Objective:To discuss the effect of downregulating of high mobility group box protein 2(HMGB2)expression on the biological behavior of the liver cancer cells and the epithelial-mesenchymal transition(EMT)process,and to clarify its mechanism.Methods:The human liver cancer LM3 cells at logarithmic growth phase were divided into negative control group and HMGB2 RNA interference group(HMGB2 siRNA group);the cells in two groups were transfected with RNA oligonucleotides(RNA oligos)with irrelevant sequences and RNA oligos designed to knock down HMGB2,and the Lipofectamine 2000 was regarded as the vector.The expression levels of HMGB2 mRNA and protein in the cells in two groups were detected by real-time fluorescence quantitative PCR(RT-qPCR)and Western blotting methods;cell scratch assay and Transwell chamber assay were used to detect the migration and invasion abilities of the cells in two groups;the expression levels of E-cadherin,N-cadherin,and Vimentin proteins and protein kinase B(AKT)/mammalian target of rapamycin(mTOR)pathway related proteins in the cells in two groups were detected by Western blotting method.Results:Compared with negative control group,the expression levels of HMGB2 mRNA and protein in the cells in HMGB2 siRNA group were significantly decreased(P<0.05),the cell scratch healing rate was significantly decreased(P<0.01),the number of invasion cells was significantly decreased(P<0.01),and the expression level of E-cadherin protein in the cells was significantly increased(P<0.01),while the expression levels of N-cadherin,Vimentin,mTOR,AKT,and phosphorylated AKT(p-AKT)proteins in the cells were significantly decreased(P<0.05 or P<0.01).Conclusion:Downregulating the expression of HMGB2 can reduce the migration and invasion abilities of the liver cancer LM3 cells and inhibit the EMT,and its mechanism may be related to regulating the expression of the AKT/mTOR pathway related proteins.

Objective To evaluate the absence of corpus callosum(ACC)and intracranial accompanying abnormalities in fetus via prenatal MRI.Methods A total of 61 cases of fetal ACC diagnosed by prenatal MRI were analyzed retrospectively.The types and numbers of intracranial accompanying abnormalities were observed,and the probability of accompanying abnormalities was counted.According to whether the corpus callosum was completely absent,all cases were divided into complete ACC and partial ACC.Statistical differences of probability of accompanying abnormalities between the two groups were analyzed.Results A total of 54.1%(33/61)patients were complicated with other intracranial abnormalities,among which the most common was cerebral cortical dysplasia,accounting for 26.2%(16/61).The probability of complete ACC and partial ACC complicated with other intracranial abnormalities was 63.4%(26/41)and 35.0%(7/20),respectively,and there was statistical difference in intracranial abnormalities between complete ACC and partial ACC(χ2=4.37,P=0.037).The probability of complete ACC and partial ACC complicated with cerebral cortical dysplasia was 39.0%(16/41)and 5.0%(1/20),respectively,and there was statistical difference in cerebral cortical dysplasia between complete ACC and partial ACC(χ2=7.74,P=0.005).Conclusion MRI can accurately diagnose the fetal ACC and intracranial accompanying abnormalities.Complex ACC is more common than isolated ACC.Compared with partial ACC,complete ACC is more likely to be complicated with other intracranial abnormalities,and cerebral cortical dysplasia is the most common,which provides reliable diagnostic basis for fetal prognosis in clinical practice.

