Abstract:Objective：To compare the accuracy of three intraoral scanner-based complete arch implant impression techniques using TRIOS 3 and Aoralscan 3 intraoral scanners. Methods：A standard edentulous maxillary implant model with 6 screw-retained abutmentlevel scan bodies was constructed. The scan bodies were numbered from 1 to 6，from the right molar to the left molar area. A control group was generated by scanning the implant model using a desktop scanner. Three intraoral scanner-based scanning techniques were tested：without any scan aids，with scan aids but without calibration，and with scan aids and perform calibration. The tests were performed on 2 intraoral scanners：TRIOS 3 and Aoralscan 3. Each technique was repeated 10 times on each scanner. Scan bodies in the tested groups were superimposed onto the control group using scan bodies #1 and #2 as references to simulate the single-screw test. For each scan body，the distance between the centers of the screw-retained abutments in the test and control groups was measured to calculate trueness. The distance between the centers of the screw-retained abutments in each pair of scans within each test group was also measured to calculate precision. Trueness and precision of the 3 tested impression techniques were compared. Results：In both tested scanners，the trueness of the scanning group with scan aids（272.32 μm for TRIOS 3；240.00 μm for Aoralscan 3）was higher than that of the group without any scan aids（606.77 μm for TRIOS 3；413.78 μm for Aoralscan 3）（all P ＜ 0.05）. Furthermore，the calibration process further improved trueness（70.51% improvement for TRIOS 3；28.00 % improvement for Aoralscan 3）. For precision，the scanning group with scan aids（75.60 μm for TRIOS 3；69.91 μm for Aoralscan 3）and the group with calibration （74.36 μm for TRIOS 3；79.42 μm for Aoralscan 3）outperformed the group without any scan aids（487.75 μm for TRIOS 3；160.74 μm for Aoralscan 3）（all P ＜ 0.05）. However，there was no statistically significant difference between the scanning group with scan aids and the group with calibration（P ＞ 0.05）. Conclusion：The accuracy of intraoral scanning for full -arch implant impressions can be significantly improved by using scan aids combined with a calibration process.

Abstract:With the development of digital technology，three-dimensional（3D）point cloud data is becoming more and more widely used in oral clinical digital diagnosis and treatment，involving many aspects such as 3D morphological comparison analysis，virtual patient construction，and defect morphological reconstruction. At present，"rigid registration" and "non-rigid registration" technologies have played important roles in the clinical application of oral 3D point cloud data. The similarities and differences between the two technologies and the algorithm principles behind them are worth in-depth discussion and exploration，so that they can better serve the clinical practice and scientific research of stomatology. The author’s team has a certain working basis for the application and research of“rigid registration”and“non - rigid registration”technologies. This article will explain the concepts，algorithm principles and their application in the field of stomatology，and summarize and prospect them to provide reference for the application of oral clinical and scientific research to the two technologies.

Abstract:Artificial intelligence（AI）is the“fourth industrial revolution”of human society，and dental implants have become the “third set of teeth”for humans. The 21st century is an era of digitization and AI，characterized by the deep integration and robust rise of AI in various fields of society. Implant prosthodontics is also rapidly developing towards high efficiency，precision，minimally invasive， and biomimetic direction with the assistance and acceleration of AI. In the future，AI will change the practice mode of implant prosthodontics and bring it to an extraordinary level. This article aims to review the research progress and application status of AI in various aspects of oral implant prosthodontics，and to make prospects for the shortcomings and future challenges.

