Objective To explore the mediating role of intolerance of uncertainty(IU)and moderating role of the negative emotion differentiation in the influence of perceived stress on anxiety among college students from a cognitive perspective.Methods A total of 271 participants were surveyed using the perceived stress scale,intolerance of uncertainty scale,depression anxiety and stress scale(Chinese version),and the test on negative emotional differentiation.SPSS 22.0 was used to perform descriptive statistics and correlation analyses and to test the moderated mediation model.Results Perceived stress affected anxiety and IU played a mediating role-perceived stress could affect anxiety through influencing IU.At the same time,the influence of IU on anxiety could be adjusted through the negative emotion differentiation.The higher the degree of negative emotion differentiation,the lower the degree of anxiety increase(β=0.17,t=5.70,P＜0.01).Conclusion It may be effective to develop training programs to reduce anxiety by regulating perceived stress,increasing acceptance of uncertainty,and improving the negative emotion differentiation,which can help individuals reduce anxiety by perceiving and adjusting anxiety-related emotional or cognitive factors in a timely manner.

BACKGROUND: The correlation between the morphological structure of the patellofemoral joint (PFJ) and the severity of knee joint osteoarthritis (KOA) remains uncertain. This study aims to investigate the correlation between the severity of knee joint osteoarthritis and the alignment of patellofemoral and patellar height on radiographs. METHODS: This multi-center, retrospective study analyzed the magnetic resonance imaging (MRI) scans and anteroposterior radiographs of 534 adult outpatients with KOA. To evaluate the radiographic severity of KOA, anteroposterior radiographs of the knee and the Kellgren-Lawrence (K-L) grade were used. Knee MRI scans were used to measure the patellar length ratio (PLR), sulcus angle (SA), lateral patellar tilt angle (LPTA), and the distance between tibial tuberosity and trochlear groove (TT-TG). We examined the association between the configuration of the PFJ, arrangement, and harshness of the KOA. Information on participants' demographics, such as age, sex, side, height, and weight, was collected. A chi-squared test was used for the correlation of radiographic severity of KOA with sex and the affected side. Spearman correlation was used for patellofemoral alignment or morphology and the radiographic severity of lateral KOA. Multiple linear regression models were used for the association between LPTA, SA, TT-TG, and severity of KOA after accounting for demographic variables. RESULTS: The study comprised of 534 patients; of these, 339 (63%) were female. A total of 586 knees were evaluated in this study. Age showed a strong positive correlation with KOA severity ( r  = 0.516, P <0.01), whereas LPTA showed a strong negative correlation ( r  = -0.662, P <0.01). Additionally, SA ( r  = 0.616, P <0.05), and TT-TG showed a strong positive correlation ( r  = 0.770, P <0.01) with tibiofemoral osteoarthritis (TFOA) severity. Multiple linear regression analysis indicated that knee osteoarthritis severity (β = -2.946, P <0.001) and side (β = -0.839, P  = 0.001) was associated with LPTA; knee osteoarthritis severity (β = 5.032, P <0.001) and age (β = -0.095, P <0.001) was associated with SA; knee osteoarthritis severity (β = 2.445, P <0.001), sex (β = -0.326, P  = 0.041), body mass index (β = -0.061, P  = 0.017) and age (β = -0.025, P <0.001) was associated with TT-TG. CONCLUSION Radiographic severity of KOA was positively associated with age, SA, and TT-TG but negatively associated with LPTA.
Humans ; Female ; Male ; Osteoarthritis, Knee/pathology* ; Middle Aged ; Retrospective Studies ; Aged ; Patellofemoral Joint/pathology* ; Magnetic Resonance Imaging ; Adult ; Patella/pathology* ; Radiography

