Objective This study was intended to determine the role of microautologous fat transplantation (MAFT) in dealing with severe sunken upper eyelids.Methods The authors performed microautologous fat transplantation (MAFT) procedure,particularly in accurately delivering small fat parcels,to treat 238 patients with sunken upper eyelids with multiple folds.Results The average total injection volume of fat were 1.8 ml in right upper lid (from 1.1 to 2.4 ml) and 1.7 ml in left upper lid (from 1.1 to 2.4 ml) separately.Only 3 cases encountered prolonged swelling more than 2 weeks.There were no severe complications.All patients were satisfied with the final results and 2 patients asked for secondary enhancement procedure.Conclusions The therapeutic effects of MAFT and the long-term clinical results of patients with sunken upper eyelids with multiple folds indicate satisfactory outcomes.

Objective To evaluate the effect of minimally invasive therapy for treating intraventricular hemorrhage.Methods The minimally invasive therapy with unilateral or bilateral drainage were received according to quantity and shape of intraventricular hemorrhage.Results It was operated 22 cases with unilateral drainage and 28 cases with bilateral drainage in the 50 cases intraventricular hemorrhage.Death was 3 cases and mortality rate was 6% in the minimally invasive therapy.ADL1 15 cases(30%),ADL2 18 CRSeS(36%),ADL3 8 cases(16%),ADLA4 cases(8%),ADL5 2 cases(4%)in leave hospital.Conclusion Minimal invasive therapy of intraventrieular hemorrhage has great superiority,such as it can operate simple,trauma mild,decrease complications and enhance curative effect.It can generalize in the basic hospital.

Objective To evaluate the diagnostic value of combined detection of serum autoantibodies against against p53 and Bmi-1 in lung cancer (LC).Methods Serum levels of autoantibodies against p53 and Bmi-1 were measured by enzyme-linked immunosorbent assay (ELISA) in 92 patients with LC and 80 normal controls.The combined diagnostic value was evaluated with the receiver operating characteristic (ROC) curve.Results The serum levels of autoantibodies against p53 and Bmi-1 were significantly higher in LC than in normal controls (0.438 ±0.705 vs 0.045 ±0.035,Z =-7.667,P ＜0.01;0.117±0.061 vs 0.068 ±0.031,Z =-7.179,P ＜0.01).The levels of autoantibodies against p53 and Bmi-1 were not related to age,gender,pathological classification,lymph node status or tumor-node-metastasis (TNM) stage (P ＞ 0.05).The combined detection of two autoantibodies provided an enhanced sensitivity of 63.0％,a specificity of 91.2％ and an area under curve (AUC) of 0.881,which showed better diagnostic efficiency compared to individual autoantibodies.Conclusions Combined detection of autoantibodies against p53 and Bmi-1 shows good diagnostic value,which may aid diagnosis of LC.

Objective To investigate the compliance of secondary prevention and the relationship with the long-term outcomes in patients undergoing percutaneous coronary intervention(PCI).Methods 589 patients undergoing PCI were followed-up,and factors including major adverse cardiac events(MACE)),smoking status and the usage of antiplatelet agents,angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB),statins,beta blocker,calcium channel blocker and nitrates were recorded.Results The average follow-up time was 18.92 months.At discharge,588 patients(99.83%)were prescribed clopidogrel for(7.89±4.96)months;there were 31 patients(5.26%)who completely discontinued antiplatelet therapy during follow-up.At discharge,the prescription rate of aspirin,ACEI/ARB,beta blocker,statins,calcium channel blocker and nitrates was 98.98%,41.94%,63.50%,83.02%,19.69%and 46.52%respectively,whereas at follow-up,these were decreased to 94.4%,35.99%,55.86%,65.89%,17.49%and 35.31%.At follow-up,there were still 105 current smokers(17.83%).Complete cessation of antiplatelet therapy and current smoking were related to the increased risk of non-fatal myocardial infarct(9.68%v.s.1.08%,P＜0.01);smoking(4.76%v.s.0.83%,P＜0.01)andMACE(19.35%v.s.6.45%,P＜0.01);smoking(11.43%v.s.6.20%,P＜0.05).Conclusion Most patients can adhere to secondary prevention during follow-up,however,the compliance with secondary prevention should be improved further.Cessation of antiplatelet therapy and current smoking contribute to poor prognosis.

