OBJECTIVE:Osteoarthritis (OA) is characterized by cartilage degeneration, oxidative stress, and chondrocyte senescence. This study investigated whether TL1A promotes OA through ENO1-associated redox, senescence and PI3K-AKT signaling mechanisms. METHOD:Human paired OA cartilage, primary chondrocytes, and mouse age-associated and destabilization of the medial meniscus (DMM)-induced OA models were used. TL1A and ENO1 were manipulated using genetic deletion, intra-articular adenoviral delivery, and siRNA-mediated silencing. Oxidative stress, cellular senescence, cartilage degeneration, ENO1-related regulatory mechanisms, and PI3K-AKT activation were assessed using histology, immunostaining, Western blotting, qPCR, RNA-seq, co-immunoprecipitation, ubiquitination assays, and pharmacological rescue experiments. RESULTS:TL1A-positive chondrocytes were increased in damaged versus paired undamaged human cartilage (n = 8 paired patients) [mean paired difference, +64.24 percentage points; 95% CI, 57.80-70.68]. In DMM mice, Tl1a deletion reduced cartilage damage [OARSI Hodges-Lehmann (HL) difference, -2.50; 95% CI, -4 to 0], whereas intra-articular Tl1a overexpression induced mild OA-like cartilage changes [OARSI HL difference, +0.75; 95% CI, 0-1.50]. TL1A silencing reduced ROS fluorescence in IL-1β-treated human chondrocytes [mean change, -53.50%; 95% CI, -61.59 to -45.41]. TL1A interacted with ENO1 and was associated with altered ENO1 ubiquitination and protein abundance; Eno1 overexpression restored OA severity in DMM-operated Tl1a-/- mice [OARSI HL difference, +3.75; 95% CI, 3-5.50]. PI3K-AKT activation contributed to this phenotype, as 740 Y-P increased OARSI scores in DMM-operated Tl1a-/- mice [HL difference, +1.25; 95% CI, 0-2.50]. CONCLUSION:TL1A contributes to OA progression by promoting ENO1-associated redox imbalance, chondrocyte senescence, and PI3K-AKT signaling, supporting the TL1A-ENO1 axis as a potential therapeutic target.

Objective: Radiographic bone age assessment (BAA) is a standard clinical procedure for the diagnosis of skeletal growth abnormalities in children and infants. Existing automated BAA algorithms based on the TannerWhitehouse 3 (TW3) method can only assess the skeletal maturity and bone age of the radius, ulna, and short bone (TW3-RUS), lacking the capability to assess the bone age of the carpal bone (TW3-C), which hinders their wider clinical adoption. Methods: We proposed a TW3-based automated BAA method to address this limitation. Firstly, a heat map regression key point detection algorithm incorporating spatial configurations was introduced to locate and segment all 20 TW3-regions of interest (ROIs). Subsequently, a skeletal maturity classification network incorporating an attention mechanism with spatial and channel features was proposed to predict the skeletal maturity scores and bone ages of the TW3-RUS and TW3-C series. Results: Our approach achieved a mean absolute error (MAE) of bone age of 0.42 (TW3-RUS) and 0.44 (TW3-C) years on a dataset of 5,235 left lateral radiographs of children of different ages. Conclusions: Our framework demonstrated the immense clinical potential of the proposed algorithm by achieving the impressive BAA results, while also providing clinicians with all the essential information they need to know about skeletal maturity and bone age. Significance: The proposed BAA algorithm which can simultaneously evaluate skeletal maturity level and bone age for both the TW3-RUS and TW3-C series is more helpful for clinicians to analyze the progression of their patients' conditions and to adjust their treatment plans.

