BACKGROUND:Prostaglandin E1(PGE1)has been shown to play a regulatory role in vasodilatation,inflammation,and leukocyte migration and adhesion,but its effects on spinal cord microcirculation after traumatic spinal cord injury(SCI)remain poorly understood. OBJECTIVE:To investigate the mechanism underlying the protective effects of PGE1 administered during the acute phase of traumatic SCI in rats on the regulation of vascular-related factors and microcirculatory function. METHODS:Seventy-two female Sprague-Dawley rats were divided into three groups(n=24 per group):control group,SCI group,and PGE1 group.An in vivo SCI model was established using Allen's blow method.Rats in the PGE1 group were injected with PGE1(10 μg/kg)via the tail vein immediately after SCI.Spinal cord microcirculatory blood flow and oxygen saturation,spinal cord microvessel diameter and area,spinal cord water content,vascular function regulators(von Willebrand factor,thromboxane A2,prostacyclin,endothelin-1),and inflammatory factors(tumor necrosis factor-α,interleukin-1β)were measured at 2 and 24 hours after SCI. RESULTS AND CONCLUSION:At 2 hours after SCI,the diameter and area of spinal cord microvessels,spinal cord microcirculatory blood flow,and oxygen saturation in the PGE1 group were higher than those in the SCI group(P<0.05),the water content of the spinal cord was lower than that in the SCI group(P<0.05),and the level of plasma von Willebrand Factor,the ratio of thromboxane A2/prostacyclin of the spinal cord and the level of endothelin-1 were lower than those in the SCI group(P<0.05).At 24 hours after SCI,the spinal cord microvessel area,blood flow,and oxygen saturation of rats in the PGE1 group were higher than those in the SCI group(P<0.05),the spinal cord water content was lower than that in the SCI group(P<0.05),and the levels of plasma von Willebrand factor,spinal cord tissue thromboxane A2/prostacyclin ratio and the levels of endothelin-1,tumor necrosis factor-α and interleukin-1β were lower than those in the SCI group(P<0.05).The diameter and area of spinal cord microvessels,spinal cord microcirculatory blood flow and blood oxygen saturation of rats in the SCI group were higher than those in the SCI group at 24 hours post-injury(P<0.05),and the levels of plasma von Willebrand factor,spinal tissue thromboxane A2/prostacyclin ratio,tumor necrosis factor-α and interleukin-1β were higher than those at 2 hours post-injury(P<0.05),but the level of endothelin-1 in spinal cord tissue was lower than that at 2 hours(P<0.05).The blood flow and oxygen saturation of spinal cord microcirculation in the PGE1 group rats at 24 hours post-injury were lower than those at 2 hours post-injury(P<0.05),and the diameter and area of spinal cord microvessels and water content of the spinal cord were higher than those at 2 hours post-injury(P<0.05).The above results indicate that intravenous administration of PGE1 in SCI rats immediately after injury can regulate vascular function regulators,inflammatory factors and improve microcirculation of the spinal cord after SCI,which provides a potential basis for the search of drugs for the treatment of acute SCI.

Gouty arthritis （GA） is an inflammatory disorder caused by monosodium urate （MSU） crystal deposition， accompanied by elevated oxidative stress and aberrant release of inflammatory cytokines， resulting in joint tissue damage and intense pain. Nuclear factor E₂-related factor 2 （Nrf2）， a key transcription factor regulating the antioxidant defence system， exerts cytoprotective effects through dissociation from Kelch-like ECH-associated protein 1 （Keap1） and activates downstream antioxidant response element （ARE）-mediated pathways. It can upregulate the expression of heme oxygenase-1 （HO-1）， NADH quinone oxidoreductase 1 （NQO1）， superoxide dismutase （SOD）， and glutathione transferase （GST） to preserve redox homeostasis. Moreover， Nrf2 can suppress activation of NOD-like receptor protein 3 （NLRP3） inflammasomes， reduce pro-inflammatory cytokine production and release， modulate nuclear factor-κB （NF-κB） transcriptional activity， regulate gut microbiota balance， enhance mitophagy， and inhibit apoptosis， so as to reduce joint inflammation and pain and promote body recovery. This review systematically examined recent advancements in traditional Chinese medicine （TCM） for GA prevention and treatment via regulating the Nrf2 signaling pathway. It delineated Nrf2's molecular mechanisms and its role in GA pathogenesis and elucidated how TCM intervenes in multiple pathways including Keap1/Nrf2/ARE， Nrf2/HO-1（NQO1）， and Nrf2/NF-κB/NLRP3 to exert therapeutic effects. The study demonstrated that TCM monomers and compounds effectively counteract oxidative damage， attenuate inflammatory responses， promote autophagy， and inhibit apoptosis via regulating the Nrf2 signaling pathway. These findings not only clarify the scientific basis of TCM in GA treatment but also offer strategic insights for developing novel Nrf2-targeted anti-gout drugs.

