Objective To explore the correlations of the severity degrees of coronary stenosis with cardiac function and exercise tolerance. Methods A total of 112 patients who underwent coronary angiography in Cardiology Department of Zhongshan Hospital, Fudan University between October 2024 and January 2025 were enrolled. According to the imaging results, the Gensini score was calculated, and the patients were divided into three groups based on the scores: mild group (＜20 points, n＝42), moderate group (20-40 points, n＝43), and severe group (＞40 points, n＝27). The left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its abnormal elevation ratio, 6-minute walk distance (6MWD), and grip strength were compared among the groups. The correlations between Gensini score and various indicators were analyzed using multivariate linear regression. And the multivariate binary logistic regression analysis was used to analyze the related factors of severe coronary stenosis. Results The 6MWD and LVEF values in the severe group were lower than those in the mild and moderate groups (P＜0.01), while the NT-proBNP level and its abnormal elevation ratio in the severe group were higher than those in the mild group (P＜0.05). The Gensini score was negatively correlated with 6MWD (β＝−0.965, P＜0.01), and positively correlated with NT-proBNP level and its abnormal elevation ratio (β＝0.015, P＜0.001; β＝0.003, P＝0.037). 6MWD and diabetes were independent related factors of severe coronary stenosis (OR＝0.956, P＜0.001; OR＝5.701, P＝0.038). Conclusions The cardiac function and exercise tolerance in patients with severe coronary stenosis decrease, 6MWD is helpful of recognizing severe coronary stenosis population.

BACKGROUND:Steroid-induced avascular necrosis of the femoral head is a common progressive,crippling and high incidence of non-traumatic osteonecrosis of the femoral head,but its exact pathogenesis is not clear.Internal heat acupuncture therapy has a good clinical effect in the treatment of steroid-induced avascular necrosis of the femoral head,but its specific mechanism is not clear.OBJECTIVE:To investigate the effect of internal heat acupuncture on osteoblast apoptosis and expression of Bcl-2-associated X protein(Bax)and B lymphocytoma-2(Bcl-2)in steroid-induced avascular necrosis of the femoral head in rabbits.METHODS:Totally 24 male New Zealand rabbits were randomly divided into blank group,model group,and internal heat acupuncture group(n=8).The rabbit model of steroid-induced avascular necrosis of the femoral head was made in the last two groups by methylprednisolone sodium succinate combined with Escherichia coli endotoxin.After successful model establishment for 4 weeks,the rabbits in the internal heat acupuncture group received internal heat acupuncture intervention on the buttocks of rabbits,once a week for 20 minutes each time,while the other two groups did not receive any intervention.After 4 weeks of treatment,samples were harvested.Morphological changes of femoral head and osteoblast apoptosis were observed by hematoxylin-eosin staining and TUNEL assay.Protein expression of Bcl-2 and Bax in rabbit femoral head tissue was detected by immunohistochemistry and western blot assay.RESULTS AND CONCLUSION:(1)In the blank group,there were abundant hematopoietic cells in the bone marrow cavity,clear and orderly trabecular structure,few adipocytes and few empty bone lacunae.In the model group,the number of adipocytes in the bone marrow cavity increased significantly,accompanied by hyperplasia,steatosis of some osteocytes and more empty bone lacunae.After the intervention of internal heat acupuncture,the number of adipocytes and hollow bone lacunae was less than that in the model group,but more obvious than that in the blank group.(2)Compared with the blank group,the apoptosis of osteoblasts in the model group was significantly increased,the expression of Bax was significantly increased(P＜0.001),and the expression of Bcl-2 was significantly decreased(P＜0.001).After the intervention of internal heat acupuncture,the apoptosis of osteoblasts was significantly decreased,the expression of Bax was significantly decreased(P＜0.001),and the expression of Bcl-2 was significantly increased(P＜0.001).(3)The results show that internal heat acupuncture can alleviate steroid-induced avascular necrosis of the femoral head by inhibiting osteoblast apoptosis in the femoral head.

