ObjectiveTo investigate the effects of Huangqi Jianzhongtang （HQJZ） on macrophage polarization and fat consumption in cancer cachexia （CC） mice. MethodsUltra-performance liquid chromatography-quadrupole/electrostatic field Orbitrap high-resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to control the quality of HQJZ. （1） In vitro experiment： HQJZ-containing serum was prepared， and the optimal concentration was determined by cytotoxicity assay. Mouse monocyte-derived macrophages （RAW264.7） were cultured and randomly divided into six groups， including a blank group， a classically activated macrophages （M1） group， an alternatively activated macrophages （M2） group， a HQJZ + blank group， a HQJZ+M1 group， and a HQJZ + M2 group. The relative expression of macrophage marker genes CD86， inducible nitric oxide synthase （iNOS）， CD206， and arginase-1 （Arg1） was detected by real-time quantitative polymerase chain reaction （Real-time PCR ）. （2） In vivo experiment： Thirty-two BALB/c mice were randomly divided into a control group， a model group， a medroxyprogesterone acetate （MPA） group， and a HQJZ group. Except for the control group， the other mice were injected with CT-26 colon cancer cells to establish a CC model. Mice in the MPA and HQJZ groups were given MPA （0.13 g·kg^-1·d^-1） or HQJZ （13.13 g·kg^-1·d^-1） by gavage， respectively， while mice in the control and model groups were given an equal volume of saline by gavage， with interventions continued for 10 d. Real-time PCR was used to detect the expression of macrophage markers （iNOS， Arg1， CD86， CD206） and fat browning-related genes uncoupling protein 1 （UCP1） and peroxisome proliferator-activated receptor γ （PPARγ） in epididymal adipose tissue. Western blot （WB） was used to detect protein expression levels of UCP1 and PPARγ. Micro-computed tomography （micro-CT） was used to measure residual fat volume， and hematoxylin-eosin （HE） staining was used to assess fat browning and calculate pathological scores. ResultsIn vitro， the dominant effective concentration of HQJZ-containing serum was 12.5%. Real-time PCR results showed that， compared with the blank group， Arg1 expression decreased in the HQJZ+blank group （P<0.05）， CD206 showed a downward trend without statistical significance， while iNOS and CD86 expression were significantly increased （P<0.05）. Compared with the M1 group， Arg1 and CD206 expression decreased in the HQJZ+M1 group （P<0.05）. Compared with the M2 group， CD206 expression decreased in the HQJZ+M2 group （P<0.05）， CD86 expression increased significantly （P<0.01）. In vivo， Real-time PCR results showed that， compared with the control group， CD86 and CD206 expression levels were significantly increased in the model group （P<0.01）. Compared with the model group， CD206 expression in the MPA group was significantly decreased （P<0.01）. In the HQJZ group， CD206 was significantly decreased （P<0.01）. WB results showed that， compared with the model group， protein expression of UCP1 and PPARγ was significantly reduced in the HQJZ group （P<0.05， P<0.01）. micro-CT results showed that the total white fat volume in the HQJZ group was greater than that in the model group （P<0.05）. HE staining results showed that pathological scores in the HQJZ group were lower than those in the model group （P<0.05）. ConclusionHQJZ may inhibit white adipose tissue browning by promoting macrophage M1 polarization and suppressing M2 polarization， thereby delaying fat consumption in CC mice.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Objective To construct a prognostic model of lung adenocarcinoma(LUAD)based on m5C modification-related genes and to explore its clinical value.Methods Based on the LUAD data in TCGA,GSE30219,GSE31210,and GSE50081 cohorts,prognosis-related m5C modification-related genes were screened,and the prognostic model was constructed by using univariate Cox,Lasso,and multivariate Cox regression analyses.Kaplan-Meier curve,ROC curve,and Cox regression were used to observe the robustness and prognostic performance of the model.The correlation between the prognostic model and clinico-pathologic features was further explored.Results A prognostic model consisting of eight m5C modifi-cation-related genes,including CDK1,CDKN1A,NOP2,RRM2,TCL6,TLR8,TRDMT1,and YTHDF2,was constructed.Risk score was an independent risk factor for the prognosis of patients with LUAD,and it is combined with age,T stage,and N stage to constitute a nomogram which can accurately predict the prognosis of patients.The infiltration of macrophages and CD4+/CD8+T cells was significantly reduced in high-risk patients.The risk score in LUAD tissues was significantly higher than that in normal tissues and was positively correlated with T stage and N stage.The risk score of smoking and EGFR wild-type patients was higher than that of non-smoking and EGFR-mutant patients.Conclusion The prognostic model constructed based on m5C modification-related genes has shown good accuracy and stability in predicting the prognosis of patients with LUAD,and it is closely related to clinical features,driver gene mutations,and immune infiltration,which can provide a potential basis for the treatment and prognostic assessment of LUAD.

