Objective: CT-P13, a biosimilar of infliximab, is widely used for treating ankylosing spondylitis (AS). However, the formation of anti-drug antibodies (ADAs) can reduce its efficacy. This study aimed to identify risk factors associated with high ADA levels in AS patients treated with CT-P13. Methods: A prospective observational study enrolled patients with intravenous CT-P13. Clinical data and disease activity was assessed at baseline, 24 weeks, and 54 weeks after CT-P13 treatment. Blood concentrations of CT-P13 and ADAs were measured at 24 and 54 weeks, and their correlation was investigated. Patients were grouped by ADA levels at 54 weeks. Univariable and multivariable logistic regression identified factors associated with high ADA concentrations. Results: A total of 34 patients was enrolled. Significant decreases in Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index scores were observed relative to baseline after 24 weeks of CT-P13 therapy. Serum concentrations of CT-P13 and ADA levels increased following treatment. The median serum CT-P13 concentration was 17.6 [12.8, 22.7] µg/mL at 24 weeks and 23.5 [11.7, 34.2] µg/mL at 54 weeks. ADA levels were 6.7 [6.5, 9.1] AU/mL at 24 weeks and 11.4 [9.0, 28.4] AU/mL at 54 weeks. The serum concentrations of CT-P13 and ADA exhibited a negative correlation. In multivariable analysis, current smoking was associated with high ADA production at 54 weeks. Conclusion Smoking is identified as a significant risk factor for elevated ADAs in AS patients treated with CT-P13. The findings underscore the importance of smoking-cessation strategies in the management of AS patients.

BACKGROUND:Traditional treatments for corneal alkali burns are limited,especially in controlling inflammation,preventing neovascularization,and inhibiting corneal scarring.Natural,synthetic,or composite materials provide a wide range of treatment options.However,the mechanism by which biomaterials promote corneal alkali burn repair has not yet been systematically understood. OBJECTIVE:To summarize the current research on biomaterials in promoting corneal alkali burn repair in and outside China,and review the mechanism and application of biomaterials in repairing corneal alkali burn. METHODS:The first author searched"cornea,alkali burn,amniotic membrane,hyaluronic acid,collagen,chitosan,polymer materials"as Chinese keywords and"amniotic membrane,hyaluronic acid,collagen,chitosan,polymer,cornea,alkali burn"as English keywords in PubMed,Web of Science,CNKI,and WanFang databases.According to inclusion and exclusion criteria,76 eligible articles were finally included for review. RESULTS AND CONCLUSION:(1)In the field of corneal alkali burn repair,biomaterials such as amniotic membrane,hyaluronic acid,collagen,chitosan,and degradable polymer materials have been widely studied and applied.Each of these biomaterials has its own characteristics,advantages,and disadvantages,and stands out in different aspects.(2)First and foremost,amniotic membranes are considered one of the most promising biomaterials due to their abundance of bioactive factors.They are biocompatible and can regulate the corneal inflammatory response.However,there are issues with donor shortages and susceptibility to infectious diseases.(3)Hyaluronic acid has good moisturizing properties and biocompatibility,and is able to improve the survival rate of corneal cells and increase corneal transparency.(4)The good biocompatibility and scaffold structure of collagen enable the promotion of corneal cell adhesion and proliferation,as well as the reconstruction of corneal tissue structure.(5)Chitosan is recognized for its good biocompatibility and degradability,making it suitable as a carrier for drug delivery and cell transplantation.(6)Degradable polymer materials have good controllability over degradation and can provide a good support and delivery platform for the repair of corneal alkali burns,but further research is needed on their stability and biocompatibility.(7)Overall,there is currently no single biomaterial that can completely address the repair problem of corneal alkali burns,and each biomaterial has its own specific application scenarios and limitations.(8)Future research directions should focus on further improving the properties and structure of biomaterials,exploring more effective combination applications,and deeply understanding the interaction mechanism between biomaterials and corneal tissue,in order to enhance the therapeutic effect of corneal alkali burns and the quality of life of patients.

We describe the updated Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of cervical cancer, version 5.1. The KSGO announced the fifth version of its clinical practice guidelines for the management of cervical cancer in March 2024. The selection of the key questions and the systematic reviews were based on data available up to December 2022. Between 2023 and 2024, substantial findings from large-scale clinical trials and new advancements in cervical cancer research remarkably emerged. Therefore, based on the existing version 5.0, we updated the guidelines with newly accumulated clinical data and added 4 new key questions reflecting the latest insights in the field of cervical cancer. For each question, recommendation was formulated with corresponding level of evidence and grade of recommendation, all established through expert consensus.

