Objective:To evaluate the changes in left ventricular structure and function in pregnant women with different severities of hypertensive disorders of pregnancy（HDP）using conventional echocardiographic parameters，strain，and tissue-tracking mitral annulus displacement（TMAD）parameters，and to validate and compare the application value of strain and TMAD parameters.Methods:A total of 148 singleton pregnant women with HDP and 100 healthy pregnant women（HP group）who attended the Third Affiliated Hospital of Zhengzhou University from October 2023 to July 2024 were selected. Conventional echocardiographic parameters，strain，and TMAD parameters were collected. Based on the severity of the disease，HDP patients were divided into the gestational hypertension group（GH group， n=49），non-severe preeclampsia group（NSPE group， n=35），and severe preeclampsia group（SPE group， n=64）. The differences in various parameters between the HP，GH，NSPE，and SPE groups were compared. The correlation between the displacement ratio of the midpoint of the mitral valve annulus in the apical 4-chamber（AP4 Midpt%），the displacement ratio of the midpoint of the mitral valve annulus in the apical 2-chamber（AP2 Midpt%）and left ventricular global longitudinal strain（LVGLS）were analyzed，and ROC curves were plotted to analyze and compare the diagnostic efficacies of LVGLS，AP4 Midpt% and AP2 Midpt% for left ventricular function changes in HDP pregnant women. Results:① The analysis revealed no statistically significant differences in maternal age and height between the HP group and the HDP subgroups（all P>0.05）. In contrast，statistically significant differences were observed in gestational age，systolic blood pressure，diastolic blood pressure，body mass index，and body surface area（all P<0.05）. Additionally，significant differences were noted in left ventricular mass，left ventricular interventricular septum thickness at end-diastole，left ventricular posterior wall thickness at end-diastole，left ventricular end-diastolic dimension，left ventricular end-systolic dimension，left ventricular end-diastolic volume，left ventricular end-systolic volume，and stroke volume between the HP group and the HDP subgroups（all P<0.05），while the difference in left ventricular ejection fraction was not statistically significant（ P>0.05）. ② Significant differences were identified in strain and TMAD parameters between the HP group and the HDP subgroups（all P<0.05），with LVGLS，AP4 Midpt% and AP2 Midpt% exhibited the largest effect sizes（ η p2=0.457，0.453，0.351）. A progressive decline in strain and TMAD parameters was observed as the severity of HDP increased. ③ There were strong positive correlations between AP4 Midpt%，AP2 Midpt% and LVGLS（ r=0.752，0.747；all P<0.001）. ④ LVGLS，AP4 Midpt% and AP2 Midpt% all demonstrated significant diagnostic efficacies for changes in left ventricular function in HDP（AUC=0.840，0.847，0.791），and the differences in AUC among the 3 curves were not statistically significant（all P>0.05）.⑤ The success rate of collecting TMAD parameters was significantly higher than that of strain parameters（99.24% vs. 93.58%， P<0.001）. Conclusions:As the severity of the disease worsens，the changes of left ventricular structure and function in pregnant women with HDP become more and more significant. Both strain and TMAD parameters can early and sensitively identify the subclinical damage of left ventricular systolic function in HDP pregnant women，and both of them have the same diagnostic value. TMAD parameters can be used as a reliable substitute parameter of LVGLS in HDP pregnant women.

