Objective:Based on the functional classification structure of the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS), the data available in the open database of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed longitudinally to construct the development trajectories of different functional dimensions among China′s elderly population.Methods:The CHARLS data for 2013, 2015 and 2018 describing persons aged 60 and older were distributed using the ICF-RS′s classification structure. Group-based multi-trajectory modeling (GBMTM) was then applied to analyze the characteristics of the development trajectories of physical functioning, daily activities and social participation.Results:Different development trajectory subtypes emerged from the data. A gradual decline in physical functioning was evident throughout the study period, while daily activities first improved and then declined. Social participation was in decline throughout the period. There were, however, significant differences in the initial functional level, the degree of decline and the degree of decline reversal among the different subtype groups.Conclusions:The overall functional performance of the elderly in China shows a downward trend, but some functional dimensions can still improve with time, at least during the specific period covered in this open database. It is recommended that the ICF-RS be integrated into the CHARLS to comprehensively assess the classification of function and developmental changes among China′s elderly.

ObjectiveTo explore effect of Xianlian Jiedu prescription on the recurrence of colorectal cancer （CRC） and investigate the related mechanisms. MethodsA postoperative recurrence model was established in 25 Balb/c mice by injecting CT26 cells subcutaneously into the armpit， followed by surgical removal of 99% of the subcutaneous tumor. The mice were randomly divided into model group， low-dose Xianlian Jiedu prescription （XLJDP-L） group （6.45 g·kg^-1·d^-1）， medium-dose Xianlian Jiedu prescription （XLJDP-M） group （12.9 g·kg^-1·d^-1）， high-dose Xianlian Jiedu prescription （XLJDP-H） group （25.8 g·kg^-1·d^-1）， and 5-fluorouracil （5-FU） group （1×10^-3 g·kg^-1·d^-1）. The mice were euthanized after 14 days of continuous intervention， and recurrent tumor tissue was harvested. Hematoxylin and eosin （HE） staining was used to observe pathological and morphological changes in the recurrent tumor tissue. Immunohistochemistry （IHC） was employed to assess the expression of proliferating cell nuclear antigen （Ki67）， vascular endothelial growth factor （VEGF）， and platelet-endothelial cell adhesion molecule （CD31） in recurrent tumor tissue. The Western blot was used to detect the protein expression levels of angiopoietin-2 （ANG-2）， VEGF， phosphorylated-protein kinase B （p-Akt）， protein kinase B （Akt）， phosphorylated-phosphatidylinositol 3-kinase （p-PI3K）， and phosphatidylinositol 3-kinase （PI3K） in recurrent tumor tissue. ResultsBefore treatment， there were no statistical differences in tumor volume， tumor weight， and body mass among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group， indicating model stability. After treatment， compared with those in the model group， the tumor volume and tumor weight in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01）， showing dose dependency. Meanwhile， there were no significant differences in body weight among the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group compared to the model group. HE staining showed that compared with that in the model group， tumor tissue in the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group had loosely arranged cells， increased intercellular spaces， small and shriveled nuclei， light staining， fewer mitotic figures and atypical nuclei， and increased necrotic areas. IHC showed that compared with those of the model group， the positive rates of Ki67， VEGF， and CD31 in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly reduced （P<0.01） in a dose-dependent manner. Western blot results showed that compared with those of the model group， the protein expression levels of ANG-2 and VEGF in the recurrent tumor tissue of the XLJDP-L， XLJDP-M， and XLJDP-H groups and the 5-FU group were significantly downregulated （P<0.05， P<0.01）， and the p-Akt/Akt and p-PI3K/PI3K ratios were significantly decreased in a dose-dependent manner （P<0.05， P<0.01）. ConclusionXianlian Jiedu prescription significantly inhibits the recurrence of CRC in mice after subcutaneous tumor surgery. The mechanism may involve regulating the PI3K/Akt pathway and downregulating key angiogenic proteins such as ANG-2， VEGF， and CD31.

Gestational diabetes mellitus(GDM)is closely associated with short-term and long-term adverse outcomes for both mothers and fetuses.In recent years,with the global prevalence of obesity and type 2 diabetes mellitus(T2DM)constantly rising,there is a significant increase in GDM incidence,with notable regional variations.Current challenges in GDM management include insufficient early screening or diagnosis,limited personalized intervention strategies,and poor adherence to long-term follow-up.Key research priorities for the future include optimizing screening methods for high-risk populations,enhancing targeted lifestyle interventions,and establishing effective follow-up and long-term health management systems.In December 2024,the American Diabetes Association(ADA)released the Standards of Care in Diabetes—2025(hereafter referred to as ADA[2025]),providing updated perspectives on the diagnosis and treatment of diabetes mellitus,as well as an overview of the definition,screening and diagnostic criteria,and management strategies for GDM.Based on ADA(2025)and the circumstances of clinical practice in China,we summarized the latest advancements in GDM research,aiming to improve comprehensive management strategies to prevent,delay,and improve adverse outcomes associated with GDM.

