With the advancement of rigid endoscopic nasal surgery techniques, the indications for surgery have continued to expand, encompassing an increasing number of anatomical regions. As a surgical adjunct, imaging-guided system assists surgeons in identifying vital structures and mitigating surgical risks, and they are extensively employed in operations involving the nasal cavity, sinuses, and skull base. Nevertheless, existing imaging-guided system faces several unresolved challenges. With ongoing technological advancements and the integration of novel technologies, these systems are demonstrating renewed vigor.
Humans ; Skull Base/surgery* ; Endoscopy/methods* ; Surgery, Computer-Assisted/methods*

Objective To develop and validate a prediction model for risk of amputation in patients with diabetic foot ulcers(DFU)based on systematic review and meta-analysis.Methods The studies on the risk factors of amputation in DFU patients was retrieved by using subject words+free words.After screening,37 cohort studies were finally included,and the Newcastle-Ottawa scale(NOS)was used for quality evaluation.Meta-analysis was performed on the risk factors of amputation in DFU.Then a prediction model for DFU amputation risk were constructed based on the statistically significant risk factors in the meta-analysis.The corresponding β value was calculated based on the combined odds ratio(OR)value of each risk factor,and each risk factor was scored to establish a scoring system model.The clinical data of 453 DFU patients hospitalized in our department from 2021 to 2023 were collected as a validation cohort.Receiver operating characteristic(ROC)curve analysis was used to evaluate the model performance.The area under the curve(AUC)was calculated,and the optimal cutoff score was determined by calculation of the maximum Youden index through sensitivity and specificity.Results Our meta-analysis showed a cumulative amputation rate of approximately 34.65%in 11 779 DFU patients.The final risk prediction models include gangrene[OR=11.92(5.86～24.24)],ulcer depth[OR=4.93(2.52～9.64)],osteomyelitis[OR=3.19(2.36～4.29)],previous amputation history[OR=3.19(2.00～5.09)]and lower extremity arterial disease[OR=3.10(2.31～4.17)].According to the weights of each risk factor,the total score of the model is 76,and the optimal cut-off score is 36.5.The prediction model performed well,with an AUC value of 0.864(0.824,0.903),a sensitivity of 0.743,a specificity of 0.859,and an accuracy rate of 83.00%.Conclusion A prediction model for DFU amputation risk is developed based on risk factor scoring,and has good discrimination and calibration,providing effective scientific basis for clinical research and clinical decision-making related to DFU amputation.

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by ac-upuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medica-tion combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,sur-face electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P＜0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P＜0.01 or P＜0.05);the cure time had no sig-nificant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P＞0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.

The different fate of liposomes among species has been discovered and mentioned in many studies, but the underlying mechanisms have not been explored. In the present work, we concentrated on the in vivo fate of PEGylated liposomes (sLip) in three commonly used species (mice, rats, and dogs). It was exhibited that the accelerated blood clearance (ABC) phenomenon and hypersensitivity in large animals (beagle dogs) were much more significant than that in rodents. We demonstrated that anti-PEG IgM (partially) and complement (mostly) determined the elimination of sLip and linked the distinct interspecies performances with the diverse complement capacity among species. Based on the data from animals and clinical patients, it was revealed that the fate of sLip in large animals was closer to that in humans, for the sufficient complement capacity could expose the potential adverse reactions caused by anti-PEG antibodies. Our results suggested that the distinctive interspecies performances of sLip were highly related to the physiological variabilities among species, which should not be overlooked in the innovation and translation of nanomedicines.

The variable domain of heavy-chain antibody (VHH) has been developed widely in drug therapy, diagnosis, and research. Escherichia coli is the most popular expression system for VHH production, whereas low bioactivity occurs sometimes. Mammalian cells are one of the most ideal hosts for VHH expression at present. To improve the yield of VHH in Expi293F cells, we optimized the signal peptide (SP) and codons of VHH. Firstly, the fusion protein VHH1-Fc was used to screen SPs. The SP IFN-α2 showed the highest secretion as quantified by enzyme-linked immunosorbent assay (ELISA). Subsequently, codon optimization by improving GC3 and GC content doubled the yield of VHH1 and kept its binding activity to Senecavirus A (SVA). Finally, the mean yields of other 5 VHHs that fused with SP IFN-α2 and codon-optimized were over 191.6 mg/L, and these VHHs had high recovery and high purity in the culture supernatant. This study confirms that SP IFN-α2 and codon optimization could produce VHHs in Expi293F cells efficiently, which provides a reference for the large-scale production of VHHs.
Codon/genetics* ; Protein Sorting Signals/genetics* ; Escherichia coli/metabolism* ; Humans ; Recombinant Fusion Proteins/biosynthesis* ; Interferon-alpha/metabolism* ; Immunoglobulin Heavy Chains/immunology* ; Cell Line ; Immunoglobulin Variable Region/immunology*

