OBJECTIVE: To observe the clinical effect of acupuncture and moxibustion combined with umbilical therapy on anxiety and depression in patients with neurogenic bladder (NB) after spinal cord injury (SCI). METHODS: Thirty cases of NB after SCI with anxiety and depression were selected and treated with acupuncture and moxibustion combined with umbilical therapy. Acupuncture was applied at Baihui (GV20), Yintang (GV24⁺), Sanyinjiao (SP6), Shenmen (HT7), Hegu (LI4), Taichong (LR3), once a day, continuous treatment for 4 weeks. Ginger moxibustion was applied at the bladder meridian of foot taiyang and governor vessel, once a day, continuous treatment for 4 weeks. In treatment of umbilical therapy, Chaihu (Radix Bupleuri), Yujin (Radix Curcumae), Rougui (Cortex Cinnamomi) were ground and mixed with the same amount of honey, put into the application, and the application was placed on the navel after filling the navel with fine salt, once a day for 4 weeks. Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, urodynamic indexes (maximum urinary flow rate [Qmax], maximum detrusor pressure [Pdet-max], residual urine volume [RUV]), neurogenic bladder symptom score (NBSS), urinary symptom distress scale (USDS) score were compared before and after treatment, and the clinical efficacy was evaluated. RESULTS: After treatment, the scores of HAMA, HAMD, NBSS, USDS and RUVwere lower than those before treatment (P<0.05), and Qmax and Pdet-max were higher than those before treatment (P<0.05). The total effective rate was 93.3 (28/30). CONCLUSION Acupuncture and moxibustion combined with umbilical therapy can effectively relieve anxiety and depression symptoms, improve urination disorders in patients with NB after SCI.
Humans ; Moxibustion ; Male ; Female ; Adult ; Middle Aged ; Acupuncture Therapy ; Spinal Cord Injuries/psychology* ; Depression/etiology* ; Anxiety/etiology* ; Urinary Bladder, Neurogenic/etiology* ; Young Adult ; Aged ; Combined Modality Therapy ; Acupuncture Points

OBJECTIVE: To explore the application value and clinical effect of 3D printing combined with customized bone plate in the treatment of acetabular fracture. METHODS: From June 2020 to June 2022, 11 patients with acetabular fractures underwent preoperative planning using 3D printing technology and were treated with customized bone plates including 8 males and 3 females, aged 25 to 66 years old. The fractures were classified according to Letournel-Judet:4 posterior wall fractures, 2 T-type fractures, 2 transverse posterior wall fractures, 2 double column fractures, and 1 anterior column with posterior semi-transverse fractures. The operative time, intraoperative blood loss, intraoperative fluoroscopy times, postoperative drainage volume, postoperative fracture healing time, and hip function score were recorded and analyzed. RESULTS: The operation time of 11 patients was 80 to 150 min, intraoperative blood volume was 150 to 700 ml, fluoroscopy frequency was 2 to 6, postoperative drainage flow was 60 to 195 ml, and the fracture healing time was 2.5 to 6.0 months. Fracture reduction was evaluated according to Matta score:anatomical reduction in 3 cases and satisfactory reduction in 8 cases. Eleven patients were followed up for 7 to 18 months. The hip Merle d'Aubigne function scores were excellent in 6 cases, good in 3 cases, fair in 1 case and poor in 1 case. Incision fat liquefaction occurred in 1 case and obturator nerve traction in 1 case. CONCLUSION The application of 3D printing technology combined with customized bone plates in the treatment of acetabular fracture is effective. In addition, the printed model can provide the operator with the results of the three-dimensional shape of the fracture, which is convenient for surgical reduction and effectively improves the efficiency of surgery.
