Objective To explore the intrinsic relationship between circadian clock and cell cycle in osteoarthritis(OA)chondrocytes,especially the regulation of cell cycle-related genes by the clock gene Bmal1.Methods The chondroid ATDC5 cells induced by insulin-transfering-selenium(ITS)were divided into control group,OA group and LV-Bmal1 group.The cell viability of each group was detected by CCK8 method.The expression of Bmal1,Per1,Wee1,Cdk1,Ccnb1 and Mmp13 mRNA in each group was detected by RT-qPCR.The expression of BMAL1,PER1,WEE1,CDK1,CCNB1 and MMP13 protein in each group was detected by Western blot.The effects of Bmal1 on different stages of cell cycle and apoptosis was analyzed by flow cytometry.The regulation of Bmal1 on Per1,Wee1,Cdk1,Ccnb1 and Mmp13 and their roles in OA were analyzed.Results Compared with the normal group,the cell viability of the OA group was increased,the relative mRNA expression of Bmal1 and Wee1 in the OA group decreased,and the relative mRNA expression of Per1,Cdk1,Ccnb1 and Mmp13 increased signif-icantly.The cell viability of LV-Bmal1 group decreased,the relative expression of Bmal1 and Wee1 mRNA in-creased,and the relative expression of Per1,Cdk1,Ccnb1 and Mmp13 mRNA decreased(P＜0.05).Correlation analysis showed that Bmal1 was positively correlated with Wee1 and they were negatively correlated with Per1,Cdk1,Ccnb1 or Mmp13.The results of Western blot showed that protein expression in different groups were con-sistent with the trend of PCR.The results of cell cycle and apoptosis showed that compared with the normal group,the S phase and G2/M phase of the OA group were shortened,the proportion of cells decreased significantly,and the proportion of early and late apoptosis increased.The S phase and G2/M phase of the LV-Bmal1 group were prolonged,the proportion of cells was increased,and the proportion of early and late apoptosis was decreased.Conclusions Circadian clock gene Bmal1 in inflammatory chondrocytes might regulate the expression of cell cycle-related genes.

Objective To investigate the signal abnormality of conus medullaris in patients with overactive bladder(OAB)and un-deractive bladder(UAB)by MRI diffusion tensor imaging(DTI). Methods From May,2021 to April,2023,23 patients with lower urinary tract dysfunction without trauma and supraspi-nal lesions were enrolled(case group).All patients underwent imaging urodynamics and pelvic floor electromy-ography.Based on the bladder contraction during the filling phase of urodynamics,the patients were divided into UAB group and OAB group.Eight healthy subjects were included as the control group.All participants under-went T10 to L5 spinal segment MRI scans and DTI scans.The position of conus medullaris was determined by comparing the DTI sequences with the MRI scans.The fractional anisotropy(FA),apparent diffusion coefficient(ADC),and relative anisotropy(RA)of the conus medullaris intermediate segment were compared. Results Twelve cases were in UAB group,and eleven in OAB goup.Abnormalities were found in the pelvic floor elec-tromyography in the case group.There was significant difference in sacral reflex arc nerve conduction testing be-tween UAB and OAB groups(P = 0.036).Compared with the control group,ADC increased(t = 2.185,P = 0.037)in the case group;FA decreased(t = 3.439,P = 0.005)and ADC increased(t = 4.582,P<0.001)in UAB group. Conclusion DTI is helpful to find the potential lesion of spinal cord in patients with lower urinary tract dysfunction.FA and ADC are valuable indicators for the diagnosis of conus medullaris injury.

The article summarizes the clinical experience of Professor JIA Chunsheng in treating cubital tunnel syndrome with various traditional Chinese medicine therapies,including superficial point-toward-point auricular acupuncture,ordinary acupuncture,fire-needle therapy,and oral Chinese medication,to inherit his academic characteristics,such as meridian-identified and stage-identified treatments,stressing the patient's body constitution and state,and emphasizing the holistic treatment,and to provide references for the popular science education and clinical treatment of cubital tunnel syndrome.