Abstract:Objective：To investigate the incidence and radiographic characteristics of mandibular deviation in patients with unilateral anterior disc displacement without reduction（ADDWoR）of the temporomandibular joint，and to analyze the related factors influencing mandibular deviation. Methods：This retrospective study enrolled 210 patients with unilateral ADDWoR who visited the department of oral and maxillofacial surgery，the Affiliated Stomatological Hospital of Nanjing Medical University between April 2020 and December 2023，which were divided into a deviation group and a control group based on whether there was mandibular deviation. Cone-beam computed tomography（CBCT）was used to analyze mandibular morphology and positional characteristics，while magnetic resonance imaging assessed disc features. Multivariate logistic regression analysis was employed to identify factors associated with mandibular deviation. Results：Among the 210 patients，104 were assigned to the deviation group[median age 18.0（13.0，34.3）years] and 106 to the control group[median age 27.0（15.0，54.0）years]. The deviation group demonstrated significantly reduced ramus height and body length on the affected side compared to the unaffected side，with the entire mandible exhibiting posterior -superior rotation toward the affected side. This rotation pattern manifested as an increased ratio of anterior to posterior space on the affected side， increased lateral and superior spaces on the unaffected side，while showing decreased lateral spaces on the affected side and a reduced ratio of anterior to posterior space on the unaffected side. The articular disc in the deviation group was shorter in length and positioned farther from the condylar apex. In adolescent patients with deviation，besides mandibular morphological and positional changes， significant alterations in disc position were observed，whereas adult patients showed no remarkable changes in disc morphology or position. Multivariate logistic regression analysis revealed that mandibular positional parameters（including the ratio of anterior to posterior space on the affected side，lateral space on the affected side，the ratio of anterior to posterior space on the unaffected side，and superior space on the unaffected side）and mandibular morphological characteristics（ramus height discrepancy and mandibular body length discrepancy）were independent influencing factors of mandibular deviation（all P ＜ 0.05）. Conclusion：The mandibular deviation associated with unilateral ADDWoR is closely related to changes in mandibular morphology and position. Sagittal shortening of the affected side and posterior-superior rotation of the entire mandible toward the affected side may be the primary contributing factors to mandibular deviation. Adolescent patients with ADDWoR are more prone to significant alterations in mandibular morphology， positional relationship，and disc status.

Abstract:Objective：To separate a new important component 5 - hydroxymethyl - 2 -furfural（5 - HMF）in cigarette smoke，which provides a guarantee for evaluating its role in the respiratory system injury caused by smoking. Methods：A combination of liquid - liquid extraction and sephadex LH-20 column chromatography was used to extract and purify 5-HMF from the cigarette smoke extract （CSE）dissolved in chloroform. First，the total CSE was subjected to two consecutive liquid -liquid extractions with double - distilled water to transfer 5-HMF from the chloroform phase to the aqueous phase. Then，sephadex LH -20 was employed to separate 5-HMF from the aqueous phase. The efficiency of the extraction and separation processes were determined using high performance liquid chromatography - ultraviolet detection（HPLC - UV）. GraphPad Prism software was used for two - way analysis of variance（two - way ANOVA）and Tukey’s multiple comparisons test to evaluate the stability and reproducibility of the method. Results：The two - step liquid -liquid extraction transferred approximately 92.18% of 5-HMF from CSE to the aqueous phase. Sephadex LH -20 enabled the separation and recovery of approximately 94.88% of 5 -HMF from the aqueous phase. The coefficient of variation（CV）was 8.53% across three independent experiments. Two -way ANOVA indicated that although minor differences existed among different cigarette samples（P ＜ 0.01），the elution profile of 5-HMF was highly consistent（tube number factor：P ＜ 0.000 1），accounting for 97.04% of the total variation，confirming the good reproducibility of the method. Based on the content calculation，this method achieved the separation of approximately 89.55% of 5-HMF from CSE，while the component of nicotine in CSE did not interfere with the separation of 5-HMF. Conclusion：This study realized the simple，rapid，efficient and stable separation and preparation of 5-HMF in cigarette smoke，which not only provided material and technical guarantee for the subsequent systematic study of the toxic effects of important components of cigarette smoke，but also provided methods and ideas for the separation and preparation of other components in the complex matrix of cigarette smoke.

