Objective To investigate the effect of closed-chain exercise training on hemiplegic shoulder pain and shoulder joint sta-bility in stroke patients,and to explore the relationship between hemiplegic shoulder pain and shoulder joint sta-bility.Methods A total of 52 stroke patients with hemiplegic shoulder pain in Jiangsu Province Hospital from October,2020 to January,2023 were selected,and were randomly divided into control group(n=26)and experimental group(n=26).Both groups received conventional rehabilitation therapy,while the experimental group additionally under-went closed-chain exercise training for shoulder joint.Pain severity and motor function were assessed using Visu-al Analog Scale(VAS)and Fugl-Meyer Assessment-Upper Extremities(FMA-UE)before and after intervention.Musculoskeletal ultrasound was used to measure acromion-greater tuberosity distance(AGT),acromion-lesser tu-berosity distance(ALT),acromiohumeral distance(AHD)and supraspinatus thickness(SST)to evaluate shoulder joint stability.Correlation analysis was conducted on the improvements in shoulder pain and shoulder joint stabil-ity in the experimental group.Results Two cases in the control group and two in the experimental group dropped down.Both groups showed signifi-cant improvements in VAS and FMA-UE scores after intervention(|t|>5.214,P<0.001),and the scores im-proved more in the experimental group than in the control group(|t|>2.087,P<0.05).The experimental group also showed significant improvements in AGT,ALT,AHD and SST(|t|>4.187,P<0.001),with AGT,ALT and AHD being superior to those in the control group(|t|>2.155,P<0.05).The difference of VAS score in the exper-imental group was correlated with the difference of FMA-UE,AGT and ALT after intervention(r>0.434,P<0.05).Conclusion Closed-chain shoulder exercise training can significantly improve shoulder joint stability while alleviating shoulder pain,and effectively enhancing upper limb function in stroke patients with hemiplegic shoulder pain.Hemiplegic shoulder pain is correlated with shoulder joint stability.

Objective:To compare minimally invasive surgery with traditional open surgery, analyze the current application status of health economic evaluations in the treatment of digestive tract cancers, such as esophageal cancer, gastric cancer, and colorectal cancer by minimally invasive surgery and provide evidence for the rational selection of clinical treatment, alleviation of disease-related economic burdens, and rational allocation of healthcare resources.Methods:By using five databases, i.e. China National Knowledge Infrastructure, Wanfang data, Chinese Biomedical Literature Database, PubMed, and Embase, a database was established to retrieve all the papers about health economic studies of minimally invasive surgery for esophageal cancer, gastric cancer, and colorectal cancer published until December 31, 2023. Literature was analyzed by using software NoteExpress 3.8, and data were processed using Excel 2021. The quality of included papers was evaluated using the CHEERS 2022 checklist, and Meta-analysis was conducted by using software Stata 17.0.Results:A total of 10 919 relevant papers were retrieved, and 59 studies were included. Only 14 studies (23.7%) used standard health economic evaluation methods. Meta-analysis results revealed no significant differences in direct medical expenditure and total expenditure between minimally invasive surgery and open surgery. However, the expenditure for minimally invasive surgery exhibited a significant increase [mean difference ( MD)=5 973.12 yuan, P<0.001], while hospital stay and indirect expenditure significantly decreased ( MD: -4.85 days and -733.79 yuan, P<0.001). In China, for gastric cancer, the direct medical expenditure of endoscopic surgery was lower than that of open surgery ( MD=-33 000.00 yuan) with no significant difference ( P<0.001). In colorectal cancer cases, the direct medical and surgical expenditures for laparoscopic surgery were higher than those for open surgery ( MD: 4 277.94 yuan and 4 267.80 yuan, P<0.001), while the indirect and total medical expenditures decreased ( MD: -768.34 yuan and -159.10 yuan). Hospital stays in patients who had minimally invasive surgery for all three types of cancer were shorter than those who had open surgery ( P<0.001). Conclusions:In the treatment of gastrointestinal cancer, compared with open surgery, minimally invasive surgery shows higher expenditure, but has advantages, such as shorter hospital stay and lower indirect expenditure, and there were no significant differences in direct medical and total expenditures between the two approaches. When conducting health economic evaluation, factors such as postoperative complications, hospital stay, and patient's economic status should be considered for their impact on total medical expenditure. It is necessary to pay attention to the application of health economic evaluations in healthcare decision-making.

