Background Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals characterized by environmental persistence and have been ubiquitously detected in pregnant women. Although existing evidence suggests that PFAS may exert endocrine-disrupting effects, evidence remains limited regarding the associations of individual legacy and emerging PFAS congeners, as well as PFAS mixtures, with fetal hormonal homeostasis. Objective Based on the Jiashan Birth Cohort in China, to investigate the associations between maternal plasma concentrations of legacy and emerging PFAS in the second trimester and levels of multiple hormones in fetal cord blood. Methods A total of 336 women in the second trimester from the Jiashan Birth Cohort were enrolled. Concentrations of 53 legacy and emerging PFAS were measured in maternal plasma, and levels of eight key hormones were determined in fetal cord blood. Multiple linear regression, restricted cubic spline, and Bayesian kernel machine regression models were used to examine the linear, nonlinear, and joint associations of individual PFAS and PFAS mixtures with fetal cord blood hormone levels. Results Maternal plasma concentrations of perfluorononanoic acid, perfluorohexane sulfonic acid, perfluorooctanesulfonic acid, and 8:2 chlorinated perfluoroether sulfonic acid were positively associated with cord blood levels of insulin-like growth factor 1 (IGF1), with β values of 0.040, 0.050, 0.040, and 0.030, respectively (all P<0.05). In contrast, perfluoroheptanoic acid was negatively associated with prolactin levels (β=−0.060, P<0.01). Restricted cubic spline models revealed a nonlinear dose–response relationship between perfluorobutane sulfonic acid and growth hormone (likelihood ratio test P=0.045), with a positive association in the intermediate concentration interval (β=0.261, P=0.010) that turned negative at higher concentrations (β=−0.425, P=0.048), as well as a nonlinear trend between 6:2 fluorotelomer sulfonic acid and prolactin (likelihood ratio test P=0.074). Bayesian kernel machine regression analysis indicated a negative trend between PFAS mixture exposure and cord blood prolactin levels. Conclusion Maternal PFAS exposure in the second trimester is associated with higher insulin-like growth factor 1 levels and lower prolactin levels in fetal cord blood. Prolactin appears to be consistently associated with both individual PFAS congeners and PFAS mixtures. These findings suggest that maternal PFAS exposure may affect fetal endocrine homeostasis by disrupting the hypothalamic-pituitary-prolactin regulatory axis.

Objective:To explore the effect, postoperative mucosal pathological changes and molecular biological changes of reboot operation for type 2 inflammation chronic rhinosinusitis with nasal polyps（CRSwNP） patients, and to provide theoretical basis for the clinical application of this kind of operation. Methods:We collected 29 patients who were diagnosed with CRSwNP with type 2 inflammatino response and underwent Reboot surgery from June 2022 to August 2023, and 27 patients who were diagnosed with deviated septum and underwent simple submucosal resection of the septum as the control group. We conducted nasal symptom scoring, endoscopic sinusitis scoring, and CT scanning of the sinuses before and after surgery, as well as HE staining, immunohistochemical staining, and detection of inflammatory factors using Elisa kits at the time of surgery, 1, 3, and 6 months postoperatively. We also observed the ultrastructural changes using transmission electron microscopy and scanning electron microscopy, and performed proteomic analysis of the mucosa in the ethmoid sinus area of the sinusitis patients at the time of surgery and 6 months postoperatively. Results:After 6 months of postoperative follow-up, CT scores of the nasal cavity and sinuses had gradually decreased compared with the preoperative period. The VAS score of main symptoms, SNOT-22 score and Lund-Kennedy endoscopic score were decreased after 12 months follow-up. The histological morphology of the mucosa in the area of the screen was significantly improved compared with the preoperative period, with a reduction in the number of eosinophils. The levels of inflammatory factors such as IL-4 and IL-5 et al. in the mucosa of the area of the screen were gradually reduced compared with the preoperative period. The histological morphology, ultrastructure, and cilia structure of the mucosa in the area of the screen were gradually improved compared with the preoperative period, though not recovered completely. The number of CD4⁺T and CD8⁺T cells not changed significantly before and after the surgery yet. By conducting proteomic analysis of the ethmoidal sinus mucosa before and after surgery, differential proteins were selected, and bioinformatics analysis was conducted on the differentially expressed proteins. By using cytoHubba to identify hub genes and intersecting them with the genes related to chronic sinusitis, we found that MMP9 expression increased in non-type 2 CRS and type 2 CRS in sequence, while ACTC1 expression decreased in non-tpye 2 CRS and type 2 CRS in sequence. Conclusion:Reboot surgery can improve the postoperative symptoms and signs of patients, improve the pathological morphology of the mucosa, and influence the expression of protein after surgery. However, the surgery may not have a significant impact on the distribution of T cell subpopulations and inflammation signal pathway in the nasal mucosa.
Humans ; Sinusitis/metabolism* ; Nasal Polyps/metabolism* ; Nasal Mucosa/ultrastructure* ; Chronic Disease ; Rhinitis/complications* ; Inflammation ; Male ; Female ; Postoperative Period ; Adult ; Interleukin-5/metabolism* ; Interleukin-4/metabolism* ; Middle Aged ; Proteomics ; Rhinosinusitis

Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans ; Denture, Complete ; Computer-Aided Design ; Denture Design/methods* ; Consensus ; Printing, Three-Dimensional

To analyze the epidemic characteristics and vaccination status of hemorrhagic fever with renal syndrome (HFRS) in Baoji City from 2008 to 2023. The descriptive epidemiological method was used to collect the incidence data of HFRS cases in Baoji City from 2008 to 2003 in the Infectious Disease Reporting Information Management System. The epidemic characteristics of HFRS cases were summarized and analyzed. The data on HFRS vaccination from 2008 to 2023 were consulted through the Baoji Hemorrhagic Fever Vaccination Report, and the relationship between vaccination status and reported incidence was analyzed. The results showed that a total of 2 690 cases of HFRS were reported in Baoji City, with an annual average reported incidence rate of 6.94/100 000, 15 cases died and a case fatality rate of 0.41%. The number of reported HFRS cases showed a fluctuating trend, with a peak in 2011-2013. Since 2016, it entered a low-level stable fluctuation period, and the annual mortality rate dropped to below 1% after 2011. From 2008 to 2023, Fufeng County, Meixian County and Chencang District reported a large number of cases, but Linyou County and other counties in the north showed an upward trend in incidence, with obvious seasonal characteristics. Cases were mainly concentrated from October to January of the following year, accounting for 75.91% of the total number of cases. Farmers were the main reported occupations, accounting for 80.19% of the total number of cases. The ratio of male to female reported cases was 3.30∶1. The age group of 35-59 years old accounted for 51.08% of the cases, and the proportion of the age group of 60 years and above showed an upward trend ( χ2=331.44, P<0.001). From 2008 to 2023, a total of 1 559 619 people were vaccinated, and the vaccination rate of the target population aged 16-60 years reached 72.23%. With the increase in the vaccination rate, the incidence of HFRS continued to decrease. In summary, with the development of HFRS vaccination work, the epidemic characteristics of HFRS in Baoji City have changed, and the peak incidence has been controlled. The proportion of cases in the age group of 60 years and above continues to increase. HFRS vaccination is still an effective way of prevention and control, and vaccination strategies should be continuously optimized according to the characteristics of HFRS.

Objective:To investigate the association between different types of lung nodules and the risk of lung cancer in a population at high risk of lung cancer and to provide an epidemiologic basis for the comprehensive management of lung nodules.Methods:Using the free lung cancer screening program of low-dose CT (LDCT) in Wenling, Zhejiang Province, we collected baseline and imaging information of high-risk groups for lung cancer who underwent LDCT screening from April 2019 to October 2021 and patients with previous history of lung cancer, tuberculosis, pneumoconiosis, and silicosis were excluded. A total of 28 539 study subjects were included in the analysis, and the follow-up ended on 31 December 2023. Based on the characteristics of the detected pulmonary nodules, the study subjects were classified with no nodules, with solid nodules, with pure ground glass nodules, and with part solid nodules groups. The association between different characteristics of lung nodules and the risk of lung cancer development was analyzed using the Cox proportional hazard regression model with a new diagnosis of lung cancer during the follow-up period as the outcome.Results:The overall detection rate of lung nodules with a mean diameter of ≥3 mm was 76.5%, of which 53.7%, 18.2%, and 4.6% were detected in the solid nodule, pure ground glass nodule, and partially solid nodule groups, respectively. There were statistically significant differences between the different nodule groups in terms of age, gender, BMI, history of toxic exposure education level, smoking status, history of lung disease, and family history of lung cancer (all P<0.05). The median follow-up time of the study population was 3.4 years, and 485 new lung cancer cases were diagnosed during the follow-up period. After adjusting for covariates, the results of multifactorial Cox proportional hazard regression model analysis showed that the risk of lung cancer was higher in pure ground glass nodules and part solid nodules compared with solid nodules, with HR values (95% CI) of 1.89 (1.52-2.35) and 6.49 (5.18-8.14), respectively. The results of subgroup analysis showed that patients in the group of part solid nodules had the highest risk of lung cancer in all strata of the population, followed by patients with pure ground glass nodules. Patients in the solid nodule group who were older or had previous lung disease had a higher risk of lung cancer, and the risk of lung cancer in the part solid nodule group differed between genders. Conclusions:The proportion of lung nodules detected is high in the high-risk group of lung cancer, and among them, patients with pure ground glass and part solid nodules have a higher risk of developing lung cancer. Attention should be paid to the annual follow-up management for patients with solid nodules who are older or who have had lung diseases, as well as for female patients with part solid nodules.

