Objective To analyze the characteristics of stroke incidence among residents in Changsha City from 2022 to 2023, and to provide a scientific basis for formulating stroke prevention and control measures. Methods The data were obtained from routine cardiovascular and cerebrovascular event monitoring data. The incidence rate, constituent ratio, standardized incidence rate, age incidence rate and other indicators were calculated using SPSS21.0 software. The incidence rate between different genders and between urban and rural areas was compared by χ² tests. Results From 2022 to 2023, a total of 67 400 stroke cases were reported in 9 districts and counties (cities) of Changsha. The incidence rate and the age standardized rate were 327.40/10⁵ and 374.68/10⁵, respectively. The incidence rate of stroke in men was higher than that in women (χ²=2501.312, P<0.001). The incidence rate of stroke in rural areas was higher than that in urban areas (χ²=2501.312, P<0.001). Among the four subtypes of stroke, cerebral infarction was the most common (62 278 cases, 92.40%). With the increase of age, the incidence rate of stroke generally showed an upward trend, with a low incidence in those aged under 40 years old, and a significant upward trend in those aged 40 years and older. The incidence rate of stroke among residents above 85 years old was the highest, reaching 3414.25/10⁵. Conclusion The incidence of stroke in Changsha residents is higher in men than in women, higher in rural areas than in urban areas, and higher with age. Therefore, targeted stroke prevention and control efforts should be carried out in key areas and populations.

The aim of this study is to investigate the inhibitory effects and mechanism of three or-ganic acids,including formic acid(FA),butyric acid(BA)and lactic acid(LA),on the pathogenic-ity of Salmonella enteritidis(SE),Escherichia coli(EC)and Staphylococcus aureus(SA).The growth of pathogens was detected by Minimum Inhibitory Concentration(MIC)and Oxford Cup antimicrobial zone assays.The motility of pathogens was detected by soft agar plate method,and the biofilm of pathogens was detected by crystal violet staining.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to measure the expression levels of genes related to the patho-genicity of SE.The results showed that FA and BA significantly inhibited the growth of SE,EC and SA,and FA had a superior inhibitory effect on EC(MIC:0.25 g/L;inhibition zone:20.0 mm)and SA(MIC:0.5 g/L;inhibition zone:25.0 mm).In addition,the three organic acids significantly inhibited the motility of SE,EC and SA as accessed by swimming and swarming assays,and FA showed the best inhibition effect.Besides,the three organic acids,especially FA,markedly inhibited the biofilm formation of SE,EC and SA.Finally,our results showed that the three organic acids in-hibited the expression of the main virulence genes encoded by SPI-1(InvA,InvF,SopE,SopB,SipB,HilA and SipA),SPI-2(SopD2),pili-related genes(FliF,LpfA,SefA and FimF)and flagellum-related genes(FlhD,FliC and FliD)of SE.This study demonstrates that FA,BA,and LA significantly inhibited the growth and pathogenicity of the four pathogens,among which FA showed the most obvious effect on inhibiting the growth,motility,biofilm formation and virulence gene expression.Our study provided a theoretical basis for the application of organic acids in the field of animal husbandry.

Cataract surgery is one of the most common ophthalmologic procedures. Advances in technology and medical policies have made it more precise. Residual refractive errors and deviation of target diopters are a main cause of dissatisfaction among patients. Refractive enhancement after cataract surgery can correct or eliminate these errors, improving patients' visual quality of life. There are multiple options for correcting residual refractive errors. The best approach depends on factors like the cause of the error, degrees of residual refractive errors, type of intraocular lens, ocular comorbidities, and patient preference. This paper summarizes the incidence and types of residual refractive errors, advancements in refractive enhancement surgeries, and provides practical solutions for clinical practice.

BACKGROUND: The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. METHODS: This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. RESULTS: Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [ n  = 278] vs . 43.7% [ n  = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45-0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs . 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82-2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. CONCLUSION This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.
Humans ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Artery Disease/drug therapy* ; Retrospective Studies ; Renal Dialysis/methods* ; Middle Aged ; Aged ; China ; Proportional Hazards Models ; Treatment Outcome

