BACKGROUND:With the continuous advancement of medical technology,the combination of oblique lumbar interbody fusion and percutaneous pedicle screw fixation has become a common method for treating lumbar degenerative diseases;however,there is still a lack of in-depth research on the relationship between changes in anterior convexity angles at different postoperative segments and fusion device settlement.OBJECTIVE:To explore the relationship between changes in anterior convexity angle of different segments and Cage subsidence after oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation surgery.METHODS:Patients(93 cases)with lumbar degenerative diseases who underwent oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation surgery in Weifang Hospital of Traditional Chinese Medicine from February 2019 to April 2023 were selected as the research subjects.According to the postoperative disc height loss value,they were divided into Cage subsidence group(25 cases,＞2 mm)and non-Cage subsidence group(68 cases,＜2 mm).Multiple Logistic regression analysis was used to analyze the risk factors for cage subsidence.Stepwise regression was utilized to evaluate the relationship of each risk factor and Cage subsidence.Risk prediction model was built and evaluated.RESULTS AND CONCLUSION:(1)After adjusting for confounding factors,there was still independent correlation between lumbar lordosis loss value and segmental lordosis improvement value and Cage subsidence risk(P＜0.05).(2)Age,oswestry disability index,disc height improvement value,segmental lordosis improvement value,and lumbar lordosis loss value were all independent influencing factors for the occurrence of Cage subsidence(P＜0.05).Among them,age,lumbar lordosis loss value,disc height improvement value,and segmental lordosis improvement value were most closely related to Cage subsidence.(3)The results of multivariate Logistic regression model analysis showed that when P=0.80,the Jordan index was the highest and the prediction effect was the best,with accuracy of 89.27％,sensitivity of 86.67％,and specificity of 89.89％.The model evaluation results showed that it had good discrimination and high accuracy.(4)As the lumbar lordosis loss value and segmental lordosis improvement value increase,the risk of Cage subsidence increases,which affects clinical efficacy.(5)It is indicated that age,lumbar lordosis loss value,disc height improvement value,and segmental lordosis improvement value are most closely related to Cage subsidence,and clinical doctors should pay more attention.

BACKGROUND:With the continuous advancement of medical technology,the combination of oblique lumbar interbody fusion and percutaneous pedicle screw fixation has become a common method for treating lumbar degenerative diseases;however,there is still a lack of in-depth research on the relationship between changes in anterior convexity angles at different postoperative segments and fusion device settlement.OBJECTIVE:To explore the relationship between changes in anterior convexity angle of different segments and Cage subsidence after oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation surgery.METHODS:Patients(93 cases)with lumbar degenerative diseases who underwent oblique lumbar interbody fusion combined with percutaneous pedicle screw fixation surgery in Weifang Hospital of Traditional Chinese Medicine from February 2019 to April 2023 were selected as the research subjects.According to the postoperative disc height loss value,they were divided into Cage subsidence group(25 cases,＞2 mm)and non-Cage subsidence group(68 cases,＜2 mm).Multiple Logistic regression analysis was used to analyze the risk factors for cage subsidence.Stepwise regression was utilized to evaluate the relationship of each risk factor and Cage subsidence.Risk prediction model was built and evaluated.RESULTS AND CONCLUSION:(1)After adjusting for confounding factors,there was still independent correlation between lumbar lordosis loss value and segmental lordosis improvement value and Cage subsidence risk(P＜0.05).(2)Age,oswestry disability index,disc height improvement value,segmental lordosis improvement value,and lumbar lordosis loss value were all independent influencing factors for the occurrence of Cage subsidence(P＜0.05).Among them,age,lumbar lordosis loss value,disc height improvement value,and segmental lordosis improvement value were most closely related to Cage subsidence.(3)The results of multivariate Logistic regression model analysis showed that when P=0.80,the Jordan index was the highest and the prediction effect was the best,with accuracy of 89.27％,sensitivity of 86.67％,and specificity of 89.89％.The model evaluation results showed that it had good discrimination and high accuracy.(4)As the lumbar lordosis loss value and segmental lordosis improvement value increase,the risk of Cage subsidence increases,which affects clinical efficacy.(5)It is indicated that age,lumbar lordosis loss value,disc height improvement value,and segmental lordosis improvement value are most closely related to Cage subsidence,and clinical doctors should pay more attention.

