ObjectiveTo construct a group-based trajectory model (GBTM) for early medication adherence check-in, and to analyze the relationship between different trajectories and treatment outcomes in tuberculosis patients using data that were generated from smart tools for monitoring their medication adherence and check-in. MethodsFrom October 1, 2022 to September 30, 2023, a total of 163 pulmonary tuberculosis patients diagnosed in Fengxian District were selected as the study subjects. The GBTM was utilized to analyze the weekly active check-in trajectories of the subjects during the first 4 weeks and establish different trajectory groups. The χ² tests were employed to compare the differences between groups and logistic regression analysis was conducted to explore the relationship between different trajectory groups and treatment outcomes. ResultsA total of four groups were generated by GBTM analyses, of which a low level of punch card was maintained in group A, 6% of the drug users increased rapidly from a low level in group B, 17% of drug users increased gradually from a low level in group C, and 18% of drug users maintained a high level of punch card in group D. The trajectory group was divided into two groups according to homogeneity, namely the low level medication punch card group (group A) and the high level medication punch card group (group B, group C, and group D). The results of multivariate logistic regression analyses revealed that low-level medication check-in (OR=3.250, 95%CI: 1.089‒9.696), increasing age (OR=1.030, 95%CI: 1.004‒1.056), and not undergoing sputum examination at the end of the fifth month (OR=2.746, 95%CI: 1.090‒7.009) were significantly associated with poor treatment outcomes. ConclusionThe medication check-in trajectory of pulmonary tuberculosis patients within the first 4 weeks is correlated with adverse outcomes, or namely consistent low-level medication adherence check-ins are associated with poor treatment outcomes, while high-level medication adherence check-ins are associated with a lower incidence of adverse outcomes.

ObjectiveTo observe the effect of gene mutation on the effectiveness of arsenic-containing Chinese herbal compound formulas in the treatment of myelodysplastic syndromes （MDS） of different traditional Chinese medicine （TCM） patterns， so as to provide the basis for the clinical application. MethodsClinical data of 442 MDS patients who were treated with arsenic-containing herbal compound formulas were retrospectively collected， including the baseline demographic and clinical characteristics of the patients. Based on the TCM four examinations， the patients were divided into the spleen-kidney deficiency group as well as the qi-yin deficiency group， and according to the results of the next-generation sequencing （NGS） test， they were divided into the group with and without gene mutation respectively. The influence of gene mutation on the clinical effectiveness of patients with different TCM patterns was analyzed， the baseline demographic and clinical characteristics of the patients with different outcomes of the two TCM patterns were compared， and multivariate Logistic regression analysis was conducted on the influencing factors of the effective rate of MDS patients with gene mutation. ResultsA total of 190 cases were included in the spleen-kidney deficiency group （119 cases with gene mutation） and 43 cases in the qi-yin deficiency group （23 cases with gene mutation）. No statistically significant differences were noted in effectiveness assessment， total effective rate， and total response rate between the spleen-kidney deficiency group and the qi-yin deficiency group （P＞0.05）. In the spleen-kidney deficiency group， the total effective rate of MDS with gene mutation was 65.55% （78/119）， which was lower than 80.28% （57/71） of MDS without gene mutation， with statistical significance （P = 0.033）， while no statistical differences in effectiveness assessment and total response rate were noted （P＞0.05）. In the qi-yin deficiency group， no statistical differences were observed in effectiveness assessment， total effective rate， and total response rate of the patients in with or without gene mutation （P＞0.05）. In the spleen-kidney deficiency group with gene mutation， the rate of complex karyotype （P = 0.031） and the mutation rate of CBL gene （P = 0.032） in the ineffective population were higher than those in the effective population， while the mutation rate of DDX41 gene in the effective population was higher than that in the ineffective population （P = 0.033）. No statistically significant differences were found in other gene mutations， age， gender distribution， number of gene mutations， bone marrow hyperplasia degree， blast cell range， reticular fiber tissue proliferation or not， and prognosis of chromosomal abnormalities between the effective and ineffective populations （P＞0.05）. In the qi-yin deficiency group with gene mutation， no statistically significant differences were found in various items between populations with different outcomes （P＞0.05）. Multivariate Logistic regression analysis showed that complex karyotype， CBL mutation， and DDX41 mutation were independently associated with the effective rate of MDS with spleen-kidney deficiency and gene mutation （P＜0.05）. DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group （OR＞1）， while complex karyotype and CBL mutation were independent risk factors （OR＜1）. ConclusionThe arsenic-containing TCM compound formulas exhibited better effectiveness in MDS with spleen-kidney deficiency pattern without mutation； and in MDS with spleen-kidney deficiency pattern without complex karyotypes， CBL mutation， and with DDX41 mutations. Furthermore， DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group， while complex karyotype and CBL mutation were independent risk factors. In MDS with qi-yin deficiency pattern， gene mutation-related factors showed no significant impact on the effectiveness of arsenic-containing TCM compound formulas.

