AIM: To investigate the influence of relevant inflammatory markers in peripheral blood on the progression of neovascular glaucoma(NVG)secondary to diabetic retinopathy(DR)patients.METHODS: Retrospective case-control study. Patients were categorized into two groups based on the presence or absence of NVG: those with proliferative diabetic retinopathy(PDR)alone(PDR group, n=148)and those with NVG secondary to PDR(NVG secondary to PDR group, n=142). Peripheral blood inflammatory markers were evaluated, including white blood cell-related indices, neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), monocyte-to-lymphocyte ratio(MLR), and systemic immune-inflammation index(SII). The distinctions in peripheral blood inflammatory markers between the two groups of patients and their relationships with NVG secondary to PDR were analyzed.RESULTS:No statistically significant differences were observed in basic characteristics between the two groups, confirming their comparability. However, significant differences were found in eosinophil percentage and MLR between the PDR group and the NVG secondary to PDR group(all P<0.05), with both values being significantly higher in the NVG secondary to PDR group. Multivariate Logistic regression analysis revealed that the eosinophil percentage and the MLR were factors influencing the development of patients with NVG secondary to PDR.CONCLUSION: Eosinophil percentage and MLR may be associated with the progression of PDR to NVG, and could serve as potential predictive markers for NVG development in PDR patients.

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*

To improve the understanding of clinicians on the diagnostic criteria and treatment principlis of pulmonary alveolar proteinosis(PAP),which is a rare respiratory disease.European Respiratory Society published the first edition guidelines for PAP,including a systematic review of the literature and the application of the grading of recommendations,assessment,development and evaluation(GRADE)approach to assess the certainty of evidence and the strength of recommendations.Five questions of patient,intervention,comparison,outcome(PICO)and two narrative questions were developed.Recommendations and evidence-based evidence were given,including management of PAP,whole lung lavage,granulocyte-macrophage colony-stimulating factor(GM-CSF)therapy,rituximab,plasma exchange,and lung transplantation.In addition,recommendations were given for the use of GM-CSF antibody testing,bronchoalveolar lavage,and lung biopsy.This study is to interpret the main content of the guideline.

Objective:To analyze the clinical characteristics of eosinophilic lung diseases(ELD) in children to enhance pediatricians′ understanding of ELD.Methods:In this retrospective cross-sectional study, a total of 149 children with ELD were recruited from Beijing Children′s Hospital, Capital Medical University between April 1, 2007 and March 31, 2022.Chi-square test, Fisher′s exact test, Mann-Whitney U test and Kruskal-Wallis test were used to analyze data and conclude clinical characteristics.Spearman correlation was used to analyze the correlation between eosinophils in peripheral blood and bronchoalveolar lavage fluid.Chi-square test and Kappa consistency test were used to compare the differences and consistency in diagnostic results between bronchoalveolar lavage fluid or lung biopsy and eosinophil elevation with chest imaging abnormalities. Results:(1)The isolated lung involvement was mostly caused by allergic bronchopulmonary aspergillosis(9 patients), and other system involvement by idiopathic hypereosinophilic syndrome(89 patients).(2)The main respiratory manifestations included coughing(90 cases, 60.4%) and expectoration(41 cases, 27.5%), while 23.5%(35 cases) of patients had no respiratory symptoms; 50.3% had digestive system involvement, and 40.9% had skin involvement.These were the two most commonly affected organs.(3)Spearman correlation was performed between eosinophils in peripheral blood and bronchoalveolar lavage fluid( r=0.3, P<0.05).Chi-square test was performed to compare ELD diagnosed by bronchoalveolar lavage fluid or lung biopsy with peripheral blood eosinophilia accompanied by abnormal chest imaging( P<0.05).Kappa consistency test(Kappa<0.2) showed poor consistency between the two diagnostic methods. Conclusions:ELD are present in children, and multiple etiologies may be pathogenic.Among children with ELD, the isolated lung involvement is mainly caused by allergic bronchopulmonary aspergillosis.The digestive system and skin are the most commonly affected organs, except for lungs.The correlation between eosinophil levels in peripheral blood and bronchoalveolar lavage fluid is poor.

