ObjectiveTo systematically assess the public health governance capacity in Zhejiang Province, to conduct an in-depth analysis of its strengths and weaknesses, so as to provide scientific basis and strategic recommendations for further enhancement. MethodsA systematic collection of policy documents, public information reports, and research literature related to public health governance capacity in Zhejiang Province from 2002 to 2023 was conducted (encompassing a total of 1 263 policy documents, 138 pieces of information reports and 631 research articles). Based on the evaluation criteria suitable for public health systems previously developed by the research team, the basic status and magnitude of change in public health governance capacity in Zhejiang Province was evaluated. Additionally, normative gap analyses were employed to identify the strengths and weaknesses. ResultsZhejiang Province ranked 4th nationwide in terms of public health governance capacity with a score of 733.4 points (1 000.0-point maximum). The province has effectively implemented the principle of health first (scoring 698.5 points in the assessment of health-first strategy implementation) and attached sufficient importance to health-related goals (scoring 658.2 points in the scientific rationality of goal setting). However, the implementation of inter-departmental coordination and incentive mechanisms only scored 178.7 points, the feasibility of management and monitoring mechanisms scored even lower at only 144.0 points, and the coverage of incentive mechanisms scored 286.0 points. ConclusionZhejiang Province has effectively implemented its health first strategy and attached great importance to health targets, but still needs to strengthen cross-departmental coordination mechanisms and health-oriented incentives.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Human cytomegalovirus (HCMV) poses a significant risk of neural damage during pregnancy. As the most prevalent intrauterine infectious agent in low- and middle-income countries, HCMV disrupts the development of neural stem cells, leading to fetal malformations and abnormal structural and physiological functions in the fetal brain. This review summarizes the current understanding of how HCMV infection dysregulates the Wnt signaling pathway to induce fetal malformations and discusses current management strategies.
Humans ; Cytomegalovirus Infections/virology* ; Wnt Signaling Pathway ; Pregnancy ; Female ; Cytomegalovirus/physiology* ; Pregnancy Complications, Infectious/virology* ; Congenital Abnormalities/virology* ; Animals

Objective:To analyze the effects of parenting care map of premature infants on parenting competence and parenting stress of primipara, with a view to providing a theoretical basis for the development, implementation and modification of clinical interventions.Methods:Convenient sampling method was used to select primigravid women who gave birth in Lishui Maternal and Child Health Hospital from January 2023 to January 2024 for randomized controlled study, which was divided into the observation group and the control group according to the random number table. The control group received routine nursing, and the observation group guided the parents of premature infants to draw the child care map together on the basis of the control group. The scores of Chinese version of parenting sense of competence scale ( C-PSOC ) and Chinese version of Simplified Parenting Stress Index ( PSI-SF ) before and after intervention were compared.Results:A total of 120 cases of primiparous women who met the inclusion and exclusion criteria were enrolled, 60 cases in the control group and 60 cases in the observation group. The age of the control group was (26.25 ± 3.93) years, and the age of the observation group was (25.86 ± 4.22) years. Before the intervention, the difference between the C-PSOC dimension scores and total scores, PSI-SF dimension scores and total scores of the 2 groups was not statistically significant (all P>0.05). After the intervention, the maternal C-PSOC efficacy, satisfaction dimension scores and total scores of primiparous women in the observation group were (32.05 ± 6.27), (40.29 ± 8.19), and (72.23 ± 9.39) points, respectively, which were higher than those of the control group, which were (28.46 ± 6.47), (37.08 ± 8.06), and (65.53 ± 10.24) points, and the differences between the 2 groups were all statistically significant ( t = 3.09, 2.16, 3.74, all P<0.05). After the intervention, the PSI-SF scores and total scores of primiparous women in the observation group on the dimensions of parental distress, personal interaction disorder, and difficult child were (24.43 ± 5.44), (27.51 ± 6.53), (29.47 ± 5.82), and (81.54 ± 10.38) points, respectively, which were lower than those of the control group (28.57 ± 5.52), (30.19 ± 7.02), (32.78 ± 5.37), and (90.97 ± 10.12) points, and the differences between the 2 groups were all statistically significant ( t = 4.41, 2.17, 3.23, 5.04, all P<0.05). Conclusions:Premature child care map can effectively improve the parenting sense of competence of primiparas and reduce their parenting pressure. It is a convenient and effective nursing intervention tool.

Objective To explore the thoughts and experiences of exercise adherence in breast cancer patients undergoing endocrine therapy,aims to provide reference for targeted intervention.Methods Employing purposive sampling,a descriptive qualitative study was conducted from Octomber 2023 to November 2024,and 24 breast cancer patients receiving endocrine therapy who visited a tertiary-level hospital in Tianjin,China,were selected for semi-structured in-depth interviews.The data was analyzed through traditional content analysis to extract themes.Results 3 primary themes and 6 sub-themes were identified,including sense of benefits from exercise(including physical benefits and psychological well-being),factors influencing exercise adherence(barriers and facilitators),and supportive needs for exercise adherence(including professional support and guidance,as well as emotional support and companionship).Conclusion Healthcare providers should consider the influencing factors,supportive needs of behavior change,and exercise experiences of breast cancer patients receiving endocrine therapy.Developing targeted exercise rehabilitation programs to address these needs could enhance exercise adherence.

