Malocclusion,identified by the World Health Organization(WHO)as one of three major oral diseases,profoundly impacts the dental-maxillofacial functions,facial esthetics,and long-term development of～260 million children in China.Beyond its physical manifestations,malocclusion also significantly influences the psycho-social well-being of these children.Timely intervention in malocclusion can foster an environment conducive to dental-maxillofacial development and substantially decrease the incidence of malocclusion or reduce the severity and complexity of malocclusion in the permanent dentition,by mitigating the negative impact of abnormal environmental influences on the growth.Early orthodontic treatment encompasses accurate identification and treatment of dental and maxillofacial morphological and functional abnormalities during various stages of dental-maxillofacial development,ranging from fetal stages to the early permanent dentition phase.From an economic and societal standpoint,the urgency for effective early orthodontic treatments for malocclusions in childhood cannot be overstated,underlining its profound practical and social importance.This consensus paper discusses the characteristics and the detrimental effects of malocclusion in children,emphasizing critical need for early treatment.It elaborates on corresponding core principles and fundamental approaches in early orthodontics,proposing comprehensive guidance for preventive and interceptive orthodontic treatment,serving as a reference for clinicians engaged in early orthodontic treatment.

Objective:To explore the pathway of influencing factors of self-management in elderly patients with type 2 diabetes mellitus (T2DM) based on health belief theory.Methods:It was a cross-sectional study. A total of 210 elderly patients with T2DM admitted to Shanghai 10th People′s Hospital from January 2021 to March 2022 were selected as research subjects.The surveys of general data questionnaire, social support rating scale, the diabetes self-management scale, the health literacy survey scale for patients with chronic diseases, and the self-efficacy scale for patients with diabetes were conducted in all the subjects. The t test and Spearman correlation analysis were used to test the correlation among variables. Results:Social support, health literacy and self-efficacy were positively correlated with self-management scores in these patients ( r=0.380, 0.392, 0.274, all P<0.001). Univariate analysis showed that there were statistically significant differences in self-management among patients with different age, education level, physical exercise, medical payment method, family history and sleep quality (all P<0.05). Path analysis showed that the mediating effect of social support in the relationship between health literacy and self-efficacy was significant (95% CI: 0.014-0.117), social support, self-efficacy and health literacy directly affected self-management( β=0.25, 0.27, 0.35, all P<0.01). Self-efficacy and health literacy also positively affected self-management through multiple mediators of social support ( β=0.16, 0.27, both P<0.01). Conclusion:Social support, self-efficacy and health literacy mediate in the self-management of elderly patients with T2DM complicated with chronic complications and interact with each other.

The global COVID-19 coronavirus pandemic has infected over 109 million people, leading to over 2 million deaths up to date and still lacking of effective drugs for patient treatment. Here, we screened about 1.8 million small molecules against the main protease (M^pro) and papain like protease (PL^pro), two major proteases in severe acute respiratory syndrome-coronavirus 2 genome, and identified 1851M^pro inhibitors and 205 PL^pro inhibitors with low nmol/l activity of the best hits. Among these inhibitors, eight small molecules showed dual inhibition effects on both M^pro and PL^pro, exhibiting potential as better candidates for COVID-19 treatment. The best inhibitors of each protease were tested in antiviral assay, with over 40% of M^pro inhibitors and over 20% of PL^pro inhibitors showing high potency in viral inhibition with low cytotoxicity. The X-ray crystal structure of SARS-CoV-2 M^pro in complex with its potent inhibitor 4a was determined at 1.8 Å resolution. Together with docking assays, our results provide a comprehensive resource for future research on anti-SARS-CoV-2 drug development.
Humans ; Antiviral Agents/chemistry* ; COVID-19 ; COVID-19 Drug Treatment ; High-Throughput Screening Assays ; Molecular Docking Simulation ; Protease Inhibitors/chemistry* ; SARS-CoV-2/enzymology* ; Viral Nonstructural Proteins

