Methods: Cervical radiographs were analyzed. EOP hyperplasia was classified into three subtypes with standardized length measurements. Variables encompassed demographics, ONL-related indices, and sagittal parameters. Subtype comparisons and multivariate regression analyses (with EOP length as dependent variable) were conducted. Results: Analysis of 187 CSM patients (64.2% male) identified gender-specific patterns: males exhibited greater EOP length (9.4±6.8 mm vs. 4.6±3.4 mm, p<0.001). Type III EOP demonstrated male predominance (82.4% vs. type I 31.8%, type II 51.4%; p<0.001), with associated longer hyperplasia length (11.6±6.6 mm vs. type II 5.1±1.9 mm, p<0.001). Type III EOP was associated with higher ONL prevalence (type III 64.8% vs. type I 45.5%, type II 41.9%; p=0.010) and longer ONL osteophyte length (type III 18.8±9.8 mm vs. type I 14.2±8.1 mm, type II 14.2±9.4 mm; p=0.046). Multivariate regression confirmed male sex (β=–3.82, p=0.009), ONL osteophyte length (β=0.16, p=0.017), T1 slope (β=0.27, p=0.041), and spino-cranial angle (β=–0.19, p=0.009) as factors independently associated with EOP length (adjusted R²=0.382). Conclusions Severe EOP hyperplasia exhibits a male-predominant distribution pattern and demonstrates significant radiological associations with ONL and cervical sagittal imbalance in CSM patients. These findings advocate for EOP evaluation in clinical evaluations to identify high-risk biomechanical profiles.

Objective:To design and develop a cone-beam CT imaging system for small animals with continuously adjustable spatial resolution.Methods:The imaging system used an X-ray source with a focal spot size of 30 μm and a flat panel detector with a pixel size of 100 μm. On this premise, a " stepping-focusing-rotating" image acquisition mode was proposed, in which the " focusing" and " stepping" systems were sequentially embedded in the " rotating" system. In this acquisition mode, the X-ray source and flat panel detector were relatively stationary to form the " focusing" system. When the " stepping" system accurately transported the object to the scanning position, the " focusing" system could achieve adjustable spatial resolution by making linear motion around the object to be scanned according to different experimental requirements. Finally the " rotating" system achieve high-quality imaging.Results:The variable spatial resolution of small animal CBCT ranges from 35.7 μm to 71.4 μm, and the FOV ranges from 39.6 mm to 108.0 mm. The conversion time for the limit spatial resolution is 19.125 s, which allowed accurate 3D reconstruction of normal mice at different resolutions with high reproducibility.Conclusions:A cone-beam CT suitable for small animals has been developed, whose spatial resolution and FOV can be adjusted arbitrarily within a certain range, which can meet the different imaging requirements in rodent experiments.

Objective:To build a data platform for medical consumables,so as to improve the management efficiency for medical consumables under the mode of diagnosis related groups(DRG)for disease.Methods:Based on the framework of data platform,the data extraction and transformation,data warehousing,big data analysis,and data mining were adopted to establish a data platform that can integrate rapid data integration,retrieval and statistics,and mining applications and other functions in one for medical consumables.A total of 122409 procurement records,2301337 records of incoming and outgoing inventory,and 740833 usage records of medical consumables at Shanghai General Hospital during March 2020 and July 2024 were selected.The data platform system and conventionally manual methods were respectively used to predict the total consumption amount of medical consumables during August to October 2024.The accuracy and duration of the predictive results between the two prediction modes were compared.In the usage records of medical consumables during August and October 2024,the usage records of 80 consumables with high price in the departments of orthopedics and neurosurgery were selected,and they were set as the tested objects after they were mixed with the un-rational usage records of 20 medical consumables that were manually set.Then,the detection functions of data platform system for rational usage of medical consumables were assessed.Results:The accuracy of the procurement plan of medical consumables that was assisted by the data platform of medical consumables closed to that of the conventional manual method,with an accuracy rate of 100%.The efficiency of generating plan was significantly better than that of conventional manual method,and the difference was statistically significant(t=1.987,P<0.05).In the application of rational analysis of the usage of medical consumables,both the accuracy rate and overall rate of the check of the data platform of medical consumables for the events of un-rational using medical consumables were equal to those of conventional method.However,the detection efficiency of the data platform of medical consumables was significantly better than that of conventional manual method,and the difference was statistically significant(t=1.972,P<0.05).Conclusion:The data platform of medical consumables connects various business links in management for medical consumables,which can reduce data barriers,and accelerate the conversion efficiency of data value by establishing data update,data governance,services of data application and other methods.It promotes the transformation of medical behavior from experience-driven to data-driven,and improves the refined level of management for medical consumables.