Objective To explore the application value of MR in prenatal screening of fetal digestive tract diseases.Methods A total of 36 fetuses who underwent abdominal MR examination were analyzed retrospectively.The data of gastrointestinal abnormalities were compared with postnatal surgery or follow-up results respectively.The characteristics of MR images were summarized,including whether the intestines movement was normal,the signal characteristics of the dilated intestinal cavity,the shape of the obstruction site of the dilated intestines,and whether there was ascites.Results Of the 36 fetuses,there were 6 cases with jejunum obstruction,2 cases with ileum obstruction,2 cases with volvulus necrosis,2 cases with colonic obstruction,8 cases with colon slightly widened due to meconium accumulation in late pregnancy diagnosed correctly via MR,3 cases with esophageal atresia,1 case with misdiagnoses,13 cases with duodenal obstruction,and 1 case with missed diagnosis.A total of 34 cases were diagnosed correctly via MR,with a diagnostic accuracy of 94.44％(34/36).The 6 cases with jejunum obstruction were all located in the left upper abdomen of the fetus,showed tortuous and dilated intestines in the middle and upper abdomen,with high signal on the T2 WI and low signal on the T1 WI in the intestinal cavity.Two cases with ileum obstruction were all located in the right middle and lower abdomen,showed that the dilated intestines near the obstruction point was slightly higher on the half-fourier acquisition single-shot turbo spin-echo(HASTE)-T2WI and T1 WI,and the colon was small.Two cases of colonic obstruction showed significant expansion of the transverse colon,with low signal on the HASTE-T2WI and high signal on the T1 WI in the intestinal cavity.The intestinal canal of 2 cases with volvulus necrosis was out of shape,with dilated and shrunken intestinal cavity and twisted mass,showed high signal on diffusion weighted imaging(DWI),and a large amount of fluid was in the abdominal cavity.Three cases with esophageal atresia showed cystic dilation in the upper and middle segments of the esophagus,without high signal gastric vesicles on the T2 WI and with empty and collapsed small intestinal cavity.One case showed esophageal patency via postnatal imaging.The"double bubble sign"was found in 13 cases with duodenal obstruction diagnosed by MR.One case was misdiagnosed due to the influence of motion artifact,resulting in poor display of anal region structure.Conclusion MR can not only determine the location of fetal gas-trointestinal dysplasia via the characteristics and location of dilated intestinal cavity signals,but also analyze the cause of obstruction.Jejunum atresia is prone to intestinal malrotation,and DWI sequence is beneficial for evaluating intestinal wall ischemia.

With the widespread application of immune checkpoint inhibitors, chemotherapy combined with immunotherapy has shown promising efficacy in the treatment of various cancers. Especially gastric cancer, this strategy is gradually expanding from first-line treatment in advanced stages to perioperative management. Compared to neoadjuvant chemotherapy alone, the combined approach not only improves pathological regression but also leads to better downstaging, which is particularly significant in gastric cancer subsets that are HER2-positive, mismatch repair deficient, PD-L1 combined positive score ≥5, or EB virus-positive. This combined treatment has made it possible to reduce the extent of gastrectomy, perform function-preserving surgeries, or even consider non-surgical strategies. Currently, exploring the optimal protocols for combining immune checkpoint inhibitors with chemotherapy, identifying potential indications for function-preserving surgery, improving surgical methods, and developing non-surgical strategies represent key issues in the surgical management of gastric cancer in the era of immunotherapy.

With the widespread application of immune checkpoint inhibitors, chemotherapy combined with immunotherapy has shown promising efficacy in the treatment of various cancers. Especially gastric cancer, this strategy is gradually expanding from first-line treatment in advanced stages to perioperative management. Compared to neoadjuvant chemotherapy alone, the combined approach not only improves pathological regression but also leads to better downstaging, which is particularly significant in gastric cancer subsets that are HER2-positive, mismatch repair deficient, PD-L1 combined positive score ≥5, or EB virus-positive. This combined treatment has made it possible to reduce the extent of gastrectomy, perform function-preserving surgeries, or even consider non-surgical strategies. Currently, exploring the optimal protocols for combining immune checkpoint inhibitors with chemotherapy, identifying potential indications for function-preserving surgery, improving surgical methods, and developing non-surgical strategies represent key issues in the surgical management of gastric cancer in the era of immunotherapy.