Background:Primary angiosarcoma of bone (ASB) is a rare and aggressive primary bone tumor. The prognostic significance of anatomical location (axial vs. appendicular skeleton) remains poorly defined. This study aimed to compare clinicopathological features and survival outcomes between these two groups. Methods:Patients diagnosed with primary ASB (1975-2019) were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Tumors were categorized as axial (spine, pelvis, ribs, skull) or appendicular (extremities). Overall survival was analyzed using Kaplan-Meier and Cox models. Cancer-specific mortality (CSM) was evaluated with Fine-Gray competing risk regression to calculate subdistribution hazard ratios (SHR). Results:Among 458 patients, 162 (35.4%) had axial and 296 (64.6%) had appendicular tumors. Axial patients were older (median 63 vs. 46 years, p < 0.001), had higher distant metastasis at diagnosis (43.2% vs. 29.1%, p = 0.002), and underwent surgery less frequently (37.0% vs. 81.1%, p < 0.001). The 5-year overall survival was significantly worse for axial tumors (16.8% vs. 38.2%, p < 0.001). The 5-year cumulative incidence of CSM was 69.5% for axial versus 50.8% for appendicular tumors (p < 0.001). Multivariate analysis confirmed axial location as an independent predictor of higher CSM (SHR 1.62, 95% CI: 1.25-2.10, p < 0.001) , independent of the year of diagnosis. Conclusions:Axial tumors represent a distinct high-risk subgroup characterized by limited surgical resectability and inferior survival. Anatomical location should be considered a critical stratification factor in clinical management and future trials.Abbreviations: ASB, Primary angiosarcoma of the bone; SEER, Surveillance, Epidemiology, and End Results; OS, Overall Survival; CSS, Cancer-Specific Survival; CSD, Cancer-Specific Death; CIF, Cumulative Incidence Function; SHR, Subdistribution Hazard Ratio; CI, Confidence Interval; HR, Hazard Ratio.

Background:Sarcopenia is a prevalent condition associated with adverse health outcomes, necessitating accurate assessment of skeletal muscle quantity and quality. Computed tomography (CT) is the gold-standard imaging modality for evaluating trunk skeletal muscle area (TrSMA) and density (TrSMD), with opportunistic CT offering a means to assess these metrics without additional radiation exposure. However, the clinical application of CT-based sarcopenia assessment in Chinese populations is hindered by the absence of large-scale, population-specific reference values and cut-off points, particularly for both myopenia (low muscle mass) and myosteatosis (fatty infiltration). This study aims to establish sex- and age-specific percentile reference values and diagnostic cut-off points for CT-derived TrSMA and TrSMD at the L1 and L3 vertebral levels with a large cohort of community-dwelling Chinese adults. Methods:We retrospectively analyzed abdominal CT scans from 4,016 community‑dwelling Chinese adults (21-80 years) across 12 regions. TrSMA and TrSMD at L1 and L3 were segmented using OsiriX. Sex- and age-specific percentile curves were modeled using the lambda-mu-sigma (LMS) method within the generalized additive models for location, scale, and shape (GAMLSS) framework. Estimated age-related differences in TrSMA and TrSMD from ages 25 to 75 years were calculated using LMS-derived medians. Sex‑specific cut‑off points for myopenia and myosteatosis were defined in the 21- to 40-year subgroup using the mean minus two standard deviations (M‑2SD) approach. Results:From ages 25 to 75 years, LMS-derived L1/L3-TrSMA values were lower by 0.45%/0.55% per year in men and 0.33%/0.41% per year in women; corresponding differences in L1/L3-TrSMD were 0.38%/0.35% and 0.55%/0.52% per year. More pronounced age-related decreases were observed in peri- and postmenopausal women and older men. M‑2SD cut‑offs at L1 were 96.0 cm2 and 29.8 Hounsfield Unit (HU) (men), 63.1 cm2 and 26.4 HU (women); at L3 were 122.3 cm2 and 31.7 HU (men), 75.4 cm2 and 27.5 HU (women). Conclusions:We provide the first CT‑based, sex‑ and age‑specific reference values and cut‑points for trunk myopenia and myosteatosis in Chinese adults, facilitating standardized sarcopenia diagnosis and research.

