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BACKGROUND: Rotator cuff calcific tendinitis (RCCT) is a common shoulder disease whose main symptoms include shoulder pain, limited mobility, and calcification deposits in the shoulder. Traditional treatment methods have certain limitations, so finding new treatment methods has become the focus of research. Extracorporeal shock wave (ESW) and platelet-rich plasma (PRP) treatments have attracted much attention due to their non-invasive and tissue repair-promoting properties; however, the efficacy of their combined treatment in RCCT remains unclear. METHODS: This study is designed as a single-center, assessment-blind, randomized controlled clinical trial with three parallel groups. Sixty subjects will be recruited and randomly divided into the ESW group, PRP group, and ESW combined with PRP group, in a 1:1:1 ratio. The entire intervention period is 4 weeks, and the follow-up period is 4 weeks. Outcomes will be measured at baseline (T0), after 1 week of intervention (T1), after 2 weeks of intervention (T2), after 4 weeks of intervention (T3), and after an additional 4 weeks of follow-up period (T4). The primary endpoint is the VAS score. Secondary endpoints are ASES, CMS, UCLA, and the location and size of calcified areas. DISCUSSION: This study aims to evaluate the efficacy of ESW therapy combined with PRP in treating RCCT. We compare the effects of single and combined treatments to explore their impact on disease symptoms, functional improvement, and calcification regression. This provides a scientific basis for identifying more effective treatment options. TRIAL REGISTRATION: ClinicalTrials.gov NCT06372600. Registered on April 17, 2024; version 1.

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Assessing and monitoring the green total factor energy efficiency (GTFEE) of cities while considering technology heterogeneity is crucial for the development of energy-conservation and emission-reduction policies. Considering that the heterogeneity of production technologies encompasses several dimensions, this paper proposes a 3E3S (Economy-Environment-Energy-Society-Science-Space) heterogeneity framework and integrates it with the improved meta-frontier global SBM-undesirable to analyze GTFEE and its decomposition. Empirical analysis of cities in the Yellow River Basin of China (YRBC) highlights the following: (1) The 3E3S heterogeneity framework facilitates the classification of all cities into three distinct groups, a finding that contrasts significantly with previous outcomes documented in the literature that relied solely on criteria such as geographic location. (2) The three groups identified under the meta-frontier exhibit substantial energy-saving potentials of 24.49%, 35.17%, and 52.46%, respectively. Additionally, there are spatiotemporal variations in GTFEE, with cities located in the central part of YRBC, particularly those in Shanxi province, demonstrating poor GTFEE performance. (3) The decomposition analysis of GTFEE indicates that technological progress plays a pivotal role in enhancing GTFEE on the whole, albeit with varying approaches for improving GTFEE depending on individual cities.

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Sustainable development in ecologically fragile areas (EFAs) has faced significant challenges in recent years, but the traditional analytical approaches fail to provide an ideal assessment for ecological performance due to spatiotemporal variability in EFAs. This paper evaluates the ecological performance of EFAs based on a modified ecological footprint model, and ecological footprint intensity (EFI) is considered an essential indicator to measure ecological performance, especially for EFAs. Empirically, taking the Π-shaped Curve Area in the Yellow River basin of China as the study area, the spatiotemporal heterogeneity of EFI of 17 cities in the area is analyzed. Then, the extended STIRPAT and geographically and temporally weighted regression (GTWR) models are employed to explore the spatiotemporal heterogeneity of the factors driving EFI. The results show that from 2006 to 2019, the overall level of EFI in the area has decreased; EFI of the area offers a significant spatial agglomeration effect; results of the GTWR model suggest that factors driving EFI have spatiotemporal heterogeneity; the impact of population size, openness, marketization, technology, industrial structure rationalization, and information communication level on EFI was two-sided, while that of affluence, government scale, environmental regulation, and industrial structure advancement show inhibitory impact with the intensity of inhibition varying across periods and cities.

