Objective To investigate the sputum metabolic profiles of patients with occupational coal workers' pneumoconiosis (CWP) by an untargeted metabolomics method, and to identify relevant differential metabolic pathways and potential biomarkers. Methods A total of 12 male patients with stage Ⅰ CWP were selected as the CWP group, and 16 healthy male individuals were selected as the control group, using a judgmental sampling method. Sputum metabolites of individuals in both groups were detected to perform non-targeted metabolomic analysis using the ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry. Differential metabolites (DMs) and their pathways were screened using principal component analysis, partial least squares discriminant analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Potential biomarkers were analyzed and identified via the receiver operating characteristic curve (ROC). Results There were apparent metabolic alterations observed in sputum of CWP patients compared with healthy controls. In the positive ion mode, a total of 42 DMs were identified in sputum from CWP patients, including 19 downregulated and 23 upregulated metabolites. In the negative ion mode, a total of 25 DMs were identified in sputum from CWP patients, including 16 downregulated and 9 upregulated metabolites. KEGG enrichment analysis of sputum from CWP patients showed that seven DMs pathways were enriched in ABC transporters, histidine metabolism, phenylalanine metabolism, arachidonic acid metabolism, linoleic acid metabolism, purine metabolism, and oxidative phosphorylation, involving 26 DMs. ROC analysis indicated that 16(R)-hydroxyarachidonic acid, pyrophosphate, and 2-hydroxyphenylacetate of these 26 DMs may serve as potential biomarkers for CWP. Conclusion Sputum metabolomic profiles were altered in CWP patients compared with healthy controls. The potential biomarkers of CWP prevention and treatment are 16(R)-hydroxyarachidonic acid, pyrophosphate, and 2-hydroxyphenylacetate.

Objective:To analyze the efficacy and safety of different surgical approaches for the treatment of anterior skull base malignancies involving the orbit.Methods:Retrospective analysis was conducted on patients with anterior skull base malignancies involving orbit who attended Xuanwu Hospital of Capital Medical University from April 2013 to July 2021. They were divided into endoscopic endonasal approach(EEA), lateral orbital approach(ELOA), and sublabial transmaxillary approach(ESTMA) groups according to the primary surgical approach. One-way analysis of variance and χ 2 test were used to compare the clinical characteristics, degree of tumour resection, rate of postoperative cranial nerve palsy and improvement of visual acuity; Log-rank test was applied to assess the difference in overall survival (OS). Results:One hundred and ninety-eight patients were enrolled, including 107 males and 91 females, aged (48.5±15.3) years. There were 153, 33, and 12 patients in the EEA, ESTMA, and ELOA groups, respectively. There were no significant differences among the three groups in age, gender, and history of radiotherapy, chemotherapy or surgery ( P>0.05 for all). All patients in ELOA group had preoperative visual impairment (12/12), with a significantly higher percentage than EEA group (56/153) and ESTMA group (14/33) ( χ2=19.72, P<0.001). There was no significant difference between three groups in the degree of tumor resection (gross total resection: 84.97% vs. 81.82% vs. 58.33%, χ2=5.58, P>0.05), postoperative cranial nerve palsy rate (13.07% vs. 30.30% vs. 16.67%, χ2=5.95, P>0.05), visual improvement rate (58.93% vs. 57.14% vs. 58.33%, χ2=0.04, P>0.05) and 5-year OS (60.69% vs. 42.66% vs. 50.00%, χ2=3.22, P>0.05). Conclusion:All three surgical approaches were safe, effective and feasible treatment modalities.

Objective To construct a distance self-attention(DSA)and long short-term memory(LSTM)model and observe its value for predicting X-ray tube arcing in CT equipment.Methods CT equipment status data of internet of medical things were collected and preprocessed,then DSA-LSTM model based on model attention(MA)module and nonlinear attenuation distance factor was constructed,and its value for predicting X-ray tube arcing in CT equipment was analyzed compared with other models.Results Compared with other models,DSA-LSTM model had better comprehensive efficiency for predicting X-ray tube arcing in CT equipment.MA module and nonlinear attenuation distance factor could improve the predictive efficiency of DSA-LSTM model,and all included features contributed to the performance of DSA-LSTM model in a certain extent.Conclusion DSA-LSTM model could effectively predict X-ray tube arcing in CT equipment.

