OBJECTIVE To explore the improvine mechanism of Yifei xuanfei jiangzhuo formula （YFXF） on vascular dementia （VAD） model rats based on the growth factor receptor-bound protein 2 （GRB2）/extracellular signal-regulated kinase （ERK）/cardiolipin synthase 1 （CRLS1） pathway. METHODS VAD rat model was established by permanent bilateral common carotid artery ligation. Forty-eight successfully modeled rats were randomly divided into the model group （normal saline）， donepezil hydrochloride group （positive control group， 0.2 g/kg）， and YFXF low- and high-dose groups （12.18 and 24.36 g/kg， calculated based on the total amount of crude drug）， respectively. In addition， a sham operation group （normal saline） was set up. There were 12 rats in each group. Daily intragastric administration of drug or normal saline was performed for 30 consecutive days. After the last administration， the spatial cognitive ability of the rats was evaluated， the pathological morphology of the hippocampus was observed， the contents of tumor necrosis factor-α （TNF-α） and interleukin-4 （IL-4） in serum were detected， the expression levels of GRB2/ERK/CRLS1 pathway-related proteins and the mRNA levels of GRB2， CRLS1， NADH dehydrogenase subunit 1（ND1）， Tafazzin （TAZ）， phospholipid scramblase 3（PLSCR3） and the ATP content in hippocampal tissue were measured. RESULTS Compared with the sham operation group， the escape latency of rats in the model group was significantly prolonged （ P ＜0.05）， and the number of crossing platform was significantly reduced （ P ＜0.05）， while the number of pyramidal cells and Nissl bodies in the hippocampus decreased sharply； the content of TNF-α in serum was significantly increased （ P ＜0.05）， and the content of IL-4 was significantly decreased （ P ＜0.05）； the expression levels of GRB2 and CRLS1 proteins， the phosphorylation level of ERK protein， the relative expression levels of GRB2， CRLS1，ND1， TAZ， and PLSCR3 mRNA， and the content of ATP in hippocampal tissue were significantly decreased （ P ＜0.05）. Compared with the model group， the above pathological changes in the hippocampal tissue of each administration group were alleviated， and the quantitative indicators were significantly restored （ P ＜0.05）. CONCLUSIONS YFXF may improve hippocampal neuron injury in VAD rats by activating the GRB2/ERK/CRLS1 pathway, maintaining cardiolipin homeostasis， and improving mitochondrial energy metabolism.

Objective: To investigate and analyze the influencing factors and intervention strategy preferences of preoperative dental anxiety in patients undergoing oral implant surgery, and to provide a basis for the clinical formulation and implementation of targeted interventions. Methods: This study was approved by the Hospital Medical Ethics Committee, and written informed consent was obtained from all participants. Using convenience sampling, a cross-sectional survey was conducted from January to October 2025 among 210 patients in the Department of Implantology of a tertiary dental hospital. All participants had been clinically diagnosed and were scheduled to undergo oral implant surgery on the day of the survey. The survey was conducted using a General Information Questionnaire, the Modified Dental Anxiety Scale (MDAS), and an Anxiety Cause Questionnaire. The General Information Questionnaire collected data on patients’ gender, age, presence of systemic diseases, dental treatment history, number of implants, whether bone augmentation was required. The MDAS was used to assess patients’ dental anxiety levels via MDAS scores, with a score ≥ 12 defined as dental anxiety. The Anxiety Cause Questionnaire covered the following items: fear of pain, concern that the instruments might cause permanent damage to their teeth, concern about the dentist’s technique and inability to achieve ideal results, fear of local anesthesia, concern about cross-infection, financial pressure, exposure to an unfamiliar environment and strangers, and previous unpleasant dental experiences. The MDAS scores of the items in the Anxiety Cause Questionnaire and General Information Questionnaire were analyzed using the Mann-Whitney U test or Kruskal-Wallis H test for univariate analysis, and factors with statistical significance in the univariate analysis were further analyzed using binary logistic regression for multivariate analysis. An Intervention Strategy Preference Questionnaire was used to survey patients’ preferences for the following interventions: understanding the surgical procedure, verbal reassurance from medical staff, distraction methods such as listening to music or using stress balls, staying in a physically and mentally relaxing environment, and others. Results: The average preoperative MDAS score of patients undergoing oral implant surgery was 10.91 ± 3.40, and the incidence of dental anxiety (MDAS ≥ 12) was 34.8% (73/210). Univariate analysis showed that female patients, patients aged < 45 years, had significantly higher MDAS scores (P < 0.05). Patients who selected “fear of pain” (79.0%), “fear of local anesthesia” (21.0%), and “exposure to an unfamiliar environment and strangers” (4.8%) as causes of their anxiety had higher MDAS scores than those who did not select these items (P < 0.05). Multivariate logistic regression analysis showed that patient's age (OR = 0.420), fear of pain (OR = 4.234), and exposure to an unfamiliar environment and strangers (OR = 8.220) were independent influencing factors of preoperative dental anxiety in patients undergoing oral implant surgery (P < 0.05). The Intervention Strategy Preference Questionnaire showed that “verbal reassurance from medical staff” (45.2%), “distraction” (43.3%), and “understanding the surgical procedure” (39.5%) were the most preferred intervention strategies among patients. Conclusions Preoperative dental anxiety is common among some patients undergoing oral implant surgery, particularly young and middle-aged patients, those treated by less experienced physicians, and those experiencing anxiety due to a fear of pain or exposure to an unfamiliar environment and strangers. Clinical attention should focus on these patient populations, and systematic preoperative education and psychological counseling should be provided accordingly.

