Objective To investigate the value of three-dimensional amide proton transfer(3D APT)imaging and multi-model diffusion weighted imaging(DWI)in evaluating the histological grade of cervical squamous cell carcinoma(CSCC).Methods A total of 54 patients with CSCC at different grades were prospectively included.All subjects underwent pelvic 3D APT and multi-b-value DWI sequences on a 3.0T MR scanner.Two radiologists blindly measured the amide proton transfer(APT)values of all continuous layers of the lesion,the apparent diffusion coefficient(ADC)of the mono-exponential-model of DWI,the ture-diffusion coefficient(D),pseudo-diffusion coefficient(D*),perfusion fraction(f)of intravoxel incoherent motion(IVIM)imaging,and the mean diffusivity(MD)and mean diffusion kurtosis(MK)values of diffusion kurtosis imaging(DKI).The receiver operating characteristic(ROC)curve was used to analyze the efficacy of each parameter in identifying different pathological grades of CSCC.Results The APT mean signal intensity(SImean),APT maximum signal intensity(SImax)and maximum mean diffusion kurtosis(MKmax)values of the high-grade group were statistically higher than those of the low-grade group,and the minimum apparent diffusion coefficient(ADCmin),minimum ture-diffusion coefficient(Dmin),and minimum mean diffusivity(MDmin)values were statistically lower than those of the low-grade group(P＜0.05).The area under the curve(AUC)increased after the combination of APT parameters and DWI parameters,which was obviously higher than that of a single parameter(P＜0.05).Conclusion Both APT and multi-model DWI are helpful to identify the degree of differentiation of CSCC,and the diagnostic value of combining the two is higher.

Objective To investigate the application value of quantitative relaxation parameters based on synthetic MRI technology in the differential diagnosis of parotid gland tumors.Methods Conventional MRI and synthetic MRI data of 59 patients with patho-logically confirmed parotid gland tumors were analyzed retrospectively.T1,T2,and proton density(PD)values of the tumor were extracted from T1,T2 and PD mapping.The differences in quantitative relaxation parameters of pleomorphic adenomas,Warthin tumors,and malignant tumors were further compared.Diagnostic performance of each quantitative relaxation parameter was assessed and com-pared via receiver operating characteristic(ROC)curve and DeLong test.Results T2 value was significantly higher in pleomorphic adenomas than that in malignant tumors(P<0.05).The T1,T2,and PD values of pleomorphic adenomas and malignant tumors were significantly higher than those of Warthin tumors(P<0.05).The area under the curve(AUC)of the T2 value in differentia-ting pleomorphic adenomas from malignant tumors was 0.794.The AUC for T1 value(0.939)in differentiating Warthin tumors from malignant tumors was significantly higher than that of T2(0.873,P=0.341)and PD(0.927,P=0.891)values,without sta-tistically significant difference.The AUC for T2 value(0.968)in differentiating pleomorphic adenomas from Warthin tumors was significantly higher than that of T1(0.931,P=0.360)and PD(0.876,P=0.120)values,without statistically significant difference.Conclusion Quantitative relaxation parameters based on synthetic MRI technology may contribute to differentiating pleomorphic adenomas,Warthin tumors,and malignant tumors of the parotid gland.

Objective To explore the effect of protective ventilation strategies based on individualized positive end expiratory pressure(PEEP)regulated by driving pressure(Pd)in infants under OLV.Methods Sixty infants undergoing elective thoracoscopic surgery were randomly divided into the control group and driving pressure group,with 30 cases in each group.The two groups were compared in terms of MAP,HR,tidal volume(Vt),PEEP,Pd,airway peak pressure(Ppeak),and static lung compliance(Cs),and arterial blood gas during OLV before the artificial pneumothorax(T0),10 min(T1),30 min(T2),and 60 min(T3)after the artificial pneumothorax,and right at the end of the artificial pneumothorax(T4).Results There were no significant differences in MAP,HR,and Vt between the two groups at all the time points(P＞0.05).Both groups showed the increase in Pd and Ppeak and decresase in Cs at T1,T2,and T3(all P＜0.05).PaO2 and OI in both group were decreased and PaCO2 was increased at T2(all P＜0.05).Compared with the control group,the driving pressure group presented lower Pd and Ppeak,higher PEEP and Cs at T1,T2,and T3(P＜0.05),and higher PaO2 and OI(P＜0.05)and no significant differences in PaCO2 and FiO2 at T2(P＜0.05).The rate of rescue ventilation during OLV was lower in the driving pressure group(2 cases)than in the control group(9 cases)(6.9%versus 32.4%,P＜0.05).There was no significant difference in the inci-dence of postoperative complications between the two groups(P＜0.05).Conclusion The individualized positive end expiratory pressure(PEEP)regulated by Pd can optimize the PEEP settings upon infant individuals under OLV and improve the compliance and oxygenation of ventilated lung.

