ObjectiveTo explore the association between the concentration of maternal serum biomarkers， including free beta-human chorionic gonadotropin （fβ-hCG）， alpha fetoprotein （AFP）， unconjugated estriol （uE3）， and inhibin A （INH A） during the second trimester pregnancy and the risk of fetal presenting with copy number variation （CNV）. MethodsA retrospective analysis was conducted on the diagnostic results of pregnant women who were identified as high risk in the second trimester quadruple serological screening. These pregnant women underwent the interventional prenatal diagnosis and performed amniotic fluid karyotype analysis and comparative genomic hybridization array （aCGH） or CNV sequencing （CNV-seq） simultaneously.The detection rates of different diagnostic methods were calculated. The concentration of serum biomarkers， fβ-hCG， AFP， uE3， and INH A were divided into three levels： abnormally low， normal， and abnormally high. The prevalence of these serum biomarkers concentration in pregnant women with aberrant aCGH/CNV-seq results compared to normal controls was statistically calculated. ResultsAmong the 1 516 cases with high-risk quadruple serological screening in the second trimester， 59 chromosomal abnormalities were revealed by karyotype analysis， while 87 abnormalities were detected by aCGH/CNV-seq， indicating a significant statistical difference in detection rate. In comparison to the result of karyotype analysis， aCGH/CNV-seq identified an additional 46 cases of fetal CNV abnormalities， whereas it failed to detect 18 cases of chromosomal structural abnormalities. Among the 1 457 cases with normal karyotype results， the most frequent abnormality was observed in the concentration of fβ-hCG， followed by abnormalities in INH A and uE3 concentrations， yet the least common abnormality was noted in AFP concentration. When the maternal serum uE3 concentration was less than 0.5 multiples of median （MoM）， there was a significant difference in the risk of fetal CNV compared to the CNV results corresponding to normal concentration of uE3. No significant differences were found in the levels of fβ-hCG， AFP， and INH A between the two groups. ConclusionLow serum uE3 concentration （<0.5 MoM） is associated with an increased risk of fetal presenting with aberrant CNV.

ObjectiveTo explore the establishment of performance assessment indicators for the classification and grading of public health staff in district-level Centers for Disease Control and Prevention (CDCs), and to provide a basis for such evaluations. MethodsThrough literature review and group interviews, performance evaluation indicators were developed based on competency evaluation. Experts were invited to evaluate the weight of performance evaluation indicators for public health staff from different categories, with the average value used to represent the weight of each indicator. ResultsTwenty-nine experts from universities in Shanghai, municipal CDCs, and district CDCs participated, yielding an expert authority coefficient of 0.86. The performance evaluation indicators for department managers were categorized into three levels, with 4 indicators at the primary level, 16 indicators at the secondary level, and 42 indicators at the tertiary level, while those for general staff included 4 primary indicators, 15 secondary indicators, and 36 tertiary indicators. Significant differences were observed in the weight coefficients of the primary indicators (internal operations, professional work, and learning and growth) between department managers and general staff. The top three secondary indicators for department managers were department management, monitoring and prevention, and level of expertise. For mid-level and senior staff, the top three secondary indicators were monitoring and prevention, level of expertise, and research work. The top three secondary indicators for junior staff were monitoring and prevention, professional expertise, and professional attitude. No significant statistical differences were found among tertiary indicators. ConclusionThe developed performance evaluation indicators are reliable. Staff at different levels and classifications should be evaluated using different performance evaluation standards to accurately reflect individual performance and contributions.

Objective To explore the application effect of a BOPPPS-based blended teaching model in adult nursing course.Methods A total of 188 undergraduate nursing students from the school of Nursing,Kunming Medical university,in the class of 2021 were enrolled as research subjects and grouped by classes(97 students in the control group and 91 students in the experimental group).During the teaching process,the control group and the experimental group respectively adopted the traditional teaching model and the blended teaching model based on BOPPPS.The teaching effect was evaluated through the pre-assessment and post-assessment theoretical scores,learning engagement,independent learning ability and teacher quality of the two groups of students.Results The differences between the pre-assessment and post-assessment theoretical scores of the two groups were statistically significant,and the scores of the experimental group were 86.80(78.73,94.09),which were higher than those of the control group 79.45(69.39,87.97)(P<0.05).There were also statistically significant differences in the scores of learning engagement and independent learning ability between the two groups after teaching(P<0.05).Conclusion The blended teaching model based on BOPPPS used in the teaching of adult nursing for undergraduate nursing students can effectively improve the teaching effect,which is conducive to improving their learning engagement and stimulating students'learning autonomy.

Antimicrobial resistance(AMR)has become a global public health crisis,posing a serious threat to the achievement of sustainable development goals(SDGs)of the United Nations.This article explores the potential con-sequences and far-reaching impacts of AMR on the global health system,economic development,and social well-being from the perspective of SDGs.This article analyzes the current situation and challenges of AMR prevention and control globally and domestically,proposes comprehensive response suggestions,such as establishing a global collaborative governance mechanism for AMR,deepening the"One Health"practice framework,perfecting survei-llance as well as infection prevention and control system on AMR,accelerating the development of new vaccines,ex-ploring AMR innovative response technologies,and strengthening AMR literacy education for all people.The re-search findings can provide reference globally,especially for developing countries to comprehensively respond to the threat of AMR and promote the SDGs process.

