Objective To investigate the efficacy of early, short-term, low-dose corticosteroid administration for the prevention and treatment of early acute lung injury (EALI) in patients undergoing thoracoscopic lobectomy. Methods A retrospective analysis was conducted on the clinical data of patients who underwent thoracoscopic lobectomy at the Department of Thoracic and Cardiovascular Surgery, Taihe Hospital, Hubei University of Medicine, from January 2019 to January 2022. Patients were divided into an early steroid therapy group and an observation group based on whether they received corticosteroids in the early postoperative period. In the early steroid therapy group, in addition to standard postoperative care, patients received a low-dose intravenous push of methylprednisolone (80-120 mg/d) for 3 consecutive days. In the observation group, patients received standard postoperative care without intravenous corticosteroids for the first 3 days. Chest plain CT scans were performed on postoperative day (POD) 1 and POD 3 or 4 to evaluate lung injury. CT scores and the incidence of postoperative EALI were recorded. Results A total of 521 patients were included (268 males, 253 females; age range: 11-80 years). There were 318 patients in the observation group and 203 in the early steroid therapy group. On POD 1, the incidence of EALI was 16.0% in the observation group and 13.8% in the early steroid therapy group, with no statistical difference (P=0.486). Correspondingly, there was no statistical difference in chest CT scores among EALI-positive patients between the two groups (P=0.927). On POD 3-4, the incidence of EALI was significantly lower in the early steroid therapy group (22.7%) compared to the observation group (33.6%) (P=0.007). Although chest CT scores among EALI-positive patients were lower in the early steroid therapy group, the difference was not statistically significant (P=0.377). The overall incidence of EALI within the first 4 postoperative days was significantly lower in the early steroid therapy group (26.1%) than in the observation group (37.4%) (P=0.007). Radiological progression (defined as new-onset EALI or progression of existing EALI) occurred in 14.8% of the early steroid therapy group, significantly lower than the 28.9% in the observation group (P<0.001). The early steroid therapy group had a shorter postoperative length of stay (P<0.001), while there was no statistical difference in the incidence of poor wound healing between the groups (P=0.762). Conclusion Early postoperative corticosteroid use effectively reduces the incidence of EALI on POD 3-4, lowers the risk of radiological progression, and decreases the overall incidence of postoperative EALI. This is achieved without prolonging the length of stay or increasing the risk of poor wound healing. Therefore, early administration of low-dose corticosteroids is beneficial in suppressing the occurrence and progression of EALI. Its early use is recommended for patients at high risk for postoperative EALI.

Objective To investigate the correlation between serum cytotoxic T lymphocyte associated pro-tein 4(CTLA4),high mobility group box 1(HMGB1)and the balance of helper T cell 17(Th17)/regulatory T cell(Treg),and to study their diagnostic significance for unexplained recurrent spontaneous abortion(URSA).Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group,and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group.The levels of serum CTLA4 and HMGB1 in the two groups were detected,the levels of Th17 and Treg in the two groups were detected,the Th17/Treg ratio was calculated,and the general data of the two groups were collected and recorded.Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17,Treg,and Th17/Treg.logistic regres-sion was used to analyze the influencing factors of URSA occurrence.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA.Results the serum CTLA4 level in the URSA group was lower than that in the healthy group,the HMGB1 level was higher than that in the healthy group,the Th17 level and Th17/Treg were higher than those in the healthy group,and the Treg level was lower than that in the healthy group(P<0.05).The serum CTLA4 level was nega-tively correlated with the Th17 level and Th17/Treg,and positively correlated with the Treg level(P<0.05).The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg,and negatively correlated with the level of Treg(P<0.05).Pregnancy frequency,serum CTLA4 level,serum HMGB1 level,Th17 level,Treg level,and Th17/Treg are independent influencing factors for the occurrence of URSA(P<0.05).The areas under the curve(AUC)of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841,0.787,and 0.908 respectively,and the Youden indices were 0.652,0.491,and 0.656 respectively.Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA,which is related to the change of Th17/Treg balance.The levels of serum CTLA4 and HMGB1 have auxiliary diag-nostic significance for URSA.

