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.

Clonorchis sinensis primarily lives in the host liver and biliary system, leading to serious health issues, such as hepatobiliary lesions and cholangiocarcinoma. Establishment of rapid, sensitive and specific tools is of great significance for early diagnosis and management of clonorchiasis. Recently, molecular biological techniques have been widely used for detection of C. sinensis infections. This review summarizes the advances in the major molecular assays for detection of C. sinensis infections in intermediate and definite hosts, including PCR, loop-mediated isothermal amplification, clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated proteins system, and high-throughput sequencing, and summarizes the characteristics and application prospects of these assays, so as to provide precision detection and management of C. sinensis infection.

OBJECTIVE To construct a pharmacy service quality evaluation system， identify weaknesses in the integrated development of pharmacy services， and provide a reference for the homogenized and high-quality development of pharmacy services in compact urban medical groups.METHODS Guided by the five core dimensions of the Servperf model， the Delphi method was used to screen and optimize items， and a tripartite pharmacy service quality evaluation system， covering clinicians， pharmacists， and patients， adapted to the characteristics of compact urban medical groups was constructed. A multicenter cross-sectional empirical investigation was conducted in six compact urban medical groups in Chongqing using the evaluation system.RESULTS Through two rounds of Delphi consultation with 12 experts， a tripartite pharmacy service quality evaluation system was successfully constructed， comprising 5 dimensions and 78 items （24 for clinical pharmacists， 23 for clinical medical staff， and 31 for patients and family members）. The Cronbach’s α coefficients for all dimensions exceeded 0.81， and the KMO values all exceeded 0.7. A total of 1 339 valid questionnaires were collected， including 279 from clinical pharmacists， 727 from clinical medical staff， and 333 from patients and family members. The empirical investigation showed that the overall quality of regional basic pharmacy services was good， but significant inter-group differences existed in service perceptions among the three groups. The score differences across the five dimensions were all statistically significant among the three groups （all P ＜0.001）. Except for the tangibles dimension， in which clinical medical staff scored significantly lower than clinical pharmacists and patients/family members， patients/family members scored significantly higher than clinical medical staff and clinical pharmacists in the other four dimensions （ P ＜0.05）. For the 78 items， expert expectations largely matched the perceptions of the three groups， with a mean difference of 0.08 points； only 13 items showed a difference exceeding 0.5 points， representing marked gap，with “participating in multidisciplinary team consultation and making effective recommendations” showing the largest difference of 0.94 points.CONCLUSIONS The physician‑ pharmacist‑patient tripartite evaluation system constructed in this study is scientific and reliable. Empirical investigation confirms that the basic pharmaceutical support services of the medical groups are well established， whereas the development of high‑level collaborative services has notable weaknesses， and marked heterogeneity exists in service perception among the three groups.

Chronic epididymitis (CE) is a long-standing inflammatory condition of the epididymis caused by unresolved acute infections, chronic infections, medication use, or other factors. Clinically, it is characterized by persistent dull pain or a dragging sensation in one or both sides of the scrotum. The disease course typically exceeds three months and is marked by insidious onset and recurrent episodes. Current studies suggest that CE may disrupt the epididymal microenvironment through multiple pathological processes, including local inflammatory responses, oxidative stress, fibrotic remodeling, and autophagy. These alterations impair sperm maturation, transport, and capacitation, thereby contributing to male reproductive dysfunction and infertility. This review summarizes the major etiologies and pathophysiological characteristics of CE and its impact on male reproductive function. It focuses on the roles of inflammatory cytokines and related signaling pathways, oxidative stress mechanisms, and fibrotic progression in the pathogenesis of CE. Moreover, it explores targeted therapeutic strategies based on these mechanisms, aiming to provide a theoretical basis for identifying key molecular targets and signaling pathways involved in CE-induced male reproductive impairment.

