Background: This study quantifies the global burden of alopecia areata (AA) in young adults (15–49 years) from 1990 to 2021 using data from the Global Burden of Disease 2021 study. Objective: To analyze trends in AA incidence and disability-adjusted life years (DALYs) across demographic and geographic strata. Methods: We evaluated age-standardized incidence rates (ASIRs) and age-standardized DALYs rates, stratified by sex, age, and Socio-demographic Index (SDI). Estimated annual percentage changes (EAPCs) were calculated to assess trends. Results: Global ASIR (EAPC, −0.20) and DALY rates (EAPC, −0.19) for AA declined 1990–2021, with larger declines in women, peak rates in 30–34-year-olds, and most prominent declines in high-SDI regions. High-SDI regions accounted for 42% of global DALYs (18% of the population). East Asia (ASIR EAPC, 0.02) and Oman (ASIR EAPC, 0.46) had rising incidence; East Asia (DALY EAPC, 0.04) and Guatemala (DALY EAPC, 0.48) had rising burden. SDI correlated positively with AA burden (ASIR: r=0.68, p<0.01; DALYs: r=0.72, p<0.001). Conclusion Significant disparities exist in AA burden, with higher rates in females and a peak in young adulthood. The strong positive correlation with SDI highlights the disproportionate impact of AA on high-income nations.

Objective:To explore the predictive potential of dual-energy CT (DECT) quantitative parameters in identifying breast cancer molecular subtypes and the expression of the epidermal growth factor receptor (EGFR) .Methods:A cohort of 97 breast cancer patients, treated between Jun. 2022 and Jun. 2024 were selected. The study compared DECT parameters-such as iodine concentration (IC) , normalized iodine concentration (NIC) , spectral curve slope (λ HU) , and effective atomic number (Z eff) in both arterial and venous phases across different molecular subtypes. A multiclass logistic regression model was employed to assess the parameters' value in predicting molecular subtypes, while a binary logistic regression model was used to evaluate their predictive value for EGFR expression. Results:Multiple Logistic regression analysis showed that after adjusting for confounder age and family history, IC ( OR=1.72, 2.78, 3.05) , NIC ( OR=2.52, 1.94, 2.93) , λ HU ( OR=2.08, 2.54, 3.17) and Z eff ( OR=2.03, 2.30, 2.37) at arterial stage were independently correlated with the molecular subtypes of breast cancer ( P<0.05) . Binary logistic regression analysis, adjusted for tumor size and lymph node metastasis, identified arterial phase IC ( OR=3.45) , NIC ( OR=2.73) , λ HU ( OR=2.59) , and Z eff ( OR=1.76) as independent risk factors for EGFR-positive breast cancer ( P<0.05) . Conclusion:DECT quantitative parameters, particularly arterial phase IC, NIC, λ HU, and Zeff, offer valuable insights into the molecular subtyping of breast cancer and EGFR expression, thereby assisting in the development of personalized treatment strategies.

The feasibility for the development of road-rail medical vehicles was discussed.The gap between China's ground medical evacuation system and medical evacuation requirements was analyzed,and the limitations of the existing mobile medical units in China were introduced.The key points for developing road-rail medical vehicles were discussed.The road-rail medical vehicle would be an ideal tool for casualty treatment and rapid evacuation at war time and peace time,which could be a future development direction of the road-rail vehicle and medical train.[Chinese Medical Equipment Journal,2025,46(10):84-90]

Objective:To compare the characteristics and temperature changes of single and double fiber Nd∶YAG laser in fresh isolated pig liver,and to provide reference for clinical ablation treatment.Methods:Single-needle single-point and double-needle double-point ablations were perf ormed on fresh isolated pig livers using a 5 W power laser,and the morphology,range,and surrounding temperature changes of the ablation lesions caused by the two in vitro liver tissues were observed.Results:The ablation lesions were divided into carbonized area,necrotic area and deformed area from inside to outside.The carbonized area in the center of the ablation lesion in the double-fiber group was larger and the cell necrosis was more thorough.The aspect ratio(LD/TD)of the laser ablation lesion in the single-fiber group was larger than that in the double fiber group(P＜0.001).The transverse diameter(TD)and volume(V)of the ablation lesion in the double-fiber group were larger than those in the single-fiber group(P＜0.001).There was no significant difference in the longitudinal diameter(LD)of the ablation lesion between the double-fiber group and the single-fiber group(P＞0.05).There was no significant difference in the temperature of 20 s,40 s and 60 s at 5 mm and 10 mm beside the ablation center between the two groups(all P＞0.05).Conclusion:Under the condition of 5 W,the temperature changes around the single and double fiber ablation are similar.The single fiber is suitable for small tumor ablation,and the double fiber ablation range is larger,which can be used for one-time full coverage ablation of larger cancer nodules.

