BACKGROUND:The extracellular-regulated protein kinase 5(ERK5)signaling protein is essential for the survival of organisms,and resveratrol can promote osteoblast proliferation through various pathways.However,whether resveratrol can regulate osteoblast function through the ERK5 signaling protein needs further verification. OBJECTIVE:To explore the regulatory effect of ERK5 on the proliferation of MC3T3-E1 cells and related secreted proteins,and to further verify whether resveratrol can complete the above process by activating ERK5. METHODS:Mouse MC3T3-E1 preosteoblasts were treated with complete culture medium,XMD8-92(an ERK5 inhibitor),epidermal growth factor(an ERK5 activator),resveratrol alone,XMD8-92+EGF,and resveratrol+XMD8-92,respectively.Western blot assay was used to detect the expression of ERK5 and p-ERK5 proteins,proliferation-related proteins Cyclin D1,CDK4 and PCNA,and osteoblast-secreted proteins osteoprotegerin and receptor activator of nuclear factor-κB ligand in MC3T3-E1 cells of each group.The fluorescence intensity of ERK5,osteoprotegerin and receptor activator of nuclear factor-κB ligand in each group was detected by cell immunofluorescence staining,and cell proliferation was detected by EdU staining,respectively.The appropriate concentration and time of resveratrol intervention in MC3T3-E1 cells were determined by cell morphology observation and cell counting kit-8 assay. RESULTS AND CONCLUSION:The activation of ERK5 signaling protein could effectively promote the proliferation of MC3T3-E1 cells,up-regulate the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio.The appropriate concentration and time for resveratrol intervention in MC3T3-E1 cells was 5 μmol/L and 24 hours,respectively.Resveratrol could activate ERK5 signaling protein,thereby promoting osteoblast proliferation and up-regulating the osteoprotegerin/RANKL ratio.All these results indicate that resveratrol can promote the proliferation of MC3T3-E1 cells and up-regulate the osteoprotegerin/RANKL ratio by activating the ERK5 signaling protein.

Objective To understand the situation of dental cone beam computed tomography (CBCT) quality control testing phantoms in radiation health technical service institutions in Guangdong province, analyze the differences among different phantoms, and provide a reference for dental CBCT quality control testing. Methods The testing phantoms of 49 radiation health technical service institutions were used as the research objects. The designated CBCT equipment was used for scanning and imaging. The Z-score method was used to evaluate the high-contrast resolution, low-contrast resolution, and distance measurement deviation of each phantom. Results The satisfaction rates of various items for the phantoms in 49 institutions ranged from 85.7% to 100%. The distance measurement deviations of four institutions were “suspicious”, and the high-contrast resolution of four institutions and the distance measurement deviation of one institution were “unsatisfactory”. Conclusion The overall performance of dental CBCT quality control testing phantoms in radiological health technical service institutions in Guangdong province is satisfactory. However, there are still some phantoms with poor results in items such as distance measurement deviation and high-contrast resolution. The structural design, material selection, and manufacturing process of the phantom may all affect the results of quality control testing. Therefore, appropriate phantoms, optimized exposure conditions, and suitable reconstruction algorithms should be used in CBCT quality control testing to ensure accurate and reliable measurements.

Objective To analyze bedside radiation dose rates for interventional surgery operators in Guangdong Province, examine dose distribution patterns, and identify potential weaknesses in radiation protection, and to provide guidance for optimizing radiation monitoring and protection measures. Methods A total of 209 digital subtraction angiography devices measured in Guangdong Province between 2017 and 2024 were used as the research objects. The first and second operator positions were set at 30 cm and 90 cm horizontally from the X-ray tube focal point, respectively. Monitoring points were set up at 155, 125, 105, 80, and 20 cm above the ground. Results The median bedside radiation dose rate for interventional surgery operators in Guangdong Province was 83.0 (3.9, 1044.0) μSv/h, indicating instances of exceeding standard limits. The overall dose rates under the old and new standards were 29.8 (3.9-346.5) μSv/h and 114.0 (4.0-1044.0) μSv/h respectively. Results for both standards showed a higher dose rate at the second than the first operator position. The dose rates at the heights of 105 cm (abdomen), 125 cm (chest), and 155 cm (head) were higher in the second operator position than in the first operator position. Additionally, 71.5% and 56.8% of the highest dose rate points under the new and old standards, respectively, were concentrated at 105 cm (abdomen), 125 cm (chest) and 155 cm (head) in the second operator position. Conclusion The principle of protection optimization should be followed, auxiliary protective facilities should be placed correctly, and attention should be paid to the protection of the second surgery operator position, especially above the abdomen. The dose rate results under the new standard were lower than those under the old standard, suggesting that the measurement method may overestimate radiation exposure at the secondary operator position.