Humans ; Female ; Male ; Middle Aged ; Acetabulum/surgery* ; Printing, Three-Dimensional ; Adult ; Aged ; Bone Plates ; Fractures, Bone/surgery* ; Fracture Fixation, Internal/methods*

Objective:To evaluate the effectiveness and safety of thulium fiber laser enucleation of the prostate(ThuFLEP)in the treatment of oversized(＞200 mL)prostate.Methods:Clinical data of 475 benign prostatic hyperplasia(BPH)patients operated by the same urologist at Peking University First Hospital from January 2022 to May 2024 were retrospectively analyzed,all of whom were treated with thu-lium fiber laser,and the patients were divided into three groups according to the total volume of the pros-tate(TPV):group A(TPV＜100 mL),group B(100 mL≤TPV＜200 mL),and group C(TPV ≥200 mL).The age of the patients in the three groups[(69.38±7.79)years,(69.64±8.69)years,(70.32±7.44)years],International Prostate Symptom Score(IPSS)[(22.7±1.9),(22.8±2.7),(25.8±3.7)],and the maximum urinary flow rate(Qmax)[(7.9±2.7)mL/s,(9.3±4.3)mL/s,(9.9±3.3)mL/s]were not statistically significant(P＞0.05).The prostate volume in the three groups[(103.49±46.19)mL,(75.73±30.69)mL,(273.49±49.19)mL]and prostate specific antigen(PSA)[3.52(1.05,8.76)μg/L,6.78(1.61,7.45)μg/L,8.52(5.05,12.76)μg/L]were statistically significant(P＜0.05).Results:All surgeries were successfully completed.The dif-ferences in enucleation time[30.0(21.2,44.5)min,41.6(31.2,52.5)min,45.1(35.2,50.0)min]and hospitalization time[(6.06±1.21)d,(6.15±1.50)d,(7.71±1.74)d]among the three groups were not statistically significant(P＞0.05);and the differences in the postoperative in-dwelling catheter time[(4.0±1.4)d,(4.0±1.3)d,(6.6±1.1)d],operative time[61(42,89)min,82(62,105)min,115(96,142)min],enucleation efficiency[1.29(0.71,1.56)g/min,1.67(1.23,2.15)g/min,2.74(2.20,3.34)g/min],and hemoglobin drop values[12(7,19)g/L,17(11,24)g/L,27(19,35)g/L]were statistically different(P＜0.05).Linear regression ana-lysis was used to show a strong positive linear correlation between enucleation efficiency and enucleation weight(r=0.880,P＜0.001),and the enucleation efficiency increased with the increase of prostate volume.The differences in IPSS[(6.6±1.7),(6.2±1.4),(4.6±1.1)]and Qmax[(18.9±3.1)mL/s,(16.8±3.8)mL/s,(22.9±7.1)mL/s]were not statistically significant among the three groups(P＞0.05),and the differences in IPSS and Qmax were statistically significant compared with those before surgery.The differences were statistically significant in preoperative comparisons,but the postoperative urinary flow rate of group C increased significantly more than the remaining two groups in terms of Qmax(P＜0.05).The patients in the three groups were followed up for 3 months,and post-operative complications were categorized into Clavien-Dindo Ⅰ(urinary retention,persistent hematu-ria),Clavien-Dindo Ⅱ(glandular remnants,urinary tract infection,blood transfusion)and Clavien-Dindo Ⅲ(urethral stenosis,contracture of the bladder neck,and reoperation for hemorrhage)based on the Clavien-Dindo Complications System score,the incidence of Clavien-Dindo in the three groups was 5.2％(13 cases),6.7％(12 cases)and 12.1％(7 cases),respectively,with statistically significant differences(P＜0.05);among them,there were statistically significant differences in urinary infection,blood transfusion and bleeding reoperation(P＜0.05),and there was no statistically significant difference in the remaining complications(P＞0.05).Conclusion:The risk of blood transfusion and re-hemostasis increases with larger prostate volume,the efficiency of enucleation increases with the increase of prostate vo-lume,and thulium fiber laser prostate enucleation is safe and effective in the treatment of large-volume BPH.