Objective:To discuss the inhibitory effects of combined application of chlorogenic acid(CA),procyanidin(PC),and paeoniflorin(PF),the active components of Paeoniae Radix Rubra,on Enterococcus faecalis(E.faecalis)and its biofilm,and to clarify the mechanism.Methods:The minimal inhibitory concentration(MIC)and minimal bactericidal concentration(MBC)of CA,PC,and PF against E.faecalis were detected by microdilution method;the fractional inhibitory concentration index(FICI)and fractional bactericidal concentration index(FBCI)of the three active components of Paeoniae Radix Rubra in combination were detected by checkerboard dilution method.The experiment was divided into control group,high concentration of single-drug groups(PF-10 group,PC-6 group,and CA-10 group),and drug combination groups(CA-2+PC-1 group,CA-2+PC-2 group,PF-4+PC-2 group,PF-6+PC-2 group,PF-4+CA-4 group,and PF-6+CA-4 group).Crystal violet staining was used to detect the biofilm formation of E.faecalis in various groups after treated with three active components in combination;scanning electron microscope(SEM)was used to observe the morphology of E.faecalis biofilm in various groups after treated with three active components in combination;spot assay was used to detect the inhibitory effects of three active components in combination on E.faecalis planktonic bacteria and biofilm in various groups;SEM was used to observe the damage to E.faecalis cell membrane in various groups after treated with three active components in combination;kit was used to detect the adenosine triphosphate(ATP)levels in E.faecalis planktonic bacteria and biofilm in various groups after treated with three active components in combination.Results:Among the three active components of Paeoniae Radix Rubra,the MIC of PC was 4 g·L?1 and the MBC was 6 g·L?1;the MIC of CA was 8 g·L?1 and the MBC was 10 g·L?1;the MIC and MBC of PF were both>10 g·L?1,and the concentration of PF was selected as 10 g·L?1.The combination of PC and CA showed synergistic effects,the combination of PC and PF showed additive effects,and the combination of CA and PF showed additive effects.The crystal violet staining results showed that compared with control group,the biofilm formations of E.faecalis in PF-10 group,PC-6 group,CA-10 group,and drug combination groups were significantly decreased(P<0.05);compared with PF-10 group,the biofilm formations of E.faecalis in PC-6 group,CA-10 group,CA-2+PC-1 group,CA-2+PC-2 group,PF-4+PC-2 group,PF-6+PC-2 group,and PF-6+CA-4 group were significantly decreased(P<0.05 or P<0.01).The SEM results showed that in control group,the E.faecalis biofilm was thick,with tightly connected bacteria,regular morphology,and intact cell membranes;in PF-10 group,PC-6 group,and CA-10 group,the thickness of E.faecalis biofilm was significantly reduced,and the arrangement of bacteria became relatively loose;in all drug combination groups,the E.faecalis biofilm was significantly reduced or even completely disappeared,and under high magnification,the biofilm structure was completely absent,with bacterial fragments adhering and aggregating,losing their original bacterial morphology.The spot assay results showed that compared with control group,the colonies of E.faecalis planktonic bacteria in PF-10 group,PC-6 group,and CA-10 group were significantly reduced after treated for 5,10,and 30 min,indicating gradually enhanced bactericidal effects;among drug combination groups,the combination of CA and PC significantly reduced the colonies of E.faecalis planktonic bacteria within 5 min,showing strong bactericidal effects.Compared with CA group and PC group,the colonies of E.faecalis planktonic bacteria in all drug combination groups showed no significant reduction after treated for 5,10,and 30 min;compared with control group,the colonies of E.faecalis biofilm in PF-10 group,PC-6 group,and CA-10 group were gradually decreased after the treated for 30 and 60 min,suggesting that the high concentration of single-drug groups exhibited gradually enhanced bactericidal effects on E.faecalis in biofilm.Among them,the biofilm-killing effect of PC-6 group was the most significant,with no colony formation observed after treated for 30 min;in drug combination groups,only a few colonies of E.faecalis biofilm were observed in CA-2+PC-2 group after treated for 30 min,indicating effective killing of bacteria in biofilm;compared with PC-6 group and CA-10 group,all drug combination groups achieved the bactericidal effects of high concentration of single-drug groups at low concentrations.The SEM results showed that in control group,E.faecalis exhibited an oval shape with intact cell membranes;in PF group,bacterial morphology was altered,and cell membrane integrity was damaged;in CA group,most bacterial cell membranes remained relatively intact,but the bacterial surface showed shrinkage and depression,with a few bacteria exhibiting disrupted cell membrane integrity;in PC group,the integrity of bacterial cell membranes was most severely damaged,leading to leakage of cellular contents and aggregation of cell fragments into flocculent structures;in all drug combination groups,E.faecalis exhibited ruptured cell membranes,leakage of contents,and aggregation of bacterial debris,especially in the combination of CA and PC,where the most severe disruption of bacterial cell membrane integrity and complete leakage of contents were observed;in the combination of PF and CA,bacterial surface pits and shrinkage were observed,with occasional cell membrane rupture.The kit results showed that compared with control group,the ATP levels in E.faecalis planktonic bacteria and biofilm in various groups were significantly decreased(P<0.01);compared with PF-10 group,the ATP levels in E.faecalis planktonic bacteria in CA-10 group,CA-2+PC-2 group,PF-4+CA-4 group,and PF-6+CA-4 group were significantly decreased(P<0.05 or P<0.01),and the ATP levels in E.faecalis biofilm in CA-10 group and CA-2+PC-2 group were significantly decreased(P<0.05 or P<0.01).Conclusion:The combined application of PF,PC,and CA,the active components of Paeoniae Radix Rubra,exhibits significant inhibitory effects on E.faecalis and its biofilm formation.The pairwise combinations of three active components show synergistic or additive effects,with the combination of CA and PC demonstrating the most significant synergistic effect.The underlying mechanism may be related to the disruption of E.faecalis cell membrane integrity and inhibition of bacterial ATP levels.

