Objective: To analyze the characteristics of alcohol poisoning cases among minors receiving pre hospital 120 emergency services in Zhengzhou, providing evidence for regional management strategies of alcohol poisoning among minors. Methods: A retrospective study was conducted on 1 630 alcohol poisoning cases (aged 0-18 years) from Zhengzhou s 120 emergency system during 2017-2019 and 2023. Data on gender, age, occurrence timeframes were analyzed using t-test and χ 2 test for intergroup comparisons. Results: Annual cases were 291 (2017), 353 (2018), 483 (2019), and 503 (2023). Compared with 2017, male alcohol poisoning cases increased by 66.94% while female cases surged 104.35% by 2023. The peak incidence of alcohol poisoning among minors occurred among 16-18 year olds (85.40%), followed by 13-15 year olds (13.74%). Most cases clustered between 21:01-03:00 (60.43%), with male cases peaking at 22:01-23:00 (12.73%) and female cases peaking at 02:01-03:00 ( 11.25 %). Between 00:01-03:00, male cases progressively decreased while female cases increased. Severity distribution showed 355 mild cases (21.78%), 1 035 moderate cases (63.50%), and 240 severe cases (14.72%). Conclusions Zhengzhou region has experienced sustained growth in underage alcohol poisoning cases, predominantly occurring from evening to early morning with moderate severity, female cases demonstrate faster growth rates. Multifaceted regulatory measures should be implemented to strengthen supervision of underage drinking behaviors.

Background::In vitro fertilization (IVF) has emerged as a transformative solution for infertility. However, achieving favorable live-birth outcomes remains challenging. Current clinical IVF practices in IVF involve the collection of heterogeneous embryo data through diverse methods, including static images and temporal videos. However, traditional embryo selection methods, primarily reliant on visual inspection of morphology, exhibit variability and are contingent on the experience of practitioners. Therefore, an automated system that can evaluate heterogeneous embryo data to predict the final outcomes of live births is highly desirable. Methods::We employed artificial intelligence (AI) for embryo morphological grading, blastocyst embryo selection, aneuploidy prediction, and final live-birth outcome prediction. We developed and validated the AI models using multitask learning for embryo morphological assessment, including pronucleus type on day 1 and the number of blastomeres, asymmetry, and fragmentation of blastomeres on day 3, using 19,201 embryo photographs from 8271 patients. A neural network was trained on embryo and clinical metadata to identify good-quality embryos for implantation on day 3 or day 5, and predict live-birth outcomes. Additionally, a 3D convolutional neural network was trained on 418 time-lapse videos of preimplantation genetic testing (PGT)-based ploidy outcomes for the prediction of aneuploidy and consequent live-birth outcomes.Results::These two approaches enabled us to automatically assess the implantation potential. By combining embryo and maternal metrics in an ensemble AI model, we evaluated live-birth outcomes in a prospective cohort that achieved higher accuracy than experienced embryologists (46.1% vs. 30.7% on day 3, 55.0% vs. 40.7% on day 5). Our results demonstrate the potential for AI-based selection of embryos based on characteristics beyond the observational abilities of human clinicians (area under the curve: 0.769, 95% confidence interval: 0.709–0.820). These findings could potentially provide a noninvasive, high-throughput, and low-cost screening tool to facilitate embryo selection and achieve better outcomes. Conclusions::Our study underscores the AI model’s ability to provide interpretable evidence for clinicians in assisted reproduction, highlighting its potential as a noninvasive, efficient, and cost-effective tool for improved embryo selection and enhanced IVF outcomes. The convergence of cutting-edge technology and reproductive medicine has opened new avenues for addressing infertility challenges and optimizing IVF success rates.

