Objective The biomechanical model for the musculoskeletal system of a human knee joint was established using a numerical simulation method.The kinematic and dynamic information captured during jumping motion simulated by the human dynamic model was used as driven data of the knee biomechanical model,followed by further analysis of the stress field distribution characteristics of the meniscus under different thermal-force coupling knee brace conditions.Methods Based on computed tomography and magnetic resonance imaging of the subject,a realistic human knee model,including bone,articular cartilage,meniscus,ligaments and peripheral soft tissues of the knee joint,was constructed.Furthermore,two gaits,namely taking-off and landing-on,of jumping motion with an increased risk of meniscus injuries were selected according to mechanical features in full-cycle jumping motion.Subsequently,the stress field characteristics of the knee meniscus under four different thermal-force coupling knee braces were analyzed,the changes of the peak stress of the meniscus and its stress concentration area were discussed,and the protective efficacy and mechanical basis of meniscal injuries and wearing knee braces were explored.Results The anterior part of the medial knee meniscus was a vulnerable area under concentrated stress.Under the knee brace thermal-force coupling condition,the stress concentration area of the medial meniscus was transferred from its narrow and weak anterior part to its wide and thick middle part,and the peak stress was also significantly reduced.The peak stress on the medial meniscus and that on the lateral meniscus were similar,indicating that the two parts of the meniscus bore the external load evenly,and the meniscus stress concentration area decreased.Conclusions Thermal-force coupling knee braces have good protective effects against knee meniscus injury.The numerical simulation provides theoretical support and technical guidance for the design of multifunctional thermal knee braces.

Objective To investigate the correlation between the expression of coagulation markers thrombomodulin(TM) and tissue plasminogen activator-plasminogen activator inhibitor-1 complex(t-PAIC) and white matter lesions(WMLs). Methods A total of 69 patients with WMLs who were hospitalized in the Department of Neurology of Shanxi Provincial People's Hospital from July 2020 to October 2022 were selected. After admission,novel coagulation markers were tested,and cranial magnetic resonance examination was completed. WMLs were graded according to the Fazekas visual rating scale,and the correlation between novel coagulation markers and WML severity in patients with WMLs was analyzed by the Kendall stau-b method. Multivariate logistic regression was used to analyze the influencing factors for WML severity. Results There were significant differences in serum TM and t-PAIC levels between the mild,moderate,and severe WML groups,and the levels of serum TM and t-PAIC in the moderate and severe WML groups were significantly increased compared with the mild WML group(P<0.05). There was a correlation between serum TM and t-PAIC levels and the severity of WMLs in the three groups(P<0.05). The high level of t-PAIC and age were risk factors for the aggravation of WMLs,with odds ratios(95% confidence interval) of 1.274(1.052-1.544) and 1.063(1.015-1.114),respectively(P<0.05). Conclusion The expression of serum TM and t-PAIC in patients with WMLs is positively correlated with the degree of white matter lesions,and t-PAIC is a risk factor for the exacerbation of white matter lesions, which may be used as a serum marker to indicate the development of WML patients.

