Objective To explore the differences and similarities in the changes of pulp repair response after direct pulp capping with iRoot BP Plus and MTA.Methods A total of 36 male SD rats were randomly divided into 3 groups,namely iRoot BP Plus group,MTA group and blank control group.Dental pulp exposure and direct pulp capping was performed on both sides of maxillary first molars of each rat.Four rats were randomly selected and sacrificed from each group at 7,14,and 28 days postoperatively,and the specimens were taken for hematoxylin-eosin(HE)staining,and then each index was observed.Results ①From the perspective of dentin tubular formation quality,at 14 d and 28 d,there were statistical differences between iRoot BP Plus group and MTA group(P＜0.05),and iRoot BP Plus was significantly better than MTA in terms of quality of restorative dentin formation.②At 14 days after operation,iRoot BP Plus had a greater area of neodontinin than that in MTA group(P＜0.05).Conclusion Both iRoot BP Plus and MTA can promote the formation of restorative dentin bridges after direct pulp capping,and the formation quality is high.The long-term effects need to be further studied.

Objective To analyze a case of violations by an occupational medical examination (OME) institution and to explore the key control points for the supervision and management of OME institutions, as well as the core role of quality assessment in this context. Methods An OME institution suspected of illegal activities was used as the study subject. Retrospective analysis was conducted. Clues of suspected violations were identified by an on-site quality assessment. After investigation and verification by the local health authorities, legal action was taken against the institution for its violations. Results During an on-site quality assessment, the Guangdong Province OME quality control expert group discovered that the OME institution violated regulations, including unqualified personnel file, exceeding the scope of services category, issuing false reports, failing to report suspected occupational diseases on time, and failing to notify workers about suspected occupational diseases as required. The evidence was then submitted to the Guangdong Province OME Quality Control Center, which subsequently forwarded the case to local health administration department for filing and investigation. After the investigation, penalties were imposed on the OME institution for its illegal activities. Conclusion The key supervision and inspection points in the quality assessment of OME institutions include personnel file configuration, the quality control management system and its implementation, the quality of OME reports, and information reporting. Quality assessment plays a pivotal role in ensuring the legal and compliant practice of OME institutions, safeguarding the health rights and interests of workers, and enhancing the overall standard of the OME industry.

Objective To investigate the safety, economic benefits and psychological effects of day breast conserving surgery for breast cancer. Methods The demographic data and clinical data of breast cancer patients undergoing day (day surgery group) and ward (ward surgery group) breast conserving surgeries in West China Hospital of Sichuan University from March 2020 to June 2021 were retrospectively collected; the demographic data, clinical data, medical and related transportation costs, and preoperative and postoperative BREAST-Q scores of breast cancer patients undergoing day (day surgery group) and ward (ward surgery group) breast conserving surgery in West China Hospital of Sichuan University from June 2021 to June 2022 were prospectively collected. The safety, economic benefit, and psychological satisfaction of day surgery was analyzed. Results A total of 42 women with breast cancer were included in the retrospective study and 39 women with breast cancer were included in the prospective study. In both prospective and retrospective studies, the mean age of patients in both groups were <50 years. There were only statistical differences between the two groups in the aspects of hypertension (P=0.022), neoadjuvant chemotherapy (P=0.037) and postoperative pathological estrogen receptor (P=0.033) in the prospective study. In postoperative complications, there were no statistical differences in the surgical-related complications or anesthesia-related complications between the two groups in either the prospective study or the retrospective study (P>0.05). In terms of the overall cost, we found that the day surgery group was more economical than the ward surgery group in the prospective study (P=0.002). There were no statistical differences in postoperative psychosocical well-being, sexual well-being, satisfaction with breasts or chest condition between the two groups (P>0.05). Conclusion It is safe and reliable to carry out breast conserving surgery in day surgery center under strict management standards, which can save medical costs and will not cause great psychological burden to patients.

