Objective: To enhance the recognition of necrotizing sialometaplasia (NS) by elucidating its clinical, pathological characteristics and key diagnostic points, providing a basis for the diagnosis and treatment of the disease. Methods: This study has been reviewed and approved by the Medical Ethics Committee, and informed consent has been obtained from patients. Review the data of a patient with NS occurring at the junction of the right soft and hard palate, and comprehensively analyze its diagnostic process based on its clinical manifestations, imaging, and histopathological examination results. And review the relevant literature on the disease. Results: This study describes a 24-year-old male patient with a documented betel nut habit (2 pieces/day for >6 months), who presented with a bone-deep, irregular crateriform ulcer (3 mm × 6 mm × 5 mm) localized to the right hard-soft palate junction. Spiral CT showed a local soft tissue defect with no apparent underlying bone destruction. Histopathology demonstrated chronic inflammation of the mucosal and minor salivary gland tissues, with no evidence of malignancy. A final diagnosis of NS was established. The ulcer healed completely three weeks after initiation of local anti-inflammatory therapy. A literature review indicates that NS is a rare, benign salivary gland disorder, typically occurring at the hard-soft palate junction in middle-aged men (40-60 years). Its etiology remains unclear, but it is widely attributed to salivary lobe infarction following mechanical trauma-induced ischemia. Due to its clinical resemblance to malignancy, it is often misdiagnosed. Treatment entails local anti-inflammatory measures and meticulous wound care aimed at promoting mucosal healing. Conclusion NS is a self-limiting, benign condition that poses a significant diagnostic challenge due to its close clinical simulation of malignancy. Thus, accurate diagnosis requires a combined assessment of clinical presentation, radiological features, and pathological findings. Treatment is predicated based on a conservative strategy with an emphasis on symptomatic management.

OBJECTIVE: To analyze the effectiveness of single three-dimensional (3D)-printed microporous titanium prostheses and flap combined prostheses implantation in the treatment of large segmental infectious bone defects in limbs. METHODS: A retrospective analysis was conducted on the clinical data of 76 patients with large segmental infectious bone defects in limbs who were treated between January 2019 and February 2024 and met the selection criteria. Among them, 51 were male and 25 were female, with an age of (47.7±9.4) years. Of the 76 patients, 51 had no soft tissue defects (single prostheses group), while 25 had associated soft tissue defects (flap combined group). The single prostheses group included 28 cases of tibial bone defects, 11 cases of femoral defects, 5 cases of humeral defects, 4 cases of radial bone defects, and 3 cases of metacarpal, or carpal bone defects, with bone defect length ranging from 3.5 to 28.0 cm. The flap combined group included 3 cases of extensive dorsum of foot soft tissue defects combined with large segmental metatarsal bone defects, 19 cases of lower leg soft tissue defects combined with large segmental tibial bone defects, and 3 cases of hand and forearm soft tissue defects combined with metacarpal, carpal, or radial bone defects, with bone defect length ranging from 3.8 to 32.0 cm and soft tissue defect areas ranging from 8 cm×5 cm to 33 cm×10 cm. In the first stage, vancomycin-loaded bone cement was used to control infection, and flap repair was performed in the flap combined group. In the second stage, 3D-printed microporous titanium prostheses were implanted. Postoperative assessments were performed to evaluate infection control and bone integration, and pain release was evaluated using the visual analogue scale (VAS) score. RESULTS: All patients were followed up postoperatively, with an average follow-up time of (35.2±13.4) months. In the 61 lower limb injury patients, the time of standing, walk with crutches, and fully bear weight were (2.2±0.6), (3.9±1.1), and (5.4±1.1) months, respectively. The VAS score at 1 year postoperatively was significantly lower than preoperative one ( t=-10.678, P<0.001). At 1 year postoperatively, 69 patients (90.8%) showed no complication such as infection, fracture, prosthesis displacement, or breakage, and X-ray films indicated good integration at the prosthesis-bone interface. According to the Paley scoring system for the healing of infectious bone defects, the results were excellent in 37 cases, good in 29 cases, fair in 3 cases, and poor in 7 cases. In the single prostheses group, during the follow-up, there was 1 case each of femoral prostheses fracture, femoral infection, and tibial infection, with a treatment success rate of 94.1% (48/51). In lower limb injury patients, the time of fully bear weight was (5.0±1.0) months. In the flap combined group, during the follow-up, 1 case of tibial fixation prostheses screw fracture occurred, along with 2 cases of recurrent foot infection in diabetic patients and 1 case of tibial infection. The treatment success rate was 84.0% (21/25). The time of fully bear weight in lower limb injury patients was (5.8±1.2) months. The overall infection eradication rate for all patients was 93.4% (71/76). CONCLUSION The use of 3D-printed microporous titanium prostheses, either alone or in combination with flaps, for the treatment of large segmental infectious bone defects in the limbs results in good effectiveness with a low incidence of complications. It is a feasible strategy for the reconstruction of infectious bone defects.
Humans ; Male ; Female ; Middle Aged ; Printing, Three-Dimensional ; Titanium ; Retrospective Studies ; Surgical Flaps ; Adult ; Prosthesis Implantation/methods* ; Plastic Surgery Procedures/methods* ; Treatment Outcome ; Prostheses and Implants ; Bone Diseases, Infectious/surgery* ; Extremities/surgery* ; Prosthesis Design

