Objective: To analyze the prevalence status and clustering patterns of risk factors for chronic diseases among adult residents in Rui' an City, Zhejiang Province, so as to provide a basis for formulating strategies for the prevention and control of chronic diseases and implementing risk factor interventions. Methods: A multi-stage random cluster sampling method was used to select residents aged ≥18 years in 5 townships (sub-districts) of Rui' an City as survey subjects from December 2023 to March 2024. Data on basic information, history of major chronic diseases, lifestyle behaviors, height, weight, and blood biochemical indicators were collected through questionnaire surveys, physical examinations, and laboratory tests. Descriptive analysis was used to analyze the prevalence status of 5 risk factors for chronic diseases. K-means clustering analysis was used to analyze clustering patterns. Results: A total of 3 060 people were surveyed, including 1 476 males, accounting for 48.24%, and 1 584 females, accounting for 51.76%. The median age was 49.00 (interquartile range, 25.00) years. There were 1 275 cases (41.67%) of hypertension, 462 cases (15.10%) of diabetes, and 1 460 cases (47.71%) of dyslipidemia. Insufficient fruit and vegetable intake, excessive salt intake, overweight and obesity, excessive red meat intake, and smoking involved 2 201, 1 878, 1 541, 1 337, and 571 people, with prevalences of 71.93%, 61.37%, 50.36%, 43.69%, and 18.66%, respectively. K-means clustering analysis identified 4 clustering patterns: smoking-insufficient fruit and vegetable intake type (249 people, accounting for 8.20%), low intake type (1 421 people, accounting for 46.75%). high red meat type (245 people, accounting for 8.07%), and high BMI-high salt type (1 118 people, accounting for 36.96%). The prevalences of hypertension and diabetes were higher in adult residents of the high BMI-high salt type, at 56.53% and 20.30%, respectively. The prevalence of dyslipidemia was higher in adult residents of the smoking-insufficient fruit and vegetable intake type, at 59.44%. Conclusions The prevalence of insufficient fruit and vegetable intake among adult residents in Rui' an City is relatively high. The clustering pattern of chronic disease risk factors is dominated by the low intake type. The prevalence of chronic diseases is higher in adult residents of the high BMI-high salt type and smoking-insufficient fruit and vegetable intake type. It is suggested to carry out health education and collaborative intervention of risk factors for different risk groups.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

ObjectiveTo investigate the ameliorative effect of Xingpi capsules on functional dyspepsia（FD） and the potential mechanism. MethodsSixty SPF-grade male SD neonatal rats（7 days old） were randomly divided into the normal group（n=12） and the modeling group（n=48）， and the FD model was prepared by iodoacetamide gavage in the modeling group. After the model was successfully prepared， the rats in the modeling group were randomly divided into the model group， the low-dose and high-dose groups of Xingpi capsules（0.135， 0.54 g·kg^-1） and the domperidone group（3 mg·kg^-1）， with 12 rats in each group. Rats in the normal and model groups were gavaged with distilled water， and rats in the rest of the groups were gavaged with the corresponding medicinal solution， once a day for 7 d. The general survival condition of the rats was observed， and the water intake and food intake of the rats were measured， the gastric emptying rate and the small intestinal propulsion rate were measured at the end of the treatment， the pathological damage of the rat duodenum was examined by hematoxylin-eosin（HE） staining， and the expressions of colonic tight junction protein（Occludin） and zonula occludens protein-1（ZO-1） were detected by immunofluorescence. The differentially expressed genes in the duodenal tissues of the model group and the normal group， and the high-dose group of Xingpi capsules and the model group were detected by transcriptome sequencing after the final administration， and Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses were carried out. The transcriptomic results were validated by Western blot， immunofluorescence， and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the active ingredients of Xingpi capsules were screened for molecular docking with the key targets. ResultsCompared with the normal group， the general survival condition of rats in the model group was poorer， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly reduced（P<0.05）， inflammatory infiltration was seen in duodenal pathology， and the fluorescence intensities of Occludin and ZO-1 in the colon were significantly reduced（P<0.01）. Compared with the model group， the general survival condition of rats in the high-dose group of Xingpi capsules improved significantly， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly increased（P<0.05）， the duodenal pathology showed a decrease in inflammatory infiltration， and the fluorescence intensities of colonic Occludin and ZO-1 were significantly increased（P<0.01）. Transcriptomic results showed that Xingpi capsules might exert therapeutic effects by regulating the phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt） through the key genes such as Slc5a1， Abhd6. The validation results showed that compared with the normal group， the phosphorylation