Objective: To investigate the awareness of knowledge about hepatitis C prevention and control among outpatients in Ningbo City, Zhejiang Province, and its influencing factors, so as to provide the evidence for strengthening health education on hepatitis C prevention and control. Methods: Based on sentinel surveillance of hepatitis C, the outpatients aged 15 to 65 years at seven hospitals in Yinzhou District, Cixi City and Xiangshan County of Ningbo City were selected using the convenient sampling method from April to June during 2020 and 2022. Demographic information, knowledge and behaviors related to hepatitis C prevention and control were collected through questionnaire surveys. The influencing factors for knowledge about hepatitis C prevention and control were analyzed using a multivariable logistic regression model. Results: A total of 2 792 participants were surveyed, including 1 157 males (41.44%) and 1 635 females (58.56%). The awareness rate of knowledge about hepatitis C prevention and control was 56.23%, and was lower in knowledge about hepatitis C vaccine and treatment. The awareness rates of knowledge about hepatitis C prevention and control among outpatients from 2020 to 2022 were 47.11%, 53.22% and 70.65%, respectively, showing an upward trend (P<0.05). Multivariable logistic regression analysis showed that participants aged 25 to <50 years (OR=1.358, 95%CI: 1.073-1.719), with an educational level of high school or junior college (OR=1.431, 95%CI: 1.134-1.806) or above junior college (OR=3.728, 95%CI: 2.958-4.699), with household monthly income per capita of 3 000 to <5 000 yuan (OR=1.828, 95%CI: 1.344-2.486) or ≥5 000 yuan (OR=1.858, 95%CI: 1.366-2.526), without a history of invasive treatments such as pedicure in public places (OR=1.287, 95%CI: 1.024-1.618), without a history of contact with family members' blood-contaminated items (OR=2.050, 95%CI: 1.552-2.707), and always using condoms during sexual contacts (OR=1.740, 95%CI: 1.273-2.378) had higher awareness of knowledge about hepatitis C prevention and control. Conclusions The awareness of knowledge about hepatitis C vaccine and treatment among outpatients in Ningbo City needs to be improved. Age, educational level, household monthly income per capita, history of invasive treatments such as pedicure in public places, history of contact with family members' blood-contaminated items and frequency of condom use during sexual contacts are associated with outpatients' awareness of knowledge about hepatitis C prevention and control.

Objective:To investigate how age and nail-tract volumetric bone mineral density (vBMD) are associated with postoperative mechanical performance of proximal femoral nail anti-rotation (PFNA-Ⅱ) fixation for geriatric intertrochanteric fractures using a finite-element analysis.Methods:Fifteen elderly patients with intertrochanteric fracture of the femur were selected for this study. They were 11 females and 4 males and divided into 5 groups based on their ages ( n=3): 55-year-old, 65-year-old, 75-year-old, 85-year-old, and 95-year-old groups. After three-dimensional models of the proximal femur were constructed using the preoperative CT data of their healthy contralateral hip, 31-A1.2 fractures of the AO/OTA type were created and PFNA-Ⅱ fixations simulated. Two loading schemes were created: graded quasi-static axial loads (700 N, 1,400 N, 2,100 N, and 2,800 N) were applied to compute equivalent plastic strain volumes in the femoral head region; displacement-controlled loading was applied to failure to derive load-displacement curves for stiffness and the maximum failure load. Nail-tract vBMD and regional hip vBMDs were measured by quantitative CT. Pearson correlation analysis was conducted to investigate the associations of age and nail-tract vBMD with the aforementioned mechanical indicators. Results:Under the same load, compared with the 55-year-old, 65-year-old, and 75-year-old groups, the plastic strain unit volumes of the fracture models in the 85-year-old and 95-year-old groups increased significantly. Under a load of 700 N, no plastic strain was observed in the fracture models in the 55-year-old, 65-year-old, and 75-year-old groups, while an average plastic strain of approximately 50 mm 3 was observed in the fracture models in the 85-year-old group. Under a load of 2,800 N, the high strain areas in the fracture models in the 85-year-old and 95-year-old groups were mainly concentrated at the tip of the head nail and the junction between the head nail and the main nail. Load-displacement curves showed a marked reduction in the failure load in patients aged ≥85 years. Under loads of 1,400 N, 2,100 N, and 2,800 N, there was a strong association between the nail-tract vBMD and the volume of the plastic strain unit ( r=-0.82, -0.88, -0.89, respectively), which was stronger than those for total-hip vBMD. Conclusions:Finite-element analysis indicates that age and nail-tract vBMD are closely related to local plastic strain and overall stiffness of the proximal femur after PFNA-Ⅱ fixation for the geriatric intertrochanteric fractures. Patients aged ≥85 years old are more prone to plastic yielding, which compromises fixation stability.

