Objective:To investigate the characteristics of cortical morphology in children with attention defi-cit hyperactivity disorder(ADHD)and those with oppositional defiant disorder(ODD)from both categorical and dimensional analyses.Methods:A total of 72 children were enrolled,including 16 children with ADHD and ODD,20 children with ADHD without ODD,and 36 age-gender-matched normal children.The diagnoses were made ac-cording to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)criteria.The Chi-nese Wechsler Intelligence Scale for Children(C-WISC)was used to access intelligence quotient.All subjects par-ticipated in the magnetic resonance imaging(MRI)scan.The features of cortical morphology were determined using FreeSurfer software.Results:Children with ADHD and ODD[(6 528.1±857.5)mm3 vs.(7 591.2±657.3)]and children with ADHD only[(6 867.2±41.3)mm3 vs.(7 591.2±657.3)mm3]had smaller volume in the left later-al superior temporal gyrus(P＜0.05)than controls.No difference was found between ADHD with ODD group and ADHD without ODD group.There was no correlation between the cortical volume of left lateral superior temporal gyrus and ODD symptoms.Conclusion:The reduced cortical volume of left lateral superior temporal gyrus may be an important indication of the abnormal brain structure of ADHD in children.And comorbid status of ODD dose not change this structural variation.

Objective:To investigate the correlation between immune function and age-related pulmonary fibrosis, as well as the potential impact of bacterial lysates on this condition.Methods:Twenty-four healthy male C57BL/6 mice, aged 24, were randomly divided into three groups: a control group(Group N), a pulmonary fibrosis group(Group M), and a pulmonary fibrosis+ bacterial lysis product intervention group(Group P). Mice in Groups M and P were intratracheally injected with bleomycin(5 mg/kg)to induce a mouse pulmonary fibrosis model, while mice in Group N were injected with saline.After modeling, mice in Group P were orally administered 0.4 ml of a bacterial lysis product once a day.After 28 days, lung tissue and blood samples were collected for analysis.Pathological changes in lung tissue were assessed using hematoxylin and tosin staining(HE)and Masson staining and the Ashcroft score.The expression of CD4+ and CD8+ in lung tissue was evaluated using immunohistochemistry.The levels of serum interferon-γ(INF-γ), interleukin-3(IL-13), and immunoglobulin A(IgA)protein were measured using Enzyme-linked Immuno Sorbent Assay(ELISA). The levels of INF-γ and IL-13 mRNA in lung tissue were determined using Real-Time Quantitative Transcription PCR(RT-qPCR). Additionally, the protein expression levels of matrix metalloprotein-9(MMP-9)and tissue inhibitor of metalloproteincise 1(TIMP-1)in lung tissue were assessed using blot analysis.Results:The degree of lung fibrosis was significantly reduced in mice in group P compared with group M when treated with bacterial lysis products.Group M showed a significant decrease in the expression of CD4+ T cells and an increase in the expression of CD8+ T cells( P<0.05)compared to group N. Additionally, the content of IgA was decreased( P<0.05)in group M. On the other hand, group P showed a significant increase in the expression of CD4+ T cells and a decrease in the expression of CD8+ T cells( P<0.05)compared to group M. Furthermore, the content of IgA was elevated( P<0.05)in group P. After bacterial lysis product intervention, mRNA and protein expression levels of IFN-γ were elevated( P<0.05), while mRNA and protein expression levels of IL-13 were reduced( P<0.05). Moreover, protein expression of MMP-9 and TIMP-1 was significantly up-regulated in group M compared with group N( P<0.05), and decreased after bacterial lysis product intervention( P<0.05). Conclusions:It is well-known that immune mechanisms play a crucial role in the development of pulmonary fibrosis.The use of bacterial lysates has been found to effectively regulate immune balance and mitigate the severity of pulmonary fibrosis in elderly mice.

Objective:To investigate the application effect of case-based learning (CBL) based on the clinical case library of stomatology in standardized residency training for comprehensive stomatology.Methods:A total of 52 residents in Department of Stomatology, Chongqing Medical University, were given CBL teaching based on the clinical case library of comprehensive stomatology, and a questionnaire survey was performed to evaluate the teaching effect. Theoretical and skill assessments were performed before and after CBL teaching, and a comparative analysis was performed. SPSS 19.0 software was used for the t-test. Results:The questionnaire survey showed that CBL teaching based on the clinical case library of stomatology effectively improved the ability of independent learning [92.31% (48/52)], the interest in learning [88.46% (46/52)], and the ability for case diagnosis and the accuracy of investigation and judgment [94.23% (49/52)]. This method helped with the mastery and understanding of the theoretical knowledge in stomatology [96.15% (50/52)] and improved the abilities for expression and communication [84.62% (44/52)] and the ability to find and solve problems [94.23% (49/52)]. It also helped to stimulate the interest in scientific research and teaching [82.69% (43/52)] and create an active classroom atmosphere [82.69% (43/52)]. Among these residents, 94.23% (49/52) liked CBL teaching, and 88.64% (46/52) thought the setting of the case library was reasonable. After the application of CBL teaching, there were significant increases in theoretical score [from (66.74±4.25) points to (81.44±7.16) points] and skill examination score [from (64.00±3.14) points to (81.96±7.50) points].Conclusions:CBL teaching based on the case library of stomatology has a good teaching effect in the standardized residency training for comprehensive stomatology and can not only improve the theoretical and skill assessments of residents, but also improve their learning interest and clinical thinking ability.