Objective:To evaluate the changes in left ventricular structure and function in pregnant women with different severities of hypertensive disorders of pregnancy（HDP）using conventional echocardiographic parameters，strain，and tissue-tracking mitral annulus displacement（TMAD）parameters，and to validate and compare the application value of strain and TMAD parameters.Methods:A total of 148 singleton pregnant women with HDP and 100 healthy pregnant women（HP group）who attended the Third Affiliated Hospital of Zhengzhou University from October 2023 to July 2024 were selected. Conventional echocardiographic parameters，strain，and TMAD parameters were collected. Based on the severity of the disease，HDP patients were divided into the gestational hypertension group（GH group， n=49），non-severe preeclampsia group（NSPE group， n=35），and severe preeclampsia group（SPE group， n=64）. The differences in various parameters between the HP，GH，NSPE，and SPE groups were compared. The correlation between the displacement ratio of the midpoint of the mitral valve annulus in the apical 4-chamber（AP4 Midpt%），the displacement ratio of the midpoint of the mitral valve annulus in the apical 2-chamber（AP2 Midpt%）and left ventricular global longitudinal strain（LVGLS）were analyzed，and ROC curves were plotted to analyze and compare the diagnostic efficacies of LVGLS，AP4 Midpt% and AP2 Midpt% for left ventricular function changes in HDP pregnant women. Results:① The analysis revealed no statistically significant differences in maternal age and height between the HP group and the HDP subgroups（all P>0.05）. In contrast，statistically significant differences were observed in gestational age，systolic blood pressure，diastolic blood pressure，body mass index，and body surface area（all P<0.05）. Additionally，significant differences were noted in left ventricular mass，left ventricular interventricular septum thickness at end-diastole，left ventricular posterior wall thickness at end-diastole，left ventricular end-diastolic dimension，left ventricular end-systolic dimension，left ventricular end-diastolic volume，left ventricular end-systolic volume，and stroke volume between the HP group and the HDP subgroups（all P<0.05），while the difference in left ventricular ejection fraction was not statistically significant（ P>0.05）. ② Significant differences were identified in strain and TMAD parameters between the HP group and the HDP subgroups（all P<0.05），with LVGLS，AP4 Midpt% and AP2 Midpt% exhibited the largest effect sizes（ η p2=0.457，0.453，0.351）. A progressive decline in strain and TMAD parameters was observed as the severity of HDP increased. ③ There were strong positive correlations between AP4 Midpt%，AP2 Midpt% and LVGLS（ r=0.752，0.747；all P<0.001）. ④ LVGLS，AP4 Midpt% and AP2 Midpt% all demonstrated significant diagnostic efficacies for changes in left ventricular function in HDP（AUC=0.840，0.847，0.791），and the differences in AUC among the 3 curves were not statistically significant（all P>0.05）.⑤ The success rate of collecting TMAD parameters was significantly higher than that of strain parameters（99.24% vs. 93.58%， P<0.001）. Conclusions:As the severity of the disease worsens，the changes of left ventricular structure and function in pregnant women with HDP become more and more significant. Both strain and TMAD parameters can early and sensitively identify the subclinical damage of left ventricular systolic function in HDP pregnant women，and both of them have the same diagnostic value. TMAD parameters can be used as a reliable substitute parameter of LVGLS in HDP pregnant women.

Influenza imposes a significant disease burden on society and individuals annually, and influenza vaccination is considered a significant public health measure to prevent influenza and reduce influenza-related severe disease and death. The low influenza vaccination rate in China is partly due to certain factors affecting the willingness and behavior of individuals to receive them. Scientific research and targeted interventions on these factors can effectively improve the vaccination situation. Commonly used individual-level theoretical models for influenza vaccination behavior include the health belief model, protection motivation theory, and theory of planned behavior. This study reviews theoretical models commonly employed in researching influenza vaccination willingness and behavior. An overview of these practical applications and challenges models is presented to provide references for relevant research and intervention programs in China.

Objective:To analyze the epidemiological characteristics of indigenous 2019-nCoV infection in population under 18 years old in 31 provinces of China, and provide evidence for the prevention and control of COVID-19.Method:Demographic and epidemiologic information of children and adolescents with 2019-nCoV infection reported in China between April 29, 2020 and May 31, 2022 were collected from China's Disease Prevention and Control Information System. We analyzed the epidemiological characteristics of the 2019-nCoV infection in children and adolescents and compared the epidemiological characteristics of the cases at different epidemic stages.Result:A total of 63 916 indigenous 2019-nCoV infection cases in children and adolescents were reported in China from April 29, 2020 to May 31, 2022, in which 14 777 (23.12%) were confirmed cases and 49 139 (76.88%) were asymptomatic cases. An obvious incidence peak (40 864 cases) was observed in April, 2022, and two sub-peaks were observed in January, 2020 and January, 2021, respectively. The 2019-nCoV infection cases occurred in 187 cities above prefecture level in 30 provinces, the cases reported in Shanghai (41 562 cases), Changchun (5 753 cases) and Jilin (3 888 cases) accounted for 80.11% of the total cases (51 203/63 916). The proportion of the cases in males was 54.34%. The age of the cases, M ( Q1, Q3) was 10 (5, 14) years, and 57.73% of the cases were 6 - 15 years old. The cases in students accounted for the highest proportion (56.14%). The interval between illness onset and diagnosis of confirmed cases, M ( Q1, Q3) was 1 (0, 2) days. Among the 2019-nCoV infection cases in children and adolescents, 76.88% were asymptomatic, 21.78% were mild ones, 1.32% were moderately severe ones, 0.02% were severe ones, and there were no critical cases and deaths. Compared with other age groups, the proportion of severe or critical cases was higher in children aged <1 year (0.12%). The proportion of asymptomatic infections was highest in Omicron variant epidemic (78.43%). Conclusion:The 2019-nCoV infection cases in children and adolescents aged <18 years in 31 provinces in China were mainly primary and secondary school students aged 6-15 years. Most cases were asymptomatic and mild ones with low clinical severity. It is still necessary to strengthen the surveillance for 2019-nCoV infection in children and adolescents to improve the prevention and control of COVID-19 in school age children.

