Chronic mucocutaneous candidiasis (CMC) is an infectious phenotype characterized by recurrent or persistent infections caused by Candida species that affect the skin, nails, oral, and genital mucosae for a duration exceeding six months. Current research suggests that CMC is an immunodeficiency disease with a complex pathogenesis. Patients with CMC have various defects in nonspecific and/or specific immunity against Candida infection, resulting in the inability of patients to defend themselves against Candida infection. CMC can be stratified into primary CMC and secondary CMC based on etiology. Primary CMC is often associated with genetic mutations leading to immunodeficiencies in T helper cell 17 and interleukin-17, whereas secondary CMC is frequently linked to factors such as human immunodeficiency virus infection, diabetes mellitus, and immunosuppressive therapy. Primary CMC typically manifests as Candida infections, with distinct genetic mutations often correlating to varied concomitant symptoms. Secondary CMC may present with not only superficial mucosal Candida infections and manifestations of the underlying primary disease but also with invasive fungal infections. Diagnosing CMC requires an integration of medical history and clinical presentation, supplemented by the outcomes of auxiliary diagnostic procedures, including microscopic examination of fungal smear, fungal culture, immunological testing, and genetic sequencing and analysis. Furthermore, confirming primary CMC requires exclusion of the aforementioned secondary factors. At present, antifungal drugs such as triazoles, echinocandins, and polyenes are the main treatment for CMC. Moreover, immunotherapy with biologics such as Janus kinase (JAK) inhibitors provides more options for the clinical treatment of patients with CMC. Gene therapy also has potential clinical application value. In this review, we discuss the etiologies, pathogenesis, clinical manifestations, diagnosis, and treatments of CMC, aiming to provide a reference for the clinical diagnosis and treatment of CMC.

Objective: To assess the effect of 12-year-old children s pit and fissure sealants on the health of first permanent molars, so as to provide evidence for optimizing caries prevention strategies among children. Methods: In March 2025, a cluster random sampling method was used to conduct oral examinations on 965 students aged 12 from Chengdu s 2021 Comprehensive Intervention Program for Pediatric Oral Diseases. Data from the Comprehensive Intervention System for Children s Oral Diseases were referenced. Participants were divided into a sealed group ( n =755) and an unsealed group ( n =210) based on whether they had received sealants on their first permanent molars. Chi square test or analysis of variance were used to compare indicators such as caries incidence, new caries detection rate, and new caries mean (DMFT increment) between the two groups Results: The sealed group showed significantly lower caries incidence, new caries detection rate, and new caries mean (33.38%, 17.65%, 0.59±1.00) compared to the unsealed group (43.81%, 24.70%, 0.87±1.22)( χ 2/F =7.79, 18.26, 9.55, all P <0.05). However, no significant difference was found in the filled teeth ratio between the two groups (20.38% , 20.16%; χ 2=0.01, P =0.94). In girls, the sealed group exhibited significantly lower caries incidence, new caries detection rate, and new caries mean (36.78%, 20.99%, 0.69± 1.10 ) than the unsealed group (57.55%, 33.52%, 1.15±1.29) ( χ 2/F =14.42, 23.76, 10.92, all P <0.05), whereas no significant differences were observed between boys in the sealed (30.47%, 14.85%, 0.50±0.89) and unsealed groups (29.81%, 16.18%, 0.59± 1.08) ( χ 2/F =0.02, 0.41, 0.74, all P >0.05). Boys had significantly lower new caries detection rates and new caries means than girls in both groups ( χ 2/F =16.20, 6.94; 29.93, 11.84, all P <0.05). In urban areas, the sealed group had lower new caries detection rates and new caries means (19.37%, 0.68±1.04) than the unsealed group (24.66%, 0.90±1.20) ( χ 2/F =6.86, 3.94, both P <0.05). In suburban areas, all indicators for the sealed group (24.71%, 13.77%, 0.42±0.87) were significantly lower than those for the unsealed group (38.81%, 24.77%, 0.82±1.28) ( χ 2/F =5.28, 15.36, 6.00, all P <0.05). Indicators from specialized dental institutions (11.25%, 4.81%, 0.16±0.56) were significantly lower than those from county level or above general hospitals (33.33%, 19.11%, 0.38±1.00) and primary healthcare institutions (37.59%, 19.24%, 0.67±1.05) ( χ 2/F =20.99, 34.31, 21.08 , all P <0.01). Conclusions The 12-year-old children s pit and fissure sealants effectively reduce the caries incidence in first permanent molars, particularly showing significant effectiveness in girls and suburban children. Intervention strategies should be optimized according to gender.

