Objective To understand the reliability of caloric test results through the analysis of the pod shape dia-gram types of caloric test and to provide a more accurate and reliable basis for vestibular system function evaluation.Meth-ods The results of caloric test in 528 patients from July 2021 to May 2022 in vertigo diagnosis and treatment center were analyzed.According to pod pattern and unilateral weakness(UW),the patients were divided into five groups:cold and warm test symmetrical group,left and right side asymmetry group,single value significant abnormal group,bilateral hypo-plasia group and pod morphology unable to be classified group.Unreliable data can be identified by comparing,explaining,and summarizing the results of UW of different groups,so as to reduce the interference of unreliable data to clinical diagno-sis and treatment.Results Cold and warm test symmetric group(n=439)included patients with symmetry of bilateral vestibular function(n=273)and decreased vestibular function of one side(n=166).Left and right symmetrical groups in-eluded pationts with bilateral symmetric vestibular function(n=11)and unilateral reduction(n=13).Single value signifi-cant abnormal group showed cases with unilateral vestibular function reduction(n=25)and bilateral symmetric vestibular function(n=11).Bilateral hypolasion group showed cases with bilateral symmetric vestibular function(n=25)and unilat-eral reduction(n=9).Pod morphology unclassified group(n=5)suggested varions interference factors.Conduson When the function of the peripheral vestibular is symmetrical and normal,we should be alert to the existence of temperature effect,and should consider the inspection of the perfusion apparatus and the calibration of the irrigation temperature.When the function of the peripheral vestibular shows unilateral weakness,repeating the irrigation is recommended when the single value of the caloric test significantly increases or decreases.If there is no change,repeating the irrigation at the same tem-perature in the other ear or even repeating the whole caloric test are recommended.The UW value could not truly reflect the state of peripheral vestibular function when the caoric test produces bilateral weakness.Therefore,water irrigation could be used to make a correct judgment based on the medical history and other auxiliary examinations.It is of great significance to judge the effectiveness of caloric test comprehensively by combining the morphology of pod diagram with UW value.

BACKGROUND:As a dominant breed pig in southwest China,the southern Yunnan small-ear pig has been widely used as an experimental animal in the basic research of other disciplines,but there are still no reports on its application in anterior cruciate ligament reconstruction. OBJECTIVE:To establish a large animal model of the southern Yunnan small-ear pig with anterior cruciate ligament with autologous Achilles tendon was established. METHODS:Twenty adult female Yunnan small-ear pigs were equally randomized into two groups.In the autologous Achilles tendon group,the right knee anterior cruciate ligament was reconstructed with autologous Achilles tendon as a graft,while in the sham-operated group,a similar operation was performed on the right knee without any treatment of the anterior cruciate ligament.General conditions of each pig were observed and recorded before and 12 months after surgery.Ligaments and grafts were taken for gross observation and MAS scoring.Hematoxylin-eosin staining was performed to observe morphological characteristics of ligaments.The staining and arrangement of type I and type Ⅲ collagen were evaluated by immunohistochemistry.Transmission electron microscopy was used to observe the type,size,diameter,ratio,and distribution of collagen fibers in ligaments. RESULTS AND CONCLUSION:All animals had normal diet and activity,good wound healing,no obvious inflammatory reaction,no local purulent infection,and no significant changes in mental and urinary conditions compared with those before surgery.The reconstructed cruciate ligament of the knee was intact,with no stiffness and normal range of motion.Both the anterior drawer and Lachman tests were negative.Gross observation of the graft:12 months after surgery,the grafts was in good position,with good integrity,obvious tension,ligament color close to the original anterior cruciate ligament,and complete surface synovial coverage.Most of the intraarticular ligaments in the autologous Achilles tendon group were defined as MAS I type and a few were defined as MAS Ⅱ type.In the sham-operated group,the intraarticular ligament was defined as MAS I type.Hematoxylin-eosin staining indicated that,12 months after surgery,collagen fibers in the autologous Achilles tendon group began to appear bundled,isotropic,and uniformly arranged,with more obvious isotropic corrugations,and the nuclei were mainly linear or spindle-shaped,which were similar to those in normal anterior cruciate ligament tissue of the sham-operated group.Immunohistochemistry results indicated that,12 months after surgery,there was a higher expression of type I collagen and significantly less expression of type Ⅲ collagen in the reconstructed anterior cruciate ligament in the autologous Achilles tendon group.The degree of type I and type Ⅲ staining was similar in the two groups.Under the transmission electron microscope,the diameter,arrangement and density of collagen fibers in the reconstructed anterior cruciate ligament of the autologous Achilles tendon group were similar to those of the original anterior cruciate ligament at 12 months after surgery,indicating that the ligament remodeling process had been basically completed in the autologous Achilles tendon group at 12 months after surgery.Through a comprehensive evaluation of animal general conditions,ligament general view,MAS score,hematoxylin-eosin staining,immunohistochemistry,and transmission electron microscopy observation,we successfully established a large animal model of anterior cruciate ligament reconstruction using autogenous Achilles tendon in southern Yunnan small-ear pigs,with good morphological,histological and ultrastructural results.

