BACKGROUND:After the internal fixation of cannulated screws in femoral neck fractures,because the affected limb is often unable to bear weight in the short term and the implants with high stiffness have a stress shielding effect on the fracture end,it is easy to cause osteoporosis of the affected limb and changes in the biomechanical distribution of the proximal femur,the incidence of osteonecrosis of the femoral head is high after surgery.At present,few studies have been conducted on the biomechanical effects of osteoporosis at the proximal end of the femur occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws. OBJECTIVE:Using finite element analysis,to investigate the biomechanical effects of osteoporosis occurring after femoral neck fracture surgery on femoral neck fracture treated with cannulated screws and explore the role of biomechanical factors in osteonecrosis of the femoral head. METHODS:Based on the obtained CT scan data of the femur in a patient with a femoral neck fracture,a proximal femoral model for internal fixation for femoral neck fracture was established by Mimics 19.0,3-Matic,UG 11.0,Hypermesh 14.0,and Abaqus software.One finite element model of the proximal femur without osteoporosis and three finite element models of the proximal femur with osteoporosis were analyzed using Abaqus software.The stress,contact pressure,displacement peak and cloud map under different components of the four models were measured and analyzed,and the internal stress changes and distribution of the femoral head were compared and analyzed. RESULTS AND CONCLUSION:The stresses and contact pressures of the femoral head and lower anterior cannulated screws varied more with the degree of osteoporosis.The peak displacement of the four models increased slowly with the degree of osteoporosis.By one-way analysis of variance,there was no significant effect of the degree of osteoporosis on the peak stress,contact pressure,and displacement of the different components.The internal stress distribution of the femoral head changed with the degree of osteoporosis.Changes in the biomechanical environment of the proximal femur have an important impact on osteonecrosis of the femoral head.

Objective To investigate the effects of icariin on high glucose-induced autophagy and apoptosis of podocytes,and the regulating effects on mammalian target of rapamycin(mTOR)/serine-threonine kinase(Akt)/cyclic adenosine monophosphate response element binding protein(CREB)pathway.Methods The mouse podocytes MPC5 were taken and divided into five groups:normal control group(5.5 mmol·L-1 glucose),high glucose group(30 mmol·L-1 glucose),icariin group(30 mmol·L-1glucose+5 μmol·L-1icariin),GDC-0349 group(30 mmol·L-1glucose+50 μmol·L-1 GDC-0349),icariin+GDC-0349 group(30 mmol·L-1 glucose+5 μmol·L-1 icariin+50 μmol·L-1 GDC-0349).Cultured for 48 hours,the tetramethylazozolium salt method was used to detect the viability of MPC5 cells;acridine orange staining was used to observe the autophagy of MPC5 cells;apoptosis of MPC5 cells was detected by flow cytometry;Western blotting was used to detect the expression of autophagy[microtubule associated protein one light chain 3(LC3)II,LC3Ⅰ,autophagy-related protein(Beclin-1)],apoptosis[Bcl-2 related X protein(Bax),B cell lymphoma-2(Bcl-2)]and mTOR/Akt/CREB pathway-related proteins of MPC5 cells.Results Compared with the normal control group,the cell viability,expression levels of Bcl-2,phosphorylated mTOR(p-mTOR)/mTOR,phosphorylated Akt(p-Akt)/Akt,phosphorylated CREB(p-CREB)/CREB protein of MPC5 cells in the high glucose group were significantly decreased(P＜0.05),the autophagy ability was enhanced,the autophagosome showed orange fluorescence,and the apoptosis rate,LC3Ⅱ/LC3Ⅰ,Beclin-1,Bax protein expression levels were significantly increased(P＜0.05).Compared with the high glucose group,the cell viability,LC3Ⅱ/LC3Ⅰ,Beclin-1,Bcl-2,p-mTOR/mTOR,p-Akt/Akt,p-CREB/CREB protein expression levels of MPC5 cells in icariin group were significantly increased,the autophagy ability was further enhanced,the number of autophagosomes was increased,the autophagosomes showed brick red fluorescence(P＜0.05),the apoptosis rate and Bax protein expression level were significantly decreased(P＜0.05),and the cell viability,LC3Ⅱ/LC3Ⅰ,Beclin-1,Bcl-2,p-mTOR/mTOR,p-Akt/Akt and p-CREB/CREB proteins expression levels of MPC5 cells in GDC-0349 group were significantly decreased,the autophagy ability was weakened,the number of autophagosomes was reduced,the autophagosomes showed orange fluorescence(P＜0.05),and the apoptosis rate and Bax protein expression level were significantly increased(P＜0.05);icariin+GDC-0349 could reverse the effect of icariin on high glucose induced MPC5 cells(P＜0.05).Conclusion Icariin promotes elevated glucose-induced podocyte autophagy and inhibits apoptosis by activating the mTOR/Akt/CREB pathway.

