Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

Objective:To evaluate the efficacy and safety of baricitinib combined with ruxolitinib cream in the treatment of progressive nonsegmental vitiligo.Methods:Clinical data were retrospectively collected from patients with progressive nonsegmental vitiligo in Boao Super Hospital. All the patients were treated with oral baricitinib daily (2 mg/day for patients weighing ≤ 50 kg; 4 mg/day for those > 50 kg) in combination with topical application of ruxolitinib cream twice daily for 24 consecutive weeks. Disease severity was assessed using the facial vitiligo area scoring index (F-VASI) and total body VASI (T-VASI) at baseline, week 12, and week 24. Adverse reactions were monitored throughout the treatment course.Results:Six patients with progressive nonsegmental vitiligo were collected, including 3 males and 3 females, aged 26 - 42 years, with the disease duration ranging from 0.5 to 25 years. At week 12, 3 patients achieved a 50% ~ < 75% improvement in facial vitiligo lesions (F-VASI 50), 1 patient achieved F-VASI 75 (75% ~ < 90% improvement), and 1 patient achieved T-VASI 50; at week 24, 4 patients achieved F-VASI 50, 1 patient achieved F-VASI 75, 1 patient achieved F-VASI 90 (≥ 90% improvement), and 3 patients achieved T-VASI 50. During the treatment, upper respiratory infection occurred in 1 patient, acne in 1 patient, pruritus in 2 patients, elevation of total cholesterol levels in 2 patients, and increase of high-density lipoprotein levels in 2 patients. No severe adverse events were observed during the treatment.Conclusion:The combination therapy with baricitinib and ruxolitinib cream may have potential efficacy and safety in the treatment of progressive nonsegmental vitiligo.

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

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

BACKGROUND: Traditionally, cranial perforate-rinse-dram operation and tube drainage were often used in the treatment of chronic subdural hematoma in the elderly, recently,instead of which oxygen-exchange therapy through dural puncture via cranium is more and more used.OBJECTIVE: To investigate the reliability and safety of the new operation-method using oxygen-exchange in treating the older people with chronic subdural hematoma in comparison with traditional cranial perforate-rinse-dram operation.DESIGN: Retrospective case analysis.SETTING: The Department of Neurosurgery, the Second Clinical College of China Medical University.PARTICIPANTS: Eleven male patients (meanly 62 years of age)who had undertaken oxygen-exchange therapy via skull without drain tube in the Department of Neurosurgery, Second Clinical College of China Medical College from January 1997 to December 2004 were enrolled in the study, with an average disease history of 1.5 months. Among them, 10 subjects suffered from head injury to different extent within 7 weeks on average. Main chief complaint was headache, and Unilateral limb asthenia above Ⅳ was found in 5 cases asking for medical service. As shown by CT and MRI, all the subjects were diagnosed as having chronic subdural hematoma located at supratentorium, 5 cases in the right side and 6 in the left side. Volume of hematom was calculated as the following formula: volume of hematom=length×width×number of layers (1 cm thick for one layer). And the range of volume was from 70 mL to 140 mL, and the average value was 105 mL. The hematom in all the cases was found to move to the midline to different extents.METHODS: Patients in lateral recumbent position were undertaken boring at the CT-located thickest area with bone awl of 0.4-0.5 cm under local anesthesia. After boring, 14-size lumbar puncture needle with trochar was used to acupuncture dura mater then moving the needle core so that blood was discharged. Then 10 mL medical oxygen was perfused into the needle guard to cause the blood discharged from hematom again. Oxygen was perfused repetitively, once for 10 mL, till there was no blood flow. Finally, 10 mL oxygen was perfused following moving of trochar and bandaging.Oxygen volume used in each case was recorded. After operation,the volume of normal saline infusion could be increased as large as possible. The duration of infusion was 2 weeks.MAIN OUTCOME MEASURES: Improvement in limb function.RESULTS: All the patients were involved in the result analysis.①Within 24 hours, volume of hematomwas decreased obviously detected with CT, and hematom completely disappeared in 3 cases,which was replaced by oxygen. Three weeks later, all the oxygen was absorbed, the structure of midline was symmetrical and the form of brain ventricles was normal. No pain was found and 5 casesof limb asthenia were also recovered. ②Advantage and disadvantage of foramen-vertebrate oxygen-exchange operation: Advantages were listed as follows: It was simple and spent shorter time,there were few complications, and patients had no limitation in movement after operation. The operation avoided the occurrence of thrombosis of lower limbs. Cranial pressure could not lower quickly. As the pressure resident in envelope, cerebraospinal fluid could not move into the envelope. Along with the absorption of oxygen,hematom was decreased gradually till completely disappeared. Occurrence of clinical symptoms resulting from cerebral blood perfusion was decreased so as to draw rein. The disadvantage of this operation was that it was not suitable for heart disease patients to undertake this operation at bedside, and headache or limb asthenia could not be alleviated immediately.CONCLUSION: The new operation-method of cranial foramen-vertebrate oxygen-exchange to treat chronic subdural hemtoma in the elderly is safe, reliable and feasible through preoperative CT localization.

