Objective: To examine the association between frailty and cognitive function in middle-aged and elderly populations using group-based trajectory model (GBTM), so as to provide insights into the prevention and intervention strategies for cognitive impairment in this population. Methods: From 2011 to 2018, data of demographic information and lifestyle behavior for individuals aged ≥45 years were collected from the China Health and Retirement Longitudinal Study. Frailty status was assessed using the frailty index, and cognitive function was evaluated using the Chinese version of the Mini-Mental State Examination. GBTM was applied to establish frailty trajectories based on the frailty index from 2011 to 2018 to analyze the trajectory of frailty changes. The association between frailty and cognitive function was analyzed using multiple linear regression model. Results: A total of 4 809 participants were included, with a mean age of (56.63±7.73) years. There were 2 621 males (54.50%) and 2 188 females (45.50%). The 2018 survey identified 574 individuals (11.94%) with cognitive function decline. GBTM identified four distinct frailty trajectories including the normal and stable group (69.27%), recovering frail group (9.32%), progressing pre-frail group (16.20%) and persistently frail group (5.22%). The mean cognitive funtion scores for these groups were (17.24±4.83) (16.38±5.53) (15.74±5.20) (15.02±5.11) points, respectively. The differences in cognitive funtion scores across groups were statistically significant (P<0.05). Multiple linear regression analysis showed, after adjusting for confounding factors such as gender, age, nighttime sleep duration, and smoking, compared with the normal and stable group, the cognitive function decline risk was higher in the frailty recovery group (β=-0.581), the pre-frail progression group (β=-0.583), and the persistently frail group (β=-0.662) compared with the non-frail stable group (all P<0.05). Conclusions There are four groups of changes in frailty among the middle-aged and elderly populations. Compared with the normal and stable group, the groups experiencing progression, persistence, and recovery of frailty exhibit a more pronounced risk of cognitive funtion decline.

OBJECTIVES: To investigate the correlation between bone mineral density (BMD) and bone metabolic markers in preschool children and the influencing factors for BMD, and to provide a clinical basis for promoting bone health in children. METHODS: A retrospective analysis was performed for the data of 127 preschool children who underwent physical examination in the Department of Child Health Care of the First Affiliated Hospital of Xinjiang Medical University, from June to December 2024. BMD and bone metabolic markers were measured, and physical examination was performed. A multiple linear regression analysis was used to investigate the effect of general information on BMD Z-score in preschool children. Spearman's rank correlation test was used to investigate the correlation of BMD Z-score with 25-hydroxyvitamin D (25-OHD), serum bone Gla protein (BGP), and parathyroid hormone (PTH). RESULTS: BMD Z-score significantly differed by ethnicity, weight category, and height category (all P<0.05). The multiple linear regression analysis indicated that weight and height significantly influenced BMD Z-score (P<0.05), whereas sex, age, ethnicity, and parental education level did not (P>0.05). In children, BMD Z-score was positively correlated with 25-OHD level (r_s=0.260, P<0.001) and BGP level (r_s=0.075, P=0.025) and was negatively correlated with PTH level (r_s=-0.043, P=0.032). CONCLUSIONS Weight, height, 25-OHD, BGP, and PTH are influencing factors for BMD in preschool children. In clinical practice, combined measurement of bone metabolic markers may provide a scientific basis for early identification of children with abnormal BMD and prevention of osteoporosis and osteomalacia.
Humans ; Bone Density ; Child, Preschool ; Female ; Male ; Retrospective Studies ; Vitamin D/blood* ; Parathyroid Hormone/blood* ; Biomarkers/blood* ; Osteocalcin/blood* ; Bone and Bones/metabolism* ; Calcium-Binding Proteins/blood* ; Linear Models ; Matrix Gla Protein ; Extracellular Matrix Proteins/blood* ; Body Weight ; Infant