Objective To improve the water solubility of natural drugs and the efficiency of their transport into the brain,to prepare nanogel dropping pills modified with lactoferrin for loading poorly soluble drugs and investigate the preparation process,and to provide a reference for drug development in the field of neurodegenerative diseases.Methods Using the insoluble drug icariin as the payload,the lactoferrin-modified zinc alginate nanogels were prepared by the reverse-phase microemulsion method.The drug loading and encapsulation rates of icariin in the nanogel were determined by HPLC.Taking the utilizing parameters such as roundness,weight difference and disintegration time as evaluation indicators,the best preparation process of dropping pills was optimized by single factor experiments and Box-Behnken response surface methodology.It was characterized by Fourier transform infrared spectroscopy,the release behavior of nanogel in dropping pills was explored by basket rotating method,and the brain entry efficiency between sublingual and oral administration of drip pills were compared by fluorescence tracing method.Results The drug loading rate of the nanogel was(2.67±0.05)%,and the encapsulation rate was(84.74±0.03)%by HPLC.The optimal preparation process for lactoferrin modified nanogel dropping pills was as follows:the ratio of matrix to nano gel was 5:1,the drop distance was 5.5 cm,and the condensation temperature was 8.5℃.Using the modified lactoferrin as a marker,its cumulative release rate in vitro reached 92.25%.Fluorescence tracing studies showed that compared to the oral group,sublingual administration of dripping pills facilitated the faster and more effective passage of drugs through the blood-brain barrier,significantly enhanced the efficiency of drug transport into the brain.Conclusion The prepared lactoferrin-modified nanogels can be used as a loading platform for poorly soluble drugs and enhance the drug solubility.When further formulated into dripping pills,it significantly enhances the efficiency of drug transport into the brain after sublingual administration.This also enhances medication compliance among neurodegenerative patients and fulfills the clinical demand for the drug.

This article introduces a recent paper published in JAMA titled " Tirzepatide for weight reduction in Chinese adults with obesity: The SURMOUNT-CN randomised clinical trial". The paper details the design, results, and implications of a randomized controlled clinical study of the efficacy and safety of tirzepatide in overweight/obese adults in China(SURMOUNT-CN). This study represents the first Chinese evidence supporting tirzepatide for the treatment of obesity, offering a potent therapeutic option for the prevention and treatment of obesity and weight-related comorbidity.

Purpose/Significance To sort out the development history,existing problems and countermeasures of public health infor-matization,and to provide decision-making reference for informatization construction and improvement of informatization system in do-mestic public health field.Method/Process Based on the literature related to the research of public health informatization in China in CNKI,the development history and problems of public health informatization are analyzed.Result/Conclusion Public health informatiza-tion in China has gone through 4 major stages of development:national co-ordination,key promotion,hierarchical pilot,and intercon-nection,and there are problems in the infrastructure of disease control informatization,infectious disease informatization construction,in-formation standard system construction,and information security construction,which need to be addressed by countermeasures.

Objective To investigate the effect of hypoxia-induced factor 1α and 2α(HIF-1α and HIF-2α)on ethanol-in-duced intestinal epithelium cellular barrier dysfunction of colorectal adenocarcinoma cell(Caco-2)monolayers and its mechanism.Methods Intestinal epithelium monolayer cellular barrier model was obtained by Caco-2 in vitro and induced by ethanol with different concentrations.The cell viability was measured by MTT method.Caco-2 cells were treated with or without ethanol according to the opti-mum concentration and time.The secretions of interleukin 1 β(IL-1 β)and interleukin 6(IL-6)were detected by ELISA.The expres-sions of HIF-lα,HIF-2α,and Neu3 were analyzed by Western blot and RT-PCR.The permeability of Caco-2 cell monolayers was evaluated by transepithelial electrical resistance(TEER).Next,Caco-2 cells were transfected with small interfering RNA(siRNA)to knock down the expression of HIF-1α and HIF-2α.The cell viability,the levels of IL-1 β and IL-6,and the expression of Neu3 and TEER in each group were detected,respectively.Then,the expression of Neu3 was inhibited with siRNA to assess the permeability of Ca-co-2 cell monolayers by TEER.Results The inhibitory effect of ethanol on Caco-2 cells was dose-dependent when the concentration of ethanol was higher than 5％.When Caco-2 cells were treated with ethanol with a concentration of 5％for one hour,the levels of proinflammatory cytokines IL-1 β and IL-6 were promoted.Compared to the control group,ethanol also induced the expression of HIF-1α,HIF-2α,Neu3 and reduced TEER values(P＜0.05).After HIF-1α or HIF-2α siRNA interference in ethanol-induced Caco-2 cells,the cell viability was inhibited,the secretions of IL-1 β and IL-6 were significantly elevated and the values of TEER were decreased(P＜0.05).Interestingly,the expression of Neu3 was inhibited when HIF-2α was deleted but not HIF-1α(P＜0.05).Furthermore,TEER analysis showed an increased cellular permeability when the expression of Neu3 was inhibited(P＜0.05).Conclusion The HIF-1α or HIF-2α signal pathway may be involved regulation process of ethanol-induced increased permeability of the intestinal epithelium cellular barrier.In this process,Neu3 may be mediated by HIF-2α but not HIF-1α,contributing to intestinal epithelium cellular barrier dysfunction in ethanol-induced Caco-2.

