Objective To explore the value of dynamic MRI imaging in investigate the morphologic and dynamic factors of low anterior resection syndrome(LARS)after anal preservation surgery in patients with low rectal cancer.Methods Thirty-five patients who developed LARS after anal preservation surgery for low rectal cancer were prospectively collected.Subjects were underwent routine MRI and dynamic MRI of pelvis 1 week before and 3 months after surgery respectively.Routine MRI was used as the resting phase,and dynamic MRI was used to obtain the rapture phase and forceful phase.Parameters such as anal rectus angle(ARA),the length of the line connecting lower edge of pubic symphysis to the posterior wall attachment point of puborectal muscle(H-line),the vertical length from posterior wall attachment point of puborectal muscle to pubococcygeal line(M-line),thickness of puborectal muscle,and thickness of internal and external anal sphincter were measured at the three time phases.The differences between preoperative and postoperative,and moderate and severe LARS patients were compared by measuring relevant indicators.Results The preoperative and postoperative ARA,H-line length and M-line length of LARS patients were the smallest in the rapture phase,the largest in the forceful phase,and the middle in the resting phase.The postoperative thickness of puborectalis muscle and internal and external anal sphincter were the largest in the rapture phase,the smallest in the forceful phase,and the middle in the resting phase.There were significant differences between the three phases(P＜0.05).There were no significant differences between the three phases of postoperative puborectalis muscle thickness and internal and external sphincter thickness(P＞0.05).The postoperative ARA was greater than preoperative ARA in LARS patients,and the thickness of puborectalis muscle,the internal anal sphincter(resting phase and rapture phase),and the external anal sphincter were smaller than preoperative ARA,and the differences were statistically significant(P＜0.05).The ARA in resting phase and rapture phase was greater in patients with severe LARS than that of patients with mild LARS,and the thickness of internal anal sphincter in resting phase was less in patients with severe LARS than that of patients with mild LARS(P＜0.05).However,the differences between the other indicators were not statistically significant(P＞0.05).Conclusion Dynamic MRI examination technology combines dynamic images with quantitative indicators can be used as an important evaluation basis for LARS patients.

AIM:To investigate the inhibitory ef-fect of Zushima ointment on inflammation and bone destruction in CIA mice.METHODS:SPF grade male DBA/1 mice were used,6 were random-ly selected as the normal group,and 18 CIA mice that were successfully modelled were randomly di-vided into the model group,the plaster group(1.0 g/kg),and the fuselage group(0.12 g per time)ac-cording to the random number table method,6 mice in each group,and each administered group was given medication according to the body mass,and saline was given to both the normal and model groups.The normal group and the model group were given saline,and breathable adhesive paper was applied once a day for 4 h/session for 4 consec-utive weeks.The arthritis scoring index was used to observe the changes of arthritis symptoms and ar-thritis index scores of mice in each group.Micro-CT was used to observe the damage of hind paw of mice,real-time fluorescence PCR was used to de-tect the mRNA expression of IL-17,IL-1β and TNF-αin ankle joint tissues,and immunohistochemistry was used to detect the expression of OPG and RANKL proteins in ankle joint tissues,and hematox-ylin-eosin(HE)staining was used to observe the pathological changes of synovial tissues after the treatment.The pathological changes of synovial tis-sue were observed after hematoxylin-eosin(HE)staining,and the changes of osteoclasts in ankle joint tissue were observed by anti-tartaric acid phosphatase(TRAP)method.RESULTS:Compared with the normal group,the arthritis index score of the model mice was significantly higher(P＜0.05).Micro-CT showed severe bone erosion in the hind paws of the mice,destruction of the bone surface and reduction of bone volume.The expression of IL-17,IL-1β and TNF-α mRNA(PCR)in the ankle joint tissues was significantly higher(P＜0.05).Im-munohistochemistry showed that the relative ex-pression of OPG protein in the ankle joint tissues was reduced(P＜0.05).Immunohistochemistry showed a decrease in the relative expression of OPG protein(P＜0.01)and an increase in the rela-tive expression of RANKL protein(P＜0.01).HE re-sults showed moderate inflammatory cell infiltra-tion,swelling of synovial cells,massive formation of vascular opacities and synovial hyperplasia;an increase in the number of osteoclasts,roughness of the surface of articular cartilage tissue,severe bone destruction and thinning of the cartilage lay-er.Compared with the model group,the arthritic symptoms of mice in the cream group and the futa-lin group were relieved and the arthritis index score was reduced;the bone density of the mice's hind paws improved,effectively relieving osteopo-rosis;the expression of IL-17,IL-1β and TNF-αmRNA(PCR)in the ankle joint tissue was signifi-cantly reduced(P＜0.05);the immunohistochemical results showed that the relative expression of OPG protein was increased(P＜0.05),the relative expres-sion of RANKL protein decreased(P＜0.01).HE re-sults showed that synovial cell enlargement was significantly improved,mild inflammatory cell infil-tration,synovial hyperplasia was not obvious;the number of broken bone was reduced,articular car-tilage destruction was significantly improved and relieved,and the thickness of cartilage layer was significantly increased.CONCLUSION:Ancestral hemp poultice relieves local symptoms of RA,re-duces the expression of inflammatory factors and attenuates the inflammatory response,possibly by inhibiting osteoclast differentiation and activation through modulation of the OPG/RANKL signalling axis,which further ameliorates the biological ef-fects of articular bone and cartilage destruction.

