Peripheral nerve injury refers to the impairment that occurs when the sens-ory nerves and motor nerves are damaged.Professor Zhang Hong has unique insights into the treatment of neurologically diseases in children.Based on the different manifestations of the disease,it is categorized under the traditional Chinese medicine concepts of"atro-phy syndrome","muscle injury"and"Bi syndrome".Professor Zhang believes that the disease is fundamentally rooted in the liver and kidneys,and that treatment should notonly address the acquired symptoms but also nurture the innate foundation.This article a-nalyze and summarize professor Zhang's clinical experience in using acupuncture,electroa-cupuncture,moving cupping,and moxibustion in the comprehensive treatment of peripheral nerve injury,providing a reference for clinical treatment of peripheral neuropathy in chil-dren.

Objective To investigate the clinical effect of autologous bone combined with allogeneic bone in repairing bone defect after microwave in situ inactivation for bone giant cell tumor around the knee.Methods A retrospective analysis was conducted on the clinical data of 39 patients with bone giant cell tumor around the knee treated in our hospital from January 2015 to December 2022.The tumor tissues of all patients were performed microwave in situ inactivation first,then followed by curettage;the subchondral bone defect adjacent to the articular surface was reconstructed with autologous bone graft,and the remaining tumor cavity was filled with a composite of autologous and allogeneic bone;then a locking plate was applied for protective fixation.The early outcomes including operative time,intraoperative blood loss,hospital stay,wound healing,and surgery-related complications were recorded.The regular follow-up was conducted after surgery,then the tumor recurrence or metastasis was observed and the status of internal fixation and bone graft fusion along with its fusion time were recorded.The knee functions before operation and at the end of follow-up were evaluated with the Musculoskeletal Tumor Society(MSTS)scoring system.The radiographic joint degeneration was evaluated by the Aboulafia classification system at the end of follow-up.Results The patients showed a mean operative time of(134.7±14.2)minutes,an averaged intraoperative blood loss of(153.9±23.0)mL,and a mean hospital stay of(17.4±3.2)days.The patients obtained Ⅰ phase wound healing without any surgery-related complications such as neurovascular injury.All patients underwent the postoperative follow-up,without local recurrence or metastasis cases during the follow-up.At the end of follow-up,the MSTS score of patients was higher than that before operation(P<0.05),with an excellent and good rate of knee function recovery of 89.7%.At the end of follow-up,X-ray films showed good filling of the lesion and bone graft fusion,with a mean fusion time of(9.4±2.1)months.No collapse or fracture of the articular surface occurred.According to the Aboulafia classification,there were 20 cases of grade 0,11 cases of grade 1,and 8 cases of grade 2.Conclusion The autologous bone and allogeneic bone in repair of bone defect after microwave in situ inactivation for bone giant cell tumor around the knee has perfect knee function recovery,and can effectively prevent the collapse and degeneration of articular surfaces,which helps in the reconstruction of tumor cavity.

Objective:To analyze the clinical effect of XinjiaHuanglong Decoction add and subtract combined with auricular point sticking on delirium after hip fracture in elderly patients.Methods:Select 80 elderly patients with postoperative delirium after hip fracture admitted to our hospital from January 2022 to June 2024,and divide them into a matched group and an observation group,with 40 cases in each group.The matched group was treated with olanzapine,and the observation group was treated with XinjiaHuanglong Decoction add and subtract combined with auricular point sticking.Inflammatory response indexes(IL-6,TNF-α,hs-CRP)and stress response indexes(dopamine(DA),5-hydroxytryptamine(5-HT)were detected before and Post-treatment in both groups.Compare the Delirium Rating Scale 98(DRS-R-98)scores,Mini Mental State Examination(MMSE)scores,and duration of delirium between two groups before and Post-treatment,comprehensively evaluate the efficacy,and record the occurrence of adverse reactions.Results:Post-treatment,the DRS-R-98 score in the observation group was lower than that in the matched group,and the MMSE score was higher than that in the matched group(P＜0.05);The duration of delirium in the observation group was shorter than that in the matched group,and the overall effective rate was higher than that in the matched group(P＜0.05).The levels of inflammatory response indicators in the observation group were lower than those in the matched group Post-treatment(P＜0.05);The level of stress response indicators in the observation group was lower than that in the matched group Post-treatment(P＜0.05);There was no difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:XinjiaHuanglong Decoction add and subtract combined with auricular point sticking has a certain effect on improving delirium after hip fracture in the elderly,and can shorten the duration of delirium,which may be related to reducing inflammation and stress response,and it is safe and worthy of clinical application.