Zhang, Xingkai, Liang He, Kai Li, Wen Li, Li Wang, Ling Chen, and Qinghai Shi. Causal relationships between high-altitude adaptation, metabolic traits, and tumors: insights from Mendelian randomization. High Alt Med Biol. 27:23-32, 2026. BACKGROUND AND OBJECTIVES:Previous studies suggest that high-altitude adaptation (HAA) and metabolic traits in high-altitude populations correlate with tumor risk, but causal mechanisms remain unclear. This Mendelian randomization (MR) study investigated genetic links between HAA, metabolic traits, and tumor susceptibility while exploring potential mediation effects. METHODS:Genome-wide association studies data for HAA, metabolic traits, and tumors were sourced from public databases. Inverse variance weighting served as the primary analytical method, supplemented by weighted mode, MR-Egger, and weighted median. Sensitivity analyses and two-step MR (TSMR) assessed robustness and mediation pathways. RESULTS:We identified a potential association between HAA and a decreased risk of pancreatic cancer (odds ratio [OR] = 8.94e-8, p = 0.011) and cervical cancer (OR = 8.04e-6, p = 0.005). In contrast, HAA showed a potential link to an increased risk of esophageal cancer (OR = 3230.25, p = 0.03) and hepatocellular carcinoma (OR = 2080.07, p = 0.015). Several metabolic traits, particularly platelet-related indices, were identified as potentially associated with tumorigenesis. However, although possible mediating pathways were suggested, no metabolic trait demonstrated a statistically significant mediating effect. CONCLUSION:These findings highlight HAA's complex role in tumor susceptibility and provide a genetic framework for understanding tumor disparities in high-altitude regions.

Background: Experimental studies indicated that maternal choline and betaine status have the potential to alter fetal growth, but epidemiological data remain sparse. Objective: We aimed to investigate the association of maternal and cord blood choline and betaine concentrations with birthweight outcomes. Methods: This prospective cohort study involved 988 mother-infant dyads from Hebei and Shandong provinces. Plasma concentrations of choline and betaine in maternal late pregnancy and cord blood were quantified using ultra-performance liquid chromatography-mass spectrometry. Multivariable linear or logistic regression was performed to examine their association with continuous or binary birthweight outcomes. Results: Maternal plasma choline and betaine concentrations in late pregnancy (median [interquartile range]; 12.34 [10.13, 14.78] and 14.99 [12.01, 18.36] μmol/L) were significantly lower than those in cord blood (29.98 [24.74, 35.93] and 31.14 [25.56, 37.28] μmol/L). Each 1 μmol/L increase of late-pregnancy and cord blood betaine concentrations were associated with 9.87 g (95% confidence interval [CI]: -16.08, -3.66 g) and 5.29 g (95% CI: -8.52, -2.06 g) lower birthweight, respectively. Compared with the lowest quintile, the highest quintiles of late-pregnancy and cord blood betaine concentrations were associated with lower risks of large-for-gestational-age (adjusted odds ratios [ORs] = 0.47 [95% CI: 0.24, 0.90] and 0.31 [95% CI: 0.17, 0.56]) and macrosomia (adjusted ORs = 0.12 [95% CI: 0.03, 0.43] and 0.15 [95% CI: 0.05, 0.40]). These associations, particularly for cord blood, persisted and appeared more pronounced in pregnancies with maternal overweight/obesity or gestational diabetes mellitus (GDM), but the interaction effect did not reach statistical significance. No significant associations were observed for choline in any periods. Conclusions: Higher plasma concentrations of betaine in maternal late-pregnancy and cord blood were associated with lower birthweight. These findings emphasize the importance of sufficient betaine status during pregnancy, especially among mothers with obesity or GDM.

