OBJECTIVE: To investigate the impact of bone mass and volume of low-density zones beneath the tibial plateau on the maximum von Mises stresses experienced by the cartilage and meniscus in the knee joint. METHODS: The study included one healthy adult volunteer, from whom CT scans were obtained, and one patient diagnosed with knee osteoarthrisis (KOA), for whom X-ray films were acquired. A static model of the knee joint featuring a low-density zone was established based on a normal knee model. In the finite element analysis, axial loads of 1 000 N and 1 800 N were applied to the weight-bearing region of the upper surface of the femoral head for model validation and subsequent finite element studies, respectively. The maximum von Mises stresses in the femoral cartilage, as well as the medial and lateral tibial cartilage and menisci, were observed, and the stress percentage of the medial and lateral components were concurrently analyzed. Additionally, HE staining, as well as alkaline magenta staining, were performed on the pathological specimens of patients with KOA in various low-density regions. RESULTS: The results of model validation indicated that the model was consistent with normal anatomical structures and correlated with previous calculations documented in the literature. Static analysis revealed that the maximum von Mises stress in the medial component of the normal knee was the lowest and increased with the advancement of the hypointensity zone. In contrast, the lateral component exhibited an opposing trend, with the maximum von Mises stress in the lateral component being the highest and decreasing as the hypointensity zone progressed. Additionally, the medial component experienced an increasing proportion of stress within the overall knee joint. HE staining demonstrated that the chondrocyte layer progressively deteriorated and may even disappear as the hypointensity zone expanded. Furthermore, alkaline magenta staining indicated that the severity of microfractures in the trabecular bone increased concurrently with the expansion of the hypointensity zone. CONCLUSION The presence of subtalar plateau low-density zone may aggravate joint degeneration. In clinical practice, it is necessary to pay attention to the changes in the subtalar plateau low-density zone and actively take effective measures to strengthen the bone status of the subtalar plateau low-density zone and restore the complete biomechanical function of the knee joint, in order to slow down or reverse the progression of osteoarthritis.
Humans ; Finite Element Analysis ; Knee Joint/physiology* ; Tibia/anatomy & histology* ; Cartilage, Articular/physiology* ; Menisci, Tibial/physiopathology* ; Tomography, X-Ray Computed ; Osteoarthritis, Knee/diagnostic imaging* ; Weight-Bearing ; Bone Density ; Adult ; Stress, Mechanical ; Male ; Middle Aged ; Biomechanical Phenomena ; Female

Objective:To investigate the value of 3.0T magnetic resonance imaging(MRI)in the assessment for clinically pathologic features of prostate cancer(PCa).Methods:The case data of 102 PCa patients who were confirmed by histology in The Second Affiliated Hospital of Bengbu Medical University from April 2020 to July 2024 were retrospectively analyzed.51 PCa patients of them were included in cancer group,and 51 patients with prostatic hyperplasia were included in hyperplasia group.Multi-parametric MRI was implemented in all patients.Imaging performance was scored by using Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1).The distribution of scores between the two groups was compared and analyzed.The correlations between the PI-RADS v2.1 scores and PCa clinically pathological features which included Gleason scores,serum prostate specific antigen(PSA)level,tumor staging and aggressiveness were analyzed and explored by using Spearman correlation analysis.The diagnostic efficacy of the 3.0T MRI technique for PCa was analyzed by using the receiver operating characteristic(ROC)curve.Results:The PI-RADS v2.1 score of cancer group was 4(4,5)scores,which was significantly higher than 2(3,4)scores of hyperplasia group,and the difference of that between two groups was significant(U=369.5,P<0.05).The rate of high scores(4,5 scores)of cancer group was more than that of hyperplasia group in the distribution of scores,and the difference of that between two groups was significant(x2=51.220,P<0.05).In patients of cancer group,PI-RADS v2.1 score showed significant correlation with serum PSA level,Gleason score,tumor staging and aggressiveness(P<0.05),respectively,and they were significant(r=0.815,0.723,0.693,P<0.05).ROC curve analysis showed that the area under curve(AUC)value of PI-RADS v2.1 score was 0.858(95%CI:0.783-0.932)in diagnosing PCa,which can effectively distinguish PCa and prostate hyperplasia.It had higher diagnostic efficacy,which was higher than that of serum PSA.Conclusions:3.0T MRI has favorable accuracy in diagnosing PCa,and it can be used as a noninvasive test method to diagnose and assess pathological features of tumor.

