Objective To investigate the diagnostic value of our regression model based on quantitative parameters of dual-energy CT and clinical features for stages T2 and T3 colorectal cancer.Methods A cross-section study was performed on 91 patients with colorectal cancer confirmed by postoperative pathology in our hospital from January 2022 to November 2023.All of them underwent dual-energy CT examination.According to the pathological T staging criteria of Chinese Colorectal Cancer Diagnosis and Treatment Standard(2020 Edition),they were divided into T2 group(n=43)and T3 group(n=48).Univariate analysis was used to compare the differences in quantitative CT parameters and clinical features between the 2 groups,and the obtained significant variables were employed to construct diagnosis models by univariate or multivariate logistic regression analysis.The area under receiver operating characteristic curve(AUC)of the CT parametric model and the model combined with clinical features was compared to evaluate the efficacy of diagnosing T2 and T3 stages.Results Univariate analysis showed that carcinoembryonic antigen(CEA),N stage,tumor location,tumor longest diameter(LD),CT value of virtual noncontrast(CT-VNC),fat fraction,electron density(Rho)and dual energy index(DEI)were significantly different between the T2 and T3 groups(P＜0.05).Multivariate logistic regression analysis found that N stage,tumor location,LD,fat fraction and DEI were independent risk factors for the diagnosis of stage T3.The AUC value of the model of above CT parameters in diagnosing stage T3 colorectal cancer was 0.671(95％CI:0.558～0.783),and the AUC value of the combined model of above CT parameters and clinical features was 0.886(95％CI:0.815～0.957),and statistical difference was observed in the AUC value between the combined model and the CT parametric model(P＜0.01).Conclusion The regression model constructed with dual-energy CT quantitative parameters combined with clinical features has high value in the preoperative diagnosis of stages T2 and T3 colorectal cancer before surgery.

Objective:To study the effects and the related molecular mechanisms of miR-148a-3p on the proliferation,invasion and migration of salivary adenoid cystic carcinoma SACC-LM cells.Methods:miR-148a-3p mimics and inhibitors,siRNA targeting EG-FR and their corresponding controls were transfected into SACC-LM cells.Bioinformatics was used to predict the potential target genes of miR-148a-3p.EGFR and miR-148a-3p mRNA expression levels were examined by qRT-PCR and the protein levels of EG-FR were detected by Western blotting.CCK-8,scratch,and Transwell assays were used to study the proliferation,migration,and invasion of SACC-LM cells,respectively.The direct targeting relationship between miR-148a-3p and EGFR was examined by using the double luciferase reporter gene assay.Statistical analysis of the data was performed by SPSS 22.0 software.Results:Overexpres-sion or inhibition of miR-148a-3p significantly inhibited or promoted the proliferation,invasion and metastasis of SACC-LM cells re-spectively(P＜0.05).Bioinformatics and double luciferase assay showed that miR-148a-3p directly targeted and regulated the expres-sion of EGFR(P＜0.001).Downregulation of EGFR inhibited the proliferation,migration and invasion of SACC-LM cells(P＜0.05)and partially reversed the promoting effect of miR-148a-3p inhibition(P＜0.05).Conclusion:The downregulation of miR-148a-3p leads to the abnormally high expression of its target gene EGFR,and promotes the proliferation,invasion,and migration of salivary adenoid cystic carcinoma cells.

Spinal nerve injury causes mechanical allodynia and structural imbalance of neurotransmission, which were typically associated with calcium overload. Storeoperated calcium entry (SOCE) is considered crucial elements-mediating intracellular calcium homeostasis, ion channel activity, and synaptic plasticity. However, the underlying mechanism of SOCE in mediating neuronal transmitter release and synaptic transmission remains ambiguous in neuropathic pain. Neuropathic rats were operated by spinal nerve ligations. Neurotransmissions were assessed by whole-cell recording in substantia gelatinosa. Immunofluorescence staining of STIM1 with neuronal and glial biomarkers in the spinal dorsal horn. The endoplasmic reticulum stress level was estimated from qRT-PCR. Intrathecal injection of SOCE antagonist SKF96365 dose-dependently alleviated mechanical allodynia in ipsilateral hind paws of neuropathic rats with ED 50 of 18 μg. Immunofluorescence staining demonstrated that STIM1 was specifically and significantly expressed in neurons but not astrocytes and microglia in the spinal dorsal horn. Bath application of SKF96365 inhibited enhanced miniature excitatory postsynaptic currents in a dosage-dependent manner without affecting miniature inhibitory postsynaptic currents. Mal-adaption of SOCE was commonly related to endoplasmic reticulum (ER) stress in the central nervous system. SKF96365 markedly suppressed ER stress levels by alleviating mRNA expression of C/ EBP homologous protein and heat shock protein 70 in neuropathic rats. Our findings suggested that nerve injury might promote SOCE-mediated calcium levels, resulting in long-term imbalance of spinal synaptic transmission and behavioral sensitization, SKF96365 produces antinociception by alleviating glutamatergic transmission and ER stress. This work demonstrated the involvement of SOCE in neuropathic pain, implying that SOCE might be a potential target for pain management.

