Abstract Objective: To examine the mental health status and related factors in children and adolescents, and to assess age groups and sexes differences in factors influencing mental health. Methods: This cross-sectional study was performed on Chinese children aged 6-18 years from November 2021 to January 2022. Mental health difficulties were accessed by the Strengths and Difficulties Questionnaire. Multivariate logistic regression was used to analyze factors associated with mental health status. Multiple linear regression was used to evaluate factors associated with the scores of the Strengths and Difficulties Questionnaire. Results: The prevalence of mental health difficulties was 12.98% (n =1348). Age (OR, 0.909, [95%CI, 0.830-0.996]), sex (OR, 1.424, [95%CI, 1.033-1.963]) and screen time on weekdays (“≥2” h/d vs “< 1” h/d: OR, 2.001, [95%CI, 1.300-3.080]) were related factors for mental health difficulties. For children (year ≤ 12), the strongest related factor for mental health difficulties was screen time on weekdays (“≥ 2” h/d vs “< 1” h/d: OR, 1.821 [95%CI, 1.203-2.755]). The risk of mental health difficulties in females with ≥ 2 h/d screen time on weekends was 3.420 times higher than those with < 1 h/d (OR, 3.420, [95%CI, 1.923-6.081]). Conclusion: The prevalence of mental health difficulties among children and adolescents was relatively high. The lower age, female sex and excessive screen time were associated with a higher risk of mental health difficulties. The factors influencing mental health varied by different age groups and sexes. Thus, specific measures for different age groups and sexes should be adopted to mitigate the impact. Objective Methods crosssectional cross sectional 618 6 18 6-1 202 2022 Questionnaire Results 1298 12 98 12.98 n =1348. 1348 =1348 . =1348) OR (OR 0909 0 909 0.909 95%CI, 95CI CI 95 [95%CI 0.8300.996, 08300996 0.830 0.996 , 830 996 0.830-0.996]) 1424 424 1.424 1.0331.963 10331963 1.033 1.963 033 963 1.033-1.963] ≥2 (“≥2 hd h d “ 2001 001 2.001 1.3003.080 13003080 1.300 3.080 300 3 080 1.300-3.080] year 12, 12) (“ 1821 821 1.82 1.2032.755. 12032755 1.203 2.755 203 755 1.203-2.755]) 3420 420 3.42 1.9236.081. 19236081 1.923 6.081 923 081 1.923-6.081]) Conclusion high Thus impact 61 6- 20 129 9 12.9 134 =134 090 90 0.90 95%CI 8300 0.8300.996 0830099 0830 0.83 0996 0.99 83 99 0.830-0.996] 142 42 1.42 0331 1.0331.96 1033196 1033 1.03 1963 1.96 03 96 1.033-1.963 200 00 2.00 3003 1.3003.08 1300308 1300 1.30 3080 3.08 30 08 1.300-3.080 ( 182 82 1.8 2032 1.2032.755 1203275 1203 1.20 2755 2.75 75 1.203-2.755] 342 3.4 9236 1.9236.081 1923608 1923 1.92 6081 6.08 92 1.923-6.081] 12. 13 =13 09 0.9 0.8300.99 083009 083 0.8 099 8 0.830-0.996 14 4 1.4 1.0331.9 103319 103 1.0 196 1.9 1.033-1.96 2.0 1.3003.0 130030 130 1.3 308 3.0 1.300-3.08 1. 1.2032.75 120327 120 1.2 275 2.7 7 1.203-2.755 34 3. 1.9236.08 192360 192 608 6.0 1.923-6.081 =1 0. 0.8300.9 08300 0.830-0.99 1.0331. 10331 10 19 1.033-1.9 2. 1.3003. 13003 1.300-3.0 1.2032.7 12032 27 1.203-2.75 1.9236.0 19236 60 6. 1.923-6.08 = 0.8300. 0.830-0.9 1.0331 1.033-1. 1.3003 1.300-3. 1.2032. 1.203-2.7 1.9236. 1.923-6.0 0.8300 0.830-0. 1.033-1 1.300-3 1.2032 1.203-2. 1.9236 1.923-6. 0.830-0 1.033- 1.300- 1.203-2 1.923-6 0.830- 1.203- 1.923-

