Objective: To investigate the barrier membrane fixation performance and enhanced guided bone regeneration (GBR) capability of a thermosensitive adhesive containing bioactive glass nanoparticles in order to provide a novel solution for membrane fixation during GBR procedures. Methods: M2NP@BGN (methoxyethyl acrylate-co-N-isopropylacrylamide-co-protocatechuic acid@Bioactive glass nanoparticle), a thermosensitive adhesive, was synthesized via free radical polymerization by compositing methoxyethyl acrylate, N-isopropylacrylamide, and protocatechuic acid into a basic adhesive that was modified with bioactive glass nanoparticle (BGN). The successful fabrication of basic adhesive M2NP was characterized by attenuated total reflection-Fourier transform infrared spectroscopy and nuclear magnetic resonance spectroscopy. The thermosensitive adhesive M2NP@BGN (BGN concentration of 1 mg/mL) was characterized by scanning electron microscopy and a rheometer. By adjusting the BGN concentration (0.1 mg/mL, 0.5 mg/mL, 1 mg/mL, and 2 mg/mL), the adhesive and mechanical strengths were investigated with a universal testing machine. Biocompatibility was evaluated with a cell counting kit-8 assay and hemolysis test to identify the optimal formulation. The optimal material’s extract was co-cultured with mouse bone marrow mesenchymal stem cells, and its osteogenic activity was examined in vitro by quantitative real-time PCR, alkaline phosphatase, and alizarin red S staining. The rat mandibular defect model was established, filled with bone graft, and divided into 3 groups based on membrane fixation method: M2NP@BGN (BGN concentration of 1 mg/mL) fixation group (M2NP@BGN), titanium nail fixation group (Nail), and unfixed control group (Negative). Bone regeneration was analyzed after 8 weeks by micro computed tomography and histological staining. Results: M2NP@BGN (BGN concentration of 1 mg/mL) was successfully synthesized and demonstrated rapid gelation under warm, humid conditions. The adhesive with a BGN concentration of 1 mg/mL exhibited the highest adhesive strength (P < 0.001) and significantly enhanced mechanical strength (P < 0.001) under 37℃ wet conditions. All formulations showed excellent biocompatibility, with cell viability > 80% and hemolysis ratio < 5%. M2NP@BGN (BGN concentration of 1 mg/mL) significantly upregulated the expression of Runx2 and Col I (P < 0.001) and enhanced the activity of osteogenic differentiation markers (P < 0.05). In the animal model, the M2NP@BGN group (BGN concentration of 1 mg/mL) achieved significantly higher bone volume fraction and better bone maturity compared to the negative and nail groups (P < 0.05). Conclusion M2NP@BGN (BGN concentration of 1 mg/mL) combines excellent wet adhesion with potent osteogenic activity, enhances the bone augmentation efficacy of membranes, and presents a novel fixation strategy with significant clinical translation potential for GBR therapy.

Objective: To investigate the association between metabolic dysfunction associated steatotic liver disease (MASLD) and bone mineral density among children and adolescents, so as to provide evidence for the early prevention and intervention of bone health in this population. Methods: In September 2022, a method combining convenience sampling with cluster sampling was used to select 5 089 children and adolescents aged 6-18 years in 9 schools from kindergarten to senior high school in Tongzhou District, Beijing, for physical measurements, ultrasound measurements, blood biochemical index testing, and questionnaire surveys. Participants were categorized into three groups: the normal control group ( n =1 515), the metabolic abnormality group (MA, n = 3 007 ), and the MASLD group ( n =567). Multivariable linear regression model was applied to examine the association between MASLD and bone speed of sound (SOS), while multivariable Logistic regression model was used to assess the association between MASLD and low bone mineral density. Subgroup analysis was conducted by sex and age groups. Results: Compared with the normal control group, the MASLD group showed significantly lower SOS values ( β =-6.31, 95% CI =-9.63 to -2.99), lower SOS Z scores ( β = -0.21, 95% CI =-0.32 to -0.10), and higher susceptibility to low bone mineral density( OR =1.56, 95% CI =1.25-1.96)（all P <0.05）. No significant differences in SOS or odds of low bone density were observed between the MA and normal control groups (all P > 0.05). In sex stratified analyses, males with MASLD exhibited significantly lower SOS Z scores ( β =-0.35, 95% CI =-0.49 to -0.20 , P <0.05), whereas no significant difference was observed in females with MASLD ( β =-0.03, 95% CI =-0.21-0.15; P >0.05). When hepatic steatosis grade (0, 1, 2, and 3) was treated as a continuous variable, each one grade increase was associated with a 31% higher odds of low bone mineral density ( OR =1.31, 95% CI =1.13 to 1.53, P <0.05). Conclusions MASLD is significantly associated with low bone mineral density among children and adolescents, with a stronger association in males. Moreover, children and adolescents with hepatic steatosis have a higher risk of impaired bone health compared with those with metabolic abnormalities alone.

