With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective To explore the application effect of ultrasound-assisted localization in spinal anesthesia for elderly patients with hip fractures.Methods A total of 114 elderly patients undergoing hip fracture surgery with spinal anesthesia in our hospital from September 2022 to June 2024 were enrolled.The random number table method was applied to allocate participants into two groups:surface anatomical landmark localization group and ultrasound-assisted localization group,with 57 patients in each group.Both groups of patients underwent spinal anesthesia via the paramedian approach for puncture.The first-attempt puncture success rate,success rate of the initial puncture site,number of skin punctures,number of adjusted epidural needle direction,positioning time of the puncture point,puncture time(puncture success time,anesthesia time,and total time),adverse events during the puncture process(nerve hypersensitivity and accidental puncture of the dura mater),spinal anesthesia related complications(back pain,headache,and nerve injury),patient satisfaction and hospital stay were observed and compared between the two groups.The quality of early postoperative recovery was evaluated by using the 15-Item Quality of Recovery(QOR-15)scale at 24 h after surgery.Results The first-attempt puncture success rate in the ultrasound-assisted localization group was 71.9％(41/57),which was significantly higher than that in the surface anatomical landmark localization group[28.1％(16/57),x2=21.930,P=0.000].The success rate of the initial puncture site in the ultrasound-assisted localization group was 87.7％(50/57),which was significantly higher than that in the surface anatomical landmark localization group[54.4％(31/57),x2=15.396,P=0.000].The number of skin punctures and adjusted epidural needle direction in the ultrasound-assisted localization group were 1(1,1)and 0(0,1)times,while in the surface anatomical landmark localization group were 2(1,3)and 3(0,5)times,with statistically significant differences(all P=0.000).The puncture positioning time in the ultrasound-assisted localization group was 2.2(1.7,3.2)min,which was significantly longer than that in the surface anatomical landmark localization group[0.8(0.5,1.2)min,Z=-8.418,P=0.000].The puncture success time,anesthesia time,and total time of the ultrasound-assisted localization group were 1.9(1.7,2.3),4.9(4.3,5.3),and 7.1(6.3,8.7)min,while of the surface anatomical landmark localization group were 5.1(2.3,8.0),7.9(5.7,11.0),and 8.6(6.6,12.0)min,with statistically significant differences(all P＜0.05).There were no statistically significant differences in the incidence of nerve hypersensitivity during operation(3.5％vs.7.0％,x2=0.176,P=0.675),accidental puncture of the dura mater by epidural needles(0％vs.3.5％,P=0.496),postoperative headache(0％vs.3.5％,P=0.496),and back pain(1.8％vs.10.5％,x2=2.435,P=0.119)between the two groups.Both groups of patients showed no symptoms of nerve injury after surgery.There were no statistically significant differences in QOR-15 scores at 24 h postoperatively[119(115,124)points vs.116(112,121)points,Z=-1.858,P=0.063]and length of hospital stay[10.0(9.0,12.5)dvs.10.0(8.0,13.0)d,Z=-0.043,P=0.966]between the two groups.The satisfaction of patients in the ultrasound-assisted localization group was significantly higher than that in the surface anatomical landmark localization group(P=0.004).Conclusion Application of ultrasound-guided localization in spinal anesthesia for elderly patients with hip fractures significantly improves the first-attempt puncture and initial puncture site success rates,reduces skin puncture attempts and adjustments of the epidural needle direction,shortens time of anesthetic procedure,and enhances patient satisfaction,making it highly recommendable for clinical use.

