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

Objective:To summarize and analyze the clinical characteristics and treatment outcomes of patients with recurrent pericarditis.Methods:This observational study consecutively recruited patients with recurrent pericarditis who were hospitalized at Peking University People′s Hospital between January 2017 and February 2024. Clinical characteristics and treatment outcomes were collected and summarized during follow-up.Results:A total of 8 recurrent pericarditis patients including 3 males were included, with an age of 34.0 (22.0, 39.5) years. In terms of clinical features, all patients presented with acute-onset severe chest pain, accompanied by fever in 7 and an audible pericardial friction rub in 2 patients. Electrocardiogram showed no diffuse ST-segment elevation or PR-segment depression in any patient. Echocardiography revealed pericardial effusion in all cases, with extensive fibrinous exudate and transient pericardial thickening observed in 6 patients. CT identified concurrent pleural and/or peritoneal effusions in 6 patients. All patients exhibited marked elevations in C-reactive protein, erythrocyte sedimentation rate and D-dimer levels. Whole-exome sequencing identified MEFV gene mutations associated with familial Mediterranean fever in 3 cases. Two patients developed cardiac tamponade requiring pericardiocentesis, which revealed hemorrhagic effusion. In the aspect of treatment outcomes, the time from recurrence to first confirmed diagnosis of recurrent pericarditis of this cohort was 14.5 (13.3, 19.5) d. Upon diagnosis, all patients promptly received standard anti-inflammatory therapy with ibuprofen and colchicine, achieving rapid relief. However, during a follow-up of 12.0 (6.0, 25.3) months, 3 patients experienced recurrence, and 2 developed transient constrictive pericarditis.Conclusion:Patients with recurrent pericarditis typically exhibit characteristic clinical presentations, laboratory abnormalities, imaging findings and potential genetic associations. Although standard anti-inflammatory therapy demonstrates favorable short-term efficacy, long-term management remains challenging due to the risks of recurrence and progression to constrictive pericarditis.

To summarise the nursing experience of caring for a patient with focal segmental glomerulosclerosis for kidney re-transplantation.Nursing key points:early recognition of recurrence of the original disease and rapid activation of emergency response;stabilization of cyclosporine concentration by precision management;optimizing in vitro anticoagulation regimens and vigilance for bleeding and clotting;regulate adrenocorticotropic hormone use and being alert for adverse effects;implementing the whole process of infection prevention and control to prevent infection;implementing the whole process of psychological counseling to alleviate negative emotions.After active treatment and careful care,the patient's transplanted kidney function recovered and was successfully discharged.After a follow-up for 2 months,the patient recovered well.

