ObjectiveTo evaluate a novel nomogram based on contrast-enhanced MRI radiomics combined with clinical variables for the preoperative prediction of perineural invasion （PNI） in intrahepatic cholangiocarcinoma （ICC）. MethodsThe clinical data of 59 ICC patients were retrospectively collected. According to postoperative pathology reports， the patients were divided into the non-PNI group （n = 33） and the PNI group （n = 26）. Regions of interest （ROI） were delineated from five MRI sequences. Radiomics features were then extracted and filtered to select those with the strongest discriminative power for PNI identification. These selected features were used to construct a radiomics model， which subsequently generated a quantitative radiomics score （radiomics score， Radscore）. Univariate analysis was applied to identify clinical variables associated with PNI， and the glm function was subsequently used to construct clinical and combined models. Finally， the models were evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis （DCA）. The combined model was then visualized as a nomogram. ResultsThe clinical model included age， carbohydrate antigen 19-9 （CA19-9）， red blood cell distribution width， and albumin， whereas the Radscore included five radiomic features. The areas under the ROC curves （AUCs） for the clinical and radiomics models were 0.717 （95%CI： 0.586-0.848） and 0.896 （95%CI： 0.820-0.973）， respectively， whereas the combined model further improved its AUC to 0.917 （95% CI：0.848-0.987）. The calibration curves and DCA showed that the nomogram was well calibrated and provided the greatest net clinical benefit. ConclusionThe novel nomogram may serve as a basis for preoperative prediction of PNI status， thereby assisting clinical decision-making and guiding personalized treatment.

BACKGROUND:Our previous studies have found that poly(vinylidene fluoride)bionic periosteum prepared by electrospinning has good cytocompatibility,but its biocompatibility is unknown. OBJECTIVE:To evaluate the biocompatibility of poly(vinylidene fluoride)bionic periosteum doped with Zn2+and Mg2+. METHODS:Poly(vinylidene fluoride),poly(vinylidene fluoride)bionic periosteum doped with 1％Zn2+,doped with 1％Mg2+,and doped with 1％(Zn2++Mg2+)were prepared by electrospinning to make bionic periosteum extract.SD rats were selected as the experimental subjects for hemolysis test,short-term systemic toxicity test,and heat source test.Guinea pigs were selected as the experimental subjects for skin sensitization test.The biocompatibility of bionic periosteum of four groups was tested. RESULTS AND CONCLUSION:(1)The hemolysis test results showed that the hemolysis rates of 1％Zn2+poly(vinylidene fluoride),1％Mg2+poly(vinylidene fluoride),1％Zn2++1％Mg2+poly(vinylidene fluoride)bionic periosteum and poly(vinylidene fluoride)extract were(0.130±0.013)％,(0.149±0.020)％,(0.466±0.018)％,and(0.037±0.018)％,respectively,which met the hemocompatibility standard of biomaterials.(2)The results of short-term systemic toxicity test showed that the four groups of bionic periosteal extract had no toxic signs such as body mass reduction,food intake changes,and dyspnea in SD rats,and had no toxic effects on major organs of rats.(3)Heat source test results showed that after intervention with poly(vinylidene fluoride)bionic periosteum doped with 1％Zn2+,doped with 1％Mg2+,and doped with 1％(Zn2++Mg2+),and poly(vinylidene fluoride)bionic periosteum extract,the elevated body temperature values of SD rats were(0.133±0.058),(0.100±0.010),(0.300±0.010),and(0.300±0.017)℃respectively.All were less than 0.6 ℃and the total temperature increase was less than 1.4 ℃.(4)The results of skin sensitization test showed that no erythema or edema was observed under the skin of guinea pigs after the intervention of bionic periosteum extract of four groups.(5)The results showed that poly(vinylidene fluoride)and poly(vinylidene fluoride)bionic periosteum doped with Zn2+and Mg2+had good biocompatibility.

