Objective To analyze the differences in bone serum protein between patients with osteoporosis accompanied by obstructive sleep apnea syndrome(OSAS)and those with osteoporosis only using proteomics.Methods A total of 80 osteoporosis patients who attended our hospital between June 2022 and June 2024 were enrolled.Based on their polysomnography results,the participants were divided into an OSAS and osteoporosis comorbidity(OSAS-osteoporosis)group(n=42)and an osteoporosis only group(n=38).Propensity score matching was applied to incorporate covariates in logistic regression so that the individual characteristics of the two groups of patients were generally balanced.Following the matching procedure,a final cohort of 20 matched pairs was obtained and subsequently utilized for further analysis.The mass spectrum was obtained using laser desorption ionization mass spectrometry.Principal component analysis(PCA)was performed to assess differences in metabolic patterns between groups.Partial least squares discriminant analysis(PLS-DA)and orthogonal PLS-DA(OPLS-DA)were employed for further data analysis.Variable importance in projection(VIP)scores of each substance were calculated with OPLS-DA to screen the metabolites showing inter-group differences.Heatmaps were generated to visualize metabolic profile differences between the OSAS-osteoporosis group and the osteoporosis group.Enrichment pathway analysis was conducted on the differential identified metabolites.Results After propensity score matching,individual characteristics between the groups were well balanced.Mass spectrometry revealed significant differences between the OSAS-osteoporosis and osteoporosis groups.In the PCA score plot,the separation trend of the two groups was not significant.The PLS-DA score plot showed a discernible separation trend,with R2 and Q2 lower than those of the corresponding results of the real model,confirming the reliability of the model.OPLS-DA showed that the total R2X of the model was 0.635,R2Y was 0.879,and O2Y was 0.728,showing obvious separation trends between the two groups.A total of 16 differential metabolites were identified,including stearyl-oleyl-glycerol phosphate choline,phosphate choline,L-histidine,erucamide,2'-deoxyuridine,1-palmitoyl glycerol,thymine,tyramine,L-pyroglutamic acid,L-glutamic acid,myristate,glycerol-3-phosphate,caprylic acid,pregnenolone,L-arginine,D-4-hydroxyphenylglycine,and isobutyric acid.Heatmaps showed significant differences in metabolic profiles between the OSAS-osteoporosis group and the osteoporosis group.Pathway enrichment analysis showed that 27 metabolic pathways were involved.27 metabolic pathways.Under the conditions of P<0.05 and pathway impact>0.2,the three most significant metabolic pathways identified included mainly alanine,aspartate,and glutamate metabolism,arginine biosynthesis,and histidine metabolism.Conclusion Significant differences were observed in the metabolic profiles between patients with both OSAS and osteoporosis and those with osteoporosis alone.

With the performance improvement of the medical electronics and the progress of social development,the utilization rate of implantable medical electronic devices in China shows an increasing trend in recent years,and will maintain a growing trend in the future as population aging is accelerating.Even though implantable medical electronic devices have extremely low failure rates,the explicit clinical accidents caused by their reliability issues deserve sufficient attention in consideration of the large quantity of patients.Compared with other countries,there is lack of domestic researches on application risk of implantable medical electronic devices due to radiation therapy and diagnosis,which is reflected in not only the clinical research,but also the researches on the underlying physical damage mechanism and macro performance of the devices.Therefore,it is crucial and urgent to explore the application risk of implantable medical electronic devices caused by radiation therapy and diagnosis,which has high clinical and scientific significance.The study conducts a literature survey on the risks of medical electronic devices in the radiation environment generated by clinical treatment,summarizes the risks encountered in the aspects of total dose effect,electromagnetic compatibility and instantaneous effect,analyzes the above behaviors from the physical mechanism and perspective,and puts forward some meaningful suggestions for medical electronic engineering and clinical treatment.

