Objective To investigate the enhanced CT and MRI imaging features of nasal sinus squamous cell carcinoma(SCC)and lymphoma(NHL),and to analyze the efficacy of different imaging features in differentiating nasal sinus SCC from NHL.Methods The imaging,clinical and pathological data of 67 patients with sinus SCC and NHL who underwent sinus CT and MRI with contrast CT and MRI in our hospital and confirmed by surgical pathology were retrospectively analyzed,and the tumor origin,maximum diameter,CT density,MRI signal intensity,enhancement degree,tumor internal necrosis,adjacent bone destruction,invasion of surrounding tissues,and The imaging features such as cervical lymph node metastasis within the scanning range were analyzed,and the receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the efficacy of different imaging features to distinguish nasal sinus SCC and NHL.Results There were statistically significant differences between the five imaging features of nasal sinus SCC and NHL,including tumor origin,maximum diameter,internal tumor necrosis,surrounding bone destruction and peripheral tissue invasion(P＜0.05),and the AUC of differentiating SCC and NHL were 0.708,0.694,0.785,0.850 and 0.629,respectively.The AUC of SCC and NHL was 0.969,and the sensitivity and specificity were 83.9%and 97.2%,respectively.Conclusion On contrast-enhanced CT and MRI,the imaging signs of tumor origin,maximum diameter,tumor internal necrosis,bone destruction and surrounding tissue invasion are helpful to distinguish nasal sinus SCC from NHL,especially if the tumor originates in the nasal cavity,necrosis is rare,bone destruction is mild,and the possibility of nasal sinus NHL should be given priority.Contrast-enhanced CT and MRI can help differentiate nasal sinus SCC from NHL,and the combination can help improve differential diagnostic performance.

ObjectiveTo provide a reference for the diagnosis of amyloidosis in experimental animals through the pathological diagnosis of systemic amyloidosis in a case of a New Zealand white rabbit. MethodsIn a 6-month repeated ocular toxicity study, an abnormal finding was noted during the routine gross anatomical examination of one New Zealand white rabbit. Its organs were prepared as paraffin sections and stained with hematoxylin-eosin (HE) staining and Congo red staining. The histopathological features were observed under optical and polarized light microscopy. ResultsGross anatomical examination of the animal revealed an enlarged spleen and changes in the color and texture of the lung. HE staining showed that the splenic tissue structure was destroyed, the white pulp of the spleen was surrounded by dense amyloid deposition in the form of nodular rings, along with pressure atrophy of the white pulp. Amyloid deposits were also observed in the submandibular lymph nodes, mesenteric lymph nodes, ileum, sacculus rotundus, vermiform appendix, jejunum, cecum, and rectum. Congo red staining showed that the amyloid deposition in the affected organs appeared salmon-pink, and exhibited characteristic apple green birefringence under polarized light microscopy.Conclusion The histo-pathological features of the New Zealand white rabbit are consistent with the diagnostic characteristics of systemic amyloidosis.

