Objective:To study the correlation between spontaneous cerebrospinal fluid rhinorrhea and increased intracranial pressure.Methods:Clinical data of patients with spontaneous cerebrospinal fluid rhinorrhea treated in the Department of Otorhinolaryngology of the Provincial Hospital of Shandong First Medical University from January 2019 to December 2023 and their epidemiology, clinical symptoms and signs, preoperative cerebrospinal fluid pressure, imaging data, leakage site, repair method and the presence or absebce of increased intracranial pressure were analysed. SPSS 23.0 software was used for statistical analysis.Results:Of the 57 patients with cerebrospinal fluid nasolacrimal leakage, 84.2%(48/57) were females and 15.8%(9/57) were males; 80.7%(46/57) were between 40 and 60 years old; and overweight and obese patients accounted for 75.4%(43/57). Of 57 patients, 35 patients received cranial MRI+magnetic resonance venography, and among them, 12(34.3%) patients were clinically with headache symptoms; the incidences of empty pterygoid and venous sinus stenosis were 40.0%(14/35) and 51.4%(18/35), respectively; and 33 patients underwent preoperative lumbar puncture examination, of whom 25(75.8%) patients had the increased cerebrospinal fluid pressure and 1 patient had idiopathic intracranial hypertension. All 57 patients underwent dural repair of the skull base, the postoperative follow-up period ranged from 3 to 60 months, and the success rate of surgery was 94.7%. The success rate was 100% in female patients and 33.3%(3/9) in male patients, including one with surgical failure receiving reoperation and two with postoperative recurrence in other areas of the skull base, with significant difference in the success rate of surgery between males and females (χ 2=16.890, P<0.001). Conclusions:Most patients with spontaneous cerebrospinal fluid rhinorrhea have the increased cerebrospinal fluid pressures, but very few fulfil the diagnosis of idiopathic intracranial hypertension. The success rate of surgical repair alone is high, but some recurrences still exist, especially in male patients.

Objective:To gain a deep understanding of the current cognition and training needs of nursing undergraduates regarding their emergency response teamwork skills, and to provide reference for the development of courses on emergency response teamwork among nursing undergraduates.Methods:From September to October 2023, purposive sampling was used to select 15 senior nursing undergraduates from Peking Union Medical College, Beijing University of Chinese Medicine, and Beijing City University as subjects for semi-structured interviews. Colazizzi 7-step analysis method was used to summarize and extract themes.Results:Three themes were extracted, including insufficient cognition and skill in emergency response, lack of emergency response teamwork cultivation, and the need for systematic and comprehensive training courses.Conclusions:Universities, hospitals, and other training institutions should work together to develop a systematic emergency response teamwork training course for nursing undergraduates, to cultivate the skills of nursing undergraduates and reserve talents for high-quality emergency response nursing teams.

This study was designed to explore the effect of DNA methyltransferase 1(DNMT1)on podocyte apoptosis and inflammatory cytokine release induced by high glucose(HG),and analyze the related molecular mechanisms.Podocyte MPC-5 cells were cultured in vitro and divided into control and HG groups.DNMT1 and SOCS1 were either silenced or overexpressed using small RNA interference technology and liposome transfection technology.The expression levels of DNMT1 and SOCS1 genes were measured using qRT-PCR.Apoptosis was assessed by flow cytometry,while ELISA was employed to determine the levels of inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β),and monocyte chemoattractant protein-1(MCP-1).Western blot was used to detect the expression of DNMT1,SOCS1 proteins,and the proteins involved in the Janus kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3)signaling pathway.Data showed that HG elevated MPC-5 cell apoptosis rate,the level of inflammatory factors and DNMT1 mRNA expression,and the expression of DNMT1,p-JAK2 and p-STAT3 proteins,while reduced SOCS1 mRNA and protein expression(P＜0.05).Both silencing DNMT1 and overexpressing SOCS1 resulted in reduce of MPC-5 cell apoptosis rate,inflammatory factors level,p-JAK2 and p-STAT3 proteins expression(P＜0.05).Additionally,silencing DNMT1 increased SOCS1 mRNA and protein expressions(P＜0.05).Conversely,silencing SOCS1 counteracted the effects of DNMT1 silencing on MPC-5 cell apoptosis,inflammation,p-JAK2 and p-STAT3 proteins expression.Therefore,silencing DNMT1 expression can reduce the apoptosis and inflammation of podocytes induced by HG,and its mechanism may be related to the inhibition of JAK2/STAT3 signaling pathway activation by upregulating SOCS1 expression.

