Gamma-aminobutyric acid (GABA) improves salinity stress tolerance in soybean seedlings by modulating their mineral nutrition, osmolyte contents, and ascorbate-glutathione cycle.

BACKGROUND: In plants, GABA plays a critical role in regulating salinity stress tolerance. However, the response of soybean seedlings (Glycine max L.) to exogenous gamma-aminobutyric acid (GABA) under saline stress conditions has not been fully elucidated. RESULTS: This study investigated the effects of exogenous GABA (2 mM) on plant biomass and the physiological mechanism through which soybean plants are affected by saline stress conditions (0, 40, and 80 mM of NaCl and Na2SO4 at a 1:1 molar ratio). We noticed that increased salinity stress negatively impacted the growth and metabolism of soybean seedlings, compared to control. The root-stem-leaf biomass (27- and 33%, 20- and 58%, and 25- and 59% under 40- and 80 mM stress, respectively]) and the concentration of chlorophyll a and chlorophyll b significantly decreased. Moreover, the carotenoid content increased significantly (by 35%) following treatment with 40 mM stress. The results exhibited significant increase in the concentration of hydrogen peroxide (H2O2), malondialdehyde (MDA), dehydroascorbic acid (DHA) oxidized glutathione (GSSG), Na+, and Cl- under 40- and 80 mM stress levels, respectively. However, the concentration of mineral nutrients, soluble proteins, and soluble sugars reduced significantly under both salinity stress levels. In contrast, the proline and glycine betaine concentrations increased compared with those in the control group. Moreover, the enzymatic activities of ascorbate peroxidase, monodehydroascorbate reductase, glutathione reductase, and glutathione peroxidase decreased significantly, while those of superoxide dismutase, catalase, peroxidase, and dehydroascorbate reductase increased following saline stress, indicating the overall sensitivity of the ascorbate-glutathione cycle (AsA-GSH). However, exogenous GABA decreased Na+, Cl-, H2O2, and MDA concentration but enhanced photosynthetic pigments, mineral nutrients (K+, K+/Na+ ratio, Zn2+, Fe2+, Mg2+, and Ca2+); osmolytes (proline, glycine betaine, soluble sugar, and soluble protein); enzymatic antioxidant activities; and AsA-GSH pools, thus reducing salinity-associated stress damage and resulting in improved growth and biomass. The positive impact of exogenously applied GABA on soybean plants could be attributed to its ability to improve their physiological stress response mechanisms and reduce harmful substances. CONCLUSION: Applying GABA to soybean plants could be an effective strategy for mitigating salinity stress. In the future, molecular studies may contribute to a better understanding of the mechanisms by which GABA regulates salt tolerance in soybeans.

Peer attachment and self-esteem mediate the relationship between family function and social anxiety in migrant children in China.

BACKGROUND: Social anxiety is a frequently reported symptom in children and adolescents. The literature suggests that family function is related to symptoms of social anxiety in children. However, relatively little is known about the potential mechanisms underlying the relationship between family function and social anxiety. Thus, the purpose of the present study is to examine the roles of peer attachment and self-esteem in the relationship between family function and social anxiety in a sample of migrant children in China. METHODS: A total of 437 participants (54.9% male; meanage = 10.87 years) were selected from two public schools of migrant children in two areas of Hangzhou and Jiaxing, the major labor-importing cities in China, in May 2016. All participants completed four questionnaires assessing family function, peer attachment, self-esteem, and social anxiety. RESULTS: The results showed that family function was bivariately and significantly related to symptoms of social anxiety. Additionally, self-esteem fully mediated the relationship between family function and social anxiety peer attachment. Moreover, the relationship between family function and social anxiety was fully mediated by peer attachment and self-esteem (in that order). CONCLUSIONS: Peer attachment and self-esteem serve as critical pathways linking family function and social anxiety. Thus, tailored interventions should consider the roles of peer attachment and self-esteem to alleviate symptoms of social anxiety in migrant children.

Oleanolic acid inhibits cervical cancer Hela cell proliferation through modulation of the ACSL4 ferroptosis signaling pathway.

