The ethical review exemption system was introduced to meet the needs of modernized ethical governance， implement hierarchical management for ethical review projects involving human subjects， and explore an ethical management model that reduces procedural supervision for specific types of research involving no greater than minimal risk. Through a comparative study， this paper seeks to elaborate on the differences between China and the United States （US） in the ethical review exemption system from multiple aspects， such as ethical regulations， risk definition， preconditions， applicable scenarios， and operational procedures. The aim is to provide references for ethical review committees to better implement the ethical review exemption system， enhance policy research， and ensure the fairness and objectivity of ethical review. Through the comparative study of the ethics review exemption system in China and the US， the following recommendations are proposed for institutions implementing the ethical review exemption system for reference. First， the system should clearly define the meaning of ethical review exemption to prevent researchers or even committee members from misunderstanding it as falling outside the scope of ethical review， thereby exposing research participants’ rights and interests to unnecessary risks. Second， the system should specifically explain the preconditions， including the requirements for research types and research risks. Among them， risks should be considered from multiple dimensions such as physiology， psychology， society， and economy. Clear explanations should be provided for involving commercial interests and sensitive personal information. Finally， the system should establish basic principles and judgment criteria for applicable scenarios， including specifying exactly what the public data refers to and legal requirements that need to be met， providing a concept of anonymization to distinguish it from deidentified information data， and clarifying the relevant regulations and ethical principles to be followed， as well as the clear requirements for informed consent.

Objective:To analyze the scientific research projects of health management disciplines in medical institutions in Beijing.Methods:This study was an observational study, and data was retrieved through computer between 2014 and 2023 from the scientific research data filling system of health management disciplines in medical institutions in Beijing region, which recorded the project name, project category, scientific research funding, institution, discipline, field, etc.. Excel 2016 was used to analyze the scientific research projects of health management disciplines in medical institutions in the Beijing region.Results:From 2014 to 2023, a total of 1 848 scientific research projects of health management disciplines in medical institutions in the Beijing region were initiated, with research funding of 1 204.775 million yuan. In terms of institutional categorization, they were mainly concentrated on central and municipal medical institutions, and in terms of research fields, there were 1 577 projects in Western medicine, with research funding of 1 133.240 million yuan, and 271 projects in Chinese medicine/combination of Chinese and Western medicine, with research funding of 71.535 million yuan. Cardiovascular diseases ranked first in the sub-discipline of Western medicine, and Chinese internal medicine ranked first in the sub-discipline of Chinese medicine.Conclusions:The scientific research projects of health management disciplines in medical institutions in Beijing are characterized by an imbalance in the distribution of institutions and the classification of funded sub-disciplines. The research innovation of health management in medical institutions needs to strengthen multidisciplinary cooperation and talent cultivation.

Objective:To investigate the impact of lesions in different nuclei of the subcortical basal ganglia on speech processing functions in patients with post-stroke dysarthria.Methods:From July 2022 to September 2023, a total of 20 patients with post-stroke dysarthria (patient group) and 22 healthy individuals (control group) were recruited. Brain imaging data, including structural magnetic resonance imaging(MRI) and diffusion-weighted imaging (DWI), as well as behavioral data of speech fluency task and picture association task were collected. Structural MRI data was analyzed using SPM12 software to perform voxel-based morphometry (VBM), measuring cortical thickness and gray matter volume (VGM) in specific nuclei of the basal ganglia. Behavioral metrics, such as reaction time (RT) and the number of valid responses were extracted for each task. Statistical analysis was conducted using SPSS 27.0 and R 4.0 softwares. Spearman correlation analysis was applied to examine relationships between neuroimaging parameters and behavioral performance indicators.Results:The patient group exhibited significantly smaller gray matter volumes in both left and right caudate nuclei((2.69±0.92)mm 3, (3.17±0.91)mm 3 ) and putamen (3.31±1.08)mm 3, (3.66±0.91)mm 3) compared to the control group (caudate nuclei (3.19±0.36)mm 3, (3.49±0.52)mm 3 putamen (4.52±0.54)mm 3, (4.72±0.64)mm 3), with statistically significant differences ( t=-2.83, 1.68; t=-3.59, 3.52, both P<0.05). Behavioral experiments revealed that the patient group exhibited significantly prolonged reaction time during picture association and naming tasks (1 910.50(1 214.25, 3 806.75) ms, 1 362.00(978.00, 2 297.00) ms) compared to the control group (1 618.00(1 162.75, 2 401.75) ms, 1 224.00(984.25, 1 661.50) ms; Z=-5.20, -4.61, both P<0.05). Gray matter volumes in the left caudate nucleus and left putamen exhibited negative correlations with reaction times during the picture naming task ( r=-0.52, -0.54, both P<0.05). Additionally, the gray matter volume of the left putamen demonstrated a positive correlation with the number of valid responses in speech fluency task-T2 ( r=0.46, P<0.05), whereas the left globus pallidus volume showed a negative correlation with speech fluency task-T1 ( r=-0.51, P<0.05) with the same measure. Conclusion:Lesions in the left subnuclei of the basal ganglia directly impair early-stage speech functions, including conceptual preparation and lexical selection, whereas right-side lesions exert less pronounced effects on linguistic performance compared to their left counterparts. Furthermore, the basal ganglia's involvement in higher-order linguistic processing may represent an indirect consequence of cognitive decline.

