Objective: To study the association between ankyloglossia and sagittal mandibular development impairment as well as lower anterior dental crowding, providing a reference for clinical practice. Methods: This study was approved by the hospital's Medical Ethics Committee. A total of 100 patients aged 7-13 years were enrolled from January 2024 to January 2025, comprising 50 patients with ankyloglossia (case group) and 50 individuals with a healthy lingual frenulum (normal group). Clinical examination was performed to assess lingual frenulum length, Kotlow classification, and the simplified Hazelbaker assessment tool for lingual frenulum function (HATLFF) score. Cephalometric radiographs were used to measure the A-point-nasion-B-point (ANB) angle, sella-nasion-B-point (SNB) angle, and mandibular total length (condylion-gnathion [Co-Gn]). Dental cast analysis was conducted to evaluate lower anterior teeth crowding. Data were compared between the two groups. Pearson correlation analysis was used to examine the relationships between the lingual frenulum length, simplified HATLFF score, and cephalometric/dental cast parameters (ANB, SNB, Co-Gn, lower anterior crowding). The diagnostic value of ankyloglossia for mandibular development and lower anterior crowding was analyzed using receiver operating characteristic (ROC) curves. Results: Ankyloglossia was significantly associated with mandibular development and lower anterior crowding (P<0.05). The case group showed significantly lower values for the lingual frenulum length, simplified HATLFF score, SNB angle, and Co-Gn, while the ANB angle and lower anterior crowding index were significantly higher compared to the normal group (P<0.05). The lingual frenulum length and simplified HATLFF score were negatively correlated with the ANB angle and lower anterior crowding index, and positively correlated with the SNB angle and Co-Gn (P<0.05). ROC curve analysis indicated that the area under the curve (AUC) for the simplified HATLFF score, and ankyloglossia in predicting mandibular development deficiency and lower anterior crowding was greater than 0.700, demonstrating good diagnostic value. Conclusion A significant correlation exists between ankyloglossia and both mandibular development deficiency and lower anterior crowding.

OBJECTIVE To explore and establish a full-cycle management model for drug traceability codes that aligns with national policy requirements and the practical needs of healthcare institutions， thereby enhancing the refinement of drug management and the level of medication safety. METHODS A tripartite strategy integrating “hardware deployment， system transformation， and process re-engineering” was adopted. This involved the introduction of intelligent identification devices （personal digital assistant， high-definition industrial reader）， the modification of the hospital information system interface， and the re-engineering of workflows （drug warehousing， dispensing and distribution， drug withdrawal， uploading to the insurance platform） to achieve comprehensive， informatized collection and association of drug traceability codes throughout all stages. RESULTS A full-cycle management model for drug traceability codes was successfully established， realizing the goals of making drugs “traceable to their source， trackable in their distribution， and accountable in their responsibility”. The patient waiting time for medication dispensing before and after the implementation was [3.08（1.67，5.58）] min and [3.28（1.77，5.98）] min， respectively. Among them， the patient waiting time under the pre-preparation mode was [3.60（2.13，6.35）] min and [3.50（2.03，6.30）] min， respectively； the patient waiting time under the real-time mode was [2.05（0.83，4.03）] min and [2.78（1.18，5.38）] min， respectively； the number of dispensing errors was 3， 0， respectively； the staffing of relevant positions had not been increased. CONCLUSIONS The drug traceability code management model constructed from a full-cycle perspective effectively meets national policy requirements. It provides data support for refined hospital management and offers solid technical and procedural safeguards for ensuring patient medication safety and strengthening medical insurance fund supervision， demonstrating practical value.

