Ischemic stroke(IS) is a complex pathological process involving multiple cellular and molecular mechanisms and it is characterized by high mortality, high disability, and high recurrence. In recent years, the incidence of IS in China has been increasing year by year, and it has a trend of occurring in increasingly young individuals. Herb pairs are the smallest unit of traditional Chinese medicine(TCM) compatibility and an important part of TCM compounding, and the research on them is of great significance in guiding the clinical medication. Pharmacological studies have confirmed that certain herb pairs can exert anti-ischemic effects through various pathways such as reducing inflammation, alleviating oxidative stress, protecting the nervous system, and promoting neovascularization. By reviewing the relevant articles in the past decade, this paper probes into the combination rules, modern experimental studies, and combination ratios of the commonly used herb pairs from the etiology and pathogenesis of IS and summarizes 18 commonly used and deeply studied herb pairs, with a view to providing reference for the application, research, and development of clinical medicines.
Humans ; Drugs, Chinese Herbal/chemistry* ; Animals ; Ischemic Stroke/metabolism* ; Medicine, Chinese Traditional

OBJECTIVE: To explore the current research status and hotspots in the field of biomechanics of diabetic foot by bibliometric analysis methods. METHODS: Literatures related to biomechanics of diabetic foot published in the Web of Scienc Core Collection (WoSCC) from 1981 to 2024 were searched. CiteSpace software and R language bibliometrics plugin were used to conduct a visual analysis of annual publication volume of the literature, including publication volume of each country and region, the publication situation of authors and institutions, the citation situation of individual literature, and the co-occurrence network of keywords. RESULTS: Totally 996 literatures were included, and the number of published papers increased steadily. The United States (261 papers) and China (89 papers) were the top two countries in terms of the number of published papers. The mediating centrality of the United States was 0.94, and that of China was 0.01. Scholars such as Cavanagh and institutions like the Cleveland Clinic were at the core of research in this field. High-frequency keywords include plantar pressure (plantar pressure), diabetic foot (diabetic foot), ulceration (ulcer), etc. The research focuses on plantar pressure, ulcer formation and prevention, etc. CONCLUSION Biomechanical research on diabetic foot mainly focuses on the pressure distribution on the sole of the foot, callus formation, mechanical analysis of soft tissues on the sole of the foot, and the study of plantar decompression caused by Achilles tendon elongation. The research trend has gradually shifted from focusing on joint range of motion to gait and the design of braces and assistive devices, and has begun to pay attention to muscle strength, gait imbalance and proprioception abnormalities.
Humans ; Diabetic Foot/physiopathology* ; Biomechanical Phenomena ; Bibliometrics

Abdominal war trauma is a common and high-risk type of injury in the modern battlefield,with rapid changes in condition and a high mortality rate.There is an urgent need for emerging medical technologies to improve the efficiency and success rate of first aid for military casualties.With the development of artificial intelligence(AI),5G,and other emerging technologies,the concept of intelligent medical treatment is gradually forming and can assist in the diagnosis and treatment of abdominal trauma.This paper reviews the characteristics of abdominal war trauma in modern wars,discusses the application of intelligent medical treatment for abdominal war trauma and its drawbacks to be solved,aiming to provide reference for research related to abdominal war trauma.

Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Objective:To compare the efficacy of O-arm navigation versus C-arm guidance for anterior internal fixation in the management of Anderson-D′Alonzo type II odontoid fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 58 patients with Anderson-D′Alonzo type II odontoid fractures admitted to Zhengzhou Orthopedic Hospital between January 2017 and September 2024, including 35 males and 23 females, aged 18-57 years [(39.3±9.0)years]. Anderson-D′Alonzo type II fractures were further classified as type IIA in 25 patients and type IIB in 33. Twenty-seven patients underwent O-arm assisted anterior internal fixation (O-arm navigation group), while 31 received C-arm guided anterior internal fixation (C-arm guidance group). The two groups were compared in terms of the operative duration, intraoperative blood loss, success rate for one-time guidewire placement, and intraoperative radiation exposure (anteroposterior and lateral views). At 3 days postoperatively, screw placement accuracy was evaluated via CT in both groups. Additionally, neck disability index (NDI) and visual analogue scale (VAS) scores were assessed preoperatively, at 1 week, 3 months postoperatively, and at the last follow-up. Bone union time and complication rate were also analyzed.Results:All the patients were followed up for 6-20 months [(13.1±3.4)months]. The O-arm navigation group exhibited significantly shorter operative duration [(91.1± 8.9)minutes] and less intraoperative blood loss [(38.9±8.2)ml], compared with (103.3±14.5)minutes and (47.3±9.1)ml in the C-arm guidance group ( P<0.01). The success rate for one-time guidewire placement was 100% (27/27) in the O-arm navigation group, significantly higher than 52% (16/31) in the C-arm guidance group ( P<0.01). Intraoperative radiation exposure for patients in the O-arm navigation group was lower in both anteroposterior view [(11 612.6±1 603.6)μSv] and lateral views [(29 738.2±6 602.5)μSv], compared with (40 638.0±9 431.9)μSv and (47 152.0±11 759.3)μSv in the C-arm guidance group ( P<0.01). CT scans at 3 days postoperatively revealed a 100% (27/27) screw placement accuracy in the O-arm navigation group, compared with 65% (20/31) in the C-arm guidance group ( P<0.01). Before operation, at 1 weeks and 3 months postoperatively, and at the last follow-up, NDI scores were (48.4±7.8)%, (21.0±3.1)%, (14.4±2.4)%, and (13.9±2.3)% in the O-arm navigation group, while they were (47.4±7.6)%, (20.9±3.2)%, (14.1±2.0)%, and (13.8±1.4)% in the C-arm guidance group ( P>0.05); VAS scores were 6.0(6.0, 7.0)points, 4.0(3.0, 4.0)points, 2.0(1.0, 2.0)points, and 2.0(1.0, 2.0)points in the O-arm navigation group, while they were 7.0(6.0, 7.0)points, 4.0(3.0, 5.0)points, 2.0(1.0, 3.0)points, and 2.0(2.0, 2.0)points in the C-arm guidance group ( P>0.05). The NDI and VAS scores in both groups were significantly improved at 1 weeks and 3 months postoperatively, and at the last follow-up compared to those preoperatively ( P<0.05), and were furtherly improved at 3 months postoperatively and at the last follow-up compared to those at 1 weeks postoperatively ( P<0.05), with no significant differences between those at 3 months postoperatively and at the last follow-up ( P>0.05). No significant difference was found in bone union time between the two groups ( P>0.05). The complication rate in the O-arm navigation group was 4% (1/27), lower than 29% (9/31) in the C-arm guidance group ( P<0.05). Conclusions:Compared with C-arm guidance, O-arm assisted anterior internal fixation for Anderson-D′Alonzo type II odontoid fractures can reduce operative duration and intraoperative blood loss, improve the success rate for one-time guidewire placement and screw accuracy, and decrease radiation exposure and complication rate.

Objective:To investigate the feasibility and clinical efficacy of percutaneous vertebroplasty (PVP) with measured saturated bone cement injection in the treatment of elderly patients with stage Ⅱ Kümmell's disease.Methods:A retrospective analysis was conducted to analyze the clinical data of the 41 elderly patients with stage Ⅱ Kümmell's disease who had been treated at Department of Spinal Orthopedics, Zhengzhou Orthopedic Hospital from June 2017 to June 2023 by PVP with bone cement injection into the intravertebral vacuum cleft. According to the amount of bone cement injected, the patients were divided into a saturated volume group (bone cement injection metered ≥ 150% of the cleft volume preoperatively measured) in which there were 21 cases, 4 males and 17 females, aged (78.4±5.2) years and a conventional volume group (bone cement injection metered was 100% to 120% of the cleft volume preoperatively measured) in which there were 20 cases, 6 males and 14 females, aged (79.5±7.4) years. The operative time, vacuum cleft volume measured, actual volume of bone cement injected, and percentage of bone cement injected were compared between the 2 groups. Visual analogue scale (VAS) for pain and Oswestry disability index (ODI) were compared between preoperation, postoperative 3 days, and the final follow-up in the 2 groups, as well as between the 2 groups. Cement leakage and other complications were documented.Results:The differences in the preoperative general data were not statistically significant between the 2 groups, indicating comparability ( P>0.05). All the 41 elderly patients successfully completed their surgery. Follow-up time was (18.1±3.3) months. The operative time [(39.7±7.5) min], actual volume of bone cement injected [(5.6±0.9) mL], and percentage of bone cement injected (1.8%±0.3%) in the saturated volume group were all significantly greater than those in the conventional volume group [(35.5±4.9) min, (4.4±1.0) mL, and 1.2%±0.1%] ( P<0.05). Postoperatively, the incisions healed completely in all patients, with no such complications as cement-related adverse reactions. Cement leakage occurred in 2 patients in the conventional volume group, leading to lumbar pain or discomfort after activity, which was relieved by cement reinforcement and nail-rod internal fixation. VAS pain scores and ODIs at 3 d postoperatively and at the final follow-up were significantly improved in all patients compared with preoperation ( P<0.05). At the final follow-up, both VAS pain score and ODI in the saturated volume group improved significantly greater than those in the conventional volume group ( P<0.05). None of the patients had complications like cement displacement at the final follow-up. Conclusion:PVP with measured saturated bone cement injection into the intravertebral vacuum clefts is a safe and effective treatment for stage Ⅱ Kümmell's disease in elderly patients, offering a new minimally invasive option.

