BACKGROUND:Chitosan has a place in the biomedical field due to its good biological properties and unique physicochemical properties,especially in tissue engineering and drug delivery with good application prospects.OBJECTIVE:To summarize the research progress of the role of chitosan in the repair and regeneration of oral soft and hard tissues.METHODS:A computerized search of CNKI and PubMed databases was performed with the search terms"chitosan,oral mucosal diseases,periodontal diseases,tissue regeneration,bacteriostatic,drug carrier,wound healing"in Chinese and English.The search time limit was from 2010 to 2024.After screening according to the inclusion and exclusion criteria,88 articles were finally included for summary analysis.RESULTS AND CONCLUSION:Chitosan is a promising biomaterial in bone and pulp regeneration as it has the ability to stimulate the recruitment and adhesion of osteogenic progenitor cells and dental pulp stem cells.Chitosan prevents caries,periodontal disease,and candidiasis by inhibiting Streptococcus pyogenes,Porphyromonas gingivalis,and Candida in the oral cavity.Chitosan nanocomposites have higher stability,better biocompatibility,and slow-release properties of drugs and can be enhanced by combining with other chemical reagents to enhance their anticancer properties.Chitosan possesses drug delivery,antibacterial activity,hemostasis and wound healing,which in turn can block the erosion of wounds by saliva and oral flora,relieve pain,repair and promote wound healing.Chitosan promotes the deposition of calcified material,which is conducive to the remineralisation of enamel and dentin.

Objective: To explore the association of outdoor activity time and sleep duration with screening myopia in primary school students, so as to provide strategies for myopia prevention. Methods: Through a convenience sampling method, a survey was conducted among 4 248 primary school students aged 7-13 years from three primary schools in Xihu District, Nanchang City, Jiangxi Province from May to July, 2023. The average daily outdoor activity time and sleep duration on both weekdays and weekends were investigated in primary school students by using a self designed questionnaire. Uncorrected visual acuity tests and non cycloplegic autorefraction were measured by professional optometrists. Inter group comparisons were conducted using the Chi square test. Logistic regression model was used to analyze the association of outdoor activity time and sleep duration with screening myopia. Results: The detection rate of screening myopia in primary school students was 33.6%, with the rate in boys (32.0%) lower than that in girls (35.3%), and the difference was statistically significant ( χ 2=5.11, P =0.02). The analysis results of Logistic regression showed that after adjusting for factors such as gender, grade and parental education level, both average daily outdoor activity time ＜2 h on both weekdays and weekends ( OR =1.27, 95% CI =1.11-1.46) and sleep duration <10 h ( OR =1.17, 95% CI =1.01- 1.35 ), as well as their combined effect ( OR =1.57, 95% CI =1.25-1.98), were associated with an increased risk of screening myopia in primary school students(all P <0.05). Subgroup analysis results indicated that compared to boys ( OR =1.46, 95% CI = 1.07 -1.99), girls( OR =1.73, 95% CI =1.22-2.44) with insufficient outdoor activity time and sleep duration had a higher risk of screening myopia(both P <0.05). Conclusions There is a negative correlation of outdoor activity time and sleep duration with screening myopia in primary school students. Outdoor activity time and extending sleep duration should be increased to reduce the risk of myopia in primary school students.

Neonatal diabetes mellitus （NDM） is a rare monogenic disorder primarily caused by insufficient insulin secretion resulting from mutations in the KCNJ11 and ABCC8 genes. Sulfonylureas， represented by glibenclamide， have become the standard therapy for this type of NDM by precisely closing the mutated ATP-sensitive potassium channels in pancreatic β cells， thereby restoring insulin secretion. Clinical studies confirm that sulfonylureas enable over 90% of patients to successfully transition from insulin to oral treatment， achieving long-term stable glycemic control and improving neurological outcomes to a certain extent. In terms of safety， severe hypoglycemia induced by sulfonylureas is relatively rare and gastrointestinal reactions are mild； moreover， sulfonylureas show good long-term tolerability， and have no adverse effects on child growth and development. In the future， by further refining the full-chain management pathway of “rapid genetic diagnosis-early intervention-specialized dosage forms-long-term follow-up”， the clinical application of sulfonylureas is expected to provide NDM patients with an optimized treatment regimen and maximize their health benefits.

