Abstract:Objective To explore the value of Fisher's discriminant function model constructed using computed tomography(CT)parameters in differential diagnosis of thymoma and anterior mediastinal cyst.Methods The clinicopathological data of patients with anterior mediastinal cysts(including thymic cysts and bronchial cysts)or thymoma proven by pathology examination after surgical resection of the cysts in Department of Thoracic Surgery,Xiangya Hospital of Central South University from January 2015 to June 2025 were retrospectively collected.The ratios of plain scan and enhanced CT values of the tumors to the CT values of the aorta were calculated.One-way analysis of variance combined with Bonferroni's correction was used for inter-group comparisons.The Fisher's discriminant function was established based on the screened CT parameters and was verified.Results A total of 236 patients were included in this study,including 159 cases of thymoma(thymoma group),54 cases of thymic cysts(thymic cyst group),and 23 cases of bronchial cysts(bronchial cyst group).There was no statistically significant difference in age among the three groups(P＞0.05).Compared with those in the thymoma group and the thymic cyst group,the proportion of female patients was higher(P＜0.001),and the maximum diameter of tumors was smaller(P＜0.001)in the bronchial cyst group,and the proportion of lobulated tumors in the thymoma group was significantly higher than that in the thymic cyst group and the bronchial cyst group(P＜0.001).The clarity rate of fat space in the thymoma group was significantly lower than that in the thymic cyst group and the bronchial cyst group(P＜0.001).The plain and enhanced CT values and the ratios of plain and enhanced CT values to aortic CT values in the thymoma group and the bronchial cyst group were significantly higher than those in the thymic cyst group(P＜0.001),and the enhanced CT value and the ratio in the bronchial cyst group were lower than those in the thymoma group(P＜0.001).The enhanced CT values in the thymic cyst group and the bronchial cyst group were significantly lower than those in the thymoma group(P＜0.001).The established Fisher's discriminant functions:D1=0.245 × gender(0=female,1=male)+0.782 × tumor shape(1=unlobulated,2=lobulated)+0.644 × fat space(0=blur,1=clear)-0.344 × enhanced CT value+97.228 × aortic enhanced CT ratio+0.059 × CT enhancement value-9.357;D2=0.970 ×gender(0=female,1=male)+0.583 × tumor shape(1=unlobulated,2=lobulated)+0.903 × fat space(0=blur,1=clear)-0.094 × enhanced CT value+4.749 × aortic enhanced CT ratio+0.110 × CT enhancement value+0.546.The cross-validation results showed that the overall diagnostic accuracy rate of the model in differentiating thymoma from anterior mediastinal cyst was 95.76％.Conclusion The discriminant function diagnostic model established according to the CT parameters has a high diagnostic value in differentiating thymoma from anterior mediastinal cyst.