Objective:To design and develop a cone-beam CT imaging system for small animals with continuously adjustable spatial resolution.Methods:The imaging system used an X-ray source with a focal spot size of 30 μm and a flat panel detector with a pixel size of 100 μm. On this premise, a " stepping-focusing-rotating" image acquisition mode was proposed, in which the " focusing" and " stepping" systems were sequentially embedded in the " rotating" system. In this acquisition mode, the X-ray source and flat panel detector were relatively stationary to form the " focusing" system. When the " stepping" system accurately transported the object to the scanning position, the " focusing" system could achieve adjustable spatial resolution by making linear motion around the object to be scanned according to different experimental requirements. Finally the " rotating" system achieve high-quality imaging.Results:The variable spatial resolution of small animal CBCT ranges from 35.7 μm to 71.4 μm, and the FOV ranges from 39.6 mm to 108.0 mm. The conversion time for the limit spatial resolution is 19.125 s, which allowed accurate 3D reconstruction of normal mice at different resolutions with high reproducibility.Conclusions:A cone-beam CT suitable for small animals has been developed, whose spatial resolution and FOV can be adjusted arbitrarily within a certain range, which can meet the different imaging requirements in rodent experiments.

Objective:To build a data platform for medical consumables,so as to improve the management efficiency for medical consumables under the mode of diagnosis related groups(DRG)for disease.Methods:Based on the framework of data platform,the data extraction and transformation,data warehousing,big data analysis,and data mining were adopted to establish a data platform that can integrate rapid data integration,retrieval and statistics,and mining applications and other functions in one for medical consumables.A total of 122409 procurement records,2301337 records of incoming and outgoing inventory,and 740833 usage records of medical consumables at Shanghai General Hospital during March 2020 and July 2024 were selected.The data platform system and conventionally manual methods were respectively used to predict the total consumption amount of medical consumables during August to October 2024.The accuracy and duration of the predictive results between the two prediction modes were compared.In the usage records of medical consumables during August and October 2024,the usage records of 80 consumables with high price in the departments of orthopedics and neurosurgery were selected,and they were set as the tested objects after they were mixed with the un-rational usage records of 20 medical consumables that were manually set.Then,the detection functions of data platform system for rational usage of medical consumables were assessed.Results:The accuracy of the procurement plan of medical consumables that was assisted by the data platform of medical consumables closed to that of the conventional manual method,with an accuracy rate of 100%.The efficiency of generating plan was significantly better than that of conventional manual method,and the difference was statistically significant(t=1.987,P<0.05).In the application of rational analysis of the usage of medical consumables,both the accuracy rate and overall rate of the check of the data platform of medical consumables for the events of un-rational using medical consumables were equal to those of conventional method.However,the detection efficiency of the data platform of medical consumables was significantly better than that of conventional manual method,and the difference was statistically significant(t=1.972,P<0.05).Conclusion:The data platform of medical consumables connects various business links in management for medical consumables,which can reduce data barriers,and accelerate the conversion efficiency of data value by establishing data update,data governance,services of data application and other methods.It promotes the transformation of medical behavior from experience-driven to data-driven,and improves the refined level of management for medical consumables.

