Background: Disorders of the blood-brain barrier (BBB) arising from diabetes mellitus are closely related to diabetic encephalopathy. Previous research has suggested that neuron-glia antigen 2 (NG2)-glia plays a key role in maintaining the integrity of the BBB. However, the mechanism by which NG2-glia regulates the diabetic BBB remains unclear. Methods: Type 2 diabetes mellitus (T2DM) db/db mice and db/m mice were used. Evans-Blue BBB permeability tests and transmission electron microscopy techniques were applied. Tight junction proteins were assessed by immunofluorescence and transmission electron microscopy. NG2-glia number and signaling pathways were evaluated by immunofluorescence. Detection of matrix metalloproteinase-9 (MMP-9) in serum was performed using enzyme-linked immunosorbent assay (ELISA). Results: In T2DM db/db mice, BBB permeability in the hippocampus significantly increased from 16 weeks of age, and the structure of tight junction proteins changed. The number of NG2-glia in the hippocampus of db/db mice increased around microvessels from 12 weeks of age. Concurrently, the expression of MMP-9 increased in the hippocampus with no change in serum. Sixteen- week-old db/db mice showed activation of the Wnt/β-catenin signaling in hippocampal NG2-glia. Treatment with XAV-939 improved structural and functional changes in the hippocampal BBB and reduced MMP-9 secretion by hippocampal NG2-glia in db/db mice. It was also found that the upregulation of β-catenin protein in NG2-glia in the hippocampus of 16-week-old db/db mice was significantly alleviated by treatment with XAV-939. Conclusion The results indicate that NG2-glia can lead to structural and functional disruption of the diabetic BBB by activating Wnt/β-catenin signaling, upregulating MMP-9, and degrading tight junction proteins.

The ocular surface must maintain homeostasis to withstand continuous environmental stimuli, while increased tear evaporation represents a critical initiating event in the progression of evaporative dry eye disease. The composition, distribution, and function of the tear film lipid layer determine its anti-evaporative capacity. Multiple factors, including meibomian gland dysfunction, abnormalities of the lipid layer, blinking disorders, mucin deficiency, and epithelial barrier impairment, collectively weaken the evaporative barrier, subsequently inducing hyperosmotic stress and ocular surface inflammation, activating neuro-immune pathways, and thereby establishing a self-perpetuating cycle and contributing to disease chronicity. The environmental characteristics of northwestern regions, including low humidity, limited rainfall,strong winds, frequent windblown dust, and high evaporation rates, may further exacerbate these processes. This review integrates modern ocular surface pathological mechanisms with the theory of “Northwest dryness syndrome” to summarize the pathogenesis of evaporative dry eye disease and the effects of dry environmental exposure, aiming to provide a reference for risk assessment and intervention strategies for dry eye in Northwest China.

Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Clamshell incision is widely used in the surgical resection of complex mediastinal tumors, but it is also controversial. Its advantages are the full exposure of the field of vision and the huge operating space, while its disadvantages are the destruction of chest wall muscles and respiratory function impairment. At present, there is a lack of norms for the selection and application of Clamshell incisions, and the definition of complex mediastinal tumors is ambiguous and the dimensions are single. Therefore, this article reviews the literature and combines practical experience to systematically summarize the application progress of Clamshell incisions in the surgical resection of complex mediastinal tumors, with the aim of providing guidance for clinical work.

Objective:To analyze the effect of dapagliflozin tablet combined with creatine phosphate sodium on blood glucose and cardiac function in patients with type 2 diabetes mellitus (T2DM) complicated with heart failure.Methods:A total of 80 patients with T2DM complicated with heart failure who received treatment in the Rehabilitation University Qingdao Hospital (Qingdao Municipal Hospital) from October 2021 to October 2022 were selected prospectively as the subjects, and they were randomly divided into two groups with 40 cases in each group by envelope method. The control group was treated with conventional methods, and the observation group was treated with dapagliflozin tablet combined with sodium creatine phosphate on the basis of conventional methods. Both groups completed the treatment for 3 months. The clinical efficacy, blood glucose control effect, cardiac function and serum indexes of the two groups were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 6.28, P<0.05). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group: (6.98 ± 0.67) mmol/L vs. (7.81 ± 0.78) mmol/L, (7.87 ± 1.58) mmol/L vs. (9.58 ± 1.49) mmol/L, (6.95 ± 0.57)% vs. (7.41 ± 0.60)%, there were statistical differences ( P<0.05). After treatment, the levels of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum interleukin6 (IL-6), C-reactive protein (CRP) and brain natriuretic peptide (BNP) in the observation group were lower than those in the control group: (61.76 ± 3.55) mm vs. (64.01 ± 3.87) mm, (45.45 ± 3.58) mm vs. (47.71 ± 3.62) mm, (8.99 ± 0.95) ng/L vs.(10.28 ± 1.16) ng/L, (4.28 ± 1.17) mg/L vs. (5.57 ± 1.31) mg/L, (199.90 ± 34.12) ng/L vs. (250.73 ± 35.11) ng/L; the cardiac output (CO) and left ventricular ejection fraction (LVEF) in the observation group were higher than those in the control group: (4.95 ± 1.06) L/min vs. (4.13 ± 0.92) L/min, (44.51 ± 3.68)% vs. (42.15 ± 3.73)%, there were statistical differences ( P<0.05). Conclusions:Dapagliflozin tablets combined with creatine phosphate sodium can improve the effective rate of patients with T2DM complicated with heart failure, reduce the level of blood sugar, help to improve the heart function, and reduce the levels of serum inflammatory factors.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

