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.

Objective To explore the effects and possible mechanism of Mongolian medicine Eridun ·Wurile(EW)on neuronal apoptosis in rats with acute spinal cord injury(SCI).Methods The male SD rats were randomly divided into sham-operated group(sham group),SCI group,EW low-dose group,EW medium-dose group,EW high-dose group and EW high dose+AG490 group,with 15 rats in each group,and the SCI model of rats was established by Allen's method.EW low-dose group,EW medium-dose group and EW high-dose group were given EW suspension at a dosage of 0.32,0.63 and 1.26 g/kg for gavage after surgery,respectively;the EW high-dose+AG490 group was given Janus kinase 2(JAK2)inhibitor AG490(5 mg/kg)by gavage before surgery and EW(1.26 g/kg)by ga-vage after surgery;and the sham and SCI groups were given equal volume of distilled water,twice a day for 2 weeks.The hind limb motor function of each group was assessed by BBB grading score at 1 day,3,7 and 14 days postoperatively;the rats were executed 12 h after the last administration and the spinal cord water content was examined;the histopathological changes were observed by Hematoxy-lin-Eosin(HE)staining in the spinal cord of each group;the apoptosis of spinal neurons was detec-ted by in situ notch end labeling(TUNEL).The expression of Cleaved caspase-3,B-lymphoblas-toma-2(Bcl-2),Bcl-2 associated X protein(Bax),phosphorylated(p)-JAK2,and p-signal transduction and transcriptional activator 3(STAT3)proteins in spinal cord were detected by West-ern blot.Results Compared with the sham group,the BBB scores of rats in the SCI group were significantly lower,spinal cord edema and pathological structural damage were severe,the number of apoptotic cells and the expression of Cleaved caspase-3,Bax,p-JAK2 and p-STAT3 proteins in the spinal cord were significantly increased,while the expression of Bcl-2 was decreased(P＜0.05 or P＜0.01);compared with the SCI group,the BBB scores of EW low-dose group,EW medium-dose group and EW high-dose group gradually increased,the pathological injury degree of spinal cord tissue was relieved,and the number of apoptotic cells in spinal cord tissue was reduced,Cleaved caspase-3,Bax,p-JAK2,and p-STAT3 protein expressions were gradually down-regulated,while Bcl-2 protein expression was gradually up-regulated(P＜0.05 or P＜0.01);compared with EW high-dose group,the expression of P-JAK2,p-STAT3,Bax,Cleaved caspase-3 proteins down-regulated in the spinal cord tissue of EW high dose+AG490 group,and Bcl-2 protein were up-regu-lated,and the differences were statistically significant(P＜0.01).Conclusion EW plays a neu-roprotective role via inhibiting JAK2/STAT3 signaling pathway and reducing apoptosis in acute spi-nal cord injury rats.

Objective:To compare the efficacy and safety of drug-coated balloons (DCB) combined with bare metal stents (BMS) and BMS only for superficial femoral atherosclerosis obliterans.Methods:The clinical and follow-up data of 80 patients (82 limbs) who received combined treatment or BMS implantation at Cardiovascular Surgery Department of China Japan Friendship Hospital from Jan 2017 to Aug 2022 were retrospectively analyzed.Results:43 patients (43 limbs) were included in combined treatment group. 37 patients (39 limbs) were in BMS only. The average lesion length of combined group was longer than BMS group (19.54±7.04 cm vs. 16.25±6.43 cm, P=0.031). The primary patency rate of combined group at 36 months was not statistically different with BMS only group (56.9% vs. 38.5%, P=0.171). The subgroup analysis of superficial femoral artery TASC C/D (Trans-Atlantic Inter-Society Consensus) and CTO (chronic total occlusion) lesions indicated that efficacy of the combined group was superior to BMS only group. The patency rates of the combined group compared with the BMS group at 36 months were 57.6% vs. 23.8%, P=0.046, 60.2% vs. 31.4%, P=0.028, respectively. There was no significant difference in the FCD-TLR (free from clinical driven target lesion revascularization) between the two groups at 36 months (72.6% vs. 66.5%, P=0.706). There was no significant difference in major adverse events between the two groups ( P>0.05). Conclusion:Paclitaxel drug-coated balloon combined with bare metal stent is a safe and effective treatment for superficial femoral atherosclerosis obliterans, which is superior to bare metal stent, especially in TASC C/D and chronic total occlusive lesions.

