Objective:To compare the efficacy of various machine learning models in predicting renal function decline after robot-assisted partial nephrectomy(RAPN),and to provide evidence for clinical risk stratification.Methods:This study retrospectively in-cluded the clinical data of 733 patients with renal cell carcinoma undergoing RAPN at the Urology Department of The First Affiliated Hospital of Chongqing Medical University from January 2019 to December 2023.Demographic characteristics,laboratory indicators,and perioperative parameters were integrated to construct seven machine learning models.Key predictors were interpreted using Shap-ley additive explanations(SHAP).Model performance was evaluated using the area under the receiver operating characteristic curve(AUC).Results:The random forest model demonstrated the best predictive performance(AUC=0.84).SHAP analysis identified neutrophil-to-lymphocyte ratio,tumor diameter,the international normalized ratio of prothrombin time,white blood cell count,and in-traoperative blood loss as significant factors influencing postoperative renal function decline.Conclusion:This study provides a poten-tial predictive tool for clinical practice,aiding in identifying high-risk patients and optimizing postoperative management strategies.

Objective:To investigate the effects of deep core muscle training on pain and motor control during load trans-fer activities in patients with postpartum pelvic girdle pain(PPGP),and to explore the potential mechanisms by which deep core stability training alleviates PPGP pain.Method:From July 2024 to April 2025,56 PPGP women at the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine were randomly divided into a control group(n=28)and an experi-mental group(n=28).Both groups received conventional treatment,while the experimental group underwent deep core stability muscle training in addition to the conventional treatment,three times a week for eight con-secutive weeks.Before and after the treatment,real-time ultrasound was used to assess the thickness of the transversus abdominis muscle(TrA)during maximal expiratory contraction,the thickness during ASLR activity,priority activation rate,the elastic modulus,and the elastic velocity,which reflect the changes in the move-ment control ability of the TrA muscle.The pelvic girdle questionnaire(PGQ)was used to assess the changes in pain and functional impairment in patients,with pain intensity assessed using the visual analogue scale(VAS),and the ASLR score used to assess the changes in load transfer activity ability between the trunk and lower limbs.Result:After eight weeks of treatment,the thickness of the TrA contraction during maximal expiratory and ASLR activity in the experimental group was significantly greater than that in the control group(P<0.05),and the contraction rate during breathing and the pre-activation rate during activation were both significantly higher than those in the control group(P<0.05).The percentage of internal oblique muscle activation in the experimental group during maximal expiration was significantly lower than that in the control group(P<0.05).The elastic modulus of TrA in the experimental group at rest,during maximal expiration,and during ASLR testing were all significantly greater than those in the control group(P<0.05).In addition,the results of pain scores and functional scales showed that the VAS score,PGQ score,and the ASLR score in the experimental group were all significantly lower than those in the control group after intervention(P<0.05).Conclusion:The deep core muscle training program can effectively alleviate pain and improve function in pa-tients with PPGP,and its mechanism may be related to enhancing TrA function and the motor control during load-transfer activities in PPGP.

Objective To observe the differences in dynamic stability and kinematic/kinetic characteristics of the lower limbs between patients with knee osteoarthritis(KOA)and healthy individuals at the begining stage of practicing Tai Chi Yunshou movement.Methods Thirty Tai Chi beginners,including 15 patients with KOA and 15 healthy controls,were recruited to practice Tai Chi Yunshou movement for two hours under the guidance of a Tai Chi expert.A motion capture system and a three-dimensional force platform were used to collect and calculate dynamic stability parameter as well as kinematic and kinetic parameters of the left lower limb during the Yunshou movement.Results Compared with healthy controls,patients with KOA demonstrated a smaller center of mass(COM)-center of pressure(COP)inclination angle,reduced mean and peak ankle dorsiflexion angle,reduced peak hip adduction angle and increased peak knee flexion moment during the Yunshou movement(P<0.05).Conclusions Patients with KOA use adaptive postural strategies to maintain the lateral stability in Tai Chi Yunshou exercise,but a comprehensive training programme should be recommended to reduce the joint loading during flexion of the lower limbs at the benginning stages of this exercise.

The biofilm is a major pathogenic factor for many types of chronic infections,and Escherichia coli bio-film plays an important role in community-acquired infection and hospital-acquired infection and is one of common causes of urinary tract infection(UTI).The quorum sensing(QS)system of E.coli biofilm can mediate intercel-lular information exchange and thus regulate the whole community to adapt to the environmental changes,and the extracellular matrix-derived complex resistance mechanisms lead to a certain degree of bacterial resistance to anti-microbial drugs and resistance to immune system,which then makes it difficult for the conventional antimicrobial drugs to effectively eradicate the biofilm-associated infections.The article focuses on the formation of E.coli bio-film,drug resistance mechanisms and treatment aspects and summarizes the progress of research on the novel substitutive therapies against the E.coli biofilms that were developed in recent years,such as phytochemicals,nanomaterials,probiotics and phage therapy,so as to provide theoretical bases for the clinical treatment and the development of novel drug therapies against the E.coli biofilm.