Objective:To investigate the diagnostic efficacy between magnetic resonance imaging(MRI)and ultrasound for training injury of medial head of gastrocnemius muscle.Methods:Clinical data of 70 cases with lower limb training injury suspected to be in the medial head of gastrocnemius muscle from Jan 2013 to Jan 2022 were retrospectively analyzed.All patients were examined by ultrasound and MRI,and their sensitivity,specificity and accuracy according to the final clinical diagnosis was compared.Results:Of the 70 cases of training injury,48 cases were finally diagnosed as medial head injury of gastrocnemius muscle,and 22 cases had no gastrocnemius injury.And there were 19 cases of gastrocnemius tissue injury,28 cases of myofascial injury edema and tissue interstitial effusion,26 cases of tendon and tendon sheath injury,and 6 cases of tendon insertion enthesiopathy.The sensitivity of ultrasound and MRI in the diagnosis of training injury of medial head of gastrocnemius muscle were 85.4%(41/48),97.9%(47/48)and the accuracy was 84.3%(59/70),95.7%(67/70),respectively.The diagnostic accuracy and sensitivity of MRI were higher than those of ultrasound(P＜0.05).There was no significant difference in specificity between the two methods(P＞0.05).Conclusion:MRI has higher accuracy and sensitivity compared with ultrasound in the diagnosis training injury of medial head of gastrocnemius muscle,which has important diagnostic value.

Objective:To study the effect of bridge orbicularis oculi muscle flap blepharoptosis in the treatment of post-burn scar contracture ectropion.Methods:The clinical data of patients wih post-burn cicatricial ectropion treated with bridge orbicularis oculi muscle flap from April 2006 to September 2020 of Department of Plastic Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University were analyzed retrospectively. For patients with severe eyelid scar contracture caused by head and face burns, after releasing the scar and resetting the eyelid margin, orbicularis oculi muscle flaps were made at the base of the upper and lower eyelid release incision, crossed the muscle flap over the eyelid adhesion point of the eye fissure, by performed bridge cross transfer, and fixed to the orbicularis oculi muscle at the base of the release incision to form eyelid adhesion. H-shaped full-thickness skin graft or medium-thickness skin graft was performed on the defect wound during the operation. Tie-over dressing fixation in the skin graft area. One year after the operation, it was confirmed that the skin graft was stable and there was no recurrence of ectropion, and then cut the adhesion. Follow-up for more than one year after the operation, foreign body sensation, conjunctival sac pusc, skin graft survival, success rate of eyelid adhesion, anti-stretching effect of muscle flap, skin retraction rate and complications were observed. The distances between eyelid margins preoperative and after incision of eyelid adhesion were measured. SPSS 25.0 software was used for data statistics, measurement data was represented by M ( Q1, Q3), and counting data was represented by cases. Results:Fourteen patients (23 eyes) were included in this study, including 11 males and 3 females, aged 41.5 (32.5, 47.0) years, and the time from burn to this treatment was 13.5 (10, 24) months. 5 cases (7 eyes) were not treated with skin grafting or blepharoptosis after burn, and 9 cases (16 eyes) were treated with blepharoptosis and/or skin transplantation. The area of skin graft during operation was 37 mm ×18 mm to 52 mm ×39 mm. Before operation, the distance between the upper and lower eyelid margins was 14 (12, 14) mm when eyes were open, and 6 (5, 9) mm when eyes were closed. After eyelid adhesion surgery, the patient had no foreign body sensation and infection, and all the skin grafts survived. The success rate of blepharoptosis was 100%, and there was no accidental rupture or elongation. The eyelid adhesions contracted synchronously when the patients closed their eyes, and the muscle flap had good anti-stretching effect. The duration of blepharoptosis was 13(12, 24) months, during which no complications or adverse reactions occurred. The average skin graft retraction rate was 9% (5%, 10%) in half a year. After incision of the orbicularis oculi muscle flap, the distance between the upper and lower eyelid margins was 9 (8, 9) mm when the eyes were open, and 0 (0, 0) mm when the eyes were closed.Conclusion:Bridge orbicularis oculi muscle flap tarsorrhaphy can provide long-term tarsorrhaphy, effectively reduce skin contracture after eyelid skin grafting, and has a stable therapeutic effect on postburn ectropion.