Objective:To investigate the association between different types of lung nodules and the risk of lung cancer in a population at high risk of lung cancer and to provide an epidemiologic basis for the comprehensive management of lung nodules.Methods:Using the free lung cancer screening program of low-dose CT (LDCT) in Wenling, Zhejiang Province, we collected baseline and imaging information of high-risk groups for lung cancer who underwent LDCT screening from April 2019 to October 2021 and patients with previous history of lung cancer, tuberculosis, pneumoconiosis, and silicosis were excluded. A total of 28 539 study subjects were included in the analysis, and the follow-up ended on 31 December 2023. Based on the characteristics of the detected pulmonary nodules, the study subjects were classified with no nodules, with solid nodules, with pure ground glass nodules, and with part solid nodules groups. The association between different characteristics of lung nodules and the risk of lung cancer development was analyzed using the Cox proportional hazard regression model with a new diagnosis of lung cancer during the follow-up period as the outcome.Results:The overall detection rate of lung nodules with a mean diameter of ≥3 mm was 76.5%, of which 53.7%, 18.2%, and 4.6% were detected in the solid nodule, pure ground glass nodule, and partially solid nodule groups, respectively. There were statistically significant differences between the different nodule groups in terms of age, gender, BMI, history of toxic exposure education level, smoking status, history of lung disease, and family history of lung cancer (all P<0.05). The median follow-up time of the study population was 3.4 years, and 485 new lung cancer cases were diagnosed during the follow-up period. After adjusting for covariates, the results of multifactorial Cox proportional hazard regression model analysis showed that the risk of lung cancer was higher in pure ground glass nodules and part solid nodules compared with solid nodules, with HR values (95% CI) of 1.89 (1.52-2.35) and 6.49 (5.18-8.14), respectively. The results of subgroup analysis showed that patients in the group of part solid nodules had the highest risk of lung cancer in all strata of the population, followed by patients with pure ground glass nodules. Patients in the solid nodule group who were older or had previous lung disease had a higher risk of lung cancer, and the risk of lung cancer in the part solid nodule group differed between genders. Conclusions:The proportion of lung nodules detected is high in the high-risk group of lung cancer, and among them, patients with pure ground glass and part solid nodules have a higher risk of developing lung cancer. Attention should be paid to the annual follow-up management for patients with solid nodules who are older or who have had lung diseases, as well as for female patients with part solid nodules.

To analyze the epidemic characteristics and vaccination status of hemorrhagic fever with renal syndrome (HFRS) in Baoji City from 2008 to 2023. The descriptive epidemiological method was used to collect the incidence data of HFRS cases in Baoji City from 2008 to 2003 in the Infectious Disease Reporting Information Management System. The epidemic characteristics of HFRS cases were summarized and analyzed. The data on HFRS vaccination from 2008 to 2023 were consulted through the Baoji Hemorrhagic Fever Vaccination Report, and the relationship between vaccination status and reported incidence was analyzed. The results showed that a total of 2 690 cases of HFRS were reported in Baoji City, with an annual average reported incidence rate of 6.94/100 000, 15 cases died and a case fatality rate of 0.41%. The number of reported HFRS cases showed a fluctuating trend, with a peak in 2011-2013. Since 2016, it entered a low-level stable fluctuation period, and the annual mortality rate dropped to below 1% after 2011. From 2008 to 2023, Fufeng County, Meixian County and Chencang District reported a large number of cases, but Linyou County and other counties in the north showed an upward trend in incidence, with obvious seasonal characteristics. Cases were mainly concentrated from October to January of the following year, accounting for 75.91% of the total number of cases. Farmers were the main reported occupations, accounting for 80.19% of the total number of cases. The ratio of male to female reported cases was 3.30∶1. The age group of 35-59 years old accounted for 51.08% of the cases, and the proportion of the age group of 60 years and above showed an upward trend ( χ2=331.44, P<0.001). From 2008 to 2023, a total of 1 559 619 people were vaccinated, and the vaccination rate of the target population aged 16-60 years reached 72.23%. With the increase in the vaccination rate, the incidence of HFRS continued to decrease. In summary, with the development of HFRS vaccination work, the epidemic characteristics of HFRS in Baoji City have changed, and the peak incidence has been controlled. The proportion of cases in the age group of 60 years and above continues to increase. HFRS vaccination is still an effective way of prevention and control, and vaccination strategies should be continuously optimized according to the characteristics of HFRS.

