OBJECTIVE: To explore the anatomical parameters of the cervical uncinate process "inflection point" through cervical CT angiography (CTA) and MRI measurements, offering a reliable and safe anatomical landmark for anterior cervical decompression surgery. METHODS: A retrospective analysis was conducted on the cervical CTA and MRI imaging data of normal adults who met the selection criteria between January 2020 and January 2024. The CTA dataset included 326 cases, with 200 males and 126 females, aged 22-55 years (mean, 46.7 years). The MRI dataset included 300 cases, with 200 males and 100 females, aged 18-55 years (mean, 43.7 years). Based on the CTA data, three-dimensional models of C ₃-C ₇ were constructed, and the following measurements were obtained from the superior view: uncinate process "inflection point" to vertebral artery distance (UIVD), uncinate process tip to vertebral artery distance (UTVD), uncinate process "inflection point" to "inflection point" distance (UID), uncinate process long-axis to sagittal angle (ULSA), and uncinate process "inflection point" to transverse foramen-sagittal angle (UITSA). From the anterior view, the anterior uncinate process to sagittal angle (AUSA) was measured. From the posterior view, the posterior uncinate process to sagittal angle (PUSA) was measured. Based on the MRI data, uncinate process "inflection point" to dural sac distance (UIDD) and dural sac width (DSW) were measured. The trends in measurement parameters of C ₃-C ₇ were observed, and the differences in measurement parameters between genders and between the left and right sides of the same segment were compared, as well as the difference in UID and DSW within the same segment was compared. RESULTS: The measurement parameters from C ₃ to C ₇ in the CTA data showed a general increasing trend, with no significant difference between the left and right sides within the same segment ( P>0.05). The UIVD, UTVD, and UID were greater in males than in females, with significant differences observed in the UIVD and UTVD at C ₃ and C ₆ and UID at C ₃, C ₆, and C ₇ ( P<0.05). The MRI measured DSW showed a general increasing trend from C ₃ to C ₇, and the DSW at C ₆ was greater in females than in males, with a significant difference ( P<0.05). The UIDD showed a gradual decreasing trend, with the smallest value at C ₆. There was no significant difference between males and females or between the left and right sides within the same segment ( P>0.05). The UID was greater than the DSW at C ₃-C ₇, and the differences were significant ( P<0.05). CONCLUSION The uncinate process "inflection point" is a constant anatomical structure located at the anteromedial aspect of the uncinate process tip and laterally to the dural sac. It maintains a certain safe distance from the vertebral artery. As a decompression landmark in anterior cervical spine surgery, it not only ensures surgical safety but also guarantees complete decompression.
Humans ; Adult ; Male ; Female ; Middle Aged ; Retrospective Studies ; Cervical Vertebrae/surgery* ; Magnetic Resonance Imaging ; Decompression, Surgical/methods* ; Young Adult ; Adolescent ; Computed Tomography Angiography ; Imaging, Three-Dimensional ; Vertebral Artery/anatomy & histology* ; Anatomic Landmarks/diagnostic imaging*

Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

Medical social work, as a bridge between social welfare policies and healthcare services, is an important force in meeting the diverse and multi-level needs of the people in medical and health care. Due to the particularity of the pediatric population, pediatric medical social work is becoming one of the key areas in the development of medical social work. Beijing Children′s Hospital, Capital Medical University has established a service mode of " collaborative medical and social worker team". The medical social workers acted as supporters to assist healthcare professionals to meet the psychological and social service needs of patients and their families as much as possible, and empowered medical staff′s career development as supporters. At the same time, the medical social workers assisted in the construction of a " child friendly" medical environment, and built a social support network for patients and families. The appropriateness and future prospects of pediatric medical social work were explored, in order to provide reference for its development.

Pancreatic ductal adenocarcinoma is a highly invasive malignant tumor of the digestive system with an extremely poor prognosis. Leukemia inhibitory factor is an important member of the interleukin-6 family and can regulate multiple physiological processes such as cell differentiation, growth, and renewing. This article reviews the mechanism of action of leukemia inhibitory factor in pancreatic ductal adenocarcinoma and the research advances in leukocyte inhibitory factor-targeted therapy based on literature evidence, and the analysis shows that leukemia inhibitory factor plays an important role in the progression, immune escape, and chemotherapy resistance of pancreatic ductal adenocarcinoma and may gradually become a potential biomarker and therapeutic target for pancreatic ductal adenocarcinoma.

