Objective To explore the biomechanical difference between bilateral pedicle screws fixation and unilateral pedicle screw combined with contralateral translaminar facet screw fixation under two endo-scopic approaches(interlaminar approach and transforaminal approach)through finite element analysis.Meth-ods The fusion model of simple fusion device(CAGEF model),interlaminar approach and transforaminal ap-proach models for bilateral pedicle screw fixation(BPSP model and BPSL model),and interlaminar approach and transforaminal approach for unilateral pedicle screw fixation combined with contralateral translaminar fac-et screw fixation(TLFSP model and TLFSL model)were established.The peak value of spinal displacement,maximum stress of the intervertebral fusion device,maximum stress of the internal fixation device,and maxi-mum stress of the L3 and L4 intervertebral disc of each model under six motion states:forward flexion,back-ward extension,left/right flexion,and left/right rotation were compared among the models.Results Com-pared with the CAGEF model,the peak spinal displacement and the maximum stress of the interbody fusion cage in the other four models were significantly reduced,and the values of the four fixed models were close to each other.The maximum stress of the internal fixation device in the three motion states of left flexion,left rotation,and right rotation in the BPSP model was greater than that in the BPSL model,while the maximum stress of the internal fixation device in TLFSP model was less than that in the TLFSL model only under the forward flexion motion state.Compared with the TLFSP model and TLFSL model,the maximum stress of the internal fixation devices in the BPSP model and BPSL model was greater only in the two motion states of flex-ion and extension,while which in the other four cases was smaller.Except for the maximum stress on the L3 and L4 intervertebral disc during rotation in the CAGEF model was higher than the other 4 models,the maxi-mum stress on the L3 and L4 intervertebral disc was similar in all other models under other motion states.Conclusion Under both interlaminar and foraminal approaches,the bilateral pedicle screws fixation and uni-lateral pedicle screw combined with contralateral translaminar facet screw fixation are both effective minimally invasive spinal fusion operations,and their biomechanical conditions are satisfactory.If choosing the interlami-nar approach,it is recommended to perform bilateral pedicle screw fixation,meanwhile decreasing the forward flexion and backward extension movements.Alternatively,a unilateral pedicle screw combined with contralat-eral interlaminar screw fixation can also be considered,while reducing left/right flexion movements.Howev-er,the specific treatment choice still needs to consider the patient's personalized treatment and the surgical operation ability of the clinical physician.

Objective To investigate the effect of propofol(Pro)regulating macrophage polari-zation on airway inflammatory response and Toll-like receptor 4-NOD-like receptor protein 3(TLR4-NLRP3)pathway in mice with bronchial asthma(BA).Methods Forty BA model mice were ran-domly divided into BA group,low-dose Pro(Pro-L)group,high-dose Pro(Pro-H)group,and Pro-H+lipopolysaccharide(LPS)group,with 10 mice in each group.Additionally,10 normal mice were included as control group.Lung function indicators[peak expiratory flow(PEF)and ventilation vol-ume(VE)],eosinophil(EOS),lymphocyte(LYM)and neutrophil(NEU)counts in bronchoalve-olar lavage fluid,and interleukin(IL)-4,IL-10,IL-5 and IL-13 levels were measured in each group;flow cytometry was used to detect M1 and M2 macrophage levels and the proportions of T helper(Th)1 and Th 2 cells in peripheral blood;the enzyme-linked immunosorbent assay(ELISA)was used to detect serum interferon-γ(IFN-γ)and immunoglobulin E(IgE)levels;the hematoxylin-e-osin(HE)staining was used to observe the pathological morphology of lung tissues;the Western blot was used to detect the protein expression of cleaved caspase-3,TLR4,NLRP3 and Caspase-1 in lung tissues.Results Compared with the control group,mice in the BA group showed significant lung tissue damage,decreased PEF,VE,IL-10 and M1 macrophage levels,Th1 cell proportion,and IFN-γ level,and significant increased EOS,LYM,NEU counts,IL-4,IL-5,IL-13 and M2 macrophage levels,Th2 cell proportion,IgE,cleaved caspase-3,TLR4,NLRP3,and Caspase-1 protein expression levels(P＜0.05).Compared with the BA group,mice in the Pro-L and Pro-H groups showed significant lung tissue damage,increased PEF,VE,IL-10 and M1 macrophage lev-els,Th1 cell proportion,and IFN-γ level,and significant decreased EOS,LYM,NEU counts,IL-4,IL-5,IL-13 and M2 macrophage levels,Th2 cell proportion,IgE,cleaved caspase-3,TLR4,NLRP3,and Caspase-1 protein expression levels(P＜0.05).LPS significantly attenuated the im-provement effect of Pro in BA mice(P＜0.05).Conclusion Pro may regulate macrophage polari-zation and immune response in BA mice by inhibiting the TLR4-NLRP3 signaling pathway,reducing the degree of inflammatory response,and improving lung tissue morphology and lung function.

