Metabolic dysfunction-associated fatty liver disease （MAFLD） is a chronic metabolic liver disorder with complex etiologies. Different clinical phenotypes of MAFLD （such as obesity， hyperlipidemia， type 2 diabetes mellitus， the postmenopausal state， and chronic hepatitis B） have different mechanisms of action in the development and progression of MAFLD， leading to high heterogeneity in its clinical progression and prognosis. This article systematically reviews the pathogeneses and clinical features of the above five clinical phenotypes of MAFLD and elaborates on the corresponding individualized diagnosis and treatment regimens integrating traditional Chinese medicine and Western medicine， in order to provide a reference for clinical practice and improve clinical diagnosis and treatment.

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

ObjectiveTo investigate the influenza virus infection status of influenza-like illness (ILI) at a sentinel hospital in Baoshan District of Shanghai, to explore the seasonal patterns of influenza, so as to provide a scientific basis for influenza prevention and control in Baoshan District of Shanghai. MethodsSurveillance data and pathogenic testing results of ILI from the monitoring year of 2015 to 2023 were collected from the sentinel hospital to describe the seasonal epidemic characteristics of influenza in this district. ResultsThe proportion of ILI visits to sentinel hospital in Baoshan District of Shanghai showed an upward trend from 2015 to 2023 (Z=2.598, P=0.09). The positive rate of influenza virus in ILI was 20.43% (1 761/8 621), of which 14.17% were positive for influenza A virus, including 8.43% for influenza A/H3N2 and 5.74% for influenza A/H1N1. The positive rate of influenza B virus was 6.25%, of which the positive detection rate of influenza B/Victoria virus was 5.35%, while that of influenza B/Yamagata virus was 0.90%. Influenza B/Yamagata virus was not detected in 2019‒2023. The highest positivity rate was observed in the 5‒<15 years age group (25.57%). The positive rate of ILI was lower in males (19.90%) than that in females (20.90%). There were three patterns of influenza epidemic in the district: with year-round circulation in 2016‒2017 and 2021‒2022; with bimodal peaks in 2015‒2016, 2017‒2018 and 2022‒2023; and with one peak in 2018‒2019 and 2019‒2020. The positive rate of influenza virus exhibited seasonal variations, with influenza A virus predominated in summer and autumn. However, influenza B virus showed an increase in spring and winter. ConclusionThe influenza epidemic in Baoshan District, Shanghai exhibits diverse patterns with heterogeneous epidemiological characteristics across different age groups and seasons. Notably, children and adolescents aged 5‒<15 years constitute the key target population for influenza prevention and control. Enhanced surveillance and targeted control measures against influenza A/H3N2 lineage viruses are particularly warranted during summer and autumn seasons.

[Purpose]To analyze the trends of mortality and probability of premature mortality caused by colorectal cancer in Jinshan District of Shanghai from 1980 to 2023.[Methods]The death database of Jinshan District from 1980 to 2023 were established based on the death reports from the medical institutions and public security bureau at all levels.The crude mortality rate,age-standardized mortality rate by Chinese standard population and world standard population(ASRC and ASRW),age-specific mortality rate,probability of premature mortality,annual percentage change(APC)and average annual percentage change(AAPC)of colorectal cancer were calculated.[Results]The crude mortality rate of colorectal cancer increased from 1980 to 2023(AAPC=2.36％,P＜0.001)and the ASRW of colorectal cancer decreased at the same period(AAPC=-1.02％,P=0.003).The ASRW of colorectal cancer in male and female showed a decreasing trend from 1990 to 1999(APC=-5.08％,-7.85％,P=0.007,0.011),but there was no significant change in other periods.The age-specific mortality rate increased with age and reached the peak at the age group of 70～74 years old during 1980-1989,75～79 years old during 1990-1999,80～84 years old during 2000-2009 and 2010-2019,85 years old and above during 2020-2023(109.22/105,77.56/105,113.78/105,172.82/105 and 236.58/105,respectively).The probability of premature mortality of colorectal cancer decreased in male and female(AAPC=-1.10％,-2.41％,P=0.047,＜0.001),but there was no change after the year of 2000.[Conclusion]The overall mortality rate of colorectal cancer in Jinshan District showed a decreasing trend from 1980 to 2023,but the standardized mortality rate and the probability of premature mortality had not shown a significant downward trend since 2000.