Background: Osteoporosis is a common bone disease characterized by low bone mineral density (BMD). Low BMD screening and early interventions during childhood can significantly decrease osteoporosis risk in adulthood. However, in clinical settings, the applicability of dual-energy X-ray absorptiometry (DXA), a technique to measure standard area BMD (aBMD), cannot adequately meet the diagnostic needs of the majority of the Chinese population. We aimed to achieve a comprehensive evaluation in clinical settings by taking a single X-ray image, which, in conjunction with the use of equivalent step phantoms, can assess bone age or injuries (such as sprains, fractures, or breaks) in the wrist while also measuring aBMD in the forearm, to further evaluate growth and development. Methods: In the present study, we used routine X-ray images of the hand and forearm to measure aBMD with step phantom. First, based on the X-ray images, the regions of interest (ROIs) and step phantom used in clinical settings were automatically located and segmented; then, their average grayscale values were calculated. Second, after fitting the linear calibration relationship between the equivalent phantom thickness and grayscale value of the phantom, the effect of soft tissue on aBMD measurement was eliminated using a Results: Our developed method was validated on 500 X-ray images taken at the clinic and compared with DXA-based aBMD measurements. Experiments revealed that the average correlation coefficient was 0.836. Conclusions: The proposed method is an automatic method for measuring aBMD in children by utilizing X-ray images of hand and forearm. Furthermore, our findings suggest the effectiveness of the developed method, which provides a comparable performance to that of clinicians.

Objective:To determine the prevalence of lumbar spondylolysis (LS) and the proportion of spondylolytic spondylolisthesis (SS) in China, and to evaluate the musculoskeletal status of patients with LS and SS. Methods:Spine Computed Tomography (CT) images were collected from community populations aged 40 and above in a nationwide multi-center project. LS was diagnosed, and SS was graded by an experienced radiologist. Bone mineral density (BMD) and paraspinal muscle parameters were quantified based on CT images. Results:One hundred and seventeen patients of a total of 3,317 individuals were diagnosed with LS, corresponding to a prevalence rate of 3.53%. 63 of the 1,214 males (5.18%) and 54 of the 2,103 females (2.57%) were diagnosed with LS. SS occurred in 64/121 vertebrae (52.89%). BMD was not associated with LS ( P = 0.341). The L5 extensor paraspinal muscle density was higher in the LS group than in the non-LS group. In the LS group, patients with SS had a smaller L5 paraspinal extensor muscle cross-sectional area than those without SS ( P = 0.003). Conclusion:The prevalence of LS in Chinese adults was 3.53%, with prevalence rates of 5.18% in males and 2.57% in females. Patients with LS have higher muscle density, whereas those with SS have smaller muscle cross-sectional areas at the L5 level.

OBJECTIVE:This study aimed to investigate the prevalence of brachydactyly type A3 (BDA3) and its associated epiphysial development abnormalities in Chinese children aged 3-17 years, and to explore differences based on gender, region and urban-rural demographics. DESIGN:Cross-sectional study. SETTING:The study was conducted across 14 provinces (28 survey sites) in China, as part of a nationwide investigation on skeletal maturation. The population was selected using multistage stratified randomised cluster sampling. PARTICIPANTS:A total of 17 850 children (8856 boys and 8994 girls) aged 3-17 years participated. The cohort was drawn from a large-scale survey conducted between 2019 and 2021. Selection criteria included children with no visible clinodactyly or hand function impairments. METHODS:Non-dominant hand-wrist radiographs were obtained using a portable X-ray device. A retrospective analysis of these radiographs was performed to identify BDA3 and epiphysial development abnormalities. Prevalence rates were calculated and compared across gender, regional and urban-rural groups. RESULTS:The overall prevalence of BDA3 was 10.0%, with a higher prevalence in girls (12.9% vs 7.1%; p<0.001). The northern region exhibited a higher prevalence compared with the southern region (11.5% vs 8.6%; p<0.001). No significant differences were observed between urban and rural areas (10.3% vs 9.8%; p=0.32). Among the BDA3 phenotypes, brachymesophalangia-5 with cone-epiphysis of mid-5 (BMP5) and BMP5 alone had prevalences of 3.6% and 6.4%, respectively. Both phenotypes were more common in girls compared with boys (p<0.001 for both). CONCLUSIONS:This nationwide, multicentre study provides the first national epidemiologic data on BDA3 and associated epiphysial features in Chinese children and adolescents, establishing a prevalence of 10.0%. This baseline supports counselling that a straight, well-functioning short fifth finger is a common anatomic variant and may help reduce unnecessary concern.