Objective:To investigate the clinical outcomes and prognosis of patients with HBV associated hepatocellular carcinoma (HCC) combined with non-alcoholic fatty liver disease (NAFLD) after liver lobectomy.Methods:113 HBV infected HCC patients (HBV HCC group), 113 HCC patients with concomitant NAFLD (NAFLD-HCC group) and 113 HCC patients with concomitant HBV infection and NAFLD (HBV/NAFLD-HCC group) who underwent liver lobectomy at Heji Hospital Affiliated to Changzhi Medical College from Jan. 2018 to Jan. 2021 were selected. All patients underwent radical liver lobectomy and were followed up every 3 months from the date of discharge. The clinical pathological parameters, surgical related indicators, postoperative complications, short-term and long-term prognosis of three groups of patients were compared. Logistic regression analysis was used to identify risk factors related to overall survival of HBV/NAFLD-HCC patients.Results:①Compared with patients in HBV-HCC group and NAFLD-HCC group, body mass index, ratio of combined basic diseases (hyperlipidemia, hypertension, diabetes), and maximum tumor diameter of patients in HBV/NAFLD-HCC group were significantly higher ( P<0.05). While the proportion of patients with liver cirrhosis in HBV HCC group was significantly higher than that in NAFLD-HCC group and HBV/NAFLD-HCC group ( P<0.05). ②There was no significant statistical difference ( P>0.05) among three groups of patients in terms of intraoperative vascular occlusion time, surgical time, intraoperative bleeding volume, blood transfusion volume, or postoperative hospitalization time. ③Compared with HBV-HCC and NAFLD-HCC groups, the incidence of postoperative complications (including postoperative bleeding, liver failure after hepatectomy, biliary fistula, subphrenic effusion, and pleural effusion) and the number of perioperative deaths in HBV/NAFLD-HCC group were significantly higher ( P<0.05). ④Compared with HBV-HCC group and NAFLD-HCC group, the postoperative recurrence rate of HBV/NAFLD-HCC group was significantly higher ( P<0.05), and the overall survival and relapse-free survival of HBV/NAFLD-HCC group were significantly shortened ( P<0.05). ⑤Multivariate Cox regression analysis showed that hyperlipidemia, hypertension, diabetes, cirrhosis, and the largest tumor diameter were risk factors affecting the overall survival of HBV/NAFLD-HCC patients ( P<0.05) . Conclusions:Compared with patients in HBV-HCC and NAFLD-HCC group, HBV/NAFLD-HCC patients have poorer postoperative complications and prognosis. Hyperlipidemia, hypertension, diabetes, cirrhosis, and tumor maximum diameter are risk factors affecting the overall survival of HBV/NAFLD-HCC patients.

Objective To retrospectively study the characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction,and to inform the clinical diagnosis and treatment of decompensated liver cirrhosis.Methods We retrospectively analyzed the clinical data of patients with liver cirrhosis and diastolic heart dysfunction admitted to Nanfang Hospital of Southern Medical University from April 1,2019 to July 31,2023.The patients were divided into compensated cirrhosis group(n=37)and decompensated cirrhosis group(n=226),and those with decompensated cirrhosis were further divided into subgroups of patients with heart dysfunction(n=84)and patients without heart dysfunction(n=142).We compared two groups using the independent samples t-test and Mann-Whitney U test for continuous data in normal distribution and data in skewed distribution,respectively;compared multiple groups using the Kruskal-Wallis H test,with subsequent paired comparisons using the Wilcoxon test;compared categorical data between two groups using the chi-square test or corrected chi-square test;identified the factors affecting patient survival using a Logistic regression model;and plotted Kaplan-Meier survival curves,with inter-group comparisons using the log-rank test.Results A total of 263 eligible patients were ultimately included,among whom 226 patients were diagnosed with decompensated liver cirrhosis(84 patients with diastolic dysfunction).Between the diastolic dysfunction group and non-diastolic dysfunction group,significant differences were detected in age(t=-4.566,P<0.05),activated partial thromboplastin time(Z=-3.026,P<0.05),prothrombin time(Z=-2.450,P<0.05),international normalized ratio(Z=2.779,P<0.05),and the proportion of moderate esophageal varices(χ2=4.273,P<0.05).During hospitalization,35 patients experienced new or aggravated ascites(18 with cardiac dysfunction and 17 without cardiac dysfunction),6 patients experienced new gastroesophageal variceal bleeding,and 9 patients experienced new or aggravated hepatic encephalopathy(3 with cardiac dysfunction and 6 without cardiac dysfunction).Jaundice was the most common decompensation event upon admission,and electrophysiological abnormalities were the most common electrocardiogram findings upon admission.During the 90-day follow-up period,30 individuals(12 with cardiac dysfunction and 18 without cardia dysfunction)died.The logistic regression analysis showed that age(odds ratio[OR]=1.075,95%confidence interval[CI]:1.033-1.119,P<0.001),N-terminal pro-B-type natriuretic peptide(NT-proBNP,OR=0.996,95%CI:0.992-0.999,P=0.016),and mild/moderate ascites(OR=0.270,95%CI:0.092-0.789,P=0.017)were independent predictive factors for cirrhotic cardiomyopathy.Conclusion Timely attention should be paid to elderly patients with decompensated liver cirrhosis and diastolic heart dysfunction who have a decline in NT-proBNP and mild to moderate ascites.Symptomatic treatment such as diuretics may improve diastolic heart dysfunction.

