Objective: This study aims to explore the association between oral lichen planus (OLP) and Hashimoto’s thyroiditis (HT) and its anti-thyroid antibodies to provide clinical evidence for thyroid disease screening in patients with OLP. Methods: This study was approved by the institutional ethics committee. A total of 125 clinically and histopathologically confirmed patients with OLP were enrolled as the case group, and they were matched with 125 non-OLP controls based on sex and age. Demographic data (gender, age, lesion type, and disease duration) were collected from both groups. Serum levels of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) were measured to analyze their associations with sex, age, lesion type, and disease duration in patients with OLP. Result: The prevalence of HT in patients with OLP was 31.20%, significantly higher than that in the control group (9.60%) (χ2=18.504, P<0.001). The prevalence of HT in female patients with OLP (39.13%) was significantly higher than that in male patients (9.09%)（χ2=10.93，P<0.001）. The positivity rate of thyroid peroxidase antibodies (TPOAb) in patients with OLP (17.6%) was significantly higher than in the control group (4.0%) (χ2=10.989, P<0.001). The TPOAb positivity rate was significantly higher in female patients (22.83%) than in male patients (3.03%) (χ2=5.210, P=0.014). There was no statistically significant difference in the positivity rate of TgAb between patients with OLP (7.2%) and the control group (3.2%) (P>0.05). Patients with erosive lesions had a significantly higher TPOAb positivity rate (25.0%, 17/68) compared to those with non-erosive lesions (8.77%, 5/57), and the difference was statistically significant (χ2=4.831, P=0.028). Logistic regression analysis revealed that female patients with OLP had an 8.935-fold higher risk of being TPOAb positive compared to males (OR=8.935, 95%CI: 1.134-70.388, P=0.038). Patients with erosive OLP lesions had a 3.199-fold higher risk of TPOAb positivity compared to those with non-erosive lesions (OR=3.199, 95%CI: 1.064-9.618, P=0.038). Conclusion The prevalence of HT is higher in patients with OLP, with higher positivity rates of anti-thyroid antibodies observed in female patients and those with erosive OLP lesions. This suggests that thyroid disease screening should be incorporated into the clinical management of patients with OLP, especially for women and patients who present with erosive lesions.

ObjectiveTo investigate the clinical efficacy and potential mechanism of Shengmai Jiuxin decoction in the treatment of acute decompensated heart failure （ADHF） with the traditional Chinese medicine （TCM） pattern of Qi and Yin deficiency， Yang deficiency， and blood stasis. MethodsA total of 68 patients diagnosed with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type were randomly assigned to an observation group （34 cases） and a control group （34 cases）. Both groups received conventional Western medical treatment， while the observation group was additionally administered Shengmai Jiuxin decoction. Parameters compared before and after treatment included： TCM syndrome score， TCM syndrome efficacy， New York Heart Association （NYHA） functional classification， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， six-minute walk distance （6MWD）， hypoxia-inducible factor-1 alpha （HIF-1α）， vascular endothelial growth factor A （VEGF-A）， Caspase-3， and the number of rehospitalizations for heart failure within one month after discharge. ResultsThere were no significant differences in sex， age， vital signs， or underlying diseases between the two groups. Compared with baseline， both groups exhibited significant reductions in TCM syndrome scores， NT-proBNP， and HIF-1α levels （P<0.01）， as well as significant increases in 6MWD， LVEF， VEGF-A， and Caspase-3 levels （P<0.05， P<0.01）. After treatment， the observation group showed significantly greater reductions in TCM syndrome score， NT-proBNP， HIF-1α， and Caspase-3 levels compared with the control group （P<0.05） and significantly greater increases in 6MWD， TCM syndrome efficacy， and VEGF-A levels （P<0.05）. No significant differences were observed between the groups in NYHA functional classification， LVEF， or the number of rehospitalizations for heart failure within one month after discharge. No drug-related adverse events were reported in either group during the treatment period. ConclusionShengmai Jiuxin decoction can improve cardiac function and clinical symptoms in patients with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type. Its mechanisms may be related to the regulation of the HIF-1 signaling pathway by modulating targets such as HIF-1α， VEGF-A， and Caspase-3.

