Objective: To investigate the effect of periodontal inflammation of maxillary molars on the mucosal thickening of the maxillary sinus and to provide references for the prevention and treatment of odontogenic maxillary sinusitis. Methods: This study was approved by the hospital’s Medical Ethics committee. A retrospective analysis was conducted on the cone beam CT (CBCT) images of the maxillary sinuses of 246 patients with periodontitis. Based on the inclusion and exclusion criteria, a total of 331 maxillary sinus images were finally included. The molars with the most severe periodontal inflammation were selected for statistical analysis, including 270 first molars and 61 second molars. CBCT images of these patients were collected. Periodontal indices of maxillary molars [minimum remaining alveolar bone height (minRABH), degree of alveolar bone absorption, furcation involvement, and vertical bone loss] were measured. The correlation between these periodontal indices and maxillary sinus mucosal thickening (defined as normal when the maximum thickness of the maxillary sinus mucosa ≤ 2 mm and thickening when>2 mm) was analyzed. Results: Among the 331 maxillary molars and their corresponding maxillary sinuses, 264 cases showed thickening of the maxillary sinus mucosa, with an average thickness of (5.9 ± 5.1) mm, accounting for 79.8%. The thickening of the maxillary sinus mucosa was significantly correlated with periodontal indices, including minRABH, degree of alveolar bone absorption, furcation involvement, and vertical bone loss (P<0.05), as well as with tooth position (P<0.05). Further binary logistic regression analysis revealed that the possibility of maxillary sinus mucosal thickening in the minRABH<4 mm group was 5.6 times that of the group with minRABH ≥ 10 mm. The possibility of maxillary sinus mucosal thickening in the group with minRABH of 4-10 mm was 2.2 times that of the group with minRABH ≥ 10 mm. The possibility of maxillary sinus mucosal thickening caused by periodontitis in the second maxillary molar was 2.8 times that of the first maxillary molar. minRABH and tooth position of the maxillary molar had a more significant impact on the thickening of the maxillary sinus mucosa compared to other factors (P<0.05). Conclusion When the minRABH of maxillary molars is less than 4 mm or when the tooth position is the second maxillary molar, the possibility of thickening of the maxillary sinus mucosa increases. This suggests that thorough periodontal treatment is an important factor in preventing odontogenic maxillary sinusitis.

Objective:To retrieve and integrate the best evidence on foot offloading management for diabetic high-risk foot patients, and to provide evidence-based basis for effectively preventing the occurrence and development of diabetic foot ulcers.Methods:Clinical practice guidelines, evidence summaries, systematic reviews and expert consensus on the management of foot offloading at high risk of diabetes were searched in Chinese and English databases, domestic and foreign diabetes association websites, clinical decision websites and guideline websites, retrieval time for libraries to March 31, 2024, respectively, by the 2 researchers quality evaluation, evidence extraction, the final summary.Results:A total of 16 articles were included, including 6 guidesline, 5 expert consensuses, 1 evidence summary and 4 systematic reviews. According to the existing evidence, the best evidence of foot offloading management in patients with diabetic high-risk foot was summarized from 6 aspects: evaluation, monitoring, referral, offloading brace, exercise advice and risk factor intervention, 14 subcategories, 32 best evidences for foot offloading management in patients with high-risk diabetic foot.Conclusions:This study summarized the best evidence for foot offloading management in patients with high-risk of diabetic foot, which is convenient for the further development of clinical practice of foot offloading management in patients with high-risk of diabetes, and provides evidence-based basis for clinical medical staff to expand related research.

Objective:To establish a quality and safety evaluation index system for the daytime chemotherapy in the Day Medical Management Quality Control Center of Fujian Province, providing references for objectively evaluating the quality of day chemotherapy.Methods:From December 2023 to August 2024, this study screened the initial indexes of the quality and safety evaluation index system for daytime chemotherapy through literature search and expert discussions. An index system and its weights were determined by using two rounds of Delphi method and precedence chart method. The quality of daytime chemotherapy services in 8 hospitals was evaluated by using a thousand point scale checklist based on this index system.Results:The expert motivation of both rounds of Delphi method was 100%, and the expert authority coefficient was 0.92. The quality and safety evaluation index system for daytime chemotherapy included 3 first-level indicators, 13 second-level indicators, and 54 third-level indicators; Among them, the weights of the first-level indicator included structure quality, process quality, and result quality were 0.334, 0.556, and 0.110, respectively. The quality and safety scores of daytime chemotherapy in 8 hospitals ranged from 812 to 980 points, with an average of 933 points.Conclusions:The quality and safety evaluation index system for daytime chemotherapy could objectively and comprehensively evaluate the quality and safety of hospital daytime chemotherapy.

