Objective: To understand the allocation of health staff and clinics in primary and secondary schools in Guangdong Province, so as to provide a reference for school health construction. Methods: In December 2020, a total of 17 205 primary and secondary schools in 21 cities in Guangdong Province were investigated by combining document verification and on site surveys. The allocation of health staff and clinics in different cities and types of schools was analyzed using SPSS 25.0 software. Results: The proportion of schools in Guangdong Province that met the national standard for school health staff ratio was 37.7%. Among different types of schools, the lowest ratio was found in nine year schools (33.1%), while the highest was in twelve year schools (61.3%). Among the 17 205 schools in the province, 12.6% had clinics with an area of >40 m 2, and 6.9% with occupational licenses for medical institutions. The proportion of full time health staff was 39.1%. Among all school health staffs, the proportions of permanent staff, temporary staff, and appointed staff were 47.5%, 29.0% and 23.6%, respectively. The rate of school health staff with professional qualifications was 44.9%, while 48.3% had graduated from medical related majors, and 20.9% held a bachelor s degree or higher as their first degree. There were differences among various types of schools, with primary schools having the lowest health staff configuration and professional level (24.0% and 35.7%, respectively). Conclusions There are still issues of insufficient staff and low professional level in health staff and establishment of clinics in primary and secondary schools in Guangdong Province, and the allocation is uneven across different types of schools. The allocation of clinics in the province is still in urgent need of improvement.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

ObjectiveTo observe the efficacy and safety of Tongguan Capsule（通冠胶囊）on ventricular remodeling in patients after acute myocardial infarction （AMI）， and to explore the possible mechanism. MethodsA total of 53 ST-segment elevation myocardial infarction （STEMI） patients were collected and randomly divided into 26 cases in the treatment group and 27 cases in the control group. The control group was given conventional therapy after percutaneous coronary intervention （PCI） for AMI， and the treatment group was given Tongguan Capsules （4.5 g each time， 3 times a day） on the basis of the control group. The course of treatment was 12 weeks. Echocardiographic data and stool samples were collected from subjects before and after the intervention， and left ventricular ejection fraction （LVEF）， left ventricular end-diastolic volume index （LVEDVi）， left ventricular end-systolic volume index （LVESVi）， left ventricular mass index （LVMi） were measured and calculated， so as to compare the number of cases of left ventricular remodeling in the two groups. At the same time， 16S rDNA sequencing was performed on the stool samples to analyze the diversity of gut microbiota （GM）， the composition of the GM， the GM difference between the groups； recording the incidence of major adverse cardiovascular events （MACEs） and adverse reactions of patients in the two groups during the study period； and performing Spearman's correlation analyses of the post-treatment flora data with LVEF， LVEDVi， LVESVi， LVM， and LVMi in the two groups. ResultsOne case fail to follow up in the treatment group and 2 cases fail to follow up in the control group， and 25 cases in each of the two groups were finally included in the analysis. LVEDVi， LVESVi， and LVMi of the control group after treatment were higher than those before treatment （P＜0.05）； after treatment， LVEDVi， LVESVi and LVMi in the treatment group were lower than those in the control group （P＜0.05）. Left ventricular remodeling occurred in 5 cases （20.00%） in the treatment group and 13 cases （52.00%） in the control group， and the incidence of left ventricular remodeling in the treatment group was lower than that in the control group （P=0.03）. After treatment， the ACE estimation and Chao estimation of bacterial abundance in the treatment group were higher than that before treatment and that in the control group （P＜0.05）. The treatment group showed an increase in Mycobacterium anisopliae phylum and a decrease in Mycobacterium thickum， Mycobacterium anisopliae phylum， and Mycobacterium patella phylum after treatment （P＜0.05）. When comparing between groups after treatment， the relative abundance of Prevotella， Agathobacter， Dialister， Eubacterium coprostanoligenes group was up-reuglated and the relative abundance of Enterococcus was down-regulated in the treatment group（P＜0.05 or P＜0.01）. There was no statistically significant difference in the incidence of MACEs and the occurrence of adverse reactions between groups during treatment （P＞0.05）. The results of correlation analysis showed that Prevotella were positively correlated with LVEF and negatively correlated with LVEDVi， LVESVi， LVM， and LVMi （P＜0.01）. Agathobacter group were negatively correlated with LVEDVi， LVESVi （P＜0.01）； Enterococcus group were positively correlated with LVESVi （P＜0.05）. ConclusionTongguan Capsules can improve ventricular remodeling in patients with acute ST-segment elevation myocardial infarction with better safety； its mechanism may be related to adjusting the enrichment of related bacteria such as Prevotella， Dialister and Enterococcus and other related bacterial genera， increasing the colonization and diversity of beneficial bacteria， and adjusting the structure of GM.

