Objective To establish and test a 3-year prognosis model for elderly intertrochanteric fractures after intramedullary nail fixation.Methods A total of 205 elderly patients with intertrochoteric fracture of femur who underwent intramedullary nail fixation in our hospital from April 2019 to April 2021 were selected for observation study,followed up for 3 years after surgery,according to the Harris score,they were divided into the good group and the poor group.Univariate analysis was conducted to investigate the influencing factors of disease prognosis in the two groups 3 years after surgery.After the variables were screened by LASSO regression and cross-validation method,the independent influencing factors of the 3-year postoperative prognosis were analyzed by multi-factor Logistic regression,and the prediction model of the nomogram was built,and the model was evaluated and validated.Results Among 205 elderly patients with intertrochanteric fractures of the femur who underwent intramedullary nailing fixation,201 were followed up for 3 years.Among them,148 patients had a Harris score of ≥70 points,while 53 patients had a score of＜70 points.Univariate analysis results showed that the poor group had a higher proportion of patients with age,stroke,osteoporosis,Evans-Jensen type Ⅲ and Ⅳ fractures,poor intraoperative reduction,and a tip-apex distance of ≥ 30 mm compared to the good group,and had a lower lateral wall thickness than the good group,the difference was statistically significant(P＜0.05).LASSO regression analysis and cross-validation were used to screen variables.Multivariate Logistic regression analysis showed that stroke(OR=2.127,95％CI:1.478-3.061)and fracture Evans-Jensen classification Ⅲ(OR=1.149,95％CI:1.105-1.195)and type Ⅳ(OR=1.187,95％CI:1.143-1.233),intraoperative reduction was not good(OR=3.290,95％CI:2.319-4.668),apex distance ≥ 30 mm(OR=1.413,95％CI:1.066-1.874)was an independent associated risk factor for disease outcome 3 years after surgery,the external wall thickness(OR=0.600,95％CI:0.428-0.841)was an independent correlated risk factor for 3-year prognosis(P＜0.05).Based on the results of multiple factors,a nomogram prediction model was drawn,and the results showed that the model had certain predictive value for the disease outcome three years after surgery.The evaluation and verification results showed that when the threshold probability was 0-96％,the model had good clinical applicability and positive clinical net benefit.Conclusion Stroke,fracture Evans-Jensen classification Ⅲ and Ⅳ,poor intraoperative reduction,apical distance ≥30 mm,and lateral wall thickness are independent and relevant factors for 3-year prognosis of senile intertrochanteric fractures after intramedullary nail fixation.The establishment of a nematographic model has good predictive value for postoperative long-term prognosis and positive clinical net benefit.It can be used as an effective model to predict the long-term prognosis of postoperative disease.

Objective To explore the feasibility of video-assisted thoracoscopic surgery(VATS)in the treatment of congenital pulmonary airway malformation(CPAM)or pulmonary isolation complicated with ipsilateral mediastinal bronchogenic cyst in children.Methods From July 2019 to July 2024,VATS was carried out to treat CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cyst in 7 children.A three-hole thoracoscopic surgery via lateral thoracic approach was performed.The patients were placed in a healthy lateral position.The observation hole was located at the intersection of the subscapular line and the 5th intercostal space,and the operating hole was established according to the surgical requirements in combination with the lumboscopic diamond rule.A 5 mm trocar was used for all three holes.The pressure of CO2 pneumothorax was 4 mm Hg and the flow rate was 2 L/min,which was adjusted at any time according to the intraoperative conditions of the children.The operation was mainly designed for lung operation.The pulmonary operation was conducted firstly,and then the bronchogenic cyst was treated.If necessary,block resection was applied to avoid serious complications of trachea.Results All the operations were performed under thoracoscopy without conversion to open surgery.The operation time was 37-191 min(median,101 min).The intraoperative bleeding volume was 1-15 ml(median,5 ml).One case was not given a closed chest drainage tube placed,and the other 6 cases were placed a closed chest drainage for 1-5 d(median,3d).Postoperative pathology showed 5 cases of CPAM combined with bronchogenic cysts,including 4 cases of type 2(bronchiole type)and 1 case of type 3(bronchiole/alveolar type),and 2 cases of extralobular pulmonary isolation combined with bronchogenic cysts.All the 7 cases were followed up for 6-57 months(median,27 months),and chest CT showed no recurrence of lesions.Conclusions CPAM or pulmonary isolation may be accompanied by bronchogenic cysts.Preoperative imaging examination should correspond to surgical observation,and careful exploration should be conducted to avoid missed diagnosis.VATS is safe and feasible for treating CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cysts.

