Objective:To explore any myogenic effect of extracorporeal shock wave therapy (ESWT) on shoulder joint contracture.Methods:Sixty-eight patients with shoulder contracture were enrolled and randomly divided into a conventional therapy group ( n=34) and an ESWT group ( n=34) for this clinical trial. The conventional therapy group received standard rehabilitation treatment, while the ESWT group received additional extracorporeal shock wave therapy. In addition, 24 Sprague-Dawley rats were randomly assigned to a blank control group, a model group, a natural recovery group, or an ESWT animal group, each of 6. All of the groups except the blank control group had contracture modeled using plaster cast immobilization of the left shoulder joint. After successful modeling, the natural recovery group was routinely raised for two weeks, while the ESWT animal group received two weeks of extracorporeal shock wave intervention. In both the clinical and animal experiments, ESWT was administered twice weekly (every Tuesday and Friday) for two consecutive weeks. Before and after the treatment, the patient groups were assessed using a visual analog scale (VAS) for pain, shoulder range of motion (ROM), and the root mean square (RMS) values of the surface electromyographs of the peri-shoulder muscles. Shoulder ROM was assessed in all four of the rat groups after the ESWT treatment, and histological analysis of the supraspinatus muscle was performed. Results:After the treatment, both patient groups showed significant improvements in their average VAS scores, active and passive shoulder ROM, and RMS values. On average, the ESWT group demonstrated significantly greater improvements than the conventional therapy group in active forward flexion, passive forward flexion, active abduction, passive abduction, and the RMS values of the deltoid, biceps brachii, and triceps brachii muscles. After the treatment the left shoulder abduction angle had been reduced significantly in the model group (to 96.00±2.37)°, the natural recovery group (103.00±4.05)° and the ESWT animal group (121.33±4.89)° compared to the blank control group (154.50±2.35)°. Both the natural recovery group and the ESWT animal group had significantly greater shoulder abduction angles than the model group, and the ESWT animal group also demonstrated a significantly larger abduction angle than the natural recovery group. After the treatment, significant differences between the model group and the blank control group were observed in the cross-sectional area of left supraspinatus muscle fibers and the proportion of collagen. The ESWT animal group too exhibited significantly improved muscle fiber cross-sectional area and collagen proportion compared to the natural recovery group.Conclusions:Shoulder joint contracture is accompanied by significant myopathic changes (muscle atrophy and fibrosis). ESWT effectively ameliorates these problems while enhancing muscle strength and functional recovery.

Objective To analyze the mediating effect of psychosocial adaptation on the relationship between loneliness and fatigue in young patients with cerebral infarction.Methods A total of 186 patients(aged 18 to 45 years)with cerebral infarction in Hengshui People's Hospital from Febru-ary,2023 to May,2024 were selected.They were investigated with Fatigue Severity Scale(FSS),Univesity of California at Los Angels Loneliness Scale(UCLA)and Psychosocial Adaptation to Illness Scale-self-report ver-sion(PAIS-SR)three months after discharging.The FSS scores were compared among patients with different characteristics.The correlation between the scores of FSS,UCLA and PAIS-SR was analyzed with Pearson's co-efficient.Structural equation modeling was used to analyze the mediating effect of PAIS-SR score on the relation-ship between scores of FSS and UCLA.Results A total of 183 valid questionnaires were returned.The FSS score was(36.78±7.23),the UCLA score was(42.26±9.18),and the PAIS-SR score was(56.62±13.89).There were significant differences in FSS scores among pa-tients with different National Institutes of Health Stroke Scale scores,modified Rankin Scale scores and depres-sion status(F>3.557,P<0.001).The FSS score was positively correlated with the UCLA score(r=0.740,P<0.001)and the PAIS-SR score(r=0.731,P<0.001),while the UCLA score was positively correlated with the PAIS-SR score(r=0.761,P<0.001).The main effect of UCLA score was significant on FSS score(effect size of 0.348),and the mediating effect of PAIS-SR score between UCLA score and FSS score was significant(effect size of 0.154).Conclusion Psychosocial adaptation plays a partial mediating role in the relationship between loneliness and fatigue for young patients with cerebral infarction.Improving psychosocial adaptation may relieve the influence of loneli-ness on fatigue.

