BACKGROUND:Patients with lumbar disc herniation have different physical deformities due to nucleus pulposus compression and mechanical imbalance. On this basis,Professor Feng Tianyou proposed the "four-step waist type." Professor Feng Wei proposed the objective quantification of three-dimensional scoliosis angle "four-step waist type."OBJECTIVE:To explore the application value of three-dimensional scoliosis angle in evaluating the efficacy of Feng's spinal manipulation in the treatment of patients with lumbar disc herniation.METHODS:A total of 149 hospitalized patients with lumbar disc herniation were enrolled sequentially,including 96 cases of type-Ⅰ/Ⅱ and 55 cases of type-Ⅲ/Ⅳ. The patients were treated with manual therapy for 2 weeks,and 10 healthy volunteers were included as healthy controls. The three-dimensional scoliosis angle was measured using surface topography technology. The difference of three scoliosis angles between patients with type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ was compared before and after treatment. The difference between patients after treatment and healthy subjects was compered. The difference of three-dimensional scoliosis angles between type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ after treatment was compared. The intrinsic correlation of each projection plane of three-dimensional scoliosis angle and its correlation with commonly used clinical efficacy scores were explored.RESULTS AND CONCLUSION:(1) The three-dimensional scoliosis angle was significantly different in patients with type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ before and after treatment (P<0.05). (2) There were significant differences in coronal curve angle and transverse curve angle between patients with type-Ⅰ/Ⅱ,type-Ⅲ/Ⅳ and healthy subjects (P<0.05),but there was no significant difference in sagittal curve angle (P>0.05). (3) There was a correlation between the angles of each section of the three-dimensional angle,and there was a correlation between the three-dimensional angle and the subjective scale. (4) It is indicated that the three-dimensional scoliosis angle can quantitatively evaluate the changes of body deformity before and after treatment. Quantitative indicators can reveal the changes in the patient's condition before and after treatment. The three-dimensional scoliosis angle can reflect the severity of the impact on the patient's living conditions,but the evaluation of scoliosis by a single plane parameter has certain limitations.

Objective:To investigate the role and molecular mechanisms of transcription factor EB (TFEB) and its target genes in the treatment of multiple myeloma (MM) with bortezomib.Methods:TFEB target genes were predicted using the GTRD database (http://gtrd.biouml.org/), identifying Ptch1 gene for further study. Expression changes of Ptch1 in RPMI8226 and U266 MM cell lines after bortezomib treatment were assessed by real time fluorogenic quantitative PCR (RT-qPCR) and Western blot. RPMI8226 and U266 cell lines were transfected with siRNA-TFEB, and mRNA and protein levels of key factors (Ptch1, Gli1) in the Ptch1/Hedgehog signaling pathway were measured by RT-qPCR and Western blot. Furthermore, Ptch1 was overexpressed in MM cell lines via lentiviral transduction. Autophagy was evaluated by acridine orange staining, and protein levels of LC3B, Beclin-1, and Lamp-1 were measured by Western blot. Lysosomal quantity changes were assessed by lysosomal fluorescent probes.Results:Bortezomib (6.0×10 -6 mmol/L, 24 h) significantly reduced Ptch1 mRNA and protein levels in both cell lines compared with blank control group (all P<0.05). siRNA-TFEB transfection reversed bortezomib’s inhibition of Hedgehog pathway key factors Ptch1 and Gli. Ptch1 overexpression in bortezomib-treated RPMI8226 and U266 cells significantly reduced the relative expression of autophagy-related proteins LC3B, Beclin-1, and Lamp-1 (all P=0.001). Acridine orange staining showed fewer acidic vesicular organelles within two cell lines (all P=0.001). The relative fluorescence expressions of lysosomal probes reflecting the number of lysosomes were also decreased ( P values of RPMI8226 and U266 cell lines were 0.001 and 0.007, respectively) . Conclusion:The knockdown of TFEB can specifically promote the expression of the Ptch1/Hedgehog signaling pathway, thereby reducing bortezomib-induced autophagy in MM cells and reversing the inhibitory effect of bortezomib on the proliferation of MM cell lines.

