OBJECTIVETo study the biomechanical change of the craniovertebral junction in conditions of atlas assimilation.

METHODSMimics software was used to process CT data of the craniovertebral junction in a health adult to obtain the three-dimensional reconstruction and the cloudy points of C1, C2 and part of the occipital bone. Then the cloudy points were imported into the Abaqus 6. 8 software to establish the occipito-atlantoaxial finite element model in normal structure. According to the established model in normal structure, the model in conditions of atlas assimilation was set by changing the model parameters. Both models of normal structure and atlas assimilation were loaded with 1. 5 N . m static moment to simulate four motions of flexion, extension, lateral bending and axial rotation respectively. The movement characteristics,joint stress force and ligament deformation was analyzed.

RESULTSUnder 1. 5 N . m moment, in model of atlas assimilation the C1-C2 range of movement decreased from 13. 55° to 11.88° in flexion,increased from 13. 22° to 15. 24° in extension and from 4. 05° to 4. 23° in lateral bending and remained unchanged in axial rotation when compared with the normal model. In flexion movement, the contact force of the atlanto-dental joint increased from 1. 59 MPa to 3. 28 MPa and the deflection of apical ligament, tectorial membrane and alar ligament increased 129. 1%, 157. 6% and 75. 1% respectively when compared with the normal model.

CONCLUSIONSThe normal C1-C2 motion mode is destructed in conditions of atlas assimilation, leading to the changes of the range of movement,joint stress force and the ligament deformation at C1 C2 junction. The atlantoaxial instability will likely occur in flexion motion.

Atlanto-Axial Joint ; physiology ; Biomechanical Phenomena ; Cervical Atlas ; physiology ; Cervical Vertebrae ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Joint Instability ; Ligaments, Articular ; Occipital Bone ; Range of Motion, Articular ; Rotation

Objective To investigate the clinic signification of newborn hearing screening combined with deafness susceptibility genes screening. Methods 1 440 newborns(3 ~ 5 days after birth) were screened for 8 hot spot hearing loss associated mutations from GJB2, mt12S rRNA and SLC26A4. At the same time, all infants received hearing screening. Those who failed to pass two-step test were referred to further audiological assessment. Results The carrier rate of commonmutations was 1.46% for GJB2 c.235delC, 0.35% for GJB2 c.299-300delAT, 0.42% for mt12S rRNA c.1555A > G, 0.42% for SLC26A4 c.IVS7-2A > G and 0.14% for SLC26A4 c.2168A > G. The total carrier rate was 2.78%. 10 infants were diagnosed as hearing loss in the hearing screening and follow-up audiology assessment (6.94‰) and 5 were diagnosed as severe hearing loss (3.47‰). 32 hearing loss associated mutation carriers passed the hearing screening. Conclusions Genetic screening of newborn hearing screening can be helpful to find out neonates with late-onset and progressive hearing impairment, which were significant for early intervention, regular follow-up and reduction of deafness.

Objective:To evaluate the clinical effectiveness and safety of combined face and neck injections of botulinum toxin type A to improve face and neck aging.Methods:From January 2020 to January 2023, 30 female patients with age of 29-66 years, average (42.2±8.8) years, underwent face and neck combined injection of A-type botulinum toxin in the Department of Dermatology, Henan Provincial People′s Hospital. The injection sites included the forehead, between the eyebrows, around the eyes, the dorsum of the nose, and the mandibular margin, etc. The efficacy was assessed by the wrinkle severity scale (FWS) and the AB value of the distance from the lowest point of the mandibular margin on the midline of the hemiface to the level of the medial canthus at 4 and 24 weeks after the injection, as well as the subjective degree of improvement by the Global Aesthetic Improvement of the Face Scale (GAIS) and the Self-perception of Age (SPA), and the satisfaction of the patients and post-injection adverse reactions.Results:At 4 weeks after the injection, the total effective rate of improvement of wrinkles in all parts of the upper face was 100% (30/30), and there was a statistically significant difference in the improvement of AB ( t=28.35, P<0.05). At 24 weeks after the injection, the total effective rate of improvement of wrinkles in all parts of the upper face ranged from 16.7% (5/30) to 36.7% (11/30), and the improvement of AB still showed a statistically significant difference ( t=3.98, P<0.05). 100% (30/30) and 66.7% (20/30) of patients assessed their facial status as improved on GAIS at 4 and 24 weeks after the injection, respectively, and 100% (30/30) and 63.3% (19/30) of patients perceived themselves as younger. Patient satisfaction was 100% (30/30). After injection, there were 5 cases of slight ecchymosis at the injection site and 1 case of weakness in eyebrow elevation in the 30 patients, which disappeared on their own within 1 to 2 weeks. Conclusions:The therapeutic effect of face and neck combined injection of botulinum toxin type A on facial rejuvenation is obvious, with high patient′s satisfaction and no serious adverse reactions.

