Objective To analyze the current status of physical activity level and its influencing factors in parturients with advanced paternal age at 6 months postpartum,and to explore the correlation between physical activity level and the incidence of overweight/obesity.Methods A total of 399 par-turients with advanced paternal age were included as study subjects.Surveys were conducted using the International Physical Activity Questionnaire-Long Form,the Edinburgh Postnatal Depression Scale,the Pittsburgh Sleep Quality Index,and the Family Support Rating Scale.Univariate analysis and bina-ry Logistic regression analysis were used to investigate the influencing factors of physical activity level in parturients with advanced paternal age at 6 months postpartum.Spearman correlation analysis was used to explore the correlation between physical activity level and the incidence of overweight/obesity.Results Among the parturients with advanced paternal age at 6 months postpartum,134 cases(33.6％)and 265 cases(66.4％)were at low and moderate physical activity levels respectively,with no cases at a high physical activity level.The body mass at 6 months postpartum was(61.31±8.16)kg,and the body mass index(BMI)was(23.57±2.39)kg/m2.The incidence of over-weight/obesity was 42.9％.A negative correlation was observed between the physical activity level and the incidence of overweight/obesity in parturients with advanced paternal age at 6 months postpar-tum(r=-0.566,P＜0.001).There were significant differences in postpartum physical activity levels among with parturients with advanced paternal age at different pre-pregnancy BMI,sleep qualities,and family supports(P＜0.05).Conclusion A higher physical activity level at 6 months postpar-tum in parturients with advanced paternal age is associated with a lower incidence of overweight/obe-sity.The physical activity level is comprehensively influenced by pre-pregnancy BMI,sleep quality,and family support.

Objective To compare the clinical outcomes and retinal volume changes in patients with ischemic and non-ischemic macular edema secondary to branch retinal vein occlusion(BRVO-ME)using optical coherence tomography angiography(OCTA).Methods The clinical data of 34 ischemic BRVO-ME patients(34 eyes,ischemic group)and 21 non-ischemic BRVO-ME patients(21 eyes,non-ischemic group)were retrospectively analyzed.Patients in both groups re-ceived intravitreal injections of ranibizumab.The best corrected visual acuity(BCVA)and retinal volume of the macular ar-ea were assessed before,1 day,1 week,1 month,3 months and 6 months after the treatment.Results The BCVA(log-MAR)at 1 day after the treatment was 0.63±0.37 in the ischemic group and 0.44±0.22 in the non-ischemic group,and the difference was statistically significant(P=0.017).The retinal volumes of the outer retina,the full retina,and the Farafovea and Perifovea subdivisions of the full retina before the treatment were(6.42±1.90)mm3,(8.75±1.82)mm3,(3.20±0.87)mm3 and(5.10±0.89)mm3 in the ischemic group and(5.52±1.57)mm3,(7.83±1.56)mm3,(2.80± 0.71)mm3,and(4.66±0.77)mm3 in the non-ischemic group,respectively;1 day after treatment,they were(4.97± 1.18)mm3,(7.46±1.47)mm3,(2.62±0.60)mm3 and(4.53±0.80)mm3 in the ischemic group and(4.25±0.48)mm3,(6.58±0.56)mm3,(2.26±0.26)mm3 and(4.06±0.40)mm3 in the non-ischemic group,respectively;at 1 week after the treatment,they were(4.40±0.82)mm3,(6.90±0.85)mm3,(2.38±0.36)mm3 and(4.24±0.49)mm3 in the ischemic group and(4.04±0.35)mm3,(6.33±0.49)mm3,(2.15±0.19)mm3 and(3.95±0.35)mm3 in the non-ische-mic group,respectively,and the differences between the two groups were statistically significant(all P＜0.05).The a-mount of retinal volume change from baseline in the outer retina and the full retina was(-2.48±2.38)mm3 and(-2.54±2.38)mm3 in the ischemic group,and(-1.31±1.58)mm3 and(-1.38±1.58)mm3 in the non-ischemic group at 1 month after treatment,respectively,and the differences between the two groups were statistically significant(both P＜0.05).Conclusion Ranibizumab is effective in treating both ischemic and non-ischemic BRVO-ME.The short-term visu-al prognosis is better in the non-ischemic group than the ischemic group,and the retinal volume is higher in the ischemic group than the non-ischemic group.However,no significant difference is observed in the visual prognosis or retinal volume between the two groups after long-term treatment.