Objective:To investigate microstructural alterations in the optic chiasm and optic radiations of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) based on diffusion kurtosis imaging (DKI).Methods:This study was a cross-sectional study. Retrospective analyses were conducted on the clinical and imaging data of 63 patients with relapsing-remitting MS (RRMS) and 62 patients with NMOSD diagnosed at First Affiliated Hospital of Chongqing Medical University from January 2019 to December 2023. According to the occurrence of optic neuritis (ON), they were categorized into ON-positive MS (ON+MS) group (40 cases), ON-negative MS (ON-MS) group (23 cases), ON-positive NMOSD (ON+NMOSD) group (40 cases) and ON-negative NMOSD (ON-NMOSD) group (22 cases). In addition, 40 healthy controls were enrolled during the same period. DKI data of all subjects were collected, and DKI post-processing was performed to obtain fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), and radial kurtosis (RK) values of the optic chiasm and bilateral optic radiations. The scores of the mini-mental state examination (MMSE), montreal cognitive assessment (MoCA), and expanded disability status scale (EDSS) were obtained. The Kruskal-Wallis test was used to analyze the differences in DKI parameters of the optic chiasm and bilateral optic radiation among the 5 groups, and the Holm-Bonferroni method was employed for multiple comparison correction in pairwise comparisons.Results:There were statistically significant overall differences in the DKI parameters of the optic chiasm and bilateral optic radiations among healthy control group, ON+MS group, ON-MS group, ON+NMOSD group, and ON-NMOSD group (all P0.05). The FA value of the optic chiasm in ON+NMOSD group was significantly lower than that of healthy control group and ON-MS group, as well as ON-NMOSD group ( P0.05). The FA value of the left optic radiation in ON+NMOSD group was lower than that in healthy control group and the ON-MS group. The RK value of the optic chiasm in ON+MS group was lower than that in the healthy control group and ON-NMOSD group ( P0.05). The MK and RK values of the left optic radiation in ON-MS group were significantly lower than those in the ON+NMOSD group and ON-NMOSD group ( P0.05). Conclusions:NMOSD and RRMS patients demonstrate varying degrees of microstructural damage in the optic chiasm and optic radiations. Differences of DKI parameters suggest different pathological mechanisms of visual pathway damage between NMOSD and MS, which may be helpful for early detection of occult visual pathway lesions.

