Objective: To investigate the impact of activin receptor type-1 (ACVR1) on odontoblastic differentiation and dentin formation based on single-cell RNA sequencing. Methods: A correlation analysis of ACVR1 with odontogenesis-related transcription factors was performed using single-cell data from healthy wild-type adult mouse incisors obtained from the Gene Expression Omnibus database (GSE146123). This experiment was approved by the Institutional Animal Care and Use Committee of the affiliated institution. Conditional knockout mice with ACVR1 deleted in the dental mesenchyme were generated using the Cre-LoxP system (experimental group: Osterix-Cre; ACVR1fx/-, control group: Osterix-Cre; ACVR1fx/+). Dental pulp tissue was extracted from the incisors of 3-week-old mice to prepare single-cell suspensions for 10 × Genomics single-cell transcriptome sequencing. Quality control, normalization, dimensionality reduction, and Harmony batch effect correction were performed using the Seurat pipeline, followed by UMAP dimensionality reduction visualization and cell subpopulation identification. Monocle was used for pseudotime analysis to infer cell differentiation trajectories, and changes in transcription factors positively correlated with ACVR1 were analyzed at the single-cell data level. Immunofluorescence staining was employed to validate the localization and expression changes of the key transcription factor Osterix and the odontoblast-specific protein DSPP. Results: Sp7/Osterix is widely expressed in the incisor mesenchyme of mice (GSE146123). Using Osterix-Cre, ACVR1 was effectively knocked out in the mesenchyme. Gene correlation analysis between ACVR1 and key odontogenic genes showed positive correlations between ACVR1 and genes such as Msx1, Msx2, and Sp7. Single-cell atlases of incisor dental pulp tissue from “Osterix-Cre; ACVR1fx/-” and “Osterix-Cre; ACVR1fx/+” mice were then constructed. The most significant increase in the proportion of pre-odontoblasts was in the experimental group, along with downregulated expression of key genes related to odontoblastic differentiation and polarization in this subpopulation. Differential gene enrichment analysis across all mesenchymal subpopulations indicated downregulated expression of most genes associated with dentin formation. Finally, as observed through single-cell differential gene analysis, pseudotime expression analysis, and immunofluorescence validation, the expression of Sp7 and DSPP were significantly downregulated in the experimental group. Conclusion The ACVR1 gene may promote odontoblastic differentiation and subsequently affect dentin formation through transcription factors such as Sp7, Msx1, and Msx2.

BACKGROUND:With the continuous development of medical technology,the treatment of distal radius fractures is facing the need for more precise and personalized treatment.The traditional splint fixation method has some limitations in clinical application,which often has defects such as unstable fixation and easy to occur pressure sores.The validation of the improved 3D printed splint with rapid grid-free simulation is expected to lead to more accurate and effective treatment options for distal radius fractures.OBJECTIVE:To explore the design method of 3D printed splint for distal radius fracture based on clinical defect improvement and verify its clinical efficacy by rapid grid-free analysis.METHODS:Clinical defects of splint fixation of extended distal radius fracture were retrospectively analyzed,and 3D printed small splint was designed with specific improvement.The digital models of traditional splint and improved new 3D printed splint were made by Computer Aided Design drawing.Total,bone,soft tissue,and splint displacement and stress distribution were calculated through simulation analysis using rapid grid-free analysis tools.RESULTS AND CONCLUSION:(1)Compared with the traditional splint,the improved new 3D printing splint exerteded more balanced pressure on the skin without obvious stress concentration,and had better body surface adhesion.The displacement was smaller and the movement range was more reasonable.(2)An 3D printed splint based on clinical defect improvement can be designed.Rapid grid-free analysis verifies the advantages of the improved 3D splint,providing a basis for clinical application.

