ObjectiveTo construct a group-based trajectory model (GBTM) for early medication adherence check-in, and to analyze the relationship between different trajectories and treatment outcomes in tuberculosis patients using data that were generated from smart tools for monitoring their medication adherence and check-in. MethodsFrom October 1, 2022 to September 30, 2023, a total of 163 pulmonary tuberculosis patients diagnosed in Fengxian District were selected as the study subjects. The GBTM was utilized to analyze the weekly active check-in trajectories of the subjects during the first 4 weeks and establish different trajectory groups. The χ² tests were employed to compare the differences between groups and logistic regression analysis was conducted to explore the relationship between different trajectory groups and treatment outcomes. ResultsA total of four groups were generated by GBTM analyses, of which a low level of punch card was maintained in group A, 6% of the drug users increased rapidly from a low level in group B, 17% of drug users increased gradually from a low level in group C, and 18% of drug users maintained a high level of punch card in group D. The trajectory group was divided into two groups according to homogeneity, namely the low level medication punch card group (group A) and the high level medication punch card group (group B, group C, and group D). The results of multivariate logistic regression analyses revealed that low-level medication check-in (OR=3.250, 95%CI: 1.089‒9.696), increasing age (OR=1.030, 95%CI: 1.004‒1.056), and not undergoing sputum examination at the end of the fifth month (OR=2.746, 95%CI: 1.090‒7.009) were significantly associated with poor treatment outcomes. ConclusionThe medication check-in trajectory of pulmonary tuberculosis patients within the first 4 weeks is correlated with adverse outcomes, or namely consistent low-level medication adherence check-ins are associated with poor treatment outcomes, while high-level medication adherence check-ins are associated with a lower incidence of adverse outcomes.

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*

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*

Objective:To investigate the clinical safety and efficacy of robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty for ureteral stricture.Methods:The clinical data of 6 patients with ureteral stricture admitted to the Guizhou Provincial People's Hospital from December 2020 to August 2022 were retrospectively analyzed. There were 3 males and 3 females, with an average age of (40.2±11.5) years old. The status of ureteral stricture and hydronephrosis was measured by ultrasonography, CT urography and ureteral retrograde angiography. There were 2 cases of left ureteral stricture and 4 cases of right ureteral stricture, including 4 cases of upper segment stricture and 2 cases of middle segment stricture. The separation of the renal pelvis on the affected side was 3.2 (2.1, 4.2) cm. The length of ureteral stricture was 3.8 (2.5, 4.3) (1.0-5.0) cm, and the preoperative blood creatinine was 90(71, 97)μmol/L. Robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty was performed in all cases under general anesthesia. The strictured ureter segment was separated and longitudinally cut during the operation. The lingual mucosal grafts 2.5-5.0 cm in length and 1.0-1.5 cm in width was cut according to the stricture. Then the lingual mucosal grafts were harvested and placed in the strictured ureter as a ventral onlay. One double J tube was placed in the affected side in all cases during operation. The perioperative outcomes and complications were analyzed. The blood creatinine and renal pelvis separation on the affected side after surgery were compared with the preoperation.Results:All the surgeries were successfully completed. The average operative time was (190.8 ± 59.0) min, median blood loss was 40 (20, 63) ml, postoperative indwelling time of the drainage tube was 6 (4, 6) days, gastrointestinal function recovery time was 3 (2, 3) days, postoperative hospital stay was 6 (6, 7) days. The patients had clear pronunciation and lingual incision recovered 1 week post-operatively. The urine tube was removed 2 weeks after surgery, and the double J tube was removed 8 (6, 10) weeks post-operatively. Radiological examination revealed significant difference in hydronephrosis on the affected side 3 months post-operatively compared with the preoperation, and the separation of the renal pelvis on the affected side was 1.2 (1.2, 1.4) cm after surgery. The blood creatinine was 79(71, 104)μmol/L at 3 month after surgery, which was also improved compared with preoperative.Conclusions:Robot-assisted laparoscopic ventral onlay lingual mucosal graft ureteroplasty is a feasible and safe option for the treatment of ureteral stricture with less trauma, rapid recovery, and less complications.