Currently,common primary malignant bone tumors in clinical practice include osteosarcoma,chondrosarcoma,Ewing's sarcoma,chordoma,and multiple myeloma.Malignant bone tumors often metastasize to the lungs through the bloodstream,but lymph node metastasis can also occur.Once lymph node metastasis occurs,the prognosis for patients is worse than with lung metastasis,making the study of lymph node metastasis in malignant bone tumors a growing research focus in recent years.According to current research,primary malignant bone tumors mainly metastasize to lymph nodes through two pathways:firstly,bone tumor cells break through the periosteum into the surrounding lymphatic tissue;secondly,they regulate the expression of VEGF-C by secreting factors like WISP-3,CCL5,BDNF,thus inducing the neogenesis of lymphatic vessels in malignant bone tumors.Past research on lymph node metastasis of primary malignant bone tumors has mostly focused on clinical studies of a single type of malignant bone tumor,lacking systematic basic research and reviews,and the mechanisms of metastasis are not yet fully elucidated.Moreover,different types of malignant bone tumors vary in their rates and sites of lymph node metastasis.Therefore,this article mainly reviews the rates,sites,diagnostic methods,potential mechanisms,and treatment methods of lymph node metastasis in these five common types of malignant bone tumors,aiming to deepen understanding of lymph node metastasis in primary malignant bone tumors and to provide new ideas for clinical treatment and drug development.

Objective:To investigate the brain activity and related hypoxic indicators in early cognitive processing stage (200-600 ms) and late cognitive processing stage (600-1 000 ms) by comparing their cognitive processing in pilots performed classical Stroop task under hypoxic state.Methods:Fifteen male Air Force pilots who were qualified in aeromedical assessment were selected. The behavioral indicators (accuracy, response time), event related potentials (ERP) component metrics (N2), and spectral metrics (Alpha band, Beta band) were monitored and analyzed when the pilots complete the cognitive conflict control task in the simulated 5 000 m hypoxic state and normal state.Results:The main effect of relationship type factors in response time indicators was significant ( F=4.10, P=0.027), and no difference found in accuracy indicators (all P>0.05). The reaction time under conflict conditions was (543.360±21.202) ms, which was higher than the reaction time under consistent conditions (509.078±14.420) ms, and the difference was significant ( F=3.28, P=0.039). The reaction time under unrelated conditions was (521.697±15.073) ms, and there was no significant difference between the reaction time under consistent and conflicting conditions (all P>0.05). Hypoxic status resulted in a significant increases in early stage indicator N2 amplitude ( F=5.34, P=0.037), and the power of Alpha, Low beta and Mid beta of late stage ( F=7.76, 5.34, 4.92, P=0.015, 0.037, 0.044). Conclusions:The amplitude of N2 can be used as the ERP indicator to investigate the pilots′ brain activities at the early stage of cognitive processing under hypoxia state; Alpha, Low beta and Mid beta bands of the spectrum can be used as the indicators to evaluate the brain activity of pilots in the late stage of cognitive processing under hypoxia state, which can be used in the training evaluation of pilots to provide more objective physiological data to improve the training effect of pilots.

Currently,common primary malignant bone tumors in clinical practice include osteosarcoma,chondrosarcoma,Ewing's sarcoma,chordoma,and multiple myeloma.Malignant bone tumors often metastasize to the lungs through the bloodstream,but lymph node metastasis can also occur.Once lymph node metastasis occurs,the prognosis for patients is worse than with lung metastasis,making the study of lymph node metastasis in malignant bone tumors a growing research focus in recent years.According to current research,primary malignant bone tumors mainly metastasize to lymph nodes through two pathways:firstly,bone tumor cells break through the periosteum into the surrounding lymphatic tissue;secondly,they regulate the expression of VEGF-C by secreting factors like WISP-3,CCL5,BDNF,thus inducing the neogenesis of lymphatic vessels in malignant bone tumors.Past research on lymph node metastasis of primary malignant bone tumors has mostly focused on clinical studies of a single type of malignant bone tumor,lacking systematic basic research and reviews,and the mechanisms of metastasis are not yet fully elucidated.Moreover,different types of malignant bone tumors vary in their rates and sites of lymph node metastasis.Therefore,this article mainly reviews the rates,sites,diagnostic methods,potential mechanisms,and treatment methods of lymph node metastasis in these five common types of malignant bone tumors,aiming to deepen understanding of lymph node metastasis in primary malignant bone tumors and to provide new ideas for clinical treatment and drug development.

