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

Objective The identification of TCM constitution plays an important role in"treating and preventing diseases"of TCM.At present,the identification of damp-heat constitution and balanced constitution is mostly determined by questionnaire,and subjective factors have a great influence.Aiming at the identification of damp-heat constitution and balanced constitution in TCM,this paper utilizes voice signal to automatically realize the constitution identification task,in order to provide assistance for the clinical identification of TCM constitution.Methods Based on deep learning Transformer and transfer learning,a pure attentional mechanism model was designed for the identification of constitution in TCM sound diagnosis.We collected 700 voices from 34 subjects,pre-processed the voice data to obtain the corresponding Mayer spectrum diagram,and used the Transformer model pre-trained based on the public data set to improve the performance of the model for audio classification.Results The accuracy of the experimental results was 83.33%,the AUC was 92.16%,the sensitivity was 80.25%,and the specificity was 87.03%.Compared with the Convolutional Neural Network(CNN),the performance of the deep learning model was better.Conclusion In this paper,the damp-heat constitution and balanced constitution identification model Transformer has achieved better identification effect,indicating that it can improve the efficiency of TCM acoustic diagnosis of constitution identification,and promote the objective and intelligent development of constitution identification.

The aging population and changes in the disease spectrum have contributed to an increasing number of chronic refractory wounds, which not only cause physical and mental pain to patients and diminish their life quality, but also place a heavy burden on both their families and the society. Clinical practice has proven that establishing wound repair department for specialized treatment of chronic refractory wounds can effectively enhance treatment outcomes. As a newly established tertiary surgical discipline, wound repair discipline in China has been in development for 5 years. The authors outlined the main difficulties encountered during the establishment of wound repair discipline and summarized the key issues over the past 5 years. To solve these difficulties, the authors reviewed measures and achievements in areas such as raising people′s awareness, building standardized wards, exploring the multiple models of discipline construction, advancing research-oriented discipline construction, defining the scope of treatment, striving for service projects and promoting establishment of specialized level IV surgical systems, formulating a series of consensus guidelines for standardized treatment, developing and translating new wound repair technologies, creating a talent education and training system, expanding academic exchanges and cooperation, as well as fostering the growth of high-level disciplines, so as to offer references to support ongoing advancement in the establishment of wound repair discipline.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

For middle-aged and elderly patients with conditions such as spinal fractures and degenerative spinal diseases, spinal internal fixation is a core surgical procedure for reconstructing spinal stability, heavily relying on the biomechanical stability provided by pedicle screw systems. Whereas, these patients are often complicated by osteoporosis that can significantly compromise the stability of the bone-pedicle screw interface, leading to a marked increase in pedicle screw loosening and surgical failure rates. The bone cement-augmented pedicle screw technique, which involves injecting bone cement into the vertebral body or screw trajectory to optimize the mechanical properties of the bone-pedicle screw composite, has been proven to significantly enhance fixation strength and effectively prevent screw-related failures, thereby reducing the incidence of internal fixation failure in high-risk populations undergoing spinal fusion. However, the widespread clinical application of this technique has faced challenges such as inaccurate clinical decision-making (indication and contraindication selection), non-standardized operative practices, and insufficient awareness of complication prevention, resulting in considerable variability in clinical outcomes and even severe complications. To address this, Prof. Luo Fei from First Affiliated Hospital of Army Medical University initiated the project and the Chinese Association Orthopaedic Surgeons organized relevant experts to develop the Evidence-based clinical practice guideline for bone cement-augmented pedicle screw technique ( version 2025), based on current evidence. The guidelines put forward 8 recommendations regarding the clinical value, scope of application, and operational standards of the technique, aiming to provide evidence-based medical support and technical standardization for clinical decision-making.

