Objective To observe the clinical effect of ultrasound-guided nerve block combined with arc edge needle-scalpel in the treatment of cervical spondylotic radiculopathy.Methods 160 cases were randomly divided into 4 groups from A to D,40 cases in each group.Group A was given nerve block,group B was given ultrasound-guided nerve block,group C was given arc edge needle-scalpel,and group D was given ultrasound-guided nerve block combined with arc edge needle-scalpel for 4 weeks.The McGill pain scale,cervical dysfunction index,cervical motion(angle of cervical left and right rotation,anterior flexion,posterior extension and lateral flexion),myoelectric-evoked potentiall(median nerve and ulnar nerve conduction velocity,latency),arterial blood flow velocity(average vertebral artery and basal artery flow velocity,end-diastolic blood flow velocity)were observed.The serum levels of neuron-specific enolase(NSE),β-endorphin(β-EP),lipoprotein-associated phospholipase A2(LpPLA2),6-ketoprostaglandin E1α(6-keto-PGE1α)were measured.The clinical efficacy and safety of each group were observed.Results The response rate in group D was taller than that in group A and group B significantly(χ2=6.605,P=0.013;χ2=4.073,P=0.044).Compared with the other three groups,the McGill pain,NDI,NSE,LpPLA2 and 6-keto-PGE1α in group D decreased significantly(P<0.05),the β-EP increased significantly(P<0.05),and the angles of left and right cervical rotation,anterior flexion,posterior extension and lateral flexion increased significantly(P<0.05),and median nerve and ulnar nerve conduction velocity,vertebral artery and basilar artery average blood flow velocity,end diastolic blood flow velocity increased significantly(P<0.05),and median nerve and ulnar nerve latency decreased significantly(P<0.05).The safety index of group D was higher than that in group A significantly(χ2=5.641,P=0.018).Conclusion Ultrasound-guided nerve block combined with arc edge needle-scalpel can relieve neck and shoulder pain,improve cervical spine function and reduce complications in patients with cervical spondylotic radiculopathy.

Objective To compare the efficacy and safety of different cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) for the treatment of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced or metastatic breast cancer. Methods Randomized controlled trials (RCTs) on CDK4/6i for the treatment of HR+/HER2− metastatic or advanced breast cancer were retrieved from databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed, with the search period ranging from database inception to August 2023. Bayesian network meta-analysis was conducted using R 4.2.0 software. Results A total of 18 RCTs from 25 articles, involving 8 031 patients and 11 treatment regimens, were included. There was no significant difference in progression-free survival (PFS) or overall survival (OS) among different CDK4/6i+ET combinations. The highest cumulative probability for PFS was observed with dalpiciclib (DAL)+fulvestrant (FUL), while ribociclib (RIB)+FUL ranked first for OS. In terms of efficacy, abemaciclib (ABE)+aromatase inhibitors (AI) and ABE+FUL ranked first in objective response rate and clinical benefit rate, respectively. Regarding safety, statistically significant difference in grade 3-4 adverse events was observed among certain types of CDK4/6i (P<0.05). Conclusion Current evidence suggests that CDK4/6i+ET is superior to ET alone for the treatment of HR+/HER2− advanced/metastatic breast cancer. Different CDK4/6i+ET combinations demonstrate comparable or similar efficacy; however, the incidence of adverse reactions is higher with combination therapy. Treatment regimens should be selected based on individual conditions.

Objective To investigate the mechanism by which the SLC7A11 gene regulates the development and progression of hepatocellular carcinoma(HCCLM3)through the ferroptosis pathway,and to evaluate its potential as a therapeutic target.Methods Differentially expressed ferroptosis-related genes in liver cancer were screened based on data from the TCGA and ICGC databases.Detection of mRNA expression levels of TERT,MIOX,MYCN,NOX4,and SLC7A11 in tumor and adjacent non-tumorous tissues from 32 clinical liver cancer samples using qRT-PCR.Further analysis of SLC7A11 and its downstream molecules SLC3A2,GSS,and GPX4 was performed through qRT-PCR,Western blot,and IHC to assess expression levels and tissue distribution.A stable SLC7A11-knockdown HCCLM3 cell line was constructed and used to establish a subcutaneous xenograft tumor model in nude mice to evaluate its effect on tumor growth.Mice were divided into two groups(n=6 per group):HCCLM3+sh-NC and HCCLM3+sh-SLC7A11.Serum levels of IL-6,IL-1β,and TNF-α were measured using ELISA.Histopathological changes in tumor tissues were examined by H&E staining,and the expression of key genes was validated through multiple approaches.Results Bioinformatics analysis showed high expression of SLC7A11 in hepatocellular carcinoma tissues(P<0.05),significantly associated with poor patient prognosis.Clinical sample validation revealed significantly higher expression of SLC7A11,SLC3A2,GSS,and GPX4 in cancer tissues compared to control groups(All P<0.05).SLC7A11 knockdown significantly inhibited tumor volume and wet weight(P<0.05),and H&E staining showed reduced vascular density in the sh-SLC7A11 group.ELISA results showed elevated serum levels of IL-1β,IL-6,and TNF-α in the sh-SLC7A11 group.qRT-PCR,Western blot,and IHC all showed significantly downregulated expression of SLC7A11,SLC3A2,GSS,and GPX4 in tumor tissues(All P<0.05).Conclusion SLC7A11 inhibits ferroptosis by regulating the GSH-GPX4 axis,promoting hepatocellular carcinoma cell growth.Targeted inhibition of SLC7A11 can induce tumor cell ferroptosis and suppress tumor progression,suggesting it may be an important therapeutic target for hepatocellular carcinoma.

