Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

The zebrafish model has attracted much attention due to its strong reproductive ability, short research cycle, and ease of maintenance. It has always been an important vertebrate model system, often used to carry out human disease research. Its motor behavior features have the advantages of being simpler, more intuitive, and quantifiable. In recent years, it has received widespread attention in the study of traditional Chinese medicine(TCM)for the treatment of sleep disorders, neurodegenerative diseases, fatigue, epilepsy, and other diseases. This paper reviews the characteristics of zebrafish motor behavior and its applications in the pharmacodynamic verification and mechanism research of TCM extracts, active ingredients, and TCM compounds, as well as in active ingredient screening and safety evaluation. The paper also analyzes its advantages and disadvantages, with the aim of improving the breadth and depth of zebrafish and its motor behavior applications in the field of TCM research.
Zebrafish/physiology* ; Medicine, Chinese Traditional ; Drugs, Chinese Herbal/therapeutic use* ; Disease Models, Animal ; Drug Evaluation, Preclinical/methods* ; Animals ; Sleep Wake Disorders/physiopathology* ; Epilepsy/physiopathology* ; Neurodegenerative Diseases/physiopathology* ; Fatigue/physiopathology* ; Behavior, Animal/physiology* ; Motor Activity/physiology*

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

It is generally believed that high-quality Bupleurum scorzonerifolium roots possess specific morphological characteristics, being red, robust, and long with strong odor. However, the scientific connotation of these characteristics has not been elucidated. According to the theory of "quality evaluation through morphological identification", we studied the correlations between appearance traits(the RGB value of root surface, root length, root diameter, dry weight, and ratio of phloem to xylem) and content of main chemical components(volatile oils, total saponins, total flavonoids, total polysaccharides, and seven saikosaponins) of B. scorzonerifolium roots. Epson Scanner and ImageJ were used to scan the root samples and measure the appearance traits. Ultraviolet spectrophotometry and HPLC were employed to determine the content of chemical components. The correlation, regression, and cluster analyses were performed to study the correlations between the appearance traits and the content of chemical components. The results showed that the content of volatile oils and saikosaponins were significantly correlated with RGB value, root length, and root diameter, indicating that within a certain range, the roots being redder, longer, and thicker had higher content of volatile oils and saikosaponins. According to the appearance traits and chemical component content, the 14 samples from different producing areas were classified into four grades, and the differences in morphological traits and chemical component content were consistent among different grades. The findings in this study demonstrate that appearance traits(RGB value, root length, and root diameter) can be used to evaluate the quality of B. scorzonerifolium roots. Meanwhile, this study lays a foundation for establishing an objective quality evaluation method for B. scorzonerifolium roots.
Bupleurum/chemistry* ; Saponins/analysis* ; Oleanolic Acid/analysis* ; Oils, Volatile/analysis* ; Plant Roots/chemistry*

Objective:To explore the differences in plasticity mechanism of cortical structure between hemispheres during rehabilitation for stroke patients at subacute stage. Methods:From October 20, 2018 to February 1, 2020, 22 patients with first-onset subcortical ischemic stroke completed the assessments of MRI and clinical evaluation at admission, and after one and two months of rehabilitation. Cortical surface area, thickness, and volume were measured to evaluate cortical structure plasticity. Two-way repeated measures analyses of variance were implemented to estimate dynamic cortical morphology changes and differences between hemispheres. Results:A significant time effect occurred between admission and after one month of rehabilitation for both hemispheres. Cortical surface area, thickness and volume for most regions in both hemispheres gradually decreased, while parahippocampal gyrus thickness and volume increased. The surface area and volume of postcentral gyrus was significant between both hemispheres (F > 4.305, P < 0.05), in which ipsilesional hemisphere was lower than contralesional hemisphere. The reduction of the thickness (r = -0.474, P = 0.026) and volume (r = -0.432, P = 0.044) of postcentral gyrus in ipsilesional hemisphere was negatively correlated with the recovery rate of motor function. Conclusion:There are differences in cortical structure plasticity during stroke rehabilitation between hemispheres. Cortical morphology markedly changes in the first two months poststroke. The greater the reduction in thickness and volume of postcentral gyrus in ipsilesional hemisphere is, the worse the recovery of motor function may be.

OBJECTIVETo use the technique of magnetic resonance imaging (MRI) T2* mapping to diagnose and follow-up of patients with iron overload.

METHODS107 patients who were suspected to have iron overload between 2011.7-2014.3 in Peking Union Medical Colleague Hospital were analyzed retrospectively. Patients had the document of MRI T2* value of liver, heart and pancreas, serum ferritin (SF), transferrin saturation (TS), transfusion amount and other related laboratory tests. T2* values were compared with SF and transfusion amount. T2* values in different organs and their relationship with SF were also evaluated. 10 patients who had been adequately chelated for more than half a year were followed up for their SF and T2* values.