Ameloblastoma is a benign tumor characterized by locally invasive phenotypes,leading to facial bone destruction and a high recurrence rate.However,the mechanisms governing tumor initiation and recurrence are poorly understood.Here,we uncovered cellular landscapes and mechanisms that underlie tumor recurrence in ameloblastoma at single-cell resolution.Our results revealed that ameloblastoma exhibits five tumor subpopulations varying with respect to immune response(IR),bone remodeling(BR),tooth development(TD),epithelial development(ED),and cell cycle(CC)signatures.Of note,we found that CC ameloblastoma cells were endowed with stemness and contributed to tumor recurrence,which was dominated by the EZH2-mediated program.Targeting EZH2 effectively eliminated CC ameloblastoma cells and inhibited tumor growth in ameloblastoma patient-derived organoids.These data described the tumor subpopulation and clarified the identity,function,and regulatory mechanism of CC ameloblastoma cells,providing a potential therapeutic target for ameloblastoma.

Objective:To explore the relationship between perceived stigma and self-transcendence meaning of life among male college students who have sex with men with HIV,and the role of fear of negation evaluation,seeking for meaning,perspective change in it.Methods:A total of 474 male college students who had sex with men with HIV were selected and tested with the simplified Berger HIV Stigma Scale(BHSS),Fear of Negative Evalua-tion Rating Scale(FNE),Chinese Meaning in Life Questionnaire(C-MLQ),Meaning-focused Coping Questionnaire(MFCQ),and Self-transcendence Meaning of Life Scale(SMLS).Results:The BHSS total scores were negatively correlated with the SMLS total scores(r=0.69,P＜0.001).The FNE scores and the seeking for meaning scores were mediating variables between the BHSS total scores and the SMLS total scores,with estimated effects of-0.13 and-0.11,respectively.The FNE score and seeking for meaning score played a chain mediating role in the total scores of BHSS and SMLS,with estimated effects of-0.16,the perspective change score played a moderating role in the score of the seeking for meaning and the SMLS total score(β=0.07,P＜0.05).Conclusion:Fear of negation evaluation and seeking for meaning play a mediating role between perceived stigma and self-transcendence meaning of life,as well as the moderating effect of perspective change between the search for meaning and self-transcendence meaning of life.

Objective:To explore the composition and trajectory of symptom clusters during perioperative period in middle-aged and elderly patients with gynecological malignant tumors, so as to provide reference for formulating symptom management programs.Methods:From December 2022 to September 2023, convenience sampling was used to select 145 middle-aged and elderly patients with gynecological malignant tumors who underwent surgical treatment at the Affiliated Cancer Hospital of Xinjiang Medical University as the study subject. A longitudinal survey was conducted on patients at four time points [1 day before surgery (T1), 1 day after surgery (T2), 3 days after surgery (T3), and 7 days after surgery (T4, before discharge) ] using the General Information Questionnaire and the Chinese version of the Anderson Symptom Inventory-Perioperative Module in Patients with Gynecological Cancer.Results:A total of 145 questionnaires were distributed, and 130 valid questionnaires were collected, with an effective response rate of 89.66% (130/145). Exploratory factor analysis extracted six symptom clusters, namely perimenopausal symptom cluster, psychological symptom cluster, fatigue-pain symptom cluster, gastrointestinal symptom cluster, energy deficiency symptom cluster, and surgery related symptom cluster. Perimenopausal symptom group was a specific symptom cluster of gynecological malignant tumor patients, existing at T1. Psychological symptom cluster persisted during the patient's perioperative period. Fatigue-pain symptom cluster and surgery related symptom cluster existed at T2 to T4. Gastrointestinal symptom cluster and energy deficiency symptom cluster existed at T2 and T3.Conclusions:Middle aged and elderly patients with gynecological malignant tumors have various symptoms during the perioperative period, and the symptoms can cluster at different time points. The number of symptom clusters increases with the progress of surgical treatment, while the core symptoms within the cluster remain relatively stable over time. Clinical nursing staff should pay attention to the dynamic changes in the patient's perioperative symptom cluster, adopt efficient and targeted management measures based on the trajectory of symptom clusters, and reduce the burden of perioperative symptoms on patients.

