BACKGROUND:Degenerative scoliosis is defined as a condition that occurs in adulthood with a coronal cobb angle of the spine>10° accompanied by sagittal deformity and rotational subluxation,which often produces symptoms of spinal cord and nerve compression,such as lumbar pain,lower limb pain,numbness,weakness,and neurogenic claudication.The finite element method is a mechanical analysis technique for computer modelling,which can be used for spinal mechanics research by building digital models that can realistically restore the human spine model and design modifications. OBJECTIVE:To review the application of finite element method in the etiology and treatment of degenerative scoliosis. METHODS:The literature databases CNKI,PubMed,and Web of Science were searched for articles on the application of finite element method in degenerative scoliosis published before October 2023.Search terms were"finite element analysis,biomechanics,stress analysis,degenerative scoliosis,adult spinal deformity"in Chinese and English.Fifty-four papers were finally included. RESULTS AND CONCLUSION:(1)The biomechanical findings from the degenerative scoliosis model constructed using the finite element method were identical to those from the in vivo experimental studies,which proves that the finite element method has a high practical value in degenerative scoliosis.(2)The study of the etiology and treatment of degenerative scoliosis by the finite element method is conducive to the prevention of the occurrence of the scoliosis,slowing down the progress of the scoliosis,the development of a more appropriate treatment plan,the reduction of complications,and the promotion of the patients'surgical operation.(3)The finite element method has gradually evolved from a single bony structure to the inclusion of soft tissues such as muscle ligaments,and the small sample content is increasingly unable to meet the research needs.(4)The finite element method has much room for exploration in degenerative scoliosis.

ObjectiveGliomas in the motor functional area can damage the corticospinal tract (CST), leading to motor dysfunction. Currently, there is a lack of unified methods for evaluating the extent of CST damage, especially in patients with high surgical risk where the minimum distance from the lesion to the CST is less than 10 mm. This study aims to further clarify the classification method and clinical significance of CST morphological changes in these patients. MethodsThis retrospective study analyzed 109 high-risk functional area glioma patients who underwent neurosurgical treatment with preoperative diffusion tensor imaging (DTI) imaging and intraoperative neurostimulation guidance between 2014 and 2024. All patients had a lesion-to-tract distance (LTD) of less than 10 mm between the CST and the lesion. Preoperative DTI evaluation of CST involvement-induced morphological changes were reviewed. Patients were divided into 3 groups: 17 cases (15.6%) with symmetric CST morphology compared to the healthy side (CST symmetry), 48 cases (44.0%) with significant CST morphology changes compared to the healthy side (CST deformation), and 44 cases (40.4%) with CST overlap with the tumor (CST overlap). Then we classified patients according to preoperative assessment of tumor-induced morphological changes, and analyze postoperative motor function for each category. ResultsPostoperative pathology showed a significantly higher proportion of high-grade gliomas (HGG) in the CST overlap group compared to the other two groups (P=0.001). Logistic regression analysis showed that CST overlap was a predictor of HGG (P=0.000). The rate of total tumor resection in the CST deformation group and overlap group was lower than in the CST symmetric group (P=0.008). There was a total of 41 postoperative hemiplegic patients, with 4 cases (23.5%) in the CST symmetric group, 11 cases (22.9%) in the CST deformation group, and 26 cases (59.1%) in the CST overlap group. CST overlap with the tumor predicted postoperative hemiplegia (P=0.016). Two-way ANOVA analysis of the affected/healthy side and CST morphology groups showed significant main effects of CST grouping and healthy-affected side (P=0.017 and P=0.010), with no significant interaction (P=0.31). The fractional anisotropy (FA) value in the CST overlap group and the affected side was lower. A decrease in the FA value on the affected side predicted postoperative hemiplegia (sensitivity 69.2%, specificity 71.9%). ConclusionWe have established a method to predict postoperative hemiplegia in high-risk motor functional area glioma patients based on preoperative CST morphological changes. CST overlap leads to a decrease in CST FA values. This method can be used for precise patient management and aid in accurate preoperative surgical planning.

