Clinical implications and predictive value of the creatinine­cystatin C ratio in patients with multiple myeloma and renal impairment.

The creatinine (Cr)-cystatin C ratio (CCR) at the time of cancer diagnosis is associated with survival; however, to the best of our knowledge, the association between this ratio and mortality in patients with multiple myeloma and renal impairment (RI) is unclear. Therefore, the present study aimed to assess this association, as well as disease prognosis and the clinical significance of the CCR in patients with multiple myeloma and RI. The present retrospective study included 191 patients diagnosed with multiple myeloma and RI between 2012 and 2022. The predictive value of the CCR was evaluated using area under the receiver operating characteristic curve (AUC) values. The factors affecting overall survival (OS) were assessed using uni- and multivariate logistic regression analyses. The effect of the CCR on survival was evaluated using a Cox regression model and the Kaplan-Meier method. There was a significant association between low CCR and poor progression-free survival (PFS) and overall survival (OS). The 1-, 2- and 3-year PFS and OS rates in patients with a low CCR were significantly lower than those in patients with a high CCR. The 1-, 2- and 3-year AUC values of the CCR were 0.712, 0.764 and 0.746 respectively. Multivariate analysis revealed sex, age, Cr levels, CCR and C-reactive protein levels as independent prognostic factors affecting OS rates. The CCR is a potential prognostic indicator in patients with multiple myeloma with RI and is associated with clinical stages.

Risk factors for central lymph node metastasis in patients with papillary thyroid carcinoma: a retrospective study.

Introduction: Thyroid cancer is the most prevalent endocrine malignancy, with its global incidence increasing annually in recent years. Papillary carcinoma is the most common subtype, frequently accompanied by cervical lymph node metastasis early on. Central lymph node metastasis (CLNM) is particularly the common metastasis form in this subtype, and the presence of lymph node metastasis correlates strongly with tumor recurrence. However, effective preoperative assessment methods for CLNM in patients with papillary thyroid carcinoma (PTC) remain lacking. Methods: Data from 400 patients diagnosed with PTC between January 1, 2018, and January 1, 2022, at the Shandong Provincial Hospital were retrospectively analyzed. This data included clinicopathological information of the patients, such as thyroid function, BRAF V600E mutation, whether complicated with Hashimoto's thyroiditis, and the presence of capsular invasion. Univariate and multivariate logistic regression analyses were performed to assess the risk factors associated with cervical CLNM in patients with PTC. Subsequently, a clinical prediction model was constructed, and prognostic risk factors were identified based on univariate and multivariate Cox regression analyses. Results: Univariate and multivariate analyses identified that age >45 years (P=0.014), body mass index ≥25 (P=0.008), tumor size ≥1 cm (P=0.001), capsular invasion (P=0.001), and the presence of BRAF V600E mutation (P<0.001) were significantly associated with an increased risk of CLNM. Integrating these factors into the nomogram revealed an area-under-the-curve of 0.791 (95% confidence interval 0.735-0.846) and 0.765 (95% confidence interval: 0.677-0.852) for the training and validation sets, respectively, indicating strong discriminative abilities. Subgroup analysis further confirmed that patients with papillary thyroid microcarcinoma and BRAF V600E mutations who underwent therapeutic central compartment neck dissection had significantly better 3-year disease-free survival than those who had prophylactic central compartment neck dissection (P<0.001). Conclusion: The study revealed that age >45 years, body mass index ≥25, tumor size ≥1 cm, BRAF V600E mutation, and capsular invasion are the related risk factors for CLNM in patients with PTC. For patients with clinically nodal-negative (cN0) papillary thyroid microcarcinoma, accurately identifying the BRAF V600E mutation is essential for guiding the central lymph node dissection approach and subsequent treatments.

Mechanical properties analysis of medical endodontic instruments based on parameterization.

To study the relationship between structural parameters and mechanical properties of endodontic instruments, the T02004B25 nickel-titanium endodontic instrument was selected for bending and torsion tests and finite element simulation analysis, which demonstrated the feasibility of simulation analysis method. Then based on the idea of parametric design, the models of the endodontic instruments with different structural parameters (cross-section, pitch, taper) were established, and the bending-torsion performance simulation analysis was completed. The results showed that the mechanical properties of endodontic instruments with different structural parameters are different. It is necessary to find the optimal parameters for different structure parameters of endodontic instruments to maximize their service life.

Exploring the Relationship between Gray and White Matter in Healthy Adults: A Hybrid Research of Cortical Reconstruction and Tractography.

The gray matter (GM) and white matter (WM) are structurally and functionally related in the human brain. Among the numerous neuroimaging studies, yet only a few have investigated these two structures in the same sample. So, there is limited and inconsistent information about how they are correlated in the brain of healthy adults. In this study, we combined cortical reconstruction with diffusion spectrum imaging (DSI) tractography to investigate the relationship between cortical morphology and microstructural properties of major WM tracts in 163 healthy young adults. The results showed that cortical thickness (CTh) was positively correlated with the coherent tract-wise fractional anisotropy (FA) value, and the correlation was stronger in the dorsal areas than in the ventral areas. For other diffusion parameters, CTh was positively correlated with axial diffusivity (AD) of coherent fibers in the frontal areas and negatively correlated with radial diffusivity (RD) of coherent fibers in the dorsal areas. These findings suggest that the correlation between GM and WM is inhomogeneity and could be interpreted with different mechanisms in different brain regions. We hope our research could provide new insights into the studies of diseases in which the GM and WM are both affected.

Reproducibility of volume and asymmetry measurements of hippocampus, amygdala, and entorhinal cortex on traveling volunteers: a multisite MP2RAGE prospective study.

BACKGROUND: Multisite studies can considerably increase the pool of normally aging individuals with neurodegenerative disorders and thereby expedite the associated research. Understanding the reproducibility of the parameters of related brain structures-including the hippocampus, amygdala, and entorhinal cortex-in multisite studies is crucial in determining the impact of healthy aging or neurodegenerative diseases. PURPOSE: To estimate the reproducibility of the fascinating structures by automatic (FreeSurfer) and manual segmentation methods in a well-controlled multisite dataset. MATERIAL AND METHODS: Three traveling individuals were scanned at 10 sites, which were equipped with the same equipment (3T Prisma Siemens). They used the same scan protocol (two inversion-contrast magnetization-prepared rapid gradient echo sequences) and operators. Validity coefficients (intraclass correlations coefficient [ICC]) and spatial overlap measures (Dice Similarity Coefficient [DSC]) were used to estimate the reproducibility of multisite data. RESULTS: ICC and DSC values varied substantially among structures and segmentation methods, and values of manual tracing were relatively higher than the automated method. ICC and DSC values of structural parameters were greater than 0.80 and 0.60 across sites, as determined by manual tracing. Low reproducibility was observed in the amygdala parameters by automatic segmentation method (ICC = 0.349-0.529, DSC = 0.380-0.873). However, ICC and DSC scores of the hippocampus were higher than 0.60 and 0.65 by two segmentation methods. CONCLUSION: This study suggests that a well-controlled multisite study could provide a reliable MRI dataset. Manual tracing of volume assessments is recommended for low reproducibility structures that require high levels of precision in multisite studies.