Abstract:Objective To explore the effects of different 5-field layout modes of intensity-modulated radiotherapy on the target area of mid-thoracic esophageal cancer and the dose of organs at risk.Methods Seven patients with esophageal cancer were selected from the Department of Oncology,Army Characteristic Medical Center,Army Medical University as the study objects,and four sets of static intensity-modulated plans were designed for each patient,respectively:PA:210°,240°,0°,120°,150°;PB:210°,240°,180°,120°,150°;PC:210°,300°,180°,60°,150°;PD:210°,300°,0°,60°,150°.The dose-volume parameters of the target areas and organs at risk were statistically compared among the four plans.Results The target dose of the four plans could reach 95％coverage requirements,and there was no statistical significance in D5％,D95％and Dmean.The V5 of PD double lungs was the lowest,which decreased by about 0.9％relative to the highest group.The V10 of PA double lungs decreased by about 1.9％relative to PC,and PA and PB were statistically significant(P＜0.05).The V20 of PD double lungs was the lowest,in which PD was equivalent to 0.9％decrease in PA.Dmean in PD double lungs was the lowest,which decreased by 15 cGy relative to the highest PA group.There was no significant difference in V30 and V40 between the four groups.The cardiac Dmean of PA and PC was significantly different(P＜0.05),and PB decreased by 36 cGy relative to PA.The spinal cord Dmax was as follows:PB＜PC＜PD＜PA.PB decreased by 122 cGy relative to PA in spinal cord dose-volume.Comparison of the monitor unit(MU)of the three plans showed that PB had the highest MU(469.28±79.71)and PD had the lowest(430.67±62.63),and there was no statistical significance in the comparison among the four groups.The MU of the PB plan in the group with the highest number of jumps increased by 10％compared to that in the PB plan in the group with the lowest number of jumps.Conclusion The target areas of the four groups can meet the requirements,and there is no statistical significance in the dose-volume of organs at risk,which indicates that four field angles designed in this paper can be selected when the intensity-modulated field distribution of conventional static 5-field for esophageal cancer is used.

Abstract:Objective To explore the effect of electroacupuncture(EA)pretreatment on mitophagy in the penumbra region and long-term neurological function recovery in a mouse model of ischemic stroke.Methods Middle cerebral artery occlusion(MCAO)model was used to simulate cerebral stroke.Forty-eight male C57BL/6J mice were randomly divided into sham surgery group(Sham group),sham surgery+EA group(EA group),model group(MCAO group),and EA pretreatment group(EA+MCAO group),with 12 mice in each group.EA group received intervention at the Baihui acupoint for 5 d,30 min per day.Western blotting was used to detect the effects of EA pretreatment on protein expression of mitophagy markers in mice 24 h after MCAO.Forelimb grip strength test,tape removal test,open field test,and Y-maze test were performed to observe the effect of EA pretreatment on the neurological function of mice 3,7,and 14 d after MCAO.Results EA pretreatment increased the expression of BCL2 interacting protein 3(BNIP3)(P＜0.01),while reducing the expression of translocase of outer mitochondrial membrane 20(P＜0.01)and cytochrome c oxidase subunit Ⅳ(P＜0.01),but had no effect on PTEN-induced putative kinase 1 expression.EA pretreatment improved forelimb grip strength of MCAO mice at 7 and 14 d post-surgery(P＜0.05),shortened the time for tape contact/removal(P＜0.05),but did not significantly affect these parameters at 3 d post-surgery.Furthermore,EA pretreatment significantly improved the symmetry of mice 14 d after surgery(P＜0.01)and increased the time spent on new arms and the number of new arm entries in the Y-maze test in MCAO mice 15 d after surgery(P＜0.05).Conclusion EA pretreatment promotes BNIP3-mediated mitophagy and improves long-term neurological function recovery in MCAO mice.

