Objective: To understand the allocation and use of safety seats for preschool children and explore its related factors, so as to provide a scientific reference for promoting the usage of safety seats. Methods: A stratified random cluster sampling method was used to select 3 143 parents of preschool children aged 3 to 6 from six kindergartens in Shunyi District, Beijing from January 3 to 10, 2022. An online questionnaire survey was conducted to collect and evaluate the equipment and use of child safety seats in different characteristics of preschool children, as well as their scores of health beliefs. Multiple factor Logistic regression analysis was used to investigated the related factors of safety seat configuration and use. Results: The equipping rate and usage rate of safety seats for preschool children were 66.56% and 58.45%, respectively. The proportion of equipped and used safety seats for preschool children in core families (69.52%, 62.23%) were higher than that in large families (64.35%, 55.62%), only child families ( 72.39 %, 64.87%) were higher than non only child families (61.49%, 52.86%), and urban families (71.63%, 63.04%) were higher than rural families (52.31%, 45.51%) ( χ 2=9.23, 13.86; 41.72, 46.44; 101.96 ,76.97,all P <0.05) . As the educational level of parents ( χ 2 trend =154.23,98.76) and annual income of the family ( χ 2 trend =155.78,127.69) rised, the reporting rates of the equipped and used child safety seats in the family also increased(all P <0.05 ). There were statistically significant differences in the scores of different dimensions of health beliefs for the provision ( t =-20.22-18.16) and use ( t =24.32-24.17) of safety seats for preschool children(all P <0.05). After adjusting for child sex, child age, family annual income, parental education level, family type, whether the child was an only child, and place of residence，multivariate Logistic regression analysis showed that preschool children with higher perceived susceptibility score( OR =1.11, 1.08), higher self efficacy score( OR =1.23, 1.33), and higher suggestive factors score( OR =1.08, 1.12) were more likely to have and use safety seats in their families, while preschool children with higher perceived impairments score( OR =0.82, 0.80) were less likely to have and use safety seats in their families (all P <0.05). Conclusions The installation rate of child safety seats needs to be improved, and there is also a certain gap in their use after installation. Parents of preschool children should improve susceptibility and self efficacy to safety seat equipment and use, and perceptual barriers should be reduced.

Infection is an important trigger for the initiation of pancreatic islet autoimmunity in type 1 diabetes mellitus （T1DM）. From the perspective of latent pathogen and dryness disorder， this study analyzes the core pathogenesis and dynamic evolution of T1DM in the subclinical and clinical stages. Combined with the T1DM "constraint， heat， deficiency， damage" state and target differentiation and treatment theory， the course of infection-induced T1DM is divided into three stages， including latent dryness， dry-heat and collateral damage. The "latent dryness" stage corresponds to the subclinical phase of T1DM， while the "dry-heat" stage corresponds to the clinical phase， and the "collateral damage" stage corresponds to the phase in which chronic complications develop. Treatment principles include supplementing deficiency and dispelling pathogen during the "latent dryness" stage， clearing heat and moistening dryness in the "dry-heat" stage， and dissolving stasis and unblocking collaterals in the "collateral damage" stage. Furthermore， syndrome-targeted and target-directed therapeutic modifications were made according to T1DM-related autoimmune activity， metabolic comorbidities， and vascular comorbidities， providing a reference for clinical management of T1DM.

