[Objective]To investigate the mechanism of Wumen Gumibao Decoction in treating senile osteoporosis(SOP)of senescence accelerated mouse prone 6(SAMP6)mice.[Methods]SAM-resistant 1(SAMR1)mice was set as control group,SAMP6 mice were randomly divided into model group(SAMP6),Chinese medicine low dose group(SAMP6+Wumen Gumibao Decoction 7.5 g·kg-1)and Chinese medicine high dose group(SAMP6+Wumen Gumibao Decoction 15.0 g·kg-1),with 10 mice in each group.Mice in control group and model group were gavaged with equal volume of 0.9%sodium chloride solution,and the two groups of Chinese medicine were given Wumen Gumibao Decoction,once a day for 12 weeks.The changes of body mass were observed during the experiment.At the end of the experiment,hematoxylin-eosin(HE)staining was used to observe the pathological changes of the femur in mice.Micro computed tomography(Micro-CT)was used to observe the microstructure and parameters of the femur.The serum levels of calcium(Ca),phosphorus(P)was detected with biochemical method,and the serum levels of calcitonin(CT),procollagen type Ⅰ N-terminal propeptide(PⅠNP),bone γ-carboxyglutamic acid-containing protein(BGP),alkaline phosphatase(ALP),tartrate resistant acid phosphatase(TRACP),procollagen type Ⅰ C-terminal propeptide(PⅠCP),insulin-like growth factor-1(IGF-1),parathyroid hormone(PTH)were detected by enzyme-linked immunosorbent assay(ELISA).Immunohistochemical(IHC)staining was used to detect Wnt3α,phosphorylated-b-catenin(p-b-catenin),osteoprotegerin(OPG),receptor activator of nuclear factor-κB(RANK)and ligand of receptor activator of NF-κB(RANKL),secretory protein Dickkopf-1(DKK1)and glycogen synthase kinase 3b(GSK3b).[Results]Compared with control group,the cortical bone texture,direction and arrangement of bone cells in bone tissue of model group were disordered,and the trabecular structure was loose,showing a state of osteoporosis,bone microstructure parameters bone mineral density,bone volume/tissue volume ratio,trabecular number,trabecular thickness decreased significantly(P<0.05)and trabecular separation increased significantly(P<0.05).The serum levels of Ca,BGP,PⅠNP,CT and ALP were significantly decreased(P<0.05),and P,TRACP,PⅠCP and IGF-1 were significantly increased(P<0.05).In addition,the expression of Wnt3a as significantly down-regulated(P<0.05),and the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3β was significantly up-regulated(P<0.05).Compared with model group,Chinese medicine low and high dose groups can improve the pathological morphology of the femur to varying degrees,increase the number of bone trabeculae and reduced the fracture of bone trabeculae,and improved the related parameters of bone microstructure(P<0.05).The levels of serum Ca,CT,BGP,PⅠNP and ALP were increased(P<0.05),and the levels of P,TRACP,PⅠCP and IGF-1 were decreased(P<0.05),and PTH was increased(P<0.05).At the same time,it could up-regulate the expression of Wnt3α protein in the femur(P<0.05)and down-regulate the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3b protein(P<0.05).[Conclusion]Wumen Gumibao Decoction has the effect of significantly improving osteoporosis in SAMP6 mice,and its mechanism may be related to its regulation of Wnt/β-catenin and OPG/RANK/RANKL signaling pathways.

Objective:To evaluate the teaching effectiveness of virtual reality (VR) technology in basic orthopedic surgery training.Methods:This study included 67 resident physicians who received standardized training in orthopedic basic skills between January 2022 and December 2023. They were divided into two groups: the control group with 32 students trained from January to December 2022 received traditional teaching, and the observation group with 35 students trained from January to December 2023 received teaching with VR technology. The two groups were compared in terms of their final surgical skill assessment scores and satisfaction with the teaching methods. STATA17.0 was used for t test and chi-square test. Results:The observation group scored significantly higher than the control group in preoperative preparation [(84.62±8.77) vs. (73.28±10.25)], surgical steps [(87.28±10.35) vs. (71.62±8.89)], and complications and treatment [(86.17±10.02) vs. (73.68±9.14)] ( P<0.05) during the final surgery assessment. In the final surgical skill assessment, the excellent rate of the observation group was significantly higher than that of the control group [88.57% (31/35) vs. 50.00% (16/32)]. In terms of satisfaction with the teaching methods, the observation group scored higher than the control group in stimulating learning enthusiasm [(81.26±7.95) vs. (55.73±8.11)], improving self-learning ability [(87.00±7.61) vs. (65.42±8.24)], promoting the cultivation of innovative thinking [(85.56±8.04) vs. (61.67±7.85)], optimizing interactive activities [(90.15±4.72) vs. (63.94±8.65)], and the depth and breadth of the course content [(89.14±7.11) vs. (68.72±6.72)]. Conclusions:Introducing VR technology into the teaching of basic orthopedic surgery operations can not only enhance students' practical skills, but also effectively improve their recognition and satisfaction with teaching methods.

Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a control group using the random number table method,with 53 cases in each group.The control group was treated with scalp acupuncture in addition to conventional rehabilitation training.The observation group was treated with synchronous scalp acupuncture and conventional rehabilitation training.Water swallowing test(WST),blood oxygen-saturation change amplitude,mini-mental state examination(MMSE),and standardized swallowing assessment(SSA)were assessed before treatment,after 2 weeks of treatment,and at follow-ups at week 4 and week 6.The effective rate was calculated based on the change in the WST grading after 2 weeks of treatment.Results:After 2 weeks of treatment,there was an insignificant difference in the total effective rate between the two groups(P>0.05),but the inter-group difference in the cured plus markedly effective rate was significant(P<0.01).The intra-group differences in the WST grading,blood oxygen-saturation change amplitude,and the scores of MMSE and SSA were significant among the 4 time points in the two groups(P<0.01).At follow-up at week 6,the WST grading and SSA score in the observation group were superior to those in the control group(P<0.01).Conclusion:Both intervention protocols can improve the swallowing function,physical function,and psychological status;the observation group's intervention is better than that of the control group in improving swallowing function.

Cancer patients often experience worsening pain due to the limitations of traditional pharmacological treatments. This paper explores the innovative application of multi-agent systems in this field. As a key component of artificial intelligence, multi-agent systems assist healthcare providers in making intelligent decisions and interventions based on patients' conditions, and can collaborate with other smart devices to provide personalized care. This review discusses the concept of multi-agent systems, their application in pain management, and the potential challenges and countermeasures, aiming to provide guidance for the intelligent management of cancer patient pain.

[Objective]To investigate the mechanism of Wumen Gumibao Decoction in treating senile osteoporosis(SOP)of senescence accelerated mouse prone 6(SAMP6)mice.[Methods]SAM-resistant 1(SAMR1)mice was set as control group,SAMP6 mice were randomly divided into model group(SAMP6),Chinese medicine low dose group(SAMP6+Wumen Gumibao Decoction 7.5 g·kg-1)and Chinese medicine high dose group(SAMP6+Wumen Gumibao Decoction 15.0 g·kg-1),with 10 mice in each group.Mice in control group and model group were gavaged with equal volume of 0.9%sodium chloride solution,and the two groups of Chinese medicine were given Wumen Gumibao Decoction,once a day for 12 weeks.The changes of body mass were observed during the experiment.At the end of the experiment,hematoxylin-eosin(HE)staining was used to observe the pathological changes of the femur in mice.Micro computed tomography(Micro-CT)was used to observe the microstructure and parameters of the femur.The serum levels of calcium(Ca),phosphorus(P)was detected with biochemical method,and the serum levels of calcitonin(CT),procollagen type Ⅰ N-terminal propeptide(PⅠNP),bone γ-carboxyglutamic acid-containing protein(BGP),alkaline phosphatase(ALP),tartrate resistant acid phosphatase(TRACP),procollagen type Ⅰ C-terminal propeptide(PⅠCP),insulin-like growth factor-1(IGF-1),parathyroid hormone(PTH)were detected by enzyme-linked immunosorbent assay(ELISA).Immunohistochemical(IHC)staining was used to detect Wnt3α,phosphorylated-b-catenin(p-b-catenin),osteoprotegerin(OPG),receptor activator of nuclear factor-κB(RANK)and ligand of receptor activator of NF-κB(RANKL),secretory protein Dickkopf-1(DKK1)and glycogen synthase kinase 3b(GSK3b).[Results]Compared with control group,the cortical bone texture,direction and arrangement of bone cells in bone tissue of model group were disordered,and the trabecular structure was loose,showing a state of osteoporosis,bone microstructure parameters bone mineral density,bone volume/tissue volume ratio,trabecular number,trabecular thickness decreased significantly(P<0.05)and trabecular separation increased significantly(P<0.05).The serum levels of Ca,BGP,PⅠNP,CT and ALP were significantly decreased(P<0.05),and P,TRACP,PⅠCP and IGF-1 were significantly increased(P<0.05).In addition,the expression of Wnt3a as significantly down-regulated(P<0.05),and the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3β was significantly up-regulated(P<0.05).Compared with model group,Chinese medicine low and high dose groups can improve the pathological morphology of the femur to varying degrees,increase the number of bone trabeculae and reduced the fracture of bone trabeculae,and improved the related parameters of bone microstructure(P<0.05).The levels of serum Ca,CT,BGP,PⅠNP and ALP were increased(P<0.05),and the levels of P,TRACP,PⅠCP and IGF-1 were decreased(P<0.05),and PTH was increased(P<0.05).At the same time,it could up-regulate the expression of Wnt3α protein in the femur(P<0.05)and down-regulate the expression of p-β-catenin,OPG,RANK,RANKL,DKK1 and GSK3b protein(P<0.05).[Conclusion]Wumen Gumibao Decoction has the effect of significantly improving osteoporosis in SAMP6 mice,and its mechanism may be related to its regulation of Wnt/β-catenin and OPG/RANK/RANKL signaling pathways.

