Objective To explore the value of MR modulated flip angle technique in refocused imaging with extended echo train(MATRIX)contrast enhanced(CE)T1-weighted fluid attenuated inversion recovery(T1 FLAIR)for detecting skull metastases.Methods Forty-four patients with malignant tumors who underwent head MR scanning for screening skull metastasis were prospectively enrolled,and skull metastasis were then confirmed by pathology or imaging examinations,including MRI,CT,radionuclide bone imaging(BS),PET/CT and follow-up.Head MATRIX CE-T1 FLAIR(group A),3D gradient recalled echo_fast spin echo with magnetization preparation(GRE_fsp)CE-T1 FLAIR(group B)and fast spin echo(FSE)CE-T1 FLAIR(group C)images of all 44 cases were acquired.The subjective scores(including images quality and diagnostic confidence)and objective evaluation results of images were compared among groups.Taken BS or PET/CT results as standards,the efficacy of 3 kinds of images for detecting skull metastases was calculated.Results The subjective scores of images quality and diagnostic confidence,as well as signal-to-noise ratio(SNR)in group A and C were all higher than those in group B(all P＜0.001),and signal intensity(SI)metastases in group A was higher than those in group B and C(both P＜0.05).No significant difference of subjective score and SNR was found between groups A and C,nor of SImetastases between groups B and C(all P＞0.05).Totally 102 skull metastases were diagnosed with PET/CT or BS,while 129,151 and 115 lesions were detected in group A,B and C,respectively,with accuracy rate of 79.07%(102/129),67.55%(102/151)and 88.70%(102/115),respectively.Conclusion MATRIX CE-T1 FLAIR sequence could be used to detect skull metastases.

BACKGROUND:Intervertebral disc degeneration is the most common cause of low back pain;however,its pathogenesis is not yet fully understood.Therefore,it is imperative to explore new strategies for the prevention and treatment of intervertebral disc degeneration.Single-cell RNA sequencing allows high-throughput sequencing of mRNAs at the single-cell level,revealing cell heterogeneity and specific subgroups.This technology provides deeper insights into the regulatory mechanisms of the development of intervertebral disc degeneration,enhances the identification of potential targets,and promotes the exploration of early diagnosis and treatment.OBJECTIVE:To understand single-cell RNA sequencing and its main processes,and to review the recent research progress in single-cell RNA sequencing in intervertebral disc degeneration over the past few years,exploring its potential applications in the discovery of targeted biomarkers.METHODS:A computerized search of relevant literature published from January 2014 to June 2024 in PubMed,Web of Science,CNKI,and WanFang databases was performed using the search terms"single-cell RNA sequencing,sequencing technology,intervertebral disc degeneration,nucleus pulposus,annulus fibrosus,cartilage endplate"in English and Chinese.A total of 57 articles were finally selected for relevant analysis after duplicate and irrelevant literature was excluded.RESULTS AND CONCLUSION:(1)Single-cell RNA sequencing has emerged as a powerful tool for studying gene expression at the single-cell level.It has identified new cell subpopulations and elucidated their functions in intervertebral disc degeneration,thereby enhancing our understanding of the pathological processes involved in this condition.Several new cell subpopulations in the nucleus pulposus have been identified,including hypertrophic cartilage-like nucleus pulposus cells,effector nucleus pulposus cells,and homeostatic nucleus pulposus cells.These findings elucidate the functions and differentiation pathways of these subpopulations during intervertebral disc degeneration,highlighting variations in their proportions and dominant groups at different stages of degeneration.New subpopulations of annulus fibrosus cells,including the Grem1+and Lum+subpopulations,have been discovered.Grem1+is a resident progenitor subpopulation in the annulus fibrosus,with Sox9 and Id1 as key regulatory factors involved in tissue development and cell differentiation.Nr2f2 and Creb5 may be responsible for the vascularization function of the Lum+subpopulation,providing potential cell sources and regulatory targets for the treatment and repair of intervertebral disc degeneration.(2)Mesenchymal chondrocytes found in the cartilage endplate can be further subdivided into homeostatic,effector,and regulatory subtypes.Homeostatic chondrocytes are primarily involved in ossification and collagen-binding processes,regulatory chondrocytes participate mainly in stimulatory and control responses,and effector chondrocytes are predominantly involved in metabolic processes.(3)Further enrichment of monocytes/macrophages in the immune cells of degenerating disc tissues into monocytes/macrophages for oxidative stress,activated tissues,and homeostasis has deepened the understanding of the different functions of monocyte/macrophage subpopulations during the progression of intervertebral disc degeneration to provide personalized treatments based on specific subpopulations.The review summarizes recent advances in single-cell RNA sequencing for identifying targeted biomarkers in intervertebral disc degeneration,offering new insights into diagnostic and therapeutic strategies.

