Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

Objective:To evaluate the efficacy and safety of upadacitinib in the real-world treatment of difficult-to-treat Crohn's disease (DTT-CD) .Methods:This multicenter, retrospective cohort study included patients diagnosed with DTT-CD according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) criteria, and treated at eight Chinese inflammatory bowel disease centers between January 2023 and March 2025. Clinical outcomes were assessed after 12 weeks of induction therapy with upadacitinib (45 mg qd), including clinical remission rate, clinical response rate, and incidence of adverse events.Results:Among 151 enrolled DTT-CD patients, the clinical remission rate was 47.0%, and the clinical response rate was 90.7% after 12 weeks of treatment. Adverse events occurred in 42 cases (27.8%) .Conclusion:Upadacitinib demonstrated favorable efficacy in inducing clinical remission in DTT-CD patients, with a good safety profile at the induction dose (45 mg qd) .

[Objective]To explore the warming and nourishing thought and diagnostic and therapeutic characteristics of FENG Zhaozhang,a doctor of the Zhejiang faction of traditional Chinese medicine.[Methods]Using the method of literature research,this study sorted out the relevant discussions on the warming and nourishing thought in the Fengshi Jinnang Milu,combined with FENG Zhaozhang's own medical cases and relevant theoretical knowledge of the warming and nourishing school,and summarized FENG Zhaozhang's warming and nourishing thought and diagnostic and therapeutic characteristics.[Results]FENG Zhaozhang's warming and nourishing thought embodies the concept of"taking Kan and filling Li".It takes true Yin and Yang as the innate and postnatal basis,and clarifies that the essence of internal injury and fever is caused by fire emptiness.By distinguishing the pulses of the congenital and central viscera,the pathogenesis is identified,and a treatment method of"regulating,calming,following and soothing"is proposed;FENG's theory emphasizes regulating and nourishing true Yin and Yang,making good use of medicinal herbs to restrain fire and bringing it back to its original state.He paid attention to the way and dosage form of medication to exert its efficacy,proposed the principle of"supplementing and proceeding",and attached importance to nourishment in the later stage of the disease.His self-created formula Quanzhen Yiqi Decoction,is a representative formula that embodies the idea of"taking Kan and filling Li"for warming and nourishing.[Conclusion]FENG Zhaozhang's diagnosis and treatment of diseases is based on the principle of prioritizing Yin and Yang,with a fundamental approach,strict principles and precise medication.This provides an effective diagnostic and treatment approach for treating severe and stubborn diseases,as well as difficult and miscellaneous diseases,which is worth promoting and learning from.

Objective:To investigate the relationship between prolonged PR interval and carotid atherosclerosis(CAS)in middle-aged and elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 537 middle-aged and elderly inpatients with T2DM in the Southern Branch of the Sixth People′s Hospital of Shanghai Jiaotong University from January 2019 to January 2021 were selected as the research objects. Color Doppler ultrasound was used to detect bilateral carotid artery intima-media thickness(CIMT). The subjects were divided into carotid atherosclerosis group(CAS group, n=352)and non-carotid atherosclerosis group(NCAS group, n=185). The difference in the PR interval of ECG between the two groups was compared. Pearson or Spearman rank correlation analysis was used for evaluating the correlation of PR interval and CAS lesions with various clinical index. The relationship between PR interval and CAS lesions was adopted by multivariate logistic regression analysis. Results:The average PR interval of middle-aged and elderly patients with T2DM was(164.57±23.02)ms. The average PR interval in CAS group was significantly higher than that in NCAS group [(169.76±24.28) vs (154.70±16.42)ms, P<0.01]. The results of multifactorial logistic regression analysis showed that age, low density lipoprotein-cholesterol, serum osteocalcin, and PR interval were independent factors influencing the development of CAS lesions in middle-aged and elderly patients with T2DM( OR=1.079, 1.936, 0.879, 1.039, respectively, P<0.05 or P<0.01)where each 1 ms increase in PR interval was associated with a 3.9% increase in the risk of CAS in middle-aged and elderly patients with T2DM( OR=1.039, 95% CI 1.006-1.073, P=0.020). Multivariate logistic regression analysis showed that middle-aged and elderly type 2 diabetic patients with PR interval≥158 ms were 4.072 times more likely to have CAS lesions than those with PR interval<158 ms( OR=4.072, 95% CI 1.417-11.702, P<0.01). Conclusion:The PR interval of electrocardiogram is correlated with CAS lesions in middle-aged and elderly patients with T2DM. Middle-aged and elderly type 2 diabetic patients with significantly prolonged PR interval should be reminded to screen for CAS lesions early.