To investigate the phenotype and genomic characterization of a mucoid-type Salmonella Saintpaul ST50 isolate from a urinary tract infection patient,promoting clinical diagnosis and treatment for urinary tract infections caused by Salmo-nella spp.Culture-based quantitative counts of midstream urine sample from the patient were conducted,and further biochemi-cal identification,mass spectrometry detection,serum agglutination test and antimicrobial susceptibility test(AST)were con-ducted on Salmonella isolate(2024JD5).Whole-genome sequencing(WGS)was performed on isolate 2024JD5 to predict sero-type,multilocus sequence type(MLST),resistance genes,and virulence genes.Two smooth-type of Salmonella Saintpaul ST50 were selected as comparative genomic reference strains from the Chinese local Salmonella genome database.The literature reviews of global Salmonella serotype of urinary tract infection were summarized.Specific serum agglutination confir-mation of isolate 2024JD5 failed due to characterization of the mucus type.The strain 2024JD5 was predicted as Salmonella Saintpaul(4,5,12:e,h:1,2)ST50 using WGS,and was resistant to ciprofloxacin,nalidixic acid,chloramphenicol and tetracy-cline with carrying aminoglycoside resistance genes aac(6')-Ⅰaa and aph(3)-Ⅱa,chloramphenicol resistance gene floR,tetra-cycline resistance gene tet,quinolone resistance gene qnrS1,and S83Y substitution in the gyrA gene was found in the quinolo-ne resistance determination region(QRDR).In addition,the strain 2024JD4 carried six types of non-plasmid-based mobile ge-netic elements and 144 virulence genes,including 71 secretion transporter genes and 58 fimbriae adhesion genes,respectively.Four types of fimbriae regulatory genes(csgB,csgC,fimW,fimY)were absent in comparison with smooth-type Salmonella Saintpaul.The literature reviews showed Salmonella Saintpaul was currently a rare Salmonella serotype in cases of urinary tract infections worldwide.Salmonella Saintpaul ST50 with mucoid-type is the pathogen of urinary tract infection with multi-drug resistant phenotypic and genotypic characteristics,and the high mucoid expression may be related to the compensatory mechanism of fimbriae regulatory genes absence in urinary tract colonization and adaptation.WGS combined with the Chinese local Salmonella genome database can effectively solve the diagnosis and biosafety assessments of rare Salmonella phenotypes.

Objective:To investigate the short-term efficacy and safety of intersegmental vein-centered planning sublobectomy (VCPS) in the treatment of intersegmental early-stage non-small cell lung cancer (NSCLC).Methods:A prospective cohort study was conducted. A total of 68 patients with early-stage NSCLC who underwent VCPS in Beijing Chao-Yang Hospital, Capital Medical University from May to November 2023 were successively included. A group of 71 patients who underwent combined segmentectomy or subsegmentectomy (CSS) during the same period was selected as the control. Preoperative three-dimensional (3D) imaging technology was used for surgical planning in the VCPS group, with tumor resection centered around intersegmental veins during the operation. In the CSS group, combined segment or subsegment resection was performed based on preoperative 3D planning. The operative time, complications, resection margin distance, hospitalization costs, and short-term follow-up results of both groups were compared.Results:The VCPS group included 29 males (42.6%) and 39 females (57.4%), with the age of (61±11) years and the tumor diameter of (10.4±3.1) mm; the postoperative pathology types revealed adenocarcinoma in situ (AIS) in 31 cases (45.6%), minimally invasive adenocarcinoma (MIA) in 23 cases (33.8%), and invasive adenocarcinoma (IA) in 14 cases (20.6%). The CSS group included 27 males (38.0%) and 44 females (62.0%), with the age of (59± 11) years and the tumor diameter of (9.9±2.9) mm; the postoperative pathology types revealed AIS in 31 cases (43.7%), MIA in 27 cases (38.0%), and IA in 13 cases (18.3%). There were no statistically significant differences in gender, age, tumor diameter and pathological type distribution between the VCPS group and CSS group (all P > 0.05). The operative time [ M ( Q1, Q3)] in the VCPS group was shorter than that in the CSS group [90 (75, 100) min vs. 150 (120, 180) min, Z = -9.83, P < 0.01]; the hospitalization cost in the VCPS group was lower than that in the CSS group [(44 969±6 929) yuan vs. (61 476±10 661) yuan, t = -10.77, P < 0.01]. There was no statistically significant difference in resection margin distance between the two groups [(18±5) mm vs. (18±5) mm, t = 0.65, P > 0.05]. Postoperative complications in the VCPS group included 2 cases of prolonged air leak and 1 case of postoperative cholecystitis, while patients in the CSS group showed 4 cases of prolonged air leak and 1 case of conversion to thoracotomy due to intraoperative bleeding. There were no statistically significant differences in the incidence of postoperative prolonged air leak and drainage time of both groups (all P > 0.05). No tumor recurrence or metastasis was observed in either group during 3-month follow-up after operation. Conclusions:VCPS, which centers surgical planning around intersegmental veins, provides more precise anatomical localization for intersegmental NSCLC lesions, shortens operative time, reduces surgical difficulty and costs, and decreases postoperative complications.

