Fatigue driving is a major cause of traffic accidents,which poses a great threat to public safety and property.In order to reduce the losses caused by fatigue driving,many researchers have devoted themselves to the study about fatigue driving,such as driver behavior monitoring,brainwave monitoring,eye tracking and facial expression analysis.Each of these methods has its own advantages and disadvantages.Behavioral monitoring reflects the fatigue state by analyzing the driver's driving habits and facial expression,which is easy to operate but prone to be affected by the external environment.Brainwave monitoring is more accurate and can detect the fatigue state in real time,but the equipment is complicated and costly,which limits its large-scale application.The detection based on eye-tracking and facial expression analysis also has a certain potential for application,but errors may occur under different light conditions.Herein the review introduces the effects of fatigue on driving ability and compares the research results of various fatigue driving detection methods by searching,collating,analyzing and summarizing the relevant literatures at home and abroad.Various detection methods are analyzed and summarized,and it is pointed out that the fatigue driving detection method based on multi-feature information fusion will become a research hotspot.

Objectives:To analyze the clinical efficacy of far-lateral transforaminal lumbar interbody fusion(TLIF)under a full-endoscope with dual-operation channels for the treatment of lumbar spondylolisthesis.Methods:A retrospective analysis was conducted on the clinical data of 20 patients with single-level lumbar spondylolisthesis who underwent dual-operation channels full-endoscopic far-lateral TLIF at the Department of Neck-shoulder and Lumbocrural Pain Division 1,Sichuan Orthopedic Hospital,from June 2023 to December 2023.Among the patients,there were 15 cases of degenerative spondylolisthesis and 5 cases of isthmic spondylolisthesis;7 females and 13 males,aged 49 to 72 years(59.95±7.16 years).The duration of symptoms ranged from 2 to 120 months(35.15±42.10 months).The operative time,intraoperative blood loss,length of hospital stay,and surgical complications were recorded.Clinical outcomes were assessed using the Oswestry disability index(ODI)and visual analog scale(VAS)scores for back and leg pain,preoperatively,1 month postoperatively,and at the final follow-up.Lumbar CT scans were used to evaluate interbody fusion according to the Bridwell criteria.Results:All the patients successfully underwent endoscopic fusion surgery.The operative time was 175min to 235min(201.75±24.40min).The follow-up period for all the cases was 12-16 months,with an average of 14.15±1.14 months.One month after surgery and final follow-up ODI,as well as VAS scores for both lower back pain and leg pain,showed significant improvement compared to preoperative levels(P＜0.05).No serious complications occurred intraoperatively,postoperatively,or during the follow-up pe-riod.Of the 20 patients who underwent lumbar CT scans during the follow-up period,19(95.0％)achieved solid bony fusion.Conclusions:The far-lateral TLIF under a dual-operation channels full-endoscope demon-strate satisfactory clinical outcomes in early follow-up,which offers a minimally invasive,safe,and effective option for the treatment of lumbar spondylolisthesis.

Alzheimer's disease(AD)is a progressive,irreversible neurodegenerative disorder characterized by gradual brain cell degeneration,leading to progressive decline in cognitive function and ultimately death.Early identification and intervention are critical to AD diagnosis.In recent years,deep learning has further advanced image-based AD classification methods and facilitated the application of deep models in the early AD diagnosis.To achieve accurate early diagnosis and subsequent classification of AD,researchers have integrated deep learning with magnetic resonance imaging to develop more precise models.By analyzing and synthesizing relevant domestic and international literature,this review introduces commonly used public datasets and evaluation criteria for AD,analyzes the application of magnetic resonance imaging in AD classification and its integration with deep learning methods,and highlights the roles of techniques such as convolutional neural networks,transfer learning,attention mechanisms,and multimodal approaches in AD classification.It also discusses the advantages,limitations,and developmental trends of deep learning in AD classification,aiming to provide new insights for the application of deep learning in AD research.

