Objective·To explore the diagnostic and treatment methods for patients with cystic fibrosis(CF)complicated by allergic bronchopulmonary aspergillosis(ABPA),and to enhance clinicians'understanding of these two diseases.Methods·A retrospectively analysis was conducted on the clinical data of 5 patients with CF complicated by ABPA admitted to the Department of Respiratory Medicine,Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine,from July 2023 to August 2024.A literature search was performed in PubMed,Web of Science,Cochrane Library,and CNKI for studies published in the past 10 years regarding the co-existence of these diseases.Clinical manifestations,treatment courses,and current epidemiological research were summarized and analyzed.Results·Common symptoms of patients with CF complicated by ABPA included aggravated cough and expectoration,wheezing,fever,and dyspnea.Whole-exome aequencing indicated mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene,and an increase in the concentration of chloride ions in sweat.The levels of total serum immunoglobulin E(IgE)and Aspergillus fumigatus-specific IgE increased,and chest computed tomography(CT)showed bronchiectasis and mucus plugging.CF complicated by ABPA is often missed or misdiagnosed for asthma.In China,ABPA is often diagnosed before CF,whereas in Caucasian populations CF is typically diagnosed first.Initial treatment usually involves long-term oral administration of antifungal drugs such as voriconazole combined with glucocorticoids such as prednisone.For patients with frequent relapses or severe side effects,alternative antifungal agents or omalizumab therapy may be considered.Co-infection with Pseudomonas aeruginosa is common,often requiring intravenous antibiotics such as cefoperazone-sulbactam.Current epidemiological research focuses mainly on clinical characteristics,treatment regimens,and novel diagnostic methods.Conclusion·ABPA and CF have overlapping symptoms.Accurate diagnosis of CF complicated by ABPA requires genetic testing,sweat chloride measurement,chest CT,and serological tests.The coexistence of these diseases often leads to missed,delayed,or incorrect diagnosis,increasing patient burden.Present epidemiological studies mainly address clinical characteristics with a lack of targeted clinical drug trials for this patient population.

Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.

Objective·To explore the diagnostic and treatment methods for patients with cystic fibrosis(CF)complicated by allergic bronchopulmonary aspergillosis(ABPA),and to enhance clinicians'understanding of these two diseases.Methods·A retrospectively analysis was conducted on the clinical data of 5 patients with CF complicated by ABPA admitted to the Department of Respiratory Medicine,Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine,from July 2023 to August 2024.A literature search was performed in PubMed,Web of Science,Cochrane Library,and CNKI for studies published in the past 10 years regarding the co-existence of these diseases.Clinical manifestations,treatment courses,and current epidemiological research were summarized and analyzed.Results·Common symptoms of patients with CF complicated by ABPA included aggravated cough and expectoration,wheezing,fever,and dyspnea.Whole-exome aequencing indicated mutations in the cystic fibrosis transmembrane conductance regulator(CFTR)gene,and an increase in the concentration of chloride ions in sweat.The levels of total serum immunoglobulin E(IgE)and Aspergillus fumigatus-specific IgE increased,and chest computed tomography(CT)showed bronchiectasis and mucus plugging.CF complicated by ABPA is often missed or misdiagnosed for asthma.In China,ABPA is often diagnosed before CF,whereas in Caucasian populations CF is typically diagnosed first.Initial treatment usually involves long-term oral administration of antifungal drugs such as voriconazole combined with glucocorticoids such as prednisone.For patients with frequent relapses or severe side effects,alternative antifungal agents or omalizumab therapy may be considered.Co-infection with Pseudomonas aeruginosa is common,often requiring intravenous antibiotics such as cefoperazone-sulbactam.Current epidemiological research focuses mainly on clinical characteristics,treatment regimens,and novel diagnostic methods.Conclusion·ABPA and CF have overlapping symptoms.Accurate diagnosis of CF complicated by ABPA requires genetic testing,sweat chloride measurement,chest CT,and serological tests.The coexistence of these diseases often leads to missed,delayed,or incorrect diagnosis,increasing patient burden.Present epidemiological studies mainly address clinical characteristics with a lack of targeted clinical drug trials for this patient population.

