Hepatocellular carcinoma （HCC） is highly prevalent worldwide with a high mortality rate. Despite the continuous advances in current treatment methods such as surgery， targeted drugs， and immunotherapy， there is still a lack of significant improvement in the 5-year survival rate of patients due to strong tumor heterogeneity， high metastatic potential， and a high drug resistance rate. Therefore， it is urgently needed to identify new therapeutic targets. The aberrant activation of Yes-associated protein （YAP） is a pivotal hub for cell proliferation， metastasis， and immune evasion of HCC. This article systematically reviews the multiple regulatory mechanisms underlying YAP activation in HCC， including the promotion of YAP nuclear translocation by Hippo pathway inactivation， G protein-coupled receptor signal activation， and changes in mechanical stress of extracellular matrix. Meanwhile， it summarizes the synergistic crosstalk between YAP and non-classical pathways such as the Wnt pathway， as well as its specific role in remodeling the immune microenvironment and facilitating tumor immune escape by upregulating programmed death ligand 1. In addition， it reviews the development of new technologies such as YAP-TEAD inhibitors and proteolysis-targeting chimera and points out that interactions between the multiple regulatory mechanisms of YAP is a key contributor to tumor heterogeneity and therapeutic resistance. Future research should focus on developing novel inhibitors targeting the YAP regulatory network， designing combined therapy strategies， and establishing molecular biomarker detection systems， which may become pivotal directions for promoting precise treatment of HCC.

Objective:To assess the effect of using different thicknesses of reconstruction layer and different thicknesses of region of interest (ROI) on the results of vertebral bone mineral density (BMD) values that were measured by quantitative computed tomography (QCT). Methods:A total of 100 patients who underwent QCT screening for opportunistic osteoporosis between May and September 2021 at the First Affiliated Hospital of Zhengzhou University were retrospectively collected. Images that the thicknesses of QCT reconstruction layer were respectively 1 and 5 mm were transferred to the QCT Pro workstation,and ROI thicknesses were adjusted to 5,7,and 9 mm,respectively. The average BMD values of QCT measurements were recorded under different thicknesses of reconstruction layer and different ROI thicknesses. Then,the effects of the choose of different thicknesses of reconstruction layer and the different ROI thicknesses on BMD values that were measured by QCT were analyzed. Results:The average BMD values of 1 mm and 5 mm thicknesses of reconstruction layer were respectively (117.41±45.97) mg/cm3 and (118.77±44.84) mg/cm3 when ROI thickness was 5 mm,with a statistically significant difference (t=-2.283,P<0.05). The average BMD values of 1 mm and 5 mm thicknesses of reconstruction layer were respectively (116.38±46.06) mg/cm3 and (119.06±44.55) mg/cm3 when the ROI thickness was 7mm,and the difference was statistically significant (t=-3.280,P<0.05). The average BMD values of 1 mm and 5 mm thicknesses of reconstruction layer were respectively (116.25±45.36) mg/cm3 and (120.12±44.10) mg/cm3 when the ROI thickness was 9 mm,and the difference was statistically significant (t=-5.841,P<0.001). The differences in BMD measurement values among 5,7 and 9 mm ROI thicknesses were not statistically significant when the thicknesses of reconstruction layer were respectively 1 and 5 mm. Conclusion:There is an effect of the thickness of QCT reconstruction layer on average BMD measurement values,and 1 mm thickness of reconstruction layer is more suitable to clinical application,while there is not significant effect in ROI thickness on average BMD measurement value of QCT. In clinical application,it is feasible to adjust ROI thickness according to actual situation so as to avoid the effect caused by some factors such as fracture or vertebral implants.

Objective:To assess the effect of using different thicknesses of reconstruction layer and different thicknesses of region of interest (ROI) on the results of vertebral bone mineral density (BMD) values that were measured by quantitative computed tomography (QCT). Methods:A total of 100 patients who underwent QCT screening for opportunistic osteoporosis between May and September 2021 at the First Affiliated Hospital of Zhengzhou University were retrospectively collected. Images that the thicknesses of QCT reconstruction layer were respectively 1 and 5 mm were transferred to the QCT Pro workstation,and ROI thicknesses were adjusted to 5,7,and 9 mm,respectively. The average BMD values of QCT measurements were recorded under different thicknesses of reconstruction layer and different ROI thicknesses. Then,the effects of the choose of different thicknesses of reconstruction layer and the different ROI thicknesses on BMD values that were measured by QCT were analyzed. Results:The average BMD values of 1 mm and 5 mm thicknesses of reconstruction layer were respectively (117.41±45.97) mg/cm3 and (118.77±44.84) mg/cm3 when ROI thickness was 5 mm,with a statistically significant difference (t=-2.283,P<0.05). The average BMD values of 1 mm and 5 mm thicknesses of reconstruction layer were respectively (116.38±46.06) mg/cm3 and (119.06±44.55) mg/cm3 when the ROI thickness was 7mm,and the difference was statistically significant (t=-3.280,P<0.05). The average BMD values of 1 mm and 5 mm thicknesses of reconstruction layer were respectively (116.25±45.36) mg/cm3 and (120.12±44.10) mg/cm3 when the ROI thickness was 9 mm,and the difference was statistically significant (t=-5.841,P<0.001). The differences in BMD measurement values among 5,7 and 9 mm ROI thicknesses were not statistically significant when the thicknesses of reconstruction layer were respectively 1 and 5 mm. Conclusion:There is an effect of the thickness of QCT reconstruction layer on average BMD measurement values,and 1 mm thickness of reconstruction layer is more suitable to clinical application,while there is not significant effect in ROI thickness on average BMD measurement value of QCT. In clinical application,it is feasible to adjust ROI thickness according to actual situation so as to avoid the effect caused by some factors such as fracture or vertebral implants.

