OBJECTIVE: To evaluate early effectiveness of posterior 180-degree decompression via unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis (LSS) combined with Michigan State University (MSU)-1 lumbar disc herniation (LDH). METHODS: A retrospective analysis was conducted on clinical data from 33 patients with LSS combined with MSU-1 LDH, who met selection criteria and were treated between March 2022 and January 2024. All patients underwent UBE-assisted 180-degree spinal canal decompression. The cohort comprised 17 males and 16 females, aged 37-82 years (mean, 67.1 years). Preoperative presentations included bilateral lower limbs intermittent claudication and radiating pain, with disease duration ranging from 5 to 13 months (mean, 8.5 months). Affected segments included L _{3, 4} in 4 cases, L _{4, 5} in 28 cases, and L ₅, S ₁ in 1 case. LSS was rated as Schizas grade A in 4 cases, grade B in 5 cases, grade C in 13 cases, and grade D in 11 cases. LDH was categorized as MSU-1A in 24 cases, MSU-1B in 2 cases, and MSU-1AB in 7 cases. Intraoperative parameters (operation time, blood loss) and postoperative hospitalization length were recorded. The visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were used to assess the lower limb pain and functional outcomes after operation. Clinical efficacy was evaluated at last follow-up via modified MacNab criteria. Quantitative radiological assessments included dural sac cross-sectional area (DSCA) measurements and spinal stenosis grading on lumbar MRI. Morphological classification of lumbar canal stenosis was determined according to the Schizas grading, categorized into four grades. RESULTS: The operation time was 60.4-90.8 minutes (mean, 80.3 minutes) and intraoperative blood loss was 13-47 mL (mean, 29.9 mL). The postoperative hospitalization length was 3-5 days (mean, 3.8 days). All patients were followed up 12-16 months (mean, 13.8 months). The VAS score and ODI improved at immediate and 3, 6, and 12 months after operation compared to before operation, and the differences between different time points were significant ( P<0.05). At last follow-up, the clinical efficacy assessed by the modified MacNab criteria were graded as excellent in 23 cases, good in 9 cases, and poor in 1 case, with an excellent and good rate of 96.97%. Postoperative lumbar MRI revealed the significant decompression of the dural sac in 32 cases, with 1 case showing inadequate dural expansion. DSCA measurements confirmed progressive enlargement and stenosis reduction over time. The differences were significant ( P<0.05) before operation, immediately after operation, and at 6 months after operation. At 6 months after operation, Schizas grading of spinal stenosis improved to grade A in 27 cases and grade B in 6 cases. CONCLUSION Posterior 180-degree decompression via UBE is a safe and feasible strategy for treating LSS combined with MSU-1 LDH, achieving effective neural decompression while preserving intervertebral disc integrity.
Humans ; Spinal Stenosis/diagnostic imaging* ; Male ; Female ; Aged ; Lumbar Vertebrae/surgery* ; Middle Aged ; Intervertebral Disc Displacement/complications* ; Decompression, Surgical/methods* ; Retrospective Studies ; Endoscopy/methods* ; Adult ; Aged, 80 and over ; Treatment Outcome

Objective To analyze the current situation of quality control and regulation of centralized decoction of Chinese materia medica in Hangzhou through a mixed study combining quantitative research and qualitative research;To provide references for its standardization.Methods A self-designed questionnaire was distributed from July 20,2023 to August 10,2023 in institutions providing centralized decoction services of Chinese materia medica in different regions of Hangzhou.Using the stratified sampling method,the institutional personnel who completed the questionnaire survey were selected as the interviewees,and the semi-structured interview was used to refine the theme according to the Colaizzi seven step method.Results Totally 98 questionnaires were distributed and 96 valid questionnaires were recovered,with a valid recovery rate of 97.96%.There were significant differences in soaking time,concentration degree,and special decoction method such as decocted earlier or later of decoction pieces of Chinese materia medica among different types of institutions(P<0.05).The centralized decoction of Chinese materia medica in Hangzhou mainly involves two themes and seven sub themes:the supervision and management of the whole process of centralized decoction of Chinese materia medica(optimizing distribution of medical resources,strengthening of supervision,demanding guidance of standards),the operation of centralized decoction of Chinese materia medica(soaking time of decoction pieces of Chinese materia medica,the pretreatment operation of"decocted earlier and decocted later",the concentration treatment of Chinese materia medica decoction,and the quality control of Chinese materia medica decoction).Conclusion At present,centralized decoction of Chinese materia medica in Hangzhou still needs to be further standardized.It is recommended to strengthen the construction of shared Chinese materia medica pharmacy in the region,establish and improve the standard system of centralized decoction of Chinese materia medica decoction,and strengthen the construction of digital full chain traceability to improve the service quality and management level of centralized decoction of Chinese materia medica in Hangzhou.