Objective:To explore the predictive potential of dual-energy CT (DECT) quantitative parameters in identifying breast cancer molecular subtypes and the expression of the epidermal growth factor receptor (EGFR) .Methods:A cohort of 97 breast cancer patients, treated between Jun. 2022 and Jun. 2024 were selected. The study compared DECT parameters-such as iodine concentration (IC) , normalized iodine concentration (NIC) , spectral curve slope (λ HU) , and effective atomic number (Z eff) in both arterial and venous phases across different molecular subtypes. A multiclass logistic regression model was employed to assess the parameters' value in predicting molecular subtypes, while a binary logistic regression model was used to evaluate their predictive value for EGFR expression. Results:Multiple Logistic regression analysis showed that after adjusting for confounder age and family history, IC ( OR=1.72, 2.78, 3.05) , NIC ( OR=2.52, 1.94, 2.93) , λ HU ( OR=2.08, 2.54, 3.17) and Z eff ( OR=2.03, 2.30, 2.37) at arterial stage were independently correlated with the molecular subtypes of breast cancer ( P<0.05) . Binary logistic regression analysis, adjusted for tumor size and lymph node metastasis, identified arterial phase IC ( OR=3.45) , NIC ( OR=2.73) , λ HU ( OR=2.59) , and Z eff ( OR=1.76) as independent risk factors for EGFR-positive breast cancer ( P<0.05) . Conclusion:DECT quantitative parameters, particularly arterial phase IC, NIC, λ HU, and Zeff, offer valuable insights into the molecular subtyping of breast cancer and EGFR expression, thereby assisting in the development of personalized treatment strategies.

Fuxiong has a long history of cultivation. Since its first record in the Beneficial Formulas from the Taiping Imperial Pharmacy of the Song Dynasty, Fuxiong had always been used by ancient physicians and became a preponderant variety for some reasons during the periods of the Ming Dynasty, Qing Dynasty, and Republic of China. However, as for modern use, only Chuanxiong Rhizoma is valued, and the medicinal value of Fuxiong is gradually being overlooked. This article systematically researches the nomenclature, producing area, origin, and efficacy of Fuxiong, proving that the planting technology of Fuxiong matured in the Song Dynasty at the latest, slightly later than the emergence of Chuanxiong Rhizoma in the Sui and Tang Dynasties. Over the years, the producing area of Fuxiong has not undergone significant changes, and it is mainly cultivated within Jiangxi province. According to the analysis of the origin of Xiongqiong, combined with modern genetic research, it can be basically clarified that the early source of Xiongqiong may not be single. With the popularization of cultivation, Chuanxiong Rhizoma became a Dao-di herb earliest, gradually replacing Xiongqiong and being recognized clinically. After cultivation, the polyploidy of Chuanxiong Rhizoma varieties formed stable inheritance, forming the later Fuxiong. Medical experts have gradually deepened their understanding of the efficacy of Fuxiong. Initially, they believed that it was a substitute for Chuanxiong Rhizoma and had weaker efficacy than Chuanxiong Rhizoma. Medical experts in Jin and Yuan Dynasties such as Zhu Danxi and Dai Sigong believed that Fuxiong was good at relieving stagnation. Books and records of materia medica in the Ming and Qing Dynasties explicitly proposed the great ability of Fuxiong to relieve stagnation. Fuxiong should be distinguished from Chuanxiong Rhizoma when applied, and the application differences should be clearly reflected in medical records. Based on the comprehensive research in this article, it can be concluded that although most of ancient physicians have attached great importance to genuineness of Chuanxiong Rhizoma, Fuxiong, as a dominant variety of traditional application, has a clear historical context and significant efficacy characteristics, worthy of further in-depth study.
Drugs, Chinese Herbal/history* ; China ; Medicine, Chinese Traditional/history* ; History, Ancient ; Humans ; History, Medieval ; Plants, Medicinal/chemistry* ; Rhizome/growth & development*

