Objective To analyze the risk factors for gait disorder in patients with developmental dysplasia of the hip(DDH)after total hip replacement.Methods Sixty DDH patients who underwent total hip replacement at The Second People's Hospital of Kunshan from August 2018 to August 2023 were selected as research objects.Of them,19 patients with gait disorders were assigned to observation group,and 41 without gait disorders were taken as control group.Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for gait disorders in DDH patients after total hip replacement.Results There was no significant difference in the gender,age,disease duration,place of residence,educational level,American Society of Anesthesiologists(ASA)grade,surgical time,intraoperative blood loss,Tonnis classification,or symmetrical skin lines on lower limbs between the two groups(P>0.05).But there were significant differences in terms of equal length of lower limbs,anterior pelvic tilt,cerebral small vessel disease,Parkinson disease,and peripheral nerve injury in lower limbs between the two groups(P<0.05).Equal length of lower limbs,anterior pelvic tilt,cerebral small vessel disease,Parkinson disease,and peripheral nerve injury in lower limbs were risk factors for gait disorders in DDH patients after total hip replacement(P<0.05).Conclusion The occurrence of gait disorders is related to the equal length of lower limbs,anterior pelvic tilt,cerebral small vessel disease,Parkinson disease,and peripheral nerve injury in lower limbs in DDH patients after total hip replacement.Symptomatic treatment should be given timely so as to prevent gait disorders and improve the prognosis.

Objective To study the application of mesoporous silica nanoparticle(MSN)as drug carriers in the treatment of osteoarthritis(OA).Methods Core-cone structured MSN(MSN-CC)was synthesized by sol-gel method,modified by polyethyleneimine(PEI),and loaded with hyaluronic acid synthase 2(HAS2).Forty OA model rats were randomly assigned to OA group,MSN-CC-PEI group,hyaluronic acid(HA)group,or MSN-CC-PEI-HAS2 group.Ten healthy rats were assigned to control group.Normal saline 100 μL was injected into the knee joint in the control group and OA group.MSN-CC-PEI 100 μL,HA solution 100 μL,and MSN-CC-PEI-HAS2 100 μL were injected in MSN-CC-PEI group,HA group,and MSN-CC-PEI-HAS2 group,respectively.The levels of HA,interleukin-1β(IL-1β),and prostaglandin E2(PGE2)in the joint effusion and the foot swelling degree were measured at 1,2,and 3 weeks after injection.Results HA level in the MSN-CC-PEI-HAS2 group was significantly lower than that in the HA group at 1 week after intervention(P<0.05),while HA level in the MSN-CC-PEI-HAS2 group was significantly higher than that in the HA group at 2 and 3 weeks after intervention(P<0.05).With the time going on,HA level in the HA group was gradually decreased(P<0.05),but HA level in the MSN-CC-PEI-HAS2 group was gradually increased(P<0.05).At 1 and 2 weeks after intervention,compared with the HA group,IL-1β,PGE2 and foot swelling degree in the MSN-CC-PEI-HAS2 group were increased(P<0.05).At 3 weeks after intervention,compared with the HA group,IL-1β,PGE2 and foot swelling degree in the MSN-CC-PEI-HAS2 group were decreased(P<0.05).With the time going on,IL-1β,PGE2 and foot swelling degree in the HA group and MSN-CC-PEI-HAS2 group were gradually decreased(P<0.05).Conclusion MSN carrier can stably stimulate the secretion of endogenous HA,reduce the inflammatory response within joint cavity of OA rats,and improve the joint morphology and soft tissue pathological changes.

