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Abstract Background Cutaneous squamous cell carcinoma (CSCC) is one of the most common types of skin cancer worldwide. Therefore, the identification of biomarkers associated with CSCC progression could aid in the early detection of high-risk squamous cell carcinoma and the development of novel therapeutic strategies. Objective This study aimed to investigate the expression patterns of silent mating type Information Regulation 2 homolog 6 (SIRT6) in CSCC and its clinical significance. Methods The protein expression level of SIRT6 in tissues was detected by immunohistochemistry, and the correlation between SIRT6 expression and clinicopathological parameters in CSCC patients was analyzed. The relative expression of SIRT6 in CSCC cell lineage and tissue specimens was determined by western blotting and PCR. The effect of SIRT6 silencing on cell proliferation was evaluated using cell counting kit 8. Wound healing, transwell method, and flow cytometry were used to investigate the migration, invasion, and cell cycle distribution/apoptosis of CSCC cells after SIRT6 silencing, respectively. Western blot was used to detect the expression of EMT (Epithelial-Mesenchymal Transition), cycle, apoptosis, and other related proteins. Results The high expression of SIRT6 was correlated with the location of cancer tissue and Broder staging in CSCC patients. Knockdown of SIRT6 inhibited the proliferation, migration, invasion and EMT of CSCC cells, and promoted their apoptosis, with cells blocked in G1 phase. Study limitations No animal experiments were conducted to further verify the results. Conclusion Decreased expression of SIRT6 can inhibit the occurrence and development of CSCC.
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SUMMARY: To measure and study the anatomical morphological data of the lumbar 5 to sacral 1 intervertebral space with the aid of CT and design an anatomical anterior lumbosacral 3D printed integrated interbody fusion for the treatment of degenerative lumbosacral spine diseases. 100 adults (50 of each sex) who underwent CT examination of the lumbar spine in our hospital were selected, and their lumbar 5 to sacral 1 intervertebral space anatomical data were measured, including the anterior lumbar convexity angle, different sagittal and coronal heights, and the sagittal and coronal diameters of the superior and inferior endplates. The measured data were also statistically analyzed, and morphological design and study of the 3D printed integrated fusion device in the anterior lumbosacral spine was performed by applying computer software. When comparing the coronal and sagittal diameters of the superior and inferior endplates from lumbar 5 to sacral 1, the differences were statistically greater in men than in women (P0.001). When comparing the height at different positions in the median sagittal plane, both males and females showed an anterior high and posterior low pattern. In the coronal plane, both males and females showed the highest height in the middle position (P0.001). CT can measure the anatomical data of the lumbosacral spinal hiatus more accurately. The 3D-printed anterior integrated fusion device of the lumbosacral spine designed according to the analysis of the data results is more in line with the anatomical structure of the lumbosacral spine, fits well with the superior and inferior endplates, and effectively restores the height and anterior convexity angle of the lumbosacral space.
El objetivo de este trabajo fue medir y estudiar los datos morfológicos anatómicos del espacio intervertebral lumbar 5 a sacro 1 con la ayuda de TC y diseñar una fusión intersomática integrada anatómica lumbosacra anterior impresa en 3D para el tratamiento de enfermedades degenerativas de la columna lumbosacra. Se seleccionaron en nuestro hospital 100 adultos (50 de cada sexo) que se sometieron a un examen de TC de la columna lumbar y se midieron los datos anatómicos del espacio intervertebral lumbar 5 al sacro 1, incluyendo el ángulo de la convexidad lumbar anterior, diferentes alturas sagital y coronal, y los diámetros sagital y coronal de las placas terminales superior e inferior. Los datos medidos también se analizaron estadísticamente y se realizó el diseño morfológico y el estudio del dispositivo de fusión integrado impreso en 3D en la columna lumbosacra anterior mediante la aplicación de software informático. Al comparar los diámetros coronal y sagital de las placas terminales superior e inferior desde lumbar 5 hasta sacro 1, las diferencias fueron estadísticamente mayores en hombres que en mujeres (P 0,001). Al comparar la altura en diferentes posiciones en el plano mediano, tanto hombres como mujeres mostraron un patrón anterior alto y posterior bajo. En el plano coronal, tanto hombres como mujeres mostraron la altura más alta en la posición media (P0,001). La TC puede medir los datos anatómicos del hiato espinal lumbosacro con mayor precisión. El dispositivo de fusión anterior integrado impreso en 3D de la columna lumbosacra diseñado de acuerdo con el análisis de los resultados de los datos está más en línea con la estructura anatómica de la columna lumbosacra, se adapta bien a las placas terminales superior e inferior y restaura eficazmente la altura y la parte anterior del ángulo de convexidad del espacio lumbosacro.