OBJECTIVE: To explore the biomechanical characteristics and clinical application effects of three-dimensional (3D) printed osteotomy guide plate combined with Ilizarov technique in the treatment of rigid clubfoot. METHODS: A retrospective analysis was performed on the clinical data of 11 patients with rigid clubfoot who met the inclusion criteria and were admitted between January 2019 and December 2024. There were 6 males and 5 females, aged 21-60 years with an average of 43.2 years. Among them, 5 cases were untreated congenital rigid clubfoot, 4 cases were recurrent rigid clubfoot after previous treatment, and 2 cases were rigid clubfoot due to disease sequelae. All 11 patients first received slow distraction using Ilizarov technique combined with circular external fixator until the force lines of the foot and ankle joint were basically normal. Then, 1 male patient aged 24 years was selected, and CT scanning was used to obtain imaging data of the ankle joint and foot. A 3D finite element model was established and validated using the plantar stress distribution nephogram of the patient. After validation, the biomechanical changes of the tibiotalar joint under the same load were simulated after triple arthrodesis and fixation. The optimal correction angle of the hindfoot was determined to fabricate 3D-printed osteotomy guide plates, and all 11 patients underwent triple arthrodesis using these guide plates. The functional recovery was evaluated by comparing the American Orthopaedic Foot and Ankle Society (AOFAS) score, International Clubfoot Study Group (ICFSG) score, and 36-Item Short Form Survey (SF-36) score before and after operation. RESULTS: Finite element analysis showed that the maximum peak von Mises stress of the tibiotalar joint was at hindfoot varus 3° and the minimum at valgus 6°; the maximum peak von Mises stress of the 3 naviculocuneiform joints under various conditions appeared at lateral naviculocuneiform joint before operation, and the minimum appeared at lateral naviculocuneiform joint at neutral position 0°; the maximum peak von Mises stress of the 5 tarsometatarsal joints under various conditions appeared at the 2nd tarsometatarsal joint at hindfoot neutral position 0°, and the minimum appeared at the 1st tarsometatarsal joint at valgus 6°. Clinical application results showed that the characteristics of clubfoot deformity observed during operation were consistent with the preoperative 3D reconstruction model. All 11 patients were followed up 8-24 months with an average of 13.1 months. One patient had postoperative incision exudation, which healed after dressing change; the remaining patients had good incision healing. All patients achieved good healing of the osteotomy segments, with a healing time of 3-6 months and an average of 4.1 months. At last follow-up, the AOFAS score, SF-36 score, and ICFSG score significantly improved when compared with those before operation ( P<0.05). CONCLUSION The 3D-printed osteotomy guide plate combined with Ilizarov technique has favorable biomechanical advantages in the treatment of rigid clubfoot, with significant clinical application effects. It can effectively improve the foot function of patients and achieve precise and personalized treatment.
Humans ; Clubfoot/diagnostic imaging* ; Printing, Three-Dimensional ; Male ; Osteotomy/instrumentation* ; Female ; Ilizarov Technique/instrumentation* ; Adult ; Retrospective Studies ; Biomechanical Phenomena ; Middle Aged ; Bone Plates ; Young Adult ; Finite Element Analysis ; Treatment Outcome ; Ankle Joint/physiopathology* ; Tomography, X-Ray Computed ; External Fixators

Objective To explore the therapeutic effect of injectable plateletrich fibrin(i-PRF)as a scaffold for pulp regeneration surgery in young permanent teeth with pulp necrosis.Methods Sixty young children with permanent tooth pulp necrosis who underwent pulp regeneration surgery in the Department of Stomatology of our hospital from March 2021 to October 2022 were included.The differ-entiation between the i-PRF group(33 cases)and the blood clot group(27 cases)was based on the different scaffold materials used dur-ing the treatment process.Follow up for 1 year,cone beam CT(CBCT)was used to measure the apical foramen diameter,dentin wall thickness,root length,root canal area,and root area of the affected tooth before treatment,at 3,6,9 and 12 months of treatment.The increase in root length,increase in dentin wall thickness,decrease in apical foramen diameter,increase in root area,decrease in root canal area,and clinical data between the two groups of patients before and after treatment were compared.The tooth color,pulp vitali-ty,and tooth eruption height of two groups of patients were recorded before and after treatment.Results At 9 and 12 months post sur-gery follow-up,the root length,dentin wall thickness,and root area of the i-PRF group were higher than those of the blood clot group(P＜0.05).According to the results of the last follow-up,it was calculated that the increase in root length,dentin wall thickness,and root area in the i-PRF group were higher than those in the blood clot group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the changes in tooth color,positive pulp vitality,and eruption height between the two groups of patients(P＞0.05).Conclusion The use of blood clots and i-PRF as scaffolds for pulp regeneration in the treatment of young permanent tooth pulp necrosis has been proven to be effective,but the use of i-PRF as a scaffold is more effective in promoting root growth and increasing dentin wall thickness.

