Objective: To explore the isotemporal substitution effects among different intensities of physical activity within a 10 minute recess period on the mental health of junior high school students, aiming to provide evidence based references for targeted practical interventions. Methods: From May to November 2024, a total of 845 junior high school students from Tianjin,Taiyuan and L Liang in Shaanxi Province,Puyang in Henan Province,Xi an in Shaanxi Province,Quzhou in Zhejiang Province,and Chaoyang in Liaoning Province were selected by using a combination of stratified random sampling and convenience sampling. ActiGraph wGT3X-BT accelerometers was used to measure physical activity during a 10 minute recess period. Mental health status was assessed with the Depression Anxiety Stress Scale (DASS-21). An isotemporal substitution model was constructed in 1 minute increments to predict the effects of substituting different physical activity behaviors on students mental health. Results: During recess, sedentary behavior (SB) was predominant among junior high school students, with an average duration of [7.08(5.85,7.98)] minutes, while moderate to vigorous physical activity (MVPA) accounted for the shortest duration at [0.42(0.21,0.85)] minutes. There were statistically significant differences in MVPA,LPA and SB time between students of different genders and grades( Z/H =-9.08,-8.34,-9.51;84.87,126.82,135.27,all P <0.01). Isotemporal substitution analysis, adjusted for gender and age, showed that replacing 1 minute of SB with 1 minute of MVPA significantly improved anxiety levels ( β =-0.29, 95% CI =-0.53 to -0.04) and overall mental health ( β =-0.72, 95% CI =-1.39 to -0.04), with both results reaching statistical significance (both P <0.05). No significant effects were observed for other substitution patterns (both P >0.05). Conclusions Substituting SB with MVPA during a 10 minute recess period exerts a positive impact on the mental health of junior high school students. It is recommended to optimize the daily recess activity structure in schools to enhance students mental well being.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Sufficient bone tissue is required to ensure the long-term stability of implants. Based on the principles of guided bone regeneration, Dr. Istvan Urban proposed the “sausage technique”. Research indicates that the horizontal bone augmentation observed with the sausage technique averages (5.3 ± 2.3) mm and the vertical bone augmentation averages (4.2 ± 1.9) mm, which is significantly greater than the outcomes achieved with traditional guided bone regeneration techniques. The sausage technique is reliable because the biological membrane has sufficient elasticity and toughness with the application of membrane screws, which stabilizes the mixture of autologous bone and bone graft materials in the bone grafting area and prevents the grafting materials from being displaced. Using substitute materials for autologous bone graft balances the osteogenic activity and the low graft absorption rate. A ball drill is used to prepare nourishing holes in the cortical bone of the recipient area, providing a pathway for mesenchymal stem cells and bone progenitor cells to migrate to the bone regeneration area. Furthermore, this method accelerates the early angiogenesis of wound healing, fully reduces tension during suturing, and ensures that excessive pressure is not applied to the healing area during suturing. Thus, the sausage technique is consistent and reliable. Despite the good outcomes demonstrated by the sausage technique in clinical applications, its potential complications related to soft and hard tissue have attracted widespread attention. These complications negatively affect the patient’s recovery process and influence the final results of the surgery. Therefore, a complete understanding of the complications associated with the sausage technique and their underlying causes is necessary to enhance the clinical safety and effectiveness of the sausage technique. This article summarizes the application principles, clinical effects, barrier membrane applications, selection of bone transplant materials, and related complications of the sausage technique, aiming to provide a reference for clinical application.

This study analyzed the epidemiological characteristics and trends of respiratory syncytial virus (RSV) infections among inpatients with acute respiratory infections (ARI) in a children′s hospital in Shenzhen City inpatients from 2020 to 2023. From January 2020 to December 2023, multiple reverse transcription polymerase chain reaction (RT-PCR) combined with capillary electrophoresis fragment analysis technology was used to detect the nucleic acids of 12 respiratory pathogens, including RSV, in hospitalized children diagnosed with ARI. The patients were divided into six age groups: 0 to <6 months, 6 months to <1 year, 1 to <2 years, 2 to <5 years, 5 to <10 years, and 10 to <18 years. A total of 53 033 children were tested, including 6 830 RSV positive cases, with an overall positivity rate of 12.88%. The annual RSV positivity rates from 2020 to 2023 were 20.04%, 16.18%, 4.89%, and 13.33%, respectively, with statistically significant differences between the years ( χ2=1 185.994, P<0.001). The positive rate of RSV detection decreased with increasing age across all years (all P trend<0.05). From 2020 to 2023, the proportion of RSV-positive cases aged 2 to 5 years and older showed an increasing trend ( P trend<0.001 for all years). Compared to 2023, the median age of RSV-infected children was lower in 2020 ( Z=7.826, P<0.001) and 2021 ( Z=6.106, P<0.001). The proportion of severe infections requiring ICU admission did not change significantly across all years ( χ2=0.179, P=0.981). The RSV epidemic season in 2020 mainly occurred during 28-43 weeks, and in 2021, it spanned from 22-43 weeks. However, in 2022, the season was delayed until the 49th week and lasted for three weeks. In 2023, the seasonal epidemic appeared earlier, starting in the 14th week and lasting for 28 weeks. From 2020 to 2023, the rate of RSV co-infections with other pathogens (mycoplasma pneumoniae, human parainfluenza virus, human bocavirus, human coronavirus, human metapneumovirus, and influenza A) significantly increased (all P trend<0.01). In conclusion, the epidemiological characteristics of RSV infections in Shenzhen Children′s Hospital changed from 2020 to 2023. In 2022, there were only delayed, low-intensity and short-lived seasonal epidemics. However, in 2023, there was an earlier and prolonged epidemic, with increased infections in children aged 2 to 5 years and older and a rise in co-infections, while the proportion of severe infections requiring ICU admission remained unchanged.

