ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

Objective: To develop a prediction model for mild cognitive impairment (MCI) risk among the elderly, so as to provide a tool for MCI early screening. Methods : From July 2022 to September 2024, a multi-stage stratified random cluster sampling method was used to recruit permanent residents aged ≥65 years from the Xinjiang Uygur Autonomous Region as study participants. Data on sociodemographic characteristics, nutritional status, body composition indices, bone mineral density, and handgrip strength were collected through questionnaires and physical examinations. Sarcopenia was defined based on appendicular skeletal muscle index and handgrip strength. MCI was assessed using the Mini-Mental State Examination, with adjustments for educational level. Participants were randomly divided into a training set and a validation set in a 7∶3 ratio. LASSO regression and multivariable logistic regression models were employed to screen for predictors and construct an MCI risk prediction model. The predictive performance of the model was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Results: A total of 1 641 participants were surveyed, including 755 males (46.01%) and 886 females (53.99%). The majority of participants were aged 65-<75 years, comprising 1 154 individuals (70.32%). MCI was detected in 517 participants, corresponding to a detection rate of 31.51%. Resultsfrom LASSO regression and multivariate logistic regression analysis showed that residence (rural, OR = 2.323, 95% CI: 1.682-3.210), age (75-<85 years, OR = 1.405, 95% CI: 1.019-1.937; ≥85 years, OR = 3.655, 95% CI: 1.696-7.875), educational level (primary school, OR = 0.341, 95% CI: 0.247-0.472; junior high school, OR = 0.255, 95% CI: 0.160-0.408; high school, OR = 0.286, 95% CI: 0.154-0.531; bachelor's degree or above, OR = 0.120, 95% CI: 0.041-0.351), history of alcohol consumption (yes, OR = 3.216, 95% CI: 2.164-4.779), risk of malnutrition (yes, OR = 1.464, 95% CI: 1.064-2.014), sarcopenia (yes, OR = 3.197, 95% CI: 2.332-4.385), and waist-to-hip ratio (abnormal, OR = 1.540, 95% CI: 1.159-2.048) were identified as predictive factors for MCI among the elderly. In the training set, the area under the ROC curve, sensitivity, and specificity were 0.788, 0.719, and 0.712, respectively. In the validation set, the corresponding values were 0.784, 0.913, and 0.542, respectively. DCA demonstrated that the model provided a higher clinical net benefit for predicting MCI risk when the risk threshold probability ranged from 0.124 to 0.764. Conclusion The prediction model developed in this study demonstrates good discriminative ability and clinical utility, indicating its substantial value for predicting the MCI risk among the elderly.

AIM:To explore the mechanism of berberine on breast cancer cells based on network pharmacology and in vitro cell experiments.METH-ODS:Firstly,berberine and breast cancer were tak-en as the research objects,the intersection targets of the two were screened by VEEN diagram,GO function and KEGG enrichment analysis were per-formed by R language,and molecular docking and visualization were carried out by Autodock Vina and Pymol software.Then,berberine treated breast cancer MCF-7 cells for 24 h,and then in vi-tro cell experiments were performed.CCK-8 was used to detect cell viability,Edu and plate cloning were used to detect cell proliferation and cloning,and apoptosis was detected by An-nexin V-FITC/PI double staining and Western blot.Laser confocal and CETSA were used to verify the binding effect of berberine and AKT1 protein.RESULTS:The results of network pharmacology showed that berberine had a good binding to the core targets AKT1,AKT2 and MAPK3.Berberine(20,40,80 μmol/L)signifi-cantly inhibited the proliferation and cloning ability of MCF-7 cells in a concentration-dependent man-ner(P＜0.05,P＜0.01).The results of laser confocal and CETSA experiments showed that berberine and AKT1 had a binding effect,and the stability of the two was enhanced after the combination.CONCLU-SION:Berberine inhibits MCF-7 cell proliferation and induces apoptosis in human breast cancer cells by targeting binding to AKT1 protein.

