OBJECTIVE To evaluate the impact of dual antiplatelet therapy （DAPT） at different durations on prognosis and safety after percutaneous coronary intervention （PCI）.METHODS PubMed，The Cochrane Library， Embase， Medline， CNKI， Wanfang data， and VIP database were searched to collect randomized controlled trials of DAPT in patients after PCI， from database inception to March 20， 2026. After literature screening， data extraction， and quality assessment， a meta-analysis was performed using RevMan 5.4 software.RESULTS A total of 19 studies were included， involving 44 072 patients. Meta-analysis results showed that there were no statistically significant differences between the two groups in incidence rate of major adverse cardiovascular events [relative risk（RR）＝0.99， 95% confidence interval（CI）（0.90， 1.08）， P ＝0.80]， all-cause mortality rate[RR＝0.93， 95%CI（0.81，1.05）， P ＝0.24]， cardiovascular-related mortality rate[RR＝0.87， 95%CI（0.73， 1.04）， P ＝0.12]， the incidence rate of myocardial infarction [RR＝1.11，95%CI（0.97，1.27）， P ＝0.14]， the incidence rate of stent thrombosis[RR＝1.50，95%CI（0.99，2.28）， P ＝0.06]， the incidence rate of revascularization[RR＝1.00， 95%CI（0.86， 1.15）， P ＝0.95]， the incidence rate of stroke[RR＝1.03， 95%CI（0.82， 1.28）， P ＝0.81]. The incidence rate of bleeding events in the short-term DAPT group was significantly lower than in the long-term DAPT group[RR＝0.61， 95%CI（0.53， 0.69）， P ＜0.000 01].CONCLUSIONS Short-term and long-term DAPT in patients after PCI were associated with comparable risks of all-cause mortality， cardiovascular-related mortality， myocardial infarction， stent thrombosis， revascularization， stroke， and major adverse cardiovascular events； however， short-term DAPT showed a more prominent advantage in reducing bleeding risk.

Tumor is the result of long-term and unlimited proliferation of cells. Tumor cells adjust various metabolic fluxes to meet increased bioenergy and biosynthetic requirements. Serine is one of the eight non-essential amino acids in the human body. It plays an important role in a variety of physiological activities and can provide one carbon unit, glycine, etc. for cell proliferation. Serine hydroxymethyltransferase (SHMT) is a key enzyme that catalyzes the conversion of glycine and serine. It is highly expressed in a variety of tumors and is a potential target for anti-tumor drugs. This article focuses on the potential of SHMT as a new target for cancer treatment and the preliminary application of its inhibitors in preclinical studies of tumors, providing reference for the development of new targeted drugs for tumors.

ObjectiveTo explore the characteristics of traditional Chinese medicine （TCM） syndromes in the patients with concurrent knee osteoarthritis （KOA） and postmenopausal osteoporosis （PMOP） and provide a scientific basis for precise TCM syndrome differentiation， diagnosis， and treatment of such concurrent diseases. MethodsA prospective， multicenter， cross-sectional clinical survey was conducted to analyze the characteristics of TCM syndromes in the patients with concurrent PMOP and KOA. Excel 2021 was used to statistically analyze the general characteristics of the included patients. Continuous variables were reported as x¯±s， and binary variables were reported as percentages. UCINET and Gephi were used to construct a complex "isease-syndrome-symptom" network for in-depth mining. Topological structure indicators， edge connection information between nodes， and weighted adjacency matrices were calculated by UCINET and Python. Gephi was used for complex network visualization. ResultsA total of 157 patients with concurrent PMOP and KOA from 12 TCM hospitals or community health service centers were selected for the collection of TCM syndrome and symptom information. A total of 4 main TCM syndromes were obtained， which were kidney-Yang deficiency （47.13%）， liver-kidney Yin deficiency （36.94%）， spleen-kidney Yang deficiency （8.92%）， and kidney Yin-Yang deficiency （7.01%）. In addition， 10 concurrent syndromes （mainly Qi stagnation and blood stasis， Qi and blood deficiency， spleen Yang deficiency， and cold-dampness） were identified. Based on the results of comprehensive frequency statistics and complex network analysis， as well as TCM theoretical knowledge and relevant guidelines， the general characteristics of concurrent PMOP and KOA and the main TCM syndromes in the dimensions of physical symptoms， pain， tongue and pulse manifestations， and defecation and urination were obtained. ConclusionThe main TCM syndromes in the patients with concurrent PMOP and KOA may be kidney Yang deficiency， liver-kidney Yin deficiency， spleen-kidney Yang deficiency， and kidney Yin-Yang deficiency， among which kidney Yang deficiency and liver-kidney Yin deficiency are the core TCM syndromes.