Objective To investigate the effect of lung lobe surface projection localization combined with lung segment drainage sputum technique on airway clearance in patients with aspiration pneumonia,providing a reference for clinical nursing practice.Methods A convenience sampling method was used to select 62 patients with perioperative aspiration pneumonia secondary to brain diseases admitted to a tertiary A hospital in Beijing from May 2022 to October 2024 as the research subjects.A total of 31 patients admitted from August 2023 to October 2024 were assigned to a control group,and 31 patients admitted from May 2022 to July 2023 were assigned to an experimental group.The experimental group received lung lobe surface projection positioning combined with lung segment drainage sputum technique on top of conventional back percussion sputum clearance technique,while the control group received conventional back percussion sputum clearance technique.After the intervention,the differences in oxygenation state,inflammatory test indicators,treatment efficiency,vital signs and frequency of suction coughing between 2 groups were compared.Results After the intervention,the experimental group showed better oxygenation index,frequency of suction coughing,white blood cell count,percentage of neutrophils,procalcitonin levels,interleukin-6 levels,and treatment efficiency compared to those in the control group(P＜0.05).There was no statistically significant difference in heart rate,respiratory rate,and C-reactive protein levels between 2 groups(P＞0.05).Conclusion Lung lobe surface projection positioning combined can effectively promote the patients with aspiration pneumonia of loosening of sputum in the lungs,improve airway clearance efficiency,enhance the patient's pulmonary ventilation and gas exchange capacity,improve oxygenation levels,and reduce systemic inflammatory levels.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

BACKGROUND:Clear aligners,due to their special material properties,are more prone to the"roller coaster effect"during the process of extracting the maxillary first premolar and closing the gap by retracting the anterior teeth,tilting and moving the teeth,leading to deepening of the anterior overjet and opening of the posterior teeth.There are fewer related studies at present concerning whether the thickness or stiffness of the aligner can be changed to reduce the"roller coaster effect"and better control the orthodontic tooth movement,.OBJECTIVE:To analyze the differences in tooth movement control ability of clear aligners of different thicknesses and stiffness when internally retracting maxillary anterior teeth by means of the three-dimensional finite element method.METHODS:Cone beam CT data of patients with convex profile were imported into Mimics and other software to simulate clinical cases.Three-dimensional finite element models were constructed to remove the first premolars,including the maxilla,teeth,and periodontal ligaments,while the diaphragms of clear aligners with thicknesses of 0.50 mm and 0.75 mm were assembled.Four sets of working conditions were created by loading the material properties of two Young's modulus of 1 000 MPa and 2 000 MPa.According to the clinical design to close of the extraction gap,and analyze the distribution of periodontal ligament stress,the displacement trend and the initial displacement of the teeth after loading and calculating in Workbench 2023 R1 software.RESULTS AND CONCLUSION:(1)The Von-Mises stress distribution pattern of periodontal ligament was consistent among the four working conditions,with the maximum value mainly distributed at the cervical part of teeth.The thicker diaphragm of the aligner,the higher the Von-Mises stress;the higher Young's modulus of the aligner,the higher the Von-Mises stress.(2)Under the four working conditions,the overall displacement trend of the maxillary dentition was that the crowns of the anterior teeth moved towards the lingual side and the roots towards the labial side,while the crowns of the posterior teeth moved towards the proximal-medial side and the roots towards the distal-medial side,and it was observed that the crown-root displacements of the teeth were in the opposite direction in all the conditions,and that the displacement of the crowns was greater than the displacement of the roots.Except for canines,the thicker the aligner diaphragm,the lower the R/C value(root-crown displacement ratio);the higher the modulus of elasticity of the aligner diaphragm,the lower the R/C value.(3)The results showed that when the maxillary anterior teeth were internally retracted using invisible aligners,the teeth showed a tendency to tilt and move without incisor torque compensation being designed;the greater the thickness of the aligner and the elastic modulus,the greater the control of the teeth,and the tendency of the teeth to tilt and move decreased;and the cuspids had to be controlled by other auxiliary means.