levels of PI3K and Akt proteins， the protein expression level of interleukin（IL）-1β， and the fluorescence intensities of IL-6 and IL-1β were significantly increased in the model group（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3， Slc5a9 and other key genes were significantly increased（P<0.01）. Compared with the model group， the phosphorylation levels of PI3K and Akt， the protein expression level of IL-1β and the fluorescence intensities of IL-6 and IL-1β in the high-dose group of Xingpi capsules were significantly reduced（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3 and Slc5a9 were significantly reduced（P<0.05）. Weighted gene co-expression network analysis and molecular docking results showed that E-nerolidol and Z-nerolidol in Xingpi capsules were well bound to ABDH6 protein， and linarionoside A， valerosidatum and senkirkine were well bound to Slc5a1 protein. ConclusionXingpi capsules can effectively improve the general survival and gastrointestinal motility of FD rats， its specific mechanism may be related to the inhibition of PI3K/Akt signaling pathway to alleviate the low-grade inflammation of duodenum， and E-nerolidol， Z-nerolidol， linarionoside A， valerosidatum and senkirkine may be its key active ingredients.

ObjectiveTo investigate the ameliorative effect of Xingpi capsules on functional dyspepsia（FD） and the potential mechanism. MethodsSixty SPF-grade male SD neonatal rats（7 days old） were randomly divided into the normal group（n=12） and the modeling group（n=48）， and the FD model was prepared by iodoacetamide gavage in the modeling group. After the model was successfully prepared， the rats in the modeling group were randomly divided into the model group， the low-dose and high-dose groups of Xingpi capsules（0.135， 0.54 g·kg^-1） and the domperidone group（3 mg·kg^-1）， with 12 rats in each group. Rats in the normal and model groups were gavaged with distilled water， and rats in the rest of the groups were gavaged with the corresponding medicinal solution， once a day for 7 d. The general survival condition of the rats was observed， and the water intake and food intake of the rats were measured， the gastric emptying rate and the small intestinal propulsion rate were measured at the end of the treatment， the pathological damage of the rat duodenum was examined by hematoxylin-eosin（HE） staining， and the expressions of colonic tight junction protein（Occludin） and zonula occludens protein-1（ZO-1） were detected by immunofluorescence. The differentially expressed genes in the duodenal tissues of the model group and the normal group， and the high-dose group of Xingpi capsules and the model group were detected by transcriptome sequencing after the final administration， and Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） enrichment analyses were carried out. The transcriptomic results were validated by Western blot， immunofluorescence， and real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the active ingredients of Xingpi capsules were screened for molecular docking with the key targets. ResultsCompared with the normal group， the general survival condition of rats in the model group was poorer， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly reduced（P<0.05）， inflammatory infiltration was seen in duodenal pathology， and the fluorescence intensities of Occludin and ZO-1 in the colon were significantly reduced（P<0.01）. Compared with the model group， the general survival condition of rats in the high-dose group of Xingpi capsules improved significantly， and the water intake， food intake， gastric emptying rate and small intestinal propulsion rate were all significantly increased（P<0.05）， the duodenal pathology showed a decrease in inflammatory infiltration， and the fluorescence intensities of colonic Occludin and ZO-1 were significantly increased（P<0.01）. Transcriptomic results showed that Xingpi capsules might exert therapeutic effects by regulating the phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt） through the key genes such as Slc5a1， Abhd6. The validation results showed that compared with the normal group， the phosphorylation levels of PI3K and Akt proteins， the protein expression level of interleukin（IL）-1β， and the fluorescence intensities of IL-6 and IL-1β were significantly increased in the model group（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3， Slc5a9 and other key genes were significantly increased（P<0.01）. Compared with the model group， the phosphorylation levels of PI3K and Akt， the protein expression level of IL-1β and the fluorescence intensities of IL-6 and IL-1β in the high-dose group of Xingpi capsules were significantly reduced（P<0.05， P<0.01）， and the mRNA levels of Slc5a1， Abhd6， Mgam， Atp1a1， Slc7a8， Cdr2， Chrm3 and Slc5a9 were significantly reduced（P<0.05）. Weighted gene co-expression network analysis and molecular docking results showed that E-nerolidol and Z-nerolidol in Xingpi capsules were well bound to ABDH6 protein， and linarionoside A， valerosidatum and senkirkine were well bound to Slc5a1 protein. ConclusionXingpi capsules can effectively improve the general survival and gastrointestinal motility of FD rats， its specific mechanism may be related to the inhibition of PI3K/Akt signaling pathway to alleviate the low-grade inflammation of duodenum， and E-nerolidol， Z-nerolidol， linarionoside A， valerosidatum and senkirkine may be its key active ingredients.

