Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

The European Federation of Periodontology (EFP) and the Association for Dental Education in Europe (ADEE) jointly held the second European Consensus Workshop on Education in Periodontology in February, 2023. Building on the first consensus workshop in 2009, expert working groups from European Workshop Committee updated four educational levels: undergraduate, specialist, continuing professional development (CPD), as well as teaching methods, culminating in the updated consensus report in March, 2024. This article introduces and interprets the contents of the 2024 consensus report. Specific to China′s national conditions, we also propose future perspectives and considerations on different levels of periodontal education in China based on this consensus.

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective:To compare knowledge graphs (KGs) constructed from standardized clinical pathways and actual examination records within 24 hours of emergency care for acute gastrointestinal hemorrhage (AGH), acute myocardial infarction (AMI), and intracerebral hemorrhage (ICH), and to visually analyze discrepancies between guideline recommendations and real-world practice, thereby exploring a novel methodology for clinical pathway optimization.Methods:KGs were developed using clinical pathway standards and actual examination data collected within the first 24 hours of emergency treatment for AGH, AMI, and ICH. Entity attributes were weighted to visually represent the frequency and extent of examination usage through variable node sizes in the KG. The constructed KGs were used to compare and analyze the differences in type and frequency of examinations performed relative to pathway standards.Results:The proportion of examination items with >50% adherence to clinical pathway standards within 24 hours was 76.92% for AGH, 44.44% for AMI, and 78.57% for ICH. Items from the clinical pathways that were not performed in over 50% of patients accounted for 15.38%, 27.78%, and 21.43% of cases, respectively. Non-pathway examinations increased by 9, 7, and 4 items for each condition, of which 17 items (85%) were performed at least once in more than half of the patients. Visualization via KGs revealed a reduction in redundant examinations by 38.64% between AGH and AMI, 35.00% between AGH and ICH, and 37.50% between AMI and ICH. Overall, a 54.84% reduction in redundant examinations was achieved across all three critical conditions.Conclusions:The visual KG approach effectively integrates both guideline-recommended and experience-driven examinations, serving as a correlational analysis tool to assess deviations between actual clinical practice and standardized pathways. It provides a quantitative foundation for optimizing clinical pathways, with potential for greater efficiency gains as more critical conditions are incorporated into the graph.

Objective To investigate the expression of EIF5A1 in intrahepatic cholangiocarcinoma cell lines and human hepatobiliary duct epithelia,and its effect on the proliferation,migration and invasion ability and Wnt/β-Catenin signaling pathway in HUCCT1 cells.Methods Western blot was used to detect the basal expression level of EIF5A1 in intrahepatic cholangiocarcinoma cell lines and human intrahepatic cholangiocarcinoma epithelial cells.Transient transfection of siRNA was used to silence the expression of EIF5A1 in intrahepatic cholangiocarcinoma cell HUCCT1.The experimental groups were divided into blank control group(Con),siRNA1 group,and siRNA2 group.The most effective siRNA was screened by Western blot.The effects of EIF5A1 silencing on the proliferation,migration and invasion ability of HUCCT1 cells were detected by CCK-8,EdU cell proliferation assay and Transwell assay.The effect of EIF5A1 silencing on the Wnt/β-Catenin signaling pathway in HUCCT1 cells was detected by Western blot.Results The results of CCK-8 and EdU cell proliferation experiments showed that the proliferation ability of HUCCT1 cells decreased after EIF5A1 silencing(P<0.05),and Transwell migration and invasion experiments showed that the migration and invasion ability of Hucct1 cells decreased after EIF5A1 silencing(P<0.05).Western blot analysis revealed decreased expression of β-Catenin,Cyclin D1,MMP-2 and Survivin in Wnt/β-Catenin signaling pathway after EIF5A1 silencing(P<0.05).Conclusion EIF5A1 may promote the proliferation,migration and invasion of intrahepatic bile duct cancer cells through Wnt/β-Catenin signaling pathway.

