BACKGROUND:Piezoelectric materials can catalyze the generation of reactive oxygen species,which can destroy bacteria by multiple ways without causing drug resistance.This indiscriminately attack bacteria strategy has obvious advantages over traditional antibiotic therapy,thus providing a novel idea for antibacterial strategies. OBJECTIVE:To summarize the properties and antibacterial mechanisms of piezoelectric materials and discuss the application status of several piezoelectric materials in the field of anti-bacteria. METHODS:The literature search was performed in PubMed,Web of Science,CNKI,and WanFang databases.Chinese search terms were"piezoelectric materials,piezoelectric catalysis,reactive oxygen species,antibacterial,bacterial infection,anti-infection,drug resistance."English search terms were"piezoelectric materials,piezoelectricity,piezoelectric catalysis,piezocatalysis,reactive oxygen species,ROS,bacterial infection,antibacterial strategies,anti-infection,drug resistance,drug-resistant bacteria."Retrieval time was from January 2013 to December 2023.Primary screening was conducted by reading the titles and abstracts.Repetitive studies and irrelevant articles were excluded.Finally,68 articles were included for review after literature quality evaluation. RESULTS AND CONCLUSION:(1)Piezoelectric materials are stable and environment-friendly materials,most of which show good biocompatibility.(2)Piezoelectric materials can catalyze a large amount of reactive oxygen species in the process of piezoelectric effect,combined with extracellular oxidation and intracellular oxidation,reactive oxygen species can destroy the membrane of bacteria,intracellular proteins,enzymes,and nucleic acids,disorder the structure and function,even kill the bacteria.The antibacterial performance is related to the rate of catalytic generation of reactive oxygen species,and the catalytic efficiency is related to many factors such as material system,morphology,and external conditions.(3)Reactive oxygen species producted by piezoelectric catalysis can kill bacteria without selectivity and show spectral antibacterial activity.This strategy does not rely on antibiotics and does not cause drug resistance.(4)Combined with the advantages of non-invasive,controllable,and penetrating ultrasound,piezoelectric materials will have significant value and great potential in the future as adjunctive or alternative treatments for drug-resistant bacterial infections and other fields.(5)The current challenge of low catalytic efficiency of piezoelectric materials limits its application in the field of antibacterial,how to improve the piezoelectric catalytic efficiency has become the focus of scholars'attention.

BACKGROUND:Ankylosing spondylitis is a chronic inflammatory disease with chronic rheumatic immunity.Soft tissue ossification and fusion and spinal stiffness can cause biomechanical changes. OBJECTIVE:To reconstruct the lumbar-sacral intervertebral disc in ankylosing spondylitis patients with lumbar kyphosis by finite element analysis,and to study the range of motion of each segment of T11-S1 and the biomechanical characteristics of annulus fibrosus and nucleus pulposus. METHODS:The imaging data were obtained from an ankylosing spondylitis patient with lumbar kyphosis.The original CT image data of continuously scanned spine were imported into Mimics 21.0 in DICOM format,and T11-S1 was reconstructed respectively.The established model was imported into 3-Matic software in the format of"Stl"to reconstruct the intervertebral disc,and the fibrous intervertebral disc model was obtained.The improved model was further imported into Hypermesh software,and the vertebra,nucleus pulposus,annulus fibrosus and ligament were mesh-divided.After the material properties were given,the model was imported into ABAQUS software to observe the range of motion of each vertebral body in seven different working conditions of T11-S1,and analyze the biomechanical characteristics of each segment of annulus fibrosus and nucleus pulposus. RESULTS AND CONCLUSION:(1)The range of motion of L1 vertebrae was higher than that of other vertebrae under six different working conditions:extension,forward flexion,rotation(left and right),and lateral flexion(left and right).The maximum range of motion was 2.18° during L1 vertebral flexion,and the minimum range of motion was 0.12° during L5 vertebral extension.(2)The annular fiber flexion at L2-L3 segments was greater than the extension(P<0.05),and the annular fiber flexion at L3-L4 and L4-L5 segments was less than the extension(P<0.05).The left rotation of L1-L2 annular fibers was greater than the right rotation(P<0.05).The left flexion of the annulus was greater than the right flexion in L1-L2,L2-L3,L3-L4,L4-L5 and L5-S1 segments(P<0.05).(3)The nucleus pulposus stresses of T11-L12,L1-L2,L2-L3,L3-L4 and L4-L5 segments in forward flexion were greater than in extension(P<0.05).The left rotation of T12-L1 and L3-L4 segments was smaller than the right rotation(P<0.05),and that of T11-T12,L1-L2,and L2-L3 segments was larger than the right rotation(P<0.05).The left flexion was larger than the right flexion in the T11-S1 segment.(4)It is concluded that in ankylosing spondylitis patients with lumbar kyphosis,the minimum range of motion of the vertebral body is located at the L5 vertebral body in extension.To prevent fractures,it is recommended to avoid exercise in the extension position.During the onset of lumbar kyphosis in patients with ankylosing spondylitis,the maximum stress of the annulus fibrosus and nucleus pulposus is located in the L1-L2 segment,which is fixed and will not alter with the change of body position.The late surgical treatment and correction of deformity should focus on releasing the pressure of the annulus fibrosus and nucleus pulposus in this segment to avoid the rupture of the annulus fibrosus and the injury of the nucleus pulposus.

