Esophageal stricture is a common esophageal lesion in adults and children, and endoscopic dilatation is currently the standard treatment. However, high recurrence rate and frequent dilations have become a major problem in patients. Esophageal stents provide sustained dilation therapy but can lead to serious complications such as displacement, perforation, and bleeding, necessitating removal. Biodegradable stents, with the advantage of both dilation and self-degradation, are promising potential solutions to this problem. Currently, biodegradable materials are mainly categorized into metals and polymers, leading to the development of magnesium alloy esophageal stents and polymer esophageal stents. Among polymer stents, poly-L-lactic acid (PLLA) stents and SX-ELLA stents have been put into clinical application. In recent years, with the advancement of 3D bioprinting technology, the personalized fabrication of biodegradable stents has become feasible. In this paper, we will outline the current research status and progress of biodegradable magnesium alloy stents and polymer stents, introduce the new process of constructing esophageal stents by 3D bioprinting technology, focusing on the clinical research of SX-ELLA stents in pediatric and adult patients. We will also analyze the existing problems with biodegradable stents and the directions for future development.

Objective:To investigate the method and clinical efficacy of simultaneous correction of sunken upper eyelid during double eyelid plasty.Methods:A retrospective analysis was conducted on patients with single eyelids and sunken upper eyelid treated at the Department of Plastic Surgery, the First People’s Hospital of Zhengzhou, from October 2022 to February 2024. All patients underwent incisional double eyelid plasty with individualized correction based on depression severity. For mild depression, a combination of pretarsal orbicularis oculi muscle flap folding and orbital septum fat flap transposition was performed for correction. For moderate depression, additional autologous stromal vascular fraction (SVF)-gel grafting would be performed if residual depression persisted after the aforementioned approach. For severe depression, if the orbital fat was sufficient, the orbicularis oculi muscle flap folding, orbital fat flap repositioning and autologous SVF-gel transplantation were used. If there was insufficient orbital fat, the correction involved the use of a orbicularis oculi muscle flap and SVF-gel transplantation. Postoperative follow-up was conducted regularly, and related complications were statistically analyzed. Six months after the surgery, two blinded plastic surgeons evaluated outcomes via visual analog scale (VAS), including five aspects: symmetry of palpebral folds(including width and curvature of the double eyelid fold), fold contour, depression improvement, scar quality, overall eyelid aesthetics. Each aspect was rated on a scale from 1 to 10, with higher scores indicating better outcomes. Patient satisfaction was scored separately (1-5 per item), with higher scores indicating greater satisfaction.Results:A total of 64 patients were enrolled, including 4 males and 60 females; the age ranged from 19 to 66 years[ (32.0±9.7) years]. The degree of sunken upper eyelid was mild in 33 cases, moderate in 19 cases and severe in 12 cases. All patients underwent double eyelid plasty and orbicularis oculi flap folding. Based on this, 45 cases (33 mild and 12 moderate cases) underwent orbital septum fat flap transposition, 11 severe cases underwent SVF-gel grafting, and 8 cases (7 moderate and 1 severe cases) required combined approaches to correct depression. During the procedure, 19 cases (38 sides) received (1.8±0.8) ml of SVF-gel injection. Among these cases, one case with severe sunken upper eyelid who did not receive orbital fat transfer was injected with high density fat (left side: 0.6 ml, right side: 0.8 ml) due to insufficient SVF-gel volume. Two cases with severe sunken upper eyelid who only had autologous SVF-gel transplantation did not fully correct the depression within 3 months post-surgery received a second SVF-gel injection[(1.0±0.1) ml]. Follow-up was conducted for 6 to 12 months after surgery. All patients experienced varying degrees of eyelid edema, which typically lasted 2 to 3 months. Ecchymosis (34 sides), conjunctival congestion (3 sides), and temporary ptosis (5 sides) all resolved within 2 weeks. Pigmentation (14 sides) and scar hyperplasia (3 sides) disappeared or stabilized within 6 months. No patients developed complications such as incision infection, hematoma, fat liquefaction, local skin unevenness, or induration. The surgeons’ VAS scores of the above five indicators were all > 8 points, and the satisfaction scores of patients for the five indicators were all > 4 points. In both scoring, the improvement of sunken upper eyelid scored the highest, which were (9.2 ± 0.9) points and (4.8 ± 0.6) points respectively.Conclusion:For patients with single eyelids and varying degrees of sunken upper eyelid, performing double eyelid plasty and orbicularis oculi muscle flap folding, individualized correction is achieved through autologous fat redistribution techniques, based on the severity of the sunken upper eyelid and the amount of orbital fat. This single procedure can restore upper eyelid volume and rejuvenate the appearance, resulting in a natural and aesthetically pleasing double eyelid with minimal complications and high patient satisfaction.