Cervical cancer remains the leading cause of cancerous death among women worldwide. Oleanolic acid (OA) is a substance that occurs naturally in the leaves, fruits, and rhizomes of plants and has anti-cancer activity. In this study, tumor-bearing mice were used as the animal model and Hela cells were used as cellular model. In vivo experiments have showed that OA significantly reduced the size and mass of cervical cancer tumors in mice. In vitro experiments have showed that OA significantly reduced the viability and proliferative capacity of Hela cells. In both in vivo and in vitro assays, OA increased the oxidative stress levels and Fe2+ content, and increased the expression of ferroptosis-related proteins. We found that ACSL4 was highly expressed in both xenograft models and cervical carcinoma cells with OA treatment. Further use of siRNA to interfere with ACSL4 expression in cervical cancer cells revealed that the inhibitory effect of OA on cell viability and proliferative capacity was counteracted, while a decrease in ROS levels and GPX4 was detected, suggesting that OA activated ferroptosis in Hela cells by promoting ACSL4 expression, thereby reducing the survival rate of Hela cells. Therefore, promotion of ACSL4-dependent ferroptosis by OA may be a potential approach for the treatment of cervical cancer.

Diagnosis of Thyroid Nodules Based on Local Non-quantitative Multi-Directional Texture Descriptor with Rotation Invariant Characteristics for Ultrasound Image.

The traditional texture feature lacks the directional analysis of graphical element, so it could not better distinguish the thyroid nodule texture image formed by the rotation of graphical element. A non-quantifiable local feature is adopted in this paper to design a robust texture descriptor so as to enhance the robustness of the texture classification in the rotation and scale changes, which can improve the diagnostic accuracy of thyroid nodules in ultrasound images. First of all, the concept of local feature with rotational symmetry is introduced. It is found that many rotation invariant local features are rotational symmetric to a certain degree. Therefore, we propose a novel local feature to describe the rotation invariant properties of the texture. In order to deal with the change of rotation and scale of ultrasound thyroid nodules in image, Pairwise rotation-invariant spatial context feature is adopted to analyze the texture feature, which can combine with the scale information without increasing the dimension of the local feature. The fadopted local features have strong robustness to rotation and gray intensity variation. The experimental results show that our proposed method outperforms the existing algorithms on thyroid ultrasound data sets, which greatly improve the Diagnosis accuracy of thyroid nodules.

Evaluation of the impact of passive smoke on arterial elasticity via echo-tracking technology in a rabbit model.

OBJECTIVES: The purpose of this study was to evaluate the elasticity of the abdominal aorta in passively smoking rabbits using echo-tracking technology and pathologic examination. METHODS: Fifty-four male New Zealand White rabbits were randomly divided into a passive smoking group and a normal control group. The elasticity indicators for the abdominal aorta of the rabbits were measured by means of echo tracking, which was performed before and 1, 2, and 3 months after passive smoking. Measured indicators included the pressure-strain elastic modulus, stiffness, arterial compliance, augmentation index, and pulse wave velocity. After the completion of the in vivo measurements, rabbits were euthanized randomly, and the corresponding arterial sites were resected for pathologic examination and in vitro measurement of vascular elasticity. RESULTS: The echo-tracking technology used in our research proved that the elastic modulus, stiffness, and pulse wave velocity gradually increased with time by passive smoking, whereas arterial compliance decreased by passive smoking. Pathologic examination and in vitro measurements were performed and further confirmed the observed in vivo results. CONCLUSIONS: Passive smoking can injure arteries and reduce arterial elasticity. Echo-tracking technology is an accurate, noninvasive, and reliable method for analysis of the impact of passive smoking on arterial elasticity and detection arterial injury, which also can provide a new instructional basis for prevention and treatment of several arterial diseases.

Screening of lignocellulose-degrading superior mushroom strains and determination of their CMCase and laccase activity.

In order to screen lignocellulose-degrading superior mushroom strains ten strains of mushrooms (Lentinus edodes939, Pholiota nameko, Lentinus edodes868, Coprinus comatus, Macrolepiota procera, Auricularia auricula, Hericium erinaceus, Grifola frondosa, Pleurotus nebrodensis, and Shiraia bambusicola) were inoculated onto carboxymethylcellulose agar-Congo red plates to evaluate their ability to produce carbomethyl cellulase (CMCase). The results showed that the ratio of transparent circle to mycelium circle of Hericium erinaceus was 8.16 (P < 0.01) higher than other strains. The filter paper culture screening test showed that Hericium erinaceus and Macrolepiota procera grew well and showed extreme decomposition of the filter paper. When cultivated in guaiacol culture medium to detect their abilities to secrete laccase, Hericium erinaceus showed the highest ability with the largest reddish brown circles of 4.330 cm. CMCase activity determination indicated that Coprinus comatus and Hericium erinaceus had the ability to produce CMCase with 33.92 U/L on the 9th day and 22.58 U/L on the 10th day, respectively, while Coprinus comatus and Pleurotus nebrodensis had the ability to produce laccase with 496.67 U/L and 489.17 U/L on the 16th day and 18th day. Based on the results, Coprinus comatus might be the most promising lignocellulose-degrading strain to produce both CMCase and laccase at high levels.