Objective To investigate the correlation between the combined assessment of preoperative 5-factor modified frailty index(mFI-5)and Naples prognostic score(NPS)with overall survival in patients with unresectable hepatocellular carcinoma(uHCC)following interventional therapy.Methods A retrospective cohort study enrolled 292 patients with uHCC who underwent interventional therapy at the Department of Hepatobiliary Pancreatic Surgery of the Second Affiliated Hospital in Army Medical University from October 2017 to December 2021.Patients were stratified into high-risk and low-risk groups based on mFI-5(≥1),NPS(≥3),and CONUT(≥4)scores.Propensity score matching(PSM)was performed to balance baseline characteristics(post-matching n=186).The primary endpoint was overall survival(OS),analyzed using Kaplan-Meier curves with log-rank tests.The predictive performance of combined indicators was evaluated by receiver operating characteristic(ROC)curves,and prognostic factors were assessed via Cox regression analysis.Results After PSM,baseline characteristics(including age,tumor markers,and treatment-related parameters)showed no significant differences between the two groups.Survival analysis demonstrated a 2.252-fold higher risk of death in the mFI-5 plus NPS high-risk group(95%CI:1.60～3.18,P<0.001).The combination of mFI-5 and NPS scores yielded an area under curve(AUC)of 0.718 for predicting 3-year overall survival,significantly outperforming either index alone(P=0.007).Multivariable Cox regression analysis identified that dual positivity for mFI-5 and NPS(HR=1.46;95%CI:1.01～2.11,P=0.044),portal vein tumor thrombosis(HR=1.49;95%CI:1.03～2.16,P=0.035),tumor diameter>5 cm(HR=2.01;95%CI:1.27～3.17,P=0.003),Barcelona clinic liver cancer(BCLC)stage C disease(HR=2.05;95%CI:1.37～3.07,P<0.001)were independent predictors of poor prognosis.Postoperative combination targeted therapy and immunotherapy was associated with significantly reduced mortality risk(HR=0.57;95%CI:0.39～0.81,P=0.002).Conclusion The combination of mFI-5 and NPS scores is significantly associated with overall survival in patients with unresectable hepatocellular carcinoma(uHCC)undergoing locoregional therapy,providing a validated tool for clinical risk stratification and personalized treatment planning.

A pyrene-phenol-based fluorescent probe PyP which showed typical intramolecular charge transfer(ICT)and monomer-excimer activities was synthesized by using pyrene carboxaldehyde hydrazone and 4-tert-butyl-2,6-diformylphenol as the raw materials.The effects of solvents on PyP were studied,and the results showed that the color of protic polar solvents(Ethanol,N,N-dimethylformamide,methanol and H2O)were successfully identified.Based on the solvent polarity-regulated PyP monomer-excimer switching,the rapid and highly sensitive ratiometric probe,"Turn-off"and"Turn-on"multimodal probes were established for detection of trace water content in organic solvents(Dimethyl sulfoxide,N,N-dimethylformamide,ethanol and methanol),with detection limits(3σ/k)of 0.0021％,0.046％,0.062％and 0.024％.The method was successfully used to detect water content in dimethyl sulfoxide,N,N-dimethy lformamide,ethanol and methanol commercial organic solvents,with recoveries ranging from 97.2％to 108.0％.The developed method showed good accuracy and stability,and had good application prospect.