Abstract:Glioma,as the most common primary malignant tumor of the central nervous system,poses a serious challenge to clinical diagnosis and treatment due to its high invasiveness,high recurrence rate,and low survival rate.The multidisciplinary diagnosis and treatment(MDT)model for glioma integrates core disciplines such as neurosurgery,imaging,pathology,radiotherapy,oncology,and neurology to construct a standardized diagnosis and treatment system based on evidence-based medicine,which has become a key strategy for improving the prognosis of glioma patients.This article systematically elaborates on the organizational structure and operational mechanism of MDT for glioma,deeply analyzes the collaborative role of multiple disciplines in precision diagnosis,personalized treatment,and full process management,and explores the innovative direction of MDT model based on the latest clinical evidence and technological breakthroughs,providing theoretical and practical references for optimizing the diagnosis and treatment strategies of glioma.

Abstract:Objective To evaluate the efficacy of modified Guizhi Fuling Powder in treating preoperative soft tissue swelling in closed calcaneal fractures and to explore its clinical mechanism of action.Methods Seventy patients scheduled for surgical treatment of closed calcaneal fractures were selected and divided into the experimental group and the control group by random number table method,with 35 cases in each group.The control group received conventional preoperative anti-edema and analgesic treatments including elevation of the affected limb,ice application to the affected area,intravenous infusion of mannitol,and lornoxicam for pain relief.The experimental group additionally received oral administration of modified Guizhi Fuling Powder.Following anti-edema treatment,both groups underwent surgical internal fixation with plates via either a lateral L-shaped calcaneal incision or a tarsal sinus incision.Comparisons were made between groups for inflammatory factors(TNF-α,IL-1β,IL-6,and CRP),D-dimer(D-D),ferritin(FER),ankle swelling difference,time to skin crease sign appearance,and postoperative incision-related adverse events before and after 5 d of edema reduction treatment.Results There were no statistically significant differences between the two groups in terms of age,gender,or affected foot(left or right).① Blood test indicators:FER expression differed between the two groups(t=2.231,P=0.029).D-D expression differed between groups based on whether patients received modified Guizhi Fuling Powder(t=-2.960,P=0.005).Intra-group differences in D-D expression were observed before and after treatment with modified Guizhi Fuling Powder(t=-5.153,P＜0.001).Intra-group differences in CRP expression were observed in the control group(t=-2.047,P=0.048),whereas no statistically significant intra-group differences were found in the experimental group(t=0.119,P=0.906).There was no statistically significant difference in CRP expression between the two groups at admission(t=-1.308,P=0.195),but there was a significant inter-group difference in CRP expression before surgery(t=-2.213,P=0.032).There were no statistically significant differences in IL-1β between groups or within the experimental group(experimental group intra-group t=-0.088,P=0.930;inter-group at admission t=-1.785,P=0.081;inter-group preoperatively t=0.685,P=0.496).Intra-group expression differed in the control group(t=2.552,P=0.015).TNF-αlevels showed no significant differences between groups or within groups(control group intra-group t=0.139,P=0.890;experimental group intra-group t=1.271,P=0.212;inter-group at admission t=-0.668,P=0.506;inter-group preoperatively t=-1.743,P=0.087).There were no statistically significant differences in IL-6 levels between groups or within the experimental group(experimental group intra-group Z=-0.098,P=0.922;inter-group at admission Z=-0.670,P=0.503;inter-group preoperatively Z=-1.186,P=0.235).Intra-group expression differed significantly in the control group(Z=-3.251,P=0.001).②Observed indicators:Significant inter-group differences were observed in ankle swelling difference at admission and preoperatively(t=2.930,P=0.005).Inter-group differences were also noted in skin crease reappearance time(t=-3.611,P=0.001).Pearson correlation analysis indicated that FER increased with longer skin crease reappearance time,showing moderate positive correlation(r=0.554,P＜0.001).No flap necrosis or infection was observed in the experimental group postoperatively.Three cases of blistering occurred,with an adverse event rate of 8.57％.The control group reported one case of flap necrosis,one case of infection,and six cases of blistering,yielding an adverse event rate of 22.86％.The experimental group demonstrated lower postoperative incision-related adverse events compared to the control group.Conclusion Modified Guizhi Fuling Powder,due to its diuretic,edema-reducing,and blood-activating effects,helps alleviate preoperative swelling in closed calcaneal fractures and promotes better postoperative wound healing.The clinical research mechanism may be related to iron metabolism and coagulation mechanism.