ObjectiveTo establish a dose-effect curve for semi-automatic analysis of dicentric chromosomes(DC) based on an automatic chromosome analysis system. Methods A total of three healthy volunteers were recruited as the study subjects, and their peripheral blood was collected and stimulated by X-ray at doses of 0.00, 0.10, 0.25, 0.50, 0.75, 1.00, 2.00, 3.00, 4.00, and 5.00 Gy, with the absorbed dose rate of 1.0 Gy/min. Images of DC in the mid-stage of cell division were collected using a high-throughput automatic chromosome analysis system. The DCScore software was used to automatically analyze DC aberrations, and a dose-effect curve for semi-automatic analysis of DC was fitted after manual confirmation. The fitted dose-effect curve for semi-automatic analysis of DC was validated for accuracy using three proficiency test samples from the national quality assessment of biological dose. Results The incidence of DC increased with increasing irradiation doses in the range of 0.00-5.00 Gy (P<0.01). The dose-effect curve for the fitted semi-automatic analysis of DC was ŷ =0.000 8 (±0.000 2) +0.009 2(±0.000 9) D+0.014 2(±0.000 4) D² (R²= 0.999 8). The relative deviation between the estimated dose and the actual dose of the three test samples was about 20.00%, indicating curve applicability for biological dose estimation. Moreover, excluding the time spent on manual analysis, the semi-automatic analysis method increased the analysis efficiency by 26.0 times. Conclusion The semi-automatic analysis dose-effect curve for DC stimulated by X-ray is constructed for biological dose estimation, which can reduce the manual analysis time, and holds great potential for application in nuclear emergency response to large-scale radiation accidents.

Objective To explore the risk factors for the occurrence of hypertension in middle-aged and elderly residents in China using the Cox regression analysis model and decision tree model, and compare the differences between the two methods. Methods The 2011-2015 China Health and Retirement Longitudinal Study data were used. The study investigated the risk factors for hypertension using both a multivariate Cox regression model and a decision tree model. Results The results showed that the incidence rate of hypertension between 2011-2015 was 22.79%. Both the Cox regression model and decision tree model identified age, education level, body mass index, and diabetes as risk factors for hypertension. The Cox regression model also identified drinking status as a risk factor, while the decision tree model identified gender and marital status as additional risk factors. The area under the curve (AUC) suggested that the Cox regression model and decision tree model had comparable ability to predict hypertension. Conclusions The risk factors for hypertension include gender, age, education level, marital status, alcohol consumption, body mass index, and history of diabetes. The effectiveness of the hypertension prediction model established based on Cox regression model and decision tree model results is not different.