Patients with chronic rhinosinusitis(CRS)often suffer from olfactory dysfunction(OD),which seriously affects their quality of life.Traditional therapeutic interventions have limited efficacy in improving olfactory function.Olfactory training(OT),based on the mechanism of olfacto-ry nerve plasticity,promotes the recovery of olfactory function and has become a research hotspot in recent years.This paper systematically reviewed the mechanisms by which OT promotes the reconstruc-tion of olfactory function in patients with chronic rhinosinusitis with olfactory dysfunction(CRS-OD),as well as its implementation strategies and evidence-based application effects.It proposes a patient-centered,stepwise OT nursing intervention plan that integrates digital adherence tracking and psycho-logical support,providing evidence-based support for the standardization of olfactory rehabilitation pathways.

To address issues such as loss of detailed information, blurred target boundaries, and unclear structural hierarchy in medical image fusion, this paper proposes an adaptive feature medical image fusion network based on a full-scale diffusion model. First, a region-level feature map is generated using a kernel-based saliency map to enhance local features and boundary details. Then, a full-scale diffusion feature extraction network is employed for global feature extraction, alongside a multi-scale denoising U-shaped network designed to fully capture cross-layer information. A multi-scale feature integration module is introduced to reinforce texture details and structural information extracted by the encoder. Finally, an adaptive fusion scheme is applied to progressively fuse region-level features, global features, and source images layer by layer, enhancing the preservation of detail information. To validate the effectiveness of the proposed method, this paper validates the proposed model on the publicly available Harvard dataset and an abdominal dataset. By comparing with nine other representative image fusion methods, the proposed approach achieved improvements across seven evaluation metrics. The results demonstrate that the proposed method effectively extracts both global and local features of medical images, enhances texture details and target boundary clarity, and generates fusion image with high contrast and rich information, providing more reliable support for subsequent clinical diagnosis.
Humans ; Image Processing, Computer-Assisted/methods* ; Algorithms ; Neural Networks, Computer ; Diagnostic Imaging/methods* ; Image Interpretation, Computer-Assisted/methods*

OBJECTIVE: To compare clinical efficacy of musculoskeletal ultrasound-guided acupuncture treatment and radiation extracorporeal shock wave therapy in myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy. METHODS: From June 2021 to April 2022, 75 patients with myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy were admitted and divided into musculoskeletal ultrasound group and extracorporeal shock wave group according to different treatment methods. There were 39 patients in musculoskeletal ultrasound group, including 12 males and 27 females, aged from 43 to 77 years old with an average of (56.33±9.45) years old;11 patients on the left side and 28 patients on the right side;the course of disease with a median of 7.00(4.00, 12.00) weeks;acupuncture treatment was performed under the guidance of musculoskeletal ultrasound. There were 36 patients in extracorporeal shock wave group, including 16 males and 20 females, aged from 46 to 72 years old with a median of (58.94±8.94) years old;12 patients on the left side and 24 patients on the right side;the course of disease with an average of 5.50(4.00, 8.00) weeks;extracorporeal shock wave therapy with radiation were performed. Visual analogue scale (VAS) and American shoulder and elbow surgeons score (ASES) were compared between two groups to evaluate improvement of shoulder joint pain and function before treatment and 1, 3, 6, 12, and 24 months after treatment. RESULTS: Both of two groups were followed up for 24 to 27 months with an average of (24.68±0.89) months. No complications such as infection and vascular and nerve injury occurred during follow-up period. At 6 months after treatment, VAS of musculoskeletal ultrasound group (2.00±1.19) was lower than that of extracorporeal shock wave group (3.08±1.02), and the difference was statistically significant (P<0.05). At 1, 3, 12 and 24 months after treatment, there were no statistically significant difference in VAS between two groups (P>0.05). At 3, 6 and 12 months after treatment, ASES scores of musculoskeletal ultrasound group were (77.44±11.56), (86.06±6.11), and (89.44±4.66) respectively, which were higher than those of extracorporeal shock wave group (55.23±12.76), (58.10±10.25), (84.03±7.36), the differences were statistically significant (P<0.05);there were no statistically significant difference in ASES between two groups at 1 and 24 months after treatment(P>0.05). CONCLUSION Musculoskeletal ultrasound-guided acupuncture treatment has advantages of faster pain relief and more rapid improvement of shoulder joint function for myofascial pain syndrome after rotator cuff suture under shoulder arthroscopy compared with radioactive extracorporeal shock wave therapy.
Humans ; Male ; Female ; Middle Aged ; Acupuncture Therapy/methods* ; Adult ; Aged ; Arthroscopy/adverse effects* ; Myofascial Pain Syndromes/etiology* ; Ultrasonography ; Rotator Cuff/surgery*

