Objective:To compare the efficacy of robot-assisted percutaneous reduction and screw fixation versus open reduction and plate fixation via the sinus tarsi approach in the treatment of Sanders types II and III calcaneal fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 82 patients (90 feet) with calcaneal fractures admitted to the Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Capital Medical University from January 2020 to April 2024, including 74 males and 8 females, aged 24-87 years [(46.4±12.1)years]. According to Essex-Lopresti classification, the fractures were classified as tongue-type in 43 patients and joint-collapse-type in 47. According to Sanders classification, 69 feet were classified as type II and 21 as type III. Forty-seven patients (52 feet) were treated with robot-assisted percutaneous reduction and screw fixation (screw fixation group) and 35 (38 feet) with open reduction and plate fixation via the sinus tarsi approach (plate fixation group). The two groups were compared in terms of the operation duration, intraoperative blood loss, length of hospital stay and time to weight-bearing. The width, height, length, B?hler angle and Gissane angle of the calcaneus before surgery and at 1 day after surgery were compared. The Maryland foot and ankle function score, American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot function score, and visual analogue scale (VAS) score at 1, 3 months postoperatively, and at the last follow-up were compared. The incidence of postoperative complications and removal rate of internal fixation were also detected in the two groups.Results:All the patients were followed up for 9-60 months [(30.0±14.5)months]. There was no significant difference in the operation duration between the two groups ( P>0.05). The intraoperative blood loss, length of hospital stay and time to weight-bearing in the screw fixation group were 10.0(10.0, 20.0)ml, 7.0(5.0, 8.0)days and (5.0±0.8)weeks, which were significantly less or shorter than 30.0(20.0, 50.0)ml, 8.0(6.0, 11.0)days and (6.9±0.7)weeks in the plate fixation group ( P<0.05). The width, height, length, B?hler angle and Gissane angle of the calcaneus at 1 day after surgery were (43.4±4.2)mm, (46.2±4.0)mm, (81.6±5.1)mm, 27.1(20.4, 30.4)° and (113.4±10.1)° in the screw fixation group, which were all improved compared with those before surgery [(47.8±4.6)mm, (39.3±4.8)mm, (79.2±5.9)mm, 9.5(0.0,16.5)° and (119.3±13.4)°] ( P<0.01). The width, height, length and B?hler angle of the calcaneus at 1 day after surgery were (41.6±5.7)mm, (48.4±4.8)mm, (83.1±5.7)mm and 27.3(21.3, 31.6)° in the plate fixation group, which were all improved compared with those before surgery [(47.8±5.0)mm, (41.7±5.1)mm, (80.1±5.9)mm and 12.9(7.2,19.8)°] ( P<0.01), with no significant difference in the Gissane angle ( P>0.05). Before surgery and at 1 day postoperatively, no significant differences were found in the width, length, B?hler angle or Gissane angle of the calcaneus between the two groups ( P>0.05), while the height of the calcaneus in the screw fixation group was lower than that in the plate fixation group ( P<0.05). At 1 month after surgery and at the last follow-up, there were no significant differences in the Maryland foot and ankle function score, AOFAS ankle and hindfoot function score, and VAS score between the two groups ( P>0.05). At 3 months after surgery in the screw fixation group, the Maryland foot and ankle function score was (79.7±3.8)points, significantly higher than (74.7±2.8)points in the plate fixation group ( P<0.01); the AOFAS ankle and hindfoot function score was (77.1±5.0)points, significantly higher than (70.1±3.6)points in the plate fixation group ( P<0.01); the VAS score was 1.0(1.0, 2.0)points, significantly lower than 2.5(2.0, 3.0)points in the plate fixation group ( P<0.01). No significant difference was detected in the incidence of postoperative complications between the two groups ( P>0.05). The removal rate of internal fixation was 10% (5/52) in the screw fixation group, significantly lower than 29% (11/38) in the plate fixation group ( P<0.05). Conclusion:Compared with open reduction and plate fixation via the sinus tarsi approach, robot-assisted percutaneous reduction and screw fixation has the advantages of less intraoperative blood loss, shorter hospital stay, earlier weight-bearing exercises, better early functional recovery and pain relief, and lower internal fixation removal rate in the treatment of Sanders types II and III calcaneal fractures.

Objective:To observe the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different frequencies on cognitive impairment due to high-altitude hypoxia.Methods:Sixty officers and soldiers displaying cognitive impairment in a hypoxic high-altitude environment were randomly divided into 15Hz, 20Hz and 25Hz groups, each of 20. They were given rTMS at those frequencies for 30 days. Before the stimulation and after 15 and 30 days, event-related potentials, latencies of mismatched negativity (MMN) and P300 signals were recorded. The participants′ cognition was also evaluated using the Montreal Cognitive Assessment Scale (MoCA). Correlation between the electrophysiological indexes and the MoCA scores was computed.Results:After 15 days, all had shorter MMN latencies, higher total MoCA scores and better memory scores. The only significant difference among the three groups was in the average memory scores. After 15 days, MMN latency was significantly negatively correlated with the memory scores in all three groups ( r=0.44 to -0.54). Conclusions:rTMS at frequencies above 15Hz can effectively relieve cognitive impairment, especially memory dysfunction, resulting from high-altitude hypoxia.

