AIM: To explore the control effects of wearing orthokeratology lens for 1 a on adolescent myopia patients with different diopters.METHODS: Prospective non-randomized controlled study. A total of 120 adolescent myopic patients(224 eyes), with an average age of 11.00±2.08 years old, who were fitted with orthokeratology lenses in the optometry department of our hospital from November 2022 to May 2023 were collected. There were 3 groups according to the spherical equivalent, including 86 eyes in the group of -0.50--2.00 D, 99 eyes in the group -2.25--4.00 D, and 39 eyes in group -4.25--6.00 D. Patients were followed up for 1 a to observe the changes of uncorrected visual acuity, axial length, corneal curvature, corneal central thickness and corneal endothelial cells density in the three groups after wearing lens for 1 a.RESULTS:A total of 113 cases(212 eyes)were followed up for 1 a, including 82 eyes in the group of -0.50--2.00 D, 95 eyes in the group of -2.25--4.00 D, and 35 eyes in the group of -4.25--6.00 D. There was no statistical difference in corneal central thickness and corneal endothelial cell density among the three groups of patients after wearing lens for 1 a(all P>0.05). Uncorrected visual acuity was significantly improved, and flat kerotometry(FK)and steep kerotometry(SK)were significantly flatter(both P<0.01). Furthermore, the growth of axial length in the three groups of patients after wearing lens for 1 a was 0.21±0.26, 0.13±0.21 and 0.09±0.10 mm, respectively(P<0.05). There were differences between the -0.50--2.00 D group and the -2.25--4.00 D group and -4.25--6.00 D group(P=0.028, 0.010), and there were no differences between the -2.25--4.00 D group and the -4.25--6.00 D group(P=0.344).CONCLUSION:It is safe and effective for young myopia patients to wear orthokeratology lenses, which can prevent the non-benign growth of the axial length and effectively delay the development of myopia, and the myopia control effect is better especially for myopia patients of above -2.0 D.

[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.

Objective To understand the situation of corn mycotoxins contamination in Heilongjiang Province , and to analyze the causes of pollution and propose prevention and control measures. Methods Among the 473 corn samples were collected from various regions in Heilongjiang Province , and 16 mycotoxins , including aflatoxins , fumonisins, deoxynivalenol and their metabolites , zearalenone , ochratoxin A , alternariol , alternariol monomethyl ether , tentoxin , and tenuazonic acid , were detected in the corn samples. The detection and quantification were carried out using ultra-high performance liquid chromatography tandem mass spectrometry isotope internal standard method. Results All samples were detected with mycotoxins, the detection rate was 100%, and each sample was contaminated by one or more mycotoxins. The detection rate of 16 mycotoxins ranged from 0.21% to 98.31%. The average contamination level ranged from 0.67 μ g/kg-259.19 μ g/kg. Three types of toxins exceeded the standard, with exceeding rates of deoxynivalenol (2.54%, 12/473), zearalenone (4.02% ,19/473), and fumonisins (2.54%,12/473), respectively. The samples exceeding the standard were distributed in Mudanjiang, Shuangyashan, Jixi, Harbin, and Qiqihar. Conclusion Corn in Heilongjiang Province is contaminated by a combination of mycotoxins. It is necessary to strengthen monitoring from multiple links and adopt a variety of ways and control measures to reduce corn contamination.