Objective:To investigate the clinical outcomes and prognosis of patients with HBV associated hepatocellular carcinoma (HCC) combined with non-alcoholic fatty liver disease (NAFLD) after liver lobectomy.Methods:113 HBV infected HCC patients (HBV HCC group), 113 HCC patients with concomitant NAFLD (NAFLD-HCC group) and 113 HCC patients with concomitant HBV infection and NAFLD (HBV/NAFLD-HCC group) who underwent liver lobectomy at Heji Hospital Affiliated to Changzhi Medical College from Jan. 2018 to Jan. 2021 were selected. All patients underwent radical liver lobectomy and were followed up every 3 months from the date of discharge. The clinical pathological parameters, surgical related indicators, postoperative complications, short-term and long-term prognosis of three groups of patients were compared. Logistic regression analysis was used to identify risk factors related to overall survival of HBV/NAFLD-HCC patients.Results:①Compared with patients in HBV-HCC group and NAFLD-HCC group, body mass index, ratio of combined basic diseases (hyperlipidemia, hypertension, diabetes), and maximum tumor diameter of patients in HBV/NAFLD-HCC group were significantly higher ( P<0.05). While the proportion of patients with liver cirrhosis in HBV HCC group was significantly higher than that in NAFLD-HCC group and HBV/NAFLD-HCC group ( P<0.05). ②There was no significant statistical difference ( P>0.05) among three groups of patients in terms of intraoperative vascular occlusion time, surgical time, intraoperative bleeding volume, blood transfusion volume, or postoperative hospitalization time. ③Compared with HBV-HCC and NAFLD-HCC groups, the incidence of postoperative complications (including postoperative bleeding, liver failure after hepatectomy, biliary fistula, subphrenic effusion, and pleural effusion) and the number of perioperative deaths in HBV/NAFLD-HCC group were significantly higher ( P<0.05). ④Compared with HBV-HCC group and NAFLD-HCC group, the postoperative recurrence rate of HBV/NAFLD-HCC group was significantly higher ( P<0.05), and the overall survival and relapse-free survival of HBV/NAFLD-HCC group were significantly shortened ( P<0.05). ⑤Multivariate Cox regression analysis showed that hyperlipidemia, hypertension, diabetes, cirrhosis, and the largest tumor diameter were risk factors affecting the overall survival of HBV/NAFLD-HCC patients ( P<0.05) . Conclusions:Compared with patients in HBV-HCC and NAFLD-HCC group, HBV/NAFLD-HCC patients have poorer postoperative complications and prognosis. Hyperlipidemia, hypertension, diabetes, cirrhosis, and tumor maximum diameter are risk factors affecting the overall survival of HBV/NAFLD-HCC patients.

