Objective To investigate the effect of preoperative oral midazolam on postoperative de-lirium in elderly patients with preoperative moderate-severe anxiety undergoing radical resection of colorectal cancer.Methods Eighty elderly patients undergoing laparoscopic surgery for radical resection of colorectal cancer,32 males and 48 females,aged 65-79 years,BMI 21-27 kg/m2,ASA physical status Ⅱ or Ⅲ,the state-trait anxiety inventory(STAI-S)≥38 scores at admission were selected.Patients were divided into two groups using random number method:control group and midazolam group,40 patients in each group.The midazolam group were administrated midazolam 7.5 mg per night till one day before surgery,while the placebo was administrated in the control group.The incidence of delirium 3 days after surgery and the STAI-S scores of one day before surgery were evaluated.The HR and MAP at entry,30 minutes after an-esthesia induction,1 hour,2 hours after anesthesia induction,and 30 minutes after extubation were recor-ded.The total dose of propofol,remifentanil and dexmedetomidine and the using rate of metaraminol were recorded.The visual analog scale scores 30 minutes after extubation,24 and 72 hours after surgery,the u-sing rate of tramadol,and the extubation time were recorded.Results Compared with the control group,the STAI-S scores of one day before surgery,and the incidence of postoperative delirium,the rate of using metaraminol,the VAS scores 30 minutes after extubation and 24 hours after surgery,the rate using of tram-adol were significantly decreased in the midazolam group(P＜0.05).There were no significant differences in total dose of propofol,remifentanil,and dexmedetomidine,extubation time between the two groups.Conclusion Preoperative oral midazolam can effectively reduce the incidence of postoperative delirium in elderly patients with preoperative moderate-severe anxiety undergoing radical resection of colorectal cancer.

Objective:To understand the epidemiological characteristics and spatiotemporal distribution of viral encephalitis in children and adolescents in Henan Province from 2012 to 2023.Methods:The information about viral encephalitis cases from October 1, 2012 to July 26, 2023 were collected from Zhengzhou Children's Hospital (National Children's Regional Medical Center),Henan Provincial Children's Hospital for the analyses on temporal distribution the cases, the severe illness rate, age distribution, pathogen type and imaging findings of the cases.Results:A total of 6 276 cases of viral encephalitis were included in this study after excluding cases with incomplete information. The cases mainly originated from Zhengzhou (38.96%), followed by Zhoukou (9.93%), Xuchang (8.68%), Zhumadian (7.90%) and Pingdingshan (7.39%). The cases in boys accounted for 62.13% and the cases in girls accounted for 37.87%. Most cases (72.45%) occurred in age group 7-13 years. The overall rate of severe illness cases was 4.51% from 2012 to 2023. There were significant differences in severe illness cases among different areas and years ( χ2=5.33, P=0.021; χ2=48.14, P<0.001). Enteroviruses were mainly detected (31.57%), in which Coxsackie virus was predominant (58.37%). Imaging findings showed that cerebral hemisphere damage was most common in children and adolescents with viral encephalitis (54.93%). Conclusions:From 2012 to 2023, more cases of viral encephalitis occurred in boys in Henan. Children and adolescents aged 7-13 years were the main affected group. The prevention of enteroviruses infection, especially Coxsackie virus, needs to be strengthened. Special attention should be paid to the prevention of cerebral hemisphere damage after viral encephalitis diagnosis.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Background The mental health problems of employees in administrative organs and public institutions are highly valued.However,there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region.Objective To analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region,so as to provide references for promoting their mental health and intervening in psychological problems.Methods From October 23 to 28,2022,a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique,and were assessed using Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).Results A total of 1797(58.04％)employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey.Depressive symptoms were noted in 579(32.22％).SDS scores yielded statistical difference among the selected employees of different ethnicities,types of job positions and educational levels(F=9.074,101.488,4.477,P<0.01),and the severity of depressive symptoms also demonstrated statistical difference among the selected employees with different ethnicities,educational levels and types of job positions(H=49.196,17.028,160.848,P<0.01).Anxiety symptoms were detected in 711(39.57％)employees.SAS scores exhibited statistical difference among the employees with different genders,ages,ethnicities,educational levels,marital status and types of job positions(t=-4.571,F=6.648,3.950,5.243,12.008,22.253,P<0.01).Statistical differences were also illustrated in the severity of anxiety symptoms among the selected employees with different ages,genders,ethnicities,educational levels,marital status and types of job positions(H=24.361,-3.788,28.365,24.268,25.976,56.204,P<0.01).Conclusion About one-third of employees in municipal and above administrative organs and public institutions in Qinghai region may have symptoms of depression and anxiety.The depression symptoms are more severe among Tibetan people,those with low education levels and ordinary civil servants.The anxiety symptoms are more severe among employees aged 30 and below,those with low education levels,unmarried and those in technical positions.

