Piezo1 is a Ca²⁺-permeable mechanosensitive ion channel that plays a central role in mechanosensing and signal transduction in dental and periodontal tissues. In tooth tissue, Piezo1 is a key factor mediating dentin sensitive pain. The flow of dentinal tubule fluid induced by external stimulation can activate the Piezo1 channel on odontoblasts, triggering neuronal signals through the pannexin-1-purinergic 2X3 receptor (PANX-1-P2X3) receptor axis, resulting in pain perception. In addition, Piezo1 has a dual regulatory role in the process of pulp inflammation and repair : on the one hand, its expression is up-regulated in an inflammatory environment, which may aggravate pain sensitivity ; on the other hand, it activates the migration, proliferation and odontogenic differentiation of dental pulp stem cells by mediating Ca²⁺influx, ATP release and downstream purinergic 2X7 receptor (P2X7R), MEK / ERK signaling pathways, thereby promoting reparative dentin formation. In periodontal tissue, Piezo1 plays a central role in maintaining periodontal tissue homeostasis and regulating alveolar bone remodeling by sensing mechanical stimuli such as bite force. During orthodontic tooth movement, Piezo1 promotes osteogenic differentiation by activating Wnt / Ca²⁺, Notch and other pathways on the tension side. It affects osteoclast activity by regulating receptor activator of nuclear factor-κB ligand/osteoprotegerin (RANKL/OPG) balance on the pressure side. At the same time, Piezo1 is also a key regulator of periodontal immune microenvironment. It is expressed in immune cells such as macrophages, neutrophils and dendritic cells. Its activation can promote the polarization of macrophages to pro-inflammatory M1 type, enhance the release of pro-inflammatory factors and matrix metalloproteinases, and thus aggravate the inflammatory destruction of periodontal tissue.In view of its multiple functions, Piezo1 has become a potential therapeutic target, including local or systemic application of its inhibitors, mechanical intervention, physical therapy, gene therapy and stem cell therapy, showing a broad clinical transformation prospect in the treatment of oral diseases. In this paper, the structural characteristics, signal transduction mechanism of Piezo1 and its expression distribution, function and regulatory network in tooth tissue and periodontal tissue are reviewed, so as to provide ideas for the development of oral disease treatment strategies targeting Piezo1.

ObjectiveThis study employed the scoping review method to systematically retrieve and analyze the basic information and clinical research evidence of expensive Chinese patent medicines （CPMs）， aiming to provide a basis for future related research and clinical applications. MethodsEight Chinese and English databases were systematically searched for the clinical research evidence on expensive CPMs. ResultsEleven expensive CPMs （Angong Niuhuang Wan， Jufang Zhibao Wan， Suhexiang Wan， Pien Tze Huang， Niuhuang Qingxin Wan， Qinggong Shoutao Wan， Compound Realgar Natural Indigo Tablets， Xihuang Wan， Dingkun Wan， Babao Wan， and Guilingji Capsules） were selected. A total of 365 related studies were included in this review， comprising 331 clinical studies （of which 291 were randomized controlled trials）， 30 systematic reviews and Meta-analyses， 3 expert consensus， and 1 rapid health technology assessment. Among the 11 CPMs， 2（Angong Niuhuang Wan and Jufang Zhibao Wan） had a daily price over 500 yuan. The famous and precious Chinese medicinal materials involved included Moschus （frequency of 7）， Bovisc Alculus （7）， and Borneol （5）. The dosage forms included pills， capsules， oral liquid， tablets， and lozenges. The diseases treated by these CPMs mainly included malignant tumors， cerebrovascular diseases， gynecological diseases， and hepatobiliary system diseases. The sample sizes of the clinical studies were mainly concentrated within the range of 51-100 cases， and the main control form was CPM + basic Western medicine treatment vs. basic Western medicine treatment. The 331 clinical studies reported a total of 44 adverse events occurred， of which 36 were determined to be adverse reactions. ConclusionThe scarcity of raw materials leads to the high prices of expensive CPMs. The difficulty of conducting clinical research and the critical and severe cases treated lead to a lack of clinical research evidence with large sample sizes. The uneven distribution of existing studies， incomplete information on medicine package， and non-standard clinical research designs remain to be addressed in the future.