With the performance improvement of the medical electronics and the progress of social development,the utilization rate of implantable medical electronic devices in China shows an increasing trend in recent years,and will maintain a growing trend in the future as population aging is accelerating.Even though implantable medical electronic devices have extremely low failure rates,the explicit clinical accidents caused by their reliability issues deserve sufficient attention in consideration of the large quantity of patients.Compared with other countries,there is lack of domestic researches on application risk of implantable medical electronic devices due to radiation therapy and diagnosis,which is reflected in not only the clinical research,but also the researches on the underlying physical damage mechanism and macro performance of the devices.Therefore,it is crucial and urgent to explore the application risk of implantable medical electronic devices caused by radiation therapy and diagnosis,which has high clinical and scientific significance.The study conducts a literature survey on the risks of medical electronic devices in the radiation environment generated by clinical treatment,summarizes the risks encountered in the aspects of total dose effect,electromagnetic compatibility and instantaneous effect,analyzes the above behaviors from the physical mechanism and perspective,and puts forward some meaningful suggestions for medical electronic engineering and clinical treatment.

OBJECTIVE To study the toxicity of the extract from Mi ao medicine Wikstroemia indica to zebrafish . METHODS Zebrafish embryo model was used as the object ，after exposure to W. indica extract （10，20，40 μg/mL），the number of spontaneous twitching within 1 min，heart rate within 10 s，the occurrence of malformation and death were detected and recorded . Zebrafish was used as the object ，after exposure to W. indica extract（10-100 μg/mL）for 24，48 and 72 h，and the median lethal concentration（LC50）of W. indica extract to zebrafish at different time points were calculated . After exposure to low ，medium and high concentration （27，37，51 μg/mL）of W. indica extract，the liver phenotype ，hepatocyte apoptosis and lipid deposition of zebrafish were observed ，and the activities of alanine aminotransferase （ALT），aspartate aminotransferase （AST）and lactate dehydrogenase（LDH）in liver tissue were detected . RESULTS Compared with blank group ，the number of spontaneous twitching ， malformation rate （except for 10 μg/mL group ）and mortality of embryos increased significantly in 10，20，40 μg/mL groups of W. indica extract，and the heart rate （except for 10，20 μg/mL group ）of embryos decreased significantly （P＜0.05）. LC50 of W. indica extract to zebrafish at 24，48 and 72 h were 39.850，28.300 and 21.490 μg/mL，respectively. After drug treatment ，the transparency of liver area of zebrafish in low ，medium and high concentration groups of W. indica extract reduced and their shape were enlarged；apoptosis and lipid deposition increased ；the activities of ALT ，AST and LDH in liver tissue were significantly increased （P＜0.05）. CONCLUSIONS Miao medicine W. indica extract had develop mental toxicity to zebrafish embryos and he patotoxicity to zebrafish .