RESULTSThere were 65 males and 42 females with the median age of 51(8-77)-year-old. They were 50 myelodysplastic syndromes (MDS), 36 aplastic anemia, 10 myelofibrosis, 7 hemachromatosis and 4 thalassemia carriers. Liver T2* value was significantly related to SF (r=0.120, P=0.001), but not related to transfusion amount (r=0.019, P=0.175), whereas cardiac MRI T2* was not related either to SF or to transfusion amount. No correlation of the T2* value was found between liver and heart (r=0.015, P=0.235). 70 patients was detected for liver, heart and pancreas T2* simultaneously. Pancreas T2* was compatible to SF (r=0.061，P=0.039) and cardiac T2* (r=0.110, P=0.005), but not correlated to heptic T2* (r=0.047, P= 0.071) or transfusion amount (r=0.000, P=0.960). For the 10 well-chelated patients, during the half year follow-up period, SF changed significantly from (2 566.5±1 152.2) μg/L before chelation to (1 473.4±803.0) μg/L after chelation(P=0.001), while liver T2* remained the same [(6.0±5.1) ms, (6.3±6.0) ms respectively, P=0.629].

CONCLUSIONMRI, although related to SF to some extent, was a valuable additional methods for quantifying iron overload. Iron deposition in different organs might be not related to each other and needed to be evaluated separately. Well-chelation therapy could change SF in half-year follow-up, but T2* change needed longer time to follow-up.

Adolescent ; Adult ; Aged ; Anemia, Aplastic ; Beijing ; Blood Transfusion ; Child ; Female ; Follow-Up Studies ; Heterozygote ; Hospitals ; Humans ; Iron Overload ; Liver ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Primary Myelofibrosis ; Retrospective Studies ; Thalassemia ; Young Adult

OBJECTIVETo evaluate the clinical efficacy and safety of integrative medical program based on blood cooling and detoxification recipe (BCDR) in treating patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF) of heat-toxicity accumulation syndrome (HTAS).

METHODSAdopting randomized controlled clinical design, a total of 105 HBV-ACLF patients of HTAS were randomly assigned to the trial group (64 cases) and the control group (41 cases). Patients in the control group were treated with comprehensive Western therapy, while those in the trial group were treated with comprehensive Western therapy plus BCDR. All were treated for 8 weeks and followed up for 40 weeks. Effect and safety of the treatment were assessed, including fatality, liver functions [total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), and aspartate transaminase (AST)], and prothrombin activity (PTA) after treatment and at week 48 of follow-ups.

RESULTSAfter 8-week treatment, there was statistical difference in the overall fatality rate (15.63% vs 34.15%), the fatality rate in the mid-term (25.0% vs 64.7%), TBIL at week 8 (64.54 +/- 79.75), AST [at week 2: (178.97 +/- 44.24) U/L vs (288.48 +/- 58.49) U/L; at week 4: (61.65 +/- 27.36) U/L vs (171.12 +/- 89.11) U/L] and PTA [at week 4: (58.30 +/- 15.29) vs (42.56 +/- 15.27); at week 6: (60.77 +/- 20.40) vs (43.08 +/- 12.79)] (all P < 0.05). At week 48 of the followup, the fatality rate of the trial group (21.88%) decreased by 17. 14% when compared with that of the control group (39.02%; P < 0.05). No obvious adverse event occurred in the two groups during the 8-week treatment period.

CONCLUSIONBCDR could significantly reduce the mortality of HBV-ACLF patients.

Acute-On-Chronic Liver Failure ; drug therapy ; virology ; Adult ; Drugs, Chinese Herbal ; therapeutic use ; End Stage Liver Disease ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Young Adult

OBJECTIVETo investigate the relationship between CD4- CD8- T cells ratio and IL-4, IFN-gamma levels in the peripheral blood of patients with pancreatic carcinoma.

METHODSFlow cytometer was used to analyze the CD4- CD8- T cells ratio in the peripheral blood of patients with pancreatic carcinoma and the IL-4, IFN-gamma levels were detected by ELISA.

RESULTSThe ratio of CD4- CD8- T cell in CD3+ T cell from 25 pancreatic carcinoma patients was (4.2 +/- 1.7)%, the ratio of CD4- CD8- T cell in CD3+ T cell from 45 healthy person was (6.3 +/- 2.6)%, there was significant deviation between the two groups (P < 0.01). The IL-4 level of 25 pancreatic carcinoma patients was (86.3 +/- 23.3) fg/L, the IL-4 level of 45 healthy person was (56.2 +/- 9.2) fg/L,there was significant deviation between the two groups (P < 0.01). The IFN-gamma level of 25 pancreatic carcinoma patients was (16.4 +/- 4.8) fg/L before operation, the IFN-gamma level of 45 healthy person was (27.4 +/- 3.8) fg/L, there was significant deviation between the two groups (P < 0.01). The ratio of CD4- CD8- T cell in pancreatic carcinoma patient after operation was higher than before operation. It could be found negative correlation between CD4- CD8- T cells ratio and IL-4 level in pancreatic carcinoma patient,it could also be found positive correlation between CD4- CD8- T cells ratio and IFN-gamma level in pancreatic carcinoma patient. In pancreatic carcinoma patient, the CD4- CD8- T cells ratio and IL-4 level was significant associated with clinical stage (P < 0.05), but no relationship with histological differentiation (P > 0.05), it could be found no relationship between IFN-gamma level and clinical stage, histological differentiation (P > 0.05).

CONCLUSIONThe CD4- CD8- T cells ratio in the peripheral blood of patients is decreased,it may be participate in the carcinogenesis and development of pancreatic carcinoma by influence the IFN-gamma levels.

Adult ; Aged ; CD4-CD8 Ratio ; Case-Control Studies ; Female ; Humans ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Male ; Middle Aged ; Pancreatic Neoplasms ; blood ; immunology ; T-Lymphocytes ; immunology