Objectives:To investigate the coccygeal morphology in adult Chinese without coccydynia using CT scans,and to provide a morphological reference for assessing the risk of coccydynia in Chinese popula-tion.Methods:A retrospective analysis was conducted on 113 patients without coccydynia who underwent pelvic three-dimensional CT scans at the Second Affiliated Hospital of Wenzhou Medical University between August 2018 and August 2023.There were 67 males and 46 females,with a mean age of 53.5±19.1 years(range:18-93 years).The morphological characteristics of the sacrococcygeal anatomical structures,including coccyx number,coccyx type(modified Nathan classification),sacrococcygeal joint fusion,intercoccygeal joint subluxation,coccygeal sacralization,lateral deviation of coccygeal tip,ventral angulation of S5,and coccygeal bony spicule,were analyzed on the three-dimensional reconstructed CT images;And relevant morphological parameters were measured,such as the coccygeal straight length,sacral straight length,sacrococcygeal straight length,sacrolumbar angle,sacrococcygeal angle,sacrococcygeal joint angle,intercoccygeal angle,and first in-tercoccygeal joint angle,with consistency tests conducted for the measurements.The differences in morpholog-ical parameters were compared between different genders and age groups(＜50 years and ≥50 years).Results:Among the 113 asymptomatic adult Chinese subjects,88 cases(77.9％)had a 4-segment coccyx,and type Ⅰcoccyx(modified Nathan classification)was the most common type(53 cases),accounting for approximately 46.9％.The incidence of sacrococcygeal joint fusion,intercoccygeal joint subluxation,coccygeal sacralization,lateral deviation of the coccygeal tip,ventral angulation of S5,and coccygeal bony spicule were 52.2％(59 cases),25.7％(29 cases),20.4％(23 cases),53.1％(60 cases),7.1％(8 cases),and 15.0％(17 cases),respectively.The consistency test showed that the consistency of the measurement data among observers was good.In Chi-nese population,the coccygeal straight length was 3.59±0.72cm,sacral straight length was 10.97±0.92cm,and sacrococcygeal straight length was 12.68(11.99,13.69)cm.The lumbosacral angle,sacrococcygeal angle,inter-coccygeal angle,and first intercoccygeal joint angle were 38.0°±7.3°,110.6°±10.6°,173.1°(164.2°,178.2°),131.5°±21.5°,and 152.8°±17.1°,respectively.Gender comparisons showed that males had greater sacrococ-cygeal straight length and sacrococcygeal angle than females(P＜0.05).Age group comparisons revealed that subjects＜50 years had shorter coccygeal straight length,smaller lumbosacral angle,sacrococcygeal joint angle,and first intercoccygeal joint angle than those ≥50 years(P＜0.05),while the sacral straight length was longer in the＜50 years group(P＜0.01).Conclusions:Among the adult Chinese without coccydynia,4 coccygeal seg-ments and type Ⅰ(modified Nathan classification)are the most common.Sacrococcygeal joint fusion,coccygeal bony spicules,intercoccygeal joint subluxation,and coccygeal sacralization have relatively high incidences.Males have longer and straighter sacrococcygeal structures than females.Compared with those ≥50 years,subjects＜50 years have shorter coccyxes,longer sacra,and smaller lumbosacral angles.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To translate the Creature of Habit Scale(COHS)into Chinese version and test its va-lidity and reliability in community adults.Methods:A total of 474 adult participants(Sample 1)were recruited through social media platforms for item analysis and exploratory factor analysis.Additionally,4 102 community a-dults(Sample 2)were recruited for confirmatory factor analysis,criterion validity,and internal consistency reliabili-ty testing.Four weeks later,235 participants were randomly selected from Sample 1 for a retest.The State-Trait Anxiety Inventory-Trait Questionnaire(STAI-T),Obsessive-Compulsive Inventory-Revised(OCI-R),and Brief Barratt Impulsiveness Scale(BBIS)were used as criterion questionnaires.Results:The Chinese version of the COHS contained 23 items,grouped into two factors,namely regularity and automaticity.The item loadings ranged from 0.40 to 0.89,with the two-factor model cumulatively explaining 56.7％of the total variance.Confirmatory factor analysis indicated a good model fit(x2/df=2.17,CFI=0.86,TLI=0.85,RMSEA=0.07,SRMR=0.06).The total COHS scores were positively correlated with the STAI-T and OCI-R scores(r=0.32,0.50;Ps＜0.01),and the automaticity factor scores were positively correlated with the BBIS scores(r=0.30,P＜0.01).The Cron-bach's α coefficient for the total scale was 0.89,and the test-retest reliability was 0.87.Conclusion:The Chinese version of the Creature of Habit Scale is a reliable and valid tool for measuring habitual behaviors in community a-dults.

