Objective: To assess the effect of 12-year-old children s pit and fissure sealants on the health of first permanent molars, so as to provide evidence for optimizing caries prevention strategies among children. Methods: In March 2025, a cluster random sampling method was used to conduct oral examinations on 965 students aged 12 from Chengdu s 2021 Comprehensive Intervention Program for Pediatric Oral Diseases. Data from the Comprehensive Intervention System for Children s Oral Diseases were referenced. Participants were divided into a sealed group ( n =755) and an unsealed group ( n =210) based on whether they had received sealants on their first permanent molars. Chi square test or analysis of variance were used to compare indicators such as caries incidence, new caries detection rate, and new caries mean (DMFT increment) between the two groups Results: The sealed group showed significantly lower caries incidence, new caries detection rate, and new caries mean (33.38%, 17.65%, 0.59±1.00) compared to the unsealed group (43.81%, 24.70%, 0.87±1.22)( χ 2/F =7.79, 18.26, 9.55, all P <0.05). However, no significant difference was found in the filled teeth ratio between the two groups (20.38% , 20.16%; χ 2=0.01, P =0.94). In girls, the sealed group exhibited significantly lower caries incidence, new caries detection rate, and new caries mean (36.78%, 20.99%, 0.69± 1.10 ) than the unsealed group (57.55%, 33.52%, 1.15±1.29) ( χ 2/F =14.42, 23.76, 10.92, all P <0.05), whereas no significant differences were observed between boys in the sealed (30.47%, 14.85%, 0.50±0.89) and unsealed groups (29.81%, 16.18%, 0.59± 1.08) ( χ 2/F =0.02, 0.41, 0.74, all P >0.05). Boys had significantly lower new caries detection rates and new caries means than girls in both groups ( χ 2/F =16.20, 6.94; 29.93, 11.84, all P <0.05). In urban areas, the sealed group had lower new caries detection rates and new caries means (19.37%, 0.68±1.04) than the unsealed group (24.66%, 0.90±1.20) ( χ 2/F =6.86, 3.94, both P <0.05). In suburban areas, all indicators for the sealed group (24.71%, 13.77%, 0.42±0.87) were significantly lower than those for the unsealed group (38.81%, 24.77%, 0.82±1.28) ( χ 2/F =5.28, 15.36, 6.00, all P <0.05). Indicators from specialized dental institutions (11.25%, 4.81%, 0.16±0.56) were significantly lower than those from county level or above general hospitals (33.33%, 19.11%, 0.38±1.00) and primary healthcare institutions (37.59%, 19.24%, 0.67±1.05) ( χ 2/F =20.99, 34.31, 21.08 , all P <0.01). Conclusions The 12-year-old children s pit and fissure sealants effectively reduce the caries incidence in first permanent molars, particularly showing significant effectiveness in girls and suburban children. Intervention strategies should be optimized according to gender.

Objective To evaluate the impact of an integrated management mode of prenatal diagnosis-postnatal treatment for congenital heart disease (CHD) on perioperative and long-term outcomes of the arterial switch operation (ASO), and to analyze the efficacy of ASO in a single center. Methods This retrospective study analyzed the clinical data of 183 children who underwent ASO at Guangdong Provincial People’s Hospital from 2018 to 2024. The cohort included 106 (57.9%) patients of transposition of the great arteries with intact ventricular septum (TGA/IVS), 61 (33.3%) patients of transposition of the great arteries with ventricular septal defect (TGA/VSD), and 16 (8.7%) patients of Taussig-bing anomaly (TBA). Perioperative indicators were compared between 91 patients in the prenatal-postnatal integrated management group (an integrated group) and 92 patients in the traditional management group (a non-integrated group). Long-term survival and reoperation rates were analyzed using Kaplan-Meier curves. Results The overall perioperative mortality rate was 4.9% (9/183), showing a downward trend year by year. The primary cause of perioperative mortality was low cardiac output syndrome (LCOS), which occurred in 12 patients (6.6% incidence) with a mortality rate of 75.0%. The integrated group had a higher proportion of males (89.0% vs. 72.8%, P<0.05) and lower body weight [3.1 (2.7, 3.3) kg vs. 3.3 (3.0, 3.7) kg, P<0.05] compared to the non-integrated group. The age at surgery was significantly earlier in the integrated group [7 (3, 10) d vs. 14 (9, 48) d, P<0.05], and all children in the integrated group underwent ASO within the optimal surgical window (100.0% vs. 82.6%, P<0.05). Intraoperatively, cardiopulmonary bypass time [173 (150, 207) min vs. 186 (159, 237) min, P<0.05] and aortic cross-clamp time [100 (90, 117) min vs. 116 (97, 142) min, P<0.05] were significantly shorter in the integrated group. Although the integrated group had longer postoperative mechanical ventilation time [145 (98, 214) h vs. 116 (77, 147) h, P<0.05] and higher 48-hour maximum vasoactive inotropic score [15 (10, 21) points vs. 12 (8, 16) points, P<0.05], there was no statistically significant difference in the incidence of severe complications (LCOS, necrotizing enterocolitis, extracorporeal membrane oxygenation) or mortality rate (3.3% vs. 6.5%, P=0.51) between the two groups, despite earlier surgical intervention and a higher proportion of critically ill cases in the integrated group. The length of hospital stay in the emergency surgery group was significantly shorter than that in the elective surgery group [20 (15, 28) d vs. 25 (21, 30) d, P<0.05], suggesting that early surgery may be of potential benefit. A total of 163 patients were successfully followed up for a median of 4.7 years, with a 5-year survival rate of 95.1% and a freedom from reintervention survival rate of 95.1%. There were no late deaths, and the most common postoperative complication was pulmonary artery stenosis. Conclusion The integrated management model allowed critically ill children with lower body weights to safely undergo surgery, significantly optimizing the timing of surgery and shortening intraoperative times. The long-term risk of reoperation after ASO is primarily concentrated on pulmonary artery stenosis, necessitating long-term follow-up and monitoring.

