China is currently experiencing rapid population aging,leading to a significant expansion of the elderly demographic.This aging process is accompanied by cognitive,motor,and sensory function decline and diseases,resulting in an increasing number of elderly individuals with disabilities.To address this challenge,extended reality technology offers a personalized,motivating,and human-computer interactive training environment that can effectively tackle the obstacles hindering active health and disability prevention in the elderly,such as inadequate infrastructure and motivation.This review summarized the current research status and effectiveness of extended reality technology in preventing disability among the elderly.Additionally,the review discusses the limitations and future prospects of extended reality technology in the context of elderly disability prevention,aiming to provide guidance for preventing disability in the elderly and promoting healthy aging.

Colorectal cancer is the most common malignant tumor of digestive tract, and BRAF V600E mutations occur in approximately 10% of patients with metastatic colorectal cancer (mCRC). Cancer patients harboring this mutation have a unique molecular profile and clinical phenotype; they show poor response to systemic chemotherapy, insensitivity to single BRAF inhibitor, and short survival rate. It is important to develop new therapeutic agents and clinical strategies to improve the prognosis of these patients. This review mainly introduces treatment methods for BRAF V600E-mutated mCRC and rationally derived combinations of targeted agents and immunotherapy.

Objective To explore the expression and significance of neutrophil extracellular traps(NETs)in peripheral blood of primary Sj?gren's syndrome(pSS)patients across different disease activity levels,and the predictive value of NETs and routine laboratory markers antithrombin Ⅲ(AT Ⅲ),alkaline phosphatase(ALP)and carbohydrate antigen 125(CA125)for pSS disease activity.Methods A total of 94 newly diagnosed pSS patients at the Affiliated Lianyungang Hospital of Xuzhou Medical University from October 2021 to December 2023 were categorized into active(n=49)and non-active(n=45)groups based on the European League Against Rheumatism(EULAR)Sj?gren's Syndrome disease activity index(ESSDAI).The levels of NETs biomarkers,namely serum myeloperoxidase(MPO)-DNA,were measured using ELISA.Laboratory routine indicators and MPO-DNA were integrated into multivariate Logistic regression to screen for independent influencing factors of pSS disease activity.Pearson's correlation was used to evaluate the relationship between MPO-DNA levels and ESSDAI scores.The efficacy of MPO-DNA alone or in combination with AT Ⅲ,ALP and CA125,for predictors of disease activity was evaluated using ROC curve.Results Serum MPO-DNA(23.884±3.494 μg/L),ALP(80.159±34.318 U/L)and CA125(20.300±16.560 U/ml)levels of active pSS patients were higher than those in the non-active patients(19.024±3.324 μ g/L,67.500±21.166U/L,13.200±6.340 U/ml),while AT Ⅲ(89.180±15.040 ng/ml)was lower than that in non-active patients(94.650±11.620 ng/ml),with significant differences(t=-7.921,-2.426,-2.925,2.094,all P＜0.05).Multivariate Logistic regression analysis showed laboratory indicator MPO-DNA,ALP and CA125 were independent risk factors,while AT Ⅲ was an independent protective factor(all P＜0.05).MPO-DNA was positively correlated with ESSDAI scores(r=0.602,P＜0.01).The AUC(95％CI)of the combination of ALP,CA125 and AT Ⅲ for predicting disease activity in pSS was 0.711(0.612～0.810).The AUC(95％CI)of MPO-DNA alone for predicting disease activity in pSS was 0.837(0.758～0.915),and the AUC(95％CI)of combination of MPO-DNA,ALP,CA125 and AT Ⅲ for predicting disease activity in pSS was 0.866(0.797～0.935),showing an improving in the predictive value.Conclusion The involvement of NETs in the occurrence and expression levels of pSS is related to its disease activity.NETs combined with ALP,CA125 and AT Ⅲ have effective diagnostic performance for the disease activity of pSS.This tool can serve as a biological indicator for predicting the disease activity of pSS.