Objective:To investigate the effects of deep core muscle training on pain and motor control during load trans-fer activities in patients with postpartum pelvic girdle pain(PPGP),and to explore the potential mechanisms by which deep core stability training alleviates PPGP pain.Method:From July 2024 to April 2025,56 PPGP women at the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine were randomly divided into a control group(n=28)and an experi-mental group(n=28).Both groups received conventional treatment,while the experimental group underwent deep core stability muscle training in addition to the conventional treatment,three times a week for eight con-secutive weeks.Before and after the treatment,real-time ultrasound was used to assess the thickness of the transversus abdominis muscle(TrA)during maximal expiratory contraction,the thickness during ASLR activity,priority activation rate,the elastic modulus,and the elastic velocity,which reflect the changes in the move-ment control ability of the TrA muscle.The pelvic girdle questionnaire(PGQ)was used to assess the changes in pain and functional impairment in patients,with pain intensity assessed using the visual analogue scale(VAS),and the ASLR score used to assess the changes in load transfer activity ability between the trunk and lower limbs.Result:After eight weeks of treatment,the thickness of the TrA contraction during maximal expiratory and ASLR activity in the experimental group was significantly greater than that in the control group(P<0.05),and the contraction rate during breathing and the pre-activation rate during activation were both significantly higher than those in the control group(P<0.05).The percentage of internal oblique muscle activation in the experimental group during maximal expiration was significantly lower than that in the control group(P<0.05).The elastic modulus of TrA in the experimental group at rest,during maximal expiration,and during ASLR testing were all significantly greater than those in the control group(P<0.05).In addition,the results of pain scores and functional scales showed that the VAS score,PGQ score,and the ASLR score in the experimental group were all significantly lower than those in the control group after intervention(P<0.05).Conclusion:The deep core muscle training program can effectively alleviate pain and improve function in pa-tients with PPGP,and its mechanism may be related to enhancing TrA function and the motor control during load-transfer activities in PPGP.

The biofilm is a major pathogenic factor for many types of chronic infections,and Escherichia coli bio-film plays an important role in community-acquired infection and hospital-acquired infection and is one of common causes of urinary tract infection(UTI).The quorum sensing(QS)system of E.coli biofilm can mediate intercel-lular information exchange and thus regulate the whole community to adapt to the environmental changes,and the extracellular matrix-derived complex resistance mechanisms lead to a certain degree of bacterial resistance to anti-microbial drugs and resistance to immune system,which then makes it difficult for the conventional antimicrobial drugs to effectively eradicate the biofilm-associated infections.The article focuses on the formation of E.coli bio-film,drug resistance mechanisms and treatment aspects and summarizes the progress of research on the novel substitutive therapies against the E.coli biofilms that were developed in recent years,such as phytochemicals,nanomaterials,probiotics and phage therapy,so as to provide theoretical bases for the clinical treatment and the development of novel drug therapies against the E.coli biofilm.

Objective To observe the differences in dynamic stability and kinematic/kinetic characteristics of the lower limbs between patients with knee osteoarthritis(KOA)and healthy individuals at the begining stage of practicing Tai Chi Yunshou movement.Methods Thirty Tai Chi beginners,including 15 patients with KOA and 15 healthy controls,were recruited to practice Tai Chi Yunshou movement for two hours under the guidance of a Tai Chi expert.A motion capture system and a three-dimensional force platform were used to collect and calculate dynamic stability parameter as well as kinematic and kinetic parameters of the left lower limb during the Yunshou movement.Results Compared with healthy controls,patients with KOA demonstrated a smaller center of mass(COM)-center of pressure(COP)inclination angle,reduced mean and peak ankle dorsiflexion angle,reduced peak hip adduction angle and increased peak knee flexion moment during the Yunshou movement(P<0.05).Conclusions Patients with KOA use adaptive postural strategies to maintain the lateral stability in Tai Chi Yunshou exercise,but a comprehensive training programme should be recommended to reduce the joint loading during flexion of the lower limbs at the benginning stages of this exercise.