Objective:To explore the acupoint selection law in acupuncture and moxibustion in treating postpartum incontinence by using data mining technology.Methods:The clinical research literature on acupuncture and moxibustion treatment for postpartum incontinence was retrieved from CNKI, Wanfang Data, VIP, CBM, China Medical Journal Full-text Database, PubMed, Embase, Web of Science from the establishment of the databases to February 1, 2023. The acupoint prescription database was established using Excel 2016 and conducting frequency statistics of acupoints, meridians and specific acupoints. Clustering analysis was performed using SPSS Statistics 25.0, and association rule analysis was performed using SPSS Modeler 18.0.Results:A total of 70 articles were included, involving 70 acupuncture prescriptions and including 31 acupoints with a total frequency of 384 times. The top five acupoints were Sanyinjiao (SP6, 46 times), Guanyuan (CV4, 45 times), Zusanli (ST36, 43 times), Zhongji (RN3, 41 times), and Qihai (CV6, 38 times). The commonly used meridians were Conception Vessel, bladder meridian and spleen meridian. The involved acupoints were mostly located in the lower limbs and belly, and most of them were Jiaohui, Mu and Wushu acupoints. Five effective clustering groups were obtained by clustering analysis of high frequency acupoints. The core acupoint combination of association rules was Sanyinjiao (SP6)-Zusanli (ST36)-Guanyuan (CV4)-Qihai (CV6)-Zhongji (RN3).Conclusions:The pathogenesis of postpartum urinary incontinence is mainly characterized by qi deficiency. Acupuncture and moxibustion treatment of postpartum urinary incontinence follows the principles of invigorating qi and tonifying spleen, nourishing lung and tonifying kidney, paying attention to the use of acupoints in abdomen and lower limbs, and using the methods of upper and lower acupoints, anterior and posterior acupoints.

Objective:To observe the effects of Zhulian stimulant type Ⅰ acupuncture on the expression of brain-derived neurotrophic factor (BDNF) and its receptor TrkB and tissue homogenate cyclic adenosine phosphate (cAMP) in rats with diabetic bladder (DCP); To explore the mechanism of Zhulian stimulant type Ⅰacupuncture on DCP.Methods:Totally 50 SD rats were divided into control group, model group, Western medicine group, ordinary acupuncture group, Zhulian stimulant type Ⅰ acupuncture treatment group (acupuncture treatment group) according to random number table method, with 10 rats in each group. DCP rat model was prepared by intraperitoneal injection of streptozotocin (STZ), except for the control group. The Western medicine group was given mecobalamine for gavage; acupoints of "Zhongji", "Sanyinjiao", "Liechou" and "Taichong" were selected. The ordinary acupuncture group was treated with ordinary acupuncture technique, and the acupuncture treatment group was treated with Zhulian stimulant type Ⅰ acupuncture, 1 time/d, 30 minutes/time. Samples were taken after 4 weeks of treatment. The maximum bladder volume, residual urine volume and wet weight of the bladder were detected. The morphology of rat bladder was observed by HE staining. The expression level of BDNF was detected by immunohistochemistry. The expression of cAMP was detected by Western blot. The level of TrkB was determined by ELISA. Real-time fluorescence quantitative PCR (RT-PCR) was used to detect the mRNA expressions of BDNF and cAMP.Results:Compared with model group, maximum bladder volume, residual urine volume and wet weight of bladder in Western medicine group, ordinary acupuncture group and acupuncture treatment group decreased ( P<0.01), and those in Western medicine group and acupuncture treatment group were lower than those in ordinary acupuncture group ( P<0.01). The expressions of BDNF mRNA and protein, cAMP mRNA and protein in Western medicine group, ordinary acupuncture group and acupuncture treatment group increased ( P<0.05), and the level of TrkB increased, and the Western medicine group and acupuncture treatment group were higher than that in ordinary acupuncture group ( P<0.05). Conclusions:Zhuliping stimulant type Ⅰ acupuncture has a protective effect on the bladder function of diabetic rats. The mechanism may be related to the up-regulation of BDNF and mRNA, TrkB, cAMP and mRNA expressions.