Objective To analyze the mediating effect of psychosocial adaptation on the relationship between loneliness and fatigue in young patients with cerebral infarction.Methods A total of 186 patients(aged 18 to 45 years)with cerebral infarction in Hengshui People's Hospital from Febru-ary,2023 to May,2024 were selected.They were investigated with Fatigue Severity Scale(FSS),Univesity of California at Los Angels Loneliness Scale(UCLA)and Psychosocial Adaptation to Illness Scale-self-report ver-sion(PAIS-SR)three months after discharging.The FSS scores were compared among patients with different characteristics.The correlation between the scores of FSS,UCLA and PAIS-SR was analyzed with Pearson's co-efficient.Structural equation modeling was used to analyze the mediating effect of PAIS-SR score on the relation-ship between scores of FSS and UCLA.Results A total of 183 valid questionnaires were returned.The FSS score was(36.78±7.23),the UCLA score was(42.26±9.18),and the PAIS-SR score was(56.62±13.89).There were significant differences in FSS scores among pa-tients with different National Institutes of Health Stroke Scale scores,modified Rankin Scale scores and depres-sion status(F>3.557,P<0.001).The FSS score was positively correlated with the UCLA score(r=0.740,P<0.001)and the PAIS-SR score(r=0.731,P<0.001),while the UCLA score was positively correlated with the PAIS-SR score(r=0.761,P<0.001).The main effect of UCLA score was significant on FSS score(effect size of 0.348),and the mediating effect of PAIS-SR score between UCLA score and FSS score was significant(effect size of 0.154).Conclusion Psychosocial adaptation plays a partial mediating role in the relationship between loneliness and fatigue for young patients with cerebral infarction.Improving psychosocial adaptation may relieve the influence of loneli-ness on fatigue.

Objective:To explore any myogenic effect of extracorporeal shock wave therapy (ESWT) on shoulder joint contracture.Methods:Sixty-eight patients with shoulder contracture were enrolled and randomly divided into a conventional therapy group ( n=34) and an ESWT group ( n=34) for this clinical trial. The conventional therapy group received standard rehabilitation treatment, while the ESWT group received additional extracorporeal shock wave therapy. In addition, 24 Sprague-Dawley rats were randomly assigned to a blank control group, a model group, a natural recovery group, or an ESWT animal group, each of 6. All of the groups except the blank control group had contracture modeled using plaster cast immobilization of the left shoulder joint. After successful modeling, the natural recovery group was routinely raised for two weeks, while the ESWT animal group received two weeks of extracorporeal shock wave intervention. In both the clinical and animal experiments, ESWT was administered twice weekly (every Tuesday and Friday) for two consecutive weeks. Before and after the treatment, the patient groups were assessed using a visual analog scale (VAS) for pain, shoulder range of motion (ROM), and the root mean square (RMS) values of the surface electromyographs of the peri-shoulder muscles. Shoulder ROM was assessed in all four of the rat groups after the ESWT treatment, and histological analysis of the supraspinatus muscle was performed. Results:After the treatment, both patient groups showed significant improvements in their average VAS scores, active and passive shoulder ROM, and RMS values. On average, the ESWT group demonstrated significantly greater improvements than the conventional therapy group in active forward flexion, passive forward flexion, active abduction, passive abduction, and the RMS values of the deltoid, biceps brachii, and triceps brachii muscles. After the treatment the left shoulder abduction angle had been reduced significantly in the model group (to 96.00±2.37)°, the natural recovery group (103.00±4.05)° and the ESWT animal group (121.33±4.89)° compared to the blank control group (154.50±2.35)°. Both the natural recovery group and the ESWT animal group had significantly greater shoulder abduction angles than the model group, and the ESWT animal group also demonstrated a significantly larger abduction angle than the natural recovery group. After the treatment, significant differences between the model group and the blank control group were observed in the cross-sectional area of left supraspinatus muscle fibers and the proportion of collagen. The ESWT animal group too exhibited significantly improved muscle fiber cross-sectional area and collagen proportion compared to the natural recovery group.Conclusions:Shoulder joint contracture is accompanied by significant myopathic changes (muscle atrophy and fibrosis). ESWT effectively ameliorates these problems while enhancing muscle strength and functional recovery.