Objective: To investigate the occupational health literacy (OHL) level and its influencing factors of key populations in Jinhua City, Zhejiang Province, so as to provide a basis for promoting occupational health. Methods: The front-line workers of 7 secondary industry enterprises (institutions) and 15 tertiary industry enterprises (institutions) in Jinhua City were selected from April to October 2023 using a stratified random cluster sampling method. Date of gender, age, length of service, and OHL were collected using the National Occupational Health Literacy Monitoring Survey for Key Population Personal Questionnaire. Factors affecting OHL level among key populations were identified using multivariable logistic regression model. Results: A total of 3 305 people were investigated, including 1 750 males (52.95%) and 1 555 females (47.05%). The median age and the length of service were 37 (interquartile range, 17) and (interquartile range, 9) years, respectively. The level of OHL was 45.63%. Multivariable logistic regression analysis identified gender (female, OR=1.675, 95%CI: 1.428-1.964), educational level (junior high school, OR=1.499, 95%CI: 1.089-2.063; high school, OR=1.905, 95%CI: 1.361-2.667; junior college, OR=4.065, 95%CI: 2.858-5.782; bachelor degree and above, OR=5.087, 95%CI: 3.597-7.194), personal monthly income (3 000-< 5 000 yuan, OR=1.373, 95%CI: 1.035-1.821; 5 000-<7 000 yuan, OR=1.653, 95%CI: 1.230-2.220; ≥7 000 yuan, OR=1.798, 95%CI: 1.322-2.447) and length of service (2-<6 years, OR=1.265, 95%CI: 1.032-1.551; 6-<11 years, OR=1.517, 95%CI: 1.184-1.943; ≥11 years, OR=1.337, 95%CI: 1.040-1.719) as factors affecting OHL level among key populations. Conclusions The OHL level of the key populations in Jinhua City is related to gender, age, education level, personal monthly income, and length of service. It is necessary to strengthen the occupational health education and health promotion of the key populations.

Rheumatoid arthritis (RA) is a common systemic inflammatory autoimmune disease characterized by synovitis and bone destruction. Its clinical characteristics are mainly joint pain, swelling, stiffness and joint deformity. Due to the poor efficacy of both drug and non-drug therapies, RA can significantly impact patients' quality of life and increase personal and socioeconomic burdens. Studies have found that the Janus kinase (JAK)/signal transduction and activator of transcription (STAT) pathway, as classical intracellular signaling pathway, plays an important role in the occurrence and development of connective tissue diseases by regulating inflammation, immunity, and cell differentiation. This article reviews the research progress on the involvement of JAK/STAT signaling pathway in the mechanism of RA pathological pain, in order to provide some reference for understanding the pathogenesis of RA pathological pain and developing specific drug.
Arthritis, Rheumatoid/metabolism* ; Humans ; Signal Transduction/physiology* ; Janus Kinases/metabolism* ; STAT Transcription Factors/metabolism* ; Pain/etiology* ; Animals

OBJECTIVE: To evaluate the clinical efficacy of self-made anatomical tower-shaped pads combined with splint plaster fixation in the treatment of unstable 2nd to 5th metacarpal fractures and to provide a reference for clinical practice. METHODS: A retrospective analysis was conducted on 98 patients with unstable 2nd to 5th metacarpal fractures treated with self-made anatomical tower-shaped pads combined with splint plaster fixation between January 2019 and December 2022. There were 74 males and 24 females, aged from 19 to 63 years old with an average of (41.58±7.23) years old. The total active movement (TAM) score was used to evaluate the metacarpophalangeal joint function. Complications and fracture healing time were recorded. RESULTS: All patients were followed up for a period ranging from 1 to 5 months, with an average duration of (3.45±1.03) months. Among the 98 patients, anatomical alignment was achieved in 75 patients, with 68 patients still maintaining anatomical alignment after fixation removal. Functional alignment was achieved in 23 patients, with 20 patients maintaining functional alignment even after fixation removal. There were 10 patients with displacement after reduction. The average fracture healing time was (5.78±1.14) weeks, and the fracture healed well without any angular or rotational deformities. TAM score was utilized to assess the hand function of patients 3 months post-treatment. The extension range of motion (10.72±1.35)° and flexion range of motion (83.19±4.08)° of the metacarpophalangeal joint were significantly higher than the pre-treatment values of (8.25±0.68)° and (70.35±2.36)°, respectively. These differences were statistically significant (P<0.05). TAM outcomes were excellent in 92 cases, good in 5, fair in 1, and poor in none. CONCLUSION The implementation of self-made anatomical tower-shaped pad combined with splint plaster fixation is effective for the conservative management of unstable 2nd to 5th metacarpal fractures.
Humans ; Male ; Female ; Adult ; Middle Aged ; Metacarpal Bones/surgery* ; Splints ; Retrospective Studies ; Fractures, Bone/therapy* ; Casts, Surgical ; Young Adult ; Fracture Fixation, Internal/instrumentation*