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Humans , Male , Female , Adolescent , Adult , Young Adult , Printing, Three-Dimensional , Lumbar Vertebrae/diagnostic imaging , Spine , Tomography, Spiral Computed , Lumbar Vertebrae/anatomy & histologyABSTRACT
Objective:To explore the effects of workshops combined with problem-based learning (PBL) in clinical teaching of joint surgery.Methods:A total of 60 students who would participate in standardized residency training from September 2019 to June 2021 were randomly divided into traditional lecture-based learning (LBL) group, PBL group, and workshops combined with PBL group, with 20 students in each group. The effects were evaluated by theoretical knowledge and clinical skill assessment and anonymous teaching quality questionnaire surveys. SPSS 25.0 was used to perform the t test and chi-squared test. Results:The workshop+PBL group showed the highest theoretical knowledge score (86.40±9.76), clinical skill score (92.15±4.49), and total score (88.70±5.75), compared with the PBL group (78.45±10.40, 85.80±10.00, and 81.39±7.27, respectively) and the LBL group (80.10±6.77, 85.20±8.12, and 82.14±6.14, respectively). According to the teaching quality questionnaire surveys, the workshop+PBL group was significantly superior to the PBL and LBL groups in self-ability evaluation and the degree of satisfaction with teaching ( P<0.05). Conclusions:Workshops combined with PBL can effectively improve students' scores of theoretical knowledge and clinical skills, with better self-ability evaluation results and higher satisfaction with teaching, which is worthy of application and promotion in clinical teaching of joint surgery.
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Objective:To study the value of standardized patient simulation combined with objective structured clinical examination (OSCE) in clinical undergraduate teaching.Methods:A total of 114 medical undergraduates who were interned in our hospital from January 2018 to January 2020 were selected as the research objects. All the students were randomly divided into observation group ( n=57) and control group ( n=57). Other undergraduate students were recruited as standardized patients and trained; students in the observation group were given standardized patient simulation teaching, while patients in the control group were given traditional teaching methods; experienced teachers prepared test questions and developed unified scoring standards, and OSCE model was adopted to assess the two groups. The scores of theory, medical history, humanistic communication, rehabilitation thinking, practical skills and total scores of the two groups were recorded. The evaluation of standardized patient simulation by 57 undergraduates and the evaluation of OSCE model by 114 undergraduates in the observation group were recorded. SPSS 22.0 statistical software was used for t test. Results:After teaching, the scores of medical history, humanistic communication, rehabilitation thinking and practical skills in the observation group were significantly higher than those in the control group ( P<0.05), but there was no significant difference in theoretical scores between the two groups ( P>0.05). Before teaching, there was no significant difference in the total scores between the two groups ( P>0.05); after teaching, the total scores of the two groups were both improved, with significant differences ( P<0.05); compared with the control group, the total score of the observation group was improved higher, with significant differences ( P<0.05). All the undergraduates in the observation group thought that the standardized patient simulation teaching improved themselves, and 89.47% of the undergraduates thought that the standardized patient simulation was worth promoting in the teaching of rehabilitation and therapy. Most of the undergraduates believed that OSCE model could reflect the students' comprehensive ability better than the traditional written examination, and could improve their communication ability and practical operation ability, cultivate their high-quality rehabilitation thinking, and change their tendency to lay stress on theoretical study. And 91.23% of the undergraduates thought that OSCE model was worth promoting in the courses of rehabilitation therapy. Conclusions:Standardized patient simulation combined with OSCE model is conducive to improving the comprehensive performance of undergraduates, improving their communication ability and practical operation ability, and cultivating their high-quality rehabilitation thinking, which can be promoted in clinical undergraduate teaching.