Objective:To investigate the impact of central screw size on the stability of the glenoid baseplate in reverse shoulder arthroplasty using a finite element analysis.Methods:Four sizes of central screws (length × diameter) were designed: 25.0 mm×5.5 mm (G1), 30.0 mm×5.5 mm (G2), 25.0 mm×6.5 mm (G3), and 30.0 mm×6.5 mm (G4), along with a glenosphere, a baseplate, and peripheral screws. The central screw of group G1 was selected for a biomechanical test along with a set of customized prosthesis. The results were used to validate a finite element model. The validated finite element model was employed to analyze the central screws of 4 different sizes under a vertically downward 490 N load in simulation. After the model calculation was completed, the total displacement of each model, the maximum Von Mises stress on the bone surface at the baseplate-bone contact interface, the maximum Von Mises stress on the bone tissue around the screw-bone interface, the maximum value of the maximum principal strain (tensile strain), the maximum value of the minimum principal strain (compressive strain), the total volume of bone damage, and the volume of bone damage around the central screw were analyzed.Results:Insignificant differences were found in the total displacement and total volume of bone damage across the 4 models. On the bone surface at the baseplate-bone contact interface, the maximum Von Mises stress in G3 and G4 (11.26 MPa and 9.88 MPa, respectively) was slightly higher than that in G1 and G2 (9.11 MPa and 8.90 MPa, respectively). On the bone tissue around the screw-bone interface, G4 exhibited significantly higher maximum stress (15.82 MPa) and significantly higher maximum value of the maximum principal strain (10.09×10 -2) than G1 (8.51 MPa, 3.88×10 -2), G2 (9.45 MPa, 4.29×10 -2), and G3 (9.92 MPa, 3.92×10 -2), while the maximum value of the minimum principal strain in G3 (12.12×10 -2)was significantly higher than that in G1 (8.23×10 -2), G2 (8.10×10 -2), and G4 (8.34×10 -2). The volume of bone damage around the central screw in G3 (11.4 mm 3) was significantly smaller than that in G1 (24.9 mm 3), G2 (28.5 mm 3), and G4 (20.3 mm 3). Conclusions:In reverse shoulder arthroplasty, to a certain extent, increasing the length of a central screw amplifies bone damage volume around the screw. Conversely, increasing only the diameter of a central screw reduces bone damage volume around the screw, consequently lowering the loosening risk of a central screw.

Elderly patients are a crucial population for medical treatment and referral.The establishment of standardized and efficient referral channels is essential for enhancing the referral process, improving treatment outcomes for the elderly, and optimizing the allocation of medical resources.Referral network analysis examines the integrity, structure, and dynamics of referrals to infer the characteristics of the network.This can offer insights for enhancing referral policies and elevating medical service standards.While existing research predominantly concentrates on referral networks within the general population, there is a noticeable gap in studies focusing on elderly patients.This review article assesses domestic and international research on networks formed between medical institutions or physicians through patient referrals, aiming to inform and enhance referral policies in our country.

