Background Microparticles (MPs) are one of the main medium of inflammatory reaction with an important role in atherosclerotic progression. Studies on association of air pollution exposure and levels of peripheral blood MPs are limited among human. Objective To evaluate the effects of short-term exposure to air pollution on levels of peripheral blood MPs. Method A panel of 73 healthy adults was followed with 4 repeated follow-ups in Beijing, China, from November 2014 to January 2016. During each visit, we collected questionnaire information, fasting venous blood, urine, and exposures to fine particulate matter (PM_2.5), black carbon, nitric oxide, nitrogen dioxide, nitrogen oxide, sulfur dioxide, carbon monoxide, and ozone. We used linear mixed-effect models to analyze associations of air pollution exposure with levels of total MPs (TMPs) and MPs derived from various cells. Stratified analysis was conducted by levels of C-reactive protein (CRP) and malondialdehyde (MDA). Results The results showed significant associations between air pollution exposure and peripheral blood TMPs at 2 h-6 d prior to the follow-ups (P<0.05), while no statistical associations were found for MPs derived from different cell types. Significant increases in TMPs of 7.8% (95%CI: 0.7%, 15.3%) and 14.3% (95%CI: 2.8%, 27.2%) were observed with each interquartile range (IQR) increase in PM_2.5 (IQR=64.9 μg·m⁻³) at prior 18 h and NO (IQR=40.5 μg·m⁻³) at prior 48 h. Among participants with low levels of CRP and MDA, significantly positive associations were observed between air pollution exposure and levels of TMPs (P<0.05). Conclusion Short-term exposure to air pollution is significantly associated with increased levels of circulating MPs in healthy adults, and in people with lower systemic inflammation, peripheral blood MPs levels are more easily affected after exposure to air pollutants.

As one of the common chronic bacterial infections, Helicobacter pylori (Hp) infection is a key pathogenic factor of chronic gastritis, peptic ulcer and gastric cancer. In the formation of gastric ulcer, Hp virulence factors directly damage the gastric mucosal barrier, induce the local inflammation and immune response, interfere with the regulation of gastric acid secretion, and ultimately destroy the mucosal stability. In the occurrence of gastric cancer, Hp-driven chronic inflammation is the basis of inflammation-cancer transformation, and it induces the genomic instability and epigenetic changes by interfering with key signaling pathways in host cells, thereby promoting malignant transformation. This paper systematically reviews the related mechanisms of Hp-induced gastric ulcer and gastric cancer in recent years, holding great significance for the development of new intervention strategies and the precise prevention and treatment of gastric cancer.

ObjectiveTo develop the Evidence Grading Scale for Ancient classical prescriptions in Traditional Chinese medicine， assess its reliability and validity， and apply it in practice to provide multi-source evidence for clinical practice guidelines development. MethodsLiterature retrieval was conducted to extract and screen existing evaluation dimensions， then the initial items were summarized using thematic analysis. Experts in the clinical medicine， medical history and literature participated in the Delphi questionnaire survey to evaluate and refine the items. An expert consensus meeting was conducted to finalize the included items， refine the method for items evaluation and evidence grading. The evidence quality rating scale for ancient classical traditional Chinese medicine （TCM） prescriptions was then established and tested for reliability and validity. ResultsThrough literature review， extraction， screening and summarization， a total of 3 dimensions and 12 initial items were formed. Questionnaires were sent to 69 experts to evaluate the initial items， with a questionnaire response rate of 100% and an expert authority coefficient of 0.92. All 12 items were retained for they had importance scores above 4. The Evidence Grading Scale on Ancient classical prescriptions in Traditional Chinese medicine includes 3 dimensions with 12 items. The 3 dimensions includes ancient evidence， inheritance status， and modern application. Each dimension contains 4 items， and each item has a full score of 5 points. The evidence was rated as high-level， moderate-level， and low-level according to the final scores. The content validity index （CVI） of the 12 items was ＞0.9， the average CVI of the scale was 0.98， and the intraclass correlation coefficient （ICC） was 0.90. ConclusionThe Evidence Grading Scale on Ancient classical prescriptions in Traditional Chinese medicine has good reliability and validity， which is practical for use in the development of TCM clinical guidelines and can better support clinical decision-making.

