Liver cirrhosis is the end-stage of various chronic liver diseases， and hepatic fibrosis caused by persistent inflammation is the core mechanism of the development and progression of liver cirrhosis. With the evolution of disease spectrum and a deeper understanding of the reversal of hepatic fibrosis， dual antiviral-antifibrotic therapy initially applied in the treatment of hepatitis B cirrhosis has gradually evolved into a broad-sense dual therapy for liver cirrhosis， which integrates etiological treatment with antifibrotic and/or anti-inflammatory interventions. This article systematically reviews the conceptual evolution of dual therapy for liver cirrhosis and related research advances.

Pancreatic portal hypertension （PPH） is a type of regional portal hypertension secondary to pancreatic diseases and their complications. Unlike portal hypertension caused by liver cirrhosis， PPH is confined to the splenic venous system， and most patients tend to have normal liver function. Splenic vein obstruction and impaired blood return are the core mechanisms underlying the development of PPH， and isolated gastric fundal varices represent a characteristic manifestation of PPH. For patients with pancreatic diseases， it is necessary to establish early warning and risk stratification strategies， and high-quality studies are needed to further confirm the safety and efficacy of anticoagulation， surgical approaches， and interventional therapies in patients with PPH. This article systematically reviews the pathogenesis， etiological classification， clinical features， and key diagnostic points of PPH and discusses the current status of PPH treatment and existing challenges.

Skeletal class Ⅱ malocclusion is characterized by maxillary protrusion,mandibular retrognathia,or a combination of both,and often accompanied by vertical dimensional discrepancies;treatment is complex,and combined orthodontic-orthognathic surgery is needed for the adult patients.Clear aligner therapy has gradually been applied in complex orthodontic cases.However,limited cases have been reported domestically and internationally regarding the application of clear aligner therapy combined with orthognathic surgery.This article presented a case of a patient with skeletal class Ⅱ high-angle malocclusion treated with the combined therapy and analyzed the clinical efficacy of the treatment appraoch to provide reference for the clinical practice.Extraction of impacted wisdom teeth 18,28,38,and 48,as well as orthodontic teeth 15,25,34,and 44,was performed in stages before orthodontic treatment.Clear aligner therapy was used for preoperative orthodontics.In sagittal plane,a super-complete class Ⅱ canine and molar relationship and a 13-14 mm overjet of the anterior teeth were established.The maxillary and mandibular arch morphology was matched horizontally.The orthognathic surgery included maxillary LeFort Ⅰ osteotomy,bilateral sagittal split ramus osteotomy(BSSRO)and chinplasty.Fine occlusal adjustment was conducted after operation.After treatment,the skeletal relationship between upper and lower jaw was corrected to normal;subspinale-nasion-supramental angle(ANB)was improved from 12.3° to 4.7°;the patient established the class Ⅰ canine and molar relationship,with normal overjet and overbite;root parallelism was good and there was no obvious root resorption;the facial soft tissue profile was significantly improved,and nasion-subnasale-pogonion angle(N-Sn-Pg)was improved from 143.9° to 162.8°.The curative effect was stable 1 year after operation.Clear aligner therapy can efficiently complete combined orthodontic and orthodontic surgery in the complex cases.Compared with the fixed appliance,it is more beneficial to the patients'need for beauty and the maintenance of periodontal health.

Objective It analyzes the current research status of the"one hospital with multiple campuses"construc-tion in public hospitals in China,focuses on research hotspots and evolution trends,and provides references for the research on"one hospital with multiple campuses"in public hospitals.Methods Using CiteSpace 6.3.R1 software,a visual analysis was conducted on 323 academic journal articles related to"one hospital with multiple campuses"in public hospitals from CNKI from 2014 to 2024.Results Over the past decade,the number of publications in this field has shown an overall upward trend;a core author group has initially formed but the density of the collaboration net-work is low;the institutions with the highest number of publications are mainly healthcare institutions and universi-ties;High-frequency keywords include public hospitals,homogenization,financial management,etc;research hot-spots generally show a trend from foundational construction to system integration,from extensive expansion to re-fined internal management,and from single-factor optimization to technology empowerment and multidimensional integration.Conclusion The research on the"one hospital with multiple campuses"construction of public hospitals in our country is clearly driven by policy,with research efforts distributed in a dual-core structure of"medical institu-tions-universities".However,interdisciplinary collaboration needs to be strengthened.Future research can focus on areas such as healthcare professionals,medical quality,the integration of business and finance systems,and inno-vation in emergency management mechanisms,providing support for the high-quality development of public hospi-tals with"one hospital with multiple campuses".