Objective To investigate the factors influencing mood and sleep among special operation personnel,so as to provide evidence for the prevention and intervention of related issues.Methods A total of 600 special operation personnel during their special duty were enrolled by random sampling method.Basic information was collected by a general information questionnaire.Mood and sleep status were evaluated by self-rating anxiety scale(SAS),self-rating depression scale(SDS),and Pittsburgh sleep quality index scale(PSQI).Results Spearman correlation analysis showed that factors associated with anxiety were years of work experience(r=0.099,P=0.016),family residence(r=-0.153,P＜0.001),and sleep status(r=0.199,P＜0.001);the factors associated with depression were relationship with parents(r=-0.134,P=0.001),family residence(r=-0.144,P＜0.001),and sleep status(r=0.122,P=0.003);and the factors associated with sleep were age(r=0.088,P=0.031),years of work experience(r=0.079,P=0.049),and number of children(r=0.083,P=0.043).Binary logistic regression analysis showed that depression was not an influencing factor of sleep(odds ratio[OR]=1.302,95%confidence interval[95%CI]0.759-1.758,P=0.086),while anxiety was an influencing factor of sleep(OR=2.187,95%CI 1.608-4.695,P=0.001).Conclusion The sleep status of special operation personnel investigated in this survey is related to age and years of work experience,and is influenced by anxiety.Therefore,greater attention should be given to sleep issues in the occupational health support of special operations.Additionally,years of work experience,family residence,relationship with parents,and sleep status are related to anxiety and depression among special operation personnel.It is necessary to focus on the mental health of older workers and those with longer tenure.

Patients with diabetes mellitus are at a significantly elevated risk of developing cognitive impairment,which adversely impacts their quality of life and imposes a substantial burden on the healthcare system.Novel antidiabetic agents,including sodium-glucose cotransporter 2 inhibitors(SGLT-2i),dipeptidyl peptidase-4 inhibitors(DPP-4i),glucagon-like peptide-1 receptor agonists(GLP-1RAs),and dual glucagon-like peptide-1 receptor/glucose-dependent insulinotropic polypeptide receptor agonists(e.g.,Tirzepatide),have been shown to not only effectively regulate glycemic control but also mitigate cognitive decline by inhibiting inflammation,reducing oxidative stress,preventing apoptosis,attenuating amyloid β-protein(Aβ)deposition,and suppressing tau protein phosphorylation.

Objective To investigate the drug resistance of Mycobacterium tuberculosis(MT)in Shaanxi Province in the past five years.Methods A total of 744 patients with culture-positive sputum specimens at the former Shaanxi Provincial Institute for Tuberculosis Control and Prevention from January 2019 to December 2023 were selected as the study subjects,and the results of their strain identification and drug susceptibility tests were collected to analyze the resistance to six antituberculosis drugs.Results The overall resistance rate of the MT complex of 726 strains was 33.33%(242/726).The rates of mono-resistance,multi-resistance,multi-drug resistance and extensive resistance were 12.95%(94/726),7.44%(54/726),12.95%(94/726)and 0.41%(3/726).The resistance rate was 31.73%(204/643)in primaries and 45.78%(38/83)in retreatment patients,and the difference between the resistance rates of primaries and retreatment patients was statistically significant(χ2=6.536,P=0.011).The resistance rates of the 6 antituberculosis drugs,in descending order,were as follows:streptomycin(SM)22.87%(166/726),isoniazid(INH)22.73%(165/726),rifampicin(RFP)15.15%(110/726),ofloxacin(OFX)9.09%(66/726),ethambutol(EMB)7.30%(53/726),kanamycin(KM)2.89%(21/726).The resistance rates for each year from 2019～2023 were 39.61%(61/154),33.33%(44/132),34.47%(81/235),24.54%(40/163)and 38.10%(16/42),respectively,and the difference in resistance rates between years was not statistically significant(χ2=8.967,P=0.062).Conclusion The burden of drug-resistant tuberculosis remains heavy in Shaanxi,and the situation of multidrug-resistant tuberculosis,in particular,is more serious,and control measures need to be strengthened and improved to reduce the incidence and spread of drug-resistant tuberculosis.