Objective: To understand the epidemiological characteristics of physical assault injuries among students in Dalian, so as to provide evidence for the prevention and control of physical assault injuries among students. Methods: Data of student physical assault injuries came from the Dalian Hospital Injury Monitoring System from 2018 to 2022, descriptive epidemiological methods and Chi square tests were used for statistical analysis. Results: A total of 1 413 cases of physical assault injuries among students were reported, and the sex ratio between male and female was 4.12∶1. The number of reported physical assault injuries dropped from 414 cases in 2018 to 209 cases in 2022. The group of senior middle school/secondary vocational school had the highest proportion of cases (40.13%). Injuries occurred in all months, with the highest number of reported cases in June, October, and November, accounting for 33.97%. The main causes of injuries were blunt instrument injuries and falls, accounting for 70.06% and 23.35% respectively. The proportion of male (71.24%) was significantly higher than female (65.22%) in blunt instrument injuries ( χ 2=3.84, P <0.05). Nearly 75.58% of injuries occurred during leisure time. The main locations of injuries took place in schools and roads, accounting for 51.52% and 23.35% respectively. Contusions and sharp instrument injuries were one of the most common types of injuries, accounting for 67.16% and 22.29% respectively. The main area of injury was concentrated in the head, accounting for 59.52%. Most of injuries were mild and moderate, accounting for 72.26% and 27.60 %, respectively. Conclusions Schools are the main location for physical assault injuries among students, with boys and middle school students being the most vulnerable populations. Targeted intervention measures should be implemented to effectively reduce the occurrence of physical assault injuries among students.

Objective To detect the association between rs4646999 polymorphisms in the promoter region of the c-Jun and the prognosis of sporadic colorectal cancer. Methods rs4646999-673C>T genetypes were deter-mined by Taqman-MGB probes in 436 colorectal cancer cases. The survival curve was analyzed by Kaplan-Meier analysis and Cox regression.Western blot was used to analyze the expression levels of c-Jun protein in different gen-otypes. Results Univariate analysis showed that the cumulative survival rate of patients with rs4646999TT geno-type was significantly higher than that of patients with CT and CC genotype. Multivariate Cox regression analysis showed that the differentiation,lymph node metastasis,distant metastasis,TNM stage and rs4646999 genetypes were prognostic factors.Compared with the carriers of TT genotype,CT/CC complex genotypes were associated with poor prognosis of colorectal cancer(P<0.05).Protein expression analysis showed that the expression of c-Jun pro-tein in CC genotype was increased.In contrast,the TT genotype was decreased.Conclusions This study provided the evidence that rs4646999-673C>T genetic variant in c-Jun promoter regions is associated with the poor survival prognosis of colorectal cancer,possibly by elevating the protein expression levels that appeared to up-regulate activ-ity of c-Jun thus tumorigenesis.

