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Objective To analyze the characteristics of spirometry and type 2 inflammation indicators of patients with CVA,ACO and CA to determine their clinical utility in identifying and distinguishing among CVA,ACO and CA patients.Methods Clinical data from 483 patients diagnosed with bronchial asthma,CVA,and bronchial asthma combined with chronic obstructive pulmonary disease in the outpatient department of the First Affiliated Hospital of Soochow University from July 2023 to June 2024 were collected and divided into CA,CVA and ACO groups according to diagnosis.Comparison of spirometry,fractional exhaled nitric oxide(FeNO),blood eosinophil(EOS),serum total immunoglobulin E(tIgE)and other tests between CA and CVA,CA and ACO groups.Perform logistic regression analysis on significant test results,then construct receiver operating characteristic(ROC)curves to compare the area under the curve and corresponding cut-off values.Result There was a statistically significant difference in tIgE between the CVA and CA groups(P=0.018),whereas no significant differences were observed in FeNO and EOS.Additionally,no notable differences were found between the ACO and CA groups in tIgE,FeNO,or EOS.Finally,FEV1％pred(OR=1.086,P=0.019),FEV1/FVC(OR=1.153,P=0.023),and MEF50％pred(OR=0.922,P=0.045)were used to construct the discriminative model between CA and CVA.ROC curves were plotted,with FEV1％pred showing an AUC of 0.680(P<0.001),a Youden index of 0.358,and a corresponding cutoff value of 89.200.FEV1/FVC had an AUC of 0.684(P<0.001),a Youden index of 0.334,and a cutoff value of 76.075.MEF50％pred had an AUC of 0.668(P<0.001),a Youden index of 0.309,and a cutoff value of 59.800.The combined sensitivity of these three measures was 0.909,specificity was 0.514,positive predictive value was 0.600,negative predictive value was 0.873,and the AUC was 0.773(P<0.001),with a Youden index of 0.423.FEV1(OR=0.002,P=0.045),FEV1％pred(OR=1.490,P=0.006),and FEV1/FVC(OR=0.749,P=0.005)were used to construct the discriminative model between CA and ACO.ROC curves were plotted,with FEV1 showing an AUC of 0.819(P<0.001),a Youden index of 0.532,and a corresponding cutoff value of 2.060.FEV1％pred had an AUC of 0.788(P<0.001),a Youden index of 0.501,and a cutoff value of 75.000.FEV1/FVC had an AUC of 0.891(P<0.001),a Youden index of 0.678,and a cutoff value of 68.620.The combined sensitivity of these three measures was 1.000,specificity was 0.904,positive predictive value was 0.771,negative predictive value was 1.000,and the AUC was 0.973(P<0.001),with a Youden index of 0.904.Conclusions Differences exist in the spirometry among CVA,ACO and CA.The spirometry results incor-porated into the discriminative models provide good discriminative value for distinguishing between CA and CVA patients with similar clinical symptoms,as well as for identifying ACO in the CA population.

Objective: To evaluate the clinical efficacy of digitally guided precision crown lengthening in secondary aesthetic rehabilitation cases, and to provide a clinical reference for digitally guided crown lengthening procedures and secondary aesthetic restorations. Methods: We present a case of a patient with tetracycline-stained teeth, partial detachment of anterior resin veneers, and gingival margin discrepancies. The patient underwent digitally guided precision crown lengthening followed by secondary aesthetic rehabilitation. Multimodal data, including intraoral, facial, and CBCT scans, were integrated to construct a four-dimensional virtual patient model (incorporating teeth, face, bone, and occlusion) for surgical planning and 3D-printed guide fabrication. Secondary aesthetic restoration was performed after achieving stable post-surgical outcomes. Based on this case, we conducted a detailed analysis and reviewed relevant literature on crown lengthening in secondary aesthetic rehabilitation. Results: The gingival contour of the anterior teeth exhibited significant improvement, with enhanced symmetry and stable gingival margin positioning that closely matched the preoperative design. The crown lengthening procedure demonstrated high precision, and the final outcome was aesthetic and functional. Literature review indicated that secondary restorations frequently present challenges such as gingival contour discrepancies and inflammation. Aesthetic crown lengthening in the anterior region should optimize both soft and hard tissue morphology to meet aesthetic standards, with digital technology improving procedural accuracy. Conclusion Precision crown lengthening effectively addresses gingival margin discrepancies in secondary aesthetic rehabilitation, ensuring stable gingival positioning and superior aesthetic outcomes. This approach is particularly suitable for cases with high aesthetic demands.