Background: In the past quite a long time, intraoperative cholangiography（IOC）was necessary during laparoscopic cholecystectomy (LC). Now magnetic resonance cholangiopancreatography (MRCP) is the main method for diagnosing common bile duct stones (CBDS). Whether MRCP can replace IOC as routine examination before LC is still inconclusive. The aim of this study was to analyze the clinical data of patientsundergoing LC for cholecystolithiasis, and to explore the necessity and feasibility of preoperative routine MRCP in patients with cholecystolithiasis. Methods: According to whether MRCP was performed before operation, 184 patients undergoing LC for cholecystolithiasis in the Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University from January 1, 2017 to December 31, 2018 were divided into non-MRCP group and MRCP group for this retrospective study. The results of preoperative laboratory test, abdominal ultrasound and MRCP, biliary related comorbidities, surgical complications, hospital stay and hospitalization expenses were compared between the two groups. Results: Among the 184 patients, there were 83 patients in non-MRCP group and 101 patients in MRCP group. In MRCP group, the detection rates of cholecystolithiasis combined with CBDS and common bile duct dilatation by MRCPwere higher than those by abdominal ultrasound ( P < 0.05). The incidence of postoperative complications in non-MRCP group (8.43%) was significantly higher ( P < 0.05) than that in MRCP group (0%). There was no significant difference in hospital stay ( P > 0.05), but there was significant difference in hospitalization expenses ( P < 0.05) between the two groups. According to the stratification of gallbladder stone patients with CBDS, hospital stay and hospitalization expenses were compared, and there was no significant difference between the two groups ( P > 0.05). Conclusions: The preoperative MRCP can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by abdominal ultrasound, which is helpful to plan the surgical methods and reduce the surgical complications. From the perspective of health economics, routine MRCP in patients with cholecystolithiasis before LC does not increase hospitalization costs, and is necessary and feasible.

Rationale and Objectives: The paravertebral muscles, characterized by their susceptibility to severe size loss and fat infiltration in old age, lack established reference values for age-related variations in muscle parameters. This study aims to fill this gap by establishing reference values for paravertebral muscles in a Chinese adult population. Materials and Methods: This cross-sectional study utilized the baseline data from the prospective cohort China Action on Spine and Hip (CASH). A total of 4305 community-dwelling participants aged 21-80 years in China were recruited between 2013 and 2017. Pregnant women, individuals with metal implants, limited mobility or diseases/conditions (spinal tumor, infection, etc.) affecting lumbar vertebra were excluded from the study. Psoas and paraspinal muscles were measured in quantitative computed tomography (QCT) images at the L3 and L5 levels using Osirix software. Age-related reference values for muscle area, density, and fat fraction were constructed as percentile charts using the lambda-mu-sigma (LMS) method. Results: The paravertebral muscles exhibited an age-related decline in muscle area and density, coupled with an increase in muscle fat fraction. Between the ages of 25 and 75, the reductions in psoas and paraspinal muscle cross-sectional area at the L3 level were - 0.47%/yr and - 0.53%/yr in men, and - 0.19%/yr and - 0.23%/yr in women, respectively. Notably, accelerated muscle loss was observed during menopause and postmenopause in women (45-75 years) and intermittently during middle and old age in men (35-55 and 60-75 years). Besides, the age-related decreases in PSMA, PMA, and PSMD and the increases in PSMFF were more pronounced in L5 than in L3 Conclusion: This study shows distinct patterns of accelerated muscle loss were identified in menopausal and postmenopausal women and in middle-aged and old men. The findings contribute valuable information for future investigations on paravertebral muscle loss and myosteatosis.

