Objective: To analyze the epidemiological characteristics of infectious diseases among children and adolescents in Lanshan District, Linyi City, 2014-2023,so as to provide a scientific basis for prevention and control strategies in schools. Methods: The surveillance data were obtained from the China Information System for Disease Control and Prevention (CISDCP). Data on reported infectious disease cases and related demographic information among school children and kindergarteners in the study area from 2014 to 2023 were collected. Rate comparison was performed by using the χ 2 test. Trend analysis was conducted by using Joinpoint Regression Progrom, and the annual percent change (APC) and average annual percent change (AAPC) were calculated. Results: A total of 10 222 cases of infectious diseases among children and adolescents were reported from 2014 to 2023, with an average annual incidence rate of 273.32 per 100 000. The overall incidence trend remained stable from 2014 to 2023 (AAPC=12.33%, 95%CI=-2.63%-29.59%, P >0.05). Whereas a significant upward trend was observed from 2014 to 2019 (AAPC=37.08%, 95% CI =12.92%-66.41%, P <0.05), followed by a stable trend from 2019 to 2023 (AAPC=-0.31%, 95%CI=-39.70%-64.83%, P>0.05). Seasonal distribution exhibited dual peaks in summer and winter. The incidence rate in urban areas(707.29/100 000) was significantly higher than that in rural areas(257.50/100 000), and the incidence rate among kindergarteners (325.49/100 000) was higher than that among school children (257.07/100 000) (χ2=1 518.60, 116.36, both P<0.01). The reported infectious diseases among children and adolescents were predominantly respiratory and intestinal infectious diseases, with incidence rates of 156.13/100 000 and 108.51/100 000, respectively. Hand, foot, and mouth disease (HFMD) was the predominant infectious disease among kindergarteners, accounting for 47.51%. Influenza was the leading condition in the primary school group, accounting for 38.64%, and other infectious diarrheal diseases were most common in junior and senior high school group, accounting for 53.34%. The top six diseases by incidence rate were other infectious diarrheal diseases(65.22/100 000), influenza(63.24/100 000), varicella(46.34/100 000), HFMD(41.07/100 000), mumps(23.42/100 000), and scarlet fever(10.56/100 000). Among them, the incidence of other infectious diarrheal diseases rose significantly (AAPC=35.31%, 95% CI =14.32%-60.14%, P <0.01). The trend transitioned from a rapid escalation during 2014-2019 (APC=69.98%, 95% CI =17.58%-145.74%, P =0.01) to a stable phase during 2019-2023 (APC=1.74%, 95% CI =-15.61%- 22.66%, P >0.05). Conclusions In Lanshan, urban educational institutions should prioritize the prevention and control of infectious diseases, with particular emphasis on other infectious diarrheal diseases, influenza and varicella. Targeted interventions should be implemented in accordance with seasonal patterns and the specific characteristics of the school age populations.

Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Functional dyspepsia (FD), characterized by persistent or recurrent dyspeptic symptoms without identifiable organic, systemic or metabolic causes, is an increasingly recognized global health issue. The objective of this guideline is to equip clinicians and nursing professionals with evidence-based strategies for the management and treatment of adult patients with FD using traditional Chinese medicine (TCM). The Guideline Development Group consulted existing TCM consensus documents on FD and convened a panel of 35 clinicians to generate initial clinical queries. To address these queries, a systematic literature search was conducted across PubMed, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP Database, China Biology Medicine (SinoMed) Database, Wanfang Database, Traditional Medicine Research Data Expanded (TMRDE), and the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS). The evidence from the literature was critically appraised using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The strength of the recommendations was ascertained through a consensus-building process involving TCM and allopathic medicine experts, methodologists, pharmacologists, nursing specialists, and health economists, leveraging their collective expertise and empirical knowledge. The guideline comprises a total of 43 evidence-informed recommendations that span a range of clinical aspects, including the pathogenesis according to TCM, diagnostic approaches, therapeutic interventions, efficacy assessments, and prognostic considerations. Please cite this article as: Zhang SS, Zhao LQ, Hou XH, Bian ZX, Zheng JH, Tian HH, Yang GH, Hong WS, He YY, Liu L, Shen H, Li YP, Xie S, Shu J, Zeng BF, Li JX, Liu Z, Xiao ZH, Xiao JD, Zheng PY, Huang SG, Chen SL, Fei GJ. International clinical practice guideline on the use of traditional Chinese medicine for functional dyspepsia (2025). J Integr Med. 2025; 23(5):502-518.
Dyspepsia/drug therapy* ; Humans ; Medicine, Chinese Traditional/methods* ; Practice Guidelines as Topic ; Drugs, Chinese Herbal/therapeutic use*

Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

ObjectiveTo investigate the analgesic effect of Tuina at the "Weizhong （BL 40）" on neuropathic pain in a rat model of chronic constriction injury （CCI） of the sciatic nerve and its potential central spinal mechanisms. MethodsThirty-two Sprague-Dawley rats were randomly divided into four groups （8 rats in each group）， sham-operated group， model group， Tuina group， and blockade group. The CCI model was established in the model group， Tuina group， and the blockade group by ligating the sciatic nerve with catgut， while the sham-operated group underwent only sciatic nerve exposure without ligation. From postoperative day 4 to day 14， rats in the Tuina group and the blockade group received Tuina manipulation at the "Weizhong （BL 40）" using a dynamic pressure distribution measurement system （5 N pressure， 2 Hz frequency， 10 min per session， once daily）. The blockade group also received intraperitoneal injections of the microglial inhibitor minocycline （10 mg/kg） once daily. The sham-operated and the model group underwent the same handling and fixation as the Tuina group without actual Tuina. Mechanical withdrawal threshold （MWT） and paw withdrawal latency （PWL） were measured before surgery and on day 3， 7， 10， and 14 post-surgery. Transmission electron microscopy was used to evaluate sciatic nerve injury and repair， measuring axon diameter and total myelinated fiber diameter to calculate the g-ratio. Western Blotting was performed to detect the protein levels of ionized calcium-binding adapter molecule 1 （Iba-1）， CD206， CD68， interleukin-10 （IL-10）， and β-endorphin （β-EP） precursor pro-opiomelanocortin （POMC） in the ipsilateral spinal dorsal horn. ResultsCompared with the sham-operated group， the model group showed significantly reduced MWT and PWL on day 3， 7， 10， and 14 （P＜0.01）. Compared with the model group， the Tuina group and the blockade group showed increased MWT and PWL on day 10 and 14 （P＜0.05）. Compared with the Tuina group， the blockade group exhibited higher MWT on day 7， 10， and 14， and higher PWL on day 10 （P＜0.05）. Sciatic nerve pathological morphology revealed intact and well-structured myelin in the sham-operated group， while the model group exhibited myelin collapse， distortion， and myelin ovoid formation. The Tuina group displayed partially irregular myelin with occasional myelin collapse， whereas the blockade group exhibited partial myelin irregularities and phospholipid shedding. Compared with the sham-operated group， the model group showed a decreased g-ratio and increased levels of Iba-1 and CD68 in the spinal dorsal horn （P＜0.05 or P＜0.01）. Compared with the model group， the Tuina group and the blockade group exhibited an increased g-ratio and reduced Iba-1 and CD68 levels. Additionally， the Tuina group showed elevated levels of CD206， IL-10， and POMC， whereas the blockade group had decreased CD206 levels （P＜0.05）. ConclusionTuina at "Weizhong （BL 40）" alleviates neuropathic pain in CCI rats， potentially by regulating microglial activation in the spinal cord， inhibiting M1 polarization while promoting M2 polarization， and activating the IL-10/β-EP pathway to exert analgesic effects.

