Gorham-Stout disease(GSD) is a rare osteolytic disorder characterized by spontaneous and progressive osteolysis, along with abnormal angiogenesis and lymphangiogenesis, with no new bone formation. We present a case of a 15-year-old female admitted due to " recurrent right leg pain for 5 years, 11 months after undergoing right femoral fracture surgery". Through comprehensive integration of the patient's clinical phenotype, laboratory tests, imaging findings, pathological examinations, and molecular biological test results, GSD was considered highly likely. A multidisciplinary treatment approach was conducted, including a combination of zoledronic acid and sirolimus to inhibit osteolysis, along with rehabilitation training and orthopedic intervention, providing a personalized and comprehensive treatment strategy.

OBJECTIVE: To explore mechanisms of acid-sensing ion channel 1 (ASIC1) mediated lumbar nucleus pulposus cell apoptosis through extracellular-signalregulated protein kinase 5 (ERK5) signaling pathway and mitochondrial dysfunction pathway. METHODS: Totally 34 patients with degenerative lumbar disc herniation (LDH) admitted from January 2020 to December 2022 were collected as research objects, including 21 males and 13 females;aged from 29 to 52 years old with an average of (37.43±4.75) years old;22 patients with grade Ⅱ and 12 patients with grade Ⅳ, according to Pfirrmann grading criteria;15 patients with L_4,5 and 19 patients with L₅S₁. The expression of ASIC1 in nucleus pulposus of LDH patients was measured by immunohistochemical staining. Nucleus pulposus cells were cultured by primary culture method, identified by toluidine blue staining and immunohistochemical staining, and the expression of ASIC1 protein was located by immunofluorescence staining. According to the addition of siRNA-ASIC1, ASIC1 overexpression plasmid, and ERK5 inhibitors, the nucleus pulpocyte was divided into three groups, named as SIRNA-silenced group, overexpression group, and inhibitor group, with 3 patients in each group. Cells of each group were collected at 72 h after intervention, expression of ASIC1, ERK5, BCL-xL/BCL-2-associated Death promoter (Bad), B-cell lymphoma-2 associated X (Bax) and B-cell lymphoblast-2 gene (Bcl-2) were detected by reverse transcription-polymerase chain reaction (RT-PCR);intracellular calcium ion levels were detected by calcium ion kit, mitochondrial membrane potential was detected by JC-1 kit, and apoptosis was observed by AV-PI kit. RESULTS: In LDH patients with grade Ⅳ, nucleus pulposus tissue removed during operation revealed poor elasticity, white color and poor ductility, and immunohistochemical results showed increased ASIC1 expression. There was no significant difference in mRNA relative expression of ASIC1 between siRNA silencing group (0.31±0.03) and inhibitor group (0.39±0.05) (P>0.05). The mRNA relative expression level of ERK5 in siRNA silencing group(0.32±0.05) was significantly higher than that in inhibitor group (0.15±0.04)(P<0.05), which suggested ERK5 was the downstream molecule of ASIC1. The mRNA relative expression levels of apoptosis promoting factor Bad and Bax in siRNA silencing group and inhibitor group were lower than those in overexpression group(P<0.05), the relative expression level of anti-apoptosis factor Bcl-2 mRNA was significantly increased (P<0.05). The calcium content in overexpression group was higher than that in siRNA silencing and inhibitor groups (P<0.05), the normal proportion of mitochondrial membrane potential in overexpression group was lower than that in siRNA silencing and inhibitor group (P<0.05), and the apoptosis rate in overexpression group was higher than that in siRNA silencing and inhibitor group (P<0.05). CONCLUSION After the activation of ASIC1 channel protein, calcium ions could enter the cells and act as a second messenger molecule to regulate apoptosis of nucleus pulposus cells by ERK5 signaling pathway and mitochondrial disorder pathway.
Humans ; Acid Sensing Ion Channels/physiology* ; Male ; Female ; Apoptosis ; Middle Aged ; Adult ; Signal Transduction ; Mitogen-Activated Protein Kinase 7/physiology* ; Mitochondrial Diseases/genetics* ; Nucleus Pulposus/metabolism* ; Intervertebral Disc Degeneration/metabolism* ; Mitochondria/metabolism* ; Intervertebral Disc Displacement/genetics*

