Objective: To evaluate the performance of 5T magnetic resonance imaging (MRI) in visualizing dental pulp and periodontal ligament (PDL) tissues in vivo in the young adult population, thereby providing a basis for the application of high-field MRI technology in clinical oral examinations. Methods: The study was approved by the Ethics Committee of the hospital. A total of 15 healthy volunteers (413 permanent teeth altogether) were recruited and underwent full-mouth 5T MRI scans. Among them, six volunteers (168 permanent teeth) also received both 3T MRI and cone-beam computed tomography (CBCT) scans. Two dental specialists independently evaluated the imaging quality of the dental pulp and PDL on the images using a 5-point Likert scale and recorded the number of detectable root canals for each tooth. Inter-rater agreement was assessed using weighted kappa statistics and intraclass correlation coefficient (ICC). Non-parametric tests were employed to compare differences in imaging performance among different tissue structures, tooth positions, and imaging modalities. Results: 5T MRI can achieve in vivo imaging for most dental pulp tissues and partial periodontal membrane structures. There was a high level of agreement between the two raters in their imaging scores for the dental pulp and PDL (dental pulp κ = 0.934, PDL κ = 0.737). The imaging scores for dental pulp were significantly higher than those for PDL (P < 0.001), and the scores for molar dental pulp were lower than those for premolars and anterior teeth. In the multimodal comparison involving six volunteers, the raters showed good consistency in scoring dental pulp and PDL imaging across 5T MRI, 3T MRI, and CBCT, as well as in root canal counts (5T MRI for dental pulp κ = 0.971, 3T MRI for dental pulp κ = 0.933, CBCT for dental pulp κ = 0.964; 5T MRI for PDL κ = 0.625, 3T MRI for PDL κ = 0.667, CBCT for PDL κ = 0.571; ICC for root canal counts all ≥ 0.990). The imaging scores for dental pulp and PDL using 5T MRI were significantly higher than those using 3T MRI (dental pulp: P < 0.001; PDL: P = 0.022), but there was no statistically significant difference in the detection rate of the number of root canals between the two (P > 0.05). Although the imaging scores for dental pulp and PDL as well as the detection rate of the number of root canals with 5T MRI were inferior to those with CBCT (dental pulp: P < 0.001; PDL: P = 0.02; number of root canals: P < 0.05), 5T MRI can truly achieve "direct imaging" of these two soft tissues. Conclusion 5T MRI enables effective in vivo direct imaging of dental pulp and PDL tissues in the young adult population, indicating its potential clinical application value in the diagnosis and treatment of pulp and periodontal diseases.

Objective To evaluate the performance of the detection of Mycobacterium tuberculosis(MTB)nucleic acids on the CFX Opus 96 Dx real-time fluorescence PCR(RT-PCR)analyzer to determine its clinical applicability.Methods 20 clinical sputum samples were collected,and MTB bacterial suspensions were serially diluted to prepare the samples.After extraction of nucleic acids using thermal lysis,MTB DNA was amplified by real-time fluorescent PCR(RT-PCR)using the MTB nucleic acid detection reagent on the CFX Opus 96 Dx real-time fluorescence PCR analyzer to evaluate the performance of the method,including the limit of detection(LOD),precision,cross-reactivity,anti-interference ability,personnel and inter-instrument comparison,and methodological compliance rate.Results The minimum detection limit of the CFX Opus 96 Dx real-time fluorescence PCR analyzer for detecting MTB DNA was 1×102 bacteria/ml,which aligns with the requirements of the reagent specification.The intra-batch coefficient of variation(CV)was 1.04%,1.61%and 1.29%for 3 repetitions of 5×102 bacteria/ml samples.The intra-batch CVs were 0.92%,0.74%and 0.59%for 3 repetitions of 5×103 bacteria/ml samples,which were all<5%.Common respiratory pathogens such as Staphylococcus aureus,Staphylococcus epidermidis,Pseudomonas aeruginosa,Klebsiella pneumoniae,Nocardia,Proteus mirabilis,Legionella pneumophila,Pneumocystis japonicus,Influenza A virus,Influenza B virus,Mycoplasma pneumoniae and SARS-CoV-2 do not cross-react with MTB.There was no statistically significant difference in the change in cycle threshold(Ct)values before and after the addition of the interfering substances Hemoglobin,Mucin,Rifampicin,Isoniazid,Amoxicillin and Levofloxacin to the MTB-positive specimens(all P>0.05).Comparison CVs between the two operators and all three PCR instruments were less than 5 percent.The positive compliance rate,negative compliance rate and total compliance rate of MTB DNA detected by the ABI 7500 real-time PCR analyzer and the CFXOpus 96 Dx real-time PCR analyzer were 100%.Conclusion The LoD,precision,cross-reactivity,anti-interference ability,personnel and inter-instrument comparison,and methodological compliance rate of the CFX Opus 96 Dx real-time fluorescence PCR analyzer for the detection of MTB DNA are all in line with the requirements of clinical molecular biology testing,which can provide a reliable basis for clinical testing.