ObjectiveTo explore the characteristics of traditional Chinese medicine （TCM） syndromes in the patients with concurrent knee osteoarthritis （KOA） and postmenopausal osteoporosis （PMOP） and provide a scientific basis for precise TCM syndrome differentiation， diagnosis， and treatment of such concurrent diseases. MethodsA prospective， multicenter， cross-sectional clinical survey was conducted to analyze the characteristics of TCM syndromes in the patients with concurrent PMOP and KOA. Excel 2021 was used to statistically analyze the general characteristics of the included patients. Continuous variables were reported as x¯±s， and binary variables were reported as percentages. UCINET and Gephi were used to construct a complex "isease-syndrome-symptom" network for in-depth mining. Topological structure indicators， edge connection information between nodes， and weighted adjacency matrices were calculated by UCINET and Python. Gephi was used for complex network visualization. ResultsA total of 157 patients with concurrent PMOP and KOA from 12 TCM hospitals or community health service centers were selected for the collection of TCM syndrome and symptom information. A total of 4 main TCM syndromes were obtained， which were kidney-Yang deficiency （47.13%）， liver-kidney Yin deficiency （36.94%）， spleen-kidney Yang deficiency （8.92%）， and kidney Yin-Yang deficiency （7.01%）. In addition， 10 concurrent syndromes （mainly Qi stagnation and blood stasis， Qi and blood deficiency， spleen Yang deficiency， and cold-dampness） were identified. Based on the results of comprehensive frequency statistics and complex network analysis， as well as TCM theoretical knowledge and relevant guidelines， the general characteristics of concurrent PMOP and KOA and the main TCM syndromes in the dimensions of physical symptoms， pain， tongue and pulse manifestations， and defecation and urination were obtained. ConclusionThe main TCM syndromes in the patients with concurrent PMOP and KOA may be kidney Yang deficiency， liver-kidney Yin deficiency， spleen-kidney Yang deficiency， and kidney Yin-Yang deficiency， among which kidney Yang deficiency and liver-kidney Yin deficiency are the core TCM syndromes.

Objective:To evaluate the clinical efficacy of a novel reduction device in the treatment of A3N0/1 thoracolumbar fracture using navigation-assisted techniques.Methods:A retrospective analysis was conducted on 45 patients (29 males, 16 females; mean age 40.67±16.11 years, range 24-57) with thoracolumbar fractures who underwent fracture reduction and pedicle screw fixation via the Wiltse approach at Zhengzhou Orthopaedic Hospital between January 2022 and January 2023. Injury levels included: T 10 in 2 cases, T 11 in 5 cases, T 12 in 13 cases, L 1 in 20 cases, L 2 in 3 cases, L 3 in 2 cases. All patients underwent fracture reduction via the Wiltse approach using the spinal fracture reduction instrument for vertebral body reduction. Among them, 20 patients received O-arm navigation-assisted internal fixation and vertebral reduction (O-arm group), while 25 received C-arm fluoroscopy-guided internal fixation and vertebral reduction (C-arm group). Operative time, intraoperative blood loss, vertebral reduction time using the instrument, first-time screw placement success rate, screw placement accuracy, and complications were compared. Mid-vertebral body height ratio (MVBHr), local Cobb angle of the fractured vertebra, visual analogue scale (VAS) score, and Oswestry disability index (ODI) were compared preoperatively, at 1 week postoperatively, 3 months postoperatively, and final follow-up. Results:All surgeries were successfully completed in both groups. Operative time was significantly shorter in the O-arm group (106.8±14.4 min) than in the C-arm group (119.1±16.4 min, P<0.05). All patients were followed up for a mean duration of 15.9±3.9 months (range 12-20 months). Vertebral reduction time was significantly shorter in the O-arm group (11.0±2.2 min) than in the C-arm group (20.4±5.7 min, P<0.05). The first-time screw placement success rate was significantly higher in the O-arm group (100%) than in the C-arm group (95.3%, P<0.05). Screw placement accuracy (Grade I) was significantly higher in the O-arm group (117 screws, 97.5%) than in the C-arm group (136 screws, 90.7%, P<0.05). No cases of wrong-level surgery, infection, or spinal cord/nerve injury occurred. Both groups showed significant improvements in MVBHr, Cobb angle, VAS, and ODI at all postoperative time points compared to preoperative values ( P<0.05). At final follow-up, the O-arm group demonstrated significantly better outcomes than the C-arm group in MVBHr (90.6%±4.5% vs. 86.4%±6.9%, P<0.05), Cobb angle (7.6°±1.8° vs. 10.1°±3.2°, P<0.05), VAS (1.3±0.4 vs. 1.7±0.6, P<0.05), and ODI (4.6%±1.9% vs. 7.7%±2.0%, P<0.01). Conclusion:O-arm navigation-assisted intrasegmental push reduction for A3N0/1 type thoracolumbar fractures demonstrates advantages including faster and more accurate screw placement, precise reduction with improved outcomes, and significant postoperative pain relief.

