ObjectiveTo investigate the clinical application value of thromboelastographic parameters in assessing coagulation function by analyzing the thromboelastographic features of patients with primary liver cancer （PLC）， and to provide a basis for coagulation management and prognostic evaluation in liver cancer patients. MethodsA retrospective analysis was performed for 1 253 PLC patients who were admitted to The First Affiliated Hospital of Xi’an Jiaotong University from May 2015 to December 2022. According to the presence or absence of cirrhosis， the patients were divided into non-cirrhosis group with 262 patients and cirrhosis group with 991 patients， and according to the presence or absence of HBV infection， they were divided into HBV infection group with 1 055 patients and non-HBV infection group with 198 patients. The patients were stratified based on the severity of liver cirrhosis （Child-Pugh class and MELD score） and liver reserve function （indocyanine green retention rate at 15 minutes ［ICGR15］）， and thromboelastography was used to measure thromboelastographic parameters （reaction time ［R］， coagulation formation time ［K］， α-angle， maximum thrombosis amplitude ［MA］， and coagulation composite index ［CI］） and conventional coagulation markers. The t-test was used for comparison of normally distributed continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the Kruskal-Wallis H test was used for comparison between multiple groups， and the Bonferroni correction method was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between grouips， and the Spearman test was used for correlation analysis. ResultsAmong the 991 patients in the cirrhosis group， 826 had Child-Pugh class A （5 — 6 points）， and 165 had Child-Pugh class B （7 — 9 points）； 812 had an MELD score of <10， and 179 had an MELD score of ≥10； 679 had an ICGR15 of <10%， and 294 had an ICGR15 of ≥10%. Compared with the patients with Child-Pugh class A， the patients with Child-Pugh class B had a significantly longer K time and significant reductions in α-angle， MA， and CI （all P <0.001）； compared with the MELD score <10 group， the MELD score ≥10 group had a significantly longer K time and significant reductions in α-angle， MA， and CI （all P<0.001）； compared with the ICGR15 <10% group， the ICGR15 ≥10% group had a significantly longer K time and a significant reduction in MA （both P <0.001）. Among the 1 253 patients， MA was strongly positively correlated with fibrinogen and platelet count （r=0.675 and 0.667， both P<0.001）； The MA had a weak correlation with Child-Pugh score， MELD score， and ICGR15 （r=-0.112， -0.250， and -0.117， all P<0.001）， while the K time，α-angle and CI were weakly correlated with the MELD score （r=0.222， -0.184， and -0.183， all P<0.001），R time was negatively correlated with ICGR15 （r=-0.080， P=0.005）. The HBV infection group had significantly higher MA and CI than the non-HBV infection group （P<0.05）. ConclusionThromboelastography can sensitively identify the hypocoagulable state associated with the progression of liver cirrhosis and the hypercoagulable tendency in HBV-related liver cancer， which provides an important reference for individualized anticoagulant therapy in clinical practice.

BACKGROUND:Orthodontic treatment to move the mandibular second molar in place of the missing first molar is a good method for preserving natural teeth.However,molars often exhibit mesial tipping when using clear aligners.The impact of attachments and overcorrection on the molar mesialization with clear aligners is unclear.OBJECTIVE:To investigate the effects of attachments and overcorrection on displacement and biomechanics of the mandibular second molar mesialization.METHODS:A finite element model with the left mandibular first molar missing was constructed using a volunteer's cone-beam CT and intraoral scan data.The experiment was divided into four groups based on the position of attachments on the left mandibular second molar:without attachment,buccal attachment,lingual attachment,and buccal-lingual attachment,with overcorrection degrees(0°,1°,2°,3°,and 4°)for each group,totaling 20 models.The calculation and analysis of the displacement trends and stress were performed using Abaqus software.RESULTS AND CONCLUSION:(1)Mesial tipping and intrusion of the molar,distal tipping of the canines and permolars,and linguaing of the incisors occurred during molar mesialization.(2)The displacement of molars increased when attachments were used,with the maximum displacement occurring when buccal-lingual attachments were applied.Molars tended to tip towards the side without attachments when attachments were designed unilaterally.However,the inclination of molars did not decrease when attachments were used.(3)Molars exhibited reduced mesial tipping and intrusion,approaching overall movement,and the stress of periodontal ligament was relieved and more evenly distributed during overcorrection treatment,and this effect became more pronounced with increased degrees of overcorrection.(4)Attachments can enhance the effectiveness of overcorrection,with the best performance observed when buccal-lingual attachments are used.Using attachments and overcorrection together helps control molar mesial tipping and intrusion,but overall molar movement is not achieved.

