Objective:To investigate application of the teaching method of problem-based learning(PBL)combined with neuronavigation technique in neurosurgical teaching,so as to improve further the teaching quality.Methods:The teaching method of PBL combined with neuronavigation technique adopted the same PBL teaching approach with conventional teaching method,and the neuronavigation technique was applied to reconstruct three dimensional(3D)graphics for patients'imaging documents.The neuronavigation technique was used to display intraoperative operation process for students,and guide their operation in surgery,and conduct teaching for them.A total of 30 medical students who conducted internship at department of neurosurgery of Beijing Tiantan Hospital,Capital Medical University during January and December 2023 were selected.A random-number table method was adopted to divide them into conventional PBL teaching method group(n=15)and PBL combined with neuronavigation technique teaching method group(n=15).The students'assessment results between two teaching methods were compared when they completed internship.A self-made survey questionnaire was adopted to investigate students'satisfaction for two kinds of teaching methods.Results:The assessment results of theory,technical ability and imaging of PBL combined with neuronavigation technique teaching method group were respectively(90.27±2.66),(90.73±2.71)and(90.13±2.77),all of which were higher than those of conventional PBL teaching method,and the differences were significant(t=13.82,7.95,13.93,P<0.05).The satisfactions about case,teacher performance,auxiliary teaching tools,learning initiative,learning efficiency,the mastery of theoretical,anatomical and imaging knowledge,the mastery of operational skills,and communication and interaction in PBL combined with neuronavigation technique teaching method group were all higher than those of conventional PBL teaching method,and the differences were significant(t=10.96,5.98,6.51,4.64,3.83,4.80,6.95,7.54,9.47,5.93,P<0.05).Conclusion:The application of the teaching method that PBL combined with neuronavigation technique in the teaching of neurosurgery for medical students can improve the teaching quality of neurosurgery,and enhance the satisfaction of students for teaching method.

A 66-year-old female patient self-administered Jingyaokang capsules (a compound preparation of traditional Chinese medicines, 3 capsules thrice daily orally) due to lumbar pain. The patient developed oliguria and edema of bilateral lower limbs after 3 doses of medication on the same day. The laboratory tests showed WBC 7.3×10 9/L, neutrophil percentage 0.70, blood urea 12.7 mmol/L, blood crea- tinine 179 μmol/L, and blood uric acid 461 μmol/L. The kidney function tests 15 days ago showed no abnormalities in the patient. Acute kidney injury caused by Jingyaokang capsules was considered. The drug was stopped and symptomatic treatments including torasemide and maintenance of fluid balance were given. The patient′s urine output gradually increased. Five days later, the patient′s edema of bilateral lower limbs disappeared, and her blood urea and creatinine decreased to normal range. The acute kidney injury in the patient may be related to strychni semen component in the Jingyaokang capsules.

A 66-year-old female patient self-administered Jingyaokang capsules (a compound preparation of traditional Chinese medicines, 3 capsules thrice daily orally) due to lumbar pain. The patient developed oliguria and edema of bilateral lower limbs after 3 doses of medication on the same day. The laboratory tests showed WBC 7.3×10 9/L, neutrophil percentage 0.70, blood urea 12.7 mmol/L, blood crea- tinine 179 μmol/L, and blood uric acid 461 μmol/L. The kidney function tests 15 days ago showed no abnormalities in the patient. Acute kidney injury caused by Jingyaokang capsules was considered. The drug was stopped and symptomatic treatments including torasemide and maintenance of fluid balance were given. The patient′s urine output gradually increased. Five days later, the patient′s edema of bilateral lower limbs disappeared, and her blood urea and creatinine decreased to normal range. The acute kidney injury in the patient may be related to strychni semen component in the Jingyaokang capsules.

