Objective To develop and validate an automated organoid image segmentation approach based on deep learning for addressing the issues of high misidentification rate,blurred boundary and poor generalization in current organoid segmentation,thereby facilitating researchers to monitor and analyze organoid growth more efficiently.Methods The wavelet scattering coefficient matrix and capsule convolution module were integrated into the U-Net architecture to construct the organoid image segmentation model OrgCapsU-Net which was trained and evaluated on 3 organoid image datasets from different tissue sources.Results Compared with current mainstream segmentation algorithms,OrgCapsU-Net could better distinguish organoid and impurity,and lead to smoother segmentation boundaries,achieving superior performance across 4 evaluation metrics on 3 datasets.Conclusion OrgCapsU-Net delivers excellent segmentation performance and can be applied to organoids from various tissue sources,showing strong potential for applications in the in vitro model establishment,high-throughput drug screening,and personalized medicine.

Objective To clarify the evidence of the frequency and risk factors for falls in knee osteoarthritis(KOA)of adults by meta-analysis.Methods Computerized searches of the CNKI,VIP,Wanfang data,CBM,PubMed,Cochrane Library,Embase,Web of Science were conducted for literature on risk factors for falls in adults with KOA from the inception of the databases to August 2024.After literature screening,data extraction,and quality evaluation,RevMan 5.4 software was used for Meta-analysis.Results A total of 26 articles were involved.Meta-analysis result showed that the rate of falls was 29.0％.Factors associated with increased risk of falls included being female(OR=1.35),decreased lower limb muscle strength(OR=1.72),decreased knee flexion muscle strength(OR=7.05),decreased static posture stability(OR=1.28),opioid use(OR=1.79),antidepressant use(OR=1.69),frequent stair climbing(OR=7.58),combined neurological disease(OR=1.77),history of falls(OR=3.29)and fear of falling(OR=2.54).Conclusion The rate of falls of patients with KOA is high.The adults with KOA who are women,have lower muscle strength of lower limbs and knee flexion muscle strength,poorer static posture stability,use opioids,antidepressant,frequent stair climbing,combined neurological disorders,previous falls in the past year and fear of falls are at higher risk of falls.Healthcare professionals should dynamically assess and detect the risk of falls in the patients with KOA and adopt targeted,individualized interventions to prevent falls.

Chemotherapy-induced peripheral neurotoxicity (CIPN) is a severe dose-limiting adverse event of chemotherapy. Presently, the mechanism underlying the induction of CIPN remains unclear, and no effective treatment is available. In this study, through metabolomics analyses, we found that nab-paclitaxel therapy markedly increased serum serotonin [5-hydroxtryptamine (5-HT)] levels in both cancer patients and mice compared to the respective controls. Furthermore, nab-paclitaxel-treated enterochromaffin (EC) cells showed increased 5-HT synthesis, and serotonin-treated Schwann cells showed damage, as indicated by the activation of CREB3L3/MMP3/FAS signaling. Venlafaxine, an inhibitor of serotonin and norepinephrine reuptake, was found to protect against nerve injury by suppressing the activation of CREB3L3/MMP3/FAS signaling in Schwann cells. Remarkably, venlafaxine was found to significantly alleviate nab-paclitaxel-induced CIPN in patients without affecting the clinical efficacy of chemotherapy. In summary, our study reveals that EC cell-derived 5-HT plays a critical role in nab-paclitaxel-related neurotoxic lesions, and venlafaxine co-administration represents a novel approach to treating chronic cumulative neurotoxicity commonly reported in nab-paclitaxel-based chemotherapy.
Paclitaxel/toxicity* ; Animals ; Albumins/adverse effects* ; Serotonin/metabolism* ; Mice ; Humans ; Male ; Female ; Venlafaxine Hydrochloride/therapeutic use* ; Neurotoxicity Syndromes/metabolism* ; Middle Aged ; Schwann Cells/metabolism* ; Peripheral Nervous System Diseases/drug therapy* ; Antineoplastic Agents