N⁶-methyladenosine (m⁶A) modification plays a critical role in cell cycle regulation, while the mechanism of m⁶A in regulating mitosis remains underexplored. Here, we found that the total m⁶A modification level in cells increased during mitosis by the liquid chromatography-mass spectrometry/mass spectrometry and m⁶A dot blot assays. Silencing methyltransferase-like 3 (METTL3) or METTL14 results in delayed mitosis, abnormal spindle assembly, and chromosome segregation defects by the immunofluorescence. By analyzing transcriptome-wide m⁶A targets in HeLa cells, we identified polo-like kinase 1 (PLK1) as a key gene modified by m⁶A in regulating mitosis. Specifically, through immunoblotting and RNA pulldown, m⁶A modification inhibits PLK1 translation via YTH N⁶-methyladenosine RNA binding protein 1, thus mediating cell cycle homeostasis. Demethylation of PLK1 mRNA leads to significant mitotic abnormalities. These findings highlight the critical role of m⁶A in regulating mitosis and the potential of m⁶A as a therapeutic target in proliferative diseases such as cancer.
Humans ; Polo-Like Kinase 1 ; Cell Cycle Proteins/metabolism* ; Proto-Oncogene Proteins/metabolism* ; Protein Serine-Threonine Kinases/metabolism* ; Mitosis/physiology* ; HeLa Cells ; Adenosine/genetics* ; Methyltransferases/metabolism* ; RNA, Messenger/metabolism* ; RNA-Binding Proteins/metabolism*

Objective:To explore the relationship between serum ferritin(SF), triglyceride-glucose(TyG) index, and metabolic dysfunction-associated fatty liver disease(MAFLD), and to assess their interaction on MAFLD risk in the health checkup population.Methods:A cross-sectional analysis was conducted with 1 439 participants from the Health Management Centre of Nanjing Drum Tower Hospital in 2022. Data were collected through physical examination, laboratory tests, and abdominal imaging. Differences in metabolic indicators, SF, and TyG index were compared between MAFLD and non-MAFLD groups. Logistic regression analysis was used to assess the associations of SF and TyG index with MAFLD, and their on MAFLD interaction was evaluated. Results:Both SF and TyG index were significantly higher in the MAFLD group between than those in the non-MAFLD group( P<0.05). After adjusting for sex, age, history of hypertension, history of diabetes, body mass index, waist circumference, haemoglobin, alanine aminotransferase, aspartate aminotransferase, and uric acid, the SF and TyG index were positively associated with the risk of MAFLD[ OR(95% CI), SF: 1.00(1.00-1.00); TyG index: 2.98(2.19-4.06). The additive interaction analysis showed that the risk of MAFLD was significantly higher in the G4 group(SF≥135.4 ng/mL, TyG index≥8.52) compared to the G1 group(SF<135.4 ng/mL, TyG index<8.52) [ OR 4.43(95% CI 2.70-7.25)]. Conclusions:Elevated SF and TyG index were independently associated with increased risk of MAFLD, with a significant synergistic interaction between the two.

[Purpose]To analyze the trends of mortality and probability of premature mortality caused by colorectal cancer in Jinshan District of Shanghai from 1980 to 2023.[Methods]The death database of Jinshan District from 1980 to 2023 were established based on the death reports from the medical institutions and public security bureau at all levels.The crude mortality rate,age-standardized mortality rate by Chinese standard population and world standard population(ASRC and ASRW),age-specific mortality rate,probability of premature mortality,annual percentage change(APC)and average annual percentage change(AAPC)of colorectal cancer were calculated.[Results]The crude mortality rate of colorectal cancer increased from 1980 to 2023(AAPC=2.36％,P＜0.001)and the ASRW of colorectal cancer decreased at the same period(AAPC=-1.02％,P=0.003).The ASRW of colorectal cancer in male and female showed a decreasing trend from 1990 to 1999(APC=-5.08％,-7.85％,P=0.007,0.011),but there was no significant change in other periods.The age-specific mortality rate increased with age and reached the peak at the age group of 70～74 years old during 1980-1989,75～79 years old during 1990-1999,80～84 years old during 2000-2009 and 2010-2019,85 years old and above during 2020-2023(109.22/105,77.56/105,113.78/105,172.82/105 and 236.58/105,respectively).The probability of premature mortality of colorectal cancer decreased in male and female(AAPC=-1.10％,-2.41％,P=0.047,＜0.001),but there was no change after the year of 2000.[Conclusion]The overall mortality rate of colorectal cancer in Jinshan District showed a decreasing trend from 1980 to 2023,but the standardized mortality rate and the probability of premature mortality had not shown a significant downward trend since 2000.

Objective:To explore the relationship between serum ferritin(SF), triglyceride-glucose(TyG) index, and metabolic dysfunction-associated fatty liver disease(MAFLD), and to assess their interaction on MAFLD risk in the health checkup population.Methods:A cross-sectional analysis was conducted with 1 439 participants from the Health Management Centre of Nanjing Drum Tower Hospital in 2022. Data were collected through physical examination, laboratory tests, and abdominal imaging. Differences in metabolic indicators, SF, and TyG index were compared between MAFLD and non-MAFLD groups. Logistic regression analysis was used to assess the associations of SF and TyG index with MAFLD, and their on MAFLD interaction was evaluated. Results:Both SF and TyG index were significantly higher in the MAFLD group between than those in the non-MAFLD group( P<0.05). After adjusting for sex, age, history of hypertension, history of diabetes, body mass index, waist circumference, haemoglobin, alanine aminotransferase, aspartate aminotransferase, and uric acid, the SF and TyG index were positively associated with the risk of MAFLD[ OR(95% CI), SF: 1.00(1.00-1.00); TyG index: 2.98(2.19-4.06). The additive interaction analysis showed that the risk of MAFLD was significantly higher in the G4 group(SF≥135.4 ng/mL, TyG index≥8.52) compared to the G1 group(SF<135.4 ng/mL, TyG index<8.52) [ OR 4.43(95% CI 2.70-7.25)]. Conclusions:Elevated SF and TyG index were independently associated with increased risk of MAFLD, with a significant synergistic interaction between the two.