OBJECTIVE：To e stablish and compare HPLC fingerprints of green Forsythia suspensa and grown F. suspensa ，and to conduct cluster analysis and principle component analysis. METHODS ：HPLC method was adopted. The determination was performed on Hypersil C 18 column with mobile phase consisted of acetonitrile- 0.1％ formic acid （gradient elution ）. The detection wavelength was 235 nm and column temperature was 25 ℃ with the flow rate of 1.0 mL/min. The sample size was 10 μL. HPLC fingerprints of 8 batches of green F. suspensa （Q1-Q8）and 6 batches of grown F. suspensa （L1-L6）were drawn ，with phillyrin as reference；the similarity evaluation was conducted by using Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition），and common peak was confirmed. Cluster analysis and principal component analysis were carried out with SPSS 23.0 software. RESULTS ：There were 19 common peaks for green F. suspensa and grown F. suspensa ，among which 6 peaks were identified，i.e. forsythoside A ，rutin，pinoresinol-β-D-glucoside，phillyrin，quercetin and phillygenin ；the similarities of HPLC fingerprints from green F. suspensa and grown F. suspensa were 0.351-0.767；results of cluster analysis showed that green F. suspensa and grown F. suspensa were classified into 4 categories，among which L 1-L6 were clustered into one category ，Q1 was clustered into one category ，Q2-Q6 were clustered into one category ；Q7-Q8 were clustered into one category. The results of principal component analysis showed that the cumulative variance contribution rate of the first three principal components was 83.14％， L1-L6 distribution was close ，Q2-Q6 distribution was close ，Q7-Q8 distribution was close ，and Q 1 distribution was independent ， which was consistent with the results of cluster analysis. CONCLUSIONS ：There were significant differences in the common peaks of fingerprint of green F. suspensa and grown F. suspensa of similarity eraluation ，cluster analysis and principle component analysis，the established HPLC fingerprint can be used for comprehensive evaluation and quality comparison of green F. suspensa and grown F. suspensa .

Objective To explore the reasonable experimental parameters on establishment of rabbit model of infusion phlebitis induced by mannitol.Methods New Zealand rabbits were injected with 20％ mannitol,then pathological lesion of rabbit auricular vein induced by different infusion velocity,different sampling time and sites were observed under microscope with vascular injury,inflammatory cell infiltration,frequency of thrombokinesis as indexes.Results The three indexes were the highest and the most obvious characteristics of infusion phlebitis were noted at the following experimental conditions:5.0 ml/min (infusion velocity),sampling time at 24h after administration and sampling site at 1cm region in front of the catheter tip.Conclusions Rabbit model of infusion phlebitis induced by mannitol can be set up more stable by using these parameters.