Objective: To examine the prevalence of e-cigarette use and associated factors among primary and secondary school students in Pudong New Area, Shanghai, and to explore the pathways linking harm perception of e-cigarettes, interpersonal social influence, and attitudes toward e-cigarette use with experimentation behavior, in order to provide scientific basis for further optimizing the prevention and control strategies of e-cigarette among adolescents. Methods: From September to October 2025, a multi stage cluster random sampling method was used to select 5 144 primary and secondary school students aged 8-19 years from 47 primary and secondary schools in Pudong New Area, Shanghai, to conduct an anonymous questionnaire survey. The questionnaire collected information on e-cigarette use, harm perception of e-cigarette, interpersonal social influence, and attitudes toward e-cigarette use. The Chi-square test was applied to analyze the differences in cigarette and e-cigarette use behavior among primary and secondary school students with different demographic characteristics. Structural equation modeling (SEM) was constructed using Mplus 8.3 software, and the bootstrap method was utilized to test the mediating effects. Results: The reported rates of cigarette experimentation, e-cigarette experimentation, and current e-cigarette use among primary and secondary school students were 1.85%, 2.10%, and 0.70%, respectively. Higher reporting rates of e-cigarette experimentation were observed among boys (2.82%), secondary school students aged 16-19 (3.39%), senior high school students (3.05%), and those with weekly pocket money >100 yuan ( 6.11% ) ( χ 2=11.67, 8.61, 8.00, 54.18, all P <0.05). Structural pathway analysis results demonstrated that e-cigarette harm perception positively predicted interpersonal social influence ( β =0.61) and e-cigarette use attitude ( β = 0.53 ), and interpersonal social influence ( β =0.65) and e-cigarette use attitude ( β =0.25) further promoted e-cigarette experimentation behavior among primary and secondary school students (all P <0.01), with interpersonal social influence playing a major mediating role (indirect effect=0.40). Conclusions E-cigarette experimentation behavior among primary and secondary school students in Pudong New Area is jointly influenced by multiple psychosocial factors. Intervention strategies should strengthen interpersonal social factors such as family and peers on the basis of health education, thereby constructing a comprehensive prevention and control strategy for e-cigarette use among primary and secondary school students.

Objective: To investigate the association characteristics between psychological resilience and Internet gaming addiction among primary and secondary school students across different educational stages, so as to provide evidence for stage specific intervention strategies. Methods: A total of 30 719 students from primary schools, junior high schools, and senior high schools in Guangzhou, were selected using a cluster random sampling method from October to December 2025. The 10 item Connor- Davidson Resilience Scale (CD-RISC-10) and the Internet Gaming Disorder Scale-Short Form (IGDS9-SF) were used to assess students phychological resilience and Internet gaming addication levels. One way analysis of variance was used for group comparisons. Network analysis was conducted to construct joint networks of psychological resilience and Internet gaming addiction across different educational stages, with a focus on identifying bridge nodes between the two domains. Results: Significant differences were observed in psychological resilience points (24.9±8.0, 24.3±8.2, 24.8±7.8) across priamry school, junior high school and senior high school ( F=18.91, P <0.01). There was a statistically significant difference in the scores of Internet game addiction points ( 17.7 ±7.6, 18.6±7.3, 19.2±7.0) among students across priamry school, junior high school and senior high school ( F=85.68, P <0.01). Psychological resilience was negatively correlated with Internet gaming addiction scores among primary school, junior high school, and senior high school students ( r =-0.27, -0.28, -0.19, all P <0.01). Network analysis revealed relatively close associations between psychological resilience and Internet gaming addiction across all educational stages. The bridge nodes were "withdrawal symptoms" for primary school, "toughness" for junior high school, and "loss of interest" for senior high school, with bridge expected influence values of 1.37, 1.31, and 1.18, respectively. The expected influence and bridge expected influence demonstrated good stability across the three educational stages, with correlation stability coefficients of 0.75. Conclusions The cross-community connections between psychological resilience and Internet gaming addiction differ across educational stages. Prevention and control of Internet gaming addiction should incorporate targeted interventions based on key bridge symptoms identified at each specific educational stage.

