BACKGROUND:Plate fixation is the mainstream method for the surgical treatment of distal femoral fractures.The intramedullary nailing has the advantages of minimally invasive,such as less soft tissue injury and bone blood supply destruction.At the same time,it is a central fixation and has better biomechanical effect.Therefore,retrograde intramedullary nailing has become another option for the internal fixation of distal femoral fractures.OBJECTIVE:The biomechanical characteristics of new retrograde intramedullary nail on lateral femur condyle,common femoral retrograde intramedullary nail,and lateral femur condyle anatomical locking plate for the treatment of A2-type distal femoral fractures were compared using finite element analysis,and the advantages of new retrograde intramedullary nail on lateral femur condyle was studied.METHODS:A new retrograde intramedullary nail on lateral femur condyle was designed,which was inserted into the bone cortex in front of the insertion point of the lateral collateral ligament of the lateral femoral condyle.A CT scan was performed on the lower limb bone of a male volunteer,and a three-dimensional model of the femur was established.The model was then segmented to create a three-dimensional model of a femoral distal A2-type fracture,The three-dimensional models of small(small group),standard type retrograde intramedullary nail on the lateral femoral condyle(standard group),common retrograde intramedullary needle(common group),and lateral femur condyle anatomical locking plate(plate group)were established respectively.The axial stresses of 600,1 800 N and the torsional load of 4 000,8 000 N·mm were applied to the models,and the displacement and stress of femur and the displacement,stress and shear force of internal fixators were observed in each group.RESULTS AND CONCLUSION:(1)When subjected to axial load of 600 and 1 800 N,the femoral peak displacement,the femoral peak stress,and the peak stress of interal fixation in the standard group were the lowest among the four groups.(2)When subjected to torsional load of 4 000 and 8 000 N·mm,the femoral peak displacement and peak displacement of the internal fixation in the standard group were the lowest among the four groups.(3)Compared with femoral lateral condylar locking plate and common retrograde intramedullary needle,the new retrograde intramedullary needle on lateral femur condyle has mechanical advantages of reducing stress concentration and decreasing the risk of internal fixation failure.

BACKGROUND:Plate fixation is the mainstream method for the surgical treatment of distal femoral fractures.The intramedullary nailing has the advantages of minimally invasive,such as less soft tissue injury and bone blood supply destruction.At the same time,it is a central fixation and has better biomechanical effect.Therefore,retrograde intramedullary nailing has become another option for the internal fixation of distal femoral fractures.OBJECTIVE:The biomechanical characteristics of new retrograde intramedullary nail on lateral femur condyle,common femoral retrograde intramedullary nail,and lateral femur condyle anatomical locking plate for the treatment of A2-type distal femoral fractures were compared using finite element analysis,and the advantages of new retrograde intramedullary nail on lateral femur condyle was studied.METHODS:A new retrograde intramedullary nail on lateral femur condyle was designed,which was inserted into the bone cortex in front of the insertion point of the lateral collateral ligament of the lateral femoral condyle.A CT scan was performed on the lower limb bone of a male volunteer,and a three-dimensional model of the femur was established.The model was then segmented to create a three-dimensional model of a femoral distal A2-type fracture,The three-dimensional models of small(small group),standard type retrograde intramedullary nail on the lateral femoral condyle(standard group),common retrograde intramedullary needle(common group),and lateral femur condyle anatomical locking plate(plate group)were established respectively.The axial stresses of 600,1 800 N and the torsional load of 4 000,8 000 N·mm were applied to the models,and the displacement and stress of femur and the displacement,stress and shear force of internal fixators were observed in each group.RESULTS AND CONCLUSION:(1)When subjected to axial load of 600 and 1 800 N,the femoral peak displacement,the femoral peak stress,and the peak stress of interal fixation in the standard group were the lowest among the four groups.(2)When subjected to torsional load of 4 000 and 8 000 N·mm,the femoral peak displacement and peak displacement of the internal fixation in the standard group were the lowest among the four groups.(3)Compared with femoral lateral condylar locking plate and common retrograde intramedullary needle,the new retrograde intramedullary needle on lateral femur condyle has mechanical advantages of reducing stress concentration and decreasing the risk of internal fixation failure.