Objective:To discuss the effect of CD40 ligand(CD40L)on the biological behavior of the human monocytic leukemia THP-1 cells through long non-coding RNA(lncRNA)linc00239,and to clarify its potential mechanism.Methods:The linc00239 over-expression vector(pcDNA-linc00239)and interference vector(sh-linc00239)were constructed and transfected into the THP-1 cells.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the transfection efficiency.The THP-1 cells were divided into control group,vector group,pcDNA-linc00239 group,sh-linc00239 group,vector+CD40L group,pcDNA-linc00239+CD40L group,and sh-linc00239+CD40L group.RT-qPCR method was used to detect the expression levels of linc00239 in the cells in various groups;CCK-8 assay was used to detect the proliferation activities of the cells in various groups;flow cytometry was used to detect the percentages of the cells at different cell cycles and the apoptotic rates of the cells in various groups;RT-qPCR and Western blotting methods were used to to detect the expression levels of B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)mRNA and proteins in the cells in various groups;Western blotting method was used to detect the expression levels of protein kinase B(AKT)and phosphorylated AKT(p-AKT)proteins in the cells in various groups,and the ratio of p-AKT/AKT was calculated.Results:Compared with vector group,the proliferation activity of the cells and the percentage of the cells at G2 phase in pcDNA-linc00239 group were significantly increased(P<0.05 or P<0.01),the expression levels of linc00239,Bcl-2 mRNA and protein,and the ratio of p-AKT/AKT were significantly increased(P<0.05 or P<0.01),the percentage of the cells at G1 phase,apoptotic rate,and expression levels of Bax mRNA and protein in the cells were significantly decreased(P<0.05);compared with vector group,the proliferation activity of the cells and percentage of the cells at G2 phase,expression levels of linc00239,Bcl-2 mRNA and protein,and ratio of p-AKT/AKT in the cells in sh-linc00239 group and vector+CD40L group were significantly decreased(P<0.05 or P<0.01),while the percentage of the cells at G1 phase,apoptotic rate,and the expression levels of Bax mRNA and protein in the cells were significantly increased(P<0.05 or P<0.01);compared with pcDNA-linc00239 group,the proliferation activity of the cells and percentage of cells at G2 phase in pcDNA-linc00239+CD40L group were significantly decreased(P<0.05 or P<0.01),the expression levels of linc00239,Bcl-2 mRNA and protein,and ratio of p-AKT/AKT were significantly decreased(P<0.05 or P<0.01),while the percentage of cells at G1 phase,apoptotic rate,and the expression levels of Bax mRNA and protein were significantly increased(P<0.05 or P<0.01);compared with sh-linc00239 group,the proliferation activity of the cells and percentage of cells at G2 phase in sh-linc00239+CD40L group were significantly decreased(P<0.05 or P<0.01),the expression levels of linc00239,Bcl-2 mRNA and protein,and ratio of p-AKT/AKT were significantly decreased(P<0.05 or P<0.01),and the percentage of the cells at G1 phase,apoptotic rate,and expression levels of Bax mRNA and protein were significantly increased(P<0.05 or P<0.01).Conclusion:CD40L can inhibit the proliferation and cell cycle progression of the THP-1 cells through linc00239 and induce the apoptosis.

Objective:To design a novel electromagnetic ejection device for endoscopic suturing to achieve continuous deployment of suture nails.Methods:An electromagnetic ejection device and its accompanying suture nail structure were designed and a prototype was fabricated based on electromagnetic ejection principles. A finite element model of the electromagnetic ejection device was constructed to study the effects of armature-coil center distance and different driving voltages on suture nail ejection speed. An experimental platform for testing electromagnetic ejection velocity was constructed, and a high-speed camera was used to detect the ejection velocity. A platform for the suture embedding experiment was built to measure the effects of different voltages on the inserting speed of suture into the gastric wall tissue. A platform for a suture extraction force experiment was built to evaluate the extraction force of sutures embedded in tissues under different driving voltages.Results:A suture nail structure and electromagnetic ejection device were designed, and a prototype was fabricated. The ejection velocity increased and then decreased with the increase of the armature-coil center distance, and the maximum ejection velocity was 15.81 m/s at the center distance of 18 mm. At this distance, the voltage was linearly related to the ejection velocity, and the experimental values of the staple basically coincided with the simulated values. When the driving voltage was in the range of 150 to 180 V, the suture nails could successfully insert in the tissues, and the 180 V voltage group had a greater insertion depth. The extraction force of the suture nails at 120, 150, 180, and 210 V voltages were (0.49 ± 0.19), (1.14 ± 0.19), (1.23 ± 0.15), and (1.85 ± 0.31) N, respectively.Conclusions:A novel electromagnetic ejection device for endoscopic suturing is proposed that is capable of continuous firing of suture nails. This device provides a new long-distance driving method for intelligent, minimally invasive surgical instruments.

