ObjectiveTo explore the potential mechanism underlying electroacupuncture therapy with the midnight-noon ebb-low method with hour-prescription for chronic obstructive pulmonary disease （COPD） with lung-qi deficiency syndrome from the perspective of brain and muscle basic helix-loop-helix ARNT-like 1 （BMAL1） as well as neutrophil extracellular traps （NETs）. MethodsThe experiment was conducted in two phases. For the therapeutic effectiveness observation， 24 rats were randomly allocated into control group 1， model group 1， midnight-noon electro-acupuncture group 1 and conventional electro-acupuncture group， with 6 rats per group. Rat models of COPD with lung-qi deficiency syndrome were established via cigarette smoke exposure combined with intratracheal instillation of lipopolysaccharide （LPS）. After successful modelling， rats in midnight-noon electro-acupuncture group 1 received electro-acupuncture at acupoints "Taiyuan （LU 9）"， "Feishu （BL 13）" and "Zusanli （ST 36）" during 05：00—07：00， 30 minutes per treatment once every other day for 14 consecutive days （7 sessions in total）. Rats in the conventional electro-acupuncture group received identical electroacupuncture manipulation at random daytime hours （08：00—18：00）. Pulmonary function parameters including forced expiratory volume in 0.3 second （FEV_0.3）， forced vital capacity （FVC） and FEV_0.3/FVC ratio were detected. Pulmonary histopathological changes were observed via hematoxylin-eosin （HE） staining. Plasma levels of pro-inflammatory factors interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α）， as well as pulmonary reactive oxygen species （ROS） content， BMAL1 protein expression and the levels of neutrophil extracellular traps （NETs） biomarkers such as myeloperoxidase （MPO）， neutrophil elastase （NE）， and citrullinated histone H3 （CitH3） in lung tissue were determined. For the mechanistic verification phase， 36 rats were divided into control group 2， model group 2， midnight-noon electro-acupuncture group 2， overexpression empty group， overexpression BMAL1 group and overexpression with midnight-noon electro-acupuncture group， with 6 rats in each group. At the 5th week of model construction， rats in the overexpression BMAL1 group and overexpression with midnight-noon electro-acupuncture group received intratracheal instillation of 100 μl adenoviral suspension carrying overexpressed Bmal1 gene. Rats in the overexpression empty group were injected with an equal titer and equal volume of blank adenovirus without the Bmal1 coding sequence into the lung at the identical time point. Midnight-noon electro-acupuncture group 2 and overexpression with midnight-noon electro-acupuncture group were consistent with the aforementioned protocol. Finally， pulmonary levels of MPO， NE and CitH3 were measured in all groups. ResultsCompared with the control group 1， the model group 1 exhibited decreased FEV_0.3， FVC and FEV_0.3/FVC ratio， elevated plasma IL-1β， TNF-α and pulmonary ROS levels， downregulated lung BMAL1 protein expression， and increased contents of MPO， NE and CitH3 （all P＜0.05）； typical NETs-like structures with sparse granular substances attached to fibrous networks were observed under scanning electron microscopy； HE staining revealed damaged alveolar architecture accompanied by inflammatory cell infiltration. Compared with model group 1， both the midnight-noon electro-acupuncture group 1 and conventional electro-acupuncture group achieved obvious improvements in all above indicators， with superior therapeutic effects in midnight-noon electro-acupuncture group 1 （P＜0.05）. Consistently， midnight-noon electro-acupuncture group 1 showed more prominent alleviation of NETs-like structure formation and lung pathological injury compared to the conventional electro-acupuncture group. Mechanistic validation results demonstrated that compared with model group 2， the average optical density of MPO as well as the protein levels of MPO， NE and CitH3 were markedly reduced in midnight-noon electro-acupuncture group 2， overexpression BMAL1 group and overexpression with midnight-noon electro-acupuncture group （P＜0.05）； furthermore， these parameters were significantly lower in the overexpression with midnight-noon electro-acupuncture group than in midnight-noon electro-acupuncture group 2 （P＜0.05）. ConclusionElectro-acupuncture based on the midnight-noon ebb-low method with hour-prescription may alleviate pulmonary inflammation in COPD by upregulating the expression of clock protein BMAL1 and inhibiting excessive accumulation of NETs in lung tissue.

