There are practical and cost-effective opportunities for the prevention and early intervention of periodontal disease, a common oral condition. Depression and anxiety represent major global mental health challenges, and they are characterized by high prevalence rates and an elevated suicide risk. Their clinical management is complicated by extended treatment timelines and substantial healthcare costs. Accumulating evidence demonstrates a statistically significant bidirectional association between periodontal disease and depression/anxiety disorders. However, established clinical pathways integrating these conditions remain lacking. This review presents a comprehensive analysis of current research examining the relationship between periodontal disease and mood disorders, specifically depression and anxiety. This study explored the bidirectional mechanisms within the microbiota-oral-brain axis, which includes both periodontal disease inducing neuroinflammation through pro-inflammatory factors, such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) activating the TLR-4/NF-κB signaling pathway, and depression and anxiety leading to “glucocorticoid resistance” through hypothalamic-pituitary-adrenal (HPA) axis dysregulation, thus causing dual immune dysfunction that exacerbates periodontal tissue destruction, as well as the mechanisms by which biological, psychological, and social factors contribute to the bidirectional association between periodontal disease and depression/anxiety. We propose implementing bidirectional referral protocols between dental and psychiatric services in clinical practice, incorporating mental health screening tools, such as Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7(GAD-7), for patients with moderate-to-severe periodontal disease, and incorporating periodontal examination into routine assessment during psychiatric services. This multidisciplinary approach aims to break the vicious circle between these conditions and provide clinicians with pragmatic intervention strategies.

Background Thyroid hormones are crucial for development and proper functioning of human physiological systems. Current research on the thyroid mainly focuses on the impacts of lifestyle factors on thyroid dysfunction, while less attention is paid to the factors affecting thyroid hormone levels, especially occupational hazards, which warrants further investigation. Objective To investigate the associations between occupational hazard exposure and thyroid-stimulating hormone (TSH) and thyroid hormone levels in male coal mine workers. Methods A cross-sectional study design was adopted. A total of 12564 workers who participated in the occupational health check-ups at the Xishan Coal Electricity (Group) Corporation Occupational Disease Prevention and Control Institute in 2023 and met the inclusion and exclusion criteria were selected as research subjects. A self-designed electronic questionnaire was used to collect basic information, occupational history, and lifestyle habits of all study subjects. Height, weight, thyroid function test results, and occupational hazard exposure of the study subjects were obtained through occupational health examinations and routine workplace occupational hazard detection records. Generalized linear regression was used to analyze the associations between occupational hazard exposure and the levels of TSH and thyroid hormones. Results The median (P₂₅, P₇₅) levels of triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), and TSH in the included 12564 male coal mine workers were 1.16 (1.03, 1.29) ng·mL⁻¹, 7.70 (6.70, 8.90) μg·dL⁻¹, 3.63 (3.40, 3.84) pg·mL⁻¹, 1.19 (1.08, 1.30) ng·dL⁻¹, and 1.93 (1.36, 2.78) μIU·mL⁻¹, respectively. The overall abnormality rate of thyroid hormones was 2.83%, with the highest rate for subclinical hypothyroidism (1.83%), followed by hyperthyroidism (0.37%), hypothyroidism (0.32%), and subclinical hyperthyroidism (0.31%). After adjustment for confounding factors, the generalized linear regression model showed that long working hours were associated with higher levels of T3 and FT3, with β (95%CI) values of 0.011 (0.003, 0.019) and 0.038 (0.019, 0.057) respectively. Night shift work was linked to increased TSH levels and decreased FT4 levels, with β (95%CI) values of 0.171 (0.016, 0.326) and −0.012 (−0.019, −0.006) respectively. Coal dust exposure was associated with decreased levels of T3 and T4, with β (95%CI) values of −0.022 (−0.037, −0.008) and −0.320 (−0.434, −0.207) respectively. Noise exposure was related to decreased levels of T4 and FT4, with β (95%CI) values of −0.102 (−0.166, −0.038) and −0.020 (−0.027, −0.013) respectively. Conclusion The TSH and thyroid hormone levels of coal miners are mostly within the normal reference ranges, with a low abnormality rate. Long work hours, night shift work, coal dust, and noise are associated with the levels of TSH and thyroid hormone levels in the male miners. Coal companies should reasonably arrange working hours, optimize the night shift scheduling system, and enhance protection against coal dust and noise to promote occupational health and safeguard the physical health of miners.