The xylitol dehydrogenase(XDH)is a crucial enzyme involved in the xylose utilization in pentose-catabolizing yeasts and fungi.In addition to producing xylulose,XDH can also be employed to develop a biosensor for monitoring xylitol concentration.In this study,the gene encoding the thermophilic fungus Talaromyces emersonii XDH(TeXDH)was heterologously expressed in Escherichia coli BL21(DE3)at 16 ℃ in the soluble form.Recombinant TeXDH with high purity was purified by using a Ni-NTA affinity column.Size-exclusion chromatography and SDS-PAGE analysis demonstrated that the puri-fied recombinant TeXDH exists as a native trimer with a molecular mass of approximately 116 kD,and is composed of three identical subunits,each with a molecular weight of around 39 kD.The TeXDH strictly preferred NAD+as a coenzyme to NADP+.The optimal temperature and pH of the TeXDH were 40 ℃and 10.0,respectively.After EDTA treatment,the enzyme activity of TeXDH decreased to 43.26％of the initial enzyme activity,while the divalent metal ions Mg2+or Ca2+could recover the enzyme activity of TeXDH,reaching 103.32％and 110.69％of the initial enzyme activity,respectively,making them the optimal divalent metal ion cofactors for TeXDH enzyme.However,the divalent metal ions of Mn2+,Ni2+,Cu2+,Zn2+,Co2+,and Cd2+significantly inhibited the activity of TeXDH.ICP-MS and molecular doc-king studies revealed that 1 mol/L of TeXDH bound 2 mol/L Zn2+ions and 1 mol/L Mg2+ion.Further-more,TeXDH exhibited a high specificity for xylitol,laying the foundation for the development of future xylitol biosensors.

The xylitol dehydrogenase(XDH)is a crucial enzyme involved in the xylose utilization in pentose-catabolizing yeasts and fungi.In addition to producing xylulose,XDH can also be employed to develop a biosensor for monitoring xylitol concentration.In this study,the gene encoding the thermophilic fungus Talaromyces emersonii XDH(TeXDH)was heterologously expressed in Escherichia coli BL21(DE3)at 16 ℃ in the soluble form.Recombinant TeXDH with high purity was purified by using a Ni-NTA affinity column.Size-exclusion chromatography and SDS-PAGE analysis demonstrated that the puri-fied recombinant TeXDH exists as a native trimer with a molecular mass of approximately 116 kD,and is composed of three identical subunits,each with a molecular weight of around 39 kD.The TeXDH strictly preferred NAD+as a coenzyme to NADP+.The optimal temperature and pH of the TeXDH were 40 ℃and 10.0,respectively.After EDTA treatment,the enzyme activity of TeXDH decreased to 43.26％of the initial enzyme activity,while the divalent metal ions Mg2+or Ca2+could recover the enzyme activity of TeXDH,reaching 103.32％and 110.69％of the initial enzyme activity,respectively,making them the optimal divalent metal ion cofactors for TeXDH enzyme.However,the divalent metal ions of Mn2+,Ni2+,Cu2+,Zn2+,Co2+,and Cd2+significantly inhibited the activity of TeXDH.ICP-MS and molecular doc-king studies revealed that 1 mol/L of TeXDH bound 2 mol/L Zn2+ions and 1 mol/L Mg2+ion.Further-more,TeXDH exhibited a high specificity for xylitol,laying the foundation for the development of future xylitol biosensors.

