Objective:To compare effects of different training modalities on cardiac remodeling(including cardiac hyper-trophy,myocardial fibrosis,fetal gene expression and capillary angiogenesis)in spontaneously hypertensive rats(SHR)and to investigate potential mechanism.Method:Forty-five male SHR were randomly divided into sedentary(SHR-SED)group,continuous endurance training(SHR-CET)group and high-intensity interval training(SHR-HIIT)group,with ten normotensive Wistar-Kyoto rats serving as the normal control(NC)group.The exercise intensity(70%—90%maximal running speed),duration(1-4min)and exercise frequency(3-5d/w)were progressively increased g in SHR-HIIT group,while SHR-CET group consistently exercised at 60%of the maximal running speed.Both groups had equal en-ergy consumption over an intervention period of 12 weeks.After the intervention,caudal artery pressure was assessed by non-invasive blood pressure tester;cardiac structure and function was evaluated by echocardio-gram;histopathological detection was detected by HE and Masson staining;myocardial microvessel density(MVD)was measured by immunohistochemistry;protein expression of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),β-myosin heavy chain(β-MHC),hypoxia inducible factor-1α(HIF-1α),endothelial nitric oxide synthase(eNOS)and vascular endothelial growth factor(VEGF)was detected by Western Blot.Result:Compared with NC group,SHR-SED group had elevated blood pressure(P<0.05),concentric hyper-trophy in the left ventricle with decreased cardiac function and myocardial fibrosis,reduced MVD(P<0.05),and increased HIF-1α protein expression(P<0.05).Compared with SHR-SED group,SHR-CET group showed a decrease in blood pressure(P<0.05),left ventricular eccentric hypertrophy with enhanced cardiac function(P<0.05),reduced myocardial fibrosis,increased MVD(P<0.05),decreased HIF-1α expression(P<0.05),and in-creased eNOS expression(P<0.05).The SHR-HIIT group showed worsened left ventricular concentric hypertro-phy and increased BNP expression(P<0.05).Conclusion:Long-term continuous endurance training(CET)alleviated while high-intensity interval training(HI-IT)aggravated cardiac remodeling in hypertensive rats.Traditional CET remains the primary exercise rehabilita-tion method for hypertension,however,the safety and effectiveness of HIIT need to be further confirmed.

Objective:To compare effects of different training modalities on cardiac remodeling(including cardiac hyper-trophy,myocardial fibrosis,fetal gene expression and capillary angiogenesis)in spontaneously hypertensive rats(SHR)and to investigate potential mechanism.Method:Forty-five male SHR were randomly divided into sedentary(SHR-SED)group,continuous endurance training(SHR-CET)group and high-intensity interval training(SHR-HIIT)group,with ten normotensive Wistar-Kyoto rats serving as the normal control(NC)group.The exercise intensity(70%—90%maximal running speed),duration(1-4min)and exercise frequency(3-5d/w)were progressively increased g in SHR-HIIT group,while SHR-CET group consistently exercised at 60%of the maximal running speed.Both groups had equal en-ergy consumption over an intervention period of 12 weeks.After the intervention,caudal artery pressure was assessed by non-invasive blood pressure tester;cardiac structure and function was evaluated by echocardio-gram;histopathological detection was detected by HE and Masson staining;myocardial microvessel density(MVD)was measured by immunohistochemistry;protein expression of atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),β-myosin heavy chain(β-MHC),hypoxia inducible factor-1α(HIF-1α),endothelial nitric oxide synthase(eNOS)and vascular endothelial growth factor(VEGF)was detected by Western Blot.Result:Compared with NC group,SHR-SED group had elevated blood pressure(P<0.05),concentric hyper-trophy in the left ventricle with decreased cardiac function and myocardial fibrosis,reduced MVD(P<0.05),and increased HIF-1α protein expression(P<0.05).Compared with SHR-SED group,SHR-CET group showed a decrease in blood pressure(P<0.05),left ventricular eccentric hypertrophy with enhanced cardiac function(P<0.05),reduced myocardial fibrosis,increased MVD(P<0.05),decreased HIF-1α expression(P<0.05),and in-creased eNOS expression(P<0.05).The SHR-HIIT group showed worsened left ventricular concentric hypertro-phy and increased BNP expression(P<0.05).Conclusion:Long-term continuous endurance training(CET)alleviated while high-intensity interval training(HI-IT)aggravated cardiac remodeling in hypertensive rats.Traditional CET remains the primary exercise rehabilita-tion method for hypertension,however,the safety and effectiveness of HIIT need to be further confirmed.

