Patients with Takayasu arteritis combined with aortic valve disease often have a poor prognosis following surgical valve replacement, frequently encountering complications such as perivalvular leakage, valve detachment, and anastomotic aneurysm. This article presents a high-risk case wherein severe aortic valve insufficiency associated with Takayasu arteritis was successfully managed through transcatheter aortic valve implantation via the transapical approach. The patient had satisfactory valve function with no complications observed during the six-month postoperative follow-up. This case provides a minimally invasive and feasible alternative for the clinical management of such high-risk patients.

This paper systematically sorts out the historical evolution and modern research progress of moxibustion in the treatment of essential hypertension.It analyzes the development of moxibustion in the treatment of hypertension from early experience to the for-mation of theory,from clinical exploration,initial systematization of clinical research to the current development results,reflecting the scientific and innovative transformation of moxibustion in the treatment of essential hypertension.It reveals that moxibustion can achieve antihypertensive effects through multiple pathways,including neuron-body fluid regulation,renin-angiotensin-aldosterone system reg-ulation,cell signaling pathway regulation,vascular homeostasis,and immune system function regulation,emphasizing its internal con-sistency from macroscopic syndrome differentiation to microscopic mechanism.Through systematic integration,it can not only highlight the unique advantages of moxibustion in"multi-dimensional adjustment",but also provide a new perspective for breaking through the single-target limitation of current antihypertensive drugs.

All four patients were female, with an average age of 28.8 days and an average weight of 3.64 kg. Only case 4 was born prematurely at 34 W+5 and was treated conservatively until 71 days to complete operation. All the others completed primary corrective surgery in the neonatal period, and all survived after operation. Two different surgical techniques were used to repair the aortic-pulmonary window and the aortic origin of the right pulmonary artery, including 1 case using the aortic internal baffle technique and another 3 cases underwent replantation of the right pulmonary artery (1 case was reconstructed in situ, and the other 2 cases were reconstructed by moving the right pulmonary artery in the anterior of aorta). Case 2 who received aortic internal baffle technique underwent two reoperation because of right pulmonary artery stenosis. While, right pulmonary artery of cases 3 and 4 developed well after being reconstructed the right pulmonary artery anterior translocation. After the diagnosis of Berry syndrome through cardiac color ultrasound and CT angiography, a primary surgical radical treatment should be performed as soon as possible at an experienced pediatric cardiac center. Although the surgery is high-risk and complex, it is safe and effective.

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 explore the correlation between the expression of serum human leukocyte antigen B27(HLA-B27) and serum amyloid A(SAA) in patients with pulmonary tuberculosis and the severity of the disease and the infection of other pulmonary pathogens. Methods From September 2021 to September 2023,120 patients with pulmonary tuberculosis complicated with pulmonary infection in Beijing Ditan Hospital Affiliated to Capital Medical University were selected as the research group,and another 120 patients with pulmonary tuberculosis were selected as the control group. According to the pneumonia severity index (PSI),the study group patients were divided into low-risk group (n=47),medium risk group (n=42) and high-risk group (n=31). Collected patient sputum for pathogen detection. Enzyme-linked immunosorbent assay (ELISA) was applied to measure the expression levels of HLA-B27 and SAA in serum. Multivariate Logistic regression was applied to analyze the factors that affected the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic efficacy of serum HLA-B27 and SAA for the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Results Compared with the control group,the positive rate of serum HLA-B27(72.50％ vs 19.17％)in the study group,expression level of SAA (9.32±2.32 ng/ml vs 4.64±1.04 ng/ml)were significantly increased,and the differences were statistically significant(x2=68.744,t=20.164,all P<0.05). A total of 84 strains of pathogenic bacteria were isolated by the research group,including 46 Gram negative bacteria,34 Gram positive bacteria,and 4 fungi,with Klebsiella pneumoniae accounting for the highest proportion (15.48％). Compared with the low-risk group,the positive rate of HLA-B27(76.19％,93.55％ vs 55.32％),the expression level of SAA(9.35±2.35ng/ml,10.94±2.42ng/ml vs 8.23±2.23ng/ml)and the PSI score(108.63±12.47score,145.93±12.44 score vs 54.48±17.31 score) in the middle-risk group and the severe-risk group were significantly higher,and the differences were statistically significant (x2=4.256,13.130,t=2.306,5.077;15.021,25.384,all P<0.05). Serum HLA-B27 and SAA levels in patients with pulmonary tuberculosis complicated with pulmonary infection were positively correlated with PSI score (r=0.385,0.522,all P<0.05). The results of multivariate Logistic regression analysis showed that HLA-B27 positivity and SAA were risk factors affecting the severity of pulmonary tuberculosis combined with pulmonary infection in patients (P<0.05). The combined diagnosis of serum HLA-B27 and SAA had the highest area under the curve (AUC) for the severity of pulmonary infection in patients,which was superior to the individual diagnosis of serum HLA-B27 and elevated SAA expression levels (Z=3.132,2.131,P=0.002,0.033). Conclusion The pathogenic bacteria in patients with pulmonary tuberculosis and pulmonary infection are mainly Gram negative bacteria. The increases in serum HLA-B27 positive rate and SAA expression level are closely related to the disease progression in patients with pulmonary tuberculosis and pulmonary infection. The combination of the two can better diagnose the severity of the disease in patients with pulmonary infection.

