Objective:To assess the status of undernutrition and appropriate catch-up growth in extremely preterm infants within 24 months of corrected age (CA).Methods:A retrospective cohort study was conducted. A total of 422 extremely preterm infants born at Shenzhen Maternity and Child Healthcare Hospital, Women and Children's Medical Center, Southern Medical University from January 2017 to December 2022 and followed up until 24 months of CA were enrolled. The extremely preterm infants were grouped by gestational age at birth (<25, 25-26, 27 weeks), birth weight (<500, 500-749, 750-999,≥1 000 g), weight for gestational age (large for gestational age (LGA), appropriate for gestational age (AGA), small for gestational age (SGA)) and sex. Weight data within 24 months of CA were collected every 3 months. Nutritional insufficiency, growth rate, and achievement of adequate catch-up growth were analyzed during the period from 0 to 24 months of CA. Z-score method was used to analyze data. Fenton 2013 preterm growth charts (Fenton 2013) were used before 40 weeks of corrected gestational age, and World Health Organization child growth standards (2009) fitted Z-scores were applied from 40 weeks of CA. Changes in weight Z-scores of extremely preterm infants from 0 to 24 months of CA were observed and compared, the occurrence of moderate to severe malnutrition and growth retardation was determined, nutritional insufficiency was assessed, and growth rate as well as the achievement of appropriate catch-up growth were analyzed. The Lambda-mu-sigma method combined with the Z-score fitting model was used to fit and analyze the distribution characteristics of weight percentiles in extremely preterm infants. The Chi-square test was used to compare differences among groups.Results:A total of 422 extremely preterm infants were included, with a gestational age at birth of 26.3(25.4, 27.2) weeks and a birth weight of (880±177) g. Among them, 238 were males and 184 were females; 36 cases (8.5%) were LGA, and 16 cases (3.8%) were SGA. During follow-up within 24 month of CA, 89 cases (21.1%) developed moderate to severe malnutrition. When compared separately among different birth weight and gestational age at birth groups, there had both statistically differences in the incidence of moderate to severe malnutrition ( χ2=42.94 and 9.17, both P<0.05). The incidence was the highest in the birth weight of CA<500 g group and the <25 weeks gestational age at birth group, while it was the lowest in the birth weight of CA≥1 000 g group and the 27 weeks gestational age at birth group in their respective groups. Growth retardation occurred in 5.2% (22/422). However, there had statistically differences in the incidence of growth retardation among different birth weight and gestational age at birth groups, in each grouped time interval ( χ2=21.61 and 4.30, both P<0.05). The proportions of rapid growth were relatively high in the 0-3 months and 3-6 months of CA groups, which were 96 cases (27.4%) and 98 cases (26.6%), respectively. Overall, appropriate catch-up growth was achieved in 341 cases (80.8%) from 0 to 24 months of CA. There had statistically differences in the completion rate of appropriate catch-up growth among different birth weight and gestational age at birth groups ( χ2=23.65 and 7.08, both P<0.05). The completion rate was the highest in the birth weight of CA<500 g group and the <25 weeks of gestational age at birth group, while it was the lowest in the birth weight of CA≥1 000 g group and the 27 weeks of gestational age at birth group. Conclusions:The lower the birth weight and gestational age of extremely preterm infants, the higher the incidence of moderate to severe malnutrition and the lower the achievement rate of adequate catch-up growth within 24 months of CA. The period of 0-6 months of CA is the critical window for catch-up in extremely preterm infants.

BACKGROUND:Orthodontic treatment to move the mandibular second molar in place of the missing first molar is a good method for preserving natural teeth.However,molars often exhibit mesial tipping when using clear aligners.The impact of attachments and overcorrection on the molar mesialization with clear aligners is unclear.OBJECTIVE:To investigate the effects of attachments and overcorrection on displacement and biomechanics of the mandibular second molar mesialization.METHODS:A finite element model with the left mandibular first molar missing was constructed using a volunteer's cone-beam CT and intraoral scan data.The experiment was divided into four groups based on the position of attachments on the left mandibular second molar:without attachment,buccal attachment,lingual attachment,and buccal-lingual attachment,with overcorrection degrees(0°,1°,2°,3°,and 4°)for each group,totaling 20 models.The calculation and analysis of the displacement trends and stress were performed using Abaqus software.RESULTS AND CONCLUSION:(1)Mesial tipping and intrusion of the molar,distal tipping of the canines and permolars,and linguaing of the incisors occurred during molar mesialization.(2)The displacement of molars increased when attachments were used,with the maximum displacement occurring when buccal-lingual attachments were applied.Molars tended to tip towards the side without attachments when attachments were designed unilaterally.However,the inclination of molars did not decrease when attachments were used.(3)Molars exhibited reduced mesial tipping and intrusion,approaching overall movement,and the stress of periodontal ligament was relieved and more evenly distributed during overcorrection treatment,and this effect became more pronounced with increased degrees of overcorrection.(4)Attachments can enhance the effectiveness of overcorrection,with the best performance observed when buccal-lingual attachments are used.Using attachments and overcorrection together helps control molar mesial tipping and intrusion,but overall molar movement is not achieved.

