OBJECTIVE: To evaluate precise assessment methods for predicting the optimal acetabular cup size in total hip arthroplasty (THA). METHODS: A clinical data of 73 patients (80 hips) who underwent primary THA between December 2022 and July 2024 and met the inclusion criteria was analyzed. There were 39 males and 34 females with an average age of 66.3 years (range, 56-78 years). Among them, 66 cases were unilateral THA and 7 were bilateral THAs. There were 29 patients (34 hips) of osteoarthritis, 35 patients (35 hips) of femoral neck fractures, and 9 patients (11 hips) of osteonecrosis of the femoral head. Based on anteroposterior pelvic X-ray films, three methods were employed to predict acetabular cup size, including preoperative template planning, radiographic femoral head diameter (FHD) measurement, and intraoperative FHD measurement. The predicted acetabular cup sizes from these methods were compared with the actual implanted sizes. RESULTS: The predicted acetabular cup sizes using the preoperative template planning, radiographic FHD measurement, and intraoperative FHD measurement were (51.25±2.81), (49.72±3.11), and (49.90±2.74) mm, respectively, compared to the actual implanted cup size of (50.57±2.74) mm, with no significant difference ( P>0.05). Regarding agreement with the actual implanted cup size, the preoperative template planning achieved exact matches in 35 hips (43.75%), one-size deviation in 41 hips (51.25%), and two-size deviations in 4 hips (5%); the radiographic FHD measurement achieved exact matches in 12 hips (15%), one-size deviation in 57 hips (71.25%), and two-size deviations in 11 hips (13.75%); and the intraoperative FHD measurement achieved exact matches in 26 hips (32.5%), one-size deviation in 52 hips (65%), and two-size deviations in 2 hips (2.5%). There were significant differences in agreement distributions between the three methods and the actual implanted cup sizes ( H=18.579, P<0.001). CONCLUSION The intraoperative FHD measurement, as a simple, cost-effective, and accurate method, effectively guides acetabular cup selection, reduces the risk of prosthesis wear, enhances postoperative joint stability.
Humans ; Arthroplasty, Replacement, Hip/instrumentation* ; Male ; Female ; Middle Aged ; Acetabulum/diagnostic imaging* ; Aged ; Hip Prosthesis ; Prosthesis Design ; Femur Head/surgery* ; Osteoarthritis, Hip/surgery* ; Radiography ; Femoral Neck Fractures/surgery* ; Femur Head Necrosis/surgery*

Patients suffering from nerve injury often experience exacerbated pain responses and complain of memory deficits. The dorsal hippocampus (dHPC), a well-defined region responsible for learning and memory, displays maladaptive plasticity upon injury, which is assumed to underlie pain hypersensitivity and cognitive deficits. However, much attention has thus far been paid to intracellular mechanisms of plasticity rather than extracellular alterations that might trigger and facilitate intracellular changes. Emerging evidence has shown that nerve injury alters the microarchitecture of the extracellular matrix (ECM) and decreases ECM rigidity in the dHPC. Despite this, it remains elusive which element of the ECM in the dHPC is affected and how it contributes to neuropathic pain and comorbid cognitive deficits. Laminin, a key element of the ECM, consists of α-, β-, and γ-chains and has been implicated in several pathophysiological processes. Here, we showed that peripheral nerve injury downregulates laminin β1 (LAMB1) in the dHPC. Silencing of hippocampal LAMB1 exacerbates pain sensitivity and induces cognitive dysfunction. Further mechanistic analysis revealed that loss of hippocampal LAMB1 causes dysregulated Src/NR2A signaling cascades via interaction with integrin β1, leading to decreased Ca²⁺ levels in pyramidal neurons, which in turn orchestrates structural and functional plasticity and eventually results in exaggerated pain responses and cognitive deficits. In this study, we shed new light on the functional capability of hippocampal ECM LAMB1 in the modulation of neuropathic pain and comorbid cognitive deficits, and reveal a mechanism that conveys extracellular alterations to intracellular plasticity. Moreover, we identified hippocampal LAMB1/integrin β1 signaling as a potential therapeutic target for the treatment of neuropathic pain and related memory loss.
Animals ; Laminin/genetics* ; Hippocampus/metabolism* ; Neuralgia/metabolism* ; Cognitive Dysfunction/etiology* ; Male ; Peripheral Nerve Injuries/metabolism* ; Extracellular Matrix/metabolism* ; Integrin beta1/metabolism* ; Pyramidal Cells/metabolism* ; Signal Transduction