Objective: This study aims to explore the influencing factors, formation mechanisms, and treatment methods of labial protuberance in the anterior maxilla during orthodontic treatment, providing a reference for clinical practice. Method: This study reports a case where the absence of upper anterior teeth 11 and 21, and the retraction tilting movement of teeth 12 and 22, resulted in labial protuberance and gingival hyperplasia. Alveolar osteoplasty and gingivoplasty were performed. The specific changes in the alveolar bone during the retraction of the anterior teeth and the characteristics of its remodeling were analyzed. Combined with relevant literature, the factors influencing the formation of labial protuberance in orthodontic patients, mechanisms, and methods for prevention and treatment were summarized. Results: After periodental surgery follow-up for 6 months, the gingival color and shape of teeth 12 and 22 were good, the labial alveolar bone was normal, and the overall condition was stable. A review of the literature showed that labial protuberance is more common in adult orthodontic patients, and the distance (>4 mm) and speed of retraction of anterior teeth are related to its formation, with the main mechanism likely being differential remodeling of the alveolar bone. In adult patients, the number of active osteoblasts and osteoclasts in the alveolar bone decreases, along with a reduction in metabolic activity and overall cellular activity, which diminishes the reactivity of the alveolar bone. After treatment of anterior teeth retraction, there is insufficient labial bone resorption. Moreover, the lack of mechanical stress-mediated periodontal ligament in the interdental space leads to reduced bone remodeling stimulation in this area, resulting in thickening of the labial alveolar bone of the upper anterior teeth. The remodeling rates of cortical and trabecular bone differ, with active trabecular bone proliferation near the tooth root surface and slow cortical bone resorption near the outer surface, which ultimately results in increased bone thickness at the labial cervical region. Specific case analysis indicates that the retraction distance of the upper anterior teeth in this case was about 6 mm. The alveolar bone at the missing sites of teeth 11 and 21, lacking periodontal ligament stimulation, showed less remodeling and absorption, likely appearing as hyperplasia. The prevention of labial bone protrusion mainly involves controlling the speed and distance of retraction of anterior teeth. Smaller labial protuberances generally do not require treatment, but those affecting function and aesthetics can be addressed with periodontal alveolar osteoplasty. Conclusion After the retraction of anterior teeth in orthodontics, a prominent, hard bone protuberance on the labial side can sometimes occur, which may be due to differential remodeling efficiency in different regions of the alveolar bone. For bone protuberance that influences aesthetics or function, periodontal alveolar osteoplasty can be a reliable option.

Objective To explore the mechanism of Huanglian Ganjiang Decoction in regulating the mitochondrial apoptotic pathway through the NF-κB/CXCL1/CXCR2 pathway in ulcerative colitis(UC).Methods Sixty C57BL/6J mice were divided into normal group,model group,Huanglian Ganzhang Decoction groups(low,medium and high doses)and mesalazine group.Except for the normal group,UC models were established in the other groups.The general conditions of the mice of all groups were recorded.HE staining was used to observe the pathological changes of the colon and rectum;electron microscopy was used to observe the mitochondrial condition;ELISA was used to determine the contents of IL-6,IL-10,D-lactic acid and DAO;Real-time PCR was used to detect the mRNA expression of NF-κB p65,CXCL1,CXCR2,Bcl-2 and Bax;Western blot was used to determine the protein expression levels of NF-κB p65,CXCL1,CXCR2,p-JAK2,p-STAT3,Bcl-2 and Bax.Results Compared with the normal group,the model group of mice showed a decline in condition,shortened length of the colon and rectum,and mitochondrial structural damage,furthermore,the levels of IL-6,DAO and D-lactic acid were increased,IL-10 level was decreased,the mRNA expression of NF-κB p65,CXCL1,CXCR2 and Bax were enhanced,Bcl-2 mRNA expression was weakened,the protein expression of NF-κB p65,CXCL1,CXCR2,p-JAK2,p-STAT3 and Bax were enhanced,Bcl-2 protein expression was weakened.Compared with the model group,the indexes mentioned above were reversed in the drug groups,especially in the high-dose group.Conclusion Huanglian Ganjiang Decoction may exert its therapeutic effect on UC in mice by regulating the NF-κB/CXCL1/CXCR2 pathway and mitochondrial apoptotic pathway.