Objective:To compare the outcomes of ranibizumab and conbercept adjunct for pars plana vitrectomy (PPV) in the treatment of proliferative diabetic retinopathy (PDR).Methods:A prospective randomized case-control study. From June 2022 to December 2023, 90 cases (90 eyes) of PDR patients diagnosed through ophthalmic examination at Department of Ophthalmology of Gansu Provincial Hospital were included in the study. All patients underwent the best corrected visual acuity (BCVA), intraocular pressure, B-mode ultrasound, and optical coherence tomography (OCT) examinations. The central macular thickness (CMT) was measured using an OCT instrument. The patients were randomly divided into a intravitreal injection of ranibizumab group (monoclonal-antibody group) and a intravitreal injection of conbercept group (fusion-protein group) using a random number table method, with 45 cases (45 eyes) in each group. Two groups of patients were intravitreal injected with 10 mg/ml ranibizumab or conbercept 0.05 ml, respectively. A standard 23G PPV was performed through the flat part of the ciliary body 3-7 days after intravitreal injection. Relevant examinations were performed using the same equipments and methods as before surgery at postoperative 1 week, 1, 3, 6, and 12 months. The PPV time, intraoperative use of intraocular electrocoagulation, incidence of iatrogenic retinal breaks, and sterile air or silicone oil tamponade rate in the vitreous cavity, the postoperative changes of BCVA and CMT, and incidence of complications were compared between two groups. Independent sample t test was used for inter group comparison. Results:The intraoperative utilization rate of intraocular electrocoagulation in the monoclonal-antibody group was higher than that in the fusion-protein group, and the difference was statistically significant ( χ2=3.876, P<0.05). There were no statistically significant differences in the PPV time ( t=0.152), intraoperative bleeding rate ( χ2=0.800), incidence of iatrogenic retinal breaks ( χ2=1.975), and sterile air and silicone oil tamponade rate in the vitreous cavity ( χ2=1.607, 1.553) between the two groups ( P>0.05). There were no statistically significant differences in early and late postoperative vitreous hemorrhage ( χ2=1.235, 2.355), and re-PPV ( χ2=2.355) between two groups ( P>0.05). The BCVA of the fusion-protein group was significantly better than that of the monoclonal-antibody group at postoperative 3 months, and the difference was statistically significant ( t=2.428, P<0.05). The CMT of the fusion-protein group was lower than that in the monoclonal-antibody group at postoperative 1 week, and the difference was statistically significant ( t=2.739, P<0.05). None of the patients experienced endophthalmitis, retinal artery occlusion, or severe cardiovascular events after surgery. Conclusion:Compared with intravitreal injection of ranibizumab before PPV, intravitreal injection of conbercept before PPV in PDR patients can shorten the surgical time, reduce intraoperative bleeding rate, lower the rate of electrocoagulation and intraocular tamponade, and incidence of iatrogenic retinal breaks, and improve the visual acuity.

To summarise the nursing experience of caring for a patient with focal segmental glomerulosclerosis for kidney re-transplantation.Nursing key points:early recognition of recurrence of the original disease and rapid activation of emergency response;stabilization of cyclosporine concentration by precision management;optimizing in vitro anticoagulation regimens and vigilance for bleeding and clotting;regulate adrenocorticotropic hormone use and being alert for adverse effects;implementing the whole process of infection prevention and control to prevent infection;implementing the whole process of psychological counseling to alleviate negative emotions.After active treatment and careful care,the patient's transplanted kidney function recovered and was successfully discharged.After a follow-up for 2 months,the patient recovered well.

Objective:To compare the outcomes of ranibizumab and conbercept adjunct for pars plana vitrectomy (PPV) in the treatment of proliferative diabetic retinopathy (PDR).Methods:A prospective randomized case-control study. From June 2022 to December 2023, 90 cases (90 eyes) of PDR patients diagnosed through ophthalmic examination at Department of Ophthalmology of Gansu Provincial Hospital were included in the study. All patients underwent the best corrected visual acuity (BCVA), intraocular pressure, B-mode ultrasound, and optical coherence tomography (OCT) examinations. The central macular thickness (CMT) was measured using an OCT instrument. The patients were randomly divided into a intravitreal injection of ranibizumab group (monoclonal-antibody group) and a intravitreal injection of conbercept group (fusion-protein group) using a random number table method, with 45 cases (45 eyes) in each group. Two groups of patients were intravitreal injected with 10 mg/ml ranibizumab or conbercept 0.05 ml, respectively. A standard 23G PPV was performed through the flat part of the ciliary body 3-7 days after intravitreal injection. Relevant examinations were performed using the same equipments and methods as before surgery at postoperative 1 week, 1, 3, 6, and 12 months. The PPV time, intraoperative use of intraocular electrocoagulation, incidence of iatrogenic retinal breaks, and sterile air or silicone oil tamponade rate in the vitreous cavity, the postoperative changes of BCVA and CMT, and incidence of complications were compared between two groups. Independent sample t test was used for inter group comparison. Results:The intraoperative utilization rate of intraocular electrocoagulation in the monoclonal-antibody group was higher than that in the fusion-protein group, and the difference was statistically significant ( χ2=3.876, P<0.05). There were no statistically significant differences in the PPV time ( t=0.152), intraoperative bleeding rate ( χ2=0.800), incidence of iatrogenic retinal breaks ( χ2=1.975), and sterile air and silicone oil tamponade rate in the vitreous cavity ( χ2=1.607, 1.553) between the two groups ( P>0.05). There were no statistically significant differences in early and late postoperative vitreous hemorrhage ( χ2=1.235, 2.355), and re-PPV ( χ2=2.355) between two groups ( P>0.05). The BCVA of the fusion-protein group was significantly better than that of the monoclonal-antibody group at postoperative 3 months, and the difference was statistically significant ( t=2.428, P<0.05). The CMT of the fusion-protein group was lower than that in the monoclonal-antibody group at postoperative 1 week, and the difference was statistically significant ( t=2.739, P<0.05). None of the patients experienced endophthalmitis, retinal artery occlusion, or severe cardiovascular events after surgery. Conclusion:Compared with intravitreal injection of ranibizumab before PPV, intravitreal injection of conbercept before PPV in PDR patients can shorten the surgical time, reduce intraoperative bleeding rate, lower the rate of electrocoagulation and intraocular tamponade, and incidence of iatrogenic retinal breaks, and improve the visual acuity.

