ObjectiveTo evaluate the application effect of morphology driven preparation technique in indirect restoration of posterior teeth. Methods84 patients with dental defects were selected and divided into the control group and the experimental group randomly， with 42 patients in each group （a total of 84 teeth）. Traditional preparation and morphology driven preparation techniques were used to complete dental preparation and adhesive glass ceramic restorations， respectively. The satisfaction， masticatory function， World Dental Federation （FDI） Scores for edge fracture and fixation，edge adaptability index，periodontal bleeding index （BI） and plaque index （PLI） of the two groups of patients were evaluated and various indicator data were recorded and statistically analyzed at 3 and 6 months after restoration completion. ResultsThere was no statistically significant difference in satisfaction between the two groups after 3 and 6 months of repair； Both groups of data showed a significant improvement in masticatory function. There was no statistical difference after 3 and 6 months of repair. However， a statistically significant difference in masticatory function was noted after 6 months of repair compared with before and after 3 months of repair. As the repair time increased， the masticatory effect improved significantly. There was no statistically significant difference in the edge fracture and fixation index between the two groups at 3 months after repair， but there was a statistically significant difference between the two groups at 6 months with the experimental group outperforming the control group（P<0.05）. The edge adaptability， BI， and PLI index were statistically significant between the two groups after 3 and 6 months of repair and the experimental group had a significant advantage （P<0.05）. ConclusionBoth types of tooth preparation techniques can improve patient masticatory function and reach high satisfaction after repair. However， morphology driven preparation technique has significant advantages in edge adaptability， edge fracture and fixation index scores and improve periodontal conditions. This technique is an effective method for improving dental preparation in adhesive indirect restoration of posterior teeth.

ObjectiveTo explore the effects and mechanism of the modified Danggui Yinzi on "itch-anxiety" model rats of chronic urticaria （CU）. MethodsThe 36 SPF-grade 6-8-week-old female SD rats were randomly divided into a blank control group，a model group，a positive control group，a low-dose modified Danggui Yinzi group，a medium-dose modified Danggui Yinzi group，and a high-dose modified Danggui Yinzi group. A "itch-anxiety" model was established by intraperitoneal injection of a suspension of sodium chloride and aluminum hydroxide and ovalbumin，combined with chronic unpredictable emotional stress stimulation. After successful modeling，rats in each group were administered drugs by gavage. The positive control group was given intragastric administration of the drug solutions of cetirizine and fluoxetine （2.08 mg·kg^-1·d^-1 fluoxetine， 2 mg·kg^-1·d^-1 cetirizine）， the low-，medium-，and high-dose modified Danggui Yinzi groups were administered traditional Chinese medicine at 1.44，2.88， 5.76 g·kg^-1， respectively，while the blank control group and model group were given an equal volume of normal saline. All interventions lasted for 15 days. Behavioral changes were evaluated by the elevated plus-maze test （detecting the percentage of entries into the open arms （OE%），the percentage of time spent in the open arms （OT%），and the total number of entries into the open and closed arms （TNE）），the open-field test （detecting total activity，average movement speed，and latency to enter the central area），and scratching behavior observation. Pathological changes of skin tissues were observed by hematoxylin-eosin （HE） staining and toluidine blue staining，while those of amygdala tissues were observed by HE staining，Nissl staining，and immunofluorescence detection of ionized calcium-binding adapter molecule-1 （Iba-1）. The content of immunoglobulin E （IgE），interleukin-33 （IL-33），histamine in serum and glutamate in the amygdala was detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the protein expression of striatal-enriched protein tyrosine phosphatase （STEP），N-methyl-D-aspartate receptor subunit 2B （NR2B）， calmodulin-dependent protein kinase Ⅱ （CaMKⅡ），phosphorylated CaMKⅡ （p-CaMKⅡ），mitogen-activated protein kinase （MAPK），phosphorylated MAPK （p-MAPK），nuclear factor kappa-light-chain-enhancer of activated B cells （NF-κB），phosphorylated NF-κB （p-NF-κB），and postsynaptic density protein-95 （PSD-95） in the amygdala. ResultsCompared with the blank control group，the model group rats showed obvious anxiety-like behaviors （decreased OE%，OT%，and TNE，reduced total activity，slower average movement speed，and prolonged latency to enter the central area），increased scratching times，obvious skin inflammation and mast cell degranulation，severe amygdala tissue damage，increased glutamate content in the amygdala，and elevated levels of IgE and IL-33 in serum. The expression of STEP，NF-κB，p-NF-κB，NR2B，MAPK，p-MAPK，CaMKⅡ，and p-CaMKⅡ proteins in the amygdala increased，while the expression of PSD-95 protein decreased （P<0.05）. Compared with the model group，the modified Danggui Yinzi group of each dose had increased OE%，OT%，TNE，total activity，and average movement speed，shortened latency to enter the central area， reduced scratching times，alleviated skin inflammation and mast cell degranulation，relieved amygdala tissue damage，decreased glutamate content in the amygdala，and reduced levels of IgE and IL-33 in serum. Moreover，compared with the model group，the low -，medium-，and high-dose modified Danggui Yinzi groups showed decreased expression levels of STEP，NF-κB，p-NF-κB，NR2B，MAPK，p-MAPK，CaMKⅡ，and p-CaMKⅡ proteins in the amygdala，and increased expression of PSD-95 protein. There was a significant dose-effect relationship，with the high-dose group showing the most significant regulatory effect （P<0.05）. ConclusionThe modified Danggui Yinzi has a therapeutic effect on "itch-anxiety" model rats of CU. Its mechanism may be related to regulating glutamate metabolism in the amygdala，modulating the STEP/NR2B/CaMKⅡ/MAPK/NF-κB pathway，and regulating the expression of PSD-95.