Abstract:The rapid development and cross-integration of tumor immunology,cell biology,and molecular technology have profoundly changed the strategies and landscape of cancer therapy.With the elucidation of tumor immune evasion mechanisms,a variety of novel immunotherapeutic strategies have emerged.Tumor immunotherapy aims to enhance the immune system's ability to recognize and eliminate tumors by activating anti-tumor immune responses and/or blocking immune escape pathways.It has become the fifth pillar of cancer treatment,following surgery,radiotherapy,chemotherapy,and targeted therapy.This review systematically outlines the theoretical foundations and key strategies of tumor immunotherapy,including immune surveillance and immunoediting hypotheses,mechanisms of immune escape,as well as design principles,approved agents,and research progress of major therapeutic approaches such as immune checkpoint inhibitors,adoptive cell therapy,and cancer vaccines,and looks forward to the future development direction.

Abstract:Objective To investigate the clinical safety and effectiveness of minimally invasive coronary artery bypass grafting(MICS-CABG)via the left intercostal approach in elderly patients(＞70 years old)with complex coronary heart disease and reduced ejection fraction(EF＜40％).Methods The clinical data of 60 patients＞70 years old with a preoperative left ventricular EF＜40％who underwent coronary artery bypass grafting in the Department of Cardiac Surgery,Xijing Hospital,Air Force Medical University from April 2022 to October 2024 were analyzed.These patients were divided into two groups:the median sternotomy group(OP-CABG group)with 30 patients and the MICS-CABG group with 30 patients.Based on matched baseline information,a retrospective analysis was conducted to compare the perioperative data and one-year follow-up results between the two groups.Results There was no significant difference in baseline levels between the MICS-CABG group and the OP-CABG group.The MICS-CABG group had shorter operative duration,less intraoperative blood loss,lower perioperative blood transfusion rate,shorter postoperative ventilator assistance time,less postoperative drainage volume,and lower incidence of postoperative pleural effusion and wound complications(all P＜0.05).One-year follow-up after surgery showed that there was no significant difference in the patency rate of bridge vessels,improvement of EF values,MACCE events,and incidence of chronic wound pain between the two groups of patients.However,the MICS-CABG group had lower incidence of complications of poor wound healing compared to the OP-CABG group(P＜0.05).Conclusion Although MICS-CABG technology is difficult and has a long learning curve,its application in elderly patients with complex coronary heart disease and heart failure with reduced EF values can effectively shorten the operative time,reduce intraoperative bleeding,postoperative drainage,and transfusion rate.Compared with conventional open chest surgery,it is more acceptable for patients.One-year follow-up after surgery shows that the improvement of EF values and patency rate of bridge vessels in the MICS-CABG group are similar to those in the OP-CABG group,and effectively avoid complications of poor wound healing.