Objective:To compare the clinical and laboratory characteristics and survival between Chinese and Western patients with myelodysplastic neoplasms (MDS) .Methods:Clinical and laboratory data were collected from 1,464 primary adult patients diagnosed with MDS at the Institute of Hematology & Blood Diseases Hospital from August 2016 to June 2024. Collected data were retrospectively analyzed and compared with 2,191 patients from the International Working Group for the Prognosis of Myelodysplastic Syndromes (IWG-PM) .Results:Chinese patients were significantly younger (median age: 56 years vs. 72 years, P<0.001) and experienced more severe hematopenia ( P<0.001) compared with patients from the IWG-PM. Further, Chinese patients exhibited a higher percentage of isolated del (20q), +8, and complex karyotypes as well as a lower percentage of normal karyotypes, del (5q), and -Y ( P<0.001). Higher U2AF1, NRAS, and NPM1 mutation rates and lower ASXL1, SF3B1, and RUNX1 mutation rates were observed in Chinese patients than in participants from the IWG-PM ( P<0.05). No significant difference in overall survival (OS) was found between the two groups (median OS: 48 [95% CI: 40 - 56]months, vs. 45[95% CI: 40 - 49] months; P=0.449). Among participants aged ≤45 years, Chinese patients demonstrated more trisomy 8 ( P=0.070) and U2AF1 mutation ( P<0.001) and higher 4-year OS rate compared with those from the IWG-PM (75.5% vs. 62.1%, P=0.001). Among participants aged ≥70 years, Chinese patients exhibited more complex karyotypes but fewer del (5q) as well as more NPM1 but less SF3B1 and TET2 compared with those from the IWG-PM ( P<0.05). Chinese patients demonstrated shorter survival (median OS: 20 [95% CI: 13 - 27] months vs. 37 [95% CI: 32 - 42] months, P<0.001) . Conclusion:Chinese and Western MDS patients differ in age of onset, clinical features, and cytogenetic or molecular genetic abnormalities, with significant differences persisting in age-matched groups. Although the OS is similar, disparities exist in survival for younger and older patients between the two populations.

Objective:To explore the clinical features and molecular characteristics of myeloproliferative neoplasms (MPNs) patients with NFE2 gene mutations.Methods:Gene targeted sequencing was used to detect NFE2 gene mutation in 723 patients diagnosed with MPNs who were admitted to Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College between April 2021 and June 2023. The association between NFE2 gene mutations and clinical features and molecular characteristics of MPNs patients were retrospectively analyzed.Results:Among 723 patients with MPNs, NFE2 gene mutations were found in 41 cases (5.7%) . NFE2 gene mutations were predominantly frameshift mutations (44.4%) , followed by nonsense mutations (33.3%) . The median number of mutations in patients with NFE2 gene mutations (4 [2,5]) was higher compared to the group without NFE2 gene mutations (2, [1,3]) ( P<0.001) . NFE2 gene mutations frequently co-occurred with mutations in MPL, ATM, PPM1D, and TET1. NFE2 gene mutations were mostly sub-clonal events, with 80.5% occurring after MPNs driver mutations (JAK2, CALR, or MPL) . NFE2 mutations were correlated with older age [median age: 60 (54, 67) years vs 54 (41, 63) years, P=0.001]. Patients with NFE2 gene mutations had a higher incidence of pre-diagnosis thrombosis (39.0% vs 22.0%, P=0.012) and pre-diagnosis arterial thrombosis (36.6% vs 20.4%, P=0.014) . Using a logistic regression analysis model adjusting for age and comorbidities (including chronic infections, malignancies, and autoimmune diseases) , NFE2 gene mutation was identified as an independent determinant of elevated tumor necrosis factor-alpha (TNF-α) ( OR=2.747, 95% CI: 1.143-6.605, P=0.024) , interferon-gamma (IFN-γ) ( OR=2.689, 95% CI: 1.191-6.076, P=0.017) , IL-10 ( OR=3.219, 95% CI: 1.343-7.717, P=0.009) , IL-12P70 ( OR=3.397, 95% CI:1.003-11.508, P=0.049) , IL-17 ( OR=2.284, 95% CI: 1.017-5.127, P=0.045) . In polycythaemia vera (PV) patients with the NFE2 gene mutation, the proportion of those classified as high-risk is notably higher in both the IWG-PV and mutation-enhanced international prognostic systems for PV (MIPSS-PV) (66.7% vs 25.3% for IWG-PV, P=0.033; 22.2% vs 2.0% for MIPSS-PV, P=0.013) . Similarly, for essential thrombocythaemia (ET) patients, the proportion in the high-risk group of the mutation-enhanced international prognostic systems for ET (MIPSS-ET) is significantly higher (15.4% vs 6.1%, P=0.021) . No statistically significant differences were observed in overall survival or cumulative incidence of thrombosis between NFE2-mutated (38 cases) and non-mutated MPNs patients (671 cases, P>0.05) . Conclusion:NFE2 gene mutations in MPNs were predominantly frameshift mutations. NFE2 gene mutations were correlated with older age, elevated levels of several inflammatory factors (including TNF-α、IFN-γ、IL-10、IL-12P70、IL-17) , and they mostly occurred in late-stage of MPNs.

