Purpose: In this study, the neural communication patterns between hypothalamic structures and cortical areas in girls diagnosed with central precocious puberty (CPP) were explored. Endocrine profiles were incorporated to clarify the pathophysiological interactions between cerebral networks and hormonal regulation. The hypothalamus was designated as the key focus area for connectivity analysis. Methods: Fifty-seven girls (37 CPP, 20 non-CPP) were recruited from the Pediatric Development Clinic at the Second Affiliated Hospital of Anhui Medical University. The collected data included demographic information, gonadotropin-releasing hormone stimulation tests, and magnetic resonance imaging scans. Hypothalamic functional connectivity (FC) was analyzed using predefined region of interest coordinates, and correlations between hormone levels and FC values were assessed. Results: Compared to the non-CPP group, the CPP group exhibited elevated baseline follicle-stimulating hormone (FSH), baseline luteinizing hormone (LH), peak FSH, peak LH, and peak LH/FSH ratios. Patients with CPP exhibited enhanced neural synchronization linking the right lateral hypothalamic effector zone to the right superior frontal gyrus (displaying a borderline significant correlation with peak LH concentrations), concurrent with diminished functional coupling of the right lateral hypothalamic efferent to the right fusiform/supramarginal gyri. The left lateral hypothalamic projections demonstrated amplified connectivity with the right cuneus. No FC differences were observed in the medial hypothalamus. Conclusion Abnormal lateral hypothalamus FC patterns were identified in CPP girls and were particularly linked to peak LH levels. The findings offer novel insights into the neuroendocrine mechanisms underlying CPP.

This paper aims to summarize Professor ZHOU Shaohua's clinical experience in treating Parkinson's disease （PD） based on the "disease-symptom-syndrome integration" approach. It is believed that kidney essence deficiency is the root cause of the disease， and phlegm-stasis accumulating toxin is the key factor for its deterioration. PD could be divided into the prodromal stage， early stage and middle-late stage. In the prodromal stage， treatment focuses on tonifying the kidney and replenishing marrow， choosing Zuogui Pill （左归丸） or Yougui Pill （右归丸） to prescribe with modifications according to accompanying non-motor symptoms such as constipation and rapid eye movement sleep behavior disorder. For the early stage， the disease is differentiated into three syndromes， liver-kidney yin deficiency with stirring wind， spleen-kidney yang deficiency， and excessive phlegm turbidity， then following the principle of "calming wind by regulating blood first"， the basic prescriptions of Dading Fengzhu Pill （大定风珠）， Yougui Pill （右归丸） and Jinshui Liujun Decoction （金水六君煎） are applied respectively， combined with Siwu Decoction （四物汤） to nourish blood and extinguish wind. For the middle-late stage， therapies of tonifying the kidney and conso-lidating original qi are combined with detoxifying and resolving turbidity， prescribing fleshy and nourishing medicinals such as deer-horn glue （Cervus nippon Temminck） and turtle shell glue （Colla Carapacis et Plastri Testudinis）， together with Huanglian Jiedu Decoction （黄连解毒汤） to clear heat， detoxify and resolve turbidity， implementing simultaneous tonification and elimination. Integrated traditional Chinese and western medicine intervention is emphasized for non-motor symptoms including orthostatic hypotension and dysphagia.

Purpose: Our previous study showed that circulating tumor cell (CTC) count combined with gene mutation detection might help differentiate benign and malignant pulmonary nodules (PNs). Herein, we aimed to expand the study cohort and conduct further sequencing analysis. Materials and Methods: Patients with PNs were included, and CTCs were identified before operation. Low-coverage whole-genome sequencing (LC-WGS) and lung cancer-related targeted gene sequencing were performed on CTCs. The diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curve. The differences in CTC counts among subgroups classified by demographic–clinical characteristics were analyzed. LC-WGS–based copy number variation (CNV) analysis and targeted gene mutation analysis were conducted. Results: A total of 172 patients were included. CTC count of 2.5 was identified by the ROC curves as the optimal diagnostic cutoff. The sensitivity and specificity of CTC count for differentiating benign and malignant PNs were 54.2% and 78.6%, respectively. The diagnostic sensitivity and specificity of combined CTC count, radiological nodule type, and any malignant imaging features were 84.7% and 71.4%, respectively. The CTC counts were significantly greater in patients with aggressive tumors, later stage, and spread through air spaces. CTCs from malignant cases had more CNVs than those from benign cases. Conclusion CTC count can be used in identifying malignant PNs. The diagnostic efficacy can be improved if combined with computed tomography imaging characteristics. Further CNV analysis might help differential diagnosis. Greater CTC count might suggest more aggressive tumors. CTC detection can provide important information and guidance for subsequent management of PNs.

