Objective To analyze the correlation between the poor position of pedicle screw after lumbar internal fixation and the occurrence of postoperative neurological symptoms.Methods The clinical data of patients who underwent lumbar pedicle screw surgery in our hospital from January 2017 to December 2023 were analyzed retrospectively.Record the patient's sex,age,diagnosis,surgical segment,the presence of postoperative neurological complications,the types of neurological complications.According to the postoperative CT,the screw penetration zone and grade were evaluated,and the distribution of different pedicle screw penetration types was recorded.The correlation between different types of pedicle screw penetration and postoperative neurological symptoms was analyzed.Results A total of 184 patients were included,including 80 males and 104 females.Age ranged from 18 to 82 years,with an average of 60.1±14.2 years.35 patients developed new neurological symptoms after operation.The incidence of postoperative neurological symptoms caused by pedicle medial quadrant screw penetration and lower quadrant screw penetration was higher than that of pedicle superior quadrant and lateral quadrant screw penetration.From L1 to L5,the risk of postoperative neurological symptoms caused by screw penetration in the medial quadrant of the pedicle increases gradually.When the penetration distance of pedicle medial quadrant screws in L4 and L5 segments is≥2mm,the risk of postoperative neurological symptoms is high.When the penetration distance of pedicle medial quadrant screws in L1,L2 and L3 segments is greater than 4mm,the risk of postoperative neurological symptoms is high.The distance of pedicle screw penetrating the medial quadrant of pedicle was positively correlated with the incidence of postoperative neurological symptoms(P<0.05).Conclusion The lateral and superior quadrants of the pedicle may be regarded as safety zones for lumbar pedicle screw placement.For the L1～L3 segments,screw penetration depth should not exceed 4 mm;whereas for the L4～L5 segments,the safety threshold must be strictly controlled within 2 mm.

Constipation is a common functional gastrointestinal disorder with a global prevalence of approximately 10％to 20％.Its causes include functional disorders,organic diseases,and drug factors,with the majority being functional constipation.In recent years,driven by advancements in biomedicine,artificial intelligence(AI),and microbiome research,significant progress has been made in the diagnosis and treatment of constipation.This review systematically explores the latest developments in constipation treatment,including the role of the gut microbiota in constipation,the metabolic regulatory effects of short-chain fatty acids(SCFAs),the impact of mental factors on intestinal motility.Additionally,it discusses future development directions such as AI-assisted diagnosis,AI-based consultation systems,personalized microbiota transplantation,and minimally invasive neuromodulation,providing new insights for precision medicine in constipation.

Objective To analyze the correlation between the poor position of pedicle screw after lumbar internal fixation and the occurrence of postoperative neurological symptoms.Methods The clinical data of patients who underwent lumbar pedicle screw surgery in our hospital from January 2017 to December 2023 were analyzed retrospectively.Record the patient's sex,age,diagnosis,surgical segment,the presence of postoperative neurological complications,the types of neurological complications.According to the postoperative CT,the screw penetration zone and grade were evaluated,and the distribution of different pedicle screw penetration types was recorded.The correlation between different types of pedicle screw penetration and postoperative neurological symptoms was analyzed.Results A total of 184 patients were included,including 80 males and 104 females.Age ranged from 18 to 82 years,with an average of 60.1±14.2 years.35 patients developed new neurological symptoms after operation.The incidence of postoperative neurological symptoms caused by pedicle medial quadrant screw penetration and lower quadrant screw penetration was higher than that of pedicle superior quadrant and lateral quadrant screw penetration.From L1 to L5,the risk of postoperative neurological symptoms caused by screw penetration in the medial quadrant of the pedicle increases gradually.When the penetration distance of pedicle medial quadrant screws in L4 and L5 segments is≥2mm,the risk of postoperative neurological symptoms is high.When the penetration distance of pedicle medial quadrant screws in L1,L2 and L3 segments is greater than 4mm,the risk of postoperative neurological symptoms is high.The distance of pedicle screw penetrating the medial quadrant of pedicle was positively correlated with the incidence of postoperative neurological symptoms(P<0.05).Conclusion The lateral and superior quadrants of the pedicle may be regarded as safety zones for lumbar pedicle screw placement.For the L1～L3 segments,screw penetration depth should not exceed 4 mm;whereas for the L4～L5 segments,the safety threshold must be strictly controlled within 2 mm.

