BACKGROUND:As a mainstream surgical technique for the treatment of cervical spondylotic myelopathy through the anterior cervical subtotal decompression and bone graft fusion,it has many advantages.However,due to the high risk of this surgery and the particularity of the cervical anatomy,it is also a challenge for the surgeon.The gradual maturity of 3D printing technology and the continuous development of applications in the medical field are now able to provide more perfect personalized treatment.OBJECTIVE:To investigate the efficacy of 3D printed titanium cage cutting model in anterior cervical vertebrae subtotal decompression and bone graft fusion.METHODS:Medical records of 57 patients undergoing anterior cervical corpectomy decompression and fusion surgery admitted to the Department of Spine Surgery of Affiliated Hospital of Yan'an University from April 2021 to April 2023 were retrospectively analyzed.According to whether the 3D printed titanium cage cutting model was used in the operation,the patients were divided into the traditional titanium cage bone grafting group(control group,n=30)and the 3D printed titanium cage model group(observation group,n=27).The general data,amount of blood loss during operation,number ofC-arm X-ray machine fluoroscopy during operation,operation time,as well as anterior intervertebral edge height(H1),posterior intervertebral edge height(H2)and C2-C7 Cobb angle of the two groups measured on the cervical lateral X-ray films before,3 days and 6 months after operation were recorded and analyzed.The settling degree of the titanium cage was assessed with the distance of the height of the anterior and posterior edges of the vertebral body at 3 days and 6 months after surgery.Visual analog scale was used to evaluate neck pain and Japanese Orthopaedic Association was used to evaluate nerve function.RESULTS AND CONCLUSION:(1)Follow-up was conducted for at least 6 months.(2)The amount of intraoperative blood loss and fluoroscopy times in the observation group were less than those in the control group(P＜0.05).The operative time of the observation group was significantly shorter than that of the control group(P＜0.05).(3)There were no significant differences in C2-C7 Cobb angle,visual analog scale score,Japanese Orthopaedic Association score,anterior vertebral border height(H1)and posterior vertebral border height(H2)before surgery,3 days and 6 months after surgery between the two groups(P＞0.05).(4)There were five patients in the observation group(with severe subsidence rate of 19％)with severe subsidence at the anterior and posterior edges of the surgical segment,and seven patients in the control group(with severe subsidence rate of 23％)with severe subsidence(H1 or H2 subsidence≥3 mm)at the surgical segment 6 months after surgery.There was no significant difference in the rate of severe subsidence of titanium cage between the two groups(P＞0.05).(5)At the last follow-up,bone fusion was achieved at the operative level in both groups,and there was no statistical significance in bone graft fusion rate between the two groups(P＞0.05).(6)The results showed that the application of 3D printed titanium cage cutting model in anterior cervical corpectomy decompression and fusion surgery had the same clinical effect as that of traditional surgery,but the former could effectively reduce the fluoroscopy times of C-arm X-ray machine,the amount of blood loss and the operation time,and had unique advantages in the pruning and implantation of titanium cage during surgery.