Purpose To investigate the value of enhanced CT gray-level co-occurrence matrix(GLCM)for predicting central lymph node metastasis(CLNM)in cN0 papillary thyroid carcinoma.Materials and Methods Between January 2020 to December 2021,55 cases confirmed cN0 papillary thyroid carcinoma in Xuzhou Central Hospital by clinical and surgical pathology were analyzed retrospectively.According to the postoperative pathological results,all 55 cases were divided into CLNM-positive(34 cases)and CLNM-negative groups(21 cases).All patients underwent dual-phase enhanced CT scan of the neck before operation.Image J software was performed to extract the GLCM parameters(angular second moment,contrast,correlation,inverse difference moment,entropy)of the maximum slice of the tumor in the arterial(A)and venous(V)phases,these parameters between the GLCM parameters of CLNM-positive and negative groups were compared.And the receiver operating characteristic curve was applied to evaluate the prediction efficiency.Results A-angular second moment,A-entropy and V-entropy were significant differences between the two groups(t/Z=-2.140,2.753,2.736,all P<0.05),no significant differences were observed in other parameters between the two groups(P>0.05).The area under curve value of A-angular second moment,A-entropy,V-entropy,combined A-angular second moment and A-entropy to predict CLNM was 0.672,0.706,0.686,0.734,respectively.Combined A-angular second moment and A-entropy had the best predictive efficacy,with the sensitivity and specificity were 76.47%and 66.67%,respectively.Conclusion Enhanced CT GLCM has the efficacy to preoperative CLNM in cN0 papillary thyroid carcinoma patients,combined arterial phase parameter A-angular second moment and A-entropy has the best prediction efficiency.

Objective:To compare the efficacy of programmed death-1(PD-1)inhibitors combined with chemotherapy with that of bevaci-zumab combined with chemotherapy as first-line treatments for advanced non-squamous non-small cell lung cancer(nsNSCLC).Methods:Retrospective collection of 237 patients with advanced nsNSCLC who received first-line treatment at the Fourth Hospital of Hebei Medical University from November 2014 to March 2024.According to the treatment plan,119 cases were assigned into PD-1 inhibitor com-bined with chemotherapy(IC group)and 118 cases were assigned into bevacizumab combined with chemotherapy(BC group).Propensity score matching(PSM)was used to balance covariates.The primary endpoint was progression-free survival(PFS),and the secondary end-points were objective response rate(ORR),disease control rate(DCR),and overall survival(OS).Results:Among 237 patients with PSM,87 were assigned to the IC group and 87 to the BC group,with respective ORRs of 31.0%(27/87)and 43.7%(38/87)(P=0.085)and respective DCRs of 96.6%(84/87)and 95.4%(83/87)(P=1.000).No significant difference in the median PFS was observed between the two groups,with a PFS value of 9.3 months in the IC group and 9.1 months in the BC group(P=0.053).In addition,the two groups also showed no significant difference in OS(neither group reached the median OS;P=0.116).Conclusions:There was no significant difference in the short-term efficacy between chemotherapy combined with PD-1 inhibitor and that combined with bevacizumab as first-line treatments for advanced nsNSCLC.