Demyelination of the central nervous system often occurs in neurodegenerative diseases， such as multiple sclerosis （MS）. The myelin sheath， a layer of myelin membrane wrapping the axon， plays a role in the rapid conduction and metabolic coupling of impulses for neurons. The exposure of the axon will lead to axonal degeneratio， and further neuronal degeneration， which is the main cause of dysfunction and even disability in patients with demyelinating neurodegenerative diseases. In addition to the demyelination of mature myelin sheath， remyelination disorder is also one of the major reasons leading to the development of the diseases. The myelin sheath is composed of oligodendrocytes （OLs） derived from oligodendrocyte progenitor cells （OPCs） which are differentiated from neural stem cells （NSCs）. The process of myelin regeneration， i.e.， remyelination， is the differentiation of NSCs into OLs. Recent studies have shown that this process is regulated by a variety of genes. MicroRNAs， as important regulators of neurodegenerative diseases， form a complex regulatory network in the process of myelin regeneration. This review summarizes the main molecular pathways of myelin regeneration and microRNAs involved in this process and classifies the mechanisms and targets. This review is expected to provide a theoretical reference for the future research on the treatment of demyelinating diseases by targeting the regulation of microRNAs.

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.
Child ; Humans ; Maxillofacial Development ; Malocclusion, Angle Class III/complications* ; Nasopharynx ; Adenoids ; Palatine Tonsil ; Mouth Breathing/etiology* ; Hypertrophy/complications* ; Mouth

Objective To explore the radiation shielding optimization plan for a medical proton cyclotron developing and commissioning building at various commissioning stages. Methods According to the maximum source termsat different commissioning stages, we used the empirical formula to estimate the instantaneous dose rate at the point of interest outside the shield of the building, and optimized the building’s shielding ateach commissioning stage. Results When adding 1.0 m mobile concrete shielding blocks (“blocks” below) each to wall 3 and wall 4 at the cyclotron commissioning stage, 1.0 m blocks to wall 4 and 1.25 m blocks to wall 5 at the beam transport line commissioning stage, and 1.0 m blocks to wall 9 and 0.4 m blocks to the ceiling at the simulated treatment room commissioning stage, the dose rates at the points of interest outside the shield could meet the dose rate limit requirements. Conclusion The application of mobile concrete shielding blocks not only meets the shielding requirements, but also has economical and space-saving advantages, conforming to the principle of shielding optimization. This can be an approach to the optimization of radiation shielding for high-energy particle accelerators or similar scientific projects.

Objective : To explore the potential targets, pathways and related mechanisms of artesunate(ART) in the treatment of hepatocellular carcinoma(HCC) based on network pharmacology and Bioinformatics. Methods: The potential targets of ART were screened through pharmmapper database, PPI network was constructed and visual analysis was performed.The data of 424 HCC samples were downloaded from TCGA database, the data information of potential target genes were screened, and the differentially expressed target genes were analyzed.The key target genes were screened by univariate-multivariate COX regression analysis.Molecular docking software was used to conduct molecular docking between ART and key target genes.Differential expression and survival analysis of key target genes were performed using network database GEPIA2. KEGG pathway enrichment analysis was performed by R language. The effects of ART on the proliferation and migration of HCC cells were verified by MTS assay and scratch test. The expression of FABP5 in HCC cells was verified by qPCR and Western blot. Western blot was used to verify the protein changes of PI3K/AKT pathway. Results : A total of 282 potential target genes were screened by network pharmacology. Finally,three key target genes were screened out. The survival analysis of FABP5 in HCC was statistically significant(P<0. 01). Molecular docking showed that ART and FABP5 had the highest binding energy. Pathway enrichment analysis showed that FABP5 was mainly enriched in PI3K/AKT signaling pathway. Cell experiments verified that ART could inhibit the expression level of FABP5,that ART could regulate the PI3K/AKT pathway,and that ART could inhibit the proliferation and migration of HCC cells. Conclusion FABP5 may regulate the PI3K/AKT pathway by inhibiting FABP5 and thus affect HCC cell proliferation and migration,and FABP5may serve as a new target gene for ART therapy of HCC.