Objective To study the population genetic structure and phylogenetic relationships by combining Y-STR haplotype genetic information from the Han population in Dalian with 32 domestic and foreign groups.Methods Blood samples of 958 Han male volunteers from Dalian were collected.Genetic typing of 42 genetic loci was completed using Y-STR fluorescent reagent kits and capillary electrophoresis.Related forensic parameters were calculated.Nei's standard genetic distances among 33 populations based on 17 Y-STR loci were computed,in order to create a principal coordinate analysis as well as construct a phylogenetic tree.Results The analysis of genetic polymorphisms at 42 Y-STR loci revealed 30 unconventional alleles at 10 loci.Genetic analysis of the population based on 17 Y-STR loci confirmed that Dalian's Han population had the closest genetic distance to the Anshan's Han population,followed by populations from Henan,Heilongjiang,Jilin,Shandong,and Chongqing.Furthermore,the genetic distances between the Han population in Dalian and the Qiang population in Beichuan or the Miao population in Guizhou were relatively closer than that to the Manchu population living in Liaoning.Conclusion The genetic distance between the Han population in Dalian and other groups is not entirely proportional to ethnicities and geographical proximity.Both population migration and ethnic assimilation or isolation may have influence on it.

Objective:To present the surgical details of manual double-layer suturing in patients with obesity combined type 2 diabetes mellitus by three-incision laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy .Methods:Clinical data and follow-up information of 52 obesity combined type 2 diabetes mellitus patients (BMI 27.59-43.71 kg/m2) who underwent three-incision laparoscopic single-anastomosis duodenal-jejunal bypass with sleeve gastrectomy from Jan 2019 to Jul 2022 at Beijing Shijitan hospital were retrospectively analyzed.Results:The procedure was successful in all patients. The median operative time was 120 (90, 120) min, and the median intraoperative bleeding was 20.0 (10.0, 27.5) ml. No fistula or serious surgical complications were observed in the patients at 1 month postoperatively. Compared with the preoperative period, the patient's weight decreased [(93.22±15.21) kg vs. (69.97±11.06) kg, t=21.707, P<0.01], BMI decreased [(33.11±4.09) kg/m 2vs. (24.86±2.95) kg/m 2, t=23.224, P<0.01], and the patient's fasting glucose level decreased [9.52 (7.57, 12.96) mmol/L vs. 5.47 (4.66, 6.39) mmol/L, Z=6.11, P<0.01]. The remission rate of various obesity comorbidities was greatly improved. Conclusion:Under the condition of three-incision laparoscopy, the pure manual duodenal and jejunal double-layer suture method is safe, feasible, and effective for patients with obesity combined with type 2 diabetes mellitus.

Loganin(LOG),a bioactive compound derived from Cornus officinalis Siebold & Zucc,has been understudied in the context of osteoarthritis(OA)treatment.In this study,we induced an inflammatory response in chondrocytes using lipopolysaccharide(LPS)and subsequently treated these cells with LOG.We employed fluorescence analysis to quantify reactive oxygen species(ROS)levels and measured the expression of NLRP3 and nuclear factor erythropoietin-2-related factor 2(NRF2)using real-time quantitative polymerase chain reaction(qRT-PCR),Western blotting,and immunofluorescence(IF)techniques.Additionally,we developed an OA mouse model by performing medial meniscus destabilization(DMM)surgery and monitored disease progression through micro-com-puted tomography(micro-CT),hematoxylin and eosin(H&E)staining,safranin O and fast green(S&F)staining,and immunohisto-chemical(IHC)analysis.Our results indicate that LOG significantly reduced LPS-induced ROS levels in chondrocytes,inhibited the activation of the NLRP3 inflammasome,and enhanced NRF2/heme oxygenase 1(HO-1)signaling.In vivo,LOG treatment mitigated cartilage degradation and osteophyte formation triggered by DMM surgery,decreased NLRP3 expression,and increased NRF2 expres-sion.These findings suggest that LOG has a protective effect against OA,potentially delaying disease progression by inhibiting the ROS-NLRP3-IL-1β axis and activating the NRF2/HO-1 pathway.

