BACKGROUND: Studies have shown that osteoporosis, sarcopenia and obesity are important factors affecting metabolic diseases such as fracture, hypertension and dyslipidemia. OBJECTIVE: To describe the prevalence and influencing factors of osteosarcopenic obesity and its effects on racture and dyslipidemia, and to explore the role of diet and exercise in preventing osteosarcopenic obesity, so as to provide theoretical basis for the prevention and treatment of osteosarcopenic obesity METHODS: The related articles Included In PubMed and WANFANG database published from 1990 to 2018 were searched using the following keywords: Osteosarcopenlc obesity, sarcopenlc obesity, osteoporosis, sarcopenla, obesity, fracture, dysllpldemla, osteosarcopenlc obesity syndrome. The language was limited to “English” or “Chinese.” A total of 71 articles were Included for analysis and discussion. RESULTS AND CONCLUSION: (1) The age, sex, nationality or race differences in prevalence of osteosarcopenlc obesity have been found. The diagnostic criteria of osteosarcopenlc obesity, not international standard, have been established in the United States, Europe, Asia and others continents or countries; (3) Osteosarcopenlc obesity is affected not only by living and eating habits, but also by genes, cytokines and metabolic hormones. (4) Osteosarcopenic obesity exerts greater impact on fracture and dyslipidemia compared with osteoporosis, sarcopenia and obesity alone.

Objective:To explore the clinical feasibility and effectiveness of using 3D printed porous titanium-alloy prosthesis to repair aseptic large bone defects in the limbs.Methods:A retrospective analysis was performed on 13 patients with aseptic bone defects of long limbs treated with 3D printed porous titanium alloy prosthesis from December 2017 to December 2022, including 7 males and 6 females, aged 52.6±11.5 years (range, 35-72 years). The bone defect locations included 2 humerus, 1 radius, 5 femur, and 6 tibia. One patient suffered both femoral and tibial defects. All 13 patients suffered from bone nonunion due to internal fixation surgery, including 5 cases of hypertrophic nonunion and 8 cases of atrophic nonunion. The interval between internal fixation surgery and this treatment was 20.1±3.6 months (range, 16.5-26.6 months). The clinical treatment effect was evaluated through parameters such as gross observation, imaging evaluation, disability of arm shoulder and hand (DASH), lower extremity functional scale (LEFS), and patient satisfaction evaluation.Results:The length of bone defect after debridement in 13 patients was 11.7±4.5 cm (range, 6.0-20.6 cm), and the length of implant was 12.9±5.3 cm (range, 6.1-22.9 cm). Partial or complete weight-bearing began at 14.8±6.5 days (range, 2-22 days) after surgery. All 13 cases were followed up for 18.3±12.5 months (range, 13-58 months). The X-ray images showed that the prosthesis and the internal fixation were stable, and the new bone gradually grew gradually from the bone defect section and formed stable bone integration with the prosthesis surface, and no prosthesis displacement or fracture occurred. At the last follow-up, the DASH scores of 3 patients with upper limb bone defect were 8.9, 10.5, and 11.2 points, respectively, and the LEFS scores of 10 patients with lower limb bone defect were 49.6±5.9 points (range, 38-56 points). No significant subsidence or loosening of all prosthetics was observed. Patient satisfaction was 9.8±0.1 points (range, 9.6-9.9).Conclusion:After the application of 3D printed porous titanium alloy prosthesis to repair the aseptic large bone defect of the limbs, the patients can carry weight and function exercise in the early stage, and the function of the affected limbs can recover significantly, and the patients have high satisfaction.

BACKGROUND: Studying the relationship between flexibility and body composition of college students is of great significance for enhancing the levels of physical health and sports. OBJECTIVE: To investigate the relationship between sit-and-reach and body composition of college students in Guangxi Zhuang Autonomous Region and differences between sexes. METHODS: Totally 2 175 students from a Guangxi university were randomly selected. Body composition was determined by the MC-180 body composition tester. The students were divided into four groups: ≤ 12.10 cm group,＞ 12.10-16.40 cm group,＞ 16.40-20.70 group and＞ 20.70 group according to quartile of sit-and-reach measured in accordance with the National Physical Health Test Standard. All data were processed by SPSS 22.0 software. RESULTS AND CONCLUSION: Sit-and-reach was significantly correlated with body mass index, percentage of body fat, fat-free mass index, upper limb lean mass and lower limb lean mass (P ＜ 0.05), and percentage of body fat was negatively correlated with sit-and-reach (P ＜ 0.05). The body mass index, fat-free mass index, upper limb lean mass and lower limb lean mass in the ≤ 12.10 cm group were significantly lower than those in the other groups. Fat-free mass index and upper limb lean mass were correlated with sit-and-reach in male college students (P ＜ 0.05). The fat-free mass index and upper limb lean mass in the＞ 16.40-20.70 cm group were significantly higher than those in the ≤ 12.10 cm group. Therefore, there is a positive correlation between the flexibility and fat-free mass index and upper limb lean mass in college students.