With the rapid advancements in surgical and interventional therapies, over 90% of children with congenital heart disease can now survive into adulthood with appropriate treatment. As a rapidly expanding population, adult congenital heart disease (ACHD) patients often present with complex anatomical abnormalities and post-procedural complications, posing significant long-term management challenges for clinicians. The American College of Cardiology and American Heart Association jointly released the 2025 guidelines for the management of adult congenital heart disease, which represents a comprehensive and fundamental update following the inaugural 2008 edition. This new guideline not only integrates the latest evidence-based data but also marks a paradigm shift in ACHD management, from a disease-centered approach to a patient-centered lifelong continuum of care. This article aims to provide an interpretation of the guidelines from the perspective of a cardiac surgeon to provide references for the management of various disease subtypes.

ObjectiveTo investigate the contamination status, transmission risk and drug resistance of Klebsiella pneumoniae (KP) on the object surfaces in the surrounding environment of hospitalized patients infected with carbapenem-resistant Klebsiella pneumoniae (CRKP) , so as to provide a scientific guidance for the prevention and control of healthcare-associated infection. MethodsSamples from the surfaces of objects in the surrounding environment of CRKP infected patients living in the intensive care unit (ICU) and hand specimens from healthcare workers were collected for KP isolation and identification, as well as drug susceptible test in a medical institution located in Minhang District, Shanghai from 2021 to 2023. Additionally, both univariate and multivariate logistic regression analyses were used to identify the influencing factors associated with KP contamination in the hospital environment. ResultsA total of 546 surface samples were collected from the surrounding environment objects of 15 patients infected with CRKP, with a KP detection rate of 6.59% (36/546).The KP detection rate in the ICU of general ward (10.22%) was higher than that in the ICU of emergency department (2.94%) (χ²=12.142, P<0.001). Moreover, the KP detection rate on the surfaces of patient-contacted items (15.66%) was higher than that on shared-use items (6.25%), cleaning items (10.00%), and medical supplies (3.30%) (χ²=17.943, P<0.001). Besides, the detection rate of KP in items sent out of hospital for disinfection (15.38%) was higher than that in those self-disinfected (4.20%) (χ²=19.996, P<0.001).The highest detection rate of KP was observed in high-temperature washing (15.13%, 18/119) (χ²=21.219, P<0.001), while the lowest detection rate was observed in antibacterial hand sanitizer with trichlorohydroxydiphenyl ether sanitizing factor (0, 0/60) ( χ²=21.219, P<0.001).The detection rate of KP in samples taken more than 24 hours after the last disinfection (23.08%) was higher than that in those taken at 4 to24 hours (12.90%) and less than 4 hours (4.22%) (χ²=23.398,P<0.001).ICU of general ward (OR=4.045, 95%CI: 2.206‒7.416), patient-contacted items (OR=3.113, 95%CI: 1.191‒8.141), and self-disinfection ( OR=0.241, 95%CI:0.144‒0.402) were influencing factors for KP contamination in environmental surface. From 2021 to 2023, the drug resistance rates of hospital environmental KP isolates showed an upward trend (P<0.001) to antibiotics such as ceftazidime and gentamicin. Furthermore, high drug resistance rates of KP (>90%) were observed to ciprofloxacin, levofloxacin, cefotaxime, ceftriaxone, and cefepime. ConclusionCRKP can be transmitted outward through the surfaces of objects in the patients’ surroundings, and the drug resistance situation is severe. In clinical settings, it is necessary to implement isolation measures for CRKP infection patients, to increase the frequency of disinfection for objects in their surroundings, to strengthen hand hygiene practices, and to use antibiotics appropriately.

