BACKGROUND:Primary osteoporosis has a high incidence,but the pathogenesis is not fully understood.Currently,there is a lack of effective early screening indicators and treatment programs. OBJECTIVE:To further explore the mechanism of primary osteoporosis through comprehensive bioinformatics analysis. METHODS:The primary osteoporosis data were obtained from the gene expression omnibus(GEO)database,and the differentially expressed genes were screened for Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.In addition,the differentially expressed genes were subjected to protein-protein interaction network to determine the core genes related to primary osteoporosis,and the least absolute shrinkage and selection operator algorithm was used to identify and verify the primary osteoporosis-related biomarkers.Immune cell correlation analysis,gene enrichment analysis and drug target network analysis were performed.Finally,the biomarkers were validated using qPCR assay. RESULTS AND CONCLUSION:A total of 126 differentially expressed genes and 5 biomarkers including prostaglandins,epidermal growth factor receptor,mitogen-activated protein kinase 3,transforming growth factor B1,and retinoblastoma gene 1 were obtained in this study.GO analysis showed that differentially expressed genes were mainly concentrated in the cellular response to oxidative stress and the regulation of autophagy.KEGG analysis showed that autophagy and senescence pathways were mainly involved.Immunoassay of biomarkers showed that prostaglandins,retinoblastoma gene 1,and mitogen-activated protein kinase 3 were closely related to immune cells.Gene enrichment analysis showed that biomarkers were associated with immune-related pathways.Drug target network analysis showed that the five biomarkers were associated with primary osteoporosis drugs.The results of qPCR showed that the expression of prostaglandins,epidermal growth factor receptor,mitogen-activated protein kinase 3,and transforming growth factor B1 in the primary osteoporosis sample was significantly increased compared with the control sample(P<0.001),while the expression of retinoblastoma gene 1 in the primary osteoporosis sample was significantly decreased compared with the control sample(P<0.001).Overall,the study screened and validated five potential biomarkers of primary osteoporosis,providing a reference basis for further in-depth investigation of the pathogenesis,early screening and diagnosis,and targeted treatment of primary osteoporosis.

High-quality development has emerged as a central theme in the cultivation of doctoral candidates for the professional degree of acupuncture-moxibustion and tuina in the new era. Focusing on the core mission and contemporary demands, and through literature analysis and research interviews, the current situation for training acupuncture-moxibustion and tuina personnel was introduced. In order to break through the four practical challenges in the high-quality training of doctoral candidates for professional degree (including homogenization of training mechanism, optimization of training mode, limited integration of training resources and lack of evaluation of training quality), it needs to explore the strategy pathways from 4 aspects, (1) adhering to the goal orientation, following the specific rules of talent training and innovating talent training system; (2) optimizing the training process by building a "medicine-teaching-research-practice" integrative training model so as to meet the needs of talent training; (3) strengthening the development of practice bases, and organizing collaborative supervisory teams to provide favorable training conditions; (4) consolidating quality-guarantee mechanism by integrating dissertation with ascertainment of practical achievements, and implementing scientific assessment and evaluation.
Humans ; Moxibustion ; Acupuncture/standards* ; Acupuncture Therapy ; Education, Graduate

