Background Recent advances in understanding the toxic effects of inorganic arsenic have revealed that arsenic exposure impacts multiple endocrine organs, thereby altering their functions. However, the mechanisms underlying arsenic-induced thyroid injury remain unclear. Objective To investigate the mechanisms by which sodium arsenite (NaAsO₂) affects the proliferation and apoptosis of normal thyroid cells (Nthy-ori3-1) through the estrogen receptor (ER)-phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway. Methods Nthy-ori3-1 cells were cultured in vitro and divided into the following groups: a control group (complete medium without drugs, 0 μmol·L⁻¹), and NaAsO₂-treated groups at 1, 2, and 4 μmol·L⁻¹. Additionally, 1 μmol·L⁻¹ of the ER inhibitor ICI182780 was used to intervene in the NaAsO₂ exposure groups, resulting in the following combinations: 1 μmol·L⁻¹ NaAsO₂ + ICI182780, 2 μmol·L⁻¹ NaAsO₂ + ICI182780, and 4 μmol·L⁻¹ NaAsO₂ + ICI182780. The median lethal concentration of NaAsO₂ was determined using cell viability assay. Cell viability was assessed at 24, 36, and 48 h using Cell Counting Kit-8 (CCK-8) assay. Colony formation ability was evaluated via plate cloning assay. Apoptosis was detected using Hoechst 33342 staining. Protein and mRNA expression levels of ERα, ERβ, c-MYC, Bax, Bcl-2, PI3K, p-PI3K, AKT, and p-AKT were measured using Western blot (WB) and real-time quantitative PCR (qRT-PCR), respectively. Results The median lethal concentration of NaAsO₂ was determined to be 4.034 μmol·L⁻¹. CCK-8 assay at 24, 36, and 48 h revealed that, compared with the control group, the 1, 2, and 4 μmol·L⁻¹ NaAsO₂ groups significantly inhibited Nthy-ori3-1 cell proliferation (P < 0.001). The plate cloning assays demonstrated a concentration-dependent reduction in colony formation ability (P < 0.001). Following the ICI182780 intervention, the cell viability and colony formation ability in the 1, 2, and 4 μmol·L⁻¹ NaAsO₂ groups were significantly restored compared with the corresponding NaAsO₂-only groups (P < 0.001, P < 0.01). The Hoechst 33342 staining indicated that compared with the control group, the nuclear staining intensity and apoptosis levels in the 1, 2, and 4 μmol·L⁻¹ NaAsO₂ groups increased in a concentration-dependent manner (P < 0.001). However, the ICI182780 intervention reduced the apoptosis levels in the NaAsO₂-treated groups compared with their NaAsO₂-only counterparts (P < 0.001). The WB analysis showed that, compared with the control group, the protein expression of ERα, ERβ, c-MYC, Bcl-2, p-PI3K, and p-AKT in the 1, 2, and 4 μmol·L⁻¹ NaAsO₂ groups decreased manner (P < 0.001, P < 0.01), while the Bax expression increased in a concentration-dependent (P < 0.001); the PI3K and AKT protein levels showed no significant differences (P > 0.05). In the ICI182780-treated NaAsO₂ groups, the ERα, ERβ, c-MYC, Bcl-2, p-PI3K, and p-AKT protein expression increased (P < 0.001, P < 0.01), the Bax expression decreased (P < 0.001), and the PI3K and AKT levels remained unchanged (P > 0.05) compared with the corresponding NaAsO₂-only groups. The mRNA expression patterns of ERα, ERβ, c-MYC, Bcl-2, and Bax were consistent with the WB results. Conclusion NaAsO₂ inhibits proliferation and promotes apoptosis in Nthy-ori3-1 cells in a dose-dependent manner. The underlying mechanism likely involves NaAsO₂-mediated suppression of the ER-PI3K/AKT signaling pathway, which subsequently regulates downstream proliferation- and apoptosis-related genes.

In light of the professional characteristics of oral medicine,oral medical students may be challenged with higher medical risks during the clinical internship stage.This article analyzes the potential risk factors in the process of oral medicine internships and proposes corresponding preventive strategies,aiming to ensure medical safety and promote the healthy development of medical students.