Ion selective electrode(ISE)is a key component of full automatic biochemical analyzer.It is very important to solve the ISE's faults in time in ensuring the operational quality of full automatic biochemical analyzer.This article proposed maintenance ideas and method after analyzed the structural composition and the working principle of full automatic biochemical analyzer,and conducted further analysis for the common faults included reference liquid suction,flushing tower overflow and results'inaccurate,which can effectively resolve the problems of the above faults.In the management for full automatic biochemical analyzer,the metrological verification work should be strengthened,so as to enhance the level of technical support of equipment engineering,and improve the quality of clinical service of equipment.

Objective:To explore the cardioprotective effects of icariin (ICA) against radiation-induced cardiac disease (RICD) in C57BL/6 mice.Methods:A total of 48 female C57BL/6J mice aged 6-8 weeks were randomly divided into three groups: the control group (CON), the irradiation group (IR), and the irradiation combined with icariin group (IR+ ICA), with 16 mice in each group. The IR and IR+ ICA groups received a single cardiac irradiation at a dose of 30 Gy, while the CON group received no radiation treatment. The IR+ ICA group was treated with ICA (70 mg·kg -1·d -1) two weeks before irradiation until the end of the experiment through intragastric administration. In contrast, the CON and IR groups were treated with an equal volume of vehicle solution (0.5% sodium carboxymethyl cellulose, NaCMC) via intragastric administration. The mice′s mental status, food intake, body weight, and survival rates were monitored during the experiment. At two weeks post-irradiation, the venous blood of the mice was collected and serum was separated for the enzyme-linked immunosorbent assays (ELISA) of creatine kinase MB isoenzyme (CK-MB) and cardiac troponin T (cTnT/TNNT2). At 12 weeks post-irradiation, the cardiac function of the mice was assessed using echocardiography. After the mice were euthanized under anesthesia, the histopathological changes and fibrosis degree of their myocardial tissues were assessed using hematoxylin and eosin (HE) and Masson′s trichrome staining, followed by the calculation of collagen volume fraction (CVF). The differential gene expression of brain natriuretic peptide (BNP), transforming growth factor-β (TGF-β), and interleukin-6 (IL-6) in the cardiac tissues of the mice was detected using real-time reverse transcription-polymerase chain reaction (RT-PCR). Apoptosis-related proteins and proteins associated with the phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway were determined using Western blotting. The survival curves of the mice were plotted using Kaplan-Meier, and the survival differences of the mice among various groups were compared using the log-rank test. Results:After irradiation, the mice in the IR group showed lethargy, as well as decreased food intake and activity, while these symptoms in the IR+ ICA group were significantly alleviated. At two weeks post-irradiation, the CK-MB and cTnT levels of the IR group were significantly elevated compared with the CON group ( t = 5.28, 8.89, P < 0.01). At 12 weeks post-irradiation, the mice in the IR group exhibited significantly decreased body weight ( t = 2.47, P < 0.05) and decreased survival rates ( HR = 8.25, 95% CI: 1.157-58.770, P < 0.05) compared with the CON group. Echocardiography revealed that the IR group featured decreased left ventricular ejection fraction (EF), decreased fractional shortening (FS), and increased left ventricular end-diastolic diameter (LVDD) compared with the CON group ( t = 7.02, 4.45, P < 0.05). Histopathological examination revealed that the IR group suffered from cardiomyocyte edema, disordered arrangement, and increased fibrosis, with an elevated CVF. The IR group exhibited significantly upregulated gene expression of BNP, TGF-β, and IL-6 in cardiac tissues compared with the CON group ( t = 4.23, 6.39, 4.61, P < 0.05). After-irradiation, the IR group exhibited upregulated apoptosis-related proteins Cleaved Caspase-3 and Bax ( t = 6.29, 9.54, P < 0.05), decreased Bcl-2 expression ( t = 8.20, P < 0.001), and decreased phosphorylation levels of PI3K and Akt ( t = 6.47, 3.42, P < 0.001). The symptoms of the mice were partially ameliorated after treatment with ICA. Specifically, the mice in the IR+ ICA group exhibited higher body weight ( t = 5.13, P < 0.001) and significantly higher survival rates ( HR = 0.121, 95% CI: 0.017-0.864, P < 0.05) than the IR group. Compared to the IR group, the IR+ ICA group showed elevated cardiac function indicators EF and FS( t = 3.23, 3.05, P < 0.05), and reduced LVDD ( t = 3.02, P < 0.05). The histopathological analysis revealed mitigated edema and disordered arrangement of cardiomyocytes in the IR+ ICA group. Furthermore, the IR+ ICA group exhibited significantly lower BNP, TGF-β, and IL-6 expression levels than the IR group ( t = 2.83, 4.15, 2.96, P < 0.05). The expression of apoptosis-related proteins Cleaved Caspase-3 and Bax was lower ( t = 3.23, 3.24, P < 0.05), Bcl-2 expression was higher ( t = 5.92, P < 0.001), and restored phosphorylation levels of PI3K and Akt ( t = 2.89, 8.35, P < 0.001). Conclusions:Icariin has protective effects against the RICD. It alleviates cardiomyocyte apoptosis possibly by upregulating the phosphorylation levels of PI3K and Akt.

Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation(rTMS)com-bined with repetitive peripheral magnetic stimulation(rPMS)on upper limb function and cortical excitability of stroke.Method:Thirty-five patients with upper limb dysfunction in stroke admitted to the Department of Rehabilita-tion Medicine of the Third Affiliated Hospital of Sun Yat-sen University from November 2021 to November 2022 were selected.They were randomly divided into experimental group(n=17)and control group(n=17).Both groups received conventional rehabilitation therapy and low-frequency rTMS.The experimental group re-ceived additional rPMS for the affected upper extremity extensors,while the control group received sham rPMS.Both groups received Fugl-Meyer assessment of the upper extremity(FMA-UE),modified Ashworth scale(MAS),modified Barthel index(MBI),rest motor threshold(rMT)assessments.23 patients underwent fNIRS to detect changes in oxyhemoglobin concentration(HbO2)in bilateral premotor and supplementary mo-tor cortex(PMC-SMA)and sensorimotor cortex(SMC)before and after treatment.Result:FMA-UE and MBI were significantly improved in both groups(P＜0.05),and the improvement of FMA-UE and the rMT of unaffected Ml were significantly higher in the experimental group than in the con-trol group after treatment(P＜0.05);the MAS grade of the flexor elbow group and Δ HbO2 of the affected SMC were significantly improved in the experimental group(P＜0.05),and the improvement of FMA-UE was correlated with the increase of the rMT of unaffected Ml and ΔHbO2 of the affected SMC(P＜0.05).There was no statistically significant difference for the MAS grade of elbow extension and wrist flexion muscle groups,ΔHbO2 of bilateral PMC-SMA area,and ΔHbO2 of unaffected SMC area(P＞0.05).Conclusion:The combination of rTMS and rPMS improved upper limb function and activities of daily living and modulated cortical excitability in stroke patients,This combination was more effective than rTMS alone,likely due to the reduced excitability of the unaffected Ml and the activation of the affected SMC.

BACKGROUND:With the continuous development of medical technology,the treatment of distal radius fractures is facing the need for more precise and personalized treatment.The traditional splint fixation method has some limitations in clinical application,which often has defects such as unstable fixation and easy to occur pressure sores.The validation of the improved 3D printed splint with rapid grid-free simulation is expected to lead to more accurate and effective treatment options for distal radius fractures.OBJECTIVE:To explore the design method of 3D printed splint for distal radius fracture based on clinical defect improvement and verify its clinical efficacy by rapid grid-free analysis.METHODS:Clinical defects of splint fixation of extended distal radius fracture were retrospectively analyzed,and 3D printed small splint was designed with specific improvement.The digital models of traditional splint and improved new 3D printed splint were made by Computer Aided Design drawing.Total,bone,soft tissue,and splint displacement and stress distribution were calculated through simulation analysis using rapid grid-free analysis tools.RESULTS AND CONCLUSION:(1)Compared with the traditional splint,the improved new 3D printing splint exerteded more balanced pressure on the skin without obvious stress concentration,and had better body surface adhesion.The displacement was smaller and the movement range was more reasonable.(2)An 3D printed splint based on clinical defect improvement can be designed.Rapid grid-free analysis verifies the advantages of the improved 3D splint,providing a basis for clinical application.