Abstract:Objective：To analyze the biological functions and gene sequence information of long non - coding RNA（lncRNA） uc004coz.1 associated with coronary artery disease（CAD）. Methods：LncRNAs were analyzed in plasma sequencing results of CAD patients. The target lncRNA uc004coz.1 was identified by clinical sample verification. Fluorescence in situ hybridization（FISH） method was used to locate uc004coz.1 in human umbilical vein endothelial cell（HUVEC），and its biological function was analyzed after knockdown with si - uc004coz.1. The effect on cell proliferation and migration was analyzed by CCK - 8，Transwell，EdU，flow cytometry，and Western blot. The full length sequence information of uc004coz.1 was obtained by rapid - amplication of cDNA ends （RACE）technique. Results：uc004coz.1 was down-regulated in CAD patients，and uc004coz.1 is mainly located in the nucleus. Cell proliferation and migration were significantly weakened after uc004coz.1 knockdown，and cell cycle - related proteins Cyclin D1 and Cyclin E1 were down-regulated. By comparing the RNA sequence and genome in the Ensembl database，we obtained that uc004coz.1 corresponding chromosome is Homo sapiens mitochondrion，complete genome（sequence ID：NC_01292-1）. The location of uc004coz.1 in the database is 15 998-16 569. The 5′-RACE sequencing results showed that the 5′ terminal position was 16 033. The 3′-RACE sequencing results showed that the terminal position of 3′ -RACE was 16 417. Conclusion：Understanding the biological function of down-regulated lncRNA uc004coz.1 in the plasma of CAD patients and analyzing its gene sequence can provide a target for the study of the mechanism of CAD and provide a theoretical basis for further study of uc004coz.1.

Abstract:Objective：To investigate the effect and mechanism of narrow-band ultraviolet B（NB-UVB）in promoting vitamin D（VD） metabolism and alleviating imiquimod（IMQ）induced psoriasis -like dermatitis in mice. Methods：C57BL/6 mice were treated with IMQ cream on the back skin to induce psoriasis-like dermatitis. The levels of VD metabolites 25（OH）D₃ and 1，25（OH）₂D₃ in serum were detected，as well as the expression of VD receptor（VDR）mRNA in the skin lesions. After determining the irradiation energy of NB-UVB irradiated mice，the model group combined with NB-UVB irradiation was performed to observe mouse skin lesions. The levels of 25（OH）D3，1，25（OH）₂D₃ in serum，VDR and inflammatory factors[interleukin（IL）-17A，IL-23，tumor necrosis factor（TNF）-α，IL-1β] mRNA expression and inflammatory factors protein contents in skin lesions，and the proportion of CD3 + CD4 + IL -17A+ T cells were detected. After pretreatment with the specific inhibitor Dafadine - A to block cytochrome P450 family 27 subfamily A member 1 （CYP27A1，a key enzyme in vitamin D metabolism）activity，the mice underwent psoriasiform dermatitis induction followed by NB -UVB irradiation. Skin lesions were observed，the proportion of CD3 + CD4 + IL - 17A+ T cells，inflammatory factors and VDR mRNA expression in the skin lesions，and serum levels of 25（OH）D₃ and 1，25（OH）2D3 were detected. Results：The levels of 25（OH）D3 and 1，25（OH）2D3 in the serum of psoriasis - like mouse models and the mRNA expression of VDR in skin lesions were significantly reduced. After NB-UVB irradiation on psoriasis-like mouse model，compared to the model group，the levels of 25（OH）D3，1，25（OH）₂D₃ in the serum of the irradiated mice and the mRNA expression of VDR in the skin lesions were upregulated. The mRNA expression and content of inflammatory factors IL -17A，IL -23，TNF - α and IL -1β in the skin lesions were downregulated，and the proportion of CD3 + CD4 + IL -17A+ T cells was significantly reduced. Compared to the IMQ+NB -UVB group，Dafadine -A pretreated mice showed significantly decreased serum levels of 25（OH）D3 and 1，25（OH）2D3，reduced VDR mRNA expression in skin lesions，along with significantly increased proportions of CD3+ CD4+ IL-17A+ T cells and elevated inflammatory cytokine levels of IL-17A，IL-23，TNF-α and IL -1β in lesions. Conclusion：NB UVB irradiation ameliorates psoriasiform dermatitis and cutaneous inflammation in mice by promoting VD metabolism. Importantly，specific inhibition of CYP27A1 markedly attenuates the therapeutic effects of NB-UVB on both psoriatic skin lesions and associated inflammatory responses.

