BACKGROUND:The study of the lumbar spine and pelvis in patients with Lenke type 5 lordosis is limited to the coronal and sagittal planes,and the three-dimensional relationship between the scoliosis and the pelvis has not yet been clarified. OBJECTIVE:To analyze the effect of lumbar scoliosis on the pelvis in patients with Lenke type 5 lordosis and to study the correlation between the lumbar spine and the three-dimensional spatial position of the pelvis. METHODS:Imaging data of 60 patients with Lenke type 5 lordosis scoliosis admitted to the 3D Printing Reception Center of Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to September 2023 were retrospectively analyzed,including Cobb angle,coronal pelvic tilt,lumbar lordosis,left and right pelvic hip width ratio(sacroiliac-anterior superior iliac spine),spinal rotation angle,pelvic tilt,sacral slope,pelvic incidence,coronal deformity angular ratio,sagittal deformity angular ratio,C7 plumb line-center sacral vertical line,apical vertebral translation,and coronal sacral inclination.The information was summarized as a database.SPSS 22.0 software was used to analyze the data related to the lumbar spine and pelvis of the patients with Lenke type 5 primary lumbar curvature adolescent idiopathic scoliosis using Spearman's correlation analysis and linear regression. RESULTS AND CONCLUSION:(1)Cobb angle was highly positively correlated with coronal deformity angular ratio,apical vertebral translation,and spinal rotation angle(r=0.91,r=0.841,r=0.736).(2)Coronal deformity angular ratio was highly positively correlated with apical vertebral translation(r=0.737),moderately positively correlated with C7 plumb line-center sacral vertical line(r=0.514),and moderately negatively correlated with sagittal deformity angular ratio(r=-0.595).(3)There was a high positive correlation between lumbar lordosis and sagittal deformity angular ratio(r=0.942)and a moderate negative correlation with coronal deformity angular ratio(r=-0.554).(4)There was a moderate positive correlation between Cobb angle with coronal pelvic tilt and coronal sacral inclination(r=0.522,r=0.534)and a moderate positive correlation between C7 plumb line-center sacral vertical line and coronal pelvic tilt(r=0.507).Apical vertebral translation with coronal pelvic tilt and coronal sacral inclination showed a moderate positive correlation(r=0.507,r=0.506).Lumbar lordosis with sacral slope and pelvic incidence showed a moderate positive correlation(r=0.512,r=0.538).Sagittal deformity angular ratio was moderately positively correlated with sacral slope and pelvic incidence(r=0.614,r=0.621).(5)Studies have found that the relative position of the lumbar spine and the pelvis is closely related in the horizontal,sagittal and coronal planes.When the lumbar spine affects scoliosis and is rotated,the relative position of the pelvis will also change to compensate,which indicates that while correcting scoliosis,the correction of the pelvis cannot be ignored.

Objective:To investigate the clinical significance and possible mechanisms of elevated homocysteine(Hcy) levels in peripheral blood of children with sepsis.Methods:The clinical data of 51 children with sepsis (sepsis group) admitted to PICU at Xuzhou Children′s Hospital from January 2019 to December 2019 were analyzed, and the levels of Hcy in plasma were compared with 50 non-septic children (common infection group) and 50 healthy children (healthy control group) during the same period.The possible mechanism of metabolic disorders about Hcy was analyzed by detecting the levels of the key rate-limiting enzymes cystathionine-β-synthase(CBS) and cystathionine-γ-lyase(CSE), which were in the downstream of metabolism in septic mouse model induced by lipopolysaccharide.Results:The level of Hcy in plasma was (12.62±5.46)μmol/L in sepsis group, which was significantly higher than those in common infection group[(9.42±2.28) μmol/L] and healthy control group[(8.14±1.60) μmol/L]( P<0.05). The level of Hcy in plasma of 12 children with acute kidney injury in sepsis group was significantly higher than that of 39 children without acute kidney injury in sepsis group[(16.48±5.87)μmol/L vs.(11.62±4.74) μmol/L, P<0.05]. The level of Hcy in plasma of six children with acute liver failure in sepsis group was significant higher than that of 45 children without acute liver failure in sepsis group[(18.35±7.10) μmol/L vs.(11.84±4.78) μmol/L, P<0.05]. The level of Hcy in serum significantly increased in septic mouse models ( P<0.01). The transcription and protein expression levels of key rate-limiting Hcy transcription enzymes CBS and CSE in liver and kidney tissues of septic mouse were significantly down-regulated ( P<0.05). Conclusion:The level of Hcy in peripheral blood of children with sepsis increases, which is more obviously in children with acute kidney injury or acute liver injury.When patients developed sepsis, the expression of CBS and CSE will be restrained, leading to disorders related to transsulfuration metabolism and elevated level of Hcy in peripheral blood.

