With the aging of the global population， osteoporosis （OP） is becoming a major public health concern worldwide. Currently， the commonly used anti-osteoporosis drugs in clinical practice have limited application due to many side effects. Therefore， developing more effective and safer strategies for the prevention and treatment of OP has become a research focus in this field. In recent years， the clinical efficacy and advantages of traditional Chinese medicine （TCM） in treating OP have been gradually recognized. With the deepening pharmacological research on TCM for OP prevention and treatment， it is found that the active ingredients of Scutellaria baicalensis can promote bone formation or inhibit bone resorption by regulating signaling pathways， including Wnt/β-catenin， osteoprotegerin （OB）/receptor activator of nuclear factor-κB ligand （RANKL）/RANK （OPG/RANKL/RANK）， and bone morphogenetic protein 2 （BMP-2）/Smad， mitogen-activated protein kinase （MAPK）， and mammalian target of rapamycin （mTOR）. However， existing research on active ingredients of S. baicalensis for OP treatment is scattered， making it difficult for scholars to gain a systematic understanding of its research and application. This review summarized the literature on the active ingredients of S. baicalensis in OP treatment worldwide， clarified their mechanisms of action， and explored some issues， providing references for the integration of TCM in OP prevention and treatment.

With the aging of the global population， osteoporosis （OP） is becoming a major public health concern worldwide. Currently， the commonly used anti-osteoporosis drugs in clinical practice have limited application due to many side effects. Therefore， developing more effective and safer strategies for the prevention and treatment of OP has become a research focus in this field. In recent years， the clinical efficacy and advantages of traditional Chinese medicine （TCM） in treating OP have been gradually recognized. With the deepening pharmacological research on TCM for OP prevention and treatment， it is found that the active ingredients of Scutellaria baicalensis can promote bone formation or inhibit bone resorption by regulating signaling pathways， including Wnt/β-catenin， osteoprotegerin （OB）/receptor activator of nuclear factor-κB ligand （RANKL）/RANK （OPG/RANKL/RANK）， and bone morphogenetic protein 2 （BMP-2）/Smad， mitogen-activated protein kinase （MAPK）， and mammalian target of rapamycin （mTOR）. However， existing research on active ingredients of S. baicalensis for OP treatment is scattered， making it difficult for scholars to gain a systematic understanding of its research and application. This review summarized the literature on the active ingredients of S. baicalensis in OP treatment worldwide， clarified their mechanisms of action， and explored some issues， providing references for the integration of TCM in OP prevention and treatment.

Objective:To design a heating and pressurizing flushing device and to assess its application effect in hysteroscopic surgery.Methods:The heating and pressurizing flushing device was composed of a heating and pressing device,a liquid crystal control panel module,flushing pipeline,heating pipeline and a support frame.A total of 100 female patients who underwent gynecological hysteroscopic surgery at Shengjing Hospital of China Medical University from May 2021 to April 2022 were selected and divided into observation group and control group by random number table method,with 50 cases in each group.The observation group adopted a heating and pressurizing device to perform heating and pressurizing operations during hysteroscopic surgery,the control group adopted manual inflatable pressurized infusion bags to perform heating and pressurizing operations during hysteroscopic surgery by inflating and squeezing the air bag.The clarity of dilated uterus,operation time,preoperative,intraoperative and postoperative body temperature of the patients,and satisfaction of doctors and nurses were compared between the two groups.Results:The clarity rate of dilated uterus and satisfaction of doctors and nurses in the observation group were significantly higher than those in the control group,the difference was statistically significant(x2=7.862,8.392,P<0.05).The operation time of the observation group was significantly lower than that of the control group,the difference was statistically significant(t=51.099,P<0.05).The body temperature of the patients at 15 minutes during operation and 20 minutes after operation in the observation group were higher than those in the control group,the difference was statistically significant(t=-13.153,-17.911,P<0.05).Conclusion:The use of heating and pressurizing device in gynecological hysteroscopic surgery can increase the clarity of dilated uterus,effectively shorten operation time,save human resources,reduce complications and improve the satisfaction of medical staff.The clinical application effect is good.

