ObjectiveTo establish a regional risk assessment system for hospital-acquired infections in neurosurgery department of general hospital, and to evaluate its prevention and control effectiveness. MethodsFailure mode and effect analysis (FMEA) was used to identify the core risk factors for infections in neurosurgery department. The risk priority number (RPN) of each risk factor was calculated to determine the priority intervention targets. Targeted interventions were developed and continuously refined through the plan-do-check-act (PDCA) cycles. Data from January to June 2023 (control group) and July to December 2023 (intervention group) were collected to compare the differences in environmental hygiene monitoring qualification rate, incidence rate of hospital-acquired infections among inpatients, and detection rate of bacterial antimicrobial resistance. ResultsHigh-risk factors for hospital-acquired infections in neurosurgery department included patient-related risk factors, inadequate implementation of isolation measures for special infections, and poor compliance with surgical site infection (SSI) prevention protocols. After intervention, the environmental hygiene qualification rate significantly increased from 81.55% to 100.00% (χ²=120.49, P<0.001). The overall hospital-acquired infection rate among inpatients decreased from 2.62% to 2.45%, the infection rate of per case declined from 3.12% to 2.84%, and the detection rate of multidrug-resistant organism infections reduced from 43.72% to 36.79%. Additionally, antimicrobial utilization rate decreased from 48.75% to 42.53% (χ²=34.09, P<0.001). ConclusionThe FMEA-based risk assessment system can effectively identify critical infection risks in neurosurgery department, and targeted interventions can significantly improve infection prevention and control performance.

