BACKGROUND:With the development of the aging trend of society,the incidence of femoral neck fractures is increasing.Currently,the preferred surgical treatment is cannulated screw internal fixation.However,post-surgical femoral neck shortening occurs in some cases,resulting in impaired hip functionality.OBJECTIVE:To investigate the incidence of femoral neck shortening following the use of half-threaded cannulated screws for internal fixation in patients with femoral neck fractures,to analyze the effect on hip function,and to identify factors contributing to neck shortening.METHODS:A retrospective analysis was conducted on the medical records of 102 patients treated with half-threaded cannulated screws in an inverted triangle setup for femoral neck fractures at Affiliated Hai'an Hospital of Nantong University from January 2016 to January 2021.This group included 36 males and 66 females at the mean age of(57.2±7.7)years,with 34 cases of Garden type Ⅰ and Ⅱ fractures and 68 of Garden type Ⅲ and Ⅳ fractures.The mean bone mineral density value T was-2.8 SD.The Harris score was used to evaluate the hip function.During the follow-up period,the occurrence of femoral neck shortening was determined using X-ray imagery,and the factors influencing this shortening were examined using both univariate and multivariate regression analyses.RESULTS AND CONCLUSION:(1)Among the 102 patients with femoral neck fractures,30 patients developed femoral neck shortening,accounting for 29.4％.72 patients had no femoral neck shortening(70.6％).(2)The Harris score for patients experiencing neck shortening was significantly lower than that for patients without shortening(P＜0.05).(3)The study identified several factors associated with femoral neck shortening following the internal fixation of femoral neck fractures included age,gender,bone mineral density value T,preoperative Garden classification,and quality of reduction.These factors not only affect the shortening of the femoral neck after surgery,but are also directly related to the functional performance of the patient's hip joint.(4)Femoral neck shortening after surgery for femoral neck fracture is associated with various clinical parameters,especially the patient's age,gender,bone mineral density,preoperative classification,and accuracy of reduction during surgery.

Microbial infections are a prevalent challenge in the prevention and treatment of oral diseases. Antibiotic therapy faces clinical limitations due to its single-target mechanism and tendency to induce resistance with repeated use, necessitating novel antibacterial strategies. Stimuli-responsive antibacterial materials, whose antimicrobial activity can be modulated by external stimuli, offer advantages such as remote controllability, potential for localized precision treatment, and a reduced risk of inducing resistance. Among these materials, mechanical force-triggered piezoelectric materials exhibit significant antibacterial activity in the biomedical field owing to their unique piezoelectric effect, excellent stability, and good biocompatibility. Research has shown that piezoelectric materials can convert mechanical energy into electrical energy in response to external forces, which enables antibacterial effects without requiring an external power source. The underlying mechanisms primarily include direct electric field effects, generation of reactive oxygen species, and immune modulation. Preliminary applications in treating oral infections (e.g., dental caries, periodontitis, and peri-implantitis) have confirmed their stability and biocompatibility, establishing a foundation for clinical translation. However, long-term efficacy and biosafety in the complex oral microenvironment require further validation. Future research should focus on optimizing material preparation protocols to enhance antibacterial efficacy and stability, further investigating the underlying antimicrobial mechanisms, and systematically evaluating their therapeutic outcomes and safety profiles across various types of oral infections. This review summarizes the antibacterial effects, mechanisms, stability, safety, and research progress of piezoelectric materials in the stomatologic field, aiming to provide new insights for further research and application in this area.

