BACKGROUND:As the end bearing joint of the human body,the ankle joint bears the top-down pressure of the body,which leads to the ankle joint is easy to be damaged in the movement,can induce functional ankle instability,which negatively affects daily life.The study of lower extremity biomechanics in patients with functional ankle instability during counter movement jump is of great significance for scientific training,prevention of ankle injury,and clinical rehabilitation after injury. OBJECTIVE:To investigate the kinetics and kinematics of lower limbs in the longitudinal jumping of functional ankle instability population. METHODS:From March to September 2023,15 male patients with functional ankle instability and 15 healthy people,aged 22-28 years old,were recruited in Soochow University.All subjects completed counter movement jump experiment.Vicon infrared high-speed motion capture system and Kistler three-dimensional force measuring table were used to simultaneously collect the lower limb kinematics and kinetics indexes of the two groups of subjects at the take-off stage of counter movement jump,the instant off the ground,the initial landing moment and the peak moment of vertical ground reaction force. RESULTS AND CONCLUSION:(1)At the instant off the ground,the affected side of the functional ankle instability group showed smaller knee internal rotation moment(P=0.020)and smaller ankle internal rotation moment(P=0.009)compared with the affected side of the healthy control group.(2)At the moment of landing,the affected side of the functional ankle instability group showed a smaller hip flexion angle than the affected side of the healthy control group(P=0.039).Compared with the healthy control group,functional ankle instability group showed smaller hip abduction angle(P=0.022),smaller knee varus angle(P=0.010),larger knee external rotation angle(P=0.021),smaller ankle varus angle(P=0.004),and smaller external ankle rotation angle(P=0.008).(3)At the peak of vertical ground reaction force,functional ankle instability group showed a smaller ankle varus angle than healthy control group(P=0.044).(4)The results showed that the lower limb biomechanical characteristics of the patients with functional ankle instability were abnormal compared with the healthy people during counter movement jump,which mainly showed the changes of the kinematics and kinetics indexes of the lower limb joints in the sagittal plane and the frontal plane at the moment of lift-off and landing.These changes reflect that people with functional ankle instability adopt rigid take-off and landing patterns when performing counter movement jump,tend to transfer the load of the affected ankle joint to other joints of the lower limb,and show compensatory phenomenon of the healthy lower limb.Therefore,detection and correction of abnormal biomechanical features should be a part of rehabilitation training for those with functional ankle instability.

Objective To investigate the effects of fractionated low-dose ionizing radiation (LDIR) on the ferroptosis in human bronchial epithelial (HBE) cells as well as the associated differentially expressed genes (DEGs), biological processes, and signaling pathways. Methods HBE cells were exposed to different single doses of X-ray irradiation (0, 25, 50, 75, and 100 mGy) for 24, 48, and 72 h, respectively. The change in cell viability was detected by MTT assay. Cells were irradiated with 0, 25, 50, and 100 mGy X-rays 5 times, with 48 h between each irradiation and a dose rate of 50 mGy/min. Cells were harvested 24 h after irradiation for the measurement of the expression of ferroptosis-related genes SLC7A11 and GPX4 at the mRNA and protein levels, cellular iron content, and the expression of FTH1 and FTL mRNAs. High-throughput sequencing was used to screen for the DEGs in each dose group, followed by Gene Ontology-Biological Process (GO-BP) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and Gene Set Enrichment Analysis (GSEA). Results Compared with the control group, single-dose LDIR significantly increased cell proliferation at 75 mGy after 24 h (P < 0.05), at 50, 75, and 100 mGy after 48 h (P < 0.05), and at 75 and 100 mGy after 72 h (P < 0.05). Compared with the control group, at the end of the fifth fractionated LDIR, SLC7A11 and GPX4 mRNAs decreased at all doses (P < 0.05), SLC7A11 protein decreased at all doses, GPX4 protein decreased at 25 and 100 mGy, iron content increased at all doses, and FTH1 and FTL mRNAs decreased at all doses (P< 0.05). Sequencing analysis identified 248, 30, and 291 DEGs and 10, 2, and 9 ferroptosis-associated genes at the three doses compared to the control. Gene Ontology-Biological Process analysis showed that DEGs were mainly enriched in biological processes such as response to lipids, cell death, and response to unfolded proteins. Kyoto Encyclopedia of Genes and Genomes analysis showed that DEGs were mainly enriched in the JAK-STAT signaling pathway, lipids and atherosclerosis, ferroptosis, protein processing in the endoplasmic reticulum, and FoxO signaling pathway. Gene set enrichment analysis showed that DEGs were mainly enriched in ferroptosis, fatty acid degradation, and glutathione metabolism. Conclusion Fractionated low-dose radiation induced ferroptosis in HBE cells, and DEGs were predominantly enriched in biological processes and signaling pathways related to inflammation, ferroptosis, and endoplasmic reticulum stress.