Objective To systematically review and quantify the content and structure of the non-accompanied wards policy texts at the provincial level in China from the perspective of policy tools,providing references and insights for optimizing and implementing future policies.Methods Using the policy analysis tools as framework,it applies content ana lysis to construct a two-dimensional analytical framework with the X-dimension and Y-dimension.A total of 19 policy texts related to non-accompanied ward issued by provincial governments in China from January 2000 to August 2024 were coded and analyzed.Results A total of 141 entries were coded.In the X-dimension,supply-oriented,demand-oriented,and environment-oriented policy tools accounted for 21.28%,19.86%,and 58.86%,respectively,indicating a greater reliance on environmental-oriented policy tools;In the Y-dimension,policies from the"12th Five-Year Plan"(16.31%),"13th Five-Year Plan"(14.89%),and"14th Five-Year Plan"(68.80%)phases were analyzed.The number of policies in the"14th Five-Year Plan"phase was the highest among the three periods.Conclusion The policy framework for non-accompanied wards in China is still in its initial exploration phase and has room for improvement.It is recommended that future policies optimize the use of policy tools,strengthen coordination among them,and support the development of non-accompanied wards.

Objective To investigate the efficacy of voriconazole in the treatment of pulmonary tuberculosis complicated with chronic pulmonary aspergillosis(CPA)based on CYP2C19 gene polymorphism detection and examine the factors affecting the efficacy for improving targeted therapy in clinical practice.Methods A total of 207 patients with pulmonary tuberculosis complicated with CPA treated in the Third People's Hospital of Kunming from December 2018 to November 2022 were randomly assigned to an observation group(105 cases)or a control group(102 cases).The patients in the control group received standard voriconazole treatment,while the patients in the observation group had their voriconazole regimen tailored based on CYP2C19 genotyping results.Plasma drug concentration levels,efficacy,and safety were compared between the two groups and in terms of CYP2C19 genotypes.Logistic regression analysis was used to identify the factors affecting treatment efficacy.Results The observation group showed significantly higher plasma voriconazole concentrations and overall antifungal efficacy compared to the control group(P＜0.05).In the observation group,CYP2C19 genotyping identified 37 extensive metabolizers(EM),47 intermediate metabolizers(IM),and 21 poor metabolizers(PM).Plasma concentration of voriconazole did not show significant difference between EM and IM(P＞0.05),but both PM and IM were associated with significantly lower plasma concentration of voriconazole than PM(P＜0.05).The clinical efficacy rate was 100％for PM,91.5％for IM,and 83.8％for EM(P＜0.05).The incidence of adverse events did not show significant difference among the three genotypes(P＞0.05).Logistic regression analysis revealed that lung cavitation,hypoalbuminemia,and agranulosis were significantly correlated with therapeutic efficacy(P＜0.05).Conclusions CYP2C19 gene polymorphism detection is valuable in clinical practice.It can inform anti-aspergillus therapy with voriconazole to effectively improve symptoms and clinical efficacy in patients with pulmonary tuberculosis complicated with CPA.Meanwhile,clinicians should be aware of the factors such as hypoproteinemia,agranulocytosis,and lung cavitation that may affect the efficacy of voriconazole.