Purpose To detect the expression of peroxiso-mal membrane protein 4(PXMP4)in breast cancer tissues and to explore the effect of PXMP4 on the proliferation,invasion,and epithelial-mesenchymal transition(EMT)of breast cancer cells.Methods Bioinformatics and immunohistochemistry(IHC)were used to detect the expression of PXMP4 in breast cancer tissues.In breast cancer cells,Western blot was used to detect the expression of Cyclin D1,E-cadherin,vimentin and N-cadherin after knockdown and overexpression of PMXP4.The proliferation ability of breast cancer cells was analyzed by CCK-8 and plate cloning assay.Scratch healing and Transwell assay an-alyzed the migration and invasion ability of breast cancer cells.Lentivirus was used to construct a PXMP4-silenced MCF-7 cell line,and the PXMP4-silenced MCF-7 cells were injected into the subcutaneous or tail vein of mice to observe lung metastasis and the number of subcutaneous tumors.Results Bioinformat-ics and IHC showed that the expression of PXMP4 in breast cancer tissues was significantly increased(P＜0.05),and the prognosis of breast cancer patients with high expression of PXMP4 was poor(P＜0.05).The clinicopathological analysis showed that the expression of PXMP4 was correlated with tumor grade and lymph node metastasis(P＜0.05).In vitro knock-down of PMXP4 inhibited the proliferation,invasion and EMT process of breast cancer cells(P＜0.05).Conversely,overex-pression of PXMP4 promoted the proliferation,invasion and EMT process of breast cancer cells(P＜0.05).In vivo,the number of lung metastases,the size of subcutaneous tumor,and the expression of Ki67 in tumor tissue were significantly de-creased after silenced PXMP4(P＜0.05).Conclusion PXMP4 is related to tumor grading and lymph node metastasis.PXMP4 promotes proliferation,invasion and EMT process of breast cancer cells.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective:To evaluate the impact of orthopedic robotic assistance and conventional freehand methods on surgical strategies, the safety of pedicle screw placement, and clinical efficacy in patients with upper cervical spine diseases.Methods:From January 2017 to March 2023, a total of 63 cases with upper cervical spine disease, were divided into two groups based on the screw placement technique: the robot-assisted pedicle screw placement (RA) group (41 cases) and the conventional freehand pedicle screw placement (CF) group (22 cases), were retrospectively included. These patients in the RA and CF groups underwent two types of posterior cervical surgery, including occipitocervical fusion (9 cases and 8 cases) and fixation and fusion of atlantoaxial and distal vertebrae (32 cases and 14 cases). The outcome parameters, including the disease course, surgical time, intraoperative blood loss, fluoroscopy frequency, radiation dose, hospital stay, treatment costs, complications, the rate of the pedicle screw placement, accuracy of upper cervical pedicle screw placement, and the risk factors that possibly affected the accuracy were recorded and analyzed. Postoperative follow-up was conducted for at least 6 months, and the efficacy of patients was assessed using imaging parameters, ASIS classification, VAS, and JOA scores.Results:Both groups had no screw-related complications and no spinal cord or vertebral artery injuries. In the RA group, the pedicle screw placement rates for the patients with occipitocervical fusion, and fixation and fusion of atlantoaxial and distal vertebrae were 100% (48/48) and 89.6% (138/154), respectively, far exceeding the placement rate in the CF group 42.9% (18/42) and 78.3% (54/69) (χ 2=37.403, P<0.001; χ 2=5.128, P=0.024). The fluoroscopic exposure dose and operation time of the two types of surgical patients in the RA group were both higher than those in the CF group ( P<0.05). Compared with the CF group, the accuracy of C 1 screws in the RA group increased from 42% (11/26) to 80% (51/64), with statistical significance (χ 2=13.342, P=0.004); while the accuracy of C 2 screws improved from 77% (33/43) to 88% (63/72) with no statistical difference (χ 2=2.863, P=0.413). Non-parametric correlation analysis found a significant correlation between the accuracy of C 1 and C 2 pedicle screw placement and the order of guide wire insertion in the RA group ( r=0.580, P<0.001; r=0.369, P=0.001). Postoperatively, both groups showed significant differences in cervicomedullary angle (CMA), Chamberlain angle (CL), McGregor angle, Boogard angle, Bull angle, clivus-canal angle (CCA), occipitocervical (C 0-C 2) angle, posterior occipitocervical angle (POCA), C 2-C 7 angle, and anterior atlantodental interval (ADI) ( P<0.05). The ASIA classification improved to varying degrees for both groups postoperatively, but there were no statistically significant differences between preoperative, postoperative, and last follow-up evaluations. VAS and JOA scores significantly improved for both groups postoperatively and at the last follow-up ( P<0.05). Conclusion:Both orthopedic robotic-assisted and conventional freehand pedicle screw placement techniques achieved satisfactory therapeutic effects in the treatment of upper cervical spine diseases. The orthopedic robot can effectively ensure the accuracy of upper cervical pedicle screw placement, the increase placement rate of pedicle screws in the upper cervical spine, and reduce fluoroscopy exposure. However, it is necessary to avoid the vertebral displacement caused by the priority insertion of the guide needle, which may affect the accuracy of subsequent planning.