The intestinal flora and gut barrier function are of great significance for gut function and human health. When the intestinal flora is disrupted and the gut barrier structure is disrupted, it can lead to bacterial translocation, endotoxin influx into the bloodstream, and the production of pro-inflammatory factors, leading to various tissue damage in the body. Tongfu method in TCM can affect the intestinal environment by regulating intestinal permeability and immune response, restoring normal intestinal movement, and regulating the structure and metabolites of intestinal flora, thereby maintaining intestinal homeostasis and body health. The research on regulating intestinal flora and improving intestinal barrier function by Tongfu method can provide reference for further research on the relationship between TCM and intestinal microecology, and provide ideas for clinical treatment.

BACKGROUND:Bone defects are caused by many factors,such as inflammation,tumor,trauma or bone diseases.Erythropoietin can promote the differentiation of mesenchymal stem cells into osteoblasts and osteoclasts and act on vascular endothelial cells to induce angiogenesis and accelerate the repair of bone and cartilage defects.Erythropoietin is a growth factor with potential application in bone tissue engineering construction. OBJECTIVE:To expound the application and potential mechanism of erythropoietin in bone tissue engineering. METHODS:The first author searched the related articles published in CNKI,WanFang,VIP,and PubMed databases from 2004 to 2022 by computer.Search terms were"erythropoietin,bone defect,bone regeneration,angiogenesis,osteogenesis,osteoblast,osteoclast,bone tissue engineering"in Chinese and English.Finally,64 articles were included for review. RESULTS AND CONCLUSION:(1)Erythropoietin can directly act on osteoblasts and osteoclasts in the bone marrow microenvironment by promoting the differentiation of mesenchymal stem cells into osteoblasts,osteoclasts,adipocytes,nerve cells and stromal cells.The activation of Wnt/β-catenin,hypoxia-inducible factor 1α/vascular endothelial growth factor,p38 MAPK and EphrinB2/EphB4 signaling pathways mediates the osteogenic differentiation of mesenchymal stem cells.(2)Erythropoietin can not only regulate the production of erythrocytes to alter the oxygen-carrying capacity of blood but also stimulate vascular endothelial cells to promote angiogenesis.The new blood vessels can carry oxygen,nutrients,growth factors,and bone progenitor cells necessary for osteogenesis to the osteogenic site,thereby promoting bone formation and fracture healing.(3)Currently,erythropoietin is being used as a growth factor with osteogenic and angiogenic effects in various types of scaffold materials such as chitosan,polycaprolactone,bioceramics,and nanofibers through various drug delivery methods.Erythropoietin,along with other growth factors such as bone morphogenetic protein-2 and bone morphogenetic protein-9,has been applied to the surface of scaffold materials to participate in the repair of bone defects.Erythropoietin has demonstrated excellent practicality in the construction of new tissue-engineered bone and has potential clinical application value.

Objective: To investigate the effect of Kamistad gel on oral ulcer healing and the expression of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and epidermal growth factor (EGF) after oral administration in ulcer tissue of rats and to provide animal experimental data for the clinical application of Kamistad gel. Methods: The oral ulcer rat model was established by chemical cauterization. The rats were randomly divided into four groups: Kamistad group (Kamistad gel), befuxin group (befuxin gel), lidocaine group (lidocaine cream), blank control group (normal saline), with 12 rats in each group. The ulcer area of the rats in each group was measured before and 1, 3 and 5 days after treatment; at 1 day after treatment, the duration of swabbing behavior within 3 minutes of intraoral capsaicin infusion was recorded to evaluate the degree of pain; the ulcer tissue was collected at 5 days after treatment, and the histopathological changes were observed by HE staining, the expression of TNF-α, IL-6 and EGF in the ulcer tissue was detected by immunohistochemistry and ELISA. Results: At 1 day after treatment, the duration of mouth wiping induced by capsaicin was significantly shorter in the Kamistad group than in the blank control and befuxin groups (P < 0.05), but there was no significant difference between the Kamistad and lidocaine groups (P >0.05). At 5 days after treatment, the ulcer area was significantly smaller in the Kamistad group than in the blank control and lidocaine groups (P < 0.05), and there was no significant difference between the Kamistad and befuxin groups (P >0.05). At 5 days after treatment, H&E staining of the oral ulcer tissue sections showed significantly reduced levels of inflammatory cells and significantly proliferated fibroblasts and better epithelial hyperplasia in the Kamistad group compared with those in the lidocaine and blank control groups, and there were no differences between the Kamistad and befuxin groups. At 5 days after treatment, the expression levels of TNF-α, IL-6 and EGF in the ulcer tissue of rats in each group were significantly different (P < 0.05). Compared with the blank control and lidocaine groups, the expression of TNF-α and IL-6 was significantly decreased and the expression of EGF was significantly increased in the Kamistad group (P < 0.05); there were no significant differences in the expression of the above three factors between the Kamistad and befuxin groups (P > 0.05). Conclusion Kamistad gel exhibited anti-inflammatory, analgesic and healing effects on experimental oral ulcers.