Objective To evaluate the clinical outcome of posterior cruciate ligament(PCL)recon-struction using ligament augmentation and reconstruction system(LARS)artificial ligament,and ana-lyze factors affecting the prognosis.Methods A total of 45 patients(31 males and 14 females,with an average age of 38.0±12.8 years)underwent PCL reconstruction using LARS artificial ligament in China-Japan Friendship Hospital in years from 2018 to 2021 were analyzed retrospectively.Their aver-age time from injury to surgery of 2.8±4.2 months.They were followed up for no less than 1 year about the stability of knee,Lysholm score and Tegner score,as well as the patient's satisfaction.Moreover,the effect of patient's age,time from injury to surgery,and complications of other ligament injuries of the knee on the final outcomes were analyzed.Results For all the 45 patients,the mean follow-up time was 35.0±14.1 months,with their satisfaction rate of 91.1%.There were 31 cases of 3° instability and 14 cases of 2° instability before surgery,which improved significantly as only 4 cas-es were of 2° instability,22 cases of 1° instability at the final follow-up(χ2=77.56,P<0.000).More-over,the average Lysholm and Tegner scores increased significantly from 37.2±15.2 and 0.9±0.9,to 85.3±12.7 and 4.4±1.3,respectively(t=16.34,P<0.000;t=15.72,P<0.000).What's more,the age of over 40 years had effect on the prognosis,while the time from injury to surgery and the com-plicated ligament injuries of the knee did not.Conclusion Using LARS artificial ligament as graft for PCL reconstruction can achieve satisfactory clinical results on the short-term.

Objective To evaluate the clinical outcome of posterior cruciate ligament(PCL)recon-struction using ligament augmentation and reconstruction system(LARS)artificial ligament,and ana-lyze factors affecting the prognosis.Methods A total of 45 patients(31 males and 14 females,with an average age of 38.0±12.8 years)underwent PCL reconstruction using LARS artificial ligament in China-Japan Friendship Hospital in years from 2018 to 2021 were analyzed retrospectively.Their aver-age time from injury to surgery of 2.8±4.2 months.They were followed up for no less than 1 year about the stability of knee,Lysholm score and Tegner score,as well as the patient's satisfaction.Moreover,the effect of patient's age,time from injury to surgery,and complications of other ligament injuries of the knee on the final outcomes were analyzed.Results For all the 45 patients,the mean follow-up time was 35.0±14.1 months,with their satisfaction rate of 91.1%.There were 31 cases of 3° instability and 14 cases of 2° instability before surgery,which improved significantly as only 4 cas-es were of 2° instability,22 cases of 1° instability at the final follow-up(χ2=77.56,P<0.000).More-over,the average Lysholm and Tegner scores increased significantly from 37.2±15.2 and 0.9±0.9,to 85.3±12.7 and 4.4±1.3,respectively(t=16.34,P<0.000;t=15.72,P<0.000).What's more,the age of over 40 years had effect on the prognosis,while the time from injury to surgery and the com-plicated ligament injuries of the knee did not.Conclusion Using LARS artificial ligament as graft for PCL reconstruction can achieve satisfactory clinical results on the short-term.

Allergen-specific immunotherapy（AIT） remains the only therapeutic approach with the potential to modify the natural course of allergic rhinitis（AR）. Nevertheless, considerable inter-individual variability exists in patients'responses to AIT. To facilitate more reliable assessment of treatment efficacy, the China Rhinopathy Research Cooperation Group（CRRCG） convened young and middle-aged nasal experts in China to formulate the present consensus. The recommended subjective outcome measures for AIT comprise symptom scores, medication scores, combined symptom and medication scores, quality-of-life assessments, evaluation of disease control, and assessment of comorbidities. Objective indicators may supplement these measures. Currently available objective approaches include skin prick testing, nasal provocation testing, and allergen exposure chambers. However, these methods remain constrained by practical limitations and are not yet appropriate for routine implementation in clinical efficacy evaluation. In addition, several biomarkers, including sIgE and the sIgE/tIgE ratio, sIgG4, serum IgE-blocking activity, IgA, cytokines and chemokines, as well as immune cell surface molecules and their functional activity, have been shown to have associations with AIT outcomes. While these biomarkers may complement subjective assessments, they are subject to significant limitations. Consequently, large-scale multicenter trials and real-world evidence are required to strengthen the evidence base. The present consensus underscores the necessity of integrating patients'subjective experiences with objective testing throughout the treatment process, thereby providing a more comprehensive and accurate framework for efficacy evaluation. Looking forward, future investigations should prioritize the incorporation of multi-omics data and artificial intelligence methodologies, which hold promise for overcoming current limitations in assessment strategies and for advancing both the standardization and personalization of AIT.
Humans ; Allergens/immunology* ; China ; Consensus ; Desensitization, Immunologic ; Immunoglobulin E ; Quality of Life ; Rhinitis, Allergic/therapy* ; Treatment Outcome ; East Asian People

