OBJECTIVE To explore the transformation of the dispensing and drug pickup process in traditional Chinese medicine pharmacy （TCM Pharmacy） in our hospital based on data-intelligence-driven， aiming to improve pharmacists’ work efficiency and patients’ drug pickup experience. METHODS Value stream mapping and journey mapping were used to systematically identify non-value-added links in pharmacists’ dispensing process and key pain points in patients’ drug pickup under the traditional process. An intelligent dispensing and drug pickup system for the TCM Pharmacy was developed based on the C# and Android television platforms， and a machine-learning model was adopted to predict patients’ drug pickup waiting time. A comprehensive evaluation was performed from three perspectives： system performance， prediction accuracy， and satisfaction of pharmacists and patients. RESULTS The system successfully streamlined non-value-added links such as “waiting for writing on the board” and “searching for drugs”， and realized multimodal dynamic prompts of dispensing status through auditory （number calling） and visual （television terminal） channels. The constructed model for predicting drug pickup waiting time exhibited good fitting degree and generalization ability （mean absolute error＝4.28 min， R 2 ＝0.882）. The comprehensive satisfaction scores of pharmacists and patients in the traditional mode were significantly increased from （70.99±1.74） and （73.58±1.98） to （90.02±1.30） and （88.61±2.08） in the new system， respectively （ P ＜0.01）. CONCLUSIONS The transformation of the intelligent drug dispensing and pickup system for TCM pharmacy based on data-intelligence-driven effectively improves the efficiency of pharmacists’ dispensing work， realizes process transparency and waiting time predictability， and significantly enhances patients’ drug pickup experience.

Background Neck-related work-related musculoskeletal disorders (WMSDs) are a major type of musculoskeletal disorders with a relatively high proportion. Shanghai has a large number of occupational populations; however, the occurrence of WMSDs at neck among the occupational populations across industries in this city has not been reported, and needs to be addressed. Objective To understand the occurrence of neck-related WMSDs and their influencing factors among occupational populations in 8 industries in Shanghai, and to provide a scientific basis for the prevention and control of WMSDs in this population. Methods From February 2024 to February 2025, a cross-sectional survey employed stratified cluster sampling to select 7829 employed workers from 48 enterprises across 8 industries in Shanghai. The study investigated the occurrence of neck-related WMSDs among the participants over the preceding 12 months. Logistic regression analysis was employed to examine the relationships between WMSDs and various occupational factors. Results A total of 7770 questionnaires were collected, yielding an effective response rate of 99.2%. Overall, the positive rate of neck-related WMSDs among the participants was 11.89% (924/7770). Among different industries, the environmental sanitation industry (19.48%), pharmaceutical manufacturing industry (14.57%), and cigarette manufacturing industry (13.66%) had higher prevalence of neck-related WMSDs. Univariate analysis showed that the risk of neck-related WMSDs was higher in the following groups: those with a job tenure ≥5 years in the current position (OR=1.50–1.70), females (OR=1.77), those with higher education levels (master’s degree or above, OR=2.27), and those with worse self-rated health (very poor health, OR=4.38) (P＜0.05). Multivariate logistic regression analysis identified the following independent risk factors for neck WMSDs: environmental sanitation industry (OR=7.30, 95%CI: 4.72, 11.87), higher educational attainment (master’s degree or above: OR=2.16, 95%CI: 1.36, 3.35), worse self-rated health status (very poor: OR=1.95, 95%CI: 1.31, 2.85), work performed in a single workshop (OR=1.36, 95%CI: 1.13, 1.64), understaffing (OR=1.46, 95%CI: 1.25, 1.70), slight neck forward flexion (OR=1.64, 95%CI: 1.32, 2.06), severe neck forward flexion (OR=2.55, 95%CI: 1.97, 3.30), and maintaining a fixed neck posture for a prolonged period (OR=2.28, 95%CI: 1.93, 2.70). Conversely, work rotation (OR=0.75, 95%CI: 0.65, 0.87), adequate rest (OR=0.70, 95%CI: 0.60, 0.82), and severe back flexion (OR=0.63, 95%CI: 0.46, 0.85) were protective factors against neck-related WMSDs. For the nomogram, the area under the curve (AUC)=0.75 (95%CI: 0.74, 0.77), Hosmer-Lemeshow test P=0.764, and Brier score=0.094, indicating that the model had good discrimination and calibration. Conclusion Among the occupational populations in Shanghai, the environmental sanitation industry, pharmaceutical manufacturing industry, and cigarette manufacturing industry are identified as high-risk industries for neck-related WMSDs. Industry affiliation, educational level, work organization patterns, and awkward neck working postures are confirmed as the core influencing factors for the development of neck-related WMSDs. Targeted and comprehensive intervention measures should be formulated focusing on the aforementioned high-risk industries and key influencing factors. Multi-dimensional collaborative efforts, including ergonomic optimization, improvement of labor management systems, and strengthened health education and promotion, should be implemented to effectively control the risk of neck-related WMSDs in the occupational population, and to provide robust statistical evidence for the advancement of regional occupational health prevention and control strategies.

