BACKGROUND:Arthroscopic anchor repair has become the main treatment method for rotator cuff tears at present.Among them,the insertion status of the anchor is a key factor in the success or failure of the operation.However,currently,the impact of the insertion depth of the anchor on the stress of the bone tunnel and the anchor under different bone density conditions remains unclear.OBJECTIVE:To explore the stress distribution of the bone tunnel and the anchor when the insertion depth of the anchor varies under different bone density conditions by using three-dimensional finite element analysis technology.METHODS:The CT image data of the humerus of volunteers were collected,and the models of the humerus and the anchor were constructed by using Mimics,3-Matic,and Solidworks software.In 3-Matic,holes with distances of 0,2,4,6,and 8 mm from the surface of the humerus were respectively created at the same position of the humerus and assembled with the anchor.In Mimics,values were assigned based on the CT gray value to obtain a model with normal bone mass(T value ≥-1.0).The parameters were changed to construct models with reduced bone mass(-2.5＜T value＜-1.0)and osteoporosis(T value＜-2.5).In each model,a 70 N pulling force was applied to the anchor along the direction tangent to the inner edge of the bone tunnel.The stress distribution and magnitude of the bone tunnel and the anchor when inserted at different depths under different bone density conditions were observed.RESULTS AND CONCLUSION:(1)When the insertion depth was the same,as the bone density decreased,the maximum equivalent stress of the anchor increased,while the maximum equivalent stress of the bone tunnel decreased.(2)When the bone density was the same,as the insertion depth of the anchor increased,the maximum equivalent stress of the anchor decreased.When the insertion depth was 4 mm,the stress of the bone tunnel was the smallest and the distribution was relatively uniform.The stress of the anchor was mainly distributed around the lower anchor hole and the proximal thread,and the stress of the bone tunnel was mainly at the part in contact with the proximal thread.The increase in the insertion depth would change the uniformity and pattern of the stress distribution,while the bone density had a relatively small impact on the stress distribution pattern.(3)It is concluded that the bone density of the humerus is crucial for the anchor repair of rotator cuff tears.It is recommended that clinicians measure the bone density of the greater tuberosity of the humerus before the operation.Excessive insertion depth of the anchor does not significantly increase its stability.Clinicians can conduct personalized preoperative assessments by using the finite element analysis method in combination with the actual situation of patients to achieve the best surgical results.

BACKGROUND:Arthroscopic anchor repair has become the main treatment method for rotator cuff tears at present.Among them,the insertion status of the anchor is a key factor in the success or failure of the operation.However,currently,the impact of the insertion depth of the anchor on the stress of the bone tunnel and the anchor under different bone density conditions remains unclear.OBJECTIVE:To explore the stress distribution of the bone tunnel and the anchor when the insertion depth of the anchor varies under different bone density conditions by using three-dimensional finite element analysis technology.METHODS:The CT image data of the humerus of volunteers were collected,and the models of the humerus and the anchor were constructed by using Mimics,3-Matic,and Solidworks software.In 3-Matic,holes with distances of 0,2,4,6,and 8 mm from the surface of the humerus were respectively created at the same position of the humerus and assembled with the anchor.In Mimics,values were assigned based on the CT gray value to obtain a model with normal bone mass(T value ≥-1.0).The parameters were changed to construct models with reduced bone mass(-2.5＜T value＜-1.0)and osteoporosis(T value＜-2.5).In each model,a 70 N pulling force was applied to the anchor along the direction tangent to the inner edge of the bone tunnel.The stress distribution and magnitude of the bone tunnel and the anchor when inserted at different depths under different bone density conditions were observed.RESULTS AND CONCLUSION:(1)When the insertion depth was the same,as the bone density decreased,the maximum equivalent stress of the anchor increased,while the maximum equivalent stress of the bone tunnel decreased.(2)When the bone density was the same,as the insertion depth of the anchor increased,the maximum equivalent stress of the anchor decreased.When the insertion depth was 4 mm,the stress of the bone tunnel was the smallest and the distribution was relatively uniform.The stress of the anchor was mainly distributed around the lower anchor hole and the proximal thread,and the stress of the bone tunnel was mainly at the part in contact with the proximal thread.The increase in the insertion depth would change the uniformity and pattern of the stress distribution,while the bone density had a relatively small impact on the stress distribution pattern.(3)It is concluded that the bone density of the humerus is crucial for the anchor repair of rotator cuff tears.It is recommended that clinicians measure the bone density of the greater tuberosity of the humerus before the operation.Excessive insertion depth of the anchor does not significantly increase its stability.Clinicians can conduct personalized preoperative assessments by using the finite element analysis method in combination with the actual situation of patients to achieve the best surgical results.

