OBJECTIVE: To observe the clinical efficacy of deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture for adenoid hypertrophy (AH) in children. METHODS: Seventy-two children with AH were randomly divided into an observation group (36 cases, 5 cases dropped out, 1 case was eliminated) and a control group (36 cases, 4 cases dropped out, 2 cases were eliminated). The observation group received deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture. The needle depth of Xiaguan (ST7) was 20-30 mm. Electroacupuncture was applied at Xiaguan (ST7), Yingxiang (LI20), Yintang (GV24⁺), Baihui (GV20), with continuous wave, in frequency of 2 Hz. Warm acupuncture was applied at Zusanli (ST36). The treatment was performed 30 min each time, once a week for 12 weeks. The control group was treated with mometasone furoate aqueous nasal spray, one spray per nostril each time, once a day for 12 weeks. The symptom score, adenoid-to-nasopharynx ratio (A/N), and 18-item health-related quality-of-life survey for children with obstructive sleep apnea (OSA-18) score were observed before and after treatment in the two groups, and the clinical efficacy was evaluated after treatment. RESULTS: After treatment, the total scores of symptom, A/N, and OSA-18 scores were decreased compared with those before treatment in both groups (P<0.01), the above indexes in the observation group were lower than those in the control group (P<0.01, P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was higher than 83.3% (25/30) in the control group (P<0.05). CONCLUSION Deep needling at Xiaguan (ST7) combined with electroacupuncture and warm acupuncture could effectively improve symptoms, reduce adenoid volume, and improve the quality of life in children with AH.
Humans ; Male ; Female ; Acupuncture Points ; Electroacupuncture ; Acupuncture Therapy ; Child ; Child, Preschool ; Hypertrophy/therapy* ; Adenoids/pathology* ; Treatment Outcome ; Combined Modality Therapy

Chemotherapy-induced peripheral neuropathy(CIPN)refers to some symptoms and signs of peripheral nerve dysfunc-tion caused by using anti-tumor drugs,which is related to the dose of chemotherapy drugs.The pathogenesis of CIPN has not been fully defined,and the efficacy of existing therapeutic drugs and methods is limited.Therefore,it is of great scientific value and social significance to explore the pathogenesis of CIPN,de-velop new therapeutic drugs and methods,and solve the unmet clinical needs.This paper will elaborate on the pathogenesis of CIPN from the molecular and cellular levels,and review the treatment progress of CIPN,so as to provide reference for clinical treatment and direction for future research.

BACKGROUND:The pelvis has abundant trabecular bone content,but the ability of conventional sacroiliac percutaneous fixation to control trabecular bone is limited,leading to fixation failure.Therefore,the development of devices that can more effectively control trabecular bone tension is of significant importance.OBJECTIVE:The mechanical properties of a novel sacroiliac tension screw were investigated using biomechanical testing and numerical modeling analysis,along with an assessment of the reliability of the pull-out force numerical model.METHODS:A mechanical model was established based on the working principle of the novel sacroiliac tension screw.Numerical methods were employed to analyze its pull-out performance,validated through mechanical testing with polyurethane material to assess the reliability of the pull-out force numerical model.Using pelvic specimens,the mechanical effectiveness of the novel sacroiliac tension screw in repairing sacroiliac joint injuries was analyzed under normal standing posture,along with an evaluation of the load stiffness of different pelvic models in the standing position.RESULTS AND CONCLUSION:(1)The average error between the computed values of the numerical model and the measured values was 13.19％,indicating a certain level of validity for the numerical model.(2)The damage to the polyurethane material after the extraction of the screw was less pronounced in the novel screw group.(3)The average effective holding displacement for the novel screw was approximately(9.24±0.27)mm,significantly greater than the average displacement of(1.71±0.57)mm observed with the lag screws.However,the maximum resistance to pullout for the lag screws was significantly higher than that for the novel screws.(4)The novel screw effectively repaired sacroiliac joint injuries.(5)The stiffness after repair of sacroiliac joint injuries was equivalent when using a single novel screw compared to using two lag screws.(6)These results prove that the theoretical model for the maximum resistance to pullout of the screws established in this study has a certain level of validity and can guide the design of them with improved mechanical performance.The novel sacroiliac spiral blade screw can effectively hold trabecular bone and has practical clinical utility.