Objective:To explore the effects of different titanium(Ti)surfaces on mitochondria metabolism and polarization of mac-rophages.Methods:The anodic oxidation method prepared nanotubes with distinct morphologies(NT5 and NT20 groups)on smooth titanium surfaces(P group)were characterized by scanning electron microscopy(SEM).After 24 hours of culturing RAW264.7 cells on the samples,SEM was employed to observe the morphology of the cells of all groups.Levels of mitochondria ATP and ROS,as well as the activity of hexokinase(HK),were measured by fluorescence probes and luciferase assays.The expression of iNOS,Arg-1,TNF-α and CD206 mRNA was evaluated by RT-qPCR.Changes in mitochondria metabolism and macrophage polarization were studied following inhibition of cellular glycolysis by using 2-deoxy-D-glucose(2-DG)in groups P*and NT20*.Results:Compared with the P group,the NT5 group showed no significant changes in mitochondria ATP,ROS levels and HK activity,but an upregula-tion in M2-associated gene expression was observed.In the NT20 group,mitochondria ATP and ROS levels were increased,HK ac-tivity was elevated,and M1-associated gene expression was upregulated.After glycolysis inhibition,there was no significant differ-ence in mitochondria ATP,ROS levels,HK activity and polarization-related gene expression levels between the P*and NT20*groups compared with the P group.Conclusion:Large-diameter nanotubes may promote macrophage M1 polarization by regulating the metabolic reprogramming that occurs in macrophage mitochondria.

ObjectiveTo study the relationship between qi stagnation constitution and suboptimal health status (SHS) or lifestyle.MethodsFrom 2012 to 2013, we conducted a cross-sectional survey of 24 159 Chinese individuals aged 12–80 years. The qi stagnation constitution was assessed using the Constitution in Chinese Medicine Questionnaire. Health status was evaluated through medical records and the Subhealth Measurement Scale V1.0 (SHMS V1.0). Health-promoting lifestyles were measured using the Health-Promoting Lifestyle Profile II (HPLP-II).ResultsOf the 24 159 participants, 16.1% and 15.2% were classified as “always” and “sometimes” having the qi stagnation constitution, respectively. Those classified as “rarely” having the qi stagnation constitution scored higher on both the HPLP-II and SHMS V1.0. The participants classified as “always” having the qi stagnation constitution showed a significant association with SHS or disease compared to other imbalanced constitutions. Those in the “always” category were approximately 21 times more likely to be classified as having SHS (odds ratio [OR]: 21.17, 95% confidence interval [CI]: 15.74–28.45), whereas those in the “sometimes” category were approximately six times more likely (OR: 5.89, 95% CI: 5.04–6.90). Accordingly, the qi stagnation constitution score was significantly associated with the diagnosis of SHS, with an area under the curve of 0.77 (P .001). A score of 18.75 yielded the highest Youden Index (0.407), with a sensitivity of 60.5% and a specificity of 80.3%. Significant associations were observed between health-promoting lifestyles and qi stagnation constitution severity in an ordinal regression analysis (P .001). Protective factors included stress management (OR: 1.59), self-actualization (OR: 1.57), and exercise (OR: 1.36). In contrast, poorer interpersonal relationships (OR: 0.79), greater health responsibilities (OR: 0.86), and poorer nutrition (OR: 0.91) were associated with increased severity.ConclusionModulating the qi stagnation constitution through lifestyle interventions may help prevent the progression of SHS to disease, which aligns with core preventive principles in traditional Chinese medicine.

OBJECTIVES: To investigate the inhibitory effect of multimerin-2 (MMRN2) overexpression on growth and metastasis of cutaneous melanoma cells. METHODS: Clinical data of patients with cutaneous melanoma were obtained from the GEO database to compare MMRN2 expressions between normal and tumor tissues. A protein-protein interaction network was constructed using the STRING database, and the intersecting genes from GEPIA2.0 were subjected to GO and KEGG enrichment analysis. The prognostic relevance of MMRN2 expression level was assessed using Cox regression and "timeROC". The correlations of MMRN2 expression level with immune infiltration and angiogenesis-related genes were analyzed using GSCA database and the ssGSEA algorithm. Colony-forming assay, Transwell assay, and wound healing assay were used to examine the changes in proliferation and migration of cultured cutaneous melanoma cells following MMRN2 knockdown. In a mouse model bearing cutaneous melanoma xenograft, the effect of MMRN2 knockdown on vital organ pathologies, survival of the mice and GM-CSF, CXCL9, and TGF‑β1 protein expressions were analyzed. RESULTS: MMRN2 was significantly upregulated in metastatic cutaneous melanoma (P<0.001). Protein interaction network analysis identified 15 intersecting genes, which were enriched in endothelium development and cell-cell junctions. In patients with cutaneous melanoma, a high MMRN2 expression was correlated with a poor prognosis, an advanced T stage, a greater Breslow depth, and ulceration (P<0.05). MMRN2 expression level was strongly correlated with 24 immune cell types (P<0.001), fibroblasts, endothelial cells, and expressions of the pro-angiogenic genes (KCNJ8, SLCO2A1, NRP1, and COL3A1; P<0.001). In cultured B16F10 cells, MMRN2 knockdown significantly suppressed cell proliferation, migration and invasion and caused remo-deling of the immunosuppressive microenvironment. CONCLUSIONS MMRN2 overexpression drives progression of cutaneous melanoma by enhancing tumor metastasis, angiogenesis and immune evasion, highlighting its potential as a therapeutic target for melanomas.
Humans ; Melanoma/metabolism* ; Animals ; Cell Movement ; Prognosis ; Skin Neoplasms/metabolism* ; Mice ; Cell Proliferation ; Neoplasm Invasiveness ; Cell Line, Tumor ; Protein Interaction Maps

