Objective To investigate the impact of high-frequency repetitive transcranial magnetic stimula-tion(rTMS)combined with biofeedback-assisted dry swallowing training on treating dysphagia following a stroke.Methods A total of 152 patients with dysphagia after stroke,admitted to the hospital from January 2022 to January 2024,were randomly divided into four groups using a random number table,with 38 cases in each group.The biofeedback group received biofeedback-assisted dry swallowing training,the magnetic stimulation group received high-frequency rTMS on the unaffected side,the combined group received both biofeedback-assisted dry swallowing training and high-frequency rTMS on the unaffected side,and the placebo group received conventional swallowing training and sham rTMS.All interventions lasted for 4 weeks.Clinical efficacy was recorded,and pre-and post-treatment assessments of the upper esophageal sphincter(UES)opening time,opening degree,and pharyngeal contraction duration were performed using multifunctional esophageal manometry.Additionally,swallowing func-tion,nutritional status,neurological function,and quality of life were compared.Results The clinical efficacy of the combined group was higher than that of the biofeedback and magnetic stimulation groups.Post-treatment UES opening time,opening degree,and pharyngeal contraction duration were(205.33±29.01)ms,(1.14±0.34)cm,and(559.19±63.48)ms,respectively,which were significantly better than those in the other 3 groups(P<0.05).The swallowing function scores of the combined group were(6.04±0.83)and(20.03±3.26)points,and significant improvements were observed in swallowing function,nutritional status,neurological function,and quality of life(P<0.05).Conclusion High-frequency rTMS combined with biofeedback-based dry swallowing training signifi-cantly improves the efficacy in the treatment of dysphagia after stroke.

Objective To investigate the impact of high-frequency repetitive transcranial magnetic stimula-tion(rTMS)combined with biofeedback-assisted dry swallowing training on treating dysphagia following a stroke.Methods A total of 152 patients with dysphagia after stroke,admitted to the hospital from January 2022 to January 2024,were randomly divided into four groups using a random number table,with 38 cases in each group.The biofeedback group received biofeedback-assisted dry swallowing training,the magnetic stimulation group received high-frequency rTMS on the unaffected side,the combined group received both biofeedback-assisted dry swallowing training and high-frequency rTMS on the unaffected side,and the placebo group received conventional swallowing training and sham rTMS.All interventions lasted for 4 weeks.Clinical efficacy was recorded,and pre-and post-treatment assessments of the upper esophageal sphincter(UES)opening time,opening degree,and pharyngeal contraction duration were performed using multifunctional esophageal manometry.Additionally,swallowing func-tion,nutritional status,neurological function,and quality of life were compared.Results The clinical efficacy of the combined group was higher than that of the biofeedback and magnetic stimulation groups.Post-treatment UES opening time,opening degree,and pharyngeal contraction duration were(205.33±29.01)ms,(1.14±0.34)cm,and(559.19±63.48)ms,respectively,which were significantly better than those in the other 3 groups(P<0.05).The swallowing function scores of the combined group were(6.04±0.83)and(20.03±3.26)points,and significant improvements were observed in swallowing function,nutritional status,neurological function,and quality of life(P<0.05).Conclusion High-frequency rTMS combined with biofeedback-based dry swallowing training signifi-cantly improves the efficacy in the treatment of dysphagia after stroke.

Objective:To investigate the relationship between screen time and content, and the mental health status of adolescents. The findings will inform the formulation of targeted intervention policies to enhance adolescent mental health.Methods:Between September and November 2023, 5 197 students from 64 junior high, senior high, and vocational schools across 13 districts in Wuhan were recruited, using the stratified whole-cluster random sampling to investigate their screen behavior and mental health status. Mental health status was measured using the Mental Health Inventory for Chinese Middle School Students (MMHI-60). A generalized additive model was used to explore the nonlinear association between screen time and mental health status. Additionally, a mixed-effects model was utilized to explore the dose-response associations between average daily total screen time, screen time for different content types, and adolescents' mental health status and the impact of the proportion of different screen contents on mental health outcomes.Results:The age of the participants was (14.40±1.48) years, with 56.07% being boys. The MMHI-60 score averaged 1.73±0.70. The M( Q1,Q3) for daily total screen time was 50.00 (0.00,128.57) minutes. The M( Q1,Q3) for screen time dedicated to gaming, studying, socializing, and watching videos were 0.00 (0.00, 20.00), 8.57 (1.64, 44.50), 4.28 (0.00, 30.00), and 0.00 (0.00, 25.71) minutes, respectively. A non-linear association was observed between average daily screen time and adolescent mental health problem score, 0-1 hour of daily screen time was beneficial for adolescent mental, compared to no screen time. However, screen time exceeding 1 hour was detrimental, with the negative impact increasing alongside screen time duration. When total daily screen time was held constant, the proportion of time spent on gaming ( β=0.14, 95% CI: 0.05-0.23, P=0.003) and video ( β=0.21, 95% CI: 0.09-0.28, P<0.001) was positively correlated with mental health problems, whereas the proportion of time spent on studying was negatively correlated with mental health problems ( β=-0.17, 95% CI: -0.24 - -0.11, P<0.001). Conclusions:Moderate screen time is advantageous for adolescent mental health. However, it is crucial to minimize the proportion of screen time dedicated to video and gaming activities to mitigate potential adverse effects.