Objective To explore the changes of the thickness of myometrium(MT),apparent diffusion coefficient value of myometrium(ADCM),thickness of junctional zone(JZT)and apparent diffusion coefficient value of junctional zone(ADCJz)in patients with endometrial fibrosis.Methods A total of 59 patients with endometrial fibrosis and 34 healthy women(volunteer)of childbearing age were prospectively included.The JZT,ADCJz,MT and ADCM were measured.Independent samples t-test was used to compare the differences in JZT,ADCJZ,MT,and ADCM between the two groups.A combined prediction model was established using binary logistic regression analysis(combining mean JZT,mean ADCJZ,and mean MT).The efficiency of each parameter's mean value and the combined prediction model in diagnosing endometrial fibrosis was evaluated using the receiver operating characteristic(ROC)curve.Results JZT(anterior wall,posterior wall,fundus and mean;P=0.007,0.035,0.001 and＜0.001,respectively),ADCJZ(anterior wall,posterior wall,fundus and mean;all P＜0.001)and MT(anterior wall,posterior wall and mean;P=0.003,＜0.001 and 0.003,respectively)were significantly larger in patients with endometrial fibrosis compared to volunteer.Mean ADCJZ[area under the curve(AUC)=0.872]and the combined prediction model(AUC=0.953)had high value for diagnosing endometrial fibrosis.Conclusion MRI can be used for noninvasively assessing the changes of myometrium and JZ in patients with endometrial fibrosis.

Tumor-associated macrophage(TAM)play a crucial role in the immune microenvironment of lung can-cer.Through changes in their phenotype and phagocytic functions,TAM contribute to the initiation and progression of lung cancer.By promoting the formation of an immune-suppressive microenvironment and accelerating the growth of abnormal tumor vasculature,TAM facilitate the invasion and metastasis of lung cancer.Macrophages can polarize into different subtypes with distinct functions and characteristics in response to various stimuli,categorized as anti-tumor M1 and pro-tumor M2 types.In tumor tissues,TAM typically polarize into the alternatively activated M2 phenotype,exhibiting inhibitory effects on tumor immunity.This article reviews the role of anti-angiogenic drugs in modulating TAM phenotypes,highlighting their po-tential to reprogram M2-type TAM into an anti-tumor M1 phenotype.Additionally,the functional alterations of TAM play a significant role in anti-angiogenic therapy and immunotherapy strategies.In summary,the regulation of TAM polarization and function opens up new avenues for lung cancer treatment and may serve as a novel target for modulating the immune microen-vironment of tumors.

This article reviews the overview of digital integration of geriatric patients and related influencing factors, the current situation of smart outpatient service, and the aging measures of smart outpatient service, with a view to providing reference for Chinese scholars to further study digital integration of geriatric patients.

