Research on the mechanisms of depression is currently a focus of the field of neuroscience.The degeneration of brain plasticity(e.g.,decrease in volume,structural degradation,and functional disorder of the hippocampus,PFC,and CG)leads to depression.Exercise is an important means of improving the symptoms of depression.Current research confirms the importance of improving the volume,structure,and function of the hippocampus,PFC,and CG,in this process,but related research has focused solely on changes to the volume of certain brain regions or connectivity functions.Thus,we lack a comprehensive understanding of the antidepressant mechanisms that improve brain plasticity with exercise.Therefore,this study aimed to explore the roles of brain plasticity in the occurrence of depression and improvements to depression through exercise,promoting a more comprehensive understanding the role of brain plasticity in depression.We also provide new ideas for exercise intervention in depression.

Traumatic supraorbital fissure syndrome (TSOFS) is a symptom complex caused by nerve entrapment in the supraorbital fissure after skull base trauma. If the compressed cranial nerve in the supraorbital fissure is not decompressed surgically, ptosis, diplopia and eye movement disorder may exist for a long time and seriously affect the patients′ quality of life. Since its overall incidence is not high, it is not familiarized with the majority of neurosurgeons and some TSOFS may be complicated with skull base vascular injury. If the supraorbital fissure surgery is performed without treatment of vascular injury, it may cause massive hemorrhage, and disability and even life-threatening in severe cases. At present, there is no consensus or guideline on the diagnosis and treatment of TSOFS that can be referred to both domestically and internationally. To improve the understanding of TSOFS among clinical physicians and establish standardized diagnosis and treatment plans, the Skull Base Trauma Group of the Neurorepair Professional Committee of the Chinese Medical Doctor Association, Neurotrauma Group of the Neurosurgery Branch of the Chinese Medical Association, Neurotrauma Group of the Traumatology Branch of the Chinese Medical Association, and Editorial Committee of Chinese Journal of Trauma organized relevant experts to formulate Chinese expert consensus on the diagnosis and treatment of traumatic supraorbital fissure syndrome ( version 2024) based on evidence of evidence-based medicine and clinical experience of diagnosis and treatment. This consensus puts forward 12 recommendations on the diagnosis, classification, treatment, efficacy evaluation and follow-up of TSOFS, aiming to provide references for neurosurgeons from hospitals of all levels to standardize the diagnosis and treatment of TSOFS.

Objective To summarize the diagnosis and treatment experience of surgical site infection(SSI)after percutaneous endoscopic lumbar discectomy(PELD).Methods A retrospective analysis was made on 11 cases of postoperative SSI after PELD from January 2016 to December 2022.After PELD surgery,severe lower back or lower limb pain occurred in all the patients,with a Visual Analog Scale(VAS)score of 7-9(average,8.1).The erythrocyte sedimentation rate(ESR)was 17-114 mm/h(average,54.4 mm/h),and the level of C-reactive protein(CRP)was 8-151 mg/L(average,56.5 mg/L).The MRI showed changes of inflammatory signals in the intervertebral space of the surgical area.The SSI was diagnosed at 2-17 d(average,9.5 d)after PELD surgery.All the cases were treated with antibiotics(4 cases with empiric antibiotic therapy and 7 cases with sensitive antibiotic treatment),8 of which underwent combined surgery,including percutaneous endoscopic lesion removal,catheter irrigation and drainage in 4 cases,posterior lesion removal in 2 cases,and posterior lesion removal combined with internal fixation in 2 cases.Results The patients were followed up for 14-75 months(average,36.8 months).According to the modified MacNab criteria,5 cases were excellent,4 cases were good,and 2 cases were fair.Conclusions SSI after PELD is characterized by acute onset,recurrent severe lower back or lower limb pain,elevated inflammatory markers,and characteristic imaging features.Standardized antibiotic treatment combined with surgery can achieve good therapeutic effects.

Objective    To investigate the effect of in vitro fenestration on reconstruction of left subclavian artery in endovascular treatment of aortic dissection. Methods    A total of 89 patients with aortic dissection involving left subclavian artery were treated by endovascular treatment in the Second Affiliated Hospital of Fujian Medical University from February 2017 to January 2020. There were 44 patients in the test group, including 36 males and 8 females, with an average age of 58.02±13.58 years. There were 45 patients in the control group, including 35 males and 10 females, with an average age of 54.10±12.32 years. The left subclavian artery was reconstructed by in vitro fenestration in the test group and by chimney technique in the control group. The clinical data were compared between the two groups. Results    The operation time of the test group was longer than that of the control group (126.16±7.53 min vs. 96.49±6.52 min, P<0.01). The median follow-up time was 31 (13-48) months. The incidence of endoleak in the test group (4.7%) was lower than that in the control group (18.6%, P=0.04) during the follow-up. There was no statistical difference in the incidence of stroke, myocardial infarction, false lumen thrombosis, retrograde aortic dissection or left subclavian artery occlusion between the two groups (P>0.05). Conclusion     In vitro fenestration for reconstructing left subclavian artery in thoracic endovascular aortic repair of aortic dissection is safe and feasible, which is worthy of further clinical promotion.