BACKGROUND:In recent years,deep learning technologies have been increasingly applied in the field of oral medicine,enhancing the efficiency and accuracy of oral imaging analysis and promoting the rapid development of intelligent oral medicine. OBJECTIVE:To elaborate the current research status,advantages,and limitations of deep learning based on oral imaging in the diagnosis and treatment decision-making of oral diseases,as well as future prospects,exploring new directions for the transformation of oral medicine under the backdrop of deep learning technology. METHODS:PubMed was searched for literature related to deep learning in oral medical imaging published from January 2017 to January 2024 with the search terms"deep learning,artificial intelligence,stomatology,oral medical imaging."According to the inclusion criteria,80 papers were finally included for review. RESULTS AND CONCLUSION:(1)Classic deep learning models include artificial neural networks,convolutional neural networks,recurrent neural networks,and generative adversarial networks.Scholars have used these models in competitive or cooperative forms to achieve more efficient interpretation of oral medical images.(2)In the field of oral medicine,the diagnosis of diseases and the formulation of treatment plans largely depend on the interpretation of medical imaging data.Deep learning technology,with its strong image processing capabilities,aids in the diagnosis of diseases such as dental caries,periapical periodontitis,vertical root fractures,periodontal disease,and jaw cysts,as well as preoperative assessments for procedures such as third molar extraction and cervical lymph node dissection,helping clinicians improve the accuracy and efficiency of decision-making.(3)Although deep learning is promising as an important auxiliary tool for the diagnosis and treatment of oral diseases,it still has certain limitations in model technology,safety ethics,and legal regulation.Future research should focus on demonstrating the scalability,robustness,and clinical practicality of deep learning,and finding the best way to integrate automated deep learning decision support systems into routine clinical workflows.

This study reported a case of neonatal Dubin-Johnson syndrome caused by variants in the ATP-binding cassette subfamily C member 2 ( ABCC2) gene. The infant, born at 36 weeks of gestation with no history of asphyxia, presented with abdominal distension accompanied by persistent skin jaundice and clay-colored stools. Whole-exome sequencing revealed two ABCC2 gene variants: an insertion (c.4237_c.4238insCT) at chromosome 10 position 101 606 808–101 606 809 inherited from the father, and a missense variant (c.517G>A) at chromosome 10 position 101 553 697 inherited from the mother. Following hepatoprotective therapy and oral administration of phenobarbital, the infant's clinical symptoms resolved. At follow-up until 3 years of age, the child exhibited normal growth and development comparable to peers.

Objective:To explore the structural equation model to explore the levels of work-related musculoskeletal disorders (WMSDs) and various risk factors in the feet and ankle of China's occupational population, providing scientific basis for for preventing WMSDs in feet and ankles.Methods:Data of 73497 national occupational epidemiological cases were selected from June 2018 to December 2023 used the Chinese version of the Electronic Questionnaire on Musculoskeletal Disorders. The adverse ergonomic factors and their source classification standard and confirmatory factor analysis were used to investigate foot and ankle WMSDs and their related risk factors (including individual factors, work organization, work posture, work type, fatigue, etc.) in key occupational groups in China, and structural equation model hypothesis, fitting, verification, and path and intermediary effect analysis were carried out. The model fit evaluation indexes included Chi-square specific degrees of freedom ( χ2/ df), gauge fit index (NFI), Tucker Lewis index (TLI), goodness of Fit index (GFI), adjusted Goodness of Fit index (AGFI) and approximate root mean square error (RMSEA) . Results:A total of 73497 occupational workers were surveyed, with local muscle fatigue and WMSDs incidence rates in the feet and ankles being 17.17% and 12.06%, respectively. The fitting index of the adjusted structural equation model basically meets the standard (GFI=1, AGFI=1, RMESA=0.042, NFI=0.716, TLI=0.663). The top three factors affecting feet and ankle WMSDs are feet and ankle muscle fatigue, work type, and work organization, with standardized path coefficients of 0.221, 0.105, and 0.095, respectively. The top two factors affecting feet and ankle muscle fatigue are work organization and work type, with standardized path coefficients of 0.548 and 0.383, respectively. Feet and ankle muscle fatigue, work type, work organization, and work posture have a direct effect on feet and ankle WMSDs, with effect values of 0.221, 0.105, 0.095, and 0.077, respectively. The organization and type of work can also have indirect effects through feet and ankle muscle fatigue, with effect values of 0.121 and 0.084, respectively.Conclusion:Feet and ankle muscle fatigue has a direct impact on WMSDs, and plays a mediating role between ankle and ankle WMSDs caused by work organization and work type. Feet and ankle muscle fatigue is an important pathway leading to feet and ankle WMSDs. It is recommended that employers and managers detect job fatigue early and take corresponding prevention and intervention measures, which can play a key role in preventing feet and ankle WMSDs.

