This case report describes a 68-year-old male patient diagnosed with primary hepatocellular carcinoma (HCC). After receiving Yttrium-90 microsphere selective internal radiation therapy (⁹⁰Y-SIRT), the tumor significantly reduced in size, and tumor markers alpha fetoprotein (AFP) and abnormal prothrombin (PIVKA-Ⅱ) decreased. Postoperative pathological results showed minimal residual tumor cells, indicating that ⁹⁰Y-SIRT has good efficacy and safety in downstaging and conversion of HCC, thereby facilitating subsequent surgical resection.

Objective To analyze the disease burden of hip osteoarthritis(HOA)and its changing trends in China from 1990 to 2021.Methods Utilizing the Global Burden of Disease(GBD)2021 database,age-standardized incidence rate(ASIR),age-standardized prevalence rate(ASPR),and age-standardized disability adjusted life years(DALY)rate(ASDR)of HOA were compared and analyzed in China,globally,and in regions with high sociodemographic index(SDI)from 1990 to 2021.Joinpoint regression model was used to analyze the temporal trend of disease burden,and age and gender were combined to deeply analyze the disease burden of HOA in China.Meanwhile,the age-period-cohort model was used to analyze the influencing factors and the Bayesian age-period-cohort model to predict the trend of China's HOA disease burden in the next 10 years.Results The ASIR,ASPR,and ASDR of HOA in China showed an increasing trend from 1990 to 2021[average annual percentage change(AAPC)were 0.87％,0.82％,and 0.81％,respectively,P＜0.001],and their AAPCs were higher than those of the global and high SDI regions,but in 2021,the ASIR,ASPR,and ASDR of China were lower than those of the global and high SDI regions.Crude incidence,crude prevalence,and crude DALY rate in Chinese HOA increased with age,with the highest number of incidence in the 55-59 age group and the highest number of prevalence,DALY,in the 65-69 age group.In 2021,the ASIR,ASPR and ASDR of HOA in Chinese males were 1.25,1.24 and 1.25 times higher than those in females.Changes in the incidence of HOA in China from 1990 to 2021 were influenced by age,period,and birth cohort.Compared with 2021,new cases of HOA are expected to increase by 37.78％by 2035,and the number of incidence cases in people aged 60 years and above will increase significantly.Conclusion The disease burden of HOA in China continued to rise from 1990 to 2021,and prevention and control need to be strengthened,with a focus on men,high BMI,and middle-aged and older populations.

Objective:To investigate the effectiveness of combined teaching method integrating case-based teaching method(CBL),problem-based teaching method(PBL),and team-based teaching method(TBL)in clinical nursing teaching in pediatric intensive care unit(PICU).Methods:A total of 60 nursing students who trained in our PICU from Jan 2021 to Jun 2022 were selected as the control group,and 60 nursing students who trained in our PICU from Jul 2022 to Jun 2024 were selected as the research group.The control group received conventional nursing teaching mode,while the research group received combined teaching mode of CBL,PBL,and TBL.The scores of academic performance,logical thinking ability,self-learning ability,and clinical nursing comprehensive ability between the two groups were compared.Result:The scores of theoretical knowledge,operational skills,post-teaching Critical Thinking Disposition Inventory-Chinese Version(CTDI-CV)scale,self-directed learning readiness scale for nursing,and Mini-clinical evaluation exercise scale(Mini-CEX)in the research group were higher than those in the control group(P＜0.05).Conclusion:The combined teaching method of CBL,PBL,and TBL can effectively improve clinical nursing teaching results and comprehensive abilities of nursing students.

