Objective To discuss the value of the apparent diffusion coefficient(ADC)in the prediction of therapeutic effect of neoadjuvant concurrent chemoradiotherapy(nCRT)in rectal cancer.Methods The clinical data of 52 patients with pathologi-cally diagnosed rectal cancer who underwent neoadjuvant chemoradiotherapy(nCRT)and received pelvic MR1 examinations before and 8 weeks after nCRT at the 900th Hospital of Joint Logistics Support Force from January 2019 to February 2023 were analyzed retrospectively.The ADC values before and after nCRT were obtained,and ΔADC and ΔADC％were calculated.The 52 patients were divided into a sensitive group(n=40)and a non-sensitive group(n=12)based on the tumor regression grade(TRG).The ADC values before nCRT,ΔADC and ΔADC％of the above two groups were compared by Mann-Whitney U test.The ADC values after nCRT of the two groups were compared by independent samples t-test.Spearman's rank correlation coefficient was used to evaluate the correlation of ΔADC and ΔADC％with TRG.The baseline data of the two groups were compared by independent samples t-test,Mann-Whitney U test and chi-square test.Binary Logistic regression was used to analyze the factors predicting efficacy.ROC was drawn to assess the ability of ΔADC in predicting nCRT efficacy,and determine optimal cut-off value.Results There was no statistical difference between the sensitive group and the non-sensitive group with regard to ADCs before and after nCRT(P＞0.05).There were statistical differences between the above two groups with regard to ΔADC and ΔADC％(P＜0.05).ΔADC and ΔADC％showed negative correlation with TRG(r=-0.378,-0.368,P＜0.05).Univariate analysis showed that there were statistically significant differences in tumor diameter between the two groups(P＜0.05).Multivariate analysis showed that ΔADC was an independent predictor of the efficacy.ROC curve analysis showed the optimal cut-off value of ΔADC was 236.600×10-6 mm2/s.Conclusion The ADC values before and after nCRT have limited predictive significance for assessing the efficacy of nCRT,whereas ΔADC can predict nCRT efficacy effectively and provide references for subsequent clinical treatment.[Chinese Medical Equipment Journal,2024,45(12):61-66]

Objective To evaluate the efficacy and safety of brexpiprazole in treating acute schizophrenia.Methods Patients with schizophrenia were randomly divided into treatment group and control group.The treatment group was given brexpiprozole 2-4 mg·d-1 orally and the control group was given aripiprazole 10-20 mg·d-1orally,both were treated for 6 weeks.Clinical efficacy of the two groups,the response rate at endpoint,the changes from baseline to endpoint of Positive and Negative Syndrome Scale(PANSS),Clinical Global Impression-Improvement(CGI-S),Personal and Social Performance scale(PSP),PANSS Positive syndrome subscale,PANSS negative syndrome subscale were compared.The incidence of treatment-related adverse events in two groups were compared.Results There were 184 patients in treatment group and 186 patients in control group.After treatment,the response rates of treatment group and control group were 79.50％(140 cases/184 cases)and 82.40％(150 cases/186 cases),the scores of CGI-I of treatment group and control group were(2.00±1.20)and(1.90±1.01),with no significant difference(all P＞0.05).From baseline to Week 6,the mean change of PANSS total score wese(-30.70±16.96)points in treatment group and(-32.20±17.00)points in control group,with no significant difference(P＞0.05).The changes of CGI-S scores in treatment group and control group were(-2.00±1.27)and(-1.90±1.22)points,PSP scores were(18.80±14.77)and(19.20±14.55)points,PANSS positive syndrome scores were(-10.30±5.93)and(-10.80±5.81)points,PANSS negative syndrome scores were(-6.80±5.98)and(-7.30±5.15)points,with no significant difference(P＞0.05).There was no significant difference in the incidence of treatment-related adverse events between the two group(69.00％vs.64.50％,P＞0.05).Conclusion The non-inferiority of Brexpiprazole to aripiprazole was established,with comparable efficacy and acceptability.

