Objective:To compare the accuracy and applicability of three adult height prediction methods based on artificial intelligence-assisted bone age assessment—the Bayley-Pinneau method(BP method), the Tanner-Whitehouse 3 method(TW3 method), and China 05 method—in girls.Methods:This bidirectional cohort study collected clinical data and 690 posteroanterior X-ray images of the left hand from 278 female children who underwent pubertal development assessments at Shenzhen Children′s Hospital between January 2014 and December 2020, with follow-up until adult height was reached. Adult height prediction was performed using BP, TW3, and China 05 methods on artificial intelligence-assisted bone age assessment.Results:The BP and TW3 methods overestimated adult height by(1.7±3.7) cm and(2.6±3.0) cm, respectively, while the China 05 method underestimated adult height by(2.3±3.5) cm. The proportion of PAH within±5 cm of FAH were 80.0% for the TW3 method, 77.0% for the BP method, and 74.2% for the China 05 method, with significant differences among them( P=0.038). Analysis of cases with prediction deviations>10 cm and subgroup comparisons revealed that the TW3 and BP methods were more likely to overestimate adult height in girls aged 6.0-<8.0 years, with delayed bone age, or in the prepubertal stage(all P<0.001). The China 05 method was more prone to underestimate adult height in those with advanced bone age( P<0.001). All three methods showed significantly greater prediction errors(absolute difference between PAH and FAH) in girls with early puberty compared to those with normal pubertal development(all P<0.05). Conclusions:The TW3 and BP methods tend to overestimate adult height in girls, while the China 05 method tends to underestimate it. Caution is warranted when predicting adult height, particularly in girls under 8 years of bone age, with delayed or advanced bone age, and those with early puberty.

Objective:To compare the accuracy and applicability of three adult height prediction methods based on artificial intelligence-assisted bone age assessment—the Bayley-Pinneau method(BP method), the Tanner-Whitehouse 3 method(TW3 method), and China 05 method—in girls.Methods:This bidirectional cohort study collected clinical data and 690 posteroanterior X-ray images of the left hand from 278 female children who underwent pubertal development assessments at Shenzhen Children′s Hospital between January 2014 and December 2020, with follow-up until adult height was reached. Adult height prediction was performed using BP, TW3, and China 05 methods on artificial intelligence-assisted bone age assessment.Results:The BP and TW3 methods overestimated adult height by(1.7±3.7) cm and(2.6±3.0) cm, respectively, while the China 05 method underestimated adult height by(2.3±3.5) cm. The proportion of PAH within±5 cm of FAH were 80.0% for the TW3 method, 77.0% for the BP method, and 74.2% for the China 05 method, with significant differences among them( P=0.038). Analysis of cases with prediction deviations>10 cm and subgroup comparisons revealed that the TW3 and BP methods were more likely to overestimate adult height in girls aged 6.0-<8.0 years, with delayed bone age, or in the prepubertal stage(all P<0.001). The China 05 method was more prone to underestimate adult height in those with advanced bone age( P<0.001). All three methods showed significantly greater prediction errors(absolute difference between PAH and FAH) in girls with early puberty compared to those with normal pubertal development(all P<0.05). Conclusions:The TW3 and BP methods tend to overestimate adult height in girls, while the China 05 method tends to underestimate it. Caution is warranted when predicting adult height, particularly in girls under 8 years of bone age, with delayed or advanced bone age, and those with early puberty.

ObjectiveTo explore the effect of virtual reality on upper limb function in stroke patients through diffusion tensor imaging (DTI). MethodsFrom September, 2021 to March, 2023, 80 stroke patients in the Fuzhou Second General Hospital were randomly divided into control group (n = 40) and experimental group (n = 40). Both groups received routine rehabilitation, while the experimental group received virtual reality training additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and Action Research Arm Test (ARAT) before treatment, after treatment and after four-week follow-up; and they were scaned with DTI to measure the fractional anisotropy (FA) and relative anisotropy (RA) of cerebral peduncle and posterior limb of inner capsule of the affected side before and after treatment. ResultsTwo cases dropped in each group. The FMA-UE and ARAT scores increased in both groups after treatment and follow-up (F > 2.790, P < 0.001), and increased more in the experimental group than in the control group (t > 2.297, P < 0.05). FA and RA in the posterior limb of inner capsule increased in both groups after treatment (t > 21.013, P < 0.001), and increased more in the experimental group (t > 2.006, P < 0.05). The d-value of FA of the posterior limb of internal capsule before and after treatment (ΔFA) was positively correlated with the d-value of FMA-UE score (r > 0.362, P < 0.05) in both groups, the ΔFA of the posterior limb of internal capsule was positively correlated with the d-value of ARAT score (r = 0.459, P < 0.01). ConclusionVirtual reality training can promote the recovery of upper limb function in stroke patients, which may associate with the conductivity of posterior limb of inner capsule.