With the aging of population， osteoporosis has become one of the main diseases endangering the health of the elderly in China. Therefore， the research on osteoporosis has become a hot spot. Since Chinese medicines demonstrate significant therapeutic effects on osteoporosis， this issue is attracting increasing attention from researchers， especially in the deciphering of the molecular mechanism. This paper introduces the mechanism of the prevention and treatment of osteoporosis by Chinese medicines via the mitogen-activated protein kinase （MAPK） signaling pathway， aiming to provide a theoretical basis for deciphering the mechanism of Chinese medicines in the treatment of osteoporosis and promoting their clinical application. MAPK signaling pathway mainly involves p38 MAPK， extracellular signal-regulated kinase 1/2 （ERK1/2）， c-Jun N-terminal kinase （JNK）， and extracellular signal-regulated kinase 5 （ERK5）. Studies have shown that these proteins play a role in the progression of osteoporosis by regulating cell proliferation， differentiation， and apoptosis. Chinese medicines as a unique therapy with Chinese characteristics has definite efficacy， high safety， and mild side effects. Researchers have proved by experiments that the extracts or compounds of Chinese medicines can significantly mitigate osteoporosis by regulating the proteins involved in the MAPK signaling pathway. Therefore， this article reviews the relevant studies with focus on these proteins.

Objective To compare the difference between four-axis positioning 3D printing guide assisted puncture and manual puncture percutaneous vertebroplasty,to clarify the clinical efficacy of 3D printing guide assisted percutaneous vertebroplasty,and to explore its clinical application value.Methods A total of 70 patients who underwent single-segment vertebroplasty for osteoporotic vertebral compression fractures in our hospital were randomly divided into a manual group(control group)and a guide plate group(observation group).Thirty-five patients in the control group underwent PVP under the traditional manual puncture,and 35 patients in the observa-tion group underwent PVP under the four-axis positioning 3D printing guide assisted puncture.The general data,perioperative data,imaging data,preoperative and postoperative functional scores of the two groups were collected and compared.Results In terms of intraoperative fluoroscopy times,operation time,and postoperative adverse reactions,the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference between the two groups in intraoperative blood loss,bone cement leakage,and whether bone cement perfusion included fracture sites.In terms of clinical efficacy,the ratio of anterior vertebral height,postoperative VAS score and postoperative JOA score of the two groups were significantly better than those before operation,and the difference was statistically significant(P<0.05).At the same time point before and after operation,there was no significant difference in the height ratio of the anterior edge of the injured vertebra,VAS score and JOA score between the two groups(P>0.05).Conclusion The clinical efficacy of four-axis positioning 3D printing guide plate-assisted puncture is the same as that of experienced clinicians with free hand puncture for PVP,which can quickly relieve pain and improve dysfunction.However,guide plate assistance can shorten the operation time,reduce the number of fluoroscopy and postoperative adverse reactions,and make vertebroplasty faster and safer.

In recent years， with the changes of population structure and the aggravation of aging， the prevalence of osteoporosis is increasing year by year. Osteoporosis poses great impacts on the body and family life of the patients and increases the burden on the society. Therefore， the research on osteoporosis is urgent and significant. The imbalance between osteoblasts， osteocytes， and osteoclasts causes abnormal bone metabolism， which destroys the fine structure of bone and increases bone fragility， thus increasing the risk of fracture. Although the pathogenesis of osteoporosis is complex， researchers have confirmed that the imbalance of the endocrine system directly or indirectly promotes the occurrence and development of osteoporosis. Traditional Chinese medicine （TCM） is a treasure of Chinese traditional culture and plays a key role in safeguarding the public health. With unique therapeutic effects and advantages， TCM has been widely accepted. Chinese medicines， moxibustion， acupuncture and other TCM therapies have play a unique role in the treatment of osteoporosis. Particularly， TCM prevention and treatment of osteoporosis by regulating the endocrine system has received extensive attention. By reviewing relevant literature， this paper introduces the research progress in the TCM modulation of bone metabolism and alleviation of bone loss by regulating estrogen， calcitonin， and parathyroid hormone in the endocrine system and affecting the hypothalamus capable of regulating these hormones， aiming to provide ideas for the TCM treatment of osteoporosis.