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Humans ; Consensus ; Prone Position ; Wakefulness ; China ; Dyspnea

As a group of nonspecific inflammatory diseases affecting the intestine, inflammatory bowel disease (IBD) exhibits the characteristics of chronic recurring inflammation, and was proven to be increasing in incidence (Kaplan, 2015). IBD induced by genetic background, environmental changes, immune functions, microbial composition, and toxin exposures (Sasson et al., 2021) primarily includes ulcerative colitis (UC) and Crohn's disease (CD) with complicated clinical symptoms featured by abdominal pain, diarrhea, and even blood in stools (Fan et al., 2021; Huang et al., 2021). UC is mainly limited to the rectum and the colon, while CD usually impacts the terminal ileum and colon in a discontinuous manner (Ordás et al., 2012; Panés and Rimola, 2017). In recent years, many studies have suggested the lack of effective measures in the diagnosis and treatment of IBD, prompting an urgent need for new strategies to understand the mechanisms of and offer promising therapies for IBD.
Chronic Disease ; Colitis, Ulcerative/therapy* ; Crohn Disease/epidemiology* ; Diarrhea ; Homeodomain Proteins ; Humans ; Inflammatory Bowel Diseases ; Mesenchymal Stem Cells/cytology* ; MicroRNAs ; RNA, Long Noncoding ; Recurrence ; Umbilical Cord/cytology*

Huaihuasan， first recorded in Puji Benshifang by XU Shu-wei from the Southern Song dynasty， consists of four herbs， namely Sophorae Flos （fried）， Platycladi Cacumen （smashed with pestle and baked）， Schizonepetae Spica， and Aurantii Fructus （cut into pieces after the removal of pulp and then fried yellow with wheat bran）. At present， Huaihuasan and its modified formulas vary in clinical usages and dosages， and the resulting outcomes have been investigated. However， there are few reviews uncovering its historical evolution. On this basis， this review systematically combed and verified the historical evolution， dose conversion between ancient and modern times， efficacy， and indications of Huaihuasan， as well as the origin and processing of the contained herbs. The findings have demonstrated that Huaihuasan is composed of four herbs， with the original plants and medicinal parts basically the same as those recorded in the 2020 edition of Chinese Pharmacopoeia. Sophorae Flos refers to the dried flower and bud of Sophora japonica in family Leguminosae， Platycladi Cacumen the dried branch and leaf of Platycladus orientalis in family Cupressaceae， Schizonepetae Spica the dried flower spike of Schizonepeta tenuifolia in family Labiatae， and Aurantii Fructus the dried immature fruit of Citrus aurantium in family Rutaceae or its cultivated varieties. On account of the efficacy in clearing intestine， stopping bleeding， dispersing wind， and moving Qi， Huaihuasan has been mainly used to treat intestinal diseases such as bloody defecation and perianal abscess. In modern clinical practice， it is mainly applicable to patients with hematochezia and bleeding due to internal hemorrhoid， ulcerative colitis， or anal fissure. It was suggested that the raw medicinal materials should be decocted and processed according to the methods described in the 2020 edition of Chinese Pharmacopoeia. Following the conversion formula of one Qian=4 g， this paper determined the dosages of Sophorae Flos （fried）， Platycladi Cacumen （smashed with pestle and baked）， Schizonepetae Spica， and Aurantii Fructus （cut into pieces after the removal of pulp and then fried yellow with wheat bran） all to be 2 g， with the total dosage being 8 g. Such comprehensive analysis based on ancient books and modern literature has provided a more scientific reference for the clinical application， research， and development of this classical formula.

