[Abstract ]Objective:To estimate dental maturation norms of permanent dentition in a group of Nanjing children using Nolla's tech-nique.Methods:549 cases of panoramic radiographs (279 males and 270 females)of Nanjing children at the age range of 3 to 16 years were collected for the study.All permanent mandibular teeth on the left side (except for the third molars)were scored according to Nolla's method,and data were presented in tables and used to plot dental maturation curves for the Nanjing boys and girls.Results:Females were found to be more advanced in the degrees of dental development.Dental maturation is significantly associated with chron-ological age (for males and females:r =0.959,P <0.001 and r =0.953,P <0.001,respectively).The mathematical model of them was established,and then the fitting equation was obtained.Conclusion:The dental maturation curve and chronology of permanent dentition can provide the growth norms of permanent teeth for Nanjing children and facilitate the way for dentists to assess the growing children during diagnosis and treatment planning.

Objective : To investigate the characteristics of mortality of falls among the elderly in Haishu District, Ningbo City, Zhejiang Province, so as to provide insights into the improvement of fall control strategy. Methods: Data pertaining to surveillance of falls in Haishu District from 2017 to 2022 were collected from the Ningbo Municipal Digital Disease Prevention and Control Platform. The trends in mortality of falls in Haishu District from 2017 to 2022 were evaluated using annual percent change (APC). The distribution of demographic characteristics, locations of falls, injury sites, interval from fall occurrence to death and type of falls specified by age were descriptively analyzed. Results: A total of 1 206 deaths occurred due to falls among the elderly at ages of 60 years and older in Haishu District from 2017 to 2022, including 414 men and 612 women, with a male to female ratio of 0.67∶1. The average age was (85.20±8.42) years. The average annual crude mortality and standardized mortality of were 101.10/105 and 85.40/105 from 2017 to 2022, respectively, with no obvious changing trends (APC=5.797% and 5.337%, all P>0.05). The standardized death rate of falls in females was higher than that of males (102.60/105 vs. 69.55/105, P<0.05). The average annual mortality of falls appeared a tendency towards a rise with age among the elderly at ages of 60 years and older, with the highest mortality of 147.18/105 seen in the elderly at ages of 85 years and older. Falls predominantly occurred at home (836 cases, 81.48%) and on the same level (881 cases, 85.87%). The injury sites were mainly lower limbs (388 cases, 37.82%) and head (308 cases, 30.02%). In addition, the interval from fall occurrence to death mainly ranged from 24 hours to 6 months (757 cases, 73.79%). Conclusion The mortality of falls appeared a tendency towards a rise with age among the elderly at ages of 60 years and older in Haishu District from 2017 to 2022, which was higher in women than in men. The location of falls was predominantly at home and the type of falls predominantly at the same level. High attention to residential environments, and reinforcement of gender- and age-specific interventions are recommended.

AIM:To investigate the effect of signal transducer and activator of transcription 1 ( STAT 1 ) on proliferation and interferon-β(IFN-β) sensitivity of human non-small-cell lung cancer H1299 cells.METHODS:STAT1 or EGFP gene was transfected into H1299 cells by the lentiviral vectors system.The cell number was counted under a mi-croscope and cell proliferation was tested by MTT assay.In addition, the cells transfected with STAT1 and EGFP were trea-ted with IFN-βand cell viability was measured by MTT assay.The protein levels of p-STAT1, ICAM-1 and PCNA were de-tected by Western blot.RESULTS: Over-expression of STAT1 inhibited H1299 cell proliferation (P<0.05).H1299 cells transfected with STAT1 gene had a higher sensitivity to IFN-βthan the control cells transfected with EGFP ( P <0.05).Overexpression of STAT1 increased the protein level of p-STAT1, and reduced IACM-1 expression in H1299 cells. Moreover, STAT1 enhanced STAT1 phosphorylation and downregulated the expression of PCNA in H1299 cells treated with IFN-β.CONCLUSION:STAT1 inhibits the proliferation and enhances the IFN-βsensitivity of non-small-cell lung cancer H1299 cells.