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Objective:To investigate the application value of cervical vascular ultrasound(CVUS)combined with transcranial Doppler ultrasound(TCD)in the diagnosis of carotid artery stenosis and collateral circulation in patients with ischemic cerebrovascular disease(ICVD).Methods:In this study,86 patients with ICVD admitted to the Cardio-Cerebrovascular Disease Specialist Hospital of Qinghai Province from January 2021 to January 2023 were selected.All patients underwent CVUS,TCD and digital subtraction cranial angiography(DSA)examination,and the diagnosis results of DSA were taken as the gold standard.To observe and compare the diagnostic efficacy of CVUS and TCD alone and combined CVUS and TCD for carotid artery stenosis and collateral circulation in ICVD patients.Results:Among the 86 patients with ICVD,a total of 597 vascular stenoses were detected by DSA examination,424 vascular stenoses were detected by CVUS,388 vascular stenoses were detected by TCD,and 586 vascular stenoses were detected by CVUS combined with TCD.The diagnostic coincidence rates of CVUS and TCD alone detection were 71.02%(424/597)and 64.99%(388/597),respectively,and the diagnostic coincidence rate of the combined detection of the two methods was 98.16%(586/597).The comparison showed that there was no statistically significant difference in the diagnostic coincidence rate of the degree of vascular stenosis between CVUS combined with TCD detection and DSA(P>0.05).Among the 86 patients with ICVD,collateral circulation formation was detected in 69 cases by DSA,in 55 cases by CVUS,in 51 cases by TCD,and in a total of 67 cases by CVUS combined with TCD.There was no significant difference in the detection rate between the combined detection of CVUS and TCD and that of DSA(P>0.05).Through analysis,it was concluded that the diagnostic sensitivity and accuracy of CVUS combined with TCD detection were both higher than those of CVUS and TCD single detection,and the difference was statistically significant(x2=10.180 and 12.204,P<0.05)14.969 and 18.124,P<0.05).The accuracy rate of the combined detection of CVUS and TCD was 96.51%,the sensitivity was 97.10%,and the specificity was 94.12%,which was highly consistent compared with DSA(Kappa value=0.896).Conclusion:CVUS combined with TCD detection has high clinical application value in the diagnosis of carotid artery stenosis and collateral circulation in ICVD patients.The combined detection of the two methods can further improve the diagnostic sensitivity,and the diagnostic accuracy is close to the gold standard,which can provide a reliable reference for clinical rational treatment and improvement of prognosis.

Objective To explore the life satisfaction and related factors of general and assistant general standardized training physicians(hereinafter referred to as training physicians),and analyze the effecting path of resilience between stress perception and life satisfaction.Methods From July to October 2024,a self-designed general demographic survey,Satisfaction With Life Scale(SWLS),Connor-Davidson Resilience Scale(CD-RISC),and Chinese Perceived Stress Scale(CPSS)were used to survey 251 training physicians from two hospitals in Xi'an to understand their life satisfaction,stress perception,and resilience in the past month.Model 4 in the Process V3.3 plugin of SPSS 25.0 software and Bootstrap method were used to analyze the effecting path of resilience between stress perception and life satisfaction among the training physicians.Results A total of 251 questionnaires were distributed,and 236 valid questionnaires were collected,with an effective response rate of 94.02％.The stress perception of 236 training physicians(24.12±7.02)was negatively correlated with life satisfaction(23.24±7.45)(r=-0.556,P＜0.01),but negatively correlated with resilience(54.88±11.37)(r=-0 658,P＜0.01).Resilience partially mediated the relationship between stress perception and life satisfaction,with a mediation effect value of-0.320 6,accounting for 54.39％ of the total effect.Conclusion Stress perception has an independent negative impact on the life satisfaction of training physicians,and indirectly affects life satisfaction through resilience.Improving life satisfaction can be achieved by reducing stress perception or enhancing resilience.