Purpose To evaluate the predictive performance of mean apparent propagator-magnetic resonance imaging(MAP-MRI)combined with habitat analysis for determining O6-methylguanine-DNA methyltransferase(MGMT)promoter methylation status in glioma.Materials and Methods This retrospective study analyzed MRI and clinical data from 55 patients with surgically confirmed glioma at Fujian Medical University Union Hospital from January 2019 to December 2023.All patients underwent structural and diffusion-weighted imaging.Three-dimensional volumes of interest were delineated in the tumor solid region using ImageJ software.The nn-FAE tool was used to segment the tumor solid region into two habitat subregions based on mean diffusivity(MD)maps:high-MD and low-MD habitats.Average diffusion parameter values were extracted from the entire tumor solid region and each habitat subregion.Differences in parameters between methylated and unmethylated groups were compared,and the area under the curve was calculated.Results Among 55 patients,significant differences were observed in all MAP-MRI parameters and MD in the tumor solid region and low-MD habitat,as well as all parameters in the high-MD habitat between methylated and unmethylated groups(t/Z=-3.780-3.153,all P<0.05).The return-to-origin probability(RTOP)in the low-MD habitat demonstrated the highest diagnostic performance,with the area under the curve improving from 0.771 before habitat analysis to 0.827 after habitat analysis.In the high-grade subgroup,significant differences were observed in return-to-axis probability(RTAP)and RTOP in the tumor solid region;RTOP,non-Gaussianity,non-Gaussianity axial,and RTAP in the low-MD habitat;and non-Gaussianity in the high-MD habitat(t/Z=-2.820--1.976,all P<0.05).RTOP in the low-MD habitat again showed optimal diagnostic efficacy(the area under the curve 0.725 before habitat analysis,0.798 after).Multivariate analysis identified RTAP and RTOP in the tumor solid region and low-MD habitat as independent predictors of MGMT methylation.Conclusion MAP-MRI diffusion parameters demonstrate the ability to predict MGMT promoter methylation status in glioma,with superior performance compared with diffusion tensor imaging.Habitat imaging further enhances the predictive efficacy of MAP-MRI parameters for MGMT promoter methylation.

Objective:To explore the mediating role of dietary health beliefs in the relationship between family functioning and the frequency of sugar-containing food intake among adolescents with dental caries, in order to clarify the underlying mechanism through which dietary health beliefs influence caries-related dietary behaviors via family factors.Methods:Using convenience sampling method, we selected adolescents patients diagnosed with dental caries and their parents who visited the Affiliated Stomatological Hospital of Nanjing Medical University from July to September 2023 as the research subjects. Conducted a cross-sectional survey using a general information questionnaire, Family Functioning Scale, Adolescent Dietary Health Belief Scale, and Sugar-Sweetened Diet Intake Frequency Scale. Mediation analysis was conducted.Results:A total of 475 questionnaires were distributed, and 460 valid responses were obtained, yielding a valid response rate of 96.84%. Among the 460 adolescent patients, 306 were female and 154 were male, with a mean age of (13.42 ± 1.17) years old. The mother's age was (40.28 ± 4.24) years old, and the father's age was (42.12 ± 4.48) years old. The score for the frequency of sugar-containing food intake was 15.95 ± 5.34, the dietary health belief score was 75.57 ± 18.62, and the family functioning score was 174.24 ± 25.39. Family functioning was positively correlated with dietary health beliefs ( r = 0.428, P<0.05), and negatively correlated with the frequency of sugar-containing food intake ( r = -0.225, P<0.05). Dietary health beliefs were negatively correlated with the frequency of sugar-containing food intake ( r = -0.332, P<0.05). The mediating effect of dietary health beliefs on the relationship between family functioning and sugar-containing food intake frequency was -0.332, accounting for 43.92% of the total effect. Conclusions:Dietary health beliefs play a partial mediating role between family function and the frequency of sugary diet intake. It is suggested that family function construction should be strengthened to improve adolescents' health beliefs and reduce the incidence of dental caries.

