[Objective] To explore the predictive value of HALP score for prognosis in patients with multiple myeloma (MM). [Methods] A retrospective analysis was conducted on laboratory indicators and related clinical data of newly diagnosed multiple myeloma (NDMM) patients, treated at the Affiliated Hospital of North Sichuan Medical College from January 2016 to October 2023, prior to their first treatment. The HALP score was calculated, and the optimal cutoff value for HALP was determined using X-tile software. Survival analysis was performed using Kaplan-Meier curves for high HALP and low HALP groups. Univariate and multivariate analyses were conducted using the Cox regression model, and a forest plot was generated using Graphpad Prism to illustrate factors that may impact patient prognosis. The predictive ability of HALP score combined with β2-microglobulin and ECOG score for prognosis in MM patients was evaluated using receiver operating characteristic curve (ROC) analysis. [Results] A total of 203 MM patients were included, with the optimal cutoff value for HALP score being 29.15 (P<0.05). Among them, 101 patients were in the low HALP score group, and 102 patients were in the high HALP score group. The results of univariate and multivariate analysis using the Cox regression model showed that a HALP score <29.15 was an independent risk factor for progression-free survival (PFS) and overall survival (OS) (P<0.05). ROC curve analysis indicated that the combination of HALP score with β2-microglobulin and ECOG score had a higher predictive value for prognosis in MM patients compared to using HALP score alone. [Conclusion] The HALP score is closely related to the prognosis of patients with NDMM. A low HALP score indicates a poorer prognosis, while the combination of HALP score with β2-microglobulin and ECOG score provides a higher predictive value when assessed together.

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Antibody-drug conjugates (ADCs) represent a promising class of targeted cancer therapeutics that combine the specificity of monoclonal antibodies with the potency of cytotoxic payloads. Despite their therapeutic potential, the use of ADCs faces significant challenges, including off/on-target toxicity and resistance development. This review examines the current landscape of ADC development, focusing on the critical aspects of target selection and antibody engineering. We discuss strategies to increase ADC efficacy and safety, including multitarget approaches, pH-dependent antibodies, and masked peptide technologies. The importance of comprehensive antigen expression profiling in both tumor and normal tissues is emphasized, highlighting the role of advanced technologies, such as single-cell sequencing and artificial intelligence, in optimizing target selection. Furthermore, we explore combination therapies and innovations in linker‒payload chemistry, which may provide approaches for expanding the therapeutic window of ADCs. These advances pave the way for the development of more precise and effective cancer treatments, potentially extending ADC applications beyond oncology.
Humans ; Immunoconjugates/adverse effects* ; Neoplasms/immunology* ; Animals ; Antibodies, Monoclonal/therapeutic use* ; Antineoplastic Agents/therapeutic use*

Objective:To explore the clinical application value of MRI ultra-short echo time sequence (MRI-UTE) in the diagnosis of pulmonary nodules.Methods:This study was a cross-sectional study. A total of 101 consecutive patients were recruited prospectively from January to August 2024 at Huazhong Fuwai Hospital of Zhengzhou University. All of the included patients were diagnosed with pulmonary nodules by chest CT examination and intended for treatment. All patients underwent low-dose CT examination and MRI-UTE examination. The number, classification, and lung imaging reporting and data system (lung-RADS) grading of the pulmonary nodules were analyzed. Nodules classification was determined as solid nodules or sub-solid nodules, and sub-solid nodules included part-solid nodules and pure ground-glass nodules. Taking the evaluation results of radiologists with 10 and 12 years of experience in chest imaging diagnosis as the reference standard, the Kappa test was used to analyze the agreement of CT and MRI-UTE in terms of the accurate diagnosis, classification, and lung-RADS grading of pulmonary nodules. Results:Among the 101 patients, a total of 216 pulmonary nodules were identified. MRI-UTE accurately diagnosed 180 pulmonary nodules, while 203 pulmonary nodules were detected by CT. The concordance was moderate ( Kappa=0.48, P<0.001). In terms of nodule classification, CT correctly classified 167 nodules as solid and 36 as sub-solid, whereas MRI-UTE correctly classified 153 as solid and 23 as sub-solid, with good agreement (weighted Kappa=0.73, P<0.001). For lung-RADS grading, CT correctly graded 186 nodules, with 85 graded as category 2, 46 as category 3, 33 as category 4A, 12 as category 4B, and 10 as category 4X; MRI-UTE correctly graded 155 nodules, with 74 graded as category 2, 30 as category 3, 30 as category 4A, 12 as category 4B, and 9 as category 4X. The agreement between the two modalities in determining lung-RADS grade was also good (weighted Kappa=0.74, P<0.001). Conclusion:MRI-UTE demonstrates good agreement with CT in the accurate diagnosis, classification, and lung-RADS grading of pulmonary nodules, indicating certain clinical application value.

