Objective: To evaluate the current situation of thermal environment in primary and secondary school classrooms during winter, and to analyze students thermal comfort needs, so as to provide a basis for improving classroom thermal environment. Methods: From December 16 to 26, 2024, a stratified cluster random sampling method was used to select 90 classrooms from 15 primary and secondary schools in centralized/air conditioned heating areas(Liaoning Province, Tianjin City, Shanghai City) and naturally ventilated areas(Anhui Province and Jiangxi Province)for on site environmental measurement. A questionnaire survey was conducted among 743 students. The differences between groups using the χ 2 test were compared. Based on actual measurement data, a predicted mean vote prepared percentage of dissatisfied (PMV-PPD) model for centralized/air conditioned classrooms and an adaptive model for naturally ventilated classrooms were established, and the thermal neutral temperature and comfort interval were calculated. Results: The average outdoor temperature during on site measurement was 4.00(0.20，7.00)℃. In classrooms with centralized or air conditioned heating systems, the measured average temperature was (19.33±2.59)℃, with a thermal comfort range of 20.35-25.35 ℃ and a thermal neutral temperature of 22.85 ℃. And 13.92% of students reported feeling cold, while 80.80% felt comfortable. In classrooms with natural ventilation, the measured average temperature was (12.26±1.83)℃, with a thermal neutral temperature of 19.67 ℃ and a thermal comfort range of 16.17-23.17 ℃. About 48.33% of students reported feeling cold, and 49.81 % felt comfortable.The results of univariate analysis showed that there were statistically significant differences in shoe thickness, temperature sensation, relative humidity sensation and wind speed sensation between centralized/air conditioned heating areas ( χ 2= 7.01 , 31.47, 13.57, 13.80,all P <0.05). There were also statistically significant differences in school stage for primary and secondary school students, body mass index, classroom location for seat, temperature sensation, relative humidity sensation and wind speed sensation between naturally ventilated areas ( χ 2=42.13, 11.13, 11.04, 60.39, 29.27, 38.46,all P <0.05). Conclusions There are differences in thermal environment and students subjective thermal comfort in primary and secondary schools under different ventilation modes in winter. The temperature standards for heated classrooms should be revised, and differentiated environmental regulation strategies should be adopted based on different ventilation methods to improve students health and comfort levels.

ObjectiveTo establish a subcutaneous xenograft model of gastric cancer in nude mice and to identify differentially expressed genes （DEGs） affected by Jianpi Yangzheng Xiaozheng formula （JPYZXZ） in diffuse gastric cancer （DGC） using transcriptome sequencing. The study aims to identify potential key prognostic factors and preliminarily elucidate the therapeutic mechanism of JPYZXZ. MethodsSubcutaneous tumor tissues were collected from nude mice treated with JPYZXZ （6 g·kg^-1）and from the untreated traditional Chinese medicine control group. High-throughput RNA sequencing was performed to extract and analyze total RNA and identify DEGs， followed by functional enrichment analysis. DEGs were intersected with cancer-associated fibroblast （CAF）-related genes identified from single-cell RNA sequencing （scRNA-seq） data. A Cox proportional hazards regression model （Cox model） was constructed to identify potential key targets， among which DAZ interacting protein 1 （DZIP1） was selected. The role of DZIP1 in DGC progression was further verified through in vitro and in vivo experiments. ResultsTranscriptome sequencing revealed that DEGs regulated by JPYZXZ were significantly enriched in biological processes such as focal adhesion， phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway， and vascular development （P<0.05）. Intersection analysis with CAF marker genes identified ten potential common target genes. Cox regression analysis combined with the Cancer Genome Atlas （TCGA） dataset for stomach adenocarcinoma （STAD） confirmed that DZIP1 is an independent prognostic factor significantly associated with poor outcomes. Transcriptome and immunohistochemical analyses showed that DZIP1 expression was significantly higher in gastric cancer tissues than in adjacent tissues， while JPYZXZ treatment downregulated DZIP1 expression in a dose-dependent manner. Clinical data further demonstrated that serum DZIP1 levels in patients treated with JPYZXZ were significantly lower than those in the control group. ConclusionJPYZXZ may inhibit the malignant progression of DGC by downregulating DZIP1 expression， thereby suppressing CAF activation and epithelial-mesenchymal transition （EMT）. These findings provide experimental evidence and identify DZIP1 as a potential therapeutic target in DGC treatment.

