Objective: To characterize longitudinal trajectories of testicular development in boys and breast development in girls, so as to provide reference data for understanding patterns of pubertal sexual maturation. Methods: Based on the Shanghai Pudong New Area Cohort Study on Growth, Development and Health in Children and Adolescents, a baseline survey was conducted in 2020 using a mult stage cluster random sampling method. A total of 2 184 children who completed all follow ups during the primary school period from 13 elementary schools in Pudong New Area,Shanghai,with annual follow ups during 2021-2025. Testicular volume and Tanner stage of breast development were assessed by professional physicians using standardized visual inspection and palpation. The age distribution of testicular volume and breast development was fitted by using cumulative link mixed models and Turnbull s nonparametric maximum likelihood estimation method. Results: Median ages for testicular volumes of 2, 3, 4 and 5 mL in boys were 7.07, 9.24, 10.29, and 11.57 years old, respectively. Median ages for Tanner breast stages Ⅱ, Ⅲ, Ⅳ, and Ⅴ in girls were 8.55 , 10.17, 11.18, and 13.78 years old, respectively. Based on overweight and obesity, stratified analysis showed that earlier pubertal onset among overweight/obesity children, and the key milestones for pubertal initiation were testicular volume reaching 4 mL in boys and breast Tanner II in girls for 10.29, 10.83; 8.18, 9.00 years. Conclusion Overweight and obesity are associated with earlier pubertal initiation,but there are certain gender and developmental stage specific patterns.

Objective:Reviewed the scope of the application of time-driven activity based costing(TDABC) in nursing costing, and the connotation of time-driven job costing, the current status of research, and the evaluation of the application effect were systematically sorted out. In order to provide an effective method for the improvement of nursing cost accounting level in China.Methods:In accordance with the scope review methodology of Arksey and O′Malley, the Cochrane Library, PubMed, Web of Science, Embase, Scopus, CINAHL, SinoMed, CNKI, Wanfang and VIP Database were systematically searched for relevant literature on the application of nursing costingrelated literature on time-driven job costing. The time frame was from the construction of the database to March 1, 2024. Summarization and analysis were conducted independently by 2 trained and qualified researchers, and third-party experts were invited to share decision-making in case of disagreement.Results:Twenty-seven literatures from nine countries were included. A review of the literature revealed that time-driven job costing is used throughout the entire process of nursing costing, and the results of its application include optimizing the allocation of nursing resources, accurately accounting for the true costs of clinical care pathways and processes, and assisting in the analysis of nursing cost decisions.Conclusions:TDABC has been widely recognized internationally, effectively supporting refined cost management and promoting decision-making optimisation. However, the current development of TDABC in nursing costing in China is yet to be perfected. In the future, we should deeply explore the combination of TDABC with the local healthcare system, and promote its wide application in China, so as to achieve the dual optimisation of cost control and nursing quality, and to better reflect the economic and social value of nursing services.

Objective:Reviewed the scope of the application of time-driven activity based costing(TDABC) in nursing costing, and the connotation of time-driven job costing, the current status of research, and the evaluation of the application effect were systematically sorted out. In order to provide an effective method for the improvement of nursing cost accounting level in China.Methods:In accordance with the scope review methodology of Arksey and O′Malley, the Cochrane Library, PubMed, Web of Science, Embase, Scopus, CINAHL, SinoMed, CNKI, Wanfang and VIP Database were systematically searched for relevant literature on the application of nursing costingrelated literature on time-driven job costing. The time frame was from the construction of the database to March 1, 2024. Summarization and analysis were conducted independently by 2 trained and qualified researchers, and third-party experts were invited to share decision-making in case of disagreement.Results:Twenty-seven literatures from nine countries were included. A review of the literature revealed that time-driven job costing is used throughout the entire process of nursing costing, and the results of its application include optimizing the allocation of nursing resources, accurately accounting for the true costs of clinical care pathways and processes, and assisting in the analysis of nursing cost decisions.Conclusions:TDABC has been widely recognized internationally, effectively supporting refined cost management and promoting decision-making optimisation. However, the current development of TDABC in nursing costing in China is yet to be perfected. In the future, we should deeply explore the combination of TDABC with the local healthcare system, and promote its wide application in China, so as to achieve the dual optimisation of cost control and nursing quality, and to better reflect the economic and social value of nursing services.