Objective To explore the feasibility of video-assisted thoracoscopic surgery(VATS)in the treatment of congenital pulmonary airway malformation(CPAM)or pulmonary isolation complicated with ipsilateral mediastinal bronchogenic cyst in children.Methods From July 2019 to July 2024,VATS was carried out to treat CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cyst in 7 children.A three-hole thoracoscopic surgery via lateral thoracic approach was performed.The patients were placed in a healthy lateral position.The observation hole was located at the intersection of the subscapular line and the 5th intercostal space,and the operating hole was established according to the surgical requirements in combination with the lumboscopic diamond rule.A 5 mm trocar was used for all three holes.The pressure of CO2 pneumothorax was 4 mm Hg and the flow rate was 2 L/min,which was adjusted at any time according to the intraoperative conditions of the children.The operation was mainly designed for lung operation.The pulmonary operation was conducted firstly,and then the bronchogenic cyst was treated.If necessary,block resection was applied to avoid serious complications of trachea.Results All the operations were performed under thoracoscopy without conversion to open surgery.The operation time was 37-191 min(median,101 min).The intraoperative bleeding volume was 1-15 ml(median,5 ml).One case was not given a closed chest drainage tube placed,and the other 6 cases were placed a closed chest drainage for 1-5 d(median,3d).Postoperative pathology showed 5 cases of CPAM combined with bronchogenic cysts,including 4 cases of type 2(bronchiole type)and 1 case of type 3(bronchiole/alveolar type),and 2 cases of extralobular pulmonary isolation combined with bronchogenic cysts.All the 7 cases were followed up for 6-57 months(median,27 months),and chest CT showed no recurrence of lesions.Conclusions CPAM or pulmonary isolation may be accompanied by bronchogenic cysts.Preoperative imaging examination should correspond to surgical observation,and careful exploration should be conducted to avoid missed diagnosis.VATS is safe and feasible for treating CPAM or pulmonary isolation with ipsilateral mediastinal bronchogenic cysts.

Parkinson's disease(PD)is one of the most common neurodegenerative disorders.Recent evidence implicates pyroptosis as one of the pathogenic mechanisms in central nervous system disorders,although its specific mechanisms remain unclear.In this study,SH-SY5Y cells were transfected with py-roptosis-related proteins GSDME full-length(GSDME-F)or GSDME-N terminal(GSDME-N)plasmids revealed that GSDME-N significantly reduced mitochondrial membrane potential(P＜0.0001).To inves-tigate the mechanism by which GSDME mediates mitochondrial dysfunction,Western blotting analysis demonstrated that transfection with GSDME-N plasmids significantly increased BAX expression and en-hanced its translocation to mitochondria in both HEK 293T and SH-SY5Y cells(P＜0.05).SH-SY5Y cells treated with varying concentrations of rotenone(ROT)exhibited GSDME cleavage,elevated BAX expression(P＜0.05),increased mitochondrial BAX aggregation(P＜0.05),and reduced mitochondrial membrane potential(P＜0.01),as confirmed by Western blotting and JC-1 staining.Concurrently,MTT assays assessing cell viability and lactate dehydrogenase(LDH)release assays indicated that ROT in-duced these processes prior to pyroptosis.Furthermore,in a ROT-induced mouse PD model,ROT trig-gered GSDME cleavage,enhanced BAX expression,caused dopaminergic neuronal damage,and induced motor deficits.In summary,this study demonstrates that GSDME-N exacerbates mitochondrial damage and increases cytotoxicity by upregulating BAX expression and facilitating its mitochondrial translocation.This study provides novel insights into the role of GSDME in PD pathogenesis and suggests potential avenues for therapeutic intervention.

