Objective To analyze the global pattern, long-term trends, and regional and population heterogeneity in the burden of 375 diseases and injuries and 88 risk factors from 1990 to 2023 using data from the Global Burden of Disease Study 2023 (GBD 2023). Methods Publicly available GBD 2023 estimates were extracted for incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life years (DALYs), and age-standardized rates at the global level and by socio-demographic index (SDI), GBD region, age group, and sex. Descriptive analysis, ranking comparison, stratified analysis, and trend analysis were performed, and 95% uncertainty interval was used to assess the stability of estimates. Results In 2023, non-communicable diseases were the leading contributor to global DALYs, accounting for 64.39% of DALYs across the three major disease and injury groups (communicable, maternal, neonatal, and nutritional diseases, non-communicable diseases, and injuries), and also had the highest age-standardized DALYs rate. From 1990 to 2023, age-standardized DALYs rates declined for three major disease and injury groups, with estimated annual percentage changes of −2.69%, −0.78%, and −1.47%, respectively. Cardiovascular diseases ranked first by both DALYs and deaths in 2023, whereas respiratory infections and tuberculosis ranked first by incidence. Non-communicable diseases were the leading cause of disease burden across all SDI strata. As the SDI level declined, the burden of communicable, maternal, neonatal, and nutritional diseases, as well as injuries, increased markedly. Behavioral and metabolic risks remained the main contributors to attributable deaths and DALYs. Conclusion From 1990 to 2023, the global burden of disease continues to shift toward non-communicable diseases; however, some regions still face a double burden of infectious, maternal and child, injury-related, and chronic diseases. Integrating deaths, DALYs, YLLs, YLDs, and risk-attributable burden helps identify priority areas for prevention and resource allocation across regions and populations.

Objective To explore changes of serum levels of tumor necrosis factor alpha(TNF-α),interleukin-10(IL-10),and Helicobacter pylori(HP)positivity rate in patients with early gastric cancer,and the diagnostic value of three factors in early gastric cancer.Methods A total of 312 patients with gastric discomfort were included in this study and used as the observation subjects.Patients were divided into the gastritis group(n=100),the precancerous lesion group(n=110)and the early gastric cancer group(n=102)based on their gastroscopy.Enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of TNF-α and IL-10.HP infection was detected in the three groups.Multivariate Logistic regression was used to analyze influencing factors of early gastric cancer.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of serum TNF-α,IL-10 and HP infection in early gastric cancer.Results The levels of TNF-α,IL-10 and HP positivity rate were increased in the gastritis group,the precancerous lesion group and the early gastric cancer group in sequence(all P＜0.05).Hot food,heavy salt,pepsinogen Ⅱ(PG Ⅱ),HP positivity and elevated levels of TNF-α and IL-10 were independent risk factors for early gastric cancer,while elevated PGⅠ was a protective factor(all P＜0.05).The areas under the curve for serum TNF-α,IL-10,HP infection and their combined diagnosis of early gastric cancer were 0.694,0.698,0.763,and 0.870,respectively.The combined diagnostic efficacy of the three was better than that of individual diagnosis(all P＜0.05).Conclusion The serum levels of TNF-α,IL-10 and HP positivity rate are significantly increased in patients with early gastric cancer,and all three have certain diagnostic value for early gastric cancer.

Dental treatments for children and adolescents have unique clinical characteristics that differ from dental care for adults in terms of children's physiology, psychology, and behavior. These differences impose specific requirements on the application of local anesthesia in pediatric dental procedures. This article presents expert consensus on the principles of local anesthesia techniques in pediatric dental therapies, including the use of common anesthetic drugs and dosage control, safety and efficacy evaluation, and prevention and management of complications. The aim is to improve the safety and quality of pediatric dental treatments and offer guidance for clinical application by dentists.
Humans ; Child ; Anesthesia, Local/methods* ; Consensus ; Anesthesia, Dental/methods* ; Adolescent ; Anesthetics, Local/administration & dosage* ; Dental Care for Children