Objective: To understand the current status and related factors of oral health behavior in preschool children, so as to provide scientific basis for improving parents oral health care abilities. Methods: From March 5 to 12, 2024, using a stratified cluster sampling method, an online questionnaire survey was conducted among parents of 1 381 preschool children aged 3-6 from 6 selected kindergartens of a district in Beijing. A structural equation model (SEM) was constructed based on the Theory of Planned Behavior framework to analyze the factors associated with preschool children s oral health behaviors. Results: The rates of parental assistance in brushing teeth, regular oral examination, and postprandial rinsing were 44.4%, 18.6% and 23.6%, respectively. Attitude, subjective norms were positively correlated with oral health behavior intention ( r =0.61, 0.55); attitude, perceived behavioral control, and behavioral intention were positively correlated with oral health behavior ( r =0.14, 0.13, 0.16) (all P < 0.01 ). The results of the SEM showed that attitude and subjective norms had a significant direct effect on oral health behavior intention ( β = 0.42 , 0.40), and the direct effect of perceived behavioral control on oral health behavior was statistically significant ( β =0.42) (all P <0.01). Conclusions The overall level of oral health behavior among preschool children needs to be improved. Perceived behavioral control is the most direct positive related factor of oral health behavior. In the future, intervention measures should focus on perceived behavioral control as the entry point and provide systematic intervention guidance in combination with planned behavior theory.

This paper comprehensively discusses on the potential neurobiological mechanisms of acupuncture in the treatment of tobacco dependence， focusing on three important aspects， including acupuncture's regulation of tobacco dependence behavior， effects of acupuncture on withdrawal syndrome， and the role of acupuncture in preventing relapse. It is found that acupuncture can inhibit drug-seeking behavior by regulating the reward pathway and related neurons， such as dopamine， thus modulating tobacco dependence behavior. It also alleviates withdrawal symptoms by improving the oral environment of smokers and reducing negative emotions after quitting. Furthermore， acupuncture can prevent relapse by decreasing brain network activity related to smoking cravings and improving cognitive brain functions like addiction memory. Currently， research on the specific neurobiological mechanism of acupuncture in treating tobacco dependence and the involved neural circuits is limited. Future research directions are proposed， including the evaluation of clinical effects， exploration of specific therapeutic mechanisms， investigation of brain pathology， and strengthening the exploration of brain functions. Additionally， combining modern technologies to clarify the neural circuits involved in acupuncture intervention will provide a basis for acupuncture treatment of tobacco addiction.

Objective To investigate the correlations of calmodulin 1(CNN1)and asymmetric dimethylarginine(ADMA)expression with Wnt/β-catenin pathway in tissues of gastric cancer and their values for prognosis.Methods Surgical specimens and serum samples from 110 patients with gastric cancer,along with serum samples from 60 healthy individuals in the hospital were collected.Immunohistochemistry and real-time fluorescent quantitative PCR were used to detect the expression levels of CNN1 protein and CNN1 mRNA in gastric cancer tissues respectively;the enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of ADMA in the serum of gastric cancer patients.The relationships of the CNN1 and ADMA expression with the clinicopathological characteristics in gastric cancer patients were analyzed.Kaplan-Meier survival curve was used to an-alyze the influence of CNN1 and ADMA expression on prognosis of gastric cancer patients;Cox re-gression analysis was used to explore independent factors affecting the prognosis of gastric cancer pa-tients;the Pearson correlation analysis was used to explore the correlation between CNN1 and ADMA expression in gastric cancer tissues,and to analyze the correlations of CNN1 mRNA and ADMA mRNA with Wnt/β-catenin signaling pathway-related indicators.Results The positive ex-pression rate of CNN1 protein in gastric cancer tissues was 38.18％(42/110),which was signifi-cantly lower than 57.27％(63/110)in adjacent tissues(x2=8.035,P=0.005).The serum ADMA level in gastric cancer patients was(0.54±0.17)μmol/L,which was significantly higher than(0.42±0.14)μmol/L in healthy individuals(t=4.752,P＜0.001).Patients with lymph node metastasis and advanced tumor stages had significantly decreased CNN1 protein positivity in gastric cancer tissues and increased serum ADMA expression(P＜0.05).The survival rate was 73.80％in the high CNN1 expression group(n=42),which was significantly higher than 39.71％in the low CNN1 expression group(n=68)(x2=22.300,P＜0.001);the survival rate was 45.68％in the high ADMA expression group(n=81),which was significantly lower than 72.41％in the low ADMA expression group(n=29)(x2=4.791,P=0.029).Univariate and multivariate Cox regression analysis showed that lymph node metastasis,advanced tumor staging,low CNN1 pro-tein expression,and high serum ADMA expression were independent risk factors for poor prognosis in gastric cancer patients(P＜0.05).The expression level of CNN1 mRNA in gastric cancer tissues was(0.41±0.13),which was significantly lower than(1.16±0.35)in adjacent tissues(t=21.068,P＜0.001).The expression levels of wnt3a mRNA and β-catenin mRNA in gastric cancer tissues were(2.02±0.42)and(2.59±0.58)respectively,both were significantly higher than(1.25±0.28)and(1.18±0.42)in adjacent tissues(t=15.999,P＜0.001;t=20.651,P＜0.001).CNN1 expression in gastric cancer tissues was negatively correlated with serum ADMA ex-pression in gastric cancer patients(r=-0.794,P＜0.001);CNN1 mRNA expression in gastric cancer tissues was negatively correlated with the expression of Wnt/β-catenin signaling pathway-re-lated indicators wnt3a mRNA and β-catenin mRNA(P＜0.001);serum ADMA mRNA expression in gastric cancer patients was positively correlated with the expression of Wnt/β-catenin signaling pathway-related indicators wnt3a mRNA and β-catenin mRNA(r=0.763,P＜0.001;r=0.874,P＜0.001).Conclusion The decreased expression of CNN1 and the increased expression of ser-um ADMA are independent risk factors for poor prognosis in gastric cancer patients,and their ex-pression levels are related to lymph node metastasis and tumor TNM staging.The expression levels of CNN 1 and ADMA are negatively correlated in gastric cancer tissues,which may be mediated by reg-ulating the Wnt/β-catenin signaling pathway.