Constipation is a common functional gastrointestinal disorder with a global prevalence of approximately 10％to 20％.Its causes include functional disorders,organic diseases,and drug factors,with the majority being functional constipation.In recent years,driven by advancements in biomedicine,artificial intelligence(AI),and microbiome research,significant progress has been made in the diagnosis and treatment of constipation.This review systematically explores the latest developments in constipation treatment,including the role of the gut microbiota in constipation,the metabolic regulatory effects of short-chain fatty acids(SCFAs),the impact of mental factors on intestinal motility.Additionally,it discusses future development directions such as AI-assisted diagnosis,AI-based consultation systems,personalized microbiota transplantation,and minimally invasive neuromodulation,providing new insights for precision medicine in constipation.

Background::Heterotaxy (HTX) is a thoracoabdominal organ anomaly syndrome and commonly accompanied by congenital heart disease (CHD). The aim of this study was to analyze rare copy number variations (CNVs) in a HTX/CHD cohort and to examine the potential mechanisms contributing to HTX/CHD.Methods::Chromosome microarray analysis was used to identify rare CNVs in a cohort of 120 unrelated HTX/CHD patients, and available samples from parents were used to confirm the inheritance pattern. Potential candidate genes in CNVs region were prioritized via the DECIPHER database, and PNPLA4 was identified as the leading candidate gene. To validate, we generated PNPLA4-overexpressing human induced pluripotent stem cell lines as well as pnpla4-overexpressing zebrafish model, followed by a series of transcriptomic, biochemical and cellular analyses. Results::Seventeen rare CNVs were identified in 15 of the 120 HTX/CHD patients (12.5%). Xp22.31 duplication was one of the inherited CNVs identified in this HTX/CHD cohort, and PNPLA4 in the Xp22.31 was a candidate gene associated with HTX/CHD. PNPLA4 is expressed in the lateral plate mesoderm, which is known to be critical for left/right embryonic patterning as well as cardiomyocyte differentiation, and in the neural crest cell lineage. Through a series of in vivo and in vitro analyses at the molecular and cellular levels, we revealed that the biological function of PNPLA4 is importantly involved in the primary cilia formation and function via its regulation of energy metabolism and mitochondria-mediated ATP production. Conclusions::Our findings demonstrated a significant association between CNVs and HTX/CHD. Our data strongly suggested that an increased genetic dose of PNPLA4 due to Xp22.31 duplication is a disease-causing risk factor for HTX/CHD.

In the field of ethics,issues related to brain-computer interface(BCI)technology mainly focus on physical and mental ethics,as well as social ethics,including personal privacy rights,whether a person is a person in the complete sense,the attribution of social responsibility.The population involved includes patients,doctors,and the whole social group in which patients live.In addition to analyzing physical and mental ethical risks,this paper also analyzed the potential ethical issues that may exist in the future large-scale application of BCI based on the current research status,mainly including the right of informed consent,privacy,and decision-making of physical and mental ethical risks,the responsibility attribution and fairness of social ethical risks,the responsibility ascription and equity of social ethical risk,and the question that whether the brain is the carrier of machine or the machine is the continuation of the brain in future ethical risks.Solutions have been proposed in the three levels of individual,system,and institution to provide governance recommendations for the future development of BCI.In addition,local data was obtained by collecting and summarizing relevant opinions through social research.Based on these,the future risks of BCI were introduced for the first time,and from the perspective of ethics,solutions to future problems were explored.

Objective:To assess the predictive efficacy of 18F-FDG PET/CT-based radiomics models for the mutation status of Kirsten rats sarcoma viral oncogene homolog (KRAS) in patients with non-small cell lung cancer (NSCLC). Methods:From January 2016 to January 2021, the 18F-FDG PET/CT images and KRAS testing of 258 NSCLC patients (180 males, 78 females; age: 33-91 years) in the First Affiliated Hospital of the Air Force Military Medical University were retrospectively analyzed. Patients were randomly divided into training set ( n=180) and validation set ( n=78) in the ratio of 7∶3. Tumor lesions on PET and CT images were drawn respectively, and the radiomics features of PET and CT lesions were extracted. The radiomics features were screened by least absolute shrinkage and selection operator (LASSO). CT radiomics score (RS) model, PET/CT RS model and composite models of PET/CT RS combined with screened clinical information were eventually developed. ROC curves were used to assess the predictive efficacy of these models. Results:The CT RS model included 4 radiomics features and the PET/CT RS model included 4 CT radiomics features and 8 PET radiomics features. The CT RS model and the PET/CT RS model both had significant differences in RS between KRAS mutant and wild-type patients in the training set and validation set ( z values: from -8.30 to -4.10, all P<0.001). In predicting KRAS mutations, the composite model of PET/CT RS combined with age showed AUCs of 0.879 and 0.852 in the training and validation sets respectively, which were higher than those of the CT RS model (0.813 and 0.770) and the PET/CT RS model (0.858 and 0.834). The accuracy of the composite model of PET/CT RS combined with age were 81.67%(147/180) and 79.49%(62/78) in the training set and validation set respectively, which were also higher than those of the CT RS model (75.00%(135/180) and 74.36%(58/78)) and the PET/CT RS model (78.89%(142/180) and 78.21%(61/78)). Conclusion:Models based on radiomics features can predict KRAS gene mutation status, and the composite model combining PET/CT RS and age can improve the prediction performance.