Objective:To investigate application of the teaching method of problem-based learning(PBL)combined with neuronavigation technique in neurosurgical teaching,so as to improve further the teaching quality.Methods:The teaching method of PBL combined with neuronavigation technique adopted the same PBL teaching approach with conventional teaching method,and the neuronavigation technique was applied to reconstruct three dimensional(3D)graphics for patients'imaging documents.The neuronavigation technique was used to display intraoperative operation process for students,and guide their operation in surgery,and conduct teaching for them.A total of 30 medical students who conducted internship at department of neurosurgery of Beijing Tiantan Hospital,Capital Medical University during January and December 2023 were selected.A random-number table method was adopted to divide them into conventional PBL teaching method group(n=15)and PBL combined with neuronavigation technique teaching method group(n=15).The students'assessment results between two teaching methods were compared when they completed internship.A self-made survey questionnaire was adopted to investigate students'satisfaction for two kinds of teaching methods.Results:The assessment results of theory,technical ability and imaging of PBL combined with neuronavigation technique teaching method group were respectively(90.27±2.66),(90.73±2.71)and(90.13±2.77),all of which were higher than those of conventional PBL teaching method,and the differences were significant(t=13.82,7.95,13.93,P<0.05).The satisfactions about case,teacher performance,auxiliary teaching tools,learning initiative,learning efficiency,the mastery of theoretical,anatomical and imaging knowledge,the mastery of operational skills,and communication and interaction in PBL combined with neuronavigation technique teaching method group were all higher than those of conventional PBL teaching method,and the differences were significant(t=10.96,5.98,6.51,4.64,3.83,4.80,6.95,7.54,9.47,5.93,P<0.05).Conclusion:The application of the teaching method that PBL combined with neuronavigation technique in the teaching of neurosurgery for medical students can improve the teaching quality of neurosurgery,and enhance the satisfaction of students for teaching method.

Developmental dysplasia of the hip (DDH) is a developmental disease with abnormal position and morphology of the acetabulum and femoral head. DDH ranges from mild dysplasia to complete dislocation, including simple acetabular dysplasia, subluxation, and total dislocation. DDH is one of the most common hip diseases in children, and its onset begins in infancy. The anatomical structure of the hip joint is complex, and there are some practical problems in the large -scale clinical diagnosis and screening work, such as heavy workload, high misdiagnosis rate and missed diagnosis rate, and a long learning period of surgery. Artificial intelligence (AI) is an emerging technology science used to research and develop theories, methods, technologies and application systems that can simulate human intelligence. The main goal is to enable machines to complete complex tasks that require human intelligence. At present, artificial intelligence is mainly used in the diagnosis and treatment of DDH. Artificial intelligence combined with X-ray or ultrasound is used to diagnose and screen DDH, which avoids subjectivity to a certain extent and improves the accuracy of diagnosis and screening. In the preoperative planning of periacetabular osteotomy and total hip arthroplasty, it can more accurately track the position of the bone block and design the size of the prosthesis, which makes the surgical planning more accurate to a certain extent. Artificial intelligence technologies such as 3D navigation system, surgical robot and robotic arm are helpful to improve the accuracy and safety of surgery. Artificial intelligence has the characteristics of simplicity, speed, high repeatability and deep learning ability, which to a certain extent saves manpower, material resources and time costs for DDH diagnosis and treatment, facilitates medical workers to share DDH diagnosis and treatment experience and reduces the burden of patients, families, society and the country. The application of artificial intelligence in DDH diagnosis and treatment is becoming more and more extensive, but at present, artificial intelligence in DDH screening is still in its preliminary stage. There are few reports on artificial intelligence technology in DDH hip preservation treatment and other surgical methods, and there is insufficient research on artificial intelligence in DDH conservative treatment, postoperative complications and prognosis prediction. It is worth exploring new ideas by researchers. At present, the application of artificial intelligence in DDH still has certain limitations, including problems such as difficult to control the quality of image data, difficult to develop and promote technology, and lack of laws and regulations. Based on the literature database and relevant data sharing network, this paper reviews the application of artificial intelligence in the diagnosis and treatment of DDH at home and abroad in recent years, summarizes the current application status of artificial intelligence in the diagnosis and treatment of DDH, and provides new ideas for the future application of artificial intelligence in the diagnosis and treatment of DDH.