Objective To develop a system for retrieving information from clinical records of Traditional Chinese Medicine(TCM)based on generative large language models(LLMs).Methods Applicational needs of the system were analyzed,and entity types to be retrieved were identified.The functions,workflows,and architecture of the system were designed by combining the automatic retrieval capabilities of LLMs with human-in-the-loop(HITL).The software was developed using such frameworks as vLLM and Node.js.Interaction of multiple commercial/open source LLMs was implemented using OpenAI-compatible interfaces.The quality of information retrieved from LLMs was enhanced by prompt engineering.Results This system supported task allocation,automatic retrieval of structured information,and manual review.To evaluate its performance,the moonshot-v1-8k model was used to retrieve clinical records of TCM before manual edition was performed.Combining large language model pre-annotation with meticulous annotator edits improved accuracy by 26.6％compared to the BERT-BiLSTM-CRF model,and enhanced extraction efficiency by 1.6-fold relative to purely manual methods.Conclusion General generative LLMs can retrieve a wide range of entity information from TCM records with high accuracy and scalability.The design and implementation of this system approach may provide a useful reference for developing other biomedical information retrieval systems.

The major histocompatibility complex(MHC)is closely related to immune regulation.MHC shows distinct genetic polymorphism,and there are also species differences in MHC restriction.The human MHC is called human leukocyte antigen(HLA),and the mouse MHC is called H-2.The construction of humanized MHC transgenic mouse models is an important strategy to overcome the differences in MHC among species and simulate the characteristics of a human immune response.MHC transgenic mice are mainly divided into MHC Ⅰ or MHC Ⅱ single-transgenic mouse models and MHC Ⅰ and MHC Ⅱ double-transgenic mouse models.The development of HLA Ⅰ transgenic mouse model went through three stages,at present,the strategy of knocking out H-2Kb and H-2Db or murine β2m is adopted to eliminate the competitive inhibition of HLA Ⅰ molecules by endogenous H-2 class Ⅰ molecules.In the construction of an HLA Ⅱtransgenic mouse model,the β strand of murine origin is knocked out and HLA Ⅱ class genes are inserted.With the optimization of construction strategies,MHC transgenic mouse models have been applied to epitope vaccine development,tumor treatment,and genetic disease-association studies,becoming a powerful tool for preclinical trials.In this paper,we summarize the relevant data on MHC transgenic mouse models,as well as the construction strategies used for MHC transgenic mouse models and their application in vaccine development and disease treatment.