Objective To investigate the efficacy of combined prediction of postpartum hypertension using 24-h urinary protein quantification(24-hUP),hematocrit and plasma albumin difference(HCT-ALB),and brain natriuretic peptide(BNP)in patients with severe preeclampsia at the end of pregnancy.Methods A retrospective study was conducted using cluster sampling to select 540 patients with severe preeclampsia from the University City Hospital affiliated to Chongqing Medical University between January 2018 and December 2022.Patients were divided into a hypertension group(n=98)and a non-hypertension group(n=442)based on the occurrence of postpartum hypertension.Clinical data[age,body mass index(BMI),maternal type,abortion history,family history of hypertension,smoking history,total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG),systolic blood pressure(SBP),diastolic blood pressure(DBP)]and levels of 24-hour urinary protein excretion(UP),hematocrit-albumin(HCT-ALB),and BNP in the third trimester of pregnancy were compared between the two groups to analyze the predictive value of these indicators for postpartum hypertension.Results The levels of BMI,family history of hypertension,TC,TG,FBG,SBP and DBP in hypertensive group were higher than those in non-hypertensive group[(25.63±1.37)kg/m2 vs(23.05±1.23)kg/m2,70.41%vs 30.54%].(5.32±1.14)mmol/L vs(3.91±0.95)mmol/L,(3.48±0.82)mmol/L vs(1.66±0.43)mmol/L,(7.24±1.60)mmol/L vs(4.83±1.22)mmol/L,(148.27±13.29)mmHg vs(127.65±10.71)mmHg,(92.36±5.17)mmHg vs(84.20±4.35)mmHg],the difference was statistically significant(P<0.05).The levels of urinary protein,HCT,HCT-ALB and BNP at 24 h at the end of pregnancy in hypertension group were also higher than those in non-hypertension group[(7.82±2.18)g/24 h vs(6.15±1.26)g/24 h,(34.22±3.15)%vs(32.80±1.77)%].(6.19±2.01)vs(3.46±0.90),(646.43±170.59)pg/mL vs(523.81±134.62)pg/mL],while ALB level was lower than that of the non-hypertension group[(28.03±1.13)g/L vs(29.34±1.44)g/L],with statistically significant differences(P<0.05).There was a positive correlation between 24-hUP,HCT,HCT-ALB,BNP and SBP,DBP,while ALB was negatively correlated with SBP and DBP,the difference was statistically significant(P<0.05).24-hUP,HCT-ALB and BNP at the end of pregnancy were independent risk factors for postpartum hypertension,with a combined prediction AUC of 0.930(95%CI:0.905～0.950),a Jordon index of 0.719,sensitivity of 85.71%,the specificity of 86.20%.The AUC of the combined prediction was significantly greater than that of each individual predictor,with statistically significant differences(P<0.05).Conclusion 24-hUP,HCT-ALB,and BNP at the end of pregnancy are independent risk factors for postpartum hypertension.Their combined predictive efficacy is significantly superior to that of individual indicators and can be used as an optimal clinical method for predicting whether patients with severe preeclampsia will develop postpartum hypertension.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.

Objective:By analyzing the curative cost of treatment for children in Beijing,it provided recommendations for further optimizing child health management policies in Beijing.Methods:The System of Health Accounts 2011(SHA 2011)was used to calculate the CCE of children in Beijing's medical institutions.Results:The CCE of children under the age of 15 in Beijing were 92.29 billion yuan,97.54 billion yuan,and 105.72 billion yuan in 2017-2019,with an average annual growth rate of 4.67%;the financing structure of children's CCE is dominated by family health expenditure,accounting for about 65%;children's outpatient and inpatient CCE primarily flew to secondary and tertiary hospitals;respiratory diseases account for the largest share of the disease categories of the CCE,with a share of 25.96%,followed by digestive diseases with a share of 10.26%.Conclusion:The financing structure needs to be optimized to lessen the financial burden of medical care on the families of child patients;the capacity of grass-roots pediatric services should be strengthened,and reasonably guide the flow of adolescent patients to institutions;financial investment should be increased for pre-pregnancy,prenatal screening and other preventive services.It needs to give careful consideration to children's safety education and encourage the implementation of children's commercial accidental injury insurance.