OBJECTIVE: To observe the clinical efficacy of different acupuncture methods in the treatment of ankylosing spondylitis (AS) at different stages. METHODS: Thirty-two patients with AS were treated with acupuncture at ashi points (tendon focus), triple acupuncture method was used in the acute phase, accompanied needling method was used in the remission phase, once a day, 5 times a week for 4 weeks. The Bath ankylosing spondylitis disease activity index (BASDAI) score, Bath ankylosing spondylitis functional index (BASFI) score and TCM symptom grade quantitative standard score before and after treatment were observed, and the efficacy was evaluated. RESULTS: After treatment, the BASDAI score, BASFI score and TCM symptom grade quantitative standard score were reduced compared with those before treatment (P<0.01), the effective rate was 96.9% (31/32). CONCLUSION Different acupuncture methods in the treatment of AS at different stages could improve signs and symptoms, such as pain, activity limitation and morning stiffness.
Humans ; Spondylitis, Ankylosing/physiopathology* ; Acupuncture Therapy/methods* ; Male ; Female ; Adult ; Middle Aged ; Young Adult ; Acupuncture Points ; Treatment Outcome

Objective To investigate the therapeutic effects of interleukin 23p19(IL-23p19) monoclonal antibody in the MRL/lpr lupus-like mouse model. Methods A total of 36 female MRL/lpr mice aged 8 weeks were randomly divided into 6 groups: PBS group (blank control), IgG group (isotype IgG), dexamethasone (DEX) group (positive control), and three IL-23p19 monoclonal antibody treatment groups with different dose gradients: low dose (LD, 1 mg/kg), medium dose (MD, 3 mg/kg), and high dose (HD, 10 mg/kg). Drug intervention began at 12 weeks of age via tail vein injection. Urine protein levels were measured using urine protein test strips; serum anti-dsDNA antibody levels were detected by ELISA; serum creatinine and blood urea nitrogen levels were measured using an automatic biochemical analyzer; renal histopathological changes were analyzed by H&E and PAS staining; immunofluorescence was used to assess IgG and C3 immune complex deposition in kidney tissues; flow cytometry was employed to examine the expression of T helper 1(Th1), Th2, Th17, T follicular helper (Tfh), and regulatory T cells(Treg) cell subsets in the spleen; and RT-qPCR was used to detect the expression of related transcription factors in the spleen. Results IL-23p19 monoclonal antibody reduced urine protein levels, alleviated splenomegaly, improved renal function, and decreased anti-dsDNA antibody levels in MRL/lpr mice. It also mitigated glomerulonephritis and reduced renal immune complex deposition. Furthermore, IL-23p19 monoclonal antibody significantly suppressed the proportion of Th1 and Th17 cells while upregulating Treg cell proportion in the spleen. Additionally, it downregulated T-bet and retinoic acid receptor-related orphan receptor γt (RORγt) mRNA levels and upregulated forkhead box P3(FOXP3) mRNA levels in the spleen. Conclusions IL-23p19 monoclonal antibody demonstrates significant therapeutic effects in MRL/lpr mice, likely through modulation of the Th17/Treg cell balance.
Animals ; Female ; Mice, Inbred MRL lpr ; T-Lymphocytes, Regulatory/drug effects* ; Th17 Cells/drug effects* ; Antibodies, Monoclonal/therapeutic use* ; Interleukin-23 Subunit p19/immunology* ; Mice ; Lupus Nephritis/drug therapy* ; Kidney/drug effects* ; Antibodies, Antinuclear/blood*

