Objective : To investigate the effectiveness of an extraoral guide plate system targeting the superior and inferior heads of the lateral pterygoid muscle in improving the accuracy of injection therapy for anterior disc displacement (ADD) of the temporomandibular joint (TMJ) with lateral pterygoid myalgia, and to provide a reference for precise clinical treatment. Methods: With approval from the institutional medical ethics committee and informed consent from patients, spiral CT scans were performed on seven patients with ADD accompanied or not accompanied by lateral pterygoid myalgia to acquire craniofacial data. Mimics 21.0 software was used to reconstruct three-dimensional craniofacial structures, identify attachment points of the superior and inferior heads of the lateral pterygoid muscle, and design dual injection paths along with a retention system. Personalized templates were fabricated using digital light procession-based 3D printing. Under the guide plate, a single targeted injection of 20 U of botulinum toxin type A (BTX-A) was administered into both the superior and/or inferior heads of the lateral pterygoid muscle. Immediate postoperative CT scans were conducted to compare actual needle placement with preoperative plans. Pain was assessed using the visual analogue scale (VAS) at 3 days and 1, 2, and 4 weeks postoperatively. Joint clicking was recorded at 2 and 4 weeks, and complications were monitored throughout the duration of the study. Results : A total of 15 sites in 7 patients were injected into the upper / lower head of the lateral pterygoid muscle under the guidance of the guide plate. Under the guide plate, all of the injections achieved an angular deviation within 2.5° (superior head: 2.49° ± 0.17°, inferior head: 2.31° ± 0.16°) and a needle tip positional deviation within 2 mm [superior head: (1.96 ± 0.25) mm, inferior head: (1.65 ± 0.21) mm]. The significant pain improvement rate (defined as ≥3-point reduction in VAS score) increased from 60% (9/15) at day 3 to 85% (13/15) at 2 weeks post-operation, stabilizing at 86.7% (13/15) at 4 weeks post-operation. Joint clicking improvement rates reached 72% (11/15) at 2 weeks post-operation and 75% (11/15) at 4 weeks post-operation. Regarding safety, only one case of injection site swelling and one case of transient paresthesia were observed; both resolved spontaneously within a short period of time. No neurovascular injury events occurred. Conclusion CT-guided guide plate achieves precise targeting design to minimize injection errors in the lateral pterygoid muscle. This technology is effective and safe, and it can provide an anatomically specific and operationally versatile targeted therapy for temporomandibular disorders.

Objective To observe the predictability of the corneal stromal reduction with smart pulse technology-as-sisted transperitoneal photorefractive keratomileusis(SPT-TPRK)and femtosecond laser-assisted in situ keratomileusis(FS-LASIK).Methods Patients undergoing laser surgery in the Department of Ophthalmology of the First Affiliated Hos-pital of Xinxiang Medical College from February to September 2023 were selected and divided by surgical modalities into an SPT-TPRK group(21 cases,37 eyes)and an FS-LASIK group(18 cases,32 eyes).The uncorrected visual acuity(UCVA),intraocular pressure,corneal thickness,and corneal epithelial thickness were measured before surgery,1 week,1 month and 3 months after surgery.The cutting deviation was calculated,and the change of corneal stromal thickness was ob-served.The correlation between the predicted corneal stromal reduction and the cutting deviation was analyzed.Results There were significant differences in UCVA among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The UCVA of patients in the FS-LASIK group was significantly higher than that in the SPT-TPRK group 1 week after surgery(P＜0.001).The difference in UCVA was not statistically significant between the two groups 1 month and 3 months after surgery(all P＞0.05).There were significant differences in intraocular pressure among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The FS-LASIK group had a lower intraocular pressure than the SPT-TPRK group 1 week after surgery(P＜0.05),but the difference in intraocular pressure was not statistically significant between the two groups 1 month and 3 months after surgery(all P＞0.05).There was significant difference between predicted cor-neal stromal reductions and actual corneal stromal reductions measured at different time points postoperatively in both SPT-TPRK and FS-LASIK groups(all P＜0.001).The actual corneal stromal reductions were higher than the predicted ones in the SPT-TPRK group at all postoperative time points(all P＜0.05).In the FS-LASIK group,the actual corneal stromal re-ductions were higher than the predicted ones 1 week and 1 month after surgery(all P＜0.05),but the actual and predicted corneal stromal reductions were not significantly different 3 months after surgery(P＞0.05).The cutting deviations were not significantly different between SPT-TPRK and FS-LASIK groups 1 month after surgery(P＞0.05),while the cutting de-viations were significantly different between the two groups 1 week and 3 months after surgery(all P＜0.05).There were significant differences in the change of the stromal thickness among different time points in both SPT-TPRK and FS-LASIK groups(all P＜0.05).There was no significant difference in the change of the stromal thickness among different time points in the SPT-TPRK group(all P＞0.05).The stromal thickness showed greater changes 1 month after surgery than that 1 week after surgery in the FS-LASIK group(P＜0.05).There were no significant differences in the change of the stromal thickness between 1 month and 3 months after surgery in the FS-LASIK group(P＞0.05).Correlation analysis showed a positive correlation between the predicted corneal stromal reduction and the cutting deviation in the SPT-TPRK group 1 week after surgery(P＜0.05),but they had no correlation 1 month and 3 months after surgery(all P＞0.05).There was no correlation between the predicted corneal stromal reduction and the cutting deviation in the FS-LASIK group at all post-operative time points(all P＞0.05).Conclusion Patients who receive SPT-TPRK or FS-LASIK can both achieve good visual acuity and a reduction in intraocular pressure.FS-LASIK has better predictability in refractive error correction than SPT-TPRK.

