Objective:To explore the medication law of TCM external therapy for the treatment of diabetic foot using data mining methods.Methods:Literature on TCM external treatment for diabetic foot was retrieved from CNKI, Wanfang Data, and Chongqing VIP from the establishment of the databases to June 30, 2024. Excel 2019 software was used to conduct frequency statistics on drug frequency, properties, tastes and meridian tropism, drug efficacy, and commonly used drug pairs. Ancient and Modern Medical Cases Cloud Platform V3.5 was used for association rules, and SPSS Statistics 27.0 was used for complex network analyses.Results:A total of 425 articles were included, involving 328 prescriptions and 232 drugs. The drugs with higher frequency were Carthami Flos, Angelicae Sinensis Radix, Cinnamomi Ramulus, Olibanum, etc. The main tastes were pungent, bitter, and sweet; the main properties were cold and warm; the main meridians were heart, spleen, and liver meridians. The main efficacy was promoting blood circulation and removing blood stasis, clearing heat, and tonifying deficiency; association rule analysis obtained 20 commonly used drug pairs; clustering analysis resulted in four core drug combinations; complex network analysis led to one core prescription.Conclusions:TCM external therapy for diabetic foot follows the guiding principles of "promoting blood circulation and unblocking collaterals, tonifying deficiency and clearing heat" with coordinated regulation of the "heart-liver-spleen meridians". The core prescription and stage-specific formulation strategies reflect a trinity diagnostic and therapeutic approach of "disease differentiation-syndrome differentiation-stage differentiation", providing valuable reference and insights for clinical prescription practices.

Objective:Micro-and nanostructures with sharp disordered and rounded ordered features were fabricated on titanium surfaces,respectively,and their osteogenic potential was evaluated both in vitro and in vivo.Methods:Sharp disordered titanium surfaces(SLA-Ti)and rounded ordered titanium surfaces(Laser-Ti)were prepared using sandblast acid etching and high-repeti-tion-rate femtosecond laser,respectively.Smooth titanium(Ti)was used as the control group,SLA-Ti and Laser-Ti were used as the experimental groups.Characterization was conducted using scanning electron microscopy coupled with hydrophilicity assess-ments.The adhesion,elongation,and osteogenic differentiation capabilities of osteoblasts in vitro were evaluated through cell mor-phology observations,cytoskeletal fluorescence staining,cell viability assays,and PCR experiments.Osteogenic potential in vivo of rabbits was assessed through Micro CT scans and histological staining(HE and Masson).Results:The surface of Laser-Ti exhibits a rounded,ordered,multi-scale micro-and nano-morphology with the best hydrophilicity(P＜0.01).In vitro,it promotes cell adhe-sion,extension,and osteogenic differentiation,while in vivo,it enhances bone regeneration around the implants.Overall,a trend of Laser-Ti＞SLA-Ti＞Ti is observed,with a higher bone volume fraction(BV/TV)(P＜0.05),greater trabecular thickness(Tb.Th)(P＜0.05),an increased number of trabeculae(Tb.N)(P＜0.05),and a larger area of bone around the implants(P＜0.05).Conclusion:The rounded ordered micro-and nano-structures fabricated using high-repetition-rate fem-tosecond laser demonstrate enhanced osteoinductive capac-ity both in vitro and in vivo.

Objective To analyze the virulence genes and antibiotics resistance of Escherichia coli(E.coli)isolates cause urinary tract infection(USI)in children,and further understand the epidemiological characteristics of E.coli isolates in children with USI.Methods Children with urinary system infection admitted to Quanzhou Maternity and Child Health Care Hospital&Children's Hospital from January to December 2021 were collected.E.coli was isolated from urine,and the drug sensitivity of the E.coli to 15 commonly used clinical antibiotics was detected by instruments.Among them,33 strains of E.coli that showed Extended-spectrum beta-lactamase(ESBL)production were increased,genomic DNA was extracted,and the whole genome sequence of the strains was analyzed by high-throughput sequencing technology.Results In the gene sequence analysis of 33 strains of E.coli,86 virulence genes were obtained,and the bacterial structural virulence genes accounted for the most(43/86),including capsular,fimbriae and cell-membrane system,followed by functional virulence genes and toxigenic genes,while fimH,fdeC and terC virulence genes had the highest detection rates.In the analysis of drug resistance,Cefazolin(96.97%)was the most resistant,and carbapenems were also found to be resistant.In addition,39 inactivation genes,18 target alteration genes and 51 e?ux system genes were obtained.The most information related to antibiotic e?ux(1 273/1 815),mainly RND and MFS superfamily e?ux pumps.There were 19～43 drug resistance genes in each E.coli genome.A variety of β-lactamase resistance genes were found,in which CTX-M/EC/TEM gene family dominated.Conclusion In the urine isolation of ESBL-producing E.coli in USI children,the β-lactamase should continue to be monitored.Virulence genes fimH,fdeC,terC and acrAB/emrAB/mdtABC-TolC e?ux pump gene detected higherratio,should be more attention.

