Objective To minimize variations in treatment outcomes of L5/S1 percutaneous intervertebral radiofrequency thermocoagulation(PIRFT)arising from physician proficiency and achieve precise quantitative risk assessment of the puncture paths.Methods We used a self-developed deep neural network DWT-UNet for automatic segmentation of the magnetic resonance(MR)images of the L5/S1 segments into 7 key structures:L5,S1,Ilium,Disc,N5,Dura mater,and Skin,based on which a needle insertion path planning environment was modeled.Six hard constraints and 6 soft constraints were proposed based on clinical criteria for needle insertion,and the physician's experience was quantified into weights using the analytic hierarchy process and incorporated into the risk function for needle insertion paths to enhance individual case adaptability.By leveraging the proposed skin entry point sampling sub-algorithm and Kambin's triangle projection area sub-algorithm in conjunction with the analytic hierarchy process,and employing various technologies such as ray tracing,CPU multi-threading,and GPU parallel computing,a puncture path was calculated that not only met clinical hard constraints but also optimized the overall soft constraints.Results A surgical team conducted a subjective evaluation of the 21 needle puncture paths planned by the algorithm,and all the paths met the clinical requirements,with 95.24%of them rated excellent or good.Compared with the physician's planning results,the plans generated by the algorithm showed inferior DIlium,DS1,and Depth(P<0.05)but much better DDura,DL5,DN5,and AKambin(P<0.05).In the 21 cases,the planning time of the algorithm averaged 7.97±3.73 s,much shorter than that by the physicians(typically beyond 10 min).Conclusion The multi-constraint optimal puncture path planning algorithm offers an efficient automated solution for PIRFT of the L5/S1 segments with great potentials for clinical application.

Objective:To investigate the factors influencing mortality within one year following hip fracture surgery in elderly patients.Methods:This study retrospectively analyzed clinical data from 1 263 elderly patients with hip fractures who underwent surgery at the First Affiliated Hospital of Air Force Medical University between January 2014 and December 2022.Based on their survival status one-year post-surgery, the patients were categorized into two groups: the death group(212 cases)and the survival group(1 051 cases).Univariate and multivariate logistic regression models were employed to identify factors associated with 1-year mortality.Results:The 1-year mortality rate was found to be 16.78%.Multivariate logistic regression analysis identified several significant predictors of 1-year mortality in elderly patients with hip fractures.These predictors include gender( OR=0.67, 95% CI: 0.48-0.95), age greater than 85 years( OR=2.23, 95% CI: 1.56-3.19), body mass index(BMI)less than 18.5( OR=1.74, 95% CI: 1.17-2.60), BMI between 30 and 40( OR=3.14, 95% CI: 1.20-8.21), history of stroke( OR=1.59, 95% CI: 1.06-2.38), presence of anemia( OR=1.75, 95% CI: 1.07-2.86), fibrinogen(FIB)levels either below 1.8 or above 3.5( OR=1.63, 95% CI: 1.12-2.37), deep vein thrombosis( OR=1.57, 95% CI: 1.13-2.18), and American Society of Anesthesiologists(ASA)grade Ⅲ/Ⅳ( OR=2.37, 95% CI: 1.56-3.59). Conclusions:In elderly patients with hip fractures, age over 85 years, a BMI less than 18.5 or between 30 and 40, the presence of stroke, anemia, FIB levels below 1.8 or above 3.5, deep vein thrombosis(DVT), and ASA classifications Ⅲ or Ⅳ are identified as independent risk factors for 1-year mortality.Conversely, being female serves as a protective factor.

Objective:To explore the views of adolescents with asthma on factors affecting disease self-management, so as to provide a basis for improving self-management of asthma children, and propose improvement suggestions.Methods:This study was a descriptive qualitative study. From February to June 2023, 10 to 17 year old children with asthma were recruited at the Asthma Clinic of the Children's Hospital affiliated to Capital Institute of Pediatrics through purposive sampling. One-on-one semi-structured interviews were conducted around self-management and its related factors, and the thematic analysis was used to analyse interview materials.Results:A total of 17 adolescents with asthma, aged (13.00±2.03) years, with a course of disease of (5.00±2.85) years, were included. The interview materials included two aspects, namely facilitators and barriers of self-management. The facilitators were coded into three themes and seven sub-themes, including the individual management awareness of children with asthma (sense of responsibility, compliance awareness), social support (parental care and compensation, teacher and classmate support, patient interaction), and health education (health guidance from doctors and nurses, school health propaganda). Barriers were encoded into three themes and six sub-themes, including disease cognition (demand competition, importance), social environment (interpersonal interaction, physical environment), and healthcare services (accessibility of medical services, school related medical resources) .Conclusions:The self-management of adolescents with asthma is affected by multiple factors. Individual management awareness, social support, and health education can promote self-management in children with asthma, while unfavorable factors in disease cognition, social environment, and healthcare services can hinder self-management in children with asthma. Medical and nursing staff should develop and implement empowerment plans for self-management of asthma children, by mobilizing multi-channel medical resources, providing multi-dimensional full process empowerment, and helping asthma children build a diverse interpersonal support network system, in order to promote effective health management transition for adolescents with asthma.

