To explore the correlation between MTHFR C677T gene polymorphism and hypertension, hyperhomocysteinemia(Hcy), and hyperlipidemia in the Tibetan population of Tibet.

Objective: To investigate the status of heat illness, knowledge awareness and adaptive behaviors of heat wave knowledge among food delivery riders, so as to provide a basis for optimizing heat wave response measures for food delivery riders. Methods: In November 2022, food delivery riders from a large food delivery platform in Ningbo City, Zhejiang Province were selected as survey subjects using a cluster sampling method. A self-designed electronic questionnaire was used to select demographic information, work status, lifestyle behaviors and disease history, heat illness status, knowledge awareness and adaptive behaviors of heatwave. Results: A total of 911 questionnaires were distributed, and 830 valid questionnaires were recovered, resulting in a valid response rate of 91.11%. Among the respondents, 796 (95.90%) were male, and 818 (98.55%) worked full-time. The mean age was (27.75±8.00) years. A total of 470 respondents (56.63%) had a work tenure of less than 1 year. The primary working hours were 8-<12 hours, with 504 people accounting for 60.72%. There were 108 cases of heatstroke, with an occurrence rate of 13.01%. And 286 people reported heat-related symptoms, with an occurrence rate of 34.46%. The overall awareness rate of heat wave knowledge was 73.22%, while the awareness rate of heat warning signal classification was relatively low at 9.04%. The heat wave cognition score was (5.86±1.31) points. There were statistically significant differences in heat wave cognition scores among food delivery riders of different ages, educational levels, family annual income, work tenures, and work durations (all P<0.05). Regarding positive adaptive behaviors, the number of riders paying attention to weather forecasts and actively learning about preventive measures was higher (734 people each, accounting for 88.43%). Regarding negative adaptive behaviors, the number of riders who often drank ice-cold beverages was higher (509 people, accounting for 61.33%). The heat wave adaptive behavior score was (6.88±1.77) points. There were statistically significant differences in adaptive behavior scores among riders with different educational levels, family annual income, work tenures, and smoking frequency (all P<0.05). Conclusions The occurrence rates of heatstroke and heat-related symptoms among food delivery riders are relatively high. The knowledge awareness and adaptive behaviors regarding heat wave are at a moderate level. It is suggested to strengthen health education, reinforce risk cognition of heat wave, and promote positive adaptive behaviors among food delivery riders.

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*

Objective To observe the effects of Baishile Capsules on neonatal neuronal activity and synaptic plasticity in hippocampus of depression model rats;To explore its mechanism of antidepressant.Methods Totally 32 SD rats were randomly divided into blank group,model group,fluoxetine group(5.4 mg/kg)and Baishile Capsules group(2.88 g/kg),with 8 rats in each group.The depression rat model was established by chronic unpredictable mild stress and single cage feeding,and drugs were administered at the same time as modeling for 21 consecutive days.Forced swimming test and open field test were used to evaluate the depressive-like behavior of rats,Golgi staining was used to observe the synaptic morphology of hippocampal neurons,and immunofluorescence was used to detect the positive expressions of BrdU/GABA-B,BrdU/c-fos,BrdU/GAP-43,BrdU/MAP-2 and CXCR4 in hippocampal tissue.Results Compared with the blank group,the immobility time of forced swimming experiment in the model group increased,and the horizontal and vertical time of open field experiment decreased significantly(P<0.01);the hippocampal neurons dendrites and dendritic spines atrophied,the density decreased,the branches became shorter,synaptic structure becomes blurred,and the longest and total lengths of synaptic branches significantly decreased(P<0.01);the positive expressions of GABA-B,c-fos,GAP-43 and MAP-2 proteins in hippocampal neonatal neurons decreased(P<0.05,P<0.01),and the expression of CXCR4 in hippocampal tissue decreased significantly(P<0.01).Compared with the model group,the immobility time of the forced swimming experiment in fluoxetine group and Baishile Capsules group significantly reduced,and the horizontal and vertical activity time of the open field experiment significantly increased(P<0.01);the number of dendritic spines in hippocampal neurons increased,synaptic damage improved,and the length of the longest and total branches of synapses significantly increased(P<0.01);the positive expressions of GABA-B,c-fos,GAP-43 and MAP-2 in hippocampal neonatal neurons significantly increased(P<0.05,P<0.01),and the positive expression of CXCR4 in hippocampal tissue significantly increased(P<0.01).Conclusion Baishile Capsules can regulate hippocampal synaptic plasticity and nerve regeneration by improving the activity and function of hippocampal neonatal neurons in depression model rats,exerting antidepressant effects.