BACKGROUND:The local immune microenvironment plays an important regulatory role in the process of bone formation,and the immune system is intricately linked to the skeletal system.OBJECTIVE:To systematically review the promotion of bone regeneration from three aspects:immune cell regulation of microenvironment,regulation of immune response by small extracellular vesicles,and induction of immune response by bone biomaterials,and to elucidate the immune regulatory mechanisms involved in bone regeneration.METHODS:Relevant literature was retrieved from PubMed,CNKI,WanFang Database,and VIP Database,using the search terms of"osteoimmunology,immune microenvironment,small extracellular vesicles,bone regeneration,bone tissue repair,biomaterials,and tissue engineering"in English and Chinese.Repeat and irrelevant literature was screened and removed,and 92 articles that met the criteria were selected for intensive reading and review.RESULTS AND CONCLUSION:Multiple immune cells and bone cells are in the same microenvironment,and immune cells can regulate the differentiation and activity of bone cells,collectively forming an immune microenvironment that affects bone regeneration.Neutrophils can significantly reduce local inflammatory responses in the early stages of bone injury,creating a favorable microenvironment for bone regeneration.M1 macrophages can clear foreign bodies and reduce early inflammatory responses,while M2 macrophages can promote the expression of osteogenic markers and factors,playing an important role in the repair process of bone injury.B cells and T cells can directly or indirectly affect the generation and activity of osteoblasts and osteoclasts,regulate bone metabolism,and promote bone regeneration.Extracellular vesicles of small cells regulate the local immune microenvironment through paracrine secretion,promoting bone formation and angiogenesis at the site of bone injury.The metal ions,surface hydrophilicity,porosity,pore size,surface morphology,and surface roughness on the surface of biomaterials can directly regulate local immune responses,and have anti-inflammatory,angiogenic,and osteogenic effects,thereby accelerating bone regeneration.

BACKGROUND:High-frequency repetitive transcranial magnetic stimulation has garnered significant attention due to its potential non-invasive benefits in modulating brain function.However,no studies have comprehensively analyzed the current research landscape and development trends of this field from a macroscopic perspective.OBJECTIVE:To explore research hotspots,current trends,and emerging frontiers in the field of high-frequency repetitive transcranial magnetic stimulation through visualized analysis.METHODS:Data were collected from the Web of Science Core Collection database from January 1,2014 to November 15,2024.CiteSpace was used for analyzing publication volume,collaborations among countries/regions,institutions and authors,citation analysis of journals and co-cited literature,as well as disciplinary distribution.Additionally,keyword co-occurrence,clustering,and burst analyses were conducted,and visualized knowledge maps were generated.RESULTS AND CONCLUSION:A total of 860 articles were included.The publication volume of high-frequency repetitive transcranial magnetic stimulation showed an overall upward trend from 2014 to 2022,followed by a decline from 2022 to 2024.China had the highest publication volume,while Ghent University ranked as the most productive institution.Universities acted as the most high-output institutions.Chris Baeken from Ghent University was identified as the most prolific author.Collaboration among leading authors and institutions worldwide remained limited.The main research hotspots in this field were associated with keywords such as depression,stroke,neuropathic pain,and Parkinson's disease.Burst keywords focused on mild cognitive impairment,reflecting a diversification in research directions.The overall research activity in high-frequency repetitive transcranial magnetic stimulation continues to rise,with primary focuses on its clinical applications for psychiatric and neurological disorders,as well as explorations of its underlying mechanisms.Future research may focus on optimizing treatment parameters for targeting different brain regions in clinical applications and expanding its applications and mechanisms across various domains.