Objective:To evaluate the therapeutic value of radiotherapy in combined immunotherapy and chemotherapy as first-line treatment for patients with oligometastatic non-small cell lung cancer (NSCLC).Methods:A retrospective analysis was conducted on data from 195 NSCLC patients who lacked epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations and were treated at the Anyang Tumor Hospital and the Fourth Hospital of Hebei Medical University from January 2019 to December 2021. These patients consisted of 166 male and 29 female cases, aged from 28 to 85 years, with an average age of (61.4 ± 9.3) years. These patients were divided into two groups, with each group receiving the radiotherapy and combined immunotherapy and chemotherapy (the radiotherapy and combination group, n = 60) and combined immunotherapy and chemotherapy only (the combination group, n = 135). Then, propensity score matching (PSM) was performed to analyze the differences in prognosis between both groups before and after PSM, as well as the short-term efficacy and adverse reactions after PSM. Results:For the 195 NSCLC patients, the median follow-up time was 31.8 months, with median overall survival (OS) and median progression-free survival (PFS) recorded at 23.8 months and 9.2 months, respectively. The radiotherapy and combination group exhibited enhanced 1-, 2-, and 3-year survival rates of 78.5%, 55.9%, and 45.1%, respectively, significantly higher than the combination group (48.3%, 35.6%, and 26.6%, respectively, χ2 = 14.65, P < 0.001). Similarly, the radiotherapy and combination group displayed 1-, 2-, and 3-year PFS rates of 51.9%, 29.5%, and 22.7%, respectively, exceeding those of the combination group (30.0%, 24.5%, and 16.9%, respectively, χ2=6.09, P=0.014). After PSM, the radiotherapy and combination group manifested an objective response rate (ORR) of 60.0% (33/55) and a disease control rate (DCR) of 89.1% (49/55), which were 16.4% (9/55) and 56.4% (31/55), respectively for the combination group. These results suggested that the radiotherapy and combination group demonstrated significantly higher ORR and DCR ( χ2 = 22.18, 14.85, P<0.001). After PSM, the radiotherapy and combination group yielded 1-, 2-, and 3-year survival rates of 70.9%, 52.3%, and 41.9%, respectively, significantly than the combination group (43.6%, 29.8%, and 27.1%, respectively, χ2=8.95, P=0.003). The radiotherapy and combination group exhibited 1-, 2-, and 3-year PFS rates of 47.3%, 27.3%, and 18.7%, respectively, significantly higher than the combination group (23.6%, 17.6%, and 15.4%, respectively, χ2 = 6.71, P = 0.010). Multivariate Cox regression analysis revealed that independent factors affecting OS included clinical stage, treatment regimen, number of immunotherapy cycles, and treatment efficacy ( HR = 1.88, 2.11, 0.23, 1.79, P < 0.05). Similarly, independent factors affecting PFS consisted of treatment regimen, number of immunotherapy cycles, and treatment efficacy ( HR = 1.62, 0.37, 3.42, P <0.05). There were no statistical differences in the incidence of grade ≥ 2 bone marrow suppression (18.2% vs. 12.7%) and grade ≥ 2 pneumonia (21.8% vs. 14.5%) between both groups ( P>0.05). Conclusions:Introducing radiotherapy into combined immunotherapy and chemotherapy as first-line treatment for oligometastatic NSCLC can optimize both local and systemic disease control and significantly improve patient prognosis without increasing treatment-related adverse reactions.

Objective To analyze in depth the job satisfaction and influencing factors of medical staff in tertiary public hospitals in Gansu Province,especially to explore the important factors affecting the survival and development of hospitals as core talents,in order to provide reference for promoting the stable development of medical staff in medical institutions in Gansu Prov-ince.Methods From July to October 2024,a random sampling method was used to select relevant personnel from tertiary public hospitals in Gansu Province for a questionnaire survey.Descriptive analysis were conducted on the collected data.Multivariate lo-gistic regression analysis was used to identify the main influencing factors of job satisfaction among medical staff.The difference is statistically significant with P＜0.05,and the test level is α=0.05.Results 1 890 questionnaires were distributed and 1 885 valid questionnaires were collected,with an effective rate of 99.74％.The overall job satisfaction score of medical staff in tertiary hospitals in Gansu Province is 3.06±0.86,which is at a moderate level.Hospitals can consider improving management models,establishing scientific,reasonable,and humane management systems,enhancing doctors'sense of belonging,and improving sat-isfaction;The satisfaction brought by salary to medical staff is higher than promotion opportunities and career development,indi-cating that a reasonable salary incentive system in hospitals,with excellent performance and compensation,can increase doctors'subjective well-being and improve satisfaction.Optimising the allocation of health human resources and appropriately in creasing personnel allocation based can help improve doctors'job satisfaction.Conclusion The overall job satisfaction of medical staff in tertiary hospitals in Gansu Province is generally satisfactory,and there are statistically significant differences in job satisfaction a-mong medical staff with different work experience,education level and monthly income(P＜0.05).When formulating policies and measures,the government pays attention to factors that affect the job satisfaction of medical personnel,optimizes the alloca-tion of health human resources,continuously improves incentive mechanisms,and improves hospital management models,enhan-cing the job satisfaction of medical staff and laying the foundation for promoting the developmrnt of provincial health talent team.

