Objective: To explore the association between daytime outdoor physical activity (OPA) and oral health indicators among primary school students, aiming to provide evidence for developing oral health intervention strategies based on natural exposure. Methods: In October 2023, based on the "Tianchang Children s Light Exposure and Growth Development Cohort", 799 second and third grades children were recruited from two primary schools in Tianchang, Chuzhou City, Anhui Province. Physical activity intensity and light exposure were objectively monitored for 24 hours over 5 consecutive days using triaxial accelerometers synchronized with portable illuminance meters. Standardized oral examinations were performed to record dental caries, gingivitis, and malocclusion. Demographics, lifestyle variables, and household socioeconomic data were collected via questionnaires. Multiple linear regression (for the number of carious teeth) and Logistic regression (for gingivitis risk) were used to analyze the relationship between daytime outdoor moderate to vigorous physical activity (MVPA) and oral health outcomes. Results: The average daytime outdoor MVPA was (0.76±0.35)h, with (0.95±0.40)h on weekdays and (0.49±0.47)h on weekends. The detection rates for dental caries, gingivitis, and malocclusion were 31.0%, 4.6%, and 59.7%, respectively. Compared with children with good oral health, the duration of outdoor MVPA on school days was reduced in children with caries or gingivitis ( Z =-11.4, -5.01, both P <0.01). Multiple regression analysis showed that after adjusting for factors such as gender, age, body mass index, oral hygiene behaviors, an increase in daytime outdoor MVPA duration was associated with a decrease in the number of dental caries ( β=-0.64, 95%CI =-0.93 to -0.35) and a reduced risk of gingivitis ( OR= 0.58 , 95%CI =0.34-0.98) in primary school students (both P <0.05). The association was primarily observed on school days ( β=-0.72, 95%CI = -1.07 to -0.37; OR=0.42, 95%CI =0.21-0.85) (both P < 0.05). Conclusions Daytime outdoor MVPA on weekdays is significantly associated with a lower number of carious teeth and a reduced risk of gingivitis in primary school students. Increasing daytime outdoor activities on weekdays may serve as a promising and potential strategy for promoting children s oral health.

ObjectiveTo construct a machine learning model combining two-dimensional shear wave elastography （2D-SWE） and serological markers， and to investigate its clinical value in differentiating primary biliary cholangitis （PBC） from overlap syndrome （OS）. MethodsA total of 199 patients with pathologically confirmed PBC or OS in Nantong Third People’s Hospital from January 2021 to December 2025 were retrospectively enrolled， with 125 patients in the PBC group and 74 in the OS group. The patients were randomly divided into a training set with 139 patients and a test set with 60 patients at a ratio of 7∶3. Related data were collected， including serological markers， conventional two-dimensional ultrasound parameters， and 2D-SWE parameters （including velocity of shear wave ［VS］ and liver fibrosis index ［LFI］）. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate Logistic regression analyses were used to identify independent predictive factors， which were then incorporated into six machine learning models， and 5-fold cross-validation was used for optimization of parameters. The indicators including the area under the receiver operating characteristic curve （AUC） were compared in the test set to determine the best model， and the SHapley additive exPlanations （SHAP） analysis was used for model interpretation. ResultsFemale patients accounted for 87.8% in the OS group and 79.2% in the PBC group. Compared with the PBC group， the OS group had significantly higher age， VS， LFI， splenic area， aspartate aminotransferase， total bilirubin， prothrombin time， immunoglobulin G （IgG）， and immunoglobulin M （Z=-2.883， -6.524， -4.000， -3.061， -2.194， -2.372， -4.079， -6.964， and -2.709， all P<0.05） and a significantly lower platelet count （Z=4.098， P<0.001）， and there were also significant differences between the two groups in the proportion of patients with positive anti-nuclear antibody， fibrosis stage， and inflammation grade （χ²=3.458， 63.198， and 101.038， all P<0.05）. Variables without multicollinearity were included in the regression analysis， and the multivariate Logistic regression analysis showed that VS （odds ratio ［OR］=4.503， 95% confidence interval ［CI］： 1.698 — 11.943， P=0.003）， LFI （OR=1.813， 95%CI： 1.050 — 3.132， P=0.033）， and IgG （OR=1.121， 95%CI： 1.026 — 1.226， P=0.012） were independent predictive factors for differentiating PBC from OS. Six machine learning models were constructed based on these variables， among which the logistic regression model showed the best predictive performance in the test set， with an AUC of 0.881 （95%CI： 0.788 — 0.974）， a sensitivity of 0.731， and a specificity of 0.794. The SHAP analysis showed that IgG contributed the most to model prediction. ConclusionThe noninvasive multimodal machine learning model combining 2D-SWE parameters （VS， LFI） and serum IgG can effectively differentiate PBC from OS， providing a reference for clinical decision-making regarding the need for liver biopsy.