Fatigue driving is a major cause of traffic accidents,which poses a great threat to public safety and property.In order to reduce the losses caused by fatigue driving,many researchers have devoted themselves to the study about fatigue driving,such as driver behavior monitoring,brainwave monitoring,eye tracking and facial expression analysis.Each of these methods has its own advantages and disadvantages.Behavioral monitoring reflects the fatigue state by analyzing the driver's driving habits and facial expression,which is easy to operate but prone to be affected by the external environment.Brainwave monitoring is more accurate and can detect the fatigue state in real time,but the equipment is complicated and costly,which limits its large-scale application.The detection based on eye-tracking and facial expression analysis also has a certain potential for application,but errors may occur under different light conditions.Herein the review introduces the effects of fatigue on driving ability and compares the research results of various fatigue driving detection methods by searching,collating,analyzing and summarizing the relevant literatures at home and abroad.Various detection methods are analyzed and summarized,and it is pointed out that the fatigue driving detection method based on multi-feature information fusion will become a research hotspot.

Objectives:To analyze the clinical efficacy of far-lateral transforaminal lumbar interbody fusion(TLIF)under a full-endoscope with dual-operation channels for the treatment of lumbar spondylolisthesis.Methods:A retrospective analysis was conducted on the clinical data of 20 patients with single-level lumbar spondylolisthesis who underwent dual-operation channels full-endoscopic far-lateral TLIF at the Department of Neck-shoulder and Lumbocrural Pain Division 1,Sichuan Orthopedic Hospital,from June 2023 to December 2023.Among the patients,there were 15 cases of degenerative spondylolisthesis and 5 cases of isthmic spondylolisthesis;7 females and 13 males,aged 49 to 72 years(59.95±7.16 years).The duration of symptoms ranged from 2 to 120 months(35.15±42.10 months).The operative time,intraoperative blood loss,length of hospital stay,and surgical complications were recorded.Clinical outcomes were assessed using the Oswestry disability index(ODI)and visual analog scale(VAS)scores for back and leg pain,preoperatively,1 month postoperatively,and at the final follow-up.Lumbar CT scans were used to evaluate interbody fusion according to the Bridwell criteria.Results:All the patients successfully underwent endoscopic fusion surgery.The operative time was 175min to 235min(201.75±24.40min).The follow-up period for all the cases was 12-16 months,with an average of 14.15±1.14 months.One month after surgery and final follow-up ODI,as well as VAS scores for both lower back pain and leg pain,showed significant improvement compared to preoperative levels(P＜0.05).No serious complications occurred intraoperatively,postoperatively,or during the follow-up pe-riod.Of the 20 patients who underwent lumbar CT scans during the follow-up period,19(95.0％)achieved solid bony fusion.Conclusions:The far-lateral TLIF under a dual-operation channels full-endoscope demon-strate satisfactory clinical outcomes in early follow-up,which offers a minimally invasive,safe,and effective option for the treatment of lumbar spondylolisthesis.

Alzheimer's disease(AD)is a progressive,irreversible neurodegenerative disorder characterized by gradual brain cell degeneration,leading to progressive decline in cognitive function and ultimately death.Early identification and intervention are critical to AD diagnosis.In recent years,deep learning has further advanced image-based AD classification methods and facilitated the application of deep models in the early AD diagnosis.To achieve accurate early diagnosis and subsequent classification of AD,researchers have integrated deep learning with magnetic resonance imaging to develop more precise models.By analyzing and synthesizing relevant domestic and international literature,this review introduces commonly used public datasets and evaluation criteria for AD,analyzes the application of magnetic resonance imaging in AD classification and its integration with deep learning methods,and highlights the roles of techniques such as convolutional neural networks,transfer learning,attention mechanisms,and multimodal approaches in AD classification.It also discusses the advantages,limitations,and developmental trends of deep learning in AD classification,aiming to provide new insights for the application of deep learning in AD research.

