[Objective]To investigate the hallux valgus angle and pathogenesis of hallux valgus in general population.[Method]A total of 1 233 adult population in Shijiazhuang were selected for this study by random cluster sampling method,then a questionnaire survey was participated including gender,age,nation,culture degree,inhabitate time,symptome occurrence time,original symptome,aggravate factors,relieve factors,family medical history,living habit,life style,et al.Hallux valgus angle was measured by protracter.The angle exceed 15? was confirmed the hallux valgus.The data was analysised with logistic multiple regression analysis.[Result]The average hallux valgus angle was(8.31?4.93)? of male and(9.72?7.12)? of female.There were 98 hallux valgus patients in this study,and the morbidity rate was 7.95%.The morbidity rate was 1.29% of male and 11.00% of female.Ratio of male to female was 1∶8.53.The average age was 22 years old.The concentrated symptome occurrence time was 20 to 45 years old;the average age was 25 years old.78 hallux valgus patients had a family medical history(79.6%).The dangerous factors of hallux valgus were inheritance,gender,flatfoot.The effective factors in female related to inheritance,the age that start wearing high-heel shoes but not to the height of the heel and the full time who were high-heel shoes.The aggravate factors were as follow:wearing high-heel shoes,long time standing,long time walking.The relieving factors were as follow:wearing flat and low-hell shoes,a warm water bath for foot,massage.[Conclusion]Female has a high risk to have hallux valgus.The hallux valgus has a close relationship with inheritance,and the age who start wearing high-heel shoes influences the incidence in female.

Objective To investigate the relationship of nuclear factor kappa B(NF-κB),Bcl-2 and Bax with limb function after acute spinal cord injury in rats. Methods Forty-eight rats were divided at random into a control group and an experimental group with 24 rats in each.The spinal cords of the rats in the experimental group were injured at the T8,9,10 level through moderate compression.Four hours,8 h,and 1,3,7 and 14 days after the injury,4 rats were selected randomly from each group and graded with a BBB score.They were then sacrificed and their spinal cords were collected.Immunohistochemical measurements were used to observe the expression of NF-κB, Bcl-2 and Bax. Results NF-κB,Bcl-2 and Bax were observed in the injured spinal nerve cells of rats in the exper imental group but were absent in the control group.After injury,the expression of these factors increased at first and then decreased.BBB scores for limb function increased gradually.No correlation was found between the changes in NF-κB and Bcl-2,but the expression of NF-κB was positively correlated with that of Bax.There was negative correla tion between NF-kB levels and BBB scores,and between NF-kB levels and the ratio of Bcl-2 to Bax. Conclusion In rats,there is a close negative correlation between NF-kappa B levels,the ratio of Bcl-2/Bax and limb function after acute spinaI cord iujury.

Objective To study 3D construction and printing of bone tissue engineering scaffolds by bone defect modeling on Mimics software based on CT data. Methods CT data of jaw bone defect from patients were acquired and the images were segmented using threshold segmentation combined with region growing . The three dimensional model was reconstructed by Boolean operation. The individual 3D digital model was reconstructed with internal structure by combining with computer; preparing poly-lactic acid scaffold in virtue of 3D technology. Results Using the Mimics software, we successfully constructed a 3D digital reconstruction model of bone defect based on CT data. The constructed scaffold model with certain internal form and structure was matched with the bone defect of patients, and the constructed model was exported onto STL standard format, which may be in common use. Conclusion The 3D digital model of bone defect scaffolds may effectively be reconstructed based on the CT data using Mimics software and computer aided design.

Anti-N-methyl-D-aspartate receptor (N-methyl-D-aspartate receptor,NMDAR) encephalitis is the most common autoimmune encephalitis,mostly in young women of childbearing age,but how pregnancy influence the disease is still unclear.This article reports a case of gestational morbidity,and analyzes 10 pregnant women in different stages and their babies published in domestic and foreign,aiming to briefly explore the influences of different fetuses during pregnancy.

