Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective:To dynamically monitor the changes of fibrinogen-like protein 2 (FGL2), Vaspin and transport protein (TSPO) in the perioperative period of craniocerebral trauma, and analyze their correlation with disease progression and significance.Methods:One hundred and eight patients with craniocerebral trauma admitted to Hubei Jianghan Oilfield General Hospital Guanghuayuan District from June 2019 to June 2022 were selected and according the scores of Glasgow outcome scale (GOS) at 3 months postoperatively they were divided into good group (GOS 4 - 5 scores, 68 cases) and poor group (GOS 1 - 3 scores, 40 cases). The changes of FGL2, Vaspin and TSPO were monitored and compared between the two groups at preoperatively, 1 d postoperatively and 3 d postoperatively. Pearson analysis was applied to analyze the relationship between FGL2, Vaspin and TSPO at 1, 3 d postoperatively. The value of FGL2, Vaspin, TSPO and combined prediction of disease regression at 3 d postoperatively was analyzed by receiver operating characteristic (ROC) curve.Results:The rate of multiple injuries and brain herniation formation in the poor group were higher than those in the good group: 30.00% (12/40) vs. 7.35% (5/68), 20.00% (8/40) vs. 2.94% (2/68), and the scores of Glasgow coma scale (GCS) was lower than that in the good group: (8.04 ± 1.25) scores vs. (9.18 ± 1.33) scores, there were statistical differences ( P<0.05). The levels of FGL2, Vaspin and TSPO were all higher at 1 d postoperatively than before surgery in patients with different disease regressions, with each index decreasing at 3 d postoperatively compared with 1 d postoperatively in the good group, but continuing to increase at 3 d postoperatively in the bad group ( P<0.05). The levels of FGL2, Vaspin and TSPO in the poor group were higher than those in the good group at 1 d and 3 d postoperatively: at 1 d postoperatively: (314.01 ± 88.67) μg/L vs. (275.33 ± 79.24) μg/L, (0.27 ± 0.08) μg/L vs. (0.22 ± 0.07) μg/L, (3.28 ± 1.03) μg/L vs. (2.01 ± 0.64) μg/L; at 3 d postoperatively: (374.85 ± 92.33) μg/L vs. (259.94 ± 81.78) μg/L, (0.30 ± 0.09) μg/L vs. (0.20 ± 0.06) μg/L, (3.77 ± 1.15) μg/L vs. (1.68 ± 0.52) μg/L, there were statistical differences ( P<0.05). The results of Pearson analysis showed that FGL2, Vaspin and TSPO were negatively correlated with GOS scores at 1 d and 3 d postoperatively (at 1 d postoperatively: r = - 0.729, - 0.796, - 0.814, P<0.05; at 3 d postoperatively: r = - 0.862, - 0.855, - 0.905, P<0.05), FGL2, Vaspin and TSPO were more strongly correlated with GOS scores at 3 d postoperatively (larger r values). The results of ROC curve analysis showed that FGL2, Vaspin and TSPO all had a predictive value for disease regression, and the area under the curve of FGL2 combined with Vaspin and TSPO was the largest (0.923 , 95% CI 0.855 to 0.965). Conclusions:There are many influencing factors in the prognosis of craniocerebral trauma. The changes of FGL2, Vaspin and TSPO during the perioperative period can predict the progress and regression of patients, and the combined dynamic monitoring is more conductive to evaluate the prognosis.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Objective To investigate the role of MLLT1 in hepatocellular carcinoma (HCC)and its impact on the tumor immune microenvironment. Methods Multivariate Cox regression analysis and tumor gene analysis tools such as GEPIA and UALCAN were used to explore the expression of the MLLT1 gene and its prognostic significance in different tumors. Real-time PCR, Western blotting, and immunohistochemistry were used to investigate the differential expression of MLLT1 between HCC tumor tissue and normal tissue. MTT assay and cell cycle analysis were performed to assess the effect of MLLT1 knockdown on cell proliferation and cell cycle. The correlation between MLLT1 and immune cells, as well as immune infiltrates in the tumor microenvironment, and their correlation with immune neoantigens, immune checkpoints, tumor mutation burden, and microsatellite instability were also explored. Results The MLLT1 gene was found to be aberrantly expressed in various solid tumors including HCC, and its high expression was associated with poor prognosis in HCC. Knockdown of MLLT1 inhibited HCC cell proliferation and blocked the cell cycle. High expression of MLLT1 was found to affect the content of multiple immune cells, including CD4

