OBJECTIVE To analyze the correlation between styloid process related parameters and symptoms in patients with styloid process syndrome.METHODS A retrospective study was conducted on the 3D reconstruction CT results of the styloid process in 68 patients diagnosed with styloid process syndrome who visited the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2024.The relationship between parameters such as styloid process length,angle,distance from styloid process tip to pharynx,and specific symptoms in patients with styloid process syndrome was analyzed.RESULTS Among 68 patients with styloid process syndrome,44 had unilateral symptoms and 24 had bilateral symptoms.The length of the styloid process on the symptomatic side of patients with unilateral symptoms(3.86±0.16)cm was significantly longer than that on the asymptomatic side(2.98±0.17)cm(Z=-2.191,P=0.028);The length of the styloid process on the side with severe symptoms in patients with bilateral symptoms(3.98±0.37)cm was also significantly longer than that in patients with mild symptoms(3.37±0.15)cm(t=2.448,P=0.024).Patients with styloid process syndrome mainly present with pharyngalgia(64.71%,44/68).There were no significant differences in the length,inclination angle,anteversion angle,and distance between the styloid process tip and the pharynx among those with unilateral pharyngalgia(n=29),bilateral pharyngalgia(n=15),and non pharyngalgia(n=24)(P>0.05).However,among the 68 patients with styloid syndrome,12 had calcification of the styloid hyoid ligament,while 56 did not.The incidence of unilateral pharyngalgia was significantly higher in patients with calcification of the styloid hyoid ligament than in patients without calcification(66.7%vs.35.7%,χ2=3.909,P=0.048).CONCLUSION The severity of symptoms in patients with styloid process syndrome is related to the length of the styloid process,and those with calcification of the styloid hyoid ligament are more likely to experience pharyngalgia.

Objective:To analyze the characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD), and to explore the comorbidity of pneumoconiosis and COPD and its influencing factors.Methods:From October to December 2022, 255 pneumoconiosis patients admitted to an occupational disease prevention and control hospital from January 2018 to December 2021 were selected as the study subjects. According to whether the pneumoconiosis patients were complicated with COPD or not, they were divided into pneumoconiosis and COPD comorbidity group and pneumoconiosis group. The general condition and dust exposure of the two groups of patients were analyzed, and the relationship between different types and different periods of pneumoconiosis and COPD comorbidity was analyzed by multivariate logistic regression.Results:A total of 255 subjects were collected, including 64 patients with comorbidity of pneumoconiosis and COPD, and the comorbidity rate was 25.1%. There were 186 males (72.9%) and 69 females (27.1%), ranging in age from 35 to 90 (63.79±11.79) years, and working age from 1 to 45 (20.31±10.57) years. The comorbidity of pneumoconiosis and COPD increased with the increase of working age (χ 2trend=8.19, P=0.004), and the comorbidity rate for COPD with working age of more than 30 years was 37.7% (23/61). The comorbidity rate of pneumoconiosis and COPD also increased with the increase of the stage of pneumoconiosis (χ 2trend=13.14, P<0.001), and the comorbidity rate of pneumoconiosis and COPD in the stage Ⅲ was as high as 44.0% (11/25). The cumulative dust exposure was negatively correlated with forced expiratory volume in one second/forced vital capacity (FEV 1/FVC), and the linear regression equation y=-0.04 x+78.4. Multivariate logistic regression analysis showed that the length of services ≥30 years ( OR=3.30, 95% CI: 1.15-9.52) and stageⅡ ( OR=3.05, 95% CI: 1.03-9.04) were the risk factors for comorbidity between pneumoconiosis and COPD ( P<0.05) . Conclusion:The comorbidity rate of pneumoconiosis and COPD is high. Working age, pneumoconiosis stage and cumulative dust exposure are the main influencing factors of pneumoconiosis and COPD comorbidity, so more attention should be paid to the comorbidity of pneumoconiosis and COPD.