Objective To investigate the relationship between polymorphisms at the rs3093030 and rs5498 loci of the intercellular adhesion molecule-1(ICAM-1)gene in combination with high sensitive C-reactive protein(hs-CRP)and susceptibility to type 2 diabetes mellitus complicated with HTN(T2MH)susceptibility.Methods 200 newly diagnosed T2DM patients,175 T2MH patients and 200 healthy controls from Affiliated Hospital of Guilin Medical University between September 2021 and January 2022.Single nucleotide polymorphisms(SNP)-scan high-throughput technology was used to detect the genotyping of serum rs3093030 and rs5498 polymorphisms in the study subjects and to detect hs-CRP levels in peripheral plasma to analysed and explore the correlation between them and the development of T2MH.Results The peripheral blood hs-CRP expression level of patients in the T2MH group[2.65(1.18,6.50)mg/L]was significantly higher than that in the T2DM group[1.82(0.80,4.48)mg/L]and healthy controls[1.02(0.54,2.29)mg/L],and the differences were statistically significant(Z=-2.729,-7.132,all P<0.001).After population classification by genotype,it was found that compared with healthy controls,rs3093030 CC(Z=-3.912,-5.800),rs5498 AA(Z=-3.293,-4.944)and AG(Z=-3.275,-4.872)genotypes had significantly higher hs-CRP levels.The peripheral blood hs-CRP levels of patients with rs3093030 CT genotype in the T2MH group were significantly higher than that of healthy controls(Z=-3.987),and the differences was statistically significant(all P<0.001),respectively.Meanwhile,regression analysis showed that HS-CRP was a risk factor for both T2MH group and healthy control group(OR=1.181,95%CI=1.095～1.274,P<0.001).Conclusion There is a correlation between ICAM-1 gene rs3093030 and rs5498 polymorphisms combined with hs-CRP levels in peripheral blood and the pathogenesis of T2MH patients.

Objective To observe the difference of bone micro-structure in different regions of proximal femur,micro-CT scanning was performed on 30 proximal femur specimens to explain the mechanism of proximal femur fracture and to provide anatomical basis for prosthesis design.Methods Totally 30 intact proximal femur specimens were obtained from 60-80 year-old cadavers.Micro-CT scanning was used to measure the trabecular thickness(Tb.Th),trabecular number(Tb.N),trabecular space(Tb.Sp),connectivity(Conn)and bone mineral density(BMD)and other parameters in 7 regions of proximal femur,including proximal pressure trabecular(PPT),distal pressure trabecular(DPT),femoral head-neck junction(FHNJ),head and neck of femoral neck(HNFN),the base of femoral neck(BPFN),intertrochanteric line(IL)and greater trochanter(GT).Results The bone mineral density of IL and GT were higher than those of BPFN,FHNJ,DPT and PPT.The trabecular thickness of GT was the largest,followed by IL,BPFN and HNFN,and the smallest was FHNJ,DPT and PPT.The trabecular space of IL was larger than that of GT,and the data of both were larger than those of other parts,among which DPT and PPT were the smallest.The trabecular number of IL and GT were the smallest,BPFN,HNFN and FHNJ were larger,and DPT was the largest.The volume fraction of IL was the smallest,BPFN and HNFN were larger,DPT and PPT were the largest.Conclusion The bone density,trabecular thickness,bone volume,and total volume of GT and IL in the proximal femur of elderly patients are all relatively large,so the reason for the high incidence of fractures is not due to weak internal bone microstructure;The bone density,trabecular thickness,and trabecular gap at the proximal and distal ends of the vertical trabecular bone are relatively small.If it is necessary to perform core decompression for prosthesis filling at this location,the design should be conducive to the mechanical conduction of the prosthesis and the regeneration of surrounding bone tissue.

