Objective:To analyze the status quo and research hotspots of palliative care development in China.Methods:It was a bibliometric analysis. Literature on palliative care in China was searched in databases of CNKI, Wanfang Data and Web of Science from 2018 to 2023. CiteSpace software was used for bibliometric analysis in terms of publication number, citation frequency, keyword co-occurrence network, and the evolution of research hotspots.Results:A total of 582 articles were included for analysis, with 534 in Chinese language (91.75%) and 48 in English (8.25%). From 2018 to 2023, the overall number of publications on palliative care in China had shown an upward trend. Most highly cited articles were published in nursing journals, and a total of 89 articles (15.29%) were marked as supported by national level funding projects. Keyword co-occurrence chart showed that the most frequent keywords were "palliative care", follwed by "end-of-life care""nurses""palliative medicine""review", and "hospice care". Keyword clustering analysis and emergent word analysis suggested that researches in the field of palliative care were gradually shifting from implementation strategies and models (2018-2020) to service practice effectiveness, personnel core competencies, social culture, patient quality of life, and other aspects(2021—2023).Conclusion:The field of palliative care in China has received more and more attention. In recent years, the research topics havs focused on the practical effectiveness of services, the capacity building of service personnel, and the overall social impact of service implementation.

Application of invisible orthodontic appliances in the treatment of adult skeletal malocclusions,especially in the cases requiring tooth extraction,has always been one of the challenges in invisible orthodontic technology.Our department received a 30-year-old female patient in March 2019;the patient presented with complaints of"crooked teeth and protruding mouth,"seeking orthodontic treatment to improve her facial profile.The patient had bilateral distal molar relationship,proclined maxillary and mandibular anterior teeth,and deep overjet;radiographic examination revealed an ANB angle of 6.2°,indicating a skeletal Class Ⅱ malocclusion.By extracting four first premolars and using four miniscrews,after 20 months of treatment,the extraction spaces were fully closed,the dental arch was aligned,and the occlusal relationship was favorable;the anterior teeth were retracted,the mandible showed a reverse rotation,and the soft tissue profile was significantly improved.Application of invisible orthodontic appliances in conjunction with miniscrews anchorage can achieve good three-dimensional control of tooth movement in adult extraction cases,providing a reference for clinical practitioners treating such patients.

Skeletal class Ⅱ malocclusion is characterized by maxillary protrusion,mandibular retrognathia,or a combination of both,and often accompanied by vertical dimensional discrepancies;treatment is complex,and combined orthodontic-orthognathic surgery is needed for the adult patients.Clear aligner therapy has gradually been applied in complex orthodontic cases.However,limited cases have been reported domestically and internationally regarding the application of clear aligner therapy combined with orthognathic surgery.This article presented a case of a patient with skeletal class Ⅱ high-angle malocclusion treated with the combined therapy and analyzed the clinical efficacy of the treatment appraoch to provide reference for the clinical practice.Extraction of impacted wisdom teeth 18,28,38,and 48,as well as orthodontic teeth 15,25,34,and 44,was performed in stages before orthodontic treatment.Clear aligner therapy was used for preoperative orthodontics.In sagittal plane,a super-complete class Ⅱ canine and molar relationship and a 13-14 mm overjet of the anterior teeth were established.The maxillary and mandibular arch morphology was matched horizontally.The orthognathic surgery included maxillary LeFort Ⅰ osteotomy,bilateral sagittal split ramus osteotomy(BSSRO)and chinplasty.Fine occlusal adjustment was conducted after operation.After treatment,the skeletal relationship between upper and lower jaw was corrected to normal;subspinale-nasion-supramental angle(ANB)was improved from 12.3° to 4.7°;the patient established the class Ⅰ canine and molar relationship,with normal overjet and overbite;root parallelism was good and there was no obvious root resorption;the facial soft tissue profile was significantly improved,and nasion-subnasale-pogonion angle(N-Sn-Pg)was improved from 143.9° to 162.8°.The curative effect was stable 1 year after operation.Clear aligner therapy can efficiently complete combined orthodontic and orthodontic surgery in the complex cases.Compared with the fixed appliance,it is more beneficial to the patients'need for beauty and the maintenance of periodontal health.