BACKGROUND:Intervertebral disc degeneration is the most common cause of low back pain;however,its pathogenesis is not yet fully understood.Therefore,it is imperative to explore new strategies for the prevention and treatment of intervertebral disc degeneration.Single-cell RNA sequencing allows high-throughput sequencing of mRNAs at the single-cell level,revealing cell heterogeneity and specific subgroups.This technology provides deeper insights into the regulatory mechanisms of the development of intervertebral disc degeneration,enhances the identification of potential targets,and promotes the exploration of early diagnosis and treatment.OBJECTIVE:To understand single-cell RNA sequencing and its main processes,and to review the recent research progress in single-cell RNA sequencing in intervertebral disc degeneration over the past few years,exploring its potential applications in the discovery of targeted biomarkers.METHODS:A computerized search of relevant literature published from January 2014 to June 2024 in PubMed,Web of Science,CNKI,and WanFang databases was performed using the search terms"single-cell RNA sequencing,sequencing technology,intervertebral disc degeneration,nucleus pulposus,annulus fibrosus,cartilage endplate"in English and Chinese.A total of 57 articles were finally selected for relevant analysis after duplicate and irrelevant literature was excluded.RESULTS AND CONCLUSION:(1)Single-cell RNA sequencing has emerged as a powerful tool for studying gene expression at the single-cell level.It has identified new cell subpopulations and elucidated their functions in intervertebral disc degeneration,thereby enhancing our understanding of the pathological processes involved in this condition.Several new cell subpopulations in the nucleus pulposus have been identified,including hypertrophic cartilage-like nucleus pulposus cells,effector nucleus pulposus cells,and homeostatic nucleus pulposus cells.These findings elucidate the functions and differentiation pathways of these subpopulations during intervertebral disc degeneration,highlighting variations in their proportions and dominant groups at different stages of degeneration.New subpopulations of annulus fibrosus cells,including the Grem1+and Lum+subpopulations,have been discovered.Grem1+is a resident progenitor subpopulation in the annulus fibrosus,with Sox9 and Id1 as key regulatory factors involved in tissue development and cell differentiation.Nr2f2 and Creb5 may be responsible for the vascularization function of the Lum+subpopulation,providing potential cell sources and regulatory targets for the treatment and repair of intervertebral disc degeneration.(2)Mesenchymal chondrocytes found in the cartilage endplate can be further subdivided into homeostatic,effector,and regulatory subtypes.Homeostatic chondrocytes are primarily involved in ossification and collagen-binding processes,regulatory chondrocytes participate mainly in stimulatory and control responses,and effector chondrocytes are predominantly involved in metabolic processes.(3)Further enrichment of monocytes/macrophages in the immune cells of degenerating disc tissues into monocytes/macrophages for oxidative stress,activated tissues,and homeostasis has deepened the understanding of the different functions of monocyte/macrophage subpopulations during the progression of intervertebral disc degeneration to provide personalized treatments based on specific subpopulations.The review summarizes recent advances in single-cell RNA sequencing for identifying targeted biomarkers in intervertebral disc degeneration,offering new insights into diagnostic and therapeutic strategies.