With the performance improvement of the medical electronics and the progress of social development,the utilization rate of implantable medical electronic devices in China shows an increasing trend in recent years,and will maintain a growing trend in the future as population aging is accelerating.Even though implantable medical electronic devices have extremely low failure rates,the explicit clinical accidents caused by their reliability issues deserve sufficient attention in consideration of the large quantity of patients.Compared with other countries,there is lack of domestic researches on application risk of implantable medical electronic devices due to radiation therapy and diagnosis,which is reflected in not only the clinical research,but also the researches on the underlying physical damage mechanism and macro performance of the devices.Therefore,it is crucial and urgent to explore the application risk of implantable medical electronic devices caused by radiation therapy and diagnosis,which has high clinical and scientific significance.The study conducts a literature survey on the risks of medical electronic devices in the radiation environment generated by clinical treatment,summarizes the risks encountered in the aspects of total dose effect,electromagnetic compatibility and instantaneous effect,analyzes the above behaviors from the physical mechanism and perspective,and puts forward some meaningful suggestions for medical electronic engineering and clinical treatment.

BACKGROUND:Clinical treatment for colon cancer mainly includes fluorouracil,irinotecan and oxaliplatin-based therapy.Studies have shown that membrane transport proteins such as ATP-binding cassette transport protein of G2(ABCG2)mediate the transport of these drugs.However,when patients develop resistance to these chemotherapeutic drugs,the high expression of ABCG2 leads to a significant decrease in the therapeutic effect and raises the problem of drug resistance in colon cancer.New drugs and treatments are urgently needed to improve the efficacy.Lycium barbarum polysaccharide has a wide range of biological activities.It can be used as anti-tumor drug to overcome the damage to normal cells in the process of chemotherapy and radiotherapy in tumor patients. OBJECTIVE:To explore the reversal effect of Lycium barbarum polysaccharide in combination with oxaliplatin on colon cancer drug-resistant cells through in vitro experiments to investigate the possible molecular mechanism of Lycium barbarum polysaccharide reversal on colon cancer drug-resistant cells. METHODS:Colon cancer cell line HCT116 and oxaliplatin-resistant cell line HCT116-OXR were selected for in vitro experiments.The optimal intervention concentration and intervention time of Lycium barbarum polysaccharide and oxaliplatin were determined by CCK8 assay of cell proliferation.Samples were further divided into the HCT116 control group,HCT116-OXR blank treatment group,Lycium barbarum polysaccharide group(2.5 mg/mL Lycium barbarum polysaccharide),and oxaliplatin group(10 μmol/L oxaliplatin),and Lycium barbarum polysaccharide + oxaliplatin group(2.5 mg/mL Lycium barbarum polysaccharide +10 μmol/L oxaliplatin).Cell apoptosis was detected by flow cytometry.The protein expression levels of phosphomannose isomerase(PMI)and ABCG2 were detected by immunofluorescence and western blot assay.Phosphatidylinositol3-kinase(PI3K),protein kinase B(AKT),B-cell lymphoma 2(Bcl-2)and BCL2-Associated X(Bax)were detected by western blot assay. RESULTS AND CONCLUSION:(1)HCT116-OXR was more sensitive to Lycium barbarum polysaccharide compared to HCT116(P<0.05).(2)Compared with the HCT116-OXR blank group,Lycium barbarum polysaccharide + oxaliplatin could promote apoptosis of HCT116-OXR cells(P<0.05).The protein expression of Bcl-2 was significantly down-regulated(P<0.05);the protein expression of Bax was significantly up-regulated(P<0.05);the protein expression of ABCG2,PMI,PI3K and AKT was significantly down-regulated(P<0.05).(3)These results indicate that Lycium barbarum polysaccharide reverses drug resistance in colon cancer by inhibiting PMI/PI3K/AKT signaling pathway,which lays the foundation for studying the molecular mechanism of Lycium barbarum polysaccharide's sensitizing chemotherapeutic effects.