Objective:To investigate the effects of prognostic nutritional index (PNI) on the readmission rate, complication rate, mortality rate and survival of patients with liver cirrhosis.Methods:From January 1, 2020 to December 31, 2022, 395 hospitalized patients with liver cirrhosis at Tianmen Hospital Affiliated to Wuhan University of Science and Technology were retrospectively enrolled. The clinical data were collected from the patients at their first hospitalization (baseline period) and re-hospitalization during follow-up period. The 18-month follow-up was divided into 4 periods, including the first period (from the 0th to the 3rd month), the second one was from the 4th to the 6th month, the third one was from the 7th to the 12th month, and the fourth one was from the 13th to the 18th month of follow-up. The prognostic value of PNI for patients with liver cirrhosis was evaluated through the receiver operating characteristic curve (ROC) of the baseline PNI. The 395 patients were divided into the low PNI group and the high PNI group based on the optimal cut-off value of PNI on the ROC. Patients readmitted during each follow-up period were divided into the PNI improvement group (PNI at follow-up -PNI at baseline>0) and the PNI non-improvement group (PNI at follow-up-PNI at baseline ≤0). Independent sample t-test, one-way analysis of variance (ANOVA), Mann-Whitney U test, chi-square test or Fisher′s exact test were used for statistical analysis. Survival curves depicting the relationship between PNI and overall survival rate of patients with liver cirrhosis were constructed using the Kaplan-Meier method. Results:The ROC analysis indicated that the optimal cut-off value of PNI at baseline was 32.65, with an area under the curve of 0.639 (95% confidence interval: 0.541 to 0.738, P=0.011), with a sensitivity of 0.567 and a specificity of 0.701. There were 269 cases in the high PNI group and 126 cases in the low PNI group. The readmission rate, complication rate and mortality rate in the low PNI group were all higher than those in the high PNI group at the first and fourth follow-up periods (32.5% (41/126) vs. 22.3% (60/269), 31.7% (40/126) vs. 20.4% (55/269), 6.3% (8/126) vs. 1.1% (3/269), 25.0% (29/116) vs. 16.2% (42/260), 25.0% (29/116) vs. 15.4% (40/260), 6.0% (7/116) vs. 1.5% (4/260)), and the differences were statistically significant ( χ2=4.72, 6.00, 6.86, 4.10, 4.95, and 4.24; P=0.030, 0.014, 0.009, 0.043, 0.026, and 0.040). The mortality rates of the PNI improvement group at the first and fourth follow-up periods were both lower than those of the PNI non-improvement group (4.3% (2/47) vs. 16.7% (9/54), 0 (0/24) vs. 23.4% (11/47)), and the differences were statistically significant ( χ2=3.99, Fisher′s exact test; P=0.046 and 0.012). There were no statistically significant difference in the incidence of complications between the PNI improvement group and the PNI non-improvement group at each follow-up period (all P>0.05). The Kaplan-Meier survival curve demonstrated that the average survival time of the high PNI group was longer than that of the low PNI group (17.54 months (95% confidence interval: 17.26 to 17.83 months) vs. 16.74 months (95% confidence interval: 16.96 to 17.52 months), and the difference was statistically significant ( χ2=9.18, P<0.001). The survival rate of the high PNI group at the 18th month of follow-up period was higher than that of the low PNI group (95.2% (256/269) vs. 86.5% (109/126), and the difference was statistically significant ( χ2=9.17, P=0.002). Conclusions:PNI has certain predictive efficacy for the survival period of patients with liver cirrhosis. Low-level PNI may increase the readmission rate, complication rate, and mortality of patients with liver cirrhosis, and shorten the survival period, indicating poor prognosis.

Objective:To investigate the effect of Tongguan Fang drug-containing serum on LPS-induced inflammation of RAW264.7 cells,so as to clarify the cellular mechanism of the Tongguan Fang in treating tubal inflammatory infertility.Methods:Lipo-polysaccharide(LPS)was used to stimulate the RAW264.7 macrophage cell line as an in vitro model,Detected levels of cellular oxida-tive stress(ROS),apoptosis and expressions of PI3K/Akt signaling pathway proteins.CCK-8 was used to detect effect of Tongguan Fang drug-containing serum on cellular inflammation.Effects of Tongguan Fang-containing serum on cell inflammation were assessed using CCK-8 assay.Cells were divided into control group,LPS-induced inflammation model group,and Tongguan Fang-containing serum-treated LPS-induced inflammation model groups of different concentrations.qPCR was performed to detect mRNA expression levels of IL-1β,IL-6 and TNF-α in different groups.Immunofluorescence and Western blot were used to evaluate phosphorylation levels of the PI3K/Akt signaling pathway and protein levels of Bcl-2,Bax and caspase-3 of apoptotic.Hoechst 33342/PI staining and flow cytometry were employed to assess the impact of Tongguan Fang-containing serum on cell apoptosis.DCFH-DA probe was used to measure cellular ROS levels affected by Tongguan Fang-containing serum.Results:①Tongguan Fang-containing serum reduced LPS-induced cellular injury in a dose-dependent manner;②Tongguan Fang-containing serum decreased production of pro-inflammatory cytokines IL-6,IL-1β and TNF-α induced by LPS;③Tongguan Fang-containing serum reduced intracellular ROS generation induced by LPS;④Pre-treatment with Tongguan Fang-containing serum activated PI3K/Akt signaling pathway;⑤Tongguan Fang-containing serum promoted cell apoptosis.Conclusion:Treatment with Tongguan Fang-containing serum can reduce cellular injury and inflam-mation,protect cells from LPS-induced cellular injury by activating the PI3K/Akt signaling pathway and promoting cell apoptosis,and further alleviate cellular inflammation levels.

