Objective To explore the relationship between systemic immune-inflammation index(SII)and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)complicat-ed with type Ⅱ respiratory failure.Methods A total of 92 patients with AECOPD complicated with type Ⅱrespiratory failure admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University from February 2022 to February 2024 were selected as the research subjects.According to the 28-day survival status,they were di-vided into the survival group(n=69)and the death group(n=23).The counts of neutrophils,lymphocytes and platelets of the patients were detected by the fully automatic hematology analyzer,and SII was calculated.The receiver operating characteristic curve was used to analyze the predictive value of SII for the prognosis of patients.Multivariate Logistic regression analysis was used to explore the influencing factors of prognosis in patients.Results The platelet count,neutrophil count,SII and acute physiology and chronic health evaluationⅡ(APACHE Ⅱ)score in the survival group were lower than those in the death group,while the lymphocyte count in the survival group was higher than that in the death group,the differences were statistically signifi-cant(P＜0.05).In patients with AECOPD complicated with type Ⅱ respiratory failure,SII was positively correlated with APACHEⅡ score(r=0.612,P＜0.001).The areas under the curve(AUC)of platelets,neu-trophils and lymphocytes in predicting the prognosis of patients with AECOPD complicated with type Ⅱ re-spiratory failure were 0.776(95％CI:0.731-0.826),0.849(95％CI:0.799-0.894),and 0.732(95％CI:0.687-0.782),respectively,the AUC of SII in predicting the prognosis of patients with AECOPD complicat-ed with type Ⅱ respiratory failure was 0.925(95％CI:0.880-0.975).The proportion of death groups com-bined with heart diseases and blood urea nitrogen(BUN),B-type natriuretic peptide(BNP)were higher than those in the survival group,while hemoglobin(Hb)was lower than that in the survival group,and the differ-ences were statistically significant(P＜0.05).Combined cardiac diseases,BUN,Hb,BNP and SII were the in-fluencing factors for the prognosis of patients with AECOPD complicated with type Ⅱ respiratory failure(P＜0.05).Conclusion The increase of SII is related to the prognosis of patients with AECOPD complicated with type Ⅱ respiratory failure,and it has certain predictive value for the prognosis of patients with AECOPD complicated with type Ⅱ respiratory failure.

Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.

Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.

BACKGROUND:Mechanical stimulation has been confirmed to promote osteogenic differentiation of bone marrow stromal stem cells,but the mechanism is unknown.Primary cilia are important mechanoreceptors and regulate various signaling pathways such as TGF-β1/BMP-2/SMAD.They are likely to be important targets for mechanical regulation of bone marrow stromal stem cells. OBJECTIVE:To investigate the effect and mechanism of fluid shear stress on osteogenic differentiation of bone marrow stromal stem cells. METHODS:Rat bone marrow stromal stem cells were divided into control group,mechanical stimulation group(fluid shear mechanics intervention by shaking table),mechanical stimulation + IFT88 silencing group(mechanical stimulation + silencing IFT88 expression with siRNA).After 24 hours of intervention,qRT-PCR was utilized to determine the expression of transforming growth factor β1 and bone morphogenetic protein 2.Western blot assay was used to detect the expression of phosphorylated SMAD2/3 protein.Immunofluorescent staining of primary cilia was conducted and morphology was analyzed. RESULTS AND CONCLUSION:Shear stress stimulation could promote the transcriptional activity of transforming growth factor β1 and bone morphogenetic protein 2 genes,and increase the expression of phosphorylated SMAD2/3 protein.After siRNA interfered with primary cilia,this mechanical response effect was significantly reduced.There was a Spearman correlation between the change ratio of the primary cilium area of bone marrow stromal stem cells and the increased ratio of transforming growth factor β1 and bone morphogenetic protein 2 gene transcription.These findings indicate that primary cilia/intraflagellar transport mediates the activation of fluid shear stress-responsive transforming growth factor β1/bone morphogenetic protein 2/SMAD signaling pathway and promotes osteogenic differentiation of bone marrow stromal stem cells.