A machine learning radiomics model based on bpMRI to predict bone metastasis in newly diagnosed prostate cancer patients.

OBJECTIVES: To develop and evaluate a machine learning radiomics model based on biparametric magnetic resonance imaging MRI (bpMRI) to predict bone metastasis (BM) status in newly diagnosed prostate cancer (PCa) patients. METHODS: We retrospectively analyzed bpMRI scans of PCa patients from multiple centers between January 2016 and October 2021. 348 PCa patients were recruited from two institutions for this study. The first institution contributed 284 patients, stratified and randomly divided into training and internal validation cohorts at a 7:3 ratio. The remaining 64 patients were sourced from the second institution and comprised the external validation cohort. Radiomics features were extracted from axial T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) tumor regions. We developed the radiomics prediction model for BM in the training cohort and validated it in the internal and external validation cohorts. As a benchmark, we trained the logistic regression model with lasso feature reduction (LFR-LRM) in the training cohort and further compared it with Naive Bayes, eXtreme Gradient Boosting (XGboost), Random Forest (RF), GBDT, SVM, Adaboost, and KNN algorithms and validated in both the internal and external cohorts. The performance of several predictive models was assessed by receiver operating characteristic (ROC). RESULTS: The LFR-LRM model achieved an area under the receiver operating characteristic curve (AUC) of 0.89 (95% CI: 0.822-0.974) and an accuracy of 0.828 (95% CI: 0.713-0.911). The AUC and accuracy in external validation were 0.866 (95% CI: 0.784-0.948) and 0.769 (95% CI: 0.648-0.864), respectively. The RF and XGBoost models outperformed the LFR-LRM, with AUCs of 0.907 (95% CI: 0.863-0.949) and 0.928 (95% CI: 0.882-0.974) and accuracies of 0.831 (95% CI: 0.727-0.907) and 0.884 (95% CI: 0.792-0.946). External validation for these models yielded AUCs and accuracies of 0.911 (95% CI: 0.861-0.966), 0.921 (95% CI: 0.889-0.953), and 0.846 (95% CI: 0.735-0.923) and 0.876 (95% CI: 0.771-0.945), respectively. CONCLUSIONS: The XGboost machine learning model is more accurate than LFR-LRM for predicting BM in patients with newly confirmed PCa.

A semi-automatic deep learning model based on biparametric MRI scanning strategy to predict bone metastases in newly diagnosed prostate cancer patients.

Objective: To develop a semi-automatic model integrating radiomics, deep learning, and clinical features for Bone Metastasis (BM) prediction in prostate cancer (PCa) patients using Biparametric MRI (bpMRI) images. Methods: A retrospective study included 414 PCa patients (BM, n=136; NO-BM, n=278) from two institutions (Center 1, n=318; Center 2, n=96) between January 2016 and December 2022. MRI scans were confirmed with BM status via PET-CT or ECT pre-treatment. Tumor areas on bpMRI images were delineated as tumor's region of interest (ROI) using auto-delineation tumor models, evaluated with Dice similarity coefficient (DSC). Samples were auto-sketched, refined, and used to train the ResNet BM prediction model. Clinical, radiomics, and deep learning data were synthesized into the ResNet-C model, evaluated using receiver operating characteristic (ROC). Results: The auto-segmentation model achieved a DSC of 0.607. Clinical BM prediction's internal validation had an accuracy (ACC) of 0.650 and area under the curve (AUC) of 0.713; external cohort had an ACC of 0.668 and AUC of 0.757. The deep learning model yielded an ACC of 0.875 and AUC of 0.907 for the internal, and ACC of 0.833 and AUC of 0.862 for the external cohort. The Radiomics model registered an ACC of 0.819 and AUC of 0.852 internally, and ACC of 0.885 and AUC of 0.903 externally. ResNet-C demonstrated the highest ACC of 0.902 and AUC of 0.934 for the internal, and ACC of 0.885 and AUC of 0.903 for the external cohort. Conclusion: The ResNet-C model, utilizing bpMRI scanning strategy, accurately assesses bone metastasis (BM) status in newly diagnosed prostate cancer (PCa) patients, facilitating precise treatment planning and improving patient prognoses.

Association between ACVR2A gene polymorphisms and risk of hypertensive disorders of pregnancy in the northern Chinese population.