Objective To compare the effects of stereotactic endoscopic hematoma evacuation on elderly patients with hypertensive intracerebral hemorrhage.Methods A total of 220 patients with hypertensive intracerebral hemorrhage in the basal ganglion admitted to our hospital from January 2020 to December 2023 were retrospectively recruited.According to their surgical treat-ment,they were divided into an observation group(stereotactic endoscopic hematoma evacuation,n=100)and a control group(craniotomy hematoma removal surgery,n=120).Postoperative recovery was observed and compared between the two groups.Results There was no significant difference in operation time between the observation group and the control group(94.56±14.75 min vs 94.03±14.50 min,t=0.268,P=0.789).No statistical differences were observed in the NIHSS score before operation between the two groups(P=0.058),but the observation group obtained significantly lower NIHSS scores in 3 and 6 months after surgery(5.90±4.02 vs 9.23±3.47,P=0.000;4.54±2.56 vs 6.50±3.07,P=0.000).There were no significant differences in GOS score and incidence of postoperative complications between the two groups(P＞0.05).Conclusion Stereotactic endoscopic hematoma evacuation can improve postoperative neurological function in patients with hypertensive intracerebral hemorrhage in the basal ganglia region.

Objective To investigate the expression of microRNA-873-5p(miR-873-5p)and C-X-C motif chemokine ligand 16(CXCL16)in thyroid cancer tissue and their relationship with pathological parameters and prognosis.Methods A total of 125 patients with thyroid cancer who underwent surgery at Nanjing Sec-ond Hospital from January 2018 to June 2019 were selected as the research subjects.Some cancer tissues and corresponding adjacent tissues of the patients were collected,and the expressions of miR-873-5p and CXCL16 mRNA were detected by real-time fluorescence quantitative polymerase chain reaction.The binding sites of miR-873-5p and CXCL16 were predicted through the online database.Pearson correlation was used to analyze the correlation between miR-873-5p and CXCL16 mRNA expression,and the correlation between miR-873-5p,CXCL16 mRNA expression and pathological parameters.According to the median expression of miR-873-5p and CXCL16 mRNA in thyroid cancer tissues,they were classified as high expression and low expression.The survival curves of patients with high and low expression of miR-873-5p and CXCL16 mRNA were plotted by the Kaplan-Meier method.Taking the survival status of patients with thyroid cancer as the dependent varia-ble,Cox regression was used to determine the relationship between the expressions of miR-873-5p and CX-CL16 mRNA and the death of patients with thyroid cancer.Results The expressions of miR-873-5p and CX-CL16 mRNA in thyroid cancer tissues were 0.83±0.12 and 1.54±0.25,respectively,and those in adjacent tissues were 1.13±0.15 and 0.98±0.13,respectively,the differences were statistically significant(t=-18.160,21.089).P＜0.001).Pearson correlation analysis showed that the expression of miR-873-5p and CXCL16 mRNA in thyroid cancer tissues was negatively correlated(r=-0.722,P＜0.001).The expression of miR-873-5p in thyroid cancer tissues was negatively correlated with pathological type,TNM stage and lymph node metastasis(r=-0.510,—0.262,-0.315,P＜0.05).The expression of CXCL16 mRNA was positively correlated with pathological type,TNM stage and lymph node metastasis(r=0.593,0.275,0.314,P＜0.05).The Kaplan-Meier survival curve showed that the 5-year overall survival rate of patients with high expression of miR-873-5p was higher than that of patients with low expression of miR-873-5p.The 5-year o-verall survival rate of patients with high expression of CXCL16 mRNA was lower than that of patients with low expression of CXCL16 mRNA,and the difference was statistically significant(x2=11.328,10.514,all P=0.001).miR-873-5p≥0.84 was an independent protective factor for death in patients with thyroid cancer,and CXCL16 mRNA≥1.55 was an independent risk factor for death in patients with thyroid cancer(P＜0.05).Conclusion The expressions of miR-873-5p and CXCL16 mRNA in thyroid cancer tissues are related to patho-logical parameters and prognosis,and may become prognostic markers for patients with thyroid cancer.

