ObjectiveThis study aimed to explore the correlation between the quality of life （QOL） and different traditional Chinese medicine （TCM） syndromes in patients with myasthenia gravis （MG）， identifying potential influencing factors to provide new insights for clinical interventions and improving the QOL of patients with MG. MethodsA questionnaire survey was conducted on 93 adults with MG who visited the Department of Neurology at the Affiliated Hospital of Changchun University of Chinese Medicine from March 2023 to January 2024. Statistical analysis was performed on the clinical data collected using SPSS 24.0 software. ResultsAmong the 93 patients with MG， the average score for myasthenia gravis quality of life-15 （MGQOL-15） was 17.65±6.27， and that for the 36-item short form health survey （SF-36） was （106.13±11.83） scores. The QOL was rated as good for 16 patients and moderate for 77 patients. There were no statistically significant differences in the scores of MGQOL-15， SF-36， and their individual scales by gender or education level. Age showed statistically significant differences in MGQOL-15 and the role physical （RP） scale （P<0.05）， and occupational type showed significant differences in the vitality （VT） scale （P<0.01）. The Myasthenia Gravis Foundation of America （MGFA） classification had statistical significance on the total SF-36 score （P<0.01）， VT scale （P<0.01）， role emotional （RE） scale （P<0.05）， social functioning （SF） scale （P<0.05）， and physical functioning （PF） scale （P<0.01）. Among patients with different TCM syndromes， there were significant differences in MGQOL-15 scores （F=4.919， P<0.01）. Moreover， significant differences were observed in SF-36 scores （P<0.01）， VT scale （P<0.01）， RE scale （P<0.05）， mental health （MH） scale （P<0.01）， and SF scale （P<0.05）. ConclusionFactors affecting the QOL of patients with MG include age， occupational type， and clinical classification of MG. Specifically， a greater impact on the QOL of older patients is observed， while physical laborers have a poorer QOL compared to non-physical laborers. Patients classified as MGFA type Ⅱ and higher have a poorer QOL. Additionally， there is a potential correlation between the QOL and TCM syndromes， with patients presenting with spleen and kidney Qi deficiency having a lower QOL than those with spleen and stomach Qi deficiency or Qi and Yin deficiency， which is particularly evident in the VT， RE， MH， and SF scales.

Objective:To analyze the efficacies of unilateral biportal endoscopy(UBE)and percutaneous endoscopic transforaminal discectomy(PETD)in treatment of lumbar disc herniation(LDH),and to explore the optimal selection of minimally invasive surgical approaches for the The LDH patients.Methods:A retrospective analysis was performed on the clinical data of 64 LDH patients who underwent surgery at Liwan Central Hospital of Guangzhou City in Guangdong Province,between January 2020 and June 2024.The surgical approaches were determined through physician-patient communication,and the patients were divided into UBE group(n=30)and PETD group(n=34).The materials of patients were recorded including gender,age,body mass index(BMI),percentages of affected segments,course of disease,duration of hospitalization,operation duration,intraoperative blood loss,numbers of intraoperative fluoroscopy,total incision length,and time to full weight-bearing(WB).The therapeutic outcomes were evaluated using Oswestry disability index(ODI),Visual Analog Scale(VAS)scores for low back pain and leg pain,MacNab criteria,and spinal canal areas at the affected segment.the postoperative complications of the patients in two groups were analyzed.Results:There were no statistically significant differences in age,gender composition ratio,BMI,course of disease,and percentages of affected segments of the patients between UBE group and PETD group(P＞0.05).Compared with PETD group,the intraoperative blood loss,total incision length,and time to full WB of the patients in UBE group were significantly increase(P＜0.01),while the number of intraoperative fluoroscopy time was decreased(P＜0.01).Compared with pre-operation,the ODI scores and VAS scores for low back and leg pain of the patients at final follow-up in both groups were decreased(P＜0.01),and the spinal canal areas at the affected segments of the patients were increased(P＜0.01).At final follow-up,compared with PETD group,the ODI score and VAS scores for low back and leg pain of patients in UBE group were decreased(P＜0.01),while the spinal canal areas at the affected segments of the patients was increased(P＜0.01).According to MacNab criteria,the percentages of excellent and good had no significant difference between two groups(P＞0.05).The incidence of complication showed no statistical difference between two groups(P＞0.05).Conclusion:Both UBE and PETD yield satisfactory outcomes in the treatment of single-segment LDH.PETD is less invasive and permits earlier time to full WB,whereas UBE provides more extensive decompression and superior long-term efficacy.The surgical approach selection should be individualized based on specific factors in the clinic.