Objective To observe the clinical effect of ultrasound-guided nerve block combined with arc edge needle-scalpel in the treatment of cervical spondylotic radiculopathy.Methods 160 cases were randomly divided into 4 groups from A to D,40 cases in each group.Group A was given nerve block,group B was given ultrasound-guided nerve block,group C was given arc edge needle-scalpel,and group D was given ultrasound-guided nerve block combined with arc edge needle-scalpel for 4 weeks.The McGill pain scale,cervical dysfunction index,cervical motion(angle of cervical left and right rotation,anterior flexion,posterior extension and lateral flexion),myoelectric-evoked potentiall(median nerve and ulnar nerve conduction velocity,latency),arterial blood flow velocity(average vertebral artery and basal artery flow velocity,end-diastolic blood flow velocity)were observed.The serum levels of neuron-specific enolase(NSE),β-endorphin(β-EP),lipoprotein-associated phospholipase A2(LpPLA2),6-ketoprostaglandin E1α(6-keto-PGE1α)were measured.The clinical efficacy and safety of each group were observed.Results The response rate in group D was taller than that in group A and group B significantly(χ2=6.605,P=0.013;χ2=4.073,P=0.044).Compared with the other three groups,the McGill pain,NDI,NSE,LpPLA2 and 6-keto-PGE1α in group D decreased significantly(P<0.05),the β-EP increased significantly(P<0.05),and the angles of left and right cervical rotation,anterior flexion,posterior extension and lateral flexion increased significantly(P<0.05),and median nerve and ulnar nerve conduction velocity,vertebral artery and basilar artery average blood flow velocity,end diastolic blood flow velocity increased significantly(P<0.05),and median nerve and ulnar nerve latency decreased significantly(P<0.05).The safety index of group D was higher than that in group A significantly(χ2=5.641,P=0.018).Conclusion Ultrasound-guided nerve block combined with arc edge needle-scalpel can relieve neck and shoulder pain,improve cervical spine function and reduce complications in patients with cervical spondylotic radiculopathy.

Objective To explore the clinical efficacy of arc-edge needle therapy based on Zaodian theory in the treatment of refractory tennis elbow.Methods 64 patients with refractory tennis elbow were collected and randomly divided into a control group and an observation group using a random number table method.Among them,32 cases in the control group were treated with local pain point injection.32 patients in the observation group were treated with arc-edge needle therapy once a week,with two treatments per group.The Number rating scale(NRS)Mayo,elbow joint performance score(MEPS)and Disabilities of the arm,shoulder and hand(DASH)score were recorded and compared between the two groups before treatment and at 1,2,4 and 24 weeks of follow-up after treatment,disease efficacy score(WDES)at 24 weeks of follow-up.Results During the treat-ment process,neither group of patients experienced serious adverse reactions.At each stage after treatment,two groups of NRS MEPS,DASH,and WDES at 24 weeks of follow-up all improved compared to before treatment.After one week of treatment,there was no statistically significant difference in NRS scores between the two groups(P>0.05).At follow-up visits at weeks 2,4,and 24,the NRS scores in the observation group were lower than those in the control group.After 1,2,4,and 24 weeks of follow-up after treatment,the DASH score was lower in the observation group than in the control group,and the MEPS score was higher in the observation group than in the control group,with statistically significant differences(P<0.05).After 24 weeks of treatment,the WDES of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Local pain point injection and arc-edge Zaodian release can alleviate pain and improve elbow joint function in the early stage of refractory tennis elbow.However,the long-term effect of local pain point injection treatment is not good,and the treatment effect of the observation group gradually improves.