BACKGROUND:Fluid shear stress plays an important role in osteoblast proliferation and apoptosis.However,whether Caveolin-1 is involved in the process of fluid shear stress-induced proliferation and apoptosis in osteoblasts is unknown. OBJECTIVE:To explore the role of Caveolin-1 in fluid shear stress-regulated osteoblast proliferation and apoptosis. METHODS:The MC3T3-E1 osteoblasts in good growth status were selected and loaded with fluid shear stress at an intensity of 1.2 Pa for different times(0,30,60,90 minutes).The expression of Caveolin-1 protein was observed and conditions with a time of 60 minutes were screened for the experiment.MC3T3-E1 cells were divided into control group,fluid shear stress group,fluid shear stress+pcDNA 3.1 group(control),fluid shear stress+pcDNA Cav-1 group(plasmid overexpression),and intervened with fluid shear stress and overexpression of Cav-1,respectively.The expression of molecules related to proliferation and apoptosis in MC3T3-E1 cells was detected by qRT-PCR and western blot.In addition,the proliferative activity of MC3T3-E1 cells was detected by cell counting kit-8 and EdU assay;and cell apoptosis was detected by Hoechst 33258 and flow cytometry. RESULTS AND CONCLUSION:The expression of Caveolin-1 in MC3T3-E1 cells was significantly down-regulated after loading fluid shear stress,and the expression level was lowest after 60 minutes.Overexpression of Caveolin-1 attenuated the proliferation-promoting and apoptosis-suppressing effects of fluid shear stress in MC3T3-E1 cells.In conclusion,Caveolin-1 has a vital role in fluid shear stress-regulated osteoblast proliferation and apoptosis,which may offer a potential therapeutic strategy for osteoporosis.

Objective To analyze thoracolumbar vertebral fractures(A3)treated by multiple manipulations using the finite element method and to explore the feasibility and advantages of the composite surgical method for treating thoracolumbar vertebral fractures(A3).Methods For three-dimensional reconstruction of thoracolumbar vertebral fractures(A3),the model was loaded with simulated hyperextension posture restoration,simple press restoration,press restoration under hyperextension posture,and composite manipulation.Subsequentially,the stress distribution of the model and displacement of the fractured vertebral body were observed.Results The equivalent stress under composite manipulation was 111.88 MPa,which was greater than that under other manipulations,and the stress under composite manipulation was more concentrated in the anterior and middle columns of the vertebral body.The peak stress under composite manipulation was 122.53 MPa,which was greater than that under other manipulations,and the stress was centrally distributed in fracture region of the fractured vertebral body.The fracture displacement under composite manipulation was 3.94 mm,which was greater than that under other manipulations,and the displacement distribution decreased from the posterior column to the anterior mid-column.The anterior longitudinal and intertransverse interligamentous ligaments of the fractured vertebral body experienced the greatest stress under composite manipulation,and the joint capsule ligaments experienced the greatest stress under hyperextension postural restoration,simple press restoration,and press restoration under the hyperextension posture.Conclusions Compound manipulation for treating thoracolumbar vertebral fractures(A3)has obvious advantages over other manipulative restorations and is a reasonable program for the current treatment of thoracolumbar vertebral fractures(A3).

Objective:To evaluate the safety and efficacy of the domestic robotic surgical system for general surgery.Methods:A prospective single-center, single-arm exploratory study was conducted at Gansu Provincial People's Hospital from Jun 2022 to Oct 2023, enrolling 54 patients undergoing general surgery using domestically produced Toumai? Endoscopic Surgical Robotic System. The primary study endpoint was surgical success rate, and the secondary study endpoints were intraoperative bleeding, operative time, complications, system performance, hospitalization days.Results:In this study, robotic surgery was successfully completed in 52 patients, and in 2 patients undergoing thyroid operation it was converted to open surgery due to bleeding, with a success rate of 96%, no organ injury or death during surgery, and no system failure. The types of surgery included cholecystectomy, radical gastric cancer resection, radical colorectal cancer resection, inguinal hernia repair, partial hepatectomy, total thyroidectomy and choledocho-jejunal anastomosis.Conclusion:The study provides preliminary evidence of the safety and efficacy of the Toumai? Endoscopic Surgical Robotic System for the treatment of general surgical diseases.

The main function of anterior cruciate ligament (ACL) is to maintain stability of the knee joint and prevent anterior displacement of the tibial plateau. ACL injury accounts for more than 50% of the knee joint injuries. If not timely handled, it will increase the risk of secondary injuries to structures such as the meniscus and cartilage, causing chronic pain and degeneration of the knee joint. Although most ACL injuries can be determined by their direct signs on MRI, the identification of complex situations and partial tears of ACL are still not satisfactory, which subsequently affects treatment strategies. After ACL injury, changes in anatomical relationship of the knee joint can also lead to morphological changes in other structures such as the posterior cruciate ligament (PCL) on MRI, and these indirect signs can assist in the diagnosis of ACL injury. The authors reviewed the application of MRI-related indicators of PCL in diagnosing ACL injury, hoping to provide references and new ideas for clinical decision-making.

In recent years, with the in-depth study of PD-1 and PD-L1 and the development of immunotherapy, the first problem is how to screen the beneficiaries. Recent clinical studies have shown that the expression level of PD-L1 in circulating tumor cells (CTC) can be used as a potential biomarker to play a guiding role in immunotherapy of malignant tumors. This article reviews the latest clinical research progress on the expression of PD-L1 in circulating tumor cells in various solid tumors.

