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.

Approximately 25%of cancers worldwide are related to obesity and sedentary lifestyle.Changing behavior(exer-cise)may be a cost-effective means of prevention and treatment.Studies have found that exercise plays an important role in reducing cancer risk,inhibiting tumor growth,improving cancer-related quality of life,and improving the effectiveness of treatment.However,this protection mechanism is largely unclear.Clarifying the mechanism of action is essential to fully exploit the potential of exercise therapy,this article reviews the possible mechanisms for exercise to reduce the risk of cancer.

Objective:To develop and validate a predictive nomogram for 28-day mortality among very older patients with sepsis, to identify high-risk patients early and improve prognosis.Methods:This study was conducted from January 1, 2022, to November 30, 2022. Very older patients aged≥80 years with sepsis admitted to the emergency department of Beijing Chao-Yang Hospital, Capital Medical University were consecutively recruited. Their clinical data within 24 h of admission and 28-day mortality was recorded. The participants were divided into training (70%) and validation cohort (30%) (random number). In the training cohort, the risk factors of 28-day mortality were selected via least absolute shrinkage and selection operator (LASSO) regression analysis and multivariable Cox proportional hazard model, and a nomogram was developed. The prediction model was verified in validation cohort.Results:In total, 507 very older patients with sepsis were included, among which the mortality rate was 31.2%. In training cohort, the independent risk factors for 28-day mortality were identified: increased age [hazard ratio ( HR)=1.059, 95% confidence interval (95% CI)=1.017-1.103, P=0.005], cognitive impairment ( HR=2.100, 95% CI=1.322-3.336, P=0.002), frailty ( HR=2.561, 95% CI=1.183-5.545, P=0.017), decreased mean arterial pressure ( HR=0.987, 95% CI=0.976-0.998, P=0.017), decreased prealbumin ( HR=0.997, 95% CI=0.994-1.000, P=0.040), increased blood urea nitrogen ( HR=1.028, 95% CI=1.010-1.045, P=0.001), increased procalcitonin ( HR=1.008, 95% CI=1.001-1.016, P=0.019) via LASSO regression analysis and multivariable Cox regression analysis. The nomogram was developed using these seven predictors. In the training and validation cohorts, the calibration curves, time-dependent AUC curves, and decision curve analysis showed that the nomogram had good calibration degree, discrimination and clinical net benefits. Conclusions:Increased age, cognitive impairment, frailty, decreased mean arterial pressure, decreased prealbumin, increased blood urea nitrogen, and increased procalcitonin are independent risk factors for 28-day mortality in very older patients with sepsis. The nomogram, which included the seven predictors, have good predictive performance, and might be helpful for prognosis assessment.