Objective:To assess the effects of recognition function of four-lead electrocardiogram(ECG)synchronization technique and multi-parameter fusion technique in reducing the number of false alarms and improving the quality of alarms in intensive care units(ICU).Methods:Four-lead ECG synchronization technique and multi-parameter fusion technique were used to strengthen the monitoring and assessment for the alarm of clinical monitors,and reduce the false alarm rate of monitors.The clinical alarm data of bed units corresponding to 48 monitors in clinical use of ICU,cardiovascular intensive care unit(CCU)and neurosurgery intensive care unit(NICU)of Hainan General Hospital from October 14 to December 27,2024 were selected.According to the opening and close of the four-lead ECG synchronization and multi-parameter fusion technique algorithm of the monitors,they were divided into group A(opened four-lead ECG synchronization and multi-parameter fusion),group B(opened four-lead ECG synchronization,but closed multi-parameter fusion),group C(closed four-lead ECG synchronization,but opened multi-parameter fusion)and group D(closed four-lead ECG synchronization and multi-parameter fusion),with 12 units in each group.The numbers of total alarms and false alarms generated by monitor of each bed unit among different optimization strategies were compared.Results:The numbers of average daily alarm of the monitors in groups A,B and C were respectively(134.2±32.4)cases,(392.5±68.2)cases and(583.4±126.5)cases,which were lower than those in group D(1 073.2±168.6),with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).The optimization rates of the alarm numbers in groups A,B and C were increased by 87.51%,63.47%and 45.67%,respectively.The rates of average false alarm of the monitors in groups A,B and C were respectively(1.04±0.15)%,(1.73±0.12)%and(2.07±0.08)%,which were lower than(3.76±0.2)%in group D,with statistically significant differences(Z=3.45,2.94,2.52,P<0.05).Conclusion:Four-lead ECG synchronization technique and multi-parameter fusion technique can effectively optimize the number of alarms in ICU,and reduce the proportion of false alarms of monitors in department,and decrease fatigue of medical staffs for alarm.

Objective To explore the value of cranial CT perfusion imaging(CTP)parameters combined with head and neck CT angiography(CTA)in assessing collateral circulation status and predicting prognosis in acute ischemic stroke(AIS).Methods A retrospective analysis was carried out on 83 AIS patients who were treated in Taikang Xianlin Drum Tower Hospital from June 2018 to June 2023.CTP and head and neck CTA examinations were performed within 24 hours after admission.Digital subtraction angiography is the gold standard for assessing collateral circulation status in AIS patients.The general information of these patients was collected,and the patient's prognosis was evaluated using the modified Rankin scale through telephone or outpatient follow-up 90 days after the occurrence of AIS.Pearson or Spearman correlation was used to analyze the correlation between collateral circulation assessment and CTP parameters and head and neck CTA scores.The value of CTP parameters and head and neck CTA scores in predicting the prognosis of AIS patients was discussed using multivariate Logistic regression.Moreover,the receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTP parameters,head and neck CTA,and the combination for the prognosis of AIS patients.Results The cerebral blood volume(CBV),cerebral blood flow(CBF),and CTA score were higher,while mean transit time(MTT)and time to peak(TTP)were shorter in the good collateral circulation group than in poor collateral circulation group(P<0.05).The collateral circulation status in AIS patients was negatively correlated with CBV,CBF,and CTA score,while positively correlated with MTT and TTP(P<0.05).Compared with poor prognosis group,good prognosis group had higher CBV,CBF,CTA,and shorter MTT and TTP(P<0.05).Multivariate Logistic regression analysis identified MTT and TTP as risk factors for poor prognosis,and CBV,CBF,and CTA scores as protective factors for poor prognosis in AIS patients(P<0.05).The ROC results showed that the area under the curve(AUC)of CBV,MTT,CBF,TTP,CTA score and the combination to predict the prognosis of AIS patients were 0.897,0.864,0.835,0.920,0.918,and 0.979,respectively,showing better predictive performance of the combination than single index alone(Z=2.194,2.910,2.521,2.229,2.171;P<0.05).Conclusion CTP parameters combined with CTA may effectively assess collateral circulation in patients with AIS and is significant for prognosis prediction.