AbstractPlateau acclimatization involves adaptive changes in the body's neurohumoral regulation and metabolic processes due to hypoxic conditions at high altitudes. This study utilizes Olink targeted proteomics to analyze serum protein expression differences in Han Chinese individuals acclimatized for 6 months–1 year at 4500 and 5300 m altitudes, compared to those residing at sea level. The objective is to elucidate the proteins' roles in tissue and cellular adaptation to hypoxia. We identified 54 metabolism‐related differentially expressed proteins (DEPs) in the serum of the high‐altitude group versus the sea‐level group, comprising 20 significantly upregulated and 34 downregulated proteins. Notably, 2 proteins were upregulated and 11 downregulated at both 4500 and 5300 m altitudes. The top three protein correlations among DEPs included CRKL with CA13, RNASE3 with NADK, and NADK with APEX1, alongside APLP1 with CTSH, CTSH with SOST, and CTSH with NT‐proBNP in inverse correlations. KEGG enrichment analysis indicated significant DEP involvement in various metabolic pathways, particularly those associated with hypoxic cellular metabolism like glycolysis/gluconeogenesis and the HIF‐1 signaling pathway. Correlation with clinical phenotypes showed positive associations of SOST, RNASE3, CA13, NADK, and CRKL with SaO2 and negative correlations with Hemoglobin and Hematocrit; ALDH1A1 positively correlated with Triglyceride; and SDC4 inversely correlated with Uric acid levels. This study provides insights into specific DEPs linked to metabolic adaptations in high‐altitude acclimatized individuals, offering a foundation for understanding acclimatization mechanisms and potential therapeutic targets.

Objective: We analyzed quantitative computed tomography (CT) and chemical shift-encoded magnetic resonance imaging (MRI) data from a Chinese cohort to investigate the effects of BMI and aging on different adipose tissue (AT) depots. Methods: In 400 healthy, community-dwelling individuals aged 22 to 83 years, we used MRI to quantify proton density fat fraction (PDFF) of the lumbar spine (L2-L4) bone marrow AT (BMAT), the psoas major and erector spinae (ES) muscles, and the liver. Abdominal total AT, visceral AT (VAT), and subcutaneous AT (SAT) areas were measured at the L2-L3 level using quantitative CT. Partial correlation analysis was used to evaluate the relationship of each AT variable with age and BMI. Multiple linear regression analysis was performed in which each AT variable was evaluated in turn as a function of age and the other five independent AT measurements. Results: Of the 168 men, 29% had normal BMI (<24.0 kg/m(2)), 47% had overweight (24.0-27.9 kg/m(2)), and 24% had obesity (>= 28.0 kg/m(2)). In the 232 women, the percentages were 46%, 32%, and 22%, respectively. Strong or very strong correlations with BMI were found for total AT, VAT, and SAT in both sexes. BMAT and ES PDFF was strongly correlated with age in women and moderately correlated in men. In both sexes, BMAT PDFF correlated only with age and not with any of the other AT depots. Psoas PDFF correlated only with ES PDFF and not with age or the other AT depots. Liver PDFF correlated with BMI and VAT and weakly with SAT in men. VAT and SAT correlated with age and each other in both sexes. Conclusions: Age and BMI are both associated with adiposity, but their effects differ depending on the type of AT.

Objective:To report the sampling study design and radiography protocol of a large-sample investigation on skeletal maturation of 3 to 18-year-old children in China.Methods:Multi-stage stratified random sampling was employed in this study. Two provinces, municipalities, or autonomous regions were randomly selected from each of the seven regions of China, including Northeast China, Northwest China, North China, Central China, East China, Southwest China, and South China. Then one rural and one urban investigation site were randomly selected from each province, municipality, or autonomous region. In total 28 sites were included. Among those sites, four residential districts were randomly selected from each urban site, and four townships from each rural site. For each residential district or township, 1-4 kindergartens, primary schools, and middle schools were chosen. Random cluster sampling was used to extract 3-<6-year-old children in kindergartens, and 6-18-year-old children in primary schools and middle schools. The investigation on skeletal maturation was sampled proportionate to the sampling of the whole study. The estimated simple size was 780 for each site, and 21 840 for all 28 sites in total. There were six groups of 3-<6-year-old children classified at 0.5-year intervals, and 12 groups of 6-18-year-old children classified at 1-year intervals. Posteroanterior position radiography of the left hand and wrist was achieved for all subjects.Results:The study was performed from August 26, 2019 to October 16, 2021. In total, 20 444 children received posteroanterior position radiography of the left hand and wrist, including 10 196 males and 10 248 females, 9 711 urban and 10 733 rural, respectively. The 3-<6-year-old group included 1 611 (male 819, female 792) subjects, and the 6 to 18-year-old group included 18 833 (male 9 377, female 9 456) subjects.Conclusion:This nationwide investigation on skeletal maturation of 3 to 18-year-old children in seven regions of China was successfully preformed. The results of this study can provide an important reference for establishing the current evaluation criteria of bone age in Chinese children and adolescents.