ObjectiveTo investigate the clinical efficacy and potential mechanism of Shengmai Jiuxin decoction in the treatment of acute decompensated heart failure （ADHF） with the traditional Chinese medicine （TCM） pattern of Qi and Yin deficiency， Yang deficiency， and blood stasis. MethodsA total of 68 patients diagnosed with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type were randomly assigned to an observation group （34 cases） and a control group （34 cases）. Both groups received conventional Western medical treatment， while the observation group was additionally administered Shengmai Jiuxin decoction. Parameters compared before and after treatment included： TCM syndrome score， TCM syndrome efficacy， New York Heart Association （NYHA） functional classification， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， six-minute walk distance （6MWD）， hypoxia-inducible factor-1 alpha （HIF-1α）， vascular endothelial growth factor A （VEGF-A）， Caspase-3， and the number of rehospitalizations for heart failure within one month after discharge. ResultsThere were no significant differences in sex， age， vital signs， or underlying diseases between the two groups. Compared with baseline， both groups exhibited significant reductions in TCM syndrome scores， NT-proBNP， and HIF-1α levels （P<0.01）， as well as significant increases in 6MWD， LVEF， VEGF-A， and Caspase-3 levels （P<0.05， P<0.01）. After treatment， the observation group showed significantly greater reductions in TCM syndrome score， NT-proBNP， HIF-1α， and Caspase-3 levels compared with the control group （P<0.05） and significantly greater increases in 6MWD， TCM syndrome efficacy， and VEGF-A levels （P<0.05）. No significant differences were observed between the groups in NYHA functional classification， LVEF， or the number of rehospitalizations for heart failure within one month after discharge. No drug-related adverse events were reported in either group during the treatment period. ConclusionShengmai Jiuxin decoction can improve cardiac function and clinical symptoms in patients with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type. Its mechanisms may be related to the regulation of the HIF-1 signaling pathway by modulating targets such as HIF-1α， VEGF-A， and Caspase-3.

Objective To investigate the relationship between neutrophil/high-density lipoprotein cholesterol ratio(NHR)and the severity of coronary artery lesions in young adults with acute myocardial infarction.Methods A total of 109 young a-dults(aged 18～45 years)with acute myocardial infarction admitted to the First Affiliated Hospital of Anhui Medical University from June 2019 to June 2023 were selected and divided into Syntax low-risk group(n=85)and Syntax medium-high-risk group(n=24)according to Syntax score.Patients with negative coronary angiography during the same period were negative control group(n=52).General clinical data and related serum markers were collected,and NHR value was calculated.Pearson correla-tion analysis and logistics regression analysis were performed to examine the correlation between NHR and the severity of coro-nary artery lesions.Subgroup analysis and interaction testing were further conducted.The receiver operating curve(ROC)was performed to evaluate the value of NHR in predicting the severity of coronary artery lesions in young adults with acute myocar-dial infarction.Results Gender,smoking rate,alcohol consumption rate,diabetes history,absolute number of neutrophils,tri-glyceride,HDL-C,NHR,VLDL-C,apolipoprotein B(APOB),fasting blood glucose and glycosylated hemoglobin were signifi-cantly different among the three groups(P＜0.05).In pairwise comparison,the absolute number of neutrophil and NHR were significantly different among the three groups.BMI was significant different between non-CHD group and Syntax medium-high-risk group.HDL-C,fasting blood glucose and glycosylated hemoglobin were significant different between Syntax low-risk group and non-CHD group,as well as between Syntax medium-high-risk group and non-CHD group(P＜0.05).Creatinine and APOB were significant different between Syntax low-risk group and non-CHD group.Triglyceride,VLDL-C and LP(a)were significant different between Syntax low-risk group and Syntax medium-high-risk group(P＜0.05).Pearson correlation analysis showed a positively correlation between NHR and Syntax score(r=0.322,P＜0.01).Univariate and multivariate binary logistic regres-sion analysis showed that NHR(OR=1.265,95％CI1.097～1.458,P＜0.05)was an independent risk factor for the severity of coronary artery lesions in young adults with acute myocardial infarction.Subgroup analysis showed that NHR was significantly associated with the severity of coronary artery lesions in patients with BMI≥24 kg/m2,smokers,drinkers and non-drinkers(P＜0.05).No significant difference was observed in interaction analysis.The ROC curve showed that the area under the curve(AUC)predicted by NHR for acute myocardial infarction in young adults was 0.758,with a cut-off value of 7.0319,sensitivity of 83.3％,and specificity of 63.53％.Conclusion NHR has a certain value in predicting the severity of coronary artery lesions in young adults with acute myocardial infarction.