Objective:To investigate and analyze basic status of radiotherapy units in Hebei Province in 2024.Methods:Led by the Fourth Hospital of Hebei Medical University, the Radiation Oncology Branch of the Hebei Medical Association, and the Radiation Oncology Expert Committee of the Hebei Society of Clinical Oncology, a province-wide survey was conducted using structured questionnaires. The survey covered key aspects such as basic information of radiotherapy institutions, personnel allocation, equipment configuration, and implementation of radiotherapy techniques. Collected data were summarized and descriptively analyzed comparing with a 2013 survey of radiotherapy in Hebei Province.Results:All 158 radiotherapy institutions across Hebei Province participated in the survey. A total of 2273 radiotherapy professionals were reported, including 1317 radiation oncologists (57.94%), 332 medical physicists (14.61%), 71 radiotherapy engineers (3.12%), and 553 radiotherapy technologists (24.33%). The number of radiotherapy devices significantly increased from 121 in 2013 to 237 in 2024, including 68 domestic radiotherapy equipment. The current inventory includes 195 medical linear accelerators (2.61 units per million population), 2 cobalt-60 units, 27 afterloading machines, 9 tomotherapy (TOMO) systems, 3 CyberKnife units, and 1 proton therapy system. Three-dimensional conformal radiotherapy and stati intensity-modulated radiotherapy have been widely adopted across the province, while advanced techniques such as volumetric-modulated arc therapy, stereotactic body radiotherapy, and respiration-gated technology, and respiratory gating are gradually being implemented.Conclusions:In recent years, the configuration of radiotherapy personnel in Hebei Province has become more balanced, and the availability of precision radiotherapy equipment has significantly improved. There is a growing trend in the adoption of domestically manufactured radiotherapy equipment, marking substantial progress in the development of radiation oncology services in the region.

Objective To observe the value of intratumoral and peritumoral radiomics based on dynamic contrast-enhanced MRI(DCE-MRI)combined with clinical indexes for predicting Ki-67 expression of prostate cancer(PCa).Methods Totally 294 PCa patients were retrospectively enrolled and randomly divided into training set(n=205)and test(n=89)set at a ratio of 7∶3,who were stratified into low-expression subgroup(Ki-67≤10%)and high-expression subgroup(Ki-67＞10%)based on pathological findings.ROIintratumoral and ROIperitumoral were delineated on DCE-MRI,and radiomics features were extracted from ROIintratumora,l ROIperitumoral and ROIintratumoral+peritumora,l respectively.Radiomic features significantly associated with Ki-67 expression status were selected to construct radiomics models.A multivariate logistic regression analysis was performed to develop a clinical predicting model,then a combined model was established combined with the optimal radiomics model.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)were calculate to evaluate the predictive efficacy of the models and compared between each two models.Decision curve analysis(DCA)was used to assess the clinical net benefit of each model.Results The AUC of modelintratumora,l modelperitumoral and modelintratumoral+peritumoral for predicting Ki-67 expression in training set was 0.905,0.867 and 0.930,and the last one was the best.In clinical model,total prostate-specific antigen(t-PSA)and T stage≥3 were both independent predictors of high Ki-67 expression of PCa(both P＜0.05).The AUC of combined model based on modelintratumoral+peritumoral and clinical model was 0.911 in test set,being not significantly different with that of modelintratumoral+peritumoral(AUC=0.906;Z=0.349,P=0.727)but higher than that of clinical model(AUC=0.684;Z=4.370,P＜0.05).DCA revealed that the combined model provided higher clinical net benefit than clinical model and modelintratumoral+peritumoral across risk thresholds of 0.10-0.70.Conclusion DCE-MRI intratumoral+peritumoral radiomics model could effectively predict Ki-67 expression status of PCa.Combining with clinical indexes could further enhance its clinical net benefit.