Objective To investigate the effect of tigecycline on coagulation function and to provide a reference for the clinical rational use of tigecycline.Methods The data of patients treated with tigecycline in Shanghai Tenth People's Hospital between June 2019 and December 2023 by retrospective analysis.Statistical analysis was performed by collecting data on patients'basic information,routine coagulation parameters and thromboelastogram(TEG)parameters before and after the use of tigecycline.Results Activated partial thromboplastin time,prothrombin time and thrombin time were prolonged and fibrinogen levels were decreased with the use of tigecycline in 41 patients,the differences were statistically significant(P＜0.05).There was no significant difference in levels of coagulation factor activation time,clot formation rate parameter,maximum angle of tangency,maximum amplitude of elastography and coagulation index after treatment with tigecycline(P＞0.05).Conclusion For patients with suspected coagulation abnormalities after tigecycline administration,a comprehensive assessment of coagulation should be made by combining routine coagulation indexes with TEG.

Objective:To construct a microfluidic organ-on-a-chip and evaluate its capability in simulating subchondral bone remodeling during the progression of osteoarthritis.Methods:The chip′s main body was designed based on the microfluidic technology and cell co-culture technique. MC3T3-E1 cells were cultured adherently within the cell seeding micro-chamber, with the culture medium perfused at a flow rate of 0.5 ml/min at the bottom of the micro-chamber. Evaluation metrics were as follows: (1) Assessment of the microfluidic organ-on-a-chip: The growth culture medium was perfused and simulation experiments were conducted to test the concentration differences and equilibrium times of the fluid inside and at the bottom of the cell seeding micro-chamber at various time points; live-dead staining was performed to observe the biocompatibility of cells cultured continuously for 3 days and 7 days at a set flow rate, which was divided into 3-day and 7-day groups. (2) Osteogenic potential of the microfluidic organ-on-a-chip: The osteogenic induction medium was perfused, and ALP staining and PCR were performed to compare the number of the black alkaline phosphatase (ALP)-positive cells and the expression levels of osteogenesis-related marker genes including osteoblast-specific transcription factor 2 (RUNX2), type I collagen (COL1A1), bone morphogenetic protein-2 (BMP-2), and osteocalcin (OCN) under static, 3-day and 7-day perfusion conditions, which was divided into static non-induced, static-induced and perfusion-induced groups. (3) Characterization of morphology and size, and biocompatibility of extracellular vesicles (EVs) of three osteoblast subtypes: Three different subtypes of osteoblasts were obtained [endothelial-type osteoblasts (EnOB)-EVs, stromal-type osteoblasts (StOB)-EVs and mineralizing-type osteoblasts (MinOB)-EVs]. Their morphology and size were obtained through transmission electron microscopy and particle size analysis. Growth medium containing EVs of three different cell subtypes was perfused, and cell proliferation/apoptosis assay was performed to compare the biocompatibility of the addition of different EVs concentrations (1, 1.25, 2.5, and 5 μg/ml) for 24 hours, which was categorized into the EnOB-EVs group, StOB-EVs group and MinOB-EVs group. (4) Osteogenic effect of EVs from three subtypes of osteoblasts: Osteogenic induction media containing EVs from three different osteoblast subtypes were perfused for 3 days, and ALP staining and PCR were performed to compare the number of black ALP-positive cells and the expression levels of osteogenesis-related marker genes including RUNX2, COL1A1, BMP-2, and OCN, which was divided into non-EVs group, EnOB-EVs group, StOB-EVs group and MinOB-EVs group.Results:(1) Evaluation