Objective To investigate the factors influencing the severity of cerebral white matter hyperintensity in hypertensive patients with acute cerebral infarction,and focus on the independ-ent roles of treatment adherence,advanced age,and multidimensional risk factors.Methods A single-center cross-sectional study was conducted on 262 hypertensive patients with acute cerebral infarction admitted to our department from January 2020 to June 2023.According to their score of Morisky Medication Adherence Scale(MMAS-8),they were divided into an adherence group(116 cases)and a non-adherence group(146 cases).Their demographic data,medical history,and blood pressure data were collected through electronic medical records.Fazekas score was assessed blind-ly to quantify the severity of white matter hyperintensity.MMAS-8 and Montreal Cognitive Assessment Scale(MoCA)were used to assess the behavioral indicators,and modified Rankin Scale(mRS)was employed to evaluate the neurological function.Univariate and multivariate logistic regression analyses were performed to screen the risk factors.Results There were statis-tical differences in marital status,mRS score and Fazekas score between the adherence group and the non-adherence group(P＜0.05,P＜0.01).The non-adherence group had significantly higher diastolic blood pressure than the adherence group[(87.29±7.51)mm Hg(1 mm Hg=0.133 kPa)vs(83.98±8.11)mm Hg,P=0.001].Univariate logistic regression analysis showed age of≥80 years,duration of hypertension≥5 years,systolic blood pressure,and MoCA score＜10 were no-tably correlated with severity of white matter hyperintensity(P＜0.01).Multivariate logistic re-gression analysis indicted that age of≥80 years(OR=3.305,95％CI:1.560-7.001,P=0.002),systolic blood pressure(OR=1.026,95％CI:1.008-1.044,P=0.003),MoCA score＜10(OR=5.210,95％CI:2.060-13.176,P=0.000),and treatment non-adherence(OR=2.380,95％CI:1.346-4.209,P=0.003)were independent risk factors for white matter hyperintensity severity,and duration of hypertension showed no significance in the multivariate model(P＞0.05).Conclusion Poor treatment adherence and advanced age are core factors for white matter hyper-intensity progression in hypertensive patients with acute cerebral infarction.

Objective To investigate the factors influencing the severity of cerebral white matter hyperintensity in hypertensive patients with acute cerebral infarction,and focus on the independ-ent roles of treatment adherence,advanced age,and multidimensional risk factors.Methods A single-center cross-sectional study was conducted on 262 hypertensive patients with acute cerebral infarction admitted to our department from January 2020 to June 2023.According to their score of Morisky Medication Adherence Scale(MMAS-8),they were divided into an adherence group(116 cases)and a non-adherence group(146 cases).Their demographic data,medical history,and blood pressure data were collected through electronic medical records.Fazekas score was assessed blind-ly to quantify the severity of white matter hyperintensity.MMAS-8 and Montreal Cognitive Assessment Scale(MoCA)were used to assess the behavioral indicators,and modified Rankin Scale(mRS)was employed to evaluate the neurological function.Univariate and multivariate logistic regression analyses were performed to screen the risk factors.Results There were statis-tical differences in marital status,mRS score and Fazekas score between the adherence group and the non-adherence group(P＜0.05,P＜0.01).The non-adherence group had significantly higher diastolic blood pressure than the adherence group[(87.29±7.51)mm Hg(1 mm Hg=0.133 kPa)vs(83.98±8.11)mm Hg,P=0.001].Univariate logistic regression analysis showed age of≥80 years,duration of hypertension≥5 years,systolic blood pressure,and MoCA score＜10 were no-tably correlated with severity of white matter hyperintensity(P＜0.01).Multivariate logistic re-gression analysis indicted that age of≥80 years(OR=3.305,95％CI:1.560-7.001,P=0.002),systolic blood pressure(OR=1.026,95％CI:1.008-1.044,P=0.003),MoCA score＜10(OR=5.210,95％CI:2.060-13.176,P=0.000),and treatment non-adherence(OR=2.380,95％CI:1.346-4.209,P=0.003)were independent risk factors for white matter hyperintensity severity,and duration of hypertension showed no significance in the multivariate model(P＞0.05).Conclusion Poor treatment adherence and advanced age are core factors for white matter hyper-intensity progression in hypertensive patients with acute cerebral infarction.