OBJECTIVE:High-intensity interval training(HIIT)and moderate-intensity continuous training(MICT)can improve the quality of life of patients with clinical chronic diseases,but their application effects and regulatory factors in adults with insufficient physical activity are still unclear.This study aimed to explore the application effects and regulatory factors of HIIT and MICT on the quality of life of adults with insufficient physical activity. METHODS:A systematic literature search was conducted in databases including Web of Science Core Collection,Medline(EBSCO Host),PubMed,and Cochrane Library.The search time limit was from the establishment of each database to September 2023.The types of included literature were randomized controlled trials,and the research subjects were physically inactive adults.RevMan 5.4 software and the GRADE evidence evaluation framework were used to assess the quality of the included literature.Main effects pooling of random effects models was performed using R Studio(version 4.2.0).Subgroup analyses,regression analyses,and sensitivity analyzes were used to explore the sources of study heterogeneity and moderators. RESULTS:(1)Thirty-two randomized controlled trials of moderate to high quality were included,involving 2 083 physically inactive adults(HIIT group n=474;MICT group n=708;control group n=901).(2)Compared with the non-training control group,HIIT[Hedges'g=0.61;95%confidence interval(CI):0.40-0.83;I2=45%]and MICT(Hedges'g=0.66;95%CI:0.25-1.08;I2=89%)significantly improved the quality of life.Direct comparison studies of HIIT and MICT found no significant differences in the quality of life(Hedges'g=-0.01;95%CI:-0.23-0.21;I2=0%).(3)Subgroup analysis showed that HIIT and MICT were more effective in improving the physical components of the quality of life(HIIT:Hedges'g=0.82 vs.0.75;MICT:Hedges'g=0.74 vs.0.55),while cycling had a better trend in improving overall quality of life(HIIT:Hedges'g=0.74 vs.0.36;MICT:Hedges'g=1.08 vs.0.52).(4)Additionally,regression analysis did not identify any significant moderators(P>0.05 for all factors).(5)None of the above meta-analyses found publication bias(Egger test P>0.05). CONCLUSION:(1)Moderate to high level evidence shows that both HIIT and MICT can improve the quality of life of adults with insufficient physical activity,and the intervention effects between the two are similar.Therefore,when choosing between these two options,it is necessary to comprehensively consider factors such as time economy,scheduling flexibility,and application feasibility to formulate a personalized exercise plan.(2)This study recommends that when applying HIIT,a low-volume protocol(for example,5 groups each time,1 minute each),3 times/week,and ride at 80%-95%of the maximum heart rate is used to achieve the theoretical best improvement effect.(3)Although MICT improves the quality of life,there is insufficient evidence that increasing exercise duration brings additional benefits.Therefore,this study recommends that when MICT is conducted,it should be carried out more than three times a week,with each training duration controlled between 25 and 60 minutes,and cycling at 50%-75%of the maximum heart rate,in order to achieve the theoretically expected best improvement effect.