Objective:To describe a systematic approach on identification of poisonous mushroom by investigating two cases of Omphalotus guepiniformis poisoning in Jianyang district, Nanping, Fujian province. Methods:Two incidents of food poisoning on 10 migrant workers were investigated. The remaining suspected mushroom samples were collected and the same fresh mushroom specimens were also collected in the following field investigations from the same dead tree and fallen trunk. These mushroom specimens were identified based on morphological and phylogenetic analyses.Results:On November 24 and 26, 2018, 8 and 2 migrant workers from Jianyang District, Nanping ate wild mushrooms and developed acute nausea, vomiting, abdominal pain and other symptoms within 10 to 90 min after consumption. They were diagnosed as mushroom poisoning, with gastroenteritis as the main manifestation. Further analysis showed that the more poisonous mushroom were consumed, the shorter latency and longer duration of nausea and vomiting were resulted. After admission, gastric lavage, catharsis, acid preparation, gastric protection, fluid replenishment and other symptomatic support treatments were given in time, all patients were discharged in 1-3 d. Based on morphological and phylogenetic analyses, the samples were identified as O. guepiniformis. Conclusions:The two incidents were caused by accidental consumption of O. guepiniformis. Awareness education about poisonous mushroom should be provided to migrant workers to prevent more such poisoning incidents in the future.

Objective: To elucidate the effect of sulfur fumigation on the content of chemical composition and quality of Panacis Quinquefolii Radix, and to discuss the identification method of sulfur fumigated Panacis Quinquefolii Radix. Method: The content changes of ginsenoside Rb₁, Re, Rg₁ in Panacis Quinquefolii Radix were determined by HPLC-DAD before and after sulfur fumigation. The content changes of 11 inorganic elements in Panacis Quinquefolii Radix before and after sulfur fumigation were detected by microwave digestion method and inductively coupled plasma emission spectrometry tandem mass spectrometry (ICP-MS). The quality difference of Panacis Quinquefolii Radix before and after sulfur fumigation was qualitatively distinguished combined with the principal component analysis. Result: Three ginsenosides were well separated and showed good linearity with R² ≥ 0.999.Before sulfur fumigation, the contents of ginsenoside Rg₁, Re and Rb₁ in Panacis Quinquefolii Radix were (0.897±0.045), (13.092±0.639), (12.896±0.430) g ·kg^-1, respectively. After sulfur fumigation, the contents of these three components in Panacis Quinquefolii Radix were (0.807±0.032), (11.968±0.627), (11.752±0.696) g ·kg^-1, respectively. After fumigation, the contents of inorganic elements (Cr, Mn, Co, Cu, As, Se, Ag, Cd, Sb, Pb and Fe) from Panacis Quinquefolii Radix increased in varying degrees. According to the distribution results of three-dimensional (3D) scattered points, sulfur and non-sulfur fumigation products of Panacis Quinquefolii Radix could be effectively distinguished. Conclusion: After sulfur fumigation, the contents of ginsenoside Re and Rb₁ in Panacis Quinquefolii Radix decrease significantly, but the contents of 11 inorganic elements increase, suggesting that sulfur fumigation may have a great influence on the quality of Panacis Quinquefolii Radix.

Objective To understand the detection rate of hashimoto's thyroiditis (HT) and the occurrence of abnormal thyroid function in medical examination population in Huanghua City,Hebei Province.Methods Using the retrospective analysis method,the thyroid examination data of residents of Huanghua City who were examined in the Cangzhou Hospital of Traditional Chinese and Western Medicine in Hebei Province from 2014 to 2016 were collected,the detection rate of HT and the occurrence of abnormal thyroid function were analyzed.Results A total of 4 413 people were examined,aged (45.76 ± 10.13) years old;including 2 099 males and 2 314 females.The HT detection rate of the medical examination population in Huanghua City was 6.55％ (289/4 413),and there was a trend of increasing year by year (x2trend =7.126,P ＜ 0.05).The difference in HT detection rates between different genders (male:2.86％,famale:9.90％) was statistically significant (x2 =89.077,P ＜ 0.05);there was a statistically significant difference in the HT detection rates among women of different age groups (x2 =18.541,P ＜ 0.05),and there was no significant difference in the detection rates of HT among men of different age groups (x2 =8.424,P ＞ 0.05).The incidence of abnormal thyroid function in HT patients was 25.61％ (74/289),of which the highest detection rate was 34.74％ (33/95) in the 40-＜ 50 years old group;the detection rates of HT with hyperthyroidism,hypothyroidism and subclinical hypothyroidism were 3.11％ (9/289),6.57％ (19/289) and 15.92％ (46/289),respectively.The detection rate of HT with subclinical hypothyroidism was higher.Conclusions The HT detection rate of the population in Huanghua City has increased year by year,and some HT patients are associated with abnormal thyroid function,and their detection rate of HT with subclinical hypothyroidism is the highest.Early diagnosis of HT should be strengthened,and appropriate prevention and treatment measures should be taken in time to reduce the occurrence of HT with abnormal thyroid function.

