BACKGROUND:The number of patients receiving total knee arthroplasty has been increasing globally each year.Pain management is a crucial aspect following total knee arthroplasty,as effective pain control can facilitate early mobilization,reduce complications,enhance patient satisfaction,and accelerate the rehabilitation process.OBJECTIVE:To construct a visual map of post-total knee arthroplasty pain,understand the international research status and trends in this field,and provide a reference for future studies.METHODS:Relevant research articles on post-total knee arthroplasty pain were retrieved from the CNKI,WanFang Data,and Web of Science core databases,covering the period from January 2000 to December 2023.The CiteSpace software(version 6.2.3)was used to analyze the annual publication output,authors,institutions,countries,keywords,and references.Utilizing R programming language(version 4.4.1),a database was established to create line charts and bar graphs.RESULTS AND CONCLUSION:(1)Our analysis included 3 796 publications,predominantly in Chinese(3 509 articles)with the remainder in English(287 articles).(2)The United States was the most productive country in English literature,with Harvard University leading institutional output.Guangzhou University of Chinese Medicine was the top publishing institution in Chinese literature.(3)Keyword clustering identified"quality of life,""phobia,"and"acupuncture"as emerging focal points in Chinese literature,while"satisfaction"and"psychological factors"were prominent in English literature over the past five years.Co-occurrence and clustering analysis revealed dense internal connections among institutions,authors,and publications,but sparse external collaborations.(4)The study's bias on visualization analysis may have introduced bias by excluding less influential papers.(5)Regarding research hotspots,domestic research emphasized the efficacy and exploration of analgesic methods,in contrast to international research that focused on pain mechanism subtyping and analgesic drug innovation.Future research is expected to trend towards traditional Chinese medicine for postoperative pain,multimodal analgesia,and the investigation and prevention of pain typing mechanisms.

BACKGROUND:The number of patients receiving total knee arthroplasty has been increasing globally each year.Pain management is a crucial aspect following total knee arthroplasty,as effective pain control can facilitate early mobilization,reduce complications,enhance patient satisfaction,and accelerate the rehabilitation process.OBJECTIVE:To construct a visual map of post-total knee arthroplasty pain,understand the international research status and trends in this field,and provide a reference for future studies.METHODS:Relevant research articles on post-total knee arthroplasty pain were retrieved from the CNKI,WanFang Data,and Web of Science core databases,covering the period from January 2000 to December 2023.The CiteSpace software(version 6.2.3)was used to analyze the annual publication output,authors,institutions,countries,keywords,and references.Utilizing R programming language(version 4.4.1),a database was established to create line charts and bar graphs.RESULTS AND CONCLUSION:(1)Our analysis included 3 796 publications,predominantly in Chinese(3 509 articles)with the remainder in English(287 articles).(2)The United States was the most productive country in English literature,with Harvard University leading institutional output.Guangzhou University of Chinese Medicine was the top publishing institution in Chinese literature.(3)Keyword clustering identified"quality of life,""phobia,"and"acupuncture"as emerging focal points in Chinese literature,while"satisfaction"and"psychological factors"were prominent in English literature over the past five years.Co-occurrence and clustering analysis revealed dense internal connections among institutions,authors,and publications,but sparse external collaborations.(4)The study's bias on visualization analysis may have introduced bias by excluding less influential papers.(5)Regarding research hotspots,domestic research emphasized the efficacy and exploration of analgesic methods,in contrast to international research that focused on pain mechanism subtyping and analgesic drug innovation.Future research is expected to trend towards traditional Chinese medicine for postoperative pain,multimodal analgesia,and the investigation and prevention of pain typing mechanisms.

ObjectiveTo verify the clinical efficacy of Qingfei Huatan Tongqiao Formula in treating children with adenoid hypertrophy （AH） of the lung-heat obstructing the nose syndrome， and to observe its effects on quality of life. MethodsA multicenter， double-blind， double-dummy， randomized controlled clinical trial was conducted. A total of 160 pediatric AH outpatients meeting the inclusion and exclusion criteria were enrolled between November 2022 and November 2024 from Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， Shanghai Municipal Hospital of Traditional Chinese Medicine， Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine， and Yueyang Hospital of Integrated Traditional Chinese and Western Medicine. The children were randomly assigned to a treatment group （80 cases） or a control group 80 cases）. The treatment group received Qingfei Huatan Tongqiao Formula combined with a montelukast sodium placebo， while the control group received a Qingfei Huatan Tongqiao Formula placebo combined with montelukast sodium. The treatment course lasted 90 days. After treatment， therapeutic efficacy， sleep monitoring parameters， and Obstructive Sleep Apnea-18 （OSA-18） scores were compared between groups. ResultsCompared with pre-treatment values within each group， both groups showed significant decreases in the adenoid-to-nasopharyngeal ratio （A/N）， primary symptom scores， and TCM syndrome scores. OSA-18 scores were significantly reduced. Sleep monitoring showed decreases in the Apnea-Hypopnea Index （AHI） and Oxygen Desaturation Index （ODI）， and an increase in minimum SpO₂ （all P<0.05）. After treatment， compared with the control group， the treatment group had a lower A/N ratio and higher overall effectiveness rate and TCM syndrome effectiveness rate. The treatment group also had lower total OSA-18 scores and lower subscale scores （sleep disturbance， physical symptoms， emotional distress， and caregiver impact）， with statistically significant differences （all P<0.05）. There was no significant difference in daytime symptoms （P=0.201）. Regarding sleep monitoring indices， the treatment group had lower AHI and ODI and higher minimum SpO₂ （all P<0.05）， with no significant difference in average SpO₂ （P=0.116）. ConclusionQingfei Huatan Tongqiao formula can significantly reduce adenoid size in children with AH， alleviate clinical symptoms， improve quality of life， reduce sleep-disordered breathing events， and ameliorate hypoxia. Its therapeutic efficacy is significantly superior to that of montelukast sodium.