BACKGROUND:Steroid-induced avascular necrosis of the femoral head is a common progressive,crippling and high incidence of non-traumatic osteonecrosis of the femoral head,but its exact pathogenesis is not clear.Internal heat acupuncture therapy has a good clinical effect in the treatment of steroid-induced avascular necrosis of the femoral head,but its specific mechanism is not clear.OBJECTIVE:To investigate the effect of internal heat acupuncture on osteoblast apoptosis and expression of Bcl-2-associated X protein(Bax)and B lymphocytoma-2(Bcl-2)in steroid-induced avascular necrosis of the femoral head in rabbits.METHODS:Totally 24 male New Zealand rabbits were randomly divided into blank group,model group,and internal heat acupuncture group(n=8).The rabbit model of steroid-induced avascular necrosis of the femoral head was made in the last two groups by methylprednisolone sodium succinate combined with Escherichia coli endotoxin.After successful model establishment for 4 weeks,the rabbits in the internal heat acupuncture group received internal heat acupuncture intervention on the buttocks of rabbits,once a week for 20 minutes each time,while the other two groups did not receive any intervention.After 4 weeks of treatment,samples were harvested.Morphological changes of femoral head and osteoblast apoptosis were observed by hematoxylin-eosin staining and TUNEL assay.Protein expression of Bcl-2 and Bax in rabbit femoral head tissue was detected by immunohistochemistry and western blot assay.RESULTS AND CONCLUSION:(1)In the blank group,there were abundant hematopoietic cells in the bone marrow cavity,clear and orderly trabecular structure,few adipocytes and few empty bone lacunae.In the model group,the number of adipocytes in the bone marrow cavity increased significantly,accompanied by hyperplasia,steatosis of some osteocytes and more empty bone lacunae.After the intervention of internal heat acupuncture,the number of adipocytes and hollow bone lacunae was less than that in the model group,but more obvious than that in the blank group.(2)Compared with the blank group,the apoptosis of osteoblasts in the model group was significantly increased,the expression of Bax was significantly increased(P＜0.001),and the expression of Bcl-2 was significantly decreased(P＜0.001).After the intervention of internal heat acupuncture,the apoptosis of osteoblasts was significantly decreased,the expression of Bax was significantly decreased(P＜0.001),and the expression of Bcl-2 was significantly increased(P＜0.001).(3)The results show that internal heat acupuncture can alleviate steroid-induced avascular necrosis of the femoral head by inhibiting osteoblast apoptosis in the femoral head.

Post-stroke gait disturbance is one of the core issues leading to impaired motor function and decreased quality of life. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive brain regulation technique, has shown unique potential in the field of stroke rehabilitation. rTMS can improve gait and balance function by enhancing neural plasticity, regulating neurotransmitter metabolism, regulating cerebral blood flow, and improving cortical excitability and ion balance. Future research should focus on the development of individualized treatment plan, treatment plan optimization, and the synergistic effect of rTMS combined with other rehabilitation methods, in order to provide more effective treatment strategies for patients with post-stroke gait disturbance.

BACKGROUND:Internal heat-type acupuncture therapy is a new treatment technique that combines acupuncture therapy with hyperthermia.It has good clinical effects on steroid-induced osteonecrosis of the femoral head,but the mechanism of action is still not fully clear. OBJECTIVE:To explore the possible mechanism of internal heat-type acupuncture therapy in treating steroid-induced osteonecrosis of the femoral head in rabbits. METHODS:Thirty-two New Zealand rabbits were randomly divided into blank group,model group,internal heat-type acupuncture group and shock wave group using a random number table method,with 8 rabbits in each group.The model group,internal heat-type acupuncture group and shock wave group were modeled using methylprednisolone sodium succinate combined with Escherichia coli endotoxin.The internal heat-type acupuncture group received an internal heat-type acupuncture intervention on the buttocks of rabbits,once a week,for 20 minutes each time.The shock wave group received shock wave intervention on the buttocks of rabbits,once a week,with 2 000 beats per session.The blank group and model group were not given any treatment.After 4 weeks of intervention,blood samples and bilateral femoral head samples were collected from experimental rabbits.The levels of tumor necrosis factor-α and interleukin-6 in serum were detected by ELISA;the histomorphology of the femoral head was observed using hematoxylin-eosin staining and the rate of empty lacunae was calculated;the protein expressions of matrix metalloproteinase 2,matrix metalloproteinase 9,matrix metalloproteinase tissue inhibitor 1,and matrix metalloproteinase tissue inhibitor 2 were detected by immunohistochemistry and western blot. RESULTS AND CONCLUSION:Compared with the blank group,the model rabbits showed reduced food intake,mental fatigue,and decreased activity;compared with the model group,the above performance of the experimental rabbits was significantly improved after internal heat-type acupuncture and shock wave treatment.Compared with the blank group,the histomorphology of the femoral head in the model group deteriorated significantly and the rate of empty bone lacuna increased(P<0.001),while the histomorphology of the femoral head in the internal heat-type acupuncture group and shock wave group was significantly improved compared with the model group,and the rate of empty bone lacuna was reduced(P<0.001).The serum levels of tumor necrosis factor-α and interleukin-6 in the model group were significantly higher than those in the blank group(P<0.05),while the serum levels of tumor necrosis factor-α and interleukin-6 in the internal heat-type acupuncture group and the shock wave group were significantly lower than those in the model group(P<0.05).Compared with the blank group,the expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 in the femoral head of the model group were significantly increased,while the expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly decreased(P<0.001);compared with the model group,the protein expression levels of matrix metalloproteinase 2 and matrix metalloproteinase 9 were significantly decreased,while the protein expression levels of matrix metalloproteinase tissue inhibitor 1 and matrix metalloproteinase tissue inhibitor 2 were significantly increased in the internal heat-type acupuncture group and the shock wave group(P<0.001).Overall,these findings indicate that internal heat-type acupuncture may promote the repair of the necrotic femoral head by regulating the levels of matrix metalloproteinases/matrix metalloproteinase tissue inhibitors and serum inflammatory factors,thus treating early steroid-induced osteonecrosis of the femoral head.

