB) signaling pathway during spinal cord injury (SCI) in rats.Methods:Thirty-six clean-grade healthy adult female Sprague-Dawley rats, weighing 210-250 g, were divided into 3 groups ( n=12 each) using a random number table method: sham surgery group (S group), SCI group, and SCI+ EA treatment group (SCI+ EA group). The SCI model was established by the Allen′s method in anesthetized animals. In group S, only the spinous processes and vertebral laminae were resected, but the spinal cord was not injured. On the 7th day after developing the model, EA of Jiaji, Dazhui, and Mingmen lasting 30 min was performed once a day for 7 consecutive days, with a depth of 2 mm, intensity of 12-15 mV, frequency of 2 Hz, in SCI+ EA group. The mechanical paw withdraw threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before developing the model and 3, 7, 14, 21 and 28 days after developing the model, and the motor function was assessed using the Basso-Beattie-Bresnahan (BBB) score. The recovery of motor function was assessed using footprint analysis at 28 days after developing the model. After the final behavioral testing, the rats were sacrificed, and spinal cord tissues were harvested to observe the pathological changes of the spinal cord tissues using hematoxylin-eosin staining, to detect the expression of P2X4R and phosphorylated NF-κB p65 (p-NF-κB p65) (by immunohistochemical analysis and Western blot) and to determine contents of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6 (by enzyme-linked immunosorbent assay). Results:Compared with the baseline measured at 1 day before developing the model, the MWT and BBB scores were significantly decreased and the TWL was shortened at each time point after developing the model in SCI group and SCI+ EA group ( P<0.05). Compared with S group, the MWT and BBB scores were significantly decreased and the TWL was shortened at each time point after developing the model, the expression of P2X4R and p-NF-κB p65 in spinal cord tissues was up-regulated, and the contents of TNF-α, IL-1β and IL-6 were increased in SCI group ( P<0.05). Compared with SCI group, the MWT and BBB scores were significantly increased and the TWL was prolonged at 14, 21 and 28 days after developing the model, the expression of P2X4R and p-NF-κB p65 in spinal cord tissues was down-regulated, and the contents of TNF-α, IL-1β and IL-6 were decreased ( P<0.05), and the pathological damage of spinal cord tissues was alleviated and footprints were reduced in SCI+ EA group. Conclusions:The mechanism by which EA alleviates SCI may be related to the inhibition of the activation of the P2X4R/NF-κB signaling pathway and the reduction in the inflammatory response in rats.

Objective:To design and develop a cone-beam CT imaging system for small animals with continuously adjustable spatial resolution.Methods:The imaging system used an X-ray source with a focal spot size of 30 μm and a flat panel detector with a pixel size of 100 μm. On this premise, a " stepping-focusing-rotating" image acquisition mode was proposed, in which the " focusing" and " stepping" systems were sequentially embedded in the " rotating" system. In this acquisition mode, the X-ray source and flat panel detector were relatively stationary to form the " focusing" system. When the " stepping" system accurately transported the object to the scanning position, the " focusing" system could achieve adjustable spatial resolution by making linear motion around the object to be scanned according to different experimental requirements. Finally the " rotating" system achieve high-quality imaging.Results:The variable spatial resolution of small animal CBCT ranges from 35.7 μm to 71.4 μm, and the FOV ranges from 39.6 mm to 108.0 mm. The conversion time for the limit spatial resolution is 19.125 s, which allowed accurate 3D reconstruction of normal mice at different resolutions with high reproducibility.Conclusions:A cone-beam CT suitable for small animals has been developed, whose spatial resolution and FOV can be adjusted arbitrarily within a certain range, which can meet the different imaging requirements in rodent experiments.

Objective To collect and analyze outpatient prescription data for exogenous cough treatment from a hospital in Shenzhen,and to identify the characteristics and medication patterns of traditional Chinese medicine(TCM).Methods This study collected prescriptions from a hospital in Shenzhen for exogenous cough treatment in January 2024.R language for data mining were used to analyze the medication frequency,clustering patterns,and association rules in the treatment of exogenous cough by TCM and to explore the medication patterns and the usage of classic formulas in TCM for this condition.Results A total of 451 outpatient prescriptions for exogenous cough were include,the top ten most frequently used herbs were Licorice,Bitter almond,Bellflower,Ephedra,Tangerine peel,Stemonae radix,Tuckahoe,Pinellia ternata,Nepeta,Bulb of thunberg fritillary.Cluster analysis and association rules revealed that San'ao decoction,Kikyodon soup,and Zhisou powder were commonly prescribed,targeting lung function,dispersing wind,and resolving phlegm to effectively alleviate cough symptoms.Significant differences in medication usage were observed across different syndrome types.For the wind cold attacking lung pattern,the core herbs were warm in nature and focused on dispersing with acrid-warm properties.Conversely,the treatment of wind heat attacking the lung pattern typically involved cold-natured herbs,with a primary focus on clearing and draining lung heat.Stratification by age revealed that the pediatric group often used drugs with mild properties,such as Stemona and Shegan.The young adult group tended to be prescribed cold-natured drugs like Forsythia and Hogfonnel Root.The middle-aged and elderly group preferred warming and tonifying drugs such as Japanese Catnip and Perilla frutescens.Conclusion The TCM treatment of exogenous cough primarily focuses on releasing the exterior and dispersing the lung.Due to the region's subtropical monsoon climate and temperature fluctuations physicians flexibly modified classical formulas such as San'ao decoction and Zhisou powder according to individual constitutions and symptom patterns.This targeted,syndrome-based approach effectively disperses the lung qi,stops cough and transforms phlegm,and alleviates cough.