Objective:To predict and evaluate the antibacterial efficacy of linezolid, teicoplanin and daptomycin against Staphylococci bloodstream infections with Monte Carlo simulation, and to optimize the clinical administration program. Methods:A total of 1 847 Staphylococci strains isolated from blood samples between January 2018 to December 2019 were collected with the help of the Blood Bacterial Resistant Investigation Collaborative System (BRICS). Minimum inhibitory concentrations (MIC) of linezolid and daptomycin were detected by broth dilution method, while MIC of teicoplanin were detected by agar dilution method. The dosage regimens of linezolid were 800 mg once daily, 500 mg once every 12 hours, 600 mg once every 12 hours and 600 mg once every eight hours. The dosage regimens of teicoplanin were 400 mg once every 12 hours, 600 mg once every 12 hours, 800 mg once every 12 hours, and 1 000 mg once every 12 hours. The dosage regimens of daptomycin were 4 mg·kg -1·d -1, 6 mg·kg -1·d -1, 8 mg·kg -1·d -1, 10 mg·kg -1·d -1and 12 mg·kg -1·d -1. The probability of target attainment (PTA) and cumulative fraction of response (CFR) of three different dosage regimens were calculated by Monte Carlo simulation. A dosage regimen with CFR≥90.0% was a reasonable choice for empirical antimicrobial therapy. Results:PTA of linezolid against Staphylococci when MIC≤0.500 mg/L at four dosage regimens (800 mg once daily, 500 mg once every 12 hours, 600 mg once every 12 hours and 600 mg once every eight hours) were all over 90.0%. When MIC was 1.000 mg/L, the PTA of linezolid against Staphylococci under the dosages of 500 mg once every 12 hours, 600 mg once every 12 hours and 600 mg once every eight hours were 92.2%, 96.6% and 97.6%, respectively. The CFR of the four dosage regimens of linezolid were 73.9%, 83.7%, 90.8% and 95.3%, respectively. When MIC≤1.000 mg/L, PTA of teicoplanin against Staphylococci were all 100.0% at four dosage regimens (400 mg once every 12 hours, 600 mg once every 12 hours, 800 mg once every 12 hours and 1 000 mg once every 12 hours). When MIC was 2.000 mg/L, the PTA of teicoplanin (800 mg once every 12 hours and 1 000 mg once every 12 hours) against Staphylococci were both 100.0%. The CFR of the four dosage regimens of teicoplanin were 90.8%, 92.8%, 93.5% and 94.6%, respectively. When MIC≤0.500 mg/L, PTA of daptomycin against Staphylococci under the five dosages of 4 mg·kg -1·d -1, 6 mg·kg -1·d -1, 8 mg·kg -1·d -1, 10 mg·kg -1·d -1 and 12 mg·kg -1·d -1 were all over 90.0%. When MIC was 1.000 mg/L, the PTA of daptomycin against Staphylococci under the three dosages of 8 mg·kg -1·d -1, 10 mg·kg -1·d -1 and 12 mg·kg -1·d -1were 96.9%, 100.0% and 100.0%, respectively. The CFR of the five dosage regimens of daptomycin against Staphylococci were 97.4%, 99.2%, 99.9%, 100.0% and 100.0%, respectively. Conclusions:Linezolid (600 mg once every 12 hours), teicoplanin (400 mg once every 12 hours) and daptomycin (4 mg·kg -1·d -1) can achieve satisfactory antibacterial activity for Staphylococci bloodstream infections.

Objective:To explore the effect of preoperative video education in patients with coronary heart disease after percutaneous coronary intervention (PCI) .Methods:From July 2018 to October 2019, convenience sampling was used to select 110 patients with coronary heart disease who received PCI in the Second Department of Cardiology, the Second Hospital of Hebei Medical University as the research object. According to the random number table, the patients were divided into the control group and the observation group, 55 cases in each group. The control group received conventional preoperative education, while the observation group was given video education on the basis of conventional preoperative education. The mastery of education knowledge, heart rate, anxiety and depression were compared between the two groups.Results:After intervention, there was no significant difference in heart rate between the two groups ( P>0.05) . The mastery of education knowledge, anxiety and depression in the observation group were better than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Preoperative video education can relieve anxiety and depression in patients with coronary heart disease after PCI, improve the effect of health education, and is worthy of popularization and application.