Objective·To construct truncations of CYLD,and to preliminarily analyze their effects on the proliferation of gastric cancer cells.Methods·TCGA,GTEx,and Kaplan-Meier Plotter databases were used to analyze the differences in the expression levels of CYLD between gastric cancer tissues and normal tissues,and their relationship with the prognosis of gastric cancer patients.Immunohistochemistry and Western blotting were used to detect the expression of CYLD in cancer tissues and adjacent noncancerous tissues.Western blotting and qRT-PCR were used to analyze the protein and mRNA expression levels of CYLD in gastric mucosal epithelial cells and gastric cancer cells.According to the sequence and structural characteristics of CYLD gene,primers were designed to construct its truncations.Their expression was detected and identified by agarose gel electrophoresis and Western blotting,and localization was observed by immunofluorescence.In the human gastric adenocarcinoma cells(AGS)with CYLD knockdown,blank NC was added to the control group,and the full-length CYLD,enzyme-inactivated mutant,and three truncated plasmids were added to the experimental group.The proliferation changes of cells in each group were detected by CCK-8 and plate cloning assays.Co-immunoprecipitation,deubiquitination,and Western blotting assays were performed to examine the binding ability of full-length CYLD,the enzyme-inactivated mutant,and the truncated variants to CAMK2A,the level of CAMK2A deubiquitination,and the expression of STAT3 and p-STAT3 proteins.Results·CYLD expression in normal gastric tissues and cells was significantly higher than in gastric cancer tissues and cells,and the prognosis of patients with high expression of CYLD was better.The truncations of human CYLD were successfully constructed,and full length CYLD,enzyme-inactivated mutant,and truncations were mainly localized in the cytoplasm.Knockdown of CYLD in gastric cancer cells significantly enhanced the proliferative ability of gastric cancer cells.Reconstitution of CYLD-knockdown cells with CYLD-WT,or truncated variants containing the CAP3 or USP domains significantly inhibited the proliferation of gastric cancer cells.In addition,CYLD bound to CAMK2A mediated K63 deubiquitination modification,and inhibited CAMK2A-induced phosphorylation of STAT3.Conclusion·The human CYLD truncation plasmids are successfully constructed,and the full length CYLD and its CAP3 and USP segments significantly inhibit the proliferation of gastric cancer cells.

Objective To explore the therapeutic effect of injectable plateletrich fibrin(i-PRF)as a scaffold for pulp regeneration surgery in young permanent teeth with pulp necrosis.Methods Sixty young children with permanent tooth pulp necrosis who underwent pulp regeneration surgery in the Department of Stomatology of our hospital from March 2021 to October 2022 were included.The differ-entiation between the i-PRF group(33 cases)and the blood clot group(27 cases)was based on the different scaffold materials used dur-ing the treatment process.Follow up for 1 year,cone beam CT(CBCT)was used to measure the apical foramen diameter,dentin wall thickness,root length,root canal area,and root area of the affected tooth before treatment,at 3,6,9 and 12 months of treatment.The increase in root length,increase in dentin wall thickness,decrease in apical foramen diameter,increase in root area,decrease in root canal area,and clinical data between the two groups of patients before and after treatment were compared.The tooth color,pulp vitali-ty,and tooth eruption height of two groups of patients were recorded before and after treatment.Results At 9 and 12 months post sur-gery follow-up,the root length,dentin wall thickness,and root area of the i-PRF group were higher than those of the blood clot group(P＜0.05).According to the results of the last follow-up,it was calculated that the increase in root length,dentin wall thickness,and root area in the i-PRF group were higher than those in the blood clot group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the changes in tooth color,positive pulp vitality,and eruption height between the two groups of patients(P＞0.05).Conclusion The use of blood clots and i-PRF as scaffolds for pulp regeneration in the treatment of young permanent tooth pulp necrosis has been proven to be effective,but the use of i-PRF as a scaffold is more effective in promoting root growth and increasing dentin wall thickness.