Objective:To investigate the brain activity and related hypoxic indicators in early cognitive processing stage (200-600 ms) and late cognitive processing stage (600-1 000 ms) by comparing their cognitive processing in pilots performed classical Stroop task under hypoxic state.Methods:Fifteen male Air Force pilots who were qualified in aeromedical assessment were selected. The behavioral indicators (accuracy, response time), event related potentials (ERP) component metrics (N2), and spectral metrics (Alpha band, Beta band) were monitored and analyzed when the pilots complete the cognitive conflict control task in the simulated 5 000 m hypoxic state and normal state.Results:The main effect of relationship type factors in response time indicators was significant ( F=4.10, P=0.027), and no difference found in accuracy indicators (all P>0.05). The reaction time under conflict conditions was (543.360±21.202) ms, which was higher than the reaction time under consistent conditions (509.078±14.420) ms, and the difference was significant ( F=3.28, P=0.039). The reaction time under unrelated conditions was (521.697±15.073) ms, and there was no significant difference between the reaction time under consistent and conflicting conditions (all P>0.05). Hypoxic status resulted in a significant increases in early stage indicator N2 amplitude ( F=5.34, P=0.037), and the power of Alpha, Low beta and Mid beta of late stage ( F=7.76, 5.34, 4.92, P=0.015, 0.037, 0.044). Conclusions:The amplitude of N2 can be used as the ERP indicator to investigate the pilots′ brain activities at the early stage of cognitive processing under hypoxia state; Alpha, Low beta and Mid beta bands of the spectrum can be used as the indicators to evaluate the brain activity of pilots in the late stage of cognitive processing under hypoxia state, which can be used in the training evaluation of pilots to provide more objective physiological data to improve the training effect of pilots.

【Objective】 To explore the clinical features, treatment and prognosis of paraganglioma of the urinary bladder (PUB). 【Methods】 The clinical data of 41 PUB patients treated at our hospital during Sep.2012 and Sep.2022 were collected. The clinical features, surgical records, pathological reports and follow-up records were retrospectively analyzed. Patients’ survival was estimated with Kaplan-Meier estimator. The differences among groups were compared with Log-rank test. 【Results】 Among the 41 patients, 20 were male and 21 were female, with a median age of 52 years. All patients were treated with surgery, including transurethral resection of bladder tumor (TURBT) in 16 cases, partial cystectomy (PC) in 23 cases, and radical cystectomy (RC) in 2 cases. All patients were followed up for 4.0 to 125.0 months, with a median of 59.0 months. Local recurrence occurred in 5 patients, and distant metastasis occurred in 5 patients. Survival analysis showed that the 5-year overall survival (OS) rate and 5-year relapse-free survival (RFS) rate were 95.7% and 84.8%, respectively. Further analysis showed statistically significant differences in OS and RFS among groups with different maximum tumor diameters, growth patterns, and Ki-67 expressions (P<0.05). For patients with a maximum tumor diameter ≤2.8 cm, there was no significant difference in OS and RFS among different surgical groups. 【Conclusion】 PUB is rare, and a definitive diagnosis is based on pathology. In addition, the main treatment is surgery and the prognosis is good.

Abstract: Objective To investigate the impact of SARS-CoV-2 virus infection on the risk of thrombosis in COVID-19 outpatient patients with mild and regular symptoms. Methods Outpatient patients during the SARS-CoV-2 large-scale infection period after the policy adjustment for COVID-19 in Beijing in 2022 were selected as the observation group, and the dynamic zero-clearing period before the policy adjustment and outpatient patients during the 2022/2021/2020 period were taken as the three control groups. The patients with physiological factors that may increase the risk of coagulation, such as thrombotic diseases, malignant tumors, female pregnancy and other physiological factors, were excluded. Pediatric patients under 14 years old were also excluded. Age was expressed as median (interquartile). The changes in blood routine, fibrin/fibrinogen degradation products, and D-Dimer in Beijing outpatient patients were studied with statistical method and data analysis techniques. Results Compared with the control groups, the observation group showed a statistically significant decrease in red blood cells (RBC), hemoglobin (Hb), and hematocrit (HCT) levels, and an increase in monocytes (MONO) and platelet (PLT) counts, all showed statistically significant differences (P<0.0001). The proportion of fibrinogen degradation product (FDP) and D-Dimer of observation group exceeding the range increased significantly. Compared with the three control groups, the number of outpatient fibrinogen degradation products (FDP) in the observation group of patients aged 50 years and verage number of patients under 50 years old in the observation group with D-Dimer exceeding the threshold increased by more than 48.98%, and the monthly average number of patients with D-Dimer exceeding the threshold in patients aged 50 or older increased by 346%-998%. Conclusions The results of this study suggest that outpatient patients with mild or regular SARS-CoV-2 infection are also at risk for thrombotic events, and monitoring blood coagulation indicators such as D-dimer is recommended to avoid the sudden onset of thrombosis-related fatal complications .

