OBJECTIVES: To explore the potential of pyrroline-5-carboxylate reductase 1 (PYCR1) as a pan-cancer biomarker and investigate its expression, function, and clinical significance in bladder cancer (BLCA). METHODS: Bioinformatics analysis was conducted to evaluate the associations of PYCR1 with prognosis, immune microenvironment remodeling, tumor mutation burden (TMB), and microsatellite instability (MSI) in cancer patients. Using the TCGA-BLCA dataset, univariate and multivariate regression analyses were performed to assess the potential of PYCR1 as an independent prognostic risk factor for BLCA, and a clinical decision model was constructed. The IMvigor210 cohort was utilized to evaluate the potential of PYCR1 for independently predicting the efficacy of immunotherapy. The pRRophetic was employed to screen candidate chemotherapeutic agents for treating BLCA with high PYCR1 expression. The CMap-XSum algorithm and molecular docking techniques were used to explore and validate small molecule inhibitors of PYCR1. RESULTS: A high expression of PYCR1 was significantly associated with poor prognosis, immune cell infiltration, TMB and MSI in various tumors (r>0.3). PYCR1 was overexpressed in BLCA, and high PYCR1 expression was closely related to poor prognosis in BLCA patients (HR: 1.14, 95% CI: 1.02-1.68, P=0.006). The IC₅₀ of the anti-cancer drugs cetuximab, 5-fluorouracil, and doxorubicin increased significantly in BLCA cell lines with high PYCR1 expressions (P<0.0001). CONCLUSIONS High PYCR1 expression is an independent risk factor for poor prognosis in BLCA patients and can serve as a significant indicator for clinical decision-making as well as a marker for predicting sensitivity to chemotherapeutic agents and the efficacy of immunotherapy.
Humans ; Urinary Bladder Neoplasms/genetics* ; Immunotherapy ; Prognosis ; Pyrroline Carboxylate Reductases/metabolism* ; Biomarkers, Tumor/genetics* ; delta-1-Pyrroline-5-Carboxylate Reductase ; Microsatellite Instability ; Tumor Microenvironment ; Mutation ; Computational Biology ; Molecular Docking Simulation

BACKGROUND:Degenerative diseases caused by bone and muscle degeneration are major reasons for the decline in physical function and mobility,increased fragility fractures,and high mortality rates in the elderly,significantly affecting their health and quality of life.OBJECTIVE:To review the research progress in the mechanisms of muscle-bone interaction and the etiology,prevention,and treatment of related diseases.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature published from 2014 to 2024.The search terms were"muscle-bone crosstalk,musculoskeletal system,inter-tissue communication,myokines,osteokines,osteosarcopenia,sarcopenia,osteoporosis,bone regeneration,fibro-adipogenic progenitors"in Chinese and English.By reading the articles,we eliminated irrelevant,outdated,and poorly focused literature,and finally 94 articles were included for review.RESULTS AND CONCLUSION:Mechanical interaction,secretion factor interaction,and stem cell interaction between muscle and bone are crucial for the metabolism and regeneration regulation of the musculoskeletal system.Systemic interventions targeting biochemical signals of muscle factors(such as myostatin and irisin)and bone factors(such as nuclear factor-κB receptor-activating factor ligand and sclerostin)can improve the quality and function of skeletal muscle and bone,and have positive effects on fracture healing.In recent years,it has been found that related stem cells in the musculoskeletal system can interact,with the activation of muscle progenitor cells(such as fibro-adipogenic progenitors)having a significant impact on bone growth,repair,and regeneration.Research on the mechanisms of muscle-bone interaction can provide insights into the etiology,prevention,and treatment of related diseases.However,there are currently no effective clinical treatments for muscle-bone comorbidities,with most research still at the cellular and animal experiment stage.Therefore,extensive research is needed in the future to gradually move from experiments to clinical applications,developing more targeted therapies and drugs to better serve clinical needs.

Objective:To systematically evaluate the risk prediction models for refeeding syndrome in critically ill patients in China and abroad, with the aim of providing feasible risk assessment tools for clinical healthcare professionals.Methods:A computerized search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Proquest, Scopous, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP was conducted for relevant literature from database inception to July 1, 2024. Two researchers independently reviewed the literature and extracted the relevant information. Quality assessment was performed using a risk of bias assessment tool specifically designed for predictive modeling.Results:A total of 8 papers were included, reporting 8 risk prediction models for refeeding syndrome in critically ill patients, with sample sizes ranging from 109 to 806 cases, outcome event rates from 22.5% to 69.8%, and area under the curve values from 0.74 to 0.95. The most frequently reported predictors included albumin (ALB), pre-albumin (PAB), blood potassium, use of diuretics, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Conclusions:The risk prediction models for refeeding syndrome in critically ill patients have good predictive performance but are still in the development stage. A high-quality, low-bias clinically applicable model should be established through multicenter, large-sample, and standardized studies.