Abstract:Objective：To screen potential pathogenic metabolites of acute pancreatitis（AP）and explore the molecular mechanism of α- ketoglutarate（αKG）regulating X ray repair cross - complementing protein 3（XRCC3）to induce AP based on animal and cell models. Methods：The study first conducted a Mendelian randomization（MR）study combined with two rounds of independent Meta-analysis to screen metabolites related to the onset of AP from a genetic perspective，and used the inverse variance weighted（IVW） method to evaluate the causal effect of metabolites on AP. Subsequently，AP animal models in C57BL/6 mice and AR42J cell models were constructed. The effects of αKG on pancreatic acinar cell injury and inflammatory response were verified by intraperitoneal injection of αKG and co-culture with the medium，respectively. The detection indicators included cell viability，levels of inflammatory factors，and histopathological changes. In addition，RNA sequencing was used to analyze the whole transcriptome differences in AR42J cells before and after αKG treatment，and the expression changes of XRCC3 and its role in the onset of AP were verified by immunohistochemistry and Western blot techniques. Results：The MR study and Meta-analysis results showed that αKG had a positive causal relationship with the onset of acute pancreatitis，while indolepropionate（INDO）showed a potential protective effect. Cell experiments indicated that 10 μmol/L of αKG could significantly inhibit the viability of AR42J cells and promote the secretion of inflammatory factors such as interleukin-6（IL-6）and IL-1β. In the animal model，intraperitoneal injection of αKG could induce the occurrence of AP in mice，manifested as pancreatic tissue edema，acinar cell injury，and elevated serum inflammatory factor levels. RNA -seq analysis revealed that αKG exacerbated acinar cell injury by inhibiting the expression of XRCC3 and weakening the DNA damage repair ability. The expression of XRCC3 in AR42J cells was significantly down - regulated after αKG treatment，which was verified by immunohistochemistry and Western blot. Additionally，overexpression of XRCC3 could partially reverse the damage effect of αKG on acinar cells. Conclusion：This study is the first to confirm at the genetic level that αKG is a pathogenic metabolite of AP， which exacerbates acinar cell injury and inflammatory response by inhibiting the XRCC3 - mediated DNA repair pathway. This discovery provides a new perspective for the metabolic mechanism research of AP and suggests that targeting the αKG -XRCC3 axis may be a potential therapeutic strategy.