At present, there is still a lack of comprehensive diagnosis and treatment criteria for pancreatic exocrine insufficiency around the world. Pancreatic surgeons often ignore or misjudge pancreatic exocrine insufficiency secondary to pancreatic cancer, and as a result, pancreatic exocrine insufficiency is not adequately treated, which greatly affects the quality of life of patients with pancreatic cancer. This article summarizes the latest research advances in the pathogenesis, typical symptoms, and diagnostic methods of pancreatic exocrine insufficiency, as well as pancreatic enzyme replacement therapy in different stages of pancreatic cancer. It is pointed out that pancreatic enzyme replacement therapy can significantly improve the quality of life of patients with different stages of pancreatic cancer.

Objective To investigate the expressions of regulatory B cells and related cytokines in patients with Guillain-Barre syndrome (GBS).MethodsForty-four patients with GBS admitted to our hospital from October 2018 to June 2019 were enrolled as GBS group; 44 healthy subjects accepted physical examination in our hospital at the same period were selected as control group. Flow cytometry was used to determine the proportions of CD19+CD24hiCD38hi regulatory B cells and CD19+CD24hiCD27+ regulatory B cells in CD19+ lymphocytes in peripheral blood mononuclear cells of the two groups. ELISA was employed to detect the serum contents of interleukin (IL)-10, IL-35 and transforming growth factor (TGF)-β1 of the two groups.ResultsAs compared with those in the control group, the proportions of CD19+CD24hiCD38hi regulatory B cells and CD19+CD24hiCD27+ regulatory B cells in CD19+B lymphocytes of the GBS group were significantly decreased (P<0.05). As compared with the control group, the GBS group had significantly decreased IL-10 and IL-35 levels (P<0.05), and obviously increased TGF-β1 content without statistical difference (P>0.05).ConclusionRegulatory B cells play a role in the pathogenesis of GBS through IL-10 and IL-35 cytokine pathways.

Objective: To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions. Methods: In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization. Results: The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30). Conclusion Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.

Objective: To explore new multidrug resistant genes of pancreatic cancer by establishment and characterization of chemo-resistant cell lines. Methods: The cisplatin-resistant cell line JF305/CDDP and the gemcitabine-resistant cell line PANC-1/GEM were induced by high-dose intermittent treatment. CCK-8 assay was used to detect the 50% inhibiting concentration (IC₅₀), drug resistance index (R), cross-resistance, and growth difference of different cells. The changes of cell cycle and migration ability of drug-resistant cells were determined by flow cytometry and transwell assay, respectively. And then real-time fluorescence quantitative PCR was used to detect the expression of multidrug resistance-related genes. Results: The drug resistance indexes of JF305/CDDP and PANC-1/GEM were 15.3 and 27.31, respectively, and there was cross-resistance. Compared with the parental cells, the proliferation rate of JF305/CDDP was decreased by 40% on the fourth day (P<0.05); the proportion of S phase was decreased from (45±2)% to (30±2)% (P<0.05), and the migration ability was enhanced from (32 ±1) cells per field to (158±5) cells per field (P<0.01). The expression of multidrug resistance-related genes MRP2, MDR1, LRP and MSX2 was increased in JF305/CDDP cells (P<0.05). Knockdown of MSX2 in JF305 cells reduced the expression of MRP2, whereas overexpression of MSX2 in PANC-1 cells upregulated MRP2 level (P<0.05). Conclusions Two stable multidrug resistant cell lines of pancreatic cancer, JF305/CDDP and PANC-1/GEM, were successfully established. MSX2 might be a new drug resistance related gene in pancreatic cancer cells by up-regulation of MRP2 expression.

Objective To evaluate the safety and efficacy of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods The safety and effectiveness of clinical application of three-dimensional printing technology in Orthopedics were analyzed by systematic review of non-control studies.Results Non-control studies showed that cortical perforation rate of screws was 3.83％ (calculated by the number of screw).Complication rate was 2.13％,surgical infection rate was 0.28％,prosthesis problematic rate was 0.79％,the average operation time was 139.23 minutes,and some results of the indicators for safety and effectiveness were similar between studies with and without control groups.Conclusion Although 3D printing application in Orthopedics has some clinical value,and its extension needs economic assessment.

Objective To assess the effect of clinical application of three-dimensional printing technology (3D printing) in Orthopedics.Methods Comparing the effect of clinical application of three-dimensional printing technology with traditional Standardized technology,through using a systematic review and Meta Analysis.Results Meta analysis of 25 studies included in the research showed that application of 3D printing reduced operation time by 26 minutes,decreased intraoperative blood loss by 77 ml,and increased accuracy rate or success rate of screw implanting(increased by 2.10 times compared with tradit onal standardized technology).Conclusion The application of 3D printing in Orthopedics has good short-term effect But its deVelopment in clinical application should be cautious.