Objective To explore the development path of"one hospital with multiple campuses"in public hospitals in China,and provide a reference for promoting the healthy and high-level construction of"one hospital with multiple campuses".Methods Based on the SPO theory,an analytical framework for studying the development path of"one hospital with multiple campuses"in public hospitals in China was constructed.Taking 41 tertiary public hospitals in 20 provinces that participated in the performance assessment and carried out the construction of"one hospital with multiple campuses"as the analysis objects,the hospital performance assessment data and the development data of"one hospital with multiple campuses"were collected.Crisp-Set Qualitative Comparative Analysis was used to explore different conditional configurations for the development of"one hospital with multiple campuses"in public hospitals in China,and to reveal the development path of"one hospital with multiple campuses"in public hospitals.Results The high-quality development path of"one hospital with multiple campuses"is the result of the combined action of multiple factors.The management structure path,support and promotion path,quality and safety path,and operation performance pathare the four configurations that promote the high-quality development of"one hospital with multiple campuses"in public hospitals.Among them,quality and safety are the necessary conditions for the high-quality development of"one hospital with multiple campuses".Conclusion There are multiple paths for the high-quality development of"one hospital with multiple campuses"in public hospitals.Hospitals need to select appropriate development strategies according to their own situations,ensure the homogenization of medical quality among different hospital districts,and form a joint force for the development of multiple hospital districts.

Generative Artificial Intelligence ishows a broad application prospect in the field of healthcare and has become an important technical means to promote the development of medical informatization.It addresses the multi-faceted challenges of medical record documentation,including efficiency,quality,and doctor-patient communica-tion.It analyzes the adaptability and feasibility of Generative Artificial Intelligence in different clinical scenarios of intelli-gent medical record generation.Additionally,it explores the issues present in current applications and proposes corre-sponding solutions,providing references for the effective application and continuous optimization of Generative Artifi-cial Intelligence in medical record documentation.This provides a theoretical foundation for further expanding the appli-cation scenarios of automatic medical record documentation in China's healthcare industry.

Peptide receptor radionuclide therapy (PRRT) with radiolabeled SSTR2 agonists is a treatment option that is highly effective in controlling metastatic and progressive neuroendocrine tumors (NETs). Previous studies have shown that an SSTR2 agonist combined with albumin binding moiety Evans blue (denoted as ¹⁷⁷Lu-EB-TATE) is characterized by a higher tumor uptake and residence time in preclinical models and in patients with metastatic NETs. This study aimed to enhance the in vivo stability, pharmacokinetics, and pharmacodynamics of ¹⁷⁷Lu-EB-TATE by replacing the maleimide-thiol group with a polyethylene glycol chain, resulting in a novel EB conjugated SSTR2-targeting radiopharmaceutical, ¹⁷⁷Lu-LNC1010, for PRRT. In preclinical studies, ¹⁷⁷Lu-LNC1010 exhibited good stability and SSTR2-binding affinity in AR42J tumor cells and enhanced uptake and prolonged retention in AR42J tumor xenografts. Thereafter, we presented the first-in-human dose escalation study of ¹⁷⁷Lu-LNC1010 in patients with advanced/metastatic NETs. ¹⁷⁷Lu-LNC1010 was well-tolerated by all patients, with minor adverse effects, and exhibited significant uptake and prolonged retention in tumor lesions, with higher tumor radiation doses than those of ¹⁷⁷Lu-EB-TATE. Preliminary PRRT efficacy results showed an 83% disease control rate and a 42% overall response rate after two ¹⁷⁷Lu-LNC1010 treatment cycles. These encouraging findings warrant further investigations through multicenter, prospective, and randomized controlled trials.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective To evaluate the recognition capability of AI-enabled Cellsee CS-BM1 automatic cell morphology analyzer for pe-ripheral blood smears and its roles in assisting manual classification,and explore the application value of AI system in the diagnosis network of tiered primary medical units.Methods The blood samples which triggered the re-examination rules were collected from six primary medical units,including the Laboratory Department of Shanghai Jiahui International Hospital,and so on,from March to No-vember 2023.The smears of peripheral blood were prepared and AI analyzer was used for pre-classification to evaluate its recognition performance in identifying the samples with abnormal WBC and RBC.The sensitivity,specificity,and accuracy of WBC classification by six junior and intermediate technicians,both with and without AI assistance,were analyzed.Additionally,the roles of the AI system in tiered diagnosis of primary medical units were also evaluated.Results The sensitivity,specificity,and accuracy of AI system in recognizing malignant primitive cells were 92.86％,95.16％,and 95.10％,respectively.The sensitivities of AI system in recognizing immature granulocytes,reactive lymphocytes,and nucleated RBCs were all greater than 90％.The sensitivity of AI system in identif-ying abnormal morphology of RBCs reached 99.59％,along with rapid quantitative analysis for various anomalous types of RBCs.In AI-assisted mode,the sensitivity of recognition for all cell types was improved to varying degrees by junior and intermediate technicians,and the sensitivity for recognizing malignant primitive cells,reactive lymphocytes,and immature granulocytes increased to 58.24％,53.39％,and 62.37％for junior technicians,and to 92.06％,83.24％,and 83.12％for intermediate technicians,respectively.The improvements for junior technicians were particularly significant,with increases of 12.46％,10.61％,and 3.71％for each cell type,respectively.Both groups achieved higher specificity and accuracy.Through AI pre-classification and manual review,a variety of pe-ripheral blood cell-related diseases were accurately diagnosed in the tiered healthcare practice of primary medical units,including 339 cases(11.13％)of red blood cell diseases,5 cases(0.16％)of platelet diseases,2 343 cases(76.90％)of infection-related disea-ses,and 28 cases(0.92％)of malignant hematological diseases.In addition,332 cases(10.90％)which lacked an obvious related cause or required further examinations were identified as well.Conclusion AI pre-classification has demonstrated strong cell recogni-tion capabilities and may assist technicians in improving the sensitivity,specificity,and accuracy of blood cell classification.AI could en-hance the disease-screening capabilities in the tiered diagnosis network of primary medical units,presenting a broad application prospect.