Objective:To investigate the relationship between screen time and content, and the mental health status of adolescents. The findings will inform the formulation of targeted intervention policies to enhance adolescent mental health.Methods:Between September and November 2023, 5 197 students from 64 junior high, senior high, and vocational schools across 13 districts in Wuhan were recruited, using the stratified whole-cluster random sampling to investigate their screen behavior and mental health status. Mental health status was measured using the Mental Health Inventory for Chinese Middle School Students (MMHI-60). A generalized additive model was used to explore the nonlinear association between screen time and mental health status. Additionally, a mixed-effects model was utilized to explore the dose-response associations between average daily total screen time, screen time for different content types, and adolescents' mental health status and the impact of the proportion of different screen contents on mental health outcomes.Results:The age of the participants was (14.40±1.48) years, with 56.07% being boys. The MMHI-60 score averaged 1.73±0.70. The M( Q1,Q3) for daily total screen time was 50.00 (0.00,128.57) minutes. The M( Q1,Q3) for screen time dedicated to gaming, studying, socializing, and watching videos were 0.00 (0.00, 20.00), 8.57 (1.64, 44.50), 4.28 (0.00, 30.00), and 0.00 (0.00, 25.71) minutes, respectively. A non-linear association was observed between average daily screen time and adolescent mental health problem score, 0-1 hour of daily screen time was beneficial for adolescent mental, compared to no screen time. However, screen time exceeding 1 hour was detrimental, with the negative impact increasing alongside screen time duration. When total daily screen time was held constant, the proportion of time spent on gaming ( β=0.14, 95% CI: 0.05-0.23, P=0.003) and video ( β=0.21, 95% CI: 0.09-0.28, P<0.001) was positively correlated with mental health problems, whereas the proportion of time spent on studying was negatively correlated with mental health problems ( β=-0.17, 95% CI: -0.24 - -0.11, P<0.001). Conclusions:Moderate screen time is advantageous for adolescent mental health. However, it is crucial to minimize the proportion of screen time dedicated to video and gaming activities to mitigate potential adverse effects.

Objective:To observe the efficacy the application of endoscope assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction of Nagata’s technique for microtia.Method:In this retrospective study, the clinical data were collected from the patients who received microtia reconstruction with autologous rib cartilage at the Department of Burns and Plastic Surgery, General Hospital of Northern Theater Command from January 2015 to January 2022. According to the surgical procedure, patients were divided into endoscopic group and open surgery group. In endoscopic group, endoscope-assisted temporoparietal fascia harvest were performed for the second-stage operation in auricular reconstruction of Nagata’s technique. In open surgery group, temporoparietal fascia flaps were harvested in open surgery for the second-stage operation in auricular reconstruction of Nagata’s technique. Regular follow-up was conducted to observe the survival of the fascia flaps, complications, patient satisfaction, and surgical scars. The patient satisfaction questionnaire for auricular reconstruction was used to assess patient satisfaction, and the patient and observer scar assessment scale (POSAS) was used to evaluate scar formation in the surgical area. Data analysis was performed using SPSS 26.0 statistical software. The measurement data were expressed by Mean ± SD, and the counting data were expressed as cases (%). The T-test was used to compare the age difference, length of hospital stay, intraoperative blood loss, scar length, patient satisfaction, and POSAS scores between the two groups. Chi-square test was used to compare the gender composition and incidence of complications between the two groups. P<0.05 was considered statistically significant. Results:A total of 51 patients were included, with 26 in the endoscopic group (14 men and 12 women) and 25 in the open surgery group (12 men and 13 women). The age of the patients in the endoscopic group was (9.8±2.9) years (ranging from 7 to 17 years), while in the open surgery group was (10.3±3.8) years (ranging from 7 to 17 years). The postoperative follow-up period was (15.4±3.4) months (1 to 2 years), and all fascia flaps survived without any severe complications. There were no statistically significant differences between the two groups in terms of age difference, length of hospital stay, intraoperative blood loss, postoperative satisfaction, sex composition ratio, and postoperative complications ( P>0.05). The scar quality in the endoscopy group was superior to that in the open surgery group, and POSAS scores of endoscopic group were lower than those in the open surgery group, and the difference was statistically significant ( P<0.05). Conclusion:Endoscope assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction of Nagata’s technique for microtia can minimize scarring, improve the postoperative appearance and is not statistically associated with the appearance of reconstructed auricles or complications.

