Objective To investigate muscle mass reduction and the effect of exercise training intervention in non-obese patients with type 2 diabetes (T2DM). Methods A total of 324 non-obese patients with T2DM admitted to the First Affiliated Hospital of Xinjiang Medical University were enrolled from February 2023 to February 2025. Dual-energy X-ray absorptiometry was adopted to detect and analyze the data of appendicular skeletal muscle index (ASMI). Non-obese T2DM patients were classified into an observation group (n=162, receive sports training intervention) and a control group (n=162, receiving routine exercise intervention) by adopting random number grouping criteria. Both groups were intervened for 3 months. The muscle mass indicators [ASMI, body mass index (BMI), and body fat rate], exercise ability [6-minute walking distance (6MWD), grip strength, and one-leg standing time], metabolic indicators [fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), and homeostasis model assessment insulin resistance index (HOMA-IR)], and quality of life [Diabetes Quality of Life Scale (DQOL)] were compared between the two groups to evaluate the effectiveness of sports training intervention. Results A total of 324 non-obese T2DM patients were enrolled, including 123 cases with reduced muscle mass (37.96%). There were no significant differences in the baseline data and the proportion of patients with muscle mass reduction between the two groups before intervention (P>0.05). After intervention, the ASMI, 6MWD, grip strength, and one-leg standing time in the observation group were higher or longer than those of the control group (P<0.05), while the body fat rate, FPG, HbA1c, HOMA-IR and DQOL scores were lower than those of the control group (P<0.05). Conclusion The incidence of muscle mass reduction is relatively high among non-obese T2DM patients, and exercise training intervention has significant effects on improving muscle mass, metabolic status, exercise capacity and quality of life in non-obese T2DM patients.

ObjectiveTo investigate the correlation of the serum levels of aminotransferases and their ratios with liver inflammation activity in pediatric chronic hepatitis B （pCHB） patients， and to provide a basis for selecting the dominant population for treatment. MethodsThis study was conducted among 1 267 pCHB patients who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2010 to August 2022 and these patients did not receive antiviral therapy. The patients were analyzed in terms of demographic features， blood routine， blood biochemistry， HBV serological markers， and liver biopsy data. According to liver inflammation activity based on liver biopsy， the patients were divided into no or mild inflammation activity （G0‍ ‍—‍ ‍G1） group and significant inflammation activity （G2‍ ‍—‍ ‍G4） group. The serum levels of aminotransferases and their ratios were compared between groups， and their correlation with liver inflammation activity in pCHB patients was analyzed. Additionally， the patients were stratified by the age， and the relationship between serum aminotransferase levels and liver inflammation activity was analyzed in each age group. For comparison of continuous data between two groups， the independent samples t-test was used when the data were normally distributed， while the Mann-Whitney U test was used when the data were not normally distributed； the chi-square test was employed for comparison of categorical data between two groups. A Spearman’s correlation analysis was performed for correlation assessment. ResultsAmong the 1 267 pCHB patients， there were 468 （36.9%） in the G0‍ ‍—‍ ‍G1 group and 799 （63.1%） in the G2‍ ‍—‍ ‍G4 group， and there were significant differences between the two groups in the levels of aspartate aminotransferase （AST）， alanine aminotransferase （ALT）， AST/ALT ratio， gamma-glutamyl transpeptidase （GGT）， total bilirubin， direct bilirubin， HBeAg quantification， low-density lipoprotein， and platelet count （PLT） （all P<0.05）. The correlation analysis showed that liver inflammation activity was negatively correlated with PLT and low-density lipoprotein （both P<0.05） and was positively correlated with GGT， total bilirubin， direct bilirubin， and HBeAg titer （all P<0.05）， while it was not significantly correlated with ALT， AST， and AST/ALT ratio （all P>0.05）. In the 0‍ ‍—‍ ‍12 years group， the 13‍ ‍—‍ ‍18 years male group， and the 13‍ ‍—‍ ‍18 years female group， liver inflammation activity aggravated with the increases in the serum levels of ALT and AST， and there were significant differences between groups （all P<0.05）. In the 0‍ ‍—‍ ‍12 years group， there was a significant difference in significant liver inflammation activity between the AST/ALT ratio >1 group and the AST/ALT ratio ≤1 group （P<0.001）. Among the 1 267 patients， 447 （35.28%） had an ALT level of <2×upper limit of normal （ULN）， among whom 196 （43.85%） had G≥2 liver inflammation， accounting for 15.47% of all children enrolled. ConclusionLiver inflammation activity is not significantly correlated with ALT， AST， and AST/ALT ratio in pCHB patients， suggesting that the serum levels of aminotransferases cannot truly reflect liver inflammation activity in pCHB patients with an aminotransferase level of <2×ULN. In clinical practice， liver biopsy should be performed for children with an aminotransferase level of <2×ULN to clarify whether antiviral therapy should be performed.

