ObjectiveTo evaluate the public health governance capacity in Jiangsu Province and provide an optimized pathway for the construction of a “strong, rich, beautiful, and high-quality” new Jiangsu. MethodsA total of 806 policy documents, 658 public information reports, and 148 research literatures related to public health governance capacity in Jiangsu Province from January 1995 to December 2023 were collected. The status of current public health goverance was assessed based on the evaluation criteria suitable for public health systems, and the strengths and the weaknesses of the system were identified. ResultsThe public health governance capability of Jiangsu Province was scored at 738.3 points, ranking 3rd nationally. Maternal health care and emergency response capacities achieved leading positions nationwide, both ranking 2nd. Jiangsu had exhibited a standardized guidance in the strategic level, a well-established management mechanism, an extensive coverage in information collection, and a scientifically established health targets setting. However, bottlenecks remained, including an unclear division of responsibilities across organizational departments, an insufficient public-health workforce, the absence of a stable growth mechanism for government funding investment, and difficulties in promptly identifying public needs. ConclusionJiangsu’s public-health system demonstrates leading nationally, yet several components remain underdeveloped. Future efforts should consolidate advantages while addressing weaknesses, further diversify content and forms, establish a stable funding increase mechanism, and clarify departmental functions, thereby providing solid health support for realizing the developmental goals of a “strong, rich, beautiful and high-quality” new Jiangsu.

ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

OBJECTIVE To investigate the improving effect and mechanism of Wenyang huayu formula on cerebral ischemia-reperfusion injury in rats based on nuclear factor-erythroid 2-related factor 2 （Nrf2）/glutathione peroxidase 4 （GPX4） signaling pathway and mitochondrial ferroptosis pathway. METHODS SD rats were randomly divided into sham operation group， model group，Nimodipine tablet group （10.8 mg/kg ）， and Wenyang huayu formula group （28 g/kg）， with 24 rats in each group. Except for the sham operation group， rats in other groups were all subjected to middle cerebral artery occlusion model by Longa thread occlusion method. After successful modeling， rats in each administration group were intragastrically gavaged with corresponding liquid for 7 days or 14 days， while rats in sham operation group and model group were given equal volume of normal saline once a day. At 7 and 14 days after administration， neurological deficit scores of rats were calculated； the ultrastructure of neuronal mitochondria in ischemic brain tissue of rats was observed；the contents of malondialdehyde （MDA）， glutathione （GSH） and Fe 2+ ， as well as the protein and mRNA expression levels of Nrf2， solute carrier family 7 member 11 （SLC7A11） and GPX4 in ischemic brain tissue of rats were detected. RESULTS At 7 and 14 days after administration， compared with the sham operation group， the neuronal mitochondria in ischemic brain tissue of rats in the model group showed typical changes of ferroptosis， and the injury continued to worsen over time； the neurological deficit scores， the contents of MDA and Fe 2+ were significantly increased （ P ＜0.05），while the content of GSH and the protein and mRNA expression levels of Nrf2， SLC7A11 and GPX4 were significantly decreased （ P ＜0.05）. Compared with the model group， the morphology of neuronal mitochondria in ischemic brain tissue of rats in Nimodipine tablet group and Wenyang huayu formula group was gradually improved over time， and the above quantitative indicators were significantly reversed （ P ＜0.05）；moreover， the improvement effect of most indicators in Wenyang huayu formula group was significantly better than that in Nimodipine tablet group （ P ＜0.05）. CONCLUSIONS Wenyang huayu formula can improve cerebral ischemia-reperfusion injury in rats， and its mechanism may be related to activating Nrf2/GPX4 signaling pathway and inhibiting mitochondrial ferroptosis.

