ObjectiveTo investigate the effect of 1，25（OH）₂D₃ on the level of peroxisome proliferator-activated receptor-γ （PPAR-γ） in the liver， the phenotype of hepatic macrophages， and liver inflammation in a rat model of nonalcoholic steatohepatitis （NASH）， as well as the mechanism of 1，25（OH）₂D₃ improving liver inflammation. MethodsAfter 1 week of adaptive feeding， 24 specific pathogen-free Wistar rats were randomly divided into normal group ［choline-supplemented L-amino acid-defined （CSAA） diet］， normal+1，25（OH）₂D₃ group ［CSAA diet+1，25（OH）₂D₃］， model group ［choline-deficient L-amino acid-defined diet （CDAA） diet］， and model+1，25（OH）₂D₃ group ［CDAA diet+1，25（OH）₂D₃］， with 6 rats in each group. The dose of 1，25（OH）₂D₃ was 5 μg/kg for intraperitoneal injection twice a week for 12 weeks. The serum levels of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） were measured， liver histopathology was observed， and SAF score was assessed. M1 hepatic macrophages and M2 hepatic macrophages were measured to analyze in the change in the phenotype of hepatic macrophages， and ELISA was used to measure the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-4 （IL-4）， and interleukin-10 （IL-10） in liver tissue， and qPCR was used to measure the mRNA level of PPAR-γ. The two-factor analysis of variance was use for comparison between groups， and the least significant difference t-test was used for further comparison； the Pearson method was used for correlation analysis. ResultsCompared with the normal group， the model rats with CDAA diet-induced NASH had significant increases in the serum levels of AST and ALT （P=0.019 and P<0.001）， the SAF score of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， and the ratio of M1 and M2 hepatic macrophages （P<0.001）， as well as a significant increase in the level of TNF-α （P<0.001） and a significant reduction in the level of IL-4 in liver tissue （P=0.025）. The 1，25（OH）₂D₃ group had significant reductions in the serum levels of ALT （P<0.001）， the SAF score of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， and the ratio of M1 and M2 hepatic macrophages （P=0.001）， the level of IL-1β （P<0.001） and a significant increase in the level of M2 hepatic macrophages （P=0.017）， the level of IL-10 （P=0.039）， the level of IL-4 （P<0.001）， the level of PPAR-γ （P=0.016）. There were significant interactions between CDAA diet-induced NASH model and 1，25（OH）₂D₃ in serum the levels of AST and ALT （P=0.007 and P=0.008）， the SAF scores of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， the level of M2 hepatic macrophages （P=0.008）， the ratio of M1 and M2 of hepatic macrophages （P=0.005）， the level of TNF-α （P<0.001）， the level of IL-10 （P=0.038）， the level of IL-4 （P<0.001） and the level of PPAR-γ （P=0.009）. The correlation analysis showed that PPAR-γ was negatively correlated with the ratio of M1 and M2 hepatic macrophages （r=-0.415， P=0.044） and was positively correlated with M2 hepatic macrophages （r=0.435， P=0.033）， IL-10 （r=0.433， P=0.035）， and IL-4 （r=0.532， P=0.007）. ConclusionThis study shows that 1，25（OH）₂D₃ improves liver inflammation in NASH by activating PPAR-γ to regulate the phenotypic transformation of hepatic macrophages.

Objective:To investigate the characteristics of neointimal hyperplasia (NIH) in patients with in-stent restenosis (ISR) over 5 years post-drug-eluting stent (DES) implantation based on optical coherence tomography (OCT).Methods:In this cross-sectional study, patients with DES-ISR who underwent OCT examination at PLA General Hospital between March 2010 and March 2022 were retrospectively included. All patients were divided into≤5 years DES-ISR group and>5 years DES-ISR group according to the time interval after DES implantation. Quantitative and qualitative analyses were conducted on OCT images to compare the clinical data and lesion characteristics of two patient groups. Furthermore, the independent clinical predictive factors of in-stent neoatherosclerosis (ISNA) were analyzed by multivariable logistic regression.Results:A total of 230 DES-ISR patients with 249 lesions were included, with an age of (63.1±10.4) years and 188 males (81.7%). The median interval after DES implantation was 6 (2, 9) years. There were 117 patients (122 ISR lesions) in the≤5 years DES-ISR group, and 113 patients (127 ISR lesions) in the>5 years DES-ISR group. Compared with≤5 years DES-ISR,>5 years DES-ISR showed more heterogeneous patterns (65.4% (83/127) vs. 48.4% (59/122), P=0.007), diffuse patterns (46.5% (59/127) vs. 31.2% (38/122), P=0.013), macrophage accumulations (44.1% (56/127) vs. 31.2% (38/122), P=0.035) in NIH and higher prevalence of ISNA (83.5% (106/127) vs. 72.1% (88/122), P=0.031). According to multivariable logistic regression, the independent predictive factor for ISNA was female ( OR=0.44, 95% CI 0.21-0.90, P=0.026). Female ( OR=0.48, 95% CI 0.23-0.99, P=0.046) and low-density lipoprotein cholesterol level ( OR=1.62, 95% CI 1.01-2.59, P=0.046) were independent predictive factors, respectively, for lipid ISNA. Calcified ISNA was independently associated with time interval of post-DES implantation ( OR=1.18, 95% CI 1.07-1.29, P=0.001). Conclusion:DES-ISR patients with a time interval of>5 years after stent implantation have a higher prevalence of ISNA and more complex lesions. Gender, the level of low-density lipoprotein cholesterol, and the time interval post-DES implantation are independently correlated with ISNA, lipid ISNA, and calcified ISNA.