Cancer is one of the major diseases of high morbidity and mortality worldwide,and its therapeutic approaches are facing great challenges.Immunotherapy,especially the activation of innate immunity represented by the cGAS-STING signaling pathway,is the current research hotspot in tumor immunotherapy.Activation of innate immune response by gas therapy is the latest development in tumor therapeutic approaches,especially the use of gas signaling molecules(NOx CO,H2S and SO2)to activate the cGAS-STING signaling pathway to induce intrinsic immunity of the organism,which leads to anti-tumor immunotherapy.Although intrinsic immunity activated by gas signaling molecules plays an important role in tumor immunotherapy,few reviews have been reported on its association with the cGAS-STING signaling mechanism.In this paper,we will comprehensively describe how gas signaling molecules damage the mitochondrial matrix and DNA damage through oxidative/nitrosative stress,thereby activating the cGAS-STING signaling pathway and triggering the innate immune cascade,aiming to summarize the process of activation of anti-tumor immune effects by gas signaling molecules,and to provide more references for the gas therapies in the future anti-tumor immunity research.

Objective·To explore the efficacy of the XP-Endo Shaper(XPS)and Reciproc(RC)engine-driven nickel-titanium file systems in removing root canal fillings,and to provide evidence for clinical application.Methods·The maxillary first permanent molars were obtained from patients who visited the Department of General Dentistry,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,between March and September 2022,which required tooth extraction due to periodontal disease.A total of 30 mesiobuccal or distobuccal root canals with moderate curvature were selected and randomly divided into the RC file group(control group,n=15)and the XPS file group(experimental group,n=15).All root canals were first negotiated and shaped using M3-PRO nickel-titanium files,followed by root canal obturation with bioceramic paste using the single-cone technique.Then,RC files(R25)were used in the control group,while XPS files were used in the experimental group to remove the root canal obturation.Cone Beam Computed Tomography(CBCT)scans were performed before and after the removal procedures.The time required for obturation removal,the percentage of residual obturation volume,the amount of apical debris extrusion,and the degree of instrument deformation were recorded.Independent-sample t-tests and chi-square test were used to compare the differences between the two groups.Results·The XPS group required slightly more time(118.87±18.58)s than the RC group(107.93±14.79)s,but the difference between two groups was not statistically significant.The XPS group had a lower percentage of residual obturation volume(7.51±8.06)%compared to the RC group(15.02±14.63)%,but the difference was not statistically significant.The XPS group had significantly less apical debris extrusion(6.15±1.42)mg than the RC group(8.29±2.01)mg,with a statistically significant difference(P=0.002).Both groups exhibited varying degrees of instrument deformation,but yet no instrument separation occurred in either group.Conclusion·The RC engine-driven nickel-titanium files were slightly more time-efficient in removing root canal fillings,whereas the XPS files achieved a higher canal cleanliness and produced less apical debris extrusion.As there was no significant difference in removal time,and considering the superior cleaning performance and reduced risk of postoperative complications,the XPS file system appears more suitable for removing root canal fillings in moderately curved root canals.