Objective To explore the main factors affecting the MV imager projection offset in the machine performance check(MPC)for Varian Vital Beam linear accelerator.Methods The MV imager projection offsets in the MPC after repairing the MV imaging arm encoder of shoulder motor,locking the treatment couch,and isocenter calibration were analyzed.Results MPC results revealed that the MV imager projection offset after repairing the MV imaging arm encoder of shoulder motor was(0.310±0.001)mm,significantly less than(0.450±0.010)mm in the blank group.The difference in MV imager projection offset between the isocenter calibration group and the blank group was trivial.The MV imager projection offset after locking the treatment couch was(0.240±0.030)mm,significantly less than(0.450±0.010)mm in the blank group.When MPC was carried out after repairing the imaging arm encoder and performing isocenter calibration,there was no significant statistical difference in MV imager center offset between the locked and unlocked treatment couch.Conclusion The damage of MV imaging arm encoder of shoulder motor is the main factor causing abnormal MV imager projection offsets.Locking the treatment couch before the MV imaging center check can reduce the results,but it cannot eliminate the MV imager projection offset.

S100A9 is an important alarmin in vivo,which plays a role in regulating inflammation and tumorigenesis.Recently,many studies have also explored the biological function and related mechanism of S100A9 in renal diseases,including acute kidney injury,chronic kidney disease,renal stone,renal transplantation,renal tumor,renal cyst,and urinary infection.They pointed out the potential role of S100A9 as a new diagnostic and therapeutic biomarker for renal diseases.In the current study,we conduct a review of these findings and summarize possible future study directions,which aims to help people understand the impact of S100A9 on renal diseases.

Objective:To explored the effect of 78c in treating collagen-induced arthritis (CIA) mice and to investigate its mechanism of effects.Methods:CIA mice model and CD38 +NK cells were treated with 78c. Cytokine concentrations and lymphocyte subtypes were measured in the mice peripheral blood and culture medium using flow cytometry. Mikenyi cell isolation kit was used to isolate CD4 + T cells and NK cells from peripheral blood mononuclear cells of healthy volunteers. CD38 + NK cells were enriched using the Miltenyi CD38 microbeads from the extracted NK cells. CD38 + NK cells with 78c pretreatment or not were cocultured with CD4 +T cells in transwells. The least significant difference (LSD) method was used for comparison between the two groups, and one-way analysis of variance was used for multi-group significance. Pearson correlation analysis was used for correlation analysis. Results:78c treatment significantly suppressed joint inflammation, inhibited the toe thickness of CIA mice, and reduced the number of while cell, neutrophils, platelets, and concentrations of IFN-γ, IL-6 and TNF-α ( t=6.10, P<0.001; t=4.00, P=0.002; t=3.09, P=0.012; t=2.31, P=0.043; t=3.58, P=0.005; t=2.68, P=0.002) in the CIA mice. The proportion of CD38 +NK cells decreased from (3.9±0.9)% to (2.4±0.3)% ( t=2.49, P=0.032), the proportion of regulatory T cell (Treg) increased from (0.81±0.33)% to (1.41±0.26)% ( t=2.74, P=0.021), and the concentration of IL-10 also increased from (99±37) pg/ml to (199±9) pg/ml( t=2.76 , P=0.020). The proportion of Treg in CD4 +T cells cocultured with 78c-pretreated CD38 +NK cells increased from (0.52±0.04)% to (0.69±0.08)% ( t=3.33, P=0.029) , the T helper cells (Th)17/Treg ratio decreased from (4.44±0.26) to (2.59±0.64) ( t=4.76 , P=0.009), and the Th1/Th2 ratio decreased from (14.8±1.6) to (8.1±1.3)( t=5.70 , P=0.005). Conclusion:78c can reduce the proportion of CD38 +NK cells, thereby reducing the inhibition of CD38 +NK cells on CD4 +T cell differentiation into Treg cells, leading to the restoration of immune balance. The results of this study suggest that 78c is a potential therapeutic agent for rheumatoid arthritis.

