Effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures

Objective:To study the effect of mid-frequency pulse therapy combined with external fixation on bone metabolism, inflammatory response and oxidative stress in patients with osteoporotic distal radial fractures.Methods: A total of 72 patients with osteoporotic distal radial fractures who were treated in the hospital between September 2015 and January 2017 were collected and divided into control group (n=36) and observation group (n=36) according to the random number table method. Control group received routine external fixation, and observation group received mid-frequency pulse therapy combined with external fixation. The differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of bone metabolism indexes, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups. After 1 month of treatment, serum BGP, TAC and SOD levels of both groups of patients were higher than those before treatment whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those before treatment, and serum BGP, TAC and SOD levels of observation group were higher than those of control group whileβ-CTX, AKP, TRAP, CRP, IL-1β, IL-6 and MDA levels were lower than those of control group.Conclusion: Mid-frequency pulse therapy combined with external fixation can promote fracture healing and reduce postoperative inflammatory response and oxidative stress response in patients with osteoporotic distal radial fracture.

Current therapies and novel approaches for biliary diseases

Chronic liver diseases that inevitably lead to hepatic fibrosis, cirrhosis and/or hepatocellular carcinoma have become a major cause of illness and death worldwide. Among them, cholangiopathies or cholestatic liver diseases comprise a large group of conditions in which injury is primarily focused on the biliary system. These include congenital diseases(such as biliary atresia and cystic fibrosis), acquired diseases(such as primary sclerosing cholangitis and primary biliary cirrhosis), and those that arise from secondary damage to the biliary tree from obstruction, cholangitis or ischaemia. These conditions are associated with a specific pattern of chronic liver injury centered on damaged bile ducts that drive the development of peribiliary fibrosis and, ultimately, biliary cirrhosis and liver failure. For most, there is no established medical therapy and, hence, these diseases remain one of the most important indications for liver transplantation.As a result, there is a major need to develop new therapies that can prevent the development of chronic biliary injury and fibrosis. This mini-review briefly discusses the pathophysiology of liver fibrosis and its progression to cirrhosis.We make a special emphasis on biliary fibrosis and current therapeutic options,such as angiotensin converting enzyme-2(known as ACE2) over-expression in the diseased liver as a novel potential therapy to treat this condition.

Current evidence of drug-elution therapy for infrapopliteal arterial disease

New and sophisticated endovascular devices, such as drug-eluting stents(DES)and drug-coated balloons(DCB), provide targeted drug delivery to affected vessels. The invention of these devices has made it possible to address the reparative cascade of arterial wall injury following balloon angioplasty that results in restenosis. DESs were first used for the treatment of infrapopliteal lesions almost 20 years ago. More recently, however, DCB technology is being investigated to improve outcomes of endovascular below-the-knee arterial procedures, avoiding the need for a metallic scaffold. Today, level IA evidence supports the use of infrapopliteal DES for short to medium length lesions,although robust evidence that justifies the use of DCBs in this anatomical area is missing. This review summarizes and discusses all available data on infrapopliteal drug-elution devices and highlights the most promising future perspectives.

Analysis of Interferential Current Therapy-Induced Skin Changes in Healthy Korean Men

We examined the changes in numerous skin conditions before and after the ap-plication of interferential current therapy to various regions of healthy male bodies. In this study, we assessed the differences in the skin’s sebum, moisture levels, pores, wrinkles, pigmentation, and elasticity on the shoulders, lower back, and the knees of Korean males in their 20s. A total of 30 healthy males were in-cluded in the study. We used a skin diagnosis meter as a device for measuring the state of the skin. A statistical difference was found when comparing the pre- and post-measurement values in regards to the moisture levels, wrinkles, and pig-mentation. In the correlation analysis results, the sebum and pigmentation, moisture levels and wrinkles, moisture levels and pigmentation, and moisture levels and elasticity were all positively correlated, respectively. The results of this study partially suggest that a change in skin condition is associated with ex-ternal stimulation. The study also found that the effects of the application of in-terferential current therapy on the various skin conditions may differ depending on the region of the body that the application is conducted as well.