Objective To investigate the induction of senescence in L02 hepatocytes by low-dose fractionated X-ray radiation and its effects on oxidative stress, oxidative damage, and nuclear factor-κB (NF-κB) pathway protein levels. Methods L02 cells were subjected to fractionated X-ray irradiation at doses of 0.1, 0.2, and 0.5 Gy per fraction for a total of six fractions. Assays were performed 24 hours after the final irradiation. Measurements included SA-β-gal staining, the mRNAs of senescence-related genes p53 and p21 and their encoded proteins, mRNAs of genes encoding senescence-associated secretory phenotype factors (IL-6, IL-8, GM-CSF, MMP-15), reactive oxygen species, oxidative and anti-oxidative markers (malondialdehyde, glutathione, superoxide dismutase), DNA oxidative damage markers (8-OHdG and γ-H2AX), and NF-κB pathway protein levels. Results Compared with the control group, at 24 hours after the end of six irradiations, the number of cells positive in SA-β-gal staining was significantly increased in all dose groups. The mRNA and protein levels of p21 and p53 were significantly elevated in the 0.2 Gy × 6 and 0.5 Gy × 6 groups (P < 0.05). The mRNA levels of genes encoding IL-6, GM-CSF, and MMP-15 were significantly increased in all dose groups (P < 0.05). The mRNA levels of the gene encoding IL-8 were significantly increased in the 0.2 Gy × 6 and 0.5 Gy × 6 groups (P < 0.05). The levels of reactive oxygen species, malondialdehyde, and glutathione were significantly increased in all dose groups (P < 0.01). The level of superoxide dismutase was significantly increased in the 0.5 Gy × 6 group (P < 0.01). The levels of 8-OHdG were significantly increased in all dose groups (P < 0.05). In both the 0.2 Gy × 6 and 0.5 Gy × 6 groups, the expression levels of γ-H2AX and p-NF-κB p65 were significantly increased (P < 0.05), and the levels of IκBα were significantly decreased (P < 0.05). Conclusion Low-dose fractionated X-ray radiation can induce senescence and cause alterations in oxidative stress, oxidative damage, and the levels of NF-κB pathway proteins in L02 hepatocytes.

Objective To observe the value of CT radiomics for differentiating spinal bone islands(BI)and osteoblastic metastases(OBM).Methods Data of 109 BI lesions in 98 patients and 282 OBM lesions in 158 patients(including 103 OBM in 48 lung cancer cases,86 OBM in 52 breast cancer cases and 93 OBM in 58 prostate cancer cases)from 3 medical institutions were retrospectively analyzed.Data obtained from institution 1 were used as the internal dataset and divided into internal training set and internal validation set at a ratio of 7∶3,from institution 2 and 3 were used as external dataset.All datasets were divided into female data subset(including OBM of female lung cancer and breast cancer)and male data subset(including OBM of male lung cancer and prostate cancer).Radiomics features were extracted and screened to construct 3 different support vector machine(SVM)models,including model1 for distinguishing BI and OBM,model2 for differentiating OBM of female lung cancer and breast cancer,and model3 for differentiating OBM of male lung cancer and prostate cancer.Diagnostic efficacy of model1,CT value alone and 3 physicians(A,B,C)for distinguishing BI and OBM were assessed,as well as differentiating efficacy for different OBM of model2 and model3.Receiver operating characteristic(ROC)curves were drawn,and area under the curves(AUC)were calculated and compared.The differential diagnostic efficacy of model2 and model3 were also assessed with ROC analysis and AUC.Results AUC of model1 for distinguishing spinal OBM from BI in internal training set,internal validation set and external dataset was 0.99,0.98 and 0.86,respectively.In internal training set,model1 had higher AUC for distinguishing BI and OBM than that of physician A(AUC=0.78),B(AUC=0.87)and C(AUC=0.93)as well as that of mean CT value(AUC=0.78,all P＜0.05).AUC in internal training set,internal validation set and external dataset of model2 for identifying female lung cancer and breast cancer OBM was 0.79,0.75 and 0.73,respectively,of model3 for discriminating male lung cancer from prostate cancer OBM was 0.77,0.74 and 0.77,respectively.Conclusion CT radiomics SVM model might reliablely distinguish OBM and BI.