Objective: To investigate the effect and possible mechanism of berberine (Ber) on myocardial injury induced by exhaustion exercise (Ee). Methods: Forty healthy male SPF Sprague-Dawley rats were randomly divided into 5 groups using the random unit group design method: control group, Ee group and Ee plus Ber group (low: 50 mg·kg^-1·d^-1, medium: 100 mg·kg^-1·d^-1 and high dose: 150 mg·kg^-1·d^-1, n=8 each). Ber (1.5 ml) or equal volume saline was given per gavage for 14 days. Rats assigned to Ee groups underwent Ee swimming once daily and rats in control group remain sedentary. After 14 days, echocardiographic measurements were performed and left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), left ventricular diastolic diameter (LVIDd) and left ventricular systolic diameter (LVIDs) were obtained. The morphological structure of heart was detected by HE and Masson staining. Serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by enzyme-linked immunosorbent assay. Cardiomyocytes apoptosis was detected by TUNEL method. The protein expression of myocardial hypertrophy marker protein B-type natriuretic peptide (BNP) and apoptotic marker protein (Bcl-2, Bax) in rat myocardial tissue was detected by Western blot. Results: (1) Both LVFS and LVEF were significantly lower, and LVIDs and LVIDd were significantly larger in Ee group than those in control group (all P<0.01). The LVFS and LVEF in medium dose of Ber and high-dose Ber groups were significantly higher, and the LVIDs and LVIDd were significantly smaller than those in Ee group (all P<0.01). (2) The results of HE staining showed that the myocardial cells in control group were closely arranged, regular, normal in morphology, clear in structure, and uniform in staining. The myocardial cells of rats in Ee group were disarranged, cell staining was uneven, and vacuoles appeared in the cytoplasm. The disorder of myocardial cell arrangement and unequal staining in the medium dose of Ber were attenuated than in Ee group. The Masson staining results showed that the myocardial cells in control group were closely arranged, regular, normal in shape, clear in structure, and rarely blue-stained (fibrosis). Myocardial cells in rats in Ee group showed obvious fibrosis. The myocardial cell fibrosis in rats with medium dose of Ber was significantly reduced than exercise group. (3) MDA content in myocardial tissue of rats in Ee group was significantly higher than that of control group, and MDA content in myocardial tissue of rats in medium dose of Ber group was significantly lower than in Ee group (P<0.01). The SOD activity of myocardial tissue in rats was significantly lower than that of control group, while that of rats with medium dose of Ber was significantly higher than that of rats in Ee group (P<0.01). (4) TUNEL staining results showed that only a small amount of apoptosis myocardial cells were seen in control group, and a large number of apoptosis myocardial cells were seen in rats in Ee group. However, the number of apoptotic cardiomyocytes in medium dose of Ber was significantly lower than that in Ee group. The AI of rat cardiomyocytes was significantly higher than that of control group (P<0.01), and the AI of rat cardiomyocytes in median dose of Ber group was significantly lower than in Ee group (P<0.01). (5) BNP and Bax protein expression in the myocardial tissues of rats in Ee group were significantly higher than in control group (P<0.01). BNP and Bax protein expression in the myocardial tissues in median dose of Ber group were significantly lower than that of Ee group (P<0.01). The myocardial protein expression level of Bax was significantly higher, and the myocardial protein level of Bcl-2 was significantly lower in Ee group than in control group (both P<0.01), treatment with median dose of Ber could partly reverse above changes (both P<0.01). Conclusion Ber can attenuate exhaustion exercise induced myocardial injury and remodeling in rats, and the beneficial effects of Ber might possibly be mediated by reducing free radical release and cardiomyocytes apoptosis.

Objective To explore the protective effect and mechanism of swimming rehabilitation training on learning and memory impairment of cerebral ischemia reperfusion gerbil. Methods Forty adult healthy male gerbils were randomly divided into sham group,sham+swimming group (Sham+S group),cere-bral ischemia / reperfusion group ( I/R group), cerebral ischemia/reperfusion+swimming group ( I/R+S group),with 10 rats in each group. The gerbil models of cerebral ischemia/reperfusion in I/R group and I/R+S group were established by blocking bilateral common carotid artery,while for gerbils in Sham group and Sham+S group, only bilateral common carotid arteries of gerbils were exposed, but no arteries were clamped. Morris water maze was used to detect the changes of learning and memory function in rats. Oxida- tive stress injury in hippocampal neurons was detected by detection kit analysis. And the expression of Bax, Bcl-2 and CaMK Ⅱ protein in hippocampal tissue was detected by Western blot. Results Compared with Sham group,the gerbils in I/R group had longer positioning cruise time and less shuttle times ( both P<0. 01). Compared with I/R group,the positioning cruise time and shuttle times in I/R+S group were signifi-cantly shortened and increased respectively (both P<0. 01). Compared with sham group( SOD:(123. 13± 7. 50)U/mg,GSH:(42. 10±2. 17) μg/g,GSH-Px:(61. 37±2. 51) μg/g,MDA:( 2. 91± 0. 23) nmol/mg), the activities of SOD,GSH,GSH-Px in I/R group decreased significantly,while the content of MDA increased significantly(SOD:(75. 50±6. 96)U/mg,GSH:(22. 50±1. 64) μg/g,GSH-Px:(33. 15±2. 04)μg/g,MDA:(5. 96±0. 32)nmol/mg;all P<0. 01). Furthermore,compared with I/R group,the above indexes in I/R+S group were significantly reversed(SOD:(110. 30±5. 90)U/mg,GSH:(34. 31±1. 73)μg/g,GSH-Px:(50. 13 ±2. 31)μg/g,MDA:(3. 57±0. 29) nmol/mg;all P<0. 01). Compared with Sham group,the expression of Bax protein in hippocampus of gerbils in I/R group was increased,while the expression of Bcl-2 protein and p-CaMK Ⅱ protein was decreased (all P<0. 05). Compared with I/R group,the expression of Bax protein in hippocampus of gerbils in I/R+S group was decreased,while the expression of Bcl-2 protein and p-CaMK Ⅱprotein was increased (all P<0. 05). Conclusion Swimming rehabilitation training can improve learning and memory impairment of gerbils after ischemia-reperfusion through anti-oxidative stress and anti-apoptosis, which may be related to CaMK Ⅱ signaling system.