Objective:To investigate the clinical, laboratory, and prognostic features of myelodysplastic neoplasm (MDS) patients harboring acute myeloid leukemia (AML) -like mutations.Methods:We retrospectively analyzed clinical, molecular, and outcome data from 1 464 adults with primary MDS diagnosed at the Institute of Hematology and Blood Diseases Hospital from August 2016 to June 2024.Results:AML-like mutations were detected in 64 patients (4.4% ). Compared with patients without AML-like mutations, those with AML-like mutations were younger [median 50 ( IQR 39–60) vs 56 (45, 65) years; P=0.001], more often female (51.6% vs 35.4% ; P=0.009), had higher bone marrow blast percentage [6.5% (3.0%, 10.5% ) vs 2.5% (1.0%, 7.0% ) ; P<0.001], a higher rate of normal karyotype (75.0% vs 48.1% ; P<0.001), and lower hemoglobin levels [73 (67, 82) g/L vs 80 (66, 98) g/L; P=0.006]. The AML-like group had a higher number of gene mutations than the non-AML-like group [3 ( IQR 2–4) vs 2 (1, 3) ; P<0.001). It was enriched for mutations in NPM1, DNMT3A, WT1, PTPN11, NRAS, BCOR, FLT3, CEBPA, and MYC (all P<0.05) and had lower rates of U2AF1, ASXL1, and TP53 mutations (all P<0.05). Overall survival (OS) did not differ between groups ( P=0.730) ; however, the AML-like group had significantly shorter leukemia-free survival (LFS) [19 months (95% CI: 13–25) vs 46 months (95% CI: 38–54) ; P=0.012] and a higher 2-year cumulative incidence of AML transformation [ (41.7±9.1) % vs (10.4±1.1) % ; P<0.001]. Within the AML-like group, OS, LFS, and cumulative incidence of AML transformation did not differ between patients with low blasts and those with excess blasts (IB). Multivariable Cox regression identified age ≥60 years and PTPN11 mutations as independent adverse prognostic factors for OS, while DNMT3A, PTPN11, and FLT3 mutations independently predicted leukemic transformation. Conclusions:MDS patients harboring AML-like mutations exhibit distinct clinical and molecular features and a higher risk of progression to AML.

Objective:To summarize the evidence for the application and management of continuous glucose monitoring, providing evidence-based support for the clinical application and management.Methods:BMJ Best Clinical Practice, UpToDate, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang and other databases, Yimaitong and and other guide networks, and diabetes related association websites were searched for the application and management of continuous glucose monitoring, the search time limit was from the establishment of the database to July 7, 2024. Researchers evaluated the quality of the included literature, extracted and summarized the evidence based on the topic.Results:A total of 13 articles were included, including 5 guidelines, 5 expert consensuses, 1 systematic review and 2 randomized controlled trials. The best evidences for the application and management of continuous glucose monitoring were summarized, including 3 themes and 13 aspects, practice norms (before, during, and after wearing), application norms, management norms (personnel, systems, information, materials, methods), with 31 pieces of evidence.Conclusions:This study summarized the evidences for the application management of continuous glucose monitoring, which could standardize the operation process of continuous glucose monitoring, provide response strategies for related nursing issues, and ensure that there were unified and clear management standards to follow.