Differentiated thyroid cancer demonstrates a wide range of clinical presentations, from very indolent cases to those with an aggressive prognosis. Therefore, diagnosing and treating each cancer appropriately based on its risk status is important. The Korean Thyroid Association (KTA) has provided and amended the clinical guidelines for thyroid cancer management since 2007. The main changes in this revised 2024 guideline include 1) individualization of surgical extent according to pathological tests and clinical findings, 2) application of active surveillance in low-risk papillary thyroid microcarcinoma, 3) indications for minimally invasive surgery, 4) adoption of World Health Organization pathological diagnostic criteria and definition of terminology in Korean, 5) update on literature evidence of recurrence risk for initial risk stratification, 6) addition of the role of molecular testing, 7) addition of definition of initial risk stratification and targeting thyroid stimulating hormone (TSH) concentrations according to ongoing risk stratification (ORS), 8) addition of treatment of perioperative hypoparathyroidism, 9) update on systemic chemotherapy, and 10) addition of treatment for pediatric patients with thyroid cancer.

Objective To discuss the value of the apparent diffusion coefficient(ADC)in the prediction of therapeutic effect of neoadjuvant concurrent chemoradiotherapy(nCRT)in rectal cancer.Methods The clinical data of 52 patients with pathologi-cally diagnosed rectal cancer who underwent neoadjuvant chemoradiotherapy(nCRT)and received pelvic MR1 examinations before and 8 weeks after nCRT at the 900th Hospital of Joint Logistics Support Force from January 2019 to February 2023 were analyzed retrospectively.The ADC values before and after nCRT were obtained,and ΔADC and ΔADC％were calculated.The 52 patients were divided into a sensitive group(n=40)and a non-sensitive group(n=12)based on the tumor regression grade(TRG).The ADC values before nCRT,ΔADC and ΔADC％of the above two groups were compared by Mann-Whitney U test.The ADC values after nCRT of the two groups were compared by independent samples t-test.Spearman's rank correlation coefficient was used to evaluate the correlation of ΔADC and ΔADC％with TRG.The baseline data of the two groups were compared by independent samples t-test,Mann-Whitney U test and chi-square test.Binary Logistic regression was used to analyze the factors predicting efficacy.ROC was drawn to assess the ability of ΔADC in predicting nCRT efficacy,and determine optimal cut-off value.Results There was no statistical difference between the sensitive group and the non-sensitive group with regard to ADCs before and after nCRT(P＞0.05).There were statistical differences between the above two groups with regard to ΔADC and ΔADC％(P＜0.05).ΔADC and ΔADC％showed negative correlation with TRG(r=-0.378,-0.368,P＜0.05).Univariate analysis showed that there were statistically significant differences in tumor diameter between the two groups(P＜0.05).Multivariate analysis showed that ΔADC was an independent predictor of the efficacy.ROC curve analysis showed the optimal cut-off value of ΔADC was 236.600×10-6 mm2/s.Conclusion The ADC values before and after nCRT have limited predictive significance for assessing the efficacy of nCRT,whereas ΔADC can predict nCRT efficacy effectively and provide references for subsequent clinical treatment.[Chinese Medical Equipment Journal,2024,45(12):61-66]

Purpose: The aim of this study was to evaluate the effects of auricular acupressure on sleep quality and pruritus in patients undergoing hemodialysis and to propose an effective and evidence-based nursing intervention. Methods: This was a single-blind, nonequivalent, group comparison study with 42 participants. The experimental period was a total of 8 weeks, and five different acupressure sites were applied in each group. Dependent variables were measured before the intervention, at the 4th week of the intervention, and at the 8th week of the intervention. Results: There were significant differences in the Pittsburgh sleep quality index, total sleep time, sleep efficiency, sleep onset latency, light sleep, deep sleep, number of awakenings, serum melatonin levels, subjective pruritus and skin hydration. No significant difference was found in skin pH between the two groups. Conclusion Auricular acupressure was found to be an effective nursing intervention to improve sleep quality and to reduce pruritus in patients undergoing hemodialysis.