With the global trend of aging populations,the prevalence of blindness is expected to increase.However,due to deficiencies and imbalances,medical resources are far from satisfactory for ophthalmic disease diagnosis and management,particularly in primary medical facilities of developing countries.Eyeball is a visualized organ with its superficial position and transparent refractory media.Therefore,many ophthalmic diseases can be screened and diagnosed from images and photographs,such as cataract,cornea diseases and retinopathy,etc.As the development of data mining technology and accumulation of large amount of ophthalmic clinical data,the conditions are ripe for establishment of artificial intelligence (AI) diagnostic platform.Currently,attention should be focused on integrating the abundant ocular imaging resources,practically applying the data mining technology and gradually developing the universal AI platform for the management of ophthalmic disease.

With the development of our economy and the progress of science and technology,the comfort medicine of children in the perioperative period is gradually promoted.Comfort medicine not only eliminates the physical pain of children,but also avoids the permanent psychological trauma caused by oper-ation and anesthesia.The incidence of preoperative anxiety in children is higher than that in adults,which may have adverse effects on perioperative period and prognosis of children.The characteristics of parents of different children,such as parental anxiety level,parental education level,parental socioeconomic back-ground,family composition,ethnicity,language,and other factors will affect the preoperative anxiety level of children.Intervention measures such as parents'participation in guiding children's preparation for anesthe-sia,management of children's fasting and drinking,and presence at the induction of anesthesia can alleviate children's preoperative anxiety level.For children with disabilities,communication between parents and medical staff in the perioperative period and intervention management of children is important.Compared with the traditional preoperative preparation program,the internet-based family preoperative preparation plat-form provides a comprehensive,effective and personalized information guidance for the families of children,ensuring the comfortable perioperative medical treatment of children.

OBJECTIVE: To explore the genetic basis for a patient with Alport syndrome (AS) and confirm the existence of a splicing variant. METHODS: An AS patient diagnosed at the Affiliated Hospital of Inner Mongolia Medical University on January 8, 2021 for significant proteinuria and occult hematuria was selected as the study subject. Clinical data was collected. Peripheral blood samples were collected for the extraction of genomic DNA. Whole exome sequencing and Sanger sequencing were carried out to identify potential genetic variants. An in vitro experiment was also conducted to verify the abnormal mRNA splicing. Bioinformatic software was used to analyze the conservation of amino acids of the variant sites and simulate the 3D structure of the variant collagen IV protein. Immunofluorescence and immunohistochemistry were carried out on renal tissues from the patient to confirm the presence of AS kidney injury. RESULTS: The patient, a 21-year-old male, had a 24-hour urine protein of 3.53 g/24 h, which fulfilled the diagnostic criteria for proteinuria. His blood uric acid has also increased to 491 μmol/L. DNA sequencing revealed that he has harbored a c.835-9T>A splice variant of the COL4A5 gene, which was not found in either of his parents. In vitro experiment confirmed that the variant has removed 57 bp from the exon 15 of the mRNA of the COL4A5 gene. The deletion may cause loss of amino acid residues from positions 279 to 297, which in turn may affect the stability of the secondary structure of the α5 chain encoded by the COL4A5 gene. The amino acids are conserved across various species. The result of homology modeling indicated that the trimerization of Col-IV with the mutated α5 chain could be achieved, however, the 3D structure was severely distorted. The AS kidney damage was confirmed through immunofluorescence assays. Based on the guidelines from the American College of Medical Genetics and Genomics, the c.835-9T>A variant was classified as likely pathogenic (PVS1_Moderate+PS3_Moderate+PM2_Supporting+PS2+PP3+PP4). CONCLUSION The c.835-9T>A variant of the COL4A5 gene probably underlay the AS in this patient. In vitro experiment has confirmed the abnormal splicing caused by the variant. Histopathological examination of the kidney tissue has provided in vivo evidence for its pathogenicity. Above finding has expanded the mutational spectrum of the COL4A5 gene.
Humans ; Male ; Young Adult ; Amino Acids ; China ; Collagen Type IV/genetics* ; Exons ; Nephritis, Hereditary/genetics* ; RNA Splicing

