Objective: To compare the effects of immediate versus delayed post-space preparation on the bond strength of fiber posts and the fracture resistance of roots after root canal obturation using iRoot SP and the single-cone technique, and to provide an experimental basis for the selection of the timing of clinical post-space preparation. Methods: This study was approved by the Medical Ethics Committee of the institution, and written informed consent was obtained from all participants. Seventy-two extracted human single-rooted premolars were randomly divided into two groups (n = 36 each): the immediate post-space preparation group (post-space preparation performed immediately after root canal obturation) and the delayed post-space preparation group (post-space preparation performed 1 week after root canal obturation). Cleanliness of the root canal walls was assessed with a dental microscope after preparation in both groups; the ultrastructural characteristics of the dentinal surface were examined via scanning electron microscopy; the fracture resistance of roots was measured with root fracture resistance tests; the bond strength of the fiber posts was measured with the thin-slice push-out test; and the bond failure modes were observed and analyzed under a stereomicroscope. Results: Under dental microscopy, the dentin surface of the immediate post-space preparation group appeared cleaner than that of the delayed post-space preparation group. Scanning electron microscopy revealed that most dentinal tubules remained open in the immediate post-space preparation group, while the tubules in the delayed post-space preparation group showed incomplete patency. The fracture resistance of the immediate post-space preparation group was (2 872 ± 241.5) N and that of the delayed post-space preparation group was (2 934 ± 353.1) N, with no statistically significant difference (t = -0.328, P = 0.751). The push-out bond strength of the immediate post-space preparation group (10.310 ± 2.907) MPa was significantly higher than that of the delayed post-space preparation group (7.917 ± 2.429) MPa, with a statistically significant difference (t = 4.457, P < 0.001). Analysis of failure modes showed that adhesive-to-dental interface failure was the predominant mode in both groups. Conclusion Following root canal obturation with iRoot SP using the single-cone technique, immediate post-space preparation yields superior fiber post bond strength compared to delayed post-space preparation, without compromising root fracture resistance.

AIM: To evaluate the effects of the myopia prevention and control guidance station(MPCGS)on axial elongation in school-age children.METHODS:This was a prospective cohort study.Students enrolled in Grades 1 to 3 of primary schools in Qingyang District, Chengdu, in the first half of 2022 who completed continuous follow-up from 2022 to 2025 were included in this study. Among them, three schools that implemented the MPCGS in 2023 were assigned to the intervention group, and another three schools in the same district without MPCGS served as the control group. The intervention group received the school-hospital-family integrated model for myopia prevention and control,while the control group only received routine vision screening without such intervention measures.Students were categorized into three groups based on their grade in 2022: Group A(Grade 1), Group B(Grade 2), and Group C(Grade 3). Comparisons were stratified by grade, with independent samples t-tests used for intergroup analyses of annual axial elongation(ΔAL)between the intervention and control groups, and repeated-measures ANOVA(Bonferroni-corrected post-hoc test)used for intervention group comparisons across different time points.RESULTS:Totally 3 404 students were enrolled in this study, including 1 709 in the intervention group(897 males and 812 females, aged 7.64±0.88 y)and 1 695 in the control group(902 males and 793 females, aged 7.75±0.97 y). In the intervention group, there were 537 students in subgroup A(293 males and 244 females, aged 7.08±0.28 y), 721 in subgroup B(369 males and 352 females, aged 8.03±0.29 y), and 451 in subgroup C(235 males and 216 females, aged 9.07±0.30 y). In the control group, there were 559 students in subgroup A(295 males and 264 females, aged 7.05±0.28 y), 497 in subgroup B(269 males and 228 females, aged 8.04±0.30 y), and 639 in subgroup C(338 males and 301 females, aged 9.08±0.30 y). No significant differences were observed between the intervention and control groups within each grade(A, B, and C)at baseline age, sex, SE, AL, ΔSE(2022-2023), and ΔAL(2022-2023)(all P>0.05). During the first intervention year(2023-2024), intergroup comparisons revealed no significant differences in ΔAL between the intervention and control groups within Groups A, B, and C(all P>0.05). During the second intervention year(2024-2025), the intervention group showed significantly lower ΔAL than the control group within Groups A and B(PSymbol|@@0.001 and P=0.017, respectively), while no significant difference in ΔAL was detected in Group C(P=0.419). In the intervention group, there were significant differences in ΔAL at different time points among Groups A, B and C(all P<0.001). Compared with the first year before intervention, the ΔAL of each subgroup significantly decreased in the second year of intervention(all P<0.0167).CONCLUSION:The implementation of the school-hospital-family integrated MPCGS model was associated with slowed axial elongation. This association exhibited a time-dependent cumulative effect and was more pronounced in lower-grade children(grades 1-2).