Objective:To evaluate the preventive effects of transcutaneous electrical acupoint stimulation (TEAS) on chronic pain after lumbar spine surgery.Methods:This was a secondary analysis conducted on the studies assessing the effect of TEAS on gastrointestinal function in patients undergoing lumbar spinal surgery. Fifty lumbar spinal stenosis patients of either sex, aged 50-75 yr, with a body mass index of 18.5-28.0 kg/m 2, of American Society of Anesthesiologists Physical Status cassification Ⅰ or Ⅱ, with expected operation time≥3 h, undergoing lumbar spinal surgery under general anesthesia, were enrolled and assigned into 2 groups ( n=25 each) using a random number table method: control group (C group) and TEAS group. In group C, stimulating electrodes were placed at the non-acupoint parts of the limbs, but no electrical stimulation was applied. In group TEAS, the bilateral Neiguan (PC6), Hegu (L14), Zusanli (ST36), Shangjuxu (ST37) and Xiajuxu (ST39) were stimulated with disperse-dense waves at a frequency of 2/100 Hz. The intensity of stimulation was the maximum current that patients could tolerate. The intervention was performed once a day for 30 min per session at 30 min prior to anesthesia induction and on postoperative days 1-7. Telephone follow-ups were conducted at 3, 6 and 12 months after surgery to record the occurrence of postoperative moderate-to-severe lower back pain and leg pain (Numerical Rating Scale score ≥4), and the Oswestry Disability Index (ODI) value and four-item neuropathic pain questionnaire scores. The pain-related medical visits and usage of nonsteroidal anti-inflammatory drugs were also recorded after surgery. Results:Three patients in each group were lost to follow-up. Compared with group C, the incidence of chronic low back pain was significantly decreased at 6-12 months after surgery, the ODI value and four-item neuropathic pain questionnaire scores were decreased at 12 months after surgery ( P<0.05), ODI value difference reached the minimal clinically important difference, the proportion of patients requiring medical visits due to postoperative pain and usage rate of nonsteroidal anti-inflammatory drugs were decreased at 6-12 months after surgery ( P<0.05), and no significant change in the incidence of chronic moderate-to-severe leg pain was found at each time period after surgery in group TEAS( P>0.05). Conclusions:TEAS can prevent the occurrence of chronic lower back pain and improve functional impairment in patients undergoing lumbar spine surgery.

Objective:To evaluate the preventive effects of transcutaneous electrical acupoint stimulation (TEAS) on chronic pain after lumbar spine surgery.Methods:This was a secondary analysis conducted on the studies assessing the effect of TEAS on gastrointestinal function in patients undergoing lumbar spinal surgery. Fifty lumbar spinal stenosis patients of either sex, aged 50-75 yr, with a body mass index of 18.5-28.0 kg/m 2, of American Society of Anesthesiologists Physical Status cassification Ⅰ or Ⅱ, with expected operation time≥3 h, undergoing lumbar spinal surgery under general anesthesia, were enrolled and assigned into 2 groups ( n=25 each) using a random number table method: control group (C group) and TEAS group. In group C, stimulating electrodes were placed at the non-acupoint parts of the limbs, but no electrical stimulation was applied. In group TEAS, the bilateral Neiguan (PC6), Hegu (L14), Zusanli (ST36), Shangjuxu (ST37) and Xiajuxu (ST39) were stimulated with disperse-dense waves at a frequency of 2/100 Hz. The intensity of stimulation was the maximum current that patients could tolerate. The intervention was performed once a day for 30 min per session at 30 min prior to anesthesia induction and on postoperative days 1-7. Telephone follow-ups were conducted at 3, 6 and 12 months after surgery to record the occurrence of postoperative moderate-to-severe lower back pain and leg pain (Numerical Rating Scale score ≥4), and the Oswestry Disability Index (ODI) value and four-item neuropathic pain questionnaire scores. The pain-related medical visits and usage of nonsteroidal anti-inflammatory drugs were also recorded after surgery. Results:Three patients in each group were lost to follow-up. Compared with group C, the incidence of chronic low back pain was significantly decreased at 6-12 months after surgery, the ODI value and four-item neuropathic pain questionnaire scores were decreased at 12 months after surgery ( P<0.05), ODI value difference reached the minimal clinically important difference, the proportion of patients requiring medical visits due to postoperative pain and usage rate of nonsteroidal anti-inflammatory drugs were decreased at 6-12 months after surgery ( P<0.05), and no significant change in the incidence of chronic moderate-to-severe leg pain was found at each time period after surgery in group TEAS( P>0.05). Conclusions:TEAS can prevent the occurrence of chronic lower back pain and improve functional impairment in patients undergoing lumbar spine surgery.