OBJECTIVE: To investigate the effectiveness of hip arthroscopy in the treatment of patients with femoroacetabular impingement (FAI) syndrome combined with ligamentum teres injury. METHODS: A retrospective analysis was conducted on 23 patients (23 hips) with Cam-type FAI syndrome combined with ligamentum teres injury who met the selection criteria between April 2022 and May 2024. The cohort included 12 males and 11 females, with a mean age of 29.16 years (range, 16-57 years). According to Tönnis classification, there were 5 cases of grade 0, 10 cases of grade Ⅰ, and 8 cases of grade Ⅱ in hip osteoarthritis. The disease duration ranged from 6 to 24 months, with an average of 12 months. Under hip arthroscopy, hypertrophic synovium and the damaged ligamentum teres were debrided, while the torn labrum and cartilage were repaired, and femoral head-neck osteoplasty was performed to eliminate impingement, restore the normal morphology of the acetabulum and femoral head-neck, and suture the joint capsule. Acetabular lateral center-edge angle (LCEA) and α angle (reflecting the degree of non-sphericity at the femoral head-neck junction) were measured before and after operation, and the modified Harris hip score (mHHS), the International Hip Outcome Tool-12 (IHOT-12), and the visual analogue scale (VAS) score for pain were evaluated. RESULTS: The operation was successfully completed in all patients. The incisions healed by first intention after operation, and there was no perioperative complications such as iatrogenic cartilage injury, fracture, infection, neurovascular traction injury, or lower extremity venous thrombosis. All the 23 patients were followed up 12-24 months, with an average of 14.6 months. The pain of hip joint significantly relieved, and the function of hip joint improved; no complication such as joint stiffness, joint instability, and osteonecrosis of the femoral head occurred. The α angle, VAS score, mHHS score, and IHOT-12 score at last follow-up were significantly better than those before operation ( P<0.05); there was no significant difference in LCEA compared to preoperative value ( P>0.05). CONCLUSION Hip arthroscopy is a safe and effective treatment for patients with FAI syndrome combined with ligamentum teres injury, which can achieve satisfactory effectiveness.
Humans ; Femoracetabular Impingement/complications* ; Arthroscopy/methods* ; Adult ; Male ; Female ; Retrospective Studies ; Middle Aged ; Adolescent ; Treatment Outcome ; Young Adult ; Hip Joint/surgery* ; Acetabulum/surgery* ; Round Ligaments/surgery* ; Range of Motion, Articular

Objective The objective of this study was to analyze the disease burden trend of leukemia in children and ado-lescents aged 0-19 years in China from 1990 to 2021,and to provide a scientific evidence for the disease prevention and control strat-egy of this population.Methods The disease burden of leukemia in children and adolescents in China(excluding Taiwan)was ana-lyzed using the Global Burden of Disease Database 2021(GBD 2021),including incidence,prevalence,mortality,and disability-ad-justed life year(DALY).DALY consisted of two parts:years of life lost(YLL)and years lived with disability(YLD).The average an-nual percentage change(AAPC)was used to comprehensively evaluate the changing trends of various indicators from the disease bur-den of childhood leukemia in China from 1990 to 2021.Results In 2021,the age-standardized incidence,prevalence,mortality and DALY rates of the 0-19 years old population in China were 7.33/100,000,51.46/100,000,1.72/100,000,and 142.14/100,000,respectively.Among them,the age-standardized incidence,prevalence,mortality and DALY rates of males were higher than those of females.The incidence,prevalence,mortality and DALY rates of the 0-years old group were higher than those of other age groups.The age-standardized incidence,prevalence,mortality and DALY rates of acute lymphoblastic leukemia(ALL)were higher than those of other leukemia subtypes.From 1990 to 2021,the leukemia age-standardized incidence in the population aged 0 to 19 years did show a significant increase or decrease(AAPC=-0.32%,95%CI:-0.66%-0.02%);the age-standardized prevalence showed a sig-nificant increase(AAPC=3.05%,95%CI:2.68%-3.42%).While age-standardized mortality and DALY rates showed a downward trend(AAPC=-4.27%,95%CI:-4.53%-4.01%;AAPC=-4.3%,95%CI:-4.56%-4.05%).Conclusion From 1990 to 2021,the disease burden of leukemia in children and adolescents aged 0 to 19 years in China is increasing,the burden of death is de-creasing,and the total DALY is decreasing.The burden of leukemia in this group varies greatly among different ages,genders,and leu-kemia subtypes.

Objective To investigate the effect of miR-378-5p on glioma angiogenesis and its molecular mechanism. Methods The expression of miR-378-5p were detected by qRT-PCR in four glioma cells. The levels of VEGF were analyzed by ELISA. HUVECs were treated conditioned medium which collected by glioma cells supernatant. The effects of miR-378-5p on the proliferation,migration,invasion,and angiogenesis of HUVECs were detected by CCK-8,Transwell assay,and tubular formation assay. Results U251 was the highest expression of miR-378-5p,while U87 MG was the lowest expression. Glioma-conditioned media increased miR-378-5p levels significantly promoted the proliferation,migration,invasion,and angiogenesis of HUVECs. The results were con-trary with glioma-conditioned media decreased miR-378-5p levels. miR-378-5p promoted the release of VEGF-A from glioma cells. The proliferation,migration,invasion,and angiogenesis of HUVECs treated-VEGF neutralizing antibody were significantly downregulated. Conclusion miR-378-5p promoted HUVECs proliferation,migration,invasion,and angiogenesis by increasing the release of VEGF from glioma cells.