The 2024 American Society of Clinical Oncology(ASCO)Annual Meeting was held in Chicago,the United States,from May 31 to June 4 in 2024.In recent years,antibody-drug conjugates(ADCs)have become one of the most popular targeted therapies because of their high specificity,efficacy,and low toxicity,making them a focal point in this ASCO meeting.Currently,over 100 ADCs are under investigation,demonstrating the considerable development potential of ADCs in the field of targeted cancer therapy.The aforementioned conference reported several recent research advancements regarding ADCs for the treatment of breast cancer(BC).This review summarizes the latest progress of ADCs in BC treatment discussed at the confer-ence.

Objective To construct a prognostic model for patients with in-hospital cardiac arrest(CA)to evaluate their short-term and long-term prognosis and provide a reference for clinical decision-making.Methods Data of in-hospital CA patients were extracted from the Medical Information Mart for Intensive Care Ⅳ 2.2 database,and randomly divided into training set and validation set at a 7∶3 ratio.A predictive nomogram model was constructed in the training set via multivariate COX regression analysis,and internally validated using the validation set.Results A total of 1787 patients were included(1250 in training set and 537 in validation set).Univariate regression,LASSO regression,and multivariate COX regression analyses identified age,body weight,base excess,red cell volume distribution width,model for end-stage liver disease,acute physiology and chronic health evaluation,systemic inflammatory response index,dopamine,norepinephrine,congestive heart failure,diabetes with complications,and metastatic solid tumor were all independent risk factors affecting the prognosis of patients with CA.The receiver operating characteristic curve of the constructed nomogram showed good discrimination,and the decision curve analysis indicated that it had good clinical applicability.Conclusion The constructed nomogram model has certain clinical application value in identifying populations with good and poor prognosis,providing an auxiliary reference for the termination of resuscitation and post-resuscitation treatment.

Objective:To investigate the occurrence of work-related musculoskeletal disorders (WMSDs) among underground coal mine workers, identify the risk factors for WMSDs, and provide a scientific evidence for the prevention and treatment of WMSDs.Methods:In March 2024, through cluster sampling, the on-the-job workers who underwent questionnaire surveys and health examinations at a certain coal mine from July to August 2018 were selected as the research subjects. Basic information of employees, ergonomics-related characteristics, and the occurrence status of WMSDs in each part were collected, and multivariate logistic regression was used for analysis.Results:The incidence rate of WMSDs in at least one site among underground coal mine workers within the past year was 62.22% (219/352). The top three sites in sequence were the lower back (44.32%, 156/352), neck (26.14%, 92/352), and knee (26.14%, 92/352). Multivariate logistic regression analysis showed that frequently exerting great force with arms or hands during work ( OR=2.223, 95% CI: 1.022-4.836), prolonged static forward bending ( OR=1.544, 95% CI: 1.305-1.972), and frequently exerting great effort to operate tools or machines ( OR=2.206, 95% CI: 1.011-4.813), absence of external support systems ( OR=1.589, 95% CI: 1.349-1.996), and repetitive full-body twisting ( OR=1.523, 95% CI: 1.298-1.916) were all risk factors for the occurrence of WMSDs in the lower back ( P<0.05). Both night shift work ( OR=1.564, 95% CI: 1.339-1.939) and frequent forward neck flexion ( OR=1.532, 95% CI: 1.312-1.907) were all risk factors for the occurrence of WMSDs in the neck ( P<0.05). Lifting heavy objects above the shoulder ( OR=1.333, 95% CI: 1.142-1.782), uncomfortable posture and inability to exert force ( OR=1.873, 95% CI: 1.104-2.712), the use of vibration tools ( OR=2.958, 95% CI: 1.255-6.972), and length of service >10 years ( OR=1.525, 95% CI: 1.105-1.967) were all risk factors for the occurrence of WMSDs in the knee ( P<0.05) . Conclusion:The incidence of WMSDs among underground coal miners is relatively high, mainly concentrated in the lower back, neck and knee, and is related to factors such as poor working postures, and work organization. Coal mining enterprises should strengthen work organization, provide appropriate working equipment, and ensure reasonable distribution of workloads.

