ObjectiveTo investigate and manage an imported dengue fever (DF) outbreak in Shanghai in 2024, to summarize the experience and lessons learned from the on-site management, and to provide a reference basis for future prevention and control of DF. MethodsEpidemiological investigation and case search were carried out for an imported DF outbreak in Shanghai, 2024. Real-time fluorescence polymerase chain reaction (RT-PCR) was used to detect dengue virus nucleic acid in the serum samples from cases. Meanwhile, emergency vector surveillance and mosquito control measures were carried out in the affected areas, and the effectiveness of the management was evaluated. ResultsAccording to the epidemiological investigation, it was confirmed that this epidemic was a family cluster of imported DF, with both cases infected in Thailand and developed symptoms successively after returning to Shanghai. Laboratory testing identified the pathogens as dengue virus serotype-3 (DENV-3). In the core and precautionary area, ultra-low-volume space spraying and residual spraying were combined to kill adult mosquitoes, and at the same time, comprehensive cleaning and elimination of mosquito breeding sites was carried out. After 2 weeks, the Breteau Index (BI) in the core area decreased from 20 to 5, and the mosquito net trap index decreased from 2 mosquitoes (net·hour)^-1 to 0.67 mosquitoes (net·hour)^-1. Continuous implementation of mosquito control measures kept the BI and net trap index below the safety thresholds [BI<5 and mosquito net trap index <2 mosquitoes (net·hour)^-1] both in the core and precautionary area. ConclusionEarly diagnosis and isolation of patients, combined with rapid suppression of the density of vector Aedes mosquitoes, are the key measures to prevent the transmission of imported DF cases.

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

Transarterial radioembolization (TARE) is a widely utilized therapeutic approach for hepatocellular carcinoma (HCC), however, the clinical implementation is constrained by the stringent preparation conditions of radioembolization agents. Herein, we incorporated the superstable homogeneous iodinated formulation technology (SHIFT), simultaneously utilizing an enhanced solvent form in a carbon dioxide supercritical fluid environment, to encapsulate radionuclides (such as ¹³¹I,¹⁷⁷Lu, or ¹⁸F) with lipiodol for the preparation of radiolipiodol. The resulting radiolipiodol exhibited exceptional stability and ultra-high labeling efficiency (≥99%) and displayed notable intratumoral radionuclide retention and in vivo stability more than 2 weeks following locoregional injection in subcutaneous tumors in mice and orthotopic liver tumors in rats and rabbits. Given these encouraging findings, ¹⁸F was authorized as a radiotracer in radiolipiodol for clinical trials in HCC patients, and showed a favorable tumor accumulation, with a tumor-to-liver uptake ratio of ≥50 and minimal radionuclide leakage, confirming the feasibility of SHIFT for TARE applications. In the context of transforming from preclinical to clinical screening, the preparation of radiolipiodol by SHIFT represents an innovative physical strategy for radionuclide encapsulation. Hence, this work offers a reliable and efficient approach for TARE in HCC, showing considerable promise for clinical application (ChiCTR2400087731).

Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.

Objective: This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite, aiming to provide a reference for clinical treatment. . Methods: This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. CBCT images of eighty-one untreated patients (40 anterior open bite patients and 41 normal overbite patients) with high-angle skeletal Class Ⅱ malocclusion were selected before treatment. Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology, and the differences between the two groups were analyzed. Results: There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group, significant differences were found in the root length of maxillary central incisor （11.12 ± 1.37） mm、mandibular central incisor（10.15 ± 1.09）mm, mandibular lateral incisor（11.27 ± 1.15）mm and mandibular canine（12.81 ± 1.48）mm between the open bite group and the normal overbite group（P<0.05）. On the other hand, the two groups were significantly different in crown-root morphology of the maxillary central incisor (1.10° ± 3.62° vs. 4.53° ± 2.30°, P<0.01) but not in the mandibular central incisor. Conclusion The root length of the maxillary central incisor, mandibular central incisor, mandibular lateral incisor, mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients, and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root. The crown-root angle is smaller, which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱ open bite patients.

ObjectiveTo explore the protective effect and mechanism of Zingiberis Rhizoma Recens alcohol extract on lipopolysaccharide （LPS）-induced acute lung injury in mice. MethodBalb/c mice were randomly divided into normal group， model group， dexamethasone group， and low- and high-dose Zingiberis Rhizoma Recens groups. Mice in the normal group were instilled with normal saline through the nose， and the other groups were instilled with normal saline containing LPS （50 μg）. After 30 minutes of modeling， the dexamethasone group was gavaged with 5 mg·kg^-1 of dexamethasone acetate solution， the low- and high-dose Zingiberis Rhizoma Recens groups were gavaged with different doses of （7， 14 g·kg^-1） of Zingiberis Rhizoma Recens alcohol extract， and the normal group and the model group were gavaged with the same volume of water. After 24 hours of modeling， the total number of white blood cells in bronchoalceolar lavage fluid （BALF） was detected by cell counter， and the levels of the inflammatory factors including tumor necrosis factor （TNF）-α， interleukin （IL）-1β， IL-6， and superoxide dismutase （SOD）， and myeloperoxidase （MPO） was detected by enzyme-linked immunosorbent assay （ELISA）. Haematoxylin-eosin （HE） staining method was used to observe the pathological changes of lung tissue in each group， and the Western blot was used to detect the protein expression of nuclear transcription factor （NF）-κB p65， phosphorylation （p）-NF-κB p65， and Toll-like receptor 4 （TLR4） in lung tissue. ResultCompared with the normal group， the white blood cell count in BALF and the levels of TNF-α， IL-1β， IL-6， and MPO in the model group was increased （P<0.01）， and the level of SOD was decreased （P<0.05）. Pathological damage of lung tissue was obvious， and the protein expression of NF-κB p65， p-NF-κB p65， and TLR4 in lung tissue was increased （P<0.01）. Compared with the model group， the white blood cell count in BALF and the levels of TNF-α， IL-1β， IL-6， and MPO in the treatment group was decreased （P<0.05，P<0.01）， and the level of SOD was increased （P<0.05，P<0.01）. Pathological damage of lung tissue was alleviated， and the protein expression of NF-κB p65， p-NF-κB p65， and TLR4 in lung tissue was decreased （P<0.01）. ConclusionZingiberis Rhizoma Recens alcohol extract may play a protective role in LPS-induced acute lung injury in mice by inhibiting the TLR4/NF-κB signaling pathway.

