Calciphylaxis, also known as calcific uremic arteriopathy (CUA), is a rare arteriosclerosis disease characterized by skin ischemia and necrosis with severe pain, which occurs in end-stage renal disease patients. The efficacy of sodium thiosulfate (STS) in CUA has been widely verified and affirmed. However, there is no unified standard for the use of STS at home and abroad.This article introduced a case of severe CUA patient who had achieved good results under different STS usage treatments, and summarized the different STS usage treatments for CUA combined with literature.

Calciphylaxis, also known as calcific uremic arteriopathy (CUA), is a rare arteriosclerosis disease characterized by skin ischemia and necrosis with severe pain, which occurs in end-stage renal disease patients. The efficacy of sodium thiosulfate (STS) in CUA has been widely verified and affirmed. However, there is no unified standard for the use of STS at home and abroad.This article introduced a case of severe CUA patient who had achieved good results under different STS usage treatments, and summarized the different STS usage treatments for CUA combined with literature.

OBJECTIVE To evaluate the effectiveness and safety of sequential therapy with parathyroid hormone analogues and bisphosphonates for osteoporosis.METHODS PubMed,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure,VIP,Wanfang data,and SinoMed were searched in both English and Chinese databases from their inception to March 25,2024.Two researchers independently conducted literature searches,screening,and data extraction.Review Manager 5.4 software was used for the meta-analysis.Subgroup analyses and sensitivity analyses were performed based on different medication sequences in the treatment group to account for potential sources of heterogeneity.RESULTS A total of 7 randomized controlled trials involving 2 461 participants were included,with 1 215 in the treatment group and 1 246 in the control group.The meta-analysis results showed that the treatment group using sequential therapy with parathyroid hormone analogues and bisphosphonates had superior effects on improving bone mineral density at the lumbar spine[SMD=0.90,95％CI(0.44,1.35),P＜0.001],total hip[SMD=0.68,95％CI(0.14,1.21),P=0.01],and femoral neck[SMD=0.45,95％CI(0.04,0.86),P=0.03]compared to the control group.It also significantly outperformed the control group in reducing the incidence of fractures post-treatment[OR=0.72,95％CI(0.54,0.97),P=0.03].No significant difference was noted in the incidence of adverse reactions between the two groups[OR=1.21,95％CI(0.99,1.46),P=0.06].Subgroup analysis based on intervention measures in the treatment group showed that switching from bisphosphonates to parathyroid hormone analogues[SMD=0.56,95％CI(0.09,1.03),P=0.02]or switching from parathyroid hormone analogues to bisphosphonates[SMD=0.97,95％CI(0.49,1.46),P＜0.001]both significantly potentiated lumbar spine bone mineral density compared to the control group.Switching from bisphosphonates to parathyroid hormone analogues also significantly promoted total hip bone mineral density compared to the control group[SMD=0.66,95％CI(0.18,1.13),P=0.007].Sensitivity analysis indicated that the results of this study were robust.CONCLUSIONS Sequential therapy with parathyroid hormone analogues and bisphosphonates can be recommended as an effective treatment for patients with osteoporosis,with good safety profiles.The medication sequences should be individually adjusted based on the patient's particular situation and the different responses of various skeletal sites.