BACKGROUND: The benefits of ideal cardiovascular-health metrics (ICVHMs) in patients with renal insufficiency remain unclear. This study aimed to investigate the associations between ICVHM and prognosis in a renal insufficiency population. METHODS: The trial enrolled 29,682 participants from the US National Health and Nutrition Examination Survey (NHANES), 2007-2018, with mortality follow-up through December 31, 2019. Participants were divided into three groups based on estimated glomerular filtration rates. Cardiovascular health was assessed using new "Life's Essential 8" metrics. Cox regression analyses based on NHANES data were used to determine the associations between ICVHMs and cardiovascular mortality in patients with renal insufficiency. RESULTS: During a mean follow-up of 6.58 years, ideal cardiovascular health (hazard ratio [HR] = 0.42; 95% confidence interval [CI]; 0.25-0.70) and ideal health behavior (HR = 0.53; 95% CI; 0.39-0.73) reduced cardiovascular mortality in participants with renal insufficiency. For each one ICVHM increment, a 25% reduction in cardiovascular mortality was recorded (95% CI; 0.69-0.82). When compared with participants with normal renal function, for those with mild renal insufficiency, the HR for cardiovascular mortality gradually decreased from 1.47 (95% CI; 0.85-2.52) in those who had ≤1 ICVHMs to 0.30 (95% CI; 0.12-0.77) in participants who had >6 ICVHMs. CONCLUSIONS From an ICVHM perspective, enhanced cardiovascular benefits were observed in individuals with renal insufficiency, coupled with a reduced risk of all-cause mortality. Furthermore, when compared with individuals with normal renal function, increased ICVHMs can mitigate adverse risks associated with renal impairment.
Humans ; Male ; Female ; Nutrition Surveys ; Middle Aged ; Renal Insufficiency/physiopathology* ; Aged ; Prognosis ; Adult ; Cardiovascular Diseases/mortality* ; Glomerular Filtration Rate/physiology* ; Proportional Hazards Models

Objective To understand the instrument distribution and capacities of inter-laboratory comparisons among occupational medical examination (OME) institutions in Guangdong Province. Methods A total of 291 OME institutions in Guangdong Province that were within the validity period of filing in June 2024 and 101 OME institutions that participated in inter-laboratory comparisons in 2023 were selected as the study subjects. Their filing categories, instrument distribution and external quality assessment in laboratories were collected and analyzed. Results The location of 291 OME institutions distributed in 21 prefectural-level cities in the province, mainly in the Pearl River Delta (PRD) region, accounting for 68.4% of the total. The public hospitals, private medical institutions, the center for disease control and prevention and occupational disease prevention and treatment institutions (hereinafter referred to as "occupational prevention institutions") accounted for 61.2%, 28.5% and 10.3%, respectively. The filing rates for physical factors, chemical factors, and dust categories among OME institutions were 91.1%, 86.9%, and 86.6%, respectively. The average number of institutional instruments, from high to low, was 53.8, 38.8 and 38.2 per unit in occupational prevention institutions, private medical institutions and public hospitals, respectively. The passing rates of inter-laboratory comparisons among OME institutions of external quality assessment in laboratories among OME institutes in Guangdong Province, from high to low were occupational prevention institutions, public hospitals and private medical institutions (96.2% vs 86.8% vs 73.0%, P<0.05). Conclusion The regional distribution of OME institutes in Guangdong Province is unbalanced, mainly concentrated in the PRD region. Low overall level of OME capacity is found in public hospitals and private medical institutions. Leading by the occupational prevention institutions, public hospitals and private medical institutions should strengthen the development and investment in OME hardware, in order to improve the OME level.

