ObjectiveThis paper aims to investigate the traditional Chinese medicine syndrome types in patients with chronic hepatitis B （CHB） complicated by metabolic dysfunction-associated fatty liver disease （MAFLD） and explore the correlations between these syndrome types and clinical indicators， as well as ocular manifestation characteristics， thereby providing a reference for syndrome differentiation and treatment strategies in traditional Chinese medicine. MethodsGeneral data， information from the four diagnostic methods of traditional Chinese medicine， clinical indicators， and ocular manifestation data were collected from 506 patients with CHB complicated by MAFLD enrolled at the Public Health Clinical Center of Chengdu between June 2024 and December 2024. Cluster analysis， principal component analysis， and complex network models were employed to identify the distribution patterns of traditional Chinese medicine syndromes. Correlations between different syndrome types and clinical indicators， as well as ocular manifestation characteristics， were further analyzed. ResultsThe predominant syndromes identified in patients with CHB complicated by MAFLD were dampness and heat accumulation （51.58%）， liver depression with spleen deficiency （31.62%）， blood stasis obstructing collaterals （8.89%）， and Qi-Yin deficiency （7.91%）. No statistically significant differences were found among the four syndrome types in routine blood tests and liver function indicators. However， patients with the dampness and heat accumulation type exhibited significantly higher levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， liver stiffness measurement （LSM）， controlled attenuation parameter （CAP）， and alpha-fetoprotein （AFP）， along with lower levels of high-density lipoprotein cholesterol （HDL-C）， compared with those with other syndrome types. Regarding ocular manifestations， the incidence of moon halo signs was significantly higher in patients with the blood stasis obstructing collaterals type than in those with other syndrome types. Additionally， the incidence in scleral zone 3 （corresponding to the large intestine） was higher in patients with the damp and heat accumulation type. ConclusionDampness and heat accumulation is the core syndrome type in patients with CHB complicated by MAFLD， commonly accompanied by spleen deficiency， liver depression， blood stasis， and Yin deficiency. A complex syndrome pattern characterized by a predominance of dampness and heat， along with a mixture of deficiency and excess， is formed. Different traditional Chinese medicine syndrome types are associated with distinct clinical indicators and ocular manifestation characteristics. Among them， patients with the dampness and heat accumulation type exhibit more pronounced metabolic disturbances and liver injury， whereas those with the blood stasis type show a higher incidence of moon halo signs. Abnormalities in scleral zone 3 are also more prevalent in patients with dampness and heat type.

