BACKGROUND:Many recent studies have shown a close relationship between inflammatory cytokines and osteoporosis and bone mineral density(BMD).However,the causal relationship between inflammatory cytokines and BMD has not been fully revealed. OBJECTIVE:To explore the potential causal relationship between inflammatory cytokines and BMD using a two-sample Mendelian randomization analysis. METHODS:The single nucleotide polymorphisms associated with 41 circulating inflammatory cytokines were selected from the open database of genome-wide association studies(GWAS)as instrumental variables.The GWAS data about BMD were from the Genetic Factors for Osteoporosis Consortium,involving a total of 32 735 individuals of European ancestry.Inverse variance weighting was used as the primary analysis to evaluate the causal effect.Weighted median,MR Egger regression,simple mode,and weighted mode methods were used to supplement the explanation.We used the MR-Egger intercept and MR-PRESSO method to conduct a pleiotropy test,the Cochran's Q test was used to determine whether there was heterogeneity in the results,and the leave-one-out method was used to evaluate the stability of the results.In addition,to more accurately assess the causality,the Bonferroni-corrected test was used to identify inflammatory cytokines that have a strong causal relationship with BMD. RESULTS AND CONCLUSION:(1)According to the results of the inverse variance weighting method,we found a positive causal relationship between interleukin-8 and lumbar spine BMD[β=0.075,95%confidence interval(CI):0.033-0.117,P=0.000 5),while a negative causal relationship between interleukin-17 and lumbar spine BMD(β=-0.083,95%CI:-0.152 to-0.014,P=0.018).There might be a negative causal relationship between tumor necrosis factor b and femoral neck BMD(β=-0.053,95%CI:-0.088 to-0.018,P=0.003),while a positive causal relationship between basic fibroblast growth factor and femoral neck BMD(β=0.085,95%CI:0.016-0.154,P=0.015).There might be a negative causal relationship between macrophage inflammatory protein-1a and total body BMD(β=-0.056,95%CI:-0.105 to-0.007,P=0.025).There was a negative causal relationship between interleukin-5(β=-0.019,95%CI:-0.031 to-0.006,P=0.004),stromal cell-derived factor-1a(β=-0.022,95%CI:-0.038 to-0.005,P=0.010),hepatocyte growth factor(β=-0.021,95%CI:-0.041 to-0.002,P=0.030),interleukin-4(β=-0.016,95%CI:-0.032 to-0.001,P=0.034)and heel BMD,while a positive causal relationship between nerve growth factor(β=0.019,95%CI:0.002-0.036,P=0.033),granulocyte colony-stimulating factor(β=0.011,95%CI:0.000-0.022,P=0.050),and heel BMD.Meanwhile,after the Bonferroni-corrected test,there was a strong positive causal effect between interleukin-8 and lumbar spine BMD(P=0.000 5).And consistent directional effects for all analyses were observed in MR Egger,weighted median,simple mode,and weighted mode methods.(2)Sensitivity analyses revealed no heterogeneity,pleiotropy,or outliers for the causal effect of circulating inflammatory cytokines on BMD.

Aim To explore the exact branched-chain amino acid(BCAA)that exacerbates acute myocardial infarction(MI)injury and mechanisms of such action.Methods At the cellular level,myocardial injury model was stimulated in H9c2 cells subjected to H2O2.The effects of the three branched-chain amino acids on MI were evaluated by measuring MTT,LDH leakage rate and cellular morphology.In vivo,the MI model was established by ligating the coronary left anterior descending artery.Electrocardiography,echocardio-graphy,TTC staining and histopathological detection were conducted.Additionally,Western blot was used to determine the effect of leucine on inflammatory sig-naling pathway in vitro.Results At the cellular lev-el,BCAA pretreatment could further inhibit the surviv-al rate of cardiomyocytes,increase LDH leakage rate,markedly decrease cell numbers and obviously shrink-age morphology,thus aggravating acute injury in car-diomyocytes.In vivo,leucine or BCAA pretreatment further deteriorated the cardiac function,increased the cardiac infarct size,worsened the histopathological changes,increased levels of the serum CK-MB and AST in the MI group rats,and ultimately exacerbated the MI injury in rats.Additionally,leucine could dosedependently exacerbate the activation of the NL-RP3 inflammasome signaling pathway induced by H2O2 stimulation in H9c2 cells.Conclusion The exacerba-ting effect of BCAA on MI injury is mainly exerted through leucine,and this effect is associated with the activation of the NLRP3 inflammasome.