Objective:To design a new jaw-lifting auxiliary tool and explore its effect in painless bronchoscopy.Methods:From January to December 2023, convenience sampling was used to select 160 patients who underwent painless bronchoscopy at the Endoscopy Center of the First Hospital of Jiaxing as subjects. The subjects were divided into an experimental group ( n=80) and a control group ( n=80) using a random number table method. During painless bronchoscopy, the experimental group used a new jaw-lifting auxiliary tool to open the airway, while the control group used traditional manual methods to open the airway. Two groups were compared patient oxygen saturation at different time points, and bronchoscopy passage time through the glottis. Results:The number of cases in which blood oxygen saturation <95% occurred at different time points in the experimental group was lower than that in the control group (all P<0.05). The time for bronchoscopy to pass through the glottis in the experimental group was shorter than that in the control group, and the difference was statistically significant [ (2.86±0.69) s vs. (3.20±0.96) s, P<0.05] . Conclusions:Using a new jaw-lifting auxiliary tool during painless bronchoscopy can reduce the decreased oxygen saturation in patients and shorten the time for bronchoscopy to pass through the glottis. It can be further promoted and applied in clinical practice.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To observe whether 10.6 μm infrared laser moxibustion provides greater pain and stiffness relief and improves joint function in patients with knee osteoarthritis(KOA)compared with sham laser moxibustion. Methods:A total of 178 patients with KOA were randomly divided into a CO2 laser moxibustion group and a sham laser moxibustion group by block randomization method.Patients in the two groups received 10.6 μm infrared laser moxibustion or sham laser moxibustion treatment symmetrically at bilateral Dubi(ST35),respectively.Patients in both groups received 20 min of treatment,3 times per week for 4 weeks.Treatment effects were assessed by changes in the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)before treatment,at mid-treatment(2 weeks),at the end of treatment(4 weeks),and 4 weeks after treatment.Completion time for walking 50 yards was evaluated as a secondary measurement. Results:There were no statistical differences in the WOMAC scores for pain,stiffness,and function between the two groups before treatment(P>0.05).Patients in the CO2 laser moxibustion group experienced greater improvement in WOMAC pain,stiffness,and function scores at mid-treatment,the end of treatment,and 4 weeks after treatment(P<0.05).No significant inter-group difference was found at each assessment of the 50-yard walking time(P>0.05). Conclusion:Compared with the sham laser moxibustion,10.6 μm laser moxibustion can significantly reduce pain and improve knee joint stiffness and function in patients with KOA.

Objective:To analyze the correlation between the severity of acute pancreatitis (AP) and the levels of zonulin, zonula occludens protein-1 (ZO-1), tumor necrosis factor -α (TNF -α) in the peripheral blood of patients with acute pancreatitis (AP), and the value of predicting moderate and severe AP.Methods:The clinical data of 115 AP patients admitted to the Second Affiliated Hospital of Anhui Medical University from June 2020 to January 2022 were retrospectively analyzed. They were divided into mild group (69 cases) and moderate severe group (46 cases). The blood levels of zonulin, ZO-1, and TNF-α were measured for all patients on the 1st, 3rd, and 7th day after admission, and the results of the two group tests were compared. The correlation between zonulin, ZO-1, TNF -α and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores on the 1st day was and the value of various indicators for predicting moderate to severe AP were analyzed.Results:The C-reactive protein (CRP) levels of AP patients in the moderate to severe group were higher than those in the mild group, and the difference was statistically significant (all P<0.05). The levels of zonulin, ZO-1, and TNF -α in AP patients in the moderate to severe group showed an upward trend on the 1st, 3rd, and 7th days after admission. The levels of zonulin, ZO-1, and TNF -α in AP patients in the moderate to severe group were higher than those in the mild group at the same time point, and the differences were statistically significant (all P<0.05). The APACHE Ⅱ score of AP patients on the first day of admission was positively correlated with the levels of zonulin, ZO-1, and TNF -α ( r=0.736, 0.552, 0.621, all P<0.05). Zonulin had the highest area under the curve (AUC) for predicting moderate to severe AP, at 0.892, with an optimal threshold of 2.075 pg/ml. Zonulin had the highest sensitivity, at 0.804, and ZO-1 had the highest specificity, at 0.926. Using zonulin ≥2.075 pg/ml, ZO-1≥399.4 ng/ml, and TNF -α≥40.88 pg/ml as thresholds; the sensitivity and specificity obtained from parallel experiments were 0.976 and 0.710, respectively; The sensitivity and specificity obtained from the series of experiments were 0.326 and 0.999, respectively. Conclusions:There is a correlation between the serum levels of zonulin, ZO-1, and TNF -α in AP patients and the severity of AP. Zonulin, ZO-1, and TNF -α have certain clinical value in predicting moderate to severe AP.

