ObjectiveTo investigate the status of tooth loss in people aged 50 and above, so as to understand their oral health status and provide scientific evidences for promoting oral health of middle-aged and elderly people. MethodsA total of 400 patients who visited the department of stomatology at Sijing Hospital in Songjiang District of Shanghai were performed oral health examinations and their information was collected according to the national epidemiological survey standards for oral health. ResultsThere were statistically significant differences in tooth loss among people aged 50 and above with different ages, educational levels, occupations, types of medical insurance and chronic diseases (P<0.05), but gender and monthly income had no statistically significant correlations with tooth loss (P>0.05). Among lifestyle factors, smoking, alcohol consumption and tea drinking had no statistically significant impacts on the number of remaining teeth (P>0.05), but toothbrushing frequency, flossing frequency, toothpick use frequency, toothbrush replacement frequency, and tooth loosening were statistically associated with the number of remaining teeth (P<0.05). Multiple linear regression analyses indicated that a total of 7 related factors including age, educational level, occupation, medical payment type, chronic disease, tooth loosening and toothpick use frequency were significantly associated with the number level of remaining teeth in individuals aged 50 and above. ConclusionAge, chronic disease, and tooth loosening were influencing factors affecting the number of teeth left in people aged 50 and above. It is recommended to strengthen oral health education and improve healthcare awareness to reduce the risk of tooth loss in people aged 50 and above.

The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.

ObjectiveTo investigate the high-risk detection rate and aggregation of cardiovascular diseases（CVD） in 8 districts of Shanghai and influencing factors， and to provide scientific references for prevention and control of CVD. MethodsBased on the Cardiovascular Disease Screening and Management Program in Shanghai from 2016 to 2021， 104 685 participants aged 35 to 75 in 8 districts of Shanghai were selected for analysis. χ² test and multivariate logistic regression were used for statistical analysis of the influencing factors of CVD and aggregation of CVD. ResultsThe proportion of high-risk CVD individuals in the population was 19.17%， including the high-risk individuals with hypertension （8.65%）， dyslipidemia （6.33%）， CVD history （5.58%）， and WHO assessed risk ≥20% types （2.69%）， respectively. Old age， overweight and obesity， central obesity， smoking， drinking， farmers， unmarried， and low family income were the risk factors of CVD， while high education level was the protective factor. In the participants， 16 323 people （81.34%） were classified as CVD high-risk groups； The number of aggregation of 1， 2 and ≥3 high risk types of CVD were 16 323（81.34%）， 3 236（16.13%）， 509（2.54%）， respectively. Old age， low education level， low annual family income， farmers， unmarried， smoking， drinking， overweight， obesity and central obesity were associated with the risk of aggregation of high risk types of CVD， and the correlation strength increased with the increase of aggregation types. ConclusionThe prevention and control of CVD in Shanghai should focus on the hypertension， elderly， overweight， obesity， central obesity， smoking， drinking， low educated， low family income， farmers and unmarried people， and targeted intervention measures should be taken to reduce the risk of CVD among residents.

ObjectiveTo investigate the prevalence of dental caries among preschool children in Chongming District， Shanghai， and to analyze the related factors influencing dental caries in preschool children in Chongming District， in order to provide references and suggestions for the prevention of dental caries in preschool children in Chongming District. MethodsFrom January to April 2022， 939 preschool children from 5 kindergartens in Chongming District of Shanghai were selected as the research objects through random cluster sampling. The dental caries prevalence rate and related risk factors of dental caries in preschool children were studied through oral examinations and questionnaire surveys. ResultsThe prevalence rate of dental caries among the 939 preschool children was 45.69%. The prevalence of dental caries in preschool children was not related to gender but increased with age （P<0.001）. Risk factors for dental caries in children included consuming desserts between meals or before bedtime （OR=3.049， P<0.001）， consuming sugared milk （OR=2.389， P=0.027）， presence of dental caries in caregivers （OR=1.888， P<0.001）， age （OR=1.758， P<0.001）， regular consumption of certain beverages by children （OR=1.250， P=0.029）， and the frequency of snack consumption （OR=1.191， P=0.034）. ConclusionTo reduce the incidence of dental caries in preschool children， it is recommended that caregivers undergo oral health examinations and dental caries treatment to reduce the transmission of cariogenic bacteria. Additionally， reducing the frequency of children’s consumption of snacks， sugary drinks， and dairy products， and avoiding unhealthy eating habits such as consuming desserts before bedtime are advised. It is also important to educate children on proper toothbrushing methods to ensure the effectiveness of toothbrushing and to encourage them to develop good oral hygiene habits.