Objective:To evaluate the effect of mixed reality (MR) in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.Methods:Twenty resident doctors, who received standardized training in the department of maxillofacial oncology of our hospital, were randomly divided into experimental group and control group. The MR teaching method was used in the experimental group, while the traditional teaching method was used in the control group. The teaching effect was evaluated by theoretical and operational tests and a questionnaire survey. Statistical analysis was performed with the SPSS 24.0 software. Statistical comparisons were performed by the Students' t-test or the Wilcoxon rank correlation test. Results:The theoretical test results showed that the scores of the experimental group were significantly higher than those of the control group (85.30±3.59 vs. 80.20±5.63, t = 2.41, P = 0.027). The operational test results showed that the scores of the experimental group were significantly higher than those of the control group (89.20±5.07 vs. 82.30±6.36, t = 2.68, P = 0.015). The questionnaire survey results showed that the MR teaching helped to easily acquire the knowledge of head and neck anatomy and operation skills. Besides, the doctors in the experimental group were more active and glad to communicate with others than those in the control group. In addition, the MR teaching method improved the learning interest of doctors. The doctors in the experimental group were more satisfied with the teaching effect than those in the control group, and they recommended that the MR teaching method be used in clinical training and teaching on oral and maxillofacial-head and neck tumor surgery. Conclusion:MR teaching can help doctors understand and master the knowledge of head and neck anatomy and operation skills and improve their learning interest, achieving a good teaching effect, so it has important application value in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.

Objective:To explore the effect of mixed reality (MR) application in the reconstruction of mandibular defects.Methods:Eighteen patients with mandibular defects were enrolled in this study, including 10 male patients and 8 female patients, whose age ranged from 27 to 45 years, and the mean age was 35.4 years. All the patients were from the Stomatological Hospital of the Fourth Military Medical University, during October 2019 to May 2021. Fibular flaps were used for the reconstruction of the mandibular defects. The patients were randomly divided into three groups, six in each group. In group one, MR-guided mandibular defect repair and reconstruction technique was used. In group two, 3D printed guide-assisted mandibular defect repair and reconstruction technique was used, and in the control group, traditional jaw defect repair and reconstruction technique was used. All the procedures were performed by the same team. Cone beam computed tomography (CBCT) was used for analysis of surgical accuracy, and questionnaires were used to evaluate the outcome of medical communication, occlusal relationship, appearance restoration, and medical experience satisfaction.Results:The mean surgical errors in the group one and group two were (1.75±0.44) mm and (1.81±0.16) mm respectively, which were both significantly lower than that in the control group (3.05±0.83) mm ( tMR=3.38, t3D=3.56, P<0.01). The medical communication (4.60±0.35, 4.52±0.28, tMR=2.90, t3D=2.77, P<0.05), occlusal relationship (4.17±0.32, 4.28±0.39, tMR=3.07, t3D=3.29, P<0.05), and medical experience satisfaction scores (4.26±0.45, 4.25±0.67, tMR=2.50, t3D=2.26, P<0.05) in the experimental groups were significantly higher than those in the control group (4.02±0.34, 3.58±0.33, 3.56±0.32, respectively). There was no significant difference in the satisfaction of appearance recovery among all the groups ( P>0.05). Conclusions:MR-guided mandibular repair and reconstruction surgery has high accuracy and is also beneficial to the recovery of occlusal relationship and medical communication.