Objective To evaluate the polishing finish of four different polishing tools.Methods Fifty specimens were selected from suitable zirconia and randomly divided into 5 groups with 10 specimens in each group.Group A was the negative control group;Group B was the EVE group;Group C was the SHOFU group;Group D was the Toboom group,and Group E was the NAIS group.All specimens were subjected to surface roughness measurements after each level of treatment.One specimen in each group was randomly selected after each level of treatment and put into the vacuum coater for surface gold spraying,and then put into the scanning electron microscope for surface morphology observation after vacuuming.Results Final Ra value:The negative group((1.677±0.066)μm)＞SHOFU group((0.357±0.037)μm)＞EVE group((0.248±0.051)μm)＞Toboom group((0.115±0.039)μm)and NAIS group((0.123±0.029)μm).Scanning electron microscope observation showed that the deepest and longest scratches were left on the surface of the specimen with the diamond needle,and the surface of the specimen was gradually smoothed by using the polishing kit to treat the surfacein turn.The surface of the specimens polished by NAIS group and Toboom group had the least and shallow scratches under the mirror.Conclu-sion Toboom and NAIS zirconia polishing tools provide the best polishing results.

BACKGROUND: Sarcopenia is an age-related progressive skeletal muscle disorder involving the loss of muscle mass or strength and physiological function. Efficient and precise AI algorithms may play a significant role in the diagnosis of sarcopenia. In this study, we aimed to develop a machine learning model for sarcopenia diagnosis using clinical characteristics and laboratory indicators of aging cohorts. METHODS: We developed models of sarcopenia using the baseline data from the West China Health and Aging Trend (WCHAT) study. For external validation, we used the Xiamen Aging Trend (XMAT) cohort. We compared the support vector machine (SVM), random forest (RF), eXtreme Gradient Boosting (XGB), and Wide and Deep (W&D) models. The area under the receiver operating curve (AUC) and accuracy (ACC) were used to evaluate the diagnostic efficiency of the models. RESULTS: The WCHAT cohort, which included a total of 4057 participants for the training and testing datasets, and the XMAT cohort, which consisted of 553 participants for the external validation dataset, were enrolled in this study. Among the four models, W&D had the best performance (AUC = 0.916 ± 0.006, ACC = 0.882 ± 0.006), followed by SVM (AUC =0.907 ± 0.004, ACC = 0.877 ± 0.006), XGB (AUC = 0.877 ± 0.005, ACC = 0.868 ± 0.005), and RF (AUC = 0.843 ± 0.031, ACC = 0.836 ± 0.024) in the training dataset. Meanwhile, in the testing dataset, the diagnostic efficiency of the models from large to small was W&D (AUC = 0.881, ACC = 0.862), XGB (AUC = 0.858, ACC = 0.861), RF (AUC = 0.843, ACC = 0.836), and SVM (AUC = 0.829, ACC = 0.857). In the external validation dataset, the performance of W&D (AUC = 0.970, ACC = 0.911) was the best among the four models, followed by RF (AUC = 0.830, ACC = 0.769), SVM (AUC = 0.766, ACC = 0.738), and XGB (AUC = 0.722, ACC = 0.749). CONCLUSIONS: The W&D model not only had excellent diagnostic performance for sarcopenia but also showed good economic efficiency and timeliness. It could be widely used in primary health care institutions or developing areas with an aging population. TRIAL REGISTRATION Chictr.org, ChiCTR 1800018895.
Humans ; Aged ; Sarcopenia/diagnosis* ; Deep Learning ; Aging ; Algorithms ; Biomarkers