Objective:To investigate the safety and effectiveness of robot-assisted total knee arthroplasty (TKA).Methods:From August 2021 to March 2022, the data of 69 patients who received robot-assisted TKA for inflammatory disease of knee in 6 hospitals were collected, including 24 males and 45 females, aged 52±6 years (range, 46-72 years), including 53 cases of knee osteoarthritis,10 cases of rheumatoid arthritis, and 6 cases of traumatic arthritis. Imaging data examination of patients was completed according to the multicenter specification. Preoperatively, the patient's CT data were extracted before surgery and a personalized prosthesis positioning plan was designed by the robotic system to determine the prosthesis size, lower limb force lines, and femoral and tibial osteotomy volumes; intraoperatively, the osteotomy template was robotically controlled to complete the osteotomy according to the prosthesis positioning plan, and the intraoperative osteotomy volumes were measured to verify the accuracy of the robot-assisted TKA osteotomy with the preoperative planning. Postoperatively, the lateral angle of the distal femur, the medial angle of the proximal tibia and the hip-knee-ankle angle were measured in the coronal plane according to radiographs; the postoperative outcome was evaluated 3 months after operation, using the American Knee Society score (KSS), including the KSS knee score and functional score.Results:The operative time was 97.3±2.3 min (range, 80-110 min) and the amount of bleeding was 320.0±6.2 ml (range, 300-350 ml) in 69 patients. Three months after operation, the mean range of motion of knee joint was increased from 82.2°±1.1° before surgery to 119.7°±0.8° after surgery ( t=27.65, P<0.001), and the line of force of lower limb was improved from 160.9°±0.5° before surgery to 178.0°±0.2° after surgery ( t=32.03, P<0.001). KSS-knee score increased from 54.8±0.7 points before operation to 85.0±0.5 points after operation, and KSS-functional score increased from 56.5±0.7 points before operation to 85.9±0.4 points after operation, the difference was statistically significant ( t=35.45, 36.58, P<0.001). The proportion of patients with intraoperative femoral and tibial osteotomies within 2 mm osteotomy error compared with preoperative planning was 97% for the lateral tibial plateau, 100% for the medial tibial plateau, 100% for the lateral distal femur, 99% for the medial distal femur, 93% for the lateral posterior femoral condyle, and 100% for the medial posterior femoral condyle; The proportion of patients with postoperative anteroposterior X-ray measurement angle error within 3° was: 100.0% for the distal lateral femoral angle, 100.0% for the proximal medial tibial angle, and 100% for the hip-knee-ankle angle. No complications occurred in all patients except for one case in which fat liquefaction occurred in the postoperative wound. Conclusion:Robot-assisted TKA is a safe and effective surgical method for the treatment of inflammatory disease of knee with accurate prosthesis installation and good postoperative recovery of lower limb alignment.

Objective:This paper is to propose a calibration model based on sine function which enables more choices to determine the functional relationship between the absorbance and the concentration of the tested substance.Methods:This paper uses Taylor series expansion and Levenberg-Marquardt to obtain the optimal parameters for the Sine model and then summarizes the characters of the Sine model. On the basis of these characters, this paper compares and evaluates the experimental data processed by the Sine model from four aspects: correctness, precision, linearity and correlation.Results:The generated sine function calibration model achieved deviations within ±3% of the national standard substance, precision ( CV%) less than 2%, and a linear correlation coefficient greater than 0.990 within the measurement range of 32-710 mg/L. The correlation coefficients between the sine model and other well-performing linear calibration models for 104 clinical samples were all greater than 0.990. Conclusions:The performance evaluation of the prealbumin assay kit using the sine function calibration model meets industry standards and shows good correlation with the results of clinical sample measurements. This indicates that the sine function calibration model can serve as a new calibration model for in vitro diagnostic research and clinical applications.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To investigate the etiology of necrotizing pneumonia (NP) in children and the clinical characteristics of NP caused by different pathogens in China.Methods:A retrospective, case-control study was performed in children with NP who were admitted to 13 hospitals in China from January 2008 to December 2019. The demographic and clinical information, laboratory data, etiological and radiological findings were analyzed. The data were divided into three groups based on the following years: 2008-2011, 2012-2015 and 2016-2019, and the distribution characteristics of the pathogens in different period were compared. Meanwhile, the pathogens of pediatric NP in the southern and northern China were compared. And the clinical characteristics of the Mycoplasma pneumoniae (MP) NP and the bacterial NP were also compared. T-test or Mann-Whitney nonparametric test was used for comparison of numerical variables, and χ 2 test was used for categorical variables. Results:A total of 494 children with NP were enrolled, the median ages were 4.7 (0.1-15.3) years, including 272 boys and 222 girls. Among these patients, pathogens were identified in 347 cases and the pathogen was unclear in the remaining 147 cases. The main pathogens were MP (238 cases), Streptococcus pneumoniae (SP) (61 cases), Staphylococcus aureus (SA) (51 cases), Pseudomonas aeruginosa (13 cases), Haemophilus influenzae (10 cases), adenovirus (10 cases), and influenza virus A (7 cases), respectively. MP was the most common pathogen in all three periods and the proportion increased yearly. The proportion of MP in 2016-2019 was significantly higher than that in 2012-2015 (52.1% (197/378) vs. 36.8% (32/87), χ 2= 6.654, P=0.010), while there was no significant difference in the proportion of MP in 2012-2015 and that in 2008-2011 (36.8% (32/87) vs. 31.0% (9/29), χ2=0.314, P=0.575).Regarding the regional distribution, 342 cases were in the southern China and 152 in the northern China. Also, MP was the most common pathogen in both regions, but the proportion of MP was higher and the proportion of SP was lower in the north than those in the south (60.5% (92/152) vs. 42.7% (146/342), χ 2=13.409, P<0.010; 7.9% (12/152) vs. 14.3% (49/342), χ 2= 4.023, P=0.045). Comparing the clinical characteristics of different pathogens, we found that fever and cough were the common symptoms in both single MP and single bacterial groups, but chest pain was more common (17.0% (34/200) vs. 6.1% (6/98), χ 2=6.697, P=0.010) while shortness of breath and wheezing were less common in MP group (16.0% (32/200) vs. 60.2% (59/98), χ 2=60.688, P<0.01; 4.5% (9/200) vs. 21.4% (21/98), χ 2=20.819, P<0.01, respectively). The white blood cell count, C-reactive protein and procalcitonin in the bacterial group were significantly higher than those in the MP group (14.7 (1.0-67.1)×10 9/L vs. 10.5 (2.5-32.2)×10 9/L, 122.5 (0.5-277.3) mg/L vs. 51.4 (0.5-200.0) g/L, 2.13 (0.05-100.00) μg/L vs. 0.24 (0.01-18.85) μg/L, Z=-3.719, -5.901 and -7.765, all P<0.01). Conclusions:The prevalence of pediatric NP in China shows an increasing trend during the past years. MP, SP and SA are the main pathogens of NP, and the most common clinical symptoms are fever and cough. The WBC count, C-reactive protein and procalcitonin in bacterial NP are significantly higher than those caused by MP.