Orthodontically induced tooth root resorption (OIRR) is a serious complication during orthodontic treatment. Stimulating cementum repair is the fundamental approach for the treatment of OIRR. Parathyroid hormone (PTH) might be a potential therapeutic agent for OIRR, but its effects still lack direct evidence, and the underlying mechanisms remain unclear. This study aims to explore the potential involvement of long noncoding RNAs (lncRNAs) in mediating the anabolic effects of intermittent PTH and contributing to cementum repair, as identifying lncRNA-disease associations can provide valuable insights for disease diagnosis and treatment. Here, we showed that intermittent PTH regulates cell proliferation and mineralization in immortalized murine cementoblast OCCM-30 via the regulation of the Wnt pathway. In vivo, daily administration of PTH is sufficient to accelerate root regeneration by locally inhibiting Wnt/β-catenin signaling. Through RNA microarray analysis, lncRNA LITTIP (LGR6 intergenic transcript under intermittent PTH) is identified as a key regulator of cementogenesis under intermittent PTH. Chromatin isolation by RNA purification (ChIRP) and RNA immunoprecipitation (RIP) assays revealed that LITTIP binds to mRNA of leucine-rich repeat-containing G-protein coupled receptor 6 (LGR6) and heterogeneous nuclear ribonucleoprotein K (HnRNPK) protein. Further co-transfection experiments confirmed that LITTIP plays a structural role in the formation of the LITTIP/Lgr6/HnRNPK complex. Moreover, LITTIP is able to promote the expression of LGR6 via the RNA-binding protein HnRNPK. Collectively, our results indicate that the intermittent PTH administration accelerates root regeneration via inhibiting Wnt pathway. The lncRNA LITTIP is identified to negatively regulate cementogenesis, which activates Wnt/β-catenin signaling via high expression of LGR6 promoted by HnRNPK.
Mice ; Animals ; Cementogenesis ; Wnt Signaling Pathway ; beta Catenin/metabolism* ; Heterogeneous-Nuclear Ribonucleoprotein K/metabolism* ; RNA, Long Noncoding/genetics* ; Parathyroid Hormone ; Receptors, G-Protein-Coupled/metabolism*

Objective:To study the clinical characteristics of neonatal plesiomonas shigelloides (P. shigelloides) septicemia.Methods:The clinical data of a neonate with P.shigelloides septicemia admitted to the Department of Neonatology of our hospital were reviewed. Literature on this subject were searched in the following databases: CNKI, CQVIP database, Wanfang Database, SinoMed, PubMed and Web of Science (up to April 2022).The clinical characteristics of reported cases of neonatal P.shigelloides septicemia were analyzed.Results:Our patient was a full-term female neonate with symptoms of tachypnea, groaning, hypotension, septic shock and poor intestinal peristalsis. The cardiac and pulmonary ultrasound indicated pulmonary hypertension and right pleural effusion (empyema). The X-ray suggested pneumothorax. The blood culture showed P.shigelloides. Lumbar puncture and brain imaging showed no central nervous system involvement. After meropenem, penicillin and symptomatic treatment, the patient was cured and discharged without sequelae. In the literature review, 14 articles and 14 cases of neonatal P.shigelloides septicemia were found (a total of 15 cases including our case).All 15 cases had fever, 10 with convulsion/seizure, 8 had jaundice, 8 with respiratory distress/respiratory failure, 6 had feeding difficulty and 6 were irritable. Brain imaging features were hydrocephalus and panencephalitis. Antibiotics and symptomatic treatment were the main therapy. 8 cases died and 7 cases survived including 2 cases with neurological sequelae.Conclusions:Neonatal P.shigelloides septicemia has nonspecific manifestations, often involves multiple organs with significant neurological involvement and a high mortality rate.