Aim To explore the role and mechanism of ginsenoside Rg3 in chronic neuropathic pain.Methods The differentially expressed genes in the prefrontal cor-tex of chronic neuropathic pain were screened and ana-lyzed.The mice were randomly divided into the sham operation group,model group and drug administration group.Neuropathic pain animal model was established by chronic sciatic nerve compression injury model.Ginsenoside Rg3 was injected intraperitoneally.The changes of pain behavior in mice were recorded.HE staining,Nissl staining,Western blot and immunohisto-chemistry were used to detect nerve and mitochondrial damage in PFC brain tissue of each group.Molecular docking was used to explore the target of ginsenoside Rg3.Mito-Tracker was used to detect mitochondrial membrane potential,and ATP kit was employed to ana-lyze ATP content.Results Compared with the sham operation group,mice in the model group showed hy-peralgesia and impaired motor ability,and nerve and mitochondrial damage in PFC(P＜0.05).Compared with the model group,ginsenoside Rg3 administration could increase the mechanical pain threshold,thermal foot contraction latency and stick rotation residence time of mice.At the same time,the number of inflam-matory cells,Nishi bodies and Dnm1l positive cells in PFC decreased,and the expression levels of c-Fos,IL-1β and Dnm1l protein were down-regulated(P＜0.05).Molecular docking showed that ginsenoside Rg3 could bind Dnm1l.At the cellular level,ginsen-oside Rg3 administration increased mitochondrial mem-brane potential and ATP content(P＜0.05).Conclu-sion Ginsenoside Rg3 can reduce the expression of inflammatory factors and mitochondria-related proteins in PFC,improve mitochondrial function,and relieve pain hypersensitivity in CCI mice.

Objective To investigate the efficacy of plantamajoside(PMS)on diabetic peripheral neuropathy(DPN)and to explore its mechanism of action from mitochondrial autophagy.Methods Mice(C57BL/6J)were randomly divided into 6 groups(n=10):normal group(Control),model group(Model),positive drug group(LA),and low(L-PMS),medium(M-PMS),and high(H-PMS)dosage groups.High-sugar and high-fat diet with intraperitoneal injection of streptozotocin was used to duplicate the DPN model.After successful model duplication,the intervention was administered by gavage for 4 weeks.Sciatic nerve was taken,and pathological changes were observed by HE and Nissl staining;oxidative stress indexes SOD,MDA,GSH-Px and inflammatory factors such as IL-1β,IL-6,TNF-αin sciatic nerve tissues were detected by kits,and the expression of VDAC1,TOM20,COX IV,PINK1,Parkin,and autophagy proteins of Beclin1,LC3,P62 in mouse sciatic nerves was detected by Western blotting.Results PMS dose-dependently improved the behavioral indexes of DPN mice,reduced the pathological damage of sciatic nerve,and resulted in tightly arranged sciatic nerve fibers,clearly visible myelin structure,uniform coloration,and increased number of Schwann cells as well as Nissl bodies.Compared with the model group,both the M-PMS group and the H-PMS group increased the expression levels of SOD and GSH-Px(P<0.05),while decreased the expression of MDA(P<0.05);the M-PMS group and the H-PMS groups reduced the expression of IL-1β,IL-6,and TNF-α(P<0.05);the L-PMS group,M-PMS group,and H-PMS group reduced the expression levels of VDAC1,TOM20,and COX IV proteins(P<0.05);the L-PMS group,M-PMS group,and H-PMS group could differentially increase the expression of PINK1,Beclin1,Parkin,and LC3 proteins(P<0.05),and decrease the expression of P62 proteins(P<0.05).Conclusion PMS can play a role in ameliorating neurological injury in DPN mice by promoting PINK1/Parkin pathway-mediated mitochondrial autophagy and alleviating oxidative stress-related inflammatory injury.

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.

Objective:The predictive value of oxidized low density lipoprotein(ox-LDL)and electrocardiogram(ECG)ischaemia grade for major adverse cardiovascular events(MACE)in patients with ST elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI)was assessed by a retrospective cohort study de-sign.Methods:A total of 336 STEMI patients admitted to Cangzhou People's Hospital between October 2019 and May 2022 were selected,and the medical record information was obtained through the hospital medical record sys-tem,and all patients received PCI and physician-recommended basic treatment.With occurrence of MACE with in 12-month follow-up as the evaluation index,they were divided into MACE group(n=65)and no MACE group(n=271).Multifactorial Logistic regression model was used to study the influencing factors of MACE after PCI in STEMI patients,and Spearman test for association of ox-LDL level,ECG ischaemia grade with MACE after PCI.ROC curve was used to evaluate the predictive efficacy of ox-LDL,ECG ischaemia grade and their combination for MACE after PCI.Results:The overall MACE incidence was 19.35％.Compared with patients in no MACE group,those in MACE group had significant higher ox-LDL level[46.34(29.46,66.29)U/L vs.33.00(23.02,50.03)U/L]and proportion of ECG grade Ⅲ ischaemia(64.62％vs.42.80％)(P＜0.01 all).Multifactorial Logistic re-gression analysis showed that ox-LDL(OR=1.022,95％CI 1.011～1.033,P=0.001)and ECG grade Ⅲ ischae-mia(OR=1.878,95％CI 1.007～3.504,P=0.048)were the independent risk factors of post-PCI MACE in STEMI patients.Spearman test showed that ox-LDL and ECG grade Ⅲ ischaemia were positively correlated with post-PCI MACE(r=0.209,0.173,P＜0.001 all).ROC curve analysis showed that the AUCs of ox-LDL,ECG grade Ⅲ ischaemia and their combination in predicting post-PCI MACE were respectively 0.653(95％CI 0.599～0.704),0.609(95％CI 0.555～0.662)and 0.758(95％CI 0.709～0.803),in which the predictive value of the combination of the two was significantly higher than any single detection(Z=2.030,3.097,P=0.042,0.002).Conclusion:ox-LDL combined with ECG ischaemia grading has a high predictive value for the occurrence of MACE with in 12 months after PCI in STEMI patients.