Objective To explore the effects and possible mechanism of Mongolian medicine Eridun ·Wurile(EW)on neuronal apoptosis in rats with acute spinal cord injury(SCI).Methods The male SD rats were randomly divided into sham-operated group(sham group),SCI group,EW low-dose group,EW medium-dose group,EW high-dose group and EW high dose+AG490 group,with 15 rats in each group,and the SCI model of rats was established by Allen's method.EW low-dose group,EW medium-dose group and EW high-dose group were given EW suspension at a dosage of 0.32,0.63 and 1.26 g/kg for gavage after surgery,respectively;the EW high-dose+AG490 group was given Janus kinase 2(JAK2)inhibitor AG490(5 mg/kg)by gavage before surgery and EW(1.26 g/kg)by ga-vage after surgery;and the sham and SCI groups were given equal volume of distilled water,twice a day for 2 weeks.The hind limb motor function of each group was assessed by BBB grading score at 1 day,3,7 and 14 days postoperatively;the rats were executed 12 h after the last administration and the spinal cord water content was examined;the histopathological changes were observed by Hematoxy-lin-Eosin(HE)staining in the spinal cord of each group;the apoptosis of spinal neurons was detec-ted by in situ notch end labeling(TUNEL).The expression of Cleaved caspase-3,B-lymphoblas-toma-2(Bcl-2),Bcl-2 associated X protein(Bax),phosphorylated(p)-JAK2,and p-signal transduction and transcriptional activator 3(STAT3)proteins in spinal cord were detected by West-ern blot.Results Compared with the sham group,the BBB scores of rats in the SCI group were significantly lower,spinal cord edema and pathological structural damage were severe,the number of apoptotic cells and the expression of Cleaved caspase-3,Bax,p-JAK2 and p-STAT3 proteins in the spinal cord were significantly increased,while the expression of Bcl-2 was decreased(P＜0.05 or P＜0.01);compared with the SCI group,the BBB scores of EW low-dose group,EW medium-dose group and EW high-dose group gradually increased,the pathological injury degree of spinal cord tissue was relieved,and the number of apoptotic cells in spinal cord tissue was reduced,Cleaved caspase-3,Bax,p-JAK2,and p-STAT3 protein expressions were gradually down-regulated,while Bcl-2 protein expression was gradually up-regulated(P＜0.05 or P＜0.01);compared with EW high-dose group,the expression of P-JAK2,p-STAT3,Bax,Cleaved caspase-3 proteins down-regulated in the spinal cord tissue of EW high dose+AG490 group,and Bcl-2 protein were up-regu-lated,and the differences were statistically significant(P＜0.01).Conclusion EW plays a neu-roprotective role via inhibiting JAK2/STAT3 signaling pathway and reducing apoptosis in acute spi-nal cord injury rats.