Objective To investigate the regulatory pathway of lipid peroxidation in ferroptosis and the pathogenesis of Parkinson's disease(PD)at animal level.Methods Zebrafish PD model was established by exposure to 200 μmol/L 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP).Zebrafish embryo in 48 h after fertilisation were grouped into a control group(n=100),a MPTP group(n=100),and a MPTP+Nomi group(1.5 μg/ml nomifensine,n=100).Behavioral analysis was performed on zebrafish in 5 d after fertilization for movement ability,rate and distance.The expression of α-synuclein and tyrosine hydroxylase in the zebrafish brain was detected by immu-nofluorescence assay to evaluate the activity of dopaminergic neurons(DA).The levels of iron,glutathione(GSH)and lipid peroxidation,which includes catalase(CAT),glutathione peroxidase 4(GPX4),lipid peroxide(LPO),malondialdehyde(MDA)and reactive oxygen species(ROS),were measured to verify whether iron deposition may cause damage to DA through the metabolic regulation mechanism of lipid peroxidation in iron death.Results Compared with the control group,the movement rate and distance were significantly reduced in the MPTP group(P＜0.01),while Nomi treatment obviously increased the movement rate and distance when compared with the MPTP group(P＜0.01).The MPTP group exhibited obvious DA damage in comparison with the control group,and Nomi treatment reversed the damage caused by MPTP.There was no sta-tistical difference in the CAT level in the three group(P＞0.05).The MPTP group had signifi-cantly increased levels of iron,LPO and MDA and decreased levels of GSH and GPX4 when com-pared with the control group(838.18±143.42 vs 478.53±112.58,P＜0.05;1.71±0.11 vs 1.48±0.14,P＜0.05;4.50±0.64 vs 4.23±0.13,P＜0.05;38.93±1.72 vs 45.97±2.32,P＜0.05;0.17±0.03 vs 0.39±0.04,P＜0.05).The MPTP+Nomi group had significantly increased levels of GSH and GPX4 and decreased levels of iron and LPO when compared with the MPTP group(40.79±1.02 vs 38.93±1.72,P＜0.05;0.26±0.05 vs 0.17±0.03,P＜0.05;326.75±110.95 vs 838.18±143.42,P＜0.05;1.01±0.27 vs 1.71±0.11,P＜0.05).The results of the ROS flow cytometry analysis showed that the percentages of ROS positive cells in the control group,MPTP group,and Nomi group were as follows:Histogram:31.6％,46.2％and 31.3％,Scatter plot:62.4％,73.0％and 65.7％,respectively.Conclusion Ferroptosis is found in PD zebrafish induced by MPTP exposure.Our study has clarified at animal level that the damage of DA caused by iron deposition is related to the metabolic mechanism of lipid peroxidation caused by iron death.

Objective To investigate the regulatory pathway of lipid peroxidation in ferroptosis and the pathogenesis of Parkinson's disease(PD)at animal level.Methods Zebrafish PD model was established by exposure to 200 μmol/L 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP).Zebrafish embryo in 48 h after fertilisation were grouped into a control group(n=100),a MPTP group(n=100),and a MPTP+Nomi group(1.5 μg/ml nomifensine,n=100).Behavioral analysis was performed on zebrafish in 5 d after fertilization for movement ability,rate and distance.The expression of α-synuclein and tyrosine hydroxylase in the zebrafish brain was detected by immu-nofluorescence assay to evaluate the activity of dopaminergic neurons(DA).The levels of iron,glutathione(GSH)and lipid peroxidation,which includes catalase(CAT),glutathione peroxidase 4(GPX4),lipid peroxide(LPO),malondialdehyde(MDA)and reactive oxygen species(ROS),were measured to verify whether iron deposition may cause damage to DA through the metabolic regulation mechanism of lipid peroxidation in iron death.Results Compared with the control group,the movement rate and distance were significantly reduced in the MPTP group(P＜0.01),while Nomi treatment obviously increased the movement rate and distance when compared with the MPTP group(P＜0.01).The MPTP group exhibited obvious DA damage in comparison with the control group,and Nomi treatment reversed the damage caused by MPTP.There was no sta-tistical difference in the CAT level in the three group(P＞0.05).The MPTP group had signifi-cantly increased levels of iron,LPO and MDA and decreased levels of GSH and GPX4 when com-pared with the control group(838.18±143.42 vs 478.53±112.58,P＜0.05;1.71±0.11 vs 1.48±0.14,P＜0.05;4.50±0.64 vs 4.23±0.13,P＜0.05;38.93±1.72 vs 45.97±2.32,P＜0.05;0.17±0.03 vs 0.39±0.04,P＜0.05).The MPTP+Nomi group had significantly increased levels of GSH and GPX4 and decreased levels of iron and LPO when compared with the MPTP group(40.79±1.02 vs 38.93±1.72,P＜0.05;0.26±0.05 vs 0.17±0.03,P＜0.05;326.75±110.95 vs 838.18±143.42,P＜0.05;1.01±0.27 vs 1.71±0.11,P＜0.05).The results of the ROS flow cytometry analysis showed that the percentages of ROS positive cells in the control group,MPTP group,and Nomi group were as follows:Histogram:31.6％,46.2％and 31.3％,Scatter plot:62.4％,73.0％and 65.7％,respectively.Conclusion Ferroptosis is found in PD zebrafish induced by MPTP exposure.Our study has clarified at animal level that the damage of DA caused by iron deposition is related to the metabolic mechanism of lipid peroxidation caused by iron death.