The patients with skeletal Class Ⅱ high-angle malocclusion are frequently complicated by idiopathic condylar resorption(ICR),which may lead to temporomandibular joint(TMJ)dysfunction and dentofacial deformities.This article reports the diagnosis and treatment process of a 24-year-old female patient with skeletal Class Ⅱ high-angle malocclusion accompanied by ICR.The patient's chief complaints were anterior open bite and TMJ pain,and was diagnosed with ICR through clinical examination and imaging.After stabilizing condylar resorption with occlusal splint therapy,combined orthodontic-orthognathic treatment was performed.The 42-month follow-up revealed:well-aligned dentition with complete closure of diastemas,significant improvement of protrusive facial profile(ANB angle reduced by 4.2°),complete resolution of TMJ pain and clicking,and establishment of stable Class Ⅰ occlusion.Three-dimensional CT demonstrated satisfactory condylar bone remodeling and normalized joint space.Through multidisciplinary treatment,both occlusal function and facial aesthetics were significantly improved.This case demonstrates that orthodontic-orthognathic treatment should be performed after condylar stabilization in ICR patients,and occlusal splint therapy serves as an effective preoperative intervention.

Objective:To analyze the status quo and research hotspots of palliative care development in China.Methods:It was a bibliometric analysis. Literature on palliative care in China was searched in databases of CNKI, Wanfang Data and Web of Science from 2018 to 2023. CiteSpace software was used for bibliometric analysis in terms of publication number, citation frequency, keyword co-occurrence network, and the evolution of research hotspots.Results:A total of 582 articles were included for analysis, with 534 in Chinese language (91.75%) and 48 in English (8.25%). From 2018 to 2023, the overall number of publications on palliative care in China had shown an upward trend. Most highly cited articles were published in nursing journals, and a total of 89 articles (15.29%) were marked as supported by national level funding projects. Keyword co-occurrence chart showed that the most frequent keywords were "palliative care", follwed by "end-of-life care""nurses""palliative medicine""review", and "hospice care". Keyword clustering analysis and emergent word analysis suggested that researches in the field of palliative care were gradually shifting from implementation strategies and models (2018-2020) to service practice effectiveness, personnel core competencies, social culture, patient quality of life, and other aspects(2021—2023).Conclusion:The field of palliative care in China has received more and more attention. In recent years, the research topics havs focused on the practical effectiveness of services, the capacity building of service personnel, and the overall social impact of service implementation.

Palliative care, as an emerging discipline, is rapidly advancing in China. However, progress in quality management has been relatively slow, hindering the homogeneity of palliative care services in a certain degree. This article takes the Shanghai Palliative Care Service Management Center as an example, outlines its practical model and achievements in the field of quality management since its establishment, and further analyzes the existing problems based on the city-wide palliative care service quality evaluation results. The article summarizes relevant experiences and offers corresponding insights, enriching research cases and practical support in the quality management of palliative care, which may have practical application value for enhancing the homogeneity of palliative care services in the region.

Objective:To evaluate the curative effect and adverse reactions of compound acid, alpha hydroxyl acid (AHA), and salicylic acid (SA) in the treatment of mild to moderate acne.Methods:A total of 105 patients admitted in Suzhou Municipal Hospital from August 2019 to May 2020 were divided into three groups randomly and treated with compound acid, AHA and SA, once every 3 weeks, 4 times totally. The efficacy was evaluated before treatment, 3 weeks after 1 time, 2 times, 3 times, and 4 times. The number of non-inflammatory lesions (comedos) and inflammatory lesions (papules or pustules) were recorded. VISIA image was used to record the patient＇s facial characteristics before treatment and 3 weeks after 4 times. The occurrence of adverse reactions was recorded.Results:Three groups were all safe and effective. The efficiency of non-inflammatory lesions showed that there was no statistically significant difference between the 3 groups (χ 2= 4.58, P=0.101). The effective rate of inflammatory lesions in the compound acid and SA groups were higher than that of AHA group, and the difference was statistically significant (χ 2=6.45, P=0.040). After 4 times, the clinical data of purpurin, red area, and spot in compound acid and SA groups were higher than those before treatment, and the difference was statistically significant ( P<0.05). While in the AHA group, the purple matter was higher than that before treatment after 4 times, the difference was statistically significant ( t=3.506, P=0.010), and the change in the red area was not statistically significant ( P>0.05). Conclusions:The compound acid is safe and effective in treating mild and moderate acne. It is effective for acne inflammatory and non-inflammatory lesions. It has less adverse reactions and is worthy of clinical application.

