Objective To explore the causal relationship between sarcopenia and cognitive impairment by using a two-sample Mendelian randomization(MR)study design.Methods Hand grip strength,usual walking pace,and appendicular lean mass(ALM)were identified as the primary exposure factors for sarcopenia,while cognitive function and cognitive performance associated with cognitive impairment were considered as the outcome.The MR statistical method was applied to examine the causal associations between both variables.Results The analysis revealed a positive correlation between sarcopenia,as indicated by hand grip strength,usual walking pace and ALM,and cognitive performance.Usual walking pace and ALM were positively associated with cognitive function.No significant causal relationship was detected between hand grip strength and cognitive function.In the reverse MR analysis,cognitive performance showed a positive correlation with usual walking pace and ALM,but no significant causal link was found with hand grip strength.Cognitive function was positively related to usual walking pace,but no significant associations were observed with hand grip strength and ALM.Conclusion Sarcopenia is associated with an increased risk of cognitive impairment,and a bidirectional causal relationship appears to exist between ALM and cognitive performance.

Objective To explore the causal relationship between sarcopenia and cognitive impairment by using a two-sample Mendelian randomization(MR)study design.Methods Hand grip strength,usual walking pace,and appendicular lean mass(ALM)were identified as the primary exposure factors for sarcopenia,while cognitive function and cognitive performance associated with cognitive impairment were considered as the outcome.The MR statistical method was applied to examine the causal associations between both variables.Results The analysis revealed a positive correlation between sarcopenia,as indicated by hand grip strength,usual walking pace and ALM,and cognitive performance.Usual walking pace and ALM were positively associated with cognitive function.No significant causal relationship was detected between hand grip strength and cognitive function.In the reverse MR analysis,cognitive performance showed a positive correlation with usual walking pace and ALM,but no significant causal link was found with hand grip strength.Cognitive function was positively related to usual walking pace,but no significant associations were observed with hand grip strength and ALM.Conclusion Sarcopenia is associated with an increased risk of cognitive impairment,and a bidirectional causal relationship appears to exist between ALM and cognitive performance.

BACKGROUND:Medical hydrogels are new functional polymer materials with three-dimensional structural networks and excellent biocompatibility,which have been widely studied in the field of tissue engineering and drug carriers,but the research on the combination of medical hydrogels and Chinese medicine for the treatment of diseases based on tissue engineering is still in the early exploration stage.Therefore,through the analysis of the mechanism of the role of medical hydrogels,the integration of medical hydrogels and Chinese medicine in the research of the joint application of the article,can better provide ideas for scientific researchers,and the joint application of Chinese medicine and medical hydrogels is of great significance. OBJECTIVE:To explore the strategy and significance of Chinese medicine combined with medical hydrogel for disease treatment based on tissue engineering research. METHODS:PubMed and CNKI were used to retrieve articles about the application of Chinese medicine combined with medical hydrogel in tissue engineering from January 2010 to November 2022,with the Chinese and English search terms"hydrogel,traditional Chinese medicine,drug carrier,tissue engineering".After the initial screening of all articles according to the inclusion and exclusion criteria,the 61 articles with high relevance were retained for review. RESULTS AND CONCLUSION:(1)Although the application of Chinese medicine combined with medical hydrogel is involved in intra-articular,intra-tissue organ,soft tissue wounds,tissue engineering,etc.,except for the clinical application of Chinese medicine combined with hydrogel dressing for soft tissue injury,other aspects are still in the experimental stage.(2)The development of Chinese medicine combined with medical hydrogel has great potential and development prospects,but there is a certain difficulty in the manufacture of the gel with high-performance requirements,and it is difficult to master the physical and chemical properties precisely.(3)At present,the comprehensive view of injectable hydrogel with the characteristics of easy to use,its joint use of Chinese medicine can be extended to a wider range,can be used for joint,organ,tissue engineering-related disease treatment.Smart hydrogel has high sensitivity and reversible transformation can also meet the use of the special environment.During the combined use of Chinese medicine,it also needs to understand the mechanism of action of Chinese medicine components.(4)The strategy of combining Chinese medicine with medical hydrogels for disease treatment should start with matching the therapeutic effects of Chinese medicine on organs,tissues and cells combined with appropriate types of medical hydrogels to make up for the shortcomings of traditional Chinese medicine delivery methods and frequent drug delivery.In tissue engineering,hydrogels can be loaded with stem cells after Chinese medicine intervention,or with both Chinese medicine and stem cells for disease treatment.(5)In future research of combined Chinese medicine and medical hydrogel application,we also need to consider:we should ensure that the biological properties of medical hydrogel can be quantified,and grasp the characteristics of hydrogel with different manufacturing processes of different materials to produce the required medical hydrogel that meets the application conditions.In Chinese medicine,we need to comprehensively understand and analyze the therapeutic effects and application mechanisms of known Chinese medicine monomer and Chinese medicine compound extracts,so as to achieve a more perfect combination between Chinese medicine and medical hydrogel under a more clear mechanism.With the continuous improvement of medical science and technology innovation,the medical hydrogel can be innovatively combined with other traditional treatment methods of Chinese medicine,such as acupuncture,massage,cupping and so on,to be used from multiple angles.

