With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

BACKGROUND: In China, lung cancer remains the cancer with the highest incidence and mortality rate. Among early-stage lung adenocarcinomas (LUAD), the micropapillary (MPP) component is prevalent and typically exhibits high aggressiveness, significantly correlating with early metastasis, lymphatic infiltration, and reduced five-year survival rates. Therefore, the study is to explore the similarities and differences between MPP and non-micropapillary (non-MPP) components in malignant pulmonary nodules characterized by GGOs in early-stage LUAD, identify unique mutational features of the MPP component and analyze the relationship between the ZNF469 gene, a member of the zinc-finger protein family, and the prognosis of early-stage LUAD, as well as its correlation with immune infiltration. METHODS: A total of 31 malignant pulmonary nodules of LUAD were collected and dissected into paired MPP and non-MPP components using microdissection. Whole-exome sequencing (WES) was performed on the components of early-stage malignant pulmonary nodules. Mutational signatures analysis was conducted using R packages such as maftools, Nonnegative Matrix Factorization (NMF), and Sigminer to unveil the genomic mutational characteristics unique to MPP components in invasive LUAD compared to other tumor tissues. Furthermore, we explored the expression of the ZNF469 gene in LUAD using The Cancer Genome Atlas (TCGA) database to investigate its potential association with the prognosis. We also investigated gene interaction networks and signaling pathways related to ZNF469 in LUAD using the GeneMANIA database and conducted Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Lastly, we analyzed the correlation between ZNF469 gene expression and levels of immune cell infiltration in LUAD using the TIMER and TISIDB databases. RESULTS: MPP components exhibited a higher number of genomic variations, particularly the 13th COSMIC (Catalogue of Somatic Mutations in Cancer) mutational signature characterized by the activity of the cytidine deaminase APOBEC family, which was unique to MPP components compared to non-MPP components in tumor tissues. This suggests the potential involvement of APOBEC in the progression of MPP components in early-stage LUAD. Additionally, MPP samples with high similarity to APOBEC signature displayed a higher tumor mutational burden (TMB), indicating that these patients may be more likely to benefit from immunotherapy. The expression of ZNF469 was significantly upregulated in LUAD compared to normal tissue, and was associated with poor prognosis in LUAD patients (P<0.05). Gene interaction network analysis and GO/KEGG enrichment analysis revealed that COL6A1, COL1A1, COL1A2, TGFB2, MMP2, COL8A2 and C2CD4C interacted with ZNF469 and were mainly involved in encoding collagen proteins and participating in the constitution of extracellular matrix. ZNF469 expression was positively correlated with immune cell infiltration in LUAD (P<0.05). CONCLUSIONS The study has unveiled distinctive mutational signatures in the MPP components of early-stage invasive LUAD in the Asian population. Furthermore, we have identified that the elevated expression of mutated ZNF469 impacts the prognosis and immune infiltration in LUAD, suggesting its potential as a diagnostic and prognostic biomarker in LUAD.
Humans ; Lung Neoplasms/genetics* ; Adenocarcinoma of Lung/genetics* ; China ; Prognosis ; Transcription Factors

