Based on commonly used acupoints in the clinical acupuncture treatment of functional dyspepsia （FD）， this study systematically analyzes the therapeutic differences and synergistic effects between local and distal point selection. It also examines the suitability of primary acupoint selection for different FD subtypes， postprandial distress syndrome （PDS） and epigastric pain syndrome （EPS）. The findings suggest that a combination of local and distal acupoints may be more appropriate as primary points for PDS， whereas local acupoints alone may be more suitable for EPS. Additionally， the study explores the impact of various factors， such as stimulation techniques， needling order， intensity or stimulation parameters， and depth， on the efficacy of acupuncture. It concludes that the intrinsic properties of acupoints are the primary determinants of therapeutic direction. Other factors mainly influence the magnitude rather than the direction of the effect. Future research may further investigate how different acupoint combinations， local versus distal， affect the treatment outcomes of FD subtypes， providing new insights for clinical acupuncture prescriptions.

OBJECTIVE: To investigate whether adding 1 transverse screw (TS) to the triangular parallel cannulated screw (TPCS) fixation has a mechanical stability advantage for Pauwels type Ⅲ femoral neck fractures by conducting finite element analysis on four internal fixation methods. METHODS: Based on CT data of a healthy adult male volunteer's femur, three Pauwels type Ⅲ femoral neck fracture models (Pauwels angle 70°, Pauwels angle 80°, and Pauwels angle 70° combined with bone defect) were constructed using Mimics 21.0 software and SolidWorks 2017 software. Four different internal fixation models were built at the same time, including TPCS, TPCS+TS, three cross screws (TCS), and TPCS+medial buttress plate (MBP). The mechanical stability of different models under the same load was compared by finite element analysis. RESULTS: The femoral model established in this study exhibited a maximum stress of 28.62 MPa, with relatively higher stress concentrated in the femoral neck. These findings were comparable to previous studies, indicating that the constructed femoral finite element model was correct. The maximum stress of internal fixation in finite element analysis showed that TCS was the lowest and TPCS+MBP was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. The maximum displacement of internal fixation in each fracture model was located at the top of the femoral head, with TCS having the highest maximum displacement of the femur. The maximum stress of fracture surface in finite element analysis showed that TCS was the lowest and TPCS was the highest in the Pauwels angle 70° model, while TPCS+MBP was the lowest and TPCS/TCS were the highest in the Pauwels angle 80° model and the Pauwels angle 70° combined with bone defect model, respectively. The maximum displacement of fracture surfece analysis showed that TPCS+MBP was the lowest and TCS was the highest in Pauwels angle 70° and 80° models, while TPCS+TS was the lowest and TCS was the highest in Pauwels angle 70° combined with bone defect model. CONCLUSION For Pauwels type Ⅲ femoral neck fractures, the biomechanical stability of TPCS+TS was superior to that of TPCS alone and TCS, but it has not yet reached the level of TPCS+MBP.
Finite Element Analysis ; Humans ; Femoral Neck Fractures/diagnostic imaging* ; Bone Screws ; Fracture Fixation, Internal/instrumentation* ; Male ; Bone Plates ; Stress, Mechanical ; Biomechanical Phenomena ; Tomography, X-Ray Computed ; Adult ; Femur Neck/surgery*

Objectives:To evaluate the incidence of neurological complications following left ventricular assist device(LVAD)implantation and to investigate related risk factors.Methods:A retrospective analysis was conducted on 151 patients who underwent LVAD implantation at Fuwai Hospital between June 2017 and September 2024.Clinical characteristics and postoperative survival outcomes were compared between patients with and without neurological complications.Results:Neurological complications occurred in 21 patients(13.9%)postoperatively,15 cases were ischemic strokes,5 cases were symptomatic intracranial hemorrhages or subarachnoid hemorrhages,and 1 case was transient ischemic attack(TIA).The total incidence of neurological complications was 0.08 events per person-year(EPPY),ischemic stroke was 0.06 EPPY and hemorrhagic stroke was 0.02 EPPY.Compared with patients without neurological complications,patients with neurological complications had a higher proportion of preoperative aortic regurgitation and tricuspid regurgitation,lower triglyceride levels,a lower rate of concurrent left atrial appendage resection and a higher rate of concurrent aortic valve replacement surgery.Multivariate cox regression analysis revealed that higher preoperative triglyceride levels(HR=0.21,95%CI:0.08-0.56,P=0.002)were associated with neurological complications.The median follow-up time was 508.0(186.5,931.5)days,12 out of 15 cases of ischemic stroke experienced no long-term sequelae,while 3 patients had varying degrees of residual deficits.All 5 patients with hemorrhagic stroke died,with 2 deaths directly attributed to hemorrhage.Kaplan-Meier survival curve analysis indicated that patients with neurological complications had a significantly lower survival rate(log-rank P=0.005).Conclusions:Neurological complications after LVAD implantation are predominantly ischemic strokes.Although less frequent,hemorrhagic strokes are associated with worse outcomes.Higher preoperative triglyceride levels is associated with neurological complications.