Objective: To investigate the prevalence of human T-lymphotropic virus (HTLV) infection among blood donors in Hunan Province from 2022 to 2024. Methods: A total of 1 830 342 blood donors from 14 prefecture-level blood centers in Hunan Province over the past three years were screened for anti-HTLV-Ⅰ/Ⅱ using enzyme-linked immunosorbent assay (ELISA). Initially reactive samples were further tested with Line Immunoassay (LIA )/MP-Western blot and RT-PCR nucleic acid test for confirmation. Blood donors confirmed positive for HTLV were tracked and followed up. Results: From 2022 to 2024, the initial ELISA reactive rate for anti-HTLV-I/II among blood donors in Hunan Province was 1.36 per 10 000 (249/1 830 342). The confirmed positive rate was 0.20 per 10 000 (37/1 830 342), accounting for 14.86% of the initially reactive donors. The follow-up success rate for confirmed HTLV-positive blood donors was only 18.92%, while that for HTLV-indeterminate donors was 54.17%. Conclusion: The confirmed HTLV infection rates in Yueyang, Loudi, Shaoyang, Yiyang, and Zhuzhou cities were higher than the provincial (0.20 per 10 000). Chenzhou, Yongzhou, Zhangjiajie, and Xiangxi were identified as low prevalence areas, with an infection rate of 0. The overall follow-up success rate was low, indicating significant difficulties and bottlenecks in follow-up work. The comprehensive screening for HTLV and follow-up studies in Hunan provide valuable data to further improve blood safety testing strategies and risk warning mechanisms.

The composition of the Gut Microbiome(GM)is regulated by numerous factors,including geography,ethnicity,diet,and genetics.This review systematically synthesizes studies on the GM across different geographic regions and ethnic minority groups in China.It focuses on elucidating the impact of geographical factors and ethnic backgrounds on GM composition and structure and provides an in-depth discussion on the association between ethnicity-specific microbial taxa,their metabolic functions,and susceptibility to diseases.By systematically comparing microbial compositional differences in microbiota-related diseases among different populations,this review aims to uncover the underlying patterns.The findings are expected to provide a theoretical foundation for ethnicity-specific GM research,the elucidation of disease mechanisms,and the development of targeted prevention and control strategies.

Objective:To apply quality function deployment(QFD)method to formulate management strategy for usage quality of medical equipment,so as to provide a reference for ensuring the safety of using medical equipment.Methods:A questionnaire about the guarantee for the requirement of usage quality of medical equipment was designed,so as to obtain the information of the users of clinical department of The Affiliated Xinghua Hospital to Kangda College of Nanjing Medical University for the requirement of usage quality of medical equipment in using medical equipment from February to April 2024,and confirm the important degree of the requirement.Then,the QFD method was adopted to convert the requirements of users for medical equipment to the required technical indicators of guaranteeing usage quality of medical equipment,and the priority technical guarantee measures of the important degree were quantitatively obtained.Results:A total of 478 questionnaires were issued,and 442 valid questionnaires were retrieved,and the valid recovery rate of questionnaire was 92.47%.The questionnaire identified and analyzed 12 requirements of three dimensions of users in using medical equipment,and they were converted to the top six technical guarantee measures of the strategy of quality management of using medical equipment,which included equipment function,criticality of equipment mission,type of service provider,compliance of rules and regulations,requirements of maintenance,and service life.Conclusion:QFD method can help medical engineering department to establish a management system of usage quality with quantitative analysis for medical equipment,and enhance the management level for the quality of medical equipment in medical institutions,and realize maximize benefit of medical equipment.

Background: Epimedii Folium is well known for its medicinal value. Four Epimedium species—Euphorbia brevicornu, E. sagittatum, E. pubescens, and E. koreanum—are the designated original plants of Epimedii Folium. Objective: The objective of this study is to facilitate the identification of the four Epimedium species and clarify their distributional responses to climate change. Methods: In this study, we assessed the genetic divergence of the four species and identified the molecular markers for species identification by using chloroplast genome sequences. Furthermore, we forecasted the distribution of potentially suitable regions of the four species Folium under climate change. Results: The authors obtained 26 chloroplast genome sequences of the four species and identified 1393 variable sites and 273 indel events. Genetic divergence analyses revealed that E. koreanum had long genetic distance from the other three species. Compared with the complete chloroplast genome, six hypervariable markers were discovered, and both rps4-trnL and ndhF were chosen as Epimedii Folium-specific DNA barcodes. Climate change is expected to influence the geographical distribution of the four Epimedium species, which were primarily found in China, South Korea, and Japan, leading to both expansion and contraction of their distribution ranges. Conclusion: Two identification markers were selected as the specific DNA barcodes for all four original plant species of Epimedii Folium. In addition, the shift of potential suitable area in various climate scenarios has been predicted. With the support of identification markers and the dynamics of suitable distribution areas, we are able to establish a foundation for the sustainable utilization of medicinal Epimedium resources in the future.