Objective:To investigate the diagnostic and early-warning value of laboratory test indicators for sepsis-induced myocardial injury (SIMD).Methods:The clinical data of 183 patients with sepsis admitted to the Department of Emergency and Critical Care Medicine of Guangdong Provincial People's Hospital from August 2016 to October 2020 were collected. The patient's age, gender, past medical history, vital signs and pathogen culture results were extracted. Cardiac function, blood routine, liver function, renal function, inflammatory factors, coagulation function, APACHE Ⅱ and SOFA scores were recorded at enrollment and 72 h after admission. SIMD was defined as cTnT ≥300 pg/mL and NT-proBNP ≥1243 pg/mL twice in 72 h intervals between enrolled cases, and the early-warning factors of patients with SIMD were analyzed. The differences in various indicators between the two groups were compared, and Logistic regression analysis was used to explore the diagnostic efficacy of cTnT and NT-proBNP combined for SIMD, and the correlation between PCT/PLT ratio and the occurrence of SIMD.Results:Among 250 patients, 67 patients were excluded for lack of the main indicators, and 183 patients (including 62 patients with history of cardiac disease) were enrolled finally. Among 183 patients with sepsis, 105 patients (57.38%) with cTNT ≥300 pg/mL and NT-proBNP ≥1 243 pg/mL, were diagnosed as myocardial injury; after excluding 62 patients with history of cardiac disease, 59 patients (48.76%) with cTNT ≥300 pg/mL and NT-proBNP ≥1 243 pg/mL were diagnosed as myocardial injury. Logistic regression analysis showed that increased PCT/PLT ratio ( OR=1.585, 95% CI: 1.124-2.237, P=0.009) was an independent risk factor for early-warning of SIMD. The PCT/PLT ratio ( OR= 1.850, 95% CI: 1.103-3.102, P=0.020) could stably predict the occurrence of SIMD in patients without previous history of heart disease. ROC curve analysis showed that PCT/PLT ratio could effectively predict the occurrence of SIMD (AUC=0.693, 95% CI: 0.617-0.769, P<0.001), the optimal cut-off value was 0.177 (sensitivity: 65.7%, specificity: 66.7%). The PCT/PLT ratio was still effective in predicting the occurrence of SIMD after excluding patients with previous history of heart disease (AUC=0.733, 95% CI: 0.643-0.823, P<0.001), and the optimal cut-off value was 0.429 (sensitivity: 55.9%, specificity: 83.9%). Conclusions:The combination of cTnT and NT-proBNP has certain diagnostic value for SIMD, and the PCT/PLT ratio could warn the occurrence of SIMD.

Objective: To evaluate the dietary quality for preschool children by diet balance index(DBI_C), and to provide an empirical reference for scientific guidance for a reasonable diet and controlling and preventing iron deficiency anemia(IDA). Methods: During September to December of 2018, 306 left behind children and 598 non left behind children aged 3-6 years old of Anhui Province were selected. Four scoring methods (TS Total Score, LBS Low Bound Score, HBS High Bound Score, DQD Diet Quality Distance) were used to evaluate the dietary quality by DBI_C, and multivariate Logistic regression was used to assess the relationship between DBI_C and IDA. Results: The anemia prevalence (AP) was 13.3% among the 3-6 year old children in Anhui rural area, whereas the left behind children (LBC) was 16.7% and the non left behind children was 10.9%, and there was statistical significance of the differences ( χ 2=8.8, P <0.05). There were significant differences of TS[-18.3(25.2，-12.7)，-15.2(-19.8，-8.6)], LBS[25.4(18.3，32.5)，22.7(16.5，30.6)] and DQD[36.8(23.9，43.4)，34.1(27.5，41.0)] in DBI_C scores between anemia group and nonanemia group ( P <0.05). There were significant differences of milk and beans [-5.9(-10.7，-0.4)，-5.0(-8.7，0.2)], animal food [-2.4(-5.6，0.8)，-0.6(3.5，1.9)], food species [-7.5(-9.1，-4.8)，-6.3(-8.0，-2.9)] in food intake scores between anemia group and non anemia group ( P <0.05). Left behind children ( OR =1.27, 95% CI =1.15-1.49) had higher proportions of getting anemia. Meat consumption >3 times per week ( OR =0.81, 95% CI =0.68-0.94) and ≥two types of fresh vegetable consumption every day ( OR =0.84, 95% CI =0.73-0.95) were associated with lower rate of anemia( P <0.05). Conclusion The AP was relatively high in 3-6 year old children in Anhui rural area, especially in those LBC. Anemia should be reduced by improving the caregivers dietary literacy, increasing intakes of animal foods and fresh vegetables.

