Objective To explore the effect of different needle track management on Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT) on liver cancer after liver biopsy. Methods A retrospective analysis was conducted on the clinical data of 21 patients with liver cancer who underwent Technetium-99m-macroaggregated albumin (^99mTc-MAA) evaluation and ⁹⁰Y-SIRT after liver biopsy from June 2023 to December 2024. The methods of needle track management, hepatic arteriovenous shunting, and lung shunt fraction (LSF) were recorded. The occurrence of hepatic arteriovenous fistula (HAVF), as well as the corresponding countermeasures were analyzed. Results Among the 21 liver cancer patients, 7 cases (medical glue group) underwent embolization of the needle tract with medical glue (N-butyl 2-cyanoacrylate [NBCA]) immediately after biopsy, and no significant HAVF was observed during the ^99mTc-MAA tests; 14 cases (non-medical glue group) were treated with delayed needle extraction or gelatin sponge particle blocking after biopsy, among which 7 cases developed significant HAVF, and the fistulas were treated with NBCA. The LSF of the medical glue group was significantly lower than that of the non-medical glue group ([7.06±2.33] % vs [12.43±7.73] %, P＝0.037). All 21 patients successfully completed ⁹⁰Y-SIRT. Conclusions Liver biopsy may affect ⁹⁰Y-SIRT by causing iatrogenic HAVF. Immediate NBCA-embolization of the needle tract after biopsy or timely NBCA-embolization of fistulas during ^99mTc-MAA tests may reduce the impact.

Objective To investigate the immediate effect of transcranial direct current stimulation(tDCS)combined with seated Tai-jiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiple-gia.Methods From September to December,2024,14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospi-tal of Xiamen.Based on the routine medication and rehabilitation,the patients were randomly assigned to a spe-cific intervention sequence,receiving three interventions in a fixed order:tDCS followed by Yunshou(S-Y group),Yunshou followed by tDCS(Y-S group),and simultaneous tDCS and Yunshou(Sim group).Functional near-infrared spectroscopy was used to detect oxyhemoglobin(HbO?)concentration in bilateral sensorimotor cor-tex,premotor and supplementary motor cortex,and prefrontal cortex before and after each intervention.Results Three patients dropped out.In all the regions of interest,inter-group effects were significant in HbO? concentra-tions(F>3.697,P<0.05),and interaction effects were significant in some brain regions(F>3.276,P<0.05).Post-hoc test showed a general trend of Sim Group≥S-Y Group>Y-S Group(P<0.05),although some varia-tions existed across different brain regions.Conclusion Both simultaneous intervention(tDCS and Yunshou)and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

In order to establish a competitive chemiluminescent enzyme-linked immunoassay for rapid and quantitative detection of Senecavirus A antibodies,the polystyrene plate was coated with inactivated Senecavirus A antigen,and the monoclonal antibodies against Senecavirus A VP2 and VP3 proteins labeled by horseradish peroxidase(HRP)were used as the competitive enzymic anti-bodies of the antibodies in the serum samples.The standard curve of the calibrator prepared by di-lution of positive serum was drawn to achieve quantitative detection.The successfully established SVA competitive CLEIA reported the result within 45 minutes.The maximum dilution of 1∶2 048 for calibrator serum was still detectable with no cross-reaction with the standard positive serum of other five kinds of virus antigens such as foot-and-mouth disease.The coefficient of variation within batches was less than 10％,and the coefficient of variation between batches was less than 15％,which showed good repeatability and stability.The positive and negative coincidence rates were 95.30％and 97.57％,respectively,and the total coincidence rate was 96.88％,showing high consistency.The SVA competitive CLEIA assay established in this study can be used for the rapid quantitative detection of Senecavirus A antibodies,filling the gap in the domestic rapid quantitative detection of SVA antibodies.

Objective:To evaluate the outcomes of minimally invasive therapy for aortic arch pathology after ascending aortic replacement.Methods:A retrospective analysis was conducted at the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from 2016 to 2024. After multidisciplinary discussion, these included patients were evaluated to be at high risk for traditional open surgery. Various minimally invasive repair techniques were employed, including Ⅳb hybrid technique, physician-modified endograft and novel unibody endograft. The study outcomes were technical success, in-hospital and follow-up mortality, stroke, endoleak, and the patency of the supra-aortic vessels.Results:A total of 40 patients(32 males and 8 females) with a median age of 60 years old were included in this study. The technique success rate was 100%, with no deaths or strokes reported. The patency of the supra-aortic vessels was 100%. 10 patients underwent Type Ⅳb hybrid surgery without any endoleaks occurring. Among the 22 patients who received physician-modified endograft, endoleaks were observed in 2 cases. One of these type Ⅰc endoleaks persisted and underwent reintervention. One patient underwent femoral artery replacement due to vascular injury. For the 8 patients who received novel unibody endograft, one case required reintervention due to persistent type Ⅰc endoleaks.Conclusion:With the development of different endovascular techniques and novel branched endograft, patients with aortic arch pathology who are at high risk for redo open surgery can achieve favorable outcomes with various minimal invasive techniques. However, long-term and large-sample follow-up studies are needed for further evaluation.