Objective:Pediatric chronic sinusitis （CRS） is a common disease within the field of otolaryngology-head and neck surgery. Due to the immaturity of sinus development and immune competence in children, its etiology and pathophysiology are complex, and its clinical features and outcomes differ significantly from those in adult patients. Currently, there are issues in the diagnosis and treatment of pediatric CRS, particularly in areas such as antibiotic use and surgical interventions, owing to a lack of sufficient attention. In recognition of this, the Chinese Rhinopathy Research Cooperation Group developed this expert consensus based on a systematic review of the latest literatures from both domestic and international sources, with reference to the latest evidence-based medical evidence worldwide, and in combination with their own clinical experience. The consensus covers various aspects including epidemiology, predisposing factors, pathophysiology, diagnosis and differential diagnosis, as well as treatment strategies such as medical therapy and surgical intervention. It aims to standardize the clinical diagnosis and treatment of pediatric CRS, improve clinical efficacy and patient satisfaction, reduce clinical expenditures, and decrease the occurrence of adverse reactions.
Humans ; Sinusitis/therapy* ; Chronic Disease ; Child ; Consensus ; Anti-Bacterial Agents/therapeutic use*

Objective:To explore the influencing factors of the secondary sex ratio (SSR) of singleton babies born following assisted reproductive technology.Methods:A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2000 to December 2018 were collected in a retrospective cohort study. The effect of influencing factors, such as maternal age, fertilization method, embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results:Among 7020 babies, 3730 were boys and 3290 were girls. The total SSR was 113∶100. The SSR of in vitro fertilization (IVF) was significantly higher than that of intracytoplasmic sperm injection (ICSI) fertilization (121∶100 vs. 95∶100, P<0.001), while other factors had no significant effect on the SSR of infants born. In the stratified analysis, there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older ( P<0.05), while the SSR of IVF in the other groups was higher than that of ICSI (<35 years old group: P<0.001; fresh embryo group: P=0.001; frozen-thawed embryo group: P=0.003; cleavage embryo transfer group: P<0.001). Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR ( OR=0.792, 95% CI=0.712-0.881, P<0.001). After removing confounding factors, logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR (a OR=0.793, 95% CI=0.713-0.883, P<0.001). Conclusion:The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns. The SSR of IVF is significantly higher than that of ICSI and the difference was significant.

Objective:To explore the influencing factors of the secondary sex ratio (SSR) of singleton babies born following assisted reproductive technology.Methods:A total of 7020 single babies delivered by assisted reproductive technology at the Reproductive Medicine Center of the First Affiliated Hospital of USTC (Anhui Provincial Hospital) from January 2000 to December 2018 were collected in a retrospective cohort study. The effect of influencing factors, such as maternal age, fertilization method, embryo transfer type and embryo transfer period on the sex of singleton babies were analyzed.Results:Among 7020 babies, 3730 were boys and 3290 were girls. The total SSR was 113∶100. The SSR of in vitro fertilization (IVF) was significantly higher than that of intracytoplasmic sperm injection (ICSI) fertilization (121∶100 vs. 95∶100, P<0.001), while other factors had no significant effect on the SSR of infants born. In the stratified analysis, there was no difference in SSR between IVF and ICSI in the blastocyst embryo transfer group with mother's age 35 years or older ( P<0.05), while the SSR of IVF in the other groups was higher than that of ICSI (<35 years old group: P<0.001; fresh embryo group: P=0.001; frozen-thawed embryo group: P=0.003; cleavage embryo transfer group: P<0.001). Univariate logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on baby SSR ( OR=0.792, 95% CI=0.712-0.881, P<0.001). After removing confounding factors, logistic regression analysis showed that the fertilization method in singleton pregnancy had a statistically significant effect on neonatal SSR (a OR=0.793, 95% CI=0.713-0.883, P<0.001). Conclusion:The fertilization method of assisted reproductive technology can affect the SSR of singleton newborns. The SSR of IVF is significantly higher than that of ICSI and the difference was significant.