Objectives:To evaluate the incidence of neurological complications following left ventricular assist device(LVAD)implantation and to investigate related risk factors.Methods:A retrospective analysis was conducted on 151 patients who underwent LVAD implantation at Fuwai Hospital between June 2017 and September 2024.Clinical characteristics and postoperative survival outcomes were compared between patients with and without neurological complications.Results:Neurological complications occurred in 21 patients(13.9%)postoperatively,15 cases were ischemic strokes,5 cases were symptomatic intracranial hemorrhages or subarachnoid hemorrhages,and 1 case was transient ischemic attack(TIA).The total incidence of neurological complications was 0.08 events per person-year(EPPY),ischemic stroke was 0.06 EPPY and hemorrhagic stroke was 0.02 EPPY.Compared with patients without neurological complications,patients with neurological complications had a higher proportion of preoperative aortic regurgitation and tricuspid regurgitation,lower triglyceride levels,a lower rate of concurrent left atrial appendage resection and a higher rate of concurrent aortic valve replacement surgery.Multivariate cox regression analysis revealed that higher preoperative triglyceride levels(HR=0.21,95%CI:0.08-0.56,P=0.002)were associated with neurological complications.The median follow-up time was 508.0(186.5,931.5)days,12 out of 15 cases of ischemic stroke experienced no long-term sequelae,while 3 patients had varying degrees of residual deficits.All 5 patients with hemorrhagic stroke died,with 2 deaths directly attributed to hemorrhage.Kaplan-Meier survival curve analysis indicated that patients with neurological complications had a significantly lower survival rate(log-rank P=0.005).Conclusions:Neurological complications after LVAD implantation are predominantly ischemic strokes.Although less frequent,hemorrhagic strokes are associated with worse outcomes.Higher preoperative triglyceride levels is associated with neurological complications.

Objective:To evaluate the clinical efficacy of cannulated screws combined with suture anchor in the treatment of comminuted patellar fractures.Methods:A retrospective study was conducted to analyze the data of 72 patients who had been admitted to Department of Orthopaedics, The Second Hospital of Shanxi Medical University for comminuted patellar fractures between January 2020 and June 2023. The patients were divided into 2 groups based on the surgical techniques used. In group A of 34 patients subjected to fixation using cannulated screws combined with suture anchors, there were 22 males and 12 females with an age of 49 (39, 58) years, and 7 cases of AO type 34-C2 and 27 cases of AO type 34-C3. In group B of 38 patients subjected to fixation using cannulated screws combined with titanium cables, there were 19 males and 19 females with an age of 55 (40, 62) years, and 11 cases of AO type 34-C2 and 27 cases of AO type 34-C3. Comparisons were made between the 2 groups regarding general preoperative data, postoperative range of knee motion, fracture healing time, complications, soft tissue irritation, secondary surgery, postoperative pain assessed by visual analogue scale (VAS), postoperative Bostman knee score, and postoperative Levack knee score.Results:The 2 groups were comparable because there were no statistically significant differences in the general preoperative data and follow-up time between them ( P>0.05). There were no statistically significant differences between the 2 groups either in postoperative range of knee motion, fracture healing time, or Bostman knee score or Levack knee score at the last follow-up (all P>0.05). In group A, the VAS pain score and the rate of soft tissue irritation at the last follow-up were respectively 0.0 (0.0, 1.0) and 0% (0/34), significantly lower than those in group B [1.0 (0.0, 1.3) and 15.8% (6/38)] ( P<0.05). The overall incidence of complications and secondary surgery rate in group A were respectively 5.9% (2/34) and 2.9% (1/34), lower than those in group B [21.1% (8/38) and 15.8% (6/38)], but showing no statistically significant difference between the 2 groups ( P>0.05). Conclusions:In the treatment of comminuted patellar fractures, fixation using cannulated screws combined with both titanium cables and suture anchors can lead to comparable clinical efficacy, but fixation using cannulated screws and suture anchors can reduce soft tissue irritation, alleviate pain, and improve the quality of life of patients.