Abstract:Objective：To investigate the expression of RNA binding motif protein 7（RBM7）in human breast cancer cell MDA-MB- 231，and its effects on the expression of A-kinase anchoring protein 12（AKAP12）. Methods：MDA-MB-231 cells were transfected with lentiviruses for RBM7 overexpression，knockdown（experimental group）and the corresponding control lentivirus（control group） respectively. Stable transfected cell lines were selected with puromycin and verified via fluorescence microscopy. The expression of RBM7 after transfection was verified by qRTPCR and Western blot experiments，respectively，and the effect of RBM7 expression change on AKAP12 expression was observed. Gene ontology（GO）enrichment analysis was performed on the differentially expressed genes obtained by RNA-sequence，and revealed significantly enriched pathways regulated by RBM7. At the same time，the UALCAN database was employed to assess AKAP12 expression in breast cancer. The relationship between RBM7 and AKAP12 was studied by RNA binding protein immunoprecipitation（RIP）assays. Furthermore，immunohistochemicalanalysis was performed to delineate the relationship between RBM7 and AKAP12 in breast cancer tissues. Results：After transfecting MDAMB-231 breast cancer cells with lentiviruses for RBM7 overexpression and knockdown respectively and screening with puromycin for 2 weeks，stably transfected cell lines with RBM7 overexpression and knockdown were obtained. GO enrichment analysis of differentially expressed genes obtained by RNA-sequence revealed that the genes significantly affected by RBM7 were mainly enriched in the cell cycle pathway. Moreover，the UALCAN database analysis showed that AKAP12 was lowly expressed in breast cancer（P ＜ 0.05）. It was observed that overexpression of RBM7 could downregulate RNA and protein expression of AKAP12，and knockdown of RBM7 upregulated RNA and protein expression of AKAP12 via qRT -PCR and Western blot（P ＜ 0.05）. RIP assays revealed that RBM7 could directly bind to mRNA of AKAP12（P ＜ 0.05）. Immunohistochemical analysis also showed that there was a significant negative correlation between the expression of RBM7 and AKAP12 in human breast cancer tissues（P ＜ 0.05）. Conclusion：RBM7 downregulates the expression of AKAP12 in breast cancer cell MDA-MB-231 and breast cancer tissues.

Abstract:Objective：To investigate the clinicopathological features，immunophenotype，and molecular genetic changes of switch/ sucrose non - fermentable complex（SWI/SNF）complex deficient carcinoma in digestive system，and to analyze the diagnosis and differential diagnosis points. Methods：The clinical data of 31 patients with SWI/SNF complex deficient carcinoma of digestive system were collected. The histological morphology was observed，and the immunohistochemical results and molecular alteration characteristics were summarized. Relevant literature was reviewed for analysis. Results：Among the 31 patients，19 were male and 12 were female，aged from 43 to 80 years，with a median age of 66 years. Location of disease：lower esophagus（gastroesophageal junction） 1 case，stomach 7 cases，right colon 3 cases，pancreas 18 cases，ampulla 2 cases. The maximum diameter of the lesions ranged from 1.5 to 18.0 cm（median，3.5 cm）. Histologically，15 tumors showed the morphology of undifferentiated carcinoma，and 16 were low - to moderately differentiated pancreatic ductal adenocarcinoma，adenosquamous carcinoma，or intraductal papillary mucinous neoplasm （IPMN）with associated invasive carcinoma. Immunophenotype：14 of the 15 undifferentiated carcinomas showed loss of BRG1 expression，and 1 pancreatic undifferentiated carcinoma showed partial loss of INI1 expression while retaining BRG1 expression；4 cases showed negative or only scattered expression of CK - pan in tumor cells，and other epithelial markers were positive in only individual tumor cells or mostly negative；7 cases showed weak to moderate positivity of Syn in some tumor cells，among which 2 cases showed scattered weak positivity of CD56 or INSM1 respectively，and all were negative for CgA. BRG1 expression was retained in 16 pancreatic/ampullary cancers，8 cases showed partial loss or reduced expression of INI1，and 8 cases retained expression；molecular pathology showed that 14 cases had SMARCB1 gene mutations，2 cases had SMARCA4 gene mutations，KRAS gene mutations were seen in all cases，and 14 cases had TP53 gene mutations. Conclusion：Some SWI/SNF complex deficient carcinomas in the digestive system are undifferentiated carcinomas without specific differentiation characteristics. Extragastrointestinal SWI/SNF complex deficient carcinoma may have more differentiated adenocarcinoma morphology. Detection of SWI/SNF proteins such as BRG1 and INI1 is recommended to reduce missed diagnosis and misdiagnoses. SWI/SNF - related gene mutations in pancreatic cancer are correlated with KRAS and TP53 gene mutations.