Objective:This study aims to analyze the disease burden trends of schizophrenia and bipolar disorder from 1990 to 2021 in China, and to predict the trends of these two disorders over the next 20 years.Methods:This study was conducted between September and October 2024. The data on incidence, prevalence, and disease burden of schizophrenia and bipolar disorder in China were retrieved from the database of the Global Burden of Disease Study 2021 (GBD2021). Temporal trends were quantified via the annual percentage change, average annual percentage change (AAPC), and their corresponding P-values, which were calculated using the empirical quantile method with the Joinpoint software. The autoregressive integrated moving average (ARIMA) model was constructed using data on the incidence, prevalence, and disease burden of schizophrenia and bipolar disorder from 1990 to 2021 to predict the trends in prevalence and disease burden of these two diseases from 2022 to 2041. Results:In China, during the period from 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rates (ASPR), and age-standardized disability-adjusted life year (DALY) rate (ASDR) of schizophrenia all showed a fluctuating upward trend. By 2021, the AAPC of these rates was 3.83% ( P<0.001), 12.99% ( P<0.001), and 14.11% ( P<0.001), respectively, indicating a significant increase. Regarding bipolar disorder, the annual average ASIR in China significantly increased (AAPC=1.25%, P<0.001), while the annual average ASPR significantly decreased (AAPC=-1.03%, P<0.001), and the annual average ASDR showed no significant change (AAPC=-0.08%, P=0.342). The incidence of schizophrenia was mainly concentrated in the 15-34 age group. The prevalence and DALY rates of schizophrenia were on the rise across all age groups. For bipolar disorder, the peak incidence occurred between the ages of 10 and 19, with higher incidence, prevalence, and DALY rates in females compared to males. Looking ahead from 2022 to 2041, the overall ASIR, ASIR for both females and males, and ASPR for males with schizophrenia are projected to gradually increase, while the ASPR and ASDR of bipolar disorder are expected to remain stable, with females continuing to bear a higher disease burden than males. Conclusion:In China, the disease burden of schizophrenia and bipolar disorder substantially changed from 1990 to 2021, with distinct differences across gender and age-groups. The disease burden of schizophrenia is projected to keep rising in the next 20 years. It is imperative to develop targeted and precise prevention and control strategies for different populations.

Objective:To evaluate the role of a single PET-CT scan in predicting survival and prognosis in patients with non-small cell lung cancer (NSCLC) who did not undergo surgery but received radiotherapy after neoadjuvant chemotherapy combined with immunotherapy.Methods:A retrospective analysis was conducted on the data of 23 NSCLC patients treated at the Cancer Hospital of the Chinese Academy of Medical Sciences from May 2022 to June 2024. All patients were pathologically confirmed, received neoadjuvant chemotherapy combined with immunotherapy, did not undergo surgery for various reasons, and instead received radiotherapy. Each patient underwent only one PET-CT scan after neoadjuvant chemotherapy combined with immunotherapy and before radiotherapy. According to the maximum standardized uptake value (SUV max) on PET-CT, patients were divided into the low-uptake group (SUV max < 8, n=12) and high-uptake group (SUV max ≥ 8, n=11). Survival analysis was performed using the Kaplan-Meier method with survival curves plotted. Univariate analysis of influencing factors of survival was conducted using the Cox proportional hazards regression model. Clinical characteristics and survival outcomes of the two groups were compared, including progression-free survival (PFS) and overall survival (OS). Results:The 1-year PFS rates were 100% in the low-uptake group, 54.5% in the high-uptake group. This difference was statistically significant ( P=0.007). The 1-year and 2-year OS rates were both 100% in the low-uptake group, the 1-year and 2-year OS rates were both 90.9% in the high-uptake group, with no statistically significant difference ( P=0.394). Univariate Cox analysis identified age as an independent factor affecting PFS. Conclusions:For NSCLC patients who did not undergo surgical resection but received radiotherapy after neoadjuvant chemotherapy combined with immunotherapy, a single PET-CT scan before radiotherapy has potential value in predicting PFS. However, clinical studies with larger sample size and longer follow-up are required to evaluate its predictive value for OS.

