OBJECTIVE: To investigate the effectiveness of using 3 hollow compression screws combined with 1 screw off-axis fixation under the guidance of three-dimensional (3D) printed guide plate with mortise-tenon joint structure (mortise-tenon joint plate) for the treatment of Pauwels type Ⅲ femoral neck fractures. METHODS: A clinical data of 78 patients with Pauwels type Ⅲ femoral neck fractures, who were admitted between August 2022 and August 2023 and met the selection criteria, was retrospectively analyzed. The operations were assisted with mortise-tenon joint plates in 26 cases (mortise-tenon joint plate group) and traditional guide plates in 28 cases (traditional plate group), and without guide plates in 24 cases (control group). There was no significant difference in the baseline data of gender, age, body mass index, cause of injury, and fracture side between groups ( P>0.05). The operation time, intraoperative blood loss, frequency of intraoperative fluoroscopy, incision length, incidence of postoperative deep vein thrombosis of lower extremity, pain visual analogue scale (VAS) score at 1 week after operation, and Harris score of hip joint at 3 months after operation were recorded and compared. X-ray re-examination was taken to check the quality of fracture reduction, fracture healing, and the shortening length of the femoral neck at 3 months after operation, and the incidences of internal fixation failure and osteonecrosis of the femoral head during operation. RESULTS: Compared with the control group, the operation time, intraoperative blood loss, and frequency of intraoperative fluoroscopy reduced in the two plate groups, and the quality of fracture reduction was better, but the incision was longer, and the differences were significant ( P<0.05). The operation time and intraoperative blood loss were significantly higher in the traditional plate group than in the mortise-tenon joint plate group ( P<0.05), the incision was significantly longer ( P<0.05); and the difference in fracture reduction quality and the frequency of intraoperative fluoroscopy was not significant between two plate groups ( P>0.05). There was 1 case of deep vein thrombosis of lower extremity in the traditional plate group and 1 case in the control group, while there was no thrombosis in the mortise-tenon joint plate group. There was no significant difference in the incidence between groups ( P>0.05). All patients were followed up 12-15 months (mean, 13 months). There was no significant difference in VAS score at 1 week and Harris score at 3 months between groups ( P>0.05). Compared with the control group, the fracture healing time and the length of femoral neck shortening at 3 months after operation were significantly shorter in the two plate groups ( P<0.05). There was no significant difference between the two plate groups ( P>0.05). There was no significant difference in the incidences of non-union fractures, osteonecrosis of the femoral head, or internal fixation failure between groups ( P>0.05). CONCLUSION For Pauwels type Ⅲ femoral neck fractures, the use of 3D printed guide plate assisted reduction and fixation can shorten the fracture healing time, reduce the incidence of postoperative complications, and be more conducive to the early functional exercise of the affected limb. Compared with the traditional guide plate, the mortise-tenon joint plate can reduce the intraoperative bleeding and shorten the operation time.
Humans ; Femoral Neck Fractures/diagnostic imaging* ; Bone Plates ; Fracture Fixation, Internal/instrumentation* ; Male ; Female ; Retrospective Studies ; Middle Aged ; Bone Screws ; Adult ; Aged ; Treatment Outcome ; Printing, Three-Dimensional ; Operative Time

[This corrects the article DOI: 10.1016/j.apsb.2022.05.019.].

Objective In this study,the potential profile characteristics of exercise self-efficacy of patients with inflammatory bowel disease(IBD)were explored,and the influencing factors of different types of patients were an-alyzed,so as to provide a reference for nurses to formulate standardized management measures.Methods From June 2023 to May 2024,a total of 342 hospitalized patients with IBD in tertiary A hospital in Wuxi were recruited as research subjects by a convenience sampling method.The General Information Questionnaire,Exercise Self-effica-cy Scale,Exercise Behavioral Stage Distribution Scale and the Social Support Rating Scale were used for investiga-tion.The latent profile analysis was conducted to classify exercise self-efficacy levels,while multiple Logistic regres-sion analysis was utilized to evaluate the influencing factors.Results A total of 320 valid questionnaires were col-lected,and the effective questionnaire recovery rate was 93.57％.The total score of exercise self-efficacy for IBD pa-tients was(64.61±14.83)points.The exercise self-efficacy was classified into 3 latent categories:low efficacy-somatic emotion group(n=64,20.00％),medium efficacy-work conflict group(n=158,49.38％),and high efficacy-social interfer-ence group(n=98,30.62％).Occupation,recurrence times,comorbid chronic diseases,self-assessed economic pressure,and social support level were found to be influencing factors of the latent profile classification of exercise self-effi-cacy in IBD patients(P＜0.05).Conclusion The levels of exercise self-efficacy of patients with IBD are significant-ly heterogeneous,and there are several important influencing factors.Nursing staff should formulate targeted inter-vention strategies based on the characteristics of exercise self-efficacy in such patients,so as to improve patients' exercise self-efficacy and the effectiveness of disease rehabilitation.

