Objective:To analyze the prevalence trends and epidemiological characteristics of cardiometabolic multimorbidity(CMM) in Beijing from 2005 to 2022.Methods:A series of representative cross-sectional surveys were conducted in Beijing between 2005 and 2022 using a stratified multistage cluster random sampling method. A total of 110 496 permanent residents aged 18-79 years participated in face-to-face interviews, physical examinations, and laboratory testing. Complex sampling logistic regression models were employed to identify factors associated with CMM, and Joinpoint regression was used to assess temporal trends in prevalence. Results:The prevalence of CMM was 22.3% in 2005 and 24.3% in 2022, with an average annual percent change of 0.1%(95% CI -1.3%-1.3%, P>0.05). In rural areas, the prevalence increased by 1.3% per year(95% CI 0.2%-2.6%, P<0.05), while among obese individuals, it decreased by 1.0% annually( P<0.05). The most common CMM patterns were hypertension combined with dyslipidemia(13.2%), hypertension combined with diabetes(7.0%), and diabetes combined with dyslipidemia(5.8%). The prevalence of hypertension and dyslipidemia comorbidity showed a long-term decline among females, those aged 60-79 and obese individuals( P<0.05). In contrast, the prevalence of hypertension and diabetes comorbidity increased over time in rural residents and individuals with normal body weight( P<0.05). Furthermore, diabetes and dyslipidemia comorbidity rates increased significantly among males, adults aged 18-59 years, those with a college education or above, rural residents and individuals with normal body weight( P<0.05). Multivariable logistic regression indicated that male, older age, overweight, obese, and lower education level were independently associated with a higher risk of CMM( P<0.05). Conclusion:From 2005 to 2022, the prevalence of CMM remained high among adults in Beijing. While prevalence decreased among obese individuals, it increased significantly in rural areas. Hypertension combined with dyslipidemia was the most common multimorbidity pattern throughout the study period.

Objective To observe the value of multi-task improved nnU-Net model based on enhanced CT for segmenting primary oral cancer and predicting patients'relapse free survival(RFS).Methods Enhanced CT data of 186 cases of primary oral cancer were retrospectively analyzed,and a multi-task improved nnU-Net model was constructed for tumor segmentation and survival prediction tasks.Pre-training of tumor segmentation was completed with nnU-Net as the baseline network,and the accuracy of recognizing and segmenting tumor was improved by enhancing the decoder through the modified skip connection.Then univariable and multivariable regression analyses were used to select clinical features closely associated with RFS.Radiomics and deep learning features were also extracted to construct a survival prediction model,with fine-tuning of the above model.The training set,validation set and test set were divided at a ratio of 7∶2∶1.Dice similarity coefficient(DSC)was used to evaluate the segmentation performance of the modified model,and the consistency index C-index was used to verify the performance of the improved model for predicting RFS.Results DSC of the multi-task improved nnU-Net model(0.78)for segmenting primary oral cancer was superior to that of 3D Inception ResNet(0.65),3D InceptSENet(0.75)and 3D U-Net models(0.69),respectively,its C-index for predicting RFS(0.798)was higher than that of Cox regression model(0.744),ICARE model(0.761),random forest model(0.744),DeepSurv model(0.735),nnU-Net model(0.760)and radiology+nnU-Net model(0.744),respectively.DSC for segmenting primary oral cancer and C-index for predicting RFS of multi-task improved nnU-Net model were both superior to those of simple baseline network(0.653 and 0.649),baseline network+multi-scale convolution fusion(0.755 and 0.752),as well as baseline network combined with clinical features(0.764 and 0.759),radiomics features(0.770 and 0.764)and clinical+radiomics features(0.773 and 0.761),respectively.Conclusion Multi-task improved nnU-Net model could be used to effectively improve the accuracy of tumor segmentation and predicting patients'RFS.

