OBJECTIVE:Anterior cervical decompression and fusion is a classic surgical method for the treatment of degenerative cervical spondylosis.The use of nail plates increases the fusion rate and stability and indirectly leads to adjacent vertebral degeneration and postoperative dysphagia.In this paper,the clinical results and complications of ROI-CTM self-locking system and traditional cage combined with screw-plate internal fixation in the treatment of degenerative cervical spondylosis were compared by meta-analysis to provide evidence-based support for the selection of internal fixation methods in anterior cervical decompression and fusion. METHODS:CNKI,WanFang,VIP,PubMed,Cochrane Library,Web of Science,and Embase databases were searched for Chinese and English literature on the application of ROI-CTM self-locking system and fusion cage combined with screw plate internal fixation in the treatment of degenerative cervical spondylosis.The retrieval time range was from inception to July 2023.Two researchers selected the literature strictly according to the inclusion and exclusion criteria.The Cochrane bias risk tool was used to evaluate the quality of randomized controlled trials.Newcastle-Ottawa Scale was used to assess the quality of cohort studies.Meta-analysis was performed using RevMan 5.4 software.Outcome indicators included operation time,intraoperative blood loss,Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,incidence of adjacent vertebral degeneration,cage subsidence rate,and incidence of dysphagia. RESULTS:Thirteen articles were included,including eleven retrospective cohort studies and two randomized controlled trials,with 1 136 patients,569 in the ROI-C group,and 567 in the cage combined with the nail plate group.Meta-analysis results showed that the operation time(MD=-15.52,95%CI:-18.62 to-12.42,P<0.000 01)and intraoperative blood loss(MD=-24.53,95%CI:-32.46 to-16.61,P<0.000 01)in the ROI-C group and the fusion device combined with nail plate group.Postoperative adjacent segment degeneration rate(RR=0.40,95%CI:0.27-0.60,P<0.000 01)and postoperative total dysphagia rate(RR=0.18,95%CI:0.13-0.26),P<0.000 01)were statistically different.The two groups had no significant difference in Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,or cage subsidence rate(P≥0.05). CONCLUSION:Applying an ROI-CTM self-locking system and traditional cage combined with plate internal fixation in anterior cervical decompression and fusion can achieve satisfactory clinical results in treating degenerative cervical spondylosis.The operation of the ROI-CTM self-locking system is more straightforward.Compared with a cage combined with plate internal fixation,the ROI-CTM self-locking system can significantly reduce the operation time and intraoperative blood loss and has obvious advantages in reducing the incidence of postoperative dysphagia and adjacent segment degeneration.The ROI-CTM self-locking system is recommended for patients with skip cervical spondylosis and adjacent vertebral disease.However,given its possible high settlement rate,using a fusion cage combined with screw-plate internal fixation is still recommended for patients with degenerative cervical spondylosis with multiple segments and high-risk factors of fusion cage settlement,such as osteoporosis and vertebral endplate damage.