BACKGROUND:Prosthesis loosening and wear are still the main problems in the failure of total ankle replacement,which are closely related to the micro-motion of the implant-bone interface,the contact stress of the articular surface and joint motion.The design of artificial joint components,including insert and tibial/talar stem prosthesis,is a key factor affecting the force,motion,and micromotion of the contact interface of the ankle joint.The development of new inserts is of great significance to improve the survival rate of artificial ankle joints. OBJECTIVE:The finite element model of the total ankle replacement model was constructed to detect the biomechanical properties of the porous structure-optimized inserts,and the effect of the porous structure-optimized inserts on reducing prosthesis micromotion and improving the contact behavior of the articular surface was analyzed. METHODS:Based on the CT scan data of the right ankle joint of a healthy adult and the INBONE Ⅱ system product manual,a three-dimensional model including bone and artificial joint system was established,and the total ankle replacement model(model A)was obtained after osteotomy and prosthesis installation,and then through four new types of inserts,G50,G60,D50,and D60,were obtained by transforming the porous structure of the original insert,and the original one was replaced with different inserts to establish an optimized total ankle replacement model(models B-E)corresponding to the inserts.The gait loads were applied on the five models to simulate the gait conditions.The differences in micromotion and articular surface contact behaviors at the implant-bone interface of all five models were compared. RESULTS AND CONCLUSION:(1)In the gait cycle,the micromotion of the prosthesis of the four optimized total ankle replacement models was lower than that of the original model.Compared with model A,the micromotion of the prosthesis in models B-E decreased by 5.4%,10.1%,8.1%,and 20.9%,respectively.The high micromotion area of t ??he tibial groove dome in the optimized model was significantly smaller than that of the original model.(2)The four optimized models obtained a larger articular surface contact area.Compared with model A,the average contact area of t ??he inserts in models B-E increased by 11.8%,14.7%,8.1%,and 32.6%,respectively.(3)Similar to the effect of increasing the contact area,compared with the original model,the contact stress of the optimized model decreased in varying degrees,and the value of model E decreased the most significantly(P<0.05),it is due to good mechanical properties and large porosity of the Diamond lattice that constitutes the D60-type insert.(4)The research results show that the use of porous structure to improve the inserts can improve the elasticity of the inserts and increase its ability to absorb joint impact,for favorable conditions are created for reducing micromotion at the implant-bone interface and improving joint contact behavior.