BACKGROUND: Tumor-adopted immunity and gene transduction technique are used to introduce tumor necrosis factor-α vector into carrier cells, which are then re-infused into the body so that cancer cells can be killed by tumor necrosis factor-α more directly and effectively with fewer side effects on the other tissues due to high local expression.OBJECTIVE: To study the bioactivity of in vitro cultured tumor necrosis factor-α transduced tumor-infiltrating lymphocytes as well as the inhibitory effects on cancer cells of cancer-loaded rats infused in different ways.DESIGN: A randomized controlled study based on experimental animals.SEETING: Cancer Research Institute of China Medical University.MATERIALS: This study was carried out at the Cancer Research Institute and the Experimental Animal Department, China Medical University,between January 2000 and December 2001. TJ8510 cell line (human brain glioblastoma cell line) was provided by the Neurological Research Institute of Tianjin Medical University Affiliated Hospital. The experimental animals were 36 BALB/C nude mice congenitally having no thymius.METHODS: Based on the establishment of tumor necrosis factor-α retroviral transduction system and the preparation of cartier cells tumor-infil-trating lymphocytes, the monoclonal virus cell line PLC-2 and PLJC-5available were used to introduce marked gene NeoR and targeted gene tumor necrosis factor-α into tumor-infiltrating lymphocytes, respectively.Then cell proliferation, tumor necrosis factor expression and in vitro antitumor activity were examined. After cancer cell inoculation, the 36 nude mice were randomly divided into 6 groups: local infusion control group, local tumor-infiltrating lymphocytes infusion group, local tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, venous infusion control group, venous tumor-infiltrating lymphocytes infusion group and venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group, and the therapeutic effects on the cancer-loaded mice were observed.proliferation and tumor necrosis factor-α expression in tumor-infiltrating oR-tumor-infiltrating lymphocytes and tumor necrosis factor-tumor-infiltrating lymphocytes was not significantly different from each other (P ＞ 0.05).NeoR-tumor-infiltrating lymphocytes, though not significantly different (P ＞0.05), significantly differ from that of tumor necrosis factor-tumor-infiltrating lymphocytes (P ＜ 0.01); moreover, tumor necrosis factor-tumor-infiltrating lymphocytes were found to express higher tumor necrosis factor-α conactivity did not significantly differ between tumor-infiltrating lymphocytes and NeoR-tumor-infiltrating lymphocytes (P ＞ 0.05), but obviously increased come of the animal experiment: 40 days after tumor necrosis factor-tumorinfiltrating lymphocytes infusion, cancer size in local tumor necrosis factortumor-infiltrating lymphocytes infusion group was found smaller than that in local infusion control group [(307±42) and (2 048±278) mm3, P ＜ 0.01],and it was also smaller in venous tumor necrosis factor-tumor-infiltrating lymphocytes infusion group than that in venous control group [(954±195)and (1 989±305) mm3 , P ＜ 0.05].CONCLUSION: Tumor necrosis factor-α gene transduced tumor-infiltrating lymphocytes could effectively express tumor necrosis factor, exerting higher and in vivo anti-tumor effects than tumor-infiltrating lymphocytes in cancer-loaded nude mice. No obvious inhibitory effects on the growth of subcutaneous solid carcinoma could be observed in nude mice after venous infusion of human brain glioblastoma tumor-infiltrating lymphocytes, but the inhibitory effects became obvious due to venous infusion of tumor necrosis factor-tumor-infiltrating lymphocytes and significant due to local tumor necrosis factor-tumor-infiltrating lymphocytes infusion, indicating that local infusion is the preferable way in the treatment of glioblastoma by immuno-gene therapy.