Health economics evidence plays an important role in linking clinical value evidence with health resource allocation decisions in the development of clinical practice guidelines. It can not only effectively balance clinical effectiveness and economic feasibility but also avoid forming "idealized" recommendations that are detached from the affordability of the healthcare system or the burden-bearing capacity of patients. To promote guideline developers to use health economics evidence more standardizedly and fully, this paper conducts an in-depth analysis of the current application status, existing challenges, access channels, and application processes of health economics evidence in current guidelines, and on this basis, puts forward considerations and suggestions for strengthening and standardizing the application of health economics evidence in China's clinical practice guidelines.

[Objective]To explore the distribution patterns and correlations of pet-related cat/dog dander allergens and mold allergens in patients with allergic diseases,providing evidence for individualized diagnosis,treatment,and prevention strategies.[Methods]A retrospective analysis was conducted on 798 patients diagnosed with allergic diseases at the Third Affiliated Hospital of Sun Yat-sen University between April 2021 and October 2023.All patients underwent UniCAP platform testing for specific immunoglobulin E(sIgE)levels against cat dander,dog dander,and mold mix(mx1/mx2),alongside total IgE(tIgE)quantification.Descriptive statistics,Mann-Whitney U tests,and chi-square analyses were employed to evaluate allergen distribution and interrelationships.[Results]Among the 798 patients(395 males,403 females,ratio 1:1.02),their ages ranged from 0.67 to 69 years(median 14 years,IQR 6-29).A total of 63.2％(504/798)had a single allergic disease,with allergic rhinitis(AR,49.2％)being the most common.The remaining 36.8％(294/798)had≥2 allergic diseases,with AR combined with atopic dermatitis(AD,10.7％)as the predominant comorbidity.The positivity rate for cat/dog dander sIgE was 24.1％(192/798),with a significantly higher prevalence in females(30.8％)than males(16.7％,P<0.05).Cat dander sensitization increased with age in patients under 18 years.Among positive cases,cat dander sIgE level 2 was most frequent(25.9％),while dog dander sIgE level 1 predominated(55％).Patients with cat dander sIgE levels 4-6 had significantly higher tIgE than those with levels 1-3(P<0.05).The positivity rate for mold mix(mx1/mx2)sIgE was 7.4％(59/798),with mx2 as the primary sensitizer and level 2 being the most common.In mx2-positive patients,the cat/dog dander sIgE positivity rate(44.8％)was significantly higher than that in mx2-negative patients(17.9％,P<0.05),and tIgE levels were also higher(P<0.05).[Conclusion]Cat dander sensitization increases with age in children.Cat/dog dander and mold allergens are closely linked to AR and AR combined with AD.Synergistic correlations exist between cat/dog dander sIgE and mold mx2 sIgE.Combined detection of these allergens is critical for precision diagnosis and management of pet-related allergic diseases.

Objective To study the clinical value of stroboscopic laryngoscope combined with narrow band imaging endoscope in the diagnosis of benign and malignant glottic lesions.Methods A total of 60 patients(84 sides of vocal cord)who visited our department from June 2022 to January 2023 with hoarseness as the main complaint and were found to have glottic lesions by electronic nasopharyngoscopy were selected.In all 60 patients with 84 sides of vocal cord degenerative lesions,stroboscopic laryngoscopy and narrow band imaging(NBI)endoscopy were com-pleted.The examination results were evaluated and graded separately.The same operative group performed the re-section biopsy of vocal cord lesions under general anesthesia and laryngoscope respectively,and the pathological re-sults were used as the diagnostic gold standard.With sensitivity,specificity,accuracy,false negative rate,and false positive rate as the main evaluation indexes,the differences in diagnostic accuracy between single test technique and combined application of the two techniques were analyzed.Results Pathological results showed squamous cell carci-noma on 18 sides,carcinoma in situ on 4 sides,severe dysplasia on 4 sides,mild and moderate dysplasia on 13 sides,and papilloma,chronic,mucosal,nflammation,hyperplasia,hypokeratosis,hyperkeratosis on 45 sides.The sensitivity of strobe laryngoscopy detection was 53.06％and specificity was 60.34％.The sensitivity of NBI endo-scopic detection was 88.46％,and the specificity was 89.66％.The sensitivity of strobe laryngoscopy combined with NBI endoscopy was 96.15％,and the specificity was 94.83％.The areas under the ROC curve of strobe laryn-goscopy,NBI endoscopy and white light imaging combined with narrowband imaging were 0.888(95％CI:0.820～0.957),0.943(95％CI:0.885～1),0.970(95％CI:0.942～0.999),respectively.The area under the curve of the combined method was higher than that of the single method,and the difference was statistically significant(P＜0.05).Conclusion Stroboscopic laryngoscope combined with NBI endoscope can improve the diagnostic accuracy of benign and malignant glottic lesions.