BACKGROUND:Currently,numerous experiments delve into the intricate anatomy and biomechanical behavior of distinct segments of the supraspinatus muscle.However,the impact of shoulder joint stress resulting from damage to various regions of this muscle remains a scarcely explored domain.Understanding the repercussions of supraspinatus muscle injuries across different regions on the stress distribution and magnitude of articular cartilage and the glenoid is crucial for providing some theoretical support for clinical diagnosis and treatment. OBJECTIVE:To ascertain the maximum stress values by simulating different degrees of supraspinatus muscle rupture on the humeral cartilage surface,glenoid lip,and glenoid cartilage joint surface using three-dimensional finite element software. METHODS:Normal and healthy shoulder joint CT or MRI scans were processed through Mimics and Geomagic to extract molds.Subsequently,models were constructed via Solidworks.Varying degrees of supraspinatus muscle damage were simulated for each model to mimic fractures in different regions.Finally,Ansys,mechanical software,was employed for three-dimensional finite element biomechanical analysis,calculating stress values for the humeral cartilage surface,glenoid lip,and glenoid cartilage joint surface. RESULTS AND CONCLUSION:(1)With worsening degrees of supraspinatus muscle injury,the stress on the shoulder joint cartilage surface and glenoid lip escalated.(2)Among various regions,the anterior part of the supraspinatus muscle exhibited paramount significance.(3)While supraspinatus muscle fractures of differing degrees impacted the magnitude of cartilage stress on the glenoid labial surface,the stress distribution remained constant.(4)It is indicated that during the initial stages of horizontal abduction of the shoulder joint,the anterior region assumes a pivotal role,followed by the posterior deep region.Injury to the anterior part of the supraspinatus muscle leads to a significant surge in stress within the shoulder joint's soft tissue,potentially causing damage to the top of the glenoid lip and the anterior part of the glenoid cartilage.

Objective:To establish an ex vivo model of button battery-induced esophageal injury in New Zealand rabbits and evaluate the interventive effects of vegetable oil through esophageal histopathological scoring.Methods:Thirty-six esophageal segments (≈5 cm length) from 10 cm specimen of 18 male rabbits were divided into model groups (15-min, 2-hr, and 6-hr exposure; n=6/group) and intervention groups (olive/peanut/soybean oil infusion; n=6/group). Button batteries were inserted to esophageal segments of model groups. Voltage drop of the battery, pH at negative electrode contact site, and histopathological injury scores were assessed. In the intervention group, button batteries were placed in the esophageal segment for 15 minutes, and olive oil, peanut oil, and soybean oil were infused. The above indicators were observed 6 hours after the button batteries were placed. One-way ANOVA was used to compare the differences of esophageal mucosal tissue damage across time points and oil types. Results:There was no significant difference in the pH value of the negative electrode contact area (9.50±0.56, 10.67±0.80, 11.17±0.40, F=1.955, P>0.05), but the discharge voltage (42.67±4.60 mV, 90.00±2.07 mV, 125.83±2.80 mV, F=156.9, P<0.001) and pathological injury scores (3.50±1.09 scores, 5.33±0.72 scores, 8.67±0.67 scores, F=9.623, P=0.002) in the model groups were significantly different. There was significant difference in pathological injury score between the 6-hour model group and the three intervention groups (8.67±0.67 scores, 7.33±0.62 scores, 6.50±0.43 scores, 6.67±0.42 scores, F=3.279, P=0.042). The difference in pathological injury score between the peanut oil intervention group and the 6-hour model group was statistically significant (mean difference=2.167, P<0.05). Conclusion:This ex vivo model effectively simulates battery-induced esophageal injury. Household peanut oil demonstrates significant protective effects, providing experimental basis for prehospital management of battery corrosion.