Objective The aim of this study is to understand the quality of the medical records front page,analyze the reasons,and propose targeted measures to continuously improve the quality of medical records front page,providing accurate and reliable data assurance for the DIP model.Methods A stratified sampling method was used to select 15 020 discharged medical records from a tertiary hospital in Guangzhou from 2022 to 2023.Senior coders performed quality control on the selected medical records front page using a double-person double-quality control mode.Data collection was conducted using Microsoft Excel 2007,and statistical description was performed using SPSS 26.0.Results The defect rate of the medical records front page in the stud-ied tertiary hospital in Guangzhou was 19.91％.The defect rates for non-surgical departments and surgical departments were 17.26％and 23.40％,respectively.There were 4,121 cases(49.28％)with information system transmission errors.The main defects affecting DIP inclusion in the medical records front page were the primary surgical or operative procedure name(903 ca-ses,10.80％)and the primary diagnosis(828 cases,9.90％).Conclusion The defect rate of the medical records front page in the studied tertiary hospital in Guangzhou is at a medium-to-high level,with prominent issues of information system transmis-sion errors and defects affecting DIP inclusion.Measures such as strengthening information construction,enhancing training and communication,and organizing medical records front page knowledge competitions should be implemented to improve the quality of medical records front page.

Objective The aim of this study is to understand the quality of the medical records front page,analyze the reasons,and propose targeted measures to continuously improve the quality of medical records front page,providing accurate and reliable data assurance for the DIP model.Methods A stratified sampling method was used to select 15 020 discharged medical records from a tertiary hospital in Guangzhou from 2022 to 2023.Senior coders performed quality control on the selected medical records front page using a double-person double-quality control mode.Data collection was conducted using Microsoft Excel 2007,and statistical description was performed using SPSS 26.0.Results The defect rate of the medical records front page in the stud-ied tertiary hospital in Guangzhou was 19.91％.The defect rates for non-surgical departments and surgical departments were 17.26％and 23.40％,respectively.There were 4,121 cases(49.28％)with information system transmission errors.The main defects affecting DIP inclusion in the medical records front page were the primary surgical or operative procedure name(903 ca-ses,10.80％)and the primary diagnosis(828 cases,9.90％).Conclusion The defect rate of the medical records front page in the studied tertiary hospital in Guangzhou is at a medium-to-high level,with prominent issues of information system transmis-sion errors and defects affecting DIP inclusion.Measures such as strengthening information construction,enhancing training and communication,and organizing medical records front page knowledge competitions should be implemented to improve the quality of medical records front page.