Lyme disease is a natural zoonotic infectious disease transmitted by ticks infected by different genotypes of Borre-lia burgdorferi sensu lato,which was discovered in the 1970s.This pathogen is prevalent primarily in temperate and subtropi-cal areas.Dogs,cats,horses,cattle,deer,and other animals are susceptible,and humans are also susceptible hosts.The main symptoms of Lyme disease in humans are erythema migrans,arthritis,and other neurological symptoms,and the common symptoms in infected animals include joint diseases,coat shedding,fever,laminitis,and lameness.Lyme disease is wide-spread,but diagnosis is difficult,and this disease is easily misdiagnosed and missed.Awareness of Lyme disease must be in-creased to avoid its toll on livestock and the pet industry.Therefore,this article reviews research progress in diagnosis and con-trol technology for animal Lyme disease and Borrelia burgdorferi,to provide a reference for accurate,rapid diagnosis and con-trol of Lyme disease.

Objective:To compare the clinical efficacy of customized titanium plate and conventional maxillary protraction treatment in patients with skeletal class Ⅲ malocclusion during growth spurt.Methods:During growth spurt, skeletal class Ⅲ patients with maxillary hypoplasia who were treated in the Department of Orthodontics, Capital Medical University School of Stomatology from August 2018 to July 2021 were prospectively enrolled. They were treated with maxillary protraction using customized titanium plates (customized titanium plate group) and conventional methods (conventional protraction group), respectively. Lateral cephalometric radiographs were collected before and after treatment for conventional cephalometric analysis, including SNA angle (angle between Sella, Nasion and A point), ANB angle (angle between A point, Nasion, and B point), FH-MP angle (mandibular plane angle), Y-axis angle, U1-L1 angle (upper to lower central incisor angle), U1-SN angle (upper incisor to SN plane angle), anterior and lower height, maxillary length, etc. The stable basicranial line (SBL) was used as the reference line to measure the distance from each reference point (ANS point, A point, Prn point, Sn point, UL point etc.) to the stable basicranial vertical line (VerT, the perpendicular line of the skull base line at the intersection point of the anterior wall of the sella image and the inferior edge of the anterior bed process). Paired t-tests were performed on the cephalometric data before and after maxillary protraction treatment in the two groups, and two independent samples t-tests were performed to compare the differences in the efficacy of the two maxillary protraction methods. Results:A total of 20 patients (9 males and 11 females), aged (10.8±1.3) years, were included in the personalized titanium plate group. A total of 20 patients (8 males and 12 females), aged (10.5±1.1) years, were included in the conventional protraction group. The SNA angle, ANB angle, FH-MP angle, Y-axis angle, anterior lower height, maxillary length, ANS-VerT distance, A-VerT distance, Prn-VerT distance, Sn-VerT distance, and UL-VerT distance were significantly higher than those before treatment in the two groups ( P<0.05). The changes of SNA angle, ANB angle and A-VerT before and after treatment in the personalized titanium plate group [3.15°±2.28°, 4.64°±1.40°, (4.41±3.43) mm, respectively] were significantly higher than those in the traditional group [2.13°±2.69°, 2.81°±1.10°, (3.13±4.76) mm, respectively]( P<0.05), and the changes of U1-L1 angle and U1-SN angle before and after treatment (-0.76°±7.42° and 1.74°±6.38°, respectively) was significantly lower than that of the control group (-5.14°±6.62° and 4.57°±5.24°, respectively, P<0.05). Conclusions:Maxillary protraction can effectively improve skeletal class Ⅲ relationships in growing patients. The linear measurements using the SBL line as a reference plane visualize the sagittal improvement in sagittal relationship after maxillary protraction. The customized titanium plate maxillary protraction treatment has a clear therapeutic effect on patients with skeletal class Ⅲ deformities, and its dental effect is relatively small.

