Objective To explore the association between the growth condition of mandibular third molars(M3)and the parameters of mandibular dental arch through a retrospective cross-sectional study on M3 in adults,and to provide a basis for the selection of clini-cal treatment of M3.Methods A total of 221 adult patients were randomly selected for our study.Dolphin software was used to analyze the CBCT of all the patients.Parameters of the mandibular dentition including the entire dental crowding(EDC)were recorded.Then the association between M3 growth condition and these parameters was analyzed.Results The mesio-impacted angle of M3 was posi-tively correlated with EDC(P＜0.05),and negatively correlated with the retromolar space(RMS,P＜0.0 1).It was worth noting that me-dian mesio-impacted M3 significantly increased EDC(P＜0.01),and the erupting M3 in the vertical orthotopic position significantly in-creased RMS(P＜0.01).Conclusion For patients with median mesio-impacted M3 or insufficient RMS,preventive removal of M3 may be considered clinically,which may help to reduce crowding and prevent relapse after orthodontic treatment.

Using conventional broth microdilution assays,the synthetic phenolic antioxidant 2,6-di-tert-butyl-4-methylphenol(butylated hydroxytoluene,BHT)was screened for synergistic antimi-crobial activity with β-lactam antibiotics.Further validation through checkerboard assays,growth curve analysis,and time-kill curve experiments confirmed the synergistic effect of BHT and β-lac-tams against methicillin-resistant Staphylococcus aureus(MRSA)(FICI≤0.5).To elucidate the underlying mechanism of synergy,this study evaluated changes in membrane permeability and pro-ton transmembrane gradients-key factors in biofilm functionality-along with critical indicators of bacterial energy metabolism,including ATP levels and the NAD+/NADH ratio.The results dem-onstrated that BHT disrupts the proton motive force(PMF),impairs membrane potential,and perturbs bacterial energy homeostasis,thereby significantly enhancing the antibacterial efficacy ofβ-lactams.Furthermore,a murine pneumonia infection model was established to assess the in vivo therapeutic efficacy of BHT combined with amoxicillin.The combination therapy alleviated pulmo-nary tissue damage,reduced bacterial loads in target organs(liver,spleen,and lungs),and decreased systemic inflammatory responses.This study elucidates the synergistic antimicrobial action and mechanistic basis of BHT combined with amoxicillin,offering a novel combinatorial therapeutic strategy to address MRSA resistance.The findings hold significant clinical potential and research value for overcoming antibiotic resistance in MRSA infections.

Objective:To analyze the preventive effect of stratified combination nursing guided by Connelly pediatric thrombosis risk model on venous thromboembolism (VTE) in children with traumatic fractures, and provide a theoretical basis for reducing the risk of VTE occurrence.Methods:A randomized controlled trial was conducted, and 94 children with traumatic fractures admitted to Beijing Jishuitan Hospital, Capital Medical University from January to June 2023 were selected as research subjects by convenience sampling method. According to the time of admission, the 47 children admitted from January to March 2023 were included in the control group, and the 47 children admitted from April to June 2023 were included in the observation group. The control group was treated with routine nursing, and the observation group was treated with stratified combination nursing guided by Connelly pediatric thrombosis risk model. The deep vein thrombosis (DVT), VTE, hospitalization related indicators (time to first get out of bed, length of hospital stay and other complications) were compared between the two groups. The platelet count (PLT) and D-dimer levels were compared between the two groups after 1 week of intervention. The scores of the Newcastle Nursing Satisfaction Scale (NSNS) were compared between the family members of two groups sick children.Results:There were 29 males and 18 females in the control group, aged (9.09 ± 1.59) years, and 32 males and 15 females in the observation group, aged (9.34 ± 1.46) years. The total incidence of VTE in the observation group was 2.13% (1/47), which was lower than 12.77% (6/47) in the control group, and the difference was statistically significant ( χ2=3.86, P<0.05). After intervention, the levels of PLT and D-dimer in the control group and observation group were (173.26 ± 20.16)×10 9/L, (168.56 ± 19.66)×10 9/L, (0.40 ± 0.12) mg/L and (0.36 ± 0.10) mg/L, which were lower than (202.71 ± 24.51)×10 9/L, (203.15 ± 25.26) × 10 9/L, (1.19 ± 0.14) mg/L, (1.15 ± 0.11) mg/L before intervention, and the differences were statistically significant ( t values were 6.36 to 36.43, all P<0.05). The time to first get out of bed and the length of hospital stay were (2.21 ± 0.55) and (6.21 ± 1.54) in the control group, and (1.76 ± 0.45) and (5.13 ± 1.21) in the observation group, respectively, and the differences between the two groups were statistically significant ( t=4.34, 3.78, both P<0.05). The total incidence of other complications was 17.02% (8/47) in the control group and 4.26% (2/47) in the observation group, and the difference between the two groups was statistically significant ( χ2=4.03, P<0.05). The satisfaction of family members in the control group was 78.72% (37/47) and 93.62% (44/47) in the observation group, and the difference of sick children between the two groups was statistically significant ( χ2=4.37, P<0.05). Conclusions:Stratified combination nursing guided by Connelly's thrombosis risk model in children can improve the level of D-dimer and PLT, reduce the occurrence of VTE, and shorten the first time of children getting out of bed and staying in hospital, which is conducive to postoperative rehabilitation of children with traumatic fractures.