Objective To establish and test a 3-year prognosis model for elderly intertrochanteric fractures after intramedullary nail fixation.Methods A total of 205 elderly patients with intertrochoteric fracture of femur who underwent intramedullary nail fixation in our hospital from April 2019 to April 2021 were selected for observation study,followed up for 3 years after surgery,according to the Harris score,they were divided into the good group and the poor group.Univariate analysis was conducted to investigate the influencing factors of disease prognosis in the two groups 3 years after surgery.After the variables were screened by LASSO regression and cross-validation method,the independent influencing factors of the 3-year postoperative prognosis were analyzed by multi-factor Logistic regression,and the prediction model of the nomogram was built,and the model was evaluated and validated.Results Among 205 elderly patients with intertrochanteric fractures of the femur who underwent intramedullary nailing fixation,201 were followed up for 3 years.Among them,148 patients had a Harris score of ≥70 points,while 53 patients had a score of＜70 points.Univariate analysis results showed that the poor group had a higher proportion of patients with age,stroke,osteoporosis,Evans-Jensen type Ⅲ and Ⅳ fractures,poor intraoperative reduction,and a tip-apex distance of ≥ 30 mm compared to the good group,and had a lower lateral wall thickness than the good group,the difference was statistically significant(P＜0.05).LASSO regression analysis and cross-validation were used to screen variables.Multivariate Logistic regression analysis showed that stroke(OR=2.127,95％CI:1.478-3.061)and fracture Evans-Jensen classification Ⅲ(OR=1.149,95％CI:1.105-1.195)and type Ⅳ(OR=1.187,95％CI:1.143-1.233),intraoperative reduction was not good(OR=3.290,95％CI:2.319-4.668),apex distance ≥ 30 mm(OR=1.413,95％CI:1.066-1.874)was an independent associated risk factor for disease outcome 3 years after surgery,the external wall thickness(OR=0.600,95％CI:0.428-0.841)was an independent correlated risk factor for 3-year prognosis(P＜0.05).Based on the results of multiple factors,a nomogram prediction model was drawn,and the results showed that the model had certain predictive value for the disease outcome three years after surgery.The evaluation and verification results showed that when the threshold probability was 0-96％,the model had good clinical applicability and positive clinical net benefit.Conclusion Stroke,fracture Evans-Jensen classification Ⅲ and Ⅳ,poor intraoperative reduction,apical distance ≥30 mm,and lateral wall thickness are independent and relevant factors for 3-year prognosis of senile intertrochanteric fractures after intramedullary nail fixation.The establishment of a nematographic model has good predictive value for postoperative long-term prognosis and positive clinical net benefit.It can be used as an effective model to predict the long-term prognosis of postoperative disease.

Objective:To explore the expression of lamin (LMN) gene in Colorectal cancer (CRC) , as well as the effects of knockdown LMNA expression in colorectal cancer cells on its migration ability and related molecular mechanisms.Methods:Paraffin-embedded specimens of tumor tissues and corresponding peritumoral tissues were collected from 37 colorectal cancer patients for the detection of LMNA protein expression. Colorectal cancer cell line SW480 was cultured in vitro and divided into Mock group (transfected MOCk-siRNA) and LMNA group (transfected LMNA-siRNA) . Real-time quantitative PCR was used to detect the LMNA mRNA content in SW480 cells of experimental group and control group. The expression levels of LMNA, Wnt and β-catenin in SW480 cells of experimental group and control group were detected by Western blotting. The migration ability of cells in each group was detected by cell scratch test. The migration ability of cells in each group were detected by transwell assay.Results:Immunohistochemical test showed that the positive rate of LMNA protein in colorectal cancer tissues was 89.19% (33/37 cases) , and the expression rate in corresponding paracancer tissues was 48.65% (18/37 cases) . The expression level of LMNA in colorectal cancer tissues was significantly higher than that in paracancer tissues ( P<0.001) . siRNA decreased the expression of LMNA protein in colorectal cancer cells SW480. The scratch healing rate was (53.71±5.34) % in the experimental group and (83.84±6.98) % in the control group. The results of Transwell experiment showed that the number of successfully migrated cells in the experimental group was 34.92±5.11, and that in the control group was 93.87±12.57. The results showed that the migration ability of SW480 cells was significantly decreased after low expression of LMNA ( P<0.01) . Western blot results showed that the relative expression level of Wnt and β-catenin in LMNA group was 0.42±0.12 and 0.22±0.11 respectively. The relative expression levels of Wnt and β-catenin in MOCK group were 1.28±0.26 and 1.14±0.21 respectively. The expression levels of P16 and Wnt and β-catenin in PC3 cells with low LMNA expression were increased ( P<0.05) , while the expressions of WNT and β-catenin were decreased (both P<0.05) . Conclusion:The expression of LMNA was significantly increased in colorectal cancer, which may be related to the malignant degree of colorectal cancer. LMNA proteins may affect the migration ability of colorectal cancer cells by regulating the Wnt/β-catenin signaling pathway.