Objective:To determine the best accurate measurement of the lateral femur wall in geriatric patients with intertrochanteric fracture by comparing 3 different methods (X-ray, CT axial scan, and CT 3D reconstruction).Methods:A retrospective study was conducted to analyze the imaging data of 109 patients with intertrochanteric fracture of the femur who had been admitted to Beijing Jishuitan Hospital, Capital Medical University from July 2023 to December 2023. There are 36 males and 73 females with an age of (80.3±9.1) years. The morphology of the femoral intertrochanteric fracture on the affected side was observed, measured, and recorded. It was observed whether the affected femoral trochanter was in a neutral position on the anteroposterior X-ray image of bilateral hip joints. The thickness of the lateral femoral wall was measured on X-ray, CT axial scan, and CT 3D reconstruction images of the bilateral hip joints. The measurements were compared between the 3 methods.Results:The affected femoral trochanter was in a neutral position on the anteroposterior X-ray image of bilateral hip joints in 57 cases [52.3% (57/109)]. The thickness of the lateral wall of the femur measured by X-ray was (29.02±8.06) mm, that by axial CT scan (21.83±8.75) mm, and that by CT 3D reconstruction (31.67±5.92) mm, showing statistically significant differences among the 3 methods ( F=47.368, P<0.001). There was a statistically significant difference in the thickness of the lateral wall of the femur between any 2 measurements ( P<0.05). In measurement of the thickness of the lateral femoral wall, based on CT scan images, the intra-group correlation coefficient between X-ray and CT axial scan images was 0.376, and the intra-group correlation coefficient between CT 3D reconstruction and CT axial scan images was 0.268, both showing poor consistency. Conclusions:Compared with X-ray and CT 3D reconstruction images of the bilateral hip joints, measurement of the thickness of the lateral femur wall on CT axial scan images is more accurate and shows strong operational feasibility. Therefore, CT axial scan has advantages in preoperative evaluation of the thickness of the lateral femur wall.

Objective:To determine the best accurate measurement of the lateral femur wall in geriatric patients with intertrochanteric fracture by comparing 3 different methods (X-ray, CT axial scan, and CT 3D reconstruction).Methods:A retrospective study was conducted to analyze the imaging data of 109 patients with intertrochanteric fracture of the femur who had been admitted to Beijing Jishuitan Hospital, Capital Medical University from July 2023 to December 2023. There are 36 males and 73 females with an age of (80.3±9.1) years. The morphology of the femoral intertrochanteric fracture on the affected side was observed, measured, and recorded. It was observed whether the affected femoral trochanter was in a neutral position on the anteroposterior X-ray image of bilateral hip joints. The thickness of the lateral femoral wall was measured on X-ray, CT axial scan, and CT 3D reconstruction images of the bilateral hip joints. The measurements were compared between the 3 methods.Results:The affected femoral trochanter was in a neutral position on the anteroposterior X-ray image of bilateral hip joints in 57 cases [52.3% (57/109)]. The thickness of the lateral wall of the femur measured by X-ray was (29.02±8.06) mm, that by axial CT scan (21.83±8.75) mm, and that by CT 3D reconstruction (31.67±5.92) mm, showing statistically significant differences among the 3 methods ( F=47.368, P<0.001). There was a statistically significant difference in the thickness of the lateral wall of the femur between any 2 measurements ( P<0.05). In measurement of the thickness of the lateral femoral wall, based on CT scan images, the intra-group correlation coefficient between X-ray and CT axial scan images was 0.376, and the intra-group correlation coefficient between CT 3D reconstruction and CT axial scan images was 0.268, both showing poor consistency. Conclusions:Compared with X-ray and CT 3D reconstruction images of the bilateral hip joints, measurement of the thickness of the lateral femur wall on CT axial scan images is more accurate and shows strong operational feasibility. Therefore, CT axial scan has advantages in preoperative evaluation of the thickness of the lateral femur wall.

Objective:To explore the feasibility of MRI to assist the early diagnosis of midfoot tendon and ligament injuries.Methods:Fifty-two patients with midfoot ligament and tendon injuries who visited Beijing Jishuitan Hospital from September 2016 to December 2021 were enrolled in the study, and 20 healthy volunteers were recruited as controls. All participants underwent mid foot coronal (short axis), sagittal, and axial (long axis) MRI T1 weighted imaging and proton fat suppression sequence examination. The MRI images were evaluated by 2 senior radiologists independently.Results:The consistency of the two radiologists in diagnosis of tendons, ligaments, bones, and soft tissues were good ( κ=0.916, 0.896, and 0.893, respectively). The tendons and ligaments of the midfoot in 20 healthy volunteers (40 feet) showed uniform bands of varying thickness with slightly low signal intensity; the anterior tibial tendon showed a thin line shape, the posterior tibial tendon showed a slightly thick band with uniform low signal intensity, and the calcaneonavicular ligament showed a thin line-like low signal intensity running in different directions. In 52 patients with midfoot tendon and ligament injuries, 18 had anterior tibial tendon injuries, 20 had posterior tibial tendon injuries, and 14 had calcaneonavicular ligament injuries. The injured tendon or ligament was characterized by uneven thickness, blurred edges, and continuous interruption on T1WI sequence, uneven enhancement of signal in the tendon or ligament running area on PD-FS sequence, accumulation of fluid in the tendon sheath, and partial tearing. The partial tear showed discontinuity and thickening of tendons, while the complete tear showed that the tendons were interrupted and retracted, the fiber structure disappeared and was filled with liquid, and the surrounding soft tissue edema was present. Conclusion:MRI can clearly display the course and anatomical structure of the attachment end of the midfoot tendon and ligament, which may assist in early diagnosis of midfoot tendon and ligament injuries.