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Objective:To investigate the effects of the hybrid scenario simulation teaching method based on small private online courses (SPOC) in undergraduate clinical teaching of pediatric dentistry.Methods:A total of 44 students of dentistry practicing in the Department of Pediatric Dentistry, The Third Affiliated Hospital, The Air Force Military Medical University, from January 2020 to December 2021 were selected, with 23 students practicing from January to December 2020 in control group (receiving traditional teaching) and 21 students practicing from January to December 2021 in experimental group (employing SPOC-based hybrid scenario simulation teaching method). At the end of the internship, an exam was given to assess the students' doctor-patient communication and standardized operation, and parental satisfaction and students' satisfaction were scored. SPSS 20.0 software was used to perform the independent samples t test for data analysis. Results:Compared with the control group, the experimental group had significantly higher scores of doctor-patient communication [(82.83±2.09) points vs. (88.40±2.22) points] and standardized operation [(82.26±4.38) points vs. (86.67±2.62) points] as well as significantly higher scores of parental satisfaction and students' satisfaction [(18.85±1.73) points vs. (20.71±0.85) points] and [(17.37±0.98) points vs. (20.57±0.66) points; all P<0.05]. Conclusions:The SPOC-based hybrid scenario simulation teaching method can effectively improve the quality of clinical teaching for undergraduate internships in pediatric dentistry, especially for cultivating doctor-patient communication ability.
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Objective To construct one high-copy BAC vector with cloning capacity for large DNA fragment insertion and use it for the haplotype analysis of CYP2A6 gene.Methods Oligos including multiple cloning sites were annealed and ligated into the Hind Ⅲ/BamH Ⅰ site of pGEM-3Z and pBeloBACll,separately.Then,the intermediate vectors were digested by Hind Ⅲ and ligated together,so as to get the head-to-tail oriented high-copy BAC vector pBAC-BJH after the blue-white spotting test.STI PCR method was used for the amplification of whole CYP2A6 gene,and purified amplicon was double digested by BstB Ⅰ/Mlu Ⅰ and ligated into the same site of newly constructed vector pBAC-BJH.Several clones were then picked up and sequenced for the haplotype analysis of carriers with newly discovered CYP2A6 variant 355A＞T.Results One high-copy BAC vector pBAC-BJH with 7 newly added multiple cloning sites was successfully constructed.High copy number and multiple cloning sites were the advantages of this plasmid.With this vector,haplotype analysis result for 22C＞T,51A＞G,355A＞T in carrier with newly detected CYP2A6mutation was CGT.Conclusion One vector pBAC-BJH convenient for cloning large DNA fragment was successfully developed,and it can be used for the haplotype analysis of cytochrome p450 gene and cloning or sequencing of other genes with large genomic DNA inserts.
