Reconstruction of low-dose CT image faced problems such as low resolution,blurred artifacts and strong noise.Deep learning reconstruction met the needs of reducing radiation dose and improving imaging quality,promoted reconstruction of CT image towards high efficiency,intelligence and integration of clinical diagnosis and treatment.The research progresses in deep learning low-dose CT imaging reconstruction were reviewed in this article.

Objective To explore the mechanism of hepatic oval cells(HOCs)regulating liver regener-ation through Wnt/β-catenin pathway in human liver cirrhosis.Methods Forty cases of Child-Pugh class A cirrhosis tissues and 10 cases of normal liver tissues were collected and divided into the normal liver tissue group,the liver fibrosis group,the mild cirrhosis group and the moderate cirrhosis group based on HE staining and the Laennec classification system.The expression of Wnt/β-catenin pathway,CyclinD1 and Jagged-1 in each group were detected and compared,and the mechanism of Wnt/β-catenin pathway in the regulation of liver regeneration by HOCs was explored.Results The expression of Wnt and β-catenin increased with the aggravation of liver cirrhosis(P＜0.05).In contrast,the expression of CyclinD1 and Jagged-1 decreased with the aggravation of liver cirrhosis(P＜0.05).The expression levels of Wnt and β-catenin were positively corre-lated with the number of HOCs per unit area(r=0.806,0.634,P＜0.01).Compared with the degree of liver cirrhosis,the expression of Wnt/β-catenin had greater influence on the number of HOCs per unit area,the ex-pression of CyclinD1 and Jagged-1,and the differences were statistically significant(P＜0.05).Conclusion Wnt/β-catenin pathway can promote the generation of HOCs in human liver cirrhosis and mediate liver regenera-tion.

Objective To investigate the biomechanical characteristics of clear aligners combined with Class Ⅱelastics during retraction of upper anterior teeth,and compare the differences between two traction methods.Methods A case with a molar distal relationship and extraction of four first premolars was selected.The finite element method was applied to analyze tooth displacement,force distribution,and periodontal ligament(PDL)stress during 0.2 mm en-masse retraction of the anterior teeth.Three working conditions were defined:en-masse retraction without elastics(Condition 1),120 g Class Ⅱ elastics with aligner-cut hooks on upper canines and lower first molars(Condition 2),120 g Class Ⅱ elastics with aligner windows and bonded buttons on upper canines and lower first molars(Condition 3).Results Class Ⅱ elastics significantly enhanced lingual movement of the upper anterior teeth and mesial movement of the lower posterior teeth,while reducing mesial movement of the upper posterior teeth and lingual movement of the lower anterior teeth.In the transverse direction,the forces exerted on the teeth in all three conditions were minimal.In the sagittal direction,in Condition 2,the mesial force of the upper posterior teeth was effectively reduced by an average of 0.13 N,and the mesial force of the lower posterior teeth was increased by an average of 0.31 N.In Condition 3,the distal force of the upper canine teeth and the mesial force of the lower first molar were significantly increased by 0.40 N and 1.14 N,respectively.In the vertical direction,In condition 2,the average extrusive force of the upper teeth and the extrusive force of the lower molars were increased by 0.22 N and 0.20 N,respectively.In Condition 3,the upper canine extrusive force was increased by 0.91 N,while the lower molar intrusive force and the second molar extrusive force were reduced by 0.27 N and 0.25 N,respectively.The PDL stress distribution in the three conditions was generally similar.In Condition 3,the maximum principal stress distribution area on the lower first molars expanded slightly,but the magnitude did not increase significantly.Conclusions Condition 2 optimized the lower posterior teeth mesialization through balanced force distribution and protected the upper posterior teeth anchorage.Condition 3 significantly increased extrusive and distal forces on the upper canines and mesial forces on the lower first molars but did not substantially elevate periodontal risks for these teeth.

