Objective To sort out the clinical research evidence on the promotion of wound healing after anal fistula surgery by traditional Chinese medicine in the past decade,and understand the evidence distribution in this field,the evidence map system was used.Methods Computer retrieval of CNKI,VIP,Wanfang,PubMed,Web of Science,EMbase,The Cochrane Library and other databases were searched.Interventional studies,observational studies,systematic review/meta-analysis on the treatment of postoperative anal fistula wounds by traditional Chinese medicine in the past decade were included.The evidence was analyzed and presented in the form of text and graphics.And the quality of clinical RCT was evaluated using Cochrane systematic review manual.AMSTAR was used to evaluate the quality of meta-analysis,and the JBI quality evaluation tool was used to evaluate the methodological quality of retrospective studies.Results A total of 544 articles were included.In recent 10 years,the number of published documents showed an increasing trend.The intervention measures of TCM to promote wound healing after anal fistula operation included single intervention mode and combined intervention mode.The outcome indexes mainly included clinical efficacy,basic wound condition,TCM syndrome score,adverse reactions,quality of life,long-term efficacy and so on.The overall quality of clinical RCT,retrospective analysis and systematic review/meta-analysis is low.Most studies showed that Chinese medicine had advantages in the treatment of vertigo,and more high-quality studies were still lacking.Conclusion More large-sample,multi-center RCTS should be carried out in the future,and the quality of relevant systematic review/meta-analysis should be improved.The advantages of TCM in promoting wound-heal after anal fistula surgery can be fully explored,which provide strong support for the effectiveness and safety of traditional Chinese medicine in improving wound management.

Objective To sort out the clinical research evidence on the promotion of wound healing after anal fistula surgery by traditional Chinese medicine in the past decade,and understand the evidence distribution in this field,the evidence map system was used.Methods Computer retrieval of CNKI,VIP,Wanfang,PubMed,Web of Science,EMbase,The Cochrane Library and other databases were searched.Interventional studies,observational studies,systematic review/meta-analysis on the treatment of postoperative anal fistula wounds by traditional Chinese medicine in the past decade were included.The evidence was analyzed and presented in the form of text and graphics.And the quality of clinical RCT was evaluated using Cochrane systematic review manual.AMSTAR was used to evaluate the quality of meta-analysis,and the JBI quality evaluation tool was used to evaluate the methodological quality of retrospective studies.Results A total of 544 articles were included.In recent 10 years,the number of published documents showed an increasing trend.The intervention measures of TCM to promote wound healing after anal fistula operation included single intervention mode and combined intervention mode.The outcome indexes mainly included clinical efficacy,basic wound condition,TCM syndrome score,adverse reactions,quality of life,long-term efficacy and so on.The overall quality of clinical RCT,retrospective analysis and systematic review/meta-analysis is low.Most studies showed that Chinese medicine had advantages in the treatment of vertigo,and more high-quality studies were still lacking.Conclusion More large-sample,multi-center RCTS should be carried out in the future,and the quality of relevant systematic review/meta-analysis should be improved.The advantages of TCM in promoting wound-heal after anal fistula surgery can be fully explored,which provide strong support for the effectiveness and safety of traditional Chinese medicine in improving wound management.

Objective To observe the expression of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(Akt)signal transducer in liver tissue of rats with bilateral ovarian castration(OVX)by electroacupuncture at Guanyuan(CV4)point,and explore the mechanism of electroacupuncture in up regulating PI3K/Akt signal pathway,regulating lipid metabolism,and reducing weight was investigated.Methods Thirty-two female SD rats were randomly divided into blank,sham operation,model and electroacupuncture group,with 8 rats in each group.Perimenopausal obesity(PMO)model was prepared by OVX in the model and the electroacupuncture group.After the model was successfully prepared,the electroacupuncture group was subjected to electroacupuncture at CV4(continuous wave,2 Hz,1 mA),once day,20 min once time,and for 14 consecutive days.The body mass of each group of rats was recorded during the whole experiment,and Lee's index was calculated during sampling.The pathological changes of liver were observed by HE staining.Serum levels of HDL,LDL and TG were detected by ELISA.Western blot analysis of PI3K,Akt,p-Akt protein expression and p-Akt/Akt in liver tissues.Results Compared with blank group and sham operation group,the body mass of rats in model group was significantly increased(P＜0.05),Lee's index was increased(P＜0.05),fat vacuoles appeared in liver,serum HDL level was decreased(P＜0.001),LDL and TG levels were increased(P＜0.01).PI3K,Akt,p-Akt,p-Akt/Akt were decreased in liver(P＜0.05).Compared with model group,body mass and Lee's index of rats in electroacupuncture group were decreased(P＜0.05),fat vacuoles in liver were decreased,HDL level was increased(P＜0.01),LDL and TG levels were decreased(P＜0.05,P＜0.01),PI3K,Akt and P-Akt were decreased(P＜0.05),and p-akt/Akt decreased(P＜0.01).Conclusion Electroacupuncture at CV4 can significantly up-regulate PI3K/Akt signaling pathway,improve lipid metabolism disorder and accumulation,and reduce body mass in OVX rats.