Objective:To observe the efficacy and safety of teriprizumab combined with bevacizumab in above the second line treatment of high-level microsatellite instability (MSI-H) type metastatic colorectal cancer (mCRC) patients.Methods:From February 2019 to September 2019, 56 patients with MSI-H mCRC admitted to the Third Affiliated Hospital of Guangdong Medical University were selected and divided into control group and test group by random number table method, with 28 cases in each group. The control group was treated with bevacizumab, and the test group was treated with teriprizumab combined with bevacizumab. The objective response rate (ORR), disease control rate (DCR), progression-free survival, overall survival and incidence of adverse reactions were compared between the two groups.Results:The ORR and DCR of the test group were 60.71% (17/28) and 75.00% (21/28) respectively, higher than 28.57% (8/28) and 46.63% (13/28) of the control group, with statistically significant differences ( χ2=5.85, P=0.016; χ2=4.79, P=0.029). The median progression-free survival of patients in the control group and the test group were 3.5 months and 5.8 months respectively, with a statistically significant difference ( χ2=9.83, P=0.003). The median overall survival of patients in the control group and the test group were 12.1 months and 16.2 months respectively, with a statistically significant difference ( χ2=6.13, P=0.007). There were no significant diffe-rences in the incidences of hematological reaction (17.86% vs. 14.29%, χ2=0.13, P=0.716), cardiovascular injury (10.71% vs. 14.29%, χ2=0.16, P=0.686), liver and kidney function injury (25.00% vs. 21.43%, χ2=0.10, P=0.752), gastrointestinal reaction (28.57% vs. 35.71%, χ2=0.33, P=0.567), skin and mucosal injury (7.14% vs. 10.71%, χ2=0.35, P=0.553), nervous system disease (3.57% vs. 14.29%, χ2=2.25, P=0.134), endocrine reaction (3.57% vs. 10.71%, χ2=1.29, P=0.256), alopecia (14.29% vs. 17.86%, χ2=0.13, P=0.716) and fatigue (25.00% vs. 28.57%, χ2=0.27, P=0.605) between the control group and the test group. Conclusion:The combination of teriprizumab and bevacizumab can improve the short-term and medium-long-term efficacy of patients with MSI-H mCRC, which is safe and reliable.

BACKGROUND: The fracture of adjacent vertebrae after vertebroplasty has been widely concerned. The finite element study of the influence of three cement diffusion types on the stress change of adjacent vertebrae after vertebroplasty has not been reported at home and abroad. OBJECTIVE: To analyze the stress changes of the adjacent vertebrae of the affected vertebrae under different loads using the finite element method. METHODS: Based on the original CT data of one L1 vertebral compression fracture patient and three L1 vertebral consolidation patients with bone cement distributed in the form of dispersion, mixture and agglomeration, the finite elements of T11-L1 vertebral functional unit compression fracture and three types of bone cement dispersion were established by dividing grids, defining material attributes and assembling models, using software such as Mimics 19. 0, Geomagic Studio 2013 and SolidWorks 2017. The models underwent three levels of pressure 0. 3 MPa (low pressure), 1. 0 MPa (medium pressure) and 4. 0 MPa (high pressure) and four load directions of forward bending, backward extension, lateral bending and rotation, respectively. The stress distribution of T12 and L2 vertebrae under different pressures and loads was observed. RESULTS AND CONCLUSION: (1) The increase of the stress of the adjacent vertebrae was positively correlated with the increase of the axial stress after the injection of bone cement. (2) The maximum stress of the adjacent vertebrae was significantly higher than that of the diffusion type and the mixed type under the four loading directions of the agglomerate type of bone cement, and the stress of the mixed type of the adjacent vertebrae was lower than that of the agglomerate type and the diffusion type under the forward bending and lateral bending loads. (3) The results showed that the agglomerate type of bone cement is an important factor leading to the increase of the stress of the adjacent vertebrae. The mixed cement distribution may reduce the risk of adjacent vertebral fractures.

Objective To investigate the developmental characteristics of static visual acuity (SVA) and kinetic visual acuity (KVA) and the correlation between the for children. Methods From April to June, 2018, SVA and KVA of 715 children aged 6 to 10 years in Suzhou were tested with logarithmic visual chart and KVA meter. Results KVA and SVA increased with age within 6 to 9 years old, and decreased then. KVA was higher in boys than in girls (t = 4.604, P < 0.001), but not significantly different for SVA (t = 1.822, P > 0.05). There was a moderate positive correlation between KVA and SVA (r = 0.552, P < 0.01). KVA can predicted SVA (B = 0.617, P < 0.001). Conclusion KVA and SVA develop for children aged 6 to 9, and moderately positive correlate with each other. It means SVA may be improved via training of KVA.