Linzi District People's Hospital

Unexpected treatment failures can occur during middle meningeal artery embolization (MMAE) in the treatment of chronic subdural hematoma cases. This study aimed to classify variations in the anatomy of the extracranial MMA (exMMA) to improve MMAE. Five heads from body donors, 300 dry skulls, and 162 head and neck CT angiography (CTA) images were used to evaluate the overall features of the exMMA. Body donors dissection were incorporated to comprehensive exMMA representation. The distal features of the exMMA were determined by evaluating the outer osseous grooves of the foramen spinosum of the skulls. Measurements of the exMMA were performed using CTA. The angles between the maxillary artery and the exMMA were 109.5° ± 32.5° (left) and 117.1° ± 34.3° (right) (p < 0.05). The angle between the exMMA and the skull base was greater on the left side (79.24° ± 4.21°, p = 0.0017). The diameters of the exMMA were 1.45 ± 0.12mm (left) and 1.44 ± 0.13mm (right) (p = 0.82). Multiple types of accessorial foramen spinosum provided the paths for the accessorial MMA. In the new classification, five types were identified. Type A was the most common (73.15%) and represented an easily accessible MMAE type. This was followed by type C (25.62%, difficult to accessible), type D (18.83%, very difficult to accessible), type B (1.23%, fairly accessible), and type E (0.17%, inaccessible). Varying levels of interventional difficulty occur within the exMMAs classification. Careful preoperative evaluations should be performed before MMAE to determine the type of exMMA and potential interventional difficulty.

To quantitatively evaluate and compare postoperative head and cervical spine mobility (HCSM) following different subaxial cervical surgeries. A cohort of 147 patients who underwent one, two, or three levels of anterior cervical discectomy and fusion (ACDF1, ACDF2, ACDF3) or laminoplasty (LAMP) surgery was assessed. Six-direction active cervical range of motion (CROM) was measured with a CROM device. The HCSM retention rate (HCSM-RR) for each patient was calculated by comparing their CROM values against a previously established normative baseline dataset. Postoperative reductions in both CROM and HCSM-RR were observed across all six movement directions, with the extent of decline varying by surgical group. In flexion/extension, ACDF1 showed the best preservation (85.4%/82.7%), whereas ACDF3 resulted in the most limited mobility (65.7%/62.9%). For lateral bending, ACDF1 demonstrated superior outcomes (85.1%/85.3%), with ACDF2 and LAMP showing intermediate and comparable results, and ACDF3 the poorest. In axial rotation, the HCSM-RR was significantly lower in the ACDF3 (75%) than in other groups (82%-91%). Among all directions, axial rotation retained the highest HCSM-RR, whereas extension exhibited the lowest. Our findings indicate that different subaxial cervical spine surgeries result in significant variations in postoperative HCSM. ACDF1 preserved the most HCSM, while ACDF3 resulted in the greatest loss. ACDF2 and LAMP exhibited similar retention rates. Quantifying the expected postoperative HCSM differences among these surgeries can aid in preoperative physician-patient communication about potential surgical outcomes and long-term quality of life, particularly for patients requiring three-level subaxial cervical surgeries.

ABSTRACT In this paper, a stochastic reaction–diffusion susceptible‐infected‐vaccinated (SIV) epidemic model with nonlocal delay is proposed. Using the Banach fixed point theorem combined with a truncation method, we establish the existence and uniqueness of positive mild solutions. The long‐term behavior of the system is characterized by a real‐valued parameter . Specifically, if , the disease will become extinct; if , the system has an invariant probability measure. Furthermore, the mean square exponential stability was proved by using the Gronwall inequality, and the critical delay that guarantees the stability of the mild solution was derived. Finally, numerical examples are given to illustrate the theoretical results.

[This retracts the article DOI: 10.1016/j.heliyon.2022.e11006.].

Botrytis cinerea, a necrotrophic phytopathogen responsible for gray mold disease, poses a significant threat to global postharvest horticultural production due to substantial spoilage of fruits and vegetables. This study systematically investigated the antifungal efficacy and molecular mechanisms of terpinen-4-ol against B. cinerea. Terpinen-4-ol exhibited a broad-spectrum of antifungal activity, significantly inhibiting both mycelium growth and conidial viability of B. cinerea. Further analyses revealed that terpinen-4-ol disrupted cell membrane integrity and induced reactive oxygen species (ROS) accumulation. The inhibitory effect may be attributed to its ability to promote ROS accumulation and induce autophagy activity, thereby disrupting the intracellular redox balance and autophagic processes in fungi, ultimately leading to apoptosis via a metacaspase-dependent pathway. Altogether, these findings revealed a specific antifungal mechanism of terpinen-4-ol against B. cinerea, suggesting its potential as an effective preservative for postharvest preservation of fruits.