Abstract:Objective To understand the current status of physical training and the incidence of training-related injuries among military personnel stationed in high-altitude regions,so as to provide data support for establishing standardized and unified comprehensive prevention and treatment protocols for training-related injuries specific to military personnel stationed in high-altitude environments.Methods By means of questionnaire surveys,face-to-face interviews,and on-site investigations,eight high-altitude military training units were investigated and studied.The research encompassed eight aspects,including basic information,routine physical and military training conditions,current physical health status,allocation of physical training equipment,levels of physical activity and sleep quality,incidence of musculoskeletal injuries,prevalence of pain in the neck,shoulder,waist,and legs,as well as diagnosis and treatment of musculoskeletal injuries.A comparative analysis of the collected data was conducted to draw meaningful insights.Results The survey results revealed a substantial occurrence of military training-related injuries,including 1 056 cases among 414 people.These injuries affected up to 11 different body regions,with a notable prevalence of injuries to the foot and ankle,as well as the knee.Additionally,there was a significant incidence of discomfort reported in the neck and waist areas.Conclusion The incidence of training-related injuries among military personnel stationed in high-altitude regions is notably elevated,so the training programs for military personnel in these areas should be systematically implemented under scientifically-informed guidance.Additionally,there should be an emphasis on health education aimed at preventing training-related injuries.These measures are essential for comprehensively enhancing the combat effectiveness of military forces stationed in high-altitude environments.

Abstract:G protein-coupled estrogen receptor(GPER),also known as G protein-coupled receptor 30,is a novel estrogen receptor.In male individuals,GPER is also widely distributed in multiple tissues,including the cardiovascular system,reproductive system,and nervous system.GPER binds to estrogen and other ligands for rapid signal transduction and transcriptional regulation,and plays an important role in pathological processes such as ventricular remodeling,blood pressure regulation,and atherosclerosis.This article mainly reviews the role of GPER in cardiovascular diseases in male.

Abstract:Leucine,isoleucine,and valine are essential amino acids in the body,collectively known as branched-chain amino acids(BCAA)due to their branched side chain structures.BCAA play a critical role not only in protein synthesis but also as bioactive molecules participating extensively in various intracellular biological processes.Studies have shown that BCAA metabolic disturbances play a crucial role in a variety of cardiometabolic diseases,including obesity,insulin resistance,type 2 diabetes,hypertension,atherosclerosis,and heart failure.This review introduces the metabolic processes of BCAA in detail,with an emphasis on summarizing how BCAA metabolic disturbances lead to the occurrence and development of cardiometabolic diseases,and explores the close relationship between BCAA metabolism and cardiometabolic health based on epidemiological evidence.Furthermore,this review also prospects future research directions,aiming to provide new perspectives for a deeper understanding of the role and mechanism of BCAA in cardiometabolic diseases.

Abstract:Premature ovarian insufficiency(POI)is a condition in which a woman develops premature ovarian function decline,which not only reduces the patient's fertility,but also brings about a series of menopausal clinical symptoms,and adversely affects the woman's reproductive and psychological health.The etiology of more than half of POI patients is unknown,and factors such as autoimmune diseases,genetics,and stress may be causative factors,with autoimmune factors accounting for a higher proportion of POI patients,which deserves our attention.Studies have shown that the production of autoimmune antibodies,imbalance of pro-inflammatory and anti-inflammatory factors,and lymphocyte disorders all play key roles in the pathogenesis of POI,and POI may be associated with certain autoimmune diseases,such as autoimmune Addison's disease and autoimmune polyendocrinopathy syndrome.At present,the immunological intervention and other therapeutic methods for POI are still under active exploration.By summarizing the relevant studies on POI and autoimmunity in recent years,this article hopes to provide reference for the reproductive immune mechanism of POI and develop ideas for clinical treatment.

Abstract:Objective To explore the effects of long-term exposure to high cortisol concentrations on human inflammatory response and microbiota-gut-brain axis by using Cushing's disease(CD)as a model.Methods We prospectively included 16 CD patients who were to be operated from May 2021 to March 2024 in the Chinese PLA General Hospital,and recruited 30 healthy controls(HC)during the same period.We compared the differences in neuropsychological and cognitive function scores,inflammatory factors,and gut microbiota between the two groups.Results Our study results showed that the average course of disease of CD patients was(55.75±39.96)months,and the levels of serum cortisol,adrenocorticotropic hormone,24-hour urinary cortisol excretion,and body mass index were significantly higher than those in HC group(P＜0.05).Neuropsychological and cognitive function scale data showed that the scores of Self-Rating Depression Scale and Self-Rating Anxiety Scale in CD patients were significantly higher than those in HC group,while the scores of Mini-Mental State Examination and Montreal Cognitive Assessment were lower than those in HC group(P＜0.000 1).The differences in gut microbial ecology structure between CD patients and HC group included decreased microbial diversity and significant differences at the species and genus levels.Analysis of blood and immunological indicators showed that the white blood cell count,neutrophil proportion,NLR,and levels of IL-1β and IL-8 in CD patients were higher,while the eosinophils proportion was lower(P＜0.05),and the levels of IL-6 and TNF were not significantly different.Conclusion High cortisol concentrations can increase the risk of obesity,cause anxiety and depression,and reduce cognitive function.In addition,it can also cause inflammatory responses,reduce immune function,and lead to changes in the composition and structure of gut microbiota and decreased diversity.

