Objective·To preliminarily investigate the value of high-order functional magnetic resonance imaging in the evaluation of benign and malignant bone and soft tissue tumors and the changes after chemotherapy.Methods·Patients clinically diagnosed with bone and soft tissue tumors at the Department of Orthopaedics,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,from October 2014 to December 2024 were enrolled.The patients were divided into a control group and an amide proton transfer-weighted imaging(APTw)group according to the imaging method.All patients underwent conventional magnetic resonance imaging(MRI),diffusion-weighted imaging(DWI),and dynamic contrast-enhanced imaging(DCE)before surgery.Patients in the APTw group received additional APTw imaging.Both groups were divided into non-malignant and malignant lesion subgroups according to pathological results.According to whether the patients received chemotherapy before enrollment,the patients with malignant lesions in the APTw group were further divided into malignant group without chemotherapy and malignant group with chemotherapy.Clinical and imaging data,including APT values,apparent diffusion coefficient(ADC),and time-intensity curves(TICs)from the largest tumor section,were collected and analyzed to assess the diagnostic performance of APTw,DWI,and DCE,and to evaluate changes after chemotherapy.Results·Eighty-five patients were enrolled,including 51 males and 34 females,with ages ranging from 10 to 84 years,and a mean age of(43.05±17.62)years.There were 51 patients in the control group(16 with non-malignant lesions and 35 with malignant lesions)and 34 patients in the APTw group(5 with non-malignant lesions and 29 with malignant lesions;23 malignant lesions without chemotherapy and 6 malignant lesions with chemotherapy).The clinical and imaging data showed that only the tumor margin of the control group and the maximum tumor diameter of the APTw group had statistically significant differences in their malignant and non-malignant lesion groups(P<0.05).In the APTw group,there was a statistically significant difference in APT values between the malignant lesion group and the non-malignant lesion group(P<0.001).Further analysis showed that the APT values in the malignant group without chemotherapy were significantly lower than that in the malignant group with chemotherapy(P<0.001).However,there were no statistically significant differences in APT values between the malignant group with chemotherapy and the non-malignant lesion group(P>0.05).There were no significant differences in ADC values and TIC types between malignant and non-malignant lesion groups in the control group and the APTw group(P>0.05).The area under the curve(AUC)of the diagnostic model in the APTw group(MRI+DWI+DCE+APTw)for distinguishing malignant from benign tumors was significantly higher than that of the control group(MRI+DWI+DCE)(P<0.05).The Youden index and specificity of the diagnostic model in the APTw group were higher than those in the control group.Conclusion·As a high-order functional MRI technique,APTw imaging is capable of evaluating the nature(benign or malignant)of bone and soft tissue tumors and detecting changes after chemotherapy.It serves as a valuable supplement to conventional MRI,DWI,and DCE imaging,providing a novel noninvasive tool for the diagnosis and treatment evaluation of bone and soft tissue tumors.

Pulmonary artery thrombectomy is an important method for treatment of acute pulmonary embolism(PE),and its successful implementation relies on the close collaboration of a multidisciplinary team.This article explores the indications,surgical strategies and key links of multidisciplinary treatment(MDT)for pulmonary artery thrombectomy through the diagnosis and treatment process of a patient with acute pulmonary embolism.The patient sought medical attention due to wheezing and was diagnosed with pulmonary embolism through imaging,with a risk stratification of medium to high risk.With the collaboration of multiple disciplines including respiratory medicine department,cardiology department,cardiac surgery department,radiology department and ultrasound department,percutaneous mechanical thrombectomy was successfully performed.After the surgery,the patient's blood flow was restored,symptoms were significantly relieved,and no serious complications occurred.This article aims to provide a reference framework for MDT in pulmonary artery thrombectomy for clinical doctors,optimize the treatment process for patients with pulmonary embolism,and provide reference for case selection and diagnosis and treatment strategies of thrombectomy treatment of pulmonary embolism.

