ObjectiveThe effects of two microbial fertilizers （Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer） on the growth and development， the accumulation of active ingredients， and the microbial community diversity of rhizosphere soil of Atractylodes chinensis were investigated. MethodsA field experiment was carried out with two-year-old Atractylodes chinensis as the test material. Plant samples were collected during the wilt stage （September 26， 2023） to determine the general agronomic traits of Atractylodes chinensis. High-performance liquid chromatography （HPLC） was utilized to evaluate the effects of microbial fertilizers on the synthesis and accumulation of four active ingredients （atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ） in Atractylodes chinensi. PacBio Sequel sequencing technology was used to explore the differences in bacterial community structures and diversity in the rhizosphere soil of Atractylodes chinensis treated with different microbial fertilizers. ResultsThe two microbial fertilizers had significant growth-promoting effects on Atractylodes chinensis. Compared with those of the CK group， the stem diameter， stem and leaf dry and fresh weight， and rhizome dry and fresh weight of Atractylodes chinensis significantly increased by 0.47-1.07 times （P<0.05） after the application of the Bacillus subtilis fertilizer （16 kg/667 m²）， and those significantly increased by 0.62-0.96 times （P<0.05） after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer （1.5 kg/667 m²）. The effect on plant height was not significant. The application of two microbial fertilizers was beneficial to the accumulation of atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ （P<0.01）， and the effect of the Bacillus subtilis fertilizer on the accumulation of active ingredients of Atractylodes chinensis was better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The results of high-throughput sequencing showed that compared with the CK group， the Bacillus subtilis fertilizer （8 kg/667 m²） could significantly increase the diversity of rhizosphere bacterial species by regulating the Simpson index and Shannon index （P<0.05）， and the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer significantly reduced the bacterial diversity （P<0.05）. The relative abundance of dominant bacteria was compared at the phylum and genus levels. The relative abundance of Proteobacteria （45.73%） and Burkholderia_Caballeronia_Paraburkholderia （9.98%） significantly increased after the application of the Bacillus subtilis fertilizer （P<0.01）， and the relative abundance of Acidobacteriota （20.53%） and Sphingomonas （3.63%） increased significantly （P<0.01） after the application of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. The relative abundance of beneficial bacteria in the Bacillus subtilis fertilizer was slightly higher than that in the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer. Pearson correlation analysis showed that Burkholderia_Caballeronia_Paraburkholderia and Sphingomonas were positively correlated with the content of atractylodin， atractylon， β-eudesmol， and atractylenolide Ⅰ （P<0.05）. ConclusionThe application of the Bacillus subtilis fertilizer and Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer can increase the yield of medicinal materials and promote the synthesis and accumulation of active ingredients by regulating the rhizosphere microecological diversity of Atractylodes chinensis， and the application effect of the Bacillus subtilis fertilizer is better than that of the Trichoderma harzianum-Purpureocillium lilacinum compound fertilizer.

Objective To observe the clinical effect of ultrasound-guided nerve block combined with arc edge needle-scalpel in the treatment of cervical spondylotic radiculopathy.Methods 160 cases were randomly divided into 4 groups from A to D,40 cases in each group.Group A was given nerve block,group B was given ultrasound-guided nerve block,group C was given arc edge needle-scalpel,and group D was given ultrasound-guided nerve block combined with arc edge needle-scalpel for 4 weeks.The McGill pain scale,cervical dysfunction index,cervical motion(angle of cervical left and right rotation,anterior flexion,posterior extension and lateral flexion),myoelectric-evoked potentiall(median nerve and ulnar nerve conduction velocity,latency),arterial blood flow velocity(average vertebral artery and basal artery flow velocity,end-diastolic blood flow velocity)were observed.The serum levels of neuron-specific enolase(NSE),β-endorphin(β-EP),lipoprotein-associated phospholipase A2(LpPLA2),6-ketoprostaglandin E1α(6-keto-PGE1α)were measured.The clinical efficacy and safety of each group were observed.Results The response rate in group D was taller than that in group A and group B significantly(χ2=6.605,P=0.013;χ2=4.073,P=0.044).Compared with the other three groups,the McGill pain,NDI,NSE,LpPLA2 and 6-keto-PGE1α in group D decreased significantly(P<0.05),the β-EP increased significantly(P<0.05),and the angles of left and right cervical rotation,anterior flexion,posterior extension and lateral flexion increased significantly(P<0.05),and median nerve and ulnar nerve conduction velocity,vertebral artery and basilar artery average blood flow velocity,end diastolic blood flow velocity increased significantly(P<0.05),and median nerve and ulnar nerve latency decreased significantly(P<0.05).The safety index of group D was higher than that in group A significantly(χ2=5.641,P=0.018).Conclusion Ultrasound-guided nerve block combined with arc edge needle-scalpel can relieve neck and shoulder pain,improve cervical spine function and reduce complications in patients with cervical spondylotic radiculopathy.

