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 investigate the association between the weight-adjusted waist index (WWI) and prostate cancer (PCa) in order to provide reference for the screening and diagnosis of PCa.Methods Data of 18732 men aged ≥20 years were obtained from the US National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. The relationship between WWI and PCa was assessed using a multivariate logistic regression model.A stratified analysis was performed across four time periods:1999—2006, 2007—2010, 2011—2014, and 2015—2018.Restricted cubic splines (RCS) and subgroup analyses were employed to evaluate the potential nonlinear associations and interactions between WWI and PCa risk. The receiver operating characteristic (ROC) curve was utilized to compare the predictive performance of WWI with other obesity-related indicators, including waist-to-height ratio (WtHR), body mass index (BMI), waist circumference, and body weight.Results In the fully adjusted model, each 1-unit increase in WWI was associated with a 74% higher risk of PCa (OR=1.74, 95%CI:1.44-2.11, P＜0.001).Individuals in the highest quartile of WWI had nearly five times greater odds of PCa compared to those in the lowest quartile (OR=4.96, 95%CI:2.69-9.15, P＜0.001).The observed association remained consistent across all four survey cycles.RCS analysis revealed a nonlinear positive association between WWI and PCa risk. Threshold analysis indicated that when WWI ≥9.97, there was a significant positive correlation with PCa risk (OR=1.39, 95% CI:1.18-1.64, P＜0.001).Subgroup analyses confirmed the robustness of this association across different demographic and clinical subpopulations.Furthermore, WWI demonstrated superior discriminatory ability for predicting PCa compared to WtHR, BMI, waist circumference, and body weight (AUC=0.706, 0.608, 0.509, 0.594, 0.488, P＜0.001).Conclusion For the general male population in the US, WWI serves as an independent risk factor for PCa.This association has remained stable over 1999—2018, and WWI outperforms conventional obesity indicators in terms of predictive accuracy.Therefore, individuals with WWI ≥9.97 should be prioritized for prostate-specific antigen (PSA) screening, which may enhance current screening and diagnostic strategies.

The incidence of vascular compression in the neck caused by an elongated styloid process is relatively low.However,it is an important and non-negligible factor because this condition can lead to transient ischemic attacks,carotid artery dissection,cerebral infarction,narrowing of the jugular vein,and even increased intracranial pressure.The clinical manifestations are diverse,which can easily lead to missed or misdiagnoses.Moreover,an elongated styloid process may also affect the therapeutic outcome of carotid artery dissection.In patients with carotid artery dissection who lack common high-risk factors,or in cases where conventional examinations cannot explain the causes of impaired Venous drainage,the possibility of an elongated styloid process should be considered.When diagnosing vascular compression in the neck caused by an elongated styloid process,it is important to consider specific head positions and be vigilant to avoid false negatives.A comprehensive assessment should be made using a variety of diagnostic tools,including carotid artery ultrasound,CTA,MRI,and DSA.There is currently no unified consensus on the treatment of vascular compression in the neck caused by an elongated styloid process.In patients with carotid artery dissection that cannot be explained by other causes and where the dissection site is closely related to the styloid process,styloidectomy should be considered.Additionally,it is crucial to guide patients to avoid head positions that may exacerbate the condition during the perioperative period.

Objective:To investigate the clinical characteristics and prognosis of acute pancreatitis (AP) with different etiologies.Methods:The retrospective cohort study was conducted. The clinical data of 702 patients with AP who were admitted to Xuanwu Hospital of Capital Medical University from January 2018 to December 2022 were collected. There were 451 males and 251 females,aged (52±17)years. Observation indicators: (1) clinical characteristics of AP patients with different etiologies; (2) complications and prognosis of AP patients with different etiologies; (3) complications and prognosis of moderately severe and severe AP patients with different etiologies. Comparison of measurement data with normal distribution among multiple groups was conducted using the one-way analysis of variance. Comparison of measurement data with skewed distribution among multiple groups was conducted using the Kruskal-Wallis H test. Comparison of count data among multiple groups was conducted using the chi-square test. Results:(1) Clinical characteris-tics of AP patients with different etiologies. Of the 702 AP patients, 434 cases were biliary AP, 199 cases were hypertriglyceridemic-induced AP,29 cases were alcoholic AP, and 40 cases were idiopathic AP. There were significant differences in gender,age,body mass index,combined cardiovascular disease,combined diabetes,combined nephrosis,disease severity and modified computed tomography severity index among AP patients with different etiologies ( χ2=24.61, F=48.65, 12.24, χ2=13.67, 12.90, 14.12, 15.56, H=17.62, P<0.05). (2) Complications and prognosis of AP patients with different etiologies. There was no significant difference in infectious pancreatic necrosis,duration of intensive care unit stay,total duration of hospital stay, and death of patients during hospitalization among AP patients with different etiologies ( P>0.05). (3) Complications and prognosis of moderately severe and severe AP patients with different etiologies. Of the 395 patients with moderately severe and severe AP, 217 cases were biliary AP, 128 cases were hypertriglyceridemic-induced AP, 19 cases were alcoholic AP, and 31 cases were idiopathic AP. There were significant differences in renal injury, multiple organ dysfunction syndrome and walled-off necrosis among moderately severe and severe AP patients with different etiologies ( χ2=12.62, 8.25, 14.33, P<0.05), and there was no significant difference in infectious pancreatic necrosis, lung injury, circulation system injury, duration of intensive care unit stay, total duration of hospital stay, or death of patients during hospitalization among moderately severe and severe AP patients with different etiologies ( P>0.05). Conclusions:The clinical charac-teristics vary among AP patients with different etiologies. The risk of complications varies among moderately severe and severe AP patients with different etiologies.

