BACKGROUND:Degenerative scoliosis is defined as a condition that occurs in adulthood with a coronal cobb angle of the spine>10° accompanied by sagittal deformity and rotational subluxation,which often produces symptoms of spinal cord and nerve compression,such as lumbar pain,lower limb pain,numbness,weakness,and neurogenic claudication.The finite element method is a mechanical analysis technique for computer modelling,which can be used for spinal mechanics research by building digital models that can realistically restore the human spine model and design modifications. OBJECTIVE:To review the application of finite element method in the etiology and treatment of degenerative scoliosis. METHODS:The literature databases CNKI,PubMed,and Web of Science were searched for articles on the application of finite element method in degenerative scoliosis published before October 2023.Search terms were"finite element analysis,biomechanics,stress analysis,degenerative scoliosis,adult spinal deformity"in Chinese and English.Fifty-four papers were finally included. RESULTS AND CONCLUSION:(1)The biomechanical findings from the degenerative scoliosis model constructed using the finite element method were identical to those from the in vivo experimental studies,which proves that the finite element method has a high practical value in degenerative scoliosis.(2)The study of the etiology and treatment of degenerative scoliosis by the finite element method is conducive to the prevention of the occurrence of the scoliosis,slowing down the progress of the scoliosis,the development of a more appropriate treatment plan,the reduction of complications,and the promotion of the patients'surgical operation.(3)The finite element method has gradually evolved from a single bony structure to the inclusion of soft tissues such as muscle ligaments,and the small sample content is increasingly unable to meet the research needs.(4)The finite element method has much room for exploration in degenerative scoliosis.

Objective To investigate the factors affecting the distribution of Pomacea and project the trends in the spread of suitable distribution areas of Pomacea in 2050 and 2070 in Dali Bai Autonomous Prefecture, so as to provide insights into Pomacea control in the prefecture. Methods The longitudes and latitudes of Pomacea sampling sites were captured based on Pomacea field survey data in 12 cities (counties) of Dali Bai Autonomous Prefecture from 2023 to 2024. A total of 19 climatic factors (annual mean temperature, mean diurnal range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the warmest month, mean temperature of the coldest month, annual precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, mean temperature of the warmest quarter, and mean temperature of the coldest quarter) and representative concentration pathways (RCPs) were retrieved from the world climate database (www.worldclim.org). All climatic variables were employed to create a maximum entropy (MaxEnt) model. The predictive accuracy of the model was assessed with the area under the receiver operating characteristic (ROC) curve (AUC), and the contributions of these 19 climatic factors to the distribution of Pomacea were analyzed in Dali Bai Autonomous Prefecture using Jackknife test. In addition, the suitable distribution areas of Pomacea were predicted with the MaxEnt model in Dali Bai Autonomous Prefecture in 2024 and in 2050 and 2070 under RCP4.5. Results Data pertaining to 91 Pomacea sampling sites were captured. ROC analysis revealed the MaxEnt model had an AUC value of 0.885 ± 0.088 for predicting the suitable distribution areas of Pomacea in Dali Bai Autonomous Prefecture. Of the 19 climatic factors, the maximum temperature of the warmest month had the highest contribution to the distribution of Pomacea in Dali Bai Autonomous Prefecture, followed by mean temperature of the driest quarter, mean temperature of the wettest quarter and minimum temperature of the coldest month. The suitable distribution area of Pomacea was predicted to be 14 555.69 km² in Dali Bai Autonomous Prefecture in 2024, and would expand gradually to the southeastern part of the prefecture in the future due to climatic factors. The suitable distribution areas of Pomacea were projected to expand to 21 475.61 km² in 2050 and 25 782.52 km² in 2070 in Dali Bai Autonomous Prefecture, respectively. Conclusions Temperature is an important contributor to the distribution of Pomacea in Dali Bai Autonomous Prefecture, and the suitable distribution area of Pomacea will gradually expand to the southeastern part of the prefecture in 2050 and 2070.

