Amyotrophic lateral sclerosis (ALS) is an irreversible, fatal neurodegenerative disorder whose incidence is positively correlated with the aging population. ALS is characterized by the progressive loss of motor neurons, leading to muscle weakness, atrophy, and ultimately respiratory failure. The pathogenesis of ALS involves multiple factors, including genetic and environmental influences, with genetic factors playing a particularly significant role. To date, several causative genes have been identified in ALS, such as the Cu/Zn superoxide dismutase 1 (Cu/Zn SOD1, also known as SOD1) gene, transactive response DNA-binding protein 43 (TDP-43) gene, fused in sarcoma (FUS) gene, and chromosome open reading frame 72 (C9orf72). Mutations in these genes have been found not only in familial ALS but also in sporadic ALS. Based on the identified ALS risk genes, various ALS animal models have been established through multiple approaches, including transgenic models, gene knockout/knock-in models, and adeno-associated virus-mediated overexpression models. These models simulate some typical pathological features of human ALS, such as motor neuron loss, ubiquitinated inclusions, and neuromuscular junction degeneration. However, these models still have limitations: (1) single-gene mutation models are insufficient to fully replicate the complex multi-factorial pathogenesis of sporadic ALS; (2) significant differences in microenvironmental regulation mechanisms and the rate of neurodegeneration between model organisms and humans may affect the accurate reproduction of disease phenotypes and the reliable evaluation of drug efficacy. To better understand the pathogenesis of ALS and promote the development of effective therapies, constructing and optimizing ALS animal models is crucial. This review aims to summarize commonly used ALS gene mutation mouse models, analyze their phenotypes and pathological characteristics, including transgenic mouse models, gene knockout/knock-in mouse models, and adeno-associated virus-mediated overexpression mouse models, and further discuss their specific applications in ALS pathogenesis research and drug development by comparing the advantages and limitations of each model.

Amyotrophic lateral sclerosis (ALS) is an irreversible, fatal neurodegenerative disorder whose incidence is positively correlated with the aging population. ALS is characterized by the progressive loss of motor neurons, leading to muscle weakness, atrophy, and ultimately respiratory failure. The pathogenesis of ALS involves multiple factors, including genetic and environmental influences, with genetic factors playing a particularly significant role. To date, several causative genes have been identified in ALS, such as the Cu/Zn superoxide dismutase 1 (Cu/Zn SOD1, also known as SOD1) gene, transactive response DNA-binding protein 43 (TDP-43) gene, fused in sarcoma (FUS) gene, and chromosome open reading frame 72 (C9orf72). Mutations in these genes have been found not only in familial ALS but also in sporadic ALS. Based on the identified ALS risk genes, various ALS animal models have been established through multiple approaches, including transgenic models, gene knockout/knock-in models, and adeno-associated virus-mediated overexpression models. These models simulate some typical pathological features of human ALS, such as motor neuron loss, ubiquitinated inclusions, and neuromuscular junction degeneration. However, these models still have limitations: (1) single-gene mutation models are insufficient to fully replicate the complex multi-factorial pathogenesis of sporadic ALS; (2) significant differences in microenvironmental regulation mechanisms and the rate of neurodegeneration between model organisms and humans may affect the accurate reproduction of disease phenotypes and the reliable evaluation of drug efficacy. To better understand the pathogenesis of ALS and promote the development of effective therapies, constructing and optimizing ALS animal models is crucial. This review aims to summarize commonly used ALS gene mutation mouse models, analyze their phenotypes and pathological characteristics, including transgenic mouse models, gene knockout/knock-in mouse models, and adeno-associated virus-mediated overexpression mouse models, and further discuss their specific applications in ALS pathogenesis research and drug development by comparing the advantages and limitations of each model.

Objective:To evaluate the long-term efficacy of percutaneous microwave ablation (MWA) therapy for hepatocellular carcinoma.Methods:2054 cases with Barcelona Clinic Liver Cancer (BCLC) stage 0~B at the Fifth Medical Center of the Chinese People's Liberation Army General Hospital from January 2006 to September 2020 were retrospectively collected. All patients were followed up for at least 2 years. The primary endpoint of overall survival and secondary endpoints (tumor-related survival, disease-free survival, and postoperative complications) of patients treated with ultrasound-guided percutaneous MWA were analyzed. Kaplan-Meier method was used for stratified survival rate analysis. Fine-and-Gray competing risk model was used to analyze overall survival.Results:A total of 5 503 HCC nodules [mean tumor diameter (2.6±1.6) cm] underwent 3 908 MWAs between January 2006 and September 2020, with a median follow-up time of 45.6 (24.0 -79.2) months.The technical effectiveness rate of 5 375 tumor nodules was 97.5%. The overall survival rates at 5, 10, and 15-years were 61.6%, 38.8%, and 27.0%, respectively. The tumor-specific survival rates were 67.1%, 47.2%, and 37.7%, respectively. The free tumor survival rates were 25.8%, 15.7%, and 9.9%, respectively. The incidence rate of severe complications was 2.8% (108/3 908). Further analysis showed that the technical effectiveness and survival rate over the passing three time periods from January 2006-2010, 2011-2015, and 2016-September 2020 were significantly increased, with P ?

