ObjectiveTo delineate imaging findings using an imaging platform and investigate the correlation between MRI characteristics of spinal cord atrophy and clinical diagnosis in children with spinal cord injury (SCI). MethodsImaging data of 150 children with SCI admitted to Beijing Bo'ai Hospital, China Rehabilitation Research Center, from January, 2002 to March, 2024 were collected and imported into the imaging platform. The anteroposterior and transverse diameters of the middle part of the spinal cord at the cross-section with the most severe atrophy were measured, and the relevant indicators of the previous normal spinal cord segment were measured as controls; the radiomic features were extracted. Clinical data of the children including gender, age, cause of injury, sensory level, motor level, spinal cord injury level, injury severity and disease course were collected. ResultsSpinal cord atrophy was identified in 81 cases (54%), among which 78 cases (96%) were American Spinal Injury Association Impairment Scale (AIS) grade A and 3 cases (4%) were AIS grade C. The upper boundary of the spinal cord atrophy site strongly correlated with the injury level, motor level and sensory level (r > 0.8, P < 0.001). ConclusionMore than half of children with SCI may develop secondary spinal cord atrophy, the vast majority of whom suffer from complete spinal cord injury; the upper boundary of spinal cord atrophy is correlated with the injury level.

Reach-to-grasp movements require integrating information on both object location and grip type, but how these elements are planned and to what extent they interact remains unclear. We designed a new experimental paradigm in which monkeys sequentially received reach and grasp cues with delays, requiring them to retain and integrate both cues to grasp the goal object with appropriate hand gestures. Neural activity in the dorsal premotor cortex (PMd) revealed that reach and grasp were similarly represented yet not independent. Upon receiving the second cue, the PMd continued encoding the first, but over half of the neurons displayed incongruent modulations: enhanced, attenuated, or even reversed. Population-level analysis showed significant changes in encoding structure, forming distinct neural patterns. Leveraging canonical correlation analysis, we identified a shared subspace preserving the initial cue's encoding, contributed by both congruent and incongruent neurons. Together, these findings reveal a novel perspective on the interactive planning of reach and grasp within the PMd, providing insights into potential applications for brain-machine interfaces.
Animals ; Motor Cortex/physiology* ; Hand Strength/physiology* ; Macaca mulatta ; Psychomotor Performance/physiology* ; Neurons/physiology* ; Male ; Cues ; Movement/physiology* ; Gestures

Objective:To explore the related influencing factors for prognosis of patients undergoing plastic and reconstructive surgery with transnasal endoscope for blowout orbital fracture(BOF),so as to adopt corresponding intervention measures for patients in clinical practices,thus improve the prognosis of patients.Methods:A total of 107 patients who underwent plastic and reconstructive surgery with transnasal endoscope for BOF in Qingdao Municipal Hospital from September 2015 and September 2024 were enrolled in this study.Preoperative and postoperative clinical data,as well as follow-up records,of patients who underwent plastic and reconstructive surgery for BOF were collected.According to follow-up data of plastic and reconstructive surgery with transnasal endoscope for BOF,the 107 patients were divided into two groups:a poor prognosis group(n=35)and a favorable prognosis group(n=72).Comparative analysis was performed for the two groups.Logistic regression analysis was subsequently employed to identify influencing factors for prognosis of patients who underwent plastic and reconstructive surgery with transnasal endoscope for BOF,and conduct assessment and analysis for risk factors.Results:In poor prognosis group with 35 patients:12 cases occurred diplopia(34.28%),and 11 cases occurred limited ocular motility(31.42%),and 11 cases occurred enophthalmos(31.42%),and 1 case occurred infraorbital nerve hypoesthesia(2.85%).The age(44.66±12.70 years old)and surgical duration(91.43±56.97 minutes)of poor prognosis group were significantly higher than those of favorable prognosis group,with statistical significance(t=-2.547,-2.23,P<0.05).The proportions of patients with hypertension history,with diabetes history,with bone defect area≥2 cm2,and interval between injury and surgery≥14 days of poor prognosis group were significantly higher than those of favorable prognosis group,with statistical differences(x2=8.756,33.142,62.163,13.769,P<0.05),respectively.Multivariate logistic regression analysis identified diabetes history,bone defect area≥2 cm2,and interval between injury and surgery≥14 days were influencing factors for the prognostic of patients who underwent plastic and reconstructive surgery with transnasal endoscope for BOF(OR=0.022,0.012,0.123,P<0.05),respectively.Conclusion:The d iabetes history,bone defect area≥2 cm2,and interval between injury and surgery≥14 days are independent risk factors for poor prognosis in patients who undergo plastic and reconstructive surgery with transnasal endoscope for BOF.It is important measure that effectively improve prognosis of patients who undergo plastic and reconstructive surgery with transnasal endoscope for BOF,which include selecting optimal surgical timing,defining the extent of bone defects and the comorbidities before surgery,and implementing glycemic control at perioperative and postoperative stage.