Dexmedetomidine displays multiple mechanisms of neuroprotection in ameliorating ischemic brain injury. In this study, we explored the beneficial effects of dexmedetomidine on blood-brain barrier (BBB) integrity and neuroinflammation in cerebral ischemia/reperfusion injury. Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 1.5 h and reperfusion for 24 h to establish a rat model of cerebral ischemia/reperfusion injury. Dexmedetomidine (9 µg/kg) was administered to rats 30 min after MCAO through intravenous injection, and SB203580 (a p38 MAPK inhibitor, 200 µg/kg) was injected intraperitoneally 30 min before MCAO. Brain damages were evaluated by 2,3,5-triphenyltetrazolium chloride staining, hematoxylin-eosin staining, Nissl staining, and brain water content assessment. BBB permeability was examined by Evans blue staining. Expression levels of claudin-5, zonula occludens-1, occludin, and matrix metalloproteinase-9 (MMP-9) as well as M1/M2 phenotypes-associated markers were assessed using immunofluorescence, RT-qPCR, Western blotting, and gelatin zymography. Enzyme-linked immunosorbent assay was used to examine inflammatory cytokine levels. We found that dexmedetomidine or SB203580 attenuated infarct volume, brain edema, BBB permeability, and neuroinflammation, and promoted M2 microglial polarization after cerebral ischemia/reperfusion injury. Increased MMP-9 activity by ischemia/reperfusion injury was inhibited by dexmedetomidine or SB203580. Dexmedetomidine inhibited the activation of the ERK, JNK, and p38 MAPK pathways. Moreover, activation of JNK or p38 MAPK reversed the protective effects of dexmedetomidine against ischemic brain injury. Overall, dexmedetomidine ameliorated brain injury by alleviating BBB permeability and promoting M2 polarization in experimental cerebral ischemia/reperfusion injury model by inhibiting the activation of JNK and p38 MAPK pathways.

Objective:To investigate the feasibility and efficacy of distal arc-shaped incision of lunula combined with nail template replantation for the treatment of subungual glomus tumor.Methods:The clinical data with subungual glomus tumor treated in the Department of Orthopedics of First Affiliated Hospital of the University of Science and Technology of China from March 2019 to June 2021 were retrospectively analyzed. Each patient removed the nail, the nail bed was cut into by a distal arc-shaped incision of the lunula. After the tumor was exposed, the tumor was resected completely, the nail bed flap was reduced in situ without suturing. The nail template was made by using the 5 ml syringe barrel or the original nail and poked the drainage holes in it, then the nail template was covered on the nail bed surface, three-point suturing and pressurized fixation, routine dressing change, and the nail template was removed 3 weeks after the procedure. The visual analogue scale (VAS) of pain was recorded preoperative and one month after the operation, and nail bed healing, pain improvement, nail growth, and tumor recurrence were observed. VAS scores before and after surgery were expressed as M( Q1, Q3), and analyzed by Mann-Whitney U test, P<0.05 was considered statistically significant. Results:A total of 37 patients were enrolled, including 5 males and 32 females. The age ranged from 18 to 67 years old, with an average of 39 years old. All patients were confirmed as subungual glomus tumors by postoperative pathology, they were followed up for 6 to 36 months, with an average of 22 months. All of the patients had no obvious pain during the dressing change, after removing the nail template, the nail bed was flat and dry, and no obvious scar formation was found. All postoperative incisions were healed in one stage, the new nail recovered smoothly with a satisfactory appearance, the pain symptoms disappeared completely, and also no recurrence occurred during follow-up. The preoperative VAS score was 5.0 (4.5, 6.0), the VAS score one month after the operation was 0.0 (0.0, 0.0), and the difference was statistically significant ( Z=-7.57, P<0.001). Conclusion:The distal arc-shaped incision of the lunula for the treatment of subungual glomus tumor can effectively protect the germinal matrix of the nail bed, with sufficient tumor exposure, complete resection, and low recurrence rate. At the same time, combined with nail template replantation can significantly reduce nail bed scar formation and effectively prevent postoperative nail deformity. The method is simple, easy to operate, and has significant clinical efficacy.

