ObjectiveTo evaluate the application effect of morphology driven preparation technique in indirect restoration of posterior teeth. Methods84 patients with dental defects were selected and divided into the control group and the experimental group randomly， with 42 patients in each group （a total of 84 teeth）. Traditional preparation and morphology driven preparation techniques were used to complete dental preparation and adhesive glass ceramic restorations， respectively. The satisfaction， masticatory function， World Dental Federation （FDI） Scores for edge fracture and fixation，edge adaptability index，periodontal bleeding index （BI） and plaque index （PLI） of the two groups of patients were evaluated and various indicator data were recorded and statistically analyzed at 3 and 6 months after restoration completion. ResultsThere was no statistically significant difference in satisfaction between the two groups after 3 and 6 months of repair； Both groups of data showed a significant improvement in masticatory function. There was no statistical difference after 3 and 6 months of repair. However， a statistically significant difference in masticatory function was noted after 6 months of repair compared with before and after 3 months of repair. As the repair time increased， the masticatory effect improved significantly. There was no statistically significant difference in the edge fracture and fixation index between the two groups at 3 months after repair， but there was a statistically significant difference between the two groups at 6 months with the experimental group outperforming the control group（P<0.05）. The edge adaptability， BI， and PLI index were statistically significant between the two groups after 3 and 6 months of repair and the experimental group had a significant advantage （P<0.05）. ConclusionBoth types of tooth preparation techniques can improve patient masticatory function and reach high satisfaction after repair. However， morphology driven preparation technique has significant advantages in edge adaptability， edge fracture and fixation index scores and improve periodontal conditions. This technique is an effective method for improving dental preparation in adhesive indirect restoration of posterior teeth.

ObjectiveTo explore the effects and mechanism of the modified Danggui Yinzi on "itch-anxiety" model rats of chronic urticaria （CU）. MethodsThe 36 SPF-grade 6-8-week-old female SD rats were randomly divided into a blank control group，a model group，a positive control group，a low-dose modified Danggui Yinzi group，a medium-dose modified Danggui Yinzi group，and a high-dose modified Danggui Yinzi group. A "itch-anxiety" model was established by intraperitoneal injection of a suspension of sodium chloride and aluminum hydroxide and ovalbumin，combined with chronic unpredictable emotional stress stimulation. After successful modeling，rats in each group were administered drugs by gavage. The positive control group was given intragastric administration of the drug solutions of cetirizine and fluoxetine （2.08 mg·kg^-1·d^-1 fluoxetine， 2 mg·kg^-1·d^-1 cetirizine）， the low-，medium-，and high-dose modified Danggui Yinzi groups were administered traditional Chinese medicine at 1.44，2.88， 5.76 g·kg^-1， respectively，while the blank control group and model group were given an equal volume of normal saline. All interventions lasted for 15 days. Behavioral changes were evaluated by the elevated plus-maze test （detecting the percentage of entries into the open arms （OE%），the percentage of time spent in the open arms （OT%），and the total number of entries into the open and closed arms （TNE）），the open-field test （detecting total activity，average movement speed，and latency to enter the central area），and scratching behavior observation. Pathological changes of skin tissues were observed by hematoxylin-eosin （HE） staining and toluidine blue staining，while those of amygdala tissues were observed by HE staining，Nissl staining，and immunofluorescence detection of ionized calcium-binding adapter molecule-1 （Iba-1）. The content of immunoglobulin E （IgE），interleukin-33 （IL-33），histamine in serum and glutamate in the amygdala was detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the protein expression of striatal-enriched protein tyrosine phosphatase （STEP），N-methyl-D-aspartate receptor subunit 2B （NR2B）， calmodulin-dependent protein kinase Ⅱ （CaMKⅡ），phosphorylated CaMKⅡ （p-CaMKⅡ），mitogen-activated protein kinase （MAPK），phosphorylated MAPK （p-MAPK），nuclear factor kappa-light-chain-enhancer of activated B cells （NF-κB），phosphorylated NF-κB （p-NF-κB），and postsynaptic density protein-95 （PSD-95） in the amygdala. ResultsCompared with the blank control group，the model group rats showed obvious anxiety-like behaviors （decreased OE%，OT%，and TNE，reduced total activity，slower average movement speed，and prolonged latency to enter the central area），increased scratching times，obvious skin inflammation and mast cell degranulation，severe amygdala tissue damage，increased glutamate content in the amygdala，and elevated levels of IgE and IL-33 in serum. The expression of STEP，NF-κB，p-NF-κB，NR2B，MAPK，p-MAPK，CaMKⅡ，and p-CaMKⅡ proteins in the amygdala increased，while the expression of PSD-95 protein decreased （P<0.05）. Compared with the model group，the modified Danggui Yinzi group of each dose had increased OE%，OT%，TNE，total activity，and average movement speed，shortened latency to enter the central area， reduced scratching times，alleviated skin inflammation and mast cell degranulation，relieved amygdala tissue damage，decreased glutamate content in the amygdala，and reduced levels of IgE and IL-33 in serum. Moreover，compared with the model group，the low -，medium-，and high-dose modified Danggui Yinzi groups showed decreased expression levels of STEP，NF-κB，p-NF-κB，NR2B，MAPK，p-MAPK，CaMKⅡ，and p-CaMKⅡ proteins in the amygdala，and increased expression of PSD-95 protein. There was a significant dose-effect relationship，with the high-dose group showing the most significant regulatory effect （P<0.05）. ConclusionThe modified Danggui Yinzi has a therapeutic effect on "itch-anxiety" model rats of CU. Its mechanism may be related to regulating glutamate metabolism in the amygdala，modulating the STEP/NR2B/CaMKⅡ/MAPK/NF-κB pathway，and regulating the expression of PSD-95.