The international dissemination of Chinese acupuncture represents a successful model of medical and cultural exchange between the East and the West, as well as an exemplary case of Chinese culture going global. In 1971, following the announcement by Xinhua News Agency that "acupuncture anesthesia technology had achieved success", American medical educator Professor Edmunds Grey Dimond became the first foreign doctor to visit China for an investigation of acupuncture anesthesia. His efforts significantly contributed to the promotion of Chinese acupuncture within western medical communities. From the perspective of acupuncture humanities, this article reviews and analyzes Dimond's academic background, his journey to study acupuncture anesthesia in China, and his unique insights into acupuncture, exploring how his open-minded and objective approach facilitated the acceptance and dissemination of acupuncture anesthesia and acupuncture techniques in the West.
China ; Humans ; History, 20th Century ; Acupuncture Therapy/history* ; Acupuncture/history* ; Acupuncture Analgesia/history* ; History, 21st Century

This paper systematically sorts out the historical evolution and modern research progress of moxibustion in the treatment of essential hypertension.It analyzes the development of moxibustion in the treatment of hypertension from early experience to the for-mation of theory,from clinical exploration,initial systematization of clinical research to the current development results,reflecting the scientific and innovative transformation of moxibustion in the treatment of essential hypertension.It reveals that moxibustion can achieve antihypertensive effects through multiple pathways,including neuron-body fluid regulation,renin-angiotensin-aldosterone system reg-ulation,cell signaling pathway regulation,vascular homeostasis,and immune system function regulation,emphasizing its internal con-sistency from macroscopic syndrome differentiation to microscopic mechanism.Through systematic integration,it can not only highlight the unique advantages of moxibustion in"multi-dimensional adjustment",but also provide a new perspective for breaking through the single-target limitation of current antihypertensive drugs.

Objective To explore the correlation between the expression of serum human leukocyte antigen B27(HLA-B27) and serum amyloid A(SAA) in patients with pulmonary tuberculosis and the severity of the disease and the infection of other pulmonary pathogens. Methods From September 2021 to September 2023,120 patients with pulmonary tuberculosis complicated with pulmonary infection in Beijing Ditan Hospital Affiliated to Capital Medical University were selected as the research group,and another 120 patients with pulmonary tuberculosis were selected as the control group. According to the pneumonia severity index (PSI),the study group patients were divided into low-risk group (n=47),medium risk group (n=42) and high-risk group (n=31). Collected patient sputum for pathogen detection. Enzyme-linked immunosorbent assay (ELISA) was applied to measure the expression levels of HLA-B27 and SAA in serum. Multivariate Logistic regression was applied to analyze the factors that affected the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic efficacy of serum HLA-B27 and SAA for the severity of pulmonary tuberculosis combined with pulmonary infection in patients. Results Compared with the control group,the positive rate of serum HLA-B27(72.50％ vs 19.17％)in the study group,expression level of SAA (9.32±2.32 ng/ml vs 4.64±1.04 ng/ml)were significantly increased,and the differences were statistically significant(x2=68.744,t=20.164,all P<0.05). A total of 84 strains of pathogenic bacteria were isolated by the research group,including 46 Gram negative bacteria,34 Gram positive bacteria,and 4 fungi,with Klebsiella pneumoniae accounting for the highest proportion (15.48％). Compared with the low-risk group,the positive rate of HLA-B27(76.19％,93.55％ vs 55.32％),the expression level of SAA(9.35±2.35ng/ml,10.94±2.42ng/ml vs 8.23±2.23ng/ml)and the PSI score(108.63±12.47score,145.93±12.44 score vs 54.48±17.31 score) in the middle-risk group and the severe-risk group were significantly higher,and the differences were statistically significant (x2=4.256,13.130,t=2.306,5.077;15.021,25.384,all P<0.05). Serum HLA-B27 and SAA levels in patients with pulmonary tuberculosis complicated with pulmonary infection were positively correlated with PSI score (r=0.385,0.522,all P<0.05). The results of multivariate Logistic regression analysis showed that HLA-B27 positivity and SAA were risk factors affecting the severity of pulmonary tuberculosis combined with pulmonary infection in patients (P<0.05). The combined diagnosis of serum HLA-B27 and SAA had the highest area under the curve (AUC) for the severity of pulmonary infection in patients,which was superior to the individual diagnosis of serum HLA-B27 and elevated SAA expression levels (Z=3.132,2.131,P=0.002,0.033). Conclusion The pathogenic bacteria in patients with pulmonary tuberculosis and pulmonary infection are mainly Gram negative bacteria. The increases in serum HLA-B27 positive rate and SAA expression level are closely related to the disease progression in patients with pulmonary tuberculosis and pulmonary infection. The combination of the two can better diagnose the severity of the disease in patients with pulmonary infection.

