Objective: To investigate the influence of sinus morphology on the safety of hydraulic sinus floor elevation surgery and provide a biomechanical basis for clinical treatment. Methods: After approval by the Medical Ethics Committee of the institution, cone beam computed tomography imaging data from nine patients were collected. The sinus morphologies were classified into slope, flat and concave types. Three-dimensional finite element models of maxillary sinuses with the aforementioned morphologies were constructed using Mimics, Geomagic, Solidworks, and ANSYS software, followed by a simulation of the hydraulic elevation process. The sinus membrane elevation height was set at 1-6 mm. The pressure required for elevation and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane were recorded and analyzed. The equivalent stress distribution on the sinus membrane was visualized using contour plots. Results: The elevation pressure and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane increased along with the elevation height. When the sinus membrane was lifted to 6 mm, the elevation pressure was (301.17 ± 98.1) kPa, (151.85 ± 3.7) kPa, and (149.36 ± 10.31) kPa in the slope, flat and concave finite element analysis models, respectively. The equivalent stress was (1 023.86 ± 201.99) kPa in the slope sinuses, comparing with (687.91 ± 69.08) kPa and (698.27 ± 96.09) kPa in the flat and concave sinuses. Higher elevation pressure and the equivalent stress, compressive stress and shear stress values were found in the slope sinus than in the flat and concave sinuses under the same elevation height (P < 0.05). Stress distribution analysis revealed that stress was uniformly distributed in the flat sinuses, followed by concave sinuses, but asymmetrically distributed in the slope sinuses Conclusions The slope sinuses demonstrated inferior safety and efficiency compared with the flat and concave sinuses when performing hydraulic sinus floor elevation surgery.

Neurocritical care involves complex pathophysiological mechanisms, and its incidence is higher, injuries are more severe, and treatment is more challenging in high-altitude environments. This consensus, based on the latest domestic and international evidence-based medical data, establishes a standardized, goal-oriented framework for neurocritical care management applicable in high-altitude regions and nationwide. The consensus was developed following international standards for evidence quality assessment and underwent two rounds of Delphi expert consultation, resulting in 32 recommendation statements covering three parts: management systems, monitoring and assessment, and core strategies. Key updates include: advocating for the establishment of independent neurocritical care units and implementing precise tiered diagnosis and treatment based on the "Five Differences in Critical Care" concept; constructing a "trinity" multimodal brain monitoring system centered on cerebral blood flow, cerebral oxygenation, and brain function, emphasizing routine bedside transcranial Doppler ultrasound, cerebral oximetry, and continuous electroencephalography monitoring; shifting management strategies from mild hypothermia therapy to targeted temperature management, and defining the "446" target management pathway for the supercritical stage; emphasizing the assessment of static and dynamic cerebrovascular autoregulation functions through multimodal methods to achieve individualized optimal mean arterial pressure management; elevating cerebrospinal fluid management goals to the level of "glymphatic system" function maintenance; implementing a multidisciplinary collaborative, whole-process management model focusing on patients' long-term neurological functional outcomes; de-escalation criteria include multidimensional indicators such as recovery of brain structure, restoration of cerebrovascular autoregulation, improvement in cerebrospinal fluid dynamics, and reduction in biomarker levels; and integrating cutting-edge technologies like artificial intelligence into post-critical care management and rehabilitation planning. This consensus systematically integrates the entire process of neurocritical care management, reflecting the modern connotation of goal-oriented, dynamic, and multimodal integration in neurocritical care medicine. It aims to adapt to new trends such as deepening understanding of pathophysiological mechanisms, the integration of medicine and engineering, and the empowerment of artificial intelligence, thereby further advancing the discipline of critical care medicine.

