Objective:To observe the effects of low expressed Angiotensin-converting enzyme 2 ( Ace2) gene on senescence related signals of alveolar type Ⅱ epithelial cells in silicotic mice. Methods:In March 2022, 20 8-12W SPF male wild-type C57BL/6 mice and 20 Ace2 gene knockdown mice (Ace2 +/-, C57BL/6 background) were randomly divided into wild-type control group, Ace2 low expression group, wild-type silicosis group, Ace2 low expression silicosis group, with 10 mice in each group. In vitro MLE-12 cells were divided into control group, MLN-4760 (ACE2 inhibitor) group, SiO 2 group and SiO 2+MLN-4760 group. The expression of ACE2, collagen I (Col I), fibronectin 1 (Fn1), α-smooth muscle actin (α-SMA), phosphorylation-ataxia telangiectasia-mutated serine/threonine kinase (p-ATM), phosphorylation-ATM Rad3-related kinase (p-ATR), p-p53, p21 and p16 in mice and MLE-12 cells were detected by Western blotting. The expression and location of β-galactosidase were detected by immunofluorescence, β-galactosidase (SA-β-Gal) staining were used to detect the senescence of MLE-12 cells. Results:HE and VG staining results showed that typical silicon nodules with collagen deposition were formed in the lung of wild-type silicotic mice and Ace2 low expression silicotic mice. Immunofluorescence staining results showed that β-galactosidase was mainly located in alveolar type Ⅱ epithelial cells. Western blot results showed that, compared with wild-type silicosis group, the expression of Col I, α-SMA, p-ATM, p-ATR, p-p53, p21 and p16 in Ace2 low expression silicosis group were significantly up-regulated by 540.71%、26.58%、336.84%、139.58%、152.78%、120.10% and 994.63% ( P<0.05). In MLE-12 cells, results of western blot showed that compared with SiO 2 group, the expression levels of p-ATM, p-ATR, p-p53, p21 and p16 in SiO 2+MLN-4760 group were significantly up-regulated by 168.71%、750.78%、149.51%、554.26% and 254.07% ( P<0.05). Immunofluorescence staining results showed that compared with SiO 2 group, β-galactosidase positive cells were strongly up-regulated in SiO 2+MLN-4760 group, and SA-β-Gal staining results showed that compared with SiO 2 group, the number of senescent cells in SiO 2+MLN-4760 group increased by 63.18% ( P<0.05) . Conclusion:Low expression of Ace2 gene activated senescence related signals of alveolar type Ⅱ epithelial cells and promoted the progression of silicotic fibrosis in mice.

Objective To compare the smile incision combined with indirect reduction technique with traditional ORIF technique and systematically evaluate the advantages of this innovative surgical method in terms of functional recovery and postoperative cosmetic effects.Methods A total of 60 patients with midshaft clavicle fractures were enrolled between October 2022 and August 2024.The patients were randomly assigned to either ORIF group(open reduction and internal fixation,n=30)or MIPPO group(MIPPO combined with smile incision,n=30).Outcomes assessed included surgical trauma,functional recovery,and cosmetic outcomes.Results The MIPPO group exhibited significantly reduced intraoperative blood loss[(32.9±7.6)mL vs.(90.2±14.0)mL,P＜0.05],shorter incision length[(3.0±0.5)cm vs.(8.5±1.2)cm,P＜0.05],and reduced operative time compared to the ORIF group.Functional recovery indicators such as bone healing time[(10.1±1.7)weeks vs.(12.8±2.0)weeks,P＜0.05],initial and complete self-care time,and weight-bearing recovery were all significantly improved in the MIPPO group.The Constant-Murley score was higher in the MIPPO group(91.5±5.1 vs.82.4±6.0,P＜0.05).Cosmetic outcomes also favored the MIPPO group,with a superior SBSES score(9.2±0.4 vs.3.0±0.7,P＜0.05)and better results in scar visibility,pigmentation,thickness,and elasticity.Conclusion The smile incision combined with indirect reduction technique significantly reduces surgical trauma,accelerates postoperative recovery,and provides substantially better cosmetic outcomes compared to conventional methods,making it particularly suitable for patients with high aesthetic expectations.