Objective: To investigate the trend of diabetes incidence among children and adolescents in Huzhou City, Zhejiang Province from 2006 to 2025, and to analyze the age, period, and cohort effects, so as to provide insights into the prevention and control of diabetes among children and adolescents. Methods: Data on diabetes cases aged 0-19 years in Huzhou City from 2006 to 2025 were collected through the Chronic Disease Surveillance and Management System of Huzhou Center for Disease Control and Prevention. The standardized incidence was calculated using the age composition of the standard population from the Sixth National Population Census in 2010. The average annual percentage change (AAPC) was used to analyze the trend in incidence. An age-period-cohort model was used to analyze the effects of age, period, and birth cohort. Results: A total of 913 diabetes cases aged 0-19 years were reported in Huzhou City from 2006 to 2025. The crude incidence and standardized incidence were 11.03/105 and 4.33/105, respectively, both showing upward trends (AAPC=13.307% and 13.226%, both P<0.05). There were 339 cases of type 1 diabetes mellitus (T1DM), with crude and standardized incidence of 3.83/105 and 0.62/105, respectively, showing upward trends (AAPC=9.944% and 10.442%, both P<0.05). There were 548 cases of type 2 diabetes mellitus (T2DM), with crude and standardized incidence of 6.20/105 and 1.97/105, respectively, showing upward trends (AAPC=14.920% and 14.213%, both P<0.05). Age-period-cohort model analysis showed that the risk of T1DM initially increased and then decreased with age, with the highest risk in the 5-<10 years age group (RR=9.189, 95%CI: 4.871-13.684). The risk of T2DM increased with age, with the highest risk in the 15-19 years age group (RR=17.316, 95%CI: 14.477-20.225). Using the period 2011-2015 as the reference group, the risk of T1DM showed an upward trend over time, with the highest risk in 2021-2025 (RR=1.474, 95%CI: 1.027-2.114). There were no statistically significant differences in incidence risk across other periods compared to 2011-2015 (all P>0.05). Using the 2006-2010 birth cohort as the reference group, the risks of both T1DM and T2DM showed upward trends with later birth cohorts. The highest risk of T1DM was observed in the 2021-2025 birth cohort (RR=2.881, 95%CI: 1.528-5.429), while the highest risk of T2DM was observed in the 2011-2016 birth cohort (RR=1.610, 95%CI: 1.081-2.397). Conclusions The incidence of diabetes among children and adolescents in Huzhou City showed an upward trend from 2006 to 2025, with T1DM being most prevalent among children aged 5-<10 years and T2DM among adolescents aged 15-19 years. The incidence risks of both T1DM and T2DM increased with later birth years.

Objective: To evaluate the vaccine effectiveness (VE) of influenza among the elderly aged ≥60 years in Jiaxing City, Zhejiang Province, so as to provide a basis for optimizing influenza vaccination strategies and improving vaccination rates. Methods: A test-negative case-control design was employed. Influenza-like illness cases aged ≥60 years who sought medical care at influenza surveillance sentinel hospitals in Jiaxing City from September 2024 to March 2025 were selected as the study subjects. Influenza virus nucleic acid was detected using real-time fluorescent quantitative reverse transcription polymerase chain reaction (qRT-PCR). Cases with positive nucleic acid tests were included in the influenza virus-positive group, while those with negative tests were included in the influenza virus-negative group. Demographic information, medical history, and influenza vaccination status were collected through questionnaire surveys, medical record information systems, and the Zhejiang Provincial Immunization Program Smart Service Information System. A multivariable logistic regression model was used to analyze the influencing factors for influenza virus positivity and to evaluate VE. Results: A total of 1 145 influenza-like illness cases were included, including 579 males and 566 females, with a male-to-female ratio of 1.02∶1. The age group of 60-<70 years was predominant, accounting for 38.86% (445 cases). A total of 415 cases (36.24%) had received influenza vaccination. There were 393 influenza virus-positive cases (34.32%), all of which were influenza A (H1N1) subtype, and 752 influenza virus-negative cases (65.68%). Multivariable logistic regression analysis revealed that influenza vaccination was associated with a significantly reduced risk of influenza virus positivity (OR=0.538, 95%CI: 0.405-0.716), with a VE of 46.16% (95%CI: 28.38%-59.52%). Subgroup analysis results indicate that influenza vaccination significantly protects older adults regardless of gender, age, underlying medical conditions, or the interval between vaccination and the onset of illness. There is no interaction between gender, age, underlying medical conditions, the interval between vaccination and onset of illness, and the influenza vaccination on influenza virus positivity (Pfor interaction>0.05). Conclusions Influenza vaccines provide protective effects against influenza A (H1N1) virus infection among the elderly in Jiaxing. It is recommended to continue promoting influenza vaccination among the elderly.