Objective:To investigate the relationship between age of onset of type 2 diabetes mellitus and renal prognosis in diabetic nephropathy (DN) patients.Methods:A total of 76 diabetic nephropathy patients diagnosed by kidney biopsy in the Second Hospital of Lanzhou University from January 2017 to January 2019 were included. Type 2 diabetes was divided into early onset group (26 cases, onset age <40 years old) and late onset group (50 cases, onset age ≥40 years old) according to the onset age of type 2 diabetes. Clinical parameters, pathological characteristics of renal tissue and correlation between clinical parameters and renal pathology of the two groups were analyzed when DN was diagnosed. After 5 years of follow-up, Log-rank test and Cox univariate regression analysis were used to determine the renal prognosis of the two groups.Results:Compared with the late onset group, the onset age of diabetes and the time of renal biopsy were earlier in the early onset group, and the duration of diabetes was longer when kidney injury occurred in the early onset group (all P<0.05). Compared with the late group, the glomerular basement membrane (GBM) was thicker in the early group ( P=0.035). GBM thickness was negatively correlated with age at onset of type 2 diabetes ( r=-0.359, P=0.003), positively correlated with duration of diabetes ( r=0.300, P=0.023), but not with age at renal biopsy ( r=-0.205, P=0.144). During follow-up, 3 and 5 patients died in the early-onset and late-onset groups, and 11 and 28 patients progressed to end-stage renal disease (ESRD), respectively. The 5-year cumulative renal survival rate in the two groups was 36.4% and 20.7%, respectively. Log-rank test showed similar renal outcomes in the two groups ( P=0.340). The risk of progression to ESRD was similar between the two groups ( HR=1.045; 95% CI: 0.977 to 1.117, P=0.199), and the estimated annual decline in estimated glomerular filtration rate (eGFR) was similar between the two groups [(26.40±21.25)% vs (33.32±25.53)%, P=0.248]. Conclusions:During 5-year follow-up, the risk of progression to ESRD was similar in the early-onset and late-onset groups. The early-onset group did not show a faster decline in renal function and a worse renal prognosis.

Objective:To establish a rapid quantitative model for the determination of moisture,extractives,and content in Pollen Typhae.Methods:Near-infrared spectra of 91 batches of Pollen Typhae samples were collected.Spectral preprocessing was performed using S-G,MSC,SNV,and CWT methods.Variable selection was conducted using CARS,SPA,and VIP methods,and compared with full-spectrum modeling.Partial least squares(PLS)mod-els were established for the quantitative determination of moisture,total ash,extractives,and content.The model performance was evaluated by calculating the coefficient of determination for the calibration set and validation set(R2 c,R2v),root mean square error of calibration and validation(RMSEc,RMSEv),and residual prediction devia-tion(RPD).Results:The PLS models for moisture,extractives,and content in Pollen Typhae showed R2c and R2v values greater than 0.9,RMSEc and RMSEv values approaching 0,and RPD values greater than 3.Conclusion:In this study,near-infrared spectroscopy was used to construct quantitative prediction models for moisture,extractives,typhaneoside,and isorhamnetin-3-O-neohesperidoside content in Pollen Typhae.This method enables rapid detection of the main quality control indicators of Pollen Typhae,providing strong technical support for its quality supervision.

Objective:To evaluate the effect of liposomal bupivacaine transversus abdominis plane block (TAPB) on the postoperative quality of recovery in patients undergoing laparoscopic colorectal surgery.Methods:In this randomized controlled trial, 100 patients of either sex, aged 18-75 yr, with a body mass index of 18.5-29.9 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective laparoscopic colorectal surgery, were allocated into 2 groups ( n=50 each) in a 1∶1 ratio using a random number table method: liposomal bupivacaine TAPB group (LB group) and hydrochloric bupivacaine TAPB group (HB group). Before anesthesia induction, ultrasound-guided bilateral TAPB was performed, liposomal bupivacaine (266 mg) 40 ml (20 ml per side) was injected in LB group, and bupivacaine hydrochloride (100 mg) 40 ml (20 ml per side) was injected in HB group. When pain scores at rest ≥4 within 72 h after the end of surgery, patient-controlled intravenous analgesia with morphine injectio 3 mg was used. The Quality of Recovery-15 scale score was recorded at 24, 48 and 72 h postoperatively. The time to first rescue analgesia and total consumption of morphine within 72 h after operation were recorded. The occurrence of adverse reactions, including nausea and vomiting, urinary retention, pruritus, local anesthetic toxicity and hematoma at the puncture site, was recorded within 72 h after surgery. Results:Compared to HB group, Quality of Recovery-15 scale scores were significantly increased at 24, 48 and 72 h postoperatively, the time to first rescue analgesia was prolonged, the consumption of morphine was reduced within 72 h postoperatively, and the incidence of postoperative nausea and vomiting was decreased( P<0.05), and no statistically significant changes in the incidence of urinary retention or pruritus were found within 72 h postoperatively in LB group ( P>0.05). No local anesthetic toxicity or hematoma at the puncture site occurred in either group. Conclusions:Liposomal bupivacaine TAPB can improve the postoperative quality of recovery in the patients undergoing laparoscopic radical resection for colorectal cancer.