Objective:To explore the application value of selective transurethral plasma kinetic resection of the prostate (PKRP) and transurethral holmium laser enucleation of the prostate (HoLEP) in the treatment of diabetes benign prostatic hyperplasia (BPH).Methods:A total of 114 patients with diabetes BPH diagnosed and treated in Lanxi People′s Hospital from September 2020 to September 2023 were retrospectively selected and divided into resection group and enunciation group according to the operation method, with 57 cases in each group. The resection group received selective PKRP and the enucleation group received HoLEP. Preoperative and postoperative stress response indexes were compared between the two groups, as well as urodynamics indexes and complications before and 3 months after surgery.Results:The quality of prostatectomy in the enucleation group was higher than that in the resection group : (39.68 ± 3.02) g vs. (30.25 ± 2.84) g; the operation time, intraoperative blood loss, bladder irrigation time and hospital stay in the enucleation group were lower than those in the resection group: (63.84 ± 5.44) min vs. (72.58 ± 11.33) min, (62.38 ± 15.84) ml vs. (89.54 ± 17.91) ml, (1.84 ± 0.71) d vs. (2.35 ± 0.80) d, (4.98 ± 1.16) d vs.(5.64 ± 1.05) d, there were statistical differences ( P<0.05). The levels of serum cortisol (COR) and norepinephrine (NE) in the enucleation group at 1, 3 d after surgery were lower than those in the excision group [1 d after surgery: (279.76 ± 17.82) ng/L vs. (289.51 ± 18.37) ng/L, (287.44 ± 26.51) ng/L vs. (300.47 ± 28.35) ng/L; 3 d after surgery: (236.58 ± 15.98) ng/L vs. (247.46 ± 16.47) ng/L, (269.13 ± 23.51) ng/L vs. (278.76 ± 25.62) ng/L, there were statistical differences ( P<0.05). Three months after surgery, the maximum urine flow rate in the enucleation group was higher than that in the excision group : (21.51 ± 3.82) ml/s vs. (18.74 ± 4.17) ml/s, and the residual urine volume (RUV) was lower than that in the excision group : (8.47 ± 3.06) ml vs. (10.25 ± 2.43) ml, there were statistical differences ( P<0.05). There was no significant difference in the incidence of urethral stricture and urinary incontinence between the two groups ( P>0.05). Conclusions:HoLEP for the treatment of diabetes BPH can reduce stress response, promote disease recovery, improve urodynamics, and has a safety comparable to that of selective PKRP.