Objective To evaluate the effect of donor gender on short-term survival rate of lung transplant recipients. Methods A retrospective analysis was conducted on the data of 1 066 lung transplant recipients. The log-rank test was used to evaluate the differences in short-term fatality among different donor gender groups and donor-recipient gender combination groups. Multivariate Cox regression, propensity score (PS) regression, and propensity score matching (PSM) were employed to control for confounding factors and further assess the differences in fatality. Subgroup analyses were also performed based on donor gender. Results Multivariate Cox regression analysis showed no statistically significant differences in fatality at 30 days, 1 year, 2 years and 3 years postoperatively between male and female donor groups (all P>0.05). After PS regression and PSM, univariate Cox regression analysis indicated that recipients from female donors had a higher fatality at 2 years postoperatively compared to those from male donors, with hazard ratios (95% confidence intervals) of 1.29 (1.01-1.65) and 1.36 (1.03-1.80) respectively. Multivariate Cox regression analysis also revealed no statistically significant differences in fatality at various follow-up time points among different donor-recipient gender combination groups (all P>0.05). Subgroup analyses based on donor sex showed no statistically significant differences in fatality among recipients of different gender within either male or female donor groups (all P>0.05). Conclusions Female donors may reduce the short-term postoperative survival rate of lung transplant recipients, but this negative impact is not sustainable in the long term. At present, there is no evidence to support the inclusion of sex as a factor in lung allocation rules.

In order to improve the teaching quality for the interns in neurosurgery,PBL combined with CBL was intro-duced into the clinical teaching,under the teachers'guide,knowledge and experience was summarized through collecting prob-lems,combinig with cases,consulting literature and group discussion,etc.The teaching effect was evaluated in terms of ques-tionnaire survey,theory test and clinical skills examination,the results showed positive rate for the new teaching mode was 91％,improvement of clinical thinking approval rate 97.4％,excellence rate of theory test 96.2％,excellence rate of clinical skill exam-ination 93.6％.This teaching mode turned the interns into main subject of learning,and it had raised their interests and enthusi-asm,cultivated their clinical thinking ability to find problem and practical ability to solve problem,making them more qualified for the diagnosis and treatment of diseases.

Objective To investigate the influencing factors of hospitals to carry out hospital-enterprise collabora-tive innovation and improve the level of hospital-enterprise collaborative innovation.Methods Based on the method of rooted theory,open coding,main axis coding and selective coding were carried out on the contents of 30 in-depth interviews with experts,and pass the theoretical saturation test.Results The influencing factor model of hospitals participating in hospital-enterprise collaborative innovation was summarized.It includes 6 main categories,including cooperative income guarantee,market two-wheel drive,organization and management level,cooperative object and mode,main body innovation ability and enterprise technical support,which are divided into 3 dimen-sions:incentive factors,process factors and demand factors.Conclusion The enthusiasm of hospitals to carry out hospital-enterprise collaborative innovation needs to be improved,and the development of hospital-enterprise col-laborative innovation can be promoted from three aspects:focusing on the incentive effect of reasonable returns,encouraging high clinical value innovation activities,and improving the management level of collaborative innovation.

Objective To compare of the efficacy of two distinct debridement techniques in membrane induction therapy for chronic tibial osteomyelitis.Methods A retrospective study was conducted on 52 patients with Cierny-Mader type IV A/B chronic tibial osteomyelitis who were treated at the Third Affiliated Hospital of Zunyi Medical University between July 2016 and December 2023.Five patients were diagnosed and treated before 2020,while 47 were managed from 2020 onward.Patients were divided into two groups:a local debridement group(n=28)and an en bloc osteotomy group(n=24).Perioperative outcomes—including operative time,incision length,intraoperative blood loss,and length of hospital stay—were assessed,along with clinical efficacy at 6 months,12 months,and final follow-up.Clinical outcomes were evaluated using the Hospital for Special Surgery(HSS)knee score,the American Orthopaedic Foot&Ankle Society(AOFAS)ankle-hindfoot score,joint range of motion(knee flexion-extension and ankle plantarflexion-dorsiflexion),recurrence rate,and the Paley classification for infectious bone defects.Results The local debridement group exhibited significantly less intraoperative blood loss(P<0.05),shorter operative time(P<0.05),and reduced hospital stay(P<0.05),as well as higher AOFAS and HSS scores at both 6 and 12 months postoperatively(P<0.05).In contrast,the osteotomy group demonstrated superior Paley classification outcomes at 6 months,12 months,and final follow-up(P<0.05),along with lower rates of infection recurrence.Longitudinal analysis indicated significant improvements in AOFAS scores,HSS scores,and joint mobility over time in both groups(P<0.05).However,no statistically significant differences were observed between groups in terms of functional scores or joint mobility parameters at final follow-up(P>0.05).Conclusion En bloc osteotomy combined with the induced membrane technique(Masquelet technique)enables more comprehensive debridement,minimizes the necessity for repeated surgical interventions,reduces postoperative complications,lowers the risk of recurrence,and promotes enhanced bone healing.