Objective To study the clinical value of stroboscopic laryngoscope combined with narrow band imaging endoscope in the diagnosis of benign and malignant glottic lesions.Methods A total of 60 patients(84 sides of vocal cord)who visited our department from June 2022 to January 2023 with hoarseness as the main complaint and were found to have glottic lesions by electronic nasopharyngoscopy were selected.In all 60 patients with 84 sides of vocal cord degenerative lesions,stroboscopic laryngoscopy and narrow band imaging(NBI)endoscopy were com-pleted.The examination results were evaluated and graded separately.The same operative group performed the re-section biopsy of vocal cord lesions under general anesthesia and laryngoscope respectively,and the pathological re-sults were used as the diagnostic gold standard.With sensitivity,specificity,accuracy,false negative rate,and false positive rate as the main evaluation indexes,the differences in diagnostic accuracy between single test technique and combined application of the two techniques were analyzed.Results Pathological results showed squamous cell carci-noma on 18 sides,carcinoma in situ on 4 sides,severe dysplasia on 4 sides,mild and moderate dysplasia on 13 sides,and papilloma,chronic,mucosal,nflammation,hyperplasia,hypokeratosis,hyperkeratosis on 45 sides.The sensitivity of strobe laryngoscopy detection was 53.06％and specificity was 60.34％.The sensitivity of NBI endo-scopic detection was 88.46％,and the specificity was 89.66％.The sensitivity of strobe laryngoscopy combined with NBI endoscopy was 96.15％,and the specificity was 94.83％.The areas under the ROC curve of strobe laryn-goscopy,NBI endoscopy and white light imaging combined with narrowband imaging were 0.888(95％CI:0.820～0.957),0.943(95％CI:0.885～1),0.970(95％CI:0.942～0.999),respectively.The area under the curve of the combined method was higher than that of the single method,and the difference was statistically significant(P＜0.05).Conclusion Stroboscopic laryngoscope combined with NBI endoscope can improve the diagnostic accuracy of benign and malignant glottic lesions.

The standardized workflow of computer-aided static guided implant surgery includes preoperative exami-nation,data acquisition,guide design,guide fabrication and surgery.Errors may occur at each step,leading to irrevers-ible cumulative effects and thus impacting the accuracy of implant placement.However,clinicians tend to focus on fac-tors causing errors in surgical operations,ignoring the possibility of irreversible errors in nonstandard guided surgery.Based on the clinical practice of domestic experts and research progress at home and abroad,this paper summarizes the sources of errors in guided implant surgery from the perspectives of preoperative inspection,data collection,guide de-signing and manufacturing and describes strategies to resolve errors so as to gain expert consensus.Consensus recom-mendation:1.Preoperative considerations:the appropriate implant guide type should be selected according to the pa-tient's oral condition before surgery,and a retaining screw-assisted support guide should be selected if necessary.2.Da-ta acquisition should be standardized as much as possible,including beam CT and extraoral scanning.CBCT performed with the patient's head fixed and with a small field of view is recommended.For patients with metal prostheses inside the mouth,a registration marker guide should be used,and the ambient temperature and light of the external oral scan-ner should be reasonably controlled.3.Optimization of computer-aided design:it is recommended to select a handle-guided planting system and a closed metal sleeve and to register images by overlapping markers.Properly designing the retaining screws,extending the support structure of the guide plate and increasing the length of the guide section are methods to feasibly reduce the incidence of surgical errors.4.Improving computer-aided production:it is also crucial to set the best printing parameters according to different printing technologies and to choose the most appropriate postpro-cessing procedures.