OBJECTIVE To analyze the drug resistance,laboratory indicators and clinical characteristics of blood-stream infections caused by Enterobacter in children,providing references for early empirical treatment.METHODS A retrospective analysis was conducted on the clinical data of 302 children(aged 29 days to 12 years)with bloodstream infections caused by Enterobacter(monomicrobial infections)admitted to the Maternity and Child Health Care of Guangxi Zhuang Autonomous Region from Jan.2017 to Dec.2023.The drug resistance of Enterobacter and major pathogens were analyzed across different age groups of children.Based on prognosis,the children were divided into a favorable prognosis group(266 cases)and a poor prognosis group(36 cases),and their laboratory indicators and clinical characteristics were compared.Multivariate logistic regression was used to analyze the risk factors for poor prognosis.RESULTS The major pathogens causing infections were Salmonella,Escherichia coli and Klebsiella pneumoniae.The distribution difference of major pathogens across age groups(29 days-6 months,＞6 months-1 year,＞1-2 years,＞2 years)was statistically significant(P＜0.001).The drug resistance rates of Salmonella to ampicillin,chloramphenicol and sulfamethoxazole/trimethoprim were 68.61％,54.01％and 44.53％,respectively.E.coli exhibited drug resistance rates of 83.33％,52.22％and 47 78％to ampicillin,sulfamethoxazole/trimethoprim and cefazolin,respectively.K.pneumoniae showed drug resistance rates exceeding 50％to ampicillin/sulbactam,cefuroxime and cefazolin.Hypoalbuminemia(OR=3.319),sepsis(OR=3.122),ventricular purulent encephalitis(OR=5.104)and prior use of penicillin-class anti-bacterial drugs before culture positivity(OR=3.374)were identified as risk factors for poor prognosis of the chil-dren with Enterobacteriaceae bloodstream infections(P＜0.05).CONCLUSIONS Bloodstream infections caused by Enterobacter in children predominantly occur in those under 2 years of age,with Salmonella,E.coli and K.pneumoniae as the major pathogens,exhibiting high drug resistance rates to penicillin and cephalosporin antibacte-rial drugs.Clinical therapeutic regimen should be adjusted early based on laboratory indicators and risk factors to improve prognosis.

Using conventional broth microdilution assays,the synthetic phenolic antioxidant 2,6-di-tert-butyl-4-methylphenol(butylated hydroxytoluene,BHT)was screened for synergistic antimi-crobial activity with β-lactam antibiotics.Further validation through checkerboard assays,growth curve analysis,and time-kill curve experiments confirmed the synergistic effect of BHT and β-lac-tams against methicillin-resistant Staphylococcus aureus(MRSA)(FICI≤0.5).To elucidate the underlying mechanism of synergy,this study evaluated changes in membrane permeability and pro-ton transmembrane gradients-key factors in biofilm functionality-along with critical indicators of bacterial energy metabolism,including ATP levels and the NAD+/NADH ratio.The results dem-onstrated that BHT disrupts the proton motive force(PMF),impairs membrane potential,and perturbs bacterial energy homeostasis,thereby significantly enhancing the antibacterial efficacy ofβ-lactams.Furthermore,a murine pneumonia infection model was established to assess the in vivo therapeutic efficacy of BHT combined with amoxicillin.The combination therapy alleviated pulmo-nary tissue damage,reduced bacterial loads in target organs(liver,spleen,and lungs),and decreased systemic inflammatory responses.This study elucidates the synergistic antimicrobial action and mechanistic basis of BHT combined with amoxicillin,offering a novel combinatorial therapeutic strategy to address MRSA resistance.The findings hold significant clinical potential and research value for overcoming antibiotic resistance in MRSA infections.