Objective To minimize variations in treatment outcomes of L5/S1 percutaneous intervertebral radiofrequency thermocoagulation(PIRFT)arising from physician proficiency and achieve precise quantitative risk assessment of the puncture paths.Methods We used a self-developed deep neural network DWT-UNet for automatic segmentation of the magnetic resonance(MR)images of the L5/S1 segments into 7 key structures:L5,S1,Ilium,Disc,N5,Dura mater,and Skin,based on which a needle insertion path planning environment was modeled.Six hard constraints and 6 soft constraints were proposed based on clinical criteria for needle insertion,and the physician's experience was quantified into weights using the analytic hierarchy process and incorporated into the risk function for needle insertion paths to enhance individual case adaptability.By leveraging the proposed skin entry point sampling sub-algorithm and Kambin's triangle projection area sub-algorithm in conjunction with the analytic hierarchy process,and employing various technologies such as ray tracing,CPU multi-threading,and GPU parallel computing,a puncture path was calculated that not only met clinical hard constraints but also optimized the overall soft constraints.Results A surgical team conducted a subjective evaluation of the 21 needle puncture paths planned by the algorithm,and all the paths met the clinical requirements,with 95.24%of them rated excellent or good.Compared with the physician's planning results,the plans generated by the algorithm showed inferior DIlium,DS1,and Depth(P<0.05)but much better DDura,DL5,DN5,and AKambin(P<0.05).In the 21 cases,the planning time of the algorithm averaged 7.97±3.73 s,much shorter than that by the physicians(typically beyond 10 min).Conclusion The multi-constraint optimal puncture path planning algorithm offers an efficient automated solution for PIRFT of the L5/S1 segments with great potentials for clinical application.

Objective:This study aimed to investigate the effect of differentiation osteogenic bone marrow mesenchymal stem cells (De-BMSCs) transplantation on the promotion of bone formation at the tendon-bone interface after anterior cruciate ligament reconstruction (ACLR), and further explored the molecular mechanism of the enhanced osteogenic effect of De-BMSCs.Methods:BMSCs from femur and tibia of New Zealand White rabbit were subjected to osteogenic induction and then cultured in no osteogenic factor medium; the obtained cell population was termed De-BMSCs. De-BMSCs were induced into osteo-, chondro-and adipo-differentiation in vitro to examine the characteristics of primitive stem cells. ACLR model with a semitendinosus tendon were performed in 48 adult rabbits, three groups were established: control group with alginate gel injectionat the tendon-bone interface, BMSCs group with the injection of alginate gel containing BMSCs, De-BMSCs group with the injection of alginate gel containing De-BMSCs. At 4 and 12 weeks after surgery, rabbits in each group were sacrificed to evaluate tendon-bone healing by histologic staining, micro-CT examination, and biomechanical test. During osteogenic differentiation of De-BMSCs, si-RNA of nuclear factor of activated T cells 2 (NFATc2) si-RNA of nuclear factor of activated T cells 1 (NFATc1) were used to verify the molecular mechanism of enhanced osteogenic effect of De-BMSCs.Results:De-BMSCs exhibited some properties similar to BMSCs including multiple differentiation potential and cell surface marker. At 4 weeks after surgery, the BV/TV value of the De-BMSCs group 0.36±0.01 was significantly higher than that of the control group 0.24±0.03 and BMSCs group 0.30±0.02 (all P<0.05), and the maximum load 40.34±1.19 N and stiffness 20.67±2.14 N/mm were significantly higher than those in the control group 14.88±2.74N, 8.67±2.19 N/mm and the BMSCs group 26.31±1.76 N, 13.81±2.14 N/mm (all P<0.05). At 12 weeks after surgery, the BV/TV value of the De-BMSCs transplantation group 0.47±0.02 was significantly higher than that of the control group 0.30±0.02 and the BMSCs group 0.35±0.03 (all P<0.05), and the maximum load 64.46±6.69 N and stiffness 25.18±3.11 N/mm were significantly higher than those in the control group 41.01±6.12 N, 11.59±2.54 N/mm and the BMSCs group 48.21±4.12 N, 15.89±2.94 N/mm (all P<0.05). During the osteogenic differentiation of De-BMSCs, the expressions of Nanog and NFATc1 were synergistically increased which promoted interaction of NFATc1 and Osterix ( P< 0.05), resulting in the increased expression of osteoblast marker genessuch as COL1A, OCN, OPN (all P< 0.05). Conclusion:De-BMSCs transplantation could promote bone formation at the tendon-bone interface after ACLR,Nanog/NFATc1/Osterix signaling pathway mediated the enhancement of the osteogenic differentiation effect of De-BMSCs.

