Objective:To address the critical issue of missing dynamic border molding information in edentulous direct digital impression technology, this study explores innovative digital solutions and conducts preliminary application validation.Methods:Based on the myostatic line theory, a methodology was established: intraoral scanner (IOS) high-frequency video was utilized to dynamically capture functional molding data of soft tissues, integrated with a self-developed mobility gradient recognition algorithm to achieve dynamic threshold segmentation between the muscle dynamic zone and myostatic zone, termed "optical digital molding technology". Ten edentulous patients with well-fitting complete dentures, treated at the Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2024 to December 2024, were enrolled. The standard deviation between the muscle static line (generated by mobility gradient algorithm with thresholds of 0.3-0.7 mm) and the denture border curve was analyzed to optimize the dynamic threshold, followed by single-case clinical validation.Results:Among the mobility thresholds of 0.3-0.7 mm, the 0.5 mm threshold yielded the smallest standard deviation between the myostatic line and denture border. Clinical validation demonstrated that dentures designed with this threshold exhibited no displacement during dynamic functional tests, with marginal sealing meeting clinical standards.Conclusions:The optical digital border molding technique for edentulous soft tissue boundaries translates the myostatic line theory into quantifiable parameters for the first time. Based on data from 10 cases, a mobility threshold of 0.5 mm is recommended for clinical application.

Objective To explore the risk factors of nonalcoholic fatty liver disease(NAFLD)in obese children,and evaluate the diagnostic value of each index for NAFLD and establish a Nomogram prediction model.Methods A total of 207 obese children admitted at Department of Pediatrics the Second Hospital of Jiaxing from January 2022 to January 2025 were selected.These children were divided into two groups based on NAFLD diagnosis:non-NAFLD group(n=99)and NAFLD group(n=108).Differences in gender,age,body mass index(BMI),and related metabolic indicators were compared between two groups.Logistic regression was employed to analyze potential risk factors for NAFLD development,while receiver operating characteristic(ROC)curve and Nomograms were used to evaluate the predictive value of different factors for NAFLD.Results ROC curve analysis demonstrated diagnostic value for NAFLD in triglyceride-glucose index(TyG),triglyceride-to-cholesterol ratio,TyG-waist circumference,and TyG-BMI.Among these,the area under the curve(AUC)of TyG showed the highest value of 0.713,with an optimal cutoff of 8.189,sensitivity of 50.5％and specificity of 83.3％.Univariate Logistic regression analysis revealed multiple insulin resistance indicators associated with NAFLD development.Multivariate analysis identified homeostatic model assessment of insulin resistance(HOMA-IR)and TyG as independent risk factors,with TyG showing the best predictive value(OR=3.038 95％CI:1.089-8.475,P＜0.05).The constructed Nomogram prediction model demonstrated strong comprehensive discriminant capability(AUC=0.742).Conclusion The Nomogram model based on HOMA-IR,TyG and its derived indexes has certain clinical application value in the screening of NAFLD in children.