BACKGROUND:Ankylosing spondylitis is a progressive inflammation of spinal stiffness deformity caused by tissue ossification and fibrosis.The posture of ankylosing spondylitis patients is abnormal and their activities are limited that minor injuries can lead to thoracolumbar fractures.Traditional medical image observation limits doctors'preoperative decision planning and postoperative disease prevention for ankylosing spondylitis treatment. OBJECTIVE:Based on the spinal model of ankylosing spondylitis patients before and after posterior spinal cancellous ossification osteotomy("Y"osteotomy for short),to explore the biomechanical changes of"Y"osteotomy and fixation in the treatment of ankylosing spondylitis. METHODS:Based on the preoperative and postoperative CT images of an ankylosing spondylitis patient who went to the Second Affiliated Hospital of Inner Mongolia Medical University,a three-dimensional spine model(T11-S1)before and after"Y"osteotomy(L3 osteotomy)was reconstructed in Mimics 19.0 software.A 7.5 Nm torque was applied to the top of T11 vertebral body to simulate the movement of the spine under six conditions:flexion,extension,left bending,right bending,left rotation and right rotation.Finally,the range of motion of each vertebral body,the stress of each intervertebral disc,and the stress of the screw rod system were simulated. RESULTS AND CONCLUSION:(1)After"Y"type osteotomy and posterior fixation,the range of motion of all vertebrae in the spine decreased,and the loss rate of upper vertebrae was large(L1:77.95%).(2)The maximum stress of the spinal intervertebral disc before operation occurred at the L1-L2 segment(0.55 MPa),and the maximum stress of the spinal intervertebral disc after operation occurred at the T11-T12 segment(0.50 MPa),and the stress of intervertebral disc below T12 was far less than that before operation.(3)The maximum stress of the screw rod system(166.67 MPa)occurred in the upper and middle segments of the rod body and the root of the pedicle screw.(4)In conclusion,the"Y"type posterior fixation operation enhances the stability of the spine and reduces the range of motion of the spine.The vertebral body decompression of the fixed segment is great and the stress-shielding phenomenon of the lower vertebral body is significant.The stiffness of the rod body and the stress concentration area of the pedicle screw should be strengthened to avoid the fracture of the rod caused by stress fatigue.