Objective To explore the effects of cerium-doped mesoporous bioactive glass nanoparticles(Ce-MBGNs)as reactive oxy-gen species(ROS)-responsive nanocarriers on inflammation in pulp and their potential to promote odontogenic differentiation of dental pulp stem cells(DPSCs).Methods The cytotoxicity of Ce-MBGNs was assessed by CCK-8.The expression of mRNA of osteogenic/odontogenic differentiation in DPSCs and that of inflammatory factor in RAW264.7 cells were detected by RT-qPCR.Alkaline phospha-tase and Alizarin Red S staining were utilized to investigate their ability to promote dentin mineralization.The ability of Ce-MBGNs to scavenge ROS was evaluated by immunofluorescence and JC-1 staining was used to assess the membrane potential(MMP)of mitochon-drial.Results Ce-MBGNs exhibited good biocompatibility and significantly increased the expression of osteogenic/odontogenic-related genes in DPSCs,promoting mineralization.Additionally,Ce-MBGNs effectively scavenged intracellular ROS,maintained MMP,inhib-ited the expression of pro-inflammatory factors,and promoted the expression of anti-inflammatory factors.Conclusion Ce-MBGNs can protect DPSCs from oxidative damage by maintaining the MMP of mitochondrial and controlling inflammation,and promote their odonto-blastic differentiation,providing a theoretical basis for the development of novel therapeutic agents for oral treatment.

Objective:To investigate the bone augmentation effects of domestic decellularized porcine small intestinal submucosa (PSIS) absorbable biomembrane and domestic bovine pericardium tissue (BPT) absorbable biomembrane in guided bone regeneration (GBR) for single-tooth implantation in diabetic patients.Methods:A prospective case-control study was conducted with 48 diabetic patients who received single-tooth implant restoration at the Department of Prosthodontics, School of Stomatology. The Fourth Military Medical University, between January 2023 and January 2024. Patients were randomly assigned to the study group (PSIS group) and the control group (BPT group) using a random number table, with 24 patients in each group. GBR was performed simultaneously with the implant surgery. Cone-beam CT was used to compare the buccal-side horizontal bone gain at 6 months post-operation between the two groups. Wound healing was evaluated at 1 and 4 weeks post-operation using wound healing scores.Results:At 6 months post-operation, the buccal-side horizontal bone gain at 2 mm below the implant abutment in the study group [69.1 (55.2, 82.4) mm] and the control group [71.4 (59.8, 77.0) mm] showed no statistically significant difference ( Z=-0.25, P=0.805). The wound healing scores at 1 and 4 weeks post-operation in the study group did not differ significantly from those in the control group at the same time points (1 week: Z=-0.49, P=0.627; 4 weeks: Z=-0.61, P=0.539). Conclusions:The use of two types of domestic absorbable collagen membranes for GBR in single-tooth implantation in diabetic patients showed comparable buccal-side horizontal bone gain effects at 6 months post-operation and similar clinical outcomes for wound healing at 1 and 4 weeks post-operation in both groups. The GBR effects of PSIS and BPT are similar.

Objective To explore the effects of cerium-doped mesoporous bioactive glass nanoparticles(Ce-MBGNs)as reactive oxy-gen species(ROS)-responsive nanocarriers on inflammation in pulp and their potential to promote odontogenic differentiation of dental pulp stem cells(DPSCs).Methods The cytotoxicity of Ce-MBGNs was assessed by CCK-8.The expression of mRNA of osteogenic/odontogenic differentiation in DPSCs and that of inflammatory factor in RAW264.7 cells were detected by RT-qPCR.Alkaline phospha-tase and Alizarin Red S staining were utilized to investigate their ability to promote dentin mineralization.The ability of Ce-MBGNs to scavenge ROS was evaluated by immunofluorescence and JC-1 staining was used to assess the membrane potential(MMP)of mitochon-drial.Results Ce-MBGNs exhibited good biocompatibility and significantly increased the expression of osteogenic/odontogenic-related genes in DPSCs,promoting mineralization.Additionally,Ce-MBGNs effectively scavenged intracellular ROS,maintained MMP,inhib-ited the expression of pro-inflammatory factors,and promoted the expression of anti-inflammatory factors.Conclusion Ce-MBGNs can protect DPSCs from oxidative damage by maintaining the MMP of mitochondrial and controlling inflammation,and promote their odonto-blastic differentiation,providing a theoretical basis for the development of novel therapeutic agents for oral treatment.

