Objective To study the value of ultrasonography combined with serum Gastrin-17 in differenti-al diagnosis of abdominal IgA vasculitis in children.Methods A total of 80 children with IgA vasculitis admit-ted to the hospital from June 2020 to December 2022 were selected,including 45 cases of abdominal IgA vascu-litis(observation group)and 35 cases of other types of IgA vasculitis(without gastrointestinal symptoms,control group).The ultrasonographic characteristics and Gastrin-17 level of abdominal IgA vasculitis were an-alyzed,and the relationship between Gastrin-17 level and purpura symptom score was analyzed.Receiver oper-ating characteristic(ROC)curve was used to analyze the diagnostic value of ultrasonography and Gastrin-17 for abdominal IgA vasculitis in children.Results The symptom score of purpura in the observation group was significantly higher than that in the control group(P<0.001),while the serum Gastrin-17 level in the obser-vation group was significantly lower than that in the control group.Pearson correlation analysis showed that serum Gastrin-17 level was negatively correlated with purpura symptom score(r=-0.758,P<0.001).Ul-trasound images showed"doughnut"-like changes in the intestinal wall,with different degrees of central-thick-ness thickening and reduced echo,mainly submucosal thickening.ROC curve analysis showed that the cut-off value of serum Gastrin-17 in the diagnosis of abdominal IgA vasculitis in children was 2.91 pmol/L,the area under the curve was 0.787(95%CI:0.685-0.888),the sensitivity and the specificity were 75.56%(34/45)and 74.29%(26/35),respectively.The sensitivity of ultrasound combined with Gastrin-17 in the diagnosis of abdominal IgA vasculitis in children was 97.78%(44/45),the negative prediction rate was 95.65%(22/23),and the accuracy rate was 82.50%(66/80),which was significantly higher than those of single diagnosis(P<0.05).Conclusion Serum Gastrin-17 level is low in children with abdominal IgA vasculitis,and ultrasound imaging shows"doughnut"-like changes in the intestinal wall and thickening of the submucosa.Combined de-tection of the two could effectively differentially diagnose abdominal IgA vasculitis in children.

Promoting wound healing is a common clinical challenge faced by surgeons, with a variety of repair method and materials currently available for clinical use. In recent years, with the continuous development of disciplines such as tissue engineering, regenerative medicine, and materials science, research on wound repair materials has progressed rapidly. This article will organize the classification, advantages and disadvantages, and the latest advancements in the preparation processes of wound repair materials. It will also discuss the current challenges faced by wound repair materials and future research directions, with the aim of providing a reference for related studies in wound repair.

Promoting wound healing is a common clinical challenge faced by surgeons, with a variety of repair methods and materials currently available for clinical application. In recent years, with the continuous development of disciplines such as tissue engineering, regenerative medicine and materials science, research on wound repair materials has progressed rapidly. This article will organize the classification, advantages and disadvantages, and the latest advancements in the preparation processes of wound repair materials. Further discussions on the current challenges and future research directions of wound repair materials are aimed to provide references for related wound repair research.

Objective To analyze the impact of patients ages on propofol dosage in painless gastroscopy.Methods A retrospective analysis was conducted on the clinical data of 158 painless gastroscopy patients from January 2017 to June 2020.They were divided into the young group(18～44 years old,n = 57),the middle-aged group(45～59 years old,n = 51),and the elderly group(≥60 years old,n = 50)based on their age.The anesthesia status and safety of each group were compared.Results The results showed that the dosage of propofol,average total dosage of propofol,MAP,HR,RR,SpO2 levels in the young group were higher than those in the middle-aged and elderly groups when consciousness disappeared,and the middle-aged group was higher than the elderly group;The onset time,anesthesia recovery time,orientation recovery time,and departure time in the young group of patients were shorter than those in the middle-aged and elderly groups,and the middle-aged group was shorter than the elderly group(P<0.05).The incidence of airway obstruction,hypoxemia,mandible support,mask ventilation,adverse cardiovascular events,sedation related adverse events,and incidence of obstructed endoscopy in the elderly group were higher than those in the young and middle-aged groups.The incidence of smooth endoscopy was lower than that in the young and middle-aged groups(P<0.05).Conclusion Aging may increase the dosage of propofol in patients underwent painless gastroscopy under anesthesia,prolong the onset time,anesthesia recovery time,orientation recovery time,and departure time,increase stress reactions and adverse reactions,and strengthen monitoring for elderly patients in clinical practice.