Objective:To investigate the risk factors of death within 7 days in patients with acute myocardial infarction (AMI) complicated by ventricular septal rupture (VSR) based on echocardiography indicators, and to construct a nomogram model of ultrasound indicator risk to predict the risk of death in patients with post-infarction ventricular septal rupture (PIVSR).Methods:The echocardiographic data of 40 patients with PIVSR admitted to the department of cardiology, Xiangya Third Hospital, Central South University from January 2014 to June 2024 were retrospectively analyzed. The patients were divided into death group and survival group based on their 7-day survival status. The risk factors affecting death within 7 days of PIVSR patients were analyzed by univariate and multivariate analyses, and the risk nomogram model of ultrasound indicators predicting death within 7 days of PIVSR patients was constructed by using R software. Calibration curve and receiver operator characteristic curve (ROC curve) were used to verify the prediction effect of the model.Results:Among the 40 patients with PIVSR, 18 died at 7 days and 22 survived. Univariate analysis showed that, compared with the survival group, patients in the death group were older (years old: 73.7±6.8 vs. 68.1±7.7), had a larger diameter of VSR (mm: 10.4±4.2 vs. 7.7±3.0), and had a higher peak pressure difference (PPG) in the perforation area [mmHg (1 mmHg≈0.133 kPa): 49.0±11.6 vs. 37.0±16.1], left ventricular ejection fraction (LVEF) and stroke volume (SV) were significantly decreased [LVEF: 0.439±0.134 vs. 0.512±0.094, SV (mL): 46.1±15.6 vs. 62.0±14.3], and the differences were statistically significant (all P < 0.05). Multivariate Logistic regression analysis showed that age [odds ratio ( OR) = 1.212, 95% confidence interval (95% CI) was 1.034-1.420, P = 0.018] and perforation area PPG ( OR = 1.248, 95% CI was 1.069-1.457, P = 0.005) were positively correlated with the occurrence of death events within 7 days in PIVSR patients, while SV was negatively correlated with the occurrence of death events within 7 days in PIVSR patients ( OR = 0.851, 95% CI was 0.756-0.957, P = 0.007). The predicted value of the nomogram model for predicting the risk of death within 7 days in patients with PIVSR was basically consistent with the actual value, and the Hosmer-Lemeshow goodness of fit test χ 2 = 10.679, P = 0.220. The area under the curve (AUC) predicted by the model was 0.960, 95% CI was 0.913-0.998. Conclusions:Age and echocardiographic indicators SV and perforation area PPG are risk factors for mortality within 7 days in PIVSR patients. The nomogram model of mortality risk within 7 days in PIVSR patients constructed using the above indicators has good discrimination and consistency.

Objective The risk evaluation indicators for the occurrence of diaphragm dysfunction in ICU patients was constructed to provide a reference for the establishment of the disease risk evaluation tools for diaphragm dysfunction.Methods The literature related to diaphragm dysfunction from CNKI,Wanfang Data,PubMed,Embase and Web of Science from the establishment of databases to November 11 th,2022 was systematically searched.After the first draft was determined through the literature review method,the first draft of the indicators was revised by brainstorming,with the opinions of 10 medical and nursing experts from May to June 2023.From June to July 2023,the content and weight of risk evaluation indicators of diaphragmatic dysfunction in ICU patients were determined through expert letter inquiry and hierarchical analysis.Results 35 experts completed the first round of letter inquiry,and 34 experts completed the second round of letter inquiry.The recovery rates of the valid questionnaires in the 2 rounds of expert correspondence were 92.1％and 97.1％,respectively,and the expert authority coefficients were 0.884 and 0.904,respectively,and the Kendall harmony coefficients of all indicators were 0.356～0.570 and 0.369～0.604,respectively(all P＜0.001).The final constructed risk evaluation indicators of diaphragm dysfunction in ICU patients includes 7 first-level indicators,34 secondary indicators and 34 tertiary indicators.Conclusion The risk evaluation index of diaphragm dysfunction in ICU patients constructed in this study is comprehensive,specific,scientific and applicable,which can guide medical staff to conduct early risk evaluation of diaphragm function in ICU patients,and provide references for the establishment of disease risk assessment tools for diaphragm function.

Objective To explore the clinical value of micro ribonucleic acid(miR)-27a and miR-1299 in predicting the long-term prognosis of patients with esophageal cancer.Methods A total of 89 patients with esophageal cancer in the hospital were enrolled between June 2020 and June 2022,and all underwent Minimally invasive thoracic and laparoscopic resection of esophageal cancer.The expression levels of miR-27a and miR-1299 were detected by real-time fluorescence quantitative polymerase chain reaction(PCR)before surgery,and level of serum ferritin(SF)was detected by enzyme linked immunosorbent assay.The relationship between miR-27a,miR-1299,SF and clinicopathology in patients with esophageal cancer was analyzed.All were followed up till February 2023 after surgery,and survival of patients was record.The relationship between miR-27a,miR-1299,SF and prognosis was analyzed.The risk factors of long-term prognosis in patients with esophageal cancer were analyzed by multivariate Cox regression model.The relationship between miR-27a,miR-1299 and serum SF was analyzed by Pearson.Results There were significant differences in miR-27a,miR-1299 and serum SF among patients with different tumor staging,lymph node metastasis and differentiation degree(P＜0.05).The results of survival analysis showed that overall survival rates in high-expression miR-27a and SF groups were lower than those in low-expression miR-27a and SF groups(P＜0.05),while which was higher in high-expression miR-1299 group than low-expression miR-1299 group(P＜0.05).Cox regression analysis showed that miR-27a ≥2.54,miR-1299＜4.18 and serum SF ≥223.78 μg/L(P＜0.05)were independent risk factors of postoperative long-term prognosis of patients with esophageal cancer.Pearson correlation analysis showed that level of serum SF was positively correlated with relative expression level of miR-27a(P＜0.05,r=0.612),while negatively correlated with relative expression level of miR-1299(P＜0.05,r=-0.517).Conclusion The miR-27a,miR-1299 and serum SF are related to tumor staging,lymph node metastasis and differentiation degree in patients with esophageal cancer,which can be applied to evaluate postoperative long-term prognosis.