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Objective To compare the difference of peripheral blood adiponectin and CD4+T cell subsets between patients with a-cute gouty arthritis and healthy controls,to explore the correlation between adiponectin and serum uric acid,disease activity,CT4+T cell subsets and some cytokines in patients with gout.Methods The clinical data(including general data,neutrophils,erythrocyte sedimen-tation rate,C-reactive protein,blood uric acid,CT4+T cell subsets and some cytokines)of acute gout group(n=90)and healthy con-trol group(n=72)were collected.The level of adiponectin in peripheral blood of two groups were detected,and the differences of adi-ponectin and CD4+T cell subsets between the two groups were compared;the correlation between adiponectin and clinical data was ana-lyzed.Results The levels of serum adiponectin in the acute gout group were significantly lower than those in the healthy control group(P＜0.001),and the levels of Th2,Thl7,Th17/Treg were significantly higher than those in the healthy control group(P＜0.05),while the levels of Treg and Th1/Th2 were significantly lower than those in the healthy control group(P＜0.05).In the acute gout group,adiponectin was negatively correlated with neutrophil,erythrocyte sedimentation rate and C-reactive proten(r=-0.244,P＜0.05;r=-0.311,P＜0.05;r=-0.506,P＜0.001),there was no correlation with serum uric acid.In acute gout group,adiponectin was posi-tively correlated with Th1 and Th1/Th2(r=0.252,P＜0.05;r=0.218,P＜0.05).In acute gout group,adiponectin in peripheral blood was positively correlated with interleukin-2(IL-2),interleukin-4(IL-4)and interleukin-10(IL-10)(r=0.323,P＜0.05;r=0.377,P＜0.05;r=0.359,P＜0.05).There was a negative correlation between interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)(r=-0.265,P＜0.05;r=-0.299,P＜0.05).Multiple linear regression analysis showed that adiponectin in the acute gout group was negatively correlated with erythrocyte sedimentation rate,C-reactive protein,IL-6 and TNF-α(BESR=-12.541,P=0.003;BCRP=-8.256,P=0.024;BIL-6=-15.907,P=0.037;BTNF-α=-79.770,P=0.040),but positively correlated with Th1(BTh1=2.959,P=0.006).Conclusion The levels of adiponectin in the peripheral blood of patients with acute gouty arthritis were decreased,the levels of Th2 and Th17 were increased,and the levels of Treg were decreased.The decrease of adi-ponectin was related to the immunological disorder and inflammation in the patients with acute gouty arthritis.
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Objective To analyze the medication rule of Traditional Chinese Medicine(TCM)in treating diabetes nephropathy(DN)and to explore the interaction between core components and key targets.Methods Based on the ancient and modern medical case cloud platform,the medication rules of TCMs and the drug pairs with the highest frequency in treating DN were summarized.Then the network pharmacology approach was utilized to analyze the pharmacodynamic material basis and mechanisms of the highest frequency-drug pairs.The potential targets were predicted by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)databases.TTD,DISGENET,and GENECARD databases were used to obtain the related targets of DN and screen out the potential targets for DN.In order to clarify the relationships between the active ingredients,the core targets,and pathways,STRING and Cytoscape 3.7.1 software were used to construct the protein-protein interaction(PPI)network and core drugs-ingredients-targets-disease interaction network,DAVID database was screened for Kyoto Encyclopedia of Genes and Gnomes(KEGG)enrichment analysis of core targets.Sybyl 2.1 software and biofilm interference verify the combined capacity between the core ingredients and key targets.Results Among 183 prescriptions,Astragali Radix had the highest use frequency and average dose,43 times and 37 g,respectively,followed by Salviae miltiorrhizae Radix and Poria cocos.To find the core combined with the highest confidence in association analysis was astragalus,salvia miltiorrhiza,and tuckahoe.Correlation analysis indicates that the core combination with the highest confidence was Astragali Radix-Salviae miltiorrhizae Radix-Poria cocos.Network pharmacologic showed 89 potential targets and 15 key signaling pathways for the treatment of DN by the drug pair.TNF signaling pathway,Nod-like receptor signaling pathway,and MAPK signaling pathway were disease-related pathways,and IL-6,TNF,and vascular endothelial growth factor A(VEGFA)were core targets.Isorhamnetin and quercetin of the drug pair had high binding ability with IL6,the scores were 8.2 and 7.4,respectively,and the dissociation constants(KD)were 5.6×10-5 mol·L-1 and 6.8×10-5 mol·L-1,respectively.Conclusion This study preliminarily finds the prescription rule of treating DN with Astragali Radix-Salviae miltiorrhizae Radix-Poria cocos as the core drug pair,isorhamnetin,and quercetin are probably the main active compounds of this drug pair in DN treatment,which provides a basis for clinical treatment and drug discovery of DN.