ObjectiveTo establish a subcutaneous xenograft model of gastric cancer in nude mice and to identify differentially expressed genes （DEGs） affected by Jianpi Yangzheng Xiaozheng formula （JPYZXZ） in diffuse gastric cancer （DGC） using transcriptome sequencing. The study aims to identify potential key prognostic factors and preliminarily elucidate the therapeutic mechanism of JPYZXZ. MethodsSubcutaneous tumor tissues were collected from nude mice treated with JPYZXZ （6 g·kg^-1）and from the untreated traditional Chinese medicine control group. High-throughput RNA sequencing was performed to extract and analyze total RNA and identify DEGs， followed by functional enrichment analysis. DEGs were intersected with cancer-associated fibroblast （CAF）-related genes identified from single-cell RNA sequencing （scRNA-seq） data. A Cox proportional hazards regression model （Cox model） was constructed to identify potential key targets， among which DAZ interacting protein 1 （DZIP1） was selected. The role of DZIP1 in DGC progression was further verified through in vitro and in vivo experiments. ResultsTranscriptome sequencing revealed that DEGs regulated by JPYZXZ were significantly enriched in biological processes such as focal adhesion， phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway， and vascular development （P<0.05）. Intersection analysis with CAF marker genes identified ten potential common target genes. Cox regression analysis combined with the Cancer Genome Atlas （TCGA） dataset for stomach adenocarcinoma （STAD） confirmed that DZIP1 is an independent prognostic factor significantly associated with poor outcomes. Transcriptome and immunohistochemical analyses showed that DZIP1 expression was significantly higher in gastric cancer tissues than in adjacent tissues， while JPYZXZ treatment downregulated DZIP1 expression in a dose-dependent manner. Clinical data further demonstrated that serum DZIP1 levels in patients treated with JPYZXZ were significantly lower than those in the control group. ConclusionJPYZXZ may inhibit the malignant progression of DGC by downregulating DZIP1 expression， thereby suppressing CAF activation and epithelial-mesenchymal transition （EMT）. These findings provide experimental evidence and identify DZIP1 as a potential therapeutic target in DGC treatment.

Yttrium-90(90Y)selective internal radiation therapy(SIRT)is an emerging modality for the treatment of hepatocellular carcinoma(HCC),leveraging the nuclide 90Y to deliver targeted radiation therapy.90Y has a long half-life and can be used to selectively ablate tumor cells by high-energy beta rays.It has high biological effectiveness and robust local control capabilities.In recent years,with the continuous advancement of basic and clinical research,the application of 90Y-SIRT in the conversion treatment of unresectable HCC(uHCC)has made significant progress.However,challenges remain in the clinical application of 90Y-SIRT,including how to improve the efficacy of conversion therapy and how to optimize therapy regimens.This review aims to summarize the research progress of90Y-SIRT in the conversion therapy of uHCC.

Objective To analyze the effects of different traction sites and directions on the maxilla and upper dentition when using clear aligners combined with protraction for the treatment of maxillary deficiency.Methods A three-dimensional(3D)finite element model including the zygomaticomaxillary complex,maxillary dentition,and clear aligners was constructed.The models were divided into Group 1(traction hook at the distal of the lateral incisor)and Group 2(traction hook at the distal of the canine).Each group was analyzed under four loading conditions with protraction angles of 0°,10°,20°,and 30° relative to the occlusal plane.A unilateral protraction force of 500 g was applied.The differences in stress distribution and displacement of the maxillary bone and dentition under different loading conditions were analyzed.Results When the protraction angle was 30°,both groups showed forward and downward displacement of the maxilla,while other angles resulted in counterclockwise rotation.Under the same protraction direction,the total displacement of the maxilla and displacements in all directions in Group 2 were greater than those in Group 1.The upper central incisors in Group 1 showed lingual displacement,which increased with the protraction angle.The maxillary dentition in Group 2 showed forward displacement,with the minimum total and sagittal displacements at a protraction angle of 30°.Stress concentration was mainly observed in the zygomaticomaxillary suture and anterior alveolar bone regions in both groups,decreasing as the protraction angle increased.Conclusions Clear aligners combined with protraction can be applied to skeletal Class Ⅲ patients with mild maxillary deficiency.When the protraction site is located at the distal of the canine with a 30° downward and forward angle to the occlusal plane,the maxilla can achieve ideal forward and downward displacement with the minimum labial movement of the upper anterior teeth.

Finite element method, as a verified numerical simulation method, has been widely applied in the biomechanical research of clear aligner treatment. The accuracy of its calculation results is closely related to the construction method of the finite element model. This paper takes the finite element modeling process of clear aligner treatment as a clue, and reviews the modeling methods of relevant research in recent years, aiming to provide reference for subsequent studies.

