Ankylosing spondylitis is a chronic immunoinflammatory disease that mainly affects the spine and the sacroiliac joint， the mechanism of which is closely related to signaling pathways， such as osteoprotegerin （OPG）/receptor activator of nuclear factor-κB （RANK）/RANK ligand， mitogen-activated protein kinase （MAPK）， Wnt/β-catenin （β-catenin）， phosphoinositide 3- kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）. Traditional Chinese medicine has the characteristics of multiple components and targets， and is widely used for the treatment of autoimmune diseases due to its low toxicity， strong specificity， and high efficacy. This review found that monomers and compounds of traditional Chinese medicine can exert anti ankylosing spondylitis effects by intervening in the aforementioned signaling pathways， regulating immune inflammatory responses， and inhibiting biological processes such as bone destruction， ectopic osteogenic differentiation， cell apoptosis， and autophagy.

ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

OBJECTIVE To investigate the efficacy and safety of tirofiban for early neurological deterioration in patients with acute ischemic stroke. METHODS A total of 126 patients with early neurological deterioration of acute ischemic stroke who were admitted to the Department of Neurology， Heji Hospital Affiliated to Changzhi Medical College from January 2022 to December 2023 were selected and divided into observation group and control group according to random number table method， with 63 cases in each group. All patients received standardized treatment such as lipid-lowering and blood pressure-lowering therapy. Based on the standard treatment， patients in the control group additionally took Aspirin enteric-coated tablets 100 mg+Clopidogrel bisulfate tablets 75 mg orally （once a day， for 14 consecutive days）. The patients in the observation group received Tirofiban hydrochloride and sodium chloride injection based on the standardized treatment [first intravenous infusion of 0.40 μg/（kg·min） for 30 min， and then continuous intravenous infusion of 0.10 μg/（kg·min） for 47.5 h]； subsequently， patients were given Aspirin enteric-coated tablets （100 mg） and Clopidogrel bisulfate tablets （75 mg） once a day for 14 consecutive days. The clinical efficacy， the National Institutes of Health Stroke Scale （NIHSS） score， modified Rankin Scale （mRS） score， and hemorheological indexes before and after treatment were compared between the two groups， and the adverse reactions were recorded. RESULTS The total effective rate （87.30%） of the observation group was significantly higher than that of the control group （71.43%） （P＜0.05）. NIHSS scores of the two groups at 1st， 7th and 14th day after treatment， the mRS score at 90th day after treatment， and the platelet aggregation rate， whole blood viscosity， plasma viscosity and fibrinogen at 14th day after treatment were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group at the same period （P＜0.05）. The total incidences of adverse reactions such as nausea， headache， fever， gastrointestinal bleeding， oral and nasal mucosal bleeding and thrombocytopenia in both groups of patients were 28.57% respectively， with no statistically significant difference （P＞0.05）. CONCLUSIONS For patients with early neurological deterioration in acute ischemic stroke， the addition of tirofiban can accelerate the recovery of neurological function， improve blood hyperviscosity and platelet aggregation， and improve the prognosis of patients with good safety.

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

Objective To investigate the effects of electrical stimulation combined with muscle strength training on knee joint biomechanical characteristics in patients with patellofemoral pain(PFP).Methods Forty-six patients with PFP were recruited and randomly assigned to the muscle strength training(MST)and electrical muscle stimulation with strength training(EMS)groups.The intervention was performed three times a week for six weeks.The anterior knee pain scale(AKPS)was used to measure the knee pain degree.Knee kinematics,dynamics,and surface electromyography(sEMG)data were collected using an infrared motion capture system,force platform,and sEMG system during drop jumps before and after the intervention.Two-way analysis of variance with repeated measures was applied to determine the differences between the dependent variables of the two groups before and after the intervention.Results Compared with pre-intervention,the AKPS score,vastus medialis oblique(VMO)activation,VMO/vastus lateralis(VMO/VL)activation,maximum knee flexion angle,and peak knee extension moment increased significantly in the EMS group;the maximum knee abduction,external rotation angle,and peak knee external rotation moment decreased significantly in the EMS group after intervention.Compared with pre-intervention,the AKPS score,maximum knee flexion angle,and peak knee extension moment increased significantly in the MST group after intervention,the peak knee abduction and external rotation moment significantly decreased in the MST group after intervention.Post-hoc comparisons indicated that compared with the MST group,the AKPS score,VMO activation,VMO/VL activation were significantly higher and the maximum knee abduction angle was significantly lower in the EMS group.Conclusions EMS contributes to the better balance muscle activation of the VMO and VL and corrects the excessive knee abduction angle during jump landing,which may be helpful in relieving pain and improving lower limb function in patients with PFP.

BACKGROUND:Lower limb peri-knee muscle strength training and neuromuscular electrical stimulation are generally safe and effective rehabilitation methods for patellofemoral joint pain,but the mechanism of their intervention is still unclear. OBJECTIVE:To determine the effect of muscle strength training combined with neuromuscular electrical stimulation on pain,lower extremity function and biomechanical characteristics in patients with patellofemoral pain. METHODS:Thirty-seven patients with patellofemoral pain were randomly divided into muscle strength training combined with electrical stimulation group(trial group,n=19)and muscle strength training group(control group,n=18).Both groups underwent intervention training for 6 weeks,three times a week.The visual analog scale and anterior knee pain scale were used to evaluate the pain level and functional level of the knee.Kinematic and kinetics data during running were collected by using an infrared motion capture system and a three-dimensional force platform simultaneously.A two-way analysis of variance with repeated measures(group*time)was applied to analyze the data. RESULTS AND CONCLUSION:(1)After the intervention,the visual analog scale scores of the trial group and the control group were significantly decreased(P<0.001),and the anterior knee pain scale scores were significantly increased(Ptrial group<0.001,Pcontrol group=0.001)in the trial group and control group.The anterior knee pain scale scores of the trial group were significantly higher compared to the control group after the intervention(P=0.001).(2)The peak knee flexion angle(P=0.011),peak knee extension moment(P<0.001),the peak knee internal rotation moment(P=0.008),the peak patellofemoral stress(P<0.001)and the peak patellofemoral contact force(P<0.001)were significantly decreased in the trial and control groups during running after the intervention compared with those before the intervention.(3)In conclusion,both muscle strength training and muscle strength training combined with electrical stimulation training are helpful to improve the subjective pain and lower limb function of patellofemoral pain patients,enhance the movement pattern during running and reduce the stress of the patellofemoral joint.Compared with muscle strength training alone,muscle strength training combined with electrical stimulation can improve lower limb function more significantly.