The treatment of glioblastoma, the most prevalent malignant tumor in the central nervous system, poses considerable challenges. Glioblastoma multiforme, classified as a grade Ⅳ highly malignant brain glioma by the World Health Organization, is typically managed through a combination of surgery, postoperative chemotherapy, and radiotherapy. The treatment of glioblastoma is complicated by its infiltrative nature, genetic heterogeneity, and presence of the blood-brain barrier. Almost all cases of glioblastoma experience recurrence despite aggressive therapy, exploring the development of updated molecular treatment strategies that can improve overall efficacy. A crucial aspect in modern neurosurgery is the precise delineation of brain regions in terms of their anatomy and function. It serves as the fundamental basis for investigating variations in the distribution of brain gliomas. Hence, this review will elucidate the origin of glioblastomas and analyze the potential factors contributing to the spatially specific distribution of gliomas on the basis of a theoretical framework of brain connectomics research. Molecular characteristics, information pathways, tumor microenvironment landscape, and immunology will inform the analysis. We aim to identify novel biomolecular targets and therapeutic pathways to gain scientific insights for effective glioblastoma treatment.

Objective To compare the diagnostic value of transvaginal ultrasound(TVS)and thin-section oblique axial T2WI in deep infiltrating endometriosis(DIE)of uterosacral ligaments(USL).Methods Retrospective analysis was conducted on preoperative TVS and MRI images from 74 patients with USL-DIE.The diagnostic efficacy of TVS and thin-section oblique axial T2WI for USL-DIE was evaluated using receiver operating characteristic(ROC)curve based on pathological findings,and area under the curve(AUC),sensitivity,specificity,accuracy,positive predictive value(PPV)and negative predictive value(NPV)were further calculated.The McNemar two-tailed test was used to analyze the difference in diagnostic accuracy between the two methods for USL-DIE.Results The AUCs of TVS and thin-section oblique axial T2WI for diagnosing left and right USL-DIE were 0.721 vs 0.842 and 0.640 vs 0.901,respectively.Thin-section oblique axial T2WI demonstrated higher sensitivity,accuracy,PPV,and NPV compared to TVS in diagnosing USL-DIE.The diagnostic accuracy was found to be statistically different between the two methods(Pleft =0.026,χ2=4.966;Pright<0.001,χ2=16.531).Conclusion Thin-section oblique axial T2WI outperformed TVS in terms of diagnostic value for USL-DIE,providing valuable imaging support for accurate clinical diagnosis.

This work aims to explore the effect of glycolysis on the replication of porcine reproductive and respiratory syndrome virus (PRRSV) in porcine alveolar macrophages (PAMs). The changes of glucose metabolism, PRRSV protein levels, PRRSV titers, and the relative expression levels of genes and proteins in PAMs were analyzed by ELISA, qPCR, virus titration, and Western blotting after PRRSV infection. The effect of hypoxia-inducible factor-1α (HIF-1α) on PRRSV replication was subsequently assessed by specific siRNAs targeting to HIF-1α. The results showed that PRRSV infection enhanced glycolysis, elevated the levels of glucose uptake and lactate in the supernatant (P<0.05 and 0.01, respectively), reduced ATP production (P<0.05), and up-regulated the expression of hexokinase 2 (HK2), 6-phosphofructo-2-kinase/fructose-2, 6-biphosphatase 3 (PFKFB3), and pyruvate kinase isozyme type M2 (PKM2) in PAMs (P<0.05 and 0.01, respectively). Glycolysis inhibitors down-regulated the expression of PRRSV proteins and reduced virus titers (P<0.01). The knockdown of HIF-1α by siRNAs inhibited glycolysis and lowered PRRSV titers (P<0.05). In addition, the interferon pathways inhibited by PRRSV infection were reversed by the inhibition of glycolysis. These findings may facilitate further investigation of the role of glycolysis in PRRSV replication.
Porcine respiratory and reproductive syndrome virus/physiology* ; Glycolysis ; Swine ; Animals ; Virus Replication ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Macrophages, Alveolar/metabolism* ; Porcine Reproductive and Respiratory Syndrome/virology* ; Cells, Cultured ; RNA, Small Interfering/genetics*