Objective:To investigate the effects of pulsed electromagnetic fields(PEMFs)combined with iron oxide nanoparticle paramagnetic gel on muscle strength,mass,and function in elderly patients with degenerative muscle atrophy.Methods:The clinical data of 40 patients with degenerative muscle atrophy who were treated in our hospital from Sep 2024 to Mar 2025 were retrospectively analyzed.According to the treatment method,patients were divided into the PEMFs group and the combined treatment group,with 20 cases in each group.The intervention sites in both groups were the bilateral quadriceps femoris.The PEMFs group received low-frequency alternating PEMFs therapy,while an iron oxide nanoparticle paramagnetic gel was applied locally to the target area prior to each PEMFs session in the combined treatment group.Muscle strength,mass,and functional indicators were assessed in both groups before and after the intervention.Results:After 12 weeks of intervention,the combined treatment group showed greater improvements in maximum voluntary contraction,rectus femoris thickness,and cross-sectional area compared to the PEMFs group(P＜0.05).Additionally,the combined treatment group showed further reductions in timed up and go test(TUGT)and five-repetition sit-to-stand test(5STS)durations,as well as increased walking distance in the 6-minute walk test(6MWT),all of which were better than those observed in the PEMFs group(P＜0.05).The combined therapy also resulted in superior improvements in skeletal muscle mass index and Berg Balance Scale score(P＜0.05).Conclusions:PEMFs have a promotive effect on muscle strength,mass,and functional performance.The combination with iron oxide nanoparticle paramagnetic gel can further enhance its therapeutic efficacy.

Objective:To investigate the effects of pulsed electromagnetic fields(PEMFs)combined with iron oxide nanoparticle paramagnetic gel on muscle strength,mass,and function in elderly patients with degenerative muscle atrophy.Methods:The clinical data of 40 patients with degenerative muscle atrophy who were treated in our hospital from Sep 2024 to Mar 2025 were retrospectively analyzed.According to the treatment method,patients were divided into the PEMFs group and the combined treatment group,with 20 cases in each group.The intervention sites in both groups were the bilateral quadriceps femoris.The PEMFs group received low-frequency alternating PEMFs therapy,while an iron oxide nanoparticle paramagnetic gel was applied locally to the target area prior to each PEMFs session in the combined treatment group.Muscle strength,mass,and functional indicators were assessed in both groups before and after the intervention.Results:After 12 weeks of intervention,the combined treatment group showed greater improvements in maximum voluntary contraction,rectus femoris thickness,and cross-sectional area compared to the PEMFs group(P＜0.05).Additionally,the combined treatment group showed further reductions in timed up and go test(TUGT)and five-repetition sit-to-stand test(5STS)durations,as well as increased walking distance in the 6-minute walk test(6MWT),all of which were better than those observed in the PEMFs group(P＜0.05).The combined therapy also resulted in superior improvements in skeletal muscle mass index and Berg Balance Scale score(P＜0.05).Conclusions:PEMFs have a promotive effect on muscle strength,mass,and functional performance.The combination with iron oxide nanoparticle paramagnetic gel can further enhance its therapeutic efficacy.

Objective:To develop a pre-processing workflow of real world data (RWD) derived from multicenter clinical laboratories so that the level of data standardization can be improved, and subsequently to produce more robust real world evidence (RWE).Methods:Purpose sampling was used to invite senior experts with experience in clinical research utilizing RWD, covering the fields of clinical laboratory, epidemiology, biostatistics, and clinical medicine. In-depth, semi-structured individual interviews were conducted and thematic analysis was used to analyze the collected data.Results:The in-depth interviews were completed in 16 experts. The experts unanimously agreed that pre-processing RWD derived from multicenter clinical laboratories is necessary prior to its application in research. Based on experts' insights, a comprehensive pre-processing workflow for RWD was constructed, comprising six key steps: ①developing a variable list based on research questions and distributing it to each clinical laboratory; ②conducting an initial quality assessment of RWD based on existing quality control results in clinical laboratories; ③cleaning the data; ④determining whether RWD (including categorical and continuous variables) is heterogeneity among different clinical laboratories; ⑤exploring potential sources of heterogeneity;⑥pre-processing RWD based on identified causes contributing to heterogeneity.Conclusion:The pre-processing workflow of RWD was established, to provide a methodological reference for controlling systematic errors in RWD derived from multicenter clinical laboratories, thereby enhancing the validity of RWE.

