BACKGROUND:Osteonecrosis of the femoral head is one of the refractory diseases in orthopedic diseases.The natural collapse course of osteonecrosis of the femoral head under different stages and types affects the progression and prognosis of the disease. OBJECTIVE:To explore the progression of natural collapse within 5 years in patients under the different classifications of China-Japan Friendship Hospital(CJFH)with stage Ⅱ osteonecrosis of the International Association for Research Circulation Osseous(ARCO),and to analyze the collapse rate and collapse risk of the femoral head under the different classifications of CJFH. METHODS:A retrospective study was performed to select patients diagnosed with ARCO Ⅱ stage osteonecrosis of the femoral head without collapse in the Honghui Hospital Affiliated to Xi'an Jiaotong University from October 2016 to October 2017.According to whether it collapsed,the number of hips was divided into the collapse group(n=82)and the non-collapsed group(n=70).The collapse risk of patients with osteonecrosis of the femoral head under different CJFH classifications,as well as the collapse time,number of collapses,and collapse rate within 5 years were counted,and then the Kaplan-Meier survival curve of the femoral head under different classification of CJFH was plotted. RESULTS AND CONCLUSION:(1)A total of 97 patients with 152 hips were enrolled,and 82 hips collapsed during the follow-up period,with a total collapse rate of 53.9%,of which the collapse rates of M type,C type,L1 type,L2 type,and L3 type were 0.0%,36.7%,51.4%,72.2%,and 77.8%,respectively,and the comparison between the groups was statistically significant(P<0.05).(2)In terms of collapse risk,the collapse risk of L1 type was 1.704 times that of C-type(P>0.05),while the collapse risks of L2 type and L3 type were 3.866 times and 6.423 times that of C type(P<0.05),respectively.(3)In terms of the Kaplan-Meier survival curve,the median survival time of the femoral head of ARCO Ⅱ stage patients was 3 years,with a 95%confidence interval of 2.885-3.471 years,and the survival rates of the femoral head at the first,third and fifth years were 65.1%(99/152),50.7%(77/152),and 46.1%(70/152),respectively.(4)These findings conclude that different CJFH classifications affect the collapse rate of ARCO Ⅱ stage osteonecrosis of the femoral head patients,among which L3 type patients have the highest collapse rate,followed by L2 type and L1 type patients;C type patients have a lower collapse rate,and M type patients do not collapse,which indicates that the preservation of the lateral column of the femoral head is of great significance for the natural collapse course of osteonecrosis of the femoral head.

Objective To discuss the medication law of Professor Gu Shizhe in the treatment of insomnia based on various data mining techniques.Methods Clinical information of patients of Professor Gu was collected from the hospital management information system of outpatient clinic of Beijing University of Chinese Medicine(BUCM)and BUCM Famous Elderly TCM Inheritance Research Integrated Platform from January 2018 to October 2022.Professor Gu's books,such as Zhi Zhen Zhi Yao,and Gu Jisheng,Gu Shizhe Yi An Yi Hua Jing Cui,and the medical records from CNKI were screened.WPS Office 5.2.1 was used to build a database of medicine data for Professor Gu's TCM prescriptions,and R 4.2.1 was used for descriptive analysis and Apriori association rule analysis.SPSS Statistics 26.0 was used for clustering analysis,combined with theoretical analysis,to extract Professor Gu's medication law and characteristics in the treatment of insomnia.Results A total of 307 prescriptions were included,involving 250 kinds of Chinese materia medica,among which 30 were high-frequency drugs.The top 5 most frequently used were Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle,Fossilizid,Poria,Bupleuri Radix,and Ziziphi Spinosae Semen.The meridians were mainly liver and lung meridian,and the properties were mainly warm and cold,and the tastes were mainly sweet and bitter.Five core drug groups were obtained by clustering analysis,including Xiaochaihu Decoction,Erchen Decoction,Huanglian Wendan Decoction,Suanzaoren Decoction,Xiaoyao Powder and other prescriptions.Conclusion The characteristics of Professor Gu's treatment of insomnia are to reconcile Shaoyang,clear the heart and soothe the mind;pay attention to yin and yang,regulate the liver;pay attention to the liver,gallbladder,spleen and stomach;the main idea of syndrome differentiation is to reconcile Shaoyang,run the Shaoyang cardinal,and at the same time regulate qi and benefit qi and nourishes yin.