[Objective] To explore the current status, influencing factors, and serological characteristics of occult hepatitis B virus infection (OBI) among blood donors in Xuzhou, so as to provide data support for improving blood safety screening strategies. [Methods] Blood samples from blood donors from January 2019 to December 2023 in Xuzhou were tested using enzyme-linked immunosorbent assay (ELISA) for serological markers and transaminase levels. Qualified samples were then subjected to nucleic acid testing (NAT). Statistical analysis was performed on the gender, age, education level, and occupation of HBV-infected donors. Logistic regression analysis was used to identify risk factors and epidemiological trends in OBI donors. Chemiluminescence immunoassay was used to quantify the levels of anti-HBs, HBeAg, anti-HBe, and anti-HBc in OBI donors and eligible donors (control group). [Results] Among the 545 292 blood donors, there were 388 OBI donors were identified, with a positive rate of 0.07%. Multivariate logistic regression analysis revealed that male gender, age >45 years, education below college level, and occupation as a farmer were associated risk factors for OBI infection. Among the 388 OBI donors, the predominant serological patterns were anti-HBs and anti-HBc positive (48.71%), anti-HBs, anti-HBe, and anti-HBc positive (16.75%), and anti-HBc alone positive (16.49%). In contrast, the most common patterns among eligible donors were anti-HBs alone positive (46.96%) and serologically negative (26.52%). Anti-HBs levels in OBI donors were significantly lower than those in eligible donors across all patterns (P<0.05). For donors positive for anti-HBc, the distribution of anti-HBs levels in OBI donors was predominantly <100 IU/L, significantly lower than that in eligible donors (P<0.05), while and the proportion of eligible donors with anti-HBs levels >1 000 IU/L was higher than that in OBI donors (P<0.05). [Conclusion] There is a certain proportion of OBI infections among blood donors in Xuzhou, with an overall declining trend. NAT contributes to improved detection rates of HBV infections. The epidemiological distribution of OBI donors in terms of gender, age, education, and occupation differs from that of eligible donors, and there are also differences in serological characteristics between the two groups.

Background and Aims:With the widespread use of electrosurgical devices in open thyroid surgery,the surgical smoke generated during procedures has become a significant concern,as it compromises surgical visibility,reduces operational efficiency,and poses health risks to medical staff.Currently,local smoke evacuation is commonly performed by an assistant using a handheld suction device,which is limited in range,interferes with surgical procedures,and increases labor costs.This study aimed to evaluate the effectiveness,safety,feasibility,and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods:A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group(41 patients each).During surgery,the observation group used a self-made annular smoke evacuation device for continuous smoke removal,while the control group used conventional manual suction via an assistant.Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field,operative time,intraoperative blood loss,and medical staff satisfaction with smoke removal.Results:During thyroid tissue dissection,the PM2.5 concentration in the observation group was(63.26±11.71)μg/m3,corresponding to a"good"air quality level,while in the control group it was(126.35±40.12)μg/m3,ranging from"mild to severe pollution"—a statistically significant difference(P<0.05).In the observation group,operative times for unilateral and bilateral procedures were(31.25±11.36)min and(71.13±17.12)min,respectively,with intraoperative blood loss of(10.5±5.3)mL and(18.6±5.5)mL.In the control group,times were(39.27±15.42)min and(78.35±22.35)min,with blood loss of(12.5±5.8)mL and(20.5±6.5)mL,respectively—all differences not statistically significant(all P>0.05).Staff satisfaction was significantly higher in the observation group compared to the control group(97.6%vs.31.7%,P<0.05).Conclusion:The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery,effectively reducing surgical smoke concentration,improving visibility,and minimizing health risks to medical staff without compromising surgical efficiency or safety.The device is cost-effective,easy to assemble,and can be repurposed postoperatively as a drainage tube,requiring no additional consumables.Its reusability and ease of integration offer strong practical value and clinical applicability.

To develop a milestone-based evaluation system for the core "knowledge and skills" competency of neurology residents that is tailored to China's medical context, so as to provide precise guidance for their training and assessment.