OBJECTIVES: To determine the pharmacological impact of hesperidin, the main component of Citri Reticulatae Pericarpium, on depressive behavior and elucidate the mechanism by which hesperidin treats depression, focusing on the gut-brain axis. METHODS: Fifty-four Sprague Dawley male rats were randomly allocated to 6 groups using a random number table, including control, model, hesperidin, probiotics, fluoxetine, and Citri Reticulatae Pericarpium groups. Except for the control group, rats in the remaining 5 groups were challenged with chronic unpredictable mild stress (CUMS) for 21 days and housed in single cages. The sucrose preference test (SPT), immobility time in the forced swim test (FST), and number in the open field test (OFT) were performed to measure the behavioral changes in the rats. Enzyme-linked immunosorbent assay was used to determine the levels of 5-hydroxytryptamine (5-HT) and brain-derived neurotrophic factor (BDNF) in brain tissue, and the histopathology was performed to evaluate the changes of colon tissue, together with sequencing of the V3-V4 regions of 16S rRNA gene on feces to explore the changes of intestinal flora in the rats. RESULTS: Compared to the control group, the rats in the model group showed notable reductions in body weight, SPF, and number in OFT (P<0.01). Hesperidin was found to ameliorate depression induced by CUMS, as seen by improvements in body weight, SPT, immobility time in FST, and number in OFT (P<0.05 or P<0.01). Regarding neurotransmitters, it was found that at a dose of 50 mg/kg hesperidin treatment upregulated the levels of 5-HT and BDNF in depressed rats (P<0.05). Compared to the control group, the colon tissue of the model group exhibited greater inflammatory cell infiltration, with markedly reduced numbers of goblet cells and crypts and were significantly improved following treatment with hesperidin. Simultaneously, the administration of hesperidin demonstrated a positive impact on the gut microbiome of rats treated with CUMS, such as Shannon index increased and Simpson index decreased (P<0.01), while the abundance of Pseudomonadota and Bacteroidota increased in the hesperidin-treated group (P<0.05). CONCLUSION The mechanism responsible for the beneficial effects of hesperidin on depressive behavior in rats may be related to inhibition of the expressions of BDNF and 5-HT and preservation of the gut microbiota.
Animals ; Hesperidin/therapeutic use* ; Rats, Sprague-Dawley ; Depression/drug therapy* ; Male ; Stress, Psychological/drug therapy* ; Brain/metabolism* ; Brain-Derived Neurotrophic Factor/metabolism* ; Serotonin/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Behavior, Animal/drug effects* ; Rats ; Brain-Gut Axis/drug effects* ; Chronic Disease ; Colon/drug effects*

Objective:To explore the changes in nutritional status and body composition of cervical cancer patients during concurrent chemoradiotherapy (CCRT) and their correlation with CCRT toxicities.Methods:In this prospective and observational clinical study, eligible treatment -na?ve patients with stage IB-IV primary cervical cancer were consecutively enrolled in the Department of Radiotherapy of Peking Union Medical College Hospital from September 2022 to August 2023. The patients were screened for nutritional risks, received dietary assessment, and were measured for body composition using multi-frequency bioelectrical impedance at baseline (prior to treatment), 4 weeks, and 8 weeks since treatment initiation. Insufficient muscle mass was diagnosed ccording to the Asian Working Group for Sarcopenia 2019 criteria. The severity of nausea, vomiting, abdominal pain, diarrhea, and hematological toxicity was assessed by the U.S. National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0).Results:A total of 109 patients were included. At baseline, there were 11 (10.1%) patients who were lean, 17 (15.6%) patients with insufficient muscle mass, and 28 patients (25.7%) at nutritional risk; at Week 8 of CCRT, patients at nutritional risk increased to 61 (56.0%). Compared to baseline, weight [(59.34±9.67) kg vs. (61.30±9.64) kg, P<0.001], skeletal muscle index [SMI, (6.15±0.74) kg/m 2vs. (6.39±0.74) kg/m 2, P<0.001], body fat percentage [(31.13±7.67) % vs. (32.07±7.70) %, P=0.004] were significantly decreased at Week 8 of CCRT. Besides, ≥10% SMI loss was only related to baseline body fat percentage ( HR=0.216, 95% CI: 0.001-0.724, P=0.038), but not related to age, nutritional status, or muscle mass (all P>0.05). At baseline and 8 weeks since CCRT, 8 (28.6%) and 40 (65.6%) patients at nutritional risk received nutritional support, respectively. During CCRT, the rates of grade ≥2 nausea and vomiting, diarrhea, and grade 3/4 hematological toxicity were 37.6%, 28.4% and 44.0%, respectively. Baseline nutritional risk was a risk factor for diarrhea ( HR=2.447, 95% CI: 1.017-6.068, P=0.047), and an advanced International Federation of Gynecology and Obstetrics (FIGO) stage was a risk factor for severe nausea and vomiting ( HR=1.735, 95% CI: 1.005-2.995, P=0.048). Patients presenting with severe nausea and vomiting had more significant reductions in body mass index [(-1.44±1.29) kg/m 2vs. (-0.59±0.84) kg/m 2, P<0.001] and SMI [(-0.37±0.41) kg/m 2vs. (-0.12±0.27) kg/m 2, P=0.013] compared to those without nausea and vomiting, while there was no significant difference in visceral fat area between these two groups [(-9.95±19.48) cm 2vs. (-5.12±15.79) cm 2, P=0.161]. Conclusions:Patients with cervical cancer have increased nutritional risk and more loss of body weight and muscle mass during CCRT. The presence of nutritional risk at baseline is a risk factor for diarrhea, while nausea and vomiting exacerbate the losses of body weight, muscle, and fat. Close monitoring, intensive symptomatic therapy, and appropriate nutritional interventions should be performed in the clinical setting to improve patients' tolerance of treatment and maintenance of body weight.