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Objective To establish an intelligent management system of operating room pharmacy,to promote the standardized management of drugs in the operating room,and to provide reference and experience for medical institutions.Methods Based on the failure mode and effect analysis(FMEA)method,the risk identification and assessment of the operating room pharmacy workflow were carried out of the Second Affiliated Hospital of Soozhou University.According to the risk priority index(RPN)value,the failure mode that needs to be improved was determined,the causes of failure were analyzed,intervention measures were formulated,and the improvement effect was evaluated.Results A total of 12 failure modes were found in the workflow of the operating room pharmacy.After the intelligent medicine cabinet and corresponding management system were used,the RPN value decreased by 337 in total,with a decrease rate of 67.8%.The level of narcotic drug management,the timeliness of patient medication,and the satisfaction of medical staff were significantly improved.Conclusions The FMEA method can effectively identify the risk links of the operating room pharmacy.The construction and application of the intelligent operating room pharmacy management system have significantly improved the drug management level of the operating room and the quality of medical services.
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Objective To analyze the problems of review of anti-tumor drug prescriptions and medical orders assisted by an information system to improve the review rules,and to provide a reference for improving review quality of anti-tumor drug prescription.Methods The problem with the pre-review of anti-tumor drug prescriptions and medical orders assisted by the information system in Sichuan Cancer Hospital during 2020-2022 were collected.The data came from the MEDICOM PASS system in Sichuan Cancer hospital.Clinical pharmacists made comments on relevant problems and analyzed the results.Results A total of 9 325 antitumor drug pre-approval problems,including 6 279 outpatient prescriptions(67.3%)and 3 046 inpatient orders(32.7%),among which 6 153(66.0%)were unsuitable indications,1 933(20.7%)were drug contraindications,449(4.8%)were problematic routes of administration,345(3.7%)were unsuitable drug compatibility,177(1.9%)were inappropriate drug frequency,133(1.4%)were problematic drug populations,74(0.8%)were unsuitable single doses,39(0.4%)were unacceptable drug interactions,22(0.2%)were unsuitable drug total.The results of clinical pharmacists'comments were 4 459 reasonable cases,with a false positive rate of 47.8%.The false positive problems included 2 264(50.8%)cases of unsuitable indications,1 933(43.3%)cases of drug contraindications,231(5.2%)cases of problematic routes of administration,and 31(0.7%)cases of unsuitable populations.Conclusion The review of anti-tumor drug prescriptions assisted by an information system can effectively intercept irrational drug use and improve the review quality of prescriptions and medical orders.However,the evidence-based medicine date of antitumor drugs is updated quickly.Pharmacists should constantly improve the prescription review rules based on the latest evidence-based medicine data.
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Objective To establish a quality control method for monitoring the blood concentrations of cyclosporin A and tacrolimus by HPLC-MS/MS,and to evaluate the quality control samples using the Westgard multi-rule theory.Methods HPLC-MS/MS was used to determine the concentration of cyclosporin A and tacrolimus in human whole blood.The quality control samples of low,medium and high concentration levels in the therapeutic drug monitoring process were statistically analyzed,Levery-Jennings and Z-score quality control charts were drawn,and the Westgard multi-rule theory was applied for in-house quality control evaluation.Results The established method was fully validated with linear ranges of 10.40-1 040.00 ng·mL-1 and 0.50-49.50 ng·mL-1,the quantification limits were 10.40 and 0.50 ng·mL-1,respectively.The extraction recoveries were 108.61％-113.24％and 101.99％-109.37％,respectively.The matrix factors normalized by internal standard were 106.68％-111.27％and 95.70％-97.81％for cyclosporin A and tacrolimus,respectively.The intra-day and inter-day accuracy and precision were less than 15.0％.Other parameters were also validated and met the acceptance criteria.Levery-Jennings and Z-score quality control charts showed that there were 4 warnings(violation of the 12s rule)in the results of the 26 groups of quality control samples in the third quarter of 2022,and no phenomenon was observed to be out of control.Conclusion The established in-house quality control system for therapeutic drug monitoring of cyclosporin A and tacrolimus can effectively ensure the accuracy of blood drug concentration detection.