To explore the safety and efficacy for radiofrequency ablation of paroxysmal supraventricular tachycardia (PSVT) guided by Carto Univu three-dimensional mapping system.
 Methods: A total of 99 patients with PSVT underwent radiofrequency catheter ablation (RFCA) were assigned to a Carto Univu group (51 patients) and a two-dimensional X-ray group (48 patients) according to the mapping method. The operation time, X-ray exposure time, X-ray exposure dose, dose area product (DAP), operation success rate and complication rate were compared between the two groups.
 Results: The Carto Univu group and the two-dimensional X-ray group were not significant difference in the operation time, the X-ray exposure time of placing catheter, the X-ray DAP of placing catheter, the number of discharge, the discharge power, and the total discharge time (P>0.05). The mapping and ablation time, total exposure time, mapping and ablation DAP and total DAP in the Carto Univu group were significantly lower than those in the two-dimensional X-ray group (P<0.01). In the right accessory pathway cases, the mapping and ablation DAP and the total DAP in the Carto Univu group decreased compared with X-ray group (P<0.05), but it decreased more profound (P<0.01) in the left accessory pathway cases and the dual atrioventricular nodal pathways cases. Seven cases in the Carto Univu group achieved "zero X-ray", including 5 cases of the dual atrioventricular nodal pathways and 2 cases of the left accessory pathway. The immediate success rate for the two groups was 100%. After 3-12 months of follow-up, there was no recurrence in the Carto Univu group but 3 suspected recurrences in the two-dimensional X-ray group. In addition, no complications occurred in the two groups. 
 Conclusion: Carto Univu electroanatomic mapping system can guide PSVT safely and effectively during radiofrequency ablation and reduce radiation exposure to both doctors and patients. It is especially suitable for dual atrioventricular nodal pathways, which may even achieve "zero X-ray". Perhaps Carto Univu will be the first choice for RFCA of dual atrioventricular nodal pathways.
Catheter Ablation ; instrumentation ; methods ; Humans ; Imaging, Three-Dimensional ; instrumentation ; methods ; Operative Time ; Radiation Exposure ; prevention & control ; statistics & numerical data ; Radiography ; statistics & numerical data ; Recurrence ; Tachycardia, Supraventricular ; diagnostic imaging ; surgery ; Treatment Outcome

Objective:To investigate the correlation between positive rate of thyroid autoantibodies in healthy people and thy -roid dysfunction.Methods:Fasting blood from 3218 healthy examined people in Cangzhou were collected and the serum was separa -ted.Automatic electrochemiluminescence immunoassay systems and reagents were used to determine the concentration of thyroid stimu -lating hormone(TSH),free triiodothyroninthyroid(FT3),free thyroxine(FT4),peroxidase antibody(TPOAb)and thyroglobulin antibody ( TgAb ) .TPOAb>34 U/ml and TgAb>115 U/ml was positives.Statistical analysis of test results .statistica analysis of test reults.Results:The positive rate of thyroid autoantibodies of tested population was 16.19%.The positive rates of TPOAb and TgAb were 14.57%,12.74%separately.The detection rate of TPOAb and TgAb was 11.12%in tested population.The positive rate of TPO-Ab and TgAb and TPOAb+TgAb were 6.92%,5.68%,5.03%separately in 1532 male subjects and were 21.53%,19.16 ,16.67%separately in 1686 female subjects,which were significantly higher in female group than that in male group (P<0.001).They gradually increased with age and reached a peak above 70 years old in female group and in 50-59 in male group.The positive rate and OR of thy-roid autoantibodies in hyperthyroidism and subclinical hyperthyroidism and in hypothyroidism and subclinical hypothyroidism and in hy -pothyroidism and subclinical hypothyroidism were statistically significant .Conclusion:The positive incidence of thyroid autoantibodies is higher in healthy people of Cangzhou .It is essential to follow-up these people of normal thyroid function with positive autoantibodies in order to facilitate prevention and early diagnosis and treatment of thyroid disease .