BACKGROUND:Several observational studies have found a close relationship between thyroid function levels and sarcopenia,but the causal relationship between thyroid function levels and the onset of sarcopenia is not yet clear. OBJECTIVE:To investigate the causal relationship between thyroid function levels and sarcopenia using a two sample Mendelian randomization method. METHODS:A two sample Mendelian randomization analysis was conducted using genome-wide association study data on thyrotropin,free triiodothyronine,free tetraiodothyronine,subclinical hyperthyroidism,subclinical hypothyroidism,and four related phenotypes of sarcopenia-lefthand grip strength,right hand grip strength,limb lean mass,and gait speed.The inverse-variance weighted method,weighted median method,simple mode method,weighted median estimator method,and MR Egger regression method were used as analysis methods,while heterogeneity test,pleiotropy test,MR-PRESSO,leave-one-out method,funnel plot and other methods were used for sensitivity analysis. RESULTS AND CONCLUSION:Elevated levels of thyroid-stimulating hormone increased left-(β=0.02,SE=0.01,P=0.01)and right-handed grip strength(β=0.02,SE=0.01,P=0.01),an increase in free triiodothyronine decreased left-(β=-0.06,SE=0.02,P=9.5×10-5)and right-handed grip strength(β=-0.07,SE=0.02,P=9.3×10-5),and subclinical hyperthyroidism decreased gait speed(β=-4.4×10-3,SE=1.7×10-3,P=0.01).The sensitivity analysis results were basically consistent with the main analysis results.To conclude,an increase in thyroid-stimulating hormone is a protective factor for sarcopenia,and elevation of free triiodothyronine and subclinical hyperthyroidism may increase the risk of sarcopenia.

Objective:To investigate long-term auditory changes and characteristics of Alport syndrome（AS） patients with different degrees of renal injury. Methods:Retrospectively analyzing clinical data of patients diagnosed AS from January 2007 to September 2022, including renal pathology, genetic detection and hearing examination. A long-term follow-up focusing on hearing and renal function was conducted. Results:This study included 70 AS patients, of which 33（25 males, 8 females, aged 3.4-27.8 years） were followed up, resulting in a loss rate of 52.9%.The follow-up period ranged from 1.1to 15.8 years, with 16 patients followed-up for over 10 years. During the follow-up, 10 patients presenting with hearing abnormalities at the time of diagnosis of AS had progressive hearing loss, and 3 patients with new hearing abnormalities were followed up, which appeared at 5-6 years of disease course. All of which were sensorineural deafness. While only 3 patients with hearing abnormalities among 13 patients received hearing aid intervention. Of these patients,7 developed end-stage renal disease（ESRD）, predominantly males （6/7）. The rate of long-term hearing loss was significantly different between ESRD group and non-ESRD group（P=0.013）. There was no correlation between the progression of renal disease and long-term hearing level（P>0.05）. kidney biopsies from 28 patients revealed varying degrees of podocyte lesion and uneven thickness of basement membrane. The severity of podocyte lesion was correlated with the rate of long-term hearing loss（P=0.048）, and there was no correlation with the severity of hearing loss（P>0.05）. Among 11 cases, theCOL4A5mutationwas most common （8 out of 11）, but there was no significant correlation between the mutation type and hearing phenotype（P>0.05）. Conclusion:AS patients exhibit progressive hearing loss with significant heterogeneity over the long-term.. THearing loss is more likely to occur 5-6 years into the disease course. Hearing abnormalities are closely related to renal disease status, kidney tissue pathology, and gene mutations, emphasizing the need for vigilant long-term hearing follow-up and early intervention.
Male ; Child ; Female ; Humans ; Nephritis, Hereditary/pathology* ; Retrospective Studies ; Kidney ; Deafness ; Hearing Loss/genetics* ; Kidney Failure, Chronic/pathology* ; Mutation