Objective:To analyze the genetic mutation characteristics of the first reported case of DNA ligase Ⅳ syndrome primarily presenting as eczematous dermatitis and purpura in China.Methods:Clinical data were collected from a child with DNA ligase Ⅳ syndrome, and whole-exome sequencing was performed to identify genetic mutations.Results:The patient presented with generalized eczematous dermatitis and purpura, accompanied by pancytopenia, growth retardation, and immunodeficiency. Genetic testing revealed compound heterozygous mutations at three sites in the DNA ligase Ⅳ gene, namely c.467C>T (p.A156V) , c.833G>T (p.R278L) , and c.1271-c.1275del (p.K424fs*20) , among which c.467C>T (p.A156V) had not been previously reported.Conclusion:Children with DNA ligase Ⅳ syndrome may present with eczematous dermatitis and purpura, and compound heterozygous mutations in the DNA ligase Ⅳ gene may represent the genetic cause of this condition.

Objective To explore the application efficacy and complication occurrences of Tubridge embolization device(TED)and Pipeline embolization device(PED)in the treatment of elderly pa-tients with complex intracranial aneurysm(ICA).Methods A total of 119 elderly patients with complex ICA admitted in our hospital from January 2021 to July 2023 were enrolled,and accord-ing to different devices they used,they were divided into a TED group(n=71)and a PED group(n=48).Device delivery and complications were observed,digital subtraction angiography(DSA)was performed intra-and post-operatively to evaluate the embolization of aneurysms(Raymond grading),and modified Rankin scale(mRS)was adopted to assess the clinical symptoms and prognosis before and at 3 and 6 months after surgery.DSA was applied again at 6 months post-operatively to evaluate the effectiveness of treatment.DSA and magnetic resonance angiography were carried out to record aneurysm images during the follow-up of 3,6 and 12 months after sur-gery.Results There were no statistical differences between the TED group and PED group in terms of the success rate of device delivery and the incidences of intraoperative and postoperative complications,of the intraoperative and postoperative Raymond grades,and of the mRS scores be-fore surgery and at 3 and 6 months after surgery,and of the O-Kelly-Marotta grades and effec-tiveness at 6 months after surgery(P＞0.05).At 3,6 and 12 months after surgery,the complete occlusion rate was 64.8％,63.8％and 69.4％respectively in the TED group,and 70.8％,71.7％and 72.5％respectively in the PED group,and there was no significant difference in the rate be-tween the two groups(P＞0.05).Conclusion TED and PED have similar efficiencies in the suc-cess rate of operation,safety,aneurysm embolization efficacy,immediate and long-term efficacies,and neurological function prognosis in the elderly patients with complex ICA.There exists a cer-tain risk of intraoperative and postoperative complications.Clinically,appropriate blood flow guid-ing devices should be selected based on the patient's actual condition.

Objective:To investigate the effects of cryopreservation on the results of nucleic acid detection and culture for Bordetella pertussis in residual culture-positive nasopharyngeal swab specimens, aiming to provide the basis for specimens preservation, transport and centralized detection. Methods:In this cross-sectional study, the residual nasopharyngeal swab specimens which were culture-positive for Bordetella pertussis were collected in the Children′s Hospital, Zhejiang University School of Medicine from January to August in 2022. The specimens were placed at ?20 ℃ and?70 ℃ by random number table method, respectively. Re-detection by culture and PCR for Bordetella pertussis were conducted after these specimens were frozen for 114.3±31.9 days. The specimens were grouped according to the cryopreservation temperature and the semi-quantitative results by bacteria culture. The positive rates of the results were compared with χ 2 test between groups. Results:A total of 244 nasopharyngeal swabs specimens were included and 166 were culture-positive after cryopreservation, the positive rate decreased by 32%. Among them, the positive rate of re-culture of specimens containing low bacterial loads decreased by 56% after cryopreservation. However, there was no significant difference in the positive rate of culture between the specimens freezing at ?70 ℃ and ?20 ℃ (χ2=1.65, P=0.20). The positive rate of DNA detection decreased by 10.6% (88.9% vs 78.3%) after cryopreservation. The positive rate of the ?70 ℃ storage group was significantly higher than that of the ?20 ℃ group (χ2=5.11, P=0.02). The positive rate of the re-detection of DNA of nasopharyngeal swabs with low bacteria loads in ?70 ℃ storage group was significantly higher than that of the ?20 ℃ group (χ2=4.86, P=0.03). While for the samples with a bacterial load of "+" or more, there was no significant difference in the positive rate of DNA detection after cryopreservation between the ?20 ℃ and -70 ℃ (χ2=1.25, P=0.26) groups. The positive rate of nasopharyngeal swab culture after cryopreservation was 68.0% (166/244), which was significantly lower than the DNA detection positive rate of 78.3% (191/244, χ2=6.52, P=0.01). Conclusions:Cryopreservation nasopharyngeal swabs specimens could be used for Bordetella pertussis culture and nucleic acid detection. The bacterial load in the original sample affects the positive detection rate after cryopreservation. Cryopreservation has less influence on the positive rate of the result of nucleic acid detection when compared with culture. Preservation at ?70 ℃ is superior to ?20 ℃.