ObjectiveTo investigate the effect of 1，25（OH）₂D₃ on the level of peroxisome proliferator-activated receptor-γ （PPAR-γ） in the liver， the phenotype of hepatic macrophages， and liver inflammation in a rat model of nonalcoholic steatohepatitis （NASH）， as well as the mechanism of 1，25（OH）₂D₃ improving liver inflammation. MethodsAfter 1 week of adaptive feeding， 24 specific pathogen-free Wistar rats were randomly divided into normal group ［choline-supplemented L-amino acid-defined （CSAA） diet］， normal+1，25（OH）₂D₃ group ［CSAA diet+1，25（OH）₂D₃］， model group ［choline-deficient L-amino acid-defined diet （CDAA） diet］， and model+1，25（OH）₂D₃ group ［CDAA diet+1，25（OH）₂D₃］， with 6 rats in each group. The dose of 1，25（OH）₂D₃ was 5 μg/kg for intraperitoneal injection twice a week for 12 weeks. The serum levels of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） were measured， liver histopathology was observed， and SAF score was assessed. M1 hepatic macrophages and M2 hepatic macrophages were measured to analyze in the change in the phenotype of hepatic macrophages， and ELISA was used to measure the levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， interleukin-4 （IL-4）， and interleukin-10 （IL-10） in liver tissue， and qPCR was used to measure the mRNA level of PPAR-γ. The two-factor analysis of variance was use for comparison between groups， and the least significant difference t-test was used for further comparison； the Pearson method was used for correlation analysis. ResultsCompared with the normal group， the model rats with CDAA diet-induced NASH had significant increases in the serum levels of AST and ALT （P=0.019 and P<0.001）， the SAF score of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， and the ratio of M1 and M2 hepatic macrophages （P<0.001）， as well as a significant increase in the level of TNF-α （P<0.001） and a significant reduction in the level of IL-4 in liver tissue （P=0.025）. The 1，25（OH）₂D₃ group had significant reductions in the serum levels of ALT （P<0.001）， the SAF score of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， and the ratio of M1 and M2 hepatic macrophages （P=0.001）， the level of IL-1β （P<0.001） and a significant increase in the level of M2 hepatic macrophages （P=0.017）， the level of IL-10 （P=0.039）， the level of IL-4 （P<0.001）， the level of PPAR-γ （P=0.016）. There were significant interactions between CDAA diet-induced NASH model and 1，25（OH）₂D₃ in serum the levels of AST and ALT （P=0.007 and P=0.008）， the SAF scores of liver histopathology （P<0.001）， the level of M1 hepatic macrophages （P<0.001）， the level of M2 hepatic macrophages （P=0.008）， the ratio of M1 and M2 of hepatic macrophages （P=0.005）， the level of TNF-α （P<0.001）， the level of IL-10 （P=0.038）， the level of IL-4 （P<0.001） and the level of PPAR-γ （P=0.009）. The correlation analysis showed that PPAR-γ was negatively correlated with the ratio of M1 and M2 hepatic macrophages （r=-0.415， P=0.044） and was positively correlated with M2 hepatic macrophages （r=0.435， P=0.033）， IL-10 （r=0.433， P=0.035）， and IL-4 （r=0.532， P=0.007）. ConclusionThis study shows that 1，25（OH）₂D₃ improves liver inflammation in NASH by activating PPAR-γ to regulate the phenotypic transformation of hepatic macrophages.

To explore the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with modified biopsy forceps for suspected malignant biliary obstruction, 72 patients with suspected malignant biliary obstruction who underwent ERCP using modified biopsy forceps from January 2017 to April 2023 in the First Affiliated Hospital of Henan University of Chinese Medicine were selected as the modified group, while 61 contemporaneous patients who underwent ERCP with traditional biopsy forceps were selected as the control group at the same time. The stenosis site was identified during the operation, and the effective pathological tissue was obtained by biopsy. Benign or malignant tumor was determined according to the medical history and clinical follow-up data. The sensitivity and specificity of the two groups were compared. The success rate of biopsy was 100.00% in the two groups. All patients had no serious complications and were diagnosed histologically. Sixty-seven cases were finally diagnosed as malignant and 5 cases were benign in the modified group. In the control group, 58 cases were malignant and 3 cases were benign. The sensitivity for diagnosis of malignant biliary stricture was 79.10% (54/67) in the modified group, and 60.34% (35/58) in the control group, with significant difference ( χ2=6.218, P= 0.013). The specificity of the two methods for the diagnosis of malignant stenosis was 100.00%. Therefore, it is safe and effective to apply ERCP combined with the modified biopsy forceps in the diagnosis of extrahepatic malignant bile duct stenosis.

Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans ; Denture, Complete ; Computer-Aided Design ; Denture Design/methods* ; Consensus ; Printing, Three-Dimensional