Objective:To investigate the clinical efficacy of 3D printed individual model combined with hyperbaric oxygen（HBO）therapy in treating complex ankle fracture，and to evaluate the therapy’s effect on prognosis.Methods:The clinical data of 45 patients with complex ankle fractures treated in the Department of Orthopedics of Penglai People’s Hospital from January 2017 to January 2021 were analyzed retrospectively. According to different treatment methods，they were divided into 3D model group（ n=21）and combined group（ n=24）. In addition，other 37 complex ankle fracture patients，who were treated in the Department of Orthopedics of Penglai People’s Hospital from January 2014 to December 2016 and had complete clinical data and detailed follow-up records，were selected as control group（conventional group）. The conventional group was given traditional surgery for complex ankle fractures，i.e.，after fracture reduction，the medial malleolus was fixed with steel wire tension band or screws，and the lateral malleolus was fixed with screws and steel plates. In the 3D model group，the strategy and approach of surgical operation were simulated and designed based on 3D printed individual models before operation. The combined group was additionally treated with HBO on the basis of the treatment of the 3D model group. The operation time，hospital length-of-stay，time to first ambulation，clinical fracture healing time，and the intraoperative bleeding loss of the three groups were observed and recorded，so as to compare the therapeutic effects of the three groups. All patients were followed up for one year. The functional recovery of postoperative ankle fracture was evaluated by Olerud-Molander Ankle Score（OMAS）. The incidences of postoperative complications were recorded. Results:The total effective rate of the 3D model group（95.24%）and the combined group（100.00%）were significantly higher than that of the conventional group（72.97%）（ P<0.05）. Regarding the operation time，hospital length-of-stay，time to first ambulation，clinical fracture healing time，and intraoperative bleeding loss，the results of the 3D model group and the combined group were significantly shorter or lower than those of the conventional group（ P<0.05）；the time to first ambulation and clinical fracture healing time of the combined group were significantly shorter than those of the control group（ P<0.05）；there was no statistically significant difference in the operation time，hospital length-of-stay，and intraoperative bleeding loss between the 3D model group and the combined group（ P>0.05）. All patients were followed up with a follow-up rate of 100.0%. The OMAS outcomes of the 3D model group and the combined group at the 1st，3rd，6th，and 12th month after operation were significantly higher than those of the conventional group at the same time points（ P<0.05），and the OMAS outcomes of the combined group at the 1st，3rd，6th，and 12th month after operation were significantly higher than those of 3D model group at the same time points（ P<0.05）. The incidence of postoperative complications was 16.22% in the conventional group，the incidence of deep venous thrombosis（DVT）was 4.8% in the 3D model group，and no complication was found in the combined group. Conclusion:The 3D printed individual model combined with HBO therapy has sound clinical efficacy and prognosis in treating complex ankle fracture. It can shorten the clinical fracture healing time and facilitate the rapid recovery of ankle function，therefore，it should be widely promoted in clinical practices.