OBJECTIVETo compare the difference in the manual measurement of Fengshi (GB 31) between the standing position and the supine position so as to determine the location.

METHODSA total of 197 volunteers were included in the manual measurement of Fengshi (GB 31) at the standing position and 92 volunteers at the supine position. The differences were compared between the two measurements.

RESULTSThe results in the manual measurement at the standing position showed that the distance was (39.27±3.83) cm from the greater trochanter of femur to the popliteal transverse crease [(39.96±4.21) cm in males, (38.82±3.49) cm in females, < 0.05]. The distance was (19.08±2.97) cm from the tip of the middle finger to the popliteal transverse crease [(18.96±3.50) cm in males, (19.16±2.58) cm in females]. After calculating according to the formula of proportional bone measurement, Fengshi (GB 31) was located (9.28±1.44) above the popliteal transverse crease [(9.07±1.64) in males, (9.42±1.29) in females]. The results in the manual measurement at the supine position showed that the distance was (41.89±3.88) cm from the greater trochanter of femur to the popliteal transverse crease [(42.36±3.88) cm in males, (41.67±3.89) cm in females]. The distance was (23.01±3.37) cm from the tip of the middle finger to the popliteal transverse crease [(22.50±3.73) cm in males, (23.25±3.20) cm in females]. After calculated according to the formula of proportional bone measurement, Fengshi (GB 31) was located (10.51±1.69) above the popliteal transverse crease [(10.16±1.75) in males, (10.67±1.63) in females].

CONCLUSIONFengshi (GB 31) is located on the femoral region, in the depression under the tip of the middle finger at the standing position. The simple localization of the acupoint at the supine position: at the supine, the palm touches the middle of the lateral side of the thigh, about 1 directly below the depression under the tip of the middle finger. The location of Fengshi (GB 31) in female is slightly upper than male.

Acupuncture Points ; Female ; Femur ; anatomy & histology ; Humans ; Male ; Meridians ; Posture ; Reference Standards ; Thigh ; anatomy & histology

In the paper, the study was reviewed on the infrared temperature characteristics of acupoints in recent 10 years. CNKI, WANFANG, VIP, SciVerse ScienceDirect and Springer databases were retrieved, with"infrared thermal imaging" and "acupoint" as the key words. The retrieving time was from January 1, 2006 to December 31, 2016. Totally, 468 relevant papers were searched and 169 papers of them were read carefully on acupoint infrared temperature. In terms of physiological condition, pathological condition and the stimulation methods such as acupuncture, moxibustion,, embedding therapy and cupping therapy, the general situation was reviewed on the infrared temperature characteristics of acupoints separately. It was found that the study on infrared temperature characteristics of acupoints in physiological condition was limited and the characteristics discovered were not enough to systematically review the physiological and physical properties of acupoints. The study in terms of the pathological condition objectively reflected the effects and rules of diseases. It was showed in the study of acupoint infrared temperature characteristics after stimulation that the changes of infrared thermal imaging tempe-rature at some specific region induced by different therapies and parameters might be used to deduce the potential mechanism and optimal parameters or schemes of intervention method and contributed to the formation and deve-lopment of quantitative diagnosis and treatment. The authors believe that the study on infrared temperature characteristics of acupoint provides the active significance in the exploration on the physiological and physical characteristics of acupoint, the effects and rules of diseases as well as the quantitative diagnosis and treatment.

TheMeridian and Acupoint Science is a basic course in the major of acupuncture-moxibustion and tuina. We applied target-guided teaching method in teaching this course to evoke student's interest in studyingMeridian and Acupoint Science through initiative guidance, and boost student's initiative and enthusiasm by exhibiting the teaching targets. During the practice, we emphasized the specification of each unit target, around which we adopted various methods; meanwhile, we also focused on prompt evaluation, based on which necessary adjustments would be made to approach the targets. Teachers should act as guider, maintainer and promoter in class, rather than transmitter, to help students to study positively rather than passively listen. Via this kind of teaching reform, students not only obtained knowledge, but also enhanced their capability and feelings.

The present circuit was designed to apply to human tissue impedance tuning and matching device in ultra-short wave treatment equipment. In order to judge if the optimum status of circuit parameter between energy emitter circuit and accepter circuit is in well syntony, we designed a high frequency envelope detect circuit to coordinate with automatic adjust device of accepter circuit, which would achieve the function of human tissue impedance matching and tuning. Using the sampling coil to receive the signal of amplitude-modulated wave, we compared the voltage signal of envelope detect circuit with electric current of energy emitter circuit. The result of experimental study was that the signal, which was transformed by the envelope detect circuit, was stable and could be recognized by low speed Analog to Digital Converter (ADC) and was proportional to the electric current signal of energy emitter circuit. It could be concluded that the voltage, transformed by envelope detect circuit can mirror the real circuit state of syntony and realize the function of human tissue impedance collecting.
Diathermy ; instrumentation ; Electric Impedance ; Humans ; Radio Waves ; Signal Processing, Computer-Assisted