Objective:To observe the efficacy the application of endoscope assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction of Nagata’s technique for microtia.Method:In this retrospective study, the clinical data were collected from the patients who received microtia reconstruction with autologous rib cartilage at the Department of Burns and Plastic Surgery, General Hospital of Northern Theater Command from January 2015 to January 2022. According to the surgical procedure, patients were divided into endoscopic group and open surgery group. In endoscopic group, endoscope-assisted temporoparietal fascia harvest were performed for the second-stage operation in auricular reconstruction of Nagata’s technique. In open surgery group, temporoparietal fascia flaps were harvested in open surgery for the second-stage operation in auricular reconstruction of Nagata’s technique. Regular follow-up was conducted to observe the survival of the fascia flaps, complications, patient satisfaction, and surgical scars. The patient satisfaction questionnaire for auricular reconstruction was used to assess patient satisfaction, and the patient and observer scar assessment scale (POSAS) was used to evaluate scar formation in the surgical area. Data analysis was performed using SPSS 26.0 statistical software. The measurement data were expressed by Mean ± SD, and the counting data were expressed as cases (%). The T-test was used to compare the age difference, length of hospital stay, intraoperative blood loss, scar length, patient satisfaction, and POSAS scores between the two groups. Chi-square test was used to compare the gender composition and incidence of complications between the two groups. P<0.05 was considered statistically significant. Results:A total of 51 patients were included, with 26 in the endoscopic group (14 men and 12 women) and 25 in the open surgery group (12 men and 13 women). The age of the patients in the endoscopic group was (9.8±2.9) years (ranging from 7 to 17 years), while in the open surgery group was (10.3±3.8) years (ranging from 7 to 17 years). The postoperative follow-up period was (15.4±3.4) months (1 to 2 years), and all fascia flaps survived without any severe complications. There were no statistically significant differences between the two groups in terms of age difference, length of hospital stay, intraoperative blood loss, postoperative satisfaction, sex composition ratio, and postoperative complications ( P>0.05). The scar quality in the endoscopy group was superior to that in the open surgery group, and POSAS scores of endoscopic group were lower than those in the open surgery group, and the difference was statistically significant ( P<0.05). Conclusion:Endoscope assisted temporoparietal fascia flap harvest for the second-stage operation in auricular reconstruction of Nagata’s technique for microtia can minimize scarring, improve the postoperative appearance and is not statistically associated with the appearance of reconstructed auricles or complications.

Objective:To evaluate the feasibility and applicability of using phospholipid-hybridization method for preparing biomimetic microbubbles (Bio-MBs) ultrasound contrast agents.Methods:Leukocyte biomimetic microbubbles (MB leu), platelet biomimetic microbubbles (MB pla) and erythrocyte biomimetic microbubbles (MB ery) were prepared by multiple steps: film-hydration, phospholipid-hybridization, mechanical oscillation. The size and zeta potential of Bio-MBs were measured by dynamic light scattering. A laser scanning confocal microscopy experiment was performed to confirm the presence of membrane proteins on the shell of Bio-MBs. The fluorescence of FITC-labeled typical membrane protein was evaluated using a flow cytometer. Sodium dodecyl sulfate polyacrylamide gel electrophoresis was used to characterize the membrane protein. Biosafety of Bio-MBs was evaluated by CCK-8 counting kit, blood and major organs. The contrast enhancement effect and stability were observed in vitro and in vivo. An in vivo fluorescence imaging system was performed to evaluate the distribution of Bio-MBs. The application value of biomimetic microbubbles was measured by ultrasound molecular imaging by using ischemia-reperfusion rat models and acute hepatitis rat models. Results:Bio-MBs with spherical shape distributed homogenously, without obvious aggregation. The membrane proteins were successfully integrated into the shell of Bio-MBs.The diameter of three Bio-MBs was similar to that of control microbubbles (MB con) ( P>0.05), three Bio-MBs had a lower zeta potential than MB con ( P<0.05). The Bio-MBs had an appreciable performance in vitro and in vivo biosafety. The Bio-MBs retained the main proteins inherited from cell membrane. Contrast enhanced ultrasound imaging in vitro and in vivo showed that the Bio-MBs had a stable imaging ability.MB leu and MB pla have good targeted imaging effect in two disease models. Conclusions:A series of Bio-MBs ultrasound contrast agents, which have high stability, biosafety and targeted imaging efficiency, were successfully prepared by using phospholipid-hybridization method. This fabrication method for obtaining Bio-MBs can be applied to different clinical scenarios with different cell types in the future.