Objective We investigated the clinical features and the potential risk factors of malnutrition in patients with chronic heart failure(CHF),and constructed the risk prediction model of malnutrition.Methods A total of459 CHF patients admitted between January 2023 and July 2024 were classified into a normal nutrition group and a malnutrition group based on the geriatric Nutrition Risk Index(GNRI)score upon admission.The patient-related data were gathered,and single-variable and multi-variable logistic analyses were first carried out to identify the risk factors associated with the malnutrition risk.Subsequently,the stepwise regression approach was employed to define the inclusion criteria and construct a malnutrition nomogram model for CHF patients.The diagnostic efficacy and calibration of this model were appraised using the ROC curve and calibration curve,and its clinical utility was assessed via the clinical decision curve.A P value less than 0.05 signified statistically significant differences.Results Anxiety(OR=1.1902,95%CI:1.0217～1.3865),urea nitrogen(OR=1.4842,95%CI:1.1187～1.9691),low body weight(OR=0.8463,95%CI:0.7852～0.9121),and low albumin(OR=0.0467,95%CI:0.0172～0.1268)were risk factors for malnutrition.The optimal model inclusion factors were selected by stepwise regression,including:Body weight,7 items of Generalized Anxiety Disorder Scale(GAD-7),urea nitrogen,uric acid,albumin,total cholesterol,high density lipoprotein cholesterol(HDL-L),low density lipoprotein cholesterol(LDL-L),D-dimer.The area under the ROC curve(AUC)of the column chart model based on the above factors is 0.996(95%CI:0.971～0.978),with a sensitivity of 97.8%and a specificity of 97.1%.The C-index validated internally in the calibration curve was 0.824.The calibration chart and validation results demonstrate good consis-tency and applicability.Conclusion The column chart prediction model created in this study based on nine factors including body weight,GAD-7,urea nitrogen,uric acid,albumin,total cholesterol,HDL-L,LDL-L,and D-dimer had good calibration and prediction performance,and had good clinical practicality,which was helpful for clinicians to make diagnosis and treatment decisions for malnutrition in CHF patients.

Objective:To analyze the epidemiological characteristics of imported malaria in Shaoxing City and provide scientific basis for formulating prevention and control measures against imported malaria.Methods:A retrospective analysis was conducted. Data on imported malaria cases reported in Shaoxing City from 2012 to 2024 were collected from the infectious disease reporting information system of China Center for Disease Control and Prevention, and the parasitic disease control information management system, including general information, epidemiological investigation reports and diagnosis/treatment status, to analyze their epidemiological characteristics.Results:From 2012 to 2024, there were 110 imported malaria cases in Shaoxing City, including 105 males and 5 females, with a sex ratio of 21 ∶ 1. The youngest patient was 21 years old and the oldest was 73 years old, with 72 cases (65.45%) in the 30-50 age group. The 110 malaria cases included 69 cases of falciparum malaria, 22 cases of vivax malaria, 15 cases of ovale malaria, 3 cases of quartan malaria, and 1 case of mixed infection. The infection sources were Africa (84.55%, 93/110) and Asia (15.45%, 17/110). Among all patients, there were 19 foreign nationals and 91 Chinese citizens. The main purposes of travel for Chinese citizens were labor work (67.03%, 61/91) and business (29.67%, 27/91). Areas with more reported cases were Zhuji City (32 cases), Keqiao District (27 cases), Xinchang County (19 cases) and Yuecheng District (19 cases). The peak months of onset were January, July and September, with 12, 12 and 18 cases respectively. The first medical visits were mainly at county-level hospitals, center for disease control and prevention at all levels and municipal hospitals, with diagnosis rates of 86.67% (52/60), 100% (21/21) and 12/15 respectively. Compared with cases without malaria history, cases with malaria history had shorter time from onset to diagnosis (median, 5.00 d vs. 2.00 d, Z =-2.40, P = 0.004). Conclusions:From 2012 to 2024, imported malaria in Shaoxing City was mainly falciparum malaria, with Africa being the main infection source. The peak incidence occurred in summer. Male young adult overseas workers were the high-risk population. The prevention and control of imported malaria in Shaoxing City should focus on preventing relapse after importation and cure.