Objective:To explore baseline clinical and imaging characteristics of children with neonatal arterial ischaemic stroke based on their long-term motor function prognoses.Methods:A retrospective cohort study was conducted. Clinical data, including magnetic resonance imaging (MRI) and electroencephalogram (EEG) findings, were collected from 31 neonates diagnosed with ischemic stroke admitted to the Department of Neonataology, Maternal and Child Health Hospital of Hubei Province between January 2015 and December 2019. Unified follow-up was conducted between May and July 2024. Long-term motor function outcomes were assessed using the modified Rankin scale(mRS) and categorized into two groups: the good motor function group (mRS score 0-1) and the motor impairment group (mRS score≥2).Baseline clinical and imaging data were summarized for all children, and differences between the two groups were analyzed using the Mann-Whitney U test and Fisher′s exact test. Results:A total of 31 neonates (21 males, 10 females) with an admission age of 1-19 days, all diagnosed within 28 days of birth, were included. At follow-up, 4-8 years after disease onset, 26 neonates (84%) showed good motor function, while 5 (16%) had motor impairments. Compared to the good motor function group, the motor impairment group had higher proportions of females (4/5 vs. 23% (6/26)), main middle cerebral artery (MCA) infarction (4/5 vs. 19% (5/26)), basal ganglia involvement (4/5 vs. 27% (7/26)), corticospinal tract involvement (posterior limb of internal capsule (PLIC) 5/5 vs. 38% (10/26) and cerebral peduncles 5/5 vs. 31% (8/26)) shown by MRI images, and meconium-stained amniotic fluid (4/5 vs. 15% (4/26))(all P<0.05).No significant differences were observed in gestational age, birth weight, abnormalities in muscle tone or primitive reflexes at admission or discharge, or abnormal EEG findings (all P>0.05). Conclusions:Neonatal arterial ischemic stroke commonly manifests as seizures, which are generally controllable, with a relatively stable clinical course and a low incidence of long-term motor impairment. Children with long-term motor impairments are more likely to have main MCA infarction, basal ganglia and corticospinal tract involvement (PLIC and cerebral peduncles), as well as meconium-stained amniotic fluid. This condition is also more commonly observed in females.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Objective To investigate the capacity of low-intensity pulsed ultrasound(LIPUS)for promoting osteogenic differentiation of senescent bone marrow mesenchymal stem cell(BMMSC)in mice,also the potential mechanism of involving myocardin-related transcription factor-A(MRTF-A)during this process.Methods Five aged mice received LIPUS irradiation on the left femur for eight weeks.Micro CT and HE staining were employed to evaluate bone status of bilateral femur.Bone marrow cells were isolated from mouse long bones,BMMSC were cultured,and the cells were divided into H2O2+LIPUS group,H2O2 group and control group.Mouse BMMSC were subjected to H2O2 for 3 days,followed by reactive oxygen species fluorescence staining and senescence-associated β-galactosidase staining to assess cellular senescence.Immunofluorescence and phalloidin staining were performed to examine MRTF-A distribution and cytoskeletal status.Based on H2O2-induced senescence model,MRTF-A nuclear translocation inhibitor CCG-100602 was applied,and the cells were further divided into H2O2+CCG-100602+LIPUS group,H2O2+CCG-100602 group,H2O2+LIPUS group and H2O2 group.Immunofluorescence staining was used to assess MRTF-A distribution.Alkaline phosphatase(ALP)and alizarin red staining were conducted to evaluate osteogenic differentiation capacity.Results LIPUS resulted in increased trabecular bone in the left femur of aged mice compared to the right femur,with increased bone volume to total volume and trabecular number and decreased trabecular spacing(both P＜0.05).Compared with H2O2 group,H2O2+LIPUS group showed increased nuclear expression of MRTF-A and increased intracellular rigid actin filament density.The nuclear expression of MRTF-A in H2O2+CCG-100602+LIPUS group was significantly lower than that in H2O2+LIPUS group.Compared with the H2O2+CCG-100602+LIPUS group and H2O2 group,the ALP and alizarin red staining positive areas in H2O2+LIPUS group were significantly larger.Conclusion LIPUS could improve osteoporosis in aged mice.Nuclear translocation of MRTF-A was a key regulator to LIPUS for promoting osteogenic differentiation of senescent BMMSC.