Objective:To investigate the correlation between three-dimensional (3D) true acetabular cup coverage and two-dimensional (2D) X-ray acetabular cup coverage in total hip arthroplasty (THA) and identify effective parameters for evaluating acetabular cup coverage.Methods:Sixteen pelvic models were 3D-printed from CT reconstruction data of healthy adult pelvises. Postoperative acetabular models were prepared using standard THA procedures. The postoperative models were centered on the acetabulum and positioned under a C-arm fluoroscope. Fluoroscopy was conducted by rotating the C-arm at different angles (15°, 30°, and 45°) to obtain anteroposterior (AP) and iliac oblique X-ray images of the hip joint. The 2D acetabular coverage at different fluoroscopic angles (AP, 15° iliac oblique, 30° iliac oblique, and 45° iliac oblique) was recorded and compared with the 3D acetabular coverage measured from the pelvic models. Two independent observers assessed related parameters (coverage, abduction angle, anteversion angle) from the 2D X-ray images, and inter-observer reliability was statistically analyzed. Differences between 2D and 3D acetabular coverage were compared, and multiple linear regression analysis was used to assess correlations between acetabular anteversion angle, abduction angle, and both 2D and 3D acetabular coverage.Results:The acetabular coverage for the 2D X-ray groups (AP, 15° iliac oblique, 30° iliac oblique, and 45° iliac oblique) was 87.37%±2.59%, 87.01%±2.53%, 85.39%±2.57%, and 83.20%±2.51%, respectively, with statistically significant differences ( F=6.700, P=0.001). The 45° iliac oblique group had significantly lower coverage than both the 30° iliac oblique group and the AP group, while the 30° iliac oblique group showed significantly lower coverage than the 15° iliac oblique group (all differences, P<0.05). The mean abduction and anteversion angles were 45.33°±2.22° and 14.61°±2.53°, respectively. The 3D acetabular coverage was 85.66%±2.51%. The 45° iliac oblique group had significantly lower coverage than the 3D coverage group ( P<0.05), whereas no significant difference was observed between the AP group and the 3D coverage group ( t=1.893, P=0.062). Multiple linear regression analysis revealed significant negative correlations between the acetabular abduction angle, anteversion angle, and both 2D and 3D acetabular coverage, with the following regression equations: 2D coverage=124.627-0.700× (abduction angle) -0.379× (anteversion angle) ( R2=0.814, P=0.001); 3D coverage=120.291-0.603× (abduction angle) -0.499× (anteversion angle) ( R2=0.917, P<0.001). Conclusion:Acetabular cup coverage rates vary with different X-ray projection angles, with the anteroposterior X-ray view potentially overestimating coverage. Changes in the abduction angle appear to significantly impact the differences between 2D and 3D coverage, thereby increasing errors in assessing true acetabular cup coverage. These discrepancies between 2D and 3D coverage should be carefully considered when evaluating minimal acetabular cup coverage.

Objective:To investigate the correlation between three-dimensional (3D) true acetabular cup coverage and two-dimensional (2D) X-ray acetabular cup coverage in total hip arthroplasty (THA) and identify effective parameters for evaluating acetabular cup coverage.Methods:Sixteen pelvic models were 3D-printed from CT reconstruction data of healthy adult pelvises. Postoperative acetabular models were prepared using standard THA procedures. The postoperative models were centered on the acetabulum and positioned under a C-arm fluoroscope. Fluoroscopy was conducted by rotating the C-arm at different angles (15°, 30°, and 45°) to obtain anteroposterior (AP) and iliac oblique X-ray images of the hip joint. The 2D acetabular coverage at different fluoroscopic angles (AP, 15° iliac oblique, 30° iliac oblique, and 45° iliac oblique) was recorded and compared with the 3D acetabular coverage measured from the pelvic models. Two independent observers assessed related parameters (coverage, abduction angle, anteversion angle) from the 2D X-ray images, and inter-observer reliability was statistically analyzed. Differences between 2D and 3D acetabular coverage were compared, and multiple linear regression analysis was used to assess correlations between acetabular anteversion angle, abduction angle, and both 2D and 3D acetabular coverage.Results:The acetabular coverage for the 2D X-ray groups (AP, 15° iliac oblique, 30° iliac oblique, and 45° iliac oblique) was 87.37%±2.59%, 87.01%±2.53%, 85.39%±2.57%, and 83.20%±2.51%, respectively, with statistically significant differences ( F=6.700, P=0.001). The 45° iliac oblique group had significantly lower coverage than both the 30° iliac oblique group and the AP group, while the 30° iliac oblique group showed significantly lower coverage than the 15° iliac oblique group (all differences, P<0.05). The mean abduction and anteversion angles were 45.33°±2.22° and 14.61°±2.53°, respectively. The 3D acetabular coverage was 85.66%±2.51%. The 45° iliac oblique group had significantly lower coverage than the 3D coverage group ( P<0.05), whereas no significant difference was observed between the AP group and the 3D coverage group ( t=1.893, P=0.062). Multiple linear regression analysis revealed significant negative correlations between the acetabular abduction angle, anteversion angle, and both 2D and 3D acetabular coverage, with the following regression equations: 2D coverage=124.627-0.700× (abduction angle) -0.379× (anteversion angle) ( R2=0.814, P=0.001); 3D coverage=120.291-0.603× (abduction angle) -0.499× (anteversion angle) ( R2=0.917, P<0.001). Conclusion:Acetabular cup coverage rates vary with different X-ray projection angles, with the anteroposterior X-ray view potentially overestimating coverage. Changes in the abduction angle appear to significantly impact the differences between 2D and 3D coverage, thereby increasing errors in assessing true acetabular cup coverage. These discrepancies between 2D and 3D coverage should be carefully considered when evaluating minimal acetabular cup coverage.