Objective To evaluate feasibility of early skeletal muscle injury by using shear wave elastography.Methods Sixty patients with unilateral knee osteoarthritis treated in Department of Orthopedics of People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from May 2020 to January 2021 were selected as the research subjects.Conventional scanning and shear wave elastography techniques were applied to investigate affected and healthy knees.Measurement included cartilage morphology,thickness and damage,joint cavity effusion,synovial membrane thickness,ligament morphology,meniscus protrusion degree,and detection of shear wave values in attachment area of quadriceps tendon on patella.Thickness and shear wave values of tendons in different observation areas on affected side and healthy side were compared.Affected knee joint was assigned a value based on the ultrasound characteristics,and Spearman correlation was used to analyze correlation between ultrasound score and shear wave value.Results Among 60 patients,fifty-six cases(56/60,93.3%)of cartilage injury in knee joint,30 cases(30/60,50.0%)of synovial hyperplasia in knee joint,35 cases(35/60,53.3%)of medial meniscus extrusion in knee joint,57 cases(57/60,95.0%)of effusion in knee joint cavity,21 cases(21/60,35%)of osteophyte formation in knee joint,and zero case of popliteal cyst in knee joint.There were 34 cases with ultrasound score less than three points,26 cases with score three to seven points,and zero case with score more than seven points.Shear wave value of the tendon in affected lateral area was significantly greater than that in affected medial area(P<0.01).Shear wave value of tendon in healthy medial area was significantly higher than that in affected medial area(P<0.01).Shear wave value of quadriceps tendon decreases with increase of ultrasound score,showed a high correlation(r=0.955,P<0.01).Conclusion Shear wave elastography is a non-invasive and relatively easy-to-operate method for evaluating muscle injury,which is highly correlated with severity of knee osteoarthritis,can help detect early strain points,providing possibilities for grading and diagnosis of knee osteoarthritis.

Objective:To explore the effectiveness of applet-assisted teaching in the pedagogy of stomatology and gain suggestions for the improvement of the applet.Methods:Using digital technology, we built a professional atlas applet for Oral Histopathology that covered a wide range of contents including illustrations, histological slides, schematic diagrams, and hand-drawn pictures of knowledge points. Based on the WeChat platform, the applet had the functions of bilingual (Chinese/English) annotation and real-time interactive communication between teachers and students. Thirty dental students were given quizzes before and after using the atlas applet. The scores were analyzed using the t-test with SPSS 22.0 software. At the same time, 45 students filled a questionnaire after using the applet for one month, which involved comments on the use of the digital atlas, the degree of satisfaction and suggestions for the applet during learning, and suggestions for its co-use by teachers and students in the future. Results:After using the atlas applet to assist with learning, the test scores of the students were improved significantly in all domains. There were significant differences between the test and control groups in the score of completion questions [(17.00±2.61) vs. (15.03±1.85), P<0.05], the score of identification of images [(27.93±5.08) vs. (25.13±3.31), P<0.05], and the total score [(78.77±8.59) vs. (72.90±6.08), P<0.05]. The questionnaire feedback showed that the students were highly satisfied with the atlas applet-assisted learning, the function of teacher-student interaction, and the overall performance of the applet. Conclusion:An atlas is one of the crucial teaching tools of Oral Histopathology for its intuitionistic and realistic presentation of tissue structures, which plays an important role in the theoretical learning process for dental students. The combination of the atlas and electronic media based on portable mobile devices is beneficial for students' understanding of knowledge.

