ObjectiveThis study aimed to investigate the action mechanism by which Banxia Xiexintang （BXT） inhibits epithelial-mesenchymal transition （EMT） in chronic atrophic gastritis （CAG） rats by regulating the interleukin-17（IL-17）/extracellular regulated protein kinases（ERK）/CCAAT enhancer binding protein β（C/EBPβ）signaling pathway， thereby providing new theoretical evidence for the treatment of CAG with classic traditional Chinese medicine formulas. MethodsA CAG rat model was established by using the combined factor method. After successful modeling， the rats were randomly divided into the model group， low-， medium-， and high-dose groups （0.549， 1.098， 2.196 g·kg^-1， respectively） of BXT， and the positive drug group （vitacoenzyme， 0.3 g·kg^-1）. A normal control group was also set up. After 8 weeks of intervention， the pathological changes of gastric tissue were evaluated. The enzyme-linked immunosorbent assay （ELISA） was used to detect the contents of IL-17， tumor necrosis factor-α （TNF-α）， cyclooxygenase-2 （COX-2）， and C/EBPβ in serum， as well as the contents of EMT markers in gastric mucosal tissue including E-cadherin， N-cadherin， and vimentin. The immunohistochemistry method was employed to determine the localization and protein expression levels of IL-17， p-ERK， and C/EBPβ in gastric mucosal tissue. Western blot was used to detect the protein expressions of C/EBPβ， ERK， and its phosphorylated form （p）-ERK in gastric mucosa. Real-time polymerase chain reaction （Real-time PCR） was applied to measure the mRNA expression levels of ERK， COX-2， and C/EBPβ in gastric mucosa. ResultsCompared with those in the normal control group， the rats in the model group showed gastric mucosal glandular atrophy and inflammatory cell infiltration. The protein and their related mRNA expressions of C/EBPβ， ERK， and p-ERK in gastric mucosa were significantly increased （P<0.05，P<0.01）. The levels of IL-17， TNF-α， COX-2， and C/EBPβ in serum were significantly increased （P<0.01）. The contents of N-cadherin and vimentin in gastric mucosal tissue were significantly increased， while the content of E-cadherin was significantly decreased （P<0.01）. Compared with the model group， after intervention with different doses of BXT， the pathological damage of the gastric mucosa was improved to varying degrees. The protein and mRNA expressions of C/EBPβ， ERK， and p-ERK in gastric mucosa were significantly reduced （P<0.05，P<0.01）. The levels of IL-17， TNF-α， COX-2， and C/EBP β in serum were significantly decreased （P<0.01）. The contents of N-cadherin and vimentin in gastric mucosa tissue were decreased， while the content of E-cadherin was increased （P<0.05，P<0.01）. ConclusionBXT can effectively improve the pathological damage of gastric mucosal tissue in CAG rats. Its action mechanism may be related to reducing the levels of IL-17 and TNF-α in serum， regulating the IL-17/ERK/C/EBPβ signaling pathway and inhibiting the EMT process.

OBJECTIVE To investigate the improving effect and mechanism of Wenyang huayu formula on cerebral ischemia-reperfusion injury in rats based on nuclear factor-erythroid 2-related factor 2 （Nrf2）/glutathione peroxidase 4 （GPX4） signaling pathway and mitochondrial ferroptosis pathway. METHODS SD rats were randomly divided into sham operation group， model group，Nimodipine tablet group （10.8 mg/kg ）， and Wenyang huayu formula group （28 g/kg）， with 24 rats in each group. Except for the sham operation group， rats in other groups were all subjected to middle cerebral artery occlusion model by Longa thread occlusion method. After successful modeling， rats in each administration group were intragastrically gavaged with corresponding liquid for 7 days or 14 days， while rats in sham operation group and model group were given equal volume of normal saline once a day. At 7 and 14 days after administration， neurological deficit scores of rats were calculated； the ultrastructure of neuronal mitochondria in ischemic brain tissue of rats was observed；the contents of malondialdehyde （MDA）， glutathione （GSH） and Fe 2+ ， as well as the protein and mRNA expression levels of Nrf2， solute carrier family 7 member 11 （SLC7A11） and GPX4 in ischemic brain tissue of rats were detected. RESULTS At 7 and 14 days after administration， compared with the sham operation group， the neuronal mitochondria in ischemic brain tissue of rats in the model group showed typical changes of ferroptosis， and the injury continued to worsen over time； the neurological deficit scores， the contents of MDA and Fe 2+ were significantly increased （ P ＜0.05），while the content of GSH and the protein and mRNA expression levels of Nrf2， SLC7A11 and GPX4 were significantly decreased （ P ＜0.05）. Compared with the model group， the morphology of neuronal mitochondria in ischemic brain tissue of rats in Nimodipine tablet group and Wenyang huayu formula group was gradually improved over time， and the above quantitative indicators were significantly reversed （ P ＜0.05）；moreover， the improvement effect of most indicators in Wenyang huayu formula group was significantly better than that in Nimodipine tablet group （ P ＜0.05）. CONCLUSIONS Wenyang huayu formula can improve cerebral ischemia-reperfusion injury in rats， and its mechanism may be related to activating Nrf2/GPX4 signaling pathway and inhibiting mitochondrial ferroptosis.