Objective:To evaluate the effectiveness of fosaprepitant in preventing postoperative nausea and vomiting (PONV) following gynecological laparoscopic surgery.Methods:In this randomized parallel-controlled trial, 100 American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ patients, aged 18-64 yr, undergoing elective gynecological laparoscopic surgery under general anesthesia at the First Affiliated Hospital of Zhengzhou University, were selected and divided into 2 groups ( n=50 each) in a ratio of 1∶1 using blocked randomization: fosaprepitant group (group F) and tropisetron group (group T). At 30 min before anesthesia induction, fosaprepitant 150 mg was intravenously infused in group F, and tropisetron 5 mg was intravenously infused in group T, both diluted in 150 ml of normal saline. Anesthesia was induced by intravenous injection of midazolam, etomidate, sufentanil and cisatracurium. Anesthesia was maintained by intravenous infusion of remifentanil and propofol. Patient-controlled intravenous analgesia was performed with hydromorphone at the end of operation until 48 h after operation. Metoclopramide was given as rescue antiemetic. The PONV, requirement for antiemetic drugs and related adverse reactions were recorded within 24 h after surgery. Results:The incidence of PONV (10% vs 30%), the incidence of vomiting(2% vs 16%) and the rescue rate of antiemetic drugs(2% vs 12%)were significantly lower in group F than in group T ( P<0.05). There was no significant difference in the incidence of related adverse reactions between the two groups ( P>0.05). Conclusions:Intravenous infusion of fosaprepitant 150 mg at 30 min before anesthesia induction effectively prevents PONV in patients undergoing gynecological laparoscopic surgery, and the efficacy is superior to that of the conventional use of tropisetron.

Objective:To establish a rapid quantitative model for the determination of moisture,extractives,and content in Pollen Typhae.Methods:Near-infrared spectra of 91 batches of Pollen Typhae samples were collected.Spectral preprocessing was performed using S-G,MSC,SNV,and CWT methods.Variable selection was conducted using CARS,SPA,and VIP methods,and compared with full-spectrum modeling.Partial least squares(PLS)mod-els were established for the quantitative determination of moisture,total ash,extractives,and content.The model performance was evaluated by calculating the coefficient of determination for the calibration set and validation set(R2 c,R2v),root mean square error of calibration and validation(RMSEc,RMSEv),and residual prediction devia-tion(RPD).Results:The PLS models for moisture,extractives,and content in Pollen Typhae showed R2c and R2v values greater than 0.9,RMSEc and RMSEv values approaching 0,and RPD values greater than 3.Conclusion:In this study,near-infrared spectroscopy was used to construct quantitative prediction models for moisture,extractives,typhaneoside,and isorhamnetin-3-O-neohesperidoside content in Pollen Typhae.This method enables rapid detection of the main quality control indicators of Pollen Typhae,providing strong technical support for its quality supervision.

Polyetheretherketone (PEEK) and its composite materials have garnered widespread attention in the field of dental implantology due to their good biocompatibility, mechanical properties, and corrosion resistance. The low elastic modulus of PEEK, comparable to that of human jawbone, helps to reduce the stress shielding effect around the implant, thereby enhancing the rate of bone integration. This article reviews the latest research progress of PEEK and its composite materials in the field of dental implantation, including the synthesis of materials, surface modification techniques, and applications in implant-abutment-crown complexes and full-arch denture bridges.