Objective:To investigate the application value of the diagnostic and surgical method for asymmetric prominent mandibular angle assisted by digital surgical design.Methods:The data of the females in Han nationality with prominent mandibular angle from December 2010 to December 2020 in the Department of Digital Plastic Surgery of Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. ProPlan CMF 3.0 software was used to preoperatively mirror the patient’s three-dimensional(3D) model to obtain a diagnosis. The characteristics of bilateral differences of asymmetry of mandible were evaluated, and the surgical method were analyzed. The effect of surgery was objectively evaluated by indicators such as gonion point width (Go-W), condyle apex height (Co-H), and mandibular angle(Ag). SPSS 18.0 was used for statistical analysis, and the data were tested by Kolmogorov-Smirnov test, and the result were in line with the normal distribution. The data were expressed in Mean±SD, and the paired t-test was used to compare the measurement result of the indicators on both sides of the mandible, and P<0.05 was a statistically significant difference. Results:A total of 30 female patients, aged from 18 to 39 years, were included. Preoperative 3D model measurements showed a longer mandibular ascending branch on one side of the mandible (long side) and a more extrusion of the mandibular angle on the other side (prominent side), which was treated with a modified surgical method of mandibular angle osteotomy. The height of the osteotomy line on the long side was the height of the exuberant osteotomy line + the height difference between the two sides, and the thickness of the outer plate grinding on the protrusion side was the thickness of the outer plate grinding on the long side + the width difference between the two sides. Both the preoperative pogonion and menton points were far from the long side of the mandible and biased towards the prominent side. The height, width and mandibular angle of the marker points on both sides of the mandible were compared, and the differences were statistically significant ( P<0.01). Among them, the asymmetrical difference between Go-W, Co-H and Ag was the largest, which could be used to evaluate the effect of surgery. The differences between Go-W, Co-H and Ag before and after surgery on the long side of the mandible were (1.10±2.05) mm, (12.84±2.96) mm, (-17.75±5.16)°, and the differences between the three indicators on the prominent side were (4.24±1.64) mm, (10.95±3.25) mm, (-14.87±5.14)°, respectively, and the differences between preoperative and postoperative comparisons were statistically significant ( P<0.01). The asymmetric differences between the three indicators on both sides of the mandible after surgery were (-0.32±2.30) mm, (-0.02±0.37) mm, (-0.01±1.87)°, respectively, and the differences were not statistically significant ( P>0.05). All patients had no complications such as hematoma and infection after surgery, and the patients were satisfied with the result of the operation. Conclusions:Asymmetric hypertrophy mandibular angle can be reconstructed by the patient’s preoperative 3D model to accurately measure the differences between the two sides of the mandible. This design can effectively guide the surgical method, improve the symmetry of the patient’s bilateral mandible, and achieve better aesthetic effects on the face.

In recent years, with the continuous research of surgical robot technology in different countries in the world, robot-assisted surgery has made great progress.Because of its ddvantages, such as of minimally invasive, accurate and less complications, it is more widely used in clinical applications.Cranio-maxillofacial surgery robots are still in the research stage, and digital technologies such as surgical navigation systems, mixed reality systems, artificial intelligence, etc. that can be combined with them are still inadequate.This article reviews the research status and application of craniofacial surgery robots and proposes its future development direction.

Objective:To investigate the application value of the diagnostic and surgical method for asymmetric prominent mandibular angle assisted by digital surgical design.Methods:The data of the females in Han nationality with prominent mandibular angle from December 2010 to December 2020 in the Department of Digital Plastic Surgery of Plastic Surgery Hospital, Chinese Academy of Medical Sciences were analyzed retrospectively. ProPlan CMF 3.0 software was used to preoperatively mirror the patient’s three-dimensional(3D) model to obtain a diagnosis. The characteristics of bilateral differences of asymmetry of mandible were evaluated, and the surgical method were analyzed. The effect of surgery was objectively evaluated by indicators such as gonion point width (Go-W), condyle apex height (Co-H), and mandibular angle(Ag). SPSS 18.0 was used for statistical analysis, and the data were tested by Kolmogorov-Smirnov test, and the result were in line with the normal distribution. The data were expressed in Mean±SD, and the paired t-test was used to compare the measurement result of the indicators on both sides of the mandible, and P<0.05 was a statistically significant difference. Results:A total of 30 female patients, aged from 18 to 39 years, were included. Preoperative 3D model measurements showed a longer mandibular ascending branch on one side of the mandible (long side) and a more extrusion of the mandibular angle on the other side (prominent side), which was treated with a modified surgical method of mandibular angle osteotomy. The height of the osteotomy line on the long side was the height of the exuberant osteotomy line + the height difference between the two sides, and the thickness of the outer plate grinding on the protrusion side was the thickness of the outer plate grinding on the long side + the width difference between the two sides. Both the preoperative pogonion and menton points were far from the long side of the mandible and biased towards the prominent side. The height, width and mandibular angle of the marker points on both sides of the mandible were compared, and the differences were statistically significant ( P<0.01). Among them, the asymmetrical difference between Go-W, Co-H and Ag was the largest, which could be used to evaluate the effect of surgery. The differences between Go-W, Co-H and Ag before and after surgery on the long side of the mandible were (1.10±2.05) mm, (12.84±2.96) mm, (-17.75±5.16)°, and the differences between the three indicators on the prominent side were (4.24±1.64) mm, (10.95±3.25) mm, (-14.87±5.14)°, respectively, and the differences between preoperative and postoperative comparisons were statistically significant ( P<0.01). The asymmetric differences between the three indicators on both sides of the mandible after surgery were (-0.32±2.30) mm, (-0.02±0.37) mm, (-0.01±1.87)°, respectively, and the differences were not statistically significant ( P>0.05). All patients had no complications such as hematoma and infection after surgery, and the patients were satisfied with the result of the operation. Conclusions:Asymmetric hypertrophy mandibular angle can be reconstructed by the patient’s preoperative 3D model to accurately measure the differences between the two sides of the mandible. This design can effectively guide the surgical method, improve the symmetry of the patient’s bilateral mandible, and achieve better aesthetic effects on the face.