Abstract:Objective To observe the safety and effectiveness of"sandwich"bone graft encapsulation technique using gelatin sponge-recombinant human bone morphogenetic protein-2(rhBMP-2)composite bioactive material in preventing graft-related leakage and promoting osseous fusion in oblique lumbar interbody fusion(OLIF).Methods A retrospective analysis was performed on the clinical data of 834 patients with lumbar degenerative diseases who underwent L4-5 segment OLIF in West China Hospital,Sichuan University from November 2017 to July 2023.The patients included 380 males(45.6％)and 454 females(54.4％),aged 23-89(63.3±11.8)years.The operation time,intraoperative blood loss and hospital stay of the patients were recorded.The clinical efficacy was evaluated by using Visual Analogue Scale(VAS)scores and Oswestry Disability Index(ODI).Sagittal lumbar three-dimensional computed tomography(3D-CT)was used to measure the disc height(DH)before the operation and 1 day,12 months and 24 months after the operation.Cage subsidence was graded by using Marchi classification system,and interbody fusion status was assessed according to Bridwell grading criteria.Results All the patients were operated successfully without any complications such as graft migration,graft leakage or graft-related neurological compression.The average operation time was(87.2±11.8)min.The average intraoperative blood loss was(33.3±7.4)mL,and the average hospital stay was(5.3±1.5)days.The postoperative follow-up duration ranged from 24 to 90 months,with a median follow-up duration of 28(24,43)months.Compared with those before the operation,the VAS scores for assessing low back pain and leg pain as well as the ODI of the patients at 3 months,12 months and 24 months after the operation continued to improve significantly,and the differences were statistically significant(P＜0.05).Postoperative imaging measurement demonstrated a restoration of DH in the operated lumber vertebra segments at 1 day after the operation,with favorable maintenance at 12 months after the operation.At 24 months after the operation,the imaging fusion rate reached 93.8％(Bridwell grades Ⅰ-Ⅱ),and the incidence of cage subsidence was 22.9％.Conclusion The application of"sandwich"bone graft encapsulation technique using gelatin sponge-rhBMP-2 composite bioactive material in OLIF shows good safety and feasibility.It has the advantages of simple operation,short operation time and low complication rate.While ensuring the efficiency of minimally invasive surgery,it achieves good clinical efficacy.

Abstract:Objective To study the associations of expressions of micro ribonucleic acid-23b-3p(miR-23b-3p)and micro ribonucleic acid-218-5p(miR-218-5p)in cervical squamous cell carcinoma(CSCC)tissues with epithelial-mesenchymal transition(EMT),clinicopathological characteristics and prognosis.Methods A total of 121 patients with CSCC who were admitted to Yancheng Third People's Hospital from June 2016 to June 2019 were selected as the research subjects.During the operation,the CSCC tissues and para-carcinoma tissues(more than 5 cm away from the carcinoma tissues)of these patients were collected,and the expressions of miR-23b-3p,miR-218-5p,epithelial cadherin(E-cadherin)and vimentin were detected by using reverse transcription-quantitative polymerase chain reaction(RT-qPCR).The patients were followed up for 5 years after the operation,and their survival prognosis was recorded.Pearson correlation was used to analyze the correlations between the indicators.Survival curves were plotted by using Kaplan-Meier method,and log-rank test was used for comparison between the groups.Cox regression was used to analyze the factors influencing the prognosis of the CSCC patients.Results The expressions of miR-23b-3p,miR-218-5p and E-cadherin in the CSCC tissues were significantly lower than those in the para-carcinoma tissues(P＜0.05),while the expression of vimentin in the CSCC tissues was significantly higher than that in the para-carcinoma tissues(P＜0.05).In the CSCC tissues,the expressions of miR-23b-3p and miR-218-5p were negatively correlated with the expression of vimentin(P＜0.05),and positively correlated with the level of E-cadherin(P＜0.05).The expressions of miR-23b-3p and miR-218-5p were correlated with International Federation of Gynecology and Obstetrics(FIGO)stage,degree of differentiation,depth of myometrial invasion and lymph node metastasis(P＜0.05),but were not correlated with age and tumor diameter(P＞0.05).The survival prognosis of the patients with high expression of miR-23b-3p(relative expression level ≥1.85,58 cases)was better than that of the patients with low expression of miR-23b-3p(relative expression level＜1.85,61 cases)(log-rank test:x2=7.720,P=0.006).The survival prognosis of the patients with high expression of miR-218-5p(relative expression level ≥1.34,59 cases)was better than that of the patients with low expression of miR-218-5p(relative expression level＜1.34,60 cases)(log-rank test:x2=5.611,P=0.018).The results of multivariate Cox regression analysis showed that lymph node metastasis was an independent risk factor for death in the patients(P＜0.05),and high expressions of E-cadherin,miR-23b-3p and miR-218-5p were protective factors inhibiting death in the patients(P＜0.05).Conclusion Expressions of miR-23b-3p and miR-218-5p are down-regulated in CSCC tissues,and low expressions of miR-23b-3p and miR-218-5p are associated with poor differentiation,advanced FIGO stage,increased depth of myometrial invasion,lymph node metastasis and poor prognosis in CSCC.