Objective:To study the effects of chlorhexidine (CHX) and ethylene diamine tetraacetic acid (EDTA) on adhesive properties of moderate fluorosis dentin.Methods:From August to September 2024, a total of 30 freshly extracted, non-carious and non-defective mandibular molars with moderate dental fluorosis, extracted for impaction or orthodontic reasons, were collected from the patients at the Department of Oral and Maxillofacial Surgery at Guiyang Stomatological Hospital and randomly divided into three groups (Groups A, B, and C, n = 10) using a simple randomization method, and pretreated for 60 s with normal saline (Group A), 17%EDTA gel (Group B), and 2%CHX solution (Group C), respectively. Subsequently, microtensile bonding strength testing and microleakage evaluation were performed. Results:The immediate bonding strengths of Groups A, B, and C were (14.23 ± 4.75), (20.94 ± 7.46), and (28.76 ± 14.61) MPa, respectively, and the bonding strengths after aging were (9.89 ± 3.81), (19.05 ± 7.85), and (22.15 ± 8.67) MPa, respectively. There were statistically significant differences in both immediate and aged bonding strengths among the three groups ( F = 6.08, 8.07, P = 0.010, 0.002). The immediate bonding strength of Group C was significantly higher than that of Group A ( P < 0.05), and the post aging bonding strength of both Group B and Group C was significantly higher than that of Group A ( P < 0.05). The proportion of silver staining area with microleakage in Groups A, B, and C were 21.87% (14.65%, 40.15%), 2.34% (1.87%, 5.29%), and 17.54% (4.59%, 20.47%), respectively, with statistically significant differences among the three groups ( H = 27.36, P = 0.001). The proportion of silver stained area with microleakage in Group B was significantly lower than that in Group A and Group C, and the difference was statistically significant ( P < 0.05). Conclusions:Pretreatment of moderate fluorosis dentin with 2%CHX or 17%EDTA can improve resin bongding performance, with EDTA being superior in reducing microleakage and CHX being better in enhancing adhesion strength.

Tuberculosis (TB) is still a major public health issue today. A novel TB vaccine is a key approach to reaching the targets of WHO's End-TB Strategy. In recent years, significant progress has been made in the research and development of TB vaccines both in China and abroad. A breakthrough has been made in both application scenarios and technological routes, and several vaccine candidates have entered phase Ⅲ clinical trials. This review summarizes information from clinical trials involving key TB vaccine candidates under development in China and abroad. It highlights six candidates that are most promising for marketing or inspiring future research and development, analyzes the current difficulties in the research and development of novel TB vaccines, and provides an outlook for the future.

Patients with lacunar infarction (LI) have a higher risk of stroke recurrence compared to other types of stroke, and it is an important pathological basis for vascular dementia. Homocysteine (Hcy) is closely associated with the occurrence and development of LI. The mechanism by which Hcy causes LI involves multiple complex biological processes (including inflammation, oxidative stress, endothelial dysfunction, etc.) and synergistic effects with various risk factors (such as hypertension and hyperglycemia), but the specific mechanism is currently not fully elucidated.

Objective:To analyze the prevalence trends and epidemiological characteristics of cardiometabolic multimorbidity(CMM) in Beijing from 2005 to 2022.Methods:A series of representative cross-sectional surveys were conducted in Beijing between 2005 and 2022 using a stratified multistage cluster random sampling method. A total of 110 496 permanent residents aged 18-79 years participated in face-to-face interviews, physical examinations, and laboratory testing. Complex sampling logistic regression models were employed to identify factors associated with CMM, and Joinpoint regression was used to assess temporal trends in prevalence. Results:The prevalence of CMM was 22.3% in 2005 and 24.3% in 2022, with an average annual percent change of 0.1%(95% CI -1.3%-1.3%, P>0.05). In rural areas, the prevalence increased by 1.3% per year(95% CI 0.2%-2.6%, P<0.05), while among obese individuals, it decreased by 1.0% annually( P<0.05). The most common CMM patterns were hypertension combined with dyslipidemia(13.2%), hypertension combined with diabetes(7.0%), and diabetes combined with dyslipidemia(5.8%). The prevalence of hypertension and dyslipidemia comorbidity showed a long-term decline among females, those aged 60-79 and obese individuals( P<0.05). In contrast, the prevalence of hypertension and diabetes comorbidity increased over time in rural residents and individuals with normal body weight( P<0.05). Furthermore, diabetes and dyslipidemia comorbidity rates increased significantly among males, adults aged 18-59 years, those with a college education or above, rural residents and individuals with normal body weight( P<0.05). Multivariable logistic regression indicated that male, older age, overweight, obese, and lower education level were independently associated with a higher risk of CMM( P<0.05). Conclusion:From 2005 to 2022, the prevalence of CMM remained high among adults in Beijing. While prevalence decreased among obese individuals, it increased significantly in rural areas. Hypertension combined with dyslipidemia was the most common multimorbidity pattern throughout the study period.