Objective:To identify risk factors influencing the incidence of hypertension among steelworkers (Homo sapiens) and establish an effective and easily implementable hypertension prediction model.Methods:In September 2023, 2214 steelworkers (Homo sapiens) were selected as study subjects. Basic demographic information, lifestyle, and occupational exposure data were collected, along with physiological measurements such as height, weight, and blood pressure. Multivariate unconditional logistic regression analysis was employed based on relevant literature to determine influencing factors for hypertension among steelworkers (Homo sapiens). Python 3.9 software was used to construct and compare logistic regression, support vector machine (SVM), random forest, extreme gradient boosting tree (XGBoost), and LGBM models. Model performance was evaluated using metrics such as receiver operating characteristic (ROC) curves, accuracy, calibration curves, and F1 scores. The Shapley Additive Explanations (SHAP) model was introduced for feature importance analysis to enhance the interpretability of the prediction model.Results:A total of 432 cases of hypertension were detected among 2214 study subjects, with a detection rate of 19.51%. Age, smoking status, salt intake, use of cooling equipment, carbon monoxide exposure, family history of hypertension, fasting blood glucose, triglycerides, and hemoglobin were identified as independent risk factors for hypertension ( P<0.05). A comparison of the five models revealed the following performance metrics: logistic regression achieved an accuracy of 0.853, F1 score of 0.680, Brier score of 0.108, and AUC of 0.907; SVM demonstrated an accuracy of 0.863, F1 score of 0.687, Brier score of 0.081, and AUC of 0.910; random forest showed an accuracy of 0.857, F1 score of 0.603, Brier score of 0.105, and AUC of 0.861; XGBoost yielded an accuracy of 0.850, F1 score of 0.684, Brier score of 0.117, and AUC of 0.899; and the LGBM model exhibited an accuracy of 0.838, F1 score of 0.625, Brier score of 0.112, and AUC of 0.870. Conclusion:The SVM model demonstrated strong predictive performance, effectively assessing the risk of hypertension among steelworkers (Homo sapiens) and facilitating targeted health management interventions.

Objective:To compare the effects of using cone beam CT (CBCT) and oral scanning registration on implant positional accuracy during robot-assisted implant surgery, and to provide a basis for selecting the appropriate registration for robot-assisted implant surgical options.Methods:One patient with dentition defect, specifically missing teeth at positions 21 and 26 and having natural teeth adjacent mesially and distally to the edentulous area, who visited the Department of Oral Implantology, School of Hospital of Stomatology Wuhan University in 2024 were selected. Based on reconstructed imaging data, 30 identical jaw models were printed. These models were divided into a CBCT registration group and an intra-oral scanning registration group (15 models per group). An associate chief physician with extensive experience in implant surgery performed preoperative registration using the implant robot and completed the implant surgeries. Postoperative CBCT scans were used to determine the three-dimensional position of the implants. The deviations between the planned implant position and the actual position were evaluated, including deviations at the implantation point, apical point, and angular deviation. The differences between the two groups were compared.Results:The implantation deviation was 0.675 (0.490) mm, apical deviation was (0.680±0.272) mm, and the angular deviation was 0.566°±0.147° in the CBCT registration group, and in the intra-oral scanning registration group, implantation deviation was 0.695 (0.313) mm, apical deviation was (0.667±0.217) mm, and the angular deviation was 0.523°±0.168°. There was no statistically significant error in implant precision between the two groups ( P>0.05). Conclusions:This in vitro experiment found that the use of intra-oral scanning registration in robot-assisted implant surgery can achieve similar implant placement accuracy as CBCT registration.