BACKGROUND:With the development of the aging trend of society,the incidence of femoral neck fractures is increasing.Currently,the preferred surgical treatment is cannulated screw internal fixation.However,post-surgical femoral neck shortening occurs in some cases,resulting in impaired hip functionality.OBJECTIVE:To investigate the incidence of femoral neck shortening following the use of half-threaded cannulated screws for internal fixation in patients with femoral neck fractures,to analyze the effect on hip function,and to identify factors contributing to neck shortening.METHODS:A retrospective analysis was conducted on the medical records of 102 patients treated with half-threaded cannulated screws in an inverted triangle setup for femoral neck fractures at Affiliated Hai'an Hospital of Nantong University from January 2016 to January 2021.This group included 36 males and 66 females at the mean age of(57.2±7.7)years,with 34 cases of Garden type Ⅰ and Ⅱ fractures and 68 of Garden type Ⅲ and Ⅳ fractures.The mean bone mineral density value T was-2.8 SD.The Harris score was used to evaluate the hip function.During the follow-up period,the occurrence of femoral neck shortening was determined using X-ray imagery,and the factors influencing this shortening were examined using both univariate and multivariate regression analyses.RESULTS AND CONCLUSION:(1)Among the 102 patients with femoral neck fractures,30 patients developed femoral neck shortening,accounting for 29.4％.72 patients had no femoral neck shortening(70.6％).(2)The Harris score for patients experiencing neck shortening was significantly lower than that for patients without shortening(P＜0.05).(3)The study identified several factors associated with femoral neck shortening following the internal fixation of femoral neck fractures included age,gender,bone mineral density value T,preoperative Garden classification,and quality of reduction.These factors not only affect the shortening of the femoral neck after surgery,but are also directly related to the functional performance of the patient's hip joint.(4)Femoral neck shortening after surgery for femoral neck fracture is associated with various clinical parameters,especially the patient's age,gender,bone mineral density,preoperative classification,and accuracy of reduction during surgery.

AIM: To investigate the changes of retinal nerve fiber layer(RNFL)thickness, retinal thickness and blood flow density in different stages of diabetic retinopathy(DR)patients based on optical coherence tomography angiography(OCTA).METHODS: A retrospective analysis was conducted on 382 patients(382 eyes)diagnosed with DR in our hospital from February 2023 to February 2024. According to the staging criteria, the patients were divided into mild group(n=121), moderate group(n=133), severe group(n=72), and proliferative group(n=56). The general clinical data of the four groups of patients was compared; OCTA was used to scan and collect data from all patients, and the RNFL thickness, retinal thickness, and blood flow density were compared among the four groups of patients.RESULTS: There was no statistically significant difference in age, gender, hypertension, chronic kidney disease, and random blood glucose among patients in the mild, moderate, severe, and proliferative groups(all P>0.05). As the stage of DR worsened, the duration of the disease gradually prolonged(P<0.05). The thickness of the RNFL(superior, inferior, temporal, nasal, and average thickness)and retinal thickness significantly increased with the severity of DR(all P<0.001); however, there was no statistically significant difference in inferior RNFL thickness between the moderate and mild groups(P>0.05). The blood flow density in the superficial and deep retinal layers, as well as in the choroidal capillary layer, significantly decreased with the progression of DR(all P<0.05). Nevertheless, there was no statistically significant difference in superficial retinal blood flow density between the moderate and severe groups(P>0.05).CONCLUSION: OCTA can accurately observe the changes in RNFL thickness, retinal thickness, and blood flow density in patients with DR at different stages, which can serve as sensitive indicators for monitoring DR progression.

Infectious disease science is a core discipline of medicine and public health, and education in this field is essential for safeguarding public health and global health security. This study examined the development and future trends of infectious disease education in China by analyzing the evolution of the content and structure of nine editions of the textbook InfectiousDiseases published by the People's Medical Publishing House. The study revealed continuous improvements in pathogen classification methods, the selection of classic infectious diseases, and the articulation of prevention strategies, reflecting scientific advancements of the discipline and shifting societal needs. The expansion and diversification of the editorial team highlight the interdisciplinary nature and international perspective of infectious disease science. The continuous updates of the textbook not only provide theoretical guidance for infectious disease prevention and control but also contribute significantly to the training of skilled health professionals and the enhancement of public health emergency response capabilities. Based on the current status, this study suggests to accelerate the dynamic updating of textbooks, strengthen clinical practice education, and promote international collaboration to better meet the demands of future infectious disease education.