Objective:To explore the related influencing factors for prognosis of patients undergoing plastic and reconstructive surgery with transnasal endoscope for blowout orbital fracture(BOF),so as to adopt corresponding intervention measures for patients in clinical practices,thus improve the prognosis of patients.Methods:A total of 107 patients who underwent plastic and reconstructive surgery with transnasal endoscope for BOF in Qingdao Municipal Hospital from September 2015 and September 2024 were enrolled in this study.Preoperative and postoperative clinical data,as well as follow-up records,of patients who underwent plastic and reconstructive surgery for BOF were collected.According to follow-up data of plastic and reconstructive surgery with transnasal endoscope for BOF,the 107 patients were divided into two groups:a poor prognosis group(n=35)and a favorable prognosis group(n=72).Comparative analysis was performed for the two groups.Logistic regression analysis was subsequently employed to identify influencing factors for prognosis of patients who underwent plastic and reconstructive surgery with transnasal endoscope for BOF,and conduct assessment and analysis for risk factors.Results:In poor prognosis group with 35 patients:12 cases occurred diplopia(34.28%),and 11 cases occurred limited ocular motility(31.42%),and 11 cases occurred enophthalmos(31.42%),and 1 case occurred infraorbital nerve hypoesthesia(2.85%).The age(44.66±12.70 years old)and surgical duration(91.43±56.97 minutes)of poor prognosis group were significantly higher than those of favorable prognosis group,with statistical significance(t=-2.547,-2.23,P<0.05).The proportions of patients with hypertension history,with diabetes history,with bone defect area≥2 cm2,and interval between injury and surgery≥14 days of poor prognosis group were significantly higher than those of favorable prognosis group,with statistical differences(x2=8.756,33.142,62.163,13.769,P<0.05),respectively.Multivariate logistic regression analysis identified diabetes history,bone defect area≥2 cm2,and interval between injury and surgery≥14 days were influencing factors for the prognostic of patients who underwent plastic and reconstructive surgery with transnasal endoscope for BOF(OR=0.022,0.012,0.123,P<0.05),respectively.Conclusion:The d iabetes history,bone defect area≥2 cm2,and interval between injury and surgery≥14 days are independent risk factors for poor prognosis in patients who undergo plastic and reconstructive surgery with transnasal endoscope for BOF.It is important measure that effectively improve prognosis of patients who undergo plastic and reconstructive surgery with transnasal endoscope for BOF,which include selecting optimal surgical timing,defining the extent of bone defects and the comorbidities before surgery,and implementing glycemic control at perioperative and postoperative stage.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Ketosis in dairy cows is often accompanied by apoptotic and inflammatory responses in adipose tissue.In order to investigate the effect of pro-apoptotic protein Bid on adipocyte apoptosis in cows with ketosis,the adipose tissue was stained by TUNEL staining technique in this study to observe the apoptotic changes in adipose tissue of cows with ketosis.In the in vivo test,protein ex-pression of apoptosis-related factors Bid,Bax,C-Caspase-3,Bcl-2 and inflammation marker factors C1q,IL-1β,IL-10 and IL-6 in adipose tissues of healthy cows and ketosis cows were detected by Western blot.In the in vitro assay,the adipocyte lipolysis model was constructed by culturing pri-mary bovine adipocytes in vitro to inhibit Bid and adding isoproterenol(ISO),and the protein ex-pression levels of apoptosis-related molecules and inflammation-related molecules in adipocytes were detected by Western blot technique.The results of TUNEL staining showed that the protein expression of pro-apoptotic factors Bid,Bax and C-Caspase-3,and pro-inflammatory markers TNF-a,IL-1β,and IL-6 were significantly higher,and the protein expression of complement C1q,anti-ap-optotic factor Bcl-2,and anti-inflammatory factor IL-10 were significantly lower in adipose tissues of ketosis cows compared with that of healthy cows.The in vitro results showed that the protein expression levels of apoptosis and inflammation-related factors in adipocytes treated with the ISO group were significantly higher compared with those in the control group,while the protein ex-pression levels of apoptosis and inflammation-related factors in adipocytes treated with the addi-tion of the Bid inhibitor group were significantly lower.The above results showed that inhibition of Bid could alleviate the apoptotic and inflammatory responses of ISO on adipocytes.This will fur-ther clarify the role of Bid/C1q in the regulation of adipose tissue and cell apoptosis and inflamma-tion in ketosis cows.

