Objective: To explore the association between mediterranean diet (MD) patterns and dental caries among children and adolescents with neurodevelopmental disorders (NDD), so as to provide a basis for developing scientific anti caries strategies related to diet. Methods: From December 2021 to June 2024, a questionnaire survey, a three day 24 hour dietary review survey, oral health examination, physical development measurement and Childhood Autism Rating Scale (CARS) evaluation were conducted involving 147 children and adolescents aged 2-22 years with NDD from nine special education schools and rehabilitation institutions in Tianjin. Group comparisons were carried out using the Mann-Whitney U test, Chi-square test, or Fisher s exact probability method. The correlation between dietary quality and dental caries was analyzed by adopting multiple linear regression analysis and restricted cubic spline. Results: There were 46 children and adolescents (31.3%) in the non dental caries group and 101 children and adolescents (68.7%) in the dental caries group. The number of decayed missing and filled teeth (dmft) was 2.0 (4.0), and the MD score was 4.0 (2.0) points. There were 62 children and adolescents (42.2%) in the low MD scores group and 85 children and adolescents (57.8%) in the high MD scores group. There was no significant difference in MD scores between NDD children in the non dental caries group and those in the dental caries group [nondental caries group:4.0(2.0), dental caries group:4.0(2.0), Z= -0.14, P >0.05]. The MD scores and dmft exhibited increasing and then decreasing trend ( P total =0.02, P non lineary = 0.04 ). Children and adolescents with NDD in the MD high scores group had a lower number of dmft than those in the MD low scores group ( β= -2.00 , 95%CI =-3.39 to -0.62, P <0.05). However, in children and adolescents with NDD and CARS scores ≥30, the above association was insignificant ( β=-0.63, 95%CI=-0.29-0.15, P >0.05). Conclusion Children and adolescents with NDD who have dietary patterns similar to the Mediterranean diet, are found to have fewer dental caries, and this is observed among those with no or mild symptoms of autism spectrum disorder.

[Objective] To explore the relationship between neutrophil activation under cardiopulmonary bypass (CPB) and the incidence of cardiac surgery-associated acute kidney injury (CS-AKI). [Methods] This prospective cohort study enrolled adult patients who scheduled for cardiac surgery under CPB at West China Hospital between May 1, 2022 and March 31, 2023. The primary outcome was acute kidney injury (AKI). Blood samples (5 mL) were obtained from the central vein before surgery, at rewarming, at the end of CPB, and 24 hours after surgery. Neutrophils were labeled with CD11b, CD54 and other markers. To assess the effect of neutrophils activation on AKI, propensity score matching (PSM) was employed to equilibrate covariates between the groups. [Results] A total of 120 patients included into the study, and 17 (14.2%) developed AKI. Both CD11b⁺ and CD54⁺ neutrophils significantly increased during the rewarming phase and the increases were kept until 24 hours after surgery. During rewarming, the numbers of CD11b⁺ neutrophils were significantly higher in AKI compared to non-AKI (4.71×10⁹/L vs 3.31×10⁹/L, Z=-2.14, P<0.05). Similarly, the CD54⁺ neutrophils counts were also significantly higher in AKI than in non-AKI before surgery (2.75×10⁹/L vs 1.79×10⁹/L, Z=-2.99, P<0.05), during rewarming (3.12×10⁹/L vs 1.62×10⁹/L, Z=-4.34, P<0.05), and at the end of CPB (4.28×10⁹/L vs 2.14×10⁹/L, Z=-3.91, P<0.05). An analysis of 32 matched patients (16 in each group) revealed that CD11b⁺ and CD54⁺ neutrophil levels of AKI were 1.74 folds (4.83×10⁹/L vs 2.77×10⁹/L, Z=-2.72, P<0.05) and 2.34 folds (3.32×10⁹/L vs 1.42×10⁹/L, Z=-4.12, P<0.05), respectively, of non-AKI at rewarming phase. [Conclusion] Neutrophils are activated during CPB, and they can be identified by CD11b/CD54 markers. The activated neutrophils of AKI patients are approximately 2 folds of non-AKI during the rewarming phase, with disparity reached peak between groups during rewarming. These findings suggest the removal of 50% of activated neutrophils during the rewarming phase may be effective to reduce the risk of AKI.

