OBJECTIVE: To investigate short-term effectiveness of using expert adolescent lateral femoral nail (EALFN) in treating femoral shaft fractures in older children and adolescents. METHODS: A retrospective analysis was conducted on the clinical data of 17 patients with femoral shaft fractures who met the inclusion criteria and were admitted between July 2020 and June 2024. All fractures were fixed with EALFN after reduction. There were 11 males and 6 females, with a mean age of 13.3 years (range, 11-16 years). The average body weight was 51.2 kg (range, 40-84 kg), and the average height was 162.1 cm (range, 150-172 cm). The causes of injury included traffic accidents ( n=9), falling from height ( n=1), and simple falls ( n=7). One patient had an open fracture treated with an external fixator and experienced delayed fracture healing. The remaining patients were closed fractures, with an average time from injury to operation of 5.8 days (range, 2-10 days). Operation time and postoperative hospital stay were documented. During follow-up, X-ray films were taken to observe the fracture healing, and the bilateral femoral length, femoral neck-shaft angle, widest femoral neck diameter (FND), and articular trochanteric distance (ATD) were measured at last follow-up. Hip function was assessed using the Harris score. The differences in the all indicators between the healthy and affected sides were compared. RESULTS: The operation time ranged from 65 to 130 minutes (mean, 94.1 minutes). Postoperative hospital stay ranged from 5 to 40 days (mean, 16.7 days). All patients were followed up 7-36 months (mean, 14.4 months). One patient exhibited delayed fracture healing during follow-up. The distal locking nail was removed at 6 months after operation, and partial weight-bearing was initiated following dynamic fracture stabilization. The fracture healing was achieved, and the intramedullary nail was removed at 24 months after operation. The other fractures healed with the healing time of 6-20 months (mean, 9.6 months), and the intramedullary nails were removed. During follow-up, no femoral fracture, abnormal development of the greater trochanter, or ischemic necrosis of the femoral head occurred. At last follow-up, there was no significant difference in femoral length, femoral neck-shaft angle, FND, ATD, or Harris score between the affected and healthy sides ( P>0.05). CONCLUSION For older children and adolescents with femoral neck fractures, the application of EALFN fixation aligns more closely with the principles of intramedullary central fixation and rapid rehabilitation. This approach is associated with fewer complications and superior short-term effectiveness.
Humans ; Male ; Femoral Fractures/surgery* ; Female ; Child ; Adolescent ; Retrospective Studies ; Bone Nails ; Fracture Fixation, Intramedullary/instrumentation* ; Fracture Healing ; Treatment Outcome

The"ying-wei imbalance"theory originates from Inner Canon of Yellow Emperor,which refers to the dynamic pathological process of yingfen and weifen circulation,distribution,posture,strength,and weakness due to internal and external disturbance,emphasizing that"ying-wei imbalance"is the key to disease occurrence.The sanjiao,as the"envoy of primordial qi,"is central to yingfen and weifen,and the coordinated operation of yingfen and weifen depends on the promotion of the qi of sanjiao.Therefore,based on the yingfen and weifen theory and sanjiao differentiation and treatment,this paper discusses the etiology and pathogenesis of chronic pulmonary heart disease,as well as the syndrome differentiation approach."Ying-wei imbalance"is the core of this mechanism:in the early stage,the loss of yingfen and weifen nutrition,combined with the deficiency of the qi of sanjiao,allows exogenous pathogens to invade the lungs.During progression,dysfunction in the transportation function of yingfen and weifen,along with the stagnation of the qi of sanjiao,results in pulmonary and cardiac involvement,accompanied by phlegm accumulation and stagnation.The end stage is characterized by the failure of both ying and wei,along with dysfunction of the sanjiao and zang-fu organs,which interact to form a pathological chain of"qi disease involving body."Accordingly,the treatment principle of"harmonizing yingfen and weifen,giving sanjiao treatment"was proposed.This is implemented through three therapeutic strategies:"harmonizing""returning",and"astringing"aimed at restoring balance.In the early stage,treatment focuses on tonifying the lungs and consolidating the exterior to eliminate pathogenic factors and activate stagnation.The selected formula is Buyuan Decoction with modifications to harmonize sanjiao.During the developmental stage,treatment focuses on promoting collaterals and dispersing phlegm,utilizing the modified Xuefu Zhuyu Decocotion to facilitate the restoration of function to the sanjiao.In the final stage,Fuyang Decoction,with modifications,is used to resolve fluid retention and nourish both qi and blood.Discussions are closely focused on the syndrome differentiation system of"sanjiao-yingfen and weifen,"in order to offer a novel perspective on the management of chronic pulmonary heart disease.