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In recent years,due to the development of disciplines such as molecular biology,cell biology,and materials science,the research of targeted therapy drugs has become a hot spot.Compared with conventional drugs,targeted therapy drugs can selectively increase the concentration and effectively reduce the toxic side effects of drugs in target tissues,which is an ideal way of drug delivery.Nanomaterial is receiving more attention for its superior performance in animals.The application and develop-ment of nanocrystals in targeted drug delivery systems has effectively broken the limitation of insoluble drugs and plays an indis-pensable role in drug delivery systems.In this paper,we briefly reviewed the characteristics and classification of targeted therapy drugs and the application of nanocrystals in pharmaceutical research to provide a reference for the related research.
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Objective To analyze the residual status,transfer behavior,and risk of paclobutrazole in the national mar-ket of Shenmai granules.Methods GC-MS/MS determined the residual amount of paclobutrazol in Shenmai granules,and ANOVA analyzed the distribution characteristics of sample residuals.The transfer rule of paclobutrazol from Ophiopogonis Radix to Shenmai granules was investigated by simulating the production process,and chronic exposure assessment was performed using the point evaluation model.Results The established method can accurately determine the residual amount of paclobutrazol in Shenmai granules.The residual amount of paclobutrazol in 85 batches of Shenmai granules ranged from 0.001 3 to 0.015 8 mg·kg-1,and there was a statistical difference in the residual amount among different enterprise samples.The transfer rate of paclobutrazol from decoction pieces to preparations was 29.8%.The chronic risk quotient(HQc)of paclobutrazol residues in Shenmai granules was 0.000 7%,far lower than 1.Conclusion There is a general presence of paclobutrazol residues in Shenmai granules.The risk assessment results show that the normal dosage of Shenmai granules does not pose an unacceptable risk to the general population.The residual distribution characteristics and process transfer rules can provide a reference for safety risk control in production enterprises.
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With the continuous development of medical science and the widespread use of antibiotics,the problem of bacterial resistance is increasing,especially the increasing carbapenem-resistant Enterobacteriaceae(CRE)infection,and the high mortality rate,which brings great challenges to clinical treatment.In this paper,the mechanism of drug resistance,existing antibac-terial drugs,and exploratory treatment options for CRE are reviewed,and the research progress in treating CRE infection is dis-cussed to provide more reliable evidence and a theoretical basis for clinical practice.
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Objective To explore the dynamic process of fluid-structure interaction(FSI)between venous blood and valves and the physiological mechanism that guarantees unidirectional blood reflux back to the heart.Methods A three-dimensional(3D)numerical model of the venous system was established using the immersed boundary/finite element method.In the simulation,information from medical images of human lower-extremity veins and the anatomical structure and size of the bovine great saphenous vein were applied.Moreover,a hyperelastic constitutive model was used to describe the incompressible,nonlinear,and hyperelastic mechanical responses of the venous valve under physiological conditions.Results The simulations visualized the process of venous blood transport and the function of venous valves in preventing reflux.The periodic characteristics of venous valve motion and blood flow were reproduced,and important physiological data during the entire cardiac cycle were discussed and quantified,including the pressure,velocity,and flow rate of venous blood;opening area of the venous valve;and stress and strain distributions on the valve surface.Conclusions The 3D FSI model numerically reproduces the physiological dynamic process within veins and potentially provides important references and guidance for revealing the pathological mechanism of venous diseases.
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Objective To investigate the effect of trunk control on the biomechanical characteristics of lower limb movements during Asian squats(AS)and Western squats(WS)in young adults to provide empirical support for the application and promotion of deep squat training.Methods Twenty-four healthy young male collegiate students performed AS and WS with and without bar control,and their lower limb kinematic and kinetic characteristics were collected using an infrared light-point motion capture system and a three-dimensional(3D)dynamometer.The 3D angles of the lower limbs were obtained using Cortex-642.6.2 software,based on the calculation of Euler angles,and the 3D moments were obtained by applying the inverse dynamics method.The effects of trunk control and deep squatting posture on the lower limb kinematic characteristics were examined using a two-factor analysis of variance with a 2×2 repeated design.Results There was no significant interaction between trunk control and the deep squatting posture for either kinematic or kinetic parameters(P>0.05).The WS group had a large knee flexion angle,peak patellofemoral contact force,and ratio of peak hip and knee extension moments,and small ankle dorsiflexion and hip flexion angles(P<0.05).The deep squat with a bar had a large ankle dorsiflexion angle,peak patellofemoral contact force,and hip flexion angle as well as a small knee flexion angle and ratio of peak hip and knee extension moments(P<0.05).Conclusions WS is helpful for training hip extension muscle groups,whereas AS is helpful for training knee extension muscle strength.The peak patellofemoral joint contact force of the WS is significantly greater than that of the AS;therefore,it is recommended that patients with patellofemoral joint pain use the AS.A squat with a bar can compensate for the body's balance;thus,people with limited ankle dorsiflexion range of motion or anterior tibial muscle weakness may consider trunk control training,such as a deep squat with a bar.This may help improve lower limb stability during squats.