Objective:To select low-dose radiation-activated genes with intrinsic radiation protection by developing a model for adaptive responses to low-dose ionizing radiation, in order to explore the mechanisms behind the radiation resistance of the candidate genes.Methods:The cells were divided into adaptive response induction group and whole transcriptome sequencing group. The level of DNA damage was assessed using the γ-H2AX immunofluorescence assay. The low-dose radiation-activated candidate genes with radiation protection were selected through whole transcriptome sequencing and quantitative reverse transcription PCR (RT-qPCR)-based validation. The anti-radiation effect of candidate gene CCND1 was assessed based on CCK-8 cell proliferation and γ-H2AX immunofluorescence assay. After up- and down-regulation of CCND1 expression, the anti-radiation mechanism of CCND1 was preliminarily explored through transcriptome sequencing analysis.Results:A model for low-dose ionizing radiation-induced adaptive responses of lymphocytes was constructed. Using this model, six candidate genes with radiation protection, including CCND1, ZMAT3, MGAT3, DFFB, CYP4F2, ITGA6, were selected. Compared to the control group, overexpressed CCND1 led to significantly enhanced proliferation ability of AHH-1 cells ( t = 7.92-14.76, P < 0.05) and distinctly lowered level of DNA damage ( t = 2.79-9.68, P < 0.05) after 2 Gy of X-ray irradiation. Furthermore, compared to the control group, the CCND1 knockdown caused significantly decreased cell proliferation ability ( t = 13.58-26.25, P < 0.05) and notably elevated level of DNA damage of cells ( t = 2.87-7.61, P < 0.05). Transcriptome sequencing revealed that up- and down-regulation of CCND1 expression resulted in the activation of pathways related to cell growth, death, and damage repair. Conclusions:By selecting six low-dose-activated candidate genes with radiation protection and revealing the function of CCND1 in radiation protection, this study provides a new perspective for the development of radiation protection agents from the perspective of adaptive responses to low-dose radiation.

BACKGROUND:Studies have shown that immune cells are involved in all processes of ischemic stroke,in which cuproptosis also plays a key role.OBJECTIVE:To screen diagnostic biomarkers related to the progression of ischemic stroke through bioinformatics,and analyze and validate cuproptosis-related genes closely related to the occurrence and development of ischemic stroke.METHODS:The GSE16561 microarray was obtained from the GEO database,containing data from 39 cases of ischemic stroke(ischemic stroke group)and 24 controls(control group).Differentially expressed genes from the ischemic stroke microarray data were analyzed.Gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed.By using LASSO and Random Forest methods,key genes affecting the occurrence and development of ischemic stroke were screened,and a diagnostic model was established and validated.Differential gene analysis was performed through immune cell infiltration and weighted gene co expression network.The differentially expressed immune-related genes were intersected with cuproptosis genes to obtain the hub genes related to cuproptosis immunity.In vitro cell experiments were conducted to divide rat hippocampal neurons into a normal group and an ischemic stroke group,and qPCR experiments were performed to verify the results.RESULTS AND CONCLUSION:(1)573 differentially expressed genes were obtained by differential analysis.Differentially expressed genes were mainly enriched in biological processes,such as positive regulation of immune response,and signaling pathways such as lipid and atherosclerosis.(2)Machine learning methods were used to screen diagnostic genes such as MFN2,PKM2,CREG1,and FOXO3A,which may have some diagnostic value for ischemic stroke.(3)Immune infiltration analysis revealed resting plasma cells,NK cells,macrophages,etc.,indicating that immune cells play a certain role in the pathogenesis of ischemic stroke.(4)Weighted gene co-expression network analysis combined with immune infiltration analysis obtained 118 key module genes,which were intersected with cuproptosis genes to obtain 2 cuproptosis and immune characteristic genes.The correlation analysis between four diagnostic genes and Hub genes showed that the expression of FOXO3A and MFN2,PKM2 and BCL2L1,MTF1 and MFN2,ATP7B and BCL2L1 were correlated.(5)The qPCR results showed significant differences in the genes MTF1 and ATP7B between the ischemic stroke group and the blank group.To conclude,ATP7B and MTF1 can serve as characteristic genes for cuproptosis in ischemic stroke.It is possible to improve ischemic stroke by intervening in ATP7B and MTF1 to regulate cuproptosis.