Objective To observe the value of intratumoral and peritumoral CT radiomics for predicting Ki-67 expression level of lung adenocarcinoma with mixed ground glass nodules.Methods Totally 284 cases of pathologically confirmed lung adenocarcinoma with mixed ground glass nodules were retrospectively enrolled,among them 197 cases were taken as training set(54 cases with high and 143 cases with low Ki-67 expression)and 87 cases as validation set(27 cases with high and 60 cases with low Ki-67 expression).Intratumoral and peritumoral radiomic features were obtained from non-contrast chest CT,and radiomic models for predicting Ki-67 expression in lung adenocarcinoma with mixed ground glass nodules were established using adaptive boosting,light gradient boosting machine(LightGBM)and multilayer perceptron algorithms based on intratumoral features,peritumoral features,as well as intratumoral+peritumoral features,respectively,and the optimal radiomics signature was selected according to the area under the receiver operating characteristic curve(AUC).Univariate and multivariate logistic regression analysis were performed to identify independent impact factors of Ki-67 expression level,and a clinical model was constructed,and the efficacy of the models were evaluated.Results Among radiomics models,LightGBMintratumoral+peritumoral model had the highest AUC(0.934 in training set and 0.845 in validation set),which were superior to that of clinical model(0.616 in training set and 0.684 in validation set)(both P＜0.05)Conclusion Intratumoral and peritumoral CT radiomics had good efficacy for predicting Ki-67 expression level of lung adenocarcinoma with mixed ground glass nodules.

Objective To observe the value of intratumoral and peritumoral CT radiomics for predicting Ki-67 expression level of lung adenocarcinoma with mixed ground glass nodules.Methods Totally 284 cases of pathologically confirmed lung adenocarcinoma with mixed ground glass nodules were retrospectively enrolled,among them 197 cases were taken as training set(54 cases with high and 143 cases with low Ki-67 expression)and 87 cases as validation set(27 cases with high and 60 cases with low Ki-67 expression).Intratumoral and peritumoral radiomic features were obtained from non-contrast chest CT,and radiomic models for predicting Ki-67 expression in lung adenocarcinoma with mixed ground glass nodules were established using adaptive boosting,light gradient boosting machine(LightGBM)and multilayer perceptron algorithms based on intratumoral features,peritumoral features,as well as intratumoral+peritumoral features,respectively,and the optimal radiomics signature was selected according to the area under the receiver operating characteristic curve(AUC).Univariate and multivariate logistic regression analysis were performed to identify independent impact factors of Ki-67 expression level,and a clinical model was constructed,and the efficacy of the models were evaluated.Results Among radiomics models,LightGBMintratumoral+peritumoral model had the highest AUC(0.934 in training set and 0.845 in validation set),which were superior to that of clinical model(0.616 in training set and 0.684 in validation set)(both P＜0.05)Conclusion Intratumoral and peritumoral CT radiomics had good efficacy for predicting Ki-67 expression level of lung adenocarcinoma with mixed ground glass nodules.

To explore the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with modified biopsy forceps for suspected malignant biliary obstruction, 72 patients with suspected malignant biliary obstruction who underwent ERCP using modified biopsy forceps from January 2017 to April 2023 in the First Affiliated Hospital of Henan University of Chinese Medicine were selected as the modified group, while 61 contemporaneous patients who underwent ERCP with traditional biopsy forceps were selected as the control group at the same time. The stenosis site was identified during the operation, and the effective pathological tissue was obtained by biopsy. Benign or malignant tumor was determined according to the medical history and clinical follow-up data. The sensitivity and specificity of the two groups were compared. The success rate of biopsy was 100.00% in the two groups. All patients had no serious complications and were diagnosed histologically. Sixty-seven cases were finally diagnosed as malignant and 5 cases were benign in the modified group. In the control group, 58 cases were malignant and 3 cases were benign. The sensitivity for diagnosis of malignant biliary stricture was 79.10% (54/67) in the modified group, and 60.34% (35/58) in the control group, with significant difference ( χ2=6.218, P= 0.013). The specificity of the two methods for the diagnosis of malignant stenosis was 100.00%. Therefore, it is safe and effective to apply ERCP combined with the modified biopsy forceps in the diagnosis of extrahepatic malignant bile duct stenosis.