Purpose To investigate the presence,proportion,clinical significance and origin of tumor cells with a macrophage phenotype in tumor tissues of patients with diffuse large B-cell lymphoma(DLBCL),and to explore wheth-er CD68 positive tumor cells can be induced in DLBCL cell lines in vitro.Methods The presence of CD68+CD163+CD20+PAX5-cells in the samples of DLBCL patients was first qualitatively detected by multiplex immunofluorescence staining,and then the proportion of CD79a+B lymphocytes,CD68+macrophages,and CD68+CD79a+double-positive cells were quantified.Patients were grouped according to the proportion of double-positive cells,and the differences in prognosis and clinicopathological features of DLBCL patients between subgroups were investigated.For cases with posi-tive BCL6 gene locus breaks,co-localization of CD68 with BCL6 gene breakapart was performed using combined immu-nofluorescence and immunological in situ hybridization to ascertain the tumor nature of B cell with a macrophage pheno-type.DLBCL cell lines(OCI-LY3,SU-DHL2)were treated with phorbol myristate acetate(PMA),and changes in the proteins levels of CD68 and PAX5 proteins were detected by flow cytometry.Quantitative real-time PCR(qRT-PCR)was used to detect mRNA levels of PAX5,an important transcription factor for B cell differentiation and develop-ment,and macrophage-related genes(CD68,ARG1,CD163,CD206,Dectin-1,PU.1,C/EBPα,C/EBPβ).In ad-dition,PMA-treated DLBCL cell lines(OCI-LY3,SU-DHL2)were co-incubated with pH-sensitive fluorescent dye pHrodo to detect the phagocytosis ability of PMA-treated DLBCL cells.Results The percentage of CD68+B lympho-cytes in 50 patients with DLBCL varied from 0 to 9.3％,and the overall survival(OS)ranged from 0.008 2 to 4.2 years.Patients with the low CD68+B lymphocytes group exhibited a significantly lower OS compared to those in the high CD68+B lymphocytes group(P=0.039).There was a significant difference in the molecular typing of DLBCL patients(P=0.009 5)between different subgroups for the proportion of CD68+B lymphocytes.CD68+B lymphocytes were derived from tumor cells in DLBCL patients.The proportion of CD68+cells and CD68+PAX5-cells significantly increased in DLBCL after treatment with PMA(P＜0.05).The other macrophage markers CD68,ARG1,CD 163,CD206,Dectin-1,PU.1,C/EBPα,C/EBPβ,and the important B-cell transcription factor PAX5 were significantly different from the control group in terms of relative mRNA expression(P＜0.05).Cellular phagocytosis was enhanced after PMA treatment of DLBCL cells.Conclusion Diffuse large B-cell lymphoma tumor tissue contains a certain per-centage of CD68+neoplastic B lymphocytes.The proportion of CD68+B lymphocytes is correlated with patient progno-sis and molecular typing.DLBCL cell lines can be induced to differentiate into CD68+tumor cells in vitro.

Objective To analyze the differences and correlations of imaging parameters in patients with Parkinson's disease(PD)combined with cerebral small vessel disease(CSVD)with different cognitive functions based on MRI.Methods A retrospective selection was conducted on 192 PD patients combined with CSVD.According to the Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)scores,they were divided into cognitive impairment PD group(n=69)and cognitive normal PD group(n=123),and the clinical data and MRI imaging parameters of the two groups were compared.Results The age and drinking history of the cog-nitive impairment PD group were higher than those of the cognitive normal PD group(P<0.05);the lacune of presumed vascular origin(LPVO)score,periventricular white matter hyperintensity(PVWMH)score,basal ganglia-perivascular space(BG-PVS)score,brain atrophy(BA)score,and CSVD total score in the cognitive impairment PD group were higher than those in the cognitive normal PD group(P<0.05),while there was no statistically significant difference in deep white matter hyperintensity(DWMH)score,cen-trum semiovale perivascular space(CS-PVS)score,and cerebral microbleed(CMB)score between the two groups(P>0.05);Multi-variate logistic analysis showed that age,LPVO score,BG-PVS score,BA score,and CSVD total score were independent influencing factors of cognitive impairment(P<0.05).Conclusion There are differences in imaging parameters such as LPVO score,PVWMH score,BG-PVS score,BA score,and CSVD total score among PD patients combined with CSVD with different cognitive functions,and they are correlated with MMSE and MoCA scores.