Objective:To discuss the effect of exosomes(Exos)loaded with microRNA-520a-5p(miR-520a-5p)on the pregnancy outcomes in fetal mice with intrauterine growth restriction(FGR),and to clarify its mechanism.Methods:The mouse placental mesenchymal stem cells(MSCs)were cultured in vitro and transfected with miR-520a-5p adenovirus vector(Ad-miR-520a-5p)to obtain the Exos with high miR-520a-5p load(miR-520a-5p-MSCs-Exos),which were then identified.The C57BL/6 mice were mated in cages at a female∶male ratio of 2∶1 to achieve successful pregnancy.Forty pregnant mice were divided into control group,FGR group,NC-MSCs-Exos group,and miR-520a-5p-MSCs-Exos group,with 10 mice in each group.Except for control group,the mice in other groups were exposed to excessive dexamethasone(DEX)during pregnancy to induce FGR models in the pregnant mice.The body weights of the fetal mice at birth and at 1,2,3,and 4 weeks after birth were detected;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of miR-520a-5p,DNA methyltransferase 3b(DNMT3b),and vascular endothelial growth factor(VEGF)mRNA in placenta tissue of the mice in various groups;Western blotting method was used to detect the expression levels of DNMT3b and VEGF proteins in placenta tissue of the mice in various groups;methylation-specific PCR(MSP)was used to analyze the methylation rates of VEGF promoter in placenta tissue of the mice in various groups;dual-luciferase reporter gene assay was used to verify the targeting relationship between miR-520a-5p and DNMT3b.Results:The results of transmission electron microscope(TEM)and nanoparticle tracking analysis(NTA)showed that the Exos were spherical with particle size concentrated near 100 nm;the Western blotting method results showed that the surface biomarkers CD63 and CD81 of Exos were positively expressed.The RT-qPCR results showed that compared with NC-MSCs-Exos and Ad-NC-MSCs-Exos,the expression level of miR-520a-5p in Ad-miR-520a-5p-MSCs-Exos was increased(P＜0.001).The differences in birth body weight and the body weights at 1,2,and 3 weeks after birth of the fetal mice among four groups were statistically significant(F=36.084,F=19.851,F=77.755,F=103.223;P＜0.001).Compared with control group,the birth body weight and the body weights at 1,2,and 3 weeks after birth of the fetal mice in FGR group were decreased(P＜0.05);compared with FGR group and NC-MSCs-Exos group,the birth body weight and the body weights at 1,2,and 3 weeks after birth of the fetal mice in miR-520a-5p-MSCs-Exos group were increased(P＜0.05).The One-way ANOVA results showed that the differences in the expression levels of miR-520a-5p,DNMT3b,and VEGF mRNA in placenta tissue of the mice among four groups were statistically significant(F=103.224,F=856.460,F=214.563;P＜0.001).The pairwise comparison between groups showed that compared with control group,the expression levels of miR-520a-5p and VEGF mRNA in placenta tissue of the mice in FGR group were decreased(P＜0.05),and the expression level of DNMT3b mRNA was increased(P＜0.05);compared with FGR group and NC-MSCs-Exos group,the expression levels of miR-520a-5p and VEGF mRNA in placenta tissue of the mice in miR-520a-5p-MSCs-Exos group were increased(P＜0.05),and the expression level of DNMT3b mRNA was decreased(P＜0.05).The One-way ANOVA results showed that the differences in the expression levels of DNMT3b and VEGF proteins in placenta tissue of the mice among four groups were statistically significant(F=245.601,F=149.360;P＜0.001).The pairwise comparison between groups showed that compared with control group,the expression level of DNMT3b protein in placenta tissue of the mice in FGR group was increased(P＜0.05),and the expression level of VEGF protein was decreased(P＜0.05);compared with FGR group and NC-MSCs-Exos group,the expression level of DNMT3b protein in placenta tissue of the mice in miR-520a-5p-MSCs-Exos group was decreased(P＜0.05),and the expression level of VEGF protein was increased(P＜0.05).The One-way ANOVA results showed that the difference in the methylation rate of VEGF promoter in placenta tissue of the mice among four groups was statistically significant(F=687.096,P＜0.001).The pairwise comparison between groups showed that compared with control group,the methylation rate of VEGF promoter in placenta tissue of the mice in FGR group was increased(P＜0.05);compared with FGR group and NC-MSCs-Exos group,the methylation rate of VEGF promoter in placenta tissue of the mice in miR-520a-5p-MSCs-Exos group was decreased(P＜0.05).Dual-luciferase reporter gene assay results showed that compared with miR-NC group,the luciferase activity in the cells containing DNMT3b-WT reporter vector in miR-520a-5p group was decreased(P＜0.05);compared with miR-NC group,the luciferase activity in the cells containing DNMT3b-MUT reporter vector in miR-520a-5p group had no change,no significant difference was observed(P＞0.05).Conclusion:The MSCs-derived Exos highly loaded with miR-520a-5p may improve the pregnancy outcomes of FGR fetal mice by targeting and down-regulating the expression of DNMT3b,inhibiting VEGF methylation,and promoting VEGF expression.