With the rapid aging of the global population, the demand for prosthodontic rehabilitation of partial edentulism continues to increase. Among the available treatment options, removable partial dentures remain an essential clinical modality for restoring partially edentulous arches and masticatory function because of their broad indications, minimal invasiveness, and cost-effectiveness. However, unlike fixed prosthodontics, which have undergone substantial digitalization, removable partial denture therapy is characterized by dual tooth-tissue support, complex biomechanics, and highly variable anatomical morphology. As a result, the digital design and fabrication of removable partial dentures have long faced major bottlenecks, including limited standardization, steep learning curves, and heavy dependence on expert experience. In recent years, artificial intelligence (AI) has undergone a paradigm shift from early expert systems to machine learning and deep learning, creating new opportunities to address the complexity and precision demands of removable partial denture design. Based on a comprehensive literature review and our team's clinical experience, this article systematically elaborates on the specific applications and normative standards of AI throughout the entire removable partial denture fabrication workflow. In the data acquisition phase, we emphasize multimodal data fusion and digital pressure impression strategies. In the intelligent diagnosis and planning phase, deep learning is utilized to achieve the automatic identification of edentulous areas and undercuts, while machine learning and expert systems assist in abutment selection and treatment plan generation. Regarding automated design logic, the article analyzes the process from the intelligent planning of the common path of insertion to parametric design based on biomechanical optimization. At the clinical operation level, a standardized human-machine collaborative workflow of “AI generation-clinician review-local fine-tuning” is proposed. In terms of ethics and accountability, the principles of algorithmic transparency and “the clinician as the ultimate responsible subject” are emphasized. Furthermore, integrating clinical practice, this article innovatively proposes a “capability grading system for AI-assisted removable partial denture design (comprising the auxiliary analysis level, the rule-based design level, and the intelligent adaptive level)”. The aim is to offer practical recommendations for dental clinicians, dental technicians, and researchers, thereby facilitating the transition of removable partial denture prosthodontics toward greater precision, intelligence, and standardization.

ObjectiveTo design a "roly-poly" style interactive home-based hand function training device based on the principle of self-stabilization and recovery in light of the characteristics of post-stroke hand dysfunction and the current scarcity of home-based hand function training devices; and explore the feasibility and clinical value of this device in hand function rehabilitation training for stroke patients. MethodsThis study adopted a phased research design consisting of two stages: device development and clinical validation. At the first stage, focusing on the principle of the tumbler's automatic return to center, combined with the clinical needs of hand function rehabilitation training for stroke patients, the development of a home-based interactive hand function training device was completed, and the application and authorization of a utility model patent were obtained. At the second stage, 30 stroke patients with post-stroke hand dysfunction hospitalized at Beijing Bo'ai Hospital from May to October, 2025 were randomly divided into control group (n = 15) and experimental group (n = 15). Both groups received conventional rehabilitation therapy, the control group added routine hand function training every evening, and the experimental group added hand function training using the device developed in this study every evening, for four weeks. The grip strength, lateral pinch strength, finger pad pinch strength, three-finger pinch strength and wrist joint range of motion (dorsal-flexion, palm-flexion, radial deviation and ulnar deviation) were measured before and after intervention. The upper limb and hand motor function was assessed with Fugl-Meyer Assessment (FMA), and the modified Barthel Index (MBI) was used to evaluate activities of daily living (ADL). ResultsA self-stabilizing hemispherical hand functional rehabilitation device was developed and granted a utility model patent. After intervention, the grip strength, lateral pinch strength, finger pad pinch strength, three-finger pinch strength, wrist joint range of motion, and FMA and MBI scores significantly improved in both groups (|t| > 5.683, P < 0.05); except for the score of MBI (P > 0.05), all the other indicators were better in the experimental group than in the control group (t > 2.633, P < 0.05). ConclusionThe self-stabilizing, closed-loop home-based functional hand interaction training device designed in this study effectively improves hand grip, pinching function and wrist joint range of motion of stroke patients, significantly enhancing upper limb and hand motor function, and demonstrates feasibility for home-based hand rehabilitation training. However, the device does not provide notable additional improvements in patients' ADL, necessitating further optimization to enhance its clinical application value.