Objective:To investigate the effects of different BMI classifications on rehabilitation outcomes and complications after total knee arthroplasty(TKA).Methods:Clinical data of 88 patients who underwent TKA in our hospital from January 2022 to June 2024 were retrospectively analyzed.According to the World Health Organization(WHO)BMI standards,patients were divided into normal weight group(18.5 ≤BMI＜24.9 kg/m2),overweight group(25.0≤BMI＜29.9 kg/m2),mild obesity group(30.0≤BMI＜34.9 kg/m2),and severe obesity group(BMI≥35.0 kg/m2).Baseline data,operation time,intraoperative blood loss,hospital stay,postoperative knee function scores,pain scores,range of motion(ROM),and incidence of complications were compared among groups.Results:With the increase of BMI,operation time was prolonged,intraoperative blood loss increased,and hospital stay extended,with statistically significant differences(P＜0.05).At 3-month and 6-month follow-ups,Knee Society Score(KSS)and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)showed that functional recovery decreased with increasing BMI(P＜0.05).Regarding postoperative complications,the incidence of poor incision healing,infection,and deep vein thrombosis(DVT)in the obese groups was significantly higher than in the normal weight and overweight groups(P＜0.05).Conclusion:BMI is an important factor affecting rehabilitation outcomes and complications after TKA.Patients with high BMI have slower functional recovery and higher complication rates.For patients with high BMI,preoperative weight loss and individualized rehabilitation programs should be considered to improve TKA prognosis.

Radical gastrectomy is the most important treatment for gastric cancer. In recent years, robot-assisted surgical systems have demonstrated significant potential in gastric cancer treatment, thanks to their minimally invasiveness, precise, and fast recovery features. As clinical research continues to deepen, a growing body of evidence has confirmed that robot-assisted gastrectomy offers distinct advantages, such as improved efficiency in lymph node dissection and a reduced incidence of postoperative complications. But at the same time, robotic surgery still has some shortcomings such as high cost, long operation time and lack of force feedback. With the emergence of high-level evidence-based medical evidence and the application of domestic robot system, robot radical gastrectomy will be further promoted and applied. Robotic surgery has broad application prospects, and further advances in techniques are expected in future in the direction of single-port, intelligent, automation and multi-technology integration .

AIM To establish the quantitative models for gallic acid,mononucleoside,loganin,resveratrol,and rhein in Yishen Xiezhuo Mixture.METHODS HPLC was adopted in the content determination of various effective components,after which the near-infrared spectroscopy(NIRS)data were collected in 128 batches of samples and pretreatment was conducted,competitive adaptive reweighting sampling(CARS)algorithm was used for screening wavelength,partial least square method(PLS)regression analysis was performed.RESULTS There were no significant differences between the predicted values obtained by PLS models and measured values obtained by HPLC for various effective components(P＞0.05).CONCLUSION The quantitative models established by NIRS combined with chemometrics display good predictive performance,which can be used for the rapid determination of effective components in Yishen Xiezhuo Mixture,and provide a reference for the rapid monitoring of other traditional Chinese medicine preparations in production processes.