Objective To discuss the feasibility of estimation on intracranial pressure of patients withbrain injury by measuring optic nerve sheath diameter (ONSD) with uhrasonography.Methods From July 2008 to December 2011,90 patients with brain injury were selected.According to the admission Glasgow Coma Scale (GCS),they were divided into experimental group 1 (60 cases with light and medium brain injury,GCS 9-15 scores) and experimental group 2 (30 cases with severe brain injury,G CS 3-8 scores).The conventional physical examination 50 cases and volunteers 50 cases in neural surgical outpatient were selected as control group.ONSD of all groups were measured 3 mm behind the globe through orbital by ultrasonography with different time after admission.The intracranial pressure was measured at 0.5-1.0 h after ultrasonography by lumbar vertebra puncturing in different groups and analyzed statistically.Results After admission 1,3,7,14 d; ONSD in experimental group 1 respectively was (4.49 ± 0.31),(4.45 ±0.28),(4.41 ±0.32),(4A3 ±0.25) mm;ONSD in experimental group 2 respectively was (5.69 ±0.32),(6.30 ± 0.47),(5.71 ± 0.26),(4.77 ± 0.36) mm.After admission 1,3,7,14 d ;the intracranial pressure in experimental group 1 respectively was (78 ± 16),(83 ± 17),(90 ± 15),(82 ± 14) mmH2O (1 mmH2O =0.0098 kPa) ;the intracranial pressure in experimental group 2 respectively was (230 ± 22),(269 ± 21),(228 ± 13),(147 ± 22) mumH2O.ONSD and the intracranial pressure was (4.58 ± 0.41)mm and(88 ± 10) mmH2O in control group.ONSD and the intracranial in Experimental group 1 and control group had no difference (P ＞0.05); those of control group and experimental group 2,experimental group 1 and experimental group 2 had difference (P＜ 0.05).Conclusions ONSD and the intracranial pressure in light,medium brain injury patients have no change.In patients with severe brain injury after different time,the intracranial pressure change differently,ONSD enlargement with the intracranial pressure rising,examination of ONSD by ultrasonography can reflect the changes of the intracranial pressure,it is a new method to evaluate the intracranial pressure,has the certain application value.

OBJECTIVEThe theory of strain energy density (SED) was combined with finite element analysis to investigate alveolar bone remodeling of the mandibular first molar with different levels of periodontal attachment under mastication loading.

METHODSThree-dimensional finite element models of the mandibular first molar with different levels of periodontal attachment were established. Based on SED theory, the user material subroutine (UMAT) (used by ABAQUS software) was developed by ourselves to simulate the remodeling process of mandibular bone. The stress distributions and bone density changes were analyzed under different mastication loading. The influence of loading magnitude on alveolar bone remodeling with different levels of periodontal attachment was investigated.

RESULTSThe results showed that the neck of buccal, lingual regions and root apex area experienced a higher stress. The stress and the density of alveolar bone increased gradually with the enhancing of the bite force at the beginning. Then the density would appear declining when the bite force exceeded the extreme load. The extreme load reduced from 420 N to 240 N with the periodontal attachment falling from normal to 1/2 of root length also. And the remodeling rate of the bone was faster as the loading increasing.

CONCLUSIONThe capability of the periodontal tissue for supporting the teeth will drop gradually as the periodontal attachment level dropping. And the decline of bone density also appeared in earlier time. The change of density is associated with mastication loading during the bone remodelling. And reducing the occlusal force properly to the molar with different attachment level is benefit for clinical treatment and prognosis of periodontal disease.

Bite Force ; Bone Density ; Bone Remodeling ; Finite Element Analysis ; Humans ; Mandible ; Mastication ; Models, Biological ; Molar ; Stress, Mechanical ; Tooth Root

Objective To explore the clinic application value of ultrasonography examination of optic nerve sheath diameter(ONSD) in brain injury.Methods From July 2008-June 2011,90 cases of brain injured patients were chosen as experimental group including light (A group),medium (B group),and heavy (C group) brain injured patients according to the admission GCS score ;50 cases of conventional physical examination and 90 cases of volunteers 50 in neurosurgical outpatient were chosen as control group.The ONSD of both groups were measured 3 mm behind the globe through orbital using color sonographic with different time after admission.3 times measurements were carried out for every optic nerve sheath.All client's ONSD mean and standard deviation were calculated.In 0.5 h after color dopplar ultrasound examination,lumbar vertebra puncturing measured intracranial pressure in different groups.Results After admission (1d,3 d,7 d,14 d),the ONSD of A group was (4.54 ±0.32)mm,(4.42 ±0.30)mm,(4.44 ±0.32) m,and (4.43 ± 0.25) mm,respectively; The ONSD of B groups was (4.48 ± 0.28) mm,(4.52 ± 0.24) mm,(4.46 ±0.28)mm,and (4.38 ±0.22)mm,respectively; The ONSD of C group was (5.67 ±0.35)mm,(6.36 ± 0.42) mm,(5.65 ± 0.23) mm,and (4.76 ± 0.35) mm,respectively.After admission (1 d,3 d,7 d,14 d),the intracranial pressure (IP) of A group was (82 ± 11) mmH2O,(79 ± 12) mmH2O,(90 ±15) mmH2O,and (86 ± 14) mmH2O,respectively; The IP of B group was (78 ± 15) mmH2O,(85 ± 10)mmH2O,(78 ± 16) mmH2O,(80 ± 11) mmH2O,The IP of C group was (225 ± 26) mmH2 O,(288 ± 23)mmH2O,(256 ± 23) mmH2O,(122 ± 18) mmH2O,respectively.Group D had the ONSD average of (4.58± 0.41)mm and IP of (88 ± 10)mmH2O after eyeball 3-mm place.No difference was found between A and B,A and D,or B and D (P＞0.05) ; A difference was found between A and C,B and C,or D and C (t =12.24～24.67,P＜0.01).Conclusions The ONSD and IP in light medium brain injured patients had no change.In patients with severe brain injury,IP changed with the time after injury,the ONSD increased with the IP,the ultrasonography examination of ONSD with the important value in the diagnosis and treatment can respond the IP increase,which is a non-invasion,convenient,fast,and feasible method for evaluation of cranial high pressure.