As a new type of production factor that can empower the development of new quality productivity, the data element is an important engine to promote the high quality development of the industry. Traditional Chinese medicine(TCM) dispensing is the most basic work of TCM clinical pharmacy, and its quality directly affects the clinical efficacy of TCM. The integration of data elements and TCM dispensing can stimulate the innovation and vitality of the TCM dispensing industry and promote the high-quality and sustainable development of the industry. A large-scale, detailed, and systematic study on TCM dispensing was conducted. The innovative practice path of data fusion construction in the whole process of TCM dispensing was investigated by integrating the digital resources "nine full activities" of TCM dispensing, creating the digital dictionary of "TCM clinical information data elements", and exploring innovative applications of TCM dispensing driven by data and technology, so as to promote the standardized, digital, and intelligent development of TCM dispensing in medical health services. The research content of this project was successfully selected as the second batch of "Data element×" typical cases of National Data Administration in 2024, which is the only selected case in the field of TCM.
Medicine, Chinese Traditional/methods* ; Drugs, Chinese Herbal ; Humans

Nonobstructive azoospermia (NOA), one of the most severe types of male infertility, etiology often remains unclear in most cases. Therefore, this study aimed to detect four biallelic detrimental variants (0.5%) in the minichromosome maintenance domain containing 2 ( MCMDC2 ) genes in 768 NOA patients by whole-exome sequencing (WES). Hematoxylin and eosin (H&E) demonstrated that MCMDC2 deleterious variants caused meiotic arrest in three patients (c.1360G>T, c.1956G>T, and c.685C>T) and hypospermatogenesis in one patient (c.94G>T), as further confirmed through immunofluorescence (IF) staining. The single-cell RNA sequencing data indicated that MCMDC2 was substantially expressed during spermatogenesis. The variants were confirmed as deleterious and responsible for patient infertility through bioinformatics and in vitro experimental analyses. The results revealed four MCMDC2 variants related to NOA, which contributes to the current perception of the function of MCMDC2 in male fertility and presents new perspectives on the genetic etiology of NOA.
Humans ; Male ; Azoospermia/genetics* ; Meiosis/genetics* ; Spermatogenesis/genetics* ; Adult ; Exome Sequencing ; Microtubule-Associated Proteins/genetics* ; Alleles ; Infertility, Male/genetics*

OBJECTIVE: To evaluate the efficacy and safety of Shexiang Tongxin Dropping Pill (STDP) in treating stable angina patients with phlegm-heat and blood-stasis syndrome by exercise duration and metabolic equivalents. METHODS: This multicenter, randomized, double-blind, placebo-controlled clinical trial enrolled stable angina patients with phlegm-heat and blood-stasis syndrome from 22 hospitals. They were randomized 1:1 to STDP (35 mg/pill, 6 pills per day) or placebo for 56 days. The primary outcome was the exercise duration and metabolic equivalents (METs) assessed by the standard Bruce exercise treadmill test after 56 days of treatment. The secondary outcomes included the total angina symptom score, Chinese medicine (CM) symptom scores, Seattle Angina Questionnaire (SAQ) scores, changes in ST-T on electrocardiogram and adverse events (AEs). RESULTS: This trial enrolled 309 patients, including 155 and 154 in the STDP and placebo groups, respectively. STDP significantly prolonged exercise duration with an increase of 51.0 s, compared to a decrease of 12.0 s with placebo (change rate: -11.1% vs. 3.2%, P<0.01). The increase in METs was significantly greater in the STDP group than in the placebo group (change: -0.4 vs. 0.0, change rate: -5.0% vs. 0.0%, P<0.01). The improvement of total angina symptom scores (25.0% vs. 0.0%), CM symptom scores (38.7% vs. 11.8%), reduction of nitroglycerin consumption (100.0% vs. 11.3%), and all domains of SAQ, were significantly greater with STDP than placebo (all P<0.01). The changes in Q-T intervals at 28 and 56 days from baseline were similar between the two groups (both P>0.05). Twenty-five participants (16.3%) with STDP and 16 (10.5%) with placebo experienced AEs (P=0.131), with no serious AEs observed. CONCLUSION STDP could improve exercise tolerance in patients with stable angina and phlegm-heat and blood stasis syndrome, with a favorable safety profile. (Registration No. ChiCTR-IPR-15006020).
Humans ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Male ; Female ; Middle Aged ; Angina, Stable/physiopathology* ; Aged ; Syndrome ; Treatment Outcome ; Placebos ; Tablets