Objective:To explore the effects of breast cancer mesenchymal stem cells (BC-MSC) on the proliferation and migration of breast cancer MCF-7 cells and the related mechanisms.Methods:The resected cancer tissues and paracancerous tissues were taken from breast cancer patients after surgery, and the bone marrow samples of healthy people were selected. BC-MSC, breast cancer paracancerous mesenchymal stem cells (BCN-MSC) and bone marrow mesenchymal stem cells (BM-MSC) of healthy people were isolated and cultured by tissue adhesion method, and their differentiation ability was induced by the addition of osteogenic and lipogenic induction, and their surface markers were detected by flow cytometry. The supernatants of BC-MSC, BCN-MSC and BM-MSC of healthy people cultured for 48 h were collected and used for the culture of MCF-7 cells as BC-MSC group, BCN-MSC group and BM-MSC group, respectively, and the control group was the conventional cultured MCF-7 cells. The proliferation ability of MCF-7 cells in each group was detected by methyl thiazol tetrazolium (MTT) assay, the clone formation ability of MCF-7 cells was detected by plate cloning assay, the migration ability of MCF-7 cells was detected by Transwell assay, and the mRNA relative expressions of interleukin (IL)-6 and epithelial mesenchymal transition (EMT)-related genes (E-cadherin, vimentin, snail) were detected by quantitative real-time fluorescence polymerase chain reaction (qRT-PCR) in MCF-7 cells. Western blotting was used to detect expressions of p-STAT3, E-cadherin, vimentin and snail proteins in MCF-7 cells. Luminex liquid microarray technology was used to detect cytokine levels in culture supernatants of different mesenchymal stem cells (MSC). IL-6 neutralizing antibody was added into the supernatant of BC-MSC, MCF-7 cells were cultured with the supernatant (BC-MSC+IL-6 neutralizing antibody group), and then the proliferation and migration abilities of MCF-7 cells were tested, as well as the expression changes of related genes and proteins.Results:BC-MSC, BCN-MSC and BM-MSC were successfully isolated; BC-MSC had positive expressions of CD29, CD44 and CD90 and negative expressions of CD14, CD34 and CD45, which were in line with the characteristics of MSC. MTT assay showed that the absorbance values of MCF-7 cells cultured for 48 h in the control group, BC-MSC group, BCN-MSC group and BM-MSC group were 0.31±0.02, 0.54±0.03, 0.43±0.02 and 0.42±0.02, respectively, and the difference was statistically significant ( F = 56.52, P < 0.05); the results of plate cloning experiments showed that the number of clones in each petri dish of the four groups were 180±9, 439±17, 319±16 and 306±19, respectively, and the difference was statistically significant ( F = 222.70, P < 0.05); Transwell assay showed that the numbers of membrane-penetrating cells in the four groups were 6.5±1.0, 23.2±2.4, 16.0±1.3 and 14.8±2.0, respectively, with the statistically significant difference ( F = 49.44, P < 0.05); qRT-PCR assay showed that the relative expressions of IL-6 mRNA in the control group, BC-MSC group, BCN-MSC group and BM-MSC group were 1.07±0.11, 13.79±3.80, 6.68±1.66 and 6.12±1.52, respectively, and the difference was statistically significant ( F = 107.60, P < 0.05), and the relative expression of E-cadherin mRNA in MCF-7 cells of BC-MSC, BCN-MSC and BM-MSC groups was lower than that of the control group, while the relative expressions of vimentin and snail mRNA were higher than those of the control group, and the differences were statistically significant (all P < 0.05). Western blotting assay showed that the relative expression of E-cadherin mRNA in MCF-7 cells of BC-MSC, BCN-MSC and BM-MSC groups was lower than that of the control group. Western blotting showed that the level of E-cadherin protein in BC-MSC, BCN-MSC and BM-MSC groups was lower than that in the control group, and the levels of vimentin and snail proteins were higher than those in the control group; Luminex liquid microarray technology showed that the content of IL-6 cytokine in the supernatants of BC-MSC, BCN-MSC and BM -MSC cultures were higher, and the relative expressions were 1.75±0.21, 1.00±0.10 and 0.96±0.08, respectively, and the difference was statistically significant ( F = 43.22, P < 0.05). The results of MTT assay showed that the absorbance values of MCF-7 cells in BC-MSC group and BC-MSC+IL-6 neutralizing antibody group were 0.56±0.05 and 0.42±0.04, respectively, and the difference was statistically significant ( t = -3.11, P < 0.05); the results of Transwell assay showed that the numbers of membrane-penetrating cells in the two groups were 30.3±1.5 and 17.3±2.1, respectively, and the difference was statistically significant ( t = -7.12, P < 0.05); qRT-PCR assay showed that the relative expressions of E-cadherin mRNA were 0.44±0.05 and 0.76±0.05 ( t = 6.40, P < 0.01), the relative expressions of vimentin mRNA were 2.90±0.21 and 1.79±0.21 ( t = 5.29, P < 0.01), and the relative expressions of snail mRNA were 3.20±0.20 and 1.91±0.30 ( t = 2.16, P < 0.01); Western blotting assay showed that the degrees to down-regulate the expression of E-cadherin protein and up-regulate the expressions of vimentin and snail proteins in the BC-MSC+IL-6 neutralizing antibody group were weakened compared with the BC-MSC group. Conclusions:BC-MSC can promote the proliferation and migration of breast cancer MCF-7 cells probably through activating IL-6-STAT3 signaling pathway-induced EMT by its secretion of IL-6.