Objective:To observe the effect of stellate ganglion block(SGB)on the inflammatory response in rats with acute peritonitis,and to explore whether the possible anti-inflammatory mechanism related to the activation of α7nAChR receptor-mediated cholinergic anti-inflammatory pathway.Methods:A total of 36 SD rats were randomly divided into three groups,with 12 rats in each group:sham operation group(S group),acute peritonitis group(AP group)and SGB treatment group(SGB group).2%acetic acid(1 ml/100 g)was intraperitoneally injected to prepare acute peritonitis rat model in AP group and SGB group,and corresponding dose of normal saline was injected into S group.Right cervical sympathetic nerve was separated but not ligated in AP group and S group,the right cervical sympathetic nerve was severed and ligated in SGB group.Abdominal aorta blood samples were collected 24 h after opera-tion,and serum levels of IL-1β,IL-6 and TNF-α were measured by ELISA,pathological changes of peritoneal tissue were observed by light microscope and expression of α7nAChR in peritoneal tissue was measured by Western blot.Results:Compared with S group,se-rum levels of IL-1β,IL-6 and TNF-α in AP and SGB groups were significantly increased(P<0.05).Serum levels of IL-1β,IL-6,TNF-α in SGB group were significantly lower than those in AP group(P<0.05).HE staining of peritoneal tissues in each group revealed that the S group maintained intact peritoneal structure with normal cellular arrangement,while the AP group exhibited disorganized archi-tecture with extensive inflammatory cell infiltration,frequent hemorrhage,and prominent necrotic cells.In contrast,the SGB group displayed only mild inflammatory infiltration with preserved cellular morphology and minimal hemorrhagic or necrotic changes.The ex-pression level of α7nAChR protein in SGB group was significantly higher than that in S group and AP group.Conclusion:SGB can re-duce the inflammatory response of acute peritonitis rats,and its mechanism may be related to the cholinergic anti-inflammatory path-way mediated by α7nAChR.

Objective:To observe the effect of stellate ganglion block(SGB)on the inflammatory response in rats with acute peritonitis,and to explore whether the possible anti-inflammatory mechanism related to the activation of α7nAChR receptor-mediated cholinergic anti-inflammatory pathway.Methods:A total of 36 SD rats were randomly divided into three groups,with 12 rats in each group:sham operation group(S group),acute peritonitis group(AP group)and SGB treatment group(SGB group).2%acetic acid(1 ml/100 g)was intraperitoneally injected to prepare acute peritonitis rat model in AP group and SGB group,and corresponding dose of normal saline was injected into S group.Right cervical sympathetic nerve was separated but not ligated in AP group and S group,the right cervical sympathetic nerve was severed and ligated in SGB group.Abdominal aorta blood samples were collected 24 h after opera-tion,and serum levels of IL-1β,IL-6 and TNF-α were measured by ELISA,pathological changes of peritoneal tissue were observed by light microscope and expression of α7nAChR in peritoneal tissue was measured by Western blot.Results:Compared with S group,se-rum levels of IL-1β,IL-6 and TNF-α in AP and SGB groups were significantly increased(P<0.05).Serum levels of IL-1β,IL-6,TNF-α in SGB group were significantly lower than those in AP group(P<0.05).HE staining of peritoneal tissues in each group revealed that the S group maintained intact peritoneal structure with normal cellular arrangement,while the AP group exhibited disorganized archi-tecture with extensive inflammatory cell infiltration,frequent hemorrhage,and prominent necrotic cells.In contrast,the SGB group displayed only mild inflammatory infiltration with preserved cellular morphology and minimal hemorrhagic or necrotic changes.The ex-pression level of α7nAChR protein in SGB group was significantly higher than that in S group and AP group.Conclusion:SGB can re-duce the inflammatory response of acute peritonitis rats,and its mechanism may be related to the cholinergic anti-inflammatory path-way mediated by α7nAChR.