Objective:To explore the application value of minimally invasive plate osteosynthesis(MIPO)and open reduction and internal fixation(ORIF)in patients with middle and lower humeral shaft fractures.Methods:A total of 32 patients with middle and lower humeral shaft fractures treated with MIPO in our hospital from Jun 2020 to Sep 2023 were selected as the observation group,and another 32 patients with middle and lower humeral shaft fractures treated with ORIF were selected as the control group.The perioperative relevant indicators,fracture healing time,pain factors[substance P(SP),prostaglandin E2(PGE2)],pain severity score,upper limb function(Neer score for shoulder joint,Mayo score for elbow joint)before and after surgery,and complications were compared between the two groups.Results:The operation time,incision length,wound healing time,hospitalization time,fracture healing time,and complete weight-bearing time in the observation group were shorter than those in the control group,and the intraoperative blood loss was lower in the observation group(P＜0.05).The levels of serum SP and PGE2 in the observation group were lower than those in the control group at 3 and 5 days after surgery(P＜0.05).The pain scores in the observation group were lower than those in the control group at 1,3,and 5 days after surgery(P＜0.05).The Neer score of the shoulder joint and the Mayo score of the elbow joint in the observation group were higher than those in the control group at 1,3,and 6 months after surgery(P＜0.05).There was no significant difference in the Neer score of the shoulder joint and the Mayo score of the elbow joint between the two groups at 12 months after surgery(P＞0.05).There was no significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion:Both MIPO and ORIF have good long-term effects and safety in the treatment of middle and lower humeral shaft fractures,but the former can reduce injury,reduce pain,promote fracture healing,and has significant advantages in improving upper limb function in the early stage.

Purpose To investigate the clinicopathological characteristics,immunophenotype,high-risk human papillomavirus(hrHPV)infection status,treatment,and prognosis of cervical carcinoma exhibiting adenoid cystic car-cinoma(ACC)features.Methods Clinical data from 10 cases of cervical cancer with ACC features were collected.A retrospective analysis was proformed on the patients'clinicopathological data,histological features,and immunopheno-type(EnVision method),along with in situ hybridization detection of hrHPV E6/E7 mRNA covering 18 hrHPV types.Results The median age of the patients was 67.5 years,comprising 4 biopsy specimens and 6 surgical specimens.Except for 2 cases detected incidentally during physical examination,the remaining 8 cases presented with unexplained vaginal bleeding or contact bleeding.The mean tumor diameter was 4.5 cm(range:2.5 to 9.0 cm),and tumor stages were available for 8 patients(5 cases in stage Ⅰ and 1 case each in stages Ⅱ,Ⅲ,and Ⅳ).The follow-up period was 8 to 42 months,excluding 1 case lost to follow-up,2 cases(Ⅲ C1 and ⅣB)died within 1 year after surgery.Histologi-cally,4 cases exhibited pure ACC morphology,while 5 cases were mixed carcinomas(combined with squamous cell carcinoma,adenoid basal cell carcinoma,high-grade neuroendocrine carcinoma,or carcinosarcoma,respectively).The characteristic ACC morphology manifested as cribriform,pseudo-glandular,tubular,trabecular,and/or solid pat-terns with one case mixed carcinoma's lymph node metastasis showing only ACC morphology.Immunohistochemically,all 10 tumors exhibited diffuse strong positivity for p16 and p63,a high Ki67 proliferation index(40％to 90％),and wild-type p53 expression,and in 50％of cases,only a minority of cells were positive for c-MYB.Additionally,SOX10 was positive in 8 of 9 cases and CD117 was positive in 7 of 10 cases,respectively.In situ hybridization for hrHPV E6/E7 mRNA confirmed the presence of transcriptionally active HPV infection in all cases.Conclusion Cervical cancer with ACC features is rare,and predominantly occurs in postmenopausal elderly women.It represents an HPV-associat-ed high-grade carcinoma in which clinical stage is a critical prognostic factor.Immunohistochemical staining for CD117 and SOX10 aids in the pathological diagnosis of this tumor type.