OBJECTIVE To explore the distribution of pathogens isolated from the cardiac surgery children with postoperative catheter-related bloodstream infection(CRBSI)and observe the transforming growth factor β1(TGF-β1)gene polymorphisms and the change of high-sensitivity C-reactive protein(hs-CRP),Smad homologue 2 and Smad 3 levels.METHODS A total of 88 children who received peripherally inserted central catheter(PICC)puncture after cardiac surgery and were complicated with postoperative CRBSI in the First People's Hospital of Zunyi from Aug.2019 to Oct.2023 were assigned as the infection group.Meanwhile,110 children who were trea-ted with PICC and did not have postoperative CRBSI were randomly chosen as the non-infection group.The base-line data,TGF-β1 gene polymorphisms and the levels of hs-CRP,Smad 2 and Smad 3 were compared between the two groups.The distribution of the pathogens isolated from the infection group was observed.The values of hs-CRP,Smad 2 and Smad 3 in diagnosis of the postoperative CRBSI in the cardiac surgery children were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of patients with intravenous cathe-ter indwelling no less than 10 days,length of intensive care unit(ICU)stay no less than 5 days,the frequencies of CC genotypes and C allele at TGF-β1+869C/T locus were higher in the infection group than those in the non-infection group(P＜0.05).Acinetobacter baumannii was the predominant species of pathogen isolated from the infection group,accounting for 24.20％.The levels of serum hs-CRP,Smad 2 and Smad 3 of the infection group were(24.65±7.65)mg/L,(13.54±2.45)pg/ml and(13.65±2.65)pg/ml,respectively,higher than those of the non-infection group(all P＜0.001).The area under the curve(AUC)of the joint detection of hs-CRP,Smad 2 and Smad 3 was highest in diagnosis of the postoperative CRBSI in the cardiac surgery children(P＜0.05).CONCLUSIONS A.baumannii is dominant among the pathogens isolated from the cardiac surgery children with postoperative CRBSI.The postoperative CRBSI may be associated with the intravenous catheter in-dwelling time and length of ICU stay.The C allele at TGF-β1+869C/T locus may be the susceptibility gene for the postoperative CRBSI.The joint detection of hs-CRP,Smad 2 and Smad 3 has the highest value in diagnosis of the postoperative CRBSI.

OBJECTIVE To explore the distribution of pathogens isolated from the cardiac surgery children with postoperative catheter-related bloodstream infection(CRBSI)and observe the transforming growth factor β1(TGF-β1)gene polymorphisms and the change of high-sensitivity C-reactive protein(hs-CRP),Smad homologue 2 and Smad 3 levels.METHODS A total of 88 children who received peripherally inserted central catheter(PICC)puncture after cardiac surgery and were complicated with postoperative CRBSI in the First People's Hospital of Zunyi from Aug.2019 to Oct.2023 were assigned as the infection group.Meanwhile,110 children who were trea-ted with PICC and did not have postoperative CRBSI were randomly chosen as the non-infection group.The base-line data,TGF-β1 gene polymorphisms and the levels of hs-CRP,Smad 2 and Smad 3 were compared between the two groups.The distribution of the pathogens isolated from the infection group was observed.The values of hs-CRP,Smad 2 and Smad 3 in diagnosis of the postoperative CRBSI in the cardiac surgery children were analyzed by receiver operating characteristic(ROC)curves.RESULTS The proportions of patients with intravenous cathe-ter indwelling no less than 10 days,length of intensive care unit(ICU)stay no less than 5 days,the frequencies of CC genotypes and C allele at TGF-β1+869C/T locus were higher in the infection group than those in the non-infection group(P＜0.05).Acinetobacter baumannii was the predominant species of pathogen isolated from the infection group,accounting for 24.20％.The levels of serum hs-CRP,Smad 2 and Smad 3 of the infection group were(24.65±7.65)mg/L,(13.54±2.45)pg/ml and(13.65±2.65)pg/ml,respectively,higher than those of the non-infection group(all P＜0.001).The area under the curve(AUC)of the joint detection of hs-CRP,Smad 2 and Smad 3 was highest in diagnosis of the postoperative CRBSI in the cardiac surgery children(P＜0.05).CONCLUSIONS A.baumannii is dominant among the pathogens isolated from the cardiac surgery children with postoperative CRBSI.The postoperative CRBSI may be associated with the intravenous catheter in-dwelling time and length of ICU stay.The C allele at TGF-β1+869C/T locus may be the susceptibility gene for the postoperative CRBSI.The joint detection of hs-CRP,Smad 2 and Smad 3 has the highest value in diagnosis of the postoperative CRBSI.