Objective:To analyze the clinical effect of XinjiaHuanglong Decoction add and subtract combined with auricular point sticking on delirium after hip fracture in elderly patients.Methods:Select 80 elderly patients with postoperative delirium after hip fracture admitted to our hospital from January 2022 to June 2024,and divide them into a matched group and an observation group,with 40 cases in each group.The matched group was treated with olanzapine,and the observation group was treated with XinjiaHuanglong Decoction add and subtract combined with auricular point sticking.Inflammatory response indexes(IL-6,TNF-α,hs-CRP)and stress response indexes(dopamine(DA),5-hydroxytryptamine(5-HT)were detected before and Post-treatment in both groups.Compare the Delirium Rating Scale 98(DRS-R-98)scores,Mini Mental State Examination(MMSE)scores,and duration of delirium between two groups before and Post-treatment,comprehensively evaluate the efficacy,and record the occurrence of adverse reactions.Results:Post-treatment,the DRS-R-98 score in the observation group was lower than that in the matched group,and the MMSE score was higher than that in the matched group(P＜0.05);The duration of delirium in the observation group was shorter than that in the matched group,and the overall effective rate was higher than that in the matched group(P＜0.05).The levels of inflammatory response indicators in the observation group were lower than those in the matched group Post-treatment(P＜0.05);The level of stress response indicators in the observation group was lower than that in the matched group Post-treatment(P＜0.05);There was no difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:XinjiaHuanglong Decoction add and subtract combined with auricular point sticking has a certain effect on improving delirium after hip fracture in the elderly,and can shorten the duration of delirium,which may be related to reducing inflammation and stress response,and it is safe and worthy of clinical application.

Peripheral nerve injury refers to the impairment that occurs when the sens-ory nerves and motor nerves are damaged.Professor Zhang Hong has unique insights into the treatment of neurologically diseases in children.Based on the different manifestations of the disease,it is categorized under the traditional Chinese medicine concepts of"atro-phy syndrome","muscle injury"and"Bi syndrome".Professor Zhang believes that the disease is fundamentally rooted in the liver and kidneys,and that treatment should notonly address the acquired symptoms but also nurture the innate foundation.This article a-nalyze and summarize professor Zhang's clinical experience in using acupuncture,electroa-cupuncture,moving cupping,and moxibustion in the comprehensive treatment of peripheral nerve injury,providing a reference for clinical treatment of peripheral neuropathy in chil-dren.

Objective To investigate the clinical effect of autologous bone combined with allogeneic bone in repairing bone defect after microwave in situ inactivation for bone giant cell tumor around the knee.Methods A retrospective analysis was conducted on the clinical data of 39 patients with bone giant cell tumor around the knee treated in our hospital from January 2015 to December 2022.The tumor tissues of all patients were performed microwave in situ inactivation first,then followed by curettage;the subchondral bone defect adjacent to the articular surface was reconstructed with autologous bone graft,and the remaining tumor cavity was filled with a composite of autologous and allogeneic bone;then a locking plate was applied for protective fixation.The early outcomes including operative time,intraoperative blood loss,hospital stay,wound healing,and surgery-related complications were recorded.The regular follow-up was conducted after surgery,then the tumor recurrence or metastasis was observed and the status of internal fixation and bone graft fusion along with its fusion time were recorded.The knee functions before operation and at the end of follow-up were evaluated with the Musculoskeletal Tumor Society(MSTS)scoring system.The radiographic joint degeneration was evaluated by the Aboulafia classification system at the end of follow-up.Results The patients showed a mean operative time of(134.7±14.2)minutes,an averaged intraoperative blood loss of(153.9±23.0)mL,and a mean hospital stay of(17.4±3.2)days.The patients obtained Ⅰ phase wound healing without any surgery-related complications such as neurovascular injury.All patients underwent the postoperative follow-up,without local recurrence or metastasis cases during the follow-up.At the end of follow-up,the MSTS score of patients was higher than that before operation(P<0.05),with an excellent and good rate of knee function recovery of 89.7%.At the end of follow-up,X-ray films showed good filling of the lesion and bone graft fusion,with a mean fusion time of(9.4±2.1)months.No collapse or fracture of the articular surface occurred.According to the Aboulafia classification,there were 20 cases of grade 0,11 cases of grade 1,and 8 cases of grade 2.Conclusion The autologous bone and allogeneic bone in repair of bone defect after microwave in situ inactivation for bone giant cell tumor around the knee has perfect knee function recovery,and can effectively prevent the collapse and degeneration of articular surfaces,which helps in the reconstruction of tumor cavity.