Objective:To develop a deep learning-based automated analysis system for precise segmentation of the optic cup and disc in fundus images and automatic measurement of the vertical cup-to-disc ratio (CDR) for early risk assessment and screening of chronic glaucoma.Methods:The proposed automated system comprised three modules: a dual coding-attention U-net (DCoAtUNet) segmentation network for optic cup and disc segmentation, a conditional random field (CRF) post-processing module, and a CDR measurement and glaucoma screening module based on the segmentation results.The system was designed to enhance boundary detection accuracy and measurement stability and its performance was evaluated on the publicly available Drishti-GS dataset.The dataset was divided into a training set and a test set in a 1∶1 ratio.Dice coefficient and intersection over union (IoU) were used to quantify segmentation accuracy and regional consistency, while accaracy, precision, recall, and F1-score were employed to assess glaucoma screening performance.Results:The DCoAtUNet combined with CRF post-processing achieved Dice coefficients of 0.976 0 for the optic disc and 0.908 1 for the optic cup, with corresponding IoU values of 0.953 4 and 0.837 9, demonstrating high segmentation precision and stability in boundary identification and region overlap.In glaucoma screening, the system achieved an accuracy of 0.843 1, precision of 0.840 9, recall of 0.973 7, and F1-score of 0.902 4, indicating good diagnostic sensitivity and accuracy.Conclusions:By integrating high-precision segmentation and automated measurement strategies, the DCoAtUNet+ CRF model significantly improves the accuracy and stability of CDR evaluation.It effectively assists in identifying high-risk individuals during early glaucoma screening and shows strong potential for clinical application in computer-aided diagnosis workflows.

This study innovatively incorporates on-site teaching with the International Museum of Stomatology into the curriculum to establish an immersive and intuitive teaching mode,promoting education from both theoretical and practical dimensions.The teaching effect is comprehensively evaluated to explore the pathway to optimization.Multi-dimensional questionnaires are designed to collect feedback data from students on teaching satisfaction,knowledge mastery,professional identity,and humanistic literacy perception,fol-lowed by in-depth quantitative and qualitative analyses.The results demonstrate that this teaching mode significantly enhances literacy,playing a critical role in helping stomatological students fully understand professional knowledge and humanistic connotations while sub-stantially improving their professional identity.This teaching mode gives a direction for innovative stomatological education,holds sig-nificant importance for cultivating stomatological professionals with both clinical skills and humanistic literacy,possessing substantial potential for promotion,application,and further refinement.