Objective Exploring the position and bone wall thickness characteristics of the maxillary central inci-sors in Southern Chinese adults to provide a clinical reference for the design of immediate maxillary central incisor im-plantation surgery.Methods The hospital ethics committee approved the study,and the patients provided informed consent.CBCT images of 990 adult patients(aged 20-79 years)from the Stomatology Hospital(January 2018 to Decem-ber 2021)were categorized based on the dental arch form and age-sex groups.Sagittal CBCT images of the maxillary central incisors were used to measure the labial and palatal bone thickness wall at 4 mm the CEJ to apical,the middle of the root,and the angle between the tooth long axis and the long axis of the alveolar process,to compare the thickness of the labial and palatal bone walls in samples of male and female patients,and to explore the relationship between the angle between the tooth long axis and the alveolar process long axis in samples of male and female patients in different age groups(20-39 years;40-59 years;60-79 years).Results Significant differences were found in the labiopalatine side of the alveolar bone of the maxillary incisor root position.A total of 95.8％(948/990)of the maxillary incisors were positioned more buccally,4.1％(41/990)were positioned more midway,and 0.1％(1/990)were positioned more palatal-ly.The thicknesses of the bone wall at the CEJ of 4 mm below the palatal side,the middle of the root,and at the apex were greater(1.82±0.56 mm,3.20±1.10 mm,and 7.70±2.00 mm,respectively)than those at the labial side(1.21± 0.32 mm,0.89±0.35 mm,and 1.86±0.82 mm,respectively),with statistical significance(P＜0.05).Male bone wall thickness was generally greater than female bone wall thickness(P＜0.05).The angle between the long axis of male teeth and the alveolar bone was 14.77°±5.66°,while that of female teeth was 12.80°±5.70°,with a statistically signifi-cant difference(P＜0.05).The angle between the long axis of teeth and the alveolar bone in the 40-59-year-old group and the 60-79-year-old group was greater than that in the 20-39-year-old group,and the difference was statistically sig-nificant(P＜0.05).Conclusion A total of 95.8％of adults in South China have maxillary central incisors with root de-viation toward the labial bone cortex.The thickness of the labial bone wall is much thinner than that of the labial bone wall,which is the middle of the thickness of the root.In Southern Chinese adults,the angle between the upper central incisor and the long axis of the alveolar bone in males is greater than that in females,and the degree of the angle in-creases with age.It is recommended to pay attention to the thickness of the bone wall around the root and the angle be-tween the teeth before immediate implantation surgery to choose a reasonable implantation plan.

Objective To analyze the spatial relationship between the roots of maxillary anterior premolars and the maxillary sinus,thus providing an anatomical basis for timing,planning,surgical approaches,and implant selection at this site.Methods Cone beam CT(CBCT)images were collected from 264 patients(aged 20-65 years)who visited the Ruihua Dental Clinic between January 2017 and March 2023.The minimum distance from the apex of the maxillary an-terior premolar roots to the lower wall of the maxillary sinus was measured on the coronal plane.The classification of the vertical relationship between the tooth root and the lower wall of the maxillary sinus was performed,and comparisons were made bilaterally,between genders,and among different age groups.Results The minimum distance(Q50)from the apex of the first maxillary premolar root to the lower wall of the maxillary sinus was 7.34 mm for the single-root type,7.80 mm for the buccal root of the double-root type,and 7.36 mm for the palatal root.For the second maxillary premo-lar,the median distance was 2.56 mm for the single root type,1.73 mm for the buccal root type,and 1.23 mm for the palatal root type.There was a significant difference in the shortest distance from the apex of the right second maxillary premolar single root to the lower wall of the maxillary sinus among the different age groups(P＜0.05),with the 20-29-year-old group having the smallest median distance(1.52 mm)and the≥40-year-old group having the largest(4.44 mm).There was no significant difference in the effect of sex or laterality on distance(P＞0.05).The most common vertical relationship between the apex of the maxillary anterior premolar roots and the lower wall of the maxillary sinus was non-contact.There was no significant difference in the vertical relationship classification between the single-root and dou-ble-root types(P＞0.05).Conclusion Most maxillary first premolar roots can provide sufficient bone height,which makes it easy to achieve immediate implantation.The maxillary second premolar root frequently involves insufficient bone,which is necessary to make full use of the bone wall of the extraction socket or the sinus floor cortical bone to achieve initial stability.The vertical relationship between the premolar root and maxillary sinus was influenced by age and dental position.Younger age groups often exhibit inadequate bone height,and the indication for immediate implan-tation should be carefully considered.The number of roots does not significantly affect the relationship between the sinus and root;however,double-rooted premolars offer more support for immediate implantation and socket healing due to the small root diameter and bony separation between the roots.

The protein kinase B(Akt)pathway can regulate the growth,proliferation,and metabolism of tumor cells and stem cells through the activation of multiple downstream target genes,thus affecting the development and treatment of a range of diseases.Thioesterase superfamily member 4(THEM4),a member of the thioesterase superfamily,is one of the Akt kinase-binding proteins.Some studies on the mechanism of cancers and other diseases have shown that THEM4 binds to Akt to regulate its phosphorylation.Initially,THEM4 was considered an endogenous inhibitor of Akt,which can inhibit the phosphorylation of Akt in diseases such as lung cancer,pancreatic cancer,and liver cancer,but subsequently,THEM4 was shown to promote the proliferation of tumor cells by positively regulating Akt activity in breast cancer and nasopharyngeal carcinoma,which contradicts previous findings.Considering these two distinct views,this review summarizes the important roles of THEM4 in the Akt pathway,focusing on THEM4 as an Akt-binding protein and its regulatory relationship with Akt phosphorylation in various diseases,especially cancer.This work provides a better understanding of the roles of THEM4 combined with Akt in the treatment of diseases.