Reversibility of visual field defects through induction of brain plasticity: vision restoration, recovery and rehabilitation using alternating current stimulation

For decades visual field defects were considered irreversible because it was thought that in the visual system the regeneration potential of the neuronal tissues is low.Nevertheless,there is always some potential for partial recovery of the visual field defect that can be achieved through induction of neuroplasticity.Neuroplasticity refers to the ability of the brain to change its own functional architecture by modulating synaptic efficacy.It is maintained throughout life and just as neurological rehabilitation can improve motor coordination,visual field defects in glaucoma,diabetic retinopathy or optic neuropathy can be improved by inducing neuroplasticity.In ophthalmology many new treatment paradigms have been tested that can induce neuroplastic changes,including non-invasive alternating current stimulation.Treatment with alternating current stimulation(e.g.,30 minutes,daily for 10 days using transorbital electrodes and^10 Hz)activates the entire retina and parts of the brain.Electroencephalography and functional magnetic resonance imaging studies revealed local activation of the visual cortex,global reorganization of functional brain networks,and enhanced blood flow,which together activate neurons and their networks.The future of low vision is optimistic because vision loss is indeed,partially reversible.

Design and performance study of a dielectric-filled cavity beam current monitor for HUST-PTF

To guarantee the exact proton dose applied to patients and ensure treatment safety while disrupting and destroying tumor cells,it is essential to accurately monitor the proton beam current in real time during patient treatment.Because clinical treatment requires a proton beam current in the∼nA range,nondestructive beam current monitors(BCMs)are preferred to minimize the degradation of beam quality.However,this poses significant challenges in accurately monitoring such extremely low beam intensities.This study proposes a cavity-type BCM equipped with a dielectric plate to reduce its dimensions and achieve sufficient measurement sensitivity for practical requirements.A prototype cavity BCM was fabricated,and off-line testing was performed using a metal wire to simulate the beam to study its performance.Both the simulation and experi-mental results showed that the cavity BCM could measure ultralow proton beam currents with a resolution up to 0.03 nA.

Clinical evidence of neoadjuvant immunotherapy for resectable locally advanced esophageal carcinoma:A systematic review

Background:Immune checkpoint inhibitors(ICIs)as the neoadjuvant therapy for resectable locally advanced esophageal carcinoma(rlaEC)remains challenging given the poor reports of efficacy and safety.This study aimed to summarize reliable evidence for the preoperative neoadjuvant immunotherapy of rlaEc by analyzing all the published clinical trials on the ICIs as the neoadjuvant therapy for rlaEC.Methods:PubMed,Cochrane Library,Embase and ClinicalTrials.gov were searched from inception until June 1st,2023,for available reports to perform a meta-analysis.The primary endpoints were RO resection,objective response rate(ORR),pathological complete response(pCR)and major pathological response(MPR),as well as treatment-related adverse events(AEs)and postoperative complications.The Stata 14.0 software was employed to estimate pooled effect size.Results:A total of 18 single-arm clinical trials involving 625 patients met the inclusion criteria.Meta-analysis showed that,among these patients with rlaEC,the pooled R0 resection rate was 97.0%(95%CI:94.0%-99.0%),the p0oled ORR was 70.0%(95%CI:64.0%-76.0%),the p0oled pCR and MPR rate were 34.0%(95%CI:29.0%-39.0%)and 56.0%(95%CI:47.0%-65.0%)respectively.The incidence of main treatment-related AEs and postoperative complications was about 6%-45% and 8%-19% respectively.Conclusions:Patients with rlaEC were tolerated to neoadjuvant immunotherapy and it might be beneficial to improve efficacy.But this meta-analysis had limitations and the conclusions still needed to be validated by more rigorous phase II randomized controlled clinical trials.

A Control System Design to Establish Dose-Response Relationships in Wound Healing Therapy

Advanced biophysical wound healing therapies can apply mechanical, electrical, or light energy to re-stimulate healing processes in chronic wounds. Despite the growing evidence of the clinical efficacy of these therapies, the optimal treatment stimulation parameters remain unknown and there are no standard treatment protocols. We introduce a closed-loop control design as an experimental system to study the dose-response of wound healing therapy treatment within a prescribed multidimensional and multimodal stimulation parameter space. Systems engineering approaches are applied to the control problem for estimation of a transfer function and model equations derived for use in optimal model-based control. The experimental control system design consisted of simultaneous application of biophysical energies inputted into a wound system. A study design set up including the use of negative pressure wound therapy, electrical stimulation therapy, and photobiomodulation device systems was described. Treatment stimulation parameters were selected from experimental ranges used in the scientific literature. Classical control methods and model-based control were suggested for model selection and evaluation and design of the overall control system. An experimental design for multimodal biophysical wound healing therapy control system is introduced to establish the dose-response interactions for development of therapeutic applications and device design.

