BACKGROUND:The sports medicine community has widely called for the use of machine learning technology to efficiently process the huge and complicated sports data resources,and construct intelligent sports injury prediction models,enabling accurate early warning of sports injuries.It is of great significance to comprehensively summarize and review such research results so as to grasp the direction of early warning model improvement and to guide the construction of sports injury prediction models in China. OBJECTIVE:To systematically review and analyze relevant research on sports injury prediction models based on machine learning technology,thereby providing references for the development of sports injury prediction models in China. METHODS:Literature search was conducted on CNKI,Web of Science and EBSCO databases,which mainly searched for literature related to machine learning techniques and sports injuries.Finally,61 articles related to sports injury prediction models were included for analysis. RESULTS AND CONCLUSION:(1)In terms of external risk feature indicators,there is a lack of competition scenario indicators,and the inclusion of related feature indicators needs to be further improved to further enrich the dimensions of the dataset for model training.In addition,the inclusion feature weighting methods of the sports injury prediction model are mainly based on filtering methods and the use of embedding and wrapping weighting methods needs to be strengthened in order to enhance the analysis of the interaction effects of multiple risk factors.(2)In terms of model body training,supervised learning algorithms become the mainstream choice.Such algorithms have higher requirements for the completeness of sample labeling information,and the application scenarios are easily limited.Therefore,the application of unsupervised and semi-supervised algorithms can be increased in the later stage.(3)In terms of model performance evaluation and optimization,the current studies mainly adopt two verification methods:HoldOut crossover and k-crossover.The range of AUC values is(0.76±0.12),the range of sensitivity is(75.92±11.03)%,the range of specificity is(0.03±4.54)%,the range of F1 score is(80.60±10.63)%,the range of accuracy is(69.96±13.10)%,and the range of precision is(70±14.71)%.Data augmentation and feature optimization are the most common model optimization operations.The accuracy and precision of the current sports injury prediction model are about 70%,and the early warning effect is good.However,the model optimization operation is relatively single,and data augmentation methods are often used to improve model performance.Further adjustments to the model algorithm and hyperparameters are needed to further improve model performance.(4)In terms of model feature extraction,most of the internal risk profile indicators included are mainly based on anthropometrics,training load,years of training,and injury history,but there is a lack of sports recovery and physical function indicators.

Objective To investigate the relationship between the expression of serum long non coding RNA nuclear-enriched abundant transcript 1(lncRNA NEAT1)and microRNA-106a-5p(miR-106a-5p)and the severity and prognosis of sepsis patients.Methods A total of 185 patients with sepsis who were diagnosed and treated in this hospital from August 2021 to July 2024 were selected as the study group,and another 215 healthy volunteers who underwent physical examinations in this hospital during the same period were selected as the control group.The research group was divided into the mild group(n=92),the severe group(n=58)and the shock group(n=35)according to the severity of the disease.The research group was divided into the good prognosis group(n=121)and the poor prognosis group(n=64)according to the prognosis.The expres-sions of lncRNA NEAT1 and miR-106a-5p were detected by real-time fluorescence quantitative polymerase chain reaction,and the correlation of the expressions of lncRNA NEAT1 and miR-106a-5p in the study group was analyzed by Pearson correlation analysis.The binding sites of lncRNA NEAT1 and miR-106a-5p were an-alyzed by StarBase,and the influencing factors of poor prognosis in patients were analyzed by multivariate Lo-gistic regression.The receiver operating characteristic curve was used to analyze the diagnostic value of the combination of lncRNA NEAT1 and miR-106a-5p for poor prognosis in patients.Results The expression of lncRNA NEAT1 in the study group was higher than that in the control group,and the expression of miR-106a-5p was lower than that in the control group,the difference was statistically significant(P＜0.05).The expressions of lncRNA NEAT1 and miR-106a-5p in the study group were negatively correlated(r=-0.413,P＜0.001),and there were binding sites between the two.With the increase of the severity of sepsis,the ex-pression of lncRNA NEAT1 increased and the expression of miR-106a-5p decreased,and the difference was statistically significant(P＜0.05).The acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score,tumor necrosis factor-α,C-reactive protein,and ln-cRNA NEAT1 in the poor prognosis group were higher than those in the good prognosis group,while the ex-pression of miR-106a-5p was lower than that in the good prognosis group,the difference was statistically sig-nificant(P＜0.05).Elevated APACHE Ⅱ score,SOFA score and lncRNA NEAT1 were independent risk fac-tors for poor prognosis in patients,and miR-106a-5p was an independent protective factor(P＜0.05).The ar-ea under the curve of the combined diagnosis of the two was 0.918(95％CI:0.868-0.953),which was supe-rior to the separate diagnosis of each(Zcombined with lncRNA NEAT1=4.112,Zcombined with miR-106a-5p=4.023,P＜0.05).Con-clusion With the increase of disease severity in patients with sepsis,the expression of lncRNA NEAT1 in-creases and the expression of miR-106a-5p decreases.The combined diagnosis of the two for poor prognosis in patients has a high clinical value.

