Objective: To analyze the association between alcohol consumption and lumbar disc herniation (LDH), so as to provide a reference for the development of prevention and treatment strategies for LDH. Methods: From May to July 2022, permanent residents aged ≥18 years from eight counties (cities/districts) in Gansu Province were selected using a multistage stratified random sampling method. Data on basic characteristics, alcohol consumption in the past 30 days, hypertension, and diabetes mellitus were collected through questionnaire surveys. LDH was determined based on imaging findings, combined with disease history or clinical symptoms. Multivariable logistic regression model was used to analyze the association between alcohol consumption and LDH, with subgroup analyses conducted by gender, age, ethnicity, and altitude of residence. Propensity score matching (PSM) was utilized for sensitivity analysis. Results: A total of 4 545 individuals were surveyed. There were 2 026 (44.58%) males and 2 519 (55.42%) females. The mean age was (44.82±15.33) years. The study participants were predominantly of Han ethnicity, with 2 598 persons accounting for 57.17%. The altitude of residence was mainly above 3 500 m, with 1 941 persons accounting for 42.71%. There were 574 alcohol drinkers, accounting for 12.63%. LDH was detected in 1 035 cases, with a detection rate of 22.77%. Multivariable logistic regression analysis showed that after adjusting for gender, age, physical activity, and hypertension, compared to non-drinking residents, alcohol-consuming residents exhibited a 27.6% reduction in the risk of LDH (OR=0.724, 95%CI: 0.544-0.963). No significant interaction effects on LDH risk were observed between alcohol consumption and gender, age, ethnicity, or altitude of residence (all Pfor interaction >0.05). The results of the sensitivity analysis indicated that compared to non-drinking residents, alcohol-consuming residents exhibited a 38.8% reduction in the risk of LDH (OR=0.612, 95%CI: 0.382-0.976). Conclusion Alcohol consumption was statistically associated with a lower risk of LDH.

Early correction of childhood malocclusion is timely managing morphological, structural, and functional abnormalities at different dentomaxillofacial developmental stages. The selection of appropriate imaging examination and comprehensive radiological diagnosis and analysis play an important role in early correction of childhood malocclusion. This expert consensus is a collaborative effort by multidisciplinary experts in dentistry across the nation based on the current clinical evidence, aiming to provide general guidance on appropriate imaging examination selection, comprehensive and accurate imaging assessment for early orthodontic treatment patients.
Humans ; Malocclusion/diagnostic imaging* ; Child ; Consensus

Bone grafting is a primary method for treating bone defects. Among various graft materials, xenogeneic bone substitutes are widely used in clinical practice due to their abundant sources, convenient processing and storage, and avoidance of secondary surgeries. With the advancement of domestic production and the limitations of imported products, an increasing number of bone filling or grafting substitute materials isentering clinical trials. Relevant experts have drafted this consensus to enhance the management of medical device clinical trials, protect the rights of participants, and ensure the scientific and effective execution of trials. It summarizes clinical experience in aspects, such as design principles, participant inclusion/exclusion criteria, observation periods, efficacy evaluation metrics, safety assessment indicators, and quality control, to provide guidance for professionals in the field.
Humans ; Bone Substitutes/therapeutic use* ; Randomized Controlled Trials as Topic/methods* ; Consensus ; Bone Transplantation ; Research Design