Objective To analyze the acupoint selection law in acupuncture treatment for sinusitis using data mining techniques.Methods Relevant literature on acupuncture treatment for sinusitis was retrieved from CNKI,Wanfang Data,VIP and CBM from January 1,2000 to December 20,2024.Descriptive statistics were performed on the frequency of acupoint usage,meridian tropism,and regional distribution.SPSS Modeler 18.0,Cytoscape 3.10.3 and Origin Pro were employed to conduct association rule mining,co-occurrence network analysis,and systematic cluster analysis on the acupoints.Results A total of 69 articles were included,yielding 114 acupoint prescriptions involving 65 distinct acupoints.The most frequently used acupoints were Yingxiang,Yintang and Hegu,etc.;the most commonly used meridians were large intestine meridian,Governor Vessel,gallbladder meridian and bladder meridian.Acupoint selection was predominantly concentrated in the head/neck region,lower limbs and upper limbs.Among the specific acupoint categories,Jiaohui acupoint,Wushu acupoint and Yuan acupoint were used most frequently.The acupoint combinations with the strongest associations were Hegu-Yingxiang,Hegu-Yintang-Yingxiang and Fengchi-Yingxiang.The top 22 high-frequency acupoints could be grouped into 5 clusters.Conclusion Acupuncture treatment for sinusitis can exert the functions to disperse wind and unblock the orifices,drain heat and resolve turbidity,expel pathogens and alleviate pain,tonify deficiency and dissipate cold,as well as harmonize qi and blood.The characteristics of acupoint combination include a primary focus on local points supplemented by distal points,pattern differentiation-based selection,and a propensity for unblocking yang qi.The core acupuncture formula is Yingxiang-Yintang-Hegu-Fengchi.

Objective:To investigate the correlations between physical, psychological and social frailty in elderly patients with multimorbidity.Methods:This study utilized a mixed method. A questionnaire survey was conducted from February to June 2024, among elderly patients with multimorbidity attending 4 primary health care centers in urban Beijing selected by the convenience sampling method. The FRAIL Frailty Assessment Scale, WHO-5 Index of Well-Being Scale, and HALFT Scale were used to assess the patients′ physical, psychological, and social frailty, respectively. Spearman correlation analysis was used to analyze the correlation between different dimensions of frailty in elderly with multimorbidity. Logistic regression model was used to analyze the factors influencing physical, psychological and social frailty. The elderly with multimorbidity who were assessed to have at least 1 or more types of frailty in the quantitative study were selected for in-depth interviews in the form of online and offline combination. The topics of in-depth interview included the real experience of the different dimensions of frailty, the possible causes and the difficulties caused. The sample size was determined according to the principle of information saturation. Thematic analysis was used to summarize, code and analyze the interview data.Results:A total of 919 participants were included in the quantitative study, with a mean age of (74.09±6.03) years, 329(35.80%) were males and 590(64.20%) were females. The prevalence of physical, psychological, and social frailty was 17.85%(164/919), 21.44%(197/919), 11.21%(103/919), respectively. A total of 21 participants were included in the qualitative study, with a mean age (76.90±5.13)years, 5(23.81%) males and 16(76.19%) females. Spearman correlation analysis showed that physical and psychological frailty were moderately correlated ( r=0.311, P<0.001), psychological and social frailty were weakly correlated ( r=0.218, P<0.001), and physical and social frailty were weakly correlated ( r=0.267, P<0.001). Logistic regression analysis showed that the age, the number of multimorbidities, the psychological frailty and social frailty were the influencing factors for physical frailty (all P<0.05). The gender, number of multimorbidity, type of medication taken, physical frailty and social frailty were influencing factors of psychological frailty (all P<0.05). And age, number of multimorbidities, physical frailty and psychological frailty were influencing factors of social frailty (all P<0.05). A total of 3 themes were extracted through in-depth interviews, namely, "physical and psychological frailty are interrelated""physical and social frailty are interrelated", and "psychological and social frailty are interrelated". Conclusions:The physical, psychological, and social frailty in elderly patients with multimorbidity interacts with each other. Whereas the number of multimorbidities is a common risk factor for all three.