BACKGROUND:The repair and clinical outcome of bone defects remains a hot and difficult area of clinical research,which is a common problem that plagues clinicians.Constructing suitable,reproducible and infinitely close to clinical animal experimental models and their scientific evaluation are essential for further clinical treatment of related diseases. OBJECTIVE:To retrospectively analyze the preparation methods and characteristics of common animal models of femoral bone defects and to assess their strengths and weaknesses,thereby providing some reference for relevant researchers to select appropriate animal models of femoral bone defects. METHODS:PubMed,Web of Science,Medline,and CNKI were retrieved for relevant literature published from January 1,2000 to August 1,2022.The keywords were"bone defect,bone,bones,defect,defects,defective,animal model,animal,model,laboratory,laboratory animal,animal laboratory"in English and"bone defect,animal model,experiment"in Chinese. RESULTS AND CONCLUSION:Twenty-seven randomized controlled animal experiments involving rats,mice,New Zealand rabbits,and sheep were included,analyzed and assessed.The most common types of bone defects were cylindrical bone defects and segmental osteotomy bone defects,generally found in the middle and distal femur.These models are mostly used to evaluate the effects of bone repair materials,drugs,drug-loaded active substances and physical therapy on bone defect repair and explore defect healing mechanisms,particularly the weight-bearing bone defect repair mechanism.Different defect kinds and femoral bone defect ranges have been found in different animal experiments.Researchers can select the suitable animal model and bone defect type based on the goal of the experiment and then set an acceptable bone defect value.Current studies have shown that cylindrical and segmental osteotomy-induced bone defects,mainly in the distal and middle femur,are mostly used in the animal models of femoral bone defects and that the surgical methods and postoperative management are more mature and operable to provide mature experimental animal models.In terms of cylindrical bone defects,rats and New Zealand rabbits are more suitable,whereas segmental osteotomy has no special requirements and all types of animals can meet the experimental requirements.

Objective: To investigate the correlation between magnetic resonance imaging-based vertebral bone quality (VBQ) score and screw loosening after dynamic pedicle screw fixation with polyetheretherketone (PEEK) rods, and evaluate its predictive value. Methods: A retrospective analysis was conducted on the patients who underwent dynamic pedicle screw fixation with PEEK rods from March 2017 to June 2022. Data on age, sex, body mass index, hypertension, diabetes, hyperlipidemia history, long-term smoking, alcohol consumption, VBQ score, L1–4 average Hounsfield unit (HU) value, surgical fixation length, and the lowest instrumented vertebra were collected. Logistic regression analysis was employed to assess the relationship between VBQ score and pedicle screw loosening (PSL). Results: A total of 24 patients experienced PSL after surgery (20.5%). PSL group and non-PSL group showed statistical differences in age, number of fixed segments, fixation to the sacrum, L1–4 average HU value, and VBQ score (p < 0.05). The VBQ score in the PSL group was higher than that in the non-PSL group (3.56 ± 0.45 vs. 2.77 ± 0.31, p < 0.001). In logistic regression analysis, VBQ score (odds ratio, 3.425; 95% confidence interval, 1.552–8.279) were identified as independent risk factors for screw loosening. The area under the receiver operating characteristic curve for VBQ score predicting PSL was 0.819 (p < 0.05), with the optimal threshold of 3.15 (sensitivity, 83.1%; specificity, 80.5%). Conclusion The VBQ score can independently predict postoperative screw loosening in patients undergoing lumbar dynamic pedicle screw fixation with PEEK rods, and its predictive value is comparable to HU value.