Objective:To explore the application value of PAX1/JAM3 methylation detection by cervical self-collected specimen in cervical cancer screening and the management of premenopausal and postmenopausal women.Method:This study is a single center cross-sectional study. From January 2023 to November 2023, cervical self-collected and physician-collected specimens at the colposcopy clinic were detected the PAX1/JAM3 methylation (PAX1 m/JAM3 m) testing. The consistency between self-collected and physician-collected specimens for PAX1 m/JAM3 m detection were compared based on histopathology. In addition, the clinical efficacy of methylation detection with high-risk human papillomavirus (hrHPV), liquid-based cytology (LBC), and their combination for cervical cancer screening were compared in the study. Results:A total of 301 women were recruited to undergo referral colposcopy examination, and statistical analysis was conducted on 272 women with pathological and diagnostic information. Among them, 102 cases (37.5%) were diagnosed as normal cervical tissue or chronic cervicitis, 72 cases (26.4%) were cervical intraepithelial neoplasia grade 1 (CIN1), 43 cases (15.8%) were CIN2, 29 cases (10.7%) were CIN3, and 26 cases (9.6%) were cervical cancer. According to the minimum quantity formula, they were divided into a consistency cohort of 81 participants and a validation cohort of 191 participants. The consistency between cervical self-collected and physician-collected specimens for detecting PAX1 m/JAM3 m. Results from spearman correlation analysis showed a positive correlation between the self-collected and physician-collected results of PAX1 m/JAM3 m detection, and the correlation coefficient R values are 0.858 ( P<0.001) and 0.828 ( P<0.001). The sensitivity and specificity of PAX1 m/JAM3 m detection for diagnosing CIN2 or more severe lesions (CIN2+) were 77.6% [95% confidence interval ( CI) 65.3%-86.4%] and 87.2% (95% CI 80.5%-91.9%), respectively. In clinical performance comparison, the sensitivity of PAX1 m/JAM3 m combined with HPV16/18 detection, 89.7% (95% CI 79.2%-95.2%), was the same as that of hrHPV detection in CIN2+and 96.0% (95% CI 80.4%-99.3%) in CIN3+, which is higher than 92.0% (95% CI 75.0%-97.8%) of hrHPV and 82.6% (95% CI 62.9%-93.0%) of LBC or the combination of sPAX1 m/JAM3 m and LBC low-grade and higher squamous intraepithelial lesion testing [87.0% (95% CI 67.9%-95.5%)]. Conclusions:Self-collected specimens by women for detection of PAX1 and JAM3 methylation as a promising screening tool for cervical cancer has operational and clinical feasibility. The methylation test can optimize the current cervical cancer screening plan, reduce the number of referral women with false positive diagnosis to colposcopy, and is of great significance for reducing fertility protection and preventing missed diagnosis in women of childbearing age.

In recent years,psoriatic arthritis has become a major problem in the medical field,with cases gradually increasing in China,and it is still incurable.Here,we summarize the pathogenesis and clinical characteristics of currently available animal models of psoriatic arthritis based on Chinese and Western medical evidence.Literature in line with this topic was collated and summarized.The etiology and pathogenesis according to Chinese and Western medicine of existing psoriatic arthritis models were given agreement scores;the diagnostic criteria of Chinese and Western medicine were compared;and the models'characteristics and degree of agreement with clinical observations were assessed.This study found that the human leukocyte antigen transgenic mouse model,the multiple hybridization transgenic mouse model,and the mannan-induced mouse model had the highest agreement scores.As psoriatic arthritis is more common in Europe,methods for the preparation of animal models have been mostly imported from abroad,and very few animal models have the characteristics of Chinese medicine;therefore,the model fitness scores of Western diagnoses were higher than those of Chinese diagnoses as a whole.We hope to leverage the unique diagnosis and treatment method of Chinese medicine further to improve the types of psoriatic arthritis animal models available.This study provides a basis for the construction of improved animal models of psoriatic arthritis with combined traditional Chinese and Western medicine characteristics.