Objective:To analyze the clinical characteristics of locally advanced rectal cancer patients with pathological complete response (pCR) after neoadjuvant chemoradiotherapy combined with immunotherapy.Methods:The retrospective cohort study was conducted. The clinicopatholo-gical data of 46 patients with locally advanced rectal cancer who were admitted to 6 medical centers, including Beijing Friendship Hospital of Capital Medical University et al, from June 2021 to November 2022 were collected. There were 29 males and 17 females, aged (61±4)years. Patients received neoadjuvant chemoradiotherapy combined with immune checkpoint inhibitor therapy, and under-went radical total mesorectal excision during 6-12 weeks after radiotherapy. Observation indicators: (1) comparison of clinical characteristics between pCR and non-pCR patients;(2) postoperative complications and adverse reactions of pCR and non-pCR patients. Comparison of measurement data with normal distribution between groups was conducted using the t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann-Whitney U test. Comparison of count data between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was conducted using the Mann-Whitney U test. Results:(1) Comparison of clinical characteristics between pCR and non-pCR patients. Before neoadjuvant therapy, there were 14 cases aged ≥50 years and 6 cases aged <50 years in pCR patients, versus 25 cases and 1 case in non-pCR patients, showing a significant difference between the two groups ( P<0.05). After neoadjuvant therapy, cases in clinical stage T0, T1, T2, T3, T4 were 11, 1, 5, 3, 0 for pCR patients versus 7, 4, 2, 11, 2 for non-pCR patients, cases of tumor regression grade 1, 2, 3, 4 were 11, 8, 1, 0 for pCR patients versus 7, 14, 4, 1 for non-pCR patients, cases in low-risk, medium-risk, high-risk of neoadjuvant rectal scoring and grading were 20, 0, 0 for pCR patients versus 4, 18, 4 for non-pCR patients, respectively, showing significant differences in above indicators between the two groups ( Z=-2.256, -2.104, -5.458, P<0.05). (2) Postoperative complications and adverse reactions of pCR and non-pCR patients. Postoperative complications occurred in 2 cases of pCR patients and 5 cases of non-pCR patients, postoperative adverse reactions occurred in 11 cases of pCR patients and 10 cases of non-pCR patients, showing no significant difference between the two groups ( P>0.05). Conclusion:Compared with locally advanced rectal cancer patients aged ≥50 years, those aged <50 years have significant benefits from neoadjuvant chemoradiotherapy combined with immunotherapy. Clinical T staging and magnetic resonance imaging-detected tumor regression grade after neoadjuvant therapy have predictive value for patients with pCR .

Objective:To explore the mechanism of G protein-coupled receptor 120(GPR120)regulating nod-like receptor family pyrin domain containing 3(NLRP3)inflammasome-mediated inflammatory response in polycystic ovary syndrome(PCOS).Methods:Forty-five wild-type female C57BL/6J mice were randomly divided into three groups:control group,model group,and TUG-891 group,with 15 mice in each group.The model and TUG-891 groups were subcutaneously implanted with 35-day testosterone(T)continuous-release pellets to induce the PCOS model,while control mice received placebo pills.Mice in the TUG-891 group were treated with daily in-traperitoneal injections of TUG-891 starting from day 21 after T implantation.The model group and the control group were injected with the same amount of normal saline intraperitoneally.At the end of the experiment(day 35),the mice were euthanized,and blood and ovarian tissue samples were collected.Immunofluorescence stai-ning was used to detect the expression of GPR120 and NLRP3 proteins in ovarian tissues.Sirius Red staining was performed to detect ovarian fibrosis.Western blot analysis was used to measure the expression of fibrosis factors:α-smooth muscle actin(α-SMA),matrix metalloproteinase 2(MMP2),transforming growth factor-β1(TGF-β1),and inflammatory factors NLRP3,Toll-like receptor 4(TLR4),and tumor necrosis factor-α(TNF-α)in tissues.O-varian granulosa cells(GCs)were isolated from female mice and cultured in DMEM-F12 medium containing 10%fetal bovine serum and 1%penicillin-streptomycin.The cells were divided into the control group,TUG-891 group,T group,and T+TUG-891 group.The vitality and apoptosis of GCs were analyzed using the MTT assay and flow cytometry,respectively.Results:Compared with the model group,the TUG-891 group showed significant increa-ses in body growth,ovarian weight,ovarian index,and the number of pre-ovulatory follicles(P<0.05),as well as significant reductions in sex hormones T,estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)levels and atretic follicle numbers(P<0.05).Compared with the model group,the Sirius red staining and the relative expressions of α-SMA,MMP2,and TGF-β1 in the ovarian tissue of the TUG-891 group were signifi-cantly lower(P<0.05).Compared with the model group,the expression of GRP120 in the ovarian tissue of the TUG-891 group was significantly increased(P<0.05),and the expression of NLRP3 was significantly decreased(P<0.05).In the in vitro experiments,compared with the T group,the T+TUG-891 group significantly increased the proliferation of GCs(P<0.05),and the apoptosis of GCs and the protein expressions of NLRP3,TLR4 and TNF-α in GCs were significantly decreased(P<0.05).Conclusions:The GPR120 agonist TUG-891 may reduce the chronic low-grade inflammation induced by hyperandrogenism in PCOS mice by inhibiting the production of NLRP3 inflammasome,thereby protecting the growth and development of ovaries and follicles in mice.