Objective To analyze the status of persistent human papillomavirus (HPV) infection and the distribution of viral subtypes in the Zhengzhou region. Methods Clinical data of 55239 patients who underwent HPV-DNA genotyping tests from 2018 to 2024 were collected. On the basis of HPV follow-up results, patients were divided into three groups: 849 cases of infection with the same HPV type, 255 cases of persistent infection with different HPV types, and 857 cases of transient HPV infection. Results Among the 9232 initially-screened patients who were positive with HPV, the high-risk HPV (HR-HPV) positive rate was 84.6% (7813/9232), and predominant subtypes were HPV-16 (20.8%), HPV-52 (17.2%), and HPV-53 (9.6%). The low-risk HPV (LR-HPV) positive rate was 15.4% (1419/9232), mainly HPV-81 (28.1%) and HPV-42 (27.0%). Among the 1961 follow-up cases, the rates of persistent and non-persistent infections with the same HPV type were 35.7% (701/1961) and 7.5% (148/1961), respectively. The rates of persistent and non-persistent infections with different HPV types were 10.9% (214/1961) and 2.1% (41/1961), respectively. Meanwhile, 43.7% (857/1961) tested negative upon follow-up. Among the 701 cases of persistent infection with the same HPV type, HR-HPV accounted for 85.7% (601/701), and LR-HPV accounted for 14.3% (100/701). Among the 214 cases of persistent infection with different HPV types, 89.7% (192/214) were high-risk transitions, and 10.3% (22/214) were low-risk transitions. Regardless of HPV types, HR-HPV was more likely to cause persistent infection than LR-HPV. In addition, over 60% of HR-HPV persistent infections resolved within 18 months, 30% developed into persistent infections, and only 15% of patients had persistent infections that last more than 24 months. Conclusion Persistent HPV infections are predominantly high-risk types. Most patients clear the infection within 18 months, approximately 30% develop persistent infections, and about 15% of patients have persistent infections that last more than 24 months. However, the HR-HPV persistent infection rates across different age groups slightly differ.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Objective:To prepare novel dental composite resins using zinc(Zn)-and nitrogen(N)-modified titanium dioxide(TiO?)nanoparticles(NPs)and mesoporous alumina(Al?O?,r type,20 mm)NPs as reinforcing fillers,systematically evaluating their antibacterial activity,mechanical strength,basic performance,and biosafety to obtain the dental composite resins with excellent antibacterial activity and mechanical strength.Methods:Zn-N-TiO? NPs and mesoporous Al?O? NPs were added into a resin matrix at varying mass ratios to prepare five composite resins:control group(no filler),group 0(Zn-N-TiO?∶Al?O?=1∶0),group 1(Zn-N-TiO?∶Al?O?=1∶1),group 2(Zn-N-TiO?∶Al?O?=1∶2),and group 3(Zn-N-TiO?∶Al?O?=1∶3).Plate colony counting method was used to detect the number of adhered bacteria on composite resin surfaces in various groups and calculate the antibacterial rate;scanning electron microscope(SEM)was used to observe the morphology of adhered bacteria in various groups;universal testing machine was used to measure flexural strength(FS)and elastic modulus(EM)of composite resins in various groups;SEM was used to observe fracture surface morphology of composite resins in various groups;microhardness tester was used to determine Vickers microhardness of the composite resins in various groups;Fourier transform infrared spectroscope was used to detect double bond conversion rate(DC)after 20 s photocuring and calculate curing depth;water contact angle meter was used to measure water contact angle(WCA),water sorption property(WSP),and water solubility level(WSL)of composite resins in various groups;cell counting kit-8(CCK-8)method was used to evaluate relative growth rate(RGR)of the mouse fibroblast L-929 cells cultured in composite resin extracts on days 1,3,and 5 and determine in vitro cytotoxicity grade.Results:The plate colony counting results showed that compared with control group,the colony counts on agar plates in the other groups were significantly reduced,with group 1 showing the lowest count.The SEM images results showed densely distributed and morphologically intact Streptococcus mutans in control group;small clusters of bacteria with depressed cell membranes in group 0 and group 3;sparsely distributed bacteria with obvious membrane shrinkage and cytoplasmic leakage in group 1 and group 2.No statistically significant difference in colony counts was found between group 1 and group 2(P>0.05),but both were lower than the other groups(P<0.05).All the composite resins in experimental groups exhibited>85%antibacterial rates,with group 1 and group 2 exceeding 99%.The composite resins in group 0 showed the lowest FS.With addition of mesoporous Al?O?,the FS of the composite resin in group 1 and group 2 were significantly increased,with the composite resin in group 2 showing the highest FS among all groups.Although the FS of the composite resin in group 3 was lower than that in group 2,but it remained higher than other groups(P<0.05).The SEM images results showed that in control group,the smooth-surfaced sillicon dioxide(SiO?)particles exhibited clear fracture interfaces with resin matrix,with>50%particle exposure;the composite resin in group 0 showed similar morphology and large Zn-N-TiO? agglomerates with tight filler-matrix bonding;the composite resin in group 1,2,and 3 showed resin adhesion to SiO? surfaces(<50%particle exposure)and uneven fracture surfaces.Fractured SiO? spheres were observed in group 2.Filler distribution was uniform in group 1 and group 2,while the minor NP agglomeration occurred in group 3.The composite resin in control group showed the lowest EM.The EM was significantly improved in experimental groups,with group 3 having the highest value.Group 0 exhibited the lowest Vickers microhardness,showing statistically significant differences among other groups(P<0.05).The Vickers microhardness of the composite resion was gradually increased with the rising of Al?O? content.The resins in group 2 and group 3 achieved>45 HV hardness,representing increases of 29.73%and 33.82%compared with control group,and 51.34%and 56.28%compared with group 0.No significant differences in DC of the composite resin were found among groups(P>0.05).The depth of cure for all composite resin groups exceeded 4 mm,with no significance differences observed between various groups(P>0.05).The composite resin in group 0 showed the smallest WCA.The hydrophobicity of the composite resion was increased with the rising of Al?O? content,but all the WCA values remained<80°.The composite resin in group 3 had the largest WCA without statistical significance compared with group 2(P>0.05).Filler incorporation reduced the water sorption/solubility.The composite resin in the CCK-8 assay results showed the composite resins in all groups had RGR>75%,meeting in vitro safety standards.Conclusion:Reinforcing fillers impart superior antibacterial activity and mechanical properties to composite resins.Under experimental conditions,group 2 composite resin achieves optimal comprehensive performance in antibacterial efficacy and mechanical strength,demonstrating promising clinical application potential.