Purpose To investigate the expression of POLR2M in colorectal cancer(CRC)and its effects on cell growth,apoptosis and invasion.Methods GEPIA2.0,TCGA and Kaplan-Meier Plotter databases were used to ana-lyze the differential expression of POLR2M in CRC tissues and normal adjacent tissues,and to evaluate its prognostic significance using the Log-rank test.Quantitative real-time PCR(qRT-PCR)was used to detect the expression of POLR2M in human colorectal cancer cell lines SW480,HCT-8,RKO,LOVO,DLD-1,HCT-116,SW620 and human normal colorectal cell line FHC.DLD-1 and RKO cells were stably transfected with lentivirus,and the POLR2M groups were up-regulated into the control group(LV-NC)and experimental group(LV-POLR2M),and the transient transfec-tion of SW620 and SW480 cells with interfering fragments of SiRNA was used to down-regulate the POLR2M groups into the control group(Si-NC)and experimental group(Si-POLR2M),and the transfection efficiency of each group was verified.CCK-8,plate cloning,Transwell and scratch healing assays were used to detect cell proliferation,invasion and migration.Flow cytometry was used to detect the effects of POLR2M on cell cycle and apoptosis.Results GE-PIA2.0,TCGA and Kaplan-Meier Plotter database analysis showed that the expression of POLR2M in colorectal cancer was significantly higher than in normal adjacent tissues(P＜0.05),and the expression of POLR2M was closely associ-ated with the histological type of colorectal cancer and lymph node metastasis(P＜0.05),but not with the age,gen-der,tumor grade and vascular invasion of patients(P＞0.05).The prognosis of patients with POLR2M overexpression was poor(P＜0.05).The results of qRT-PCR showed that compared with FHC cells,the mRNA expression of POLR2M in SW480,HCT-8,RKO,LOVO,DLD-1,HCT-116 and SW620 cell lines was increased(F=97.7,P＜0.05),and POLR2M stable overexpression and interference cell lines were successfully constructed.Compared with the LV-NC group,the viability,colony number,number of cells passing through the chamber and cell mobility of DLD-1 and RKO cells in the LV-POLR2M group were significantly increased(P＜0.05).Compared with the Si-NC group,the viability,colony number,number of cells passing through the chamber,and cell mobility of SW620 and SW480 cells in the Si-POLR2M group were significantly decreased(P＜0.05).Downregulation of POLR2M induced cell cycle arrest in G1 phase and promotes apoptosis(P＜0.05).Conclusion POLR2M may play a role as a pro-tumor gene in CRC,and its high expression can significantly promote the proliferation and invasion of CRC cells.

Objective:Using resting-state functional magnetic resonance imaging (rs-fMRI), we explored the changes in dynamic functional network connections (dFNC) in the brains of patients with first-episode schizophrenia (SZ) and evaluated the potential clinical value of dFNC changes in combination with a machine learning model.Methods:Clinical data of 50 patients with schizophrenia (schizophrenia group), 29 males and 21 females, aged 18-47 (28.3±7.2) years, who attended the psychiatric department of the Second Affiliated Hospital of Xinxiang Medical College from January 2022 to August 2023, were retrospectively included. In the same period, 50 healthy controls matched for age and education (healthy control group) were recruited, of which 24 were male and 26 were female, aged 18-48 (28.0±6.9) years. The rs-fMRI imaging data were acquired for each subject. The dFNC cluster analysis was performed based on independent component analysis, and the differences between groups with different state FNC matrices were statistically analyzed. The dataset samples were divided into a training set (35 SZ patients and 35 healthy controls) and a validation set (15 SZ patients and 15 healthy controls) in a 7∶3 ratio. A machine learning classification model was constructed based on the dFNC matri. The performance of the model for distinguishing between schizophrenia and healthy controls was assessed by five-fold cross-validation using accuracy (ACC), recall (REC), F1 score, and area under curve (AUC) metrics of the working characteristics of the subjects.Results:Five network functional connectivity states were obtained by dFNC cluster analysis. Patients with first SZ showed a wide range of high connectivity and low connectivity changes on the neural dynamic functional networks, as shown by increased dynamic connectivity within the visual network (VIS) in state 1 (weak connectivity); The dynamic connectivity between executive control network (ECN) and VIS, frontal parietal network (FPN) and VIS decreases at state 3 (strong connectivity); The dynamic connectivity between default mode network (DMN) and FPN, DMN and ventral attention network (VAN) decreases at state 4 (weak connectivity). The machine learning results show that the classification model constructed by the dFNC matrix combined with SVM in state 3 (strongly connected) in the validation set obtains the best classification results (ACC=0.938; REC=0.938; F1=0.937; AUC=0.984), and the overall average classification ACC of the five states reaches 0.751, and AUC reaches 0.784.Conclusion:Patients with first-episode SZ have some brain functional network connectivity abnormalities, and a machine learning model based on dFNC features has high classification performance in distinguishing first-episode SZ from HC.