OBJECTIVE：To investigate the “dose-effect-toxicity”correlation of Miao medicine Wikstroemia indica before and after processed on anti-immnue inflammation of mice . METHODS ：Mice were divided into blank group ，model group ，ethanol extract of W. indica raw product groups 1-6，ethanol extract of W. indica processed product by “sweat soaking method ”groups 1-6 （hereinafter called “raw groups 1-6”“processed groups 1-6”for short ，drug dosage were 0.13，0.20，0.26，0.52，1.04，2.6 g/kg）， positive group （cyclophosphamide，36.4 mg/kg），with 10 mice in each group. Except for blank group ，other groups were given 1％ 2，4-dinitrofluorobenzene-acetone-sesame oil mixed solution to induce delayed type hypersensitivity model. After modeling， blank group and model group were given constant volume of 1.0％ CMC-Na solution intragastrically ，and administration groups were given relevant medicine 20 mL/kg intrag astrically，oncea day ，for consecutive 5 d. A fter last medication ，ear swelling degree of mice were recorded ；the inhibition rate of swelling degree， half effective dose （ED50） and 95％ confidence 158-02-32）； interval（CI）of raw and processed products were calculated ； the weight of heart ，liver，spleen，lung and kidney were measured and the indexes of organs were calculated ；ELISA 1161472062@qq.com and modified chemical oxidation method were used to determine the serum levels of inflammatory factors （TNF-α， IL-10） and liver and renal function indexes （ALT，AST， TBIL，BUN，CREA）. RESULTS：Compared with blank group ，the degree of ear swelling in the model group was significantly increased（P＜0.05）. Compared with model group ，ear swelling degree of mice were decreased significantly in different doses groups of ethanol extract of raw and processed products of W. indica （P＜0.05）. The inhibition rate of swelling increased with the increase of dose ，ED50 and 95％CI of delayed hypersensitivity ear swelling were 0.239 6（0.129 0，0.445 2）g/kg and 0.147 3（0.076 8，0.282 7）g/kg，respectively. Compared with blank group ，liver index and serum TNF-α level of mice were increased significantly in model group ，while lung index and serum IL- 10 level were decreased significantly （P＜0.05）. Compared with model group ，the levels of liver indexes （positive group ，raw group 3，processed groups 1-6）and serum TNF-α levels（positive group ，raw groups 1-3，processed groups 1-4） were decreased significantly in different administration groups ；while the levels of lung indexes （positive group ，raw groups 3-6 and processed groups 3-6），serum IL- 10 levels（raw groups 1，2，4 and 5，processed groups 2-6），ALT，AST，BUN and CREA levels （raw groups 4-6），TBIL levels （raw groups 3-6 ）were increased significantly （P＜ 0.05）. CONCLUSIONS ：The ethanol extract of raw product of W. indica has certain anti-inflammatory activity ，and has certain hepatorenal toxicity to mice ，with certain “dose-effect-toxity”correlation. The ethanol ectract of processed product of W. indica has certain anti-inflammatory activity too ，but its hepatorenal toxicity was lower than raw product. The “sweat soaking method ” possesses the function of “retaining efficiency and reducing toxicity ”for processing W. indica .

OBJECTIVE:To compare the acute toxicity of ethanol extract from raw product and different processed products of Wikstroemia indica on mice,and provide basis for optimizing the processing technology of perspiration method for W. indica and medication safety. METHODS:Perspiration method was used to process the W. indica pieces for 30 d to get processed product 1 and process its coarse powder for 14,7 d to get processed product 2,processed product 3,respectively. Then using 70％ ethanol as solvent,percolation method was used to extract the raw W. indica and its different processed products,and acute toxicity test was conducted on mice for different ethanol extracts. RESULTS:The median lethal dose(LD50)of ethanol extracts from raw W. in-dica and processed product 1 were 4.05 and 6.65 g/kg,equivalent to 19,32 times of the clinical daily dose of a 70 kg adult,re-spectively. While the LD50 of ethanol extract from processed product 2 and processed product 3 can not be measured,the maximum tolerated dose(MTD)were measured as 20.0,15.0 g/kg,equivalent to 95,71 times of the clinical daily dose of a 70 kg adult,re-spectively;the maximum dose(MLD)were measured as approximately 30.0,20.0 g/kg,equivalent to 143,95 times of the clini-cal daily dose of a 70 kg adult,respectively. CONCLUSIONS:The toxicity of processed products of W. indica is obviously lower than that of raw products,and its toxicity after processing the coarse powder for 14 d is lower than that after processing the coarse powder for 7 d.

OBJECTIVE:To compare the composition changes of Aurantii fructus before and after fermentation processing and optimize its fermentation processing technology. METHODS:UPLC was conducted to compare the raw and fermentation processed products of same batch of Aurantii fructus,and ensure the chromatographic peaks after fermentation processing. Using peak areas of 4 chromatographic peaks and mildew characteristics of samples as index,fermentation temperature,humidity and time as factor, L9(34)orthogonal test was designed to optimize the fermentation processing technology,and verified it. RESULTS:After fermenta-tion processing,Aurantii fructus obviously showed 2 new monosaccharide glycosides components;the optimized fermentation tech-nology was as follows as fermentation temperature of 30 ℃,humidity of 70% and time of 7 d;verification test results showed RSD of each indicator of decoction pieces prepared by optimized fermentation technology in 3 tests were lower than 2.0%(n=3). CONCLUSIONS:Fermentation processing may lead obvious chemical composition changes in Aurantii fructus;the optimized fer-mentation processing technology can increase the contents of characteristic peaks.