Objective To investigate the interaction relationship among symptoms in middle-aged patients during the recovery period of stroke and explore its correlation with rehabilitation confidence,providing a reference for the implementation of precise rehabilitation nursing.Methods A cross-sectional study was conducted,and 365 middle-aged patients in the recovery period of stroke who were hospitalized in 4 tertiary general hospitals in Wuhan from April 20 to August 31,2024 were conveniently selected as the subjects of the investigation.Data were collected using the General Information Questionnaire,Stroke Symptom Experience Scale,and Confidence after Stroke Measure Questionnaire.Symptom network analysis was conducted using R software,and a network structure model of symptoms-rehabilitation confidence was constructed;meanwhile,the stability of the network structure was evaluated.Results Finally,350 middle-aged stroke patients in the recovery period were included.The most common symptom was"limb weakness"(81.1％).Symptom network analysis showed that"limited limb movement"was the core symptom(rs=1.118).The symptoms strongly associated with recovery confidence were"limited physical movement","annoyance at not being able to do what you want to do"and"slow reaction times".Stability tests suggest that the model results are all good.Conclusion Symptoms of middle-aged patients in the recovery period after stroke are interrelated,and the mechanisms by which different symptoms affect rehabilitation confidence are also different.It is recommended that healthcare professionals prioritize interventions based on core symptoms and inter-symptom relationships in order to accurately enhance patient outcomes and improve recovery outcomes.

Objective:To explore the influences of FibroScan detection on the pregnancy outcomes of pregnant rats transfected with hepatitis B virus and the growth of their offspring rats.Methods:Sixty SPF-grade SD rats with a male-to-female ratio of 5∶1 were selected，randomly divided the female rats into the groups of mid-pregnancy with hepatitis B，late-pregnancy with hepatitis B，normal mid-pregnancy，normal late-pregnancy，and control group，and the rats in the mid-pregnancy and late-pregnancy groups were subjected to FibroScan testing on the 10th and 15th days of gestation respectively. The number of offspring rats in each group was randomly reduced to 10 on the 3rd day after delivery，and the offspring rats were divided into the groups of mid-pregnancy with hepatitis B，late-pregnancy with hepatitis B，normal mid-pregnancy，normal late-pregnancy，and control group. The pregnancy outcome levels of pregnant rats were observed by adopting a stratified analysis strategy，including differences in weight changes，number of deliveries，fetal rat outcomes，lactation conditions，litter size，and litter weight. The growth levels of offspring rats，including differences in weight，body length，tail length，and the time of fur growth，tooth eruption，eye opening，and ear standing on the 21st day were observed，and the survival rate of the offspring rats was compared.Results:With regard to the pregnancy outcome levels of the pregnant rats，there were no statistically significant differences in weight changes during pregnancy among the five groups of pregnant rats［ F（4，45）=2.627，Adjusted P=0.222］. There were also no statistically significant differences in the number of deliveries，fetal rat outcomes，and lactation conditions（Adjusted P=1.000）. The number of deliveries［ F（4，21.095）=2.280，Adjusted P=0.222］and litter weight［ F（4，20.128）=2.159，Adjusted P=0.222］showed no statistically significant differences. After correction using the BH method，none of the indicators showed significant differences（ P>0.05）. In terms of the growth levels of the offspring rats，among the five groups of offspring rats，there were no statistically significant differences in body weight on the 21st day［H（4）=11.623，Adjusted P=0.135］，body length on the 21st day［H（4）=10.962，Adjusted P=0.135］，and tail length on the 21st day［H（4）=9.126，Adjusted P=0.058］. Besides，the differences in the time of fur growth，tooth eruption，eye opening，and ear standing［H（4）=0.000，Adjust P=1.000］showed no statistical significance. The survival rate on the 7th day，14th day，and 21st day was 100%，with no significant differences（Adjusted P=1.000）. After correction using the BH method，none of the indicators showed significant differences（ P>0.05）. Conclusion:FibroScan detection had no significant influences on the pregnancy outcomes of pregnant rats with hepatitis B or on the growth of their offspring rats in multiple stages，dimensions，and indicators，indicating that FibroScan detection is safe for pregnant rats. This research provides an animal experimental basis for the safe use of FibroScan in pregnant women with chronic HBV infection.