Objective To explore the clinical efficacy of the medicated stick massage at meridian knot points in treating Qi stagnation and blood stasis type lumbar disc herniation(LDH)based on the meridian theory.Methods The patients with LDH in the ward 5 of orthopedics department in this hospital from Sep-tember 2024 to April 2025 were selected as the research subjects.On the basis of routine treatment and care,the control group adopted the medicated stick massage at points,while the experimental group adopted the medicated stick massage at meridian knots.The visual analogue scale(VAS)scores,Japanese Orthopaedic So-ciety(JOA)score,TCM syndrome scores and TCM syndrome therapeutic effects before intervention and in two weeks after intervention were compared between the two groups.Results The VAS scores,each item score and total score of JOA,TCM syndrome scores and TCM therapeutic effects after 2-week intervention in the experimental group all were superior to those in the control group,and the differences were statistically significant(P＜0.05).Conclusion Selecting the medicated stick massage at the meridian knots under the guidance of meridian theory could significantly improve the pain symptoms,lumbar function,TCM syndrome scores,the therapeutic effects are definite,and is worthy of clinical promotion and application.

BACKGROUND:Patients with lumbar disc herniation have different physical deformities due to nucleus pulposus compression and mechanical imbalance. On this basis,Professor Feng Tianyou proposed the "four-step waist type." Professor Feng Wei proposed the objective quantification of three-dimensional scoliosis angle "four-step waist type."OBJECTIVE:To explore the application value of three-dimensional scoliosis angle in evaluating the efficacy of Feng's spinal manipulation in the treatment of patients with lumbar disc herniation.METHODS:A total of 149 hospitalized patients with lumbar disc herniation were enrolled sequentially,including 96 cases of type-Ⅰ/Ⅱ and 55 cases of type-Ⅲ/Ⅳ. The patients were treated with manual therapy for 2 weeks,and 10 healthy volunteers were included as healthy controls. The three-dimensional scoliosis angle was measured using surface topography technology. The difference of three scoliosis angles between patients with type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ was compared before and after treatment. The difference between patients after treatment and healthy subjects was compered. The difference of three-dimensional scoliosis angles between type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ after treatment was compared. The intrinsic correlation of each projection plane of three-dimensional scoliosis angle and its correlation with commonly used clinical efficacy scores were explored.RESULTS AND CONCLUSION:(1) The three-dimensional scoliosis angle was significantly different in patients with type-Ⅰ/Ⅱ and type-Ⅲ/Ⅳ before and after treatment (P<0.05). (2) There were significant differences in coronal curve angle and transverse curve angle between patients with type-Ⅰ/Ⅱ,type-Ⅲ/Ⅳ and healthy subjects (P<0.05),but there was no significant difference in sagittal curve angle (P>0.05). (3) There was a correlation between the angles of each section of the three-dimensional angle,and there was a correlation between the three-dimensional angle and the subjective scale. (4) It is indicated that the three-dimensional scoliosis angle can quantitatively evaluate the changes of body deformity before and after treatment. Quantitative indicators can reveal the changes in the patient's condition before and after treatment. The three-dimensional scoliosis angle can reflect the severity of the impact on the patient's living conditions,but the evaluation of scoliosis by a single plane parameter has certain limitations.

Objective:To investigate the role and molecular mechanisms of transcription factor EB (TFEB) and its target genes in the treatment of multiple myeloma (MM) with bortezomib.Methods:TFEB target genes were predicted using the GTRD database (http://gtrd.biouml.org/), identifying Ptch1 gene for further study. Expression changes of Ptch1 in RPMI8226 and U266 MM cell lines after bortezomib treatment were assessed by real time fluorogenic quantitative PCR (RT-qPCR) and Western blot. RPMI8226 and U266 cell lines were transfected with siRNA-TFEB, and mRNA and protein levels of key factors (Ptch1, Gli1) in the Ptch1/Hedgehog signaling pathway were measured by RT-qPCR and Western blot. Furthermore, Ptch1 was overexpressed in MM cell lines via lentiviral transduction. Autophagy was evaluated by acridine orange staining, and protein levels of LC3B, Beclin-1, and Lamp-1 were measured by Western blot. Lysosomal quantity changes were assessed by lysosomal fluorescent probes.Results:Bortezomib (6.0×10 -6 mmol/L, 24 h) significantly reduced Ptch1 mRNA and protein levels in both cell lines compared with blank control group (all P<0.05). siRNA-TFEB transfection reversed bortezomib’s inhibition of Hedgehog pathway key factors Ptch1 and Gli. Ptch1 overexpression in bortezomib-treated RPMI8226 and U266 cells significantly reduced the relative expression of autophagy-related proteins LC3B, Beclin-1, and Lamp-1 (all P=0.001). Acridine orange staining showed fewer acidic vesicular organelles within two cell lines (all P=0.001). The relative fluorescence expressions of lysosomal probes reflecting the number of lysosomes were also decreased ( P values of RPMI8226 and U266 cell lines were 0.001 and 0.007, respectively) . Conclusion:The knockdown of TFEB can specifically promote the expression of the Ptch1/Hedgehog signaling pathway, thereby reducing bortezomib-induced autophagy in MM cells and reversing the inhibitory effect of bortezomib on the proliferation of MM cell lines.

