Objective: To explore the comorbidity and associated factors of dental caries and overweight/obesity among primary and secondary school students in Guangxi, so as to provide a scientific basis for the development of targeted prevention strategies. Methods: A stratified cluster random sampling method was used to survey 178 700 students from the fourth grade of primary school to the third year of high school in Guangxi Zhuang Autonomous Region from September to November 2023, including physical examination, oral screening, and questionnaire survey. Chisquare tests and binary Logistic regression analysis were employed to investigate the related factors of the cooccurrence of dental caries and overweight/obesity among students. Results: The comorbidity rate of dental caries and overweight/obesity was 9.55%, with urban areas (9.95%) higher than rural counties (9.24%), boys (10.54%) higher than girls (8.54%), primary school students (11.49%) higher than senior high school students (8.92%) and junior high school students (8.05%), and nonboarding students (11.44%) higher than boarding students (7.94%), and all differences were statistically significant (χ2=26.07, 207.91, 471.54, 629.14,P<0.01). Multivariate Logistic regression analysis showed that consuming cereal for breakfast (OR=0.91, 95%CI=0.88-0.94), drinking milk in the past week (OR=0.89, 95%CI=0.83-0.95), meeting sleep standards (OR=0.95, 95%CI=0.91-0.99), and brushing teeth at least once a day (OR=0.82, 95%CI=0.73-0.93) had a lower risk of the comorbidity of dental caries and overweight/obesity. In contrast, drinking beverages in the past week (OR=1.14, 95%CI=1.09-1.20), consuming fried foods in the past week (OR=1.11, 95%CI=1.06-1.17), eating fruit ≥1 time every day (OR=1.06, 95%CI=1.02-1.11), consuming fruit ≥1 type every day (OR=1.07, 95%CI=1.01-1.12), and having fish, poultry, meat, or eggbased breakfasts (OR=1.03, 95%CI=1.05-1.13) had a higher risk of the comorbidity of dental caries and overweight/obesity (P<0.05). Conclusions Dietary habits and lifestyle behaviors are associated with the comorbidity of dental caries and overweight/obesity among primary and secondary school students in Guangxi. Guiding students to form healthy living habits is helpful to preven dental caries and overweight/obesity.

Objective: To investigate the prevalence and associated factors of spinal curvature abnormalities among primary and secondary school students in the Guangxi Zhuang Autonomous Region, so as to provide a scientific basis for the prevention and control of such abnormalities. Methods: From September to November 2023, adopting a stratified cluster random sampling method, spinal curvature screenings and questionnaire surveys were conducted among 168 931 students from grade 4 of primary school to grade 12 of high school in 111 districts and counties across 14 cities in Guangxi. Chi square tests and binary Logistic regression analysis were used to analyze influencing factors of spinal curvature abnormalities. Results: In 2023, the detection rate of poor posture among students above grade 4 in Guangxi was 4.24% , and the detection rate of spinal curvature abnormalities was 2.13%. The detection rate was higher among urban students (2.84%) than rural students (1.66%), boarding students (2.61%) than non-boarding students (1.60%), and high school students (3.16%) than junior high (2.45%) and primary school students (1.15%), and the differences were statistically significant ( χ 2=269.85, 221.44, 565.10, P <0.01). A trend of increasing detection rates with higher grade levels was observed ( χ 2 trend =617.63, P <0.01). Binary Logistic regression analysis indicated that students without boarding at school ( OR =0.82, 95% CI =0.75-0.90), engaging in high-intensity physical activity for over 60 min per day ≥5 days per week ( OR =0.90, 95% CI =0.82-0.98), and adequate sleep ( OR =0.87, 95% CI =0.81-0.94) had lower risks of detecting spinal curvature abnormalities ( P <0.05). Conclusions The prevalence of spinal curvature abnormalities increases with grade level among primary and secondary school students in Guangxi. Regular moderate-to-vigorous physical activity demonstrates protective effects against spinal abnormalities.

