ObjectiveTo observe clinical effectiveness and safety of lumbar oscillatory manipulation in the treatment of patients with lumbar disc herniation. MethodsThis study recruited 90 lumbar disc herniation patients who were randomly divided into 45 cases each in the treatment group and the control group. The treatment group was given lumbar oscillatory manipulation， while the control group was given traditional lumbar obliquely pulling manipulation， and both groups were treated twice a week for 4 weeks. The Oswestry dysfunction index （ODI） score， lumbar spine mobility， and the absolute values of difference in hardness between the left and right sides of the lumbar erector spinae muscle were compared between groups of patients before treatment and after 2 and 4 weeks of treatment； the shear wave elastic modulus of multifidus muscle and abdominal muscle thickness were compared between groups before treatment and after 4 weeks of treatment； the clinical effectiveness of the treatment was compared， and the safety evaluation was carried out. ResultsCompared with the group before treatment， the ODI scores and the the absolute values of difference in hardness between the left and right sides of the lumbar erector spinae muscle decreased after 2 and 4 weeks treatment in both groups， and the mobility of the lumbar vertebrae in all directions of anterior flexion， posterior extension， left lateral flexion， and right lateral flexion increased； the shear wave elastic modulus of bilateral multifidus muscles of the fourth lumbar vertebral segments decreased， and the thickness of abdominal muscle increased after 4 weeks of treatment in both groups （P＜0.05）. Compared with the control group， the ODI score of the treatment group decreased after 2 weeks of treatment， and the shear wave elastic modulus value of bilateral multifidus muscle of the fourth lumbar vertebral segment decreased and the thickness of abdominal muscle increased after 4 weeks of treatment （P＜0.05）. The total effective rate was 90.48% （38/42） in the treatment group and 71.43% （30/42） in the control group， and the clinical effectiveness of the treatment group was better than that of the control group （P＜0.05）. No adverse events occurred in both groups during the study. ConclusionLumbar oscillatory manipulation is superior to traditional lumbar obliquely pulling manipulation in relieving symptoms of lumbar disc herniation and improving lumbar spine function， which may be related to its improvement in the elasticity of the multifidus muscle.

ObjectiveTo investigate the association between estimated glucose disposal rate （eGDR） and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients （mean age： 62（53-68） years） who underwent coronary angiography for suspected coronary artery disease （53.9% were male）. Insulin resistance level （IR） was calculated according to eGDR formula： eGDR = 21.158 - （0.09 × WC） - （3.407 × hypertension） - （0.551 × HbA1c） ［hypertension （yes = 1 / no = 0）， HbA1c = HbA1c （%）］. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels： no-obstructive CAD group （all coronary stenosis were<50%， n=704）， Single-vessel CAD group （only one involved major coronary artery stenosis≥50%， n=205）， Multi-vessel CAD group （two or more involved major coronary arteries stenosis≥50%， n=349）； Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic （ROC） curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. In multivariate logistic regression models， individuals with the lowest quantile of eGDR （T1） were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR （T3） （OR： 2.79； 95%CI： 1.72~4.55； P<0.001）. Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD （P-nonlinear>0.05）. In non-diabetic patients， compared with the reference group （T3）， the T1 group had a significantly increased risk of CAD （OR： 1.42； 95% CI： 1.00~2.01； P<0.05） and multi-vessel CAD （OR： 1.86； 95%CI： 1.21~2.86； P<0.05）. No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis， when eGDR was added to traditional model for CAD， significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR， as a non-insulin measure to assess IR， could be a valuable indicator of CAD severity for population.

OBJECTIVE To investigate the effect mechanism of Gualou guizhi granule on neurological function and synaptic plasticity in rats with cerebral ischemia-reperfusion injury. METHODS The rats were randomly divided into sham operation group， model group and Gualou guizhi granule group （3.6 g/kg）， with 6 rats in each group. The cerebral ischemia-reperfusion injury model was established by the suture occlusion method. Two hours after modeling， the model rats were given relevant medicine or normal saline intragastrically， once a day， for 7 consecutive days. After the last medication， the neurological function of rats was evaluated [calculated by modified neurological severity scores （mNSS） and corner turning percentage]； the neuronal apoptosis rate of brain histiocyte in the ischemic side of rats was detected in each group； the positive expressions of growth associated protein 43 （GAP43） and microtubule associated protein 2 （MAP2） were detected； protein expressions of neuron-specific nuclear protein （NeuN）， synaptophysin-1 （Syn-1）， postsynaptic density protein-95 （PSD-95）， peroxisome proliferators-activated receptor γ （PPARγ）， brain-derived neurotrophic factor （BDNF） and tropomyosin receptor kinase B （TrkB）， as well as mRNA expressions of NeuN， Syn-1 and PSD-95 were detected. RESULTS Compared with the model group， mNSS， corner turning percentage and neuronal apoptotic rate were decreased significantly in Gualou guizhi granule group （P＜0.01）； GAP43 represented weak immunoreactivity， and MAP2 represented moderate immunoreactivity； protein expressions of NeuN， Syn-1， PSD-95， PPARγ， BDNF， TrkB and mRNA expressions of Syn-1， NeuN， PSD-95 were all increased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Gualou guizhi granule can promote synaptic plasticity by activating BDNF/TrkB signaling pathway， thus playing a protective role in cerebral ischemia-reperfusion injury in rats.