BACKGROUND:Asperosaponin Ⅵ has good osteogenic effects,but its ability to promote cellular osteogenesis under hypoxia environment is not yet clear.OBJECTIVE:To investigate the effect and potential mechanism of Asperosaponin Ⅵ on osteogenic differentiation of MC3T3-E1 cells under hypoxia environment.METHODS:MC3T3-E1 cells were divided into three groups.Cells in the control group were cultured in a complete medium under normoxic conditions(volume fraction of 21％O2);cells in the hypoxia group were cultured in the complete medium under hypoxia conditions(volume fraction of 0.5％O2);and cells in the Asperosaponin Ⅵ group were cultured in the complete medium containing Asperosaponin Ⅵ under hypoxia conditions(volume fraction of 0.5％oxygen).After 24 hours of culture,cell counting kit-8 method and EdU staining were used to detect cell proliferation activity,TUNEL staining and western blot assay were performed to detect cell apoptosis,and flow cytometry was used to detect intracellular reactive oxygen species levels and cell cycle distribution.Each group of cells was cultured in an osteogenic induction medium containing 1×10-5,1×10-6,and 1×10-7 mol/L Asperosaponin Ⅵ under hypoxia conditions for 7 days.The optimal concentration of Asperosaponin Ⅵ for intervention was identified using alkaline phosphatase staining under optical microscopy.Western blot was used to detect the expression of bone morphogenetic protein 2,osteopontin,and PI3K/AKT signaling axis-related proteins.RESULTS AND CONCLUSION:(1)Compared with the control group,the proliferation ability of MC3T3-E1 cells decreased under hypoxia conditions.1×10-6 mol/L Asperosaponin Ⅵ could significantly improve the cell proliferation ability under hypoxia conditions and reduce cell apoptosis.(2)Compared with the hypoxia group,the Asperosaponin Ⅵ group showed a decrease in intracellular reactive oxygen species and a significant increase in the proportion of cells in the S phase.(3)Compared with the hypoxia group,the cell morphology in the 1×10-6 mol/L Asperosaponin Ⅵ group was elongated,with more protrusions and darker alkaline phosphatase staining.(4)Compared with the hypoxia group,the expression of bone morphogenetic protein 2 and osteopontin increased in the Asperosaponin Ⅵ group,while the expression of p-PI3K and p-AKT proteins decreased.These findings indicate that under hypoxia conditions,Asperosaponin Ⅵcan promote osteogenic differentiation of MC3T3-E1 cells,possibly by regulating the PI3K/AKT pathway.