Objective To prepare paclitaxel-natural borneol complex,and to explore the prescription and preparation process of paclitaxel-natural borneol complex drug-loaded submicroemulsion,and its in vitro anti-tumor effect.Methods The Paclitaxel-natural borneol complex was prepared by grinding method and identified by Fourier Transform infrared spectroscopy(FT-IR)and differential scanning calorimetry(DSC).The compound drug-loaded submicroemulsion was prepared using a two-step high-pressure emulsification method.The single-factor investigation and the orthogonal experimental design were applied to optimize the formulation and preparation process.MTT assay,cell cloning assay,and cell scratch assay were used to evaluate the effect of this preparation on HCT-116 cells.Results The infrared spectral absorption peaks of taxol-natural borneol complex at 3 312.76 cm-1 and 3 513.92 cm-1 disappeared,and DSC analysis showed that a new absorption peak of taxol-natural borneol complex appeared at 154.56 ℃,indicating that taxol be coupled with natural borneol to form a new complex.The optimal prescription was 0.44％active pharmaceutical ingredient[paclitaxel-natural borneol(1∶3)],10％medium chain triglyceride,3％emulsifier[egg yolk lecithin-Poloxam 188(1∶2)],2％glycerol,0.3％oleate.The optimal process was emulsification at 80 ℃,60 MPa high pressure homogenization 10 times.The half inhibitory concentration(IC50)was 0.75 μg·mL-1 by MTT asssy in cell.In the cell cloning assay,the scratch healing area of blank control group,paclitaxel raw material and paclitaxel/natural borneol submicroemulsion were(36.44±3.35)％,(13.59±9.28)％,(8.30±4.09)％,respectively.The results were statistically significant(P＜0.05).In the plate cloning experiment,the cell cloning rates of blank control group,paclitaxel bulk drug group and submicroemulsion group were(37.92±0.729)％,(9.16±1.335)％and(3.36±1.065)％,respectively,the differents were statistically significant(P＜0.05).Conclusion This submicroemulsion has reasonable prescription,feasible process and good stability.Cell experiments showed that the submicronemulision effectively inhibits the proliferation and migration of HCT-116 cells,suggesting its potential as a promising antitumor agent.

Objective To explore the main categories and changing directions of hospitalization expenses of gynecological tumors,and provide strategies and suggestions for effectively controlling hospitalization expenses and improving the payment scheme of medical insurance fund.Methods The expense information of patients discharged from Huzhou Central Hospital from January 2020 to December 2022 was collected,and analyzed by the payment method of structural variation and disease diagnosis related groups(DRG)with grey correlation,and the correlation degree was observed.Results From 2020 to 2022,the average hospitalization cost of 2 138 gynecological tumor patients showed a downward trend.The hospitalization cost structure of patients showed that surgical and laboratory expenses accounted for a relatively high proportion,while nursing and treatment expenses accounted for a relatively low proportion.The changes in the hospitalization structure of patients showed that material costs were gradually decreasing,while operating costs,bed fees,pathology fees,and nursing fees were gradually increasing.Diagnosis and treatment fees,drug fees,radiation fees,testing fees,treatment fees,surgery fees,and other expenses were first decreasing and then increasing.In the hospitalization expenses of gynecological tumors from 2020 to 2022,the most closely related expenses were surgical expenses,drug expenses,and laboratory expenses,while the least related expenses were bed expenses,nursing expenses,and treatment expenses.The proportion of patient hospitalization expenses was basically consistent with the degree of correlation.The structural change rate of hospitalization expenses for gynecological tumors from 2020 to 2022 was 13.67％,with a structural change rate of 14.61％from 2020 to 2021 and 10.77％from 2021 to 2022.The direction of structural changes showed that from 2020 to 2022,there were positive changes in operating fees,bed fees,pathology fees,and nursing fees,with significant changes in surgical fees.The largest contribution rate of changes in the hospitalization cost structure of gynecological tumors from 2020 to 2022 was surgical expenses,accounting for 37.29％,followed by examination expenses,accounting for 13.08％.The contribution rates of various expenses to the structural changes of average hospitalization expenses varied during different time periods.From 2020 to 2021,the largest contribution rate of hospitalization expense structural changes was surgical expenses,accounting for 33.05％,followed by drug expenses,accounting for 12.05％.From 2021 to 2022,the largest contribution rate of hospitalization expense structural changes was surgical expenses,accounting for 48.00％,followed by drug expenses,accounting for 16.85％.Correlation analysis showed that the hospitalization expenses of patients were related to medical insurance type and length of stay(P＜0.05).Conclusion The average hospitalization cost of gynecological tumor patients has been effectively controlled,and their clinical hospitalization costs are gradually rationalized.However,material and surgical costs still have a significant impact on the hospitalization costs of patients,indicating that the labor value of clinical medical personnel has increased less.DRG payment can control clinical medical expenses to a certain extent,and further optimization is needed to improve supporting policies,enhance the technical value of medical personnel,and strengthen the management of medical consumables.