Objective:To evaluate the effect of esketamine on caspase-11-mediated non-canonical pathway pyroptosis in sepsis-induced acute lung injury in rats.Methods:Eighteen SPF healthy Sprague-Dawley rats, aged 8-12 weeks, weighing 280-320 g, were divided into 3 groups ( n=6 each) using a random number table method: sham operation group (Sham group), cecal ligation and puncture (CLP) group and CLP+ esketamine group (CLP+ ES group). Sepsis was induced by CLP in anesthetized animals. Esketamine 10 mg/kg was injected via the tail vein immediately after development of the model, and the equal volume of normal saline was injected via the tail vein in the other two groups. At 24 h after development of the model, the rats were sacrificed under anesthesia, and the lung tissues and blood samples were taken. The wet to dry lung weight ratio (W/D ratio) was calculated, and the pathological changes were observed and the lung injury was scored. The expression of caspase-11, gasdermin D-N (GSDMD-N), phosphorylated phosphatidylinositol 3-kinase (p-PI3K) and phosphorylated protein kinase B (p-AKT) was detected by Western blot. The expression of caspase-11 and GSDMD-N mRNA was detected by quantitative real-time polymerase chain reaction. The serum concentration of interleukin-1β (IL-1β) was determined by enzyme-linked immunosorbent assay. Results:Compared with Sham group, the lung injury score and W/D ratio were significantly increased, the expression of caspase-11 and GSDMD-N protein and mRNA was up-regulated, the expression of p-PI3K and p-AKT was down-regulated, and the concentration of IL-1β was increased in CLP group ( P<0.05). Compared with CLP group, the lung injury score and W/D ratio were significantly decreased, the expression of caspase-11 and GSDMD-N protein and mRNA was down-regulated, the expression of p-PI3K and p-AKT was up-regulated, and the concentration of IL-1β was decreased in CLP+ ES group ( P<0.05). Conclusions:The mechanism by which esketamine alleviates sepsis-induced acute lung injury may be related to the inhibition of caspase-11-mediated non-canonical pathway pyroptosis in rats.

Objective:To investigate the radiation dose levels of digital radiography (DR) in adult patients and explore the diagnostic reference level (DRL) of radiation dose in Beijing.Methods:Radiation dose data were collected from 39 medical institutions in Beijing on 18 930 DR examinations of chest anterior and lateral view, abdomen anterior and posterior view, abdomen standing view, cervical spine anterior and lateral view, lumbar spine anterior and lateral view, knee joint anterior and lateral view as well as 5 266 digital mammography (CC view and MLO view). For ordinary DR examinations, the incident air kinetic energy ( Ka, i), incident air specific kinetic energy area product ( PKA) and effective dose ( E) to the examined individuals were used for the investigation and estimation of radiation dose. For digital mammography, the average glandular dose (AGD) was calculated. DRLs should be set at the 75 th percentile of median values obtained in each medical institution. Results:The Ka, i, PKA and E of DRL for Chest (PA), Chest (lateral), abdominal(PA), abdominal (AP), Pelvic(AP), Cervical (AP), Cervical (lateral), Lumbar (AP), Lumbar (lateral), Knee joint (AP) and Knee joint (lateral) of conventional DR were 0.14, 0.31, 1.25, 2.18, 1.86, 0.51, 0.14, 2.97, 8.39, 0.37, 0.37 mGy, 159, 259, 1 917, 2 336, 2 867, 312, 301, 3 500, 3 359, 269, 255 mGy·cm 2, 0.03, 0.05, 0.20, 0.43, 0.23, 0.03, 0.02, 0.47, 0.35, <0.001, <0.001 mSv. The DRLs for digital mammography were calculated to be 1.87 mGy (CC view), 1.94 mGy (MLO view) and 3.99 mGy (accumulated for one examination). Conclusions:The radiation dose from DR examinations is relatively low. In clinical practice, the selection of imaging parameters should be further standardized on the basis of the local DRL.