BACKGROUND:Due to the unstable drug release rate of uniaxial bone scaffolds,multi-structure composite printing methods have been sought in and outside China in recent years.Currently,coaxial drug-loaded bone scaffolds,which combine drug-loaded sustained release system with bone transplantation and repair technology,not only replace the defective bone after implantation,but also release drugs slowly,providing a microenvironment conducive to bone formation at the implant site. OBJECTIVE:To explore and assess the in vitro antibacterial properties of uniaxial and coaxial minocycline hydrochloride bone scaffolds. METHODS:Rapid prototyping technology was used to prepare uniaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,uniaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,coaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,and coaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold,respectively,which were named S1,S2,T1 and T2.The morphology,porosity,degradation performance,in vitro sustained-release performance and cytotoxicity of scaffolds were characterized.Four kinds of bone scaffolds were immersed in PBS to prepare the extracts at different time points(1,3,5,7,14,21,and 28 days).The qualitative filter paper was placed into the extract for 24 hours.The filter paper was co-cultured with Porphyromonas gingivalis and Fusobacterium nucleatum for 72 hours.The bacteriostatic effect of four groups of scaffolds was detected by the agar diffusion method. RESULTS AND CONCLUSION:(1)Scaffold characterization:Four groups of scaffolds were well formed.The surface of micro-wires in the S1 and S2 groups was dense and smooth,and the surface of micro-wires in the T1 and T2 groups was rough.Porosity was between 40%-47%and met the requirements of bone scaffolds.Compared with the S2 group,sustained release time was longer in the T2 group.The sustained release concentration of the drug was between 1-10 μg/mL for a long time,which was more conducive to bacteriostasis and osteogenesis.After 10 weeks of immersion in PBS in vitro,the degradation rate of the coaxial printed bone scaffold was faster than that of the corresponding uniaxial printed bone scaffold,and the degradation rate of the coaxial loaded bone scaffold was lower than that of the coaxial non-loaded bone scaffold.The four groups of scaffold extracts were co-cultured with osteoblasts respectively.CCK-8 assay displayed that the cell proliferation rate was greater than 75%,which met the requirements of biocompatibility.(2)In vitro antibacterial effect:S1 and T1 did not have antibacterial activity.S2 and T2 had an obvious antibacterial effect.Under the extraction solution on day 28,the diameter of Porphyromonas gingivalis and Fusobacterium nucleatum inhibition zone in the S2 group was smaller than that in the T2 group(P<0.05).(3)These findings exhibit that hydroxyapatite/silk fibroin-polyvinyl alcohol scaffolds with coaxial minocycline have good physical properties and bacteriostatic properties.

BACKGROUND:Polyvinylidene fluoride(PVDF)with piezoelectric properties,good biocompatibility and nontoxicity make it a suitable candidate for periosteal repair. OBJECTIVE:To evaluate the cytotoxicity of PVDF bionic periosteum by electrospinning with zinc and magnesium ions in vitro. METHODS:Pure PVDF,zinc-doped PVDF,magnesium-doped PVDF and Zinc-magnesium ion PVDF piezoelectric bionic periosteum were prepared by electrospinning technology,respectively.They were named PVDF,PVDF-Zn,PVDF-Mg and PVDF-Zn-Mg,in which the mass fraction of zinc and magnesium ions were all 1%.Osteoblasts and vascular endothelial cells were co-cultured with four groups of bionic periosteum.Cell compatibility of bionic periosteum was determined by alkaline phosphatase staining,CD31 immunofluorescence staining,and scanning electron microscopy. RESULTS AND CONCLUSION:(1)Osteoblasts:Alkaline phosphatase staining after 7 days of culture showed that the PVDF-Zn group secreted more alkaline phosphatase than the other three groups.Under a scanning electron microscopy,after 1 day of culture,the cells had a certain spread on the surface of PVDF-Mg and PVDF-Zn-Mg bionic periosteum,and the pseudopod extended to all sides.On day 3,the cell edge of each group extended pseudopods to the material.By days 5 and 7,the cells were fully spread,well grown and firmly covered the surface of the fibers,and the cellular pseudopods extended around and into the interstitial space of the fibers.CCK-8 assay showed that the cell proliferation on the bionic periosteum of each group showed an increasing trend over time and the relative proliferation rate of cells at 1,3,5,and 7 days was≥75%,and the cytotoxicity was≤grade 1.(2)Vascular endothelial cells:CD31 immunofluorescence staining for 3 days showed that the cells adhered and spread well on the bionic periosteum of each group and connected with each other,and the number of cells in the PVDF-Zn-Mg group was more than that in the other three groups.Under scanning electron microscope,the cells began to adhere to the surface of each group of fibers after 1 and 3 days of culture.On day 5,the cells were well spread on the surface of the fibers and extended obvious pseudopods.On day 7,the cells on the PVDF-Mg and PVDF-Zn-Mg bionic periosteum grew in multiple layers and extended the pseudopod into the fibrous void.CCK-8 assay showed that the cell proliferation on the bionic periosteum of each group showed a downward trend over time,and the relative proliferation rate of cells at 1,3,5 and 7 days was≥125%,and the cytotoxicity was grade 0.(3)The results showed that Zn-Mg electrospun PVDF piezoelectric bionic periosteum had good cytocompatibility.