Objective: To analyze the association between alcohol consumption and hyperuricemia among residents in Chengdu City, so as to provide the evidence for prevention and control of hyperuricemia. Methods: Based on the Natural Cohort Study in Southwest Area, residents at ages of 30 to 79 years were recruited in Chengdu City in 2018. Information of demographics, smoking, alcohol consumption and diet were collected through a questionnaire survey. Blood uric acid was tested in the laboratory. Participants were divided into never, moderate and excessive drinking groups based on alcohol consumption. A multivariable logistic regression model was used to analyze the association between alcohol consumption and hyperuricemia, and subgroup analysis was conducted according to gender, current residence, physical activity and body mass index (BMI). Results: A total of 20 164 residents were investigated, including 8 776 males (43.52%) and 11 388 females (56.48%), with a mean age of (51.22±12.33) years. There were 9 769 never-drinkers (48.45%), 8 310 moderate-drinkers (41.21%), and 2 085 excessive-drinkers (10.34%). Hyperuricemia was detected in 4 101 patients, with a detection rate of 20.34%. Multivariable logistic regression analysis showed that moderate drinking (OR=1.122, 95%CI: 1.031-1.222) and excessive drinking (OR=1.529, 95%CI: 1.349-1.734) were associated with an increased risk of hyperuricemia. Moderate and excessive drinking were associated with an increased risk of hyperuricemia among men, urban residents, residents with a high level of physical activity, and those with BMI less than 24 kg/m2 (all P<0.05). Excessive drinking were associated with an increased risk of hyperuricemia among rural residents, residents with a low level of physical activity and with BMI of 24 kg/m2 and higher (all P<0.05). Conclusions Both moderate and excessive drinking are associated with an increased risk of hyperuricemia. Moderate drinking is not associated with a higher risk of hyperuricemia among rural residents, residents with a low level of physical activity and with BMI of 24 kg/m2 and higher.

ObjectiveTo collect common prescriptions from multiple channels based on the mainstream guidance materials combined with ancient books to provide references for the selection principles of common prescriptions in clinical practice guidelines of traditional Chinese medicine （TCM） and western medicine. MethodWith the research on the selection of commonly used prescriptions in Clinical Practice Guidelines of Chinese and Western Medicine for Cough in Children as an example，the nation-recommended Schedule Ⅲ drugs and prescriptions for cough in children in the clinical diagnosis and treatment guidelines of TCM （TCM and western medicine）/expert consensus/clinical pathway/diagnosis and treatment protocols，three TCM pediatric textbooks， the experience of famous experts， and ancient books were searched for the establishment of a prescription database and analysis of medication regularity. ResultThe results showed that there were 71 commonly used prescriptions for the treatment of cough in children. The top 3 clinically indicated syndromes were the syndrome of phlegm-heat blocking the lung，the syndrome of wind-heat invading the lung，and the syndrome of wind-cold attacking the lung，and the top 5 efficacies corresponding to high-frequency drugs were reliving cough and dyspnea， clearing heat/resolving phlegm， dispersing wind/dissipating cold， clearing heat/purging fire， and dispersing wind/dissipating heat. The most commonly used Chinese medicines included Armeniacae Semen Amarum， Platycodonis Radix， Bolbostemmatis Rhizoma， Ephedrae Herba， Scutellariae Radix， Pinelliae