Objective To explore the predictive effect of serum 25-hydroxyvitamin D3 [25(OH)D3] and blood lipid metabolism indexes on the occurrence of osteoporosis in type 2 diabetes mellitus (T2DM). Methods Totally 98 patients with T2DM in the hospital from January 2022 to January 2024 were classified into osteoporosis group (38 cases) and non-osteoporosis group (60 cases) by means of concurrent osteoporosis status. The levels of serum 25(OH)D3 and blood lipid metabolism indexes [high density lipoprotein (HDL), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), VLDL] were measured in study subjects. The association of serum 25(OH)D3 and blood lipid metabolism indexes with osteoporosis was explored by Logistic regression analysis. The predictive value of serum 25(OH)D3 and blood lipid metabolism indexes on osteoporosis was analyzed by receiver operating characteristic curve (ROC). Results Serum 25(OH)D3 and HDL levels in the osteoporosis group were lower while TG and LDL levels were higher than those in the non-osteoporosis group (P<0.05). The differences in the levels of TC and VLDL were insignificant between groups (P>0.05). After logistic regression analysis, the levels of serum 25(OH)D3, HDL, TG and LDL were closely related to the occurrence of osteoporosis (P<0.05). ROC curve indicated that the area under the curve (AUC), sensitivity and specificity of combined prediction of osteoporosis by serum 25(OH)D3, HDL, TG, and LDL were 0.943, 92.11% and 85.00%, and the efficiency of combined prediction was better than that of each index alone (P<0.05). Conclusion The levels of serum 25(OH)D3, HDL, TG and LDL in T2DM are closely related to osteoporosis. Early combined monitoring of the indicators can provide reference value for clinical prediction of osteoporosis occurrence in patients with T2DM.

Scientific bibliometric tools were employed to conduct a visual analysis of literature related to neuroimaging ethics， revealing information such as the core authors and key topics in the field of neuroimaging ethics. From the perspective of neuroethics， it analyzed the research topics of neuroimaging ethics， encompassing the impacts of neuroimaging technologies on foundational research in morality， as well as the ethical issues arising from medical and non-medical applications of neuroimaging technologies. Among these， ethical issues in the medical application of neuroimaging technologies included general ethical concerns such as security challenges， privacy protection， and informed consent in neuroimaging practices， together with specific ethical dilemmas， including ethical challenges in assessing disorders of consciousness， incidental findings， and other aspects. Furthermore， this paper explored the frontier trends in neuroimaging ethics， aiming to provide certain ethical guidance for the advancement and application of neuroimaging technologies.

ObjectiveTo investigate the effects of different antiplatelet therapy regimens （aspirin versus clopidogrel at specific doses） on cognitive function， blood biomarkers and brain imaging biomarkers when used prophylactically in patients with cerebral small vessel disease （CSVD）. MethodsA randomized controlled trial was conducted involving 160 CSVD patients who were randomly assigned to four groups： aspirin group （ASA）， low-dose clopidogrel group （CLOP-50）， standard-dose clopidogrel group （CLOP-75）， and control group （HC）. Cognitive function ［auditory verbal learning test-immediate recall （AVLT-IR）， auditory verbal learning test-short-delay recall （AVLT-SDR）， auditory verbal learning test-long-delay recall （AVLT-LDR）， hamilton anxiety rating scale （HAMA）， and hamilton depression rating scale （HAMD）， ADL（activities of daily living scale ）， （ascertain dementia 8-item questionnaire，AD8）］， blood biomarkers ［platelet count （PLT） and mean platelet volume （MPV）］， and CSVD-related imaging biomarkers ［white matter hyperintensities （WMH） and cerebral microbleeds （CMB）］ were assessed in all groups at baseline and at the 6-month follow-up. ResultsAfter 6 months of treatment， within-group comparisons showed that， compared with baseline， the ASA group had significantly increased scores on the AVLT immediate recall （AVLT-IR）， short-delay recall （AVLT-SDR）， and long-delay recall （AVLT-LDR） （P<0.05）. The CLOP-75 group showed significantly decreased HAMA and HAMD scores （P<0.05）， along with a significant increase in AVLT-LDR scores （P<0.05）. The number of CMBs increased from baseline in both the ASA and CLOP-75 groups （P<0.05）， whereas no statistically significant changes in blood biomarkers were observed in either group. By contrast， the CLOP-50 and HC groups showed no significant changes in cognitive function， blood biomarkers， or CSVD-related imaging biomarkers compared with baseline （all P<0.05）. Comparisons between groups showed that the AVLT-LDR scores and the number of CMBs increased faster in the ASA group than in the HC group （β=-0.187， P=0.04； β=-0.805， P<0.001）. In addition， the rate of CMB increase was also faster in the ASA group than in the CLOP-50 group （β=-0.695， P<0.01）. The ADL scores increased faster in the HC group than in the ASA group （β=0.170， P=0.02）. The AD8 scores decreased faster in the CLOP-75 group than in the HC group （β=-0.128， P=0.04）， but the rate of CMB increase in the CLOP-75 group was also faster than that in the HC group （β=0.604， P=0.04）. ConclusionIn CSVD patients， aspirin 100 mg or clopidogrel 75 mg improves cognitive function but increases the risk of cerebral hemorrhage. Clopidogrel 50 mg shows no short-term clinical benefit or imaging improvement.