【Objective】 To evaluate the effectiveness of Roche Cobas s 201 in detecting HBV by analyzing its blood nucleic acid testing (NAT) results. 【Methods】 The results were grouped according to the enzyme-linked immunosorbent assay (ELISA) and NAT minipool test (MP), NAT individual test (ID) and repeated NAT ID test (rID), and categorized into 4 groups as ELISA+ /NAT(ID)+ , ELISA+ /NAT(rID)+ , ELISA-/NAT(ID)+ and ELISA-/NAT(rID)+ . The data were statistically analyzed to explore whether there was a difference in the detection of reactive results by repeated NAT, and the correlation between cycle threshold (Ct) and nucleic acid detection rate for NAT-reactive samples with different ELISA results. The true infection status of blood donors was further analyzed by supplementary tests, including NAT systems and chemiluminescence serological marker assays using other methodologies. 【Results】 A total of 1 691 groups of 766 293 blood donor samples were HBV NAT(MP)+ , of which 1 418 groups(83.86%) were detected with reactive results (1 418 HBV NAT+ , 7 090 NAT-), and there were still 273 groups (16.14%) that remained undetected after repeated testing[a total of 1 638 NAT-, Ct(MP): 39.49±3.62]. Of the HBV NAT+ , 881(62.13%) were ELISA+ /NAT(ID)+ , 19(1.34%) were ELISA+ /NAT(rID)+ , 451(31.81%) were ELISA-/NAT(ID)+ , and 67(4.72%) were ELISA-/NAT(rID)+ . For samples with different ELISA results, difference was found in the detection of HBV by repeated NAT (P<0.05). There was no difference in Ct(ID) values between groups ELISA+ /NAT(rID)+ and ELISA-/ NAT(ID)+ , and groups ELISA+ /NAT(rID)+ and ELISA-/ NAT(rID)+ (P>0.05), but there were significant differences between other groups compared pairwise (P<0.05). Supplementary tests were performed on 228 ELISA-/ NAT(MP)+ (ID)- samples, 56 (24.56%) were reactive by chemiluminescent detection of HBsAg+ and 7 (3.07%) by other NAT systems. Among the remaining 221 NAT- samples/donors (96.93%), 53 (23.98%) HBsAg+ donors were likely to have chronic infection, 40 (18.10%) anti-HBe+ and/or anti-HBc+ donors might have previous infections, and the remaining 128 (57.92%) donors who were non-reactive were NAT (MP) pseudo-reactive, with significant differences in anti-HBs levels \'between groups (P<0.05). 【Conclusion】 Repeated NAT has differential detection of donor samples with different reactivity categories or different serologic results, especially within a certain interval, and repeated NAT for ELISA- samples can significantly improve the detection rate. Ct values can assist in assessing the stability and accuracy of the NAT system. For ELISA-/NAT(MP)+ (ID)- donors, the combination of other highly sensitive assays can reduce the risk of viral residuals and safeguard clinical blood safety.

Objective To investigate the enhanced CT and MRI imaging features of nasal sinus squamous cell carcinoma(SCC)and lymphoma(NHL),and to analyze the efficacy of different imaging features in differentiating nasal sinus SCC from NHL.Methods The imaging,clinical and pathological data of 67 patients with sinus SCC and NHL who underwent sinus CT and MRI with contrast CT and MRI in our hospital and confirmed by surgical pathology were retrospectively analyzed,and the tumor origin,maximum diameter,CT density,MRI signal intensity,enhancement degree,tumor internal necrosis,adjacent bone destruction,invasion of surrounding tissues,and The imaging features such as cervical lymph node metastasis within the scanning range were analyzed,and the receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the efficacy of different imaging features to distinguish nasal sinus SCC and NHL.Results There were statistically significant differences between the five imaging features of nasal sinus SCC and NHL,including tumor origin,maximum diameter,internal tumor necrosis,surrounding bone destruction and peripheral tissue invasion(P＜0.05),and the AUC of differentiating SCC and NHL were 0.708,0.694,0.785,0.850 and 0.629,respectively.The AUC of SCC and NHL was 0.969,and the sensitivity and specificity were 83.9%and 97.2%,respectively.Conclusion On contrast-enhanced CT and MRI,the imaging signs of tumor origin,maximum diameter,tumor internal necrosis,bone destruction and surrounding tissue invasion are helpful to distinguish nasal sinus SCC from NHL,especially if the tumor originates in the nasal cavity,necrosis is rare,bone destruction is mild,and the possibility of nasal sinus NHL should be given priority.Contrast-enhanced CT and MRI can help differentiate nasal sinus SCC from NHL,and the combination can help improve differential diagnostic performance.

Objective To investigate the value of enhanced CT radiomics combined with CT features model(combined model)for differentiating squamous cell carcinoma(SNSCC)and sinonasal lymphoma(SL).Methods Totally 68 patients with SNSCC and 63 patients with SL were retrospectively collected and divided into training set(n=92,including 48 SNSCC and 44 SL)and verification set(n=39,including 20 SNSCC and 19 SL)at the ratio of 7:3.Univariate analysis and logistic regression were used to analyze clinical data and CT manifestations in training set,and the independent predictive factors for differentiating SNSCC and SL were screened and used to construct a CT features model.Based on enhanced venous phase CT of training set,the best radiomics features of lesions were extracted and screened.The radiomics model was then established,and the radiomics label was calculated.The combined model was finally constructed based on CT model and radiomics labels,and its nomogram was drawn.Receiver operating characteristic(ROC)curve were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficacy of each model for differentiating SNSCC and SL.Calibration and decision curve analysis were used to evaluate the calibration efficacy and clinical benefit of the obtained combined model.Results The primary location of the lesion and bone invasion showed on CT were both independent predictive factors for SNSCC and SL(both P＜0.05),and CT model was constructed.Based on enhanced venous phase CT,3 best radiomics features were selected to establish the radiomics model.The AUC of CT,radiomics and combined model in training set was 0.895,0.730 and 0.925,respectively,and significant differences of AUC were found among 3 models(Z=-3.964 to-1.833,all P＜0.05).The AUC of CT,radiomics and combined model in verification set was 0.845,0.684 and 0.868,respectively,of combined model was greater than of radiomics model(Z=-2.568,P=0.010).The combined model had good calibration.Taken 15％-62％ and 85％-92％ as the thresholds in training set and 88％ to 95％ in validation set,the clinical net benefit of combined model was high.Conclusion The obtained enhanced CT radiomics combined with CT features model could be used to effectively differentiate SNSCC and SL.