Objective This study aimed to investigate the relationship between multiple inflammatory markers and poor outcome in patients with intracerebral hemorrhage,and to compare their predictive abilities.Methods We retrospectively analyzed the patients with intracerebral hemorrhage admitted to the Department of Neurology of the First Affiliated Hospital of Nanchang University from January 1,2015 to March 31,2023.According to the Modified Rankin Scale at 90 days after onset,the patients were divided into good outcome(mRS≤2 points)and poor outcome(mRS score≥3 points).Clinical information,laboratory examinations and follow-up data were compared between the two groups.Inflammatory markers include neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),monocyte to high-density lipoprotein ratio(MHR),systemic inflammatory response index(SIRI),systemic immune-inflammation index(SII),white blood cell count to mean platelet volume ratio(WMR),lymphocyte to monocyte ratio(LMR),and systemic coagulation-inflammation index(SCI).Univariate and multivariate logistic regression analysis were used to analyze the predictors of poor prognosis after intracerebral hemorrhage,and receiver operating characteristic curve(ROC)was constructed to compare their predictive ability.Results A total of 510 patients with intracerebral hemorrhage were included.Of those,297(58.2%)had good outcome,and 213(41.8%)had poor outcome.Comparison of baseline characteristics demonstrated that patients with poor prognosis had higher levels of white blood cells,neutrophils,high-density lipoprotein,fibrinogen,NLR,PLR,SIRI,SII,WMR at admission,larger baseline hematoma volume and baseline perihematomal edema volume,a higher proportion of lobar hemorrhage,older age,and lower levels of platelets,lymphocytes,LMR,and SCI(P<0.05).Multivariate regression analysis showed that NLR(OR:1.081,95%CI:1.032～1.1131,P=0.001),SIRI(OR:1.089,95%CI:1.014～1.169,P=0.019),SII(OR:1.000,95%CI:1.000～1.001,P=0.011),WMR(OR:2.627,95%CI:1.267～5.445,P=0.009)were independently associated with poor prognosis in patients with ICH.In ROC analysis,the area under the curve of NLR(0.729,95%CI:0.685～0.774)was higher than SIRI(0.692,95%CI:0.645～0.738),SII(0.688,95%CI:0.641～0.735)and WMR(0.65,95%CI:0.602～0.698)for predicting poor outcomes.Conclusion NLR,SIRI,SII and WMR at admission are independently associated with poor outcomes in patients with intracerebral hemorrhage,and NLR has the strongest predictive ability.

Objective To explore the magnetic resonance(MR)imaging characteristics of joint damage caused by Chikungunya virus(CHIKV)and its correlation with pain severity,and analyze the value of T2-Mapping in asse-ssing the severity and prognosis of such damage.Methods A multicenter retrospective study design was adopted,and patients with CHIKV infection accompanied by joint pain were included in analysis.Multi-joint MR scans were performed to assess joint effusion,synovial thickening,bone marrow edema,and cartilage damage.T2-Mapping values were measured.Pain severity was assessed using the Visual Analog Scale(VAS),and imaging findings were independently assessed by two radiologists.Results A total of 131 patients were included in the study.The inci-dence of joint cavity and/or synovial sac effusion was the highest(77.1％,n=101),with knee and ankle joint effu-sion accounting for 81.2％(severe,mild-moderate were 17 and 65 cases,respectively),other joint effusion were mild.78 cases had synovial thickening(14 and 64 were severe and mild-moderate cases,respectively),27 cases had tenosynovitis,21 cases had bone marrow edema(primarily in the knee and ankle joints).19 cases had cartilage damage,114 cases presented muscle soft tissue edema(17 and 97 were severe and mild-moderate cases,respective-ly),28 cases had Kager's fat pad edema.Patients with elevated T2-Mapping values exhibited more pronounced chronic joint pain,with T2-Mapping values in the cartilage damage site increasing by 40％-60％compared with normal cartilage site(19 cases in total).The T2-Mapping value for severely damaged soft tissue was(52.3+6.7)ms,while for mildly to moderately damaged soft tissue was(42.3±5.2)ms,both significantly higher than normal refe-rence values(＜35 ms,both P＜0.05).Among 17 patients with severe soft tissue damage,12 experienced persistent pain for over one month,with statistically significant differences in T2 values compared with those with mild-mode-rate damage(P＜0.05).This further suggested that the degree of elevation in T2-Mapping values was closely related to the duration of pain and the severity of damage.After one-month follow-up,103 patients had pain relief.Among the 28 patients with ongoing pain,17 developed into subacute bone joint pain.Bone marrow edema(81.0％),ele-vation of T2-Mapping value of cartilage(89.5％),and severe synovial thickening(71.4％)were high-risk MR manifestations of subacute bone joint pain.The incidences of subacute joint cavity/sac effusion and subacute tenosy-novitis were 3.0％and 7.4％,respectively.Conclusion MR can clearly display the inflammatory and structural changes in CHIKV joint damage,and T2-Mapping values may serve as a potential imaging measurement parameter for assessing severity and prognosis of damage.