Objective To construct and evaluate the prediction model of maternal mortality in Yunnan Province,and predict the maternal mortality rate in Yunnan Province from 2024 to 2030.Methods Based on the maternal mortality rates in Yunnan Province from 1994 to 2023,a grey prediction model and a autoregressive integrated moving average model were constructed,The models were compared using mean absolute error,mean square error and root mean square error to assess their fitting performance,and the optimal model was used to predict the maternal mortality rate in Yunnan Province from 2024 to 2030.Resuls The maternal mortality rate in Yunnan Province showed a continuous decline from 1994 to 2023(χ2=50 170.0,P<0.05).The mean absolute error,mean-square error and root mean-square error for the grey prediction model were 2.424,12.389,3.519,respectively,while for the differential autoregressive moving average model,they were 3.966,27.651,5.258,respectively.The prediction effect of the grey prediction model is superior to that of the autoregressive integrated moving average model,with a posterior difference ratio C=0.079 and a low probability error P=1,indicating a prediction accuracy of level 1.Using the grey prediction model,the maternal mortality rates for Yunnan Province from 2024 to 2030 are 10.05/100 000,9.16/100 000,8.34/100 000,7.59/100 000,691/100 000,6.30/100 000 and 5.73/100 000,respectively.Conclusion The grey prediction model has a good prediction effect on maternal mortality in Yunnan Province.It is predicted that the maternal mortality rate in Yunnan Province in 2030 can meet the control targets outlined in the"Healthy China 2030 Plan",the"Outline of Chinese Women's Development(2021-2030)"and the"Yunnan Women's Development Plan(2021-2030)".

Objective:To investigate the prevalence of and risk factors associated with Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and high-risk human papillomavirus (HPV) coinfections among patients with newly diagnosed syphilis at a hospital in Nanjing. Methods:A cross-sectional study was conducted on patients with newly diagnosed syphilis at the STD Clinic, Hospital of Dermatology, Chinese Academy of Medical Sciences in Nanjing, China from May 2023 to April 2024. Urethral, cervical or rectal swabs were collected according to the gender and types of sexual behavior of the patients. Screening tests for CT, NG and HPV infections were then performed by nucleic acid amplification testing. High-risk HPV testing was performed only in female patients. Univariate analysis was carried out to investigate risk factors associated with CT infection. The chi-square test, chi-square test with continuity correction, or Fisher's exact test was chosen based on the sample size and expected values.Results:A total of 111 newly diagnosed syphilis patients with test specimens were collected, including 71 males (64%) and 40 females (36%), and their ages ranged from 16 to 87 years; there were 82 patients with early syphilis and 29 with late latent syphilis; the number of sexual partners in the past 3 months ranged from 0 to 3. Among the 60 male patients with early syphilis, 1 (1.7%) was co-infected with NG, and 12 (20%) with CT; among the 16 men who have sex with men, 7 (43.8%) were co-infected with CT, while 5 (11.4%) of the 44 heterosexual patients were co-infected with CT, showing a significant difference in CT infection rates between the two groups ( χ2 = 5.80, P = 0.016). Among the 22 female patients with early syphilis, 1 (4.5%) was co-infected with NG, and 8 (36.4%) with CT; among the 12 female patients aged < 25 years, 8 (66.7%) were infected with CT, while none of the 7 patients aged 25-44 years or the 3 patients aged ≥ 45 years were infected with CT, showing a significant difference in CT infection rates among the 3 age groups ( P = 0.005) ; among the 16 female patients with 1 sexual partner in the past 3 months, 3 were infected with CT, while 5 were infected with CT in the 6 female patients with 2-3 sexual partners in the past 3 months, with a significant difference in CT infection rates between the two groups ( P = 0.011). Out of the 40 female patients with syphilis, 16 (40%) were co-infected with high-risk HPV; the HPV infection rates did not differ among different age groups (age groups of < 25 years, 25-44 years, ≥ 45 years: 8/14, 2/9, 6/17, respectively; P = 0.265) . Conclusion:The CT infection rate was relatively high in patients with newly diagnosed early syphilis, and a relatively high infection rate of high-risk HPV was observed in female patients with syphilis aged < 25 years.

