Objective To analyze the research progress of acupuncture and moxibustion in the treatment of simple obesity,thus to provide reference for further research in this field.Methods The relevant literature in China National Knowledge Infrastructure(CNKI)and Wanfang Data Knowledge Service Platform in the past 24 years were retrieved,and analysis of authors,institutions,and keywords were carried out by CiteSpace 6.2.R6 software,and visualization maps were drawn.Results A total of 889 valid articles were included,and the number of annual publications tended to be stable;the authors in this field were Zhou Zhongyu and Chen Xia as the core author team;the most involved research institution in the institutional cooperation map was the Nanjing University of Chinese Medicine;the high-frequency keywords mainly concentrated on"acupuncture therapy","acupuncture and muxibustion therapy","simple obesity","acupoint catgut embedding therapy",etc.;the keyword clusters covered a total of 13 items,namely"electroacupuncture","acupuncture","acupuncture and moxibustion","acupoint catgut embedding",etc.Conclusion There are many studies on acupuncture and moxibustion in the treatment of simple obesity,and the hot spots of the study are focused on small-sample clinical observation,literature research,and research on the mechanism of action.In the future,researchers can conduct further high-quality studies as well as research on the application and mechanism of action of specific acupuncture therapies,with the aim of developing the preferable therapeutic approaches of acupuncture for the treatment of simple obesity.

Based on the theory of"body fluid and blood sharing the same origin",this paper reveals that the core pathogenesis of atopic dermatitis(AD)lies in the abnormal distribution and transformation of body fluid and blood,which is closely related to dysfunction of the lung,spleen,and kidney.Integrating modern medical research on immune regulation and skin barrier function,we propose that in the early stage of AD,due to deficient endowment,acquired loss of nutrition,insufficiency of the spleen and kidney,and failure of the lung-defense system to protect,external pathogens stagnate in the fleshy exterior.This leads to dysfunction of the lung's governance over the skin,impaired distribution of body fluid,obstruction of qi and blood circulation,and stagnation in the skin,resulting in exudative dampness.The dampness stagnates and transforms into heat.Acupuncture should primarily focus on clearing the lung,dispersing stagnation,distributing body fluid,and unblocking collaterals.In the middle and late stages,as lung disease affects the spleen and kidney,acupuncture should emphasize supplementing and tonifying the spleen and kidney,nourishing blood,and moistening dryness,while simultaneously addressing both the root and the branch.For intractable pruritus,fire needling or pricking-collateral cupping can be employed to control itching and reduce recurrence.

eIF3a is a N ⁶-methyladenosine (m⁶A) reader that regulates mRNA translation by recognizing m⁶A modifications of these mRNAs. It has been suggested that eIF3a may play an important role in regulating translation initiation via m⁶A during infection when canonical cap-dependent initiation is inhibited. However, the death of animal model studies impedes our understanding of the functional significance of eIF3a in immunity and regulation in vivo. In this study, we investigated the in vivo function of eIF3a using eIF3a knockout and knockdown mouse models and found that eIF3a deficiency resulted in splenic tissue structural disruption and multi-organ damage, which contributed to severe sepsis induced by Lipopolysaccharide (LPS). Ectopic eIF3a overexpression in the eIF3a knockdown mice rescued mice from LPS-induced severe sepsis. We further showed that eIF3a maintains a functional and healthy immune system by regulating B cell function and quantity through m⁶A modification of mRNAs. These findings unveil a novel mechanism underlying sepsis, implicating the pivotal role of B cells in this complex disease process regulated by eIF3a. Furthermore, eIF3a may be used to develop a potential strategy for treating sepsis.

Metformin has been demonstrated to attenuate hyperglycaemia by modulating the gut microbiota. However, the mechanisms through which the microbiome mediates metformin monotherapy failure (MMF) are unclear. Herein, in a prospective clinical cohort study of newly diagnosed type 2 diabetes mellitus (T2DM) patients treated with metformin monotherapy, metagenomic sequencing of faecal samples revealed that Phocaeicola vulgatus abundance was approximately 12 times higher in nonresponders than in responders. P. vulgatus rapidly hydrolysed taurine-conjugated bile acids, leading to ceramide accumulation and reversing the improvements in glucose intolerance conferred by metformin in high-fat diet-fed mice. Interestingly, C22:0 ceramide bound to mitochondrial fission factor to induce mitochondrial fragmentation and impair hepatic oxidative phosphorylation in P. vulgatus-colonized hyperglycaemic mice, which could be exacerbated by metformin. This work suggests that metformin may be unsuitable for P. vulgatus-rich T2DM patients and that clinicians should be aware of metformin toxicity to mitochondria. Suppressing P. vulgatus growth with cefaclor or improving mitochondrial function using adenosylcobalamin may represent simple, safe, effective therapeutic strategies for addressing MMF.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