Objective:To explore risk factors for refracture after percutaneous kyphoplasty(PKP)in elderly patients with osteoporotic vertebral compression fractures(OVCF)and provide clinical guidance.Methods:A retrospective analysis was conducted on clinical data from elderly patients with OVCF who underwent PKP surgery at the Department of Orthopedics, Shanxi Bethune Hospital, between January 2017 and December 2022.All patients were followed up for a minimum of one-year post-surgery.The elderly patients were categorized into a refracture group(59 cases)and a non-refracture group(200 cases)based on post-surgery refracture occurrence.Univariate analysis was initially conducted on the collected data, followed by multivariate Logistic regression analysis on statistically significant indicators to identify risk factors for refracture in elderly patients with OVCF following PKP.Results:The results of the univariate analysis indicated that there was no statistically significant difference in gender, history of diabetes mellitus, history of smoking, history of hormone medication, and body mass index(BMI)between the refracture group and the non-refracture group of elderly patients.However, the refracture group was found to be older than the non-refracture group( t=9.085, P=0.003).Additionally, there were no significant differences in preoperative indicators such as preoperative calcium, preoperative phosphorus, and site of first fracture(all P>0.05).The time from first fracture to surgery being greater than 14 days was more common in the refracture group compared to the non-refracture group( χ2=20.409, P=0.001), and the number of vertebrae fractured for the first time was higher in the re-fracture group( t=6.189, P=0.017).Cement injection method, amount of cement injected, and distribution of cement did not show significant differences between the two groups(all P>0.05).However, there were statistically significant variations in the proportion of postoperative anti-osteoporosis treatment( χ2=13.431, P=0.001)and bone mineral density( χ2=13.431, P=0.001)between the refracture and non-refracture groups.Furthermore, multifactorial Logistic regression analysis revealed that increasing age( OR=1.061, 95% CI: 1.021-1.103, P=0.003), time from first fracture to surgery exceeding 14 days( OR=5.026, 95% CI: 1.968-12.835, P=0.001), lack of anti-osteoporosis treatment( OR=3.493, 95% CI: 1.239-9.846, P=0.018), and decreased bone mineral density( OR=10.682, 95% CI: 2.707-42.151, P=0.001)were identified as influential factors in the occurrence of secondary vertebral compression fracture after surgery. Conclusions:The independent risk factors for refracture after PKP in elderly patients with OVCF include increasing age, time from first fracture to surgery greater than 14 days, lack of anti-osteoporosis treatment, and decreased bone mineral density.In clinical practice, targeted interventions can be implemented for prevention and effective management based on these risk factors to enhance the prognosis of elderly patients with OVCF.

Objective To investigate the content stability of polymyxin B sulfate in high concentration solution and its finished infusion,and to provide a scientific basis for clinical administration.Methods Polymyxin B sulfate was dissolved in 0.9%sodium chloride injection and 5%glucose solution to the concentrations of 0.5 mg·mL-1,1 mg·mL-1 and 5 mg·mL-1,respectively.The content of polymyxin B was determined at 0,2,4,6,8,12,16,20 and 24 h by high-performance liquid chromatography under storage conditions of 4℃and 25℃.Results Polymyxin B sulfate was stable in the concentrations of 0.5 mg·mL-1,1 mg·mL-1 and 5 mg·mL-1,respectively,in 0.9%sodium chloride injection or 5%glucose injection.Under the storage conditions of 4℃and 25℃,the content of polymyxin B1 and polymyxin B2 ranged from 97.23%to 101.26%and 97.30%to 102.63%,respectively.Conclusion Polymyxin B sulfate was stable within 24 h dissolved either in 0.9%sodium chloride injection or in 5%glucose injection with the concentrations of 0.5 mg·mL-1,1 mg·mL-1 and 5 mg·mL-1 under the storage condition of 4℃and 25℃.

