Background Anxiety and depression are common perinatal mental health issues that often occur together and can have serious negative effects on both maternal and infant health. Objective To examine the relationships between lifestyle factors and comorbid anxiety and depression (CAD) among pregnant women in Shanghai. Methods The study estimated the prevalence of CAD during the first, second, and third trimesters of pregnancy using the Self-rating Anxiety Scale (SAS) and Center for Epidemiological Studies-Depression (CES-D) based on data from the China National Birth Cohort (CNBC) embryonic-derived diseases with assisted reproductive technology (ART) sub-cohort. Information on demographics, sleep status, nutritional intake, and exercise during each trimester was collected through self-made questionnaires, the Pittsburgh Sleep Quality Index (PSQI), and the Food Frequency Questionnaire (FFQ). Lifestyle factors (such as sleep status, nutritional intake, and exercise during each trimester) were analyzed using logistic regression and generalized linear mixed models (GLMM) to determine their impacts on the prevalence of CAD (yes or no) among pregnant women. Results A total of 2876 pregnant women were included in this study. The prevalence of CAD was 10.6% (305), 3.6% (103), and 5.5% (159) in the first, second, and third trimesters of pregnancy, respectively. The logistic regression analysis revealed that poor sleep quality throughout the entire pregnancy were statistically associated with an increased prevalence of CAD, and the odds ratios (OR) with 95% confidence intervals (CI) were 2.817 (1.845, 4.301), 2.840 (1.855, 4.347), and 9.316 (5.835, 14.876) for the first, second, and third trimesters, respectively, when compared to good sleep quality. Additionally, compared to an intake frequency of 7 times per week, the frequency of egg intake ≤3 times per week in the first trimester (OR=2.025, 95%CI: 1.197, 3.425) and the frequency of egg intake of 4–6 times per week (OR=1.896, 95%CI: 1.117, 3.216) or ≤3 times per week (OR=1.906, 95%CI: 1.082, 3.357) in the third trimester were associated with an increased risk of CAD (P<0.05). Moreover, when compared to a frequency of exercise >3 times per week, never or almost never exercising in the second trimester (OR=2.218, 95%CI: 1.220, 4.035) was associated with an increased risk of CAD (P<0.05). The GLMM analysis also demonstrated a significant association between poor sleep quality, lower exercise frequency, or lower intake frequency of vegetables, eggs, or milk and an increased risk of CAD (P<0.05). Conclusion The prevalence of CAD among pregnant women in Shanghai follows a U-shaped distribution, with the highest rate occurring in early pregnancy and the lowest rate in mid-pregnancy. Factors such as poor sleep quality, inadequate intake of vegetables, eggs, or milk, and lack of exercise during pregnancy may increase the risk of CAD. Implementing lifestyle interventions during pregnancy could potentially reduce the risk of mental health problems and improve the overall health of both mothers and babies.

Objective:To establish the animal model of cervicofacial venous malformations(VMs)by surgical reconstruction of exter-nal jugular vein in sheep.Methods:The external jugular veins of 5 sheep were dissected,and the position,course,branch and exter-nal diameter were observed and measured.The models of VMs with draining and returning veins were constructed by suturing or constric-ting the proximal part of main trunk and ligating or constricting the distal part of the jugular or branch veins.The animal model was eval-uated by Doppler ultrasound,gross observation and histological observation at the 4th week after surgery.Results:The external jugular veins of sheep is in the lateral side of bilateral neck,and the main trunk is formed by the maxillary vein and lingual facial vein.The ex-ternal diameter ranges from 6 to 12 mm,with an average external diameter of 9.3 mm.Immediately after the external jugular vein was sutured and narrowed at the proximal part of the main vein,the distal part of the vein branch was ligated or narrowed,the blood flow speed slowed down and the veins in the model area bulged.4 weeks after surgery,gross observation showed that most veins narrowed and thrombosis was formed in part of the venous lumen.The central region of some specimens was dilated,and the peripheral collateral veins were dilated in some models.Doppler ultrasonography showed that the lumens of most veins were dilated and the returning veins and the inflow veins were narrowed.Colored blood flow was seen in the lumen.Histological observation showed that the structure of vein endothelium and wall was close to the normal vein,and the vein vessel wall of some specimens was thickened.Conclusion:The VMs model estab-lished by external jugular vein of sheep basically meets the re-quirements and is expected to be used in the therapeutic meth-odology research of cervicofacial VMs.