Objective:To develop a deep learning-based automated analysis system for precise segmentation of the optic cup and disc in fundus images and automatic measurement of the vertical cup-to-disc ratio (CDR) for early risk assessment and screening of chronic glaucoma.Methods:The proposed automated system comprised three modules: a dual coding-attention U-net (DCoAtUNet) segmentation network for optic cup and disc segmentation, a conditional random field (CRF) post-processing module, and a CDR measurement and glaucoma screening module based on the segmentation results.The system was designed to enhance boundary detection accuracy and measurement stability and its performance was evaluated on the publicly available Drishti-GS dataset.The dataset was divided into a training set and a test set in a 1∶1 ratio.Dice coefficient and intersection over union (IoU) were used to quantify segmentation accuracy and regional consistency, while accaracy, precision, recall, and F1-score were employed to assess glaucoma screening performance.Results:The DCoAtUNet combined with CRF post-processing achieved Dice coefficients of 0.976 0 for the optic disc and 0.908 1 for the optic cup, with corresponding IoU values of 0.953 4 and 0.837 9, demonstrating high segmentation precision and stability in boundary identification and region overlap.In glaucoma screening, the system achieved an accuracy of 0.843 1, precision of 0.840 9, recall of 0.973 7, and F1-score of 0.902 4, indicating good diagnostic sensitivity and accuracy.Conclusions:By integrating high-precision segmentation and automated measurement strategies, the DCoAtUNet+ CRF model significantly improves the accuracy and stability of CDR evaluation.It effectively assists in identifying high-risk individuals during early glaucoma screening and shows strong potential for clinical application in computer-aided diagnosis workflows.

This study innovatively incorporates on-site teaching with the International Museum of Stomatology into the curriculum to establish an immersive and intuitive teaching mode,promoting education from both theoretical and practical dimensions.The teaching effect is comprehensively evaluated to explore the pathway to optimization.Multi-dimensional questionnaires are designed to collect feedback data from students on teaching satisfaction,knowledge mastery,professional identity,and humanistic literacy perception,fol-lowed by in-depth quantitative and qualitative analyses.The results demonstrate that this teaching mode significantly enhances literacy,playing a critical role in helping stomatological students fully understand professional knowledge and humanistic connotations while sub-stantially improving their professional identity.This teaching mode gives a direction for innovative stomatological education,holds sig-nificant importance for cultivating stomatological professionals with both clinical skills and humanistic literacy,possessing substantial potential for promotion,application,and further refinement.

Objective:Based on the functional classification structure of the International Classification of Functioning, Disability and Health′s rehabilitation set (ICF-RS), the data available in the open database of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed longitudinally to construct the development trajectories of different functional dimensions among China′s elderly population.Methods:The CHARLS data for 2013, 2015 and 2018 describing persons aged 60 and older were distributed using the ICF-RS′s classification structure. Group-based multi-trajectory modeling (GBMTM) was then applied to analyze the characteristics of the development trajectories of physical functioning, daily activities and social participation.Results:Different development trajectory subtypes emerged from the data. A gradual decline in physical functioning was evident throughout the study period, while daily activities first improved and then declined. Social participation was in decline throughout the period. There were, however, significant differences in the initial functional level, the degree of decline and the degree of decline reversal among the different subtype groups.Conclusions:The overall functional performance of the elderly in China shows a downward trend, but some functional dimensions can still improve with time, at least during the specific period covered in this open database. It is recommended that the ICF-RS be integrated into the CHARLS to comprehensively assess the classification of function and developmental changes among China′s elderly.

Objective: To investigate the status of passive smoking among pregnant women in Jinshan District, Shanghai Municipality, so as to provide insights into developing targeted smoking control measures and promoting maternal and infant health. Methods: Pregnant women who had early pregnancy registration at Jinshan District Community Health Service Center from April 2021 to December 2023 were selected as subjects. The basic information, passive smoking and awareness of passive smoking hazards among pregnant women were collected through questionnaire surveys, and passive smoking rate and awareness rate of passive smoking hazards were analyzed. Results: Totally 8 273 questionnaires were allocated, and 8 216 valid questionnaires were recovered, with an effective rate of 99.31%. The mean age of participants was (29.52±4.60) years. There were 4 991 participants with an education of college degree or above, accounting for 60.75%; 3 565 participants with the first pregnancy, accounting for 43.39%; 3 990 primiparas, accounting for 48.56%; 3 193 participants living with smokers, accounting for 38.86%. A total of 3 710 participants passively smoked, with a passive smoking rate of 45.16%. There were 2 817 participants passively smoked in public places, accounting for 75.93%; 2 253 participants passively smoked in workplaces, accounting for 60.73%; 1 563 participants that passively smoked at home, accounting for 42.13%. The awareness rates regarding the hazards of passive smoking to health, causing lung cancer in adults, causing lung diseases in children, causing preterm birth and low birth weight infants, and causing heart diseases in adults were 92.13%, 88.85%, 87.99%, 82.05% and 62.56%, respectively. Conclusion The rate of passive smoking among pregnant women in Jinshan District is comparatively high, while their awareness regarding non-respiratory diseases emanating from passive smoking is comparatively low.