Purpose: In this study, the neural communication patterns between hypothalamic structures and cortical areas in girls diagnosed with central precocious puberty (CPP) were explored. Endocrine profiles were incorporated to clarify the pathophysiological interactions between cerebral networks and hormonal regulation. The hypothalamus was designated as the key focus area for connectivity analysis. Methods: Fifty-seven girls (37 CPP, 20 non-CPP) were recruited from the Pediatric Development Clinic at the Second Affiliated Hospital of Anhui Medical University. The collected data included demographic information, gonadotropin-releasing hormone stimulation tests, and magnetic resonance imaging scans. Hypothalamic functional connectivity (FC) was analyzed using predefined region of interest coordinates, and correlations between hormone levels and FC values were assessed. Results: Compared to the non-CPP group, the CPP group exhibited elevated baseline follicle-stimulating hormone (FSH), baseline luteinizing hormone (LH), peak FSH, peak LH, and peak LH/FSH ratios. Patients with CPP exhibited enhanced neural synchronization linking the right lateral hypothalamic effector zone to the right superior frontal gyrus (displaying a borderline significant correlation with peak LH concentrations), concurrent with diminished functional coupling of the right lateral hypothalamic efferent to the right fusiform/supramarginal gyri. The left lateral hypothalamic projections demonstrated amplified connectivity with the right cuneus. No FC differences were observed in the medial hypothalamus. Conclusion Abnormal lateral hypothalamus FC patterns were identified in CPP girls and were particularly linked to peak LH levels. The findings offer novel insights into the neuroendocrine mechanisms underlying CPP.

Objective:To compare the midium-to-long-term clinical outcomes of Ceramage? polymer ceramic composite resoin on-lay and CAD/CAM fabricated all-ceramic onlays in the restoration of endodontically treated posterior teeth.Methods:A total of 75 patients with 92 endodontically treated posterior teeth exhibiting class Ⅱ defects were included and randomly divided into two groups:the Ceramage? composite resin group(48 teeth)and the CAD/CAM fabricated all-ceramic group(44 teeth).The respective restora-tions were performed,and patients were followed up for 24 months.Clinical outcomes of the restorations and periodontal conditions were evaluated using the modified USPHS criteria,and patient satisfaction was assessed.Results:After 24 months of follow-up,the Ceramage? composite resin group showed higher rates of secondary caries,marginal discrepancy,and marginal discoloration,as well as higher plaque index,gingival index,and sulcus bleeding index compared to the CAD/CAM fabricated all-ceramic group.Howev-er,the Ceramage? group exhibited lower rates of restoration wear and fracture(P＜0.05).Patient satisfaction was similar between the two groups(P＞0.05).Conclusion:Both Ceramage? polymer ceramic composite resoin onlay and CAD/CAM fabricated all-ce-ramic onlays achieved favorable mid-to-long-term clinical outcomes.The choice of restoration method should comprehensively con-sider the patient's oral condition and restorative needs.

AIM: To explore the diagnostic value of 18 MHz color Doppler ultrasonography for epiretinal membrane.METHODS: A total of 44 cases(80 eyes)of patients with proposed diagnosis of cataract and vitreous opacity by fundus examination in our hospital between January 2020 and January 2022 were collected, and the affected eyes were examined by optical coherence tomography(OCT)and 18 MHz color Doppler ultrasonography, and the differences in the diagnostic sensitivity, specificity, and accuracy were compared between 18 MHz color Doppler ultrasonography and OCT for the diagnosis of epiretinal membrane.RESULTS: In the 80 eyes detected by 18 MHz color Doppler ultrasonography, 62 had epiretinal membrane and 18 had non epiretinal membrane. Totally 54 eyes were confirmed to have epiretinal membrane by OCT, 13 eyes were not diagnosed with epiretinal membrane, 5 eyes were missed diagnosis, and 8 eyes were misdiagnosed. The diagnostic consistency between 18 MHz color Doppler ultrasonography and OCT was high(Kappa=0.892, P<0.05); the 18 MHz color Doppler ultrasonography detection sensitivity of epiretinal membrane was 92%, specificity was 62%, missed diagnosis rate was 8%, misdiagnosis rate was 38%, and accuracy was 84%; compared with OCT detection, 18 MHz color Doppler ultrasonography detected a lower specificity, correct rate, positive prediction accuracy, negative prediction accuracy, and higher misdiagnosis rate(all P<0.05), and the difference in diagnostic sensitivity compared with leakage rate was not statistically significant(all P>0.05).CONCLUSION: 18 MHz color Doppler ultrasonography has some value in identifying epiretinal membrane lesions and is consistent with OCT testing.