Objective:To analyze the characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD), and to explore the comorbidity of pneumoconiosis and COPD and its influencing factors.Methods:From October to December 2022, 255 pneumoconiosis patients admitted to an occupational disease prevention and control hospital from January 2018 to December 2021 were selected as the study subjects. According to whether the pneumoconiosis patients were complicated with COPD or not, they were divided into pneumoconiosis and COPD comorbidity group and pneumoconiosis group. The general condition and dust exposure of the two groups of patients were analyzed, and the relationship between different types and different periods of pneumoconiosis and COPD comorbidity was analyzed by multivariate logistic regression.Results:A total of 255 subjects were collected, including 64 patients with comorbidity of pneumoconiosis and COPD, and the comorbidity rate was 25.1%. There were 186 males (72.9%) and 69 females (27.1%), ranging in age from 35 to 90 (63.79±11.79) years, and working age from 1 to 45 (20.31±10.57) years. The comorbidity of pneumoconiosis and COPD increased with the increase of working age (χ 2trend=8.19, P=0.004), and the comorbidity rate for COPD with working age of more than 30 years was 37.7% (23/61). The comorbidity rate of pneumoconiosis and COPD also increased with the increase of the stage of pneumoconiosis (χ 2trend=13.14, P<0.001), and the comorbidity rate of pneumoconiosis and COPD in the stage Ⅲ was as high as 44.0% (11/25). The cumulative dust exposure was negatively correlated with forced expiratory volume in one second/forced vital capacity (FEV 1/FVC), and the linear regression equation y=-0.04 x+78.4. Multivariate logistic regression analysis showed that the length of services ≥30 years ( OR=3.30, 95% CI: 1.15-9.52) and stageⅡ ( OR=3.05, 95% CI: 1.03-9.04) were the risk factors for comorbidity between pneumoconiosis and COPD ( P<0.05) . Conclusion:The comorbidity rate of pneumoconiosis and COPD is high. Working age, pneumoconiosis stage and cumulative dust exposure are the main influencing factors of pneumoconiosis and COPD comorbidity, so more attention should be paid to the comorbidity of pneumoconiosis and COPD.

Purpose To explore the pathological features of angioimmunoblastic T-cell lymphoma(AITL)with bone marrow involvement and to improve awareness of bone marrow infiltration in AITL.Methods The tissue morphology of 32 cases of AITL with bone marrow involvement was retrospectively analyzed.Im-munohistochemistry using the EnVision method and ten-color flow cytometry were conducted to detect AITL-related immune markers.T cell clonality was analyzed through T cell receptor(TCR)gene rearrangement.Results The predominant pat-terns of tumor cell infiltration were nodular(20/32,62.5％)and interstitial or small clusters(10/32,31.3％).The nodules showed a mixture of cellular components.In some cases,the fo-ci contained a mixture of cells with characteristic"granuloma-toid"changes.The tumor cells were mainly small to medium-sized lymphocytes with inconspicuous atypia.Some cases showed plasma cell proliferation.19 cases were subject to immunohisto-chemical staining,which revealed a low count of CD4-positive T cells,with an average of 8.4％.The positive rates of T follic-ular helper cells(TFH)markers were as follows:CD10(7/14,50.0％),BCL6(6/19,31.6％),PD-1(13/19,68.4％),and CXCL13(13/19,68.4％).In most cases,tumor cells showed co-expression of PD-1 and CXCL13,but the number of positive cells was less than 1％.Flow cytometry analysis was performed in 24 cases,among which 22 cases all consistently expressed cytoplasmic CD3(cCD3),CD5,CD4,and CD2,with varying degrees of CD10 expression.In some cases,there was a lack of expression of surface CD3(sCD3)(12/22,54.5％),while there was a lack of expression of CD7(8/22,36.4％).and no abnormal T cells were found in 2 cases.TCR gene rearrangement analysis was performed in 7 cases,with 3 cases showing TCR clonality.Conclusion AITL with bone marrow involvement exhibits a lower proportion of tumor cells and less atypia,making it prone to misdiagnosis.The presence of lymphocytic foci with mixed cellular components in the bone marrow can indicate bone marrow involvement in AITL.Flow cy-tometry detection of abnormal T cells(double positive for CD4 and CD10)strongly suggests bone marrow infiltration in AITL.A comprehensive diagnosis of bone marrow involvement in AITL re-quires consideration of bone marrow biopsy,flow cytometry,and TCR gene rearrangement analysis.