Objective:To study the clinical features and risk factors of prognosis of neonatal appendicitis.Methods:From January 2014 to December 2022, all infants with neonatal appendicitis and received surgery in our hospital were retrospectively analyzed.Results:A total of 6 cases were enrolled, including 1 boy and 5 girls, with gestational age 36-40 weeks, birth weight 1 990~3 300 g, age of admission 5-11 d and time from illness onset to admission 0.5-4 d. All infants had abdominal distension, combined with vomiting in 4 cases, fever in 3 cases and blood in stool in 1 case. Gastrointestinal perforation was found on preoperative abdominal X-ray in 5 cases. All 6 cases received surgery and confirmed the diagnosis of appendicitis with perforation during the surgery. Appendectomy was performed without mortality. 1 case had Amyand hernia and received high ligation of the hernia sac during operation. 1 case had meningitis and was cured after 3 weeks of antibiotic treatment. 1 case developed adhesive intestinal obstruction 3 months after surgery and underwent intestinal adhesiolysis. One case developed colonic stenosis one month after surgery. The stenotic segment of the colon was resected and primary intestinal anastomosis was performed.Conclusions:Neonatal appendicitis progresses rapidly and is difficult to diagnose. The possibility of appendicitis with perforation should be considered when preoperative abdominal X-ray suggesting pneumoperitoneum. Intraoperatively, it is necessary to pay attention to the relationship between appendiceal perforation and other lesions for comprehensive treatment, and change the surgical approach accordingly.

Objective To evaluate the value of miniprobe endoscopic ultrasound(EUS)in guiding endoscopic treatment of small-diameter(maximum diameter less than 1 cm)and low-grade(G1 grade)rectum neuroendocrine neoplasm(R-NEN),and to provide evidence and clues for its clinical application and further research.Methods The clinical data of 85 cases of low-grade(G1 grade)R-NEN with a maximum diameter of less than 1 cm who underwent endoscopic treatment in our center from January 2014 to December 2020 were retrospectively analyzed.The patients were divided into the EUS group(37 cases)and control group(48 cases)according to whether EUS was performed before endoscopic treatment.The positive rate of incision margin,the incidence of complications,the recurrence rate,the hospital stay,the cost of hospitalization and endoscopic therapy were compared between the two groups.Results The positive rate of incision margin in the EUS group was significantly lower than that in control group(P<0.05).There was no significant difference in the incidence of complications,tumor recurrence rate,hospital stay or hospital costs between the two groups(P>0.05).There was statistically significant difference in the endoscopic therapy between the two groups(P<0.05).Conclusion Evaluating the lesion depth of small-diameter and low-grade(G1 grade)R-NEN before surgery by miniprobe EUS and selecting endoscopic surgery according to its results of can significantly reduce the residual risk of resection margin tumors.