Objective:To explore the effect of combining ultrasound stimulation with continuous passive movement (CPM) on triceps crus spasms and the motor functioning of children with spastic cerebral palsy.Methods:Sixty children with spastic cerebral palsy were randomly divided into a control group, a CPM group, and a combined treatment group, each of 20. All received routine rehabilitation treatment (including exercise therapy, electrical stimulation and massage), while the CPM and combined groups were additionally provided with CPM and CPM + ultrasound stimulation, respectively. All of the children were treated once a day, 6 times a week, for 4 consecutive weeks. Before and after the treatment, the Tardieu scale (MTS) was used to assess the degree of triceps spasm, and the Berg Balance Scale (BBS), the Gross Motor Function Test (GMFM-88), and 10m walking speed (10MWT) were employed to assess motor function.Results:After the treatment, the average MTS scores, BBS scores and GMFM-88 scale scores in the D and E areas of all 3 groups had improved significantly compared with before the treatment, with those of the observation and CPM groups significantly better than among the control group. With the knee flexed and extended, the Tardiu scale R1, R2 and X values of the combined treatment group were significantly better than those of the CPM group, on average. The combined group′s average BBS score and its average score in the D-zone of the GMFM-88 were also significantly better than the CPM group′s averages.Conclusions:Ultrasound combined with continuous passive movement can effectively relieve triceps spasm in children with cerebral palsy, and improve their static posture control during squatting, sitting and standing.

Pulmonary artery thrombectomy is an important method for treatment of acute pulmonary embolism(PE),and its successful implementation relies on the close collaboration of a multidisciplinary team.This article explores the indications,surgical strategies and key links of multidisciplinary treatment(MDT)for pulmonary artery thrombectomy through the diagnosis and treatment process of a patient with acute pulmonary embolism.The patient sought medical attention due to wheezing and was diagnosed with pulmonary embolism through imaging,with a risk stratification of medium to high risk.With the collaboration of multiple disciplines including respiratory medicine department,cardiology department,cardiac surgery department,radiology department and ultrasound department,percutaneous mechanical thrombectomy was successfully performed.After the surgery,the patient's blood flow was restored,symptoms were significantly relieved,and no serious complications occurred.This article aims to provide a reference framework for MDT in pulmonary artery thrombectomy for clinical doctors,optimize the treatment process for patients with pulmonary embolism,and provide reference for case selection and diagnosis and treatment strategies of thrombectomy treatment of pulmonary embolism.

Objective:To investigate the development trajectory of subjective cognitive decline (SCD) in elderly patients with depression and analyze the influencing factors of its categorical differences.Methods:The elderly patients with depression who received treatment in Shaoxing Seventh People′s Hospital from May 2021 to May 2024, were selected as the research subjects through convenience sampling. A cross-sectional survey was conducted using 21-Item Subjective Cognitive Decline Questionnaire on the second day of admission, one week after treatment, one month after treatment, and three months after treatment. The optimal number of categories was analyzed and classified using a growth mixed model. Potential independent influencing factors between categories were analyzed through multivariate logistic regression.Results:This study included 200 elderly patients with depression, including 79 males and 121 females, aged (70.00 ± 3.15) years.The development trajectory of SCD can be divided into three potential categories. Among them, the low SCD persistent type accounts for 49% (98/200), the high SCD remission type accounts for 22% (44/200), and the high SCD persistent type accounts for 29% (58/200).The results of multivariate logistic regression analysis showed that age, gender, place of residence, occupation, history of hypertension, Hamilton Depression Scale-17(HAMD-17) score, presence of visual impairment, slow gait, nutritional risk, and fall status within the past year were independent influencing factors for the development of SCD in elderly patients with depression ( χ2 values were 4.51-11.24, all P<0.05). Conclusions:The development of SCD in elderly patients with depression is consistent to some extent, influenced by factors such as HAMD-17 score, visual impairment, and nutritional risk. This suggests that personalized plans can be developed for different types of development in the care of elderly patients with depression, and timely interventions can be made for the development of SCD in patients.