Abstract:Objective To mine and analyze the adverse drug event signals of pembrolizumab,so as to provide reference for safe medication in clinic.Methods Adverse event reports from Q4 2014 to Q4 2022 were extracted from the Food and Drug Administration Adverse Event Reporting System database,and data mining was conducted using reporting odds ratio method and Medicines and Healthcare Products Regulatory Agency method.Results A total of 853 adverse event signals were obtained in the reports of pembrolizumab as the primary suspect drug after screening,and the signals with the highest intensity were immune-mediated hypothyroidism,immune-mediated kidney disease,and immune-mediated gastritis.The top 50 adverse events for signal strength involved a total of 17 systems,including diseases of the hepatobiliary system,endocrine system,and immune system.Conclusion The study finds a variety of adverse event signals not reported by the drug label,such as immune-mediated cystitis,adrenocorticotropic hormone deficiency,and tumour hyperprogression,which can provide references for clinical safe drug use.

Abstract:Objective To analyze the correlation of paravertebral muscle parameters,including muscle cross-sectional area(CSA)and fat infiltration rate(FIR),with gender,left and right sides,body mass index(BMI),age,Visual Analogue Scale(VAS)and Oswestry Disability Index(ODI)in patients with chronic low back pain(CLBP).Methods A total of 109 CLBP patients with complete data were collected from Xijing Hospital,Air Force Medical University from April 2023 to December 2023.FIR was calculated by using ImageJ software to measure the fat infiltration area of L2-3,L3-4,L4-5,and L5-S1 multifidus muscle,erector spinae muscle and psoas major muscle,as well as muscle CSA.Gender,BMI,age,VAS,ODI and other information of the patients were obtained from the cases.Non-parametric Mann-Whitney U test was used to analyze the measured paravertebral muscle of each segment and gender,as well as FIR on both sides of the muscle.Spearman correlation analysis was used to measure the correlation between paravertebral muscle and BMI,age,VAS and ODI.Results ①There was no difference between left and right side of paravertebral muscle FIR in CLBP patients(P＞0.05),but there was a difference between genders(P＜0.05).②There was no significant correlation between paravertebral muscle FIR and BMI in CLBP patients,while multifidus muscle FIR and erector spinae muscle FIR were correlated with age,VAS and ODI.③There was no significant correlation between paravertebral muscle CSA and BMI,age,VAS and ODI in CLBP patients.Conclusion This study excludes some irrelevant factors of paravertebral muscle fat infiltration,explores the group more prone to low back pain,and analyzes the relationship between paravertebral muscle FIR and the degree of low back pain and life impact,providing a new idea for evaluating the degree of low back pain of patients and evaluating the therapeutic effect.

