Objective The biomechanical performance of Ilizarov fixator models with different configurations for humeral shaft defect was compared,so as to provide a biomechanical basis for selecting the appropriate circular external fixation structure for the clinical treatment of humeral shaft defects using Ilizarov technology.Methods Based on CT data of the humerus from a healthy volunteer,the external fixators with three configurations,namely,hybrid frame,semi-ring frame and 90° fan frame were established.The finite element method was used to simulate the displacement and stress distribution under different loading conditions,and the finite element results were validated by biomechanical tests.Results Finite element analysis results:in terms of displacement,under compression,tensile and torque conditions,the displacement of 90° fan model was smaller than that of hybrid and semi-ring models.In terms of stress,the 90° fan model had the smallest displacement under tensile condition.In compression and torque tests,the semi-annular model had the lowest stress.Biomechanical test results:the semi-ring model exhibited the smallest displacement under axial compression,but there was no significant difference between the three models(P＞0.05).Conclusions The semi-ring and 90° fan frames can achieve a similar stability as the traditional hybrid frame through the strategy of'reducing the ring and increasing the stem'.The unilateral structure of the 90° fan frame has the advantages of small size,light weight,and structural stability,as well as a small impact on the shoulder and elbow joints,which makes it more valuable in clinical applications.

Objective To explore the effect of training weights on energy expenditure(EE)among young males during squatting.Methods Twenty young males with strength training experience≥1 year were recruited and performed 3 sets of squats,with 5 repetitions per set,at 40%1RM,60%1RM and 80%1RM,respectively,with an interval of at least 72 hours.Oxygen uptake(VO2),heart rate,blood lactate,and the mechanical work on the barbell during squat exercises were measured before,during,and after each sets.Moreover,one-way repeated-measures ANOVA was used to compare EE differenc-es between different training weights,and two-way ANOVA was employed to examine the weight×method effect on metabolic equivalent(MET)values.Meanwhile,Pearson's correlation analysis was conducted to examine the correlation between EE and barbell mechanical work.Results(1)Training weight has significant effects on the total energy expenditure and EE during excess post-exercise oxy-gen consumption(EPOC)stage(P<0.001),while a significant increase was observed in the glycolytic EE only at 80%1RM and the aerobic EE with no less than 60%1RM(P<0.01 and P<0.05).(2)The percentage of EPOC-stage and glycolytic EE in the total energy expenditure was significantly higher than the aerobic EE(P<0.01),while that of aerobic EE at 40%1RM and 60%1RM was significantly higher than at 80%1RM(P<0.01).(3)Total energy expenditure(r=0.65,P<0.001)and EPOC-stage EE(r=0.68,P<0.001)showed moderate correlation with the mechanical work done.(4)Aerobic EE was significantly lower than the mechanical work done during squatting(P<0.001).Moreover,the MET values of squats calculated using aerobic EE during exercise at 40%-80%1RM was 2.42±0.54,2.89±0.87 and 2.7±0.56,while the MET ones calculated using the total energy expenditure reached 14.99±2.94,20.52±4.51 and 28.57±6.88.Conclusions Only EPOC-stage and glycolytic EE elevate with the increase of weight.Moreover,EE and the MET value scalculated using VO2 dur-ing exercise may under estimate the actual intensity of squat.Meanwhile,the accuracy of EE estima-tion may be improved by introducing the mechanical work.