Abstract OBJECTIVE To retrospectively analyze the efficacy and safety of pamidronate disodium(APD) in the treatment of osteogenic imperfecta(OI) in children. METHODS Children who first used APD at the Children's Hospital Affiliated to Chongqing Medical University from January 1, 2014 to June 30, 2023 were selected as the research subjects. The growth and development status, improvement of bone metabolism and biochemical indicators, changes in bone density(BMD) and fractures, and occurrence of adverse drug reactions(ADRs) before and after treatment were compared. RESULTS A total of 14 pediatric patients were included, with a median age of 5.16 years. All children, regardless of the duration of treatment(1, 2 years, 3 years or more), showed significant improvements in height, body mass, and lumbar BMD compared to before treatment, while the average number of fractures per year decreased significantly(P<0.05). After 1 year of treatment, the alkaline phosphatase significantly increased(P=0.024). After 2 years of treatment, the total 25-hydroxyvitamin D3(T-25OHD3) significantly improved(P=0.014). After 3 years of treatment, the Z-value of height significantly improved(P=0.036). The most common ADR were fever, skeletal muscle pain, asymptomatic hypocalcemia and hypophosphatemia. CONCLUSION Pediatric patients with OI have good tolerance to APD treatment, with increased lumbar BMD and BMD Z values, reduced fracture rates, and improved growth and development.

Abstract OBJECTIVE To retrospectively analyze the efficacy and safety of pamidronate disodium(APD) in the treatment of osteogenic imperfecta(OI) in children. METHODS Children who first used APD at the Children's Hospital Affiliated to Chongqing Medical University from January 1, 2014 to June 30, 2023 were selected as the research subjects. The growth and development status, improvement of bone metabolism and biochemical indicators, changes in bone density(BMD) and fractures, and occurrence of adverse drug reactions(ADRs) before and after treatment were compared. RESULTS A total of 14 pediatric patients were included, with a median age of 5.16 years. All children, regardless of the duration of treatment(1, 2 years, 3 years or more), showed significant improvements in height, body mass, and lumbar BMD compared to before treatment, while the average number of fractures per year decreased significantly(P<0.05). After 1 year of treatment, the alkaline phosphatase significantly increased(P=0.024). After 2 years of treatment, the total 25-hydroxyvitamin D3(T-25OHD3) significantly improved(P=0.014). After 3 years of treatment, the Z-value of height significantly improved(P=0.036). The most common ADR were fever, skeletal muscle pain, asymptomatic hypocalcemia and hypophosphatemia. CONCLUSION Pediatric patients with OI have good tolerance to APD treatment, with increased lumbar BMD and BMD Z values, reduced fracture rates, and improved growth and development.

Objective:To investigate the value of MR subtraction images in improving the interobserver agreement for Bosniak Ⅱ, ⅡF, and Ⅲ cystic renal masses (CRMs) with Bosniak classification version 2019.Methods:From January 2009 to August 2020, 323 patients (335 CRMs) with surgical pathology results and complete preoperative MRI examination (T 2WI, T 1WI precontrast images and enhanced MRI in corticomedullary, nephrographic, and excretory phases) were retrospectively collected in the First Medical Center of PLA General Hospital. The CRMs of Bosniak Ⅱ, ⅡF, and Ⅲ were selected and classified by 2 experienced genitourinary radiologists according to the Bosniak classification version 2019. The "Subtraction" function in the American GE ADW 4.4 workstation was used to perform subtraction images reconstruction on the enhanced images in the corticomedullary, nephrographic, and excretory phases. Blinded to pathologic information, the other 2 radiologists independently classified the enrolled CRM cases with and without subtraction MR images, respectively, with an interval of 1 month. Ultimately, by using weighted Kappa value, interobserver agreement was evaluated, and the differences in weighted Kappa value were compared using the Gwet coefficient. Results:A total of 187 patients with 187 CRMs were enrolled in the study. The results of the classification of Bosniak Ⅱ, ⅡF, and Ⅲ CRMs categorized by 2 radiologists without and with subtraction images showed that 119 and 141 cases were consistent, and 68 and 46 were inconsistent, respectively. The weighted Kappa value for interobserver agreement among two radiologists without and with subtraction MR images was 0.60 (95%CI 0.53-0.68) and 0.73 (95%CI 0.66-0.80), respectively. The interobserver agreement was higher with subtraction images than that without subtraction images ( t=-2.56, P=0.011). Conclusion:According to the MRI criteria of Bosniak classification version 2019, the interobserver agreement for Bosniak Ⅱ, ⅡF, and Ⅲ CRMs could be improved using subtraction MR images, which may facilitate the popularization and application of Bosniak classification version 2019.