Objective To investigate the immediate effect of transcranial direct current stimulation(tDCS)combined with seated Tai-jiquan Yunshou training under different sequences on cerebral cortical activation in stroke patients with hemiple-gia.Methods From September to December,2024,14 stroke inpatients with hemiplegia were enrolled from the Fifth Hospi-tal of Xiamen.Based on the routine medication and rehabilitation,the patients were randomly assigned to a spe-cific intervention sequence,receiving three interventions in a fixed order:tDCS followed by Yunshou(S-Y group),Yunshou followed by tDCS(Y-S group),and simultaneous tDCS and Yunshou(Sim group).Functional near-infrared spectroscopy was used to detect oxyhemoglobin(HbO?)concentration in bilateral sensorimotor cor-tex,premotor and supplementary motor cortex,and prefrontal cortex before and after each intervention.Results Three patients dropped out.In all the regions of interest,inter-group effects were significant in HbO? concentra-tions(F>3.697,P<0.05),and interaction effects were significant in some brain regions(F>3.276,P<0.05).Post-hoc test showed a general trend of Sim Group≥S-Y Group>Y-S Group(P<0.05),although some varia-tions existed across different brain regions.Conclusion Both simultaneous intervention(tDCS and Yunshou)and tDCS followed by Yunshou are more effective on immediate activation of key motor-related cortices in stroke patients with hemiplegia than Yunshou followed by tDCS intervention.

In order to establish a competitive chemiluminescent enzyme-linked immunoassay for rapid and quantitative detection of Senecavirus A antibodies,the polystyrene plate was coated with inactivated Senecavirus A antigen,and the monoclonal antibodies against Senecavirus A VP2 and VP3 proteins labeled by horseradish peroxidase(HRP)were used as the competitive enzymic anti-bodies of the antibodies in the serum samples.The standard curve of the calibrator prepared by di-lution of positive serum was drawn to achieve quantitative detection.The successfully established SVA competitive CLEIA reported the result within 45 minutes.The maximum dilution of 1∶2 048 for calibrator serum was still detectable with no cross-reaction with the standard positive serum of other five kinds of virus antigens such as foot-and-mouth disease.The coefficient of variation within batches was less than 10％,and the coefficient of variation between batches was less than 15％,which showed good repeatability and stability.The positive and negative coincidence rates were 95.30％and 97.57％,respectively,and the total coincidence rate was 96.88％,showing high consistency.The SVA competitive CLEIA assay established in this study can be used for the rapid quantitative detection of Senecavirus A antibodies,filling the gap in the domestic rapid quantitative detection of SVA antibodies.

Objective:To evaluate the outcomes of minimally invasive therapy for aortic arch pathology after ascending aortic replacement.Methods:A retrospective analysis was conducted at the Department of Cardiovascular Surgery, West China Hospital of Sichuan University from 2016 to 2024. After multidisciplinary discussion, these included patients were evaluated to be at high risk for traditional open surgery. Various minimally invasive repair techniques were employed, including Ⅳb hybrid technique, physician-modified endograft and novel unibody endograft. The study outcomes were technical success, in-hospital and follow-up mortality, stroke, endoleak, and the patency of the supra-aortic vessels.Results:A total of 40 patients(32 males and 8 females) with a median age of 60 years old were included in this study. The technique success rate was 100%, with no deaths or strokes reported. The patency of the supra-aortic vessels was 100%. 10 patients underwent Type Ⅳb hybrid surgery without any endoleaks occurring. Among the 22 patients who received physician-modified endograft, endoleaks were observed in 2 cases. One of these type Ⅰc endoleaks persisted and underwent reintervention. One patient underwent femoral artery replacement due to vascular injury. For the 8 patients who received novel unibody endograft, one case required reintervention due to persistent type Ⅰc endoleaks.Conclusion:With the development of different endovascular techniques and novel branched endograft, patients with aortic arch pathology who are at high risk for redo open surgery can achieve favorable outcomes with various minimal invasive techniques. However, long-term and large-sample follow-up studies are needed for further evaluation.