Objective:This study aims to analyze the disease burden trends of schizophrenia and bipolar disorder from 1990 to 2021 in China, and to predict the trends of these two disorders over the next 20 years.Methods:This study was conducted between September and October 2024. The data on incidence, prevalence, and disease burden of schizophrenia and bipolar disorder in China were retrieved from the database of the Global Burden of Disease Study 2021 (GBD2021). Temporal trends were quantified via the annual percentage change, average annual percentage change (AAPC), and their corresponding P-values, which were calculated using the empirical quantile method with the Joinpoint software. The autoregressive integrated moving average (ARIMA) model was constructed using data on the incidence, prevalence, and disease burden of schizophrenia and bipolar disorder from 1990 to 2021 to predict the trends in prevalence and disease burden of these two diseases from 2022 to 2041. Results:In China, during the period from 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rates (ASPR), and age-standardized disability-adjusted life year (DALY) rate (ASDR) of schizophrenia all showed a fluctuating upward trend. By 2021, the AAPC of these rates was 3.83% ( P<0.001), 12.99% ( P<0.001), and 14.11% ( P<0.001), respectively, indicating a significant increase. Regarding bipolar disorder, the annual average ASIR in China significantly increased (AAPC=1.25%, P<0.001), while the annual average ASPR significantly decreased (AAPC=-1.03%, P<0.001), and the annual average ASDR showed no significant change (AAPC=-0.08%, P=0.342). The incidence of schizophrenia was mainly concentrated in the 15-34 age group. The prevalence and DALY rates of schizophrenia were on the rise across all age groups. For bipolar disorder, the peak incidence occurred between the ages of 10 and 19, with higher incidence, prevalence, and DALY rates in females compared to males. Looking ahead from 2022 to 2041, the overall ASIR, ASIR for both females and males, and ASPR for males with schizophrenia are projected to gradually increase, while the ASPR and ASDR of bipolar disorder are expected to remain stable, with females continuing to bear a higher disease burden than males. Conclusion:In China, the disease burden of schizophrenia and bipolar disorder substantially changed from 1990 to 2021, with distinct differences across gender and age-groups. The disease burden of schizophrenia is projected to keep rising in the next 20 years. It is imperative to develop targeted and precise prevention and control strategies for different populations.

Objective:To evaluate the role of a single PET-CT scan in predicting survival and prognosis in patients with non-small cell lung cancer (NSCLC) who did not undergo surgery but received radiotherapy after neoadjuvant chemotherapy combined with immunotherapy.Methods:A retrospective analysis was conducted on the data of 23 NSCLC patients treated at the Cancer Hospital of the Chinese Academy of Medical Sciences from May 2022 to June 2024. All patients were pathologically confirmed, received neoadjuvant chemotherapy combined with immunotherapy, did not undergo surgery for various reasons, and instead received radiotherapy. Each patient underwent only one PET-CT scan after neoadjuvant chemotherapy combined with immunotherapy and before radiotherapy. According to the maximum standardized uptake value (SUV max) on PET-CT, patients were divided into the low-uptake group (SUV max < 8, n=12) and high-uptake group (SUV max ≥ 8, n=11). Survival analysis was performed using the Kaplan-Meier method with survival curves plotted. Univariate analysis of influencing factors of survival was conducted using the Cox proportional hazards regression model. Clinical characteristics and survival outcomes of the two groups were compared, including progression-free survival (PFS) and overall survival (OS). Results:The 1-year PFS rates were 100% in the low-uptake group, 54.5% in the high-uptake group. This difference was statistically significant ( P=0.007). The 1-year and 2-year OS rates were both 100% in the low-uptake group, the 1-year and 2-year OS rates were both 90.9% in the high-uptake group, with no statistically significant difference ( P=0.394). Univariate Cox analysis identified age as an independent factor affecting PFS. Conclusions:For NSCLC patients who did not undergo surgical resection but received radiotherapy after neoadjuvant chemotherapy combined with immunotherapy, a single PET-CT scan before radiotherapy has potential value in predicting PFS. However, clinical studies with larger sample size and longer follow-up are required to evaluate its predictive value for OS.