Objective To comparatively explore the prognosis of hepatocellular carcinoma(HCC)patients with hepatitis B(HB)and hepatitis C(HC)after microwave ablation(MWA).Methods Data of 159 HCC patients with HB(HB-HCC)and 159 HCC patients with HC(HC-HCC)who received MWA treatment were retrospectively collected.The oncologic outcomes were compared between groups,the causes of death were analyzed,and the risk factors of overall survival(OS)in HCC patients after MWA were observed.Results The OS rate in HC-HCC group was lower than that in HB-HCC group(P=0.045),while no significant difference of disease free survival rate(P=0.095)nor cancer specific survival rate(P=0.180)was found between groups.Compared with HB-HCC group,HC-HCC group had higher risk of death due to complications related to liver cirrhosis(HR=2.339,P=0.043).Child-Pugh class B(HR=3.082,P＜0.001),hepatitis viral load＞500 IU/ml(HR=1.654,P=0.006)and the maximum diameter of lesion≥3.0 cm(HR=1.541,P=0.017)were all independent risk factors of OS in HCC patients after MWA.Conclusion Compared with HB-HCC patients,HC-HCC patients had shorter OS after MWA.

Objective:To explore the influence of family function and personal characteristics on death anxiety in patients with advanced cancer, providing reference for finding methods and approaches to alleviate death anxiety in advanced cancer patients.Methods:From March to June 2023, convenience sampling was used to select 182 advanced cancer patients admitted to the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University. The Chinese Version of Death and Dying Distress Scale and Family APGAR Index were used to investigate patients' death anxiety and family function. The Numerical Rating Scale and Kamofsky Performance Status were used to assess patients' pain and performance status. Single factor analysis and multiple linear regression were used to analyze the influencing factors of death anxiety in advanced cancer patients.Results:A total of 182 questionnaires were distributed, and 165 valid questionnaires were collected, with a valid response rate of 90.7%. The death anxiety score of advanced cancer patients was (22.52±15.27), and 10.3% (17/165) of patients had moderate or above death anxiety. The patients' total family function score was (8.62±1.97), and 86.7%(143/165) patients self-reported good family function. The death anxiety score was negatively correlated with the family function score ( P<0.05). Multiple linear regression analysis showed that Kamofsky Performance Status score, pre-illness employment, family function, place of residence, and pain score were the influencing factors of death anxiety in advanced cancer patients, and the differences were statistically significant ( R2=0.196, P<0.01) . Conclusions:The advanced cancer patients have low levels of death anxiety in our study. Advanced cancer patients with moderate family dysfunction, living in rural areas, working before illness, and high pain scores have high levels of death anxiety, while patients with good performance status have low levels of death anxiety. It is recommended that clinical workers strengthen the assessment of death anxiety and family function in patients with advanced cancer, take timely and effective measures based on influencing factors, and help alleviate death anxiety in patients with advanced cancer.

Objective:To study the structure of medical students' professional psychological quality and to compile a questionnaire.Methods:Based on the grounded theory research and semi-structured interviews, the concept and structure of medical students' professional psychological quality were constructed, and the questionnaire of professional psychological quality of medical students with qualified reliability and validity was compiled. The medical students from multiple universities in Sichuan were tested by convenient sampling. A total of 300 valid questionnaires were collected for item analysis, 400 for correlation analysis and exploratory factor analysis, and 400 for confirmatory factor analysis and reliability analysis. SPSS 25.0 was used to perform correlation analysis, exploratory factor analysis, and reliability analysis, and AMOS 26.0 was used to make confirmatory factor analysis.Results:The questionnaire of medical students' professional psychological quality consisted of three subscales: professional psychological personality, professional psychological ability and professional identity, consisting of 13 secondary factors and 61 items. The total Cronbach's α=0.947, the internal consistency coefficients of the total questionnaire and the three subscales were from 0.845 to 0.947, and the correlation coefficients between the three subscales and the total questionnaire were from 0.850 to 0.869. The three factor model fitted well (GFI=0.945, AGFI=0.906, NFI=0.936, RFI=0.906, IFI=0.957, TLI=0.935, RMSEA=0.070). Conclusion:Professional psychological personality, professional psychological ability, and professional identity are the core structures of medical students' professional psychological quality. Medical students' professional psychological quality questionnaire has good content validity, structural validity and internal consistency reliability, which can be used as an effective tool to evaluate the professional psychological quality of medical students.