BACKGROUND:Computer-assisted implant surgery can improve implantation accuracy,but the use of implant template in the posterior tooth area is limited for patients with small opening and small interocclusal distance.Therefore,the digital guide has been improved. OBJECTIVE:To study the effect of modified implant template on the accuracy of assisted implantation in missing second molars. METHODS:From July 2020 to July 2023,40 patients who received digital guide plate implantation or free hand implantation to repair missing second molars were selected from First Affiliated Hospital of Guangzhou Medical University.According to the coin toss method,patients were randomly divided into a trial group(n=22;modified digital guide assisted implantation)and a control group(n=18;free hand implantation).The data of neck deviation,tip deviation,depth deviation,and angle deviation were compared between groups for preoperative and postoperative cone beam CT overlap analysis.One week after the operation,the patients'satisfaction with the operation was assessed by visual analog scale score. RESULTS AND CONCLUSION:(1)The trial group included 25 implants(12 in the upper jaw and 13 in the lower jaw);the control group included 23 implants(8 in the upper jaw and 15 in the lower jaw).The neck deviation,tip deviation,depth deviation,and angle deviation of the trial group were all smaller than those of the control group(P<0.05,P<0.001).There was no significant difference in accuracy between the maxillary and mandibular implant site in the trial group(P>0.05).(2)There was no significant difference in satisfaction with the operation between the two groups(P>0.05).(3)The results showed that improving the digital guide plate for assisted implantation for missing second molar can improve surgical accuracy and is suitable for patients with small opening and small interocclusal distance in the posterior tooth area.

Objective To evaluate the efficacy of Puerariae lobatae radix （PLR） and Anemarrhenae Rhizoma （AR） in preventing and treating Alzheimer’s disease （AD） and explore its potential mechanism of action by LC-MS serum metabolomics strategy. Methods The AD rat model was established by administering aluminum chloride （AlCl₃） and D-galactose （D-gal） for 20 weeks. The traditional Chinese medicine intervention group was given the PLR, AR, and PLR-AR extracts for 8 weeks by gavage. The model effect and efficacy were evaluated by Morris water maze test and biochemical indicators including SOD, NO, and MDA; Metabolomics research based on the UHPLC-Q/TOF-MS method was conducted, and relevant metabolic pathways were analyzed through the MetaboAnalyst online website. Results The learning and memory abilities of AD model rats were significantly decreased compared with the control group, and the levels of oxidative stress and lipid peroxides were significantly increased （P<0.05）, while the SOD content was decreased considerably （P<0.01）. The learning and memory abilities of AD model rats were improved, oxidative stress and lipid peroxidation levels were reversed, and serum SOD content was increased significantly after the intervention of PLR-AR, with better effects than single drugs. Through metabolomics, 70 differential metabolites were identified between the AD model group and the control group, mainly involving 10 pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis, phenylalanine metabolism, and unsaturated fatty acid biosynthesis, et.al. The intervention of PLR-AR could adjust 47 metabolites, with 20 metabolites showing significant differences （P<0.05）. The significantly adjusted metabolites involve 6 pathways, including phenylalanine, tyrosine, and tryptophan biosynthesis, et al. Conclusion The combination of PLR and AR could significantly improve the learning and memory abilities of AD rat models. The mechanism may be related to the improvement of oxidative stress and lipid peroxidation levels, the increase of serum SOD content, and the regulation of phenylalanine, tyrosine, and tryptophan biosynthesis pathways.

The chemical constituents in dried roots of Atractylodes macrocephala were investigated in this study. Through utilizing normal-phase silica gel and ODS column chromatography, TLC, and semi-preparative HPLC, 4 new sesquiterpenoids were purified from the ethyl acetate extract of A. macrocephala. By various spectroscopic techniques, such as 1D and 2D NMR, HR-ESI-MS, IR, UV, and CD, their structures were identified as atractylmacron A (1), 9β-hydroxyasterolide (2), atractylenolide H (3), atractylenolide J (4). Compound 1 possesses a rare 6/7 bicyclic skeleton.

Background/Aims: Exercise is a key component of the management of axial spondyloarthritis (axSpA), providing symptomatic relief and helping prevent ankylosis. However, there is a lack of quantitative studies evaluating daily exercise patterns in patients with axSpA. This study assessed the types, frequency, and duration of exercises performed by these patients through a structured questionnaire. Methods: This cross-sectional study included radiographic axSpA patients who visited a rheumatology clinic between September 2014 and March 2016 and provided informed consent to participate. The survey captured information on four types of exercise: high-intensity exercise, moderate-intensity exercise, strength training, and walking. Disease activity and functional status were evaluated using the Bath ankylosing spondylitis disease activity index (BASDAI) and the Bath ankylosing spondylitis functional index (BASFI), respectively. Results: A total of 645 patients participated in the study. Among them, 25.1% engaged in high-intensity exercise, 36.0% in moderate-intensity exercise, 81.2% in walking, and 32.8% in strength training. The median weekly exercise frequency was 3.0 days (interquartile range [IQR], 2.0-4.0) for high-intensity exercise, 3.0 days (IQR, 2.0-5.0) for moderate-intensity exercise, 5.5 days (IQR, 4.0-7.0) for walking, and 3.0 days (IQR, 2.0-5.0) for strength training. The median daily exercise duration was 60 minutes (IQR, 60-120) for high-intensity exercise, 60 minutes (IQR, 30-90) for moderate-intensity exercise, 30 minutes (IQR, 20-60) for walking, and 30 minutes (IQR, 20-60) for strength training. Comparisons by disease activity showed that BASFI scores were more strongly associated with differences in exercise patterns than BASDAI scores. Conclusion Radiographic axSpA patients predominantly engaged in low-intensity activities, particularly walking, typically for short durations. Given the observed variations in exercise patterns based on disease activity, personalized exercise education and guidance should be prioritized in clinical practice to optimize axSpA management.

