Dental treatments for children and adolescents have unique clinical characteristics that differ from dental care for adults in terms of children's physiology, psychology, and behavior. These differences impose specific requirements on the application of local anesthesia in pediatric dental procedures. This article presents expert consensus on the principles of local anesthesia techniques in pediatric dental therapies, including the use of common anesthetic drugs and dosage control, safety and efficacy evaluation, and prevention and management of complications. The aim is to improve the safety and quality of pediatric dental treatments and offer guidance for clinical application by dentists.
Humans ; Child ; Anesthesia, Local/methods* ; Consensus ; Anesthesia, Dental/methods* ; Adolescent ; Anesthetics, Local/administration & dosage* ; Dental Care for Children

This study was aimed at studying the drug resistance,serotypes,and molecular characteristics of Vibrio parahaemo-lyticus(VP)in Suzhou,to provide basic data for the prevention and control of VP-related diseases.Drug susceptibility testing of 177 VP strains isolated from Suzhou City in 2023 was performed with the microbroth dilution method.Virulence genes,serotypes,and multi-locus sequence typing(MLST)were analyzed on the basis of whole genome sequencing results.The drug resistance rate of 177 VP strains was highest against cefazolin(100.00%),followed by ampicillin(77.97%),and polymyxine E(63.84%),and the multiple drug resistance rate was 53.67%.In clinical isolates,O10∶K4(37.41%)was the most abundant serotype,and was followed by O3∶K6(28.78%),and ST3 was the dominant ST type.The main virulence genes of clinical isolates were tlh+,tdh+,and trh-(79.86%),whereas the virulence genes in food isolates were all tlh+,tdh-,and trh-.Strains of the same serotype clustered together in the SNP phylogenetic tree.The environmental isolates showed no obvious dominant serotype or ST type.In Suzhou,VP has a high proportion of multi-drug resistance,the clinical isolates have prevalent serotypes and ST types,and most isolates carried virulence genes;there-fore,monitoring should be strengthened.

Objective:To construct a multilevel nursing featured case bank, and to explore the effect of the case bank in clinical teaching of professional postgraduate nursing students, and to provide new ideas for teaching reform.Methods:Sixty professional postgraduate nursing students who interned in the First Affiliated Hospital of Nanchang University from May to September 2022 and from May to September 2023 were selected. The 30 professional postgraduate nursing students who interned from May to September 2022 were included in the control group, and the 30 professional postgraduate nursing students who interned from May to September 2023 were included in the intervention group. The control group was taught by the teaching teacher using the traditional teaching courseware of the internship department and instructed by the teaching teacher for taking care of the real patients and writing nursing records. The intervention group employed the multilevel nursing featured case bank for teaching on this basis. The autonomous learning ability and critical thinking ability were compared between the two groups before and after 2 months of intervention, respectively, and the satisfaction to the case bank was evaluated. The SPSS 25.0 statistical software was used for t-test and chi-square test. Results:After 2 months of teaching, the autonomous learning ability and critical thinking ability scores were (104.50±7.20) points and (283.73±19.42) points in the control group and (113.27±4.90) points and (304.60±13.40) points in the intervention group, and the differences between the two groups were statistically significant ( P<0.05). Twenty-seven (90.00%) students were satisfied with the multilevel nursing featured case bank. Conclusions:Application of the multilevel nursing featured case bank to clinical teaching can effectively improve the autonomous learning ability and critical thinking ability of professional postgraduate nursing students. It is an effective way to cultivate professional postgraduate nursing students.

This study was aimed at studying the drug resistance,serotypes,and molecular characteristics of Vibrio parahaemo-lyticus(VP)in Suzhou,to provide basic data for the prevention and control of VP-related diseases.Drug susceptibility testing of 177 VP strains isolated from Suzhou City in 2023 was performed with the microbroth dilution method.Virulence genes,serotypes,and multi-locus sequence typing(MLST)were analyzed on the basis of whole genome sequencing results.The drug resistance rate of 177 VP strains was highest against cefazolin(100.00%),followed by ampicillin(77.97%),and polymyxine E(63.84%),and the multiple drug resistance rate was 53.67%.In clinical isolates,O10∶K4(37.41%)was the most abundant serotype,and was followed by O3∶K6(28.78%),and ST3 was the dominant ST type.The main virulence genes of clinical isolates were tlh+,tdh+,and trh-(79.86%),whereas the virulence genes in food isolates were all tlh+,tdh-,and trh-.Strains of the same serotype clustered together in the SNP phylogenetic tree.The environmental isolates showed no obvious dominant serotype or ST type.In Suzhou,VP has a high proportion of multi-drug resistance,the clinical isolates have prevalent serotypes and ST types,and most isolates carried virulence genes;there-fore,monitoring should be strengthened.