Rhizoma， and Citri Reticulatae Pericarpium. Some drugs showed high internal correlations with Armeniacae Semen Amarum and Platycodonis Radix. There were 228 prescriptions for the treatment of cough in children based on the ancient books in the Chinese Medical Code. The most commonly used Chinese medicines were Pinelliae Rhizoma， Armeniacae Semen Amarum， Ginseng Radix et Rhizoma， Poria， Citri Reticulatae Pericarpium， Platycodonis Radix， Zingiberis Rhizoma Recens， and Bolbostemmatis Rhizoma. The top 5 efficacies corresponding to high-frequency drugs were dispersing wind/dissipating cold， relieving cough and dyspnea， clearing heat/resolving phlegm， warming cold/resolving phlegm， and tonifying Qi. Some drugs showed high internal correlations with Pinelliae Rhizoma and Platycodonis Radix. As revealed by the comparison of ancient and modern medication， the medication principles could be roughly classified into two categories： ventilating the lung/descending Qi and resolving phlegm. In ancient medication， the drugs for cough in children were mainly used for warming， tonifying， dissipating cold， excreting water， alleviating edema， and astringing lung and intestines， while in modern medication， the prescriptions were mainly for dispersing wind， clearing heat， tonifying yin， and moistening dampness. ConclusionThis study systematically analyzed the commonly used prescriptions for the treatment of cough in children and provided references for the selection of TCM in clinical practice guidelines.

Objective:To investigate the clinical efficacy of amoxicillin combined with metronidazole in the treatment of peri-implantitis and its effect on serum matrix metalloproteinase-8 (MMP-8), tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels.Methods:Sixty-four patients with peri-implantitis who received treatment from January 2017 to December 2019 in Xiasha Hospital, SiR Run Run Shaw Hospital, Zhejiang University School of Medicine were included in this study. They were randomly assigned to receive treatment with metronidazole (control group, n = 32) or amoxicillin combined with metronidazole (observation group, n = 32). Clinical efficacy, periodontal pocket depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), plaque index (PLI), matrix metalloproteinase-8 (MMP-8), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) levels and the incidence of adverse reactions were compared between the control and observation groups. PD, CAL, SBI and PLI were correlated with MMP-8, TNF-α and IL-1β levels. Results:The clinical efficacy in the observation group was significantly higher than that in the control group [93.75% (30/32) vs. 75.00% (24/32), χ2 = 4.267, P < 0.05]. After treatment, PD [(3.02 ± 0.24) mm], CAL [(1.70 ± 0.14) mm], SBI [(11.54 ± 3.26)%], PLI (0.87 ± 0.11) in the observation group were significantly lower than those in the control group [(4.47 ± 1.37) mm, (3.77 ± 1.06) mm, (18.84 ± 5.11)%, (1.12 ± 0.15), t = 5.897, 10.952, 6.813, 7.603, all P < 0.01]. After treatment, serum MMP-8 [(0.78 ± 0.23) μg/L], TNF-α [(71.24 ± 10.33) μg/L], IL-1β [(1.20 ± 0.14) μg/L] levels in the observation group were significantly lower compared with the control group [(1.12 ± 0.35) μg/L, (113.28 ± 15.73) μg/L, (2.55 ± 1.02) μg/L, t = 4.592, 12.637, 7.417, all P < 0.01]. Spearman correlation coefficient analysis showed that PD, CAL, SBI and PLI were positively correlated with serum MMP-8, TNF-α and IL-1β levels (all P < 0.01). Conclusion:Amoxicillin combined with metronidazole is highly effective in the treatment of peri-implantitis because it can promote plaque regression, reduce inflammatory reaction, and has a certain clinical promotion value.