Objective To study the effect of a curved hollow-fiber bioreactor on the mass transfer in an artificial liver to provide references for the optimal design of new bioreactor structures and operation parameters for clinical treatment.Methods A computational fluid dynamics(CFD)model of a hollow fiber bioreactor was established using numerical simulation.The diffusion and convection mass transfer in the hollow fiber bioreactor were considered by the K-K equation and Darcy's law.The effects of the bending count and bending amplitude on the mass transfer behavior in a hollow fiber bioreactor were analyzed.Results Dean vortices were generated in the curved hollow fiber bioreactor owing to the centrifugal force.This promoted solute remixing in the tube and thereby,diffusion mass transfer.Meanwhile,the higher transmembrane pressure in the curved hollow fiber bioreactor also promoted convection mass transfer.Consequently,the Dean vortices and high transmembrane pressure increased the solute clearance rate.When the bending counts were 0,3,6,9,and 12 and the bending amplitude was 1 mm,the bilirubin clearance rates were 113.44,117.95,121.89,129.89,and 140.57 mL/min respectively.When the bending amplitudes were 0,0.5,1.0,1.5,and 2.0 mm and the bending count was three,the bilirubin clearance rates were 113.44,115.45,117.95,120.16,and 123.14 mL/min,respectively.Conclusions The curved hollow fiber bioreactor improved the toxin removal efficiency in the artificial liver.

Objective To study the safety and effectiveness of arc edge needle therapy for moderate to severe tenosynovitis of the flexor digitorum tendon in the thumb.Methods A total of 62 patients with moderate to severe stenosing tenosynovitis of the flexor digitorum thumb who met the inclusion criteria were collected.The patients were randomly assigned 1:1 to the arc edge needle group and the needle knife group using a random number table method.Among them,31 patients in the arc edge needle group were treated with arc edge needles,while 31 patients in the needle knife group were treated with traditional needle knife release surgery.Both groups were treated once.Record the number rating scale(NRS),range of motion(ROM),Quinell grade,and disease efficacy score(WDES)of patients before and after treatment at various stages(1 week,2 weeks,4 weeks),and at follow-up after 24 weeks to evaluate the treatment effect.Results During the 24 weeks follow-up of 62 patients after treatment,the Quinell grading comparison between the two groups showed that the arc edge needle group was better than the needle knife group(P<0.05);The total effective rate of disease efficacy score(WDES)was 96.77%in the arc edge needle group and 83.87%in the needle knife group.The clinical total effective rate of the arc edge needle group was better than that of the needle knife group(P<0.05);After treatment,both groups showed significant improvement in pain numerical score(NRS)and joint range of motion(ROM),and the degree of improvement increased over time(P<0.05);And the inter group comparison at 1 week,2 weeks,4 weeks and 24 weeks time points after treatment showed that the curved blade needle was superior to the needle knife group in improving pain and joint mobility(P<0.05).Conclusion Both the 45° tenosynovitis incision and release surgery with arc edge needle and traditional needle knife release surgery are effective in treating moderate to severe tenosynovitis of the thumb flexor digitorum tendon.However,the 45° tenosynovitis incision and release surgery with arc edge needle has significant advantages in improving pain,interphalangeal joint mobility,and safety.

Objective To explore the value of plaque-to-aorta CT value ratio(standardized CT value)in differentiating coronary lipid and fibrous plaques,and to preliminarily analyze the stability of the cutoff.Methods Patients who underwent coronary computed tomography angiography(CCTA)and intravascular ultrasound(IVUS)within 1 week were included.The plaque CT value was obtained by measuring the all,four and two short-axis planes,respectively.The CT value of the ascending aorta was measured and standardized(plaque-to-aorta CT value ratio).The receiver operating characteristic(ROC)curves of the standardized and the traditional CT values were drawn.Results A total of 60 patients with 74 plaques were included,35 lipid and 39 fibrous plaques were diagnosed by IVUS.The aorta CT value was significantly correlated with the plaque(r=0.420,P<0.01);the cutoffs for the CT value of all,four and two plaque slices were 55 HU,48 HU and 52 HU,respectively,and all there of the cutoffs of standardized CT value were 0.149;the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of four-slice traditional and standardized CT values to differentiate lipid and fibrous plaques were 69%,87%,83%,76%and 91%,82%,82%,91%,respectively.Conclusion Compared with traditional CT value,the standardized CT value can greatly improve the sensitivity and NPV in differentiating coronary lipid and fibrous plaques,while maintaining modest to high specificity and PPV.Furthermore,the cutoff is stable.

