Osteoporosis （OP） is a skeletal metabolic disease characterized by bone loss and destruction of bone microstructure. Changes in estrogen levels are not the only pathogenic factors for the occurrence and development of OP. MicroRNA （miRNA） plays an important regulatory role in cells. The complementary sequences of miRNA and targeted mRNA combine to inhibit the expression of targeted mRNA through post-transcriptional regulation， forming a complex regulatory network. Research suggests that miRNA is closely related to the occurrence and development of various diseases， including inflammatory diseases， metabolic diseases， and cancer. Targeted mRNA participates in post-transcriptional gene expression regulation in OP， mainly regulating the balance among bone construction， bone resorption， and osteoblast differentiation. Therefore， miRNA-based gene therapy is a rapidly developing disease treatment strategy. Traditional Chinese medicine can improve bone metabolism by intervening in miRNA differential expression to target and regulate osteogenic/osteoclast differentiation. This article summarized the targeting effects of miRNAs in physiological and developmental processes such as bone cell proliferation， differentiation， survival， and apoptosis， reviewed and classified their mechanisms of action and targets， and sorted out the current treatment methods of traditional Chinese medicine for preventing and treating OP and drugs that exert bone protective functions through miRNAs. This review is expected to provide theoretical reference and research guidance for future research on OP treatment by regulating miRNA.

BACKGROUND:Osteoarthritis is a common chronic inflammation of joints caused by degenerative changes of articular cartilage.More and more studies have shown that mechanical stress is closely related to the development of osteoarthritis.The Hippo pathway is not only involved in the development of tissue cells,but also an effecting factor of mechanical stress,which is involved in the regulation of bone metabolism and cartilage metabolism. OBJECTIVE:Regulation of the Hippo pathway may become one of the new targets for intervention in osteoarthritis.Therefore,this paper reviewed the research on the effect of mechanical stress regulation of the Hippo pathway on osteoarthritis to provide ideas for the pathogenesis of osteoarthritis and provide a new theoretical basis for the treatment of osteoarthritis. METHODS:PubMed,Web of Science,Embase,CNKI,VIP,and WanFang databases were used for a literature search for articles published from inception to 2023 concerning the influence of mechanical stress on osteoarthritis and mechanical stress,Hippo pathway,and osteoarthritis.A total of 75 articles were finally reviewed. RESULTS AND CONCLUSION:(1)Different mechanical stresses may play different roles in cell proliferation,apoptosis and differentiation,osteoarthritis inflammation,and vascular homeostasis in osteoarthritis.(2)Hard extracellular matrix,low cell density,medium shear force,medium tensile force,and compression force can achieve cell proliferation,osteogenic differentiation,and vascular homeostasis,and inhibit inflammatory response by activating YAP/TAZ.(3)Soft extracellular matrix,high cell density,excessive shear force,excessive tensile force,and compressive force inhibit cell proliferation,enhance cartilage differentiation,disrupt vascular homeostasis,and promote inflammation through inactivation of YAP/TAZ,thus promoting the process of osteoarthritis.

Objective To explore the protective effect and mechanism of Jinyinqingre oral liquid on acute lung injury in-duced by lipopolysaccharide(LPS)in mice.Methods C57BL/6J mice were randomly divided into six groups according to the random number table method:blank control group,model control group,Jinyinqingre oral liquid low-dose group,Jinyinqingre oral liquid medium-dose group,Jinyinqingre oral liquid high-dose group,and dexamethasone group.Except for the blank control group,the other groups were injected with lipopolysac charide(LPS)(5 mg·kg-1)into the trachea to establish the acute lung injury model of mice,and the Jinyinqingre oral liquid low,medium,and high groups were continuously administered the drug by gavage for three days.After 24 h,lung tissue and bronchoalveolar lavage fluid(BALF)were collected from the six groups for follow-up detection.The pathological injury of lung tissue in each group was observed by HE staining.The total number of cells in BALF was detected.The to-tal protein content of BALF was detected by the BCA method.The contents of inflammatory cytokines TNF-α,IL-1β,IL-6,and IgM in BALF were detected by ELISA.The expression of NF-κB and NLRP3 proteins in lung tissues was detected by immunohistochemistry and Western blotting.Results Compared with model control group,Jinyinqingre oral liquid alleviated the pathological injury of lung tissue(P＜0.05),decreased the total cell count,total protein content and IgM expression in BALF(P＜0.01),and the expres-sion of inflammatory cytokines TNF-α,IL-6 and IL-1β in BALF was dreased(P＜0.05),the protein expressions of NF-κB and NL-RP3 in lung tissues was dreased(P＜0.05).Conclusion Jinyinqingre oral liquid attenuated the pathological injury,inflammatory exudation,and expression of inflammatory cytokines in LPS-induced lung injury in mice,and its mechanism may be through the reg-ulation of NF-κB/NLRP3 signaling pathway,providing a theoretical basis for its clinical application.