Objective:To explore the efficacy of percutaneous vertebroplasty (PVP) using the partition injection technique in the treatment of Kümmell’s disease of stages Ⅰ and Ⅱ.Methods:A retrospective study was conducted of the 30 patients with stage Ⅰ or Ⅱ Kümmell’s disease (the partition group) who had been treated by PVP using the partition injection technique at Department of Spinal Surgery, Zhengzhou Orthopedic Hospital from January 2020 to January 2022. The data of another 30 patients who had been treated at the same department and the same period using conventional PVP for stage Ⅰ or Ⅱ Kümmell's disease were selected as the conventional group. In the partition group, there were 13 males and 17 females, with an age of (72.3±10.1) years and disease duration of (3.1±1.5) months. Seventeen thoracic and 13 lumbar vertebrae were affected. In the conventional group, there were 11 males and 19 females, with an age of (75.5±12.7) years and disease duration of (3.5±1.8) months. Eighteen thoracic and 12 lumbar vertebrae were affected. Surgical time, volume of bone cement injected, bone cement leakage, and bone cement distribution were compared between the 2 groups. The heights of the anterior and middle vertebral bodies, kyphotic Cobb angle, visual analog scale (VAS) pain score, and Oswestry disability index (ODI) were assessed postoperatively at 1 day, 6 months, and the last follow-up and compared between the 2 groups.Results:No significant differences were found in the baseline data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (17.3±3.1) months. There were no significant differences in the surgical time or bone cement leakage between the 2 groups ( P>0.05). The volume of bone cement injected in the partition group was significantly higher [(6.3±1.5) mL] than that in the conventional group [(4.9±1.0) mL] ( P<0.05). Bone cement distribution was significantly better in the partition group than that in the conventional group ( P<0.05). At postoperative 1 day, 6 months, and the last follow-up, the partition group was significantly better than the conventional group in anterior vertebral body height, middle vertebral body height, and kyphotic Cobb angle ( P<0.05). At the 6-month and the last follow-ups, the partition group was also significantly better than the conventional group in VAS pain score and ODI ( P<0.05). Conclusion:In the treatment of Kümmell’s disease of stages Ⅰ and Ⅱ, compared with conventional PVP, PVP using the partition injection technique may lead to better long-term outcomes due to its better bone cement distribution, more adequate cement injection, and better restoration of vertebral body heights and correction of local deformity.

Objective: To investigate the vitamin D levels in children aged 1 year in Shaoxing City, Zhejiang Province, so as to provide the basis for prevention and treatment of vitamin D deficiency in children and promoting their health. Methods: The 1-year-old children who underwent health examinations at the Department of Child Health Care of Shaoxing Maternal and Child Health Care Hospital from September 2023 to August 2024 were selected. Basic information of the children was collected through the medical record information system, and their length and weight were measured. The length, weight and nutritional status were evaluated according to the Technical Specifications for the Management of Nutritional Diseases in Children. Serum 25-hydroxyvitamin D [25- (OH) D] levels were measured using electrochemiluminescence assay, and vitamin D levels were assessed based on the fifth edition of Child Health Care. The vitamin D levels were analyzed among the children with different genders, testing months, and growth status. Results: A total of 2 245 children were recruited, including 1 189 boys (52.96%) and 1 056 girls (47.04%). The median serum 25- (OH) D level was 39.98 (interquartile range, 16.63) ng/mL. Vitamin D insufficiency was observed in 279 children, with an insufficiency rate of 12.43%. The median serum 25- (OH) D level in boys was 39.26 (interquartile range, 17.75) ng/mL, which was lower than that in girls at 41.39 (17.75) ng/mL (P<0.05). The vitamin D insufficiency rate was 13.04% in boys and 11.74% in girls, with no statistically significant difference (P>0.05). The lowest vitamin D insufficiency rate was observed in August at 4.95%, while the highest rate was in September at 23.89%, showing the statistically significant difference across testing months (P<0.05). The children with above-average length ratings, higher weight ratings and obesity had higher vitamin D insufficiency rates, at 17.29%, 20.86% and 20.88%, respectively. The vitamin D insufficiency rate increased with higher weight and nutritional status ratings (both P<0.05), but no significant change was observed with higher length ratings (P>0.05). Conclusions The vitamin D insufficiency rate among 1-year-old children in Shaoxing City was 12.43%, with variations observed in different testing months, weight and nutritional status. Targeted prevention and intervention measures should be implemented to address these differences.

