BACKGROUND:Induced resorption of herniated nucleus pulpous is a minimally invasive,non-invasive and innovative method for the treatment of cervical/lumbar intervertebral disc herniation.After induced resorption of herniated nucleus pulpous,the research about whether cervical/lumbar intervertebral disc can maintain the original biomechanical strength has not been reported.OBJECTIVE:To measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc before and after induced resorption of herniated nucleus pulpous operation to analyze the changes of the biomechanical strength of the intervertebral disc after reclining and to provide a new basis for induced resorption of herniated nucleus pulpous treatment of cervical and lumbar intervertebral disc herniation.METHODS:A retrospective analysis was performed on 140 patients with cervical/lumbar intervertebral disc herniation who received induced resorption of herniated nucleus pulpous surgery in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023.Related software was used to measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc of patients at each follow-up time point before and after induced resorption of herniated nucleus pulpous surgery in Magnetic Resonance Imaging image data under Artificial Intelligence-assisted calibration.Unoperated T1/T2 and T12/L1 segments were taken respectively as controls.Those with preoperative height of adjacent vertebral centroid less than 8％of the corresponding T1/T2 or T12/L1 control segment were in the"height reduction group"(hereafter referred to as group A)and the rest were in the"height unchanged group"(hereafter referred to as group B).The difference of height of adjacent vertebral centroid before and after operation between the group A and the group B was statistically analyzed.Simultaneously,the correlation between the volume of cervical and lumbar herniated discs and the changes of height of adjacent vertebral centroid was analyzed according to the result measured by artificial intelligence.RESULTS AND CONCLUSION:(1)The study maintained a total of 140 patients,including 60 cases of cervical disc herniation and 80 cases of lumbar disc herniation.The postoperative follow-up period was 7 days to 12 months.(2)A total of 281 discs were measured in the cervical vertebra group,including 60 intervertebral discs in the control group.The mean value of height of adjacent vertebral centroid before and at the last postoperative follow-up was about 20.46 mm and 20.17 mm,respectively,with no statistical difference(P＞0.05).There were 162 cervical discs in group A.The average height of adjacent vertebral centroid before and after operation was 16.65 mm and 15.92 mm,respectively,with no statistically significant difference(P＞0.05).The mean cervical disc herniation volume before and after surgery was 510.28 mm3 and 364.76 mm3,respectively,which was not significantly correlated with height of adjacent vertebral centroid change(P＞0.05).There were 64 discs in the group B,with average of 20.15 mm before operation and 19.09 mm at the last follow-up,and there was no significant difference(P＞0.05).The mean volume of cervical disc herniation before and after surgery was 515.32 mm3 and 361.98 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P＞0.05).(3)A total of 258 discs were measured in the lumbar spine group,of which 80 intervertebral discs in the control group,the average height of adjacent vertebral centroid was 33.03 mm before operation and 32.40 mm at the last follow-up,and there was no significant difference.There were 59 discs in the group A,and the average height of adjacent vertebral centroid before and after operation was 30.08 mm and 31.67 mm,respectively,with no statistically significant difference.The mean volume of lumbar disc herniation before and after operation was 690.51 mm3 and 496.58 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P＞0.05).There were 119 discs in the group B,with an average height of adjacent vertebral centroid of 35.91 mm before surgery and 34.12 mm at the last follow-up.The mean volume of lumbar disc herniation before and after operation was 698.70 mm3 and 535.99 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid.(4)It is concluded that patients with cervical/lumbar intervertebral disc herniation can maintain the same intervertebral height level after induced resorption of herniated nucleus pulpous regardless of whether the intervertebral height has decreased before operation.It can be inferred that the resorption of the herniated disc does not affect its biomechanical strength.It suggests that induced resorption of herniated nucleus pulpous surgery should be performed before the intervertebral height of the degenerate segment has decreased.The induced resorption of herniated nucleus pulpous is more valuable to maintain the biomechanical strength of the resorptive disc.

This article reports a case of membranous nephropathy in an adolescent accompanied by monoclonal IgG1-κ deposition. The 16-year-old female patient was hospitalized for experiencing proteinuria and hematuria for more than 20 days. The patient had a history of mycoplasma infection and acute kidney injury, and renal pathology revealed glomerular membrane lesions accompanied by crescent formation. Electron microscopy showed electron dense deposits in the subepithelial and mesangial regions, and immunofluorescence demonstrated monotypic IgG1-κ deposits in the glomerulus. Bone marrow examination did not find any abnormal plasma cells, nor were there significant abnormalities in serum or urine free light chain κ/λ ratio. The diagnosis was proliferative glomerulonephritis characterized by membranous lesions with monoclonal IgG1-κ deposits. This disease is rare in children and adolescents, and currently there is limited understanding of its mechanism, with limited clinical treatment experience. This article aims to provide clinical insights through case analysis and literature review.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.