Objective:To evaluate the relationship between microRNA-29a (miR-29a) and p53 up-regulated modulator of apoptosis (PUMA) in propofol-induced reduction of glucose deprivation (GD)-induced injury to human glioma cells.Methods:Human glioma U87 cells were cultured in vitro to the logarithmic growth phase. Cells were then divided into 6 groups ( n=24 each) by the random number table method: control group (group C), group GD, propofol + GD group (group P+ GD), miR-29a inhibitor group (group I), miR-29a inhibitor + GD group (group I+ GD) and miR-29a inhibitor+ propofol+ GD group (group I+ P+ GD). Cells were cultured in normal condition in group C. The culture medium was changed to glucose-free DMEM solution, and the cells were cultured for 12 h in group GD. In group P+ GD, cells were incubated with propofol 10 μmol/L for 12 h and then incubated in glucose-free DMEM solution for 12 h. In group I, group I+ GD and group I+ P+ GD, miR-29a inhibitor was transfected into cells using lipofectamine transfection kit, and then the cells were cultured for 48 h, and the other treatments were similar to those previously described in group P+ GD. The cell survival rate, mitochondrial membrane potential and level of reactive oxygen species (ROS) were determined. The expression of miR-29a was detected by quantitative real-time polymerase chain reaction, and the expression PUMA was detected by Western blot. Results:Compared with group C, the cell survival rate and mitochondrial membrane potential were significantly decreased, the level of ROS was increased, the expression of miR-29a was down-regulated, and the expression of PUMA was up-regulated in group GD and group I ( P<0.05). Compared with group GD, the cell survival rate and mitochondrial membrane potential were significantly increased, the level of ROS was decreased, the expression of miR-29a was up-regulated, and the expression of PUMA was down-regulated in group P+ GD, and the cell survival rate and mitochondrial membrane potential were significantly decreased, the level of ROS was increased, the expression of miR-29a was down-regulated, and the expression of PUMA was up-regulated in group I+ GD ( P<0.05). Compared with group P+ GD, the cell survival rate and mitochondrial membrane potential were significantly decreased, the level of ROS was increased, the expression of miR-29a was down-regulated, and the expression of PUMA was up-regulated in group I+ P+ GD ( P<0.05). Conclusions:The mechanism by which propofol reduces glucose deprivation-induced injury to human glioma cells is related to up-regulation of miR-29a expression and down-regulation of PUMA expression.

Objective:To evaluate the relationship between microRNA-29a (miR-29a) and p53 up-regulated modulator of apoptosis (PUMA) in propofol-induced reduction of glucose deprivation (GD)-induced injury to human glioma cells.Methods:Human glioma U87 cells were cultured in vitro to the logarithmic growth phase. Cells were then divided into 6 groups ( n=24 each) by the random number table method: control group (group C), group GD, propofol + GD group (group P+ GD), miR-29a inhibitor group (group I), miR-29a inhibitor + GD group (group I+ GD) and miR-29a inhibitor+ propofol+ GD group (group I+ P+ GD). Cells were cultured in normal condition in group C. The culture medium was changed to glucose-free DMEM solution, and the cells were cultured for 12 h in group GD. In group P+ GD, cells were incubated with propofol 10 μmol/L for 12 h and then incubated in glucose-free DMEM solution for 12 h. In group I, group I+ GD and group I+ P+ GD, miR-29a inhibitor was transfected into cells using lipofectamine transfection kit, and then the cells were cultured for 48 h, and the other treatments were similar to those previously described in group P+ GD. The cell survival rate, mitochondrial membrane potential and level of reactive oxygen species (ROS) were determined. The expression of miR-29a was detected by quantitative real-time polymerase chain reaction, and the expression PUMA was detected by Western blot. Results:Compared with group C, the cell survival rate and mitochondrial membrane potential were significantly decreased, the level of ROS was increased, the expression of miR-29a was down-regulated, and the expression of PUMA was up-regulated in group GD and group I ( P<0.05). Compared with group GD, the cell survival rate and mitochondrial membrane potential were significantly increased, the level of ROS was decreased, the expression of miR-29a was up-regulated, and the expression of PUMA was down-regulated in group P+ GD, and the cell survival rate and mitochondrial membrane potential were significantly decreased, the level of ROS was increased, the expression of miR-29a was down-regulated, and the expression of PUMA was up-regulated in group I+ GD ( P<0.05). Compared with group P+ GD, the cell survival rate and mitochondrial membrane potential were significantly decreased, the level of ROS was increased, the expression of miR-29a was down-regulated, and the expression of PUMA was up-regulated in group I+ P+ GD ( P<0.05). Conclusions:The mechanism by which propofol reduces glucose deprivation-induced injury to human glioma cells is related to up-regulation of miR-29a expression and down-regulation of PUMA expression.