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

The Healthy China 2030 Plan set the goal of reducing premature deaths from diabetes by 30% by 2030. However, there has been a lack of assessment of premature mortality for diabetes since the action plan was issued. This study used data from the Global Burden of Disease Study 2021, calculated the premature deaths for diabetes by sex, provinces, and subtypes from 1990 to 2021. We explored the temporal trend of premature mortality using the average annual percent change (AAPC) for different sexes, provinces, and subtypes from 1990 to 2021. Furthermore, we predicted premature mortality for diabetes through 2030 for China and its provinces according to the average annual change rate from 2010 to 2021. There was a first slow upward trend in premature mortality for diabetes from 0.5% in 1990 to 0.6% in 2004, and then a decline until 2021 with premature mortality of 0.4%. By 2030, only Fujian (30.3%) will achieve the desired level of reduction, with only seven provinces meeting the target for females and none for males. There is a large range in the degree of decline between inland and coastal regions, showing obvious geographic differences, and there should be a focus on balancing medical resources.
Humans ; China/epidemiology* ; Female ; Male ; Mortality, Premature/trends* ; Diabetes Mellitus/mortality* ; Goals ; Middle Aged ; Adult

Objective:To investigate the effect of low frequency repetitive transcranial magnetic stimulation(rTMS)com-bined with rehabilitation robot on balance function and motor ability of stroke patients.Method:Sixty stroke patients with hemiplegia who met the inclusion criteria were randomly divided into the rT-MS group(group A),the lower limb robot group(group B)and the rTMS combined with lower limb robot group(group C),with 20 subjects in each group.All the three groups also received conventional rehabilita-tion treatment for 4 weeks.The Berg balance scale(BBS)and Pro-kin balance test were used to evaluate the balance function of the three groups before and after treatment.The Fugl-Meyer assessment of lower extremity motor function(FMA-L)and functional ambulation category(FAC)scale were used to evaluate the patients'lower extremity function and walking ability.Result:Before treatment,there was no significant difference in BBS,balance test,FMA-L and FAC among the three groups(P＞0.05).After treatment,the BBS,balance test,FMA-L and FAC of the three groups were significantly improved compared with those before treatment(P＜0.05).The improvement of the BBS,bal-ance test,FMA-L and FAC in group C was significantly higher than that in group A and group B(P＜0.05).Conclusion:Low frequency rTMS combined with lower limb rehabilitation robot has a significant effect on bal-ance function and motor ability in stroke patients.

Objective:To investigate the effect of low frequency repetitive transcranial magnetic stimulation(rTMS)com-bined with rehabilitation robot on balance function and motor ability of stroke patients.Method:Sixty stroke patients with hemiplegia who met the inclusion criteria were randomly divided into the rT-MS group(group A),the lower limb robot group(group B)and the rTMS combined with lower limb robot group(group C),with 20 subjects in each group.All the three groups also received conventional rehabilita-tion treatment for 4 weeks.The Berg balance scale(BBS)and Pro-kin balance test were used to evaluate the balance function of the three groups before and after treatment.The Fugl-Meyer assessment of lower extremity motor function(FMA-L)and functional ambulation category(FAC)scale were used to evaluate the patients'lower extremity function and walking ability.Result:Before treatment,there was no significant difference in BBS,balance test,FMA-L and FAC among the three groups(P＞0.05).After treatment,the BBS,balance test,FMA-L and FAC of the three groups were significantly improved compared with those before treatment(P＜0.05).The improvement of the BBS,bal-ance test,FMA-L and FAC in group C was significantly higher than that in group A and group B(P＜0.05).Conclusion:Low frequency rTMS combined with lower limb rehabilitation robot has a significant effect on bal-ance function and motor ability in stroke patients.

