ObjectiveTo explore the current situation of forensic ethics practice and education by designing a questionnaire on forensic ethics， with a view to exploring the path of forensic ethics education construction. MethodsA total of 667 valid questionnaires were collected using the online survey method， basically covering various regions across the country and all sub-specialties of forensic medicine. Descriptive analysis was used to analyze the relevant data. ResultsMost practitioners had relevant ethical reflections in the process of forensic practice. 69.12% of the respondents indicated that they had studied the relevant rules， but approximately half stated that there were no corresponding ethical norms or standard operating manuals. The specific behaviors violating ethics in different units were diverse. 23.04% of the respondents reported that they had encountered unethical behaviors， but only 4.9% of them reported such violations. In terms of forensic ethics education， 87.75% of the respondents believed that there were issues with the current model of forensic ethics education. Meanwhile， the respondents showed a high degree of recognition for receiving forensic ethics education， with 84.15% of respondents expressing willingness to participate in relevant courses. More than half of respondents were willing to participate in forensic ethics education during undergraduate studies， new employee training， and regular post-employment training. ConclusionCurrently， there is a problem of ethical neglect in forensic work in China. Combining ethics courses with professional courses at the practitioner training stage and providing regular training at the practice stage are effective measures to popularize forensic ethics knowledge， enhance ethical awareness， and improve the quality of practice.

Objective To identify and analyze risk factors for acute renal failure (ARF) following lung transplantation and to develop a predictive model. Methods Data for this study were obtained from the United Network for Organ Sharing (UNOS) database, encompassing patients who underwent unilateral or bilateral lung transplantation between 2015 and 2022. We analyzed both preoperative and postoperative clinical characteristics of the patients. A combined approach utilizing random forest and least absolute shrinkage and selection operator (LASSO) regression was employed to identify key factors associated with the incidence of ARF post-transplantation, based on which a nomogram model was developed. The predictive performance of the constructed model was evaluated in both training and validation sets, using receiver operating characteristic (ROC) curves and area under the curve (AUC) metrics to verify and compare model effectiveness. Results A total of 15 110 lung transplantation patients were included in the study, consisting of6 041 males and 9 069 females, with a median age of 62.00 years (interquartile range: 54.00 to 67.00). The analysis revealed statistically significant differences between postoperative renal dialysis and non-dialysis patients regarding preoperative lung diagnosis, estimated glomerular filtration rate (eGFR), mechanical ventilation, preoperative ICU treatment, extracorporeal membrane oxygenation (ECMO) support, infections occurring within two weeks prior to transplantation, Karnofsky Performance Status (KPS) score, waitlist duration, double-lung transplantation, and ischemia time (P<0.05). Five key variables associated with ARF after lung transplantation were identified through random forest and LASSO regression: recipients’ eGFR, preoperative ICU treatment, ECMO support, bilateral lung transplantation, and ischemia time. A nomogram model was subsequently established. Model evaluation demonstrated that the constructed predictive model achieved high accuracy in both training and validation sets, with favorable AUC values, confirming its validity and reliability. Conclusion This study identifies common risk factors for ARF following lung transplantation and introduces an effective predictive model with potential clinical applications.

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

Objective To analyze the predictive value of neurotrophic factors for cognitive impairment in the elderly after cerebral infarction.Methods The clinical data of 137 elderly patients with cerebral infarction who were admitted to Wujin Hospital of Traditional Chinese Medicine from February 2022 to January 2024 were retrospectively analyzed.At 7 days after the onset of cerebral infarction,the patients were classified into occurrence group(n=49)and non-occurrence group(n=88)according to the occurrence of cognitive impairment.The levels of nutrition-related factors,such as brain-derived neurotrophic factor(BDNF)and glial cell derived neurotrophic factor(GDNF),were compared between the two groups.The influencing factors of cognitive impairment in elderly patients with cerebral infarction were screened,and a risk prediction model for cognitive impairment in elderly patients with cerebral infarction was constructed and verified.Results The levels of serum BDNF and GDNF in the occurrence group were lower than those in the non-occurrence group(P<0.05).The proportion of females,the National Institutes of Health stroke scale(NIHSS)score and the level of low-density lipoprotein cholesterol(LDL-C)in the occurrence group were higher than those in the non-occurrence group(P<0.05).Logistic regression analysis showed that serum BDNF(OR=0.271,95%CI:0.128-0.662),serum GDNF(OR=0.227,95%CI:0.100-0.516),NIHSS score(OR=4.768,95%CI:2.096～10.847),and LDL-C(OR=3.955,95%CI:1.749-8.997)were the influential factors for cognitive impairment in elderly patients with cerebral infarction(P<0.05).The sensitivity,specificity and area under the curve of the nomogram model were 79.6%(95%CI:65.2%～89.3%),90.9%(95%CI:95%CI:82.4%～95.7%),and 0.903(95%CI:0.821-0.965)for the prediction of cognitive impairment in elderly patients with cerebral infarction.Conclusion The levels of BDNF and GDNF are related to cognitive impairment in elderly patients with cerebral infarction.The risk prediction model constructed based on BDNF,GDNF,NIHSS score and LDL-C can help to predict the risk of cognitive impairment in elderly patients with cerebral infarction.