Objective:To investigate the effect of Notch on periprosthetic fracture (PPF) of the femoral prosthesis after primary total knee arthroplasty.Methods:A total of 34 patients diagnosed with femoral PPF at Xi'an Honghui Hospital were retrospectively collected from January 2013 to December 2020. There were 4 males and 30 females with a mean age of 69.2±7.2 years (range, 55-84 years). A total of 102 patients without PPF were matched by gender and age as the control group in a ratio of 1∶3. There were 12 males and 90 females with a mean age of 69.2±7.2 years (range, 55-84 years). The main observation indexes included patients' general information and factors such as coronal alignment, prosthesis design and Notch conditions. Then, subgroup analysis was performed with the depth and Tayside classification of Notch to analyze their effects on PPF.Results:The PPF and control groups were comparable in terms of baseline information such as gender, age, body mass index (BMI), and surgical side. There was no significant difference between the two groups in coronal alignment (χ 2=1.019, P=0.601) and prosthesis design (χ 2=1.545, P=0.214). There was no statistical difference in Notch between the PPF and control groups (χ 2=3.548, P=0.060). The mean length of Notch in the PPF group was 4.5±2.7 mm, compared with 4.9±2.8 mm in the control group, with no significant difference between the two groups ( t=0.732, P=0.465). Further subgroup analysis using a Notch depth of 3 mm as a cut-off and Tayside classification revealed a statistical difference between the two groups (χ 2=11.262, P=0.004; χ 2=14.601, P=0.003). Compared with patients without Notch, the risk of PPF was higher when the depth of Notch exceeded 3 mm, with an odds ratio ( OR) of 4.88 (95% CI: 1.76, 13.51). The incidence of PPF was higher when Notch depth reached Tayside grade 3 or 4. Compared with patients without Notch, the risk of PPF would be 6.99-fold (95% CI: 1.85, 26.32) higher when Notch depth reached grade 3. In female patients, there was a significant difference in Notch status between the PPF and control groups (χ 2=3.956, P=0.047), with a higher risk of PPF in female patients with Notch, OR 2.33 (95% CI: 1.01, 5.43). In patients who underwent right-sided TKA, the risk of PPF was higher in patients with Notch compared to those without Notch (χ 2=5.502, P=0.019), with an OR of 3.58 (95% CI: 1.19, 10.75). Conclusion:The Notch has no significant effect on the femoral PPF after primary total knee arthroplasty. However, the risk of PPF will increase significantly when the Notch depth exceeds 3 mm or is above Tayside grade 3.

