ObjectiveTo make clear exercise combined with Shenghui Tang interferes in acetylcholine receptor （M1AChR） to improve mitochondrial autophagy and enhance cognition of Alzheimer's disease （AD） model rats through the adenylate activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） signaling pathway. MethodsForty-eight male SD rats of SPF grade were randomly divided into a blank group， a model group， a Shenghui Tang group （9.3 g·kg^-1）， an exercise group， an exercise + Shenghui Tang group （9.3 g·kg^-1）， and a rapamycin group （1.5 mg·kg^-1）. Except for the blank group， the rat model of AD was constructed by injecting amyloid beta （Aβ_1-42） into hippocampus stereotaxically. The exercise group received treadmill exercise for 4 weeks， while the Shenghui Tang group received intragastric administration for 4 weeks， and the exercise + Shenghui Tang group received treadmill exercise and intragastric administration of Shenghui Tang for 4 weeks simultaneously. After the intervention， the Morris water maze test was used to detect the learning and memory ability. Spontaneous behavior was observed in the open field test. The pathological structure of hippocampal neurons was observed by NISSl staining. The expression level of M1AChR in hippocampus was detected by immunohistochemistry （IHC）. The autophagy ultrastructure of hippocampal neurons was observed by transmission electron microscopy. The apoptosis rate was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL）. The expression of Beclin1 and microtubule-associated protein light chain 3β （LC3β） was detected by immunofluorescence （IF）. The protein expression of M1AChR， AMPK， p-AMPK， mTOR， Beclin1， LC3β， and chelate 1 （SQSTM1/p62） in hippocampus was detected by Western blot. ResultsCompared with the blank group， the model group exhibited significantly increased platform escape latency on the fifth day （P<0.01） and significantly decreased activity distance in the target quadrant and times of crossing the platform （P<0.01）. The total movement distance in the open field， the time of movement in the central area， and the average speed obviously decreased （P<0.05）. The arrangement of nerve cells in hippocampus CA1 region was dispersed， and the numbers of Nissl bodies and M1AChR positive cells significantly decreased （P<0.01）. The expression of TUNEL positive cells was significantly increased （P<0.01）. The typical autophagic lysosomal structure decreased. The protein expression of M1AChR， p-AMPK/AMPK， p-mTOR/mTOR， Beclin1， LC3Ⅱ/Ⅰ in hippocampus was significantly decreased （P<0.01）， and the protein expression of p62 was significantly increased （P<0.01）. Compared with the model group， the exercise + Shenghui Tang group exhibited obviously improved space exploration and positioning navigation ability （P<0.05， P<0.01）. The total movement distance in the open field， the time of movement in the central area， and the average speed of movement significantly increased （P<0.01）. The number of Nissl bodies significantly increased （P<0.01）. The number of M1AChR positive cells in hippocampus was significantly increased （P<0.01）. The expression of TUNEL positive cells was significantly decreased （P<0.01）. The protein expression of M1AChR， p-AMPK/AMPK， p-mTOR/mTOR， Beclin1， LC3Ⅱ/Ⅰ in hippocampus was significantly increased （P<0.01）， while the protein expression of p62 was significantly decreased （P<0.01）. Compared with the exercise + Shenghui Tang group， the Shenghui Tang group and the exercise group showed significantly increased platform escape latency on the fifth day （P<0.01） and obviously decreased activity distance in the target quadrant and times of crossing the platform （P<0.05， P<0.01）. The total movement distance in the open field， the time of movement in the central area， and the average speed of movement significantly decreased （P<0.01）. The number of Nissl bodies and the number of M1AChR positive cells significantly decreased （P<0.01）. The expression of TUNEL positive cells was obviously increased （P<0.05）. Ultrastructure of the hippocampal region showed decreased autophagy level. The protein expression of M1AChR， p-AMPK/AMPK， p-mTOR/mTOR， LC3Ⅱ/Ⅰ in the hippocampus was obviously decreased in the Shenghui Tang group （P<0.05， P<0.01）， while the protein expression of p62 was significantly increased （P<0.01）. In the exercise group， the protein expression of M1AChR， p-AMPK/AMPK， Beclin1， and LC3Ⅱ/Ⅰ was obviously decreased （P<0.05， P<0.01）， while the protein expression of p-mTOR/mTOR and p62 was significantly increased （P<0.01）. ConclusionExercise combined with traditional Chinese medicine can enhance the expression of M1AChR in the hippocampus of AD model rats， induce autophagy through the AMPK/mTOR signaling pathway， and improve the learning and memory ability of AD rats.