Objective To investigate the impact of lack of progesterone receptor ( PR) expression on the prognosis of patients with operable ER ( estrogen receptor)?positive invasive breast cancer. Methods We retrospectively analyzed the clinicopathological features, treatment and survival data of 318 women with ER+/PR+ and ER+/PR? invasive breast cancer. Results Among the 318 patients, there were 219 PR?positive and 99 PR?negative cases. The 5?year overall survival ( OS ) rate was 92. 5%, and the 5?year disease?free survival ( DFS) rate was 87. 2% in the 318 ER?positive patients. Among them, the 5?year OS rates were significantly different between the PR?positive group (94.6%) and PR?negative group (87.8%, P=0.020), and the 5?year DFS rates were also significantly different from each other (89.8% and 81.6%, respectively, P=0.019).Univariate analysis showed that PR status, tumor size, T stage, axillary lymph node metastasis, and clinical stage were prognostic factors for OS ( P<0.05 for all) . Multivariate analysis showed that lack of PR expression, T stage ≥2, and positive axillary lymph node metastasis were independent risk factors for poor DFS and OS in ER?positive breast cancer patients ( P<0. 05 for all ) . Subgroup analysis showed that lack of PR expression was not significant in predicting poor DFS or OS when patients were in stageⅠ or with a small tumor (≤2 cm) (P>0.05 for all), and also showed that premenopausal women with PR?negative disease had poorer DFS and OS than PR?positive patients ( P<0.05 for both) . Conclusions Lack of PR expression is an independent risk factor for poor prognosis in patients with operable ER?positive invasive breast cancer, especially in patients with a large tumor (>2 cm) , advanced clinical stage ( StageⅡ or Ⅲ) or in premenopausal status.

Objective To investigate the impact of lack of progesterone receptor ( PR) expression on the prognosis of patients with operable ER ( estrogen receptor)?positive invasive breast cancer. Methods We retrospectively analyzed the clinicopathological features, treatment and survival data of 318 women with ER+/PR+ and ER+/PR? invasive breast cancer. Results Among the 318 patients, there were 219 PR?positive and 99 PR?negative cases. The 5?year overall survival ( OS ) rate was 92. 5%, and the 5?year disease?free survival ( DFS) rate was 87. 2% in the 318 ER?positive patients. Among them, the 5?year OS rates were significantly different between the PR?positive group (94.6%) and PR?negative group (87.8%, P=0.020), and the 5?year DFS rates were also significantly different from each other (89.8% and 81.6%, respectively, P=0.019).Univariate analysis showed that PR status, tumor size, T stage, axillary lymph node metastasis, and clinical stage were prognostic factors for OS ( P<0.05 for all) . Multivariate analysis showed that lack of PR expression, T stage ≥2, and positive axillary lymph node metastasis were independent risk factors for poor DFS and OS in ER?positive breast cancer patients ( P<0. 05 for all ) . Subgroup analysis showed that lack of PR expression was not significant in predicting poor DFS or OS when patients were in stageⅠ or with a small tumor (≤2 cm) (P>0.05 for all), and also showed that premenopausal women with PR?negative disease had poorer DFS and OS than PR?positive patients ( P<0.05 for both) . Conclusions Lack of PR expression is an independent risk factor for poor prognosis in patients with operable ER?positive invasive breast cancer, especially in patients with a large tumor (>2 cm) , advanced clinical stage ( StageⅡ or Ⅲ) or in premenopausal status.

OBJECTIVETo observe changes in velopharyngeal airway condition post pharyngoplasty.

METHODSThirty-five patients underwent sphincter pharyngoplasty (SPP) or pharyngeal flap (PF). The follow-up period was approximately six months. Duration of velopharyngeal airway obstruction was recorded.

RESULTSAverage obstruction duration was (42.8 +/- 32.4) d. No significant difference in obstruction duration was found between the SPP and PF groups. Twenty-eight patients complained of mouth and lip dryness. Thirty-four patients experienced snoring while sleeping.

CONCLUSIONAverage obstruction duration post pharyngoplasty is 42.8 d. Oral respiration and snoring are common complications.