Objective:To identify the influence of age factors on biological characteristics of human adipose-derived stem cells (ADSCs), and to compare the differences in morphology, aging characteristics, differentiation potential, surface marker expression, and proliferation ability of human ADSCs with different ages and the effect of human ADSCs of different ages on proliferation and migration of fibroblasts.Methods:Adipose tissues from 27 individuals of healthy beauty treatments, aged 0-59 years, were collected from Department of Burns and Plastic Surgery, the 940th Hospital of Joint Logistics Support Force from January 2020 to December 2020. According to the age of the donor, they were divided into 6 groups. 0-9 years old group (4 cases), 10-19 years old group (4 cases), 20-29 years old group (5 cases), 30- 39 years old group (5 cases), 40-49 years old group (5 cases), and 50-59 years old group (4 cases). We obtained and cultured the ADSCs of each group, subcultured to obtain the ADSCs, and observed the morphological characteristics of each group; the proliferation ability of each group of ADSCs was detected by CCK-8 method; the differentiation potential of each group of ADSCs was detected by in vitro adipogenesis and osteogenic induction. Flow cytometry was used to detect the surface marker expression levels of each group of ADSCs, and qPCR was used to detect the expression levels of HGF, PPAR-γ, type Ⅲ collagen and DbX2 in each group. We also collected the skin tissues of a healthy person from Department of Burns and Plastic Surgery of the 940th Hospital of Joint Logistics Support Force in 2020, obtained and cultured fibroblasts, subcultured to obtain the second generation of fibroblasts, and prepared each group of ADSCs conditioned medium (ADSCs-CM); the proliferation ability of fibroblasts cultured in each group of ADSCs-CM was detected by CCK-8 method, and the migration ability of fibroblasts cultured in each group of ADSCs-CM was detected by cell scratch method. SPSS 21.0 software was used for data analysis and P<0.05 was considered statistically significant. Results:The cells of all age groups were in a typical spindle shape. The cells of the younger age group showed small nuclei and the cell morphology were uniform and similar; the cells of the older age group had larger nuclei and uneven morphology. With aging, the proliferation ability of ADSCs gradually decreased. In vitro adipogenic differentiation induction results showed that with the increase in age, the ability of ADSCs to differentiate into adipocytes gradually decreased. In vitro osteogenic differentiation induction results also demonstrated that with the increase in age, the ability of ADSCs to differentiate into osteoblasts gradually decreased. The expression rates of positive surface markers of ADSCs in each group of ADSCs were all above 93%. With aging, the expression levels of PPAR-γ, HGF, and type Ⅲ collagen decreased, and the expression levels of DbX2 showed an upward trend with age. The number of β-galactosidase staining positive cells increased with age, while the difference between groups A, B and C was not statistically significant, and the difference between groups A and D, E, and F was statistically significant ( P<0.05). The ADSCs conditioned medium of each group was able to promote the proliferation of fibroblasts, but the difference between the groups was not statistically significant. With aging, the ability of ADSCs conditioned medium to promote the migration of fibroblasts gradually decreased. Conclusions:The proliferation ability and multidirectional differentiation ability of human ADSCs and the ability to secrete a variety of cytokines that promote the proliferation and migration of fibroblasts show a downward trend, but the adipogenic differentiation ability of ADSCs declines significantly after the age of 40 years. ADSCs in all age groups could promote the proliferation and migration of fibroblasts.

Objective:To prepare human decellular adipose tissue matrix (DAT) as injectable homogenate by a specially developed high-speed soft tissue homogenizer with controllable temperature, and to investigate its cellular compatibility and filling effect.Methods:From March 2019 to March 2021, DAT was obtained in the 940th Hospital from normal adipose tissue after decellular treatment. The DAT was mixed with normal saline at the rate of 1: 12. The specially developed high-speed soft tissue homogenizer with controllable temperature was used to conduct homogenization at 803×g for 10 min. The produced DAT homogenizer could pass through the 27G needle smoothly. DAT homogenate was observed under scanning electron microscope and its cytocompatibility was detected. Finally, granular fat, DAT homogenate and DAT homogenate + ADSCs were injected into the back of rats respectively, and the filling effect, angiogenesis ability and inflammatory infiltration were compared.Results:After decellular treatment, adipose tissue changed into DAT without cellular residue. The particle size of DAT homogenate was about (749.91±136.79) nm, which was prepared by the specially developed temperature controlled high-speed soft tissue homogenater. The adhesion rate was (92.16±1.00) %, and the A value increased with time. The cell growth was good, and the homogenate had no toxicity to the cells. In vivo experiment, the filling effect of DAT homogenate and DAT homogenate + ADSCs was significantly better than that of granulated fat group ( P<0.01). In the granulated fat group, a large number of adipocytes were necrotic and fused to form oil sacs, while DAT homogenate, DAT homogenate + ADSCs showed no obvious degradation, and some adipocytes were generated. The results of CD31 staining indicated that the number of microvessels in DAT homogenate group and DAT homogenate + ADSCs group was higher than that in granulated fat group ( P<0.01). The results of CD68 staining indicated that the inflammatory infiltration in DAT homogenate group and DAT homogenate + ADSCs group was lower than that in granule fat group ( P<0.01). Conclusions:Using the self-developed temperature controlled high-speed soft tissue homogenate device, DAT could be prepared into DAT homogenate that can pass through 27G needle. It has good biocompatibility and filling advantages, and injective process is simple, and the trauma is small, and so it could be used as filling material.