Objective To establish an artificial intelligence(AI)diagnostic model for the histopathologic diagnosis of extramammary Paget's disease(EMPD)and to evaluate its efficiency for the diagnosis and differential diagnosis of EMPD.Methods All non-tumor skin disease patients who underwent skin tissue biopsy in Department of Dermatology of First Affiliated Hospital of Army Medical University from September 2003 to February 2023 were recruited,and their pathological data were collected,including EMPD,Bowen's disease(BD),squamous cell carcinoma(SCC),and epidermal hyperplasia and hypertrophy.With EMPD as the main research subject,the histopathological images of BD,SCC,and non-tumor skin diseases were included in the study.The histopathological data of 4 types of diseases was classified and diagnosed by ResNet101 and DenseNet121 deep learning neural networks,and the performance of these models was evaluated.Results The AUC values of the ResNet101 diagnostic model for the diagnosis of EMPD,BD,SCC and non-tumor skin diseases on the images at x20 magnification were 0.97,0.98,1.00 and 0.96,respectively,with an accuracy of 0.925±0.011,while the AUC values on the images at x40 magnification were 1.00,0.99,1.00 and 0.97,respectively,with an accuracy of 0.943±0.017.The AUC values of the DenseNet121 diagnostic model for the diagnosis of 4 diseases on the images at x20 magnification were 0.98,0.95,0.99 and 1.00,respectively,with an accuracy of 0.912±0.034,while the AUC values on the images at x40 magnification were 0.99,0.96,1.00 and 1.00,respectively,with an accuracy of 0.971±0.012.Our results indicated that the histopathologic diagnostic model could effectively differentiate EMPD from BD,SCC and non-tumor skin diseases at low power magnification.The FLPOs of ResNet101 was 786.6 M,and the parameter was 4.5 M;The FLPOs of DensNet121 was 289.7 M,and the parameter was 0.8M.Conclusion Our AI diagnostic model is of good effectiveness in the diagnosis and differential diagnosis of EMPD.DenseNet121 is recommended as the dermatopathological diagnostic model of this study.

Objective To investigate the accuracy of body mass index (BMI) as the evaluation standard for obesity in Miao adults in Guangxi, to find out the BMI cutoff value suitable for the evaluation standard of adult obesity, and to provide an accurate and reliable reference value for the prevention and treatment of obesity in Miao nationality adults. Methods Using a cross-sectional design, residents aged 18 years or older in the Miao villages in Rongshui Miao Autonomous County, Guangxi, were selected as the research subjects, and their body composition was measured. The percent body fat (PBF) standard was used as the ^“gold standard^” for obesity, and the BMI standard for obesity in Chinese adults was used as the positive screening standard. The accuracy of the BMI standard was evaluated, and the ROC curve analysis was used to determine the optimal BMI cutoff value for obesity in Miao adults. Results The detection rate of obesity of Miao adults in Guangxi by BMI method was lower than that by PBF method (10.3% vs 19.0%, χ²=426.62, P<0.001). The results of reliability evaluation showed that BMI was in good agreement with PBF in judging obesity (Kappa=0.59, P<0.001). BMI as a screening criterion for obesity in Miao adults showed high specificity and low sensitivity, low Yordon index, high positive predictive value and high positive likelihood ratio, and low negative predictive value and high negative likelihood ratio. When the PBF was used as the ^“gold standard^”, BMI had a good diagnostic performance for obesity in Miao adults (AUC=0.959, P<0.001). The optimal BMI cutoff points for obesity in adults of Miao nationality in Guangxi were 25.85 kg/m² and 25.55 kg/m² for men and women, respectively. Conclusion BMI is of great value for the diagnosis of obesity in Miao adults, but it should not be used as an exclusion criterion for obesity. Especially in the case of a small sample size, the risk of misclassification bias is relatively high.

Central nervous system (CNS) injuries, including stroke, traumatic brain injury, and spinal cord injury, are essential causes of death and long-term disability and are difficult to cure, mainly due to the limited neuron regeneration and the glial scar formation. Herein, we apply extracellular vesicles (EVs) secreted by M2 microglia to improve the differentiation of neural stem cells (NSCs) at the injured site, and simultaneously modify them with the injured vascular targeting peptide (DA7R) and the stem cell recruiting factor (SDF-1) on their surface via copper-free click chemistry to recruit NSCs, inducing their neuronal differentiation, and serving as the nanocarriers at the injured site (Dual-EV). Results prove that the Dual-EV could target human umbilical vascular endothelial cells (HUVECs), recruit NSCs, and promote the neuronal differentiation of NSCs in vitro. Furthermore, 10 miRNAs are found to be upregulated in Dual-M2-EVs compared to Dual-M0-EVs via bioinformatic analysis, and further NSC differentiation experiment by flow cytometry reveals that among these miRNAs, miR30b-3p, miR-222-3p, miR-129-5p, and miR-155-5p may exert effect of inducing NSC to differentiate into neurons. In vivo experiments show that Dual-EV nanocarriers achieve improved accumulation in the ischemic area of stroke model mice, potentiate NSCs recruitment, and increase neurogenesis. This work provides new insights for the treatment of neuronal regeneration after CNS injuries as well as endogenous stem cells, and the click chemistry EV/peptide/chemokine and related nanocarriers for improving human health.