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Objective:To explore a method that can improve the detecting accuracy for faults of magnetic resonance(MR)through diagnostic technique based on firefly algorithm for fault of MR coil of magnetic resonance imaging(MRI)equipment with superconductivity,so as to enhance the performance and reliability of MRI equipment.Methods:A diagnosis technique for fault of MR coils in MRI equipment with superconductivity was proposed.Wavelet basis function was used to decompose initial vibration signals,and they were separated into resonance components with high-frequency and that with low-frequency,so as to enhance signal purity.The signal entropy value of deconvolution became the minimum value through iteratively adjusted the filter's coefficients,and identified the optimal system function of inverse filter,thus,to effectively recover the resonance characteristic of initially high and low frequency.A multi-objective function,which integrated entropy value of low-resonance component,smoothness and the differentiation of that with high-resonance components,was constructed.An improved firefly algorithm was introduced to combine linearly decreasing inertia weight factor,and simulate the process of swarm intelligence optimization,so as to realize global search and precise identification for faults'characteristics.Finally,the optimally diagnostic result was outputted.Results:The diagnostic technique based on firefly algorithm for fault of MR coil of MRI equipment with superconductivity can effectively decompose and enhance the original signal,and significantly suppress the interference of background noise.The algorithm can approach the true solution of the fault,which only need 298 iterations through global search for the combination of faults'features and diagnostic parameters.It can realize accurate identification for the faults of MR coil.Conclusion:The diagnostic technique,which based on firefly algorithm for fault of MR coil of MRI equipment with superconductivity,appears obvious advantages on diagnostic accuracy and convergence speed.It can provide a feasible approach for rapid diagnosis for fault of MRI equipment with superconductivity.

Objective:To investigate the effect of laparoscopic splenectomy and azygoportal disconnection (LSD) on liver synthesis and development of liver cirrhosis.Methods:This is a prospective case series study.The clinical data of liver cirrhotic patients with portal hypertension who received LSD at the Department of Hepatobiliary Surgery of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University from September 2014 to January 2016 were included. This study analyzed the diameter of the portal vein, the velocity of portal blood flow, the routine blood parameters, the liver function, the synthetic proteins of liver (antithrombin Ⅲ (AT-Ⅲ), protein S, protein C), and the serum content of liver fibrotic markers(collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase). Repeated measures ANOVA was used for comparison between multiple groups, and least significance difference was used for post-hoc multiple comparison.Results:A total of 106 patients were included in the study, including 70 males and 36 females, aged (51.8±9.8) years(range: 28 to 75 years).Compared with the preoperative results, the diameter of portal vein and the velocity of portal vein decreased after surgery ( F=14.03, 12.15, respectively, both P<0.01). Compared with the preoperative results, the total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score and classification were improved ( F=17.96, 56.01, 66.63, 35.83, 33.49, and 27.50, respectively, all P<0.01), and the AT-Ⅲ, protein S, protein C,collagen type Ⅳ, procollagen type Ⅲ, laminin and hyaluronidase levels were also improved ( F=47.87, 36.26, 18.02, 2.79, 14.58, 44.35, and 14.38, respectively, all P<0.01). Compared with the preoperative period, the diameter of portal vein was reduced from the first week to the 24 th month after surgery ( t=5.45 to 9.39, all P<0.01). Compared with the preoperative period, the velocity of portal vein blood from the first week after surgery to the 24 th month after surgery was decreased ( t=4.02 to 8.43, all P<0.01). Compared with the preoperative period, routine blood parameters (white blood count, hemoglobin, platelet count), liver function (total bilirubin, albumin, prothrombin time, international normalized ratio, Child-Pugh score), liver synthetic protein (AT-Ⅲ, protein S, protein C) and liver fibrotic markers (collagen type Ⅳ, procollagen type Ⅲ, laminin, hyaluronidase) were improved to varying degrees at the 24th month after surgery ( t=-20.46 to 11.93, all P<0.01). Conclusion:Preliminary findings show that LSD can reduce portal vein pressure, restore blood cell number, and improve liver synthesis function and the degree of liver fibrosis in patients with portal hypertension in liver cirrhosis.