Objective:To investigate the clinical effectiveness of Piezocision combined with a microporous technique in accelerating periodontal tissue reconstruction during the anterior migration of mandibular molars in adults.Methods:A prospective, randomized, controlled study was conducted on 30 adult orthodontic patients recruited from Shaoxing Hospital of Traditional Chinese Medicine between January 2020 and September 2022. The inclusion criteria were patients who were unable to retain their first molars due to severe caries or long-term absence and were not suitable for implantation. Using the random number table method, the patients were randomly assigned to two groups: a simple orthodontic control group (Group A, n = 15) and a group that received Piezocision combined with a microporous technique (Group B, n = 15). After treatment, a comparison was made between the two groups in terms of mesial movement distance of the mandibular second molar, plaque index, gingival index, periodontal pocket depth, width of keratinized gingiva, gingival recession, clinical attachment loss, mesial root resorption of the mandibular second molar, alveolar bone height (measured as the distance from the center of the lower incisor to the anterior margin of the chin, referred to as the LM-AC distance), mandibular bone height (measured by the distance from the distal or mesial surface of the root to the alveolar bone margin, denoted as the CEJ-AC distance), and orthodontic satisfaction. Results:The mesial movement distances of the mandibular second molar in Group A patients were (0.86 ± 0.13) mm, (2.75 ± 0.24) mm, (3.54 ± 0.24) mm, and (4.67 ± 0.13) mm at 4, 6, 8, and 12 weeks, respectively. These values were significantly greater than those observed in Group B, which were (0.43 ± 0.06) mm, (1.27 ± 0.14) mm, (1.85 ± 0.53) mm, and (2.65 ± 0.06) mm ( t = 6.83, 14.13, 18.24, 23.78, all P < 0.001). Prior to treatment, there were no statistically significant differences in plaque index, gingival index, periodontal pocket depth, width of keratinized gingiva, gingival recession, or clinical attachment loss between the two groups (all P > 0.05). After treatment, Group A did not exhibit statistically significant differences in plaque index, gingival index, width of keratinized gingiva, and gingival recession compared with baseline values (all P > 0.05). However, in Group A, periodontal pocket depth and clinical attachment loss significantly increased compared with pretreatment levels ( t = -2.57, -7.50, both P < 0.05). After treatment, Group B exhibited significantly increased values for periodontal pocket depth, width of keratinized gingiva, gingival recession, and clinical attachment loss compared with baseline levels ( t = -8.66, -5.57, -45.33, -9.72, all P < 0.001). Furthermore, these values were significantly higher in Group B compared with those in Group A ( t = -4.28, -3.18, 10.00, 10.69, all P < 0.001). A statistically significant difference was also observed between the two groups in terms of mesial root resorption of the mandibular second molar ( t = 4.14, P < 0.001). However, there was no statistically significant difference in LM-AC distance between the two groups after treatment ( P > 0.05). Conclusion:The combination of Piezocision and a microporous technique can effectively accelerate the anterior migration of mandibular molars in adults while maintaining the health of periodontal tissues. This approach holds great potential for clinical promotion.

Objective To assess the effect of ultrasonic thyroid artificial intelligence(AI)-assisted diagnostic system(AI-assisted diagnostic system)for diagnosing medullary thyroid carcinoma(MTC)compared with different physicians and taken papillary thyroid carcinoma(PTC)as the controls.Methods Totally 63 MTC,70 PTC and 62 benign thyroid nodules confirmed by pathology were enrolled.AI-assisted diagnostic system was utilized to analyze thyroid nodules and identify the likelihood of malignancy,and the probability value threshold was set at ≥0.40.All thyroid nodules were retrospectively reviewed and categorized by 3 physicians(1 senior physician,1 attending physician and 1 junior physician)according to Chinese thyroid imaging reporting and data system(C-TIRADS).The efficacy of AI-assisted diagnostic system and physicians for diagnosing MTC and PTC were evaluated.Results AI-assisted diagnostic system showed lower sensitivity,specificity,positive predictive value,negative predictive value,accuracy,and area under the curve(AUC)for diagnosing MTC and PTC compared with physicians.Significant differences of AUC were found between senior physician and AI-assisted diagnostic system,as well as between attending physician and AI-assisted diagnostic system for diagnosing MTC and PTC(all P＜0.01),while no significant difference of AUC was between junior physicians and AI-assisted diagnostic system(both P＞0.05).The sensitivity,specificity,positive predictive value,negative predictive value,accuracy and AUC for AI-assisted diagnostic system for diagnosing MTC were all lower than those for diagnosing PTC,but the AUC was not significantly different(P＞0.05).Conclusion Ultrasonic thyroid AI-assisted diagnostic system had relatively high value for diagnosing MTC.