Brain tinnitus is a common clinical condition whose pathogenesis is not yet fully understood,and it still lacks effective therapies in clinical practice.Professor Liu Maocai believes that the clinical manifestations of brain tinnitus are usually characterized by deficiency syndrome,and sometimes are complicated excess syndrome.The disease is located in the brain and is closely related to the liver,spleen,and kidney.The treatment of brain tinnitus should be focused on tonifying the liver and kidney,and strengthening the spleen,and methods of calming the liver to extinguish wind,resolving phlegm to open the orifices,and activating blood circulation to unblock collaterals can be used for excess syndrome.In clinical practice,Professor Liu Maocai is skilled in using herb pairs such as Astragali Radix-Codonopsis Radix,Eucommiae Cortex-Achyranthis Bidentatae Radix,Paeoniae Radix Alba-Bupleuri Radix,Angelicae Sinensis Radix-Chuanxiong Rhizoma,Gastrodiae Rhizoma-Uncariae Ramulus cum Uncis,and Acori Tatarinowii Rhizoma-Polygalae Radix.Professor Liu Maocai's experience in treating brain tinnitus from the perspective of the liver,spleen,and kidney can provide valuable references for the clinical diagnosis and treatment of brain tinnitus with traditional Chinese medicine.

Objective:To observe the effects of low expressed Angiotensin-converting enzyme 2 ( Ace2) gene on senescence related signals of alveolar type Ⅱ epithelial cells in silicotic mice. Methods:In March 2022, 20 8-12W SPF male wild-type C57BL/6 mice and 20 Ace2 gene knockdown mice (Ace2 +/-, C57BL/6 background) were randomly divided into wild-type control group, Ace2 low expression group, wild-type silicosis group, Ace2 low expression silicosis group, with 10 mice in each group. In vitro MLE-12 cells were divided into control group, MLN-4760 (ACE2 inhibitor) group, SiO 2 group and SiO 2+MLN-4760 group. The expression of ACE2, collagen I (Col I), fibronectin 1 (Fn1), α-smooth muscle actin (α-SMA), phosphorylation-ataxia telangiectasia-mutated serine/threonine kinase (p-ATM), phosphorylation-ATM Rad3-related kinase (p-ATR), p-p53, p21 and p16 in mice and MLE-12 cells were detected by Western blotting. The expression and location of β-galactosidase were detected by immunofluorescence, β-galactosidase (SA-β-Gal) staining were used to detect the senescence of MLE-12 cells. Results:HE and VG staining results showed that typical silicon nodules with collagen deposition were formed in the lung of wild-type silicotic mice and Ace2 low expression silicotic mice. Immunofluorescence staining results showed that β-galactosidase was mainly located in alveolar type Ⅱ epithelial cells. Western blot results showed that, compared with wild-type silicosis group, the expression of Col I, α-SMA, p-ATM, p-ATR, p-p53, p21 and p16 in Ace2 low expression silicosis group were significantly up-regulated by 540.71%、26.58%、336.84%、139.58%、152.78%、120.10% and 994.63% ( P<0.05). In MLE-12 cells, results of western blot showed that compared with SiO 2 group, the expression levels of p-ATM, p-ATR, p-p53, p21 and p16 in SiO 2+MLN-4760 group were significantly up-regulated by 168.71%、750.78%、149.51%、554.26% and 254.07% ( P<0.05). Immunofluorescence staining results showed that compared with SiO 2 group, β-galactosidase positive cells were strongly up-regulated in SiO 2+MLN-4760 group, and SA-β-Gal staining results showed that compared with SiO 2 group, the number of senescent cells in SiO 2+MLN-4760 group increased by 63.18% ( P<0.05) . Conclusion:Low expression of Ace2 gene activated senescence related signals of alveolar type Ⅱ epithelial cells and promoted the progression of silicotic fibrosis in mice.

Objective To compare the smile incision combined with indirect reduction technique with traditional ORIF technique and systematically evaluate the advantages of this innovative surgical method in terms of functional recovery and postoperative cosmetic effects.Methods A total of 60 patients with midshaft clavicle fractures were enrolled between October 2022 and August 2024.The patients were randomly assigned to either ORIF group(open reduction and internal fixation,n=30)or MIPPO group(MIPPO combined with smile incision,n=30).Outcomes assessed included surgical trauma,functional recovery,and cosmetic outcomes.Results The MIPPO group exhibited significantly reduced intraoperative blood loss[(32.9±7.6)mL vs.(90.2±14.0)mL,P＜0.05],shorter incision length[(3.0±0.5)cm vs.(8.5±1.2)cm,P＜0.05],and reduced operative time compared to the ORIF group.Functional recovery indicators such as bone healing time[(10.1±1.7)weeks vs.(12.8±2.0)weeks,P＜0.05],initial and complete self-care time,and weight-bearing recovery were all significantly improved in the MIPPO group.The Constant-Murley score was higher in the MIPPO group(91.5±5.1 vs.82.4±6.0,P＜0.05).Cosmetic outcomes also favored the MIPPO group,with a superior SBSES score(9.2±0.4 vs.3.0±0.7,P＜0.05)and better results in scar visibility,pigmentation,thickness,and elasticity.Conclusion The smile incision combined with indirect reduction technique significantly reduces surgical trauma,accelerates postoperative recovery,and provides substantially better cosmetic outcomes compared to conventional methods,making it particularly suitable for patients with high aesthetic expectations.