Objective To explore the efficacy of Da Shuyu Gao(DSG,a formulation developed from the modification of Shuyu Wan and Ziwan Decoction)in treating persistent postural-perceptual dizziness(PPPD)based on the theory of phlegm-qi obstruction.Methods A prospective study was conducted on 120 cases of PPPD patients admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 2022 to July 2023.The patients were randomly divided into a combination group and a control group using a random number table,with 60 patients in each group.The control group received conventional western medicine treatment(Betahistine+Mecobalamin),while the combination group was treated with the decoction of DSG orally in addition to the conventional treatment.The treatment course for the two groups lasted for 2 months.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome score,Somatic Symptom Self-Rating Scale(SSSRS),Hamilton Anxiety Scale(HAMA)score,Hamilton Depression Scale(HAMD)score,Pittsburgh Sleep Quality Index(PSQI)score,and the frequency and duration of dizziness episodes.After two months of treatment,the clinical efficacy of the two groups was compared.Results(1)After 2 months of treatment,the total effective rate of the combination group was 93.33%(56/60),and that of the control group was 78.33%(47/60).The intergroup comparison(tested by chi-square test)showed that the clinical efficacy of the combination group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the scores of TCM symptoms of dizziness,tinnitus,vexation,irritability,dry mouth,and bitterness in the mouth in both groups were improved compared to those before treatment(P＜0.05),and the combination group showed significant improvement compared with the control group(P＜0.01).(3)After treatment,the scores of the cognitive,imaginative,biological,irritability,and inhibitory dimension of SSSRS,as well as the total scores on the SSSRS were significantly improved in both groups compared to those before treatment(P＜0.05),and the combination group showed significant improvement compared with the control group(P＜0.01).(4)After treatment,HAMA,HAMD,and PSQI scores were significantly decreased in both groups compared to those before treatment(P＜0.05),and the decrease in the combination group was superior to that in the control group(P＜0.01).(5)After treatment,the frequency and duration of dizziness episodes were significantly decreased in both groups compared to those before treatment(P＜0.05),and the decrease in the combination group was superior to that in the control group(P＜0.01).Conclusion DSG,formulated based on the theory of phlegm-qi obstruction and clinical practice,demonstrates significant efficacy in treating PPPD.It is effective in decreasing TCM syndrome scores,alleviating somatic symptoms,improving emotional disorders such as anxiety and depression,enhancing sleep quality,and reducing the frequency and duration of dizziness episodes,thereby improving patients'quality of life.The application of DSG will provide a new approach for the clinical treatment of PPPD.

Rare diseases have a significant and profound impact on society, the economy, and the healthcare system. The path to developing drugs for rare diseases is particularly arduous. Due to the small number of patients and limited market demand, pharmaceutical companies don′t have enough incentives and resources to invest in drug research and development. Additionally, the long development cycles, high costs, and high risks have led to a number of potential therapeutic drug failures at the early stages of development. This article summarizes a series of encouraging policies adopted by the National Medical Products Administration for rare diseases, which is an important public health issue, as well as the achievements in the review and approval of rare disease drugs in recent years. These policies have accelerated the approval process. Meanwhile, the policies ensure the safety and effectiveness of drugs and offer more treatment options and hopes to patients with rare diseases. With the continuous effort at optimizing the policy environment and the advancement of research and development technologies, China′s drug regulatory authorities will continue to focus on the clinical needs of rare diseases, to implement " patient-centered " approach to drug development, inject new vitality into the research and development of drugs of rare diseases, and offer more precise and effective treatment choices for patients with rare diseases.

Cibotii Rhizoma has a long history of folk usage and clinical applications,which is commonly used to treat symptoms such as waist and knee soreness,numbness of hands and feet.Its chemical components mainly include sugars and glycosides,aromatics,volatile oils,pterosins,flavonoids,steroids,pyranones,amino acids and inorganic elements.Pharmacological studies have shown that Cibotii Rhizoma has antioxidant,anti-inflammatory,anti-osteoporosis,gastrointestinal protection,antibacterial,liver protection,anticancer,analgesic and other effects.This paper systematically reviews the research status of chemical constituents,pharmacological effects and quality control of Cibotii Rhizoma,which provides reference for the development and rational use of Cibotii Rhizoma.

The concept of "Bo" （搏） originates from The Inner Canon of Yellow Emperor （《黄帝内经》）. Its original meaning mostly refers to gathering and attacking， but in pulseology it reflects the potential of conflict and was widely used in the methods of taking pulse from zang-fu organs and yin and yang. This paper conducted a literature research on the concept and connotation of "Bo" （搏）， and summarized the seven meanings of it， including contention， intersection， stop， change， attachment， pulse， and pathological pulse. At the same time， the pathomechanism of "Bo" （搏） was explained and its four characteristics are summarized， including contention to transformation， concurrent transformation， latent pathogen gathering， and changes transforming to qi； the pathomechanism and locations of "Bo" （搏） were also summarized， including zang-fu organs， channels and collaterals， five body constituents， qi level， blood level， and other aspects， involving therapeutic methods like the opening and diffusing， expressing and tonifying， regulating balance. The concept and connotation of "Bo" （搏） were systematically studied and improved to provide new perspectives and ideas for the diagnosis and treatment of many modern intractable diseases.