INTRODUCTION: To investigate the possible roles of selected single-nucleotide gene polymorphisms (SNPs) of the activin A receptor type 2A (ACVR2A) gene in the pathogenesis of hypertensive disorders of pregnancy (HDP). METHODS: In this study, the six SNPs of the ACVR2A gene were analyzed by multiplex polymerase chain reaction (PCR) combined with next-generation sequencing methods in 186 HDP patients and 380 healthy pregnant women. Multivariate logistic regression analysis combined with 10,000 permutation tests was used to analyze the potential relationship between ACVR2A gene polymorphisms and HDP, especially its subset pre-eclampsia. RESULTS: Our findings showed that the rs1424954, rs1014064, rs1128919, and rs3768687 differed significantly between HDP patients and control group (p = 0.035, p = 0.035, p = 0.024 and p = 0.035, respectively), which remained significant after 10,000 permutation tests. In addition, rs1424954, rs1014064, rs1128919, rs3768687, rs3764955, and rs13430086 were all statistically significant among the PE patients compared with the controls (p = 0.013, p = 0.016, p = 0.018, p = 0.019, p = 0.024 and p = 0.029, respectively). The significance still existed after 10,000 permutation tests. DISCUSSION: ACVR2A gene polymorphisms may play a role in the pathogenesis of HDP and its subset PE.

Cases report and diagnosis and treatment of passenger lymphocyte syndrome after liver and renal transplantation / 中国输血杂志

【Objective】 To summarize the clinical features, serological features, blood transfusion protocols and treatment of 3 cases of passenger lymphocyte syndrome(PLS) after ABO-incompatibility liver and renal transplantation in our hospital, in order to provide guidance for comprehensive clinical understanding and recognition of this disease, especially early recognition and treatment. 【Methods】 By collecting the basic information of the patients and the time of cross-matching incompatibility of homologous blood after transplantation, observing the skin yellow staining, detecting hemoglobin value and other hemolysis indexes, and blood group serological detection results before and after transfusion, the diagnosis and analysis were performed. The diagnosis and treatment effect of PLS were analyzed by collecting the clinical outcome information after immunization and blood transfusion. 【Results】 Three cases of ABO-incompatible liver transplantation showed decreased hemoglobin and hemolysis, incompatible cross-matching of homologous blood, and anti-A and anti-B IgG antibodies were confirmed by serological test. After treatment such as immunosuppression and plasma exchange, blood transfusion was effective, hemolysis was improved, and antibodies gradually disappeared. 【Conclusion】 ABO blood group antibody screening, unexpected antibody screening and direct antiglobulin test(DAT)should be performed regularly for ABO-incompatible liver and renal transplantation cases, in order to detect the PLS early. A series of laboratory tests related to PLS should be performed in time to diagnose and adjust the treatment plan, including transfusion strategy, when homologous cross-matching is incompatible.

Efficacy of tele-rehabilitation program for preschool children with functional articulation disorders / 中国儿童保健杂志

【Objective】 To observe the effect of tele-rehabilitation program on the articulation resolution of preschool children with functional articulation disorders (FAD), so as to provide reference for the clinical application of tele-rehabilitation in this context. 【Methods】 A total of 66 preschool children diagnosed with FAD in the outpatient department of Child Rehabilitation, Tangshan Maternal and Child Health Hospital from March 2022 to March 2023 were selected into this study, and were divided into tele-rehabilitation group (n=32) and control group (n=34) by random number table method. The control group received daily family rehabilitation guidance, while the tele-rehabilitation group underwent a tele-rehabilitation program lasting for 3 months. All children were assessed using the Chinese phonological ability evaluation lexicon before and 3 months after the treatment. 【Results】 After 3 months of treatment, both the tele-rehabilitation group and the control group showed significant improvements in articulation resolution compared to before treatment (t=12.165、12.986, P0.05). 【Conclusion】 Tele-rehabilitation program effectively improves articulation resolution in preschool children with FAD, especially for mild to moderate preschool children with FAD.

Comparison of clinical effectiveness and safety between generic and branded dienogest tablets in the treatment of endometriosis / 中国临床药理学与治疗学

AIM:To evaluate the clinical effective-ness and safety of generic and branded dienogest in the treatment of endometriosis.so as to provide the basis for clinical use of dienogest.MEHTODS:The data of patients admitted to Third Affiliated Hospital of Zhengzhou University from August 2022 to August 2023 who received dienogest(2 mg/d,orally,for 6 months)for treatment of endometrio-sis were collected.The clinical efficacy and adverse reactions of generic drugs and original drugs in the treatment of endometriosis-related pain were com-pared through follow-up surveys of the two groups of patients at 3 months and 6 months respectively.RESULTS:There was highly significant reduction in pelvic pain in both groups with mean of similar in generic group(34.0±3.0)mm and branded group(34.5±3.9)mm.The most frequent drug-related ad-verse effects in generic dienogest was vaginal bleeding(93%)which was no statistical difference with branded dienogest(90%).CONCLUSION:The generic and branded dienogest have the same clini-cal effectiveness and similar safety.