Objective To investigate the effect of microglial derived extracellular vesicles on neuronal damage in the context of heat stress.Methods After BV2 microglial cells were exposed to heat stress,the supernatant was collected and subjected to ultracentrifugation at different speeds to obtain large and small vesicles,respectively.Nano Particle Tracking and Zeta Potential Distribution Analyzer was used to measure and analyze the size distribution of the large vesicles and small vesicles.Western blotting was used to detect the expression of specific vesicle surface markers,TSG101,CD63 and flotillin-1.Microglial extracellular vesicles were labeled with PKH67 dye and then co-cultured with N2a cells to examine the uptake by capacity the neurons.After large and small vesicles derived from microglia after heat stress stimulation were co-cultured with N2a cells,respectively,CCK-8 assay,lactate dehydrogenase (LDH)assay,Trypan blue staining and TUNEL assay were employed to evaluate heat stress induced neuronal damage.Results The small vesicles were in a particle size of 30～120 nm,and highly expressed TSG101 and CD63,whereas the large vesicles,in a size of 90～1000 nm,highly expressed flotillin-1.The BV2-derived extracellular vesicles could be taken up by N2a cells and were proved to be involved in the modulation of N2a cell injury caused by heat stress.CCK-8 assay showed that both large and small vesicles of microglial cells inhibited the viability of N2a cells after heat exposure (P<0.05).The results of LDH assay,Trypan blue staining and TUNEL assay showed that both large (P<0.05)and small vesicles (P<0.01)significantly enhanced the LDH release,blue stain intensity and apoptosis of N2a cells after heat exposure,and the release,intensity and apoptosis were stronger in the cells treated with small vesicles than those group of large vesicles.Conclusion Microglia aggravate heat stress-induced neuronal damage through releasing extracellular vesicles.

OBJECTIVE To study the improvement effects and mechan ism of thalidomide on Alzheimer ’s disease （AD）model of Caenorhabditis elegans . METHODS In this study ，the BR 5270 strain of C. elegans was used as AD model and BR 5271 strain as the control. The effects of thalidomide （0.5，2.0，6.0，15.0 mg/mL）on the motility of BR 5270 strains of C. elegans were studied by the basal slowing response assay ；the effects of thalidomide （0.5，2.0，6.0，15.0 mg/mL）on the survival time of BR 5270 strain of C. elegans were studied by life assay ；the effects of thalidomide （0.5，2.0，6.0 mg/mL）on learning and memory ability of BR 5270 strain of C. elegans were studied by short-term and long-term learning and memory assay. RT-PCR technology was used to study the effects of thalidomide （0.5，2.0，6.0 mg/mL）on mRNA expression of phosphatidylinositol 3-kinase（PI3K）/protein kinase B （Akt）signal pathway related genes （Age-1，Akt-1，Gsk-3）and calpain homologous gene （Clp-1）in BR 5270 strain of C. elegans . RESULTS After the intervention of thalidomide ，oscillation times of BR 5270 strain of C. elegans increased significantly within 30 s （except for 0.5 mg/mL group ），and the 10％ of maximum life span was prolonged significantly （only 0.5 mg/mL group ）；the short-term and long-term learning indexes were improved significantly （only 6.0 mg/mL group ）；mRNA expression of Age-1 and Akt-1（except for 0.5，2.0 mg/mL groups ）were increased significantly ，mRNA expression of Gsk-3（except for 0.5 mg/mL group ） and Clp-1 were decreased （P＜0.05 or P＜0.01）. CONCLUSIONS Thalidomide can ameliorate the dyskinesia of AD model of C. elegans，prolong the lifespan of this strain ，and enhance its learning and memory ability. Its mechanism of action may be related to activation of PI 3K/Akt signaling pathway and inhibition of calpain.