Objective To observe the influence of different energy windows of the medium-energy general-purpose(MEGP)collimator on image quality,so as to optimize the energy window of yttrium-90(90Y)bremsstrahlung SPECT imaging.Methods 90Y bremsstrahlung spectrum was acquired,and the sensitivity,percentage of the source counts in useful field of view(S/FOV%)and signal-to-background ratio(S/B)of 90Y bremsstrahlung SPECT imaging at MEGP under different energy windows were compared.Results The energy spectrum of 90Y bremsstrahlung was a continuous curve,with the peak of 76.2 keV with MEGP collimator.The images obtained with MEGP collimator were clear,and no significant differences of S/FOV%nor S/B was found between 10%and 20%window width groups(both P＞0.05),but the sensitivities of the latter was higher than the former(P＜0.05).The sensitivity of 70-90 keV images was relatively high,while the S/FOV%and S/B had decreased.The S/FOV%and S/B of images ranging from 40-60 keV were high,but the sensitivity was low.Images acquired with 100 keV±20%showed fairly high sensitivity,S/FOV%and S/B,which was 69.73%,0.62 and 1.64,respectively.Conclusion When performing 90Y bremsstrahlung SPECT with MEGP collimator,the image quality at 20%window width was better than at 10%window width,and 100 keV±20%showed fairly high sensitivity and not significantly decreased S/FOV%and S/B.

The development and change patterns as well as the disease course management of multiple ground-glass nodules(GGNs)in the lungs are currently hotspots and difficulties in clinical lung cancer research.Understanding the latest advancements in the natural history of multiple GGNs is crucial for grasping the disease variation patterns and formulat-ing management strategies.Meanwhile,utilizing advanced methods such as intelligent follow-up management platforms makes the long-term standardized management of GGNs possible.Therefore,this article provides an overview of the latest research advancements on the natural history of multiple GGNs and new experience in GGNs management.

With the performance improvement of the medical electronics and the progress of social development,the utilization rate of implantable medical electronic devices in China shows an increasing trend in recent years,and will maintain a growing trend in the future as population aging is accelerating.Even though implantable medical electronic devices have extremely low failure rates,the explicit clinical accidents caused by their reliability issues deserve sufficient attention in consideration of the large quantity of patients.Compared with other countries,there is lack of domestic researches on application risk of implantable medical electronic devices due to radiation therapy and diagnosis,which is reflected in not only the clinical research,but also the researches on the underlying physical damage mechanism and macro performance of the devices.Therefore,it is crucial and urgent to explore the application risk of implantable medical electronic devices caused by radiation therapy and diagnosis,which has high clinical and scientific significance.The study conducts a literature survey on the risks of medical electronic devices in the radiation environment generated by clinical treatment,summarizes the risks encountered in the aspects of total dose effect,electromagnetic compatibility and instantaneous effect,analyzes the above behaviors from the physical mechanism and perspective,and puts forward some meaningful suggestions for medical electronic engineering and clinical treatment.

Objective To investigate the changes of anti-cyclic citrullinated peptide antibody ,rheumatoid factor (RF) ,erythrocyte sedimentation rate(ESR) and C reactive protein(CRP) levels in the patients with early rheumatoid arthritis (RA) and their applica-tion value in the diagnosis and treatment.Methods A total of 210 cases of early RA in sixth affiliated hospital of Guangzhou Medi-cal University from December 2015 to June 2016 were selected as the RA group ,including 28 males and 182 females ,at the same time 115 cases of other rheumatism were selected as the non-RA group ,male ,including 38 males and 77 females.85 persons under-going the healthy physical examination were taken as the health group ,including 46 males and 39 females.The latex enhanced im-mune turbidimetry was adopted to quantitatively detect anti-cyclic citrullinated peptide antibody.The RF and CRP levels were quan-titatively detected by using the immune turbidimetry.The Westergren method was used to test the ESR ,their content changes in RA ,non-RA arthritis and other autoimmune diseases were detected.Results The sensitivity ,specificity ,positive predictive value , negative predictive value and Youden index of anti-cyclic citrullinated peptide antibody in the RA group were 60.95% ,97.64% , 98.46% ,50.30% and 0.59 respectively ,which of RF test were 52.38% ,95.29% ,96.49% ,44.75% and 0.48 respectively ,which of CRP test were 30.48% ,89.41% ,87.67% ,87.67% ,34.23% and 0.20 respectively ,which of ESR test were 49.52% ,87.06% , 90.43% ,41.11% and 0.37 respectively.Anti-cyclic citrullinated peptide antibody detection in the RA group was obviously higher than that of the RF test ,their test results were obviously higher than those of the non-RA group and healthy group ,the differences were statistically significant (P<0.05).CRP and ESR detection had no statistical difference between the RA group and non-RA group (P>0.05).Conclusion Anti-cyclic citrullinated peptide antibody level is higher in the patients with RA ,which is signifi-cantly superior to the RF test ,and anti-cyclic citrullinated peptide antibody detection has higher value for early diagnosis of RA.