Effective Ingredients of Chinese Medicine in Prevention and Treatment of Osteoarthritis by Regulating Oxidative Stress： A Review / 中国实验方剂学杂志

Osteoarthritis （OA） is a common degenerative joint disease with a rising incidence rate year by year. Treatment often relies on analgesics and non-steroidal anti-inflammatory drugs （NSAIDs）， which can lead to gastrointestinal damage with long-term use and the recurrence of symptoms. Chinese medicine has a long history of preventing and treating OA， with widespread application and fewer side effects. It offers unique advantages such as a broad treatment scope， multiple targets， and pathways. The effective components of Chinese medicine can reduce the content of reactive oxygen species （ROS）， relieve oxidative stress （OS） damage， and increase the antioxidant capacity of the body by interfering with the expression of biomarkers of OS response such as malondialdehyde （MDA） and superoxide dismutase （SOD）. Through the modulation of signaling pathways such as nuclear factor E2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1）， phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt）， nuclear factor kappa B （NF-κB）， c-Jun N-terminal kinase （JNK）， NOD-like receptor protein 3 （NLRP3）， and osteoprotegerin （OPG）， they downregulated the expression of inflammatory factors such as interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α）， thereby effectively relieving local joint inflammation， protecting chondrocytes and bone tissue， inhibiting chondrocyte apoptosis， and further alleviating the progression of OA. Currently， there are still certain limitations in the medical research status and development trends of OA， necessitating the continued advancement of traditional Chinese medicine. This paper reviewed the literature on the regulation of OS response by effective components of Chinese medicine for the prevention and treatment of OA， providing new directions and ideas for future research.

Effects of bisdemethoxycurcumin promoting neuronal differentiation of neuroblastoma cells in mice and its mechanism / 中国药房

OBJECTIVE To study the effects of the curcumin derivative bisdemethoxycurcumin （BC） promoting neuronal differentiation of neuroblastoma cells Neuro-2a （N2a） in mice and its mechanism. METHODS The effects of BC （1， 2， 4， 6， 8， 10 μmol/L） on the viability of N2a cells were detected by MTT assay to determine the concentration range of drug treatment. The control group， retinoic acid （RA） group （10 μmol/L） and BC groups （1， 2 and 4 μmol/L） were set up， and the length of neural protrusions of the differentiated cells was measured and the cell differentiation rate was calculated after 48 h and 72 h of culture. Compared with 0 min group， Western blot was used to detect the phosphorylation levels of protein kinase B （Akt）， extracellular- signal regulated kinase 1/2 （ERK1/2）， and p38 mitogen-activated protein kinase （p38） proteins in cells treated by 4 μmol/L BC for 5， 15， 30， 60， 120 min. After intervention with inhibitors LY294002 （LY） and PD98059 （PD）， the effects of BC on Akt and ERK1/2 protein phosphorylation levels and promoting neural differentiation were further validated. RESULTS According to the MTT experiment， the BC concentrations for subsequent induction of cell differentiation were determined to be 1， 2， and 4 μmol/L. After 48 hours of differentiation， compared with the control group， the cell differentiation rate in RA group and BC 1， 2 and 4 μmol/L groups， the length of cellular neural processes wjxhhxx413@163.com in the BC 4 μmol/L group significantly increased （P＜0.05 or P＜0.01）；after inducing differentiation of BC for 72 hours，compared with the control group， the cell differentiation rate and the length of cellular neural processes in the RA group， the cell differentiation rate in the BC 4 μmol/L group， and the length of cellular neural processes in the BC 2 μmol/L group all significantly increased （P＜0.05 or P＜0.01）.Compared with the 0 min group， the phosphorylation levels of Akt， ERK1/2， and p38 proteins in cells of the 5， 15， 30， 60 and 120 min groups increased to varying degrees after treated by 4 μmol/L BC， and some differences were statistically significant （P＜0.05 or P＜0.01）. After adding the inhibitor LY/PD， compared with the BC group， the phosphorylation level of ERK1/2 protein in the PD+BC group cells were significantly reduced （P＜0.01）， and the cell differentiation rates in the LY group， LY+BC group， PD group， and PD+BC group was significantly reduced （P＜0.01）. CONCLUSIONS BC promotes N2a cell differentiation mainly by increasing cell differentiation rate and neural protrusion length. The mechanism may be related to the activation of mitogen-activated protein kinase/ ERK and PI3K/Akt signaling pathways.