Objective:To construct a multilevel nursing featured case bank, and to explore the effect of the case bank in clinical teaching of professional postgraduate nursing students, and to provide new ideas for teaching reform.Methods:Sixty professional postgraduate nursing students who interned in the First Affiliated Hospital of Nanchang University from May to September 2022 and from May to September 2023 were selected. The 30 professional postgraduate nursing students who interned from May to September 2022 were included in the control group, and the 30 professional postgraduate nursing students who interned from May to September 2023 were included in the intervention group. The control group was taught by the teaching teacher using the traditional teaching courseware of the internship department and instructed by the teaching teacher for taking care of the real patients and writing nursing records. The intervention group employed the multilevel nursing featured case bank for teaching on this basis. The autonomous learning ability and critical thinking ability were compared between the two groups before and after 2 months of intervention, respectively, and the satisfaction to the case bank was evaluated. The SPSS 25.0 statistical software was used for t-test and chi-square test. Results:After 2 months of teaching, the autonomous learning ability and critical thinking ability scores were (104.50±7.20) points and (283.73±19.42) points in the control group and (113.27±4.90) points and (304.60±13.40) points in the intervention group, and the differences between the two groups were statistically significant ( P<0.05). Twenty-seven (90.00%) students were satisfied with the multilevel nursing featured case bank. Conclusions:Application of the multilevel nursing featured case bank to clinical teaching can effectively improve the autonomous learning ability and critical thinking ability of professional postgraduate nursing students. It is an effective way to cultivate professional postgraduate nursing students.

Objective Studies on the relationship between iodine,vitamin A(VA),and vitamin D(VD)and thyroid function are limited.This study aimed to analyze iodine and thyroid-stimulating hormone(TSH)status and their possible relationships with VA,VD,and other factors in postpartum women. Methods A total of 1,311 mothers(896 lactating and 415 non-lactating)from Hebei,Zhejiang,and Guangxi provinces were included in this study.The urinary iodine concentration(UIC),TSH,VA,and VD were measured. Results The median UIC of total and lactating participants were 142.00 μg/L and 139.95 μg/L,respectively.The median TSH,VA,and VD levels in all the participants were 1.89 mIU/L,0.44 μg/mL,and 24.04 ng/mL,respectively.No differences in the UIC were found between lactating and non-lactating mothers.UIC and TSH levels were significantly different among the three provinces.The rural UIC was higher than the urban UIC.Obese mothers had a higher UIC and a higher prevalence of excessive TSH.Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group.After adjustment,no linear correlation was observed between UIC and VA/VD.No interaction was found between vitamins A/D and UIC on TSH levels. Conclusion The mothers in the present study had no iodine deficiency.Region,area type,BMI,and VD may be related to the iodine status or TSH levels.

The odor fingerprint of Pollygonati Rhizoma samples with different mildewing degrees was analyzed and the relationship between the odor variation and the mildewing degree was explored. A fast discriminant model was established according to the response intensity of electronic nose. The α-FOX3000 electronic nose was applied to analyze the odor fingerprint of Pollygonati Rhizoma samples with different mildewing degrees and the radar map was used to analyze the main contributors among the volatile organic compounds. The feature data were processed and analyzed by partial least squares discriminant analysis(PLS-DA), K-nearest neighbor(KNN), sequential minimal optimization(SMO), random forest(RF) and naive Bayes(NB), respectively. According to the radar map of the electronic nose, the response values of three sensors, namely T70/2, T30/1, and P10/2, increased with the mildewing, indicating that the Pollygonati Rhizoma produced alkanes and aromatic compounds after the mildewing. According to PLS-DA model, Pollygonati Rhizoma samples of three mildewing degrees could be well distinguished in three areas. Afterwards, the variable importance analysis of the sensors was carried out and then five sensors that contributed a lot to the classification were screened out: T70/2, T30/1, PA/2, P10/1 and P40/1. The classification accuracy of all the four models(KNN, SMO, RF, and NB) was above 90%, and KNN was most accurate(accuracy: 97.2%). Different volatile organic compounds were produced after the mildewing of Pollygonati Rhizoma, and they could be detected by electronic nose, which laid a foundation for the establishment of a rapid discrimination model for mildewed Pollygonati Rhizoma. This paper shed lights on further research on change pattern and quick detection of volatile organic compounds in moldy Chinese herbal medicines.
Electronic Nose ; Odorants/analysis* ; Volatile Organic Compounds/analysis* ; Bayes Theorem ; Drugs, Chinese Herbal/analysis* ; Discriminant Analysis