OBJECTIVE: To establish a three-dimensional finite element model of a digital wire loop space maintainer for the mandible and primary tooth loss, in order to investigate the stress, deformation, and shear force experienced by patients with the loss of the second primary molar when wearing the wire loop space maintainer. METHODS: Cone beam computed tomography (CBCT) scans were performed on the patients to create a digital model of the mandible with the absence of the second primary molar using Mimics 21.0 software. A digital model integrating the crown's retention and the wire loop structure of the full crown and ring wire loop space maintainer was constructed using pediatric space maintainer design software, utilizing three different materials: cobalt-chromium alloy, polyether ether ketone (PEEK), and titanium alloy. In ANSYS Work Beach 2023 R2 software, vertical loads of 70 N, tilted 45° along the long axis of the tooth loads of 70 N, and a 10 N load on the surface of the wire loop were applied to the occlusal surfaces of models 46 and 84, simulating centric and lateral occlusions during chewing with the wire loop space maintainer in place. The stress states of the wire loop space maintainer and supporting teeth were analyzed. RESULTS: Under various loading conditions, the maximum principal stress of the ring wire loop space maintainer was significantly lower than that of the full crown. Stress contour maps indicated that the peak of the maximum principal stress occurred at the junction of the wire loop and crown structure, indicating that this area was more susceptible to fracture. The ring wire loop space maintainer made from PEEK material exhibited the lowest maximum shear stress on the internal organizational surfaces, with equivalent stresses of 23.18 MPa and 36.35 MPa for models 46 and 84, respectively. Stress contour maps demonstrated that the maximum stress on tooth 46 was located at its mesial, while the maximum stress on tooth 84 was situated near the root area on its distal, in contact with the wire loop space maintainer. CONCLUSION In cases of second primary molar loss, wearing the digital ring wire loop space maintainer can effectively distribute stress, and the ring wire loop space maintainer made from PEEK material reduces the stress experienced by supporting teeth to some extent, demonstrating its superiority in clinical application.
Finite Element Analysis ; Humans ; Tooth, Deciduous ; Cone-Beam Computed Tomography ; Space Maintenance, Orthodontic/methods* ; Imaging, Three-Dimensional ; Orthodontic Wires ; Dental Stress Analysis ; Mandible ; Stress, Mechanical

A chemical investigation of secondary metabolites (SMs) from Aspergillus nidulans resulted in the identification of five novel dioxopiperazine (DKP)-diphenyl ether hybrids, designated as diphenylemestrins A-E (1-5). These compounds 1-5 represent the first known dimers combining DKP and diphenyl ether structures, with compound 4 featuring an uncommon dibenzofuran as the diphenyl ether component. The structural elucidation and determination of absolute stereochemistry were accomplished through spectroscopic analysis and electronic circular dichroism (ECD) calculations. Notably, diphenylemestrin C (3) exhibited moderate cytostatic activity against NB4 cells, with a half maximal inhibitory concentration (IC₅₀) value of 21.99 μmol·L^-1, and induced apoptosis at higher concentrations.
Aspergillus nidulans/metabolism* ; Diketopiperazines/pharmacology* ; Molecular Structure ; Phenyl Ethers/pharmacology* ; Humans ; Apoptosis/drug effects* ; Cell Line, Tumor

Objective:To study the clinical characteristics of different types of neonatal sepsis.Methods:From January 2012 to December 2019, neonates with confirmed sepsis from 5 neonatal centers of central-south China were reviewed. The neonates were assigned into early-onset sepsis (EOS) and late-onset sepsis (LOS) group, and the latter was further subgrouped into hospital-acquired LOS (hLOS) group and community-acquired LOS (cLOS) group. The etiological and clinical characteristics were analyzed. SPSS 26.0 was used for statistical analysis.Results:A total of 580 neonates were enrolled, including 286 (49.3%) in the EOS group and 294 (50.7%) in the LOS group. In LOS group, 147 were in hLOS group and 147 were in cLOS group. The gestational age and birth weight of hLOS group were significantly lower than the other two groups [(32.7±3.6) weeks vs. (37.1±3.7) weeks and (37.7±3.0) weeks, (1 810±717) g vs. (2 837±865) g and (3 024±710) g] ( P<0.05). The common pathogens in EOS and cLOS groups were coagulase-negative staphylococci and Escherichia coli, while Klebsiella pneumoniae was common in hLOS group. Carbapenems usage in the hLOS group was significantly higher than the other two groups [62.6% vs. 28.7% and 16.2%] ( P<0.05). Antibiotics duration in the hLOS group was longer than the other two groups [19 (14, 27) d vs. 15 (12, 20) d and 14 (12, 19) d] ( P<0.05). Conclusions:The clinical characteristics of neonatal sepsis vary among different types of infections, and it is necessary to establish appropriate prevention, control, diagnosis and treatment protocols.

