Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.

Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

Objective:To assess the effectiveness of pelvic bone marrow (PBM)-sparing intensity-modulated radiation therapy (IMRT) in mit-igating acute hematologic toxicity (HT) in older patients with cervical cancer. Methods:A retrospective analysis of the data from 41 older pa-tients with cervical cancer who underwent postoperative concurrent chemoradiotherapy (CCRT) between January 2015 and December 2016 at Tianjin Medical University Cancer Institute & Hospital was conducted. The patients were grouped into PBM sparing and non-PBM sparing groups. The HT grades,white blood cells,absolute neutrophils,hemoglobin,and nadir platelet count were assessed. In addition,the volumes of PBM with various radiation doses (V10,V20,V30,and V40) were calculated. Regression models with multiple independent predictors were used to examine the association between dosimetric parameters and HT. Results:The PBM sparing group exhibited a significantly lower incidence of HT and RT breaks than the non-PBM-sparing group. Decreased V20 and V40 were significantly correlated with lower rates of grades ≥2 and ≥3 leukopenia,respectively. A partitioning analysis identified a cutoff value of 61％ for V20 of the whole pelvic bone to predict grade ≥2 leukopenia and 33.5％ for V40 to predict grade ≥3 leukopenia. Conclusions:PBM-sparing RT significantly reduced the in-cidence of acute HT and treatment breaks. Increased PBM V20 and V40 were associated with higher rates of grade ≥2 and grade ≥3 leuko-penia,respectively.

Objective:To assess the effectiveness of pelvic bone marrow (PBM)-sparing intensity-modulated radiation therapy (IMRT) in mit-igating acute hematologic toxicity (HT) in older patients with cervical cancer. Methods:A retrospective analysis of the data from 41 older pa-tients with cervical cancer who underwent postoperative concurrent chemoradiotherapy (CCRT) between January 2015 and December 2016 at Tianjin Medical University Cancer Institute & Hospital was conducted. The patients were grouped into PBM sparing and non-PBM sparing groups. The HT grades,white blood cells,absolute neutrophils,hemoglobin,and nadir platelet count were assessed. In addition,the volumes of PBM with various radiation doses (V10,V20,V30,and V40) were calculated. Regression models with multiple independent predictors were used to examine the association between dosimetric parameters and HT. Results:The PBM sparing group exhibited a significantly lower incidence of HT and RT breaks than the non-PBM-sparing group. Decreased V20 and V40 were significantly correlated with lower rates of grades ≥2 and ≥3 leukopenia,respectively. A partitioning analysis identified a cutoff value of 61％ for V20 of the whole pelvic bone to predict grade ≥2 leukopenia and 33.5％ for V40 to predict grade ≥3 leukopenia. Conclusions:PBM-sparing RT significantly reduced the in-cidence of acute HT and treatment breaks. Increased PBM V20 and V40 were associated with higher rates of grade ≥2 and grade ≥3 leuko-penia,respectively.

A 45-year-old male patient underwent craniotomy and biopsy for intracranial lesions. In order to prevent epilepsy, sodium valproate 800 mg dissolved in 0.9% sodium chloride injection 8 ml was injected intravenously after operation, and then the sodium valproate solution of this concentration was continuously pumped at a speed of 0.6 ml/h. One hour after administration, the serum lactate level of the patient increased gradually, reaching the highest level of 14.7 mmol/L, accompanied by metabolic acidosis and compensatory respiratory alkalosis, and with the lowest pH of 7.09 and the lowest base excess of -26.3. The patient fell into a coma. The hyperlactatemia and metabolic acidosis were considered to be related to sodium valproate. Sodium valproate was stopped, intravenous infusion of 5% sodium bicarbonate injection and blood purification were given at the same time. After 3 days, the lactate level of the patient returned to normal, metabolic acidosis was basically corrected, and his mind was clear.