Purpose:To investigated the factors that influence BMAC.Patients and Methods:Quantitative computed tomography (QCT) and magnetic resonance imaging (MRI) were applied to measure abdominal fat areas, liver fat content, erector muscle fat content, and BMAC of the L2-4 vertebrae. Sex hormone, adipokine, and inflammatory factor levels were measured on the same day.Results:Although age, erector muscle fat content, estradiol, testosterone, and adiponectin/leptin levels showed correlations with BMAC in the correlation analysis, the equations obtained from the whole population by multivariate analysis were unclear. Patients were stratified according to BMAC quartiles, and differences were found in vBMD, age, estradiol, testosterone, and erector muscle fat content among the four quartiles. Logistic analyses confirmed that age, estradiol/testosterone ratio, and TNF-α had independent effects on BMAC in all quartiles. In addition, height was related to higher BMAC quartiles, and glucose was related to lower BMAC quartiles.Conclusion:Compared to other body fats, BMAC is a unique fat depot. Age, estradiol/testosterone ratio, and TNF-α are all key influencing factors related to BMAC in postmenopausal women. Furthermore, height and glucose levels were related to BMAC in the higher and lower BMAC quartiles, respectively.

Organ fat may affect bone metabolism and be associated with vertebral fracture (VF). This study aimed to explore relationships between VF, adiposity indexes measured by MRI, and volumetric BMD (vBMD) measured by quantitative CT (QCT). Four hundred volunteers, ranging in age from 22 to 83 years, were recruited and underwent same-day abdominal QCT and chemical shift–encoded (CSE) MRI. We used MRI to quantify the fat content of bone marrow (BMF), psoas major and paraspinal muscles, and the liver. Abdominal fat, VF, and vBMD of the lumbar spine were measured by QCT. For VF discrimination analysis, we examined both the whole cohort (60 VF cases in 30 men and 30 women) and a restricted subgroup of those aged over 50 years (50 VF cases in 23 men and 27 women). Amongst the men, a 1 SD increase in BMF was associated with a 27.67 (95

Abstract Objective To demonstrate if patients with cholecystolithiasis at low risk of common bile duct stones (CBDS) require magnetic resonance cholangiopancreatography (MRCP) before laparoscopic cholecystectomy (LC). This study investigated the clinical value of routine MRCP before LC in patients with gallstones. Methods We adopted a non-randomized controlled experiment according to whether MRCP performed prior to LC, 277 patients with cholecystolithiasis at low risk of CBDS were divided into two groups:142 patients in the control group only underwent abdominal ultrasound, while 135 patients in the experimental group underwent both abdominal ultrasound and MRCP. The results of laboratory test, abdominal ultrasound and MRCP, surgical complications, length of stay and hospitalization costs were compared between the two groups. Result The detection rates of CBDS, cystic duct stones, gallbladder adenomyomatosis and anatomical variants of biliary tract by preoperative MRCP were higher than those by abdominal ultrasound (P < 0.05). The incidence of postoperative complications in the experimental group was significantly lower than that in the control group (0% vs. 5.63%, P < 0.05). The length of stay in the experimental group was shorter than that in the control group (P < 0.05). Conclusion Routine MRCP before LC can detect CBDS, cystic duct stones and anatomical variants of biliary tract that cannot be diagnosed by ultrasound. MRCP helps surgeons better understand the anatomical variation of extrahepatic bile duct, plan the operation rationally and efficiently reduce the occurrence of postoperative complications. Moreover, MRCP shorten the length of stay without increasing the hospitalization costs.