Objective:To analyze the hot spots and frontiers of medical quality and safety management since the new medical reform, and to provide reference for the continuous improvement of medical quality and safety management.Methods:Chinese literatures related to medical quality and medical safety management in CNKI database from April 2009 to December 2022 were retrieved, and the included literatures were processed and analyzed by CiteSpace software and Excel software.Results:1 921 literatures related to medical quality management and 2 497 literatures related to medical safety management were included. The publication trend showed a " double peak", showing a downward trend. The research hotspots in literature related to medical quality and safety management in China since the new medical reform have focused on practice exploration and influencing factors. The trend of future research is to closely follow the background of the times in medical quality and safety management research and intelligent medical quality and safety management evaluation system research.Conclusions:In the future, research on medical quality and safety management should be more in line with the changes of medical reform policies, focus on high-quality development to deepen the research on micro issues, promote information construction to continuously improve the indicator evaluation system, so as to promote the sustainable and high-quality development of medical quality and safety management in China.

Objective:To construct future-oriented theoretical management model for medical quality and patient safety.Methods:Procedure grounded theory was applied to code data including 30 expert interview records from July 2021 to June 2022 and the qualitative analysis results of 71 core literatures in Chinese and English, and then the theoretical model was constructed.Results:After three-level coding, 555 reference points, 249 initial concepts, 41 categories, 27 main categories and 7 core categories related to medical quality and safety management were sorted out, and the theoretical model of SQ (I-SPORT) matrix for medical quality and safety management was constructed. This model extended the traditional dimension in quality and safety management.Conclusions:Regarding medical quality and safety management, on one hand, should focus on the systematic improvement of structure, process, results, reengineering, education and training in terms of management functions; on the other hand, it is necessary to improve the organization, employees, resources, technology and tools, and patient experience in terms of management elements.

Objective:To explore the application effect of immersive experiential teaching strategies in the teaching of clinical anesthesiology for undergraduates.Methods:Undergraduates majoring in 5-year clinical medicine in Air Force Medical University from January 2022 to May 2022 were enrolled as the research objects. Students were randomly divided into the immersive teaching group and the traditional teaching group, with 35 students in each. Students in the immersive teaching group underwent immersive experiential teaching strategies and the traditional teaching group received lecture-based teaching strategies. After classes, all students in these two groups took the same theoretical and operational examination, and conducted a teaching satisfaction survey and a comprehensive ability evaluation. The results were analyzed by t-test and Chi-square test using SPSS 22.0 software. Results:Students in the immersive teaching group were more satisfied with teaching (88.32±7.28 vs.70.15±7.11) ( P=0.001), and had higher scores of theorical examination (86.34±7.42 vs. 77.31±5.32) ( P=0.020) and operational examination (92.23±5.33 vs. 81.21±4.98) ( P=0.022) than those in the traditional teaching group. In addition, the scores of communication ability ( P=0.026), response ability ( P<0.001) adaptability ( P=0.007), and critical thinking ( P<0.001) in the immersive teaching group were higher than those in the traditional teaching group. Conclusion:The immersive experiential teaching strategies can effectively improve the theoretical and practical operational ability of undergraduates after completing courses of clinical anesthesiology, and can effectively stimulate the enthusiasm of students. It is worthy to be popularized in subsequent teaching abilities.