Reactive oxygen species play a crucial role in maintaining metabolic balance in the body. They are not only important mediators in maintaining a normal physiological environment, but also important triggers for the occurrence and development of many diseases. Osteoarthritis is the most common degenerative joint disease at present. Due to the aging population, extended life expectancy and obesity, the incidence rate and prevalence of osteoarthritis have increased year by year. Recent studies on osteoarthritis show that reactive oxygen species play a crucial role in its occurrence and development, and are key factors leading to extracellular matrix degradation, mitochondrial dysfunction, chondrocyte apoptosis and the progress of osteoarthritis. For osteoarthritis, moderate levels of reactive oxygen species can promote the proliferation of chondrocytes and the formation of cartilage matrix. However, excessive accumulation of reactive oxygen species can induce oxidative stress, leading to degeneration of chondrocytes and breakdown of cartilage matrix, ultimately resulting in the occurrence of osteoarthritis and many other metabolic diseases. In recent years, hydrogels have attracted attention as new biomaterials for the treatment of osteoarthritis. Reactive oxygen scavenging hydrogels are a new type of polymer biomaterials with drug intelligent delivery function that can regulate tissue oxidative stress and inflammatory reaction. They mainly include traditional reactive oxygen scavenging hydrogels with the main function of loading reactive oxygen scavenging drugs and reactive oxygen responsive hydrogels with reactive oxygen responsive groups. The former mainly uses slow-release drugs with reactive oxygen species scavenging properties encapsulated in it to treat osteoarthritis, while the latter can not only clear the reactive oxygen species generated during the occurrence and development of osteoarthritis by breaking the reactive oxygen species responsive groups, but also responsively deliver various drugs for treating osteoarthritis. Reactive oxygen scavenging hydrogels have a good prospect in the treatment of osteoarthritis and repair.

Objective:To develop a deep transfer learning method for the differential diagnosis of osteonecrosis of the femoral head (ONFH) with other common hip diseases using anteroposterior hip radiographs.Methods:Patients suffering from ONFH, DDH, and other hip diseases including primary hip osteoarthritis, non-infectious inflammatory hip disease, and femoral neck fracture treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2018 to December 2020 were enrolled in the study. A clinical data set containing anteroposterior hip radiographs of the eligible patients was created. Data augmentation by rotating and flipping images was performed to enlarge the data set, then the data set was divided equally into a training data set and a testing data set. The ResNet-152, a deep neural network model, was used in the study, but the original Batch Normalization was replaced with Transferable Normalization to construct a novel deep transfer learning model. The model was trained to distinguish ONFH and DDH from other common hip diseases using anteroposterior hip radiographs on the training data set and its classification performance was evaluated on the testing data set.Results:The clinical data set was comprised of anteroposterior hip radiographs of 1024 hips, including 542 with ONFH, 296 with DDH, and 186 with other common hip diseases (56 hips with primary osteoarthritis, 85 hips with non-infectious inflammatory osteoarthritis, 45 hips with femoral neck fracture). After data augmentation, the size of the data set multiplied to 6144. The model was trained 100 050 times in each task. Accuracy was used as the representative parameter to evaluate the performance of the model. In the binary classification task to identify ONFH, the best accuracy was 95.80%. As for the multi-classification task for classification of ONFH and DDH from other hip diseases, the best accuracy was 91.40%. The plateau of the model was observed in each task after 50 000 times of training. The mean accuracy in plateaus was 95.35% (95% CI: 95.33%, 95.37%), and 90.85% (95% CI: 90.82%, 90.87%), respectively. Conclusion:The present study proves the encouraging performance of a deep transfer learning method for the first-visit classification of ONFH, DDH, and other hip diseases using the convenient and economical anteroposterior hip radiographs.