Bone defect repair is an urgent problem in the field of orthopedics,and numerous researchers are working to develop more effective treatment plans.The accurate evaluation of bone repair after surgery is a crucial step.In line with the development of computed tomography(CT)imaging,dual-energy CT imaging has shown significant advantages in analyzing bone composition and reducing metal artifacts.This article reviews the application of dual-energy CT imaging for the evaluation of bone repair in animals.

Bone defect repair is an urgent problem in the field of orthopedics,and numerous researchers are working to develop more effective treatment plans.The accurate evaluation of bone repair after surgery is a crucial step.In line with the development of computed tomography(CT)imaging,dual-energy CT imaging has shown significant advantages in analyzing bone composition and reducing metal artifacts.This article reviews the application of dual-energy CT imaging for the evaluation of bone repair in animals.

Objective To investigate the dynamic mechanical responses and damage characteristics of peri-implant bone structures subjected to impact load.Methods A finite element model of the peri-implant bone microstructure was established,and an initial velocity was applied to the rigid body to simulate the impact load.A stress failure criterion was employed and a user-material subroutine was developed to assess failure.Subsequently,bone damage after the impact load was analyzed according to the material subroutine.Results After the impact load,the stress on the cortical bone increased rapidly,reaching a peak value(16.01 MPa)immediately.In contrast,the stress on the trabecular bone at the bottom of the implant reached its peak value(5.85 MPa)at 0.1 μs.The impact load resulted in stress waves that propagated and diffused within the bone structure,causing changes in the bone structure damage over time.The generated impact energy could be absorbed and dissipated by the trabecular bone through deformation.The deformed trabecular bone experienced damage and failure upon reaching the yield limit,whereas the cortical bone did not experience damage or failure under an impact load.Conclusions Structural changes in the trabecular bone should be considered in patients with impact damage.The numerical model established in this study can effectively predict bone impact damage by combining the structural mechanical properties and geometric characteristics of the bones.These findings can serve as a reference for assessing bone damage and post-damage treatment in patients subjected to impact loads in clinical practice.

BACKGROUND:As a unique structure of the cervical spine,the occurrence,development and progression of the uncovertebral joint directly affect the stability and range of motion of the cervical spine,and are also closely related to the pathogenesis of cervical spondylosis.A thorough understanding of the developmental characteristics of the uncovertebral joint is of great significance for the pathogenesis,diagnosis,and treatment of cervical spondylosis. OBJECTIVE:By using imaging and three-dimensional reconstruction technology to measure and observe the cervical uncinate process-related angle in a large sample of different age groups,the aim is to reveal the characteristics of its changes with age and vertebral growth,as well as its relationship with cervical spine stability. METHODS:Using a retrospective research design,we collected 1 447 cases of raw CT imaging data that meet the study requirements for complete cervical spine segments.The raw data were imported into Mimics 21.0 software in DICOM format for post-processing and measurement of angle of uncinate process and sagittal angle of uncinate process.The data were grouped based on gender,age,and side. RESULTS AND CONCLUSION:(1)With the increase of vertebral sequence,the angle of uncinate process increased in a V-shaped shape,and the lowest peak was at C5.The overall population showed a sharp peak with the increase of age,and the peak value mostly occurred in the age range of 30-39 years.(2)The sagittal angle of the uncinate process increased like a fishhook with the increase of the vertebral sequence,and the overall angle of the uncinate process increased with age,and the peak value mostly occurred in the age range of 20-29 years.The uncinate process angle and sagittal angle showed only partial significant differences between sides and genders(P<0.05).(3)It is concluded that the angle of the uncinate process increased with the increase of vertebral sequence in a V-shaped manner.The sagittal angle of the uncinate process increases like a fish hook with increasing vertebral order,while the two angles generally peak with increasing age.The angle of the uncinate process is about 131°,which may be closely related to the stability of the cervical spine,while the sagittal angle of the uncinate process is about 14°,and its function may play a certain role in limiting the excessive rotation of the cervical spine.

