BACKGROUND:Degenerative scoliosis is defined as a condition that occurs in adulthood with a coronal cobb angle of the spine>10° accompanied by sagittal deformity and rotational subluxation,which often produces symptoms of spinal cord and nerve compression,such as lumbar pain,lower limb pain,numbness,weakness,and neurogenic claudication.The finite element method is a mechanical analysis technique for computer modelling,which can be used for spinal mechanics research by building digital models that can realistically restore the human spine model and design modifications. OBJECTIVE:To review the application of finite element method in the etiology and treatment of degenerative scoliosis. METHODS:The literature databases CNKI,PubMed,and Web of Science were searched for articles on the application of finite element method in degenerative scoliosis published before October 2023.Search terms were"finite element analysis,biomechanics,stress analysis,degenerative scoliosis,adult spinal deformity"in Chinese and English.Fifty-four papers were finally included. RESULTS AND CONCLUSION:(1)The biomechanical findings from the degenerative scoliosis model constructed using the finite element method were identical to those from the in vivo experimental studies,which proves that the finite element method has a high practical value in degenerative scoliosis.(2)The study of the etiology and treatment of degenerative scoliosis by the finite element method is conducive to the prevention of the occurrence of the scoliosis,slowing down the progress of the scoliosis,the development of a more appropriate treatment plan,the reduction of complications,and the promotion of the patients'surgical operation.(3)The finite element method has gradually evolved from a single bony structure to the inclusion of soft tissues such as muscle ligaments,and the small sample content is increasingly unable to meet the research needs.(4)The finite element method has much room for exploration in degenerative scoliosis.

Objective:To systematically review the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures.Methods:PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database and VIP Database were systematically searched to collect literature on the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures from inception to June 30, 2024. The languages were limited to Chinese and English. Two researchers screened the literature according to the inclusion and exclusion criteria. Data extraction was performed using the checklist for critical appraisal and data extraction for systematic reviews of prediction modeling studies (CHARMS), encompassing basic study characteristics, model development features, and model performance metrics. The predictors, validation methods, presentation formats, and predictive performance of the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures were evaluated. The prediction model risk-of-bias assessment tool (PROBAST) was employed to assess risk of bias and applicability of the included studies.Results:A total of 11 studies, comprising of 16 prediction models, were included, with a total sample size of 283-1 508 patients and a pulmonary infection incidence rate of 5.4%-16.25%. The independent predictive factors repeatedly included in the models were age, American Society of Anesthesiologists (ASA) scale, preoperative comorbidities, chronic obstructive pulmonary disease (COPD), preoperative albumin level, white blood cell count (WBC), and C-reactive protein (CRP) level. The models were internally validated in 7 studies and externally validated in 3. The models were visualized in the form of a nomogram in 7 studies and a web-based risk calculator in 1. Model prediction performance was analyzed: (1) In terms of the discrimination, 9 studies reported the area under the receiver operating characteristic curve (AUC), with the overall AUC range of 0.664-0.905. (2) In terms of the calibration, 5 studies had Hosmer-Lemeshow test, with the P-values all above 0.05; 2 studies reported the calibration plots, with the slopes close to 1 and the Brier scores of 0.016 and 0.112; 4 studies reported the sensitivity of the models of 73.91%-92.40% and specificity of 57.10%-92.41%. According to PROBAST, all 11 studies exhibited certain risk of bias while maintaining favorable applicability. Conclusions:Age, ASA scale, preoperative comorbidities, COPD, preoperative albumin level, WBC, and CRP level are found to be independent predictive factors repeatedly reported in the risk prediction models for postoperative pulmonary infection in elderly patients with hip fractures. The existing models demonstrate a robust overall prediction performance despite certain risks of bias.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To observe the clinical efficacy of self-prescribed Chaigui Tongmai Formula combined with warm needle moxibustion in treating lower extremity arteriosclerosis obliterans(LEASO)with cold coagulation and blood stasis syndrome.Methods A total of 90 patients diagnosed with LEASO of cold coagulation and blood stasis syndrome who were treated in the outpatient and inpatient departments of the Ulcer and Vascular Disease Department of Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine between November 2022 and November 2023 were selected as study subjects.Patients were randomly divided into an observation group and a control group using a random number table,with 45 cases in each group.Both groups received health education and conventional treatment.The control group was treated with oral administration of self-prescribed Chaigui Tongmai Formula,while the observation group received additional warm needle moxibustion based on the control group's treatment.Both groups were treated for 3 weeks.After treatment,clinical efficacy was evaluated by observing changes in TCM syndrome scores,intermittent claudication distance,ankle-brachial index(ABI),toe-brachial index(TBI),hemodynamic parameters,and serum inflammatory factor levels before and after treatment in both groups.Safety and adverse reactions were also assessed.Results(1)The total effective rate was 95.56％(43/45)in the observation group and 80.00％(36/45)in the control group.The efficacy of the observation group was significantly superior to that of the control group,with a statistically significant difference(P＜0.05).(2)After treatment,TCM syndrome scores and intermittent claudication distance were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(3)After treatment,intermittent claudication distance was significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(4)After treatment,ABI and TBI were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(5)After treatment,whole blood low-shear viscosity,high-shear viscosity,and plasma viscosity levels were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(6)After treatment,levels of IL-18,hs-CRP,and IC AM-1 were significantly improved in both groups(P＜0.05),and the improvement in the observation group was significantly greater than that in the control group,with a statistically significant difference(P＜0.05).(7)During treatment,the incidence of adverse reactions was 4.44％(2/45)in the observation group and 6.66％(3/45)in the control group.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion Self-prescribed Chaigui Tongmai Formula combined with warm needle moxibustion significantly promotes the recovery of clinical symptoms,reduces inflammatory responses,improves hemodynamic parameters,and enhances the quality of life in patients with LEASO of cold coagulation and blood stasis syndrome,demonstrating notable efficacy and good safety.