Abstract:Objective：To conduct an in-depth analysis of the key factors influe-ncing the risk of malnutrition in elderly diabetic patients with cognitive frailty（CF）and to construct an accurate risk prediction nomogram model based on these factors. Methods：A cross-sectional study design was adopted，enrolling 124 elderly diabetic patients with CF. The patients’frailty，cognitive function， psychological state and risk of malnutrition were evaluated. Multivariate logistic regression analysis was used to identify influencing factors for malnutrition risk，and the R language was used to construct the prediction model and draw the nomogram. Model validation was carried out by receiver operating characteristic curve analysis，Hosmer-Lemeshow test and concordance index evaluation，and calibration curve drawing. Results：The malnut-rition risk rate among the 124 elderly diabetic patients with CF was 67.7%（84/124）. These 84 patients were assigned to the malnutrition risk group，and the remaining 40 were assigned to the well-nourished group. Age， marital status，body mass index（BMI），geriatric depression scale（GDS）score，albumin，and prealbumin levels were identified as independent predictors of malnutrition risk in elderly diabetic patients with CF（all P ＜ 0.05）. The nomogram model constructed based on these influencing factors had a C-index of 0.781（95% CI：0.695-0.867）. The Hosmer-Lemeshow test indicated a good fit for the nomogram model. Decision curve analysis showed that when the threshold probability ranged from 0.10 to 0.67，the net benefit rate of using this nomogram model to predict malnutrition risk in elderly diabetic patients with CF was 0.46-0.60. Conclusion：In elderly diabetic patients with CF，age，marital status，BMI，GDS score，albumin，and prealbumin levels are key factors influencing the risk of malnutrition. The established risk prediction model demonstrates moderate predictive performance and good clinical application value for assessing the risk of malnutrition in such patients.

Abstract:Objective：To explore the new D-dimer cutoff values after cesarean section as a predictive factor for pulmonary embolism （PE）. Methods：A total of 198 women with suspected PE after cesarean section who delivered at the Women’s Hospital Affiliated to Nanjing Medical University from January 1，2018，to December 31，2024，were selected for a retrospective case - control study. 33 patients were finally diagnosed with PE by computed tomographic pulmonary angiography（CTPA）and were included in the study group，while 165 patients were excluded from having PE by CTPA and were included in the control group. Analyze the age，body mass index（BMI），gestational age at delivery（weeks），number of fetuses，surgical indications，risk factors for venous thromboembolism （VTE）after delivery，D-dimer concenrtration within postpartum 24 h，and the time of using LMWH after cesarean section. The receiver operating characteristic（ROC）curve of D-dimer was plotted to determine the optimal sensitivity and specificity of the D-dimer value， and the area under the curve（AUC）was used to evaluate the cutoff value. The risk factors for PE were analyzed，and the odds ratio（OR） and 95% confidence interval were calculated. Results：The D - dimer level in the PE group was 6.82（4.46，13.06）mg/L，significantly higher than that in the non-PE group 3.83（2.35，5.21）mg/L（P ＜ 0.01），and the anticoagulation initiation time after surgery in the PE group was later than that in the non-PE group[1（0，3）d vs. 2（1，5）d，P ＜ 0.05]. The optimal cut-off value of D-dimer within 24 h post - cesarean was 7.48 mg/L，with a specificity of 93.9% and sensitivity of 62.4%. The AUC was 0.75（95% CI：0.652-0.848，P ＜ 0.001）. When the D-dimer cut-off was adjusted to 1.59 mg/L，its sensitivity and specificity were 100% and 43.2%，respectively，with the highest Youden index for negative predictive value. This threshold may be particularly meaningful for early PE screening after cesarean delivery. Prolonged immobilization and D-dimer levels were identified as two independent risk factors for PE. Notably ， D - dimer was a continuous risk factor（OR=1.58）. Conclusion：D - dimer within 24 h after cesarean section is a continuous and independent risk factor for PE and a strong predictive indicator. It can be used as a more convenient and safe screening method to identify PE after cesarean section，so as to intervene in time and reduce unnecessary imaging examinations.

