Objective: To investigate the factors influencing follow-up visit behavior among patients with chronic periodontitis after supragingival scaling, and to provide evidence for early identification of high-risk dropouts and improvement of treatment continuity. Methods: This study was approved by the Institutional Medical Ethics Committee, and written informed consent was obtained from all participants. A retrospective analysis was conducted on 572 patients with chronic periodontitis who received supragingival scaling at the Outpatient Department of The Affiliated Stomatological Hospital of Nanjing University School of Medicine from July 2022 to July 2023 and required subsequent periodontal sequential therapy. Data regarding sex, age, monthly income, education level, oral health literacy, reason for visit, and satisfaction with care were collected. Patients were divided into a follow-up group and a dropout group based on whether they adhered to the scheduled appointments within 12 months. Chi-square tests and independent samples t-tests were used for univariate comparisons between the groups. Variables with P<0.05 in the univariate analysis (gender, education level, monthly income, reason for visit, oral health literacy, and satisfaction with care), along with age (as a covariate), were included in a multivariate logistic regression model to analyze the factors influencing follow-up behavior. Results: Among the 572 patients, 239 attended follow-up visits, while 333 dropped out, resulting in a dropout rate of 58.22%. Univariate analysis revealed statistically significant differences between the two groups in terms of gender, education level, monthly income, reason for visit, oral health literacy, and satisfaction with care (P<0.05). Multivariate logistic regression analysis showed that patients referred for treatment had significantly lower compliance (OR=0.241, 95% CI: 0.154-0.377, P<0.001). Conversely, higher oral health literacy scores (OR=1.159, 95% CI: 1.056-1.272, P=0.002) and higher satisfaction with care (OR=4.090, 95% CI: 1.732-9.656, P=0.001) were associated with better follow-up adherence. Conclusion Follow-up behavior in patients with chronic periodontitis after supragingival scaling is primarily influenced by the reason for visit, oral health literacy, and satisfaction with care. These factors can serve as intervention targets to reduce dropout rates in clinical practice.

ObjectiveTo investigate the role of interleukin （IL）-17A in acute inhalational pneumonia induced by the highly drug-resistant and hypervirulent Staphylococcus aureus strain USA300-R in mice. MethodsAn acute inhalational pneumonia model was established in mice using an aerosolized pulmonary delivery technique. RNA sequencing （RNA-seq） and enzyme-linked immunosorbent assay （ELISA） were employed to examine the expression dynamics of Il17a mRNA and IL-17A protein， respectively， in the lungs of infected mice. Il17a knockout （Il17a^-/-） mice were generated using CRISPR/Cas9 gene editing technology. The survival rate， body weight， bacterial load in lung tissue， and histopathological changes were compared between Il17a^-/- and wild-type （WT） mice following inhalational infection with USA300-R. Results12 hours after USA300-R infection， compared to pre-infection， the expression level of Il17a mRNA in lung tissue and the level of IL-17A protein in bronchoalveolar lavage fluid （BALF） increased by approximately 50-fold （P<0.01） and 6-fold （P<0.001）， respectively. Compared to WT mice， Il17a^-/- mice exhibited approximately 10-fold higher bacterial loads in lung tissue at both 12 and 24 hours post-infection （P<0.001， P<0.05）. However， they showed significantly attenuated lung histopathological injury， reduced alveolar wall thickening， markedly decreased neutrophil infiltration， and an approximately 50% improvement in survival rate （P<0.05）. ConclusionIn acute Staphylococcus aureus USA300-R inhalational pneumonia， IL-17A contributes to bacterial clearance by recruiting neutrophils； however， excessive neutrophil infiltration exacerbates pulmonary inflammation and injury， reduces survival rates， and represents a potential therapeutic target.