Hypospadias is a common congenital malformation of the genitourinary system in children. Surgery is the only way to treat hypospadias. The anatomical conditions of the penis directly affect the choice of surgical methods and prognosis. It is urgent to establish an individualized surgical strategy to adapt to different types of hypospadias in order to improve the prognosis of children. Therefore，this paper focuses on the evaluation of hypospadias anatomy，selection of surgical methods and postoperative efficacy，in order to provide reference for the establishment of individualized surgical strategies for hypospadias.

Objective To evaluate the performance of the detection of Mycobacterium tuberculosis(MTB)nucleic acids on the CFX Opus 96 Dx real-time fluorescence PCR(RT-PCR)analyzer to determine its clinical applicability.Methods 20 clinical sputum samples were collected,and MTB bacterial suspensions were serially diluted to prepare the samples.After extraction of nucleic acids using thermal lysis,MTB DNA was amplified by real-time fluorescent PCR(RT-PCR)using the MTB nucleic acid detection reagent on the CFX Opus 96 Dx real-time fluorescence PCR analyzer to evaluate the performance of the method,including the limit of detection(LOD),precision,cross-reactivity,anti-interference ability,personnel and inter-instrument comparison,and methodological compliance rate.Results The minimum detection limit of the CFX Opus 96 Dx real-time fluorescence PCR analyzer for detecting MTB DNA was 1×102 bacteria/ml,which aligns with the requirements of the reagent specification.The intra-batch coefficient of variation(CV)was 1.04%,1.61%and 1.29%for 3 repetitions of 5×102 bacteria/ml samples.The intra-batch CVs were 0.92%,0.74%and 0.59%for 3 repetitions of 5×103 bacteria/ml samples,which were all<5%.Common respiratory pathogens such as Staphylococcus aureus,Staphylococcus epidermidis,Pseudomonas aeruginosa,Klebsiella pneumoniae,Nocardia,Proteus mirabilis,Legionella pneumophila,Pneumocystis japonicus,Influenza A virus,Influenza B virus,Mycoplasma pneumoniae and SARS-CoV-2 do not cross-react with MTB.There was no statistically significant difference in the change in cycle threshold(Ct)values before and after the addition of the interfering substances Hemoglobin,Mucin,Rifampicin,Isoniazid,Amoxicillin and Levofloxacin to the MTB-positive specimens(all P>0.05).Comparison CVs between the two operators and all three PCR instruments were less than 5 percent.The positive compliance rate,negative compliance rate and total compliance rate of MTB DNA detected by the ABI 7500 real-time PCR analyzer and the CFXOpus 96 Dx real-time PCR analyzer were 100%.Conclusion The LoD,precision,cross-reactivity,anti-interference ability,personnel and inter-instrument comparison,and methodological compliance rate of the CFX Opus 96 Dx real-time fluorescence PCR analyzer for the detection of MTB DNA are all in line with the requirements of clinical molecular biology testing,which can provide a reliable basis for clinical testing.