Objective:To investigate the efficacy of radiotherapy in patients with advanced esophageal cancer receiving first-line chemoimmunotherapy.Methods:A retrospective analysis was conducted on the data of 137 patients with Stage Ⅳ esophageal squamous cell carcinoma (ESCC) treated at our hospital from January 2018 to May 2023. These patients were divided into two groups: a group treated with first-line chemoimmunotherapy combined with radiotherapy (chemoimmunotherapy + radiotherapy group, n = 43) and a group treated with only chemoimmunotherapy ( n = 94). Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the groups. With overall survival (OS) and progression-free survival (PFS) as study endpoints, the survival data were analyzed using the Kaplan-Meier method, the log-rank test, and the Cox regression method. Results:Before calibration, the chemoimmunotherapy + radiotherapy group significantly outperformed the sole chemoimmunotherapy group in median PFS (13.6 months vs. 7.0 months; HR: 0.501, 95% CI: 0.309-0.811, P = 0.005). After calibration using the COX proportional-hazards model for age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, smoking history, T/N/M stage, and tumor location, the chemoimmunotherapy + radiotherapy group still had significant advantages in PFS (14.7 months vs. 7.0 months; HR: 0.441, 95% CI: 0.261-0.745, P = 0.002). IPTW analysis further confirmed this trend (13.9 months vs. 7.0 months; HR: 0.492, 95% CI: 0.304-0.795, P < 0.001). Specifically, the median OS of the chemoimmunotherapy + radiotherapy group demonstrated significant improvement in all analyses: pre-calibration (29.5 months vs. 18.0 months; HR: 0.507, 95% CI: 0.297-0.867, P = 0.013), after calibration using the Cox model (27.5 months vs. 16.7 months; HR: 0.470, 95% CI: 0.266-0.830, P = 0.009), and after calibration using IPTW (29.5 months vs. 16.9 months; HR: 0.448, 95% CI: 0.262-0.764, P < 0.001). Conclusions:The combination of radiotherapy and first-line chemoimmunotherapy can significantly improve survival outcomes of patients with advanced ESCC, suggesting its potential as a standard treatment strategy.

[Objective]To investigate the protective effect of overexpressed miRNA-200a&c on Angiostrongylus cantonensis-induced demyelinating optic neuritis in Balb/c mice.[Methods]SPF-grade Balb/c mice(2-3 weeks old)were divided into four groups:a normal group,and three A.cantonensis-infected groups at 7,14,and 21 days post-infection(dpi).Body weight,survival status,neurobehavioral scores,and visual function scores were recorded.Visual evoked potential(VEP)was used to detect visual damage,and transmission electron microscope(TEM)was applied to observe ocular structural changes.On day 7 post-infection,mice were stereotactically injected with exogenous miRNA-200a&c mimics into the lateral ventricle,and then divided into four groups:normal control,A.cantonensis-infected(AC-21 dpi),A.cantonensis-infected+negative control(AC+NC),and A.cantonensis-infected+overexpressed miRNA-200a&c(AC+miRNA-200a&c)mimics.VEP and TEM were repeated to assess visual damage and ocular structural changes.Immunofluorescence was performed to quantify retinal ganglion cells(RGCs)and oligodendrocytes(OLs)in the optic nerve.[Results]At 21 dpi,some mice exhibited complete eyelid closure(32.52±4.67)%or ocular atrophy(15.79±3.23)%,weight loss(P＜0.05)and altered consciousness.Neurobehavioral scores significantly decreased(P＜0.01),with a 68%decline in rotarod performance;some mice even displayed hemiplegia,slowed movement,ataxia,and directional deficits.Additionally,a subset of mice showed diminished sensory responses,unilateral vision loss(83%reduction in optokinetic threshold),and impaired visual function(P＜0.05).VEP results revealed a mild prolongation of latency in infected mice at 21 dpi(P＜0.05),predominantly affecting one eye.Following overexpression of miRNA-200a&c,compared with the 21 dpi group,VEP showed significantly shortened P1 latency(P＜0.05);TEM showed alleviated cytoplasmic swelling of RGCs,and improved compactness and uniformity of myelin sheath(P＜0.05);immunofluorescence showed increased numbers of RGCs and OLs with improved cell alignment(P＜0.05).[Conclusions]A.cantonensis infection induces demyelinating optic neuritis in Balb/c mice.Overexpression of miRNA-200a&c alleviates the resulting damage and ameliorates ocular injury.