Objective　To timely understand the current status and distribution of nail snails (Oncomelania hupensis) in Tongjiang River channels in Zhenjiang City, providing a scientific basis for achieving the goal of eliminating schistosomiasis. Methods　From 2019 to 2023, nine Tongjiang River channels on the south bank of the Yangtze River under the jurisdiction of Zhenjiang City were selected as the monitoring area. Snail monitoring was carried out onshore and beach nail snails floats in the Tongjiang River channels, nail snails on attachments in hardened areas, snails induced by straw curtains, and snails carried by boats and domestic animals. Results　The monitoring results of shoreline snail from 2019 to 2023 showed that the snail situation in the Tongjiang River channel and its outer river bank remained relatively stable from 2019 to 2020; however, in 2021, under the influence of the Yangtze River flooding disaster in 2020, the area of snails increased significantly. In 2021, the area with snails in the Tongjiang River channel and the outer river bank increased by 45.70% (11.95/26.15) and 100.00% (20.00/20.00) compared to 2020; the average density of nails snails in the Tongjiang River channel and the outer river bank and the emergence rate of snail frames both showed a significant increase, rising by 94.73% (0.18/0.19) and 68.08% (8.68/12.75) compared to 2020, and by 122.73% (0.81/0.66) and 102.78% (43.26/42.09), respectively. The differences in the increase in the occurrence rate of spiked frames in the Tongjiang River channel Chili River and Renmin River were not statistically significant (χ2=0.329, P>0.05; χ2=0.646, P>0.05). From 2022 to 2023, the density of nail snails and the occurrence rate of framed snails in the Tongjiang River channel showed a decreasing trend (F=4.72, P=0.04 and χ2=372.58, P<0.01). The area of nail snails, density of live snails, and occurrence rate of framed snails in the outer river bank showed a decreasing trend (F=13.96, P=0.02; F=23.43, P<0.01; χ2=1 029.69, P<0.01). During the five years, no nail snails were detected in the ancient canal and 11 tributaries. From 2019 to 2023, 180 times of 3 003 kg of floating objects were salvaged, with a total of 148 live snails detected. A total of 17 live snails were captured on attachments in the hardened berm area; a total of 11 live snails were captured by straw curtain snail baiting;112 boats were inspected, and no snails were found; there were 112 boats surveyed, and no snails were found; 97 cattle were observed, and 2 cattle were found to carry 1 live snail on their hooves; 321 sheep were observed, and no snails were found on their hooves; and no infectious snails were found in the monitoring area in 5 years. Conclusions　Nail snails continue to exist in the Tongjiang River channel, and the risk factors for schistosomiasis transmission have not been completely eliminated. It is still necessary to carry out accurate monitoring of the snail situation in the Tongjiang River and the river bank, so as to grasp the risk of transmission in time and take emergency measures.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Abstract Biomarkers could improve the understanding of the causes of obesity and its association with chronic diseases for people. The purpose of the review is to summarize recent advances in transcriptomic, proteomic, and metabolomic phenotypic biomarkers of obesity in order to deepen the understanding of the etiology of obesity and its metabolic consequences. In the precise prevention and control of childhood obesity, different groups of biomarkers can improve the accuracy of the word "obesity" and help early detection of specific biomarkers with risk characteristics, so as to realize the transformation of childhood obesity from a one size fits all prevention and control strategy to a personalized prevention and control plan during the development of obesity.

Objective:To establish a scientific and standardized evaluation index system of neonatal breastfeeding nursing quality under the state of mother-infant separation, in order to provide a tool for the detection and management of neonatal breastfeeding nursing quality under mother-infant separation, so as to promote the implementation of breastfeeding in China.Methods:A systematic and comprehensive search of Chinese and English databases was conducted to collect guidelines on neonatal breastfeeding in the state of mother-infant separation. Based on the "structure-process - result" three-dimensional quality structure model, the preliminary draft of evaluation indexes of neonatal breastfeeding nursing quality in the state of mother-infant separation was formed. The evaluation indexes of neonatal breastfeeding nursing quality in the state of mother-infant separation were constructed by Delphi expert correspondence method from July to October, 2023.Results:The effective recovery rates were 95.83% (23/24) and 91.30% (21/23), respectively. The expert authority coefficients were 0.895 and 0.870, respectively. The Kendall harmony coefficients of the whole index were 0.134 and 0.178 (both P<0.01), respectively. The final evaluation index system of neonatal breastfeeding nursing quality under the state of mother-infant separation includes 3 first-level indicators, 18 second-level indicators and 82 third-level indicators. Conclusions:The evaluation index system of neonatal breastfeeding nursing quality in the state of mother-infant separation established in this study is highly scientific and reliable, highlighting the characteristics of neonatal breastfeeding nursing work in the state of mother-infant separation, and can provide a reference for the evaluation of neonatal breastfeeding nursing quality in the state of mother-infant separation.

