Objective:To explore the effect of 3D printing extravascular stent implantation on the hemodynamics of the relevant large vessels in patients with nutcracker syndrome（NCS），and to discuss the clinical safety of this new procedure.Methods:A total of 30 NCS patients admitted to Tangdu Hospital Affiliated to Air Force Military Medical University from May to December 2023 were prospectively included. All the patients were received laparoscopic 3D printing extravascular stent implantation for NCS treatment. Whether the lumbago，abdominal pain，hematuria，proteinuria and varicocele had improved after the stent implantation were observed. The inner diameter，blood flow velocity of left renal vein，abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava were measured by ultrasound 1 day before surgery and 8 days after surgery，respectively.In addition，the carotid-femoral pulse wave velocity（cfPWV）was measured by a newly developed method，by which the arterial stiffness could be detected based on Doppler ultrasound. The blood flow Doppler spectra of each subject were recorded at the right common carotid artery and the right common femoral artery，respectively，then based on that，the cfPWV was automatically calculated by this new technique. The above internal diameters，blood flow velocity and cfPWV were compared before and after the laparoscopic 3D printing extravascular stent implantation.Results:Among the 30 patients，the postoperative blood flow velocity at the left renal vein compression site was significantly lower than that before surgery［（50.7 ± 14.8）cm/s vs（122.1 ± 24.1）cm/s， P<0.001）］，and the clinical symptoms，including lumbago and abdominal pain，hematuria，proteinuria and varicocele were significantly improved（all P<0.05）. There were no significant changes in the internal diameter，blood flow velocity of abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava，and cfPWV before and after operation（all P>0.05）. Conclusions:The 3D printing extravascular stent implantation through laparoscope can effectively improve left renal vein compression in patients with NCS，and cause no significant change in large arterial hemodynamics，suggesting that this surgical method is a safe and reliable treatment for patients with NCS.

Objective To evaluate the clinical efficacy of hip-knee-ankle active and passive exercise therapy in patients with early-to mid-stage knee osteoarthritis(KOA).Methods A total of 180 patients with early to mid-stage knee osteoarthritis(KOA)were recruited from the First Affiliated Hospital of Hebei University of Tradi-tional Chinese Medicine between March 2023 and March 2024.Patients were randomly assigned to one of four groups:active movement group,passive movement group,combined movement group,and control group,with 45 patients in each group.The active movement group received hip-knee-ankle active movement therapy daily until the end of follow-up.The passive movement group underwent hip-knee-ankle passive movement therapy three times per week for two weeks.The combined movement group received both active and passive therapies.The control group was administered oral celecoxib capsules(200 mg once daily for two weeks).Joint function was assessed in all four groups before treatment,at two weeks post-treatment,and at 14 weeks post-treatment.The primary outcome measure was the WOMAC joint function score,while secondary outcomes included the WOMAC pain score,stiffness score,and quality of life score(SF-12).Results A total of 160 patients completed the trial,with 39 in the active group,42 in the passive group,40 in the combined group,and 39 in the control group.There were no significant differences in baseline characteristics among the groups(P>0.05).Compared to baseline,the WOMAC scores for function,pain,and stiffness in the passive,combined,and control groups decreased significantly at both 2 and 14 weeks post-treatment(P<0.05),while the SF-12 scores increased significantly(P<0.05).Between 2 and 14 weeks post-treat-ment,the active and combined groups showed further significant decreases in WOMAC function,pain,and stiffness scores(P<0.05)and increases in SF-12 scores(P<0.05).At 2 weeks post-treatment,compared to the control group,the passive and combined groups exhibited significantly lower WOMAC function scores(P<0.05),with no significant difference between the passive and combined groups(P>0.05).By 14 weeks post-treatment,the active and combined groups demonstrated significantly lower WOMAC function scores(P<0.05),with the combined group showing a significantly lower score than the active group(P<0.05).Conclusion The four therapeutic approaches demonstrate a certain degree of efficacy in improving joint function for patients with early and mid-stage KOA.The passive therapy group exhibits superior short-term outcomes,while the active therapy group shows better long-term benefits.The combined therapy group presents notable advantages in both short-term and long-term effi-cacy,although its short-term effectiveness does not surpass that of the passive therapy group.It is recommended for patients with early and mid-stage KOA who have underlying gastrointestinal and cardiovascular conditions.