Objective:To investigate the effects of low-frequency repetitive transcranial magnetic stimulation(rTMS)com-bined with repetitive peripheral magnetic stimulation(rPMS)on upper limb function and cortical excitability of stroke.Method:Thirty-five patients with upper limb dysfunction in stroke admitted to the Department of Rehabilita-tion Medicine of the Third Affiliated Hospital of Sun Yat-sen University from November 2021 to November 2022 were selected.They were randomly divided into experimental group(n=17)and control group(n=17).Both groups received conventional rehabilitation therapy and low-frequency rTMS.The experimental group re-ceived additional rPMS for the affected upper extremity extensors,while the control group received sham rPMS.Both groups received Fugl-Meyer assessment of the upper extremity(FMA-UE),modified Ashworth scale(MAS),modified Barthel index(MBI),rest motor threshold(rMT)assessments.23 patients underwent fNIRS to detect changes in oxyhemoglobin concentration(HbO2)in bilateral premotor and supplementary mo-tor cortex(PMC-SMA)and sensorimotor cortex(SMC)before and after treatment.Result:FMA-UE and MBI were significantly improved in both groups(P＜0.05),and the improvement of FMA-UE and the rMT of unaffected Ml were significantly higher in the experimental group than in the con-trol group after treatment(P＜0.05);the MAS grade of the flexor elbow group and Δ HbO2 of the affected SMC were significantly improved in the experimental group(P＜0.05),and the improvement of FMA-UE was correlated with the increase of the rMT of unaffected Ml and ΔHbO2 of the affected SMC(P＜0.05).There was no statistically significant difference for the MAS grade of elbow extension and wrist flexion muscle groups,ΔHbO2 of bilateral PMC-SMA area,and ΔHbO2 of unaffected SMC area(P＞0.05).Conclusion:The combination of rTMS and rPMS improved upper limb function and activities of daily living and modulated cortical excitability in stroke patients,This combination was more effective than rTMS alone,likely due to the reduced excitability of the unaffected Ml and the activation of the affected SMC.

Objective:To construct decision indicator system for the allocation of life-support equipment on the basis of hospital-based health technology assessment(HB-HTA)theory,and explore its application value in the management for life-support equipment.Methods:The decision indicators of the allocation of life-support equipment were formulated from four dimensions that included equipment safety,effectiveness,suitability and economy on the basis of HB-HTA theory,so as to assess and manage the decision for allocation of equipment.A total of 149 using life-support equipment in clinical work in West China Hospital of Sichuan University from January 2022 to December 2023 were selected,and expert review mode was adopted to conduct decision for allocation of 138 equipment received management for allocation from January to December 2022,and the decision indicator system for the allocation of life-support equipment on the basis of HB-HTA theory was adopted to conduct decision management for the allocation of 143 equipment(included 132 equipment received expert review mode for management of allocation)that received management for allocation from January to December 2023.The predictive assessment value for target,the achievement ratio of HB-HTA performance,the result of examination of management level of 46 personnel from clinical department,15 personnel from department of equipment,and 11 personnel from other department in items of allocation of equipment were compared between two kinds of management modes for allocation.Results:The predictive assessment values for target of the allocation items of heart-support equipment,respiratory-support equipment,anesthesia-support equipment and other support equipment which adopted HB-HTA management mode for allocation were respectively 0.65±0.22,0.68±0.16,0.70±0.15 and 0.58±0.20,which were higher all than those of management mode of expert review for allocation,and the differences were statistically significant(t=3.362,3.585,f4.152,3.247,P<0.05).The achievement ratio of average performance of safety,effectiveness,suitability and economy of allocation items of HB-HTA management mode were respectively(97.29±1.65)%,(96.19±2.08)%,(95.82±2.29)%and(94.92±2.29)%,all of which were higher than those of expert review management mode for allocation,and the differences were statistically significant(t=2.297,2.377,2.753,2.951,P<0.05).The results of the personnel who worked in clinical department,equipment department and other department were respectively(93.24±3.12)scores,(95.35±3.22)scores and(95.78±1.82)scores in adopting HB-HTA management mode for allocation to conduct examination for the management level about allocation items of life-support equipment with allocation decision,all of which were higher than those of expert review management mode for allocation,and the differences of them were statistically significant(t=3.220,2.435,2.404,P<0.05).Conclusion:The application of HB-HTA theory in indicator system of allocation decision of life-support equipment can comprehensively analyze the safety,effectiveness,suitability and economy of equipment allocation,and enhance the scientific nature of declaring project for allocation of life-support equipment,and improve the achievement degree of the target of implementing the project of the allocation of life-support equipment,and raise the business level of the management team for the project of allocation of life-support equipment.