AIM: To observe the changes of corneal densitometry(CD)and higher-order aberrations after small incision lenticule extraction(SMILE), and to explore their correlations and influencing factors.METHODS: Prospective study. A total of 62 high-degree myopia and compound myopic astigmatism patients(62 eyes)who underwent SMILE in Urumqi Aier Eye Hospital from December 2022 to November 2023 were collected. The CD, root mean square of corneal higher-order aberrations(RMS HOA), spherical aberration, vertical coma, horizontal coma, and corneal epithelial thickness(CET)of the patients were measured before surgery, and at 1 d, 1 wk, 1, 3, and 6 mo after surgery, respectively.RESULTS:There were 4 patients lost to follow-up during the period, all due to failure to attend scheduled reexaminations. The number of complete and valid cases was 58 eyes. The CD in the central and paracentral regions of the anterior, middle, and total layer of the cornea increased significantly on the first day after surgery(all P<0.003). At 6 mo after surgery, there was a slight but statistically significant decrease in the CD of the central and paracentral regions of the anterior and the total anterior layer(all P<0.003). Compared with the preoperative baseline values, the RMS HOA, spherical aberration, and vertical coma significantly increased at 6 mo after surgery(all P<0.003), while the change in horizontal coma was not statistically significant. Compared with the preoperative baseline values, the CET in the central, paracentral, and peripheral regions of the cornea, as well as the total average CET in the 0-7 mm range of the cornea increased at 6 mo after surgery(all P<0.003). At 1 d after surgery, CD of the anterior layer and total layer in the central region of the cornea were positively correlated with the CET in the central region(rs=0.327, rs=0.250, all P<0.05). At 6 mo after the surgery, the CD of the middle layer and posterior layer in the central corneal region were negatively correlated with the preoperative spherical equivalent and the change of RMS HOA(all P<0.05).CONCLUSION:The anterior CD decreases at 6 mo after SMILE for high myopia correction, and there is a certain correlation between the changes in CD and some clinical parameters.

Objective To investigate the effects of miR-126 on myocardial remodeling and macrophage polarization after acute myocardial infarction(AMI).Methods(1)Twenty-one rats were divided into a sham operation group and an AMI group.The AMI group was further divided into postoperative days 1,3,5,7,9,and 11 days(AMI-1,AMI-3,AMI-5,AMI-7,AMI-9,AMI-11),with 3 rats in each group,and postoperative day 3 was selected for subsequent study.(2)Thirty rats were randomly divided into three groups:sham operation group,AMI group and miR-126 overexpression group,with 10 rats in each group.RT-qPCR was used to detect the expression levels of miR-126 mRNA.2,3,5-Triphenyltetrazole chloride(TTC)staining was used to detect the infarct size.Myocardial fibrosis was detected by Masson staining.The cross-sectional area of the myocardium was determined by H&E staining.Immunofluorescence staining was used to detect the protein levels of CD86 and CD206 in myocardial tissue.Western blotting was used to detect the protein levels of CD86 and CD206 in myocardial tissue.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β)and IL-6 in serum were detected by ELISA kit.Results Compared with the sham operation group,the expression level of miR-126 mRNA in myocardial tissue of rats in the AMI group was significantly decreased on postoperative day 1(P<0.05),reached the lowest level on postoperative day 3.And then although it rose to a certain extent,it remained lower than that of the sham operation group on postoperative day 11(P<0.05),and postoperative day 3 was selected for further study.Compared with the sham operation group,the expression of miR-126 mRNA in myocardial tissue of the AMI group was decreased(P<0.05),and the myocardial fibrosis,infarct size and myocardial cross-sectional area were increased(P<0.05).The expression of CD86 protein in myocardial tissue was increased and the expression of CD206 protein was decreased(P<0.05).The serum levels of TNF-α,IL-6 and IL-1β were increased(P<0.05).Compared with the AMI group,the rats in the miR-126 overexpression group had a significant increase in the mRNA expression of miR-126 in myocardial tissue(P<0.05),a significant reduction in myocardial fibrosis,infarct size,and myocardial cross-sectional area(P<0.05),a significant reduction in the expression of CD86 protein in myocardial tissue,and a significant increase in the expression of CD206 protein(P<0.05).The serum levels of TNF-α,IL-6 and IL-1β were significantly decreased(P<0.05).Conclusion Over-expression of miR-126 can improve myocardial remodeling and promote M2 macrophage polarization in AMI rats.