Laboratory testing is a vital chain in the prevention and control of genital chlamydia trachomatis infection. The prevalence of genital chlamydia trachomatis infection is high, but the detection rate of the infection is low in men who have sex with men (MSM) in China. Self-sampling for genital chlamydia trachomatis detection by MSM is a new option to address this problem, which would play a significant role in expanding genital chlamydia trachomatis infection screening in this population. This paper summarizes the progress in research of self-sampling for the detection of genital chlamydia trachomatis and the related factors in MSM both at home and abroad to provide reference for the promotion of self-sampling for the detection of genital chlamydia trachomatis in this population.

Objective To explore the mechanism of microRNA-378a-3p(miR-378a-3p)affecting the deve-lopment of breast cancer(BC)cells.Methods The expression of miR-378a-3p in BC cells based on the Cancer Genome Atlas Program database was analyzed.The starBase,miRDB,and miRWalk databases were used to predict the target genes of miR-378a-3p.Double-luciferase reporter experiments were performed to verify the targeted regulation of miR-378a-3p on NUAK family kinase 2(NUAK2).Real-time fluorescence quantitative PCR and Western blot analyses were used to detect the expression of miR-378a-3p and NUAK2 mRNA and protein in BC cells.Cell proliferation ability was detected through cell-proliferation experiments.Cell scratch assay and invasion assay were used to detect the migration and invasion abilities of cells,respectively.Apoptosis and cell-cycle experiments were conducted to detect cell apoptosis rate and cell cycle distribution.Results The expression of miR-378a-3p was significantly downregulated in BC cells,and miR-378a-3p overexpression inhibited the proliferation,migration,and invasion of BC cells.miR-378a-3p directly targeted NUAK2 and inhibited the mRNA and protein expression of NUAK2.Conclusion miR-378a-3p inhibits the proliferation,migration,and invasion of BC cells by targeting NUAK2.

Retinal vein occlusion(RVO), the second most prevalent retinal vascular disease, has complex pathophysiological mechanism. Except for mechanical pressure on blood vessel, inflammation and endothelin have been confirmed to be involved in the pathogenesis of RVO. However, its specific mechanism remains unclear. Hypertension, diabetes and dyslipidemia have been previously shown to be the most common risk factors in elder population, while recent studies found that coagulation and hemorheological abnormalities are more common in people under 50 years old. Ocular risk factors including glaucoma, high corrected intraocular pressure and retinal vessels abnormality, have gained more and more attention. These factors probably exert a synergistic effect when present simultaneously in the same patient. Therefore, early identification and intervention of those factors could lower the incidence of RVO. This article aims to review recent research and summarize existing mechanism and theories, giving some new research ideas for potential therapy targets and providing references for identification and management of risk factors.

Objective:To analyze the influencing factors of low liver regeneration in patients with hilar cholangiocarcinoma (HCCA) after portal vein embolization (PVE).Method:Clinical data of 62 patients with HCCA undergoing PVE at Henan Provincial People's Hospital (People's Hospital of Zhengzhou University) from January 2019 to March 2024 were retrospectively analyzed, including 33 males and 29 females, aged (59.1±10.3) years. Patients were divided into two groups based on the median regeneration rate of remnant liver volume (28.6%) three weeks after PVE: low regeneration ( n=31, <28.6%) and high regeneration group ( n=31, ≥28.6%). The proportion of lymph node metastasis, history of alcohol consumption, liver fibrosis, biliary tract infection, alkaline phosphatase (ALP), and tumor necrosis factor-α (TNF-α) were compared between two groups. Multivariate logistic regression analysis was used to indentify the influencing factors of low liver regeneration in patients with HCCA after PVE surgery. Results:The proportion of lymph node metastasis, history of alcohol consumption, liver fibrosis, biliary tract infection, ALP, and level of TNF-α were higher in the low regeneration group than those in the high regeneration group (all P<0.05). Multivariate logistic regression analysis showed that patients with regional lymph node metastasis ( OR=2.561, 95% CI: 1.265-5.185), history of alcohol consumption ( OR=2.616, 95% CI: 1.321-5.181), liver fibrosis ( OR=2.351, 95% CI: 1.265-4.369), biliary tract infection ( OR=2.461, 95% CI: 1.226-4.940), elevated level of ALP ( OR=2.687, 95% CI: 1.351-5.344), and elevated level of TNF-α ( OR=2.781, 95% CI: 1.452-5.326) had an increased risk of low liver regeneration after PVE (all P<0.05). Conclusion:Regional lymph node metastasis, history of alcohol consumption, liver fibrosis, biliary tract infection, and elevated ALP and TNF-α are risk factors for low liver regeneration in patients with HCCA after PVE surgery, which should be noted in clinical practice.