Objective To construct a distance self-attention(DSA)and long short-term memory(LSTM)model and observe its value for predicting X-ray tube arcing in CT equipment.Methods CT equipment status data of internet of medical things were collected and preprocessed,then DSA-LSTM model based on model attention(MA)module and nonlinear attenuation distance factor was constructed,and its value for predicting X-ray tube arcing in CT equipment was analyzed compared with other models.Results Compared with other models,DSA-LSTM model had better comprehensive efficiency for predicting X-ray tube arcing in CT equipment.MA module and nonlinear attenuation distance factor could improve the predictive efficiency of DSA-LSTM model,and all included features contributed to the performance of DSA-LSTM model in a certain extent.Conclusion DSA-LSTM model could effectively predict X-ray tube arcing in CT equipment.

ObjectiveTo investigate the efficacy of ovarian tissue cryopreservation and autologous transplantation in preserving fertility and ovarian endocrine function in patients with cervical cancer. MethodsA 26-year-old patient with stage ⅡA1 cervical cancer underwent ovarian tissue harvesting and cryopreservation during cancer surgery. Following complete remission of the cancer， autologous ovarian tissue transplantation was performed. Follow-up monitoring included assessment of menopausal symptoms， hormone levels， and follicular development. ResultsSix months after transplantation， follicle-stimulating hormone levels decreased to 6.60 U/L， and estradiol levels increased from ＜10.00 ng/L to 89.00 ng/L. At 10 months after transplantation， ultrasound monitoring confirmed follicular development and physiological ovulation in the transplanted ovarian tissue. By 15 months after transplantation， follicle-stimulating hormone levels remained stable at 7.24 U/L， and estradiol levels further increased to 368.00 ng/L. Over 2 years after transplantation， the patient successfully gave birth to a healthy baby through assisted reproductive technology. ConclusionThe restoration of endocrine and ovulation functions in the transplanted cryopreserved ovarian tissue， followed by successful pregnancy， demonstrates the clinical success of ovarian tissue transplantation.

Objective: This study investigated the effect of applying different torque values on the sagittal displacement tendency of mandibular incisors during intrusion using clear aligners, with the aim of providing a reference for achieving true vertical intrusion (intrusion without labiolingual movement) of mandibular incisors in clear aligner therapy. Methods: This study was approved by the institutional ethics committee. A volunteer with an incisor mandibular plane angle of 94° was selected. Using cone-beam computed tomography and intraoral scan data, a high-precision three-dimensional finite element model was established. An intrusion amount of 0.2 mm was set for the mandibular incisors, and four simulation groups were defined by applying 0°, 1°, 2°, and 3° of root labial torque. The displacement tendency of the incisors and the stress distribution within the periodontal ligament were analyzed. Results: When 0° of root labial torque was applied, the mandibular incisors exhibited intrusion accompanied by crown-labial, root-lingual inclination. When 1°-3° of root labial torque was applied, the mandibular incisors exhibited intrusion accompanied by the inclination gradually shifted from crown-labial, root-lingual towards crown-lingual, root-labial. Based on the line graph of sagittal displacement, the central incisors and lateral incisors approximated true vertical intrusion when 1.8° and 2.5° of root labial torque was applied, respectively. The mandibular canines consistently exhibited extrusion accompanied by labial crown inclination. Stress within the periodontal ligament of the incisors and canines was primarily concentrated at the root apex and cervical region. After applying root labial torque, the area of stress concentration in the incisors cervical periodontal ligament shifted from the labial side to the lingual side. The stress in the periodontal ligament at the cervical region of the canines is predominantly concentrated on the labial side. Conclusion Applying appropriate torque control during mandibular incisor intrusion with clear aligners facilitates true vertical intrusion, thereby enhancing the efficiency of the intrusion.