The prefrontal cortex (PFC) plays a pivotal role in orchestrating higher-order emotional and cognitive processes, a function that depends on the precise modulation of synaptic activity. Although pharmacological studies have demonstrated that dopamine signaling through dopamine D1 receptor (DRD1) in the PFC is essential for these functions, the cell-type-specific and molecular mechanisms underlying the neuromodulatory effects remain elusive. Using cell-type-specific knockout mice and patch-clamp recordings, we investigated the regulatory role of DRD1 on neurons and astrocytes in synaptic transmission and plasticity. Furthermore, we explored the mechanisms by which DRD1 on astrocytes regulate synaptic transmission and plasticity at the cellular level, as well as emotional and cognitive functions at the behavioral level, through two-photon imaging, microdialysis, high-performance liquid chromatography, transcriptome sequencing, and behavioral testing. We found that conditional knockout of the Drd1 in astrocytes (CKO^AST) increased glutamatergic synaptic transmission and long-term potentiation (LTP) in the medial prefrontal cortex (mPFC), whereas Drd1 deletion in pyramidal neurons did not affect synaptic transmission. The elevated level of d-serine in the mPFC of CKO^AST mice increased glutamatergic transmission and LTP through NMDA receptors. In addition, CKO^AST mice exhibited abnormal emotional and cognitive function. Notably, these behavioral changes in CKO^AST mice could be reversed through the administration of d-serine degrease to the mPFC. These results highlight the critical role of the astrocytic DRD1 in modulating mPFC synaptic transmission and plasticity, as well as higher brain functions through d-serine, and may shed light on the treatment of mental disorders.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

To summarize the nursing experience of a patient with T-cell precursor acute lymphoblastic leukemia complicated with excessive dynamic airway collapse.Key nursing points include:efficient treatment of airway collapse to avoid causes of airway hyper responsiveness;avoiding the blockage of phlegm suppository,ensuring a safe and smooth airway;preventing the risks of hemorrhage and thrombosis,and strictly implement hospital infection prevention and control measures.After active rescue and careful nursing care,the patient was transferred back to the general thoracic surgery ward 13 days later,improved 17 days later,and was admitted to the cancer hospital for continued treatment.

Objective To evaluate the preliminary effects of a Traditronal Chinese Medicine(TCM)incentive policy aimed at the number of discharge patients on the synergistic improvement of performance assessment indicators in the Traditional Chinese Hospital.Methods It selected detailed data from the first page of medical records at the grade A teritary hospital from October,2018 to October,2021.Using the Interrupted Time Series analysis method,two breakpoints were taken as the start time of COVID-19(December 2019)and the official implementation time of dis-charge performance program(September 2020).The utilization rate of TCM decoction pieces among discharged pa-tients,the utilization rate of TCM non-drug therapy among discharged patients,the proportion of discharged pa-tients mainly treated with TCM,and the proportion of inpatient medical service income before and after the break-point were analyzed.Results Despite the impact of COVID-19,after the policy was implemented,four key indicators showed a positive growth trend:the proportion of discharged patients treated primarily with TCM,the rate of TCM decoction use among discharged patients,the rate of TCM non-pharmaceutical therapy use among discharged pa-tients,and the proportion of medical service income,respectively.Conclusion The introduction of a TCM reward module in the discharge performance bonus plan of the sample hospital effectively stimulated the enthusiasm of medical staff in applying TCM.The utilization rate of TCM decoction slices,the utilization rate of TCM non-drug therapy,the proportion of discharged patients treated mainly by TCM and the proportion of medical service income all showed an upward trend,indicating that the incentive policy of TCM has a positive impact on the national examination index of TCM hospitals.