Objective:To explore the effects of an intervention strategy based on dyadic illness management theory on dyadic coping level, supportive care needs, and patients' disease symptoms with chemotherapy-stage ovarian cancer patients and their spouses, and to provide reference for improving their disease coping ability and quality of life.Methods:This study used the method of randomized controlled trial. Seventy pairs of ovarian cancer patients and their spouses who received regular chemotherapy and their spouses from Obstetrics and Gynecology Hospital, Fudan University from July 2022 to June 2023 were selected using convenience sampling method. They were assigned to the control group (36 pairs) and the observation group (36 pairs) by the random number table method. Participants in the control group received routine nursing care and the observation group received the intervention strategy of dyadic illness management theory. Data were collected and compared the differences in dyadic coping levels, care needs, and disease symptoms between two groups of patients and their spouses before intervention (before chemotherapy) and after intervention (after the end of the chemotherapy cycle). SPSS 20.0 software was used for analysis, and t-tests, χ2 tests, and Wilcoxon rank sum tests were used to compare the two groups. Results:Finally, 36 pairs were included in the control group and 34 pairs in the observation group. The age of the control group patients was (52.03 ± 9.44) years old, while that of the observation group patients was (53.41 ± 10.14) years old. After the intervention, the total score of dyadic coping level in the patients and their spouses of the observation group were (113.50 ± 8.03), (114.62 ± 10.59) points, respectively, which were higher than (106.64 ± 10.06), (108.78 ± 10.89) points of the control group with significant differences ( t=-3.14, -2.27, both P<0.05); the total score of care needs in the patients and their spouses of the observation group were (89.65 ± 8.29), (95.12 ± 7.25) points, respectively, which were lower than (100.25 ± 10.82), (110.11 ± 7.58) points of the control group with significant differences ( t=4.58, 8.45, both P<0.001); the total score of disease symptoms in the patients of the observation group was (20.09 ± 4.70) points, which was lower than (31.53 ± 6.08) points of the control group with significant differences ( t=8.77, P<0.001). Conclusions:The model of dyadic illness management can improve dyadic coping level and supportive care needs of chemotherapy-stage ovarian cancer patients and their spouses, and alleviate patients′ disease symptoms.

Objective:To explore the different reaction patterns among family caregivers of patients with advanced gynecological malignancies, and to analyze the influencing factors of different profiles.Methods:A cross-sectional study was conducted with 210 family caregivers of patients with advanced gynecological malignancies from Obstetrics and Gynecology Hospital in Shanghai from January 2022 to December 2022. Data were collected by Caregiver Reaction Assessment, Mishel's Uncertainty in Illness Scale-Family Member Form and Perceived Social Support Scale. Latent profile analysis was used to explore the different reaction patterns among family caregivers of patients with advanced gynecological malignancies. The influencing factors of caregiver reaction were identified by multivariate Logistic regression.Results:Totally 208 questionnaires were effectively collected. The family caregivers among patients with advanced gynecological malignancies included 163 males and 45 females, aged (53.89 ± 12.61) years old. The reaction characteristics of 208 family caregivers among patients with advanced gynecological malignancies were divided into three categories: low burden and high benefit group (24.5%, 51/208), moderate burden and benefit group (30.8%, 64/208), and high burden and low benefit group (44.7%, 93/208). Compared to the low burden and high benefit group, caregivers with lower levels of social support were more likely to be classified as moderate burden and benefit group, high burden and low benefit group ( OR = 0.563, 0.407, both P<0.01). Caregivers with moderate burden and benefit group, high burden and low benefit group had higher levels of disease uncertainty ( OR = 1.328, 2.064, both P<0.01). The caregiver′s age, monthly family income, education level, and co-caregivers were also influencing factors regarding to care reaction among family caregivers of patients with advanced gynecological malignancies ( OR values were 0.207-6.422, all P<0.05). Conclusions:The care reaction of family caregivers among patients with advanced gynecological malignancies has obvious categorical features. Healthcare professionals should implement targeted nursing interventions according to their reaction characteristics, so as to reduce the care burden of family caregivers and improve the quality of care for patients with advanced gynecological malignancies.