ObjectiveIn nature, objects cast shadows due to illumination, forming the basis for stereoscopic perception. Birds need to adapt to changes in lighting (meaning they can recognize stereoscopic shapes even when shadows look different) to accurately perceive different three-dimensional forms. However, how neurons in the key visual brain area in birds handle these lighting changes remains largely unreported. In this study, pigeons (Columba livia) were used as subjects to investigate how neurons in pigeon’s ventrolateral mesopallium (MVL) represent stereoscopic shapes consistently, regardless of changes in lighting. MethodsVisual cognitive training combined with neuronal recording was employed. Pigeons were first trained to discriminate different stereoscopic shapes (concave/convex). We then tested whether and how light luminance angle and surface appearance of the stereoscopic shapes affect their recognition accuracy, and further verify whether the results rely on specify luminance color. Simultaneously, neuronal firing activity of neurons was recorded with multiple electrode array implanted from the MVL during the presentation of difference shapes. The response was finally analyzed how selectively they responded to different stereoscopic shapes and whether their selectivity was affected by the changes of luminance condition (like lighting angle) or surface look. Support vector machine (SVM) models were trained on neuronal population responses recorded under one condition (light luminance angle of 45°) and used to decode responses under other conditions (light luminance angle of 135°, 225°, 315°) to verify the invariance of responses to different luminance conditions. ResultsBehavioral results from 6 pigeons consistently showed that the pigeons could reliably identify the core 3D shape (over 80% accuracy), and this ability wasn’t affected by changes in light angle or surface appearance. Statistical analysis of 88 recorded neurons from 6 pigeons revealed that 83% (73/88) showed strong selectivity for specific 3D shapes (selectivity index>0.3), and responses to convex shapes were consistently stronger than to concave shapes. These shape-selective responses remained stable across changes in light angle and surface appearance. Neural patterns were consistent under both blue and orange lighting. The decoding accuracy achieves above 70%, suggesting stable responses under different conditions (e.g., different lighting angles or surface appearance). ConclusionNeurons in the pigeon MVL maintain a consistent neural encoding pattern for different stereoscopic shapes, unaffected by illumination or surface appearance. This ensures stable object recognition by pigeons in changing visual environments. Our findings provide new physiological evidence for understanding how birds achieve stable perception (“invariant neural representations”) while coping with variations in the visual field.

A derivatizaton method combined with gas chromatography-mass spectrometry(GC-MS)was established for detection of isobutyl chloroformate(IBCF)residue in active pharmaceutical ingredient of agatroban.The extraction and derivatization reagents,derivatization time,qualitative and quantitative ions were selected and optimized,respectively.The possible mechanism of derivatization and characteristic fragment ions fragmentation were speculated.The agatroban samples were dissolved and extracted by methanol,and the residual IBCF was derived with methanol to generate methyl isobutyl carbonate(MIBCB).After 24 h static derivatization at room temperature,IBCF was completely transformed into MIBCB,which could be used to indirectly detect IBCF accurately.The results showed that the linearity of this method was good in the range of 25-500 ng/mL(R2=0.9999).The limit of detection(LOD,S/N=3)was 0.75 μg/g,and the limit of quantification(LOQ,S/N=10)was 2.50 μg/g.Good recoveries(95.2%-97.8%)and relative standard deviations(RSDs)less than 3.1%(n=6)were obtained from agatroban samples at three spiked levels of IBCF(2.50,25.00,50.00 μg/g),which showed good accuracy of this method.Good precision of detection results was obtained by different laboratory technicians at different times,the mean value of spiked sample solution(25.00 μg/g)was 24.28 μg/g,and the RSD was 2.1%(n=12).The durability was good,minor changes of detection conditions had little effect on the results.Under the original condition and conditions with initial column temperature±5℃,heating rate±2℃/min,column flow rate±0.1 mL/min,the IBCF content of spiked sample solution(25.00 μg/g)was detected,the mean value of detection results was 24.16 μg/g,and the RSD was 2.2%(n=7).Eight batches of agatroban samples from two manufacturers were detected using the established method,and the results showed that no IBCF residue was detected in any of these samples.The agatroban samples could be dissolved by methanol,and then the IBCF residue could be simultaneously extracted and derived with methanol as well.This detection method had the advantages of simple operation,high sensitivity,low matrix effect and accurate quantification,which provided a new effective method for detection of IBCF residue in agatroban.