BACKGROUND:Degeneration of nucleus pulposus cells is a key component of intervertebral disc degeneration.Ferroptosis,a novel form of programmed cell death,is closely associated with the onset and progression of intervertebral disc degeneration;however,its precise mechanisms remain unclear.OBJECTIVE:To establish an oxidative stress model in vitro by inducing ferroptosis in nucleus pulposus cells using tert-butyl hydroperoxide and to investigate the mechanisms of tert-butyl hydroperoxide-induced ferroptosis in nucleus pulposus cells,thereby elucidating the role of ferroptosis in the pathogenesis of intervertebral disc degeneration.METHODS:Nucleus pulposus cells were treated with varying concentrations of tert-butyl hydroperoxide(0,25,50,100,and 200 μmol/L),and cell morphology and viability were assessed using fluorescence microscopy and the cell counting kit-8 assay.Interventions with 100 μmol/L tert-butyl hydroperoxide,10 μmol/L RSL3,or dimethylsulfoxide were applied to nucleus pulposus cells,and cell proliferation was evaluated using the EdU assay.The expression levels of ferroptosis-related proteins(glutathione peroxidase 4,ferritin heavy chain 1,PTGS2,and ACSL4)and intervertebral disc degeneration marker proteins(matrix metalloproteinase 13 and Col2A)were analyzed via western blot and immunofluorescence.Additionally,reactive oxygen species and lipid peroxidation levels were quantified using the reactive oxygen species detection kit and C11-BODIPY probe.Mitochondrial morphological changes were observed under transmission electron microscopy.RESULTS AND CONCLUSION:(1)tert-Butyl hydroperoxide treatment significantly reduced the viability and proliferation of nucleus pulposus cells.(2)tert-Butyl hydroperoxide induced typical ferroptosis-related morphological changes in nucleus pulposus cells.(3)tert-Butyl hydroperoxide exposure led to a decrease in the expression of ferroptosis-suppressing proteins glutathione peroxidase 4 and ferritin heavy chain 1,while increasing the expression of ferroptosis-promoting factors ACSL4 and PTGS2.(4)tert-Butyl hydroperoxide elevated intracellular reactive oxygen species production and lipid peroxidation levels in nucleus pulposus cells.(5)Transmission electron microscopy revealed ferroptosis-specific mitochondrial changes in nucleus pulposus cells treated with tert-butyl hydroperoxide,including contraction,reduced cristae,and increased membrane density.(6)tert-Butyl hydroperoxide treatment also resulted in the increased expression of matrix metalloproteinase 13 and decreased expression of Col2A in nucleus pulposus cells.In conclusion,tert-butyl hydroperoxide induces ferroptosis in nucleus pulposus cells,contributing to the development of intervertebral disc degeneration.This process may represent a key pathological mechanism in intervertebral disc degeneration and offers potential targets for developing novel therapeutic strategies.

Objective:To evaluate the effectiveness and safety of thulium fiber laser enucleation of the prostate(ThuFLEP)in the treatment of oversized(＞200 mL)prostate.Methods:Clinical data of 475 benign prostatic hyperplasia(BPH)patients operated by the same urologist at Peking University First Hospital from January 2022 to May 2024 were retrospectively analyzed,all of whom were treated with thu-lium fiber laser,and the patients were divided into three groups according to the total volume of the pros-tate(TPV):group A(TPV＜100 mL),group B(100 mL≤TPV＜200 mL),and group C(TPV ≥200 mL).The age of the patients in the three groups[(69.38±7.79)years,(69.64±8.69)years,(70.32±7.44)years],International Prostate Symptom Score(IPSS)[(22.7±1.9),(22.8±2.7),(25.8±3.7)],and the maximum urinary flow rate(Qmax)[(7.9±2.7)mL/s,(9.3±4.3)mL/s,(9.9±3.3)mL/s]were not statistically significant(P＞0.05).The prostate volume in the three groups[(103.49±46.19)mL,(75.73±30.69)mL,(273.49±49.19)mL]and prostate specific antigen(PSA)[3.52(1.05,8.76)μg/L,6.78(1.61,7.45)μg/L,8.52(5.05,12.76)μg/L]were statistically significant(P＜0.05).Results:All surgeries were successfully completed.The dif-ferences in enucleation time[30.0(21.2,44.5)min,41.6(31.2,52.5)min,45.1(35.2,50.0)min]and