Objective To examine the impact on impulsivity trait by monoamine oxidase A variable nucleotide tan?dem repeat (MAOA-VNTR) genotype and children’s abuse experience. Methods The self-reported questionnaire of Bar?ratt Impulsiveness Scale (BIS), Childhood Trauma Questionnaire (CTQ) were conducted in 403 normal Han female adoles?cents from north-west of China. The DNA were extracted from their venous blood sample and were genotyped for the MAOA-VNTR polymorphism. A linear regression model was used to investigate the main effects of MAOA-VNTR and children's abuse, and their interaction effect on impulsivity. Results The main effect of Children’s maltreatment experi?ence on trait impulsivity was significant (P<0.01). The main effect of MAOA-VNTR gene and the interaction between MAOA-VNTR genotype and children's maltreatment experience were insignificant (P>0.05). Conclusion The MAOA-VNTR genotype may not be involved in the female adolescents’impulsivity traits related to childhood maltreat?ment.

BACKGROUNDEndoscopic submucosal dissection of the esophagogastric junction is the most difficult gastric and esophageal dissection procedure. No reports of endoscopic submucosal dissection for Siewert type II carcinoma of the esophagogastric junction have compared the outcomes of endoscopic submucosal dissection for all three Siewert types of adenocarcinoma. This study aimed to evaluate the efficacy and safety of endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction.

METHODSFrom October 2008 to June 2013, 73 patients underwent endoscopic submucosal dissection for intraepithelial neoplasia of the esophagogastric junction. The patients were prospectively evaluated regarding the executability of the technique, short-term results of the procedure, en bloc resection rate, curative resection rate, complications and additional treatment after endoscopic submucosal dissection, and follow-up outcomes.

RESULTSSixty-eight of the 73 patients (93.2%) underwent en bloc resection; the mean maximum specimen diameter was 33.7 mm. Fifty-seven of 61 patients (93.4%) who underwent curative resection were successfully followed-up for 1.0 to 56.0 months (average, 24.1 months). Local recurrence developed in one patient with high-grade intraepithelial neoplasm. Twelve patients underwent noncurative resection, including lateral resection margin residues in three, vertical resection margin residues in one, signet ring cell carcinoma or undifferentiated adenocarcinoma in four, lymphatic or vessel invasion in one, vertical residual margin residues combined with signet ring cell carcinoma in one, and undifferentiated adenocarcinoma with lymphatic or vessel invasion in two. In the noncurative resection group, one patient was lost to follow-up, seven underwent additional surgery, and the remaining four were periodically followed up; none had local recurrence or distant metastases. The only complication was delayed bleeding in three patients, which was successfully controlled by conservative treatment or endoscopic therapy.

CONCLUSIONSEndoscopic submucosal dissection is safe and effective for intraepithelial neoplasia of the esophagogastric junction. R0 en bloc resection is possible and can avoid the risk of local recurrence.