Objective To explore the effect of platelet-rich fibrin(PRF)combined with sulfadiazine silver dressing on healing time and curative effect of chronic refractory wounds.Methods A total of 126 patients with chronic refractory wounds who were treated in Ningde City Hospital from December 1,2022 to December 1,2023 were selected as research objects.They were randomly divided into control group and experimental group according to odd-even number,with 63 cases in each group.The control group was treated with sulfadiazine silver dressing,and the experimental group was treated with PRF and sulfadiazine silver dressing.The curative effect,wound recovery,serum inflammatory cytokine levels and complications were compared between the two groups.Results The total effective rate of the experimental group was significantly higher than that of the control group([96.83%,61/63]vs[77.78%,49/63],χ2=10.309,P<0.05).The frequency of dressing changes and wound healing time in the experimental group were significantly less than those in the control group([4.44±1.53]times vs[9.16±2.23]times,[15.35±2.29]d vs[20.25±3.24]d,P<0.05).The reduction of wound area in the experimental group was significantly higher than that in the control group([14.95±2.80]cm2 vs[11.21±2.35]cm2,P<0.05).There was no significant difference in serum inflammatory cytokine levels between the two groups before treatment(t=0.209,0.295,0.088,P>0.05).After 14 of treatment,the levels of CRP,PCT,and IL-6 were decreased in both groups,and the levels of CRP,PCT,and IL-6 in the experimental group were significantly lower than those in the control group([1.14±0.86]mg/L vs[2.11±0.75]mg/L,[4.07±0.56]μg/L vs[4.96±0.71]μg/L,[61.54±25.33]ng/L vs[84.48±24.76]ng/L,t=6.748,7.809,5.140,P<0.05).The total incidence of complications in the experimental group was significantly lower than that in the control group(9.52%vs 25.40%,χ2=5.507,P<0.05).Conclusion PRF combined with sulfadiazine silver dressing can increase curative effects,accelerate wound healing,improve serum inflammatory markers,and reduce complications in patients with chronic refractory wounds.

Objective To analyze the current status and influencing factors of occupational health literacy (OHL) among noise-exposed workers in the automotive manufacturing industry. Methods A total of 1 188 front-line workers in noise-exposed positions in the automotive manufacturing industry were selected by judgment sampling method. The OHL status of the workers was investigated using the Occupational Health Literacy Questionnaire of National Key Population, and the influencing factors of OHL were analyzed. Results The overall OHL level was 30.13% (358/1 188). The result of binary logistic regression analysis showed that marital status, educational level, personal monthly income, household registration, enterprise scale and weekly working hours were influencing factors of OHL level (all P<0.05). Specifically, being married, having a high school education or higher, monthly personal income >5 000 yuan, being from a non-agricultural household, working in a medium-sized enterprise, and working more than >40-48 hours per week were protective factors for high OHL levels (all P<0.05). Conclusion There is considerable room for improvement in the OHL of noise-exposed workers in the automotive manufacturing industry. Focus should be placed on workers who are unmarried, widowed, or divorced, have educational levels below high school, earn less than 5 000 yuan per month, have agricultural household registrations, work in small or micro-sized enterprises, or work ≤40 hours per week, with targeted strategies to improve their overall OHL level.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Objective To explore the differences and similarities in the changes of pulp repair response after direct pulp capping with iRoot BP Plus and MTA.Methods A total of 36 male SD rats were randomly divided into 3 groups,namely iRoot BP Plus group,MTA group and blank control group.Dental pulp exposure and direct pulp capping was performed on both sides of maxillary first molars of each rat.Four rats were randomly selected and sacrificed from each group at 7,14,and 28 days postoperatively,and the specimens were taken for hematoxylin-eosin(HE)staining,and then each index was observed.Results ①From the perspective of dentin tubular formation quality,at 14 d and 28 d,there were statistical differences between iRoot BP Plus group and MTA group(P＜0.05),and iRoot BP Plus was significantly better than MTA in terms of quality of restorative dentin formation.②At 14 days after operation,iRoot BP Plus had a greater area of neodontinin than that in MTA group(P＜0.05).Conclusion Both iRoot BP Plus and MTA can promote the formation of restorative dentin bridges after direct pulp capping,and the formation quality is high.The long-term effects need to be further studied.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.