Objective To explore the risk factors of acute respiratory failure(ARF)in adult patients with community-acquired pneu-monia(CAP),and thereby construct and validate the efficacy of nomogram model.Methods The clinical and laboratory data of 172 adult CAP patients admitted to Taikang Xianlin Drum Tower Hospital affiliated to Nanjing University School of Medicine from January 2018 to December 2021 were retrospectively collected.The patients were divided into two groups based on whether they had concurrent ARF.After the comparison for the differences of single factor between the two groups,collinearity analysis was assessed.The risk fac-tors were then screened by binary logistic regression analysis with forward stepwise regression method.A nomogram model was subse-quently constructed and the discrimination and accuracy of the model were evaluated by ROC and colibration curves.Results Among the 172 CAP patients,53 cases(30.8％)developed ARF.The results of univariate analysis showed that the CAP patients with concur-rent ARF group had higher age,CURB-65 score and inflammatory markers than the non-concurrent ARF group,and the incidence of complex infection(culturing two or more pathogenic bacteria)was high.The values of CRP(C-reactive protein)and BUN/Alb(blood urea nitrogen/albumin)were significantly different between the two groups(53.910[25.900,101.200]vs.23.300[6.800,48.930],0.231[0.160,0.302]vs.0.123[0.089,0.171],P＜0.05).Multivariate analysis indicated:glucose(Glu)≥6.06 mmol/L(odds ra-tio(OR):2.737,95％confidence interval(CI):1.116-7.037),AST(aspartate aminotransferase)≥22.5 U/L(OR:4.291,95％CI:1.779-11.120),fibrinogen(Fib)≤3.83 g/L(OR:3.955,95％CI:1.631-10.237),uric acid(UA)188.07 μmol/L(OR:4.617,95％CI:1.859-12.489),BUN/Alb≥0.15 mmol/g(OR:6.381,95％CI:2.423-18.513),total number of multicomor-bidity≥3(OR:6.191,95％CI:2.088-21.905)were the risk factors(P＜0.05).All the screened indicators were incorporate into the nomogram model and its efficacy was verified.The results showed that the area under the curve of the model was 0.888[95％CI:0.840-0.935](P＜0.05),the sensitivity was 0.868,and the specificity was 0.790.The calibration curve showed that the predicted probability of adult CAP patients-associated with ARF was in good consistency with the observed probability(Briser Score:0.125;H-L test:x2=7.563,P=0.477).Conclusion The established model has a good ability to predict adult CAP associated with ARF,and can provide a reference basis for early clinical prediction and intervention treatment.

Objective To investigate the effect of early closed reduction and percutaneous Kirschner wire pinning for Gartland type Ⅱ and Ⅲ pediatric supracondylar humerus fractures.Methods Clinical data of 123 children with Gartland type Ⅱ and Ⅲsupracondylar humerus fractures admitted to our hospital from January 2021 to December 2022 were retrospectively analyzed.According to the time from injury to operation,they were divided into early group(≤ 24 h)and delayed group(＞24 h).The perioperative conditions,postoperative complications,fracture healing,and elbow joint functional recovery were compared between the two groups.Results Compared to the delayed group,the early group had less operation time[(22.9±11.3)min vs.(40.3±17.5)min,t=-6.116,P=0.000],less number of intraoperative fluoroscopy[(10.6±4.5)times vs.(17.4±5.5)times,t=-7.471,P=0.000],shorter hospital stay[(3.3±1.0)d vs.(4.2±1.3)d,t=-3.866,P=0.000],and less hospitalization cost[(10 555.0±971.2)yuan vs.(10 972.4±938.9)yuan,t=-2.345,P=0.021].The rate of anatomical reduction in the early group was higher than that in the delayed group[79.0％(60/76)vs.59.6％(28/47),x2=5.354,P=0.021].No serious complications such as vascular and nerve injury,compartment syndrome,ischemic myosclerosis,myositis ossificans,or cubitus varus and valgus occurred in both group after surgery.The incidences of tension blisters[6.6％(5/76)vs.23.4％(11/47),x2=7.265,P=0.007],plaster loosening[22.4％(17/76)vs.40.4％(19/47),x2=4.574,P=0.032],and pin tract infection[2.6％(2/76)vs.14.9％(7/47),x2=4.757,P=0.029]in the early group were lower than those in the delayed group.The fracture union time,and the time to start active and full weight-bearing activities in the early group were earlier than those in the delayed group(P＜0.05).The Flynn elbow joint scores at 3 and 6 months after surgery in the early group were better than those in the delayed group(Z=-3.469,P=0.001;Z=-2.961,P=0.003).Conclusion Early closed reduction and percutaneous Kirschner wire pinning is effective in the treatment of pediatric supracondylar humerus fractures,which can shorten the operation time and hospital stay,reduce the hospitalization cost,lower the incidence of complications,and restore elbow joint function in early stage.

