Osteonecrosis of the mandible is also called avascular necrosis of the jaw, and it is a rare complication of bisphosphonates. It is characterized with pain, swelling, exposure of bone, local infection and pathologic fractures of the jaw. With the widespread usage of bisphosphonates in bone metastasis of malignant tumors and osteoporosis, this rare complication has received more attention in recent years. Here, we reported a case of bisphosphonates-related osteonecrosis of the jaw (BRONJ) caused by intravenous zoledronic acid for osteoporosis. A 62-year-old female patient with 7-year history of Sjögren's syndrome and 3-year history of osteoporosis developed BRONJ after 3-year treatment of zoledronic acid. Two months before she went to the Peking University International Hospital, she visited the dentist for periodontal purulent secretion and extracted one tooth from the right mandible. However, the condition was not improved and she felt persistent pain and swelling in the right mandible. Hence, she received repeated root curettage, but there was no improvement. Finally, she was diagnosed with osteonecrosis of the mandible based on the digital volume tomography scan, which showed right mandibular osteonecrosis bone destruction. She underwent surgical debridement of the necrotic bone and administered intravenous antibio-tics at the Peking University International Hospital. Histopathological analysis of the bone biopsy further confirmed the diagnosis of BRONJ. Her condition was improved successfully during a 3-year follow-up. Osteonecrosis of the mandible become more common with the increased use of bisphosphonates. Recent study has reported that osteonecrosis of the mandible is more likely to occur in patients with Sjögren's syndrome. In addition, age, long-term and irregular administration of glucocorticoids, irregular oral examination and treatment also might be the risk factors in the pathogenesis of osteonecrosis of the mandible. For the elder osteoporosis patients who would receive or had received bisphosphonate-related drugs, oral health status and the disease states associated with necrosis of the mandible such as Sjögren's syndrome should be comprehensively measured and fully evaluated during the whole process. Furthermore, to better understand and prevent or reduce the occurrence of this complication, we reviewed the patho-genesis, diagnosis, treatment, and prevention of BRONJ.
Humans ; Female ; Middle Aged ; Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology* ; Diphosphonates/administration & dosage* ; Zoledronic Acid ; Imidazoles/administration & dosage* ; Bone Density Conservation Agents/adverse effects* ; Osteoporosis/drug therapy*

OBJECTIVE: Referring to the application of the NEH (Nawaz-Enscore-Ham) algorithm in flow shop scheduling, this paper proposes an optimization method of hospital medical consumables discrete scheduling based on the extended NEH algorithm, in order to obtain the optimal medical consumables discrete scheduling scheme and achieve the optimization of medical consumables discrete scheduling. METHODS: Thoroughly analyze the scheduling needs of medical consumables in hospitals, predict the demand for medical consumables in each department. Construct a discrete scheduling optimization model for medical consumables and determine the constraint conditions for building the model (residual coefficient matrix, efficiency constraint matrix, and time window function). Then, solve the discrete scheduling optimization model for medical consumables based on the extended NEH algorithm. RESULTS: By comparison the data before and after the experiment, it is found that the discrete scheduling time and cost of medical consumables in experimental departments have decreased to varying degrees, and all the differences are statistically significant ( P<0.05). CONCLUSION Through experiments, it is known that the optimized medical consumables discrete scheduling scheme proposed meets the requirements of discrete scheduling time and cost, providing a better solution for hospital medical consumables discrete scheduling.
Algorithms ; Materials Management, Hospital ; Appointments and Schedules