Dental developmental abnormalities and dental development-related diagnosis and treatment represents a critical and challenging area of clinical practice. This process spans multiple stages, from diagnosis to the creation of treatment plans, requiring substantial theoretical knowledge and rich clinical experience. In recent years, the development of artificial intelligence (AI), particularly deep learning technologies exemplified by convolutional neural networks, has been facilitated by the abundance of dental clinical image resources. Advancements in AI have provided substantial support for the diagnosis and treatment of oral diseases, significantly enhancing clinical efficiency. Deep learning has numerous applications in developmental abnormalities and dental development-related diagnosis and treatment. First, deep learning can assist in the identification of developmental abnormalities in radiographs and intraoral images, helping dentists make accurate diagnoses. Second, this technology can be used to assess dental development and predict tooth eruption, providing valuable reference for the formulation of personalized treatment plans. Furthermore, deep learning can identify root and root canal morphology, as well as locate challenging root canals, thereby enhancing the dentists' understanding of root canal anatomy and improving the success rate of endodontic treatments. Despite its significant potential in these areas, research in this field remains in the early stage. There are several limitations in the literature, including the inability to implement systematic disease diagnosis and treatment and a lack of multi-center studies. Future research should aim to design multi-center studies and develop deep learning models that integrate disease diagnosis, developmental assessment, and other factors, conducting a comprehensive analysis of multiple variables to further enhance the practical value of these models.

Objective:To investigate the effect of Yiqi Shengqing Formula on neuronal damage in ischemic stroke(IS)rats by regulating brain-derived neurotrophic factor(BDNF)-extracellular regulated protein kinase(ERK)-cyclic adenosine monophosphate-responsive element binding protein(CREB)signal pathway.Methods:IS rat model was prepared by modified thread suppository method,and randomly divided into model group,low dose Yiqi Shengqing Formula(3 g/kg)group,high dose Yiqi Shengqing Formula(6 g/kg)group,high dose Yiqi Shengqing Formula(6 g/kg)+empty load group,high dose Yiqi Shengqing Formula(6 g/kg)+BDNF knockdown group,with 10 rats in each group,another 10 healthy rats were set as sham operation group.After intervention with Yiqi Shengqing Formula and plasmid,neural function of rats in each group was scored with Longa scoring method;Morris water maze test was used to detect cognitive impairment of rats in each group;Nissl staining was used to detect the number of neurons in ischemic peripheral brain tissue and hippocampus of rats in each group;synaptic morphology of ischemic peripheral brain tissue was detected by silver staining;levels of TNF-α and IL-8 in brain tissue and serum of rats in each group were measured by ELISA;expressions of BDNF-ERK-CREB signal pathway related proteins in rat brain were detected by Western blot.Results:Compared with sham operation group,synaptic morphology of ischemic peripheral brain tissue in model group was severely damaged,retention time in target quad-rant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were decreased significantly(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were increased significantly(P<0.05).Compared with model group,synaptic morphological damage of ischemic peripheral brain tissue in rats in low dose Yiqi Shengqing Formula group and high dose Yiqi Shengqing Formula group was alleviated,retention time in target quadrant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were increased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were decreased(P<0.05).Compared with low dose Yiqi Shengqing Formula group,damage of synaptic morphology in ischemic peripheral brain tissue of rats in high dose Yiqi Shengqing Formula group was further alleviated,retention time in target quadrant,times of crossing platform,the number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were further increased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were further reduced(P<0.05).Compared with high dose Yiqi Shengqing Formula group,synaptic morphological damage of ischemic peripheral brain tissue in high dose Yiqi Shengqing Formula+BDNF knockdown group was aggravated,retention time in target quadrant,times of crossing the platform,number of neurons in ischemic peripheral brain tissue and hippocampus,expressions of BDNF protein and p-ERK/ERK,p-CREB/CREB in brain tissue were decreased(P<0.05),while neurological function score and levels of inflammatory factors TNF-α and IL-8 in brain tissue and serum were increased(P<0.05);there was no significant changes in each index of rats in high dose Yiqi Shengqing Formula+empty load group(P>0.05).Conclusion:Yiqi Shengqing Formula can inhibit the neuroinflammation of IS rats by activating BDNF-ERK-CREB signal,thereby reducing the damage of its neurons and improving its neural function.