ObjectiveTo compare the clinical features of patients with hepatitis B virus （HBV）-related early-onset liver cancer and those with late-onset liver cancer， to assess the severity of the disease， and to provide a theoretical basis for the early diagnosis and treatment of liver cancer. MethodsA retrospective analysis was performed for 695 patients who were diagnosed with HBV-related liver cancer for the first time in Guangzhou Eighth People’s Hospital， Guangzhou Medical University， from January 2019 to August 2023， among whom 93 had early-onset liver cancer （defined as an age of50 years for female patients and40 years for male patients） and 602 had late-onset liver cancer （defined as an age of ≥50 years for female patients and ≥40 years for male patients）. Related clinical data were collected， including demographic data， clinical symptoms at initial diagnosis， comorbidities， smoking history， drinking history， family history， routine blood test results， biochemical parameters of liver function， serum alpha-fetoprotein（AFP）， virological indicators， coagulation function， and imaging findings. The pan-inflammatory indices neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， and lymphocyte-to-monocyte ratio （LMR） were calculated， as well as FIB-4 index， aspartate aminotransferase-to-platelet ratio index （APRI）， S index， Model for End-Stage Liver Disease （MELD） score， Child-Turcotte-Pugh （CTP） score， albumin-bilirubin （AIBL） grade， and Barcelona Clinic Liver Cancer （BCLC） stage. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or Fisher’s exact test were used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in the proportion of male patients and the incidence rates of diabetes， hypertension， and fatty liver disease （χ²=6.357， 15.230， 11.467， and 14.204， all P0.05）， and compared with the late-onset liver cancer group， the early-onset liver cancer group had a significantly higher proportion of patients progressing to liver cancer without underlying cirrhosis （χ²=24.657， P0.001） and a significantly higher proportion of patients with advanced BCLC stage （χ²=6.172， P=0.046）. For the overall population， the most common clinical symptoms included abdominal distension， abdominal pain， poor appetite， weakness， a reduction in body weight， edema of both lower limbs， jaundice， yellow urine， and nausea， and 55 patients （7.9%） had no obvious symptoms at the time of diagnosis and were found to have liver cancer by routine reexamination， physical examination suggesting an increase in AFP， or radiological examination indicating hepatic space-occupying lesion； compared with the late-onset liver cancer group， the patients in the early-onset liver cancer group were more likely to have the symptoms of abdominal distension， abdominal pain， and jaundice （all P0.05）. Compared with the late-onset liver cancer group， the early-onset liver cancer group had a significantly larger tumor diameter （Z=2.845， P=0.034）， with higher prevalence rates of multiple tumors and intrahepatic， perihepatic， or distant metastasis （χ²=5.889 and 4.079， both P0.05）， and there were significant differences between the two groups in tumor location and size （χ²=3.948 and 11.317， both P0.05）. Compared with the late-onset liver cancer group， the early-onset liver cancer group had significantly lower FIB-4 index， proportion of patients with HBsAg ≤1 500 IU/mL， and levels of LMR and Cr （all P0.05）， as well as significantly higher positive rate of HBeAg and levels of log₁₀ HBV DNA， AFP， WBC， Hb， PLT， NLR， PLR， TBil， ALT， Alb， and TC （all P0.05）. ConclusionCompared with late-onset liver cancer， patients with early-onset liver cancer tend to develop liver cancer without liver cirrhosis and have multiple tumors， obvious clinical symptoms， and advanced BCLC stage， which indicates a poor prognosis.