Objective:To explore the safety and efficacy of Tumai domestic multi-port robot-assisted surgery system in the clinical application of distal pancreatectomy in pancreatic tumor patients.Methods:A prospective, single-center, single-arm exploratory study was conducted. A total of 20 patients who underwent robot-assisted pancreatic body-tail resection in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from March 2023 to November 2023 were enrolled, including 13 males and 7 females, aged (57.9±11.2) years. All the patients underwent robot-assisted distal pancreatectomy with Tumai multi-port surgical robot. Clinical data of complications, intraoperative blood loss, operative time, postoperative drainage tube retention time, and postoperative pathology were collected and statistically analyzed.Results:All the 20 patients underwent surgery successfully. Only 1 patient (5.0%) was diagnosed with pancreatic neuroendocrine tumor (G1 stage), and the rest were benign pancreatic tumors, including serous cystadenoma and mucinous cystadenoma. No instrument-related organ or blood vessel injury occurred, no intraoperative complications occurred. Of 7 patients (35.0%) had postoperative complications, including 3 infections, 3 abdominal effusion, and 1 hypokalemia. According to the Clavien-Dindo grading, all the cases were grade Ⅰ except 1 case with grade Ⅱ abdominal effusion. No serious complications above grade Ⅲ occurred. The intraoperative blood loss of the 20 patients was 100(20, 200) ml, the operative time was (125.7±76.9) min, and the postoperative retention time of drainage tube was (7.9±3.4) d.Conclusion:Tumai domestic multi-port robot-assisted surgery system has acceptable safety and efficacy in the clinical application of distal pancreatectomy.

The dental pulp is the only soft tissue structure within the tooth,serving functions such as sensation and nutrition.However,the dental pulp is highly susceptible to necrosis due to external factors.Currently,root canal therapy is the most commonly used treatment for pulp necrosis.Nevertheless,teeth treated with root canal therapy are prone to secondary infections and adverse outcomes like vertical root fractures.Regenerative endodontic therapy has emerged as a solution,aiming to replace damaged tooth structures,including dentin,root structure,and the pulp-dentin complex cells.This approach demonstrates significant advantages in addressing clinical symptoms and achieving regeneration of the root and even the pulp.Since the discovery of dental pulp stem cells,regenerative endodontic therapy has gained new momentum.Advances in cell transplantation and cell homing techniques have rapidly developed,showing promising potential for clinical applications.

Objective To observe the value of amide proton transfer(APT)imaging for assessing central nervous system damages in stable chronic obstructive pulmonary disease(COPD)and the correlations with MR spectroscopy(MRS)and lung function parameters.Methods Thirty-nine stable COPD patients(COPD group)and 34 healthy subjects(control group)were prospectively enrolled.Images of plain head MR,3D-APT and thalami MRS were acquired,and parameters of lung function were obtained.The basic data,outcomes of voxel-based morphometry(VBM)analysis,APT values in multiple brain regions and thalami MRS metabolite parameters were compared between groups,and the correlations of thalamus APT values with thalamus MRS metabolites parameters and lung function parameters were explored.Results Lung function parameters in COPD group were lower than those in control group,while cerebrospinal fluid volume(CSFV)and total brain volume(TIV)in COPD group were lager than those in control group(all P＜0.05).Compared with those in control group,APT values of bilateral thalami,right temporal lobe and right occipital lobe in COPD group were higher,and the peak value of N-acetyl aspartate(NAA)of bilateral thalami and NAA/creatin of right thalamus in COPD group were lower(all P＜0.05).Within COPD group,APT values of bilateral thalami were positively correlated(r=0.641),while APT values of left thalamus showed negative correlation(r=-0.435)with NAA values left thalamus and negative correlation(r=-0.432)with the forced expiratory volume in the first one second after bronchodilator administration(FEV1)(all P＜0.05).Conclusion APT values of central nervous system elevated and NAA values decreased in COPD patients.There were negative correlations between left thalamus APT and NAA values,also between APT values of left thalamus and FEV1.

AIM: To compare the results calculated by population pharmacokinetic analysis tools Phoenix NLME, Monolix, R nlmixr package and CPhaMAS cloud platform with the gold standard sofeware NONMEM. METHODS: Fifty sparse sampling data sets based on a one-compartment model and fifty dense sampling data sets based on a two-compartment model were simulated, and the above five analysis tools were used to calculate the population typical value, individual variability and individual pharmacokinetic parameters. RESULTS: The population typical value and individual variability calculated by CPhaMAS and Phoenix NLME had the highest matching degree with NONMEM, followed by nlmixr. Monolix had the lowest matching degree, but Monolix and nlmixr might be more robust. The correspondence between clearance and distribution volume was better than the absorption rate constant. Except the absorption rate constant calculated by Monolix and intercompartmental clearance calculated by nlmixr, the correlation coefficients of individual pharmacokinetic parameters calculated by all analytical tools were greater than 0.99. CONCLUSION: The results calculated by the above four population pharmacokinetic analysis tools are highly correlated with that of NONMEM.