Objective:To investigate the correlation between paraspinal muscle atrophy, morphological changes of facet joints and adjacent segment disease (ASDis) after lumbar fusion operation.Methods:A retrospective study was conducted among 195 patients who underwent posterior lumbar fusion again for ASDis at this institution from January 2014 to December 2020, including 29 patients with ASDis whose initial surgical fusion segment was L 4,5. According to Roussouly's staging, there were 5 cases of type I, 9 cases of type II, 10 cases of type III, and 5 cases of type IV. Another 29 cases were selected from patients without ASDis after lumbar fusion as a control group. The control group was paired 1∶1 with the ASDis group according to gender, fusion segment, and Roussouly typing of the lumbar spine. The cross-sectional area (CSA) and fat infiltration (FI) of paravertebral muscle, facet joint angle (F-J) and pedicle facet (P-F) angle before the first (second) operation were measured and compared between the two groups. Then logistic regression analysis was used to determine the predictors of ASDis after posterior lumbar fusion. Finally, the receiver operation characteristic (ROC) curve was described, and the area under the curve (AUC) and cut-off point were calculated. At the same time, the paraspinal muscle atrophy before the second operation in ASDis group was measured. Results:The average follow-up time of 98 patients was 59.25±6.38 months (range, 49-73 months). The average body mass index (BMI) of ASDis group was 24.76±3.64 kg/m 2, which was higher than that in control group (22.24±2.92 kg/m 2) ( t=2.481, P=0.041). The average CSA and relative cross-sectional area (rCSA) of paraspinal muscle in ASDis group were 3 214.32± 421.15 mm 2 and 1.69±0.36 respectively, which were less than 3 978.91±459.87 mm 2 and 2.26±0.29 in control group ( t=10.22, P=0.012; t=9.47, P=0.038). The FI degree of paraspinal muscle in ASDis group (21.95%±5.89%) was significantly higher than that in control group (14.64%±7.11%) ( t=7.32, P=0.002). The F-J angle in ASDis group was 35.06°±3.45°, which was less than 38.39°±4.67° in control group ( t=4.76, P=0.027). The P-F angle in ASDis group was 117.39°±8.13°, which was greater than 111.32°±4.78° in control group ( t=5.25, P=0.031). Multivariate logistic regression analysis showed that higher BMI ( OR=1.34, P=0.038), smaller rCSA of paraspinal muscle ( OR=0.02, P=0.017) and higher FI of paraspinal muscle ( OR=1.58, P=0.032) were the risk factors of postoperative ASDis. The ROC curve showed that the AUC of BMI was 0.680 and the cut-off point was 22.58 kg/m 2; The AUC of the FI of paraspinal muscle was 0.716 and the cut-off point was 15.69%; The AUC of rCSA of paraspinal muscle was 0.227 and the cut-off point was 1.92. For ASDis patients, the paraspinal muscle before the second operation had a higher degree of FI (25.47%±6.59% vs. 21.95%±5.89%, t=3.99, P=0.042) and a smaller rCSA (1.52±0.28 vs. 1.69±0.36, t=3.85, P=0.038) than that before the first operation. The difference between the FI degree of paraspinal muscle before the second operation and the first operation was negatively correlated with the occurrence time of ASDis ( r=-0.53, P=0.039) , and the difference of rCSA was positively correlated with the occurrence time of ASDis ( r=0.64, P=0.043) . Conclusion:When BMI >22.58 kg/m 2, FI of paraspinal muscle >15.69%, and rCSA of paraspinal muscle <1.92, it suggests that ASDis is more likely to occur after operation. And the more obvious paraspinal muscle atrophy after the first operation, the earlier ASDis may occur. Morphological changes of facet joints cannot be used as an index to predict the occurrence of ASDis.