Objective To evaluate the short-term clinical efficacy of photodynamic therapy(PDT)assisted mechanical debridement(MD)in the treatment of peri-implantitis.Methods According to the new international classification of periodontal diseases and peri-implant diseases in 2018,single tooth implants diagnosed as peri-implantitis were included.Before treatment,the probing depth(PD),modified sulcus bleeding index(mSBI),and modified plaque index(mPLI)were recorded as the baseline,with mSBI≥1 sites as the treatment sites.The MD group was a control group,and only mechanical subgingival debridement was performed.The PDT group was treated with photodynamic therapy twice,immediately after subgingival debridement and one week after.Follow-up was ar-ranged at 6 and 12 weeks after the end of treatment to examine the changes in PD,mSBI,and mPLI at the included implant treatment sites.Results A total of 35 patients were included in this study,with 38 teeth affected by peri-implantitis and 154 treatment sites.The PDT group and MD group included 20 and 18 implants respectively,with a total of 78 treatment sites included in the PDT group,51 sites with PD≥6 mm,and 27 sites with PD＜6 mm.A total of 76 treatment sites were included in the MD group,including 53 sites with PD≥6 mm and 23 sites with PD＜6 mm.At baseline,there was no statistically significant difference in PD,mSBI,and mPLI between the two groups.At 6 and 12 weeks after treatment,there were statistically significant differences in clinical indicators between the two groups compared to baseline(P＜0.05).Among them,the mSBI in the PDT group was significantly lower than that in the MD group at 6 weeks after treatment(P＜0.05).At sites with PD≥6 mm,the mSBI of the PDT group was significantly lower than that of the MD group at 6 and 12 weeks after treatment(P＜0.05).The number of implants in the PDT group and MD group that reached the treatment endpoint at 12 weeks follow-up was 70.00%and 55.56%,respectively,and there was no difference between the two groups(P＞0.05).Conclusion Photodynamic therapy assisted with mechanical debridement can effectively treat peri-implantitis and is a safe and ef-fective auxiliary method,and has significant therapeutic effects on in-flammation control and improvement of mSBI in those sites with PD≥6 mm.

OBJECTIVE To screen and identify the differential substance bases of Pinellia ternate and its different concoctions,conduct network pharmacological analysis on the common and differential substance bases,and explore the relationship between the substance bases and the changes in the efficacy of Pinellia ternate before and after concoction based on the UPLC-Q-TOF-MS/MS and multivariate statistical analysis.METHODS The main substance bases of 42 batches of samples were examined by UPLC-Q-TOF-MS/MS,and the differential components were screened by orthogonal partial least squares discriminant analysis(OPLS-DA)with VIP>1.5,P<0.01 and FC>2 or<0.5 as the screening criteria.The targets were further retrieved from the TCMIP database,and their protein interactions were analysed by GO enrichment and KEGG enrichment to visualise the"herbal-component-target-pathway"map.RESULTS Compared with Pinellia ternate,Pinelliae Rhizoma Praeparatum has 14 different components,mainly glycyrrhetinic acid,glycyrrhizic acid and glycyrrhizin,etc.The components with reduced content were mainly amides.There were 18 differential constituents between raw and ginger,mainly nucleosides,flavonoids and amino acids.The content of guanosine,xanthine and tyrosine was reduced,while the content of adenosine monophosphate was increased.There were 18 differential components between raw and Pinelliae Rhizoma Praeparatum Cum Alumine,and the relative content of many components in Pinelliae Rhizoma Praeparatum Cum Alu-mine was reduced,such as sphingomyelin.Further,the TCMIP database was used to retrieve targets from the differential substance base,and protein interaction analysis was performed on the targets,resulting in 67 core targets for Pinellia ternate,45 core targets for Pinelliae Rhizoma Praeparatum,and 38 core targets for Pinelliae Rhizoma Praeparatum cum Zingibere Et Alumine.Finally,the meta-bolic pathways were analyzed by GO enrichment and KEGG enrichment.CONCLUSION The UPLC-Q-TOF-MS/MS method estab-lished in this experiment can better isolate and identify the chemical components in Pinellia ternate.Combined with multivariate statisti-cal analysis and network pharmacology,the material basis and potential mechanism of action of Pinellia ternate and its concoction prod-ucts can provide ideas for the study of the action targets and provide data support for the rational clinical application of Pinellia ternate and its concoction products.