Objective: To explore the relationship between adolescent sports participation and aggression, so as to provide a reference basis for sports interventions aimed at reducing adolescent aggression. Methods: The search databases used in the study included China National Knowledge Infrastructure, Vipo, Wanfang, Web of Science, Ebsco, Pro Quest, and PubMed, and the search period was from the construction of the database to October 22, 2023. The search terms for sports participation were "sport" "exercise" "exercise" "physical activity" "physical activity"; the search terms for aggressive behavior were "assault" "aggressive behavior" "aggression"; the search terms for aggressive behavior were "assault" "aggressive behavior" "aggression" "bullying", and "violence", and the above keywords were jointly searched. Foreign language data were searched using Web of Science, Ebsco, Pro Quest, PubMed and supplemented by Google Scholar. The search terms for sports participation were sport, athletics, exercise, train, fitness, physical exercise, physical activity, physical education; and the search terms for aggressive behavior were aggression, bullying, violence, atrocity, fighting, aggressive behavior, physical assault; the above keywords were jointly searched. Statistical analysis was performed using CMA 3.0 software. Results: A total of 20 studies with 80 effect sizes and 9 308 subjects were included. The Metaanalysis showed that adolescent sports participation was moderately negatively correlated with indicators of aggression (r=-0.11), physical aggression (r=-0.14), verbal aggression (r=-0.14), and hostility (r=-0.16), and weakly negatively correlated with indicators of anger (r=-0.08) (P<0.05). Aggressive behavior was influenced by gender, school stage, mode of exercise, and the sports participants region (P<0.05). Conclusions Exercise participation has a positive impact on reducing aggressive behavior in adolescents, and mode of exercise, age, gender, and region are moderating variables in the relationship. Schools can reduce adolescent aggression by developing exercise and physical education interventions.

ObjectiveTo explore the mechanism of Buzhong Yiqitang in ameliorating inflammatory injury in autoimmune thyroiditis (AIT) mice based on the Toll-like receptor 4（TLR4）/nuclear transcription factor-kappa B（NF-κB）/absent in melanoma 2（AIM2）inflammasome signaling pathway. MethodThe 120 genetically susceptible 8-week-old NOD.H-2^h4 mice were selected and randomly divided into control group， model group， low， medium and high dose groups of Buzhong Yiqitang （4.78， 9.56， 19.12 g·kg^-1）， and western medicine group （selenium yeast tablets， 3.033×10^-5 g·kg^-1）. The AIT model mice in each group drank ad libitum 0.05% sodium iodide aqueous solution for 8 weeks to establish the AIT model， and the control group drank ad libitum distilled water. Eight weeks later， the mice in each dosing group were divided into groups and gavage. The swelling of thyroid tissue was observed with the naked eye， and the weight of spleen was weighed. The content of serum inflammatory factors interleukin-1β （IL-1β）， interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α） was measured by enzyme-linked immunosorbent assay （ELISA）， and Real-time PCR was used to detect the expression of HMGB1， TLR4， AIM2， NF-κB p65，apoptosis-associated speck-like protein（ASC），cysteinyl aspartate-specific protease-1（Caspase-1）， IL-1β mRNA. Western blot was used to detect the expression of high motility group protein 1 （HMGB1）， TLR4， AIM2， NF-κB p65， phosphorylation（p）-NF-κB p65， ASC， Caspase-1， and IL-1β proteins in thyroid tissue， and immunofluorescence staining was used to observe the protein expression of HMGB1， AIM2， and NF-κB p65 in thyroid tissue of mice. ResultCompared with the control group， the thyroid tissue of mice in the model group was significantly swollen， the spleen quality was significantly increased， and the expression of HMGB1， TLR4， NF-κB p65， AIM2， ASC， Caspase-1， IL-1β in thyroid tissue was significantly increased （P<0.01）. Compared with the model group， the swelling of thyroid tissue in mice in each dose group of Buzhong Yiqitang was improved， the quality of spleen was significantly reduced， and the expression of HMGB1， TLR4， AIM2， NF-κB p65， p-NF-κB p65， ASC， Caspase-1， IL-1β in thyroid tissue was significantly reduced （P<0.05， P<0.01）. ConclusionBuzhong Yiqitang can effectively improve the inflammatory injury of AIT， and regulating the abnormal activation of the TLR4/NF-κB/AIM2 inflammasome signal pathway may be one of its intervention mechanisms.