Red doctor’s spirit is an important part of China’s advanced revolutionary culture and a valuable resource for medical students’ ideological and political education. Under the background of the new era, integrating the red doctor’s spirit into the ideological and political course of medical students is not only conducive to encouraging medical students to bravely shoulder the responsibility of the times and actively participate in the cause of human health, but also helps medical students to inherit the red culture and strengthen cultural confidence, which is also of great significance to improving the vitality and effectiveness of ideological and political courses.Teachers of Ideological and political courses should deeply explore the new era connotation of the red doctor’s spirit and constantly improve the guiding force of ideological and political courses; using Virtual Reality technology to realize the visual expression of red medicine spirit and enhance the appeal of ideological and political course; skillfully use four kinds of classes to strengthen the recognition of ideological and political course.

Objective To evaluate the correlation and consistency between an artificial intelligence(AI)bone mineral density(BMD)measurement system based on 3D-Densenet neural network technology and quantitative computed tomography(QCT)in measuring BMD,as well as to assess its effectiveness in diagnosing osteoporosis(OP).Methods A total of 1 201 participants who underwent low dose computed tomography(LDCT)were retrospectively included.The AI BMD measurement system and QCT were utilized to measure the BMD of T12,L1,L2 vertebrae,and the average BMD.Consistency and correlation of BMD measurements between the two methods were assessed using Bland-Altman,Pearson,and Kappa analyses.With QCT results as the reference standard,the receiver operating characteristic(ROC)curve was drawn to evaluate the accuracy of AI BMD measurement system in diagnosing OP.Results The r and r2 for the average BMD measured by the two methods were 0.997 and 0.993,respectively.The Kappa value for the diagnosis of normal BMD,low bone mass,and OP using the AI BMD measurement system was 0.905.The area under the curve(AUC)for diagnosing OP using the AI BMD measurement system was 0.998,with a sensitivity of 0.888 and specificity of 0.997.Conclusion The AI BMD measurement system based on 3D-Densenet neural network technology has a high correlation and consistency with the QCT measurement result,which can accurately diagnose normal BMD,low bone mass,and OP.

Objective:To investigate the expression profile of IL-36 family members in patients with coronary atherosclerotic heart disease (CAHD) and to assess the regulatory effects of exogenous IL-36 on CD8 + T cell function in CAHD patients. Methods:Twenty controls and 82 CAHD patients including 31 with stable angina pectoris (SAP), 27 with unstable angina pectoris (UAP) and 24 with acute myocardial infarction (AMI) were enrolled in this study. Anti-coagulant peripheral blood samples were collected. Plasma and peripheral blood mononuclear cells were isolated. The levels of IL-36α, IL-36β, IL-36γ and IL-36 receptor antagonist (IL-36RA) in plasma were measured by ELISA. CD8 + T cells were enriched. The expression of IL-36 receptor subunits at mRNA level was semi-quantified by real time PCR. Flow cytometry was used to detect the expression of programmed death-1 (PD-1), cytotoxic T lymphocytes associated protein-4(CTLA-4) and lymphocyte-activation gene-3 (LAG-3) in CD8 + T cells. Levels of periforin, granzyme B, granulysin, IFN-γ and TNF-α in the culture supernatants of CD8 + T cells were measured by ELISA. Purified CD8 + T cells from controls and AMI patients were stimulated with recombinant human IL-36RA. Changes in the expression of immune checkpoint molecules and the secretion of cytotoxic molecules and cytokines after IL-36RA stimulation were analyzed. One-way analysis of variance or paired t-test was used for statistical analysis. Results:There were no significant differences in plasma IL-36α, IL-36β or IL-36γ level between the control, SAP, UAP and AMI groups ( P>0.05). Plasma IL-36RA level was significantly down-regulated in the AMI group as compared with that in the control, SAP and UAP groups[(1 159.57±297.83) pg/ml vs (1 773.47±754.29) pg/ml, (1 600.12±740.48) pg/ml and (1 578.72±720.42) pg/ml; P<0.05]. The expression of IL-1 receptor 6 (IL-1R6) and IL-1 receptor accessory protein (IL-1RAcP) at mRNA level, the expression of PD-1 and CTLA-4, and the secretion of IFN-γ and TNF-α by CD8 + T cells showed no significant differences between the four groups ( P>0.05). Periforin, granzyme B and granulysin levels secreted by CD8 + T cells of the AMI group were significantly higherthan those of the control, SAP and UAP groups ( P<0.05). In the control group, recombinant human IL-36RA stimulation did not affect the expression of immune checkpoint molecule or the secretion of cytotoxic molecules and cytokines by CD8 + T cells ( P>0.05). In the AMI group, the percentage of PD-1 + CD8 + T cells increased after recombinant human IL-36RA stimulation ( P=0.033), but no significant change in the percentage of CTLA-4 + CD8 + T cells was observed ( P=0.288). Moreover, recombinant human IL-36RA stimulation suppressed the CD8 + T cells of AMI patients to secrete periforin, granzyme B and granulysin ( P<0.05), but not affect the secretion of IFN-γ and TNF-α ( P>0.05). Conclusions:The reduced IL-36RA level in AMI patients might induce the enhancement of CD8 + T cell activity by promoting CD8 + T cells to secrete cytotoxic molecules, which was involved in the immunopathogenesis of AMI.