BACKGROUND:The titanium alloy bone trabecular bone socket cup prosthesis printed by 3D technology has superior biological characteristics,which helps to promote osteogenic differentiation of stem cells.The Kidney Tonifying and Blood Activating Decoction has the functions of tonifying the kidneys,strengthening tendons,promoting blood circulation,and relieving pain.However,the application of the combination of the two in elderly hip arthroplasty is rarely reported.OBJECTIVE:To evaluate the application value and safety of 3D printed titanium alloy bone trabecular cup prosthesis combined with modified Kidney Tonifying and Blood Activating Decoction in elderly hip arthroplasty.METHODS:A total of 200 elderly patients who received hip arthroplasty in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to January 2024 were selected and randomly divided into control group(n=100)and trial group(n=100).The control group underwent Pinnaele cup prosthesis hip arthroplasty combined with modified Kidney Tonifying and Blood Activating Decoction,while the trial group underwent 3D printed titanium alloy bone trabecular cup prosthesis hip arthroplasty combined with modified Kidney Tonifying and Blood Activating Decoction.The medication was taken continuously for 1 week before hip arthroplasty and for 4 weeks after arthroplasty.The differences in pain,swelling,hemorheology,inflammatory factors,bone metabolism,intra-articular stress,and hip abduction muscle strength were compared between the two groups to evaluate the clinical efficacy and safety of the two treatment options.RESULTS AND CONCLUSION:(1)Four weeks after surgery,the pain visual analog scale score,limb swelling,whole blood viscosity,and plasma viscosity of the trial group were lower than those of the control group(P＜0.05).The interleukin-6 level of the trial group was lower than that of the control group,and the interleukin-10 level was higher than that of the control group(P＜0.05).The levels of type Ⅰ collagen carboxyl terminal peptide β specific sequence and tartrate-resistant acid phosphatase 5b in the trial group were lower than those in the control group,while the levels of osteocalcin,bone-specific phosphatase and typeⅠ procollagen amino-terminal propeptide were higher than those in the control group(P＜0.05).The intra-articular stress and hip abduction muscle strength in the trial group were higher than that of the control group(P＜0.05).(2)Three months after surgery,the excellent and good treatment rate in the trial group was higher than that in the control group,and the incidence of safety evaluation events such as postoperative incision hematoma and infection was lower than that in the control group(P＜0.05).(3)It suggests that 3D printed titanium alloy trabecular acetabular cup prosthesis combined with modified Kidney Tonifying and Blood Activating Decoction can improve the blood rheology of elderly patients with hip arthroplasty,inhibit inflammatory response,reduce postoperative pain and swelling,and enhance bone metabolism,thereby promoting postoperative hip joint function recovery,and reducing the incidence of adverse events,with high safety.

Objective: To investigate the associations between childhood obesity and performance of six minute walk test (6MWT), providing evidence for exercise tolerance assessment and exercise intervention strategies for children and adolescents. Methods: From March 2021 to December 2023, a cohort study was conducted among students recruited from a primary and secondary school in Chongqing, a total of 709 valid samples were included. The 6MWT was used to assess exercise tolerance, with vital signs measured before and after the test. Anthropometric indicators, including height, weight, and waist circumference, were measured using standardized procedures. Generalized additive models (GAM) and restricted cubic spline (RCS) regression were employed to analyze the nonlinear relationships between obesity related indicators and six minute walk distance (6MWD). Results: The mean 6MWD of participants was (602.59±70.73)m. GAM showed that after adjusting for confounding factors, body mass index (BMI) and weight had non linear relationships with 6MWD [effective degrees of freedom were 1.55 and 7.13 respectively], and overweight/obesity was associated with a decrease in 6MWD ( β =-18.65) (all P <0.01). Further RCS regression analysis showed that both BMI and weight showed an "inverted U shaped" non linear relationship with 6MWD in the overall population and sex stratified subgroups; the 6MWD of females was lower than that of males, and it showed a significant downward trend with the increase of BMI or weight (all P <0.05). Conclusion Body weight and BMI in children and adolescents have an important impact on 6MWD, and obesity in children and adolescents is markedly associated with decline in exercise tolerance.