Objective:To study echinococcosis in the population and canine Echinococcus infection in Yushu City, Qinghai Province, and to explore the current epidemic situation and main transmission species of Echinococcus. Methods:In June 2023, a multi-stage sampling method was used to select 2 villages each in Shanglaxiu Township and Longbao Town, Yushu City, Qinghai Province. Each village included at least 100 permanent residents who had lived locally for at least 1 year and were 2 years old or older as the survey subjects. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum antibodies against Echinococcus larvae in the population, and B-mode ultrasound was used for abdominal organ scanning. Meanwhile, on the main roads of Shanglaxiu Township and Longbao Town, canine feces were collected in designated areas at intervals. ELISA was used to detect the antigen of canine fecal Echinococcus, and PCR was used to detect the types of parasites ( Echinococcus multilocularis, Echinococcus granulosus and Echinococcus shiquicus). Results:A total of 511 residents were investigated in Yushu City, and the positive rate of serum Echinococcus larvae antibodies in the population was 26.22% (134/511), and the detection rate of echinococcosis B-mode ultrasound was 1.37% (7/511). Among them, the detection rates of B-mode ultrasound for cystic echinococcosis (CE) and alveolar echinococcosis (AE) were 1.17% (6/511) and 0.20% (1/511), respectively. The positive rate of Echinococcus antigen in 543 canine feces detected by ELISA was 12.89% (70/543). PCR was used to test 497 canine feces, and the detection rate of Echinococcus was 3.02% (15/497). Among them, the detection rate of Echinococcus multilocularis was higher than that of Echinococcus granulosus [2.82% (14/497) vs 0.20% (1/497)], and the difference was statistically significant (χ 2 = 11.44, P < 0.001). No Echinococcus shiquicus was detected. Conclusions:The positive rates of Echinococcus larvae antibodies in the population and canine Echinococcus antigen in Yushu City, Qinghai Province are both relatively high. There is a mixed epidemic of CE and AE, with Echinococcus multilocularis being the main species.

Objective We investigated the clinical features and the potential risk factors of malnutrition in patients with chronic heart failure(CHF),and constructed the risk prediction model of malnutrition.Methods A total of459 CHF patients admitted between January 2023 and July 2024 were classified into a normal nutrition group and a malnutrition group based on the geriatric Nutrition Risk Index(GNRI)score upon admission.The patient-related data were gathered,and single-variable and multi-variable logistic analyses were first carried out to identify the risk factors associated with the malnutrition risk.Subsequently,the stepwise regression approach was employed to define the inclusion criteria and construct a malnutrition nomogram model for CHF patients.The diagnostic efficacy and calibration of this model were appraised using the ROC curve and calibration curve,and its clinical utility was assessed via the clinical decision curve.A P value less than 0.05 signified statistically significant differences.Results Anxiety(OR=1.1902,95%CI:1.0217～1.3865),urea nitrogen(OR=1.4842,95%CI:1.1187～1.9691),low body weight(OR=0.8463,95%CI:0.7852～0.9121),and low albumin(OR=0.0467,95%CI:0.0172～0.1268)were risk factors for malnutrition.The optimal model inclusion factors were selected by stepwise regression,including:Body weight,7 items of Generalized Anxiety Disorder Scale(GAD-7),urea nitrogen,uric acid,albumin,total cholesterol,high density lipoprotein cholesterol(HDL-L),low density lipoprotein cholesterol(LDL-L),D-dimer.The area under the ROC curve(AUC)of the column chart model based on the above factors is 0.996(95%CI:0.971～0.978),with a sensitivity of 97.8%and a specificity of 97.1%.The C-index validated internally in the calibration curve was 0.824.The calibration chart and validation results demonstrate good consis-tency and applicability.Conclusion The column chart prediction model created in this study based on nine factors including body weight,GAD-7,urea nitrogen,uric acid,albumin,total cholesterol,HDL-L,LDL-L,and D-dimer had good calibration and prediction performance,and had good clinical practicality,which was helpful for clinicians to make diagnosis and treatment decisions for malnutrition in CHF patients.

This consensus was developed by the Orthodontic Society of the Chinese Stomatological Association to provide a systematic, scientific, and practical guideline for informed consent in orthodontic care. Orthodontic treatment is typically lengthy, highly individualized, and involves multiple factors such as growth and development, occlusal function, and facial esthetics. Rapid technological advances and diverse risk profiles make the traditional reliance on orthodontist experience or institutional templates insufficient to ensure patients′ full understanding and autonomous decision-making. To address this, the expert panel conducted extensive reviews of domestic and international guidelines, analyzed representative dispute cases, and performed multicenter patient-clinician surveys. Using a multi-round Delphi method, the group established a standardized informed consent framework covering the initial consultation, treatment, and retention phases. The consensus emphasizes that informed consent is not only a fundamental legal and ethical requirement but also a key step in building trust, improving patient compliance, and enhancing treatment satisfaction. Orthodontists should clearly and comprehensively explain treatment plans, potential risks, uncertainties, and associated costs, while respecting the autonomy of patients or guardians, and maintain continuous communication and dynamic evaluation throughout the treatment process. The release of this consensus provides unified and authoritative guidance for clinical orthodontics, helping to standardize informed consent, enhance its transparency, safeguard patient rights, reduce medical risks, and promote high-quality, sustainable development of orthodontic practice.