Objective:To explore the efficacy and safety of intense pulsed light (IPL) for facial early linear scars.Methods:The patients who underwent facial plastic surgery and cosmetic suturing at the Department of Plastic and Aesthetic Surgery, the Second Affiliated Hospital of Soochow University from June to December 2023 were included. A randomized self-controlled study was conducted. Each post-operative wound was divided into the treatment and control sides by random number. The treatment side received 3 sessions of IPL treatment at 2-3 d after wound suturing, 6-7 d after suture removal and 6 weeks after surgery, respectively. The control side did not receive IPL treatment. After 3 months follow-up, the Vancouver scar scale (VSS), patient and observer scar assessment scale (POSAS) were used to evaluate the scars on both sides. Adverse reactions were recorded. VSS evaluated scar severity through four items: vascularity (0-3 points), pigmentation (0-3 points), thickness (0-4 points), and pliability (0-5 points), with a total score of 0-15 points. The higher the score, the more serious the scar was. POSAS consisted of observer scar assessment scale (OSAS) and patient scar assessment scale (PSAS), OSAS included vascularity, pigmentation, thickness, surface relief, pliability, surface area and overall opinion. While PSAS included pain, itching, color, thickness, stiffness, irregularity, and overall opinion. Each component was assessed on a scale ranging from 1 to 10, while maximum scores indicated the worst outcome. Statistical analysis was performed using the Graphpad Prism 8.0 software. Normal distributed measurement data were expressed as Mean±SD, and non-normally distributed measurement data were expressed as M( Q1, Q3). Comparisons of VSS, OSAS, PSAS scores between the treatment and control sides were performed using paired sample t-test or paired sample Wilcoxon rank sum test. P<0.05 was considered statistically significant. Results:A total of 23 facial trauma patients with 27 scars formed after debridement and aesthetic suture were enrolled in this study, including 17 males and 6 females, aged (28.2±6.1) years old. The length of the scars were (5.9±1.8) cm. After three sessions of treatment and 3 months follow-up, with regard to VSS, the treatment sides scored vascularity [0(0, 1) vs. 1(1, 1)], thickness [0(0, 0) vs. 0(0, 1)], and total scores [0.5(0, 1) vs. 1(1, 2.75)], which were statistically lower than the control sides (all P<0.05). With regard to OSAS, the treatment sides scored vascularity(2.1±0.9 vs. 3.0±1.0), pigmentation(2.2±0.8 vs. 2.3±0.8), thickness(1.4±0.7 vs. 1.9±0.9), surface relief(1.7±0.6 vs. 2.2±1.1), pliability(1.8±0.8 vs. 2.1±1.1), overall opinion(1.9±0.8 vs. 2.8±1.1) and total scores(12.6±4.4 vs. 16.2±6.2), which were statistically lower than the control sides(all P<0.05).With regard to PSAS, the treatment sides scored scar color(2.9±1.3 vs. 3.9±1.7), thickness(1.8±1.4 vs. 2.4±1.5), overall opinion(2.2±1.0 vs. 3.1±1.3) and total scores(14.3±6.7 vs. 17.7±7.7), which were statistically lower than the control sides(all P<0.05). No adverse reactions such as wound infection, delayed wound healing and blister formation were observed in all patients. Conclusion:IPL is effective in the treatment of early facial scars, which can significantly improve the vascularity, thickness, pigmentation, surface relief and pliability of scars, and improve the scars appearance. This treatment method is safe with few adverse reactions.

The historical development of endogenous wind （内风） is traced with time as the thread， based on the progression of factors such as syndromes， causes of disease， and pathogenesis. It is believed that the concept of wind syndrome originated in The Inner Canon of Yellow Emperor （《黄帝内经》）， encompassing both exogenous wind （外风） and endogenous wind syndrome. Over time， exogenous wind syndrome gradually evolved into mild syndromes and severe syndromes， while endogenous wind syndrome emerged from severe syndromes of exogenous wind. Endogenous wind syndrome has both syndrome and pathogenic attributes， and its theoretical system has gradually become more refined. Based on the theories of ancient and modern medical practitioners， and combining the holistic perspectives with Xiang （象） thinking， it is proposed that endogenous wind has both physiological and pathological distinctions. The physiological endogenous wind refers to the liver's moderate dispersing and regulating function， which helps to distribute qi （气）， blood， and body fluids， while pathological endogenous wind arises from abnormal liver dispersal. Therefore， in clinical practice， different treatment methods， such as tonifying， unblocking， and warming， can be applied according to the differentiation of deficiency and excess in the pathogenesis.

Objective　To analyze the monitoring data of SARS-CoV-2 variants from local cases in Hainan Province between January 2023 and March 2024, and to understand the predominant variants epidemic situation and population characteristics of SARS-CoV-2 in Hainan Province, providing scientific guidance for the prevention and control strategies formulation, early warning of the risk of SARS-CoV-2 infection. Methods　The variation surveillance data submitted by five sentinel monitoring hospitals in Hainan Province from January 2023 to March 2024 were collected, and general descriptive analysis was conducted on the dynamic epidemic trend of the dominant clade, population characteristics, and disease severity. Results　From January 2023 to March 2024, a total of 2 600 local cases clade information in Hainan Province were collected, all of which were Omicron variant strains involving 115 evolutionary branches. The three phases identified include: the co-dominance of BA.5.2.48 and BF.7 from the first week of 2023 to the 13th week of 2024; the prevalence of XBB and its subclades from the 16th to the 52nd week of 2023; and the predominance of BA.2.86 and its subclades from the first to the 13th week of 2024, with Omicron BA.2.75 causing small-scale sporadic outbreaks. Among all the age groups of branch infection cases, individuals aged >18~60 years constituted the largest group, while those under 4 years were the smallest, with no significant gender differences. The severity of the clinical disease was mainly asymptomatic and mild. Conclusions　Different dominant evolutionary clades of SARS-CoV-2 showed sequential replacement characteristics, and the clinical severity of illnesses has gradually decreased. In the future, the focus should be on individuals aged >60 years and above and those aged >18~60 years with underlying conditions, along with continuous enhancement of variant monitoring and analysis. This will ensure a timely understanding of the dynamic epidemic trend of dominant evolutionary clades in time, and focus on the immunogenicity of the new variant branch and changes in immunogenicity and vaccine protection of new variant clades, providing scientific guidance for the vaccine research, clinical treatment, and immunization strategy formulation.

