ObjectiveTo investigate the awareness and clinical practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. MethodsFrom July 19 to December 31， 2024， a self-designed electronic questionnaire was distributed via the WeChat mini program to collect related data from 1 588 clinicians nationwide， including their awareness and practice based on 18 questions regarding testing and referral， diagnosis and treatment， and follow-up. ResultsAmong all respondents， only 350 clinicians correctly understood all the updated key points of antiviral indications and treatment for special populations in the 2022 edition of guidelines for the prevention and treatment of chronic hepatitis B， with an overall awareness rate of 22.0%. Only 20% ‍—‍ ‍40% of the patients with positive HBV DNA and an age of >30 years receive antiviral therapy， while 80% ‍—‍ ‍100% of the patients with positive HBV DNA and a family history of hepatitis B cirrhosis or hepatocellular carcinoma receive antiviral therapy. The median follow-up rates at 1 year， 3 years， and 5 years were 67.5% 57.5% and 47.5%，respectively， showing a trend of gradual reduction， which might be associated with the influencing factors such as insufficient time for follow-up management by clinicians， insufficient awareness of the disease among patients， and poor adherence to follow-up. ConclusionThere is a gap between the awareness and practice of guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） among clinicians. It is recommended to further strengthen training and focus on the whole process of “detection， diagnosis， treatment， and management” for patients with chronic hepatitis B in healthcare institutions， in order to promote the implementation of the guidelines.

Traditional Chinese Medicine (TCM), as a treasure of the Chinese nation, plays a significant role in maintaining public health. In 2019, the Central Committee of the Communist Party of China and the State Council proposed for the first time the establishment of a TCM registration and evaluation evidence system that integrates TCM theory, "personal experience" and clinical trials (referred to as the "Three-in-One" System) to promote the inheritance and innovation of TCM. Subsequently, the National Medical Products Administration issued several guiding principles to advance the improvement and implementation of this system. Owing to the complexity of its implementation, there are still differing understandings within the TCM industry regarding the positioning of the "Three-in-One" Registration and Evaluation Evidence System, as well as the connotation and value orientation of the "personal experience." To address this, Academician WANG Qi, President of the TCM Association, China International Exchange and Promotion Association for Medical and Healthcare and TCM master, led a group of academicians, TCM masters, TCM pharmacology experts and clinical TCM experts to convene a "Seminar on Promoting the Implementation of the ′Three-in-One′ Registration and Evaluation Evidence System for Chinese Medicinals." Through extensive discussions, an expert consensus was formed, clarifying the different roles of the TCM theory, "personal experience" and clinical trials within the system. It was further emphasized that the "personal experience" is the core of this system, and its data should be derived from clinical practice scenarios. In the future, the improvement of this system will require collaborative efforts across multiple fields to promote the high-quality development of the Chinese medicinal industry.

Objective To investigate the association between cavitary pulmonary tuberculosis and im-munonutritional status in the Kangbei Plateau and construct a prediction model.Methods A total of 121 pa-tients with active pulmonary tuberculosis treated at Ganzi County People's Hospital from June 2023 to June 2024 were retrospectively enrolled and divided into cavitary group(n=53)and non-cavitary group(n=68)based on imaging findings.Clinical and laboratory data were collected.Influencing factors for pulmonary cavi-tation in tuberculosis were screened using univariate and multivariate logistic regression analysis to construct a prediction model.The model's performance was evaluated using receiver operating characteristic(ROC)curve analysis and the Hosmer-Lemeshow test.Results The cavitary group had higher proportions of smokers,spu-tum-positive cases,patients with disease duration>6 months,and patients with respiratory symptoms at ini-tial diagnosis,as well as higher neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),neutrophil count,and platelet count than the non-cavitary group(P<0.05).Conversely,the prognostic nutri-tional index(PNI),lymphocyte count,and albumin(ALB)level were lower in the cavitary group(P<0.05).Multivariate analysis identified disease duration,NLR,and ALB as influencing factors for pulmonary cavitation in tuberculosis patients(P<0.05).The prediction model yielded an area under the curve(AUC)of 0.909,and the Hosmer-Lemeshow test indicated good model fit(χ2=10.740,P=0.217).Conclusion Pulmonary cavitation in high-altitude tuberculosis patients is associated with disease duration,ALB,and NLR.The com-bined predictive value of these three indicators is high.