Medication reconciliation plays a key role in improving patient medication safety,reducing inappropriate polypharmacy,and promoting the high-quality development of pharmaceutical services.Compared to advanced international guidelines,China's medication reconciliation service standards have deficiencies in areas such as definition and process design,and multidisciplinary team building.There is a need to establish a comprehensive medication reconciliation effect evaluation index system,develop pharmacist-led multidisciplinary teams,promote the advancement of artificial intelligence and big data technologies,and strengthen outpatient and community medication reconciliation coverage,thereby contributing to the high-quality development of pharmaceutical services in China.

Objective:To compare the efficacy of O-arm navigation versus C-arm guidance for anterior internal fixation in the management of Anderson-D′Alonzo type II odontoid fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 58 patients with Anderson-D′Alonzo type II odontoid fractures admitted to Zhengzhou Orthopedic Hospital between January 2017 and September 2024, including 35 males and 23 females, aged 18-57 years [(39.3±9.0)years]. Anderson-D′Alonzo type II fractures were further classified as type IIA in 25 patients and type IIB in 33. Twenty-seven patients underwent O-arm assisted anterior internal fixation (O-arm navigation group), while 31 received C-arm guided anterior internal fixation (C-arm guidance group). The two groups were compared in terms of the operative duration, intraoperative blood loss, success rate for one-time guidewire placement, and intraoperative radiation exposure (anteroposterior and lateral views). At 3 days postoperatively, screw placement accuracy was evaluated via CT in both groups. Additionally, neck disability index (NDI) and visual analogue scale (VAS) scores were assessed preoperatively, at 1 week, 3 months postoperatively, and at the last follow-up. Bone union time and complication rate were also analyzed.Results:All the patients were followed up for 6-20 months [(13.1±3.4)months]. The O-arm navigation group exhibited significantly shorter operative duration [(91.1± 8.9)minutes] and less intraoperative blood loss [(38.9±8.2)ml], compared with (103.3±14.5)minutes and (47.3±9.1)ml in the C-arm guidance group ( P<0.01). The success rate for one-time guidewire placement was 100% (27/27) in the O-arm navigation group, significantly higher than 52% (16/31) in the C-arm guidance group ( P<0.01). Intraoperative radiation exposure for patients in the O-arm navigation group was lower in both anteroposterior view [(11 612.6±1 603.6)μSv] and lateral views [(29 738.2±6 602.5)μSv], compared with (40 638.0±9 431.9)μSv and (47 152.0±11 759.3)μSv in the C-arm guidance group ( P<0.01). CT scans at 3 days postoperatively revealed a 100% (27/27) screw placement accuracy in the O-arm navigation group, compared with 65% (20/31) in the C-arm guidance group ( P<0.01). Before operation, at 1 weeks and 3 months postoperatively, and at the last follow-up, NDI scores were (48.4±7.8)%, (21.0±3.1)%, (14.4±2.4)%, and (13.9±2.3)% in the O-arm navigation group, while they were (47.4±7.6)%, (20.9±3.2)%, (14.1±2.0)%, and (13.8±1.4)% in the C-arm guidance group ( P>0.05); VAS scores were 6.0(6.0, 7.0)points, 4.0(3.0, 4.0)points, 2.0(1.0, 2.0)points, and 2.0(1.0, 2.0)points in the O-arm navigation group, while they were 7.0(6.0, 7.0)points, 4.0(3.0, 5.0)points, 2.0(1.0, 3.0)points, and 2.0(2.0, 2.0)points in the C-arm guidance group ( P>0.05). The NDI and VAS scores in both groups were significantly improved at 1 weeks and 3 months postoperatively, and at the last follow-up compared to those preoperatively ( P<0.05), and were furtherly improved at 3 months postoperatively and at the last follow-up compared to those at 1 weeks postoperatively ( P<0.05), with no significant differences between those at 3 months postoperatively and at the last follow-up ( P>0.05). No significant difference was found in bone union time between the two groups ( P>0.05). The complication rate in the O-arm navigation group was 4% (1/27), lower than 29% (9/31) in the C-arm guidance group ( P<0.05). Conclusions:Compared with C-arm guidance, O-arm assisted anterior internal fixation for Anderson-D′Alonzo type II odontoid fractures can reduce operative duration and intraoperative blood loss, improve the success rate for one-time guidewire placement and screw accuracy, and decrease radiation exposure and complication rate.