Correlation analysis between the structural changes of the anterior chamber and pelvic floor dysfunction observed by transperineal pelvic floor ultrasound after natural childbirth / 中国医师进修杂志

Objective:To investigate the correlation between the structural changes of the anterior chamber and pelvic floor dysfunction (PFD) observed by transperineal pelvic floor ultrasound after natural childbirth.Methods:Eight hundred patients underwent transperineal pelvic floor four-dimensional ultrasonography after natural childbirth in Hunan Provincial Hospital of Traditional Chinese Medicine from January to December 2021 were enrolled. Among them, 320 cases with PFD were selected as the research group, and 480 cases without PFD were selected as the control group. The anterior chamber structure parameters were compared between the two groups at rest and during the maximal Valsalva maneuver, and the value of the anterior chamber structure parameters in diagnosing PFD after natural childbirth was analyzed. The structural parameters of the anterior chamber in patients with different degrees of pelvic organ prolapse and different degrees of stress urinary incontinence at rest and during the maximum Valsalva maneuver were compared, and the correlation between the structural parameters of the anterior chamber and pelvic floor function were analyzed.Results:The position of the bladder neck in the research group was lower than that in the control group at rest: (22.67 ± 4.02) mm vs. (25.53 ± 4.07) mm, the posterior angle of the bladder and the movement of the bladder neck and the angle of urethral rotation during the maximal Valsalva maneuver were larger than those in the control group :(134.26 ± 21.54)° vs. (115.31 ± 17.82)°, (30.27 ± 8.41) mm vs. (21.94 ± 7.69) mm, (45.29 ± 12.74)° vs. (33.26 ± 11.52)°, there were statistical differences ( P<0.05). The area under the curve (AUC) of bladder neck position at rest, bladder posterior angle and maximum Valsalva maneuver, bladder neck movement and urethral rotation angle for the diagnosis of PFD after natural childbirth were 0.731 (95% CI 0.699-0.761), 0.783 (95% CI 0.753-0.811), 0.737 (95% CI 0.705-0.767), 0.774 (95% CI 0.743-0.803), the AUC of the combined diagnosis of each index was the largest, which was 0.893 (95% CI 0.870-0.914). In the research group, the position of the bladder neck in the resting state gradually decreased with the degree of pelvic organ prolapse ( P<0.05). In the research group, the position of the bladder neck in the resting state gradually decreased with the increase of the degree of stress urinary incontinence ( P<0.05). The position of the bladder neck in the resting state was negatively correlated with the degree of pelvic organ prolapse and stress urinary incontinence ( r = - 0.574, - 0.569, P<0.05). Mobility and urethral rotation angle were positively correlated with pelvic organ prolapse and stress urinary incontinence ( r = 0.531, 0.537, 0.498, 0.512, 0.511 and 0.537, P<0.05). Conclusions:Transperineal pelvic floor four-dimensional ultrasonography has important reference value in the diagnosis of PFD by observing the structural changes of the anterior chamber after natural childbirth, and the ultrasonic parameters of the structural changes of the anterior chamber are closely related to the degree of pelvic organ prolapse and stress urinary incontinence, which is helpful to assess the degree of impairment of pelvic floor function in patients.

Observation on the long-term efficacy of posterior atlantoaxial fixation without fusion for the treat-ment of fresh type Ⅱ odontoid fractures / 中国脊柱脊髓杂志