Objective:To explore the effect of double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva.Methods:The data of patients received double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva in Department of Medical Aesthetic Surgery, People’s Hospital of Rizhao, and Department of Plastic Surgery, Yimeitiancheng’s Cosmetic and Plastic Hospital of Rizhao from January 2021 to June 2022 were retrospectively analyzed. Before the operation, the double eyelid line was designed and 5 points were evenly marked along the line as A, B, C, D and E (from the lateral to the internal). During the operation, 10 ml needle was used to puncture the 5 points marked on the double eyelid line. Starting from the outermost point A, the needle was inserted obliquely inward on the skin surface, and then the upper eyelid was turned over, and the stitches was stabed-out from the conjunctival surface of the upper margin of tarsus. The stitches was inserted again from the original point pierced on the conjunctival surface, and the stitches was stabed-out diagonally inward through the skin surface at the point B. The same method was used to penetrate points C, D and E successively. Then E, D, C, B and A points were penetrated in turn from the inside to the outside. The two suture ends were passed through the 3/8 arc round stitches, which was inserted from the point A and stabed-out skin surface of the outer orbital margin above the double eyelid line through the deep. The tightness was adjusted and tied the knotted. After the surgery, the surgical results and complications were observed, and patients’ satisfaction was evaluated before and 6 months after the surgery, which included four factors: eyelid curvature, width, smoothness, and symmetry, with a maximum score of 100. Higher scores indicated greater patients’ satisfaction. Measurement data were expressed as Mean±SD, and paired sample t-test was used to compare the satisfaction of the same patient before and after surgery. P<0.05 indicated statistically significant difference. Results:A total of 82 patients with 160 eyes were included, including 75 females and 7 males. The age ranged from 18 to 32 years old, with a mean of 25.4 years old. 78 cases were treated with both eyes and 4 with one eye. In the early postoperative period, 8 patients had local cyanosis and slight swelling of eyelid, which was improved after routine cold compress treatment. Two cases reported a foreign body sensation in the eyeball, which improved with application of levofloxacin for 1 week. The remaining patients had good eyelid morphology with no significant swelling or foreign body sensation. A total of 60 patients were followed up for 6 months, and their eyelid morphology appeared natural and aesthetically pleasing. The eyelid crease was smooth when opened, and there were no obvious surgical scars when closed. Only one patient had a shallow eyelid crease, which was satisfactorily repaired with additional suturing. None of the patients experienced external suture exposure or subcutaneous nodules. The patient satisfaction score was (58.15±5.07) before operation and (98.68±1.69) 6 months after operation, the difference was statistically significant ( t=-70.33, P<0.001). Conclusion:Double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva has the advantages of minimally invasion, simple performence, direct vision operation, with natural appearance of double eyelid, and high patient satisfaction.