Objective Toevaluatehysterosalpingography(HSG)and MRImanifestationsofintrauterineadhesion(IUA).Methods 40patientswithIUAconfirmedbyhysteroscopyunderwentHSGand MRIexamination.Wefoundoutthefeaturesofthoseimages, andworkedoutthedetectablerateofeachexamination.Results Inall40patients,19patientsweremildIUAprovedbyhysteroscopy,in which10patientswerediscoveredbyHSG,10patientsby MRIT2WI,16patientsby MRICUBE.16patientsweremiddleIUA,in which9patientswerediscoveredbyHSG,10patientsbyMRIT2WI,16patientsbyMRICUBE.5patientsweresevereIUA,allpatients werediscoveredbyHSG,MRIT2WIand MRICUBE.Andinallcases,therewere12casesofmembraneadhesions,inwhich5cases wereshowninHSG,8casesinMRIT2WIand10casesinMRICUBE.23caseswerefibrousadhesions,inwhich12caseswereshown in HSG,17casesinMRIT2WIand22casesinMRICUBE.5patientsweremuscularadhesions,allpatientswerediscoveredbyHSG, MRIT2WIandMRICUBE.Conclusion ComparingtoHSG,MRIexaminationshowshigherdetectablerateofIUA.MRICUBEsequences playsanimportantpartinthediagnosisofIUA.

Objective:Under the guidance of "Five Elements Construction Model(FECM)" , Chengdu elderly care hospital has conducted the combination model of medical care and elderly care service.Based on the FECM, in the practice of health services for the elderly, Chengdu Elderly Care Hospital has actively explored the training of professional technicians, the creating of an aging patients-caring environment, the taking of effective and scientific measures, the adopting of the advanced theory at home and abroad, the setting up and operating of the specialized wards for the cognitive impairment in the elderly.And the combination model of Medical Care and Elderly Care in our hospital has got obvious achievement and progress.

Objective:To conduct data mining on hospital accreditation results for inspirations and clues in hospital management.Methods:The Apriori function contained in the arules package of R software was used to extract the association rules. This practice aimed to analyze association rules of the accreditation results of 56 tertiary hospitals which were made based on tertiary hospital accreditation standard(2011)and Detailed Rules from 2017 to 2019; to explore the correlation between the clauses, and analyze the inspirations for hospital management.Results:A total of 6 566 138 and 247 rules were generated for all clauses and core clauses, receptively. The top 10 rules sorted by lift were selected as strong association rules. Among them, the minimum lift of all clauses and core clauses was 1.41 and 1.53, respectively. There was a strong correlation between the establishment of a quality and safety management team in the hospital and the development & implementation of relevant regulations by the hospital. There were strong correlations among emergency service procedure and regulations, patient rights to know, responsibility system by the first one to receive a complaint, medical safety(adverse)event reporting, development & implementation of antimicrobial management system, as well as training for prevention of multi-drug resistance infection measures, and multi-drug resistance infection hospital infection control system.Conclusions:This study suggested that hospital management should highlight the correlation between regulations development and staffing, that between indicator systems and monitoring feedback systems, and that between indicators in different sectors in the medical process. These correlations can be used as management clues and inspirations for hospital management.

Objective: To report an investigation of a family cluster of coronavirus disease 2019 ( COVID-19 ) in Ningbo, so as to provide reference for the prevention and control measures. Methods: According to the COVID-19 Prevention and Control Program ( fourth version ) , an epidemiological investigation was conducted to collect the demographic information, clinical features and exposure history, to find the close contacts, and to figure out the source and route of infection. Results: Twelve confirmed cases and one asymptomatic case were reported. The attack rate was 16.05%. Among them, five were males and eight were females; the age ranged from 11 to 85 years old, with a median of 39 years old; most had mild symptoms. The incubation period was 2-13 days, with a median of 6.5 days. The first case ( Case 1 ) developed the symptoms on January 22, and had close contact with Zhang, an asymptomatic case, on January 20. Zhang was related to a cluster in the Buddhist assembly on January 19. Case 1, who caused the spread of the epidemic among family members, participated in several family visits and dinners from January 22 to 27 with other 24 families, resulting in six secondary cases and six third-generation cases. There were 54 close contacts except the family members, no infection was found. Conclusion This family cluster may result from the close contact with an asymptomatic case, and then spread within families through having dinners and living together.

Neonatal hypoxic-ischemic encephalopathy (HIE)is the brain injury caused by asphyxiation in the perinatal period.HIE is a serious health-threatening disease associated with significant morbidity and mortality,and there is no effective treatment for the disease.Melatonin is a neuroendocrine hormone,which is synthesized primarily by the pineal gland.The synthesis and seretion of melatonin are regulated by light intensity.Melatonin has a high affinity for the central nervous system,which can easily penetrate the blood-brain barrier and blood placental barrier.It has been found that melatonin has functions in regulating the sleep cycle,antioxidant and anti-inflammatory.Melatonin has also been shown to regulate lipid and glucose metabolism.Recent research suggests that the melatonin appears to be a versatile anti-oxidative,anti-inflammatory,anti-apoptotic agent,as well as a molecule with regulation of mitochondrial function and autophagy process,and plays a neuroprotective role in HIE.Therefore,this review focuses on the established mechanisms of injury brain protection,progress of animal studies and clinical trials of melatonin in HIE,to provide references for its clinical application.