Objective:To analyze the risk factors associated with future exacerbations in patients with chronic obstructive pulmonary disease (COPD) who have no history of exacerbation in the past year.Methods:COPD patients with no exacerbation history in the past year, registered in the RealDTC study from January 2018 to December 2023, were enrolled. Demographic data, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea questionnaire scores, forced expiratory volume in the first second predicted of percentage (FEV 1%pred), forced expiratory volume in one second (FEV 1) to forced vital capacity (FVC), Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, GOLD groups, and inhaled medication regimens were collected. All patients were followed up for one year, and the number of exacerbations was recorded. Patients were divided into an exacerbation group and a non-exacerbation group based on the occurrence of exacerbations during the follow-up period. Logistic regression analysis was used to screen the influencing factors for exacerbations in COPD patients. Results:A total of 2 901 COPD patients were included, among which 633 patients (21.8%) experienced exacerbations during the follow-up period. Compared with the non-exacerbation group, patients in the exacerbation group were older, with higher CAT and mMRC scores, lower body mass index (BMI), FEV 1%pred, and FEV 1/FVC. The proportions of patients with high school education or above and those using long-acting β 2-agonist (LABA) + long-acting muscarinic antagonist (LAMA) medications were also lower (all P<0.05). Logistic regression analysis showed that age ( OR=1.010, 95% CI: 1.000-1.021), CAT score ≥20 ( OR=1.415, 95% CI: 1.074-1.865), education level of junior high school or below ( OR=1.243, 95% CI: 1.003-1.540), LABA + LAMA inhalation ( OR=0.605, 95% CI: 0.432-0.848), and BMI ( OR=0.969, 95% CI: 0.943-0.995) were independent risk factors for future exacerbations in COPD patients with no exacerbation history in the past year (all P<0.05). Conclusions:The risk of future exacerbations remains high in COPD patients with no exacerbation history in the past year. High CAT scores, low education levels, and low BMI are associated with future exacerbations. Clinicians should pay close attention to the management of such patients and implement appropriate interventions.

Objective:To analyze the risk factors associated with future exacerbations in patients with chronic obstructive pulmonary disease (COPD) who have no history of exacerbation in the past year.Methods:COPD patients with no exacerbation history in the past year, registered in the RealDTC study from January 2018 to December 2023, were enrolled. Demographic data, COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea questionnaire scores, forced expiratory volume in the first second predicted of percentage (FEV 1%pred), forced expiratory volume in one second (FEV 1) to forced vital capacity (FVC), Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification, GOLD groups, and inhaled medication regimens were collected. All patients were followed up for one year, and the number of exacerbations was recorded. Patients were divided into an exacerbation group and a non-exacerbation group based on the occurrence of exacerbations during the follow-up period. Logistic regression analysis was used to screen the influencing factors for exacerbations in COPD patients. Results:A total of 2 901 COPD patients were included, among which 633 patients (21.8%) experienced exacerbations during the follow-up period. Compared with the non-exacerbation group, patients in the exacerbation group were older, with higher CAT and mMRC scores, lower body mass index (BMI), FEV 1%pred, and FEV 1/FVC. The proportions of patients with high school education or above and those using long-acting β 2-agonist (LABA) + long-acting muscarinic antagonist (LAMA) medications were also lower (all P<0.05). Logistic regression analysis showed that age ( OR=1.010, 95% CI: 1.000-1.021), CAT score ≥20 ( OR=1.415, 95% CI: 1.074-1.865), education level of junior high school or below ( OR=1.243, 95% CI: 1.003-1.540), LABA + LAMA inhalation ( OR=0.605, 95% CI: 0.432-0.848), and BMI ( OR=0.969, 95% CI: 0.943-0.995) were independent risk factors for future exacerbations in COPD patients with no exacerbation history in the past year (all P<0.05). Conclusions:The risk of future exacerbations remains high in COPD patients with no exacerbation history in the past year. High CAT scores, low education levels, and low BMI are associated with future exacerbations. Clinicians should pay close attention to the management of such patients and implement appropriate interventions.