Objective To investigate the relationship between circKIF4A expression and clinicopathologic features and prognosis of thyroid cancer patients.Methods A total of 120 patients diagnosed with thyroid cancer in our hospital from April 2016 to April 2017 were selected by random sampling method.Cancer tissues and adjacent tissues were taken during surgery and divided into thyroid cancer group and adjacent cancer group according to surgical pathologic detection.The relative expression level of circKIF4A in thyroid cancer group and paracancer group was detected by qRT-PCR,and the relationship between circKIF4A expression and clini-copathological features of thyroid cancer was analyzed.Kaplan-Meier survival curve was used to analyze the relationship between circKIF4A expression and prognosis of thyroid cancer patients.Cox regression analysis was performed to analyze the factors influencing the poor prognosis of patients with thyroid cancer 5 years af-ter surgery.Results The relative expression level of circKIF4A in thyroid cancer group was higher than that in paracancer group,and the difference was statistically significant(P＜0.05).The expression of circKIF4A was correlated with the degree of capsule invasion,lymph node metastasis and differentiation(P＜0.05).Kap-lan-Meier survival curve analysis showed that the 5-year cumulative survival rate of patients with high cir-cKIF4A expression was lower than those with low circKIF4A expression,and the difference was statistically significant(x2=11.368,P=0.001).Multivariate analysis showed that envelope invasion,degree of differenti-ation,lymph node metastasis and circKIF4A expression level were the influencing factors for poor prognosis of thyroid cancer patients at 5 years after surgery(P＜0.05).Conclusion circKIF4A is highly expressed in thy-roid cancer tissues,which is related to the clinicopathological features and 5-year postoperative survival of thy-roid cancer patients,and may be used as a potential prognostic marker for thyroid cancer.

Objective To measure the transaction costs of compact urban medical groups and analyze the evaluation of transaction costs by various stakeholders.Methods Using the typical sampling method,it took the Compact Urban Medical Group of J District General Hospital in Zhengzhou City,Henan Province as an example.A questionnaire sur-vey was conducted on the construction party(health administration department,leading hospital and member units)and related staff from January 19 to 24,2024.The contents of the survey included institutional statements,basic information of the respondents,relevant fees or costs of each participant,and the evaluation of transaction costs by the staff of each institutional participant.Results In 2023,the total transaction cost of District J Medical Group in Zhengzhou City was 75 811 014.49 yuan;the majority of transaction costs were borne by the leading hospi-tal(98.1％);all stakeholders confirmed the existence of transaction costs in the medical group,but there were dif-ferences in the perception of the manifestations and distribution of transaction costs(P＜0.05).Conclusion The transaction costs of compact urban medical group are high,most of which are borne by the leading hospital;The stakeholders have not yet clearly understood the form and distribution of transaction costs.The measures to deal with transaction costs include"facing up to the widespread existence of transaction costs","improving the compensation incentive mechanism"and"establishing a saving system supply path".

Objective To measure the transaction costs of compact county medical alliance and propose counter-measures.Methods Based on Williamson-Zhang Wuchang analysis paradigm,it established the measure matrix of transaction cost of compact county medical alliance.Through the typical sampling method,the medical community of D city in Haixi Prefecture,Qinghai Province was selected as a research example to carry out an empirical study.Results The total transaction cost of the compact county medical community was 6 292 500.00 yuan,the transac-tion cost of the leading hospital was 6 234 300.00 yuan,accounting for 99.07％,and the special investment of the leading hospital reached to 5 887 100.00 yuan,accounting for 94.43％.The total transaction cost of the 298 referred patients was 308 400.00 yuan,and the average transaction cost per patient was 1 035.05 yuan.Conclusion The transaction costs of compact county medical alliance was generally high,most of which was borne by the leading hospital,and the patients also had to bear the corresponding transaction costs.In the next stage,the transaction costs should be dealt with from three aspects,including recognizing the secrecy and universality of the transaction costs,establishing economical system supply and establishing a sound compensation mechanism.