Objective To explore the value of serum Annexin A2(ANXA2),vasohibin-1(VASH1)and caveolin-1(CAV-1)in evaluating pregnancy outcomes in patients with hypertensive disorders of pregnancy(HDP).Methods From June 2020 to April 2023,125 patients with HDP admitted to Qingdao Women's and Children's Hospital were regarded as the research group,according to the pregnancy outcomes,they were separated into a good pregnancy outcome group(n=77)and a poor pregnancy outcome group(n=48).In addition,100 normal pregnant women who underwent pregnancy tests during the same period were regarded as the control group.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of ANXA2,VASH1,and CAV-1.Binary logistic regression was used to analyze the influencing factors of pregnancy outcomes in pregnant women with HDP,and receiver operating characteristic(ROC)curves were drawn to analyze the diagnostic value of serum ANXA2,VASH1,and CAV-1 in the diagnosis of HDP patients pregnancy outcome.Correlation of serum ANXA2,VASH1 and CAV-1 with 24-h urine protein content and blood pressure indices analyzed by Pearson's method.Results Compared with the healthy group,the serum ANXA2(353.19±37.31 μg/L vs 415.32±42.65 μg/L)and CAV-1(6.05±0.64 μg/L vs 6.89±0.73 μg/L)levels in the case group were greatly reduced(t=11.644,9.188),while VASH1(615.48±62.46 ng/L vs 528.63±54.39 ng/L)level was greatly increased(t=10.969),and the differences were statistically significant(all P<0.05).The serum NXA2(322.54±34.24 μg/L vs 372.29±39.23 μg/L)and CAV-1(5.56±0.59 μg/L vs 6.38±0.67 μg/L)levels in poor pregnancy outcomes group were greatly lower than those in good pregnancy outcomes group(t=7.323,6.706),while VASH1(660.29±67.34 ng/L vs 587.56±59.42 ng/L)level was greatly higher(t=6.321),and the differences were statistically significant(all P<0.05).24h urine protein level,VASH1 were risk factors affecting adverse pregnancy outcomes in patients with HDP(P<0.05),serum ANXA2 and CAV-1 were protective factors affecting adverse pregnancy outcomes in patients with HDP,and the differences were statistically significant(P<0.05).ROC curve results showed that the Area under the curve(AUC)of ANXA2,VASH1,CAV-1,and their combination in predicting pregnancy outcomes in HDP patients was 0.809,0.747,0.775 and 0.909,respectively.The AUC predicted by the combination of ANXA2,VASH1,and CAV-1 were greatly better than those predicted by ANXA2,VASH1 and CAV-1 alone(Z=2.720,3.334,3.320,all P＜0.05).ANXA2,VASH1 was negatively correlated with 24h urine protein level and systolic and diastolic blood pressure(r=-0.435～-0.406,all P<0.05),and CAV-1 was positively correlated with 24h urine protein level and systolic and diastolic blood pressure(r=0.428,0.409,0.421,P<0.05).Conclusion The serum ANXA2 and CAV-1 levels in HDP patients decreased,while Ang1 level increased,which has certain auxiliary predictive value for the diagnosis of HDP and the evaluation of pregnancy outcomes.