Objective:To assess the effectiveness of combining color Doppler ultrasound (CDU) with shear wave elastography (SWE) in forecasting the likelihood of breast cancer (BC) recurrence.Methods:From Jan. 2022 to Jan. 2024, we gathered data on 92 BC patients admitted to Shanxi Maternal and Child Health Hospital and Shanxi Cancer Hospital, focusing on their lesion characteristics. Each patient underwent CDU and SWE examinations pre-surgery and was monitored for a year. Based on BC recurrence, patients were categorized into recurrence and non-recurrence groups. We compared CDU imaging and hemodynamic features of BC between these groups and evaluated SWE elastic modulus values. To assess the agreement between CDU, SWE, and their combined use in predicting BC recurrence and pathological diagnosis, we employed the Kappa test. Additionally, we plotted ROC curves to analyze the predictive power of CDU, SWE, and their combination in assessing BC recurrence risk. Results:Among the 92 BC patients studied, 38 experienced recurrence, while 54 did not. CDU examination revealed that the non-recurrence group exhibited significantly larger tumor maximum diameter, higher peak systolic velocity (PSV), a higher proportion of aspect ratio ≥ 1, irregular margins, calcification, and increased vascular abundance, compared to the recurrence group ( t/ χ2=17.188, 18.491, 6.099, 15.374, 14.526, 19.318, P<0.05). Additionally, the vascular resistance index (RI) was lower in the non-recurrence group ( t=-26.429, P<0.05). SWE results indicated that the recurrence group had higher average (E mean), maximum (E max), and minimum (E min) elastic moduli compared to the non-recurrence group ( t=14.39, 12.34, 8.29, P<0.05). CDU and SWE predictions showed substantial agreement with pathological results, with Kappa values of 0.66 and 0.69, respectively ( P<0.05). The combination of CDU and SWE predictions demonstrated excellent concordance with pathological outcomes ( Kappa=0.91, P<0.05). In terms of predicting BC recurrence risk, CDU and SWE had accuracies of 83.70% and 84.21%, respectively. The ROC curve analysis showed AUC values of 0.830 for CDU, 0.847 for SWE, and 0.955 for their combination. Sensitivity was 0.870 for CDU, 0.852 for SWE, and 0.963 for the combination. Specificity was 0.789 for CDU, 0.842 for SWE, and 0.947 for the combination. Positive predictive values were 78.95% for CDU, 84.21% for SWE, and 94.74% for the combination, while negative predictive values were 87.04% for CDU, 85.19% for SWE, and 96.30% for the combination. The AUC for CDU in predicting post-operative BC recurrence risk was not significantly different from SWE ( χ2=0.04, P>0.05), but the combined prediction AUC was significantly higher than individual predictions ( χ2=8.00, 7.04, P<0.05) . Conclusion:The predictive value of CDU and SWE combined examination for the recurrence risk of BC is better than that of single examination, and it is suggested that the combined examination method should be popularized in clinic.

BACKGROUND:Asperosaponin Ⅵ has good osteogenic effects,but its ability to promote cellular osteogenesis under hypoxia environment is not yet clear.OBJECTIVE:To investigate the effect and potential mechanism of Asperosaponin Ⅵ on osteogenic differentiation of MC3T3-E1 cells under hypoxia environment.METHODS:MC3T3-E1 cells were divided into three groups.Cells in the control group were cultured in a complete medium under normoxic conditions(volume fraction of 21％O2);cells in the hypoxia group were cultured in the complete medium under hypoxia conditions(volume fraction of 0.5％O2);and cells in the Asperosaponin Ⅵ group were cultured in the complete medium containing Asperosaponin Ⅵ under hypoxia conditions(volume fraction of 0.5％oxygen).After 24 hours of culture,cell counting kit-8 method and EdU staining were used to detect cell proliferation activity,TUNEL staining and western blot assay were performed to detect cell apoptosis,and flow cytometry was used to detect intracellular reactive oxygen species levels and cell cycle distribution.Each group of cells was cultured in an osteogenic induction medium containing 1×10-5,1×10-6,and 1×10-7 mol/L Asperosaponin Ⅵ under hypoxia conditions for 7 days.The optimal concentration of Asperosaponin Ⅵ for intervention was identified using alkaline phosphatase staining under optical microscopy.Western blot was used to detect the expression of bone morphogenetic protein 2,osteopontin,and PI3K/AKT signaling axis-related proteins.RESULTS AND CONCLUSION:(1)Compared with the control group,the proliferation ability of MC3T3-E1 cells decreased under hypoxia conditions.1×10-6 mol/L Asperosaponin Ⅵ could significantly improve the cell proliferation ability under hypoxia conditions and reduce cell apoptosis.(2)Compared with the hypoxia group,the Asperosaponin Ⅵ group showed a decrease in intracellular reactive oxygen species and a significant increase in the proportion of cells in the S phase.(3)Compared with the hypoxia group,the cell morphology in the 1×10-6 mol/L Asperosaponin Ⅵ group was elongated,with more protrusions and darker alkaline phosphatase staining.(4)Compared with the hypoxia group,the expression of bone morphogenetic protein 2 and osteopontin increased in the Asperosaponin Ⅵ group,while the expression of p-PI3K and p-AKT proteins decreased.These findings indicate that under hypoxia conditions,Asperosaponin Ⅵcan promote osteogenic differentiation of MC3T3-E1 cells,possibly by regulating the PI3K/AKT pathway.