Objective: To explore the influencing factors of incident caries at age 5 among caries-free 3-year-old children in Beijing, construct a machine learning prediction model based on oral health behavioral data, and provide a scientific basis and practical tool for early risk identification, stratified prevention and control, and home-kindergarten-medical collaborative intervention of incident dental caries in preschool children. Methods: This study has been reviewed and approved by the Medical Ethics Committee, and written informed consent was obtained from the guardians of the study participants and their guardians. Children with complete baseline data at age 3 and follow-up data at age 5 from Beijing public oral health programs were included. Oral examinations were conducted according to World Health Organization diagnostic criteria, and questionnaires were completed by guardians. Risk factors were screened by Logistic regression. The total sample was randomly divided into a test set (20%) and a validation set (80%). Five-fold cross-validation was performed on the validation set for model training and tuning, and the final model performance was evaluated on the test set. Four machine learning models—decision tree, random forest, Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM)—were constructed. Model performance was evaluated using the area under the curve (AUC), accuracy, and specificity. Shapley Additive Explanations (SHAP) was used for model interpretation. Results: The incidence of incident caries for 3 372 5-year-old children in Beijing was 50.96%. Multivariate logistic regression showed that parental caries, sleeping with milk, frequent feeding at night, no postprandial cleaning, high sugar intake, insufficient bedtime tooth brushing, and non-fluoride toothpaste use were significant risk factors (P < 0.05). Although all four machine learning models performed well, the XGBoost model performed the best (AUC = 0.806). Feature importance and SHAP analysis indicated that the frequency of bedtime tooth brushing, the frequency of candy consumption, and parental caries status were the top three predictors. Conclusion The XGBoost model based on oral health behaviors at age 3 can accurately predict the risk of incident caries in 5-year-old children in Beijing. Bedtime tooth brushing, sugar control, and parental oral health management are key points for caries prevention in preschool children.

To explore the correlation between human body fat distribution and carotid athero-sclerosis.

Objective To investigate the relationship between between the levels of serum malondialdehyde(MDA)and superoxide dismutase(SOD),the balance of oxidative/antioxidant stress,and the prognostic nu-tritional index(PNI)and the risk of early neurological deterioration in patients with acute ischemic stroke(AIS).Methods A total of 95 patients with suspected AIS admitted to the Second People's Hospital of Fos-han,Foshan from January to April 2023 were selected as the research subjects.Among them,71 patients who were finally diagnosed with AIS were included in the stroke group,and the remaining 24 non-AIS patients were included in the control group.According to the National Institutes of Health Stroke Rating Scale(NIH-SS)score,the stroke group was divided into the moderate-severe stroke group and the mild stroke group.Ac-cording to whether early neurological deterioration(END)occurred,it was divided into the END group and the non-END group.To analyze the correlations between the levels of serum SOD and MDA,SOD/MDA,and the PNI and the severity of stroke.The receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of each index for the risk of END.By fitting the indicators with high diagnostic efficacy,a Fisher discriminant function model for evaluating the risk of END was established to verify the overall accura-cy rate.Results The levels of serum MDA and SOD,SOD/MDA and the PNI in the moderate to severe stroke group were statistically different from those in the mild stroke group(P＜0.05).There were statistically sig-nificant differences in the levels of serum MDA and SOD,SOD/MDA and the PNI among the END group,the non-END group and the control group(P＜0.05).The areas under the curve(AUC)of SOD,MDA,SOD/MDA and PNI for evaluating END were 0.692,0.727,0.777 and 0.819,respectively.The Fisher discriminant function model established by fitting the NIHSS score,the SOD/MDA and the PNI has an overall accuracy rate of 85.9％.Conclusion The END risk prediction model established by applying the Fisher discriminant function can provide early and objective reference basis for clinical prediction of END risk and has certain practical value.