Hypospadias is a common congenital malformation of the genitourinary system in children. Surgery is the only way to treat hypospadias. The anatomical conditions of the penis directly affect the choice of surgical methods and prognosis. It is urgent to establish an individualized surgical strategy to adapt to different types of hypospadias in order to improve the prognosis of children. Therefore，this paper focuses on the evaluation of hypospadias anatomy，selection of surgical methods and postoperative efficacy，in order to provide reference for the establishment of individualized surgical strategies for hypospadias.

OBJECTIVE To investigate the mechanisms of rutin in alleviating depressive symptoms associated with premenstrual dysphoric disorder(PMDD)characterized by liver qi stagnation syndrome.METHODS Network pharmacology was employed to identify the intersecting targets of action between PMDD and rutin.A protein-protein interaction network was constructed to screen core targets,followed by gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis.Molecular docking simulations validated rutin's binding affinity to core targets.The bilateral ovaries of female Wistar rats were removed,followed by artificial hormone induction.The rats were then randomly divided into normal group(10 rats)and modeling group(50 rats).PMDD rat model with liver qi stagnation syndrome was established via restraint stress.The successfully modeled rats were further divided into model group,fluoxetine group(positive control)and rutin group,with 12 rats in each group.The corresponding drug solutions or water were administered by gavage at 9:00 a.m.every day,continuing for two estrous cycles.The open-field test,forced swimming test and Y-maze test were utilized to evaluate the effects of rutin on the behavioral indexes of model rats.Additionally,the density of neuronal dendritic spines in the hippocampal tissues of the rats was observed.Serum brain-derived neurotrophic factor(BDNF)levels and the expressions of BDNF,tyrosine kinase receptor type B(TrkB),synuclein(Syn),and postsynaptic density protein 95(PSD95)in hippocampal tissues were quantified,respectively.RESULTS Network pharmacology and molecular docking revealed the core targets through which rutin ameliorated PMDD characterized by liver qi stagnation syndrome included BDNF,TrkB,PSD65,Syn,etc.The results of experimental validation demonstrated that rutin significantly increased the spontaneous alternation behavior scores of PMDD model rats with liver qi stagnation syndrome during the non-receptive phase,shortened their immobility time during the forced swimming test,and enhanced the density of neuronal dendritic spines in the hippocampal tissues.Additionally,rutin upregulated the levels of serum BDNF and the protein expressions of BDNF,TrkB and Syn in the hippocampal tissues(P＜0.05).However,it had no significant effect on the above indexes in model rats during the receptive phase(P＞0.05).CONCLUSIONS Rutin ameliorates depressive symptoms,enhances spatial memory capabilities,and reduces neuronal damage in PMDD model rats with liver qi stagnation syndrome.These effects may be associated with the activation of BDNF/TrkB signaling pathway and upregulation of Syn protein expression.

Objective To observe the value of nomogram model based on clinical and ultrasonic characteristics for diagnosing lymphoma.Methods Data of 176 patients with suspected lymphoma due to enlarged superficial lymph nodes were retrospective analyzed.The patients were divided into lymphoma group(n=90,invasive subgroup[n=40]and non-invasive subgroup[n=50])or non-lymphoma group(n=86)based on pathological results.Clinical and ultrasonic data were compared between groups and subgroups.Multivariate logistic regression was used to screen the independent risk factors of lymphoma,and then a nomogram was constructed.Receiver operating characteristic curves were drawn to evaluate the efficacy of conventional ultrasound,conventional contrast-enhanced ultrasound(C-CEUS),high-frame-rate contrast-enhanced ultrasound(H-CEUS)and nomogram for diagnosing lymphoma.Results Multivariate logistic regression analysis revealed that age＞59 years,cortical stripe/reticular hyperecho of lymph nodes and"centrifugal firework"enhancement pattern showed with H-CEUS were all independent risk factors of lymphoma(all P＜0.05).Taken 59 years as the best cut-off value of patients'age,the sensitivity,specificity,accuracy and the area under the curve(AUC)for diagnosing lymphoma was 67.78%,58.10%,63.06%and 0.630,respectively.The sensitivity,specificity,accuracy and AUC of cortical stripe/reticular hyperecho of lymph nodes for diagnosing lymphoma was 73.33%,58.10%,65.91%and 0.657,respectively,while of"centrifugal firework"pattern enhancement in H-CEUS was 77.78%,69.80%,73.86%and 0.738,respectively.AUC of conventional ultrasound,C-CEUS,H-CEUS and nomogram for diagnosing lymphoma was 0.657,0.540,0.738 and 0.844,respectively.Conclusion Nomogram model based on clinical and ultrasonic characteristics had good diagnostic efficacy for lymphoma,and"centrifugal firework"pattern enhancement in H-CEUS could be regarded as the specific characteristic of lymphoma.