In this study, we employed a combination of genome mining and heteronuclear single quantum coherence (HSQC)-based small molecule accurate recognition technology (SMART) technology to search for fernane-type triterpenoids. Initially, potential endophytic fungi were identified through genome mining. Subsequently, fine fractions containing various fernane-type triterpenoids were selected using HSQC data collection and SMART prediction. These triterpenoids were then obtained through targeted isolation and identification. Finally, their antifungal activity was evaluated. As a result, three fernane-type triterpenoids, including two novel compounds, along with two new sesquiterpenes and four known compounds were isolated from one potential strain, Diaporthe discoidispora. Their structures were elucidated through analysis of high-resolution electrospray ionization mass spectrometry (HR-ESI-MS) and nuclear magnetic resonance (NMR) spectroscopic data. The absolute configurations were determined using single-crystal X-ray diffraction analysis and electron capture detector (ECD) analysis. Compound 3 exhibited moderate antifungal activity against Candida albicans CMCC 98001 and Aspergillus niger.
Triterpenes/isolation & purification* ; Antifungal Agents/isolation & purification* ; Molecular Structure ; Candida albicans/drug effects* ; Ascomycota/genetics* ; Magnetic Resonance Spectroscopy ; Aspergillus niger/drug effects* ; Genome, Fungal ; Microbial Sensitivity Tests

Nonalcoholic steatohepatitis （NASH） is a chronic liver disease with the main pathological features of hepatic steatosis， inflammatory cell infiltration， and interstitial fibroplasia， and it is an important risk factor for liver fibrosis， liver cirrhosis， and hepatocellular carcinoma. NOD-like receptor protein 3 （NLRP3） inflammasome is the core of innate immunity， and the abnormal activation of NLRP3 inflammasome is closely associated with the development and progression of NASH， which involves multiple links such as inflammatory response and oxidative stress. A large number of studies have shown that the active ingredients of traditional Chinese medicine （TCM） and TCM compound prescriptions can improve oxidative stress， regulate lipid metabolism， and alleviate liver inflammation by regulating NLRP3 inflammasome. TCM treatment applied in clinical practice has achieved a good therapeutic effect， while inflammasome is one of the key pathways or targets for TCM in improving NASH. This article reviews the mechanism of action of NLRP3 inflammasome in NASH and the research advances in TCM intervention of NLRP3 inflammasome， in order to provide ideas for the clinical TCM treatment of NASH， as well as reference targets and research directions for the research and development of new TCM drugs.

Kounis syndrome is an acute coronary syndrome triggered by an allergic reaction, which is clinically rare and frequently subject to misdiagnosis or missed diagnosis. This article presents a case report of a 70-year-old male patient who developed a rash, pruritus, and chest pain following colon polyp resection. Coronary angiography revealed occlusion of the left anterior descending artery, and blood flow was restored after stent implantation. However, the patient experienced recurrent symptoms accompanied by loss of consciousness. Drug skin tests confirmed positive reactions to chlorhexidine and fondaparinux sodium, leading to a diagnosis of type Ⅱ Kounis syndrome. By avoiding allergenic drugs and combining antihistamines with symptomatic treatment to correct myocardial ischemia, the patient′s clinical symptoms significantly improved, and he eventually recovered and was discharged from the hospital. This case underscores the importance of maintaining vigilance for this syndrome in patients with allergies accompanied by chest pain and promptly identifying and avoiding allergens.