OBJECTIVE To evaluate the clinical efficacy and safety of eravacycline in intensive care unit （ICU） patients with carbapenem-resistant Acinetobacter baumannii （CRAB） and/or carbapenem-resistant Klebsiella pneumoniae （CRKP） pneumonia.METHODS Clinical data of patients with CRAB and/or CRKP pneumonia who were admitted to the ICU of Peking Union Medical College Hospital， Chinese Academy of Medical Sciences， and received eravacycline treatment from July 2023 to November 2024 were collected. The 28-day all-cause mortality rate， clinical failure rate， 28-day ICU-free days among surviving patients， 28-day mechanical ventilation-free days among surviving patients， microbiological clearance， and adverse reactions were recorded.RESULTS A total of 37 patients were included. Among the 37 patients， 11 （29.73%） experienced clinical failure， and the 28-day all-cause mortality rate was 18.92% （7/37）. The 28-day ICU-free days among surviving patients were （14.60±10.61） days， and the 28-day mechanical ventilation-free days among surviving patients were （24.55±4.29） days. Microbiological clearance was achieved in 12 patients （32.43%）， and the mean time to conversion was （10.58±12.05） days. Adverse reactions occurred in 5 patients （13.51%）， including 2 cases of elevated liver enzymes， 2 cases of coagulopathy， and 1 case of drug hypersensitivity syndrome.CONCLUSIONS Eravacycline can effectively control systemic bacterial infection and inflammatory response in ICU patients with pneumonia caused by CRAB and/or CRKP. However， patients with underlying liver disease or receiving multiple antibacterial agents should be alert to elevated liver enzymes， coagulation abnormalities， and the rare drug hypersensitivity syndrome.

During orthodontic treatment, clinical monitoring of patients is a crucial factor in determining treatment success. It aids in timely problem detection and resolution, ensuring adherence to the intended treatment plan. In recent years, digital technology has increasingly permeated orthodontic clinical diagnosis and treatment, facilitating clinical decision-making, treatment planning, and follow-up monitoring. This review summarizes recent advancements in digital technology for monitoring orthodontic tooth movement, related complications, and appliance-wearing compliance. It aims to provide insights for researchers and clinicians to enhance the application of digital technology in orthodontics, improve treatment outcomes, and optimize patient experience. The digitization of diagnostic data and the visualization of dental models make chair-side follow-up monitoring more convenient, accurate, and efficient. At the same time, the emergence of remote monitoring technology allows orthodontists to promptly identify oral health issues in patients and take corresponding measures. Furthermore, the multimodal data fusion method offers valuable insights into the monitoring of the root-alveolar relationship. Artificial intelligence technology has made initial strides in automating the identification of orthodontic tooth movement, associated complications, and patient compliance evaluation. Sensors are effective tools for monitoring patient adherence and providing data-driven support for clinical decision-making. The application of digital technology in orthodontic monitoring holds great promise. However, challenges like technical bottlenecks, ethical considerations, and patient acceptance remain.

