A unified consensus statement on medication-related osteonecrosis of the jaw (MRONJ) has not yet been established among the Asian member countries or regions of the Asian Federation of Osteoporosis Societies (AFOS). This study aimed to develop a consensus on MRONJ in patients with osteoporosis across these countries and regions. In this study, the term “Asia-Pacific” refers specifically to the Asian member countries and regions of AFOS. A structured survey consisting of nine MRONJ-related questions was distributed across 10 countries and regions to assess the level of agreement and summarize regional perspectives. In addition, a manual literature review and voting were conducted to evaluate the current evidence on MRONJ. The key aspects of MRONJ, including definition, staging, diagnosis, pathogenesis, risk factors, management, and prevention, were generally consistent among the AFOS countries and regions. The annual incidence and incidence rate of MRONJ associated with low-dose antiresorptive therapy in patients with osteoporosis ranged from 0.025% to 0.136% and 21 to 283 cases per 100,000 person-years, respectively. However, evidence regarding the benefits of drug discontinuation before dental surgery, such as tooth extraction, remains insufficient. Large-scale, multinational studies across AFOS countries and regions are warranted to determine the incidence of MRONJ better and evaluate the impact of antiresorptive drug discontinuation before dental procedures. These findings may contribute to the devel opment of effective evidence-based strategies for preventing MRONJ in patients with osteoporosis.

Objective To analyze the related factors of recurrent readmission in patients with hypertriglyceridemic acute pancreatitis(HTG-AP)in the short term,and to construct and verify the risk early warning model.Methods A total of 176 patients with HTG-AP admitted from January to November 2023 were selected as the research objects.According to whether they were readmitted and recurred in the short term,they were divided into recurrent readmission group(n=53)and non-recurrent readmission group(n=123).Univariate and multivariate Logistic regression were used to construct the risk prediction model.A total of 53 HTG-AP patients admitted from December 2023 to April 2024 were selected for external validation of the model.Results The probability of recurrence and readmission in 176 patients with HTG-AP in the short term was 30.11％.According to univariate and Logistic multivariate analysis,the results showed acute physiology and chronic health evaluation Ⅱ score ≥ 8 points,Ranson score ≥ 3 points,neutrophil to lymphocyte ratio,serum amylase and lactic dehydrogenase were independent risk factors for recurrence and readmission in HTG-AP patients in the short term,while Ca2+was the protective factor(P＜0.05).According to the H-L goodness of fit test results of 176 patients with HTG-AP,x2=5.212,P=0.735;Area under the curve(AUC)was 0.877(P＜0.001,95％CI:0.824-0.931),the sensitivity was 86.80％,the specificity was 73.20％,and the maximum Youden index was 0.600.According to the H-L goodness of fit test results of 53 patients with HTG-AP,x2=3.391,P=0.907;AUC was 0.881(P＜0.001,95％CI:0.791-0.971),the sensitivity was 78.10％,the specificity was 81.00％,and the maximum Youden index was 0.591.The results showed that the model had good goodness of fit and good predictive efficacy in predicting the short-term recurrence of HTG-AP patients.Conclusion The short-term recurrence and readmission of HTG-AP patients are affected by multiple factors,and the risk prediction model has good consistency and discrimination.

Digital storytelling,as an emerging form of communication and therapy,is subtly transforming the landscape of clinical care.This paper systematically introduces the historical evolution,fundamental methods,and clinical applications of digital storytelling,while exploring and analyzing its effects on various patient groups.A comprehensive evaluation index system has been developed,with the aim of providing references and evidence for the broader application and development of digital sto-rytelling in clinical care,along with recommendations for improvement to address existing limitations.

Digital storytelling,as an emerging form of communication and therapy,is subtly transforming the landscape of clinical care.This paper systematically introduces the historical evolution,fundamental methods,and clinical applications of digital storytelling,while exploring and analyzing its effects on various patient groups.A comprehensive evaluation index system has been developed,with the aim of providing references and evidence for the broader application and development of digital sto-rytelling in clinical care,along with recommendations for improvement to address existing limitations.

Objective:To investigate the effects of different intensities of grip strength training on arteriovenous fistula (AVF) in patients with chronic kidney disease.Methods:Different intensities of grip strength training programs were developed through literature analysis, expert argumentation, and group discussion. From July to November 2024, 90 hospitalized patients with chronic kidney disease and AVF in the Department of Nephrology of the First Affiliated Hospital of Hunan Traditional Chinese Medical College were selected as study subjects using convenience sampling. Using the random number table method, study subjects were divided into group A, group B, and group C, with 30 cases in each group. Group A underwent low-intensity grip strength training, group B underwent moderate-intensity grip strength training, and group C underwent high-intensity grip strength training. The intervention period lasted six weeks. After intervention, the internal diameter of the cephalic vein, anastomotic blood flow, and incidence of complications were compared among three groups of patients with chronic kidney disease.Results:After intervention, the internal diameter of the cephalic vein in group C was larger than that in group A and group B ( P<0.05). The anastomotic blood flow in group B and group C was higher than that in group A ( P<0.05). There was no statistically significant difference in the incidence of complications among the three groups ( P>0.05) . Conclusions:Appropriately increasing the intensity of grip strength training has a positive effect on enlarging the internal diameter of the cephalic vein and enhancing anastomotic blood flow.