Objective:To evaluate the safety and oncological outcomes of robot-assisted laparoscopic inferior vena cava(IVC)segmental resection in renal tumor with IVC tumor thrombus(IVCTT).Methods:Clinical data from renal tumor patients undergoing robot-assisted laparoscopic IVC segmental resection at Peking University Third Hospital from Jan.2021 to Feb.2025 were retrospectively analyzed.Data collection included baseline demographics,tumor characteristics,perioperative parameters,and follow-up outcomes.Surgical records and pathological reports were retrieved from the electronic medical record system.Continuous variables were presented as median(P25,P75),and categorical variables as frequency(percentage).Results:Forty-four patients were enrolled.The cohort comprised 31 malesand 13 females,with a median age of 62(55,68)years.Right-sided tumors were observed in 39 cases and left-sided in 5 cases.Median tumor diameter was 8.1(6.1,10.1)cm.Mayo classifications included grade Ⅱ(n=37),Ⅲ(n=6),and Ⅳ(n=1).Neoadjuvant therapy was administered to 23 patients.Seventeen patients were complicated by IVC bland thrombus.Median operative time was 224.0(167.3,303.8)min,with intraoperative blood loss of 500.0(300.0,850.0)mL.Transfusion was administered to 19 patients,with a median blood transfusion of 800.0(400.0,1 200.0)mL.Postoperative complica-tions occurred in 25 cases(56.8％),classified as Clavien-Dindo grade Ⅰ(n=8)and grade Ⅱ(n=17).Procedure-specific complications included deep vein thrombosis(n=6),transfusion-requiring ane-mia(n=5),lower extremity edema(n=2),and pulmonary embolism(n=2),with no procedure-related mortality.Median postoperative serum creatinine was 116.0(86.5,157.5)μmnol/L.Pathological examination identified clear cell renal cell carcinoma as the predominant subtype,observed in 34 cases(77.3％).Pathological staging revealed T3b(n=12),T3c(n=29),and T4(n=3)disease,with nodal involvement(N1)in 8 cases and distant metastasis(M1)in 17.At a median follow-up of 10 months(range:1-49 months),cancer-specific mortality occurred in 3 patients,while 1 succumbed to other causes.Disease progression included pulmonary metastasis(n=5),hepatic metastasis(n=4),and local recurrence(n=4).Adjuvant therapy regimens comprised targeted-immunotherapy combina-tions(n=9)and targeted monotherapy(n=18).Conclusion:Robot-assisted laparoscopic I VC seg-mental resection achieves precise thrombus removal with confirmed short-term efficacy in renal tumor with IVCTT,though vigilance against vascular complications remains critical.