Objective:To study the implementation progress of the prevention and control measures for drinking water-borne endemic fluorosis and the changing trend of fluorosis conditions in Inner Mongolia Autonomous Region, comprehensively evaluate the effectiveness of prevention and control measures, and provide a basis for the next step of prevention and control of the disease.Methods:In 2015 and 2023, a cross-sectional survey method was used to investigate the water improvement situation, the operation of water improvement projects, the detection of fluoride level in water, and the prevalence of dental fluorosis in children aged 8 to 12 in all affected villages of 11 leagues (cities) in the entire autonomous region. The prevention and control effect of drinking water-borne endemic fluorosis in the entire autonomous region was evaluated.Results:The water improvement rates of all affected villages in the entire autonomous region in 2015 and 2023 were 84.12% (8 218/9 769) and 95.38% (8 944/9 377), respectively. The qualified rates of water fluoride in the villages with water improvement in the entire autonomous region were 66.21% (5 441/8 218) and 91.00% (8 139/8 944), respectively. The water improvement rate and water fluoride qualification rate of water improvement villages in 2023 were both higher than those in 2015, and the differences were statistically significant (χ 2 = 652.96, 1 593.81, P < 0.001). The detection rates of dental fluorosis in children aged 8 to 12 years in the entire autonomous region in 2015 and 2023 were 9.26% (7 548/81 484) and 4.46% (3 441/77 155), respectively. The detection rate of dental fluorosis in children in 2023 was lower than that in 2015, and the difference was statistically significant (χ 2 = 1 418.20, P < 0.001). In 2015 and 2023, the total compliance rate of all affected villages in the entire autonomous region reaching the control standards were 57.94% (5 660/ 9 769) and 92.37% (8 662/9 377), respectively. The total compliance rate of all affected villages in 2023 was higher than that in 2015, and the difference was statistically significant (χ 2 = 3 010.38, P < 0.001). Conclusions:Compared with 2015, the prevention and control measures of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region have been effectively implemented in 2023, with a significant decrease in the detection rate of dental fluorosis in children. However, there are still a few affected villages that have not achieved the control standards, and prevention and control work still need to be further strengthened.

Objective:To investigate the characteristics of the population of skeletal fluorosis patients in drinking-tea-borne endemic fluorosis (referred to as drinking-tea-borne fluorosis) areas in Inner Mongolia Autonomous Region (referred to as Inner Mongolia) and the influencing factors of treatment willingness, and to provide a basis for improving the prevention and control measures of drinking-tea-borne fluorosis and the treatment plan of skeletal fluorosis.Methods:From August to October 2022, a face-to-face questionnaire survey was conducted in key areas of drinking-tea-borne fluorosis in Inner Mongolia (administrative villages with an average daily intake of tea fluoride > 3.5 mg and skeletal fluorosis patients identified by the general survey of drinking-tea-borne fluorosis in Inner Mongolia in 2019), and to investigate the demographic, severity, and treatment status of patients with skeletal fluorosis, analyze the demographic characteristics of patients with skeletal fluorosis and the influencing factors of treatment willingness.Results:A total of 734 patients with skeletal fluorosis were investigated, including 543 mild cases, 125 moderate cases and 66 severe cases. The gender ratio of patients with skeletal fluorosis was 0.71 ∶ 1.00 (305/429), the age was concentrated in > 50 - 70 years old (70.57%, 518/734), the proportion of Mongolians was 94.28% (692/734), the proportion of herders was 97.68% (717/734), the educational level was mainly primary school (54.63%, 401/734), and the proportion of poor households and immigrants who had moved to their current residence was 7.08% (52/734) and 8.04% (59/734), respectively. The distribution of the severity of skeletal fluorosis in patients of different ages, genders, and educational levels was compared, and the differences were statistically significant ( P < 0.05). Fifty-three point two seven percent (391/734) of the patients had a willingness to undergo non-pharmacological treatment, of which 69.82% (273/391) had already started non-pharmacological treatment, with a treatment effectiveness rate of 73.99% (202/273). Sixty-five point two six percent (479/734) of the patients had a willingness to receive medication treatment, of which 7.31% (35/479) had already started medication treatment, with a treatment effectiveness rate of 54.29% (19/35). Zero point two seven percent (2/734) of the patients expressed a willingness to undergo surgical treatment, while no patients underwent surgical treatment. Multivariate logistic regression analysis showed that the age, ethnicity, occupation, educational level, poverty status, immigrants status, and the severity of skeletal fluorosis were all influencing factors of non-pharmacological treatment willingness ( P < 0.05). Occupation, educational level, poverty status, immigrants status, and the severity of skeletal fluorosis were all influencing factors of medication treatment willingness ( P < 0.05). Conclusions:Patients with skeletal fluorosis caused by tea drinking in Inner Mongolia are mainly from Mongolian ethnic groups, herders, middle-aged and elderly people, and those with a lower educational levels. The willingness of patients to receive treatment is influenced by various factors, and corresponding intervention measures can be formulated and taken based on these influencing factors to effectively improve the disease prevention awareness and treatment willingness of patients and the public.