Objective To evaluate the correction rate,accuracy of pedicle screw fixation and overall clinical efficacy of intravertebral osteotomy and internal fixation surgery with the assistance of 3D printing guide plates in treatment of severe kyphosis.Methods A single-center nonrandomized clinical pilot study was conducted on 19 patients(8 males and 11 females)with severe kyphosis undergoing intravertebral osteotomy between December 2018 and June 2023.Seven of them(CAD group)had preoperative planning with computer-aided design(CAD)and intraoperative guidance of individualized 3D printing guide plates.And another 12 patients(control group)were corrected with conventional pedicle screw placement.Postoperative evaluation included assessment of posterior Cobb angle,spinal angular correction rate,accuracy of pedicle screw placement and Oswestry Dysfunction Index(ODI)questionnaire.Results The 19 patients were at a mean age of 48.0 years,and followed up for 26.4(9～54)months.All of them achieved relatively satisfactory corrective results,with those of the CAD group having a correction rate of 96.83％and those of the control group of 86.61％.There were no statistical differences in average intraoperative blood loss(857 vs 1 045 mL)and average operative time(344 vs 402 min),but significant difference was observed in average length of hospital stay(11 vs 18 d,P＜0.05)between the 2 groups.A total of 278 nails were placed in this study,including 70 guide-assisted pedicle screws,97.1％of which were grade A or B.In the control group,208 pedicle screws were placed,93.8％of which were grade A or B.Postoperative CT/X-ray scanning displayed that both groups achieved certain correction for kyphosis.No obvious difference was found in the average spinal angular correction(43.37° vs 36.10°),and significantly higher correction rate was seen in the CAD group than the control group(96.83％vs 86.61％,P＜0.01).The ODI value was notably lower in the CAD group than the control group(P＜0.05).Conclusion CAD-assisted preoperative planning,surgical simulation and individualized 3D printing guide plates can promote surgical correction and accuracy of pedicle screw placement and improves the quality of life of patients with severe kyphotic deformity.

Transplantations for repairing tissue and organ defects caused by disease and injury require a large number of donor tissues and organs.Therefore,people are increasingly hoping to restore or rebuild normal physical functions by establishing the body's own regenerative capacity.For this reason,regenerative medicine is rapidly emerging and becoming a research hotspot.The regeneration of tissues and organs is a complex process involving multiple layers of structures and requiring multiple factors to interact.Compared with traditional biomolecular technologies,biological omics based on biomolecular groups has obvious advantages in regenerative medicine researches and has became an important tool correlational researches.In this paper,the methods and progress of biomedical techniques for regenerative medicine researches in recent years were summarized,and the advantages of biological omics technology in regenerative medicine were analyzed and prospected.

Objective To determine the risk factors for moderate and severe postoperative pain in patients undergoing percutaneous nephrolithotomy.Methods Eighty-one patients of both sexes,aged 18-70 yr,with body mass index of 19-42 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,undergoing elective percutaneous nephrolithotomy under general anesthesia,were selected.When moderate and severe postoperative pain developed (visual analog scale score ≥ 4),dezocine 5 mg was intravenously injected with the dosing interval greater than 4 h.According to the occurrence of moderate and severe pain within 24 h after operation,the patients were divided into moderate and severe pain group and non-moderate and severe pain group.The age,sex,American Society of Anesthesiologists physical status,body mass index,preoperative abnormality of creatinine,urinary leukocyte,urinary bacteria,surgical site,severity of hydronephrosis,the number of affected renal calyx,CT value of stones,length of puncture channel,operation time,the number of postoperative drainage tube and residual stones were collected.Multivariate logistic regression analysis was performed to stratify the risk factors for moderate and severe postoperative pain.Results A total of 79 patients were included in this study.Among the 79 patients,47 patients developed moderate or severe pain,and the incidence was 59％.The results of multivariate logistic regression analysis showed that the number of preoperative affected renal calyx＞3,CT value of stones ＞ 1 000 and postoperative residual stones were independent risk factors for moderate and severe pain after percutaneous nephrolithotomy (P＜0.05).Conclusion The number of preoperative affected renal calyx＞3,CT value of stones ＞ 1 000 and postoperative residual stones are independent risk factors for moderate and severe postoperative pain in the patients undergoing percutaneous nephrolithotomy.