Objective:The aim of this study is to re-evaluate the systematic reviews and meta-analyses on statins for the treat-ment of erectile dysfunction(ED)and construct an umbrella review,thereby providing robust evidence-based for the clinical applica-tion of statins in ED treatment.Methods:A comprehensive computerized search was conducted across CNKI,Wanfang Database,VIP,WOS,Embase,PubMed,and Cochrane Library databases from their inception to September 12,2024,for all systematic reviews and meta-analyses addressing statin interventions in ED.The methodological quality,reporting quality,and evidence quality of the in-cluded studies were assessed and summarized using PRISMA 2020,AMSTAR 2,and GRADE systems.Results:Four systematic re-views and meta-analyses were included.According to the AMSTAR 2 evaluation,one paper was rated as low quality,while the remai-ning three were classified as very low quality.PRISMA 2020 evaluation results indicated that the average score of the four included studies was 29,with all being of medium quality but exhibiting partial deficiencies.The proportion of fully consistent items across the four studies ranged from 52.38％to 80.95％.GRADE system tool evaluation revealed 11 outcome indicators,of which only one was rated as intermediate evidence.The remainders were categorized as low or very low evidence,with no high-quality evidence identified.Conclusion:Statins demonstrate efficacy in treating ED.However,the current quality of relevant systematic reviews is suboptimal,with notable deficiencies in methodological,reporting,and evidential quality.Further high-quality studies are warranted to provide more reliable evidence-based medical guidance for clinical practice.

Objective:This study aims to investigate the spillover effects of the Diagnosis-Related Groups payment reform on medical expenditures.Methods:Based on the medical record data of inpatients in a tertiary Grade A hospital in Wuhan,Hubei Province,the Difference-in-Differences method was applied to estimate the impact of the DRG reform on medical expenditures for non-local patients.Results:After the implementation of DRG payment,the total medical expenses(β=-0.13),out-of-pocket expenses(β=-0.22),drug expenses(β=-0.25),consumable expenses(β=-0.26)decreased significantly.Meanwhile,the reduction ranges of the level and proportion of out-of-pocket expenses for non-local inpatients were significantly larger than those for local inpatients.However,the reduction range of the proportion of drug expenses for non-local inpatients was significantly smaller than that for local inpatients.The gaps between the two groups in terms of the level of out-of-pocket expenses and the proportion of drug expenses gradually narrowed.Conclusion:The DRG payment reform has produced a significant spillover effect,leading to a decrease in the medical expense level and an improvement in the expense structure for non-local inpatients.However,the medical expenses of non-local inpatients remain relatively high.It is suggested to accelerate the inclusion of non-local inpatients in disease-specific payment management and strengthen the coordination between the hospital's internal operation management and the reform of medical insurance payment methods.

Aim To explore the role and mechanism of ginsenoside Rg3 in chronic neuropathic pain.Methods The differentially expressed genes in the prefrontal cor-tex of chronic neuropathic pain were screened and ana-lyzed.The mice were randomly divided into the sham operation group,model group and drug administration group.Neuropathic pain animal model was established by chronic sciatic nerve compression injury model.Ginsenoside Rg3 was injected intraperitoneally.The changes of pain behavior in mice were recorded.HE staining,Nissl staining,Western blot and immunohisto-chemistry were used to detect nerve and mitochondrial damage in PFC brain tissue of each group.Molecular docking was used to explore the target of ginsenoside Rg3.Mito-Tracker was used to detect mitochondrial membrane potential,and ATP kit was employed to ana-lyze ATP content.Results Compared with the sham operation group,mice in the model group showed hy-peralgesia and impaired motor ability,and nerve and mitochondrial damage in PFC(P＜0.05).Compared with the model group,ginsenoside Rg3 administration could increase the mechanical pain threshold,thermal foot contraction latency and stick rotation residence time of mice.At the same time,the number of inflam-matory cells,Nishi bodies and Dnm1l positive cells in PFC decreased,and the expression levels of c-Fos,IL-1β and Dnm1l protein were down-regulated(P＜0.05).Molecular docking showed that ginsenoside Rg3 could bind Dnm1l.At the cellular level,ginsen-oside Rg3 administration increased mitochondrial mem-brane potential and ATP content(P＜0.05).Conclu-sion Ginsenoside Rg3 can reduce the expression of inflammatory factors and mitochondria-related proteins in PFC,improve mitochondrial function,and relieve pain hypersensitivity in CCI mice.