Objective:The components of Rubus parvifolius L. were analyzed based on UPLC-MS/MS technology and combined with network pharmacology analysis to explore the mechanism of action of Rubi Parvifolii Radix in treating inflammation, cough, fever, influenza and sore throat. Method:The chemical constituents of Rubi Parvifolii Radix were identified according to the information of mass spectrometry. The network pharmacology was used to analyze the corresponding targets and related pathways of its chemical components, and the "component-target-pathway" interaction diagram was drawn. PyMOL 2.5.7 software wasused to perform molecular docking between active components and key targets.Results:Twenty chemical components were identified by UPLC-MS/MS, and 15 components were screened out by network pharmacology, which can be used as quality markers of Rubi Parvifolii Radix, namely Azelaic acid, Procyanidol B3, Caprolactam, Bis (2-ethylhexyl) adipate, Cryptochlorogenic acid, 3-O-Feruloylquinic, Ellagic acid, Aurantiamide acetate, 2 α,3 β,19 α,23-Tetrahydroxyurs-12-en-28-oic acid, L-Epicatechin, (E)-3-Indoleacrylic acid, Euscaphic acid, Suberic acid, Diisononyl phthalate and Prodelphinidin T4. Molecular docking showed that 5 compounds compared with the reference substance could bind to the target proteins of disease well. Conclusions:The 15 active ingredients in Rubi Parvifolii Radix, including Caprolactam and (E)-3-Indoleacrylic acid, may play a therapeutic role in treating colds, high fever, sore throat, and inflammation by acting on targets such as AKT1 and TNF. This provides a certain reference for the clinical application of Rubi Parvifolii Radix.

The ability to localize sound sources rapidly allows human beings to efficiently understand the surrounding environment. Previous studies have suggested that there is an auditory "where" pathway in the cortex for processing sound locations. The neural activation in regions along this pathway encodes sound locations by opponent hemifield coding, in which each unilateral region is activated by sounds coming from the contralateral hemifield. However, it is still unclear how these regions interact with each other to form a unified representation of the auditory space. In the present study, we investigated whether functional connectivity in the auditory "where" pathway encoded sound locations during passive listening. Participants underwent functional magnetic resonance imaging while passively listening to sounds from five distinct horizontal locations (-90°, -45°, 0°, 45°, 90°). We were able to decode sound locations from the functional connectivity patterns of the "where" pathway. Furthermore, we found that such neural representation of sound locations was primarily based on the coding of sound lateralization angles to the frontal midline. In addition, whole-brain analysis indicated that functional connectivity between occipital regions and the primary auditory cortex also encoded sound locations by lateralization angles. Overall, our results reveal a lateralization-angle-based representation of sound locations encoded by functional connectivity patterns, which could add on the activation-based opponent hemifield coding to provide a more precise representation of the auditory space.
Humans ; Sound Localization/physiology* ; Male ; Female ; Magnetic Resonance Imaging ; Young Adult ; Functional Laterality/physiology* ; Adult ; Brain Mapping ; Auditory Cortex/physiology* ; Acoustic Stimulation ; Auditory Pathways/physiology* ; Brain/physiology*

Objective:In order to establish benchmark values for new medical service items,it aims to investigate the predictive models and influencing elements that affect the work relative value unit in clinical surgical items in China.Methods:Generalized Linear Model(GLM)and BP neural network techniques were used to investigate influencing factors and build prediction models using the National Medical Service Project Technical Specification(2023 Edition)as the value database.Results:The average relative value of human resource usage was 41.9,with a total of 6 011 items across 16 systems and anesthesia.The GLM's mean prediction error was 4%and its linear correlation coefficient was 0.997.The top 5 predictor variables in terms of importance were technical complexity(0.45),risk level(0.30),physician time(0.08),number of physicians(0.06),and nurse time(0.03).With a mean prediction error of 1.5%,the neural network model obtained a correlation coefficient of 0.996.Technical difficulty(0.20),physician time(0.20),perfusionist time(0.19),risk level(0.15),and medical technician time(0.06)were the top five predictors.Conclusion:Both types of predictive models are well-fitted and valid,and future medical service items can provide relative values of human resource consumption,creating an integrated relative point system.

Objective:In order to establish benchmark values for new medical service items,it aims to investigate the predictive models and influencing elements that affect the work relative value unit in clinical surgical items in China.Methods:Generalized Linear Model(GLM)and BP neural network techniques were used to investigate influencing factors and build prediction models using the National Medical Service Project Technical Specification(2023 Edition)as the value database.Results:The average relative value of human resource usage was 41.9,with a total of 6 011 items across 16 systems and anesthesia.The GLM's mean prediction error was 4%and its linear correlation coefficient was 0.997.The top 5 predictor variables in terms of importance were technical complexity(0.45),risk level(0.30),physician time(0.08),number of physicians(0.06),and nurse time(0.03).With a mean prediction error of 1.5%,the neural network model obtained a correlation coefficient of 0.996.Technical difficulty(0.20),physician time(0.20),perfusionist time(0.19),risk level(0.15),and medical technician time(0.06)were the top five predictors.Conclusion:Both types of predictive models are well-fitted and valid,and future medical service items can provide relative values of human resource consumption,creating an integrated relative point system.