骨龄评估是儿科放射学的一个重要研究课题。传统的骨龄评定方法要求放射科或者内分泌科医生对少儿非优势侧手腕部X线图像进行人工判读，这种评定方法存在判读过程耗时长、结果不稳定等问题。因此，亟须一种自动评估骨龄的方法来辅助临床诊断。近年来，随着计算机技术和人工智能算法的空前发展，各种骨龄相关计算机人工智能辅助评估系统的研究进展迅速。本文对以往具有代表性的基于人工智能的骨龄自动评估系统研究与发展进行了综述，希望能为骨龄自动评估技术的发展提供新的思路。

STATEMENT OF PROBLEM:The surgical extrusion technique has been advocated for severely damaged teeth as well as for intruded and unerupted teeth. However, a quantitative literature analysis is lacking. PURPOSE:The purpose of this bibliometric analysis was to provide a comprehensive overview of surgical extrusion, assess the applications and outcomes, and evaluate topics for future research. MATERIAL AND METHODS:An electronic search was conducted in leading databases in April 2023. Human studies with surgical tooth extrusion or synonyms in titles or abstracts were included. A bibliographic analysis, co-occurrence analysis, and coupling of publications were performed. The analysis of variance was used to assess the characteristics of the subgroups based on indications. The survival rate was evaluated by using the Kaplan-Meier method in the R software program (α=.05). RESULTS:Fifty-one studies from 1982 to 2023 were included. The Journal of Dental Traumatology and the Journal of Prosthetic Dentistry combined published approximately one-third of the papers and acquired the most citations. The burst detection of keywords revealed 4 popular research topics: the Benex extraction system, chlorhexidine for infection control, rigid or semi-rigid splints to decrease the risk of complications, and novel restorative materials to improve esthetics. An overall survival rate of 96.36% was reported among 316 participants with 330 extruded teeth. No significant differences were found in study types, geographic distribution, year of publication, or citation counts among the 4 subgroups (surgical extrusion for subgingival fractures, extensive caries, intruded teeth, and unerupted teeth). A significant difference was observed among the Kaplan-Meier curves of the 4 subgroups (P=.030). CONCLUSIONS:Surgical extrusion may be used to save otherwise nonrestorable teeth, and the procedure has shown promising survival rates when teeth are properly selected and the procedure is well executed. Subgingival fractures and extensive caries near bone level are the predominant indications, as well as intruded and unerupted teeth. Surgical extrusion is a reliable treatment option to facilitate tooth restoration for severely damaged teeth, especially for maxillary anterior teeth.

Background Bone age assessment (BAA) is a crucial research topic in pediatric radiology. Interest in the development of automated methods for BAA is increasing. The current BAA algorithms based on deep learning have displayed the following deficiencies: (I) most methods involve end-to-end prediction, lacking integration with clinically interpretable methods; (II) BAA methods exhibit racial and geographical differences. Methods A novel, automatic skeletal maturity assessment (SMA) method with clinically interpretable methods was proposed based on a multi-region ensemble of convolutional neural networks (CNNs). This method predicted skeletal maturity scores and thus assessed bone age by utilizing left-hand radiographs and key regional patches of clinical concern. Results Experiments included 4,861 left-hand radiographs from the database of Beijing Jishuitan Hospital and revealed that the mean absolute error (MAE) was 31.4±0.19 points (skeletal maturity scores) and 0.45±0.13 years (bone age) for the carpal bones-series and 29.9±0.21 points and 0.43±0.17 years, respectively, for the radius, ulna, and short (RUS) bones series based on the Tanner-Whitehouse 3 (TW3) method. Conclusions The proposed automatic SMA method, which was without racial and geographical influence, is a novel, automatic method for assessing childhood bone development by utilizing skeletal maturity. Furthermore, it provides a comparable performance to endocrinologists, with greater stability and efficiency.