Objective:To compare the parameters for infra-acetabular screw placement between men and women using a digital Chinese anatomical model of the pelvis and acetabulum.Methods:The normal pelvic CT data were collected from the 163 adult patients who had been admitted to the Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2018 to December 2021. There were 61 males and 102 females with an age of 53.0 (45.0, 60.0) years. Mimics 21.0 software was used to reconstruct the three dimensional pelvis which was then imported into Autodesk maya 2022 software before the model was flattened. Polygonal modeling tools were used to create a cylinder to simulate an infra-acetabular screw for length and angle measurements of the screw. The diameters of the infra-acetabular screws were measured by axial fluoroscopy in Mimics 21.0 software. The maximum diameters and maximum lengths of the infra-acetabular bone channel were compared between males and females, and the angles between the axis of the infra-acetabular screw and the anterior pelvic plane and the median sagittal plane were also compared between genders.Results:The maximum diameters of the left and right infra-acetabular corridors were 5.24 (4.26, 6.38) mm and 5.04 (4.50, 6.57) mm in males, and 3.99 (3.81, 4.51) mm and 3.89 (3.65, 4.90) mm in females; the maximum lengths of the left and right infra-acetabular corridors were (98.43±4.42) mm and (98.01±5.08) mm in males and 87.73 (84.22, 90.98) mm and 87.51 (84.59, 90.15) mm in females. The left and right angles between the infra-acetabular screw axis and the median sagittal plane were -0.98°±4.79° and -1.08°±4.91° in men, and 6.20° (3.34°, 11.16°) and 6.44° (3.77°, 11.85°) in women. The differences in the above data between men and women were statistically significant ( P<0.05). There was no statistically significant difference between men and women in the angle between the infra-acetabular screw axis and the anterior pelvic plane ( P>0.05). Conclusions:The length and diameter of the infra-acetabular corridor in males are greater than those in females, the angle between the infra-acetabular corridor and the sagittal plane in males is smaller than that in females, and the infra-acetabular corridor in males is more parallel to the sagittal plane. Therefore, the fluoroscopy angle should be adjusted for males to reduce the difficulty in screw placement when an infra-acetabular screw is placed during surgery.

The principles for surgical treatment of femoral neck fracture are anatomical reduction, rigid fixation and reduction of iatrogenic tissue damage to maintain sufficient blood supply and reduce the risk of complications such as avascular necrosis of the femoral head. In the evolution of internal fixation structures for femoral neck fracture, a variety of new products have been developed, such as the neck-shaft angle stabilization structure represented by dynamic hip screw, the multi-screw structure represented by three cannulated screws, and the plate-screw structure represented by multi-screw structure combined with a locked plate. These internal fixation structures have their own advantages and disadvantages in terms of stability and reduced risk of complications. However, none of them can perfectly meet the requirements of all the surgical principles. Femoral neck system (FNS) was firstly applied in clinic practice in 2017 to further improve the internal fixation of femoral neck fracture. In recent years, its mechanical properties and clinical effects have been widely reported in an attempt to further improve the implantation of this internal fixation device. This article reviews the researches on the mechanical properties and clinical efficacy of FNS and the suggestions put forward by orthopedic surgeons to improve the implantation methods of FNS.