By analyzing the current application of multi-modal data in the diagnosis of gastric "inflammation-cancer" transformation， this study explored the feasibility and strategies for constructing a disease-syndrome integrated diagnosis and treatment system. Based on traditional Chinese medicine （TCM） phenomics， we proposed utilizing multi-modal data from literature research， cross-sectional studies， and cohort follow-ups， combined with artificial intelligence technology， to establish a multi-dimensional diagnostic and treatment index system. This approach aims to uncover the complex pathogenesis and transformation patterns of gastric "inflammation-cancer" progression. Additionally， by dynamically collecting TCM four-diagnostic information and modern medical diagnostic information through a long-term follow-up system， we developed three major modules including information extraction， multi-modal phenotypic modeling， and information output， to make it enable real-world clinical data-driven long-term follow-up and treatment of chronic atrophic gastritis. This system can provide technical support for clinical diagnosis， treatment evaluation， and research， while also offering insights and methods for intelligent TCM diagnosis.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective:To explore the promotion effect on remineralization of demineralized dentin of urushiol primer applicated in acid-etch-rinse adhesives,and to clarify its impact on the longevity of dentin adhesion.Methods:Ninety-six freshly extracted,caries-free third molars were selected to prepare the dentin specimens.Following acid etching with 37％phosphoric acid gel,the specimens were randomly divided into blank control group,0.3％,0.7％,1.0％,and 1.5％urushiol groups,and positive control group(acetone solvent).The treated samples were placed in modified simulated body fluids for remineralization for 14 and 28 d.Attenuated total reflection Fourier transform infrared spectroscopy(ATR-FTIR)was used to detect the relative mineralization mass of minerals in the dentinal tubules in various groups,and X-ray Diffractometery and Energy Dispersive spectrometer were used to analyze the dentin surface material compositions in various groups.Scanning electron microscope(SEM)was used to observe the surface morphology of the specimens in various groups,Vickers hardness tester was used to measure the microhardness of the dentin surface in various groups,and microtensile strength(μTBS)was used to examine the effect of the bond strengthes in various groups.Results:Compared with blank control group,the conversion rate of adhesive double bonds by primer in positive control group was decreased,but the difference was not significant(P＞0.05);but the conversion rates of adhesive double bonds by primer in 0.3％,0.7％,1.0％,and 1.5％urushiol groups were increased(P＜0.05).The SEM results revealed that at 14 and 28 d,compared with bland control group,a minimal membranous deposit in dentinal tubules was seen in positive control group,minimal mineralization displayed in 0.3％urushiol group,significant deposition of loose mineral particles with blocking the tubule orifices was found in 0.7％urushiol group,noticeable mineral precipitates exhibited in 1.0％urushiol group,and relatively empty dentinal tubules were seen in 1.5％urushiol group.The microhardness results showed that at 14 d after remineralization,compared with blank control group,the microhardness in positive control group showed no significant improvement(P＞0.05),while the differences in 0.3％,0.7％,1.0％and 1.5％urushiol groups were statistically significant(P＜0.05);at 14 d after remineralization compared with positive control group,the microhardness of dertin in 0.7％and 1.0％urushiol groups were increased(P＜0.05);at 28 d after remineralization,compared with blank control and postive control groups,the microhardness in urushiol groups were significantly increased(P＜0.05),espectially in 0.7％to 1.5％urushiol groups(P＜0.05).In the μTBS test,at 14 d after remineralization,compared with postive control group,theμTBS in 0.3％,0.7％,1.0％and 1.5％urushiol groups were increased(P＜0.05);at 28 d after remineralization,the μTBS in blank control group was the lowest;compared with blank control group,there was no significant difference in the μTBS in postive control group(P＞0.05);compared with positive control group,the μTBS in 0.3％,0.7％,1.0％,and 1.5％urushiol groups were increased(P＜0.05),espectially in 0.7％,1.0,and 1.5％urushiol groups(P＜0.05).Conclusion:Natural-derived urushiol,as a novel primer,can pretreat the demineralized dentin substrates,and facilitate collagen cross-linking within the dentin matrix;moreover,it leverages the phenolic hydroxyl groups within its structure to attact calcium and phosphate ions,envelope dentin collagen fibers to promote remineralization,in order to enhance the strength of the resin-dentin bonding interface.