Objective:To investigate the application of combined deep learning and radiomic features derived from enhanced arterial phase CT imaging with clinical data to differentiate between T2 and T3 staging in patients with esophageal cancer.Methods:A retrospective study was conducted using clinical and CT data from 388 patients with pathologically confirmed esophageal cancer treated at The First Affiliated Hospital of Wannan Medical College between May 2015 and April 2024.The dataset was randomly divided into a training set(271 cases)and validation set(117 cases)in a 7:3 ratio.Radiomic and deep learning features were extracted from enhanced arterial phase CT images.The least absolute shrinkage and selection operator algorithm was employed for feature reduction and selection,leading to the development of radiomic(Radscore)and deep learning(Deepscore)scores.Univariate and multivariate Logistic regression analyses were conducted to identify independent risk factors,and clinical,radiomic,deep learning,and combined models were constructed.A nomogram was gener-ated for the combined model.The diagnostic performance of the models was evaluated using the area under the receiver operating charac-teristic curve(AUC)and compared using the DeLong test.Clinical net benefit was assessed through decision curve analysis,and model calib-ration was evaluated using calibration curves.Results:Nine radiomicand 12 deep learning features were selected after dimensionality reduc-tion.Multivariate Logistic regression identified tumor length,boundary,Radscore,and Deepscore as independent risk factors for distinguish-ing between T2 and T3 staging.In the training set,the AUC of the combined model was 0.867,which was significantly higher than that of the clinical(0.774,P<0.001),radiomic(0.795,P<0.001),and deep learning(0.821,P=0.001)models.In the validation set,the AUC of the com-bined model was 0.810,which was significantly higher than that of the clinical(0.653,P=0.002),radiomic(0.719,P=0.033),and deep learn-ing(0.750,P=0.009)models.The decision curve analysis indicated that the combined model provided the highest clinical benefit in both datasets.The calibration curves demonstrated a good fit for both datasets(P=0.084,0.053).Conclusion:The integration of deep learning and radiomic features obtained from enhanced arterial phase CT images with clinical data offers a reliable method for accurately distinguishing between preoperative T2 and T3 staging in esophageal cancer,thereby supporting clinical decision-making for treatment planning.

Objective To develop and evaluate the equivalence of the Mandarin test material for tracking of noise tolerance(TNT)test.Methods Six different speech materials were developed(themes including daily life,entertainment,family,festivals,outdoors,and school).Four-minute TNT tests were measured in 21 normal hear-ing subjects using six different test materials.For each session,the tolerable noise level(TNL)and TNT scores were acquired and calculated for 3 time windows(31～240 s,31～120 s,151～240 s).Results Statistic analysis showed significant differences in the TNL(F=43.611,P＜0.05)among the normal hearing listeners.There were statistically significant differences in standardize z-scored TNT scores of the six different materials in the three time windows(P＜0.05).Post-hoc comparisons revealed that all significant differences involved the family and daily life themes.Conclusion Entertainment,festival,outdoors and school themed test materials can serve as the materials of Mandarin tracking of noise tolerance test and can be appied in research and clinical testing.