Metabolic-associated fatty liver disease (MAFLD), which is previously known as non-alcoholic fatty liver disease (NAFLD), represents a major health concern worldwide with limited therapy. Here, we provide evidence that ferroptosis, a novel form of regulated cell death characterized by iron-driven lipid peroxidation, was comprehensively activated in liver tissues from MAFLD patients. The canonical-GPX4 (cGPX4), which is the most important negative controller of ferroptosis, is downregulated at protein but not mRNA level. Interestingly, a non-canonical GPX4 transcript-variant is induced (inducible-GPX4, iGPX4) in MAFLD condition. The high fat-fructose/sucrose diet (HFFD) and methionine/choline-deficient diet (MCD)-induced MAFLD pathologies, including hepatocellular ballooning, steatohepatitis and fibrosis, were attenuated and aggravated, respectively, in cGPX4-and iGPX4-knockin mice. cGPX4 and iGPX4 isoforms also displayed opposing effects on oxidative stress and ferroptosis in hepatocytes. Knockdown of iGPX4 by siRNA alleviated lipid stress, ferroptosis and cell injury. Mechanistically, the triggered iGPX4 interacts with cGPX4 to facilitate the transformation of cGPX4 from enzymatic-active monomer to enzymatic-inactive oligomers upon lipid stress, and thus promotes ferroptosis. Co-immunoprecipitation and nano LC-MS/MS analyses confirmed the interaction between iGPX4 and cGPX4. Our results reveal a detrimental role of non-canonical GPX4 isoform in ferroptosis, and indicate selectively targeting iGPX4 may be a promising therapeutic strategy for MAFLD.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective To identify prognostic factors ofmotorfunctionafter surgery of metastatic spinal cord compression (MSCC).Methods The clinical data of 681 patients with spinal metastases from January 2008 to December 2017 were retrospectively analyzed.According to inclusion and exclusion criteria,a total of 206 patients with spinal metastatic were included.Postoperative neurological function was assessed using Frankel classification.The influence of age,gender,preoperative status,number of spine metastases,location of spinal metastases,visceral metastases,bone metastases,primary tumor type,interval from symptom to surgery,time of developing motor deficits,interval from primary tumor diagnosis to MSCC,preoperativethe Eastern Cooperative Oncology Group performance status (ECOG-PS),Karnofsky Performance score (KPS) and surgical procedures on postoperative function outcomes were explored.Results 140 (68.0％) patients were able to walk postoperatively compared with 88 (42.7％) patients preoperatively.Moreover,in 89.8％ of all patients,79 ambulatory patients maintained ambulation after treatment.The univariate analysis according to Ordered-logit model showed thatnumber of spine metastases,location of spinal metastases,preoperative ECOG-PS,preoperative KPS,interval from symptom to surgery and time of developing motor deficits were related with posttreatment motor functions.The multivariable analysis showed that number of spine metastases (OR=2.03;95％CI:1.12-3.33;P=0.04),preoperative ECOG-PS (OR=4.84;95％CI:2.42-8.15;P=0.038),interval from symptom to surgery (OR=3.78;95％CI:3.12-9.15;P=0.024),time of developing motor deficits(OR=2.75;95％CI:1.22-3.89;P=0.01) were independent prognostic factors for function outcomes.Conclusion 1-2 levels of metastasis,Interval from symptom to treatment ≥ 48 h,time of developing motor deficits ≥7 d,and ECOG-PS 1-2 can be considered as the most significant positive prognosticfactors for post-treatment ambulatory status.Spinal metastasis should have a higher priority,and immediate intervention should be started before the development of irreversible neurologic deficits.Increasing awareness of early symptoms and earlier screeningwith regular outpatient review might make a difference for patients with MSCC.Consequently,the identified prognostic factors can be considered as apreoperative assessment tool to predict the neurologic outcomeand guide clinical treatment for individual patients with MSCC.

Objectives To investigate the factors influencing long-term quality of life (QOL)of patients with first-episode ischemic stroke(IS)and partial side limb dysfunction.Methods 126 cases of the first ischemic stroke patients with partial side limb dysfunction admitted to hospital from November 2012 to July 2013 in Shanghai First People's Hospital were selected.General information of patients was collected and evaluated using NIH Stroke Scale(NIHSS)and Modified Rankin Scale(MRS).Following-up was conducted using NIHSS,MRS,stroke specific quality of life (SS-QOL) and Hamilton Depression Scale (HAMD) during 2-3 years after stroke Factors related to long-term QOL were screened by single factor analysis,then factors influencing QOL by multiple stepwise regression analysis.Results The average QOL score of patients with first IS partial side limb dysfunction was(181.5 ± 46.4)points scale.In each single scoring,the scale was(10.4±4.3)points in energy,(10.8±4.2)points in family roles,(21.8±6.2)points in language,(22.5 ±7.6) points in activity,(18.5±6.3)points in mood,(10.1±4.4)in personality,(19.2±5.9)points in self-care ability,(16.1 ± 7.0) points in social roles,(11.65 ± 3.31) points in thinking,(19.1 ± 6.6) points in upper limb function,(14.0 ± 2.0) points in visual acuity,(8.7 ± 4.1) points in work.The multiple regression analysis showed that the influencing factors of life quality included long-term NIHSS evaluation(β=-0.376,P＜0.01),HAMD evaluation(β=-0.375,P＜0.01),hypertension history(β=-0.178,P＜0.05).HAMD evaluation affected 9 fields of QOL,and NIHSS as long-term evaluation affected 6 fields of QOL.Conclusions Predictive factors for declined QOL of first-episode ischemic stroke patients with partial side limb dysfunction include higher NIHSS score,severer depression after long-term stroke and combined hypertension in the early stage.These indicate that recovering of body structure and function injury,control of hypertension,effective prevention and treatment of post-stroke depression maybe important measures for improving life quality of ischemic stroke patients with partial side limb dysfunction.