BACKGROUND:Overactive osteoclasts disrupt bone homeostasis and play a bad role in the pathological mechanisms of related skeletal diseases,such as osteoporosis,fragility fractures,and osteoarthritis.Studies have confirmed that ellagic acid and ellagtannin have the potential to inhibit osteoclast differentiation.As their natural metabolites,urolithin A has antioxidant,anti-inflammatory,anti-proliferative and anti-cancer effects,but its effect on osteoclast differentiation and its underlying molecular mechanisms remain unclear. OBJECTIVE:To explore the effect of urolithin A on osteoclast differentiation induced by receptor activator for nuclear factor-κB ligand and its mechanism. METHODS:Mouse mononuclear macrophage leukemia cells(RAW264.7)that grew stably were cultured in vitro.Toxicity of urolithin A(0,0.1,0.5,1.5,2.5 μmol/L)to RAW264.7 cells were detected by cytotoxic MTS assay to screen out the safe concentration.Different concentrations of urolithin A were used again to intervene with receptor activator for nuclear factor-κB ligand-induced differentiation of RAW264.7 cells in vitro.Then,tartrate-resistant acid phosphatase staining and F-actin ring and nucleus staining were performed to observe its effect on the formation and function of osteoclasts.Finally,the expressions of urolithin A on upstream and downstream genes and proteins in the MAPK signaling pathway were observed by western blot and RT-qPCR assays. RESULTS AND CONCLUSION:Urolithin A inhibited osteoclast differentiation and F-actin ring formation in a concentration-dependent manner and 2.5 μmol/L had the strongest inhibitory effect.Urolithin A inhibited the mRNA expression of Nfatc1,Ctsk,Mmp9 and Atp6v0d2 and the protein synthesis of Nfatc1 and Ctsk,related to osteoclast formation and bone resorption.Urolithin A inhibited the activity of osteoclasts by downregulating the phosphorylation of p38 protein to inhibit the mitogen-activated protein kinase signaling pathway.

Objective To explore the clinicopathological and immunohistochemical features of nephrogenic adenoma(NA).Methods Clinical data of NA patients diagnosed in the Department of Pathology,Zhongshan Hospital,Fudan University from July 2016 to October 2022 were collected and analyzed to explore their clinicopathological features.Results A total of 13 NA cases were enrolled.There were 11 males and 2 females.Organs involved:ureter(n=7),bladder(n=5),bladder and ureter(n=1),renal pelvis(n=2).NA patients performed as ureteral stenosis(6/7),rough bladder wall(3/5),and renal pelvis polyp(2/2).The typical microscopical features of NA were tubular(13/13)and papillary(4/13)structures,covered with cuboidal or columnar epithelium(13/13),or a mixed hobnail-spike eosinophilic epithelium(12/13);the interstitium was loose,containing varied amounts of vasculature and inflammatory cells(13/13).Immunohistochemistry revealed specific expressions of CK7,PAX-8,CK19 and CK8.Conclusions NA is a rare neoplasm of the urinary system with unique histological features.NA has the risk of misdiagnosis and over-treatment,and the potential of recurrence and malignant conversion.The diagnosis of NA depends on pathology,and the immunohistochemistry can be helpful for its pathological diagnosis.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.

Objective:To introduce the health insurance fund supervision model in Japan,compare the current situation of health insurance fund supervision in China,learn from experiences,and propose suggestions for improvement.Methods:By combining cases and regulatory effects,it introduces Japan's"guidance-inspection"based health insurance fund supervision model.Results:Japan's"guidance-inspection"based health insurance fund supervision model is relatively effective.Compared with China,it has a higher level of organizational hierarchy,focuses on education in its supervisory approach,clarifies the direction of patients'self-paid expences,and has a well-developed dual-way communication mechanism.Conclusion:China should establish a comprehensive health insurance fund supervision pathway,clearly define the resolution pathway for self-paid expenses caused by violations,and improve the mechanisms for negotiation and dispute resolution during the process.