Objective To evaluate the application of serum soluble suppression of tumorigenicity-2(sST2),glo-merular filtration rate(GFR),and serum iron(SI)combined test for predicting prognosis of acute decompensated heart failure(ADHF)patients.Methods A total of 575 ADHF patients were included in this study.Serum sST2,GFR,SI levels and other biomarkers were measured and followed up.Patients were divided into poor prognosis and good prognosis groups based on the occurrence of major adverse cardiovascular events(MACEs).Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the prognostic value of these indicators,and receiver operating characteristic(ROC)curves were employed to compare the prediction outcome of single and combined indicators.Results In the poor prognosis group,heart rate,systolic blood pressure,diastolic blood pres-sure and fasting blood glucose level were all significantly higher than in those in the control group(P＜0.05).Ad-ditionally,the poor prognosis group had higher level of sST2 and total iron-binding capacity,while GFR,SI and transferring saturation were lower as compared to control group(P＜0.05).Cox multivariate survival analysis showed that sST2,GFR,and SI were independent predictors of poor prognosis in ADHF patients(P＜0.05).Kaplan-Meier survival analysis revealed that higher level of sST2 was associated with poor survival prognosis.ROC curve analysis showed that when the biomarkers like sST2,GFR and SI were used together,the area under the curve(AUC)in-creased to 0.834,with a sensitivity of 80.2%and a specificity of 75.6%.Conclusions Combination test of serum sST2,GFR and SI significantly supports the predictive function for ADHF patients'prognosis.The highest AUC val-ue from the combined biomarker prediction may contribute to a more accurate assessment of patient risk.This com-bined test of indicators provides a more reliable tool for clinicians in terms of early identification of high-risk pa-tients,guiding treatment decisions and improving the prognosis management of patients.

Objective This study aims to investigate the expression, phenotypic changes, and mechanisms of action of guanylate-binding protein 2 (GBP2) in the process of silica-induced pulmonary fibrosis. Methods The expression and localization of GBP2 in silicotic lung tissue were detected by immunohistochemical staining and immunofluorescence. An in vitro cell model was constructed, and methods such as Western blot and real-time quantitative reverse transcription polymerasechain reaction were utilized to investigate the function of GBP2 in different cell lines following silica stimulation. The mechanism of action of GBP2 in various cell lines was elucidated using Western blot analysis. Results GBP2 was highly expressed in the lung tissue of patients with silicosis. Immunohistochemical staining and immunofluorescence have revealed that GBP2 was localized in macrophages and epithelial cells. In vitro cell experiments demonstrated that silicon dioxide stimulated THP-1 cells to activate the c-Jun pathway through GBP2, promoting the secretion of inflammatory factors and facilitating the occurrence of M2 macrophage polarization. In epithelial cells, GBP2 promoted the occurrence of epithelial to mesenchymal transition (EMT) by upregulating Krueppel-like factor 8 (KLF8). Conclusion GBP2 not only activates c-Jun in macrophages to promote the production of inflammatory factors and the occurrence of M2 macrophage polarization, but also activates the transcription factor KLF8 in epithelial cells to induce EMT, collectively promoting the progression of silicosis.
Humans ; Silicosis/genetics* ; Macrophages/cytology* ; Epithelial Cells/pathology* ; GTP-Binding Proteins/physiology* ; Epithelial-Mesenchymal Transition ; Disease Progression ; Cell Line ; Male

Protrusive facial deformities, characterized by the forward displacement of the teeth and/or jaws beyond the normal range, affect a considerable portion of the population. The manifestations and morphological mechanisms of protrusive facial deformities are complex and diverse, requiring orthodontists to possess a high level of theoretical knowledge and practical experience in the relevant orthodontic field. To further optimize the correction of protrusive facial deformities, this consensus proposes that the morphological mechanisms and diagnosis of protrusive facial deformities should be analyzed and judged from multiple dimensions and factors to accurately formulate treatment plans. It emphasizes the use of orthodontic strategies, including jaw growth modification, tooth extraction or non-extraction for anterior teeth retraction, and maxillofacial vertical control. These strategies aim to reduce anterior teeth and lip protrusion, increase chin prominence, harmonize nasolabial and chin-lip relationships, and improve the facial profile of patients with protrusive facial deformities. For severe skeletal protrusive facial deformities, orthodontic-orthognathic combined treatment may be suggested. This consensus summarizes the theoretical knowledge and clinical experience of numerous renowned oral experts nationwide, offering reference strategies for the correction of protrusive facial deformities.
Humans ; Orthodontics, Corrective/methods* ; Consensus ; Malocclusion/therapy* ; Patient Care Planning ; Cephalometry

Atopic dermatitis and psoriasis are two chronic inflammatory skin diseases with distinct immune mechanisms, primarily driven by Th2-type inflammation and Th1/Th17 pathways, respectively. However, some patients may simultaneously or sequentially exhibit overlapping phenotypes of atopic dermatitis and psoriasis (psoriasis-atopic dermatitis overlap, PAO), characterized by the coexistence of scaly erythema and eczematous lesions. Currently, the nomenclature, diagnostic criteria, and pathogenesis of PAO remain unclear, and its incidence is increasing due to the widespread use of targeted therapies. The diagnosis of PAO requires an integrated assessment of clinical features, histopathological findings, and biomarker profiles, while treatment necessitates a balance between immune modulation and individualized strategies. This article summarizes the characteristic manifestations of and genetic-immune interactions involved in PAO based on clinical practice, and explores diagnostic challenges and therapeutic options to address this complex and increasingly prominent clinical issue.