Direct electrical stimulation of the human cortex can produce subjective visual sensations, yet these sensations are unstable. The underlying mechanisms may stem from differences in electrophysiological activity within the distributed network outside the stimulated site. To address this problem, we recruited 69 patients who experienced visual sensations during invasive electrical stimulation while intracranial electroencephalography (iEEG) data were recorded. We found significantly flattened power spectral slopes in distributed regions involving different brain networks and decreased integrated information during elicited visual sensations compared with the non-sensation condition. Further analysis based on minimum information partitions revealed that the reconfigured network interactions primarily involved the inferior frontal cortex, posterior superior temporal sulcus, and temporoparietal junction. The flattened power spectral slope in the inferior frontal gyrus was also correlated with integrated information. Taken together, this study indicates that the altered electrophysiological signatures provide insights into the neural mechanisms underlying subjective visual sensations.
Humans ; Male ; Female ; Adult ; Visual Perception/physiology* ; Electric Stimulation ; Middle Aged ; Young Adult ; Electrocorticography ; Electroencephalography ; Brain Mapping

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective: To explore the impact of sleep quality, experience of childhood maltreatment, and their interaction on depressive symptoms among middle school students, so as to provide the reference for early intervention of depressive symptoms among middle school students. Methods: From September to December 2023, a questionnaire survey was conducted among 1 231 students from two secondary schools in Harbin, Heilongjiang Province by a convenient sampling method. The survey included general demographic information, Childhood Trauma Questionnaire Short Form, Pittsburgh Sleep Quality Index and Short Version of Center for Epidemiological Studies Depression Scale. The Chi square test was used to analyze the differences in depressive symptom, sleep quality and childhood maltreatment among students with different demographic characteristics. Correlation analysis was conducted using Logistic regression, and interaction analysis was performed by both additive and multiplicative interaction models. Results: The detection rate of depressive symptoms among middle school students was 22.7%, and the rate for high school students (35.2%) was significantly higher than that for middle school students (17.0%) ( χ 2=50.35, P <0.01). The detection rates of depressive symptoms among middle school students with a history of childhood maltreatment and poor sleep quality were 45.8% and 44.0%, respectively. Multivariate Logistic regression analysis showed that compared to students without a history of childhood maltreatment, students with a history of childhood maltreatment had a higher risk of depressive symptoms ( OR =4.49，95% CI =3.31~ 6.09 , P <0.01);students with poor sleep quality had a higher risk of depressive symptoms than students with good sleep quality ( OR = 5.99，95% CI =4.37~8.22, P <0.01).The interaction results showed that the presence of childhood maltreatment and poor sleep quality had an additive interaction on the occurrence of depression in middle school students. Compared with students without childhood maltreatment and having good sleep quality, students with childhood maltreatment and poor sleep quality had a 22.49 times higher risk of developing depression ( OR =22.49，95% CI =14.22~35.59, P <0.01). Conclusion Depressive symptoms among middle school students are associated with childhood maltreatment and poor sleep quality, and there is an additive interaction between childhood maltreatment and poor sleep quality on the impact of depressive symptoms.