Objective:To preliminarily evaluate the accuracy of a segmented rotational motion-based osteotomy module for autonomous dental implant robots in immediate implant placement in the anterior region through an in vitro model experiment, providing references for clinical practice. Methods:Twenty-three identical commercial maxillary resin models with dentition defects for immediate implant placement were divided into three groups: a fully guided static computer-assisted implant surgery (sCAIS) group ( n=5), a robotic computer-assisted implant surgery (rCAIS) group based on conventional coronal-apical linear motion osteotomy (rCAIS-C, n=9) and a rCAIS group based on segmented rotational motion osteotomy (rCAIS-S, n=9). Two implants were placed in each model using the corresponding surgical protocols. Intraoral scan data of pre-and post-operative models were imported into software to evaluate deviations between the actual and planned implant positions. Results:In the rCAIS-S group, the global deviations at the implant platform and apex were 0.50 (0.32) mm and 0.52 (0.22) mm, respectively, with an angular deviation of 1.08° (0.49°). These values were significantly smaller than those in the sCAIS group [platform: 0.88 (0.50) mm, apex: 1.44 (0.50) mm, angular deviation: 2.86° (1.76°), P<0.05]. rCAIS-S group also showed significantly smaller platform and apex deviations compared to rCAIS-C group [platform: 0.69 (0.12) mm, apex: 0.94 (0.16) mm, P<0.05], though angular deviations of rCAIS-S group did not differ significantly from rCAIS-C group [1.27° (0.56°), P>0.05]. Conclusions:Within the limitation of this study, the segmented rotational motion-based osteotomy module for dental implant robots demonstrates superior accuracy in immediate implant placement in the anterior area compared to sCAIS and rCAIS based on conventional coronal-apical linear motion osteotomy.

Objective:To analyze the results of anonymous review and influencing factors of master's degree theses in Chinese Center for Disease Control and Prevention (CDC) from 2018 to 2023, and provide a reference for improving the quality of graduate education.Methods:Using the anonymous review data of 766 master's degree theses submitted by CDC from 2018 to 2023, a statistical analysis was performed on the overall evaluation and four evaluation indicators using the Excel and SPSS 27.0. Potential factors influencing thesis quality were also explored.Results:The overall evaluation scores of the 766 master's degree theses submitted by CDC from 2018 to 2023 were generally rated as "good", with a mean score of (16.58±1.95). The mean scores of the four indicators were all rated as "good" and above. The scores were in the order of thesis topics (17.32±1.81), basic knowledge and research ability (16.51±2.10), innovation and thesis value (16.21±1.96), and thesis standardization (16.08±2.20). The overall evaluation score of students recommended and exempted from entrance exams (17.14±1.54) was higher than that of students admitted through national entrance exams (16.54±1.96). Specifically, significant differences were observed in basic knowledge and research ability and thesis standardization ( P<0.05). The overall evaluation score of academic degree theses (16.81±1.88) was higher than professional degree theses (16.32±1.99). The overall evaluation score of degree theses on basic research (16.99±1.86) was significantly higher than that of theses on applied research (16.33±1.96) and comprehensive research (16.27±1.91) ( P<0.05). The overall evaluation score of theses supported by national funds (17.01±1.77) was significantly higher than that of theses funded by provincial and ministerial projects (16.67±1.96) and other projects (16.18±1.99) ( P<0.05). Conclusions:During 2018-2023, the overall evaluation scores of master's degree theses of CDC were generally rated as "good". The quality of theses and graduate education can be enhanced by improving the quality of sources of students, expanding basic research, applying for high-level fund projects, and establishing effective process management mechanism.

Objective To explore the effects of respiratory training in proprioceptive neuromuscular facilitation(PNF)mode on exercise function and cardiopulmonary function in patients with chronic heart failure(CHF).Methods A total of 82 CHF patients admitted to Huai'an Second People's Hospital from October 2022 to July 2024 were enrolled and assigned to observation group or control group by a random number table,with 41 patients in each group.The control group underwent conventional rehabilitation training,while the observation group received respiratory training in PNF mode in addition to the conventional rehabilitation.Clinical efficacy,cardiac function indicators,such as E-wave,A-wave,stroke volume(SV),left ventricular ejection fraction(LVEF),and fractional shortening(FS),serum NT-proBNP,and 6-min walking distance(6MWD)were evaluated.Results After 8 weeks of intervention,the total effective rate,E-wave,SV,LVEF,and FS in the observation group were significantly higher than those in the control group(P<0.05),A-wave and serum NT-proBNP in the observation group were significantly lower than those in the control group(P<0.05),the 6MWD in the observation group was significantly longer than that in the control group(P<0.05).Conclusion Respiratory training in PNF mode is more effective than conventional rehabilitation,significantly improving exercise tolerance in CHF patients,left ventricular diastolic and systolic function.Additionally,it shows greater efficacy in reducing heart failure-related biochemical markers.As an adjunctive therapy in the rehabilitation of heart failure patients,it holds high clinical application value.