Objective:To construct a deep learning model based on YOLOV8-Seg algorithm to conduct automatic segmentation for the central gland(CG)and peripheral zone(PZ)of prostate,so as to provide a reliable basis for clinical diagnosis and treatment.Methods:The sequence data of T2-weighted imaging(T2WI)of horizontal relaxation time of 158 patients were selected from a public data set of magnetic resonance imaging(MRI)for prostate MRI,which was provided by the Charité University Hospital in Berlin,were selected.The all data were divided into a training set(109 cases),a validation set(16 cases),and a test set(33 cases)as the ratio of 7 to1 to 2.A lightweight asymmetric decoupled head(LADH)structure and the large kernel UniRepLKNetBlock module were integrated into the YOLOV8-Seg algorithm to enhance the capabilities of model's extraction feature,and the new model was named as YOLOV8-URLK.The assessment model with mean Average Precision(mAP),Dice Similarity Coefficient(DSC),95%Hausdorff Distance(HD95),and Average Surface Distance(ASD)was adopted to segment performance of the detection at prostate CG and PZ.Comparative experiments were conducted among that and YOLOV8-Seg,TransU-Net,and U-Net network,so as to validate the effectiveness of YOLOV8-URLK for detection and segmentation at prostate zone.Results:On the test set,the mAP@0.5(box)of YOLOV8-URLK model was 0.878,and the mean Dice coefficients,the mean HD95 values and the ASD values of that at CG and PZ were respectively(0.867,17.123 and 1.461)and(14.902,0.898 and 1.112).On the test set,the mAP@0.5(box)of YOLOV8-Seg model was 0.860,and the mean Dice coefficients of that at CG and PZ were 0.851 and 0.884,the mean HD95 values of that at them were 19.174 and 15.298,and ASD values of that at them were 1.781 and 1.219,respectively.On test set,the mean Dice coefficients of TransU-Net model at CG and PZ were 0.864 and 0.824,and the mean HD95 values of that at them were 18.134 and 19.402,and ASD values of that at them were 1.698 and 1.717,respectively.On the test set,the mean Dice coefficients of the U-Net model at CG and PZ were 0.857 and 0.690,and the mean HD95 values of that at them were 18.976 and 26.934,and ASD values of that at them were 1.753 and 2.135.The YOLOV8-URLK model can better reappear the segmentation trend of manual annotations.Conclusion:The YOLOV8-URLK model demonstrates higher precision in the detection and segmentation of MRI images of prostate,which were superior to YOLOV8-Seg,TransU-Net and U-Net.It can enhance the efficiency of the detection and segmentation.

Objective:To explore the clinical significance of trisomy 7 signaled by non-invasive prenatal testing (NIPT).Methods:Pregnant women with high risk for trisomy 7 by NIPT from January 2017 to December 2023 were selected as the study subjects, and the results of prenatal diagnosis and follow-up were analyzed. Literature related to pregnant women with a high risk for trisomy 7 by NIPT from January 2016 to July 2024 was retrieved from China Biomedical Literature Database, Wanfang Database, China National Knowledge Infrastructure and PubMed database. Relevant information such as the incidence of trisomy 7 by NIPT, positive predictive value (PPV), and pregnancy outcomes were collected. This study has been approved by the Medical Ethics Committee of Lianyungang Maternal and Child Health Care Hospital (Ethics No. JS2022010).Results:A total of 51 women with a high risk for trisomy 7 by NIPT were identified. Thirty-two of them had chosen chromosomal microarray analysis (CMA) of amniotic fluid cells, and 1 case of mosaic trisomy 7 was detected, which had yielded a PPV of 3.13%. Four women had opted termination of pregnancy, 1 had miscarriage, 4 had pre-term and/or low weight birth, whilst the remaining 42(82.4%) had full-term delivery. In total 19 literature were retrieved, which had involved 278 cases of trisomy 7 signaled by NIPT, among which 5 fetuses with mosaic trisomy 7 (3.14%) were confirmed. Among the 211 women with follow-up outcomes, 2 (0.95%) had intrauterine growth restriction, 3 (1.42%) had abnormal fetal structure detected by ultrasound, 2 (0.95%) had miscarriage, 9 (4.27%) underwent pregnancy termination, 28 (13.27%) had preterm and/or low weight birth, whilst 167 (79.14%) had normal delivery. In 18 cases, chromosomal analysis of placental tissue was carried out, and 17 were confirmed to have mosaicism trisomy 7.Conclusion:The PPV for trisomy 7 signaled by NIPT is extremely low. Although most of such women had a full term delivery, adverse pregnancy outcomes may still occur in a minority of cases. Clinicians should provide adequate genetic counseling for such women and recommend appropriate prenatal diagnosis strategies and optimal perinatal management plans.