The core pathogenesis of disease caused by latent toxin is deficiency of healthy qi and lingering pathogen, which is characterized by lingering and recurrent courses, and onset upon exogenous induction. The biological mechanisms of disease caused by latent toxin present multi-dimensional and synergistic characteristics. Immune dysfunction and inflammatory response serve as the core links, involving the abnormal activation of signaling pathways such as Wnt/β-catenin, PI3K/Akt/mTOR, TLR, and NF-κB; the accumulation of metabolites, as the microscopic carrier of latent toxin, participates in chronic complications of diabetes by damaging vascular endothelium and inhibiting repair pathways; immune escape and tolerance, as well as weakened tumor suppressor function, supplement the potential mechanisms of latent toxin from the perspectives of pathogen/tumor cell latency and congenital insufficiency; the imbalance of tissue repair and remodeling, and the imbalance of protein metabolism and cellular homeostasis further improve the mechanism network of latent toxin. Among these, immune dysfunction, tumor suppressor gene mutation, and regulatory dysfunction may be the microscopic manifestations of "healthy qi deficiency"; inflammatory factors, metabolites, viruses, and tumor cells may be the microscopic manifestations of "latent toxin". Current studies have limitations, such as unclear specific biomarkers for different types of latent toxin, insufficient research on the interaction of multiple mechanisms, and lack of clinical verification. It is suggested that future research should be further carried out around "latent toxin classification-mechanism-efficacy".

Objective Hypobaric chamber and simulated weightless bed are essential methods for aerospace medical research,and conducting state assessment of volunteers before and after hypobaric chamber and simulated weightless bed tests is an essential guideline for aerospace implementation medicine.To further improve the efficiency of human condition assessment,in addition to the conventional biochemical and physiological indicators,the human oral exhaled gas can be used for condition assessment,and the olfactometry acquisition equipment and analysis software can collect and detect most volatile gases to complete the human oral exhaled gas data acquisition.Conducting comparative analysis of olfactory mapping data from different populations may be a means to assess the status of the body.Methods The olfactometry acquisition equipment was used to collect the oral exhaled breath olfactometry profiles of the general population,hypobaric cabin volunteers,and ambulatory volunteers.The olfactometry analysis software was used to calculate the 12 eigenvalues of the olfactometry profiles and the t-SNE downscaling,and the radar plots were used to analyze the olfactometry profiles of the general population,low-pressure cabin volunteers,and ambulatory volunteers respectively.A comparative analysis of different populations was conducted.Results(1)The t-SNE mapping data of the general population and the ambulatory volunteers were almost indistinguishable;(2)the t-SNE mapping data of the hypobaric cabin volunteers and the general population had a slight overlap,but the distinguishability of the vast majority of the t-SNE mapping data was obvious;(3)the t-SNE mapping data of the hypobaric cabin volunteers and the ambulatory volunteers were distinguishable with no overlap,and the ambulatory t SNE data are highly aggregated,and the distribution of t-SNE data in low-pressure cabin is more discrete;(4)there are 2-3 sensors with large eigenvalues and a large range of variation for both low-pressure cabin volunteers and recumbent volunteers after training activities,and the common sensor with a large range of variation is S6.Conclusion Olfactory diagnostic analysis mapping may be a means to assess the health status of the body and may be useful for spaceflight health status assessment in the future.The analysis and application of flight health state assessment can be a reference in the future.