Objective: An isochronous substitution model was established to explore the association and substitution effect between college students 24 hour activity behavior and physical health, so as to provide specific activity behavior suggestions for college students to improve their physical health. Methods: A stratified random cluster sampling method was used to conduct physical fitness tests and 24 hour activity behavior surveys among 2 794 college students in 12 colleges and universities in Tianjin.Time spent on sedentary behavior(SB), light intensity physical activity(LPA), moderate to vigorous physical activity(MVPA) and sleep(SLP) time. The isochronous method of components was used to explore the relationship between 24 h activity behavior and physical health. Results: Except for 50 m running, MVPA was negatively correlated with BMI Z ( β =-0.62, P <0.05), but positively correlated with other physical fitness indexes ( β =0.34~274.23, P <0.05). LPA was not associated with lung capacity, sitting forward flexion and 50 m running, and negatively correlated with other physical fitness indexes ( β =-14.30- -0.19, P <0.05). SB was negatively correlated with most physical fitness indexes ( β =-11.57- -0.33, P <0.05), but positively correlated with BMI Z ( β =0.45, P < 0.05 ). In addition to lung capacity, SLP was positively correlated with BMI Z , total physical fitness score,1 minute sit-ups, pull ups, 800/1 000 m running, sitting forward flexion, and 50 m running ( β =0.27-11.21, P <0.05), but negatively correlated with long jump ( β =-0.10, P <0.05）. Isochronous substitution showed that the adverse effects of 30 min/d SB and LPA substitution of MVPA were much greater than the beneficial effects of MVPA substitution for corresponding behaviors (total physical score: SB, -0.58 vs 0.47 points; LPA, -0.50 vs 0.38 points). Conclusion MVPA and SLP have been found to have a positive effect on physical fitness among college students. Therefore, in the process of improving the physical health of college students, ensuring adequate sleep, improving MVPA and reducing SB as much as possible may be one of the effective methods.

Objective:To evaluate the efficacy between pedicle screws combined with vertebroplasty (PSV) and pedicle screws combined with intermediate screws (PSIS) for the treatment of osteoporotic thoracolumbar fracture (OTLF).Methods:PubMed, Cochrane Library, Web of Science, CNKI, VIP and Wanfang database were searched for all randomized controlled trial (RCT) or case-control trial (CCT) studies that comparing PSV and PSIS for the treatment of OTLF. Two reviewers independently screened the studies in the light of the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. The Meta-analysis was performed using the RevMan 5.4 software. The subjects were divided into PSV group and PSIS group according to different treatment methods. Operation time, intraoperative blood loss, postoperative incision infection rate, postoperative short-, mid- and long-term visual analogue scale (VAS) score, postoperative short- and mid-term Oswestry disability index (ODI), hospitalization time, postoperative short-, mid- and long-term Cobb angle, postoperative short-, mid- and long-term anterior vertebral height ratio (VBH) and implant failure rate were compared between the two groups.Results:A total of 12 studies were enrolled for review, involving 870 subjects (433 in PSV group and 437 in PSIS group). The results showed insignificant difference between the two groups in operation time ( WMD=7.07, 95% CI -4.00, 18.13, P>0.05), intraoperative blood loss ( WMD=0.62, 95% CI -7.19, 8.43, P>0.05), postoperative incision infection rate ( OR=0.65, 95% CI 0.10, 4.08, P>0.05), postoperative short-term Cobb angle ( WMD=-0.19, 95% CI -0.43, 0.05, P>0.05) and postoperative short-term VBH ( WMD=0.91, 95% CI -1.30, 3.13, P>0.05). However, there was significant difference between the two groups in postoperative short-term VAS score ( WMD=-0.59, 95% CI -1.02, -0.15, P<0.05), mid-term VAS score ( WMD=-0.41, 95% CI -0.65, -0.16, P<0.05), long-term VAS score ( WMD=-0.51, 95% CI -0.59, -0.43, P<0.05), postoperative short-term ODI ( WMD=-6.26, 95% CI -9.65, -2.87, P<0.05), postoperative mid-term ODI ( WMD=-2.44, 95% CI -3.43, -1.45, P<0.05), hospitalization time ( WMD=-2.65, 95% CI -4.61, -0.68, P<0.05), postoperative mid-term Cobb angle ( WMD=-1.40, 95% CI -2.41, -0.39, P<0.05), postoperative long-term Cobb angle ( WMD=-1.06, 95% CI -1.59, -0.52, P<0.05), postoperative mid-term VBH ( WMD=3.06, 95% CI 1.31, 4.81, P<0.05), postoperative long-term VBH ( WMD=4.11, 95% CI 2.44, 5.77, P<0.05) and implant failure rate ( OR=2.06, 95% CI 0.11, 0.59, P<0.05). Conclusion:Compared with PSIS, PSV can not reduce the operation time, intraoperative blood loss and incision infection in the treatment of OTLF, but it can significantly relieve pain, improve function, decrease reduce hospitalization time, help to maintain Cobb angle and anterior vertebral height after operation, and reduce implant failure rate.