With the improvement of sanitation, the infection rate of hookworm is greatly reduced and the severe infected case is rarely reported. Combined morphological and molecular biological examinations, a severe hookworm infection patient was diagnosed in Department of Laboratorial Examination, Quanzhou First Affiliated Hospital of Fujian Medical University. The morphological methods such as direct fecal smear microscopy, saturated brine flotation and hookworm larvae culture methods were used to identify the eggs and larvae from stool samples of the patient. There were a large number of hookworm eggs in patient's stool samples, and the average count was 60 840 per gram by modified Kato method, which belonged to severe hookworm infection. Meanwhile, to distinguish the hookworm species, the semi-nested RT-PCR assay was employed to detect hookworm internal transcribed spacer series from eggs in patient's stool samples, and the result showed that the hookworm species was confirmed to be Necator americanus.
Ancylostomatoidea/genetics* ; Animals ; Feces ; Hookworm Infections/diagnosis* ; Humans ; Necator americanus/genetics* ; Polymerase Chain Reaction

Objective:To establish an early prediction model with multiple indicators to predict the risk of severe acute pancreatitis (SAP) in hyperlipidemic acute pancreatitis (HLAP).Methods:The clinical data of 92 patients with HLAP admitted to the Emergency Department of our hospital from March 2018 to February 2020 were analyzed retrospectively. Among them, 29 cases deteriorated to SAP and 63 cases did not. Univariate analysis was used to screen predictive indicators related to hyperlipidemic severe acute pancreatitis (HL-SAP), and logistic regression analysis was used to screen independent predictive indicators related to HL-SAP. Then a prediction model was established. The area under (AUC) the receiver operating curve (ROC) was used to evaluate the predictive ability of each predictive indicator and the model for HL-SAP. Bootstrap resampling technology was used to validate the predictive ability of the model.Results:Univariate analysis showed that procalcitonin, D-dimer, C-reactive protein, albumin, cholesterol and CT grade had influence on the progression of HLAP to SAP ( P<0.05). Logistic regression analysis showed that D-dimer ( OR=2.112, 95% CI: 1.022-4.366; P<0.05), CT grade ( OR=5.818, 95% CI: 2.481-13.643; P<0.01) and cholesterol ( OR=1.146, 95% CI: 1.004-1.308; P<0.05) were independent risk factor of HL-SAP. The AUC of D-dimer, CT grade, cholesterol and the model were 0.802, 0.875, 0.665 and 0.927, respectively. Internal validation of the predictive ability of the model showed that the C-index was 0.927. Conclusions:In the early phase, application of the prediction model that composes D-dimer, CT grade and cholesterol has a good predictive effect on HL-SAP.

Congenital heart disease (CHD) is the most common birth defect worldwide. Long non-coding RNAs (lncRNAs) have been implicated in many diseases. However, their involvement in CHD is not well understood. This study aimed to investigate the role of dysregulated lncRNAs in CHD. We used Gene Expression Omnibus data mining, bioinformatics analysis, and analysis of clinical tissue samples and observed that the novel lncRNA SAP30-2:1 with unknown function was significantly downregulated in damaged cardiac tissues from patients with CHD. Knockdown of lncRNA SAP30-2:1 inhibited the proliferation of human embryonic kidney and AC16 cells and decreased the expression of heart and neural crest derivatives expressed 2 (HAND2). Moreover, lncRNA SAP30-2:1 was associated with HAND2 by RNA immunoprecipitation. Overall, these results suggest that lncRNA SAP30-2:1 may be involved in heart development through affecting cell proliferation via targeting HAND2 and may thus represent a novel therapeutic target for CHD.
Basic Helix-Loop-Helix Transcription Factors ; Cell Proliferation ; Heart Defects, Congenital/genetics* ; Histone Deacetylases ; Humans ; RNA, Long Noncoding/genetics* ; Transcription Factors