The impaction rate of third molars is increasingly high, leading to more and more serious clinical problems. For a long time, the primary approach to managing third molars has been direct extraction, with a notable lack of systematic and diversified treatment methods. This article introduces, for the first time, the concept of whole life-cycle health management for third molars and suggests that the window for third molars life-cycle health management should be moved forward to the tooth germ stage. For tooth germs of third molars with severe risks, timely and necessary intervention should be administered. For normally erupting third molars, efforts should be made to maintain their health so they can function over the long term. For impacted third molars that have not caused related clinical symptoms, careful observation and cautious extraction should be considered. If necessary, techniques such as orthodontics and autotransplantation can be used to functionalize them. For impacted third molars that have caused clinical symptoms, functional oral surgical principles should be applied to reduce surgical trauma and prevent intraoperative and postoperative complications using advanced clinical techniques.

Purpose/Significance To provide high-quality health information services,to promote the coordinated development of medical and educational services,and to help build a healthy China service system.Method/Process By using the methods of network investigation,literature investigation and telephone interview,the paper investigates the current situation of teaching support services of 30 libraries of medical universities and colleges in China,and analyzes the existing problems from four aspects:teaching resource serv-ices,information literacy services,disciplinary services and service guarantee.Result/Conclusion Libraries of medical universities and colleges should establish and improve the teaching support service system,strengthen discipline teaching support services,provide accu-rate health information services,strengthen regional or departmental collaboration,and innovate intelligent service modes,so as to be-come an important driving force for healthy China initiative.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To analyze the characteristics and risk factors of previous low-energy fractures in elderly patients with hip fractures admitted to our hospital.Methods:The data for this study was collected from 596 hip fracture patients admitted to Zhongda Hospital Affiliated to Southeast University between January 2018 and December 2021.Out of these patients, there were 404 females and 192 males.Based on the history of low-energy fracture before hip fracture, the patients were divided into two groups: a low-energy fracture group and a non-low-energy fracture group.A comparison was made between the two groups in terms of gender, age, fracture type, BMI, number of combined medical diseases, ASA score, and other characteristics.Results:The study included a total of 596 patients, with 368 patients having no history of low-energy fractures and 228 patients with low-energy fractures.Among the patients with low-energy fractures, there were 118 vertebral fractures, 69 hip fractures, 57 rib fractures, 19 radial fractures, 14 humerus fractures, and 12 patella fractures.Univariate analysis revealed significant differences in age, gender, fracture type, number of combined medical diseases, and ASA score between the two groups( P<0.05 for all). The results of multivariate Logistic analysis indicated that age( OR=1.046, 95% CI: 1.022-1.070), female sex( OR=1.474, 95% CI: 1.011-2.148), and the number of comorbid medical diseases( OR=1.211, 95% CI: 1.113-1.318)were independent risk factors for patients with a history of low-energy fractures. Conclusions:Our findings provide evidence that vertebral, hip, and rib fractures were the three most common previous low-energy fractures in elderly patients with hip fractures.We identified age, female gender, and number of medical diseases as independent risk factors for prior low-energy fractures in this population.

Objective:To explore the effect of early quantitative activities combined with integrated care concept on postoperative rehabilitation of patients undergoing radical prostatectomy.Methods:A total of 62 patients who were admitted to the PLA Navy Anqing Hospital and underwent laparoscopic radical prostatectomy from March 2018 to December 2021 were selected as the research objects by the convenient sampling method. They were divided into the control group and the observation group according to admission time, with 31 cases in each group. The control group was given early quantitative activities intervention, while the observation group was given early quantitative activities combined with integrated care concept intervention. The postoperative recovery and activity changes of the two groups were recorded, and the difference of self-care ability before and at discharge between the two groups was compared.Results:There was no statistically significant difference in the first postoperative exhaust time and the first postoperative ambulation time between the two groups ( P>0.05) . The duration of postoperative hospitalization in the observation group was shorter than that in the control group ( P<0.05) . At second and third day after surgery, the number of walking steps in the observation group were higher than that in the control group ( P<0.05) . The self-care ability score of the observation group was higher than that of the control group at discharge ( P<0.05) . Conclusions:Early quantitative activities combined with integrated care concept can promote postoperative rehabilitation of patients undergoing radical prostatectomy and improve their self-care ability.

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Objective To study the mechanism of platelet aggregation induced by Streptococcus suis serotype 2 muramidase-released protein (MRP) and to provide scientific proof and theoretical basis for clinical treatment of patients with Streptococcus suis infection. Methods Nickel column affinity chromatogra-phy was used to purify recombinant proteins of MRP-N and MRP-C. Platelet aggregometer, thromboelastog-raphy (TEG) and scanning electron microscope were used to observe the platelet aggregation induced by MRP. Results Streptococcus suis 2 wild type strain,but not the mutant strain ΔMRP,could induce platelet aggregation. It was MRP-N but not MRP-C that induced platelet aggregation. GPRP,an inhibitor of β2inte-grin receptor,could significantly inhibit the platelet aggregation induced by MRP. Conclusion Streptococ-cus suis 2 MRP induces platelet aggregation through β2integrin receptor pathway.