Objective:To investigate the current state of oral health knowledge,attitude and practice(KAP)of plateau military personnels and to analyze the disease condition,aiming to explore new strategies for enhancing oral health.Methods:A question-naire was developed to survey 500 individuals at high altitudes(≥3 000 m)and 500 at low altitudes(≤1 000 m)regarding their oral health KAP,with 100 subjects randomly selected from each group for oral examinations.Logistic regression analysis was ap-plied to examine the correlation between KAP and disease status.Based on these findings,a survey of the oral health needs of mili-tary personnels was conducted in conjunction with their KAP.And an innovative training system,"Perception-Comprehension-Inte-gration"(PCI),was established to improve the competencies of primary healthcare providers,with its effectiveness being evaluated.Results:The high altitude group had significantly lower rates of overall oral health awareness(53.61％),positive attitude(55.00％)and positive practice(40.29％)compared with the low altitude group(P＜0.05);the incidence in high altitude group experiencing dental caries(73％),wedge-shaped defects(34％),pericoronitis(16％),gingival bleeding(74％),dental calculus(81％)and cheilitis(37％)were significantly higher than those in the low altitude group(P＜0.05).There was a significant nega-tive correlation between KAP scores and disease prevalence.The subjects in both groups showed a substantial demand(exceeding 70％)for oral health.The innovative PCI training system has markedly strengthened the health personnel's compre-hensive preventive and health care capabilities.Conclu-sion:The oral health status of plateau military personnels is in dire need of enhancement.And the PCI training sys-tem is poised to serve as a novel approach to tackling this critical concern.

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

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective:To investigate the current state of oral health knowledge,attitude and practice(KAP)of plateau military personnels and to analyze the disease condition,aiming to explore new strategies for enhancing oral health.Methods:A question-naire was developed to survey 500 individuals at high altitudes(≥3 000 m)and 500 at low altitudes(≤1 000 m)regarding their oral health KAP,with 100 subjects randomly selected from each group for oral examinations.Logistic regression analysis was ap-plied to examine the correlation between KAP and disease status.Based on these findings,a survey of the oral health needs of mili-tary personnels was conducted in conjunction with their KAP.And an innovative training system,"Perception-Comprehension-Inte-gration"(PCI),was established to improve the competencies of primary healthcare providers,with its effectiveness being evaluated.Results:The high altitude group had significantly lower rates of overall oral health awareness(53.61％),positive attitude(55.00％)and positive practice(40.29％)compared with the low altitude group(P＜0.05);the incidence in high altitude group experiencing dental caries(73％),wedge-shaped defects(34％),pericoronitis(16％),gingival bleeding(74％),dental calculus(81％)and cheilitis(37％)were significantly higher than those in the low altitude group(P＜0.05).There was a significant nega-tive correlation between KAP scores and disease prevalence.The subjects in both groups showed a substantial demand(exceeding 70％)for oral health.The innovative PCI training system has markedly strengthened the health personnel's compre-hensive preventive and health care capabilities.Conclu-sion:The oral health status of plateau military personnels is in dire need of enhancement.And the PCI training sys-tem is poised to serve as a novel approach to tackling this critical concern.

Objective To investigate the interaction relationship among symptoms in middle-aged patients during the recovery period of stroke and explore its correlation with rehabilitation confidence,providing a reference for the implementation of precise rehabilitation nursing.Methods A cross-sectional study was conducted,and 365 middle-aged patients in the recovery period of stroke who were hospitalized in 4 tertiary general hospitals in Wuhan from April 20 to August 31,2024 were conveniently selected as the subjects of the investigation.Data were collected using the General Information Questionnaire,Stroke Symptom Experience Scale,and Confidence after Stroke Measure Questionnaire.Symptom network analysis was conducted using R software,and a network structure model of symptoms-rehabilitation confidence was constructed;meanwhile,the stability of the network structure was evaluated.Results Finally,350 middle-aged stroke patients in the recovery period were included.The most common symptom was"limb weakness"(81.1％).Symptom network analysis showed that"limited limb movement"was the core symptom(rs=1.118).The symptoms strongly associated with recovery confidence were"limited physical movement","annoyance at not being able to do what you want to do"and"slow reaction times".Stability tests suggest that the model results are all good.Conclusion Symptoms of middle-aged patients in the recovery period after stroke are interrelated,and the mechanisms by which different symptoms affect rehabilitation confidence are also different.It is recommended that healthcare professionals prioritize interventions based on core symptoms and inter-symptom relationships in order to accurately enhance patient outcomes and improve recovery outcomes.