Objective:To explore the influencing factors of the poor sustainability of the evidence-based practice project for irritant dermatitis around urostomy.Methods:This is a qualitative study. From April to May 2020, 12 nurses working in the Urology Surgery of Peking University First Hospital were selected by purposive sampling for the semi-structured interview. The integrated-Promoting Action on Research Implementation in Health Services framework (i-PARIHS framework) was applied to analyze and extract the obtained data.Results:The interview results found that, in terms of transform (evidence) , the localization and continuity of evidence for the evidence-based practice project of irritant dermatitis around urostomy needed to be improved, including the high matching between evidence and practice environment, and the insufficient continuity of evidence application. In terms of transform recipients, the leadership of project practitioner needed to be improved, including the conflict between the roles of practitioners and researchers, the lack of knowledge reserves of practitioners, and the conflict among the values of practitioners. In terms of organizational environment, the leadership of managers and the imformatization degree of project needed to be improved, including insufficient support from leaders and insufficient facilities.Conclusions:At the initial stage of formulating the nursing evidence-based practice project, the project implementer should fully incorporate the opinions of stakeholders for localization debugging, and consider the sustainability of the project. In addition, the leadership of managers, nurses and interns should be increased, the use and training of urostomy talents should be strengthened, the training of urostomy knowledge should be continued, the information-based follow-up system should be improved, and the intervention strategy should be continuously adjusted to ensure the project is carried out.

Objective:To investigation of efficacy and safety of Ticagrelor vs.Clopidogrel as add-on to a common therapy of Aspirin in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)and undergoing percutaneous coronary intervention(PCI). Methods:A total of 208 elderly patients with STEMI and receiving PCI were divided into the Ticagrelor group(n=103, receiving Ticagrelor 180 mg, followed by 90 mg twice a day)and the Clopidogrel group(n=105, receiving Clopidogrel 600 mg, followed by 75 mg/d)as add-on to a common therapy of Aspirin(300 mg before operation, followed by 100 mg/d). Both groups were treated for 12 months.Coronary artery blood flow, platelet aggregation rate, left ventricular ejection fraction(LVEF), left ventricular end-diastolic diameter(LVEDD), bleeding events and major adverse cardiovascular events(MACE)after PCI were compared between the two groups.Results:The TIMI(thrombolysis in myocardial infarction)grading after PCI was better in the Ticagrelor group than in the Clopidogrel group( Z=2.58, P=0.010). The incidence of no-reflow or slow blood flow was lower in the Ticagrelor group than in the Clopidogrel group(6.8% or 7/103 vs. 19.1% or 20/105, χ2=6.91, P=0.009). The variance analysis of repeated data showed that the platelet aggregation rate was decreased along with time in both groups( Ftime=87.54, P<0.001). The decrement of platelet aggregation rate was higher in the Ticagrelor group than in the Clopidogrel group( Ftime×group=6.16, P<0.001). The overall level of platelet aggregation was lower in the Ticagrelor group than in the Clopidogrel group( Fgroup=17.84, P<0.001). The platelet aggregation rates at 1 hour, 1 day and 3 days after operation were lower in the Ticagrelor group than in the Clopidogrel group( t=14.39, 13.19 and 6.53, respectively, P<0.001). LVEF was increased in both groups after PCI( t=7.46 and 4.33, all P<0.001), while LVEF was higher in the ticagrelor group than in the clopidogrel group( t=4.28, P<0.001). LVEDD was decreased in both groups after PCI( t=9.36 and 6.47, all P<0.001), while LVEDD was lower in the ticagrelor group than in the clopidogrel group( t=4.38, P<0.001). There were no significant differences in the incidences of hemorrhage and MACE between the two groups( χ2=0.91 and 2.32, all P>0.05). Conclusions:Ticagrelor has good anti-platelet aggregation effect in the treatment of STEMI after PCI in the elderly, and it reduces the incidences of no-or slow reflow, improves cardiac function.