Objective:To explore the effect of 3D printing extravascular stent implantation on the hemodynamics of the relevant large vessels in patients with nutcracker syndrome（NCS），and to discuss the clinical safety of this new procedure.Methods:A total of 30 NCS patients admitted to Tangdu Hospital Affiliated to Air Force Military Medical University from May to December 2023 were prospectively included. All the patients were received laparoscopic 3D printing extravascular stent implantation for NCS treatment. Whether the lumbago，abdominal pain，hematuria，proteinuria and varicocele had improved after the stent implantation were observed. The inner diameter，blood flow velocity of left renal vein，abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava were measured by ultrasound 1 day before surgery and 8 days after surgery，respectively.In addition，the carotid-femoral pulse wave velocity（cfPWV）was measured by a newly developed method，by which the arterial stiffness could be detected based on Doppler ultrasound. The blood flow Doppler spectra of each subject were recorded at the right common carotid artery and the right common femoral artery，respectively，then based on that，the cfPWV was automatically calculated by this new technique. The above internal diameters，blood flow velocity and cfPWV were compared before and after the laparoscopic 3D printing extravascular stent implantation.Results:Among the 30 patients，the postoperative blood flow velocity at the left renal vein compression site was significantly lower than that before surgery［（50.7 ± 14.8）cm/s vs（122.1 ± 24.1）cm/s， P<0.001）］，and the clinical symptoms，including lumbago and abdominal pain，hematuria，proteinuria and varicocele were significantly improved（all P<0.05）. There were no significant changes in the internal diameter，blood flow velocity of abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava，and cfPWV before and after operation（all P>0.05）. Conclusions:The 3D printing extravascular stent implantation through laparoscope can effectively improve left renal vein compression in patients with NCS，and cause no significant change in large arterial hemodynamics，suggesting that this surgical method is a safe and reliable treatment for patients with NCS.

Objective To evaluate the clinical efficacy of hip-knee-ankle active and passive exercise therapy in patients with early-to mid-stage knee osteoarthritis(KOA).Methods A total of 180 patients with early to mid-stage knee osteoarthritis(KOA)were recruited from the First Affiliated Hospital of Hebei University of Tradi-tional Chinese Medicine between March 2023 and March 2024.Patients were randomly assigned to one of four groups:active movement group,passive movement group,combined movement group,and control group,with 45 patients in each group.The active movement group received hip-knee-ankle active movement therapy daily until the end of follow-up.The passive movement group underwent hip-knee-ankle passive movement therapy three times per week for two weeks.The combined movement group received both active and passive therapies.The control group was administered oral celecoxib capsules(200 mg once daily for two weeks).Joint function was assessed in all four groups before treatment,at two weeks post-treatment,and at 14 weeks post-treatment.The primary outcome measure was the WOMAC joint function score,while secondary outcomes included the WOMAC pain score,stiffness score,and quality of life score(SF-12).Results A total of 160 patients completed the trial,with 39 in the active group,42 in the passive group,40 in the combined group,and 39 in the control group.There were no significant differences in baseline characteristics among the groups(P>0.05).Compared to baseline,the WOMAC scores for function,pain,and stiffness in the passive,combined,and control groups decreased significantly at both 2 and 14 weeks post-treatment(P<0.05),while the SF-12 scores increased significantly(P<0.05).Between 2 and 14 weeks post-treat-ment,the active and combined groups showed further significant decreases in WOMAC function,pain,and stiffness scores(P<0.05)and increases in SF-12 scores(P<0.05).At 2 weeks post-treatment,compared to the control group,the passive and combined groups exhibited significantly lower WOMAC function scores(P<0.05),with no significant difference between the passive and combined groups(P>0.05).By 14 weeks post-treatment,the active and combined groups demonstrated significantly lower WOMAC function scores(P<0.05),with the combined group showing a significantly lower score than the active group(P<0.05).Conclusion The four therapeutic approaches demonstrate a certain degree of efficacy in improving joint function for patients with early and mid-stage KOA.The passive therapy group exhibits superior short-term outcomes,while the active therapy group shows better long-term benefits.The combined therapy group presents notable advantages in both short-term and long-term effi-cacy,although its short-term effectiveness does not surpass that of the passive therapy group.It is recommended for patients with early and mid-stage KOA who have underlying gastrointestinal and cardiovascular conditions.