Objective:To explore the differences in the cost structures of Hemophagocytic Lymphohistiocytosis(HLH)and Still's disease,and provide a basis for optimizing the medical insurance and hierarchical diagnosis and treatment policies for rare diseases.Methods:Based on the theories and methods of SHA 2011,the treatment costs and financing models of HLH and Still's disease in 2020 were calculated and analyzed to calculate its financing mode.Results:In 2020,the treatment cost of HLH in China was 436 million yuan,with 98.62%occurring in inpatient services;the treatment cost of Still's disease was 159 million yuan,with 82.32%occurring in inpatient services.In terms of the financing composition,the proportion of household health expenditure in outpatient services for HLH reached to 65.51%;for adult Still's disease,the proportion of household health expenditure in outpatient services was 65.13%;for pediatric Still's disease,the proportion of household health expenditure in outpatient services was as high as 93.15%,and the compensation from social medical insurance was less than 4%.Conclusion:In China,there are problems such as imbalanced cost structures,uneven distribution of diagnosis and treatment resources,heavy family burdens,and differentiation in the attention paid to rare diseases.It is necessary to improve the accounting system,strengthen grassroots diagnosis and treatment,optimize the financing mechanism,increase the attention to"non-star"rare diseases,and promote universal protection.

Objective:To construct a training program for epilepsy specialist nurses, so as to provide a theoretical basis for the training and development of epilepsy specialist nurses.Methods:A preliminary training program for epilepsy specialist nurses was developed based on literature review, semi-structured interview, focus group discussion and clinical practice experience. Delphi method was used to select 20 experts from several regions of China for two rounds of consultation.Results:In the two rounds of expert consultation, the effective recovery rate of the questionnaire was both 100%, the expert authority coefficient was 0.908 and 0.958, and the degree of coordination of expert opinions was 0.180 to 0.229 and 0.138 to 0.189, respectively ( P<0.05). The standardized training program for epilepsy specialist nurses was finally constructed, including 5 first-level indicators (admission conditions, general theory courses, specialty theory courses, specialty nursing practice courses, training modes and effectiveness evaluation), 15 second-level indicators and 61 third-level indicators. Conclusions:The training program constructed for epilepsy specialist nurses is scientific and reasonable, with certain reliability and practicality, which provides a theoretical basis for the training of epilepsy specialist nurses, and promotes the common development of China's epilepsy specialist nurse team.

Objective:To construct a curriculum system for malignant fungating wounds based on Kolb experience learning theory.Methods:The first draft of a curriculum system for malignant fungating wounds was constructed based on literature search and group discussion using Kolb experience learning theory as a guide. Between February and May 2024, purposive sampling was used to select 16 experts for two rounds of expert consultation based on the Delphi method to form the final draft of the curriculum system for malignant fungating wounds.Results:A total of 16 questionnaires were distributed in both rounds of expert consultation and 16 questionnaires were effectively recovered with an effective recovery rate of 100.00%. The expert authority coefficients in two rounds of consultation were all 0.916, and Kendall's W values ranged from 0.089 to 0.192 (all P<0.05). The final curriculum system for malignant fungating wounds included four primary indicators, 10 secondary indicators, and 32 tertiary indicators. Conclusions:The curriculum system for malignant fungating wounds constructed under the guidance of Kolb experience learning theory is scientific and practical, and can provide a basis for conducting malignant fungating wound training.