Objective:To provide theoretical support and practice model for improving the clinical medical education supervision system of university-affiliated hospitals.Methods:This study focused on the group of reserve teaching supervision experts. Through literature research, questionnaire survey, and expert interview, the Competency Evaluation Criteria for Reserve Teaching Supervision Experts was constructed, which was implemented according to the training framework of "theory, practice, summary, and feedback". The paired t-test was performed using SPSS 24.0. Results:The research team formulated the Competency Evaluation Criteria for Reserve Teaching Supervision Experts through expert interviews. Six basic competencies and three advanced competencies for reserve teaching supervision experts were identified and their weights were assigned. A supervision team was established with supervision experts (including reserve teaching supervision experts) and teaching staff at a ratio of 1∶6.9, achieving an increase in the coverage of supervised specialties. A toolkit for enhancing the supervision capabilities of reserve experts was developed, and its effectiveness was analyzed. Statistical analysis showed that the overall score gap between reserve teaching supervision experts and senior supervision experts gradually narrowed. In terms of teaching demeanor and teaching effectiveness, there were no significant differences between the two types of experts. However, in terms of teaching content scores, there was a significant difference between reserve teaching supervision experts and senior supervision experts ( P<0.05). Conclusions:The training mechanism of reserve teaching supervision experts can effectively bridge the structural defects of the traditional supervision team. However, further emphasis is needed on the standardization and professionalization of teaching content supervision.

Objective To explore the mechanism of IgA nephropathy(IgAN)caused by multi-glycosides of Tripterygium wilfordii(GTW)through the regulation of Silent information regulatory factor 1(SIRT 1)/nuclear transcription factor E2-related factor 2(Nrf 2)/antioxidant enzyme heme oxygenase 1(HO-1)signaling pathway.Methods Forty-five male SD rats were selected and randomly divided into two groups:the blank group(n=9)and the model group(n=36).In addition to the blank group,the BSA+CCl4+LPS group was used.At the end of 12 weeks,two rats were randomly selected for verification,and the model was successfully established.The 34 model rats were randomly divided into 3 groups:the model group(n=10),prednisone group(n=12),and GTW group(n=12).Urine,blood and kidney tissues were harvested 4 weeks after drug administration.Urinary erythrocyte number,24-h urinary protein quantification(24 h-UTP),alanine transaminase(ALT),serum albumin(ALB),urea nitrogen(BUN),and blood creatinine(SCr)were performed for each group;the protein expression of SIRT1,Nrf2,HO-1 and PINK1 was detected by Western blotting analysis;real-time polymerase chain reaction(RT-PCR)detection of SIRT1,Nrf2,HO-1 and PINK1 mRNA expression in rat kidney tissue;and detection of IgA deposition in the renal mesangial area by immunofluorescence.Kidney histopathological changes were observed in all the rats by hematoxylin-eosin(HE)staining.Results The results compared with those in the blank group,the urinary red blood cell count and 24 h-UTP,ALT,BUN,and SCr levels were significantly greater(P<0.01);The ALB level was significantly lower(P<0.01);renal tissue SIRT1,Nrf2,HO-1,PINK1 protein and mRNA expression were significantly lower(P<0.01);IgA deposition in the mesentery was obvious;renal pathological damage was severe;and the difference was statistically significant. Compared with those in the model group,urinary red blood cell counts and 24 h-UTP,ALT,BUN,and SCr levels in the prednisone and GTW groups were significantly lower (P<0.01);ALB levels were significantly greater (P<0.01);SIRT1,Nrf2,HO-1,PINK1 protein and mRNA expression were significantly greater (P<0.01);IgA deposition in the mesangial area was reduced,and renal pathology was improved,with statistically significant difference. Conclusions GTW may alleviate oxidative stress injury,protect renal function,and improve renal injury by activating the SIRT 1/Nrf 2/HO-1 signaling pathway.

Gastroblastoma (GB) is a rare gastric epithelial tumor without special clinical manifestations, whose histologic origin and pathogenesis remain unclear due to less related reports.Low-grade cell forms with biphasic differentiation are typical histological characteristics of GB.Immunohistochemistry and molecular tests can help with its differential diagnosis.GB is an invasive low-grade malignant tumor and the first treatment is surgical resection.However, there is no uniform standard treatment plan at present and most patients have a good prognosis.In this article, the histopathology, diagnosis and identification diagnosis of GB was reviewed to provide a theoretical basis for its origin, development, treatment and patient prognosis.