Objective:To compare the clinical outcomes of arthroscopic external tension band fixation versus open reduction and internal fixation in the treatment of greater tubercle fracture of the humerus.Methods:A retrospective cohort study was conducted on 55 patients with greater tubercle fracture of the humerus admitted to Taizhou Hospital of Zhejiang Province from September 2019 to June 2022, including 24 males and 31 females, aged 26-80 years [(61.7±10.5)years]. Out of them, 35 patients treated with open reduction and internal fixation (open reduction group), and 20 patients were treated with external anchor tension band under arthroscopy (arthroscopy group). The operation time, and the Visual Analogue Scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and shoulder active range of motion (anterior flexion, abduction and posterior extension) before operation, at 1 month after operation and at the last follow-up were compared between the two groups. Bone healing was observed in both groups at the last follow-up. Postoperative complications were compared between the two groups.Results:All the patients were followed up for 12-29 months [(16.9±4.0)months]. There was no significant difference in operation time between the two groups ( P>0.05). There were no significant differences in the VAS score, ASES score, Constant-Murley score and shoulder active range of motion between the two groups before operation ( P>0.05). The VAS score of the arthroscopy group was 3(2, 3)points at 1 month after operation, which was significantly lower than that of the open reduction group [4(3, 4) points] ( P<0.01). No significant difference was found in the VAS score at the last follow-up between the two groups ( P>0.05).The ASES scores of the arthroscopy group were (70.6±4.2)points and (90.2±3.7)points at 1 month after operation and at the last follow-up respectively, which were significantly higher than those of the open reduction group [(64.7±6.4)points and (87.5±4.9)points respectively] ( P<0.05 or 0.01). There was no significant difference in the Constant-Murley score between the arthroscopy group [(71.8±4.3)points] and the open reduction group [(70.9±5.3)points] at 1 month after operation ( P>0.05), while the Constant-Murley score of the arthroscopy group was (94.1±3.1)points at the last follow-up, which was significantly higher than that of the open reduction group [(89.2±4.7)points] ( P<0.01). At 1 month after operation and at the last follow-up, ranges of motion of the anterior flexion, abduction and posterior extension were (52.7±12.3)° and (140.0±16.9)°, (57.4±8.6)° and (125.0±14.3)°, and 16(15, 19)° and 25(20, 30)° in the arthroscopy group respectively, which were significantly higher than those in the open reduction group [(42.2±5.2)° and (110.9±14.0)°, (52.8±6.0)° and (103.7±11.7)°, and 10(10, 20)° and 16(15, 25)° respectively] ( P<0.05 or 0.01). At the last follow-up, it was found that bony union was achieved in both groups. There were no obvious complications such as incision infection or joint stiffnessin both groups. In the open reduction group, 2 patients had internal fixation failure within 1-3 months after operation but was treated with revision operation; 6 patients developed shoulder stiffness at 3-6 months after operation but had outpatient rehabilitation. The incidence rate of postoperative complications in the arthroscopy group [0%(0/20)] was significantly lower than that in the open reduction group [23%(8/35)] ( P<0.05). Conclusion:Compared with open reduction and internal fixation with plates and screws, arthroscopic external anchor tension band fixation in the treatment of greater tuberosity fracture of the humerus has the advantages of earlier pain relief, better shoulder functional improvement, better recovery of shoulder mobility, and fewer complications.

Disseminated intravascular coagulation (DIC) triggered by sepsis is a major challenge in the emergency and critical care of severely ill patients. The inflammasome is an essential component of the human immune system, and its activation can mediate pyroptosis and then release interleukin (IL)-1β and IL-18, which further activates platelets and the coagulation system and exacerbates inflammatory responses and coagulation processes, thus creating great uncertainty for the treatment and prognosis of sepsis. This article aims to review the correlation between the inflammasome and pyroptosis, as well as their impact on coagulation function, in hope of providing new insights for the clinical treatment of DIC.

Objective To explore the related factors for the unilateral flap and bilateral flap by changing the origi-nal operation plan in the extraction of maxillary impacted mesiodens.Methods 81 patients with impacted mesio-dens in the middle of the maxillary were retrospectively analyzed.The primary outcome variables were planned sur-gery (unilateral flap) and unplanned surgery (bilateral flap) .The secondary outcome variables consisted of opera-tion time and postoperative swelling.The predictive variables were as follows:the differential value of the shortest distance from the supernumerary tooth to the labial and palatal bone plates, which was divided into≥1.5 mm group and<1.5 mm group; the ratio of the distance from the adjacent tooth apex to the nasal floor, compared to the length of the supernumerary teeth, was recorded as≥1 and< 1.A statistical software SPSS 20 was used to com-plete the statistical analysis.Results When the differential value was less than 1.5 mm, the possibility of un-planned surgery increased, and the probability of planned surgery was 0.085 times than that of unplanned surgery.With age growing each 1-year, the probability of planned surgery gradually decreased, HR=0.745.The postopera-tive swelling of the palatal approach was only 0.374 times than that of the labial approach.With age increasing, the operation time increased gradually, B=1.213.The ratio of the distance from the adjacent tooth apex to the na-sal floor to the length of the supernumerary teeth did not affect the change of the surgical plan during the operation.Conclusion The shortest distance difference between the supernumerary teeth and the labial and palatal bone plates can be used as a reference for the selection of surgical approach for the extraction of maxillary impacted me-siodens.