Objective:To investigate the feasibility and efficacy of distal arc-shaped incision of lunula combined with nail template replantation for the treatment of subungual glomus tumor.Methods:The clinical data with subungual glomus tumor treated in the Department of Orthopedics of First Affiliated Hospital of the University of Science and Technology of China from March 2019 to June 2021 were retrospectively analyzed. Each patient removed the nail, the nail bed was cut into by a distal arc-shaped incision of the lunula. After the tumor was exposed, the tumor was resected completely, the nail bed flap was reduced in situ without suturing. The nail template was made by using the 5 ml syringe barrel or the original nail and poked the drainage holes in it, then the nail template was covered on the nail bed surface, three-point suturing and pressurized fixation, routine dressing change, and the nail template was removed 3 weeks after the procedure. The visual analogue scale (VAS) of pain was recorded preoperative and one month after the operation, and nail bed healing, pain improvement, nail growth, and tumor recurrence were observed. VAS scores before and after surgery were expressed as M( Q1, Q3), and analyzed by Mann-Whitney U test, P<0.05 was considered statistically significant. Results:A total of 37 patients were enrolled, including 5 males and 32 females. The age ranged from 18 to 67 years old, with an average of 39 years old. All patients were confirmed as subungual glomus tumors by postoperative pathology, they were followed up for 6 to 36 months, with an average of 22 months. All of the patients had no obvious pain during the dressing change, after removing the nail template, the nail bed was flat and dry, and no obvious scar formation was found. All postoperative incisions were healed in one stage, the new nail recovered smoothly with a satisfactory appearance, the pain symptoms disappeared completely, and also no recurrence occurred during follow-up. The preoperative VAS score was 5.0 (4.5, 6.0), the VAS score one month after the operation was 0.0 (0.0, 0.0), and the difference was statistically significant ( Z=-7.57, P<0.001). Conclusion:The distal arc-shaped incision of the lunula for the treatment of subungual glomus tumor can effectively protect the germinal matrix of the nail bed, with sufficient tumor exposure, complete resection, and low recurrence rate. At the same time, combined with nail template replantation can significantly reduce nail bed scar formation and effectively prevent postoperative nail deformity. The method is simple, easy to operate, and has significant clinical efficacy.

ObjectiveTo test the inter-tester reliability and test-retest reliability of MyotonPRO for evaluating neck and shoulder muscle performance parameters in patients with unilateral chronic neck pain, observe the difference of muscle performance between the healthy and affected sides of patients with chronic neck pain, and analyze the factors that cause the imbalance of muscle performance in patients with chronic neck pain. MethodsFrom January to June, 2023, 32 patients with unilateral chronic neck pain in Guangdong Second Traditional Chinese Medicine Hospital were selected. Two testers used the same MyotonPRO equipment to measure the muscle tone, muscle hardness and muscle elasticity on both sides of the sternocleidomastoid muscle and the upper trapezius muscle in the relaxed position. Tester 1 repeated the measurement after an interval of 30 minutes, and Tester 2 was measured within the time interval between the two measurements of Tester 1. The intraclass correlation coefficient (ICC), standard error of mean (SEM) and minimum detectable change (MDC) were calculated simultaneously. The measurement results were plotted into Bland-Altman diagram and systematic bias analysis was performed. The difference in muscle characteristics between the affected side and the healthy side was compared. At the same time, the Visual Analogue Scale (VAS) score and body mass index (BMI) of the subjects were collected for correlation analysis. ResultsExcept the sternocleidomastoid muscle elasticity of the affected side (ICC = 0.697), the inter-tester reliability of all other parameters was high to very high (ICC = 0.719 to 0.952, SEM = 0.04 to 6.53, MDC = 0.12 to 18.11). The test-retest reliability of all parameters was high (ICC = 0.883 to 0.981, SEM = 0.03 to 5.72, MDC = 0.09 to 15.84). Bland-Altman plot analysis showed that the scatter distribution was consistent. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle were higher on the affected side than on the healthy side (t > 2.846, P < 0.05). The asymmetry index of tension, hardness and elasticity of upper trapezius muscle and sternocleidomastoid muscle was significantly positively correlated with VAS score and BMI (r > 0.385, P < 0.05). ConclusionMyotonPRO has good inter-tester reliability and retest reliability in evaluating the muscle performance of both sides of patients with chronic neck pain. The muscle tone, muscle hardness and muscle elasticity of sternocleidomastoid muscle and upper trapezius muscle on the affected side were higher than on the healthy side, and the difference of muscle performance was positively correlated with pain and BMI.