Objective To investigate the value of prone-position MRI of lumbar spine for diagnosing pediatric occult tethered cord syndrome(OTCS).Methods A total of 67 children with suspected tethered cord syndrome(TCS)and confirmed OTCS by surgery were prospectively enrolled as OTCS group,while 73 healthy subjects were recruited as control group.Supine-and prone-position lumbar MR examinations were performed in both groups.The position of filum terminale on prone axial T2WI and the presence or absence of"sunset sign"(i.e.filum terminale located within the dorsal 1/2 of spinal canal on prone axial T2WI)were observed,spinal cord conus mobility was calculated.The efficacy of"sunset sign"for diagnosing OTCS in children was calculated through comparison between groups.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the diagnostic efficacy of spinal cord conus mobility.Results On prone-position axial T2WI,"sunset sign"was found in 58 cases(58/67,86.57％)but not in 9 cases(9/67,13.43％)in OTCS group,which was not even observed in control group.The sensitivity of"sunset sign"for diagnosing pediatric OTCS was 86.57％(58/67),with specificity of 100％(73/73),positive predictive value of 100％(58/58)and negative predictive value of 89.02％(73/82).The spinal cord conus mobility was(19.30±5.89)％in OTCS group and(31.71±6.58)％in control group,being statistically different between groups(t=-11.722,P＜0.001).The sensitivity,specificity and AUC of spinal cord conus mobility for diagnosing pediatric OTCS was 80.60％,90.41％and 0.920,respectively.Conclusion Prone-position MRI of lumbar spine could be used in diagnosing pediatric OTCS.

Objective To investigate the role and mechanism of inflammatory marker C5a in regulating the polarization of M2 macro-phages as well as its clinical application value in the prognosis evaluation of lung cancer.Methods The phorbol 12-myristate 13-ace-tate(PMA)-pulsed human monocytic leukemia cell line THP-1 was stimulated with C5a for 0,6,12,24,and 48 h or 0,1,2,3,6,and 12 h,and then the expression levels of M2 markers CD163 and CD206 mRNA were determined by real-time fluorescence quantita-tive PCR(qRT-PCR).The expression level of general control non-repressed protein 5(GCN5)with histone acetyltransferase(HAT)activity was detected by Western blot.Co-immunoprecipitation(co-IP)was used to determine the acetylation of GATA binding protein 3(GATA3),a key transcription factor for macrophages,and its binding ability to GCN5 and E1A binding protein p300(Ep300/p300).After the macrophages pre-treated with GCN5 inhibitor butyrolactone 3(MB-3)were stimulated with C5a,the expression levels of CD163 and CD206,acetylation of GATA3,and its binding ability to GCN5 were determined by Western blot and co-IP.The clinical significance of the expression of C5a receptor 1(C5aR1)and GCN5 in lung cancer tissues in the prognosis of lung cancer patients was analyzed using the KM plotter database.Results C5a could significantly increase the expression levels of CD163 and CD206 mRNA,expression of GCN5,acetylation of GATA3,and its binding ability to GCN5 in PMA-induced adherent macrophages,but did not affect the binding of GATA3 to p300.Inhibiting the activity of GCN5 not only significantly reduced the acetylation of GATA3 and its binding ability to GCN5,but also down-regulated the expressions of CD163 and CD206.The overall survival rate of lung cancer patients with high expression of C5aR1 or GCN5 was significantly reduced.Conclusion C5a promotes the polarization of M2 macrophages by indu-cing GCN5 to acetylate GATA3.The expressions of C5aR1 and GCN5 in lung cancer tissues may have certain clinical application value for the prognosis of the patients.