Objective:To explore the law of Chinese medicine patent compound prescription in treating diabetic retinopathy (DR).Methods:The patents of TCM compound for the treatment of DR Published in the patent database of China National Knowledge Resource Database (CNKI) from the establishment of the database to September 1, 2022 were searched and screened. The Ancient and Modern Medical Record Cloud Platform V2.0 was used to analyze the frequency of medication, nature, taste, and meridian distribution, and the rules of compatibility of medication were mined and analyzed based on association rules and cluster analysis.Results:A total of 113 compound patents were included, involving 201 kinds of Chinese materia medica. The top five drugs in frequency of use were Rehmanniae Radix, Notoginseng Radix et Rhizoma, Angelicae Sinensis Radix, Ganoderma and Astragali Radix. Their properties were mostly cold and warm, and their tastes were sweet and bitter. The top three meridians were liver meridian, lung meridian and kidney meridian. Six pairs of commonly used drugs were obtained, and four kinds of medicines were obtained by clustering analysis. Complex network analysis showed that core TCM combination was Rehmanniae Radix, Notoginseng Radix et Rhizoma, Angelicae Sinensis Radix, Ganoderma, Astragali Radix, Salviae Miltiorrhizae Radix et Rhizoma, Lycii Fructus, Prinsepiae Nux, and Cuscutae Semen.Conclusions:TCM compound patents for the treatment of DR are mainly used to treat cold and liver meridian, and the medication is mainly used to replenish qi and nourish yin, clear heat and cool blood, promote blood circulation and remove blood stasis, and tonify liver and kidney. The drug pairs are mainly used to supplement qi and nourish yin, clear heat and detoxify, invigorate qi and nourish blood, and invigorate qi and stop bleeding. The modified Danggui Buxue Decoction and Siwu Decoction are often used in treatment, and wind drugs are added as appropriate to soothe liver and improve eyesight, which can provide reference for clinic.

Objective:To systematically summarize the psychological experience of cancer patients caregivers, and comprehensively understand their inner needs, so as to provide basis for better clinical medical work.Methods:CNKI, Wanfang DATA, VIP, EMBASE, PubMed, BMJ Journals, CINAHL, Cochrane Library, ProQuest, and other databases were searched from their inception to May 2020, to collect qualitative studies on psychological experience of cancer patients caregivers. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for Qualitative Studies in Australia. The results were integrated by integrating methods.Results:A total of 10 studies were included. 22 research results were extracted and grouped into 9 new categories according to similarities. These categories resulted in 3 synthesized findings: caregivers suffered from physical and psychological sufferings, and were tortured with mainly negative emotions and mixed positive emotions; after self adjustment, the role of caregiver grew; their thirst for information and support.Conclusion:Healthcare workers should pay attention to psychological changes and information needs of cancer patients caregivers, provide necessary support to help them adapt their roles, and improve their quality of life.

