ObjectiveTo explore the surgical methods and its efficacy on severe chronic obstructive pneumonia disease (COPD) with spontaneous pneumothorax.MethodsClinical features and surgical efficacies of 16 cases of severe COPD were analyzed.Results No death occurred and all patients recovered and discharged.The lung function index including subjective symptoms,motor ability and endurance in 14 cases showed obvious improvement compared with those before combination of pneumothorax.Two patients improved to the level before surgery.ConclusionThe lung function index of patients with severe COPD and pnumothorax can be relatively less restricted and open-chest surgery should be performed as soon as possible.Linear nailing and simple lung volume reduction surgery are recommended to improve lung function,shorten operation time and reduce surgical risks.

Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism(VTE)in grassroots hospitals.Methods Based on rel-evant guidelines and expert consensuses on VTE prevention and treatment,domestic and foreign litera-ture was reviewed.A research and development team composed of clinical experts in VTE prevention and treatment,medical and nursing quality management experts,and information engineers conducted investigations and research in surrounding grassroots hospitals.Through evidence-based research and surveys,the team identified relevant business needs,user needs,and functional requirements of grass-roots hospitals,and finally formulated a detailed design plan.The main program of system was written in Java.The interface obtained data from the hospital's data platform through Webservice and view in-terfaces.To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion,the XXL-JOB distributed task schedu-ling platform was adopted to handle VTE assessments by medical staff.Results After the clinical ap-plication of the intelligent VTE prevention and treatment system,the bleeding risk assessment rate in-creased from 26.20％at the initial system launch in January 2023 to 83.04％by the end of 2023.In January 2023,the implementation rates of mechanical prevention,pharmacological prevention,and combined prevention for medium-to-high-risk VTE patients were 21.39％,16.39％,and 5.26％,re-spectively,which increased to 51.75％,25.50％,and 25.65％in December 2023.Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve devel-opment efficiency,enhance the clinical practicality of the system,reduce the workload of medical staff,promote standardization and normalization in VTE prevention and treatment,strengthen closed-loop management of medical quality for VTE as a single disease,and effectively improve the preven-tion and treatment capabilities and levels of VTE within hospitals.

Objective To explore the construction and practice of an intelligent prevention and treatment system for venous thromboembolism(VTE)in grassroots hospitals.Methods Based on rel-evant guidelines and expert consensuses on VTE prevention and treatment,domestic and foreign litera-ture was reviewed.A research and development team composed of clinical experts in VTE prevention and treatment,medical and nursing quality management experts,and information engineers conducted investigations and research in surrounding grassroots hospitals.Through evidence-based research and surveys,the team identified relevant business needs,user needs,and functional requirements of grass-roots hospitals,and finally formulated a detailed design plan.The main program of system was written in Java.The interface obtained data from the hospital's data platform through Webservice and view in-terfaces.To prevent issues of repeated data extraction when multiple applications perform time tasks to assess the same patient during later server usage and expansion,the XXL-JOB distributed task schedu-ling platform was adopted to handle VTE assessments by medical staff.Results After the clinical ap-plication of the intelligent VTE prevention and treatment system,the bleeding risk assessment rate in-creased from 26.20％at the initial system launch in January 2023 to 83.04％by the end of 2023.In January 2023,the implementation rates of mechanical prevention,pharmacological prevention,and combined prevention for medium-to-high-risk VTE patients were 21.39％,16.39％,and 5.26％,re-spectively,which increased to 51.75％,25.50％,and 25.65％in December 2023.Conclusion The VTE prevention and treatment software system developed by grassroots hospitals can improve devel-opment efficiency,enhance the clinical practicality of the system,reduce the workload of medical staff,promote standardization and normalization in VTE prevention and treatment,strengthen closed-loop management of medical quality for VTE as a single disease,and effectively improve the preven-tion and treatment capabilities and levels of VTE within hospitals.

Aging-elevated DNMT3A R882H-driven clonal hematopoiesis (CH) is a risk factor for myeloid malignancies remission and overall survival. Although some studies were conducted to investigate this phenomenon, the exact mechanism is still under debate. In this study, we observed that DNMT3A R878H bone marrow cells (human allele: DNMT3A R882H) displayed enhanced reconstitution capacity in aged bone marrow milieu and upon inflammatory insult. DNMT3A R878H protects hematopoietic stem and progenitor cells from the damage induced by chronic inflammation, especially TNFα insults. Mechanistically, we identified that RIPK1-RIPK3-MLKL-mediated necroptosis signaling was compromised in R878H cells in response to proliferation stress and TNFα insults. Briefly, we elucidated the molecular mechanism driving DNMT3A R878H-based clonal hematopoiesis, which raises clinical value for treating DNMT3A R882H-driven clonal hematopoiesis and myeloid malignancies with aging.

Objective : To investigate the achieved intrusion amount of the maxillary incisors and the influencing factors in clear aligner cases treated with extraction of premolars. Methods : This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. Thirty adult female patients who underwent extraction of the bilateral maxillary first premolars followed by clear aligner therapy were included. CBCT data before and after treatment were obtained, and three-dimensional reconstruction with registration alignment was performed. A spatial coordinate system was established, and the achieved intrusion amount was measured, followed by calculation of the intrusion efficacy. The factors related to the achieved intrusion amount were investigated through multiple linear regression analysis. Results : The overall efficacy of maxillary incisor intrusion was 54%, with the maxillary central incisors (48%) lower than the lateral incisors (59%), which was statistically significant (P<0.001). Regression analysis showed that the designed intrusion amount and the stepwise intrusion design were positively correlated with the achieved intrusion amount. The designed retroclination amount and use of class Ⅱ intermaxillary elastics were negatively correlated with the achieved intrusion amount. The initial overbite, overjet, crowding, upper central incisor inclination, amount of the first series of aligners, canine attachment type, posterior teeth attachment type and bite ramps had no significant correlation with the achieved intrusion amount. Conclusion In maxillary first premolar extraction cases treated with clear aligners, the upper central incisors have lower efficacy of intrusion movement than the lateral incisors. The achieved intrusion amount of maxillary incisors was influenced by multiple factors, which should be considered comprehensively for better vertical control in such cases.