With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective:To investigate the mediating role of frailty in the relationship between sedentary behavior and quality of life in patients with stable chronic obstructive pulmonary disease (COPD), so as to provide empirical evidence for improving the quality of life in COPD patients.Methods:This was a cross-sectional survey. Two hundred and twenty-eight patients with stable COPD attending outpatient clinic in Chongming Branch of Shanghai Tenth People′s Hospital from January 2022 to February 2023 were selected by convenience sampling method. The General Information Questionnaire, the International Physical Activity Questionnaire, the Tilburg Frailty Indicator, and the COPD Assessment Test Questionnaire were investigated. Structural equation modeling was used to analyze the mediating role of frailty between sedentary behavior and quality of life, and Bootstrap method was used to analyze the mediating effect values.Results:Finally, 219 valid questionnaires were collected. The effective recovery rate was 96.05%(219/228). There were 168 males and 51 females, aged 69(62, 74) years old. The sedentary time of stable COPD patients was 6(5, 8) h/d, the frailty score was 5(3, 7) points, and the quality of life score was (13.56 ± 2.56) points. Pearson correlation analysis showed that the sedentary time, frailty in stable COPD were positively correlated with quality of life( r=0.420, 0.582, both P<0.01), and the sedentary time was also positively correlated with frailty ( r=0.698, P<0.01). Bootstrap method test results showed that the direct effect of sedentary time was 0.228 (95% CI 0.082-0.374), the indirect effect mediated by frailty was 0.169 (95% CI 0.080-0.215), and the total effect was 0.397, and the 95% CI of both the direct effect and the mediated effect did not contain 0. This model was partially mediated model with a 42.57% mediated effect. Conclusions:The quality of life of patients with stable COPD is at an intermediate level, and sedentary behavior can not only directly affect quality of life, but also indirectly affect quality of life by causing or aggravating debilitation. In clinical work, patients should be encouraged to avoid causing or aggravating debilitation due to prolonged sedentary behavior by standing, changing position frequently or performing light physical activities to promote the improvement of quality of life in the stable phase.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

Objective:To evaluate the application of 3D printed osteotomy template in total knee arthroplasty (TKA) for valgus knee.Methods:A retrospective analysis was performed of the 21 patients with valgus knee who had undergone TKA at Department Ⅰ of Joint Surgery, Orthopaedics Hospital of Zhengzhou from March 2016 to February 2018. They were 5 males and 16 females, aged from 62 to 78 years (average, 66.7 years). TKA was performed with the assistance of a 3D printed personalized osteotomy template for each patient. The efficacy of the personalized osteotomy templates was evaluated by comparing the femorotibial angle, knee range of motion, Hospital for Special Surgery (HSS) knee scores of the patients between preoperation and postoperation.Results:The 21 patients were followed up for a mean duration of 16.3 months(range, from 10 months to 4 years). All incisions healed by the first intention. The last follow-ups showed that their preoperative femorotibial angle 17.6°±5.7° was improved significantly to 6.3°±1.2°, their preoperative knee range of motion 71.3°±5.8° increased significantly to 102.4°±7.5°, and their preoperative HSS scores 38.2±5.7 increased significantly to 87.5±3.5 ( P<0.001). Their radiographic evaluation at the last follow-up showed stable prosthetic components with no implant loosing or osteolysis. Conclusion:A personalized 3D printed osteotomy template can be used in TKA for valgus knee, leading to accurate osteotomy, effective correction of mechanical alignment and satisfactory clinical outcomes.

Objective To analyze the main practices of capitation payment system reform in the case areas and put forward enlightenments and suggestions in this regard. Methods The implementation practices of the case areas were summarized, and descriptive statistical analysis was carried out on the implementation effects. Results By analyzing the effectiveness of the case areas′reform, it was found that the case areas are curbing the excessive growth of medical expenses (for example, outpatient fees per visit of Dingyuan county-level hospitals decreased from 245.11 yuan in 2015 to 218.40 yuan in 2017), increasing the actual compensation ratio of residents ( for example, the actual compensation ratio of Funan increased from 59.80% in 2015 to 63.28% in 2017), forming a medical treatment pattern within the county (for example, out-of-county compensation ratio in Dingyuan decreased from 37.38% in 2015 to 31.13% in 2017), achieving double-way referrals (for example, the number of referrals to superior hospitals of Jimo increased from 98 in 2015 to 328 in 2017), improving the subsidence of quality services, and controlling the risks of medical insurance funds. Conclusions At present, the reform of the case areas has been implemented steadily and achieved results. It is recommended to further improve such aspects as reform coordination, insurance standard setting, incentive mechanism establishment, and leadership to ensure the reform progress.

Pilot areas have achieved initial success in capitation reform. On the other hand, challenges remain unsolved in terms of practical pathways, change of national medical insurance management system, related measures, incentives and allocative mechanism for implement of the reform. With the concerning on progress, practice, effects and challenges of typical areas, this article established an institutional framework. On such basis, we propose to design and refine a scheme in terms of 5 aspects, namely strengthening the basic medical care packages′financing, setting contents and standard of the basic medical care packages rationally, establishing effective evaluation system and formulating supporting measures.

OBJECTIVE To explore the expression of long non-coding RNA (LncRNA) HOTAIR, enhancer of Zeste homolog 2 (EZH2) and vascular endothelial growth factor (VEGF) in nasopharyngeal carcinoma (NPC) and their relationship between HOTAIR and prognosis. METHODS We examined the expression of HOTAIR, EZH2 and VEGF in NPC tissues, and analyzed the clinical significance of HOTAIR expression in patients with NPC. RESULTS We found that the expression of HOTAIR, EZH2 and VEGF in the NPC tissues were significantly higher than those in the chronic nasopharyngitis tissues in the gene and protein levels (U=955,P<0.05). The HOTAIR was positively correlated with VEGF (r=0.599,P<0.001), VEGF was positively correlated with EZH2 (r=0.369, P=0.012), and HOTAIR had no significant correlation with EZH2 (r=0.139,P=0.357). Moreover, HOTAIR expression levels increased with clinical stage progression. CONCLUSION The expression of HOTAIR, EZH2 and VEGF were significantly increased in the NPC tissues, and the expression of HOTAIR was related with the TNM stage, the clinical stage and the short term therapeutic effect of the NPC patients, which indicated that the HOTAIR might be used as a biological indicator to determine the prognosis of the NPC.