Objective To describe the significance of the pretreatment inflammatory indicators in predicting the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after undergoing radical radiotherapy. Methods The data of 246 ESCC patients who underwent radical radiotherapy were retrospectively collected. Receiver operating characteristic (ROC) curves were drawn to determine the optimal cutoff values for platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII). The Kaplan-Meier method was used for survival analysis. We conducted univariate and multivariate analyses by using the Cox proportional risk regression model. Software R (version 4.2.0) was used to create the nomogram of prognostic factors. Results The results of the ROC curve analysis showed that the optimal cutoff values of PLR, NLR, and SII were 146.06, 2.67, and 493.97, respectively. The overall response rates were 77.6% and 64.5% in the low and high NLR groups, respectively (P<0.05). The results of the Kaplan-Meier survival analysis revealed that the prognosis of patients in the low PLR, NLR, and SII group was better than that of patients in the high PLR, NLR, and SII group (all P<0.05). The results of the multivariate Cox regression analysis showed that gender, treatment modalities, T stage, and NLR were independent factors affecting the overall survival (OS). In addition, T stage and NLR were independent factors affecting the progression-free survival (PFS) (all P<0.05). The nomogram models of OS and PFS prediction were established based on multivariate analysis. The C-index values were 0.703 and 0.668. The calibration curves showed excellent consistency between the predicted and observed OS and PFS. Conclusion The pretreatment values of PLR, NLR, and SII are correlated with the prognosis of patients with ESCC who underwent radical radiotherapy. Moreover, NLR is an independent factor affecting the OS and PFS of ESCC patients. The NLR-based nomogram model has a good predictive ability.

Macrophages are innate immune cells connected with the development of inflammation. Retinoic acid has previously been proved to have anti-inflammatory and anti-arthritic properties. However, the exact mechanism through which retinoic acid modulates arthritis remains unclear. This study aimed to investigate whether retinoic acid ameliorates rheumatoid arthritis by modulating macrophage polarization. This study used retinoic acid to treat mice with adjuvant arthritis and evaluated anti-inflammatory effects by arthritis score, thermal nociceptive sensitization test, histopathologic examination and immunofluorescence assays. In addition, its specific anti-arthritic mechanism was investigated by flow cytometry, cell transfection and inflammatory signaling pathway assays in RAW264.7 macrophages in vitro. Retinoic acid significantly relieved joint pain and attenuated inflammatory cell infiltration in mice. Furthermore, this treatment modulated peritoneal macrophage polarization, increased levels of arginase 1, as well as decreased inducible nitric oxide synthase expression. In vitro, we verified that retinoic acid promotes macrophage transition from the M1 to M2 type by upregulating mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1) expression and inhibiting P38, JNK and ERK phosphorylation in lipopolysaccharide-stimulated RAW264.7 cells. Notably, the therapeutic effects of retinoic acid were inhibited by MKP-1 knockdown. Retinoic acid exerts a significant therapeutic effect on adjuvant arthritis in mice by regulating macrophage polarization through the MKP-1/MAPK pathway, and play an important role in the treatment of rheumatic diseases.

Macrophages are innate immune cells connected with the development of inflammation. Retinoic acid has previously been proved to have anti-inflammatory and anti-arthritic properties. However, the exact mechanism through which retinoic acid modulates arthritis remains unclear. This study aimed to investigate whether retinoic acid ameliorates rheumatoid arthritis by modulating macrophage polarization. This study used retinoic acid to treat mice with adjuvant arthritis and evaluated anti-inflammatory effects by arthritis score, thermal nociceptive sensitization test, histopathologic examination and immunofluorescence assays. In addition, its specific anti-arthritic mechanism was investigated by flow cytometry, cell transfection and inflammatory signaling pathway assays in RAW264.7 macrophages in vitro. Retinoic acid significantly relieved joint pain and attenuated inflammatory cell infiltration in mice. Furthermore, this treatment modulated peritoneal macrophage polarization, increased levels of arginase 1, as well as decreased inducible nitric oxide synthase expression. In vitro, we verified that retinoic acid promotes macrophage transition from the M1 to M2 type by upregulating mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1) expression and inhibiting P38, JNK and ERK phosphorylation in lipopolysaccharide-stimulated RAW264.7 cells. Notably, the therapeutic effects of retinoic acid were inhibited by MKP-1 knockdown. Retinoic acid exerts a significant therapeutic effect on adjuvant arthritis in mice by regulating macrophage polarization through the MKP-1/MAPK pathway, and play an important role in the treatment of rheumatic diseases.