Objective:To analyze the effect of dapagliflozin tablet combined with creatine phosphate sodium on blood glucose and cardiac function in patients with type 2 diabetes mellitus (T2DM) complicated with heart failure.Methods:A total of 80 patients with T2DM complicated with heart failure who received treatment in the Rehabilitation University Qingdao Hospital (Qingdao Municipal Hospital) from October 2021 to October 2022 were selected prospectively as the subjects, and they were randomly divided into two groups with 40 cases in each group by envelope method. The control group was treated with conventional methods, and the observation group was treated with dapagliflozin tablet combined with sodium creatine phosphate on the basis of conventional methods. Both groups completed the treatment for 3 months. The clinical efficacy, blood glucose control effect, cardiac function and serum indexes of the two groups were compared between the two groups.Results:The total effective rate in the observation group was higher than that in the control group: 95.00%(38/40) vs. 75.00%(30/40), there was statistical difference ( χ2 = 6.28, P<0.05). After treatment, the levels of fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin in the observation group were lower than those in the control group: (6.98 ± 0.67) mmol/L vs. (7.81 ± 0.78) mmol/L, (7.87 ± 1.58) mmol/L vs. (9.58 ± 1.49) mmol/L, (6.95 ± 0.57)% vs. (7.41 ± 0.60)%, there were statistical differences ( P<0.05). After treatment, the levels of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum interleukin6 (IL-6), C-reactive protein (CRP) and brain natriuretic peptide (BNP) in the observation group were lower than those in the control group: (61.76 ± 3.55) mm vs. (64.01 ± 3.87) mm, (45.45 ± 3.58) mm vs. (47.71 ± 3.62) mm, (8.99 ± 0.95) ng/L vs.(10.28 ± 1.16) ng/L, (4.28 ± 1.17) mg/L vs. (5.57 ± 1.31) mg/L, (199.90 ± 34.12) ng/L vs. (250.73 ± 35.11) ng/L; the cardiac output (CO) and left ventricular ejection fraction (LVEF) in the observation group were higher than those in the control group: (4.95 ± 1.06) L/min vs. (4.13 ± 0.92) L/min, (44.51 ± 3.68)% vs. (42.15 ± 3.73)%, there were statistical differences ( P<0.05). Conclusions:Dapagliflozin tablets combined with creatine phosphate sodium can improve the effective rate of patients with T2DM complicated with heart failure, reduce the level of blood sugar, help to improve the heart function, and reduce the levels of serum inflammatory factors.

Objective:To compare the efficacy of Ilizarov ring external fixation and unilateral rail external fixation in the treatment of infected bone defects following surgery for tibial fractures.Methods:A retrospective cohort study was conducted to analyze the clinical data of 50 patients with infected bone defects after surgery for tibial fractures, who were admitted to the 940th Hospital of the Joint Logistics Support Force of the PLA from August 2019 to November 2021, including 37 males and 13 females, aged 19-59 years [(42.2±8.8)years]. After debridement and osteotomy, 28 patients were treated with Ilizarov ring external fixation (Ilizarov group) and 22 with unilateral rail external fixation (unilateral fixation group). All the patients in the two groups had previously undergone internal fixation with plates or Kirschner wires for tibial fracture before bone transport. Bone transport started at one week for three stages after successful infection control and osteotomy and was conducted. The following parameters were compared between the two groups: frame-wearing time and healing index after bone transport, self-rating anxiety scale (SAS) grade at 6 months after bone transport, Paley score and Association for the Study and Application of the Method of Ilizarov (ASAMI) score at the last follow-up, Hospital for Special Surgery (HSS) knee score and Baird-Jackson ankle score on admission, after external fixator removal and at the last follow-up, and incidence of postoperative complications.Results:All the patients were followed up for 28-36 months [(32.5±1.6)months]. There were no significant differences in frame-wearing time or healing index between the two groups after bone transport ( P>0.05). At 6 months after bone transport, the SAS grade in the unilateral fixation group (13 patients with mild anxiety, 8 with moderate anxiety, and 1 with severe anxiety) was better than that in the Ilizarov group (6 patients with mild anxiety, 19 with moderate anxiety, 3 with severe anxiety) ( P<0.01). No significant differences were found in the Paley score or ASAMI score between the two groups at the last follow-up ( P>0.05). There were no significant differences in HSS knee score or Baird-Jackson ankle score between the two groups on admission, after external fixator removal or at the last follow-up ( P>0.05). No significant differences were observed in the incidence of pin tract infection, poor healing, infection in the bone elongation area, or re-fracture between the two groups ( P>0.05). The incidence of postoperative axial deviation was 0 in the Ilizarov group, lower than 18% in the unilateral fixation group (4/22) ( P<0.05). Conclusion:Although Ilizarov ring external fixation and unilateral rail external fixation demonstrate comparable efficacy in the treatment of infected bone defects after surgery for tibial fractures, the former provides superior mechanical stability and postoperative axial deviation correction, while the latter offers advantages in reducing psychological burden and enhancing treatment tolerance.

Clamshell incision is widely used in the surgical resection of complex mediastinal tumors, but it is also controversial. Its advantages are the full exposure of the field of vision and the huge operating space, while its disadvantages are the destruction of chest wall muscles and respiratory function impairment. At present, there is a lack of norms for the selection and application of Clamshell incisions, and the definition of complex mediastinal tumors is ambiguous and the dimensions are single. Therefore, this article reviews the literature and combines practical experience to systematically summarize the application progress of Clamshell incisions in the surgical resection of complex mediastinal tumors, with the aim of providing guidance for clinical work.