OBJECTIVE To investigate the awareness rate of diabetic otology diseases and evaluate hearing in patients with diabetes under community management,analyze the characteristics of hearing loss in patients with diabetes,and provide scientific basis for incorporating hearing care into community diabetes management.METHODS From 2018 to 2020,719 patients(1438 ears)with diabetes in a community in Beijing were investigated by questionnaire,medical history collection,specialist physical examination and audiology examination.The results were analyzed statistically.RESULTS 1.The awareness rate of hearing loss was 32.5%(234/719)in patients with diabetes,94.7%(1 362/1 438)reported hearing loss after pure tone hearing examination.Of the 954 ears that reported normal hearing,92.8%(885/954)were found to have varying degrees of hearing loss.2.In the young and middle-aged group(438 ears),89.7%(393/438)had hearing loss,and 80.6%(353/438)had high-frequency hearing loss.Of the 334 ears with normal hearing,88.0%(294/334)had some degree of hearing loss.3.Hearing loss was more severe in patients with diabetes with a disease duration≥10 years than patients with a disease duration<10 years(P<0.05).The degree of hearing loss was more severe in patients with diabetes with hypertension and/or hyperlipidemia(P<0.05).CONCLUSION The self-examination rate of hearing loss in patients with diabetes is low and the incidence is high,especially in young and middle-aged patients.The course and comorbidities of diabetes are risk factors for the development of hearing loss,which should be paid attention to by both doctors and patients.

Objective:To improve clinicians′ understanding of developmental and epileptic encephalopathy (DEE) caused by PPP3CA gene mutation. Methods:Clinical data of a patient with DEE diagnosed in the First Department of Neurology, Hebei Children′s Hospital in September 2018 were collected. The whole-exome sequencing of the proband′s family was performed, and the characteristics of gene mutation were analyzed. Literature review was carried out based on the reported cases related to PPP3CA gene. Results:The proband, a 3 months and 20 days old girl, was admitted to the hospital with a history of paroxysmal confusion with extremities shaking for 2 days. The clinical manifestations included frequent epilepsy seizures and hypoevolutism. Brain magnetic resonance imaging showed that the bilateral frontotemporal extracerebral space was slightly wider. The video electroencephalography showed hyperarrhythmia and a cluster of spastic seizures. Whole exome sequencing of the family revealed that the proband had a heterozygous de novo frameshift truncating mutation in the PPP3CA gene: c.1255-1256delAG (p.Ser419Cysfs*31). From the establishment of the database to May 2022, 8 foreign literatures and 1 Chinese literature were retrieved, and a total of 21 children with PPP3CA gene mutation were reported, with clinical developmental delay, cognitive dysfunction and abnormal electroencephalography activity. Conclusions:The frameshift truncating mutation of the PPP3CA gene (c.1255-1256delAG) is the hereditary etiology of this patient. For cases of frequent seizures with poor efficacy of antiepileptic drugs, and developmental delay, genetic testing should be performed to confirm diagnosis and treatment.

Objective To study whether rheumatoid arthritis (RA) increased the risk of stroke by systematically reviewing the literature. Methods Databases including PubMed, Web of Science, CNKI, Wan Fang database, The Cochrane Library (Issue 12, 2017), Embase and Sinomed database were searched to collect case-control studies and cohort studies up to February 1, 2018. The association between RA and stroke was analyzed. Meta-analysis and sub-group meta-analysis were conducted using Revman 5.3 software, and sensitive analysis and publication bias analysis were performed using Stata12.0 software. Results Finally 19 studies involving 248784 RA patients and 5970133 controls were included. Heterogeneity test was carried out and heterogeneity of each study was found to be statistically significant ( χ2=442.77, P<0.01, I2=96％), thus, the random effect model was used for meta-analysis. The risk of RA patients with stroke was 1.40 (1.21, 1.61) compared to the general population or patients without RA. Further subgroup analysis was performed by stratifing for race than indicating that the risk of RA combined with stroke was 1.21 (1.03, 1.56) versus one of non-RA patients among Caucasian. When stratified by whether control group matched on age and sex, the data had shown that the risk of RA with stroke was higher than that of the non-RA patients, whether control group was matched or not, and the risk ratio was 1.36(1.16, 1.60), 1.47(1.00, 2.15) respectively (P=0.001, P=0.05). When stratified by whether arthrophlogosis and/or immune related diseases were excluded in the control group, the risk of RA patients with stroke was 1.45(1.23, 1.72) compared to the non-RA patients when related diseases were not excluded (P<0.01). Conclusion RA patients may have a higher risk of stroke than the general population or patients without RA, especially in Caucasians.