Objective:To explore the effect of combining ultrasound stimulation with continuous passive movement (CPM) on triceps crus spasms and the motor functioning of children with spastic cerebral palsy.Methods:Sixty children with spastic cerebral palsy were randomly divided into a control group, a CPM group, and a combined treatment group, each of 20. All received routine rehabilitation treatment (including exercise therapy, electrical stimulation and massage), while the CPM and combined groups were additionally provided with CPM and CPM + ultrasound stimulation, respectively. All of the children were treated once a day, 6 times a week, for 4 consecutive weeks. Before and after the treatment, the Tardieu scale (MTS) was used to assess the degree of triceps spasm, and the Berg Balance Scale (BBS), the Gross Motor Function Test (GMFM-88), and 10m walking speed (10MWT) were employed to assess motor function.Results:After the treatment, the average MTS scores, BBS scores and GMFM-88 scale scores in the D and E areas of all 3 groups had improved significantly compared with before the treatment, with those of the observation and CPM groups significantly better than among the control group. With the knee flexed and extended, the Tardiu scale R1, R2 and X values of the combined treatment group were significantly better than those of the CPM group, on average. The combined group′s average BBS score and its average score in the D-zone of the GMFM-88 were also significantly better than the CPM group′s averages.Conclusions:Ultrasound combined with continuous passive movement can effectively relieve triceps spasm in children with cerebral palsy, and improve their static posture control during squatting, sitting and standing.

In February 2025, a local cluster outbreak caused by the D8 genotype Measles virus (MV) was first discovered in Henan Province. Epidemiological investigations and laboratory testing were conducted, including the collection of serum and throat swabs for MV IgM antibody and nucleic acid detection, virus isolation and genetic homology analysis. Measures such as close contact tracing, vaccination rate assessment and supplementary immunization activities were implemented, successfully preventing broader community transmission. A total of three cases were reported during the outbreak, including one imported-related adolescent and two secondary local adult cases. All cases presented with typical symptoms such as fever and rash. Both adult cases were complicated by pneumonia, with one case developing into severe pneumonia. MV genotyping showed that the two secondary cases were both the D8 genotype, with the viral sequences being completely homologous to the Kazakhstan strain. Among the close contacts, 98.2% were adults, and 142 individuals received emergency vaccination.

AIM:To investigate the protective effects of soy isoflavones on retinal ganglion cells(RGCs)damage in diabetic rats and related mechanisms.METHODS: Totally 80 male SD rats(80 eyes), aged 4-6 weeks, were randomly divided into four groups(n=20 per group): a control group, a diabetic model group, a low-dose soy isoflavone treatment group, and a high-dose soy isoflavone treatment group. Among them, the control group was fed normal chow, while the diabetic group, soy isoflavone low-dose-treated group, and soy isoflavone high-dose-treated group were fed high-fat chow. After a feeding period of 4 wk, rats in the diabetic group, as well as those in the soy isoflavone low-dose and high-dose treatment groups, were injected intraperitoneally with streptozotocin(STZ)at a dose of 50 mg/kg to establish a diabetic model. Rats in the control group received an equivalent volume of sodium citrate buffer acid. The soy isoflavone low-dose-treated group was administered 360 mg/kg of soy isoflavones daily via gavage, while the soy isoflavone high-dose-treated group received 540 mg/kg of soy isoflavones daily via gavage. Both the control group and the diabetic group were given an equal amount of purified water daily via gavage. Body weight and blood glucose levels were measured at 4 and 8 wk post-gavage treatment. The eyes were extracted and the retinas were dissected at 8 wk following the gavage treatment. The number of RGCs in each group was determined using immunochemical tissue staining and protein blotting techniques, while the superoxide dismutase(SOD)activity and malondialdehyde(MDA)content of the rat retinal tissue were measured through histochemical methods.RESULTS: Compared with diabetic rats, treatment with high-dose soy isoflavones for 8 wk resulted in a reduction of blood glucose to 8.9±1.23 mmol/L, an increase in intraretinal SOD activity to 849.93±63.71 U/mgprot, a decrease in MDA content to 45.77±0.59 nmol/mgprot, and an increase in the number of RGCs to 76±1 cells/mm2, which is comparable to the control group's data(all P<0.05).CONCLUSION: Soy isoflavones can reduce retinal oxidative stress in diabetic rats and protect RGCs.