Objective:To summarize and analyze the clinical characteristics and treatment outcomes of patients with recurrent pericarditis.Methods:This observational study consecutively recruited patients with recurrent pericarditis who were hospitalized at Peking University People′s Hospital between January 2017 and February 2024. Clinical characteristics and treatment outcomes were collected and summarized during follow-up.Results:A total of 8 recurrent pericarditis patients including 3 males were included, with an age of 34.0 (22.0, 39.5) years. In terms of clinical features, all patients presented with acute-onset severe chest pain, accompanied by fever in 7 and an audible pericardial friction rub in 2 patients. Electrocardiogram showed no diffuse ST-segment elevation or PR-segment depression in any patient. Echocardiography revealed pericardial effusion in all cases, with extensive fibrinous exudate and transient pericardial thickening observed in 6 patients. CT identified concurrent pleural and/or peritoneal effusions in 6 patients. All patients exhibited marked elevations in C-reactive protein, erythrocyte sedimentation rate and D-dimer levels. Whole-exome sequencing identified MEFV gene mutations associated with familial Mediterranean fever in 3 cases. Two patients developed cardiac tamponade requiring pericardiocentesis, which revealed hemorrhagic effusion. In the aspect of treatment outcomes, the time from recurrence to first confirmed diagnosis of recurrent pericarditis of this cohort was 14.5 (13.3, 19.5) d. Upon diagnosis, all patients promptly received standard anti-inflammatory therapy with ibuprofen and colchicine, achieving rapid relief. However, during a follow-up of 12.0 (6.0, 25.3) months, 3 patients experienced recurrence, and 2 developed transient constrictive pericarditis.Conclusion:Patients with recurrent pericarditis typically exhibit characteristic clinical presentations, laboratory abnormalities, imaging findings and potential genetic associations. Although standard anti-inflammatory therapy demonstrates favorable short-term efficacy, long-term management remains challenging due to the risks of recurrence and progression to constrictive pericarditis.

Objective To investigate the predictive value of the expression levels of YY1 transcription fac-tor(YY1)and microRNA(miR)-181a-5p in peripheral blood mononuclear cell for adverse pregnancy out-comes in gestational diabetes mellitus(GDM).Methods A total of 200 patients with GDM were enrolled as the GDM group.100 healthy pregnant women who underwent prenatal examinations during the same period were selected as the control group.The expressions levels of YY1 and miR-181a-5p in peripheral blood mono-nuclear cell were detected by fluorescent quantitative PCR.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of YY1 and miR-181a-5p for adverse pregnancy outcomes in GDM pa-tients.Results Compared with the control group,the expression levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell of GDM group were obviously decreased(P＜0.05),and the incidence rates of post-partum hemorrhage,macrosomia and neonatal hypoglycemia in GDM group were obviously higher(P＜0.05).Multivariate Logistic regression analysis showed that age and poor blood glucose control were inde-pendent risk factors for adverse pregnancy outcomes in GDM patients(P＜0.05),and the expression levels of peripheral blood mononuclear cell YY1 and miR-181a-5p were independent protective factors for adverse preg-nancy outcomes in GDM patients(P＜0.05).ROC curve results showed that the area under the curve(AUC)of the expression levels of YY1 and miR-181a-5p in peripheral blood alone and in combination in predicting ad-verse pregnancy outcomes in GDM patients was 0.717,0.751 and 0.832,respectively,and the AUC of their combination was obviously higher than that of the two alone(P＜0.05).Conclusion The decreased expres-sion levels of YY1 and miR-181a-5p in peripheral blood mononuclear cell of GDM patients could increase the risk of adverse pregnancy outcomes,YY1 and miR-181a-5p are closely related to adverse pregnancy outcomes in GDM patients,and both could be used as predictors of adverse pregnancy outcomes in GDM patients.