Natural products are an important source for innovative drugs,but unclear molecular targets and mechanisms limit their further development and application.The authors proposed a new method for the target identification of natural products based on proteolysis-targeting chimera(PROTAC)technology and quantitative proteomics,and established the targeted degradomics(TGDO) technology for the identification of weak-affinity tar-gets.This article summarizes the standardized workflow and the application of TGDO for target identification of natural products.

Objective:Elucidating causal links between gut microbiota and breast malignancies using mendelian randomization(MR)to Identify specific causal microbial taxa.Methods:Genome-wide association studies(GWAS)summary statistics on gut microbiota and breast malignancies,MiBioGen studied GWAS(N=18473)as exposure samples,and GWAS(N=123579)of breast malignancies in the IEU Open GWAS database as outcome samples.The in-verse variance weighted(IVW),weighted median and MR-Egger methods were used to analyze the MR statistical re-suits.Results:Increased abundance of Pasteurellales increased the risk of breast malignancy(IVW PFDR＜0.05,OR=1.21,95％Cl:1.07～1.36),heterogeneity test and pleiotropy test showed no effect on causality,and the"leave-one-out"method showed that the identified causal association was not driven by any single instrumental variable.The causal relationship is positive.Conclusion:Elevated abundance of pasteurellales in the gut microbiota is associated with an increased risk of breast malignancies

Objective:To explore the clinical value of autologous umbilical cord whole blood(UCB) priming of the cardiopulmonary bypass(CPB) circuit in neonatal cardiac surgery for congenital heart disease(CHD).Methods:This prospective non-randomized controlled trial included neonates undergoing CHD surgery at Guangdong Provincial People’s Hospital from August 2024 to January 2025. The experimental group used autologous UCB for CPB circuit priming, while the control group used adult allogeneic blood(AAB) priming when UCB was unavailable. Preoperative characteristics, intraoperative CPB and aortic cross-clamping(ACC) times, postoperative ICU stay duration, mechanical ventilation time, and hospitalization length were compared.Results:There were no significant differences in preoperative baseline characteristics between the two groups( P>0.05). At the end of surgery, red blood cell count(RBC), hemoglobin level(Hb), and creatine kinase(CK) showed no significant differences between the groups( P> 0.05). Additionally, perioperative left ventricular ejection fraction(LVEF) demonstrated no statistically significant variations( P>0.05). At surgery completion, the UCB group exhibited lower hematocrit(HCT) and higher blood lactic acid(Lac) levels but these differences resolved by 6 hours postoperatively( P>0.05). The UCB group had higher maximum vasoactive-inotropic scores(VISmax) within 48 hours and longer ICU stays, though total hospitalization and mechanical ventilation durations showed no significant differences( P>0.05). Conclusion:Autologous UCB priming reduces AAB requirements and has minimal impact on postoperative cardiac and pulmonary function recovery, or homeostasis., which is safe and feasible. This study provides evidence supporting the clinical application of UCB priming in CPB circuits.

Objective To analyze the imaging features of cerebral small vessel disease in patients with type 2 diabetes mellitus by multimodal MRI.Methods The clinical data of 160 patients with cerebral small vessel disease admitted to our hospital from January to December 2020 were retrospectively analyzed.According to whether they were complicated with type 2 diabetes mellitus,they were divided into the diabetic group and the non-diabetic group,with 80 cases in each group.Both groups underwent multimodal MRI scans.And the severity of lacunar infarction,the severity of subcortical and periventricular white matter lesions,white matter integral and cerebral microbleeds of patients in the two groups were compared.Results The severity of lacunar infarction(χ2=34.076,P=0.001),subcortical white matter lesions(χ2=25.000,P=0.001),periventricular white matter lesions(χ2=22.895,P=0.001)and white matter integral(t=12.370,P=0.001)of patients in the diabetic group were significantly higher than those in the non-diabetic group.No cerebral microbleeds were detected in either group of patients.Conclusion Patients with cerebral small vessel disease and type 2 diabetes mellitus show characteristic multimodal MRI changes.The increase in the number of lacunar infarction lesions and the aggravation of white matter lesions can be used as the characteristic imaging basis for the diagnosis of type 2 diabetes mellitus related cerebral small vessel disease.