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Objective To analyze the lumbar/hip imaging and surface electromyography data of professional equestrian riders,to understand the incidence of chronic diseases in the hip and lower back of the rider,and to explore the causes of chronic pain in riders.Methods Twenty-five equestrian riders from the Shanghai Equestrian Sports Management Center were divided into chronic lower-back pain and chronic hip pain groups.Twelve healthy subjects without hip or lower-back pain were included in the control group.Medical history,X-ray,and magnetic resonance imaging of the hip and lower back,and surface electromyography data of the core muscle were collected.Results The JOA score of the lumbar spine in patients with chronic lower-back pain was significantly lower than that in the control group(P<0.05).The riders had relatively mild chronic hip pain,but the Harris score was significantly lower than that of the control group(P<0.05).The JOA score of the equestrian rider's waist significantly correlated with the Pfirrmann grading.However,the visual analog scale and Harris hip pain scores were not significantly correlated with imaging parameters.The root mean square amplitudes of the rectus abdominis,erector spinalis,rectus femoris,gluteus medius,and multifidus were greater in the riding position than in the normal sitting position(P<0.05).Conclusions The cause of chronic lower-back pain in riders may be related to soft tissue overwork and lumbar degeneration.Changes in the lumbar-hip sagittal sequence pelvic and sacral inclination angles can reflect the degree of lumbar stiffness of the riders.
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Breast cancer is the most prevalent malignant tumor among women globally,posing a serious threat to women's health.With the establishment of staging and typing principles for breast cancer diagnosis and treatment,and the development and application of novel antitumor drugs,the survival and quality of life of breast cancer patients have been continuously improving.In China,the large base of breast cancer patients possesses unique incidence characteristics,necessitating ongoing exploration of more appropriate treatment strategies;the volume and level of clinical research are also continuously advancing.In 2023,significant clinical research results were reported for different subtypes of breast cancer.In surgical treatment,clinical trials on targeted axillary lymph node dissection and the establishment of a predictive model BRCA-CRisk for contralateral breast cancer risk provide more evidence for de-escalation in surgical treatment.In the area of human epidermal growth factor receptor 2(HER2)-positive breast cancer,pyrotinib has shown significant efficacy in advanced breast cancer treatment.In triple-negative breast cancer,precision subtype treatment and immunotherapy continue to improve patient survival.For hormone receptor-positive breast cancer,significant research results were obtained in exempting low-risk patients from chemotherapy and exploring alternative options after resistance to endocrine therapy.In the aspect of BRCA mutations,BGB-290-201 further confirmed the therapeutic efficacy and safety of poly(ADP-ribose)polymerase(PARP)inhibitors for the Chinese population.For advanced HER2-negative patients carrying germline BRCA(gBRCA)1/2 mutations,pamiparib will be an ideal treatment choice.This article reviews the important clinical research in the field of breast cancer in China in 2023,summarizes key results,and aims to provide reference ideas for future clinical research.