Objective:To study the clinical effect of omalizumab for asthmatic children,and to analyze its effect on immune re-sponse,inflammatory transmitters and airway remodeling.Methods:Eighty-two children with bronchial asthma in Nanyang Second People's Hospital from May 2018 to May 2022 were selected,and classified into Control group(n=36)and experimental group(n=46)according to the admission time.Control group received budesonide and formoterol fumarate powder for inhalation,based on this,experimental group received subcutaneous injections of omalizumab therapy.Palmaer method was applied to assess the clinical out-come of children.Forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)and FEV1/FVC were measured using a spirometer.The percentage of Th1,Th2 and Treg cells were detected by flow cytometry.Levels of IL-4,IL-5,IFN-γ,TGF-β1,IL-10 and IL-35 were detected by ELISA.The lumen area(LA),wall area(WA)and percentage(WA%),and wall thickness(WT)of RB1(apical segment of the right upper lobe),RB10(posterobasal segment of the right lower lobe),LB1+2(apicoposterior seg-ment of the left upper lobe)and LB10(posterobasal segment of the left lower lobe)were obtained via CT scan,meantime,the quanti-tative assessment of the percentage of voxels below-950 hounsfield unit(HU)in inspiratory(IN-950),the volume at the end of deep inspiration(Vin)and the mean lung density(MLD)were also performed.Then comparison was conducted between two groups.Results:The clinical efficacy rate was 93.48%in experimental group,which was higher than 75.00%in control group,with statistical difference(P<0.05).No statistical difference was found in the lung function,immune response,inflammatory transmitters and airway remodeling between two groups before intervention(all P>0.05).After treatment,an increase in the lung function parameters FVC and FEV1,the immune response parameters Th1 cell ratio and Th1/Th2 levels,the expression level of the inflammatory transmitter IFN-γ,IL-10,IL-35,and the airway remodeling parameters LA normalized to body surface area(LA/BSA),WA/BSA and WT/√BSA,along with a decrease in Th2 and Treg cell percentage,IL-4,IL-5 and TGF-β1 expression and IN-950 were observed in experi-mental group compared with control group,with statistical difference(all P<0.05),while FEV1/FVC,WA%,Vin and MLDin no statis-tical difference between two groups(P>0.05).Conclusion:Omalizumab improves the clinical outcome of children with asthma by up-regulating the level of immune response,attenuating body inflammatory response and reducing airway remodeling caused by inflamma-tory stimuli,thus promoting the recovery of bronchial lumen of the children.

Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.

