BACKGROUND:Eucommia ulmoides has a certain osteogenic effect,which can promote the proliferation and differentiation of osteoblasts.However,it is unclear whether Eucommia ulmoides has effects on alveolar bone formation and Wnt/β-Catenin signaling pathway. OBJECTIVE:To investigate the mechanism by which Eucommia ulmoides promotes alveolar bone formation in ovariectomized rats based on the Wnt/β-Catenin signaling pathway. METHODS:Sixty female Sprague-Dawley rats were selected and randomly divided into five groups:blank control group,sham-operation group,model group,low-dose group Eucommia ulmoides group,and high-dose Eucommia ulmoides group,with twelve rats in each group.Osteoporosis animal models were constructed by bilateral oophorectomy in the model group and the low-dose and high-dose Eucommia ulmoides groups.The sham-operation group underwent the same method to remove adipose tissue of equal mass around the bilateral ovaries.Three months after surgery,the low-and high-dose Eucommia ulmoides groups were given 2.1 g/kg/d and 4.2 g/kg/d Eucommia ulmoides by gavage,respectively.The sham-operation group and model group were given the same amount of physiological saline by gavage.After 12 weeks of drug intervention,the changes in alveolar bone mass of rats in each group were observed through Micro-CT;hematoxylin-eosin staining was used to observe the pathological structural changes of alveolar bone in rats;enzyme linked immunosorbent assay was used to detect the expression levels of alkaline phosphatase and osteocalcin in the serum of rats;western blot was used to detect the expression levels of β-Catenin and Frizzled9 receptor proteins in the alveolar bone of rats;and real-time fluorescence quantitative PCR was used to detect the expression of osteocalcin,Runt-related transcription factor 2(Runx2),alkaline phosphatase,β-catenin,and frizzled9 mRNAs in alveolar bone tissues of rats. RESULTS AND CONCLUSION:Compared with the blank control group,bone volume fraction,trabecular number,trabecular thickness,and bone mineral density were reduced in the model group(P＜0.05),and trabecular separation was elevated(P＜0.05).Pathological observation showed that the arrangement of trabeculae was disordered and irregular,the trabeculae were thinned or broken,and the marrow cavity was enlarged in the model group,with a significant reduction in bone volume;the level of alkaline phosphatase in the serum was increased(P＜0.05),and the level of osteocalcin was decreased(P＜0.05);mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were decreased(P＜0.05);protein expression of β-Catenin and Frizzled9 was decreased(P＜0.05).Compared with the model group,the low-and high-dose Eucommia ulmoides groups showed an increase in bone volume fraction,trabecular number,trabecular thickness,and bone mineral density(P＜0.05)and a decrease in trabecular separation(P＜0.05).In the low-and high-dose Eucommia ulmoides groups,bone trabeculae were slightly aligned and thickened,with a significant increase in bone mass.Compared with the model group,the serum level of alkaline phosphatase was reduced(P＜0.05)and the serum level of osteocalcin was elevated(P＜0.05)in the low-and high-dose Eucommia ulmoides groups.Compared with the model group,the mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were increased in the low-and high-dose Eucommia ulmoides groups(P＜0.05).Compared with the model group,the protein expression of Frizzled9 was increased in the low-dose Eucommia ulmoides group(P＜0.05),while the protein expression of β-Catenin and Frizzled9 was increased in the high-dose Eucommia ulmoides group(P＜0.05).Compared with the low-dose Eucommia ulmoides group,the high-dose Eucommia ulmoides group had a more significant improvement in the above indexes.To conclude,Eucommia ulmoides can effectively promote the alveolar bone formation,and its mechanism of action might be related to the activation of the Wnt/β-catenin signaling pathway.