Objective:To analyze the iodine nutrition status of pregnant women in Weihai City before and after (2022, 2023) the iodine deficiency disorders (IDD) intervention, evaluate the effectiveness of intervention measures, and provide a scientific basis for adjusting IDD prevention strategies in the city.Methods:In May 2023, the intervention action of IDD was carried out for pregnent women in Weihai City. In April 2022 and December 2023, respectively, a cross-sectional survey method was conducted in four districts (cities) of Weihai City. Each district (city) was divided into five areas (east, west, south, north, and central) each year, and one township (street) was selected from each areas. At least 20 pregnant women were selected from each township (street) as survey subjects, and their household salt samples and random urine samples were collected to measure salt iodine and urinary iodine concentrations, and to compare the test results.Results:A total of 922 household salt samples were tested, including 530 iodized salt samples and 469 qualified iodized salt samples. The median salt iodine was 24.00 mg/kg. The coverage rate of iodized salt, the qualified rate of iodized salt, and the consumption rate of qualified iodized salt were 57.48%, 88.49%, and 50.87%, respectively. No significant difference was observed in medians salt iodine between 2022 (24.26 mg/kg) and 2023 (24.00 mg/kg, Z = - 1.58, P = 0.113). However, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in 2023 werehigher than those in 2022 [73.72% (373/506) vs 37.74% (157/416), 65.22% (330/506) vs 33.41% (139/416), χ 2 = 120.90, 92.40, P < 0.001]. A total of 922 urine samples were collected from pregnant women, with a median urinary iodine of 135.90 μg/L. The median urinary iodine of pregnant women in 2022 was 113.55 μg/L. There was a statistically significant difference in medians urinary iodine among different regions ( H = 27.91, P < 0.001). The median urinary iodine of pregnant women in 2023 was 153.00 μg/L. There was no statistically significant difference in medians urinary iodine among different regions ( H = 3.33, P = 0.343). The medians urinary iodine of pregnant women in Huancui District, Wendeng District, and Rushan City in 2023 (156.60, 155.00, 140.85 μg/L) were higher than those in 2022 (93.60, 110.00, 110.70 μg/L), and the differences were statistically significant ( Z = - 5.44, - 4.92, - 5.99, P < 0.001). The median urinary iodine of pregnant women in Weihai City in 2023 showed a statistically significant difference compared to 2022 ( Z = - 7.62, P < 0.001). Conclusions:The IDD intervention measures in Weihai City have achieved good results, and the coverage of iodized salt, the consumption rate of qualified iodized salt, and the iodine nutrition level of pregnant women have improved. We should continue to implement intervention measures, improve the iodine nutrition level of key populations, and maintain a sustained elimination of IDD.

Objective To investigate the mechanism of the miR-518a-5p/histone deacetylase 6(HDAC6)axis in DNA oxidative damage in ovarian cancer(OC)SKOV3 cells.Methods Expression levels of miR-518a-5p and HDAC6 mRNA in OC tissues and in various cancer cells(A2780,SKOV3,CAOV3)were detected by qRT-PCR.SKOV3 cells were separated into Control,miR-NC,miR-518a-5p mimics,miR-518a-5p mimics+pcDNA-NC,and miR-518a-5p mimics+pc-HDAC6 groups.Cell proliferation and apoptosis were analyzed by colony-forming assay and Hoechst 33258 staining.Expression of phosphorylated histone H2AX(γ-H2AX)was detected by immunofluorescence assay and reactive oxygen species(ROS)were detected by flow cytometry.HDAC6,Bcl-2-associated X protein(Bax),and B-cell lymphoma-2(Bcl-2)protein expression were analyzed by Western blot.The regulatory relationship between miR-518a-5p and HDAC6 was analyzed by dual luciferase assay.The effect and mechanism of miR-518a-5p on oxidative DNA damage in OC cells were studied in a xenotransplantation tumor model.Results miR-518a-5p expression was decreased and HDAC6 expression was increased in OC tissues and A2780,SKOV3,and CAOV3 cells(P＜0.001).Expression levels of miR-518a-5p were lowest and expression levels of HDAC6 were highest in SKOV3 cells,and SKOV3 cells were therefore selected for subsequent experiments.miR-518a-5p expression,apoptosis rate,number of γ-H2AX-positive cells,relative ROS fluorescence intensity,and expression of Bax were all higher in the miR-518a-5p mimics group compared with the miR-NC group,while HDAC6 mRNA and protein expression,Bcl-2 expression,and colony-formation number were all lower(P＜0.001).HDAC6 mRNA and protein expression,colony-formation number,and expression of Bcl-2 were higher in the miR-518a-5p mimics+pc-HDAC6 group compared with the miR-518a-5p mimics+pcDNA-NC group,and the apoptosis rate,number of γ-H2AX-positive cells,relative ROS fluorescence intensity,and expression of Bax were all lower(P＜0.001).HDAC6 had a targeted regulatory relationship with miR-518a-5p.Overexpression of miR-518a-5p decreased tumor volume,weight,and HDAC6 protein expression in tumor tissues,and increased γ-H2AX expression in vivo(P＜0.001).Upregulation of HDAC6 expression by overexpression of miR-518a-5p increased graft tumor volume,weight,and HDAC6 protein expression and decreased γ-H2AX-positive expression(P＜0.05).Conclusions miR-518a-5p expression is reduced and HDAC6 expression is increased in OC tissues and cells.Overexpression of miR-518a-5p can induce oxidative DNA damage in SKOV3 cells by inhibiting HDAC6 expression,thereby inhibiting cell proliferation and promoting cell apoptosis.

