BACKGROUND:Eucommia ulmoides has a certain osteogenic effect,which can promote the proliferation and differentiation of osteoblasts.However,it is unclear whether Eucommia ulmoides has effects on alveolar bone formation and Wnt/β-Catenin signaling pathway. OBJECTIVE:To investigate the mechanism by which Eucommia ulmoides promotes alveolar bone formation in ovariectomized rats based on the Wnt/β-Catenin signaling pathway. METHODS:Sixty female Sprague-Dawley rats were selected and randomly divided into five groups:blank control group,sham-operation group,model group,low-dose group Eucommia ulmoides group,and high-dose Eucommia ulmoides group,with twelve rats in each group.Osteoporosis animal models were constructed by bilateral oophorectomy in the model group and the low-dose and high-dose Eucommia ulmoides groups.The sham-operation group underwent the same method to remove adipose tissue of equal mass around the bilateral ovaries.Three months after surgery,the low-and high-dose Eucommia ulmoides groups were given 2.1 g/kg/d and 4.2 g/kg/d Eucommia ulmoides by gavage,respectively.The sham-operation group and model group were given the same amount of physiological saline by gavage.After 12 weeks of drug intervention,the changes in alveolar bone mass of rats in each group were observed through Micro-CT;hematoxylin-eosin staining was used to observe the pathological structural changes of alveolar bone in rats;enzyme linked immunosorbent assay was used to detect the expression levels of alkaline phosphatase and osteocalcin in the serum of rats;western blot was used to detect the expression levels of β-Catenin and Frizzled9 receptor proteins in the alveolar bone of rats;and real-time fluorescence quantitative PCR was used to detect the expression of osteocalcin,Runt-related transcription factor 2(Runx2),alkaline phosphatase,β-catenin,and frizzled9 mRNAs in alveolar bone tissues of rats. RESULTS AND CONCLUSION:Compared with the blank control group,bone volume fraction,trabecular number,trabecular thickness,and bone mineral density were reduced in the model group(P＜0.05),and trabecular separation was elevated(P＜0.05).Pathological observation showed that the arrangement of trabeculae was disordered and irregular,the trabeculae were thinned or broken,and the marrow cavity was enlarged in the model group,with a significant reduction in bone volume;the level of alkaline phosphatase in the serum was increased(P＜0.05),and the level of osteocalcin was decreased(P＜0.05);mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were decreased(P＜0.05);protein expression of β-Catenin and Frizzled9 was decreased(P＜0.05).Compared with the model group,the low-and high-dose Eucommia ulmoides groups showed an increase in bone volume fraction,trabecular number,trabecular thickness,and bone mineral density(P＜0.05)and a decrease in trabecular separation(P＜0.05).In the low-and high-dose Eucommia ulmoides groups,bone trabeculae were slightly aligned and thickened,with a significant increase in bone mass.Compared with the model group,the serum level of alkaline phosphatase was reduced(P＜0.05)and the serum level of osteocalcin was elevated(P＜0.05)in the low-and high-dose Eucommia ulmoides groups.Compared with the model group,the mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were increased in the low-and high-dose Eucommia ulmoides groups(P＜0.05).Compared with the model group,the protein expression of Frizzled9 was increased in the low-dose Eucommia ulmoides group(P＜0.05),while the protein expression of β-Catenin and Frizzled9 was increased in the high-dose Eucommia ulmoides group(P＜0.05).Compared with the low-dose Eucommia ulmoides group,the high-dose Eucommia ulmoides group had a more significant improvement in the above indexes.To conclude,Eucommia ulmoides can effectively promote the alveolar bone formation,and its mechanism of action might be related to the activation of the Wnt/β-catenin signaling pathway.