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Hypertrophic cardiomyopathy (HCM) is a major contributor to cardiovascular diseases (CVD), the leading cause of death globally. HCM can precipitate heart failure (HF) by causing the cardiac tissue to weaken and stretch, thereby impairing its pumping efficiency. Moreover, HCM increases the risk of atrial fibrillation, which in turn elevates the likelihood of thrombus formation and stroke. Given these significant clinical ramifications, research into the etiology and pathogenesis of HCM is intensifying at multiple levels. In this review, we discuss and synthesize the latest findings on HCM pathogenesis, drawing on key experimental studies conducted both in vitro and in vivo. We also offer our insights and perspectives on these mechanisms, while highlighting the limitations of current research. Advancing fundamental research in this area is essential for developing effective therapeutic interventions and enhancing the clinical management of HCM.
Cardiomyopathy, Hypertrophic/physiopathology* ; Humans ; Animals

Objective:To investigate the therapeutic efficacy of proximal ulnar osteotomy combined with autologous iliac bone grafting for the repair of chronic elbow varus with posteromedial rotational instability caused by coronoid process bone defects.Methods:A retrospective analysis was conducted on the data of 9 male patients with chronic elbow varus and posteromedial rotational instability caused by coronoid process bone defects who were treated with proximal ulnar osteotomy combined with autologous iliac bone grafting at Sichuan Provincial Orthopaedic Hospital from January 2017 to May 2024. The patients' ages ranged from 20 to 46 years, with an average of 29.78±8.77 years old. There were 3 cases on the right side and 6 on the left side. The height of the bone defect on the anteromedial surface of the coronoid process ranged from 5.24 to 12.23 mm, with an average of 9.01±2.61 mm. The time from injury to surgery ranged from 5 to 9 months, with an average of 6.78±1.39 months. During the operation, proximal ulnar osteotomy combined with autologous iliac bone grafting was used to repair the coronoid process bone defect. Simultaneously, the lateral ulnar collateral ligament was reconstructed using the suture anchors (3 patients) or repaired with autologous palmaris longus tendon (6 patients). Finally, a hinged external fixator was applied in all cases. The range of motion (ROM) of the elbow joint was recorded before and after the surgery. The visual analogue score (VAS) was used to evaluate the degree of pain, and the Mayo elbow performance score (MEPS) was employed to assess the elbow joint function.Results:All surgical incisions healed primarily, and no case of infection occurred. All 9 patients were followed up, with a follow-up period ranging from 11 to 25 months, and an average of 17.78 ± 5.16 months. The bone grafts all healed, with a healing time ranging from 3 to 5 months, and an average of 3.56±0.73 months. The elbow extension angles before surgery, at 6 months postoperatively, and at the last follow-up were 24.44°±14.24°, 11.11°±9.28°, and 2.22°±4.41°, respectively. The flexion angles were 118.89°±5.46°, 123.33°±5.00°, and 128.89°±3.33°, respectively. The flexion-extension ROMs were 94.44°±18.28°, 112.22°±13.02°, and 126.67°±7.07°, respectively. The pronation angles were 61.67°±6.12°, 61.67°±3.54°, and 67.22°±5.07°, respectively. The differences in these angles were all statistically significant ( P<0.05). The supination angles before surgery, at 6 months postoperatively, and at the last follow-up were 77.22°±7.55°, 78.89°±6.01°, and 79.44°±6.35°, respectively. The rotational ROMs were 138.89°±11.93°, 140.56°±7.26°, and 146.67°±10.31°, respectively. No statistically significant differences were observed ( P>0.05). The VAS scores before surgery, at 6 months postoperatively, and at the last follow-up were 6.89±0.78 points, 2.33±1.00 points, and 0(0, 0.5) points, respectively, and the difference was statistically significant ( H=23.216, P<0.001). The MEPS scores were 42.22±5.65 points, 76.67±7.05 points, and 95.00±7.50 points, respectively, and the difference was also statistically significant ( F=134.212, P<0.001). The cantilever test confirmed that none of the patients had elbow joint instability symptoms, and the patients were satisfied with the treatment effect. Conclusions:Proximal ulnar osteotomy combined with autologous iliac bone grafting, simultaneous repair or reconstruction of the lateral ligament complex, and fixation with a hinged external fixator is an effective treatment approach for chronic elbow varus with posteromedial rotational instability. This method can alleviate elbow pain, improve the ROM, and enhance elbow function in patients, yielding satisfactory short-term outcomes.