Background: Influenza A virus (IAV) is a negative-sense RNA virus of the Orthomyxoviridae family and is the etiological agent of a highly contagious acute respiratory disease that can lead to acute lung injury. Objective: To elucidate the molecular mechanisms of IAV infection, an integrative research approach combining gene expression profiling, multinetwork analysis, and in vivo experimental validations was employed. Methods: First, a series of network-based analyses were performed, including protein-protein interaction network construction, weighted gene co-expression network analysis, and subsequent gene set enrichment analysis, to identify the major underlying mechanisms of IAV infection. Following gene expression analysis, core targets, both direct and indirect regulators, were screened. An IAV (H1N1) strain A/PR/8/34-induced acute lung injury mouse model was constructed for in vivo validations. Batch one included two groups to evaluate findings from the multi-network analysis: Mock (n = 10; 5 males and 5 females) and IAV (n = 10; 5 males and 5 females). Batch two included three groups to assess the role of toll-like receptor 3 (TLR3) in IAV infection: Mock (n = 6; 3 males and 3 females), IAV (n = 6; 3 males and 3 females), and TLR3 inhibitor (n = 6; 3 males and 3 females). Body weight was measured on days 0, 3, and 5 after infection. On day 5, lung tissues were collected to assess viral load and histopathological changes. Key targets were examined using enzyme-linked immunosorbent assay, Western blotting, and immunofluorescence staining, both in sera and lung tissues. Results: IAV infection was significantly associated with dysregulation of the immune-inflammation system, such as the LTR, nucle-otide-binding oligomerization domain-(NOD) like receptor, retinoic acid-inducible gene I-like receptor, and nuclear factor kappa-B signaling pathways. Gene set enrichment analysis further indicated that the TLR and necroptosis signaling pathways played crucial roles in the progression of IAV infection (TLR signaling pathway normalized enrichment score = 2.3941, P = 1.00 × 10 ⁻¹⁰; necroptosis normalized enrichment score = 1.9421, P = 6.21 × 10 ⁻⁷). Among the core targets, TLR3 and mixed lineage kinase domain-like protein (MLKL) may regulate gene expression at the transcriptional level (all P < 0.05). In vivo validation using an IAV (PR8) infected acute lung injury mouse model demonstrated increased viral load and lung index, alveolar structural damage, and inflammatory cell infiltration. Immunofluorescence staining exhibited large gaps in Lamin B1 staining and breaches in Emerin signals following IAV-PR8 infection. Expression levels of TLR3, p-receptor-interacting serine/threonine-protein kinase 3 (RIPK3)/RIPK3, and p-mixed lineage kinase domain-like protein (MLKL)/MLKL proteins in lung tissues, as well as proinflammatory factors and mediators in sera, were significantly elevated after IAV infection. Moreover, enhanced neutrophil infiltration (myeloperoxidase) and citrullinated histone H3 (a neutrophil extracellular trap-specific marker), both established indicators of neutrophil extracellular trap formation, were observed. Notably, treatment with a TLR3 inhibitor significantly ameliorated IAV-induced acute lung injury by regulating necroptosis-related targets. Conclusion: Our study provides network-based in vivo evidence that TLR3-receptor-interacting serine/threonine-protein kinase 3-MLKL-mediated necroptosis may underlie IAV-induced acute lung injury and could serve as a potential therapeutic target in severe influenza cases.

Objective To investigate the post-discharge exercise behavior and factors influencing moderate to vigorous intensity physical activity (MVPA) in patients undergoing lung surgery. Methods A total of 2874 patients from the large prospective, observational perioperative lung symptom study cohort (CN-PRO-Lung 3) in the Department of Thoracic Surgery at Sichuan Cancer Hospital between April 7, 2021, and January 31, 2024, were selected as the survey subjects. A survey was conducted using the Investigation of Exercise Behavior after Lung Surgery questionnaire and the International Physical Activity Questionnaire-Short Form (IPAQ-SF) among patients who underwent lung surgery. Binary logistic regression was used to analyze the factors influencing patients’ engagement in MVPA. Results A total of 702 patients were surveyed, including 252 males and 450 females, with an average age of (52.4±10.2) years. Patients with lung cancer accounted for 85.9%. Only 36.0% of the patients had regular exercise habits, while 42.3% did not engage in any physical activity. The three main barriers for postoperative exercise were physical discomfort (pain, coughing, shortness of breath, etc, 54.7%), lack of professional guidance (41.7%), and concerns about the surgical wound (28.9%). The proportions of patients engaging in vigorous, moderate, and low-intensity physical activity were 5.7%, 28.2%, and 66.1%, respectively. Multivariate analysis showed that patients with a personal annual income ≥50000 yuan (OR=1.52, 95%CI 1.01-2.29, P=0.044), high school education or above (OR=1.92, 95%CI 1.33-2.76, P<0.001), and lobectomy (OR=1.44, 95%CI 1.02-2.03, P=0.037) engaged in more MVPA. Conclusion Patients undergoing lung surgery have inadequate physical activity after discharge, particularly lacking in MVPA. Patients with higher income, higher educational levels, and lobectomy are more frequently engaged in MVPA. Measures such as symptom control, providing exercise guidance, and enhancing education on wound care may potentially improve the inadequate physical activity in lung surgery patients after discharge.