Objective To investigate whether Danshen injection (DSI) can protect human brain organoids from oxidative stress damage by regulating the Nrf2 signaling pathway and its mechanism. Methods A Nrf2 plasmid was constructed, lentivirus was packaged and transfected into human induced pluripotent stem cell (hiPSC) to form a stable cell line. Brain organoids with Nrf2 overexpression (LV-Nrf2 group) and knockdown (sh-Nrf2 group) were constructed using kit. The transfection efficiency was verified by real-time fluorescence quantitative polymerase chain reaction. An oxidative stress injury model was established by inducing hydrogen peroxide (H₂O₂). Intervention was performed either in combination or without DSI pre-treatment. Cell viability was detected by Cell Counting Kit-8 (CCK-8), and the expression levels of Nrf2, malondialdehyde (MDA), interleukin (IL)-1β, sex-determining region Y-box protein 2 (SOX2) and neuronal-specific nuclear protein (NeuN) were detected by Western blot and immunofluorescence staining. Total RNA from human brain organoids was extracted for transcriptome sequencing and analysis. Results LV-Nrf2 group and sh-Nrf2 group brain organoid models were successfully constructed. The CCK-8 results determined that the oxidative stress model was established with 32 mmol/L H₂O₂ intervention conditions. The fluorescence expression of Nrf2 in LV-Nrf2 group was higher than that in control group, and the fluorescence expressions of MDA and IL-1β were lower than those in control group; sh-Nrf2 group showed a damage phenotype of low Nrf2 expression, high MDA and IL-1β expression (all P < 0.05). Compared with H₂O₂ group, the Nrf2 signal in DSI + H₂O₂ group was stronger, and the levels of MDA and IL-1β were lower. Among them, the protective effect of LV-Nrf2 was the most significant. H₂O₂ treatment could down-regulate the protein levels of Nrf2, SOX2 and NeuN, and DSI intervention could effectively reverse the downward trend of these indicators. Sh-Nrf2 could weaken the recovery effect of DSI on SOX2 and NeuN, while LV-Nrf2 could synergistically enhance the regulatory effect of DSI. Conclusions DSI may antagonize oxidative stress damage in human brain organoids through the Nrf2 signaling pathway, and maintaining the stability of the neural cell lineage is its core therapeutic characteristic.

Objective To observe the clinical efficacy of Tongyuan acupuncture combined with Tiaoqi Huoxue Jieyu Decoction in treating stroke in recovery period of qi deficiency and blood stasis complicated by liver stagnation syndrome.Methods A total of 80 patients with stroke in recovery period were randomly divided into observation group and control group,40 cases in each group.The control group was intervened by conventional western medicine and rehabilitation training,the observation group was treated by Tongyuan acupuncture combined with Tiaoqi Huoxue Jieyu Decoction on the basis of the treatment in the control group.The course of treatment covered one month continuously.After one month of treatment,the clinical efficacy of the two groups was evaluated,and the changes of scores in the patients of the two groups before and after treatment as follows were observed,including Mini-Mental State Examination(MMSE),muscle strength and National Institutes of Health Stroke Scale(NIHSS),as well as Pittsburgh Sleep Quality Index(PSQI),Activity of Daily Living Scale(ADL),and traditional Chinese medicine(TCM)syndrome.The changes of procalcitonin(PCT),tumor necrosis factor α(TNF-α),and interleukin 6(IL-6)levels before and after treatment were compared between the two groups.The safety and occurrence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate was 95.00%(38/40)in the observation group and 77.50%(31/40)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically significant differences(P<0.05).(3)After treatment,the MMSE scores of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the muscle strength scores and NIHSS scores of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically significant difference(P<0.05).(5)After treatment,the PSQI scores and ADL scores of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically significant difference(P<0.05).(6)After treatment,the PCT,TNF-α,and IL-6 levels of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with statistically significant difference(P<0.05).(7)The incidence rate of adverse reactions was 10.00%in the observation group and 5.00%in the control group.The intergroup comparison showed that the difference being not statistically significant(P>0.05).Conclusion Tongyuan acupuncture combined with Tiaoqi Huoxue Jieyu Decoction in treating stroke in recovery period of qi deficiency and blood stasis complicated by liver stagnation syndrome can significantly improve patients'cognitive function,neurological function and muscle strength of limbs,enhance patients'sleep quality and living ability,and adjust the normal physiological state of the body,thus improving patients'quality of life.

Objective To investigate the effects of Yiqi Wenyang Lishui Formula(derived from Wuling San combined with Astragali Radix and Descurainiae Semen Lepidii Semen)on cardiac function and remodeling in heart failure(HF)patients with yang deficiency and fluid retention syndrome and to analyze risk factors for influencing therapeutic efficacy.Methods A total of 120 HF patients with yang deficiency and fluid retention syndrome admitted to Liaocheng Hospital of Traditional Chinese Medicine from February 2022 to January 2024 were enrolled and randomly divided into observation group(n=60)and control group(n=60)using a random number table.The control group received conventional western therapy,while the observation group received Yiqi Wenyang Lishui Formula additionally.Both groups were treated for 2 months.Changes in cardiac function indicators and remodeling markers were observed.Clinical efficacy was evaluated,and univariate and binary logistic regression analyses were performed to identify independent risk factors affecting treatment outcomes.Results(1)The total effective rate was 81.67％(49/60)in the observation group versus 70.00％(42/60)in the control group.Intergroup comparison(by chi-square test)showed that the efficacy in the observation group was superior to the control group(P＜0.05).(2)After treatment,both groups showed significant reductions compared to those before treatment in left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),and N-terminal pro-brain natriuretic peptide(NT-proBNP)(P＜0.01).The reduction in LVEDD,LVESD,and serum NT-proBNP levels in the observation group was significantly greater than that in the control group(P＜0.05 or P＜0.01).(3)Univariate analysis revealed that New York Heart Association(NYHA)functional classification,LVEDD,LVESD,and NT-proBNP levels were significantly associated with the therapeutic efficacy of the Yiqi Wenyang Lishui Formula in heart failure patients with yang deficiency and fluid retention syndrome(P＜0.05).(4)Logistic regression identified NYHA classification,LVEDD,LVESD,and NT-proBNP as independent risk factors(P＜0.05)in affecting therapeutic effect of Yiqi Wenyang Lishui Formula in treating HF with yang deficency and fluid retention syndrome,increasing the risk of ineffective treatment by 4.12-fold,1.21-fold,1.19-fold,and 1.00-fold,respectively.Conclusion Yiqi Wenyang Lishui Formula effectively improves cardiac function and remodeling in HF patients with yang deficiency and fluid retention syndrome.NYHA classification,LVEDD,LVESD,and NT-proBNP are independent risk factors for influencing efficacy,warranting close monitoring for optimized therapeutic adjustments.