Objective:To investigate the effect of Tongguan Fang drug-containing serum on LPS-induced inflammation of RAW264.7 cells,so as to clarify the cellular mechanism of the Tongguan Fang in treating tubal inflammatory infertility.Methods:Lipo-polysaccharide(LPS)was used to stimulate the RAW264.7 macrophage cell line as an in vitro model,Detected levels of cellular oxida-tive stress(ROS),apoptosis and expressions of PI3K/Akt signaling pathway proteins.CCK-8 was used to detect effect of Tongguan Fang drug-containing serum on cellular inflammation.Effects of Tongguan Fang-containing serum on cell inflammation were assessed using CCK-8 assay.Cells were divided into control group,LPS-induced inflammation model group,and Tongguan Fang-containing serum-treated LPS-induced inflammation model groups of different concentrations.qPCR was performed to detect mRNA expression levels of IL-1β,IL-6 and TNF-α in different groups.Immunofluorescence and Western blot were used to evaluate phosphorylation levels of the PI3K/Akt signaling pathway and protein levels of Bcl-2,Bax and caspase-3 of apoptotic.Hoechst 33342/PI staining and flow cytometry were employed to assess the impact of Tongguan Fang-containing serum on cell apoptosis.DCFH-DA probe was used to measure cellular ROS levels affected by Tongguan Fang-containing serum.Results:①Tongguan Fang-containing serum reduced LPS-induced cellular injury in a dose-dependent manner;②Tongguan Fang-containing serum decreased production of pro-inflammatory cytokines IL-6,IL-1β and TNF-α induced by LPS;③Tongguan Fang-containing serum reduced intracellular ROS generation induced by LPS;④Pre-treatment with Tongguan Fang-containing serum activated PI3K/Akt signaling pathway;⑤Tongguan Fang-containing serum promoted cell apoptosis.Conclusion:Treatment with Tongguan Fang-containing serum can reduce cellular injury and inflam-mation,protect cells from LPS-induced cellular injury by activating the PI3K/Akt signaling pathway and promoting cell apoptosis,and further alleviate cellular inflammation levels.

Objective:To investigate microstructural alterations in the optic chiasm and optic radiations of multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) based on diffusion kurtosis imaging (DKI).Methods:This study was a cross-sectional study. Retrospective analyses were conducted on the clinical and imaging data of 63 patients with relapsing-remitting MS (RRMS) and 62 patients with NMOSD diagnosed at First Affiliated Hospital of Chongqing Medical University from January 2019 to December 2023. According to the occurrence of optic neuritis (ON), they were categorized into ON-positive MS (ON+MS) group (40 cases), ON-negative MS (ON-MS) group (23 cases), ON-positive NMOSD (ON+NMOSD) group (40 cases) and ON-negative NMOSD (ON-NMOSD) group (22 cases). In addition, 40 healthy controls were enrolled during the same period. DKI data of all subjects were collected, and DKI post-processing was performed to obtain fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), and radial kurtosis (RK) values of the optic chiasm and bilateral optic radiations. The scores of the mini-mental state examination (MMSE), montreal cognitive assessment (MoCA), and expanded disability status scale (EDSS) were obtained. The Kruskal-Wallis test was used to analyze the differences in DKI parameters of the optic chiasm and bilateral optic radiation among the 5 groups, and the Holm-Bonferroni method was employed for multiple comparison correction in pairwise comparisons.Results:There were statistically significant overall differences in the DKI parameters of the optic chiasm and bilateral optic radiations among healthy control group, ON+MS group, ON-MS group, ON+NMOSD group, and ON-NMOSD group (all P0.05). The FA value of the optic chiasm in ON+NMOSD group was significantly lower than that of healthy control group and ON-MS group, as well as ON-NMOSD group ( P0.05). The FA value of the left optic radiation in ON+NMOSD group was lower than that in healthy control group and the ON-MS group. The RK value of the optic chiasm in ON+MS group was lower than that in the healthy control group and ON-NMOSD group ( P0.05). The MK and RK values of the left optic radiation in ON-MS group were significantly lower than those in the ON+NMOSD group and ON-NMOSD group ( P0.05). Conclusions:NMOSD and RRMS patients demonstrate varying degrees of microstructural damage in the optic chiasm and optic radiations. Differences of DKI parameters suggest different pathological mechanisms of visual pathway damage between NMOSD and MS, which may be helpful for early detection of occult visual pathway lesions.