ABSTRACT Objective: To evaluate objective treatment efficacy and safety, and subjective patient-reported outcomes in patients with complex ureteral strictures (US) undergoing minimally invasive lingual mucosal graft ureteroplasty (LMGU). Materials and Methods: We prospectively enrolled patients underwent robotic or laparoscopic LMGU between May 2020 and July 2022. Clinical success was defined as symptom-free and no radiographic evidence of re-obstruction. Patient-reported outcomes, including health-related quality of life (HRQoL), mental health status and oral health-related quality of life (OHRQoL), were longitudinally evaluated before surgery, 6 and 12 months postoperatively. Results: Overall, 41 consecutive patients were included. All procedures were performed successfully with 32 patients in robotic approach and 9 in laparoscopic. Forty (97.56%) patients achieved clinical success during the median follow-up of 29 (range 15-41) months. Although patients with complex US experienced poor baseline HRQoL, there was a remarkable improvement following LMGU. Specifically, the 6-month and 12-month postoperative scores were significantly improved compared to the baseline (p < 0.05) in most domains. Twenty-eight (68.3%) and 31 (75.6%) patients had anxiety and depression symptoms before surgery, respectively. However, no significant decrease in the incidence of these symptoms was observed postoperatively. Moreover, there was no significant deterioration of OHRQoL at 6 months and 12 months postoperatively when compared to the baseline. Conclusions: LMGU is a safe and efficient procedure for complex ureteral reconstruction that significantly improves patient-reported HRQoL without compromising OHRQoL. Assessing patients’ quality of life enables us to monitor postoperative recovery and progress, which should be considered as one of the criteria for surgical success. Objective safety patientreported patient reported (US . (LMGU) Methods 202 2022 symptomfree symptom free reobstruction. reobstruction re obstruction. obstruction re-obstruction Patientreported Patient healthrelated related , (HRQoL) OHRQoL, (OHRQoL) surgery 1 Results Overall 4 included 3 97.56% 9756 97 56 (97.56% followup follow up 2 range 1541 15 15-41 Specifically 6month month 12month p 0.05 005 0 05 domains Twentyeight Twenty eight 68.3% 683 68 (68.3% 75.6% 756 75 (75.6% respectively However Moreover Conclusions progress (LMGU 20 (HRQoL (OHRQoL 97.56 975 5 (97.56 154 15-4 0.0 00 68.3 (68.3 75.6 7 (75.6 97.5 (97.5 15- 0. 68. (68. 75. (75. 97. (97. (68 (75 (97 (6 (7 (9 (

Abstract Objectives To investigate the impact of Three-Dimensional (3D) laparoscopy compared to traditional laparotomy on serum tumor markers and coagulation function in patients diagnosed with early-stage Endometrial Cancer (EC). Method The authors retrospectively analyzed the clinical data of 75 patients diagnosed with early-stage EC and categorized them into two groups based on the surgical techniques employed. The 3D group consisted of 36 patients who underwent 3D laparoscopic surgery, while the Laparotomy group comprised 39 patients who underwent traditional laparotomy. The authors then compared the alterations in serum tumor markers and coagulation function between the two groups. Results Postoperatively, serum levels of CA125, CA199, and HE4 were notably reduced in both groups on the third day, with the levels being more diminished in the 3D group than in the Laparotomy Group (p < 0.05). Conversely, FIB levels escalated significantly in both groups on the third-day post-surgery, with a more pronounced increase in the 3D group. Additionally, PT and APTT durations were reduced and were more so in the 3D group than in the laparotomy group (p < 0.05). Conclusions When juxtaposed with traditional laparotomy, 3D laparoscopic surgery for early-stage EC appears to be more efficacious, characterized by reduced complications, and expedited recovery. It can effectively mitigate serum tumor marker levels, attenuate the inflammatory response and damage to immune function, foster urinary function recovery, and enhance the quality of life. However, it exerts a more significant influence on the patient's coagulation parameters, necessitating meticulous prevention and treatment strategies for thromboembolic events in clinical settings. ThreeDimensional Three Dimensional D (3D earlystage early stage EC. . (EC) 7 employed 3 Postoperatively CA125 CA CA199 HE day p 0.05. 005 0.05 0 05 0.05) Conversely thirdday postsurgery, postsurgery post post-surgery Additionally efficacious complications recovery life However patient s parameters settings (EC CA12 CA19 00 0.0 CA1 0.