Objective To explore the effect of management model of clinical pharmacists participating in multidisciplinary collaborative diagnosis and treatment(MDT)for new anti-tumor drugs in the national medical insurance drug negotiation(hereinafter referred to as"national negotiation"),including efficacy,safe-ty,economy and rationality.Methods The medical records of 326 cases using novel anti-tumor drugs by na-tional negotiation and conforming to the including and excluding standards in this hospital from July 2018 to June 2023 were retrospectively analyzed.The patients were divided into the MDT group(n=122)and non-MDT group(n=204).The patients diagnosed as non-small cell lung cancer(NSCLC)in the two groups were extracted and defined as the MDT-NSCLC subgroup(n=41)and non-MDT-NSCLC subgroup(n=77).The progression-free survival(PFS),overall survival(OS),disease control rate(DCR)and the indexes such as survival quality and medical quality control were compared between the groups.Results The median PFS in the two groups was 12.7 months and 8.0 months,the median OS was 75.2 months and 56.3 months,DCR was 96.72％and 81.86％respectively,and the differences were statistically significant(P＜0.05).The COX multivariate regression analysis indicated that the HR value of clinical pharmacists participating in MDT was higher than the other influencing factors.The median PFS time in the MDT-NSCLC subgroup and non-MDT-NSCLC subgroup was 10.5 months and 6.7 months,DCR was 97.30％and 75.64％respectively,and the differences were statistically significant(P＜0.05),the median OS time was 55.1 months and 40.3 months respectively,and the difference was statistically significant(P＞0.05).The COX multivariate regression anal-ysis indicated that the HR value with clinical pharmacists participating in MDT was higher than the other in-fluencing factors;The adverse reaction occurrence rate in the MDT group and non-MDT group was 45.9％and 58.3％respectively,and the difference was statistically significant(P＜0.05).The KPS score after treatment in the MDT group was higher than that in the non-MDT group,and the difference was statistically significant;in the aspect of medical quality control,the average drug proportion in the MDT group and non-MDT group was 63.93％and 64.54％respectively,the rational drug rate of comments on prescription was 98.36％and 88.73％respectively,the patient satisfaction average value was 90.69 points and 87.36 points respectively and the differences were statistically significant(P＜0.05).Conclusion Clinical pharmacists participating in MDT related to novel anti-tumor drugs by national negotiation is beneficial to improve the therapeutic effects,living quality and patient satisfaction,also benefit to management and control of off-label drug use and medical quality control indexes.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

The prevalence of Class III malocclusion varies among different countries and regions. The populations from Southeast Asian countries (Chinese and Malaysian) showed the highest prevalence rate of 15.8%, which can seriously affect oral function, facial appearance, and mental health. As anterior crossbite tends to worsen with growth, early orthodontic treatment can harness growth potential to normalize maxillofacial development or reduce skeletal malformation severity, thereby reducing the difficulty and shortening the treatment cycle of later-stage treatment. This is beneficial for the physical and mental growth of children. Therefore, early orthodontic treatment for Class III malocclusion is particularly important. Determining the optimal timing for early orthodontic treatment requires a comprehensive assessment of clinical manifestations, dental age, and skeletal age, and can lead to better results with less effort. Currently, standardized treatment guidelines for early orthodontic treatment of Class III malocclusion are lacking. This review provides a comprehensive summary of the etiology, clinical manifestations, classification, and early orthodontic techniques for Class III malocclusion, along with systematic discussions on selecting early treatment plans. The purpose of this expert consensus is to standardize clinical practices and improve the treatment outcomes of Class III malocclusion through early orthodontic treatment.
Humans ; Malocclusion, Angle Class III/classification* ; Orthodontics, Corrective/methods* ; Consensus ; Child

The rapid screening of bioactive constituents within traditional Chinese medicine (TCM) presents a significant challenge to researchers. Prevailing strategies for the screening of active components in TCM often overlook trace components owing to their concealment by more abundant constituents. To address this limitation, a fishing strategy based on offline two-dimensional liquid chromatography (2D-LC) combined with surface plasmon resonance (SPR) was utilized to screen bioactive trace components targeting peroxiredoxin 3 (PRDX3), using Uncaria alkaloids (UAs) as a case study. Initially, an orthogonal preparative offline 2D-LC system combining a positively charged C₁₈ column and a conventional C₁₈ column under disparate mobile phase conditions was constructed. To fully reveal the trace alkaloids, 13 2D fractions of UAs were prepared, and their components were characterized using mass spectrometry (MS). Subsequently, employing PRDX3 as the targeting protein, a SPR-based screening approach was established and rigorously validated with geissoschizine methyl ether (GSM) serving as a positive control for binding. Employing this refined strategy, 29 candidate binding alkaloids were fished from the 13 2D fractions. Notably, combining offline 2D-LC with SPR increased the yield of candidate binding components from 10 to 29 when compared to SPR-based screening alone. Subsequent binding affinity assays confirmed that PRDX3 was a direct binding target for the 12 fished alkaloids, with isovallesiachotamine (IV), corynoxeine N-oxide (CO-N), and cadambine (CAD) demonstrating the highest affinity for PRDX3. Their interactions were further validated through molecular docking analysis. Subsequent intracellular H₂O₂ measurement assays and transfection experiments confirmed that these three trace alkaloids enhanced PRDX3-mediated H₂O₂ clearance. In conclusion, this study introduced an innovative strategy for the identification of active trace components in TCM. This approach holds promise for accelerating research on medicinal components within this field.