HYD-PEP06, an endostatin-modified polypeptide, has been shown to produce effective anti-colorectal carcinoma effects through inhibiting epithelial-mesenchymal transition (EMT). However, whether HYD-PEP06 has similar suppressive effect on hepatocellular carcinoma (HCC) remained unknown. In this study, HYD-PEP06 inhibited metastasis and EMT but not proliferation

Objective:To explore the predictive value of preoperative prognostic nutritional index(PNI) and systemic immune-inflammation index(SII) for local tumor stage in bladder cancer after radical cystectomy(RC).Methods:This study is a retrospective study, collecting information on 195 patients with bladder cancer who underwent RC at the Second Hospital of Tianjin Medical University from April 2011 to October 2019. Extract the patient’s preoperative laboratory examination and calculate the PNI and SII. The calculation formula was PNI=albumin (g/L)+ 5×total lymphocyte count (10 9/L); SII=platelets×neutrophils/lymphocytes . Univariate and multivariate Cox regression analysis were used to analyze whether PNI and SII can be used as predictors of muscular invasive bladder cancer(MIBC) and non-muscular invasive bladder cancer(NMIBC). Continuous variables were expressed as mean±standard deviation ( Mean± SD), and t-test was used for comparison between groups; Chi-square test was used for comparison of categorical variables between groups. Generate receiver operating characteristic curve (ROC), calculate area under the curve (AUC) to judge the predictive ability of PNI and SII scoring indicators. The larger of AUC, the stronger the predictive ability. Univariate and multivariate Cox regression analysis were used to calculate the corresponding odds ratio ( OR) and 95% CI. Results:All patients were males, with a mean age of (67.94±8.97) years. Mean serum albumin was (42.13±4.28) g/L, mean PNI was 51.29±6.09 and mean SII was 661.67±506.22. Univariate Cox regression analysis showed that both PNI and SII had statistical significance for the incidence of MIBC; multivariate Cox regression analysis showed that PNI and SII could not be used as the diagnosis of MIBC and NMIBC. PNI was an independent risk factor for predicting tumor stage (pT<3a and pT≥3a).Conclusion:The low preoperative PNI can be used as an independent factor for predicting poor pathological stage (pT≥3a).

Prostate cancer in patients with dwarfism is rarely reported. One case was reported in this article. The patient was admitted to the hospital due to the PSA elevation for more than 4 years. Due to the dwarf disease, the patient could not accommodate the transrectal ultrasound probe, and was highly suspected of prostate cancer.The prostate needle biopsy was not performed. Combined with the medical history, PSA level, preoperative MRI and PSMA-PET/CT examination, the patient was clinically diagnosed with localized prostate cancer, and radical surgical treatment was performed.

There has been a large number of related literature reports on sleep disorders, but in pediatrics, especially for children aged 0-5 years old, sleep disorders have not received enough attention.In order to raise pediatricians′ awareness of sleep disorders in children aged 0-5 years old, the relevant studies during the past 10 years have been reviewed, and the clinical manifestations and treatments were summarized.The clinical manifestations of sleep disorders in infants aged 0-5 years old are not typical and the incidence is high.Sleep disorders have profound effects on the cognitive and behavioral development of children aged 0-5 years old.