Objective To investigate the effect and possible mechanism of berberine (Ber) on myocardial injury induced by exhaustion exercise (Ee).Methods Forty healthy male SPF Sprague?Dawley rats were randomly divided into 5 groups using the random unit group design method: control group, Ee group and Ee plus Ber group (low: 50 mg·kg-1·d-1, medium: 100 mg·kg-1·d-1 and high dose: 150 mg·kg-1·d-1, n=8 each). Ber (1.5 ml) or equal volume saline was given per gavage for 14 days. Rats assigned to Ee groups underwent Ee swimming once daily and rats in control group remain sedentary. After 14 days, echocardiographic measurements were performed and left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), left ventricular diastolic diameter (LVIDd) and left ventricular systolic diameter (LVIDs) were obtained. The morphological structure of heart was detected by HE and Masson staining. Serum superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by enzyme?linked immunosorbent assay. Cardiomyocytes apoptosis was detected by TUNEL method. The protein expression of myocardial hypertrophy marker protein B?type natriuretic peptide (BNP) and apoptotic marker protein (Bcl?2, Bax) in rat myocardial tissue was detected by Western blot. Results (1) Both LVFS and LVEF were significantly lower, and LVIDs and LVIDd were significantly larger in Ee group than those in control group (all P<0.01). The LVFS and LVEF in medium dose of Ber and high?dose Ber groups were significantly higher, and the LVIDs and LVIDd were significantly smaller than those in Ee group (all P<0.01). (2) The results of HE staining showed that the myocardial cells in control group were closely arranged, regular, normal in morphology, clear in structure, and uniform in staining. The myocardial cells of rats in Ee group were disarranged, cell staining was uneven, and vacuoles appeared in the cytoplasm. The disorder of myocardial cell arrangement and unequal staining in the medium dose of Ber were attenuated than in Ee group. The Masson staining results showed that the myocardial cells in control group were closely arranged, regular, normal in shape, clear in structure, and rarely blue?stained (fibrosis). Myocardial cells in rats in Ee group showed obvious fibrosis. The myocardial cell fibrosis in rats with medium dose of Ber was significantly reduced than exercise group. (3) MDA content in myocardial tissue of rats in Ee group was significantly higher than that of control group, and MDA content in myocardial tissue of rats in medium dose of Ber group was significantly lower than in Ee group (P<0.01). The SOD activity of myocardial tissue in rats was significantly lower than that of control group, while that of rats with medium dose of Ber was significantly higher than that of rats in Ee group (P<0.01). (4) TUNEL staining results showed that only a small amount of apoptosis myocardial cells were seen in control group, and a large number of apoptosis myocardial cells were seen in rats in Ee group. However, the number of apoptotic cardiomyocytes in medium dose of Ber was significantly lower than that in Ee group. The AI of rat cardiomyocytes was significantly higher than that of control group (P<0.01), and the AI of rat cardiomyocytes in median dose of Ber group was significantly lower than in Ee group (P<0.01). (5) BNP and Bax protein expression in the myocardial tissues of rats in Ee group were significantly higher than in control group (P<0.01). BNP and Bax protein expression in the myocardial tissues in median dose of Ber group were significantly lower than that of Ee group (P<0.01). The myocardial protein expression level of Bax was significantly higher, and the myocardial protein level of Bcl?2 was significantly lower in Ee group than in control group (both P<0.01), treatment with median dose of Ber could partly reverse above changes(both P<0.01). Conclusion Ber can attenuate exhaustion exercise induced myocardial injury and remodeling in rats, and the beneficial effects of Ber might possibly be mediated by reducing free radical release and cardiomyocytes apoptosis.