Objective:To evaluate the therapeutic efficacy of the Wenyang Huazhuo Formula on spontaneous pregnancy outcomes in advanced-age infertile patients with spleen-kidney yang deficiency syndrome.Methods:A retrospective cohort study design was employed to gather clinical data from 303 advanced-age infertile patients with spleen-kidney yang deficiency syndrome who sought treatment at the Department of Reproductive Medicine in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine between June 2019 and June 2023. Patients were categorized into two groups based on their treatment regiments: a basic treatment group (non-exposed group, n=151) and a group receiving basic treatment in conjunction with the Wenyang Huazhuo Formula (exposed group, n=152). The study compared and analyzed pregnancy outcomes, including time to pregnancy (TTP) within one year, ongoing pregnancy rate, and clinical pregnancy rate, between the two groups over a one-year follow-up period. Additionally, stratified analyses were performed based on age and anti-Müllerian hormone (AMH) levels to evaluate the impact of Wenyang Huazhuo Formula on pregnancy outcomes across different patient subgroups. Results:The TTP in the exposed group was significantly reduced compared with the non-exposed group ( HR=1.70, 95% CI: 1.12-2.57, P=0.013), suggesting a significant shortening of their TTP, and the ongoing pregnancy rate [28.29% (43/152)] and the clinical pregnancy rate [33.55% (51/152)] were significantly higher than those in the non-exposed group [13.91% (21/151), P=0.020; 21.85% (33/151), P=0.023], and the early abortion rate [15.69% (8/51)] was significantly reduced compared with the non-exposed group [36.36% (12/33), P=0.031]. Stratified analyses by age revealed that for patients aged 35-37 years, the exposed group exhibited a significantly shorter TTP ( HR=1.67, 95% CI: 1.03-2.70, P=0.038), while no significant difference in TTP was observed in the 38-44-year old patients ( HR=1.78, 95% CI: 0.77-4.10, P=0.174). Regarding the ongoing pregnancy rate, the exposed group showed a significant higher rate [31.31% (31/99)] than the non-exposed group [13.91% (15/112), P=0.022] among patients aged 35-37 years, whereas no significant difference was observed in the 38-44 years old group ( P=0.386). Stratified analysis based on AMH levels showed that both low AMH levels (<1.68 μg/L) and high AMH levels (≥1.68 μg/L) patients in the exposed group experienced a significant reduction in TTP compared with the non-exposed group ( HR=8.07, 95% CI: 1.04-62.52, P=0.046; HR=1.57, 95% CI: 1.01-2.43, P=0.044, respectively), along with a notable improvement in the ongoing pregnancy rate [13.64% (6/44) vs. 0% (0/29), P=0.038; 34.26% (37/108) vs.17.21% (21/122), P=0.028, respectively]. Further stratified analysis indicated that, compared with patients with low AMH levels, both the exposed group and the non-exposed group of patients with high AMH levels exhibited a significantly shorter TTP ( HR=1.91, 95% CI: 1.02-3.69, P=0.043; HR=9.48, 95% CI: 1.30-69.22, P=0.002, respectively), along with a significantly higher ongoing pregnancy rate ( P=0.014; P=0.008). Conclusion:The Wenyang Huazhuo Formula significantly shortens TTP, enhances both the clinical pregnancy rate and the ongoing pregnancy rate and reduces the early abortion rate in advanced-age infertile women diagnosed with spleen-kidney yang deficiency syndrome.