Objective Preparation of aqueous reference materials for cholesterol and glycerol.Methods Study on reference materials.The certified reference materials GBW09203b and GBW09149 were weighed accurately and dissolved into 20% of methyl cyclodextrin aqueous solution to prepare six kinds of candidate reference materials of cholesterol and glycerol according to the concentration.The materials were tested for homogeneity and stability using routine methods.The reference methods of isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS) were used to determine the concentration of cholesterol and glycerol to evaluate the accuracy of the certified values.Meanwhile, the blank verification test was carried out.The expanded uncertainty was the combination of standard uncertainty of measurement, unhomogeneity and instability.Results It showed that the six candidate reference materials were homogeneous and stable for at least 1 year at-70 ℃ and-20 ℃.The certified values (reference value ± expanded uncertainty,mmol/L) were as follows,for cholesterol:0.65±0.01,1.31 ±0.01,2.57±0.02,5.21±0.06,7.71±0.08,10.24±0.06;for glycerol:0.29±0.01,0.58±0.01,1.22±0.02,2.24±0.02,3.46±0.04,4.52 ±0.04.The results of reference methods were consistent with the certified values.Blank validation tests showed that the concentration of the analytes would not be affected by the reagent and the blank matrix.Conclusions Certified reference materials for cholesterol and glycerol in aqueous solution have been prepared successfully.These materials are homogeneous and stable, and the certified values are reliable.Therefore the materials have been approved to be the Certificate Reference Materials of GBW 09823, GBW 09824, GBW 09825, GBW09826, GBW09827 and GBW 09828.

Objective The article is to study on the detection of α-helix proteins in post-traumatic epileptogenic focus by FTIR-mapping. Methods Fourier transform infrared spectroscopy-mapping were applied to identifying α-helix by point-by-point scanning in post-traumatic epileptogenic focus sections and to develop FTIR-mapping profiles. Result The high absorbance of α-helix is accord with post-traumatic epilepsy, there are some significant differences between high absorbance and low absorbance. Conclusion α-helix proteins are distributed in post-traumatic epileptogenic focus widely, thus α-helix protein are involved in post-traumatic epilepsy.

Objective To prepare the serum reference materials for total thyroxine .Methods Individual blood samples were collected from 13 healthy donors (7 males and 6 females) aged from 20 to 50 years old, and the sera were separated and mixed into 4 serum pools according to the concentration of thyroxine.The materials were tested for homogeneity and stability using routine methods .The method of isotope dilution liquid chromatography tandem mass spectrometry ( ID-LC/MS/MS) was used to determine the concentration of thyroxine .The candidate reference materials were also measured by four conventional methods to analyze the commutability of the materials .Results It showed that the four candidate reference materials were homogeneous and commutable in four conventional methods and they were tested to be stable for at least 1 year at -70 ℃using the isochronous stability study .The certified values ( reference value ± expanded uncertainty ,nmol/L) were:75.9 ±1.8,105.3 ±2.2,114.7 ±2.1 and 187.4 ±2.9.Conclusions Certified reference materials for serum thyroxine have been prepared .These materials have been approved to be the Certificate Reference Materials of GBW 09127,GBW 09128,GBW 09129 and GBW 09130.