BACKGROUND:Orthodontic treatment to move the mandibular second molar in place of the missing first molar is a good method for preserving natural teeth.However,molars often exhibit mesial tipping when using clear aligners.The impact of attachments and overcorrection on the molar mesialization with clear aligners is unclear.OBJECTIVE:To investigate the effects of attachments and overcorrection on displacement and biomechanics of the mandibular second molar mesialization.METHODS:A finite element model with the left mandibular first molar missing was constructed using a volunteer's cone-beam CT and intraoral scan data.The experiment was divided into four groups based on the position of attachments on the left mandibular second molar:without attachment,buccal attachment,lingual attachment,and buccal-lingual attachment,with overcorrection degrees(0°,1°,2°,3°,and 4°)for each group,totaling 20 models.The calculation and analysis of the displacement trends and stress were performed using Abaqus software.RESULTS AND CONCLUSION:(1)Mesial tipping and intrusion of the molar,distal tipping of the canines and permolars,and linguaing of the incisors occurred during molar mesialization.(2)The displacement of molars increased when attachments were used,with the maximum displacement occurring when buccal-lingual attachments were applied.Molars tended to tip towards the side without attachments when attachments were designed unilaterally.However,the inclination of molars did not decrease when attachments were used.(3)Molars exhibited reduced mesial tipping and intrusion,approaching overall movement,and the stress of periodontal ligament was relieved and more evenly distributed during overcorrection treatment,and this effect became more pronounced with increased degrees of overcorrection.(4)Attachments can enhance the effectiveness of overcorrection,with the best performance observed when buccal-lingual attachments are used.Using attachments and overcorrection together helps control molar mesial tipping and intrusion,but overall molar movement is not achieved.

Objective To analyze the dual-channel with single channel recorded somatosensory evoked potentials(SSEPs)monitoring in the thoracic vertebral disease that underwent surgical fixation surgery waveform differentiation and evaluate the value of dual-channel SSEPs applied in thoracic surgery diseases.Methods The study included 135 patients who underwent surgery for thoracic vertebra disease in Xi'an Honghui hospital from November 2019 to November 2023.Of them,66 underwent conventional single-channel SSEPs monitoring and 69 underwent dual-channel SSEPs monitoring.By observing the waveform differentiation of single-channel SSEPs and dual-channel SSEPs,Chi-square test and Fisher exact test were used to analyze the influences of age and etiological classification on the waveform differentiation and monitoring success rate of SSEPs.The success rate of intraoperative monitoring and the incidence of postoperative adverse events in alarm cases were compared between the two groups.Results Univariate analysis showed that age group and etiological classification of thoracic vertebral diseases affected the success rate of intraoperative SSEPs monitoring.Among the etiological classification,the SSEPs waveform differentiation in fracture group was the least ideal.Intraoperative monitoring results showed that the success rate of single-channel SSEPs monitoring was 80.30％,while the success rate of dual-channel SSEPS monitoring was 98.55％(P＜0.05).In the intraoperative alarm cases,the incidence of postoperative adverse events monitored by single-channel SSEPs was 66.67％;the incidence of adverse events after dual-channel SSEPs monitoring was 33.33％.Conclusion The age of patients and etiological type of thoracic spine diseases affect the success rate of intraoperative SSEPs monitoring.Dual-channel SSEPs monitoring can effectively and accurately evaluate the function of patients with posterior spinal cord conduction pathway.Using dual-channel SSEPs monitoring can significantly improve the success rate of monitoring and reduce the occurrence of postoperative adverse events in patients with thoracic vertebra disease.

Objective:To explore the relationship between the dark triad, fear of missing out and smartphone addiction, as well as the mediating role of fear of missing out between the dark triad and smartphone addiction.Methods:A total of 408 college students were assessed using dirty dozen, fear of missing out scale, and mobile phone addiction index. SPSS 24.0 software was used for common method bias tests, descriptive statistical analysis, and correlation analysis. Mplus 8.3 software was employed to construct a structural equation model, and the Bootstrap method was used for mediation effect analysis.Results:The dark triad (36.14±9.06) was positively correlated with fear of missing out (22.55±6.60) and smartphone addiction (46.77±13.62) ( r=0.48, 0.45, both P<0.01). Fear of missing out was also positively correlated with smartphone addiction ( r=0.54, P<0.01). Fear of missing out played a partial mediating role in the relationship between the dark triad and smartphone addiction, with a total effect value of 0.495 and a mediating effect value of 0.217. Conclusion:Fear of missing out partially mediates the relationship between the dark triad and smartphone addiction. The dark triad not only directly predicts smartphone addiction but also indirectly influences smartphone addiction through fear of missing out.