Objective:To explore the incidence of sudden deafness accompanied with tinnitus, the selection of examination protocols and treatment, and to provide reference for the establishment of new guidelines for sudden deafness.Methods:CiteSpace software was used for analysis and data mining to analyze and summarize the computer-retrieved articles on diagnostic examination and treatment of sudden deafness accompanied with tinnitus collected from CNIC, Wanfang and Web of Science databases from 2011 to 2021.Results:A total of 207 randomized controlled studies were retrieved in this study, including 121 in Chinese and 86 in English. Finally, 74 Chinese literatures and 16 English literatures were included. Among the 74 valid Chinese literatures, 64 (86.5%) were accompanied with tinnitus, 58 (78.4%) with dizziness/vertigo, 25 (33.8%) with aural fullness, 10 (13.5%) with headache, 4 (5.4%) with insomnia, 4 (5.4%) with a mixture of dizziness and tinnitus, and 2 (2.7%) with vomiting. Among the 16 English literatures, 15 (93.8%) were accompanied with tinnitus, 12 (75.0%) with vertigo, 1 (6.3%) with aural fullness, and 1 (6.3%) with a mixture of various symptoms. Among the 64 Chinese articles mentioning tinnitus, only 9 mentioned tinnitus matching tests, and 1 mentioned that the treatment for tinnitus accompanying symptoms was sound therapy and psychological counseling. The incidence rates of tinnitus accompanying four different types of sudden deafness, from low to high, are as follows: low-to-mid frequency, 82.4%; mid-to-high frequency, 90.7%; complete deafness, 92.4%; and flat type, 92.8%.Conclusion:Tinnitus is the most common accompanying symptom of sudden deafness, and tinnitus matching test is an effective evaluation method. When establishing a scientific, comprehensive, and systematic diagnosis and treatment system or guidelines for sudden deafness, attention should be paid to the diagnosis and treatment of tinnitus symptoms and their adverse psychological reactions, in order to reduce the incidence of tinnitus patients in the later stage of recovery from sudden deafness.

Background Pneumoconiosis is the most serious occupational disease in China, and silicosis accounts for about half of it. Any intervention effect of physical exercise as the key and core of lung rehabilitation training on silicosis is still unclear. Objective To explore potential intervention effect of physical exercise on silicotic mice. Methods Forty SPF C57BL/6 male mice were randomly divided into four groups, 10 in each group, including a control group, a physical exercise group, a silicosis model group, and a silicosis model + physical exercise intervention group. Silicotic mouse model was established by using 50 μL SiO₂ suspension (200 mg·mL⁻¹). A treadmill was used to prepare mice receiving physical exercise at 0° inclination, 12.3 m·min⁻¹, 60 min·d⁻¹, 5 d·week⁻¹ for 4 weeks. Pathological morphology of lung tissues was evaluated after hematoxylin-eosin (HE) staining; deposition of collagen in lung tissues was evaluated after Van Gieson (VG) staining; expression of p-protein kinase R-like endoplasmic reticulum kinase (PERK) was detected by immunofluorescence staining; expressions of cyclin dependent kinase inhibitors (p21) and p-p38 mitogen activated protein kinase (p38) were detected by immunohistochemistry. The protein expressions of endoplasmic reticulum stress signal factors [p-inositol-requiring enzyme-1α (p-IRE-1α), p-PERK, and p-eukaryotic initiation factor-2α (p-eIF-2α)], senescence signal factors (p-p53, p21, and p16), mitogen-activated protein kinase (MAPK) signal factors [p-p38, p-extracellular regulated protein kinases (p-ERK), and p-stress-activated protein kinase (p-JNK)] were detected by Western blotting. Results After designed acute SiO₂ exposure, the images of micro computed tomography (CT) showed high density shadows in lung tissues of the silicotic mice and less shadows in lung tissues of the physical exercise intervention mice. After HE staining, the proportions of silicotic nodule area in lung tissues was (18.67±3.89) % in the silicosis model group, and significantly decreased to (8.78±1.05) % in the silicosis model + physical exercise intervention group (P<0.05). After VG staining, the proportion of collagen fiber area of lung tissues was (10.37±2.18) % in the silicosis model group, and significantly decreased to (4.35±0.89) % in the silicosis model + physical exercise intervention group (P<0.05). The results of immunofluorescence staining showed that in the silicosis model group, the expression of p-PERK increased at the location of silicotic nodules, while in the silicotic model + physical exercise intervention group, the expression of p-PERK decreased. The immunohistochemical staining results showed that the expression of p21 and p-p38 increased in the lung tissues of the silicosis model group; the expression of p21 and p-p38 decreased in the lung tissues of the silicosis model + physical exercise intervention group. The results of Western blotting showed that compared with the control group, the expression levels of p-IRE-1α (0.11±0.03), p-PERK (0.95±0.40), p-eIF-2α (3.53±0.91), p-p53 (1.78±0.07), p21 (1.98±0.10), p16 (1.26±0.17), p-p38 (0.41±0.09), p-ERK (0.42±0.05), and p-JNK (3.20±1.23) of the silicosis model group were all upregulated (P<0.05). Compared with the silicosis model group, the expression levels of p-IRE-1α (0.03±0.01), p-PERK (0.31±0.12), p-eIF-2α (0.30±0.06), p-p53 (0.76±0.08), p21 (0.18±0.11), p16 (0.70±0.24), p-p38 (0.03±0.00), p-ERK (0.19±0.03), and p-JNK (0.46±0.21) of the silicosis model + physical exercise intervention group were downregulated (P<0.05). Conclusion Physical exercise may alleviate pulmonary fibrosis in silicotic mice, and inhibit abnormal expressions of endoplasmic reticulum stress signal, MAPK signal, and senescent signal.