Objective:To construct the prediction model of knee degeneration in patients with knee osteoarthritis based on bioelectrical impedance index, and evaluate the prediction performance and application efficiency of the model.Methods:This was a cross-sectional study. From May to July 2021, 248 knee joints of 124 patients with knee osteoarthritis at home from Shijiazhuang Yuqiang Community Health Service Center who participated in physical examination were selected by convenience sampling to establish the model. According to Kellgren-Lawrence (K-L) grading system, the knee joints were divided into four groups, namely K-L1 ( n=19) , K-L2 ( n=103) , K-L3 ( n=96) , and K-L4 ( n=30) . The indicators included in the model were selected through analysis of variance or Kruskal-Wallis test, and a prediction model of knee degeneration was established using support vector machine, and the model was optimized using grid parameter optimization method. The prediction performance of the model was evaluated by the area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, accuracy, positive predictive value and negative predictive value. Results:The indicators in the model included age, complications, lumbar/back/hip pain, high-risk occupation, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) -pain, WOMAC-function, capacitive reactance and phase angle. The area under the ROC curve of the training set model was 0.999, the prediction accuracy was 0.920, and the 95% confidence interval was 0.868 to 0.957. The area under the ROC curve of the test set model was 0.833, the prediction accuracy was 0.682, and the 95% confidence interval was 0.572 to 0.780.Conclusions:The prediction model of knee degeneration has good prediction performance and is easy to use, which can be used as a screening tool for knee degeneration in patients with knee osteoarthritis.

Objective:To investigate the alterations of brain functional network related to disease progression in patients with temporal lobe epilepsy (TLE) and the potential neural mechanism of executive dysfunction.Methods:Nineteen temporal lobe epilepsy patients with a disease course of less than or equal to 5 years (TLE-SD group) and 24 temporal lobe epilepsy patients with a disease course of more than 5 years (TLE-LD group) were recruited from the Epilepsy Clinic of the First Affiliated Hospital of Guangxi Medical University from December 2019 to December 2021. At the same time, 21 healthy control individuals (healthy control group) were recruited from the society and matched with gender, age, and education level. All subjects were evaluated demographic and clinical data, and performed resting state functional magnetic resonance imaging (rs-fMRI) and attention network test (ANT). The topological properties of functional brain network of 3 groups of subjects were calculated using graph theory, and then the hubs were determined. Then the inter-group comparison of hubs properties was carried out, and the correlation analysis with executive control function was performed.Results:The distribution pattern of hub nodes in TLE-SD patients was changed. Compared with the TLE-LD and healthy control groups, the TLE-SD group significantly increased the nodal degree values in brain regions such as the ventrolateral area of the left middle frontal gyrus, the left anterior central gyrus (upper limb area), the cephalic and caudal areas of the left parietal lobule, as well as the inner parietal lobe area, the caudal side of the right parietal lobule, and the right lateral occipital cortex. The nodal values of the brain areas such as the lateral and parietal inner area, the caudal side of the right upper upper lobule, and the right lateral occipital cortex were significantly increased. TLE-SD patients had a significant increase in the middle of the right upper frontal gyrus and the head of the left upper upper lobule. The node efficiency was significantly lower than that of TLE-LD patients, and the node efficiency in the middle of the right upper frontal gyrus was significantly lower than that of the healthy control group. The node network attributes of the left upper lobe were positively correlated with the execution control efficiency, and negatively correlated with the orientation efficiency. No significant difference was detected between TLE-LD patients and healthy controls.Conclusions:In TLE patients, the hubs in the middle of the right superior frontal gyrus were first damaged, and new hubs appeared in the dorsal attention network, the left anterior central gyrus and the right occipital lobe and were overloaded. With the progression of the disease, hubs tended to be redistributed to normality. The left superior parietal lobule may play an important role in the impairment of executive control function in TLE patients.

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

ObjectiveTo explore the factors associated with the risk of violent behaviour in inpatients with acute mental disorders， and to provide references for early detection and intervention of violent behaviour in patients with acute mental disorders. MethodsBased on the medical record system of the Affiliated Brain Hospital of Guangzhou Medical University， 1 107 inpatients with acute mental disorders from January to December 2016 were selected， all of whom met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10）. At admission， the risk assessment tools were used to assess the risk level of violent behaviour of inpatients， and 8 variables containing general demographic data and clinical data were selected to explore the factors associated with the risk of violent behaviour in inpatients with acute mental disorders. Thereafter， Logistic regression analysis was performed to screen the factors affecting the high risk of violent behaviour among inpatients. ResultsAmong the 1 107 inpatients with acute mental disorders， 357 （32.25%） patients were at high risk of violence. Regression analysis showed that gender of male （OR=1.747， 95% CI： 1.303~2.342）， manic episodes （OR=2.018， 95% CI： 1.310~3.108） and emergency admission （OR=4.244， 95% CI： 3.083~5.840） were risk factors affecting the high risk of violent behaviour of inpatients. Among different types of mental disorders， patients with depressive disorder had a relatively low risk of violent behaviour （OR=0.397， 95% CI： 0.233~0.677）. ConclusionAmong inpatients with acute mental disorders， patients of emergency admission， being male and manic episodes are more likely to be at high risk of violent behaviour.