Objective: To understand the current status of acquired immunodeficiency syndrome (AIDS) knowledge, attitudes, and practices of college students in Tianjin City and to further investigate the associated factors of high risk sexual behaviors, so as to provide a scientific and theoretical basis for accurate prevention and treatment of AIDS. Methods: A stratified cluster random sample of 64 697 students in 56 colleges and universities in Tianjin City in November to December 2022 was investigated about the current status of AIDS knowledge, attitudes and practices. Information was collected using online survey via Questionnaire Star. Descriptive analysis was used for the current status of AIDS knowledge, attitudes and practices among college students. Chi square test and multiple Logistic regression analysis were used to analyze the influencing factors of high risk sexual behavior among college students. Results: The AIDS awareness rate of college students in Tianjin City reached 87.33%. The sexual openness rate was 70.73 %. Among the 3 463 students who had sex during the past year, 42.13% of students reported high risk sexual behavior. Multivariate Logistic regression showed that female, having a romantic partner, having received sex education and prevention and treatment knowledge of AIDS were negatively associated with high risk sexual behavior ( OR =0.66, 0.59, 0.81, 0.59, P <0.05). Being in sophomore year, non heterosexuality (homosexuality, bisexuality, not knowing), prejudice against AIDS, and misunderstanding the testing methods for AIDS showed positive correlations with highrisk sexual behavior ( OR =1.22, 2.49, 2.30, 3.17, 1.43, 1.22 , P <0.05). Conclusions The awareness rate of AIDS in college students in Tianjin is high, but high risk sexual behaviors are still at a high level. Further targeted knowledge education and behavioral interventions are needed to scientifically prevent the spread of AIDS.

Objective To analyze the current status,hotspots,and trends in the research field of traditional Chinese medicine and pharmacy combined with transcatheter arterial chemoembolization(TACE)for the treatment of hepatocellular carcinoma.Methods The relevant literatures on traditional Chinese medicine and pharmacy combined with TACE treatment for hepatocellular carcinoma collected by China National Knowledge Infrastructure from January 1994 to December 2022,and use CiteSpace 6.1.R6 software to analyze its publication volume,authors,research institutions,and key words.Results This study included a total of 686 articles.The publication volume showed a fluctuating upward trend from 1994 to 2015,but it had decreased since 2016,indicating that further breakthrough research was needed in this field.The communication between authors and research institutions needed to be strengthened,with low levels of cross institutional and cross regional cooperation and uneven geographical distribution.Cooperation should be strengthened.High frequency key words included hepatocellular carcinoma,Chinese materia medica,interventional therapy,therapeutic,etc.,resulting in 9 key word clustering labels.Conclusion Currently,there is a lack of experimental research and related mechanism research,the future research hotspots of traditional Chinese medicine and pharmacy combined with TACE treatment for hepatocellular carcinoma will focus more on traditional Chinese medicine and pharmacy,interventional therapy,clinical observation,and cell apoptosis,which provides new ideas for researchers conducting related research in the future.

AIM:To establish pupil diameter measurement algorithms based on infrared images that can be used in real-world clinical settings.METHODS:A total of 188 patients from outpatient clinic at He Eye Specialist Shenyang Hospital from Spetember to December 2022 were included, and 13 470 infrared pupil images were collected for the study. All infrared images for pupil segmentation were labeled using the Labelme software. The computation of pupil diameter is divided into four steps: image pre-processing, pupil identification and localization, pupil segmentation, and diameter calculation. Two major models are used in the computation process: the modified YoloV3 and Deeplabv3+ models, which must be trained beforehand.RESULTS:The test dataset included 1 348 infrared pupil images. On the test dataset, the modified YoloV3 model had a detection rate of 99.98% and an average precision(AP)of 0.80 for pupils. The DeeplabV3+ model achieved a background intersection over union(IOU)of 99.23%, a pupil IOU of 93.81%, and a mean IOU of 96.52%. The pupil diameters in the test dataset ranged from 20 to 56 pixels, with a mean of 36.06±6.85 pixels. The absolute error in pupil diameters between predicted and actual values ranged from 0 to 7 pixels, with a mean absolute error(MAE)of 1.06±0.96 pixels.CONCLUSION:This study successfully demonstrates a robust infrared image-based pupil diameter measurement algorithm, proven to be highly accurate and reliable for clinical application.