This article reported two cases of axillary artery thrombosis in extremely low/very low birth weight infants following the placement of a local arterial catheter, who hospitalized in Shengjing Hospital of China Medical Universityin in April 2023 and August 2022, respectively. Case 1: Before surgery for necrotizing enterocolitis, an arterial catheter was placed in the left axilla of the infant. On the same day, the infant developed cyanosis of the left upper limb and weakened radial artery pulse. Ultrasound examination confirmed the presence of left axillary artery thrombosis. Despite subcutaneous injection of low molecular weight heparin (LMWH) and plasma infusion, there was no improvement in blood circulation. The infant also exhibited reduced movement in the left upper limb and loss of radial artery pulse. Thrombolytic therapy with recombinant tissue-type plasminogen activator was administered. Six hours after the treatment, the radial artery pulse became palpable. Thrombolysis was then terminated, and anticoagulation with LMWH was supplied for two weeks. At one year and eight months of age, the infant had a weaker left-hand grip strength compared to the right, but the overall functionality was largely preserved. Case 2: The infant developed late-onset sepsis at 17 days old and had an arterial catheter placed in the axilla. Pale left upper limb was observed in the following day, and the brachial and radial artery pulses were absent. Vascular ultrasound indicated the presence of left axillary artery thrombosis. Anticoagulation therapy with subcutaneous injection of LMWH was provided, along with thrombolysis using urokinase. On the sixth day after thrombolysis, an ultrasound examination showed no thrombus-like echoes. At one year and eight months of age, the development and movement of the affected upper limb became normal.

