Objective To investigate the effect of fibulin-3 on the senescence of intervertebral disc nucleus pulposus cells(NPCs)through the regulation of tissue inhibitor of metalloproteinases 3(TIMP-3)expression and to elucidate the molecular mechanisms involved.Methods 1).The nucleus pulposus tissues and imaging data of 37 patients who had undergone intervertebral disc surgery were collected.The degree of degeneration of the intervertebral discs were classified according to the Pfirrmann grading system.The senescence degree of NPCs was determined using senescence-associated β-galactosidase(SA-β-gal)staining.Fibulin-3 expression levels were determined using Western blot and ELISA.The relationship between fibulin-3 and disc degeneration and NPCs senescence was investigated.2).Human intervertebral disc NPCs were cultured in vitro.The proliferation and senescence of NPC across continuous passage were observed via CCK-8 assay and SA-β-gal staining,respectively.Fibulin-3 expression levels and the expression of inflammatory cytokines and matrix metalloproteinases were assessed.Exogenous fibulin-3 was added to verify its effect on the proliferation and senescence of NPCs.3).The effect of fibulin-3 on the apoptosis and proliferation of NPCs was verified through gene overexpression,which was used in combination with an apoptosis inhibitor for bidirectional verification.4).Bioinformatics analysis was performed to explore the relationship between fibulin-3 and the TIMP family.Experiments overexpressing fibulin-3 and silencing the TIMP-3 gene were performed to verify their role in NPCs senescence.Results 1).The intervertebral disc degeneration samples from 37 patients were classified according to the Pfirrmann grading system.The higher the degeneration grade,the lower fibulin-3 expression.Spearman correlation analysis showed that the disc grade was negatively correlated with the NPC senescence grade(r=-0.87,P＜0.001)and fibulin-3 expression(r=-0.79,P＜0.001).2).As the passage number of NPCs increased,fibulin-3 expression gradually decreased,cell proliferation ability weakened,and the expression of inflammatory cytokines and matrix metalloproteinases increased.After exogenous fibulin-3 was added,cell morphology and growth status were maintained,cell senescence was significantly inhibited,and the expression of inflammatory cytokines and matrix metalloproteinases was markedly reduced.3).Gene overexpression experiments showed that fibulin-3 reduced NPC apoptosis and promoted cell proliferation,thereby inhibiting NPC senescence.4).Bioinformatics analysis revealed a significant association between fibulin-3 and TIMP-3 of the TIMP family.Further experiments confirmed that overexpressing fibulin-3 enhanced TIMP-3 expression,while silencing the TIMP-3 gene significantly weakened the inhibitory effect of fibulin-3 on NPCs senescence.This indicates that,through regulating TIMP-3,fibulin-3 inhibits the activity of matrix metalloproteinases,affects the synthesis and degradation of the extracellular matrix,and ultimately inhibits NPCs senescence.Conclusion This study demonstrates that fibulin-3 plays a crucial role in inhibiting the senescence of intervertebral disc NPCs by regulating TIMP-3.The specific mechanisms involved are as follows,fibulin-3 upregulates TIMP-3 expression,inhibits matrix metalloproteinase activity,and reduces extracellular matrix degradation,thereby promoting extracellular matrix synthesis.Additionally,fibulin-3 inhibits NPCs senescence by reducing apoptosis and promoting cell proliferation.Therefore,fibulin-3 and TIMP-3 have potential therapeutic significance in maintaining intervertebral disc health and delaying degeneration.

Prenatal ultrasound screening is an important means to exclude fetal structural abnormalities. With the continuous development of technology, more vascular abnormalities can be found more early, which improves the quality of the social population. Traditional Doppler ultrasonic images have a low resolution and poorly display small blood vessels. SlowflowHD is a particularly sensitive power Doppler designed to detect small microvessels with a low flow rate, and can improve the resolution of fine blood vessels. SlowflowHD has been gradually applied to prenatal screening because of its unique characteristics such as high display frame rate, high line density (high resolution), and good sensitivity. This article aims to explore the clinical application progress of SlowflowHD in prenatal screening.

With the increasing frequency and impact of public health incidents in the world's medical and health services in recent years,it has become extremely necessary to train public health talents suitable for the medical environment in China.This article mainly discusses the training model of professional postgraduate students in public health in Australian universities (Sydney University and Melbourne University) and Japanese universities (Tokyo University and Hokkaido University).Both countries attach importance to the education of practical ability.Australian universities focus on the training of allround and comprehensive public health talents,while Japanese universities emphasizes the training of professional public health talents.At present,there is a lack of a clear understanding of public health and detailed standards in China,which is the main problem of public health education in China.A detailed and efficient training model of public health talents should be established based on the unique features of our country.

Objective To assess the effect of ultrasound-guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation of hepatic carcinomas. Methods Ninety-six patients with 112 liver malignancies were treated with ultrasound-guided percutaneous radiofrequency ablation using multiple-spot sector stereotaxis method. Conventional multi-section ultrasound scanning was performed to determine the exact location of tumors. Contrast enhanced ultrasound (CEUS) was performed 15 minutes after treatment to determine whether the tumors were completely inactivated. Contrast enhanced CT (CECT) and CEUS were performed 1 month after treatment to evaluate the therapeutic effect. Results A total of 293 punctures were performed for 112 tumors, technical successful rate with a successful rate of puncture was 91.81% (269/293). CEUS showed no blood flow signals in the tumors 15 minutes after therapy. One month after therapy, CT showed the volume of tumors shrunk, no enhancement was found in 100 tumors (100/112, 89.29%), while partial reinforcement was noticed in 12 tumors (10.71%). Meanwhile, CEUS showed no enhancement in 90 tumors (90/103, 87.38%), when partial reinforcement was noticed in 13 tumors (13/103, 12.62%). Conclusion Ultrasound-guided multiple-spot sector stereotaxis unipolar cooling cycle radiofrequency ablation is an effective and reliable method to treat hepatic carcinomas.