Objective To investigate the serum C-C motif chemokine ligand 27(CCL27)and laminin sub-unit gamma-2(LAMC2)levels and prognostic value before transurethral resection of bladder tumor(TURBT)in patients with non-muscle-invasive bladder cancer(NMIBC).Methods A total of 104 patients with NMIBC who underwent primary TURBT at the First Affiliated Hospital of Air Force Medical University from February 2019 to February 2021 were retrospectively selected as the NMIBC group,and another 50 healthy individuals who underwent physical examinations at the same hospital during the same period were se-lected as the control group.The levels of serum CCL27 and LAMC2 before TURBT in the two groups were detected by enzyme-linked immunosorbent assay.Kaplan-Meier curve was used to analyze the effect of serum CCL27 and LAMC2 before TURBT on the prognosis of NMIBC patients.COX regression was used to analyze the prognostic factors of patients with NMIBC.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CCL27 and LAMC2 before TURBT in evaluating the prognosis of NMIBC pa-tients.Results The levels of serum CCL27 and LAMC2 in the NMIBC group before TURBT were higher than those in the control group,and the difference was statistically significant(P<0.05).The levels of serum CCL27 and LAMC2 before TURBT in patients with NMIBC at tumor stage T1 and high-grade pathological grade were higher than those in patients with tumor stage Ta/Tis and low-grade pathological grade,and the difference was statistically significant(P<0.05).The 3-year progression-free survival rate of patients in the high-level CCL27 group was lower than that in the low-level CCL27 group,and the difference was statistically significant(χ2=20.021,P<0.001).The 3-year progression-free survival rate of patients in the high-level LAMC2 group was lower than that in the low-level LAMC2 group,and the difference was statistically signifi-cant(χ2=11.012,P<0.001).Tumor stage T1,high-grade pathological grade,high level of serum CCL27,and high level of serum LAMC2 were risk factors affecting the prognosis of patients with NMIBC(P<0.05).The results of ROC curve analysis showed that the area under the curve and 95%CI of the combined serum CCL27 and LAMC2 before TURBT for the prognosis assessment of NMIBC patients were 0.901(0.881-0.925),which were larger than those of the single detection,and the difference was statistically significant(Z=4.620,4.912,P<0.001).Conclusion The elevated levels of serum CCL27 and LAMC2 before TURBT in NMIBC patients are related to the degree of tumor malignancy,and can serve as prognostic markers for in-dividualized treatment strategies.

Lymphoma is a highly heterogeneous malignancy characterized by complex molecular regulatory mechanisms that result in significant differences in aggressiveness and prognosis across its subtypes.Gene copy number alteration(CNA)analysis,an emerging technology,has become a pivotal tool in the precision re-search and management of lymphoma.By detecting DNA deletions,amplifications,and chromosomal copy number changes,CNA analysis addresses the limitations of traditional cytogenetic techniques,enhances the ac-curacy of subtype classification,and aids in evaluating tumor heterogeneity and disease progression.This re-view provides a comprehensive summary of CNA detection methods and their applications in lymphoma,with a focus on recent advancements in the field.It offers a comparative analysis of CNA detection techniques and discusses their role in precision diagnosis,subtype classification,monitoring disease progression,predicting therapeutic resistance,and assessing prognosis.Additionally,the review explores the potential applications of CNA analysis in uncovering molecular regulatory mechanisms,optimizing therapeutic strategies,and impro-ving patient survival outcomes.

Objective To report a case of fungal keratitis caused by plant pathogens,evidenced by laboratory testing.Methods Specimens were collected by corneal scraping from a 52-year-old male patient for pathogen culture.The patient was treated at Qionghai People's Hospital for fungal keratitis.The isolates were identified and tested for antimicrobial susceptibility.PubMed,CNKI,Wanfang,and VIP database were searched using keywords Diaporthe or Diaporthe phaseolorum in English and Chinese from the establishment of the database to December 10,2024.A retrospective literature review was conducted on the cases of human infection caused by Diaporthe.Results The specimens from corneal scraping were directly examined under a microscope.Septate fungal hyphae were observed.The isolate was identified as Diaporthe phaseolorum by targeted DNA sequencing.Antimicrobial susceptibility testing by microdilution method showed that the minimum inhibitory concentrations(MIC)of fluorocytosine,fluconazole,amphotericin B,voriconazole,itraconazole,posaconazole,micafungin,caspofungin,and anidulafungin against this strain were＞64,64,0.5,0.12,2,0.06,0.03,＜0.03,and 0.12 mg/L,respectively.Clinicians adjusted the antifungal treatment plan timely based on the antimicrobial susceptibility testing results.The patient's vision was restored.Literature review found that of the 12 reported cases of infection worldwide,6 were localized skin or soft tissue infections,3 were peritonitis,and the remaining 3 cases were keratitis.Overall,9 patients were immunocompromised and 3 had normal immune function.Human infections caused by Diaporthe often occur in immunocompromised individuals.Invasive infections often lead to patient mortality.There are no established breakpoints for common antifungal agents against Diaporthe.The MICs against the strain were higher for flucytosine and fluconazole,but lower for azoles,echinocandins,and polyenes.Conclusions Fungal keratitis caused by D.phaseolorum is an emerging infection.The information in this case,including clinical symptoms,the morphology of D.phaseolorum under microscope after corneal scraping,the growth characteristics and antifungal susceptibility testing,targeted DNA sequencing,can inform the microbiology laboratory staff and clinicians of D.phaseolorum infections in the future.