Objective To analysa the correlation between the mRNA expression of potassium voltage-gated channel subfamily F member 1(KCNF1)in lung cancer tissue and clinical pathological features and prognosis.Methods 102 patients with lung cancer in Shexian People's Hospital and the First Affiliated Hospital of Bengbu Medical University from December 2019 to December 2021 were selected as the research object.All patients were divided into metastasis group(n=34)and non metastasis group(n=68)according to whether the patients had lung cancer metastasis.Compared the expression of KCNF1 protein and mRNA in lung cancer tissues and adjacent normal tissues.The influencing factors of metastasis of lung cancer were analyzed by univariate analysis.Spearman correlation was used to analyze the relationship between KCNF1mRNA expression and metastasis related factors.Analyzed the independent correlation between the expression of KCNF1 mRNA and the metastasis of lung cancer.Used survival curve analysis to investigate the relationship between KCNF1 protein levels and 3-year survival of lung cancer.Results The high expression rate of KCNF1 protein in lung cancer tissues was 38.24%(39/102),which was significantly higher than 7.84%(8/102)in adjacent normal tissues(χ2=26.568,P<0.001).The relative expression levels of KCNF1 mRNA in lung cancer tissues were significantly higher than those in adjacent normal tissues,the difference was statistically significant(t=23.127,P<0.001).Compared with the non metastatic group,the proportion of high and moderate differentiation in the metastatic group was higher,the proportion of TNM stages III to IV,KCNF1,Epidermal Growth Factor Receptor(EGFR),C-erbB-2,the mRNA expression levels of chemokine receptor 2(CXCR2),matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and HIF-l α were significantly increased,the differences were statistically significant(χ2/t=3.036～19.555,all P<0.05).The expression of KCNF1mRNA in lung cancer tissues was independently correlated with the metastasis of lung cancer.The expression of KCNF1mRNA and the transfer related factor EGFR,C-erbB-2,CXCR2,MMP-9,the expression of VEGF and HIF-l α was positively correlated(r=0.633～0.803,all P<0.05).The 3-year survival rate of patients with high expression of KCNF1 protein was significantly shorter than that of patients with low expression(HR=1.85,95%CI:1.04～3.27,P=0.032).Conclusion KCNF1mRNA and protein are highly expressed in lung cancer tissues,and its expression level is closely related to the metastasis and prognosis of patients with lung cancer,which is a risk factor for predicting the metastasis of lung cancer.

OBJECTIVE To investigate the ameliorative effect and potential mechanism of imperatorin(IMP)on doxorubicin(DOX)resistance in breast cancer.METHODS The effects of maximum non-toxic concentration(100 μg/mL)of IMP combined with different concentrations of DOX(12.5,25,50,75,100 μg/mL)on the proliferation of MCF-7/DOX cells were determined by MTT method.MCF-7/DOX cells were divided into blank control group(1‰ dimethyl sulfoxide),DOX group(50 μg/mL),IMP+DOX group(100 μg/mL IMP+50 μg/mL DOX)and IMP group(100 μg/mL).mRNA and protein expressions of multidrug resistance protein 1(MDR1)and multidrug resistance-associated protein l in each group were measured.The relevant pathways and targets involved in the improvement of DOX resistance in breast cancer cells by IMP were screened and validated by using transcriptome sequencing technology,along with gene ontology(GO)enrichment analyses and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analyses.RESULTS Compared with DOX alone,the combination of IMP and DOX reduced the half inhibitory concentration of DOX on MCF-7/DOX cells from 81.965 μg/mL to 43.170 μg/mL,the reverse fold was 1.90,and the mRNA expression of MDR1 was significantly down-regulated(P＜0.05).The results of GO enrichment analyses and KEGG pathway enrichment analyses indicated that the reversal of DOX resistance in breast cancer by IMP was mainly associated with the regulation of biological processes such as detoxification,multiple biological processes,and cell killing.The main pathway involved was the p53 signaling pathway,and the key targets mainly included constitutively photomorphogenic protein 1(COP1),cyclin E1(CCNE1),growth arrest and DNA damage-inducible protein 45A(GADD45A)and GADD45B.The results of the verification experiments showed that compared with DOX group,there was a trend of up-regulation of COP1 mRNA,and significant down-regulation of CCNE1,GADD45A,and GADD45B mRNA expression in IMP+DOX group(P＜0.05).CONCLUSIONS The effect of IMP in ameliorating DOX resistance in breast cancer is related to its regulation of COP1,CCNE1,GADD45A and GADD45B targets in the p53 signaling pathway.