Objectives:To observe the long-term efficacy of posterior atlantoaxial fixation without fusion for the treatment of fresh type Ⅱ odontoid fractures.Methods:Retrospective analysis of the clinical data of 22 patients with fresh type Ⅱ odontoid fractures who underwent posterior atlantoaxial fixation without fusion at the Affiliated Hospital of Southwest Medical University from June 2006 to December 2017 and were followed up for more than 5 years was conducted.Among the patients,there were 19 males and 3 females,aged 19-58 years old(average of 40.9±10.5 years old)at the time of fracture;17 cases were with no displacement or mild displacement(displacement≤2mm),and 5 cases were with obvious displacement(displacement＞2mm).The visual analog scale(VAS)of neck pain,neck disability index(NDI),and grade of American Spinal Injury Association(ASIA)were compared between before operation,before removal of fixations,and at final follow-up,respec-tively.The neck stiffness severity of the patients was compared between before removal of fixations and at fi-nal follow-up using the method proposed by Landells et al.X-ray,multiplanar reconstruction CT,and func-tional CT were used to evaluate postoperative fracture healing,stability of atlantoaxial joint,degeneration grade of atlanto-odontoid and lateral atlantoaxial joints,and range of motion of the atlantoaxial joint.Correlation analysis was further performed to explore the factors that affect the rotational motion of atlantoaxial joint at fi-nal follow-up.Results:All the patients were removed for implants at 11.0±2.7 months after fixation surgery,and were followed up for 7.9±2.0 years.The median VAS scores before surgery,before removal of fixations,and at final follow-up were 6.5(6.0,7.0)points,1.0(1.0,2.0)points,and 1.0(1.0,1.0)points,respectively.The VAS score before the removal of fixations was significantly lower than that before surgery(P＜0.05),which was not statistically different from that at the final follow-up(P＞0.05).The median NDI before surgery,before the removal of fixations,and at final follow-up were 28.5(26.5,32.0),3.5(3.0,5.0),and 2.0(2.0,3.0),respectively.The NDI before the removal of fixations was significantly reduced compared with before surgery(P＜0.05),and it further decreased at the final follow-up(P＜0.05).Before the removal of fixations and at final follow-up,3 patients who had spinal cord injury achieved 1 level improvement of ASIA grade compared to before surgery.There was no statistically significant difference in ASIA grade between before surgery,before the removal of fixations,and at final follow-up(P＞0.05).At final follow-up,the proportion of patients with severe neck stiff-ness was significantly lower than that before the removal of fixations(36.4％vs.77.3％,P＜0.05).All the pa-tients had fracture healing before the removal of fixations,and no implants breakage or fixation displacement was found.And at the final follow-up,no atlantoaxial instability was observed.At the final follow-up,the degeneration of the atlanto-odontoid joint worsened compared with before removal of fixations(P＜0.05),and there was no statistically significant difference in the degeneration grade of the lateral atlantoaxial joints com-pared with before removal of fixations(P＞0.05).At the final follow-up,the range of motions in flexion-exten-sion and rotation of the atlantoaxial joint were 2.0°(0.9°,3.0°)and 5.4°(3.7°,9.5°),respectively.The correla-tion analysis showed that there was negative correlations between the degree of fracture displacement and the degeneration grade of the atlanto-odontoid joint and the rotational activity of the atlantoaxial joint in long-term follow-up(r=-0.381,P=0.038;r=-0.584,P=0.001).Conclusions:The treatment of fresh type Ⅱodontoid process fractures using posterior atlantoaxial fixation without fusion can achieve satisfactory long-term clinical results,but the range of motion of the atlantoaxial joint cannot be preserved well in the long term,which is related to the severe fracture displacement and progressive degeneration of the atlanto-odontoid joint.

Application and research progress on PET-CT in radiotherapy and follow-up for glioma / 中华放射肿瘤学杂志

Glioma is the most common primary intracranial central nervous system tumor, and postoperative radiotherapy is an important treatment for glioma. At present, computed tomography (CT) and magnetic resonance imaging (MRI) are widely applied in the delineation of radiotherapy targets for glioma. However, there are still some deficiencies in evaluating tumor scope, recurrence, radiation necrosis and prognosis, etc. Positron emission tomography (PET) / computed tomography (PET-CT) combines the molecular images of PET with the anatomical images of CT, which plays an important role in the diagnosis and differential diagnosis of glioma. With the popularization and application of multimodal imaging technology in radiotherapy, PET-CT molecular imaging, as an important supplement, contributes to the delineation of glioma target volume and the development of accurate radiotherapy, and brings benefits to the prognosis and follow-up of glioma patients. In this article, the application and research progress on PET-CT in the diagnosis, treatment and follow-up for glioma were reviewed.

Hypoglycemic effect of electroacupuncture at "Tianshu" (ST 25) combined with metformin on rats with type 2 diabetes mellitus based on AMPK / 中国针灸