ABSTRACT CONTEXT: Scrub typhus, caused by Orientia tsutsugamushi, has a wide range of clinical manifestations, including meningoencephalitis, acute renal failure, pneumonitis, myocarditis, and septic shock. However, there are no documented cases of scrub typhus with hypokalemia. In this report, we present a case of scrub typhus with hypokalemia and multiple organ failure syndrome, highlighting the importance of electrolyte imbalance in patients with scrub typhus. CASE REPORT: A 59-year-old woman presented to the emergency department with abdominal pain that had been present for 1 day. On admission, the physical examination and laboratory test results indicated that the patient had renal, liver, and circulatory failure, and hypokalemia. She developed meningitis and disseminated intravascular coagulation during hospitalization. She recovered with appropriate management, and was discharged on day 17. CONCLUSION: This report highlights the potential for atypical presentations of scrub typhus, including a previously undocumented association with hypokalemia. Although the contribution of hypokalemia to the patient’s clinical course remains uncertain, this case underscores the importance of considering electrolyte imbalance in the management of patients with scrub typhus. Further research is warranted to better understand the relationship between scrub typhus and electrolyte imbalance. CONTEXT tsutsugamushi manifestations meningoencephalitis pneumonitis myocarditis shock However syndrome REPORT 59yearold yearold 59 year old admission liver hospitalization 17 CONCLUSION s uncertain 5

Abstract Objective To explore the feasibility of injectable platelet-rich fibrin (i-PRF) in regenerative endodontics by comparing the effect of i-PRF and platelet-rich fibrin (PRF) on the biological behavior and angiogenesis of human stem cells from the apical papilla (SCAPs). Methodology i-PRF and PRF were obtained from venous blood by two different centrifugation methods, followed by hematoxylin-eosin (HE) staining and scanning electron microscopy (SEM). Enzyme-linked immunosorbent assay (ELISA) was conducted to quantify the growth factors. SCAPs were cultured with different concentrations of i-PRF extract (i-PRFe) and PRF extract (PRFe), and the optimal concentrations were selected using the Cell Counting Kit-8 (CCK-8) assay. The cell proliferation and migration potentials of SCAPs were then observed using the CCK-8 and Transwell assays. Mineralization ability was detected by alizarin red staining (ARS), and angiogenesis ability was detected by tube formation assay. Real-time quantitative polymerase chain reaction (RT-qPCR) was performed to evaluate the expression of genes related to mineralization and angiogenesis. The data were subjected to statistical analysis. Results i-PRF and PRF showed a similar three-dimensional fibrin structure, while i-PRF released a higher concentration of growth factors than PRF ( P <.05). 1/4× i-PRFe and 1/4× PRFe were selected as the optimal concentrations. The cell proliferation rate of the i-PRFe group was higher than that of the PRFe group ( P <.05), while no statistical difference was observed between them in terms of cell mitigation ( P >.05). More importantly, our results showed that i-PRFe had a stronger effect on SCAPs than PRFe in facilitating mineralization and angiogenesis, with the consistent result of RT-qPCR ( P <.05). Conclusion This study revealed that i-PRF released a higher concentration of growth factors and was superior to PRF in promoting proliferation, mineralization and angiogenesis of SCAPs, which indicates that i-PRF could be a promising biological scaffold for application in pulp regeneration. plateletrich platelet rich iPRF i (i-PRF (PRF SCAPs. . (SCAPs) methods hematoxylineosin hematoxylin eosin HE (HE SEM. SEM (SEM) Enzymelinked Enzyme linked ELISA (ELISA iPRFe (i-PRFe PRFe, , (PRFe) Kit8 Kit 8 Kit- CCK8 CCK (CCK-8 CCK- assays ARS, ARS (ARS) Realtime Real time RTqPCR RT qPCR (RT-qPCR analysis threedimensional three dimensional structure <.05. 05 <.05 <.05) 14 1 4 1/4 <.05, >.05. >.05 >.05) importantly regeneration (SCAPs (SEM (PRFe (CCK- (ARS 0 <.0 1/ >.0 (CCK <. >. < >

