BACKGROUND:Currently,exercise therapy is an effective non-pharmacological treatment for low back pain,and exercise therapy can maintain lumbar spine stabilization through mechanical-chemical coupling between bones and muscles,but there is no clear description of the research progress and optimal treatment protocols for exercise therapy to relieve chronic non-specific lower back pain through mechanical-chemical coupling. OBJECTIVE:To review the research progress related to the influence of paravertebral muscles on lumbar spine stabilization during exercise therapy through mechanical-chemical coupling,which in turn relieves chronic non-specific lower back pain,as well as the current optimal treatment protocols of exercise therapy for chronic non-specific lower back pain. METHODS:Literature searches were performed in WanFang database,CNKI,VIP,Web of Science,and PubMed database,with search terms of"chronic non-specific low back pain,lumbar spine stabilization,paravertebral muscles,exercise therapy"in Chinese and English.Relevant literature published from database inception to January 2024 was searched and 93 articles were included for final summarization. RESULTS AND CONCLUSION:Exercise therapy can act on the paravertebral muscles and bones through appropriate mechanical stimulation and produce corresponding changes.Exercise therapy is an important intervention for chronic non-specific lower back pain as it improves the quality of the paravertebral muscles,primarily through mechanical-chemical coupling,and thus maintains lumbar spine stabilization for better relief of chronic non-specific lower back pain.However,there are no clear reports on the exact effective protocols for exercise therapy to treat chronic non-specific lower back pain through lumbar spine stabilization.The development of an individualized exercise program is particularly important for the treatment and prognosis of chronic non-specific low back pain.Muscle mass and bone mass of the same individual are closely related,and imaging assessment of paravertebral muscle mass and quantity is important for disease detection and intervention.

BACKGROUND:With the continuous advancement of medical technology,stem cell therapy has been used to treat a variety of diseases,including amyotrophic lateral sclerosis. OBJECTIVE:To review the research progress of stem cell therapy for amyotrophic lateral sclerosis,and prospect the development trend of this field. METHODS:PubMed,China National Knowledge Infrastructure(CNKI),and WanFang Data were searched for articles published from 1995 to 2024 using the key words"amyotrophic lateral sclerosis,mesenchymal stem cells,neural stem/progenitor cells,pluripotent stem cells."A total of more than 1 700 articles were retrieved,and 58 articles were finally included in this review. RESULTS AND CONCLUSION:Amyotrophic lateral sclerosis is a neurodegenerative disease that affects lower motor neurons in the brainstem and spinal cord and upper motor neurons in the motor cortex.The related research of stem cells in the treatment of amyotrophic lateral sclerosis has become a research hotspot.In this review,we summarize the application of different types of stem cells in amyotrophic lateral sclerosis research,including mesenchymal stem cells,neural stem progenitor cells,and induced pluripotent stem cells,and evaluate the key points of preclinical research such as stem cell source,cell volume,stem cell modification methods,and drug delivery routes,which lays the foundation for the future application of stem cell therapy.

Objective: To investigate the current status of iron metabolism among apheresis donors in Guangzhou and analyze the improvement effects of health education on iron deficiency in frequent apheresis donors. Methods: Using a generalized linear mixed model (GLMM), a 180-day follow-up was conducted on 261 eligible apheresis donors at the Guangzhou Blood Center from January to July 2024. Hemoglobin (Hb), serum ferritin (SF), unsaturated iron-binding capacity (UIBC), total iron-binding capacity (TIBC), and transferrin saturation (TS) were selected as outcome variables. The effects of gender, age group, and number of donations within 180 days on these outcomes were analyzed and modeled. A general linear model (GLM) with repeated measures was applied to 55 donors who received health education interventions, comparing changes in Hb and iron metabolism-related indicators before and after follow-up and health education. Results: No significant difference in Hb levels was observed between first-time and regular apheresis donors, but SF levels were significantly higher in first-time donors (F=6.195, P<0.05). The GLMM revealed that female donors exhibited more significant reductions in Hb (T=-12.546) and SF (T=-5.829)(P<0.05 for both). Age group showed no interactive effects on Hb or SF changes. While number of donations within 180 days had no interactive effect on Hb, SF levels significantly decreased with increased number of donations (using ≥9 donations as the reference group; P<0.05 for all groups). After health education, Hb levels remained unchanged, but SF increased compared to pre-intervention levels (mean difference: -18.571, P<0.05), though a declining trend persisted compared to baseline (mean difference from baseline to post-intervention: 23.068,P<0.05). Conclusion: Female and number of donations are primary factors contributing to SF reduction in apheresis donors. Health education interventions promote SF recovery. Extending donation intervals and reinforcing iron deficiency-related health education may improve iron status in donors.