Objective To investigate the efficacy of voriconazole in the treatment of pulmonary tuberculosis complicated with chronic pulmonary aspergillosis(CPA)based on CYP2C19 gene polymorphism detection and examine the factors affecting the efficacy for improving targeted therapy in clinical practice.Methods A total of 207 patients with pulmonary tuberculosis complicated with CPA treated in the Third People's Hospital of Kunming from December 2018 to November 2022 were randomly assigned to an observation group(105 cases)or a control group(102 cases).The patients in the control group received standard voriconazole treatment,while the patients in the observation group had their voriconazole regimen tailored based on CYP2C19 genotyping results.Plasma drug concentration levels,efficacy,and safety were compared between the two groups and in terms of CYP2C19 genotypes.Logistic regression analysis was used to identify the factors affecting treatment efficacy.Results The observation group showed significantly higher plasma voriconazole concentrations and overall antifungal efficacy compared to the control group(P＜0.05).In the observation group,CYP2C19 genotyping identified 37 extensive metabolizers(EM),47 intermediate metabolizers(IM),and 21 poor metabolizers(PM).Plasma concentration of voriconazole did not show significant difference between EM and IM(P＞0.05),but both PM and IM were associated with significantly lower plasma concentration of voriconazole than PM(P＜0.05).The clinical efficacy rate was 100％for PM,91.5％for IM,and 83.8％for EM(P＜0.05).The incidence of adverse events did not show significant difference among the three genotypes(P＞0.05).Logistic regression analysis revealed that lung cavitation,hypoalbuminemia,and agranulosis were significantly correlated with therapeutic efficacy(P＜0.05).Conclusions CYP2C19 gene polymorphism detection is valuable in clinical practice.It can inform anti-aspergillus therapy with voriconazole to effectively improve symptoms and clinical efficacy in patients with pulmonary tuberculosis complicated with CPA.Meanwhile,clinicians should be aware of the factors such as hypoproteinemia,agranulocytosis,and lung cavitation that may affect the efficacy of voriconazole.

Objective:To investigate the value of 3.0T magnetic resonance imaging(MRI)in the assessment for clinically pathologic features of prostate cancer(PCa).Methods:The case data of 102 PCa patients who were confirmed by histology in The Second Affiliated Hospital of Bengbu Medical University from April 2020 to July 2024 were retrospectively analyzed.51 PCa patients of them were included in cancer group,and 51 patients with prostatic hyperplasia were included in hyperplasia group.Multi-parametric MRI was implemented in all patients.Imaging performance was scored by using Prostate Imaging Reporting and Data System version 2.1(PI-RADS v2.1).The distribution of scores between the two groups was compared and analyzed.The correlations between the PI-RADS v2.1 scores and PCa clinically pathological features which included Gleason scores,serum prostate specific antigen(PSA)level,tumor staging and aggressiveness were analyzed and explored by using Spearman correlation analysis.The diagnostic efficacy of the 3.0T MRI technique for PCa was analyzed by using the receiver operating characteristic(ROC)curve.Results:The PI-RADS v2.1 score of cancer group was 4(4,5)scores,which was significantly higher than 2(3,4)scores of hyperplasia group,and the difference of that between two groups was significant(U=369.5,P<0.05).The rate of high scores(4,5 scores)of cancer group was more than that of hyperplasia group in the distribution of scores,and the difference of that between two groups was significant(x2=51.220,P<0.05).In patients of cancer group,PI-RADS v2.1 score showed significant correlation with serum PSA level,Gleason score,tumor staging and aggressiveness(P<0.05),respectively,and they were significant(r=0.815,0.723,0.693,P<0.05).ROC curve analysis showed that the area under curve(AUC)value of PI-RADS v2.1 score was 0.858(95%CI:0.783-0.932)in diagnosing PCa,which can effectively distinguish PCa and prostate hyperplasia.It had higher diagnostic efficacy,which was higher than that of serum PSA.Conclusions:3.0T MRI has favorable accuracy in diagnosing PCa,and it can be used as a noninvasive test method to diagnose and assess pathological features of tumor.

Objective To systematically review and quantify the content and structure of the non-accompanied wards policy texts at the provincial level in China from the perspective of policy tools,providing references and insights for optimizing and implementing future policies.Methods Using the policy analysis tools as framework,it applies content ana lysis to construct a two-dimensional analytical framework with the X-dimension and Y-dimension.A total of 19 policy texts related to non-accompanied ward issued by provincial governments in China from January 2000 to August 2024 were coded and analyzed.Results A total of 141 entries were coded.In the X-dimension,supply-oriented,demand-oriented,and environment-oriented policy tools accounted for 21.28%,19.86%,and 58.86%,respectively,indicating a greater reliance on environmental-oriented policy tools;In the Y-dimension,policies from the"12th Five-Year Plan"(16.31%),"13th Five-Year Plan"(14.89%),and"14th Five-Year Plan"(68.80%)phases were analyzed.The number of policies in the"14th Five-Year Plan"phase was the highest among the three periods.Conclusion The policy framework for non-accompanied wards in China is still in its initial exploration phase and has room for improvement.It is recommended that future policies optimize the use of policy tools,strengthen coordination among them,and support the development of non-accompanied wards.