Objective:To investigate the effectiveness and safety of fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins during sublobar resection for the treatment of early-stage non-small cell lung cancer (NSCLC).Methods:This is a prospective cohort study. Patients with early-stage NSCLC who underwent fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins for sublobar resection in the Department of Thoracic Surgery, Beijing Chaoyang Hospital, Capital Medical University, from January to April 2024 were included. Based on whether the artery or vein was blocked during surgery, the patients were divided into the arterial group and the venous group. The surgical time, intraoperative blood loss, distance from the lesion to the resection margin, and boundary duration were collected and compared between the two groups. Independent sample t test, Mann-Whitney U test, or χ2 test was used to compare the data between the two groups. Results:A total of 64 patients were enrolled. There were 25 males and 39 females, aged (57.3±12.1) years (range: 34 to 80 years). The tumor diameter was (9.8±2.9) mm (range: 5 to 16 mm). The distance between the surgical margin and the lesion was (16.5±3.9) mm (range: 10 to 30 mm) and the surgical time was (61.5±13.9) minutes (range: 30 to 120 minutes). Pathological examination of the surgical specimens showed that all margins met pathological requirements. The chest drainage tube retention time ( M(IQR)) was 2 (1) days (range: 1 to 7 days), and no serious postoperative complications occurred. The boundary duration for the arterial group ( n=23) and venous group ( n=41) was (147.9±22.2) seconds (range: 119 to 188 seconds) and (40.9±8.0) seconds (range: 20 to 60 seconds), respectively ( t=27.935, P<0.01). Conclusion:Fluorescence thoracoscopy-assisted temporary occlusion of pulmonary arteries and veins can effectively and accurately delineate surgical resection boundaries, ensuring sufficient margin width to meet oncological requirements.

BACKGROUND: Preclinical studies have indicated that Angong Niuhuang Pills (ANP) reduce cerebral infarct and edema volumes. This study aimed to investigate whether ANP safely reduces cerebral infarct and edema volumes in patients with moderate to severe acute ischemic stroke. METHODS: This randomized, double-blind, placebo-controlled pilot trial included patients with acute ischemic stroke with National Institutes of Health Stroke Scale (NIHSS) scores ranging from 10 to 20 in 17 centers in China between April 2021 and July 2022. Patients were allocated within 36 h after onset via block randomization to receive ANP or placebo (3 g/day for 5 days). The primary outcomes were changes in cerebral infarct and edema volumes after 14 days of treatment. The primary safety outcome was severe adverse events (SAEs) for 90 days. RESULTS: There were 57 and 60 patients finally included in the ANP and placebo groups, respectively for modified intention-to-treat analysis. The median age was 66.0 years, and the median NIHSS score at baseline was 12.0. The changes in cerebral infarct volume at day 14 were 0.3 mL and 0.4 mL in the ANP and placebo groups, respectively (median difference: -7.1 mL; interquartile range [IQR]: -18.3 to 2.3 mL, P = 0.30). The changes in cerebral edema volume of the ANP and placebo groups on day 14 were 11.4 mL and 4.0 mL, respectively ( median difference: 3.0 mL, IQR: -1.3 to 9.9 mL, P = 0.15). The rates of SAE within 90 days were similar in the ANP (3/57, 5%) and placebo (7/60, 12%) groups ( P = 0.36). Changes in serum mercury and arsenic concentrations were comparable. In patients with large artery atherosclerosis, ANP reduced the cerebral infarct volume at 14 days (median difference: -12.3 mL; IQR: -27.7 to -0.3 mL, P = 0.03). CONCLUSIONS: ANP showed a similar safety profile to placebo and non-significant tendency to reduce cerebral infarct volume in patients with moderate-to-severe stroke. Further studies are warranted to assess the efficacy of ANP in reducing cerebral infarcts and improving clinical prognosis. TRAIL REGISTRATION Clinicaltrials.gov , No. NCT04475328.
Aged ; Female ; Humans ; Male ; Middle Aged ; Double-Blind Method ; Drugs, Chinese Herbal/adverse effects* ; Ischemic Stroke/drug therapy* ; Pilot Projects ; Stroke/drug therapy* ; Treatment Outcome