Objective To explore the relationship of changes in serum neuron-specific enolase(NSE),neuropeptide Y(NPY)and hypocretin(Hcrt)levels with sleep disorders in the elderly stroke patients.Methods A total of 105 elderly stroke patients admitted in our department from February 2021 to February 2024 were retrospectively enrolled in this study.According to the re-sults of Pittsburgh sleep quality index(PSQI)evaluation,they were divided into sleep disorder group(64 cases)and non-sleep disorder group(41 cases).The serum NSE,NPY and Hcrt levels at admission were measured,their sleep status was evaluated with PSQI questionnaire,and the levels and clinical data were compared between groups.Multivariate logistic regression analysis was applied to analyze the influencing factors of sleep disorders in elderly stroke patients,and ROC curve analysis was performed.Results The NSE level was significantly higher,and the le-vels of NPY and Hcrt were obviously lower in the sleep disorder group than the non-sleep disor-der group(P＜0.01).Multivariate logistic regression analysis suggested that NSE,NPY,Hcrt,age,NIHSS score and history of stroke were independent influencing factor for sleep disorders in elderly stroke patients(P＜0.05,P＜0.01).ROC curve analysis indicated that the AUC value of NSE,NPY and Hcrt in predicting the occurrence of sleep disorders was 0.797,0.754 and 0.915,re-spectively.Conclusion Serum NSE,NPY and Hcrt are closely associated with sleep disorders in elderly stroke patients,and are of important value in predicting the occurrence of sleep disorders.

Objective:To explore the short-term oncological efficacy of the total prostatic urethra preservation（TPUP）technique in laparoscopic radical prostatectomy and its impact on postoperative urinary continence rate.Methods:The clinical data of 17 prostate cancer patients admitted to Shaoxing People’s Hospital from July 2023 to July 2024 were retrospectively analyzed. The age was（70.5 ± 6.5）years，the body mass index was（23.6 ± 2.5）kg/m 2，and the prostate-specific antigen（PSA）level was（7.845 ± 3.929）ng/ml. The preoperative biopsy pathological Gleason score were 6 in 8 cases，and 7 in 9 cases. All patients underwent laparoscopic radical prostatectomy，and the TPUP technique was used during the operation. The integrity of the preserved urethra was improved by preserving the prostatic surgical capsule closely attached to the corpus spongiosum of the urethra. During the operation，the urethra was completely preserved in 2 cases，nearly completely preserved in 14 cases，and partially preserved in 1 case. The recovery of urinary continence on the day of catheter removal and at 1 and 3 months after the operation was recorded. Recovery of urinary continence was defined as pad within 24 hours. PSA was re - examined at 6 weeks and 3 months after the operation. Results:All 17 operations in this study were successfully completed. The operation time was（143.6 ± 31.6）minutes，and the intraoperative blood loss was 50.0（20.0，50.0）ml. None of the cases was converted to open surgery，and no Clavien - Dindo grade ≥ 2 complications such as blood transfusion or intestinal injury occurred during the peri-operative period. The PSA levels at 6 weeks and 3 months after the operation were 0.054（0.008，0.215）ng/ml and 0.008（0.005，0.037）ng/ml，respectively. The indwelling catheter time after the operation was（13.4 ± 2.1）days. The number of cases with recovered urinary continence on the day of catheter removal and at 1 and 3 months after the operation was 10，15，and 17，respectively.Conclusions:The TPUP technique in laparoscopic radical prostatectomy leads to good recovery of postoperative urinary continence，and there is a slowly PSA decrease in the short term.