Cardiac remodeling in microgravity exerts effects on astronauts'health and space mission efficiency.This paper analyzes the etiology,pathogenesis,prevention,and treatment of cardiac remodeling in microgravity based on the Trinity View of"Physique-Qi-Spirit"of traditional Chinese medicine.The microgravity environment disrupts the heaven-earth qi interaction law described in"Suwen Yin Yang Ying Xiang Da Lun":"Earth qi ascends to form clouds through heavenly evaporation,while heaven qi descends as rain".This disruption causes upward reversal of human qi and cephalad fluid shift,consequently influencing the dynamic balance of the physique-qi-spirit system and inducing cardiac remodeling.The core pathogenesis initiates with qi upward reversal at the initial stage,advances through spiritual disturbance during progression,and culminates in physical impairment at the terminal stage.We therefore propose a holistic"physique-qi-spirit"co-regulation strategy implemented via three therapeutic principles:regulating qi,stabilizing spirit,and restoring physique.This approach aims to restore the dynamic balance of the"physique-qi-spirit"system in microgravity,apply the concept of"preventive treatment of diseases",holistically prevent or delay cardiac remodeling,and provide Traditional Chinese Medicine solutions for safeguarding astronauts'cardiovascular health.

The"ying-wei imbalance"theory originates from Inner Canon of Yellow Emperor,which refers to the dynamic pathological process of yingfen and weifen circulation,distribution,posture,strength,and weakness due to internal and external disturbance,emphasizing that"ying-wei imbalance"is the key to disease occurrence.The sanjiao,as the"envoy of primordial qi,"is central to yingfen and weifen,and the coordinated operation of yingfen and weifen depends on the promotion of the qi of sanjiao.Therefore,based on the yingfen and weifen theory and sanjiao differentiation and treatment,this paper discusses the etiology and pathogenesis of chronic pulmonary heart disease,as well as the syndrome differentiation approach."Ying-wei imbalance"is the core of this mechanism:in the early stage,the loss of yingfen and weifen nutrition,combined with the deficiency of the qi of sanjiao,allows exogenous pathogens to invade the lungs.During progression,dysfunction in the transportation function of yingfen and weifen,along with the stagnation of the qi of sanjiao,results in pulmonary and cardiac involvement,accompanied by phlegm accumulation and stagnation.The end stage is characterized by the failure of both ying and wei,along with dysfunction of the sanjiao and zang-fu organs,which interact to form a pathological chain of"qi disease involving body."Accordingly,the treatment principle of"harmonizing yingfen and weifen,giving sanjiao treatment"was proposed.This is implemented through three therapeutic strategies:"harmonizing""returning",and"astringing"aimed at restoring balance.In the early stage,treatment focuses on tonifying the lungs and consolidating the exterior to eliminate pathogenic factors and activate stagnation.The selected formula is Buyuan Decoction with modifications to harmonize sanjiao.During the developmental stage,treatment focuses on promoting collaterals and dispersing phlegm,utilizing the modified Xuefu Zhuyu Decocotion to facilitate the restoration of function to the sanjiao.In the final stage,Fuyang Decoction,with modifications,is used to resolve fluid retention and nourish both qi and blood.Discussions are closely focused on the syndrome differentiation system of"sanjiao-yingfen and weifen,"in order to offer a novel perspective on the management of chronic pulmonary heart disease.