The frequent challenges encountered in spinal surgeries utilizing pedicle screws for osteoporotic patients include inadequate fixation strength and postoperative screw loosening or displacement, often requiring reinforcement or surgical revision. The bone cement-augmented technique, without altering the diameter, length, or material of the screws, can solidly enhance the stability of internal fixation and improve surgical efficacy. The bone cement types that are widely applied in clinical practice encompass Polymethyl Methacrylate (PMMA), Calcium Phosphate Cement (CPC), and their composite series.The bone cement reinforcement techniques are mainly divided into two categories: bone cement augmentation within pedicle screw pathway and hollow lateral-hole screw reinforcement. The technique of pedicle screw pathway bone cement augmentation significantly enhances the stability of internal fixation by pre-injecting bone cement into the pedicle screw pathway before inserting the screw. However, it poses potential risks such as difficulty in precisely controlling the distribution of bone cement and susceptibility to leakage. In comparison, hollow lateral-hole screw augmentation, through the optimization of bone cement injection techniques and screw design, not only augments screw stability but also effectively decreases the incidence of complications such as bone cement leakage, especially exhibiting outstanding performance in both primary and revision surgeries. For patients with severe osteoporosis or those requiring revision surgery due to compromised pedicle screw tracts, the bone cement-augmented cortical bone trajectory (CBT) exhibits favorable mechanical properties. By adjusting the screw placement pathway, it may potentially avoid the central venous sinus of the vertebra, thereby reducing the risk of bone cement leakage and embolism. However, further research is needed to confirm these findings. With the rapid development of robot-assisted pedicle screw placement technology, the precision and safety of spinal screws augmented with bone cement have been significantly enhanced, effectively minimizing surgical trauma and reducing the risk of complications. In the future, clinicians will make more scientific and objective selections of appropriate screw types and method of screw placement based on patients' bone quality, further reducing complications and adhering to the principle of personalized treatment. This will continuously enhance patient outcomes and prognosis, ultimately providing safer and more effective treatment options for patients.

Objective·To construct truncations of CYLD,and to preliminarily analyze their effects on the proliferation of gastric cancer cells.Methods·TCGA,GTEx,and Kaplan-Meier Plotter databases were used to analyze the differences in the expression levels of CYLD between gastric cancer tissues and normal tissues,and their relationship with the prognosis of gastric cancer patients.Immunohistochemistry and Western blotting were used to detect the expression of CYLD in cancer tissues and adjacent noncancerous tissues.Western blotting and qRT-PCR were used to analyze the protein and mRNA expression levels of CYLD in gastric mucosal epithelial cells and gastric cancer cells.According to the sequence and structural characteristics of CYLD gene,primers were designed to construct its truncations.Their expression was detected and identified by agarose gel electrophoresis and Western blotting,and localization was observed by immunofluorescence.In the human gastric adenocarcinoma cells(AGS)with CYLD knockdown,blank NC was added to the control group,and the full-length CYLD,enzyme-inactivated mutant,and three truncated plasmids were added to the experimental group.The proliferation changes of cells in each group were detected by CCK-8 and plate cloning assays.Co-immunoprecipitation,deubiquitination,and Western blotting assays were performed to examine the binding ability of full-length CYLD,the enzyme-inactivated mutant,and the truncated variants to CAMK2A,the level of CAMK2A deubiquitination,and the expression of STAT3 and p-STAT3 proteins.Results·CYLD expression in normal gastric tissues and cells was significantly higher than in gastric cancer tissues and cells,and the prognosis of patients with high expression of CYLD was better.The truncations of human CYLD were successfully constructed,and full length CYLD,enzyme-inactivated mutant,and truncations were mainly localized in the cytoplasm.Knockdown of CYLD in gastric cancer cells significantly enhanced the proliferative ability of gastric cancer cells.Reconstitution of CYLD-knockdown cells with CYLD-WT,or truncated variants containing the CAP3 or USP domains significantly inhibited the proliferation of gastric cancer cells.In addition,CYLD bound to CAMK2A mediated K63 deubiquitination modification,and inhibited CAMK2A-induced phosphorylation of STAT3.Conclusion·The human CYLD truncation plasmids are successfully constructed,and the full length CYLD and its CAP3 and USP segments significantly inhibit the proliferation of gastric cancer cells.