Objectives:To explore the CT classification and evaluation methods of thoracoabdominal folded deformity in ankylosing spondylitis(AS).Methods:A retrospective analysis was conducted on 31 patients with AS thoracolumbar kyphosis who underwent thoracolumbar CT examinations between July 2017 and January 2024.There were 28 males and 3 females,with an average age of 45.0±8.9 years.The thoracoabdominal folded angle(TAFA)and the distances between xiphoid process and the superior edge of the pubic symphysis(XP)were measured on the mid-sagittal plane of thoracolumbar CT.The global kyphosis(GK),thoracic kypho-sis(TK),and lumbar lordosis(LL)Cobb angle and sagittal vertical axis(SVA)were measured on the full-length lateral radiograph of the spine.According to the effect of sagittal lumbar physiological curvature on the change of abdominal volume,a CT classification of AS thoracoabdominal folded deformity was innovatively classified into three types,type Ⅰ when there was physiological lordosis in the lumbar spine,type Ⅱ when the physiological curvature of the lumbar spine became straight,and type Ⅲ when there was lumbar kyphosis deformity.According to TAFA,type Ⅲ patients were divided into two subtypes:TAFA＞90° was subtype A,and TAFA ≤90° was subtype B.Five trained spinal surgeons independently evaluated and classified the clini-cal data of patients(with a 10d interval),and used Kendall's W-test to analyze the consistency of multiple observation results.Using one-way analysis of variance to compare the differences in the above measurement parameters between different types.Results:Among the 31 patients,there were 5 cases of thoracoabdominal folded deformity type Ⅰ,8 cases of type Ⅱ,12 cases of type Ⅲ A,and 6 cases of type ⅢB.The Kendall's W consistency coefficient for inter-observer classification was 0.954(P＜0.001).The average GK,TK,LL,SV A,TAFA,and XP of patients were 83.7°±29.9°,48.7°±21.3°,-13.9°±25.3°,22.8±14.9cm,128.1°±50.5°,and 16.8±8.9cm,respectively;The Kendall's W consistency coefficients between the different groups'measurement values of TAFA and XP were 0.946(P＜0.001)and 0.979(P＜0.001),respectively;There were significant differ-ences in TAFA and XP pairwise comparisons between different subtypes(P＜0.001).Conclusions:CT imaging classification can objectively evaluate the thoracoabdominal folded deformity in AS,and the distance between the xiphoid process and pubic symphysis and the TAFA are important indicators for evaluating the thoracoab-dominal folded deformity in AS.

Objective:To investigate the clinical efficacy of perforator-based bilobed flaps in the treatment of stage 4 pressure ulcers.Methods:This retrospective observational study included 29 patients (21 males, 8 females) with stage 4 pressure ulcers admitted to the Department of Burn and Plastic Surgery and Wound Repair at Xuzhou First People's Hospital from August 2021 to May 2023. The patients' ages ranged from 12 to 82 (61.3±15.7) years. For ischial tuberosity pressure ulcers, reconstruction was performed using a posterior femoral bilobed flap based on the first perforator of the deep femoral artery, combined with a small gluteus maximus muscle flap. Sacrococcygeal pressure ulcers were repaired using a bilobed flap based on the superior or inferior gluteal artery perforator. Post-operative follow-up lasted for 2-36 months, during which flap survival and complications were assessed.Results:All the 29 bilobed flaps were successfully rotated and provided for adequate coverage without the need for pedicle division or perforator vessel dissection. Primary healing was achieved in 26 cases, with suture removal occurring two weeks post-operatively. Three patients experienced partial wound dehiscence and marginal necrosis due to post-operative pressure, which healed after two weeks of debridement and dressing changes. During follow-up for 2-36 months, no pressure ulcer recurrence was observed. The flaps demonstrated excellent survival, with soft texture, good elasticity, and adequate blood supply. The donor sites healed with only linear scars, and no severe complications were reported.Conclusion:Bilobed flaps based on artery perforators demonstrate excellent clinical outcomes in the treatment of stage 4 pressure ulcers.