Gliomas are a group of refractory heterogeneous diseases. Gliomas even at the same pathological type and grade exhibit different outcomes after treatment. Therefore, glioma patients have obvious survival difference. The development of intraoperative auxiliary means has greatly contributed to surgical resection of glioma and remarkably increased therapeutic effects. The development of sensitizer realizes the combination of radiotherapy and chemotherapy and can improve the anti-tumor effects of oral temozolomide. Molecular markers and signal pathways involved in glioma, such as isocitrate dehydrogenase-1 mutation, epidermal growth factor amplification, high expression of vascular endothelial growth factor, Notch signal pathway, miRNA, etc. are involved in the occurrence and development of glioma and have an obvious impact on the proliferation, metastasis and invasion of glioma. They are potential molecular targets for the clinical treatment of glioma. Many different immunotherapy schemes are actively carried out in patients with glioma, but the unique tumor immune microenvironment of the central nervous system needs to be considered. This paper reviews the treatment progress of glioma in recent years.

Objective: o study the effect of cleaning treatment with hydrofluoric acid (HF) on the surface and bonding strength of IPS e.max and Vita Mark II ceramic inlays. Methods: Fifty pieces of IPS e.max and Vita Mark II ceramic inlay specimens were made separately using CAD/CAM. After uniformly bonding surfaces using 9% HF etching, they were randomly divided into an untreated control group (group A) and the following experimental groups: neutralizing powder (B group), 37% phosphoric acid (group C), ultrasonic cleaning (group D) and neutralizing powder + 37% phosphoric acid + ultrasonic cleaning (group E). Each set of 8 specimens was bonded to Variolink N resin adhesive under standard conditions. The shear adhesive strength was measured after exposure to a constant-temperature water bath at 37 ℃ for 24 h. The location of the fracture and the type of adhesion failure were recorded. The shear adhesion and the average strength of the connection were analyzed. The remaining 2 specimens were used for scanning electron microscopy (SEM) to observe the surface morphology, including the crystal structure, pore pattern, and residue. Results : The results were similar for the IPS e.max and Vita Mark II inlays. The maximum bond strength was observed in the IPS e.max ceramic inlays in group E, with an average bond strength 11.96 MPa higher than that in group A. Among the Vita Mark II porcelain inlays, the maximum bond strength was observed in group E. The average bond strength was 9.74 MPa higher than that in group A. The results of the statistical analysis were similar for the IPS e.max and Vita Mark II porcelain inlays, with significant differences in the bond strengths between groups C, D, and E and the control group (P < 0.05). There was no significant difference in the adhesive strength between groups B and A. At the same time, there was no significant difference in the bond strength between the treatment groups B, C, D, and E (P > 0.05). SEM revealed that the pores on the surface of ceramics subjected to the acid etching treatment were broadened and uniform, with less residue than observed in the control group. The effects of treatments D and E were the best. Conclusion The HF etching treatment can enhance the bonding strength of IPS e.max and Vita Mark Ⅱ ceramic inlays while leaving little residue, and the joint strength is highest when the joints are treated together.

Objective To explore the prevalence and influential factors of chronic respiratory system diseases among resi-dents over 1 5 years old in Hubei province and provide evidence for disease prevention.Methods During October to November in 2013,through stratified cluster sampling,we sampled 20 cities or counties.The survey included the the general condition of family, individual,chronic diseases.Results A total of 28 563 residents answered the questionnaire and 423 of them reported chronic re-spiratory system diseases by themselves.The prevalence rate was 14.8‰.These included 229 cases with COPD(54.1%),44 cases with asthma(10.4%),35 cases with chronic pharyngolaryngitis(8.3%)and 1 1 5 cases with other chronic respiratory system disea-ses(27.2%).In urban and rural area,the prevalence rate were 13.6‰ and 1 5.7‰ respectively.Multivariate logistic analysis showed that gender,age,economic status and medical insurance are influential factors of chronic respiratory system diseases.Conclusion Prevalence rate of chronic respiratory system diseases among residents over 1 5 years old in Hubei province was slightly increased and disease control measures should be brought out.