OBJECTIVE@#To observe the hypoglycemic effect of electroacupuncture (EA) at "Tianshu" (ST 25) combined with metformin on rats with type 2 diabetes mellitus (T2DM) as well as its effect on expression of adenosine monophosphate activated protein kinase (AMPK) in liver and pancreas.@*METHODS@#Thirty-six male SD rats were randomly divided into a blank group (6 rats) and a model establishing group (30 rats). The rats in the model establishing group were fed with high-fat diet and treated with intraperitoneal injection of low-dose streptozotocin (STZ) to establish T2DM model. The rats with successful model establishment were randomly divided into a model group, a control group, a metformin group, an EA group and a combination group, 6 rats in each group. The rats in the EA group were treated with EA at "Tianshu" (ST 25), dense-disperse wave, 2 Hz/15 Hz in frequency and 2 mA in current intensity, 20 min each time. The rats in the metformin group were treated with intragastric administration of metformin (190 mg/kg) dissolved in 0.9% sodium chloride solution (2 mL/kg). The rats in the combination group were treated with EA at "Tianshu" (ST 25) and intragastric administration of metformin. The rats in the control group were treated with intragastric administration of 0.9% sodium chloride solution with the same dose. All the treatments were given once a day for 5 weeks. After the intervention, the body mass and random blood glucose were detected; the serum insulin level was detected by ELISA; the expression of AMPK and phosphorylated adenosine monophosphate activated protein kinase (p-AMPK) in liver and pancreas was detected by Western blot method; the expression of protein gene product 9.5 (PGP9.5) was detected by immunofluorescence.@*RESULTS@#①Compared with the blank group, the body mass in the model group was decreased (P<0.05); compared with the model group, the body mass in the EA group and the combination group was decreased (P<0.05); the body mass in the EA group and the combination group was lower than the metformin group (P<0.05). Compared with the blank group, the random blood glucose in the model group was increased (P<0.01); compared with the model group, the random blood glucose in the metformin group, the EA group and the combination group was decreased (P<0.01). The random blood glucose in the combination group was lower than the metformin group and the EA group (P<0.05). ②Compared with the blank group, the insulin level in the model group was decreased (P<0.05); compared with the model group, the insulin level in the metformin group, the EA group and the combination group was all increased (P<0.05). The insulin level in the combination group was higher than the metformin group and the EA group (P<0.05). ③Compared with the blank group, the protein expression of AMPK and p-AMPK in liver tissue was decreased (P<0.05), and the protein expression of AMPK and p-AMPK in pancreatic tissue was increased (P<0.05) in the model group. Compared with the model group, the protein expression of AMPK and p-AMPK in liver tissue in the metformin group, the EA group and the combination group was increased (P<0.05, P<0.01); the protein expression of AMPK in pancreatic tissue in the metformin group was increased (P<0.05); the protein expression of AMPK in pancreatic tissue in the EA group and the combination group was decreased (P<0.05); the protein expression of p-AMPK in pancreatic tissue in the metformin group, the EA group and the combination group was decreased (P<0.05). The protein expression of AMPK and p-AMPK in liver tissue in the combination group was higher than that in the metformin group and the EA group (P<0.05); the protein expression of AMPK in pancreatic tissue in the EA group and the combination group was less than that in the metformin group (P<0.05), and the expression of p-AMPK protein in pancreatic tissue in the combination group was less than that in the metformin group and the EA group (P<0.05). ④Compared with the blank group, the expression of PGP9.5 in pancreatic tissue in the model group was increased (P<0.01); compared with the model group, the expression of PGP9.5 in pancreatic tissue in the metformin group, the EA group and the combination group was decreased (P<0.05, P<0.01). The expression of PGP9.5 in pancreatic tissue in the EA group was lower than the metformin group and the combination group (P<0.05).@*CONCLUSION@#Electroacupuncture at "Tianshu" (ST 25) could promote the effect of metformin on activating AMPK in liver tissue of T2DM rats, improve the negative effect of metformin on AMPK in pancreatic tissue, and enhance the hypoglycemic effect of metformin. The mechanism may be related to the inhibition of pancreatic intrinsic nervous system.

Evaluation and treatment strategy of limb length discrepancy after total hip arthroplasty / 中华外科杂志

Limb length discrepancy(LLD) is a common complication after total hip arthroplasty (THA). Good positioning of the prosthesis and suitable soft tissue tension are essential to ensure hip joint stability. Patients will be more satisfied if almost the same length of both lower extremities is achieved. Preoperative comprehensive evaluation of patients is helpful to prevent the occurrence of LLD after surgery. Therefore, the pelvic spine conditions, as well as type and cause of LLD should be analyzed in detail before surgery. During operation, limb length should be adjusted by touching the position of patella, Kirschner's wires positioning and referring to the relationship between the center of femoral head and the tip of greater trochanter. After surgery, it is necessary to clearly distinguish true LLD from functional LLD, and make a reasonable therapeutic plan according to patient's symptoms and the range of differences in limb length. This article reviews the latest literatures based on clinical practice experience and summarizes the research status of LLD after THA, which helps joint surgeons to have an in-depth understanding of this postoperative complication.