Objective:To explore the influence of short-time pasteurization (62.5±0.5℃ for 5 s) on the main bioactive components and immune cells in human breast milk.Methods:Fresh breast milk was collected from 53 women whose premature infants were admitted to the neonatal intensive care unit of the Children's Hospital of Fudan University from May 2020 to October 2020. Each sample (20 ml) was divided into unsterilized, Holder pasteurized (62.5 ℃ for 30 min), or short-time pasteurized groups. The concentration of secretory immunoglobulin A (sIgA), lactoferrin (LTF), lysozyme (LZM), and insulin-like growth factor binding protein-3 (IGFBP-3) in breastmilk whey were detected by enzyme-linked immunosorbent assay and the number of viable immune cells (leukocytes, monocytes, T cells, and B cells) in breastmilk by flow cytometry.Results:(1) A total of 87 breast milk samples were collected. The levels of sIgA, LTF, and LZM were the highest in the unsterilized group, followed by the short-time and Holder pasteurized group [0.42 mg/ml (0.33-0.65 mg/ml) vs 0.40 mg/ml (0.28-0.62 mg/ml) and 0.25 mg/ml (0.17-0.37 mg/ml); (3.57±1.06) vs (3.53±1.11) and (0.85±0.58) mg/ml; 128.60 μg/ml (77.18-203.00 μg/ml) vs 121.70 μg/ml (68.66-188.20 μg/ml) and 83.40 μg/ml (47.40-151.40 μg/ml); all P<0.05]. There was no significant difference in the level of IGFBP-3 among the groups. The median retention rates of sIgA, LTF, and LZM in the Holder pasteurized group were all lower than those in the short-time pasteurized group [55.87% (46.01%-71.41%) vs 96.93% (83.03%-115.90%); 21.72% (12.54%-29.42%) vs 97.88% (88.98%-104.30%); 69.26% (49.42%-89.08%) vs 93.80% (74.85%-110.20%); all P<0.05]. No significant difference in the level of preserved IGFBP-3 was observed between the three groups ( P>0.05). (2) The number of viable leukocytes, monocytes, T cells, and B cells in the Holder pasteurized group were lower than those in the unsterilized group [leukocytes: 185.50 (87.00-356.50) vs 1 271.00 (540.50-2 283.00); monocytes: 12.00 (6.00-16.75) vs 266.00 (137.30-518.80); T cells: 1.00 (0.00-2.00) vs 47.50 (28.50-116.00); B cells: 1.00 (0.00-1.75) vs 21.00(10.00-41.50); all P<0.05]. The percentage of viable leukocyte to the total leukocyte and the viable monocytes, T cells, and B cells to the viable leukocytes were lower in the Holder pasteurized group than those in the unsterilized group [24.80%(16.00%-36.80%) vs 74.20%(63.55%-86.45%); 5.91%(4.09%-8.77%) vs 21.90%(17.40%-29.30%); 0.31%(0.00%-1.31%) vs 4.00%(2.69%-6.43%); 0.30%(0.00%-0.86%) vs 1.27%(0.57%-2.85%); all P<0.05]. A similar trend was observed between short-time pasteurization and unsterilized groups (all P<0.05). (3) The percentages of viable monocytes, T cells, and B cells in their subsets were lower in both Holder and short-time pasteurized groups than those in the unsterilized group [2.94%(1.33%-7.14%) vs 9.72%(5.77%-16.00%) and 52.60%(31.35%-68.75%); 0.00%(0.00%-1.61%) vs 0.49%(0.00%-2.53%) and 28.10%(10.55%-57.00%); 0.00%(0.00%-0.83%) vs 0.24%(0.00%-2.47%) and 13.80%(3.27%-41.00%); all P<0.05].The number and percentage of viable leukocytes in total leukocytes and viable monocytes in total monocytes [leukocytes: 279.50(116.80-548.50), 32.20%(20.70%-45.75%); monocytes: 32.00(21.00- 83.75),15.60%(11.10%-19.15%)] were higher than those in the pasteurized group (all P>0.05). The short-time pasteurized group was noted only for a higher percentage of the viable monocytes to viable leukocytes than the Holder pasteurized group (all P<0.05). Conclusions:Compared with the Holder pasteurization, sIgA, LTF, LZM level, and monocyte activity in breast milk can be better preserved by short-time pasteurization.