Objective To search for new biomarkers to predict prognosis in colorectal cancer (CRC) patients.Methods A prognostic model was developed for colorectal cancer with immune-related genes from the cancer ge-nome atlas (TCGA) database using one-way Cox regression analysis and least absolute shrinkage and selection op-erator (LASSO) regression analysis.Moreover, the immune infiltration characteristics of patients in high and low risk groups was compared by sstimation of stromal and immune cells in malignant tumor tissues using expression da-ta (ESTIMATE) and cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT) .In addition, the expression levels of immune checkpoints were analyzed in patients from different risk groups.The sen-sitivity of patients in the two risk groups to chemotherapeutic agents was also compared based on genomics of drug sensitivity in cancer (GDSC).Results It was found that the prognostic model constructed based on immune genes could better predict the overall survival (OS) of CRC patients,and the results showed area under curve (AUC) values of 0.764 (95％ CI:0.751-0.793), 0.773 (95％ CI:0.761 -0.779), and 0.760 (95％ CI:0.742 -0.774) for 1-, 3-, and 5-year OS, respectively.Patients in the low-risk group had higher expression levels of im-mune checkpoints and more abundant immune cells such as T cells (P<0.001) , dendritic cells (P<0.001) , macrophages (P<0.001) , neutrophils (P<0.001) .Patients in the high-risk group might be more sensitive to some chemotherapeutic agents such as axitinib, imatinib, methotrexate, pazopanib, rapamycin, sunitinib and tasig-arnib.Conclusion A prognostic model based on 19 immune genes was effective in predicting the prognosis of CRC patients.The number and activity of immune cells in the immune microenvironment in different patients may be an important factor influencing their response to immunocheck inhibitors and chemotherapeutic agents.

Objective To adopt the systematical evaluation method to compare the efficacies between endoscopic retrograde appendicitis therapy (ERAT) versus laparoscopic appendectomy (LA) for treating feca-lith incarceration appendicitis.Methods The databases of PubMed,WANGFANG,CNKI,Cochrane Library and Embase were retrieved by computer.The retrieval time was 2016-2021.The EART related clinical trials were collected,the literatures conforming to the inclusion standard conducted the Jadad scoring,the basic situ-ation of each study and various observation indications (abdominal pain relief,time in bed,hospitalization du-ration,hospitalization expenses,postoperative CRP,postoperative complications) in the ERAT group and LA group were extracted respectively.The RevMan 5.3 software was used for conducting the statistical analysis. Results A total of 33 trials with a total of 2630 patients were included.There were 1294 cases in the ERAT group and 1336 cases in the LA group.The meta analysis results showed that the remission rate of abdominal pain at postoperative 12 h (RR=1.23,95％CI:1.06-1.43),time in bed (with d or h as the unit,WMD=-3.00,95％CI:-3.93 to-2.07;WMD=-9.51,95％CI:-16.12 to-2.90),hospitalization duration (WMD=-2.44,95％CI:-2.90 to-1.98),treatment costs (WMD=-3.00,95％CI:-5.34 to-0.67),postoperative CRP (WMD=-4.94,95％CI:-7.43 to-2.45) and postoperative complications incidence rate (RR=0.24,95％CI:0.18-0.32) had statistical difference between the two groups (P<0.05).Conclu-sion ERAT has more advantages than LA in treating fecalith incarceration appendicitis.

Objective To investigate the effects of intrauterine perfusion with granulocyte colony-stimulating factor(G-CSF)on the endometrial thickness,volume,and blood flow parameters of patients with thin endometrium and their clinical outcomes.Methods We designed a prospective non-randomized synchronous controlled trial and recruited patients with thin endometrium who underwent frozen-thawed embryo transfer(FET)at Mianyang Central Hospital between September 1,2021 and September 1,2023.They were divided into two groups,an experimental group of patients who received the experimental treatment of intrauterine perfusion with G-CSF and a control group of patients who did not receive the experimental treatment.The general data and the clinical outcomes of the two groups were analyzed and compared.The endometrial thickness,volume and blood flow parameters of patients in the experimental group before and after intrauterine perfusion with G-CSF were analyzed.Results The clinical data of 83 patients were included in the study.The experimental group included 51 cases,while the control group included 31 cases.There were no significant differences in the baseline data between the two groups.The clinical pregnancy rate of the experimental group(56.86% )was higher than that of the control group(50.00% )and the rate of spontaneous abortion in the experimental group(27.59% )was lower than that in the control group(37.50% ),but the differences were not statistically significant(P>0.05).In the experimental group,the postperfusion endometrial thickness([0.67±0.1]cm)was greater than the preperfusion endometrial thickness([0.59±0.09]cm),the postperfusion([1.84±0.81]cm3)was greater than the preperfusion endometrial volume([1.54±0.69]cm3),and the postperfusion vascularization flow index(VFI)(1.97±2.82)was greater than the preperfusion VFI(0.99±1.04),with all the differences being statistically significant(P<0.05).Conclusion Intrauterine perfusion with G-CSF can enhance the endometrial thickness,volume,and some blood flow parameters in patients with thin endometrium.