ABSTRACT Introduction: This study aimed to investigate the predictive value of the vasoactive-inotropic score (VIS) at different time points for postoperative prolonged mechanical ventilation (PMV) in adult congenital heart disease patients undergoing surgical treatment combined with coronary artery bypass grafting. Methods: Patients were divided into two groups that developed PMV or not. The propensity score matching method was applied to reduce the effects of confounding factors between the two groups. VIS at different time points (VIS at the end of surgery, VIS6h, VIS12h, and VIS12h max) after surgery were recorded and calculated. The value of VIS in predicting PMV was analyzed by the receiver operating characteristic (ROC) curve, and multivariate logistic regression was used to analyze independent risk factors. Results: Among 250 patients, 52 were in the PMV group, and 198 were in the non-PMV group. PMV rate was 20.8%. After propensity score matching, 94 patients were matched in pairs. At each time point, the area under the ROC curve predicted by VIS for PMV was > 0.500, among which VIS at the end of surgery was the largest (0.805). The optimal cutoff point for VIS of 6.5 could predict PMV with 78.7% sensitivity and 72.3% specificity. VIS at the end of surgery was an independent risk factor for PMV (odds ratio=1.301, 95% confidence interval 1.091~1.551, P<0.01). Conclusion: VIS at the end of surgery is an independent predictor for PMV in patients with adult congenital heart disease surgical treatment combined with coronary artery bypass grafting. Introduction vasoactiveinotropic vasoactive inotropic (PMV grafting Methods not VIS6h VISh h max calculated (ROC Results 25 5 group 19 nonPMV non 208 20 8 20.8% 9 pairs 0500 0 500 0.500 0.805. 0805 0.805 . 805 (0.805) 65 6 6. 787 78 7 78.7 723 72 3 72.3 specificity odds ratio1301 ratio 1 301 ratio=1.301 95 10911551 091 551 1.091~1.551 P<0.01. P001 P P<0.01 01 P<0.01) Conclusion 2 20.8 050 50 0.50 080 0.80 80 (0.805 78. 72. ratio130 30 ratio=1.30 1091155 09 55 1.091~1.55 P00 P<0.0 20. 05 0.5 08 0.8 (0.80 ratio13 ratio=1.3 109115 1.091~1.5 P0 P<0. 0. (0.8 ratio1 ratio=1. 10911 1.091~1. P<0 (0. ratio=1 1091 1.091~1 P< (0 ratio= 109 1.091~ ( 10 1.091 1.09 1.0 1.

Resumo Fundamento: A associação entre a duração do sono e a aterosclerose foi relatada em muitos estudos observacionais. No entanto, pouco se sabe sobre a sua importância como fator de risco para aterosclerose ou como consequência negativa da aterosclerose. Objetivo: Este estudo teve como objetivo avaliar a associação causal entre a duração do sono e o risco de aterosclerose usando estatísticas resumidas de estudos de associação genômica ampla (GWAS) disponíveis publicamente. Métodos: Empregamos um método de randomização mendeliana (RM) de duas amostras com 2 coortes do MRC-IEU (n = 460.099) e do UK Biobank (n = 361.194) para investigar a associação causal entre a duração do sono e o risco de aterosclerose. Três métodos, incluindo a técnica de variância inversa ponderada (IVW), escore de perfil ajustado robusto (RAPS) e abordagem de mediana simples e ponderada, foram usados para obter resultados confiáveis, e uma razão de chances com intervalo de confiança (IC) de 95% foi calculada. P<0,05 foi considerado diferença estatística. Além disso, foram utilizadas análises de regressão: MR-Egger regression, Radial MR, MR-PRESSO e leave-one-out para avaliar os possíveis efeitos de pleiotropia. Resultados: Não foi encontrada associação causal entre duração do sono e aterosclerose [OR (IC95%): 0,90 (0,98-1,00), p = 0,186]. As análises Leave-one-out, MR-Egger, e MR-PRESSO não conseguiram detectar pleiotropia horizontal. Conclusões: Esta análise de RM não indicou nenhuma associação causal entre a duração do sono geneticamente prevista e a aterosclerose nas populações europeias. Fundamento observacionais entanto Objetivo GWAS (GWAS publicamente Métodos (RM MRCIEU MRC IEU n 460.099 460099 460 099 361.194 361194 361 194 métodos IVW, IVW , (IVW) RAPS (RAPS confiáveis IC (IC 95 calculada P005 P 0 05 P<0,0 estatística disso regressão MREgger MR Egger regression MRPRESSO PRESSO leaveoneout leave one out Resultados OR IC95% IC95 (IC95%) 090 90 0,9 0,981,00, 098100 0,98 1,00 98 1 00 (0,98-1,00) 0,186. 0186 0,186 . 186 0,186] Leaveoneout, Leaveoneout Leave out, Leave-one-out MREgger, Egger, horizontal Conclusões europeias 460.09 46009 46 09 361.19 36119 36 19 (IVW 9 P00 P<0, IC9 (IC95% 0, 981 0,981,00 09810 098 100 1,0 (0,98-1,00 018 0,18 18 460.0 4600 4 361.1 3611 3 P0 P<0 (IC95 0,981,0 0981 10 1, (0,98-1,0 01 0,1 460. 361. P< (IC9 0,981, (0,98-1, 0,981 (0,98-1 (0,98- (0,98 (0,9 (0, (0 (