Objective:To investigate the efficacy and safety of bridging thrombectomy and direct thrombectomy in patients with acute anterior circulation large core infarction.Methods:A retrospective cross-sectional study was performed; 131 patients with acute anterior circulation large core infarction with an onset time≤ 24 hours received endovascular treatment (EVT) at Department of Intervention Neurosurgery, Nanyang Central Hospital, Xinxiang Medical University, from June 2022 to June 2024 were chosen; they were divided into bridging thrombectomy group (accepted intravenous thrombolysis [IVT] before EVT, n=55) and direct thrombectomy group ( n=76). Statistical analysis was conducted to compare the differences in efficacy and safety between the two groups. Efficacy indicators included modified Rankin scale (mRS) score 90 days after thrombectomy, and good prognosis rate 90 days after thrombectomy (mRS scores of 0-2). Safety indicators included intracranial hemorrhage (ICH) incidence within 72 hours of thrombectomy, symptomatic intracranial hemorrhage (sICH) incidence within 72 hours of thrombectomy, mortality 90 days after thrombectomy, and ratio of patients receiving decompressive craniectomy after surgery. Results:No significant difference between the direct thrombectomy group and bridging thrombectomy group was noted in terms of mRS score 90 days after thrombectomy (3 [2, 6] vs. 3 [2, 6]), good prognosis rate 90 days after thrombectomy (38.2% vs. 25.5%), ICH incidence within 72 hours of thrombectomy (30.3% vs. 40.0%), sICH incidence within 72 hours of thrombectomy (21.1% vs. 21.8%), mortality rate within 90 days of thrombectomy (28.9% vs. 25.5%), and ratio of patients receiving decompressive craniectomy after surgery (9.2% vs. 9.1%, P>0.05). Core infarction volume at 100 mL was used as grouping standard, subgroup analysis showed that when the core infarction volume was 70-100 mL and >100 mL, respectively, no significant difference in sICH incidence was noted between the bridging thrombectomy group and direct thrombectomy group ( P>0.05). Conclusion:For patients with acute anterior circulation large core infarction with an onset time≤ 24 hours, bridging thrombectomy has similar efficacy and safety as direct thrombectomy.

Objective To explore the mechanism of action of tanthine in the treatment of allergic rhinitis(AR)complicated with asthma in rats by regulating microRNA-27a-3p(miR-27a-3p)targeting thymic stromal lymphopoietin(TSLP).Methods The AR-asthma rat model was established using ovalbumin(OVA)sensitization and nasal drip attack method.Fifty rats were divided into control group(equal volume 0.9％NaCl),model group(AR-asthma model+equal volume 0.9％NaCl),experimental group(AR-asthma model+100 mg·kg-1 xanthortin)and miR-27a-3p inhibitor group(caudal vein injection of 0.5 nmol·μL-1 miR-27a-3p inhibitor 10 μL on the basis of the experimental group),si-TSLP group(0.5 nmol·μL-1 si-TSLP 10 μL intravenously injected on the basis of miR-27a-3p inhibitor group),10 rats in each group.Serum immunoglobulin E(IgE),interleukin-2(IL-2),IL-13 and tumor necrosis factor-α(TNF-α)levels of rats were detected by enzyme-linked immunosorbent assay.The level of superoxide dismutase(SOD)was detected by xanthoxine oxidase method.The level of malonaldehyde(MDA)was detected by thiobarbituric acid method(TBA).Results The levels of IgE in control group,model group,experimental group,miR-27a-3p inhibitor group and si-TSLP group were(18.33±3.53),(89.95±17.62),(55.70±10.08),(78.43±15.30)and(47.87±9.44)ng·mL-1,respectively;IL-2 levels were(8.01±1.36),(19.61±3.94),(14.12±2.51),(17.33±3.18)and(11.89±2.03)pg·mL-1,respectively;IL-13 levels were(6.79±1.33),(34.15±7.02),(24.70±5.13),(35.97±7.24)and(20.53±4.26)pg·mL-1,respectively;TNF-α levels were(94.08±19.07),(312.47±58.61),(209.78±41.49),(296.42±55.99)and(187.45±37.28)pg·mL-1,respectively;SOD levels were(29.14±5.04),(13.25±2.63),(24.19±4.89),(17.28±3.16)and(33.94±5.87)U·mg prot-1,respectively;MDA levels were(2.26±0.51),(4.43±0.72),(3.17±0.58),(3.94±0.69)and(2.62±0.45)nmol·m gprot-1,respectively.The above indicators were compared between control group and model group,model group and experimental group,experimental group and miR-27a-3p inhibitor group,miR-27a-3p inhibitor group and si-TSLP group.The differences were statistically significant(all P＜0.05).Conclusion Xanthine can improve oxidative stress and reduce inflammation of AR complicated with asthma in rats,and its mechanism may be related to the regulation of miR-27 a-3p targeting TSLP.