Objective:To conduct an in-depth analysis of endoscope maintenance data using text mining techniques,establish a maintenance level prediction model,and identify key features to optimize maintenance management decisions.Methods:A total of 19 676 maintenance data of Olympus endoscope from 2005 to 2020 in Southwest China were collected.The Jieba segmentation-TF-IDF combined feature extraction was adopted to process fault text.A classification model about maintenance grade was constructed on the basis of Xgboost algorithm.And then,the feature selection algorithm was combined to identify key feature.Results:The model achieved an accuracy of 90%,AUC of 0.85,sensitivity of 76%,specificity of 95%,and F1-score of 0.80.The top 10 features ranked by importance were:image abnormality,wear,leakage,insertion tube,device category,light guide tube,button,angle malfunction,CCD glass,and rubber.Conclusion:The text mining-based prediction model for maintenance grade of endoscope can accurately predict the grade of repair.The paper provides suggestions for engineers to pay key attention to preventive maintenance for insertion tube,CCD glass of endoscope,so as to reduce cost and enhance usage efficiency of equipment.

Objective To analyze the short-term clinical outcomes of emergency conversion to surgery during transcatheter aortic valve replacement (TAVR). Methods Clinical data of patients who underwent emergency surgical conversion from TAVR in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University, from 2018 to 2023 were collected. Postoperative follow-up results at 1 month were recorded. Results A total of 253 patients underwent TAVR, of whom 11 (4.3%) required emergency conversion to surgery. Among these 11 patients, 7 were male and 4 were female, with a mean age of (69.55±5.01) years. The primary cause for emergency surgical conversion was valve stent displacement (63.6%), followed by left ventricular perforation/rupture (18.2%) and significant perivalvular regurgitation persisting after a second valve implantation (18.2%). One (9.1%) patient died intraoperatively. Among the 10 surviving patients, postoperative complications included pulmonary infection in 8 patients, severe pneumonia in 7, pleural effusion in 3, liver dysfunction in 8, renal dysfunction in 3, upper gastrointestinal bleeding in 5, cerebrovascular complications in 1, atrial fibrillation in 1, ventricular premature contractions in 1, atrioventricular block in 1, and complete left bundle branch block in 3. At 1-month postoperative follow-up, one additional patient died, yielding a 30-day mortality rate of 18.2% after TAVR emergency surgical conversion. The quality of life improved significantly compared to preoperative status in 9 (81.8%) patients, and no patients were readmitted for cardiovascular diseases. Conclusion The incidence of emergency conversion to surgery during TAVR is low, but the rates of surgical complications and 30-day postoperative mortality are high. Nevertheless, when severe complications occur during TAVR, emergency conversion to surgery can still yield satisfactory short-term clinical outcomes for a majority of these patients.