Objective To discuss the clinical application value of super selective renal artery embolization-assisted(SRAE-assisted)laparoscopic partial nephrectomy(LPN).Methods A retrospective analysis of the clinical data of patients with stage T1 renal carcinoma,who received LPN,was conducted.The patients were divided into SRAE group(performing LPN without adopting renal hilum vascular clamping)and VC group(performing LPN with adopting renal hilum vascular clamping).The time spent for operation,amount of intraoperative blood loss,and preoperative and postoperative renal functions were compared between the two groups.According to the warm ischemia time(WIT),the patients of the VC group were subdivided into WIT＜25 min subgroup and WIT≥25 min subgroup,and the preoperative and postoperative renal functions were compared between the two subgroups.Results A total of 59 patients with renal carcinoma were enrolled in this study,including 12 patients in SRAE group and 47 patients in VC group.In VC group,WIT＜25 min subgroup had 33 patients and WIT≥25 min subgroup had 14 patients.In both SRAE group and VC group,no patient was referred to open surgery or total nephrectomy.No patient in SRAE group was referred to traditional LPN.The time spent for operation in SRAE group and VC group was 100.50(73.75,132.50)min and 120.00(90.00,145.00)min respectively,the difference between the two groups was not statistically significant(P＞0.05).The postoperative estimated glomerular filtration rate(eGFR)in SRAE group was 100.56(82.85,106.81),which was remarkably higher than 84.66(70.84,94.85)in VC group(P＜0.05).The postoperative serum creatinine level in VC group was 90.50(77.10,104.90)μmol/L,which was strikingly higher than 72.24(65.97,80.27)μmol/L in SRAE group(P＜0.05).The amount of intraoperative blood loss in SRAE group was 50(50,50)mL,which was lower than 50(50,100)mL in VC group(P＜0.05).In VC group,the postoperative eGFR in WIT≥25 min subgroup was 66.13(47.08,82.50),which was lower than 90.80(77.18,98.78)in WIT＜25 min subgroup(P＜0.05).During the postoperative one-year follow-up,no recurrence was observed in both groups.Conclusion Compared with traditional LPN,SRAE-assisted LPN doesn't need to obstruct the renal hilus during surgery,which can avoid the ischemic impairment of the residual renal function and reduce the amount of intraoperative blood loss,moreover,it doesn't increase the operation time,doesn't increase the incidence of complications such as postoperative bleeding,etc.and doesn't affect the curative efficacy and patient's prognosis.

Objective To observe the drainage pathways of interstitial fluid(ISF)and substance clearance pattern in rat brain with fluorescence tracing imaging and treacer-based MRI.Methods Thirty-three male SD rats were randomly divided into fluorescence tracing group(F group,n=18)and treacer-based MRI group(MRI group,n=15),then further divided into thalamic,hippocampal and caudate nucleus subgroups,respectively.Evans blue was injected to rats in F group,and cardiac perfusion was performed after injection,then brain tissue was harvested,and frozen sections were made to observe the drainage pathways of IFS in different subgroups.MRI was performed on rats in MRI group before and after injection of gadolinium-diethylenetriamine pentaacetic acid(Gd-DTPA)to observe signal intensity in ROI of brain regions in different subgroups,the signal unit ratio was calculated,and the changing trend was explored.Results ISF in thalamus,hippocampus and caudate nucleus had different dominant drainage pathways,and the time of tracer reached to adjacent brain regions and whole brain in F group were different.In MRI group,within 4 h after injection of Gd-DTPA,there were differences in direction and clearance rate among tracer in thalamus,hippocampus and caudate nucleus,mainly manifesting as the tracer in thalamus and hippocampus drained to the ipsilateral cortex and lateral ventricle,while the tracer in the caudate nucleus diffused to the cortex and midbrain,and there were differences of the peak time of tracer signal among adjacent drainage brain regions.Conclusion Fluorescence and MR dual-mode imaging showed that there were differences in the dominant drainage pathways of IFS and clearance rates of small molecule substances among hypothalamus,hippocampus and caudate nucleus of rats.

Spinal cord injury, a severe injury of the central nervous system, shows high disability and mortality rate and seriously affects the patients′ quality of life. It is difficult to restore the spinal cord and achieve satisfactory neurological function improvement with various current treatments for spinal cord injury. Electric stimulation can accelerate axonal growth and myelination and promote nervous tissue repair and regeneration. Conductive hydrogels that can load electric stimulation have great potential in the treatment of spinal cord injuries. Under electric stimulation, different types of conductive hydrogels have different characteristics and can perform a variety of functions. However, clinicians still lack a comprehensive understanding of their application effects in repair of spinal cord injury. To this end, the authors reviewed the research progress on the role of electric stimulation as well as the characteristics and applications of different types of conductive hydrogels in repair of spinal cord injury to provide references for the synthesis and clinical transformation of conductive hydrogels for repair of spinal cord injury.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

Primary adrenal small cell neuroendocrine carcinoma is clinically rare. This article reported a patient, who was diagnosed as primary adrenal small cell neuroendocrine carcinoma complicated with renal vein cancer thrombus, and underwent laparoscopic left adrenal + left kidney + left renal vein tumor embolectomy.The carcinoma relapsed after 19 months of follow-up after surgery. The patient and his family refused further treatment.