Objective To develop a nurse-led case management practice program for ovarian cancer patients,and to investigate its application effect initially.Methods The case management practice model of ovarian cancer was formed through literature analysis,qualitative research and expert meeting method.Ovarian cancer patients who were given conventional nursing interventions from Aug 2022 to Jun 2023 and from Jul 2023 to Mar 2024 in Obstetrics and Gynecology Hospital,Fudan University were selected as the control group(n=16)and the intervention group(n=16).The patients'supportive care needs,disease symptoms and unplanned readmission rates were compared before and after intervention between two groups.Supportive Care Needs Survey Shortform 34(SCNS-SF34)was used to collect patients'supportive care needs,and M.D.Anderson Symptom Inventory(MDASI)was used to assess disease symptoms.Results The ovarian cancer case management practice program was constructed and revised to determine the qualification and professional competence of the ovarian cancer case manager,the core of practice,and the specific implementation pathway.After intervention,the total score and scores of all dimensions of SCNS-SF34 in the intervention group were lower than those of the control group(P<0.001),the total score and scores of all dimensions of MDASI in the intervention group were lower than those of the control group(P<0.05).There was no statistically significant difference in unplanned readmission rates between the two groups.Conclusion The case management practice program for ovarian cancer patients was constructed with scientific validity,which can effectively meet the care needs of patients and alleviate their disease symptoms.

With the development of genetics and advances in genetic testing technology,the demand for cancer genetic counseling has increased dramatically.Advanced practice nurses play a key role in personalized health care delivery.The oncology genetic nurse-led genetic counseling services in foreign countries are becoming more and more mature,but in China,the work of oncology genetic counseling started late,and the combination of genetics/genomics with nursing is still in its infancy.There is still a lack of relevant research on oncology genetic nurses.This article introduced the qualification certification,core competence and clinical practice content of foreign oncology genetic nurses,and summarized the clinical practice effect of oncology genetic nurses and the enlightenment to China's advanced nursing practice,which provided references for the construction of oncology genetic nurses training programs and clinical service models suitable for China's national conditions,so as to meet the needs of the development of advanced nursing practice and the growing demand for precision oncology and high-quality genetic medical care.

As artificial intelligence technology rapidly advances, its deployment within the medical sector presents substantial ethical challenges. Consequently, it becomes crucial to create a standardized, transparent, and secure framework for processing medical data. This includes setting the ethical boundaries for medical artificial intelligence and safeguarding both patient rights and data integrity. This consensus governs every facet of medical data handling through artificial intelligence, encompassing data gathering, processing, storage, transmission, utilization, and sharing. Its purpose is to ensure the management of medical data adheres to ethical standards and legal requirements, while safeguarding patient privacy and data security. Concurrently, the principles of compliance with the law, patient privacy respect, patient interest protection, and safety and reliability are underscored. Key issues such as informed consent, data usage, intellectual property protection, conflict of interest, and benefit sharing are examined in depth. The enactment of this expert consensus is intended to foster the profound integration and sustainable advancement of artificial intelligence within the medical domain, while simultaneously ensuring that artificial intelligence adheres strictly to the relevant ethical norms and legal frameworks during the processing of medical data.
Artificial Intelligence/legislation & jurisprudence* ; Humans ; Consensus ; Computer Security/standards* ; Confidentiality/ethics* ; Informed Consent/ethics*