Objective To observe the clinical effect of traditional Chinese medicine bone-setting technique using spinal,pelvi-lower extremity line to treat patients with knee osteoarthritis(KOA).Methods 426 patients with KOA were all from the First Affiliated Hospital of Hebei University of Traditional Chinese Medicine.They were randomly divided into experimental group(384 cases,57 cases of elimination,shedding and termination)by computer generated sequence.Traditional Chinese bone setting techniques were applied with spinal-pelvic-lower limb force line(divided into three parts:lumbar fixed point reduction method,hip joint push-pull and extension method and knee peripheral tendon recovery method every 3 days.2 weeks)treatment;The control group was the waiting treatment group(48 cases,6 cases were eliminated,abscission,termination),which was only used for clinical observation for 2 weeks.The main outcome index was WOMAC pain score.Secondary outcome measures were WOMAC stiffness score,functional score,standardized score and quality of life score(SF-12).The test time points were baseline,2 weeks after enrollment,and follow-up(14 weeks after enrollment).The control group was at baseline and 2 weeks after enrollment.Results Compared with baseline,WOMAC pain score,stiffness score,functional score and standardized score were all decreased in 2 groups 2 weeks after enrollment(P<0.05),but the experimental group was significantly decreased compared with the control group(P<0.001).SF-12 quality of life scores were all higher than before(P<0.001),but the experimental group was significantly higher than the control group(P<0.001).At follow-up,compared with 2 weeks after enrollment,WOMAC pain scores were increased(P<0.001),WOMAC stiffness,joint function and standardized scores were decreased(P<0.001),and SF-12 scores were increased(P<0.001).Conclusion The use of spinal-pelvi-lower extremity line of traditional Chinese medicine bone-setting technique in the treatment of KOA is effective in improving the knee joint function and improving the quality of life of patients,but the short-term effect of pain relief is good,and the long-term effect is not good.Its safety is good,and it can be considered in clinical application for KOA patients with joint dysfunction as the main manifestation.

Objective:To explore the level of arterial stiffness and its influencing factors in prediabetic population.Methods:From June 2021 to June 2022, 207 prediabetes patients were prospectively and randomly recruited from the physical examination center and outpatient clinic of Tangdu Hospital of Air Force Military Medical University to be the prediabetic group and 130 healthy volunteers at the same time with the same gender and age as the healthy controls. The carotid-femoral pulse wave velocity (PWV), brachial-radial PWV, and femoral-ankle PWV were measured by an automatic ultrasonic arterial stiffness measurement technology. The common carotid artery wall intima-media thickness (IMT) and left heart function were routinely evaluated. A questionnaire was designed to investigate the subjects′ smoking, drinking, diet, staying up late, exercise and other living habits. Comparison between groups and multivariate linear regression analysis were used to analyze the relevant data.Results:The carotid-femoral PWV and common carotid artery wall IMT in prediabetic group were significantly higher than those in healthy controls [(7.10±2.00)m/s vs (6.26±1.14)m/s, (0.57±0.11)mm vs (0.51±0.08)mm; both P<0.001], but there were no significant differences in the brachial-radial PWV and femoral-ankle PWV between the two groups (both P>0.05). Multivariate linear regression analysis showed that prediabetes was an independent influencing factor in carotid-femoral PWV after adjusting for confounding factors ( P<0.001), in addition, age ( P<0.001), diastolic blood pressure ( P<0.001), staying up late ( P=0.011) and low density lipoprotein cholesterol ( P=0.022) were also the independent influencing factors of carotid-femoral PWV. Conclusions:Compared with healthy people, the stiffness of aorta is significantly increased in prediabetic people, but there is no significant change in the stiffness of peripheral arteries. Prediabetes, age, diastolic blood pressure, staying up late and low density lipoprotein cholesterol are independent influencing factors of carotid-femoral PWV.

Objective:To investigate the accuracy and reproducibility of a new method, Automatic Measurement of Arterial Stiffness(AMAS) system, for arterial stiffness automatic measurement based on regional pulse wave velocity (PWV).Methods:A total of 30 hypertensive patients who were hospitalized in the Department of Cardiology in Tangdu Hospital, Air Force Military Medical University from September 1 to 30, 2019 were enrolled as hypertensive group, while 30 healthy participants at the same time were collected as healthy group. Carotid-femoral PWV (cfPWV) was measured in all subjects by two independent observers using the conventional manual method and the AMAS system. The measurements were compared and the agreement was analyzed.Results:There was no significant difference of cfPWV between AMAS system and the manual method, and the intraclass correlation coefficient was 0.953 (95% CI=0.922-0.971). Bland-Altman plots showed good agreement [mean difference: -(0.08±0.40)m/s; limit of agreement: -0.87-0.71 m/s]. Time consumption for cfPWV measurement using the AMAS system was significantly less than that of conventional manual method, saving about 70% of the time. The cfPWV measured by AMAS showed good intra- and inter-observer reproducibility. Conclusions:AMAS system is accurate and reproducible in measuring arterial stiffness. It may provide a noninvasive, rapid, reliable approach for arterial stiffness evaluation in clinical settings.