Calcitonin gene-related peptides(CGRP)are peptides that are ubiquitous in the central and peripheral nervous systems,which has been shown to be associated with pain,setting off a boom in the development of chemical small molecule antagonists targeting CGRP receptors,but most of them have failed due to greater hepatotoxicity.Anti-CGRP/CGRPR antibodies have attracted widespread attention due to their high specificity and safety,especially lower hepatotoxicity.This article reviews the structure and function of CGRP and its receptors,as well as the research progress of anti-CGRP-related neutralizing antibodies in order to provide a reference for the exploration of disease mechanisms and drug development related to CGRP.

BACKGROUND:The highest incidence of spinal fracture is in the thoracolumbar segment,and its symptoms are back pain,posterior convexity deformity,activity limitation,or with spinal cord nerve injury causing lower limb pain,numbness,and even paraplegia and other complications.The finite element method is a digital computer modeling technique,which can simulate the physical model and carry out force analysis realistically.OBJECTIVE:To review the application of finite element method in thoracolumbar spine fractures.METHODS:We searched the Chinese and English literature databases PubMed,Web of Science,and CNKI for relevant literature on the application of the finite element analysis method in spinal thoracolumbar fracture published before March 2024.The search terms in Chinese and English were:finite element analysis methods,biomechanical phenomena,stress analysis,thoracolumbar fractures,spinal fractures.Finally,55 papers were included.RESULTS AND CONCLUSION:(1)The exploration of thoracolumbar fractures caused by different etiologies(osteoporotic,traumatic,and pathological)through the finite element method is conducive to a deeper understanding of the biomechanics of various types of thoracolumbar fractures,and to improve the individualized and fine-tuned treatment of thoracolumbar fractures.(2)The finite element analysis of a single sample or a small number of samples has the chance,and a larger number of samples are required for the future finite element analysis to reduce the chance caused by the sample.(3)The rigid structure of bones alone cannot meet the biomechanical working conditions of the integrity of the physical object,and future finite element models need to incorporate all the structures of the physical object(e.g.,soft tissues,such as muscles and ligaments)as far as possible.(4)The finite element method has been used in more studies on osteoporotic and traumatic thoracolumbar spine fractures,which will need to be more in-depth in the future,and less in the field of pathologic thoracolumbar fractures,which has a wider scope for future research.