Objective:To investigate the value of midtreatment 18F-FDG PET/CT metabolic parameters for predicting the pathological response in patients with locally advanced gastric cancer (LAGC) after neoadjuvant immunochemotherapy (NICT). Methods:Twenty-five LAGC patients (19 males, 6 females, age: (64.8±8.6) years) who underwent 18F-FDG PET/CT after NICT in Henan Cancer Hospital from August 2019 to June 2024 were retrospectively analyzed. The lesion′s ROI was delineated, then the SUV max and metabolic tumor volume (MTV) were measured, and the SUV max was divided by SUV mean of the descending aorta to obtain the tumor-to-background ratio (TBR). Patients underwent surgery after PET/CT imaging. Based on the tumor regression grade (TRG) system by the American Joint Committee on Cancer (AJCC) criteria on surgical specimen, patients were divided into responders (TRG0+ 1) and non-responders (TRG2+ 3). Independent-sample t test, Mann-Whitney U test, one-way analysis of variance, and Kruskal-Wallis rank-sum test were used to compare the differences of data. The predictive efficacy of PET/CT metabolic parameters was assessed by the ROC curve analysis. Results:Postsurgical pathology showed that 9 patients were responders and 16 were non-responders. The SUV max (3.10±1.95) and TBR (2.44±1.54) of primary lesions in responders were lower than those in non-responders (7.40±4.68, 5.85±3.74; t values: -2.61, -2.59, both P<0.05), while the MTV of primary tumors and short diameter and metabolic parameters of positive lymph nodes were not significantly different between those 2 groups ( t=-1.50, Z values: -1.09 to -0.75, all P>0.05). No significant relation was found between PET/CT parameters and pathological differentiation or Lauren classification, or other pathological features ( t values: -1.55 to 1.38, Z values: -1.84 to 0, F values: 0.12-2.43, H values: 0.13-0.98, all P>0.05). ROC curve showed that the cut-off value of SUV max for predicting postoperative TRG was 5.40, and the AUC reached 0.77 (95% CI: 0.56-0.91), with the sensitivity and specificity of 9/16, 9/9, respectively. With TBR=3.54 as the cut-off value, its AUC reached 0.77 (95% CI: 0.56-0.91), and the sensitivity and specificity were 11/16, 8/9, respectively. The sensitivity and specificity of PET/CT for predicting lymph node positivity of patients were 8/12 and 13/13, respectively. Conclusion:Interim 18F-FDG PET/CT metabolic parameters can accurately predict the pathological response of LAGC patients after NICT.

Objective:To compare the changes in fracture displacement under different vertical loadings between the 2 different internal fixation modalities for vertically unstable femoral neck fractures of Pauwels type Ⅲ by a mechanical study and a finite element analysis.Methods:Twelve biomimic bones were transversely dissected from 10 cm below the lesser trochanter of the femur to create femoral neck fracture models with a Pauwels angle of 70° using a swing saw. The models were equally divided into 2 groups ( n=6): group A was fixed with 3 cannulated screws after fracture reduction (scheme A), and group B with 3 cannulated screws plus a self-designed anteromedial support plate after fracture reduction (scheme B). Continuous vertical force was applied using a mechanical testing machine. Changes in displacement were recorded and load-displacement curves were plotted. One volunteer (female, 28 years old, 168 cm in height and 65 kg in weight) was selected for finite element analysis of her CT images of both lower limbs to examine the maximum displacement and the maximum Mises stress in scheme A and scheme B respectively. Results:In groups A and B respectively: All the 6 biomimic mimetic bones had similar load and displacement curves, and similar fracture displacements (Dx) at different loading points (N X); the curves of 6 biomimic bones were highly fitted with S-shaped curve equation (the r-square value was close to 1). At the initial loading stage (0 N0.05). When the load was 100 N

Objective:To apply multifunctional debridement machine in burn wounds and complicated skin ulcers of wound surgery on the basis of its convenience in application,and analyze its application value.Methods:The multi-functional debridement machine realized the design of hardware system,the design of intelligent handle,the design of frequency tracking system and other integration design,so as to deal with wound quickly and accurately.A total of 156 patients with burn wounds and complicated skin ulcers who admitted to West Branch of Qingdao Municipal Hospital from January 2022 to January 2024 were selected,and they were divided into control group(78 cases)and observation group(78 cases)by random number method.Patients in the control group were treated by using the mode with bedhead and bedside debridement and dressing change every other day,while patients in the observation group were treated by multi-functional debridement machine.The effect was analyzed after treatment.Results:The healing rate of the observation group was 93.59%,which was significantly higher than that of the control group(73.08%)(x2=11.815,P＜0.05),and the healing time of the observation group was significantly shorter than that of the control group,and the difference was statistically significant(t=10.701,P＜0.05).The scores of wound depth,range of wound injury and degree of tissue necrosis in the observation group were lower than those in the control group,and the score of growth speed of granulation tissue was significantly higher than that in the control group,and the differences were statistical significance(t=5.617,7.993,4.781,5.133,P＜0.05).The pain scores on 1st day,7th day and 14th day after dressing change in the observation group were all lower than those in the control group,and the differences were statistical significance(t=19.898,11.801,10.191,P＜0.05).The sterilization rates of wound on the 3rd day,7th day and 10th day after treatment in the observation group were all higher than these in the control group,and the differences were statistical significance(t=15.168,13.476,6.785,P＜0.05).Conclusion:The hardware system of multifunctional debridement machine has large output power,high efficiency and obvious debridement effect.It has significant advantages in the treatment of burn wounds and complicated skin ulcers of wound surgery,which can relieve the degree of wound pain,and improve the cleaning effect and promote rapid recovery of wound.