Objective:To investigate the clinical efficacy of 3D printed individual model combined with hyperbaric oxygen（HBO）therapy in treating complex ankle fracture，and to evaluate the therapy’s effect on prognosis.Methods:The clinical data of 45 patients with complex ankle fractures treated in the Department of Orthopedics of Penglai People’s Hospital from January 2017 to January 2021 were analyzed retrospectively. According to different treatment methods，they were divided into 3D model group（ n=21）and combined group（ n=24）. In addition，other 37 complex ankle fracture patients，who were treated in the Department of Orthopedics of Penglai People’s Hospital from January 2014 to December 2016 and had complete clinical data and detailed follow-up records，were selected as control group（conventional group）. The conventional group was given traditional surgery for complex ankle fractures，i.e.，after fracture reduction，the medial malleolus was fixed with steel wire tension band or screws，and the lateral malleolus was fixed with screws and steel plates. In the 3D model group，the strategy and approach of surgical operation were simulated and designed based on 3D printed individual models before operation. The combined group was additionally treated with HBO on the basis of the treatment of the 3D model group. The operation time，hospital length-of-stay，time to first ambulation，clinical fracture healing time，and the intraoperative bleeding loss of the three groups were observed and recorded，so as to compare the therapeutic effects of the three groups. All patients were followed up for one year. The functional recovery of postoperative ankle fracture was evaluated by Olerud-Molander Ankle Score（OMAS）. The incidences of postoperative complications were recorded. Results:The total effective rate of the 3D model group（95.24%）and the combined group（100.00%）were significantly higher than that of the conventional group（72.97%）（ P<0.05）. Regarding the operation time，hospital length-of-stay，time to first ambulation，clinical fracture healing time，and intraoperative bleeding loss，the results of the 3D model group and the combined group were significantly shorter or lower than those of the conventional group（ P<0.05）；the time to first ambulation and clinical fracture healing time of the combined group were significantly shorter than those of the control group（ P<0.05）；there was no statistically significant difference in the operation time，hospital length-of-stay，and intraoperative bleeding loss between the 3D model group and the combined group（ P>0.05）. All patients were followed up with a follow-up rate of 100.0%. The OMAS outcomes of the 3D model group and the combined group at the 1st，3rd，6th，and 12th month after operation were significantly higher than those of the conventional group at the same time points（ P<0.05），and the OMAS outcomes of the combined group at the 1st，3rd，6th，and 12th month after operation were significantly higher than those of 3D model group at the same time points（ P<0.05）. The incidence of postoperative complications was 16.22% in the conventional group，the incidence of deep venous thrombosis（DVT）was 4.8% in the 3D model group，and no complication was found in the combined group. Conclusion:The 3D printed individual model combined with HBO therapy has sound clinical efficacy and prognosis in treating complex ankle fracture. It can shorten the clinical fracture healing time and facilitate the rapid recovery of ankle function，therefore，it should be widely promoted in clinical practices.

For locally advanced rectal cancer,neoadjuvant chemoradiotherapy,followed by surgery and postoperative adjuvant chemotherapy has become a standard treatment mode.Neoadjuvant chemoradiotherapy can induce the tumors to shrink to different extent.Partial patients can obtain complete remission validated by postoperative pathological examination,which contributes to increasing the probability of radical surgery for rectal cancer patients,reducing the recurrence rate and improving the long-term clinical prognosis.In recent years,the prediction and evaluation of the clinical efficacy of neoadjuvant therapy has captivated widespread attentions from clinicians.In terms of imaging methods,conventional morphological imaging techniques cannot accurately assess the clinical efficacy of neoadjuvant chemoradiotherapy,whereas DWI-MRI,DCE-MRI,PET-CT and other functional imaging techniques can not only reflect the degree of tumor shrinkage,but also reveal the changes in the functional metabolism of tumors before and after treatment and yield higher accuracy.In this article,recent application of imaging techniques in the evaluation of clinical efficacy of neoadjuvant chemoradiotherapy for rectal cancer was reviewed.

