Objective To investigate the effects of dapagliflozin on inflammatory factors and prognosis in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI). Methods In a randomized, double-blind trial, 146 patients with T2DM and AMI (within 7 days of onset) were divided into dapagliflozin (dapagliflozin 10 mg/d combining AMI standard therapy) and control (AMI standard therapy) groups, and were followed up for 12 months. Serum levels of interleukin-1β (IL-1β), IL-6, high-sensitivity C reactive protein (hs-CRP) at baseline, 1, 3, 6, and 12 months, and left ventricular ejection fraction (LVEF), brain natriuretic peptide (BNP), and major adverse cardiovascular events (MACE) rate at 12 months were compared between the two groups. Kaplan-Meier curves were used to analyze the cumulative incidences of MACE in the two groups. Results Three patients were withdrawn or dropped out. At 12 months, IL-1β, IL-6, and hs-CRP levels were significantly lower in dapagliflozin group (n＝71) than those in control group (n＝72, P＜0.01), approaching normal levels. Compared with the control group, LVEF was higher (P＜0.01), BNP was lower (P＜0.01), MACE incidence was lower (P＝0.047) in dapagliflozin group at 12 months. Generalized linear mixed models showed significant group-time interactions in IL-1β, IL-6, and hs-CRP (P＜0.001), and these factors declined faster in the dapagliflozin group. Kaplan-Meier curve showed the cumulative incidences of MACE and heart failure were lower in dapagliflozin group than those in non-dapagliflozin group (P＜0.05). Conclusions For patients with T2DM patients and AMI, dapagliflozin has good anti-inflammatory and cardioprotective effects.

To analyze the disease burden of acute lymphoid leukemia(ALL) and its changing trends in China and globally from 1990 to 2021, aiming to provide a theoretical basis for disease prevention, treatment, and policy formulation.

In the context of global warming, protecting outdoor workers from occupational heat exposure has become an important public health concern. This review summarized the principle, applicability, and limitation of three categories of wet bulb globe temperature (WBGT) prediction models: empirical regression models, heat-balance models, and machine-learning models. Drawing on international experience from the United States, Europe, and Japan, this review further examined the technical challenges of applying WBGT-based prediction models to large-scale occupational heat stress early warning systems. In response to gaps in occupational heat stress management in China, WBGT should be considered a core assessment indicator to support a transition from passive response to proactive intervention. A localized implementation pathway is proposed, incorporating mechanism-based model calibration, regional parameter adaptation, and multi-source data fusion. Strengthening collaboration between public health and meteorological departments and developing platform-based flexible intervention strategies for workers in new forms of employment may improve the targeting of occupational heat stress early warning and health protection. Future research should focus on physics-constrained machine learning, refined microenvironmental prediction, and individualized risk assessment to support the development of a digitally enabled occupational heat-health protection framework.

Addressing the current clinical problems of conventional antidepressants， such as delayed onset of action and prominent adverse reactions， this paper explores the theoretical basis， mechanism of action， and application prospects of nasal administration as a novel rapid antidepressant strategy. By clarifying the conceptual connotation of rapid antidepressants， elucidating their clinical demands and application advantages， and explaining the physiological basis of nasal-to-brain delivery， it is proposed that the olfactory and trigeminal nerve pathways can bypass the blood-brain barrier to achieve rapid targeted delivery of drugs to brain tissue. On this basis， combined with the theory of opening orifices with aromatic medicinals in traditional Chinese medicine （TCM） as well as related research in modern aromatherapy， the ancient and modern clinical evidence of nasal administration in regulating emotions was systematically reviewed. Furthermore， this article discusses the application advantages of nasal administration in special populations such as the elderly， children， and pregnant women， and analyzes the practical bottlenecks such as mucosal clearance， limited formulation volume， and safety evaluation. Nasal administration is expected to become an important supplementary means for rapid antidepressants， and the integrated model of "TCM aromatic medicinals plus nanopreparations plus nasal administration" can provide new ideas for research on the integration of TCM and western medicine in treating depression.

Objective This study aims to conduct a comprehensive analysis of the domestic and international standards for prefilled syringes to advance the scientific and international alignment of China's PFS standard system.Methods A thorough review of the framework,scope,and quality control key points of the 2015 national pharmaceutical packaging material standards(abbreviated as YBB standards),the ISO 11040 international standard system and the United States Pharmacopeia standard system was conducted.Comparative analysis was employed to reveal the similarities and differences among the three,thereby uncovering the unique characteristics of each.Results The YBB standards emphasize quality control for prefilled syringes,offering clear and operational guidelines that provide companies with precise directives for production and testing.However,the scope of these standards is relatively limited.ISO standards apply to a wide range of products,featuring comprehensive coverage and a degree of flexibility.They emphasize the universality of products and compatibility with other international standards,which facilitates global production and trade.USP includes several chapters related to prefilled syringes but lacks a certain level of specificity and systematic approach.Conclusion By thoroughly studying and drawing upon the quality control philosophies,standard frameworks,and key control points of prefilled syringes from both domestic and international standards,we aim to provide valuable references for the development of a robust prefilled syringe standard system within the Chinese Pharmacopoeia.

