Objective To investigate the association between abdominal visceral fat content and the occur-rence of type 2 diabetes mellitus(T2DM)and the potential of predicting the incidence of T2DM with abdominal visceral fat content.Methods The study included 45 patients with T2DM who underwent 3.0T MRI and 80 control patients,recruited from the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology.IDEAL software was utilized for automated image recombination to obtain fat fraction,relaxation rate(R2*),lipid phase,water phase,and in-phase images.Fat fraction images were transferred to AW 4.6 workstation for measurement of fat fraction plots by two observers using a double-blind approach.ITK-SNAP software was employed for semi-automatic delineation of abdominal visceral fat and subcutaneous adipose tissue through threshold segmentation method,followed by volume calculation.Statistical analysis of the data was performed using SPSS 26.0 software.Results(1)The T2DM group exhibited significantly higher levels of abdominal visceral adipocyte volume(VATV),hepatic fat fraction(HFF),pancreatic fat fraction(PFF),triglyceride(TG),and fasting blood glucose(FBG)compared to the control group.Conversely,the high density lipoprotein(HDL)level was significantly lower in the T2DM group than in the control group(P＜0.05).The correlation analysis revealed that in male patients,abdominal VATV exhibited positive associations with body mass index(BMI),waist circumference,subcutaneous adipose tissue volume(SATV),hepatic fat fraction(HFF),TG,and FBG;while displaying a negative association with HDL.In female patients,VATV demonstrated positive correlations with BMI,waist circumference,SATV,and HFF.(2)The ROC curve analysis demonstrated that the area under the curve(AUC)for PFF in diagnosing T2DM was 0.656(P＜0.01,95%CI:0.534～0.777).The determined cut-off value was 8.44%,yielding a sensitivity of 50%and specificity of 82.5%.Similarly,HFF exhibited an AUC of 0.744(P＜0.05,95%CI:0.637～0.851),with a cut-off value of 2.99%,sensitivity of 97.5%,and specificity of 42%.In male patients,VATV displayed an optimal threshold for T2DM diagnosis at a volume of approximately 3 466 cm3,resulting in a sensitivity of 63.2%,specificity of 89.5%,and AUC of 0.78(P＜0.01).The sensitivity was 78.9%and specificity was 84.2%when SATV,PFF and HFF were combined and the AUC was 0.839(P＜0.01).The optimal threshold for diagnosing T2DM with VATV in female patients was 2 103cm3,and the sensitivity,specificity and AUC of T2DM with VATV were 66.7%,66.7%and 0.68(P＜0.05).When SATV,PFF and HFF were combined,the sensitivity was 90.5%.The specificity was 76.2%and the AUC was 0.909(P＜0.01).(3)For each additional unit of TG and FBG,the risk of T2DM respectively increased by 3986.3%and 417.1%,in other words,TG and FBG were independent predictors of the occurrence of T2DM.Conclusion The predictive value of pancreatic fat fraction,liver fat fraction,and abdominal visceral fat tissue volume for the onset of type 2 diabetes is limited.However,combining abdominal visceral adipose tissue volume with subcutaneous adipose tissue volume,pancreatic fat fraction,and liver fat fraction significantly enhances the efficacy,sensitivity,and specificity of predicting type 2 diabetes occurrence.The IDEAL-IQ technique offers a convenient method for quantitatively evaluat-ing intra-abdominal ectopic adipose tissue deposition in patients with type 2 diabetes mellitus.It demonstrates advantages such as simplicity,good stability,high reproducibility and holds great potential.

Objective To study the effect of panatinib on cholangiocarcinoma(CCA)and its molecular mechanism.Methods QBC939 cells were divided into control group(no treatment),low dose group(0.1 μmol·L-1 panatinib treatment),medium dose group(0.5μmol·L-1panatinib treatment),high dose group(1.0 μmol·L-1 panatinib treatment)and high dose+microRNA-92b-3 group(after treatment with 1.0 μmol·L-1 panatinib transfected miR-92b-3p mimic),high-dose+miR-92b-3p mimic+overexpressed homologous domain interacting protein kinase 3 plasmid(oe-HIPK3)group(after treatment with 1.0 μmol·L-1 panatinib,miR-92b-3p mimic and oe-HIPK3),mimic-NC group(transfected miR-92b-3p NC),and miR-92b-3p mimic group(transfected miR-92b-3p mimic)were transfected.Cell proliferation was detected by cell counting kit 8(CCK-8);cell migration was detected by Transwell,the relative expression level of protein was detected by Western blot.Results Cell proliferation rates of control group,high-dose group,high-dose+miR-92b-3p mimic group,and high-dose+miR-92b-3p mimic group mimic+oe-HIPK3 group were(76.58±8.56)％,(61.85±7.77)％,(74.54±7.68)％and(58.63±6.87)％,respectively;the number of cells migrated were 185.32±20.14,132.33±18.99,168.23±19.85 and 138.66±15.95,respectively;phosphorylated phosphatidyl inositide 3-kinase(p-PI3K)/PI3K ratios were 1.00±0.23,0.68±0.09,0.91±0.18 and 0.60±0.08,respectively;phosphorylated protein kinase B(p-AKT)/AKT ratios were 1.00±0.25,0.61±0.08,1.12±0.28 and 0.72±0.14,respectively.The above indexes were compared with those of the control group in the high-dose group,and those of the high-dose+miR-92b-3p mimic group in the high-dose+miR-92b-3p mimic group in the oe-HIPK3 group.There were statistically significant differences(all P＜0.05).Conclusion Panatinib can effectively inhibit the evil biological behavior of cholangiocarcinoma,which may be related to inhibiting the level of miR-92b-3p and promoting HIPK3-mediated PI3K/AKT signaling pathway.