Abstract:Objective To explore the potential targets and molecular mechanisms of genistein in the treatment of periodontitis based on network pharmacology,molecular docking technology and bioinformatics analysis.Methods A variety of databases were used to predict the targets of genistein and periodontitis,and GO functional analysis and KEGG enrichment analysis were conducted.The protein-protein interaction network of genistein-periodontitis was plotted using STRING database,and the top 10 key targets were obtained using Cytoscape software.The key targets of genistein in the treatment of periodontitis were analyzed by molecular docking technology.The key cell types on which genistein might act were analyzed using a periodontal single-cell sequencing dataset.Results A total of 731 periodontitis-related disease targets and 89 genistein targets were obtained from the database,and 27 key targets were screened.GO and KEGG pathway enrichment analysis showed that genistein might play a therapeutic role by regulating signaling pathways such as estrogen and serine-type endopeptidase.The results of molecular docking analysis showed that genistein had good binding potential with multiple targets.Conclusion This study explores the potential targets and mechanisms of genistein in the treatment of periodontitis,providing a reference for promoting drug research and development and application.

Abstract:Objective To investigate the effects of lncRNA RUSC1-AS1 on the growth and epithelial-mesenchymal transition of human hepatocellular carcinoma cell SK-HEP-1 xenograft in nude mice,and to explore its mechanism.Methods RUSC1-AS1 shRNA and negative control recombinant plasmids were constructed.The model of human hepatocellular carcinoma cell SK-HEP-1 xenograft was established in nude mice.The nude mice were divided into three groups:Control group,shRNA group and shRNA-NC group.Mice in shRNA group and shRNA-NC group were injected with plasmid through tail vein.The body mass of mice was observed and the tumor volume was recorded during plasmid injection.The tumor tissues were collected and photographed after the last injection.HE staining was used to observe the pathological status of tumor tissues in each group.The mRNA and protein expression levels of E-cadherin(E-cad),N-cadherin(N-cad)and Vimentin in tumor tissues of each group were detected by qRT-PCR and Western blotting.The expression of RUSC1-AS1 and miR-125b-5p in tumor tissues of each group was detected by qRT-PCR.Results Compared with Control group or shRNA-NC group,body mass and mRNA and protein expression levels of E-cad in tumor tissues of shRNA group were significantly increased(P＜0.05).Tumor volume and mRNA and protein expression levels of N-cad and Vimentin in tumor tissues were significantly decreased(P＜0.05).The expression of miR-125b-5p in tumor tissues of nude mice in shRNA group was significantly increased(P＜0.05).Conclusion Interference with the expression of RUSC1-AS1 can significantly inhibit the growth and epithelial-mesenchymal transition of human hepatocellular carcinoma cell SK-HEP-1 xenograft in nude mice,and its mechanism may be related to upregulating the expression of miR-125b-5p.

Abstract:Objective To investigate the effects of intermittent theta-burst stimulation(iTBS)on depression-like behaviors and hippocampal amino acid metabolism in a mouse model with chronic restraint stress(CRS).Methods Twenty-four male C57BL/6J mice aged 6-8 weeks were randomly divided into control group(Sham group),depression group(CRS group),and iTBS treatment group(CRS+iTBS group),with eight mice in each group.Following a week of adaptive feeding,mice in the CRS group and CRS+iTBS group underwent CRS modeling for 14 d.After modeling,the CRS+iTBS group received iTBS intervention for 5 d,while the Sham group and the CRS group underwent sham iTBS intervention for 5 d.Behavioral tests(sucrose preference test,novelty-suppressed feeding test,and tail suspension test)were conducted 24 h after iTBS intervention to evaluate depression-like behaviors.Subsequently,after 24 h of behavioral tests,the animals were sacrificed and hippocampal tissues from all groups were analyzed using untargeted metabolomics via ultra-high-performance liquid chromatography/quadrupole time-of-flight tandem mass spectrometry(UHPLC-QTOF/MS)to assess alterations in amino acid metabolism.Results ①The results of sucrose preference test,novelty-suppressed feeding test,and tail suspension test among the three groups of mice were statistically significant(all P＜0.01).In the sucrose preference test,the CRS group exhibited a significantly lower sucrose preference rate compared to the Sham group and the CRS+iTBS group(both P＜0.01).In the novelty-suppressed feeding test,the feeding latency of mice in the CRS group was significantly higher than that in Sham group and CRS+iTBS group(both P＜0.01).In the tail suspension test,mice in the CRS group displayed a markedly longer immobility time compared to those in Sham group and CRS+iTBS group(both P＜0.01).②The results of UHPLC-QTOF/MS untargeted metabolomics analysis showed that a total of 119 amino acid metabolites were detected in the hippocampus of mice.Compared with the Sham group,there were 23 significantly down-regulated amino acid metabolites and 11 significantly up-regulated amino acid metabolites in the CRS group(both P＜0.05).Compared with the CRS group,a total of 19 significantly down-regulated amino acid metabolites and 1 significantly up-regulated amino acid metabolite were detected in the hippocampus of CRS+iTBS group after iTBS stimulation(P＜0.05).Conclusion iTBS can significantly improve depression-like behaviors in mice with CRS,and its regulatory effect on hippocampal amino acid metabolites may be one of its antidepressant mechanisms.