Objective To observe the effect of human umbilical cord mesenchymal stem cell-derived exo-somes(HUC-MSC-Exo)on microglial polarization in neonatal rats with white matter injury(WMI).Methods Three-day-old Sprague-Dawley rats were randomly divided into sham group(Sham),hypoxia-ischemia group(HI)and HUC-MSC-Exo group,with 12 rats in each group.Unilateral common carotid artery ligation combined with hy-poxia(8％oxygen and 92％nitrogen)was used to construct a WMI rat model.Exosomes were extracted by ultra-high-speed centrifugation and characterized by nanoflow cytometry,western blot experiments and transmission electron mi-croscopy.Brain stereotaxic-assisted inferior ventricular transplantation exo(2×108 particles/μL)was performed and brain tissue samples were collected 14 days after HI.Hematoxylin-eosin(HE)staining was used to observe morpho-logical changes of brain tissue.Nissl staining was used to observe Nissl body formation in brain tissue;Luxol fast blue(LFB)staining was used to observe the formation of myelin sheath in brain tissue.Immunofluorescence staining was used to observe the localized expression of ionic calcium binds adaptor molecule 1(Iba1).The protein expres-sion levels of cluster of differentiation 86(CD86),inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),CD206,arginase-1(Arg-1),IL-10 and transforming growth factor-β(TGF-β)were detected by western blot.Results The results of nanoflow cytometry,western blot and transmission electron microscopy showed that the diameter of HUC-MSC-Exo particles was between 30 and 150 nm,and the oval-like shape and membrane-like structure were visible,and the exo markers CD9,CD63 and TSG101 were positive,while calnexin was negative.HE staining,Nissl staining and LFB staining showed that compared with the Sham group,the HI group had brain tissue structure destruction,which was manifested by cell morphological changes,nerve fiber ar-rangement disorder and vacuolation,Nissl body dissolution or even disappearance,and myelination was blocked.HUC-MSC-Exo significantly reversed the pathological changes in the HI group.The results of immunofluorescence staining and western blot showed that the microglial marker Iba1 was mainly expressed in the subventricular zone(SVZ),and the expression of Iba1 protein in the SVZ region increased after HI compared with the Sham group(t=15.95、20.31,P<0.01).HUC-MSC-Exo significantly reduced the expression of Iba1 protein in the HI group(t=10.35、11.01,P<0.01).The results of western blot showed that the expressions of M1 microglia markers(CD86 and iNOS)and pro-inflammatory cytokines(TNF-α and IL-1β)were significantly increased after HI(t=10.98、7.68、15.13、13.13,both P<0.01),and the expressions of M2 microglia markers(CD206 and Arg-1)and anti-inflammatory cytokines(IL-10 and TGF-β)were also increased after HI(t=14.26、9.38、8.82、7.42,both P<0.01).HUC-MSC-Exo decreased the protein expression of CD86,iNOS,TNF-α and IL-1β(t=9.79、5.81、8.06、7.03,all P<0.01)and increased the protein expression levels of CD206,Arg-1,IL-10 and TGF-β compared to the HI group(t=12.90、8.16、8.98、9.49,both P<0.01).Conclusion HUC-MSC-Exo attenuates WMI in neonatal rats by regulating microglial polarization.

Objective To establish a ultrahigh-performance liquid chromatography-orbitrap high-resolution mass spectrometry(UHPLC-Orbitrap HRMS)method for the determination of the genotoxic impurity N-nitroso propranolol(NPPN)in propranolol hydrochloride sustained-release tablets.Methods The test sample was ultrasonically extracted using methanol as the solvent,then centrifuged and filtered before injection analysis.Chromatographic separation was performed using a 2.7 μm particle size C18 UHPLC column with a mobile phase of 0.1％formic acid(A)in water and 0.1％formic acid(B)in acetonitrile,using gradient elution.Mass spectrometry was conducted with an HESI ion source in positive ion parallel reaction monitoring(PRM)scan mode,monitoring the NPPN fragment ion at m/z 72.080 8,and quantification was performed using the standard curve method.Results The calibration curve was in good linearity in the range of 0.51-20.30 ng·mL-1 with excellent correlation coefficient(r)of 0.9999.The recoveries of NPPN at three levels(low,medium,and high)were in the range of 95.4％～98.3％,while the RSDs were from 2.5％to 4.2％.The limit of detection(LOD)was 0.20 ng·mL-1 while the limit of quantitfication(LOQ)was 0.51 ng·mL-1.This analytical method was used to determine NPPN in six batches of propranolol hydrochloride sustained release tablet samples.NPPN was detected in all six samples,among which the detection amount of 3 batches have exceeded the acceptable limit.Conclusion This method is sensitive,accurate,and fast,making it useful for pharmaceutical companies in controlling production processes and providing robust technical support for regulatory authorities.