Objective To explore the effect of lncRNA of growth arrest-specific 5 (lncRNA GAS5) on the radiosensitivity of colon cancer cells by targeting miR-223.Methods The expressions of lncRNA GAS5 in a few of colon cancer cell lines were detected by real-time quantitative PCR (qPCR).The cell lines with low expression level of lncRNA GAS5 were selected for subsequent study.The effect of overexpression of lncRNA GAS5 on the radiosensitivity of colon cancer SW480 cells was detected by cell cloning experiments.The target gene miR-223 of lncRNA GAS5 was predicted and validated by the bioinformatics database starBase and dual luciferase reporter assays.qPCR was used to detect the expression of miR-223 in various colon cancer cell lines and the influence of lncRNA GAS5 overexpression on the expression of miR-223 in SW480 cells.Results Compared with normal human colonic epithelial cells (NCM460),the expressions of lncRNA GAS5 in the colon cancer SW480,LOVO,HT-29 and SW620 cell lines were significantly lower(t =15.25,8.69,14.42,11.62,P ＜ 0.05),with the lowest level in SW480 cells.Both overexpression of lncRNA GAS5 and down-regulation of miR-223 significantly increased the radiosensitivity of colon cancer cells by decreasing cell survival fraction (at 8 Gy,lncRNA GAS5,t =13.51,P ＜ 0.05;anti-miR-223,t =14.93,P ＜ 0.05)and promoting apoptosis (lncRNA GAS5,t =8.30,P ＜ 0.05;anti-miR-223,t =7.32,P ＜ 0.05).Bioinformatics analysis showed that the 3'sequence of lncRNA GAS5 contained the binding sites with miR-223.After overexpression or downregulation of lncRNA GAS5,the expression of miR-223 was enhanced or reduced.Conclusions The lncRNA GAS5 promotes the apoptosis of colon cancer cells and inhibits its survival by targeting miR-223 expression,thereby increases the radiosensitivity of colon cancer cells.

Objective To study the effect of treadmill exercise on spatial learning and memory of autism rats and its possible mechanism.Methods Ten normal wistar rats were chosen as control group,and autism-like animal models were induced in other 20 rats by intraperitoneal injection of 600 mg/kg valproate acid (VPA);the autism models were randomly divided into vehicle group and training group (n=10).The rats in the training group were forced to run on a treadmill for 30 min once a d for 28 consecutive d,while rats in vehicle group and control group were housed on static treadmill only.Then,learning and memory capabilities of all rats were tested by Morris water maze test.Superoxide dismutase (SOD) and catalase (CAT) activities and methylene dioxyamphetamine (MDA) content of the hippocampus tissues were subsequently detected by ELISA Kits.Brain-derived neurotrophic factor (BDNF),phosphorylate (p)-protein kinase (Akt),B-cell lymphoma-2 (Bcl-2),and Bcl-2 associated X protein (Bax) expressions in the hippocampus CA1 were detected by Western blotting.Nissl staining and NeuN immunohistochemistry were utilized to observe the number of normal and mature neurons.Results (1) As compared with rats in the vehicle group,the rats in the training group had significantly shortened escape latency and increased times of passing through the platform (P＜0.05).(2) Nissl staining indicated that as compared with the rats in the vehicle group,the rats in the training group had significantly smaller number of apoptotic neurons in CA1 area of the hippocampus (P＜0.05).(3) NeuN immunohistochemistry showed that number of NeuN positive cells of the vehicle control group was significantly smaller than that of the control group,while that of the training group was significantly larger than that of the vehicle group (P＜0.05).(4) Western blotting showed that MDA content significantly decreased,glutathione content significantly increased,and SOD and glutathion peroxidase activities significantly enhanced in the training group as compared with those in the vehicle group (P＜0.05);The expressions of Bcl-2,BDNF,p-Akt/Akt,p-calmodulin-dependent kinase Ⅱa (CaMKⅡ)/CaMKⅡ and pcAMP-response element binding protein(CREB)/CREB were significant up-regulated,and caspase-3 and Bax expressions were significant down-regulated in the training group as compared with those in th evehicle group (P＜0.05).Conclusion The treadmill exercise may improve the spatial learning and memory abilities of autism rats;treadmill exercise strengthens the brain antioxidant ability and plays a neuroprotective role in hippocampal neuronal cells.