Objective:To compare the effectivity and safety of ureteral stenting and percutaneous nephrostomy for patients with upper urinary calculi and sepsis.Methods:From June 2013 to June 2019, 429 patients with upper urinary calculi and urosepsis were accepted in the second hospital of Tianjin Medical University. According to surgical decompression, patients were divided into two groups, ureteral stenting (US, n=304) and percutaneous nephrostomy (PCN, n=125).121 patients were accompanied with septic shock in US group, 56 in PCN group. The effectivity of decompression was analyzed separately in patients with or without shock. For decompression, data included the success rate of decompression, the time of infection related parameters (temperature, blood WBC and CRP) returning to normal and the complications (progress of infection within 30min after decompression, perforation of ureter or pelvis). When urosepsis was cured, ureteroscopic lithotripsy was followed for all patients. The operation time, the stone free rate, the rate of using RIRS and the complications were compared.Results:For patients without septic shock, the success rate of decompression in PCN was higher (68/69)than that of US(165/183)( P =0.025); there was no significant difference in hospital stay for infection control and the time of infection related parameters (temperature, blood WBC and CRP) returning to normal ( P>0.05). The rate of infection progress within 30min in US(25/183) was higher than PCN(3/69)( P=0.036). When ureteroscopic lithotripsy was mentioned, the operation time in US(38.5±6.8 min) was longer than PCN(32.8±4.5 min)( P=0.000), the stone free rate and the rate of using RIRS were lower in PCN( P=0.044, P=0.0002). For patients with septic shock, the success rate of decompression in PCN was higher (55/56)than that of US(106/121)( P=0.022). The rate of infection progress within 30min after decompression was still higher in US ( P=0.048), the time of infection related parameters (temperature, blood WBC and CRP) returning to normal was shorter in PCN ( P=0.000, P=0.003, P=0.000). For lithotripsy, the operation time was longer in US ( P=0.017), the stone free rate and the rate of using RIRS were lower in PCN ( P=0.024, P=0.005). Conclusions:For patients with upper urinary calculi and urosepsis, both ureteral stenting and percutaneous nephrostomy can drainage the pelvis effectively. PCN provides quick recovery, especially when septic shock is involved. For the following ureteroscopic lithotripsy, PCN contributes to less operation time and higher stone free rate, reduces the use of flexible ureteroscope.

The 2013 National Practitioners Qualification Examination Work Conference proposed to reform the traditional one-stop test into two stage. In May 2017, Fujian University of Traditional Chinese Medicine participated in this empirical study as a pilot for the first time. This paper made a preliminary summary and analysis of the results of the phased examination. Because of the absence and deficiency of clinical skills of students in our school, we carried out a series of reform measures for clinical skill courses: enhancing teaching facilities, enriching teaching contents and methods, reforming assessment mode and strengthening the monitoring of the teaching quality of clinical skills. According to the students, reform measures are conducive to consolidating theoretical knowledge and improving clinical skills, laying a good foundation for successfully passing the national examination of medical practitioners and becoming a qualified medical talent.

Two male patients (patient 1,30 years old;patient 2,54 years old)were treated with topiramate for symptomatic epilepsy and migraine,respectively. The dosage of topiramate in patient 1 was 50 mg/ d and 75 mg/ d in the first and second weeks,respectively,and 100 mg/ d since the third week. Six months after topiramate treatment,the patient told the doctor that his epilepsy did not recur,but he developed hypomnesia,decreased libido,and premature ejaculation when topiramate was taken for 2 weeks. He did not stop topiramate despite that his symptoms persisted. The International Index of Erectile Function (IIEF)score showed that IIEF-1 score was 19 and IIEF-5 score was 16. He was diagnosed as sexual dysfunction. Levetiracetam was given for epilepsy,and topiramate was gradually reduced and finally discontinued within one month. The patient′ s sexual dysfunction improved after 2 weeks of topiramate reduction,disappeared after one month of drug withdrawal,and the IIEF-1 score was 28. The patient 2 took topiramate at a dose of 50 mg/ d. After 2 weeks of topiramate treatment,the patient developed decreased libido and erectile dysfunction. The IIEF-1 score was 23. Because the drug was effective in treating his headache,the patient took topiramate intermittently during headache attacks. The patient′s anaphrodisia and erectile dysfunction persisted.

Two male patients (patient 1,30 years old;patient 2,54 years old)were treated with topiramate for symptomatic epilepsy and migraine,respectively. The dosage of topiramate in patient 1 was 50 mg/ d and 75 mg/ d in the first and second weeks,respectively,and 100 mg/ d since the third week. Six months after topiramate treatment,the patient told the doctor that his epilepsy did not recur,but he developed hypomnesia,decreased libido,and premature ejaculation when topiramate was taken for 2 weeks. He did not stop topiramate despite that his symptoms persisted. The International Index of Erectile Function (IIEF)score showed that IIEF-1 score was 19 and IIEF-5 score was 16. He was diagnosed as sexual dysfunction. Levetiracetam was given for epilepsy,and topiramate was gradually reduced and finally discontinued within one month. The patient′ s sexual dysfunction improved after 2 weeks of topiramate reduction,disappeared after one month of drug withdrawal,and the IIEF-1 score was 28. The patient 2 took topiramate at a dose of 50 mg/ d. After 2 weeks of topiramate treatment,the patient developed decreased libido and erectile dysfunction. The IIEF-1 score was 23. Because the drug was effective in treating his headache,the patient took topiramate intermittently during headache attacks. The patient′s anaphrodisia and erectile dysfunction persisted.