Objective:To explore the characteristics of parental emotional regulation(ER)and its influence on the ER of children with attention deficit hyperactivity disorder(ADHD).Methods:A total of 140 children with ADHD meeting the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)criteria and their parents,68 normal controls and their parents were recruited.ER was assessed using the Difficulties in Emotion Regulation Scale(DERS),Emotion Regulation Questionnaire(ERQ)and Emotion Regulation Checklist(ERC).Re-sults:Higher scores of DERS in emotion regulation strategies,impulse control and goal-directed behavior were found in parents of children with ADHD compared with parents of normal controls(Ps＜0.05).The higher emo-tional lability(EL)of ERC and lower ER of ERC detected in children with ADHD were correlated with the emo-tion regulation strategies,impulse control and goal-directed behavior of their parents(Ps＜0.01).The mediation an-alyses suggested that ER in children with ADHD may mediate the relationship of parental emotion regulation strate-gies and parental impulse control with children's EL.Conclusion:Parents of children with ADHD may exhibit emo-tional dysregulation in multiple subdimensions which might affect emotional regulation and aggravate the emotional lability of children with ADHD.

Objective:To explore the characteristics of delay discounting and non-systematic response data in intertemporal choice of adults with attention deficit hyperactivity disorder(ADHD),and to explore the best data processing strategy for delay discounting task.Methods:Totally 108 adults with ADHD meeting the diagnostic cri-teria of the Diagnostic and Statistical Manual of Mental Health Disorder,Fifth Edition(DSM-5)and 87 gender matched normal controls were enrolled.ADHD symptoms were assessed using the ADHD Symptom Rating Scale,the delay discounting task was used to measure the delay discounting rate,and a model-free algorithm was used to i-dentify non-systematic response data.Results:There was no significant difference in the proportion of non-systemat-ic response data between ADHD group and normal control group(P＞0.05).In the data sets using different data screening strategies,the delay discounting rates were higher in the ADHD group than in the normal control group(Ps＜0.05).The delay discounting rates were positively correlated with the hyperactive impulse scores(r=0.24,P=0.001),the inattention scores(r=0.20,P＜0.01)and the total scores of ADHD symptom Rating Scale(r=0.22,P＜0.01).Conclusion:Adults with ADHD prefer to obtain immediate small rewards in intertemporal choice.The immediate preference of intertemporal choice may be mainly related to hyperactive impulsive symp-toms.Exclusion strategy of non-systematic response data may be more applicable to delay discount task research.

Objective:To investigate and explore the clinical significance of the expression levels and differences of autophagy related genes ATG3, ATG5, ATG12, ATG16, LC3 and Beclin-1 in peripheral blood mononuclear cells of patients with refractory moderate-to-severe rheumatoid arthritis (RA), who were treated with abatacept.Methods:Peripheral blood samples of 30 patients admitted to the affiliated hospital of North Sichuan Medical College from June 2020 to June 2022 were collected before and after abatacept treatment. Autophagy associated genes were detected by RT-qPCR and, autophagy associated proteins were detected by Western Blot. Correlation analysis with clinical parameters was performed. SPSS26.0 and GraphPad Prism 9.0 were used for statistical analysis, Independent sample t-test was used for comparison between groups, and non-normal distribution data were expressed as M ( Q1, Q3), Spearman correlation analysis was used to analyze the correlation between variables, and P<0.05 was considered statistically significant. Results:①Compared with the mRNA expression levels of ATG12(0.007 6±0.005 9), ATG16(0.003 1±0.002 2) and LC3(0.038 2±0.017 1) before treatment, after 24 weeks treatment with abatacept, the mRNA expression levels of ATG12 (0.011 4±0.003 1) and ATG16 (0.004 2±0.000 7) increased ( t=-2.49, P=0.042; t=-2.15, P=0.038), and the mRNA expression level of LC3 (0.022 6±0.008 3) was decreased ( t=3.28, P=0.003) after 24 weeks of abatacept treatment.②After 24 weeks, the expression level of ATG16 mRNA in the remission group (0.004 8±0.000 8) was higher than that in the non-remission group (0.003 8±0.000 3) ( t=-3.41, P=0.003). The expression level of LC3 mRNA in remission group (0.027 3±0.007 3) was lower than that in non-remission group (0.017 9±0.006 5) ( t=3.69, P=0.017). ③ATG5 mRNA expression level was positively correlated with TJC, ESR and anti-CCP antibody ( r=0.75, P=0.049; r=0.43, P=0.044; r=0.97, P=0.011). The expression level of ATG12 mRNA was negatively correlated with DAS28, ESR and hsCRP ( r=-0.46, P=0.025; r=-0.51, P=0.026; r=-0.41, P=0.031). The expression level of ATG16 mRNA was positively correlated with ESR and hsCRP ( r=0.50, P=0.030; r=0.40, P=0.024). The expression level of Beclin-1 mRNA was significantly higher than TJC, RF-IgG and anti-CCP antibody were negatively correlated ( r=-0.51, P=0.025; r=-0.42, P=0.035; r=-0.81, P=0.043). The expression level of LC-3 mRNA was positively correlated with ESR and hsCRP ( r=0.55, P=0.028; r=0.56, P=0.024). ④Compared with the protein expression level before the treatment, of ATG12 (0.675 3±0.036 3), which (1.547 7±0.080 5) increased after 24 weeks of treatment ( t=-7.80, P=0.001). Compared with the protein expression levels of ATG16 (0.817 1±0.089 0), LC3Ⅱ (0.807 1±0.072 1) and IL-1β (1.129 7±0.118 9) before treatment, 24 weeks after, the protein expression levels of ATG16 (0.424 6±0.103 5), LC3Ⅱ (0.353 7±0.056 9) and IL-1β (0.346 7±0.050 8) decreased ( t=2.62, P=0.042; t=2.88, P=0.045; t=2.25, P=0.038) 24 weeks after treatment. Conclusion:Autophagy related genes is associated with several clinical presentations and disease activity. The results of this study suggest that autophageius are involved in the pathogenesis of RA. Abatacept may be a potential autophage modulator by regulating autophagy related genes including ATG12、ATG16 and LC3.