Objective To study the effect of a curved hollow-fiber bioreactor on the mass transfer in an artificial liver to provide references for the optimal design of new bioreactor structures and operation parameters for clinical treatment.Methods A computational fluid dynamics(CFD)model of a hollow fiber bioreactor was established using numerical simulation.The diffusion and convection mass transfer in the hollow fiber bioreactor were considered by the K-K equation and Darcy's law.The effects of the bending count and bending amplitude on the mass transfer behavior in a hollow fiber bioreactor were analyzed.Results Dean vortices were generated in the curved hollow fiber bioreactor owing to the centrifugal force.This promoted solute remixing in the tube and thereby,diffusion mass transfer.Meanwhile,the higher transmembrane pressure in the curved hollow fiber bioreactor also promoted convection mass transfer.Consequently,the Dean vortices and high transmembrane pressure increased the solute clearance rate.When the bending counts were 0,3,6,9,and 12 and the bending amplitude was 1 mm,the bilirubin clearance rates were 113.44,117.95,121.89,129.89,and 140.57 mL/min respectively.When the bending amplitudes were 0,0.5,1.0,1.5,and 2.0 mm and the bending count was three,the bilirubin clearance rates were 113.44,115.45,117.95,120.16,and 123.14 mL/min,respectively.Conclusions The curved hollow fiber bioreactor improved the toxin removal efficiency in the artificial liver.

Objective:To investigate the correlation between preoperative platelet parameters and the clinicopathological features of differentiated thyroid cancer. Methods:We retrospectively analyzed the medical records of patients with thyroid tumors admitted to Zhongda Hospital affiliated to Southeast University and healthy adults with normal physical examination results in our hospital from January 2019 to December 2020, and collected their general information and preoperative blood routine data. Patients with undifferentiated thyroid cancer, diabetes, coronary heart disease, hematological diseases, kidney diseases, autoimmune diseases, genetic diseases, infectious diseases, other systemic tumors, hepatitis or cirrhosis, or those taking anticoagulants were excluded. The exclusion criteria for healthy adults were the absence of the above diseases and normal physical examination results. Differences in platelet parameters among the three groups were compared, and the correlation between clinicopathological characteristics of thyroid cancer, accompanying cervical lymph node metastasis, and platelet parameters of patients was analyzed. A multivariate logistic regression model was used to analyze the risk factors of thyroid cancer with cervical lymph node metastasis. Results:A total of 117 cases of differentiated thyroid cancer were collected, including 33 males and 84 females, with an average age of （41.64±12.25） years; 46 patients had benign thyroid tumors, including 15 males and 31 females, with an average age of （41.35±12.52） years; 50 healthy adults with normal physical examination results in our hospital during the same period were also included, including 18 males and 32 females, with an average age of（42.02±9.62） years, without underlying diseases. The platelet count of the differentiated thyroid cancer group was higher than that of the benign thyroid tumor group（t=-2.219, P=0.028） and the normal control group（t=2.069, P=0.04）, while the platelet distribution width of the differentiated thyroid cancer group was lower than that of the benign thyroid tumor group（t=2.238, P=0.027） and the normal control group（t=-2.618, P=0.002）. These differences were statistically significant. Preoperative age ≤45 years（χ²=4.225, P=0.04）, tumor diameter>1 cm（χ²=4.415, P=0.036）, PLT（t=-4.018, P<0.01） increase, and PDW（t=4.568, P<0.01） decrease were significantly correlated with cervical lymph node metastasis of thyroid cancer and had statistical significance. Univariate analysis showed that age ≤45 years（OR=0.447, 95%CI 0.206-0.970, P=0.042）, tumor diameter>1 cm（OR=2.3, 95%CI 1.050-5.039, P=0.037）, PLT（OR=1.012, 95%CI 1.005-1.019, P=0.001）, and PDW（OR=0.693, 95%CI 0.518-0.827, P<0.01） were risk factors for cervical lymph node metastasis of thyroid cancer. The results of multifactorial logistic regression analysis showed that PLT（OR=1.008, 95%CI 1.001-1.016, P=0.026） and PDW（OR=0.692, 95%CI 0.564-0.848, P<0.01） were independent risk factors for thyroid cancer with cervical lymph node metastasis. Conclusion:PLT and PDW may be useful predictive factors for the differentiation of thyroid cancer malignancy and central lymph node metastasis.
Adult ; Male ; Female ; Humans ; Middle Aged ; Lymphatic Metastasis/pathology* ; Retrospective Studies ; Thyroid Neoplasms/surgery* ; Neck/pathology* ; Lymph Nodes/pathology* ; Adenocarcinoma