Ergonomic Principle for the Prevention of Work-Related Musculoskeletal Disorders Part 1: General Principles (T/WSJD 14.1-2020) is the first guideline standard for the prevention of work-related musculoskeletal disorders provided to employers and occupational health technical service institutions in China, which covers ergonomic risk factors and their hazard definition, ergonomic prevention principles, risk assessment process, risk control process and risk evaluation principles. The standard specifically clarify the specific types of adverse ergonomic risk factors and control strategies and the standard process of systematic ergonomic risk assessment, providing implementation paths and practical guidance for eliminating/reducing adverse ergonomic risks and enhance workplace environments to prevent work-related musculoskeletal disorders. This paper interprets and analyzes the background of standard establishment, formulation process, fundamental basis, and main content, etc., to provide scientific and accurate technical support for enterprise managers, labours and technical personnel of occupational health institutions to optimize the use of this standard.

Attention refers to the body's capacity to maintain alert awareness of internal and external stimuli.Attention deficit can impair an individual's learning capacity and working proficiency,resulting in a heavy burden to the family and society.Vagus nerve stimulation(VNS)is an emerging neuro regulatory technique that can achieve reciprocal interaction between the central and peripheral nervous systems,which has demonstrated great potential for the treatment of neurological and psychiatric diseases;however,it has not been used clinically to treat attention-deficient developmental disorders in children or neurodegenerative diseases in the aged population.We briefly review the anatomical and physiological bases of VNS,and its application status and potential use in treating attention deficit diseases.A potential mechanism by which VNS participates in attention-related nervous regulation is proposed,to lay a theoretical foundation for the application of VNS in the field of attention nervous regulation.

Objective:To identify the risk factors affecting the effectiveness of conservative treatment for acute sinusitis with orbital complications and provide evidence for recognition of high-risk patients.Methods:A retrospective analysis was conducted on 86 patients with acute sinusitis and orbital complications treated at Qingdao University Affiliated Hospital from 2017 to 2024 (61 males, 25 females; median age: 6.5 years). Patients were divided into an ineffective conservative treatment group and an effective conservative treatment group based on the outcomes after 48-72 hours of conservative treatment. Clinical characteristics were collected, and variables were screened using Lasso regression. Multivariate logistic regression was used to analyze the risk factors for poor conservative treatment outcomes, and a nomogram model was constructed to validate its predictive performance.Results:The overall success rate of conservative treatment was 50% (43/86). Multivariate logistic analysis showed that type Ⅲ orbital complications ( OR=0.17, P=0.017) and the presence of bone destruction ( OR=0.29, P=0.046) were independent risk factors for poor conservative treatment outcomes. The area under the ROC curve (AUC) of the combined predictive model was 0.762, with a sensitivity of 76.7% and a specificity of 69.8%. Conclusion:Patients with acute sinusitis and orbital complications, especially those with subperiosteal abscesses (type Ⅲ) and concurrent bone destruction, have a lower effectiveness rate of conservative treatment. These patients should be closely monitored for clinical signs and considered for prompt surgical intervention when necessary.