Objective:To investigate the clinical experience of different types of femoral perforator flaps in the reconstruction of oral and maxillofacial head and neck defects.Methods:From January 2018 to January 2021, 573 patients with oral and maxillofacial head and neck defects reconstructed by femoral perforator flap were collected in the Department of Maxillofacial Oncology, the Third Affiliated Hospital of Air Force Military Medical University (age range of 21-76 years, with a male to female ratio of 1.23∶1). According to the type of perforator flap, the patients were divided into ALT group, AMT group, TFL flap group and free muscle flap group. The incidence of postoperative complications, wound healing time and drainage volume in femoral area were compared among the 4 groups.Results:The ALT flap was used in 527 cases: 22 flaps had vascular crisis, 14 flaps had infection, 8 flaps had necrosis, 519 flaps survived; the mean healing time of the wound was (14.50±3.19) days, and the mean drainage volume was (49.9±21.3) ml. 28 cases were repaired with AMT flap: 2 flaps had vascular crisis and 1 had infection. All the flaps survived; the mean healing time of the wound was (14.18±2.75) days, and the mean drainage volume was (50.3±23.0) ml. 11 cases were repaired by TFL flap: 1 flap had vascular crisis and 1 had infection. All the flaps survived. The mean healing time of the wound was (14.09±2.66) days, and the mean drainage volume was (54.1±25.0) ml. 7 cases were repaired by free muscle flap survived without vascular crisis, infection and other postoperative complications; the mean healing time of the wound was 14.14±1.86, and the mean postoperative drainage volume was (49.9±21.1) ml. There was no significant difference in complication rate (flap necrosis, vascular crisis, infection, etc.) and repair effect among 573 patients with different flap types. The postoperative follow-up was conducted for 6-24 months, and the donor area was smooth and good in appearance, without obvious scar or functional influence. The repair effect of the affected area was satisfactory.Conclusions:Although there is a certain proportion of perforator vessel variation in the femoral perforator flap, the flap can be designed freely according to different types of variation. The thigh perforator flap has an essential application value in the repair of oral and maxillofacial head and neck defects.

Objective:To analyze the monitoring results of iodine deficiency disorders in Nanning City in 2020, learn about the consumption of iodized salt among residents and the iodine nutrition status of key populations, and provide scientific basis for formulating or adjusting targeted prevention and control measures of iodine deficiency disorders.Methods:According to the Guangxi Iodine Deficiency Disorders Monitoring Plan, monitoring was carried out in all of 12 districts (counties) in Nanning City. One township (street) was selected from each of the five directions of east, west, south, north, and central. Forty non-boarding children aged 8 to 10 and 20 pregnant women were selected as monitoring subjects in each township (street). Edible salt samples were collected from children and pregnant women to detect salt iodine content, random mid-course urine samples from children and morning urine samples from pregnant women were collected to detect urinary iodine content; in addition, thyroid examination of children was conducted in Qingxiu District, Liangqing District, Long an County and Shanglin County.Results:In 2020, a total of 2 434 children aged 8 to 10 and 1 207 pregnant women were surveyed in Nanning City. The coverage rate of iodized salt, the qualified rate of iodized salt and the qualified iodine salt consumption rate were 99.67%(3 629/3 641), 97.99%(3 556/3 629) and 97.67%(3 556/3 641), respectively. The median urinary iodine of children was 182.0 μg/L, and the median values ranged from 146.5 to 234.8 μg/L in different districts (counties), there were significant differences in median urinary iodine between urban and non-urban areas, different gender and age groups ( U = 2.38, 2.41, P = 0.017, 0.016; H = 16.42, P < 0.001). The goiter rate of children was 0.99%(8/807), and the rate ranged from 0 to 2.00% (4/200) in the 4 districts (counties) examined, there were significant differences in thyroid volume between urban and non-urban areas and different ages ( U = - 3.52, P < 0.001; H = 47.67, P < 0.001). The median urinary iodine of pregnant women was 191.0 μg/L. The median urinary iodine of different districts (counties) ranged from 141.0 to 241.5 μg/L, and the difference was statistically significant at different gestational stages ( H = 24.37, P < 0.001). Conclusion:In 2020, the coverage rate of iodized salt, the qualified rate of iodized salt and the qualified iodine salt consumption rate by residents in Nanning City are high, and the iodine nutrition of both children and pregnant women are at an appropriate level.

Objective To investigate the value of dual-energy CT quantitative parameters combined with CT features for predicting perineural invasion(PNI)of colorectal adenocarcinoma.Methods Preoperative whole-abdominal CT data of 79 patients with colorectal adenocarcinoma confirmed by postoperative pathology were retrospectively analyzed.The patients were divided into PNI group(n=31)or no PNI group(n=48).Univariate analysis was used to compare CT features and dual-energy CT quantitative parameters between groups,and the variables with significant differences were included in binary logistic regression analysis to construct a combined model.Receiver operating characteristic(ROC)curves were drawn and area under the curve(AUC)were calculated,the efficacy of single CT parameters and combined model for predicting PNI of colorectal adenocarcinoma were evaluated.Results There were significant differences of the location of the primary lesion,the maximum thickness of the diseased intestinal wall,the presence or absence of peritumoral lymph node metastases,peritumoral mesenteric streak shadow and tumor deposits shown on CT between groups(all P＜0.05).Significant differences of the arterial phase slope of energy spectrum curve(λHU),iodine concentration(IC),normalized IC(NIC),dual energy index and the venous phase NIC of dual energy index were found between groups(all P＜0.05).AUC of the above single parameters for predicting PNI of colorectal adenocarcinoma ranged from 0.615 to 0.698,while of the combined model was 0.864.Conclusion Dual-energy CT quantitative parameters combined with CT features could be used to effectively predict PNI of colorectal adenocarcinoma.