We describe the updated Korean Society of Gynecologic Oncology (KSGO) practice guideline for the management of cervical cancer, version 5.1. The KSGO announced the fifth version of its clinical practice guidelines for the management of cervical cancer in March 2024. The selection of the key questions and the systematic reviews were based on data available up to December 2022. Between 2023 and 2024, substantial findings from large-scale clinical trials and new advancements in cervical cancer research remarkably emerged. Therefore, based on the existing version 5.0, we updated the guidelines with newly accumulated clinical data and added 4 new key questions reflecting the latest insights in the field of cervical cancer. For each question, recommendation was formulated with corresponding level of evidence and grade of recommendation, all established through expert consensus.

Background/Aims: Exercise is a key component of the management of axial spondyloarthritis (axSpA), providing symptomatic relief and helping prevent ankylosis. However, there is a lack of quantitative studies evaluating daily exercise patterns in patients with axSpA. This study assessed the types, frequency, and duration of exercises performed by these patients through a structured questionnaire. Methods: This cross-sectional study included radiographic axSpA patients who visited a rheumatology clinic between September 2014 and March 2016 and provided informed consent to participate. The survey captured information on four types of exercise: high-intensity exercise, moderate-intensity exercise, strength training, and walking. Disease activity and functional status were evaluated using the Bath ankylosing spondylitis disease activity index (BASDAI) and the Bath ankylosing spondylitis functional index (BASFI), respectively. Results: A total of 645 patients participated in the study. Among them, 25.1% engaged in high-intensity exercise, 36.0% in moderate-intensity exercise, 81.2% in walking, and 32.8% in strength training. The median weekly exercise frequency was 3.0 days (interquartile range [IQR], 2.0-4.0) for high-intensity exercise, 3.0 days (IQR, 2.0-5.0) for moderate-intensity exercise, 5.5 days (IQR, 4.0-7.0) for walking, and 3.0 days (IQR, 2.0-5.0) for strength training. The median daily exercise duration was 60 minutes (IQR, 60-120) for high-intensity exercise, 60 minutes (IQR, 30-90) for moderate-intensity exercise, 30 minutes (IQR, 20-60) for walking, and 30 minutes (IQR, 20-60) for strength training. Comparisons by disease activity showed that BASFI scores were more strongly associated with differences in exercise patterns than BASDAI scores. Conclusion Radiographic axSpA patients predominantly engaged in low-intensity activities, particularly walking, typically for short durations. Given the observed variations in exercise patterns based on disease activity, personalized exercise education and guidance should be prioritized in clinical practice to optimize axSpA management.

Objective: CT-P13, a biosimilar of infliximab, is widely used for treating ankylosing spondylitis (AS). However, the formation of anti-drug antibodies (ADAs) can reduce its efficacy. This study aimed to identify risk factors associated with high ADA levels in AS patients treated with CT-P13. Methods: A prospective observational study enrolled patients with intravenous CT-P13. Clinical data and disease activity was assessed at baseline, 24 weeks, and 54 weeks after CT-P13 treatment. Blood concentrations of CT-P13 and ADAs were measured at 24 and 54 weeks, and their correlation was investigated. Patients were grouped by ADA levels at 54 weeks. Univariable and multivariable logistic regression identified factors associated with high ADA concentrations. Results: A total of 34 patients was enrolled. Significant decreases in Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index scores were observed relative to baseline after 24 weeks of CT-P13 therapy. Serum concentrations of CT-P13 and ADA levels increased following treatment. The median serum CT-P13 concentration was 17.6 [12.8, 22.7] µg/mL at 24 weeks and 23.5 [11.7, 34.2] µg/mL at 54 weeks. ADA levels were 6.7 [6.5, 9.1] AU/mL at 24 weeks and 11.4 [9.0, 28.4] AU/mL at 54 weeks. The serum concentrations of CT-P13 and ADA exhibited a negative correlation. In multivariable analysis, current smoking was associated with high ADA production at 54 weeks. Conclusion Smoking is identified as a significant risk factor for elevated ADAs in AS patients treated with CT-P13. The findings underscore the importance of smoking-cessation strategies in the management of AS patients.