Objectives:There is a lack of long-term follow-up study results on severe microvascular complications in a larger Chinese population with diabetes.This study aims to explore long-term impact of newly diagnosed diabetes(NDD)on the incidence and risk of severe microvascular complications.Methods:A total of 598 NDD and 493 normal glucose tolerance(NGT)subjects were included in this study in 1986.By questionnaire and systematic case review,the occurrence of severe microvascular complications,including severe diabetic retinopathy,severe diabetic nephropathy,and severe diabetic neuropathy,was followed up and collected over a period of 34 years.Results:The cumulative incidence of severe microvascular complications in the NDD population was 65.03%(95%CI:58.90%-70.48%)over 34 years,significantly higher than that in the NGT population(16.8%,95%CI:12.64%-20.11%).After adjusting for related risk factors,the risk of severe microvascular complications in the NDD population was 7.08 times than that of the NGT population(HR=7.08,95%CI:5.09-9.84,P<0.0001).Stratified analysis by sex showed that the cumulative incidence and risk of severe microvascular complications were slightly higher in male NDD population(68.02%,95%CI:57.27%-76.61%;HR=9.45,95%CI:5.78-15.47,P<0.0001)than in female NDD population(63.37%,95%CI:55.69%-70.09%;HR=5.86,95%CI:3.75-9.16,P<0.0001);however,the cumulative incidence increased more rapidly in women during the follow-up period of 10-25 years.Conclusions:The incidence and risk of severe microvascular complications in diabetes were significantly higher than those in the NGT population;and the incidence of severe vascular complications increased rapidly after the duration of diabetes exceeded 10 years,indicating that strict control of blood glucose in the early stage of diabetes is of vital importance.

Objective To investigate the influencing factors of the course of perioperative prophylactic antibiotics in patients undergoing total hip arthroplasty,and explore management strategies for enhancing perioperative prophylactic medication administration.Methods The clinical data for patients undergoing total hip arthroplasty at Affiliated Hospital of Chengdu University from January,2020 to September,2024 were retrospectively collected.Patients were divided into a 24 h group and a 48-72 h group based on the duration of prophylactic antibacterial therapy.The general characteristics,surgical-related indicators,preoperative and postoperative laboratory test results,and surgical outcome measures between the two groups of patients were compared.Multivariate Logistic regression analysis was performed to identify influencing factors associated with prolonged duration of prophylactic antibacterial therapy.Results A total of 126 patients who underwent total hip arthroplasty were enrolled,including 74 cases in the 24 h group and 52 cases in the 48-72 h group.Univariate analysis results showed that there were statistically significant differences in the following indicators between the two groups:surgical cause,surgical duration,intraoperative blood loss,drainage duration of plasma drainage tubes,preoperative white blood cell count,and preoperative neutrophil count(P<0.05).The results of multivariate Logistic regression analysis showed that the reason for surgery and the duration of plasma drain tube drainage were the influencing factors of antimicrobial treatment course for total hip arthroplasty(P<0.05).The results of receiver operating characteristic curve analysis showed that the prediction model(constructed based on the drainage time of plasma drainage tube)for prophylactic antimicrobial treatment course to 48-72 h was 0.721.When the drainage time of plasma drainage tubes was≥40.56 h,the risk of requiring prophylactic antimicrobial therapy for an extended course of 48-72 h increased significantly.Conclusion The patient's surgical reason and the duration of plasma drain drainage may be related to the prophylactic antimicrobial course of more than 24 hours.Clinical pharmacists may utilize this parameter as a patient-specific characteristic,with the support of information systems,the hierarchical patient management can be implemented,thereby enhancing the effectiveness of medication surveillance and progressively elevating the 24 h discontinuation rate of perioperative prophylactic antibiotics.