Objective:To address the critical issue of missing dynamic border molding information in edentulous direct digital impression technology, this study explores innovative digital solutions and conducts preliminary application validation.Methods:Based on the myostatic line theory, a methodology was established: intraoral scanner (IOS) high-frequency video was utilized to dynamically capture functional molding data of soft tissues, integrated with a self-developed mobility gradient recognition algorithm to achieve dynamic threshold segmentation between the muscle dynamic zone and myostatic zone, termed "optical digital molding technology". Ten edentulous patients with well-fitting complete dentures, treated at the Department of Prosthodontics, Peking University School and Hospital of Stomatology from January 2024 to December 2024, were enrolled. The standard deviation between the muscle static line (generated by mobility gradient algorithm with thresholds of 0.3-0.7 mm) and the denture border curve was analyzed to optimize the dynamic threshold, followed by single-case clinical validation.Results:Among the mobility thresholds of 0.3-0.7 mm, the 0.5 mm threshold yielded the smallest standard deviation between the myostatic line and denture border. Clinical validation demonstrated that dentures designed with this threshold exhibited no displacement during dynamic functional tests, with marginal sealing meeting clinical standards.Conclusions:The optical digital border molding technique for edentulous soft tissue boundaries translates the myostatic line theory into quantifiable parameters for the first time. Based on data from 10 cases, a mobility threshold of 0.5 mm is recommended for clinical application.

Objective To explore the risk factors of nonalcoholic fatty liver disease(NAFLD)in obese children,and evaluate the diagnostic value of each index for NAFLD and establish a Nomogram prediction model.Methods A total of 207 obese children admitted at Department of Pediatrics the Second Hospital of Jiaxing from January 2022 to January 2025 were selected.These children were divided into two groups based on NAFLD diagnosis:non-NAFLD group(n=99)and NAFLD group(n=108).Differences in gender,age,body mass index(BMI),and related metabolic indicators were compared between two groups.Logistic regression was employed to analyze potential risk factors for NAFLD development,while receiver operating characteristic(ROC)curve and Nomograms were used to evaluate the predictive value of different factors for NAFLD.Results ROC curve analysis demonstrated diagnostic value for NAFLD in triglyceride-glucose index(TyG),triglyceride-to-cholesterol ratio,TyG-waist circumference,and TyG-BMI.Among these,the area under the curve(AUC)of TyG showed the highest value of 0.713,with an optimal cutoff of 8.189,sensitivity of 50.5％and specificity of 83.3％.Univariate Logistic regression analysis revealed multiple insulin resistance indicators associated with NAFLD development.Multivariate analysis identified homeostatic model assessment of insulin resistance(HOMA-IR)and TyG as independent risk factors,with TyG showing the best predictive value(OR=3.038 95％CI:1.089-8.475,P＜0.05).The constructed Nomogram prediction model demonstrated strong comprehensive discriminant capability(AUC=0.742).Conclusion The Nomogram model based on HOMA-IR,TyG and its derived indexes has certain clinical application value in the screening of NAFLD in children.

Objective To establish a ultrahigh-performance liquid chromatography-orbitrap high-resolution mass spectrometry(UHPLC-Orbitrap HRMS)method for the determination of the genotoxic impurity N-nitroso propranolol(NPPN)in propranolol hydrochloride sustained-release tablets.Methods The test sample was ultrasonically extracted using methanol as the solvent,then centrifuged and filtered before injection analysis.Chromatographic separation was performed using a 2.7 μm particle size C18 UHPLC column with a mobile phase of 0.1％formic acid(A)in water and 0.1％formic acid(B)in acetonitrile,using gradient elution.Mass spectrometry was conducted with an HESI ion source in positive ion parallel reaction monitoring(PRM)scan mode,monitoring the NPPN fragment ion at m/z 72.080 8,and quantification was performed using the standard curve method.Results The calibration curve was in good linearity in the range of 0.51-20.30 ng·mL-1 with excellent correlation coefficient(r)of 0.9999.The recoveries of NPPN at three levels(low,medium,and high)were in the range of 95.4％～98.3％,while the RSDs were from 2.5％to 4.2％.The limit of detection(LOD)was 0.20 ng·mL-1 while the limit of quantitfication(LOQ)was 0.51 ng·mL-1.This analytical method was used to determine NPPN in six batches of propranolol hydrochloride sustained release tablet samples.NPPN was detected in all six samples,among which the detection amount of 3 batches have exceeded the acceptable limit.Conclusion This method is sensitive,accurate,and fast,making it useful for pharmaceutical companies in controlling production processes and providing robust technical support for regulatory authorities.