Objective To investigate the effect of early closed reduction and percutaneous Kirschner wire pinning for Gartland type Ⅱ and Ⅲ pediatric supracondylar humerus fractures.Methods Clinical data of 123 children with Gartland type Ⅱ and Ⅲsupracondylar humerus fractures admitted to our hospital from January 2021 to December 2022 were retrospectively analyzed.According to the time from injury to operation,they were divided into early group(≤ 24 h)and delayed group(＞24 h).The perioperative conditions,postoperative complications,fracture healing,and elbow joint functional recovery were compared between the two groups.Results Compared to the delayed group,the early group had less operation time[(22.9±11.3)min vs.(40.3±17.5)min,t=-6.116,P=0.000],less number of intraoperative fluoroscopy[(10.6±4.5)times vs.(17.4±5.5)times,t=-7.471,P=0.000],shorter hospital stay[(3.3±1.0)d vs.(4.2±1.3)d,t=-3.866,P=0.000],and less hospitalization cost[(10 555.0±971.2)yuan vs.(10 972.4±938.9)yuan,t=-2.345,P=0.021].The rate of anatomical reduction in the early group was higher than that in the delayed group[79.0％(60/76)vs.59.6％(28/47),x2=5.354,P=0.021].No serious complications such as vascular and nerve injury,compartment syndrome,ischemic myosclerosis,myositis ossificans,or cubitus varus and valgus occurred in both group after surgery.The incidences of tension blisters[6.6％(5/76)vs.23.4％(11/47),x2=7.265,P=0.007],plaster loosening[22.4％(17/76)vs.40.4％(19/47),x2=4.574,P=0.032],and pin tract infection[2.6％(2/76)vs.14.9％(7/47),x2=4.757,P=0.029]in the early group were lower than those in the delayed group.The fracture union time,and the time to start active and full weight-bearing activities in the early group were earlier than those in the delayed group(P＜0.05).The Flynn elbow joint scores at 3 and 6 months after surgery in the early group were better than those in the delayed group(Z=-3.469,P=0.001;Z=-2.961,P=0.003).Conclusion Early closed reduction and percutaneous Kirschner wire pinning is effective in the treatment of pediatric supracondylar humerus fractures,which can shorten the operation time and hospital stay,reduce the hospitalization cost,lower the incidence of complications,and restore elbow joint function in early stage.

Based on the practice of National Diabetes Prevention and Control Center (DPCC) in Hunan Province for five years, this paper systematically reviewed the excellent experience and advanced practices of diabetes prevention and control in several demonstration areas.