Objective:To construct a comprehensive management platform for medical waste based on Internet of Things technique,so as to achieve standardized and refined management for medical waste. Methods:Based on radio frequency identification (RFID) technology,automation equipment technique,artificial intelligence (AI) robotics technique,big data,5G communication and other digital techniques,the browser and server (B/S) architecture was adopted to set perception layer,edge computing layer,transmission layer,platform layer,application layer and presentation layer,and to build a comprehensive management platform of medical waste that integrated real-time tracking,monitoring,control and management of the entire process of collection,transportation and disposal for medical waste. Results:The comprehensive management platform for medical waste was designed on the basis of Internet of Things architecture,which consisted of intelligent hardware equipment,business management system of medical waste,and auxiliary decision-making system. It can complete automated classification,identification,sterilization,environmental information collection,operation recording,and automated distribution and transportation of entire process and each stage of collection and processing for medical waste,and can realize traceability of whole course for "zero contact" processing,comprehensive "zero blind spots" monitoring,and full data "one network" analysis of the entire process included each stage from collection to disposal for medical waste. Conclusion:The comprehensive management platform for medical waste based on Internet of Things technique can meet the supervision of full process for the disposal of medical waste,and can improve the daily operational efficiency of management institutions of medical waste,and reduce labor costs.

Objective:To construct a comprehensive management platform for medical waste based on Internet of Things technique,so as to achieve standardized and refined management for medical waste. Methods:Based on radio frequency identification (RFID) technology,automation equipment technique,artificial intelligence (AI) robotics technique,big data,5G communication and other digital techniques,the browser and server (B/S) architecture was adopted to set perception layer,edge computing layer,transmission layer,platform layer,application layer and presentation layer,and to build a comprehensive management platform of medical waste that integrated real-time tracking,monitoring,control and management of the entire process of collection,transportation and disposal for medical waste. Results:The comprehensive management platform for medical waste was designed on the basis of Internet of Things architecture,which consisted of intelligent hardware equipment,business management system of medical waste,and auxiliary decision-making system. It can complete automated classification,identification,sterilization,environmental information collection,operation recording,and automated distribution and transportation of entire process and each stage of collection and processing for medical waste,and can realize traceability of whole course for "zero contact" processing,comprehensive "zero blind spots" monitoring,and full data "one network" analysis of the entire process included each stage from collection to disposal for medical waste. Conclusion:The comprehensive management platform for medical waste based on Internet of Things technique can meet the supervision of full process for the disposal of medical waste,and can improve the daily operational efficiency of management institutions of medical waste,and reduce labor costs.

Objective:To explore the relevance of a new comprehensive respiratory mechanics parameter, elastic power, to the 28-day prognosis of ARDS patients.Methods:Patients with ARDS hospitalized for at least 48 h with invasive mechanical ventilation in five intensive care units in three local hospitals in Lianyungang City from June 2018 to June 2022 were included in the study. Their baseline data and respiratory mechanics parameters were collected. Elastic power, mechanical power, driving pressure and lung compliance are calculated according to the corresponding formulae. The prognostic risk factors of ARDS patients were analysed using COX multi-factor regression, and the predictive value of EP/Cst on the 28-day prognosis of ARDS patients was evaluated based on ROC curve analysis and Kaplan-Meier survival curve.Results:There was no significantly difference in tidal volume and PEEP settings between the patients in the ARDS survivor and death groups ( P> 0.05). However, the differences in respiratory rate, plateau pressure, driving pressure, lung compliance, mechanical work, elastic work, EP/cst and MP/cst between the two groups were significantly different (all P< 0.01). Multifactorial COX regression analysis showed that EP/cst ( HR=1.211, 95% CI:1.091-1.323) and RR ( HR=1.209, 95% CI:1.046-1.339) were strongly associated with a more severe degree of illness and a worse prognosis in ARDS. And the cumulative survival rate at 28 d was significantly lower in the high Cst-EP group than in the low Cst-EP group (50.00% vs. 82.40%, P < 0.01). Conclusions:The new respiratory mechanics parameters EP and EP/Cst can assess the severity of ARDS with a good predictive effect on patient prognosis at 28 days.