Objective:To investigate whether biochanin A(BCA)has a protective effect against dextran sodium sulfate(DSS)-in-duced ulcerative colitis(UC)in mice.Methods:Thirty C57BL/6N mice were randomly divided into normal control group,DSS model group,sulfasalazine(SASP)-positive drug control group,and low/medium/high-dose(5 mg/kg,10 mg/kg,and 20 mg/kg)BCA groups.The mouse model of UC was induced by administering 2.5%DSS aqueous solution for 7 days.During the experimental period,both the normal control and model groups were given 0.5%carboxymethyl cellulose sodium solution daily by gavage.The positive control group was given 100 mg/kg SASP,while the BCA groups were given BCA suspensions at doses of 5 mg/kg,10 mg/kg,and 20 mg/kg.The ad-ministration lasted for 10 days.Body weight changes and fecal status of the mice were recorded every day;the colon was dissected,col-lected,and measured for its length.The colon was stained with Hematoxylin-Eosin for pathomorphological study.Quantitative poly-merase chain reaction was used to determine the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-10(IL-10)in the colon.Immunofluorescence was used to determine the expression of tight junction proteins,zonula occluden-1(ZO-1)and occludin,in the colon.Results:It showed that 5 mg/kg and 10 mg/kg BCA significantly alleviated weight loss in mice with UC,while 5 mg/kg,10 mg/kg,and 20 mg/kg BCA reduced the disease activity index scores.Additionally,BCA showed similar effects to SASP in improving the structure and reducing the shortening of the colon in mice with UC.Compared with the model group,all BCA groups had significantly decreased TNF-α(P=0.024、P=0.060、P=0.003)and IL-6(P=0.002、P<0.001、P<0.001)and significantly increased IL-10(P=0.006、P=0.003、P<0.001),with varying degrees of up-regulated expression of tight junction proteins.Conclusion:BCA can effectively alleviate DSS-induced symptoms,reduce intes-tinal damage,and protect the intestinal barrier in mice with UC.

Objective To explore the value of the ratio of soluble FmS-like tyrosine kinase-1(sFlt-1)to placental growth factor(PlGF)in predicting vitamin D deficiency in pregnant women with preeclampsia.Methods A total of 740 singleton pregnant women who underwent prenatal examination in Qijiang Health Center for Maternal and Child Care from January to November 2023 and were able to complete follow-up were selected as the research subjects.They were divided into the normal group(n=44)and the deficiency group(n=696)according to the vitamin D[1,25-(OH)2D3]level.Information such as age,BMI,pregnancy histo-ry,family history and medical history of each group was collected.5 mL of peripheral venous blood was drawn after fasting for 6-8 hours at 12-14 weeks of pregnancy to detect the levels of sFlt-1,PlGF and vitamin D in peripheral blood,and evaluated the predictive value of sFlt-1/PlGF for vitamin D deficiency in preeclampsia.Results There were no statistically significant differences in general conditions such as height,age,BMI,edu-cational level and occupation between the two groups(P>0.05).There were statistically significant differ-ences in the prenatal weight,vitamin D level,sFlt-1/PlGF and neonatal birth weight between the two groups(P<0.05).The results of univariate analysis showed that the prenatal weight,sFlt-1/PlGF,and neonatal birth weight were risk factors for vitamin D deficiency in patients with PE.The results of multivariate analysis showed that sFlt-1/PlGF and neonatal birth weight were factors for predicting vitamin D deficiency in patients with PE(P<0.05).All these variables are used to establish the nomogram prediction model.The receiver op-erating characteristic(ROC)curve showed that area under the curve(AUC)of the training group and the val-idation group was 0.66(95%CI:0.56-0.77)and 0.63(95%CI:0.49-0.76),respectively.Conclusion In pregnant women with preeclampsia,elevated sFlt-1/PlGF may be an early warning indicator for predicting vi-tamin D deficiency.

Heparin-induced thrombocytopenia(HIT)is an antibody-mediated adverse reaction to heparin that is clinically manifested as a progressive reduction in platelet count after heparin administration,leading to venous and/or arterial thromboembolism and even death in severe cases.Acquired thrombocytopenia is commonly observed in hospitalized patients,the pathological mechanism is associated with drugs,autoimmune diseases,and consumptive thrombocytopenia.Patients with HIT frequently have complex clinical situations,and their manifestations are often atypical or mixed with other symptoms and signs,posing significant challenges to diagnosis and treatment for clinicians.Through the multidisciplinary diagnosis and treatment process of a HIT patient,this paper discusses HIT occurrence mechanism,clinical evaluation,laboratory testing and alternative anticoagulant therapy,so as to provide reference for doctors to accurately identify and effectively intervention in clinical practice.