Objective To learn the current capacity building of emergency response teams in Tianjin for the purpose of goals setting.Methods Health Emergency Capacity Questionnaire was issued to 89 secondary and above medical institutions and 19 CDCs in Tianjin.The form covered such items as basic institutional information, workforce makeup, emergency preparations, detection and early warning, emergency response, and summary/assessment.Data collected in the questionnaire were subject to descriptive and correlation analysis.Results Tianjin has scored an initial success in emergency medicine as evidenced in its emergency response mechanisms in place, elevated capacity in emergency medical rescue and disposal, and enhanced competence of emergency teams.Rooms of improvement however include insufficient professionalism and independence of health emergency, inadequate emergency commanding and decision making system functions, insufficient laboratory test capacity at district/county levels, and insufficient social involvement in health emergency.Conclusions Top-down design should be emphasized, health emergency response should be enhanced in terms of management and response planning system, while capacity building of the teams and long-term primary care emergency mechanism deserve higher attention.

Objective To compare the difference of cutpoint and clinical significance of HbA1C for the diagnosis of abnormal glucose metabolism in two population groups with different ages.Methods According to oral glucose tolerance test(OGTT),the cutpoint and clinical significance of HbA1C for the diagnosis of type 2 diabetes and impaired glucose regulation(IGR)were investigated in the two population groups.Results The mean HbA1C of 1 064 young subjects in an academy and 1 671 aged subjects in a community were 5.31% ±0.41% and 5.79% ±0.71%,respectively.The cutpoints of HbA1C for diagnosis of diabetes were 5.7%(specificity 86.7%,sensitivity 66.7%)and 5.9%(specificity 73.8%,sensitivity 80.1%)in the two population groups,and 5.6% for diagnosis of IGR (specificity 82.8%,sensitivity 55.8%)and 5.7%(specificity 60.9%,sensitivity 64.3%),respectively.87.8%,78.7%,and 38.5% were diagnosed diabetes by current OGTT criteria at HbA1C levels of ≥5.7%,≥5.9%,and≥6.5%,IGR being 61.6%,39.6%,and 4.1%,and normal glucose tolerance being 24.4%,10.0%,and 0.4%.Conclusion The cutpoints of HbA1C for diagnosis of diabetes and IGR are different in populations with different ages and HbA1C levels.As one of diagnostic criteria for diabetes,HbA1C 6.5% with relatively higher specificity and lower sensitivity must be combined with fasting blood glucose,random blood glucose,and OGTT.

Objective To investigate the feasibility of using a new type carina type tracheal prosthesis made of complex material to replace trachea and carina defects. Methods According to biomechanics index, a new carina type tracheal prosthesis was designed and constituted with carbon fiber and silicon. 19 dogs were divided into two groups randomly: group A(n=11), the carina type tracheal prosthesis anastomosed directly to dog′s trachea and bronchus;group B(n=8), based on group A, meanwhile the diaphragm was incised and the pedicel caul was transplanted from abdominal cavity to thorax to enwrap the carina type tracheal prosthesis and anastomotic site. Results The average survival period post operation in group A and group B were (3.462?1.849)d and (6.475?1.062)d ,respectively. There was significant difference of the survival period between two groups(P