To investigate the clinical features and influencing factors for new-onset atrial fibrillation (AF) early after coronary artery bypass grafting. Methods    The clinical data of 339 patients undergoing coronary artery bypass grafting in our hospital from January 2012 to January 2019 were retrospectively analyzed. There were 267 males and 72 females with an average age of 37-83 (58.03±8.90) years. The clinical features and influencing factors for new-onset AF after surgery were investigated. Results    There were 234 patients of off-pump coronary artery bypass grafting (OPCABG), with 36 (15.4%) new-onset AF patients after operation, among whom 16.1% were males and 12.5% were females. There were 105 patients of on-pump coronary artery bypass grafting (CABG), with 39 (37.1%) new-onset AF patients, among whom 40.7% were males and 25.0% were females. The incidence was higher after the CABG surgery than that after the OPCABG surgery (37.1% vs. 15.4%, P<0.05). There was no statistical difference in the incidence rate between males and females (P>0.05). The incidence of new-onset AF after surgery was higher in ≥60 years patients for both  operations (18.9% and 45.8%), which was significantly higher than that in <45 years patients (P<0.05). For both operations, the incidence of new-onset AF after surgery was high on the second day (24-48 h) after surgery, and most of the AF lasted for 1 day (P<0.05). The hypertension (OR=4.983, P=0.036), frequent premature atrial contraction or atrial tachycardia (OR=17.682, P=0.002), postoperative creatine kinase isoenzyme MB (CKMB) (OR=0.152, P=0.042), left anterior and posterior diameters (OR=17.614, P<0.001) and preoperative ejection fraction (OR=7.094, P=0.011) were influencing factors for new-onset AF after OPCABG. Diabetes (OR=11.631, P=0.020), other cardiac malformations (OR=29.023, P=0.002), frequent premature ventricular contraction or ventricular tachycardia (OR=0.047, P=0.001), and postoperative CKMB (OR=3.672, P=0.040) were influencing factors for new-onset AF after CABG. Conclusion    The incidence of new-onset AF after CABG is higher than that after OPCABG, and it increases with age increasing. There is no difference in the incidence between males and females. The influencing factors for the two operations are different.

Objective To explore the development of the cross sign of olivepontocerebellar atrophy(OPCA) and its diagnostic value.Methods The clinical and imaging data of 8 patients with OPCA were analyzed retrospec-tively.MRI imaging used SE sequence,plain T1 WI,T2 WI,axial,coronal,sagittal imaging.Results All patients were hide onset.The major clinical presentation was cerebellar atsxia and autonomic nerve dysfunction.Positive radiographic findings were consistent with clinical presentation,mainly for the brain stem atrophy,8 patients of the group had this performance,followed by cerebellar atrophy,6 patients had symmetrical atrophy and 2 patients had asymmetric atro-phy.6 patients after onset of 1.5 -3 years showed a typical cross.Conclusion The cross sign gradually appears at a certain stage of development,and it has high specificity.So the combination of clinical and MRI is valuable for the diagnosis and differential diagnosis of OPCA.

Objective To observe the effects of general anesthesia and combined spinal epidural anesthesia in elderly patients with lower limb fracture surgery, and to evaluate the effect of postoperative cognitive function and pain score.Methods Retrospective analysis, screening of intraoperative anesthesia, postoperative change lost invalid cases, from November 2012 to October 2015 in our hospital accepted surgical treatment of 180 patients with lower limb fracture surgery were selected according to different patients with different anesthesia methods can be divided into treatment group and control group, 90 cases each group of patients.Patients in the treatment group were treated with combined spinal epidural anesthesia , while the control group received general anesthesia.The incidence of cognitive dysfunction and postoperative pain scores were compared between the two groups. Results the incidence of cognitive dysfunction after surgery in 90 cases of observation group was lower than that of the control group , and the difference was statistically significant (P<0.05).The evaluation of two groups of postoperative chronic pain for 3 days, 6 days, 10 days, 15 days, the incidence rate of VAS score and the character, whether the impact on the daily life and the rest, the patients in the treatment group pain scores were significantly lower than the control group, the difference was significant (P <0.05).Conclusion After lumbar epidural anesthesia in elderly lower limb fracture surgery effect on cognitive function in patients with small, and can reduce the pain of patients, in the actual work according to the actual situation of different specific problems in different specific analysis.

Objective To explore the correlation between serum growth differentiation factor‐15(GDF‐15) level and acute myocardial infarction(AMI) to provide a basis for the prognostic evaluation of AMI .Methods Totally 192 Han patients with AMI (AMI group) and non‐coronary heart disease (NCHD ,NCHD group) diagnosed in Chengde Municipal Central Hospital from Sep‐tember 2013 to January 2015 ,were selected and their clinical data were collected .The biochemical markers and serum GDF‐15 level were detected .Results Comparing the AMI group with the NCHD group ,differences in the patients′age ,smoking ,blood glucose (Glu) ,TC ,TG ,LDL‐C levels had statistical significance (P<0 .05);the serum GDF‐15 level in the AMI group was significantly higher than that in the NCHD ;serum GDF‐15 level was positively correlated with TC ,LDL‐C ,hs‐CRP and Glu in the AMI group . Conclusion The increase of serum GDF‐15 level is obviously correlated AMI ,therefore GDF‐15 can serve as an indicator for moni‐toring myocardial infarction .