Objective To analyze the epidemiological patterns and pathogens of clusters of diarrhea in Xicheng Distract , Beijing during 2017-2022 , in order to update the policy of prevention. Mehods Between January 2017 and December 2022, stool samples of patients and partly cooks in clusters of diarrhea were collected and tested by Real-time PCR for Rotavirus, Norovirus, Adenovirus, Sapovirus and Astrovirus. Part of ORF1/ORF2 from Norovirus positive samples were amplified using RT-PCR. PCR products were sequenced and the genetypes were determined. Results Four hundreds and one clusters of diarrheas were reported. Among them , 369 were reported in kindergartens, primary schools and secondary schools. The morbidities were 4.14, 2.13 and 0.69 per thousand, respectively. Seventy four cooks in 15 clusters of diarrhea were Norovirus positive. The rate was 8.67%. Among these pathogens, Norovirus had the largest proportion , but the trend was declining. At least three kinds of genetype of GⅡ Norovirus were detected every year. Conclusion Clusters of diarrhea mainly occurred in kindergartens, primary schools and secondary schools. Result from the increasing proportions of unknown-cause clusters of diarrhea, the testing methods and scopes of pathogens should be extended. Diverse genetypes of Norovirus coexist and alternate in Beijing. So appearance of new genetypes and recombination of existed ones of Norovirus should be closely concerned.

Objective To compare the efficacy of mediastinoscope-assisted transhiatal esophagectomy (MATHE) and functional minimally invasive esophagectomy (FMIE) for esophageal cancer. Methods Patients who underwent minimally invasive esophagectomy at Jining No.1 Hospital from March 2018 to September 2022 were retrospectively included. The patients were divided into a MATHE group and a FMIE group according to the procedures. The patients were matched via propensity score matching (PSM) with a ratio of 1 : 1 and a caliper value of 0.2. The clinical data of the patients were compared after the matching. Results A total of 73 patients were include in the study, including 54 males and 19 females, with an average age of (65.12±7.87) years. There were 37 patients in the MATHE group and 36 patients in the FMIE group. Thirty pairs were successfully matched. Compared with the FMIE group, MATHE group had shorter operation time (P=0.022), lower postoperative 24 h pain score (P=0.031), and less drainage on postoperative 1-3 days (P<0.001). FMIE group had more lymph node dissection (P<0.001), lower incidence of postoperative hoarseness (P=0.038), lower white blood cell and neutrophil counts on postoperative 1 day (P<0.001). There was no statistically significant difference in the bleeding volume, R0 resection, hospital mortality, postoperative hospital stay, anastomotic leak, chylothorax, or pulmonary infection between the two groups (P>0.05). Conclusion Compared with the FMIE, MATHE has shorter operation time, less postoperative pain and drainage, but removes less lymph nodes, which is deficient in oncology. For some special patients such as those with early cancer or extensive pleural adhesions, MATHE may be a suitable surgical method.

Objective To investigate the epidemiological chatacteristics and genotypes of parechovirus A (PeV-A) from children with acute diarrhea in Beijing in 2021. Methods Fecal samples were randomly collected from outpatient children under 60 months with acute diarrhea in a sentinel hospital in Beijing from January to December of 2021. RNA was extracted and detected for PeV-A by real-time RT-PCR. Nested RT-PCR was performed to amplify the VP3/VP1 conjunction region. PeV-A genotypes were determined based on sequencing and NCBI BLAST. Group A rotavirus, norovirus, enteric adenovirus, astrovirus and sapovirus were also detected for co-infection analysis. Phylogenetic and statistical analyses were performed using bioinformatics and statistical software. Results Of the 198 stool samples, 11 were positive for PeV-A, with a detection rate of 5.56% (11/198). Among them, 2 cases were co-infected with enteric adenovirus. 81.82% (9/11) of PeV-A infected cases were under 24 months. The highest detection rate was observed in fall, which was 12.50% (7/56). 90.91%（10/11）of PeV-A infection occurred in summer and fall. Among the 11 PeV-A isolates, 9 were sequenced successfully, of which 7 belonged to PeV-A1B genotype and 2 belonged to PeV-A3 genotype. Conclusion PeV-A1B and PeV-A3 are identified in children with acute gastroenteritis in Beijing in 2021. Infants and young children under 2 years old are the high-risk population for PeV-A infection. Most infections occur in summer and fall.