Objective To design an image processing system for skeletal measurement of arch,calcaneus and knee joint.Methods The image processing system had its hardware part composed of an image acquisition system,a body mass measurement system and a height measurement system.The image acquisition system consisted of an arch image acquisition module,a calcaneus image acquisition modue and a knee joint image acquisition module;the height measurement system included mainly a height meter component with a mechanically retractable structure;the body mass measurement system used CZL902 sensor combined with the hardware architecture to determine the body mass.The software system of the image processing system was developed with C#language and the application program interface was constructed by combining WinForm technique.Thirty-two healthy children and adult volunteers without significant foot or knee disease were recruited to assess the reliability and validity of the system by means of the consistency testing method.Results The system developed gained high reliability in the reliability and validity of the data on arch,calcaneus and knee joint(intragroup coefficient>0.75,P<0.05),and all the indexes except ankle sapcing width had higher intra-and inter-tester reliablity for the child volunteers than for the adult ones.Conclusion The system developed with high convenience and accuracy can be used for skeletal measurement of arch,calcaneus and knee joint.[Chinese Medical Equipment Journal,2025,46(10):36-40]

Aim To explore the exact branched-chain amino acid(BCAA)that exacerbates acute myocardial infarction(MI)injury and mechanisms of such action.Methods At the cellular level,myocardial injury model was stimulated in H9c2 cells subjected to H2O2.The effects of the three branched-chain amino acids on MI were evaluated by measuring MTT,LDH leakage rate and cellular morphology.In vivo,the MI model was established by ligating the coronary left anterior descending artery.Electrocardiography,echocardio-graphy,TTC staining and histopathological detection were conducted.Additionally,Western blot was used to determine the effect of leucine on inflammatory sig-naling pathway in vitro.Results At the cellular lev-el,BCAA pretreatment could further inhibit the surviv-al rate of cardiomyocytes,increase LDH leakage rate,markedly decrease cell numbers and obviously shrink-age morphology,thus aggravating acute injury in car-diomyocytes.In vivo,leucine or BCAA pretreatment further deteriorated the cardiac function,increased the cardiac infarct size,worsened the histopathological changes,increased levels of the serum CK-MB and AST in the MI group rats,and ultimately exacerbated the MI injury in rats.Additionally,leucine could dosedependently exacerbate the activation of the NL-RP3 inflammasome signaling pathway induced by H2O2 stimulation in H9c2 cells.Conclusion The exacerba-ting effect of BCAA on MI injury is mainly exerted through leucine,and this effect is associated with the activation of the NLRP3 inflammasome.

Objective To evaluate"sequential theory"combined with"clinical simulation"method in teaching ultrasound-guided musculoskeletal intervention therapy.Methods Thirty-four students who participated in the"Musculoskeletal Ultrasound and New Technology Excellent Class"organized by the Department of Ultrasound Medicine of Peking University Third Hospital from November 20 to November 24,2023 were selected as the study objects.After"sequential theory"and"clinical simulation"training,the trainees joined theoretical exami-nation,ultrasound operation and model puncture examination,then a questionnaire survey was carried out.Results The theoretical and practical test scores of 34 students were all qualified,and there was no statistical difference in theoretical and practical test results among students with different educational backgrounds,profes-sional titles and whether they came from basic hospitals.The questionnaire showed that the students were satisfied with the content of the class.Conclusions The application of"sequential theory"and"clinical simulation"methods improves training outcomes of musculoskeletal ultrasound interventional therapy and shortens the learning curve of students.