The production of high-quality oocytes requires precisely orchestrated intercellular communication. Extracellular vesicles (EVs) are cell-derived nanoparticles that play a vital role in the transfer of bioactive molecules, which has gained much attention in the field of diagnosis and treatment. Over the past ten years, the participation of EVs in the reproductive processes of oocytes has been broadly studied and has shown great potential for elucidating the intricacies of female reproductive health. This review provides an extensive discussion of the influence of EVs on oocytes, emphasizing their involvement in normal physiology and altered cargo under pathological conditions. In addition, the positive impact of therapeutic EVs on oocyte quality and their role in alleviating ovarian pathological conditions are summarized.
Humans ; Extracellular Vesicles/physiology* ; Oocytes/cytology* ; Female ; Animals ; Cell Communication/physiology*

Objective:To observe the efficacy of synchronous scalp acupuncture and rehabilitation training in the treatment of poststroke dysphagia.Methods:A total of 106 participants were divided into an observation group and a control group using the random number table method,with 53 cases in each group.The control group was treated with scalp acupuncture in addition to conventional rehabilitation training.The observation group was treated with synchronous scalp acupuncture and conventional rehabilitation training.Water swallowing test(WST),blood oxygen-saturation change amplitude,mini-mental state examination(MMSE),and standardized swallowing assessment(SSA)were assessed before treatment,after 2 weeks of treatment,and at follow-ups at week 4 and week 6.The effective rate was calculated based on the change in the WST grading after 2 weeks of treatment.Results:After 2 weeks of treatment,there was an insignificant difference in the total effective rate between the two groups(P>0.05),but the inter-group difference in the cured plus markedly effective rate was significant(P<0.01).The intra-group differences in the WST grading,blood oxygen-saturation change amplitude,and the scores of MMSE and SSA were significant among the 4 time points in the two groups(P<0.01).At follow-up at week 6,the WST grading and SSA score in the observation group were superior to those in the control group(P<0.01).Conclusion:Both intervention protocols can improve the swallowing function,physical function,and psychological status;the observation group's intervention is better than that of the control group in improving swallowing function.

Objective To analyze white matter hyperintensities(WMH)and 11C-CFT PET/CT characteristics in patients with PD,and explore their relationship.Methods A total of 84 PD pa-tients admitted to our department between March 2021 and March 2025 were retrospectively en-rolled,and they were divided into young group(33 cases)and elderly group(aged＞65 years,51 cases)and also into non-WMH group(22 cases)and WMH group(62 cases)based on the severity of WMH.The degree of white matter lesions was scored,including periventricular white matter hyperintense(PVH)score and deep white matter hyperintense(DWMH)score.All patients un-derwent head MRI and 11C-CFT-PET/CT scanning.The T/N value and asymmetry index were calculated.Results The elderly PD patients exhibited significantly advanced age and higher H-Y stages,but lower T/N values of affected side of caudate nucleus,contralateral caudate nucleus,affected side of anterior putamen,contralateral anterior putamen and contralateral posterior puta-men,and posterior putamen asymmetry index than the young patients(P＜0.05,P＜0.01).Simi-lar results were observed in the WMH group when compared with the non-WMH group(P＜0.05,P＜0.01).The PVH score was negatively correlated with the T/N values of affected side of caudate nucleus(r=-0.282,P=0.009),contralateral caudate nucleus(r=-0.215,P=0.049),affected side of anterior putamen(r=-0.249,P=0.022),contralateral anterior putamen(r=-0.280,P=0.010)and contralateral posterior putamen(r=-0.285,P=0.009),and DWMH score was also negatively correlated with the T/N values in the affected side of caudate nucleus and affected side of anterior putamen(P＜0.05).Conclusion Both age and disease severity impact WMH and dopaminergic system in PD patients.A higher WMH load is associated with dopamin-ergic neuronal damage.