Abstract:Objective To explore the clinical effect of optimized percutaneous vertebroplasty(PVP)in treatment of osteoporotic vertebral fracture nonunion(Kümmell's disease,KD).Methods A retrospective analysis was conducted on the clinical data of 153 patients with KD who underwent PVP in the Department of Spinal Surgery of Shanghai Fourth People's Hospital,Tongji University from January 2021 to January 2024.Among the patients,78 patients receiving conventional PVP were assigned to the control group,while the other 75 patients receiving optimized PVP(including cross-puncture,filling with gelatin sponge and artificial bone,bone cement trailing and vacuum intravertebral cleft freshness)were assigned to the observation group.The Visual Analogue Scale(VAS)scores for assessing low back pain and the Oswestry Disability Index(ODI),the vertebral body height of the injured vertebrae,the angles formed between the upper endplate and the lower endplate of the injured vertebrae,and the thoracolumbar Cobb angles were collected before the operation,and at 3 days,1 month,3 months,6 months and 12 months after the operation for comparative analysis.Results The VAS scores and ODI in the two groups at each time point after the operation were significantly lower than those before the operation(P＜0.05),but there were no significant defferences between the two groups(P＞0.05).The vertebral body height of the injured vertebrae,the angles formed between the upper endplate and the lower endplate of the injured vertebrae,and the thoracolumbar Cobb angles in the two groups at each time point after the operation were significantly improved compared with those before the operation(P＜0.05),and the improvement in the observation group was more significant(P＜0.05).The incidence of complications in the observation group was lower than that in the control group,with a statistically significant difference between the two groups(2.7％vs 25.6％;x2=16.392,P＜0.001).Conclusion The optimized PVP can enhance bone cement anchoring,restore and maintain the vertebral height of the injured vertebrae,and significantly alleviate back pain in the KD patients,improve their lumbar function and quality of life.

Abstract:Among intracranial secondary malignant tumors,cystic metastatic brain tumors are relatively uncommon.In view of the large volume and obvious space-occupying effect of cystic metastatic brain tumors,the clinical symptoms of the patients with cystic metastatic brain tumors are relatively serious and their prognoses are relatively poor.At present,there is still a lack of a standard treatment regimen for cystic metastatic brain tumors.Therefore,optimizing treatment regimens to improve the patients' quality of life,prolong their survival period and improve their long-term prognoses has become an important issue of concern for clinicians.In this paper,the research progress in diagnosis and treatment of cystic metastatic brain tumors is reviewed.

Abstract:Objective To systematically search literature and summarize the relevant evidence for early postoperative ambulation in patients with lumbar degenerative diseases(LDD),providing a basis for evidence-based clinical practice.Methods The relevant literature on early postoperative ambulation of the LDD patients from January 2015 to March 2025 was systematically searched,and the quality evaluation,evidence extraction,and grading of the included literature were conducted.Results A total of 12 papers were included,including 3 papers on guidelines,5 papers on expert consensus,2 papers on systematic review,and 2 papers on randomized controlled trials.The best evidence could be summarized as 7 dimensions,including prehabilitation,pain management,gastrointestinal and nutritional management,sleep management,assessment before ambulation,activities for ambulation,and safety management for ambulation,totaling 24 pieces of evidence.Conclusion The best evidence summarized in this study provides an evidence-based basis for standardizing early ambulation in LDD patients after the operation.When applying the evidence in clinical practice,it is necessary to comprehensively assess the patients' physical condition in light of the actual situation and formulate a personalized plan for early postoperative ambulation.