Abstract:Objective：To summarize the characteristics and patterns of organ injury in patients diagnosed with severe fever with thrombocytopenia syndrome（SFTS）. Methods：A retrospective analysis was conducted on patients with SFTS admitted to the First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. During hospitalization，concurrent organ injuries were recorded and statistically analyzed. Logistic regression analysis was performed to evaluate the association between organ injury and prognosis. Furthermore，a nomogram was developed to predict discharge outcomes based on organ injury assessment in SFTS patients. Results：A total of 284 SFTS patients were enrolled in this study，among whom 252（88.7%）exhibited signs of organ injury. Cardiac injury was most commonly observed. Multivariate logistic regression analysis revealed that age（OR=1.103，95%CI：1.042-1.176， P=0.001），pancreatic injury（OR=3.414，95%CI：1.296-9.299，P=0.014），renal injury（OR=16.365，95%CI：5.699-53.234，P ＜ 0.001）， pulmonary injury（OR=3.805，95%CI：1.494-9.955，P=0.005），and cerebral injury（OR=3.414，95%CI：1.283-9.289，P=0.014）were independently associated with increased risk of in-hospital mortality in SFTS patients. The constructed nomogram demonstrated strong predictive performance for discharge outcomes. Internal validation using the bootstrap method（resampling=1 000）showed an average area under the receiver operating characteristic（ROC）curve of 0.937（95% CI：0.910- 0.965）. Conclusion：The majority of SFTS patients experienced concurrent organ injuries. Increased age these，pancreatic，renal，pulmonary，and cerebral injuries were significantly associated with increased mortality risk. The nomogram based on organ injuries for predicting discharge outcomes had good clinical application value.

Abstract:Objective：To analyze the factors associated with prolonged postoperative hospital stay（ ≥30 days）after distal pancreatectomy（DP），identify independent risk factors，and provide a basis for optimizing perioperative management. Methods：A retrospective analysis was conducted on 1 215 patients who underwent DP at a single center from January 2020 to June 2024. Based on postoperative hospital stay，patients were divided into two groups：≥30 days（80 cases）and ＜30 days（1 135 cases）. Univariate analysis was used to compare differences in clinical characteristics between the two groups，and multivariate logistic regression was employed to identify independent risk factors. Results：Among the 1 215 DP cases，80（6.6% ）had a postoperative hospital stay ≥30 days. Univariate analysis revealed that gender，age，tumor type，modified Appleby procedure，combined organ resection，combined vascular resection，dissection of the Heidelberg triangle，as well as complications such as pancreatic fistula，delayed gastric emptying（DGE）， postoperative bleeding，and chylous fistula were significantly associated with prolonged postoperative hospital stay（all P ＜ 0.05）. Multivariate logistic regression analysis demonstrated that modified Appleby procedure（OR=3.167，P=0.007），combined organ resection（OR=3.334，P ＜ 0.001），postoperative bleeding（OR=4.148，P=0.025），DGE（OR=10.482，P ＜ 0.001），intra - abdominal infection（OR=5.718，P ＜ 0.001），chylous fistula（OR=2.457，P=0.022），sepsis（OR=13.485，P ＜ 0.001），and postoperative invasive interventions（OR=6.045，P ＜ 0.001）were independent risk factors for a hospital stay ≥30 days. Conclusion：Prolonged postoperative hospital stay（≥30 days）after DP is associated with various perioperative factors. Developing individualized diagnostic and treatment strategies targeting high-risk factors and optimizing management can help shorten the length of hospital stay.