Objective:To determine appropriate cutoff values for evaluating hypoxemia severity in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study selected data from 1, 781 young patients with obstructive sleep apnea (OSA) who underwent polysomnography in the Department of Otorhinolaryngology Head and Neck Surgery of the Sixth Medical Center of PLA General Hospital from January 2015 to June 2023. The cohort included 1, 604 males and 177 females, with a mean age of (32.6±5.3) years. The relationship between the minimum arterial oxygen saturation (MSaO 2) and the prevalence of hypertension in this population was investigated. Subjects were categorized into seven groups based on MSaO 2 levels: Group 1 (MSaO 2≥90%), Group 2 (85%≤MSaO 2<90%), Group 3 (80%≤MSaO 2<85%), Group 4 (75%≤MSaO 2<80%), Group 5 (70%≤MSaO 2<75%), Group 6 (65%≤MSaO 2<70%), and Group 7 (MSaO 2<65%). The prevalence of hypertension in each group was statistically analyzed, and the chi-square test was used to identify significant differences in hypertension prevalence. The diagnostic performance of the new versus traditional grouping methods was evaluated using receiver operating characteristic (ROC) curve analysis. Results:Among the 1, 781 OSA patients, 915 had hypertension. The prevalence of hypertension in Groups 1 to 7 was 27.8%, 42.4%, 52.2%, 54.1%, 59.5%, 70.5%, and 75.4%, respectively. Significant differences in hypertension prevalence were observed between Group 1 and other groups, Group 2 and Groups 5-7, Group 3 and Groups 6-7, and Group 4 and Group 7( χ2=187.94, P<0.001). After merging the groups based on MSaO 2 thresholds of≥90%, 90%>MSaO 2≥85%, 85%>MSaO 2≥75%, and MSaO 2<75%, the prevalence of hypertension in the new groups was 27.8%, 42.4%, 53.0%, and 71.2%, respectively, with significant differences between adjacent groups( χ2=178.99, P<0.001). ROC curve analysis revealed that the area under the curve (AUC) for the new grouping method (0.676) was higher than that for the original grouping method (0.664). Conclusions:As hypoxemia severity increases in OSA, so does the prevalence of comorbid hypertension. Using MSaO 2 cutoff values of 90%, 85%, and 75% to categorize hypoxemia severity appears more appropriate compared to the existing guideline values of 90%, 85%, and 80%.

Objective:To study the characteristics of laryngopharyngeal reflux (LPR) events in patients with obstructive sleep apnea (OSA).Methods:This cross-sectional study analyzed OSA patients who were admitted in the Department of Otolaryngology-Head and Neck Surgery, the Sixth Medical Center of the Chinese PLA General Hospital between November 2020 to July 2023[OSA group, 52 males, 6 females, aged 23-69 (41.22±11.42) years], and non-OSA patients admitted during the same period serve as the control group[non-OSA group, 40 males, 1 female, aged 21-68 (45.12±11.30) years]. All participants completed the Reflux Symptom Index (RSI), Reflux Finding Score (RFS) scale, and 24-hour Hypopharyngeal Esophageal Multichannel Intraluminal Impedance-pH (HEMII-pH) monitoring. LPR events were categorized based on their physical composition-liquid, gas, or gas-liquid mixed, according to the change of impedance values; and further classified by pH levels as acidic, weakly acidic, or alkaline. Differences in LPR events physical properties and the time trends of LPR events between the two groups were compared. Group comparisons were performed using t-test or Mann-Whitney U-test. Analyses were conducted using Pearson, Spearman, or Kendall′s tau-b correlation analysis. Categorical data were analyzed using chi-square test. Results:A total of 99 patients were enrolled, including 58 with OSA and 41 without OSA. Of these, 88.89% (88/99) met the diagnostic criteria for laryngopharyngeal reflux disease (LPRD). In LPRD patients, the median proportion of non gas reflux events and the number of alkaline reflux were significantly higher in the OSA with LPRD group than in the non OSA with LPRD group (70.00% vs 36.36%, 0 vs 0, Z-values respectively -3.373, -3.134, P<0.01). Liquid reflux proportion and the number of both liquid and mixed reflux events showed a positive correlation with the apnea-hypopnea index (AHI) ( r-values respectively 0.304, 0.326, 0.268, P<0.05), while the gas reflux constituent ratio was inversely correlated with AHI ( r=-0.358, P<0.01). The frequency and proportion of nocturnal reflux events showed a positive correlation with AHI ( r-values respectively 0.250, 0.211, P<0.05). A significantly higher proportion of OSA with LPRD group experienced both daytime and nighttime reflux compared to non OSA with LPRD group (66.67% vs 38.71%, P<0.05). In LPRD patients, over 50% of all LPR events occurred within 3 hours after each of the three main meals. Conclusions:In OSA with LPRD patients, LPR events are predominantly non gas in nature. OSA with LPRD patients exhibits a higher proportion and frequency of nocturnal reflux events and a greater number of alkaline reflux episodes compared to non OSA with LPRD patients.