BACKGROUND:The utilization of miniscrews for assisting in molar distalization with clear aligners is a commonly adopted clinical approach.However,treatment outcomes may be influenced by the implantation position of miniscrew and the hooks in various tooth location.OBJECTIVE:To analyze the biomechanical effects of hooks at different tooth positions and the assistance of buccal and palatal miniscrews in distalizing molars with clear aligners by using the finite element method.METHODS:By integrating volunteer cone beam CT and Itero intraoral scan data,high-precision finite element models were constructed to simulate the combined use of miniscrews and hooks to assist in the distalization of the maxillary first and second molars with clear aligners,aiming for a designed distalization magnitude of 0.2 mm.Four conditions were established based on the placement of buccal or palatal miniscrews,as well as the located of hooks at the canine or first premolar.The buccal anchorage screw was used in combination with hooks on the buccal side of the canine;the buccal anchorage screw was used in combination with hooks on the buccal side of the first premolar;the palatal anchorage screw was used in combination with hooks on the lingual side of the canine,and the palatal anchorage screw was used in combination with hooks on the lingual side of the first premolar.Analysis using ANSYS software was conducted to evaluate the three-dimensional displacement trends of maxillary teeth and the maximum equivalent stress on the periodontal ligament under each condition.RESULTS AND CONCLUSION:(1)Regardless of whether hooks were placed on canines or first premolars,palatal miniscrews had been shown to enhance the distal movement of maxillary molars and reduce the mesial movement of premolars as well as the labial tipping tendency of anterior teeth,compared to buccal miniscrews.The maximum equivalent stress in the periodontal ligament of molars was increased,while that of anterior teeth was decreased.(2)Regardless of whether the miniscrews were located on the buccal or palatal side,compared with hooks at the first premolar,when hooks were done at the canine,the labial inclination trend of the anterior teeth was reduced,the distal movement of the molars was reduced,the mesial movement of the premolars was increased,and the maximum equivalent stress of the molar and the periodontal membrane of the anterior teeth was reduced.(3)Regardless of whether miniscrews were located on the buccal or palatal side,and the hooks were located on the canine or the first premolar,the molar could not achieve overall movement.(4)The results show that clear aligner combined with palatal miniscrews and hooks at the first premolar are more conducive to improving the efficiency of maxillary molar distalization,but attention should be paid to protecting the anterior tooth miniscrews and molar torque control;clear aligner combined with palatal miniscrews and hooks at the canine is more conducive to reducing the labial tipping tendency of anterior teeth,but the efficiency of molar distalization will be relatively reduced.

Mycophenolic acid (MPA), the active moiety of both mycophenolate mofetil (MMF) and enteric-coated mycophenolate sodium (EC-MPS), serves as a primary immunosuppressant for maintaining solid organ transplants. Therapeutic drug monitoring (TDM) enhances treatment outcomes through tailored approaches. This study aimed to develop an evidence-based guideline for MPA TDM, facilitating its rational application in clinical settings. The guideline plan was drawn from the Institute of Medicine and World Health Organization (WHO) guidelines. Using the Delphi method, clinical questions and outcome indicators were generated. Systematic reviews, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence quality evaluations, expert opinions, and patient values guided evidence-based suggestions for the guideline. External reviews further refined the recommendations. The guideline for the TDM of MPA (IPGRP-2020CN099) consists of four sections and 16 recommendations encompassing target populations, monitoring strategies, dosage regimens, and influencing factors. High-risk populations, timing of TDM, area under the curve (AUC) versus trough concentration (C₀), target concentration ranges, monitoring frequency, and analytical methods are addressed. Formulation-specific recommendations, initial dosage regimens, populations with unique considerations, pharmacokinetic-informed dosing, body weight factors, pharmacogenetics, and drug‍-‍drug interactions are covered. The evidence-based guideline offers a comprehensive recommendation for solid organ transplant recipients undergoing MPA therapy, promoting standardization of MPA TDM, and enhancing treatment efficacy and safety.
Mycophenolic Acid/administration & dosage* ; Drug Monitoring/methods* ; Humans ; Organ Transplantation ; Immunosuppressive Agents/administration & dosage* ; Delphi Technique

Objective To evaluate the efficacy and safety of rabbit anti-human thymocyte immuneglobulin(rATG)induction therapy in kidney transplant recipients from donation after cardiac death in China.Methods This was a prospective,multicenter,single-arm and interventional study conducted in China(NCT03099122).Adult patients who underwent kidney transplantation from donation after cardiac death and received rATG induction therapy(cumulative dose of 5 mg/kg)were included.Univariate and multivariate logistic regression analyses were used to identify factors associated with acute rejection(AR),delayed graft function(DGF),graft failure and patient death.The occurrence of adverse events was also analyzed.Results A total of 115 adult patients were enrolled in the study,of whom 107 were evaluable for efficacy.The incidence of biopsy-proven acute rejection(BPAR)and acute rejection(AR)was 2.8%(95%confidence interval 0.6%-8.0%)and 4.7%(95%confidence interval 1.5%-10.6%),respectively.The incidence of delayed graft function(DGF)was 13.1%(95%confidence interval 7.3%-21.0%).Graft and patient survival rates were 97.2%(95%confidence interval 92.0%-99.4%)and 99.1%(95%confidence interval 94.9%-100%),respectively.Multivariate logistic regression analysis showed that donor serum creatinine and recipient panel reactive antibodies were risk factors for DGF(both P<0.05).Common treatment-emergent adverse events(incidence>5%)included anemia(8.7%),infectious pneumonia(8.7%),and urinary tract infection(8.7%).Conclusions Standard-dose rATG induction therapy demonstrates low incidences of BPAR,AR,and DGF,and good safety in kidney transplant recipients from donation after cardiac death in China.