As the global population ages and cancer diagnostic and treatment technologies improve, the number of elderly cancer survivors continues to increase, and their complex care needs challenge the traditional mono-disciplinary care model. This paper explores the dilemmas of implementing a long-term care system and suggestions for future research through a comprehensive overview of the care needs of elderly cancer survivors and the progress of interdisciplinary research, with the aim of providing a theoretical basis and practical reference for improving the long-term care system and enhancing patients' quality of life.

As the global population ages and cancer diagnostic and treatment technologies improve, the number of elderly cancer survivors continues to increase, and their complex care needs challenge the traditional mono-disciplinary care model. This paper explores the dilemmas of implementing a long-term care system and suggestions for future research through a comprehensive overview of the care needs of elderly cancer survivors and the progress of interdisciplinary research, with the aim of providing a theoretical basis and practical reference for improving the long-term care system and enhancing patients' quality of life.

[Objective]To explore the characteristics of acupuncture and moxibustion in the treatment of"arthromyodynia of shoulder"in Puji Prescription,so as to bring inspiration to the treatment of shoulder-related soft tissue diseases.[Methods]Chinese Medical Code·Acupuncture and Massage·General Theory·Puji Prescription·Acupuncture and Moxibustion was searched,and the rules of acupuncture and moxibustion treatment of"arthromyodynia of shoulder"were sorted out from four aspects:acupoints,meridians,acupuncture and moxibustion,symptoms and signs.[Results]Acupuncture prescription:There are 54 acupoints,with single acupoint prescriptions accounting for 80.0%,and the most frequent acupoint is Jianyu.Multiple acupoint prescriptions account for 20.0%.The distribution of acupoints is in the following order:upper limbs,scapula,shoulder,back,neck,abdomen,chest,waist,ear and head,with the upper limbs appearing the most frequently,accounting for 52.1%.Meridian involvement:It involves 10 meridians,in the order of the Large Intestine Meridian of Hand-Yangming,Small Intestine Meridian of Hand-Taiyang,Tri-Jiao Meridian of Hand-Shaoyang,Bladder Meridian of Foot-Taiyang,Lung Meridian of Hand-Taiyin,Gallbladder Meridian of Foot-Shaoyang,Liver Meridian of Foot-Jueyin,Heart Meridian of Hand-Shaoyin,Stomach Meridian of Foot-Yangming and the Governing Vessel,with the Large Intestine Meridian of Hand-Yangming having the highest proportion of 26.7%.Moxibustion and acupuncture techniques:Moxibustion accounts for 74.4%,all of which are direct moxibustion(grain-sized moxibustion),while acupuncture accounts for 25.6%.Symptoms and signs:The most common is"pain",accounting for 67.3%,and the most frequent limitation of movement is"inability to raise",accounting for 64.1%.The academic content of the book is greatly influenced in the Song Dynasty,with specific descriptions of the main therapeutic effects of acupoints,quantified operations,and clear indications and contraindications.[Conclusion]In Puji Prescription,acupuncture and moxibustion are used to treat"arthromyodynia of shoulder".Selection of acupoints is based on different symptoms and signs,with a focus on moxibustion techniques and integration of the theory of meridians and muscles,which is worth reference in modern acupuncture practices.

Objective To analyze the current situation of quality control and regulation of centralized decoction of Chinese materia medica in Hangzhou through a mixed study combining quantitative research and qualitative research;To provide references for its standardization.Methods A self-designed questionnaire was distributed from July 20,2023 to August 10,2023 in institutions providing centralized decoction services of Chinese materia medica in different regions of Hangzhou.Using the stratified sampling method,the institutional personnel who completed the questionnaire survey were selected as the interviewees,and the semi-structured interview was used to refine the theme according to the Colaizzi seven step method.Results Totally 98 questionnaires were distributed and 96 valid questionnaires were recovered,with a valid recovery rate of 97.96%.There were significant differences in soaking time,concentration degree,and special decoction method such as decocted earlier or later of decoction pieces of Chinese materia medica among different types of institutions(P<0.05).The centralized decoction of Chinese materia medica in Hangzhou mainly involves two themes and seven sub themes:the supervision and management of the whole process of centralized decoction of Chinese materia medica(optimizing distribution of medical resources,strengthening of supervision,demanding guidance of standards),the operation of centralized decoction of Chinese materia medica(soaking time of decoction pieces of Chinese materia medica,the pretreatment operation of"decocted earlier and decocted later",the concentration treatment of Chinese materia medica decoction,and the quality control of Chinese materia medica decoction).Conclusion At present,centralized decoction of Chinese materia medica in Hangzhou still needs to be further standardized.It is recommended to strengthen the construction of shared Chinese materia medica pharmacy in the region,establish and improve the standard system of centralized decoction of Chinese materia medica decoction,and strengthen the construction of digital full chain traceability to improve the service quality and management level of centralized decoction of Chinese materia medica in Hangzhou.