Objective:To explore the current implementation status and challenges of family doctor contract services (FDCS) from the perspective of contracted residents.Methods:This qualitative study used purposive sampling to select contracted residents from 11 primary healthcare institutions across five cities in China. Semi-structured interviews were conducted from March to December 2024, covering topics such as awareness of contracting, service experience, health needs, service continuity, and policy recommendations. Thematic framework analysis was applied to organize, code, and summarize the data.Results:A total of 25 contracted residents were interviewed (6 men, 19 women; 11 from central urban areas, 14 from suburban or rural towns; 8 with chronic diseases). Three main themes and ten sub-themes emerged: Theme Ⅰ: Pathways to improved service accessibility (optimized chronic disease management, more efficient referrals, and improved health education). Theme Ⅱ: Structural misalignment between supply and demand (limited specialty services despite patient needs, insufficient coverage and public awareness of home-based medical care, imbalanced human resources, and service disruption due to clinician turnover). Theme Ⅲ: Challenges in service awareness and communication mechanisms (information asymmetry and public misperception regarding FDCS, perverse incentives in administrative performance evaluation, and communication barriers in building patient-doctor trust).Conclusions:While FDCS has shown progress in chronic disease management, referral coordination, and health education, structural supply-demand gaps and communication challenges continue to hinder service quality. Improvements in resource allocation and service models are needed to support high-quality development.

Objective:To explore the association between the metabolic score for insulin resistance (METS-IR) and metabolic dysfunction-associated fatty liver disease (MAFLD), and to compare the diagnostic ability of METS-IR with the fatty liver index (FLI) and hepatic steatosis index (HSI) for MAFLD.Methods:This cross-sectional study enrolled 551 individuals participating in community health screenings in Suzhou between September and November 2022. Data collected included basic demographics, clinical indicators, and iLivTouch? (FibroTouch FT5000, Wuxi Hisky Medical Technologies, China) transient elastography results. Participants were categorized into non-MAFLD ( n=218) and MAFLD ( n=333) groups based on an ultrasound attenuation parameter (UAP) cutoff of 244 dB/m measured by iLivTouch. Logistic regression and restricted cubic spline (RCS) analyses were employed to assess the relationship between METS-IR and MAFLD. The diagnostic value of METS-IR was evaluated using receiver operating characteristic (ROC) curves. DeLong′s test was used to compare the diagnostic performance of the different indices. Results:Among the 551 participants, the prevalence of MAFLD diagnosed by transient elastography was 60.4% (333/552). Compared to the non-MAFLD group, the MAFLD group had significantly higher levels of BMI, SBP, DBP, HbA1c, FPG, 2hPG, TC, TG, LDL-C, ALT, AST, GGT, SUA, liver stiffness measurement (LSM), METS-IR, FLI, and HSI, while HDL-C levels were lower (all P<0.05). The MAFLD group also had a higher prevalence of males, overweight/obesity, smoking, hypertension, pre-diabetes, dyslipidemia, hyperuricemia, metabolic syndrome, and antihypertensive medication use (all P<0.05). Multivariate logistic regression analysis, after adjusting for gender, age, smoking, alcohol consumption, hypertension, diabetes, dyslipidemia, hyperuricemia, ALT, AST, and GGT, demonstrated that METS-IR, FLI, and HSI remained significantly associated with an increased risk of MAFLD ( OR=1.148, 1.042, 1.270, respectively; all P<0.001). The areas under the ROC curve for METS-IR, FLI, and HSI in diagnosing MAFLD were 0.733 (95% CI: 0.691-0.774), 0.727 (95% CI: 0.685-0.770), and 0.677 (95% CI: 0.632-0.722), respectively. The sensitivities were 57.40%, 62.20%, and 48.30%; specificities were 78.00%, 72.90%, and 78.40%; and optimal cutoff values were 38.526, 35.225, and 35.386, respectively. DeLong′s test indicated no significant difference in diagnostic performance between METS-IR and FLI ( P=0.722). However, both METS-IR and FLI demonstrated significantly better diagnostic performance than HSI ( P=0.008 and P=0.018, respectively). Conclusion:METS-IR is significantly associated with MAFLD and effectively identifies MAFLD in community settings. Its diagnostic performance is comparable to FLI and superior to HSI.