Objective:To investigate the expression, prognosis, and role of G protein-coupled receptor kinase-interacting protein 1 (GIT1) in patients with hepatocellular carcinoma (HCC) tumor micro environments.Methods:Clinical data of 140 cases who underwent complete HCC surgical resection from January 2015 to December 2021 in Subei People's Hospital affiliated to Yangzhou University, Jiangsu Province, were included. Tumor tissue and adjacent tissue samples were collected for immunohistochemical analysis. The patients were divided into a high expression group and a low expression group according to the expression of GIT1. Cox regression was used to analyze the risk factors for prognosis in patients with HCC. Fifteen pairs of cancer tissues and adjacent tissues were randomly matched for quantitative polymerase chain reaction (RT-PCR), western blot (WB), and immunohistochemical analysis. GITI knockout or overexpression cell lines of human hepatoma cell lines HepG2, HuH7 and MHCC97-H, and mouse hepatoma cell line Hepa 1-6 were constructed. The effects on M2 macrophage polarization were analyzed by flow cytometry. A mice tumor model was constructed. The growth curve of tumor tissue overexpressing GIT1 was plotted. Bioinformatics analysis of the Cancer Genome Atlas (TCGA) data was performed using OncoLnc, Kaplan-Meier Plotter, UALCAN, and GEPIA databases to explore the differential expression of GIT1 in HCC patients and its effect on prognosis.Results:Bioinformatics analysis showed that the expression level of GIT1 was significantly higher in HCC tissues than in normal liver tissues ( P<0.05). RT-PCR and WB experiments showed that GIT1 was highly expressed in HCC. The follow-up results showed that high expression of GIT1 was associated with poor prognosis in patients with HCC. The high expression of GIT1 was an independent risk factor for the prognosis in patients with HCC ( HR=2.562, 95% CI: 0.231-0.704, P<0.05). Functional enrichment analysis combined with TIMER database analysis found that GIT1 expression level was associated with multiple immune cell infiltrations in HCC, but the correlation coefficient with macrophage infiltration was the highest ( r=0.545, P<0.001). Mice tumorigenesis experiments showed that the tumor volume of GIT1-overexpressing mice was significantly increased ( P<0.05). Additionally, flow cytometry indicated that after GIT1 overexpression, there was a low degree of M1 infiltration/polarization (wild type: 5.06%±0.11%, overexpression type: 4.09%±0.04%; P<0.05) and a high degree of M2 infiltration/polarization (wild type: 10.20%±0.33%, overexpression type: 14.7%±0.12%; P<0.05). Conclusion:GIT1 serves as a prognostic biomarker in HCC, promoting tumor progression through its high expression and enhances M2 macrophage infiltration.

Objective:To explore the characteristics of brain structure and morphology changes in patients with chronic knee osteoarthritis(OA).Method:Voxel-based morphometry(VBM)analysis,surface-based morphometry(SBM)analysis and structural covariance networks(SCN)based on gray matter volume were used to exam the differences in brain structure and morphology between patients with chronic knee osteoarthritis(KO A)and healthy control(HC).Result:①VBM analysis:Compared with HC subjects,chronic KOA patients showed a significant reduction in gray matter volume of the left temporal pole as the central region(voxels level,P＜0.001;cluster level,P=0.049,FWE correction,voxels size=833).②SBM analysis:Compared with HC subjects,the sulcus depth in the pars opercularis of the left inferior frontal gyrus decreased significantly in patients with chronic KOA(voxels level,P＜0.001;cluster level,P=0.003,FWE correction,voxels size=293).③SCN analysis:Compared with HC subjects,the SCN constructed based on local gray matter volume in patients with chronic KOA was more robust than that in healthy controls(P=0.032).Conclusion:Chronic KOA patients have structural abnormalities in the brain,providing a new insights into the potential impact of chronic KOA on the central nervous system.

Ethanol detection plays an important role in food industry,environmental monitoring,medical health monitoring,prevention of drunk driving,etc.The development of low-cost,high-performance ethanol sensors has important application value.In this study,a ZnO/FeS nano heterojunction ethanol sensor was prepared on commercial ceramic silver electrode substrate.The sensing characteristics of the sensor for ethanol gas were systematically studied.The results showed that ZnO had a nanowire structure,and the FeS was coated on the ZnO nanowire in the form of nanosheets.The sensor performed well for ethanol detection in environments with relative humidity ranging from 30%to 60%,with a detection range from 0.2 mg/m3 to 50 mg/m3.At the optimum operating temperature of 300℃,the response of ZnO/FeS nano heterojunction sensor to 50 mg/m3 ethanol was 15.6,the response time was 5.0 s,and the detection limit was as low as 0.101 mg/m3,which was obviously better than that of commercial ethanol sensor.This sensor was highly selective for ethanol compared to other gases such as CO,NH3,acetone,etc,and could steadily work for 30 days.The fabricated sensor had good development potential in the field of low-cost and high-performance ethanol gas detection.