BACKGROUND:Degenerative diseases caused by bone and muscle degeneration are major reasons for the decline in physical function and mobility,increased fragility fractures,and high mortality rates in the elderly,significantly affecting their health and quality of life.OBJECTIVE:To review the research progress in the mechanisms of muscle-bone interaction and the etiology,prevention,and treatment of related diseases.METHODS:CNKI,WanFang and PubMed databases were searched for relevant literature published from 2014 to 2024.The search terms were"muscle-bone crosstalk,musculoskeletal system,inter-tissue communication,myokines,osteokines,osteosarcopenia,sarcopenia,osteoporosis,bone regeneration,fibro-adipogenic progenitors"in Chinese and English.By reading the articles,we eliminated irrelevant,outdated,and poorly focused literature,and finally 94 articles were included for review.RESULTS AND CONCLUSION:Mechanical interaction,secretion factor interaction,and stem cell interaction between muscle and bone are crucial for the metabolism and regeneration regulation of the musculoskeletal system.Systemic interventions targeting biochemical signals of muscle factors(such as myostatin and irisin)and bone factors(such as nuclear factor-κB receptor-activating factor ligand and sclerostin)can improve the quality and function of skeletal muscle and bone,and have positive effects on fracture healing.In recent years,it has been found that related stem cells in the musculoskeletal system can interact,with the activation of muscle progenitor cells(such as fibro-adipogenic progenitors)having a significant impact on bone growth,repair,and regeneration.Research on the mechanisms of muscle-bone interaction can provide insights into the etiology,prevention,and treatment of related diseases.However,there are currently no effective clinical treatments for muscle-bone comorbidities,with most research still at the cellular and animal experiment stage.Therefore,extensive research is needed in the future to gradually move from experiments to clinical applications,developing more targeted therapies and drugs to better serve clinical needs.

BACKGROUND:At present,there is a main kind of operation,which is represented by the proximal femoral nail antirotation,to treat femoral intertrochanteric fractures,but some sequelae still occur such as internal fixation loosening,failure,and nail withdrawal.We designed a new femoral neck spiral blade system to solve this problem,so we analyze the mechanical structure by the finite element method that can be regard as the theoretical basis for the system.OBJECTIVE:To compare the mechanical properties of the new femoral neck spiral blade system and the proximal femoral nail antirotation in the treatment of femoral intertrochanteric fracture by the finite element method.METHODS:Based on the finite element model of the femur,the A1.2 and A2.2 femoral intertrochanteric fracture models were established according to the AO fracture classification principle of 2018 edition.The models were fixed with the proximal femoral nail antirotation and the new internal fixation system,applying an axial load of 700,1 400,and 2 100 N above the femoral head.The mechanical characteristics of the two internal fixation methods were respectively compared and analyzed by observing the maximum equivalent stress and the maximum deformation of each group.RESULTS AND CONCLUSION:(1)The maximum equivalent stress of the new internal fixation group under different compressive loads was smaller than that of the proximal femoral nail antirotation group.(2)In the A1.2 fracture model,under different compression loads,the deformation of the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.113 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 2.017 mm between the two.(3)In the A1.2 fracture model,under different compressive loads,the maximum deformation of the spiral blade fixed by the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.062 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 1.891 mm between the two.(4)The results indicate that the new femoral neck spiral blade system has a lower internal fixation stress value compared to the proximal femoral nail antirotation,and a smaller displacement value of the femur after fixation and internal fixation.It can more effectively fix fractures and prevent the spiral blade from retracting or cutting out in the femoral neck.