Objective To investigate the risk factors of the infarct growth rate(IGR)in patients with acute anterior circulation large vessel occlusion.Methods This is a retrospective analysis of consecutive patients having acute anterior circulation large-vessel occlusion and being admitted to the Department of Neurointerventional Intervention,Central Hospital affiliated to Dalian University of Technology between September 2021 and July 2023.Patients were dichotomized into rapid and slow growth groups based on the median value of IGR,with 145 cases in each group.Univariate and multivariate Logistic regression models were used to analyze the risk factors of preoperative IGR.Results Multivariable Logistic regression analysis,after univariate screening,showed that hypertension(OR=2.27,95%CI:1.39-3.71),atrial fibrillation(OR=1.95,95%CI:1.22-3.12),and intracranial internal carotid artery occlusion(OR=1.98,95%CI:1.19-3.28)were risk factors of preoperative IGR(P<0.05).Hypertension,atrial fibrillation,and internal carotid artery occlusion all exhibited relatively low predictive value for IGR(P<0.05).The area under the curve for predicting IGR by combining these three factors was 0.642(95%CI:0.579-0.704),indicating a slight improvement in predictive performance,yet it remained relatively low.Conclusion Hypertension,atrial fibrillation,and proximal occlusion are risk factors of IGR in patients having acute anterior circulation large vessel occlusion.

Objective This study aims to conduct a comprehensive analysis of the domestic and international standards for prefilled syringes to advance the scientific and international alignment of China's PFS standard system.Methods A thorough review of the framework,scope,and quality control key points of the 2015 national pharmaceutical packaging material standards(abbreviated as YBB standards),the ISO 11040 international standard system and the United States Pharmacopeia standard system was conducted.Comparative analysis was employed to reveal the similarities and differences among the three,thereby uncovering the unique characteristics of each.Results The YBB standards emphasize quality control for prefilled syringes,offering clear and operational guidelines that provide companies with precise directives for production and testing.However,the scope of these standards is relatively limited.ISO standards apply to a wide range of products,featuring comprehensive coverage and a degree of flexibility.They emphasize the universality of products and compatibility with other international standards,which facilitates global production and trade.USP includes several chapters related to prefilled syringes but lacks a certain level of specificity and systematic approach.Conclusion By thoroughly studying and drawing upon the quality control philosophies,standard frameworks,and key control points of prefilled syringes from both domestic and international standards,we aim to provide valuable references for the development of a robust prefilled syringe standard system within the Chinese Pharmacopoeia.

Objective:To explore the correlation between serum soluble triggering receptor expressed on myeloid cells 2 (sTREM2) and cognitive impairment in patients with cerebral small vessel disease (CSVD), and the role of deep medullary vein (DMV) score in this process.Methods:A total of 140 patients with CSVD admitted to the Department of Neurology, the First Affiliated Hospital of Henan Medical University from December 2022 to August 2024 were selected as the research objects. The basic data statistics, head magnetic resonance imaging examination, cognitive function assessment, serum sTREM2 detection and DMV score were performed. All data were analyzed by SPSS 29.0 software and GraphPad Prism 10.0 software packages. Logistic regression model was used to explore the influencing factors of cognitive impairment. Structural equation model was used to analyze the mediating effect of DMV score on the association between serum sTREM2 and cognitive impairment. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum sTREM2 level and DMV score for cognitive impairment in CSVD patients.Results:Serum sTREM2 level ( B=0.017, OR=1.017, 95% CI=1.003-1.031), DMV score ( B=0.375, OR=1.455, 95% CI=1.175-1.802) and years of education ( B=-0.248, OR=0.780, 95% CI=0.635-0.958) were risk factors for cognitive impairment (all P<0.05). sTREM2 not only directly affected cognitive function, but also indirectly affected cognitive function through DMV score. The direct effect (effect size=-0.022) and mediating effect (effect size=-0.007) accounted for 75.9% and 24.1% of the total effect (effect size=-0.029), respectively. The areas under the ROC curve of serum sTREM2 level, DMV score, and their combination for predicting cognitive impairment in CSVD patients were 0.880, 0.891, and 0.910, respectively (all P<0.001). Conclusion:Serum sTREM2 not only directly affects the cognitive function of patients with cerebral small vessel disease, but also indirectly affects cognitive function through DMV score. The combination of serum sTREM2 levels and DMV score has high predictive value for the risk of CSVD-related cognitive impairment.