A lightweight object detection algorithm based on an enhanced YOLOv8 framework(YOLOv8-DLE)is proposed to improve the accuracy and efficiency of wrist fracture detection in X-ray images.On the basis of original YOLOv8 framework,the model integrates a dilation-wise residual module,a large separable kernel attention module and an EfficientRepBiPAN for improving the model's ability to detect small targets and manage complex backgrounds while reducing computational cost.Experimental results on the GRAZPEDWRI-DX dataset demonstrate that YOLOv8-DLE outperforms the original YOLOv8,achieving a 3.7%increase in mAP@50 and a 1.7%increase in mAP@50:95,with reductions in parameters from 11.1 M to 10.9 M and GFLOPs from 28.5 to 26.0.The model's compactness and efficiency make it well-suited for embedded devices and remote healthcare systems,particularly in resource-limited environments.YOLOv8-DLE can provide real-time auxiliary diagnostic support for doctors and improve the accuracy and efficiency of diagnosis,showing strong potential for real-time clinical deployment and broad applicability in medical image analysis.

A lightweight object detection algorithm based on an enhanced YOLOv8 framework(YOLOv8-DLE)is proposed to improve the accuracy and efficiency of wrist fracture detection in X-ray images.On the basis of original YOLOv8 framework,the model integrates a dilation-wise residual module,a large separable kernel attention module and an EfficientRepBiPAN for improving the model's ability to detect small targets and manage complex backgrounds while reducing computational cost.Experimental results on the GRAZPEDWRI-DX dataset demonstrate that YOLOv8-DLE outperforms the original YOLOv8,achieving a 3.7%increase in mAP@50 and a 1.7%increase in mAP@50:95,with reductions in parameters from 11.1 M to 10.9 M and GFLOPs from 28.5 to 26.0.The model's compactness and efficiency make it well-suited for embedded devices and remote healthcare systems,particularly in resource-limited environments.YOLOv8-DLE can provide real-time auxiliary diagnostic support for doctors and improve the accuracy and efficiency of diagnosis,showing strong potential for real-time clinical deployment and broad applicability in medical image analysis.

Objective:To analyze the risk factors for complications of the retromandibular approach in patients with parotid gland posterior and lower pole tumors.Methods:A retrospective analysis was conducted on the clinical data of 140 patients with parotid posterior lower pole tumors admitted to the Xingtai Third Hospital from October 2019 to October 2021. They were divided into two groups based on whether complications occurred: the occurrence group and the non occurrence group. General data of the two groups of patients were collected, including age, gender, course of disease, previous surgical history, number of tumors, tumor length, resection range, facial nerve dissociation, tumor site resection frequency, and fascia preservation; Single factor and logistic multivariate analysis were conducted to determine the risk factors for complications of the posterior retromandibular approach in patients with parotid gland posterior and lower pole tumors.Results:A total of 140 patients with parotid gland posterior lower pole tumors underwent retromandibular approach treatment, with complications occurring in 38 cases (27.14%), including 7 cases of temporary facial paralysis, 10 cases of facial depression, 11 cases of Frey syndrome, 2 cases of fistula, and 8 cases of sensory abnormalities of the greater auricular nerve. Through logistic multivariate analysis, it was found that the number of tumors ≥ 2 ( OR=2.856), the resection range (total resection) ( OR=2.477), the number of surgeries ≥3 ( OR=5.637), facial nerve dissociation ( OR=3.526), and lack of fascia preservation ( OR=2.551) were all risk factors for postoperative complications in patients with parotid posterior pole tumors (all P<0.05). Conclusions:In clinical practice, relevant prevention and treatment measures should be formulated for these high-risk factors to reduce the incidence of postoperative complications.