ObjectiveTo investigate the efficacy of Xingpi capsules （XPC） in treating diarrhea-predominant irritable bowel syndrome （IBS-D） with spleen deficiency and elucidate its potential molecular mechanisms. MethodsA rat model of IBS-D with spleen deficiency was established by administering senna leaf in combination with restrained stress and swimming fatigue for 14 d. Ten specific pathogen free （SPF）-grade healthy rats were used as the normal control group. After successful modeling， SPF-grade rats were randomly divided into a model group， a pinaverium bromide group （1.5 mg·kg^-1）， and low- and high-dose XPC groups （0.135 and 0.54 g·kg^-1）， with 10 rats in each group. Rats in the normal control group and the model group were given distilled water by gavage， while the remaining groups were administered corresponding drug solutions by gavage once a day for 14 consecutive days. The rat body weights and fecal condition were observed every day， and the Bristol score was recorded. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of 5-hydroxytryptamine （5-HT） in serum and colon tissue. Transmission electron microscopy was used to observe the microvilli and tight junctions in the colon. The integrity of the colonic barrier， intestinal motility， and expression of related pathway proteins were evaluated by hematoxylin-eosin （HE） staining， immunohistochemistry， and Western blot. ResultsCompared with those in the normal control group， rats in the model group showed a significantly decreased body weight and increased diarrhea rate， diarrhea grade， and Bristol score （P<0.01）. HE staining revealed incomplete colonic mucosa in the model group， with evident congestion and edema observed. Electron microscopy results indicated decreased density and integrity of the colonic barrier， shedding and disappearance of microvilli， and significant widening of tight junctions. The expression levels of colonic tight junction proteins Occludin and Claudin-5 were downregulated （P<0.01）， and the levels of 5-HT in serum and colon tissue were elevated （P<0.01）. The small intestine propulsion rate significantly increased （P<0.01）， and the expression of contractile proteins Ras homolog family member A （RhoA） and Rho-associated coiled-coil containing protein kinase 2 （ROCK2） in colon and phosphorylation of myosin light chain （MLC₂₀） were upregulated （P<0.01）. Compared with the model group， the treatment groups showed alleviated diarrhea， diarrhea-associated symptoms， and pathological manifestations of colon tissue to varying degrees. Specifically， high-dose XPC exhibited effectively relieved diarrhea， promoted recovery of colonic mucosal structure， significantly reduced congestion and edema， upregulated expression of Occludin and Claudin-5 （P<0.01）， decreased levels of 5-HT in serum and colon tissue （P<0.05，P<0.01）， significantly slowed small intestine propulsion rate （P<0.01）， and significantly downregulated expression of contractile proteins RhoA and ROCK2 in colon and phosphorylation of MLC₂₀ （P<0.05，P<0.01）. ConclusionXPC effectively alleviates symptoms of spleen deficiency and diarrhea and regulates the secretion of brain-gut peptide. The characteristics of XPC are mainly manifested in alleviating IBS-D with spleen deficiency from the aspects of protecting intestinal mucosa and inhibiting smooth muscle contraction， and the mechanism is closely related to the regulation of the 5-HT-RhoA/ROCK2 pathway expression.