Objective:To evaluate the diagnostic value of gene testing in familial hypercholesterolemia (FH) in patients with premature myocardial infarction(PMI).Methods:This study was a single center cross-sectional study. A retrospective analysis was made on PMI patients who visited the People′s Hospital of Peking University from May 1, 2015 to March 31, 2017. Clinical data of patients was collected and gene testing of FH related genes low density lipoprotein receptor (LDLR), proprotein convertase subtilisin/kexin type 9 (PCSK9), apolipoprotein B(APOB) and low density lipoprotein receptor adaptor protein 1(LDLRAP1) was carried out. Clinical diagnosis of FH patients was performed using Simon Broome criteria, DLCN criteria, and FH Chinese expert consensus.Results:There were 188 males (83.6%) among 225 PMI patients, and the age of the first myocardial infarction was (46.6±7.2) years old. Ten patients carried FH pathogenic or possibly pathogenic mutations (4.4%). Compared with Simon Broome standard, DLCN standard and FH Chinese expert consensus, gene testing increased the diagnostic rate of FH by 53.3%, 33.3% and 42.1% respectively.Conclusion:Gene testing is helpful to improve the diagnosis of FH, and it is important to start the standard treatment of FH as early as possible in patients with premature myocardial infarction.

AIM:This study aims to examine the ependymin-related protein 1(EPDR1)expression in various tissues from wild-type C57BL/6 mice and type 2 diabetes(db/db)mice.The impact of EPDR1 on lipid accumulation in al-pha mouse liver 12(AML12)hepatocytes was also investigated.METHODS:Western blot was used to detect EPDR1 protein expression in the heart,liver,spleen,lung,kidney,gastrocnemius,brown adipose and brain tissues of C57BL/6 mice.Western blot and immunohistochemical(IHC)staining were also used to compare EPDR1 protein expression in the liver,gastrocnemius muscle,heart and kidney tissues of db/db and C57BL/6 mice.To develop an AML12 cell lipid deposi-tion model,palmitic acid(PA)+oleic acid(OA)was used,and the cells were transfected with adenovirus overexpressing EPDR1 or treated with exogenous recombinant EPDR1 protein(rEPDR1).ELISA was conducted to determine intracellu-lar triglyceride(TG)content,and oil red O staining was employed to assess the effect of EPDR1 on lipid accumulation in AML12 cells.RESULTS:Western blot and IHC staining results revealed that EPDR1 was widely expressed in various tis-sues of wild-type mice,with the liver exhibiting the highest protein expression level.However,EPDR1 expression was down-regulated in the liver,gastrocnemius muscle,heart and kidney tissues in diabetic db/db mice compared with wild-type mice.Oil red O staining revealed that overexpression of EPDR1 in AML12 liver cells or rEPDR1 treatment led to re-duced lipid accumulation.Furthermore,the TG content significantly decreased compared with the model group(P<0.05).CONCLUSION:EPDR1 is expressed in various tissues of wild-type mice,but showed diminished expression in the liver tissues of diabetic mice.Nevertheless,enhancing the expression of EPDR1 can aid in reducing lipid accumula-tion in hepatocytes.These findings provide an experimental foundation for further exploration of the role of EPDR1 in the development of fatty liver in diabetic liver tissue.