Objective·To investigate the efficacy and safety of a dose-reduced,all-oral lenalidomide/melphalan/prednisone acetate(RMP)regimen in elderly and frail patients with newly diagnosed multiple myeloma(NDMM).Methods·Elderly and frail NDMM patients who visited the Department of Hematology of Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,and the Third People's Hospital of Kunshan from April 2018 to March 2024 were retrospectively included.Clinical data and laboratory indicators were collected,and all patients were treated with the RMP regimen.SPSS 27.0 and R software were used for statistical analysis.Independent t-test was applied to normally distributed quantitative data,Mann-Whitney U test to non-normally distributed quantitative data,and x2 test and Fisher's exact probability method to qualitative data.Kaplan-Meier survival curves and Log-rank test were used for survival analysis.Results·Among the 22 elderly and frail NDMM patients treated with RMP,the median age was 76.3(68.4,95.0)years,and the median follow-up time was 25.5 months.The overall response rate(ORR)was 68.2%,and the rate of≥very good partial response(VGPR)was 36.4%.The median progression-free survival(PFS)was 20.53 months.The median PFS in the≤75-year-old group was 25.23(95%CI 12.95?37.52)months,while in the>75-year-old group it was 18.23(95%CI 14.86?21.61)months.There was no significant difference between the two groups.The median PFS in the≥partial response(PR)group was 20.67(95%CI 13.57?27.76)months,and in the

Objective:To investigate the risk of developing pulmonary hypertension (PH) in children with bronchopulmonary dysplasia (BPD) exposed to hemodynamically significant patent ductus arteriosus (hsPDA) and the correlation between PH and exposure to hsPDA.Methods:Retrospective case-control study.The clinical data of extremely premature infants (gestational age <32 weeks) admitted to the Department of Neonatology, Shanghai Children′s Hospital from January 2018 to December 2022 were retrospectively analyzed.All the very premature infants had a corrected gestational age≥36 weeks, required respiratory support, and were diagnosed with BPD.Their echocardiograms were evaluated by a team of physicians specialized in ultrasound.The patients were divided into a non-PH group and a PH group based on whether they were complicated by PH.The risk factors of PH in infant with BPD were analyzed by univariate and multivariate analyses.The influence of hsPDA on the outcome of PH in infant with BPD was analyzed by a Logistic model, whose performance was evaluated by the receiver-operating characteristic (ROC) curve.Results:(1)A total of 147 infants with BPD were included, with 74 cases in the non-PH group and 73 cases in the PH group.There was no significant difference in gestational age[(204.5±11.8) days vs.(201.6±11.5) days] and birth weight[(1 222±273) g vs.(1 153±237) g] between the non-PH and PH groups(all P>0.05).(2)Univariate ANOVA showed the development of PH in children with BPD was significantly related to postnatal positive pressure ventilation resuscitation ( P=0.036), invasive respiratory support ( P=0.002), prenatal glucocorticoids ( P=0.043), intravenous hormones ( P=0.003), liquid restriction ( P<0.001), hypercapnia ( P=0.004), PDA ( P=0.010), and hsPDA ( P<0.001).(3)The Logistic regression analysis suggested that exposure to hsPDA ( OR=5.414, 95% CI: 1.852-15.824, P=0.002) was an independent risk factor for PH development in children with BPD.The ROC curve is plotted through the prediction probability of the model, which has an optimal cut-off value of 42.9% (sensitivity=83.6%, specificity=63.5%, area under the ROC curve=0.794, and Youden index=0.471). Conclusions:Exposure to hsPDA increases the risk and is an independent risk factor of PH development in infants with BPD.