ObjectiveTo investigate the efficacy of Xingpi capsules （XPC） in treating diarrhea-predominant irritable bowel syndrome （IBS-D） with spleen deficiency and elucidate its potential molecular mechanisms. MethodsA rat model of IBS-D with spleen deficiency was established by administering senna leaf in combination with restrained stress and swimming fatigue for 14 d. Ten specific pathogen free （SPF）-grade healthy rats were used as the normal control group. After successful modeling， SPF-grade rats were randomly divided into a model group， a pinaverium bromide group （1.5 mg·kg^-1）， and low- and high-dose XPC groups （0.135 and 0.54 g·kg^-1）， with 10 rats in each group. Rats in the normal control group and the model group were given distilled water by gavage， while the remaining groups were administered corresponding drug solutions by gavage once a day for 14 consecutive days. The rat body weights and fecal condition were observed every day， and the Bristol score was recorded. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of 5-hydroxytryptamine （5-HT） in serum and colon tissue. Transmission electron microscopy was used to observe the microvilli and tight junctions in the colon. The integrity of the colonic barrier， intestinal motility， and expression of related pathway proteins were evaluated by hematoxylin-eosin （HE） staining， immunohistochemistry， and Western blot. ResultsCompared with those in the normal control group， rats in the model group showed a significantly decreased body weight and increased diarrhea rate， diarrhea grade， and Bristol score （P<0.01）. HE staining revealed incomplete colonic mucosa in the model group， with evident congestion and edema observed. Electron microscopy results indicated decreased density and integrity of the colonic barrier， shedding and disappearance of microvilli， and significant widening of tight junctions. The expression levels of colonic tight junction proteins Occludin and Claudin-5 were downregulated （P<0.01）， and the levels of 5-HT in serum and colon tissue were elevated （P<0.01）. The small intestine propulsion rate significantly increased （P<0.01）， and the expression of contractile proteins Ras homolog family member A （RhoA） and Rho-associated coiled-coil containing protein kinase 2 （ROCK2） in colon and phosphorylation of myosin light chain （MLC₂₀） were upregulated （P<0.01）. Compared with the model group， the treatment groups showed alleviated diarrhea， diarrhea-associated symptoms， and pathological manifestations of colon tissue to varying degrees. Specifically， high-dose XPC exhibited effectively relieved diarrhea， promoted recovery of colonic mucosal structure， significantly reduced congestion and edema， upregulated expression of Occludin and Claudin-5 （P<0.01）， decreased levels of 5-HT in serum and colon tissue （P<0.05，P<0.01）， significantly slowed small intestine propulsion rate （P<0.01）， and significantly downregulated expression of contractile proteins RhoA and ROCK2 in colon and phosphorylation of MLC₂₀ （P<0.05，P<0.01）. ConclusionXPC effectively alleviates symptoms of spleen deficiency and diarrhea and regulates the secretion of brain-gut peptide. The characteristics of XPC are mainly manifested in alleviating IBS-D with spleen deficiency from the aspects of protecting intestinal mucosa and inhibiting smooth muscle contraction， and the mechanism is closely related to the regulation of the 5-HT-RhoA/ROCK2 pathway expression.

Objective To investigate the role of long non-coding RNA-small nucleolar RNA host gene 3(lncRNA-Snhg3)and its regulatory mechanism in the hepatic glucose metabolism of mice.Methods Adenovirus Snhg3 was over-expressed by the tail vein injection in db/db mice,and then glucose tolerance and pyruvate tolerance were meas-ured.The mRNA expression of mouse liver gluconeogenesis-related genes phosphoenolpyruvate carboxylase(Pepck)and glucose-6-phosphatase(G6pc)and stress-inducing protein 2(Sestrin2,Sesn2,a gene adjacent to Snhg3)were de-tected by RT-qPCR.The dual luciferase reporter assay was used to detect the effect of Snhg3 on the Sesn2 promoter activity in 293T cells.Results Snhg3 over-expression improved glucose tolerance and pyruvate tolerance in db/db mice.Snhg3 over-expression inhibited the mRNA of gluconeogenesis genes of Pepck(P＜0.05)and G6pc(P＜0.05),while promoted the mRNA of Sesn2(P＜0.01).Meanwhile,Snhg3 over-expression promoted Sesn2 promoter activity in 293T cells(P＜0.05).Conclusions Snhg3 improves glucose metabolism in mice by promoting Sestrin2 expression.