Objective To exploring the correlation between serum periostin,uric acid/albumen ratio(UAR) levels and recurrence after radiofrequency ablation (RFCA) in elderly patients with nonvalvular atrial fibrillation (NVAF). Methods The 108 elderly NAVF patients who received RFCA treatment at the Cardiovascular Center of Peking Tongren Hospital Affiliated to Capital Medical University from January 2019 to October 2022 were selected as the observation group,selected 108 healthy individuals who had medical checkups at Beijing Tongren Hospital Affiliated to Capital Medical University during the same period as the control group,and the patients were followed up for a period of 1 year. And according to the follow-up,they were divided into the recurrence group (n=42) and the non-recurrence group (n=66). Sex,age,body mass index (BMI),history of hypertension,diabetes mellitus,hyperlipidemia,smoking,alcohol consumption,left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD),white blood cell counts were collected. Enzyme linked immunosorbent assay (ELISA) was applied to detect serum Periostin level. Fully automated biochemical analyzer was applied to measure the levels of serum albumin (ALB) and uric acid (UA),whose ratio was the level of UAR. Logistic regression was applied to analyze the influencing factors of recurrence in NVAF patients after RFCA. Receiver Operating Characteristic (ROC) curve was applied to analyze the predictive value of serum Periostin and UAR levels for recurrence after RFCA in elderly NAVF patients. Results Preoperative Periostin,UAR levels in the observation group were significantly higher than serum Periostin (53.53±6.27ng/L),UAR (4.09±0.78) in the postoperative(50.53±7.23 ng/L,3.41±0.91)and control groups(31.29±4.21 ng/L,1.24±0.27),and the differences were statistically significant (t=3.258,30.603;5.896,35.883,all P<0.05). The LVEF was lower in the recurrent group (51.16％±6.49％) than in the non-recurrent group (55.39％±6.71％),the levels of UAR (4.01±0.92),Periostin (55.77±6.56 ng/L) and percentage of history of hyperlipidemia (66.67％) were higher in the relapse group than those in the non-relapse group (3.02±0.63,47.19±5.44 ng/L,34.85％),and the differences were statistically significant (x2/t=3.234,6.458,7.180,10.426,all P<0.05). Serum Periostin[OR(95％ CI):1.856(1.148～3.000)]and UAR[OR(95％ CI):2.127(1.145～3.951)]were independent risk factors for recurrence after RFCA in patients (P<0.05). The area under the curve (95％ confidence interval)[AUC(95％CI)]of serum Periostin and UAR levels to predict relapse after RFCA in elderly NAVF patients were 0.856(0.776～0.916),0.817(0.731～0.884),respectively,the cutoff values were 53.00 ng/L,3.99,the Youden index was 0.569,0.509,the sensitivity was 88.10％,85.71％ and the specificity was 71.21％,65.15％,respectively. The combined predicted of the AUC(95％CI),Youdon index,sensitivity and specificity by the two method were as flows 0.924 (0.857～0.966),0.736,85.71％ and 87.88％,respectively. The combined prediction was significantly higher than that of each index alone (Z=2.296,2.880,P=0.022,0.004). Conclusion Serum Periostin and UAR levels are upregulated in elderly patients with NAVF,there is a certain correlation with recurrence after RFCA,the combination of the two has a high efficacy in predicting recurrence in elderly NAVF patients after RFCA.

Ischemic heart disease(IHD)is associated with high morbidity and mortality rates.Reperfusion therapy is the best treatment option for this condition.However,reperfusion can aggravate myocardial damage through a phenomenon known as myocardial ischemia/reperfusion(I/R)injury,which has recently gained the attention of researchers.Several studies have shown that Chinese herbal medicines and their natural monomeric components exert therapeutic effects against I/R injury.This review outlines the current knowledge on the pathological mechanisms through which mitochondria participate in I/R injury,focusing on the issues related to energy metabolism,mitochondrial quality control disorders,oxidative stress,and calcium.The mechanisms by which mitochondria mediate cell death have also been discussed.To develop a resource for the prevention and management of clinical myocardial I/R damage,we compiled the most recent research on the effects of Chinese herbal remedies and their monomer components.

Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T _NANC), time to symptom improvement (T _SI), and time of hospital stay (T _HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T _NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Ischemic heart disease (IHD) is associated with high morbidity and mortality rates. Reperfusion therapy is the best treatment option for this condition. However, reperfusion can aggravate myocardial damage through a phenomenon known as myocardial ischemia/reperfusion (I/R) injury, which has recently gained the attention of researchers. Several studies have shown that Chinese herbal medicines and their natural monomeric components exert therapeutic effects against I/R injury. This review outlines the current knowledge on the pathological mechanisms through which mitochondria participate in I/R injury, focusing on the issues related to energy metabolism, mitochondrial quality control disorders, oxidative stress, and calcium. The mechanisms by which mitochondria mediate cell death have also been discussed. To develop a resource for the prevention and management of clinical myocardial I/R damage, we compiled the most recent research on the effects of Chinese herbal remedies and their monomer components.

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