Objective To explore changes of serum levels of tumor necrosis factor alpha(TNF-α),interleukin-10(IL-10),and Helicobacter pylori(HP)positivity rate in patients with early gastric cancer,and the diagnostic value of three factors in early gastric cancer.Methods A total of 312 patients with gastric discomfort were included in this study and used as the observation subjects.Patients were divided into the gastritis group(n=100),the precancerous lesion group(n=110)and the early gastric cancer group(n=102)based on their gastroscopy.Enzyme linked immunosorbent assay(ELISA)was used to detect serum levels of TNF-α and IL-10.HP infection was detected in the three groups.Multivariate Logistic regression was used to analyze influencing factors of early gastric cancer.Receiver operating characteristic(ROC)curve analysis was used to evaluate the diagnostic value of serum TNF-α,IL-10 and HP infection in early gastric cancer.Results The levels of TNF-α,IL-10 and HP positivity rate were increased in the gastritis group,the precancerous lesion group and the early gastric cancer group in sequence(all P＜0.05).Hot food,heavy salt,pepsinogen Ⅱ(PG Ⅱ),HP positivity and elevated levels of TNF-α and IL-10 were independent risk factors for early gastric cancer,while elevated PGⅠ was a protective factor(all P＜0.05).The areas under the curve for serum TNF-α,IL-10,HP infection and their combined diagnosis of early gastric cancer were 0.694,0.698,0.763,and 0.870,respectively.The combined diagnostic efficacy of the three was better than that of individual diagnosis(all P＜0.05).Conclusion The serum levels of TNF-α,IL-10 and HP positivity rate are significantly increased in patients with early gastric cancer,and all three have certain diagnostic value for early gastric cancer.

Objective:To investigate the efficacy of metagenomic next generation sequencing (mNGS) in the etiological diagnosis of patients with spinal infection, so as to provide reference for timely diagnosis and treatment.Methods:A total of 40 patients with suspected spinal infection admitted to the Department of Infectious Diseases in Henan Provincial People′s Hospital from January 2020 to July 2022 were included. The results of tissue culture, histopathological examination and tissue mNGS detection were analyzed retrospectively. According to the clinical diagnose, the patients were divided into the spinal infection group (28 cases) and the non-spinal infection group (12 cases). The positive rate, sensitivity and specificity of mNGS and tissue culture in the pathogen detection of patients with spinal infection were compared. McNemar test was used for statistical analysis.Results:There were 23 males and 17 females in 40 patients. The positive rate of mNGS was higher than that of tissue culture (75.0%(30/40) vs 12.5%(5/40)), and the difference was statistically significant ( χ2=0.08, P<0.001). Based on clinical diagnostic criteria, the sensitivity of mNGS in the diagnosis of spinal infection was higher than that of tissue culture (82.1% vs 17.9%), with a statistically significant difference ( χ2=0.02, P<0.001), while the specificity compared to the tissue culture (33.3% vs 100.0%), the difference was not statistically significant ( P>0.05). Conclusions:mNGS has a high pathogen detection rate and sensitivity in the etiological diagnosis of patients with spinal infection, which could provide clinical guidance for the diagnosis and treatment of patients with spinal infection.

Objective: To observe ascitic interleukin-7 expression level in cirrhotic patients complicated with spontaneous bacterial peritonitis, and to detect the effect of recombinant human IL-7 on CD4⁺ and CD8⁺T lymphocyte function. Methods: A total of 84 patients with liver cirrhosis who were hospitalized from August 2017 to April 2018 were selected. Among them, 51 cases were complicated with cirrhosis and untainted ascites, and 33 cases were cirrhosis complicated with spontaneous bacterial peritonitis. Peripheral blood and ascites were collected routinely. The levels of IL-7 in peripheral blood and ascites were measured by enzyme-linked immunosorbent assay. CD4⁺T cells and CD8⁺T cells were purified from ascites, and were stimulated with recombinant IL-7. Cellular proliferation, key transcription factors for mRNA, and cytokines production by CD4⁺T cells in response to IL-7 stimulation was measured. mRNA expression corresponding to perforin, granzyme B, and granulysin as well as cytokines production by CD8⁺T cells was also measured in response to IL-7 stimulation. Cytolytic and non-cytolytic activity of CD8⁺T cells in response to IL-7 stimulation was also investigated in both direct and indirect contact co-culture system. Measurement data of the normal distribution were compared between the two groups by Student’s t-test and the data before and after stimulation were compared by paired t-test. Measurements that did not conform to normal distribution were compared between the two groups using Mann-Whitney U test, and data before and after stimulation were compared using Wilcoxon paired test. Results: There was no significant statistical difference in serum IL-7 levels between the two groups [(5 001 ± 1 458) pg/ml vs. (4 768 ± 1 128) pg/ml, P = 0.41]. The level of ascitic IL-7 in cirrhotic patients complicated with SBP was significantly lower than cirrhosis patients with untainted ascites [(966.4 + 155.8) pg/ml vs. (792.1 + 126.4) pg/ml, P < 0.01]. Recombinant IL-7 stimulation promoted the proliferation of CD4⁺ and CD8⁺T cells from ascites in patients with liver cirrhosis complicated by SBP. T-bet mRNA relative expression and IFN-γ secretion in CD4⁺T cells was also elevated in response to IL-7 stimulation in vitro. Moreover, IL-7 stimulation also increased the mRNA expressions of perforin, granzyme B, and granulysin as well as productions of IFN-γ and TNF-α by CD8⁺T cells. Recombinant IL-7 stimulation elevated cytolytic and non-cytolytic activity of CD8⁺T cells from ascites in patients with liver cirrohosis complicated by SBP, which manifested as increased target cell death and IFN-γ production in both direct and indirect contact co-culture system. Conclusion Ascitic IL-7 promotes T lymphocyte function in patients with liver cirrhosis complicated with SBP.

