【Objective】 To systematically evaluate the effects of various rehabilitation therapies, including hydrotherapy, rehabilitation robot, core stability training (CST), whole-body vibration training (WBV), repetitive transcranial magnetic stimulation (rTMS), sling exercise training (SET), task-oriented training (TOT) and virtual reality (VR), on motor dysfunction in children with spastic cerebral palsy, so as to provide a reference for the scientific selection of rehabilitation programs for children. 【Methods】 Randomized controlled trials (RCTs) of the 8 rehabilitation therapies in the treatment of motor dysfunction in children with spastic cerebral palsy were searched from various databases, including PubMed, The Cochrane Library, Web of Science, EmBase, CNKI, CBM, VIP, and WanFang Database, from database inception to December 2022. Two researchers independently conducted literature screening, data extraction, and literature quality evaluation. Network Meta-analysis was performed using ADDIS 1.16.6 software, and Stata 16.0 software was used for graphic representation. 【Results】 A total of 43 RCTs involving 2 722 children with spastic cerebral palsy were included in the analysis. The results of the network Meta-analysis indicated that WBV had the most significant effect in improving the GMFM-88 score (MD=18.56, 95%CI: 34.91 - 2.45, P<0.05). Rehabilitation robot had the most significant effect in improving dimensions D (MD=6.30, 95%CI: 8.44 - 4.41, P<0.05) and E (MD=10.03, 95%CI: 15.03 - 4.84, P<0.05) of the GMFM-88 score. Additionally, hydrotherapy showed the most significant effect in improving the BBS score (MD=11.24, 95%CI: 22.26 - 0.20, P<0.05). 【Conclusions】 For children with spastic cerebral palsy, WBV is the most effective rehabilitation therapy to improve gross motor function, rehabilitation robot is the most effective therapy for improving standing and walking function, and hydrotherapy is the most effective therapy for improving balance.

Aim To explore the effect of Danggui Shaoyao San on edema in rats with nephrotic syndrome and the underlying mechanism.Methods Rats were randomly divided into control group,model group,Danggui Shaoyao San group(17.2 g·kg-1·d-1),losartan group(30 mg·kg-1·d-1)and tolvaptan group(3 mg·kg-1·d-1).The rat model of nephrot-ic syndrome was established by tail vein injection of adriamycin.After four weeks of treatment,the levels of renal function and 24 h urinary protein were detected.The distribution of aquaporin 2(AQP2)and pS256-AQP2 in renal tissue was detected by immunohisto-chemistry.The levels of plasma arginine vasopressin(AVP)and angiotensin Ⅱ(Ang Ⅱ)were measured by radioimmunoassay.The expressions of renal AQP2,pS256-AQP2,angiotensin type 1 receptor(AT1R),arginine vasopressin receptor 2(V2R)protein and mRNA were measured by Western blot and RT-PCR,respectively.Results The three drugs could improve renal function,reduce proteinuria,decrease plasma AVP and Ang Ⅱ levels,and down-regulate AQP2 and pS256-AQP2 protein and mRNA expression in model rats.Danggui Shaoyao San and tolvaptan were more ef-fective than losartan in reducing plasma AVP levels.Conclusions Danggui Shaoyao San may regulate the expression of AQP2 by reducing the levels of AVP and Ang Ⅱ,and improve the edema of nephrotic syndrome rats.

Objective To evaluate the clinical application effect of fracture liaison service(FLS)mode after percutaneous vertebroplasty(PVP)/percutaneous kyphoplasty(PKP)for thoracolumbar fragility fracture.Methods A prospective study was conducted,and 762 patients with thoracolumbar fragility fracture who underwent PVP/PKP in the department of orthopedics in our hospital from January 2018 to May 2021 were included and divided into the control group(374 cases)and the observation group(388 cases)according to the random number table method.Patients in the control group received routine osteoporosis intervention,while the patients in the observation group implemented FLS through Blue Bull Medical Care or Chronic Health APP on the basis of the control group to systematically manage the osteoporosis treatment after discharge.The follow-up lasted for 12 months,and the 8-item Morisky medication adherence scale(MMAS-8)score,pain visual analogue scale(VAS)score,Oswestry disability index(ODI)score and Hamilton depression rating scale(HAMD)score at discharge,and 6 months and 12 months after discharge of the two groups were compared.The incidences of re-fracture and constipation 6 months and 12 months after discharge of the two groups were compared.The Cobb angle and bone mineral density T-value of injured vertebrae 6 months and 12 months after discharge of the two groups were compared.Results There was no statistically significant difference in the MMAS-8 score,VAS score,ODI score or HAMD score at discharge of patients between the two groups(P>0.05).The VAS score,ODI score and HAMD score 6 months and 12 months after discharge in the observation group were lower than those in the control group(P<0.05),the MMAS-8 score in the observation group was higher than that in the control group(P<0.05),and the incidences of re-fracture and constipation in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the Cobb angle of injured vertebrae 12 months after discharge of patients between the two groups(P>0.05).The bone mineral density T-value 12 months after discharge in the observation group was higher than that in the control group(P<0.05).Conclusion The FLS mode can significantly improve the medication compliance of patients,relieve pain,depression and constipation,improve bone mineral density,and significantly reduce the incidence of vertebral re-fracture in patients after vertebral augmentation surgery;however,it has no significant effect on the Cobb angle of injured vertebrae.