This study compared the chemical profiles, component content, dry paste yield, and pharmacological effects of samples obtained from the mixed single decoctions and the combined decoction of Gegen Qinlian Decoction(GQD), aiming to provide an experimental foundation for evaluating the equivalence of the two decocting methods and the suitability of TCM formula granules in clinical application. The same decoction process was used to prepare the combined decoction and mixed single decoctions of GQD. Ultra-performance liquid chromatography coupled with Q-Exactive Orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap MS) was employed to compare the chemical profiles between the two groups. High-performance liquid chromatography(HPLC) was used to compare the content of nine characteristic components between the two groups. Then, a delayed diarrhea mouse model induced by irinotecan was established to compare the pharmacological effects of the two groups on chemotherapy-induced diarrhea. The UPLC-Q-Exactive Orbitrap MS in ESI~+ and ESI~- modes identified 59 chemical components in the compound decoction and mixed single decoctions, which showed no obvious differences in component species. The content of baicalin and wogonoside was higher in the compound decoction, while that of puerarin, daidzein-8-C-apiosylglucoside, berberine, epiberberine, wogonin, glycyrrhizic acid, and daidzein was higher in the mixed single decoctions. Further statistical analysis revealed no significant difference in the content of the nine characteristic components between the compound decoction and the mixed single decoctions. The dry paste yield had no significant difference between the two groups. Compared with the model group, both compound decoction and mixed single decoctions alleviated the weight loss and reduced diarrhea index in mice. Both of them lowered the levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), cyclooxygenase-2(COX-2), intercellular adhesion molecule-1(ICAM-1), interleukin-10(IL-10), malondialdehyde(MDA), and nitric oxide(NO) in the colon tissue. Furthermore, they significantly increased the levels of glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD). Hematoxylin-eosin(HE) staining showed that colon tissue cells were tightly arranged with clear nuclei in both groups without obvious difference. The compound decoction and mixed single decoctions showed no significant differences in chemical component species, content of nine characteristic components, dry paste yield, or the pharmacological effects on alleviating chemotherapy-induced diarrhea. The findings provide a reference for evaluating the flexibility and superiority of combined or single decocting method in the preparation of TCM decoctions or formula granules.
Animals ; Mice ; Biological Products ; Chromatography, High Pressure Liquid ; Coleoptera ; Cyclooxygenase 2 ; Diarrhea/drug therapy* ; Antineoplastic Agents

This study aimed to investigate the development status of traditional Chinese medicine(TCM) intervention in psoriasis in recent ten years, analyze the research hotspots, and summarize the development trends to provide reference materials for scholars in this field. Taking the available literature related to the field of TCM intervention in psoriasis as the research object, the trends, contents, and source publications were statistically analyzed based on bibliometrics. The research cooperation and co-occurrence of keywords in this field were studied by the knowledge map analysis method based on CiteSpace. The total number of Chinese papers was 2 993 and English papers 285. In terms of publication trend, the annual publication of English papers was low but showed an obvious upward trend, while the increase in Chinese papers fluctuated and tended to be flat. In terms of the content of Chinese papers published, TCM ranked first according to the discipline(2 415). In English papers, the number of publications in pharmacology and pharmaceutical science was the highest(87). Literature source analysis showed that the Chinese and English journals with the most publications were China Journal of Traditional Chinese Medicine and Pharmacy and Evidence Based Complementary and Alternative Medicine, respectively. Beijing University of Chinese Medicine published the most dissertations in China(99). The authors with the most publications in Chinese and English were LI Bin(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine) and LU Chuan-jian(Guangdong Hospital of Traditional Chinese Medicine). As revealed by the CiteSpace analysis of the research cooperation network, there were four mature and stable core teams in this field, but the cooperation intensity between different teams was weak. According to the keywords co-occurrence knowledge graph constructed by CiteSpace, the current hot keywords in this field are as follows: psoriasis, blood-heat syndrome, blood-stasis syndrome, fire needle, blood-dryness type, imiquimod, TCM bath, etiology and pathogenesis, cytokines, cupping therapy, etc. In summary, Chinese scholars have conducted active exploration and research in the field of TCM intervention in psoriasis in recent ten years. The overall development trend is good, and the breadth and depth of the research are constantly extending. It is suggested that relevant research should be free from discipline restrictions and strive for interdisciplinary integration.
Humans ; Medicine, Chinese Traditional ; Psoriasis/drug therapy*

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.