Objective To investigate the capacity of low-intensity pulsed ultrasound(LIPUS)for promoting osteogenic differentiation of senescent bone marrow mesenchymal stem cell(BMMSC)in mice,also the potential mechanism of involving myocardin-related transcription factor-A(MRTF-A)during this process.Methods Five aged mice received LIPUS irradiation on the left femur for eight weeks.Micro CT and HE staining were employed to evaluate bone status of bilateral femur.Bone marrow cells were isolated from mouse long bones,BMMSC were cultured,and the cells were divided into H2O2+LIPUS group,H2O2 group and control group.Mouse BMMSC were subjected to H2O2 for 3 days,followed by reactive oxygen species fluorescence staining and senescence-associated β-galactosidase staining to assess cellular senescence.Immunofluorescence and phalloidin staining were performed to examine MRTF-A distribution and cytoskeletal status.Based on H2O2-induced senescence model,MRTF-A nuclear translocation inhibitor CCG-100602 was applied,and the cells were further divided into H2O2+CCG-100602+LIPUS group,H2O2+CCG-100602 group,H2O2+LIPUS group and H2O2 group.Immunofluorescence staining was used to assess MRTF-A distribution.Alkaline phosphatase(ALP)and alizarin red staining were conducted to evaluate osteogenic differentiation capacity.Results LIPUS resulted in increased trabecular bone in the left femur of aged mice compared to the right femur,with increased bone volume to total volume and trabecular number and decreased trabecular spacing(both P＜0.05).Compared with H2O2 group,H2O2+LIPUS group showed increased nuclear expression of MRTF-A and increased intracellular rigid actin filament density.The nuclear expression of MRTF-A in H2O2+CCG-100602+LIPUS group was significantly lower than that in H2O2+LIPUS group.Compared with the H2O2+CCG-100602+LIPUS group and H2O2 group,the ALP and alizarin red staining positive areas in H2O2+LIPUS group were significantly larger.Conclusion LIPUS could improve osteoporosis in aged mice.Nuclear translocation of MRTF-A was a key regulator to LIPUS for promoting osteogenic differentiation of senescent BMMSC.

Elderly patients are a crucial population for medical treatment and referral.The establishment of standardized and efficient referral channels is essential for enhancing the referral process, improving treatment outcomes for the elderly, and optimizing the allocation of medical resources.Referral network analysis examines the integrity, structure, and dynamics of referrals to infer the characteristics of the network.This can offer insights for enhancing referral policies and elevating medical service standards.While existing research predominantly concentrates on referral networks within the general population, there is a noticeable gap in studies focusing on elderly patients.This review article assesses domestic and international research on networks formed between medical institutions or physicians through patient referrals, aiming to inform and enhance referral policies in our country.

Objective:To explore baseline clinical and imaging characteristics of children with neonatal arterial ischaemic stroke based on their long-term motor function prognoses.Methods:A retrospective cohort study was conducted. Clinical data, including magnetic resonance imaging (MRI) and electroencephalogram (EEG) findings, were collected from 31 neonates diagnosed with ischemic stroke admitted to the Department of Neonataology, Maternal and Child Health Hospital of Hubei Province between January 2015 and December 2019. Unified follow-up was conducted between May and July 2024. Long-term motor function outcomes were assessed using the modified Rankin scale(mRS) and categorized into two groups: the good motor function group (mRS score 0-1) and the motor impairment group (mRS score≥2).Baseline clinical and imaging data were summarized for all children, and differences between the two groups were analyzed using the Mann-Whitney U test and Fisher′s exact test. Results:A total of 31 neonates (21 males, 10 females) with an admission age of 1-19 days, all diagnosed within 28 days of birth, were included. At follow-up, 4-8 years after disease onset, 26 neonates (84%) showed good motor function, while 5 (16%) had motor impairments. Compared to the good motor function group, the motor impairment group had higher proportions of females (4/5 vs. 23% (6/26)), main middle cerebral artery (MCA) infarction (4/5 vs. 19% (5/26)), basal ganglia involvement (4/5 vs. 27% (7/26)), corticospinal tract involvement (posterior limb of internal capsule (PLIC) 5/5 vs. 38% (10/26) and cerebral peduncles 5/5 vs. 31% (8/26)) shown by MRI images, and meconium-stained amniotic fluid (4/5 vs. 15% (4/26))(all P<0.05).No significant differences were observed in gestational age, birth weight, abnormalities in muscle tone or primitive reflexes at admission or discharge, or abnormal EEG findings (all P>0.05). Conclusions:Neonatal arterial ischemic stroke commonly manifests as seizures, which are generally controllable, with a relatively stable clinical course and a low incidence of long-term motor impairment. Children with long-term motor impairments are more likely to have main MCA infarction, basal ganglia and corticospinal tract involvement (PLIC and cerebral peduncles), as well as meconium-stained amniotic fluid. This condition is also more commonly observed in females.