Objective:To explore the features the gait of elderly persons with type 2 diabetes and peri-pheral neuropathy.Methods:Twenty patients no less than 60 years old with type 2 diabetes and peripheral neuropathy (DPN) formed a DPN group, while 20 counterparts with type 2 diabetes but without peripheral neuropathy composed the DM group, and another 20 healthy counterparts served as a control group. The three groups were tested using the Swedish Qualisys motion capture system and their walking speed, step length, step width, stride frequency and stride length, bipedal foot support phase time, single foot support phase time, peak plantar pressure, and regional-holding time were collected and compared.Results:The average walking speed, stride length and stepping frequency of the DPN group were all significantly lower than the other 2 groups′ averages. Their bipedal support phase was significantly longer, but their single foot support phase time was significantly shorter. And in the DPN group the average first and second peak plantar pressures and the second peak pressure time were significantly greater than the other groups′ averages.Conclusions:Elderly patients with type 2 diabetes and peripheral neuropathy have significant gait abnormalities, decreased walking stability, as well as increased plantar pressure and plantar compression time.

Amyotrophic lateral sclerosis (ALS) is a relentless, progressive, and presently incurable neurodegenerative disease. Its drug development has been hampered by the lack of effective biomarkers for early diagnosis, progression and prognosis. Recently, significant progress has been made for the identification of body fluid biomarkers for ALS, which conferred both theoretical and practical feasibility for the early diagnosis and progression monitoring. Meanwhile, it also facilitated identification of genes and/or pathways for the pathogenesis of ALS. This review summarized biomarkers identified from cerebrospinal fluid, blood and urine of ALS patients and their clinical implications.
Amyotrophic Lateral Sclerosis/genetics* ; Biomarkers ; Humans ; Neurodegenerative Diseases ; Prognosis

Objective:To evaluate the effect of combined use of Guben-Tiaoping Decoction on the success rate of stepwise treatment and life quality of asthma patients. Methods:A total of 76 patients with asthma in remission stage who were using ICS were divided into treatment group (38 cases) and control group(38 cases) according to random number table. Both groups were treated with ICS reduction based on the 2017 Gina Protocol. The treatment group was treated with Guben-Tiaoping Decoction for 12 weeks. The number of patients who were able to successfully complete the stepwise treatment after the end of the trial was calculated, the relevant indexes of Asthma Control Test (ACT), TCM Syndrome score, St. George’s respiratory questionnaire (SGRQ) and lung function were collected before and after treatment. Result:After 12 weeks’ treatment, the success rate of stepwise was 89.5% (34/38) in the treatment group and 78.9% (30/38) in the control group ( χ2=14.862, P=0.001). Meanwhile, the ACT score of the treatment group were better than those in the control group (Daytime symptoms t=-3.860, P=0.001, Dyspnea t=-2.007, P=0.40, Night waking t=-2.732, P=0.009, Reliever needed for symptoms t=-2.262, P=0.031, Control situation t=-6.994, P=0.001, Total Score t=-9.562, P=0.001). The score of TCM Syndrome in the treatment group was significantly lower than that of the control group ( P=0.001); PEF in treatment group [(6.92 ± 1.71) L vs. (5.84 ± 1.22) L; t=-2.880, P=0.005] was significantly better than that of the control group. Conclusion:Guben-Tiaoping Decoction is helpful to improve the success rate of ICS stepwise treatment and the life quality of patients.

【Objective】 To investigate the changes of platelet, white blood cell, red blood cell counts, Hb and PCV before and after plateletpheresis donation. 【Methods】 10 444 platelet donors who donated platelet from Aug 1, 2019 to Jul 31, 2020 were selected as subjects, among which first-time donors were selected as control group and donors who donated twice or more as donation group. After matching gender and age using Propensity Score Matching method in the two groups, the changes of platelet, white blood cell, red blood cell counts, Hb and PCV of platelet blood donors were compared by t test. 【Results】 There were a slight increase in Plt (t=-6.651, P<0.05), a decrease in WBC (t=2.312, P<0.05), a decrease in hemoglobin(t=4.643, P<0.05), and no change in RBC (t=1.439, P>0.05) and in PCV (t=0.030, P>0.05) after plateletpheresis donation. 【Conclusion】 Plateletpheresis donation has an effect on some peripheral blood parameters, but within the normal reference range.

With the development of technology and instruments, more and more giant liver tumors have been resected under laparoscopy. Compared with traditional approach hepatectomy, anterior hepatectomy is more suitable for laparoscopic resection of huge liver tumors, and it is also more in line with the " tumor-free principle" when it is used in the resection of liver malignant tumors. Our team summarized the experiences and lessons of laparoscopic hepatectomy and communicated with domestic and foreign experts to form a set of single center standardized process of laparoscopic anterior right hepatectomy, which is summarized as follows.