Objective:To analyze the frequency and characteristics of polymyositis (PM) in idiopathic inflammatory myopathy (IIM), and to investigate whether PM is over-diagnosed.Methods:Patients diagnosed as IIM according to the Bohan & Peter criteria of IIM hospitalized in the Department of Rheumatology of China-Japan Friendship Hospital from 2008 to 2019 were involved in the study. Definite PM (dPM) was defined as typical clinical and pathological features including elevated creatine kinase (CK) level, muscle weakness and muscle biopsy findings with endomysial CD8 + T cell infiltration and expression of MHC-1 on sarcolemma. Meanwhile, dermatomyositis (DM), anti-synthase syndrome(ASS), immune-mediated necrotic myopathy(IMNM), sporadic inclusion body myositis(sIBM) and other myopathies were excluded according to the new classification criteria of IIM subtypes respectively. Statistical analysis was performed using SPSS software 24.0. The Kruskal-Wallis test and χ2 test were used to compare the clinical characteristics between the dPM group and other IIM subtypes. Results:A total of 1 259 patients with IIM including 1 015 (80.6%) DM and 244(19.4%) PM were enrolled in this study. According to the strict definition of PM criteria, only 0.5% of patients (6/1 259) in IIM could be diagnosed as dPM. Most PM patients were IMNM and ASS according to the new IIM subtypes criteria, of which 48.0% (117/244) were IMNM and 32.0% (78/244) were ASS. 66.7%(4/6) of dPM patients were women. One complicated with RA, and one was dPM overlaped with systemic sclerosis. All of them had muscle weakness, mild elevation of CK level [611(391,1 451) U/L], and were myositis-specific autoantibodies negative. Except one dPM patients who did not receive immunoregulatory therapy due to chronic obstructive pulmonary disease, the others were administrated with low or medium dose prednisone combined with or without immunosuppressive agents. After a median follow-up of (38±26) months, the muscle strength of dPM patients were improved.Conclusion:dPM is a very rare clinical subtype of IIM. PM is an over-diagnosed entity in clinical practice. Patients with dPM have mild symptoms and good outcome.

Objective:To systematically evaluate the efficacy and safety of precision thoracic radiotherapy (TRT) in the limited-stage small cell lung cancer (LS-SCLC) patients by network meta-analysis.Methods:Randomized controlled trials (RCTs) of TRT regimes in the LS-SCLC were electronically searched from PubMed, Web of Science, The Cochrane Library, CNKI and Wanfang Data from inception to September 1 st, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Statistical analysis was performed by Stata 17 and R 4.1.1 software. Results:A total of 6 RCTs involving 1730 patients with six radiation regimens including hyperfractionated radiotherapy (HFRT): HFRT 45(45 Gy/30 F) and HFRT 60(60 Gy/40 F); conventional fractionated radiotherapy (CFRT): CFRT 70(70 Gy/35 F) and CFRT 66(66 Gy/33 F); moderately hypofractionated radiotherapy (MHFRT): MHFRT 65(65 Gy/26 F) and MHFRT 42(42 Gy/15 F) were included. The network meta-analysis showed that: in terms of improving progression-free survival and overall survival, there was no statistically significant difference among the six radiotherapy regimens. The probabilistic ranking results were: MHFRT 65> HFRT 60>CFRT 66>CFRT 70>MHFRT 42>HFRT 45, and HFRT 60>MHFRT 65>CFRT 66>CFRT 70>HFRT 45>MHFRT 42, respectively. The HFRT 60 regimen was superior to other regimens in reducing the incidence of grade ≥3 pneumonia, and there was no difference between the regimens in causing grade ≥3 radiation esophagitis, and the results of ranking probability were: HFRT 60> MHFRT 42>CFRT 66>CFRT 70>HFRT 45>MHFRT 65, and HFRT 60>CFRT 70>CFRT 66>HFRT 45>MHFRT 42>MHFRT 65, respectively. Conclusions:HFRT 60 radiotherapy regimen may be more effective and safer in the treatment of LS-SCLC patients as a priority choice for LS-SCLC TRT. Limited by the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.

Ambystoma mexicanum/immunology* ; Amputation ; Animals ; Biomarkers/metabolism* ; Blastomeres/immunology* ; Cell Lineage/immunology* ; Connective Tissue Cells/immunology* ; Epithelial Cells/immunology* ; Forelimb ; Gene Expression ; High-Throughput Nucleotide Sequencing ; Humans ; Immunity ; Peroxiredoxins/immunology* ; Regeneration/immunology* ; Regenerative Medicine/methods* ; Single-Cell Analysis/methods*