Objective To investigate the biomechanical characteristics of clear aligners combined with Class Ⅱelastics during retraction of upper anterior teeth,and compare the differences between two traction methods.Methods A case with a molar distal relationship and extraction of four first premolars was selected.The finite element method was applied to analyze tooth displacement,force distribution,and periodontal ligament(PDL)stress during 0.2 mm en-masse retraction of the anterior teeth.Three working conditions were defined:en-masse retraction without elastics(Condition 1),120 g Class Ⅱ elastics with aligner-cut hooks on upper canines and lower first molars(Condition 2),120 g Class Ⅱ elastics with aligner windows and bonded buttons on upper canines and lower first molars(Condition 3).Results Class Ⅱ elastics significantly enhanced lingual movement of the upper anterior teeth and mesial movement of the lower posterior teeth,while reducing mesial movement of the upper posterior teeth and lingual movement of the lower anterior teeth.In the transverse direction,the forces exerted on the teeth in all three conditions were minimal.In the sagittal direction,in Condition 2,the mesial force of the upper posterior teeth was effectively reduced by an average of 0.13 N,and the mesial force of the lower posterior teeth was increased by an average of 0.31 N.In Condition 3,the distal force of the upper canine teeth and the mesial force of the lower first molar were significantly increased by 0.40 N and 1.14 N,respectively.In the vertical direction,In condition 2,the average extrusive force of the upper teeth and the extrusive force of the lower molars were increased by 0.22 N and 0.20 N,respectively.In Condition 3,the upper canine extrusive force was increased by 0.91 N,while the lower molar intrusive force and the second molar extrusive force were reduced by 0.27 N and 0.25 N,respectively.The PDL stress distribution in the three conditions was generally similar.In Condition 3,the maximum principal stress distribution area on the lower first molars expanded slightly,but the magnitude did not increase significantly.Conclusions Condition 2 optimized the lower posterior teeth mesialization through balanced force distribution and protected the upper posterior teeth anchorage.Condition 3 significantly increased extrusive and distal forces on the upper canines and mesial forces on the lower first molars but did not substantially elevate periodontal risks for these teeth.

Reconstruction of low-dose CT image faced problems such as low resolution,blurred artifacts and strong noise.Deep learning reconstruction met the needs of reducing radiation dose and improving imaging quality,promoted reconstruction of CT image towards high efficiency,intelligence and integration of clinical diagnosis and treatment.The research progresses in deep learning low-dose CT imaging reconstruction were reviewed in this article.

Background As the population ages, there has been a growing focus on the decline in fertility. Research has identified age and fertility history as the primary influencing factors. Nevertheless, there is a deficiency in fundamental data regarding the fertility status among different industries. Objective To investigate the fertility status and influencing factors among female workers aged 22-35 years in different industries. Methods From July 2020 to February 2021, a cross-sectional survey was conducted using a staged sampling approach. This survey specifically targeted 22-35-year-old married female workers with a history of pregnancy in industries such as education, healthcare, finance, and telecommunications, totaling 22903 participants. The survey encompassed industry, demographic characteristics, pregnancy history, time to pregnancy (TTP), and other influencing factors. The influencing factors of decline in fertility were identified by chi-square test and Cox proportional hazards regression. Subsequent industry-specific Cox proportional hazards regression models were used to compared fertility decline patterns across a spectrum of industries after selected influencing factors were adjusted. Results Among the 22903 respondents, 19194 valid questionnaires were collected, with a valid recovery rate of 83.8%. The cumulative pregnancy rates (CRP) of 1-6 months and 1-12 months for the 22-35-year-old female workers were 67.23% and 91.33% respectively. The multivariate analysis showed that region, age, education level, personal annual income, housework time, coping style, gravidity, parity, and spontaneous abortion were influencing factors of fertility decline (P<0.05). Female workers with ≥3 gravidities and ≥2 spontaneous abortions had a higher risk of fertility decline, with hazard ratios (HR) and associated 95% confidence interval (95%CI) of 0.633 (0.582, 0.688) and 0.785 (0.670, 0.921) respectively (P<0.01). Compared to the education industry, the healthcare and finance industries showed a higher risk of fertility decline, with HR (95%CI) values of 0.876 (0.834, 0.920) and 0.909 (0.866, 0.954), respectively (P<0.05). These two HR (95%CI) values remained statistically significant [0.899 (0.852, 0.948) and 0.882 (0.833, 0.934) respectively, P<0.05)] after further adjustment with nine influencing factors such as region and age. Conclusion Regions, age, education level, personal annual income, housework time, coping style, pregnancy and childbirth times, and natural abortion times are influencing factors of fertility decline in female workers. Compared to the education industry, the healthcare and finance industries have a higher risk of declining fertility.