Objective:To evaluate the clinical efficacy of the Kechuansan acupoint plaster combined with acupoint injection of Chuankezhi in treating bronchial asthma. Methods:A total of 65 patients with bronchial asthma, who met the inclusion criteria in Shanghai Municipal Hospital of TCM from June 2018 to September 2018, were selected anddivided into control group and observation group by random number table method, 32 in the control group and 33 in the observation group. The control group was treated with acupoint injection of Chuankezhi, while the observation group was treated with acupoint plaster of Kechuansan combined with acupoint injection of Chuankezhi. Both groups were treated for 6 weeks. TCM syndromes and frequency of acute attackin one year before and after the treatment was scored and recorded. The patients' quality of life was assessed by Asthma Control Test (ACT) and the fractional exhaled nitric oxide (FeNO) level was measured by Sunvou-p100 nakurun breath analyzer to evaluate the clinical efficacy. Results:Through out the treatment, there were 3 dropouts in the observation group and 2 dropouts in the control group. 30 cases were completed in each group. The total effective rate in the observation group was 93.3% (28/30), and the control group was 73.3% (22/30). The difference was statistically significant ( χ2=4.320, P=0.038). After the treatment, the scores of TCM syndromes and ACT in the observation groups were significantly higher than those of the control group ( t values were 4.834 and 5.642, respectively, all Ps<0.01). The FeNO in the observation group were significantly lower than those in the control group ( t=3.180, P=0.020). The frequency of acute attack in one year in the observation group was less than that ofthe control group ( t=5.466, P<0.01). Conclusions:Acupoint plaster Kechuansan combined with acupoint injection of Chuankezhi can relieve the clinical symptoms of asthma, reduce the frequency of asthma attack, improve the control ability of asthma, reduce airway inflammation, which is more effective than using acupoint injection therapy alone.

Objective This study was to evaluate the safety of 640 corneal donors by analysing the serological testing results.Methods We retrospectively analyzed the serological testing results from Changsha Aier Eye Bank and Chengdu Kangqiao Aier Eye Bank from January 2011 to December 2015,hepatitis B virus surface antigen (HBsAg),hepatitis C virus (HCV),treponema pallidum (TP) and human immunodeficiency virus (HIV) were detected by colloidal gold or enzyme-linked immunosorbent assay (ELISA).Results There were 83 out of 640 serum samples showed positive immuno-reaction assayed markers,the positive rate was 12.97％,including HBsAg(n=60,9.38％),HCV(n=3,0.47％),TP(n=11,1.72％) and HIV(n=2,0.31％).Moreover,3 corneal donors were both positive against HBsAg and HCV,2 donors positive against HCV and TP,1 donor positive against HBsAg and HIV,1 donor positive against HBsAg and TP.Conclusions There is a high proportion of positive results of blood-borne diseases in cornea donors,which is a potential threat to corneal receptors and eye bank workers.Therefore,it is very important to detect serological test strictly for corneal donors.

Objective To study port-externalized tissue expansion technique and to provide a safe,simple and effective skin tissue expansion for extensive skin lesion reconstruction.Methods A lot of 247 patients with extensive skin lesion were chosen for the study.400-1000 ml tissue expanders were used for overexpansion and repeated expansion.Expanders were inserted into subcutaneous pockets through mini-invasive incisions and intermittent injection was carried out 4 days after first stage operation.After expansion finished,expanded skin flaps were transplanted for skin lesion reconstruction.During inflation period,complications and expander failures were observed.Results In 741 expanders of 247 patients,complication rate was 16.5 ％ with total 122 cases of complications.Expansion success rate was 98.9 ％ with 8 expander failures.Expanders were inflated successfully between 64-113 days,with average 92.7 days.The inflated saline volume was 2.38 times of marked expander capacity.In this group of 733 expanded skin flaps,721 flaps were well survived with 98.4％ success rate.276 expanded flaps of 116 patients were followed up for one to five years post-operation.The width of incision scar was between 0.3-1.2 mm.Conclusions The port-externalized overexpansion with giant expanders is a safe,simple and feasible technique,which is worthy of further clinical application.