Objective To establish a rat model of Alzheimer's disease (AD) expressing human triple mutant amyloid precursor protein (APP) in the hippocampus, and to provide a model for the study of disease mechanisms and drug development. Methods Twenty-four 12-week-old SPF-grade female SD rats were randomly divided into a blank control group, a virus control group and an experimental group, with eight rats in each group; among them, the experimental group received a stereotaxic injection of adeno-associated virus (AAV) carrying the human triple mutant APP and NanoLuc luciferase genes into the hippocampus. In vivo imaging was used to observe viral expression in the brains of rats in each group, the novel object recognition test was used to assess the recognition memory of the rats in each group, real-time fluorescent quantitative PCR was used to detect the expression level of the APP gene, HE staining was used to examine the brain histopathology, Nissl staining was used to assess the hippocampal lesions, and immunohistochemistry was used to detect the deposition of amyloid β-protein (Aβ). Results In vivo imaging showed that reporter fluorescence was detected in the brains of rats in both experimental and virus control groups. Fluorescence quantitative PCR showed that the expression level of the APP gene was significantly increased in the brains of rats in the experimental group (P<0.01). Novel object recognition test revealed that the recognition memory of rats in the experimental group was significantly reduced compared with that of the blank control group (P<0.01). Six months after recombinant AAV virus infection, HE staining and Nissl staining of brain tissues showed that the number of neurons and Nissl bodies in the CA1 region of the hippocampus in the experimental group was reduced and disorganized; immuno-histochemistry testing of the CA1 region of the hippocampus and the pyramidal cell layer of the experimental group revealed prominent brown deposits, indicating Aβ protein deposition. Conclusion The rat model successfully established by stereotaxic injection and AAV-mediated delivery of human triple mutant APP gene exhibits typical AD features, providing a valuable animal model for studying AD pathology and developing drug therapies targeting Aβ protein deposition.

Objective To establish a rat model of Alzheimer's disease (AD) expressing human triple mutant amyloid precursor protein (APP) in the hippocampus, and to provide a model for the study of disease mechanisms and drug development. Methods Twenty-four 12-week-old SPF-grade female SD rats were randomly divided into a blank control group, a virus control group and an experimental group, with eight rats in each group; among them, the experimental group received a stereotaxic injection of adeno-associated virus (AAV) carrying the human triple mutant APP and NanoLuc luciferase genes into the hippocampus. In vivo imaging was used to observe viral expression in the brains of rats in each group, the novel object recognition test was used to assess the recognition memory of the rats in each group, real-time fluorescent quantitative PCR was used to detect the expression level of the APP gene, HE staining was used to examine the brain histopathology, Nissl staining was used to assess the hippocampal lesions, and immunohistochemistry was used to detect the deposition of amyloid β-protein (Aβ). Results In vivo imaging showed that reporter fluorescence was detected in the brains of rats in both experimental and virus control groups. Fluorescence quantitative PCR showed that the expression level of the APP gene was significantly increased in the brains of rats in the experimental group (P<0.01). Novel object recognition test revealed that the recognition memory of rats in the experimental group was significantly reduced compared with that of the blank control group (P<0.01). Six months after recombinant AAV virus infection, HE staining and Nissl staining of brain tissues showed that the number of neurons and Nissl bodies in the CA1 region of the hippocampus in the experimental group was reduced and disorganized; immuno-histochemistry testing of the CA1 region of the hippocampus and the pyramidal cell layer of the experimental group revealed prominent brown deposits, indicating Aβ protein deposition. Conclusion The rat model successfully established by stereotaxic injection and AAV-mediated delivery of human triple mutant APP gene exhibits typical AD features, providing a valuable animal model for studying AD pathology and developing drug therapies targeting Aβ protein deposition.

Objective: To investigate the clinical efficacy of oral microscope-assisted microflap periodontal bone grafting in treating class Ⅱ furcation involvement in mandibular molars, and to provide clinical evidence for its treatment in furcation involvement. Methods: This study was reviewed and approved by the institutional ethics committee, and informed consent was obtained from all patients. Sixty mandibular molars with class II furcation involvement caused by periodontitis were enrolled in a randomized controlled clinical study, utilizing a random number table method. Patients were categorized into a control group (n=30) and an experimental group (n=30) based on the surgical procedure employed. The control group underwent periodontal flap surgery with an internal oblique incision and vertical incision; this procedure was performed without the aid of a microscope. Conversely, the experimental group underwent micro flap periodontal bone grafting surgery without vertical incision; an oral microscope was used for this procedure. Both groups were analyzed 6 months after surgery, and postoperative gingival recession (GR), probing depth (PD), bleeding index (BI), vertical bone height increase (VBHI), pain level, and complications were recorded. Results: Both groups showed improvement in PD and BI after 6 months compared to preoperative levels: the control group had a preoperative PD of (7.33 ± 1.72 mm) and a 6-month postoperative PD of (3.37 ± 0.96 mm), with statistically significant differences (P<0.001). The preoperative PD of the experimental group was (7.27 ± 1.57 mm), and the 6-month postoperative PD was (3.00 ± 0.69 mm), with statistically significant differences (P<0.001). The BI of the control group decreased from 3.03 ± 1.03 before surgery to 0.77 ± 0.82 at 6 months after surgery (P<0.001), while the BI of the experimental group decreased from 3.20 ± 1.09 before surgery to 0.73 ± 0.64 at 6 months after surgery (P<0.001), and the differences were statistically significant. The experimental group showed a significant improvement in GR (0.70 ± 0.59 mm) compared to preoperative GR (1.26 ± 0.94 mm) at 6 months after surgery (P=0.007), while the control group showed an increase in GR (1.37 ± 0.89 mm) at 6 months after surgery compared to preoperative GR (1.13 ± 0.97 mm), but the difference was not statistically significant (P=0.337). The inter group comparison results showed that there were no statistically significant differences in PD and BI between the two groups at 6 months after surgery (PD: P=0.096, BI: P=0.861); The GR of the experimental group was lower than that of the control group, and the difference was statistically significant (P=0.001). There was no statistically significant difference in postoperative VBHI between the two groups (P=0.128). The pain level scores of the experimental group were lower than those of the control group at 4 and 24 hours after surgery (P<0.001). None of the patients experienced complications. Conclusion Microflap periodontal bone grafting assisted by an oral microscope effectively improves the periodontal condition of patients with grade Ⅱ root bifurcation lesions of mandibular molars, and the bone grafting effect is good, with mild pain and good safety.