Objective To investigate the effects and mechanisms of combined prescriptions of essential oils from five traditional Chinese medicinal herbs,namely peppermint,turmeric,ginger,Tibetan fennel,and cumin,on symptoms related to functional abdominal pain syndrome(FAPS).Methods Gas chromatography-mass spectrometry(GC-MS)was employed to analyze the chemical constituents of five essential oils,while network pharmacology was utilized to predict the key targets and signaling pathways associated with these essential oils in alleviating functional abdominal pain syndrome.A formula design methodology centered on these core targets and signaling pathways was developed for creating new prescriptions.Molecular docking technology was conducted to predict its the underlying mechanisms.Subsequently,animal experiments were performed to assess pharmacological activity,including hot plate tests and acetic acid-induced writhing assays to validate the analgesic effects of the newly formulated prescription,as well as xylene-induced ear swelling tests to evaluate its anti-inflammatory properties.The impact of the essential oil formulation on intestinal peristaltic function was examined through intestinal propulsion experiments.Additionally,enzyme-linked immunosorbent assay(ELISA)methods were employed to measure levels of serotonin(5-HT),prostaglandin E2(PGE2),and gamma-aminobutyric acid(GABA)in brain tissue.Western blot analysis was conducted to determine protein expression levels of TPH1 and SERT in the intestine,along with TPH2 and SERT in the brain.Results The main chemical components in five essential oils were identified and screened(peppermint:12,turmeric:8,ginger:14,cumin:2,fennel:6).Based on the network pharmacology analysis,four new essential oil prescriptions were successfully designed according to the complementary relationship between the five essential oils in improving functional abdominal pain syndrome at the target level,including 4 new prescription named Prescription A,B,C and D,these four prescriptions were all based on ginger and turmeric essential oils,with other essential oils serving as supplements or enhancements.The results of animal experiments showed that Prescription D could significantly reduce the writhe frequency of mice(P<0.05),all the four groups could significantly prolong the pain threshold of mice(P<0.05),and Prescription C had a significant effect on reducing the degree of ear swelling(P<0.05).The prescription of essential oil did not significantly affect the function of peristalsis and the speed of propulsion.The levels of 5-HT and PGE2 in the brain tissue were significantly inhibited(P<0.05),and the level of GABA was significantly increased(P<0.05).Prescription C could reduce the expression of TPH1 in the intestinal tissue(P<0.05),Prescription A,C and D could reduce the expression of TPH2,and all groups had a tendency to increase the expression of SERT in the brain tissue.Conclusion In summary,the therapeutic effects of the four novel prescriptions composed of the five essential oils demonstrated potential in improving symptoms related to FAPS,the mechanism might be through modulating abnormalities in the brain-gut axis system.

Peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) is the most common subtype of peripheral T-cell lymphoma. The overall incidence rate of this disease is low and the heterogeneity is strong. At present, its diagnosis mainly relies on exclusive diagnosis. Clinically, the first-line treatment of PTCL-NOS mostly refers to CHOP-like chemotherapy regimens for B-cell non-Hodgkin lymphoma, but its efficacy is unsatisfactory, with high recurrence rate and poor long-term survival. The widespread application of new targeted drugs and antibody conjugated drugs, such as chidamide, pralatrexate and brentuximab vedotin have improved the therapeutic effects of patients to some extent. However, the prognosis of relapsed/refractory patients is still not satisfactory. This article reviews the pathological characteristics, immunophenotype, genetic characteristics, clinical features, and treatment progress of PTCL-NOS.