of the microfluidic organ-on-a-chip: Simulation results showed that the concentration in the top layer of the upper chamber reached more than 95% of that in the lower chamber and that the concentration in the bottom layer was about 96.5% of that in the lower chamber after 12 hours of continuous perfusion, reaching an equilibrium state of the concentration difference between the upper and lower chambers. The results of live-dead staining showed that the chip was biocompatible at a flow rate of 0.5 ml/min, and the cell survival rate at 3 and 7 days of perfusion was (99.48±0.12)% and (97.07±1.05)% ( P<0.01). (2) ALP staining results showed that at 3 days, the perfusion-induced group showed the highest number of black ALP-positive cells, followed by the static-induced group, and the least in the static non-induced group. At 7 days, the static-induced group had the highest number of black ALP-positive cells, followed by the perfusion-induced group, and the least in the static non-induced group. PCR results indicated that at 3 days, the expression levels of RUNX2, COL1A1, BMP-2, and OCN were 1.00±0.03, 1.00±0.12, 1.00±0.01, and 1.00±0.02 respectively in the static non-induced group; 1.80±0.04, 4.05±0.37, 9.80±1.94, and 4.38±0.89 respectively in the static-induced group, and 2.45±0.23, 5.48±0.42, 91.50±4.56, and 10.82±4.96 respectively in the perfusion-induced group ( P<0.01). At 7 days, the expression levels of RUNX2 was 1.00±0.01 in the static non-induced group, 1.46±0.46 in the static-induced group, and 1.11±0.08 in the perfusion-induced group ( P>0.05); the expression levels of COL1A1, BMP-2, and OCN were 1.00±0.03, 1.00±0.13, and 1.00±0.09 respectively in the static non-induced group, 9.38±0.25, 14.27±4.35, and 84.01±4.02 respectviely in the static-induced group, and 2.39±0.08, 133.64±8.87, and 86.64±8.36 respectively in the perfusion-induced group ( P<0.01). When comparing the static non-induced, static-induced, and perfusion-induced groups at both 3 and 7 days, the perfusion-induced group demonstrated the strongest osteogenic capability. (3) Characterization of morphology and size and biocompatibility of EVs from three osteoblast subtypes: Under the transmission electron microscope, EVs from EnOB-EVs, StOB-EVs, and MinOB-EVs all exhibited a typical saucer-shaped morphology. The particle sizes of EnOB-EVs, StOB-EVs, and MinOB-EVs were (91.3±14.7)nm, (106.0±16.0)nm, and (68.1±10.7)nm, respectively. Cell proliferation/apoptosis assay results indicated that the optimal administration concentration of EnOB-EVs, StOB-EVs, and MinOB-EVs was all 1.25 μg/mL. (4) Validation of osteogenic effect of the microfluidic organ-on-a-chip on three types of EVs: ALP staining results showed that the non-EVs group had the fewest black ALP-positive cells, followed by the EnOB-EVs group, then the StOB-EVs group, and the MinOB-EVs group had the most. PCR results showed that the expression levels of RUNX2, COL1A1, BMP-2, and OCN were 1.00±0.01, 1.00±0.03, 1.00±0.02, and 1.00±0.02 respectively in the non-EVs group, 1.95±0.11, 6.78±2.04, 7.99±0.57, and 6.93±3.83 repectively in the EnOB-EVs group, 0.79±0.12, 5.68±1.53, 12.59±3.15, and 25.59±0.95 respectively in the StOB-EVs group, and 0.68±0.10, 4.36±0.69, 18.75±3.21, and 34.74±3.98 repectively in the MinOB-EVs group ( P<0.01). Compared with the non-EVs group, EnOB-EVs group, StOB-EVs group, and MinOB-EVs group, the MinOB-EVs group showed the most significant osteogenic effect. Conclusions:The microfluidic organ-on-a-chip constructed using microfluidic technology and cell co-culture techniques is capable of maintaining the normal growth of MC3T3-E1 cells, enhancing their proliferation and osteogenic induction differentiation. EVs released by osteoblasts at different stages possess osteogenic effects and can accelerate the bone sclerosis in the remodeling of subchondral bone during the progression of osteoarthritis.