Abstract:Innate immunity,as the first line of defense for the body against the invasion of pathogens,plays a significant role in maintaining the homeostasis of the immune system,and in recognizing and eliminating the invading pathogens.However,under aseptic conditions,the abnormal activation of innate immunity may induce autoinflammatory diseases.Chronic recurrent multifocal osteomyelitis(CRMO),as a typical representative of autoinflammatory diseases,still has many fundamental theoretical and clinical management problems that need to be urgently solved in clinical diagnosis and treatment.The Pstpip2-/-mouse model is widely used in the research fields of autoinflammatory diseases and CRMO,which facilitates the understanding of the regulatory mechanisms of CRMO at the molecular and cellular levels.This paper summarizes the clinical manifestations and classifications of general autoinflammatory diseases,with a focus on discussing the role of membrane-regulating protein proline-serine-threonine-phosphatase-interacting protein 2(PSTPIP2)in the Pstpip2-/-mouse model of CRMO,aiming to provide a reference for analyzing the pathogenesis of osteolytic osteomyelitis and formulating therapeutic strategies.

Abstract:Objective To construct and internally validate a nomogram model for predicting early tibial component loosening after unicompartmental knee arthroplasty(UKA)in elderly patients with osteoporosis.Methods The clinical data of 125 elderly patients with osteoporosis who underwent UKA in Yuncheng Central Hospital Affiliated to Shanxi Medical University due to knee osteoarthritis from May 2022 to May 2023 were retrospectively collected.Among the patients,21 patients had early tibial component loosening after the operation(loosening group),and 104 patients did not have early tibial component loosening after the operation(non-loosening group).Multivariate logistic regression was used to analyze the influencing factors for developing early tibial component loosening after UKA in the elderly patients with osteoporosis.A nomogram model was constructed based on the independent predictors and was internally validated by using Bootstrap(1 000 iterations),and the prediction efficacy of the nomogram model for developing early tibial component loosening after UKA in the elderly patients with osteoporosis was evaluated by using receiver operating characteristic(ROC)curve.Results Compared with those in the non-loosening group,the maximum total point motion(MTPM)measured by radiostereometric analysis(RSA)was significantly increased(P＜0.05),and the volumetric bone mineral density(vBMD)of proximal tibia measured by quantitative computed tomography(QCT)was significantly decreased(P＜0.05),and the beta-carboxy-terminal cross-linking telopeptide of type Ⅰ collagen(β-CTX)level was significantly increased in the loosening group(P＜0.05).Multivariate logistic regression analysis showed that MTPM measured by RSA[OR(95％CI)=3.32(2.11-5.21)]and β-CTX[OR(95％CI)=1.13(1.06-1.20)]were independent risk factors for developing early tibial component loosening after UKA(P＜0.05),while the vBMD of proximal tibia measured by QCT[OR(95％CI)=0.63(0.44-0.82)]was an independent protective factor inhibiting development of early tibial component loosening after UKA(P＜0.05).The nomogram model constructed based on the above 3 indicators was verified internally to have good discrimination(C-index=0.785,AUC=0.792),and the decision curve analysis showed that the model had high net clinical benefit within the threshold probability range of 0.15-0.38.Conclusion The nomogram model constructed according to the vBMD of proximal tibia measured by QCT,MTPM measured by RSA and bone resorption indicator β-CTX has good predictive performance and clinical application potential,and can be used for risk assessment of early tibial component loosening and stratified management.

Abstract:The incidence of type 2 diabetes mellitus(T2DM)is on a continuous upward trend.The pathological mechanisms of T2DM are relatively complex,involving insulin resistance,disorders of glucose and lipid metabolism and intestinal flora imbalance.Marine-derived chitooligosaccharides(COS)and its derivatives have significant multiple biological activities such as anti-inflammation,antioxidation,improving glucose and lipid metabolism,and regulating gut microbiota.The multi-target synergistic mechanisms of COS and its derivatives in anti-diabetes provide theoretical support for the construction of targeted nutritional intervention programs and highlight the clinical translational value in the comprehensive treatment of diabetes.In this paper,the research progress in mechanisms of COS regulating T2DM through multiple targets is reviewed.