Objective To explore the effect of Sufu on lung adenocarcinoma by observing its mutation and the changes in Gli1 transcription after its mutation.Methods cBioPortal for Cancer Genomics was used to obtain the mutation status of Sufu in lung cancer.Four Sufu single base mutation vectors were constructed and transfected into lung adenocarcinoma cell lines A549 and H1975 to establish cells with Sufu overexpression and knockout.Wounding healing assay was employed to determine the effect of Sufu on cell migration,and RT-qPCR,immunofluorescence assay and dual luciferase reporter gene assay were utilized to explore the changes in Gli1 transcription after Sufu mutation.Results cBioPortal data showed that the mutation rate of Sufu in lung cancer was 11.76％in squamous cell carcinoma(2/17),0.96％in adenocarcinoma(6/625),1.01％in small cell lung cancer(4/396),and 0.69％in non-small cell lung cancer(77/11 227).The median survival of lung cancer patients was significantly decreased in those with Sufu mutation than those without(38.00 vs 54.34 months,HR=1.943,P＜0.05).A549 cells were sensitive to Sufu knockout,and it resulted in significant increase of the transcription level of Gli1(P＜0.05).Overexpression of Sufu inhibited cell migration ability in both A549 and H1975 cells(P＜0.05).Sufu mutation had no significant influence on the location of Gli1 in the cells.The Sufu-T411M mutation up-regulated the the transcription level of Gli1(P＜0.05).Conclusion Sufu has an inhibitory effect on lung adenocarcinoma metastasis,and can be regarded as a potential target for lung adenocarcinoma metastasis.

Objective:To develop a nucleic acid detection system for Helicobacter pylori ( H. pylori) based on recombinase-aided isothermal amplification (RAA) and clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated(Cas13a). Methods:Thirty strains of H. pylori, as well as two strains each of Escherichia coli, Staphylococcus aureus, Enterococcus faecalis, Enterobacter cloacae, and Klebsiella pneumoniae were collected from the Emergency General Hospital between 2021 and 2022. The specific primers and CRISPR RNA (crRNA) required for this newly established method were designed based on the conserved region of the ureC gene of H. pylori. Then, the primer pair that produced the least non-specific products was screened out using agarose gel electrophoresis, and the crRNA sequence with the highest cleavage efficiency was screened according to the fluorescence intensity produced by Cas13a cutting fluorescence probe. The RAA-Cas13a nucleic acid detection system was developed, and the limit of detection and the specificity of which were evaluated by detecting gradient dilutions of H. pylori ATCC 43504 genomic DNA and 5 different clinically common pathogens′ genomic DNA. The consistency with quantitative real-time PCR(qPCR) method was obtained by simultaneously detecting clinical strains using this method and established qPCR method. Two-tailed paired t-test was used to compare the fluorescence results between the two groups, and a P value less than 0.05 indicates a statistically significant difference. Results:The established RAA-Cas13a nucleic acid detection system could detect target DNA as low as 10 copies/μl. within 1 hour ( t=11.05, P<0.01), without cross-reaction with the other 5 clinically common strains. That method also showed good consistency compared to the qPCR method, the kappa coefficient=1. Conclusions:A method combining RAA with CRISPR-Cas13a for detecting H. pylori has been established, which can be used for rapid and sensitive identification of H. pylori infection.

The incidence of invasive fungal diseases has been increasing annually, becoming one of the most serious infectious diseases affecting clinical departments. Currently, the primary indicators for early diagnosis of invasive fungal disease are the 1-3-β-D-glucan test and the galactomannan antigen test, known as the G test and GM test, respectively. The National Health Commission of the People′s Republic of China, in Goal Four of the'National Medical Quality and Safety Improvement Goals′, proposed to'increase the submission rate of pathogen examination before antibiotic treatment in hospitalized patients′, and emphasized the importance of tests such as G test as common clinical mycological diagnostic tools. Moreover, it is of paramount significance for clinical laboratories to ensure the quality of fungal detection. This paper provides a detailed discussion of the key factors affecting the G test and GM test, and the importance of launching the national external quality assessments.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.