Objective:To establish a method of dual nueleic acid test strips for rapid detection of Bacillus cereus cytK and nhe toxin genes based on polymerase chain reaction(PCR)and colloidal gold technique,and to evaluate its specificity,sensitivity,repeatability and stability.Methods:Bacillus cereus DNA was extracted by boiling method.Specific primers were designed with Bacillus cereus cytK and nhe as the target genes.Clonal transformation was used to identify the PCR products.The optimal labeling amounts of colloidal gold-labeled streptavidin,quality control line(C line),cytK detection line(T1)and nhe detection line(T2)were determined.The nucleic acid test strips were assembled and its specificity,sensitivity,reproducibility and stability were evaluated.Results:The DNA concentration of Bacillus cereus was 248 mg·L-1,and the purities were 1.8-2.0.After cloning and plasmid sequencing,the similarities between the PCR products and the sequences of cytK and nhe registered in the GenBank database were 100％.Under the condition of pH 7.0,the optimal amount of streptavidin labeling per 200 μL of colloidal gold solution was 6.0 μL;the optimal marking amount was 2.00 g·L-1 for the quality control line(C line),0.550 g·L-1 for cytK gene detection line(T1)and 0.2 g·L-1 for nhe gene detection line(T2).In the specificity test,positive result on the test strips was seen only for Bacillus cereus,and no cross-reactivity was observed for Staphylococcus aureus,Escherichia coli,Pseudomonas aeruginosa and Bacillus subtilis,which were consistent with the electrophoresis results.Sensitivity assay showed that even when DNA concentration was reduced to 10-2 mg·L-1,three bands(C line,T1 line and T2 line)could be observed,and the detection limit of the test strip was one-tenth of agarose gel electrophoresis(10-1 mg·L-1).The nucleic acid test strips were verified by different operators in different laboratories,and the results were consistent.The stability of the test strips was verified at the 6th,9th and 12th months,and the results showed good stability.Conclusion:The dual nucleic acid test strip method established in this study can simutaneously detect the cytK and nhe toxin genes of Bacillus cereus with high sensitivity and specificity,achieving short-term visual detection.

Objective:To establish a rapid detection method for pathogenic microorganisms by combining loop-mediated isothermal amplification(LAMP)and clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein 12a(Cas12a)(CRISPR-Cas12a)system,and to evaluate its efficacy for detecting the thermolabile hemolysin(tlh)gene of Vibrio parahaemolyticus(Vp).Methods:Using the tlh gene of Vp as the target gene,LAMP primers and CRISPR RNA(crRNA)were designed to construct and optimize the optimal concentration ratio of each component in the LAMP-CRISPR detection system.Bacillus cereus,Staphylococcus aureus,and Escherichia coli were used as control groups,and the specificity,sensitivity,reproducibility and positive conformity rate were verified to establish a rapid LAMP-CRISPR/Cas12a method for detecting the tlh gene of Vp.Results:The method specifically detected Vp,while Bacillus cereus,Staphylococcus aureus,and Escherichia coli yielded negative results.The DNA extraction concentration of Vp was 190.67 mg·L-1 with an A(260)/(A280)ratio of 1.84.Under the reaction conditions of 37℃ with 80 cycles for 40 min using quantitative PCR(qPCR)method,when the concentrations of Cas12a protein and crRNA in the LAMP-CRISPR/Cas12a system were 50 nmol·L-1,the visual brightness and relative fluorescence intensity peaks were high.The sensitivity of LAMP CRISPR/Cas12a for detecting Vp DNA concentration could reach 10-6 mg·L-1.The reproducibility test results showed that different experimenters had consistent results in different experimental environments and times.Conclusion:The established LAMP-CRISPR/Cas12a method can rapidly detect the tlh gene of Vp with high sensitivity and specificity,and can achieve short-term visual detection in the field.

Objective To establish a management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships and to evaluate its application.Methods The clinical practice,guidelines,expert consensus and systematic evaluation on the prevention and control of sudden respiratory infectious diseases at home and abroad were systematically retrieved.At the same time,the research team proposed a preliminary draft of the management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships by referring to the literatures on the management of major epidemics at home and abroad in recent years.After 2 rounds of discussion and amendment suggested by expert demonstration meetings,the management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships was finally formed,and preliminary verification was carried out in"Mission Harmony-2022".Results The hospital ship management scheme for the prevention and control of sudden respiratory infectious diseases included 6 first-level items,22 second-level items,and 40 third-level items(including 34 level-A recommended indicators and 6 level-B recommended indicators).The scheme was applied in"Mission Harmony-2022"and the task was successfully completed.Conclusion The management scheme for the prevention and control of sudden respiratory infectious diseases on hospital ships is systematic,comprehensive,rigorous,practical and scientific,and can provide a guiding reference for the rescue task of sudden respiratory infectious diseases on hospital ships.