Objective:A retrospective analysis was conducted on the clinical characteristics and polysomnography (PSG) features of patients with obstructive sleep apnea (OSA) of different ages.Methods:From January 2015 to March 2024, the patients who underwent overnight PSG monitoring at the Sleep Respiratory Disease Diagnosis and Treatment Center, Department of Otolaryngology, Head and Neck Surgery, Sixth Medical Center of the PLA General Hospital were sequentially enrolled.A total of 4 396 patients[aged from 18 to 97(46.04±12.60)years] with OSA who met the criteria were finally enrolled and divided into the youth group (18-44 years old, n=2 099), middle-aged group (45-59 years old, n=1 641), and elderly group (≥60 years old, n=656).The differences in general condition, Epworth sleepiness Scale (ESS) score, rapid eye movement sleep (REM) sleep time in total sleep time, micro-awakening index, apnea hypopnea index (AHI), minimum oxygen saturation at night (LSpO 2), oxygen hypoxia index (ODI) and so on were compared.Multivariate Logistic regression was used to analyze the relationship between age stratification and different severity of OSA (mild 5≤AHI≤15, moderate 1530, Times per hour). Results:The neck circumference [(39.11±3.71) cm], body mass index [BMI, (26.63±3.70) kg/m2], total sleep time [(386.13±66.09) min], the percentage of deep sleep in total sleep time [(3.05±4.80)%], the percentage of REM sleep time in total sleep time [(16.73±6.83)%], apnea-hypopnea index [AHI, (31.17±19.20) events/h], oxygen desaturation index [ODI, (46.57±33.54) events/h], microarousal index [(14.82±12.27) events/h], and Epworth Sleepiness Scale (ESS) score (8.29±5.92) in the elderly group were all lower than those in the young group [neck circumference (41.36±3.37) cm, BMI (28.55±4.21) kg/m2, total sleep time [(424.67±62.21) min], the percentage of deep sleep in total sleep time (5.89±6.79)%, the percentage of REM sleep time in total sleep time (17.95±6.67)%, AHI (39.55±27.89) events/h, ODI (61.88±34.60) events/h, microarousal index (22.77±19.31) events/h, ESS score (9.63±5.82)] and the middle-aged group [neck circumference (40.75±3.59) cm, BMI (27.89±3.55)kg/m2, total sleep time [(410.98±63.02)min], the percentage of deep sleep in total sleep time (3.59±5.11)%, the percentage of REM sleep time in total sleep time (17.47±6.63)%, AHI (36.01±23.63) events/h, ODI (57.20±34.75) events/h, microarousal index (19.23±15.59) events/h, ESS score (9.98±6.11)], with F values of 102.62, 62.15, 95.87, 95.94, 8.71, 29.60, 49.72, 59.11, and 19.03, respectively, and all P values were <0.001. The proportion of females [29.57% (94/656)], the proportion of patients with hypertension [37.20% (244/656)], and the nocturnal LSpO 2 [(79.09±9.88)%] in the elderly group were all higher than those in the young group [proportion of females [6.48% (136/2 099)], proportion of patients with hypertension 18.10% (380/2 099), nocturnal LSpO 2(75.19±12.90)%] and the middle-aged group [proportion of females [15.84%(260/1 641)], proportion of patients with hypertension 33.09% (543/1 641), nocturnal LSpO 2(76.15±12.44)%], with F values of 242.62, 150.90, and 25.05, respectively, and all P values were <0.001.There were no significant differences in neck circumference, percentage of REM sleep time in total sleep time, AHI and LSpO 2 at night between young and middle-aged groups ( P>0.05). After adjusting for gender, neck circumference, BMI, and hypertension confounders, the risk of severe OSA in the older group was increased by 27.4% compared with the younger group ( OR=1.274, 95% CI=1.036-1.566, P<0.05). Further stratified analysis showed that neck circumference and BMI were independent factors for severe OSA in the young and middle-aged groups ( P<0.01), while, only neck circumference was independently associated with severe OSA in the elderly group (OR=1.119, 95% CI=1.039-1.207, P<0.01). Conclusion:The severity of OSA in young and middle-aged patients is more serious than that in elderly patients. Obesity is an important factor affecting the degree of OSA in young and middle-aged patients. After controlling for confounding factors such as obesity, the risk of severe OSA in elderly patients is higher than that in young patients, which is considered to be related to factors such as pharyngeal collapse and relaxation of pharyngeal muscles.