Objective:To investigate the predictive value of platelet/lymphocyte ratio (PLR) for conversion surgery in patients with small bowel obstruction treated with intestinal obstruction catheter. Methods:The clinical data of patients with intestinal obstruction treated by intestinal obstruction catheter in the 900TH Hospital of Joint Logistics Support the Force were retrospectively collected. Logistic regression analyses were performed to identify independent predictors of conversion surgery. Restricted cubic spline (RCS) curves assessed the dose-response relationship between PLR and conversion surgery. Receiver operating characteristic (ROC) curves assessed the validity of the predictive model. Results:A total of 73 patients with small bowel obstruction treated conservatively with intestinal obstruction catheter were included and 25 (34.2％) patients were referred for surgical intervention after poor outcome of conservative treatment. Multivariate logistic regression analysis showed that PLR was an independent predictor of conversion surgery (P=0.032). The RCS analysis showed a non-linear correlation between a progressively higher risk of conversion surgery as the PLR increased. The ROC curves show that the incorporation of PLR into the prediction model significantly enhances its predictive efficacy (All P<0.05). Conclusion:PLR was found to be significantly associated with conversion surgery in small bowel obstruction patients treated with intestinal obstruction catheter,with a non-linear correlation. Incorporating PLR into the prediction model can significantly enhance the predictive efficacy,thus providing reference value for clinicians' decision-making.

Objective:To evaluate the effectiveness of correcting breast ptosis using the rotational filling of an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision.Methods:A retrospective study was conducted on 34 female patients (68 breasts) with breast ptosis treated at the Department of Plastic Surgery at the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University from January 2016 to June 2023. The patients＇ ages ranged from 23 to 53 years, with an average of (37.4±7.9) years. All patients underwent correction of breast ptosis using an inferolaterally pedicled tongue-shaped parenchymal flap via a double periareolar incision. Pre-operative and post-operative measurements were taken to assess the corrective outcomes, including mammary base width (MBW), areola diameter (AD), nipple-to-nipple distance (NN), suprasternal notch-to-nipple distance (SSN-N), nipple-to-inframammary fold distance (N-IMF), and thoracic circumference at the nipple level (TN). Patients＇ satisfaction was assessed using the BREAST-questionnaire (BREAST-Q) module.Results:Postoperative first-stage wound healing was achieved in all 34 patients without complications such as hematoma, infection, or nipple necrosis. The follow-up period ranged from 6 to 60 months, with a median of 12 months. Early postoperative observations showed periareolar folds, which disappeared within 3 to 6 months in 31 cases, while mild periareolar folds, persisted for up to 12 months in 3 cases. Four patients reported reduced nipple sensation postoperatively. Measurements showed a statistically significant increase in TN and a reduction in NN, SSN-N, AD, N-IMF, and MBW compared to preoperative values (all P<0.001). BREAST-Q scores indicated significant improvements in satisfaction with breasts, psychosocial well-being and physical well-being, with preoperative scores of (21.6±8.9), (42.4±11.9) and (49.7±12.9) scores increasing to (82.3±8.5), (81.9±8.1) and (81.2±8.3) scores, respectively (all P<0.001). Conclusions:The double periareolar incision technique with rotational filling of an inferolaterally pedicled tongue-shaped glandular flap is a safe and effective method for correcting breast ptosis.

Isolated superior mesenteric artery dissection (ISMAD) has attracted more and more clinicians' attention in recent years. Patients onset of ISMAD often present with abdominal pain. The misdiagnosis or miss diagnosis is common because of the non-specific symptoms and signs, which even can endanger lives in serious cases. Imaging classification is of great significance for diagnosis and treatment of ISMAD. The Sakamoto classification and the Yun classification are two classical classified methods. However, with the further study of ISMAD, various new classifications emerge. Conservative treatment was once considered as the preferred. As the rapid development of endovascular therapy and the great progress of new devices, stenting therapy can significantly improve symptoms and achieve satisfactory long-term effects, and be even expected to become the preferred method for clinical therapy of ISMAD. However, the long-term effects of endovascular therapy still need a large number of follow-up data, and complications after stent implantation can't be ignored.
Humans ; Mesenteric Artery, Superior ; Treatment Outcome ; Tomography, X-Ray Computed ; Aortic Dissection/therapy* ; Stents ; Endovascular Procedures ; Retrospective Studies