Objective:To explore the evaluation method for key performance indicators of autonomous ultrasound scanning robots,so as to establish a testing scheme and conduct experiments.Methods:Based on the working principle of autonomous ultrasound scanning robots,three key performance indicators,which included scanning speed,scanning contact force,and accuracy of online adjustment,were established.The speed of the robotic arm,which execute autonomous scanning,was tested through laser rangefinders and a design of process equipment for displacement.The contact force of autonomous scanning was monitored and evaluated using a combination of ultrasound phantom and sensor with six-dimensional force.The displacement differences of phantom and robotic arm were monitored to evaluate the accuracy of online adjustment through designed a synchronization detection device for the displacements of phantom and robotic arm.Results:This research designed and provided test method and test device,which realized successful measurements for the speed,contact force,and accuracy of online adjustment in autonomous scanning of the ultrasonic scanning robot.Conclusion:The speed,contact force,and accuracy of online adjustment in scanning can be used as evaluation indicators of systematic performance of autonomous ultrasound scanning robots.The feasibility of these indicators is demonstrated through designed evaluation methods and corresponding experiments.

Objective To investigate the effects of Bushen Zhuanggu decoction on total N-terminal propeptide of type Ⅰprocollagen(t-PINP)and β-C-terminal telopeptide of type Ⅰ collagen(β-CTX)in patients with knee osteoarthritis(KOA).Methods A total of 120 patients with liver-kidney deficiency KOA treated in Linping District Hospital of Traditional Chinese Medicine from June 2021 to April 2024 were selected and divided into study group and control group according to random number table method,with 60 cases in each group.The patients of control group was given oral treatment with etocoxib and omeprazole,and patients of study group was given oral treatment of Bushen Zhuanggu decoction on the basis of control group.Both groups were treated for one month.The clinical efficacy,TCM syndrome scores,serum t-PINP and β-CTX leves,t-PINP/β-CTX,Western Ontario and Mcmaster Universities osteoarthritis index(WOMAC)scores and adverse reactions during treatment were compared between two groups.Results The total effective rate in study group was significantly higher than that in control group(x2=4.5 13,P=0.034).After treatment,the TCM syndrome scores,serum t-PINP and β-CTX levels and WOMAC scores in two groups were significantly lower than before treatment,and t-PINP/β-CTX were significantly higher than before treatment(P＜0.05).The TCM syndrome scores,serum t-PINP and β-CTX levels and WOMAC scores in study group were significantly lower than those in control group,and t-PINP/β-CTX was significantly higher than that in control group(P＜0.05).There was no significant difference in incidence of adverse reactions between two groups(x2=0.686,P=0.408).Conclusion Bushen Zhuanggu decoction can improve the clinical efficacy of KOA patients with liver-kidney deficiency,relieve clinical symptoms and pain,increase t-PINP/β-CTX,and reduce the incidence of adverse reactions.