Objective: To determine differences in pain, salivary components and taste between burning mouth syn⁃ drome (BMS) patients and the normal population and to study the effects of intramuscular injections of vitamin B1 (VitB1) and vitamin B12 (VitB12) on BMS. Methods: Before treatment: We observed and compared differences in un⁃ stimulated salivary flow rate (USFR); stimulated salivary flow rate (SSFR); salivary amylase, cortisol, and secretory im⁃ munoglobulin A (SIgA) concentrations; and taste levels between BMS patients and normal controls. After treatment: The treatment group received an intramuscular injection of 100 mg VitB1 and 0.5 mg VitB12 in the buttocks once per day for 10 days. The above indexes were recorded before and after treatment and compared. A visual analog scale (VAS) score was used to assess the degree of pain relief in patients and as a clinical evaluation index. Results: Before treat⁃ ment: SSFR, salivary amylase levels and bitter taste levels of the treatment group were significantly lower than those of the control group (P < 0.05). The concentration of SIgA was significantly higher than that of the control group (P < 0.05), and the USFR and the cortisol concentration were not significant different from the those of the control group (P > 0.05). After treatment: The total effective rate of VitB1 and VitB12 on BMS was up to 70%. USFR was increased signifi⁃ cantly after treatment (P < 0.05), and the concentration of SIgA decreased (P < 0.05). There were no significant differ⁃ ences in the SSFR or the cortisol and salivary amylase concentrations (P > 0.05). Taste levels improved by varying de⁃ grees. Conclusions The abnormal decreases in SSFR, salivary amylase levels, and taste sensitivity and the abnormal increase in SIgA levels seen in BMS patients may be sensitive salivary indicators for the diagnosis of BMS. A VitB1 and VitB12 intramuscular injection is an effective treatment for patients with BMS, who showed pain relief. Changes in SIgA levels may be used as an indicator during follow⁃up and for the prognosis of BMS patients.

Objective:To summarize the best evidence of intracranial hypertension nursing for adult patients with severe brain injury, and to provide reference for clinical nursing practice.Methods:According to the evidence-based methodology, a systematic search of Chinese and English literature on intracranial hypertension nursing of adult patients with severe brain injury was conducted in domestic and foreign databases such as CNKI, Wanfang, PubMed, Cochrane Library and Cinahl Plus and so on, as well as related guide websites and professional association websites from the establishment of database to August 2022. Two researchers independently evaluated literature quality and screened evidence, and then the project team summarized and concluded the evidence.Results:A total of 6 009 articles were obtained through preliminary search, and 33 articles were included after screening, including 13 guidelines, 1 systematic review, 17 expert consensus, 1 evidence summary, and 1 meta-analysis. In total, 33 pieces of best evidence were obtained from 8 dimensions, including intracranial pressure related threshold, assessment and monitoring, respiratory care, circulation care, analgesic and sedative care, temperature care, nutrition care and cerebrospinal fluid care.Conclusions:This study summarizes the evidence-based basis of intracranial hypertension nursing in adult patients with severe brain injury, which provides a basis for the standardized construction of clinical nursing strategies and empirical research.