Objective:To systematically evaluate the risk prediction models for refeeding syndrome in critically ill patients in China and abroad, with the aim of providing feasible risk assessment tools for clinical healthcare professionals.Methods:A computerized search of PubMed, Embase, Web of Science, Cochrane Library, CINAHL, Proquest, Scopous, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP was conducted for relevant literature from database inception to July 1, 2024. Two researchers independently reviewed the literature and extracted the relevant information. Quality assessment was performed using a risk of bias assessment tool specifically designed for predictive modeling.Results:A total of 8 papers were included, reporting 8 risk prediction models for refeeding syndrome in critically ill patients, with sample sizes ranging from 109 to 806 cases, outcome event rates from 22.5% to 69.8%, and area under the curve values from 0.74 to 0.95. The most frequently reported predictors included albumin (ALB), pre-albumin (PAB), blood potassium, use of diuretics, and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores.Conclusions:The risk prediction models for refeeding syndrome in critically ill patients have good predictive performance but are still in the development stage. A high-quality, low-bias clinically applicable model should be established through multicenter, large-sample, and standardized studies.

BACKGROUND:At present,there is a main kind of operation,which is represented by the proximal femoral nail antirotation,to treat femoral intertrochanteric fractures,but some sequelae still occur such as internal fixation loosening,failure,and nail withdrawal.We designed a new femoral neck spiral blade system to solve this problem,so we analyze the mechanical structure by the finite element method that can be regard as the theoretical basis for the system.OBJECTIVE:To compare the mechanical properties of the new femoral neck spiral blade system and the proximal femoral nail antirotation in the treatment of femoral intertrochanteric fracture by the finite element method.METHODS:Based on the finite element model of the femur,the A1.2 and A2.2 femoral intertrochanteric fracture models were established according to the AO fracture classification principle of 2018 edition.The models were fixed with the proximal femoral nail antirotation and the new internal fixation system,applying an axial load of 700,1 400,and 2 100 N above the femoral head.The mechanical characteristics of the two internal fixation methods were respectively compared and analyzed by observing the maximum equivalent stress and the maximum deformation of each group.RESULTS AND CONCLUSION:(1)The maximum equivalent stress of the new internal fixation group under different compressive loads was smaller than that of the proximal femoral nail antirotation group.(2)In the A1.2 fracture model,under different compression loads,the deformation of the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.113 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 2.017 mm between the two.(3)In the A1.2 fracture model,under different compressive loads,the maximum deformation of the spiral blade fixed by the new internal fixation system was smaller than that of the proximal femoral nail antirotation group,and the average value of difference between the two was 1.062 mm;the result of the A2.2 type fracture model was the same as that in the A1.1 with an average value of difference of 1.891 mm between the two.(4)The results indicate that the new femoral neck spiral blade system has a lower internal fixation stress value compared to the proximal femoral nail antirotation,and a smaller displacement value of the femur after fixation and internal fixation.It can more effectively fix fractures and prevent the spiral blade from retracting or cutting out in the femoral neck.

【Objective】 To establish a risk model for predicting spontaneous rupture bleeding of renal angiomyolipoma (RAML) in order to better assess and deal with the risk. 【Methods】 The information of 436 RAML patients diagnosed during Jan.2018 and Dec.2022 was retrospectively analyzed.According to the inclusion and exclusion criteria, 216 patients were included and divided into the rupture bleeding group (n=35) and non-rupture bleeding group (n=181).The factors influencing spontaneous rupture bleeding were identified using univariate and multivariate analysis, and a nomogram was constructed accordingly with R language.The nomogram was evaluated using Calibration curve and area under the receiver operator characteristic curve (AUC). 【Results】 It was found that clinical manifestations, tumor diameter, tumor convexity, tumor blood supply, and tuberous sclerosis complex (TSC) were significantly correlated with rupture bleeding.The Calibration curve fitted well with the nomogram.The AUC was 0.956 (95%CI: 0.856-0.943), indicating that the nomogram had good statistical performance. 【Conclusion】 The model can effectively predict the risk of spontaneous rupture bleeding of renal angiomyolipoma.