Parkinson disease is a common neurodegenerative disease.At present,the main therapeutic drugs have problems such as adverse reactions,lack of targeting,and low bioavailability.The development of new drugs is an important direction for research related to Parkinson disease.TCM flavonoids have various pharmacological activities and are widely used in anti-tumor and cardiovascular disease treatment,but there is relatively little research on their intervention in neurological diseases.This article elaborated on the mechanism of intervention of TCM flavonoids in Parkinson disease and summarized treatment strategies from six categories:flavonoids,flavonols,isoflavones,flavonoid glycosides,dihydroflavonols,and others,with the purpose to provide reference for the research and clinical application of TCM flavonoids.

Objective:To analyze the concentration of formic acid,propionic acid and butyric acid in gingival crevicular fluid(GCF)of patients with stages Ⅲ and Ⅳ periodontitis,and their relationship with periodontitis.Methods:The study enrolled 37 systemically healthy patients with periodontitis and 19 healthy controls who visited Department of Periodontology,Peking University School and Hospital of Sto-matology from February 2008 to May 2011.Their GCFs were collected from the mesial-buccal site of one molar or incisor in each quadrant.Periodontal clinical parameters,including plaque index(PLI),probing depth(PD),bleeding index(BI),and attachment loss(AL).Concentrations of formic acid,propionic acid and butyric acid in the supernatant of the GCFs were analyzed by high-performance capil-lary electrophoresis(HPCE).The prediction ability of formic acid,propionic acid and butyric acid with the risk of periodontitis and the differences between grade B and grade C periodontitis were analyzed.Results:In this study,32 patients with stage Ⅲ and 5 patients with stage Ⅳ were enrolled,including 9 patients with grade B and 28 patients with grade C.Clinical periodontal variables in the patients with pe-riodontitis were significantly higher than those in the control group(P＜0.001).Formic acid was signifi-cantly lower in periodontitis than that in the control group[5.37(3.39,8.49)mmol/L vs.12.29(8.35,16.57)mmol/L,P＜0.001].Propionic acid and butyric acid in periodontitis were significantly higher than those in the control group:Propionic acid,10.23(4.28,14.90)mmol/L vs.2.71(0.00,4.25)mmol/L,P＜0.001;butyric acid,2.63(0.47,3.81)mmol/L vs.0.00(0.00,0.24)mmol/L,P＜0.001.There was no significant difference in formic acid,propionic acid and butyric acid concentrations between grade B and grade C periodontitis(P＞0.05).Propionic acid and butyric acid in the deep pocket were significantly higher than in the shallow pocket,while the concentration of formic acid decreased with the increase of PD.Propionic acid(OR=1.51,95％CI:1.29-1.75)and butyric acid(OR=3.72,95％CI:1.93-7.17)were risk factors for periodontitis,while formic acid(OR=0.87,95％CI:0.81-0.93)might be a protective factor for periodontitis.Propionic acid(AUC=0.852,95％CI:0.805-0.900),butyric acid(AUC=0.889,95％CI:0.841-0.937),f(formic acid,AUC=0.844,95％CI:0.793-0.895)demonstrated a good predictive capacity for the risk of periodontitis.Conclusion:The concentration of formic acid decrease in the GCF of periodontitis patients,which is a protective factor for periodontitis,its reciprocal have good predictive capacity.However,propionic acid and butyric acid increase,which are risk factors for periodontitis and have good predictive capacity.The concentration of formic acid,propionic acid,and butyric acid vary with probing depth,but there is no significant difference between grade B and grade C periodontitis.