Abstract:Objective To study the mechanisms of action of Daotan decoction in treatment of hypertension based on network pharmacology and molecular docking.Methods The active ingredients of Daotan decoction,potential targets and hypertension targets were obtained through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)and GeneCards database.The intersection of the potential action targets of Daotan decoction and the hypertension targets were used for analysis.The active ingredients of Daotan decoction-hypertension target interaction network and protein-protein interaction(PPI)network were constructed.The main active ingredients and core targets of action were screened.The potential mechanisms of action of Daotan decoction in treatment of hypertension were explored via Gene Ontology(GO)functional analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.The binding ability of the main active ingredients to the core targets was analyzed by molecular docking method.Results There were a total of 110 intersection targets between the action targets of Daotan decoction and the hypertension targets.A total of 15 active ingredients with degree values ≥20 were extracted from the active ingredients of Daotan decoction-hypertension target interaction network.Among the 110 intersection targets,109 targets were involved in the PPI network,and 26 action targets whose degree value,betweenness,and centrality all exceeded the average values were identified and presumed to be the core targets of Daotan decoction in treating hypertension.The results of GO functional analysis revealed that 146 enrichment results were obtained from the 110 intersecting targets(P＜0.05),including 89 biological processes(BP),42 molecular functions(MF),and 15 cellular components(CC).A total of 95 related signaling pathways were identified by using KEGG pathway enrichment analysis(P＜0.05).The molecular docking results showed that the binding energy values of β-sitosterol,cavidine,stigmasterol and luteolin to tumor necrosis factor(TNF),interleukin-6(IL-6),prostaglandin-endoperoxide synthase 2(PTGS2),and estrogen receptor 1(ESR1)were all below 0 kcal/mol.Conclusion Daotan decoction has the characteristics of multi-component,multi-target and multi-pathway synergistic effects in treatment of hypertension.

Abstract:In May 2025,Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD)in People with Diabetes:the Need for Screening and Early Intervention.A Consensus of the American Diabetes Association,was published in Diabetes Care.This consensus elaborates on the reasons for nomenclatural changes in MASLD,how to conduct risk stratification,current treatments and long-term monitoring and the importance of managements of MASLD by a multi-disciplinary professional team.In this paper,the authors interpret this consensus by combining the recent expert consensuses and clinical guidelines on diabetes complicated with MASLD at home and abroad,hoping to improve the understanding of MASLD and the disease risks associated with MASLD,and to screen,diagnose,treat and standardly manage prediabetes and type 2 diabetes mellitus(T2DM)patients complicated with MASLD at an early stage.

Abstract:Objective To observe the clinical effect of spinal fine-tuning manipulation combined with neck three-needle technique in treatment of neck-type cervical spondylosis(NTCS).Methods A total of 132 patients with NTCS who were admitted to Handan Hospital of Integrated Traditional Chinese Medicine and Western Medicine from October 2022 to December 2023 were recruited and divided into observation group and control group by using random number table method,with 66 patients in each group.The control group was treated with spinal fine-tuning manipulation,while the observation group was treated with spinal fine-tuning manipulation combined with neck three-needle technique,3 times weekly,1 week as a course of treatment.Both groups were treated continuously for 4 courses of treatment.The clinical effective rate,pain condition,cervical spine function,cervical ranges of motions,serum nitric oxide(NO)and endothelin(ET)levels,and relapse rate were compared between the two groups.The occurrence of adverse reactions in the patients during the treatment was recorded.Results The total clinical effective rate of the observation group was significantly higher than that of the control group(93.94％vs 74.24％;x2=9.570,P=0.002).After the treatment,the Visual Analogue Scale(VAS)scores and Neck Disability Index(NDI)scores in the observation group were significantly lower than those in the control group(P＜0.05),and the cervical ranges of motions including cervical anterior flexion,backward extension,left-handed rotation and right-handed rotation in the observation group were significantly greater than those in the control group(P＜0.05).After the treatment,the serum ET level in the observation group was lower than that in the control group,and the serum NO level in the observation group was higher than that in the control group,with statistically significant differences between the two groups(P＜0.05).After the treatment,the Activities of Daily Living(ADL)scale scores in the observation group were significantly higher than those in the control group(P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(9.09％vs 3.03％;x2=1.198,P=0.274).At 6 months after the treatment,the relapse rate in the observation group was lower than that in the control group,with statistically significant difference between the two groups(8.06％vs 26.53％;x2=6.869,P=0.009).Conclusion The combination of spinal fine-tuning manipulation and neck three-needle technique is safe and effective in treatment of NTCS,and is worthy of clinical recommendation.