OBJECTIVE To establish the specific chromatogram of Qianghuo Shengshi Tang(QHSS) reference sample, clarify the key quality attributes of QHSS, providing reference for the quality evaluation of QHSS reference sample. METHODS The SilGreen C18 column(4.6 mm×250 mm, 5 μm) was used. The mobile phase consisted acetonitrile and 0.2% formic acid aqueous solution. The detection wavelength was 328 nm. Established an HPLC characteristic spectrum analysis method for the reference sample of QHSS. A variety of chromatographic columns and different instruments were applied to investigate the adaptability of the system. HPLC-LTQ-Orbitrap MS was used to identify the specific peaks of the QHSS reference samples in positive ion mode. RESULTS There were 14 peaks in the specific chromatogram, which belonged to Notopterygii Rhizoma Et Radix, Angelicae Pubescentis Radix, Ligustici Rhizoma Et Radix, Chuanxiong Rhizome, Viticis Fructus, respectively. Ferulic acid(peak 3) was reference peak. A total of 22 compounds were identified by mass spectrometry, including coumarin and flavonoids. CONCLUSION The established specific chromatogram method of QHSS is simple, stable and reproducible. The material basis of QHSS reference sample is basically determined, providing a reference for the development and quality control of QHSS.

The hippocampus and its circuits play crucial roles in human learning, memory, and emotional regulation. Whether it is vascular cognitive impairment (VCI) or Alzheimer's disease (AD), damage to the hippocampus is a prominent pathological feature. This review summarizes the recent advance in multimodal magnetic resonance imaging in anatomy, blood supply, structure and function of the hippocampus and the circuits related to VCI and AD in recent years, aiming to provide help in early recognizing and differentially diagnosing VCI and AD.

Objective To explore the association between the single nucleotide polymorphism（SNP）of the core clock genes（ARNTL rs6486122 and PER1 rs2253820）of the circadian molecular clockwork and the incidence of ischemic stroke. Methods Candidate SNP genotypes were determined using the SNaPshot method. Genotypes were set as categorical variables. Logistic regression analysis was performed to compare genotypes and genetic models between the disease group and the control group，adjusting for related risk factors including age，sex，dyslipidemia，and past medical history，and the adjusted odds ratios（OR）and 95% confidence intervals（CI）of different genotypes and genetic models were calculated. Results The multivariable logistic regression analysis showed that the risk of stroke increased significantly with the age of subjects（OR=6.704，95%CI 5.188-8.644，P<0.001）；patients with hypertension had a 2.565-fold increased risk of ischemic stroke compared with individuals without hypertension（OR=2.565，95%CI 1.971-3.338，P<0.001）；patients with dyslipidemia were 1.700 times more likely to have ischemic stroke than individuals with normal blood lipid levels（OR=1.700，95% CI 1.230-2.348，P=0.001）；and increased systolic and diastolic blood pressure levels also increased the risk of stroke. For the rs2253820 locus of the PER1 gene，using the wild-type homozygous TT genotype as the reference，the CT genotype，CC genotype，and dominant genetic model significantly increased the risk of stroke（CT vs TT：OR=1.552，95% CI 1.194-2.018，P=0.001；CC vs TT： OR=1.295，95% CI 1.035-1.621，P=0.024；and the dominant model：OR=1.563，95% CI 1.215-2.012，P=0.001，respectively）. For the rs6486122 locus of the ARNTL gene，there was no significant association of any genotype or the genetic model with the incidence of ischemic stroke after adjustment（P > 0.05）. Conclusion Genetic variation at PER1 rs2253820 can increase the risk of ischemic stroke，where the C allele poses a higher risk of ischemic stroke. There is no significant association between ARNTL rs6486122 and the occurrence of ischemic stroke.