Objective To construct a mutant strain of Streptococcus suis type 2 05ZYH33 express-ing ABC transporter SSU05 0946 and to study the pathogenicity of ABC transporter SSU05 0946 for better understanding the immune evasion strategies by Streptococcus suis. Methods Genome of the Streptococcus suis type 2 05ZYH33 strain was extracted and used as a template to amplify SSU05 0946 upstream and down-stream homeodomains. Chloramphenicol-resistance gene was amplified by using pSET1 plasmid as the tem-plate. These three amplified fragments were fused and integrated with the thermo-sensitive plasmid pSET4s by using overlap extension PCR. Homologous recombination method was used to construct the mutant strain 05ZYH33Δ0946. Differences between the mutant and wild type strains were evaluated through bacterial ad-hesion assay,whole blood killing assay and challenge test in mice and piglets. Results The mutant strain 05ZYH33Δ0946 was successfully constructed. Results of bacterial adhesion assay demonstrated that SSU05 0946 was not involved in the adherence of Streptococcus suis to human epithelial cells. SSU05 0946 was an ovel anti-phagocytic factor and virulence factor of Streptococcus suis. Conclusion Streptococcus suis type 2 ABC transporter SSU05 0946 is a newly discovered virulence factor of Streptococcus suis, playing an impor-tant role in the evasion of host innate immunity by Streptococcus suis.

Objective_To investigate the potential effect of bone marrow mesenchymal stem cells ( MSCs) on repai-ring the colon epithelial cell,and on the treatment of rats with ulcerative colitis ( UC) .Methods_Monocytes were purified from bone marrow, amplified and identified as MSCs in vitro.Thirty female Wistar rats were randomly di-vided into 3 groups, the normal control, model and MSCs groups (10 rats/group).The rats in model and MSCs groups were induced colitis with trinitro-benzene-sulfonic acid;The rats in normal control group and model groups were injected with 1mL saline via tail vein, while those in MSCs group with 1 mL MSCs suspension.After two weeks, colon tissue samples were analyzed for histopathology,and the colon tissues were made into serial section for determining the distribution of Y chromosome and CK20 double positive cells,analyzing the mRNA levels of CK20,NF-κB, IL-4 by RT-PCR,and assaying colonic NF-κB protein expression with Westen blot,detecting colon tissues IL-4 content with ELISA.Results_Y chromosome and CK20 double positive cells were found in MSCs transplanted colon tissues.The expression of CK20 increased in the colon tissues of UC rats(P<0.01) and in MSCs group in-creased as compared with model group( P<0.01) .The expression of NF-κB increased in the colon tissues of UC rats (P<0.01), but decreased MSCs group as compared with model group (P<0.01).The expression of IL-4 was decreased in the colon tissues of UC rats ( P<0.01) , while in MSCs group it was increased as compared with model group ( P<0.01) .Conclusions_MSCs may have therapeutic efficacy on colitis in rats through differentiating into colon epithelial cells.

Objective To investigate the therapeutic effects and safety of beraprost sodium on vascular endothelial dysfunction in elderly patients with lower extremity arteriosclerotic occlusive disease (LEAOD).Methods A total of 80 patients with LEAOD were randomly divided into 2 groups:the treatment group and the control group (n=40 each group).All patients were treated with conventional antihypertensive,antidiabetic,hypolipidemic,antiplatelet drug therapy and non-drug therapy such as smoking cessation,foot care.In addition,patients in the treatment group received 40 μg oral beraprost sodium at a dose of 120 μg/day,3 times/day for 30 days.The changes in symptoms,vital signs,the function of liver and kidney,hemorheology,and serum nitric oxide (NO)were observed before and after the treatment.Results No adverse reactions happened among all patients.After 30 days treatment,there was a significant difference in the total efficacy between the treatment and control groups (80％ vs.35％,x2 =19.60,P＜0.01).The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the control group were (1.70±0.19) mpas.s,5.69±1.08,(43.86±5.20) μmol/L,respectively before the treatment and (1.36±0.14) mpas.s,3.23±0.67,(56.84 ± 7.05) μmol/L,respectively after the treatment.The levels of plasma viscosity,erythrocyte aggregation index and serum NO in the treatment group were (1.71 ±0.18) mpas.s,5.70±1.04,(44.24±5.40) μmol/L,respectively before the treatment and (1.10±0.12) mpas.s,2.80 ±0.52,(64.00±8.15) μmol/L,respectively after the treatment.Compared with pretreatment,the levels of plasma viscosity and erythrocyte aggregation index in the two groups were significantly decreased and serum NO level was increased after the treatment (t=9.07,12.17,17.85,15.76,9.38,12.78,respectively,all P＜0.05).Compared with the control group,the levels of plasma viscosity and erythrocyte aggregation index in the treatment group were significantly decreased and serum NO level was increased (t =8.91,3.27,4.21,all P＜0.05).Conclusions The oral beraprost sodium can effectively and safely improve the hemorheologic and endothelial function in elderly patients with LEAOD.