Objective To investigate the prevalence of Schistosoma japonicum infections in wild rodents in schistosomiasis-endemic areas of China, so as to provide insights into formulation of technical guidelines for monitoring of and the precise control strategy for S. japonicum infections in wild rodents during the elimination phase. Methods Two administrative villages where schistosomiasis was historically highly prevalent were selected each from Dongzhi County, Anhui Province, and Duchang County, Jiangxi Province as study villages. Wild rodents were captured from study villages with baited traps or cages at night in June and September, 2021. The number of rodents captured was recorded, and the rodent species was characterized based on morphologi-cal characteristics. Liver tissues were sampled from captured rodents for macroscopical observation of the presence of egg granu- lomas, and S. japonicum infection was detected simultaneously using liver tissue homogenate microscopy, examinations of mesenteric tissues for parasites, and modified Kato-Katz thick smear technique (Kato-Katz technique). A positive S. japonicum infection was defined as detection of S. japonicum eggs or adult worms by any of these methods. The rate of wild rodent capture and prevalence of S. japonicum infections in wild rodents were compared in different study villages and at different time periods, and the detection of S. japonicum infections in wild rodents was compared by different assays. Results The overall rate of wild ro- dent capture was 8.28% (237/2 861) in Dongzhi County, and the wild rodent capture rates were 9.24% (133/1 439) and 7.31% (104/1 422) in two study villages (χ² = 3.503, P = 0.061), and were 8.59% (121/1 409) and 7.99% (116/1 452) in June and September, 2021, respectively (χ² = 0.337, P = 0.561). The overall rate of wild rodent capture was 3.72% (77/2 072) in Duchang County, and the wild rodent capture rates were 6.91% (67/970) and 0.91% (10/1 102) in two study villages (χ² = 51.901, P < 0.001), and were 4.13% (39/945) and 3.37% (38/1 127) in June and September, 2021, respectively (χ² = 0.815, P = 0.365). Rattus norvegicus was the predominant rodent species captured in both counties, accounting for 70.04% (166/237) of all captured wild rodents in Dongzhi County and 88.31% (68/77) in Duchang County. No S. japonicum infection was detected in wild rodents captured in Duchang County. Nevertheless, the overall prevalence of S. japonicum infections was 51.05% (121/237) in wild rodents captured in Dongzhi County, with prevalence rates of 50.38% (67/133) and 51.92% (54/104) in two study villages (χ² = 0.098, P = 0.755), and 54.31% (63/116) and 47.93% (58/121) in September and June, 2021, respectively (χ² = 0.964, P = 0.326). Of 237 wild rodents captured in Dongzhi County, there were 140 (59.07%) rodents with visible hepatic egg granulomas, 117 (49.47%) tested positive for S. japonicum eggs by liver tissue homogenate microscopy, 34 (14.35%) tested positive for S. japonicum eggs with Kato-Katz technique; however, no adult S. japonicum worms were detected in mesenteric tissues. In addition, hepatic egg granulomas were found in all wild rodents tested positive for S. japonicum eggs with liver tissue homogenate microscopy. Conclusions The rate of wild rodent capture and prevalence of S. japonicum infection in wild rodents vary greatly in schistosomiasis-endemic areas of China, and the prevalence of S. japonicum infection is slightly higher in wild rodents captured in autumn than in summer. Liver tissue is recommended as the preferred sample for surveillance of S. japonicum infection in wild rodents, and a combination of macroscopical observation of hepatic egg granulomas and liver tissue homogenate microscopy may be a standard method for surveillance of S. japonicum infection in wild rodents.