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Ductal carcinoma in situ(DCIS),a pathological type of breast cancer that is limited to the terminal ducts of the breast without breaking through the basement membrane,is considered as the precursor of invasive ductal carcinoma(IDC).When DCIS breaks through the basement membrane and invades surrounding tissues,it can form infiltrating lesions.If the maximum diameter of a single infiltrating lesion is less than 1mm or the maximum diameter of multiple infiltrating lesions is less than 1mm,it is defined as ductal carcinoma in situ with microinvasion(DCIS-Mi).About 12%-40%of untreated and intervened DCIS will progress to IDC,and DCIS and IDC can also coexist.However,there is a considerable portion of DCIS that never progresses with good prognosis.Recently,overdiagnosis and overtreatment of DCIS have become the research hotspots.The histological grade of DCIS is mainly based on the morphology of the nucleus,which is divided into three nuclear levels:low,medium,and high.There are also significant differences in receptor expression and molecular type distribution between DCIS,DCIS-Mi,and IDC.For DCIS with or without microinvasion as well as different histological grades,there are many controversies about the treatment regimen,clinical prognosis and risk.The development of modern imaging technology has achieved preliminary evaluation of histological grading,infiltration status,and prognosis prediction of DCIS.The most commonly used breast imaging techniques in clinical practice currently include mammography(MG),ultrasound(US),and magnetic resonance imaging(MRI).The imaging principles of these three techniques are different,and each has its own advantages and disadvantages in breast disease imaging diagnosis.However,they can complement each other and play an important role in disease diagnosis,treatment,and prognosis evaluation.Mammography has the advantages of safety,reliability and good repeatability.It is the preferred screening method for breast cancer recommended by international guidelines.The main manifestations of DCIS on MG can be divided into non calcified lesions and calcified lesions.On US,the main manifestations are lesions and non-lesion type,which can be further divided into hypoechoic changes,calcification,ductal changes,and structural disorders and distortions.MRI has higher sensitivity in detecting DCIS without calcification and multifocal DCIS compared with MG,and has higher accuracy in evaluating the lesion range.However,there are also shortcomings such as low diagnostic specificity and insensitivity to microcalcification display.In addition,radiomics has great potential in the histopathological evaluation,prediction,and guidance of individualized precision treatment of DCIS.In the current era of precision medicine,image features,histopathology,molecular genes,etc.are increasingly significant in predicting the prognosis of breast cancer.The early accurate diagnosis and molecular type of DCIS are also extremely important in clinical work.It has become a consensus in clinical treatment to predict the potential benefits of different treatments through molecular typing,histological grade,and imaging findings,in order to develop the most suitable personalized treatment plan.This article reviewed the correlation between imaging features and the molecular subtype,histopathology and prognosis of DCIS.
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AIM:To explore the mechanism of ATP synthase mitochondrial F0 complex H+ transporting,sub-unit F6(ATP5J)in affecting the metastasis of hepatoma carcinoma cells by regulating mitochondrial function-mediated cy-toskeletal remodeling.METHODS:Hepatocellular carcinoma cells Li-7 were used to construct the ATP5J overexpression and knockdown models.JC-1 staining was used to detect the mitochondrial membrane potential in each group,reactive oxygen species(ROS)levels were examined by DCHF-DA,and mitochondrial ATP fluorescence probe was used to assess mito-chondrial function.Cytoskeletal remodeling was detected with a microfilament green fluorescent probe(Actin-Tracker Green-488).Transwell assay was used to assess cell invasion ability.The expression levels of ATP5J and translocase of outer mitochondrial membrane 20(TOMM20)were determined by Western blot.RESULTS:Overexpression of ATP5J up-regulated mitochondrial membrane potential and mitochondrial ATP fluorescence intensity,induced cytoskeletal re-modeling,promoted cell invasion and TOMM20 expression,and inhibited ROS production(P＜0.01).On the contrary,knockdown of ATP5J significantly decreased mitochondrial membrane potential and mitochondrial ATP fluorescence inten-sity,significantly decreased cell invasion ability and TOMM20 expression,promoted ROS production and blocked cyto-skeletal remodeling(P＜0.01).CONCLUSION:ATP5J regulates mitochondrial energy transformation in hepatocellular carcinoma cells,and affects metastasis of hepatoma carcinoma cells by regulating mitochondrial membrane potential and mitochondrial ATP production-mediated cytoskeletal remodeling through TOMM20.