The phenotype of peri-implant soft tissue is crucial to the long-term treatment outcome of implant restoration, but soft tissue phenotype deficiencies are common in clinical practice and need to be improved through soft tissue augmentation. Although autologous soft tissue graft is still the gold standard for soft tissue augmentation, it has limitations such as limited donor area, increased trauma, and low patient acceptance. Plasmatrix has sufficient sources, is easy to prepare, and has a scaffold structure, growth factors, and cell components that support soft tissue growth. It can be used to improve the phenotype of peri-implant soft tissue. However, there are currently limited clinical studies on the application of plasmatrix in improving the phenotype of peri-implant soft tissue, and there is a lack of consensus conclusions, which makes the majority of clinicians feel confused when using plasmatrix. This article will try to combine existing clinical studies and the clinical experience of the author′s team to explain the classification of peri-implant soft tissue phenotypes and the application of plasmatrix in improving soft tissue phenotypes, in order to provide a reference for related clinical treatments.

Objective:To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Beijing in 2024, to investigate the infection status of reservoir hosts, vector organisms, and baseline human populations, and provide a scientific basis for formulating prevention and control strategies.Methods:Epidemiological surveys were conducted on all confirmed cases. Serum samples from healthy populations and reservoir hosts were collected for SFTSV antibody detection. Questing ticks were monitored using the flagging method. Real-time fluorescent quantitative PCR was employed to detect SFTSV in cases, reservoir hosts, and ticks. Positive samples underwent whole-genome sequencing and genetic evolution analysis.Results:In 2024, Beijing reported 15 locally infected cases with 4 deaths. The age of onset ranged from 50 to 80 years (median: 66 years). Cases showed a certain degree of geographical clustering, with June being the peak month of onset. The affected population was predominantly farmers, with a male-to-female ratio of 3∶2. Animal contact history emerged as a significant risk factor alongside tick bites. Parthenogenetic tick populations were identified in Pinggu district, while SFTSV-carrying ticks were detected in endemic areas (Mentougou, Shijingshan, and Fengtai Districts). Viral presence was also confirmed in ticks or dogs from non-endemic areas. Sequencing and phylogenetic analysis revealed stable clustering of strains into two distinct genotypes (A and B). Antibody-positive individuals were identified in healthy populations from non-endemic areas.Conclusions:The incidence of SFTS in Beijing is increasing, with natural viral circulation already established in non-endemic regions. Enhanced surveillance and adjusted prevention strategies are urgently needed.

Background and aims:Primary sclerosing cholangitis(PSC)is an autoimmune liver disease characterized by complex pathogenesis and limited available therapeutic options.The mechanisms underlying the development and progression of PSCs remain unclear.Liver X receptor beta(LXR-β)is recognized to modulate lipid metabolism and immune response,but its specific involvement in the PSC has not been elucidated.Here,we explored the role and mechanism of LXR-β in PSC induced by 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine(DDC).Methods:CRISPR-Cas9 technology was applied to generate Abcb4(coding MDR2,next named as Mdr2),Nr1h2(coding LXR-β,next named as Lxrβ),and Rag2(coding RAG2)knockout mice.DDC was used to induce PSC.Hematoxylin and eosin and Sirius red staining were used to assess the extent of hepatic injury and fibrosis.Flow cytometry was used to observe immune cell subsets.Results:We observed a declining trend in hepatic Lxrβ in the PSC model.Unexpectedly,Lxrβ knockout failed to modulate DDC-induced PSC pathogenesis.Concomitantly,assessment of the influence of Rag2 deficiency on PSC progression revealed the absence of aggravated or alleviated hepatic injury or fibrosis in the Rag2-/-DDC mice.However,Lxrβ depletion intensified DDC-induced PSC in the Rag2-/-mice,with more abundant infiltrative inflammatory cells and more severe liver fibrosis.Compared with Rag2-/-DDC mice,Lxrβ-/-Rag2-/-DDC mice had higher serum ALT and AST levels and mRNA expression of proinflammatory and profibrotic genes.Flow cytometry showed that LXR-β deficiency resulted in a diminished population of hepatic innate immune cells.Conclusion:This study indicated innate immune cell LXR-β deficiency can exacerbate hepatic injury and fibrosis in murine models of PSC suggesting that LXR-β may regulate the function of innate immunity in the fibrotic advancement of PSC.