Objective To examine resting-state whole-brain network connectivity in children with Chinese developmental dyslexia(DD)and typically developing(TD)children using functional near-infrared spectroscopy(fNIRS).Methods From November to December,2024,19 DD children aged six to twelve years in Children's Hospital of Fudan University were enrolled,along with 18 TD children matching age and sex.Regions of interest included frontal cortex(FC),temporal lobe(TL),occipital lobe(OL)and parietal lobe(PL).Resting-state data were acquired by fNIRS for five minutes in both groups.Functional connectivity strength was calculated at rest,and between-group differences in connectivity strength and brain networks were compared,based on the time series of oxyhe-moglobin concentration.Results The whole-brain functional connectivity strength was higher in DD group than in TD group(t=2.100,P<0.05).Connectivity between the right OL-right FC(t=2.426,P<0.05),right OL-left FC(t=2.483,P<0.05),right TL-right FC(t=2.568,P<0.05)and right TL-left FC(t=2.304,P<0.05)were stonger in DD group than in TD group.The major regions exhibiting differences of whole-brain connectivity between two groups were the right dorsolateral prefrontal cortex,right visual association cortex,right frontal cortex,left orbitofrontal cortex,left visual association cortex,left primary visual cortex and right primary motor cortex.Conclusion Children with DD exhibited significantly stronger connectivity in the right occipital and temporal lobes,as well as between these regions and the prefrontal cortex,suggesting possible right-hemispheric compensation for insufficiency in the left-hemisphere reading network.

TAFRO syndrome is an idiopathic systemic inflammatory disease that overlaps with idiopathic multicentric Castleman disease (iMCD). The clinical features of TAFRO syndrome include thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis/renal insufficiency (R) and organomegaly (O). The paper reports a special clinical subtype of iMCD—TAFRO syndrome in a patient, manifested as multiple-system involvement including serous effusion (ascites), fever, thrombocytopenia, anemia, multiple lymphadenopathies, pancreatitis and renal insufficiency. Bone marrow biopsy pathology showed active bone marrow hyperplasia. Renal biopsy revealed renal thrombotic microangiopathy, acute renal tubular interstitial injury combined with chronic lesions. Lymph node biopsy demonstrated lymphoproliferative lesions consistent with Castleman disease (hyaline vascular type). Following diagnosis, glucocorticoids, tacrolimus, rituximab and lenalidomide were administered, resulting in significant symptomatic improvement: ascites disappeared, and urinary findings, erythrocyte counts, renal function and hematological indexes normalized. The paper describes the patient's clinical manifestations, diagnosis and treatment process, and prognosis, and reviews relevant literature, to improve clinicians' understanding of this rare disease.

Objective To examine resting-state whole-brain network connectivity in children with Chinese developmental dyslexia(DD)and typically developing(TD)children using functional near-infrared spectroscopy(fNIRS).Methods From November to December,2024,19 DD children aged six to twelve years in Children's Hospital of Fudan University were enrolled,along with 18 TD children matching age and sex.Regions of interest included frontal cortex(FC),temporal lobe(TL),occipital lobe(OL)and parietal lobe(PL).Resting-state data were acquired by fNIRS for five minutes in both groups.Functional connectivity strength was calculated at rest,and between-group differences in connectivity strength and brain networks were compared,based on the time series of oxyhe-moglobin concentration.Results The whole-brain functional connectivity strength was higher in DD group than in TD group(t=2.100,P<0.05).Connectivity between the right OL-right FC(t=2.426,P<0.05),right OL-left FC(t=2.483,P<0.05),right TL-right FC(t=2.568,P<0.05)and right TL-left FC(t=2.304,P<0.05)were stonger in DD group than in TD group.The major regions exhibiting differences of whole-brain connectivity between two groups were the right dorsolateral prefrontal cortex,right visual association cortex,right frontal cortex,left orbitofrontal cortex,left visual association cortex,left primary visual cortex and right primary motor cortex.Conclusion Children with DD exhibited significantly stronger connectivity in the right occipital and temporal lobes,as well as between these regions and the prefrontal cortex,suggesting possible right-hemispheric compensation for insufficiency in the left-hemisphere reading network.