Trauma registration is an important tool to record the process and timeline in the treatment of trauma patients. The operation of trauma database is of great significance for reducing the mortality of patients, promoting the construction of trauma treatment system, and providing reference for policy-making. Trauma registration system has been established in the United States, United Kingdom, Germany and other developed countries for many years. However, the domestic system is still at an initial stage, and there are problems like data deficiencies, data incoherence, no item of complications, no treatment data after discharge and limits of human and financial resources. Therefore, there is room for improvements in terms of personnel fixation, financial support and continuous data monitoring should be further improved. In this study, the authors summarize the traum registration system from aspects of basic situation both at home and abroad, data analysis, clinical value, operation mechanism and challenges so as to provide important data for clinical researches.

Osteoarthritis (OA) is a prevalent joint disease with no effective treatment strategies. Aberrant mechanical stimuli was demonstrated to be an essential factor for OA pathogenesis. Although multiple studies have detected potential regulatory mechanisms underlying OA and have concentrated on developing novel treatment strategies, the epigenetic control of OA remains unclear. Histone demethylase JMJD3 has been reported to mediate multiple physiological and pathological processes, including cell differentiation, proliferation, autophagy, and apoptosis. However, the regulation of JMJD3 in aberrant force-related OA and its mediatory effect on disease progression are still unknown. In this work, we confirmed the upregulation of JMJD3 in aberrant force-induced cartilage injury in vitro and in vivo. Functionally, inhibition of JMJD3 by its inhibitor, GSK-J4, or downregulation of JMJD3 by adenovirus infection of sh-JMJD3 could alleviate the aberrant force-induced chondrocyte injury. Mechanistic investigation illustrated that aberrant force induces JMJD3 expression and then demethylates H3K27me3 at the NR4A1 promoter to promote its expression. Further experiments indicated that NR4A1 can regulate chondrocyte apoptosis, cartilage degeneration, extracellular matrix degradation, and inflammatory responses. In vivo, anterior cruciate ligament transection (ACLT) was performed to construct an OA model, and the therapeutic effect of GSK-J4 was validated. More importantly, we adopted a peptide-siRNA nanoplatform to deliver si-JMJD3 into articular cartilage, and the severity of joint degeneration was remarkably mitigated. Taken together, our findings demonstrated that JMJD3 is flow-responsive and epigenetically regulates OA progression. Our work provides evidences for JMJD3 inhibition as an innovative epigenetic therapy approach for joint diseases by utilizing p5RHH-siRNA nanocomplexes.
Cartilage, Articular/pathology* ; Chondrocytes/metabolism* ; Down-Regulation ; Epigenesis, Genetic ; Humans ; Jumonji Domain-Containing Histone Demethylases/metabolism* ; Nuclear Receptor Subfamily 4, Group A, Member 1/metabolism* ; Osteoarthritis/pathology* ; RNA, Small Interfering/pharmacology*