Objective:To investigate the effect of roxadustat combined with levocarnitine in the treatment of renal anemia in hemodialysis patients with diabetic kidney disease (DKD), and its effects on iron metabolism, microinflammation status and microvascular complications.Methods:The clinical data of 89 hemodialysis renal anemia patients with DKD from January 2020 to October 2021 in Beijing Geriatric Hospital were retrospectively analyzed. Among them, 44 patients (control group)were treated with recombinant human erythropoietin and levocarnitine for renal anemia, and 45 patients (study group) were treated with recombinant human erythropoietin, levocarnitine and roxadustat for renal anemia. Both groups were treated for 3 months. The efficacy was compared between two groups. The laboratory indexes were measured before treatment and after 1, 3 months of treatment, including anemia related indexes such as hemoglobin, red blood cell count and mean corpuscular volume (MCV); iron metabolism indexes such as serum iron, ferritin and transferrin saturation (TSAT); inflammatory indexes such as interleukin-8 (IL-8), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α). The adverse reactions were recorded. The patients were followed up for 1 year after treatment, the incidence of diabetic microvascular complications, including diabetic peripheral neuropathy (DPN) and diabetic retinopathy (DR), was recorded.Results:The total effective rate in study group was significantly higher than that in control group: 93.33% (42/45) vs. 77.27% (34/44), and there was statistical difference ( χ2 = 4.60, P<0.05). There were no statistical differences in the laboratory indexes before treatment between two groups ( P<0.05); the hemoglobin, red blood cell count, MCV, serum iron, ferritin and TSAT after 1 and 3 months of treatment in study group were significantly higher than those in control group, the IL-8, CRP and TNF-α were significantly lower than those in control group, and there were statistical differences ( P<0.01 or <0.05). There was no significant difference in the incidence of adverse reactions between two groups ( P>0.05). After 1 year follow-up, 2 cases were lost in study group and 3 cases in the control group. The incidence of DR and DPN in study group were significantly lower than those in control group: 0 vs. 14.63% (6/41) and 2.33% (1/43) vs. 19.51% (8/41), and there were statistical differences ( χ2 = 4.75 and 4.81, P<0.05). Conclusions:Roxadustat combined with levocarnitine in the treatment of renal anemia in hemodialysis patients with DKD is reliable and safe, and can effectively relieve anemia symptoms, improve iron metabolism, reduce inflammatory response, and reduce the risk of diabetic microvascular complications.

Endometriosis (EM) is a common gynecological disease in women of childbearing age, and its pathogenesis is currently not fully understood. EM are a chronic inflammatory response, and long-term inflammatory exudation can lead to the production of fibrotic adhesions. Inflammatory response and fibrosis formation are the main pathological features of EM, as well as the main causes of pain and infertility. Research has shown that there are certain differentially expressed microRNAs (miRNAs) in EM that participate in inflammation and fibrosis processes and play important regulatory roles. This article reviews the mechanism of miRNA in the inflammatory and fibrotic pathological processes of EM, aiming to find new directions and ideas for exploring the pathogenesis and diagnosis and treatment of EM.

Diabetic foot has become one of the heavy burdens of global public health problems. As a revolutionary emerging technology, artificial intelligence has the advantages of accuracy, intelligence and efficiency, which can make up for the shortcomings of traditional risk assessment, monitoring and management of diabetic foot. This paper reviews the application of artificial intelligence in risk prediction model of diabetic foot, wound image analysis, and intelligent wearable devices, analyzes the challenges and suggestions faced in technical barriers, data quality, and talent shortage, so as to provide a reference for the clinical practice of artificial intelligence in the field of diabetic foot.

Objective Stereotactic body radiotherapy(SBRT)and radiofrequency ablation(RFA)are primary treatments for hepatocellular carcinoma(HCC)at present.However,the effect of these treatments in clinical trails are rather controversial.The purpose of this paper is to conduct a meta-analysis on the clinical effect and related complications of SBRT and RFA for HCC.Methods A computerized retrieval of academic papers concerning the treatment effect of SBRT and RFA for HCC from the databases of PubMed,Embase,Cochrane Library,Scopus,Web of Science,CBM,CNKI,Wanfang database,VIP was conducted.The retrieval time period was from the establishment of the database to June 2022.Stata14.0 software was used to make meta-analysis.Results A total of 14 retrospective studies including 6 806 patients were included in this analysis.The results of combined hazard ratio(HR)based on overall survival(OS)showed that the OS rate of SBRT was lower than that of RFA(HR=1.25,95％CI=1.10-1.43,12=0％,P=0.000 9),while the results of combined HR of local control(LC)rate indicated that SBRT had a better therapeutic effect(HR=0.61,95％CI=0.47-0.78,I2=0％,P=0.000 1).Subgroup analysis revealed that the combined HR of LC rate favored the performance of SBRT for patients with tumor diameter larger than 2 cm(HR=2.64,95％CI=1.56-4.48,I=0％,P=0.000 3).No statistically significant difference in the incidence of late serious adverse reactions existed between SBRTgroup and RFA group(OR=1.01,95％CI=0.59-1.73,I2=30％,P=0.97).Conclusion SBRT is superior to RFA in controlling local HCC lesions,especially in patients whose tumor diameter is larger than 2 cm,although it does not show certain advantages in the survival benefit.(J Intervent Radiol,2023,32:1233-1241)