Objective:To study the implementation progress of the prevention and control measures for drinking water-borne endemic fluorosis and the changing trend of fluorosis conditions in Inner Mongolia Autonomous Region, comprehensively evaluate the effectiveness of prevention and control measures, and provide a basis for the next step of prevention and control of the disease.Methods:In 2015 and 2023, a cross-sectional survey method was used to investigate the water improvement situation, the operation of water improvement projects, the detection of fluoride level in water, and the prevalence of dental fluorosis in children aged 8 to 12 in all affected villages of 11 leagues (cities) in the entire autonomous region. The prevention and control effect of drinking water-borne endemic fluorosis in the entire autonomous region was evaluated.Results:The water improvement rates of all affected villages in the entire autonomous region in 2015 and 2023 were 84.12% (8 218/9 769) and 95.38% (8 944/9 377), respectively. The qualified rates of water fluoride in the villages with water improvement in the entire autonomous region were 66.21% (5 441/8 218) and 91.00% (8 139/8 944), respectively. The water improvement rate and water fluoride qualification rate of water improvement villages in 2023 were both higher than those in 2015, and the differences were statistically significant (χ 2 = 652.96, 1 593.81, P < 0.001). The detection rates of dental fluorosis in children aged 8 to 12 years in the entire autonomous region in 2015 and 2023 were 9.26% (7 548/81 484) and 4.46% (3 441/77 155), respectively. The detection rate of dental fluorosis in children in 2023 was lower than that in 2015, and the difference was statistically significant (χ 2 = 1 418.20, P < 0.001). In 2015 and 2023, the total compliance rate of all affected villages in the entire autonomous region reaching the control standards were 57.94% (5 660/ 9 769) and 92.37% (8 662/9 377), respectively. The total compliance rate of all affected villages in 2023 was higher than that in 2015, and the difference was statistically significant (χ 2 = 3 010.38, P < 0.001). Conclusions:Compared with 2015, the prevention and control measures of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region have been effectively implemented in 2023, with a significant decrease in the detection rate of dental fluorosis in children. However, there are still a few affected villages that have not achieved the control standards, and prevention and control work still need to be further strengthened.

Objective:To investigate the characteristics of the population of skeletal fluorosis patients in drinking-tea-borne endemic fluorosis (referred to as drinking-tea-borne fluorosis) areas in Inner Mongolia Autonomous Region (referred to as Inner Mongolia) and the influencing factors of treatment willingness, and to provide a basis for improving the prevention and control measures of drinking-tea-borne fluorosis and the treatment plan of skeletal fluorosis.Methods:From August to October 2022, a face-to-face questionnaire survey was conducted in key areas of drinking-tea-borne fluorosis in Inner Mongolia (administrative villages with an average daily intake of tea fluoride > 3.5 mg and skeletal fluorosis patients identified by the general survey of drinking-tea-borne fluorosis in Inner Mongolia in 2019), and to investigate the demographic, severity, and treatment status of patients with skeletal fluorosis, analyze the demographic characteristics of patients with skeletal fluorosis and the influencing factors of treatment willingness.Results:A total of 734 patients with skeletal fluorosis were investigated, including 543 mild cases, 125 moderate cases and 66 severe cases. The gender ratio of patients with skeletal fluorosis was 0.71 ∶ 1.00 (305/429), the age was concentrated in > 50 - 70 years old (70.57%, 518/734), the proportion of Mongolians was 94.28% (692/734), the proportion of herders was 97.68% (717/734), the educational level was mainly primary school (54.63%, 401/734), and the proportion of poor households and immigrants who had moved to their current residence was 7.08% (52/734) and 8.04% (59/734), respectively. The distribution of the severity of skeletal fluorosis in patients of different ages, genders, and educational levels was compared, and the differences were statistically significant ( P < 0.05). Fifty-three point two seven percent (391/734) of the patients had a willingness to undergo non-pharmacological treatment, of which 69.82% (273/391) had already started non-pharmacological treatment, with a treatment effectiveness rate of 73.99% (202/273). Sixty-five point two six percent (479/734) of the patients had a willingness to receive medication treatment, of which 7.31% (35/479) had already started medication treatment, with a treatment effectiveness rate of 54.29% (19/35). Zero point two seven percent (2/734) of the patients expressed a willingness to undergo surgical treatment, while no patients underwent surgical treatment. Multivariate logistic regression analysis showed that the age, ethnicity, occupation, educational level, poverty status, immigrants status, and the severity of skeletal fluorosis were all influencing factors of non-pharmacological treatment willingness ( P < 0.05). Occupation, educational level, poverty status, immigrants status, and the severity of skeletal fluorosis were all influencing factors of medication treatment willingness ( P < 0.05). Conclusions:Patients with skeletal fluorosis caused by tea drinking in Inner Mongolia are mainly from Mongolian ethnic groups, herders, middle-aged and elderly people, and those with a lower educational levels. The willingness of patients to receive treatment is influenced by various factors, and corresponding intervention measures can be formulated and taken based on these influencing factors to effectively improve the disease prevention awareness and treatment willingness of patients and the public.