Objective: To explore the therapeutic mechanism of puerarin in treating rheumatoid arthritis (RA) rats based on the serine/tyrosine protein kinase B (AKT)-phosphorylated forkhead box protein O1 (FOXO1)-interleukin-9 (AKT-FOXO1-IL-9) signaling pathway. Methods : 36 rats were randomly divided into a blank group , a model group , a positive control group , and low , medium , and high dose groups of puerarin. Except for the blank group , the other groups were induced with type Ⅱ collagen to establish a RA rat model. After successful modeling , different doses of puerarin and methotrexate were given to treat the rats. The body mass and toe thickness of the rats were measured , and biochemical indicators of rat blood rheology were detected. X-ray was used to observe changes in rat joint morphology. Safranin green staining were used to observe the pathology of rat joint tissue. ELISA was used to detect the levels of IL-9 and rheumatoid factors in rat serum , and Western blot was used to detect changes in levels of AKT and FOXO1 . 36 rats were randomly divided into a blank group , a model group , a positive control group , and low , medium , and high dose groups of puerarin. Except for the blank group , the other groups were induced with type Ⅱ collagen to establish a RA rat model. After successful modeling , different doses of puerarin and methotrexate were given to treat the rats. The body mass and toe thickness of the rats were measured , and biochemical indicators of rat blood rheology were detected. X-ray was used to observe changes in rat joint morphology. Safranin green staining were used to observe the pathology of rat joint tissue. ELISA was used to detect the levels of IL-9 and rheumatoid factors in rat serum , and Western blot was used to detect changes in levels of AKT and FOXO1 . Results: Compared with the blank group , the model group had the lowest toe thickness , and X-ray images showed more obvious segmental stenosis and more severe marginal bone invasion ; scaly like changes appeared at the edges of joints stained with safranin green , accompanied by the exudation of inflammatory cells and increased proliferation and secretion of chondrocytes ; the expression levels of inflammatory factors IL-9 and rheumatoid factors were the highest , and the expression levels of AKT and FOXO1 proteins were the highest (P < 0. 05) . Compared with the model group , the toe thickness of rats treated with different doses of puerarin decreased ; X-ray images showed that the puerarin treatment group of rats showed improvement in plantar joint stenosis and marginal bone invasion ; the results of safranin green staining showed that after treatment with different doses of puerarin , the infiltration of inflammatory cells decreased , and the expression levels of inflammatory factor IL-9 , rheumatoid factors , AKT , and FOXO1 proteins decreased significantly ( P < 0. 05 ) , with the high-dose puerarin group showing the most significant difference. Compared with the high-dose puerarin group , the positive control group showed a significant decrease in the above results and statistical differences (P < 0. 05) . Conclusion Puerarin has a good therapeutic effect on rats with RA by inhibiting the AKT-FOXO1-IL-9 pathway. The high-dose puerarin group (60 mg/kg) has the best therapeutic effect and the results show a dose-response relationship.

Objectives:To analyze whether there is a causal relationship between plasma proteins and the risk of coronary atherosclerosis(CAS)based on a two-sample Mendelian randomization(MR)analysis and to identify potential therapeutic targets for CAS.Methods:Single nucleotide polymorphisms(SNP)associated with plasma proteins from the UK Biobank Pharmacoproteomics Program(UKB-PPP)database were used as instrumental variables and outcome data were obtained from genome-wide association study databases.The Wald ratio method and inverse variance weighted(IVW)method in two-sample MR were employed as the primary approaches to assess the causal relationship between plasma proteins and CAS.Colocalization analysis was conducted as a sensitivity analysis to ensure the robustness of the MR findings.Results:A total of 132 plasma proteins were found to have causal associations with an increased risk of CAS.Colocalization analysis revealed that 12 plasma proteins shared genetic variants with CAS.Among them,Proprotein convertase subtilise/kexin type 9(PCSK9)(OR=1.23,95%CI:1.15-1.32,P<0.01)and neurocan(NCAN)(OR=1.35,95%CI:1.21-1.52,P<0.01)exhibited posterior probability of hypothesis4(PPH4)values<0.80 in the colocalization analysis,indicating strong support for colocalization and suggesting their potential as primary plasma protein drug targets for CAS.Conclusions:PCSK9 is associated with an increased risk of CAS and is confirmed as a therapeutic target for CAS.NCAN emerges as another potential therapeutic target for CAS.