Objective:To conduct a comparative analysis of the biomechanical properties of Seinsheimer type V subtrochanteric femoral fractures treated with different fixation methods, including proximal femoral locking plate, Cephalomedullary nail + plate, Cephalomedullary nail + titanium cable, reconstructive intramedullary nail + plate, and reconstructive intramedullary nail+titanium cable, using finite element analysis.Methods:CT scan data of the left femur from a healthy adult volunteer was obtained and utilized to create a finite element model of Seinsheimer V subtrochanteric femoral fracture through software simulation. The construction of femoral proximal locking plates, cephalomedullary nails, reconstructive intramedullary nails, steel plates, and titanium cable internal fixation devices was based on manufacturer-provided product manuals. Following the assembly of fracture and internal fixation components, comparisons were made under physiological loads regarding the maximum displacement, maximum stress, and stress excitation effects on fracture fragments and internal fixation components across the various fixation models.Results:The maximum displacements of the femoral proximal locking plate, cephalomedullary nail + plate, cephalomedullary nail+titanium cable, reconstructive intramedullary nail+plate, and reconstructive intramedullary nail+titanium cable were 7.9, 5.7, 4.3, 4.3, and 4.9 mm, respectively. The maximum displacements of the internal fixation systems were 7.4, 5.8, 4.3, 4.3, and 4.9 mm, respectively. The maximum torsion angles of the internal fixation systems were 1.8°, 1.5°, 1.4°, 1.3°, and 1.5°, respectively. The maximum stresses on the fracture fragments of the femoral proximal locking plate were 172.0, 114.1, 115.4, 93.5, and 118.5 MPa, respectively. The maximum stresses on the internal fixation systems were 4,530.0, 993.6, 1,179.0, 890.4, and 847.2 MPa, respectively. The maximum contact stress on the contact surfaces of the distal and proximal fracture contact surface of the medial wall, and the distal and proximal fracture contact surface of the lateral wall of the proximal femoral locking plate was 48.9, 37.9, 4.4, 18.7 MPa, which was the highest among the five fixation methods, respectively. The contact stress of the cephalomedullary nail+titanium cable on contact surfaces mentioned above was 16.1, 18.1, 6.9, 11.7 MPa, exceeding the 0.0, 0.0, 5.5, 7.5 MPa of the cephalomedullary nail+plate. The contact stress of the reconstructive intramedullary nail+titanium cable on contact surfaces mentioned above was 13.7, 13.4, 6.9, 14.1 MPa, exceeding the 0.0, 0.0, 5.6, 11.0 MPa of the reconstructive intramedullary nail + plate as well.Conclusion:The utilization of the reconstructive intramedullary nail + titanium cable fixation method for treating Seinsheimer type V subtrochanteric femoral fractures demonstrates superior performance in terms of structural stability, durability, and stress stimulation on the bone cortex.

Objective To studyexplore the reversal effect of S-adenosylmethionine(SAM)on chemotherapy resistancechemoresis-tance of pancreatic cancer and explore its related mechanisms.Methods After treatment of human pancreatic cancer resistant cell lines PANC-1/GEM with SAM,the cell proliferation activity of PANC-1/GEM cells and their resistance to gemcitabine(GEM)were ana-lyzed by MTT assay;The the effect of SAM on apoptosis rate of PANC-1/GEM cells was detected by flow cytometry;the change of SAM on the migration activity of drug-resistant cell lines was detected by cell scratch assay;the expression of NEDD4-1 protein in drug-re-sistant cell lines and the changes of NEDD4-1,p-JAK2,p-STAT3 and P-gp protein levels after SAM treatment were detected by Western blot.Results SAM could inhibit the activity of pancreatic cancer PANC-1/GEM resistant cell lines and significantly decreased its resistance to GEM chemotherapy.The IC50 value decreased from 1557.50±201.10nmol/L to 218.39±20.61 nmol/L(P＜0.01);SAM can obviously induced the apoptosis of drug-resistant cell lines and inhibited their migration activity;the expression of NEDD4-1 protein was up-regulated in drug-resistant cell lines,and SAM could inhibit the activation levels of NEDD4-1,p-JAK2,p-STAT3 and P-gp proteins.Conclusion SAM can reduce the chemotherapy resistance of PANC-1/GEM cells to GEM by regulating NEDD4-1 to inhibit the activity of JAK2/STAT3 pathway and regulate the activity of P-gp protein,which provides some experimental evidence for the clinical application of SAM in the treatment of chemotherapy resistance in tumor patients.