Review of Dietary Therapy Development in Ming and Qing Dynasties

In the Ming and Qing Dynasties,with the development of politics,economy and culture,the development of health maintenance of traditional Chinese medicine entered a heyday.Food therapy is an important part of the health theory of traditional Chinese medicine.In the 5,000 years of Chinese civilization,you can see the record of food therapy everywhere.It can be said that food therapy of traditional Chinese medicine develops together with traditional Chinese medicine.As a treasure in the treasure-house of Chinese medicine,food therapy has a long history and rich practice.Based on the current research,further research on relevant theories remains to be carried out.Focusing on the historical period of Ming and Qing dynasties,this paper takes the works related to food,nutrition and therapy(including general works and monographs on diet),the health thoughts and practice characteristics of representative health practitioners as the research perspective,and sorts out the above research contents in the past 20 years,analyzes the research overview and trend.It is found that in the study of food nourishing in Ming and Qing dynasties,there are few studies on the contents of diet nourishing in the general works.This suggests that when we study the development of diet nourishing in Ming and Qing Dynasties,we should not only study the monograph of diet nourishing and the thoughts of doctors,but also pay attention to the diet nourishing thought reflected in the general works.The study of diet monographs in Ming Dynasty mainly focused on the textual research of wild plants,and the study of diet monographs in Qing Dynasty mainly focused on the application.The study on the health care thought of doctors in Ming and Qing Dynasties mainly focused on the views of food nourishing and personal health care.These studies are summarized in order to provide reference for further theoretical research and provide reference for contemporary research on food nourishing diet.

我国医疗机构输血科开展输血治疗的现状调查报告

目的本调查研究旨在了解国内医疗机构输血科开展输血治疗的现状,探讨输血科开展输血治疗的发展方向。方法通过线上问卷调研法面向全国医疗机构输血科人员发放自行设计的调查问卷,对输血科开展输血治疗的情况进行调查分析。结果本次调查最终回收有效问卷482份,其中325份问卷的医疗机构输血科已经开展了输血治疗的业务,占比68.0%。开展输血治疗5年以上的输血科有186家(57.2%)。开展输血治疗的项目种类共计24种,其中开展单位数量较多的前三位治疗项目是自体全血采集(223,68.6%)、自体富血小板血浆采集(180,55.4%)和离心式血浆置换(125,38.5%)。50.5%的医疗机构输血科年均治疗量少于50人次,7.1%的医疗机构输血科年均治疗量超过1000人次。从事输血治疗的人员包括医师、技师和护士,其中医技组合占比最高为34.2%,医护组合占比仅为7.7%。参与调查的人员中认为输血科开展治疗最大的阻力和障碍是其他临床科室已开展相关治疗项目。结论目前各级医疗机构输血科在积极拓展输血治疗业务,但整体上还处在探索阶段,距形成标准化、规范化、规模化的输血治疗体系仍有较大差距。

国内儿童言语语言障碍治疗现状调查

目的调查分析国内儿童言语语言障碍治疗现状。方法2022年11月至2023年5月,以国内从事儿童言语治疗工作从业人员为调查对象,通过网络问卷的方式,调查国内言语语言障碍儿童的言语治疗内容及形式。结果共回收有效调查问卷679份。参与调查的儿童言语治疗从业人员中康复治疗师占64.06%。接受干预的言语语言障碍儿童中语言发育迟缓、脑性瘫痪所致的运动性构音障碍及发音障碍(机能性)占比较高,分别为22.20%、14.80%及13.60%。儿童言语治疗的主要问题为缺少判定儿童语言障碍的全国统一标准化评估工具,缺乏系统性规范性的治疗方法,分别占12.30%和12.20%。结论语言发育迟缓是国内儿童言语语言障碍的主要类型。我国儿童言语治疗存在区域发展不均衡、专科康复医生不足、缺乏标准化的评估工具及规范化的治疗方法等问题。

经颅直流电刺激与失眠障碍的研究进展

失眠障碍是最为常见的睡眠问题之一,近年来患病率呈现增高趋势。失眠的认知行为疗法和药物疗法是目前临床主要的治疗方法,但在临床上存在治疗费用高或副作用大等问题。经颅直流电刺激通过对大脑皮层施加微电流刺激改变皮质兴奋性、增加突触可塑性、增加慢波活动、调节脑血流等机制治疗失眠,安全性高,副作用小,有可能成为一种有价值的治疗方法。本文总结分析经颅直流电刺激治疗失眠障碍的安全性、使用方法及作用机制等,为失眠障碍的临床治疗提供新思路。