Objective To design and synthesize derivatives of oleanolic acid and ursolic acid, and investigate their anti-hepatitis C virus （HCV） activity along with that of common triterpenoid acids. To explore the structure-activity relationship and provide a reference for the research of anti-HCV drugs derived from natural products through obtaining compounds with higher activity. Methods Oleanolic acid and ursolic acid were directly reacted with corresponding amines using PyBOP as a condensing agent in the presence of DIEA. Alternatively, the target compounds were prepared through PCC oxidation followed by the Baeyer-Villiger reaction catalyzed by m-CPBA. In vitro anti-HCV activity was tested using the HCVcc infection model. Molecular docking was performed by Autodock software to investigate the interaction between the active compounds and HCV NS5B. Results Oleanolic acid, glycyrrhetinic acid, ursolic acid, and asiatic acid all exhibited certain anti-HCV effects. Specifically, oleanolic acid derivatives OA2-OA4, OA6, and OA7, as well as ursolic acid derivatives UA1 and UA2, demonstrated superior anti-HCV activity compared to their parent compounds. Preliminary structure-activity relationship analysis revealed that introducing a bulky group to 28-COOH of oleanolic acid and ursolic acid enhanced their activity. Molecular docking results demonstrated that the active compounds could stably bind to HCV NS5B, thereby exhibiting antiviral activity. Conclusion Pentacyclic triterpenoids possessed anti-HCV effects, and their derivatives coud be synthesized to obtain more active compounds. The anti-HCV mechanism of these compounds may be associated with their inhibition of NS5B.

Objective To explore the thoughts and experiences of exercise adherence in breast cancer patients undergoing endocrine therapy,aims to provide reference for targeted intervention.Methods Employing purposive sampling,a descriptive qualitative study was conducted from Octomber 2023 to November 2024,and 24 breast cancer patients receiving endocrine therapy who visited a tertiary-level hospital in Tianjin,China,were selected for semi-structured in-depth interviews.The data was analyzed through traditional content analysis to extract themes.Results 3 primary themes and 6 sub-themes were identified,including sense of benefits from exercise(including physical benefits and psychological well-being),factors influencing exercise adherence(barriers and facilitators),and supportive needs for exercise adherence(including professional support and guidance,as well as emotional support and companionship).Conclusion Healthcare providers should consider the influencing factors,supportive needs of behavior change,and exercise experiences of breast cancer patients receiving endocrine therapy.Developing targeted exercise rehabilitation programs to address these needs could enhance exercise adherence.

Objective:To analyze the effects of parenting care map of premature infants on parenting competence and parenting stress of primipara, with a view to providing a theoretical basis for the development, implementation and modification of clinical interventions.Methods:Convenient sampling method was used to select primigravid women who gave birth in Lishui Maternal and Child Health Hospital from January 2023 to January 2024 for randomized controlled study, which was divided into the observation group and the control group according to the random number table. The control group received routine nursing, and the observation group guided the parents of premature infants to draw the child care map together on the basis of the control group. The scores of Chinese version of parenting sense of competence scale ( C-PSOC ) and Chinese version of Simplified Parenting Stress Index ( PSI-SF ) before and after intervention were compared.Results:A total of 120 cases of primiparous women who met the inclusion and exclusion criteria were enrolled, 60 cases in the control group and 60 cases in the observation group. The age of the control group was (26.25 ± 3.93) years, and the age of the observation group was (25.86 ± 4.22) years. Before the intervention, the difference between the C-PSOC dimension scores and total scores, PSI-SF dimension scores and total scores of the 2 groups was not statistically significant (all P>0.05). After the intervention, the maternal C-PSOC efficacy, satisfaction dimension scores and total scores of primiparous women in the observation group were (32.05 ± 6.27), (40.29 ± 8.19), and (72.23 ± 9.39) points, respectively, which were higher than those of the control group, which were (28.46 ± 6.47), (37.08 ± 8.06), and (65.53 ± 10.24) points, and the differences between the 2 groups were all statistically significant ( t = 3.09, 2.16, 3.74, all P<0.05). After the intervention, the PSI-SF scores and total scores of primiparous women in the observation group on the dimensions of parental distress, personal interaction disorder, and difficult child were (24.43 ± 5.44), (27.51 ± 6.53), (29.47 ± 5.82), and (81.54 ± 10.38) points, respectively, which were lower than those of the control group (28.57 ± 5.52), (30.19 ± 7.02), (32.78 ± 5.37), and (90.97 ± 10.12) points, and the differences between the 2 groups were all statistically significant ( t = 4.41, 2.17, 3.23, 5.04, all P<0.05). Conclusions:Premature child care map can effectively improve the parenting sense of competence of primiparas and reduce their parenting pressure. It is a convenient and effective nursing intervention tool.

OBJECTIVE To establish a GC-MS/MS analytical method for the determination of 1-chloroethyl cyclohexyl carbonate in candesartan cilexetil tablets. METHODS The analytical column was DB-5MS(30 m×0.25 mm, 0.25 μm). The column temperature was maintained at 80 ℃, then was raised to 300 ℃ at the rate of 20 ℃·min–1 and was maintained for 5 min. Helium was used as carrier gas, and its flow rate was 1.0 mL·min–1. The detection was achieved in multiple reaction monitoring mode. RESULTS The calibration curve of 1-chloroethyl cyclohexyl carbonate had good linearity in the concentration range of 4.4−437.8 ng·mL–1. The limits of quantification and detection were 4.4 and 2.2 ng·mL–1, respectively. The average recovery was 95.6%(RSD=6.3%, n=9). CONCLUSION This method has satisfactory convenience, good sensitivity and high accuracy, and it is suitable for the determination of 1-chloroethyl cyclohexyl carbonate in candesartan cilexetil tablets.