Facing of mounting resource constraints and rising demands for personalization in medical education,regional anatomy teaching urgently requires transformation.In this paper,we focus on the regional anatomy of the thoracic wall,in order to explore a novel AI-driven teaching paradigm.Anchored in the core principle of"virtual-real integration with cadaveric dissection as the cornerstone,"the paradigm redefines educational objective and constructs an intelligent,closed-loop teaching model integrating students,computers,and instructors.Leveraging the robust support of digital intelligence(e.g.,DeepSeek),this paradigm incorporates interactive method including group collaboration,branching instruction,and gamified assessments.It achieves a comprehensive intelligent transformation of the entire teaching process-from goal setting and plan customization to activity implementation,task completion,outcome exchange,multidimensional evaluation,and reflective iteration.This new paradigm centers on medical students and leverages digital intelligence to activate deep personalized learning potential.It seamlessly integrates fundamental anatomical knowledge with clinical scenarios(e.g.,key anatomy in breast cancer surgery,flap design in breast reconstruction),and significantly enhances clinical decision-making abilities,scientific research and innovative thinking,as well as medical humanistic literacy,paving a new path for intelligent medical education.

Objective To understand the implementation status of"Diagnosis of Ascariasis"(WS/T 565-2017)and provide a scientific basis for promoting,revising,and improving the Standard.Methods Using the convenient sampling method,the investigation targeted professional and technical personnel at the provincial,city,county,and township levels engaged in parasitic disease prevention,control,or diagnosis and treatment in Anhui and Sichuan provinces.No less than 150 individuals were included in each province.The implementation survey of Diagnosis of Ascariasis(WS/T 565-2017)was conducted by the subjects completing a questionnaire by themselves.Results The response rate to the questionnaire was 91.90%(386/420).The awareness and utilization rates of the Standard were 81.87%and 49.22%,respectively and both increased with age(χ2 trend=7.977 and 19.016,respectively,P＜0.01).Respondents with college degrees(90.72%)had a higher awareness rate(χ2=8.619,P＜0.05).In terms of utilization rate,males(58.38%),those with college degrees(67.01%),staff members of provincial-level units(77.78%),and personnel in medical institutions(71.43%)had higher utilization rates(χ2=13.486,17.166,8.426,and 5.956,respectively,all P＜0.05).The survey indicated that 57.77%of the work units of respondents have conducted promotional activities,and 53.89%of the work units of respondents have sent personnel to participate in training.Moreover,this proportion tended to increase as the unit level decreased(χ2 trend=9.403 and 14.729,P＜0.01).The level of participation in publicity and training by medical institutions(89.29%)was significantly higher than that of disease control institutions(55.31%and 51.12%,respectively,χ2=12.290 and 15.225,P＜0.01).Furthermore,training participation is a crucial factor in enhancing awareness rates.A total of 368 respondents(95.34%)reported that their work units have conducted testing for ascariasis.Additionally,378 individuals(97.92%)believe that the Standard is"applicable"or"basically applicable,"while 369(95.60%)felt that no revisions were needed.Conclusions The results indicated that"Diagnosis of Ascariasis"(WS/T 565-2017)remains applicable to the diagnostic needs of ascariasis and it is recommended to strengthen its promotion and implementation.