Objective To investigate the clinical features of chronic hepatitis C(CHC)patients with hepatitis C virus genotype 3(HCV GT3)infection and the risk factors for disease progression.Methods A multicenter retrospective cohort study was conducted among 1 002 CHC patients from 11 clinical centers in Northwest China from December 2017 to November 2023,and according to their genotype,they were divided into GT1,GT2,GT3,and GT6 groups.Clinical features were compared between the patients with different genotypes.The one-way analysis of variance was used for comparison of normally distributed continuous data between groups,and the Scheffe test was used for further comparison between two groups.The Kruskal-Wallis H test was used for comparison of data with skewed distribution between groups;the chi-square test or Fisher test was used for comparison of categorical data between groups.The multivariate logistic regression analysis was used to explore the influencing factors for the progression of CHC to liver cirrhosis.Results In terms of the genotype,there were 427 patients with GT1 infection,242 with GT2 infection,299 with GT3 infection(210 patients with GT3a infection,87 with GT3b infection,and 2 with unclassified genotype),and 34 with GT6 infection.The patients with GT3 infection had a significantly younger age than those with GT1 infection(51.3±0.5 years vs 53.2±0.6 years,P<0.05)or GT2 infection(51.3±0.5 years vs 53.7±0.8 years,P<0.05),and for the patients with liver cirrhosis,the patients with GT3 infection had a significantly younger age than those with GT1 infection(52.1±0.5 years vs 59.4±0.9 years,P<0.001)or GT2 infection(52.1±0.5 years vs 58.1±1.1 years,P<0.001).Among the patients with GT3 infection,male patients accounted for 77.9%and the patients with liver cirrhosis accounted for 46.2%,which were significantly higher than those among the patients with GT1,GT2 or GT6 infection(all P<0.001).At baseline,the patients with GT3 infection had significantly higher levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)than those with GT1 or GT2 infection,significantly higher aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis-4(FIB4)than those with GT1,GT2 or GT6 infection,a significantly lower platelet count(PLT)than those with GT2 or GT6 infection,a significantly higher level of alpha-fetoprotein than those with GT2 or GT6 infection,and a significantly lower level of albumin(Alb)than those with GT6 infection(all P<0.05).There were no significant differences between the patients with GT3a infection and those with GT3b infection in age,sex,the proportion of patients with liver cirrhosis,comorbidities,HCV RNA quantification,PLT,ALT,AST,alkaline phosphatase,Alb,APRI,and FIB-4(all P>0.05).The multivariate logistic regression analysis showed that PLT≤150×109/L(odds ratio[OR]=10.72,95%confidence interval[CI]:5.76-35.86,P<0.001)and Alb≤35 g/L(OR=3.74,95%CI:1.22-11.45,P=0.021)were risk factors for liver cirrhosis.Conclusion Most CHC patients with GT3 infection are male in Northwest China,and compared with the patients with other genotypes,such patients tend to have a younger age of onset and higher degrees of liver inflammation activity and fibrosis.Low PLT and a low level of Alb are risk factors for progression to liver cirrhosis in CHC patients with GT3 infection.