PURPOSE: To assess the relationship between dislocation and functional outcomes in supination-external rotation (SER) ankle fractures. METHODS: A retrospective case series study was performed on patients with ankle fractures treated surgically at a large trauma center from January 2015 to December 2021. The inclusion criteria were young and middle-aged patients of 18 - 65 years with SER ankle fractures that can be classified by Lauge-Hansen classification and underwent surgery at our trauma center. Exclusion criteria were serious life-threatening diseases, open fractures, fractures delayed for more than 3 weeks, fracture sites ≥ 2, etc. Then patients were divided into dislocation and no-dislocation groups. Patient demographics, injury characteristics, surgery-related outcomes, and postoperative functional outcomes were collected and analyzed. The functional outcomes of SER ankle fractures were assessed postoperatively at 1-year face-to-face follow-up using the foot and ankle outcome score (FAOS) and American Orthopedic Foot and Ankle Society ankle hindfoot score and by 2 experienced orthopedic physicians. Relevant data were analyzed using SPSS version 22.0 by Chi-square or t-test. RESULTS: During the study period, there were 371 ankle fractures. Among them, 190 (51.2%) were SER patterns with 69 (36.3%) combined with dislocations. Compared with the no-dislocation group, the dislocation group showed no statistically significant differences in gender, age composition, fracture type, diabetes, or smoking history, preoperative waiting time, operation time, and length of hospital stay (all p > 0.05), but a significantly higher Lauge-Hansen injury grade (p < 0.001) and syndesmotic screw fixation rate (p = 0.033). Moreover, the functional recovery was poorer, revealing a significantly lower FAOS in the sport/rec scale (p < 0.001). Subgroup analysis showed that among SER IV ankle fracture patients, FAOS was much lower in pain (p = 0.042) and sport/rec scales (p < 0.001) for those with dislocations. American Orthopedic Foot and Ankle Society ankle hindfoot score revealed no significant difference between dislocation and no-dislocation patients. CONCLUSION Dislocation in SER ankle fractures suggests more severe injury and negatively affects functional recovery, mainly manifested as more pain and poorer motor function, especially in SER IV ankle cases.
Humans ; Ankle Fractures/physiopathology* ; Male ; Female ; Retrospective Studies ; Adult ; Middle Aged ; Supination ; Aged ; Young Adult ; Rotation ; Joint Dislocations/surgery* ; Fracture Fixation, Internal/methods* ; Adolescent ; Recovery of Function ; Treatment Outcome

The feasibility for the development of road-rail medical vehicles was discussed.The gap between China's ground medical evacuation system and medical evacuation requirements was analyzed,and the limitations of the existing mobile medical units in China were introduced.The key points for developing road-rail medical vehicles were discussed.The road-rail medical vehicle would be an ideal tool for casualty treatment and rapid evacuation at war time and peace time,which could be a future development direction of the road-rail vehicle and medical train.[Chinese Medical Equipment Journal,2025,46(10):84-90]