BACKGROUND:The distribution of horizontal pressure in adolescent idiopathic scoliosis can be used to evaluate the coronal imbalance.Currently,there are no reports on the characteristics of coronal pressure distribution and its correlation with coronal imbalance. OBJECTIVE:To explore the correlation between coronal pressure variation and coronal imbalance in adolescent idiopathic scoliosis patients. METHODS:A total of 39 adolescent idiopathic scoliosis patients who met the inclusion and exclusion criteria in Lianyungang First People's Hospital from March 2021 to June 2022 were selected as the adolescent idiopathic scoliosis group,and 30 matched healthy volunteers were recruited from the outpatient department as the control group.The horizontal position pressure,folding position pressure,coefficient of variation,and global and trunk pressure variation were measured by the TBED Postural Couch evaluation system.In the adolescent idiopathic scoliosis group,full-length spine radiographs were taken to measure Cobb angle,coronal balance,apical vertebral deviation and Nash-Moe rotation.The characteristics of coronal pressure variation and its correlation with coronal imbalance were analyzed. RESULTS AND CONCLUSION:(1)Compared with the control group,there was no statistically significant difference in the horizontal position pressure and folding position pressure in the adolescent idiopathic scoliosis group(P>0.05),but the global pressure variation and coefficient of variation were significantly increased(all P<0.05).(2)There were differences in both sides of the trunk of the adolescent idiopathic scoliosis group and the control group(P<0.05),and the convex side pressure variation in the adolescent idiopathic scoliosis group was higher than the concave side pressure variation in the left and right side pressure variation in the control group(all P<0.05).(3)The variation of the convex side pressure of the trunk in adolescent idiopathic scoliosis patients was positively correlated with coronal balance intensity(r=0.692,P<0.05),moderately positively correlated with Cobb angle and apical vertebral deviation(r=0.499,0.595,all P<0.05),and weakly correlated with Nash-Moe grade(r=0.377,P<0.05).The variation of the concave side pressure of the trunk was moderately positively correlated with coronal balance(r=0.410,P<0.05),and the rest was weakly correlated or not correlated(P>0.05).(4)These findings indicate that pressure variation may be used as an adjoint assessment tool in patients with mild to moderate scoliosis.

BACKGROUND:The threaded conical implant has a good ability to control micro movements and is conducive to immediate loading.However,the effects of double-threaded conical cylindrical implants and conical cylindrical implants on stress distribution and initial stability of implant-bone interface after immediate loading have not been reported. OBJECTIVE:To investigate the impact of double-threaded conical cylindrical implants and conical cylindrical implants on the biological distribution of the implant and the surrounding bone interface during immediate loading in the mandibular molar region. METHODS:(1)Three-dimensional finite element analysis:Conical beam CT scans of the mandible and first molar of a volunteer were used to develop a basal model of the mandible.The double-threaded conical cylindrical implants and conical cylindrical implants were assembled with the mandibular models,and an immediate-load(or delayed implantation)implant model(a total of four models)for the first mandibular molar was established.Loads in four directions(100 N):axial,lingual and buccal 45°,mesial and distal,and buccal and lingual,were applied to the central fossa of each model's crown.Three-dimensional finite element method was used to analyze the implant displacement and the stress distribution at the implant-bone interface.(2)In vitro experiment:With the assistance of the oral implant robot,the double-threaded conical cylindrical implants and conical cylindrical implants were implanted on the same artificial bone pieces,separately,and the immediate load model of immediate implant implantation(or delayed implantation)was established in vitro(a total of four groups of models).Osstell resonance frequency analyzer and SmartPeg sensor were used to measure the implant stability coefficient in four vertical directions:front,rear,left,and right measurements,evaluate the initial stability,and verify the finite element analysis results. RESULTS AND CONCLUSION:(1)The displacement difference between double-threaded conical cylindrical implants and conical cylindrical implants was small when the immediate loading of delayed implantation was applied,but the maximum stress value of conical cylindrical implant-bone interface was greater than that of double-threaded conical cylindrical implant-bone interface.When the immediate loading of immediate implantation was applied,the maximum stress value and the maximum displacement of bone around the implant appeared when the load was applied in mesiodistal direction.The stress value of the conical cylindrical implant reached 298.84 MPa and the maximum displacement was 0.31 mm,both of which were larger than that of the double-threaded conical cylindrical implant.(2)The results of in vitro experiments showed that the stability coefficient of the double-threaded conical cylindrical implant was greater than that of the conical cylindrical implant.(3)Compared with the conical cylindrical implant,the double-threaded conical cylindrical implant has higher initial stability under immediate loading,suggesting that the use of double-threaded conical cylindrical implant should be given priority in clinical immediate loading.