The frequent challenges encountered in spinal surgeries utilizing pedicle screws for osteoporotic patients include inadequate fixation strength and postoperative screw loosening or displacement, often requiring reinforcement or surgical revision. The bone cement-augmented technique, without altering the diameter, length, or material of the screws, can solidly enhance the stability of internal fixation and improve surgical efficacy. The bone cement types that are widely applied in clinical practice encompass Polymethyl Methacrylate (PMMA), Calcium Phosphate Cement (CPC), and their composite series.The bone cement reinforcement techniques are mainly divided into two categories: bone cement augmentation within pedicle screw pathway and hollow lateral-hole screw reinforcement. The technique of pedicle screw pathway bone cement augmentation significantly enhances the stability of internal fixation by pre-injecting bone cement into the pedicle screw pathway before inserting the screw. However, it poses potential risks such as difficulty in precisely controlling the distribution of bone cement and susceptibility to leakage. In comparison, hollow lateral-hole screw augmentation, through the optimization of bone cement injection techniques and screw design, not only augments screw stability but also effectively decreases the incidence of complications such as bone cement leakage, especially exhibiting outstanding performance in both primary and revision surgeries. For patients with severe osteoporosis or those requiring revision surgery due to compromised pedicle screw tracts, the bone cement-augmented cortical bone trajectory (CBT) exhibits favorable mechanical properties. By adjusting the screw placement pathway, it may potentially avoid the central venous sinus of the vertebra, thereby reducing the risk of bone cement leakage and embolism. However, further research is needed to confirm these findings. With the rapid development of robot-assisted pedicle screw placement technology, the precision and safety of spinal screws augmented with bone cement have been significantly enhanced, effectively minimizing surgical trauma and reducing the risk of complications. In the future, clinicians will make more scientific and objective selections of appropriate screw types and method of screw placement based on patients' bone quality, further reducing complications and adhering to the principle of personalized treatment. This will continuously enhance patient outcomes and prognosis, ultimately providing safer and more effective treatment options for patients.

Objective To analyze the latest research hotspots and development trends of hyperuricemia and cardiovascular diseases in the past 20 years by using CiteSpace software and VOSviewer software.Methods The Web of Science database was searched from January 2005 to July 2024 for the literature on hyperuricemia and cardiovascular diseases,and the keywords,authors,institutions,and countries were analyzed by CiteSpace software and VOSviewer software,and the network cooperation map was constructed.Results A total of 2344 articles written by 5844 authors from 75 countries and 1713 institutions were analyzed.The journal Nutrition Metabolism and Cardiovascular Diseases had published the most papers in this field,with a total of 36 articles.Scholar Johnson has published 19 papers in this field,ranking first.A total of 2678 keywords were included,and the keywords that identified the research frontier and continued through 2024 were"asymptomatic hyperuricemia""xanthine oxidoreductase""adults".Conclusion The literature published in the field of hyperuricemia and cardiovascular disease correlation from 2005 to 2024,are comprehensively summarize,and sort out the development trends and research hotspots in this field in the past 20 years,through bibliometrics and visual analysis,which is expected to provide a reference direction for researchers in this field for subsequent research.