ObjectiveTo investigate the status, characteristics of population distribution and trends of chronic obstructive pulmonary disease (COPD) deaths among the registered residents in Chongming District, Shanghai from 2002 to 2022, and to provide a scientific basis for precise prevention and control of COPD. MethodsCOPD death data were obtained from the Shanghai Chongming District Death Surveillance System, and indicators such as crude mortality rate, standardized mortality rate, mortality rate by age group, and probability of premature death were calculated for the registered residents with COPD. Joinpoint 5.0.2 software was adopted to analyze the annual percent change (APC) and average annual percent change (AAPC), followed by an analysis of trend changes. ResultsFrom 2002 to 2022, the average annual crude mortality rate and average annual standardized mortality rate of COPD among the residents of Chongming District were 73.49/100 000 and 34.00/100 000, respectively, and both were higher in males than those in females. The crude mortality rate of COPD among the residents aged ≤69 years in Chongming District was 6.78/100 000, followed by 218.28/100 000 in the age group of ≥70 years and 1 042.77/100 000 in the age group of ≥80 years, respectively. The standardized mortality rates for the whole population (AAPC=-9.75%), males (AAPC=-9.06%) , and females (AAPC=-12.25%) all showed a downward trend (all P<0.001). In addition, there was a decreasing trend in the crude mortality rates for the residents aged ≤69 years (AAPC=-7.51%), aged ≥70 years (AAPC=-9.89%), and aged ≥80 years (AAPC=-8.85%) (all P<0.001). Furthermore, the probability of premature death of COPD decreased from 1.45% in 2002 to 0.08% in 2022. ConclusionThe mortality rate and probability of early premature death of COPD among the registered residents in Chongming District, Shanghai from 2002 to 2022 show a downward trend, and the mortality rate of declining in males is slower than that in females. The elderly with advanced age account for the highest number of deaths. Therefore, targeted intervention measures should be taken for key groups to reduce the mortality rate of COPD.

Objective To investigate the clinical significance and level changes of uric acid(UA)/albumin(ALB)ratio(UAR)in patients with chronic kidney disease(CKD)complicated with coronary heart disease(CHD).Methods A total of 175 patients with CKD were divided into the simple CKD group(control group,n=94)and the CKD complicated with CHD group(experimental group,n=81).The differences of blood routine,blood lipid,renal function and UAR were compared between the two groups.The influencing factors of CKD complicated with CHD were analyzed by binary Logistic regression.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of each index for CKD complicated with CHD.Results There were no significant differences in white blood cell count(WBC),monocytes(Mon),total cholesterol(TC),total triglyceride(TG),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)between the two groups.The levels of neutrophils(Neu),red cell distribution width variation coefficient(RDW-CV),blood urea nitrogen(BUN),creatinine(Cr),UA and UAR levels were higher in the experimental group than those in the control group(R＜0.05).The levels of lymphocyte(Lym),red blood cell count(RBC),mean corpuscular hemoglobin concentration(MCHC),platelet(PLT),estimated glomerular filtration rate(eGFR)and albumin(Alb)were lower in the experimental group than those in the control group(R＜0.05).Logistic regression analysis showed that lower levels of RBC and MCHC,and higher levels of UAR were independent risk factors for CKD complicated with CHD.ROC curve showed that the area under the UAR curve was the largest in RBC,MCHC and UAR detection,which was 0.912(95%CI:0.870-0.953),the sensitivity was 90.10%,the specificity was 77.70%,the Yoden index was 0.678 and the cutoff value was 10.935.The AUC of combined detection of RBC,MCHC and UAR was 0.987(95%CI:0.974-0.999),the sensitivity was 93.80%and the specificity was 97.90%.Conclusion The increased serum UAR level in patients with CKD is a predictor of CHD.The combined detection of UAR,RBC and MCHC has higher prediction efficiency.

Objective To investigate the effect of resveratrol on endoplasmic reticulum stress and apoptosis in thyroid follicular cells induced by high iodine. Methods The thyroid follicular cell line Nthy-ori 3-1 was cultured in vitro and divided into four groups based on different culture methods: normal culture group (Normal group), high iodine group (HI group), resveratrol group (RES group), and high iodine combined with resveratrol group (HI+RES group). Cell proliferation activity was detected by CCK-8 assay, cell apoptosis was detected by TUNEL assay, and the BIP, CHOP, IRE1 mRNA expressions were detected by real-time quantitative polymerase chain reaction (PCR). Western blot was used to detect the protein expressions of BIP, CHOP, and IRE1. Results Compared with the Normal group, the proliferation activity of cells in the HI group decreased after 72 hours of culture, the proportion of apoptotic cells increased, the proportion of TUNEL staining positive cells increased, and the relative expressions of BIP, CHOP, IRE1 mRNA, as well as BIP and CHOP proteins were significantly elevated (P < 0.001 or P < 0.05). Compared with the HI group, the proliferation activity of cells in the HI+RES group increased after 72 hours of culture, the proportion of apoptotic cells decreased, the proportion of TUNEL staining positive cells decreased, and the relative expressions of BIP, CHOP mRNA, as well as BIP and CHOP proteins, were significantly reduced(P < 0.001 or P < 0.01). Conclusion Resveratrol exerts a protective effect on thyroid follicular cells induced by high iodine, significantly inhibiting endoplasmic reticulum stress and apoptosis caused by excessive iodine intake.