Objective:To investigate the application effect of a novel zipper device in wound healing after incision and drainage of cuta-neous abscesses in children,and to explore its optimal intervention timing.Methods:A total of 50 children who attended the outpatient service of Department of Pediatric surgery from September 2023 to September 2024 were enrolled and divided into two groups accord-ing to the parity of the date of visit.The 26 children with the odd date of visit were enrolled as experimental group,and the 24 children with the even date of visit were enrolled as control group.The same anti-infective dressings were used for wound dressing in both groups after incision and drainage,and when there was a significant reduction in wound exudate and the fresh granulation tissue emerged at wound base,the zipper device was used for the children in the experimental group,and dressing change was performed for the children in the control group until the wound was completely healed.The two groups were compared in terms of wound healing time,healing rate,and the total costs of dressing change,and the multiple linear regression model and the restricted cubic spline(RCS)model were used to analyze the association between the in-tervention time of the zipper device and wound healing time.Re-sults:Compared with the control group,the experimental group had a significantly shorter wound healing time,a significantly higher wound healing rate,and significantly lower total costs of dressing change(P<0.001).The multiple linear regression model showed that the infection size of skin abscess and the intervention time of the zipper device were strongly associated with wound healing time(P<0.05).After adjustment for infection size,the RCS model analysis showed a significant linear dose-response relationship between intervention time and wound healing time(Pnonlinear=0.406),and wound healing time shortened with the reduction in intervention time(P<0.001).Conclusion:The application of the novel zipper device can help with the healing of cutaneous abscesses in children,and it is recommended to apply the device as early as possible after control of wound infection,in order to promote early wound healing.

Objective To investigate the status quo of health management behaviors in elderly patients with type 2 diabetes mellitus(T2DM)complicating chronic complications and the influencing factors based on health ecology theory.Methods The convenience sampling method was used to select elderly patients with T2DM complicating chronic complications in the Shanghai City from January to July 2022 as the respondents.Based on the health ecology theory,the five aspects of personality traits,psychological and behavioral traits,family and community interpersonal networks,living and working conditions and policy environment were in-vestigated.The Pearson correlation coefficient was used to analyze the correlation of various variables.The hi-erarchical linear regression was used to analyze the influencing factors of health management behaviors in eld-erly patients with T2DM complicating chronic complications.Results A total of 272 questionnaires were dis-tributed and 264 valid questionnaires were recovered,with an effective recovery rate of 97.06％(264/272).There were statistically significant differences in DSMB-Oscores among the patients with different chronic complications number,sleep quality,per capita monthly household income and medical payment methods(P＜0.05).The DSMB-Oscore in elderly patients with T2DM complicating chronic complications was positively correlated with HLSCP,DES,PACIC and CIRS scores(P＜0.05),and negatively correlated with the PAID-5 score(P＜0.05).Conclusion The health management behaviors of elderly patients with T2DM complicating chronic complications is jointly affected and acted by many factors,and it is necessary to identify and manage the related influencing factors from different aspects and different levels.

Objective:To investigate the association of skeletal muscle function(including muscle strength and physical performance) and insulin resistance as well as type 2 diabetes mellitus(T2DM).Methods:The retrospective study included 942 patients who visited the Department of Geriatrics at Renji Hospital, Shanghai Jiao Tong University School of Medicine, between October 2020 and July 2024. Low skeletal muscle function was defined as either reduced muscle strength or impaired physical performance. Muscle strength was assessed by grip strength, while physical performance was evaluated using the 5-time chair stand test. The associations between muscle function, insulin resistance, and T2DM were analyzed.Results:A significant association was observed between decreased skeletal muscle function and a higher prevalence of T2DM( P=0.001). Further analysis revealed that decreased physical performance was significantly associated with increased T2DM prevalence( P<0.001), whereas reduced muscle strength showed no significant association with T2DM prevalence( P=0.331). Linear regression analysis indicated that both the homeostasis model assessment of insulin resistance(HOMA2-IR) and fasting blood glucose levels increased significantly with longer chair stand times( P<0.05). Restrictive cubic spline(RCS) analysis demonstrated a nonlinear relationship between chair-rising time and HOMA2-IR. Notably, when the cumulative chair-rising time exceed 8.1 s, HOMA2-IR increased significantly with prolonged chair stand time. Logistic regression analysis showed that compared with patients with normal physical performance, those with decreased physical performance had significantly higher odds of T2DM( OR=2.64, P<0.001) and insulin resistance( OR=2.34, P=0.002). Conclusion:Decline in physical performance is significantly positively associated with insulin resistance and the risk of T2DM. Morever, when the cumulative chair stand time exceed 8.1 s, HOMA2-IR increases progressively with further prolongation of chair stand time.