Objective:To understand the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Shandong province from 2010 to 2022, analyze the trends in morbidity and mortality, and provide a scientific basis for the prevention, control, diagnosis, and treatment of SFTS.Methods:The data on SFTS cases and deaths were retrospectively collected through the China Disease Control and Prevention Information System′s infectious disease surveillance system and the Shandong province all-cause mortality surveillance system. Descriptive epidemiological method was used for epidemiological analysis, and the Joinpoint regression model was applied to analyze trends in morbidity and mortality.Results:From 2010 to 2022, 6 714 SFTS cases were reported in Shandong, with an average crude incidence rate (CIR) and age-standardized incidence rate (ASIR) of 0.52/100 000 and 0.43/100 000, respectively. Among these, 1, 064 cases died within 30 days of onset, with an average crude mortality rate (CMR) and age-standardized mortality rate (ASMR) of 0.08/100, 000 and 0.06/100 000, respectively, and an average case fatality rate of 15.85%. The average incidence rates for males and females were 0.52/100 000 and 0.53/100 000, respectively, with no statistically significant difference ( P>0.05). The average annual mortality rate for males (0.09/100 000) was higher than that for females (0.08/100 000), and the average annual case fatality rate for males (17.21%) was higher than that for females (14.48%), with statistically significant differences ( P<0.05); 93.95% of the cases were over 45 years old, and 86.56% of the deaths were over 60 years old. Both cases and deaths were primarily among farmers, accounting for over 85% of the total. From 2010 to 2022, the incidence rate of SFTS in Shandong showed an overall upward trend, with an average annual percentage change (AAPC) in CIR of 23.58% and an AAPC in ASIR of 19.97%, P<0.05. The mortality rate of SFTS cases in Shandong from 2010 to 2022 showed a continuous and significant upward trend, with a CMR AAPC of 27.64% and an ASMR AAPC of 22.70%, P<0.05. SFTS incidence and mortality in Shandong exhibited clear seasonality, with high occurrence from May to October, primarily concentrated in the Jiaodong Peninsula and the hilly areas of central Shandong. The number of affected counties increased in a wave-like pattern, expanding from 6 in 2010 to 79 in 2021 for cases and from 2 in 2010 to 53 in 2022 for deaths. Conclusions:From 2010 to 2022, the incidence and mortality of SFTS in Shandong showed an upward and expanding trend, with a particularly heavy disease burden among middle-aged and elderly farmers.

Intertrochanteric fractures of the femur are common hip fractures in the elderly. Their treatment goals include reducing incidence of complications, improving quality of life and increasing survival rate for the patients. Compared with traditional internal fixation, hip arthroplasty shows certain advantages in the primary treatment of intertrochanteric fractures of the femur and the revision following failure of internal fixation. It enables patients to do early weight-bearing activities to effectively improve their joint function, and reduces the risk of complications associated with long-term bed rest. However, at present, there has been no unified consensus in the academic community regarding the treatment plan of hip arthroplasty for intertrochanteric fractures of the femur. This paper mainly reviews the research progress in such aspects as indications of hip arthroplasty for primary intertrochanteric fractures of the femur and for revision after failure of internal fixation, anatomical and biomechanical characteristics of the femoral trochanter, principles for selection of types and models of joint prosthesis, key operative techniques like intraoperative fixation of bone fragments and prosthesis implantation, and methods of peri-operative comprehensive assessment.

Objective To investigate the preventive effect of ipratropium bromide on sufentanil-induced cough during general anesthesia induction.Methods A total of 201 patients undergoing elective surgery under general anesthesia from June 2022 to September 2024 were selected and divided into the ipratropium bromide group(group P,n=100)and the normal saline group(group C,n=101).Thirty minutes before anesthesia in-duction,group P and group C received oral administration of ipratropium bromide inhalation aerosol(2 puffs,equivalent to 42 μg C20H30BrNO3·H2O)and 0.9%normal saline spray(2 puffs),respectively.Anesthesiolo-gists intravenously administered sufentanil(0.5 μg/kg)within 5 seconds,followed by propofol(2 mg/kg)and rocuronium(0.6 mg/kg)after 3 minutes.Endotracheal intubation was performed using a videolaryngo-scope after achieving satisfactory muscle relaxation.The occurrence of cough within 1 minute after sufentanil administration was recorded.Heart rate(HR),mean arterial pressure(MAP),and pulse oxygen saturation(SpO2)were measured at different time points.Results Within 1 min after sufentanil administration,the in-cidence of severe cough and total cough in group P was significantly lower than that in group C(P<0.05).There was no significant difference in HR,MAP,or SpO2 between the two groups at different times(P>0.05).No adverse reactions such as nausea,vomiting,or arrhythmia occurred in either group.Conclusion In-haling ipratropium bromide 30 min before anesthesia induction could effectively reduce sufentanil-induced cough and decrease the incidence of severe cough.