ObjectiveTo investigate the differential expression of integrin alpha-6（ITGA6） in abdominal wall endometriosis （AWE） tissues and its molecular mechanisms in regulating AWE. Methods36 AWE lesions were designated as the experimental group， while 36 cases of normal endometrial tissues served as the controls. Differential expression of ITGA6 between the two groups was assessed through immunohistochemical （IHC） staining. Human ITGA6 gene-specific interference sequences were designed， synthesized， and packaged into lentiviral vectors to establish the Ishikawa cell line with ITGA6-knockdown. Similarly， the ITGA6-overexpression cell line was constructed using the coding sequence （CDS） of the gene. Real-time PCR and Western blot were performed to detect changes in epithelial-mesenchymal transition（EMT）-related markers and angiogenesis-related indicators. Cell invasion and migration capabilities were assessed by Cell Scratch and Transwell assays. Furthermore， Western blot was conducted to profile PI3K/AKT pathway dynamics. ResultsEctopic endometrial tissues exhibited a marked increase in the number of ITGA6-positive cells and their expression intensity compared to eutopic endometrium （each P < 0.001）. Compared with the NC group， the ITGA6-knockdown group showed significantly reduced expression of N-cadherin， VEGF， and TGF-β1 （all P < 0.01）， while E-cadherin expression was markedly increased （P < 0.01）. Concomitantly， the invasion and migration capacities of ITGA6-low expression were significantly impaired （P < 0.001 for both）， accompanied by a marked reduction in AKT and phosphorylated AKT（p-AKT） levels （P < 0.001）. Conversely， overexpressing ITGA6 resulted in opposite effects. ConclusionITGA6 modulates EMT and angiogenesis in Ishikawa cells via the PI3K/AKT signaling pathway， thereby enhancing cell invasion and migration capabilities， which contributes to the pathogenesis of AWE.

BACKGROUND:Research on carbon nanomaterials in the biomedical field is booming,and related scientific research results are increasing year by year.However,visualization analysis of the annual number of publications,the research status of countries,institutions,authors,and research hotspots and trends in this field is relatively scarce. OBJECTIVE:To present the research status of carbon nanomaterials in biomedical field,reveal the main research subjects,explore the research hotspots and development trends,and provide a reference for the future development of this field. METHODS:The core data set of Web of Science was used as the literature source to search the relevant researches on carbon nanomaterials in the biomedical field from 2012 to 2023.The knowledge map was generated by using Citespace software with countries,institutions,authors,keywords,and co-citations as nodes and for visualization analysis. RESULTS AND CONCLUSION:(1)A total of 2 932 papers were included in this study.In the medical field,carbon nanomaterials had a large number of papers and a fast growth rate.The United States has a large number of papers;China is an emerging force in this field,although the number of papers is the largest,but the level of research and influence need to be improved.The Chinese Academy of Sciences is the largest cooperative network institution,which mainly targets domestic institutions and lacks cooperation with well-known foreign institutions.(2)Keyword analysis displays that the green synthesis method and application of displaying carbon points have been the focus of research,followed by the new method of combining carbon nanomaterials with cancer phototherapy and immunotherapy,the key direction of future research.(3)The dynamic development trend of co-citations suggests that tissue engineering is a hot research topic of carbon nanomaterials in the field of biomedicine,mainly including the research of carbon nanomaterials for the repair and regeneration of heart and nerve tissue and as a bio-ink additive for 3D and 4D bioprinting.(4)In the future,with the development of the biomedical field in the direction of precision and treatment,researchers should speed up the creation of carbon-based systems formed by the combination of scientific and effective carbon nanomaterials with science and technology,new polymers or organic molecules,and new therapeutic methods,so as to give full play to the maximum effect of carbon nanomaterials.