Macrophages are innate immune cells connected with the development of inflammation. Retinoic acid has previously been proved to have anti-inflammatory and anti-arthritic properties. However, the exact mechanism through which retinoic acid modulates arthritis remains unclear. This study aimed to investigate whether retinoic acid ameliorates rheumatoid arthritis by modulating macrophage polarization. This study used retinoic acid to treat mice with adjuvant arthritis and evaluated anti-inflammatory effects by arthritis score, thermal nociceptive sensitization test, histopathologic examination and immunofluorescence assays. In addition, its specific anti-arthritic mechanism was investigated by flow cytometry, cell transfection and inflammatory signaling pathway assays in RAW264.7 macrophages in vitro. Retinoic acid significantly relieved joint pain and attenuated inflammatory cell infiltration in mice. Furthermore, this treatment modulated peritoneal macrophage polarization, increased levels of arginase 1, as well as decreased inducible nitric oxide synthase expression. In vitro, we verified that retinoic acid promotes macrophage transition from the M1 to M2 type by upregulating mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1) expression and inhibiting P38, JNK and ERK phosphorylation in lipopolysaccharide-stimulated RAW264.7 cells. Notably, the therapeutic effects of retinoic acid were inhibited by MKP-1 knockdown. Retinoic acid exerts a significant therapeutic effect on adjuvant arthritis in mice by regulating macrophage polarization through the MKP-1/MAPK pathway, and play an important role in the treatment of rheumatic diseases.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective To investigate the current status of operational management in tertiary maternal and child health(MCH)hospitals in Guizhou Province and propose recommendations for refining their operational management practices.Meth-ods A self-designed electronic questionnaire was distributed to seven tertiary MCH hospitals in Guizhou Province.The survey fo-cused on fundamental dimensions of operational management,particularly the implementation of refined management practices,with results analyzed using descriptive statistics.Results Among the seven hospitals,five had independently established opera-tional management departments,with three staffing 3-4 personnel.Sixty percent of the hospitals engaged in data statistics,strate-gic management,and process optimization.Only two hospitals had implemented operational management information systems(HRP),but these systems featured incomplete modules and lacked interconnectivity between subsystems,failing to meet opera-tional needs.Additionally,while total expenditures increased year-over-year across all hospitals,insufficient government compen-sation has heightened operational pressures.Conclusions Operational management in Guizhou's tertiary MCH hospitals faces multiple challenges,including incomplete organizational structures and systems,inadequate execution of core functions,subopti-mal information systems for refined management,and limited fiscal support.Recommendations include establishing a multi-tiered operational management framework,implementing comprehensive long-term safeguards,and developing an integrated data man-agement platform.Simultaneously,improving government compensation mechanisms through increased fiscal investment and sup-portive policies is critical to enhancing operational capabilities and achieving high-quality development.

Objective:To evaluate the clinical efficacy of botulinum toxin type A (BTX-A) combined with sodium hyaluronate solution for facial microdroplet injection in improving facial skin photoaging.Methods:A prospective randomized controlled trial was conducted. From January to July 2024, patients with facial photoaging problems were recruited from the Plastic Surgery Department of the Affiliated Hospital of Xuzhou Medical University and randomly divided into a monotherapy group (sodium hyaluronate solution droplet injection) and a combination therapy group (BTX-A + sodium hyaluronate solution droplet injection) by hierarchical block randomization method. The treatment regimen was 3 months, with one treatment for each month, with a total of 3 treatment. The combination therapy group only used a combination therapy of two drugs (BTX-A 25 U+ 5 ml sodium hyaluronate solution) during the first injection. During the three treatments of the monotherapy group and the second and third treatments of the combination therapy group, 5 ml of sodium hyaluronate solution was injected as the solo ingredient. Follow up was conducted at 1, 2, and 4 months after the last treatment. Serum superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels were detected by test kit. Five skin texture indicators (moisture content, transepidermal water loss rate, elasticity, glossiness, and pH) were evaluated using the German CK skin tester. VISIA skin detector was used for facial two-dimensional photography and skin condition analysis. Clinical efficacy (significant improvement, obvious improvement, improvement, no improvement) and global aesthetic improvement scale (GAIS) scores on a 5-point scale were recorded. Patient satisfaction levels (very satisfied, satisfied, and dissatisfied) were investigated. The data were analyzed using SPSS 27.0 software. Count data was presented as examples and(or) percentages, and analyzed using a chi-square test. Normal distribution measurement data was represented by Mean±SD and analyzed using t-test. Results:A total of 100 patients were included, with 50 cases in each group. There were 17 males and 33 females in the monotherapy group, with an age of (31.3±7.1) years, and there were 5, 14, 29 and 2 patients in the Ⅰ to Ⅳ types of Glogau skin photoaging classification, respectively. There were 15 males and 35 females in the combination therapy group, with an age of (32.1±8.4) years old, and there were 4, 15, 27 and 4 patients in the Ⅰ to Ⅳ types of Glogau skin photoaging classification, respectively. There was no statistically significant difference in gender composition, age, and Glogau skin photoaging classification between the two groups (all P>0.05). One month after the first treatment, both groups showed an increase in SOD activity and a decrease in MDA levels, with more significant changes observed in the combination therapy group ( P<0.01 for both). At the follow-up of 1, 2, and 4 months after the last treatment, the combination therapy group outperformed the monotherapy group in all 5 skin texture indicators (all P<0.05). One month after the last treatment, the total effective rate of the combination therapy group was 76.0% (38/50), which were significantly higher than that of the monotherapy group’s 50.0% (25/50) ( P<0.05); in addition, the combination therapy group showed significant advantages in facial aesthetic GAIS scores, as well as patient satisfaction, with a satisfaction rate of up to 98.0% (49/50), which was higher than the 88.0% (44/50) of the monotherapy group ( P<0.01). Throughout the entire treatment process, neither group experienced serious adverse reactions. Conclusion:Facial microdroplet injection of BTX-A combined with sodium hyaluronate solution effectively improves symptoms of facial skin photoaging, enhancing skin hydration and elasticity, reducing transepidermal water loss, improving skin gloss, regulating skin pH, and enhancing skin antioxidant capacity, ultimately achieving facial skin rejuvenation. This method is safe, effective and holds high clinical relevence and patient satisfaction.