Objective:To establish a digital anatomical model of the pelvic and compare the differences in morphological parameters of the infra-acetabular screw safety channel between men and women.Methods:A retrospective analysis was performed on the pelvic data of 106 normal adults who underwent plain pelvic CT scan for non-pelvic disorders diseases in the Affiliated Hospital of Traditional Chinese Medicine of Xinjiang Medical University from January 2022 to December 2022, including 56 males and 50 females, aged 50.58±11.22 years (range, 21-68 years). Use reverse reconstruction software to reconstruct the pelvis and import it into Autodesk maya 2022 software to level the model. Use polygonal modeling tools to simulate the insertion of infra-acetabular screws and measure the length of the screw, the screw insertion angle, and the distance between the needle entry point and the apex of the iliopubic eminence. Measure the diameter of the infra-acetabular screw through axial fluoroscopy; measure the needle entry area, narrow area and needle exit area in Mimics 21.0 software; compare the differences in the above indicators between men and women.Results:The maximum diameters of male and female infra-acetabular screws were 4.82±1.07 mm and 3.93±0.65 mm respectively; the maximum lengths were 97.74±93.8 mm and 88.23±4.55 mm respectively; the angles with the sagittal plane were -1.33°±4.96°and 7.29°±6.20° respectively; the needle insertion areas were 314.83±4.79 mm 2 and 198.29±78.70 mm 2 respectively, the narrow areas were 75.61±19.00 mm 2 and 47.33±13.34 mm 2 respectively, and the needle exit areas were 400.52±88.86 mm 2 and 268.27±120.71 mm 2 respectively; the differences between male and female were statistically significant ( P<0.05). The infra-acetabular screw insertion points for men and women are respectively 9.39±1.44 mm and 9.68±1.41 mm inside the iliopubic eminence apex, and 8.87±1.22 mm and 9.28±1.56 anterior to the iliopubic eminence apex; the angles between the infra-acetabular screw and the anterior pelvic plane were 52.69°±7.38°and 52.32°±1.24°respectively; the differences were not statistically significant ( P>0.05). When the screw diameter was 3.5 mm, 88% (49/56) of men and 76% (38/50) of women have corridor in the pelvis for screws to pass through, and the difference was not statistically significant (χ 2=2.375, P=0.123). But when the screw diameter was 4.5 mm, 59% (33/56) of men and 20% (10/50) of women have corridor in the pelvis for screws to pass through, and the difference was statistically significant (χ 2=16.603, P<0.001). Conclusion:There are large individual differences in infra-acetabular corridor parameters. The length, diameter, needle entry area, narrow area and needle exit area of the infra-acetabular screw in men are larger than those in women, while the angle with the sagittal plane in men is smaller than that in women. There is no significant difference between men and women in the distance between the insertion point of the infra-acetabular screw and the iliopubic eminence and the angle between the screw and the anterior pelvic plane. There was no significant difference in the pass rate of screws with a diameter of 3.5 mm between males and females in the acetabular canal, while the pass rate of screws with a diameter of 4.5 mm was higher than that of females.

Objective To summarize the best evidence of nutrition management in patients with severe pneumonia,aiming to offer evidence-based guidance for clinical healthcare professionals.Methods All evidence on nutrition management in patients with severe pneumonia was retrieved from various databases and websites including BMJ Best Practice,UpToDate,National Guideline Clearinghous(NGC),Guidelines International Network(GIN),Registered Nurses'Association of Ontario(RNAO),National Institute for Health and Care Excellence(NICE),Cochrane Library,OVID,PubMed,Embase,Web of Science,CINAHL,Chinese Medical Journal Full-text Database,CNKI,VIP,Wanfang,CBM,American Society for Parenteral and Enteral Nutrition(ASPEN),European Society for Clinical Nutrition and Metabolism(ESPEN),Society of Critical Care Medicine(SCCM)and European Society of Intensive Care Medicine(ESICM).The retrieved evidence included clinical decisions,guidelines,systematic reviews,expert consensuses and evidence summaries.The search period ranged from January 1st,2012 to December 31st,2022.There were 2 researchers who independently assessed the quality of the included studies and then extracted and summarized the evidence by topic.Results A total of 13 articles were involved,including 3 clinical decisions,4 guidelines,1 systematic review,and 5 expert consensuses.A total of 24 pieces of evidence were summarized across 6 aspects which encompassed team building,nutrition screening and assessment,nutritional requirements,nutrition intervention,nutrition monitoring,and health education.Conclusion The production process of this evidence summary followed standardized procedures,ensuring comprehensive content.Medical professionals should integrate clinical conditions,patient factors,and family preferences to select the most optimal evidence in order to enhance patient prognosis and improve medical quality.