Objective To analyze the prescription patterns of Professor Huang Feng,a nationally renowned traditional Chinese medicine(TCM)practitioner,in treating osteomyelitis using data mining methods.Methods Prescription data from effective medical records of osteomyelitis treated by Professor Huang Feng between January 2018 and December 2022 were collected and screened.Microsoft Excel,SPSS Modeler 18.0,and SPSS Statistics 25 were used to analyze the frequency and the distribution of properties,flavors,and meridian tropism of prescribed medications,along with association rule analysis and cluster analysis of high-frequency drugs.Results A total of 137 prescriptions involving 86 Chinese medicinals were included.Eighteen high-frequency medicinals(frequency＞30 times)were identified,namely Glycyrrhizae Radix et Rhizoma,Astragali Radix,Coicis Semen,Angelicae Sinensis Radix,Smilacis Glabrae Rhizoma,Achyranthis Bidentatae Radix,Bletillae Rhizoma,Rehmanniae Radix,Paeoniae Radix Alba,Dendrobii Caulis,Polygalae Radix,Lablab Semen Album,Corydalis Rhizoma,Angelicae Dahuricae Radix,Drynariae Rhizoma,Sanguisorbae Radix,Poria,and Mume Fructus.Most of the prescribed medicinals were neutral in nature,sweet,bitter,and pungent in flavor,and had the meridian tropism of liver,spleen,and lung meridians.Association rule analysis yielded 67 drug association rules,and the high-support combinations were the drug combinations of Astragali Radix respectively with Coicis Semen,Angelicae Sinensis Radix,Smilacis Glabrae Rhizoma and Achyranthis Bidentatae Radix,reflecting the compatibility principles of supplementing and invigorating qi-blood,activating blood circulation to resolve stasis,and draining dampness to remove toxins.Cluster analysis revealed three core clusters:Cluster 1 consisted of Glycyrrhizae Radix et Rhizoma,Astragali Radix,Coicis Semen,Smilacis Glabrae Rhizoma,Angelicae Sinensis Radix,Bletillae Rhizoma,Paeoniae Radix Alba,Angelicae Dahuricae Radix,Mume Fructus,Polygalae Radix and Sanguisorbae Radix;Cluster 2 consisted of Rehmanniae Radix and Dendrobii Caulis;Cluster 3 consisted of Achyranthis Bidentatae Radix,Lablab Semen Album,Corydalis Rhizoma and Poria.Conclusion For the treatment of osteomyelitis,Professor Huang Feng follows the principle of combining supporting healthy qi with eliminating pathogens,focuses on clearing damp-heat and pathogenic toxins accompanied by activating blood circulation to resolve stasis,and lays stress on adaptation to local condition and activating spleen-stomach to reinforce vital qi.

ObjectiveTo investigate the effects of artemisinin （ART） on histopathological damage and salivary secretion in the submandibular gland （SMG） of mice with Sjögren's syndrome （SS） model，and on the expression of aquaporin 5 （AQP5） in SMG cells. MethodsThe NOD/Ltj mice were used as a model of SS and randomly divided into the SS model group，the ART group，and the hydroxychloroquine sulfate （HCQ） group，with six mice per group. Another 6 female BALB/c mice at the same week were selected as the control group. Mice in the ART group was fed with the ART solution daily in the dosage of 50 mg·kg^-1，and mice in the HCQ group was given with the HCQ solution （1 300 mg·kg^-1）. Mice in the SS model and control groups were given saline daily. The treatment lasted for 8 weeks. The 24-hour average water intake，salivary flow rate，SMG pathology scores of mice in each group were measured，as well as the expression levels of AQP5 protein and gene in the SMG tissues. ResultsCompared with the control group，the 24-hour average water intake of mice in the model group was significantly increased （P<0.01），and the saliva flow rate was significantly decreased （P<0.01）. Compared to the SS model group，the 24-hour average water intake of mice in the ART and HCQ groups was significantly reduced （P<0.01），and the salivary flow rate was significantly increased in the ART group（P<0.01），comparisons between groups showed that the ART was superior to the HCQ in reducing water intake and improving saliva flow rate in SS model mice （P<0.05）. The HE staining results showed that，compared with the normal group，the number of lymphocyte infiltration foci in SMG tissue in the model group increased，and the pathological score increased （P<0.01）. Compared to the SS model group，after the intervention of the ART and HCQ，the number of lymphocytic infiltration foci in the SMG tissue decreased，the area of the lymphocytic infiltration foci was reduced，and the pathology score of the SMG tissues was lowered in the ART group（P<0.01）. However，there was no difference in pathological scores between the ART and HCQ groups . The results of IHC，Western blot，and Real-time PCR showed that，compared with the normal group，the expression levels of AQP5 protein and gene in SMG tissue in the model group significantly decreased （P<0.05）. Comparing with the SS model group，the ART and HCQ groups could significantly up-regulated the expression levels of AQP5 protein and mRNA in the SMG tissue，and the treatment effect was better than that of HCQ. ConclusionART was able to ameliorate SMG structural damage and salivary secretion function in SS model mice，and its mechanism of action may be related to the up-regulation of AQP5 protein and gene expression levels in SMG cells.