Objective:To explore the surgical treatment strategies for Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures.Methods:A retrospective analysis was performed on the clinical data of 25 adult patients with Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures, admitted to the Upper Extremity Orthopaedics Department of Zhengzhou Orthopaedic Hospital from June 2013 to June 2023. There were 15 males and 10 females, with an average age of 43.5±14.7 years (range: 20-67 years). Among them, 5 cases were complicated with humeroulnar joint dislocation. The patients were divided into two groups: 17 cases were treated with open reduction and internal fixation (ORIF) of radial head fractures combined with ORIF of proximal ulnar fractures (open reduction group), and 8 cases were treated with radial head replacement combined with ORIF of proximal ulnar fractures (radial head replacement group). At the last follow-up, elbow joint range of motion was recorded, and pain, elbow function, and subjective upper limb function were evaluated using the Visual Analogue Scale (VAS), Mayo Elbow Performance Score (MEPS), and Disabilities of the Arm, Shoulder and Hand (DASH) scale. The incidence of complications was also recorded.Results:All 25 patients were followed up for an average of 25.6±9.0 months (range: 12-45 months). At the last follow-up, the affected elbows in the open reduction group had a flexion of 124.47°±12.59° (range, 90°-140°), extension of 21.12°±10.07° (range, 10°-50°), pronation of 48.59°±11.62° (range, 20°-61°), and supination of 48.53°±8.43° (range, 30°-60°). In the radial head replacement group, the affected elbows showed flexion of 128.75°±13.17° (range, 100°-140°), extension of 14.00°±7.71° (range, 0°-25°), pronation of 61.25°±10.26° (range, 60°-80°), and supination of 71.88°±10.33° (range, 60°-80°). The MEPS score in the open reduction group was 82(75, 85) points (range, 55-90 points), the VAS pain score was 1(1, 2) points (range, 0-3 points), and the DASH score was 9(8, 14) points. In the radial head replacement group, the MEPS score was 90(85, 90) points (range, 85-90 points), the VAS pain score was 1(0, 1) points (range, 0-1 points), and the DASH score was 5(5, 6) points. Complications included 5 cases of heterotopic ossification, 1 case of incision infection, 1 case of nonunion, 1 case of ulnar nerve injury combined with traumatic arthritis, and 1 case of proximal radioulnar bone bridge formation.Conclusions:Both radial head replacement and open reduction internal fixation combined with proximal ulnar fracture fixation can effectively treat Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures. There was no significant difference in postoperative flexion and extension, but the radial head replacement group demonstrated better forearm rotation and DASH scores postoperatively.

Objective:To systematically analyze the disease burden of soft tissue and extraosseous sarcomas (STEOS) among individuals aged 15-49 years old worldwide and in the Chinese mainland from 1990 to 2021, and explore the relationship between socio-economic development and disease burden.Methods:Incidence, mortality and disability-adjusted life year (DALY) for STEOS in populations aged from 15 to 49 were collected from the Global Burden of Disease (GBD2021) database. The temporal trends in disease burden were quantified using the average annual percentage change (AAPC). The socio-demographic index (SDI) was employed to examine the socio-economic development.Results:The global incidence rate of STEOS among individuals aged 15-49 remained relatively stable (AAPC=-0.13, 95% CI:-0.23--0.04, P=0.299). In contrast, significant declines were observed in both mortality rate (AAPC=-0.39, 95% CI:-0.47--0.31, P<0.001) and DALY rate (AAPC=-0.46, 95% CI:-0.54--0.38, P<0.001). In the Chinese mainland, the incidence of STEOS among individuals aged 15-49 remained relatively stable (AAPC=-0.10, 95% CI:-0.31-0.10, P=0.314), while the mortality rate (AAPC=-1.42, 95% CI:-1.59--1.25, P<0.001) and DALY rate (AAPC=-1.62, 95% CI:-1.82--1.42, P<0.001) declined steadily from 1990 to 2021. In 2021, high-SDI regions reported high incidence rate (1.38/100 000, 95% UI:1.28/100 000-1.46/100 000), mortality rate (0.42/100 000, 95% UI:0.39/100 000-0.43/100 000) and DALY rate (23.05/100 000, 95% UI:21.84/100 000-24.00/100 000), while low-SDI regions reported high mortality rate (0.36/100 000, 95% UI:0.27/100 000-0.54/100 000) and DALY rate (20.50/100 000, 95% UI:15.46/100 000-30.96/100 000). Conclusion:The disease burden of STEOS worldwide and in the Chinese mainland populations aged from 15 to 49 has declined consistently. Notably, STEOS constitutes a substantial disease burden, particularly among countries and regions with high-SDI and low-SDI in 2021.

Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

Objective:To systematically analyze the disease burden of soft tissue and extraosseous sarcomas (STEOS) among individuals aged 15-49 years old worldwide and in the Chinese mainland from 1990 to 2021, and explore the relationship between socio-economic development and disease burden.Methods:Incidence, mortality and disability-adjusted life year (DALY) for STEOS in populations aged from 15 to 49 were collected from the Global Burden of Disease (GBD2021) database. The temporal trends in disease burden were quantified using the average annual percentage change (AAPC). The socio-demographic index (SDI) was employed to examine the socio-economic development.Results:The global incidence rate of STEOS among individuals aged 15-49 remained relatively stable (AAPC=-0.13, 95% CI:-0.23--0.04, P=0.299). In contrast, significant declines were observed in both mortality rate (AAPC=-0.39, 95% CI:-0.47--0.31, P<0.001) and DALY rate (AAPC=-0.46, 95% CI:-0.54--0.38, P<0.001). In the Chinese mainland, the incidence of STEOS among individuals aged 15-49 remained relatively stable (AAPC=-0.10, 95% CI:-0.31-0.10, P=0.314), while the mortality rate (AAPC=-1.42, 95% CI:-1.59--1.25, P<0.001) and DALY rate (AAPC=-1.62, 95% CI:-1.82--1.42, P<0.001) declined steadily from 1990 to 2021. In 2021, high-SDI regions reported high incidence rate (1.38/100 000, 95% UI:1.28/100 000-1.46/100 000), mortality rate (0.42/100 000, 95% UI:0.39/100 000-0.43/100 000) and DALY rate (23.05/100 000, 95% UI:21.84/100 000-24.00/100 000), while low-SDI regions reported high mortality rate (0.36/100 000, 95% UI:0.27/100 000-0.54/100 000) and DALY rate (20.50/100 000, 95% UI:15.46/100 000-30.96/100 000). Conclusion:The disease burden of STEOS worldwide and in the Chinese mainland populations aged from 15 to 49 has declined consistently. Notably, STEOS constitutes a substantial disease burden, particularly among countries and regions with high-SDI and low-SDI in 2021.

Objective:To explore the surgical treatment strategies for Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures.Methods:A retrospective analysis was performed on the clinical data of 25 adult patients with Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures, admitted to the Upper Extremity Orthopaedics Department of Zhengzhou Orthopaedic Hospital from June 2013 to June 2023. There were 15 males and 10 females, with an average age of 43.5±14.7 years (range: 20-67 years). Among them, 5 cases were complicated with humeroulnar joint dislocation. The patients were divided into two groups: 17 cases were treated with open reduction and internal fixation (ORIF) of radial head fractures combined with ORIF of proximal ulnar fractures (open reduction group), and 8 cases were treated with radial head replacement combined with ORIF of proximal ulnar fractures (radial head replacement group). At the last follow-up, elbow joint range of motion was recorded, and pain, elbow function, and subjective upper limb function were evaluated using the Visual Analogue Scale (VAS), Mayo Elbow Performance Score (MEPS), and Disabilities of the Arm, Shoulder and Hand (DASH) scale. The incidence of complications was also recorded.Results:All 25 patients were followed up for an average of 25.6±9.0 months (range: 12-45 months). At the last follow-up, the affected elbows in the open reduction group had a flexion of 124.47°±12.59° (range, 90°-140°), extension of 21.12°±10.07° (range, 10°-50°), pronation of 48.59°±11.62° (range, 20°-61°), and supination of 48.53°±8.43° (range, 30°-60°). In the radial head replacement group, the affected elbows showed flexion of 128.75°±13.17° (range, 100°-140°), extension of 14.00°±7.71° (range, 0°-25°), pronation of 61.25°±10.26° (range, 60°-80°), and supination of 71.88°±10.33° (range, 60°-80°). The MEPS score in the open reduction group was 82(75, 85) points (range, 55-90 points), the VAS pain score was 1(1, 2) points (range, 0-3 points), and the DASH score was 9(8, 14) points. In the radial head replacement group, the MEPS score was 90(85, 90) points (range, 85-90 points), the VAS pain score was 1(0, 1) points (range, 0-1 points), and the DASH score was 5(5, 6) points. Complications included 5 cases of heterotopic ossification, 1 case of incision infection, 1 case of nonunion, 1 case of ulnar nerve injury combined with traumatic arthritis, and 1 case of proximal radioulnar bone bridge formation.Conclusions:Both radial head replacement and open reduction internal fixation combined with proximal ulnar fracture fixation can effectively treat Mason type III radial head fractures complicated with adult Bado type II Monteggia fractures. There was no significant difference in postoperative flexion and extension, but the radial head replacement group demonstrated better forearm rotation and DASH scores postoperatively.