ObjectiveTo explore the potential mechanism of Erchen Decoction （二陈汤， ECD） in improving metabolic syndrome （MS） with phlegm syndrome. MethodsForty mice were randomly divided into a blank group of 10 mice and a modeling group of 30 mice. The MS model with phlegm syndrome was induced in the modeling group by high-fat diet. Thirty successfully modeled mice were randomly divided into a model group， a ECD group， and a metformin group， with 10 mice in each group. The ECD group was given 0.4 g/（kg·d） of ECD， while the metformin group was intervened with 11.1 g/（kg·d） of metformin solution， and the blank group and the model group were given 0.02 ml/（g·d） of sterilized drinking water， all by gavage， once daily for 4 weeks. Body weight， abdominal circumfe-rence， body length， Lee's index and food intake were recorded. Blood glucose and blood lipid levels including fasting blood glucose， triglycerides （TG）， total cholesterol （TC）， high-density lipoprotein cholesterol （HDL-C）， and low-density lipoprotein cholesterol （LDL-C） were measured. ELISA was used to detect serum leptin levels， while HE staining was used to observe liver pathological changes. Western Blot and q-PCR were used to detect protein and mRNA expression of hypothalamic leptin receptor （LepR）， pro melanocortin （POMC）， and neuropeptide Y （NPY） in the hypothalamus. Immunofluorescence was used to detect fluorescence expression of POMC and NPY in the hypothalamic arcuate nucleus region. ResultsPathological results showed that the mice in the model group had numerous fat vacuoles in hepatocytes and significant liver fat deposition， while the ECD and metformin groups showed reduced fat vacuoles and less liver fat deposition. Compared to those in the blank group， the mice in the model group mice showed liver fat deposition， increased body weight， abdominal circumference， Lee's index and food intake； fasting blood glucose， TG， TC， LDL-C， and serum leptin levels were elevated， while HDL-C was decreased； the expression of LepR， POMC protein levels and their mRNA expression decreased， while the protein level and mRNA expression of NPY increased； the fluorescence expression of POMC in the arcuate nucleus was reduced， while NPY fluorescence expression increased （P＜0.05 or P＜0.01）. Compared to the model group， the ECD group and metformin group showed significant improvements in the above indicators （P＜0.05 or P＜0.01）. Compared to the ECD group， the metformin group showed a reduction in body weight and NPY fluorescence expression， and an increase in HDL-C levels （P＜0.05 or P＜0.01）. ConclusionECD can downregulate serum leptin levels and improve glucose and lipid metabolism in the MS of phlegm syndrome. Its mechanism of action may be to reduce liver fat deposition and thereafter affect the expression of neuropeptides related to feeding activity in the hypothalamus.