Objective:To investigate the molecular features of hand, foot and mouth disease (HFMD) caused by coxsackievirus A10 (CVA10) in Qingdao and analyze the clinical features of mild and severe cases.Methods:A total of 6 677 cases of HFMD routinely monitored by Qingdao Women and Children Hospital from 2014 to 2021 were enrolled. Throat swab samples were collected. Clinical data of these cases were retrospectively analyzed. Virus nucleic acid was extracted from the samples and the serotypes of enteroviruses were identified. The VP1 genes of CVA10 strains were amplified and sequenced. A phylogenetic tree based on the VP1 gene sequences was constructed using MEGA7. 0 software. SPSS23.0 software was used for statistical analysis.Results:There were 285 cases positive for CVA10, including 183 males and 102 females, and children under five years old accounted for 89.8%. Most of CVA10 infection occurred between the months of April to September. The count of white blood cells, the percentage of neutrophils, the concentration of hemoglobin, and the levels of aspartate aminotransferase and alanine transaminase were significantly higher in severe patients than in mild patients. Besides, chest radiography and brain CT revealed more abnormalities in severe patients, and the duration of ECG monitoring was longer in them. Compared with mild cases, severe cases developed rash early than fever with rash mostly on buttocks ( P<0.05). Phylogenetic analysis showed that most of the CVA10 strains circulating in Qingdao between 2014 and 2021 belonged to clade Ⅰ, and there were two variations A23V and I283V in the amino acid sequence of clade Ⅰ. Conclusions:This study showed that children of all ages were susceptible to CVA10, especially those under five years old. CVA10 showed complex and diverse epidemic trends in different regions and years.

Objective:To evaluate the cryopreservation effect of the home-made Strawtop micro-carrier method and Straw method for cryopreservation of human low volume sperm.Methods:A prospective study was performed to analyze the post-thaw results of cryopreserved human sperm using the home-made Strawtop method and Straw method. Compare the survival rate, sperm DNA fragmentation index (DFI), ultrastructure, fertilization ability and embryo developmental competence of donated semen samples from the patients who underwent intracytoplasmic sperm injection (ICSI) treatment in Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine during the period from May 1, 2018 to June 30, 2018.Results:The survival rate of Strawtop group (46.8%±17.1%) was significantly higher than that of Straw group (23.1%±13.7%, P=0.001). Compared with fresh sperm (18.9%±11.6%), Straw method (33.5%±15.0%) significantly increased the sperm DFI ( P=0.019), while Strawtop method didn't (23.4%±11.7%, P=0.375). The sperm ultrastructure of Strawtop group was superior to that of Straw group. There was no difference among Strawtop, Straw and fresh group in normal fertilization rates, cleavage rates and day 2 high-quality embryo rates. Conclusion:For human low volume sperm cryopreservation, the Strawtop method was simple and convenient. The survival rate of Strawtop method was higher than that of straw method and the sperm could be used for ICSI directly after thawing. The strawtop method is worth to be widely used in clinical practice.

Objective:To evaluate the cryopreservation effect of the home-made Strawtop micro-carrier method and Straw method for cryopreservation of human low volume sperm.Methods:A prospective study was performed to analyze the post-thaw results of cryopreserved human sperm using the home-made Strawtop method and Straw method. Compare the survival rate, sperm DNA fragmentation index (DFI), ultrastructure, fertilization ability and embryo developmental competence of donated semen samples from the patients who underwent intracytoplasmic sperm injection (ICSI) treatment in Center for Reproductive Medicine, Shanghai East Hospital, Tongji University School of Medicine during the period from May 1, 2018 to June 30, 2018.Results:The survival rate of Strawtop group (46.8%±17.1%) was significantly higher than that of Straw group (23.1%±13.7%, P=0.001). Compared with fresh sperm (18.9%±11.6%), Straw method (33.5%±15.0%) significantly increased the sperm DFI ( P=0.019), while Strawtop method didn't (23.4%±11.7%, P=0.375). The sperm ultrastructure of Strawtop group was superior to that of Straw group. There was no difference among Strawtop, Straw and fresh group in normal fertilization rates, cleavage rates and day 2 high-quality embryo rates. Conclusion:For human low volume sperm cryopreservation, the Strawtop method was simple and convenient. The survival rate of Strawtop method was higher than that of straw method and the sperm could be used for ICSI directly after thawing. The strawtop method is worth to be widely used in clinical practice.