Objective:To develop an ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses and to test its reliability and validity.Methods:The initial questionnaire was constructed through literature review, group discussion, Delphi expert consultation, and pilot-testing based on the theory of knowledge, attitude and practice. Convenience sampling was used to select 301 ICU nurses from Class Ⅲ Grade A hospitals in Honghe Hani and Yi Autonomous Prefecture, Beijing City, Yantai City, Wuhan City, and Xi'an City from January to February 2024 to examine the reliability and validity of the questionnaire.Results:The ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses consisted of three dimensions of knowledge, attitude, and practice with a total of 52 items. In the two rounds of consultation, the expert authority coefficients were all 0.871, and Kendall's harmony coefficient was 0.186 and 0.161, respectively ( P<0.01) . Exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 74.989%. The split-half reliability of the questionnaire was 0.835, and the Cronbach's α coefficient was 0.979, and the Cronbach's α coefficients for knowledge, attitude, and practice dimensions were 0.976, 0.989, and 0.972, respectively. The content validity index at the questionnaire level was 0.996, and the content validity index at the item level was 0.800 to 1.000. Conclusions:The ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses has good reliability and validity, and can be used as a tool to assess the knowledge, attitude and practice of nurses towards ICU acquired dysphagia.

Objective To explore the effect of training weights on energy expenditure(EE)among young males during squatting.Methods Twenty young males with strength training experience≥1 year were recruited and performed 3 sets of squats,with 5 repetitions per set,at 40%1RM,60%1RM and 80%1RM,respectively,with an interval of at least 72 hours.Oxygen uptake(VO2),heart rate,blood lactate,and the mechanical work on the barbell during squat exercises were measured before,during,and after each sets.Moreover,one-way repeated-measures ANOVA was used to compare EE differenc-es between different training weights,and two-way ANOVA was employed to examine the weight×method effect on metabolic equivalent(MET)values.Meanwhile,Pearson's correlation analysis was conducted to examine the correlation between EE and barbell mechanical work.Results(1)Training weight has significant effects on the total energy expenditure and EE during excess post-exercise oxy-gen consumption(EPOC)stage(P<0.001),while a significant increase was observed in the glycolytic EE only at 80%1RM and the aerobic EE with no less than 60%1RM(P<0.01 and P<0.05).(2)The percentage of EPOC-stage and glycolytic EE in the total energy expenditure was significantly higher than the aerobic EE(P<0.01),while that of aerobic EE at 40%1RM and 60%1RM was significantly higher than at 80%1RM(P<0.01).(3)Total energy expenditure(r=0.65,P<0.001)and EPOC-stage EE(r=0.68,P<0.001)showed moderate correlation with the mechanical work done.(4)Aerobic EE was significantly lower than the mechanical work done during squatting(P<0.001).Moreover,the MET values of squats calculated using aerobic EE during exercise at 40%-80%1RM was 2.42±0.54,2.89±0.87 and 2.7±0.56,while the MET ones calculated using the total energy expenditure reached 14.99±2.94,20.52±4.51 and 28.57±6.88.Conclusions Only EPOC-stage and glycolytic EE elevate with the increase of weight.Moreover,EE and the MET value scalculated using VO2 dur-ing exercise may under estimate the actual intensity of squat.Meanwhile,the accuracy of EE estima-tion may be improved by introducing the mechanical work.

Objective The biomechanical performance of Ilizarov fixator models with different configurations for humeral shaft defect was compared,so as to provide a biomechanical basis for selecting the appropriate circular external fixation structure for the clinical treatment of humeral shaft defects using Ilizarov technology.Methods Based on CT data of the humerus from a healthy volunteer,the external fixators with three configurations,namely,hybrid frame,semi-ring frame and 90° fan frame were established.The finite element method was used to simulate the displacement and stress distribution under different loading conditions,and the finite element results were validated by biomechanical tests.Results Finite element analysis results:in terms of displacement,under compression,tensile and torque conditions,the displacement of 90° fan model was smaller than that of hybrid and semi-ring models.In terms of stress,the 90° fan model had the smallest displacement under tensile condition.In compression and torque tests,the semi-annular model had the lowest stress.Biomechanical test results:the semi-ring model exhibited the smallest displacement under axial compression,but there was no significant difference between the three models(P＞0.05).Conclusions The semi-ring and 90° fan frames can achieve a similar stability as the traditional hybrid frame through the strategy of'reducing the ring and increasing the stem'.The unilateral structure of the 90° fan frame has the advantages of small size,light weight,and structural stability,as well as a small impact on the shoulder and elbow joints,which makes it more valuable in clinical applications.