Aim To investigate the protective effects of resveratrol(RSV)on hypoxia/reoxygenation(H/R)-induced apoptosis in H9c2 cardiomyocytes and the un-derlying mechanisms.Methods A model of H/R was established in H9c2 cardiomyocytes.Cell apoptosis was determined by flow cytometry.The expressions of Bax,Bcl-2,cleaved caspase-3 and JAK2/STAT3 signa-ling pathway proteins were detected by Western blot.The inhibitor of JAK2,AG490,was used to assess the effect of RSV on H/R-induced apoptosis in H9c2 car-diomyocytes after inhibiting JAK2/STAT3 signaling pathway.Results RSV could effectively inhibit H/R-provoked cell apoptosis in H9c2 cardiomyocytes and increase the expression of p-JAK2 and p-STAT3.After AG490 intervention,the anti-apoptotic effect of RSV on H9c2 cardiomyocytes caused by H/R was significantly counteracted.Conclusions RSV can inhibit H/R-in-duced apoptosis in H9c2 cardiomyocytes through the activation of JAK2/STAT3 signaling pathway.

Objective·To analyze the molecular epidemiological characteristics of Klebsiella pneumoniae isolated from children,including the distribution of serotypes,resistance genes,and virulence genes,to provide a scientific basis for the prevention and treatment strategies of Klebsiella pneumoniae infections in children.Methods·A total of 133 non-duplicate strains of Klebsiella pneumoniae clinically isolated from Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine,from April 2023 to April 2024,were collected.Antimicrobial susceptibility testing was performed by using the Vitek-2 Compact system.Capsular polysaccharide K antigen serotypes(K types)were determined by wzy-dependent initiator(wzi)gene sequencing.Resistance genes were detected by the colloidal gold method.Virulence genes and lipopolysaccharide O antigen serotypes(O types)were identified by PCR method.Results·Among the 133 strains of Klebsiella pneumoniae,a total of 50 strains of carbapenem-resistant Klebsiella pneumoniae(CRKP)were detected,mainly distributed in the neonatal ward and intensive care unit(ICU).CRKP exhibited high resistance to most antimicrobial agents,and the main type of carbapenemase gene was blaNDM(34/50,68.00%),followed by co-carriage of blaNDM+blaOXA-48(10/50,20.00%)and blaKPC(6/50,12.00%).Serotype analysis revealed that the 50 CRKP strains could be divided into 8 K types and 6 O types.The most common K type was KL17(30/50,60.00%),followed by KL105(10/50,20.00%)and KL47(5/50,10.00%).The most common O type was O4(30/50,60.00%),followed by O3b(7/50,14.00%,),O3/O3a(6/50,12.00%),and OL101(5/50,10.00%).Significant correlations were identified between KL47 and OL101 serotypes(KL47:OL101),between KL17 and O4 serotypes(KL17:O4),and between KL1/KL2 and O1 serotypes(KL1/KL2:O1).Conclusion·The CRKP strains infecting children primarily carry blaNDM-type carbapenemase genes,showing a significant difference compared to CRKP-infected adults.The detection rate of CRKP in the neonatal ward is significantly higher than those in other departments,suggesting that infection prevention and control measures in this ward need to be strengthened.