Objective To evaluate the value of magnetic resonance imaging (MRI) in screening for prostate cancer. Methods A total of 120 patients with a confirmed diagnosis of prostate cancer were enrolled in Nanjing Municipal First Hospital from March 2020 to March 2023, and 100 age-matched health volunteers during the study period served as controls. All patients and healthy individuals received prostate MRI scanning, and apparent diffusion coefficient (ADC) was estimated. Post-surgical pathology was used as a gold standard to evaluate the sensitivity and specificity of MRI in screening for prostate cancer. The correlation between pathological staging and ADC values in prostate cancer patients was investigated using Spearman correlation analysis. Results The mean ADC values were (1.01 ± 0.15) × 10⁻³, (0.88 ± 0.21) × 10⁻³, (0.72 ± 0.11) × 10⁻³, and (0.59 ± 0.09) × 10⁻³ mm²/s, respectively, for stage A, B, C, and D prostate cancer patients, and the differences were significant (F = 38.99, P < 0.01).Pearson correlation analysis showed a significant negative correlation between pathological staging and ADC value (r = −0.81, P < 0.05). In addition, the sensitivity and specificity of MRI in prostate cancer screening were 92.50% and 91.00%, respectively. Conclusion MRI shows a high value in screening for prostate cancer, and the ADC value is of great significance for staging prostate cancer.

Background: and Purpose Intravenous tenecteplase (TNK) efficacy has not been well demonstrated in acute ischemic stroke (AIS) beyond 4.5 hours after onset. This study aimed to determine the effect of intravenous TNK for AIS within 4.5 to 24 hours of onset. Methods: In this pilot trial, eligible AIS patients with diffusion-weighted imaging (DWI)-fluid attenuated inversion recovery (FLAIR) mismatch were randomly allocated to intravenous TNK (0.25 mg/kg) or standard care within 4.5–24 hours of onset. The primary endpoint was excellent functional outcome at 90 days (modified Rankin Scale [mRS] score of 0–1). The primary safety endpoint was symptomatic intracranial hemorrhage (sICH). Results: Of the randomly assigned 80 patients, the primary endpoint occurred in 52.5% (21/40) of TNK group and 50.0% (20/40) of control group, with no significant difference (unadjusted odds ratio, 1.11; 95% confidence interval 0.46–2.66; P=0.82). More early neurological improvement occurred in TNK group than in control group (11 vs. 3, P=0.03), but no significant differences were found in other secondary endpoints, such as mRS 0–2 at 90 days, shift analysis of mRS at 90 days, and change in National Institutes of Health Stroke Scale score at 24 hours and 7 days. There were no cases of sICH in this trial; however, asymptomatic intracranial hemorrhage occurred in 3 of the 40 patients (7.5%) in the TNK group. Conclusion This phase 2, randomized, multicenter study suggests that intravenous TNK within 4.5–24 hours of onset may be safe and feasible in AIS patients with a DWI-FLAIR mismatch.

Abstract: Objective　To analyze the epidemiological characteristics of public health emergencies in Xishuangbanna Dai Autonomous Prefecture from 2012 to 2021, and to provide reference for formulating relevant prevention and control measures. Methods　The data of public health emergencies reported in Xishuangbanna from 2012 to 2021 were collected and analyzed through the China Disease Prevention and Control Information System. Results A total of 78 public health emergencies (including "Unrated" events) were reported in Xishuangbanna from 2012 to 2021. The highest 21 cases and the lowest 3 cases were reported every year. A total of 1 0374 cases were reported in 78 public health emergencies, involving a population of 1 703 049, with a morbidity of 609.14/100 000, 24 deaths, mortality of 1.41/100 000 and fatality rate of 231.35/100 000. The event level was mainly "general (level Ⅳ)" with 52 incidents, accounting for 66.67%, and 17 incidents of "major (level Ⅲ)", accounting for 21.79%. 51 cases were mainly infectious diseases, accounting for 65.39%. The peak periods for incidents were May-July and November-February of the next year; there were 39 incidents in schools, accounting for 50%, followed by 20 incidents in families, accounting for 25.64%. The top three reported cases were food poisoning (32.05%), chicken pox 17 (21.79%) and dengue fever 10 (12.82%). Among the 24 deaths in public health emergencies, 22 were caused by food poisoning. Wild bacteria poisoning and alcohol poisoning were the main causes of food poisoning, accounting for 45.83% and 37.5% of the total deaths, respectively. Conclusion Infectious diseases, especially respiratory diseases and food poisoning are the focus of the prevention and control of public health emergencies in Xishuangbanna Dai Autonomous Prefecture, of which Schools and families should be pay close attention. Plague, a Class A infectious disease, caused by the bacterium Yersinia pestis has occurred in two inter-animal outbreaks in 10 years and spread to the population, which should be of great concern.