OBJECTIVE To explore the effects of dexmedetomidine （DEX） increasing serpin peptidase inhibitor clade E member 1 （SERPINE1） protein on the malignant biological behavior of thyroid carcinoma （THCA） cells. METHODS THCA cells （KTC-1， TPC-1） were treated with 1， 10 and 100 nmol/L DEX， and their viabilities， clone formation rates， migration rates and invasion number were examined. Potential biological functions of DEX in THCA cells were analyzed through whole genome sequencing and gene ontology enrichment analysis. The core targets of DEX were mined through a protein-protein interaction network. The expression characteristics of DEX core targets and their relationship with patient prognosis were evaluated. The effects of DEX on mRNA and protein expressions of core targets and protein secretion in 2 types of THCA cells were detected， and the effects of this target on DEX-related effects were validated preliminarily by knocking down the core target. RESULTS Compared with the control group （0 nmol/L DEX）， DEX at 1， 10 and 100 nmol/L significantly increased the viabilities of 2 types of THCA cells （except for the KTC-1 cells in the 1 nmol/L DEX group at 24 h）， concentration-dependently elevated the rates of clone formation， migration rates （except for 2 types of THCA cells in 1 nmol/L DEX group）， and the number of invasion （P＜0.05）. A total of 287 differently expressed genes （75 up- tongxueyan180@163.com regulated and 212 down-regulated） were enriched in signaling pathways such as phosphatidylinositol 3-kinase/protein kinase B， Wnt， and senescence-associated secretory phenotypes in the 2 kinds of DEX-treated or non-treated THCA cells. SERPINE1 was a core target of DEX for THCA， and its mRNA and protein expression in THCA tissues/cells were significantly elevated and associated with poor prognosis of the patients （P＜0.05）. Compared with the control group， mRNA and protein expression of SERPINE1 was significantly up-regulated in 2 types of cells in the 1， 10 and 100 nmol/L DEX groups， while the secretion of this protein in conditioned medium was also significantly increased， all of which showed concentration-dependence （P＜0.05）. After knocking down SERPINE1， the promoting effects of DEX on the proliferation， colony formation， migration and invasion abilities of two types of THCA cells were significantly inhibited （P＜0.05）. CONCLUSIONS DEX can promote the proliferation， migration and invasion of THCA cell， and the above effects may be associated with the expression of increased secretory SERPINE1 protein.

Objective:Explore the clinical utility of TRBC1/TRBC2 dual staining by flow cytometry in determining clonality in T-cell lymphomas.Methods:This is a retrospective case-control study. A total of 40 patients with T-cell lymphoma involving bone marrow from the First Affiliated Hospital of Zhengzhou University were enrolled between December 10, 2024 and March 5, 2025. This cohort included 30 cases of mature T-cell lymphoma, 16 males and 14 females, age 62 (54, 71)years, and 10 cases of T-lymphoblastic leukemia/lymphoma[age 11(7, 33)years ]. Additionally, 30 control subjects without T-cell lymphoproliferative disorders were included (17 males and 13 females[age 55(47, 67)years]. Multiparameter flow cytometry (FCM) was performed to analyze TRBC1 and TRBC2 expression patterns in different αβ-T cell subsets within bone marrow samples. Neoplastic T lymphocytes were identified and gated based on immunophenotypic markers (CD3, CD2, CD5, CD7, etc.), followed by characterization of their TRBC1 and TRBC2 expression profiles. Statistical comparisons among multiple groups were conducted using the Kruskal-Wallis test, while the Wilcoxon rank-sum test was employed for pairwise comparisons.Results:In the mature T-cell lymphoma group, 66.7% (21/30) of cases demonstrated monotypic expression of either TRBC1 or TRBC2. Despite the rest 33.3% (9/30) of cases with surface CD3 negativity showed complete loss of both surface and intracellular TRBC1 and TRBC2 (dual-negative), TCR gene rearrangement positivity confirmed their biologically monoclonal proliferation. In contrast, control group αβ-T cells and their subsets exhibited polytypic TRBC1 and TRBC2 expression. Compared to control αβ-T cells, mature T-cell lymphomas showed statistically significant differences in TRBC1 ( U=270.00, P<0.05) and TRBC2 ( U=300.00, P<0.05) distribution. Within control group T-cell subsets, using a threshold of>85% TRBC1-or TRBC2-positive cells, T-cell clones of uncertain significance (T-CUS) were detected in 23% (7/30) of controls, in which 12 clonal proliferations were totally found. These T-CUS clones were significantly associated with CD57+T cells, suggesting a possible link to immunosenescence or chronic antigen stimulation. Among T-ALL/LBL patients, 2 cases showed intracellular TRBC monotypic expression, while 8 cases exhibited dual-negative intracellular TRBC expression, which aids in differentiating T-ALL/LBL from normal thymocytes (which usually display polytypic TRBC expression). Conclusion:Multiparameter flow cytometry (FCM) combined with TRBC1/TRBC2 dual staining can effectively distinguish neoplastic T cells from normal T lymphocyte populations. This approach serves as a crucial determinant for assessing T-cell clonality and can definitively identify TRBC subtypes (TRBC1 or TRBC2).