Objectives:To compare the effects of 3D-printed personalized guiding template and robot-assisted pedicle screw placements in orthopedic surgery for adult degenerative scoliosis(ADS).Methods:Retrospective analysis was conducted on 18 ADS patients hospitalized and treated with corrective surgery in the department between January 2020 and December 2022.There were 3 males and 15 females,aged 46-73(63.2±8.2)years old.A total of 236 pedicle screws were placed,and the patients were divided into two groups according to the auxiliary screw placement methods:the 3D-printed personalized guiding template group(3D-printed group,1 1 cases,142 pedicle screws were placed)and robot-assisted screw placement group(Robot group,7 cases,94 pedicle screws were placed).The patients were followed up for 6 months and more.The vertex rotation angle and scoliosis Cobb angle were measured and compared between groups before operation.All pedicle screws were classified by Gertzbein-Robbins classification standard at 1 week after operation,and the accuracy and satisfaction of screw placement in the two groups were compared;And the operative time and incidence of complications were also analyzed and compared between the two groups.Re-sults:The 3D-printed group was not statistically different from the robot group in terms of age(63.6±9.0 years vs.62.6±7.3 years),gender ratio(male/female:2/9 vs.1/6),number of screws placed(12.91±3.83 vs.13.43± 3.60),Cobb angle(40.36°±1 1.82° vs.38.14°±12.84°),and vertex rotation angle(30.27°±7.25° vs.29.86°±9.65°),respectively(P＞0.05).The robot group was longer in operative time than that of 3D-printed group(354.29± 53.73min vs.282.27±73.87min,P＜0.05).Of the total 142 pedicle screws placed in the 3D-printed group,128 screws were of class A,10 were of class B,and 4 were of class C;Of the total 94 pedicle screws placed in the robot group,86 screws were of class A,5 were of class B,and 3 were of class C;No class D or E screws in the two groups.The accuracy rate of screw placement(90.14％)and satisfaction rate(97.18％)of the 3D-printed group were not statistically different from the accuracy rate(91.49％)and satisfaction rate(96.81％)of the robot group,respectively(P＞0.05).The incidence of complications in the 3D-printed group(36.36％)was not significantly different from that in the robot group(57.14％,P＞0.05).Conclusions:Both auxiliary screw placement methods can assist spinal surgeons to accurately place screws in ADS patients,but 3D-printed personalized guiding template needs less time in screw placement.

OBJECTIVE To investigate the improvement effect and potential mechanism of “Layers adjusting external application” paste on synovial fibrosis （SF） in rats with knee osteoarthritis （KOA）. METHODS Male SD rats were randomly divided into sham operation group， KOA group and Layers adjusting external application group， with 8 rats in each group. KOA model was induced by the anterior cruciate ligament disruption method in KOA group and Layers adjusting external application group. Fourteen days after modeling， the Layers adjusting external application group was given “Layers adjusting external application” paste [Sanse powder （8 g for every 100 cm2）， Compound sanhuang ointment （5 g for every 100 cm2）] on the knee joint， 8 h every day， for 28 d in total. After the last administration， the degree of synovitis and fibrosis in rats was observed， and Krenn scoring was performed in each group. The expressions of collagen Ⅰ， high mobility group protein B1 （HMGB1） and phosphorylated nuclear factor-κB p65 （p-NF-κB p65） were detected in the synovial membrane； the contents of interleukin-1β （IL- 1β）， IL-6 and tumor necrosis factor-α （TNF-α） in serum as well as the expressions of fibrosis-related and HMGB1/Toll-like receptor 4 （TLR4）/NF-κB signaling pathway-related proteins and mRNA were detected in synovial tissue. RESULTS Compared with the sham operation group， the synovial lining cells in the KOA group showed significant proliferation and disordered arrangement， the inflammatory cell infiltration and collagen fiber deposition were obvious； the positive expressing cells of collagen Ⅰ， HMGB1 and p-NF-κB p65 were increased significantly； the contents of IL-1β， IL-6 and TNF-α in serum， the expressions of fibrosis-related protein （transforming growth factor-β， collagen Ⅰ， tissue inhibitor of metalloproteinase 1， α-smooth muscle actin） and their mRNA as well as theexpressions of HMGB1， TLR4 protein and their mRNA， the expressions of p-NF-κB p65 protein and NF-κB p65 mRNA were all increased significantly in synovial tissues of rats （P＜0.01）. Compared with the KOA group， the pathological changes in the synovial tissue of rats in Layers adjusting external application group were significantly improved， and the above quantitative indicators were significantly reversed （P＜0.05 or P＜0.01）. CONCLUSIONS “Layers adjusting external application” paste could significantly improve SF in KOA rats， the mechanism of which may be associated with the inhibition of the activation of HMGB1/ TLR4/NF-κB signaling pathway.

The standardization of medical management is critical for facing the challenge of public health emergencies in primary medical and health institutions. During the COVID-19 epidemic a quality standard system for pharmacy management was developed in Shanghai Gubei Community Health Service Center, which included 4 standardized modules: medication management module, pharmacy administration modules, pharmacy service module and specialized disease management module. In this article the author discusses the construction of pharmacy quality management standards, its application and roles in COVID-19 epidemics, to provide reference for quality pharmacy management during public health emergencies in grass-roots medical and health institutions.