Cleft lip and palate, as one of the most common congenital deformities of the oral and maxillofacial region, not only affects the physiological functions of patients, but also has a profound impact on their psychological well-being. Traditional sequential treatment for cleft lip and palate aims to restore primary functions and typically concludes intervention after orthodontic treatment. However, this management protocol often fails to meet patients′ expectations for esthetic outcomes. In the process of dental esthetic restoration, it is essential to adhere to the principles of comprehensive planning, sequential treatment, and tooth preservation, while formulating individualized treatment strategies. This article delves into the main challenges and corresponding therapeutic measures in dental esthetic restoration following sequential treatment for cleft lip and palate patients. It systematically analyzes the causes, clinical manifestations, and treatment methods for esthetic defects in dental arch space, dental hard tissues, and periodontal soft tissues. The study proposes that dental esthetic restoration can be implemented during three critical phases of sequential treatment: the mixed dentition stage, early permanent dentition stage, and adulthood stage to reduce the complexity of subsequent treatments, thereby preserving more dental and periodontal tissues. Through multidisciplinary collaboration and the application of digital technology, not only has the efficiency and predictability of treatment been enhanced, but more economical and effective treatment options have also been provided for patients. The aim is to offer clinicians comprehensive treatment insights, promoting a shift in the treatment philosophy for cleft lip and palate patients from "function-oriented" to a multidimensional approach that equally emphasizes" function-aesthetics-psychosocial aspects", ultimately achieving a comprehensive improvement in patients′ quality of life.

Objective:To understand the current status of epidemiological investigation task force construction and the performance of infectious disease epidemic response in county (district) Centers for Disease Control and Prevention (CDCs) in China, analyze the influencing factors and provide scientific evidence to improve the construction of grassroot epidemiological investigation task force.Methods:A survey was conducted in epidemiological investigation staff in county (district) CDCs in 31 provinces (autonomous regions/municipalities) and Xinjiang Production and Construction Corps in China. A self-designed questionnaire was used to collect information based on the epidemiological dynamic data collection platform of China CDC. A descriptive epidemiological analysis was conducted, and multiple linear regression models were used to identify the factors associated with the performance of infectious disease epidemic response.Results:A total of 24 934 epidemiological investigation task force members from 2 897 county (district) CDCs were surveyed in the study. In the epidemiological investigation task force, women, those with bachelor's degree and public health workers accounted for 62.46%, 71.36%, and 49.05% respectively. Up to 91.72% of the task force members had participated in field epidemic response. The average score of awareness of epidemic investigation procedures was 60.00, while the average score of key skill proficiency in the investigation was 42.22. The epidemic response performance showed correlations with area, gender, age, education level, major, and field epidemiology training programs, those who had received longer training showed higher competency scores (all P<0.001). Conclusions:Progress has been made in the construction of epidemiological investigation task force in grass-root CDCs in China, but further improvements are needed, especially in the knowledge awareness and investigation skills of the task force. Field epidemiology training demonstrated substantial impact on the improvement of epidemic response performance, indicating that it is necessary to further strengthen the training in grassroot public health workers for the better response to infectious disease epidemics.

Objective To investigate the influencing factors of bone mineral density(BMD)in school-stage children with different degrees of obesity and their relationship with body composition.Methods A total of 271 obese children aged 6-12 years who underwent pediatric health checkups in our hospital between October 2018 and December 2023 were selected.The children were divided into two groups according to their degree of obesity:a simple obesity group(n=171)and an extreme obesity group(n=100).All children were examined for metabolic indicators,body composition,BMD,and abdominal ultrasonography.Comparisons of various indicators between the two groups were made using the independent samplesttest,Mann-Whitney Utest,or chi-square test.The relationship between BMD and body composition was analyzed using multiple linear regression and Spearman correlation analyses.Results Compared with simple obesity group,the body weight,body mass index(BMI)z-score,body fat index,muscle mass index,fat-free body mass index,body fat percentage,waist-to-hip ratio,fasting insulin level,insulin resistance index,uric acid,and fatty liver incidence were significantly higher in extreme obesity group(all P<0.05).No statistically significant differences in height,BMD,BMD z-score,25-hydroxy-vitamin D,blood sugar,calcium,phosphorus,alkaline phosphatase,or rate of puberty development were observed between the two groups(all P>0.05).The results of the Spearman correlation analysis showed that the BMI z-score,body fat index,muscle mass index,and fat-free BMI were pos-itively correlated with the BMD z-scores of all participants and in girls(all P<0.05).In boys,the BMD z-score was positively correlated with muscle mass index and fat-free mass index(both P<0.05).The results of multiple linear regression analysis of BMD z-scores and body composition showed that in boys and the simple obesity group,body fat percentage and body fat index were independent influencing factors of BMD z-scores(both P<0.05).Conclusion Higher body fat percentage and body fat index may be adverse factors influencing BMD in school-stage children with obesity.Meanwhile,the BMD of school-age children with obesity increased with an increase in fat-free mass index.