Objective:To analyze the correlation of poorly differentiated cluster(PDC)grade with clinicopathological features and prognosis of patients with colon cancer.Methods:Hematoxylin-eosin-stained specimens and data from 102 patients with colon cancer who under-went surgery at the Affiliated Hospital of Anhui West Health Vocational College between December 2016 and July 2021 were analyzed in this study.The PDC grades of tumor tissues were determined in all colon cancer cases.Additionally,associations between the PDC grade and clinicopathological features of patients were analyzed via Chi-square test and Logistic regression analysis,whereas the association between the PDC grade and patient prognosis was evaluated using Cox regression analysis.Results:In total,52 cases were identified as PDC G1,14 as PDC G2,and 36 as PDC G3.Tumor budding(TB)was independently and positively associated with PDC,whereas tumor infiltrating lympho-cytes(TIL)were independently and negatively associated with PDC(all P<0.05).Lymph node metastasis or presence of cancerous nodules(hazard ratio[HR]=2.377;95%confidence interval[CI]=1.237-4.568;P=0.009),distant metastasis(HR=7.455;95%CI=2.597-21.399;P<0.001),and the PDC grade(HR=2.095;95%CI=1.099-3.994;P=0.025)were independent risk factors for colon cancer progression.Conclu-sions:Our findings suggest that both TIL and TB affect the colon cancer PDC grade.Therefore,evaluating the PDC grade in cancer tissues can facilitate the prognostic stratification of patients with colon cancer.

Objective To observe the correlations of conventional ultrasound and contrast-enhanced ultrasound(CEUS)features with expression level of Ki-67 of intrahepatic cholangiocarcinoma(ICC).Methods A total of 77 patients with pathologically confirmed ICC were retrospectively enrolled.According to the expression level of Ki-67 of target lesions,the patients were divided into high expression group(Ki-67≥20%,n=53)and low expression group(Ki-67＜20%,n=24).The features showed on conventional ultrasound and CEUS were compared between groups,and the variables being significantly different were analyzed with multivariate logistic regression to select ultrasonic features being correlated with Ki-67 expression level of ICC.Results The mean maximum diameter of ICC in high expression group was larger than that in low expression group([6.2±2.0]cm vs.[5.2±1.9]cm,P=0.041),and the percentage of ICC with maximum diameter>5 cm in high expression group was higher than that in low expression group(66.04%vs.33.33%,P=0.007).No significant difference of the lesions shape,border nor the internal echogenicity showed on conventional ultrasound was found between groups(all P＞0.05).The percentage of ICC with peripheral rim enhancement and enlargement after enhancement in high expression group were both higher than those in low expression group(both P＜0.05),but no significant difference of the enhancement pattern,the presence or absence of non-enhance area within the lesion nor the peak intensity of lesions was found between groups(all P＞0.05).The maximum diameter larger than 5 cm(OR=5.612,P=0.004)and peripheral rim enhancement(OR=3.880,P=0.025)were both independent factors for predicting high Ki-67 expression level of ICC.Conclusion ICC with the maximum diameter larger than 5 cm and peripheral rim enhancement on CEUS might indicate high expression level of Ki-67,which was helpful for clinical treatment decisions.

Objective:To deeply explore the experience and feelings of postpartum weight management in primiparas, so as to provide reference for optimizing postpartum management strategies.Methods:This study was qualitative. From May to June 2023, purposive sampling was used to select 15 primiparas who underwent postpartum follow-up at the Affiliated Suzhou Hospital of Nanjing Medical University as the research subject for semi-structured interviews. The Colaizzi 7-step analysis method was used to analyze data and extract themes.Results:The lived experience of postpartum weight management in primiparas was extracted into three themes and 11 sub-themes, including cognitive differences in postpartum weight management (awareness of importance and adoption of positive behaviors, neglect and avoidance), facilitators and obstacles in weight management (facilitators included self-expectations, positive evaluations and feedback from others, beneficial experiences, while obstacles included eating and exercise behavior disorders, physical symptom interference, role conflicts, negative emotions), and a desire to receive support from multiple aspects (continuous information support from medical institutions, support and acceptance from families and society) .Conclusions:Primiparas have a relatively insufficient cognition of postpartum weight management, and the weight management process is influenced by many factors. Medical and nursing staff should adopt effective strategies to correct cognitive biases in maternal weight management, make full use of facilitators, actively respond to obstacles, and pay attention to multiple sources of support, so as to promote postpartum recovery.