In January 2021, an acute chemical poisoning incident occurred at a fluorine polymerization plant. Through the analysis of the occupational health situation of the enterprise, combined with the clinical manifestations of the poisoned patients and the laboratory examination results, it was determined that the incident was an acute poisoning incident caused by the inhalation of organic fluorine mixed gas in the fluorine polymerization plant. Subsequently, it was clarified that the accident was caused by the illegal operation of the employees of the fluorine polymerization plant, which caused the discharge of the organic fluorine mixed gas containing high concentration of octafluoroisobutene, resulting in the poisoning of the on-site construction personnel. In order to avoid the occurrence of similar incidents, enterprises should implement the main responsibility of safety production, regularly organize supervision and inspection, eliminate illegal operations, conduct safety education and training for the staff of the unit and outsourced staff, and improve the emergency rescue ability of sudden poisoning incidents.

Objective:To analyze the correlation between drug-induced sleep endoscopy (DISE), results, polysomnography (PSG) indicators, and clinical parameters in patients with obstructive sleep apnea (OSA), and to establish and validate a predictive model for tongue base plane obstruction.Methods:This retrospective study analyzed 117 OSA patients diagnosed via PSG and treated at the Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, between October 2014 and March 2022. The cohort comprised of 114 males and 3 females, with an age range of 20 to 54 years (mean age 38.1±8.4 years). Data on DISE results, PSG results, and clinical indicators were collected for all 117 patients. Logistic regression analysis was performed to identify relevant indicators, and a predictive model for tongue base plane obstruction was constructed and internally validated using the R programming language.Results:Univariate logistic regression analysis identified four independent risk factors for predicting tongue root plane obstruction: tonsil grading, N2, N3, and rapid eye movement sleep(REM) stage [ OR:0.412(0.260~0.652),1.045(1.012~1.079),0.943(0.903~0.984),0.961(0.925~0.998), P <0.05]. Multivariate logistic regression analysis confirmed tonsil grading and N3 sleep stage (12.48±12.22%) as significant predictors. A nomogram model incorporating these factors demonstrated good predictive performance, with an area under curve(AUC) of 0.82 (95% CI: 0.548-1.000), an optimal cutoff of 0.519, a specificity of 80.0%, and a sensitivity of 86.7%. Internal validation of the model in the validation cohort yielded an AUC of 0.751 (95% CI: 0.625-0.876). Conclusions:Tongue base plane obstruction observed during DISE in OSA patients is associated with tonsil grading and N3 sleep stage duration. The predictive model developed for tongue base plane obstruction based on DISE demonstrates good efficacy, as evidenced by its internal validation.

Objective To compare the clinical effects of arthroscopically-assisted reduction and internal fixation(ARIF)combined with enhanced recovery after surgery(ERAS)and open reduction and internal fixation surgery(ORIF)in the treatment of posterior lateral tibial plateau fractures.Methods Seventy patients with posterior lateral tibial plateau fractures in the Department of Orthopaedics,Xuzhou Central Hospital,from January 2020 to November 2022 were retrospectively selected and divided into ARIF group(with ERAS,n=32)and ORIF group(without ERAS,n=38)according to the treatment methods.All patients were evaluated for fracture type by imaging examination after admission.The operation time,length of hospital stay,early postoperative pain score(evaluated by visual analogue scale[VAS]),knee joint function(evaluated by hospital for special surgery[HSS]scale)at 3 months and thigh circumference difference at 6 months postoperatively were compared between the two groups.Results The operation time in the ARIF group was significantly shorter than that in the ORIF group([67.84±9.89]min vs[85.16±9.18]min,P＜0.001),and the length of hospital stay was significantly shorter in the ARIF group([7.13±1.41]d vs[8.74±1.84]d,P＜0.001).On the third day after operation,the VAS score in the ARIF group was significantly lower than that in the ORIF group([4.00±1.44]vs[5.39±1.24],P＜0.001).ARIF group had better joint function than ORIF group 3 months after operation,and the difference of 10 cm thigh circumference on patella in ARIF group was smaller than that in ORIF group 6 months after operation.Conclusions Compared to ORIF,patients with posterior lateral tibial plateau fractures treated with ARIF combined with ERAS showed faster postoperative recovery,shorter hospital stay,and more precise clinical efficacy.