Objective:To develop an ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses and to test its reliability and validity.Methods:The initial questionnaire was constructed through literature review, group discussion, Delphi expert consultation, and pilot-testing based on the theory of knowledge, attitude and practice. Convenience sampling was used to select 301 ICU nurses from Class Ⅲ Grade A hospitals in Honghe Hani and Yi Autonomous Prefecture, Beijing City, Yantai City, Wuhan City, and Xi'an City from January to February 2024 to examine the reliability and validity of the questionnaire.Results:The ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses consisted of three dimensions of knowledge, attitude, and practice with a total of 52 items. In the two rounds of consultation, the expert authority coefficients were all 0.871, and Kendall's harmony coefficient was 0.186 and 0.161, respectively ( P<0.01) . Exploratory factor analysis extracted three common factors with a cumulative variance contribution rate of 74.989%. The split-half reliability of the questionnaire was 0.835, and the Cronbach's α coefficient was 0.979, and the Cronbach's α coefficients for knowledge, attitude, and practice dimensions were 0.976, 0.989, and 0.972, respectively. The content validity index at the questionnaire level was 0.996, and the content validity index at the item level was 0.800 to 1.000. Conclusions:The ICU-acquired Swallowing Disorders Knowledge, Attitude and Practice Questionnaire for Nurses has good reliability and validity, and can be used as a tool to assess the knowledge, attitude and practice of nurses towards ICU acquired dysphagia.

Objective:To investigate the prevalence of dental caries of 4-year-old children in Miyun District of Beijing by international caries detection and assessment system(ICDAS),to detect the caries activity Cariostat value and to analyze the correlation between the Cariostat value and dental caries.Methods:Totally 815 children aged 4 years in 7 kindergartens in Miyun District of Beijing were recrui-ted.The clinical examination of all children was conducted by one examiner using ICDAS.The oral de-birs and plaques were collected by one doctor who recorded the Cariostat scores.The results of clinical examination were compared between genders.At the same time,the prevalence of dental caries,the mean d3-6ft/d3_6fs and d1-6ft/d1-6fs among high Cariostat scores group(2.0-3.0),medium Cariostat scores group(1.5)and low Cariostat scores group(0-1.0)were compared.The distributions of incipi-ent caries in different Cariostat scores groups were compared among children with incipient caries only.Results:All the children had incipient caries,and 78.3％of the children had cavitated caries with ICDAS score of 3 or above.The mean d1-2t scores were 9.76±3.65,the mean d3-6ft scores was 4.64±4.43 and the mean d1-6ft scores were 14.41±3.42.The incipient caries with ICDAS score of 1-2 were widely distributed,accounting for 67.7％of the total numbers of caries.There was no significant diffe-rence in caries prevalence and caries experience between genders(P＞0.05).The proportion of children with high Cariostat scores in boys(43.6％)was higher than that in girls(33％)and the difference was statistically significant(P＜0.05).With the increase of Cariostat scores,the prevalence of cavitated caries,the mean d3-6ft/d3-6fs and d1-6ft/d,_6fs scores in children was on the increase and the difference among the three groups was statistically significant(P＜0.05).For children with incipient caries only,the distribution of incipient caries in different Cariostat scores groups was no significant difference(P＞0.05).Conclusion:ICDAS can detect early enamel demineralization of deciduous teeth in children.The prevalence of dental caries among 815 4-year-old children in Miyun District of Beijing is more serious,and incipient caries is widely distributed in children.Cariostat value reflects the status of cavi-tated caries and has no correlation with the distribution of incipient caries.Therefore,the combined ap-plication of ICDAS and Cariostat caries activity detection method is helpful for the detection of incipient caries and screening of caries high-risk children,which has great significance for the comprehensive ma-nagement of caries in children and the formulation of early preventive measures.