hospitalization time[(6.06±1.21)d,(6.15±1.50)d,(7.71±1.74)d]among the three groups were not statistically significant(P＞0.05);and the differences in the postoperative in-dwelling catheter time[(4.0±1.4)d,(4.0±1.3)d,(6.6±1.1)d],operative time[61(42,89)min,82(62,105)min,115(96,142)min],enucleation efficiency[1.29(0.71,1.56)g/min,1.67(1.23,2.15)g/min,2.74(2.20,3.34)g/min],and hemoglobin drop values[12(7,19)g/L,17(11,24)g/L,27(19,35)g/L]were statistically different(P＜0.05).Linear regression ana-lysis was used to show a strong positive linear correlation between enucleation efficiency and enucleation weight(r=0.880,P＜0.001),and the enucleation efficiency increased with the increase of prostate volume.The differences in IPSS[(6.6±1.7),(6.2±1.4),(4.6±1.1)]and Qmax[(18.9±3.1)mL/s,(16.8±3.8)mL/s,(22.9±7.1)mL/s]were not statistically significant among the three groups(P＞0.05),and the differences in IPSS and Qmax were statistically significant compared with those before surgery.The differences were statistically significant in preoperative comparisons,but the postoperative urinary flow rate of group C increased significantly more than the remaining two groups in terms of Qmax(P＜0.05).The patients in the three groups were followed up for 3 months,and post-operative complications were categorized into Clavien-Dindo Ⅰ(urinary retention,persistent hematu-ria),Clavien-Dindo Ⅱ(glandular remnants,urinary tract infection,blood transfusion)and Clavien-Dindo Ⅲ(urethral stenosis,contracture of the bladder neck,and reoperation for hemorrhage)based on the Clavien-Dindo Complications System score,the incidence of Clavien-Dindo in the three groups was 5.2％(13 cases),6.7％(12 cases)and 12.1％(7 cases),respectively,with statistically significant differences(P＜0.05);among them,there were statistically significant differences in urinary infection,blood transfusion and bleeding reoperation(P＜0.05),and there was no statistically significant difference in the remaining complications(P＞0.05).Conclusion:The risk of blood transfusion and re-hemostasis increases with larger prostate volume,the efficiency of enucleation increases with the increase of prostate vo-lume,and thulium fiber laser prostate enucleation is safe and effective in the treatment of large-volume BPH.

Objective To investigate the relationship between polymorphisms at the rs3093030 and rs5498 loci of the intercellular adhesion molecule-1(ICAM-1)gene in combination with high sensitive C-reactive protein(hs-CRP)and susceptibility to type 2 diabetes mellitus complicated with HTN(T2MH)susceptibility.Methods 200 newly diagnosed T2DM patients,175 T2MH patients and 200 healthy controls from Affiliated Hospital of Guilin Medical University between September 2021 and January 2022.Single nucleotide polymorphisms(SNP)-scan high-throughput technology was used to detect the genotyping of serum rs3093030 and rs5498 polymorphisms in the study subjects and to detect hs-CRP levels in peripheral plasma to analysed and explore the correlation between them and the development of T2MH.Results The peripheral blood hs-CRP expression level of patients in the T2MH group[2.65(1.18,6.50)mg/L]was significantly higher than that in the T2DM group[1.82(0.80,4.48)mg/L]and healthy controls[1.02(0.54,2.29)mg/L],and the differences were statistically significant(Z=-2.729,-7.132,all P<0.001).After population classification by genotype,it was found that compared with healthy controls,rs3093030 CC(Z=-3.912,-5.800),rs5498 AA(Z=-3.293,-4.944)and AG(Z=-3.275,-4.872)genotypes had significantly higher hs-CRP levels.The peripheral blood hs-CRP levels of patients with rs3093030 CT genotype in the T2MH group were significantly higher than that of healthy controls(Z=-3.987),and the differences was statistically significant(all P<0.001),respectively.Meanwhile,regression analysis showed that HS-CRP was a risk factor for both T2MH group and healthy control group(OR=1.181,95%CI=1.095～1.274,P<0.001).Conclusion There is a correlation between ICAM-1 gene rs3093030 and rs5498 polymorphisms combined with hs-CRP levels in peripheral blood and the pathogenesis of T2MH patients.