Purpose To investigate the distribution characteristics of tumor-associated macrophages(TAM)in different regions of breast cancer with enhanced contrast-enhanced ultrasound(CEUS),and to further explore the relationship between TAM and CEUS indicators and clinicopathology in different regions of breast cancer.Materials and Methods A total of 119 patients with suspected breast cancer admitted to the Cancer Hospital Affiliated to Xinjiang Medical University from March 2021 to March 2023 were prospectively included.CEUS was applied to the tumor,and ultrasound-guided puncture biopsy was also taken.The lesions diagnosed as breast cancer by pathology was outlined the central area,marginal area and normal area next to the cancer,and was obtained the time intensity curves of different areas.The tissues were taken for immunohistochemistry and flow cytometry,and the TAM cells were stained and distinguished.The characteristics of TAM in different regions of breast cancer and its correlation with clinical pathology were analyzed,respectively.Results By immunohistochemistry and flow cytometry,there were significant differences in the number of TAM infiltration in the border area,central area and adjacent area of breast cancer(immunohistochemistry:F=382.326,P<0.05;flow cytometry:F=24.955,P<0.05).The characteristics of CEUS in three different regions showed that the TAM in the central region of breast cancer increased when filling defect appeared(t=2.631,P<0.05),but the TAM in the peripheral region was more(t=2.999,P<0.05).After angiography,lesions showed high perfusion,and there was significantly more TAM in the edge and central area of the lesion than that in normal area next to the cancer(t=5.529,P<0.05;t=2.584,P<0.05).Clinical stage was related to the TAM in three regions.When the clinical stage was high,there were more TAM in all three regions(t=6.658,2.367,2.400,all P<0.05).Histological grading was high,and TAM in all three areas was high(F=101.151,16.922,26.822,all P<0.05).Conclusion There was a decreasing trend of TAM in the marginal area,central area and adjacent tissues of breast cancer during CEUS.The edge region has more malignant CEUS characteristics than that in the central region and the normal region adjacent to cancer;and the number of TAM is more in breast cancer with late clinical grading,poor tissue differentiation and obvious contrast-enhanced ultrasound malignant characteristics.The distribution characteristics of TAM represent the malignant degree and metastatic probability of breast cancer to a certain extent,and TAM is a factor related to the invasion of breast cancer.

Objective To classify the foot types of young Chinese males,extract characteristic indicators of foot types,and construct a standard foot type database.Methods Foot type data from 1 483 healthy young male individuals were collected.Spectral clustering algorithm was utilized to categorize foot types,and a deep neural network(DNN)was employed for training the classification model.Layer-wise relevance propagation(LRP)and the correlation coefficient method were combined to extract foot type features,and the differences in various foot type characteristics were compared.Results Spectral clustering yielded 4 distinct foot type categories.Foot type 1 was characterized by a high-arched foot with a prominent big toe,inwardly rotated 5th toe,and a high heel with a wide foot;foot type 2 was characterized by a narrow foot with hallux valgus;foot type 3 was characterized by a low-arched foot with hallux valgus;foot type 4 was characterized by a high-arched foot with a prominent big toe.By integrating interpretable neural networks and the correlation coefficient method,nine indicators were extracted from 27 foot type indicators,including the heel to the sole length,hallux height,navicular bone height,lateral malleolus height,hallux valgus angle,5th toe angle,dorsal foot circumference,heel angle,and longitudinal arch angle.The classification model constructed with these extracted indicators achieved an overall discrimination accuracy rate of 93.67％.Conclusions Chinese young males can be classified into four typical foot types.By examining the rearfoot,midfoot,and forefoot regions,nine key foot morphology parameters,including length,height,circumference,and angle,can be extracted.These parameters provide both theoretical and empirical support for establishing normative data on foot morphology for Chinese young males and for advancing biomechanical researches on the foot and ankle.

Objective To explore the effect of cognitive-motor dual tasks with different cognitive loads(none,simple and difficult)on activation of prefrontal cortex and static posture control in young man.Methods From June to July,2024,27 healthy male college students were recruited in Hebei Normal University.Static postural control parameters(C90 area),lower limb electromyography data(muscle energy proportion)and pre-frontal cortex hemodynamic signals of subjects under single task without cognitive load,dual-task with simple cognitive load,and dual-task with difficult cognitive load were collected using a balanced testing and training system,a wireless surface electromyography device,and functional near-infrared spectroscopy technology.Results The C90 areas of dual-tasks with simple and difficult cognitive load were smaller than that of the single task without cognitive load(P<0.05).The proportion of β band energy in the medial and lateral gastrocnemius mus-cles in the dual-task with simple cognitive load was greater than that in the single task without cognitive load(P<0.05),while the proportion of piper band energy in the lateral gastrocnemius muscle and tibialis anterior muscle was less(P<0.05).During dual-task with difficult cognitive load,the activation levels of bilateral ventro-lateral prefrontal cortex and right dorsolateral prefrontal cortex were higher than those in the single task without cognitive load(P<0.05).Conclusion Dual tasks with appopriate cognitive loads are effective on postural stability in young man.Simple cognitive load promote posture maintenance through optimizing the neuromuscular control of the lower limb muscle groups,while difficult cognitive load through activating the right prefrontal cortex involved in working memory and executive control,involving the neurocognitive compensatory.