Purpose: Exercise is an effective non-pharmacological approach for alleviating treatment-related adverse effects and enhancing physical fitness in breast cancer survivors. A Kinect-based mixed reality device (KMR), with real-time feedback and user data collection, is an innovative exercise intervention for breast cancer survivors. This study aimed to investigate the effect of KMR exercise program on quality of life (QOL) and physical function in breast cancer survivors. Materials and Methods: Seventy-seven participants were randomly assigned to either the KMR exercise group or home stretching group with an 8-week intervention. Physical function (shoulder range of motion, body composition, aerobic capacity, and hand grip strength) was evaluated before and after the intervention period. Participants completed questionnaires such as the Disabilities of the Arm, Shoulder, and Hand (DASH), Functional Assessment of Cancer Therapy-Breast, and International Physical Activity Questionnaire (IPAQ) to assess upper extremity disabilities, QOL, and physical activity levels. Results: Significant group-by-time interaction was found for flexion of the operated arm (154.3±12.5 to 165.8±11.2), and the non-operated arm (158.2±13.8 to 166.5±12.2), abduction of the non-operated arm (154.8±31.6 to 161.1±28.1), and adduction of the operated arm (46.5±9.1 to 52.6±7.2). Significant improvements were also observed in DASH (46.8±9.1 to 40.8±9.3) and IPAQ (1,136.3±612.8 to 1,287±664.1). Conclusion The KMR exercise program effectively improved the physical function, alleviated edema, reduced upper extremity disability, and enhanced the QOL in breast cancer survivors. Coupled with significant group-by-time interactions for various outcomes, the results emphasize the potential benefits of incorporating the KMR exercise program to improve the QOL in breast cancer survivors.

Purpose: Exercise is an effective non-pharmacological approach for alleviating treatment-related adverse effects and enhancing physical fitness in breast cancer survivors. A Kinect-based mixed reality device (KMR), with real-time feedback and user data collection, is an innovative exercise intervention for breast cancer survivors. This study aimed to investigate the effect of KMR exercise program on quality of life (QOL) and physical function in breast cancer survivors. Materials and Methods: Seventy-seven participants were randomly assigned to either the KMR exercise group or home stretching group with an 8-week intervention. Physical function (shoulder range of motion, body composition, aerobic capacity, and hand grip strength) was evaluated before and after the intervention period. Participants completed questionnaires such as the Disabilities of the Arm, Shoulder, and Hand (DASH), Functional Assessment of Cancer Therapy-Breast, and International Physical Activity Questionnaire (IPAQ) to assess upper extremity disabilities, QOL, and physical activity levels. Results: Significant group-by-time interaction was found for flexion of the operated arm (154.3±12.5 to 165.8±11.2), and the non-operated arm (158.2±13.8 to 166.5±12.2), abduction of the non-operated arm (154.8±31.6 to 161.1±28.1), and adduction of the operated arm (46.5±9.1 to 52.6±7.2). Significant improvements were also observed in DASH (46.8±9.1 to 40.8±9.3) and IPAQ (1,136.3±612.8 to 1,287±664.1). Conclusion The KMR exercise program effectively improved the physical function, alleviated edema, reduced upper extremity disability, and enhanced the QOL in breast cancer survivors. Coupled with significant group-by-time interactions for various outcomes, the results emphasize the potential benefits of incorporating the KMR exercise program to improve the QOL in breast cancer survivors.

Purpose: Exercise is an effective non-pharmacological approach for alleviating treatment-related adverse effects and enhancing physical fitness in breast cancer survivors. A Kinect-based mixed reality device (KMR), with real-time feedback and user data collection, is an innovative exercise intervention for breast cancer survivors. This study aimed to investigate the effect of KMR exercise program on quality of life (QOL) and physical function in breast cancer survivors. Materials and Methods: Seventy-seven participants were randomly assigned to either the KMR exercise group or home stretching group with an 8-week intervention. Physical function (shoulder range of motion, body composition, aerobic capacity, and hand grip strength) was evaluated before and after the intervention period. Participants completed questionnaires such as the Disabilities of the Arm, Shoulder, and Hand (DASH), Functional Assessment of Cancer Therapy-Breast, and International Physical Activity Questionnaire (IPAQ) to assess upper extremity disabilities, QOL, and physical activity levels. Results: Significant group-by-time interaction was found for flexion of the operated arm (154.3±12.5 to 165.8±11.2), and the non-operated arm (158.2±13.8 to 166.5±12.2), abduction of the non-operated arm (154.8±31.6 to 161.1±28.1), and adduction of the operated arm (46.5±9.1 to 52.6±7.2). Significant improvements were also observed in DASH (46.8±9.1 to 40.8±9.3) and IPAQ (1,136.3±612.8 to 1,287±664.1). Conclusion The KMR exercise program effectively improved the physical function, alleviated edema, reduced upper extremity disability, and enhanced the QOL in breast cancer survivors. Coupled with significant group-by-time interactions for various outcomes, the results emphasize the potential benefits of incorporating the KMR exercise program to improve the QOL in breast cancer survivors.