Objective To analyze the current status,hotspots,and development trends of granulocyte-macrophage colony stimulating factor(GM-CSF)in immune-inflammatory response based on bibliometric analysis.Methods The Web of Science Core Collection database was utilized to retrieve relevant literatures from Jan.1,1990 to Jan.1,2024,and CiteSpace was applied to visualize and analyze the data.Results A total of 1219 GM-CSF in immunoinflammation related papers were included,and the number of publications was on the rise overall.The number of publications in the United States ranked the first in the world with 445 articles.The institution with the highest number was the University of Melbourne 25 articles.The authors tied for the first place were Jordana M and Becher B(10 articles for each),and the author with the highest citation count was Hamilton JA 128 times;the most cited journal was Journal of Immunology 986 times,and the high frequency keywords related to GM-CSF in immunoinflammation were mainly obtained on inflammation,dendritic cell,T cell,etc.The hotspots of research in recent years are focused on immunity and microglia.Conclusion The research of GM-CSF in immuno-inflammation continues to deepen,and its academic influence is gradually broadened.The future research direction lies in exploring the mechanism of GM-CSF in immunoinflammation and targeted therapy.

Metal-organic complexes have a long history of clinical application and have shown remarkable efficacy in the treatment of hypertension,skin infections and gastrointestinal diseases.In recent years,the application of metalloids in anti-bacterial infection thera-py and their mechanism of action have been widely studied.In this paper,three commonly used metallodrugs are selected as examples to review the progress and mechanism of metalloids in antibacterial applications,the research of novel metal-based drugs and the metallo-drugs with extracted components of traditional Chinese medicines and their derivatives,and to analyze the potential advantages of metallo-drugs in the field of antibacterial.

OBJECTIVE: The design and development of split memory alloy sternum bone plate are discussed, and the effect of split memory alloy sternum bone plate internal fixation in the treatment of sternal fractures are analysed. METHODS: The structure of the product is designed according to the anatomy and physiological characteristics of human bones, and the cross section shape of the product is designed according to the cross section shape of human bones. Internal fixation is effective in the treatment of sternal fracture. RESULTS: The split memory alloy sternal plate was successfully designed and developed, and all the patients with sternal fractures treated by internal fixation were clinically healed, the hospitalization and fracture healing time were significantly shortened, and no obvious complications occurred. CONCLUSIONS The application of split memory alloy sternal plate internal fixation in the treatment of sternal fracture has the advantages of small trauma, simple operation, safety, reliable fixation, good histocompatibility and less complications, and is conducive to promoting fracture healing and respiratory function improvement.
Alloys ; Bone Plates ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Sternum/surgery*

[摘 要] 目的：探讨miR-125a-5p通过调控Bcl-2相关永生基因4（Bcl-2-associated athanogene 4，BAG4）的表达抑制胃癌细胞迁移和侵袭的分子机制。方法：选用2014年1月至2015年12月兰州大学第一医院手术切除的82例胃癌组织标本及配对的癌旁组织以及人胃癌细胞系MGC803、BGC823、SGC7901、HGC27及人胃黏膜上皮细胞（GES-1），qPCR法检测胃癌组织、癌旁组织及胃癌细胞系中miR-125a-5p的表达水平。分别将miR-125a-5p mimic、miR-125a-5p inhibitor、（si-BAG4）siRNA-BAG4及阴性对照质粒转染至胃癌细胞，划痕愈合实验和Transwell侵袭实验分别检测miR-125a-5p/BAG4信号轴对胃癌细胞迁移和侵袭能力的影响。WB检测胃癌细胞中BAG4蛋白的表达。荧光素酶报告基因实验验证miR-125a-5p和BAG4之间的靶向调控关系。结果：miR-125a-5p在胃癌组织和细胞系中均低表达（均P<0.01）。miR-125a-5p的表达与患者的性别（P=0.953）、年龄（P=0.772）、肿瘤部位(P=0.867)、组织学分级（P=0.745）和肿瘤大小（P=0.088）无相关性，与胃癌患者的T分期（P=0.003）、N分期（P=0.001）、M分期（P=0.027）和TNM分期（P=0.035）显著相关，差异有统计学意义。miR-125a-5p低表达是胃癌患者总生存时间的独立危险因素。过表达miR-125a-5p显著抑制胃癌细胞的迁移和侵袭能力（均P<0.01）。敲降BAG4可逆转miR-125a-5p inhibitor对胃癌细胞迁移和侵袭能力的抑制作用。荧光素酶报告基因实验证实miR-125a-5p可与BAG4 3'非翻译区（untranslated regions，UTR）结合抑制其表达。结论：miR-125a-5p通过靶向下调BAG4的表达水平进而抑制胃癌细胞的迁移和侵袭。