In recent years, clinicians have paid more attention to the biological and esthetic effects of the 2 mm keratinized mucosa width (KMW) around dental implant. How to increase the keratinized mucosa is the focus of clinicians. While the free gingival graft (FGG) is still the gold standard of keratinized mucosa augmentation, alveolar ridge preservation (ARP), connective tissue graft (CTG) and apically positioned flap (APF) can also be used to obtain more than 2 mm keratinized mucosa width when they are used before implantation, with implantation, within the implant-healing phase, with second stage of implantation or after rehabilitation according to different indications. This article comprehensively summarizes the influencing factors of timing and surgical procedures for keratinized mucosa augmentation, providing guidance for clinicians to treat peri-implant keratinized mucosa deficiencies.

Objective:To compare the clinical efficacy between robot-assisted and free-hand percutaneous cannulated screwing (PCS) in the treatment of femoral neck fractures in the middle-aged and young patients.Methods:A retrospective study was conducted to analyze the clinical data of 53 patients with femoral neck fracture who had been treated with PCS from May 2020 to May 2022 at Department of Traumatic Surgery, Maoming Hospital Affiliated to Southern Medical University. In the robot group of 25 patients subjected to robot-assisted PCS, there were 11 males and 14 females with an age of (48.2 ± 11.9) years; in the free-hand group of 28 patients subjected to free-hand PCS, there were 13 males and 15 females with an age of (48.5 ± 9.8) years. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative guide drills, intraoperative fluoroscopy frequency, fracture union time, Harris hip score at the last follow-up and postoperative complications. Postoperative imaging examination was performed to evaluate distribution accuracy of the cannulated screws in the femoral neck (deviation between the screws and the femoral neck axis, parallelism between the screws and distance between the screws and the neck cortex).Results:There was no statistically significant difference between the robot and free-hand groups in the general clinical data before operation, showing comparability ( P>0.05). The robot group showed significantly shorter operation time [(32.7 ± 4.8) min], significantly less intraoperative bleeding [(14.6 ± 4.8) mL], significantly less intraoperative guide drillings [(3.5 ± 0.7) times] and significantly less intraoperative fluoroscopy frequency [(7.9 ± 1.4) times] than the free-hand group [(56.9 ± 11.3) min, (27.0 ± 7.3) mL, (9.1 ± 1.8) times and (16.3 ± 6.0) times)] (all P<0.05). Postoperative imaging showed that the deviation between the screws and the femoral neck axis was 4.4° ± 1.1° on the anteroposterior X-ray film and 3.2° ± 0.8° on the lateral X-ray film, the parallelism between the screws 4.9° ± 0.8° on the anteroposterior X-ray film and 3.0° ± 0.7° on the lateral X-ray film, and the distance between the screws and the femoral neck cortex (10.4 ± 2.7) mm in the robot group, all significantly smaller than those in the free-hand group [10.5° ± 2.8°, 4.9° ± 1.1°, 12.1° ± 4.0°, 5.1° ± 1.3°, and (15.4 ± 3.2) mm] (all P<0.05). All the 53 patients were followed up for (22.2 ± 8.5) months. All fractures got united. The fracture union time in the robot group [(20.6 ± 4.6) weeks] was insignificantly shorter than that in the free-hand group [(23.7 ± 7.7) weeks] ( P>0.05). At the last follow-up, the Harris hip score in the robot group [(88.6 ± 5.6) points] was significantly higher than that in the free-hand group [(84.8 ± 6.3) points] ( P<0.05). Follow-ups revealed 2 cases of internal fixation loosening, 1 case of screw head cutting and 1 case of femoral head necrosis in the free-hand group but none of such complications in the robot group. Conclusion:In the treatment of femoral neck fractures in the middle-aged and young patients, compared with free-hand PCS, robot-assisted PCS shows advantages of shorter intraoperative time, less bleeding, less fluoroscopic radiation, higher accuracy of screw placement, a lower incidence of postoperative complications and better functional recovery of the hip joint.