Objective: To investigate the epidemic situation of notifiable infectious diseases in Zhejiang Province in 2024, so as to summarize the epidemic characteristics. Methods: Data of notifiable infectious diseases cases in Zhejiang Province from January 1 to December 31, 2024 were collected from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The epidemiological characteristics were analyzed according to the classification and transmission routes using the descriptive epidemiological method. Results: A total of 32 types of notifiable infectious diseases with 1 858 695 cases and 392 deaths were reported in Zhejiang Province in 2024, with a reported incidence of 2 804.73/105 and a reported mortality of 0.591 5/100 000. A total of 238 infectious disease public health emergencies were reported, of which 218 (91.60%) occurred in schools and kindergartens. There were 22 types of class A and B notifiable infectious diseases reported, with incidence of 470.62/100 000 and mortality of 0.591 5/100 000. Totally 10 types of class C notifiable infectious diseases, with a reported incidence of 2 334.11/105, and no deaths were reported. Classified by transmission route, respiratory infectious diseases had the highest reported incidence of 2 423.87/100 000, among which influenza exhibited the highest reported incidence of 2 024.22/100 000. The reported incidence of intestinal infectious diseases was 312.94/105, among which the incidence of other infectious diarrhea and hand-foot-mouth disease (HFMD) were high, with reported incidences of 169.52/100 000 and 136.18/100 000, respectively. Blood-borne and sexually transmitted infectious diseases accounted for the largest number of reported deaths, among which AIDS had the highest mortality of 0.424 0/100 000. Natural and insect-borne infectious diseases exhibited a low reported incidence of 1.37/105. The reported incidence of dengue fever was 0.40/100 000, and 95.08% of the cases were imported. Conclusions The reported incidence of respiratory and intestinal infectious diseases and the reported mortality of AIDS were high in Zhejiang Province in 2024. It is recommended to strengthen the prevention and control of infectious diseases such as influenza, other infectious diarrhea, and HMFD in schools and kindergartens.

Objective To evaluate the efficacy and safety of ozone injection therapy for lumbar disc hemiation(LDH).Methods A computerized retrieval of academic papers concerning the randomized controlled trial(RCT)on ozone injection therapy for LDH from the databases of Embase,PubMed,Cochrane library and Web of science was conducted.The retrieval time period was from the establishment of the database to February 2023.The literature retrieval,screening,and data extraction were independently performed by two researchers.Cochrane bias risk assessment tool was used to assess the quality of the included literature.Stata 17.0 software was used to make meta-analysis.Results A total of 9 RCTs including 702 patients were finally included in this study.The results of meta-analysis showed that compared with radiofrequency thermocoagulation,percutaneous rotation and other treatments for LDH,the combination use of ozone injection could signifiicantly improve the effective rate based on Macnab efficacy evaluation criteria(RR=1.097,95％CI:1.038～1.159,P=0.001)and the excellent rate(RR=1.185～95％CI:1.074～1.309,P=0.001),and decrease the visual analog scale(VAS)pain score(WMD=-0.810～95％CI:-1.205～-0.414,P=0.000),and the differences in the above indexes were statistically significant.Conclusion Compared with the simple use of radiofrequency thermocoagulation,percutaneous rotation,and other treatment for LDH,the combination use of ozone injection therapy can significantly improve the effective rate and excellent rate based on Macnab efficacy evaluation criteria,decrease VAS score,with a high clinical safety.Limited by the quantity and quality of the original studies included in this study,the above conclusions need to be further verified by multi-center,large-sample and high-quality studies.

Objective: To investigate epidemiological characteristics of notifiable infectious diseases in Zhejiang Province in 2023, so as to provide the evidence for strengthening prevention and control of infectious diseases. Methods: Data pertaining to notifiable infectious diseases reported in Zhejiang Province in 2023 were retrieved from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The incidence and mortality were analyzed according to the classification of notifiable infectious diseases and transmission routes, and epidemiological characteristics of infectious diseases were descriptively analyzed. Results: Thirty types of notifiable infectious diseases with 2 955 699 cases and 427 deaths were reported in Zhejiang Province in 2023, with a reported incidence rate of 4 493.93/105 and a reported mortality rate of 0.649 2/105. A total of 679 notifiable infectious disease emergencies were reported, with 26 514 cases and 1 case death (rabies). The emergencies mainly occurred in schools and preschool institutions, with 621 cases accounting for 91.46%. There were 1 case of cholera reported in class A notifiable infectious diseases and no death, 22 types of class B notifiable infectious diseases, with a reported incidence rate of 552.46/105 and a reported mortality rate of 0.644 7/105, and 8 types of class C notifiable infectious diseases, with a reported incidence rate of 3 941.48/105 and a reported mortality rate of 0.004 6/105. The incidence rates of respiratory, intestinal, blood-borne and sexually transmitted, natural and insect-borne infectious diseases were 4 028.67/105, 381.59/105, 81.15/105 and 1.35/105, respectively, according to transmission routes. Influenza (3 561.78/105) and COVID-19 (423.77/105) reported the highest incidence, and AIDS (0.477 4/105) and tuberculosis (0.130 8/105) reported the highest mortality. Conclusion The incidence rates of respiratory and intestinal infectious diseases were high in Zhejiang Province in 2023, and schools and preschool institutions were the main places of diseases occurred.