This article highlights the limitations of traditional treatment methods for non-muscle-invasive bladder cancer and the multi-dimensional exploration of emerging strategies.It firsty reviews the history and challenges of BCG immunotherapy,pointing out its bottlenecks in efficacy,tolerance,and supply,and focuses on its chemicobiological modifications,such as the optimization of nanoparticle drug delivery systems and immune-active components.Subsequently,it summarizes the development of various new treatment approaches,including gene therapy,photodynamic/sonodynamic therapy,chemodynamic therapy,and proteolysis-targeting chimeras for targeted protein degradation strategies.It particularly emphasizes the enhancement of drug delivery efficiency and targeting in the bladder through nanotechnology,aptamer-mediated systems,and biomimetic carriers.The treatment of bladder cancer is gradually transforming from local and single-mode to precise,synergistic,and low-toxicity directions,with chemicobiological means playing a core role in driving this transformation.Interdisciplinary integration provides a broad space and new hope for the treatment of bladder cancer.

Objective To predict the potential suitable areas of Cyperus rotundus L.in China;To provide a theoretical basis for the protection of wild resources of Cyperus rotundus L.and its artificial cultivation.Methods The data of 732 sample points were collected,combined with the data of 36 environmental factors,and the feature combination and regularization multiplier parameters were optimized using R 3.6.3.The MaxEnt model and geographic information system software ArcGIS 10.4.1 were used to analyze the distribution of the main environmental factors affecting the distribution of the suitability and the distribution of the suitable areas of Cyperus rotundus L.Results The main environmental factors that significantly affected the distribution of the suitability of Cyperus rotundus L.were minimum temperature of coldest month,precipitation of driest month,mean temperature of wettest quarter,mean temperature of warmest quarter,and precipitation of warmest quarter.The highly suitable areas of Cyperus rotundus L.are mainly located in Hainan,Guangdong,Guangxi,western and southern Taiwan,southern Yunnan,southern Tibet,east-central Hubei,eastern Hunan,northern Anhui,and central Jiangxi.Conclusion The results of this study can provide references for the sustainable development of wild resources,artificial cultivation optimization,planting site selection and management.

Objective To investigate the efficiency and mechanism of C1q tumor necrosis factor-related protein 3(CTRP3)on reprogramming of cardiac fibroblasts(CFs)into induced cardiomyocyte-like cells(iCMs)by Sendai virus(SeV)vector overexpressing Gata4,Mef2c and Tbx5(SeVGMT).Methods CFs were divided into Control,NC-Lv,CTRP3-Lv,NC-sh,and CTRP3-sh groups.NC-Lv,CTRP3-Lv,NC-sh,and CTRP3-sh were transfected into CFs using Lipofectamine 3000 reagent for 48 hours.Lipofectamine 3000 reagent was then mixed with SeVGMT and incubated at room temperature for 48 hours,the culture medium was then replaced,and cells were cultured for 21 days.Cell morphology was observed under a microscope at 0,3,7,14,and 21 days.Expression levels of the myocardial-specific proteins α-myosin heavy chain(α-MHC),α-actin,cardiac troponin T(cTnT),connexin 43(Cx43),cardiac muscle α-actin(Actc1),and myosin heavy chain 6(Myh6)were detected at different time points by immunofluorescence,quantitative reverse transcription-polymerase chain reaction,and Western blot,and the proportions of beating cells at different time points were calculated.Results The relative fluorescence intensity and mRNA and protein levels of α-MHC,α-actin,cTnT,Cx43,Actc1,and Myh6 in CFs in each group increased with increasing culture time(P＜0.05),with significantly higher expression levels of myocardial-specific proteins at 14 days of culture than at 7 days(P＜0.05).The relative fluorescence intensities and mRNA and protein levels of α-MHC,α-actin,cTnT,Cx43,Actc1,and Myh6 in CFs at 3,7,14,and 21 days of culture were significantly increased in the CTRP3-Lv group compared with the NC-Lv group(P＜0.05),but were significantly decreased in CFs in the CTRP3-sh group compared with the NC-sh group(P＜0.05).Beating cells appeared in CFs in each group at 7 days of culture.The proportion of beating cells in each group increased with increasing culture time(P＜0.05),and the proportion was significantly higher at 14 days than at 7 days(P＜0.05).The proportion of beating cells among CFs was increased in the CTRP3-Lv group at 7,14,and 21 days of culture compared with the NC-Lv group(P＜0.05),while the proportion of beating cells in the CTRP3-sh group was decreased compared with the NC-sh group(P＜0.05).Conclusions CTRP3 can enhance SeVGMT reprogramming of CFs into iCMs.