Objective The objective of this study was to analyze the disease burden trend of leukemia in children and ado-lescents aged 0-19 years in China from 1990 to 2021,and to provide a scientific evidence for the disease prevention and control strat-egy of this population.Methods The disease burden of leukemia in children and adolescents in China(excluding Taiwan)was ana-lyzed using the Global Burden of Disease Database 2021(GBD 2021),including incidence,prevalence,mortality,and disability-ad-justed life year(DALY).DALY consisted of two parts:years of life lost(YLL)and years lived with disability(YLD).The average an-nual percentage change(AAPC)was used to comprehensively evaluate the changing trends of various indicators from the disease bur-den of childhood leukemia in China from 1990 to 2021.Results In 2021,the age-standardized incidence,prevalence,mortality and DALY rates of the 0-19 years old population in China were 7.33/100,000,51.46/100,000,1.72/100,000,and 142.14/100,000,respectively.Among them,the age-standardized incidence,prevalence,mortality and DALY rates of males were higher than those of females.The incidence,prevalence,mortality and DALY rates of the 0-years old group were higher than those of other age groups.The age-standardized incidence,prevalence,mortality and DALY rates of acute lymphoblastic leukemia(ALL)were higher than those of other leukemia subtypes.From 1990 to 2021,the leukemia age-standardized incidence in the population aged 0 to 19 years did show a significant increase or decrease(AAPC=-0.32%,95%CI:-0.66%-0.02%);the age-standardized prevalence showed a sig-nificant increase(AAPC=3.05%,95%CI:2.68%-3.42%).While age-standardized mortality and DALY rates showed a downward trend(AAPC=-4.27%,95%CI:-4.53%-4.01%;AAPC=-4.3%,95%CI:-4.56%-4.05%).Conclusion From 1990 to 2021,the disease burden of leukemia in children and adolescents aged 0 to 19 years in China is increasing,the burden of death is de-creasing,and the total DALY is decreasing.The burden of leukemia in this group varies greatly among different ages,genders,and leu-kemia subtypes.

Objective:To develop a pre-processing workflow of real world data (RWD) derived from multicenter clinical laboratories so that the level of data standardization can be improved, and subsequently to produce more robust real world evidence (RWE).Methods:Purpose sampling was used to invite senior experts with experience in clinical research utilizing RWD, covering the fields of clinical laboratory, epidemiology, biostatistics, and clinical medicine. In-depth, semi-structured individual interviews were conducted and thematic analysis was used to analyze the collected data.Results:The in-depth interviews were completed in 16 experts. The experts unanimously agreed that pre-processing RWD derived from multicenter clinical laboratories is necessary prior to its application in research. Based on experts' insights, a comprehensive pre-processing workflow for RWD was constructed, comprising six key steps: ①developing a variable list based on research questions and distributing it to each clinical laboratory; ②conducting an initial quality assessment of RWD based on existing quality control results in clinical laboratories; ③cleaning the data; ④determining whether RWD (including categorical and continuous variables) is heterogeneity among different clinical laboratories; ⑤exploring potential sources of heterogeneity;⑥pre-processing RWD based on identified causes contributing to heterogeneity.Conclusion:The pre-processing workflow of RWD was established, to provide a methodological reference for controlling systematic errors in RWD derived from multicenter clinical laboratories, thereby enhancing the validity of RWE.

Objective:By using cognitive interviews,the interviewees' cognition and understanding of the inflammatory bowel disease(IBD) self-efficacy scale for adolescents and young adults (IBDSES-A) were evaluated,and the semantic content of IBDSES-A,which was initially translated into Chinese,was tested and revised.Methods:Using purposive sampling,15 IBD patients aged 12-18 were selected from Beijing Children's Hospital,Capital Medical University,between January and February 2025,stratified by age group and disease type.Two rounds of cognitive interviews were conducted.Feedback and suggestions from interviewees were analyzed using a question appraisal system for coding and integration.Based on expert panel discussions,ambiguous items were revised to finalize the Chinese version of the IBDSES-A.Results:In the first round,10 interviewees were interviewed,followed by 5 interviewees in the second round.There were no statistically significant differences ( P>0.05) between the interviewees of two rounds in terms of age,gender,and education level.During the first round of interview,interviewees expressed comprehension difficulties with 76.9% (10/13) of the items.Coding analysis revealed that the primary issue was "clarification",as unclear wording made it difficult for interviewees to fully grasp the intended meaning of certain items.Based on these findings,the expert panel revised 10 of the 13 items in the IBDSES-A.The second round of cognitive interview showed that the interviewees generally understood the revised items，achieving linguistic and semantic consistency with the original scale. Conclusion:The application of cognitive interviews in the translation process of the IBDSES-A helps reduce comprehension biases caused by inappropriate wording，ensuring that the localized version of the scale is more accessible and understandable to the target population.