Abstract Background: The association between the length of sleep and atherosclerosis has been reported in many observational studies. However, little is known about its significance as a risk factor for atherosclerosis or as a negative consequence of atherosclerosis. Objective: This study aimed to assess the causal association between sleep duration and the risk of atherosclerosis using publicly available genome-wide association studies (GWAS) summary statistics. Methods: We employed a two-sample Mendelian randomization (MR) method with 2 cohorts from MRC-IEU (n=460,099) and UK Biobank (n=361,194) to investigate the causal association between sleep duration and the risk of atherosclerosis. Three methods including the inverse-variance weighted (IVW) technique, Robust adjusted profile score (RAPS), and simple-and weighted-median approach were used to obtain reliable results, and an odds ratio with a 95% confidence interval (CI) was calculated. P<0.05 was considered as a statistical difference. In addition, MR-Egger regression, Radial MR, MR-PRESSO, and leave-one-out analyses were used to assess the possible pleiotropy effects. Results: No causal association of sleep duration with atherosclerosis was found [OR (95%CI): 0.90 (0.98-1.00), p = 0.186]. Leave-one-out, MR-Egger, and MR-PRESSO analyses failed to detect horizontal pleiotropy. Conclusions: This MR analysis indicated no causal association between genetically predicted sleep duration and atherosclerosis across European populations. Background However Objective genomewide genome wide GWAS (GWAS statistics Methods twosample two sample (MR MRCIEU MRC IEU n=460,099 n460099 n 460 099 (n=460,099 n=361,194 n361194 361 194 (n=361,194 inversevariance inverse variance IVW (IVW technique RAPS, RAPS , (RAPS) simpleand simple weightedmedian median results 95 CI (CI calculated P005 P 0 05 P<0.0 difference addition MREgger Egger regression MRPRESSO, MRPRESSO PRESSO, PRESSO leaveoneout leave one out effects Results OR 95%CI 95CI (95%CI) 090 90 0.9 0.981.00, 098100 0.98 1.00 98 1 00 (0.98-1.00) 0.186. 0186 0.186 . 186 0.186] Leaveoneout, Leaveoneout Leave out, Leave-one-out MREgger, Egger, Conclusions populations n=460,09 n46009 46 09 (n=460,09 n=361,19 n36119 36 19 (n=361,19 (RAPS 9 P00 P<0. (95%CI 0. 981 0.981.00 09810 098 100 1.0 (0.98-1.00 018 0.18 18 n=460,0 n4600 4 (n=460,0 n=361,1 n3611 3 (n=361,1 P0 P<0 0.981.0 0981 10 1. (0.98-1.0 01 0.1 n=460, n460 (n=460, n=361, n361 (n=361, P< 0.981. (0.98-1. n=460 n46 (n=460 n=361 n36 (n=361 0.981 (0.98-1 n=46 n4 (n=46 n=36 n3 (n=36 (0.98- n=4 (n=4 n=3 (n=3 (0.98 n= (n= (0.9 (n (0. (0 (

Abstract Objectives: The degree of endolymphatic hydrops in Meniere’s disease may be related to hearing loss. However, the results of prior studies have been inconsistent. We aimed to investigate the relationship between endolymphatic hydrops and hearing loss characteristics in Meniere’s disease. Methods: This study included 54 patients (62 ears) with Meniere’s disease. Patients underwent three-dimensional real inversion recovery sequences for magnetic resonance imaging and puretone audiometry. Endolymphatic hydrops were assessed according to Gurkov’s criteria (2011). Correlations between different degrees of endolymphatic hydrops and pure-tone audiometry, as well as staging, were analysed. Results: Pure tone audiometry and staging were higher for vestibular endolymphatic hydrops complicated by cochlear ones than isolated cochlear or vestibular hydrops (both p<0.05). There was no significant correlation between vestibular endolymphatic hydrops and pure-tonal audiometry or staging (all p > 0.05). The degree of hydrops in the middle turn was correlated with the mid-frequency hearing threshold (p<0.05). The degree of cochlear hydrops was correlated with the audiometry, low-frequency hearing thresholds, mid-frequency hearing thresholds and staging (p<0.01). Conclusion: The types and sites of endolymphatic hydrops based on a 3D-real inversion recovery sequence can be used to indicate the degree of hearing loss in patients with Meniere's disease. Level of evidence: Level III. Objectives Menieres Meniere s However inconsistent Methods 5 62 (6 ears threedimensional three dimensional Gurkovs Gurkov 2011. 2011 . (2011) pure analysed Results both p<0.05. p005 p<0.05 0 05 p<0.05) puretonal tonal all 0.05. 005 0.05 0.05) midfrequency mid frequency (p<0.05) lowfrequency low p<0.01. p001 p<0.01 01 (p<0.01) Conclusion 3Dreal Dreal 3D D evidence III 6 ( 201 (2011 p00 p<0.0 00 0.0 (p<0.05 (p<0.01 20 (201 p0 p<0. 0. (p<0.0 2 (20 p<0 (p<0. (2 p< (p<0 (p< (p