Liquid biopsy,as an emerging minimally invasive early detection method for tumors,has shown great potential;however,several challenges limit its application in tumor diagnosis.Tetrahedral framework nucleic acids(tFNAs)have garnered significant attention in the biomedical field due to their structural stabili-ty,programmability,and superior intracellular endocytosis and tissue penetration capabilities.These properties make tFNAs an ideal candidate for constructing advanced biosensing platforms for liquid biopsy applications.tFNAs significantly enhance the binding efficiency of circulating tumor cells(CTCs),circulating tumor DNA(ctDNA),and extracellular vesicles(EVs),thereby improving the sensitivity and detection capability of the liquid biopsy biosensing platform.This review provides a comprehensive overview of tFNAs-based biosensors in the liquid biopsy field.It elaborates on the synthesis,characteristics,and applications of tFNAs in detecting CTCs,ctDNA,and EVs.Additionally,it discusses the diverse strategies and advantages of tFNAs in biosens-ing applications,highlighting how these features significantly enhance the performance and reliability of bio-sensors.Finally,this review addresses the current challenges faced by tFNAs in liquid biopsy and explores their future prospects,aiming to facilitate early screening,precise diagnosis,and integrated diagnostic-treat-ment approaches for tumors.

In the field of healthcare service,it is crucial to optimize medical innovation services by combining the preferences of health service providers and demanders(i.e.,stakeholders).The best-worst scaling(BWS)method is a recently developed stated preference method for assessing preferences with distinctive advantages.Nevertheless,there is a lack of a comprehensive introduction to stakeholder preference assessment using BWS,thus constraining its applications and promotion.This paper introduces the process of using BWS to assess service providers'preferences for the Shared Medical Appointment for diabetes(SMART),an integrated healthcare service of medicine and health management,in the hope of providing reference for researchers for promoting the use of BWS in implementation research.

Objective To study the effects of porous prothesis with radial gradient and homogenized structures on stress transmission in the tibia by using finite element method.Methods Based on the reverse engineering technology,the tibial model was constructed,and the bionic trabecular bone structure prosthesis with gradient change of pore edge diameter and the homogeneous bionic trabecular bone structure prosthesis were designed.The Vicon dynamic capture platform was used to obtain the human gait and the axial force of the tibia-femoral joint during flexion,which was imported into ANSYS Workbench as a boundary condition for mechanical performance analysis.Results In the case of proximal defect,the von Mises stress of the bone for prosthesis with radial gradient structure was increased by 3.68 MPa,and that in the case of distal defect was increased by 7.34 MPa.Compared with the homogenized prosthesis,the von Mises stress of the proximal and distal defects was decreased by 171 MPa and 190.4 MPa,respectively.Conclusions The stress of the radial gradient structure prosthesis diffuses from the outside to the middle high porosity area along the prosthesis,which can effectively transfer the tibial plateau load,reduce stress concentration of the prosthesis,improve bone stress and prolong service life of the prosthesis.This study provides a theoretical reference for clinical prosthesis replacement.