Objective: To analyze the epidemic periods and excess cases of hand, foot and mouth disease (HFMD) in Jiaxing City, Zhejiang Province from 2015 to 2024, so as to provide evidence for optimizing prevention and control strategies for HFMD. Methods: Data on HFMD cases in Jiaxing City from 2015 to 2024 were collected through the Infectious Disease Reporting Information System of China Disease Prevention and Control Information System. Descriptive analyze demographic and temporal distributions of HFMD. The adjusted Serfling regression model was constructed based on the weekly number of HFMD cases reported in Jiaxing City from 2015 to 2024 to estimate the baseline and epidemic threshold of HFMD incidence. An epidemic period was defined as a period during which the actual number of cases exceeded the epidemic threshold for more than 2 consecutive weeks, with an interval of no more than 1 week between epidemic periods. Excess cases were defined as the difference between the reported number of cases and the baseline number of cases during the epidemic periods. Results: A total of 91 859 HFMD cases were reported in Jiaxing City from 2015 to 2024, with an average annual reported incidence of 183.90/105. There were 54 064 male cases (58.86%) and 37 795 female cases (41.14%). The majority of cases were aged 0-<5 years and scattered-living children, with 71 505 cases (77.84%) and 47 387 cases (51.59%). The temporal distribution of HFMD presented a bimodal pattern, with two peaks from May to July and September to November, with 44 578 cases (48.53%) and 23 434 cases (25.51%), respectively. After excluding data of 2017 (promotional vaccination of inactivated enterovirus 71 vaccine) and 2020-2022 (COVID-19 prevention and control), the adjusted Serfling regression model achieved good fitting performance (R2=0.740). Six epidemic periods were identified from 2015 to 2024, including June 2016, May to July and September to October 2018, June to August and September to October 2023, and June to July 2024, with a cumulative epidemic duration of 28 weeks, and 16 772 excess cases accumulated in these periods. Conclusions HFMD in Jiaxing City showed a bimodal temporal distribution from 2015 to 2024, with high incidence among children aged 0-<5 years and scattered-living children. Six epidemic periods were identified by the adjusted Serfling regression model. Early warning should be strengthened for spring and summer peaks and high-risk populations.

Objective To investigate the feasibility of selectively omitting ureteral stent placement after ureteroscopic lithotripsy(URL).Methods A total of 118 patients with distal ureteral calculi undergoing URL from 2021 to 2024 were enrolled.Patients were divided into a control group(indwelling ureteral stent for 2 weeks,n=86)and an observation group(no ureteral stent placement,n=32).General data,operation time,hospital stay,and total medical costs were compared between the two groups.Patients were followed 2 weeks postoperatively for assessment of flank pain visual analogue scale(VAS)scores,bladder irritation symptoms,hematuria,and incidence of urinary tract infection.Hydronephrosis was evaluated by ultrasonography 3 months after surgery.Results There was no significant difference in the general information and operation time between the two groups(P>0.05).The length of hospital stay and total treatment cost in the observa-tion group were significantly lower than those in the control group(P<0.05).Two weeks after surgery,the VAS scores of low back pain on the affected side and occurrence rates of bladder irritation symptoms,hematu-ria,and urinary tract infection in the observation group were significantly lower than those in the control group(P<0.01).Three months after operation,no hydronephrosis was observed in both groups.Conclusion It is safe and feasible to avoid indwelling ureteral stent after URL in appropriate cases.

A method for simultaneous determination of 21 kinds of Aconitum alkaloids(ATS)in biological specimens and infused liquor using ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)was developed.The biological samples were pretreated with methanol-acetonitrile(1∶2,V/V)for protein precipitation,while infused liquors were diluted 100-fold with acetonitrile,followed by centrifugation,and filtration by a 0.22-μm membrane.Chromatographic separation was carried out on an EC-C18 column using gradient elution with the mixture of 10 mmol/L ammonium acetate and 0.2%formic acid as mobile phase A and acetonitrile as mobile phase B.With this method,all the analytes were separated within 9.5 min.The samples were detected in positive ESI mode with dynamic multiple reaction monitoring(MRM)and quantified via external standard calibration.The results showed that the concentrations of the analytes in the range of 2-1000 ng/mL had excellent linearity(R2>0.9992)with the peak area.The developed method was successfully used for detection of 21 kinds of aconitum alkaloids,with limits of detection of 0.5-2 ng/mL,quantification limits of 2-6 ng/mL,intra/inter-day precision≤6.0%,spiked recoveries of 89.4%-100.9%,extraction recoveries of 74.2%-104.4%,and matrix effects ranging from-11.1%to 9.2%in blood/urine.The method was applied to detection of 12 samples from 4 fatal aconite poisoning cases,and all 21 kinds of ATS with total alkaloid concentrations of 0.04-4.18 μg/mL in blood and 154.96-422.83 μg/mL in medicinal liquors were detected.Tissue distribution revealed that the order of concentrations from highest to lowest is as follows:urine(157.22 μg/mL)>gastric contents(51.37 μg/mL)>kidney(21.6 μg/g)>whole blood(4.18 μg/mL)>liver(0.03 μg/g).This method showed many advantages such as simple pretreatment,low detection limits,accurate quantification,broad analyte coverage,and superior anti-interference capability in complex matrices,proving ideal for forensic and toxicological analysis of aconitum alkaloids.