Objective:To analyze the imaging features of primary leiomyosarcoma of the inferior vena cava (PLV).Methods:This study was a case series analysis. The clinical and imaging data of 17 patients with PLV confirmed by pathology who underwent CT, MRI and/or PET-CT examinations in the Second Affiliated Hospital of Zhejiang University School of Medicine from June 2012 to September 2022 were retrospectively collected. The CT or MRI findings, including the number, location, size, shape, margin, density (signal), enhancement characteristics, surrounding invasion, and metastasis of the lesion were analyzed.Results:Among the 17 cases there were 7 males and 10 females, aged 32 to 78 years. All patients had single tumors, the maximum diameter of the mass was 3.8 to 19.0 cm, and in 12 cases it was consistent with the inferior venacava.There were 11 cases of "petal-like" necrosis cystic lesion, and 6 cases of "fissure" necrosis cystic lesion. Collateral circulation was found around the mass in 15 cases. There were 3 cases of intraluminal type, 2 cases of extraluminal type, and 12 cases of junctional type. The tumors of intraluminal type presented as "worm-like" appearance, while the extraluminal and junctional type tumors presented as lobulated shape, with local "umbilical depression sign". The margins were clear in 3 cases and unclear in 14 cases. Vascular invasion by the mass was observed in 7 cases. On CT plain scan, the solid component of PLV presented as isodense or slightly hypodense. On MRI T1-weighted images, the solid component presented as isodense or slightly hypodense, and on fat-suppressed T2-weighted images, it presented as isodense or slightly hyperdense. On MRI diffusion-weighted imaging, 12 cases showed high signal intensity, and the corresponding apparent diffusion coefficient map showed low signal intensity. On CT enhanced scan, 8 cases showed mild to moderate enhancement of the solid part of PLV in the arterial phase and 9 cases showed obvious enhancement. In the venous phase and delayed phase, 10 cases showed continuous enhancement and 7 cases showed progressive enhancement. On MRI enhanced scan, 8 cases showed moderate enhancement and 6 cases showed obvious enhancement of the solid part of PLV in the arterial phase. In the venous phase and delayed phase, continuous progressive enhancement was observed; no enhancement was seen in the necrotic and cystic areas.Conclusion:The imaging characteristics of PLV show that the maximum diameter of the masses are consistent with the direction of inferior vena cava, most masses exhibit a "petal-like" necrotic cyst morphology with collateral circulation, and a localized "umbilical concave sign", and some cases possess hemophilic tube features.

Large language models (LLMs), represented by ChatGPT, have garnered significant attention due to their powerful capabilities in understanding and generating human language. Research on the application of LLMs across various medical tasks has shown a vigorous development trend. This review aims to outline the development and clinical applications of LLMs, with a focus on the primary tasks of medical intelligent assistants, including their associated opportunities and challenges. At the technical level, we provide a detailed explanation of the architecture and training processes of existing medical LLMs, and summarize the general technical steps for adapting large models to the healthcare domain. At the application level, we introduce the main tasks of medical intelligent assistants from both healthcare provider- and patient-oriented perspectives, andcompare the performance of different LLMs across various medical tasks to illustrate their unique advantages and limitations in medical applications.

Objective To explore the protective effect of hydroalcoholic extract of Portulaca oleracea L.(POHA)on ulcerative colitis(UC)and bone loss in mice.Methods The C57BL/6 mice were treated with dextran sulfate sodium(DSS)to establish UC model.A total of 50 mice were randomly assigned to including control group,DSS group,mesalazine(MS)group,low dose of POHA(POHAL)group,or high dose of POHA(POHAH)group.The control group freely drank drinking water,while the DSS,MS,POHAL and POHAH groups drank drinking water containing DSS for 8 weeks.Since the 2nd week,the control group and DSS group were given normal saline by gavage.The MS group was given MS(100 mg/kg)by gavage.The POHAL group and POHAH group were given POHA(1 000 mg/kg and 2 000 mg/kg)by gavage,respectively.Body weight and disease activity index(DAI)were recorded and calculated every 2 d.On the 56th day,the colon weight index,liver index,and spleen index were calculated,and the histological changes of colon were observed.Serum levels of bone metabolism markers and microstructure parameters of femur were detected.Results Compared with the control group,the DSS group showed significantly increased DAI score,colon weight index,liver index,and spleen index(all P＜0.01).The DSS group exhibited significant pathological damage in colon tissues and significantly increased serum levels of osteocalcin,C-terminal peptide of collagen type Ⅰ,and tartrate-resistant acid phosphatase 5b(P＜0.01).The bone loss was significant in the DSS group,manifested by markedly decreased bone mineral density(BMD),bone tissue volume to tissue volume ratio(BV/TV),trabecular bone number(Tb.N),and trabecular bone thickness(Tb.Th),and markedly increased bone surface to bone volume ratio(BS/BV)and trabecular bone separation(Tb.Sp)(P＜0.05 or P＜0.01).Compared with the DSS group,the BMD,BV/TV,Tb.N and Tb.Th of the femur in the MS group and POHAH group of mice were all increased(P＜0.05 or P＜0.01),the BS/BV all decreased(P＜0.05 or P＜0.01),and the Tb.Sp all decreased without significant differences(all P＞0.05).The above bone microstructure parameters in the POHAL group showed no significant differences compared with those in the DSS group(all P＞0.05).Conclusion POHA has protective effect on DSS-induced UC and bone loss,and the mechanism may be related to the inhibition of hyperactive bone metabolism.