Objective To investigate the prevalence status and influencing factors of metabolic syndrome (MS) in adult patients with hypopituitarism (HP) during hospitalization. Methods The data of adult HP patients who received treatment in the hospital were collected from March 2021 to March 2024. The prevalence status of MS in adult HP patients was counted, and logistic regression analysis was adopted to analyze the influencing factors of MS in adult HP patients. Results Among the 308 adult HP patients in this study, 121 cases developed MS and 187 cases did not develop MS, and they were included in the MS group (n=148) and the non-MS group (n=232). The incidence of MS in adult HP patients was 38.95% (148/380). Compared with the non-MS group, the levels of high-density lipoprotein cholesterol, serum total cholesterol and low-density lipoprotein cholesterol in the MS group were higher, the waist circumference was larger, and the growth hormone was lower (P<0.05). After logistic regression analysis, it was found that high-density lipoprotein cholesterol (OR=1.069, 95%CI: 1.010-1.132, P=0.021), total serum cholesterol (OR=1.065, 95%CI: 1.014-1.119, P=0.012), low-density lipoprotein cholesterol (OR=1.055, 95%CI: 1.005-1.108, P=0.031), waist circumference (OR=1.063, 95%CI: 1.006-1.123, P=0.030) and growth hormone (OR=1.077, 95%CI: 1.019-1.138, P=0.009) could independently affect the occurrence of MS in adult HP patients (P<0.05). Conclusion Adult HP patients during hospitalization are often complicated with MS. High-density lipoprotein cholesterol, serum total cholesterol, low-density lipoprotein cholesterol, waist circumference, and growth hormone are factors affecting the occurrence of MS in adult HP patients.

Metabolic dysfunction-associated fatty liver disease （MAFLD） and its progressive form， metabolic dysfunction-associated steatohepatitis （MASH）， have emerged as significant types of chronic liver disease worldwide and are closely associated with metabolic syndrome. The liver-extrahepatic organ/tissue axis and the “spill-over effect” of intrahepatic inflammation play pivotal roles in the pathogenesis and progression of MAFLD/MASH， significantly impacting multi-organ metabolic homeostasis and leading to various extrahepatic injuries. These include cardiovascular diseases， sarcopenia， chronic kidney disease， non-alcoholic fatty pancreas disease， polycystic ovary syndrome， hepatocellular carcinoma， and various related solid tumors. There is a notable epidemiological link between MAFLD and the development of both liver cancer and extrahepatic malignancies. The risk of associated tumorigenesis is related to multiple factors， including persistent metabolic disorders， chronic low-grade inflammation， and gut microbiota dysbiosis. Recent research perspectives have shifted from focusing solely on hepatic pathology to recognizing systemic metabolic dysregulation， emphasizing the central role of liver-extrahepatic organ interactions in disease progression. This article aims to explore the pathogenesis of MAFLD/MASH and to review the mechanisms underlying related multi-organ extrahepatic injuries.