OBJECTIVE: To observe the clinical efficacy of 3D printing spinal external fixator combined with McKenzie therapy for patients with lumbar dics herniation (LDH). METHODS: Sixty patients with LDH between January 2022 and January 2023 were enrolled. Among them, 30 patients were given McKinsey training. According to different treatment methods, all patients were divided into McKenzie group and McKenzie + 3D printing group, 30 patients in each group. The McKenzie group provided McKenzie therapy. The McKenzie + 3D printing group were treated with 3D printing spinal external fixation brace on the basis of McKenzie therapy. Patients in both groups were between 25 and 60 years of age and had their first illness. In the McKenzie group, there were 19 males and 11 females, with an average age of (48.57±5.86) years old, and the disease duration was (7.03 ±2.39) months. The McKenzie + 3D printing group, there were 21 males and 9 females, with an average age of (48.80±5.92) years old, and the disease duration was(7.30±2.56) months. Pain was evaluated using the visual analogue scale (VAS), and lumbar spine function was assessed using the Oswestry disability index (ODI) and the Japanese Orthopaedic Association (JOA) score. VAS, ODI and JOA scores were compared between two groups before treatment and at 1, 3, 6, 9 and 12 months after treatment. RESULTS: All patients were followed up for 12 months. The VAS for the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(6.533±0.860), (5.133±1.008), (3.933±0.868), (2.900±0.759), (2.067±0.640), (1.433±0.504), respectively. In the McKenzie group, the corresponding scores were (6.467±0.860), (5.067±1.048), (4.600±0.968), (3.533±1.008), (2.567±0.728), (1.967±0.809), respectively. The ODI of the McKenzie group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were (41.033±6.810)%, (37.933±6.209)%, (35.467±6.962)%, (27.567±10.081)%, (20.800±7.531)%, (13.533±5.158)%, respectively. For the McKenzie combined with 3D printing group, the corresponding ODI were(38.033±5.605)%, (33.000±6.192)%, (28.767±7.045)%, (22.200±5.517)%, (17.700±4.836)%, (11.900±2.771)%, respectively. The JOA scores of the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(8.900±2.074), (13.133±2.330), (15.700±3.583), (20.400±3.480), (22.267±3.084), (24.833±2.640), respectively. In the McKenzie group, the corresponding scores were(9.200±2.091), (12.267±2.406), (15.333±3.198), (18.467±2.240), (20.133±2.751), (22.467±2.849), respectively. Before the initiation of treatment, no statistically significant differences were observed in the VAS, ODI, and JOA scores between two groups (P>0.05). At 3, 6, 9, and 12 months post-treatment, the VAS in the McKenzie combined with 3D printing group was significantly lower than that in the McKenzie group, and the difference was statistically significant (P<0.05). The comparison of ODI between two groups at 1, 3, 6, 9, and 12 months post-treatment revealed statistically significant differences (P<0.05). At 6, 9, and 12 months post-treatment, the JOA score in the McKenzie combined with 3D printing group was significantly higher than that in the McKenzie-only group, and the difference was statistically significant (P<0.05). CONCLUSION The combination of 3D printed functional spinal external fixation brace with McKenzie therapy can significantly improve and maintain lumbar function in patients with LDH.
Humans ; Male ; Female ; Middle Aged ; Printing, Three-Dimensional ; Intervertebral Disc Displacement/surgery* ; External Fixators ; Lumbar Vertebrae/surgery* ; Adult ; Braces ; Treatment Outcome