Objective To discuss the application value of CT and DSA multimodal image fusion technology in endovascular interventional therapy for arterial occlusive lesions of lower extremities and to evaluate its efficacy and safety so as to provide a scientific basis for clinical decision-making.Methods A total of 283 lower limbs with arterial complete occlusive lesions,who received treatment at Affiliated Baiyun Hospital of Guizhou Medical University hospital from January 2020 to December 2023,were selected for this study.The 283 diseased lower limbs were randomly divided into study group(n=142)and control group(n=141).In the study group the endovascular interventional therapy assisted by CT and DSA multimodal image fusion technology was adopted,while in the control group the traditional DSA-guided endovascular interventional therapy was employed.The imaging parameters,surgical success rates,X-ray exposure doses,time spent for operation,incidence of postoperative complications,changes of ankle-brachial index(ABI),primary patency rate,assisted primary patency rate,and secondary patency rate were compared between the two groups.Results The surgical success rate in the study group was 96.47％,which was significantly higher than 87.94％in the control group(P＜0.05).The mean time spent for operation in the study group was(125.42±23.74)minutes,which was shorter than(147.81±29.33)minutes in the control group.The mean X-ray exposure dose in the study group was(2 856.34±427.82)mGy·cm2,which was lower than(3 674.53±512.60)mGy·cm2 in the control group.The incidence of postoperative complications in the study group was 4.23％,which was significantly lower than 12.57％in the control group(P＜0.05).The ABI values of the affected limbs in the study group and control group increased from preoperative(0.65±0.15)and(0.60±0.18)respectively to postoperative(1.09±0.32)and(0.90±0.28)respectively.The postoperative ABI value in the study group was higher than that in the control group(P＜0.05).The postoperative 12-month primary patency rate,assisted primary patency rate and secondary patency rate in the study group were 78.17％,85.92％and 90.14％respectively,which were better than 67.38％,75.89％and 80.85％respectively in the control group.Conclusion For arterial occlusive lesions of lower extremities,endovascular interventional therapy with the help of CT and DSA multimodal image fusion technology has high surgical success rates,low incidence of complications,and satisfactory revascularization rate.This technology provides new idea and method for the treatment of arterial occlusive lesions of lower extremities with high clinical safety.Therefore,this technology is worthy of clinical promotion and application.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective:To evaluate the efficacy and safety of telitacicept in the treatment of systemic lupus erythematosus (SLE) .Methods:The clinical data of 25 SLE patients who received standard therapy combined with telitacicept at the Department of Dermatology, Xiangya Second Hospital, Central South University, from 2021 to 2024 were retrospectively collected. Baseline demographic and clinical characteristics were analyzed. Changes in skin lesions, joint pain symptoms, complete blood count, and biochemical parameters at 4, 12, and 24 weeks of treatment were compared with baseline (week 0). The Wilcoxon signed-rank test was used to compare complement C3 and C4 levels before and after treatment, and univariate logistic regression analysis was performed to explore factors influencing the efficacy of telitacicept.Results:Among the 25 SLE patients, 3 were male (12.0%) and 22 were female (88.0%). Based on the SLE Disease Activity Index (SLEDAI) -2000 scores, 8 patients were mild, 13 were moderate, and 4 were severe. Of the 11 SLE patients with rashes before treatment, 6 achieved complete remission at 12 weeks. Among the 7 patients with joint pain before treatment, 4 experienced symptom resolution at 24 weeks. The proportion of patients with leukopenia at baseline and at 4, 12, and 24 weeks was 10/25 (40.0%), 0/24 (0), 1/22 (4.5%), and 2/19 (10.5%), respectively. The proportion of patients with thrombocytopenia was 6/25 (24.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively, and the proportion of patients with anemia was 7/25 (28.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively. At baseline, 11 out of 25 patients (44.0%) had proteinuria. At 12 weeks, the urinary protein quantification level (0.4 [0, 0.6] g/L) was significantly lower than at baseline (0.9 [0.8, 1.2] g/L). The SLE responder index-4 (SRI4) response rates at 4, 12, and 24 weeks were 14/18, 15/17, and 12/14, respectively. Complement C3 and C4 levels were significantly higher at 4, 12, and 24 weeks compared to baseline (all P < 0.001). Univariate logistic regression analysis showed that age, disease duration, glucocorticoid dosage, baseline complement C4 levels, antinuclear antibody titer, and SLEDAI-2K score did not significantly affect the efficacy of telitacicept (SRI4 response rate at 12 weeks) (all P > 0.05). No serious adverse reactions related to telitacicept were observed in patients. Conclusions:Telitacicept improved skin lesions, complement C3 and C4 levels, and anti-double-stranded DNA antibody levels in SLE patients. No association was found between the efficacy of telitacicept and baseline SLEDAI-2K scores, antinuclear antibody titers, or complement C4 levels, suggesting that telitacicept is an effective and safe treatment for SLE patients.

The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.

Objective:To investigate the therapeutic value of visual endoscopic retrograde appendicitis therapy (vERAT) in pediatric patients with acute suppurative appendicitis (ASA).Methods:This was a retrospective cohort study. A total of 55 ASA patients who underwent vERAT at the Pediatric Department of the Tangdu Hospital of Air Force Medical University between November 2023 and January 2025 were selected and divided into groups based on the presence or absence of fecaliths: fecalith group and non-fecalith group. The baseline characteristics, initial treatment success rates, treatment costs, hospital stay duration, procedure time, and recurrence rates between two groups were compared. Mann-Whitney U test and χ2 test were used to evaluate group differences. Results:A total of 55 ASA patients were enrolled, including 38 males and 17 females, with the age of 11.2 (9.2, 13.1) years. Based on the presence of fecaliths, patients were divided into two groups: fecalith group (32 cases) and non-fecalith group (23 cases). No statistically significant differences were observed between the two groups in terms of age, gender, duration of abdominal pain, white blood cell count, neutrophil percentage, diameter of appendix, thickness of appendix clinical symptoms or signs (all P>0.05). The initial treatment success rates were 91% (29/32) in fecalith group and 96% (22/23) in non-fecalith group, with no statistically significant difference ( P=0.632). However, significant differences were noted in stent placement ( χ2=5.85, P=0.026) and procedure time ( Z=4.75, P<0.001). The follow-up duration time was 6.0 (2.0, 12.0) and 7.0 (2.0, 8.5) months for the fecalith and non-fecalith groups, respectively, with no significant difference ( Z=0.05, P=0.962). The recurrence rates were 14% (4/29) in fecalith group and 5% (1/22) in non-fecalith group, with no statistically significant difference ( P=0.375). Conclusions:vERAT can safely and effectively treat pediatric ASA, regardless of the presence or absence of fecaliths. It can provide a new treatment option for ASA.