Left ventricular assist device (LVAD) serves as a critical therapeutic option for patients with end-stage heart failure, significantly enhancing survival rates and quality of life. However, LVAD implantation exerts complex and profound effects on right ventricular (RV) function, with RV dysfunction emerging as a key factor influencing the prognosis of LVAD patients. This article systematically reviews the relationship between LVAD and RV function, exploring the importance of RV function in LVAD patients, assessment methods, underlying mechanisms of impact, and strategies for prevention and management. Comprehensive evidence suggests that preoperative evaluation of RV function is crucial for predicting the risk of RV dysfunction, while effective prevention and management rely on preoperative optimization, meticulous intraoperative techniques, rigorous postoperative monitoring, and multidisciplinary collaboration. Furthermore, this review discusses the potential and future directions of emerging technologies, such as improved LVAD designs, biventricular assist devices, gene therapy, and personalized medicine, in ameliorating RV dysfunction. In conclusion, RV function is one of the key determinants of successful LVAD therapy. Through comprehensive assessment, prevention, and management of RV function, coupled with the application of novel technologies, the clinical outcomes of LVAD patients can be further improved.

BACKGROUND:In recent years,tranexamic acid has been extensively used to mitigate the substantial blood loss associated with total knee arthroplasty.However,the optimal method of topical application has not yet been established. OBJECTIVE:To evaluate the effectiveness and safety of intraoperative topical application of tranexamic acid combined with physical compression dressing in reducing perioperative blood loss in total knee arthroplasty. METHODS:A retrospective analysis was conducted on 90 patients who underwent total knee arthroplasty at the Honghui Hospital in Xi'an from January 2021 to December 2022.Based on the different topical use methods of tranexamic acid during surgery,patients were divided into three groups,with 30 cases in each group.In the compression dressing group,2 g of tranexamic acid was placed in the articular cavity,and after packing the wound with gauze and cotton pads,a bandage was used to compress the wound.In the periarticular injection group,2 g of tranexamic acid was injected into the surrounding tissue of the articular cavity.In the intra-articular injection group,2 g of tranexamic acid was injected into the articular cavity.The blood loss,operation time,coagulation indicators,inflammatory indicators,and postoperative complications of the three groups were statistically analyzed. RESULTS AND CONCLUSION:(1)In terms of total blood loss,hidden blood loss,and maximum hemoglobin drop,the periarticular injection group had the least amount,and there was no statistically significant difference between the compression dressing group and periarticular injection group(P>0.05).In terms of intraoperative blood loss,the compression dressing group had the least amount,and there were statistically significant differences compared with the periarticular injection group and intra-articular injection group(P<0.05).There was no statistically significant difference in operation time among the three groups(P>0.05).(2)There were no statistically significant differences in coagulation indicators(D-dimer and fibrinogen degradation products)and inflammation indicators(C-reactive protein and erythrocyte sedimentation rate)among the three groups preoperatively and on the first and third days after operation(P>0.05).(3)There was no statistically significant difference observed among the three groups in terms of slow blood flow in the affected limb,intramuscular venous thrombosis,soft tissue swelling,and incidence of wound complications(P>0.05).Additionally,no cases of deep vein thrombosis or pulmonary embolism were detected in any of the groups.(4)The topical application of tranexamic acid combined with compression dressing achieves the same effect as a periarticular injection in terms of simplicity of operation and reduced perioperative blood loss.This method also avoids the trauma caused by repeated punctures and does not increase the incidence of postoperative complications,making it a worthwhile option for clinical promotion.

Objective: To analyze the association between latent class of health-risk behaviors and depressive symptoms among middle school students, so as to provide the evidence for the prevention and intervention of depressive symptoms among middle school students. Methods: Students in two junior high schools, two senior high schools and one vocational high school in Yinzhou District, Ningbo City, Zhejiang Province, were selected using a stratified multi-stage cluster sampling method. Demography and health-risk behaviors were collected using questionnaire surveys, depressive symptoms were investigated using the Center for Epidemiological Studies Depression-10 Scale, and latent class analysis was conducted for health-risk behaviors. The association between different latent classes and depressive symptoms was analyzed using a multivariable logistic regression model. Results: A total of 1 247 students were surveyed, including 641 boys (51.40%) and 606 girls (48.60%). There were 452 junior high school students (36.25%), 532 high school students (42.66%) and 263 vocational high school students (21.09%). Latent class analysis showed that health-risk behaviors in students were classified into three groups, namely healthy behavior group (52.93%), poor diet group (39.94%) and high-risk behavior group (7.14%), and the detection rates of depressive symptoms were 7.12%, 18.88% and 52.81%, respectively, with a statistically significant difference between groups (P<0.05). Multivariable logistic regression analysis showed that after adjusting for age, gender, native place, only child and living on campus, the poor diet group (OR=3.107, 95%CI: 2.086-4.627) and high-risk behavior group (OR=15.401, 95%CI: 9.031-26.262) had higher risks of depressive symptoms compared with the healthy behavior group. Conclusion Having high-risk behaviors and poor diet may increase the risk of developing depressive symptoms among middle school students.