Objective To explore the differentially expressed micro RNAs (miRNAs) in serum-derived extracellular vesicles (EVs) of patients with Parkinson's disease (PD) and healthy individuals.Methods Thirty-six patients with late-onset Parkinson's disease (LOPD,age of onset being more than 50 years),20 patients with early-onset Parkinson's disease (EOPD,age of onset being no more than 50 years),and 10 healthy individuals were collected in our hospital from January 2015 to December 2017.Serum of all subjects was collected and EVs were extracted.The miRNA chip and real-time quantitative (qRT)-PCR were used to analyze and verify the differentially expressed exosomal miRNAs between PD patients and healthy individuals;Cytoscape software was used to analyze the common target genes regulated by differentially expressed miRNAs,and String database was used to analyze the interaction and function of target genes.And qRT-PCR was further used to analyze the expression level and correlation of differentially expressed miRNAs and their target genes in patients with EOPD and LOPD,respectively.Results As compared with healthy individuals,LOPD patients had significantly up-regulated expression levels ofmiR-143-3p and miR-1180 in the serum derived EVs,and statistically down-regulated miR-451 and miR-500 levels (P＜0.05).The miR-143-3p expression level in EOPD patients was significantly higher than that in LOPD patients (t=3.888,P=0.018).The target genes B-cell lymphoma-2 (BCL2) and AKT1 were involved in regulating the cholinergic synapses and neurotrophin signaling pathways,and the BCL2 relative expression level in EOPD patients was significantly higher than that in LOPD patients and healthy controls (P＜0.05);and the relative expression levels of BCL2 and miR-143-3p were negatively correlated in the serum derived EVs of EOPD patients (r=-0.556,P=0.025).Conclusion The miR-143-3p and BCL2 expression levels are negatively correlated in the serum derived EVs of EOPD patients;changes of expression level may be related to plasticity of synaptic structure and apoptosis of nerve cells.

Objective: To illuminate the gene characteristics and clinical characterization of Coxsackievirus B5 (CV-B5) strains isolated from patients with sevre hand, foot and mouth disease (HFMD) in Qingdao city. Methods: A total of 1 844 patients of HFMD were consecutively admitted to Qingdao Women and Children's Hospital from 2013 to 2014. Information of the study population described above was collected retrospectively. The samples were collected from at least 1 site (throat swab, cerebrospinal fluid), which viral nucleic acid extracted and the entire VP1 gene sequences of CV-B5 isolates were amplified and sequenced, then the homology and phylogeny analysis were conducted by MEGA7.0. The prototype Faulkner strain and other VP1 amino acid sequences were derived from the GenBank database. Results: A total of 8 CV-B5 positive cases were obtained, including 4 males and 4 females; 6 severe hospitalized cases and 2 outpatients. The age of 6 hospitalized patients ranged from 3 to 48 months, with a median of 26 months. For the six inpatients, fever, convulsions vomiting, diarrhea and rash were the main clinical manifestation, and all combined with viral encephalitis. Compared with the prototype strain Faulkner, in the VP1 region,the nucleotide and the amino acid homologies was 77.3%-78.8% and 95.5%-97.0% respectively. Five out of the six severe cases with substitution of serine (S) to asparagine (N) at amino acid site 95 in the VP1 region. The sequences of 8 CV-B5 strains were classified into genogroup D. Conclusion Hand, foot and mouth disease associated with CV-B5 virus infection can result in nervous system involvement and the main complication was viral encephalitis. The CV-B5 strains associated with severe hand, foot and mouth disease had high nucleotide homology and present a certain regional aggregation.

Objective To investigate the effect of preoperative percutaneous dilatational trache-otomy (PDT)in oral and maxillofacial surgery anesthesia versus traditional surgical tracheotomy (ST).Methods General data,vital signs,operation time,anesthetics,the amount of bleeding and complications during the procedure were analyzed after reviewing the clinical data of 124 cases under-going radical correction of oral and maxillofacial tumor plus flap transferring and repairing and trache-otomy during May 2013 to May 201 5.Results A total of 124 cases were divided into two groups:PDT group (group P,n =41)and ST group (group S,n =83).There was no significant difference of general data between the two groups.The incision length and operation time were significantly shorter and the amount of bleeding was remarkably lower in group P than those in group S (P <0.05),while the incidence of complications was not significantly different between the two groups.Conclusion PDT has more advantages over traditional ST and is a better airway approach in oral and maxillofacial surgery.