Resumen Antecedentes: La enfermedad de injerto contra huésped (EICH) es una complicación importante después del trasplante alogénico de células madre hematopoyéticas. Objetivos: Para dilucidar el papel de TLR4, el principal receptor de LPS bacteriano, en el desarrollo de GVHD, construimos un modelo de GVHD en ratones knockout para TLR4 (TLR4-/-) y monitoreamos el quimerismo celular. Métodos: En este estudio, usamos PCR para identificar si se establecieron ratones knockout para TLR4 (TLR4-/-). Antes del trasplante, pretratamos a los ratones con irradiación para obtener la dosis de irradiación adecuada. Se aplicó citometría de flujo para medir el estado de quimerismo, las distribuciones de APC y células T en ratones receptores TLR4+/+ y TLR4-/-. Resultados: El estado general de los receptores de TLR4-/- fue mejor que el de los receptores de TLR4+/+, y los ratones receptores de TLR4-/- mostraron manifestaciones de GVHD menos graves que los ratones receptores de TLR4+/+. La mayoría de las APC y las células T en el bazo del ratón huésped se derivaron de las células del donante, y las células T CD4+, incluidas las células T de memoria, se encontraban en su mayoría en los ratones huéspedes. Conclusión: En general, nuestros datos muestran que la eliminación de TLR4 atenuó el desarrollo de GVHD, lo que sugiere que TLR4 podría usarse como un nuevo objetivo y paradigma terapéutico en las terapias de GVHD.

Abstract Background: Graft-versus-host disease (GVHD) is a major complication after allogeneic hematopoietic stem cell transplantation. Objective: To elucidate the role of Toll-like receptor 4 (TLR4), the major receptor for bacterial lipopolysaccharide, in the development of GVHD, we constructed a GVHD model in TLR4 knockout (TLR4-/-) mice and monitored the cell chimerism. Methods: In this study, we used polymerase chain reaction to identify whether TLR4 knockout (TLR4-/-) mice were established. Before transplantation, we pretreated mice with irradiation so as to obtain an appropriate irradiation dose. Flow cytometry was applied to measure the chimerism status, the distributions of antigen-presenting cells (APCs), and T-cells in TLR4+/+ and TLR4-/- recipient mice. Results: The general condition of TLR4-/- recipients was better than that of TLR4+/+ recipients, and the TLR4-/- recipient mice showed less severe GVHD manifestations than the TLR4+/+ recipient mice. Most of the APCs and T-cells in the host mouse spleen were derived from donor cells, and CD4+ T-cells, including memory T-cells, were in the majority in host mice. Conclusion: In general, our data show that TLR4 deletion attenuated GVHD development, which suggests that TLR4 could be used as a novel target and therapeutic paradigm in GVHD therapies.