Extramedullary plasmacytoma(EMP)is a malignant neoplasm characterized by monoclonal plasma cell proliferation originating outside the bone marrow and hematopoietic tissues.The co-occurrence of multiple myeloma(MM)with mammary EMP is clinically rare.This case report describes the diagnostic and therapeutic management of a middle-aged female patient with MM and mammary EMP,accompanied by a litera-ture review.The patient presented with persistent fever and was found to have a right breast mass via PET/CT during routine follow-up for MM.The lesion was biopsy-confirmed as mammary EMP,and the patient subse-quently underwent chemotherapy.This case highlights the critical importance of differential diagnosis between breast cancer and rare hematologic metastatic tumors in early prevention of disease progression.

Objective:To examine the validity and reliability of the Basic Psychological Needs Satisfaction and Frustration Scale(BPNSFS)in the adult population.Methods:A total of 488 adults were recruited and random-ly divided into 2 groups.One half(n=244)was utilized for item analysis and exploratory factor analysis,while the other half(n=244)was reserved for confirmatory factor analysis.One month later,a convenient sample of 100 in-dividuals was selected for retesting.The Depression-Anxiety-Stress Scale-21(DASS-21)and the Satisfaction with Life Scale(SWLS)were employed as criterion measures.Results:Both subscales of the BPNSFS demonstrated a 3-factor structure,explaining a total variance of 60.99％and 60.31％,respectively.The 3-factor model exhibited good fit indices(x2/df=1.85,2.47;RMSEA=0.06,0.08;CFI=0.95,0.94;TLI=0.94,0.92;SRMR=0.04,0.05).Scores on both subscales and their dimensions were significantly correlated with DASS-21 and SWLS scores(|r|=0.16-0.57,Ps＜0.001).The Cronbach α coefficients for the 2 subscales were 0.87 and 0.89,with Cronbach α values for each dimension ranging from 0.73 to 0.81.The test-retest reliabilities(ICC)for the 2 sub-scales were 0.84 and 0.80,with ICC values for each dimension ranging from 0.65 to 0.83.Conclusion:The validi-ty and reliability of the Chinese version of the Basic Psychological Needs Satisfaction and Frustration Scale demon-strate good measurement properties in assessing the adult population.

A 36-year-old male developed unconsciousness and no response to voice stimuli after taking approximately 2 050 mg felodipine (the specific time was unknown). Two hours later, he was sent to the department of emergency by his family and admitted to the hospital. His vital signs showed body temperature 35.1 ℃, pulse 148 times/min, respiration 32 times/min, and blood pressure 65/34 mmHg. Acute drug poisoning, acute toxic cardiomyopathy, acute toxic shock, acute type Ⅱ respiratory failure, acute toxic encephalopathy, and acute renal failure were diagnosed based on the patient′s clinical manifestations combined with laboratory tests results, cardiac ultrasound, chest and abdominal CT scans. Endotracheal intubation connected to a ventilator for invasive assisted ventilation, pressure boosting, and fluid resuscitation were given. At the same time, repeated gastric lavage and enema were performed to remove toxins. Blood perfusion was intermittently and repeatedly administered, and continuous renal replacement therapy was used. The blood concentration of felodipine was 1 298 μg/L at 2 hours after admission, and cardiac arrest occurred at 4 hours. Venous-arterial extracorporeal membrane oxygenation (V-A ECMO) treatment was administered immediately. After 48 hours of ECMO operation, sedatives were discontinued and the patient′s consciousness was improved after 4 hours. On the 5th day of ECMO treatment, his heart rate was 72 beats per minute, and blood pressure was 127/65 mmHg. The blood concentration of felodipine decreased to 2 μg/L. The patient′s vital signs were significantly improved and ECMO supportive treatment was withdrawn. After 26 days of hospitalization, the patient recovered and was discharged.