Objective To develop a deep learning network based on attention mechanism to identify the number of the vertical man-dibular third molar(MTM)roots(single or double)on panoramic radiographs in an automatic way.Methods The sample consisted of 1 045 patients with 1 642 MTMs on paired panoramic radiographs and Cone-beam computed tomography(CBCT)and were randomly grouped into the training(80%),the validation(10%),and the test(10%).The evaluation of CBCT was defined as the ground truth.A deep learning network based on attention mechanism,which was named as RN-MTMnet,was trained to judge if the MTM on pano-ramic radiographs had one or two roots.Diagnostic performance was evaluated by accuracy,sensitivity,specificity,and positive predict value(PPV),and the receiver operating characteristic(ROC)curve with the area under the ROC curve(AUC).Its diagnostic perform-ance was compared with dentists'diagnosis,Faster-RCNN,CenterNet,and SSD using evaluation metrics.Results On CBCT images,single-rooted MTM was observed on 336(20.46%)sides,while two-rooted MTM was 1 306(79.54%).The RN-MTMnet achieved an accuracy of 0.888,a sensitivity of 0.885,a specificity of 0.903,a PPV of 0.976,and the AUC value of 0.90.Conclusion RN-MTM-net is developed as a novel,robust and accurate method for detecting the numberof MTM roots on panoramic radiographs.

Objective:To study the effect of bridge orbicularis oculi muscle flap blepharoptosis in the treatment of post-burn scar contracture ectropion.Methods:The clinical data of patients wih post-burn cicatricial ectropion treated with bridge orbicularis oculi muscle flap from April 2006 to September 2020 of Department of Plastic Surgery, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University were analyzed retrospectively. For patients with severe eyelid scar contracture caused by head and face burns, after releasing the scar and resetting the eyelid margin, orbicularis oculi muscle flaps were made at the base of the upper and lower eyelid release incision, crossed the muscle flap over the eyelid adhesion point of the eye fissure, by performed bridge cross transfer, and fixed to the orbicularis oculi muscle at the base of the release incision to form eyelid adhesion. H-shaped full-thickness skin graft or medium-thickness skin graft was performed on the defect wound during the operation. Tie-over dressing fixation in the skin graft area. One year after the operation, it was confirmed that the skin graft was stable and there was no recurrence of ectropion, and then cut the adhesion. Follow-up for more than one year after the operation, foreign body sensation, conjunctival sac pusc, skin graft survival, success rate of eyelid adhesion, anti-stretching effect of muscle flap, skin retraction rate and complications were observed. The distances between eyelid margins preoperative and after incision of eyelid adhesion were measured. SPSS 25.0 software was used for data statistics, measurement data was represented by M ( Q1, Q3), and counting data was represented by cases. Results:Fourteen patients (23 eyes) were included in this study, including 11 males and 3 females, aged 41.5 (32.5, 47.0) years, and the time from burn to this treatment was 13.5 (10, 24) months. 5 cases (7 eyes) were not treated with skin grafting or blepharoptosis after burn, and 9 cases (16 eyes) were treated with blepharoptosis and/or skin transplantation. The area of skin graft during operation was 37 mm ×18 mm to 52 mm ×39 mm. Before operation, the distance between the upper and lower eyelid margins was 14 (12, 14) mm when eyes were open, and 6 (5, 9) mm when eyes were closed. After eyelid adhesion surgery, the patient had no foreign body sensation and infection, and all the skin grafts survived. The success rate of blepharoptosis was 100%, and there was no accidental rupture or elongation. The eyelid adhesions contracted synchronously when the patients closed their eyes, and the muscle flap had good anti-stretching effect. The duration of blepharoptosis was 13(12, 24) months, during which no complications or adverse reactions occurred. The average skin graft retraction rate was 9% (5%, 10%) in half a year. After incision of the orbicularis oculi muscle flap, the distance between the upper and lower eyelid margins was 9 (8, 9) mm when the eyes were open, and 0 (0, 0) mm when the eyes were closed.Conclusion:Bridge orbicularis oculi muscle flap tarsorrhaphy can provide long-term tarsorrhaphy, effectively reduce skin contracture after eyelid skin grafting, and has a stable therapeutic effect on postburn ectropion.