中国森林康养产业现状与未来展望

随着健康理念的不断提升和人们对自然环境需求的增加,森林康养作为一种新兴的健康养生方式在全球迅速发展,并逐渐形成森林康养产业。为全面分析中国森林康养产业的现状及其未来发展前景,采用相关文献分析和实地调研相结合的方法,对中国森林康养及中国森林康养产业的定义、产业发展基础、演进历程、产业现状及存在的问题进行分析。结果表明,中国森林康养产业作为正在快速发展的新兴产业,发展潜力巨大,康养旅游、康复服务以及科研与教育等重点领域成为主要发展方向。但产业发展过程中也存在着基础研究薄弱、标准规范不足、人才培养短缺等方面的问题。未来可通过加强科研、标准制定和人才培养等措施,促进中国森林康养产业健康、可持续发展,在生态保护和提升公众健康方面发挥重要作用。

火针疗法治疗常见病的效应机制研究进展

火针疗法适应证广泛,效应机制复杂,其治疗常见病的机制研究主要集中于皮肤疾病、肌肉骨骼系统疾病和神经系统疾病领域,体现出多层次、多靶点、多途径和多环节的特点,其主要效应机制包括:①抗炎与调节免疫;②调控细胞增殖、分化和凋亡;③调节内分泌;④改善血液循环,修复血管;⑤调节神经递质和神经肽;⑥抑制氧化应激反应;⑦修复皮损;⑧保护神经。今后应在临床机制研究中提高方法学质量和报告质量,研发标准化火针针具,制定针对不同疾病的标准治疗方案,重点探索火针疗法的温热性传导机制,并对比火针在不同条件下产生的治疗效应,客观评价火针的安全性,借助多样化的医学成像技术揭示火针疗法的外周和中枢效应机制,并通过系统生物学组学技术整体、动态地阐释火针疗法的综合治疗作用。

经颅直流电刺激治疗卒中后认知障碍的相关研究进展

卒中后认知障碍(PSCI)是指脑卒中后出现认知功能下降,严重影响患者的生活质量及生存时间。与其他神经系统疾病引起的认知障碍相比,可预防性和可治疗性是PSCI的重要特点,因此早期干预尤为重要。经颅直流电刺激(tDCS)属于非侵入性脑刺激技术,具备安全性高、疼痛感低等优点,是PSCI的一种有效神经康复治疗手段。PSCI的tDCS治疗方案通常为1~2 mA的刺激强度作用于背外侧前额叶皮层20~30 min。刺激部位通常选择背外侧前额叶,也有学者证实其他刺激区域的有效性,如双侧M1区、右顶叶皮层等。tDCS通过影响神经递质(如星形胶质细胞中的钙离子和γ-氨基丁酸)、神经元的状态、脑血流量以及大脑功能区域的连接发挥疗效,改善认知功能。tDCS不仅可产生即刻的促进效应、刺激后约1 h有效的后效应,而且具有长时程增强(LTP)和长时程抑制(LTD)效应。因此,在临床应用tDCS时应把握好治疗时机。目前认知功能的各种传统治疗手段(如药物治疗、认知训练、虚拟现实技术、针灸等)虽各有所长,但仍存在着药物不良反应、治疗时间长、恢复慢等问题。为弥补单独应用tDCS的局限与不足、达到更佳的治疗效果,可选择在tDCS刺激的同时或1 h内联合应用其他认知康复手段。本文旨在综述tDCS及其他认知康复方法在PSCI方面的相关研究进展,藉此为PSCI全面康复提供治疗经验和参考依据。