Objective:To examine the validity and reliability of the Basic Psychological Needs Satisfaction and Frustration Scale(BPNSFS)in the adult population.Methods:A total of 488 adults were recruited and random-ly divided into 2 groups.One half(n=244)was utilized for item analysis and exploratory factor analysis,while the other half(n=244)was reserved for confirmatory factor analysis.One month later,a convenient sample of 100 in-dividuals was selected for retesting.The Depression-Anxiety-Stress Scale-21(DASS-21)and the Satisfaction with Life Scale(SWLS)were employed as criterion measures.Results:Both subscales of the BPNSFS demonstrated a 3-factor structure,explaining a total variance of 60.99％and 60.31％,respectively.The 3-factor model exhibited good fit indices(x2/df=1.85,2.47;RMSEA=0.06,0.08;CFI=0.95,0.94;TLI=0.94,0.92;SRMR=0.04,0.05).Scores on both subscales and their dimensions were significantly correlated with DASS-21 and SWLS scores(|r|=0.16-0.57,Ps＜0.001).The Cronbach α coefficients for the 2 subscales were 0.87 and 0.89,with Cronbach α values for each dimension ranging from 0.73 to 0.81.The test-retest reliabilities(ICC)for the 2 sub-scales were 0.84 and 0.80,with ICC values for each dimension ranging from 0.65 to 0.83.Conclusion:The validi-ty and reliability of the Chinese version of the Basic Psychological Needs Satisfaction and Frustration Scale demon-strate good measurement properties in assessing the adult population.

The female reproductive system is essential for sustaining reproductive endocrine homeostasis,however,its vulnerability to various endogenous and exogenous insults,including pathological conditions,pharmacological agents,genetic predispositions,and environmental factors,often results in compromised fertility.The existing protective approaches(including surgical interventions,hormonal replacement therapies,and assisted reproductive techniques)are constrained by several limitations,such as adverse therapeutic effects,technical complexities,and their incapacity to reverse ovarian senescence.Artemisinin and its derivatives(ARTs),characterized by their unique endoperoxide bridge configuration,have exhibited outstanding therapeutic performance across multiple domains including malaria treatment,anticancer therapy,inflammation modulation,and parasitic infection control.Emerging research has identified their novel protective capabilities against various reproductive system pathologies.This comprehensive review systematically elucidates the molecular mechanisms underlying artemisinin-based interventions in reproductive pathologies and evaluates their clinical translation prospects,thereby proposing innovative strategies for the development of next-generation fertility-protective agents with enhanced safety and efficacy profiles.

Objective To investigate and analyze the current situation of the construction of Smart Hospital in the dis-trict-level hospital of Beijing,and to provide reference for thedistrict-level hospitals to promote the construction of Smart Hospitals.Methods A questionnaire survey was conducted in Beijing district-level hospitals,and the construc-tion of Smart Hospital was analyzed by descriptive statistical analysis.Results The overall construction rate of Beijing district-level hospitals smart service business function was 50.98％,and the overall average construction rate of hos-pital smart management business function was 46.72％.93.75％hospitals thought that the investment in Smart Hos-pital construction was insufficient.The functions of smart service and management in different grades and categories of hospitals were different.Conclusion In order to promote the construction of Smart Hospital in Beijingdistrict-level hospitals,we should improve the top-level system such as strategic planning for the construction of smart hospi-tals,increase the investment in hospital informatization and talent teams,strengthen the standardization of intercon-nection between different hospitals,enhance the sharing and utilization of medical data and information,and strengthen the application of new hospital technologies and hospital information security.

Objective:To explore the differences in the cost structures of Hemophagocytic Lymphohistiocytosis(HLH)and Still's disease,and provide a basis for optimizing the medical insurance and hierarchical diagnosis and treatment policies for rare diseases.Methods:Based on the theories and methods of SHA 2011,the treatment costs and financing models of HLH and Still's disease in 2020 were calculated and analyzed to calculate its financing mode.Results:In 2020,the treatment cost of HLH in China was 436 million yuan,with 98.62%occurring in inpatient services;the treatment cost of Still's disease was 159 million yuan,with 82.32%occurring in inpatient services.In terms of the financing composition,the proportion of household health expenditure in outpatient services for HLH reached to 65.51%;for adult Still's disease,the proportion of household health expenditure in outpatient services was 65.13%;for pediatric Still's disease,the proportion of household health expenditure in outpatient services was as high as 93.15%,and the compensation from social medical insurance was less than 4%.Conclusion:In China,there are problems such as imbalanced cost structures,uneven distribution of diagnosis and treatment resources,heavy family burdens,and differentiation in the attention paid to rare diseases.It is necessary to improve the accounting system,strengthen grassroots diagnosis and treatment,optimize the financing mechanism,increase the attention to"non-star"rare diseases,and promote universal protection.