In recent years, the application of artificial intelligence (AI) in medicine has advanced rapidly, demonstrating remarkable potential particularly in the field of plastic surgery. As a major subdiscipline of plastic surgery, craniomaxillofacial surgery characterized by its heavy reliance on imaging, anatomical precision, and meticulous surgical techniques is especially amenable to the integration and transformation enabled by AI technologies. This review systematically summarized the current applications of AI in craniomaxillofacial surgery, including preoperative imaging analysis, diagnosis, and postoperative evaluation. Special emphasis was placed on the role of AI in the management of congenital craniofacial anomalies and facial contouring procedures. Additionally, the article discussed the existing challenges in technical implementation, clinical translation, and ethical governance. Finally, it explored the future potential of AI in multimodal data integration, high-throughput image annotation, and personalized treatment planning. AI is poised to propel craniomaxillofacial surgery toward a more precise, efficient, and intelligent era.

BACKGROUND:The extracellular-regulated protein kinase 5(ERK5)signaling protein is essential for the survival of organisms,and resveratrol can promote osteoblast proliferation through various pathways.However,whether resveratrol can regulate osteoblast function through the ERK5 signaling protein needs further verification. OBJECTIVE:To explore the regulatory effect of ERK5 on the proliferation of MC3T3-E1 cells and related secreted proteins,and to further verify whether resveratrol can complete the above process by activating ERK5. METHODS:Mouse MC3T3-E1 preosteoblasts were treated with complete culture medium,XMD8-92(an ERK5 inhibitor),epidermal growth factor(an ERK5 activator),resveratrol alone,XMD8-92+EGF,and resveratrol+XMD8-92,respectively.Western blot assay was used to detect the expression of ERK5 and p-ERK5 proteins,proliferation-related proteins Cyclin D1,CDK4 and PCNA,and osteoblast-secreted proteins osteoprotegerin and receptor activator of nuclear factor-κB ligand in MC3T3-E1 cells of each group.The fluorescence intensity of ERK5,osteoprotegerin and receptor activator of nuclear factor-κB ligand in each group was detected by cell immunofluorescence staining,and cell proliferation was detected by EdU staining,respectively.The appropriate concentration and time of resveratrol intervention in MC3T3-E1 cells were determined by cell morphology observation and cell counting kit-8 assay. RESULTS AND CONCLUSION:The activation of ERK5 signaling protein could effectively promote the proliferation of MC3T3-E1 cells,up-regulate the osteoprotegerin/receptor activator of nuclear factor-κB ligand ratio.The appropriate concentration and time for resveratrol intervention in MC3T3-E1 cells was 5 μmol/L and 24 hours,respectively.Resveratrol could activate ERK5 signaling protein,thereby promoting osteoblast proliferation and up-regulating the osteoprotegerin/RANKL ratio.All these results indicate that resveratrol can promote the proliferation of MC3T3-E1 cells and up-regulate the osteoprotegerin/RANKL ratio by activating the ERK5 signaling protein.