Objective To investigate the influencing factors of hospitals to carry out hospital-enterprise collabora-tive innovation and improve the level of hospital-enterprise collaborative innovation.Methods Based on the method of rooted theory,open coding,main axis coding and selective coding were carried out on the contents of 30 in-depth interviews with experts,and pass the theoretical saturation test.Results The influencing factor model of hospitals participating in hospital-enterprise collaborative innovation was summarized.It includes 6 main categories,including cooperative income guarantee,market two-wheel drive,organization and management level,cooperative object and mode,main body innovation ability and enterprise technical support,which are divided into 3 dimen-sions:incentive factors,process factors and demand factors.Conclusion The enthusiasm of hospitals to carry out hospital-enterprise collaborative innovation needs to be improved,and the development of hospital-enterprise col-laborative innovation can be promoted from three aspects:focusing on the incentive effect of reasonable returns,encouraging high clinical value innovation activities,and improving the management level of collaborative innovation.

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

Lung transplantation is an important means to treat end-stage lung disease and improve the survival rate and quality of life of patients. However, many postoperative complications seriously affect the prognosis of recipients. Accurate identification of key prognostic factors and construction of individualized and accurate prediction models are of great significance for postoperative prognosis evaluation, treatment strategy formulation and clinical decision-making. In recent years, the clinical prediction model of lung transplantation has gradually changed from traditional statistical methods to machine learning-driven. Compared with traditional models such as Cox regression and Logistic regression, machine learning models such as random forest, support vector machine and artificial neural network have certain advantages in postoperative survival rate prediction, early warning of complications and pulmonary function evaluation. However, their application is also affected by insufficient sample size and poor interpretability of models. Under the condition of small samples, the traditional model still has important value in prediction accuracy. The appropriate prediction model should be selected according to the clinical status of lung transplantation in China, considering the factors such as sample size, variable complexity and model interpretability. In the future, a multi-center, large-sample lung transplantation database should be constructed to further optimize and tap the potential of machine learning algorithms to improve the robustness and clinical applicability of the model.

Objective:To explore the feasibility of joint screening of the two primary immunodeficiency diseases [severe combined immunodeficiency (SCID) and X-linked agammaglobulinemia(XLA)] and spinal muscular atrophy(SMA) in newborns by multiplex real-time quantitative PCR technology, and to provide evidence for early screening, diagnosis and treatment of children.Methods:Cross-sectional study. From July 2021 to January 2023, a total of 103 240 dry blood spots samples of newborns were collected which were delivered to Neonatal Disease Screening Center of Zhejiang by cold chain transportation. The concentrations of the T cell receptor excision ring (TREC), Kappa deletion of the recombinant excision loop (KREC), and exon 7 deletion of Survival Motor Neuron 1 (SMN1) gene in dry blood spots were simultaneously detected by multiplex real-time fluorescence quantitative PCR, taken ribonuclease P/MRP 30 000 subunits (RPP30) as an internal reference gene. The positive newborns were further diagnosed by other laboratory tests and gene sequencing was taken as gold standard. Children samples from 1 case of SCID, 3 cases of XLA and 2 cases of SMA were used for positive verification. The correlation between detected concentration of TREC/KREC and basic information in newborns were analyzed. The differences among groups for each factor were analyzed.Results:One case of SCID, 2 cases of XLA, 9 cases of SMA and 7 cases of other genetic diseases (4 cases of DiGeorge syndrome, 1 case of trisomy 21 syndrome, 1 case of Noonan syndrome and 1 case of super male syndrome) were identified by multiplex real-time fluorescence quantitative PCR. The positive predictive values of screening neonatal SCID, XLA and SMA were 2.44% (1/41), 2.78% (2/72) and 9/9 respectively. Taking the samples from clinically diagnosed 1 case of SCID, 3 cases of XLA and 2 cases of SMA as positive validation samples, which were all identified. The detected results of TREC/KREC correlated with time of blood collection, sex, weight, gestational age and delivery mode of newborns, whose r values were 0.162/0.187, 0.066/0.032, 0.045/0.042, ?0.015/?0.088 and 0.014/0.068 respectively (all P<0.05). Conclusions:Relying on current neonatal screening platform in Zhejiang, it is feasible to screen jointly two kinds of primary immunodeficiency diseases and spinal muscular atrophy in newborns by multiple real-time fluorescence quantitative PCR technology.