BACKGROUND:The asymmetrical biomechanical environment of adolescent idiopathic scoliosis can lead to further wedge deformation of the vertebral body,which may affect cardiopulmonary function and compress nerves in severe cases.Adolescent idiopathic scoliosis with different degrees of scoliosis should be treated with exercise,bracing,and surgery.However,the mechanical mechanism of selecting an orthopedic approach remains unclear due to the individual variability of patients.OBJECTIVE:To investigate the biomechanical mechanism of different orthopedic modalities for the treatment of adolescent idiopathic scoliosis to provide a basis for clinical selection of treatment modalities based on the spine model of adolescent idiopathic scoliosis patients.METHODS:Based on the CT images of an adolescent idiopathic scoliosis patient,a scoliosis model(C7-L5)was reconstructed in Mimics software in three dimensions,and lateral thrust force was applied at the T8/T9 thorax and vertical distraction force was applied over the C7 vertebra with the magnitude of 20,40,60,80,100,and 120 N.The intervertebral disc stress and vertebral displacement in concave and convex sides,and Cobb angle of the spine were analyzed under two orthopedic modalities.RESULTS AND CONCLUSION:(1)With lateral thrust,there was no significant change in the C7T1-T7T8 intervertebral disc.The concave and convex stress of T7T8-L4L5 segment decreased first and then increased with the increase of lateral thrust force.The correction effect of lateral thrust on the segment near T8T9 was obvious and weakened with the extension of the segment to the cephalic and caudal ends.At 120 N of lateral thrust,the thoracic Cobb angle changed from 53.2° to 32.5° and the lumbar Cobb angle changed from 50.2° to 43.9°.(2)With the vertical distraction,the thoracic intervertebral disc stresses first decreased and then increased,and all the lumbar disc stresses decreased.The C7 displacement was the most obvious,and the correction effect gradually diminished with the segment extended to the caudal end.At a vertical distraction force of 120 N,the thoracic Cobb angle changed from 53.2° to 39.4° and the lumbar Cobb angle changed from 50.2° to 47.6°.(3)It is concluded that both orthopedic modalities provide improvement in the degree of scoliosis,with the thoracic correction being greater than the lumbar correction.Also,the asymmetric stress distribution on the concave and convex sides is improved,which contributes to normal bone growth.A vertical distraction approach is appropriate for larger Cobb angles,and a lateral thrust approach is appropriate for smaller Cobb angles.The results of this study help to understand the mechanism of spinal orthosis and provide a theoretical basis for the choice of orthopedic approach.

Objective To assess the global and Chinese disease burden of early-onset lung cancer(di-agnosed in patients aged 15-49 years)and its major risk factors.Methods Based on the GLOBOCAN 2022 and Global Burden of Disease(GBD)2021 datasets,we evaluated the disease burden and associated risk fac-tors of early-onset lung cancer globally and in China,stratified by age,sex,geographic location,and human development index(HDI).Key indicators included age-standardized incidence rate(ASIR),age-standardized mortality rate(ASMR),and disability adjusted life years(DALYs)attributable to risk factors.Results In 2022,there were 137 705 new cases and 72 646 deaths from early-onset lung cancer globally,with ASIR and ASMR of 3.43 per 100 000 and 1.82 per 100 000 population,respectively.The disease burden was higher in males than in females(ASIR:3.72 per 100 000 vs.3.14 per 100 000;ASMR:2.31 per 100 000 vs.1.33 per 100 000).High-HDI regions exhibited the highest ASIR(5.51 per 100 000)and ASMR(2.57 per 100 000),with health inequality analysis revealing a concentration of disease burden in higher-HDI areas.China bore the heaviest burden,accounting for 48.69%of global new cases and 35.77%of deaths.China's ASIR(8.21 per 100 000)and ASMR(3.17 per 100 000)exceeded global averages,with incidence higher in fe-males(8.78 per 100 000 vs.7.67 per 100 000)but mortality higher in males(4.01 per 100 000 vs.2.29 per 100 000).Smoking and ambient particulate matter pollution were the leading risk factors globally(DALYs contribution:42.01%and15.62%)and in China(DALYs contribution:46.78%and 20.84%).Globally,household air pollution ranked third,whereas in China,secondhand smoke replaced it as the third leading risk factor,with household air pollution dropping to fifth.Risk factor profiles varied significantly across age groups,with modifiable risks contributing less to disease burden in the 15-24 age group.Conclusions The burden of early-onset lung cancer varies markedly by sex,region,and HDI,with China facing a disproportionately high burden.Policymakers should prioritize equitable resource allocation and targeted interventions,particularly in tobacco control and air pollution mitigation,to enhance cancer prevention and control efforts.