Objective:Factors influencing the prognosis of hemophagocytic lymphohistiocytosis (HLH) in adults were analyzed based on multicentric data.Methods:Clinical data of 124 adult patients with HLH diagnosed in eight medical centers in the Huaihai Lymphoma Working Group from March 2014 to July 2020 were collected. The optimal truncation value of continuous variables was obtained based on the Maxstat algorithm, X-Tile software, and restricted cubic spline. Cox proportional risk regression model was used to construct the adult HLH risk prediction model, and the visualization of the model was realized through the histogram. The bootstrap resampling method was used to verify the model, C-index and calibration curve was used to verify the histogram, and the prediction accuracy was checked. Kaplan-Meier analysis was used to calculate the survival rate and draw the survival curve. Furthermore, the differences between groups were tested by log-rank.Results:The median age of the 124 patients was 55 (18-84) years, including 61 (49.19%) males. The most common etiology was infection. Serum ferritin increased in 110 cases (88.71%) , hepatosplenomegaly in 57 cases (45.97%) . Of the 124 patients, 77 (62.10%) died, and the median survival time of the patients was 7.07 months. Univariate results showed that the prognosis of adult HLH was influenced by sex, age, fibrinogen, serum creatinine, alanine aminotransferase, and albumin ( P<0.05) . The results of multivariate analysis showed that gender, platelet, albumin, alanine aminotransferase, and treatment regimens were independent influencing factors for prognosis. Based on the above five risk factors, the prediction model of the histogram was established, and the C-index of the model was 0.739. Finally, the calibration chart showed good consistency between the observed and predicted values of HLH. Conclusion:The prognosis of the adult hemophagocytic syndrome is influenced by many factors. Gender, platelet, albumin, alanine aminotransferase, and treatment regimens are independent risk factors. Therefore, the established histogram provides a visual tool for clinicians to evaluate the prognosis of adult HLH.

Due to the decline of motor ability and the impact of the diseases, abnormalities in gait is common in the elderly population, which will raise the risk of fall and cause serious injury. This study focuses on the analysis of the gait kinematics parameters of normal adults' gait, aiming to investigate the characteristics of gait parameters in different age groups and to explore the role of gait parameters in motor function assessment and clinical diagnosis. Based on the gait data gained by electronic walkway, the relationship among the toe out angles and their correlation with age and gender etc. were quantitatively analyzed. The results show that most normal subjects walk with positive toe out angles, and the angles increase with age. Such changes are slow in the young and middle age groups. However, the elevations of the left out toe angle and the angles between the feet are statistically significant after entering elder age ( >60 years). The results also suggest that the angle between the feet is a kind of practical gait parameter for varying applications. This study concludes that feet angle analysis is potential to provide a convenient and quantitative tool for the assessment of lower limb motor ability and the diagnosis of knee joint diseases.

Objective To investigate the effects of quality control circle on the improvement of nursing satisfaction in orthope -dic military inpatients in the island hospital .Methods Through the establishment of quality control circle organization , the determina-tion of the theme , as well as the development of the quality control circle activity plan , the present status and cause analysis concerning nursing satisfaction in orthopedic military inpatients in the island hospital were investigated , and in the meantime , targets were set , and related countermeasures were developed and implemented .Results Following the implementation of quality control circle , nursing sat-isfaction in the orthopedic military inpatients was increased from 90.6%to 99.12%.Conclusion Through the implementation of quali-ty control circle activities , nursing satisfaction in the orthopedic military inpatients of the island hospital was improved considerably and significant effects were achieved .

To solve the problem that mostly gait analysis is independent from the treatment, this work proposes a system that integrates the functions of gait training and assessment for foot drop treatment. The system uses a set of sensors to collect gait parameters and designes multi-mode functional electrical stimulators as actuator. Body area network technology is introduced to coordinate the data communication and execution of the sensors and stimulators, synchronize the gait analysis and foot drop treatment. Bluetooth 4.0 is applied to low the power consumption of the system. The system realizes the synchronization of treatment and gait analysis. It is able to acquire and analyze the dynamic parameters of ankle, knee and hip in real-time, and treat patients by guiding functional electrical stimulation delivery to the specific body locations of patients.
Electric Stimulation ; Electric Stimulation Therapy ; Exercise Therapy ; Gait ; Humans ; Wireless Technology

To solve the problem that mostly gait analysis is independent from the treatment, this work proposes a system that integrates the functions of gait training and assessment for foot drop treatment. The system uses a set of sensors to col ect gait parameters and designes multi-mode functional electrical stimulators as actuator. Body area network technology is introduced to coordinate the data communication and execution of the sensors and stimulators, synchronize the gait analysis and foot drop treatment. Bluetooth 4.0 is applied to low the power consumption of the system. The system realizes the synchronization of treatment and gait analysis. It is able to acquire and analyze the dynamic parameters of ankle, knee and hip in real-time, and treat patients by guiding functional electrical stimulation delivery to the specific body locations of patients.