Objective To analyze the nonlinear relationship between hypothermic machine perfusion (HMP) parameters and delayed graft function (DGF) and optimize the construction of a predictive model for DGF. Methods The data of 923 recipients who underwent kidney transplantation from deceased donors were retrospectively analyzed. According to the occurrence of DGF, the recipients were divided into DGF group (n=823) and non-DGF group (n=100). Donor data, HMP parameters and recipient data were analyzed for both groups. The nonlinear relationship between HMP parameters and the occurrence of DGF was explored based on restricted cubic splines (RCS). Over-sampling, under-sampling and balanced sampling were used to address the imbalance in the proportion of DGF to construct logistic regression predictive models. The area under the curve (AUC) of each model was compared in the validation set, and a nomogram model was constructed. Results Donor BMI, cold ischemia time of the donor kidney, and HMP parameters (initial and final pressures, resistance, and perfusion time) were significantly different between the DGF and non-DGF groups (all P<0.05). The RCS analysis revealed a threshold-like nonlinear relationship between HMP parameters and the risk of DGF. Among the models constructed using different sampling methods, the balanced sampling model had the highest AUC. Using this model, a nomogram was constructed to stratify recipients based on risk scores. Recipients in the high-risk group had higher serum creatinine levels at 1, 6, and 12 months after kidney transplantation compared to those in the low-risk group (all P<0.05). Conclusions There is a nonlinear relationship between HMP parameters and the risk of DGF, and the threshold is helpful for organ quality assessment and monitoring of graft function after transplantation. The predictive model for DGF constructed on the base of balanced sampling algorithms helps perioperative decision-making and postoperative graft function monitoring of kidney transplantation.

In February 2023, a 48-year-old male with cough and expectoration was admitted to the Department of Pulmonary and Critical Care Medicine of Peking University People’s Hospital. CT indicated mediastinal soft-tissue mass under the tracheal carina. Meta-genomics next generation sequencing of mediastinal abscess suggested infection with Tropheryma whipplei, which was positive for periodic acid-Schiff staining. The patient had no history of diarrhea, weight loss, or joint pain. The patient was diagnosed with Whipple’s disease and treated with ceftriaxone followed by trimethoprim-sulfamethoxazole therapy. After 1-year post-discharge therapy, the patieny’s symptoms and general condition improved significantly, and remained to follow.

[摘 要] 目的：探讨2',4'-二羟基查尔酮（D2）通过调控miR-7-5p诱导自噬，抑制结直肠癌细胞增殖、迁移及上皮间质转化（EMT）的分子机制。方法：选取结直肠癌细胞系HCT-15、SW620为研究对象，分别用不同浓度（0、12.5、25、50 µmol/L）的D2处理细胞，采用MTT法和平板克隆实验检测细胞增殖活力及克隆形成能力，划痕愈合实验及Transwell实验评估细胞迁移能力，WB法检测EMT相关蛋白、自噬相关蛋白及PI3K/AKT/mTOR信号通路蛋白的表达情况，免疫荧光染色法观察自噬小体的形成。基于TCGA数据库分析miR-7-5p在结直肠癌中的表达水平，并借助KEGG富集分析探究miR-7-5p与结直肠癌的关联。运用RT-qPCR检测miR-7-5p的表达量，同时采用慢病毒转染技术构建miR-7-5p稳定敲低或过表达的细胞系。结果：D2抑制结直肠癌细胞的增殖、迁移及EMT进程（P < 0.05或P < 0.01）。TCGA数据库分析及KEGG富集分析显示，miR-7-5p在结直肠癌中呈低表达，且与结直肠癌的发生有密切关联。12.5、25、50 µmol/L D2处理均可上调HCT-15、SW620细胞miR-7-5p的表达水平（均P < 0.01）。25 µmol/L D2处理组HCT-15、SW620细胞中 LC3、p-ULK1等自噬相关蛋白表达增加，而PI3K/AKT/mTOR信号通路受到抑制（均P < 0.05），细胞内自噬小体数量增加（均P < 0.01）；与D2单独处理组相比，经 D2处理的miR-7-5p敲减细胞中LC3、p-ULK表达量有所下降（P < 0.05或P < 0.01）。结论：D2通过调控miR-7-5p诱导自噬，抑制结直肠癌细胞的增殖、迁移及EMT进程，其机制可能与抑制PI3K/AKT/mTOR信号通路有关。