Objective:To evaluate the efficacy of compatibility of different opioids for postoperative patient-controlled intravenous analgesia (PCIA) in the patients undergoing gastrointestinal surgery.Methods:A total of 6 556 patients undergoing PCIA after gastrointestinal surgery in the first affiliated Hospital of Air Force military Medical University from May 2018 to March 2022 were retrospectively collected and divided into sufentanil plus nalbuphine group (SN group), hydromorphine plus nalbuphine group (HN group) and sufentanil group (S group). In SN, HN and S groups, the PCIA solutions contained sufentanil 100 μg+ nalbuphine 40 mg, hydromorphone 10 mg+ nalbuphine 40 mg, sufentanil 200 μg, respectively, in 100 ml of normal saline, and the PCA pump was set up with a background infusion at a rate of 1 ml/h, bolus dose 0.5 ml, and lockout interval 10 min.The demographic data, the number of patients with insufficient analgesia at rest and during activity (visual analog scale score≥4) at 24 and 48 h after operation, adverse reactions, time to first flatus and first postoperative off-bed time were collected.Results:Compared with S group, the incidence of insufficient analgesia at rest and during activity, dizziness, nausea and vomiting, effective pressing times of PCA and consumption of drugs in the analgesic pump were significantly decreased at 24 and 48 h after operation in HN group and SN group, the incidence of drowsiness was decreased at 24 h after operation, and the time to first flatus and first postoperative off-bed time were shortened in HN group, and the incidence of somnolence was increased at 48 h after operation in SN group ( P<0.05). Compared with SN group, the incidence of insufficient analgesia at rest at 24 and 48 h after operation was significantly increased, the incidence of insufficient analgesia during activity, dizziness, nausea and vomiting, effective pressing times of PCA and consumption of drugs in the analgesic pump were decreased, the incidence of drowsiness was increased at 24 h after operation, the incidence of somnolence was decreased at 48 h after operation, and the time to first flatus and first postoperative off-bed time were shortened in HN group ( P<0.05). Conclusions:Hydromorphine mixed with nalbuphine provides better efficacy than sufentanil mixed with nalbuphine and sufentanil and is helpful in shortening the recovery time of gastrointestinal function when used for postoperative PCIA in the patients undergoing gastrointestinal surgery.

ObjectivesTo introduce the progress in neurological classification of spinal cord injury (SCI) with complications. MethodsThe literatures in recent ten years were reviewed and summarized. ResultsIn January, 2022, a new neurological classification of SCI with complications in the International Standards for Neurological Classification of SCI (ISNCSCI) was published by the focus group of the American Spinal Injury Association (ASIA) International Standards Committee, with the extended "*"-tag concept, sensory and motor examination results impacted by SCI complication above, at, or below the neurological level of injury (NLI) could be consistently documented, scored, and classified. ConclusionThis new taxonomy in neurological classification of SCI with complications has overcome the shortcomings of the previous ISNCSCI versions and benefits the accuracy of ISNCSCI classifications, it could be tried in the clinical application.

Objective: To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of stage Ⅲ Kümmell＇s disease with no neurological symptom. Methods: From January 2009 to June 2018, 45 patients underwent PKP for stage Ⅲ Kümmell＇s disease with no neurological symptom at Department of Orthopaedics, The First Hospital Affiliated to Soochow University. They were 12 males and 33 females, aged from 61 to 85 years (average, 70.9 years). Their visual analog scale (VAS) scores for back pain, Oswestry disability indexes (ODI), heights of fractured vertebrae and kyphosis cob angles were recorded and compared between preoperation, one day, 3 months and final follow-up after operation. Results: All the 45 patients were followed up for 12 to 48 months (average, 28.0 months). Their VAS scores (2.4±0.7, 2.2±0.7 and 2.3±0.6), ODI sores (34.7±6.8, 34.2±6.5 and 34.1±6.6) and cobb angles (15.7°±2.2°, 15.8°±2.2° and 15.9°±2.4°) at one day, 3 months and final follow-up after operation were significantly lower than those (8.2±1.1, 75.3±9.0 and 25.2°±3.9°) before operation (P<0.001). Their anterior height ratios of the fractured vertebra (54.0%±4.3%, 53.7%±4.2% and 53.6%±4.0%) and median height ratios of the fractured vertebra (56.8%±4.0%, 56.5%±3.9% and 56.6%±3.9%) at one day, 3 months and final follow-up after operation were significantly higher than those (25.8%±3.9% and 27.2%±3.1%) before operation (P<0.001). The rate of cement leakage was 13.3%(6/45). No patients had neurological symptoms after operation. Conclusion PKP is a minimally invasive, safe and effective treatment for stage Ⅲ Kümmell's disease with no neurological symptom, because it can relieve the symptoms of the patients, restore the height of the fractured vertebral body and reduce the local kyphosis cobb angle.