ObjectiveTo observe the analgesic efficacy and safety of Qihuang acupuncture theory combined with opioid analgesics in patients with moderate to severe cancer pain due to lung cancer. MethodsPatients with moderate to severe cancer pain from lung cancer were randomly divided into Qihuang acupuncture group and control group， with 33 cases in each group. The control group was treated with long-acting opioid analgesics at maintenance doses and supplementary analgesic medications as needed. In case of breakthrough pain， short-acting opioids were used for rescue. The Qihuang acupuncture group received Qihuang acupuncture treatment in addition to the treatment used in the control group， administered once every other day， with 3 sessions constituting one treatment course. The treatment duration for both groups was 5 days. The primary outcome was the change in pain intensity， measured using the numerical rating scale （NRS） before and after treatment， and the NRS change rate was calculated. Secondary endpoints included the daily NRS change rate， the Eastern Cooperative Oncology Group （ECOG） Performance Status （PS） score， the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire （EORTC QLQ-C30） score， and the 24-hour equivalent hydrocodone sustained-release tablet dose. Laboratory tests， including routine blood， urine， stool， liver function， and kidney function， were performed before and after treatment. Adverse events were recorded throughout the trial. ResultsAll patients completed the trial， and both groups showed a decrease in average NRS scores and PS scores after treatment， with the Qihuang acupuncture group showing lower average NRS scores and PS scores than the control group （P＜0.05 or P＜0.01）. After treatment， the NRS change rate in the Qihuang acupuncture group was （0.42±0.17）， significantly higher than that in the control group （0.14±0.27， P＜0.01）. The daily NRS change rate during treatment was also higher in the Qihuang acupuncture group compared to the control group （P＜0.01）. The Qihuang acupuncture group showed an increase in overall health status and functional scores in the EORTC QLQ-C30， and a decrease in symptom scores for fatigue， nausea and vomiting， pain， dyspnea， insomnia， appetite loss， constipation， and financial difficulties. In contrast， overall health status and constipation scores in the control group increased， while scores of fatigue， nausea and vomiting， pain， and appetite loss decreased （P＜0.05 or P＜0.01）. After treatment， the 24-hour equivalent hydrocodone sustained-release tablet dose did not show significant difference in the Qihuang acupuncture group （P＞0.05）， while the control group showed a significant increase in the 24-hour dose （P＜0.01）. No significant abnormalities were observed in laboratory tests before and after treatment in either group. During the study， the incidence of nausea and vomiting as well as constipation in the Qihuang acupuncture group was both 3.03% （1/33）， while the incidence in the control group was 27.27% （9/33） and 36.36% （12/33）， respectively， with the Qihuang acupuncture group showing significantly lower incidence （P＜0.01）. No serious adverse reactions were observed in either group. ConclusionQihuang acupuncture therapy combined with opioid analgesics is more effective than using opioids alone in relieving pain in patients with moderate to severe cancer pain due to lung cancer. It can improve the patients' physical condition and quality of life， reduce the dose of opioid analgesics， and has good safety.

Objective To construct a model for predicting ki-67 expression in hepatocellular carcinoma using the intratumoral and peritumoral radiomic features of contrast enhanced magnetic resonance imaging(CEMRI)in the arterial phase as well as clinical imaging features.Methods A total of 120 patients pathologically diagnosed with hepatocellular carcinoma(HCC)from January 2016 to December 2024 in No.910 Hospital of the Joint Logis-tics Support Force of the Chinese People's Liberation Army were retrospectively enrolled and randomly divided into a training set(84 cases)and a test set(36 cases)in a ratio of 7∶3.ITK-SNAP software was used to delineate the global region of interest(ROI)of HCC on the arterial phase MR images.The ROIs of all patients were automatically expanded outward by 2 mm,and then the intratumoral ROI areas were eliminated to obtain the peritumoral ROI.With the help of PyRadiomics software,1 198 intratumoral and peritumoral radiomic features were extracted.Spearman correlation analysis,maximum relevance-minimum redundancy(mRMR),and least absolute shrinkage and selection operator(LASSO)regression were used to reduce the data dimension and select the best features.Then,a radiomics model of the logistic regression(LR)machine learning algorithm was constructed.A combined model including clinical imaging features and radiomics features was established.The area under the curve(AUC),accuracy,sensitivity,specificity,positive predictive value(PPV),negative predictive value(NPV),calibration curve and decision curve analysis(DCA)were used to evaluate the efficacy of the intratumoral and peritumoral radiomics features combined with clinical imaging features model in predicting ki-67 expression in hepatocellular car-cinoma.Results The intratumor model exhibited an efficacy in predicting the expression of ki-67 in hepatocellular carcinoma with AUC values of 0.817 and 0.787 in the training set and test set,respectively.The peritumoral model showed an efficacy with AUC values of 0.805 and 0.633 in the training set and test set,respectively.The intratumoral and peritumoral model demonstrated AUC values of 0.874 and 0.836 in the training set and test set,respectively.The combined model constructed by integrating the intratumoral and peritumoral model with clinical imaging features yielded AUC values of 0.877 and 0.849 in the training set and test set,respectively,indicating clinical imaging features improved the performance of the model.DCA showed that the combined models all had good clinical benefits,with the intratumoral and peritumoral model performing the best.Conclusion The intratumoral and peritumoral radiomics model based on CEMRI arterial phase combined with clinical imaging data can accurately predict the expression of ki-67 in hepatocellular carcinoma.This combined model yields the best clinical benefit.