Objective To explore the effect of high sn-2 palmitate infant formula (HPIF) on stool frequency and consistency,fatty acids,calcium and magnesium contents in infants.Methods A prospective,double-blind,randomized,controlled clinical study was conducted including 94 healthy mature infants of single birth and appropriate for gestational age,born from June 2013 to December 2014.All eligible infants were enrolled within 21 days after birth.All the infant formula fed subjects were divided randomly into two groups as standard infant formula (IF) group and high sn-2 palmitate infant formula (HPIF) group.Breast-fed infants were enrolled as control group (BF group).All infants were followed up until 90 days old.The growth indexes and defecation status of the three groups were monitored dynamically.Meanwhile,stool fatty acid profile and mineral contents were also detected.Results There was no significant difference in head circumference,body length and body weight among the three groups at enrollment,42 days and 90 days old.The stool frequency and mushy stool frequency of HPIF and IF groups were significantly lower than that of BF group at 42 days and 90 days old;formed stool frequency was higher in HPIF and IF groups than in BF group.The fecal palmitic acid level in dry feces was significantly higher in HPIF and IF groups than in BF group [(31.1 ± 9.8),(30.9± 10.7) vs.(10.8± 8.8) mg/g] at 42 days old.At 90 days old,the fecal palmitic acid level in dry feces was significantly lower in HPIF group than in IF group [(24.3± 9.8) vs.(29.9± 7.9) mg/mg],while was significantly higher in both infant formula fed groups than in BF group [(8.9± 8.4) mg/g].The fecal calcium level in dry feces of HPIF and IF groups were significantly higher than that of BF group [(38.3± 14.0),(38.8± 15.5) vs.(21.3± 13.7) mg/g] at 42 days old.At 90 days old,the fecal calcium level in dry feces of HPIF group was significantly lower than that of IF group [(31.1 11.2) vs.(45.9 ± 16.5) mg/g,dry stool] and significantly higher than that of BF group [(21.5 ± 9.9) mg/g].The fecal magnesium level was similar between HPIF and IF groups,and significantly higher than that of BF group at 42 days and 90 days old.The fecal calcium level was positively correlated with the content of fecal palmitic acid among three groups (r =0.43,P＜ 0.01).Conclusions Breast milk is the best food for infants.Compared with standard infant formula,feeding with high sn-2 palmitate infant formula can reduce the fecal excretion of calcium and palmitic acid,making it closer to the level of breast-fed infants.

OBJECTIVE:To provide reference for rational drug use and hospital infection control. METHODS:AmpC enzyme-producing Enterobacter cloacae were isolated from non-sputum specimen of a hospital during Jan. 2011-Oct. 2017. Drug sensitivity test was conducted by using MIC. The situation of AmpC enzyme production was confirmed by three dimensional test, and that of ESBLs-producing stain was detected with double-disk synergy test. RESULTS:There were 546 strains of AmpC enzyme-producing E. cloacae isolated from non-sputum specimen of the hospital,accounting for 4.80% of non-sputum specimen (546/11 375)and 38.97% of E. cloacae(546/1 401). Top 3 non-sputum samples in the list of detection rate were wound secretion (27.29%),midstream urine(25.82%)and blood(21.79%),and the departments with high detection rate were ICU(22.89%), neurosurgery department(18.68%)and general surgery department(16.67%). Resistance rate of AmpC enzyme-producing E. cloacae to most commonly used antibiotics was higher than 40%. There was statistical significance in resistant rate of the bacteria to ceftriaxone, cefotaxime, gentamicin, nitrofurantoin, levofloxacin, piperacillin/tazobactam, cefoperazone, ceftazidime,cefepime,tobramycin and minocycline among different years (P<0.05). The resistant rate to imipenem and meropenem was lower than 2%. Among 546 strains of AmpC enzyme-producing E. cloacae,68 strains of ESBLs were detected,and detection rates were 5.77%,6.06%,8.70%,10.26%,13.79%,17.35%,18.75% during 2011-2017. CONCLUSIONS:AmpC enzyme-producing E. cloacae are mainly isolated from samples as wound secretion and midstream urine,and mainly come from ICU and neurosurgery department. The drug resistance of the bacteria is severe,and drug resistance of the bacteria to antibiotics as β-lactams and quinolones is increased significantly. The detection rate of ESBLs-producing strain increases year by year. The bacteria are sensitive to carbapenems antibiotics,which can be regarded as first choice. It is necessary to strengthen drug resistance and enzyme production monitoring of AmpC enzyme-producing E. cloacae,select antibiotics combined with results of drug sensitivity test so as to prevent or delay the rapid increase of its resistance rate.