Objective:To explore the effect of double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva.Methods:The data of patients received double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva in Department of Medical Aesthetic Surgery, People’s Hospital of Rizhao, and Department of Plastic Surgery, Yimeitiancheng’s Cosmetic and Plastic Hospital of Rizhao from January 2021 to June 2022 were retrospectively analyzed. Before the operation, the double eyelid line was designed and 5 points were evenly marked along the line as A, B, C, D and E (from the lateral to the internal). During the operation, 10 ml needle was used to puncture the 5 points marked on the double eyelid line. Starting from the outermost point A, the needle was inserted obliquely inward on the skin surface, and then the upper eyelid was turned over, and the stitches was stabed-out from the conjunctival surface of the upper margin of tarsus. The stitches was inserted again from the original point pierced on the conjunctival surface, and the stitches was stabed-out diagonally inward through the skin surface at the point B. The same method was used to penetrate points C, D and E successively. Then E, D, C, B and A points were penetrated in turn from the inside to the outside. The two suture ends were passed through the 3/8 arc round stitches, which was inserted from the point A and stabed-out skin surface of the outer orbital margin above the double eyelid line through the deep. The tightness was adjusted and tied the knotted. After the surgery, the surgical results and complications were observed, and patients’ satisfaction was evaluated before and 6 months after the surgery, which included four factors: eyelid curvature, width, smoothness, and symmetry, with a maximum score of 100. Higher scores indicated greater patients’ satisfaction. Measurement data were expressed as Mean±SD, and paired sample t-test was used to compare the satisfaction of the same patient before and after surgery. P<0.05 indicated statistically significant difference. Results:A total of 82 patients with 160 eyes were included, including 75 females and 7 males. The age ranged from 18 to 32 years old, with a mean of 25.4 years old. 78 cases were treated with both eyes and 4 with one eye. In the early postoperative period, 8 patients had local cyanosis and slight swelling of eyelid, which was improved after routine cold compress treatment. Two cases reported a foreign body sensation in the eyeball, which improved with application of levofloxacin for 1 week. The remaining patients had good eyelid morphology with no significant swelling or foreign body sensation. A total of 60 patients were followed up for 6 months, and their eyelid morphology appeared natural and aesthetically pleasing. The eyelid crease was smooth when opened, and there were no obvious surgical scars when closed. Only one patient had a shallow eyelid crease, which was satisfactorily repaired with additional suturing. None of the patients experienced external suture exposure or subcutaneous nodules. The patient satisfaction score was (58.15±5.07) before operation and (98.68±1.69) 6 months after operation, the difference was statistically significant ( t=-70.33, P<0.001). Conclusion:Double-eyelid blepharoplasty by continuously double W-shape buried suture method through skin and conjunctiva has the advantages of minimally invasion, simple performence, direct vision operation, with natural appearance of double eyelid, and high patient satisfaction.

Objective To use feature selection and Likert grading method to quantify the data of lung cancer medical records,to construct a deep extreme learning machine model optimized by the sparrow search algorithm,to classify and predict the syndrome types of traditional Chinese medicine medical record data of lung cancer,and to provide scientific and effective research on syndrome type classification of traditional Chinese medicine.means.Methods The medical records of 497 cases diagnosed with lung cancer from January 2015 to December 2021 were collected from the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,and 412 medical records were screened as the research objects.Syndromic factors of different syndromes were summarized by feature selection and feature importance ranking,and the syndrome factors were quantified by Likert grading method.Build a deep extreme learning machine optimized based on the sparrow search algorithm,and train and test the model.Finally,the model built in this paper is compared with other machine learning models according to three evaluation criteria.Results The average classification accuracy of the SSA-DELM model established in this paper was 88.44%,while the average accuracy of the support vector machine and Bayesian network was 83.39%and 84.53%,respectively.The recall rate and F1 value of the SSA-DELM model on the five syndrome types are mostly above 80%,which is also better than other traditional machine learning models.Conclusion The results of the study show that the use of feature selection combined with Likert grading method to quantify the lung cancer medical record data,compared with the 0-1 processing data,can show the characteristics of the data,improve the accuracy of the classification model,SSA-DELM new Compared with other traditional machine learning classification models,the model has better representation learning ability and learning speed.This model not only provides a scientific and technical means for the clinical treatment of lung cancer,but also provides a useful reference for the informatization and intelligent development of TCM syndrome differentiation and treatment.