Objective To investigate the effect of orthosis design parameters on correction of scoliosis and orthosis-trunk interface pressure.Methods A finite element model of scoliosis was constructed to simulate the assembly effect of the orthosis.The orthosis was divided into four loading areas(left rib,right rib,anterior-left and posterior-right area)to simulate six modification conditions.In Models 1,2 and 3,a fixed modification of 20 mm was applied on the anterior left and posterior right areas,while the displacement loads of 20,25 and 30 mm were applied on both the left rib and right rib areas.In Models 4,5 and 6,a fixed modification of 25 mm was applied on left rib and right rib areas,with the displacement loads of 15,20 and 25 mm applied on both anterior left and posterior right areas.The Cobb angle,apical vertebral rotation(AVR)and interface pressure were calculated.Results The correction of Cobb angle in Models 1,2 and 3 was 8.94°,15.62° and 17.91°,respectively,with AVR correction of 7.53°,6.69° and 5.87°,respectively.In Models 4,5 and 6,the correction of Cobb angle was 14.55°,15.62° and 16.09°,with AVR correction of 5.25°,6.69° and 8.63°,respectively.In Model 6,the correction rate of Cobb angle and AVR was 45.48%and 41.22%,respectively,with a maximum pressure of 26.51 kPa on orthosis-trunk interface,achieving the most significant outcome.Conclusions The modification of orthosis has a significant effect on the correction of Cobb and AVR angles.The loading on the left rib and right rib areas mainly affect the Cobb angle,while the loading on the anterior left and posterior right areas mainly affect the spinal axial-rotation.A modification of 25 mm on all loading areas achieves the optimal spinal correction.This study provides the quantitative data for orthosis design.

Intraoperative neural monitoring (IONM) is a critical technique for the protection of recurrent laryngeal nerve (RLN) function during thyroid surgery. In recent years, continuous innovations in IONM have established it as a cornerstone of modern thyroid surgery. However, current methodologies still exhibit limitations in the accurate assessment of neural function, and guidelines have yet to provide clear strategies for managing patients with intraoperative signal loss who subsequently develop postoperative voice disorders. This article reviews representative advances in the application of deep learning to bioelectrophysiological signals and systematically summarizes the use of deep learning in the field of voice medicine, thereby exploring the feasibility of integrating IONM with deep learning technologies.