Objective: To investigate the impact of preschool children s aquatic motor skill (AMS) acquisition on their fundamental motor skill (FMS) development and the correlation between AMS and FMS development, so ao to provide a scientific basis for early childhood education and physical education teaching. Methods: From April to June 2024, 60 children, recruited by random sampling from a kindergarten in Taiyuan, were stratified randomly divided into an experimental group ( n =30) and a control group ( n =30). The experimental group were further divided into five classes of six each. They received AMS practice interventions twice weekly, 40 minutes per session, over eight weeks (16 sessions total) at a designated swimming center. The control group maintained their usual routine. Children s FMS and AMS were assessed pre and post intervention using the Test of Gross Motor Development-3rd (TGMD3) and Actual Aquatic Skills Test (AAST), respectively. Before and after test comparisons within and between groups employed t-tests, Wilcoxon signedrank tests, ANCOVA (including ranktransformed ANCOVA), and Cohen s d effect sizes were calculated for standardized mean differences. Spearman rank correlation was used to analyze relationships between FMS and AMS. Results: After the aquatic learning, the experimental group scored significantly higher than the control group on locomotor skills ( F=20.47, P <0.01, η 2=0.26), FMS ( F=4.59, P =0.04, η 2=0.08), and AMS ( F=109.71, P<0.01, η 2=0.79). The experimental groups improvement in locomotor skills 5.0(3.8, 7.3) versus the control group (2.8±2.5) yielded a medium effect size (Cohen s d =0.71); AMS gains in the experimental group [26.0(20.8, 28.0)] versus controls [1.0(0, 2.3)] showed a very large effect size (Cohen s d =4.73) (both P <0.01). Among preschool children, AMS acquisition was positively correlated with locomotor skills ( r =0.39) and overall FMS ( r =0.43)(both P <0.05). Skill specific assessments revealed lower proficiency in headfirst entry (immersion), treading water, and sagittalplane rotation. Conclusion Preschool children s acquisition of AMS has a positive effect on their FMS, with mutual facilitation between the two, especially in locomotor abilities.

Objective:To compare the midium-to-long-term clinical outcomes of Ceramage? polymer ceramic composite resoin on-lay and CAD/CAM fabricated all-ceramic onlays in the restoration of endodontically treated posterior teeth.Methods:A total of 75 patients with 92 endodontically treated posterior teeth exhibiting class Ⅱ defects were included and randomly divided into two groups:the Ceramage? composite resin group(48 teeth)and the CAD/CAM fabricated all-ceramic group(44 teeth).The respective restora-tions were performed,and patients were followed up for 24 months.Clinical outcomes of the restorations and periodontal conditions were evaluated using the modified USPHS criteria,and patient satisfaction was assessed.Results:After 24 months of follow-up,the Ceramage? composite resin group showed higher rates of secondary caries,marginal discrepancy,and marginal discoloration,as well as higher plaque index,gingival index,and sulcus bleeding index compared to the CAD/CAM fabricated all-ceramic group.Howev-er,the Ceramage? group exhibited lower rates of restoration wear and fracture(P＜0.05).Patient satisfaction was similar between the two groups(P＞0.05).Conclusion:Both Ceramage? polymer ceramic composite resoin onlay and CAD/CAM fabricated all-ce-ramic onlays achieved favorable mid-to-long-term clinical outcomes.The choice of restoration method should comprehensively con-sider the patient's oral condition and restorative needs.