Objective: To investigate the characteristics of public health emergencies in Zhejiang Province in 2023, so as to provide the reference for public health risk management. Methods: Data of public health emergencies and related information in Zhejiang Province from January 1 to December 31, 2023 was collected through Emergency Public Reporting System of Chinese Disease Prevention and Control Information System. Attack rates, disease types, distribution of time and places, and responses were descriptively analyzed. Results: A total of 718 public health emergencies were reported in 2023 in Zhejiang Province, and all were infectious disease events. There were 27 128 reported cases and 3 deaths, with an attack rate of 3.22%. The top five infectious diseases with the highest number of reported events were influenza, norovirus infection, monkeypox, varicella and hand, foot and mouth disease, accounting for 95.54% of total reported events. There were 355 public health emergencies with less than 30 cases each, accounting for 49.44%. The reported emergencies peaked from February to March (186 events, 25.91%) and from November to December (327 events, 45.54%), and mainly occurred in schools and preschool institutions (651 events, 90.67%). The median responding time, reporting time and duration of emergencies were 6.50 (interquartile range, 10.84) h, 0.53 (interquartile range, 0.63) h and 7.24 (interquartile range, 11.71) d, respectively. Conclusion Public health emergencies in Zhejiang Province in 2023 were mainly caused by influenza and norovirus infection, with February, March, November and December being the peak reporting periods, and schools and preschool institutions being the main places where these events occurred.

Phospholipase Cζ (PLCζ) is composed of XY domain, EF-hand domains and a C2 domain, which specifically hydrolyzes phosphatidylinositol (4,5)-bisphosphate (PIP 2) in the oocyte cytoplasm but not on the plasma membrane through the classical PIP 2→(1,4,5)-inositol trisphosphate (IP 3)+diacylglycerol (DAG) signal transduction pathway, which causes oscillation of calcium ion in oocytes, and plays an irreplaceable role in activating oocytes and initiating gamete development. Clinical data have shown that the reduced or absent expression level of PLCζ can lead to the inability of sperm activating oocytes and are closely related to various sperm abnormalities, ultimately leading to male subfertility and even infertility. In summary, this article reviews the structure and biological functions of PLCζ, the clinical diseases caused by abnormal PLCζ and their following therapeutic progresses.

Objective:To explore the different metabolites in the follicular fluids (FFs) of polycystic ovary syndrome (PCOS) patients and non-PCOS patients and their effects on the maturation of mouse oocytes and the developmental potential of in vitro fertilization (IVF) embryos. Methods:The clinical data were collected for the retrospective cohort study. Animal experiments were conducted in a randomized controlled trial. This study included PCOS ( n=71) and non-PCOS ( n=70) patients who underwent the first IVF or intracytoplasmic sperm injection (ICSI) cycle in Shanghai JIAI Genetics & IVF institute from June 2019 to June 2020. The patients' FFs were collected and the clinical data from these patients were analyzed. Raman spectroscopy analysis technology was used to detect differences in the metabolic spectra of FFs between the two groups. Mouse GV phase oocytes were placed in FFs from PCOS patients and non-PCOS patients for in vitro maturation (IVM) culture respectively, then the matured mouse oocytes were collected for IVF. The effects of differential metabolites in FFs on mouse oocyte maturation and embryonic development were further explored. The Raman spectrum was also applied to identify the differences of the IVM spent culture media. Results:The MⅡ rate [82.19% (886/1 078)] and day 3 available embryo rate [51.30% (553/1 078)] from PCOS group were significantly lower than those of the non-PCOS group [85.85% (625/728), P=0.038; 53.30% (388/728), P=0.042]. However, there were no significant differences between the two groups in the cumulative clinical pregnancy rate and the cumulative live birth rate (all P>0.05). Raman was capable of distinguishing PCOS from non-PCOS FFs. The characteristic Raman displacement difference between the two groups is mainly concentrated in the 600-1 000 cm -1, as well as 1 168 cm -1, 1 344 cm -1, 1 440 cm -1, 1 504 cm -1, 1 632 cm -1 and 1 664 cm -1. The Raman characteristic shift database showed that the different metabolites of the two sets of FFs samples were mainly concentrated in protein, lipids, free nucleic acis, glucose, cholesterol, carotenoids, and amino acids. Mouse oocyte IVM results showed that the PCOS-FF group had a lower MⅡ rate [49.04% (77/157)] than that of non-PCOS group [65.07% (95/146), P=0.005). IVF results showed the PCOS-FF group had a significantly lower cleavage rate [46.75% (36/77)] than that of non-PCOS group [63.16% (60/95), P=0.031], but there was no significant difference in the blastocyst rate between the two groups ( P>0.05). Conclusion:Differential metabolites detected by Raman spectrum in the PCOS FFs may cause defected maturation of the oocytes, leading to infertility, and Raman spectroscopy is an effective approach towards PCOS diagnosis and the identification of metabolomics differences.