Objective: To analyze the longitudinal relationship between cumulative multiple risks and depressive emotions in primary and secondary school students, and to examine the mediating role of executive function in the association, so as to provide scientific evidence for preventing and alleviating depressive emotions in adolescents. Methods: Using convenience sampling, 946 students from Shandong and Hunan provinces were tracked for one year (December 2023 to December 2024) regarding their exposure to multiple risks, executive function, and depressive emotion. Pearson correlation analysis was employed to examine variable relationships, while mediation modeling with Bootstrap testing (5 000 iterations) was conducted to verify the mediating effect. Results: At baseline, the prevalence of survival risks was relatively low, with 37.98% of primary school students and 30.87% of middle school students reporting no exposure to such risks. In contrast, developmental risks and harmful risks showed substantially higher prevalence, with 63.20% of primary school students and 69.63% of middle school students experiencing two or more risk factors in developmental risks, and 44.81% of primary school students and 71.60% of middle school students experiencing two or more harmful risks. After controlling for gender, age, baseline executive function and depressive emotions:higher cumulative developmental risks ( β=0.06, P <0.01) and hazardous risks ( β=0.08, P <0.01) predicted elevated depressive emotion, while survival risks showed no significant prediction ( β=0.03, P >0.05). Executive function significantly mediated the effects of both developmental risks ( Effect=0.02, 95%CI =0.01-0.04) and hazardous risks ( Effect=0.02, 95%CI =0.01-0.04) on depressive emotion (both P <0.05). Conclusions Increased exposure to developmental and hazardous risks predicts poorer executive function, which subsequently exacerbates depressive emotions in students.

Objective: To investigate the distribution of pupil diameter and its association with myopia in school age children, providing ideas into the mechanisms of the role of pupil diameter in the onset and development of myopia. Methods: Adopting a combination of stratified cluster random sampling and convenience sampling method, 3 839 children from six schools in Shandong Province were included in September 2021. Pupil diameters distribution was analyzed by age, sex, and myopic status. Pearson correlation analysis was used to assess the relationship between pupil diameter and cycloplegic spherical equivalent (SE), as well as axial length (AL) and other variables. Propensity score matching (PSM) was applied to match myopic and non myopic children at a 1∶1 ratio based on age and sex. A generalized linear model (GLM) was constructed with pupil diameter as the dependent variable to identify independent factors influencing pupil size and its association with myopia. Results: The mean pupil diameter of school age children was (5.77±0.80)mm. Pupil diameter exhibited a significant increasing trend with age ( F =49.34， P trend ＜ 0.01). Myopic children had a significantly larger mean pupil diameter [(6.10±0.73)mm] compared to non myopic children [(5.62±0.79)mm] with a statistically significant difference( t=18.10, P <0.01). Multivariable GLM analysis, adjusted for age, amplitude of accommodation, and uncorrected visual acuity, revealed a negative correlation between pupil diameter and cycloplegic SE (before PSM: β =-0.089, after PSM: β =-0.063, both P ＜0.01). Conclusions Myopic school age children exhibite larger pupil diameters than their non myopic counterparts. Pupil diameter may serve as a potential indicator for monitoring myopia development in school age children.

Objective: This study investigated the effect of applying different torque values on the sagittal displacement tendency of mandibular incisors during intrusion using clear aligners, with the aim of providing a reference for achieving true vertical intrusion (intrusion without labiolingual movement) of mandibular incisors in clear aligner therapy. Methods: This study was approved by the institutional ethics committee. A volunteer with an incisor mandibular plane angle of 94° was selected. Using cone-beam computed tomography and intraoral scan data, a high-precision three-dimensional finite element model was established. An intrusion amount of 0.2 mm was set for the mandibular incisors, and four simulation groups were defined by applying 0°, 1°, 2°, and 3° of root labial torque. The displacement tendency of the incisors and the stress distribution within the periodontal ligament were analyzed. Results: When 0° of root labial torque was applied, the mandibular incisors exhibited intrusion accompanied by crown-labial, root-lingual inclination. When 1°-3° of root labial torque was applied, the mandibular incisors exhibited intrusion accompanied by the inclination gradually shifted from crown-labial, root-lingual towards crown-lingual, root-labial. Based on the line graph of sagittal displacement, the central incisors and lateral incisors approximated true vertical intrusion when 1.8° and 2.5° of root labial torque was applied, respectively. The mandibular canines consistently exhibited extrusion accompanied by labial crown inclination. Stress within the periodontal ligament of the incisors and canines was primarily concentrated at the root apex and cervical region. After applying root labial torque, the area of stress concentration in the incisors cervical periodontal ligament shifted from the labial side to the lingual side. The stress in the periodontal ligament at the cervical region of the canines is predominantly concentrated on the labial side. Conclusion Applying appropriate torque control during mandibular incisor intrusion with clear aligners facilitates true vertical intrusion, thereby enhancing the efficiency of the intrusion.

With the widespread application of artificial intelligence （AI） technology in medical data analysis， the issue of protecting patients’ privacy rights has become increasingly prominent. This paper sorted out the development trends and current situation of medical data analysis and revealed the main dilemmas in privacy protection， including the risks in the process of data collection and storage， the imperfections of laws and regulations， and the impact of ethical issues. It further explored effective ways to enhance patients’ privacy education and awareness， including comprehensively strengthening the promotion of data anonymization technology in the process of data collection and storage， improving laws， regulations， and industry standards to ensure patient privacy security， establishing a multi-party cooperative privacy protection mechanism to achieve collaborative governance and shared responsibility， as well as enhancing patient privacy awareness to strengthen their cognition and trust in privacy protection， which can effectively promote collaborative governance and shared responsibility for privacy protection.