目的 探讨应激性高血糖比率（SHR）与大动脉粥样硬化型脑梗死患者卒中后认知功能障碍（PSCI）的相关性。方法 连续性筛选2023年7月1日—2024年6月30日在北京京煤集团总医院住院的大动脉粥样硬化型脑梗死患者，共计1 222例纳入分析。根据SHR的三分位数水平，将患者分为3组：低值组（0.175~0.764，n=408），中值组（0.765~0.905，n=407）及高值组（0.906~2.760，n=407）。采用单因素分析比较两组间相关指标的差异，采用单因素及多因素Logistic回归分析，找出PSCI发生的独立危险因素；使用限制性三次样条（RCS）来阐明SHR水平与PSCI发生的关联，并进行阈值效应分析。结果 所有随访的患者中，PSCI发生率为16.3%（199/1 222）；高值组患者的年龄、平均动脉压（MAP）、入院时NIHSS评分、出院时MRS评分及PSCI发生率均增高，同时，MMSE评分及高学历占比显著降低（P均<0.05）；在校正相关因素后，除年龄大、高低密度脂蛋白水平、高同型半胱氨酸水平、高血清肌酐、合并糖尿病病史及出院高MRS评分外，高SHR（OR=5.19，95%CI 3.15~8.55，P<0.001）是PSCI发生的独立危险因素；SHR与PSCI发生率呈“倒V”型的非线性关系（Pfor overall<0.001，Pfor nonlinear<0.001），且两者之间的关联存在阈值效应（Pfor likelihood test<0.001），即当SHR<1.28时，SHR和PSCI为正向关联（OR=93.26，95%CI 27.23~319.42），当SHR>1.28时，SHR和PSCI为负向关联（OR=0.08，95%CI 0.02~0.41）。结论 在大动脉粥样硬化型脑梗死患者中，PSCI发生率较高；SHR与PSCI的发生呈“倒V”型的非线性关系。

ObjectiveTo develop a novel precision rehabilitation service model for structural problems in rural rehabilitation services for persons with disabilities in China, such as shortages of professional resources, imprecise assessment and lack of service continuity, guided by International Classification of Functioning, Disability and Health (ICF) and supported by digital technologies. MethodsUsing ICF as an analytical tool and rural disability rehabilitation services as the application scenario, this study adopted a problem-oriented approach focused on current service challenges. Through literature review, situation analysis and strategy exploration, elements of body functions and structures, activities and participation, environmental factors, and digital technologies were organically integrated to form systematic solutions. ResultsA precision rehabilitation service model developed for rural persons with disabilities was constructed based on ICF and integrated with digital technologies such as the Internet of Things, big data and telerehabilitation. The model encompassed three dimensions: precise assessment of body functions, precise matching of intervention modalities and precise adjustment of environmental factors. An implementation pathway for digital technology-empowered precision rehabilitation in rural areas was proposed. ConclusionThe digitally empowered precision rehabilitation service model based on ICF is helpful for addressing the challenges of equity and precision in rural rehabilitation services in China, promoting access fairer, more accessible and systematically continuous rehabilitation services.

Triclosan (TCS) and triclocarban (TCC) are widely used synthetic broad-spectrum antibacterial agents that can enter the human body through the skin, gastrointestinal tract, and other pathways. More and more studies have found that exposure to TCS and TCC can affect human health, but currently, review reports on the health effects of human exposure to TCS and TCC are limited. Therefore, this study reviewed population studies on the relationship between TCS and TCC exposure and health effects by searching the PubMed database, summarized the associated health outcomes, and elucidated the biological mechanisms. A total of 56 studies were retrieved, among which cross-sectional studies (25 studies, 44.64%) and cohort studies (25 studies, 44.64%) accounted for a relatively large proportion, while case-control studies (6 studies, 10.72%) were relatively few. Studies on TCS exposure (48 studies, 85.71%) were far more prevalent than those on TCC exposure (2 studies, 3.57%). The remaining 6 studies involved both TCS and TCC exposure. The research results revealed that TCS exposure was associated with male and female abnormal reproductive functions, fetal growth restriction, abnormal behavior development in children, obesity, gestational diabetes mellitus (GDM), and immune-related diseases. Although the results of different studies show significant differences, they have indicated that exposure to TCS is a potential risk factor for these health problems. Due to the limited number of studies, the evidence for the relationship between TCC exposure and most of the aforementioned health effects is insufficient. Population studies and in vitro and in vivo studies have shown that exposure to TCS and TCC can interfere with the microbial homeostasis, the endocrine system, oxidative stress and immune function of the body, which are potential mechanisms causing adverse health effects. In the future, large-scale prospective cohort studies, as well as in vivo and in vitro studies, are still needed to further clarify the associations between TCS and TCC exposure and health effects, and to deeply explore its mechanism of action. These efforts will provide references for clarifying the human health hazards of TCS and TCC exposure and formulating targeted prevention and control strategies.