The poor mechanical property and vulnerability to bacterial infections are the main problems in clinic for dental restoration resins. Based on this problem, the purpose of this study is to synthesize silver-titanium dioxide (Ag-TiO₂) nanoparticles with good photocatalytic properties, and add them to the composite resin to improve the mechanical properties and photocatalytic antibacterial capability of the resin. The microstructure and chemical composition of Ag-TiO₂ nanoparticles and composite resins were characterized. The results indicated that Ag existed in both metallic and silver oxide state in the Ag-TiO₂, and Ag-TiO₂ nanoparticles were uniformly dispersed in the resins. The results of mechanical experiments suggested that the mechanical properties of the composite resin were significantly improved due to the incorporation of Ag-TiO₂ nanoparticles. The antibacterial results indicated that the Ag-TiO₂ nanoparticle-filled composite resins exhibited excellent antibacterial activities under 660 nm light irradiation for 10 min due to the photocatalysis, and the Ag-TiO₂ nanoparticle-filled composite resins could also exhibit excellent antibacterial activities after contact with bacteria for 24 h without light irradiation because of the release of Ag ions. In summary, this study provides a new antibacterial idea for the field of dental composite resins.
Anti-Bacterial Agents/pharmacology* ; Composite Resins ; Metal Nanoparticles/chemistry* ; Nanoparticles ; Titanium/pharmacology*

Objective:By analyzing factors associated with lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years old, a nomogram model for lower urinary tract symptoms was constructed to assist the clinical development of targeted interventions to reduce the incidence of lower urinary tract symptoms in this population.Methods:In the cross-sectional study, 798 middle-aged and elderly women aged 55-65 years receiving physical examination in the Health Management Center of Third Xiangya Hospital from November 2013 to December 2020 were selected as research participants.Univariate regression analysis was used to compare differences in the basic data related to lower urinary tract symptoms in the population.Multivariate Logistic regression analysis was used to identify related influencing factors, and a nomogram model for lower urinary tract symptoms in the population was established.Results:Among 798 middle-aged and elderly women surveyed, the prevalence of lower urinary tract symptoms was 81.08 %(647 cases), and the rate of urinary tract infections was 21.48 %(139 cases). Variables with statistical significance in univariate regression analysis were included in multivariate Logistic regression analysis.The results showed that body mass index, vaginal delivery, strength of pelvic floor type Ⅱ fiber muscle, pelvic and abdominal coordination and mental health were independent influencing factors for lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years( OR=1.099, 2.681, 0.895, 0.658, 1.057, P=0.010, 0.030, 0.040, 0.010, 0.038). The monogram model based on the five risk prediction indexes produced a consistency index(C-index)of 0.651 and a diagnostic sensitivity and specificity of 66.9% and 58.9%, respectively.The correction curve showed that the predicted results of the model were essentially the same as the actual probability of condition. Conclusions:In this study, the independent influencing factors for lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years were screened by univariate regression and multivariate Logistic regression analysis and a nomogram model for risk prediction of the population was constructed, was proved to have a good ability for accurately and effectively predicting the risk of lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years, and will assist clinicians to screen for high-risk patients, formulate targeted interventions, and reduce the incidence of lower urinary tract symptoms in middle-aged and elderly women aged 55-65 years.

Animals ; Antibodies, Neutralizing ; Antibodies, Viral ; Foot-and-Mouth Disease Virus

Dissolving microneedles carried drug molecules can effectively penetrate the stratum corneum of skin to improve the transdermal drug delivery. The traditional Chinese medicine acupuncture is based on the needle stimulation at a specific location (acupoint) to generate and transmit biochemical and physiological signals which alter the pathophysiological state of patients. However, the pain associated with conventional acupuncture needles and the requirement of highly trained professionals limit the development of acupuncture in non-Asian countries. The purpose of this study is to investigate whether the dissolving microneedles can be utilized as a self-administered painless replacement for acupuncture and locally released drug molecules can achieve expected therapeutic outcomes. Immunosuppressive rats were treated with acupuncture at Zusanli (ST36) acupoint using microneedles containing thymopentin. The immune functions and psychological mood of the immunosuppressed animals were examined. The proliferation of splenocytes was examined by CCK-8 assay. CD4 and CD8 expression patterns in spleen cells were detected by flow cytometry. The current study showed that use of either microneedles containing thymopentin or conventional acupuncture both resulted in immune cell proliferation, which was confirmed by flow cytometry. Furthermore, either conventional acupuncture or microneedles were able to effectively mitigate the anxiety caused by immune-suppression when applied on the ST36.

Dry powder inhalers (DPIs) offer distinct advantages as a means of pulmonary drug delivery and have attracted much attention in the field of pharmaceutical science. DPIs commonly contain micronized drug particles which, because of their cohesiveness and strong propensity to aggregate, have poor aerosolization performance. Thus carriers with a larger particle size are added to address this problem. However, the performance of DPIs is profoundly influenced by the physical properties of the carrier, particularly their particle size, morphology/shape and surface roughness. Because these factors are interdependent, it is difficult to completely understand how they individually influence DPI performance. The purpose of this review is to summarize and illuminate how these factors affect drug-carrier interaction and influence the performance of DPIs.