Suffering is prevalent in the palliative care population and is an important factor affecting the quality of life of palliative care patients and their family caregivers. In this paper, we review the assessment content, measurement methods, current application status and advantages and disadvantages of suffering assessment tools for palliative care patients, analyze the problems of current suffering assessment tools for palliative care patients and make suggestions, aiming to provide reference for palliative suffering treatment in China.

The purpose of establishing nuclear power plants is to meet the growing energy demand. Unfortunately, there have been five major nuclear accidents in history, which have diverse and lasting effects on individuals and society. The well-known health effects are tissue reactions caused by high radiation doses and carcinogenic effects of low radiation doses. In recent years, studies on adult residents, mothers with young children, and clean-up/decontamination workers exposed to high doses of radiation in the areas affected by nuclear power plant accidents show long-term impacts on the mental health of these people. This paper reviews these psychological impacts.

Objective:To investigate the clinical value of different doses of paricalcitol combined with cinacalcet in the treatment of secondary hyperparathyroidism (SHPT) in patients with maintenance hemodialysis (MHD).Methods:The clinical data of 90 patients with MHD combined with SHPT from December 2020 to December 2022 in Beijing Geriatric Hospital were retrospectively analyzed. Among them, 30 patients were treated with cinacalcet (control group), 30 patients were treated with fixed dose paricalcitol combined with cinacalcet (experimental group A), and 30 patients were treated with adjusting dose of paricalcitol based on the level of intact parathyroid hormone (iPTH) combined with cinacalcet (experimental group B). All patients were continuously treated for 8 weeks. The blood calcium, blood phosphorus, iPTH, osteoprotegerin, osteocalcin, type Ⅰ collagen carboxy terminal peptide cross-linking (β-CTX), N-terminal medium molecule fragment of calcium (N-MID), fibroblast growth factor-23 (FGF-23) and Klotho protein before treatment and after 4 and 8 weeks of treatment were detected; coronary artery calcification (CAC) score and abdominal aortic calcification (AAC) score were evaluated. The adverse reactions were recorded.Results:There were no statistical differences in the indexes before treatment among three groups ( P>0.05). There were no statistical differences in blood calcium and blood phosphorus after 4 and 8 weeks of treatment among three groups ( P>0.05). After 4 and 8 weeks of treatment, the iPTH, β-CTX, osteoprotegerin, N-MID, osteocalcin and FGF-23 in experimental group A and experimental group B were significantly lower than those in control group, after 4 weeks of treatment: (936.99 ± 202.36) and (635.74 ± 135.44) ng/L vs. (1 028.56 ± 11.39) ng/L, (1.85 ± 0.32) and (1.50 ± 0.27) μg/L vs. (2.27 ± 0.69) μg/L, (71.18 ± 6.98) and (64.33 ± 7.87) ng/L vs. (80.15 ± 10.85) ng/L, (106.36 ± 14.42) and (92.64 ± 11.32) μg/L vs. (135.19 ± 15.18) μg/L, (66.17 ± 8.52) and (60.21 ± 7.85) μg/L vs. (73.15 ± 9.44) μg/L, (109.17 ± 11.24) and (98.50 ± 10.36) ng/L vs. (126.18 ± 15.64) ng/L; after 8 weeks of treatment: (632.17 ± 154.98) and (526.85 ± 98.45) ng/L vs. (819.85 ± 169.78) ng/L, (1.33 ± 0.15) and (1.15 ± 0.20) μg/L vs. (1.78 ± 0.27) μg/L, (65.78 ± 9.74) and (52.77 ± 7.18) ng/L vs. (74.26 ± 11.58) ng/L, (85.64 ± 11.62) and (70.25 ± 8.59) μg/L vs. (105.92 ± 19.17) μg/L, (48.17 ± 5.99) and (41.15 ± 6.44) μg/L vs. (59.24 ± 6.87) μg/L, (90.15 ± 11.25) and (82.58 ± 9.74) ng/L vs. (105.26 ± 14.35) ng/L, the indexes in experimental group B were significantly lower than those in experimental group A, and there were statistical differences ( P<0.05). After 4 and 8 weeks of treatment, the Klotho protein in experimental group A and experimental group B was significantly higher than that in control group, after 4 weeks of treatment: (124.25 ± 14.85) and (146.31 ± 16.85) U/L vs. (107.26 ± 11.36) U/L, after 8 weeks of treatment: (135.62 ± 16.87) and (150.24 ± 17.43) U/L vs. (115.56 ± 15.48) U/L, the Klotho protein in experimental group B was significantly higher than that in experimental group A, and there were statistical differences ( P<0.05). After 4 and 8 weeks of treatment, the CAC score and AAC score in experimental group A and experimental group B were significantly lower than those in control group, the indexes in experimental group B were significantly lower than those in experimental group A, and there were statistical differences ( P<0.05). There was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:Compared with the fixed dose of paricalcitol combined with cinacalcet therapy, the adjusting the dosage of paricalcitol combined with cinacalcet therapy based on iPTH level has more definite therapeutic effects in patients with MHD combined with SHPT, which can improve bone metabolism and reduce vascular calcification.

