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 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 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 culturally adapt the eHealth Literacy Questionnaire (eHLQ) into Chinese and validate its reliability and validity in stroke patients, so as to provide a basis for comprehensive evaluation of electronic health literacy in stroke patients.Methods:From May to September 2024, the Brislin translation model was adopted for translation, and the expert consultation was used for cultural adaptation. Followed by preliminary testing to finalize the Chinese version of eHLQ. A convenience sample of the stroke patients was recruited from Beijing Tiantan Hospital, Capital Medical University and Tianjin Huanhu Hospital between October 2024 to February 2025 to conduct a cross-sectional study and evaluate the scale's reliability and validity.Results:Finally, 415 stroke patients were included, with 284 males and 131 females, aged (61.26 ± 9.75) years. The Chinese eHLQ comprised 7 dimensions and 35 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index of universal agreement was 0.857. Exploratory factor analysis revealed KMO value of 0.922, with a cumulative variance contribution rate of 68.90% and factor loading ranging from 0.515 to 0.803. Confirmatory factor analysis demonstrated satisfactory model fit indices: χ2/ df was 1.639, incremental fit index was 0.913, Tucker-Lewis index was 0.902, comparative fit index was 0.912, goodness-of-fit index was 0.812, and root mean square error of approximation was 0.056. The overall Cronbach α coefficient was 0.941, with subscale Cronbach α ranging from 0.825 to 0.894. The test-retest reliability was 0.954. Conclusions:The Chinese version of the eHLQ exhibits excellent reliability and validity, serving as an effective tool for assessing eHealth literacy among stroke patients in China.

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 culturally adapt the eHealth Literacy Questionnaire (eHLQ) into Chinese and validate its reliability and validity in stroke patients, so as to provide a basis for comprehensive evaluation of electronic health literacy in stroke patients.Methods:From May to September 2024, the Brislin translation model was adopted for translation, and the expert consultation was used for cultural adaptation. Followed by preliminary testing to finalize the Chinese version of eHLQ. A convenience sample of the stroke patients was recruited from Beijing Tiantan Hospital, Capital Medical University and Tianjin Huanhu Hospital between October 2024 to February 2025 to conduct a cross-sectional study and evaluate the scale's reliability and validity.Results:Finally, 415 stroke patients were included, with 284 males and 131 females, aged (61.26 ± 9.75) years. The Chinese eHLQ comprised 7 dimensions and 35 items. The item-level content validity index ranged from 0.875 to 1.000, and the scale-level content validity index of universal agreement was 0.857. Exploratory factor analysis revealed KMO value of 0.922, with a cumulative variance contribution rate of 68.90% and factor loading ranging from 0.515 to 0.803. Confirmatory factor analysis demonstrated satisfactory model fit indices: χ2/ df was 1.639, incremental fit index was 0.913, Tucker-Lewis index was 0.902, comparative fit index was 0.912, goodness-of-fit index was 0.812, and root mean square error of approximation was 0.056. The overall Cronbach α coefficient was 0.941, with subscale Cronbach α ranging from 0.825 to 0.894. The test-retest reliability was 0.954. Conclusions:The Chinese version of the eHLQ exhibits excellent reliability and validity, serving as an effective tool for assessing eHealth literacy among stroke patients in China.

Objective:To explore the clinical manifestations and genetic basis for a rare case of Generalized arterial calcification of infancy (GACI).Methods:A 44-day-old female infant who was treated at Baoding Hospital of Beijing Children′s Hospital Affiliated to Capital Medical University on August 26, 2022 was selected as the study subject. Clinical data of the child was collected, and Trio-whole exome sequencing (Trio-WES), whole genome copy number variation sequencing (CNV-seq) and minigene splicing assay were carried out to analyze the pathogenicity of the variants.Results:The child had presented with fever and high inflammatory indicators, for which treatment with various antibiotics was ineffective. Ultrasound had revealed extensive arterial calcification and arterial wall thickening. The child was suspected for GACI with arteritis related to the primary disease. Her fever was relieved by treatment with glucocorticoid and biological agents. Trio-WES revealed that she has harbored compound heterozygous variants of the ABCC6 gene, namely c. 4404-1G>A and c. 4041+ 5G>T, for which the latter was unreported previously. Based on the guidelines from the American College of Medical Genetics and Genomics, the variants were classified as likely pathogenic (PVS1+ PM2_Supporting) and variant of unknown significance (PM2_Supporting+ PM3+ PP3), respectively. The result of CNV-seq was negative. And the minigene splicing assay has further verified that both variants can result in alternative splicing. Conclusion:For pyrexia with unknown causes and refractory to conventional treatment, it is necessary to recommend early genetic testing to avoid missed diagnosis of GACI.