Objective:To study the effect of repetitive facilitative exercise (RFE) combined with repetitive transcranial magnetic stimulation (rTMS) on upper limb motor function in subacute stroke patients.Methods:A total of 80 patients with subacute stroke diagnosed and treated in the First Affiliated Hospital of Wenzhou Medical University from November 2023 to March 2024 were prospectively selected and divided into control group, RFE group, RFE+ low frequency rTMS group and RFE+ high frequency rTMS group by random number table method, with 20 cases in each group. The control group received conventional rehabilitation therapy, the RFE group received conventional rehabilitation therapy +RFE, the RFE+ low frequency rTMS group received conventional rehabilitation therapy +RFE+ low frequency (1 Hz) rTMS therapy, and the RFE+ high frequency rTMS group received conventional rehabilitation therapy +RFE+ high frequency (10 Hz) rTMS therapy. All of four groups were treated continuously for 2 weeks. The changes of Fugl-Meyer Scale (Motor Function) Upper Limb (FMA-UE) score, Modified Ashworth Scale (MAS) score, Modified Barthel Index (MBI) score, hemiplegic hand grip strength and BrunnstromScale (BRSS) score before and after treatment were compared among the four groups.Results:There were no statistical differences in the FMA-UE score, MAS grade, MBI score and hemiplegic hand grip strength among the four groups before treatment ( P>0.05). After treatment, the FMA-UE, MBI scores and hemiplegic hand grip strength were increased in the four groups, and MAS grade were decreased, there were statistical differences ( P<0.05). RFE+ low-frequency rTMS group had the highest FMA-UE, MBI score and hemiplegic hand grip strength, and MAS grade was the lowest, and compared with RFE+ high-frequency rTMS group, there were statistical differences : (43.65 ± 2.11) scores vs. (40.95 ± 2.12) scores, (49.20 ± 4.06) scores vs. (44.80 ± 2.48) scores, (32.45 ± 2.59) kg vs. (29.30 ± 2.94) kg, (0.37 ± 0.09) grade vs. (0.56 ± 0.10) grade, P<0.01. The BRSS unupgradingrate among the four groups after treatment were 10/20, 8/20, 2/20, 5/20, there was statistical difference ( χ2 = 8.65, P = 0.031), and the RFE+ low-frequency rTMS group had the lowest number of BRSS unupgraded cases. Conclusions:The efficacy of RFE combined with low-frequency rTMS in the treatment of subacute stroke is obvious, which is conducive to promoting the recovery of muscle strength, grip strength and motor function of the hemiplegic side of the patients.

Objective To analyze the virus subtypes, molecular evolutional and molecular transmission network features of the first confirmed mpox case in Huai’an City, Jiangsu Province, so as to provide insights into understanding of the transmission and evolution dynamics of mpox virus and formulation of the mpox control strategy in the city. Methods Genomic DNA was extracted from swabs of the first confirmed mpox case’s skin lesions in Huai’an City, and the amplicon sequencing library was constructed using the hypersensitive mpox virus whole-genome capture kit. High-throughput sequencing was performed using the GridION X5 nanopore sequencer on the Nanopore sequencing platform, and single nucleotide polymorphism (SNP) analysis of mpox virus genome sequences was performed following sequence assembly. In addition, phylogenetic analysis, genetic genealogy and molecular traceability analysis were performed. Results The virus whole genome sequence of the first confirmed mpox case was successfully obtained by high-throughput sequencing, with a full length of 197 182 bp, and was named hMpxV/China/JS-HA01/2023, which belonged to the clade IIb (West African clade) lineage B.1.3. Compared with the mpox virus reference sequence MPXV-M5312_HM12_Rivers-001 (GenBank accession number: NC_063383), the genome sequence of the Huai’an virus isolate carried 86 SNPs, including 40 SNPs in the coding region as non-synonymous mutations and 73 SNPs as nucleotide mutations caused by APOBEC3 (APOBEC3). Of the 97 mpox virus gene sequences, 79 sequences were included in the molecular network (81.44%), and the threshold of the genetic distance accessed to the network was 0.35/10⁵. There were two large molecular transmission clusters and one scattered cluster in the molecular transmission network of the mpox virus, andthehMpxV/China/JS-HA01/2023 sequence was located in the large cluster. The 97 gene sequences formed 92 haplotypes, including three shared haplotypes Hap_4, Hap_6 and Hap_38, and an exclusive haplotype Hap_1 of hMpxV/China/JS-HA01/2023 generated from mutation of the exclusive haplotype Hap_43, while the exclusive haplotype Hap_43 was generated from mutation of the shared haplotype Hap_38. Conclusions The whole genome sequence of the mpox virus isolated from the first confirmed mpox case in Huai’an City has been successfully obtained, and the molecular evolutionary and molecular transmission network characteristics of the virus have been preliminarily understood.