Abstract:This paper reports a case of intramural pregnancy.

Abstract:Objective To observe the effect of activating Qi and promoting blood circulation with round-sharp needles stimulating meridian points combined with small needle-knife in treatment of de Quervain's tenosynovitis(DQT).Methods A total of 106 patients with DQT who were admitted to the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine from February 2022 to February 2024 were recruited.These patients were randomly divided into the observation group(receiving the treatment of activating Qi and promoting blood circulation with round-sharp needles stimulating meridian points combined with small needle-knife)and the control group(receiving small needle-knife treatment)by using random number table method,with 53 patients in each group.The treatment course was 1 month for both groups.The traditional Chinese medicine(TCM)syndrome scores and the levels of wrist joint function indicators were compared between the two groups before and after the treatment.The occurrence of adverse reactions and the recurrence of DQT within 6 months after the treatment were compared between the two groups.Results After the treatment,the TCM syndrome scores in both groups were significantly lower than those before the treatment(P＜0.05),and the TCM syndrome scores in the observation group were lower than those in the control group after the treatment,with statistically significant differences(P＜0.05).After the treatment,the Cooney scores in both groups were significantly increased compared with those before the treatment(P＜0.05),and the ranges of motions of flexion and extension,ulnar deviation and radial deviation of the wrist joint were significantly great compared with those before the treatment(P＜0.05).After the treatment,the Cooney scores in the observation group were higher than those in the control group,and the ranges of motions of flexion and extension,ulnar deviation and radial deviation of the wrist joint in the observation group were greater than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions between the two groups(5.66％vs 1.89％;x2=0.260,P=0.610).There was no statistically significant difference in the recurrence rate between the two groups(3.77％vs 0.00％;P=0.495).Conclusion Activating Qi and promoting blood circulation with round-sharp needles stimulating meridian points combined with small needle-knife is safe and effective in treatment of de DQT.The combination treatment can significantly improve the wrist joint function of the patients.

Abstract:The prevalence rate of cyclic vomiting syndrome(CVS)is low in children,characterized by recurrent vomiting,which seriously affects the quality of life of the affected children.At present,the pathogenesis of CVS is not yet clear,and there is a lack of evidence-based treatment regimens.The clinical treatment process lacks consistency and standardization.In 2025,China released the Guidelines for Treatment of Cyclic Vomiting Syndrome in Children(2025),aiming to guide and standardize the clinical treatment practice of CVS in children in China.In the same year,North American Society for Pediatric Gastroenterology,Hepatology,and Nutrition also released Guidelines for Management of Cyclic Vomiting Syndrome in Children(2025),replacing the 2008 version of the recommendations of the society on CVS.This paper mainly analyzes and interprets the similarities and differences between the two guidelines,aiming to provide a theoretical basis for clinical practice and offer references for clinicians to select appropriate prevention and treatment regimens.