BACKGROUND:Prevention of fractures after stroke is very important,and there are currently no models to predict the occurrence of hip fractures after stroke. OBJECTIVE:To investigate the risk factors leading to hip fracture in stroke patients and to establish a risk prediction model to visualize this risk. METHODS:A total of 439 stroke patients were selected from the Affiliated Hospital of Xuzhou Medical University from June 2014 to June 2017,including 107 males and 332 females,with a mean age of(71.38±9.74)years.They were divided into fracture group(n=35)and non-fracture group(n=404)according to the presence or absence of hip fracture.Univariate and multivariate analyses were used to determine the risk factors for hip fracture after stroke.The data were randomly divided into training set(70%)and test set(30%).Nomogram predicting the risk of hip fracture occurrence was created based on the results of the multifactor analysis,and performance was evaluated using receiver operating characteristic curve,calibration curves,and decision curve analysis.A web calculator was created to facilitate a more convenient interactive experience for clinicians. RESULTS AND CONCLUSION:(1)Univariate analysis showed significant differences between the two groups in the number of falls,smoking,hypertension,glucocorticoids,number of strokes,Mini-Mental State Examination,visual acuity level,National Institute of Health Stroke Scale,Berg Balance Scale,and Stop Walking When Talking scale scores(P<0.05).(2)Multivariate analysis showed that number of falls[OR=17.104,95%CI(3.727-78.489),P=0.000],National Institute of Health Stroke Scale[OR=1.565,95%CI(1.193-2.052),P=0.001],Stop Walking When Talking[OR=12.080,95%CI(2.398-60.851),P=0.003]were independent risk factors positively associated with new hip fractures.Bone mineral density[OR=0.155,95%CI(0.044-0.546),P=0.012]and Berg Balance Scale[OR=0.840,95%CI(0.739-0.954),P=0.007]were negatively associated with new hip fractures after stroke.(3)The AUC values of nomogram were 0.956 and 0.907 in the training and test sets,respectively,and the calibration curves showed a high agreement between predicted and actual status with an area under the decision curve of 0.038 and 0.030,respectively.(4)These findings conclude that the number of falls,low bone mineral density,low Berg Balance Scale score,high National Institute of Health Stroke Scale score,and positive Stop Walking When Talking are risk factors for hip fracture after stroke.Based on this,a nomogram with high accuracy was developed and a web calculator(https://stroke.shinyapps.io/DynNomapp/)was created.