Objective:To investigate whether prophylactic use of metal clips is necessary after cold snare polypectomy (CSP) of colorectal polyps of 6-10 mm.Methods:A total of 200 patients with 6-10 mm polyps that met the criteria of cold snare resection in Chengdu Third People's Hospital from 15 February 2022 to 30 May 2022 were randomly divided into two groups: a group that received preventive metal clip treatment and an observation group. Age, gender, body mass index (BMI), Boston score, endoscopy entry time, wound size, operation time, intraoperative bleeding time, postoperative delayed bleeding rate and cost between the two groups were compared and analyzed.Results:Ninety-eight patients in the metal clip group had 122 polyps removed, and 97 patients in the observation group had 119 polyps removed. There was no significant difference in the age, gender, BMI, Boston score, endoscopy entry time or wound size between the two groups. There were significant differences in the operation time (171.03±90.78 s VS 69.81±43.26 s, t=2.266， P=0.010), intraoperative bleeding time (19.98±17.37 s VS 29.16±17.56 s, t=-2.875， P=0.006) and surgery cost (571.63±110.92 yuan VS 366.32±13.2 yuan, t=18.102， P<0.001) between the metal clip group and the observation group. There was no significant difference in the delayed bleeding incidence［0.0%（0/98）VS 1.0%（1/97）， P=0.497］between the two groups. Conclusion:For patients with continuous bleeding time <60 seconds after CSP of 6-10 mm colonic polyps, the prophylactic use of metal clips may reduce the bleeding time, but may increase the operation time and cost. Metal clips have little effect on preventing postoperative complications.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective: We previously elucidated that long non-coding RNA Promoter of CDKN1A Antisense DNA damage Activated RNA (PANDAR) as a p53-dependent oncogene to promote cisplatin resistance in ovarian cancer (OC). Intriguingly, high level of p53-independent PANDAR was found in cisplatin-resistant patients with p53 mutation. Here, our study probed the new roles and the underlying mechanisms of PANDAR in p53-mutant OC cisplatin-resistance. Methods: A2780 and A2780-DDP cells were served as OC cisplatin-sensitive and cisplatinresistant cells. HO-8910PM cells were subjected to construct chemotherapy-induced extracellular vesicles (Chemo-EVs). Transmission electron microscopy (TEM) and nanoparticle tracking analysis were employed to evaluate Chemo-EVs. Cell viability was assessed using cell counting kit-8 and colony formation assays. Cell apoptosis was assessed using Annexin V and propidium iodide staining. The relationships between PANDAR, serine and arginine-rich premRNA splicing factor 9 (SRSF9) were verified by RNA immunoprecipitation and fluorescence in situ hybridization. Tumor xenograft experiment was employed to evaluate the effects of PANDAR-Chemo-EVs on OC cisplatin-resistance in vivo. Immunofluorescent staining and immunohistochemistry were performed in tumor tissue. Results: PANDAR level increased in OC patients with p53-mutation. PANDAR efflux enacted via exosomes under cisplatin conditions. Additionally, exosomes from OC cell lines carried PANDAR, which significantly increased cell survival and chemoresistance in vitro and tumor progression and metastasis in vivo. During cisplatin-induced stress, SRSF9 was recruited to nuclear bodies by increased PANDAR and muted apoptosis in response to cisplatin. Besides, SRSF9 significantly increased the ratio of SIRT4/SIRT6 mRNA in OC. Conclusion Cisplatin-induced exosomes transfer PANDAR and lead to a rapid adaptation of OC cell survival through accumulating SRSF9 following cisplatin stress exposure.

Objective: We previously elucidated that long non-coding RNA Promoter of CDKN1A Antisense DNA damage Activated RNA (PANDAR) as a p53-dependent oncogene to promote cisplatin resistance in ovarian cancer (OC). Intriguingly, high level of p53-independent PANDAR was found in cisplatin-resistant patients with p53 mutation. Here, our study probed the new roles and the underlying mechanisms of PANDAR in p53-mutant OC cisplatin-resistance. Methods: A2780 and A2780-DDP cells were served as OC cisplatin-sensitive and cisplatinresistant cells. HO-8910PM cells were subjected to construct chemotherapy-induced extracellular vesicles (Chemo-EVs). Transmission electron microscopy (TEM) and nanoparticle tracking analysis were employed to evaluate Chemo-EVs. Cell viability was assessed using cell counting kit-8 and colony formation assays. Cell apoptosis was assessed using Annexin V and propidium iodide staining. The relationships between PANDAR, serine and arginine-rich premRNA splicing factor 9 (SRSF9) were verified by RNA immunoprecipitation and fluorescence in situ hybridization. Tumor xenograft experiment was employed to evaluate the effects of PANDAR-Chemo-EVs on OC cisplatin-resistance in vivo. Immunofluorescent staining and immunohistochemistry were performed in tumor tissue. Results: PANDAR level increased in OC patients with p53-mutation. PANDAR efflux enacted via exosomes under cisplatin conditions. Additionally, exosomes from OC cell lines carried PANDAR, which significantly increased cell survival and chemoresistance in vitro and tumor progression and metastasis in vivo. During cisplatin-induced stress, SRSF9 was recruited to nuclear bodies by increased PANDAR and muted apoptosis in response to cisplatin. Besides, SRSF9 significantly increased the ratio of SIRT4/SIRT6 mRNA in OC. Conclusion Cisplatin-induced exosomes transfer PANDAR and lead to a rapid adaptation of OC cell survival through accumulating SRSF9 following cisplatin stress exposure.