Objective To construct a database for molecular mass spectra of toxins and drugs in order to facilitate the management and retrieval of mass spectra for nerve agents,metabolites and other small molecules.Methods Requirement analysis and functional design were performed using software engineering methods.The Spec2Vec algorithm was used for vector representation of mass spectra,while SMILES molecular structures were vectorized using the extended connectivity fingerprint(ECFP).A data storage model integrating structured information and vector representations was established using the Milvus database.Similarity search of mass spectra and molecular structures was conducted via vector similarity comparison and the FlashEntropySearch algorithm.Results The constructed database of mass spectra encompassed over 400,000 entries from such sources as OCAD,NIST,MASSBANK,metabolic products,and natural products of TCM,which was capable of searching for similarities in mass spectra and molecular structures.On a standard server,similarity search of mass spectra took no more than 5 seconds,while that of molecular structures took no more than 1 second.Conclusion The system enables efficient management of complex mass spectra and provides rapid retrieval and comparison of mass spectra-related information through advanced vector indexing technology,offering robust data support and research tools for toxicology and pharmacology.

Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.

Objective To observe the clinical efficacy of lumbar disc resection under unilateral biportal endoscopy(UBE)for calcified lumbar disc herniation(CLDH).Methods A retrospective analysis was conducted on 25 patients with single-segment CLDH who underwent lumbar disc resection under UBE from January 2020 to January 2022.The operation time,postoperative hospital stay,and postoperative complications were recorded.The visual analogue scale(VAS)score for low back and leg pain,Japanese Orthopaedic Association(JOA)score for the lumbar spine,and Oswestry disability index(ODI)were used to evaluate the efficacy before surgery,3 d after surgery,1 month after surgery,and at the last follow-up.At the last follow-up,the modified Macnab standard was used to assess the excellent and good rate.Results The patients were followed up for 12～24 months,with an average of(15.60±2.60)months.The average operation time was(58.67±10.73)min,and the postoperative hospital stay was(4.65±0.63)d.The VAS score,and ODI were lower,and JOA score was higher at 3 d after surgery,1 month after surgery,and the last follow-up compared with those before surgery,and the differences were statistically significant(P<0.05).At the last follow-up,according to the modified Macnab criteria,15 cases were rated as excellent,9 cases as good,and 1 case as fair.The excellent and good rate was 96.00%(24/25).Postoperative complications included a tear of the ventral dural sac of the nerve root,about 5 mm in length,without dural sac repair.The patient was instructed to stay in bed for 5 d after surgery and was given fluid replacement.The patient did not complain of discomfort such as headache when he got out of bed,and the postoperative MRI showed no massive epidural effusion.One patient had lower limb sensory disturbance and was treated with neurotrophic drugs,and recovered at the 1-month follow-up after surgery.Postoperative imaging examinations showed that the free calcified tissues were basically completely resected and the nerve roots were adequately decompressed.At the last follow-up,no recurrent cases were found.Conclusion Lumbar disc resection under UBE for CLDH is an effective and safe minimally invasive technique.