Objective:To investigate the application of ultrasound imaging in evaluating the curative effect of patients with nutcracker syndrome (NCS) treated with three-dimensional(3D) printing extravascular titanium stents.Methods:From December 2015 to December 2018, a total of 41 NCS patients enrolled in the Second Affiliated Hospital of the Air Force Military Medical University to receive 3D-printing extravascular titanium stents treatment were included in this study. Ultrasound and CT angiography (CTA) were performed before and 1 week after operation to evaluate the compression of left renal vein and related hemodynamic changes.Results:Before the operative, the ultrasound examination showed that the angle between the abdominal aorta and superior mesenteric artery was (21.29±4.53)°, which was significantly improved in 1 week after treatment [(47.42±7.45)°, P<0.001]. Left renal vein was significantly compressed before treatment, with the smallest inner diameter of (1.51±0.49)mm and its peak blood flow velocity was (143.92±50.40)cm/s. Postoperative ultrasound images showed the significant expansion of left renal vein and no high velocity blood flow was observed. Ultrasound examination also showed that the diameter of left renal vein at renal hilum, blood flow velocity at renal hilum and inner diameter of spermatic vein were significantly improved after treatment ( P<0.001). Similar to ultrasound results, CTA also found that the angle between abdominal aorta and superior mesenteric artery increased significantly after treatment[(17.59±4.56)° vs (52.27±9.01)°, P<0.001]. CTA also showed the left renal vein was compressed before treatment, with the smallest inner diameter of (2.09±0.86)mm, and it was significantly expanded after operation. The inner diameter of left renal vein at renal hilum was also significantly reduced after treatment ( P<0.001). Conclusions:Ultrasound imaging can effectively evaluate the LRV compression and related hemodynamic changes before and after 3D printed stent implantation treatment in NCS patients and provide a reliable method to evaluate its clinical efficacy for these patients.

Objective To explore the relationship between atherosclerotic plaque stability and junctional adhesion molecule A (JAM-A) in atherosclerotic mice.Methods Twenty-six apolipoprotein E gene knockout(ApoE-/-) mice were divided into three groups.Group A (six mice) was control group,group B (ten mice) was disposed by ligation and high-fat diet and group C was disposed by high-fat diet with ten mice.The formation process of plaques were observed with high resolution ultrasound(22 MHz),and plaque markers were detected to evaluate palque stability for secondary grouping (group D was vulnerable plaque group and group E was stable plaque group).The plaque stability were evaluated by plaque vulnerability index and the expression of JAM-A were analyzed using immunohistochemical staining.The relationship between atherosclerotic plaque stability and JAM-A in atherosclerotic mice were estimated with statistical methods at last.Results There was no plaque in carotid artery of group A.On the contrary,obvious plaques were observed in carotid artery of group B and C.The total serum lipids level in group A was normal.But high-fat diet could obviously decrease the serum HDL-cholesterol level of group B and group C when compared with the controls(P ＜0.05).High-fat diet could increase the ratio of non-HDL-cholesterol (TC,TG,LDL).As shown with pathological staining,the content of extracellular lipids and foam cells in the plaque were significantly increased vs.control (P ＜ 0.05).On the contrary,the content of smooth muscle cells and collagen fibers were significantly increased vs.control(P ＜0.05).The plaque vulnerability index of group D was higher than that in group E(P ＜0.01).The expression of JAMA was increased in group D and E,and in group D was higher(P ＜0.01).While,few JAM-A expression in group A.There was significant correlation between plaque vulnerability index and JAM-A (P＜0.01).Conclusions High resolution uhrasound(22 MHz) can observe the formation of carotid plaque in ApoE-/-mice.There was a positive correlation between JAM-A expression and the vulnerability of plaque in carotid artery.JAM-A might be used for evaluation of plaque stability as a new indicator.

ObjectrueTo evaluate magnetic resonancec ho langiopancreatography (MRCP) in the diagnosis of acute or chronic pancreatitis . MethodsMRCP was undertaken in 30 patients with chronic and 9 with acute pancreatitis. Comparison was m ade with findings at ERCP.ResultsOf 196 segments of biliary-pancreatic duct analyzed, 17 were not seen at MR CP (sensitivity, 91%). Of the segments visualized at MRCP, 14 were incorrect ly characterized (accuracy, 92%). At MRCP, segments not detected or mischara cterized were either normal, slightly dilated, or narrowed. MRCP image quali ty was not interpretable in two cases due to artifacts. ConclusionVery good correlation between ERCP and MRCP findings was demonstrated. MRCP may substitude for ERCP, particularly in pa tients who cannot undergo ERCP or in whom ERCP has been unsuccessful.