BackgroundReduction mammaplasty (RM) is a commonly performed plastic surgery procedure, but various postoperative complications have been noted. This study aims to identify and quantify the association between risk factors and the occurrence of postoperative complications following RM.MethodsWe systematically reviewed PubMed, Medline, Cochrane Library and Web of Science for relevant publications, extracting suspected risk factors and associated postoperative complications. Meta-analyses were then conducted to evaluate their associations.ResultsWe included 61 articles encompassing 71,149 patients. Seven suspected risk factors and eighteen complications were identified. Five risk factors were significantly associated with any complications after RM: body mass index (BMI) ≥ 30 kg/m2 (OR 1.59, 95% CI 1.45–1.74, p = 0.000, I2 = 35.2%); smoking (OR 1.80, 95% CI 1.29–2.50, p = 0.000, I2 = 87.5%); diabetes (OR 1.41, 95% CI 1.11–1.79, p = 0.005, I2 = 11.2%); previous radiation therapy (OR 3.24, 95% CI 1.94–5.40, p = 0.000, I2 = 12.6%); and surgical techniques including inferior pedicle (IP) vs. superomedial pedicle (SMP) (OR 1.59, 95% CI 1.27–1.99, p = 0.000, I2 = 27.5%); IP vs. medial pedicle (MP) (OR 2.34, 95% CI 1.48–3.72, p = 0.000, I2 = 47.0%); and superior pedicle vs. SMP (OR 0.59, 95% CI 0.37–0.95, p = 0.028, I2 = 0.0%). Furthermore, BMI ≥ 30 kg/m2 was linked to higher risks of delayed healing, fat necrosis, wound infection, and dehiscence. Previous radiation therapy increased the risks of fat necrosis, wound infection, and seroma. Smoking was associated with higher risks of wound infection and dehiscence. Compared to MP, IP had a higher risk of wound dehiscence; compared to SMP, IP had a higher risk of wound infection but a lower risk of seroma (all P < 0.05).ConclusionsThese findings highlight the importance of comprehensive preoperative risk assessment and individualized surgical planning to minimize postoperative complications and improve patient outcomes.

Although it has been shown that abnormal expression of Wilm's tumor gene 1 (WT1) is associated with the occurrence of leukemia, the specific mechanism via which it induces leukemia cells to differentiate into macrophages remains poorly understood. Based on the prediction that the microRNA miRNA-132-3p is the miRNA that possibly lies upstream of the WT1 gene, we hypothesized that miRNA-132-3p may participate in the polarization process of macrophages through regulating expression of the WT1 gene. The focus of the present study was therefore to investigate the role of the miRNA-132-3p/WT1 signaling axis in the differentiation of THP-1 leukemia cells into macrophages induced by PMA. The results obtained indicated that, compared with the control group, the proliferation of THP-1 cells was clearly inhibited by PMA, and the cell cycle was arrested at G0/G1 phase, associated with an upregulation of CD11b and CD14 expression. Induced by PMA, the expression level of miRNA-132-3p was increased, WT1 expression was decreased, and the expression level of TGF-β1 was increased. Following transfection with miRNA-132-3p mimics, however, the expression of WT1 in the THP-1 cells was downregulated, with upregulation of the CD11b and CD14 antigens, whereas this downregulation of WT1 mediated by miRNA-132-3p mimics could be reversed by co-transfection with WT1 vector, which was accompanied by downregulation of the CD11b and CD14 antigens. The luciferase activity of the co-transfected miRNA-132-3p mimic + WT1-wild-type (WT) group was found to be statistically significantly lower compared with that of the co-transfected miRNA-132-3p mimic + WT1-mutated (MUT) group. Furthermore, chromatin immunoprecipitation experiments showed that WT1 was able to directly target the promoter of the downstream target gene TGF-β1, which led to the negative modulation of TGF-β1 expression, whereas downregulation of WT1 led to an upregulation of the expression of TGF-β1, which thereby promoted the differentiation of THP-1 cells into macrophages. Taken together, the present study has provided evidence, to the best of the authors' knowledge for the first time, that the miRNA-132-3p/WT1/TGF-β1 axis is able to regulate the committed differentiation of leukemia cells into macrophages.