Background Swimming is becoming increasingly popular for its combined leisure and fitness benefits. However, polluted swimming pool water may pose various health risks. Previous studies have indicated that health indicators of swimming venues have lower qualification rates compared to other public places, highlighting the urgent need to optimize hygiene management measures. Objective To assess the overall hygiene status and identify the key factors influencing water quality in Shanghai’s swimming venues from 2010 to 2024, and to provide a scientific basis for optimizing water quality management. Methods Water quality was assessed in three stages (2010—2019, 2020—2022, and 2023—2024) based on the monitoring data of Shanghai’s swimming venues (2010—2024). The influences of monitoring stage, region, season, scale, day of week, and per capita attendance on water quality were analyzed using chi-square tests and logistic regression. Results From 2010 to 2024, water quality was monitored in 1478 swimming venues. The compliance rates of turbidity, pH, urea, oxidation-reduction potential, free residual chlorine, combined residual chlorine, total bacteria, coliforms, and heat-resistant coliforms in swimming pool water, and free residual chlorine in the foot disinfection basin water samples were 99.56%, 94.73%, 73.00%, 47.50%, 56.55%, 54.12%, 97.74%, 99.49%, 99.90%, and 69.19%, respectively. The overall water quality compliance rate was 85.28%. The main non-compliant indicators for swimming pool water were urea, ORP, free residual chlorine, and combined residual chlorine, along with free chlorine residual in the foot disinfection basin water samples. Using the period before the implementation of the new national standard as reference, the results of logistic regression revealed that the qualification rates of urea, ORP, and free residual chlorine in the swimming pool water samples, as well as free residual chlorine in foot disinfection basin water samples, were significantly higher during the two phases after launching the new standard (2020–2022 and 2023–2024), and the associated odds ratios (95%CI) were 1.28 (1.00, 1.64) and 1.48 (1.12, 1.95), 13.35 (7.63, 23.37) and 10.78 (7.00, 16.60), 2.54 (1.81, 3.58) and 3.18 (2.41, 4.20), and 3.14 (2.14, 4.60) and 2.83 (1.89, 4.23), respectively. Compared with the reference group, those sampled in urban pools and in non-summer seasons showed higher qualification rates of urea and ORP; in contrast, the pools with high visitor flow showed lower qualification rates of free residual chlorine in both water samples of swimming pools and foot disinfection basins (P<0.05). Conclusion The implementation of the new national standard has effectively enhanced the management standards and significantly improved overall water quality of swimming venues in Shanghai. However, the compliance rates of free residual chlorine and urea in swimming pool water still need further improvement. The compliance of some indicators is influenced by region, season, scale, and average passenger flow, particularly in small suburban swimming venues. Future efforts should focus on refining water quality management strategies and enhancing public health management.

Objective:To apply multifunctional debridement machine in burn wounds and complicated skin ulcers of wound surgery on the basis of its convenience in application,and analyze its application value.Methods:The multi-functional debridement machine realized the design of hardware system,the design of intelligent handle,the design of frequency tracking system and other integration design,so as to deal with wound quickly and accurately.A total of 156 patients with burn wounds and complicated skin ulcers who admitted to West Branch of Qingdao Municipal Hospital from January 2022 to January 2024 were selected,and they were divided into control group(78 cases)and observation group(78 cases)by random number method.Patients in the control group were treated by using the mode with bedhead and bedside debridement and dressing change every other day,while patients in the observation group were treated by multi-functional debridement machine.The effect was analyzed after treatment.Results:The healing rate of the observation group was 93.59%,which was significantly higher than that of the control group(73.08%)(x2=11.815,P＜0.05),and the healing time of the observation group was significantly shorter than that of the control group,and the difference was statistically significant(t=10.701,P＜0.05).The scores of wound depth,range of wound injury and degree of tissue necrosis in the observation group were lower than those in the control group,and the score of growth speed of granulation tissue was significantly higher than that in the control group,and the differences were statistical significance(t=5.617,7.993,4.781,5.133,P＜0.05).The pain scores on 1st day,7th day and 14th day after dressing change in the observation group were all lower than those in the control group,and the differences were statistical significance(t=19.898,11.801,10.191,P＜0.05).The sterilization rates of wound on the 3rd day,7th day and 10th day after treatment in the observation group were all higher than these in the control group,and the differences were statistical significance(t=15.168,13.476,6.785,P＜0.05).Conclusion:The hardware system of multifunctional debridement machine has large output power,high efficiency and obvious debridement effect.It has significant advantages in the treatment of burn wounds and complicated skin ulcers of wound surgery,which can relieve the degree of wound pain,and improve the cleaning effect and promote rapid recovery of wound.