Objective:To observe the efficacy and safety of albumin paclitaxel in patients with advanced breast cancer.Methods:A retrospective analysis was performed on 138 patients with advanced breast cancer admitted to Xiangyang Central Hospital from June 2018 to June 2021. The patients were divided into groups according to molecular type, number of treatment lines for albumin paclitaxel, number of metastatic sites, specific metastatic sites, past use of docetaxel and paclitaxel and combination therapy of albumin paclitaxel. Median progression-free survival (mPFS) and treatment-related adverse reactions in different subgroups treated with albumin paclitaxel were investigated. Survival curves were plotted by Kaplan-Meier method and log-rank test was performed, and multivariate analysis was performed by Cox model.Results:The mPFS of the overall population was 8.2 months. The mPFS of triple negative breast cancer, human epidermal growth factor receptor-2 (HER-2) positive breast cancer and Luminal breast cancer were 6.4 months, 11.2 months and 8.1 months respectively, with a statistically significant difference (χ 2=7.42, P=0.025) . The mPFS of patients treated with first- and second-line albumin paclitaxel was 9.5 months, and the mPFS of patients treated with third- to seventh-line was 6.3 months (χ 2=3.86, P=0.049) . The mPFS of patients with ≤3 metastatic sites was 8.1 months, and the mPFS of patients with >3 metastatic sites was 7.0 months (χ 2=0.38, P=0.535) . The mPFS of patients with liver and brain metastases was 6.8 months, and the mPFS of patients with extrahepatic and extracerebral metastases was 9.6 months (χ 2=7.53, P=0.006) . The mPFS of patients who had previously treated with docetaxel and paclitaxel was 8.2 months, and the mPFS of patients who had not previously received docetaxel or paclitaxel was 9.6 months (χ 2=0.03, P=0.862) . The mPFS of patients with albumin paclitaxel combined with targeted therapy, combined with immunotherapy, combined with chemotherapy and monotherapy were 12.1, 7.8, 9.0 and 7.1 months respectively, with a statistically significant difference (χ 2=8.96, P=0.030) . Multivariate analysis showed that molecular type (triple negative breast cancer RR=1.87, 95% CI: 1.24-4.22, P=0.008; HER-2 positive breast cancer RR=0.63, 95% CI: 0.52-0.94, P=0.042) , number of treatment lines ( RR=0.67, 95% CI: 0.32-0.86, P=0.011) , specific metastatic sites ( RR=1.26, 95% CI: 1.12-2.75, P=0.014) and combination therapy (combined with targeted therapy RR=0.74, 95% CI: 0.16-0.86, P=0.021; combined with chemotherapy RR=0.93, 95% CI: 0.48-0.96, P=0.045; combined with immunotherapy RR=0.81, 95% CI: 0.17-0.78, P=0.032) were independent factors for prognosis. The main adverse reactions were alopecia, neutropenia, peripheral neurotoxicity and rash, and there was no death caused by adverse reactions. Conclusion:Albumin paclitaxel is effective in the treatment of advanced breast cancer with controllable adverse reactions.

A 45-year-old male patient was treated with canagliflozin 100 mg once daily orally for type 2 diabetes mellitus due to poor blood sugar control. On the 4th day of medication, the patient developed slight abdominal distension and fatigue; on the 5th day, the patient felt nausea and general fatigue, and the color of urine became dark brown. The laboratory tests showed serum creatinine (Scr) 136 μmol/L, blood urea nitrogen (BUN) 9.7 mmol/L, urine protein (+), and urinary occult blood (++). Acute kidney injury induced by canagliflozin was considered. Canagliflozin was stopped, and acarbose 50 mg (before meal), 2 Haikun Shenxi capsules (海昆肾喜胶囊), and 3 Jinshuibao capsules (金水宝胶囊) orally thrice daily were given. After 2 days of drug withdrawal, the symptoms of nausea and fatigue disappeared, and the color of urine was normal. After 5 days of drug withdrawal, laboratory tests showed fasting blood glucose 5.6 mmol/L, Scr 112 μmol/L, BUN 8.5 mmol/L, urine protein (-), and urine occult blood (-). After 19 days of drug withdrawal, the patient′s renal function indexes were all within the normal range, and no discomfort symptoms recurred.

A 45-year-old male patient was treated with canagliflozin 100 mg once daily orally for type 2 diabetes mellitus due to poor blood sugar control. On the 4th day of medication, the patient developed slight abdominal distension and fatigue; on the 5th day, the patient felt nausea and general fatigue, and the color of urine became dark brown. The laboratory tests showed serum creatinine (Scr) 136 μmol/L, blood urea nitrogen (BUN) 9.7 mmol/L, urine protein (+), and urinary occult blood (++). Acute kidney injury induced by canagliflozin was considered. Canagliflozin was stopped, and acarbose 50 mg (before meal), 2 Haikun Shenxi capsules (海昆肾喜胶囊), and 3 Jinshuibao capsules (金水宝胶囊) orally thrice daily were given. After 2 days of drug withdrawal, the symptoms of nausea and fatigue disappeared, and the color of urine was normal. After 5 days of drug withdrawal, laboratory tests showed fasting blood glucose 5.6 mmol/L, Scr 112 μmol/L, BUN 8.5 mmol/L, urine protein (-), and urine occult blood (-). After 19 days of drug withdrawal, the patient′s renal function indexes were all within the normal range, and no discomfort symptoms recurred.