Objective:To investigate the prevalence of skeletal fluorosis and the management and treatment of patients in endemic fluorosis areas of Shaanxi Province.Methods:From March to November 2023, in accordance with the requirements of the "2023 Monitoring Plan for Endemic Fluorosis in Shaanxi Province", the implementation of prevention and control measures of endemic fluorosis in Shaanxi Province was investigated. The data of patients with skeletal fluorosis from January to December 2023 were downloaded from Shaanxi Province Endemic Disease Control Information Management Platform, and the epidemiological characteristics were analyzed. At the same time, the management and treatment of patients with skeletal fluorosis in endemic fluorosis areas of Shaanxi Province were carried out in accordance with the requirements of the "Shaanxi Province Endemic Disease Patient Management Service Specification".Results:In 2023, there were 10 drinking water-borne endemic fluorosis cities in Shaanxi Province, involving 3 715 endemic villages, including 3 650 water improvement villages with a water-improving rate of 98.25%. There were 2 coal-burning-borne endemic fluorosis cities in Shaanxi Province, involving 641 746 households in 1 414 endemic villages. Among them, 641 617 households had changed their furnaces and stoves, with a furnace and stove change rate of 99.98%. There were 37 462 patients with skeletal fluorosis in the province, with 35 792 from drinking water-borne endemic fluorosis areas and 1 670 from coal-burning-borne endemic fluorosis areas. The condition was mainly mild and moderate (94.12%, 35 258/37 462), with females accounting for 55.13% (20 654/37 462). The education level was mainly primary school and illiteracy (83.64%, 31 333/37 462), and the occupation was mainly farmers (99.29%, 37 196/37 462). A total of 37 116 patients with skeletal fluorosis were followed up and managed, with a management rate of 99.08% (37 116/37 462). A total of 35 756 patients were managed in a standardized manner, and the standardized management rate was 96.34% (35 756/37 116). A total of 30 649 patients with skeletal fluorosis were actually treated, with a treatment rate of 84.27% (30 649/36 370) and a total effective rate of 98.08% (30 062/30 649).Conclusion:In 2023, the prevalence of skeletal fluorosis in endemic fluorosis areas of Shaanxi Province is mainly mild and moderate, with a wide coverage of community management and a high level of treatment efficiency.

Objective To explore the risk factors of acute respiratory failure(ARF)in adult patients with community-acquired pneu-monia(CAP),and thereby construct and validate the efficacy of nomogram model.Methods The clinical and laboratory data of 172 adult CAP patients admitted to Taikang Xianlin Drum Tower Hospital affiliated to Nanjing University School of Medicine from January 2018 to December 2021 were retrospectively collected.The patients were divided into two groups based on whether they had concurrent ARF.After the comparison for the differences of single factor between the two groups,collinearity analysis was assessed.The risk fac-tors were then screened by binary logistic regression analysis with forward stepwise regression method.A nomogram model was subse-quently constructed and the discrimination and accuracy of the model were evaluated by ROC and colibration curves.Results Among the 172 CAP patients,53 cases(30.8％)developed ARF.The results of univariate analysis showed that the CAP patients with concur-rent ARF group had higher age,CURB-65 score and inflammatory markers than the non-concurrent ARF group,and the incidence of complex infection(culturing two or more pathogenic bacteria)was high.The values of CRP(C-reactive protein)and BUN/Alb(blood urea nitrogen/albumin)were significantly different between the two groups(53.910[25.900,101.200]vs.23.300[6.800,48.930],0.231[0.160,0.302]vs.0.123[0.089,0.171],P＜0.05).Multivariate analysis indicated:glucose(Glu)≥6.06 mmol/L(odds ra-tio(OR):2.737,95％confidence interval(CI):1.116-7.037),AST(aspartate aminotransferase)≥22.5 U/L(OR:4.291,95％CI:1.779-11.120),fibrinogen(Fib)≤3.83 g/L(OR:3.955,95％CI:1.631-10.237),uric acid(UA)188.07 μmol/L(OR:4.617,95％CI:1.859-12.489),BUN/Alb≥0.15 mmol/g(OR:6.381,95％CI:2.423-18.513),total number of multicomor-bidity≥3(OR:6.191,95％CI:2.088-21.905)were the risk factors(P＜0.05).All the screened indicators were incorporate into the nomogram model and its efficacy was verified.The results showed that the area under the curve of the model was 0.888[95％CI:0.840-0.935](P＜0.05),the sensitivity was 0.868,and the specificity was 0.790.The calibration curve showed that the predicted probability of adult CAP patients-associated with ARF was in good consistency with the observed probability(Briser Score:0.125;H-L test:x2=7.563,P=0.477).Conclusion The established model has a good ability to predict adult CAP associated with ARF,and can provide a reference basis for early clinical prediction and intervention treatment.