Objective This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite,aiming to provide a refer-ence for clinical treatment.Methods This study was reviewed and approved by the Ethics Committee,and informed consent was obtained from the patients.CBCT images of eighty-one untreated patients(40 anterior open bite patients and 41 normal overbite patients)with high-angle skeletal Class Ⅱ malocclusion were selected before treatment.Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root mor-phology,and the differences between the two groups were analyzed.Results There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group,signifi-cant differences were found in the root length of maxillary central incisor(11.12±1.37)mm、mandibular central inci-sor(10.15±1.09)mm,mandibular lateral incisor(11.27±1.15)mm and mandibular canine(12.81±1.48)mm be-tween the open bite group and the normal overbite group(P＜0.05).On the other hand,the two groups were significant-ly different in crown-root morphology of the maxillary central incisor(1.10°±3.62° vs.4.53°±2.30°,P＜0.01)but not in the mandibular central incisor.Conclusion The root length of the maxillary central incisor,mandibular central inci-sor,mandibular lateral incisor,mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients,and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root.The crown-root angle is smaller,which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱopen bite patients.

Objective This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite,aiming to provide a refer-ence for clinical treatment.Methods This study was reviewed and approved by the Ethics Committee,and informed consent was obtained from the patients.CBCT images of eighty-one untreated patients(40 anterior open bite patients and 41 normal overbite patients)with high-angle skeletal Class Ⅱ malocclusion were selected before treatment.Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root mor-phology,and the differences between the two groups were analyzed.Results There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group,signifi-cant differences were found in the root length of maxillary central incisor(11.12±1.37)mm、mandibular central inci-sor(10.15±1.09)mm,mandibular lateral incisor(11.27±1.15)mm and mandibular canine(12.81±1.48)mm be-tween the open bite group and the normal overbite group(P＜0.05).On the other hand,the two groups were significant-ly different in crown-root morphology of the maxillary central incisor(1.10°±3.62° vs.4.53°±2.30°,P＜0.01)but not in the mandibular central incisor.Conclusion The root length of the maxillary central incisor,mandibular central inci-sor,mandibular lateral incisor,mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients,and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root.The crown-root angle is smaller,which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱopen bite patients.

Objective This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite,aiming to provide a refer-ence for clinical treatment.Methods This study was reviewed and approved by the Ethics Committee,and informed consent was obtained from the patients.CBCT images of eighty-one untreated patients(40 anterior open bite patients and 41 normal overbite patients)with high-angle skeletal Class Ⅱ malocclusion were selected before treatment.Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root mor-phology,and the differences between the two groups were analyzed.Results There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group,signifi-cant differences were found in the root length of maxillary central incisor(11.12±1.37)mm、mandibular central inci-sor(10.15±1.09)mm,mandibular lateral incisor(11.27±1.15)mm and mandibular canine(12.81±1.48)mm be-tween the open bite group and the normal overbite group(P＜0.05).On the other hand,the two groups were significant-ly different in crown-root morphology of the maxillary central incisor(1.10°±3.62° vs.4.53°±2.30°,P＜0.01)but not in the mandibular central incisor.Conclusion The root length of the maxillary central incisor,mandibular central inci-sor,mandibular lateral incisor,mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients,and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root.The crown-root angle is smaller,which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱopen bite patients.

Objective This study aimed to explore the root length of maxillary and mandibular anterior teeth and central incisor crown-root morphology in patients with high-angle skeletal Class Ⅱ open bite,aiming to provide a refer-ence for clinical treatment.Methods This study was reviewed and approved by the Ethics Committee,and informed consent was obtained from the patients.CBCT images of eighty-one untreated patients(40 anterior open bite patients and 41 normal overbite patients)with high-angle skeletal Class Ⅱ malocclusion were selected before treatment.Dolphin software was used to study the root length of maxillary and mandibular anterior teeth and central incisor crown-root mor-phology,and the differences between the two groups were analyzed.Results There was no statistical significance in the root length of maxillary lateral incisor and canine between the open bite group and the normal overbite group,signifi-cant differences were found in the root length of maxillary central incisor(11.12±1.37)mm、mandibular central inci-sor(10.15±1.09)mm,mandibular lateral incisor(11.27±1.15)mm and mandibular canine(12.81±1.48)mm be-tween the open bite group and the normal overbite group(P＜0.05).On the other hand,the two groups were significant-ly different in crown-root morphology of the maxillary central incisor(1.10°±3.62° vs.4.53°±2.30°,P＜0.01)but not in the mandibular central incisor.Conclusion The root length of the maxillary central incisor,mandibular central inci-sor,mandibular lateral incisor,mandibular canine in high-angle Class Ⅱ open bite patients is shorter than that in high-angle Class Ⅱ normal overbite patients,and the long axis of the crown of the maxillary central incisor in high-angle Class Ⅱ open bite patients obviously deviates toward the labial side relative to the long axis of the root.The crown-root angle is smaller,which is beneficial to torque control or adduction movement of the anterior teeth in high-angle Class Ⅱopen bite patients.