Objective To observe the effect of human umbilical cord mesenchymal stem cell-derived exo-somes(HUC-MSC-Exo)on microglial polarization in neonatal rats with white matter injury(WMI).Methods Three-day-old Sprague-Dawley rats were randomly divided into sham group(Sham),hypoxia-ischemia group(HI)and HUC-MSC-Exo group,with 12 rats in each group.Unilateral common carotid artery ligation combined with hy-poxia(8％oxygen and 92％nitrogen)was used to construct a WMI rat model.Exosomes were extracted by ultra-high-speed centrifugation and characterized by nanoflow cytometry,western blot experiments and transmission electron mi-croscopy.Brain stereotaxic-assisted inferior ventricular transplantation exo(2×108 particles/μL)was performed and brain tissue samples were collected 14 days after HI.Hematoxylin-eosin(HE)staining was used to observe morpho-logical changes of brain tissue.Nissl staining was used to observe Nissl body formation in brain tissue;Luxol fast blue(LFB)staining was used to observe the formation of myelin sheath in brain tissue.Immunofluorescence staining was used to observe the localized expression of ionic calcium binds adaptor molecule 1(Iba1).The protein expres-sion levels of cluster of differentiation 86(CD86),inducible nitric oxide synthase(iNOS),tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),CD206,arginase-1(Arg-1),IL-10 and transforming growth factor-β(TGF-β)were detected by western blot.Results The results of nanoflow cytometry,western blot and transmission electron microscopy showed that the diameter of HUC-MSC-Exo particles was between 30 and 150 nm,and the oval-like shape and membrane-like structure were visible,and the exo markers CD9,CD63 and TSG101 were positive,while calnexin was negative.HE staining,Nissl staining and LFB staining showed that compared with the Sham group,the HI group had brain tissue structure destruction,which was manifested by cell morphological changes,nerve fiber ar-rangement disorder and vacuolation,Nissl body dissolution or even disappearance,and myelination was blocked.HUC-MSC-Exo significantly reversed the pathological changes in the HI group.The results of immunofluorescence staining and western blot showed that the microglial marker Iba1 was mainly expressed in the subventricular zone(SVZ),and the expression of Iba1 protein in the SVZ region increased after HI compared with the Sham group(t=15.95、20.31,P<0.01).HUC-MSC-Exo significantly reduced the expression of Iba1 protein in the HI group(t=10.35、11.01,P<0.01).The results of western blot showed that the expressions of M1 microglia markers(CD86 and iNOS)and pro-inflammatory cytokines(TNF-α and IL-1β)were significantly increased after HI(t=10.98、7.68、15.13、13.13,both P<0.01),and the expressions of M2 microglia markers(CD206 and Arg-1)and anti-inflammatory cytokines(IL-10 and TGF-β)were also increased after HI(t=14.26、9.38、8.82、7.42,both P<0.01).HUC-MSC-Exo decreased the protein expression of CD86,iNOS,TNF-α and IL-1β(t=9.79、5.81、8.06、7.03,all P<0.01)and increased the protein expression levels of CD206,Arg-1,IL-10 and TGF-β compared to the HI group(t=12.90、8.16、8.98、9.49,both P<0.01).Conclusion HUC-MSC-Exo attenuates WMI in neonatal rats by regulating microglial polarization.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To systematically evaluate the qualitative researches on cardiac telerehabilitation experience of patients with cardiovascular disease (CVD), so as to provide reference for clinical development and improvement of cardiac telerehabilitation services.Methods:Qualitative studies on cardiac telerehabilitation experience of CVD patients in PubMed, Web of Science, Embase, CINAHL, Cochrane Library, Scopus, China National Knowledge Infrastructure, China Biology Medicine disc, Wanfang Database and VIP were searched by computer. The search period was from establishment of the databases to August 2023. The quality of the literature was evaluated according to the quality evaluation criteria of the Evidence-Based Health Care Center of the Joanna Briggs Institute in Australia, and the results were integrated by aggregative integration method.Results:A total of 13 articles were included, 52 research results were extracted and classified into 11 categories. Four integrated results were formed, including the benefits, promoting factors, obstacle, expectations and suggestions for cardiac telerehabilitation experience in CVD patients.Conclusions:CVD patients benefit significantly from participating in cardiac telerehabilitation. In the future, it is supposed to pay more attention to the factors that affect patients' participation in cardiac telerehabilitation, actively develop domestic cardiac telerehabilitation tools and optimize the cardiac telerehabilitation model according to the needs and suggestions of patients.