Objective:To utilize usculoskeletal ultrasound technology for real-time assessment of related muscle characteris-tics in patients with chronic nonspecific low back pain(NLBP)and to analyze the correlation with visual ana-logue scale(VAS)and Oswestry disability index questionnaire(ODI).Method:A total of 180 patients diagnosed with chronic NLBP in the department of rehabilitation of the Sec-ond Hospital in Fuzhou from December 2022 to June 2023 were selected as NLBP group,and 120 healthy subjects who underwent physical examination at the same time period were selected as the control group.VAS and ODI questionnaires were used to assess the two groups of subjects.Based on musculoskeletal ultrasound technology,the muscle thickness and elastic modulus of transverse abdominal muscle and multifidus muscle in resting and contraction positions were detected in real time.Finally,the correlation analysis was performed be-tween the real-time muscle characteristics monitoring indexes of musculoskeletal ultrasound and the VAS and ODI scores in NLBP patients.Result:The VAS score showed that the healthy group was 0.58±0.73 and the NLBP group was 3.29±0.42.There was a significant difference in VAS score between the two groups(t=40.729,P＜0.001).The ODI score showed that the healthy group was 4.25±0.36 and the NLBP group was 14.41±1.63.The difference of ODI score between the two groups was statistically significant(t=-67.162,P＜0.001).The transverse abdominal muscle test showed that the thickness of the healthy group was 3.89±0.31 mm,and the thickness of the NLBP group was 2.85±0.26 mm.At the contraction position,the thickness of the healthy group was 5.18±0.35 mm,and the thickness of the NLBP group was 3.64±0.29 mm.The multifidus muscle test showed that the thickness of the healthy group was 2.19±0.14 cm,and the thickness of the NLBP group was 1.82±0.16 cm.At the contraction position,the thickness of the healthy group was 3.15±0.22 cm,and the thickness of the NLBP group was 2.41±0.21 cm.Compared with the healthy group,the muscle thickness of the transverse abdominis of the NLBP group(t=-31.401,-48.751;P＜0.001)and multifidus muscle thickness were significantly reduced(t=-20.610,-29.335;P＜0.001).The correlation analysis showed that there was a significant negative correlation between VAS score and transverse abdominal muscle thickness(r=-0.69,P＜0.001)and multifidus muscle thickness(r--0.45,P＜0.001)at rest.There was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.59,P＜0.001)and the thickness of the multifidus muscle(r=-0.31,P＜0.001).At rest,there was a significant negative correlation between ODI score and transverse abdominal muscle thickness(r=-0.58,P＜0.001)and multifidus muscle thickness(r=-0.36,P＜0.001).In the contractile position,there was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.54,P＜0.001)and the thickness of the multifidus muscle(r=-0.22,P=0.0029).Conclusion:Musculoskeletal ultrasonography can be used as a real-time detection method to evaluate the rele-vant characteristic indexes of NLBP in subjects.

Objective To analyze the influencing factors and management of benign anastomotic stenosis in patients with colorectal cancer after concurrent prophylactic ileostomy.Methods The clinical data of 74 colorectal cancer patients undergoing preventive ileostomy admitted to Quanzhou First Hospital Affiliated to Fujian Medical University from April 2018 to June 2022 were selected,according to the presence or absence of anastomotic stenosis after surgery,patients were divided into anastomotic stenosis group and anastomotic normal group.The influencing factors of stenosis were analyzed using statistical methods,and the management methods for anastomotic stenosis were summarized.Results 15 cases of anastomotic stenosis occurred after surgery,with an incidence rate of 20.3%.Compared with anastomotic normal group,patients in anastomotic stenosis group had a higher proportion of preoperative radiation therapy,preoperative neoadjuvant chemotherapy,and a higher incidence of postoperative anastomotic leakage/pelvic infection,with statistical significance(P<0.05);Multivariate analysis suggests that preoperative radiotherapy,anastomotic leakage/pelvic infection are independent risk factors for anastomotic stenosis.Conclusion Patients with colorectal cancer who undergo preoperative radiotherapy,neoadjuvant chemotherapy,and postoperative anastomotic leakage/pelvic infection should pay attention to the occurrence of anastomotic stenosis after undergoing ileostomy;Postoperative anastomotic stenosis should be treated according to the characteristics of the stenosis.