Objective:To explore the clinical features, strategies, and prognostic factors of treatment of squamous cell carcinoma (SCC) secondary to chronic osteomyelitis of the tibia (COMT).Methods:A computer search was conducted in the PubMed, Embase, Cochrane, Wanfang, VIP, and CNKI databases for cases of SCC arising from COMT published between January 1990 and December 2024. The data extracted were clinical features, treatment strategies, incidence of local recurrence, metastasis, all-cause mortality, and SCC-related mortality. Potential factors influencing the efficacy and prognosis of SCC treatment were investigated.Results:A total of 38 studies involving 101 relevant cases were included (86 males, 15 females). The age at diagnosis of COMT was (29.5±16.5) years while that of SCC (58.8±15.0) years. The disease duration from COMT to SCC was (29.4±15.3) years. The most common etiology was secondary trauma (78.2%, 68/87), and the most frequent symptom local sinus tract formation (61.8%, 55/89). The positive rate of pathogenic culture was 94.4% (34/36), with polymicrobial culture positivity accounting for 73.5% (25/34). The primary treatment was amputation (79.6%, 78/98), followed by wide tumor resection (17.3%, 17/98), while conservative treatment was less frequently applied (3.1%, 3/98). The overall local recurrence rate was 19.6% (11/56), the metastasis rate 14.5% (8/55), the all-cause mortality 25.0% (23/92), and the SCC-related mortality 9.8% (9/92). The patients with regional lymph node involvement at the time of diagnosis of SCC secondary to COMT had significantly higher risks of local recurrence, SCC-related mortality, and all-cause mortality than those without lymph node involvement ( P<0.05). Similarly, patients with moderately to poorly differentiated SCC had significantly higher risks of local recurrence, metastasis, and all-cause mortality than those with well-differentiated SCC ( P<0.05). Conclusions:SCC secondary to COMT occurs predominantly in males, has a long disease course, and presents primarily with sinus tracts and ulcers as clinical symptoms. Amputation is the main treatment strategy, but the overall prognosis remains poor, with high incidences of local recurrence, metastasis, and cancer-related mortality. Those with local lymph node involvement and moderately to poorly differentiated SCC have a worse prognosis which requires close follow-up.

Objective Currently, there is no commercially available quantitative detection kit for the main Felis domestic allergen (Fel d 1) in China. To establish a rapid detection method for Fel d 1, this study aims to prepare monoclonal antibodies against Fel d 1 protein. Methods The codon preference of Escherichia coli was utilized to optimize and synthesize the Fel d 1 gene. The prokaryotic expression plasmid pET-28a-Fel d 1 was constructed and used to express and purify the recombinant Fel d 1 protein. Subsequently, the recombinant protein was immunized into BALB/c mice and monoclonal antibodies (mAbs) were prepared by the hybridoma technique. An indirect ELISA was established using the recombinant Fel d 1 as the coating antigen, and hybridoma cell lines were screened for positive clones. The specificity and antigenic epitopes of the mAbs were confirmed by Western blot analysis. Finally, the selected hybridoma cells were injected into the peritoneal cavities of BALB/c mice for large-scale monoclonal antibody production. Results The recombinant plasmid pET-28a-Fel d 1 was successfully constructed, and soluble Fel d 1 protein was obtained after optimizing the expression conditions. Western blot and antibody titer assays confirmed the successful isolation of two hybridoma cell lines, 7D11 and 5H4, which stably secreted mAbs specific to Fel d 1. Antibody characterization revealed that the 5H4 mAb was of the IgG2a subtype and could recognize the amino acid region 105-163 of Fel d 1, while the 7D11 mAb was the IgG1 subtype and could recognize the amino acid region 1-59. Conclusion The high-purity recombinant Fel d 1 protein produced in this study provides a promising alternative for clinical immunotherapy of cat allergies. Furthermore, the monoclonal antibody prepared in this experiment lays a material foundation for the in-depth study of the biological function of Fel d 1 and the development of ELISA detection.
Animals ; Antibodies, Monoclonal/biosynthesis* ; Mice, Inbred BALB C ; Cats ; Mice ; Allergens/genetics* ; Glycoproteins/genetics* ; Enzyme-Linked Immunosorbent Assay ; Hybridomas/immunology* ; Recombinant Proteins/genetics* ; Female ; Antibody Specificity