Myopia is a common eye disease among children and adolescents, and it is also a major and common public health problem for children and adolescents worldwide. Although the myopia rate among children and adolescents in different provinces , cities , and regions varies , the incidence of myopia is generally high , showing a trend of high incidence and younger age. Myopia in children and adolescents is closely related to sleep conditions . The sleep time of most children and adolescents in China does not reach the recommended length of time for this age group, and their sleep quality is poor, which affects their study and life. The biological connection and molecular mechanism between sleep and myopia are hot topics in clinical research . This article reviews the epidemiological characteristics of myopia and sleep status in children and adolescents , as well as the biological mechanisms between sleep and myopia , with the aim of providing a theoretical basis for preventing myopia in children and adolescents.

Objective　To analyze the treatment outcomes and influencing factors of elderly pulmonary tuberculosis patients in Henan Province, so as to provide a scientific basis for formulating relevant prevention and control measures as well as effective treatment strategies for elderly tuberculosis patients. Methods　A retrospective research method was conducted to extract the case information of pulmonary tuberculosis patients aged ≥65 years in Henan Province from January 1, 2017, to December 31, 2022, from the subsystem "Tuberculosis Information Management System" under the "National Health Insurance Information Project - China Disease Control and Prevention Information System". Percentage (%) was used to characterize the distribution characteristics, a chi-square trend test was used to describe time variation trends, and a chi-square test along with multivariate logistic regression model was used to analyze the influencing factors. Results　From 2017-2022, the successful treatment rate of elderly pulmonary tuberculosis patients in Henan Province was 94.89%（60 016/63 252）, while the rate of adverse outcomes was 5.12%（3 236/63 252）. The rate of adverse outcomes showed a fluctuating upward trend (χ2 trnd=50.577, P<0.01). Regarding regional distribution, Xuchang City had the lowest rate of adverse outcomes (3.71%) and Luoyang City had the highest rate (9.66%), with a statistically significant difference (χ2=78.531, P<0.01). Influencing factor analysis showed that, in comparison to females, those aged 65-<70, farmers, without comorbidities, newly treated, and pathology negative, the following were identified as risk factors for unsuccessful treatment outcomes: males (OR=1.332, 95% CI: 1.231-1.441), age 70-<75 (OR=1.302, 95% CI: 1.188-1.427), age 75-<80 (OR=1.659, 95% CI: 1.510-1.822), ≥80 years (OR=2.705, 95% CI: 2.479~2.952), those engaged in housework or unemployed (OR=1.408, 95% CI: 1.240-1.599), comorbidities (OR=1.327, 95% CI: 1.198-1.470), retreatment (OR=1.431, 95% CI: 1.297-1.579), and positive pathology (OR=1.562, 95% CI: 1.460-1.670). Conclusions　The rate of successful treatment of elderly pulmonary tuberculosis patients in Henan Province from 2017 to 2022 met the planned target (90%), but the rate of adverse outcomes showed a fluctuating upward trend with uneven geographical distribution. It is necessary to focus on high-risk populations, including males, comorbidities, retreatment, positive pathology, and advanced-age individuals (especially ≥80 years).

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

In the ever-evolving landscape of cancer therapy, while cancer treatments such as chemotherapy, radiotherapy, and targeted therapy aim to eradicate malignant cells, they also inadvertently trigger cellular senescence in both cancerous and microenvironmental tissues. Therapy-induced senescence (TIS) can act as a barrier against tumor growth by halting cell proliferation in the short term, but the long-term persistence of therapy-induced senescent (TISnt) cells may pose a significant challenge in cancer management. Their distinct characteristics, like senescence-associated secretory phenotype (SASP), metabolic dysregulation, and immune evasion, make them exhibit remarkable heterogeneity to orchestrate the tumor microenvironment (TME), resulting in therapy resistance. However, how these TISnt cells functioning differently in cancer progression, and the intricate mechanisms by which they remodel the senescence-associated immunosuppressive microenvironment present challenges for improving anticancer therapy. Therefore, this review summarizes the heterogeneous TISnt cell phenotypes contributing to an accumulated senescent state, outlines their multidimensional interactions in the senescent microenvironment, and discusses current senescence-targeting strategies. Building on the current understanding of TIS, we propose potential avenues for improving TIS-targeting methodologies in the context of head and neck cancer, a representative heterogeneous malignancy, which can substantially enhance the efficacy of the "one-two punch" sequential treatment approach for head and neck cancer.
Humans ; Cellular Senescence/drug effects* ; Tumor Microenvironment ; Neoplasms/pathology* ; Senescence-Associated Secretory Phenotype