Objective:To address the inefficiency, safety hazards, and resource wastage in traditional medical laboratory management, this study proposes a digital laboratory information management system (LIMS) based on Total Quality Management (TQM) principles. The LIMS has been implemented at the National Center for Geriatric Medicine (Huashan) affiliated with Fudan University.Methods:Centered on the principles of " all-staff participation, whole-process control, and comprehensive management", a multidimensional management framework was developed to integrate personnel, equipment, reagents, and safety protocols. The system incorporated IoT, digital twin, and artificial intelligence (AI) technologies to achieve end-to-end digital control. A layered architecture (physical layer, data layer, model layer, etc.) was designed to integrate functional modules such as full lifecycle equipment management, dual-authentication for hazardous chemicals, and intelligent resource scheduling. A 3D digital twin model was deployed to visualize real-time laboratory operations.Results:Post-implementation, equipment reservation frequency and usage duration at the National Center increased by 114% and 124%, respectively, with no safety incidents reported. Equipment sharing utilization reached 85%, and reagent expiration waste decreased by 30%.Conclusions:The system transforms laboratory management from experience-driven to data-driven by breaking data silos and optimizing collaboration mechanisms. It provides a replicable technical pathway and practical insights for the healthcare industry′s digital transformation. However, further improvements are needed in mobile support and system scalability.

Objective:To investigate the application and management status of midline catheters in 1 954 hospitals, providing a basis for optimizing intravenous therapy nursing practices.Methods:This study used convenience sampling. From November 2023, members of the Intravenous Therapy Nursing Professional Committee of the Chinese Nursing Association selected 1 954 hospitals across various regions of China. Questionnaire on the Current Status of Intravenous Therapy in Hospitals at All Levels designed by the committee, based on literature review and expert discussions, was used to collect data on intravenous therapy practices in different hospitals. Multiple response analysis was applied to analysis the results of multiple-choice questions, where response numbers represent the total number of times each option was selected, and response rates refer to the proportion of selected times for each option out of all selected responses.Results:A total of 1 954 questionnaires were distributed across 31 provinces/municipalities/autonomous regions, and 1 954 valid questionnaires were returned, achieving a 100.0% valid response rate. Among the hospitals surveyed, 844 used midline catheters. Regarding the skin disinfection area for midline catheter insertion, the highest response rate was for a range of>20 cm. The highest response rate for catheter insertion techniques was ultrasound-guided Seldinger puncture. The highest response rate for maintenance interval was once a week. The top three responses for nursing documentation related to midline catheters were informed consent for intubation, puncture record, and maintenance record. The most frequently chosen processes were catheter placement, maintenance, removal, and complication management processes. The qualification for midline catheter intravenous therapy specialist nurses was mostly obtained through specialized nurse training, followed by hospital-based and department-based training.Conclusions:The application of midline catheters has rapidly developed but still reveals some deficiencies, including the choice of puncture tools, infection control, and catheter maintenance. It is recommended to improve nursing documentation and management processes related to midline catheters, establish industry standards suitable for China's national conditions, and strengthen and standardize the specialized training of intravenous therapy nurses to promote the healthy development of intravenous therapy in China.