Adult ; Aged ; Aged, 80 and over ; Carcinoma in Situ ; surgery ; Dissection ; adverse effects ; methods ; Esophageal Neoplasms ; surgery ; Esophagogastric Junction ; surgery ; Female ; Gastric Mucosa ; surgery ; Humans ; Male ; Middle Aged ; Prospective Studies

This study investigated the tight junction (TJ) protein expression of the intestinal mucosa in a rat tail-suspension model under simulated weightlessness. Twenty-four Wistar rats were randomly divided into three groups: CON group (n=8), control; SUS-14 d group (n=8), tail-suspension for 14 days; SUS-21 d group (n=8), tail-suspension for 21 days. Occludin and Zonula Occluden-1 (ZO-1) expression levels were determined by immunohistochemical analysis and mRNA fluorescent quantitative PCR. Plasma levels of diamine oxidase (DAO) and d-lactate were determined using enzymatic spectrophotometry. Immunohistochemical results for occludin and ZO-1 showed disruption of the TJs in the intestinal mucosa in SUS-14 d and SUS-21 d groups. The expression levels of occludin and ZO-1 in SUS-21 d group were lower than those in SUS-14 d group, and significantly lower than those in CON group (Occldin: 0.86±0.02 vs 1.01±0.03 vs 1.63±0.03 and ZO-1: 0.82±0.01 vs 1.00±0.02 vs 1.55±0.01, P<0.01). Moreover, the levels of plasma DAO and d-lactate in SUS-21 d group were higher than those in SUS-14 d group, and significantly higher than those in CON group (DAO: 27.58±0.49 vs 20.74±0.49 vs 12.94±0.21 and d-lactate: 37.86±0.74 vs 28.26±1.01 vs 17.76±0.91, P<0.01). There were significant negative correlations between occludin or ZO-1 expression levels and DAO (r (2)=0.9014, r (2)=0.9355, P<0.01) or d-lactate levels (r (2)=0.8989, r (2)=0.9331, P<0.01). Occludin and Zo-1 were reduced in intestinal mucosa both in mRNA and protein levels in the rat tail-suspension model. The significant negative correlations between expression levels of TJs and plasma levels of DAO or d-lactate support the hypothesis that intestinal permeability is increased due to a decrease in TJ protein expression during tail-suspension from 14 days to 21 days.

This study investigated the tight junction (TJ) protein expression of the intestinal mucosa in a rat tail-suspension model under simulated weightlessness.Twenty-four Wistar rats were randomly divided into three groups:CON group (n=8),control; SUS-14 d group (n=8),tail-suspension for 14 days;SUS-21 d group (n=8),tail-suspension for 21 days.Occludin and Zonula Occluden-1 (ZO-1) expression levels were determined by immunohistochemical analysis and mRNA fluorescent quantitative PCR.Plasma levels of diamine oxidase (DAO) and d-lactate were determined using enzymatic spectrophotometry.Immunohistochemical results for occludin and ZO-1 showed disruption of the TJs in the intestinal mucosa in SUS-14 d and SUS-21 d groups.The expression levels of occludin and ZO-1 in SUS-21 d group were lower than those in SUS-14 d group,and significantly lower than those in CON group (Occldin:0.86±0.02 vs 1.01±0.03 vs 1.63±0.03 and ZO-1:0.82±0.01 vs 1.00±0.02 vs 1.55±0.01,P＜0.01).Moreover,the levels of plasma DAO and d-lactate in SUS-21 d group were higher than those in SUS-14 d group,and significantly higher than those in CON group (DAO:27.58±0.49 vs 20.74±0.49 vs 12.94±0.21 and d-lactate:37.86±0.74 vs 28.26±1.01 vs 17.76±0.91,P＜0.01).There were significant negative co rrelations between occludin or ZO-1 expression levels and DAO (r2=0.9014,r2=0.9355,P＜0.01) or d-lactate levels (r2=0.8989,r2=0.9331,P＜0.01).Occludin and Zo-1 were reduced in intestinal mucosa both in mRNA and protein levels in the rat tail-suspension model.The significant negative correlations between expression levels of TJs and plasma levels of DAO or d-lactate support the hypothesis that intestinal permeability is increased due to a decrease in TJ protein expression during tail-suspension from 14 days to 21 days.