BACKGROUND:Exercise rehabilitation is an important means of non-drug treatment for patients with myocardial infarction.It can improve myocardial perfusion and cardiovascular function.The mechanism may be related to angiogenesis and repair mediated by vascular endothelial cells,while endothelial progenitor cells are the precursors of vascular endothelial cells.OBJECTIVE:To explore the impact of 12-week aerobic exercise on mobilization and function of endothelial progenitor cells in patients with myocardial infarction.METHODS:(1)A total of 66 patients with acute myocardial infarction who received percutaneous coronary intervention in First Affiliated Hospital of Zhengzhou University from January to October 2022 were selected and divided into exercise group(n=33)and control group(n=33)according to random number table method.Patients in the control group received conventional cardiac rehabilitation treatment for 12 weeks.Patients in the exercise group received conventional cardiac rehabilitation+12 weeks of aerobic exercise intervention.Cardiopulmonary fitness,New York Heart Association classification,left ventricular ejection fraction,serum troponin I,brain natriuretic peptide levels,and peripheral blood endothelial progenitor cells were measured before and 72 hours after intervention.(2)Endothelial cells were isolated from peripheral blood of the two groups of patients before intervention and 72 hours after intervention,and the proliferation,adhesion,and migration ability of endothelial cells were detected.RESULTS AND CONCLUSION:(1)At 72 hours after the intervention,New York Heart Association classification,serum troponin I and serum brain natriuretic peptide decreased(P<0.05);peak oxygen uptake,maximum power,completion time of incremental load test,and left ventricular ejection fraction at peak exercise increased(P<0.05);average heart rate and average subjective fatigue sensation score decreased(P<0.05);peripheral blood endothelial cell count increased(P<0.05)in the exercise group compared with those before intervention and the control group.(2)At 72 hours after intervention,the cell proliferation,adhesion,and migration ability of peripheral blood endothelial cells in the exercise group were higher than those before intervention and control group(P<0.05).(3)Regular aerobic exercise can promote mobilization of endothelial progenitor cells and enhance ability of proliferation,adhesion,and migration,thereby improving clinical condition,cardiac function,and cardiopulmonary fitness of patients with myocardial infarction.

Background Vascular endothelial damage associated with endothelial progenitor cell dysfunction is considered as an initiating step of hypertension and target organ damage, in which oxidative stress plays a key role. High-intensity intermittent exercise is an effective prevention and treatment method of various chronic diseases; however, little attention has been paid to its effects and mechanisms on endothelial progenitor cells. Objective To observe the effect of high-intensity intermittent exercise on the function of endothelial progenitor cells in patients with hypertension and explore the mechanism of oxidative stress. Methods A total of 60 patients with essential hypertension were randomly divided into a control group and an exercise group. The control group received conventional drug treatment (including diuretics, calcium blockers, and beta-blockers), and the exercise group performed high-intensity intermittent exercise for 8 weeks (3 times·week⁻¹) in addition to the treatment plan of the control group. Before and after intervention, brachial artery flow-mediated vasodilation (FMD) was used to evaluate vascular endothelial function; venous blood was sampled to perfrom circulating endothelial progenitor cell counts; endothelial progenitor cells were cultured in vitro, and the modified Boyden chamber assay and Matrigel lumen formation assay were used to detect their migration and tube formation ability, superoxide fluorescent anion probe method to detect reactive oxygen species levels, terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) staining method to detect cell apoptosis, Western blotting to determine protein expression of reduced nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2, NADPH oxidase 4, and superoxide dismutase. Results Four patients (13.3%) in the control group and 2 patients (6.7%) in the exercise group dropped out; the completion rate of the exercise group's training plan was 94.9%. Compared with the before-intervention indicators, blood pressure decreased, brachial artery FMD increased, number of circulating endothelial progenitor cells increased, their migration and tube formation ability were enhanced, reactive oxygen species levels and cell apoptosis rate were reduced, NADPH oxidase 2 and NADPH oxidase 4 protein expressions were down-regulated, and superoxide dismutase protein expression was up-regulated in the after-intervention exercise group, and the differences were all statistically significant (P < 0.05). There was no significant difference in the above indicators in the control group between before and after intervention (P > 0.05). Conclusion High-intensity intermittent exercise regulates oxidative stress mediated by NADPH oxidase, improves endothelial progenitor cell function, and restores vascular endothelial disorders in patients with essential hypertension.