Objective: To investigate the influence of sinus morphology on the safety of hydraulic sinus floor elevation surgery and provide a biomechanical basis for clinical treatment. Methods: After approval by the Medical Ethics Committee of the institution, cone beam computed tomography imaging data from nine patients were collected. The sinus morphologies were classified into slope, flat and concave types. Three-dimensional finite element models of maxillary sinuses with the aforementioned morphologies were constructed using Mimics, Geomagic, Solidworks, and ANSYS software, followed by a simulation of the hydraulic elevation process. The sinus membrane elevation height was set at 1-6 mm. The pressure required for elevation and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane were recorded and analyzed. The equivalent stress distribution on the sinus membrane was visualized using contour plots. Results: The elevation pressure and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane increased along with the elevation height. When the sinus membrane was lifted to 6 mm, the elevation pressure was (301.17 ± 98.1) kPa, (151.85 ± 3.7) kPa, and (149.36 ± 10.31) kPa in the slope, flat and concave finite element analysis models, respectively. The equivalent stress was (1 023.86 ± 201.99) kPa in the slope sinuses, comparing with (687.91 ± 69.08) kPa and (698.27 ± 96.09) kPa in the flat and concave sinuses. Higher elevation pressure and the equivalent stress, compressive stress and shear stress values were found in the slope sinus than in the flat and concave sinuses under the same elevation height (P < 0.05). Stress distribution analysis revealed that stress was uniformly distributed in the flat sinuses, followed by concave sinuses, but asymmetrically distributed in the slope sinuses Conclusions The slope sinuses demonstrated inferior safety and efficiency compared with the flat and concave sinuses when performing hydraulic sinus floor elevation surgery.

Based on traditional Chinese medicine （TCM） theory and modern scientific research， and in accordance with the core functions of the Belt Channel in girdling and regulation of qi movement， a preliminary framework of the Belt Channel network hypothesis is constructed. It is proposed that the Belt Channel network consists of three synergistic subsystems， fascial biomechanics， neural conduction， and endocrine metabolism. Structurally， it is based on a "biomechanical ring" formed by the transversalis fascia and the core muscle group. Functionally， it integrates signals through the lumbosacral plexus and the autonomic nervous system， and is capable of regulating the hypothalamic-pituitary-target gland axis and immune homeostasis. Compared with other longitudinal meridians， the uniqueness of the Belt Channel network lies in its dual regulatory effects in coordinating somatic and visceral girdling and in maintaining systemic homeostasis. By integrating the traditional theory of the Belt Channel with mechanisms identified in modern research， this study provides new insights into the modern interpretation of the Belt Channel functions in girdling and regulation of qi movement， as well as the expansion of its clinical applications.

This paper summarizes professor TU Jinwen's clinical experience in treating cancer-related insomnia （CRI） based on different qi and fire. It is believed that the pathogenesis of CRI can be divided into three stages. At the initial stage， qi movement is constrained， while the strong fire begins to stir， and the sovereign fire is unsettled， when qi is abundant， but the fire is not excessive. For this， Sanhua Jieyu Anshen Decoction （三花解郁安神汤） is suggested， which can move qi and vent constraint， clear and diffuse strong fire， calm the heart and spirit. At the progressive stage， strong fire becomes intense and burning， and qi transformation weakens， with toxin fire harassing the spirit. This is the stage where both qi and fire are excessive， for which Huanglian Jiedu Anshen Decoction （黄连解毒安神汤） can be used to clear and dissipate strong fire， drain fire and resolve toxin， clear heart and calm spirit. At the terminal stage， strong fire subsides， and consumption of qi damages healthy qi， with failure of nourishment of heart spirit， when both qi and fire deplete. Correspondingly， Erren Yangxin Anshen Decoction （二仁养心安神汤） is used to boost qi and nourish yin， restore interaction between the heart and the kidney， nourish the heart and calm spirit.