Neuropathic pain(NPP)is a recurrent and intractable pain syndrome,and microglial polarization is closely related to it.Recent studies have shown that after cell polarization,M1 pro-inflammatory and M2 anti-inflammatory types could be formed,and M1 and M2 microglial cells are involved in NPP through the modulation of inflammatory responses.The two types of microglial cells have different roles in NPP,just like a double-edged sword.M1 pro-inflammatory type plays an injurious role in NPP through the release of pro-inflammatory factors and noxious substances,whereas M2 anti-inflammatory type plays a protective role by secreting anti-inflammatory factors.In this article,the role of microglia polarization on NPP are reviewed.

Glioma, the most common intrinsic tumor of the central nervous system, is characterized by its high incidence and poor prognosis. The aim of this study was to identify differentially expressed genes (DEGs) between glioblastoma multiforme (GBM) and low-grade glioma (LGG) to explore prognostic factors of different grades of gliomas. Single-cell transcriptome sequencing data of gliomas were collected from the NCBI Gene Expression Omnibus (GEO), which included a total of 29 097 cell samples from three datasets. For the analysis of human gliomas of different grades, 21 071 cells were obtained by filtering, and 70 genes were screened from differentially expressed genes by gene ontology (GO) analysis, Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis, from which the gene DLL3 was focused by reviewing the literature. The TCGA-based gene expression profiling interactive analysis (GEPIA) database was used to explore the survival curves of genes in LGG and GBM, and the gene expression profiling interactive analysis and tumor immune estimation resource (TIMER) database was used to study the expression of key genes in gliomas of different grades, predicting biomarkers that were closely related to immunotherapy. The cBioPortal database was used to explore the relationship between DLL3 expression and 25 immune checkpoints. Gene set enrichment analysis (GSEA) further identified pathways associated with central genes. Finally, the efficacy of biomarkers in prognosis and prediction was validated in the Chinese glioma genome atlas (CGGA). These results demonstrated that prognostic genes are associated with tumor proliferation and progression. Analysis of biological information and survival suggested that these genes might serve as a promising prognostic biomarker and as new targets for selecting therapeutic strategies.
Humans ; Biomarkers ; Brain Neoplasms/pathology* ; Gene Expression Profiling/methods* ; Glioblastoma/pathology* ; Glioma/pathology* ; Intracellular Signaling Peptides and Proteins ; Membrane Proteins/genetics* ; Prognosis ; Transcriptome ; Tumor Microenvironment/genetics* ; Biomarkers, Tumor

Retinoblastoma (RB) is the most common intraocular malignant tumor in infants and young children. The key causative factors in the progression of RB remain unclear. Therefore, identifying genes closely associated with RB progression may provide important clues for disease diagnosis and gene therapy. However, tumor tissues have strong cellular heterogeneity. There may be significant differences in cell function and gene expression among cells in different pathological states. In this study, we downloaded single-cell transcriptome sequencing data of RB tumors and adjacent tissues from the GEO public database. Subsequently, we analyzed RB tumor transcriptional profiles with different disease duration at the single-cell level and identified cell groups and gene sets potentially associated with RB progression. The results showed that the tumor tissue and the adjacent tissues had overall consistency in the single-cell transcriptional map, but there were obvious differences in the distribution proportions of G1 phase cells, G2 phase cells, and microglia cells of cone precursors in RB tumor and the adjacent tissues. Furthermore, the role of three cell populations in the progression of RB tumors was emphatically analyzed. We found that in the early stage of RB tumors, cone precursor cells proliferated abnormally in G1 phase. With the progression of RB tumors, the proportion of cone precursor cells in G2 phase increased significantly. Meanwhile, the results of differential analysis of microglial populations during RB progression showed that the key genes mainly involved in immune response include RPL23, B2M, and HLA superfamily genes. This study provides new perspectives and data resources for the research of RB pathogenesis and progress.
Child ; Infant ; Humans ; Child, Preschool ; Retinoblastoma/pathology* ; Transcriptome ; Retinal Neoplasms/pathology*