Objective To investigate the role of ATP citrate lyase(ACLY)in the development of hepatocellular carcinoma(HCC)and the impact of this enzyme on the immune microenvironment of HCC.Methods We utilized the University of Alabama at Birmingham Cancer Data Analysis Portal and the Gene Expression Profiling Interactive Analysis to identify the changes in ACLY expression and prognosis across different tumor types from The Cancer Genome Atlas.With HCC as the disease model,we analyzed the ACLY expression in HCC samples from the gene expression database.Furthermore,we collected the clinical specimens from HCC patients to verify the mRNA and protein levels of ACLY.In addition,we conducted transcriptome sequencing after knocking down the expression of ACLY to analyze the differentially expressed genes and investigated the impact of ACLY expression interference on cell proliferation and other functions.Finally,we explored the correlations of ACLY with immune cells and immune infiltration in the tumor microenvironment,new antigens,and immune checkpoint genes.Results ACLY expression was significantly up-regulated in solid tumors including HCC(all P<0.05),and high ACLY expression was associated with overall survival rate in HCC(P=0.005).Furthermore,high ACLY expression affected the presence of immune cells(e.g.,tumor-associated fibroblasts)and the expression of genes involved in lipid metabolism(all P<0.05).Conclusions ACLY is closely related to the occurrence and development of HCC and lipid metabolism abnormalities.Moreover,it has a specific impact on the immune microenvironment of HCC.
Humans ; ATP Citrate (pro-S)-Lyase/metabolism* ; Carcinoma, Hepatocellular ; Clinical Relevance ; Lipid Metabolism ; Liver Neoplasms ; Tumor Microenvironment

Humans ; Otitis Media, Suppurative ; Chronic Disease ; Biofilms ; Otitis Media

This study aims to improve the solubility and bioavailability of daidzein by preparing the β-cyclodextrin-daidzein/PEG_(20000)/Carbomer_(940) nanocrystals. Specifically, the nanocrystals were prepared with daidzein as a model drug, PEG_(20000), Carbomer_(940), and NaOH as a plasticizer, a gelling agent, and a crosslinking agent, respectively. A two-step method was employed to prepare the β-cyclodextrin-daidzein/PEG_(20000)/Carbomer_(940) nanocystals. First, the insoluble drug daidzein was embedded in β-cyclodextrin to form inclusion complexes, which were then encapsulated in the PEG_(20000)/Carbomer_(940) nanocrystals. The optimal mass fraction of NaOH was determined as 0.8% by the drug release rate, redispersability, SEM morphology, encapsulation rate, and drug loading. The inclusion status of daidzein nanocrystals was determined by Fourier transform infrared spectroscopy(FTIR), thermogravimetric analysis(TGA), and X-ray diffraction(XRD) analysis to verify the feasibility of the preparation. The prepared nanocrystals showed the average Zeta potential of(-30.77±0.15)mV and(-37.47±0.64)mV and the particle sizes of(333.60±3.81)nm and(544.60±7.66)nm before and after daidzein loading, respectively. The irregular distribution of nanocrystals before and after daidzein loading was observed under SEM. The redispersability experiment showed high dispersion efficiency of the nanocrystals. The in vitro dissolution rate of nanocrystals in intestinal fluid was significantly faster than that of daidzein, and followed the first-order drug release kinetic model. XRD, FTIR, and TGA were employed to determine the polycrystalline properties, drug loading, and thermal stability of the nanocrystals before and after drug loading. The nanocrystals loaded with daidzein demonstrated obvious antibacterial effect. The nanocrystals had more significant inhibitory effects on Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa than daidzein because of the improved solubility of daidzein. The prepared nanocrystals can significantly increase the dissolution rate and oral bioavailability of the insoluble drug daidzein.
Sodium Hydroxide ; Acrylic Resins ; Escherichia coli ; Nanoparticles