Macrophages are innate immune cells connected with the development of inflammation. Retinoic acid has previously been proved to have anti-inflammatory and anti-arthritic properties. However, the exact mechanism through which retinoic acid modulates arthritis remains unclear. This study aimed to investigate whether retinoic acid ameliorates rheumatoid arthritis by modulating macrophage polarization. This study used retinoic acid to treat mice with adjuvant arthritis and evaluated anti-inflammatory effects by arthritis score, thermal nociceptive sensitization test, histopathologic examination and immunofluorescence assays. In addition, its specific anti-arthritic mechanism was investigated by flow cytometry, cell transfection and inflammatory signaling pathway assays in RAW264.7 macrophages in vitro. Retinoic acid significantly relieved joint pain and attenuated inflammatory cell infiltration in mice. Furthermore, this treatment modulated peritoneal macrophage polarization, increased levels of arginase 1, as well as decreased inducible nitric oxide synthase expression. In vitro, we verified that retinoic acid promotes macrophage transition from the M1 to M2 type by upregulating mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1) expression and inhibiting P38, JNK and ERK phosphorylation in lipopolysaccharide-stimulated RAW264.7 cells. Notably, the therapeutic effects of retinoic acid were inhibited by MKP-1 knockdown. Retinoic acid exerts a significant therapeutic effect on adjuvant arthritis in mice by regulating macrophage polarization through the MKP-1/MAPK pathway, and play an important role in the treatment of rheumatic diseases.

Macrophages are innate immune cells connected with the development of inflammation. Retinoic acid has previously been proved to have anti-inflammatory and anti-arthritic properties. However, the exact mechanism through which retinoic acid modulates arthritis remains unclear. This study aimed to investigate whether retinoic acid ameliorates rheumatoid arthritis by modulating macrophage polarization. This study used retinoic acid to treat mice with adjuvant arthritis and evaluated anti-inflammatory effects by arthritis score, thermal nociceptive sensitization test, histopathologic examination and immunofluorescence assays. In addition, its specific anti-arthritic mechanism was investigated by flow cytometry, cell transfection and inflammatory signaling pathway assays in RAW264.7 macrophages in vitro. Retinoic acid significantly relieved joint pain and attenuated inflammatory cell infiltration in mice. Furthermore, this treatment modulated peritoneal macrophage polarization, increased levels of arginase 1, as well as decreased inducible nitric oxide synthase expression. In vitro, we verified that retinoic acid promotes macrophage transition from the M1 to M2 type by upregulating mitogen-activated protein kinase (MAPK) phosphatase 1 (MKP-1) expression and inhibiting P38, JNK and ERK phosphorylation in lipopolysaccharide-stimulated RAW264.7 cells. Notably, the therapeutic effects of retinoic acid were inhibited by MKP-1 knockdown. Retinoic acid exerts a significant therapeutic effect on adjuvant arthritis in mice by regulating macrophage polarization through the MKP-1/MAPK pathway, and play an important role in the treatment of rheumatic diseases.

Clear aligner treatment is a novel technique in current orthodontic practice. Distinct from traditional fixed orthodontic appliances, clear aligners have different material features and biomechanical characteristics and treatment efficiencies, presenting new clinical challenges. Therefore, a comprehensive and systematic description of the key clinical aspects of clear aligner treatment is essential to enhance treatment efficacy and facilitate the advancement and wide adoption of this new technique. This expert consensus discusses case selection and grading of treatment difficulty, principle of clear aligner therapy, clinical procedures and potential complications, which are crucial to the clinical success of clear aligner treatment.
Humans ; Consensus ; Orthodontic Appliance Design ; Orthodontic Appliances, Removable ; Tooth Movement Techniques/methods* ; Malocclusion/therapy* ; Orthodontics, Corrective/instrumentation*