Abstract:Objective To explore the efficacy and safety of endoscopic nipple-sparing mastectomy(E-NSM)with immediate reconstruction for breast cancer.Methods This study retrospectively investigated 257 patients who underwent nipple-sparing mastectomy at the Department of Thyroid,Breast and Vascular Surgery,Xijing Hospital,Air Force Medical University from January 1,2019 to December 31,2022.Among them,142 patients received conventional open surgery,while 115 patients received endoscopic-assisted surgery.The clinical data of these patients were retrospectively analyzed,including pathological characteristics,surgical procedures,operative time,prosthesis size,flap necrosis,and postoperative infection rates.The BREAST-Q 2.0 questionnaire was used to assess patient satisfaction and quality of life.Results No statistically significant difference was observed in operative time between the conventional nipple-sparing mastectomy group(C-NSM group)and E-NSM group[130(110,170)minvs 135(110,175)min,P=0.232 9].However,the C-NSM group had significantly larger implant compared to the E-NSM group[(236.78±47.36)mL vs(218.52±50.52)mL,P=0.003 8].The median follow-up duration was significantly longer in the C-NSM group than that in the E-NSM group[48(32,58)months vs 32(26,40)months,P＜0.000 1].During postoperative follow-up,although the C-NSM group exhibited a higher number of implant loss compared to the E-NSM group[9 cases(6.34％)vs 2 cases(1.74％)],the difference between the two groups was not statistically significant(P＞0.05).In terms of short-term postoperative complications,including hemorrhage,flap ischemia,nipple-areola complex ischemia,and infection,the C-NSM group demonstrated a significantly higher complication rate compared to the E-NSM group,with statistically significant difference(P＜0.05).At the final follow-up,the E-NSM group demonstrated superior BREAST-Q 2.0 scores in breast satisfaction,psychosocial well-being,and chest pain compared to the C-NSM group,with statistically significant difference(P＜0.05).During the long-term postoperative follow-up period,3 patients in the C-NSM group and 2 patients in the E-NSM group experienced local recurrence,and only one case of distant metastasis was observed in the C-NSM group.In terms of endoscopic operations,the operative time was analyzed,and it was found that the learning curve gradually shortened with the accumulation of surgical experience and case numbers over time.Conclusion E-NSM causes less damage compared with traditional open surgery,and the operative time is not prolonged,with fewer postoperative complications,superior aesthetic outcomes,and short learning curve,demonstrating promising clinical application potential.