Objective A binary Logistic regression model was developed to forecast the pathological grade of invasive adenocarcino-ma by utilizing the CT characteristics of lung nodules.Methods A retrospective analysis was conducted on the clinical data,pathological types,and imaging findings of 303 cases of ground-glass nodules diagnosed with postoperative pathological infiltrative adenocarcinoma at the First Affiliated Hospital of Henan Polytechnic University and the First Affiliated Hospital of Xinxiang Medical College from January 2021 to February 2023.Based on the pathological results,these lesions were categorized into two groups:the low-grade group(compri-sing 262 cases characterized by adherent,acinar,or papillary types as predominant forms of adenocarcinoma with no more than 20％high-grade pattern)and the high-grade group(consisting of 41 cases exhibiting any form of adenocarcinoma with over 20％high-grade components).The Mann-Whitney U test was employed to compare quantitative parameters between both groups,while qualitative parameters were analyzed using the x2 test.Additionally,binary Logistic regression models were utilized to identify independent predictors;further evaluation included area under curve(AUC)values,calibration curves,and decision analysis curves to assess model differentia-tion,calibration accuracy,and clinical applicability.Results Univariate analysis revealed that gender,air bronchial sign,vacuole sign,vascular cluster sign,pleural depression sign,long diameter,short diameter,and CT-enhanced net increment exhibited statistical signifi-cance(P＜0.05),whereas location,burr sign,and solid component ratio did not demonstrate statistical significance(P＞0.05).Binary Logistic regression analysis identified long diameter,CT-enhanced net increment,vascular cluster sign,pleural depression sign,and vacu-ole sign as independent predictors of the pathological grade model for invasive adenocarcinoma.The results of ROC curve analysis indicated that the AUC value of the Logistic regression model was 0.846 with a sensitivity of 81.25％and specificity of 86.52％.Conclusion The logistic regression model based on CT signs has excellent ability and stability in predicting the pathological grade of invasive adenocarcinoma.

Objective To assess functional abnormalities in frontoparietal attention network of patients with traumatic brain injury(TBI),and to analyze neural mechanism of its attention disorders based on independent component analysis(ICA).Methods Totally 84 TBI patients were prospectively enrolled and divided into mild(n=33),moderate(n=27)and severe TBI groups(n=24)according to symptoms,non-contrast enhanced MRI findings,Glasgow coma scale(GCS)and Mayo craniocerebral trauma grading criteria.ICA was used to extract and analyze the optimal independent components(IC)of the dorsal attention network(DAN)and ventral attention network(VAN).Multiple linear regression analyses were performed to explore the correlations of functional connectivity(FC)of brain regions being significantly different among groups within attention network and the scores of trail making test A/B(TMT-A/B).Results Compared with control group and mild TBI group,spatial distribution of DAN(especially bilateral frontal eye field[FEF])in moderate and severe TBI groups were significantly smaller,the clusters tended to be discrete,and the intensity were significantly weakened.The right temporal parietal junction(TPJ)and right ventral frontal cortex(VFC)of VAN in control group,mild and moderate TBI groups were significantly affected,and VFC connection strength was the highest in severe TBI group.FC intensity in right VFC of TBI patients was positively correlated with TMT-A score(r=0.654,P＜0.001),which in left FEF was negatively correlated with TMT-B score(r=—0.383,P＜0.001).Conclusion FC of frontoparietal attention network was abnormal in TBI patients,which might be neural mechanism for its attention behavior disorders.