Purpose: This study aimed to investigate reproductive concerns among breast cancer patients of reproductive age, analyze the influencing factors, explore the relationship between coping styles, fear of progression (FOP), and reproductive concerns, and identify the multiple effects of coping styles on the relationship between FOP and reproductive concerns among Chinese breast cancer patients. Methods: A cross-sectional, descriptive study was conducted among breast cancer patients in four tertiary grade A hospitals in Fujian, China, from January 2022 to September 2022. A total of 210 patients were recruited to complete paper-based questionnaires, which included the general data questionnaires, the Reproductive Concerns After Cancer Scale (RCACS), the Fear of Progression Questionnaire-Short Form (FOP-Q-SF), and the Medical Coping Modes Questionnaire (MCMQ). Structural equation models were utilized to evaluate the multiple effects of coping styles on FOP and reproductive concerns. Results: Reproductive concerns in breast cancer patients had a mean score of 53.02 (SD, 10.69), out of a total score of 90, and coping styles for cancer (confrontation, avoidance) were closely associated with FOP and reproductive concerns. FOP showed a significant positive correlation with reproductive concerns (r = .52, p < .01). At the same time, confrontation was significantly negatively correlated with both FOP (r = −.28, p < .01) and reproductive concerns (r = −.39, p < .01). Avoidance was positively correlated to both FOP (r = .25, p < .01) and reproductive concerns (r = .34, p < .01). The impact of FOP on reproductive concerns is partially mediated by confrontation and avoidance, with effect sizes of .07 and .04, respectively. These mediating factors account for 22.0% of the total effect. Conclusions The FOP directly impacted reproductive concerns, while coping styles could partially mediate the association between FOP and reproductive concerns. This study illustrates the role of confrontation and avoidance in alleviating reproductive concerns, suggesting that it is necessary to focus on the changes in reproductive concerns among reproductive-age breast cancer patients. Healthcare professionals can improve disease awareness and reduce patients' FOP, thereby promoting positive psychological and coping behaviors and ultimately alleviating reproductive concerns.