Objective:To investigate the clinical value of imaging features of primary lesions combined with venous phase CT value in predicting central group lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC) .Methods:Clinical data of 170 PTC patients who underwent central group LN dissection in the First People's Hospital of Handan City of Hebei Province from January 2017 to June 2020 were retrospectively analyzed. All patients were divided into different groups according to whether central group LN metastasis or not, and there were 89 patients with central group LN metastasis and 81 patients without central group LN metastasis. The CT value and imaging features of primary lesions in different periods were analyzed, and the imaging features of primary lesions combined with venous phase CT values to predict the central group LN metastasis were evaluated by the receiver operating characteristic (ROC) curve.Results:There were no statistically significant differences in CT value in plain scan phase and CT value, net increased CT value, standardized CT value in arterial phase between patients with and without central group LN metastasis (all P>0.05) . The CT value, net increased CT value and standardized CT value in venous phase of patients with central group LN metastasis were (113.84±22.95) HU, (59.05±12.10) HU and 0.72±0.14 respectively, which were significantly higher than those of patients without central group LN metastasis [ (103.99±17.67) HU, (51.29±14.45) HU and 0.59±0.10] ( t=3.26, P<0.001; t=3.81, P<0.001; t=3.67, P<0.001) . ROC curve analysis showed that the area under the curve for diagnosing central group LN metastasis of PTC patients was 0.75, 0.70 and 0.76 when the cut-off values of CT value, net increased CT value and standardized CT value in venous phase were 115.78 HU, 62.37 HU and 0.75 respectively. There were statistically significant differences in the diameter of primary focus and the contact area of thyroid capsule between patients with and without central group LN metastasis ( Z=-2.34, P=0.019; Z=-2.08, P=0.037) . There were no statistically significant differences between calcification and primary lesion location (both P>0.05) . Lesion diameter >2 cm (87.73%) and capsule contact range ≥1/2 (92.17%) had the highest specificity in predicting central group LN metastasis. The imaging features of primary lesion combined with standardized CT value in venous phase was in good agreement with histopathological diagnosis results in predicting central group LN metastasis (Kappa=0.475) , and the sensitivity and specificity were 73.12% and 82.75% respectively. Conclusion:The imaging features of the primary lesion combined with CT value in venous phase have a good clinical value in predicting central group LN metastasis in PTC patients. Patients with primary lesion diameter >2 cm, capsule contact range ≥1/2 and the standardized CT value in venous phase >0.75 are more likely to have central group LN metastasis.

The design of a clip-on moxibustion instrument which could adjust the directions and absorb harmful granules of moxa smoke was introduced in this paper. It was designed to solve the problems in home health care and clinical treatment, such as the inconvenience of adjustment of moxibustion directions and temperature, more dust and granules of moxa smoke and inconvenience of moxibustion placement. The main part of moxibustion instrument was made up of moxibustion box, bracket and base clamp. The moxibustion box could fix moxa stick and absorb smoke granules; the bracket could be twisted to adjust the direction of moxibustion box; the base clamp was aimed to fix moxibustion box on the edge of the object to save space. This moxibustion instrument could be used for various indications of moxibustion, especially in the joints or body parts with less muscles; and it can significantly enhance the pertinence and safety of moxibustion, and reduce the labor intensity. This moxibustion instrument is original and unique, simple and reasonable, easy to operate, with low cost and good effect, which will increase new vitality for the popularization and development of moxibustion.

Objective To observe the effect of Zhuang Medicine Jib on spasm in hemiplegics after stroke. Methods From January, 2014 to December, 2015, 55 patients with spastic hemiplegia after stroke were divided randomly into treatment group (n=27) and control group (n=28). Both groups accepted routine rehabilitation and acupuncture, while the treatment group accepted Zhuang Medicine Jib in addition. They were assessed with modified Ashworth Scale (MAS), Barthel index (BI), Simpling Fugl-Meyer Assessment (FMA) before and four weeks after treatment. The side-effects within three months after treatment were recorded. Results The scores of MAS, BI and FMA improved in both groups after treatment (t>3.32, P<0.01), and improved more in the treatment group than in the control group (t>2.286, P<0.05). No side-effect was found in the follow-up. Conclusion Zhuang Medicine Jib can further relieve spasm after stroke, and improve the motor function and activities of daily living.