Objective:To investigate the expressions and prognostic value of lysyl oxidase like protein 2(LOXL2),chemo-kine c-c-motif ligand 18(CCL-18)and chitinase protein 40(YKL-40)in connective tissue disease with pulmonary interstitial lesions.Methods:A total of 308 patients with connective tissue disease who were treated in the First Affiliated Hospital of Hebei North Univer-sity from July 2021 to February 2022 were selected,including 108 patients with pulmonary interstitial disease(pathological group),200 patients without pulmonary interstitial disease(non pathological group),and another 35 healthy volunteers as the control group.Serum levels of LOXL2,CCL-18 and YKL-40 were detected by ELISA;Logistic regression analysis was applied to analyze the factors affecting the prognosis of patients with connective tissue disease and pulmonary interstitial disease;the predictive value of serum LOXL2,CCL-18 and YKL-40 levels on the prognosis of patients with connective tissue disease and pulmonary interstitial disease was analyzed by receiver operating characteristic(ROC)curve analysis.Results:Compared with control group,the serum levels of LOXL2,CCL-18 and YKL-40 in patients with connective tissue disease in the non pathological group and the pathological group were obviously increased(P<0.05);the serum levels of LOXL2,CCL-18 and YKL-40 in patients with connective tissue disease in the le-sion group were higher than those in the non lesion group(P<0.05);compared with the survival group,the serum levels of LOXL2,CCL-18 and YKL-40 in patients with connective tissue disease and pulmonary interstitial disease in the death group were obviously higher(P<0.05);Logistic regression analysis showed that LOXL2,CCL-18 and YKL-40 were risk factors for the prognosis of patients with connective tissue disease and pulmonary interstitial disease(P<0.05);the area under the ROC curve(AUC)of the combined detection of serum LOXL2,CCL-18 and YKL-40 in predicting the prognosis of patients with connective tissue disease and pulmonary interstitial disease was 0.967,which was better than their respective independent prediction(Zcombined detection-LOXL2=1.735,P=0.041;Zcombined detection-CCL-18=2.481,P=0.007;Zcombined detection-YKL-40=2.008,P=0.022).Conclusion:The serum levels of LOXL2,CCL-18 and YKL-40 in patients with connective tissue disease and pulmonary interstitial disease are elevated,which has certain value in the prognosis evaluation of patients with connective tissue disease combined with pulmonary interstitial disease.

Objective To explore the value of MR modulated flip angle technique in refocused imaging with extended echo train(MATRIX)contrast enhanced(CE)T1-weighted fluid attenuated inversion recovery(T1 FLAIR)for detecting skull metastases.Methods Forty-four patients with malignant tumors who underwent head MR scanning for screening skull metastasis were prospectively enrolled,and skull metastasis were then confirmed by pathology or imaging examinations,including MRI,CT,radionuclide bone imaging(BS),PET/CT and follow-up.Head MATRIX CE-T1 FLAIR(group A),3D gradient recalled echo_fast spin echo with magnetization preparation(GRE_fsp)CE-T1 FLAIR(group B)and fast spin echo(FSE)CE-T1 FLAIR(group C)images of all 44 cases were acquired.The subjective scores(including images quality and diagnostic confidence)and objective evaluation results of images were compared among groups.Taken BS or PET/CT results as standards,the efficacy of 3 kinds of images for detecting skull metastases was calculated.Results The subjective scores of images quality and diagnostic confidence,as well as signal-to-noise ratio(SNR)in group A and C were all higher than those in group B(all P＜0.001),and signal intensity(SI)metastases in group A was higher than those in group B and C(both P＜0.05).No significant difference of subjective score and SNR was found between groups A and C,nor of SImetastases between groups B and C(all P＞0.05).Totally 102 skull metastases were diagnosed with PET/CT or BS,while 129,151 and 115 lesions were detected in group A,B and C,respectively,with accuracy rate of 79.07%(102/129),67.55%(102/151)and 88.70%(102/115),respectively.Conclusion MATRIX CE-T1 FLAIR sequence could be used to detect skull metastases.

Objective:To investigate the current status of subjective well-being among stroke patients, and to explore the pathways and effects of influencing factors using structural equation model, so as to provide reference for improving subjective well-being among stroke patients.Methods:From July to November 2024, the stroke patients admitted to the First Affiliated Hospital of Bengbu Medical University, the Second Affiliated Hospital of Bengbu Medical University, Hefei First People′s Hospital were selected by convenience sampling method. A cross-sectional survey was conducted using a general demographic questionnaire, General Well-Being Scale, Cognitive Reserve Index questionnaire, Social Support Rating Scale, Stroke Symptom Cluster Scale, and FRAIL Scale, and AMOS 26.0 was used to analyse the pathways and effects of influencing factors of subjective well-being.Results:A total of 435 questionnaires were collected, 410 were valid.Among 410 cases, 266 case were males, 144 were females, with an age of (65.96 ± 12.15) years. The subjective well-being scores of stroke patients were (72.58 ± 11.66) points. Cognitive reserve and social support were positively correlated with subjective well-being ( r = 0.517, 0.554, both P<0.01), while symptom burden and frailty were negatively correlated with subjective well-being ( r = -0.687, -0.670, both P<0.01). Path analysis showed that symptom burden, frailty, cognitive reserve, and social support had a direct impact on subjective well-being (path coefficients were -0.500, -0.266, 0.148, and 0.144, respectively, all P<0.05), while cognitive reserve, social support, and symptom burden had an indirect impact on subjective well-being (path coefficients were 0.287, 0.249, and 0.108, respectively, all P<0.05). Conclusions:The subjective well-being of stroke patients is influenced by multiple factors, with symptom burden being an important factor affecting subjective well-being. Intervention strategies such as improving cognitive reserve, strengthening social support systems, and preventing frailty can improve the subjective well-being of patients.