Objective:To study the application value of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses.Methods:The study selected 126 nursing trainees taking an internship in the Department of Gastroenterology in our hospital from January 2018 to June 2020 as the teaching objects, and they were randomized into two groups, Control Group and Experimental group, with 63 cases in each group. The control group adopted traditional teaching and the experimental group took traditional teaching combined with WeChat video teaching. The internship time of both groups was 4 weeks. The scores of comprehensive ability assessment after practice were compared between the two groups, and the critical thinking ability scale and nursing students' clinical practice satisfaction scale were used to evaluate the critical thinking ability and satisfaction of practice nurses of the two groups before and after teaching. SPSS 19.0 was used for statistical analysis of the research data. Continuous variables were expressed as (mean ± standard deviation), t test was performed, categorical variables were expressed as percentage, four-grid test was conducted, and the test level was α=0.05. Results:The scores of comprehensive ability, theoretical knowledge and operation skills of the experimental group were significantly higher than those of the control group ( P<0.05). After teaching, the scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the two groups were significantly higher than those before teaching ( P<0.05), and there was no significant difference in the score of thinking self-confidence before and after the teaching ( P>0.05). The scores of seeking truth, opening mind, systematization ability, analytical ability, curiosity, cognitive maturity and total scale score of the experimental group were significantly higher than those of the control group ( P<0.05), and there was no significant difference in the score of thinking self-confidence between the two groups ( P>0.05). The experimental group's practice management, practice environment, teaching content, practice effect score and total scale score were significantly higher than those of the control group ( P<0.05), and compared with the control group, the score of teaching quality was poorer, without significant differences ( P>0.05). Conclusion:The application of WeChat video teaching mode in clinical teaching of digestive endoscopy nurses can improve the performance and satisfaction of comprehensive ability assessment of practice nurses, and enhance their ability of critical thinking.

Objective:To investigate the clinical efficacy of laparoscopic resection of retrorectal cystic lesions.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 58 patients undergoing laparoscopic resection of retrorectal cystic lesions in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from August 2012 to August 2019 were collected. There were 5 males and 53 females, aged from 15 to 70 years, with a median age of 38 years. All the 58 patients underwent laparoscopic resection of retrorectal cystic lesions and the combined operation through the transsacral approach was chosen according to the patient condition. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) postoperative histopathological examination; (4) follow-up. Patients were followed up regularly using outpatient examination once every 6 months during the first postoperative year and once every 12 months after the first postoperative year. The recurrence of cysts was evaluated by computed tomography or magnetic resonance imaging examinations during the follow-up up to August 2020. Measurement data with normal distribution were represented as Mean± SD and measurement data with skewed distribution were described as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations: of the 58 patients, 54 cases underwent laparoscopic resection of retrorectal cystic lesions and 4 cases underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation. One of the 58 patients who had a huge cyst surrounding the rectum underwent transverse colostomy after repairing the damage of separated posterior wall of rectum. Two cases underwent preventive transverse colostomy because the external rectal wall heat injury could not be excluded after separation of the tight adhesion between cyst and rectum. The operation time and volume of intraoperative blood loss were (123±56)minutes, 20 mL(range, 5?500 mL) of 54 cases who underwent laparoscopic resection of retrorectal cystic lesions and (232±38)minutes, 90 mL(range, 30?800 mL) of 4 cases who underwent laparoscopic resection of retrorectal cystic lesions combined with the transsacral approach operation, respectively. (2) Postoperative situations: 7 of the 58 patients had complica-tions. Of the 7 patients, 2 cases had postoperative rectal fistula and were cured after the treatment of transverse colostomy combined with pelvic drainage, 2 cases had postoperative urinary tract infection and were relieved after anti-infection treatment, 2 cases had urinary retention after removal of catheter and were recovered after 3 weeks of re-indwelling catheter, and 1 case had poor incision healing of transsacral and was healed after wound dressing change. The duration of postoperative hospital stay of the 58 patients was (7±4)days. (3) Postoperative histopathological examination: results of the postoperative histopathological examination showed that there were 26 of 58 patients with epidermoid cyst, 20 patients with teratoma (2 cases with mature teratoma accompanied by mucinous adenocarcinoma and 1 case with mature teratoma accompanied by neuroendocrine carcinoma), 10 patients with dermoid cyst, and 2 patients with tailgut cyst. (4) Follow-up: 57 of the 58 patients were followed up for 2-85 months, with a median follow-up time of 51 months. Of the 57 patients who were followed up, 1 patient was diagnosed with buttock subcutaneous cyst at postoperative 8 months and treated with local excision, 1 patient was diagnosed with a small presacral cyst recurrence by pelvic magnetic resonance imaging at postoperative 6 months and continued follow-up as the cyst without obvious enlargement, and the other 55 patients had no cyst recurrence.Conclusion:The laparoscopic resection of retrorectal cystic lesions is safe and feasible.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