Objective To explore the effect of CB-103 on pyroptosis in oral squamous cell carcinoma(OSCC)cells via the reactive oxygen species(ROS)/caspase-3/gasdermin-E(GSDME)signaling pathway.Methods The OSCC cell line SCC-7 was treated with varying concentrations of CB-103(0,20,40,60,80,and 100 μg/mL).The proliferation activity of CB-103 cells was measured using cell counting kit-8(CCK-8)assay.The cell migration was assessed using a wound-healing assay.Morphological changes in the cells were observed under an inverted microscope.Western blotting was performed to evaluate the protein expression of GSDME,GSDME-N ter-minal,and cleaved caspase-3.ATP release was measured using an ATP detection kit.The levels of intracellular high-mobility group box 1(HMGB1)and ROS were quantified by immunofluorescence.Results Compared to the control group,CB-103 inhibited the proliferation and migration of SCC-7 cells.Additionally,CB-103 increased ROS levels and upregulated the expression of cleaved caspase-3 protein.Furthermore,CB-103 promoted the cleavage of GSDME and increased the number of GSDME-N terminal fragments(all P＜0.05),thereby inducing pyroptosis in SCC-7 cells.Conclusion CB-103 promotes pyroptosis in OSCC cells by activating the ROS/caspase-3/GSDME pathway.

ObjectiveTo observe and compare the effects of different concentrations of cyclophosphamide (CTX) in inducing premature ovarian insufficiency (POI) model in mice and investigate the mechanism of injury. MethodsThirty-two 6~8-week-old female C57BL/6J mice were randomly divided into four groups (n=8 per group) using a weight-based block randomization method. The POI model was established via a single intraperitoneal injection of 75 mg/kg cyclophosphamide (CTX), 120 mg/kg CTX, 120 mg/kg CTX + 12 mg/kg Busulfan, or an equivalent volume of normal saline (control). Ovarian coefficients, serum estradiol (E₂) and follicle-stimulating hormone (FSH) levels were measured. Western blotting was performed to assess changes in ovarian expression levels of NAD-dependent deacetylase sirtuin-5 (SIRT5) and forkhead box O3a (FOXO3a) under different modeling conditions. After determining the optimal CTX concentration for modeling, an additional forty 6~8-week-old femal C57BL/6J mice were randomly divided into five groups (n=8 per group) using a weight-based block randomization method: saline control, 120 mg/kg CTX sampling at 1, 2, 7, or 14 days after modeling. Western blotting was used to evaluate temporal changes of ovarian SIRT5 and FOXO3a protein expression. ResultsCompared with the saline control, all concentrations of CTX (75 mg/kg CTX, 120 mg/kg CTX) and 120 mg/kg CTX + 12 mg/kg Busulfan induced POI injury in mice. The 120 mg/kg CTX group exhibited smaller changes in ovarian coefficients (P<0.001) and E₂ levels (P<0.05), whereas the 120 mg/kg CTX + 12 mg/kg Busulfan group showed rough and reduced luster fur, sluggish response and was in the worst state. Compared with the saline control group, FOXO3a expression was significantly down-regulated (P<0.05), while SIRT5 remained unchanged in the 75 mg/kg CTX group (P>0.05). In contrast, both SIRT5 (P<0.05) and FOXO3a (P<0.05) were significantly down-regulated in the 120 mg/kg CTX group. Further analysis revealed that on day 2 and 7 after 120 mg/kg CTX modeling, the expressions of SIRT5 (P<0.01) and FOXO3a (P<0.001) were significantly down-regulated, with the largest decrease observed on day 7 (SIRT5, P<0.000 1; FOXO3a, P<0.000 1). ConclusionOvarian injury in the POI model induced by 120 mg/kg CTX is milder than that in the POI model induced by 75 mg/kg CTX. Moreover, the expression changes of SIRT5 and FOXO3a are most significant on day 7 after modeling induced by 120 mg/kg CTX, which may be related to the inhibition of the SIRT5-FOXO3a signaling pathway.