Objective:To explore the brain function changes in patients with cervical vertigo using functional MRI.Methods:Twenty-two patients who were diagnosed with cervical vertigo were recruited in this study for functional MRI (fMRI) analysis, while 25 age- and sex-matched adult healthy individuals were chose forhealthy controls. The Visual Analogue Scale(VAS) and Dizziness Handicap Inventory (DHI) were used to access the severity of cervical vertigo, and the six-point categorical rating scale was used to measure the frequency of vertigo. Functional MRI was used to investigate the regions with brain functional changes between the cervical vertigo group and the control group. All the data was analyzed using low-frequency oscillation amplitude (ALFF) to explore local brain function changes. The ALFF values between the two groups were tested by two independent samples t-tests. Finally, the ALFF values in abnormal brain regions were extracted using the REST software package and correlated with the diseaseduration of cervical vertigo and thevertigo scores (VAS and DHI) using Pearson correlation analysis. P <0.05 was considered statistically significant. Results:Compared to healthy controls, patients with cervical vertigo haddecreased ALFF valuesin the left superior temporal gyrus (voxel=45, t=-3.36), right superior temporal gyrus (voxel=32, t=-2.82) and left supramarginal gyrus (voxel=57, t=-4.85), and increased ALFF values in the left and right cerebellum (voxel=41, t=4.26; voxel=33, t=4.57; respectively)(AlphaSim Rest, all P values >0.05). The ALFF values of left and right superior temporal gyrus were negatively correlated with the disease duration of vertigo (left R2=0.437, right R2==0.259), the VAS score (left R2==0.453, right R2==0.341) and DHI score (left R2=0.553, right R2=0.594), respectively, and there were significant differences (all P values < 0.05). The ALFF values of left and right cerebellum were positively correlated with the disease duration of vertigo (left R2==0.555, right R2=0.490) and the VAS score (left R2=0.307, right R2=0.282) and DHI score (left R2=0.632, right R2=0.591), respectively, and the differences were significant (all P values < 0.05). Conclusion:Patients with cervical vertigo have reduced spontaneous nerve activity in bilateral Vestibular cortex, and increased spontaneous nerve activity in the bilateral cerebellum. The brain functional changes were correlated with the disease duration and the severity of vertigo.