Abstract Background Currently, only a few studies have described the general characteristics of patients with primary Sjögren's syndrome (pSS) who tested negatives for anti-SSA and anti-SSB antibodies. We aimed to further investigate the clinical characteristics of these patients in a large sample. Methods Data from patients with pSS who were treated at a tertiary hospital in China between 2013 and 2022 were retrospectively analyzed. Clinical characteristics of the patients were compared between those with and without anti-SSA and anti-SSB antibody negativity. Factors associated with anti-SSA and anti-SSB negativity were identified by logistic regression analysis. Results Overall, 934 patients with pSS were included in this study, among whom 299 (32.0%) tested negative for anti-SSA and anti-SSB antibodies. Compared with patients testing positive for anti-SSA or anti-SSB antibodies, that testing negative for the two antibodies had a lower proportion of females (75.3% vs. 90.6%, p < 0.001) and thrombocytopenia (6.7% vs. 13.6%, p = 0.002), but a higher proportion of abnormal Schirmer I tests (96.0% vs. 89.1%, p = 0.001) and interstitial lung disease (ILD) (59.2% vs. 28.8%, p = 0.001). Anti-SSA and anti-SSB negativity was positively associated with male sex (odds ratio [OR] = 1.86, 95% confidence interval [CI]: 1.05, 3.31), abnormal Schirmer I tests (OR = 2.85, 95% CI: 1.24, 6.53), and ILD (OR = 2.54, 95% CI: 1.67, 3.85). However, it was negatively related to thrombocytopenia (OR = 0.47, 95% CI: 0.24, 0.95). Conclusion Approximately one third of pSS patients had anti-SSA and anti-SSB negativity. pSS patients testing negative for anti-SSA and anti-SSB showed a higher risk of abnormal Schirmer I tests and ILD, but a lower risk of thrombocytopenia. Currently Sjögrens Sjögren s (pSS antiSSA anti SSA antiSSB SSB sample 201 202 analyzed analysis Overall 93 study 29 32.0% 320 32 0 (32.0% 75.3% 753 75 3 (75.3 vs 906 90 6 90.6% 0.001 0001 001 6.7% 67 7 (6.7 136 13 13.6% 0.002, 0002 0.002 , 002 0.002) 96.0% 960 96 (96.0 891 89 1 89.1% (ILD 59.2% 592 59 2 (59.2 288 28 8 28.8% 0.001. . AntiSSA Anti odds OR [OR 186 86 1.86 95 CI [CI] 105 05 1.05 3.31, 331 3.31 31 3.31) 285 85 2.85 124 24 1.24 6.53, 653 6.53 53 6.53) 254 54 2.54 167 1.67 3.85. 385 3.85 3.85) However 047 47 0.47 024 0.24 0.95. 095 0.95 0.95) 20 9 32.0 (32.0 75.3 (75. 90.6 0.00 000 00 6.7 (6. 13.6 96.0 (96. 89.1 59.2 5 (59. 28.8 18 1.8 [CI 10 1.0 33 3.3 2.8 12 1.2 65 6.5 25 2.5 16 1.6 38 3.8 04 4 0.4 02 0.2 09 0.9 32. (32. 75. (75 90. 0.0 6. (6 13. 96. (96 89. 59. (59 28. 1. 3. 2. 0. (32 (7 ( (9 (5 (3

Abstract The image of an athlete's ankle joint injury can help to check whether the athlete's ankle joint is damaged, and plays a very important role in clinical diagnosis. To address the problem of poor segmentation effect of traditional athletes' ankle injury image segmentation algorithm, an ankle injury image segmentation algorithm based on residual double attention U-Net model is proposed. First, the region of interest is extracted from the original ankle injury image. After translation, rotation and turnover, the image data is expanded. Second, the residual structure is used to adjust the gradient propagation and residual feedback of the segmentation framework, extract the attribute information in the region of interest, and combine the two to retain more image features. Finally, combined with the double attention module to improve the weight ratio of image features, the athlete ankle injury image segmentation is realized in the image segmentation framework based on residual double attention U-Net model. The results demonstrate that the maximum values of DSC, ASSD, PM, and CR for the proposed algorithm are 0.93, 0.1, 0.96, and 0.95, respectively, and the F1 score is 95.7%, indicating that the segmentation effect of this algorithm is closer to the theoretical segmentation effect, and higher precision in segmentation, and the segmented image has a high degree of similarity to the original image, resulting in excellent segmentation performance. athletes s damaged diagnosis UNet U Net First translation turnover expanded Second features Finally DSC ASSD PM 093 0 93 0.93 01 1 0.1 096 96 0.96 095 95 0.95 respectively F 957 7 95.7% performance 09 9 0.9 0. 95.7 95.