Abstract The cooccurrence of multi disease among children and adolescents has become increasingly prominent, necessitating a shift from "single disease separate treatment" to "multi disease co prevention". Focusing on four common health problems in children and adolescents, namely, myopia, depression, overweight/obesity, and spinal abnormalities, the paper systematically reviews the association between four categories of factors, society, environment, family, and individual behavior, and the co occurrence of the aforementioned health problems. The findings indicate that particulate matter 2.5 exposure, light at night, physical inactivity, excessive screen time, and unhealthy diet constitute the primary cross dimensional risk network. Based on these findings, the paper proposes a collaborative action framework involving family, school, and society, emphasizing systematic strategies ranging from upstream environmental governance to downstream behavioral intervention, so as to provide evidence for the practice and policy making of multi disease co-prevention in children and adolescents.

Dendritic cells (DCs) serve as the primary antigen-presenting cells in autoimmune diseases, like rheumatoid arthritis (RA), and exhibit distinct signaling profiles due to antigenic diversity. Type II collagen (CII) has been recognized as an RA-specific antigen; however, little is known about CII-stimulated DCs, limiting the development of RA-specific therapeutic interventions. In this study, we show that CII-stimulated DCs display a preferential gene expression profile associated with migration, offering a new perspective for targeting DC migration in RA treatment. Then, saikosaponin D (SSD) was identified as a compound capable of blocking CII-induced DC migration and effectively ameliorating arthritis. Optineurin (OPTN) is further revealed as a potential SSD target, with Optn deletion impairing CII-pulsed DC migration without affecting maturation. Function analyses uncover that OPTN prevents the proteasomal transport and ubiquitin-dependent degradation of C-C chemokine receptor 7 (CCR7), a pivotal chemokine receptor in DC migration. Optn-deficient DCs exhibit reduced CCR7 expression, leading to slower migration in CII-surrounded environment, thus alleviating arthritis progression. Our findings underscore the significance of antigen-specific DC activation in RA and suggest OPTN is a crucial regulator of CII-specific DC migration. OPTN emerges as a promising drug target for RA, potentially offering significant value for the therapeutic management of RA.

BACKGROUND:Primary osteoporosis has a high incidence,but the pathogenesis is not fully understood.Currently,there is a lack of effective early screening indicators and treatment programs. OBJECTIVE:To further explore the mechanism of primary osteoporosis through comprehensive bioinformatics analysis. METHODS:The primary osteoporosis data were obtained from the gene expression omnibus(GEO)database,and the differentially expressed genes were screened for Gene Ontology(GO)function and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.In addition,the differentially expressed genes were subjected to protein-protein interaction network to determine the core genes related to primary osteoporosis,and the least absolute shrinkage and selection operator algorithm was used to identify and verify the primary osteoporosis-related biomarkers.Immune cell correlation analysis,gene enrichment analysis and drug target network analysis were performed.Finally,the biomarkers were validated using qPCR assay. RESULTS AND CONCLUSION:A total of 126 differentially expressed genes and 5 biomarkers including prostaglandins,epidermal growth factor receptor,mitogen-activated protein kinase 3,transforming growth factor B1,and retinoblastoma gene 1 were obtained in this study.GO analysis showed that differentially expressed genes were mainly concentrated in the cellular response to oxidative stress and the regulation of autophagy.KEGG analysis showed that autophagy and senescence pathways were mainly involved.Immunoassay of biomarkers showed that prostaglandins,retinoblastoma gene 1,and mitogen-activated protein kinase 3 were closely related to immune cells.Gene enrichment analysis showed that biomarkers were associated with immune-related pathways.Drug target network analysis showed that the five biomarkers were associated with primary osteoporosis drugs.The results of qPCR showed that the expression of prostaglandins,epidermal growth factor receptor,mitogen-activated protein kinase 3,and transforming growth factor B1 in the primary osteoporosis sample was significantly increased compared with the control sample(P<0.001),while the expression of retinoblastoma gene 1 in the primary osteoporosis sample was significantly decreased compared with the control sample(P<0.001).Overall,the study screened and validated five potential biomarkers of primary osteoporosis,providing a reference basis for further in-depth investigation of the pathogenesis,early screening and diagnosis,and targeted treatment of primary osteoporosis.