Objective To investigate the clinical features of chronic hepatitis C(CHC)patients with hepatitis C virus genotype 3(HCV GT3)infection and the risk factors for disease progression.Methods A multicenter retrospective cohort study was conducted among 1 002 CHC patients from 11 clinical centers in Northwest China from December 2017 to November 2023,and according to their genotype,they were divided into GT1,GT2,GT3,and GT6 groups.Clinical features were compared between the patients with different genotypes.The one-way analysis of variance was used for comparison of normally distributed continuous data between groups,and the Scheffe test was used for further comparison between two groups.The Kruskal-Wallis H test was used for comparison of data with skewed distribution between groups;the chi-square test or Fisher test was used for comparison of categorical data between groups.The multivariate logistic regression analysis was used to explore the influencing factors for the progression of CHC to liver cirrhosis.Results In terms of the genotype,there were 427 patients with GT1 infection,242 with GT2 infection,299 with GT3 infection(210 patients with GT3a infection,87 with GT3b infection,and 2 with unclassified genotype),and 34 with GT6 infection.The patients with GT3 infection had a significantly younger age than those with GT1 infection(51.3±0.5 years vs 53.2±0.6 years,P<0.05)or GT2 infection(51.3±0.5 years vs 53.7±0.8 years,P<0.05),and for the patients with liver cirrhosis,the patients with GT3 infection had a significantly younger age than those with GT1 infection(52.1±0.5 years vs 59.4±0.9 years,P<0.001)or GT2 infection(52.1±0.5 years vs 58.1±1.1 years,P<0.001).Among the patients with GT3 infection,male patients accounted for 77.9%and the patients with liver cirrhosis accounted for 46.2%,which were significantly higher than those among the patients with GT1,GT2 or GT6 infection(all P<0.001).At baseline,the patients with GT3 infection had significantly higher levels of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)than those with GT1 or GT2 infection,significantly higher aspartate aminotransferase-to-platelet ratio index(APRI)and fibrosis-4(FIB4)than those with GT1,GT2 or GT6 infection,a significantly lower platelet count(PLT)than those with GT2 or GT6 infection,a significantly higher level of alpha-fetoprotein than those with GT2 or GT6 infection,and a significantly lower level of albumin(Alb)than those with GT6 infection(all P<0.05).There were no significant differences between the patients with GT3a infection and those with GT3b infection in age,sex,the proportion of patients with liver cirrhosis,comorbidities,HCV RNA quantification,PLT,ALT,AST,alkaline phosphatase,Alb,APRI,and FIB-4(all P>0.05).The multivariate logistic regression analysis showed that PLT≤150×109/L(odds ratio[OR]=10.72,95%confidence interval[CI]:5.76-35.86,P<0.001)and Alb≤35 g/L(OR=3.74,95%CI:1.22-11.45,P=0.021)were risk factors for liver cirrhosis.Conclusion Most CHC patients with GT3 infection are male in Northwest China,and compared with the patients with other genotypes,such patients tend to have a younger age of onset and higher degrees of liver inflammation activity and fibrosis.Low PLT and a low level of Alb are risk factors for progression to liver cirrhosis in CHC patients with GT3 infection.