Objective To explore the diagnostic value of MRI radiomics model for clinically significant prostate cancer(csPCa)in the transition zone with prostate imaging reporting and data system(PI-RADS)3-4.Methods According to the ratio of prostate cancer(PCa)∶benign prostatic hyperplasia(BPH)=1∶1,the relevant data of patients with transition zone lesions confirmed by pathology were retrospectively collected.Patients were divided into csPCa group and non-csPCa group according to pathological results.Region of interest(ROI)were drawn along the edge of the lesion in T2WI,diffusion weighted imaging(DWI),and apparent diffusion coeffi-cient(ADC)sequences,the radiomics features were extracted,and a single sequence logistic regression model was constructed and validated after feature cleaning and screening.The diagnostic performances of the radiomics model for transition zone csPCa were evaluated and compared.Results A total of 204 patients were included,and there were 94 cases in the csPCa group and 110 cases in the non-csPCa group.There were statistically significant differences in PI-RADS,prostate volume(PV),prostate specific antigen(PSA)and its derivative indicators between csPCa and non-csPCa groups.In the validation set,the area under the cunve(AUC)of the ADC model was 0.766,and the DeLong test showed that the diagnostic performance of the ADC model was significantly higher than that of the DWI and T2WI models.Conclusion When the PI-RADS classification of transition zone lesion is 3-4,the ADC radiomics model has good diag-nostic performance for csPCa,which can reduce unnecessary biopsy in some patients.Radiomics is expected to become a more objec-tive and accurate medical diagnostic tool.

Objective:To explore the effect of "Internet plus" exercise prescription intervention on upper limb dysfunction and quality of life of breast cancer patients at home after surgery, so as to provide reference for health management of breast cancer patients after surgery.Methods:Adopting a prospective randomized controlled trial research method. From November 2021 to January 2023, 124 breast cancer patients in the breast and thyroid surgery department of Xiang′an Hospital Affiliated to Xiamen University were selected for the study. According to the random number table method, they were randomly divided into an intervention group (62 cases) and a control group (62 cases). The control group patients were given routine training, and the intervention group patients received routine training in the first four weeks after operation, and "Internet plus" exercise prescription intervention in the fifth week after operation. The upper limb dysfunction, quality of life before and after the intervention and motor compliance after the intervention between the two groups were compared.Results:A total of 117 patients were ultimately included, and they were all female, with 58 patients in the intervention group aged (51.01 ± 9.77) years old and 59 patients in the control group aged (51.47 ± 9.85) years old. There was no statistically significant difference in upper limb dysfunction and quality of life between the two groups of patients before intervention ( P>0.05). After the intervention, the degree of upper limb dysfunction in the intervention group was (63.55 ± 7.02) points, which were lower than that in the control group (67.13 ± 7.25) points, and the difference was statistically significant ( t = 2.71, P<0.01). After the intervention, the total score of quality of life and the scores of physiological status, social/family status, emotional status, functional status and additional attention of breast cancer patients in the intervention group were (115.27 ± 17.35), (22.65 ± 4.53), (22.79 ± 4.36), (20.96 ± 3.95), (19.56 ± 4.22), (29.31 ± 5.24) points, which were higher than those in the control group (104.28 ± 17.04), (20.57 ± 4.48), (20.85 ± 4.23), (18.75 ± 4.04), (17.18 ± 4.06), (26.93 ± 5.21) points, the differences were statistically significant ( t values were 2.44-3.46, all P<0.05). In terms of exercise compliance of breast cancer patients in the intervention group, the aerobic exercise completion rate was 91.38% (53/58), muscle strength training completion rate was 77.59% (45/58), stretching exercise completion rate was 86.21% (50/58), exercise frequency was (3.96 ± 1.13) times/week, exercise duration was (29.51 ± 7.64) min/time, which was superior to 77.97% (46/59), 57.63% (34/59), 69.49% (41/59), (3.38 ± 0.94) times/week, (23.96 ± 7.33) min/time in the control group, the differences were statistically significant ( χ2 = 4.04, 5.31, 4.73, t = 3.02, 4.01, all P<0.05). Conclusions:"Internet plus" exercise prescription intervention has the characteristics of convenience, intuition and strong operability, which is conducive to improving the upper limb dysfunction, quality of life and exercise compliance of breast cancer patients at home after surgery. It is recommended to be popularized and applied clinically.