Objective:To evaluate the safety and oncological outcomes of robot-assisted laparoscopic inferior vena cava(IVC)segmental resection in renal tumor with IVC tumor thrombus(IVCTT).Methods:Clinical data from renal tumor patients undergoing robot-assisted laparoscopic IVC segmental resection at Peking University Third Hospital from Jan.2021 to Feb.2025 were retrospectively analyzed.Data collection included baseline demographics,tumor characteristics,perioperative parameters,and follow-up outcomes.Surgical records and pathological reports were retrieved from the electronic medical record system.Continuous variables were presented as median(P25,P75),and categorical variables as frequency(percentage).Results:Forty-four patients were enrolled.The cohort comprised 31 malesand 13 females,with a median age of 62(55,68)years.Right-sided tumors were observed in 39 cases and left-sided in 5 cases.Median tumor diameter was 8.1(6.1,10.1)cm.Mayo classifications included grade Ⅱ(n=37),Ⅲ(n=6),and Ⅳ(n=1).Neoadjuvant therapy was administered to 23 patients.Seventeen patients were complicated by IVC bland thrombus.Median operative time was 224.0(167.3,303.8)min,with intraoperative blood loss of 500.0(300.0,850.0)mL.Transfusion was administered to 19 patients,with a median blood transfusion of 800.0(400.0,1 200.0)mL.Postoperative complica-tions occurred in 25 cases(56.8％),classified as Clavien-Dindo grade Ⅰ(n=8)and grade Ⅱ(n=17).Procedure-specific complications included deep vein thrombosis(n=6),transfusion-requiring ane-mia(n=5),lower extremity edema(n=2),and pulmonary embolism(n=2),with no procedure-related mortality.Median postoperative serum creatinine was 116.0(86.5,157.5)μmnol/L.Pathological examination identified clear cell renal cell carcinoma as the predominant subtype,observed in 34 cases(77.3％).Pathological staging revealed T3b(n=12),T3c(n=29),and T4(n=3)disease,with nodal involvement(N1)in 8 cases and distant metastasis(M1)in 17.At a median follow-up of 10 months(range:1-49 months),cancer-specific mortality occurred in 3 patients,while 1 succumbed to other causes.Disease progression included pulmonary metastasis(n=5),hepatic metastasis(n=4),and local recurrence(n=4).Adjuvant therapy regimens comprised targeted-immunotherapy combina-tions(n=9)and targeted monotherapy(n=18).Conclusion:Robot-assisted laparoscopic I VC seg-mental resection achieves precise thrombus removal with confirmed short-term efficacy in renal tumor with IVCTT,though vigilance against vascular complications remains critical.

The accuracy of medical imaging diagnosis will directly impact the clinical forensic evaluation's scientific validity and objectivity.This study systematically analyzed the primary causes of misdiagnosis and missed diagnosis in imaging examinations,focusing on representative cases,including rib fractures,traumatic subarachnoid hemorrhage,joint injuries with ligament damage,nasal fractures,congenital skeletal variations,and epiphyseal injuries.Key contributing factors encompassed limitation of imaging technologies,the insufficient interpretive experience of examiners,the complexity of injury mechanisms,and inadequate post-traumatic dynamic imaging follow-up.To address these issues,improvement strategies are proposed,which were establishing standardized imaging review protocols,implementing multimodal imaging approaches,rigorous evaluation of original imaging data,and enhancing professional knowledge regarding anatomical variations and injury differentiation.These measures aim to elevate the quality of forensic imaging diagnosis,providing more precise and reliable strategies for forensic clinical identifications.

The accuracy of medical imaging diagnosis will directly impact the clinical forensic evaluation's scientific validity and objectivity.This study systematically analyzed the primary causes of misdiagnosis and missed diagnosis in imaging examinations,focusing on representative cases,including rib fractures,traumatic subarachnoid hemorrhage,joint injuries with ligament damage,nasal fractures,congenital skeletal variations,and epiphyseal injuries.Key contributing factors encompassed limitation of imaging technologies,the insufficient interpretive experience of examiners,the complexity of injury mechanisms,and inadequate post-traumatic dynamic imaging follow-up.To address these issues,improvement strategies are proposed,which were establishing standardized imaging review protocols,implementing multimodal imaging approaches,rigorous evaluation of original imaging data,and enhancing professional knowledge regarding anatomical variations and injury differentiation.These measures aim to elevate the quality of forensic imaging diagnosis,providing more precise and reliable strategies for forensic clinical identifications.

BACKGROUND:The pelvis has abundant trabecular bone content,but the ability of conventional sacroiliac percutaneous fixation to control trabecular bone is limited,leading to fixation failure.Therefore,the development of devices that can more effectively control trabecular bone tension is of significant importance.OBJECTIVE:The mechanical properties of a novel sacroiliac tension screw were investigated using biomechanical testing and numerical modeling analysis,along with an assessment of the reliability of the pull-out force numerical model.METHODS:A mechanical model was established based on the working principle of the novel sacroiliac tension screw.Numerical methods were employed to analyze its pull-out performance,validated through mechanical testing with polyurethane material to assess the reliability of the pull-out force numerical model.Using pelvic specimens,the mechanical effectiveness of the novel sacroiliac tension screw in repairing sacroiliac joint injuries was analyzed under normal standing posture,along with an evaluation of the load stiffness of different pelvic models in the standing position.RESULTS AND CONCLUSION:(1)The average error between the computed values of the numerical model and the measured values was 13.19％,indicating a certain level of validity for the numerical model.(2)The damage to the polyurethane material after the extraction of the screw was less pronounced in the novel screw group.(3)The average effective holding displacement for the novel screw was approximately(9.24±0.27)mm,significantly greater than the average displacement of(1.71±0.57)mm observed with the lag screws.However,the maximum resistance to pullout for the lag screws was significantly higher than that for the novel screws.(4)The novel screw effectively repaired sacroiliac joint injuries.(5)The stiffness after repair of sacroiliac joint injuries was equivalent when using a single novel screw compared to using two lag screws.(6)These results prove that the theoretical model for the maximum resistance to pullout of the screws established in this study has a certain level of validity and can guide the design of them with improved mechanical performance.The novel sacroiliac spiral blade screw can effectively hold trabecular bone and has practical clinical utility.