Objective To explore the influencing factors of gastric cancer and construct the clinical prediction model.Methods From December 2020 to October 2023,the clinical data of 1000 patients with stomach neoplasm admitted to Putuo Hospital,Shanghai U-niversity of Traditional Chinese Medicine and Shuguang Hospital,Shanghai University of Traditional Chinese Medicine were collected.Af-ter data cleaning and eliminating abnormal values,the patients were divided into gastric polyps group(n=487)and gastric cancer group(n=479).Non-parametric test was used to screen out meaningful indicators,Lasso regression to screen out the characteristic factors re-lated to gastric cancer with non-zero coefficient,and stepwise Logistic regression analysis to screen out the factors with significant correla-tion,and Lasso-Logistic regression model was constructed.The receiver operator characteristic(ROC)curve was plotted to calculate the area under the curve(AUC)and the confusion matrix to evaluate the model efficiency.Results The results of multivariate Logistic re-gression analysis showed that age,white blood cell(WBC)count,monocyte(M)count,alanine amiontransferase(ALT),cancer anti-gen 724(CA724),cancer antigen 242(CA242),cancer antigen 50(CA50)and carcinoembryonic antigen(CEA)were independent factors affecting gastric cancer.Based on the results of multivariate Logistic regression analysis,the risk prediction nomogram model of gas-tric cancer was constructed.The AUC of test set was 0.91,the accuracy rate was 100％,and the recall rate was 100％;the AUC of valida-tion set was 0.93,the accuracy rate was 93.63％,and the recall rate was 74.1％.The model has good prediction efficiency.Conclusion In this study,8 common predictors of gastric cancer were constructed,and the Lasso-logistic regression prediction model had good differen-tiation,which could be used to complete the early screening of gastric cancer based on the physical examination reports of patients.

BACKGROUND: The switch/sucrose nonfermentable chromatin-remodeling (SWI/SNF) complex is a pivotal chromatin remodeling complex, and the genomic alterations (GAs) of the SWI/SNF complex are observed in several cancer types, correlating with multiple biological features of tumor cells. However, their role in liver metastasis of non-small cell lung cancer (NSCLC) remains unclear. Our study aims to investigate the role and potential mechanisms underlying NSCLC liver metastasis induced by the GAs of SWI/SNF complex. METHODS: The GAs of SWI/SNF complex in NSCLC cell lines (H1299, H23 and H460) were identified by whole-exome sequencing (WES). ARID1A knockout H1299 cell was constructed with the CRISPR/Cas9 technology. The mouse model of liver metastasis from NSCLC was established to simulate lung cancer liver metastasis and observe the metastasis rate under different gene mutation conditions. RNA sequencing and Western blot were conducted for differential gene expression analysis. Immunohistochemistry (IHC) analysis was used to assess protein expression levels of SWI/SNF-regulated target molecules in mouse liver metastases. RESULTS: WES analysis revealed intracellular gene mutations. The animal experiments demonstrated a correlation between the GAs of SWI/SNF complex and a higher liver metastasis rate in immunodeficient mice. Transcriptome sequencing and Western blot analysis showed upregulated expression of ALDH1A1 and APOBEC3B in SWI/SNF-mut cells, particularly in ARID1A-deficient H460 and H1299 sgARID1A cells. IHC staining of mouse liver metastases further demonstrated elevated expression of ALDH1A1 in the H460 and H1299 sgARID1A group. CONCLUSIONS This study underscores the critical role of the GAs of SWI/SNF complex, such as ARID1A and SMARCA4, in promoting liver metastasis of lung cancer cells. The GAs of SWI/SNF complex may promote liver-specific metastasis by upregulating ALDH1A1 and APOBEC3B expression, providing novel insights into the molecular mechanisms underlying lung cancer liver metastasis.
Animals ; Mice ; Carcinoma, Non-Small-Cell Lung/genetics* ; Lung Neoplasms/genetics* ; Mutation ; Liver Neoplasms/genetics*