BACKGROUND:Induced resorption of herniated nucleus pulpous is a minimally invasive,non-invasive and innovative method for the treatment of cervical/lumbar intervertebral disc herniation.After induced resorption of herniated nucleus pulpous,the research about whether cervical/lumbar intervertebral disc can maintain the original biomechanical strength has not been reported.OBJECTIVE:To measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc before and after induced resorption of herniated nucleus pulpous operation to analyze the changes of the biomechanical strength of the intervertebral disc after reclining and to provide a new basis for induced resorption of herniated nucleus pulpous treatment of cervical and lumbar intervertebral disc herniation.METHODS:A retrospective analysis was performed on 140 patients with cervical/lumbar intervertebral disc herniation who received induced resorption of herniated nucleus pulpous surgery in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023.Related software was used to measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc of patients at each follow-up time point before and after induced resorption of herniated nucleus pulpous surgery in Magnetic Resonance Imaging image data under Artificial Intelligence-assisted calibration.Unoperated T1/T2 and T12/L1 segments were taken respectively as controls.Those with preoperative height of adjacent vertebral centroid less than 8％of the corresponding T1/T2 or T12/L1 control segment were in the"height reduction group"(hereafter referred to as group A)and the rest were in the"height unchanged group"(hereafter referred to as group B).The difference of height of adjacent vertebral centroid before and after operation between the group A and the group B was statistically analyzed.Simultaneously,the correlation between the volume of cervical and lumbar herniated discs and the changes of height of adjacent vertebral centroid was analyzed according to the result measured by artificial intelligence.RESULTS AND CONCLUSION:(1)The study maintained a total of 140 patients,including 60 cases of cervical disc herniation and 80 cases of lumbar disc herniation.The postoperative follow-up period was 7 days to 12 months.(2)A total of 281 discs were measured in the cervical vertebra group,including 60 intervertebral discs in the control group.The mean value of height of adjacent vertebral centroid before and at the last postoperative follow-up was about 20.46 mm and 20.17 mm,respectively,with no statistical difference(P＞0.05).There were 162 cervical discs in group A.The average height of adjacent vertebral centroid before and after operation was 16.65 mm and 15.92 mm,respectively,with no statistically significant difference(P＞0.05).The mean cervical disc herniation volume before and after surgery was 510.28 mm3 and 364.76 mm3,respectively,which was not significantly correlated with height of adjacent vertebral centroid change(P＞0.05).There were 64 discs in the group B,with average of 20.15 mm before operation and 19.09 mm at the last follow-up,and there was no significant difference(P＞0.05).The mean volume of cervical disc herniation before and after surgery was 515.32 mm3 and 361.98 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P＞0.05).(3)A total of 258 discs were measured in the lumbar spine group,of which 80 intervertebral discs in the control group,the average height of adjacent vertebral centroid was 33.03 mm before operation and 32.40 mm at the last follow-up,and there was no significant difference.There were 59 discs in the group A,and the average height of adjacent vertebral centroid before and after operation was 30.08 mm and 31.67 mm,respectively,with no statistically significant difference.The mean volume of lumbar disc herniation before and after operation was 690.51 mm3 and 496.58 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P＞0.05).There were 119 discs in the group B,with an average height of adjacent vertebral centroid of 35.91 mm before surgery and 34.12 mm at the last follow-up.The mean volume of lumbar disc herniation before and after operation was 698.70 mm3 and 535.99 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid.(4)It is concluded that patients with cervical/lumbar intervertebral disc herniation can maintain the same intervertebral height level after induced resorption of herniated nucleus pulpous regardless of whether the intervertebral height has decreased before operation.It can be inferred that the resorption of the herniated disc does not affect its biomechanical strength.It suggests that induced resorption of herniated nucleus pulpous surgery should be performed before the intervertebral height of the degenerate segment has decreased.The induced resorption of herniated nucleus pulpous is more valuable to maintain the biomechanical strength of the resorptive disc.

This article reports a case of membranous nephropathy in an adolescent accompanied by monoclonal IgG1-κ deposition. The 16-year-old female patient was hospitalized for experiencing proteinuria and hematuria for more than 20 days. The patient had a history of mycoplasma infection and acute kidney injury, and renal pathology revealed glomerular membrane lesions accompanied by crescent formation. Electron microscopy showed electron dense deposits in the subepithelial and mesangial regions, and immunofluorescence demonstrated monotypic IgG1-κ deposits in the glomerulus. Bone marrow examination did not find any abnormal plasma cells, nor were there significant abnormalities in serum or urine free light chain κ/λ ratio. The diagnosis was proliferative glomerulonephritis characterized by membranous lesions with monoclonal IgG1-κ deposits. This disease is rare in children and adolescents, and currently there is limited understanding of its mechanism, with limited clinical treatment experience. This article aims to provide clinical insights through case analysis and literature review.

Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.