Objective : To investigate the effect of silencing histone deacetylase 9 (HDAC9) expression on the proliferation and osteogenic differentiation of periodontal ligament stem cells (PDLSCs). Methods: PDLSCs were isolated, cultured and identified in vitro. An siRNA construct specific for HDAC9 was transfected into PDLSCs (siHDAC9 group), and a nontargeting siRNA was used as a control (siNC group). The interference effect was determined by qRT-PCR. The cell cycle progression of PDLSCs was detected using flow cytometry. The proliferation activity of PDLSCs was detected via CCK-8 assay. Western blotting was used to detect the protein expression of proliferating cell nuclear antigen (PCNA). The mRNA expression of runt-related transcription factor 2 (RUNX2) and alkaline phosphatase (ALP) was investigated by qRT-PCR. The protein expression of RUNX2 was detected by western blotting. In addition, the formation of mineralized nodules was assessed by alizarin red staining. Results: Compared with that in the siNC group, the mRNA expression of HDAC9 in the siHDAC9 group was lower (P < 0.01). Moreover, compared with those in the siNC group, the proliferation index (P<0.01), proliferation activity (P<0.05) and protein expression of PCNA (P<0.01) in the siHDAC9 group were all increased. Compared with the siNC group, the siHDAC9 group exhibited higher mRNA expression of RUNX2 and ALP (P < 0.05), and the protein expression of RUNX2 showed the same results (P < 0.01). The results of alizarin red staining showed that compared to the siNC group, the siHDAC9 group formed more mineralized nodules. Conclusion Silencing HDAC9 expression can promote the proliferation and osteogenic differentiation of PDLSCs.

Ferroptosis is an iron-dependent novel type of programmed cell death. The main features of ferroptosis include lipid reactive oxygen accumulation, iron accumulation and lipid peroxidation. The main mechanisms and signal pathways of ferroptosis are complex and closely related to cystine/glutamate antiporter system, glutathione peroxidase 4, ferroptosis suppressor protein 1, and dihydroorotate dehydrogenase. This review summarizes the current regulatory mechanisms of ferroptosis and discusses the research progress of ferroptosis in tumors, non-alcoholic fatty liver disease, Parkinson's disease, and congestive heart failure.

Objective:To study the patterns of tocilizumab (TCZ) use, its efficacy and safety in patients with rheumatoid arthritis (RA) in routine clinical practice.Methods:A total of 407 patients with RA were enrolled from 23 centers and treated with TCZ within 8 weeks prior to the enrollment visit, and were followed for 6-month. The patterns of TCZ treatment at 6 months, the effectiveness and safety outcomes were recorded. Statistical analysis was performed using SAS version 9.4.Results:A total of 396 patients were included for analysis, in which 330 (83.3%) patients received TCZ combined with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), and 16.7%(66/396) received TCZ monotherapy. At baseline, TCZ was initiated in 56.6%(224/396) and 9.6%(38/396) of patients after failure of DMARDs and other biological agents (bDMARDs) respectively. During the 6-month follow-up period, the mean frequency of TCZ administration was (3.7±1.6), the mean TCZ dosage was (7.4±1.2) mg/kg, and the mean interval between doses was (40±13) days. 120(25.8%) patients were on TCZ treatment at the end of the study. Improvements in disease activity, systemic symptoms and patient report outcomes were observed at the end of the study. 22.7%(90/396) patients experienced at least one treatment related adverse event, and 8 patients experienced at least one serious adverse event.Conclusion:This study demonstrates that TCZ treatment is effective in patients with RA when being treated for 6 months with an acceptable safety profile. The duration of TCZ treatment needs to be extended.

Objective: To establish human embryonic kidney(HEK) 293 cell lines that that can stably express the muscle nicotinic acetylcholine receptor(AChR).Methods: The pcDNA3.1 plasmid was constructed and transfected into HEK293 cells with lipofectin,the stable transfectants screened by G418 and the protein expression identified and analyzed by immunohistochemistry.Results: After G418 screening,14 of the transfected cell lines highly expreesed ?-nAchR and 4 showed an obvious expression of ?-nAChR,as demonstrated by the immunohistochemical analysis.Conclusion: HEK293 cell lines stably expressing m-nAChR were constructed successfully.