Objective:To investigate the effects of lezumab adjuvant therapy on the degree of retinal vasculopathy and immune response in the treatment of macular central diabetic retinopathy (DR).Methods:From July 2022 to December 2023, 120 patients with DR in macular central who received treatment in the Xi′an People′s Hospital (Xi′an Fourth Hospital) were retrospectively selected and divided into two groups according to the treatment methods: the observation group (60 cases, lezumab combined with sitagliptin), and the control group (60 cases, sitagliptin). Patients′glucose metabolism, visual acuity, degree of retinopathy, inflammation [tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), interleukin-10 (IL-10)] and angiogenesis related factors [serum vascular endothelial growth factor (VEGF), midkine (MK), 5′-nucleotidase (CD73)] were evaluated, and the curative efficacy of the two groups was compared. The security of the two schemes was compared.Results:Compared with the control group, the serum concentrations of MK, CD73, TNF-α and VEGF were lower in the observation group after treatment: (1.44 ± 0.06) ng/L vs. (1.67 ± 0.11) ng/L, (1.10 ± 0.27) ng/L vs. (1.31 ± 0.26) ng/L, (11.62 ± 0.89) ng/L vs. (15.96 ± 4.42) ng/L, (84.07 ± 27.07) ng/L vs. (100.72 ± 16.05) ng/L, while the concentration of IL-10 was higher: (65.65 ± 8.68) ng/L vs. (60.02 ± 5.07) ng/L, with statistically significant differences ( P<0.05). There were no statistically significant differences in fasting blood glucose (FBG) and 2 h postprandial blood glucose between two groups before and after treatment ( P>0.05). After treatment, the macular thickness and visual field gray value in the observation group were lower than those in the control group: (302.81 ± 77.08) μm vs. (336.44 ± 10.35) μm, (1.55 ± 0.43)% vs. (2.09 ± 0.51)% ( P<0.05). After 3 months of treatment, the visual acuity in the observation group was higher than that in the control group: 0.493 ± 0.103 vs. 0.439 ± 0.084 ( P<0.05). No serious adverse reactions occurred in both groups. Conclusions:Lezumab assisted sitagliptin has a significant effect in the treatment of DR, which can reduce the degree of lesions, improve vision, and reduce the levels of inflammation and angiogenesis related factors.

To establish a rapid visual detection method for Akabane virus(AKAV)on site,specific primers and probes based on the S fragment of AKAV were designed in this experiment.Corre-sponding groups were added to the primers or probes to fulfil the requirement of the combination of recombinase polymerase amplification(RPA)with lateral flow dipstick(LFD).The reaction temperature and time,concentrations of the primer and probe were optimized to establish the RPA-LFD method for detecting AKAV.After that,the specificity,sensitivity and clinical reliability of the method were evaluated.The results showed that after 20 minutes of reaction at 37 ℃,the test results could be read on LFD paper.There was no cross reaction against blue tongue virus,Pasteurella multocida,bovine infectious rhinotracheitis virus and bovine Mycoplasma bovis,and the detection limit was 2.5 × 100 copies/μL of standard plasmid.Detection of clinical samples showed a consistent results with that by RT-PCR method.These findings indicated that the RPA-LFD method established had the advantages of good specificity,high sensitivity,simple operation and visualization,and could be applied to clinical detection,which provides new technical support for the rapid diagnosis and prevention and control of AKAV.

To establish a rapid visual detection method for Akabane virus(AKAV)on site,specific primers and probes based on the S fragment of AKAV were designed in this experiment.Corre-sponding groups were added to the primers or probes to fulfil the requirement of the combination of recombinase polymerase amplification(RPA)with lateral flow dipstick(LFD).The reaction temperature and time,concentrations of the primer and probe were optimized to establish the RPA-LFD method for detecting AKAV.After that,the specificity,sensitivity and clinical reliability of the method were evaluated.The results showed that after 20 minutes of reaction at 37 ℃,the test results could be read on LFD paper.There was no cross reaction against blue tongue virus,Pasteurella multocida,bovine infectious rhinotracheitis virus and bovine Mycoplasma bovis,and the detection limit was 2.5 × 100 copies/μL of standard plasmid.Detection of clinical samples showed a consistent results with that by RT-PCR method.These findings indicated that the RPA-LFD method established had the advantages of good specificity,high sensitivity,simple operation and visualization,and could be applied to clinical detection,which provides new technical support for the rapid diagnosis and prevention and control of AKAV.