Diabetes mellitus complicated with cerebral infarction is the commonest and most serious vascular complication of diabetes mellitus. With a high disability and mortality rate, it seriously threatens human health. Because the pathogenesis is still unclear, more and more scholars have focused on the research of diabetic cerebral infarction at home and abroad. Traditional Chinese medicine(TCM) compounds have a remarkable curative effect in the treatment of diabetic cerebral infarction. Its mechanisms of action mainly include anti-hypertension, reduction of blood sugar and lipid, promotion of vascular regeneration and vascular endothelial function, anticoagulation, anti-thrombosis, improvement of nerve function defect, reduction of infarct volume, improvement of hemorheological, inhibition of inflammation and platelet aggregation, and promotion of collateral circulation. Through literature search, this paper summarizes the research progress of the mechanisms of TCM compounds in treating diabetic cerebral infarction in recent five years at home and abroad, in order to provide reference for clinical treatment.

Dental implants represent the majority of treatment strategies used to replace missing teeth. However, peri-implant diseases caused by disturbance in peri-implant microbiological balance are among the reasons for implant failure. Since the 1980s, peri-implant microorganisms have been a hot research topic in dental microbiology. The bacterial ecology between the disease and health largely differs, which directly or indirectly increases the risk of peri-implant diseases. Accordingly, the determination of the 'core microbiome' of peri-implantitis and peri-implant mucositis is a key point of recent research.
Bacteria ; Dental Implants ; Humans ; Microbiota ; Peri-Implantitis ; Stomatitis

Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.
Coated Materials, Biocompatible ; Dental Implants ; Esthetics, Dental ; Osseointegration ; Surface Properties ; Titanium

Objective To explore the effect of low-intensity pulsed ultrasound (LIPUS) on long bone fracture healing and to examine caveolin-1 gene expression in the radius defects of rabbits.Methods A total of 24 New Zealand rabbits with 3-mm bone defects at lower 1/3 in both radii were randomly assigned to 4 groups (n=6).Daily LIPUS treatment was performed to the right fracture sites at a intensity of 30 mW/cm2 for 20 minutes,while the left sites received sham treatment with power off.To assess the effects of LIPUS on bone defects,X-ray imaging and hematoxylin-eosin staining were applied 7,14,21,28 days after the surgery.Additionally,the immunohistochemical staining was used to determine the subcllular localization of caveolin-1 and semi-quantify the caveolin-1 level,qPCR was performed to detect the mRNA level of caveolin-1,gene Col2a1 and Col10a1,and osteocalcin.Results On day 14,the radiological score of the right radii and mineralized callus area were significantly higher than that of the left ones,both of them were elevated with time flied.Histological examination suggested that the differentiation and apoptosis of chondrocytes along with the formation and bridging of the bone trabeculas appeared earlier in the right radius defects.The immunohistochemical staining showed that on day 7 and 14,the level of caveolin-1 increased with the proliferation and differentiation of condrocytes,and was significantly higher in callus tissues on the right sites.On day 21 and 28,the mesenchymal stem cells migrated to the surface of cartilage matrix started to differentiate into osteoblasts,the level of caveolin-1 decreased,and was significantly lower on the right sites.The result of qPCR indicated that compared with the left sites the caveolin-1 gene expression on the right sites was significantly higher on day 7,while significantly lower on day 21.The mRNA expression levels of Col2a1,Col10a1 and osteocalcin on the right sites were significantly higher on day 7 and 14,but they were significantly lower on day 21 and 28,except for Col10a1 on day 28.Conclusions Advancing endochondral ossification is considered to be a crucial mechanism during long bone fracture healing promoted by LIPUS.The caveolin-1 gene expression first increased in the chondrocytes then decreased in the mesenchymal stem cells during the process.

Brugada syndrome is an arrhythmic syndrome characterized by right bundle branch block, ST segment elevation in the precordial lead (V1-V3), and sudden death caused by ventricular fibrillation, which is not effectively prevented by anti-arrhythmic drug therapy. We are reporting a 30-year-old male patient with Brugada syndrome who got an exploratory laparotomy and a tenorrhaphy due to stab wound which was managed with general anesthesia and brachial plexus block without any complications.
Adult ; Anesthesia, General ; Brachial Plexus Block* ; Brachial Plexus* ; Brugada Syndrome* ; Bundle-Branch Block ; Death, Sudden ; Drug Therapy ; Humans ; Laparotomy ; Male ; Ventricular Fibrillation ; Wounds, Stab