Background To date,pharmacologic therapy is considered the standard first-line treatment for insomnia disorder,but there are still some concerns over the adverse reactions.Repetitive transcranial magnetic stimulation(rTMS)and cognitive behavioral therapy for insomnia(CBT-I)as an alternative to pharmacologic therapy have the advantages of fewer side effects and better patient tolerance in the treatment of chronic insomnia disorder.Objective To explore the clinical efficacy of rTMS and CBT-I on chronic insomnia disorder,so as to provide a novel therapeutic option for the treatment of chronic insomnia disorder.Methods A total of 50 patients with chronic insomnia disorder attending the outpatient clinic of Inner Mongolia Autonomous Region Mental Health Center or community hospital from September 21,2020 to December 16,2021 and fulfilling the International Classification of Sleep Disorders,third edition(ICSD-3)diagnostic criteria were enrolled.Additionally,16 age-and sex-matched healthy controls recruited from the community were set as control group.Patients were randomly divided into rTMS group and CBT-I group,25 cases in each group,and received rTMS or CBT-I intervention for 6 weeks respectively.At enrollment and completion of intervention,patients were subjected to Polysomnography(PSG),Pittsburgh Sleep Quality Index(PSQI),Insomnia Severity Index(ISI)and Repeatable Battery for the Assessment of Neuropsychological Status(RBANS).All participants underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans,and amplitude of low-frequency fluctuation(ALFF)was calculated.The brain regions with statistically different ALFF values between patient group and control group were chosen as regions of interest(ROIs),and whole-brain seed-based functional connectivity analyses were conducted.Results After a 6-week intervention in the two groups,the main effect of time was significant for PSQI(F=41.160,P<0.05),ISI(F=69.615,P<0.05)and RBANS immediate memory(F=47.923,P<0.05),language(F=12.090,P<0.05)and delayed memory indices(F=28.193,P<0.05).A significant main effect of time for total sleep time(F=8.995,P<0.05),a significant main effect of time for sleep efficiency(F=12.414,P<0.05),a significant main effect of group for sleep efficiency(F=4.342,P<0.05)and a significant main effect of time for N1%(F=7.806,P<0.05)were observed.Sleep efficacy in CBT-I group improved significantly from pre-to post-test(t=-2.785,P<0.05).Patients in rTMS group showed increased functional connectivity between the orbital superior frontal gyrus and other regions including left lentiform nucleus putamen(t=4.991,P<0.05),right median cingulate and paracingulate gyri(t=4.471,P<0.05)and right postcentral gyrus(t=4.922,P<0.05),and increased functional connectivity between the orbital superior frontal gyrus and left middle frontal gyrus was found in CBT-I group(t=6.586,P<0.05).Conclusion rTMS and CBT-I may help alleviate insomnia and improve cognitive function of patients with chronic insomnia disorder.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Purpose/Significance To evaluate and study the quality of information published by users of internet medical platforms u-sing text content analysis method.Method/Process The text content of typical internet medical platforms in China is obtained by Python crawler,natural language processing(NLP)and clustering analysis are performed.Feature indexes are extracted and logistic regression model and grey relational degree correction are designed to construct an information quality evaluation index system.Result/Conclusion The information release and presentation of internet medical platforms can be strengthened from the aspects of information richness,char-acteristics of information publishers and user interaction,and users can be guided to release high-quality information and quickly identi-fy valuable information,so as to promote the sustainable development of internet medical platforms.

In view of the clinical graduate students' problems existing in the teaching of evidence-based medicine, such as having little knowledge of the course, lack of interest, not knowing how to retrieve, evaluate evidence and effectively use evidence, Xinjiang Medical University has car-ried on the reform in the curriculum content, teaching process, evaluation content and method of the teaching of EBM for the clinical graduate students. Practice shows that the clinical graduate students have significant improvement in objective examination average score, subjective examination average grades, total score and the students' satisfaction of the classroom teaching, and at the same time their interest in EBM courses and clinical thinking have also improved.