Objective: To analyze the expression of sigma factor in drug resistance gene mutations of Mycobacterium tuberculosis (MTB), so as to provide a reference for the drug resistance mechanism of tuberculosis. Methods: Clinical sputum specimens of outpatients at Tianjin Center for Tuberculosis from 2018 to 2022 were collected. A total of 899 MTB-positive strains were obtained by culture, and 492 phenotypically sensitive strains and 407 phenotypically resistant strains were identified by an in vitro phenotypic drug susceptibility test. Thirty drug-sensitive strains of MTB were randomly selected, and 98 drug-resistant strains with specific resistance phenotypes were chosen; all were subjected to melting curve analysis for detection of drug-resistance gene mutations. The strains were divided into sensitive strains without gene mutation, isoniazid-resistant strains with inhA mutation or katG mutation, rifampicin-resistant strains with rpoB mutation, and multigene mutation-resistant strains with inhA+rpoB mutation or katG+rpoB mutation. The mRNA relative expression of sigma factor was detected by fluorescence quantitative PCR, and the ratio of sigma factor mRNA relative expression between the experimental strain and the standard strain >2 was used to screen for highly expressed sigma factor. The differences in sigma factor mRNA relative expression and high expression rate between drug-resistant gene mutant strains and sensitive strains were analyzed. Results: Thirty sensitive strains and 90 drug-resistant strains were included. Among them, there were 16 strains with inhA mutation, 22 strains with katG mutation, 13 strains with rpoB mutation, 15 strains with inhA+rpoB mutation, and 24 strains with katG+rpoB mutation. Compared to the sigma factors of the sensitive strains, the mRNA expression levels of sigG and sigI in inhA-mutated strains, sigF, sigG, sigH, sigI, sigJ, and sigL in katG-mutated strains, and sigF, sigG, sigH, sigJ, and sigL in rpoB-mutated, inhA+rpoB-mutated, and katG+rpoB-mutated strains were significantly higher (all P<0.05). Additionally, the high-expression rates of sigI in inhA-mutated strains, sigF, sigG, sigI, sigJ, and sigL in katG-mutated and inhA+rpoB-mutated strains, and sigF, sigG, sigH, sigJ, and sigL in rpoB-mutated and katG+rpoB-mutated strains were also higher (all P<0.05). Conclusion Compared to sensitive MTB strains, sigI showed higher relative expression of mRNA and high-expression rate in inhA-mutated strains, and sigF, sigG, sigJ, and sigL had higher mRNA relative expression and high-expression rates in katG-mutated, rpoB-mutated, and multi-drug-resistant strains.

Cardiac fibrosis is characterized by an elevated amount of extracellular matrix (ECM) within the heart. However, the persistence of cardiac fibrosis ultimately diminishes contractility and precipitates cardiac dysfunction. Circular RNAs (circRNAs) are emerging as important regulators of cardiac fibrosis. Here, we elucidate the functional role of a specific circular RNA CELF1 in cardiac fibrosis and delineate a novel feedback loop mechanism. Functionally, circ-CELF1 was involved in enhancing fibrosis-related markers' expression and promoting the proliferation of cardiac fibroblasts (CFs), thereby exacerbating cardiac fibrosis. Mechanistically, circ-CELF1 reduced the ubiquitination-degradation rate of BRPF3, leading to an elevation of BRPF3 protein levels. Additionally, BRPF3 acted as a modular scaffold for the recruitment of histone acetyltransferase KAT7 to facilitate the induction of H3K14 acetylation within the promoters of the Celf1 gene. Thus, the transcription of Celf1 was dramatically activated, thereby inhibiting the subsequent response of their downstream target gene Smad7 expression to promote cardiac fibrosis. Moreover, Celf1 further promoted Celf1 pre-mRNA transcription and back-splicing, thereby establishing a feedback loop for circ-CELF1 production. Consequently, a novel feedback loop involving CELF1/circ-CELF1/BRPF3/KAT7 was established, suggesting that circ-CELF1 may serve as a potential novel therapeutic target for cardiac fibrosis.

Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans ; Denture, Complete ; Computer-Aided Design ; Denture Design/methods* ; Consensus ; Printing, Three-Dimensional

Objective: To analyze the relationship between parental psychological control and Internet Gaming Disorder (IGD) among junior high school students, so as to provide evidence for preventing IGD development in adolescents. Methods: From August 2019 to February 2020, a survey was conducted among 1 169 junior high school students from three middle schools in Xian using stratified cluster sampling. The Parental Psychological Control Scale and IGD Scale were administered to assess parental psychological control and IGD prevalence. Univariate and binary Logistic regression analyses were used to explore IGD risk factors and their correlation with parental psychological control. Results: The detection rate of IGD in middle school students was 19.9%(184/1 169). Multivariate Logistic regression revealed that compared to those with lower parental psychological control scores(≤21 points), students with higher parental psychological control scores (>21 points) had a higher risk of IGD (OR=1.82, 95%CI=1.21-2.74), a 1.58fold higher risk of selfperceived gaming addiction (95%CI=1.07-2.30), as well as reduced likelihood of seeking external help to reduce gaming time (OR=0.66, 95%CI=0.47-0.94) (P<0.05). Conclusions Parental psychological control may elevate the risks of IGD and selfperceived addiction while diminishing proactive helpseeking behaviors to reduce gaming time. Parents should enhance communication with adolescents and provide positive guidance to mitigate potential gamingrelated harms.