Objective To observe the expression of phosphatidylinositol 3-kinase(PI3K)and protein kinase B(Akt)signal transducer in liver tissue of rats with bilateral ovarian castration(OVX)by electroacupuncture at Guanyuan(CV4)point,and explore the mechanism of electroacupuncture in up regulating PI3K/Akt signal pathway,regulating lipid metabolism,and reducing weight was investigated.Methods Thirty-two female SD rats were randomly divided into blank,sham operation,model and electroacupuncture group,with 8 rats in each group.Perimenopausal obesity(PMO)model was prepared by OVX in the model and the electroacupuncture group.After the model was successfully prepared,the electroacupuncture group was subjected to electroacupuncture at CV4(continuous wave,2 Hz,1 mA),once day,20 min once time,and for 14 consecutive days.The body mass of each group of rats was recorded during the whole experiment,and Lee's index was calculated during sampling.The pathological changes of liver were observed by HE staining.Serum levels of HDL,LDL and TG were detected by ELISA.Western blot analysis of PI3K,Akt,p-Akt protein expression and p-Akt/Akt in liver tissues.Results Compared with blank group and sham operation group,the body mass of rats in model group was significantly increased(P＜0.05),Lee's index was increased(P＜0.05),fat vacuoles appeared in liver,serum HDL level was decreased(P＜0.001),LDL and TG levels were increased(P＜0.01).PI3K,Akt,p-Akt,p-Akt/Akt were decreased in liver(P＜0.05).Compared with model group,body mass and Lee's index of rats in electroacupuncture group were decreased(P＜0.05),fat vacuoles in liver were decreased,HDL level was increased(P＜0.01),LDL and TG levels were decreased(P＜0.05,P＜0.01),PI3K,Akt and P-Akt were decreased(P＜0.05),and p-akt/Akt decreased(P＜0.01).Conclusion Electroacupuncture at CV4 can significantly up-regulate PI3K/Akt signaling pathway,improve lipid metabolism disorder and accumulation,and reduce body mass in OVX rats.

Objective To compare the causes of poor effects after surgical treatment for severe cervical spondylotic myelopathy,and to analyze the clinical value of posterior surgery in the treatment of severe cervical spondylotic myelopathy.Methods From September 2013 to November 2016,ninety-two patients with severe cervical myelopathy in Shiyan Medical Hospital were selected as the research object,the patients were divided into the observation group and the control group,50 cases in each group,according to the different surgical methods,the control group received anterior cervical discectomy and interbody fusion and internal fixation treatment,the observation group was treated with cervical posterior decompression surgical treatment,the prognosis and the changes of cervical vertebra function in the two groups were recorded.Results There were statistically significant differences between the two groups in terms of operation time,intraoperative blood loss and postoperative hospital stay(t=5.392,7.114,4.552,P<0.05).The intervertebral height at 1 month after surgery in the observation group and the control group were(4.92 ± 1.51)mm and(4.26 ± 1.32)mm,significantly lower than those before the operation((3.72±0.42)mm,(3.78±0.93)mm)(t=10.495,6.114,P<0.05) .At 1 month after operation,the intervertebral height of the observation group was significantly higher than that of the control group(t=4.521,P<0.05).The excellent and good rate of JOA score of the observation group and control group at 1 month after operation were 97.6% and 84.0%,respectively,and the rate of the observation group was significantly higher than that of the control group(χ2=4.797,P<0.05).In the observation group and the control group,there were 1 case of throat pain after operation,and they were relieved after suitable treatment.Conclusion Compared with the anterior approach,the posterior treatment of severe cervical spondylotic myelopathy can reduce the trauma of patients,promote the recovery of intervertebral height and improve the function of the cervical spine,so as to achieve better results.