The patient, an 84-year-old man, was admitted to the hospital with "low back pain with limitation of movement for more than half a year". Admission examination: mild kyphotic deformity of the spine, significant tenderness and percussion pain in the lower back, bilateral lower limb muscle strength graded 5, normal skin sensation. Lumbar MRI and CT revealed a compressive fracture of the L 4 vertebra. Dual-energy X-ray absorptiometry (DEXA) indicated a bone mineral density T-score of -2.6, suggesting osteoporosis. Admission diagnosis: osteoporotic compressive fracture of the L 4 vertebra. The patient underwent thorough examinations to exclude surgical contraindications. On the fourth day of admission, the patient underwent percutaneous vertebroplasty of the L 4 vertebra. At the end of the operation, the patient became unresponsive, with a blood pressure drop to 94/63 mmHg and oxygen saturation falling to 80%. Cranial CT showed multiple punctate gas density shadows within the brain. Lumbar CT revealed gas accumulation in the soft tissue adjacent to the lumbar spinous processes, localized intraductal gas, and punctate gas density shadows within the vessels in both groin areas. The diagnosis was intracranial arterial gas embolism. The patient's condition deteriorated further, with loss of consciousness, neck stiffness, increased muscle tone of both lower limbs, and positive Babinski's sign on both sides. Symptomatic treatments included brain protection, maintaining cerebral perfusion, and improving collateral cerebral circulation, but the patient did not regain consciousness. The patient developed a pulmonary infection one month postoperatively and died three months postoperatively due to respiratory failure. This case highlights the potential risk of gas embolism during vertebroplasty. Measures to reduce such complications should be implemented, such as minimizing the duration of venous blood-air contact, pre-filling the cannula with saline to reduce the venous blood-air interface, and appropriately increasing venous pressure to reduce the risk of gas entry. It is recommended to use smaller diameter catheters. For patients with pre-existing cardiac conditions or elderly patients, preoperative cardiac Doppler ultrasound should be performed to exclude anatomical abnormalities such as patent foramen ovale.

Objective To evaluate the effectiveness of internet-based decision aids(DA)in colorectal cancer screening.Methods Randomized controlled trials of efficacy of internet-based DA in colorectal cancer screening were searched by computer from CNKI,Wanfang Data,VIP,CBM,PubMed,the Cochrane Library,Embase and Web of Science.The retrieval period was from the establishment of the database to June 2023.Descriptive analysis was used to analyze the main contents and summarize their clinical application effects.Results A total of 12 literatures were included,including 6038 subjects,of which 3089 were in experimental group and 2949 were in control group.The results showed that the contents of internet-based DA mainly included basic information support,benefits and risks of colorectal cancer screening,and clarification of patients'personal values.It could help patients enhance screening willingness,improve informed decision-making ability,reduce decision-making conflicts,and promote the positive role of patients in decision-making.Patients have higher satisfaction with internet-based DA.Conclusion Internet-based DA has shown positive results in the application of colorectal cancer screening,and has unique advantages over the traditional paper version of the manual,but it still has certain limitations.In the future,we can learn from the relevant theoretical achievements of foreign decision-making assistance,research and develop a more comprehensive DA for colorectal cancer screening combined with China's national conditions.