In recent years, with the continuous research of surgical robot technology in different countries in the world, robot-assisted surgery has made great progress.Because of its ddvantages, such as of minimally invasive, accurate and less complications, it is more widely used in clinical applications.Cranio-maxillofacial surgery robots are still in the research stage, and digital technologies such as surgical navigation systems, mixed reality systems, artificial intelligence, etc. that can be combined with them are still inadequate.This article reviews the research status and application of craniofacial surgery robots and proposes its future development direction.

In recent years, with the continuous research of surgical robot technology in various countries in the world, robot-assisted surgery has made great progress. Because of its characteristics of minimally invasive, accurate and less complications, it is more widely used in clinical applications. Cranio-maxillofacial surgery robots are still in the research stage, and digital technologies such as surgical navigation systems, mixed reality systems, artificial intelligence, etc. that can be combined with them are still inadequate. This article reviews the research status and application of craniofacial surgery robots and looks forward to its future development direction.

In recent years, with the continuous research of surgical robot technology in various countries in the world, robot-assisted surgery has made great progress. Because of its characteristics of minimally invasive, accurate and less complications, it is more widely used in clinical applications. Cranio-maxillofacial surgery robots are still in the research stage, and digital technologies such as surgical navigation systems, mixed reality systems, artificial intelligence, etc. that can be combined with them are still inadequate. This article reviews the research status and application of craniofacial surgery robots and looks forward to its future development direction.

Objective To investigate the effect of radial artery calcification (RAC) on survival of arteriovenous fistula (AVF) and the patients in end?stage renal disease. Methods Adult ESRD patients undergoing AVF surgery between January 2013 and January 2016 at the Eighth Affiliated Hospital of Sun Yat?sen University were enrolled in this study. The clinical and biochemical data were collected. Segment of radial artery were obtained from the operation of AVF. RAC at the site of anastomotic were observed by alizarin red S and hematoxylin and eosin staining. According to RAC, the patients were divided into calcification group and non?calcification group. Kaplan?Meier analysis was performed to analyze the survival rates of the two groups, and Cox proportional hazards regression——model was used to estimate the risk factors of AVF dysfunction and all?cause mortality in ESRD patients. Results Among 180 cases of ESRD patients, 38 cases (21.1％) were developed RAC at the site of anastomotic in different degrees. Compared with the non?calcification groups, the calcification groups had a longer dialysis vintage, a higher proportion of diabetes and higher level of HbAlc (all P﹤0.05). Binary logistic regression analysis showed that dialysis vintage>5 years and diabetics were two independent risk factors of RAC at the site of anastomotic. Kaplan?Meier survival analysis demonstrated that there were no statistical differences between two groups in AVF survival (χ2=0.009, P=0.926). Calcification group had higher all?cause mortality than non?calcification groups (χ2=9.809, P=0.002). Multivariate Cox regression analysis demonstrated that homocysteine was independent risk factor for AVF dysfunction (HR=1.027, 95％CI: 1.003-1.051, P=0.027). Age was independent risk factor for all?cause mortality (HR=1.078, 95％CI: 1.035-1.122, P=0.000). Conclusions Dialysis vintage>5 years and diabetes were two independent risk factors of RAC at the site of anastomotic in ESRD patients. RAC at the site of anastomotic had no effect on AVF survival, but increased all?cause mortality.