Objective: To establish a method for the determination of aluminum in blood, and to detect the aluminum content in the blood of occupational aluminum workers. Methods: The morning blood of the aluminum workers was collected in an anticoagulation tube, and the supernatant was centrifuged. The supernatant was diluted with 4% nitric acid containing 1% Triton for 24 h at room temperature, and the supernatant was centrifuged. The supernatant was filtered and the blood aluminum concentration was measured by inductively coupled plasma mass spectrometry and quantified by external standard method. Results: The detection limit of ICP-MS method was 0.39 μg/L, the linear range was 0-160 μg/L, the recoveries were 98.24%-99.65%, and the precision was 0.19%-0.28%. The recoveries of graphite furnace atomic absorption spectrophotometry (GFAAS) were 97.17%-111.18%, and the precision was 0.35%-0.44%. The average blood aluminum concentration of aluminum workers in the normal control group was (19.87±10.65) μg/L. The average blood aluminum concentration of aluminum workers in the expose group was (31.12±11.43) μg/L. Conclusion The method of ICP-MS for the determination of aluminum concentration in blood has a simple pretreatment process, high recovery rate, low detection limit and high precision, which is suitable for popularization.

Objective: To detect the expression levels of microRNA200 (miR200) family in the plasma of the breast cancer patients and the normal controls, and to evaluate their potential values in the screening, progression and prognosis evaluation of breast cancer. Methods: A total of 82 cases of plasma samples of the patients with breast cancer (breast cancer group) and 30 cases of healthy plasma samples (control group) were collected. The microRNAs (miRNAs) were extracted from the plasma samples, the expression levels of miR200 family (miR200a, miR200b, miR200c, miR141 and miR429) were quantified by using real-time PCR technique. The receiver-operating characteristic (ROC) curve was used to assess the diagnostic value of miRNAs, and the associations between the levels of miRNAs and the clinicopathological characteristics were analyzed. Cox proportional hazard mode was used for survival analysis. Results: Compared with control group, the expression level of miR141 in the plasma of the patients in breast cancer group was decreased (P < 0 . 01), and the area under the ROC curve (AUC) was 0. 717 (P < 0 . 01); the expression level of miR200b was also decreased (P = 0 . 006), the AUC was 0. 685 (P = 0. 003); the expression levels of miR200a, miR200c and miR429 had no significant differences between two groups (P = 0 . 268, P = 0 . 075, P = 0 . 872). The AUC of combination of miR200b and miR141 was 0. 735 (P < 0 . 01), the efficacy was superior to that of miR141 used alone. There were no statistically significant associations between the expression levels of miR200 family and the clinicopathological characteristics of breast cancer and postoperative overall survival (P > 0 . 05). Concuson: MiR200b and miR141 are likely to become the molecular biological parameters for the diagnosis of breast cancer.