Objective:To explore the value of cardiovascular MR (CMR) T 1 mapping in evaluating myocardial injury in patients recovered from COVID-19. Methods:The clinical and image data of 15 patients with COVID-19 (9 with moderate clinical manifestation, 6 with severe clinical manifestation) who underwent CMR screening at 3 months after being discharged from the Second People′s Hospital of Fuyang City during May 2020 to June 2020 were prospective collected. Fifteen COVID-19 patients were selected as case group, and another 11 healthy volunteers were selected as control group. A standardized CMR protocol included cine, native and enhanced T 1 mapping, late gadolinium enhancement (LGE). Cardiac functional parameters, native T 1 value of left ventricular and extracellular volume fraction (ECV) were measured. One way ANOVA was used to assess the difference between CMR parameters among moderate and severe manifestation groups and control group, and LSD- t was used to assess the difference between the three groups. Results:LGE value was negative in all subjects. ECV values were higher in recovered COVID-19 patients with either moderate (27.9%±2.7%) or severe manifestation (30.0%±3.7%) than control group (23.2±1.9%) ( P<0.05); there was no significant difference of ECV values between recovered COVID-19 patients with moderate and severe manifestation ( P=0.100). There was no difference of native T 1 values and other functional and morphologic parameters of left ventricular and right ventricular among recovered COVID-19 patients with moderate and severe manifestation and control group ( P>0.05). Conclusion:CMR myocardial tissue ECV increase in patients who recovered from COVID-19, suggesting subclinical myocardial injury.

Objective To explore the high-risk factors of metabolic bone disease (MBD) in premature infants by retrospective analysis of the clinical data so as to provide evidence for optimal clinical management. Methods Clinical data of premature infants with birth weight<1500 g admitted in our hospital from January 2016 to December 2017 were retrospectively analyzed. Infants with serum alkaline phosphatase ( ALP )>500 IU/L and blood phosphorus <1. 5 mmol/L were selected as MBD group and premature infants with birth weight <1500 g were selected randomly as non-MBD group. General data, pulmonary surfactant, continuous positive airway pressure, mechanical ventilation, start time of enteral nutrition, parenteral nutrition ( PN) time, breast feeding time and breast milk fortifier adding, drug usage, hospitalization time and complications were re-corded and compared between the two groups. Results A total of 440 premature infants with birth weight<1500 g were admitted to the hospital during the study period. 58 [ 13. 2％ ( 58/440) ] infants were enrolled in the MBD group, among which infants with birth weight<1000 g accounting for 56. 9％ ( 33/58) . High birth weight (OR=0. 62, 95％ CI:0. 389-0. 990) was an independent protective factor of MBD in premature in-fants. The higher the birth weight, the lower the risk of MBD in premature infants. The longer duration of breast feeding time ( OR= 2. 191, 95％ CI:1. 628-2. 950) , later initial time of enteral feeding ( OR=2. 695, 95％CI:1. 710-4. 248), longer duration of PN (OR=6. 205, 95％ CI:3. 359-11. 463) time, longer duration of respiratory supporting time ( OR=1. 046, 95％ CI:1. 026-. 067) , longer hospital stay time ( OR=1. 703, 95％ CI:1. 109-2. 615) and small for gestational age ( OR=2. 965, 95％ CI:1. 163-5. 658) were inde-pendent risk factors of MBD in premature infants. The duration of PN was the most important independent risk factor of MBD in premature infants (OR=6.205, 95％ CI: 3.359-11.463). Conclusion Multiple factors can lead to MBD of premature infants. The high birth weight is an independent protective factor of MBD and the duration of PN is the most important independent risk factor of MBD in premature infants.

Objective To explore the clinical effect of endoscopic-assisted intraoral reduction mandibuloplasty.Methods From January 2010 to December 2014,a total of 186 patients with prominent mandibular angles underwent one stage long-curved ostectomy combined with splitting corticectomy through an intraoral approach with endoscopic assistence according to preoperative design for reduction mandible three-dimensionally,and achieved reduced width of the lower face with smooth curve of mandibular edge.The distance between both gonions was measured and the complications recorded to evaluate the clinical effect of the surgery during follow-up.Results All the 186 patients had no complications of bleeding and infection.The mean distance between both gonions measurement was (117.3±2.5) mm before surgery and (102.6±2.3) mm after operation;it was reduced (14.1 ±2.4)mm.After 1 month to 2 years of follow up,the width of the lower face was reduced in the frontal view and the mandibular angle appeared natural and inconspicuous in the lateral view.The patients were satisfied with both their frontal and lateral appearances.Conclusions Intraoral approach mandibular ostectomy with endoscopic-assisted allows surgeons to perform accurate,safe and reproducible ostectomies and to recontour mandible symmetrically and reduce the complications.