Objective:To explore the expression of lamin (LMN) gene in Colorectal cancer (CRC) , as well as the effects of knockdown LMNA expression in colorectal cancer cells on its migration ability and related molecular mechanisms.Methods:Paraffin-embedded specimens of tumor tissues and corresponding peritumoral tissues were collected from 37 colorectal cancer patients for the detection of LMNA protein expression. Colorectal cancer cell line SW480 was cultured in vitro and divided into Mock group (transfected MOCk-siRNA) and LMNA group (transfected LMNA-siRNA) . Real-time quantitative PCR was used to detect the LMNA mRNA content in SW480 cells of experimental group and control group. The expression levels of LMNA, Wnt and β-catenin in SW480 cells of experimental group and control group were detected by Western blotting. The migration ability of cells in each group was detected by cell scratch test. The migration ability of cells in each group were detected by transwell assay.Results:Immunohistochemical test showed that the positive rate of LMNA protein in colorectal cancer tissues was 89.19% (33/37 cases) , and the expression rate in corresponding paracancer tissues was 48.65% (18/37 cases) . The expression level of LMNA in colorectal cancer tissues was significantly higher than that in paracancer tissues ( P<0.001) . siRNA decreased the expression of LMNA protein in colorectal cancer cells SW480. The scratch healing rate was (53.71±5.34) % in the experimental group and (83.84±6.98) % in the control group. The results of Transwell experiment showed that the number of successfully migrated cells in the experimental group was 34.92±5.11, and that in the control group was 93.87±12.57. The results showed that the migration ability of SW480 cells was significantly decreased after low expression of LMNA ( P<0.01) . Western blot results showed that the relative expression level of Wnt and β-catenin in LMNA group was 0.42±0.12 and 0.22±0.11 respectively. The relative expression levels of Wnt and β-catenin in MOCK group were 1.28±0.26 and 1.14±0.21 respectively. The expression levels of P16 and Wnt and β-catenin in PC3 cells with low LMNA expression were increased ( P<0.05) , while the expressions of WNT and β-catenin were decreased (both P<0.05) . Conclusion:The expression of LMNA was significantly increased in colorectal cancer, which may be related to the malignant degree of colorectal cancer. LMNA proteins may affect the migration ability of colorectal cancer cells by regulating the Wnt/β-catenin signaling pathway.

To explore the experience for diagnosis and treatment of recurrent autoimmune encephalitis with anti-myelin oligodendrocyte glycoprotein(MOG)antibody and anti-N-methyl-D-aspartate receptor(NMDAR)double-positive.Methods Clinical data of a autoimmune encephalitis patient with double-positive for MOG antibody and anti-NMDAR antibody was obtained through retrospective analysis.Results Male patient,18 years old.He presented with intermittent headaches,a single episode of loss of consciousness and a convulsion in October 2017.He experienced decreased vision in the right eye in April 2018.Brain MRI showed abnormal signals in the right temporal-occipital junction and optic nerve,with the MOG-IgG antibody positive in the serum.The symptoms improved after treatment with methylprednisolone without immunosuppressants.In October 2018,the patient had another seizure.The MOG-IgG antibodies,both in serum and CSF,were positive,and the NMDAR-IgG antibody was positive in the CSF.Brain MRI exhibited abnormal signals and peripheral enhancement in the bilateral parietal,occipital,temporal lobes,and the corpus callosum.A diagnosis of MOG antibody-associated disease(MOGAD)was confirmed.The Symptoms controlled after administration of methylprednisolone and symptomatic treatment.Follow-up MRI showed a reduction in lesion signal and disappearance of enhancement.Subsequently,Rituximab was administered sequentially in October 2018,April 2019,August 2020 and July 2021.MOG and AQP4 antibodies in serum were negative when tested in July 2021 and July 2022.Unfortunately,the patient again experienced weakness in the left limb and episodic confusion with limb convulsions in March 2023.The re-test of MOG antibodies in serum and CSF were positive again,and CSF NMDAR-IgG antibody was also positive.MRI showed abnormal signals in the right frontal-parietal cortex with gyral-like enhancement.MOGAD relapse was considered,and symptoms improved after treatment with methylprednisolone.The re-examination of brain MRI showed the disappearance of the lesions.The patient was discharged after sequential Rituximab treatment.The patient had not experienced any further recurrence until 20th June 2023.Conclusions A clinical phenotype of this case of autoimmune encephalitis with double-positive antibodies for MOG and NMDAR is thought to be MOGAD.The treatment procedure indicated that positive antibodies can turn negative after immunotherapy.However,relapse may occur after drug discontinuation.Thus,it is worth further investigating the timing of starting and stopping immunosuppressive therapy,the frequency of monitoring autoantibodies,and the guidance for restarting immunotherapy.