Disseminated intravascular coagulation (DIC) triggered by sepsis is a major challenge in the emergency and critical care of severely ill patients. The inflammasome is an essential component of the human immune system, and its activation can mediate pyroptosis and then release interleukin (IL)-1β and IL-18, which further activates platelets and the coagulation system and exacerbates inflammatory responses and coagulation processes, thus creating great uncertainty for the treatment and prognosis of sepsis. This article aims to review the correlation between the inflammasome and pyroptosis, as well as their impact on coagulation function, in hope of providing new insights for the clinical treatment of DIC.

Objective To investigate the predictive value of systemic immune-inflammation index (SII) for venous thrombo embolism (VTE) in patients with lung cancer.Methods The patients with lung cancer admitted and treated in Chengdu Municipal Second People's Hospital from March 2022 to October 2023 were selected as the study subjects and divided into the VTE group (n=33) and the non-VTE group (n=37) ac-cording to whether or not complicating VTE.The clinical characteristics and laboratory indexes were collect-ed.The multivariate logistic regress was used to analyze the influencing factors.The receiver operating charac-teristic (ROC) curve was drawn.The difference of the areas under curve (AUC) was compared.The Kaplan-Meier survival curve was used to evaluate the risk stratification capability of the related variables for VTE oc-currence in the patients with lung cancer.Results There were statistically significant differences in WBC,neutrophil,lymphocyte,albumin (ALB),D-dimer (D-D),plasma viscosity,neutrophil-to-lymphocyte ratio (NLR),platelet-to-lymphocyte ratio (PLR) and SII between the two groups (P<0.05).The multivariate lo-gistic regression analysis showed that high SII,tumor stage (Ⅲ-Ⅳ stage) and plasma viscosity were inde-pendent risk factors for VTE occurrence in the patients with lung cancer (P<0.05).The ROC curve analysis showed that AUC of the Khorana score,SII,modified Khorana score,NLR and PLR were 0.747,0.776,0.866,0.754 and 0.672,respectively.The predictive efficiency of SII for VTE occurrence in the patients with lung cancer was better than that of Khorana score,NLR and PLR.Conclusion High SII is an independent risk factor for VTE occurrence in the patients with lung cancer,its risk stratification for VTE occurrence in the pa-tients with lung cancer is conducive to early recognize the high risk population.

Objective To observe the clinical efficacy of Redo-Bentall surgery in the reoperation of aortic root lesions.Methods A retrospective analysis was performed on 46 patients who underwent Redo-Bentall surgery for aortic root lesions in our department from June 2010 to April 2022.They were 35 males and 11 females,at a mean age of 43.37±12.79 years,in 4.96±6.76 years since the last operation.General clinical data in perioperative period and during follow-up were collected and analyzed.Kaplan-Meier survival analysis was used to compare the survival rates of each etiological group.Results There were 9 cases of central end otitis,12 cases of Behset's disease,and 25 cases of other causes.After operation,4 cases(8.70％)experienced cardiac arrest,4 cases(8.70％)renal failure,2 cases(4.35％)gastrointestinal bleeding,2 cases(4.35％)new third-degree atrioventricular block and 2 cases(4.35％)permanent pacemaker placement.In perioperative period,3 cases(6.52％)died in hospital.During a mean follow-up of 5.03±3.27 years after discharge,5 cases(11.63％)were lost to follow-up,1 case died(2.33％),1 case had lacunar infarction(2.33％),and no severe bleeding or embolism complications was observed in the rest patients.The long-term survival rate was significantly lower in the endocarditis group(62.3％)and the Behcet's disease group(70％)than the other etiological groups(80％,P＜0.05).Conclusion The application of Redo-Bentall in the reoperation of aortic root lesions is safe and effective,but the survival rate is quite lower in the patients with infective endocarditis and Behcet's disease.