BACKGROUND:Chitosan has a place in the biomedical field due to its good biological properties and unique physicochemical properties,especially in tissue engineering and drug delivery with good application prospects.OBJECTIVE:To summarize the research progress of the role of chitosan in the repair and regeneration of oral soft and hard tissues.METHODS:A computerized search of CNKI and PubMed databases was performed with the search terms"chitosan,oral mucosal diseases,periodontal diseases,tissue regeneration,bacteriostatic,drug carrier,wound healing"in Chinese and English.The search time limit was from 2010 to 2024.After screening according to the inclusion and exclusion criteria,88 articles were finally included for summary analysis.RESULTS AND CONCLUSION:Chitosan is a promising biomaterial in bone and pulp regeneration as it has the ability to stimulate the recruitment and adhesion of osteogenic progenitor cells and dental pulp stem cells.Chitosan prevents caries,periodontal disease,and candidiasis by inhibiting Streptococcus pyogenes,Porphyromonas gingivalis,and Candida in the oral cavity.Chitosan nanocomposites have higher stability,better biocompatibility,and slow-release properties of drugs and can be enhanced by combining with other chemical reagents to enhance their anticancer properties.Chitosan possesses drug delivery,antibacterial activity,hemostasis and wound healing,which in turn can block the erosion of wounds by saliva and oral flora,relieve pain,repair and promote wound healing.Chitosan promotes the deposition of calcified material,which is conducive to the remineralisation of enamel and dentin.

Transthyretin cardiac amyloidosis (ATTR-CA) is a restrictive cardiomyopathy caused by the abnormal deposition of transthyretin (TTR) in the myocardial interstitium, which often manifests as heart failure, atrial fibrillation, and conduction disorders. The significant heterogeneity of its clinical presentation poses a major challenge to accurate diagnosis. The dissociation of the TTR tetramer is the key initiating step of amyloid deposition in ATTR-CA, but the TTR tetramer is not currently included among the clinically applied biomarkers. This article systematically reviews the conventional biomarkers for ATTR-CA and focuses on discussing the potential value of the TTR tetramer as a novel indicator. Investigating the concentration, peak profile, and dissociation rate of the TTR tetramer is of great value for achieving early identification, risk stratification, and prognostic judgment of ATTR-CA.

Objective:To evaluate the clinical efficacy of Cai's gynecological nourishing kidney therapy for patients with diminished ovarian reserve (DOR).Methods:A randomly controlled trail was conducted. A total of 63 patients with DOR who were treated in the gynecology outpatient clinic of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine from September 2020 to January 2022 were set as observation subjects, and were divided into control group ( n=31) and observation group ( n=32) according to the random number table method. The patients in the control group were treated with Femoston, and the patients in the observation group were treated with Cai's gynecological nourishing kidney therapy on the basis of Femoston treatment. Both groups were treated for 3 menstrual cycles. Both antral follicle count (AFC) was performed by vaginal ultrasound, serum levels of TGF-β1, IL-1β, IL-2, IL-6 and IL-21 were detected by ELISA, and serum levels of FSH, LH, E2, anti-Müllerian hormone (AMH) and MDA were detected by biochemical methods. The TCM syndrome score was used to evaluate the severity of symptoms, and the menstrual score was used to evaluate the abnormal menstruation. Clinical efficacy was evaluated. Results:The total effective rate was 87.50% (28/32) in the observation group and 58.06% (18/31) in the control group, with statistical significance ( χ2=8.42, P=0.004). After treatment, the AFC in the observation group (3.93±2.32 vs. 2.21±2.18, t=3.03) was higher than that of the control group ( P<0.01). After treatment, the serum FSH level of the observation group [10.05 (8.35, 21.48) IU/L vs. 20.60 (8.00, 43.30) IU/L, Z=2.18] was lower than that of the control group ( P<0.05), and the level of AMH [0.19 (0.03, 0.47) μg/L vs. 0.02 (0.01, 0.24) μg/L, Z=-1.54] in the observation group was higher than that of the control group ( P<0.05). The serum levels of TGF-β1 [(68.27±11.76) ng/L vs. (55.33±13.03) ng/L, t=4.14] and IL-1β [(58.00±7.53) ng/L vs. (52.31±8.06) ng/L, t=2.89] in the observation group were higher than those in the control group, and the levels of IL-6 [(33.26±7.45) ng/L vs. (40.69±11.69) ng/L, t=3.02], the level of IL-21 [(118.37±15.56) ng/L vs. (140.43±25.51) ng/L, t=-4.04] was lower than that of the control group ( P<0.01). Conclusions:Cai's gynecological nourishing kidney therapy combined with Fenmaotong can effectively increase the AFC of DOR patients and improve clinical efficacy. Its mechanism of action may be related to reducing serum FSH and LH levels and increasing E2 levels.