Objective To optimize the processing technology of Curculigo orchioides Gaertn.Methods On the basis of single factor experiment,the ratio of material to liquid,frying temperature and frying time were taken as the influencing factors,and the comprehensive scores of appearance traits,curculigoside,orcinol glucoside and orcinol gentiobioside were taken as the evaluation indexes.The optimal processing technology was optimized by Box-Behnken response surface method combined with analytic hierarchy process,and the process verification was carried out.Results The optimal process was as follows:the raw C.orchioides pieces were mixed with the same amount of Evodia rutaecarpa juice,placed in a closed container,moistened until the juice was completely absorbed,stir-fried at 130 ℃ for 6 min,taken out and dried at 60 ℃.For each 100 kg of Curculigo,10 kg of Evodia rutaecarpa was used.Evodia rutaecarpa juice preparation method:10 kg of Evodia rutaecarpa was soaked in 12 times the amount of water for 60 min,decocted for 50 min,extracted for 3 times,combined with the filtrate,and concentrated to 100 kg to obtain Evodia rutaecarpa juice.Conclusion The optimal processing technology of Curculigo orchioides Gaertn.is stable and feasible.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Objective To investigate the correlation between serum cytotoxic T lymphocyte associated pro-tein 4(CTLA4),high mobility group box 1(HMGB1)and the balance of helper T cell 17(Th17)/regulatory T cell(Treg),and to study their diagnostic significance for unexplained recurrent spontaneous abortion(URSA).Methods A total of 102 patients with URSA admitted to the hospital from September 2022 to September 2024 were selected as the URSA group,and another 80 healthy pregnant women who underwent prenatal examinations in the hospital during the same period were selected as the healthy group.The levels of serum CTLA4 and HMGB1 in the two groups were detected,the levels of Th17 and Treg in the two groups were detected,the Th17/Treg ratio was calculated,and the general data of the two groups were collected and recorded.Pearson was used to analyze the correlations between the levels of serum CLTA4 and HMGB1 and Th17,Treg,and Th17/Treg.logistic regres-sion was used to analyze the influencing factors of URSA occurrence.The receiver operating characteristic(ROC)curve was used to analyze the value of serum CTLA4 and HMGB1 levels in evaluating the occurrence of URSA.Results the serum CTLA4 level in the URSA group was lower than that in the healthy group,the HMGB1 level was higher than that in the healthy group,the Th17 level and Th17/Treg were higher than those in the healthy group,and the Treg level was lower than that in the healthy group(P<0.05).The serum CTLA4 level was nega-tively correlated with the Th17 level and Th17/Treg,and positively correlated with the Treg level(P<0.05).The level of HMGB1 was positively correlated with the level of Th17 and Th17/Treg,and negatively correlated with the level of Treg(P<0.05).Pregnancy frequency,serum CTLA4 level,serum HMGB1 level,Th17 level,Treg level,and Th17/Treg are independent influencing factors for the occurrence of URSA(P<0.05).The areas under the curve(AUC)of serum CTLA4 and HMGB1 levels and the combined evaluation of URSA by the two indicators were 0.841,0.787,and 0.908 respectively,and the Youden indices were 0.652,0.491,and 0.656 respectively.Conclusions The serum CTLA4 level is decreased and the HMGB1 level is increased in patients with URSA,which is related to the change of Th17/Treg balance.The levels of serum CTLA4 and HMGB1 have auxiliary diag-nostic significance for URSA.

Objective To optimize the processing technology of Curculigo orchioides Gaertn.Methods On the basis of single factor experiment,the ratio of material to liquid,frying temperature and frying time were taken as the influencing factors,and the comprehensive scores of appearance traits,curculigoside,orcinol glucoside and orcinol gentiobioside were taken as the evaluation indexes.The optimal processing technology was optimized by Box-Behnken response surface method combined with analytic hierarchy process,and the process verification was carried out.Results The optimal process was as follows:the raw C.orchioides pieces were mixed with the same amount of Evodia rutaecarpa juice,placed in a closed container,moistened until the juice was completely absorbed,stir-fried at 130 ℃ for 6 min,taken out and dried at 60 ℃.For each 100 kg of Curculigo,10 kg of Evodia rutaecarpa was used.Evodia rutaecarpa juice preparation method:10 kg of Evodia rutaecarpa was soaked in 12 times the amount of water for 60 min,decocted for 50 min,extracted for 3 times,combined with the filtrate,and concentrated to 100 kg to obtain Evodia rutaecarpa juice.Conclusion The optimal processing technology of Curculigo orchioides Gaertn.is stable and feasible.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.