AIM:To observe the effect of icariin-astragaloside Ⅳ-puerarin mixture(Yin-Huang-Ge mixture,YHG)on cognitive function and ferroptosis amino acid metabolism pathway in hepcidin(HAMP)knockout APPswe/PS1dE9(APP/PS1 HAMP-/-)mice.METHODS:The mice were divided into 7 groups:negative control(C57BL/6 mice)group,APP/PS1 group,APP/PS1 HAMP-/-group,APP/PS1+YHG group,APP/PS1 HAMP-/-+YHG group,APP/PS1+de-ferasirox(DFX)group,and APP/PS1 HAMP-/-+DFX group,with 6 mice in each group.The YHG and DFX were adminis-tered intragastrically,while the mice in C57 group,APP/PS1 group and APP/PS1 HAMP-/-group were given intragastric administration of distilled water,once a day for 2 months.The iron content in mouse brain tissues was detected by tissue iron kit.The morphological changes of the mitochondria in hippocampal neurons were observed by transmission electron microscopy.Morris water maze was used to detect the learning and memory ability of the mice.The content of neuronal nu-clear antigen(NeuN)in mouse brain tissues was detected by immunofluorescence staining.The expression of glutathione(GSH)in mouse brain tissues was detected by biochemical kit.The expression levels of glutamate-cysteine ligase catalytic subunit(GCLC)and glutamatase 2(GLS2)in mouse brain tissues were detected by Western blot.RESULTS:Compared with C57BL/6 mice,the brain iron content of APP/PS1 mice was significantly increased(P＜0.01),the mitochondria were seriously damaged,the learning and memory ability was significantly decreased(P＜0.05),the brain neurons were seri-ously damaged(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly decreased(P＜0.01).Compared with APP/PS1 mice,the brain iron content of APP/PS1 HAMP-/-mice was significantly increased(P＜0.01),the mitochondria were seriously damaged,the learning and memory ability was significantly decreased(P＜0.05),the brain neurons were seriously damaged(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly decreased(P＜0.05).After treatment with YHG and DFX,the brain iron content was significantly decreased(P＜0.01),the mitochondrial damage was alleviated,the learning and memory ability was significantly increased(P＜0.05),the brain neuron damage was alleviated(P＜0.01),and the expression levels of GSH,GCLC and GLS2 were significantly increased(P＜0.05).CONCLUSION:The YHG can improve the cognitive function of APP/PS1 HAMP-/-mice,and its mechanism may be related to the regulation of ferroptosis amino acid metabolism and the enhancement of antioxidant capacity.

Nonalcoholic steatohepatitis(NASH)is a liver disease closely associated with metabolic syndrome,and its pathogenesis includes insulin resistance,lipid metabolism disorders,and inflammatory response.This article briefly describes how CD8+T cells exert a cytotoxic effect through the three pathways of the Fas-Fas ligand signaling pathway,the release of perforin and granzymes,and the secretion of tumor necrosis factor-α and other cytokines,and these mechanisms allow CD8+T cells to specifically kill virus-infected cells and tumor target cells,thereby participating in immune regulation.At the same time,this article summarizes that CD8+T cells promote the recruitment of macrophages cooperate with natural killer T cells to participate in the development of adipose tissue inflammation,and lead to liver injury through automatic attack and epigenetic mechanisms,finally promoting the pathogenesis of NASH.It is concluded that CD8+T cells may become a new therapeutic target for NASH,and in-depth research on the specific mechanism of CD8+T cells affecting the pathogenesis in NASH in the future may help to further guide clinical treatment.

Objective To explore the characteristics of echolalic speech of children with moderate to severe autism spectrum disor-der(ASD)aged three to eight. Methods From January to March,2024,15 minutes rehabilitation course video of five children with moderate to severe ASD aged three to eight were collected in institutional and family settings,respectively.Language sample analy-sis and self-compiled coding were used to analyze the echo speech sample content,structure,and collect their oral language ability.The correlation between the echo speech and case oral language ability was analyzed. Results A total of 235 echoic speech-related speech rounds were recorded.Among them,the ratio of immediacy to de-layed echo speech was 7∶1;one echo speech was found in every two to three speech responses,with average sen-tence length of 2.97 and average word length of 2.23.The frequency of verbs and nouns was high,accounting for 45.03%and 38.48%,respectively;and there were many declarative words and sentences,accounting for 72.58%on average.The type of echo speech structure was the most frequently at the end of the reconstructed discourse,accounting for 29.98%on average.The type,frequency,sentence length,sentence pattern and structure of echoic speech were not significantly different in institutional and family settings.The language ability scores of imita-tion sentence length,word understanding and naming were significantly correlated with the number,frequency,sentence length and sentence type frequency of echoic speech(r>0.881,P<0.01). Conclusion Echoic speech activity in children with moderate to severe ASD aged three to eight shows transsituational stability,and is related with their understanding language and expressive language ability;characterized as instant echo speech,short sentence,the advantage of real words,declarative sentences,often repeat the end of the origi-nal sentence.