ObjectiveTo explore the molecular mechanism of Buzhong Yiqitang in attenuating cisplatin resistance of non-small cell lung cancer （NSCLC） cells （A549/DDP） by regulating endoplasmic reticulum stress （ERS） via the nuclear factor E₂-related factor 2 （Nrf2）/reactive oxygen species （ROS）/double-stranded RNA-activated protein kinase R （PKR）-like endoplasmic reticulum kinase （PERK）/CCAAT enhancer-binding protein homologous protein （CHOP） signaling pathway. MethodsSprague Dawley （SD） rats were used to prepare blank serum and Buzhong Yiqitang-containing serum samples， and A549/DDP cells were sub-cultured and randomly allocated into 9 groups： Blank （10% blank rat serum medium）， model （10% blank rat serum medium+20 mg·L^-1 cisplatin）， traditional Chinese medicine（TCM） （10% Buzhong Yiqitang-containing rat serum medium+20 mg·L^-1 cisplatin）， TBHQ （10% blank rat serum medium+5 μmol·L^-1 TBHQ+20 mg·L^-1 cisplatin）， TBHQ+TCM （10% Buzhong Yiqitang-containing rat serum medium+5 μmol·L^-1 TBHQ+20 mg·L^-1 cisplatin）， NAC （10% blank rat serum medium+600 μmol·L^-1 NAC+20 mg·L^-1 cisplatin）， NAC+TCM （10% Buzhong Yiqitang-containing rat serum medium+600 μmol·L^-1 NAC+20 mg·L^-1 cisplatin）， Salubrinal （10% blank rat serum medium+20 μmol·L^-1 Salubrinal+20 mg·L^-1 cisplatin）， and Salubrinal+TCM （10% Buzhong Yiqitang-containing rat serum medium+20 μmol·L^-1 Salubrinal+20 mg·L^-1 cisplatin）. The median inhibitory concentration （IC₅₀） of cisplatin in each group was determined by the cell counting kit-8 （CCK-8） method. The ROS level was detected by flow cytometry. The ultrastructure of endoplasmic reticulum （ER） was observed by transmission electron microscopy. Western blot was employed to determine the protein levels of Nrf2， phosphorylated （p）-Nrf2， CHOP， PERK， p-PERK， eukaryotic translation initiation factor 2α （eIF2α）， p-eIF2α， and activated transcription factor 4 （ATF4）. The fluorescence intensity of CHOP and p-PERK was detected by confocal fluorescence localization. ResultsCompared with the model group， the TCM group showed a decrease in IC₅₀ of cisplatin in A549/DDP cells （P<0.01）. TBHQ， NAC， and Salubrinal groups showed increases in IC₅₀ of cisplatin in A549/DDP cells （P<0.01）. TCM combined with TBHQ， NAC， and Salubrinal reduced the IC₅₀ （P<0.01）. Compared with that in the blank group， the ROS level in the model group elevated （P<0.01）. Compared with that in the model group， the ROS level in the TCM group elevated （P<0.01）. The ROS levels in the TBHQ， NAC， and Salubrinal groups were lower than that in the model group （P<0.01）. The combinations of TBHQ， NAC， and Salubrinal with TCM raised the ROS levels of A549/DDP cells （P<0.01）. A flat saclike and neatly arranged ER structure was observed in the blank group， and slight expansion of ER was observed in the model group. Significant expansion of ER was observed in the TCM group. The expansion of ER was not obvious in the TBHQ， NAC， and Salubrinal groups but significant after TBHQ， NAC， and Salubrinal were combined with TCM. CHOP and p-PERK showed higher fluorescence intensity in the model group than in the blank group （P<0.01）， and the fluorescence signal intensity in the TCM group was higher than that in the model group （P<0.01）. The fluorescence intensity in the TBHQ， NAC， and Salubrinal groups was lower than that in the model group （P<0.01）. The fluorescence intensity in the groups of TBHQ， NAC， and Salubrinal combined with TCM was higher than that in corresponding groups without TCM （P<0.01）. Compared with those in the blank group， the expression levels of Nrf2 and p-Nrf2 were up-regulated in the model group （P<0.05）. Compared with the model group， the TCM group showed down-regulated expression levels of Nrf2 and p-Nrf2 （P<0.05）. TBHQ， NAC， and Salubrinal increased the expression levels of Nrf2 and p-Nrf2 （P<0.05）， while their combinations with TCM decreased the expression levels of Nrf2 and p-Nrf2 compared with the corresponding groups without TCM （P<0.01）. There were no significant differences in the expression levels of PERK and eIF2α between groups. The expression levels of CHOP， p-PERK/PERK， p-eIF2α/eIF2α， and ATF4 were up-regulated in the model group compared with those in the blank group （P<0.05）. Compared with the model group， the TCM group showed up-regulated expression levels of CHOP， p-PERK/PERK， p-eIF2α/eIF2α， and ATF4 （P<0.05）， while the TBHQ， NAC， and Salubrinal groups showed down-regulated expression levels （P<0.05）. The groups of TBHQ， NAC， and Salubrinal combined with TCM had higher expression levels than the groups without TCM （P<0.01）. ConclusionBuzhong Yiqitang regulates ERS via the Nrf2/ROS/PERK/CHOP signaling pathway to attenuate cisplatin resistance in NSCLC.