Objective To investigate status of postoperative kinesiophobia in patients with ankle fracture and to identify the factors influencing kinesiophobia,thereby offering references for developing targeted nursing interventions.Methods A cross-sectional study was conducted between June 2023 and May 2024.With convenience sampling,338 first-time ankle fracture patients who received surgical treatment were recruited from a Tier-IIIA orthopaedic hospital in Xinjiang.Data was collected among the patients at 24 hours after surgery through the general information questionnaire,kinesiophobia scoring scale,pain visual analogue scale,hospital anxiety and depression scale,social support rating scale and general self-efficacy scale.Logistic regression was employed to identify factors influencing kinesiophobia.Results A total of 320 patients completed the study.The prevalence among the patients with kinesiophobia was 38.1%,and scored at(39.6±1.5).Logistic regression analysis identified that the pain,social support and self-efficacy were the independent risk factors of kinesiophobia(all P<0.05).Conclusion Patients with ankle fractures have a high prevalence of postoperative kinesiophobia.Pain,social support and self-efficacy are the key factors that influence kinesiophobia.Intervention strategies should be adopted in response to the influencing factors in order to promote the recovery of patients.

Objective To explore the effectiveness of a hospital-to-home transitional health management program for caregivers of children with severe encephalitis,aiming to provide a reference for optimizing transitional care models for these patients.Methods A convenience sampling method was used to select 84 children with severe encephalitis and their caregivers admitted to the neurology department of a tertiary hospital in Zhengzhou between March 2023 and June 2024.According to the admission time,they were divided into an experimental group and a control group,with 42 cases in each group.The experimental group received a hospital-to-home transitional health management program in addition to routine care,while the control group received standard care and discharge instructions.Differences in caregivers' perceived benefits,caregiver burden,disease management ability,and post-intervention outcomes of the children were compared between the 2 groups before and after the intervention.Results All 42 participants in both groups completed the study.After the intervention,the experimental group reported higher perceived benefits of(91.29±9.76)compared to(84.81±12.86)in the control group,lower caregiver burden of(48.55±7.15)compared to(54.71±11.23)in the control group,greater disease management ability of(41.83±4.97)than(37.79±5.23)in the control group,and lower difficulty in disease management of(31.52±7.82)compared to(34.55±3.96)in the control group,with all differences being statistically significant(P＜0.05).No statistically significant difference was found in the prognosis of the children between the 2 groups(P=0.500).Conclusion The hospital-to-home transitional health management program can effectively enhance caregivers'perceived benefits and disease management capabilities,reduce their caregiving burden,and provide scientific evidence for optimizing transitional care for children with severe encephalitis.

Addressing the enduring challenge of evaluating traditional Chinese medicines (TCMs), the integrated evidence chain-based effectiveness evaluation of TCMs (Eff-iEC) has emerged. This paper explored its capacity through a demonstration study that evaluated the effectiveness evidence of six commonly used anti-hepatic fibrosis Chinese patent medicines (CPMs), including Biejiajian Pill (BP), Dahuang Zhechong Pill (DZP), Biejia Ruangan Compound (BRC), Fuzheng Huayu Capsule (FHC), Anluo Huaxian Pill (AHP), and Heluo Shugan Capsule (HSC), using both Eff-iEC and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. The recognition of these CPMs within the TCM academic community was also assessed through their inclusion in relevant medical documents. Results showed that the evidence of BRC and FHC received higher assessments in both Eff-iEC and GRADE system, while the assessments for others varied. Analysis of community recognition revealed that Eff-iEC more accurately reflects the clinical value of these CPMs, exhibiting superior evaluative capabilities. By breaking through the conventional pattern of TCMs effectiveness evaluation, Eff-iEC offers a novel epistemology that better aligns with the clinical realities and reasoning of TCMs, providing a coherent methodology for clinical decision-making, new drug evaluations, and health policy formulation.

Metastatic dissemination is the major cause of death from breast-cancer (BC). Fusobacterium nucleatum (F.n) is widely enriched in BC and has recently been identified as one of the high-risk factors for promoting BC metastasis. Here, with an experimental model, we demonstrated that intratumoral F.n induced BC aggressiveness by transcriptionally activating Epithelial-mesenchymal transition-associated genes. Therefore, the F.n may be a potential target to prevent metastasis. Given the fact that cancer-associated fibroblasts (CAFs) are abundant in BC and located near blood vessels, we report an optogenetic system that drives CAF to in situ produce human antibacterial peptide LL37, with the characteristics of biosafety and freely intercellular trafficking, for depleting intratumoral F.n, leading to a 72.1% reduction in lung metastatic nodules number without affecting the balance of the systemic flora. Notably, mild photothermal treatment was found that could normalize CAF, contributing to synergistically inhibiting BC metastasis. In addition, the system can also simultaneously encode a gene of TNF-related apoptosis-inducing ligand to suppress the primary tumor. Together, our study highlights the potential of local elimination of tumor pathogenic bacteria to prevent BC metastasis.