In recent years, post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) have gradually attracted the attention of scholars as common stroke-related non-motor symptoms. As an emerging non-invasive neuroimaging tool, functional near-infrared spectroscopy (fNIRS) has been widely used in the study of neurological diseases, which can evaluate the functional status and recovery of these patients by monitoring changes in cerebral blood circulation and oxygenation signals; fNIRS is now being increasingly used in PSD and PSCI studies. This review mainly focuses on the research progress of fNIRS in identifying PSD and PSCI, exploring their neural mechanisms, and evaluating treatment effects, as well as advantages, disadvantages and future development prospects of fNIRS in clinical application, so as to provide some references for research on rehabilitation of affective disorders and cognitive disorders in stroke patients.

Burkitt lymphoma is a highly aggressive B-cell lymphoma and the fastest proliferating human malignant tumor.If the disease is found in the early stage,the patient could have a high possibility to be cured successfully,whereas the prognosis is poor in the late stage.Burkitt lymphoma can occur in children and adults,and it is categorized as local(Africa),sporadic,and immunodeficiency associated type.Sporadic Burkitt lymphoma mainly affects children and ado-lescents,and the most common initial sites are abdominal organs and lymph nodes.Sporadic Burkitt lymphoma manifested by initial oral and maxillofacial lesions is rela-tively rare.Here,a case of pediatric sporadic Burkitt lym-phoma,with oral and maxillofacial lesions as the first symptoms,was reported.The patient was treated in the Department of Periodontology,Shandong University School and Hospital of Stomatology.After timely checkup was pro-vided,the patient was transferred to another hospital and had good results.In this article,an incidence of Burkitt lympho-ma,with oral and maxillofacial lesions as the first symptom,was reviewed to provide reference for oral clinicians to achieve early diagnosis and treatment of patients with Burkitt lymphoma with oral diseases and improve the success rate of treatment.

White matter hyperintensities (WMHs) were once thought to be a normal aging phenomenon. However, the available evidences suggest that WMHs are an indicator of poor brain and cardiovascular health, indicating an increased risk of ischemic stroke, cognitive impairment, depression, and death. This article reviews the effects and mechanisms of physical activity and exercise on WMHs, so as to provide a basis for better prevention of WMHs.

Objective:To learn about the operation of fluoride reduction and water improvement projects, the current situation of water fluoride level and the changing trend of fluorosis in drinking water-borne endemic fluorosis areas in Shaanxi Province, and to evaluate the effect of prevention and control measures.Methods:From March 2014 to December 2021, 15 endemic villages in drinking water-borne endemic fluorosis areas of Dali, Dingbian, Jingbian, Jingyang and Liquan counties in Shaanxi Province were selected as monitoring villages to investigate the operation of water improvement projects. Water samples were collected, and the water fluoride level was detected according to the "Standard Examination Methods for Drinking Water - Nonmetal Parameters" (GB/T 5750.5-2006). "Diagnosis of Dental Fluorosis" (WS/T 208-2011) was done to detect dental fluorosis in all children aged 8 - 12 who were born and lived in the monitoring village. Using "Diagnostic Standard for Endemic Skeletal Fluorosis" (WS/T 192-2008) and "Determination of Fluoride in Urine - Ion Selective Electrode Method" (WS/T 89-2015), X-ray examination and urine fluoride level test were performed on adults over 25 years old who had lived in the monitoring village for more than 5 years, respectively.Results:From 2014 to 2021, a total of 122 water improvement projects were investigated, all of which were in normal operation. The qualified rate of water fluoride increased from 81.25% (13/16) in 2014 to 100.00% (11/11) in 2021. A total of 5 595 children aged 8 - 12 were examined, 1 790 children with dental fluorosis were detected, with a detection rate of 31.99%. The detection rate of dental fluorosis in children decreased from 52.05% (304/584) in 2014 to 9.68% (93/961) in 2021, showing an overall downward trend (χ 2trend = 533.76, P < 0.001). In 2014, 791 adults were examined, and 256 patients with skeletal fluorosis were detected, the detection rate was 32.36%. In 2019, 770 adults were examined, and 88 patients with skeletal fluorosis were detected, with a detection rate of 11.43%. The detection rate of skeletal fluorosis in adults in 2019 was lower than that in 2014, and the difference was statistically significant (χ 2 = 99.54, P < 0.001). In 2014, 754 adult urine samples were collected, and the geometric mean of urine fluoride was 2.571 mg/L. In 2019, 770 adult urine samples were collected, and the geometric mean of urine fluoride was 1.292 mg/L. The geometric mean of urine fluoride in adults in 2019 was lower than that in 2014, and the difference was statistically significant ( Z = - 12.74, P < 0.001). Conclusions:From 2014 to 2021, the water improvement projects in drinking water-borne endemic fluorosis areas in Shaanxi Province are running normally, and the qualified rate of water fluoride has increased. The incidence of dental fluorosis in children and skeletal fluorosis in adults has decreased. In the later stage, it is necessary to continuously strengthen the monitoring and management of water improvement projects to prevent the rebound of water fluoride from causing residents' illness.

BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However， there is insufficient research on anxiety symptoms in preschool children， especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children， so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021， a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior （SIB） and Spence Preschool Anxiety Scale （SPAS） were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 （99.64%） valid questionnaires were collected. Anxiety symptoms were detected in 344（4.09%） firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration， monthly family income， maternal age， maternal education level， paternal education level， family living conditions and whether they are left-behind children （χ²/t=9.906， 33.490， 5.136， 13.485， 9.690， 17.332， 21.975， P<0.05 or 0.01）. Compared with non-anxiety group， children in the anxiety group scored higher on the SIB dimensions of rivalry， aggression and avoidance （t=165.322， 74.471， 286.419， P<0.01）， and lower on companionship， empathy and teaching （t=59.133， 42.417， 39.112， P<0.01）. Risk factors for anxiety symptoms in firstborn preschool children included left-behind children， as well as negative sibling relationships characterized by rivalry and avoidance （OR=1.195， 1.143， 1.260， P<0.05 or 0.01）. ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships， characterized by competition and avoidance， may also contribute to the emergence of anxiety symptoms in firstborn preschool children.

Objective:To explore the molecular mechanism of dexmedetomidine(Dex)protecting ischemia/reperfusion(I/R)myocardium.Methods:Wild type mice were grouped into control(Control)group,sham operation(Sham)group,WT I/R group,WT Dex group,and Dectin-1 knock out mice were grouped into KO I/R group and KO Dex group in the in vivo study(n=6).TTC stain-ing was used to determine the myocardial infarction area(%)of the above six groups of mice.HE staining and pathological analyze was used to determine the myocardial injury.Serum TNF-α,IL-6 and IL-10 levels in mice were detected by ELISA.Flow cytometry(FCM)was used to count and sort of infiltrating M2 macrophages and neutrophils in myocardium.qPCR assay was used to determine the Dectin-1 mRNA expression in the above sorted cells.Results:TTC results showed that there was no myocardial infarction in the mice of Control group and Sham group.Compared with the WT I/R group,the infarct volume was significantly lower in WT Dex group,KO I/R group and KO Dex group(P<0.05).Compared with the KO I/R group,the infarct volume was reduced in KO Dex group(P<0.05).The results of HE staining showed that the myocardial fibers of the WT I/R group of mice were disorderly arranged,with a large number of broken myocardial fibers,while the myocardial fibers of the WT Dex group,KO I/R group and KO Dex group of mice had a little breakage,the structural damage was not significant,and the myocardial arrangement was relatively neat.The degree of myocardi-al injury of mice in KO Dex group were less than that in KO I/R group mice.ELISA results showed that compared with Sham group,the serum TNF-α and IL-6 levels of the mice in WT I/R group were significantly increased,and the IL-10 level was significantly de-creased.Compared with WT I/R group,serum TNF-α and IL-6 levels of the mice in WT Dex group and KO I/R group were significant-ly decreased,and IL-10 level was significantly increased.Compared with KO I/R group,the serum TNF-α and IL-6 levels of the mice in KO Dex group were significantly decreased,and the IL-10 level was significantly increased(P<0.05).FCM cell counting results showed that compared with Sham group,a large number of M2 macrophages and neutrophils were infiltrated in the myocardium of WT I/R group of mice(P<0.05).Compared with WT I/R group,the M2 macrophages and neutrophils infiltrated in the myocardium were significantly decreased in WT Dex group,KO I/R group and KO Dex group of mice(P<0.05).While there was no significant differ-ence between the KO I/R group and the KO Dex group mice(P>0.05).qPCR results showed that compared with Sham group,the ex-pression level of Dectin-1 mRNA in the myocardial infiltrated M2 macrophages and neutrophils were significantly up-regulated in WT I/R group of mice(P<0.05).While compared with WT I/R group,the expression level of Dectin-1 mRNA in Dex group of mice was sig-nificantly lower(P<0.05).Mice in KO I/R group and KO Dex group did not express Dectin-1.Conclusion:The protective mecha-nisms of Dex preconditioning on I/R injured myocardium involves reducing the infiltrating number of M2 macrophages and neutrophils in myocardium after I/R injury,which may be achieved by inhibiting the expression of Dectin-1.