A 46-year-old male patient developed scatterred reddish-brown plaques and nodules on the back 6 years prior to the presentation. Then, the lesions gradually spread to the axillary fossa and protothorax, and became indurated with slight itching in winter. Laboratory examination revealed hypergammaglobulinemia. Computed tomography(CT)scan showed multiple nodular or patchy shadows in both lungs, lymphadenectasis in axillary, mediastinal and inguinal regions, and spleen enlargement. Histopathological examination of skin lesions showed granulomatous infiltrates with plenty of lymphocytes, histiocytes and mature plasma cells in the middle and lower dermis with the presence of lymphoid follicle-like structures, but no cell atypia was observed. Immunohistochemical study showed positive staining for CD38, CD138, CD79a, κ and λ light chains. According to clinical manifestations and laboratory examination results, the patient was diagnosed with cutaneous and systemic plasmacytosis.

In order to investigate the role of murine double minute 2 (MDM2) in cell proliferation and carcinogenesis in condyloma acuminatum (CA), immunohistochemistry and in situ hybridization were used to detect the expression of MDM2 protein and mRNA in normal skin and skin lesions of CA of vulva. PCR was also used to detect HPV types. The results showed that in 32 observed CA specimens, the expression of MDM2 protein and mRNA was detected in 18 (56.25%) and 22 (68.75%) respectively, while the co-expression of MDM2 protein and mRNA was found in 14. PCR results revealed that HPV6/11 and HPV16/18 subtypes were shown in 28(87.5%) and 4 (12.5%) respectively out of 32 CA specimens. Out of the 18 positive specimens expressing MDM2 protein, HPV6/11 subtypes were shown in 15 and HPV16/18 subtypes in 3. In 22 positive specimens expressing MDM2 mRNA, HPV6/11 subtypes were shown in 18 and HPV16/18 subtypes in 4. No expression of MDM2 protein and MDM2 mRNA was observed in normal skin. Our study indicated that the overexpression of MDM2 might be involved in malignant proliferation and carcinogenesis of CA.
Adolescent ; Adult ; Cell Transformation, Neoplastic ; metabolism ; Child ; Child, Preschool ; Condylomata Acuminata ; metabolism ; microbiology ; pathology ; Female ; Humans ; Infant ; Male ; Middle Aged ; Papillomaviridae ; Papillomavirus Infections ; metabolism ; Proto-Oncogene Proteins c-mdm2 ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics

Objective To investigate the role of MDM2in the cell proliferation and carcinogenesis in condyloma acuminatum(CA).Methods The technique of immunohistochemistry and in situ hybridization were used to detect the expression of MDM2protein and mRNA in skin lesions of CA and normal skin of genital area.Polymerase-chain reaction(PCR)was used to type HPV DNA.Results Out of32CA specimens,the expression of MDM2protein was found in18(56.25%),the expression of MDM2mRNA was found in22(68.75%),while co-expression of MDM2protein and MDM2mRNA was found in14.According to PCR results,HPV6/11subtype was shown in28out of32CA specimens(87.5%),and HPV16/18subtype was shown in4out of32(12.5%).In eighteen out of positive specimens expressing MDM2protein,HPV6/11subtype was shown in15and HPV16/18subtype3.In twenty-two positive specimens expressing MDM2mRNA,there were HPV6/11subtype in18,and4were HPV16/18subtype.No expression of MDM2protein and MDM2mRNA was observed in normal skin.Conclusion The overexpression of MDM2may be involved in malignant proliferation and carcinomatous change of condyloma acuminatum.