Objective To investigate the effect of intravenous lidocaine on postoperative fatigue syndrome(POFS)in patients undergoing laparoscopic resection for gastric carcinoma.Methods A total of 80 patients who underwent elective laparoscopic resection for gastric carcinoma at Xuzhou Central Hospital between September 2023 and June 2024 were enrolled.Inclusion criteria included age 18～75 years,ASA physical status classificationⅠ～Ⅲ,body mass index(BMI)of 18.5～27.9 kg/m2,preoperative Christensen score≤4,and estimated operation time≤4 hours.Patients were randomly allocated into either the lidocaine group(Group L)or the saline group(Group C)using a random number table,with 40 patients in each group.Group L received an intravenous infusion of lidocaine at a dose of 1.5 mg·kg?1 over 15 minutes,initiated 30 minutes before anesthesia induction.If no adverse reactions occurred,lidocaine was maintained at a rate of 1.5 mg/(kg·h)throughout the surgery until its conclusion.Group C received an equivalent volume of normal saline administered in the same manner.The Christensen score and Visual Analogue Scale(VAS)scores were recorded on postoperative days 1,3,5,and 7,and the time-weighted average(TWA)of the Christensen score was calculated.Postoperative inflammatory markers were measured,and additional outcomes including extubation time,post-anesthesia care unit(PACU)stay duration,postoperative nausea and vomiting(PONV),consumption of rescue analgesics,time to first flatus and defecation,and length of hospital stay were also documented.Results Compared with Group C,the TWA of the Christensen score in Group L decreased by 0.44 points(95％CI:0.11～0.76;P<0.05).The VAS scores were significantly lower in Group L on postoperative days 1 and 3(P<0.05).Levels of IL-6 and TNF-α at the end of surgery and 24 hours after surgery were also lower in Group L(P<0.05).The time to first flatus and defecation was significantly shorter in Group L(P<0.05).There were no significant differences between the two groups regarding extubation time,PACU stay duration,incidence of PONV,postoperative consumption of remedial analgesic drugs,or length of hospital stay(P>0.05).Conclusion Intravenous lidocaine may improve POFS in patients following laparo-scopic resection for gastric carcinoma by attenuating inflammatory responses,alleviating pain,and facilitating gastrointestinal function recovery,while maintaining a favorable safety profile.

Objective To investigate the effect of orthosis design parameters on correction of scoliosis and orthosis-trunk interface pressure.Methods A finite element model of scoliosis was constructed to simulate the assembly effect of the orthosis.The orthosis was divided into four loading areas(left rib,right rib,anterior-left and posterior-right area)to simulate six modification conditions.In Models 1,2 and 3,a fixed modification of 20 mm was applied on the anterior left and posterior right areas,while the displacement loads of 20,25 and 30 mm were applied on both the left rib and right rib areas.In Models 4,5 and 6,a fixed modification of 25 mm was applied on left rib and right rib areas,with the displacement loads of 15,20 and 25 mm applied on both anterior left and posterior right areas.The Cobb angle,apical vertebral rotation(AVR)and interface pressure were calculated.Results The correction of Cobb angle in Models 1,2 and 3 was 8.94°,15.62° and 17.91°,respectively,with AVR correction of 7.53°,6.69° and 5.87°,respectively.In Models 4,5 and 6,the correction of Cobb angle was 14.55°,15.62° and 16.09°,with AVR correction of 5.25°,6.69° and 8.63°,respectively.In Model 6,the correction rate of Cobb angle and AVR was 45.48%and 41.22%,respectively,with a maximum pressure of 26.51 kPa on orthosis-trunk interface,achieving the most significant outcome.Conclusions The modification of orthosis has a significant effect on the correction of Cobb and AVR angles.The loading on the left rib and right rib areas mainly affect the Cobb angle,while the loading on the anterior left and posterior right areas mainly affect the spinal axial-rotation.A modification of 25 mm on all loading areas achieves the optimal spinal correction.This study provides the quantitative data for orthosis design.