Objective To explore the sex difference in clinical manifestations, echocardiographic features and prognosis of patients with bicuspid aortic valve (BAV) combined with moderate to severe aortic stenosis (AS). Methods The clinical data and echocardiographic follow-up parameters of patients diagnosed with BAV combined with moderate to severe AS at Zhongshan Hospital, Fudan University, from July 30, 2010 to August 1, 2015 were retrospectively collected. The composite endpoint was defined as all-cause mortality or surgical intervention. Kaplan-Meier survival curve and log-rank test were used to compare the risk of composite endpoint events between male and female patients, and Cox regression models were used to analyze independent risk factors for composite endpoint events. Results A total of 144 patients were included, with 69 males and 75 females, and a median age of 60 years. Compared to males, female patients were younger (58[46, 65] years vs 61[54, 67] years, P＝0.046), had a lower proportion of aortic valve calcification (61.1% vs 81.1%, P＝0.009), and a higher peak transvalvular pressure gradient (72[59, 88] mmHg vs 63[55, 72] mmHg, P＝0.002). In terms of left ventricular remodeling types, the proportion of concentric remodeling was higher in females than in males (36.0% vs 15.9%, P＝0.006), while the proportion of eccentric hypertrophy was lower in females than in males (10.7% vs 29.0%, P＝0.006). The proportion of female patients classified as New York Heart Association (NYHA) functional class Ⅲ-Ⅳ was higher than that of males (45.3% vs 17.4%, P＜0.001), and left ventricular ejection fraction was higher in females (68%[65%, 72%] vs 65%[60%, 70%], P＝0.003). With a median follow-up of 49 months, Kaplan-Meier survival analysis showed that the risk of composite endpoint events was higher in females than in males (P＜0.001). Independent risk factors for composite endpoint events included female (HR＝1.74, 95%CI 1.02-2.96, P＝0.042), severe AS (HR＝1.99, 95%CI 1.18-3.36, P＝0.010), and NYHA functional class Ⅲ-Ⅳ (HR＝2.08, 95% CI 1.24-3.47, P＝0.005). Conclusions Sex significantly affects the clinical manifestations, echocardiographic characteristics, and prognosis of patients with BAV combined with moderate to severe AS, suggesting that sex-specific echocardiographic assessment and follow-up monitoring should be conducted for these patients.

Objective This clinical study aimed to evaluate the accuracy of a fully digital technique for mea-suring sagittal condylar inclination(SCI),as well as vali-dating whether differences existed between the left and right SCI values of the same participant,to provide a ref-erence for clinical practice.Methods Ten participants with good occlusal relationship and normal temporomandibular joint were recruited.Three methods were used to mea-sure the SCI values of the participants,namely,A(mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration),B(face scan-based virtual facebow and virtual ar-ticulator-based measuring method with digital protrusive interocclusal registration),and C(jaw motion tracking system-based measuring method).With the group subjected to methods A and C as the control,the SCI values obtained by the three methods were statistically analyzed.The left and right SCI values of the same participant were also compared.Re-sults The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°,those by method B were 35.09°±12.49° and 37.63°±12.10°,and those by method C were 39.43°±8.72° and 38.45°±6.91°.No significant dif-ference existed among the SCI values measured by the three methods(P>0.05).Meanwhile,no statistical difference existed between the SCI values on the left and right sides of the same participant(P>0.05).Conclusion The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods.The SCI values on the left and right sides of the same participant were similar.Clinically,an appropriate SCI measurement and setting strategy can be selected based on the actual situations.

Objective This clinical study aimed to as-sess the trueness of three intraoral scanners for the recor-ding of the maximal intercuspal position(MIP)to provide a reference for clinical practice.Methods Ten participants with good occlusal relationship and healthy temporomandibular joint were recruited.For the control group,facebow transferring procedures were performed,and bite registrations at the MIP were used to transfer maxillary and mandibular casts to a mechanical articulator,which were then scanned with a laboratory scanner to obtain digital cast data.For the experimental groups,three intraoral scanners(Trios 3,Carestream 3600,and Aoralscan 3)were used to obtain digital casts of the participants at the MIP following the scanning workflows endorsed by the corresponding manufacturers.Sub-sequently,measurement points were marked on the control group's digital casts at the central incisors,canines,and first molars,and corresponding distances between these points on the maxillary and mandibular casts were measured to calcu-late the sum of measured distances(DA).Distances between measurement points in the incisor(DI),canine(DC),and first molar(DM)regions were also calculated.The control group's maxillary and mandibular digital casts with the added mea-surement points were aligned with the experimental group's casts,and DA,DI,DC,and DM values of the aligned control casts were determined.Statistical analysis was performed on DA,DI,DC,and DM obtained from both the control and ex-perimental groups to evaluate the trueness of the three intraoral scanners for the recording of MIP.Results In the con-trol group,DA,DI,DC,and DM values were(39.58±6.40),(13.64±3.58),(14.91±2.85),and(11.03±1.56)mm.The Trios 3 group had values of(38.99±6.60),(13.42±3.66),(14.55±2.87),and(11.03±1.69)mm.The Carestream 3600 group showed values of(38.57±6.36),(13.56±3.68),(14.45±2.85),and(10.55±1.41)mm,while the Aoralscan 3 group had val-ues of(38.16±5.69),(13.03±3.54),(14.23±2.59),and(10.90±1.54)mm.Analysis of variance revealed no statistically sig-nificant differences between the experimental and control groups for overall deviation DA(P=0.96),as well as local devi-ations DI(P=0.98),DC(P=0.96),and DM(P=0.89).Conclusion With standardized scanning protocols,the three intra-oral scanners demonstrated comparable trueness to traditional methods in recording MIP,fulfilling clinical requirements.