OBJECTIVE To explore the characteristics and regulations of adverse drug reactions （ADR） caused by apatinib， and to provide a reference for the safe use of apatinib in clinic. METHODS Case and group reports on ADR and safety evaluation of apatinib were retrieved from Chinese and English databases such as CNKI， Wanfang medical network， VIP and PubMed since its listing in 2014， literature data were extracted and statistically analyzed after screening. RESULTS Totally 101 cases were included， involving 221 ADR. In the above cases， the male-to-female ratio was 1.24∶1， with the highest proportion of patients aged 51 to 70 years， most of the patients were given a dose of 500 mg or more， and the patients given low dose of apatinib combined with other antitumor drugs were also likely to have ADR. One to two types of adverse reaction were the most common， while the types could reach up to six. Most ADR occurred within 30 days after medication， and the systems/organs involved were mainly the cardiovascular system damage，skin and its accessories damage， gastrointestinal system damage and urinary system damage； the main clinical manifestations were hypertension/aggravation，hand-foot syndrome，abdominal pain diarrhea and albuminuria， etc. Hypertension/aggravation， hand-foot syndrome and myelosuppression were the most common serious ADR. Most ADR could be improved/cured by suspension of administration， dose downregulation and symptomatic treatment. All 4 patients who died had underlying diseases， and their ECOG scores all ≥2 points. Special ADR （such as reversible posterior encephalopathy syndrome， psychiatric disorders， and cognitive impairment） were mostly caused by apatinib itself， or may be caused by apatinib in combination with the primary or underlying disease. CONCLUSIONS Advanced age， large dose， combination medication， underlying diseases and poor physical condition might be the high risks for ADR caused by apatinib. It is recommended to monitor the blood pressure，urine protein and skin of hands and feet of all patients with medication on a daily basis，pay attention to the occurrence of special ADR， and timely detect abnormal states and give effective intervention，so as to avoid the aggravation of ADR and other secondary ADR.