Objective:To measure the partial parameters of the soft tissues of upper eyelid in young women with single eyelid in Shantou City, Guangdong Province, and to explore the asymmetry rate of the left and right palpebral fissure and its regularity.Methods:From March 2018 to July 2019, the Medical Cosmetology Center of the First Affiliated Hospital of Shantou University Medical College measured 108 young women with single eyelid, aged 18-35 years, with an average age of 24.6 years. Before operation, palpebral fissure width (PFW), palpebral fissure height (PFH), palpebral fissure inclination (PFI) and central eyebrow height (CEH) were measured. The resected intra-orbital septum fat pad during the procedure was weighed. Both direct measurement and the photo measurement were used to obtain the average value of the two sets of data for final analysis. We calculated out the incidence rate of asymmetry of each palpebral item.Results:The paired t-test showed that the mean value of PFW was (25.76±1.50) mm on the left and (26.04±1.55) mm on the right ( t=2.93); the mean value of PFH was (9.70±1.15) mm on the left and (9.49±1.05) mm on the right ( t=3.12); the mean value of PFI was (9.77±2.57)° on the left and (9.67±2.28)° on the right ( t=2.01); the mean value of CEH was (12.05±1.61) mm on the left and (12.32±1.69) mm on the right ( t=-2.66); the mean value of the weight of the intra-orbital septum fat pad was (0.20±0.11) g on the left and (0.22±0.12) g on the right ( t=2.29). There were significant differences between the two sets of data (all P<0.05). Conclusions:The asymmetric phenomenon of the upper eyelid is commonly found in Shantou young female undergraduates, in which the PFH in the left is higher than that in the left; the PFW, the CEH, the weight of the intra-orbital septum fat pad in the right more commonly found than that in the left.. This study provides a certain reference for the clinical evaluation of the operation.

Objective:To explore the differences between emergency healthcare-associated pneumonia (HCAP) and community-acquired pneumonia (CAP), to analyze whether HCAP is a relatively independent type pneumonia in the emergency department in China.Methods:Clinical data of HCAP and CAP patients admitted to the emergency department of Beijing Tiantan Hospital, Beijing Chaoyang Hospital of Capital Medical University and Huilongguan Hospital from September 2018 to May 2019 were retrospectively analyzed. General information of the patients, types of basic diseases, laboratory examination within 24 h of admission, etiological examination results, empirical anti-infection treatment plan, mechanical ventilation and clinical outcome were collected. The pneumonia severity index (PSI) was used to assess the pneumonia severity. The measurement data were expressed as mean ± standard deviation for t test, and the counting data were performed by χ 2 test. A P<0.05 indicated statistical difference. Results:One hundred and five HCAP patients and 105 CAP patients were collected. The number of HCAP combined with two or more basic diseases was higher than that of the CAP group. There were statistically significant differences between the two groups in white blood cell count, mean hemoglobin and blood lactic acid level.The PSI score of the HCAP group was higher than that of the CAP group (134.0±26.3 vs 113.0±16.34). The PSI score grade IV of the HCAP group was lower than that of the CAP group, while the PSI score grade V of the HCAP group was higher than that of the CAP group, with statistically significant differences ( P<0.05). In the HCAP group, 73 strains (69.52%) and 55 strains (52.38%) of multi-drug resistant strains were isolated. Acinetobacter baumannii and Streptococcus pneumoniae, Klebsiella pneumoniae and Escherichia coli in the HCAP group were more than those in the CAP group. The drug resistance rate of pseudomonas aeruginosa to imipenem in the HCAP group was higher than that in the CAP group (22.2% vs 10.0%); the drug resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was lower than that in the CAP group (27.3% vs 54.5%); the drug resistance rate of Pseudomonas aeruginosa to Meropenem was lower than that in the CAP group (45.5% vs 72.7%). The proportion of carbapenems in the initial empirical anti-infection treatment in the HCAP group was higher than that in the CAP group (21.00% vs 10.48%), and the difference was statistically significant. The ratio of invasive mechanical ventilation and the fatality rate in the HCAP group were higher than those in the CAP group (21.00% vs 7.62%, 21.00% vs 8.57%; both P<0.05). Conclusions:HCAP patients in emergency department are complicated with a variety of basic diseases, high drug resistance rate of pathogenic bacteria, and more advanced drugs are required for initial empirical anti-infection treatment, high proportion of mechanical ventilation, and high fatality rate. HCAP is a relatively independent category of pneumonia in emergency in China.