Porcine reproductive and respiratory syndrome(PRRS),an infectious disease,poses a significant threat to the swine industry.The causative agent of the disease is porcine reproductive and respiratory syndrome virus(PRRSV),which primarily infects porcine alveolar macrophages and destroys the immune system.In the absence of specific antiviral drugs targeting PRRSV,vacci-nation is of paramount importance for the prevention and control of this disease.Currently,there are numerous types of PRRS vaccines,such as attenuated live vaccines,inactivated vaccines,sub-unit vaccines,DNA vaccines,vector vaccines,and so forth.However,only attenuated live virus and inactivated virus vaccines are widely employed for the prevention and control of PRRS.Live vac-cines offer relatively better protection effects,but they have weak cross-protection and pose safety concerns.Inactivated vaccines are safe but have poor immunogenicity.This article conducts a com-prehensive review of the advantages,disadvantages,and applicability of PRRS vaccines,including attenuated live vaccines,inactivated vaccines,subunit vaccines,vector vaccines,DNA vaccines,mR-NA vaccines,virus-like particle vaccines,etc.,aiming to provide a theoretical basis for the research and development of the next generation of PRRS vaccines.

Porcine reproductive and respiratory syndrome(PRRS),an infectious disease,poses a significant threat to the swine industry.The causative agent of the disease is porcine reproductive and respiratory syndrome virus(PRRSV),which primarily infects porcine alveolar macrophages and destroys the immune system.In the absence of specific antiviral drugs targeting PRRSV,vacci-nation is of paramount importance for the prevention and control of this disease.Currently,there are numerous types of PRRS vaccines,such as attenuated live vaccines,inactivated vaccines,sub-unit vaccines,DNA vaccines,vector vaccines,and so forth.However,only attenuated live virus and inactivated virus vaccines are widely employed for the prevention and control of PRRS.Live vac-cines offer relatively better protection effects,but they have weak cross-protection and pose safety concerns.Inactivated vaccines are safe but have poor immunogenicity.This article conducts a com-prehensive review of the advantages,disadvantages,and applicability of PRRS vaccines,including attenuated live vaccines,inactivated vaccines,subunit vaccines,vector vaccines,DNA vaccines,mR-NA vaccines,virus-like particle vaccines,etc.,aiming to provide a theoretical basis for the research and development of the next generation of PRRS vaccines.

Objective:To explore the biodistribution characteristics of mixed activated killer (MAK) immune cells in immunodeficient mice after administration.Methods:Ninety-six immune immunodeficient (NOG) mice (half male and half female) were equally divided into MAK cell group and solvent control group. The MAK cell group mice were injected with DiR-labeled MAK cells via the tail vein, while those in the solvent control group were injected with an equal amount of solvent via the tail vein. The number of MAK cells in the peripheral blood of mice was detected using a flow cytometry at 11 time points from 15 minutes to 84 days after administration. The distribution of MAK cells in mice was measured using in vivo bioluminescence imaging at 18 time points from 5 minutes to 84 days after administration. And at 8 time points from 3 hours to 84 days after administration, the heart, liver, spleen, lungs, kidneys, brain, stomach, duodenum, colon, bone marrow, fat, skeletal muscle, testes/uterus, epididymis/ovary, and blood were collected from corresponding mice. The DNA levels of MAK cells in blood and various organs of these mice were detected using fluorescence real-time quantitative polymerase chain reaction (qPCR) method.Results:The flow cytometry results showed that MAK cells could be detected in the peripheral blood of mice 15 minutes after administration, and the highest number of MAK cells in blood appeared during 3 hours to 1 day. By 14 days after administration, MAK cells were almost undetectable in peripheral blood of mice. In vivo bioluminescence imaging results showed that the fluorescence intensity of MAK cells in mice was strongest on days 1 and 2 after administration, and MAK cells were mostly distributed in the liver, spleen, lung, and leg bone of mouse. The qPCR detection results showed that MAK cells were mainly distributed in the spleen and lungs. High levels of MAK cell DNA amplification were observed in organs such as the spleen and lungs 28-56 days after administration, and a certain amount of MAK cell DNA could still be detected in organs of mice such as the spleen at 84 days.Conclusions:After administration, MAK cells were mainly distributed in the spleen, lung, liver and other organs of NOG mice. From 28 to 56 days after administration, MAK cells are significantly activated and proliferate, and a certain amount of MAK cell DNA can still be detected in the spleen and other organs after 84 days in mice.