Objective:To utilize usculoskeletal ultrasound technology for real-time assessment of related muscle characteris-tics in patients with chronic nonspecific low back pain(NLBP)and to analyze the correlation with visual ana-logue scale(VAS)and Oswestry disability index questionnaire(ODI).Method:A total of 180 patients diagnosed with chronic NLBP in the department of rehabilitation of the Sec-ond Hospital in Fuzhou from December 2022 to June 2023 were selected as NLBP group,and 120 healthy subjects who underwent physical examination at the same time period were selected as the control group.VAS and ODI questionnaires were used to assess the two groups of subjects.Based on musculoskeletal ultrasound technology,the muscle thickness and elastic modulus of transverse abdominal muscle and multifidus muscle in resting and contraction positions were detected in real time.Finally,the correlation analysis was performed be-tween the real-time muscle characteristics monitoring indexes of musculoskeletal ultrasound and the VAS and ODI scores in NLBP patients.Result:The VAS score showed that the healthy group was 0.58±0.73 and the NLBP group was 3.29±0.42.There was a significant difference in VAS score between the two groups(t=40.729,P＜0.001).The ODI score showed that the healthy group was 4.25±0.36 and the NLBP group was 14.41±1.63.The difference of ODI score between the two groups was statistically significant(t=-67.162,P＜0.001).The transverse abdominal muscle test showed that the thickness of the healthy group was 3.89±0.31 mm,and the thickness of the NLBP group was 2.85±0.26 mm.At the contraction position,the thickness of the healthy group was 5.18±0.35 mm,and the thickness of the NLBP group was 3.64±0.29 mm.The multifidus muscle test showed that the thickness of the healthy group was 2.19±0.14 cm,and the thickness of the NLBP group was 1.82±0.16 cm.At the contraction position,the thickness of the healthy group was 3.15±0.22 cm,and the thickness of the NLBP group was 2.41±0.21 cm.Compared with the healthy group,the muscle thickness of the transverse abdominis of the NLBP group(t=-31.401,-48.751;P＜0.001)and multifidus muscle thickness were significantly reduced(t=-20.610,-29.335;P＜0.001).The correlation analysis showed that there was a significant negative correlation between VAS score and transverse abdominal muscle thickness(r=-0.69,P＜0.001)and multifidus muscle thickness(r--0.45,P＜0.001)at rest.There was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.59,P＜0.001)and the thickness of the multifidus muscle(r=-0.31,P＜0.001).At rest,there was a significant negative correlation between ODI score and transverse abdominal muscle thickness(r=-0.58,P＜0.001)and multifidus muscle thickness(r=-0.36,P＜0.001).In the contractile position,there was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.54,P＜0.001)and the thickness of the multifidus muscle(r=-0.22,P=0.0029).Conclusion:Musculoskeletal ultrasonography can be used as a real-time detection method to evaluate the rele-vant characteristic indexes of NLBP in subjects.

Objective:To investigate the effects of myeloid differentiation protein-2 (MD-2) on paclitaxel resistance cells in triple negative breast cancer (TNBC) through EGFR signaling pathway.Methods:Immunohistochemical method was used to detect the expression of MD-2 in cancer tissue and adjacent tissue of TNBC patients, and the relationship between MD-2 expression and clinicopathological parameters of patients was analyzed. The TNBC paclitaxel-resistant cell line was constructed and MD-2 expression in cells was interfered. Cell invasion was detected by Transwell, and cell apoptosis was detected by flow cytometry. The signaling pathways regulated by MD-2 were screened by transcriptome sequencing and verified by Western blot.Results:The expression of MD-2 was significantly enhanced in cancer tissues relative to adjacent tissues. High expression of MD-2 was closely related to clinical stage, tumor size, tumor recurrence and metastasis ( χ2=4.50, P=0.032; χ2=2.55, P=0.011; χ2=4.40, P=0.036). In cell experiments, compared with normal breast cells, the expression of MD-2 in TNBC cell lines was significantly enhanced. Compared with sh-NC group (100±11.52) (6.81±0.57), knockdown of MD-2 could inhibit the invasion (61.44±6.78) ( t=4.99, P=0.008) but promote apoptosis (15.19±1.06) ( t=12.06, P<0.001) of paclitaxel resistant TNBC cells. Transcriptome sequencing and Western blot results showed that MD-2 mainly affects the biological behavior of TNBC cells by regulating the EGFR signaling pathway. Conclusions:MD-2 promoted TNBC cell invasion and paclitaxel resistance, which may be achieved by affecting the EGFR signaling pathway. MD-2 is expected to become an effective target in TNBC treatment.