OBJECTIVE From the perspective of China’s health system， to evaluate the cost-effectiveness of maintenance therapy with clopidogrel or aspirin monotherapy in percutaneous coronary intervention （PCI） patients after dual antiplatelet therapy （DAPT）. METHODS A Markov model was adopted with a research period of 25 years and a cycle period of 1 year. Cohort simulations were conducted respectively for the clopidogrel group and aspirin group to predict and compare the long-term economic and health outcomes of PCI patients receiving either clopidogrel or aspirin monotherapy maintenance regimens after DAPT， and cost-effectiveness analysis was conducted. The willingness-to-pay （WTP） threshold was set at the level of 1 times China’s per capita gross domestic product （GDP） in 2024[95 749 yuan per quality-adjusted life year （QALY）]， and the incremental cost- effectiveness ratio （ICER） was calculated. The robustness of the basic analysis results was verified by using single-factor sensitivity analysis and probabilistic sensitivity analysis. RESULTS After PCI， patients received DAPT， clopidogrel monotherapy maintenance treatment reduced the occurrence of death events， and aspirin monotherapy maintenance treatment had a lower probability of stroke and myocardial infarction events. The ICER of the clopidogrel group regimen compared with the aspirin group regimen was 34 644.87 yuan/QALY， which was less than the WTP threshold set in this study. The results of univariate sensitivity analysis indicated that notable uncertainties affecting the basic analysis results were the probability of event-free progression to death in the aspirin group， the event-free cost in the clopidogrel group， and the event-free cost in the aspirin group. The results of probabilistic sensitivity analysis indicated that when the WTP threshold was 95 749 yuan /QALY， the economic probabilities of the clopidogrel group and the aspirin group were 83% and 17%， respectively. The economic probability of the clopidogrel group regimens showed an upward trend with the increase of the WTP threshold. CONCLUSIONS Compared to aspirin monotherapy for maintenance therapy， under the WTP threshold of 1 times China’s per capita GDP in 2024， receiving clopidogrel monotherapy for maintenance therapy after DAPT in PCI patients is more cost-effective.

Objective: To explore the factors affecting language development delay among children aged <3 years, so as to provide a basis for the prevention and early intervention of children's language development problems. Methods: Eighty-one children aged <3 years with language development delay who visited the children's language development clinic of Shaoxing Maternal and Child Health Hospital from January to December 2024 as the case group. Meanwhile, 118 children who underwent routine physical examinations at the children's health clinic during the same period, had normal language development were randomly selected as the control group. Data on children's basic information, parenting environment, and screen exposure were collected through questionnaire surveys. Language development delay was assessed using the Early Language Milestone Scale and the Gesell Developmental Diagnosis Scale. The factors for language development delay were analyzed using a multivariable logistic regression model. Results: The case group comprised 81 children, including 56 boys (69.14%) and 25 girls (30.86%), with a mean age of (23.14±4.84) months. The control group consisted of 118 children, including 81 boys (68.64%) and 37 girls (31.36%), with a mean age of (23.81±4.60) months. Multivariable logistic regression analysis showed that daily parental companionship time of ≥2 hours (OR=0.121, 95%CI: 0.040-0.367), attending childcare institutions (OR=0.103, 95%CI: 0.030-0.352), the average daily screen exposure time <1 hour (OR=0.614, 95%CI: 0.400-0.942), interactive parental accompaniment during screen exposure (OR=0.350, 95%CI: 0.157-0.779), and restricting screen exposure time (OR=0.162, 95%CI: 0.056-0.470) were associated with a lower risk of language development delay among children aged <3 years. Conclusion Daily paternal companionship of 2 hours or more, attending childcare institutions, daily screen exposure time of less than 1 hour, interactive parental companionship during screen time, and limiting screen exposure time can reduce the risk of language developmental delay among children aged under 3 years.