Objective To study the effects of porous prothesis with radial gradient and homogenized structures on stress transmission in the tibia by using finite element method.Methods Based on the reverse engineering technology,the tibial model was constructed,and the bionic trabecular bone structure prosthesis with gradient change of pore edge diameter and the homogeneous bionic trabecular bone structure prosthesis were designed.The Vicon dynamic capture platform was used to obtain the human gait and the axial force of the tibia-femoral joint during flexion,which was imported into ANSYS Workbench as a boundary condition for mechanical performance analysis.Results In the case of proximal defect,the von Mises stress of the bone for prosthesis with radial gradient structure was increased by 3.68 MPa,and that in the case of distal defect was increased by 7.34 MPa.Compared with the homogenized prosthesis,the von Mises stress of the proximal and distal defects was decreased by 171 MPa and 190.4 MPa,respectively.Conclusions The stress of the radial gradient structure prosthesis diffuses from the outside to the middle high porosity area along the prosthesis,which can effectively transfer the tibial plateau load,reduce stress concentration of the prosthesis,improve bone stress and prolong service life of the prosthesis.This study provides a theoretical reference for clinical prosthesis replacement.

Objective:To investigate the effects of lezumab adjuvant therapy on the degree of retinal vasculopathy and immune response in the treatment of macular central diabetic retinopathy (DR).Methods:From July 2022 to December 2023, 120 patients with DR in macular central who received treatment in the Xi′an People′s Hospital (Xi′an Fourth Hospital) were retrospectively selected and divided into two groups according to the treatment methods: the observation group (60 cases, lezumab combined with sitagliptin), and the control group (60 cases, sitagliptin). Patients′glucose metabolism, visual acuity, degree of retinopathy, inflammation [tumor necrosis factor-alpha (TNF-α), interleukin-2 (IL-2), interleukin-10 (IL-10)] and angiogenesis related factors [serum vascular endothelial growth factor (VEGF), midkine (MK), 5′-nucleotidase (CD73)] were evaluated, and the curative efficacy of the two groups was compared. The security of the two schemes was compared.Results:Compared with the control group, the serum concentrations of MK, CD73, TNF-α and VEGF were lower in the observation group after treatment: (1.44 ± 0.06) ng/L vs. (1.67 ± 0.11) ng/L, (1.10 ± 0.27) ng/L vs. (1.31 ± 0.26) ng/L, (11.62 ± 0.89) ng/L vs. (15.96 ± 4.42) ng/L, (84.07 ± 27.07) ng/L vs. (100.72 ± 16.05) ng/L, while the concentration of IL-10 was higher: (65.65 ± 8.68) ng/L vs. (60.02 ± 5.07) ng/L, with statistically significant differences ( P<0.05). There were no statistically significant differences in fasting blood glucose (FBG) and 2 h postprandial blood glucose between two groups before and after treatment ( P>0.05). After treatment, the macular thickness and visual field gray value in the observation group were lower than those in the control group: (302.81 ± 77.08) μm vs. (336.44 ± 10.35) μm, (1.55 ± 0.43)% vs. (2.09 ± 0.51)% ( P<0.05). After 3 months of treatment, the visual acuity in the observation group was higher than that in the control group: 0.493 ± 0.103 vs. 0.439 ± 0.084 ( P<0.05). No serious adverse reactions occurred in both groups. Conclusions:Lezumab assisted sitagliptin has a significant effect in the treatment of DR, which can reduce the degree of lesions, improve vision, and reduce the levels of inflammation and angiogenesis related factors.