Objective: To evaluate the efficacy and safety of Nocardia rubra cell wall skeleton (Nr-CWS) in the treatment of persistent cervical high-risk human papillomavirus (HR-HPV) infection. Methods: A randomized, double blind, multi-center trial was conducted. A total of 688 patients with clinically and pathologically confirmed HR-HPV infection of the cervix diagnosed in 13 hispital nationwide were recruited and divided into: (1) patients with simple HR-HPV infection lasting for 12 months or more; (2) patients with cervical intraepithelial neoplasia (CIN) Ⅰ and HR-HPV infection lasting for 12 months or more; (3) patients with the same HR-HPV subtype with no CINⅡ and more lesions after treatment with CINⅡ or CIN Ⅲ (CINⅡ/CIN Ⅲ). All participants were randomly divided into the test group and the control group at a ratio of 2∶1. The test group was locally treated with Nr-CWS freeze-dried powder and the control group was treated with freeze-dried powder without Nr-CWS. The efficacy and negative conversion rate of various subtypes of HR-HPV were evaluated at 1, 4, 8, and 12 months after treatment. The safety indicators of initial diagnosis and treatment were observed. Results: (1) This study included 555 patients with HR-HPV infection in the cervix (included 368 in the test group and 187 in the control group), with an age of (44.1±10.0) years. The baseline characteristics of the two groups of subjects, including age, proportion of Han people, weight, composition of HR-HPV subtypes, and proportion of each subgroup, were compared with no statistically significant differences (all P>0.05). (2) After 12 months of treatment, the effective rates of the test group and the control group were 91.0% (335/368) and 44.9% (84/187), respectively. The difference between the two groups was statistically significant (χ²=142.520, P<0.001). After 12 months of treatment, the negative conversion rates of HPV 16, 18, 52, and 58 infection in the test group were 79.2% (84/106), 73.3% (22/30), 83.1% (54/65), and 77.4% (48/62), respectively. The control group were 21.6% (11/51), 1/9, 35.1% (13/37), and 20.0% (8/40), respectively. The differences between the two groups were statistically significant (all P<0.001). (3) There were no statistically significant differences in vital signs (body weight, body temperature, respiration, pulse rate, systolic blood pressure, diastolic blood pressure, etc.) and laboratory routine indicators (blood cell analysis, urine routine examination) between the test group and the control group before treatment and at 1, 4, 8, and 12 months after treatment (all P>0.05); there was no statistically significant difference in the incidence of adverse reactions related to the investigational drug between the two groups of subjects [8.7% (32/368) vs 8.0% (15/187), respectively; χ²=0.073, P=0.787]. Conclusion: External use of Nr-CWS has good efficacy and safety in the treatment of high-risk HPV persistent infection in the cervix.
Female ; Humans ; Adult ; Middle Aged ; Cervix Uteri/pathology* ; Uterine Cervical Neoplasms/pathology* ; Papillomavirus Infections/diagnosis* ; Cell Wall Skeleton ; Persistent Infection ; Powders ; Uterine Cervical Dysplasia/pathology* ; Immunotherapy ; Papillomaviridae

With scarce resources, natural Bovis Calculus is expensive and hard to meet clinical demand. At the moment, four kinds of Bovis Calculus are available on the market: the natural product, in vitro cultured product, synthesized product, and the product formed in cow after manual intervention. In this study, papers on the four kinds of Bovis Calculus products and relevant Chinese patent medicines were searched from Web of Science, PubMed, and China National Knowledge Infrastructure(CNKI). CiteSpace, citexs AI, and CNKI were employed for bibliometric analysis and knowledge map analysis. On this basis, the status, trend, and focuses of research on Bovis Calculus and relevant Chinese patent medicines were summarized. The results suggested overall slow development in the research on Bovis Calculus and relevant Chinese patent medicines with three typical growth stages. It is consistent with the development of Bovis Calculus substitutes and the national policy for the development of traditional Chinese medicine. At the moment, the research on Bovis Calculus and relevant Chinese patent medicines has been on the rise. In recent years, there has been an explosion of research on them, particularly the quality control of Bovis Calculus and the Chinese patent medicines, the pharmacological efficacy of Chinese patent medicines, such as Angong Niuhuang Pills, and the comparison of the quality of various Bovis Calculus products. However, there is a paucity of research on the pharmacological efficacy and the mechanism of Bovis Calculus. This medicinal and the relevant Chinese patent medicines have been studied from diverse perspectives and China becomes outstanding in this research field. However, it is still necessary to reveal the chemical composition, pharmacological efficacy, and mechanism through multi-dimensional deep research.
Animals ; Cattle ; Female ; Bibliometrics ; Biological Products ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Nonprescription Drugs

OBJECTIVES: To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia. METHODS: A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively. RESULTS: Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia. CONCLUSIONS The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn ; Humans ; Male ; Pregnancy ; Female ; Nomograms ; Retrospective Studies ; Cesarean Section ; Risk Factors ; Asphyxia Neonatorum/etiology*