tDCS联合MT对脑卒中患者上肢功能和日常生活活动能力康复效果的Meta分析

目的系统评价经颅直流电刺激(tDCS)联合镜像疗法(MT)对脑卒中患者上肢功能和日常生活活动能力的康复效果。方法计算机检索PubMed、Web of Science、The Cochrane library、Embase、中国知网、万方、维普和中国生物医学文献数据库,收集所有经tDCS联合MT治疗脑卒中患者上肢障碍的随机对照试验,检索时限从建库至2023年1月,由两名研究者独立提取数据。使用RevMan5.4软件进行Meta分析。评价主要结局指标:Fugl-Meyer上肢功能评定量表(FMA-UL)评分和改良Barthel指数量表(MBI)评分。次要结局指标:盒子积木测试(BBT)评分。结果共纳入7篇随机对照试验,包含379例患者。Meta分析结果显示,与单独tDCS组相比,联合组FMA-UL评分[MD=5.17,95%CI(3.80,6.54)]和MBI评分[MD=6.71,95%CI(4.61,8.80)]均显著提高;与单独MT组相比,联合组FMA-UL评分[MD=6.72,95%CI(3.67,9.76)]、MBI评分[MD=17.91,95%CI(2.49,33.33)]及BBT评分[MD=9.52,95%CI(3.30,15.74)]均显著提高。结论相较于单独使用tDCS或MT,tDCS联合MT改善脑卒中患者上肢运动功能和日常生活活动能力的疗效更显著。

一种用于情绪调控的脑机音乐接口方法

为了改善受失眠困扰人群的失眠症状,将脑机接口前沿技术和音乐治疗这一心理治疗手段相结合,提出了一种区别于传统药物治疗的解决方案,用以干预抑郁、焦虑状态。本文采用自主研发的音乐协同电刺激耳机系统进行临床试验,选取60例受失眠困扰的志愿者作为研究对象,开展为期10天的干预治疗。获取志愿者的脑电图、近红外脑功能成像数据及其填写的量表信息,对比分析干预前后的数据,验证了音乐协同电刺激耳机系统能够在一定程度上达到提升入睡速度、改善失眠症状、调节异常脑电波形的效果。此外,志愿者均无不良反应,表明该耳机系统兼具有效性和安全性。

大动脉粥样硬化性缺血性卒中再灌注治疗的研究进展

急性缺血性卒中是一种严重威胁人类健康的疾病,其中大动脉粥样硬化性卒中症状更重,预后更差,再灌注治疗可有效改善这类患者的功能预后。近年来再灌注治疗技术发展迅速,但也面临一些挑战,如治疗时间窗内患者比例低、再灌注损伤、出血转化等。要解决这些问题,需要从多个层面采取对策,如优化急救流程、革新操作技术、加强损伤防护等。本文对大动脉粥样硬化性缺血性卒中再灌注治疗面临的挑战和对策进行了初步讨论。

社区药物治疗管理现状及展望

现阶段,对于很多疾病通常采取药物治疗,多数患者无需住院,一般遵从医嘱进行社区居家治疗即可。然而社区药物治疗的效果受个体认知、药物依从性、用药管理等因素影响。目前,社区药物治疗管理面临依从性低、信息不对称等。需要加强社区药物治疗管理,且融合智能化技术,使未来药物治疗管理不断向智能化的方向发展。分析社区药物治疗管理的特点、存在现状、管理经验和未来展望,探讨提升社区药物治疗管理效果的关键因素和策略,旨在为社区药物治疗管理的实践提供参考。

音乐治疗基础上联合经颅直流电刺激对失眠效果的随机对照试验

目的探讨经颅直流电刺激(tDCS)联合音乐治疗对失眠患者的疗效。方法2023年7月至2024年4月,苏州大学附属第四医院失眠患者70例,随机分为对照组(n=35)和观察组(n=35)。两组均予音乐治疗,观察组予tDCS,对照组予假tDCS,共4周。治疗前后,采用匹兹堡睡眠质量指数量表(PSQI)总分和亚分、17项汉密尔顿抑郁量表(HAMD-17)、汉密尔顿焦虑量表(HAMA)、中文版压力知觉量表(CPSS)进行评定,测量静息态脑电相对功率,采用经颅多普勒测量脑各支动脉平均血流速度(Vm)。结果对照组脱落5例,观察组脱落4例。治疗后,观察组PSQI总分和亚分、HAMD-17、HAMA和CPSS评分均明显下降(|t|>3.503,P<0.01),除睡眠时间、睡眠效率和CPSS评分外,其他指标均优于对照组(|t|>2.304,P<0.05);观察组δ、θ频段相对功率增加,α、β和γ频段相对功率显著降低(|t|>6.468,P<0.001),且均优于对照组(|t|>2.395,P<0.05);观察组各支动脉Vm均显著提高(|t|>4.624,P<0.001),且均优于对照组(|t|>2.147,P<0.05)。结论在音乐治疗基础上联合tDCS有助于进一步改善失眠患者的睡眠质量和脑电活动,提高脑血流速度,减少不良情绪。