Tryptophan 2,3-dioxygnease 2 (TDO2) is specific for metabolizing tryptophan to kynurenine (KYN), which plays a critical role in mediating immune escape of cancer. Although accumulating evidence demonstrates that TDO2 overexpression is implicated in the development and progression of multiple cancers, its tumor-promoting role in esophageal squamous cell carcinoma (ESCC) remains unclear. Here, we observed that TDO2 was overexpressed in ESCC tissues and correlated significantly with lymph node metastasis, advanced clinical stage, and unfavorable prognosis. Functional experiments showed that TDO2 promoted tumor cell proliferation, migration, and colony formation, which could be prevented by inhibition of TDO2 and aryl hydrocarbon receptor (AHR). Further experimentation demonstrated that TDO2 could promote the tumor growth of KYSE150 tumor-bearing model, tumor burden of C57BL/6 mice with ESCC induced by 4-NQO, enhance the expression of phosphorylated AKT, with subsequent phosphorylation of GSK3

A 55-year-old male patient presented with plaques on the face for more than 20 years,and no immunodeficiency diseases were diagnosed.Skin examination showed large areas of pink plaques on the nose,bilateral cheeks and upper oral lips with slight desquamation,verrucous hyperplasia on the dorsal area of the nose,and a bean-sized verrucous protuberance on the tip of the nose.Histopathological examination of the skin lesions revealed pseudoepitheliomatous hyperplasia in the epidermis and hyphae-like structures in the stratum corneum.Moreover,there was diffuse infiltration of inflammatory cells in the dermis,which mainly included neutrophils,lymphocytes,histiocytes and multinucleated giant cells.Periodic acid-Schiff (PAS)-positive spore-like structures were observed in the multinucleated giant cells.Culture of the lesional tissues on Sabouraud dextrose agar (SDA) medium showed grey-brown villous colonies.Microculture on the potato dextrose agar (PDA) medium yielded dark septate hyphae and pycnidia filled with a large number of spores.Microsphaeropsis arundinis was identified by fungal molecular biological techniques.The patient was diagnosed with cutaneous phaeohyphomycosis caused by Microsphaeropsis arundinis.The patient was treated with CO2 laser for the removal of verrucous protuberance on the tip of the nose,and oral itraconazole capsules at a dose of 200 mg twice a day.After 3-month treatment,the skin lesions subsided and the drug was withdrew.During 6-month follow-up,no relapse occurred.

Objective To evaluate the efficacy and safety of posaconazole for preventing invasive fungal disease (IFD) in the aplastic anemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Methods A total of 46 aplastic anemia patients received allogeneic HSCT. They were treated with oral posaconazole 200 mg, three times a day from HSCT pretreatment to granulocyte recovery after transplantation. G test and GM test were done 1, 2 and 4 weeks after the end of posaconazole treatment, and chest CT scan repeated 4 weeks after the end of posaconazole treatment. Posaconazole prophylaxis was defined as successful if there were no clinical manifestations indicative of fungal infection. Results All the 46 patients experienced neutropenia. The median of absolute neutrophil count (ANC) nadir was 0.02 (0-0.05)×109/L for a median time of 10 (8-19) days. The median duration of posaconazole prophylaxis was 26 (15-41) days. Neutropenic fever was reported in 45 patients, which lasted a median time of 5 (1-13) days. Six patients (13.3％ of the patients with neutropenic fever) failed to respond to the empirical treatment of broad spectrum antibiotics with persistent fever over 7 days. Their treatment was switched to short-term empirical treatment with broad spectrum antifungal agents. However, subsequent G test, GM test and chest CT showed negative results. None of the six patient was consistent with IFD diagnosis. Breakthrough fungal infection was not considered. Oral posaconazole solution was resumed for preventing IFD. G test, GM test and chest CT scan did not show any sign of fungal infection 1, 2 and 4 weeks after the end of posaconazole prophylactic treatment in all the 46 patients, proving the success of oral posaconazole in preventing IFD. Posaconazole was not discontinued due to adverse drug reaction in any patient. Conclusions Posaconazole is effective for preventing IFD in the aplastic anemia patients receiving HSCT with good safety profile and few adverse reactions.