OBJECTIVE: Gut microbiome is an intricate micro-ecosystem mediating the human health and drug efficacy. Physalis alkekengi (PAL) is an edible and time-honored traditional Chinese medicine. Several pharmacological effects of PAL have been verified and gut bacteria are implied in its therapeutic actions. However, the detailed modulation of PAL on gut bacterial species and on gut fungi remains largely unknown. We, therefore, designed a preliminary experiment in normal mice to reveal the modulation effect of PAL on both gut bacteria and fungi, and explore the interaction between them. METHODS: Herein, the aqueous extract of PAL was orally administrated to normal C57BL/6 mice for four weeks. The full-length 16S rRNA and ITS1/2 gene sequencing were explored to detect the taxa of gut bacteria and gut fungi after PAL treatment, respectively. RESULTS: Oral administration of PAL notably enriched anti-inflammatory bacterial species such as Duncaniella spp. and Kineothrix alysoides, whereas decreased pro-inflammatory species such as Mucispirillum schaedleri. Simultaneously, PAL increased the abundance of gut fungi Aspergillus ochraceus, Cladosporium sp. and Alternaria sp., and decreased Penicillium janthinellum. Correlation network analysis identified two co-existing microbial groups (groups 1 and 2) that were negatively associated with each other. The group 1 comprised PAL-enriched bacteria and fungi, while group 2 was mainly normal chow-enriched bacteria and fungi. In group 1, Antrodia monomitica, Aspergillus clavatus, Mortierella kuhlmanii and Sarcinomyces sp. MA 4787 were positively correlated with Bifidobacterium globosum, Romboutsia ilealis and so on. In group 2, Chaetomium subspirilliferum, Septoria orchidearum and Cephaliophora tropica were positively related to Lactobacillus spp. CONCLUSION Altogether, this preliminary study first demonstrated the modulation effect of PAL on both gut bacteria and gut fungi, which may shed light on the elucidation of PAL's pharmacological mechanism.

Objective To analyze the the incidence of sedation-related adverse events occurring during percutaneous microwave ablation(PMWA)under deep sedation,and to identify the risk factors for hypoxemia,hypertension and body movement response.Methods The clinical data of 506 patients with liver cancer,who received PMWA under deep sedation at the First Affiliated Hospital of Nanjing Medical University of China between December 2018 and December 2022,were retrospectively analyzed.The sedation-related adverse events including hypoxemia,hypertension and body movement response were recorded.Univariate analysis and multivariate logistic regression analysis were used to assess the risk factors for hypoxemia,hypertension and body movement response.Results After excluding 20 patients whose clinical data were incomplete,the final study sample consisted of 486 patients.After deep sedation,hypotension occurred in 5 patients(1％),and the incidences of hypoxemia,hypertension and body movement response were 13.8％,13.2％and 25.5％respectively.No patient required urgent endotracheal intubation and no cardiovascular complications occurred.The body movement response did not increase the complications of PMWA.Multivariate analysis revealed that age ≥65 years(OR=1.034,P=0.033),BMI＞30 kg/m2(OR=1.865,P=0.039),and Child-Pugh grade B/C(OR=1.113,P=0.046)were the risk factors for hypoxemia.The ablation zone contacting the parietal peritoneum(OR=2.536,P＜0.01),ablation zone contacting the diaphragm(OR=1.795,P=0.001),and ablation zone contacting the adrenal gland(OR=1.581,P＜0.01)were the risk factors for hypertension.The ablation zone contacted the parietal peritoneum(OR=2.831,P＜0.01)and ablation zone contacted the diaphragm(OR=2.213,P=0.026)were the risk factors for body movement response.Conclusion For the treatment of liver cancer,PMWA under deep sedation is clinically safe and effective.The age ≥ 65 years,BMI＞30kg/m2,and Child-Pugh grade B/C are the risk factors for hypoxemia.The ablation zone contacting the parietal peritoneum,the diaphragm or the adrenal gland are the risk factors for hypertension.The ablation zone contacting the parietal peritoneum or the diaphragm are the risk factors for body movement response.(J Intervent Radiol,2023,32:1202-1206)

ObjectiveTo analyze the mortality data of children under 5 years in Chongming District， Shanghai， and to analyze the main causes of death of children under 5 years， so as to provide scientific basis for reducing the mortality of children under 5 years in Chongming District. MethodsData of children under 5 years in Chongming District from 2011 to 2020 were collected from the Maternal and Child Health Information System of Chongming District， Shanghai. The mortality rate and main causes of death of children under 5 years in Chongming District were analyzed retrospectively. ResultsFrom 2011 to 2020， the average mortality rate of children under 5 years in Chongming District was 6.51‰， and the overall trend was stable. The mortality rate of children under 5 years with non-local household registration （11.44‰） was significantly higher than that of children under 5 years of age with local household registration （4.88‰） （P<0.05）. The main causes of death for children under 5 years were accidental deaths （drowning， accidental asphyxia， traffic accidents）， while the main causes of death for infants were congenital heart disease， premature birth or low birth weight， congenital abnormalities， birth asphyxia and pneumonia. ConclusionIt is necessary to strengthen safety education for children and their guardians and strengthen safety management for children who are not registered in this city. Departments of obstetrics and gynecology and the departments of pediatrics should be expanded， and prenatal examination should be strenthened for high risk or elderly parturient women to further reduce the death rate of children under 5 years old.