Objective:To investigate the expression levels of serum receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) in children with dental fluorosis.Methods:In April 2018, a case-control study was conducted to select 8 - 12 year old children diagnosed with dental fluorosis residing within 1.5 km of an aluminum smelting facility in Guangxi Zhuang Autonomous Region as the dental fluorosis group ( n = 49) according to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011). The control group ( n = 98) comprised healthy children aged 8 - 12 years old without dental fluorosis lived more than 5.0 km from the aluminum smelting facility. Fasting venous blood samples were collected from all participants. Blood fluoride level were measured using an ion-selective electrode method. Serum RANK, RANKL, and OPG levels were determined using double-antibody sandwich enzyme-linked immunosorbent assay. Results:The levels of serum fluoride [ M ( Q1, Q3): 0.033 (0.032, 0.036) vs 0.026 (0.025, 0.028) mg/L], RANK [1.21 (0.87, 1.64) vs 0.73 (0.50, 1.13) μg/L], RANKL [81.3 (50.6, 118.6) vs 134.3 (98.1, 199.2) ng/L], OPG [433.3 (321.6, 574.3) vs 509.1 (406.8, 709.3) μg/L], and OPG/RANKL ratio [5.6 (3.1, 7.8) vs 3.6 (2.9, 5.0)] were compared between the fluorosis group and the control group, and the differences were statistically significant ( Z = 8.35, 3.83, 3.99, 2.35, 2.47, P < 0.05). Correlation analysis revealed that dental fluorosis severity was positively correlated with serum fluoride level( r s = 0.68, P < 0.001). Serum fluoride level was negatively correlated with both serum RANKL and OPG levels ( r s = - 0.49, - 0.17, P < 0.05). Conclusion:The level of serum RANK in children with dental fluorosis is higher than that in healthy children, while the levels of RANKL and OPG are lower than those in healthy children.

Objective The aim of this study was to explore the acceptance and influencing factors of self-collected urine samples for human papillomavirus(HPV)testing in cervical cancer screening among eligible women,and to provide scientific evidence for promoting this testing in low resource areas.Methods A population-based cross-sectional study was conducted from 2022 to 2023 at the Maternal and Child Health Hospital in Shuangliu district,Chengdu City Sichuan Province.The study subjects were women aged 21 to 69 years old,and a customized questionnaire was used to conduct general information and acceptance surveys on the partic-ipants.Results A total of 2,062 women were included,with an average age of 51.58±9.34 years.Among them,1,501(72.79％)women believed that self-sampling urine was very easy.However,although 1,333(64.65％)women were still willing to accept doctor sampling as a cervical cancer screening method,only 729(35.35％)were more willing to accept self-sampling urine HPV testing.Age,educational level,annual household income,awareness of HPV,HPV vaccination status,and a sense of shame about the doctor's sampling process were all associated with the acceptance of self-collected urine HPV testing among women undergoing cervical cancer screening(P＜0.001).The results of multivariate logistic regression analysis indicated that older women(OR=0.965,95％CI:0.951-0.979)and those who were not familiar with HPV(OR=0.760,95％CI:0.602-0.961)were more likely to undergo self sampling urine HPV testing,while those with junior high school education(OR=1.330,95％CI:1.053-1.682),high school education or a-bove(OR=1.990,95％CI:1.401-2.827),and a sense of shame towards the doctor's sampling process(OR=2.314,95％CI:1.706-3.142)were more likely to undergo self sampling urine for HPV testing.Conclusions Most women believe that self sampling urine for HPV testing is very easy,but compared to doctor sampling,only some women choose to self sample urine for HPV testing.Key health education interventions should be carried out for older and lower educated populations to promote acceptance of urine HPV testing.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Occult hepatitis B virus(HBV)infection(OBI)represents a potential reservoir for HBV transmission,capable of spreading through routes such as blood transfusion.Additionally,OBI can con-tribute to the chronic progression of hepatitis B-related diseases,sustaining a state of chronic HBV infec-tion.In individuals with compromised immune function or undergoing immunosuppressive therapy,OBI may lead to HBV re-activation,potentially triggering severe liver conditions such as acute hepatitis or liv-er failure.As a result,OBI poses a significant public health challenge,profoundly impacting the health and well-being of affected populations and complicating HBV infection control efforts in China.Clinically diagnosing OBI remains challenging,but its hallmark is serum hepatitis B surface antigen negative and the presence of HBV covalently closed circular DNA(cccDNA)in the liver.With the increasing focus on achieving functional cure for chronic hepatitis B,both domestic and international guidelines have re-fined functional cure.Notably,these guidelines acknowledge that cccDNA may persist in the liver tissue of individuals who have achieved functional cure,suggesting resemblance of an occult infection state.Here,we provide a comprehensive overview of OBI,including its definition,classification,public health implications,underlying mechanisms,and clinical reactivation.By updating the understanding of OBI,we aim to raise awareness among clinicians and public health professionals regarding the significance of OBI in the current context and encourage greater attention to this population.