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Reducing carbon emissions is key to achieving the 13th UN sustainable development goals. With the acceleration of informatization and urbanization in the "Belt and Road Initiative" (BRI) countries, it is necessary to explore the impact of ICT and urbanization on carbon emissions in the BRI countries. This paper uses the Driscoll-Kraay panel regression method, multi-chain mediation effect model, and panel moment quantile regression method to study the influence channel and heterogeneous impact of ICT, urbanization, and their interaction on carbon emissions in 42 selected BRI countries. The main empirical results reveal the inhibition of ICT and the promotion of urbanization on carbon emissions. Moreover, the integrated development of ICT and urbanization contributes to reducing carbon emissions. Industrial structure upgrading and energy intensity are found to be the channels through which ICT, urbanization, and their interactions affect carbon emissions. In addition, the impact of ICT, urbanization, and their interaction on carbon emissions varies with different measurement indicators and quantiles. Therefore, it is suggested that BRI countries should formulate appropriate ICT development policies according to their conditions, strengthen ICT application, and especially promote the integrated development of ICT and urbanization, to achieve sustainable urban development.

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BACKGROUND: The Proximal Femoral Nail Antirotation (PFNA) system for treatment of intertrochanteric fractures is currently widely applied worldwide. However, even though the PFNA has produced good clinical outcomes, a poor introduction technique with an inappropriate entry point can cause surgical complications. Some researchers suggest improving clinical outcomes by modifying the entry point, but no research has focused on this issue. The purpose of the present study is to compare the clinical and radiological outcomes of two different trochanteric entry points for the treatment of intertrochanteric fractures using the PFNA system. METHODS: From May 2010 to October 2015, a total of 212 elderly patients with intertrochanteric fractures who were treated with the PFNA-II system were included into this retrospective cohort study. Group LA (98 patients) was treated using a lateral anterior trochanteric entry point, and group MP (114 patients) was treated using a medial posterior trochanteric entry point. All patients underwent follow-up assessments at 1, 3, 6, and 12 months after surgery. Radiographic evaluation was based on the impingement, tip-apex distance (TAD) and the position of the helical blade within the femoral head. Clinical evaluation was based on the surgical time, fluoroscopy time, blood loss, hospital stay, visual analogue scale (VAS), thigh pain, and Harris hip score. RESULTS: The impingement was significantly reduced (P = 0.011) in group MP. The helical blade positions were significantly lower (P = 0.001) in group MP. The TADs in group LA (22.40 ± 4.43) and group MP (23.39 ± 3.60) were not significantly different (P = 0.075). The fluoroscopy time of group LA (53.26 ± 14.44) was shorter than that of group MP (63.29 ± 11.12, P = 0.000). Five iatrogenic lateral proximal fractures and 3 helical blade cutouts occurred in group LA, but none occurred in group MP. At 1 and 3 months postoperation, the Harris hip scores were significantly higher in group MP (P = 0.001 and P = 0.000, respectively), and the VAS scores were lower (P < 0.05). CONCLUSIONS: The medial posterior trochanteric entry point achieved excellent nail and helical blade position, reduced surgical complications, and enabled early hip function recovery but required longer fluoroscopy time than the lateral anterior trochanteric entry point.

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Methylene blue (MB) attenuates acute lung injury (ALI) induced by liver or pancreas ischemia-reperfusion. But the protective effects of MB on paraquat (PQ)-induced ALI have not been elucidated. In this study, we aimed to study the effects of MB on ALI caused by PQ in rats. Male Sprague-Dawley rats were challenged acutely by PQ (25mg/kg, i.p.) with or without MB posttreatment (2mg/kg, i.p.) 2h after PQ administration. Lung specimens and the bronchoalveolar lavage fluid were isolated for pathological examinations and biochemical analyses 24h after PQ exposure. We found that the administration of MB significantly increased the activity of superoxide dismutase and decreased lung wet dry radio, the content of malondialdehyde and lactate dehydrogenase, the total cell number and the level of myeloperoxidase in bronchoalveolar lavage fluid. Pathological examination also revealed that MB alleviated PQ-induced histological damage. These results provide evidence that MB may be a new therapy in the treatment of PQ-induced ALI.

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Being a biologic toxin, scorpion toxins have complicate physiologic and pharmalogic actions because of its intricate components. This text reviewed the effect of scorpion toxins on endothelial cell function, platelet function, microcirculation, atherosclerosis, ironic channel, and cardiac function.

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