Chemotherapy-induced peripheral neuropathy(CIPN)refers to some symptoms and signs of peripheral nerve dysfunc-tion caused by using anti-tumor drugs,which is related to the dose of chemotherapy drugs.The pathogenesis of CIPN has not been fully defined,and the efficacy of existing therapeutic drugs and methods is limited.Therefore,it is of great scientific value and social significance to explore the pathogenesis of CIPN,de-velop new therapeutic drugs and methods,and solve the unmet clinical needs.This paper will elaborate on the pathogenesis of CIPN from the molecular and cellular levels,and review the treatment progress of CIPN,so as to provide reference for clinical treatment and direction for future research.

BACKGROUND:The stability of the pelvis is mainly determined by the posterior pelvic ring and the sacroiliac joint.The posterior pelvic ring injury and the dislocation of the sacroiliac joint caused by high energy impacts such as car accidents increase year by year.Surgical treatment is the best method,and there are many kinds of endophytorepair methods in clinical practice,but which treatment method has the best biomechanical properties is still controversial. OBJECTIVE:To compare the biomechanical properties of three kinds of internal implants:anterior double plates,posterior bridging plate and tension nail in the repair of unilateral unstable pelvic posterior ring injury,to provide a reference for the clinical treatment and development of a new pelvic tension screw. METHODS:(1)Finite element simulation:Mimics,Wrap and SolidWorks were used to establish normal pelvic model,unilateral injured pelvis model,and three kinds of internal implant repaired models(anterior double plates,posterior bridging plate and tension nail).Ansys was used to analyze the stress and deformation of the models.(2)Biomechanical test:A total of 15 intact pelvic specimens were randomly grouped into five groups,normal pelvic model,unilateral injured pelvis model,anterior double plates,posterior bridging plate and tension nail groups.The mechanical test was performed using an Instron E10000 testing machine. RESULTS AND CONCLUSION:(1)Simulation:In the normal pelvic model,the average displacement of the sacrum was 0.174 mm,and the maximum stress of the sacral iliac bone was 10.51 MPa,and the stress distribution was uniform.The mean sacral displacement of the unilateral injured pelvis model was 0.267 mm,and the stress concentration of the model was obvious.The mean displacement of the sacrum in the three repaired models was close to that in the normal pelvic model,and the stress distribution of the sacral iliac bone in the tension nail repaired model was uniform.(2)Mechanical test:The stiffness of the normal pelvic model was(226.38±4.18)N/mm,and that of the unilateral unstable pelvic model was the smallest(130.02±2.19)N/mm.The deviation of the normal pelvic model stiffness and the three repaired models'stiffness were all within(±10%),and the repair effect was obvious.(3)The simulation results were in agreement with the experimental results.(4)The biomechanics of the tension nail repaired model was the most similar to that of the normal pelvis,and this method was the best.The repairing stiffness of the anterior double plate was too large,and the stress shielding effect was more significant.The posterior bridging plate repair could not solve the compensatory effect of the normal side soft tissue and had defects.This study provides an optimal basis for clinical surgery.(5)The new type of pelvic tension nail should be improved from the point of view of the tension nail to retain the good biomechanical properties of the tension nail,while adding other advantages,such as being used for the osteoporotic pelvis.