ObjectiveTo analyze the incidence and spatiotemporal distribution of typhus fever in Baoshan City, Yunnan Province from 2005 to 2023, to identify high-risk populations and regions, so as to provide a scientific basis for optimizing the allocation of local prevention and control resources and developing targeted intervention measures. MethodsData of typhus fever cases in Baoshan City from 2005 to 2023 were obtained from the Infectious Disease Information Management System of the Chinese Center for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the temporal, spatial and demographic distribution of typhus fever cases. Spatial clustering was assessed using spatial dynamic window scan statistics (circular and elliptical windows), flexible spatial scan statistics, and local spatial autocorrelation methods (including local Moran’s I, local Geary’s C, and Getis-Ord G_i*). Retrospective spatiotemporal scan statistics were employed to detect spatiotemporal clusters. ResultsA total of 1 099 typhus fever cases were reported in Baoshan City from 2005 to 2023. The incidence rate peaked at 6.31/ 100 000 in 2007, followed by a decline until reaching its lowest level at 0.21/100 000 in 2015 , and subsequently rebounded during 2016‒2023. The highest proportion of cases was among children under 10 years of age (31.12%), and the top three occupations of cases were farmers, students, and children, accounting for 88.62% of all cases. Cases occurred predominantly between June and September each year. The incidence was relatively high in Jiucheng Town (62.58/100 000), Yaoguan Town (57.15/100 000), and Dianyang Town (46.81/100 000) of Shidian County. Spatial clustering analyses indicated that high-risk areas were mainly located in the southern part of Baoshan City, showing a south-to-north trend. Spatiotemporal scan analyses identified five clusters, with the most likely cluster centered around Yaoguan Town, covering ten towns (subdistricts) during the period 2007‒2010. ConclusionThe incidence of typhus fever in Baoshan City exhibits a clear seasonal and spatial clustering pattern, with peak incidence occurring in summer and autumn. Spatially, cases are primarily distributed in the southern part of Baoshan City, and high-risk clusters exhibit a south-to-north trend. Farmers, students, and children are the high-risk groups.

To systematically synthesize evidence on multiple KRAS G12C inhibitors(KRAS G12C inhibitors, KRAS G12Ci) as monotherapy within a unified population and recommended-dose framework, establish a comparable benchmark range of efficacy and safety for previously treated patients with advanced or metastatic KRAS G12C-mutant non-small cell lung cancer(NSCLC), and explore potential effect modifiers.

BACKGROUND:Orthodontic treatment to move the mandibular second molar in place of the missing first molar is a good method for preserving natural teeth.However,molars often exhibit mesial tipping when using clear aligners.The impact of attachments and overcorrection on the molar mesialization with clear aligners is unclear.OBJECTIVE:To investigate the effects of attachments and overcorrection on displacement and biomechanics of the mandibular second molar mesialization.METHODS:A finite element model with the left mandibular first molar missing was constructed using a volunteer's cone-beam CT and intraoral scan data.The experiment was divided into four groups based on the position of attachments on the left mandibular second molar:without attachment,buccal attachment,lingual attachment,and buccal-lingual attachment,with overcorrection degrees(0°,1°,2°,3°,and 4°)for each group,totaling 20 models.The calculation and analysis of the displacement trends and stress were performed using Abaqus software.RESULTS AND CONCLUSION:(1)Mesial tipping and intrusion of the molar,distal tipping of the canines and permolars,and linguaing of the incisors occurred during molar mesialization.(2)The displacement of molars increased when attachments were used,with the maximum displacement occurring when buccal-lingual attachments were applied.Molars tended to tip towards the side without attachments when attachments were designed unilaterally.However,the inclination of molars did not decrease when attachments were used.(3)Molars exhibited reduced mesial tipping and intrusion,approaching overall movement,and the stress of periodontal ligament was relieved and more evenly distributed during overcorrection treatment,and this effect became more pronounced with increased degrees of overcorrection.(4)Attachments can enhance the effectiveness of overcorrection,with the best performance observed when buccal-lingual attachments are used.Using attachments and overcorrection together helps control molar mesial tipping and intrusion,but overall molar movement is not achieved.