Abstract Background The main features of polycystic ovary syndrome (PCOS) are abnormal follicular development and ovulatory dysfunction, which are caused by excessive apoptosis of ovarian granulosa cells. Acupuncture has been shown to improve follicular development abnormalities in patients with PCOS, but its mechanism is unknown. This study hypothesized that the mechanism of acupuncture on follicular development abnormalities in PCOS patients is the inhibition of granulosa cell apoptosis through LncMEG3-mediated regulation of miR-21-3p. Methods A PCOS-like rat model was established using subcutaneous injection of dehydroepiandrosterone (DHEA). Acupuncture was performed on rats for 15 d (CV-4, RN-3, CV-6, SP-6 and EX-CA 1). Ovarian morphology was observed by HE staining, and sex hormone and AMH levels were detected by ELISA. Primary granulosa cells were isolated from each group of rats to assess the association of acupuncture treatment, LncMEG3, miR-21-3p, and granulosa cell apoptosis in rats with PCOS. Results LncMEG3 and miR-21-3p were highly expressed in the ovarian granulosa cells of rats with PCOS, and LncMEG3-mediated regulation of miR-21-3p was involved in the development of PCOS in rats. Silencing of MEG3 attenuated sex hormone dysregulation and ovarian histopathological changes in PCOS rats and promoted follicle cell development and maturation. In addition, silencing MEG3 increased the viability and number of granulosa cells. In addition, silencing MEG3 further inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats. Acupuncture improved polycystic ovarian morphology and sex hormone levels in PCOS rats. Acupuncture intervention increased the viability and number of granulosa cells. Acupuncture intervention inhibited early and late apoptosis of ovarian granulosa cells in PCOS rats by targeting miR-21-3p via LncMEG3. Conclusion These results suggest that acupuncture can downregulate LncMEG3, thereby targeting and regulating miR-21-3p to suppress early and late granulosa cell apoptosis and normalize their proliferation. These factors ultimately compensate for abnormal follicular development. These findings shed light on the clinical potential of acupuncture as a safe treatment for follicular developmental abnormalities in PCOS. Highlights LncMEG3-mediated inhibition of miR-21-3p regulates ovarian granulosa cell apoptosis. LncMEG3 and miR-21-3p are involved in the occurrence and development of PCOS-related abnormal follicular development. CuONPs induce co-occurrence of autophagy activation and autophagic flux blockade. Acupuncture can improve the sex hormone levels and follicular development in the context of PCOS. The underlying mechanism of acupuncture in the treatment of PCOS abnormal follicular development was revealed.

Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children’s and adolescents’ participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.

Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children’s and adolescents’ participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.

ABSTRACT Purpose: To investigate the role of renal denervation (RDN) on endogenous ouabain (EO) secretion in spontaneously hypertensive rats (SHR). Methods: Sixteen 12-week-old male SHR were randomly separated into the renal denervation group (RDNX group) and sham operation group (sham group), and eight age-matched Wistar Kyoto rats (WKY) were served as control group. EO concentrations, the Na+- K+-ATPaseactivity, and the expression of Na+-K+-ATPase were assessed. Results: EO levels in serum, kidneys and hypothalamus of sham group were higher than in RDNX group (p < 0.05). Renal Na+-K+-ATPase activity subjected to denervation surgery showed significantly reduction when compared with the sham groups (p < 0.05). A positive correlation existed between norepinephrine (NE) content and Na+-K+-ATPase activity in the kidney (r2 = 0.579). Renal Na+-K+-ATPase α1 subunit mRNA expression was down-regulated in the RDNX group compared with the sham group (P < 0.05), while renal Na+-K+-ATPase α1 subunit mRNA expression was no statistical significance between the groups (P = 0.63). Immunohistochemical analysis showed that there were significant differences in the renal expression of Na+-K+-ATPasebetween the three groups (P < 0.05). Conclusions: These experiments demonstrate that RDN exerted an anti-hypertensive effect with reduction of EO levels and Na+-K+-ATPase activity and Na+-K+-ATPase α1 subunit expression of kidney in SHR. Purpose (RDN (EO . (SHR) Methods 12weekold weekold 12 week old group, , agematched age matched WKY (WKY concentrations Na+ Na K+ATPaseactivity, KATPaseactivity K+ ATPaseactivity, K ATPaseactivity K+-ATPaseactivity Na+K+ATPase NaKATPase ATPase assessed Results serum p 0.05. 005 0.05 0 05 0.05) NE (NE r2 r (r 0.579. 0579 0.579 579 0.579) α downregulated down regulated P 0.05, 0.63. 063 0.63 63 0.63) Na+K+ATPasebetween NaKATPasebetween ATPasebetween Conclusions antihypertensive anti (SHR 1 K+ATPaseactivity 00 0.0 057 0.57 57 06 0.6 6 0. 0.5 5