This paper summarized the game mechanism, application status and application effect of serious games in self-management education for children and adolescents with type 1 diabetes mellitus (T1DM), and put forward the existing shortcomings and suggestions, which can provide references for Chinese medical personnel to carry out health education and develop relevant serious games in the future.

In January 2021, an acute chemical poisoning incident occurred at a fluorine polymerization plant. Through the analysis of the occupational health situation of the enterprise, combined with the clinical manifestations of the poisoned patients and the laboratory examination results, it was determined that the incident was an acute poisoning incident caused by the inhalation of organic fluorine mixed gas in the fluorine polymerization plant. Subsequently, it was clarified that the accident was caused by the illegal operation of the employees of the fluorine polymerization plant, which caused the discharge of the organic fluorine mixed gas containing high concentration of octafluoroisobutene, resulting in the poisoning of the on-site construction personnel. In order to avoid the occurrence of similar incidents, enterprises should implement the main responsibility of safety production, regularly organize supervision and inspection, eliminate illegal operations, conduct safety education and training for the staff of the unit and outsourced staff, and improve the emergency rescue ability of sudden poisoning incidents.

Endometrial receptivity is key to clinical pregnancy by in vitro fertilization-embryo transfer(IVF-ET)technique.Endometrial thickness(EMT)is a major index for pregnancy monitoring,but the optimal time indicating endometrial receptivity is controversially uncertain.Multiple studies have demonstrated the correlation between EMT and IVF pregnancy outcomes and EMT of a moderate range is essential for good pregnancy outcomes and a thin endometrium produces negative pregnancy outcomes.In this paper,we reviewed the research on the im-pact of EMT on IVF-ET pregnancy outcomes in terms of timing of EMT measurement,clinical pregnancy rate,live birth rate,ectopic pregnancy rate,placenta praevia,and low birth weight,investigating the mechanism of occur-rence and treatment of thin endometrium so as to provide clinical references for improving IVF pregnancy outcomes.

Objective To explore the effects of different endometrial preparation regimens on the pregnancy and obstetrical outcomes of single euploid blastocyst transfer after preimplantation genetic testing for aneuploidies(PGT-A).Methods The clinical data on patients with single euploid blastocyst transfer after PGT-A in our center from September 2015 to July 2021 were analyzed retrospectively.According to the different preparation regimens,the patients were divided into a natural cycle group(n = 80 cycles)and a hormone replacement cycle group(n = 259 cycles).The differences of pregnancy and obstetrical outcomes between the two groups were com-pared.Binary logistic regression was used to explore the influencing factors of pregnancy and obstetrical outcomes after PGT-A.The pregnancy outcomes of different endometrial preparation regimens were further explored by age stratification.Results As compared with that in the natural cycle group,the rate of high-quality blastocyst was significantly higher in the hormone replacement cycle group,but the live birth rate was lower and the abortion rate was higher(P<0.05).There was no statistical difference in the clinical pregnancy rate between the two groups.The incidence of cesarean section and macrosomia was higher in the hormone replacement cycle group than that in the natural cycle group,while the rate of low birth weight was lower,but there were no significant differences(P>0.05).Binary logistic regression showed that female age was an independent influencing factor of abortion.Female age and the days of blastocyst development were independent influencing factors of live birth.However,endometrial prepa-ration regimen was not a factor affecting pregnancy and obstetrical outcomes(P>0.05).The results of further analysis showed that the live birth rate in the natural cycle group was significantly higher than that in the hormone replacement cycle group,while the abortion rate in the natural cycle group was significantly lower than that in the hormone replacement cycle group for female patients aged over 35(P<0.05).Conclusions The endometrial preparation regimens did not affect the pregnancy and obstetrical outcomes of patients receiving single euploid blas-tocyst transfer after PGT-A.However,in the older patients,the natural cycle regimen can obtain a higher live birth rate and a lower abortion rate.