Objective:To investigate the promoting effect of individualized instruction combined with a blended learning model (IIBLM) in continuing training of neurology.Methods:A total of 93 trainees who received continuing training in Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, from August 2022 to December 2024 were enrolled as subjects. The 50 trainees registered since January 2024 were enrolled as observation group and received IIBLM teaching, including sub-specialty modular training, a cycle-adaptive cultivation system, a "mutual-selection" mentorship program, an on/off-line dual-track curriculum system, a dynamic course allocation mechanism based on "mutual selection", and a competency growth evaluation system, while the 43 trainees registered before January 2024 were enrolled as control group and received traditional teaching. A questionnaire survey and comprehensive competency assessments were performed to evaluate the effect of teaching, and the t-test, the chi-square test, and the qualitative analysis were used for statistical analysis. Results:Compared with the control group, the experimental group showed systematic improvements in clinical contents, theoretical curriculum, faculty competency, and workflow arrangement during continuing training, with a significant difference in the score of workflow arrangement between the two groups [(9.58±0.67) vs. (9.07±1.44), t=-2.13, P=0.037]. The observation group had a score of (97.70±1.30) for dynamic course allocation, an overall satisfaction rate of 97.15%, and a course benefit rate of 97.55%. The qualitative analysis showed that the trainees in the control group mainly complained of course monotony, while those in the observation group expected to enhance interdisciplinary integration and the cultivation of scientific research abilities. In addition, the results of competency assessment showed a continuous improvement in teaching effect after reform, with no significant difference. Conclusions:IIBLM teaching effectively enhances professional qualities, clinical competency, and the degree of satisfaction with courses among the trainees receiving continuing training, and it also revealed the necessity of interdisciplinary collaborative teaching and the integration of research and clinical practice.

BACKGROUND:Research suggests that exercise interventions may be more advantageous than pharmacologic treatments or dietary restriction alone for fat loss,but fewer studies have simultaneously examined the effects of training modalities and training cycles on visceral and subcutaneous fat in obese populations. OBJECTIVE:To investigate the impact of training modalities and training cycles on visceral and subcutaneous fat in recessive obesity female college students. METHODS:Sixty-three female college students with hidden obesity(body mass index<24 kg/m2 and body fat content percentage≥30%)were recruited from Zhengzhou College of Commerce and Industry,and were randomly divided into a high-intensity intermittent training group(n=32)and a moderate-intensity continuous training group(n=31)using the lottery method.Subjects in both groups performed exercise training of corresponding intensity on a running platform and ensured that the exercise volume of both groups was equal,3 times per week,every 4 weeks as one training cycle for 16 weeks.Before training and at the end of each training cycle,subjects'visceral fat,subcutaneous fat,and overall fat were measured using the corresponding test devices. RESULTS AND CONCLUSION:The repeated measures F results indicated that the main effects of training cycles on visceral fat area,visceral fat index,abdominal subcutaneous fat thickness,percentage of body fat and body mass index were significant,while the main effects of training modalities were significant for subcutaneous fat thickness in the triceps brachii and scapula regions.All the interaction effects between training modalities and training cycles were significant(P<0.05).Results from the simple effect tests revealed that the significant simple effects of training modalities at the 4th and 12th weeks for visceral fat area and visceral fat index,at the 8th and 12th weeks for subcutaneous fat thickness in the triceps brachii,scapula region,and abdominal regions,and at the 8th week for the percentage of body fat and body mass index.Simple effects of training cycles were significant for all measures within each group.(3)The results of multiple comparison tests indicated that in the high-intensity intermittent training group,visceral fat area,visceral fat index,percentage of body fat,body mass index and abdominal subcutaneous fat thickness decreased sequentially at the 4th,8th,12th,and 16th weeks,and subcutaneous fat thickness of the triceps brachii and scapula decreased sequentially at the 8th,12th,and 16th weeks(P<0.05).In the moderate-intensity continuous training group,visceral fat area,visceral fat index,subcutaneous fat thickness of the triceps brachii and scapula,percentage of body fat and body mass index decreased successively at the 8th,12th,and 16th weeks,while abdominal subcutaneous fat thickness decreased successively at the 4th,8th,12th,and 16th weeks(P<0.05).To conclude,both training modalities and training cycles are factors influencing visceral and subcutaneous fat in recessive obesity female college students.Training modality primarily affects subcutaneous fat in the triceps brachii and scapular region,but the fat loss effects may converge over a longer training cycle;training cycle primarily affects visceral fat area,visceral fat index,abdominal subcutaneous fat,body fat content,and body mass index.