Abstract The association of childhood sleep disorders and common oral diseases are increasingly recognized as public health challenges. The paper reviews epidemiological evidence on the bidirectional associations between multidimensional sleep indicators-including insufficient sleep duration,sleep related disorders (sleep apnea and bruxism) and evening chronotype and common oral diseases such as dental caries, periodontal diseases, and craniofacial developmental anomalies. It also explores potential neurobiological mechanisms underlying these associations. The review proposes that future research should employ longitudinal cohort studies and multi omics technologies to further validate prospective causal relationships, thereby providing a theoretical foundation for developing childhood health interventions.

Parkinson's disease(PD),the second most common neurodegenerative disorder,involves dopaminergic neuron degeneration,abnormal α-synuclein aggregation,and energy metabolic disruption.AMP-activated protein kinase(AMPK),a key cellular energy metabolic regulator,has multiple roles in PD progression.This paper explores the structure and function of AMPK and its regulatory mechanisms in PD,including its roles in modulating neuronal energy metabolism,mediating mitochondrial function,inhibiting oxidative stress,inducing autophagy,and regulating neuroinflammation and apoptosis.Potential AMPK-based PD therapies are also reviewed,including natural products(e.g.,resveratrol,curcumin),gene therapy,and targeted delivery systems,while noting the need to precisely control the dual effects of AMPK(e.g.,overactivation causes energy stress).Future research should focus on clarifying interactions between AMPK and other pathways(e.g.,SIRT1 and NF-κB)and improving the spatiotemporal specificity of targeted treatments for clinical translation.This study offers crucial theoretical support for understanding mechanisms underlying PD and developing AMPK-targeted therapies.

Parkinson's disease(PD),the second most common neurodegenerative disorder,involves dopaminergic neuron degeneration,abnormal α-synuclein aggregation,and energy metabolic disruption.AMP-activated protein kinase(AMPK),a key cellular energy metabolic regulator,has multiple roles in PD progression.This paper explores the structure and function of AMPK and its regulatory mechanisms in PD,including its roles in modulating neuronal energy metabolism,mediating mitochondrial function,inhibiting oxidative stress,inducing autophagy,and regulating neuroinflammation and apoptosis.Potential AMPK-based PD therapies are also reviewed,including natural products(e.g.,resveratrol,curcumin),gene therapy,and targeted delivery systems,while noting the need to precisely control the dual effects of AMPK(e.g.,overactivation causes energy stress).Future research should focus on clarifying interactions between AMPK and other pathways(e.g.,SIRT1 and NF-κB)and improving the spatiotemporal specificity of targeted treatments for clinical translation.This study offers crucial theoretical support for understanding mechanisms underlying PD and developing AMPK-targeted therapies.

Alzheimer's disease(AD)is a neurodegenerative disorder associated with aging,characterized by neurofibrillary tangles,accumulation of amyloid-β(Aβ)plaques,and neuronal death.These pathological changes lead to a gradual decline in cognitive function,ultimately impairing the ability to perform daily activities.Currently,treatment options for AD are limited,with pharmacological interventions often being ineffective and frequently accompanied by side effects.Therefore,the study of non-pharmacological therapies,especially nutritional interventions,has become particularly important.Omega-3 polyunsaturated fatty acids(ω-3PUFAs)are essential fatty acids crucial for health,primarily found in fish oil and certain plant oils.They play a key role in anti-inflammatory,antioxidant,neuroprotective,and immunomodulatory activities.Epidemiological evidence and clinical trials have shown that supplementation with ω-3PUFAs is associated with improved cognitive function,with particularly positive effects demonstrated in the use of docosahexaenoic acid(DHA)and eicosapentaenoic acid(EPA).This article reviews the role of ω-3PUFAs in AD and the latest advances in their mechanism of action,with a particular focus on their ability to reduce brain Aβ deposition and Tau protein phosphorylation,inhibit oxidative stress and neuroinflammation,maintain the integrity of the blood-brain barrier,and regulate energy metabolism.However,current research findings remain inconsistent,especially regarding the significant differences in effects among individuals with different genotypes.Therefore,future studies need to further explore the role of ω-3PUFAs in early intervention and optimize their dosage and formulations to achieve the best neuroprotective effects.Additionally,this article provides dietary recommendations and dosage suggestions based on existing research,hoping to offer new directions for the prevention and treatment of AD.