Objective:To explore the relationship between the dark triad, fear of missing out and smartphone addiction, as well as the mediating role of fear of missing out between the dark triad and smartphone addiction.Methods:A total of 408 college students were assessed using dirty dozen, fear of missing out scale, and mobile phone addiction index. SPSS 24.0 software was used for common method bias tests, descriptive statistical analysis, and correlation analysis. Mplus 8.3 software was employed to construct a structural equation model, and the Bootstrap method was used for mediation effect analysis.Results:The dark triad (36.14±9.06) was positively correlated with fear of missing out (22.55±6.60) and smartphone addiction (46.77±13.62) ( r=0.48, 0.45, both P<0.01). Fear of missing out was also positively correlated with smartphone addiction ( r=0.54, P<0.01). Fear of missing out played a partial mediating role in the relationship between the dark triad and smartphone addiction, with a total effect value of 0.495 and a mediating effect value of 0.217. Conclusion:Fear of missing out partially mediates the relationship between the dark triad and smartphone addiction. The dark triad not only directly predicts smartphone addiction but also indirectly influences smartphone addiction through fear of missing out.

Objective To analyze the dual-channel with single channel recorded somatosensory evoked potentials(SSEPs)monitoring in the thoracic vertebral disease that underwent surgical fixation surgery waveform differentiation and evaluate the value of dual-channel SSEPs applied in thoracic surgery diseases.Methods The study included 135 patients who underwent surgery for thoracic vertebra disease in Xi'an Honghui hospital from November 2019 to November 2023.Of them,66 underwent conventional single-channel SSEPs monitoring and 69 underwent dual-channel SSEPs monitoring.By observing the waveform differentiation of single-channel SSEPs and dual-channel SSEPs,Chi-square test and Fisher exact test were used to analyze the influences of age and etiological classification on the waveform differentiation and monitoring success rate of SSEPs.The success rate of intraoperative monitoring and the incidence of postoperative adverse events in alarm cases were compared between the two groups.Results Univariate analysis showed that age group and etiological classification of thoracic vertebral diseases affected the success rate of intraoperative SSEPs monitoring.Among the etiological classification,the SSEPs waveform differentiation in fracture group was the least ideal.Intraoperative monitoring results showed that the success rate of single-channel SSEPs monitoring was 80.30％,while the success rate of dual-channel SSEPS monitoring was 98.55％(P＜0.05).In the intraoperative alarm cases,the incidence of postoperative adverse events monitored by single-channel SSEPs was 66.67％;the incidence of adverse events after dual-channel SSEPs monitoring was 33.33％.Conclusion The age of patients and etiological type of thoracic spine diseases affect the success rate of intraoperative SSEPs monitoring.Dual-channel SSEPs monitoring can effectively and accurately evaluate the function of patients with posterior spinal cord conduction pathway.Using dual-channel SSEPs monitoring can significantly improve the success rate of monitoring and reduce the occurrence of postoperative adverse events in patients with thoracic vertebra disease.

Objective:To investigate the predictive value of serum levels of C-C motif chemokine ligand 21 (CCL21) and C-X-C motif chemokine receptor 3 (CXCR3) for stroke-associated pneumonia (SAP) in patients with acute ischemic stroke (AIS).Methods:Patients with AIS admitted to No.215 Hospital of Shaanxi Nuclear Industry from July 2020 to December 2023 were prospectively included. Serum CCL21 and CXCR3 test results and general clinical data at admission were collected using the hospital electronic medical record system. The independent influencing factors of SAP were identified through multivariate logistic regression analysis, and the predictive value of serum CCL21 and CXCR3 levels for SAP were analyzed by receiver operating characteristic (ROC) curves. Results:A total of 150 patients with AIS were enrolled, including 91 males (60.67%), aged 61.48±7.92 years. Among them, 41 patients (27.33%) developed SAP during hospitalization. There were significant differences in serum CCL21 and CXCR3 levels, National Institutes of Health Stroke Scale score, Glasgow Coma Scale score, invasive mechanical ventilation, length of hospital stay, and the proportion of patients with hypertension and diabetes between the SAP group and the non-SAP group (all P<0.05). Multivariate logistic regression analysis showed that serum CCL21 (odds ratio [ OR] 1.022, 95% confidence interval [ CI] 1.006-1.039; P=0.006) and CXCR3 ( OR 1.036, 95% CI 1.018-1.054; P<0.001) levels were the independent risk factors for SAP. ROC curve analysis showed that serum CCL21 and CXCR3 levels had good predictive power separately for SAP. The areas under the curve was 0.730 (95% CI 0.634-0.825) and 0.807 (95% CI 0.721-0.892), respectively. The combined prediction of the two showed an area under the curve of 0.881 (95% CI 0.819-0.943). Conclusion:The patients with AIS generally have higher levels of serum CCL21 and CXCR3. The levels of serum CCL21 and CXCR3 are closely associated with SAP, and both of them have a good predictive effect on SAP alone or in combination.