Perioperative neurocognitive disorder(PND)significantly threatens brain health,leading to prolonged hospitalization,increased patient mortality risk,and poor long-term prognosis.Sleep disorder may substantially elevate the risk of neurocognitive dysfunction.However,the specific role of sleep in PND development remains to be elucidated.In addition,controversy exists over whether interventions for perioperative sleep disorder can effectively prevent PND.Therefore,this review aims to explore the basic function and regulatory principles of sleep,the clinical characteristics of perioperative sleep disorder,its role and potential mechanisms in PND development.Furthermore,we also provide new evidence on the potential therapeutic strategies to modulate sleep disorder for PND management,to improve patient's neurocognitive prognosis and long-term outcomes.

Objective To observe the changes of memory function in patients with mild traumatic brain injury(mTBI),and to explore the correlation between functional connection(FC)changes and montreal cognitive assessment(MoCA)scale scores in the mTBI cohort.Methods Thirty-nine patients with acute mTBI and 39 healthy controls were prospectively collected.All subjects underwent rs-fMRI scans,and FC values were calculated in both groups.Results Compared with healthy controls,the FC of the left posterior cingulate cortex,the left cuneus and the right calcarine fissure were enhanced.The FC of the left orbital superior frontal gyrus with the right superior temporal gyrus and the right postcentral gyrus was enhanced,and the FC of the right parahippocampal gyrus with the right medial and lateral cingulate gyrus,right thalamus and right caudate nucleus was weakened.Correlation analysis showed that there was no significant correlation between MoCA scale score and FC based on DMN network nodes.Conclusion The DMN network was damaged in patients with acute mTBI,and the memory function was impaired.In addition,no correlation was found between FC abnormalities and MoCA scale scores in this study

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Bone organoids can simulate the complex structure and function of the bone tissues, which makes them a frontier technology in organoid researches. Bone organoids show a tremendous potential of applications in bone disease modeling, bone injury repair, and medicine screening. Although advancements have been made so far in constructing bone organoids with functional structures like mineralization, bone marrow, trabecular bone, callus, woven bone, etc, the researches in this field are confronted with numerous challenges such as lack of standardized construction strategies and unified evaluation criteria, which limits their further promotion and application. To standardize researches in bone organoids, the Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, the Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, the Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and the Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine organized related experts to formulate Expert consensus on the construction, evaluation, and application of bone organoids ( version 2024) based on an evidence-based approach. A total of 17 recommendations were put forth, aiming to standardize researches and clinical applications of bone organoids and enhance their value in scientific research and clinical practice.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

ObjectiveTo study the brain network during balance control tasks in older adults. MethodsFrom January to April, 2022, 22 healthy young adults and 20 healthy older adults were recruited from the Fifth Affiliated Hospital of Guangzhou Medical University and communities. They were asked to finish standing tasks on the plantar pressure plate with eyes opening and closing, while the functional connectivities (FC) of prefrontal cortex (PFC) and primary motor cortex (PMC) were measured with functional near-infrared spectroscopy. ResultsCompared with the young adults, the area of the ellipse (Z = -2.884, P < 0.01) and the maximum swing (Z = -2.481, P < 0.05) increased in the older adults as eyes closing. During the standing task, the intra-FC of left (t = 2.978, P < 0.01) and right (Z = -3.123, P < 0.01) PFC decreased in the older adults, and the inter-FC of right PMC to left PFC (t = 2.087, P < 0.05) and right PFC to left PFC (t = 3.471, P < 0.001) decreased, too. ConclusionThe FC of PFC decreased in healthy older adults during balance control tasks, which may be a indicator for aging brain.

Objective To investigate the dynamic change of fatty liver (FL) in patients with fatty liver-related acute pancreatitis (FLAP) and related influencing factors. Methods A total of 136 FLAP patients who were admitted to The First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, from December 2017 to December 2021 were enrolled as subjects. With the first CT examination after admission as the starting point and the last CT examination before discharge as the ending point, the subjects were divided into FL aggravation group (FLAG group), FL mild mitigation group (FLMMG group), and FL significant mitigation group (FLSMG group) according to the degree of change in FL. General information and clinical data were compared between groups. General information included age, sex, length of hospital stay, etiology of acute pancreatitis (AP), and changes in body weight and temperature, and clinical data included treatment modality and the changes in laboratory markers and AP severity. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Mann-Whitney U test with Bonferroni correction was used for further comparison between two groups. Dynamic changes of data were expressed as the difference from the starting point to the ending point, and a covariance analysis was used for comparison of data with dynamic changes. The Spearman correlation analysis was used to investigate the correlation of indices with significant changes with the degree of change in FL. Results Among the 136 FLAP patients, 61 achieved mild mitigation of FL, 59 achieved significant mitigation of FL, and 16 experienced aggravation of FL at the ending point of the study. There were significant differences between the three groups in the length of hospital stay ( χ 2 =16.215, P < 0.001) and the change in body weight ( F =3.908, P < 0.05), and the FLSMG group had a greater reduction in body weight and a longer length of hospital stay. There were also significant differences between the three groups in the number of fasting days ( χ 2 =11.020, P =0.004) and the degree of changes in C-reactive protein (CRP) ( F =8.589, P < 0.001), white blood cell count (WBC) ( F =5.448, P =0.005), and CT severity index (CTSI) ( F =7.544, P =0.001), and the FLSMG group had greater reductions in CRP, WBC, and CTSI and a longer duration of fasting. Length of hospital stay, number of fasting days, and changes in CRP and CTSI were significantly correlated with the change in FL ( r =0.352, 0.372, -0.365, and -0.350, all P < 0.001). Conclusion Most FLAP patients tend to have mitigation of FL, and its dynamic changes are closely associated with the changes in CRP and CTSI.