Objective To explore the sleep quality and mental fatigue level in elderly patients with cerebrovascular small disease(CSVD).Methods A total of 222 patients aged over 65 years old hospitalized due to chronic diseases in Department of Neurology of the Affiliated Jiangning Hospi-tal of Nanjing Medical University from August 2022 to June 2024 were recruited prospectively and continuously.According to the CSVD score,they were divided into a CSVD group(CSVD score≥1,148 cases)and a non-CSVD group(CSVD score=0,74 cases).All the patients were evaluated by sleep quality,fatigue and neuropsychological scale when they were fully cooperated and in good condition.Subsequently,the patients in the CSVD group were further assigned into a good sleep subgroup(117 cases)and a poor sleep subgroup(31 patients).Results The CSVD group had significantly higher total score of Pittsburgh sleep quality index(PSQI),sleep quality score,sleep disturbance score,total score of self-rating fatigue,and mental fatigue score than the non-CSVD group(P＜0.01).The sleep quality score,sleep disturbance score,and mental fatigue score were risk factors for CSVD(P＜0.05).The mental fatigue score was significantly higher in the CSVD patients with poor sleep than those with good sleep(4.13±1.15 vs 2.50±1.92,P＜0.01).Conclusion Elderly CSVD patients were more likely to have decreased sleep quality and mental fatigue,and among them,those with poor sleep quality are prone to having mental fatigue than those with good sleep.

Objective:To investigate the risk factors associated with 90-day mortality in critically ill patients receiving continuous renal replacement therapy (CRRT), with a particular focus on the association between hypotension within the first hour of CRRT initiation and 90-day mortality after hospital admission.Methods:This study was a post hoc analysis of a prospective cohort study investigating the impact of colloid versus crystalloid priming solutions on early hemodynamics in critically ill patients undergoing CRRT. The study enrolled intensive care unit patients who received CRRT at West China Hospital of Sichuan University from January 2024 to May 2024. The data were collected including demographic characteristics, laboratory tests, CRRT-related parameters, blood pressure, heart rate, sequential organ failure assessment scores, and vasoactive-inotropic score, etc. The 90-day survival outcome after hospital admission of critically ill patients aged 18-80 years who received continuous veno-venous hemodiafiltration was used as the primary outcome indicator. A Cox proportional hazards model analysis was conducted, and the predictive ability of the model was evaluated along with the test of the proportional hazards assumption. The risk factors associated with the 90-day mortality after hospital admission of critically ill patients receiving CRRT were explored, with a particular focus on whether hypotension occurring within the first hour of CRRT initiation was one of these risk factors.Results:A total of 208 patients were included in this study. Within 90 days after hospital admission, 141 patients (67.8%) died, among whom 102 were male (72.3%) and the median age was 61.0 (50.0, 71.5) years; 67 patients (32.2%) survived, among whom 53 were males (79.1%) and the median age was 56.0 (47.0, 68.0) years. The incidence of hypotension within the first hour of CRRT initiation was significantly higher in the death group than in the survival group [29.8% (42/141) vs. 16.4% (11/67), χ2=4.275, P=0.039]. Moreover, The mortality rate of the group with hypotension within the first hour of CRRT initiation was higher than that of the group without hypotension [79.2% (42/53) vs. 63.9% (99/155), χ2=4.275, P=0.039]. The Kaplan-Meier survival analysis showed that the median survival time of patients without hypotension within the first hour of CRRT initiation [39.0 d (95% CI 23.2-54.8)] was longer than that of patients with hypotension [26.0 d (95% CI 18.9-33.1)], and the 90-day cumulative survival rate after hospital admission of patients without hypotension was significantly higher than that of patients with hypotension (Log-rank test, χ2=5.100, P=0.024). Univariate and multivariate Cox proportional hazards analyses demonstrated that serum albumin ( HR=0.964, 95% CI 0.933-0.997, P=0.030), sequential organ failure assessment score ( HR=1.064, 95% CI 1.012-1.118, P=0.015), and the use of mechanical ventilation ( HR=8.272, 95% CI 1.145-59.743, P=0.036) were significantly associated with 90-day mortality in critically ill patients undergoing CRRT. In contrast, the vasoactive-inotropic score ( HR=1.004, 95% CI 0.999-1.008, P=0.079) and the presence of hypotension within the first hour of CRRT initiation ( HR=1.236, 95% CI 0.833-1.835, P=0.293) were not significantly associated with 90-day mortality in critically ill patients undergoing CRRT. The consistency index of this model was 0.654 (95% CI 0.617-0.691), the area under the receiver operating characteristic curve was 0.724 (95% CI 0.658-0.800), and the calibration curve showed that the predicted values of the model were well fitted to the actual observations, suggesting that the predictive effect of this model was relatively ideal. Conclusions:In critically ill patients undergoing CRRT, the occurrence of hypotension within the first hour of CRRT initiation was not significantly associated with 90-day mortality after hospital admission. Lower serum albumin levels, higher sequential organ failure assessment scores, and the use of mechanical ventilation may be the risk factors for 90-day mortality in this population.