Osteosarcomas are the most common primary malignant bone tumors in children and adolescents. Osteolysis is a common feature of all osteosarcomas (traditional, intramedullary, and periosteum). However, the specific mechanism of osteolysis is unknown and many researchers have studied it from different perspectives. Osteolysis is a process in which physiological bone remodeling is disrupted and excessive bone resorption occurs. Osteoclasts, the only cells with bone resorption function in the human body, play a key role in the pathological process of osteolysis in osteosarcomas. Osteoclasts play a leading role in osteolysis by secreting a high concentration of acid and collagenase, and they also mediate the occurrence and development of osteolysis in osteosarcoma through synergistic interaction with osteosarcoma cells. At the same time, osteolysis is an essential part of the pathological process of osteosarcoma, which can promote the occurrence and development of osteosarcoma and form a vicious cycle. Inhibiting osteolysis is of great significance to break this cycle and prevent the occurrence and development of osteosarcoma. However, the specific regulatory mechanism between osteosarcoma cells and osteoclasts and whether other cells in osteosarcoma are also involved in this pathological process remain unclear. Currently, bisphosphonates, small molecule inhibitors and natural compounds are the main drugs used to treat osteolysis of osteosarcoma. However, their efficacy and mechanism are still in the early stage of research. Previous studies on neoplastic osteolysis have mostly focused on metastatic bone tumors. Recently, studies on osteolysis of osteosarcoma have attracted more and more attention. The mechanism of osteoclasts and osteosarcoma cells in tumor-mediated osteolysis and the status of drug therapy of these two cell types as therapeutic targets are reviewed and analyzed. A deeper understanding of the role of osteolysis in the initiation and development of osteosarcoma will provide a theoretical basis and direction for the treatment of osteolysis in the context of osteosarcoma.

Objective:To evaluate the clinical efficacy of the modified biplane Chevron osteotomy and autogenous osteochondral transplantation for the treatment of talar cartilage injury with bone cyst.Methods:From February 2016 to February 2019, 26 patients with talar cartilage injury and bone cyst were treated at Department of Orthopaedics, The First Affiliated Hospital to Guangxi Medical University. They were 16 males and 10 females, aged from 22 to 50 years (average, 36.2 years). According to the Hepple classification, there were 5 cases of type Ⅳ and 21 cases of type Ⅴ. The extent and range of talar cartilage injury were evaluated by arthroscopy, the modified biplane Chevron osteotomy of medial malleolus was performed to expose cartilage defects medial to the talus, unstable cartilage was removed thoroughly, sclerotic wall of the bone cyst was freshly treated, and an osteochondral column taken from the non-weight-bearing area of the ipsilateral femoral medial condyle was implanted into the injured area of talar cartilage. The clinical efficacy was evaluated by comparing the ankle-hindfoot scores of American Orthopedic Foot and Ankle Society (AOFAS), Karlsson ankle scores, visual analogue scale (VAS) and Lysholm ankle scores between preoperation and one year post-operation.Results:All the 26 patients were followed up for an average of 20.6 months (from 12 to 30 months). Follow-up did not observe any postoperative complications like incision infection, cyst recurrence or malunion, or any obvious pain or movement limitation at the donor knee joint. The AOFAS ankle-hindfoot scores were significantly increased from preoperative 64.3±3.9 to 89.5±5.1 one year postoperation, the Karlsson scores were significantly increased from preoperative 60.5±5.5 to 85.2±6.9 one year postoperation, and the VAS scores were significantly decreased from preoperative 6.2±1.1 to 1.8±0.9 one year post-operation (all P<0.05). The Lysholm ankle scores before and after operation were 94.7±1.9 and 94.1±1.8, respectively, showing no significant difference ( P>0.05). Conclusion:In the treatment of talar osteochondral injury and bone cyst, the modified biplane Chevron osteotomy of medial malleolus and autogenous transplantation of osteochondral column can effectively relieve ankle pain and improve ankle function, leading to satisfactory clinical efficacy.