Objective:To explore the relationship between the morphology of the carotid siphon, its related risk factors, and cerebral blood flow perfusion in patients with arteriosclerotic cerebral small vessel disease (aCSVD), and provide imaging evidence for the etiology of aCSVD.Methods:A total of 130 aCSVD patients hospitalized in the Department of Neurology of the First People′s Hospital of Hefei from March 2022 to June 2024, all of whom underwent multimodal imaging assessments, were enrolled. The baseline data were collected, and the morphology of the carotid siphon was visually evaluated using post-processing of head and neck computed tomography angiography (CTA), which was categorized into U-type ( n=63), C-type ( n=32), and V-type ( n=35). Calcification degree was semi-quantitatively assessed based on transverse CTA images. Cerebral perfusion was measured using magnetic resonance arterial spin labeling. The relationship between different siphon segment morphologies, calcification degrees, their risk factors, and cerebral blood flow perfusion was analyzed using analysis of variance and multinomial Logistic regression. Results:Univariate analysis of the 3 siphon types showed significant differences in low-density lipoprotein cholesterol [U-type (2.44±0.84) mmol/L,V-type (2.21±0.57) mmol/L, C-type (2.89±1.07) mmol/L, F=5.578, P=0.005], calcification degree [Among the 63 cases in the U-type group, 19 cases (30.15%) had mild calcification, 20 cases (31.75%) had moderate calcification, and 24 cases (38.10%) had severe calcification; among the 35 cases in the V-type group, 20 cases (57.14%) had mild calcification, 10 cases (28.57%) had moderate calcification, and 5 cases (14.29%) had severe calcification; among the 32 cases in the C-type group, 12 cases (37.50%) had mild calcification, 14 cases (43.75%) had moderate calcification, and 6 cases (18.75%) had severe calcification; χ2=13.092, P=0.011], and total aCSVD load [modified aCSVD load score: U-type 4.00(1.00, 4.00),V-type 3.00(1.00, 4.00),C-type 2.00(2.00, 4.00), H=9.997, P=0.007]. Multivariate Logistic regression revealed that patients with U-shaped siphons had a significantly higher overall aCSVD load than those with C-shaped siphons, with a regression coefficient of 0.728, and a statistically significant difference ( OR=2.070 ,95% CI 1.026-4.178, P=0.042). Additionally, total brain and white matter cerebral blood flow were decreased in patients with U-type siphons compared to those with C-type and V-type, primarily involving bilateral superior frontal gyri, left orbital frontal gyrus, and left straight gyrus regions (false discovery rate correction, P<0.05). Conclusions:The imaging manifestations of aCSVD are closely related to the shape of the internal carotid artery siphon.The U type siphon is more likely to lead to hemodynamic changes, resulting in decreased global and regional cerebral blood flow, and demonstrating a higher overall burden of aCSVD, which has certain clinical reference value for assessing the etiology of aCSVD.

Objective To develop an assessment scale for post-intensive care syndrome in pediatrics(PICS-p)and evaluate its reliability and validity,aiming to provide a scientifically sound and feasible tool for clinical assessment.Methods Based on the PICS-p conceptual framework,combined with literature review,semi-structured interviews,and Delphi expert consultation,a preliminary scale was developed.From June to December 2023,a survey was conducted among 330 pediatric patients who were discharged from a tertiary children's hospital in Hangzhou,followed by a two-week retest with 30 children to assess the reliability and validity of the scale.Results Finally 304 children completed the survey.The Post-Intensive Care Syndrome Scale for Children consists of 4 dimensions of physical dysfunction,cognitive dysfunction,psychological dysfunction and social dysfunction,with a total of 29 entries,with a cumulative variance contribution of 61.705％.The content validity index for individual items ranged from 0.800 to 1.000,and the content validity index for the scale as a whole was 0.98.The dimensions of the scale showed positive correlations with the Functional Status Scale(r=0.438-0.581,P＜0.001).The overall Cronbach's α coefficient of the scale was 0.847;the split-half reliability was 0.868;the test-retest reliability was 0.832.Conclusion The scale demonstrates good reliability and validity,and it is suitable for assessing the severity of PICS-p in pediatric patients discharged from the PICU.