Objective To investigate the value of ¹⁸F-FDG PET/CT metabolic parameters in the prognostic assessment of nasopharyngeal cancer patients. Methods The clinical data and PET/CT metabolic parameters of 185 nasopharyngeal cancer patients were retrospectively analyzed. The collected parameters were SUV_max, MTV, TLG, total metabolic tumor volume (TMTV) and whole-body total lesion glycolysis (WTLG). The ROC curve was used to determine the optimal cut-off values of PET/CT metabolic parameters. Univariate and multivariate Cox regression models were used to screen the independent prognostic factors. Kaplan–Meier curves were used to analyze the survival differences. Results The results of univariate Cox regression analysis showed that age, pathologic type, WTLG, TMTV, MTV, and TLG were closely associated with OS and PFS; and SUV_max was associated with PFS (P<0.05). Multivariate Cox regression analysis results showed that age, TMTV, and WTLG were the independent prognostic factors for OS and PFS (P<0.05). The combination of WTLG with T/N staging (AUC=0.781 and 0.781) and TMTV with T/N staging (AUC=0.800 and 0.790) yielded greater predictive accuracy than that of WTLG and TMTV alone (AUC=0.724 and 0.719) or T/N staging (AUC=0.593 and 0.575). Conclusion TMTV and WTLG are important prognostic predictors of nasopharyngeal carcinoma. TLG and MTV of primary lesions are prognostic factors for patients’ PFS and OS. SUV_max has limited prognostic value. Systemic metabolic indexes (TMTV and WTLG), when combined with T/N staging, can optimize prognostic stratification.

[Objective]To explore the inheritance status and academic characteristics of SHI's acupuncture and moxibustion school in northern Zhejiang,and to further enrich the connotation of Xiushui medical school.[Methods]Using the method of reviewing and researching the traditional medical history literature and modern literature,the origin,inheritance and academic characteristics of SHI's acupuncture and moxibustion were excavated,analyzed and sorted out.[Results]The culture of traditional Chinese medicine in northern Zhejiang is profound,there are many genres of acupuncture and moxibustion,and many famous doctors and scholars.The more influential schools of acupuncture and moxibustion are LING,SHI,YAN,SHENG and JIN,which have been passed down from generation to generation and innovated repeatedly.As one of the typical representatives,SHI's acupuncture has a long history,active inheritance and rich content.In clinical practice,great importance is attached to the spleen and stomach,and the treatment principle is to strengthen the spleen and benefit the stomach,warm and transport Yang Qi of middle-Jiao,and be good at applying warm acupuncture,so that Qi can be warmed and operated easier,and the acupuncture can be helped to regulate Qi.SHI's acupuncture also pays attention to the combination of acupuncture and moxibustion,and the combination of acupuncture and medicine to improve clinical efficacy.SHI's descendants are constantly innovating while inheriting and keeping the right,so as to enrich the disease spectrum,enrich the treatment methods and improve the clinical efficacy.[Conclusion]In the process of continuous inheritance and innovation,SHI's acupuncture has gradually formed a diagnosis and treatment system with acupuncture characteristics in northern Zhejiang,which can provide learning and reference for clinical practice.

ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.

This article reviewed the concept of advance care planning, the status, functions, scales, influencing factors and strategies of the participation of advance care planning in families of terminal-stage cancer patients. It is aimed to provide reference for clinical medical staff to promote the participation of advance care planning in families of terminal-stage cancer patients, to improve the quality of agency decision-making, to improve quality of life in patients, and to construct of localized advance care planning.

Objective To explore the expression levels of serum spalt-like transcription factor 4(SALL4)mRNA,ol-factomedin 4(OLFM4)mRNA,and activin-A in patients with rheumatoid arthritis(RA),and analyze their correlation with clinical characteristics and their predictive value on joint deformities.Methods A total of 130 RA patients admitted to the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2021 to April 2023 were selected as the RA group,and 102 healthy volunteers who underwent physical examinations in the outpatient during the same period were selected as the control group.The serum Activin-A level was measured by using the enzyme-linked immunosorbent assay,and the serum SALL4 and OLFM4 mRNA levels were measured by using the reverse transcription polymerase chain reaction on the second day of admission for patients in the RA group and on the day of physical examination for patients in the control group.The serum SALL4 mRNA,OLFM4 mRNA and Activin-A levels were compared between the RA group and the control group and among the RA patients with different clinical characteristics.The influencing factors of RA combined with joint deformities were identified by using univariate and multivariate logistic regression.The receiver operating characteristic curve was used to analyze the value of SALL4 mRNA,OLFM4 mRNA and Activin-A in predicting joint deformities in RA.Results The relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients in the RA group were significantly higher than those in the control group(P＜0.05).The relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients with severe disease activity were significantly higher than those of patients with moderate and mild disease activity,and the relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients with moderate disease activity were significantly higher than those of patients with mild disease activity(P＜0.05).The relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients with the number of affected joints≥10,duration of synovitis≥6 weeks,and joint deformities were significantly higher than those in patients with the number of affected joints＜10,duration of synovitis＜6 weeks,and no joint deformities(P＜0.05).There was no statistically significant difference in the relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A among patients of different ages and genders(P＞0.05).The multivariate logistic regression analysis showed that the severe disease activity and elevated SALL4 mRNA,OLFM4 mRNA and Activin-A levels were risk factors for joint deformities in RA(P＜0.05).The cut-off values of Activin-A,SALL4 mRNA,and OLFM4 mRNA for predicting joint deformities in RA were 15.06 pg·L-1,3.412,and 3.802,respectively,and the areas under the curves were 0.699,0.693,and 0.756,respectively.The area under the curve for the predication of joint deformities in RA based on the combination of SALL4 mRNA,OLFM4 mRNA,and Activin-A was 0.892,which significantly higher than the prediction by the said indexes alone(Z=4.171,2.785,3.626,P＜0.05).Conclusion The increased levels of serum SALL4 mRNA,OLFM4 mRNA and Activin-A in RA patients are associated with RA disease activity,number of affected joints,duration of synovitis,and joint deformities.The combined detection of SALL4 mRNA,OLFM4 mRNA and Activin-A for predicting joint deformities in RA is more effective than the individual detection of the three.

Objective:To explore the effect of discharge preparation services in patients undergoing uniportal video-assisted thoracoscopic surgery for lung cancer.Methods:A total of 192 lung cancer patients who underwent uniportal video-assisted thoracoscopic surgery between April 2021 and May 2023 were selected using a convenience sampling method. The 97 patients admitted from April 2021 to April 2022 were designated as the control group and received routine care, while the 95 patients admitted from May 2022 to May 2023 were designated as the observation group and received discharge preparation services. Postoperative recovery indicators (e.g., time to first meal, time to first ambulation), the Readiness for Hospital Discharge Scale (RHDS), the Chinese version of the Functional Assessment of Cancer Therapy-Lung (FACT-L), and the nursing service satisfaction questionnaire were used to evaluate the intervention's effects.Results:The observation group had significantly shorter times to first meal, first ambulation, and drain removal, as well as lower complication rates compared to the control group, with statistically significant differences ( P<0.05). After the intervention, the RHDS, FACT-L, and nursing service satisfaction questionnaire scores were significantly higher in the observation group compared to the control group, with statistically significant differences ( P<0.05) . Conclusions:The application of discharge preparation services improves postoperative recovery, discharge readiness, quality of life, and satisfaction with nursing services in patients undergoing lung cancer surgery.