ObjectiveTo study the expression changes of peripheral blood monocyte human leukocyte antigen DR (HLA-DR) in patients with severe craniocerebral injury,and investigate the correlation between HLA-DR expression and infection and prognosis.MethodsNinety patients with craniocerebral injury were selected as experimental group and were divided according to the Glasgow coma scale (GCS) score after hospitalization into experimental group 1 (GCS score 13-15 scores ),experimental group 2 (GCS score 9-12 scores) and experimental group 3 (GCS score 3-8 scores) with 30 patients each,which were moderate,medium,severe craniocerebral injury,respectively.Thirty healthy people were chosen at the same period as control group.The HLA-DR expression of experimental group was detected after 1,3,7 and 14 d of admission by flow cytometry,and the HLA-DR expression of control group was detected on the day they got physical examination.The rates of infection,cure,disability,vegetative state and mortality were counted after 30 d of admission.ResultsThe HLA-DR expressions in experimental group 1 and experimental group 2 after 1,3,7,14 d of admission were (28.11 ± 2.37),(26.45 ± 1.63),(27.75 ± 1.83),(27.15 ± 2.17) MCF and (29.34 ±2.07),(27.55 ± 1.63),(28.42 ± 1.94),(29.46 ±2.12) MCF,which had no statistical difference compared with that in control group [(29.18 ± 1.91 ) MCF](P＞ 0.05).The HLA-DR expressions in experimental group 1 and experimental group 2 after 1,3,7 d of admission and control group had statistical differences compared with those in experimental group 3 after 1,3,7 d of admission [(18.02 ± 1.78),(16.05 ± 1.97 ),(20.76 ± 1.65) MCF ] (P ＜ 0.05).The HLA-DR expressions in experimental group 1 and experimental group 2 after 14 d of admission and control group had no statistical significance compared with that in experimental group 3 after 14 d of admission [ (26.13 ± 2.15) MCF](P＞ 0.05).The infection rates of experimental group 1,experimental group 2 and experimental group 3 were 0,3.6％(1/28),82.8％(24/29),respectively,while the cure rates were 100.0％ (30/30),100.0％ (28/28),10.3％ (3/29),the disability rates were 0,0,41.4％ (12/29),the vegetative state rates were 0,0,20.7％ (6/29),and the mortality were 0,0,27.6％ (8/29).There was no statistical significance in the rates of infection,cure,disability,vegetative state and mortality between experimental group 1 and experimental group 2 (P＞ 0.05 ).While there was statistical differences in the rates of infection,cure,disability,vegetative state and mortality among experimental group 1,experimental group 2 and experimental group 3 (P ＜ 0.05).ConclusionsThe HLA-DR expression changes of patients with moderate and medium craniocerebral injury after 1,3,7,14 d of admission are not significant.The HLA-DR expression of patients with severe craniocerebral injury begins to decline from 1 d after injury,declines obviously at 3 d,increases from 7 d,returns to normal level at 14 d.The decline of HLA-DR expression in patients with severe craniocerebral injury is correlated with the infection,and predicts poor prognosis.