Abstract:Objective To compare the differences of heart rate and heart rate variability(HRV)between the parachutists at rest and in the wind tunnel,and to explore the changes of psychological stress and cardiovascular autonomic regulation in the parachutists during parachute descent.Methods Eight young male parachutists were chosen and the process of parachute descent was simulated by wind tunnel experiment.Before the experiment,the parachute cold-weather survival suit and physiological parameter recording detector were worn,and the ECG signal was continuously recorded in the ground resting state.The experiment was carried out in the wind tunnel for at least 10 min,and the ECG signal was continuously dynamically recorded until the end of the experiment.Two states of ECG steady signals were selected for 5 min each.Paired t-test was used to analyze the differences of heart rate,blood oxygen saturation(SpO2)and HRV under these two states,as well as the changes of body temperature of parachutists at the beginning of the experiment and 15 min after the experiment.Results Compared with the ground resting state,the heart rate during blowing in the wind tunnel was significantly increased(P＜0.01),SpO2 was significantly decreased(P＜0.01),and the body temperature was significantly increased 15 min after the experiment(P＜0.01).The time domain related indexes of HRV,including RR interval,average RR,median RR,standard deviation of NN intervals,coefficient of variation of R-R intervals,standard deviation of differences between adjacent NN intervals,root mean square of successive differences and percentage of RR intervals that differ by 50 ms were all significantly decreased(P＜0.01,P＜0.05).The frequency domain related indexes of very low frequency power and low frequency power(LF)were significantly decreased(P＜0.05),while high frequency power(HF)showed no significant change(P=0.060 9),and LF/HF was significantly increased(P＜0.05).Conclusion The stress level,heart rate and HRV of the parachutists increase during parachute descent.Parachute descent has an impact on stress regulation of the cardiovascular autonomic nervous system,and autonomic nervous function develops towards the dominance of sympathetic nervous system.

Abstract:Objective To observe the changes of electroencephalogram(EEG)and the effect of electrical acupoint stimulation during 24 h simulated weightlessness in head down bed rest.Methods A total of 22 volunteers were randomly divided into electroacupuncture group and control group,with 11 people in each group.The control group rested in bed in a head-low position for 24 h,while the electroacupuncture group rested in bed in a head-low position for 24 h and then stimulated bilateral Neiguan acupoints for 30 min.The changes of power spectral density(PSD)of EEG signals in resting state and mood states were analyzed and compared between the two groups before and after bed rest.Results Compared with that before bed rest,the PSD of θ and α band generally decreased in all brain regions,the PSD of right temporal lobe θ band and the PSD of right central region,right parietal lobe,and left occipital lobe α band significantly reduced(P＜0.05).The score of fatigue,depression,and anger,as well as the total score of negative mood disorder of Profile of Mood States(POMS)significantly increased(P＜0.05),while the score of energy significantly decreased(P＜0.05)after 24 h of head down bed rest.Compared with the control group,the PSD in the right frontal lobe θ band was significantly reduced in the electroacupuncture group(P＜0.05),and the depression score of POMS showed a decreasing trend after bed rest.Conclusion The simulated weightlessness effect of 24 h head down bed rest alters the activities of θ and α band of certain brain regions at rest,and can be more likely to cause negative emotions.Electroacupuncture stimulation regulates the activity of the right frontal lobe θ bands and potentially has a positive regulatory effect on the activity of α bands of various brain regions.To some extent,electroacupuncture stimulation also alleviates the generation of negative emotions caused by head down bed rest.

Abstract:Osteoporosis(OP)is a common systemic bone degenerative disease,and imbalance in bone remodeling is an important pathogenesis of OP and fragility fractures.Epigenetics refers to changes in gene expression and function caused by other regulatory mechanisms without altering the DNA sequence,such as post-translational modification of histones,DNA methylation,noncoding RNA,and chromatin remodeling.Histone demethylation modification is one of the current research hotspots in epigenetic mechanism,and is strictly regulated by histone demethylase.Histone lysine demethylases(KDMs)have been confirmed to be involved in the process of bone remodeling,including homeostasis between osteoblasts and osteoclasts.However,as a member of the newly discovered KDMs family in recent years,including KDM7A,KDM7B and KDM7C,the role of KDM7 in the process of bone reconstruction is rarely reported.This paper mainly reviews the latest research progress of epigenetic regulation,histone demethylation modification and KDM7 in bone reconstruction,so as to provide new ideas for the prevention and intervention of OP.