ObjectiveTo explore the impact of blood-invigorating and stasis-dissolving medicinals combined with conventional western medicine on the major adverse cardiovascular events （MACE） in patients with coronary heart disease （CHD） after percutaneous coronary intervention （PCI）. MethodsA prospective cohort study was conducted to collect data on consecutive cases of CHD after PCI. According to whether blood-invigorating and stasis-dissolving medicinals were used， the cases were divided into a Chinese herbal medicinals （CHM） group and control group. The primary outcome was the incidence of MACE one year after PCI， while the secondary outcomes included TCM syndrome score and echocardiography left ventricular ejection fraction （LVEF）. Logistic regression analysis was performed to explore the influencing factors of MACE. ResultsA total of 844 patients who met the criteria were included， with 617 in the CHM group and 227 in the control group. The main blood-invigorating and stasis-dissolving medicinals being used were Danshen （Radix et Rhizoma Salviae Miltiorrhizae， 46.35%）， Chuanxiong （Rhizoma Chuanxiong， 45.87%）， and Chishao （Radix Paeoniae Rubra， 42.30%）. After a median follow-up of 12.73 months， the incidence of MACE in the CHM group （142/617， 23.01%） was significantly lower than that in the control group （68/227， 29.96%） with significant difference （OR=0.70， 95%CI 0.50 to 0.98， P = 0.04）. The LVEF of the CHM group ［（60.06±6.13）%］ was higher than that of the control group ［（58.27±7.36）%］ with significant difference （t = 0.356， P＜0.01）. The TCM syndrome score in the CHM group decreased to 12.66±4.47， while that in the control group increased to 13.81±3.88， with the results favoring the CHM group （t = 2.78， P＜0.01）. Univariate analysis showed correlations between the incidence of MACE after PCI and the use of blood-invigorating and stasis-dissolving medicinals， LVEF， usage of renin-angiotensin-aldosterone system （RAAS） inhibitors， TCM syndrome score， and usage of β blockers （P＜0.05）. Multivariate analysis showed that the use of blood-invigorating and stasis-dissolving medicinals was significantly associated with the reduction of MACE （P＜0.01）， while the baseline LVEF decline， TCM syndrome score increase， no use of RAAS inhibitors or β blockers were the risk factors of MACE after PCI （P＜0.05）. ConclusionThe use of blood-invigorating and stasis-dissolving medicinals based on the conventional western medicine can reduce the risk of MACE one year after PCI of CHD， improve the TCM syndromes and protect heart function.

Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population. Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA). Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively). Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.

Objective:To understand the current status, hotspots and trends of hospice care education for nursing staff at home and abroad, so as to provide the reference for follow-up research.Methods:Literatures related to hospice care education for nursing staff were retrieved from China National Knowledge Infrastructure and Web of Science database from January 1, 2000 to October 8, 2023. EndNote21 was used for bibliometric analysis. CiteSpace6.2.R2 software was used to draw and interpret the knowledge map of keywords.Results:A total of 445 and 3 637 articles were included in China National Knowledge Infrastructure and Web of Science database. The number of publications was on the rise. A total of 11 clusters and 12 emerging keywords were obtained from China National Knowledge Infrastructure database. A total of 11 clusters and 25 emerging keywords were obtained from Web of Science database.Conclusions:The construction of standardized and homogeneous curriculum system and feedback evaluation system of hospice care education has been a research hotspot at home and abroad in recent years. For nurses with multi-level education, the use of multidisciplinary, multi-center, in-depth intervention research and evidence-based research to explore the hospice care education model in line with China′s national conditions is the development trend in the future.

Objective:To conduct a visual analysis of the related literature on hydrogel materials that promote wound healing, and to explore the research status, hotspots and future development trends in this field, in order to provide a reference for future research and development.Methods:The Web of Science Core Collection database was searched to obtain relevant literature on the promotion of wound healing by hydrogel materials from January 1, 2010 to October 1, 2023. Bibliometrics method were used to integrate the year, author, publication, number of national and institutional publications, cumulative citation and co-citation frequency and key words of the included literatures. VOSviewer 1.6.19 and CiteSpace 6.2.R4 were used for the literature’s visualization analysis and mapping.Results:A total of 3 863 literatures were included, involving 18 921 authors, and the number of publications in this field showed a significant increasing trend from 2010 to 2023. Zhao YJ, the researcher with the most publications, published 38 articles. There were 557 journals that had collected relevant literatures, and the International Journal of Biological Macromolecules had published the most literature, with a total of 286 publications. A total of 92 countries and 3 307 institutions had conducted research in related fields, with China publishing the most papers. Research institutions mainly come from China and the United States. The literature with the highest cumulative citation frequency was "Alginate: properties and biomedical applications", which reached 4 737 times. The highest cumulative co-citation frequency was the literature published by Qu J, et al in 2018, with a total of 404 times. Keyword co-occurrence, clustering, time line and emergence analysis showed that the early research in this field mainly focused on the process of wound healing and the cellular mechanism at the molecular level, and later gradually focused on the development of precise controlled release function of nanoparticles and antibacterial compounds in hydrogel scaffolds. Conclusion:Research on the application of hydrogel materials in wound healing is attracting increasing international attention. According to the changes of hot words, the future research trend in this field is to develop intelligent hydrogels with regulatory capabilities, wound monitoring, controlled drug delivery and diversified functions.