The incidence and mortality rate of heart failure (HF) are increasing annually, resulting in a huge medical and economic burden worldwide. B-type natriuretic peptide (BNP) is the gold standard biomarker of HF recommended by national and international guidelines for the diagnosis and prognosis evaluation of HF. Recent studies suggest that BNP can be truncated in multiple forms by different enzymes rather than complete fragments in circulation, which can be contributing to the diagnosis and classification of HF. The immunoassay mostly used in clinics are unable to distinguish different truncated BNP forms due to cross-reactivity of antibody, while mass spectrometry is more accurate because it can easily distinguish through their mass-to-charge ratios. With the maturation of ambient ionization mass spectrometry and ion mobility mass spectrometry, it can help to simplify sample pre-treatment and improve the separation efficiency, in order to explore the clinical value of the heterogeneity of BNP truncated forms.

Objective To investigate the temporal properties of dynamic functional connectivity of brain networks and the variability of network topology in patients with end-stage renal disease(ESRD).Methods Data of 30 ESRD patients(ESRD group)and 33 healthy subjects(control group)were retrospectively analyzed.Based on cranial resting-state functional MRI(rs-fMRI),dynamic functional connectivity(dFC)and graph theory analysis were employed,and the abnormalities in network topology and dFC in ESRD patients were assessed through comparison of groups.Pearson correlation analysis was used to observe the correlation between abnormal dFC indicators and clinical variables.Results Compared with control group,temporal scores and the mean residence time in ESRD group were significantly higher under state Ⅱ but significantly lower under state Ⅲ(both P＜0.05).The abnormal functional connectivity in ESRD patients under states Ⅱ and Ⅲ distributed mainly within and between default mode network,sensorimotor network,subcortical nuclei,execution and attention network,visual network and cerebellum networks.Network density and bilateral superior temporal gyrus nodal degrees in ESRD group were all significantly lower than those in control group(all P＜0.05).No significant correlation was found between the abnormal parameters of functional connectivity and graph theory attributes in ESRD group and clinical indicators under states Ⅱ nor Ⅲ(all P＞0.05).Conclusion ESRD patients had abnormal temporal attributes and network topology of brain dynamic networks related to cognitive impairments.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

The purpose of this study was to identify the tick species native to Xindi Township,Yumin County,Xinjiang,China.Preliminary morphological identification of parasitic ticks collected from animals in the area was conducted with an ultra-depth of field three-dimensional VHX 600 digital stereo microscope.Total DNA of the ticks was extracted,amplified by PCR based on the COI and ITS2 gene loci,and the posi-tive PCR products were sequenced.The sequence were a-ligned with reference sequences from the NCBI database were aligned with the Basic Local Alignment Search Tool.A genet-ic phylogenetic tree was generated with the neighbor-joining method of MEGA 7.0 software to determine the evolutionary biological characteristics of ticks.Morphological identification showed that the ticks collected from Xindi Township of Yu-min County were consistent with the characteristics of Hya-lomma asiaticum.An evolutionary tree based on the COI and ITS2 gene sequences showed that the ticks collected in this study were clustered with known H.asiaticum sequences.The PCR products of COI and ITS2 were sequenced and compared,which confirmed that the collected tick species were H.asiaticum,in agreement with the morphological and molecular biological results.These findings help to clarify the distribution of ticks in Xindi Township of Xinjiang,and provide basic data for the analysis of tick genetic and evolutionary characteristics,as reference for surveillance and control of ticks in the Xinjiang Uygur Autonomous Region.

Objective:To explore the impact of social support, self-efficacy, and neurological function on disease acceptance in stroke patients.Methods:From September 2022 to February 2023, convenience sampling was used to select 322 stroke patients from Shanghai Hospital of Traditional Chinese Medicine and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine as participants. The survey was conducted using the General Information Questionnaire, Perceived Social Support Scale (PSSS), Stroke Self-Efficacy Questionnaire (SSEQ), Acceptance of Illness Scale (AIS), and National Institute of Health Stroke Scale (NIHSS) .Results:The AIS, PSSS, SSEQ, and NIHSS scores of stroke patients were (21.88±10.66), (52.64±13.80), (73.92±28.91), and (5.37±3.64), respectively. Social support of patients had a positive impact on disease acceptance ( P<0.01). Self-efficacy partially mediated the relationship between social support and disease acceptance, with indirect effects accounting for 48.84% of the total effect. The second half of the mediating effect of "social support→self-efficacy→disease acceptance" (self-efficacy→disease acceptance) was regulated by neurological function ( β=-0.020, P<0.01) . Conclusions:Medical and nursing staff can increase patients' social support, enhance their self-efficacy, and strengthen targeted interventions for patients with high levels of neurological deficits, thereby improving their disease acceptance.