OBJECTIVETo observe the analgesic effect of electroacupuncture (EA) on collagen-induced arthritis (CIA) rats and its regulating effect on inflammation reaction and the endogenous opioid system of synovial tissues. Methods A total of 30 healthy male Wistar rats were randomly divided into a control group, a model group and an EA group, 10 rats in each one. The chronic pain model of CIA rats was made by cattle type-II collagen in the model group and EA group. Rats in the EA group were treated with EA at "Zusanli" (ST 36) and "Kunlun" (BL 60) for 30 min from 16th day after model establishment, once a day for consecutive 10 days. Rats in the control group did not receive any treatment. Rats in the model group were treated with fixation as the EA group. Threshold of pain, arthritis index, paw swelling were measured before model establishment and 16 d, 20 d, 23 d and 25 d after model establishment. The levels of beta-endorphin (β-END), met-enkephalin (met-ENK), dynorphin A (Dyn A) were measured by radioimmunoassay; the mRNA expressions of mu opioid receptor (MOR), kappa opioid receptor (KOR) and delta opioid receptor (DOR) in synovial tissues of CIA rats were detected by I quantitative polymerase chain reaction (qPCR).

RESULTSCompared with the control group, threshold of pain was reduced (all P<0. 01), arthritis index was increased (all P<0. 01) and paw swelling was increased (all P<0. 01) in the model group on the 16th day, 20th day, 23rd day, 25th day after model establishment. Compared with the model group, the threshold of pain was increased in the EA group (all P<0. 01), arthritis index and paw swelling were reduced (all P<0. 01) on the 23rd day and 25th day after model establishment. Compared with the control group, the level of Dyn A in synovial tissues of CIA rats was increased in the model group (P<0. 01); the mRNA expressions of MOR, KOR and DOR were down-regulated lower than 0. 5 fold of normal level. Compared with the model group, the level of β-END in synovial tissues of the knee joint was increased in the EA group (P<0. 05), and the mRNA expressions of MOR, KOR and DOR in synovial tissues of CIA rats were up-regulated more than 2 folds of normal level.

CONCLUSIONThe intervention of EA on chronic pain of CIA rats is superior, which is likely to be related with effects of EA on anti-inflammation and up-regulation of synovial tissue β-END and MOR, KOR, DOR.

Acupuncture Analgesia ; Acupuncture Points ; Analgesics, Opioid ; immunology ; Animals ; Arthritis, Rheumatoid ; immunology ; therapy ; Cattle ; Chronic Pain ; immunology ; therapy ; Dynorphins ; genetics ; immunology ; Electroacupuncture ; Enkephalin, Methionine ; genetics ; immunology ; Humans ; Male ; Rats ; Rats, Wistar ; Receptors, Opioid, mu ; genetics ; immunology ; Synovial Fluid ; immunology ; beta-Endorphin ; genetics ; immunology

Objective To characterize the cardiac magnetic resonance (CMR) features of peripartum cardiomyopathy(PPCM) and idiopathic dilated cardiomyopathy(IDCM), and to explore the value of MRI in the diagnosis of PPCM. Methods Ten cases of PPCM and 10 cases of Idiopathic dilated cardiomyopathy (IDCM) were included in this study. With 1.5 T MRI scanner, the heart shape (atrioventricular size, hypertrabeculation, thickness of the thinnest ventricular wall), function (ventricular wall movement and the overall function), cardiomyopathy perfusion were comprehensively evaluated. Paired samples t?test and Fisher exact probability method were used for statistical analysis. Results Between PPCM and IDCM group, there was no statistical significant difference in the atrioventricular size, cardiac output(CO), end diastolic volume(EDV), ejection fraction (EF), end systolic volume (ESV) and stroke volume (SV) (P>0.05). IDCM and PPCM group both showed ventricular wall thinning on MRI, with 4 cases of PPCM and 3 cases of IDCM presenting hypertrabeculation in the left ventricular apex. Seven cases of PPCM and 4 cases of IDCM depicted left ventricular local dysfunction, while 3 cases of PPCM and 6 cases of IDCM had abnormal integral movement. Two cases of PPCM appeared local delayed enhancement, while 4 cases of IDCM showed intramural delayed enhancement. After one year of follow?up, heart function recovered in 10 cases of PPCM and 4 cases of IDCM. Conclusions MRI diagnosis using multiple sequences is an ideal method in the evaluation of PPCM. Although there were no differences in cardiac morphology and function between PPCM and IDCM, the prognosis of PPCM is better than IDCM.