Objective:To construct a dynamic competency assessment system suitable for standardized training of resident physicians in the department of pediatric infectious diseases, verify its teaching practice effectiveness, and enhance the core competence of specialist physicians.Methods:Based on the Delphi method, an evaluation system was constructed. Through two rounds of expert consultation ( n=20, authority coefficient Cr=0.889-0.895), 5 primary indicators, 13 secondary indicators, and 38 tertiary indicators were established, covering dimensions such as clinical thinking, operational skills, and professional ethics. The hierarchical and progressive design and dynamic feedback mechanism were adopted. Sixty residents were randomly divide into an observation group (dynamic evaluation system) and a control group (traditional evaluation). Differences between the two groups were compared in terms of short-term teaching effectiveness (e.g., OSCE assessment and Mini CEX score) and long-term clinical competencies (e.g., exit assessment pass rate and incidence of adverse events). SPSS 24.0 was used for t-test, Mann Whitney U test, and internal consistency test (Cronbach's alpha=0.89). Results:The observation group outperformed the control group in core specialty competencies and clinical practice outcomes. In terms of core specialty competencies, the observation group had a higher response speed score for pathogen results [(4.10±0.84) vs. (3.60±0.95), P=0.042]. This indicates that the dynamic evaluation system effectively enhanced the ability of trained physicians to quickly adjust treatment plans based on pathogenic evidence. The implementation rate of infection prevention and control standards and diagnostic accuracy were also higher in the observation group compared to the control group, reflecting the advantages of this system in standardizing clinical operations and improving diagnostic levels. In terms of long-term clinical competencies, the observation group showed significantly increased exit assessment pass rate and significantly decreased incidence of medical adverse events, further verifying the continuous promotion effect of the dynamic evaluation system on the clinical competence of trained physicians. Conclusions:The dynamic evaluation system constructed in this study can effectively enhance the core specialty competencies (e.g., pathogen response and infection prevention and control) and long-term clinical competence of residents in the department of pediatric infectious diseases, providing scientific basis for optimizing the training models of specialist physicians.

Objective To analyze the related factors of recurrent readmission in patients with hypertriglyceridemic acute pancreatitis(HTG-AP)in the short term,and to construct and verify the risk early warning model.Methods A total of 176 patients with HTG-AP admitted from January to November 2023 were selected as the research objects.According to whether they were readmitted and recurred in the short term,they were divided into recurrent readmission group(n=53)and non-recurrent readmission group(n=123).Univariate and multivariate Logistic regression were used to construct the risk prediction model.A total of 53 HTG-AP patients admitted from December 2023 to April 2024 were selected for external validation of the model.Results The probability of recurrence and readmission in 176 patients with HTG-AP in the short term was 30.11％.According to univariate and Logistic multivariate analysis,the results showed acute physiology and chronic health evaluation Ⅱ score ≥ 8 points,Ranson score ≥ 3 points,neutrophil to lymphocyte ratio,serum amylase and lactic dehydrogenase were independent risk factors for recurrence and readmission in HTG-AP patients in the short term,while Ca2+was the protective factor(P＜0.05).According to the H-L goodness of fit test results of 176 patients with HTG-AP,x2=5.212,P=0.735;Area under the curve(AUC)was 0.877(P＜0.001,95％CI:0.824-0.931),the sensitivity was 86.80％,the specificity was 73.20％,and the maximum Youden index was 0.600.According to the H-L goodness of fit test results of 53 patients with HTG-AP,x2=3.391,P=0.907;AUC was 0.881(P＜0.001,95％CI:0.791-0.971),the sensitivity was 78.10％,the specificity was 81.00％,and the maximum Youden index was 0.591.The results showed that the model had good goodness of fit and good predictive efficacy in predicting the short-term recurrence of HTG-AP patients.Conclusion The short-term recurrence and readmission of HTG-AP patients are affected by multiple factors,and the risk prediction model has good consistency and discrimination.

Aim To explore the relationship between serum levels of proprotein convertase subtilisin/kexin type 9(PCSK9),macrophage migration inhibitory factor(MIF)and the severity of coronary artery lesions in patients with coro-nary heart disease(CHD).Methods A cross-sectional study was conducted involving 139 patients with CHD and 69 control subjects who underwent coronary angiography during the same period,all of whom were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from November 2023 to May 2024.Clinical data and coronary angiography results were collected,and the severity of coronary artery stenosis was quantitatively assessed using the Gensini score.Pa-tients with the Gensini scores＞0 were classified into three groups based on tertiles:the mild stenosis group(1～18 points,54 cases),the moderate stenosis group(19～36 points,54 cases),and the severe stenosis group(＞36 points,54 ca-ses).Serum levels of PCSK9 and MIF were measured by ELISA kit.Results Serum levels of PCSK9 and MIF were significantly higher in the CHD group than those in the control group(P＜0.05).Multivariable Logistic regression analy-sis revealed that high levels of serum PCSK9 and MIF were independent risk factors for CHD.Spearman correlation analy-sis showed that serum PCSK9 and MIF levels were positively correlated with Gensini score(rs=0.619 6 and r,=0.411 4,both P＜0.001).Further subgroup analysis showed that serum total cholesterol and low density lipoprotein cholesterol lev-els were significantly increased in patients with high-level PCSK9,while patients with high-level MIF had higher inflamma-tory coefficients such as systemic inflammatory response index(SIRI)and systemic immune-inflammation index(SII)(all P＜0.05).Conclusion Serum levels of PCSK9 and MIF are positively correlated with the severity of coronary artery stenosis.High levels of serum PCSK9 and MIF are independent risk factors for CHD.