OBJECTIVE: To explore the genetic bases of 3 patients with periventricular nodular heterotopia and epileptic seizure. METHODS: The clinical data of three patients presenting with periventricular nodular ectopic with epileptic seizure were analyzed. Whole exome sequencing (WES) was performed on the patients, and Sanger sequencing was used to validate the suspected variants. RESULTS: In three female patients, head MRI showed nodular gray matter ectopic in the bilateral ventricle. WES identified the heterozygous c.2720del T(p.Leu907Argfs*39) variant of FLNA gene in case 1 and her mother (case 2), and heterozygous c.1387_1390del GTGC(p.Val463Profs*34) of FLNA gene in case 3. According to the American College of Medical Genetics and Genomics standards and guidelines, the c.2720delT(p.Leu907Argfs*39) and c.1387_1390del GTGC (p.Val463Profs*34) variants of FLNA gene were predicted to be pathogenic (PVS1+PM2+PP1) and likely pathogenic(PVS1+PM2), respectively. CONCLUSION The c.2720delT(p.Leu907Argfs*39) and c.1387_1390del GTGC(p.Val463Profs*34) variants of FLNA gene may be the genetic cause of the three patients.
Epilepsy/genetics* ; Female ; Filamins/genetics* ; Heterozygote ; Humans ; Magnetic Resonance Imaging ; Mutation ; Periventricular Nodular Heterotopia/genetics* ; Seizures

Mammalian/mechanistic targets of rapamycin (mTOR) consist in two functional complexes, mTORC1 and mTORC2, which modulate the essential physical process in organism through responding to growth factor, glutamine, neurotransmitter and so on. Overaction of mTOR pathway in the central nervous system is responsible for epilepsy. The article reviews the existing reports to analyze and conclude the phenotypes of the mTOR related epilepsies as well as the likely mechanism, and to provide reference for the diagnosis and treatment of mTOR related epilepsy.

Objective To investigate the expression characteristics of T lymphocyte subsets in peripheral blood of patients with newly diagnosed multiple myeloma(MM),as well as the equilibrium relationship between the ratio of helper T cells 17(Thl7)and CD4+CD25+Foxp3+regulatory T cells(Treg cells),and analyze their clinical significance in the pathogenesis of MM.Methods The proportion of CD3+,CD3+CD4+,CD3+CD8+cells,Th17 cells,Treg cells in peripheral blood and the ratios of CD3+CD4+/CD3+CD8+、Th17/Treg were analyzed between the 30 patients with MM in newly diagnosed and 20 healthy volunteers(control group),then analysis the differences between MM patients and control group.In 30 cases of newly diagnosed MM patients(patient group)and 20 healthy volunteers(control group),total T cells in peripheral blood(CD3+),auxiliary T cells /induced T cells(CD3+CD4+),the inhibitory T cell /cytotoxic T cells(CD3+CD8+),the ratio of(CD3+CD4)/(CD3+CD8+),the percentages of Th17 cells and Treg cell and the ratio of Thl7 and Treg were detected,and the differences between MM patients and control group were compared.Results The ratio of inhibition/cytotoxic T cells(CD3+CD8+)in the patient group was higher than that in the control group(P<0.05).(CD3+CD4+)/(CD3+CD8+)ratio in the patient group was lower than that in the control group(P<0.05);in the patient group,the ratio of Th17 cells in peripheral blood of patients was(5.9 ± 1.9)%,which was increased compared with the control group(4.0 ± 0.9)%(P<0.05);the ratio of Treg cells in the patient group was(1.2 ± 0.3)%,which was decreased com-pared with the control group(2.1 ± 0.4%)(P< 0.05);and the ratio of Th17/Treg cells was significantly higher in the patient group,and the difference was statistically significant(P<0.05).Conclusion Peripheral blood T cell subsets disorder exists in pa-tients with MM,Thl7/Treg cell imbalance caused by the increase of Thl7 cell ratio and the decrease of the ratio of Treg cells,and the imbalance of immune system may play a role in the occurrence and development of MM,and has some guiding value for the prognosis.