Objective To explore the potential profiles of symptom burden among stroke patients and to analyze the differences in the characteristics of different classes of stroke patients,providing references for clinical nursing practice.Methods A convenience sampling method was used to select 485 stroke patients treated at 4 tertiary-level general hospitals in Anhui Province from July to December 2024 as the study population.The general information questionnaire,Stroke Symptom Cluster Scale,Personal Mastery Scale,and Cognitive Reserve Index questionnaire.Latent profile analysis was employed to explore the categories of symptom burden among stroke patients,and multiple logistic regression was used to assess the influence factors of each category.Results A total of 456 valid questionnaires were collected,with a valid response rate of 94.02％.Symptom burden among stroke patients can be divided into 4 latent profiles:low symptom burden group(69.08％),multiple symptom burden group(8.12％),moderate burden-physical activity impairment group(11.18％),and moderate burden-emotional and cognitive language impairment group(11.62％).The patient's age,number of stroke episodes,number of chronic diseases,systemic inflammation response index,personal mastery,and cognitive reserve were the factors influencing the latent profiles of symptom burden in stroke patients(P＜0.05).Conclusion The symptom burden of stroke patients shows significant heterogeneity.Medical staff can develop targeted nursing interventions based on the category characteristics and influencing factors of the symptom burden in stroke patients.

Objective To explore the effects of Mahuang Lianqiao Chixiaodu Decoction on IgA nephropathy model rats and its mechanism based on C3a/C3aR signaling pathway.Methods Nine rats were randomly selected from 30 male Wistar rats as control group(9 rats),the remaining 21 rats were prepared IgA nephropathy models using the bovine serum albumin-lipopolysaccharide-carbon tetrachloride complex immunization method.Finally 18 successfully modeled rats were randomly divided into model group,Chinese medicine group and Western medicine group,Chinese medicine group was treated with Mahuang Lianqiao Chixiaodou Decoction suspension by gavage,the Western medicine group was treated with losartan suspension by gavage,the control group and model group were treated with normal saline by gavage.The intervention lasted for 4 weeks.HE,PAS and Masson staining were used to observe the morphology of renal tissue,the expression of IgA in glomerular mesangial area was detected by immunofluorescence,the contents of IL-6,TNF-α and C3a in renal tissue were detected by ELISA,the protein expressions of C3/C3b/C3c,C3aR,CFB,TLR4 and NF-κBp65 in renal tissue were detected by Western blot,the positive expressions of C3,C3aR and CFB in renal tissue were detected by immunohistochemistry.Results Compared with the control group,the model group showed compensatory expansion of large glomeruli,proliferation of mesangial cells,expansion of mesangial matrix,and strong positive IgA immune complex deposition in mesangial area(P<0.01),the contents of IL-6,TNF-α and C3a in renal tissue significantly increased(P<0.01),the expressions of C3/C3b/C3c,C3aR,CFB,TLR4 and NF-κBp65 protein in renal tissue increased(P<0.05),the positive expressions of C3,C3aR and CFB in renal tissue significantly increased(P<0.01).Compared with the model group,the pathological damage of Chinese medicine group and Western medicine group was alleviated,the deposition of IgA immune complex was significantly reduced(P<0.01),the contents of IL-6 and TNF-α in renal tissue significantly decreased(P<0.01,P<0.05),and the expressions of C3/C3b/C3c,C3aR,CFB,TLR4 and NF-κBp65 protein in renal tissue decreased(P<0.01,P<0.05),the positive expressions of C3,C3aR and CFB in renal tissues decreased(P<0.01).Conclusion Mahuang Lianqiao Chixiaodou Decoction can inhibit the inflammatory response and improve renal pathological damage in IgA nephropathy rats,and the mechanism may be related to the inhibition of alternative pathway complement activation and the regulation of C3a/C3aR and TLR4/NF-κB signaling pathways.