Abstract:Expanding antiviral treatment for chronic hepatitis B(CHB)is gradually becoming a consensus.In the future,more patients with the immune tolerance state of high baseline hepatitis B virus(HBV)deoxyribonucleic acid(DNA)levels will be included in antiviral treatment.Because these patients lack the host immune-mediated covalently closed circular DNA(cccDNA)clearance effect,it is expected that they will often need a longer time to achieve complete control of viral DNA replication when receiving antiviral treatment with nucleos(t)ide analogues(NAs),which is complete response postpone(CRP).Therefore,it is not appropriate to simply classify the delayed complete virological response to NAs as low-level viremia(LLV)with poor response to antiviral therapy,in order to avoid treatment hesitancy or adjust the clinical treatment regimes too early.

Abstract:Osteoporosis(OP)is a globally prevalent skeletal disease that imposes a substantial health and economic burden on society.Homocysteine(Hcy),as a metabolic intermediate of sulfur-containing amino acids,has been confirmed as an independent risk factor for cardiovascular and cerebrovascular diseases when its plasma levels are elevated-a condition known as hyperhomocysteinemia(HHcy).In recent years,some researches have found that HHcy is closely associated with decreased bone mineral density,increased fracture risk and disordered bone metabolism.However,its mechanism of action and clinical significance remain controversial.This paper systematically reviews the research progress in the relationships between Hcy and OP.Firstly,it sorts out epidemiological evidence to clarify the complex relationships between Hcy levels and bone mineral density as well as fracture risk,and summarizes the effects of genetic polymorphisms(e.g.,the MTHFR gene)and the levels of B vitamins on these relationships.Secondly,it deeply explores the molecular and cellular biological mechanisms,focusing on the core role of Hcy in disrupting bone metabolic balance via inducing oxidative stress and inflammatory responses,and interfering with specific signaling pathways.Finally,it evaluates the potential and challenges of reducing Hcy levels and preventing and treating OP through nutritional interventions(e.g.,supplement with folic acid and vitamin B12)and pharmacological interventions.This review aims to provide a comprehensive perspective for a deeper understanding of the role of Hcy in the pathogenesis of OP and offers a theoretical basis for studying new prevention and treatment strategies for OP.

Abstract:In the context of global population aging,the coexistence of lumbar degenerative diseases and osteoporosis significantly increases the risk of complications associated with lumbar spinal fusion and internal fixation,making it an urgent clinical challenge that spinal surgery needs to deal with.In recent years,with the deepening of researches,there have been a more comprehensive understanding and more effective treatment strategies for the lumbar spinal fusion and internal fixation patients complicated with osteoporosis.Based on a review of the relevant literature,this paper comments on the fundamental management strategies for lumbar spinal fusion and internal fixation in patients complicated with osteoporosis,with the aim of providing a reference for the clinical management of lumbar spinal fusion and internal fixation in patients with osteoporosis,and reducing the incidence of complications.