Objective:To investigate the effect of circRNA-102231 on the sensitivity of colon cancer HT-29 cells to cisplatin and its mechanism.Methods:The expression of circRNA-102231 and ABCB1 were detected by Western blot and RT-qPCR in cisplatin-resistant HT-29/DDP cell lines. Overexpress or knockdown circRNA-102231 in HT-29 cells were respectively followed by treatment with cisplatin, CCK-8 method was used to detect cell viability, Western blot and RT-qPCR were used to detect the protein and mRNA expression levels of circ-102231 and ABCB1; The circRNA-102231 combined microRNA was predicted by the database and verified with RT-qPCR; Activation or inhibition of ERK and overexpression of miR-145, Western blot and RT-qPCR were used to detect the protein and mRNA levels of ABCB1, and the luciferase reporter assay was used to detect the ABCB1 promoter activity.Results:Compared with HT-29 cells, the expression levels of circRNA-102231 and ABCB1 were significantly up-regulated in HT-29/DDP cells(all P<0.05). Overexpression of circRNA-102231 up-regulated the expression of ABCB1 and decreased the sensitivity of cells to cisplatin( P<0.05). Knockdown of circRNA-102231 down-regulated the expression of ABCB1, hence increased the sensitivity to cisplatin( P<0.05); circRNA-102231 can recruit miR-145 and promote its expression; miR-145 induce ERK phosphorylation, activation or inhibition of ERK activity can promote or up regulate the expression level and promote activity of ABCB1( P<0.05). Conclusion:circRNA-102231 may increase the resistance of HT-29 cells to cisplatin by promoting the up-regulation of ABCB1 through miRNA-145/ERK pathway.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2016 to December 2017. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI) 2019. WHONET 5.6 was used to analyze data.Results:During the study period, 8 154 bacterial strains were collected from 33 hospitals, of which 2 325 (28.5%) were Gram-positive bacteria and 5 829 (71.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (34.7%), Klebsiella pneumoniae (15.8%), Staphylococcus aureus (11.3%), coagulase-negative Staphylococci (7.4%), Acinetobacter baumannii (4.6%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.8%), Streptococci (2.9%), Enterobacter cloacae (2.7%) and Enterococcus faecalis (2.5%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 34.2%(315/922) and 77.7%(470/605), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rate of Enterococcus faecium to vancomycin was 0.6%(2/312), and no vancomycin-resistant Enterococcus faecium was detected. The ESBLs-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus were 55.7%(1 576/2 831), 29.9%(386/1 289) and 38.5%(15/39), respectively. The incidences of carbapenem-resistance in Escherichia coli, Klebsiella pneumoniae were 1.2%(33/2 831), 17.5%(226/1 289), respectively. The resistance rates of Acinetobacter baumannii to polymyxin and tigecycline were 14.8%(55/372) and 5.9%(22/372) respectively, and those of Pseudomonas aeruginosa to polymyxin and carbapenem were 1.3%(4/315) and 18.7%(59/315), respectively. Conclusion:The surveillance results from 2016 to 2017 showed that the main pathogens of blood stream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen; the MRSA incidence was lower than other surveillance data in the same period in China; carbapenem-resistant Escherichia coli was at a low level during this surveillance, while carbapenem-resistant Klebsiella pneumoniae is on the rise.