Objective:To understand the potential categories of e-health literacy of elderly diabetic patients in community, and analyze the relationship between each category and physical activity level, in order to provide theoretical basis for formulating intervention measures to improve e-health literacy of elderly diabetic patients.Methods:This study was across-sectional survey. Elderly diabetic patients from 3 community health service centers in Fenyang City, Shanxi Province were selected by convenient sampling method from January to June 2023. General data questionnaire, e-Health Literacy Scale and International Physical Activity Questionnaire were used to investigate the elderly diabetic patients. Mplus8.0 was used for potential profile analysis, and SPSS 26.0 software was used to compare the differences in physical activity levels among different categories of e-health literacy.Results:Totally 248 elderly diabetes patients in the community aged 60-88 (63.8 ± 6.4) years, 135 males (54.4%) and 113 females (45.6%). The e-health literacy scores of 248 elderly diabetic patients in community were (17.70 ± 5.30), which could be divided into three potential categories: general low literacy group (56.0%, 139/248), high evaluation ability-medium literacy group (18.2%, 45/248) and high access ability-high literacy group (25.8%, 64/248). Three potential categories of physical activity levels were (1 464.74 ± 190.37), (2 094.40 ± 139.70), (2 368.44 ± 157.27) metabolic equivalent-min per week, and the difference was statistically significant ( F=118.83, P<0.001). Conclusions:The e-health literacy of elderly diabetic patients in community can be divided into three potential categories, and the physical activity level of patients with different e-health literacy categories is different. It is suggested that targeted intervention should be conducted based on the homogenous group of elderly diabetic patients with e-health literacy to improve their physical activity level.

Objective:To investigate the symptoms and symptom clusters of elderly stroke patients in the acute phase, analyze the factors influencing the symptom clusters and to provide a basis for the implementation of targeted symptom management in elderly stroke patients.Methods:Convenience sampling method was used to select 257 acute-phase elderly stroke patients who attended Fenyang Hospital in Shanxi Province from October 2022 to January 2023, and a cross-sectional survey was conducted by the General Information Questionnaire, Memory Symptom Evaluation Inventory, Modified Barthel Index Scale (MBI), and the National Institutes of Health Stroke Scale (NIHSS), and the symptom clusters were extracted by means of exploratory factor analysis, and the factors influencing symptom clusters were explored by means of binary logistic regression analysis.Results:Of the 257 patients, 138 were male and 119 were female, aged 60 to 90 (70.34 ± 6.94) years old. Factor analysis yielded four symptom clusters, which were named oral-intestinal symptom cluster, negative emotional symptom cluster, fatigue symptom cluster, and perceptual symptom cluster according to the symptom characteristics; regression analysis showed that: stroke site and NIHSS scores were the influencing factors of the oral-intestinal symptom cluster (all P<0.05); per capita monthly family income, number of episodes and MBI scores were the influencing factors of the negative emotional symptom cluster (all P<0.05); number of chronic diseases, type of stroke, and gender were the influencing factors of the fatigue emotional symptom cluster (all P<0.05); and literacy and stroke site were influencing factors of the perception symptom cluster (all P<0.05). Conclusions:Elderly stroke patients in the acute phase of the existence of more symptoms, symptoms interact with each other to form symptom clusters, health care personnel should be symptom clusters as a unit, the implementation of interventions for their influencing factors, effective symptom management, in order to improve the quality of life of patients.