During long-term extravehicular activities(EVA),there have been multiple instances of localized discomfort due to cold extremities such as hands and feet.The primary reason is that the design of space suit gloves prioritizes maximizing operational flexibility,which leads to reduced passive thermal protection in certain areas.Insufficient local thermal protection can cause the hands to lose metabolic heat in cold environments over time,resulting in cold stress.Therefore,it is necessary to conduct research on temperature control technology to meet the thermal comfort requirements of astronauts' hands during EVA.Effective active temperature measures can expand the range of low temperature working environments that astronauts' hands can adapt to during EVA,enhance hand thermal comfort,and ensure hand operational capabilities,preventing excessive cold from exceeding medical requirement and affecting extravehicular missions.This paper combines the metabolic heat generation patterns of the human hand to analyze the temperature control requirements for extravehicular gloves,simulate and optimize the layout of electric heaters,and evaluate the feasibility of the electric heating system for extravehicular gloves by building a thermal simulation model.Through prototype vacuum thermal testing,comprehensive verification of the temperature control module for extravehicular gloves was achieved,demonstrating the effectiveness of the temperature control system.

Objective To observe the value of machine learning(ML)models based on CT angiography(CTA)morphology combined with blood inflammation indicators for predicting rupture of intracranial aneurysms(IA).Methods Totally 286 IA patients were enrolled,including 143 cases in ruptured group and 143 case in unruptured group.Among them 200 cases(100 in ruptured subgroup and 100 in unruptured subgroup)were taken as training set,while 86 cases(43 in ruptured subgroup and 43 in unruptured subgroup)were taken as validation set.CTA morphological parameters and blood inflammation indicators were compared between subgroups in training set,and the impact factors of IA ruptured among univariate variables were screened using stepwise logistic regression analysis.Logistic regression(LR),classification and regression tree(CART)and backpropagation neural network(BPNN)models were constructed based on the above impact factors,respectively.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of these models for predicting IA rupture.Results Neutrophil,neutrophil-lymphocyte ratio,interleukin-10,tumor necrosis factor-α,transforming growth factor-β,as well as tumor width,height and size ratio(SR)were all impact factors of IA rupture(all P＜0.05),and collinearity diagnosis suggested that no covariate relationship existed among these factors.LR,CART and BPNN models had good efficacy for predicting IA rupture in both training and validation sets with AUC of 0.878-0.993,and BPNN model had the best predictive efficacy(AUC of 0.993,0.976).Conclusion ML models based on CTA morphology combined with blood inflammation indicators could be used to predict IA rupture effectively,among which BPNN model had the best efficacy.