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*

OBJECTIVE To evaluate the efficacy and safety of programmed death-1/programmed death-ligand 1 （PD-1/PD-L1） inhibitors combined with bevacizumab in the treatment of advanced non-small cell lung cancer （NSCLC） based on platinum- containing dual therapy. METHODS Retrieved from CNKI， Wanfang， VIP， Web of Science， PubMed and other Chinese and English databases， cohort studies or randomized controlled trial studies on the treatment of advanced NSCLC with platinum- containing double agents in combination with PD-1/PD-L1 inhibitors and bevacizumab （trial group） versus platinum-containing double agents with or without PD-1/PD-L1 inhibitor or bevacizumab （control group） were collected from the inception to April 25， 2024. After screening literature， extracting data and evaluating quality， meta-analysis and sensitivity analysis were performed by using RevMan 5.4.1 software. RESULTS A total of 15 pieces of literature were included， involving 13 clinical studies with a total of 3 282 patients. Compared with the control group， partial response rate [RR＝0.75，95%CI（0.68，0.82），P＜0.000 01]， complete response rate [RR＝0.47，95%CI（0.29，0.76），P＝0.002]， progressive disease rate [RR＝1.23，95%CI（1.11，1.37），P＜0.000 1]， objective response rate （ORR） [RR＝0.72，95%CI（0.67，0.79），P＜0.000 01] and disease control rate （DCR） [RR＝0.85， 95%CI （0.77，0.95），P＝0.003] were higher in the trial group. There was no statistically significant difference in the stable disease rate [RR＝1.25， 95%CI （0.86， 1.83）， P＝0.25] or overall adverse drug reaction incidence rate [RR＝0.95， 95%CI （0.90， 1.00）， P＝ 0.07] between the two groups of patients. Sensitivity analyses showed robust and reliable results for all outcome indicators. CONCLUSIONS PD-1/PD-L1 inhibitors combined with bevacizumab based on platinum-containing dual therapy in the treatment of advanced NSCLC can improve patients’ clinical benefits， such as ORR and DCR， without increasing the risk of adverse drug reaction.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To analyze the clinical characteristics and all-cause mortality influencing factors of patients with Keshan disease.Methods:Clinical data of patients with Keshan disease from Keshan disease areas in Sichuan Province and Yunnan Province were collected and retrospectively analyzed for clinical characteristics and survival status during regular follow-up. According to the survival status of patients, the survey subjects were divided into a survival group and a death group. All-cause mortality (referring to the death caused by various reasons throughout the follow-up period) was used as the study endpoint. Kaplan-Meier (K-M) survival curve analysis and log-rank χ 2 test were performed, univariate and multivariate Cox regression analysis were used for all-cause mortality factor analysis. Results:A total of 176 patients with Keshan disease were collected, including 92 cases in Sichuan Province and 84 cases in Yunnan Province. Among all the patients, there were 105 males, accounting for 59.66%, and 71 females, accounting for 40.34%. The age was (53.89 ± 13.19) years old. Thirty-five cases died from all causes, with a mortality rate of 19.89%. There were significant differences in age ( t = 2.09, P = 0.038), New York Heart Association (NYHA) cardiac function grading (χ 2 = 14.62, P < 0.001) and ventricular premature contraction (χ 2 = 6.82, P = 0.009) between the survival group and the death group. K-M survival curve analysis showed that patients with Keshan disease complicated by premature ventricular contraction and high NYHA cardiac function grading (Ⅲ and Ⅳ) had higher all-cause mortality (log-rank χ 2 = 8.72, 22.49, P < 0.05). Univariate Cox regression analysis showed that NYHA cardiac function grading and ventricular premature contraction ( HR = 3.09, 2.71, P < 0.05) were predictive influencing factors for all-cause mortality in patients with Keshan disease. Multivariate Cox regression analysis showed that NYHA cardiac function grading ( HR = 6.57, P = 0.002) and ventricular premature contraction ( HR = 2.98, P = 0.050) were independent factors for all-cause mortality in patients with Keshan disease. Conclusions:Among 176 patients with Keshan disease, the number of patients with poor cardiac function (NYHA cardiac function grading Ⅲ and Ⅳ) and arrhythmia is high. NYHA cardiac function grading and ventricular premature contractions are independent influencing factors for all-cause mortality in patients with Keshan disease.

Medicinal plants are a valuable source of essential medicines and herbal products for healthcare and disease therapy. Compared with chemical synthesis and extraction, the biosynthesis of natural products is a very promising alternative for the successful conservation of medicinal plants, and its rapid development will greatly facilitate the conservation and sustainable utilization of medicinal plants. Here, we summarize the advances in strategies and methods concerning the biosynthesis and production of natural products of medicinal plants. The strategies and methods mainly include genetic engineering, plant cell culture engineering, metabolic engineering, and synthetic biology based on multiple "OMICS" technologies, with paradigms for the biosynthesis of terpenoids and alkaloids. We also highlight the biosynthetic approaches and discuss progress in the production of some valuable natural products, exemplifying compounds such as vindoline (alkaloid), artemisinin and paclitaxel (terpenoids), to illustrate the power of biotechnology in medicinal plants.