Occult hepatitis B virus(HBV)infection(OBI)represents a potential reservoir for HBV transmission,capable of spreading through routes such as blood transfusion.Additionally,OBI can con-tribute to the chronic progression of hepatitis B-related diseases,sustaining a state of chronic HBV infec-tion.In individuals with compromised immune function or undergoing immunosuppressive therapy,OBI may lead to HBV re-activation,potentially triggering severe liver conditions such as acute hepatitis or liv-er failure.As a result,OBI poses a significant public health challenge,profoundly impacting the health and well-being of affected populations and complicating HBV infection control efforts in China.Clinically diagnosing OBI remains challenging,but its hallmark is serum hepatitis B surface antigen negative and the presence of HBV covalently closed circular DNA(cccDNA)in the liver.With the increasing focus on achieving functional cure for chronic hepatitis B,both domestic and international guidelines have re-fined functional cure.Notably,these guidelines acknowledge that cccDNA may persist in the liver tissue of individuals who have achieved functional cure,suggesting resemblance of an occult infection state.Here,we provide a comprehensive overview of OBI,including its definition,classification,public health implications,underlying mechanisms,and clinical reactivation.By updating the understanding of OBI,we aim to raise awareness among clinicians and public health professionals regarding the significance of OBI in the current context and encourage greater attention to this population.

Objective The aim of this study was to explore the acceptance and influencing factors of self-collected urine samples for human papillomavirus(HPV)testing in cervical cancer screening among eligible women,and to provide scientific evidence for promoting this testing in low resource areas.Methods A population-based cross-sectional study was conducted from 2022 to 2023 at the Maternal and Child Health Hospital in Shuangliu district,Chengdu City Sichuan Province.The study subjects were women aged 21 to 69 years old,and a customized questionnaire was used to conduct general information and acceptance surveys on the partic-ipants.Results A total of 2,062 women were included,with an average age of 51.58±9.34 years.Among them,1,501(72.79％)women believed that self-sampling urine was very easy.However,although 1,333(64.65％)women were still willing to accept doctor sampling as a cervical cancer screening method,only 729(35.35％)were more willing to accept self-sampling urine HPV testing.Age,educational level,annual household income,awareness of HPV,HPV vaccination status,and a sense of shame about the doctor's sampling process were all associated with the acceptance of self-collected urine HPV testing among women undergoing cervical cancer screening(P＜0.001).The results of multivariate logistic regression analysis indicated that older women(OR=0.965,95％CI:0.951-0.979)and those who were not familiar with HPV(OR=0.760,95％CI:0.602-0.961)were more likely to undergo self sampling urine HPV testing,while those with junior high school education(OR=1.330,95％CI:1.053-1.682),high school education or a-bove(OR=1.990,95％CI:1.401-2.827),and a sense of shame towards the doctor's sampling process(OR=2.314,95％CI:1.706-3.142)were more likely to undergo self sampling urine for HPV testing.Conclusions Most women believe that self sampling urine for HPV testing is very easy,but compared to doctor sampling,only some women choose to self sample urine for HPV testing.Key health education interventions should be carried out for older and lower educated populations to promote acceptance of urine HPV testing.

Objective:To investigate the expression levels of serum receptor activator of nuclear factor-κB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) in children with dental fluorosis.Methods:In April 2018, a case-control study was conducted to select 8 - 12 year old children diagnosed with dental fluorosis residing within 1.5 km of an aluminum smelting facility in Guangxi Zhuang Autonomous Region as the dental fluorosis group ( n = 49) according to the criteria of "Diagnosis of Dental Fluorosis" (WS/T 208-2011). The control group ( n = 98) comprised healthy children aged 8 - 12 years old without dental fluorosis lived more than 5.0 km from the aluminum smelting facility. Fasting venous blood samples were collected from all participants. Blood fluoride level were measured using an ion-selective electrode method. Serum RANK, RANKL, and OPG levels were determined using double-antibody sandwich enzyme-linked immunosorbent assay. Results:The levels of serum fluoride [ M ( Q1, Q3): 0.033 (0.032, 0.036) vs 0.026 (0.025, 0.028) mg/L], RANK [1.21 (0.87, 1.64) vs 0.73 (0.50, 1.13) μg/L], RANKL [81.3 (50.6, 118.6) vs 134.3 (98.1, 199.2) ng/L], OPG [433.3 (321.6, 574.3) vs 509.1 (406.8, 709.3) μg/L], and OPG/RANKL ratio [5.6 (3.1, 7.8) vs 3.6 (2.9, 5.0)] were compared between the fluorosis group and the control group, and the differences were statistically significant ( Z = 8.35, 3.83, 3.99, 2.35, 2.47, P < 0.05). Correlation analysis revealed that dental fluorosis severity was positively correlated with serum fluoride level( r s = 0.68, P < 0.001). Serum fluoride level was negatively correlated with both serum RANKL and OPG levels ( r s = - 0.49, - 0.17, P < 0.05). Conclusion:The level of serum RANK in children with dental fluorosis is higher than that in healthy children, while the levels of RANKL and OPG are lower than those in healthy children.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.