Objective To observe the value of multi-task improved nnU-Net model based on enhanced CT for segmenting primary oral cancer and predicting patients'relapse free survival(RFS).Methods Enhanced CT data of 186 cases of primary oral cancer were retrospectively analyzed,and a multi-task improved nnU-Net model was constructed for tumor segmentation and survival prediction tasks.Pre-training of tumor segmentation was completed with nnU-Net as the baseline network,and the accuracy of recognizing and segmenting tumor was improved by enhancing the decoder through the modified skip connection.Then univariable and multivariable regression analyses were used to select clinical features closely associated with RFS.Radiomics and deep learning features were also extracted to construct a survival prediction model,with fine-tuning of the above model.The training set,validation set and test set were divided at a ratio of 7∶2∶1.Dice similarity coefficient(DSC)was used to evaluate the segmentation performance of the modified model,and the consistency index C-index was used to verify the performance of the improved model for predicting RFS.Results DSC of the multi-task improved nnU-Net model(0.78)for segmenting primary oral cancer was superior to that of 3D Inception ResNet(0.65),3D InceptSENet(0.75)and 3D U-Net models(0.69),respectively,its C-index for predicting RFS(0.798)was higher than that of Cox regression model(0.744),ICARE model(0.761),random forest model(0.744),DeepSurv model(0.735),nnU-Net model(0.760)and radiology+nnU-Net model(0.744),respectively.DSC for segmenting primary oral cancer and C-index for predicting RFS of multi-task improved nnU-Net model were both superior to those of simple baseline network(0.653 and 0.649),baseline network+multi-scale convolution fusion(0.755 and 0.752),as well as baseline network combined with clinical features(0.764 and 0.759),radiomics features(0.770 and 0.764)and clinical+radiomics features(0.773 and 0.761),respectively.Conclusion Multi-task improved nnU-Net model could be used to effectively improve the accuracy of tumor segmentation and predicting patients'RFS.

Tuberculosis (TB) is still a major public health issue today. A novel TB vaccine is a key approach to reaching the targets of WHO's End-TB Strategy. In recent years, significant progress has been made in the research and development of TB vaccines both in China and abroad. A breakthrough has been made in both application scenarios and technological routes, and several vaccine candidates have entered phase Ⅲ clinical trials. This review summarizes information from clinical trials involving key TB vaccine candidates under development in China and abroad. It highlights six candidates that are most promising for marketing or inspiring future research and development, analyzes the current difficulties in the research and development of novel TB vaccines, and provides an outlook for the future.

To analyze the treatment strategy for a 78-year-old female patient with mismatch repair deficient (dMMR) gastric cancer who achieved long-term survival. After third-line chemotherapy failed, gene testing showed ARID1A p.Gln748fs, c.2733-1G＞T variation, with PD-L1 TPS 30%, CPS 60%. The nivolumab was employed, and two weeks later, the best response was partial response (PR). During the fourth-line immunotherapy maintenance treatment, progression of left adrenal metastasis was observed. The expression of human epidermal growth factor receptor-2 (HER-2) was positive, and the antibody drug conjugate disitamab vedotin (RC48) was chosen for treatment. After 10 months of treatment with nivolumab combined with RC48, the best efficacy was assessed as stable disease (SD), with a progression free survival (PFS) of up to 12 months. Radiotherapy was employed, and immunotherapy was maintained, allowing the patient to achieve a PFS of 18 months again. During immunotherapy, a clinical pharmacist developed a personalized pharmaceutical care plan for this patient. At the last follow-up, this patient achieved 78 months of long-term survival.

Objective: To analyze the association between altitudes and nutritional status of children and adolescents, and to explore the moderating effects of dietary behaviors and physical activity, so as to provide a scientific basis for developing lifestyle interventions tailored to local conditions. Methods: From September to November 2023, physical examinations and questionnaire surveys were conducted among children and adolescents aged 7-17 in two autonomous regions, Inner Mongolia and Xizang, with a final sample of 156 511 participants by the stratified cluster random sampling method. Height and weight were measured to calculate body mass index (BMI). Sociodemographic characteristics, dietary behaviors, and physical activity were collected via questionnaires, while the altitude of each participant s school was obtained using Amap. Logistic regression was performed to examine the relationship between altitudes and nutritional status. Interaction terms and stratified analyses were applied to assess the moderating effects of dietary behaviors and physical activity. Restricted cubic spline (RCS) were used for visualization. Results: In 2023, the prevalence of wasting and overweight/obesity among children and adolescents in Xizang were 9.7% and 9.0%, respectively, compared to 2.9% and 22.0% in Inner Mongolia. Logistic regression analysis results showed that for every 1 km increase in altitude, the risk of wasting increased, while the risk of overweight/obesity decreased ( OR =1.43, 0.19, both P <0.05). The results of the stratified analysis showed that compared to those living at altitudes <1 km, children and adolescents with healthy diets showed no significant association between altitudes (1-<2 and 2-<3 km) and wasting ( OR =1.22, 0.75, both P >0.05), whereas significant associations were observed at 3-<4 and ≥4 km altitudes ( OR =2.25, 2.89, both P <0.05). In contrast, unhealthy dietary groups showed statistically significant associations across altitudes ( OR =1.18-4.04, all P <0.05), consistent with RCS results. No moderating effects were observed for physical activity on the altitude wasting association or for dietary behaviors and physical activity combined on the altitude overweight/obesity association ( P interaction =0.63, 0.10, 0.53). Conclusion Healthy dietary behaviors play a critical role in improving the nutritional status of children and adolescents and reducing regional disparities, providing a scientific foundation for public health policy formulation and implementation.