Objective: To investigate the characteristics of fall injuries among primary and middle school students in Yinzhou District, Ningbo City, Zhejiang Province from 2010 to 2022, so as to provide insights into prevention and control of fall injuries among primary and middle school students. Methods: Data of 6 to 17 year-old primary and middle school students with initial diagnosis of fall injury from 2010 to 2022 were collected through Injury Subsystem of Zhejiang Provincial Chronic Disease Surveillance Information Management System. The time, place, activity and clinical characteristics of fall injury were analyzed using a descriptive method. Results: Totally 7 808 fall injury cases among primary and middle school students were reported in Yinzhou District from 2010 to 2022, accounting for 45.72% of the total injury cases in the same age. There were 5 413 boys and 2 395 girls, with a boy/girl ratio of 2.26∶1. Primary school students were the majority, accounting for 55.10%. The incidence of fall injuries among girls, junior high school students and high school students showed increasing trends from 2012 to 2022 (both P<0.05). The primary peak of fall injury was from September to November, and the secondary peak was from May to July, with 4 510 cases (57.76%). The place of fall injury development mainly included schools (2 680 cases, 34.32%), homes (2 343 cases, 30.01%) and streets/urban areas (2 247 cases, 28.78%). The activities at the time of fall injury mainly included leisure time (3 490 cases, 44.70%), sports (2 861 cases, 36.64%) and school activities (1 094 cases, 14.01%). Soft tissue injury was the main characteristics (6 224 cases, 79.71%). Lower limbs (3 101 cases, 39.72%), head (2 419 cases, 30.98%) and upper limbs (1 974 cases, 25.28%) were the main injury sites. Mild injury was predominant (5 896 cases, 75.51%). Conclusions Boys and primary school students are high-risk groups of fall injury in Yinzhou District, schools are high-risk places of fall injury. Schools should be regarded as key intervention places and health education on fall injury prevention should be strengthened.

Specific pathogen-free(SPF)chickens are widely used in the research of avian diseases and vaccines.Vertically transmissible diseases are transmitted to chickens through vertical transmission,seriously affecting their survival rate,increasing production costs,and causing significant economic losses to the poultry industry,while severely impacting the breeding and use of SPF chickens.Therefore,it is crucial for researchers and managers to enhance their understanding of vertically transmissible pathogens in chickens and to develop effective monitoring measures.Quality monitoring is an important part of ensuring the quality of SPF chickens,with pathogen detection being the primary step.Based on this,it is necessary to cultivate qualified SPF chickens through purification methods and biosecurity measures.This paper reviews the major vertically transmissible pathogens in chickens,including viral pathogens,bacterial pathogens and mycoplasmas,as well as their detection methods.This study compares the differences in microbiological testing items and methods for SPF chickens between the U.S.corporate standard and the Chinese national standard.Analysis of the results shows that in both standards,vertically transmissible pathogens such as Escherichia coli,Proteus mirabilis,Salmonella,and avian leukosis are not included in the microbiological testing items for SPF chickens.Instead,these pathogens are characterized by mixed infections,and outbreaks can seriously affect flock health.To produce higher-quality SPF chickens,it is necessary to include these pathogens in the mandatory testing items.The aim of this paper is to help readers understand the relevant standards for microbiological monitoring of SPF chickens,the hazards of vertically transmissible pathogens,and prevention and control strategies,so as to provide a reference for the detection and purification of pathogens in SPF chickens.

Objective The prediction of RR intervals in hypertensive patients can help clinicians to analyze and warn patients'heart condition.Methods Using 8 patients'data as samples,the RR intervals of patients were predicted by long short-term memory network(LSTM)and gradient lift tree(XGBoost),and the prediction results of the two models were combined by the inverse variance method to overcome the disadvantage of single model prediction.Results Compared with the single model,the proposed combined model had a different degree of improvement in the prediction of RR intervals in 8 patients.Conclusion LSTM-XGBoost model provides a method for predicting RR intervals in hypertensive patients,which has potential clinical feasibility.