Objective To analyze the incidence and influencing factors of postoperative malnutrition in children under 5 years old with congenital heart disease.Methods A retrospective analysis was conducted on the clinical data of 103 children under 5 years old with congenital heart disease who underwent open-heart rad-ical surgery at the hospital from August 2019 to December 2020.Age-specific height Z-scores(HAZ),age-spe-cific weight Z-scores(WAZ),and weight-for-height Z-scores(WHZ)were calculated.Malnutrition was de-fined as any Z-score<-2.Based on nutritional status,patients were divided into a malnutrition group and a normal nutrition group.Preoperative differences between the two groups in different age periods were com-pared,and nutritional status was followed up at 1,3,and 6 months postoperatively to analyze the influencing factors for postoperative malnutrition.Results Among 103 pediatric patients,42 had preoperative malnutri-tion,with a malnutrition incidence of 40.8%.The incidence of malnutrition decreased to 24.3%(25/103)six months after surgery.At one month postoperatively,HAZ,WAZ,and WHZ decreased compared with preoper-ative values across different age groups,while they increased at three and six months postoperatively;howev-er,only the WHZ in the toddler group showed a statistically significant difference compared to preoperative values(P<0.05).Multivariate logistic regression analysis indicated that preoperative malnutrition was a risk factor for malnutrition six months after surgery(P<0.05),whereas age stage had no effect on postoperative malnutrition at six months(P>0.05).Conclusion Children with congenital heart disease generally suffer from malnutrition before surgery,and early identification and intervention should be carried out to promote their growth and development.

Objective To analyze the characteristics of real-world adverse drug events(ADEs)of trabectedin based on the FDA Adverse Event Reporting System(FAERS)database in order to provide references for clinical drug safety management.Methods A total of 1 349 trabectedin-related reports were extracted from the FAERS database from Q1 2007 to Q4 2024.Using the MedDRA coding classification system for system organ class(SOC)and preferred term(PT),signal detection was performed through 4 proportional imbalance methods,including reporting odds ratio(ROR)and proportional reporting ratio(PRR).Subgroup analyses by gender,age,and temporal trends were also conducted.Results Hematological and lymphatic system disorders and hepatobiliary system disorders were the primary SOCs involved.High-frequency PTs included neutropenia(123 cases)and anemia(117 cases).Eight potential ADEs that have not been listed in the drug product instruction were identified.The median onset time of ADEs was 21 d,showing an early failure pattern,with differences observed by gender(females more prone to hematological toxicity)and age(elderly more susceptible to febrile neutropenia).Conclusion Trabectedin requires close attention to hematological toxicity,hepatotoxicity,and newly identified multi-system potential risks.Clinically,monitoring should be strengthened based on time windows and population characteristics to optimize drug regimens.Countermeasure It is recommended to strengthen the full cycle monitoring of anti-tumor drugs,standardize the reporting of adverse reactions,and establish a multi-departmental collaborative research platform.

Objective With the development of manned space missions to the moon and space exploration,extravehicular activities become more frequent and extravehicular mission become more complex,which puts forward higher requirements for the extravehicular spacesuit.In order to ensure the ergonomics of spacesuit,the flexible joints are usually adopted in the limbs of spacesuit.The structural design of large angle of movement and low resistance joints is the basic for ensuring the ergonomics of spacesuit.Methods This study established a method of spacesuit joint structure to analysis the motion characteristic of typical joints.Firstly,the structure and activity characteristics of the spacesuit and lunar space suits were comprehensively analyzed,and the activity characteristics of different typical structure are qualitatively analyzed based on existing empirical method.Then,the dynamics of typical structure was analyzed by finite element model.By studying the change trend of motion of spacesuit joint with motion angle,and the motion characteristic curve was obtained.Finally,the model was studied according to different structural size parameters.The influence of structural parameters on the motion characteristics was analyzed,and the curves was obtained to provide a basis for design of spacesuit motion joint structure.Results Through the above analysis,the motion characteristics of different typical structure are obtained qualitatively.And the influence of different structure parameters on the motion characteristics was analyzed.This establishes the method basis for structure design.Conclusion The study was carried out a method based on finite element model for joint motion analysis,which is suitable for the design of typical joint structure of spacesuit.