Abstract:Objective To explore the role and mechanism of regulatory B cells(Bregs)in progression of diabetic retinopathy(DR).Methods Forty male C57/BL6 mice aged 8 weeks were selected and randomly divided into control group and DR group,with 20 mice in each group.The mice in the DR group were intraperitoneally injected with streptozotocin(STZ)at a dose of 30 mg/kg to establish the DR model.The mice in the control group were intraperitoneally injected with the same volume of sodium citrate solution.At the age of 28 weeks,the fundi of the mice were observed by using fundus photography,optical coherence tomography(OCT)and fluorescein fundus angiography(FFA).The spleen and peripheral blood samples of these mice were collected and the levels of Bregs were detected by using flow cytometry.Sixteen patients with DR who were admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from April 2020 to August 2024 were recruited as the case group,among whom 7 patients had proliferative diabetic retinopathy(PDR)and 9 patients had non-proliferative diabetic retinopathy(NPDR),and 12 age-matched healthy individuals undergoing physical examination during the same period were recruited as the healthy control group.The plasma levels of interleukin-10(IL-10),tumor growth factor-β(TGF-β)and programmed death-ligand-1(PD-L1)were detected by using enzyme-linked immunosorbent assay(ELISA),and the correlations between these indicators and the severity of the disease were analyzed.Results Fundus color photography showed that no typical microangiomas or hemorrhagic exudates were observed in the retinas of the mice in both the DR group and the control group.OCT examination revealed the presence of localized hyperreflective foci in front of the optic papilla in the mice of the DR group.The FFA examination results showed that the microcirculation of the retinas in the mice of the DR group was abnormal,specifically manifested as the formation of abnormal arteriovenous anastomoses,which was consistent with the early vascular pathological characteristics of DR lesions.The detection results of flow cytometry showed that the levels of Bregs in the spleen and peripheral blood of the mice in the DR group were significantly lower than those in the control group(P＜0.05).The detection results of ELISA showed that the plasma levels of IL-10,TGF-β,and PD-L1 in the case group were significantly lower than those in the healthy control group(P＜0.05).The levels of plasma IL-10 and PD-L1 in the PDR group were significantly lower than those in the NPDR group(P＜0.05),while there was no statistically significant difference in the plasma TGF-β level between the two groups(P＞0.05).Conclusion Bregs are involved in the occurrence and progression of DR by regulating inflammatory responses.

Abstract:Objective To analyze the serum microribonucleic acid(miR)-515-5p and homeobox protein B13(HOXB13)levels in non-small cell lung cancer(NSCLC)patients and their associations with clinicopathological features and prognosis.Methods A total of 118 patients with NSCLC who were admitted to the First People's Hospital of Foshan from July 2019 to July 2021 were recruited as research group,and 118 healthy individuals who underwent physical examination during the same period were selected as control group.The levels of relative expressions of serum miR-515-5p and HOXB13 mRNA were detected by using real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).The patients were followed up for 3 years after discharge from the hospital.According to the survival status of the patients during the follow-up period,they were divided into poor prognosis group(51 patients)and good prognosis group(67 patients).Pearson correlation was used to analyze the correlation between miR-515-5p level and HOXB13 level.The survival curve was plotted by using Kaplan-Meier method,and the inter-group comparison was conducted by using log-rank test.Cox regression was used to analyze the influencing factors of death in the NSCLC patients.Results The level of miR-515-5p in the research group was significantly lower than that in the control group(P＜0.05),while the level of HOXB13 in the research group was significantly higher than that in the control group(P＜0.05).The results of Pearson correlation analysis showed that the miR-515-5p level in the NSCLC patients was negatively correlated with the HOXB13 level(r=-0.742,P＜0.001).The levels of miR-515-5p and HOXB13 in the NSCLC patients were related to TNM stage,degree of differentiation and lymph node metastasis(P＜0.05),but were not significantly related to age,gender,pathological type and tumor diameter(P＞0.05).The serum miR-515-5p level in the poor prognosis group was significantly lower than that in the good prognosis group(P＜0.05),while the serum HOXB13 level in the poor prognosis group was significantly higher than that in the good prognosis group(P＜0.05).The survival prognosis of the patients with high expression of miR-515-5p(≥0.50)was significantly better than that of the patients with low expression of miR-515-5p(＜0.50)(log-rank test:x2=36.627,P＜0.001).The survival prognosis of the patients with low expression of HOXB13(＜2.08)was significantly better than that of the patients with high expression of HOXB13(≥ 2.08)(log-rank test:x2=12.755,P＜0.001).The results of multivariate Cox regression analysis showed that high expression of HOXB13,TNM stages Ⅲ-Ⅳ,low degree of differentiation,and lymph node metastasis were risk factors for death in the patients(P＜0.05),and high expression of miR-515-5p was a protective factor for inhibiting death in the patients(P＜0.05).Conclusion Serum miR-515-5p level is decreased and serum HOXB13 level is increased in NSCLC patients.Both miR-515-5p and HOXB13 are related to the clinicopathological features and prognosis of the patients.