Objective: To explore the influence of heat and noise exposure on the risk of hypertension in workers,and to provide evidence for prevention of hypertension in occupational population. Methods: Cluster sampling method was used to recruit 2 130 steel workers from four factories（north iron-making,long steel,cold steel and power department）of some steel company. A cross-sectional study was conducted to collect physical examination results,heat and noise exposure. Logistic regression models were used to analyze the effects of noise,heat and their interaction on hypertension. Results: Totally 1 971 valid questionnaires were collected,and the response rate was 92.54%. There were 654 workers suffering from hypertension,with a prevalence rate of 33.18%. There were 1 006 workers exposed to noise,accounting for 51.04%;and 853 workers exposed to heat,accounting for 43.28%. The prevalence rates of hypertension in workers exposed to noise and heat were higher than those in workers without the above exposure（P<0.05）. The prevalence rates of hypertension increased with the increase of age and working years（P<0.05）. The results of multivariate logistic regression analysis showed that noise（OR=1.711,95%CI：1.380-2.121）,heat（OR=1.721,95%CI：1.394-2.125）were risk factors for hypertension;the interaction between noise and heat on hypertension was not statistically significant（P>0.05）,while the interaction between noise and age（OR=1.086,95%CI：1.057-1.115）,between heat and age（OR=1.087,95%CI：1.059-1.115）both increased the risk of hypertension. Conclusion Occupational exposure to heat and noise are risk factors for hypertension. These two occupational hazards also interact with age,which can increase the risk of hypertension in workers.

Objective To explore the efficacy of the single versus combination drug therapies for benign prostatic hyperplasia(BPH) combined with overactive bladder(OAB).Methods A total of 471 outpatients with BPH and OAB meeting the inclusion/exclusion criteria were enrolled in this prospective cohort study from March 2012 to October 2015.Patients were divided into two groups:(1) the single alpha-blocker treatment group (prostate volume ＜ 30 ml),and (2) the 5 alpha reductase inhibitors(5-ARIs) plus alpha-blocker combination treatment group(prostate volume ≥ 30 ml).The 318 patients were treated with alpha blockers for 4 weeks,and then received a continuing alpha-blocker treatment for 8 weeks if IPSS score changes were less than 30％ (i.e.single alpha-blocker treatment group).And 153 patients were treated with 5-ARIs for 12 weeks,then received 5-ARIs plus alpha-blocker combination treatment for another 4 weeks(a total of 16 weeks)if IPSS score changes were less than 30 ％ (i.e.combination treatment group).The improvements of post-voiding residual(PVR),PV,maximum urinary flow rate(Qmax),international prostate symptom score(IPSS),overactive bladder symptom score (OABSS),quality of life (QOL),urine storage period symptom score (USPSS) and voiding symptom score(VSS)were compared between the two groups.Results The values of IPSS,OABSS,QOL,USPSS and VSS index in the two groups were improved after treatment as compared with pre-treatment(all P≤0.05).Patients in combination treatment group had little improvement in PVR and Qmax after treatment.The OAB symptom remission rates of BPH patients with OAB in single alpha-blocker treatment group were 70.5％ (206/292)and 78.6％ (165/210)after 4 and 12 weeks of treatment respectively.The OAB symptoms remission rates of BPH patients with OAB in combination treatment group were 54.5 ％ (64/122) and 67.1％ (53/79) after 12 and 16 weeks of treatment respectively.Conclusions Both single alpha-blocker treatment and alpha-blocker plus 5ARIs combination treatment,which identification was based on prostate volume,have good effects on BPH patients with OAB.The single alpha-blocker treatment can improve PVR and Qmax,and the alpha-blockers plus 5ARIs combination treatment can improve the prostate volume in BPH patients with OAB.