Objective To analyze the risk factors of pulmonary infection in elderly patients with heart fail-ure with reduced left ventricular ejection fraction heart failure,and establish a risk predicting model of pulmonary infection in those patients by decision tree CART algorithm.Methods 320 elderly patients with heart failure with reduced left ventricular ejection fraction admitted from January 2020 to December 2022 were retrospectively selected as study objects,and were divided into an infection group and a non-infection group according to whether the patients were complicated with pulmonary infection.Logistic regression model and decision tree CART model were used to construct a prediction model of heart failure with reduced left ventricular ejection fraction complicated with pulmonary infection,and 5-fold cross-validation method was used for internal verification.The prediction effi-ciency of the models was compared.Results In the 320 patients,the incidence of pulmonary infection was 30.94％.The data on age,smoking history,diabetes mellitus,cardiac function grades,COPD,invasive procedures,length of hospital stay were compared between the infection and non-infection groups(P＜0.05).logistic regression analysis showed that age of ≥ 75 years smoking history,complications with diabetes or/and COPD,cardiac function gradeⅢ/Ⅳ,invasive procedures,and hospital stay of ≥ 14 days were independent risk factors for pulmonary infection in the patients(P＜0.05).Probability forecasting model P=1/[1+e(-3368+0.763*X1+0.814*X2+0.652*X3+1.05*X4+0.865*X5+1.027*X6+0.652*X7)],with an overall accurate rate of prediction of 80.9％.The Omnibus test showed P＜0.001.The accuracy of predic-tion was 73.6％after the cross-validation of 5 fold.The decision tree model showed that invasive procedures were the most important influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction,with an information gain of 0.280.The ROC showed that the AUC value of logistic regression model was slightly higher than that of the decision tree(Z=2.850,P=0.004),and the prediction efficiency of both models was medium.Conclusions Age,smoking history,complications with diabetes mellitus or/and COPD,cardiac function grades,invasive procedures,and length of hospital stay are all influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction.The deci-sion tree model constructed in this study has a better efficiency for risk prediction,and it can provide reference for early clinical screening and intervention of heart failure with reduced left ventricular ejection fraction.

Objective To analyze the risk factors of pulmonary infection in elderly patients with heart fail-ure with reduced left ventricular ejection fraction heart failure,and establish a risk predicting model of pulmonary infection in those patients by decision tree CART algorithm.Methods 320 elderly patients with heart failure with reduced left ventricular ejection fraction admitted from January 2020 to December 2022 were retrospectively selected as study objects,and were divided into an infection group and a non-infection group according to whether the patients were complicated with pulmonary infection.Logistic regression model and decision tree CART model were used to construct a prediction model of heart failure with reduced left ventricular ejection fraction complicated with pulmonary infection,and 5-fold cross-validation method was used for internal verification.The prediction effi-ciency of the models was compared.Results In the 320 patients,the incidence of pulmonary infection was 30.94％.The data on age,smoking history,diabetes mellitus,cardiac function grades,COPD,invasive procedures,length of hospital stay were compared between the infection and non-infection groups(P＜0.05).logistic regression analysis showed that age of ≥ 75 years smoking history,complications with diabetes or/and COPD,cardiac function gradeⅢ/Ⅳ,invasive procedures,and hospital stay of ≥ 14 days were independent risk factors for pulmonary infection in the patients(P＜0.05).Probability forecasting model P=1/[1+e(-3368+0.763*X1+0.814*X2+0.652*X3+1.05*X4+0.865*X5+1.027*X6+0.652*X7)],with an overall accurate rate of prediction of 80.9％.The Omnibus test showed P＜0.001.The accuracy of predic-tion was 73.6％after the cross-validation of 5 fold.The decision tree model showed that invasive procedures were the most important influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction,with an information gain of 0.280.The ROC showed that the AUC value of logistic regression model was slightly higher than that of the decision tree(Z=2.850,P=0.004),and the prediction efficiency of both models was medium.Conclusions Age,smoking history,complications with diabetes mellitus or/and COPD,cardiac function grades,invasive procedures,and length of hospital stay are all influencing factors for pulmonary infection in elderly patients with heart failure with reduced left ventricular ejection fraction.The deci-sion tree model constructed in this study has a better efficiency for risk prediction,and it can provide reference for early clinical screening and intervention of heart failure with reduced left ventricular ejection fraction.

Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed. Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.

【Objective】 A two-sample Mendelian randomization method was used to explore whether there is a causal relationship between the intake of alcohol, coffee, green tea and dairy products and the incidence of prostate cancer (PCa), in order to clarify the risk factors for the incidence of PCa and find a prevention pathway for PCa. 【Methods】 Data of alcohol, coffee, green tea, dairy products and prostate cancer were collected with genome-wide association study (GWAS).The causal relationship between their intake and the risk of PCa was analyzed with two-sample Mendelian randomization (2SMR).MR analysis was conducted with inverse-variance weighting (IVW).Sensitivity analysis was performed with weighted median, MR-Egger regression, Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) tests. 【Results】 Coffee intake (OR: 0.994, 95%CI: 0.990-0.999, P=0.014) and green tea intake (OR: 0.999, 95%CI: 0.998-0.999, P=0.036) were negatively correlated with the risk of PCa.Alcohol intake (OR: 0.997, 95%CI: 0.990-1.004, P=0.392) and dairy intake (OR: 1.025, 95%CI: 0.983-1.069, P=0.256) were not associated with the risk of PCa.In weighted median, MR-Egger regression, and retention one method analyses, the results were robust without heterogeneity or pleiotropy. 【Conclusion】 There was a causal association between coffee intake and green tea intake and the onset of PCa, but no causal association between alcohol intake and dairy intake and PCa onset.

Objective To explore the application of serum signal transducers and activators of transduction 3(STAT3)and SMAD4 expression levels in the early diagnosis and clinical staging of primary glaucoma patients.Methods 86 patients with primary glaucoma admitted to Cangzhou Eye Hospital from August 2021 to May 2023 were selected as the study group,according to the clinical symptoms and visual examination results of the research group,they were divided into mild injury stage(n=30),moderate injury stage(n=34)and severe injury stage(n=22).Another 86 healthy individuals who underwent physical examinations in Cangzhou Eye Hospital during the same period were collected as the control group.Enzyme linked immunosorbent assay(ELISA)was applied to detect the expression levels of serum STAT3 and SMAD4.Multivariate Logistic regression was applied to analyze the relevant factors affecting clinical staging of primary glaucoma,receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum STAT3 and SMAD4 in patients with moderate/severe primary glaucoma injury.Results The expression levels of serum STAT3(13.96±3.45 ng/ml)and SMAD4(11.23±2.85 ng/ml)in the study group were obviously higher than those in the control group(9.83±1.72 ng/ml,7.78±1.95 ng/ml),the differences were statistically significant(F=13.085,17.513,all P＜0.05).The expression levels of serum STAT3(11.88±2.52 ng/ml,13.85±3.51 ng/ml,16.96±4.63 ng/ml)and SMAD4(9.15±1.95 ng/ml,11.23±2.83 ng/ml,14.08±4.12 ng/ml)in patients with primary glaucoma in mild,moderate and severe injury groups were gradually increased,the differences were statistically significant(F=13.085,17.513,all P＜0.05).There was a statistically obvious difference in intraocular pressure among patients with mild,moderate(24.21±5.03 mmHg,28.16±6.31 mmHg,32.26±7.57mmHg),and severe injuries(F=10.577.P＜0.05).serum STAT3[OR(95%CI)=2.728(1.409～5.281)],SMAD4[OR(95%CI)=2.849(1.507～5.387)],and intraocular pressure[OR(95%CI)=2.435(1.094～5.417)]were risk factors affecting clinical staging of primary glaucoma(all P＜0.05).The area under the curve(AUC)of the combined diagnosis of serum STAT3 and SMAD4 for moderate/severe injury in patients with primary glaucoma was 0.963(95%CI:0.899～0.992),which was superior to their respective individual diagnoses(Z =2.558,1.961;P=0.010,0.049),their sensitivity and specificity were 96.43%and 83.33%,respectively.Conclusion The higher the expression levels of STAT3 and SMAD4 in serum,the more severe the clinical symptoms in patients.The combined detection of the two has good diagnostic value for patients with moderate/severe injury.