Hemodynamics numerical simulation,a multidisciplinary research approach integrating fluid dynamics,clinical medicine,and computer simulation techniques,offers an objective and quantitative analysis of cardiovascular blood flow dynamics through calculating data such as flow rate,pressure,resistance,and wall stress.This review provides a comprehensive overview of the modeling methods and characteristics of numerical simulations within the cardiovascular system.Additionally,it also summarizes the research advancements and potential clinical applications of numerical simulations in the context of various cardiovascular diseases,including vascular aneurysms,aortic dissection,atherosclerosis,structural heart diseases,heart failure,ventricular assist devices,cardiogenic shock,and extracorporeal membrane oxygenation.The goal is to facilitate the deep integration of clinical medicine with engineering technologies,thereby fostering innovative solutions for the precise diagnosis and treatment of cardiovascular disease.

Objective To analyze the relationship between the visceral adiposity index(VAI)and nocturia in the US adult population.Methods A cross-sectional study was performed.Data from subjects aged≥20 years in the National Health and Nutrition Examination Survey(NHANES)database from 2007 to 2020 were collected,including waist circumference,triglyceride,body mass index(BMI),high-density lipoprotein,age,gender,race,poverty income ratio,education level,marital status,smoking,alcohol consumption,sleep disorders,depression,occupation,hypertension,diabetes,congestive heart failure,cancer,and nocturnal urination frequency.Weighted analysis,multivariate logistic regression,generalized additive model(GAM),and curve fitting were employed to evaluate the association between VAI and nocturia,adjusting for age,gender,race,poverty income ratio,education level,marital status,smoking,alcohol consumption,sleep disorders,depression,occupation,hypertension,diabetes,congestive heart failure,and cancer.Subgroup analyses were conducted based on age,gender,race,hypertension and diabetes to further evaluate the relationship between VAI and the risk of nocturia.Results A total of 29,196 American adults were included.All subjects were divided into 4 groups based on VAI quartiles:Q1 group(0.32≤VAI<1.01),Q2 group(1.01≤VAI<1.70),Q3 group(1.70≤VAI<2.95),and Q4 group(2.95≤VAI<13.59),with nocturia prevalence rates of 28.5%,31.4%,33.3%,and 34.9%,respectively.In subgroup analyses,the risk of nocturia significantly increased with higher VAI in the 20-40 age group,females and other Hispanics(OR=1.04,95%CI 1.01-1.08,P=0.006;OR=1.02,95%CI 1.00-1.04,P=0.035;OR=1.05,95%CI 1.01-1.09,P=0.026).GAM analysis results showed a nonlinear relationship between VAI and nocturia.Conclusion VAI is positively associated with the risk of nocturia,and may be an effective indicator for predicting the risk of nocturia occurrence.

Objective To design an image processing system for skeletal measurement of arch,calcaneus and knee joint.Methods The image processing system had its hardware part composed of an image acquisition system,a body mass measurement system and a height measurement system.The image acquisition system consisted of an arch image acquisition module,a calcaneus image acquisition modue and a knee joint image acquisition module;the height measurement system included mainly a height meter component with a mechanically retractable structure;the body mass measurement system used CZL902 sensor combined with the hardware architecture to determine the body mass.The software system of the image processing system was developed with C#language and the application program interface was constructed by combining WinForm technique.Thirty-two healthy children and adult volunteers without significant foot or knee disease were recruited to assess the reliability and validity of the system by means of the consistency testing method.Results The system developed gained high reliability in the reliability and validity of the data on arch,calcaneus and knee joint(intragroup coefficient>0.75,P<0.05),and all the indexes except ankle sapcing width had higher intra-and inter-tester reliablity for the child volunteers than for the adult ones.Conclusion The system developed with high convenience and accuracy can be used for skeletal measurement of arch,calcaneus and knee joint.[Chinese Medical Equipment Journal,2025,46(10):36-40]