【Objective】 To analyze the association between the composition of gut microbiota and blood pressure in children aged 6 - 9 years, in order to provide new ideas for childhood hypertension prevention and treatment. 【Methods】 A total of 411 children aged 6 - 9 years were recruited in Guangzhou from December 2015 to March 2017. The gut microbiota was characterized by 16S ribosomal RNA amplicon sequencing. The multivariate methods with unbiased variable selection in R (MUVR) were performed to identify the significant OTUs. Spearman correlation as well as multiple linear regression were used to explore the relationship between gut microbiota and blood pressure in children. 【Results】 Significant difference in β diversity index was observed between children with normal blood pressure and those with abnormal blood pressure (R²weighted=0.015,Pweighted=0.01; R²unweighted=0.027, Punweighted=0.001). After adjustment for covariates and controlling the false discovery rate (FDR), multiple linear regression analysis showed that blood pressure level in children decreased with the increasing abundance of OTU_3 (genus Blautia), OTU_131 (genus [Clostridium]_innocuum_group), OTU_1776 (genus Blautia), OTU_2159 (genus Prevotella) and OTU_91 (species Bifidobacterium_breve) (β:-0.18 --0.14; PFDR<0.05. In contrast, blood pressure in children increased with the increasing abundance of OTU_108(genus Sutterella), OTU_1(species Faecalibacterium_prausnitzii)、OTU_8(genus Roseburia), OTU_48 (genus Lachnoclostridium), OTU_81 (genus Coprococcus), OTU_401 (family Lachnospiraceae), OTU_1284 (family Lachnospiraceae) and OTU_2793 (family Lachnospiraceae)(β: 0.14 - 0.21; PFDR<0.05. The influence of gut microbiota on systolic pressure and diastolic pressure may be mediated by the increase of body mass index (BMI). 【Conclusions】 Pediatric blood pressure level is associated with the composition of gut microbiota, while BMI partially plays a mediating role in the relationship. It is recommended to modulate the abundance of microbiota as genus Blautia, Sutterella and so on to prevent hypertension in children.

Objective: To investigate the effect of cluster sedation and analgesia for patients with mechanical ventilation. Methods: From June 2016 to June 2017, 234 patients with mechanical ventilation admitted to the ICU of the Second Hospital of Jiaxing were selected and divided into study group (120 cases) and control group (114 cases) according to the random number method.The control group received conventional nursing, while the study group was given cluster sedation and analgesia.The drug use dose, mechanical ventilation time, ICU admission time, sputum incidence and 1-month survival rate were compared between the two groups. Results: The total dose and unit dose in the study group were lower than those in the control group [(252.17±38.42)mg vs.(326.50±50.88)mg, (60.50±9.33)μg·kg^-1·h^-1 vs.(79.41±10.52)μg·kg^-1·h^-1, t=12.562, 14.564, P=0.000, 0.000]. The duration of mechanical ventilation and ICU stay in the study group were also shorter than those in the control group [(5.13±0.73)d vs.(7.57±0.95)d, (7.02±0.91)d vs.(10.55±1.26)d, t=21.949, 24.460, P=0.000, 0.000]. The incidence rate of delirium in the study group was lower than that in the control group (28.33% vs.50.88%, χ²=12.453, P=0.000). The 1-month survival rate of the study group was higher than that of the control group (91.67% vs.80.70%, χ²=5.954, P=0.015). Conclusion Cluster sedation and analgesia is an effective method for ICU mechanical ventilation patients, which can improve the quality of medical and nursing, and is an important embodiment in critical medical management, it is worthy of attention in intensive care workers.

Objective To evaluate the accuracy of simple anthropometric parameters in diagnosing obesity in children in Guangzhou. Methods A cross-sectional study, including 465 children aged 6-9 years, was carried out in Guangzhou. Their body height and weight, waist circumference (WC) and hip circumference were measured according to standard procedure. Body mass index (BMI), waist to hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Body fat percentage (BF%)was determined by dual-energy X-ray absorptiometry. Multiple regression analysis was applied to evaluate the correlations between age-adjusted physical indicators and BF%, after the adjustment for age. Obesity was defined by BF%. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic accuracy of the indicators for childhood obesity. Area under-ROC curves (AUCs) were calculated and the best cut-off point that maximizing'sensitivity+specificity-1'was determined. Results BMI showed the strongest association with BF% through multiple regression analysis. For'per-standard deviation increase' of BMI, BF%increased by 5.3%(t=23.1, P<0.01) in boys and 4.6%(t=17.5, P<0.01) in girls, respectively. The ROC curve analysis indicated that BMI exhibited the largest AUC in both boys (AUC=0.908) and girls (AUC=0.895). The sensitivity was 80.8% in boys and 81.8% in girls, and the specificity was 88.2%in boys and 87.1%in girls. Both the AUCs for WHtR and WC were less than 0.8 in boys and girls. WHR had the smallest AUCs (<0.8) in both boys and girls. Conclusion BMI appeared to be a good predicator for BF%in children aged 6-9 years in Guangzhou.