Objective To evaluate the clinical effects of minimally invasive percutaneous new C2transpedicular lag-screw fixation for management of Hangman's fractures.Methods From October 2015 to June 2017,25 patients who had Hang-man's fracture were operated with minimally invasive percutaneous new C2transpedicular lag-screw fixation assisted by infrared navigation,among them there were 18 male and 7 female,aged from 28 to 70 years[average(46.1±13.3)years].According to the Levine-Edwards classification:16 patients were TypeⅠ,6 patients were TypeⅡand 3 patients were TypeⅡA.The cause of the in-jury was road traffic accident in 20 patients and fall from height in 5 patients.19 patients were simple Hangman's fracture and oth-er associated lesions included odontoid fracture of TypeⅡ(2 patients),atlas fracture of TypeⅠ(2 patients),rupture of spleen(1 pa-tient),and rib fractures(1 patient).According to American Association for spinal cord injury,graded as spinal cord injury D in 3 cases and E in 22 cases.The clinical outcomes were evaluated by visual analog scale(VAS)scores and related indicators,such as operation time,the range of motion(ROM)of cervical spine and ratio of bony union were recorded.The pre-and post-operative VAS scores of neck pain were compared with repeated measures analysis of variance. Results The mean follow-up time was (12.5±6.0)months,ranging from 3 to 24 months.Satisfactory reduction was obtained in all cases(minimal translation≤2 mm with-out obvious C2,3angulation).The average operation time was(65.9±12.1)min.At first day,one month,three months and the last fol-low-up, VAS scores of neck pain decreased comparing with preoperational measurements. There was significant difference be-tween the pre-and post-operative VAS scores of neck pain(t=24.7,25.8,23.1,24.1,P<0.001).According to American Associa-tion for spinal cord injury,three cases restored from D to E.There was no spinal cord or vertebral artery injury during operation and there was no screw loosing or breakage and cervical malformation happened during follow-up period. Bony fusion was achieved in all of these cases and the range of neck rotation was stored normal at the last follow-up.The average time of Bony fu-sion was(3.4±0.8)months.Conclusion The primary clinical efficacies of minimally invasive percutaneous new C2transpedicu-lar lag-screw fixation for treatment of Hangman's fracture were satisfactory,which carries precision and safety,immediate stability and more reliable.So it could be considered as a new choice for management of Hangman's fractures.

Objective To explore the prevention for hip dysplasia after pediatric spinal cord injury. Methods From March, 2017, the families of 47 children with spinal cord injury accepted education for preventing improper posture of sitting and sleeping and other interventions, and 23 of them were followed up for three months or more. Results New hip dislocation was found in one child, and 18 children developed almost normally in hip, the other four children with old hip dislocation did not worsen.Conclusion Intervention in time may prevent the hip dislocation in children with spinal cord injury.

Vascular morphology and function changes exist in degenerative retinopathy,which have an important influence on the development and prognosis of the disease.The literature has been reported that retinal vascular structure and function change can be found early by using the retinal oximeter,color Doppler flow imaging,ocular pulse amplitude and so on,as well as exploring the primary and secondary factors affecting the development of retinal blood vessels.This article reviews the vascular behavior characteristics in degenerative retinopathy and their influence factors.