Objective To compare the 12-month efficacy and safety of N-butyl cyanoacrylate (NBCA) versus radiofrequency ablation (RFA) in treating great saphenous vein (GSV) insufficiency. Methods A total of 155 patients with GSV insufficiency from five centers were randomly allocated to the NBCA group or RFA group. Postoperative efficacy and safety outcomes were evaluated. Results Immediate postoperative closure rates of the GSV trunk were 100% in both groups. The closure rates of NBCA and RFA group were 98.6% and 98.5% at 3 months, 97.1% and 98.5% at 6 months, 98.1% and 95.9% at 12 months, with no statistically significant differences (P>0.05). After treatment, CEAP classification improved significantly from baseline in both groups. In terms of safety, 1 case of phlebitis, 1 case of ablation-related thrombus extension (ARTE) and 2 cases of calf muscle venous thrombosis(CMVT) occurred in the NBCA group, while 2 cases of limb numbness, 1 case of persistent thigh pain and 2 cases of CMVT in the RFA group. All reported serious adverse events in both groups were assessed as unrelated to the medical device or the trial procedure. Conclusions NBCA demonstrates non-inferior efficacy and safety compared to RFA for treating GSV insufficiency over 12 months.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Objective:To explore the gaze characteristics towards emotional portraits in children with attention deficit hyperactivity disorder(ADHD),in order to reveal their potential unique patterns of emotional cognition.Methods:A case-control design was employed,including 81 children diagnosed with the DSM-5 ADHD and 57 normal control(NC)children.Emotional images from the Chinese Children's Emotional Image Library were used as stimuli.The Tobii Pro X3-120 eye-tracking device was utilized to record fixation count(FC)and fixation duration percentage(FDP)under a free-viewing paradigm.Mixed-effects ANOVA was applied to explore the effects of group,gaze region(eyes and mouth),and emotional attributes on gaze characteristics,controlling for gen-der and age.Results:The FC and FDP of ADHD children were lower than those of NC children,particularly in the eye region of non-negative emotional images(P＜0.05).However,no significant differences were observed be-tween the two groups when viewing negative emotional images(sadness and anger)(P＞0.05).NC children ex-hibited a significant emotional bias effect in their gaze behavior towards emotional portraits(P＜0.05),whereas ADHD group showed only slight differences between non-negative emotional images(adjusted P＜0.05),indica-ting a weaker overall emotional attention bias.Conclusion:Children with ADHD display reduced attention to non-negative emotional expressions and a diminished emotional attention bias,suggesting potential deficits in emotional processing during face perception.

Recent studies have shown that the physiological homeostasis of oral mucosal cells is regulated by the circadian clock.Dis-ruption or dysfunction of the circadian clock is closely associated with the development of oral squamous cell carcinoma(OSCC).Research based on the circadian clock offers a novel perspective on the pathogenesis and therapeutic strategies for OSCC.However,there is current-ly limited research on this topic,and people generally have insufficient understanding and recognition of the circadian clock.Given the complexity and challenges of circadian clock which is the fourth dimension of medical research,we organize relevant experts based on summarizing the current research results of circadian clock in the pathogenesis and precision diagnosis and treatment of OSCC,combining the scientific principles of the circadian clock's role and their long-term research experience,then summarizes and recommends the con-sensus opinions for the research of circadian clock in the pathogenesis mechanism and precision diagnosis and treatment of human OSCC,with the hope of providing guidance for the basic research and clinical application of circadian clock or circadian rhythm in the pathogene-sis mechanism and precision diagnosis and treatment of oral and maxillofacial squamous cell carcinoma.

The regulatory processes in developmental biology research are significantly influenced by long non-coding RNAs (lncRNAs). However, the dynamics of lncRNA expression during human tooth development remain poorly understood. In this research, we examined the lncRNAs present in the dental epithelium (DE) and dental mesenchyme (DM) at the late bud, cap, and early bell stages of human fetal tooth development through bulk RNA sequencing. Developmental regulators co-expressed with neighboring lncRNAs were significantly enriched in odontogenesis. Specific lncRNAs expressed in the DE and DM, such as PANCR, MIR205HG, DLX6-AS1, and DNM3OS, were identified through a combination of bulk RNA sequencing and single-cell analysis. Further subcluster analysis revealed lncRNAs specifically expressed in important regions of the tooth germ, such as the inner enamel epithelium and coronal dental papilla (CDP). Functionally, we demonstrated that CDP-specific DLX6-AS1 enhanced odontoblastic differentiation in human tooth germ mesenchymal cells and dental pulp stem cells. These findings suggest that lncRNAs could serve as valuable cell markers for tooth development and potential therapeutic targets for tooth regeneration.
Humans ; RNA, Long Noncoding/metabolism* ; Odontogenesis/genetics* ; Tooth Germ/embryology* ; Cell Differentiation ; Gene Expression Regulation, Developmental ; Mesoderm/metabolism* ; Tooth/embryology* ; Gene Expression Profiling ; Sequence Analysis, RNA ; Dental Pulp/cytology*