Objective To screen the active chemical components with potential therapeutic effects against lung cancer in tea and to provide new insights into the treatment and prevention of lung cancer.Methods Based on net-work pharmacology,the main active components from 13 types of tea samples were analyzed using liquid chromatog-raphy-mass spectrometry(LC-MS).The targets of these small molecules were obtained from the BATMAN-TCM da-tabase to construct a"component-target-disease"network.Lung cancer-related disease targets were retrieved from the GeneCard and Malacard databases followed by Gene Ontology(GO)functional and KEGG pathway enrichment analyses of potential pharmacological targets.A protein-protein interaction(PPI)network was constructed using the STRING database.The molecular docking was employed to screen small molecules with potential anti-cancer ac-tivity,and their potential inhibition to proliferation of human non-small cell lung cancer cell line A549 and human large cell lung cancer cell line H460.Results A total of 37 active components and 429 targets were identified in tea,with 182 overlapping targets associated with lung cancer.GO analysis revealed that these targets were primarily involved in biological processes such as cell proliferation,response to stimuli,and metabolic processes.KEGG pathway analysis indicated that these targets were mainly enriched in the p53 signaling pathway,ErbB signaling pathway,and PI3K-Akt signaling pathway.PPI network analysis identified key targets including MAPK1,AKT1,SRC,MAPK3,and p53.Molecular docking screened coumestrol as a molecule capable of binding to human estro-gen receptor 2(ESR2),and its inhibitory effect on the proliferation of A549 and H460 cells was experimentally validated(P＜0.000 1).Conclusions The active components in tea may intervene in the development and progres-sion of lung cancer through a multi-component,multi-target,and multi-pathway mechanism,The results suggests po-tential components against lung cancer in tea,which may be applied in the prevention of human lung cancer.

Objective Based on 25 indicators including immune factors, cell count classification, and smear results of the knee joint fluid, machine learning models were established to distinguish between osteoarthritis (OA) and rheumatoid arthritis (RA). Methods 100 OA and 40 RA patients scheduled for total knee arthroplasty were enrolled respectively. Each patient's knee joint fluid was collected preoperatively. Nucleated cells were counted and classified. The expression levels of immune factors, including tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, IL-8, IL-15, matrix metalloproteinase 3 (MMP3), MMP9, MMP13, rheumatoid factor (RF), serum amyloid A (SAA), C-reactive protein (CRP), and others were measured. Smears and microscopic classification of all the immune factors were performed. Independent influencing factors for OA or RA were identified using univariate binary logistic regression, Lasso regression, and multivariate binary logistic regression. Based on the independent influencing factors, three machine learning models were constructed which are logistic regression, random forest, and support vector machine. Receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) were used to evaluate and compare the models. Results A total of 5 indicators in the knee joint fluid were screened out to distinguish OA and RA, which were IL-1β(odds ratio(OR)=10.512, 95× confidence interval (95×CI) was 1.048-105.42, P=0.045), IL-6 (OR=1.007, 95×CI was 1.001-1.014, P=0.022), MMP9 (OR=3.202, 95×CI was 1.235-8.305, P=0.017), MMP13 (OR=1.002, 95× CI was 1-1.004, P=0.049), and RF (OR=1.091, 95×CI was 1.01-1.179, P=0.026). According to the results of ROC, calibration curve and DCA, the accuracy (0.979), sensitivity (0.98) and area under the curve (AUC, 0.996, 95×CI was 0.991-1) of the random forest model were the highest. It has good validity and feasibility, and its distinguishing ability is better than the other two models. Conclusion The machine learning model based on immune factors in the knee joint fluid holds significant value in distinguishing OA and RA. It provides an important reference for the clinical early differential diagnosis, prevention and treatment of OA and RA.
Humans ; Arthritis, Rheumatoid/metabolism* ; Machine Learning ; Male ; Female ; Middle Aged ; Aged ; Synovial Fluid/immunology* ; Osteoarthritis, Knee/metabolism* ; Knee Joint/metabolism* ; ROC Curve ; Diagnosis, Differential