Objective:To evaluate the prognosis of Hall technique and traditional performed metal crown (PMC) restoration technique, and to follow up the occlusal changes before and after treatment with Hall technique, providing references for the promotion of Hall technique.Methods:Children who visited the Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University from May 2021 to December 2022 were screened according to the inclusion and exclusion criteria. The therapeutic effects of the two groups were followed up at three time points: 1, 2 and 3 months after operation. The observation results were divided into three outcomes: success (crown in place, no symptoms of pulpitis or periapical periodontitis, no obvious abnormality in occlusion, no need for further treatment), partial failure (crown falling off or crown broken, tooth defect can be repaired, reversible pulpitis) and complete failure (irreversible pulpitis or periapical periodontitis, crown falling off and tooth defect irreparable), and statistical analysis was made. At the same time, the Hall technique group was followed up at five time points as before operation, immediately after operation, 2 weeks after operation, 4 weeks after operation and 8 weeks after operation respectively, in which the occlusion was analyzed by Dental Prescale Ⅱ system. The vertical dimension of occlusion (VDO), overbite and coverage, and canine relationship were recorded and compared. Three-dimensional finite element method was used to model and analyze the stress of the teeth treated with traditional PMC treatment and Hall technique, and the differences between them were compared.Results:Finally, 21 children were included in the Hall technique group, including 12 boys and 9 girls, with age of (5.0±1.4) years. Meanwhile, 22 children including 15 boys and 7 girls were in the traditional PMC group, with age of (5.1±1.3) years. There were 0 cases of complete failure and 0 cases of partial failure both in the Hall technique group and in the traditional PMC group within 1 month. There were 0 cases of complete failure and 1 case of partial failure in the Hall technique group, while 0 cases of complete failure and 0 cases of partial failure in the traditional PMC group within 2 months after operation. Hall technique group failed completely in 1 case and partially in 1 case, while the traditional pre-crown group failed completely in 0 cases and partially in 0 cases 3 months after operation. There was no significant difference in the incidence of primary index/complete failure and secondary index/partial failure between Hall technique group and traditional PMC group (all P>0.05). The occlusal area and occlusal force of children treated with Hall technique decreased immediately after operation compared with those before operation, but gradually recovered to the preoperative level at 2, 4 and 8 weeks after operation. To elaborate, the occlusal area decreased significantly from (14.79±3.55) mm 2 before operation to (10.15±3.17) mm 2 immediately after operation ( P=0.001), and recovered to (15.58±3.39) mm 2 at 8 weeks after operation ( P>0.05 compared with pre-operation). The occlusal force decreased significantly from (436.94±109.59) N before operation to (292.70±96.05) N immediately after operation ( P=0.001), and recovered to (441.86±104.31) N at 8 weeks after operation ( P>0.05 compared with pre-operation). Overbite decreased significantly from (2.54±1.05) mm before operation to (1.80±0.94) mm immediately after operation ( P=0.044) and then recovered to (2.35±1.02) mm ( P>0.05 compared with pre-operation). The coverage changed from (2.41±0.66) mm before operation to (2.27±0.61) mm immediately after operation ( P>0.05) and then recovered to (2.48±0.62) mm ( P>0.05 compared with pre-operation). The canine relationship was (3.12±0.54) mm before operation, and decreased significantly immediately after operation (2.17±0.89) mm ( P=0.001), and recovered to (3.05±0.61) mm after 8 weeks ( P>0.05 compared with pre-operation). In the three-dimensional finite element analysis, the maximum stress of all parts of the affected tooth increased immediately after Hall technique treatment, but with occlusal adjustment, the maximum stress of all parts of the affected tooth decreased, which was similar to that of the traditional metal pre-crown group. The vertical load and oblique load of pre-crown decreased from 180.11 and 496.16 MPa to 108.05 and 297.69 MPa, respectively. The vertical load and oblique load of enamel decreased from 94.83 and 255.94 MPa to 57.21 and 156.44 MPa, respectively. The vertical load and oblique load of dentin decreased from 55.19 and 124.77 MPa to 33.19 and 74.59 MPa, respectively. Conclusions:During the experimental observation period, there is no obvious difference between Hall technique and traditional PMC treatment technology in terms of post-treatment occlusion and clinical prognosis, which supports clinical application.