Objective:To establish standard spatial brain template and ROIs template of 11C-methyl- N-2β-carbomethoxy-3β-(4-fluorophenyl)tropane (CFT) PET images for automated quantitative analysis of dopamine transporter (DAT) distribution. Methods:From May 2014 to December 2015, 11C-CFT PET and MRI T 1 brain images of 16 healthy volunteers (3 males, 13 females; age (63.3±6.9) years) from Huashan Hospital, Fudan University were co-registered and smoothed using statistical parametric mapping(SPM)5 software based on MATLAB to create a standard spatial brain template. The ROIs template was established by ScAnVp procedures. These templates were clinically verified by using 11C-CFT PET images of 37 healthy volunteers (23 males, 14 females; age (61.7±7.1) years), 32 Parkinson′s disease (PD) patients (20 males, 12 females; age (61.1±5.4) years), 10 multiple system atrophy with predominant parkinsonism (MSA-P) patients (7 males, 3 females; age (60.8±7.1) years) and 10 progressive supranuclear palsy (PSP) patients (5 males, 5 females; age (58.4±6.1) years) from Huashan Hospital, Fudan University between January 2014 and March 2019. One-way analysis of variance was used to analyze data. Results:Based on the 11C-CFT PET images and MRI T 1 images of healthy volunteers, a standard spatial brain template for normalization of 11C-CFT PET images was created. The ROIs template was established including seven regions: bilateral caudate, anterior putamen, posterior putamen (along the long axis) and the occipital cortex. The ROIs template was accurately aligned in each verification group. The normal reference values of semi-quantitative DAT distribution in caudate, anterior putamen and posterior putamen were obtained (1.84±0.13, 2.18±0.16, 1.77±0.11). The semi-quantitative values of 11C-CFT uptake in each ROI in patients were significantly lower than those in healthy volunteers ( F values: 49.79-283.83, all P<0.05). Conclusion:The established brain templates with accurate spatial alignment for 11C-CFT image analysis can provide foundational tools for the application of 11C-CFT PET imaging in clinical practice and scientific research.

Colorectal cancer (CRC), as one of the most common gastrointestinal malignancy, is original from the epithelial/endothelial cells of colorectal tissues. CRC is one of the highest incidence and mortality rates of any malignancy in humans today. Moving forward the early diagnosis window of colorectal cancer, dynamic monitoring of the risk of postoperative recurrence and metastasis, early intervention is of great value in improving the diagnosis and treatment outcome of colorectal cancer. The clinical diagnosis of CRC via circulating tumor cells (CTC) has been considered as one of the fast, noninvasive, reproducible liquid biopsy methods, and it has been widely used in the early diagnosis, treatment monitoring and prognosis evaluation of colorectal cancer. This review systematically expounded the applied research values of CTC counting, protein expression (phosphatase of regenerating liver-3, matrix metalloproteinase, etc), molecular characterization (adenomatous polyp of colon, erb-b2 receptor tyrosine kinase, etc), mRNA expression profile and single cell sequencing in the diagnosis and treatment of colorectal cancer, in order to assist clinical in rational use of CTC monitoring indicators and provide support for improving the prognosis of colorectal cancer.

Objective To investigate the computed tomography (CT) features of solitary nodular invasive mucinous lung adenocarcinoma (IMA) in stage IA and establish its prediction model. Methods We included 53 lesions of 53 patients with stage-IA IMA and 141 control lesions of 141 patients with invasive non-mucinous lung adenocarcinoma (NIMA) that were confirmed by surgical pathology in our hospital from January 2017 to December 2019. Univariable analysis was used to compare the demographics and CT signs of the two groups. Multivariable logistic regression analysis was performed to determine the main factors influencing solitary nodular IMA. A risk score prediction model was constructed based on the regression coefficients of the main influencing factors. A receiver operating characteristic (ROC) curve was used to assess the performance of the model. Results The univariable analysis showed significant differences between the two groups in age, largest nodule diameter, tumor-lung interface, lobulation, spiculation, air-bronchogram or vacuole sign, vessel abnormalities (P < 0.05). The spiculation sign was different between the two groups, which was longer and softer in the IMA group while shorter and harder in the NIMA group. There was no significant difference in sex, nodule shape, or pleural retraction (P > 0.05), but irregular shapes were slightly more frequent in the IMA group. The multivariable logistic regression analysis showed that obscure tumor-lung interface (odds ratio (OR = 20.930, P < 0.05), air-bronchogram or vacuole sign (OR = 7.126, P < 0.05), spiculation sign (OR = 4.207, P < 0.05), and vessel abnormalities (OR = 0.147, P < 0.05) were the main influencing factors. The prediction model based on those factors’ regression coefficients had an area under the ROC curve of 0.829 (P < 0.05). Conclusion Compared with those with NIMA, patients with solitary nodular IMA in stage IA were older and more likely to have the CT features of obscure tumor-lung interface, air-bronchogram or vacuole sign, and longer and softer spiculation. Based on the regression coefficients of tumor-lung interface, air-bronchogram or vacuole sign, spiculation, and vessel abnormalities, the risk score prediction model showed good predictive performance for solitary nodular IMA.