Objective To investigate a rapid detection method for compressed Nitrous oxide(N2O).Methods The GC-MS system was employed under conventional chromatographic conditions(without replacing standard columns or utilizing headspace sampling)by directly injecting a small gas sample for analysis.N2O identification was performed via NIST spectral library matching,while qualitative and quantitative purity assessments were achieved by monitoring the relative abundance variation of the characteristic fragment ion m/z 30 to eliminate CO2 interference.Results The fragment ion m/z 30 demonstrated specificity for N2O identification.A linear correlation was observed between the peak area of m/z 30 and N2O purity(y=22.741x-1.4565,R2=0.912 6),enabling quantitative purity determination.Additionally,the abundance of m/z30 exhibited a correlation with N2O in CO2 mixtures(y=0.7787x-0.0387,R2=0.722 2).Conclusion Conventional N2O identification typically requires dedicated GC-MS systems,gas-specific chromatographic columns,and headspace sampling.This study successfully utilized routine chromatographic conditions for organic toxicant screening to achieve rapid N2O analysis.The proposed method holds practical significance for compressed N2O identification in forensic and analytical applications.

Objective:To systematically review the progress in the method development and application of distributed learning in the estimation of epidemiological effect and provide methodological reference for multi-center studies.Methods:We conducted a literature retrieval for English papers published up to December 31, 2023 by using keywords of "health/medical big data" and "distributed/federated learning". After consulting experts, we set criteria of paper inclusion and exclusion and created a framework for data extraction. We collected information about basic study details, including method, application, and evaluation. Two researchers independently screened the papers and extracted information. We used EndNote 20 for the management of literatures and EpiData for the management of data.Results:A total of 3 444 papers were collected, and 29 papers were included in the final analysis. Most of the papers (25, 86.2%) were published in or after 2019, and the papers were mainly from the United States (21/29, 72.4%). For the estimation of epidemiological effects, 22 distributed learning methods had been developed, including methods for logistic regression (8), Cox regression (8), Poisson regression (2), and generalized linear mixed model (GLMM) (4), as well as three platforms for distributed analysis (VLP, Vantage6, AusCAT). The 29 papers described 45 applications, with 20 (44.4%) focusing on the establishment of prediction model and 25 (55.6%) on association analysis. Importantly, except for GLMM, current distributed learning methods can estimate effects with little bias in 1-3 rounds of communication. These methods show less bias compared with meta-analysis, especially in the address of data heterogeneity and rare outcomes. However, less studies examined how differences in data structure and sparse data affect results, an area that requires further research.Conclusion:While distributed learning shows promise in epidemiological effect estimation, it is still in early development, requiring further research on data heterogeneity handling and communication efficiency improvement.

Objective To retrospectively study the characteristics and short-term outcomes of patients with decompensated liver cirrhosis accompanied by diastolic cardiac dysfunction,and to inform the clinical diagnosis and treatment of decompensated liver cirrhosis.Methods We retrospectively analyzed the clinical data of patients with liver cirrhosis and diastolic heart dysfunction admitted to Nanfang Hospital of Southern Medical University from April 1,2019 to July 31,2023.The patients were divided into compensated cirrhosis group(n=37)and decompensated cirrhosis group(n=226),and those with decompensated cirrhosis were further divided into subgroups of patients with heart dysfunction(n=84)and patients without heart dysfunction(n=142).We compared two groups using the independent samples t-test and Mann-Whitney U test for continuous data in normal distribution and data in skewed distribution,respectively;compared multiple groups using the Kruskal-Wallis H test,with subsequent paired comparisons using the Wilcoxon test;compared categorical data between two groups using the chi-square test or corrected chi-square test;identified the factors affecting patient survival using a Logistic regression model;and plotted Kaplan-Meier survival curves,with inter-group comparisons using the log-rank test.Results A total of 263 eligible patients were ultimately included,among whom 226 patients were diagnosed with decompensated liver cirrhosis(84 patients with diastolic dysfunction).Between the diastolic dysfunction group and non-diastolic dysfunction group,significant differences were detected in age(t=-4.566,P<0.05),activated partial thromboplastin time(Z=-3.026,P<0.05),prothrombin time(Z=-2.450,P<0.05),international normalized ratio(Z=2.779,P<0.05),and the proportion of moderate esophageal varices(χ2=4.273,P<0.05).During hospitalization,35 patients experienced new or aggravated ascites(18 with cardiac dysfunction and 17 without cardiac dysfunction),6 patients experienced new gastroesophageal variceal bleeding,and 9 patients experienced new or aggravated hepatic encephalopathy(3 with cardiac dysfunction and 6 without cardiac dysfunction).Jaundice was the most common decompensation event upon admission,and electrophysiological abnormalities were the most common electrocardiogram findings upon admission.During the 90-day follow-up period,30 individuals(12 with cardiac dysfunction and 18 without cardia dysfunction)died.The logistic regression analysis showed that age(odds ratio[OR]=1.075,95%confidence interval[CI]:1.033-1.119,P<0.001),N-terminal pro-B-type natriuretic peptide(NT-proBNP,OR=0.996,95%CI:0.992-0.999,P=0.016),and mild/moderate ascites(OR=0.270,95%CI:0.092-0.789,P=0.017)were independent predictive factors for cirrhotic cardiomyopathy.Conclusion Timely attention should be paid to elderly patients with decompensated liver cirrhosis and diastolic heart dysfunction who have a decline in NT-proBNP and mild to moderate ascites.Symptomatic treatment such as diuretics may improve diastolic heart dysfunction.