Objective : By observing the changes of interleukin-22 ( IL-22) ，signal transduction and transcriptional activator 3 (STAT3) ，fasting blood glucose ( FBG) and fasting insulin ( FINS) of rats under the circumstance of chronic intermittent hypoxia and reoxygenation，to explore the role of IL-22 / STAT3 pathway in insulin resistance in- duced by chronic intermittent hypoxia． Methods : 4 SD rats were randomly divided into control group (NC group) and intermittent hypoxia group ( CIH group) ，with 12 rats in each group．NC group was placed in normoxia environment for 12 weeks，while CIH group was first given intermittent hypoxia for 8 weeks and then resumed normoxia feeding until 12 weeks．FBG，FINS，IL-22 and p-STAT3 / STAT3 levels were measured at baseline，week 8 and week 12 in both groups，and insulin resistance index (HOMA-IR) was calculated．The differences between the two groups were compared. Results : ① There was no significant difference of the observation indexes between the two groups at baseline (P＞0. 05) ．At 8 weeks，the levels of FBG，FINS and HOMA-IR in CIH group were higher than those in NC group (P＜0. 05) ，and the levels of IL-22 were lower than those in NC group (P ＜0. 05) ．p-STAT3 / STAT3 showed a decreasing trend，but not statistically significant．At 4 weeks of reoxygenation，there were no significant differences in FBG，FINS，HOMA-IR and IL-22 levels between the two groups (P ＞0. 05 ) ．p-STAT3 / STAT3 in CIH group was significantly higher than that in NC group ( P ＜0. 05 ) . ② Spearman rank correlation analysis showed that HOMA-IR was negatively correlated with IL-22 and p-STAT3 / STAT3 ( all P ＜0. 05) ． Conclusion Chronic intermittent hypoxia can inhibit the expression of IL-22 / STAT3 signaling pathway，IL-22 / STAT3 signaling pathway may mediate insulin resistance induced by chronic intermittent hypoxia.

Objective : To investigate the role of endoplasmic reticulum stress in hepatic insulin resistance induced by intermittent hypoxia in rats． Methods : Twenty-four SD rats were randomly divided into control group ( NC group) and intermittent hypoxia group ( CIH group) ．The NC group was placed in a normoxia environment for 12 weeks，and the CIH group was given intermittent hypoxia for 8 weeks，and then returned to normoxia until the 12th week．In both groups，fasting blood glucose (FBG) ，fasting insulin (FINS) ，and liver inositol-requiring enzyme- 1 α(IRE1 α) ，X-box binding protein 1s(XBP1s) ，forkhead box transcription factor O1 (FoxO1) ，activating transcription factor-6(ATF6) ，cAMP-response element binding protein( CREB) ，CREB-regulated transcription coacti- vator-2( CRTC2) ，double-stranded RNA-dependent protein kinase-like ER kinase ( PERK) ，eukaryotic initiation factor 2 α(eIF2 α) ，protein kinase B ( AKT) ，phosphoenolpyruvate carboxykinase ( PEPCK) ，glucose-6-phosphat- ase( G6Pase) mRNA were measured at baseline，week 8，and week 12 . Results : There was no significant differ- ence in each observation index between the two groups at baseline ; at 8 weeks，the levels of FBG，FINS and the mRNA levels of IRE1α , XBP1s，ATF6，PERK，eIF2 α , PEPCK and G6Pase in the CIH group were higher than those in the NC group (P＜0. 05) ，while the mRNA levels of CREB，CRTC2 and AKT were lower than those in the NC group (P＜0. 05) ; at 12 weeks，there was no significant difference in each observation index between the two groups．Pearson correlation analysis showed(8th week of intermittent hypoxia group) : homeostasis model as- sessment-insulin resistance(HOMA-IR) was positively correlated with FoxO1，CREB，CRTC2 and PERK，eIF2 α mRNA levels (r = 0. 172，0. 595，0. 183，0. 702，0. 608 ; P＜0. 05) while it was negatively correlated with IRE1α , XBP1s，ATF6，AKT mRNA levels (r = －0. 422 ，－0. 327 ，－0. 309 ，－0. 399 ; P＜0. 05) ． Conclusion Intermittent hypoxia can lead to insulin resistance，and endoplasmic reticulum stress may mediate this effect.