Objective:To investigate clinical efficacy of conformal sphincter preservation operation (CSPO) versus intersphincteric resection (ISR) in the treatment of low rectal cancer.Methods:The retrospective cohort study was conducted. The clinicopathological data of 183 patients with low rectal cancer who were admitted to two medical centers (117 in the Changhai Hospital of Naval Medical University and 66 in the Huashan Hospital of Fudan University) from August 2011 to April 2020 were collected. There were 110 males and 73 females, aged (57±11)years. Of 183 patients, 117 cases undergoing CSPO were allocated into CSPO group, and 66 cases undergoing ISR were allocated into ISR group, respectively. Observation indicators: (1) surgical situations of patients with low rectal cancer in the two groups; (2) postoperative complications of patients with low rectal cancer in the two groups; (3) follow-up; (4) influencing factors for prognosis of patients with low rectal cancer; (5) influencing factors for satisfaction with the anal function of patients with low rectal cancer. Follow-up was conducted using outpatient examination, questionnaire and telephone interview to determine local recurrence, distal metastasis, survival, stomal closure, satisfaction with the anal function of patients. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test.The Kaplan-Meier method was used to draw survival curves, and life table method was used to calculate survival rates. Log-rank test was used for survival analysis. Univariate analysis was performed using the linear regression. Variables with P<0.10 in the univariate linear regression analysis were included for multivariate analysis. Multivariate analysis was performed using the COX stepwise regression model and linear regression analysis. Results:(1) Surgical situations of patients with low rectal cancer in the two groups: cases with laparoscopic surgery, operation time, volume of intraoperative blood loss, distance from tumor to distal margin, cases with postoperative chemotherapy, duration of postoperative hospital stay were 44, (165±54)minutes, (142±101)mL, (0.6±0.4)cm, 76, (6.6±2.5)days for the CSPO group, respectively, versus 55, (268±101)minutes, (91±85)mL, (1.9±0.6)cm, 9, (7.9±4.7)days for the ISR group, showing significant differences between the two groups ( χ2=35.531, t=8.995, -3.437, -3.088, χ2=44.681, t=2.267, P<0.05). (2) Postoperative complications of patients with low rectal cancer in the two groups: 19 patients in the CSPO group had complications. There were 6 cases with grade Ⅰ complications, 12 cases with grade Ⅱ complications, 1 case with grade Ⅲb complication. Fourteen patients in the ISR group had complications. There were 4 cases with grade Ⅰ complications, 7 cases with grade Ⅱ complications, 1 case with grade Ⅲa complication, 2 cases with grade Ⅲb complications. There was no significant difference in the postoperative complications between the two groups ( χ2=0.706, P>0.05). Patients with complications in the two groups were improved after symptomatic and supportive treatment. There was no perioperative death in the postoperative 30 days of the two groups. (3) Follow-up: 183 patients received follow-up. Patients of the CSPO group and ISR group were followed up for (41±27)months and (37±19)months, respectively, showing no significant difference between the two groups ( t=-1.104, P>0.05). There were 2 cases with local recurrence and 9 cases with distal metastasis of the CSPO group, respectively, versus 3 cases and 4 cases of the ISR group, showing no significant difference between the two groups ( χ2=1.277, 0.170, P>0.05). The 3-year disease-free survival rate and 3-year total survival rate were 84.0% and 99.0% for the CSPO group, versus 88.6% and 92.8% for the ISR group, showing no significant difference between the two groups ( χ2=0.218, 0.002, P>0.05). The stomal closure rate was 92.16%(94/102) and 96.97%(64/66) for 102 patients of CSPO group and 66 patients of ISR group up to postoperative 12 months,respectively, showing no significant difference between the two groups ( χ2=1.658, P>0.05). Of the 8 cases without stomal closure in the CSPO group, 2 cases refused due to advanced age, 4 cases subjectively refused, and 2 cases were irreducible due to scar caused by radiotherapy. Two cases in the ISR group had no stomal closure including 1 case of postoperative liver metastasis and 1 case of subjective refusal. There were 92 and 61 patients followed up to 12 months after stomal closure, of which 75 cases and 38 cases completed questionnaires of satisfaction with the anal function. The satisfaction score with the anal function was 6.8±2.8 and 5.4±3.0 for CSPO group and ISR group, respectively, showing a significant difference between the two groups ( t=-2.542, P<0.05). Fifty-four cases in the CSPO group and 21 cases in the ISR group had satisfaction score with the anal function >5, showing no significant difference between the two groups ( χ2=3.165, P>0.05). (4) Influencing factors for prognosis of patients with low rectal cancer: results of COX stepwise regression analysis showed that gender and pT staging were independent influencing factors for disease-free survival rate of patients with low rectal cancer ( hazard ratio=2.883, 1.963, 95% confidence interval as 1.090 to 7.622, 1.129 to 3.413, P<0.05). Gender and pT staging were independent influencing factors for total survival rate of patients with low rectal cancer ( hazard ratio=10.963,3.187, 95% confidence interval as 1.292 to 93.063, 1.240 to 8.188, P<0.05). (5) Influencing factors for satisfaction with the anal function of patients with low rectal cancer: results of univariate analysis showed that surgical method and tumor differentiation degree were related factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.464, -1.580, 95% confidence interval as 0.323 to 2.605, -2.950 to -0.209, P<0.05). Results of multivariate analysis showed that surgical method, tumor differentiation degree and preoperative radiotherapy were independent influencing factors for satisfaction with the anal function of patients with low rectal cancer (partial regression coefficient=1.637, -1.456, -1.668, 95% confidence interval as 0.485 to 2.788, -2.796 to -0.116, -2.888 to -0.447, P<0.05). Conclusion:Compared with ISR, CSPO can safely preserve the anus in the treatment of low rectal cancer, without increasing the incidence of postoperative complications, which can also guarantee the oncological safety and improve the postoperative anal function.