Objective:The clinical symptoms of children with global developmental delay (GDD) were analyzed to provide the scientific basis for the intervention of children with GDD.Methods:The results of the neuro-psychobehavioral scale were collected from 32 511 children with GDD from June 2020 to November 2023. Inclusion criteria: Children diagnosed with GDD according to the Diagnostic and Statistical Manual of Mental Disorders-V, ages 0.0 to 4.9 years. Exclusion criteria: children with common hearing impairment and visual impairment. The Chi-square tests were used for statistical analysis.Results:There were more boys than girls with GDD in outpatient clinics (68.2% vs. 31.8%). Among the children, the proportion of developmental delay in 5, 4, 3, and 2 domains was 31.1%, 23.4%, 22.9% and 22.6% respectively. The rate of delay in 2-3 domains was lower in boys (41.9%) than in girls (53.1%). The rate of delay in 4-5 domains was higher in boys (58.1%) than in girls (46.9%) ( χ2=352.11, P<0.001). Overall, outpatient GDD decreased with age. From 1.0-1.9 to 4.0-4.9 years of age, the proportion of children with developmental delay in 5 domains increased with age (18.2%, 36.4%, 43.9%, 52.4%). Among children aged 0.0-0.9 years, the proportion of 2 domains of developmental delay was higher (33.4%).Among children aged 1.0-1.9 years, the proportion of 2-3 domains of developmental delay was higher (30.7%). Among children aged 2.0-, 3.0-, 4.0-4.9 years, the proportion of developmental delay in 5 domains was higher (36.4%, 43.9%, 52.4%). In children with GDD, the fine motor delay occurred most frequently (85.1%), followed by social self-care (83.9%), language (79.0%), adaptation (62.3%), and gross motor (52.8%). The frequency of developmental delays in fine motor, adaptability, language, and social self-care in boys was higher than that in girls ( χ2=161.37, χ2=41.10, χ2=320.90, χ2=238.54, all P<0.001). The age groups with the highest delay incidence of gross motor, fine motor, adaptability, language, and social self-care were: 4.0-4.9 years (70.6%), 3.0-3.9 years (97.4%), 4.0-4.9 years (81.2%), 2.0-2.9 years (90.9%),2.0-2.9 years (95.4%). The proportions of fine motor delay in GDD children aged 0.0-0.9, 3.0-3.9 and 4.0-4.9 years were (74.5%, 97.4%, 96.8%) and the proportions of social self-care delay in GDD children aged 1.0- and 2.0-2.9 years were (92.1%, 95.4%). Peripheral and mild developmental delays were predominant in children with GDD. The proportion of severe language delay (6.4%) was higher than that in other fields. Conclusions:The proportion of GDD children with developmental delay in 4-5 domains was 54.5%. The most frequent domain of delay was fine motor. The frequencies of developmental delays in fine motor skills, adaptability, language, and social self-care in boys were higher than in girls. Most of the developmental delays in GDD children were marginal and mild. The rate of severe developmental delay in language was higher than in other domains.

Objective:To investigate the association between serum ferritin levels, erythrocyte parameters, and the risk of developing type 2 diabetes mellitus.Methods:A total of 11 408 subjects aged 40 to 70 years who underwent physical examinations at a hospital in Qingdao from 2014 to 2015 were enrolled in the study. Data were collected through questionnaires, physical examinations, and assessments of blood biochemical indices, serum ferritin, and related erythrocyte parameters. A multivariate logistic regression model was employed to analyze the relationship of serum ferritin and red cell parameters with type 2 diabetes mellitus, while a linear regression model was utilized to examine the association between serum ferritin, red cell parameters and fasting blood glucose levels.Results:The median ( Q1, Q3) age of the subjects was 51 (45, 58) years, with 55.3% (6 305) being male. The prevalence of type 2 diabetes in women was 5.9% (300/5 103), which was lower than that in men [13.0% (817/6 305)] ( P<0.001).After adjusting for age, sex, body mass index (BMI), smoking status, alcohol consumption, and family history of diabetes, serum ferritin levels were found to be positively associated with both type 2 diabetes and fasting blood glucose levels, with OR (95% CI) and β(95% CI) values of 1.70 (1.37, 2.11) and 0.002 (0.002, 0.003), respectively. Additionally, hemoglobin, red blood cell count, and hematocrit were positively correlated with type 2 diabetes and fasting blood glucose, with OR (95% CI) values of 1.72 (1.32, 2.24), 1.91 (1.51, 2.41), and 1.52 (1.17, 1.97), and β (95% CI) values of 0.008 (0.006, 0.011), 0.365 (0.286, 0.445), and 2.543 (1.564, 3.521), respectively. Conversely, mean erythrocyte volume was negatively associated with type 2 diabetes and fasting blood glucose, with OR (95% CI) and β (95% CI) values of 0.54 (0.45, 0.66) and -0.017 (-0.023, -0.011), respectively (all P values<0.001). Conclusion:The findings indicate that serum ferritin and related erythrocyte parameters are significantly correlated with the risk of type 2 diabetes mellitus and fasting blood glucose levels.