Dental stem cells(DSCs),a distinct subset of mesenchymal stem cells(MSCs),are isola-ted from dental tissues,such as dental pulp,exfoliated deciduous teeth,periodontal ligament,and apical papilla.They have emerged as a promising source of stem cell therapy for tissue regeneration and autoim-mune disorders.The main types of DSCs include dental pulp stem cells(DPSCs),stem cells from hu-man exfoliated deciduous teeth(SHED),periodontal ligament stem cells(PDLSCs),and stem cells from apical papilla(SC AP).Each type exhibits distinct advantages:easy access via minimally invasive procedures,multi-lineage differentiation potential,and excellent ethical acceptability.DSCs have demon-strated outstanding clinical efficacy in oral and maxillofacial regeneration,and their long-term safety has been verified.In oral tissue regeneration,DSCs are highly effective in oral tissue regeneration for critical applications such as the restoration of dental pulp vitality and periodontal tissue repair.A defining advan-tage of DSCs lies in their ability to integrate with host tissues and promote physiological regeneration,which render them a better option for oral tissue regenerative therapies.Beyond oral applications,DSCs also exhibit promising potential in the treatment of systemic diseases,including type Ⅱ diabetes and au-toimmune diseases due to their immunomodulatory effects.Moreover,extracellular vesicles(EVs)de-rived from DSCs act as critical mediators for DSCs' paracrine functions.Possessing regulatory properties similar to their parental cells,EVs are extensively utilized in research targeting tissue repair,immuno-modulation,and regenerative therapy—offering a"cell-free"strategy to mitigate the limitations associated with cell-based therapies.Despite these advancements,standardizing large-scale manufacturing,maintai-ning strict quality control,and clarifying the molecular mechanisms underlying the interaction of DSCs and their EVs with recipient tissues remain major obstacles to the clinical translation of these treatments into broad clinical use.Addressing these barriers will be critical to enhancing their clinical applicability and therapeutic efficacy.In conclusion,DSCs and their EVs represent a transformative approach in re-generative medicine,and increasing clinical evidence supports their application in oral and systemic diseases.Continuous innovation remains essential to unlocking the widespread clinical potential of DSCs.

Objective To investigate the molecular mechanism by which receptor activator of nuclear factor-κB ligand(RANKL)regulates autophagy and osteoclast differentiation through the ROS-HIF-1α signaling axis.Methods Mouse monocytic/macrophage RAW264.7 cells were randomly divided into control group,RANKL group,and 3 combined intervention groups,that is,RANKL+CQ group(intervention with autophagy inhibitor,CQ),RANKL+FG-4592 group(intervention with HIF-1α stabilizer,FG-4592),and RANKL+NAC group(intervention with ROS scavenger,NAC).The number of mature multinucleated osteoclasts was quantitatively detected with tartrate-resistant acid phosphatase(TRAP)staining;the protein levels of HIF-1α and LC3 were detected by Western blotting and the mRNA levels of osteoclast differentiation-related genes(TRAP,Cath K and MMP-9)were analyzed by qRT-PCR;autophagy flux and activity were observed by adenovirus mRFP-GFP-LC3 labeling system combined with confocal laser microscopy;and the production of intracellular reactive oxygen species(ROS)was measured by DCFH-DA probe.Results Compared with the control group,the RANKL group obtained significantly increased number of TRAP-positive multinucleated osteoclasts(P<0.05),up-regulated mRNA levels of osteoclast differentiation-related genes,activated autophagy pathway,as evidenced by the increased LC3-Ⅱ/LC3-Ⅰ ratio(P<0.05)and number of autophagic lysosomes(P<0.05),elevated intracellular ROS generation(P<0.05),and down-regulated HIF-1α protein level(P<0.05).NAC intervention significantly inhibited intracellular ROS accumulation(P<0.05),reversed the lowered expression of HIF-1α protein(P<0.05),decreased the LC3-Ⅱ/LC3-Ⅰ ratio(P<0.05)and autophagy flux and activity(P<0.05),and reduced expression levels of osteoclast differentiation-related genes and the number of mature osteoclasts(P<0.05).In the RANKL+FG-4592 group,HIF-1α protein level was significantly increased(P<0.05),autophagy activation was inhibited[with decreased LC3-Ⅱ/LC3-Ⅰ ratio(P<0.05)and autophagy flux and activity(P<0.05)],and the expression of osteoclast differentiation-related genes and number of mature osteoclasts were decreased(P<0.05)when compared with the RANKL group.While CQ treatment resulted in inhibited autophagy flux and activity(P<0.05),declined expression levels of osteoclast differentiation-related genes,and reduced number of mature osteoclasts(P<0.05).Conclusion RANKL activates autophagy through ROS-mediated down-regulation of HIF-1α,and thereby promotes osteoclast differentiation.