A wireless wearable sleep monitoring system based on EEG signals is developed.The collected EEG signals are wirelessly sent to the PC or mobile phone Bluetooth APP for real-time display.The system is small in size,low in power consumption,and light in weight.It can be worn on the patient's forehead and is comfortable.It can be applied to home sleep monitoring scenarios and has good application value.The key performance indicators of the system are compared with the industry-related medical device measurement standards,and the measurement results are better than the special standards.

Pulse rate and blood oxygen levels are crucial physiological parameters that reflect physiological and pathological information within the human body.The system designs a wireless pulse wave monitoring system utilizing a flexible reflective probe and the AFE4490,which is capable of monitoring pulse wave and blood oxygen levels on the human forehead.The system is predominantly based on a reflective flexible probe,the AFE4490,a power supply module,a control microcontroller unit(MCU),and a Wi-Fi module.Post-processing by a slave computer,the collected pulse wave data is wirelessly transmitted to a smartphone.The real-time pulse waveform,pulse rate,and blood oxygen levels are displayed on an application.Following relevant tests and verifications,the system can accurately detect pulse wave signals,meet the requirements for wearable technology,and possesses significant market application potential.

Objective:To explore the manifestations of magnetic resonance imaging(MRI)on acute traumatic lateral patellar dislocation of children and adolescents.Methods:MRI images of the affected side and healthy side of 110 children and adolescents with acute traumatic lateral patellar dislocation who were treated in the Second Hospital of Tangshan from July 2016 to April 2022 were retrospectively analyzed.The correlation of the medial patellofemoral ligament(MPFL)on the affected side between the tear location and tear degree was compared and analyzed.According to the cartilage injury grading system of international cartilage repair society(ICRS),the articular cartilage injury of affected side was divided into 4 grades,and the correlation between the articular cartilage injury grading and the articular cartilage injury location was compared and analyzed.Three methods of measuring patellar height,which included Insall-Salvati index(ISI),patellotrocheal index(PTI)and Caton-Deschamps index(CDI),were used to compare and analyze the differences of MRI data of patellar height between the affected side of knee joint and the healthy knee joint of pediatric children.Results:In 110 patients with MPFL injury,73 cases were partial tears and 37 cases were complete tears.There was significant difference in the injury at MPFL patellar attachment location between complete tears(22 cases)and partial tears(19 cases)(x2=11.740,P<0.05),and there was significant difference in MPFL multiple injury between partial tear(40 cases)and complete tear(8 cases)(x2=10.990,P<0.05).There were no significant differences in the injuries of MPFL middle segment and the origin of femur between partial tears and complete tears.There were 162 lesions in 110 cases with osteochondral injury,which included 55 lesions on the patellar side,33 lesions on the femur side and 74 multiple lesions according to the part of injury.There was significant difference between the location of osteochondral injury and injury grading(x2=38.153,P<0.05).The ISI,PTI and CDI on the affected side were significantly lower than those on the healthy side in pediatric patients with acute traumatic lateral patellar dislocation of children and adolescents(x2=30.853,12.586,19.656,P<0.05),respectively.Conclusion:The complete tears are more likely to occur in the injury of MPFL patellar attachment location of pediatric patients with acute traumatic lateral patellar dislocation of children and adolescents,while multiple injuries are more likely to be in partial tears.There is correlation between the articular cartilage injury grading and the articular cartilage injury location in pediatric patients.MRI is an important method to diagnose MPFL injury,which can provide more evidence for clinical treatment.