BACKGROUND:Gingival thickness is an important indicator to determine gingival phenotype.The correct evaluation of gingival phenotype is helpful for the smooth going of periodontal surgery,implant implantation and orthodontic treatment.The search for a comfortable,accurate and convenient method of measuring gingival thickness has always been a research hotspot in this field. OBJECTIVE:To analyze the gingival thickness in different dental positions and to study the consistency of cone-beam computed tomography(CBCT)image and digital intraoral scanners and cone-beam computed tomography(DIS-CBCT)superimposition image for measuring gingival thickness and determining whether the gingiva is thick or thin. METHODS:Twenty volunteers(10 males and 10 females)with complete maxillary dentition were recruited.The thickness of the gingiva 2 mm below the buccal gingival margin of 160 teeth was measured by CBCT image and DIS-CBCT digital superimposition image.Gingival thickness was used to determine whether the gingiva was thick or thin.Paired t-test was used to analyze the differences in gingival thickness measured by the two methods.Pearson correlation analysis was used to evaluate the correlation between the gingival thickness results of the two methods.The intraclass correlation coefficient(ICC)and Bland-AItman chart were used to analyze the repeatability and consistency in measuring gingival thickness using the two methods.Kappa value was used to analyze the consistency in determining whether the gingiva was thick or thin using the two methods. RESULTS AND CONCLUSION:The gingival thickness measured by CBCT image and DIS-CBCT digital superimposition image was(1.47±0.39)and(1.42±0.36)mm,respectively(t=5.673,P＜0.05).Pearson correlation analysis showed that the gingival thickness measured by the two methods was positively correlated(r=0.968,P＜0.001).In the CBCT group,the values of intraobserver and interobserver ICC were 0.980-0.982 and 0.984,respectively;in the DIS-CBCT group,the values of intraobserver and interobserver ICC were 0.941-0.984 and 0.964,respectively(P＜0.001).The intergroup ICC value of gingival thickness measured by the two methods was 0.967(P＜0.001).Bland-AItman analysis showed that 4.37%(7/160)of the points measured by both methods for gingival thickness was outside the 95%limits of agreement.There were 71 cases of thick-gingiva and 89 cases of thin-gingiva measured by CBCT imaging,and 59 cases of thick-gingiva and 101 cases of thin-gingiva measured by DIS-CBCT digital superimposition image.The Kappa value of the two groups was 0.845(P＜0.001).These findings indicate that there is a significant difference in the thickness measurement of the gingiva 2 mm below the gingival margin between the CBCT group and the DIS-CBCT group,but the correlation is very strong.The repeatability and consistency of gingival thickness measurement are both high,and there is a good consistency between the two methods when used to determine whether the gingiva is thick or thin.

Objective:To evaluate the accuracy of continuous photoplethysmography algorithms for atrial fibrillation diagnosis and atrial fibrillation burden evaluation via wearable devices.Methods:This study was a self-controlled prospective cohort study. A total of 254 consecutive inpatients were recruited from the Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University from September 2022 to November 2022. All participants were required to wear two devices at the same time: (1) an electrocardiogram (ECG) watch for acquisition of photoplethysmography (watch-recorded-photoplethysmography, W-PPG) and electrocardiogram (watch-recorded-electrocardiogram, W-ECG); (2) an ECG patch for acquisition of electrocardiogram (patch-recorded-electrocardiogram, P-ECG). The results were measured in 30 s data segments and individual participants, separately, which were calculated for sensitivity and specificity by comparing them with the results of expert-read ECG according to the receiver operating characteristic curve. Four groups were separated according to the proportion of the atrial fibrillation burden, and the difference of atrial fibrillation burden from algorithm and expert-read ECG was calculated.Results:All 254 subjects completed the study. The mean age of participants was (63.04±11.04) years old, 99 (38.98%) of them were female, and 97 (38.19%) patients had persistent atrial fibrillation. Expert-read ECG results were taken as standard criteria in all calculations. The P-ECG algorithm had a sensitivity of 94.86% (95% CI: 94.81%-94.91%) and a specificity of 99.30% (95% CI: 99.28%-99.31%) when measured in data segments. The W-PPG algorithm had a sensitivity of 96.07% (95% CI: 95.97%-96.18%) and a specificity of 98.62% (95% CI: 98.59%-98.65%). When measured in terms of individual participants, the P-ECG algorithm had a sensitivity of 92.55% (95% CI: 87.57%-95.71%) and a specificity of 96.39% (95% CI: 93.45%-98.09%), while the W-PPG algorithm had a sensitivity of 93.71% (95% CI: 88.75%-96.67%) and a specificity of 89.62% (95% CI: 85.61%-92.65%). When measured in terms of a single acquisition of W-ECG records, the W-ECG algorithm had a sensitivity of 92.04% (95% CI: 88.14%-94.78%) and a specificity of 96.19% (95% CI: 94.35%-97.47%). For atrial fibrillation burden assessment, the difference between the W-PPG analysis results and the expert-read ECG results was less than 2% in all burden distribution intervals. Conclusions:Continuous photoplethysmography algorithm applied to wearable devices to detect atrial fibrillation is a feasible strategy. Taking expert-read ECG results as standard, continuous monitoring of PPG by a smartwatch is highly accurate for atrial fibrillation diagnosis and can also be used to effectively complete atrial fibrillation burden assessment.