Objective:To study the growth inhibition of Thunberg Fritillary extract on non-small cell lung cancer.Methods:The Thunberg Fritillary extract was prepared and characterized by UPLC-QE/MS.Replicated Lewis lung carcinoma ectopic tumor-bear-ing mouse model,yeast injection induced acute inflammation,compared the effect of Thunberg Fritillary extract combination with acute inflammation on the growth,tumor volume and tumor suppression rate of Lewis lung carcinoma mice,and determine the content of inflammatory factors by the flow CBA method(IL-6,IL-1β,IL-1α,IL-10,IL-27,IL-17A,IL-12p70,IL-23,TNF-α,IFN-γ,IFN-β,GM-CSF,MCP-1).Results:The inhibition of Lewis lung carcinoma mice was similar to that of cisplatin alone,and the tumor suppression rate was 35%;the tumor suppression rate of Thunberg Fritillary extract combined with acute inflammatory stimulation of yeast was 62%,1.8 times that of cisplatin alone.The decrease in the expressions of cytokines IL-23,MCP-1 after acute inflammatory stimulation in yeast was associated with tumor suppression;while the increased expressions of IL-6,IL-1β,IL-1α,IL-10,IL-27,IL-17A,IL-12p70,TNF-α,IFN-γ,IFN-β and GM-CSF cytokines were associated with tumor suppression.Conclusion:The Thun-berg Fritillary extract combination with acute inflammation can play a positive role against non-small cell lung cancer,which will pro-vide new research ideas and methods for the prevention and treatment of non-small cell lung cancer.

Objectives:To explore the therapeutic efficacy of balloon stent kissing technique(BSKT)and jailing wire technique(JWT)in patients with true bifurcation lesions of the left anterior descending branch-diagonal branch of the coronary artery,and to observe the impact of these two interventional procedures on the lumen area,angina symptoms,cardiac function,myocardial injury,and myocardial perfusion of patients.Methods:A retrospective analysis was conducted in 203 patients with true bifurcation lesions of the left anterior descending branch-diagonal branch who underwent BSKT and JWT procedures and completed a 6-month follow-up in the Department of Cardiovascular Medicine at Shijiazhuang People's Hospital from January 2022 to January 2024.Patients were randomly assigned to the BSKT group(n=107)or the JWT group(n=96).The safety,efficacy,and myocardial perfusion indicators of the two groups were compared.Results:The minimum lumen area measured by intravascular ultrasound immediately after procedure,the Canadian Cardiovascular Society angina classification at 6 months post-intervention,the total score of resting+stress myocardial perfusion at 6 months post-intervention,the total number of segments with resting+stress myocardial ischemia,and the abnormal myocardial perfusion area in both the BSKT group and JWT group were significantly improved compared to baseline values(all P<0.05).In the BSKT group,87 cases(81.3%)achieved immediate success in stent placement,whereas in the JWT group,64 cases(66.7%)achieved immediate success in stent placement.The BSKT group significantly outperformed the JWT group.In terms of the myocardial injury and cardiac function indicators assessed on postoperative day 1,the cardiac troponin I level([0.22±0.13]ng/ml vs.[0.45±0.27]ng/ml,P<0.001),creatine kinase MB([35.24±13.15]U/L vs.[42.39±21.66]U/L,P=0.004),and B-type natriuretic peptide([133.52±25.62]pg/ml vs.[167.22±22.04]pg/ml,P<0.001)were all significantly lower in the BSKT group than in the JWT group.In terms of the myocardial perfusion indicators at 6 months post-intervention,the number of ischemic segments under stress(3.23±1.54 vs.3.87±1.62,P=0.004),the total score of stress perfusion(4.18±2.21 vs.4.97±2.96,P=0.031),and the abnormal myocardial perfusion area([7.04±3.27]%vs.[8.24±3.69]%,P=0.014)were all significantly lower in the BSKT group than in the JWT group.Conclusions:Both BSKT and JWT procedures can significantly improve the lumen area of the left anterior descending branch,angina symptoms,and myocardial perfusion in patients with true bifurcation lesions of the left anterior descending branch-diagonal branch.The BSKT procedure provides more adequate protection for the bifurcation vessels compared to the JWT procedure.