The incidence of vascular compression in the neck caused by an elongated styloid process is relatively low.However,it is an important and non-negligible factor because this condition can lead to transient ischemic attacks,carotid artery dissection,cerebral infarction,narrowing of the jugular vein,and even increased intracranial pressure.The clinical manifestations are diverse,which can easily lead to missed or misdiagnoses.Moreover,an elongated styloid process may also affect the therapeutic outcome of carotid artery dissection.In patients with carotid artery dissection who lack common high-risk factors,or in cases where conventional examinations cannot explain the causes of impaired Venous drainage,the possibility of an elongated styloid process should be considered.When diagnosing vascular compression in the neck caused by an elongated styloid process,it is important to consider specific head positions and be vigilant to avoid false negatives.A comprehensive assessment should be made using a variety of diagnostic tools,including carotid artery ultrasound,CTA,MRI,and DSA.There is currently no unified consensus on the treatment of vascular compression in the neck caused by an elongated styloid process.In patients with carotid artery dissection that cannot be explained by other causes and where the dissection site is closely related to the styloid process,styloidectomy should be considered.Additionally,it is crucial to guide patients to avoid head positions that may exacerbate the condition during the perioperative period.

Purpose This study aimed to evaluate the consistency of human epidermal growth factor receptor 2(HER2)status between primary breast cancer lesions and lung metastatic lesions and to establish a prognostic model for predicting the survival rate of HER2 low expression(HER2-low)breast cancer patients with lung metastasis.Methods Clinicopathological data from a cohort of 252 patients with breast cancer and lung metastasis were retrospec-tively analyzed.Results 50.00％of the patients had HER2-low expression in metastatic lesions,and HER2-low ex-pression was the most prevalent subgroup in both primary and metastatic lesions.A discordance in HER2 status be-tween primary and metastatic sites was observed in 28.07％of cases.The most frequent shift was from HER2-zero in the primary tumor to HER2-low expression in the metastasis(12.28％of all cases).Estrogen receptor(ER)status,menopausal status,and histological type were identified as independent prognostic factors for overall survival(OS)by univariate and multivariate Cox regression analyses.A prognostic model incorporating these factors was constructed to predict 3-year and 5-year survival.The model demonstrated area under the curve(AUC)values of 0.765 and 0.780 for 3-year and 5-year OS in the training cohort,and 0.667 and 0.706 in the validation cohort,respectively.Conclu-sion HER2-low expression is the most common subtype among breast cancer patients with lung metastasis.The ob-served shift from HER2-zero in primary lesions to HER2-low in metastases underscores the clinical necessity of re-biop-sy at metastatic sites.The developed prognostic model effectively predicts OS in this patient population.

The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.

Hepatocellular carcinoma(HCC)is the most common type of liver cancer and a leading cause of cancer-related deaths worldwide.While early detection significantly improves prognosis,patients with alpha-fetoprotein-negative hepatocellular carcinoma(ANHCC)often face diagnostic challenges due to the lack of reliable biomarkers.This review systematically explores the potential of various circulating biomarkers in the early diagnosis of ANHCC,including AFP-L3,PIVKA-Ⅱ,lymphocyte-to-monocyte ratio,exosomes,circulating cell-free DNA(cfDNA),circulating tumor cells,osteopontin,paraoxonase 1,autoantibodies,and RNA-related biomarkers.The combined use of these markers,particularly AFP-L3 and PIVKA-Ⅱ,demonstrates enhanced diagnostic accuracy and specificity compared to single markers.Emerging evidence also highlights the diagnostic potential of exosomes,cfDNA,and RNA markers due to their non-invasive nature and high stability.Despite promising results,further large-scale,multicenter studies are needed to validate these findings,address challenges such as standardization of detection methods,and elucidate underlying mechanisms.These advances are anticipated to significantly improve early detection and personalized management of ANHCC.