Objective:To conduct a visual analysis of the related literature on hydrogel materials that promote wound healing, and to explore the research status, hotspots and future development trends in this field, in order to provide a reference for future research and development.Methods:The Web of Science Core Collection database was searched to obtain relevant literature on the promotion of wound healing by hydrogel materials from January 1, 2010 to October 1, 2023. Bibliometrics method were used to integrate the year, author, publication, number of national and institutional publications, cumulative citation and co-citation frequency and key words of the included literatures. VOSviewer 1.6.19 and CiteSpace 6.2.R4 were used for the literature’s visualization analysis and mapping.Results:A total of 3 863 literatures were included, involving 18 921 authors, and the number of publications in this field showed a significant increasing trend from 2010 to 2023. Zhao YJ, the researcher with the most publications, published 38 articles. There were 557 journals that had collected relevant literatures, and the International Journal of Biological Macromolecules had published the most literature, with a total of 286 publications. A total of 92 countries and 3 307 institutions had conducted research in related fields, with China publishing the most papers. Research institutions mainly come from China and the United States. The literature with the highest cumulative citation frequency was "Alginate: properties and biomedical applications", which reached 4 737 times. The highest cumulative co-citation frequency was the literature published by Qu J, et al in 2018, with a total of 404 times. Keyword co-occurrence, clustering, time line and emergence analysis showed that the early research in this field mainly focused on the process of wound healing and the cellular mechanism at the molecular level, and later gradually focused on the development of precise controlled release function of nanoparticles and antibacterial compounds in hydrogel scaffolds. Conclusion:Research on the application of hydrogel materials in wound healing is attracting increasing international attention. According to the changes of hot words, the future research trend in this field is to develop intelligent hydrogels with regulatory capabilities, wound monitoring, controlled drug delivery and diversified functions.

Objective To study the efficiency and influencing factors of medical resource allocation in 30 provinces and cities of China.Methods Evaluating the efficiency of medical resource allocation in three regions in Chinese mainland,including 30 provincial administrative regions from 2009 to 2021 using the three-stage DEA-Tobit model.Results After excluding environmental factors,the mean value of the technical efficiency of medical resource allocation in China showed a slight downward trend.Per capita GDP and population density had a generally positive effect on the adjusted efficiency of medical resource allocation.In the eastern and central regions,the per capita GDP had consistent coefficients of 0.09 for the efficiency of medical resource allocation.Conclusion In regions of China where medical resources are relatively abundant,the allocation efficiency is relatively low,such as in Beijing and Tianjin.Conversely,the allocation efficiency is relatively higher in areas where medical resources are less abundant.

Objective To develop a Chinese specialist consensus based on the latest evidences,aim-ing to provide objective and scientific guidance regarding the anterior cruciate ligament(ACL)recon-struction using the new-generation artificial ligaments(NGAL).Methods The consensus was found using the modified Delphi method,including two rounds of online expert consultation and one face-to-face meeting.The experts selected were thirty-one sports medicine specialists from the Chinese Society of Sports Medicine and the Chinese Association of Orthopaedic Surgeons,working on university teaching hospitals across 16 provinces and municipalities.On the average,they had 25 years of practice experi-ence,with 17 years in knee surgery and 13 years in ACL reconstruction.Among them,58.1%had performed over 100 ACL surgeries,and 90.3%had published at least one related paper.The draft came into being according to the latest evidence and was converted into a questionnaireusing the Sprague method.The second draft was compiled after two-round online surveys and discussed in a face-to-face meeting.Consensus items were discussed,modified,and voted on during the face-to-face meeting,with consensus reached when the agreement rate was no less than 85%.Results Twenty-six specialists completed the two rounds of questionnaire surveys and attended the face-to-face meeting.Consensus was reached on 5 items with an agreement rate of 100%,while 1 item did not achieve con-sensus with the agreement rate of 19.2%.Conclusion Compared to autografts and allografts,ACL recon-struction with NGAL can achieve faster rehabilitation and quicker recovery,as well as significantly bet-ter joint stability and early functional recovery in the short and mediumterm.After standardized rehabili-tation training,patients typically return to sport within 5 months postoperatively.Therefore,ACL recon-struction with NGAL lays foundation for faster postoperative recovery and is a valuable option for pa-tients seeking early return to sport.