Objective:To investigate the effects of prognostic nutritional index (PNI) on the readmission rate, complication rate, mortality rate and survival of patients with liver cirrhosis.Methods:From January 1, 2020 to December 31, 2022, 395 hospitalized patients with liver cirrhosis at Tianmen Hospital Affiliated to Wuhan University of Science and Technology were retrospectively enrolled. The clinical data were collected from the patients at their first hospitalization (baseline period) and re-hospitalization during follow-up period. The 18-month follow-up was divided into 4 periods, including the first period (from the 0th to the 3rd month), the second one was from the 4th to the 6th month, the third one was from the 7th to the 12th month, and the fourth one was from the 13th to the 18th month of follow-up. The prognostic value of PNI for patients with liver cirrhosis was evaluated through the receiver operating characteristic curve (ROC) of the baseline PNI. The 395 patients were divided into the low PNI group and the high PNI group based on the optimal cut-off value of PNI on the ROC. Patients readmitted during each follow-up period were divided into the PNI improvement group (PNI at follow-up -PNI at baseline>0) and the PNI non-improvement group (PNI at follow-up-PNI at baseline ≤0). Independent sample t-test, one-way analysis of variance (ANOVA), Mann-Whitney U test, chi-square test or Fisher′s exact test were used for statistical analysis. Survival curves depicting the relationship between PNI and overall survival rate of patients with liver cirrhosis were constructed using the Kaplan-Meier method. Results:The ROC analysis indicated that the optimal cut-off value of PNI at baseline was 32.65, with an area under the curve of 0.639 (95% confidence interval: 0.541 to 0.738, P=0.011), with a sensitivity of 0.567 and a specificity of 0.701. There were 269 cases in the high PNI group and 126 cases in the low PNI group. The readmission rate, complication rate and mortality rate in the low PNI group were all higher than those in the high PNI group at the first and fourth follow-up periods (32.5% (41/126) vs. 22.3% (60/269), 31.7% (40/126) vs. 20.4% (55/269), 6.3% (8/126) vs. 1.1% (3/269), 25.0% (29/116) vs. 16.2% (42/260), 25.0% (29/116) vs. 15.4% (40/260), 6.0% (7/116) vs. 1.5% (4/260)), and the differences were statistically significant ( χ2=4.72, 6.00, 6.86, 4.10, 4.95, and 4.24; P=0.030, 0.014, 0.009, 0.043, 0.026, and 0.040). The mortality rates of the PNI improvement group at the first and fourth follow-up periods were both lower than those of the PNI non-improvement group (4.3% (2/47) vs. 16.7% (9/54), 0 (0/24) vs. 23.4% (11/47)), and the differences were statistically significant ( χ2=3.99, Fisher′s exact test; P=0.046 and 0.012). There were no statistically significant difference in the incidence of complications between the PNI improvement group and the PNI non-improvement group at each follow-up period (all P>0.05). The Kaplan-Meier survival curve demonstrated that the average survival time of the high PNI group was longer than that of the low PNI group (17.54 months (95% confidence interval: 17.26 to 17.83 months) vs. 16.74 months (95% confidence interval: 16.96 to 17.52 months), and the difference was statistically significant ( χ2=9.18, P<0.001). The survival rate of the high PNI group at the 18th month of follow-up period was higher than that of the low PNI group (95.2% (256/269) vs. 86.5% (109/126), and the difference was statistically significant ( χ2=9.17, P=0.002). Conclusions:PNI has certain predictive efficacy for the survival period of patients with liver cirrhosis. Low-level PNI may increase the readmission rate, complication rate, and mortality of patients with liver cirrhosis, and shorten the survival period, indicating poor prognosis.