Objective:To investigate the clinical application value of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area.Methods:Twenty-six patients who underwent laparoscopic cholecystectomy based on the concept of enhancing recovery after surgery using the LEER model in People's Hospital of Jinkouhe District of Leshan from January to October 2021 were included in the observation group. An additional 20 patients who concurrently underwent laparoscopic cholecystectomy and conventional intervention were included in the control group. Clinical efficacy, postoperative complications and postoperative pain were compared between the two groups.Results:Postoperative fasting time, length of hospital stay, and total hospital days in the observation group were 6 (6, 6) hours, 2 (2, 3) days and 4 (4, 6) days respectively, which were significantly shorter than 24 (24, 36) hours, 5 (5, 6) days, 7 (7, 9) days in the control group ( H = 351.00, 407.50, 458.00, all P < 0.05). Hospitalization cost in the observation group was 5 454.58 (5 014.11, 6 016.58) yuan, which was significantly lower than 6 611.91 (6 192.68, 7 841.73) yuan in the control group ( H = 420.00, P < 0.05). There were no significant differences in operative time and postoperative complications between the two groups (both P > 0.05). At postoperative 6 hours, Visual Analogue Scale score in the observation group was 3 (3, 4) points, and patients with mild pain accounted for 73.07% (19/26). At postoperative 24 hours, Visual Analogue Scale score in the observation group was 2 (2, 3) points, and patients with mild pain accounted for 92.31% (24/26). Overall pain was well controlled after surgery. Patient satisfaction rate in the observation was 96.15% (25/26). All patients recovered and were discharged. Conclusion:Application of enhanced recovery after surgery using the LEER model in patients subjected to laparoscopic cholecystectomy in basic hospitals of Yi nationality area can promote postoperative recovery, contribute to changing the theory of diagnosis and treatment, and improve overall medical quality. The enhanced recovery after surgery protocol using the LEER model has a good application value.

Background Women face more reproductive health problems in their whole life cycle. Occupational exposure to harmful factors in the petrochemical industry may have a synergistic effect on women’s existing health problems. Objective To analyze the influencing factors of perimenopausal syndrome (PMS) in female workers in petrochemical industry, and establish a nomogram model of the risk of PMS in female workers, so as to provide a easy and quick health monitoring and evaluation method for female workers. Methods A total of 2653 perimenopausal female workers aged 45-55 years old were selected from a petrochemical enterprise. A questionnaire survey was conducted to collect information on demographic characteristics, occupational characteristics, psychological status, and reproductive health information. The prevalence of PMS of female workers was evaluated by the Kupperman Index Scale, the physical fatigue and mental fatigue were evaluated by the Fatigue Scale. A linear graph prediction model was established by multiple logistic regression. A nomogram was presented and C-index was used to verify the differentiation of the model. Then Bootstrap method was used for internal validation. Results Among the 2653 female worker, a total of 1306 cases (49.2%) presented PMS with a Kupperman score ≥7. The main symptoms were fatigue (79.95%), irritability (71.32%), and insomnia (66.79%). Significant differences in PMS prevalence were found among female workers of different age, body mass index, and working posture groups (P < 0.05). The participants with alcohol drinking, maternal premature or late menopause, hypertension, lack of physical exercise, heavy lifting, sick leave in the last 6 months, combined occupational exposures to dust, chemicals, noise [> 80 dB(A)], or electromagnetic field, and not wearing protective masks, gloves or protective earplugs reported higher prevalence rates of PMS (P < 0.05). The prevalence rate of PMS in female workers with sleep duration ≤ 6 h was higher than that with > 6 h (P < 0.05), and higher in female workers with physical and mental fatigue than in those without (P < 0.05). The results of logistic regression analysis showed that those with maternal premature or late menopause (OR=1.572, 95%CI: 1.320−1.872), hypertension (OR=1.579, 95%CI: 1.127−2.213), alcohol drinking (OR=1.286, 95%CI: 1.080−1.532), no physical exercise (OR=1.598, 95%CI: 1.330−1.920), sleep duration ≤ 6 h (OR=1.853, 95%CI: 1.518−2.263), sick leave in recent 6 months (OR=1.614, 95%CI: 1.226−2.123), physical fatigue (OR=2.384, 95%CI: 1.887−3.012), mental fatigue (OR=5.649, 95%CI: 4.382−7.283), combined exposure to occupational harmful factors (OR=1.329, 95%CI: 1.108−1.593), long-time sitting (OR=2.014, 95%CI: 1.271−3.190), and heavy lifting (OR=1.505, 95%CI: 1.178−1.923) showed a higher risk of reporting PMS (P<0.05). The C-index from the ROC curve of the nomogram model was 0.748 (95%CI: 0.729−0.766). The results of Bootstrap validation showed that the standard curve and the predicted curve almost overlapped, and the absolute error was 0.008, indicating that the model fitness was good. Conclusion PMS in female petrochemical workers may occur due to long-term exposures to multiple factors. The established nomogram model has good predictive ability and could be applied to monitor and evaluate female reproductive health in petroleum industry.