Finite element method, as a verified numerical simulation method, has been widely applied in the biomechanical research of clear aligner treatment. The accuracy of its calculation results is closely related to the construction method of the finite element model. This paper takes the finite element modeling process of clear aligner treatment as a clue, and reviews the modeling methods of relevant research in recent years, aiming to provide reference for subsequent studies.

Objective To analyze the effects of different traction sites and directions on the maxilla and upper dentition when using clear aligners combined with protraction for the treatment of maxillary deficiency.Methods A three-dimensional(3D)finite element model including the zygomaticomaxillary complex,maxillary dentition,and clear aligners was constructed.The models were divided into Group 1(traction hook at the distal of the lateral incisor)and Group 2(traction hook at the distal of the canine).Each group was analyzed under four loading conditions with protraction angles of 0°,10°,20°,and 30° relative to the occlusal plane.A unilateral protraction force of 500 g was applied.The differences in stress distribution and displacement of the maxillary bone and dentition under different loading conditions were analyzed.Results When the protraction angle was 30°,both groups showed forward and downward displacement of the maxilla,while other angles resulted in counterclockwise rotation.Under the same protraction direction,the total displacement of the maxilla and displacements in all directions in Group 2 were greater than those in Group 1.The upper central incisors in Group 1 showed lingual displacement,which increased with the protraction angle.The maxillary dentition in Group 2 showed forward displacement,with the minimum total and sagittal displacements at a protraction angle of 30°.Stress concentration was mainly observed in the zygomaticomaxillary suture and anterior alveolar bone regions in both groups,decreasing as the protraction angle increased.Conclusions Clear aligners combined with protraction can be applied to skeletal Class Ⅲ patients with mild maxillary deficiency.When the protraction site is located at the distal of the canine with a 30° downward and forward angle to the occlusal plane,the maxilla can achieve ideal forward and downward displacement with the minimum labial movement of the upper anterior teeth.

Objective:To explore the rehabilitation effect of multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly on patients with cognitive impairment after first-episode stroke, and to provide reference for rehabilitation nursing of cognitive impairment after stroke.Methods:The quasi-experiment research scheme was adopted and convenience sampling method was used to select participants with first-episode stroke cognitive impairment hospitalized in the General Hospital of Tianjin Medical University Airport Site. The 50 patients admitted from January to June 2022 were selected as the control group, and 50 patients admitted from July to December 2022 were selected as the intervention group. The control group received routine rehabilitation nursing and health education, and the intervention group received the Finnish model of prevention of cognitive impairment in the elderly on patients before discharge on the basis of the control group. The Mini-Mental State Examination (MMSE) and Health Education Compliance Assessment Scale for Stroke Patients were used to evaluate the changes of overall cognitive function and rehabilitation compliance before intervention, 3 and 6 months after intervention.Results:The final control group included 49 cases, including 35 males and 14 females, aged (64.67 ± 7.47) years old; the intervention group included 50 cases, 32 males and 18 females, aged (66.68 ± 8.75) years old. Before intervention, there were no significant differences in overall cognitive function and compliance of rehabilitation score ( P>0.05). At 3 and 6 months after intervention, the overall cognitive function score, the total score on compliance of rehabilitation, dimension scores of diet compliance, exercise rehabilitation compliance and health behavior compliance of the intervention group were (26.36±2.36) , (125.96 ± 13.80) , (23.30 ± 5.26) , (27.72 ± 4.46) , (43.66 ± 6.80) and (27.26 ± 3.71) , (152.44 ± 9.06) , (30.12 ± 6.42) , (33.32 ± 3.02) , (52.36 ± 4.70) , respectively. They were higher than the control group (24.04 ± 4.50) , (116.67 ± 10.26) , (19.31 ± 3.95) , (25.29 ± 3.45) , (40.59 ± 4.33) and (24.27 ± 4.33) , (138.92 ± 16.71) , (24.20 ± 4.48) , (30.00 ± 5.53) , (47.65 ± 8.03) , and the differences had statistical significance ( t values were -5.31- -2.67, all P<0.05). According to the variance analysis of repeated measurement, intergroup and time factor, the interaction between groups and time had significant impact on general cognitive function score, the total score of rehabilitation compliance, the dimension scores of diet, exercise rehabilitation and health behavior compliance ( Fgroup values were 8.33-18.08, Ftime values were 135.71-944.69, Finteraction values were 5.46-27.30, all P<0.05) . Time factor had significant impact on patient medication adherence score ( Ftime=206.23, P<0.05) . Conclusions:Multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly can improve the overall cognitive function and rehabilitation compliance of patients with cognitive impairment after first-episode stroke.