ObjectiveTo investigate the expression of D-bifunctional protein (DBP) in hepatocellular carcinoma (HCC) tissue and its correlation with serum tumor markers alpha-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9), as well as the clinical value of DBP in early diagnosis and prognostic evaluation of HCC. MethodsA total of 20 patients who underwent hepatectomy for liver cancer in Tangshan Maternal and Child Health Hospital and Tangshan People’s Hospital from June 2015 to May 2017 were enrolled as experimental group, and 20 healthy subjects who underwent physical examination in these two hospital during the same period of time were enrolled as control group. Chemiluminescence was used to measure the expression of AFP and CA19-9, and immunohistochemistry was used to measure the expression of DBP, which was expressed as integrated optical density (IOD), in HCC tissue and adjacent tissue. The t-test was used for comparison of continuous data between groups, and the Pearson correlation analysis was used to investigate correlation between indices. ResultsThe IOD value of DBP in HCC tissue was significantly higher than that in adjacent tissues (220.52±101.30 vs 40.49±1932, t=-7.00, P＜0.01). The expression of DBP was positively correlated with that of AFP (r2=0.868, P＜0.01) and CA19-9 (r2=0.814, P＜0.01). ConclusionThe expression of DBP increases in HCC patients, which is closely associated with the development and progression of HCC. Therefore, it provides a new target for the diagnosis of HCC.

Objective: To evaluate the safety, reliability and effectiveness of "free style endoscopic technique" assisted transaxillary high level dual plane breast augmentation; To explore endoscopic techniques that can achieve higher efficiency and better result ; To discover a safe and effective method for dual plane dissection with the help of endoscopy. Methods: Using new endoscopic techniques to perform transaxillary dual plane breast augmentation: ① High level dual plane technique, the muscle division line is about 1.5 cm higher than the original inferior mammary fold, the cephalic side of the muscle is retracted to the lower border of the areola with a special retractor to form a high level dual plane cavity, thus the upper and lower portion of the implant would be covered by pectorilis major muscle, while the rest of the implant was partially under breast parenchyma. ② "Free style endoscopic techniques" , the endoscopy and retractor are not fixed to each other, thus the space is exposed by an assistant with a new designed special retractor, while the operator is concentrate on dissecting with endoscopy in one hand and long tipped bowie in the other hand. ③ Accurate navigate technique, define the dissection border by acupuncture via skin in a 90 degree angle, thus to make the dissection right as preoperative design. Results: There were 1 106 cases underwent this kind of surgery, while 405 of them, whose minimum follow up were 12 months were included in this retrospective study. The follow up period ranged from 12-60 months, the average follow up period is 24.3 months. The average operation time is (1.47 ±0.46) h, the average drainage removal time is (4.23±0.51) d after surgery. The perioperative complication rate is 0.99%, including an incision site change caused by intraoperative bleeding, 1 case of pneumothorax, 2 cases of bleeding after surgery. Long period complication including: 6 cases (1.48%) Ⅲ grade capsular contracture, 21 cases (5.20%) of nipple-areola sensation disorders, implant palpable occurred in 14 case (3.46%), 3 cases (0.74%) implant malposition, 2 cases (0.49%) implant distortion, the total reoperation rate is 2.47%. There was no infection, hematoma, seroma, curtain deformity, double bubble deformity occurred in our study. Conclusions The high level dual plane techniques not only can solve the deficient soft tissue coverage problem thus to lower the rate of implant palpability, but also can relieve the relationship of the pectorilis major muscle and the inframammary fold(IMF), offering an option to replace Ⅱ and Ⅲ type of dual plane techniques, decrease the risk of curtain deformity and double bubble deformity. The free style endoscopic techniques are very flexible and efficient, with the help of accurate navigate technique, it can archive an accurate cavity dissection, accurate and definite IMF, and a lower complication rate. Though the learning curve is relatively longer, it is really a safe and effective breast augmentation method worthwhile to learn and spread.

Objective To understand the correlation of constitutional type of Traditional Chinese Medicine between undergraduate nursing students and their agnate grandparents, so as to provide references for disease prevention and health guidance. Methods A total 800 undergraduate nursing students and their agnate grandparents were investigated with constitution in Chinese medicine questionnaire ( CCMQ ) designed by professor Wang Qi. Results A total of 784 questionnaires were collected. There were 569 effective questionnaires for nursing students which indicated that their agnate grandparents were living. There were 296 questionnaires for grandfather and 353 questionnaires for grandmother. Among the population, there were 389 persons ( 31. 94%) belong to Gentleness constitution, 769 persons ( 63. 14%) belong to lopsided constitutions. The most common constitutions types were gentleness type, Yang-deficiency type, Qi-deficiency type in nursing students (44. 46%) and their grandmothers (26. 62%). Nevertheless, the first three types of constitutions were Yang-deficiency type, Qi-deficiency type, Gentleness type in grandfather. Correlation analysis of constitutional type between nursing students and their grandparents indicated that there was no correlation in Gentleness constitution (r= -0. 09,0. 09;P>0. 05), but there were correlations in other constitutional types between nursing students and their grandparents (r=0. 20 0. 43;P<0. 01). Conclusions The correlation is not significant in constitutional type of traditional Chinese medicine between nursing students and their agnate grandparents, but it still has a certain directive significance for disease prevention and control in some family.