Objective To investigate the prevalence of thyroid nodules in the physical examination population in Mianyang region and analyze its association with metabolic syndrome. Methods A retrospective study was conducted on 9 978 individuals who underwent health examinations at our hospital from January 2024 to May 2025. Thyroid examinations were performed using color Doppler ultrasound to analyze the prevalence of thyroid nodules in this population. Clinical data of all subjects were collected, and logistic regression analysis was employed to assess the association between metabolic syndrome and the risk of thyroid nodule development. Results The prevalence of thyroid nodules in the physical examination population of Mianyang region was 17.98% (1 794/9 978). The logistic regression results showed that after adjusting for gender, age, BMI, occupation, consumption of non-iodized salt, staying up late, daily sleep duration, anxiety, and depression, metabolic syndrome (OR=6.593, 95% CI: 3.961-10.975) was associated with thyroid nodules (P<0.05). Conclusion The prevalence of thyroid nodules among the physical examination population in the Mianyang area is 17.98%, and metabolic syndrome remains associated with the risk of thyroid nodules after effectively controlling for confounding factors.

ObjectiveTo clarify whether METTL14 mediates the core role of acupuncture at Neiguan (PC6) in promoting myelination and improving behavior in young autistic rats through gene intervention technology. MethodsThe ASD model was established by intraperitoneal injection of valproic acid (VPA) in pregnant rats. Male offspring were intracerebroventricularly injected with adenovirus-packaged METTL14 shRNA (sh-METTL14) or its control (sh-NC) on postnatal day 1, with a model group set as well. Subsequently, the juvenile rats were divided into model group, acupuncture group, acupuncture+sh-NC group, and acupuncture+sh-METTL14 group. The acupuncture group received acupuncture at Neiguan (PC6) from postnatal day 7, once daily for 21 consecutive days. Neurobehavioral changes were evaluated by behavioral tests; METTL14 knockdown efficiency and the expression of METTL14, METTL3, and PTEN were detected by quantitative real-time PCR (qRT-PCR) and Western blot (WB); PTEN m⁶A levels were measured by RNA immunoprecipitation-qPCR (RIP-qPCR); myelin ultrastructure, expression of myelin basic protein (MBP) and neurofascin 155 (NF155), and dendritic spine density were observed using transmission electron microscopy (TEM), enzyme-linked immunosorbent assay (ELISA), immunofluorescence, qRT-PCR, and primary neuron culture. ResultsBehaviorally, knockdown of METTL14 significantly counteracted the beneficial effects of acupuncture in improving self-grooming, open field exploration, three-chamber social interaction, and Morris water maze learning and memory (P<0.05, P<0.01). Compared with the acupuncture+sh-NC group, the acupuncture+sh-METTL14 group showed significantly decreased mRNA and protein expression of hippocampal METTL14 (P<0.01), and the upregulating effects of acupuncture on METTL3 and PTEN expression were reversed (P<0.01). Meanwhile, knockdown of METTL14 significantly inhibited the acupuncture-induced increase in PTEN m⁶A levels (P<0.01). Morphologically, knockdown of METTL14 attenuated the improvement of myelin structure by acupuncture, reversed the downregulation of MBP and upregulation of NF155 induced by acupuncture, and blocked the increase in dendritic spine density (P<0.05, P<0.01). ConclusionMETTL14 is a key molecule mediating the therapeutic effect of acupuncture at Neiguan. Acupuncture at Neiguan upregulates METTL14, thereby enhancing m⁶A methylation modification of PTEN mRNA to stabilize its expression, ultimately promoting myelin development and improving behavioral symptoms in ASD juvenile rats. This preliminarily reveals the modern biological connotation of “opening Xuanfu and dredging myelin”.