Objective To analyze the characteristics of spirometry and type 2 inflammation indicators of patients with CVA,ACO and CA to determine their clinical utility in identifying and distinguishing among CVA,ACO and CA patients.Methods Clinical data from 483 patients diagnosed with bronchial asthma,CVA,and bronchial asthma combined with chronic obstructive pulmonary disease in the outpatient department of the First Affiliated Hospital of Soochow University from July 2023 to June 2024 were collected and divided into CA,CVA and ACO groups according to diagnosis.Comparison of spirometry,fractional exhaled nitric oxide(FeNO),blood eosinophil(EOS),serum total immunoglobulin E(tIgE)and other tests between CA and CVA,CA and ACO groups.Perform logistic regression analysis on significant test results,then construct receiver operating characteristic(ROC)curves to compare the area under the curve and corresponding cut-off values.Result There was a statistically significant difference in tIgE between the CVA and CA groups(P=0.018),whereas no significant differences were observed in FeNO and EOS.Additionally,no notable differences were found between the ACO and CA groups in tIgE,FeNO,or EOS.Finally,FEV1％pred(OR=1.086,P=0.019),FEV1/FVC(OR=1.153,P=0.023),and MEF50％pred(OR=0.922,P=0.045)were used to construct the discriminative model between CA and CVA.ROC curves were plotted,with FEV1％pred showing an AUC of 0.680(P<0.001),a Youden index of 0.358,and a corresponding cutoff value of 89.200.FEV1/FVC had an AUC of 0.684(P<0.001),a Youden index of 0.334,and a cutoff value of 76.075.MEF50％pred had an AUC of 0.668(P<0.001),a Youden index of 0.309,and a cutoff value of 59.800.The combined sensitivity of these three measures was 0.909,specificity was 0.514,positive predictive value was 0.600,negative predictive value was 0.873,and the AUC was 0.773(P<0.001),with a Youden index of 0.423.FEV1(OR=0.002,P=0.045),FEV1％pred(OR=1.490,P=0.006),and FEV1/FVC(OR=0.749,P=0.005)were used to construct the discriminative model between CA and ACO.ROC curves were plotted,with FEV1 showing an AUC of 0.819(P<0.001),a Youden index of 0.532,and a corresponding cutoff value of 2.060.FEV1％pred had an AUC of 0.788(P<0.001),a Youden index of 0.501,and a cutoff value of 75.000.FEV1/FVC had an AUC of 0.891(P<0.001),a Youden index of 0.678,and a cutoff value of 68.620.The combined sensitivity of these three measures was 1.000,specificity was 0.904,positive predictive value was 0.771,negative predictive value was 1.000,and the AUC was 0.973(P<0.001),with a Youden index of 0.904.Conclusions Differences exist in the spirometry among CVA,ACO and CA.The spirometry results incor-porated into the discriminative models provide good discriminative value for distinguishing between CA and CVA patients with similar clinical symptoms,as well as for identifying ACO in the CA population.

Lung cancer is the malignant tumor with the highest incidence and mortality among the Chinese.Tumor node metastasis(TNM)staging established by the American Joint Committee on Cancer(AJCC)and International Union Against Cancer(UICC)is a commonly used criterion,but it still has limitations in judging the prognosis of non-small cell lung cancer(NSCLC)patients.With the advantages of real-time and convenient sampling,the immune score based on peripheral blood biomarkers have the ability to predict prognosis and efficacy of NSCLC patients,which have been developed and validated in clinical studies.However,clinical impleruentation of peripheral immune scores is still not widely in NSCLC patients.Therefore,this study introduces and evaluates the 6 peripheral immune scores and reviews the reseach progress of them in the treatment of NSCLC.

【Objective】 To analyze the quality level of the laboratory pre-analytical phase, so as to take effective quality improvement interventions to further standardize the operation and provide basis for ensuring the quality of blood testing. 【Methods】 Pre-analytical phase quality indicators of blood screening laboratory in Shanghai Blood Center were established, and those had serious impact on blood safety were defined as the sentinel indicators. The pre-analytical quality level of our laboratory from 2018 to 2020 was statistically analyzed in terms of four parts including sample collection, preservation and submission, centrifugation and quality inspection, which contained 17 indicators. 【Results】 Eleven sentinel indicators were established, and the order of peak value from high to low in three years was as follows: " label omission" rated at 0.000 62% (2020), " label error" 0.000 57% (2018), " inappropriate storage of samples before detection" 0.007 39 (2018), " unqualified application form for sample detection" 0.007 39 (2018). The causes were analyzed and relevant measures were taken. Six monitoring indicators were established, and the order of peak value from high to low in three years was as follows: " insufficient sample" rated at 0.002 59% (year 2018), " hemolysis" 0.002 80% (year 2020), " pale color of blood supernatant (diluted)" 0.000 86 (2018), " automatic sampling interfered by blood clot" 0.027 02% (2018). 【Conclusion】 The quality indexes of pre-analytical phase in our laboratory have reached the level of domestic and international clinical laboratories. The establishment of pre-analytical quality indicators and sentinel indicators, with effective analysis and application, can fully record and monitor the quality of each link before laboratory testing, which is helpful to timely identify risks, detect deviations, and quickly implement corrective and preventive measures, thus further ensure the safety of clinical blood use.