Objective To analyze changes in sleep,mood state,and brain function in healthy populations living in near-sea-level environments before and after exposure to high-altitude environment,and to explore the correlations between regional brain functional changes and variations in sleep and mood states.Methods A total of 45 healthy volunteers were enrolled.The participants came from regions of near-sea-level altitudes and were exposed to the high-altitude environment for a short period of time.The Pittsburgh Sleep Quality Index(PSQI),Zung Self-Rating Depression Scale(SDS),Patient Health Questionnaire-9(PHQ-9),Zung Self-Rating Anxiety Scale(SAS),and Generalized Anxiety Disorder-7(GAD-7)were administered to assess sleep quality as well as depressive and anxiety symptoms at 4 time points—prior to high-altitude exposure,immediately after exposure,one month after returning to low-altitude regions,and three months after returning to low-altitude regions.Resting-state functional magnetic resonance imaging(rs-fMRI)data were collected before and after high-altitude exposure,and regional brain functional parameters,including the amplitude of low-frequency fluctuations(ALFF)and functional connectivity strength,were analyzed.Statistical analyses were performed,including a linear mixed-effects model to evaluate longitudinal changes in scale scores,paired-sample t-tests to compare brain function differences before and after exposure,and Pearson correlation analyses to examine the relationship between brain functional changes and alterations in sleep and mood states.Results Compared with the pre-exposure findings,the participants exhibited significantly increased PSQI scores(8.89±4.41 vs.5.08±2.69,P<0.05)and PHQ-9 scores(3.60±4.19 vs.1.54±2.30,P<0.05)immediately after high-altitude exposure.One month after returning to the low-altitude environment,both sleep and depression scores decreased relative to the findings immediately after exposure(PSQI:3.88±2.13 vs.8.89±4.41,P<0.05;PHQ-9:1.50±2.25 vs.3.60±4.19,P<0.05)and showed no statistically significant difference compared with the pre-exposure findings(P>0.05).Three months after returning to near-sea-level environment,sleep,depression,and anxiety scores were all reduced compared with the findings immediately after exposure(PSQI:3.76±2.31 vs.8.89±4.41,P<0.05;PHQ-9:1.24±2.13 vs.3.60±4.19,P<0.05;SAS:23.84±5.93 vs.27.93±7.05,P<0.05),also showing no significant difference compared with the pre-exposure levels(P>0.05).Brain function analysis revealed that,relative to the pre-exposure levels,ALFF in the bilateral superior temporal gyrus,insula,and dorsolateral prefrontal cortex(DLPFC)increased after high-altitude exposure(P<0.05),and that functional connectivity strength in the DLPFC was also elevated(P<0.05).Furthermore,changes in DLPFC functional connectivity strength were positively correlated with changes in sleep and mood scores(P<0.05).Conclusion High-altitude exposure has a significant impact on the sleep,mood states,and brain function of populations from near-sea-level regions,and DLPFC,in particular,is closely associated with changes in sleep and mood states.The findings of this study provide a theoretical basis for health management and intervention strategies in high-altitude environments.

Objective:To evaluate the teaching effectiveness of virtual reality (VR) technology in basic orthopedic surgery training.Methods:This study included 67 resident physicians who received standardized training in orthopedic basic skills between January 2022 and December 2023. They were divided into two groups: the control group with 32 students trained from January to December 2022 received traditional teaching, and the observation group with 35 students trained from January to December 2023 received teaching with VR technology. The two groups were compared in terms of their final surgical skill assessment scores and satisfaction with the teaching methods. STATA17.0 was used for t test and chi-square test. Results:The observation group scored significantly higher than the control group in preoperative preparation [(84.62±8.77) vs. (73.28±10.25)], surgical steps [(87.28±10.35) vs. (71.62±8.89)], and complications and treatment [(86.17±10.02) vs. (73.68±9.14)] ( P<0.05) during the final surgery assessment. In the final surgical skill assessment, the excellent rate of the observation group was significantly higher than that of the control group [88.57% (31/35) vs. 50.00% (16/32)]. In terms of satisfaction with the teaching methods, the observation group scored higher than the control group in stimulating learning enthusiasm [(81.26±7.95) vs. (55.73±8.11)], improving self-learning ability [(87.00±7.61) vs. (65.42±8.24)], promoting the cultivation of innovative thinking [(85.56±8.04) vs. (61.67±7.85)], optimizing interactive activities [(90.15±4.72) vs. (63.94±8.65)], and the depth and breadth of the course content [(89.14±7.11) vs. (68.72±6.72)]. Conclusions:Introducing VR technology into the teaching of basic orthopedic surgery operations can not only enhance students' practical skills, but also effectively improve their recognition and satisfaction with teaching methods.