Objective To measure the transaction costs of the health management alliance with the clue of the re-ferral treatment of patients with hypertension and diabetes.Methods Based on the Williamson-Zhang Wuchang analy-sis paradigm,a transaction cost measurement matrix of health management alliance was established.Through the typical sampling method,the health management alliance of County N in Shandong Province was selected as a re-search example to carry out empirical research.Results In 2023,the total transaction costs of the sampled health management alliance reached to 6 726 700.00 yuan,and the average transaction cost per referral patient was 3 846 yuan.The leading hospital accounted for 79.45％of the transaction cost,followed by the CDC.Meanwhile,busi-ness coordination cost accounted for 47.18％of the total transaction cost,and the average transaction cost per refer patient with hypertension or diabetes was 700.90 yuan.Conclusion The total transaction costs of the health manage-ment alliance was large,and it was mainly borne by the leading hospital.Patients also need to bear considerable transaction costs.The countermeasures included improving the service integration mechanism,establishing economi-cal system supply path,and coordinating actions between social health insurance system and health care system.

AIM: To analyze the research status and future development trends of intermittent exotropia(IXT)by bibliometric study.METHODS: Bibliometrics methods were used and the related literatures in the Web of Science Core Collection(WoSCC)database from 2003 to 2022 were retrieved. CiteSpace6.2.R2 software was used to conduct visualized analysis of publications of one year, countries, institutions, journals, authors, references and keywords.RESULTS: A total of 620 literatures on IXT were retrieved from 2003 to 2022, and there has been a progressive increase in the number of publications. South Korea and the United States, Mayo Clinc and Holmes JM were the most productive and impactful country, institution and author, respectively. The Journal of American Association for Pediatric Ophthalmology and Strabismus(J AAPOS)published the most manuscripts(78 publications). The keywords with the strongest citation burst were surgery, epidemiology, alignment and recurrence.CONCLUSION: Visualized analysis conducted by CiteSpace software could objectively show the quantity changes and distribution of literatures on IXT from 2003 to 2022. Furthermore, the research hotspot of IXT has gradually shifted from surgery and epidemiology to fusion and recurrence.

Objective:To analyze the clinical phenotype and genetic characteristics for a child with Canavan disease.Methods:A child who was admitted to the Children's Hospital Affiliated to Shandong University on April 9, 2021 for inability to uphold his head for 2 months and increased muscle tone for one week was subjected to whole exome sequencing, and candidate variants were verified by Sanger sequencing.Results:Genetic testing revealed that the child has harbored compound heterozygous variants of the ASPA gene, including a paternally derived c. 556_559dupGTTC (p. L187Rfs*5) and a maternally derived c.919delA (p. S307Vfs*24). Based on the guidelines from the American College of Medical Genetics and Genomics, both variants were predicted to be pathogenic (PVS1+ PM2_Supporting+ PM3). Conclusion:The c. 556_559dupGTTC (p.L187Rfs*5) and c. 919delA (p.S307Vfs*24) compound heterozygous variants of the ASPA gene probably underlay the pathogenesis of Canavan disease in this child.

As a potential vectored vaccine,Newcastle disease virus(NDV)has been subject to various studies for vaccine development,while relatively little research has outlined the immunomodulatory effect of the virus in antigen presentation.To elucidate the key inhibitory factor in regulating the interaction of infected dendritic cells(DCs)and T cells,DCs were pretreated with the NDV vaccine strain LaSota as an inhibitor and stimulated with lipopolysaccharide(LPS)for further detection by enzyme-linked immunosorbent assay(ELISA),flow cytometry,immunoblotting,and quantitative real-time polymerase chain reaction(qRT-PCR).The results revealed that NDV infection resulted in the inhibition of interleukin(IL)-12p40 in DCs through a p38 mitogen-activated protein kinase(MAPK)-dependent manner,thus inhibiting the synthesis of IL-12p70,leading to the reduction in T cell proliferation and the secretion of interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),and IL-6 induced by DCs.Consequently,downregulated cytokines accelerated the infection and viral transmission from DCs to T cells.Furthermore,several other strains of NDV also exhibited inhibitory activity.The current study reveals that NDV can modulate the intensity of the innate?adaptive immune cell crosstalk critically toward viral invasion improvement,highlighting a novel mechanism of virus-induced immunosuppression and providing new perspectives on the improvement of NDV-vectored vaccine.