Type 2 diabetes (T2D) is characterized by the malfunction of pancreatic β cells. Susceptibility and pathogenesis of T2D can be affected by multiple factors, including sex differences. However, the mechanisms underlying sex differences in T2D susceptibility and pathogenesis remain unclear. Using single-cell RNA sequencing (scRNA-seq), we demonstrate the presence of sexually dimorphic transcriptomes in mouse β cells. Using a high-fat diet-induced T2D mouse model, we identified sex-dependent T2D altered genes, suggesting sex-based differences in the pathological mechanisms of T2D. Furthermore, based on islet transplantation experiments, we found that compared to mice with sex-matched islet transplants, sex-mismatched islet transplants in healthy mice showed down-regulation of genes involved in the longevity regulating pathway of β cells. Moreover, the diabetic mice with sex-mismatched islet transplants showed impaired glucose tolerance. These data suggest sexual dimorphism in T2D pathogenicity, indicating that sex should be considered when treating T2D. We hope that our findings could provide new insights for the development of precision medicine in T2D.

Objective:To investigate the clinical treatment of large segmental humeral defects with unilateral external fixation and bone transport.Methods:A retrospective study was conducted of the 9 patients who had been treated at Department of Orthopedics, Shenzhen People's Hospital for large segmental humeral defects from September 2017 to June 2019. They were 5 males and 4 females with an average age of 29 years (from 21 to 41 years). Their defects were caused by trauma in 2 cases, by chronic osteomyelitis in 6 cases and by bone tumor in one case. The length of bone defect ranged from 4.2 to 9.0 cm, with an average of 5.9 cm. A unilateral external fixator was placed in operation, and adjusted regularly 7 to 10 days after operation for bone transport and bone lengthening to restore the length of humerus gradually. The external fixation bracket was removed after 3 to 4 layers of cortex were observed on X-ray films. Recorded were length and rate of humeral lengthening, fracture healing time, time for carrying external fixator and complications; the Disabilities of the Arm, Shoulder and Hand (DASH) scores were compared between preoperation and 15 months postoperation.Results:All the patients were followed up for 15 to 36 months (mean, 19 months). The length of lengthening averaged 5.9 cm (from 4.2 to 9.0 cm) with an average lengthening rate of 26%, the healing index 31 d/cm, the bone healing time 8.3 months, and the time for carrying external fixator 10.8 months(from 8.0 to 13.5 months). Their average DASH scores improved significantly from 25.0 ± 2.4 preoperation to 12.0 ± 1.8 at 15 months postoperation ( P<0.05). Good correction of large humeral defects was achieved in all but one case who reported temporary radial nerve paralysis. There were no such complications as neurovascular injury. The shoulder and elbow functions were basically normal after operation. Conclusions:In the treatment of large segmental humeral defects, unilateral external fixation plus bone transport can quickly repair the defects and recover the upper limb function of the patients.

This paper aims to explore the feasibility of building a finite element model of left atrial diverticulum (LAD) using reverse engineering software based on computed tomography (CT) images. The study was based on a three-dimensional cardiac CT images of a atrial fibrillation patient with LAD. The left atrium and LAD anatomical features were accurately reproduced by using Geomagic Studio 12 and Mimics 15 reverse engineering software. In addition, one left atrial model with LAD and one without LAD were created with ANSYS finite element analysis software, and the validity of the two models were verified. The results show that it is feasible to establish the LAD finite element model based on cardiac three-dimensional CT images using reverse engineering software. The results of this paper will lay a theoretical foundation for further hemodynamic analysis of LAD.