OBJECTIVE: To retrospectively analyze the characteristics and influencing factors of COVID-19 infection in patients with multiple myeloma (MM) who underwent autologous hematopoietic stem cell transplantation (AHSCT). METHODS: The clinical data of MM patients who underwent AHSCT in Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 26, 2021 to December 26, 2022 were collected. The onset of COVID-19 infection, corresponding symptoms and laboratory tests were followed up in outpatient or by the means of telephone contact and online questionnaires. Related analysis was then performed. RESULTS: This study included 96 patients, and 72 cases among them were infected with COVID-19 while 24 cases were uninfected. Logistic regression analysis showed that vaccination did not significantly reduce the risk of COVID-19 infection, but patients who received two doses of the vaccine had a lower risk of developing moderate and severe disease than those who did not receive or received one dose (OR =0.06, P =0.029). Patients who received daratumumab before had a higher risk of COVID-19 infection (OR =5.78, P =0.039), while those with a history of immunomodulatory drugs (IMiDs) had the opposite effect (OR =0.31, P =0.028). The use of both drugs did not affect the severity of COVID-19 infection. CONCLUSION For MM patients undergoing AHSCT as first-line chemotherapy, COVID-19 vaccination does not significantly reduce the infection rate, but it plays a role in preventing moderate and severe cases. The application of antineoplastic drugs with different mechanisms has a certain impact on the susceptibility to the COVID-19, which should be considered comprehensively when creating treatment plans.
Humans ; Multiple Myeloma/complications* ; COVID-19/epidemiology* ; Hematopoietic Stem Cell Transplantation ; Transplantation, Autologous ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Male ; Female ; Middle Aged ; SARS-CoV-2 ; Adult ; Antibodies, Monoclonal

Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

eIF3a is a N ⁶-methyladenosine (m⁶A) reader that regulates mRNA translation by recognizing m⁶A modifications of these mRNAs. It has been suggested that eIF3a may play an important role in regulating translation initiation via m⁶A during infection when canonical cap-dependent initiation is inhibited. However, the death of animal model studies impedes our understanding of the functional significance of eIF3a in immunity and regulation in vivo. In this study, we investigated the in vivo function of eIF3a using eIF3a knockout and knockdown mouse models and found that eIF3a deficiency resulted in splenic tissue structural disruption and multi-organ damage, which contributed to severe sepsis induced by Lipopolysaccharide (LPS). Ectopic eIF3a overexpression in the eIF3a knockdown mice rescued mice from LPS-induced severe sepsis. We further showed that eIF3a maintains a functional and healthy immune system by regulating B cell function and quantity through m⁶A modification of mRNAs. These findings unveil a novel mechanism underlying sepsis, implicating the pivotal role of B cells in this complex disease process regulated by eIF3a. Furthermore, eIF3a may be used to develop a potential strategy for treating sepsis.