OBJECTIVE To explore the possible mechanism of Qingchang Huashi Formula in the treatment of ulcerative colitis(UC).METHODS Fifty C57BL/6 male mice were randomly divided into a control(Ctrl)group,a model group,a low-dose Qingchang Huashi Formula group,a high-dose Qingchang Huashi Formula group,and a 5-aminosalicylic acid(5-ASA)group based on body weight.The UC model was established in mice by drinking 3%dextran sulfate sodium(DSS)for 6 d.On d7 and d8,DSS was withdrawn and ultrapure water was given daily.Ultrapure water or different drugs were administered orally throughout the experiment:Ctrl and model groups received 0.2 mL of ultrapure water,while the low-dose and high-dose Qingchang Huashi Formula groups re-ceived 6 and 12 g·kg-1,respectively,and the concentration of 5-ASA was 100 mg·kg-1.Body weight and fecal characteristics of the mice were recorded daily,and the experiment ended on d9.Serum was collected from mice for serum metabolomics and inflam-matory factor expression analysis.The colons of the mice were isolated and their lengths were measured,and the distal colon was ob-tained for pathological analysis.The livers and colons of the mice were isolated for subsequent total bile acid analysis.RESULTS Compared with the Ctrl group,the model group mice showed a significant decrease in body weight and colon length(P<0.000 1),a remarkable increase in disease activity index(P<0.000 1).The concentration of inflammatory factors IL-1β and TNF-α was signifi-cantly increased(P<0.000 1).High-dose and low-dose Qingchang Huashi Formula,as well as 5-ASA could significantly alleviate the loss of body weight,increased DAI,colon shortening,and disappearance of colon tissue morphology in mice.Through ELISA tes-ting,it was found the concentration of IL-1β and TNF-α was remarkably decreased after Qingchang Huashi Formula and 5-ASA treat-ment(P<0.01,P<0.000 1).Through LC-MS analysis of serum metabolites and KEGG enrichment analysis,we found that interven-tion with Qingchang Huashi Formula could significantly affect the primary bile acid synthesis,secondary bile acid synthesis and bile se-cretion.Using total bile acid reagent kit,we found that the total bile acid in the liver of colitis mice did not show significant changes when compared with the Ctrl group of mice,and the concentration of total bile acid in the serum was significantly reduced,the concen-tration of TBA in the colon was significantly increased(P<0.05).After intervention with the Qingchang Huashi Formula,the concen-tration of total bile acid in the serum of mice was significantly increased,while the concentration of total bile acid in the colon was re-duced(P<0.05).Compared with mice in Ctrl group,the levels of deoxycholic acid(DCA)and taurine deoxycholic acid(TDCA)in serum of colitis mice were significantly reduced(P<0.05).After intervention with Qingchang Huashi Formula,the levels of DCA,TD-CA and Ursodeoxycholic acid(UDCA)in serum of mice were restored(P<0.01).CONCLUSION Qingchang Huashi Formula can effectively relieve DSS-induced colitis in mice,reducing immune inflammatory response,reregulating the disorder of serum metabolism and enterohepatic circulation.

This study investigated the infectious status and pathogen characteristics of Leptospira in rodents and the environment in Fujian province to provide data for the prevention and control of leptospirosis.A total of 723 rodents and 31 water samples were col-lected from 19 regions in Fujian Province during 2020-2023.The prevalent rodent species was Rattus losea(35.82%,259/723),which was followed by Rattus norvegicus(20.06%,145/723),Rattus tanezumi(19.64%,142/723),and Niviventer fulvescens(13.97%,101/723).A total of 144 positive samples of Leptospira spp.were detected in rodent kidney samples,accounting for 19.92%(144/723).The positivity rate of Leptospira spp.in wild rodents was higher than that in domestic rodents(χ2=8.48,P<0.05),and the positivity rate in adult rodents was higher than that in juvenile rodents(χ2=14.19,P<0.05).The positivity rates varied among rodent species(χ2=46.11,P<0.05),and differences in the positivity rates of Leptospira spp.were observed among regions(χ2=32.113,P<0.05).Ten strains were isolated from 440 rodent samples,and the isolation rate was 2.27%(10/440).Genospecies identification indi-cated that Leptospira borgpetersenii accounted for seven of the ten isolates,and L.interrogans accounted for three.MLST typing divided 10 isolates into three ST types:ST1,ST16,and ST143.5 isolates were isolated from 31 water samples,with an isolation rate of 16.13%,all of which were nonpathogenic L.tsangambouensis.Although pathogenic Leptospira spp.were not isolated from the water samples,the rodents in Fujian Province were generally infected with pathogenic Leptospira spp.Surveillance of the environment and ro-dents infected with Leptospira spp.should be strengthened.