OBJECTIVES: To investigate the molecular epidemiology of children with phenylketonuria (PKU) in Gansu, China, providing foundational data for intervention strategies. METHODS: A retrospective analysis was conducted on 1 159 PKU families who attended Gansu Provincial Maternity and Child Care Hospital from January 2012 to December 2024. Sanger sequencing, multiplex ligation-dependent probe amplification, whole exome sequencing, and deep intronic variant analysis were used to analyze the PAH gene. RESULTS: For the 1 159 children with PKU, 2 295 variants were identified in 2 318 alleles, resulting in a detection rate of 99.01%. The detection rates were 100% (914/914) in 457 classic PKU families, 99.45% (907/912) in 456 mild PKU families, and 96.34% (474/492) in 246 mild hyperphenylalaninemia families. The 2 295 variants detected comprised 208 distinct mutation types, among which c.728G>A (14.95%, 343/2 295) had the highest frequency, followed by c.611A>G (4.88%, 112/2 295) and c.721C>T (4.79%, 110/2 295). The cumulative frequency of the top 23 hotspot variants reached 70.28% (1 613/2 295), and most variant alleles were detected in exon 7 (29.19%, 670/2 295). CONCLUSIONS Deep intronic variant analysis of the PAH gene can improve the genetic diagnostic rate of PKU. The development of targeted detection kits for PAH hotspot variants may enable precision screening programs and enhance preventive strategies for PKU.
Humans ; Phenylketonurias/epidemiology* ; Female ; Male ; Retrospective Studies ; Phenylalanine Hydroxylase/genetics* ; Mutation ; Child, Preschool ; China/epidemiology* ; Child ; Infant

OBJECTIVE: To investigate the significance of serum β₂-microglobulin (β₂-MG) for survival and relapse of patients with diffuse large B-cell lymphoma (DLBCL) in the rituximab era. METHODS: Clinical data of 92 patients with DLBCL admitted from December 2003 to July 2015 were retrospectively analyzed. The optimal cutoff value of β₂-MG levels for predicting prognosis of the DLBCL patients was determined using receiver operating characteristic (ROC) curve. KaplanMeier analysis was used to estimate progression-free survival (PFS) and overall survival (OS). Cox logistic regression analysis was used to explore potential prognostic factors associated with survival. Binary logistic regression analysis was used to analyze the relationship between various factors and relapse. RESULTS: The most discriminative cutoff value for β₂-MG level was determined to be 2.25 mg/L by the ROC curve. Subgroup analysis showed that patients in the elevated β₂-MG (＞2.25 mg/L) group had significantly worse PFS(P =0.006) and a trend toward worse OS compared with those in the low β₂-MG (≤2.25 mg/L) group(P =0.053). Univariate analysis showed that elevated β₂-MG, age>60 years, Ann Arbor stage III-IV, as well as IPI score ≥3 were associated with worse PFS. Binary logistic regression analysis showed that age＞60 years and β₂-MG＞2.25 mg/L were potential influencing factors for relapse of DLBCL patients. CONCLUSION Serum β ₂-MG might be an important predictor for the survival and relapse of DLBCL patients in the rituximab era.
Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; beta 2-Microglobulin/blood* ; Rituximab ; Retrospective Studies ; Prognosis ; Female ; Male ; Middle Aged ; Recurrence ; ROC Curve

OBJECTIVE: To analyze the effect of altitude on NIH-CPSI score in patients with chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) Methods: Clinical data and the results of NIH-CPSI Questionnaire of the 321 patients with CP/CPPS at different altitudes were collected from March 2021 to March 2022. And the influence of altitudes on NIH-CPSI score of CP/CPPS was analyzed. RESULT: The NIH-CPSI score of patients living at an altitude of 4 300 m was significantly higher than that of patients living at an altitude of 1 500 m and 2 200 m. The CP/CPPS patients who lived in the higher altitude had more severe symptoms of pain and urination as well as lower scores of life quality (P<0.05). CONCLUSION NIH-CPSI score increased significantly with higher altitude, indicating more severe symptoms and decreased quality of life in CP/CPPS patients. These findings highlight the need for management strategies for specific heights in patients with CP/CPPS.
Humans ; Male ; Prostatitis ; Altitude ; Quality of Life ; Surveys and Questionnaires ; Pelvic Pain ; Adult ; Chronic Disease ; Middle Aged