Objective To explore the MRI characteristics of anatomy and injuries of the tendons and ligaments in the midfoot.Methods Twenty healthy volunteers and 46 patients with midfoot trauma were selected for retrospective analysis.All subjects underwent examination on MR T1WI and proton density-fat suppression(PD FS)scans on three planes,respectively.Then the MRI features of tendon and ligaments injury were compared.Results The tendons and ligaments of 20 healthy volunteers(40 lateral feet)showed homogeneous low signal intensity with varing thickness.The anterior tibialis tendons showed a thin linear shape,and the posterior tibialis tendons showed a slightly thick band with uniform low signal intensity,and the calcaneonavicular ligament showed thin linelike low signal in different directions.In the 46 patients with midfoot injuries,there were 16 cases of anterior tibialis tendons injuries,18 cases of posterior tibialis tendons injuries,and 12 cases of calcaneonavicular ligament injuries.According to the MRI findings,the degree of injuries of tendons and ligaments was divided into injury,partial tear,and complete rupture.Conclusion MRI can clearly show the anatomy and injury features of ligaments and tendons in midfoot,which is of important value for the early diagnosis and accurate treatment of the ligaments and tendons injuries.

OBJECTIVE To establish an analytical method for the simultaneous determination of multiple anesthetics and their metabolites in aquatic products by ultra performance liquid chromatography-tandem mass spectrometry with pass-through solid phase extraction purification. METHODS After homogenization, the samples were extracted by 80% acetonitrile aqueous solution, and purified by ProElt PLS-A pass-through solid phase extraction column. The extract was determined by positive ion mode with mobile phase of 0.1% formic acid water and 0.1% formic acid acetonitrile in the separation by programmed gradient. Multiple reaction monitoring mode was used to draw standard curves with the matrix-matched method. RESULTS The calibration curves of the 14 anesthetics showed good linearity in the concentration range of 1-50 µg·L-1 and their metabolites showed good linearity in the concentration range of 10-500 μg·L-1, with the correlation coefficients >0.99. The limits of detection were 0.5 μg·kg-1 in anesthetics and 5 µg·kg-1 in their metabolites. The lower limits of quantification were 1 μg·kg-1 in anesthetics and 10 μg·kg-1 in their metabolites. The recoveries at high, medium and low concentrations ranged from 62.48% to 116.5% with RSDs<10%. CONCLUSION The method is simple and can be used for the accurate detection of anesthetics and their metabolites in aquatic products with high reliabilities.

Objective:To analyze the MRI findings of tendinopathy of the common extensor tendon (CET) and common flexor tendon (CFT) and to explore its application for injury classification.Methods:Sixty-two patients with elbow tendinopathy of CET and/or CFT who were examined in the Radiology Department of Beijing Jishuitan Hospital from August 2019 to April 2022 were enrolled as the case group, and 20 healthy subjects (40 elbows) were recruited as the control group. The clinical data of patients and MRI findings of elbow joint of all subjects were reviewed. The MRI of tendinopathy of CFT and CET were read by 2 senior radiologists independently, and the consistency was tested by the κ test. The MRI manifestations for injury classification were discussed. Results:The κ values of CFT, CET, medial collateral ligament complex and lateral collateral ligament complex were 0.645, 0.657, 0.615 and 0.653 respectively. MRI clearly showed the anatomical structure of CFT, CET and surrounding soft tissue. The CFT and CET of the elbow of 20 normal volunteers (40 sides) in the control group showed thin line or banded low signal in each MRI sequence, and the muscle fibers were continuous. In 27 patients with classification Ⅰ injury of CFT and/or CET of elbow joint, MRI showed thickening or thinning of tendons and increased signal intensity on fat suppression T2-weighted imaging. In 27 cases of classification Ⅱ injury, MRI showed that the fluid signal involved 20% to 80% of the tendon thickness. In 8 cases of classification Ⅲ injury, MRI showed that the fluid signal involved more than 80% of the tendon thickness. Conclusions:Tendinopathy of CFT and CET of elbow joint has its characteristic MRI manifestations, indicating that MRI can be used for the diagnosis of tendinopathy. In addition, MRI can also be used for the injury classification.