The patient, a 28-year-old male, had experienced splenomegaly for four years with lymphadenopathy for more than two months and presented to the First Affiliated Hospital of the Naval Medical University on October 16th, 2024. On July 31, 2024, he noticed right upper quadrant pain, and an enhanced abdominal CT performed in an external facility revealed splenomegaly with a rounded nodular lesion at the splenic hilum, suggestive of an accessory spleen; in addition to retroperitoneal lymphadenopathy, while tumor marker levels were unremarkable. A complete blood count on August 22nd, 2024, demonstrated leukopenia (2.22×10 9/L), hemoglobin level of 144 g/L, and thrombocytopenia (60×10 9/L). To further elucidate the diagnosis, the patient visit our hematology clinic on August 26th, 2024. His physical examination was normal in general condition, except for a firm palpable spleen 10 cm below the left costal margin, and ultrasonography revealed right thyroid nodule and hepatosplenomegaly. Because of hepatosplenomegaly and retroperitoneal lymphadenopathy, a PET-CT scan was performed. The scan confirmed marked hepatosplenomegaly, multiple enlarged lymph nodes in the retroperitoneal and mesenteric regions with increased metabolic activity, and evidence of elevated bone metabolic activity in the proximal limbs and axial skeleton. Given the possibility of a hematologic lymphoproliferative disorder, a bone marrow biopsy was recommended. On September 12th, 2024, the patient underwent a bone marrow biopsy for evaluations of cell morphology, initial lymphoma immunophenotyping, cytogenetic analysis, and lymphoma-related FISH testing. Flow cytometry, cytogenetic analysis, and FISH results on September 14th, 2024, were unremarkable, manual microscopy of bone marrow morphological evaluation revealed a small population of poorly differentiated lymphocytes; additionally, AI-assisted automated cell scan identified a subset of abnormal cells suspected to be ′Gaucher cells′. Bone marrow pathology indicated a histiocytic neoplasm accompanied by stage 2 myelofibrosis (MF), with tumor cells comprising approximately 70% of the nucleated cells in the marrow, suggesting immunohistochemistry for confirmation. On October 16th, immunohistochemical analysis confirmed the presence of a histiocytic proliferative disorder suspecting Gaucher disease. After admission, the patient initiated enzyme replacement therapy, receiving an initial intravenous dose of 60 U/kg in a weekly basis. On October 31st, 2024, based on enzyme activity assays, genetic testing, and other results, adult Gaucher disease was finally diagnosed. The patient was scheduled for follow-up with stable vital signs, and reduced size of the spleen compared with previous assessments.

Obesity and overweight remain major global public health challenges.In this paper,we examine current applications of digital nutrition technologies in weight management using the scoping review framework of Arksey and O'Malley.Visual recognition technologies have evolved from early-stage food image recognition into more advanced systems,although the vast diversity of food types continues to pose challenges for accuracy and generalizability.The combination of wearable devices and non-wearable sensors has increased the diversity of collected data and improved user comfort.Data integration and analysis tools,such as digital virtual twins,support personalized interventions by integrating multidimensional data.In addition,emerging applications have demonstrated encouraging clinical outcomes.However,existing studies have limitations,such as small sample sizes,high levels of information bias,and low evidence quality.Barriers,such as limited accessibility and high initial costs,further constrain the scalability of digital nutrition tools.Future studies should focus on expanding sample sizes,improving population diversity,and developing effective assessment methods and adjustments for specific target populations.Privacy and data security concerns must also be addressed to ensure safe implementation.Overall,digital nutrition technologies offer a promising approach to weight management,but continuous efforts in research and cost reduction are needed to fully realize their potential in weight management and to promote health for all.