Objective:To sinicize the Modified Version of Motivation Scale for Stroke Rehabilitation (MORE) based on cognitive interviewing, and test its reliability and validity.Methods:The initial Chinese version of the MORE was developed based on the Brislin model and expert analysis method. From April to May 2021, purposive sampling was used to select 22 stroke patients from Linquan People's Hospital as the research subject for three rounds of semi-structured interviews. The Chinese version of the MORE was revised based on interview results to form the final version. From June 2021 to April 2023, convenience sampling was used to select 200 stroke patients from Linquan People's Hospital for investigation, to test the reliability and validity of the scale.Results:After three rounds of semi-structured interviews, a Chinese version of the MORE consisting of 17 items was formed. The content validity index at the item level was 0.913 to 1.000, and the content validity index at the scale level was 0.921. Three common factors were extracted using the maximum variance orthogonal rotation, with a cumulative variance contribution rate of 77.318%. The Cronbach's α coefficient of the Chinese version of the MORE was 0.937, the half coefficient was 0.898, and the test-retest reliability was 0.911.Conclusions:The understanding of the Chinese version of the MORE by stroke patients is comprehensively understood through cognitive interviewing. The reliability and validity test finds that the Chinese version of the MORE is an effective and reliable scale for evaluating the rehabilitation motivation of stroke patients, providing a reference basis for analyzing the influencing factors of rehabilitation motivation of stroke patients and formulating prevention and intervention measures.

Objective:To explore the effect of sinomenine(SIN)on LPS-induced apoptosis and autophagy of lung epithelial cells through the JNK/c-Jun signaling pathway.Methods:MLE-12 lung epithelial cells were cultured,and the toxicity of SIN was detected by CCK-8.Apoptosis was detected by flow cytometry,the number of autophagosomes was detected by immunofluorescence,and the expression levels of apoptosis,autophagy and JNK/c-Jun signaling pathway-related proteins were detected by Western blot.Results:After LPS modeling,apoptosis rate and the number of autophagosomes were increased,the protein levels of Cleaved caspase-3,Bax,and Beclin-1,and LC3Ⅱ/LC3Ⅰ,p-JNK/JNK and p-c-Jun/c-Jun were increased(P<0.05);Bcl-2 and P62 protein levels were decreased(P<0.05).SIN treatment can significantly improve the effects of LPS on apoptosis and autophagy,as well as the regulation of the JNK/c-Jun signaling pathway(P<0.05).Treatment with the autophagy inhibitor 3-MA or the JNK agonist ANISO could partially reverse the protective effect of SIN on LPS-induced lung epithelial cells(P<0.05).Conclusion:SIN may increase autophagy and pro-tect lung epithelial cells damaged by LPS by regulating proteins related to the JNK/c-Jun signaling pathway.

Objective:To explore the influencing factors of health seeking behavior in older women with stress urinary incontinence (SUI), so as to provide theoretical basis for improving the health seeking behavior of this group.Methods:Guided by the methodological framework of Arksey and O'Malley's scoping review, literature was retrieved in PubMed, CINAHL, APA PsycInfo, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang Data, VIP, and China Biology Medicine disc. The search period was from database establishment to December 31, 2023. The data was extracted and summarized from the included literature.Results:A total of 16 articles were included. The influencing factors of health seeking behavior in SUI older women included urinary incontinence cognition, symptom severity, quality of life, coping efficacy, stigma, access to medical resources, and demographic factors.Conclusions:The cognition of urinary incontinence is the primary factor affecting the health seeking behavior of older women with SUI. Medical and nursing staff should consider cultural differences in clinical practice and assist older women in improving their awareness of urinary incontinence, in order to enhance their health seeking literacy and quality of life.