A 45-year-old male patient underwent craniotomy and biopsy for intracranial lesions. In order to prevent epilepsy, sodium valproate 800 mg dissolved in 0.9% sodium chloride injection 8 ml was injected intravenously after operation, and then the sodium valproate solution of this concentration was continuously pumped at a speed of 0.6 ml/h. One hour after administration, the serum lactate level of the patient increased gradually, reaching the highest level of 14.7 mmol/L, accompanied by metabolic acidosis and compensatory respiratory alkalosis, and with the lowest pH of 7.09 and the lowest base excess of -26.3. The patient fell into a coma. The hyperlactatemia and metabolic acidosis were considered to be related to sodium valproate. Sodium valproate was stopped, intravenous infusion of 5% sodium bicarbonate injection and blood purification were given at the same time. After 3 days, the lactate level of the patient returned to normal, metabolic acidosis was basically corrected, and his mind was clear.

Objective To investigate the efficacy and safety of progressive dose-adding of alprazolam midazolam in the treatment of chronic tinnitus.Methods A total of 80 chronic tinnitus patients were divided into observation group and control group,with 40 cases in each group.The control group was treated with conventional nutritional nerve and improved circulation treatment,while the observation group was additionally treated with alprazolam progressive incremental treatment.The therapeutic effects of the two groups were observed.The THI score,VAS score,tinnitus loudness and adverse reactions after treatment were observed.Results The total effective rate of the observation group was significantly higher than that of the control group (80％ vs.57.5％,P ＜ 0.05).There were no significant differences in the THI score,VAS score and tinnitus loudness between the two groups before treatment (P ＞ 0.05).After treatment,the THI score,VAS score and tinnitus loudness of the two groups were lower than treatment before (P ＜ 0.05),and the observation group was lower than the control group (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion Application of progressive incremental alprazolam therapy for patients with chronic tinnitus has prominent efficacy and higher safety.

Objective To investigate the efficacy and safety of progressive dose-adding of alprazolam midazolam in the treatment of chronic tinnitus.Methods A total of 80 chronic tinnitus patients were divided into observation group and control group,with 40 cases in each group.The control group was treated with conventional nutritional nerve and improved circulation treatment,while the observation group was additionally treated with alprazolam progressive incremental treatment.The therapeutic effects of the two groups were observed.The THI score,VAS score,tinnitus loudness and adverse reactions after treatment were observed.Results The total effective rate of the observation group was significantly higher than that of the control group (80％ vs.57.5％,P ＜ 0.05).There were no significant differences in the THI score,VAS score and tinnitus loudness between the two groups before treatment (P ＞ 0.05).After treatment,the THI score,VAS score and tinnitus loudness of the two groups were lower than treatment before (P ＜ 0.05),and the observation group was lower than the control group (P ＜ 0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P ＞ 0.05).Conclusion Application of progressive incremental alprazolam therapy for patients with chronic tinnitus has prominent efficacy and higher safety.

Objective To evaluate the performance of progressive optimization algorithm-based Auto-Planning module in automated volumetric-modulated arc therapy(VMAT)planning for nasopharyngeal carcinoma. Methods Thirteen treated VMAT plans of nasopharyngeal carcinoma were re-planed with Auto-Planning module. Only one cycle of automated optimization of the Auto-Planning module was performed for each plan without any manual intervention. The dosimetric parameters of the automated treatment plans were compared with those of the manual plans. Paired t-test was used for statistical analysis. The time required for automated planning using the Auto-Planning module was also measured. Results All plans generated with the Auto-Planning module met the routine dosimetric requirements and were acceptable for clinical use. The homogeneity index of targets was superior in the automated plans than in manual plans(P= 0.000).In addition,the automated plans had significantly improved protection for some organs at risk than the manual plans. The mean dose to the left and right parotids were reduced by 7.75 Gy(P=0.000)and 5.79 Gy(P=0.000)in the automated plans,respectively. Furthermore,the V60(0.58% vs. 3.12%,P=0.000)and Dmean(34.11 Gy vs. 40.78 Gy,P= 0.000)of the mandible were also significantly lower with Auto-Planning than with manual planning. Conclusions Auto-Planning module can improve the overall quality and consistency of treatment plans,and reduce the workload and time of treatment planning,resulting in substantially enhanced treatment planning efficiency.