Objective To evaluate the efficacy and safety of polyethylene glycol electrolyte powder(PEG)combined with linaclotide(Lin)for bowel preparation in elderly constipated patients before colonoscopy.Methods In this prospective,randomized controlled trial,90 elderly patients with constipation undergoing colonoscopy were recruited at our hospital from June 2022 to December 2023.Participants were randomly assigned to three groups(n=30 each):PEG-3L alone,PEG-3L+Lin,and PEG-2L+Lin.Primary outcome was Boston Bowel Preparation Scale(BBPS)score and secondary outcomes included adverse event rates,colonoscopy completion rate,withdrawal time,and polyp detection rate.Statistical analysis was performed using independent t-tests and chi-square tests.Results The PEG-3L+Lin group achieved significantly higher BBPS scores than both PEG-3L alone and PEG-2L+Lin groups did(both P<0.001).The PEG-2L+Lin group also outperformed the PEG-3L alone group in cleansing efficacy(90.0%vs.76.7%,P=0.008).The PEG-2L+Lin group demonstrated the best tolerability and lowest adverse event rate,the PEG-3L group had the longest withdrawal time(P<0.05),but the three groups showed no significant difference in polyp detection rates.Conclusion PEG combined with linaclotide significantly improves bowel cleansing in elderly constipated patients.PEG-2L+Lin regimen provides optimal balance between efficacy,safety,and tolerability,making it a preferable choice for this population.

Objective:To preliminarily evaluate the accuracy of a segmented rotational motion-based osteotomy module for autonomous dental implant robots in immediate implant placement in the anterior region through an in vitro model experiment, providing references for clinical practice. Methods:Twenty-three identical commercial maxillary resin models with dentition defects for immediate implant placement were divided into three groups: a fully guided static computer-assisted implant surgery (sCAIS) group ( n=5), a robotic computer-assisted implant surgery (rCAIS) group based on conventional coronal-apical linear motion osteotomy (rCAIS-C, n=9) and a rCAIS group based on segmented rotational motion osteotomy (rCAIS-S, n=9). Two implants were placed in each model using the corresponding surgical protocols. Intraoral scan data of pre-and post-operative models were imported into software to evaluate deviations between the actual and planned implant positions. Results:In the rCAIS-S group, the global deviations at the implant platform and apex were 0.50 (0.32) mm and 0.52 (0.22) mm, respectively, with an angular deviation of 1.08° (0.49°). These values were significantly smaller than those in the sCAIS group [platform: 0.88 (0.50) mm, apex: 1.44 (0.50) mm, angular deviation: 2.86° (1.76°), P<0.05]. rCAIS-S group also showed significantly smaller platform and apex deviations compared to rCAIS-C group [platform: 0.69 (0.12) mm, apex: 0.94 (0.16) mm, P<0.05], though angular deviations of rCAIS-S group did not differ significantly from rCAIS-C group [1.27° (0.56°), P>0.05]. Conclusions:Within the limitation of this study, the segmented rotational motion-based osteotomy module for dental implant robots demonstrates superior accuracy in immediate implant placement in the anterior area compared to sCAIS and rCAIS based on conventional coronal-apical linear motion osteotomy.

Objectives:To analyze whether there is a causal relationship between plasma proteins and the risk of coronary atherosclerosis(CAS)based on a two-sample Mendelian randomization(MR)analysis and to identify potential therapeutic targets for CAS.Methods:Single nucleotide polymorphisms(SNP)associated with plasma proteins from the UK Biobank Pharmacoproteomics Program(UKB-PPP)database were used as instrumental variables and outcome data were obtained from genome-wide association study databases.The Wald ratio method and inverse variance weighted(IVW)method in two-sample MR were employed as the primary approaches to assess the causal relationship between plasma proteins and CAS.Colocalization analysis was conducted as a sensitivity analysis to ensure the robustness of the MR findings.Results:A total of 132 plasma proteins were found to have causal associations with an increased risk of CAS.Colocalization analysis revealed that 12 plasma proteins shared genetic variants with CAS.Among them,Proprotein convertase subtilise/kexin type 9(PCSK9)(OR=1.23,95%CI:1.15-1.32,P<0.01)and neurocan(NCAN)(OR=1.35,95%CI:1.21-1.52,P<0.01)exhibited posterior probability of hypothesis4(PPH4)values<0.80 in the colocalization analysis,indicating strong support for colocalization and suggesting their potential as primary plasma protein drug targets for CAS.Conclusions:PCSK9 is associated with an increased risk of CAS and is confirmed as a therapeutic target for CAS.NCAN emerges as another potential therapeutic target for CAS.