Objective: To analyze the relationship between inflammatory factors and relevant risk factors in patients of essential hypertension (EH) combining acute coronary syndrome (ACS) with its clinical significance. Methods: Our research included 3 groups: EH group, n=79 patients with standard criteria, EH+ACS group, n=85 and Control group, n=48 normal subjects. Blood levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), tryptase (TPS) and relevant clinical, biochemical parameters were measured; risk factors for cardiovascular disease were examined and the relationship between above parameters, risk factors and ACS occurrence in EH patients was studied by Logistic regression analysis. Results: The OR values were all greater than 1 in fibrinogen (Fbg), high-sensitivity C-reactive protein (hs-CRP), TPS, atherosclerotic plaque, Lp-PLA2 and EH grading. Fbg was the most significant independent risk factor (OR=22.242, 95% CI 6.458-76.609, P<0.0001), the standardized partial regression coefficient b'as absolute value (b') was 1.079 which was the highestone in above 6 variables with the strongest impact for ACS occurrence in EH patients. Conclusion: Fbg, hs-CRP, TPS, atherosclerotic plaque and EH grading were the independent risk factors for ACS occurrence in EH patients; Fbg was the highest risk factor for ACS occurrence with the strongest impact, which provided a new direction for ACS prevention and treatment.

Objective To investigate the value of blood oxygenation level dependent(BOLD)fMRI in assessing the functional changes of the lumbar dorsal extensor muscles before and after exercise in healthy young people.Methods The changes of the R2*value of lumbar dorsal extensor group in 30 healthy young volunteers(15 males and 15 females)before and after exercise was prospectively studied.BOLD-fMRI scans were performed on healthy young volunteers before and after exercise, the exercise mode was to perform the upper body flexion and extension movement with a simple Rome stool.The scanned images were processed and analyzed, the cross-sectional area and R2* value of the lumbar dorsal extensor muscles (including the multifidus,the longissimus and the iliocostalis)were measured at the upper margin of the L3 and L4 vertebral body before and after exercise.The paired t test was used to compare CSA and R2*values of muscles before and after loading. The CSA and R2* value of different muscles in different sides were compared by independent sample t test. Pearson correlation analysis was used to analyze the relevance between CSA and R2* in muscle before and after exercise. Results After exercise, the R2* values of multifidus,longissimus and iliocostalis at the upper margin of the L4 vertebral body were[(39.2±8.6),(38.9± 7.7),(41.6±7.8)]Hz,significantly lower than before exercise[(46.1±6.9),(45.3±6.2),(46.0±6.7)]Hz(P<0.01);the changes of R2*values of the muscles between the left and right sides before and after the movements were not statistically significant(P>0.05).The R2*values of longissimus and iliocostalis at the upper margin of the L3 vertebral body were[(44.2±9.1),(46.6±9.3)]Hz,significantly lower than before exercise[(48.6±7.2),(49.7± 6.8)]Hz (P<0.01), but the R2* values of multifidus after loading was (43.9 ± 9.0)Hz, there was no statistical difference compared with before exercise (46.8 ± 6.6)Hz (P>0.05);there was a significant difference in the changes of R2*value before and after the movement between the left and right side of iliocostalis(P<0.05).A significant negative correlation between CSA and R2*value was found in the iliocostalis on the right side at the upper margin of L3 vertebral body and in the multifidus on the left side at the upper margin of L4 vertebral body,and the correlation coefficients were (-0.697,-0.616).Conclusion BOLD-fMRI can be a new way to assess the functional changes of the lumbar dorsal extensor group before and after exercise.

Objective To compare the effect of 89Sr radionuclide therapy and radiotherapy in the treatment of metastatic cancer pain of vertebral column. Methods 80 patients with cancer pain of vertebral metastasis in the second People's hospital of Yibin from April 2015 to April 2017, were randomly divided into the control group treated by radiotherapy treatment (n=40) and the the observation group treated by 89Sr radionuclide therapy(n=40), and the effect of treatment were compared between two groups. Results In the observation group, the total effective rate of pain response in patients with metastatic cancer pain of vertebral column was 85.0％, and the control group was 82.5％. There was no significant difference between two groups. The onset time of treatment in the observation group was (6.5±1.7)d, significantly shorter than that of the control group (12.9±2.6)d, and the difference was statistically significance (P<0.05). Conclusion The application of 89Sr radionuclide therapy in the treatment of vertebral metastatic pain is equivalent to the radiotherapy in improving the pain response, but the efficacy could be achieved in a short period of time, so it is worth popularizing widely in clinical practice.