OBJECTIVE To observe the influence of carbapenem-resistant Klebsiella pneumoniae(CRKP)infec-tion/colonization on mortality risk of the intensive care unit(ICU)patients.METHODS The patients who were hospitalized in ICUs of West China Hospital of Sichuan University from Jan.1,2016 to Dec.31,2018 were recrui-ted as the research subjects.By means of retrospective cohort study,the enrolled patients were divided into the CRKP infection/colonization group and the non-CRKP infection/colonization group according to the status of isola-tion of CRKP strains from the clinical specimens of the ICU patients.The 30-day mortality risk of the CRKP in-fection/colonization group and the non-CRKP infection/colonization group was analyzed by Kaplan-Meier.The in-fluencing factors for the 30-day mortality risk of the ICU patients were analyzed by means of Cox proportional haz-ard model.RESULTS A total of 2229 patients were enrolled in the study,of which 89 were assigned as the CRKP infection/colonization group,and 2140 were assigned as the non-CRKP infection/colonization group.The sputum was the major specimen source from the patients with CRKP infection/colonization,and the lower respira-tory tract was the major infection site.The 30-day survival rate was 66.49％in the CRKP infection/colonization group,78.49％in the non-CRKP infection/colonization group,and there was significant difference(x2=7.200,P=0.007).The Cox proportional hazard model analysis showed that the CRKP infection/colonization could in-crease the 30-day mortality risk of the ICU patients(HR=1.839,95％CI:1.126 to 3.002,P=0.015);the age(HR=1.014,95％CI:1.006 to 1.022,P＜0.001),APACHE Ⅱ(HR=1.035,95％CI:1.018 to 1.053,P＜0.001),use of caspofungin(HR=1.398,95％CI:1.038 to 1.882,P=0.028),central venous catheter indwelling(HR=3.752,95％CI:1.808 to 7.790,P＜0.001)and blood purification(HR=2.061,95％CI:1.518 to 2.797,P＜0.001)may also increase the 30-day mortality risk of the ICU patients.CONCLUSIONS The CRKP infection/colonization patients are at higher 30-day mortality risk than the non-CRKP infection/colonization patients.It is necessary to formulate and implement the prevention and control measures to reduce the incidence of CRKP infection/colonization and take measures to reduce the mortality rate of the patients so as to improve the prognosis.

Asarum forbesii is a perennial herb born in a shaded and humid environment, which is warm in nature. With the efficacy of warming lung, resolving fluid retention, and relieving coughs, it can be used to treat the syndrome of cold fluid accumulating in lung. To investigate the effects of different shading conditions on the composition and efficacy of A. forbesii, this study planted A. forbesii under 20% natural light(NL20), 40% natural light(NL40), 60% natural light(NL60), and 80% natural light(NL80) and utilized ultra performance liquid chromatography(UPLC) and micro broth 2-fold dilution method to detect the volatile chemical compounds and the minimum inhibitory concentration. At the same time, the study investigated the effects of A. forbesii grown under different shading conditions on the signs, pathological changes of lung tissues, serum cytokine levels, activities of mitochondrial respiratory chain complexes Ⅰ-Ⅴ in lung tissues, and relative expression of related genes of mice with syndrome of cold fluid accumulating in lung. The results indicated that with the increase of shading, the content of kakuol, methyl eugenol, and asarinin in A. forbesii and the antibacterial effect showed a tendency of increasing first and then decreasing, and the NL40 group was significantly better than the other groups. Under the conditions of NL20 and NL40, A. forbesii significantly alleviated the pathological damage to lung tissues, restored the homeostasis of the lung, and enhanced the energy metabolism level of mice with syndrome of cold fluid accumulating in lung. In addition, A. forbesii planted under the two conditions reduced the content of interleukin-8(IL-8), interleukin-13(IL-13), tumor necrosis factor-α(TNF-α), and mucin 5AC(MUC5AC), increased the levels of interleukin-10(IL-10) and aquaporin 1(AQP1), lowered the expression of MMP9, VEGF, TGF-β, and MAPK3. In conclusion, the therapeutic effect of A. forbesii on the syndrome of cold fluid accumulating in lung was positively correlated with the degree of shading, and the chemical composition and efficacy of warming lung and resolving fluid retention were optimal under the conditions of NL20-NL40. This study can provide reference for the pharmacological research and cultivation of A. forbesii.
Animals ; Mice ; Lung/pathology* ; Drugs, Chinese Herbal/administration & dosage* ; Male ; Light ; Cytokines/genetics* ; Humans