Objective To provide references,this study investigated the clinical characteristics of patients with non-syndromic oligodontia.Methods The information of 178 patients with oligodontia was collected,including histories,oral examinations,and panoramic radiographs.Tooth agenesis characteristics were calculated and evaluated.All the data were statistically analyzed with SPSS 24.0 software.Results No significant difference in the number of missing teeth was found between sexes nor between the right and left sides,and congenitally missing teeth affected the maxillary arch(P<0.05).The highest prevalence of tooth agenesis was observed in the mandibular second premolars.In the maxillary arch,the most common pattern of tooth agenesis was agenesis of the bilateral first and second premolars.The agenesis of the bilateral second premolars was observed in the mandibular arch.The prevalence of a symmetric pattern between the right and left quadrants was significantly higher than that of matched patterns between the maxillary and mandibular an-tagonistic quadrants.Approximately 16.85%of patients with nonsyndromic oligodontia were affected by other tooth-re-lated anomalies.Conclusion The common patterns of tooth agenesis were successfully identified in patients with non-syndromic oligodontia.Dentists need to provide multidisciplinary treatments for patients with nonsyndromic oligodontia because of variations in occluding and full-mouth tooth agenesis patterns.

Objective:To investigate the changes in structural brain network topology and microstructural damage in patients with multiple sclerosis (MS), and to analyze its correlation with cognitive function.Methods:Clinical and imaging data of 114 patients with MS (MS group) diagnosed in the First Affiliated Hospital of Chongqing Medical University from May 2021 to September 2022 were analyzed retrospectively. In addition, 71 volunteers were recruited as a healthy control group (HC group) during the same period. All subjects were performed on cognitive assessment and 3D-T 1 magnetization-prepared rapid gradient echo, 3D-fluid-attenuated inversion recovery, and diffusion kurtosis imaging (DKI) scans. GRETNA software was used to obtain network topology attributes, and global attributes included global efficiency, local efficiency, and small-world attributes [clustering coefficient(Cp), shortest path length(Lp), normalized Cp(γ), normalized Lp, and small-world index (σ)]. Local attributes included betweenness centrality (BC), degree centrality (DC), nodal clustering coefficient (NCp), nodal efficiency, nodal local efficiency (NLe) and nodal shortest path length. The DKI parameter map generated by the post-processing software was used to extract the DKI parameter values of the brain region with abnormal local topology of the brain structure network. The differences of global attributes, local attributes and DKI parameter values [kurtosis fractional anisotropy (KFA), mean kurtosis (MK), radial kurtosis (RK) and axial kurtosis (AK) values] were analyzed by independent sample t-test or Mann-Whitney U test, and corrected by false discovery rate (FDR). Spearman or Pearson correlation analysis was used to evaluate the correlation between abnormal brain structure network topology attributes and cognitive scale scores in the MS group. Results:Both the MS group and the HC group structure network showed small-world attributes, and the γ and σ values of the MS group were significantly lower than those in the HC group (FDR correction, P<0.05). Compared with the HC group, BC, DC, NCp and NLe broadly reduced in the MS group, mainly involving in bilateral frontal, temporal, precuneus, amygdala, and thalamus (FDR correction, P<0.05). After FDR correction, compared with the HC group, the KFA, MK, RK and AK values of 23 brain regions with abnormal local attributes of the network in the MS group were significantly changed in several brain regions (FDR correction, P<0.05). The correlation analysis showed, after FDR correction, the DC value of the right putamen in MS patients was positively correlated with the digit span test (DST) scores ( r=0.318 ,P=0.001). Conclusion:There are extensive changes in the structural brain network of MS patients, accompanied by varying degrees of microstructural damage, and the reduction of degree centrality in the basal ganglia putamen region is associated with cognitive impairment.