Apnea test (AT) is a key step in the diagnosis of adult brain death, which provides important basis for the loss of brainstem function in patients with adult brain death. In recent years, with extensive development of adult brain death determination and organ donation transplantation, discussion and research of AT have been gradually promoted. In formulation of adult brain death criteria, countries have paid more attention to the standardization and normalization of AT implementation, and medical staffs have improved the AT implementation process. This article reviews the current AT implementation standards, conventional AT procedures and complications, modified AT exploration, AT implementation with extracorporeal membrane oxygenation, and treatments and auxiliary examinations after AT failure, in order to deepen the understanding and cognition of adult brain death determination physicians on AT, and promote AT development in a more standardized and orderly way.

Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by cartilage loss and accounts for a major source of pain and disability worldwide. However, effective strategies for cartilage repair are lacking, and patients with advanced OA usually need joint replacement. Better comprehending OA pathogenesis may lead to transformative therapeutics. Recently studies have reported that exosomes act as a new means of cell-to-cell communication by delivering multiple bioactive molecules to create a particular microenvironment that tunes cartilage behavior. Specifically, exosome cargos, such as noncoding RNAs (ncRNAs) and proteins, play a crucial role in OA progression by regulating the proliferation, apoptosis, autophagy, and inflammatory response of joint cells, rendering them promising candidates for OA monitoring and treatment. This review systematically summarizes the current insight regarding the biogenesis and function of exosomes and their potential as therapeutic tools targeting cell-to-cell communication in OA, suggesting new realms to improve OA management.
Apoptosis ; Cartilage/pathology* ; Cartilage, Articular/metabolism* ; Cell Communication ; Chondrocytes/metabolism* ; Exosomes/pathology* ; Humans ; Osteoarthritis/therapy*

Objective:Explore the " project-talent-base" combining international science and technology cooperation management model and mechanism through summarizing the practical experience of a tertiary pediatric hospital in Beijing in recent years, to provide reference for strengthening the hospital′s international science and technology cooperation.Methods:Main problems existing in the management of international science and technology cooperation in domestic medical institutions are analyzed, and management methods of international science and technology cooperation adopted by the hospital are classified through policy sorting, literature research, summarization and classification.Results:The hospital has established an efficient and high-quality international science and technology cooperation management model mainly through four aspects: improving the international cooperation management system, enriching international cooperation and exchange projects, building different types of international science and technology cooperation platforms, and strengthening personnel training.Conclusions:Under the background of the globalization of science and technology and the accelerating pace of scientific research in China, improving the hospital′s international science and technology cooperation management model will effectively promote the introduction of international advanced technologies and concepts, and enhance the overall science and technology innovation capabilities and discipline construction.