Scavenger receptor class B, member 2 (SCARB2) is linked to Gaucher disease and Parkinson's disease. Deficiency in the SCARB2 gene causes progressive myoclonus epilepsy (PME), a rare group of inherited neurodegenerative diseases characterized by myoclonus. We found that Scarb2 deficiency in mice leads to age-dependent dietary lipid malabsorption, accompanied with vitamin E deficiency. Our investigation revealed that Scarb2 deficiency is associated with gut dysbiosis and an altered bile acid pool, leading to hyperactivation of FXR in intestine. Hyperactivation of FXR impairs epithelium renewal and lipid absorption. Patients with SCARB2 mutations have a severe reduction in their vitamin E levels and cannot absorb dietary vitamin E. Finally, inhibiting FXR or supplementing vitamin E ameliorates the neuromotor impairment and neuropathy in Scarb2 knockout mice. These data indicate that gastrointestinal dysfunction is associated with SCARB2 deficiency-related neurodegeneration, and SCARB2-associated neurodegeneration can be improved by addressing the nutrition deficits and gastrointestinal issues.
Animals ; Mice ; Dysbiosis/metabolism* ; Mice, Knockout ; Humans ; Lysosomal Membrane Proteins/genetics* ; Receptors, Scavenger/genetics* ; Gastrointestinal Microbiome ; Myoclonic Epilepsies, Progressive/genetics* ; Vitamin E Deficiency/complications* ; Neurodegenerative Diseases/genetics* ; Bile Acids and Salts/metabolism* ; Male ; Lipid Metabolism ; Intestinal Mucosa/pathology*

Objective:To explore the effect of feedback health education combined with positive psychological suggestion on the rehabilitation of patients undergoing artificial total knee arthroplasty.Methods:From August 2020 to July 2021, the convenient sampling method was used to select 126 patients with artificial total knee arthroplasty admitted to the Orthopedic Department of Henan Provincial People's Hospital. They were randomly divided into the control group and the observation group in a 1∶1 ratio using a random number table method. The control group received routine health education combined with positive psychological suggestion, while the observation group received feedback based health education combined with positive psychological suggestion intervention. The level of knowledge, attitude and practice, scores on the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale (VAS), American Knee Society (AKS) score, knee swelling rate and nursing satisfaction were compared between two groups of patients.Results:The knowledge, attitude and practice scores of the two groups at discharge were higher than those at admission ( P<0.05), and the knowledge, attitude and practice scores of the observation group were higher than those of the control group at discharge ( P<0.05). The SAS and SDS scores of the observation group were lower than those of the control group before and on the third day after surgery ( P<0.05). The VAS of the observation group on the first day and 2 weeks after surgery were lower than those of the control group ( P<0.05), while AKS was higher than that of the control group ( P<0.05). The postoperative swelling rates in the observation group were lower than those in the control group at 1 week and 3 months after surgery ( P<0.05). The nursing satisfaction scores of the observation group in terms of health education, service attitude, department environment, psychological intervention, and nursing outcomes were higher than those of the control group ( P<0.05) . Conclusions:Feedback health education combined with positive psychological cues can improve the knowledge, attitude and practice levels of patients undergoing artificial total knee arthroplasty, reduce anxiety and depression, and improve rehabilitation effectiveness and nursing satisfaction.

A 10-year follow-up case of aldosterone and cortisol-secreting adrenocortical carcinoma, a rare disease presenting as an adrenal space-occupying lesion accompanied with hypertension and hypokalemia was reported, and the medical record was investigated in detail. Through case presentation and literature review, it was noted that patients with adrenocortical carcinoma presented a difference in clinical manifestations, pathology, and biological behaviors. This paper may help clinicians enhance their understanding of adrenocortical carcinoma. Especially significant adrenal space-occupying lesions highly suspicious of recurrence and producing different types of endocrine hormones should be paid more attention.