Central serous chorioretinopathy(CSC), the first described pachychoroid disease, is characterized by visual distortions and loss of vision, which are commonly seen in middle-aged male. Research has demonstrated that ocular blood flow in CSC is in a state of overload, characterized by the dilation of vortex vein ampullae and choroidal vasculature. The obstruction of venous outflow is linked to scleral thickness, while the choriocapillaris exhibits perfusion deficits due to compression from the engorged vascular layer. Over time, vascular remodeling occurs, with venous anastomoses forming to create alternative drainage pathways and mitigate blood stasis. These abnormalities in vortex vein dynamics and choroidal circulation play a critical role in elucidating the underlying pathogenesis and clinical manifestations of CSC. This review highlights the alterations in vortex vein and choroidal vasculature in CSC, hoping to understand how the changes of blood flow affect the course of CSC and their correlation with treatment response. By evaluating blood flow dynamics, we aim to determine the disease stage more accurately, optimize therapeutic strategies, and ultimately enhance patient outcomes.

Objective:To analyze the causal relationship between type 2 diabetes and lumbar bone mineral density and spinal fractures and to further explore the impact of central obesity on the diabetic bone paradox.Methods:A Mendelian randomization (MR) study was implemented. Single nucleotide polymorphisms (SNPs) associated with type 2 diabetes were selected from the data of genome-wide association studies as instrumental variables, with lumbar bone density and spinal fractures as the outcome variables. The inverse variance weighting method, weighted median method, and MR-Egger regression were applied to identify a causal relationship between type 2 diabetes and osteoporosis at the genetic level. Additionally, to analyze the impact of central obesity in the diabetic bone paradox, the waist-to-hip ratio was introduced as a new exposure variable, with type 2 diabetes and lumbar bone density as outcome variables, and the MR method was applied again to uncover the influencing factors.Results:The screening criteria were based on the three main assumptions of MR. Finally, 62 SNPs for type 2 diabetes and 241 SNPs for waist-to-hip ratio were included in the MR analysis. Using inverse variance weighting as the primary analysis, the causal association effect analysis indicated a causal relationship between type 2 diabetes and increased lumbar bone density ( OR=1.047 6, P=0.007) and spinal fractures ( OR=1.000 9, P=0.014). A causal relationship between waist-to-hip ratio and type 2 diabetes ( OR=1.638 6, P<0.001) was identified, indicating that the waist-to-hip ratio was a risk factor for type 2 diabetes and may have a causal association with increased lumbar bone density ( OR=1.096 3, P=0.044). This suggests that the waist-to-hip ratio may indirectly affect the relationship between diabetes and osteoporosis. The MR-Egger intercept test showed no horizontal pleiotropy in this study. The leave-one-out analysis indicated that no single SNP had a significant impact on the overall results. Furthermore, the MR-pleiotropy residual sum and outlier (MR-PRESSO) test results did not detect any outlier SNPs. Conclusion:MR analysis identified a causal relationship between type 2 diabetes and increased lumbar bone density as well as a higher risk of spinal fractures, a paradox that may be related to central obesity.

Objective:To explore the effect of combining transcranial magnetic stimulation (rTMS) with acupuncture in the treatment of patients with vascular cognitive impairment (VCI).Methods:A total of 40 VCI patients were randomly assigned to either the control group or the experimental group ( n=20 per group) using a random number table. Both groups received routine treatment and rTMS, while the experimental group was additionally provided with acupuncture for four weeks. The rTMS was at 10Hz at 90% of the motor threshold. Before and after the treatment, both groups′ cognition was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assays. Results:Significant improvement was observed in both groups′ average MoCA, MMSE, and MBI scores, along with reductions in peripheral serum IL-6 and TNF-α levels. The experimental group exhibited significantly higher MoCA subdomain scores in the visuospatial and executive function, attention, and delayed recall subdomains, as well as a higher total MoCA score compared to the control group. The average MMSE and MBI scores were significantly higher in the experimental group than the control group, and that group′s serum IL-6 and TNF-α levels were significantly lower, on average. Pearson correlation analysis demonstrated a positive correlation between the improvements in MoCA and MMSE scores and the reductions in IL-6 and TNF-α levels in both groups.Conclusions:rTMS combined with acupuncture effectively improves cognition and ADL ability among VCI patients. The underlying mechanism may be associated with the reduction of neuroinflammatory factors IL-6 and TNF-α.