Periodontitis is a common chronic inflammatory disease that causes the periodontal bone destruction and may ultimately result in tooth loss.With the progression of periodontitis,the osteoimmunology microenvironment in periodontitis is damaged and leads to the formation of pathological alveolar bone resorption.CD301b+macrophages are specific to the osteoimmunology microenvironment,and are emerging as vital booster for conducting bone regeneration.However,the key upstream targets of CD301b+macrophages and their potential mechanism in periodontitis remain elusive.In this study,we concentrated on the role of Tim4,a latent upstream regulator of CD301b+macrophages.We first demonstrated that the transcription level of Timd4(gene name of Tim4)in CD301b+macrophages was significantly upregulated compared to CD301b-macrophages via high-throughput RNA sequencing.Moreover,several Tim4-related functions such as apoptotic cell clearance,phagocytosis and engulfment were positively regulated by CD301b+macrophages.The single-cell RNA sequencing analysis subsequently discovered that Cd301b and Timd4 were specifically co-expressed in macrophages.The following flow cytometric analysis indicated that Tim4 positive expression rates in total macrophages shared highly synchronized dynamic changes with the proportions of CD301b+macrophages as periodontitis progressed.Furthermore,the deficiency of Tim4 in mice decreased CD301b+macrophages and eventually magnified alveolar bone resorption in periodontitis.Additionally,Tim4 controlled the p38 MAPK signaling pathway to ultimately mediate CD301b+macrophages phenotype.In a word,Tim4 might regulate CD301b+macrophages through p38 MAPK signaling pathway in periodontitis,which provided new insights into periodontitis immunoregulation as well as help to develop innovative therapeutic targets and treatment strategies for periodontitis.

Objective To explore the risk factors of rheumatoid arthritis patients complicated with skeletal system involvement,and es-tablish a prediction model and evaluate its performance.Methods A total of 165 patients,who were initially diagnosed with rheuma-toid arthritis in Taikang Xianlin Drum Tower Hospital and Eastern Theater General Hospital from September 2015 to March 2021,were included in this study.The clinical and serological parameters of the patients with and without complicated skeletal system involvement were compared.The predictive factors with important significance in LASSO-Logistic analysis were used as the candidate variables,and a nomogram model was established based on the screened predictive factors.The discrimination and calibration of the model were evalu-ated with receiver operating curve(ROC)and the calibration curve,and the clinical effectiveness of the model was evaluated by clini-cal decision curve and clinical impact curve.Results The incidence of rheumatoid arthritis patients complicated with skeletal system involvement was 60%(99/165).Compared with the group of non-complicated with skeletal system involvement,statistically significant differences were found in age,course of disease,IgG4 level,IgG4/IgG ratio,rheumatoid arthritis(RF),antistreptolysin O(ASO),plateletcrit(PCT)and other parameters of laboratory tests in the complication group(P＜0.05).The nomogram model of rheumatoid arthritis complicated with skeletal system involvement was established by five indicators,i.e.,age,course of disease,IgG4/IgG ratio,RF and PCT.The statistic of the model C was 0.848(95%CI:0.785 to 0.910).Calibration curves showed good predictive performance in internal validation,and the results of Hosmer-lemeshaw test indicated goodness of fit(χ2=7.562,P=0.477,＞0.05).Both the clin-ical decision curve and clinical impact curve showed its clinical practicability.Conclusion The established simple and practical nomo-gram model exhibited good ability to identify rheumatoid arthritis patients complicated with skeletal system involvement,which may pro-vide reference basis for clinical diagnosis and treatment.