AIM:To observe the different effects of three intervention approaches on related biometric parameters in children diagnosed with latent myopia, and to investigate different control effects on children with latent myopia.METHODS:Prospective cohort concurrent controls trials. A total of 60 cases(120 eyes)of children who were initially diagnosed as latent myopia and untreated previously at ophthalmology clinic of the Affiliated Hospital of Chengde Medical University from December 2021 to May 2022 were recruited. They were randomly divided into three groups, with 20 cases(40 eyes)in group A treated with 0.01% Atropine eye drops, 20 cases(40 eyes)in group B treated with vision training with a flip chart, and 20 cases(40 eyes)in group C treated with esculin and digitalis glycosides eye drops. They were followed-up for 12 mo, and the spherical equivalent(SE), axial length(AL), corneal curvature(CC), accommodative facility(AF), and macular retinal thickness of the three groups of children were compared at 6 and 12 mo post-intervention.RESULTS:Significant statistical differences were found in AL, SE and AF of the three groups of children at 6 and 12 mo(all P<0.05), and there were significant differences between 6 and 12 mo after the intervention(all P<0.05). SE and AF in the group B and C were higher than those in the group A(all P<0.05). However, there were no significant differences in CC before and after the intervention(all P>0.05). The retinal thickness of the temporal, nasal, inferior and macular fovea of the outer ring at 6 and 12 mo after intervention in the three groups was significantly different from that at the initial diagnosis(all P<0.05), and there was significant difference between 6 mo and 12 mo after intervention(all P<0.05). There was no significant difference in the retinal thickness of the other macular areas among the three groups before and after intervention(all P>0.05).CONCLUSION:When it comes to preventing and controlling myopia, 0.01% Atropine is more effective than flip chart training and esculin and digitalis glycosides eye drops. Therefore, the administration of 0.01% atropine and the implementation of flip chart training can effectively slow down the advancement of latent myopia.

Objective:To investigate the application effects of a novel framework: the external septal retention bionic framework in East Asian rhinoplasty.Methods:A retrospective analysis was performed based on the clinical data of the patients who received treatments in Department of Plastic and Aesthetic ( Burn) Surgery, the Second Xiangya Hospital, Central South University from January 2022 to July 2023 using an external septal retention bionic framework with autologous costal cartilage rhinoplasty. The patients were all treated with a V-shaped incision at the nasal columella, which continued to both sides of the nose to form a bird-shaped incision. During the operation, the sixth or seventh costal cartilage was sculpted to form the nasal columella support grafts (sturt), external nasal septal graft, cap grafts, and shield grafts, in which the nasal column support graft and external nasal septal graft were implanted in a mortise-and-tenon joint structure to form a septum bionic retained external stent in order to lengthen the nasal columellar column and strengthen the septum. A capsular graft was used to shape the tip of the nose and the rectus abdominis fascia was covered to soften the tip of the nose, and the shield grafts were used to fill out the subnasal lobules. A bulb was sculpted, shaped and implanted in the dorsal space to elevate the nasal dorsum. To observe the postoperative results and complications, a postoperative satisfaction survey was completed using the rhinoplasty outcome evaluation (ROE) and the visual analogue scale (VAS) with regular follow-up. Comparison of preoperative and postoperative scale scores was performed using paired samples t-test. Nasal stent stability was assessed by measuring the patients’ preoperative and postoperative nasolabial angle and nasal tip protrusion. The comparison of preoperative and postoperative nasolabial angle was performed using the paired-sample t-test, and the comparison of nasal tip protrusion was performed using the Wilcoxon signed rank-sum test, P<0.05 considered a statistically significant difference. Results:A total of 33 patients were enrolled, including 4 males and 29 females, with average age of 23.8 years(15-42 years). The follow-up period is (14.52 ± 4.72) months (3 to 21 months). Thirty-three patients recovered well after surgery, and no short-term complications such as infection or bleeding occurred. The patients' nasal aesthetic problems such as saddle nose, deviated nasal columella, bilateral asymmetry of the nose, bilateral nasal base depression, and rounded shield of the nasal tip were improved after surgery. Satisfaction survey results: ROE and VAS scores were significantly higher than those before surgery, which were [(17.92±2.56) vs.(12.78±3.14)] and [(8.08±1.66)vs(5.15±1.99)], ( P<0.05), 87.9% (27/33)of the patients were satisfied with the aesthetic and functional outcomes of the nose. Comparisons of nasolabial angle [(87.28±2.58)° vs. (97.64±1.95)°] and tip protrusion [1.88 (1.78, 1.95) cm vs. 2.16(2.01, 2.32) cm] measurements between preoperative and postoperative period of the 33 patients, the differences were statistically significant ( P<0.05). Conclusion:Rhinoplasty for East Asians employs an external septal retention bionic framework to retain the nasal septum. This technique can avoid septal cartilage resorption caused by compression of grafts transplanted in the future, and cause less damage to the anatomy and physiology of the nose. The framework is relatively easy to construct, with a stable and strong stent, and good patient satisfaction. It can achieve a more desirable aesthetic effect of the nose.