Progressive pulmonary fibrosis (PPF) is a progressive and lethal condition with few effective treatment options. Improvements in quality of life for patients with PPF remain limited even while receiving treatment with approved antifibrotic drugs. Traditional Chinese medicine (TCM) has the potential to improve cough, dyspnea and fatigue symptoms of patients with PPF. TCM treatments are typically diverse and individualized, requiring urgent development of efficient and precise design strategies to identify effective treatment options. We designed an innovative Bayesian adaptive two-stage trial, hoping to provide new ideas for the rapid evaluation of the effectiveness of TCM in PPF. An open-label, two-stage, adaptive Bayesian randomized controlled trial will be conducted in China. Based on Bayesian methods, the trial will employ response-adaptive randomization to allocate patients to study groups based on data collected over the course of the trial. The adaptive Bayesian trial design will employ a Bayesian hierarchical model with "stopping" and "continuation" criteria once a predetermined posterior probability of superiority or futility and a decision threshold are reached. The trial can be implemented more efficiently by sharing the master protocol and organizational management mechanisms of the sub-trial we have implemented. The primary patient-reported outcome is a change in the Leicester Cough Questionnaire score, reflecting an improvement in cough-specific quality of life. The adaptive Bayesian trial design may be a promising method to facilitate the rapid clinical evaluation of TCM effectiveness for PPF, and will provide an example for how to evaluate TCM effectiveness in rare and refractory diseases. However, due to the complexity of the trial implementation, sufficient simulation analysis by professional statistical analysts is required to construct a Bayesian response-adaptive randomization procedure for timely response. Moreover, detailed standard operating procedures need to be developed to ensure the feasibility of the trial implementation. Please cite this article as: Zhang C, Nie YS, Zhang CT, Yang HJ, Zhang HR, Xiao W, Cui GF, Li J, Li SJ, Huang QS, Yan SY. An adaptive Bayesian randomized controlled trial of traditional Chinese medicine in progressive pulmonary fibrosis: Rationale and study design. J Integr Med. 2025; 23(2): 138-145.
Female ; Humans ; Male ; Bayes Theorem ; Disease Progression ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional/methods* ; Pulmonary Fibrosis/therapy* ; Quality of Life ; Randomized Controlled Trials as Topic ; Research Design ; Adaptive Clinical Trials as Topic

OBJECTIVE: High-altitude hypoxia exposure often damages hippocampus-dependent learning and memory. Nogo-A is an important axonal growth inhibitory factor. However, its function in high-altitude hypoxia and its mechanism of action remain unclear. METHODS: In an in vivo study, a low-pressure oxygen chamber was used to simulate high-altitude hypoxia, and genetic or pharmacological intervention was used to block the Nogo-A/NgR1 signaling pathway. Contextual fear conditioning and Morris water maze behavioral tests were used to assess learning and memory in rats, and synaptic damage in the hippocampus and changes in oxidative stress levels were observed. In vitro, SH-SY5Y cells were used to assess oxidative stress and mitochondrial function with or without Nogo-A knockdown in Oxygen Glucose-Deprivation/Reperfusion (OGD/R) models. RESULTS: Exposure to acute high-altitude hypoxia for 3 or 7 days impaired learning and memory in rats, triggered oxidative stress in the hippocampal tissue, and reduced the dendritic spine density of hippocampal neurons. Blocking the Nogo-A/NgR1 pathway ameliorated oxidative stress, synaptic damage, and the learning and memory impairment induced by high-altitude exposure. CONCLUSION: Our results demonstrate the detrimental role of Nogo-A protein in mediating learning and memory impairment under high-altitude hypoxia and suggest the potential of the Nogo-A/NgR1 signaling pathway as a crucial therapeutic target for alleviating learning and memory dysfunction induced by high-altitude exposure. GRAPHICAL ABSTRACT available in www.besjournal.com.
Animals ; Oxidative Stress ; Hippocampus/metabolism* ; Rats ; Nogo Proteins/genetics* ; Male ; Rats, Sprague-Dawley ; Hypoxia/metabolism* ; Altitude ; Synapses ; Humans ; Altitude Sickness/metabolism*