Objective:To investigate the current status of the implementation of home-based phototherapy (HBPT) in patients with vitiligo, and to analyze management needs among patients receiving HBPT.Methods:A questionnaire survey was conducted on the application of HBPT among patients with vitiligo who visited the outpatient clinic of the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from December 2021 to November 2022. Additionally, the popularization and usage of HBPT as well as needs of patient management were investigated and analyzed in these vitiligo patients.Results:A total of 496 valid questionnaires were collected from 496 patients with vitiligo (241 males [48.5%] and 255 females [51.5%]) . Their ages at visit ranged from 2 to 67 (30.87 ± 12.36) years. The most commonly affected sites were the head and face (52.2%) , followed by hair (32.1%) , hands and feet (31.4%) , trunk (30.2%) , limbs (24.3%) , neck (19.5%) , and perineum (9.9%) . Among the participants, 320 (64.5%) were currently using or had used HBPT, and 352 (70.8%) expressed a willingness to learn more about HBPT usage guidelines and health education. Regarding the repigmentation outcomes after HBPT: among 312 patients, 54 (17.3%) reported complete recovery, 64 (20.5%) were markedly improved, 142 (45.5%) experienced improvement, and 52 (16.7%) showed no response. Adverse reactions occurred in 223 patients (71.5%) , of whom 28 (9.0%) experienced severe adverse reactions. The most desired guiding information was the adjustment method for phototherapy dosage and treatment duration (184/352, 52.3%) ; the most effective way to receive health education information was through verbal education by medical staff (177/352, 50.3%) .Conclusion:For vitiligo patients who were willing to accept and use HBPT, the most desired guiding information was the adjustment method for phototherapy dosage and treatment duration, and verbal health education by medical staff appeared to be the main way to obtain health education information.

Objective:To analyze the effects of the classic skin reset method and the modified skin reset method in correcting epicanthus.Methods:A retrospective study was conducted on 61 patients who underwent epicanthoplasty at Daqing Oilfield General Hospital from September 2019 to September 2021. Among them, 54 were female and 7 were male, with ages of 18-47 (25.7±4.6) years. The patients were divided into two groups based on different surgical methods: the classic skin repositioning method (control group, 30 cases) and the modified skin repositioning method (experimental group, 31 cases). Postoperative follow-up was conducted for 6 to 24 months. Photos were taken before the operation and during the follow-up period after the operation, and the inter-pupillary distance (IPD) and intercanthal distance (IED) were measured. For patients who underwent double eyelid surgery simultaneously, the proportion of postoperative outward rotation type effect was compared between the two groups. The incidence of adverse reactions such as visible scars, hypertrophic scars, overcorrection, and under-correction after the operation was recorded.Results:The preoperative and postoperative IED/IPD ratios were 0.63±0.02 and 0.56±0.03 in control group, and 0.64±0.02 and 0.56±0.02 in experimental group, respectively. There was no significant difference in IED/IPD ratio between the two groups before and after surgery (all P>0.05). By intra-group comparison, postoperative IED/IPD ratios were lower in both groups than that before surgery. In the experimental group, 83.9% (26/31) of patients underwent double blepharoplasty, which was higher than that in the control group (16.7%, 5/30) ( P<0.001). In the control group, the incidence of adverse reactions was 33.3% (10/30), including 4 cases of mild under-correction and 6 cases of lower eyelid scar. There was no correction deficiency and no visible scar in the experimental group. No overcorrection, hypertrophic scar and other complications were found in both groups. Conclusion:The modified skin replacement method is effective and can prevent the deficiency of epicanthus correction.

Objective:To investigate the current status of the implementation of home-based phototherapy (HBPT) in patients with vitiligo, and to analyze management needs among patients receiving HBPT.Methods:A questionnaire survey was conducted on the application of HBPT among patients with vitiligo who visited the outpatient clinic of the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from December 2021 to November 2022. Additionally, the popularization and usage of HBPT as well as needs of patient management were investigated and analyzed in these vitiligo patients.Results:A total of 496 valid questionnaires were collected from 496 patients with vitiligo (241 males [48.5%] and 255 females [51.5%]) . Their ages at visit ranged from 2 to 67 (30.87 ± 12.36) years. The most commonly affected sites were the head and face (52.2%) , followed by hair (32.1%) , hands and feet (31.4%) , trunk (30.2%) , limbs (24.3%) , neck (19.5%) , and perineum (9.9%) . Among the participants, 320 (64.5%) were currently using or had used HBPT, and 352 (70.8%) expressed a willingness to learn more about HBPT usage guidelines and health education. Regarding the repigmentation outcomes after HBPT: among 312 patients, 54 (17.3%) reported complete recovery, 64 (20.5%) were markedly improved, 142 (45.5%) experienced improvement, and 52 (16.7%) showed no response. Adverse reactions occurred in 223 patients (71.5%) , of whom 28 (9.0%) experienced severe adverse reactions. The most desired guiding information was the adjustment method for phototherapy dosage and treatment duration (184/352, 52.3%) ; the most effective way to receive health education information was through verbal education by medical staff (177/352, 50.3%) .Conclusion:For vitiligo patients who were willing to accept and use HBPT, the most desired guiding information was the adjustment method for phototherapy dosage and treatment duration, and verbal health education by medical staff appeared to be the main way to obtain health education information.