Objective： To investigate the effects of 3D laparoscopic radical resection prostatectomy(LRP) on urinary control and sexual function of patients with prostatic cancer. Methods： A total of 268 patients who were treated with LRP in the Fifth People's Hospital of Huai'an City from January 2019 to May 2022 were selected and divided into 2 groups according to surgical methods, with 134 cases in each group. The patients in the control group were treated with traditional LRP, and the 3D LRP was used in the observation group. The clinical effects of the two groups were compared. Results： The patients in observation group had less blood loss (［135.62±13.58］ mL vs ［143.18±14.89］ mL) and shorter indwelling catheter time (［8.26±1.47］ d vs ［9.78±1.73］ d) compared with control group, but the operation time (［160.52±10.78］ min vs ［154.47±10.41］ min) was longer than that in the control group (P<0.05). The recovery of sexual function and urinary control in the observation group was better than that in the control group after 3, 6 and 12 months of the surgery(P<0.05). After one month of surgery, the scores of ICIQ-SF and 1h urine pad test were lower than those of the control group. The EPIC-UIN score（［72.63±6.85］ points vs ［67.15±5.09］ points）of the observation group was higher than that of the control group (P < 0.05). The patients in the observation group had lower level of residual urine volume（［60.26±6.63］mL vs ［76.89±7.89］mL）, higher maximum urine flow rate（［7.52±0.46］mL/s vs ［6.17±0.43］mL/s） and detrusor pressure（［85.19±7.18］mL vs ［76.29±6.85］mL） at maximum urine flow rate compared with the control group (P<0.05). There was no difference in the incidence of complications between the observation group and the control group (5.97% vs8.27%，P>0.05). The recurrence rate of tumor 3 years after operation in the observation group was lower than that in the control group (11.94% vs 29.10%, χ2=12.102, P<0.05). Conclusion： 3D LRP has obvious advantages in surgical clarity and precision, which reduces the risk of postoperative complications and improves urinary control ability and sexual function of patients.
Humans ; Male ; Prostatectomy/methods* ; Laparoscopy/methods* ; Prostatic Neoplasms/surgery* ; Urination ; Middle Aged ; Aged

OBJECTIVE: To investigate the therapeutic potential of pseudolaric acid B (PAB) on non-alcoholic fatty liver disease (NAFLD) and its underlying molecular mechanism in vitro and in vivo. METHODS: Eight-week-old male C57BL/6J mice (n=32) were fed either a normal chow diet (NCD) or a high-fat diet (HFD) for 8 weeks. The HFD mice were divided into 3 groups according to a simple random method, including HFD, PAB low-dose [10 mg/(kg·d), PAB-L], and PAB high-dose [20 mg/(kg·d), PAB-H] groups. After 8 weeks of treatment, glucose metabolism and insulin resistance were assessed by oral glucose tolerance test (OGTT) and insulin tolerance test (ITT). Biochemical assays were used to measure the serum and cellular levels of total cholesterol (TC), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). White adipose tissue (WAT), brown adipose tissue (BAT) and liver tissue were subjected to hematoxylin and eosin (H&E) staining or Oil Red O staining to observe the alterations in adipose tissue and liver injury. PharmMapper and DisGeNet were used to predict the NAFLD-related PAB targets. Peroxisome proliferator-activated receptor alpha (PPARα) pathway involvement was suggested by Kyoto Encyclopedia of Genes and Genomes (KEGG) and search tool Retrieval of Interacting Genes (STRING) analyses. Luciferase reporter assay, cellular thermal shift assay (CETSA), and drug affinity responsive target stability assay (DARTS) were conducted to confirm direct binding of PAB with PPARα. Molecular dynamics simulations were applied to further validate target engagement. RT-qPCR and Western blot were performed to assess the downstream genes and proteins expression, and validated by PPARα inhibitor MK886. RESULTS: PAB significantly reduced serum TC, TG, LDL-C, AST, and ALT levels, and increased HDL-C level in HFD mice (P<0.01). Target prediction analysis indicated a significant correlation between PAB and PPARα pathway. PAB direct target binding with PPARα was confirmed through luciferase reporter assay, CETSA, and DARTS (P<0.05 or P<0.01). The target engagement between PAB and PPARα protein was further confirmed by molecular dynamics simulations and the top 3 amino acid residues, LEU321, MET355, and PHE273 showed the most significant changes in mutational energy. Subsequently, PAB upregulated the genes expressions involved in lipid metabolism and mitochondrial biogenesis downstream of PPARα (P<0.05 or P<0.01). Significantly, the PPARα inhibitor MK886 effectively reversed the lipid-lowering and PPARα activation properties of PAB (P<0.05 or P<0.01). CONCLUSION PAB mitigates lipid accumulation, ameliorates liver damage, and improves mitochondrial biogenesis by binding with PPARα, thus presenting a potential candidate for pharmaceutical development in the treatment of NAFLD.
Animals ; PPAR alpha/metabolism* ; Non-alcoholic Fatty Liver Disease/pathology* ; Male ; Mice, Inbred C57BL ; Lipid Metabolism/drug effects* ; Diterpenes/therapeutic use* ; Organelle Biogenesis ; Diet, High-Fat ; Humans ; Mice ; Liver/metabolism* ; Insulin Resistance ; Mitochondria/metabolism* ; Molecular Docking Simulation