Objective:To investigate the related risk factors related to patellar dislocation combined with osteochondral fracture (OCF).Methods:A case control study was conducted to analyze the clinical data of 278 patients with patellar dislocation admitted to Second Hospital of Lanzhou University from January 2016 to June 2020, including 98 males and 180 females; aged 12-41 years [(21.1±4.6)years]. The patients were divided into OCF group ( n=112) and non-OCF group ( n=166) according to the surgical records and occurrence of OCF or not under intraoperative arthroscopy. The data of the two groups were recorded, including basic characteristics (ie, sex, age, sides of injury, whether or not the epiphysis is closed), patella height, patellar inclination angle, tibial tubercle-trochlear groove (TT-TG), femoral trochlear shape, tibial lateral rotation angle and femoral anteversion angle. Univariate analysis was adopted to evaluate the correlation of the data with patellar dislocation combined with OCF. Multivariate Logistic regression analysis was used to determine the independent risk factors of patellar dislocation combined with OCF. Results:Univariate analysis showed that patellar dislocation combined with OCF was related to male, patellar inclination angle and femoral anteversion angle ( P<0.05 or 0.01), while not to age, epiphysis is closed or not, sides of injury, patella height, TT-TG, femoral trochlear shape and tibial lateral rotation angle (all P>0.05). Multivariate Logistic regression analysis showed that male ( OR=1.75, 95% CI 1.07-2.90, P<0.05) and increased femoral anteversion angle ( OR=3.12, 95% CI 1.89-5.17, P<0.05) were significantly correlated with patellar dislocation combined with OCF. Conclusion:Male and increased femoral anteversion angle are independent risk factors for patellar dislocation combined with OCF.

Objective:To compare the efficacy of medial patellofemoral ligament (MPFL) reconstruction using single half tunnel, double half curved tunnel and suture anchor fixation in the treatment of patellar dislocation.Methods:A retrospective cohort study was used to analyze the clinical data of 58 patients with patellar dislocation treated in Second Hospital of Lanzhou University from June 2018 to February 2021, including 22 males and 36 females, aged 12-34 years [(19.6±5.5)years]. MPFL reconstruction was performed arthroscopically using single half tunnel fixation in 20 patients (single half tunnel group), double half curved tunnel fixation in 18 (double half curved tunnel group) and suture anchor fixation in 20 (suture anchor group). The Lysholm score, International Knee Documentation Committee (IKDC) score and Tegner activity score were compared among groups before operation, at 3 months after operation and at the last follow-up. The knee range of motion was compared among the three groups at 3 months after operation and at the last follow-up. The postoperative complications of the three groups were observed at the last follow-up.Results:All patients were followed up for 9-39 months [(26.5±9.1)months]. In single half tunnel group, double half curved tunnel group and suture anchor group, the Lysholm score was (78.4±12.0)points, (88.7±7.5)points and (81.1±9.8)points at 3 months after operation, and (80.4±14.2)points, (90.9±9.0)points and (83.3±9.1)points at the last follow-up. The postoperative Lysholm score in all groups was significantly increased from that preoperatively (all P<0.01). The Lysholm score in double half curved tunnel group was significantly higher than that in other two groups at 3 months after operation and at last follow-up (all P<0.05), but there was no significant difference between other groups (all P>0.05). In single half tunnel group, double half curved tunnel group and suture anchor group, the IKDC score was (76.7±12.2)points, (78.4±8.9)points and (81.0±8.1)points at 3 months after operation, and (77.6±15.8)points, (83.2±7.8)points and (82.4±12.4)points at the last follow-up. The postoperative IKDC score in all groups was significantly increased from that preoperatively (all P<0.01), but there was no significant difference among the three groups (all P>0.05). In single half tunnel group, double half curved tunnel group and suture anchor group, the Tegner score was (4.0±1.2)points, (5.4±1.7)points and (5.3±1.7)points at 3 months after operation, and (4.1±1.4)points, (5.8±1.8)points and (5.3±2.2)points at the last follow-up. The postoperative Tegner score in all groups was significantly improved from that preoperatively (all P<0.01). The Tegner score in single half tunnel group was significantly lower than that in other two groups at 3 months after operation and at last follow-up (all P<0.05), but there was no significant difference between other groups (all P>0.05). In single half tunnel group, double half curved tunnel group and suture anchor group, the knee range of motion was (122.3±6.4)°, (121.7±7.1)° and (123.3±5.7)° at the last follow-up, which were significantly increased from (117.3±8.0)°, (115.3±7.9)° and (116.8±8.3)° at 3 months after operation (all P<0.05), with no significant difference among the three groups (all P>0.05). The postoperative complication rate was 10.0% (2/20) in single half tunnel group, 5.6% (1/18) in double half curved tunnel group, and 25.0% (5/20) in suture anchor group ( P>0.05). Conclusions:For patellar dislocation, MPFL reconstruction using single half tunnel, double half curve tunnel and suture anchor fixation have achieved satisfactory improvement of knee range of motion, but knee functional recovery is much better after double half curved tunnel fixation.