Objective:To explore the effect of combining transcranial magnetic stimulation (rTMS) with acupuncture in the treatment of patients with vascular cognitive impairment (VCI).Methods:A total of 40 VCI patients were randomly assigned to either the control group or the experimental group ( n=20 per group) using a random number table. Both groups received routine treatment and rTMS, while the experimental group was additionally provided with acupuncture for four weeks. The rTMS was at 10Hz at 90% of the motor threshold. Before and after the treatment, both groups′ cognition was evaluated using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). Ability in the activities of daily living (ADL) was quantified using the modified Barthel Index (MBI). Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured using enzyme-linked immunosorbent assays. Results:Significant improvement was observed in both groups′ average MoCA, MMSE, and MBI scores, along with reductions in peripheral serum IL-6 and TNF-α levels. The experimental group exhibited significantly higher MoCA subdomain scores in the visuospatial and executive function, attention, and delayed recall subdomains, as well as a higher total MoCA score compared to the control group. The average MMSE and MBI scores were significantly higher in the experimental group than the control group, and that group′s serum IL-6 and TNF-α levels were significantly lower, on average. Pearson correlation analysis demonstrated a positive correlation between the improvements in MoCA and MMSE scores and the reductions in IL-6 and TNF-α levels in both groups.Conclusions:rTMS combined with acupuncture effectively improves cognition and ADL ability among VCI patients. The underlying mechanism may be associated with the reduction of neuroinflammatory factors IL-6 and TNF-α.

Objective:To analyze the causal relationship between type 2 diabetes and lumbar bone mineral density and spinal fractures and to further explore the impact of central obesity on the diabetic bone paradox.Methods:A Mendelian randomization (MR) study was implemented. Single nucleotide polymorphisms (SNPs) associated with type 2 diabetes were selected from the data of genome-wide association studies as instrumental variables, with lumbar bone density and spinal fractures as the outcome variables. The inverse variance weighting method, weighted median method, and MR-Egger regression were applied to identify a causal relationship between type 2 diabetes and osteoporosis at the genetic level. Additionally, to analyze the impact of central obesity in the diabetic bone paradox, the waist-to-hip ratio was introduced as a new exposure variable, with type 2 diabetes and lumbar bone density as outcome variables, and the MR method was applied again to uncover the influencing factors.Results:The screening criteria were based on the three main assumptions of MR. Finally, 62 SNPs for type 2 diabetes and 241 SNPs for waist-to-hip ratio were included in the MR analysis. Using inverse variance weighting as the primary analysis, the causal association effect analysis indicated a causal relationship between type 2 diabetes and increased lumbar bone density ( OR=1.047 6, P=0.007) and spinal fractures ( OR=1.000 9, P=0.014). A causal relationship between waist-to-hip ratio and type 2 diabetes ( OR=1.638 6, P<0.001) was identified, indicating that the waist-to-hip ratio was a risk factor for type 2 diabetes and may have a causal association with increased lumbar bone density ( OR=1.096 3, P=0.044). This suggests that the waist-to-hip ratio may indirectly affect the relationship between diabetes and osteoporosis. The MR-Egger intercept test showed no horizontal pleiotropy in this study. The leave-one-out analysis indicated that no single SNP had a significant impact on the overall results. Furthermore, the MR-pleiotropy residual sum and outlier (MR-PRESSO) test results did not detect any outlier SNPs. Conclusion:MR analysis identified a causal relationship between type 2 diabetes and increased lumbar bone density as well as a higher risk of spinal fractures, a paradox that may be related to central obesity.

Objective:To investigate ability of HCA587/MAGE-C2 protein combined with different adjuvants inducing antigen-specific immune response and antitumor effects in mice model.Methods:C57BL/6J mice were immunized with HCA587 protein com-bined with Freund's complete adjuvant(CFA)/Freund's incomplete adjuvant(IFA)and different doses of CpG ODN 1826(CpG),cellular and humoral immunity levels induced by different schemes were compared.ELISpot was used to evaluate frequency of IFN-γ-producing splenocytes.HCA587-specific antibodies were detected by ELISA.Intracellular cytokine staining(ICCS)analysis was mea-sured by flow cytometry.A tumor-bearing animal model was created by subcutaneously injection of B16-HCA587 tumor cells into right flank of C57BL/6J mice,which was treated with strategy with the strongest cellular and humoral immune response in immune compari-son protocol.Vernier calipers were used to measure tumor volume,and Log-rank test was used to analyze survival curve.Results:HCA587 protein combined with CFA and 50 μg CpG elicited strongest specific IFN-γ-secreting splenocytes and anti-HCA587 anti-bodies,which induced highest IFN-γ+CD4+T cells(P<0.05).In tumor treatment model,HCA587 protein combined with CFA and 50 μg CpG significantly inhibited tumor growth(P=0.026),while Log-rank test showed no significant effect on survival(P>0.05).Conclusion:HCA587 protein vaccine formulated with CFA and 50 μg CpG causes a significant cellular and humoral immune response and partial antitumor effect in mice model,providing new experimental data for preclinical research of tumor antigen protein vaccine.