Objective To explore the value of dynamic monitoring of the neutrophils/lymphocyte ratio ( NLR ) in peripheral blood for the prognosis of patients with bloodstream infection ( BSI ). Methods A retrospective study was conducted. 205 patients who were≥18 years old, their length of hospital stay>24 hours, and they were treated in the China-Japanese Friendship Hospital from January 2013 to October 2014 were enrolled. According to the 28-day survival, the patients were divided into survival group ( n=160 ) and death group ( n=45 ). The white blood cell ( WBC ), neutrophils count ( NEU ), neutrophils ratio ( Neut%), lymphocyte count ( LYM ), lymphocyte ratio ( Lym%), and NLR in peripheral blood were recorded at 1, 3, 7 days after admission. Receiver-operating characteristic curve ( ROC ) was plotted for evaluating the value of these factors on the 28-day prognosis, and logistic regression analysis was used to evaluate the risk factors for predicting the outcome. Results ①On the 1st day, WBC, NEU, Neut%, NLR, and procalcitonin ( PCT ) in the death group were significantly higher than those in the survival group [ WBC (×109/L ):15.28±8.23 vs. 11.58±6.55, NEU (×109/L ):13.34±7.53 vs. 10.03±5.31, Neut%:0.886±0.076 vs. 0.845±0.102, NLR:21.20 ( 13.10, 28.80 ) vs. 12.08 ( 6.81, 20.47 ), PCT (μg/L ):3.13 ( 0.85, 10.12 ) vs. 1.34 ( 0.36, 5.81 ), P<0.05 or P<0.01 ], while hemoglobin ( Hb ), platelet count ( PLT ), albumin ( ALB ) content were significantly lower than those of the survival group [ Hb ( g/L ):86.09±19.83 vs. 107.89±22.82, PLT (×109/L ):157.51±117.81 vs. 195.44±97.28, ALB ( g/L ):24.11±6.94 vs. 31.99±6.89, P<0.05 or P<0.01 ]. On the 3rd day and 7th day, WBC, NEU and NLR in the death group were significantly higher than those of the survival group [ WBC (×109/L ):16.61±10.25 vs. 8.91±4.93, 16.05±9.46 vs. 8.79±4.45; NEU (×109/L ): 14.15±9.98 vs. 6.97±4.64, 14.36±9.03 vs. 6.59±4.07; NLR: 24.13 ( 8.49, 38.26 ) vs. 5.52 ( 3.58, 8.87 ), 17.74 ( 10.74, 32.85 ) vs. 4.35 ( 2.78, 7.27 ), all P<0.01 ], and the LYM and Lym%were significantly lower than those in the survival group [ LYM (×109/L ):0.61 ( 0.38, 1.04 ) vs. 1.05 ( 0.78, 1.43 ), 0.69 ( 0.35, 0.92 ) vs. 1.37 ( 0.93, 1.76 );Lym%:0.039 ( 0.024, 0.101 ) vs. 0.135 ( 0.094, 0.186 ), 0.056 ( 0.033, 0.082 ) vs. 0.170 ( 0.108, 0.237 ), all P<0.01 ].②It was shown by ROC curve that the maximum area under the ROC curve ( AUC ) of WBC, NEU, Neut%, LYM, Lym%, and NLR about prognosis of BSI were observed on 7 days ( 0.777, 0.819, 0.905, 0.755, 0.880, 0.887 ). Based on Neut%>0.855 on the 7th day as a predictor of cut-off value of death in 28 days, the sensitivity was 78.8%, specificity 89.1%, respectively. When Lym%<0.088 on the 7th day as a predictor of cut-off value of death on 28 days, the sensitivity was 89.5%, and specificity was 83.9%. When NLR>10.34 on the 7th day as a predictor of cut-off value of death in 28 days, the sensitivity was 81.8%, and specificity was 91.0%.③Survival analysis showed that the 28-day survival rate in the patients with 7-day NLR<10.34 was significantly higher than that in those with 7-day NLR>10.34 ( 95.0%vs. 34.1%,χ2=82.650, P=0.000 ).④It was shown by multi-factor logistic regression analysis that the levels of 1-day Hb and 7-day NLR were the independent prognostic predictors of 28-day mortality [ Hb: odds ratio ( OR ) = 0.946, 95% confidence interval ( 95%CI ) = 0.913-0.981, P = 0.003; 7-day NLR:OR=34.941, 95%CI=8.728-139.884, P=0.000 ]. Conclusions The trend of changes in NEU, LYM and NLR as shown by repeated routine blood examinations contributes to prediction of the outcome of patients with BSI. The levels of 1-day Hb and 7-day NLR are the independent prognostic predictors for 28-day mortality.