Objective:This study aimed to compare short-chain fatty acid (SCFA) levels in saliva between patients with laryngopharyngeal reflux disease (LPRD) and healthy controls, and to explore the relationship between these SCFAs and the salivary microbiota.Methods:A retrospective case-control study was conducted, enrolling 36 patients with laryngopharyngeal reflux disease (LPRD) who visited the Department of Otorhinolaryngology Head and Neck Surgery, the Eighth Medical Center, Chinese PLA General Hospital between February and November 2023. All patients were diagnosed via pharyngeal pH monitoring. The LPRD group included 30 males and 6 females, aged 20-53 years (30.61±7.83 years). In addition, 39 healthy volunteers were recruited as the control group, comprising 25 males and 14 females, aged 18–58 years (28.64±7.97 years). Unstimulated mixed saliva samples were collected from all participants. Concentrations of eight SCFAs (acetic acid, propionic acid, isobutyric acid, butyric acid, valeric acid, isovaleric acid, hexanoic acid, and heptanoic acid) in saliva were quantified using gas chromatography-mass spectrometry (GC-MS). Salivary DNA was extracted, followed by amplification and sequencing of the 16S rRNA gene to analyze the microbiota composition at the genus level. The SCFA concentrations and the differences in bacterial species between the LPRD and control groups were compared, and the correlation between SCFA concentrations and the relative abundance of different bacterial genera in the salivary microbiota was analyzed. All statistical analyses were performed using R version 3.6.1 and SPSS version 26.0, while, microbiome analyses were conducted using R language.Results:Salivary hexanoic acid concentration was significantly higher in the LPRD group than in the control group [(29.50±19.61) ng/ml vs. (10.15±3.65) ng/ml; t=-2.72, P<0.05]. Significant differences in the relative abundance of 17 bacterial genera were observed between the two groups ( P<0.05), including Prevotella, Butyrivibrio, Streptococcus, and Actinomyces. Correlation analysis revealed that hexanoic acid concentration was significantly positively correlated with the abundance of Butyrivibrio (γ=0.73, P<0.05) and Streptococcus (γ=0.78, P<0.05), while showing a significant negative correlation with Actinomyces (γ=-0.73, P<0.05). Conclusion:Elevated salivary hexanoic acid levels may be associated with the development of LPRD. Dysbiosis of the salivary microbiota might contribute to LPRD pathogenesis by altering the concentrations of SCFA, particularly hexanoic acid.

Objective:To evaluate clinical outcomes of occlusion-guided vascularized folded fibula flap reconstruction with delayed implant restoration for mandibular defects after benign tumor resection.Methods:A total of 12 patients with benign mandibular tumors underwent free folded fibula flap reconstruction at the First Affiliated Hospital of Bengbu Medical University between January 2020 and December 2023, including 7 males and 5 females, aged 21-52 years. Six months after mandibular reconstruction, the internal fixation titanium plates were removed, and dental implants were placed using a preoperatively fabricated occlusal guide, followed by second-stage implant surgery and prosthetic restoration. Mandibular CT scans were obtained 6 months after reconstruction to compare the fitting accuracy between the preoperative virtual design and the actual reconstructed mandible. The implant stability quotient (ISQ) was measured 3 months after implant placement. Masticatory efficiency and Enneking lower limb function scores were evaluated at the following time points: before tumor surgery (T1), before implant placement (T2), 6 months (T3) and 9 months (T4) after implant crown restoration. One-way repeated measures ANOVA was used to analyze the masticatory efficiency and lower limb function scores.Results:The free folded fibula grafts were successfully performed via an intraoral approach in all 12 patients, with a 100% of survival rate. Mandibular defects included Brown class I in 6 cases, class II in 2 cases, and class III in 4 cases. A total of 42 implants were placed with successful osseointegration. The ISQ measured at 3 months post-placement was 64.10±4.18. At 6 months postoperatively, morphological analysis comparing the preoperative virtual surgical design with the actual postoperative reconstructed mandible revealed a reconstruction accuracy of 84.27%±4.23%. Significant differences were observed in Enneking scores and masticatory efficiency across all four time points (all P<0.001). Masticatory function showed significant improvement at T4 compared that at T2 [(88.06±3.66)% vs. (65.44±3.82)%, P<0.05]. Conclusion:Occlusal function-guided mandibular reconstruction with vascularized folded fibula flap after removal of benign mandibular tumors is a reliable method, which is associated with minimal donor-site morbidity and enables patients to restore precise occlusion and to achieve favorable masticatory efficiency.