Purpose To explore the application value of contrast enhancement boost(CE-Boost)technique in image quality of tumors and their feeding arteries in preoperative evaluation of renal cancer patients.Materials and Methods A total of 36 renal cancer patients in People's Hospital Affiliated to Shandong First Medical University from August 2022 to May 2023 with pathologically confirmed were retrospective collected.All patients underwent renal enhanced CT.The cortical phase images were post-processed using the CE-Boost technique to obtain CE-Boost images.The cortical phase images were set as group A and the CE-Boost images were set as group B.The CT value and image noise(SD)of abdominal aorta,renal artery,tumor and its adjacent renal cortex,and SD of the vertical spinal muscle on both sides of the spine of two groups were measured and recorded,and then the signal-to-noise ratio and contrast-to-noise ratio of tumor,abdominal aorta and renal artery were calculated.The image quality of the tumor,tumor feeding artery and renal artery was scored on 4 points by 2 doctors with double-blind method.Results The signal-to-noise ratio,contrast-to-noise ratio and CT value of group B were significantly higher than those of group A(t=-27.385--5.267,all P<0.05).The SD of tumor,abdominal aorta,right and left renal artery were not significantly different between group A and B(t=-1.849-0.993,all P>0.05).The subjective score of tumor in group A and B were no significant difference(Z=-1.490,P=0.136).However,the subjective score of tumor feeding arteries and renal arteries were significantly higher in group B than in group A(Z=-3.512,P=0.000;Z=-2.127,P=0.033).Conclusion The CT CE-Boost technique can improve the image quality of renal enhanced CT and provide visualization of tumor feeding arteries.

Objective:To analyze the factors associated with residual low back pain in older adults with osteoporotic thoracolumbar compression fractures after surgery, and to construct a predictive model based on the collected data and assess its effectiveness.Methods:The clinical data of 101 older adult patients with osteoporotic thoracolumbar compression fractures who underwent surgical treatment at Xi 'an International Medical Center Hospital from January 2020 to December 2022 were retrospectively analyzed. The patients were divided into two groups based on the presence or absence of low back pain after surgery: those with low back pain and those without.Postoperative pain intensity was recorded in detail. Univariate and multivariate analyses were performed to identify independent influential factors. In addition, a predictive model was constructed and its accuracy and prediction ability were tested.Results:Among 101 patients with osteoporotic thoracolumbar compression fractures, 43 (42.57%) experienced low back pain after surgery, while 58 (57.43%) did not. Univariate analysis revealed that patients with low back pain were older compared with those without low back pain [(67.81 ± 3.65) years vs. (64.21 ± 3.11) years, t = 5.34]. Patients with low back pain had a higher level of education, with 62.79% holding a college degree or higher compared to 41.38% of patients without low back pain (χ2 = 4.52). The prevalence of psychological disorders was higher in patients with low back pain compared with those without low back pain (39.53% vs. 20.69%, χ2 = 4.28), as was the proportion of patients who smoke (34.88% vs. 13.79%, χ2 = 6.25). Additionally, the proportion of patients with a history of fractures was greater in patients with low back pain compared with those without low back pain (25.58% vs. 10.34%, χ2 = 4.09). The bone density in patients with low back pain was lower than that in patients without low back pain [(3.18 ± 0.48) g/cm3 vs. (3.67 ± 0.43) g/cm3, t = -5.38]. The American Society of Anesthesiologists (ASA) classification was also higher in patients with low back pain, with proportions of ASA Ⅰ, Ⅱ, Ⅲ, and Ⅳ being 18.60%, 25.58%, 32.56%, and 23.26% compared with 34.48%, 37.93%, 20.69%, and 6.90% in patients without low back pain (χ2 = 9.51). The volume of bone cement injected was lower in patients with low back pain than in those without low back pain [(4.62 ± 0.21) mL vs. (4.85 ± 0.18) mL, t = -5.91]. The incidence of cement leakage was higher in patients with low back pain than in those without low back pain (18.60% vs. 1.72%, χ2 = 6.71). All differences were statistically significant (all P < 0.05). Multivariate logistic regression analysis indicated that age and cement leakage were independent risk factors for residual low back pain ( OR = 1.634, 3.379, both P < 0.05), while bone density and the amount of injected cement were protective factors against residual low back pain ( OR = 0.017, 0.003, both P < 0.05). Model validation showed that the regression model had good fit (Hosmer-Lemeshow χ2 = 6.73, P > 0.05). A risk prediction model was constructed based on the selected variables, yielding a C-index of 0.792. Using the independent variables and P values, a receiver operating characteristic curve was generated to predict the likelihood of low back pain in patients, with areas under the curve of 0.749, 0.754, 0.754, 0.642, and 0.945, respectively. Conclusion:Residual low back pain after surgery in older adult patients with osteoporotic thoracolumbar compression fractures is associated with age, bone density, volume of bone cement injected, and cement leakage. The constructed nomogram model, based on these factors, demonstrates good predictive capability for residual low back pain in this population.