Objective To investigate the protective effect of Naoluoxintong(NLXT)on mouse hippocampal neuronal HT22 cells in the oxygen-glucose deprivation/reoxygenation(OGD/R)model,focusing on its impact on mitochondrial function and the role of the cal-cium/calmodulin-dependent protein kinase kinase β(CaMKKβ)in it.Methods HT22 cell were cultured to establish OGD/R model,and the cell were divided into normal group(Control),model group(OGD/R),NLXT group(OGD/R+10％NLXT),positive drug dl-3-n-butylphthalide(NBP)group(OGD/R+NBP 50μmol/L)after the screening of the optimal concentrations of different con-centrations of NLXT-containing serum(0-20％)in interfering with the HT22 cells by the CCK-8 assay.Then,using CCK-8 assay to detect the cell survival rate of each group,inverted fluorescence microscope to observe the morphology of each group,flow cytometry to detect the apoptosis rate of each group,and the kit to detect the activity or content of malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH)in each group.Nest,the CaMKKβ inhibitor(STO-609,5μmol/L)was introduced,HT22 cells were di-vided into Control group,OGD/R group,OGD/R+10％NLXT group,OGD/R+NBP group,OGD/R+STO-609group,OGD/R+STO-609+NLXT group.The mitochondrial membrane potential in each group was observed by using JC-1 fluorescent probe,and the end products Na+-K+-ATP,Ca+-Mg+-ATPase activity were detected by the kit.The expression changes of CaMKKβ protein in cells of each group were detected by Western blot,the changes of mitochondrial DNA copy number and CaMKKβ mRNA expression in cells of each group were detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).Results The optimal concentration of NLXT-containing serum was 10％,which resulted in the most significant effects.Compared with the OGD/R group,NLXT intervention significantly increased cell viability(P＜0.05)and restored cellular morphological characteristics.Compared with the Control group,the OGD/R group showed significantly increased apoptosis(P＜0.05),elevated MDA levels,and decreased activities of SOD and GSH,alongside a reduction in mitochondrial membrane potential,ATP activity,and mitochondrial DNA copy number.Further-more,CaMKKβ protein and mRNA expression were downregulated(P＜0.05).Compared with the OGD/R group,the NLXT and NBP groups antagonized these effects and upregulated CaMKKβ protein and mRNA expression(P＜0.05).Additionally,the application of the CaMKKβ inhibitor STO-609 significantly attenuated the protective effects of NLXT on mitochondrial function and neurons(P＜0.05).Conclusion NLXT exerts neuroprotective effects by activating the CaMKKβ to enhance mitochondrial function after OGD/R in HT22 cells.

Objective:To investigate the association between high-risk human papillomavirus (hrHPV) persistent infection and vaginal microecology.Methods:A total of 53 women were enrolled in the gynecological clinic of Beijing Obstetrics and Gynecology Hospital from January 2020 to January 2021, including 7 women without HPV and 46 women with hrHPV infection. Among the hrHPV infected women, 24 woemn who did not use any drugs were classified as the observation group and the other 22 women who were given standardized interferon vaginal administration for 3 months were regarded as the treatment group. Vaginal secretions of all women were taken for Gram-stained microecological test at the time of enrollment and at the 4, 8, and 12 month follow-up. HPV turning negative was taken as the end point of follow-up.Results:(1) Women of hrHPV persistent infection in the observation and treatmnet groups had more times of abortions ( P=0.180). (2) The hrHPV negative conversion rate was 17% (4/24) in the observation group and 36% (8/22) in the treatment group, but the difference was not significant ( P=0.183). The median hrHPV negative conversion time were 11.0 months and 7.5 months in the observation and treatment groups, respectively, and the difference was statistically significant ( P=0.001). (3) Vaginal microecology was generally normal at the time of enrollment and at the end of follow-up in women with HPV natural negative conversion in the observation group. While vaginal microecological disorders were more common in women with hrHPV persistent infection in the observation and treatmnet groups, including high vaginal pH value, poor vaginal cleanliness, poor grade of Lactobacillus and increased vaginal clutter bacteria, and the vaginal microecological situation did not improve after the 12-month follow-up. (4) In the treatment group, women who turned HPV negative within six months all had normal vaginal microecology when enrollment (5/5). While those who turned negative six months later had a higher proportion of vaginal clutter bacteria (2/3), a poor grade of Lactobacillus (2/3) and a higher proportion of vaginal dysbiosis (2/3). Conclusions:(1) Interferon therapy could shorten the negative turning time of hrHPV. (2) Women with normal vaginal microecology have the ability to naturally clear hrHPV. (3) The vaginal microecological Gram-stain test has limited value in predicting hrHPV clearance, perhaps due to its inability to detect Lactobacillus subtypes.