This case report presents a 16-year-old male patient with deficiency of adenosine deaminase 2(DADA2). The patient had a history of Raynaud′s phenomenon with digital ulcers since childhood. As the disease progressed, the patient developed retinal vasculitis, intracranial hemorrhage, skin necrosis, severe malnutrition, refractory hypertension, and gastrointestinal bleeding. Genetic testing revealed compound heterozygous mutations in the ADA2 gene (paternal c.1072G > A pathogenic mutation + maternal c.1065C > A variant of unknown clinical significance). ADA2 enzyme activity was significantly reduced (0.1 U/L). A multidisciplinary treatment team developed an individualized plan to address key issues, including nutritional support, blood pressure control, rehabilitation, pain management, and balancing anticoagulation/bleeding risks. After systematic intervention, the patient′s condition showed partial improvement. This case reveals clinical challenges such as anticoagulation decisions and nutritional support of DADA2. It also emphasizes the importance of early molecular diagnosis, tumor necrosis factor-α inhibitor targeted therapy, and multidisciplinary collaboration in management, underlining the core value of precision medicine in rare disease management.

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

OBJECTIVE： To provi de reference for relevant departments to formulate innovation subsidy policies for pharmaceutical enterprises and enterprises to make their own business strategy decisions. METHODS ：The listed enterprises in China ’s pharmaceutical industry listed before 2012 were selected as the sample enterprises. The annual reports of listed enterprises in pharmaceutical industry and related panel data in CSMAR database during 2012-2019 were colected. Referring to related literatures ， multivariate regression model and threshold model were established to investigate the effects of technology innovation investment ability of sample enterprises ，so as to put forward relevant suggestions. RESULTS & CONCLUSIONS ：A total of 57 sample enterprises were included. The panel data of sample enterprises showed that the technology innovation investment of Chinese pharmaceutical enterprises was basically increasing year by year ，but compared with international standards ，the technology innovation investment of Chinese pharmaceutical enterprises still needed to be improved. The results of multiple regression model showed that the technology innovation investment of pharmaceutical enterprises had no significant impact on their current financial performance and the financial performance of the first and second lags （P＞0.05）. The results of threshold model showed that there was a significant single threshold effect between technology innovation investment and financial performance when enterprise size was taken as the threshold variable （P＜0.05）. When the enterprise size was less than the threshold value of 20.986，the enterprise ’s technology innovation investment had a negative impact on its financial performance （P＜0.05）；when the enterprise size was greater than the threshold value of 20.986，the correlation between the enterprise ’s technology innovation investment and financial performance was not significant （P＜0.05）. It is suggested that China ’s pharmaceutical enterprises should carry out technology innovation activities according to their own strength ，and enterprise managers should formulate different innovation development strategies according to the ac tual situation ，enable enterprises to maintain a reasonable capital structure by broadening financing channels ，identify innovation points according to their own ability ，reduce costs and risks ，and innovate R&D modes，so as to promote the transformation and effective utilization of R&D achievements. Government departments should give full play to the guiding role ，encourage pharmaceutical enterprises to maintain the vitality of R&D and innovation and guide the sustainable innovation and healthy development of the pharmaceutical industry.

OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy in the treatment of mycoplasma pneumonia in children. METHODS:67 children with mycoplasma pneumonia were randomly divided into control group(34 cases) and observation group (33 cases). All children received conventional treatment,such as fever,cough,supplemented by nutrition support;based on it,control group received 10 mg/kg Azithromycin for injection,adding into 5% Glucose injection by intrave-nous drip in 200 ml,once a day;observation group received azithromycin(the same dosage with control group)after intravenous drip 5 d,switched to 10 mg/(kg·d)Azithromycin dry suspension,orally,then stopped 4 d after continuous 3 d. The treatment course was 7-10 d. Clinical efficacy,disappearance time of fever,cough and lung rales,and lung indexes before and after treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the to-tal effective rate,disappearance time of fever,cough and lung rales in 2 groups(P>0.05). After treatment,the lung function in-dexes were significantly higher than before,the differences were statistically significant(P<0.01),but there was no significant dif-ference between 2 groups (P>0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant (P<0.05). CONCLUSIONS:Based on conventional treatment,azithromycin se-quential therapy shows similar efficacy to without sequential therapy in the treatment of mycoplasma pneumonia in children,but with better safety.