Objective:To explore the clinical value of autologous umbilical cord whole blood(UCB) priming of the cardiopulmonary bypass(CPB) circuit in neonatal cardiac surgery for congenital heart disease(CHD).Methods:This prospective non-randomized controlled trial included neonates undergoing CHD surgery at Guangdong Provincial People’s Hospital from August 2024 to January 2025. The experimental group used autologous UCB for CPB circuit priming, while the control group used adult allogeneic blood(AAB) priming when UCB was unavailable. Preoperative characteristics, intraoperative CPB and aortic cross-clamping(ACC) times, postoperative ICU stay duration, mechanical ventilation time, and hospitalization length were compared.Results:There were no significant differences in preoperative baseline characteristics between the two groups( P>0.05). At the end of surgery, red blood cell count(RBC), hemoglobin level(Hb), and creatine kinase(CK) showed no significant differences between the groups( P> 0.05). Additionally, perioperative left ventricular ejection fraction(LVEF) demonstrated no statistically significant variations( P>0.05). At surgery completion, the UCB group exhibited lower hematocrit(HCT) and higher blood lactic acid(Lac) levels but these differences resolved by 6 hours postoperatively( P>0.05). The UCB group had higher maximum vasoactive-inotropic scores(VISmax) within 48 hours and longer ICU stays, though total hospitalization and mechanical ventilation durations showed no significant differences( P>0.05). Conclusion:Autologous UCB priming reduces AAB requirements and has minimal impact on postoperative cardiac and pulmonary function recovery, or homeostasis., which is safe and feasible. This study provides evidence supporting the clinical application of UCB priming in CPB circuits.

OBJECTIVE:This study comprehensively and quantitatively evaluates the effect of low-volume high-intensity interval training (LV-HIIT) on the prevention of cardiovascular disease in obese or overweight people through a meta-analysis,and further verifies the feasibility of LV-HIIT application in special populations such as obese people. METHODS:Literature addressing randomized controlled trials of LV-HIIT-related studies was searched in CNKI,PubMed,Web of Science,Cochrane library,and EBSCO-SPORTD Exercise Science full-text database from database inception to February 2024. Screening,quality assessment and data extraction of included studies were performed by two researchers,and Meta-analyses of outcome indicators,including combined effect sizes,subgroup analyses,Leave-One-Out sensitivity analyses,as well as the publication of Egger's test and the plotting of funnel plots,were performed using the software Review Manager 5.4 and the software Stata 17.0. The protocol was registered with the International Prospective Registry for Systematic Reviews (CRD42024534409). RESULTS:(1) Finally,13 randomized controlled trials,including 349 subjects,were eligible and included,and the overall quality of the included literature was high. (2) LV-HIIT intervention significantly improved cardiorespiratory fitness[standardized mean difference (SMD)=-0.65,95％ confidence interval (CI):-0.87 to-0.43,P<0.05],systolic blood pressure (SMD=0.38,95％ CI:0.11-0.65,P<0.05),diastolic blood pressure (SMD=0.42,95％ CI:0.15-0.68,P<0.05),and body fat percentage (SMD=0.25,95％ CI:0.02-0.49,P<0.05). (3) LV-HIIT and moderate-intensity continuous training (MICT) had similar interventional effects on cardiorespiratory fitness,systolic blood pressure,diastolic blood pressure,body fat percentage,standardized body weight,body mass index,high-density lipoprotein,low-density lipoprotein,and total cholesterol in people with overweight or obesity (P>0.05),but MICT was better than LV-HIIT in improving triglyceride level (SMD=-0.30,95％ CI:-0.57 to-0.02,P<0.05). (4) The results of subgroup analyses further showed that LV-HIIT and MICT interventions showed similar improvements in each index. CONCLUSION:Current evidence suggests that LV-HIIT can effectively enhance cardiopulmonary adaptive capacity and promote fat loss and blood pressure regulation in overweight or obese people,and the improvements are similar to those of MICT. Short-term LV-HIIT is more time-effective than long-term MICT. Future studies are recommended to determine the optimal LV-HIIT exercise prescription for overweight or obese populations.