Objective To carry out quality control testing of anesthesia ventilators to ensure the reliability and safety during their clinical use.Methods Totally 88 anesthesia ventilators used in some hospital underwent quality control testing in terms of tidal volume,peak airway pressure and positive end-expiratory pressure by using a gas flow analyzer according to JJF(E)61-2020 Calibration Specification of Anesthetic Machines,which included 31 ones,36 ones,12 ones and 9 ones respectively from brand A,B,C and D.The Kruskal-Wallis test was used to analyze the variability of the measured values and errors of the performance indicators between different brands of anesthesia ventilators,the chi-square test was applied to discussing the variability of the accuracy class of the performance indicators between different brands of anesthesia ventilators,and the Pearson correlation coefficient was adopted to investigate the correlation between the years of use and the absolute values of the relative errors of the performance indicators.Results The 88 anesthesia ventilators had the overall pass rate for quality control testing being 42.05%,of which,brand B had the highest pass rate(52.78%)and brand C had the lowest pass rate(8.33%).Brand B gained advantages in tidal volume when compared with brand A,C and D,with the differences being significant(P<0.05);brand A behaved the best in peak airway pressure and positive end-expiratory pressure when compared with brand B,C and D,with the differences being significant(P<0.05).Brand A had the highest proportion(63.08%)of distinction and credit in terms of the three performance indicators.The absolute value of the relative error in tidal volume was positively correlated with the years of use at the 3 measurement points for setting values of 400,600,and 800 mL respectively(P<0.05),and there was a significant correlation between the absolute value of the relative error and the years of use at a peak airway pressure setting of 10 cmH2O(1 cmH2O=98.07 Pa)(P<0.05).Conclusion Quality control testing of anesthesia ventilators contributes to finding the risks during their application,which can be an effective tool to ensure the safety of anesthesia ventilators used in medical institutions.[Chinese Medical Equipment Journal,2025,46(9):75-80]

Objective To evaluate the value of biparametric MRI(bpMRI)radiomics for predicting postoperation Gleason score(GS)upgrade of prostate cancer(PCa).Methods Totally 344 PCa patients who underwent radical prostatectomy(RP)were retrospectively enrolled and divided into training set(n=241)and test set(n=103)at a ratio of 7∶3.T2WI,diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)map radiomics signatures were constructed based on preoperative bpMRI,respectively,then logistic regression(LR)algorithm was used to establish bpMRI radiomics model.Univariate and multivariate logistic regression analyses were performed to screen independent risk factors for postoperation GS upgrade of PCa,and a clinical model was constructed.Then a clinical-radiomics combined model was established based on clinical model and bpMRI radiomics model.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of each model for predicting postoperation GS upgrade of PCa.Results Elevated preoperative prostate imaging reporting and data system(PI-RADS)score and reduced biopsy Gleason grade group(GG)were both independent risk factors of postoperation GS upgrade of PCa(both P＜0.05).The AUC of bpMRI radiomics model and clinical-radiomics combined model for predicting postoperation GS upgrade of PCa were higher than that of single-sequence radiomics signatures and clinical model(all P＜0.05),while no significant difference was found between the former two(P＞0.05).The clinical-radiomics combined model demonstrated good efficacy for predicting postoperation GS upgrade of PCa with different biopsy GG before operation,with AUC ranging from 0.835 to 0.949 in training set and 0.803 to 0.948 in test set.Conclusion bpMRI radiomics model could effectively predict postoperation GS upgrade of PCa.

Objective: To analyze the changes in classroom lighting environment of schools in Suzhou and their impact on refractive progression among primary and secondary school students, so as to provide the basis for accurate provention and control of myopia. Methods: A baseline investigation was conducted in October 2022 by using a stratified cluster random sampling method to recruit primary and secondary school students from Suzhou. A follow up visit was performed in October 2023. A total of 12 302 students and 360 classrooms that participated in both surveys were included analysis. The visual acuity progression over one year and classroom lighting conditions were assessed. Group comparisons were performed by using the Wilcoxon or Kruskal-Wallis rank-sum, and Chi-square tests. Multivariate Logistic regression was employed to identify the major factors influencing refractive changes. Results: The compliance rate of average illuminance on classroom blackboard surface increased from 72.22% to 75.28%, while the compliance rate of average illuminance on desks decreased from 89.44% to 87.22%, the overall myopia rate among students rose from 59.63% to 66.99% from 2022 to 2023. The average annual progression of equivalent spherical power(SE) in the right eye of students was -0.25(-0.75,0.06)D. Significant statistical differences were observed in the annual mean changes across different school levels, regions, baseline refractive statuses, and classroom lighting environment change groups ( Z/H =316.59, -8.27, 38.80 , 51.01, all P <0.05). Multivariate Logistic regression analysis showed that pre myopia, low myopia, junior high school, senior high school, vocational high school, and improved classroom lighting environment were protective factors of reducing the risk of rapid progression in refractive error ( OR =0.58, 0.69, 0.81, 0.50, 0.28, 0.82, all P <0.05). Conversely, female students and rural students had higher risks of rapid myopia progression ( OR =1.09, 1.42, both P <0.05). Conclusions Over one year follow up, the complance rate of classroom lighting indicators in Suzhou remaines stable, while students refractive status shows a trend toward myopia. Improving classroom lighting environment can reduce the risk of rapid myopia progression.