[Objective]To explore the characteristics of acupuncture and moxibustion in the treatment of"arthromyodynia of shoulder"in Puji Prescription,so as to bring inspiration to the treatment of shoulder-related soft tissue diseases.[Methods]Chinese Medical Code·Acupuncture and Massage·General Theory·Puji Prescription·Acupuncture and Moxibustion was searched,and the rules of acupuncture and moxibustion treatment of"arthromyodynia of shoulder"were sorted out from four aspects:acupoints,meridians,acupuncture and moxibustion,symptoms and signs.[Results]Acupuncture prescription:There are 54 acupoints,with single acupoint prescriptions accounting for 80.0%,and the most frequent acupoint is Jianyu.Multiple acupoint prescriptions account for 20.0%.The distribution of acupoints is in the following order:upper limbs,scapula,shoulder,back,neck,abdomen,chest,waist,ear and head,with the upper limbs appearing the most frequently,accounting for 52.1%.Meridian involvement:It involves 10 meridians,in the order of the Large Intestine Meridian of Hand-Yangming,Small Intestine Meridian of Hand-Taiyang,Tri-Jiao Meridian of Hand-Shaoyang,Bladder Meridian of Foot-Taiyang,Lung Meridian of Hand-Taiyin,Gallbladder Meridian of Foot-Shaoyang,Liver Meridian of Foot-Jueyin,Heart Meridian of Hand-Shaoyin,Stomach Meridian of Foot-Yangming and the Governing Vessel,with the Large Intestine Meridian of Hand-Yangming having the highest proportion of 26.7%.Moxibustion and acupuncture techniques:Moxibustion accounts for 74.4%,all of which are direct moxibustion(grain-sized moxibustion),while acupuncture accounts for 25.6%.Symptoms and signs:The most common is"pain",accounting for 67.3%,and the most frequent limitation of movement is"inability to raise",accounting for 64.1%.The academic content of the book is greatly influenced in the Song Dynasty,with specific descriptions of the main therapeutic effects of acupoints,quantified operations,and clear indications and contraindications.[Conclusion]In Puji Prescription,acupuncture and moxibustion are used to treat"arthromyodynia of shoulder".Selection of acupoints is based on different symptoms and signs,with a focus on moxibustion techniques and integration of the theory of meridians and muscles,which is worth reference in modern acupuncture practices.

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues.Magnesium has been proved to promote bone healing under normal conditions.Here,we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status.We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised,with significantly decreased angiogenesis.We then developed Mg-coating implants with hydrothermal synthesis.These implants successfully improved the vascularization and osseointegration in diabetic status.Mechanically,Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1(Keap1)and the nucleation of nuclear factor erythroid 2-related factor 2(Nrf2)by up-regulating the expression of sestrin 2(SESN2)in endothelial cells,thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia.Altogether,our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

Diabetes has long been considered a risk factor in implant therapy and impaired wound healing in soft and hard oral tissues.Magnesium has been proved to promote bone healing under normal conditions.Here,we elucidate the mechanism by which Mg2+ promotes angiogenesis and osseointegration in diabetic status.We generated a diabetic mice model and demonstrated the alveolar bone healing was compromised,with significantly decreased angiogenesis.We then developed Mg-coating implants with hydrothermal synthesis.These implants successfully improved the vascularization and osseointegration in diabetic status.Mechanically,Mg2+ promoted the degradation of Kelch-like ECH-associated protein 1(Keap1)and the nucleation of nuclear factor erythroid 2-related factor 2(Nrf2)by up-regulating the expression of sestrin 2(SESN2)in endothelial cells,thus reducing the elevated levels of oxidative stress in mitochondria and relieving endothelial cell dysfunction under hyperglycemia.Altogether,our data suggested that Mg2+ promoted angiogenesis and osseointegration in diabetic mice by regulating endothelial mitochondrial metabolism.