Objective To evaluate the feasibility of wholeGtumor texture analysis of contrastGenhanced T1 WI (T1 Ce)in differentiating cystic glioma (CG)from brain abscess (BA).Methods MRI data of 25 cases of ringGenhanced CG and 24 cases of BA proven pathologically were retrospectively studied.All the patients underwent preGsurgery MRI plain and contrastGenhanced scans.FireVoxel software was used to outline the ROI of the wholeGtumor.The signal intensity histogram and related texture parameters of the 3D ROI were obtained,including mean, median,standard deviation,inhomogeneity,skewness,kurtosis and entropy.The data were first tested for normality and the differences in wholeG tumor texture analysis parameters of T1 Ce between CGs and BAs were compared using the independentGsample t test(normal distribution)and MannGWhitney rank sum test (skewed distribution).ROC curve was used to evaluate the efficacy of the parameter in differentiating CG from BA.Results There were statistical significances in the parameters of mean,median,standard deviation,inhomogeneity and skewness between CGs and BAs(P＜0.05),and there were no any statistical significances in kurtosis and entropy between CGs and BAs(P＞0.05).In all the texture parameters,the AUC of inhomogeneity was the largest(0.988),and when the threshold was 0.314, the sensitivity and the specificity were 92.60% and 9 7.1 0%,respectively.Conclusion Some of the quantitative parameters of the wholeGtumor texture analysis of T1 Ce(mean,median,standard deviation,inhomogeneity and skewness)could provide reliable and objective evidences for imaging differential diagnosis of CG and BA preGsurgery.

To determine the value of radiomics in identifying lymph node (LN) metastasis in patients with rectal nonmucinous adenocarcinoma.
 Methods: Imaging data of 91 patients were retrospectively analyzed (61 in the training set and 30 in the test set). A total of 1 301 radiomics features were extracted from high-resolution T2-weighted images of the whole primary tumor. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the optimal features and construct a radiomics classifier in the training set. Its discrimination performance was compared with that of morphological criteria by receiver operating characteristic (ROC) curve analysis, which was validated in the test set.
 Results: The radiomics classifier combined with five key features was significantly associated with LN metastasis, which distinguished LN metastasis with an area under curve (AUC) at 0.874 (95% CI 0.787 to 0.960) in the training set, and the performance was similar in the test set (AUC 0.878, 95% CI 0.727 to 1.000). The AUCs according to the morphological criteria in the training set and test set were 0.619 (95% CI 0.487 to 0.752) and 0.556 (95% CI 0.355 to 0.756), respectively. Discrimination of the radiomics classifier was superior to that of morphological criteria in both the two datasets (both P <0.05).
 Conclusion: The radiomics classifier provides individualized risk estimation for LN metastasis in rectal nonmucinous adenocarcinoma patients and it has the advantage over the morphological criteria.
Adenocarcinoma ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Rectal Neoplasms ; Retrospective Studies

Acupuncture safety is an unavoidable problem in acupuncture clinical. is the earliest ancient literature on acupuncture taboo, which has a far-reaching influence on the clinical acupuncture safety regulation. of - absorbs the essence of , retaining most of the contents of the theory and rearranging it. This paper tries to explore the discussions about , compared with , from the point of "anatomy" and "spirit", to describe the early understanding of acupuncture taboo, to emphasize the importance of acupuncture safety from three aspects, as human anatomy, needle and operation, and mental and functional status. It is suggested that a relatively preliminary acupuncture safety regulation was being formed at the time, in order to bring inspiration to the contemporary acupuncture clinical .
Acupuncture Therapy ; adverse effects ; China ; Moxibustion ; Needles

Through analyzing the origin and evolution of the thunder-fire moxibustion therapy, the mysteries and misunderstandings of it were revealed. As a result, a more objective and comprehensive recognition of this ancient therapy was displayed to the people nowadays. The thunder-fire moxibustion therapy maybe originate from the Taoism magic arts before the Dynasty and became matured in the middle of the Dynasty. Two categories were divided during the long-term evolution in the history. In one category, the peach twig was taken as the moxa material rather than moxa stick and the incantation of Taoism remained. Regarding the other category, the herbal medicine was mixed in the moxa stick and the herbal composition was relatively specified. The incantation was removed. The moxibustion in the first category vanished at the end of the Dynasty. The latter one kept on development from the middle of the Dynasty through the modern times. Additionally, the herbal composition of moxa material has been modified; the indication enlarged and the operation improved. This therapy is still developed and applied by many doctors at the present times.
Acupuncture Therapy ; History, Medieval ; Humans ; Moxibustion ; history ; Phytotherapy