Objective:To explore effect of human umbilical cord mesenchymal stem cells(hUC-MSCs)on macrophage M1/M2 polarization.Methods:hUC-MSCs were co-cultured with pTHP-1 cells which were macrophage-like cells induced by PMA and tran-scriptome sequencing data were analyzed.Differentially expressed genes were screened and analyzed by GO and KEGG enrichment analysis.Effect of hUC-MSCs on pTHP-1 cells proliferation was analyzed by cell proliferation assay(CCK-8 and EdU).Flow cytometry was used to verify influence of hUC-MSCs on relative contents of inflammatory cytokine TNF-α and anti-inflammatory cytokine IL-10 in pTHP-1 cells which were interaction with LPS.Effect of hUC-MSCs on M1/M2-related molecular phenotype of pTHP-1 cells was studied by qRT-PCR and flow cytometry.Results:Transcriptome sequencing data analysis showed that M1-related genes TNF-α(P<0.05)and HLA-DRA(P<0.01)decreased to a great extent and M2-related gene ARG1(P<0.05)increased to a great extent in pTHP-1 cells after co-culture with hUC-MSCs,suggesting that hUC-MSCs inhibited macrophage M1 polarization.GO and KEGG analysis showed that these dysregulated genes regulated inflammation and immune response.hUC-MSCs inhibited proliferation of pTHP-1 cells,reduced content of TNF-α and increased content of IL-10(P<0.001).qRT-PCR and flow cytometry showed mRNA expressions of HLA-DRA(P<0.05)and CD68(P<0.01)and CD14+CD11c+M1 macrophage percentage were down-regulated,while mRNA expressions of CD163(P<0.001),CD206(P<0.001)and CD14+CD163+M2 macrophage percentage were significantly up-regulated in pTHP-1 cells after co-culture with hUC-MSCs.Conclusion:hUC-MSCs inhibit macrophage polarization to M1 and promote polariza-tion to M2 in vitro.

Objective To investigate the correlation between serum soluble fibrinogen like protein 2(sFGL2)and adipocyte fatty acid-binding protein(AFABP)with the severity and prognosis of patients with chronic heart failure.Methods A total of 102 confirmed chronic heart failure patients treated in Tangshan People's Hospital(the hospital)from June 2020 to June 2022 were regarded as the disease group.They were divided into grade Ⅱ group(28 cases),grade Ⅲ group(35 cases),and grade Ⅳ group(39 cases)based on their illness severity.They were separated into MACE group(44 cases)and non MACE group(58 cases)based on their prognosis.Additionally,102 healthy individuals who came to Tangshan People's Hospital for physical examination were regarded as the control group.The levels of serum sFGL2 and AFABP in each group were compared.Logistic regression was applied to analyze the influencing factors of poor prognosis in patients.Receiver operating characteristic(ROC)curve was applied to analyze the predictive value of serum sFGL2 and AFABP levels for poor prognosis in patients.Results Compared with the control group,the serum sFGL2 level in the diseased group was greatly reduced(P＜0.05),while the AFABP level was greatly in-creased(P＜0.05).The serum sFGL2 level in grade Ⅱ group,grade Ⅲ group,and grade Ⅳ group decreased sequentially(P＜0.05),while the AFABP level increased sequentially(P＜0.05).The heart rate and sFGL2 level in the MACE group were greatly lower than those in the non MACE group(P＜0.05),while the propor-tion of atrial fibrillation and AFABP level were greatly higher than those in the non MACE group(P＜0.05).Heart rate,atrial fibrillation,and AFABP were independent risk factors for MACE in patients(P＜0.05),while sFGL2 was an independent protective factor for MACE in patients(P＜0.05).The area under the curve(AUC)of serum sFGL2 and AFABP for predicting MACE in patients was 0.842 and 0.858,respectively,the AUC of the combination of the two was 0.943,and the combined prediction of the two was better than the in-dividual prediction(Zcombined prediction-sFGL2=2.898,P=0.004;Zcombinedprediction-AFABP=2.608,P=0.009).Conclusion Ser-um sFGL2 level is down regulated and AFABP level is up regulated in patients with chronic heart failure,which are influencing factors for the occurrence of MACE.The combination of the two has higher efficacy in predicting the prognosis of the patients.