Objective:To observe the inhibiting effects of manual acupuncture(MA)on bladder cell apoptosis in rats with diabetic neurogenic bladder(DNB)based on the protein and mRNA expression of B-cell lymphoma-leukemia(Bcl)-2,Bcl-2-associated X(Bax)protein,caspase-3,and the protein expression of α-smooth muscle actin(α-SMA),transforming growth factor(TGF)-β in the bladder tissue. Methods:A DNB rat model was established via intraperitoneal injection of streptozotocin(STZ).The rats were randomly divided into a control group,a model group,and an MA group,with 10 rats in each group.For the MA group,MA was applied after modeling.The body mass,fasting blood glucose(FBG),bladder wet weight,and bladder histomorphology were observed.Protein and mRNA expression levels of Bcl-2,Bax,and caspase-3 and the protein expression of α-SMA and TGF-β in the bladder tissue were determined.The apoptotic index of bladder cells was also evaluated. Results:After STZ injection,compared with the control group,the model group and the MA group both showed higher FBG from week 3 and lower body mass from week 9(P<0.05),and had a larger bladder wet weight(P<0.05).Compared with the model group,the MA group showed a smaller bladder wet weight(P<0.05).The histopathological evaluation indicated that MA improved muscle fiber alignment and detrusor cell compensatory hypertrophy in the bladder tissue.In addition,compared with the control group,the apoptotic index increased significantly in the model group and the MA group(P<0.05);the protein and mRNA expression levels of Bax and caspase-3 and the protein expression level of TGF-β in the bladder tissue in the model group and the MA group increased significantly(P<0.05),while the protein and mRNA expression levels of Bcl-2 and the protein expression level of α-SMA in the bladder tissue decreased significantly(P<0.05).Compared with the model group,the apoptotic index of the MA group decreased significantly(P<0.05);the protein and mRNA expression levels of Bax and caspase-3 and the protein expression level of TGF-β in the bladder tissue decreased significantly(P<0.05),while the protein and mRNA expression levels of Bcl-2 and the protein expression level of α-SMA in the bladder tissue increased significantly(P<0.05). Conclusion:MA can protect the bladder by inhibiting the excessive apoptosis of bladder cells,which may be related to the down-regulation of Bax and caspase-3 proteins and mRNAs and TGF-β protein expression,and the up-regulation of Bcl-2 protein and mRNA and α-SMA protein expression.

Objective:To systematically evaluate the application effect of somatosensory interactive games in patients with chronic obstructive pulmonary disease (COPD) in order to provide a basis for clinical application.Methods:Randomized controlled trials and quasi-experimental studies on the application of somatosensory interactive games in patients with COPD were retrieved from PubMed, Embase, Cochrane Library, CINAHL, Chinese Biomedical Literature Database, Wanfang, China Knowledge Network and VIP. The retrieval time limit is from the establishment of the database to October 2022. RevMan5.2 software was used for Meta analysis.Results:Ten articles involving 611 patients were included. The results of Meta-analysis showed that the somatosensory interactive game group was superior to the conventional training group in improving FEV 1/FVC% ( WMD=6.83, 95% CI 3.71-9.95, Z=4.29, P<0.01), 6-minute walking distance (6MWD) ( WMD=13.36, 95% CI 0.50-26.23, Z=2.04, P<0.05), Hospital Anxiety and Depression Scale ( WMD=-1.64, 95% CI -2.31--0.97, Z=4.78, P<0.01), COPD Assessment Test score ( WMD=-2.95, 95%CI -4.08--1.82, Z=5.13, P<0.01) in COPD patients. However, there was no significant difference in FEV1 % ( WMD=2.91, 95% CI -1.61-7.43, P=0.210) and dyspnea ( SMD=0.63,95% CI -0.24-1.49, P=0.150) between the two groups. Conclusions:Compared with conventional training, somatosensory interactive game training can effectively improve lung function and quality of life in patients with COPD, relieve anxiety and depression. Due to the limited quantity and quality of the included literature, the reliability of the conclusions still needs to be verified by more high-quality studies.