Objective To explore the association between post-stroke blood pressure and collaterals and functional outcome in acute ischemic stroke (AIS) patients with large vessel occlusion/stenosis.Methods Consecutive AIS patients with large vessel occlusion/stenosis who had symptom onset within 6 hours in Huashan Hospital from July 2011 to October 2017 were retrospectively recruited and enrolled.Collaterals were analyzed through CT perfusion imaging.And all the patients were followed up for 3 months.And the association between baseline blood pressure,collaterals and outcomes was analyzed using multivariate linear and Logistic models.A total of 126 patients were enrolled for multivariate Logistic and linear regression analysis.Results Multivariate Logistic regression analysis revealed that with every increment of 10 mmHg (1 mmHg =0.133 kPa) systolic blood pressure,the odds of poor functional outcome increased by 20％ (unadjusted OR =1.20,95％ CI 1.02-1.42,P =0.03).After adjusting for age and sex,the odds increased by 21％ (OR =1.21,95％ CI 1.01-1.46,P =0.04).However,no statistical significance was shown after multivariate adjustment (OR--1.02,95％ CI 0.99-1.05,P =0.06).Multivariate linear regression analysis demonstrated that diastolic blood pressure (DBP) was negatively associated with the volume of hypoperfused and severely hypoperfused lesion.With every increment of 10 mmHg DBP,the volume of delay time (DT) ＞ 6 s lesion downsized by 7.6 ml (unstandardized coefficient -7.56,95％ CI-14.89--0.24,P =0.04).The DT ＞6 s/DT ＞3 s ratio was also decreased with the elevation of DBP (unstandardized coefficient-0.03,95 ％ CI-0.06--0.01,P =0.01).Conclusions For AIS patients,though higher DBP seems to be associated with better collaterals,it may still relate with poor functional outcome.

Objective To evaluate the effect of robot-assisted gait training on the walking ability of hemiplegic patients.Methods Sixty hemiplegic patients were randomly divided into a control group and a treatment group,each of 30.Both groups were given traditional rehabilitation and drug therapy.The control group was additionally provided with the traditional gait training,while the treatment group additionally received robot-assisted gait training.The gait training lasted 30 minutes a day,5 days per week.Before and after 8 weeks of training,the time parameters,phase parameters,the joint angles of the lower limbs,and the peak ground reaction forces of both groups were evaluated using a three-dimensional gait analysis system.Results After the intervention,the walking velocity,stride frequency and stride length had increased in the treatment group,while stride width had decreased.Significant improvement was observed in the treatment group in terms of the percentage of swing phase on the paretic side,the percentage of stance phase on the paretic side,the single support time ratio,the percentage of double support phase,the range of motion of the hip and knee joints,and the peak vertical and forward ground reaction force as a percentage of body weight.The improvements were significantly greater than those observed in the control group.Conclusions Compared with traditional walking training,robot-assisted gait training can be more effective in improving the walking ability of hemiplegic patients.

Objective To clarify the intravenous thrombolysis utilization of acute ischemic stroke patients in Huashan hospital,and to analyze the factors affecting thrombolytic therapy compliance.Methods The data from a prospective cohort were analyzed.Consecutive acute stroke and transient ischemic attack patients from Huashan Hospital emergency room were recruited in 2014.Eligible ischemic stroke patients were divided into two groups according to intravenous thrombolysis or not.Results Totally 220 patients from emergency room were assessed in 2014.Among eligible patients,43 patients refused intravenous thrombolysis,whereas 59 patients chose this therapy.After multiple analysis,age,baseline NIHSS score,limb weakness,hemiplegic paralysis,facial paralysis or speech symptoms were significantly different between the two groups (U =936.000,P =0.024;U =284.500,P ＜ 0.01;x2 =8.824,P =0.003;x2 =7.732,P=0.005;x2 =5.169,P=0.038;x2 =5.040,P=0.025).Patients with NIHSS score ＜7 tended to refuse thrombolysis therapy in the receiver operating characteristic curve analysis (sensitivity 0.93,specificity 0.71).From 2008 to 2014,244 cases were analyzed in the thrombolysis database.Compared with patients with higher baseline NIHSS score,intracranial hemorrhage rate (2.6％ vs 19.4％;x2 =12.466,P ＜0.01),7-day mortality rate (1.3％ vs 16.9％;x2 =12.308,P ＜0.01) and 3-month mortality rate (3.8％ vs 21.1％;x2 =11.993,P ＜0.01) were lower in patients whose baseline NIHSS score ＜ 7 (minor group).A higher rate of excellent outcome (3-month modified Rankin Scale score ≤ 1)was observed in minor group (78.2％ vs 38.0％;x2 =34.403,P ＜ 0.01).Conclusions Intravenous thrombolysis was performed in 54.6％ of eligible ischemic stroke patients.Age,baseline NIHSS score,limb weakness,hemiplegic paralysis,facial paralysis or speech symptoms were associated with patients' decision of thrombolysis.The effectiveness and safety of intravenous thrombolysis were promising for patients with mild stroke.