Objective: To compare the survival rates difference between diabetic kidney disease (DKD) and non-DKD maintenance hemodialysis patients. Methods: The eligible patients who started hemodialysis treatment in Dalian Municipal Central Hospital from January 1, 2010 to December 31, 2016 were enrolled. The endpoint was all-cause death. Patients were divided into two groups according to the primary disease: DKD group and non-DKD group. Survival between two groups was compared by Kaplan-Meier plots and log-rank test. Survival was timed from the start of dialysis until the date of death and was censored for the date of end of the study period (December 31, 2016). SPSS 13.0 software was used for statistical analysis. Univariate COX regression analysis was used for risk assessment. Independent analysis was performed by multivariate COX regression. P < 0.05 indicated that the difference was statistically significant. Results: A total of 769 patients were enrolled, including 305 patients with DKD (39.7%) and 464 patients with non-DKD (60.3%). There were 465 males, accounting for 60.5%, and 304 females, accounting for 39.5%. The mean age of starting dialysis was (56.2 ± 14.9) years. The median follow-up time was 21 months. One hundred and seventy patients died due to all causes, accounting for 21.7%. The 1-, 2-, 3-, 4-, 5-, 6- and 7-year survival rates in the diabetic kidney disease group were 94%, 77%, 68%, 56%, 44%, 31% and 26%. The 1-, 2-, 3-, 4-, 5-, 6- and 7-year survival rates in the non-diabetic kidney disease group were 94%, 87%, 81%, 77%, 69%, 65% and 60%. The survival rate of DKD group was significantly lower than that of non-DKD group (χ²=23.656, P < 0.01). Multivariate Cox regression analysis showed that age of onset of dialysis, primary disease, low density lipoprotein, serum potassium, ejection fraction (EF), coronary heart disease and stroke were independent risk factors of mortality (P < 0.05). Conclusions The survival rate of patients with diabetic kidney disease is significantly lower than that of patients with non-diabetic kidney disease in the maintenance hemodialysis patients in our center. Age, primary disease, low density lipoprotein, EF, coronary heart disease, and stroke are independent predictors of death.

PURPOSE: Long non-coding RNA (lncRNA) nuclear paraspeckle assembly transcript 1 (NEAT1) has been implicated as an oncogene in the development and progression of osteosarcoma. This study aims to explore the mechanism of NEAT1 in osteosarcoma. MATERIALS AND METHODS: Expressions of NEAT1 and miR-194 in osteosarcoma tissues and cells were detected by quantitative real-time PCR. The effects of NEAT1 knockdown or miR-194 overexpression on cell proliferation, invasion, and apoptosis were determined by 3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyl tetrazolium bromide (MTT) assay, transwell invasive assay, and flow cytometry analysis, respectively. Luciferase reporter assay was performed to observe the possible interaction between NEAT1 and miR-194. RESULTS: NEAT1 was upregulated and miR-194 was downregulated in osteosarcoma tissues and cells. Knockdown of NEAT1 or overexpression of miR-194 suppressed proliferation and invasion and induced apoptosis of osteosarcoma cells in vitro. Luciferase reporter assay validated that NEAT1 could interact with miR-194 and negatively modulated its expression. Furthermore, inhibition of miR-194 reversed the suppression of proliferation and invasion and the promotion of apoptosis induced by NEAT1 depletion in osteosarcoma cells. CONCLUSION: Knockdown of NEAT1 suppressed proliferation and invasion and induced apoptosis in osteosarcoma cells by inhibiting miR-194 expression.
Apoptosis* ; Carcinogenesis ; Cell Proliferation ; Flow Cytometry ; In Vitro Techniques ; Luciferases ; Oncogenes ; Osteosarcoma* ; Real-Time Polymerase Chain Reaction ; RNA, Long Noncoding*

Objective T o detect the genotype of A B O blood group by SN aPshot technology. Methods D N A w ere extracted from the peripheral blood sam ples w ith know n blood groups (obtained by serology) of 107 unrelated individuals in Y unnan. Six SN P loci of the 261th, 297th, 681th, 703th, 802th, and 803th nucleotide positions w ere detected by SN aPshot M ultiplex kit, and relevant genetics param eters w ere cal-culated. Results In 107 blood sam ples, the allele frequencies of types A , B , O A, and O G w ere 0.3551, 0.1682, 0.2300 and 0.2476, respectively, w hile that of types A G and cis A B w ere not detected. T he geno-typing results of A B O blood group w ere consistent w ith that of serologic testing. Conclusion SN aPshot technology can be adapted for genotyping of A B O blood group.