OBJECTIVES: To evaluate the impact of HBV infection on pre- and postpartum health-related quality of life (HRQoL) in pregnant women. METHODS: A prospective matched cohort consisting of 70 HBV-infected and 70 healthy pregnant women was recruited from the Fifth Affiliated Hospital of Guangzhou Medical University between April 17 and September 25, 2023. HRQoL of the participants was assessed at 16-24 weeks of gestation, between 32 weeks and delivery, and 5-13 weeks postpartum. Mixed linear models were used for evaluating temporal trends of HRQoL changes, and univariate ANOVA with multiple linear regression was used to identify the predictors of HRQoL. RESULTS: Compared with healthy pregnant women, HBV-infected pregnant women had consistently lower total HRQoL scores across all the 3 intervals, with the lowest scores observed between 32 weeks of gestation and delivery, during which these women had significantly reduced mental component scores (74.27±13.43 vs 80.21±12.9, P=0.009) and postpartum mental (76.52±16.19 vs 85.02±6.51, P<0.001) and physical component scale scores (77.17±14.71 vs 83.09±10.1, P=0.009). HBV infection was identified as an independent risk factor affecting HRQoL during late pregnancy and postpartum periods. Additional independent risk factors for postpartum HRQoL reduction included self-pay medical expenses, spouse's neutral attitude toward the current pregnancy, and preexisting comorbidities (all P<0.05). CONCLUSIONS HRQoL of pregnant women deteriorates progressively in late pregnancy, and HBV infection exacerbates reductions of physical function and role emotion in late pregnancy and after delivery, suggesting the importance of targeted interventions for financial burdens, partner support and comorbid conditions to improve HRQoL of pregnant women with HBV infection.
Humans ; Female ; Pregnancy ; Quality of Life ; Prospective Studies ; Postpartum Period ; Hepatitis B, Chronic/psychology* ; Adult ; Pregnancy Trimester, Third ; Pregnancy Trimester, Second ; Pregnancy Complications, Infectious

Working memory is an executive memory process that includes encoding, maintenance, and retrieval. These processes can be modulated by transcranial alternating current stimulation (tACS) with sinusoidal waves. However, little is known about the impact of the rate of current change on working memory. In this study, we aimed to investigate the effects of two types of tACS with different rates of current change on working memory performance and brain activity. We applied a randomized, single-blind design and divided 81 young participants who received triangular wave tACS, sinusoidal wave tACS, or sham stimulation into three groups. Participants performed n-back tasks, and electroencephalograms were recorded before, during, and after active or sham stimulation. Compared to the baseline, working memory performance (accuracy and response time) improved after stimulation under all stimulation conditions. According to drift-diffusion model analysis, triangular wave tACS significantly increased the efficiency of non-target information processing. In addition, compared with sham conditions, triangular wave tACS reduced alpha power oscillations in the occipital lobe throughout the encoding period, while sinusoidal wave tACS increased theta power in the central frontal region only during the later encoding period. The brain network connectivity results showed that triangular wave tACS improved the clustering coefficient, local efficiency, and node degree intensity in the early encoding stage, and these parameters were positively correlated with the non-target drift rate and decision starting point. Our findings on how tACS modulates working memory indicate that triangular wave tACS significantly enhances brain network connectivity during the early encoding stage, demonstrating an improvement in the efficiency of working memory processing. In contrast, sinusoidal wave tACS increased the theta power during the later encoding stage, suggesting its potential critical role in late-stage information processing. These findings provide valuable insights into the potential mechanisms by which tACS modulates working memory.
Humans ; Memory, Short-Term/physiology* ; Male ; Female ; Young Adult ; Transcranial Direct Current Stimulation/methods* ; Brain/physiology* ; Adult ; Electroencephalography ; Single-Blind Method

Human naïve pluripotent stem cells (PSCs) hold great promise for embryonic development studies. Existing induction and culture strategies for these cells, heavily dependent on MEK inhibitors, lead to widespread DNA hypomethylation, aberrant imprinting loss, and genomic instability during extended culture. Here, employing high-content analysis alongside a bifluorescence reporter system indicative of human naïve pluripotency, we screened over 1,600 chemicals and identified seven promising candidates. From these, we developed four optimized media-LAY, LADY, LUDY, and LKPY-that effectively induce and sustain PSCs in the naïve state. Notably, cells reset or cultured in these media, especially in the LAY system, demonstrate improved genome-wide DNA methylation status closely resembling that of pre-implantation counterparts, with partially restored imprinting and significantly enhanced genomic stability. Overall, our study contributes advancements to naïve pluripotency induction and long-term maintenance, providing insights for further applications of naïve PSCs.
Humans ; DNA Methylation/drug effects* ; Genomic Instability ; Pluripotent Stem Cells/metabolism* ; Cell Culture Techniques/methods* ; Cells, Cultured