Objective:To investigate the influence of interbody cage height during oblique lumbar interbody fusion (OLIF) on lumbar biomechanics with different degrees of degeneration and to provide a reference for cage choice.Methods:The finite element model of normal lower lumbar spine (L 3-S 1) was built and validated, then constructed three different degenerative segments in L 3, 4, and the cages with different height (8, 10,12, 14 mm) were implanted into L 4, 5 disc. All the twelve models were loaded with pure moment of 7.5 N·m to produce flexion, extension, lateral bending and axial rotation motions on lumbar spine, and the effects of cage height on range of motion (ROM), intervertebral pressure in adjacent segments and stress in facet joints were investigated. Results:The ROM of adjacent segments and the maximum stress of intervertebral discs increased with the increase of cage height, but this trend was not obvious in moderate and severe degeneration groups. After implantation of 4 different height cages (8, 10, 12, 14 mm), the ROM of L 3, 4 segment reached the maximum during extension. The ROM of mild degeneration group was 2.68 °, 2.71 °, 2.94 °, 2.98 °, moderate degeneration group was 2.33°, 2.37°, 2.41°, 2.49°, and severe degeneration group was 1.94 °, 1.99 °, 2.14 °, 2.21 °. The stress of L 3, 4 intervertebral disc reached the maximum during right bending. The maximum stress of L 3, 4 intervertebral disc was 23.95 MPa, 24.60 MPa, 24.90 MPa and 25.34 MPa in mild group, 25.57 MPa, 25.60 MPa, 25.82 MPa and 25.89 MPa in moderate group, and 25.95 MPa, 25.99 MPa, 26.48 MPa and 27.13 MPa in severe group. The maximum stress of L 3, 4 facet joint was 15.87 MPa, 15.78 MPa, 16.29 MPa and 16.43 MPa in mild group, 15.97 MPa, 16.31 MPa, 16.53 MPa and 16.79 MPa in moderate group, and 16.17 MPa, 16.49 MPa, 16.95 MPa and 17.35 MPa in severe group. Conclusion:For patients with mild lumbar degeneration requiring OLIF surgery, the intervertebral height of the surgical segment should not be overstretched. But for patients with moderate to severe lumbar degenerative disease who need to undergo OLIF surgery, it is recommended that the cage height be 0-2 mm higher than the original intervertebral space height.

Head and neck squamous cell carcinoma (HNSCC), as the most common type (>90%) of head and neck cancer, includes various epithelial malignancies that arise in the nasal cavity, oral cavity, pharynx, and larynx. In 2020, approximately 878 ‍ 000 new cases and 444 000 deaths linked to HNSCC occurred worldwide (Sung et al., 2021). Due to the associated frequent recurrence and metastasis, HNSCC patients have poor prognosis with a five-year survival rate of 40%-50% (Jou and Hess, 2017). Therefore, novel prognostic biomarkers need to be developed to identify high-risk HNSCC patients and improve their disease outcomes.
Biomarkers, Tumor/genetics* ; Head and Neck Neoplasms/genetics* ; Humans ; Kaplan-Meier Estimate ; RNA ; Squamous Cell Carcinoma of Head and Neck ; Survival Analysis ; Survival Rate