Objective:To explore the evaluation and relationship of hepatitis B virus(HBV)surface antigen(HBsAg)in clinical laboratory in different detection systems,further scientifically and reasonably to explain the test results for serving clinical practices.Methods:During the period from June 2021 to July 2022,100 425 specimens of patients with screened,suspected and confirmed HBV infections were collected from the clinical departments(mainly infectious hepatology)of Nanyang Central Hospital.Detection methodology included quantitative(electrochemiluminescence and chemiluminescence),qualitative(gold standard),semi-quantita-tive(ELISA),and highly sensitive HBV-DNA(RT-PCR)methods,and then analyzed the strengths and weaknesses and closeness be-tween each methodology.The relationship between the two Roche HBsAg detection systems was analyzed by correlation analysis.The HBsAg efficacy analysis was validated using Cut/Off value setting and detection limit,which in turn analyzed the distribution of false-positive and false-negative reporting models.Results:Detection results for low-and medium-concentration HBsAg showed a correla-tion between the electrochemical luminescence semi-quantitative method and ELISA method.ELISA method still had advantages in terms of sensitivity and specificity when detecting HBsAg,and there were no significant differences compared to domestic and interna-tional HBsAg quantitative detection systems.Performance validation conducted in accordance with the CNAS-GL038 document showed that the minimum detection limit for HBsAg calculated using the ELISA method in this laboratory was 0.1 U/ml.When the ROC curve Cut/Off value was set to 0.105,the area under the curve was the largest(AUC=0.986).Based on Roche's semi-quantitative electroche-miluminescence detection and patient medical history,in the common reporting model for hepatitis B five-item detection using ELISA method,HBsAg false positives occurred most frequently when HBsAg was positive alone,and HBsAg occurred most frequently in the false positive range when the OD value was less than 0.5.In ELISA method for detecting HBsAg,as the OD value increased from 0.01 to 0.10,the number of false-negative results also increased.Roche Elecsys HBsAg Ⅱ Quant Ⅱ and Elecsys HBsAg Ⅱ testing systems exhibited good linearity under certain conditions,with a ratio of approximately 1/0.18.In Elecsys HBsAg Ⅱ Quant Ⅱ detection sys-tem,the test results of HBsAg samples diluted 400 times were highly consistent with the original test results with a coefficient of deter-mination R2=0.993 8.Conclusion:There was a certain relationship between various detection systems of HBsAg at a suitable concen-tration.The detection of HBsAg by ELISA can meet the needs of clinical detection.

Objective:To explore the diagnostic value of intratumoral area(ITA)and peritumoral area(PTA)ultrasound image-based bioin-formatics models for small breast cancer.Methods:We retrospectively analyzed data of 305 breast lesions from 292 patients with small breast nodules(diameter≤2 cm)who were treated at People's Hospital of Xinjiang Uygur Autonomous Region between January 2021 and January 2025.The lesions were randomly assigned into the training(214 lesions)and validation sets(91 lesions)in a 7:3 ratio.Radiomics fea-tures were extracted from the intertumoral area(ITA)and peritumoral area(PTA)regions at 2,4,6,and 8 mm,followed by feature selection and dimensionality reduction.A Logistic regression(LR)algorithm was used to construct a model.The performance of the models were eval-uated via receiver operating characteristic(ROC)curve analysis,Hosmer-Lemeshow test,and decision curve analysis(DCA).Results:In the training set,the areas under the ROC curves(AUC)for the ITA,2 mm PTA,and 2 mm fusion models were 0.869,0.897,and 0.909,respect-ively.In the test set,these respective AUC values were 0.813,0.825,and 0.840.For breast lesions≤2 cm,<1 cm,and 1-2 cm,the overall ac-curacies of the 2 mm fusion model were 81.0%,82.7%,and 80.1%,respectively,whereas the respective overall accuracies of BI-RADS were 76.4%,81.7%,and 73.6%.Conclusions:ITA and PTA ultrasound imaging-based radiomics models had a high diagnostic value for small breast cancers.The fusion model can effectively improve predictive performance,outperforming the BI-RADS classification in diagnosing small breast lesions of different diameters.Thus,these models have the potential to serve as an auxiliary diagnostic tool in clinical practice.