Phospholipase Cζ (PLCζ) is composed of XY domain, EF-hand domains and a C2 domain, which specifically hydrolyzes phosphatidylinositol (4,5)-bisphosphate (PIP 2) in the oocyte cytoplasm but not on the plasma membrane through the classical PIP 2→(1,4,5)-inositol trisphosphate (IP 3)+diacylglycerol (DAG) signal transduction pathway, which causes oscillation of calcium ion in oocytes, and plays an irreplaceable role in activating oocytes and initiating gamete development. Clinical data have shown that the reduced or absent expression level of PLCζ can lead to the inability of sperm activating oocytes and are closely related to various sperm abnormalities, ultimately leading to male subfertility and even infertility. In summary, this article reviews the structure and biological functions of PLCζ, the clinical diseases caused by abnormal PLCζ and their following therapeutic progresses.

Objective:To explore the different metabolites in the follicular fluids (FFs) of polycystic ovary syndrome (PCOS) patients and non-PCOS patients and their effects on the maturation of mouse oocytes and the developmental potential of in vitro fertilization (IVF) embryos. Methods:The clinical data were collected for the retrospective cohort study. Animal experiments were conducted in a randomized controlled trial. This study included PCOS ( n=71) and non-PCOS ( n=70) patients who underwent the first IVF or intracytoplasmic sperm injection (ICSI) cycle in Shanghai JIAI Genetics & IVF institute from June 2019 to June 2020. The patients' FFs were collected and the clinical data from these patients were analyzed. Raman spectroscopy analysis technology was used to detect differences in the metabolic spectra of FFs between the two groups. Mouse GV phase oocytes were placed in FFs from PCOS patients and non-PCOS patients for in vitro maturation (IVM) culture respectively, then the matured mouse oocytes were collected for IVF. The effects of differential metabolites in FFs on mouse oocyte maturation and embryonic development were further explored. The Raman spectrum was also applied to identify the differences of the IVM spent culture media. Results:The MⅡ rate [82.19% (886/1 078)] and day 3 available embryo rate [51.30% (553/1 078)] from PCOS group were significantly lower than those of the non-PCOS group [85.85% (625/728), P=0.038; 53.30% (388/728), P=0.042]. However, there were no significant differences between the two groups in the cumulative clinical pregnancy rate and the cumulative live birth rate (all P>0.05). Raman was capable of distinguishing PCOS from non-PCOS FFs. The characteristic Raman displacement difference between the two groups is mainly concentrated in the 600-1 000 cm -1, as well as 1 168 cm -1, 1 344 cm -1, 1 440 cm -1, 1 504 cm -1, 1 632 cm -1 and 1 664 cm -1. The Raman characteristic shift database showed that the different metabolites of the two sets of FFs samples were mainly concentrated in protein, lipids, free nucleic acis, glucose, cholesterol, carotenoids, and amino acids. Mouse oocyte IVM results showed that the PCOS-FF group had a lower MⅡ rate [49.04% (77/157)] than that of non-PCOS group [65.07% (95/146), P=0.005). IVF results showed the PCOS-FF group had a significantly lower cleavage rate [46.75% (36/77)] than that of non-PCOS group [63.16% (60/95), P=0.031], but there was no significant difference in the blastocyst rate between the two groups ( P>0.05). Conclusion:Differential metabolites detected by Raman spectrum in the PCOS FFs may cause defected maturation of the oocytes, leading to infertility, and Raman spectroscopy is an effective approach towards PCOS diagnosis and the identification of metabolomics differences.