Objective To explore the evaluation value of thyroid function indicators[thyroid stimulating hormone(TSH),free thyroxine(FT4),free triiodothyronine(FT3)]combined with transcranial Doppler ultrasound(TCD)and carotid ultrasound in the assessment of vascular stenosis in atherosclerotic cerebral infarction(ASCI),providing a reference for clinical targeted treatment.Methods A total of 182 patients with ASCI admitted to Handan Frist Hospital from October 2021 to September 2023 were selected and all of them underwent TCD,carotid artery ultrasound and thyroid function examination.Digital subtraction angiography was used as the gold standard to analyze the evaluation effect of TCD and carotid artery ultrasound combined with TSH,FT4 and FT3 in vascular stenosis of ASCI.Results Among the 182 patients with ASCI,DSA confirmed 64 cases(35.16％)with mild internal carotid artery stenosis,69 cases(37.91％)with moderate stenosis,29 cases(15.93％)with severe stenosis,and 20 cases(10.99％)with complete occlusion.There was no statistically significant difference in clinical data among groups with different degrees of vascular stenosis(P＞0.05).The peak systolic velocity(PSV)and end-diastolic volume(EDV)of the internal carotid artery in different groups with different degrees of vascular stenosis showed an increasing trend with the severity of vascular stenosis,while the pulse index(PI),resistance index(RI),and diameter(D)showed a decreasing trend(P＜0.05).In different groups with different degrees of vascular stenosis,TSH and FT4 levels increased with the severity of stenosis,while FT3 levels decreased(P＜0.05).TSH and FT4 were positively correlated with the degree of vascular stenosis,while FT3 was negatively correlated(P＜0.05).TSH and FT4 were positively correlated with PSV and EDV,and negatively correlated with RI,PI,and D.FT3 was positively correlated with RI,PI,and D,and negatively correlated with PSV and EDV(P＜0.05).The combined evaluation of RI,PI,D,PSV,EDV,TSH,FT4,and FT3 yielded the highest area under the curve(AUC)value of 0.941 for assessing ASCI vascular stenosis(P＜0.05).Conclusion The combination of TCD,carotid ultrasound,and thyroid function tests have high value in the assessment of ASCI vascular stenosis.The joint evaluation of RI,PI,D,PSV,EDV,TSH,FT4 and FT3 is beneficial for diagnosing different degrees of vascular stenosis,providing a reference for clinical treatment.r clinical treatment.

Objective: To explore the brain-predicted age difference (Brain-PAD) in patients with type 2 diabetes mellitus (T2DM) by a machine learning prediction model based on structural magnetic resonance ( sMRI) in the Southwest University Adult Lifespan Dataset (SALD) , and to reveal the relationship between Brain-PAD and dura- tion of T2DM and cognition . Methods: Group comparisons about demographic variables and cognitive function were conducted respectively in local database of 104 T2DM patients and 83 healthy controls (HC) . The prediction model via Gaussian process regression (GPR) was constructed by training sMRI data of 329 healthy volunteers in SALD , then its performance was validated and evaluated . Furthermore , Brain-PAD ( predicted age-chronological age) in the local database was calculated . Group comparisons of Brain-PAD between T2DM patients and HCs were conducted by Mann-Whitney U test. Finally , Pearson correlation coefficient (r) was calculated between Brain-PAD and duration of disease and cognition . Results: Poor performance in auditory verbal learning test (AVLT)-delayed recall , AVLT-recognition , symbol digital modalities test (SDMT) (P < 0. 05) , and increased Brain-PAD were ob- served in T2DM patients , compared with HCs [1 . 619 ( - 4. 001 , 8. 272) years vs - 1 . 289 ( - 4. 128 , 4. 134) years , Z = 2. 056 , P = 0. 034] . Notably , the median of Brain-PAD in T2DM group was positive , indicating that the brain of T2DM patient maybe relatively “older”than his chronological age . Brain-PAD in T2DM group was as- sociated with performance in AVLT-immediate recall ( r = 0. 291 , P = 0. 003) , AVLT-delayed recall ( r = 0. 248 , P = 0. 011) , SDMT( r = 0. 376 , P = 0. 001) and trail making test (TMT)-A ( r = - 0. 206 , P = 0. 036) . However , the relationships between Brain-PAD and duration of T2DM were not explored . Conclusion Decreased cognitive function in patients with T2DM is demonstrated in this study . The machine learning prediction model based on sMRI supports the identification of brain aging objectively in patients with T2DM .