Objective To study the cytotoxicity of bi-chimeric antigen receptors modified T lymphocytes (BiCAR-T) on the human acute myeloid leukemia (AML) cell line HL60 in vitro and the anti-tumor effects of BiCAR-T on the NOD SCID mouse model of AML in vivo.Methods The BiCAR-T were prepared and the expression of chimeric antigen receptor (CAR) of prepared BiCAR-T was analyzed by flow cytometry.In vitro study was divided into two groups:the experiment group (BiCAR-T) and the control group (T lymphocyte).The killing rate of BiCAR-T in vitro on HL60 cells was determined by CCK8 assay and the level of interferon-γ (IFN-γ) secreted from BiCAR-T co-culturing with HL60 cells for 48 hours was detected by enzyme linked immunosorbent assay (ELISA) at different effect/target ratios (5∶1,10 ∶ 1,20 ∶ 1).The NOD SCID mice AML model was established by the injection of HL60 cells through tail vein and used to assess the antitumor effects in vivo.The mice were randomly divided into three groups according to the random number table:the blank control group receiving 0.9％ NaCl 0.2 ml through tail vein,the model group and the treatment group receiving 1 × 107 HL60 cells in 0.2 ml phosphate buffer saline (PBS).After 20 days,the treatment group was injected with 2 × 107BiCAR-T in 0.2 ml PBS 3 times a week for 2 weeks,while the other two groups received 0.9％ NaCl 0.2 ml.The pathological changes in the mice livers and spleens were observed after 2 weeks of treatment.Results The CAR expression rates of BiCAR-T were more than 50.00％.In vitro experiments proved that the killing rates of BiCAR-T in the experimental group and T lymphocytes in the control group on HL60 cells were (25.43 ±1.32)％ vs.(16.18 ±0.75)％,(50.33±3.11)％ vs.(25.47±1.27)％,and (85.89 ± 3.96) ％ vs.(49.45 ± 2.77) ％ at different effect/target ratios (5 ∶ 1,10 ∶ 1,20 ∶ 1).The killing efficiency of BiCAR-T and T lymphocytes on HL60 cells was significantly different (F =404.17,P ＜ 0.001);the killing efficiency of BiCAR-T and T lymphocytes on HL60 cells was significantly different at different effect/ target ratios (F =548.09,P ＜ 0.001);and the killing efficiency on HL60 cells in the experimental group (BiCAR-T) was significantly higher than that in the control group (T lymphocytes) at different effect/target ratios (F =45.36,P ＜ 0.001).The IFN-γlevels secreted from BiCAR-T in the experiment group and T lymphocytes in the control group co-culturing with HL60 ceils after 48 h were (435.65 ± 20.44) pg/ml vs.(356.75 ± 19.87) pg/ml,(1 639.98 ± 95.75) pg/ml vs.(1 109.37 ± 80.98) pg/ml,and (3 467.43 ± 187.54)pg/ml vs.(2 245.52 ± 112.66)pg/ml.The IFN-γlevel in the experiment group (BiCAR-T) and the control group (T lymphocytes) was significantly different (F =156.24,P ＜ 0.001);the IFN-γ level was significantly different at different effect/target ratios (F =857.67,P ＜ 0.001);the IFN-γlevel in the experimental group (BiCAR-T) was significantly higher than that in the control group (T lymphocytes) at different effect/ target ratios of 5 ∶ 1,10 ∶ 1,20 ∶ 1,respectively (F =46.31,P ＜ 0.001).The result of hematoxylineosin staining (HE) staining showed that leukocyte infiltration in the treatment group was significantly decreased compared with the model group.Conclusion The experimental results showed that BiCAR-T is a kind of efficient targeted immunocyte modified by gene engineering,and it can significantly inhibit leukocyte infiltration of AML in vivo and in vitro.

Objective To investigate nurses' scientific research competency and training demand in Chinese tertiary hospital.Methods It was a multi-stage large-scale survey.A total of 27 335 nurses from 22 provinces/autonomous regions/municipalities were recruited to complete the self-designed questionnaire,including demographic data(7 items),scientific research competency(objective index of 4 items,and subjective index of 6 subscales with 40 items),and training demand evaluation(6 subscales with 16 items).Results There were 1 130(4.14％) nurses who had managed or were managing the research projects as principal investigators(PIs),2 147(7.85％)nurses who had attended or were attending research programs,1 463(5.35％) nurses had published papers,and 557(2.04％) nurses obtained patents.The self-evaluated competency score was 25.00 (12.50,37.50)(rangedfrom 0 to 100)and training demand score was 53.13(37.50,75.00)(ranged from 0 to 100).Conclusion The nurses' scientific research competency should be improved and they had strong training demands.In order to improve nurses' research competency and quality,nursing administrators should pay more attention to post-graduate training focusing on research competency.