Objective:To analyze the current status, research hotspots, and development trends on the integration of primary care and prevention in China.Methods:This was a bibliometric analysis. Literature related to research on the integration of primary care and prevention in China was retrieved from CNIKI, Wanfang, VIP, Chinese Medical Journal Full Text Database, PubMed, and Web of Science for the period from January 1, 2015, to April 1, 2025. CiteSpace software was used to conduct a visual analysis of publication volume, authors and their collaborations, institutions, and keywords in the included literature.Results:A total of 292 domestic publications on the integration of primary healthcare and public health were analyzed. Research on primary healthcare-public health integration in China exhibited an overall upward trend from 2015 to 2025. Based on publication volume and temporal distribution, domestic research can be categorized into an exploratory phase (2015-2020) and a rapid development phase (2021-2025). The institutions publishing relevant research were predominantly universities and research centers, with a low institutional network density (0.013), indicating relative weak inter-institutional collaboration. The co-occurrence density among authors was 0.013 9. Collaboration predominantly occurred in small clusters, with limited cross-regional cooperation. Keywords that appeared frequently and had an intermediary centrality exceeding 0.1 included chronic diseases (0.40), public health (0.23),health management (0.18), and hypertension (0.17). Keyword clustering analysis showed that the top three categories mainly focused on public health, chronic diseases, and health management. Since 2024, emerging keywords with high burst intensity have included big data, health literacy, primary care hospitals, and infectious diseases.Conclusions:Research on the integration of medical and preventive care at the primary healthcare level in China has entered a stage of rapid development. Current research hotspots focus primarily on chronic disease management, the implementation status and barriers of primary healthcare and prevention integration models. Future research is expected to emphasize the application of intelligent technologies, and the enhancement of public health emergency response capacity.

Objective To study the characteristics of animal models of pulmonary fibrosis so as to provide a reference for the standardization of such models,and to guide research on the pathogenesis,diagnosis,and treatment of pulmonary fibrosis.Methods Studies using experimental pulmonary fibrosis in animals published in the past 10 years were retrieved from the CNKI,Wanfang,VIP,SinoMed,and PubMed databases.Factors including animal species,sex,modeling method,and detection index were summarized,and the data were analyzed using Excel.Results A total of 292 eligible studies were included.The animals mainly included SD rats,Wistar rats,and C57BL/6 mice,and most were male.The most common modeling drugs were bleomycin,paraquat,and silica suspension,mainly administered by intratracheal injection,with a typical modeling cycle of 28 d.The detection indexes mainly comprised lung tissue pathology and measurements of protein expression,cytokine levels,and biochemical indexes.Conclusions SD rats and C57BL/6 mice were the most commonly used animals for experimental pulmonary fibrosis,and intratracheal injection of bleomycin(5 mg/kg)was the most frequently used modeling method.This approach allows for the straightforward and effective replication of pathological features resembling human pulmonary fibrosis,and may serve as a reference for future experimental studies using animal models of pulmonary fibrosis.

Objective To mine adverse drug event(ADE)signals of deucravacitinib,and to guide its rational clinical use.Methods ADE reports reported to the U.S.Food and Drug Administration Adverse Event Reporting System(FAERS)database from the third quarter of 2022 to the third quarter of 2024 were collected,ADE reports with deucravacitinib as the primary suspect drug were selected for analysis.ADE signals were identified using reporting adds ratios method and Bayesian confidence propagation neural networks method.Results A total of 1,777 ADE reports were collected involving 3,258 ADEs.Sixty-two ADE signals were identified,spanning 14 system-organ classifications.The top five ADE signals based on the number of reported cases were acne,oral ulcers,folliculitis,urticaria,and oral pain.The top five ADE signals based on signal intensity were cystic acne,hepatitis A,acne vulgaris,pustular acne,and folliculitis.ADE signals such as pigmenturia,hepatitis A,and gingival swelling were not included in the drug instructions.The median duration of ADEs associated with deucravacitinib was 22 days,with 58.33％occurring within the first month of treatment.Women may have a higher risk of developing acne than men.Conclusions When using deutericolaxitinib,healthcare professionals should focus on skin and subcutaneous tissue disorders,gastrointestinal system disorders,and infections and infestations to monitor the occurrence of acne in female patients.The latent ADEs that are not mentioned in the instructions should be remained vigilant to ensure safe drug use.