Peri-implantitis,as a common complication after implant restoration,seriously affects the prognosis of the patients and causes a lot of inconvenience to the normal life of the patients,and its pathogene-sis is not entirely clear.In recent years,laser therapy,photodynamic therapy,local sustained-release drug-load-ed materials and many other emerging technologies have been gradually applied in clinical practice,and have played a positive promoting role in the treatment of peri-implantitis.However,the research on the application of local sustained-release materials in peri-implantitis is still in the initial stage,and there is a lack of systemat-ic induction and summary of relevant research literatures.This article reviews the research status quo,treat-ment status quo and application of emerging local sustained-release drug-loaded materials for peri-implantitis by consulting domestic and foreign literatures,so as to provide reference for clinical research and application.

Objective:To explore the effect of SQLE on the biological characteristics of pan-cancer,using bioinformatics methods to predict and analyze the correlation between SQLE and the clinical prognosis and immunity of pan-cancer.Methods:The ex-pression level of SQLE in tumor and normal tissues and its correlation with different clinical stages of pan-cancer were analyzed,and the relationship between SQLE expression and overall survival and tumor microenvironment were evaluated.Gene enrichment analysis was conducted to study the biological functions and signaling pathways related to SQLE gene,then,calculate the correlation between SQLE gene and tumor mutation load and microsatellite instability,and analyze the correlation between SQLE gene and immunomodula-tory genes.Results:SQLE gene was highly expressed in variety of tumors,and differentially expressed in different tumor stages.High expression of SQLE was a risk factor in variety of tumors.Patients with high expression of SQLE hade a worse prognosis.SQLE was cor-related with TMB and MSI,and involved in tumor development through different pathways.Conclusion:SQLE,as a valuable prognos-tic biomarker and new therapeutic target for variety of cancers,has certain application value in basic research and clinical treatment of various cancers.

Total hip arthroplasty(THA)is an effective treatment for elderly femoral neck fractures,mid-to late-stage femoral head necrosis,and end-stage hip osteoarthritis.However,serious complications such as aseptic loosening of the prosthesis,peripheral fractures,and dislocation of the prosthesis still exist following THA,which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons.Currently,the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional(2D)X-ray or three-dimensional(3D)computed tomography(CT),which fail to adequately consider the hip joint in weight-bearing as well as motion,lumbar-hip joint changes,and prosthetic impingement during motion.Recently,the dual fluoroscopic imaging system,as a new in-vivo,dynamic radiological imaging technology,provides comprehensive and accurate dynamic 3D data for THA preoperative planning.However,the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established,which affects the promotion and application of this technology.In light of the above,national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues,and the'expert recommendation rate'and'strong recommendation rate'were obtained through a questionnaire survey on the recommendations of the participating experts.This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.

Total hip arthroplasty(THA)is an effective treatment for elderly femoral neck fractures,mid-to late-stage femoral head necrosis,and end-stage hip osteoarthritis.However,serious complications such as aseptic loosening of the prosthesis,peripheral fractures,and dislocation of the prosthesis still exist following THA,which makes the selection of the appropriate hip prosthesis type and placement position before THA an important challenge for surgeons.Currently,the commonly used preoperative planning methods for THA mainly rely on static images from two-dimensional(2D)X-ray or three-dimensional(3D)computed tomography(CT),which fail to adequately consider the hip joint in weight-bearing as well as motion,lumbar-hip joint changes,and prosthetic impingement during motion.Recently,the dual fluoroscopic imaging system,as a new in-vivo,dynamic radiological imaging technology,provides comprehensive and accurate dynamic 3D data for THA preoperative planning.However,the technical process and expert consensus on preoperative 3D planning of THA using a dual fluoroscopic imaging system have not yet been established,which affects the promotion and application of this technology.In light of the above,national orthopaedic experts and related professional representatives discussed and proposed seven consensus issues,and the'expert recommendation rate'and'strong recommendation rate'were obtained through a questionnaire survey on the recommendations of the participating experts.This consensus aims to provide guidance and reference for the standardised application of preoperative 3D planning of THA using the dual fluoroscopic imaging system.