Chronic respiratory diseases (CRD) are major contributors to mortality. The “obesity paradox” suggests that higher body mass index (BMI) may confer survival benefits in CRD patients. This study investigates the association between BMI and mortality risk in CRD patients, focusing on the mediating role of the triglyceride-glucose (TyG) index. A cross-sectional analysis of 7689 participants with CRD was conducted. Participants were categorized by BMI into <25.0, 25.0–29.9, 30.0–34.9, 35.0–39.9, and ≥40 kg/m2. Outcomes included all-cause mortality, cardiovascular disease (CVD) mortality, and non-CVD mortality. Cox regression models assessed associations, and mediation analysis evaluated the role of the TyG index. Among 7689 CRD patients, higher BMI was associated with lower all-cause mortality (HR for BMI 25.0–29.9: 0.81, 95% CI 0.70–0.94; HR for BMI 30.0–34.9: 0.72, 95% CI 0.61–0.85; HR for BMI 35.0–39.9: 0.72, 95% CI 0.59–0.88; HR for BMI ≥ 40: 0.82, 95% CI 0.66–1.02) and non-CVD mortality (HR for BMI 25.0–29.9: 0.77, 95% CI 0.65–0.91; HR for BMI 30.0–34.9: 0.65, 95% CI 0.54–0.79; HR for BMI 35.0–39.9: 0.66, 95% CI 0.52–0.83; HR for BMI ≥ 40: 0.69, 95% CI 0.53–0.89), but not CVD mortality. The TyG index mediated a significant proportion of the association between BMI and mortality (mediation effects: −22.39 to −18.49%). Kaplan-Meier survival curves and restricted cubic spline regression further illustrated the significant associations between BMI and all-cause mortality and non-CVD mortality, while no significant association was observed for CVD mortality. Higher BMI is associated with lower mortality risk in CRD patients, particularly for non-CVD causes, mediated by the TyG index. This highlights the potential role of insulin resistance in the “obesity paradox” and suggests that metabolic health interventions may improve outcomes in CRD.

Abstract Background HIV remains a critical global public health challenge, with 39 million people living with HIV as of 2022 and over 40.4 million lives lost to the epidemic. In China, the burden is similarly significant, with over 1.33 million HIV cases reported as of 2024. The challenges are particularly acute in western regions like Yunnan Province, which face resource limitations, socio-demographic disparities, and a high prevalence of HIV among ethnic minorities. Objectives This study examines the challenges in HIV/AIDS diagnosis, treatment, and prevention across various institutions in Yunnan Province, including government bodies, hospitals, disease control centers, and primary healthcare institutions. It aims to provide insights for optimizing prevention and treatment strategies in areas with ethnic minorities and impoverished mountainous regions. Methods This study employs Grounded Theory to examine the systemic, socio-demographic, and cultural barriers to integrating HIV prevention and treatment in M City, a resource-limited border region in Yunnan Province. Data were collected through semi-structured interviews with 23 participants, including individuals living with HIV, village doctors, healthcare providers, and policymakers, to gain a comprehensive understanding of the challenges in HIV management. Results The study identifies several critical barriers to integrating HIV prevention and treatment. Patients’ low health awareness, poor medication adherence driven by stigma, weak family support, and high-risk behaviors such as low condom use and migration significantly exacerbate transmission risks. Village doctors face logistical challenges and stigma in conducting follow-ups, while hospitals are overburdened with insufficient staff and resources to manage increasing patient loads. Additionally, weak inter-agency collaboration and inadequate referral mechanisms hinder coordinated care and timely interventions. The burden of managing comorbidities and ART-related complications, including osteoporosis and liver dysfunction, further strains the under-resourced healthcare system. These challenges collectively underscore the urgent need for integrated, multisectoral solutions. Conclusion This study highlights the complex challenges in HIV prevention, treatment, and integration in economically underdeveloped regions, emphasizing the need for improved patient awareness, healthcare system efficiency, and cross-institutional collaboration. Future research should focus on multi-center, longitudinal studies and real-world implementation to refine and scale the integration model for sustainable HIV care in these regions.

Aims/Background Intrahepatic cholestasis of pregnancy (ICP) is associated with adverse perinatal outcomes, yet the correlation between ICP and the neutrophil-to-lymphocyte ratio (NLR) remains unclear. This study aims to investigate the diagnostic value of NLR in ICP. Methods In this retrospective case-control study, 113 patients with ICP treated in Beilun District People's Hospital from January 2020 to December 2022 were recruited and categorized as the ICP group, and 209 healthy pregnant women treated during the same period were selected as the control group. The levels of NLR and mean platelet volume (MPV) were compared between the two groups. The NLR of patients with different ICP severity were compared. Logistic regression model was used to analyze the relationship between relevant indicators and ICP. The capability of NLR in predicting ICP was evaluated using receiver operating characteristic (ROC) curves. Results There were significant differences in age, neutrophil count, lymphocyte count, platelet count, MPV, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), NLR, and serum total bile acid (sTBA) among all groups (p < 0.05). The NLR in the severe ICP group was significantly higher than that in the mild ICP group (p < 0.05). Logistic regression analysis showed that MPV (odds ratio [OR] = 1.247) and NLR (OR = 1.885) were independent factors influencing the occurrence of ICP (p < 0.05). ROC curve analysis showed that the area under the curve (AUC) for both mild ICP and severe ICP was 0.679 and 0.869, respectively, substantiating the diagnostic value of NLR. Conclusion NLR can be used as an auxiliary indicator in the diagnosis of ICP and has important clinical value in predicting adverse pregnancy outcomes in ICP patients.