Objective: To evaluate the bone repair effect of 3D-printed magnesium (Mg)-loaded polycaprolactone (PCL) scaffolds in a rat skull defect model. Methods: PCL scaffolds mixed with Mg microparticles were prepared by using 3D printing technology, as were pure PCL scaffolds. The surface morphologies of the two scaffolds were observed by scanning electron microscopy (SEM), and the surface elemental composition was analyzed via energy dispersive spectroscopy (EDS). The physical properties of the scaffolds were characterized through contact angle measurements and an electronic universal testing machine. This study has been reviewed and approved by the Ethics Committee. A critical size defect model was established in the skull of 15 Sprague-Dawley (SD) rats, which were divided into the PCL group, PCL-Mg group, and untreated group, with 5 rats in each group. Micro-CT scanning was performed to detect and analyze skull defect healing at 4 and 8 weeks after surgery, and samples from the skull defect area and major organs of the rats were obtained for histological staining at 8 weeks after surgery. Results: The scaffolds had a pore size of (480 ± 25) μm, a fiber diameter of (300 ± 25) μm, and a porosity of approximately 66%. The PCL-Mg scaffolds contained 1.0 At% Mg, indicating successful incorporation of Mg microparticles. The contact angle of the PCL-Mg scaffolds was 68.97° ± 1.39°, indicating improved wettability compared to that of pure PCL scaffolds. Additionally, compared with that of pure PCL scaffolds, the compressive modulus of the PCL-Mg scaffolds was (57.37 ± 8.33) MPa, demonstrating enhanced strength. The PCL-Mg group exhibited the best bone formation behavior in the skull defect area compared with the control group and PCL group at 4 and 8 weeks after surgery. Moreover, quantitative parameters, such as bone volume (BV), bone volume/total volume (BV/TV), bone surface (BS), bone surface/total volume (BS/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N) and bone mineral density (BMD), of skull defects were better than those in the other groups, indicating the best bone regeneration effect. H&E, Goldner, and VG staining revealed more mineralized new bone formation in the PCL-Mg group than in the other groups, and H&E staining of the major organs revealed good biosafety of the material. Conclusion PCL-Mg scaffolds can promote the repair of bone defects and have clinical potential as a new scaffold material for the repair of maxillofacial bone defects.

Objective:To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases.Methods:In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function.Results:From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ 2=301.79, 7.87, 1614.54, P<0.05), and the lung function abnormality rate showed a downward trend year by year (χ 2trend=1516.19, P<0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ 2=61.65, 8.04, 15.22, P<0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ 2trend=6.47, 10.81, 4.72, P<0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function ( OR=0.369, 0.568, 0.546; 95% CI: 0.298-0.458, 0.367-0.879, 0.388-0.767; P<0.05) . Conclusion:Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.

Objective To explore the effect of disposable electronic soft mirror and conventional repeatable soft mirror on the renal function and prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)levels in patients with upper ureteral calculi and analyze the factors influencing recurrence after retrograde intrarenal surgery(RIRS).Methods 114 patients with upper ureteral calculi from March 2022 to March 2023 were selected and randomly divided into two groups,with 57 cases forming the observation group and 57 cases forming the control group.The observation group was administrated with RIRS via disposable electronic soft mirror,while the control group accepted RIRS via conventional repeatable soft mirror.The two groups were compared in the aspect of surgical data.Patients'serum renal function indicators[blood urea nitrogen(BUN),creatinine(Cr),cystatin C(CysC)],PGE2 and 5-HT levels were tested preoperative and postoperative 24 h.Postoperative complications and recurrence were compared between the two groups after 6 months follow-up.The patients were grouped according to whether there was recurrence or not.The medical records of recurrence group and non-recurrence group were collected,and the risk factors of recurrence were analyzed statistically.Results There was no sxtatistically significant difference between the observation group and the control group in terms of surgical time,intraoperative bleeding,one-time stone removal rate,and hospital stay(P>0.05).After operation both groups saw much higher levels of BUN,Cr,CysC,PGE2 and 5-HT than they did before the operation(P<0.05),but no significant difference in the aforementioned indicators was seen between the two groups either before or after the operation(P>0.05).The incidence of complications and recurrence rate of the observation group were 3.51%and 15.79%respectively,seeing no big difference from 12.28%and 21.05%of the control group(P>0.05).The body mass index(BMI),postoperative residual calculi and urinary tract infections in the recurrence team were remarkably higher than those in the non recurrence team(P<0.05).The results of multivariate Logistic regression analysis showed that after adjusting for confounding factors such as gender,age,course of disease,maximum diameter of calculi,number of calculi,location of calculi,and surgical method,postoperative residual calculi and postoperative urinary tract infections were independent risk factors for postoperative recurrence of upper ureteral calculi after RIRS(P<0.05).Conclusion Both disposable electronic soft endoscopy and conventional repeatable soft endoscopy can achieve satisfactory results in the treatment of upper ureteral calculi,both can impact the renal function and serum PGE2,5-HT levels in patients to a certain extent,and both present a risk of recurrence after surgery.Residual postoperative calculi and postoperative urinary tract infections are independent risk factors inducing recurrence of upper ureteral calculi after RIRS.