Objective To investigate the regulatory effect of cognitive behavioral therapy (CBT) on the functional connectivity of cognitive control network in untreated obsessive-compulsive disorder (OCD) patients,so as to provide evidence for understanding the neurobiological mechanism of CBT.Methods A total of 45 OCD patients and 45 matched normal controls were recruited at the outpatient clinic in Beijing Anding Hospital.Four therapists provided 14 times of CBT treatment for OCD patients.All subjects underwent clinical symptom assessment and magnetic resonance imaging at baseline and at the end of 12 weeks.The clinical symptoms were assessed by the psychiatrists using Y-BOCS,HAMD17 and HAMA.The clinical symptoms of OCD patients before and after CBT treatment were compared.The GRETNA software package was used to preprocess the resting-state fMRI data.The whole brain function network was constructed with the template of Power 264 functional brain area as the network node.The function connection intensity outside the cognitive control network was calculated,and the function connection of 2 groups of brain networks at two timepoints were compared by repeated measurement of variance analysis.Results A total of 41 patients completed CBT.The scores of obsessive-compulsive symptoms,anxiety symptoms and depressive symptoms decreased at the end of 12th week,of which 32 patients were improved (Y-BOCS reduction ≥35％).Single factor repeated analysis of variance and post hoc tests were performed between patients with improvement and normal controls.At baseline,the functional connection between the cingulo-opercular network and the salience network of OCD patients was lower than that of the normal control (0.172±0.060 vs.0.215±0.076,t=1.731,P=0.040),it increased after treatment (0.186±0.171 vs.0.172±0.060,t=2.480,P=0.010).At baseline,the functional connection of cingulo-opercular network and subcortical network in OCD patients was lower than that of normal control (0.119±0.081 vs.0.129±0.070,t=1.640,P=0.040),and it increased after treatment (0.130±0.161 vs.0.119±0.081,t=2.421,P=0.020).At baseline,the functional connection between the frontal-parietal network and subcortical network was lower than that of normal controls (-0.004 ± 0.039 vs.0.021 ± 0.054,t=2.280,P=0.020),and it increased after treatment (0.020±0.042 vs.-0.004±0.039,t=-2.300 P=0.020).Conclusions CBT could effectively improve obsessive-compulsive symptoms accompanying with improvement of the external functional connectivity of cognitive control network in OCD patients.

Objective To investigate the regulatory effect of cognitive behavioral therapy (CBT) on the functional connectivity of cognitive control network in untreated obsessive-compulsive disorder (OCD) patients,so as to provide evidence for understanding the neurobiological mechanism of CBT.Methods A total of 45 OCD patients and 45 matched normal controls were recruited at the outpatient clinic in Beijing Anding Hospital.Four therapists provided 14 times of CBT treatment for OCD patients.All subjects underwent clinical symptom assessment and magnetic resonance imaging at baseline and at the end of 12 weeks.The clinical symptoms were assessed by the psychiatrists using Y-BOCS,HAMD17 and HAMA.The clinical symptoms of OCD patients before and after CBT treatment were compared.The GRETNA software package was used to preprocess the resting-state fMRI data.The whole brain function network was constructed with the template of Power 264 functional brain area as the network node.The function connection intensity outside the cognitive control network was calculated,and the function connection of 2 groups of brain networks at two timepoints were compared by repeated measurement of variance analysis.Results A total of 41 patients completed CBT.The scores of obsessive-compulsive symptoms,anxiety symptoms and depressive symptoms decreased at the end of 12th week,of which 32 patients were improved (Y-BOCS reduction ≥35％).Single factor repeated analysis of variance and post hoc tests were performed between patients with improvement and normal controls.At baseline,the functional connection between the cingulo-opercular network and the salience network of OCD patients was lower than that of the normal control (0.172±0.060 vs.0.215±0.076,t=1.731,P=0.040),it increased after treatment (0.186±0.171 vs.0.172±0.060,t=2.480,P=0.010).At baseline,the functional connection of cingulo-opercular network and subcortical network in OCD patients was lower than that of normal control (0.119±0.081 vs.0.129±0.070,t=1.640,P=0.040),and it increased after treatment (0.130±0.161 vs.0.119±0.081,t=2.421,P=0.020).At baseline,the functional connection between the frontal-parietal network and subcortical network was lower than that of normal controls (-0.004 ± 0.039 vs.0.021 ± 0.054,t=2.280,P=0.020),and it increased after treatment (0.020±0.042 vs.-0.004±0.039,t=-2.300 P=0.020).Conclusions CBT could effectively improve obsessive-compulsive symptoms accompanying with improvement of the external functional connectivity of cognitive control network in OCD patients.