Objective:To introduce a novel ridge preservation technique with micro-titanium plate avoiding the use of bone grafting materials,and evaluate the potential horizontal bone preservation effect of this new technique,applied on single maxillary central incisors after tooth extraction for future implant restoration.Methods:Nine patients (six women and three men),mean age (26.0 ±5.7)years(from 1 8 to 34 years)referred to the Department of Oral Implantology,Peking University School and Hospital of Stomotology,were selected and diagnosed with unsalvageable single middle incisor with fine general con-ditions,no signs of acute local inflammation,no ongoing or previous periodontitis,healthy neighboring teeth and intact buccal bone walls.Tooth extraction,delayed implant placement and implant-supported single crown restoration were selected as treatment plan.The teeth were extracted atraumatically with lo-cal anesthesia,followed by a reflection of a minor flap to exposed 2-3 mm of the buccal bone plate.Af-ter that,a micro-titanium plate was trimmed and bended to fit the convexity of the labial bone and fixed by two mini pins with intent to support the labial soft tissue.The flap was then repositioned over the micro titanium plate and secured with two single sutures.No bone grafting materials or releasing incisions were needed.The sockets were left to heal without any intention of primary wound closure.Cone-beam compu-ted tomographic (CBCT)scans were obtained before and four months after tooth extraction.Horizontal ridge widths were measured with CBCT software,and the preservation effects were calculated and recor-ded by the percentage of horizontal ridge alteration.Results:The nine extraction sockets were healed un-eventfully.The average socket width before extraction was (7.51 ±0.48)mm (6.92-7.82 mm).The average alveolar ridge labial-palatal width at the control point of the edentulous area was (6.81 ±0.44) mm (6.04-7.38 mm)4 months after tooth extraction,the mean percentage of ridge width preserved was 90.87%±2.91%(87.28%-95.60%).Conclusion:This novel ridge preservation method by the usage of a micro-titanium plate did not interfere with the natural socket healing process,and at the same time,largely preserved the width of alveolar ridge without any bone grafting procedures.Long term results remain to be seen.

Objective To investigate the changes of renal resident dendritic cells (rDC)during kidney ischemia-reperfusion injury (IRI). Methods C57BL/6J mice models with bilateral renal warm ischemia were established. The kidney tissue was prepared for single cell suspension at 24 h and 48 h after reperfusion. The changes in the percentage of CD45 +cells and CD1 1 c +rDCs were evaluated by flow cytometry. The renal tissues of mice labeled with green fluorescent protein and diphtheria toxin receptor (CD1 1 c +GDTR ) were prepared for single cell suspension. The percentage and phenotype of CD1 1 c +rDCs were analyzed by flow cytometry. CD1 1 c +GDTR mice models with bilateral renal warm ischemia were established. The renal tissue was prepared for single cell suspension at 24 h after reperfusion. CD45 + cells was gathered by magnetic-activated cell separation (MACS ). The expression levels of co-stimulatory molecules on the rDC surface were analyzed by flow cytometry. Results At 24 h after reperfusion,the percentage of CD45 +cells in the kidney of C57BL/6J mice was significantly elevated,and further increased at 48 h after reperfusion. At 24 h after reperfusion,the quantity of CD1 1 c +rDCs was equally increased,whereas the percentage of CD1 1 c +rDCs in CD45 +cells was dramatically declined and restored at 48 h after reperfusion,slightly higher compared with that in the sham group. In healthy CD1 1 c +GDTR mice,the percentage of CD45 +cells in the kidney was lower than 1%,consisting of approximately 40%of CD1 1 c +rDCs,which mainly presented as CD11bintF4/80 -MHCⅡ+. At 24 h after reperfusion,the percentage of CD11c +F4/80 -subset rDC surface co-stimulatory molecules was significantly enhanced,such as CD40,CD80 and CD86. Conclusions Following warm IRI,the percentage and quantity of rDCs,and the expression level of rDC surface co-stimulatory molecule are significantly increased,prompting that renal rDC infiltration is increased and phenotype becomes matured.