Objective:To investigate the effects of differential torque of maxillary posterior teeth with clear aligner on anterior teeth 3D mechanics.Methods:4 maxillary models were designed for differential torque of posterior teeth on the basis of 3D me-chanical test model with first premolar extraction.The stereolithography models were made with the same size as the standard model by 3D printing.According to the torque of the 6 keys to normal occlusion of Andrews,the standard torque of Andrews was used in group A1.The posterior teeth with lingual-crown torque of 5° were used in groups A2,and those with buccal-crown torque of 5° and 10° were respecitvely used in group A3 and A4.4 sets of corresponding clear aligners were fabricated with a 0.75 mm thick thermoplastic material.Each group had 12 pairs of the same clear aligners.The anterior teeth underwent 0.25 mm activation for en-mass retraction.The six-axis force/torque transducer measurement system was used to measure the force applied by the clear align-ers on the anterior teeth in the 3D directions.Results:In buccolingual direction:in group A1,the 4 incisors received lingual force,in groups A2-A4,the anterior teeth received labial force,and the force on the central incisors was greater than that on later-al incisors.In mesiodistal direction:in group A1-A4,4 incisors received mesial force,and the force on lateral incisors was greater than that on central incisors;in group A1-A4,the canines received distal force;the force on canine in group A4 was greater than that in A2 or A3 groups(P＜0.05).The force in the vertical direction on the anterior teeth among the 4 groups(P＞0.05).Conclu-sion:When en-mass retraction of the anterior teeth with clear aligner,attention should be taken to the torque of the incisors and the tip of the canines.When the posterior teeth with standard torque,the activation of labial-crown overcorrection of the anterior teeth should be increased.When the posterior teeth with lingual-crown torque or buccal-crown torque,the activation of labial-crown over-correction of the anterior teeth should be appropriately reduced.Increasing the mesial overcorrection design of canines may avoid the extrusion of anterior teeth and the deepening of o-verbite due to the distal inclination of canines.

Objective:To explore the pathogenesis,clinical features,treatment strategies,and prognosis of pediatric lymphoepithelioma-like carcinoma(LELC).Methods:A retrospective analysis was conducted on the clinical data of patients with LELC aged<18 years,treated at Sun Yat-sen University Cancer Center from March 2008 to June 2023.Results:A total of 19 children and adolescents were included in the analys-is,comprising 10 males(52.6%)and 9 females(47.4%),with a median age of 12.9(4.3-17.0)years.Fourteen patients(73.7%)lived in Guangdong province,with the remainder scattered across other regions.Primary LELC sites were the mediastinum(11 cases,57.9%),parot-id glands(4 cases,21%),neck(1 case,5.3%),lungs(1 case,5.3%),salivary glands(1 case,5.3%),and submandibular glands(1 case,5.3%).Among these,15 patients(78.9%)had at least one distant metastasis at initial diagnosis,with common metastasis sites being cervical lymph nodes.Multivariate Cox regression analysis identified tumor volume≥801 cm3 as an independent adverse prognostic factor of poor overall survival(OS)(P<0.01).The 2-year OS and progression-free survival(PFS)rates were 84.2%and 57.9%,respectively.The 2-year OS for pa-tients who underwent surgery,chemotherapy,and radiotherapy was 100%,compared with 25%for those who received only partial treat-ment(P=0.007).The 2-year PFS rate was significantly higher in patients receiving first-line combination therapy with programmed death-1(PD-1)antibodies(100%)compared with those not treated with PD-1 antibodies(38.5%)(P=0.020).For patients with tumor volume≥801 cm3,the 2-year OS was 40.0%,whereas for those with a tumor volume<801 cm3,the 2-year OS was 100%(P<0.001).The 2-year OS for pa-tients who underwent radiotherapy was 100%,while it was 0 for those who did not receive radiotherapy(P<0.001).Conclusions:Pediatric LELC exhibits a relatively favorable prognosis with multidisciplinary treatment,including surgery,chemotherapy,and radiotherapy.The com-bined use of PD-1 antibodies at the time of initial diagnosis could offer potential benefits and warrants further exploration.