Objective Feasibility application of microelectrode recording(MER)during sub thalamic nucleus deep brain stimulation(STN-DBS)implantation under desflurane general anesthesia(GA)in patients with Par-kinson's disease(PD).Methods A prospective cohort of 20 PD patients undergoing STN-DBS under desflurane general anesthesia were enrolled.Intraoperative MER quality,pos-operative acute pain,cognitive function,anxi-ety/depression status,quality of life,and clinical efficacy of DBS were evaluated.Results Among the patients,14 were male with average PD duration of(8.1±3.6)years.Hoehn-Yahr staging averaged 2.8±0.5 in"on"state and 2.3±0.5 in"off"state.The mean DBS surgery duration was 87.4 minutes.Highly normalized root-mean-square(NRMS)signals were successfully recorded in all cases,with remedial measures applied in 4 pa-tients to achieve satisfactory MER signals.Post-operative Visual Analogue Scale(VAS)pain scores on days 1,2,and 3 were 3.7±2.2,2.8±1.6,and 1.8±2.0,respectively.Montreal Cognitive Assessment(MoCA)scores showed no statistical difference during hospitalization as compared to pre-operative values,but significantly de-creased at 6-month follow-up(24.3±4.1 vs.21.5±3.5,P＜0.05).All patients demonstrated significant reduc-tion in Hamilton Anxiety Scale(HAMA),Hamilton Depression Rating Scale(HAMD),and Parkinson's disease Questionnaire-39(PDQ-39)scores at 6-month follow-up.The unified Parkinson's disease rating scale(UPDRS-Ⅲ)improvement rates were 51.4%±39.2%(medication-on)and 61.6%±26.8%(medication-off)respectively with Levodopa Equivalent Daily Dose(LEDD)improvement rate of 48.6%±23.0%.Conclusions Desflurane general anesthesia is safe and feasible for electrods implantation in STN-DBS of PD patients,without interfering with intra-operative MER or postoperative outcomes.

Objective To analyze the multimodal ultrasound imaging characteristics in patients with different molecular subtypes of breast cancer.Methods The medical records of 85 patients with breast cancer were retrospectively collected and classified into 12 cases of Luminal A,35 cases of Lu-minal B,21 cases of HER2,and 17 cases of triple-negative breast cancer based on immunohisto-chemical results.All patients underwent conventional ultrasound,color Doppler ultrasound,ultra-sound elastography,and contrast-enhanced ultrasound.The relationship between multimodal ultra-sound characteristics and breast cancer molecular subtypes and their diagnostic value were analyzed.Results Conventional ultrasound and color Doppler ultrasound results showed statistically significant differences in the margin characteristics of breast cancer lesions among the four molecular subtypes(P＜0.05).Ultrasound elastography results revealed that the maximum elastic modulus(Emax)lev-els of HER2 and triple-negative subtypes were higher than those of Luminal A and Luminal B,respec-tively.The ratios of elastic modulus to normal tissue(Eratio)for Luminal B,HER2,and triple-nega-tive subtypes were higher than that of Luminal A,and the Eratio level of Luminal Bwas lower than that of HER2(P＜0.05).Contrast-enhanced ultrasound results showed statistically significant differences in enhancement levels,perfusion defects,and peak intensity(IMAX),time to peak(TTP),and augmentation time(AT)among the four molecular subtypes of breast cancer lesions(P＜0.05).Multivariate Logistic regression analysis showed that margin characteristics,Emax,Emin,Emean,Eratio,IMAX,TTP,and AT were independent influencing factors for breast cancer molecular subtypes(P＜0.05).Receiver operating characteristic curve analysis showed that the area under the curve and sensitivity of multimodal ultrasound imaging characteristics(combined indicators)for diagnosing breast cancer molecular subtypes were significantly greater than those of individual indicators(P＜0.05).Conclusion There are differences in two-dimensional ultrasound,color Doppler ultra-sound,ultrasound elastography,and contrast-enhanced ultrasound results among different molecular-subtypes of breast cancer.Multimodal ultrasound imaging characteristics have high diagnostic value for breast cancer molecular subtypes.