Single-door laminoplasty has been widely used in the treatment of multisegment cervical myelopathy, with the clinical advantages of decompression of the spinal cord, relieving preoperative neurological symptoms or signs, and maintaining cervical mobility. However, in clinical work, patients with limited cervical spine activity after single open door laminoplasty are often encountered, and the direct contact with the adjacent vertebral arch can be observed in the postoperative X-ray of the anterior and lateral cervical spine, which is called the adjacent vertebral arch bone impact, which is one of the important causes of the limited cervical spine movement. In recent years, there have been many reports on the prevention of bone impact, although the short-term clinical effect is significant, but long-term clinical efficacy to be further study, and the cause and the pathogenesis of bone impact is no consensus, this paper on the surgery of adjacent vertebral arch impact epidemiology, biomechanics, clinical performance, surgical effect and improvement.

Objective To investigate the role of phosphoglycerate kinase 1 (PGK1) in tumorigenesis and its potential post-translational modification sites were investigated by bioinformatics method and molecular biology experimental techniques, in order to provide evidence for PGK1 as a hepatocellular carcinoma ( HCC) diagnostic biomarker and therapeutic target. Methods From pan-cancer's point of view, 10 967 samples were obtained from the cancer genome database TCGAs, and the expression of PGK1 in different tumors was explored by using cBioPortal and UALCAN analysis tools; Focusing on HCC, the expression differences of PGK1 in hepatocellular carcinoma tumor tissues and normal tissues were further analyzed by using GEO database analysis, Real-time PCR, Western blotting and cell invasion assay;The String database was used to analyze the protein-protein interaction network and gene set enrichment analysis; The CSS-Palm database and bioinformatics method were used to predict protein post-translational modification sites on PGK1. Results The PGK1 gene was abnormally amplified and overexpressed in various solid tumors, including hepatocellular carcinoma, and overexpression of PGK1 was correlated with a poor prognosis in hepatocellular carcinoma. Multiple novel posttranslational modifications were existed on PGK1. Conclusion PGK1 is closely related to the occurrence and development of various cancers including HCC and glycolytic metabolism abnormalities. Epigenetic modifications can regulate PGK1 and affect its cellular function in HCC.

A total of 15 batches of the substance reference of Guizhi Jia Gegen Decoction(GZGGD) were prepared and the characteristic fingerprints of them were established. Furthermore, the similarity of the fingerprints and peak attributes were explored. The extraction rate, and the content and the transfer rate ranges of the index components, puerarin, paeoniflorin, liquiritin, and ammonium glycyrrhizate were determined for the analysis of the quality value transfer. The result demonstrated that the fingerprints of the 15 batches of the samples showed high similarity(>0.99). A total of 15 characteristic peaks were identified from the fingerprints, with 10 for Puerariae Lobatae Radix, 1 for Cinnamomi Ramulus, 2 for Paeoniae Radix Alba, and 2 for Glycyrrhizae Radix et Rhizoma. The content of puerarin was 11.05-18.35 mg·g~(-1) and the average transfer rate was 21.27%-39.49%. The corresponding figures were 7.95-10.90 mg·g~(-1) and 23.28%-43.23% for paeoniflorin, 3.25-4.95 mg·g~(-1) and 32.31%-61.27% for ammonium glycyrrhizate, and 3.65-5.80 mg·g~(-1) and 14.57%-27.05% for liquiritin. The extraction rate of the 15 batches of samples was in the range of 16.85%-21.78%. In this paper, the quality value transfer of the substance reference of GZGGD was analyzed based on characteristic fingerprint, content of index components, and the extraction rate. This study is expected to lay a basis for the quality control and further development of GZGGD.
Ammonium Compounds ; Benchmarking ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Paeonia