Objective To investigate the the effects of fracture fragment size and fixation method on biomechanical stability of distal tibial epiphyseal injuries in children.Methods A three-dimensional(3D)finite element model of a Salter-Harris Ⅱ(SH-Ⅱ)epiphyseal injury with fracture fragments of varying sizes(Small,Middle,Big)was constructed using computed tomography(CT)data from the lower limb of a 10-year-old volunteer.and bone-internal fixation assemblies were created with 1-3 screws(1 S group,2 S group,3 S group)and Kirschner wire(K group).The model was subjected to gravitational forces,posterior drawer forces,and external rotation.Displacement and stress distributions on fracture fragments and fixation devices were analyzed.Results The maximum displacement for the four groups of models was concentrated at the distal end of the fracture fragment.Under gravity conditions,the maximum displacement of the distal end of the fracture fragment in the 1 S,2 S,3 S and K models in Small group was 5.69,5.57,5.56,0.11 mm,respectively,and the bone stress was 16.95,12.26,8.57 and 5.00 MPa,respectively.A high stress area at the epiphyseal plate and the fracture line was easily formed under screw fixation,while a high stress area at the edge of the epiphyseal plate was formed under Kirschner wire fixation.Conclusions When distal tibial epiphyseal injuries in children are treated by using screws,increasing the number of screws can improve the fixation stability and share local bone stress,but the connection area between the fracture fragment and the epiphyseal plate cannot be too small.Kirschner wire fixation can provide better biomechanical effects than screw fixation.

Objective The athletic performance and physiological indicators of two top seated cross-country skiers during simulated competitions were analyzed,and the characteristics of exercise intensity and pacing strategies in different terrains were explored,so as to provide a scientific basis for physical fitness allocation and speed rhythm optimization of the athletes.Methods Differential global positioning system and Momentum Technology MT-Sports T2 were used to test athlete A and athlete B with class of locomotor winter 10(LW 10),who were the first and second runners-up of Beijing Winter Paralympic mid-distance cross-country ski race.The athletes' real-time gliding speed and heart rate during five consecutive 15 km cross-country skiing time trials were collected,and the time spent on each section,speed and heart rate changes in each course were analyzed.Results The coefficient of variation(CV)of mean heart rate on uphill and flat terrain sections were significantly correlated with total scores.The average gliding speed and average heart rate as a percentage of maximum heart rate(HRmax)of the athletes in three terrains were significantly correlated with total scores.The correlation between the mean time spent on uphill and flat terrain and total performance was stronger than that between the mean time spent on downhill terrain and total scores.Both athletes used a cumulative acceleration speed rhythm.Conclusions Uphill and flat terrain time are critical to race performance.Athletes adopt a progressive pacing strategy,gradually increasing speed in the first half,maintaining stable output in the mid-race,and finishing the last lap at a high-speed.Heart rates are mainly distributed between 70％-90％HRmax,and balancing high-intensity efforts on uphills with recovery on downhills helps optimize energy expenditure.

Objective To investigate the the effects of fracture fragment size and fixation method on biomechanical stability of distal tibial epiphyseal injuries in children.Methods A three-dimensional(3D)finite element model of a Salter-Harris Ⅱ(SH-Ⅱ)epiphyseal injury with fracture fragments of varying sizes(Small,Middle,Big)was constructed using computed tomography(CT)data from the lower limb of a 10-year-old volunteer.and bone-internal fixation assemblies were created with 1-3 screws(1 S group,2 S group,3 S group)and Kirschner wire(K group).The model was subjected to gravitational forces,posterior drawer forces,and external rotation.Displacement and stress distributions on fracture fragments and fixation devices were analyzed.Results The maximum displacement for the four groups of models was concentrated at the distal end of the fracture fragment.Under gravity conditions,the maximum displacement of the distal end of the fracture fragment in the 1 S,2 S,3 S and K models in Small group was 5.69,5.57,5.56,0.11 mm,respectively,and the bone stress was 16.95,12.26,8.57 and 5.00 MPa,respectively.A high stress area at the epiphyseal plate and the fracture line was easily formed under screw fixation,while a high stress area at the edge of the epiphyseal plate was formed under Kirschner wire fixation.Conclusions When distal tibial epiphyseal injuries in children are treated by using screws,increasing the number of screws can improve the fixation stability and share local bone stress,but the connection area between the fracture fragment and the epiphyseal plate cannot be too small.Kirschner wire fixation can provide better biomechanical effects than screw fixation.