Abstract:The sphingosine-1-phosphate（S1P）signaling axis plays a pivotal role in maintaining vascular homeostasis，modulating inflammatory responses，and promoting cardiomyocyte survival. However，current research has largely centered on the macrovascular and global cardiac function，with limited systematic exploration of S1P’s role in the cardiac microcirculation，a key driver of myocardial ischemia，heart failure，and fibrosis. In this review，we adopt a microcirculatory perspective to delineate the differential expression patterns and functional roles of S1P receptor subtypes in microvascular endothelial cells，vascular smooth muscle cells，and immune cell populations. We further summarize the therapeutic advances and limitations of S1P modulators，including fingolimod， siponimod，and sphingosine kinase inhibitors，in models of myocardial ischemia，heart failure，diabetic cardiomyopathy，and hypertensive heart disease. Precision intervention strategies are then proposed，integrating biomarker - guided patient stratification， receptor-subtype selective modulation，targeted nanocarrier delivery，and multi-target combination therapy. Looking ahead，single-cell spatial omics to resolve dynamic S1P receptor expression，optimized carrier design，and stratified clinical trials hold promises to accelerate the translational application of S1P pathway-based therapies in microcirculation-related cardiac diseases.

Abstract:Depressive disorders have become one of the most common and significantly harmful psychological conditions among adolescents. The incidence of nonsuicidal self -injury（NSSI）in adolescents with depressive disorders is on the rise，posing a severe challenge to their physical and mental health. Previous studies have indicated that the mechanisms underlying adolescent depressive disorders and NSSI are complex，involving the interplay of multiple factors，including neurotransmitter levels，hormonal changes， immune -inflammatory responses，genetic susceptibility，and psychosocial influences. NSSI is not only an important manifestation of risky behavior in patients with depressive disorders but also closely related to suicide risk. Current treatments for adolescent depressive disorders and NSSI are primarily centered on psychotherapy，with multimodal interventions，including pharmacotherapy and physical treatments，as adjuncts. Different intervention approaches have shown certain differences in improving NSSI behaviors and prognosis. This article reviews the relevant epidemiology，pathophysiological mechanisms，and risk factors，and systematically summarizes the major research advances and clinical intervention strategies for adolescent depressive disorders with NSSI in recent years，aiming to provide theoretical references for further optimizing treatment models and improving patients’prognosis and quality of life.

Abstract:Rheumatoid arthritis（RA）is a chronic systemic autoimmune disease characterized by synovitis and progressive joint destruction，leading to a high disability rate and complex complications that severely compromise patients’quality of life. Although traditional diagnosis and treatment have been shown to significantly enhance patient symptoms，challenges such as the difficulty of early diagnosis，substantial individual variability in treatment response，and the high prevalence of complications，including cardiovascular diseases and interstitial lung disease，continue to be focal points in clinical practice. Recent rapid advancements in artificial intelligence and machine learning（ML）technologies offer novel opportunities to overcome these bottlenecks in RA management. By deeply mining RA multimodal medical data，such as patient imaging，genomics，and electronic health records，ML models have shown potential advantages in early diagnosis，stratified management of treatment response，and modeling of complication risk，such as early warning of cardiovascular events. However，barriers such as data heterogeneity，limited model interpretability，and challenges in clinical translation hinder its widespread adoption. This paper systematically reviews the latest research progress in applying ML to RA diagnosis and treatment，aiming to provide a theoretical foundation and practical reference for realizing ML-driven precision medicine in RA.

Abstract:Dilated cardiomyopathy（DCM）exhibits significant gender differences，the incidence is approximately 2-3 times higher in males than in females，and male patients often present with more severe clinical phenotypes and poorer prognoses. As pathogenic genes related to DCM，X chromosome-linked genes（such as DMD，regulated by X chromosome inactivation），Y chromosome-related genes（such as SRY and SOX families），and some autosomal genes（such as TTN，RBM20，LMNA）have higher penetrance or pathogenicity in males. At the molecular level，estrogen exerts cardioprotective effects mainly through estrogen receptor（ER）α/ERβ- mediated activation of the PI3K/Akt signaling pathway，while testosterone，via androgen receptor（AR）signaling，promotes fibrosis and maladaptive cardiac remodeling. Additionally，male patients tend to exhibit greater mitochondrial dysfunction and heightened inflammatory responses. Based on these gender - related molecular mechanisms，researchers have proposed and developed a series of gender-tailored precision therapies，with the aim of providing new approaches for individualized treatment of DCM.