Objective:To investigate the relationship between susceptibility to hearing loss in noise-exposed Han Chinese male homo sapiens and glutathione S-transferase (GST) gene polymorphisms, providing a scientific basis for further understanding the pathogenic mechanisms of noise-induced hearing loss (NIHL) and screening for genetic susceptibility biomarkers.Methods:In May 2024, a cross-sectional survey was conducted to recruit 332 male Han workers exposed to noise from a prominent mechanical maintenance enterprise. Workers were classified into the hearing loss group if they exhibited a binaural high-frequency average hearing threshold exceeding 25 dB and a binaural speech frequency average hearing threshold loss that was less than the binaural high-frequency average hearing threshold loss, resulting in a total of 332 individuals in this group. Furthermore, a matched group of 332 hearing-normal workers was established on a 1∶1 basis for each hearing-impaired worker, using criteria such as the same job type, age, and a noise exposure duration of ≤4 years. Basic data of worker was collected through a questionnaire survey, and individual noise exposure levels were assessed using cumulative noise exposure (CNE). Various PCR and high-throughput sequencing techniques were employed to identify polymorphisms in the GSTT1, GSTM1, and GSTP1rs1695 genes. The basic information and genotypes of the two groups were compared using paired t-tests and paired chi-square tests. A Cox regression model was utilized to establish a 1∶1 paired logistic regression model to examine the correlation between GST gene polymorphisms and susceptibility to NIHL. Results:Individuals with GSTM1 and GSTT1 gene deletion are more susceptible to NIHL compared to those with existing genes, even after adjusting for other factors ( OR=1.464, 95% CI: 1.02-2.09; OR=0.68, 95% CI: 1.06-2.02). Wearing protective equipment occasionally, rather than consistently, significantly increases the risk of NIHL ( OR=1.38, 95% CI: 1.01-1.88). There was no link between GSTP1rs1695 polymorphism and NIHL risk ( P>0.05) . Conclusion:The deletion of GSTM1 and GSTT1 genes is an independent influencing factor that increases the risk of NIHL, and can be considered as a genetic susceptibility biomarker for the NIHL population. Strengthening personal hearing protection is an effective measure to reduce the risk of NIHL.

Objective:To retrospectively analyze the pathogenic factors of retrograde peri-implantitis (RPI) and assess the effectiveness of treatment, and to provide clinicians evidence for the prevention and treatment of RPI.Methods:A total of 2 731 patients with missing teeth (4 016 implants) who underwent implant restoration in the Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University between January 2004 and December 2022 were included in the study. According to the diagnostic criteria of RPI, a total of 20 cases (23 implants) of RPI were collected, including 4 female (5 implants) and 16 male (18 implants), and the treatment medical records, intraoral photos and cone beam CT or oral panoramic radiographs records of each patient were collected. Each patient with RPI was treated accordingly and followed up regularly to evaluate its efficacy.Results:After treatment, the follow-up time for 20 patients with clinical symptoms of RPI was 13 (6, 40) months (1 month to 13 years), and the survival rate of the treated implants was 91% (21/23). There were 7 patients (8 implants) with inactive RPI, no clinical symptoms, no loosening of the implant, with normal occlusal load, and the disease was at the inactive stage and was not treated. The pulp vitality of the natural tooth adjacent to the implant was normal, and the implant could function normally. There were 13 patients (15 implants) with infected RPI, 1 patient (1 implant) had no loosening of the implant, and the periapical radiolucency of the implant disappeared after endodontic treatment of the natural tooth adjacent to the implant; 12 patients (14 implants) had clinical symptoms such as implant loosening, pus discharge, etc. Among them, 10 patients (12 implants) were successfully implanted in situ or in adjacent sites after removing the implants, and were successfully implanted after 3 to 20 months. Two patients(2 implants) were removed and no further implants were placed. Among them, 2 implants with infected RPI had cystic lesions, which was similar to natural root apex cysts.Conclusions:The etiology of RPI is related to inflammation of adjacent tooth root tips or bacterial residues from inflammatory lesions in the alveolar bone and bone augmentation. RPI can be treated by perfect root canal treatment of adjacent teeth, removal of inflammatory tissue, or simultaneous guided bone regeneration techniques.