Tumor microenvironments (TMEs) are closely related to tumor resistance. TMEs are divided into cellular components and acellular components. The cellular components include tumor-associated macrophages, tumor-associated fibroblasts, mesenchymal stem cells, etc., which can enhance tumor resistance through recruitment and secretion of a variety of protective cytokines; acellular components such as extracellular matrix, hypoxia and acidification, etc., can mediate drug resistance by constructing physical barriers, affecting tumor cell growth and metabolism. Studying the mechanisms of TME-mediated drug resistance and reshaping TMEs can provide new strategies for anti-tumor therapy.

Objective:To observe the curative effects of berberine in rats with high-fat diet induced non-alcoholic fatty liver and to further explore its possible mechanism.Methods:Twenty-six Sprague-Dawley rats (120-160 g) were randomly divided into 3 groups: control group ( n = 8), model group ( n = 10) and treatment group ( n = 8). Rats in the control group were fed with regular diet, and the model group and the treatment group were fed a high-fat diet. At the 12th week, two rats in the in the model group were sacrificed to verify whether model was successful established. Subsequently, treatment group rats were given a gavage of berberine at a dose of 150 mg·kg -1·d -1 for 4 weeks, and the control and the model group rats were given the same dose of normal saline. Rats were sacrificed at week 16th. HE staining was used to observe the changes in the intestinal mucosa of rats. Sudan black B staining was used to observe the fatty changes in liver. Immunohistochemical staining was used to observe the expression level of occludin protein in the intestinal epithelium. A real-time 16S rDNA PCR method was used to measure the number of escherichia coli, bacteroides and faecalibacterium prausnitzii in the feces of rats. Results:Model group had a higher serum levels of endotoxin (0.288 ± 0.045) and tumor necrosis factor (TNF)-α (1.07 ± 0.11) than the control group (0.192 ± 0.049, 0.94 ± 0.07) ( P < 0.05). Berberine intervention had significantly reduced endotoxin (0.213 ± 0.025) and TNF-α level (0.93 ± 0.07) ( P < 0.05). The expression level of occludin protein was significantly lower in the intestinal mucosa of model group than that of control group (0.166 ± 0.014), and berberine had promoted the expression of occludin protein in intestinal mucosa (0.055 ± 0.009), but the difference was not statistically significant ( P > 0.05). At the same time, compared with the model group (7.29 ± 0.47), the number of bacteroidetes in the control group (9.49 ± 0.59) was decreased, while the number of bacteroidetes in the treatment group was increased (9.77 ± 0.87). The number of escherichia coli (6.92 ± 0.77) and faecalibacterium prausnitzii (8.70 ± 0.62) in the model group were increased than control group (5.42 ± 0.63, 9.49 ± 0.59), while the number of escherichia coli (6.34 ± 0.71) and faecalibacterium prausnitzii (9.77 ± 0.87) ( P < 0.05) was reduced with the intervention of berberine. Conclusion:Berberine could effectively protect the intestinal barrier function in rats with NAFLD and the possible mechanism of action behind it may be the regulation of intestinal flora.

Objective: To elucidate the clinicopathological characters and prognostic factors of invasive micropapillary carcinoma of the breast (IMPC) by compared with invasive ductal carcinoma, not otherwise specified of the breast (IDC). Methods: The retrospective study was performed with female patients who had undergone curative resection for breast cancer without neoadjuvant chemotherapy from June 2008 to April 2016 in Breast Center of Beijing Hospital. Forty-seven mixed or pure IMPC patients and 93 pure IDC patients(admitted in the same center from October 2008 to January 2016 ) were matched for tumor stage, nodal status and age. Follow-up was done every 3 to 6 months postoperatively. The deadline was July 31, 2016. The curves of disease free survival and overall survival were drawn by the Kaplan-Meier method, and survival rates were compared by means of the Log-rank test. Potential prognostic variables that were identified on univariate analysis were analyzed with Cox′s proportional hazards regression model for multivariate analysis. The χ² test or Fisher′s exact test was used to compare distributions across 2 groups and the Mann-Whitney U test or t test was used to analyze the medians or means of 2 groups. Results: With exact matches, the rates of lymphovascular invasion (LVI) (29.8% vs. 12.9%, χ²=5.885, P=0.015)and histological grade 3 (40.4% vs. 21.5%, χ²=-2.690, P=0.007) were both significantly higher in patients with IMPC than that in IDC group, but the survival between the two pathological types were not significantly different (all P>0.05). The percent of IMPC component didn′t influence the clinicopathologic characters (all P >0.05), but a significantly longer median disease free survival (χ²=11.731, P=0.001) when the patients had more than 50% of IMPC component was found. Conclusions Higher rates of LVI and histological grade 3 were found in IMPC than that in IDC, but the survival was comparable between the two groups. A longer DFS occurred in patients with IMPC component more than 50%.