OBJECTIVES: To investigate the association between methylation levels of tumor suppressing subtransferable candidate 1 (TSSC1) and melanophilin (MLPH) genes in peripheral blood and coronary heart disease (CHD) in Chinese population. METHODS: This case-control study was conducted in 86 CHD patients and 95 healthy individuals, whose methylation levels of TSSC1 and MLPH genes in peripheral blood were determined using mass spectrometry. Mann-Whitney U test was used to compare the methylation levels in different subgroups. The correlation of TSSC1 and MLPH gene methylation levels with age and gender were evaluated using Spearman correlation coefficient and contingency coefficient, respectively. RESULTS: Compared with the healthy individuals, the CHD patients showed a significant correlation between MLPH hypermethylation and myocardial infarction (MI) (MLPH_CpG_2.7: P=0.045; MLPH_CpG_3/cg06639874: P=0.049; MLPH_CpG_5: P=0.019), and this correlation was even stronger in individuals below 65 years of age (MLPH_CpG_2.7: P=0.014; MLPH_CpG_4: P=0.001) and in male subjects (MLPH_CpG_2.7: P=0.004; MLPH_CpG_3/cg06639874: P=0.044). The methylation level of TSSC1 gene in peripheral blood was not found to correlate with CHD or its subtypes. CONCLUSIONS Our findings suggest a correlation of MLPH hypermethylation in peripheral blood with CHD and MI in Chinese population, especially in individuals below 65 years and in male individuals.
Humans ; DNA Methylation ; Male ; Female ; Middle Aged ; Case-Control Studies ; Aged ; Coronary Disease/blood* ; Adult ; CpG Islands

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*

Objective:To search, evaluate, and summarize the best evidence of built-in fecal incontinence management device, to inform the management of incontinence dermatitis by clinical healthcare professionals.Methods:BMJ Best Practice, UpToDate, Guideline International Network, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses′Association of Ontario, The Cochrane Library, Medline, Embase, SinoMed, CINAHL, PubMed, Web of Science, OVID, China National Knowledge Infrastructure, Wanfang Database were systematically searched for all evidence regarding the application of fecal collection devices. It included clinical practice, guidelines, systematic reviews, expert consensuses, evidence summaries, and randomized controlled trial. Two researchers independently evaluated the literature quality and extracted the literature that met the standards.Results:A total of 12 pieces of the literature were involved, including 2 best practice, 5 guidelines, 3 expert consensuses, and 2 systematic reviews. This study summarized 26 pieces of best evidence in relation to the following 5 themes: indications and contraindications, device insertion, device maintenance, device removal and effectiveness evaluation.Conclusions:This study scientifically and systematically summarized the best evidence regarding the insertion and maintenance of built-in fecal incontinence management device. We recommend that clinical practitioners integrate this evidence into their practice, while considering individual patient preferences and medical contexts. Adhering to individualization for evidence translation improves standardization and benefits patients in the clinical use of fecal collection devices.

Objective:To explore the relationship between early fecal calprotectin (FC) level and the long-term efficacy of infliximab (IFX) in the treatment of Crohn′s disease (CD) and predictive the value.Methods:From January 2018 to December 2023, at the First Affiliated Hospital with Nanjing Medical University, the clinical data of patients with moderate-to-severe CD who received IFX as first-line therapy were retrospectively collected. The main outcomes were clinical and endoscopic remission at week 52 after IFX treatment, and the secondary outcome was clinical response at week 14 after IFX treatment. The predictive value of FC levels at week 0 (at baseline when first administered) and week 14 of treatment was evaluated for the clinical and endoscopic remission at week 52 after IFX treatment. Multivariate logistic regression was performed to investigate the factors predicting endoscopic remission. The optimal cutoff value was calculated, model was established, the data was divided into training set and validation set at a ratio of 7∶3 using the random number table method and the corresponding column chart was drawn. Receiver operating characteristic curve (ROC) and calibration curve were used to evaluate the discrimination and calibration of the model, respectively. Mann-Whitney U test was used for statistical comparison. Results:A total of 165 patients with CD were enrolled, of whom 150 cases (90.9%) achieved clinical response after induction therapy, and 15 cases (9.1%) were primary non-response. Among the 150 patients with clinical response, 112 cases (74.7%) achieved clinical remission at week 52 after treatment, while 38 cases (25.3%) did not achieve clinical remission. Endoscopic evaluation was performed at week 52 after treatment in 139 patients, of whom 54 cases (38.8%) achieved endoscopic remission and 85 cases (61.2%) did not. At week 14 of treatment, there was no statistically significant difference in FC level between the patients achieved and did not achieve clinical response (263.24 (93.96, 675.28) μg/g vs. 556.35 (245.77, 953.56) μg/g, P>0.05). At week 52 after treatment, the FC level of patients who achieved clinical remission was lower than that of patients did not achieve(103.20(44.11, 456.57) μg/g vs. 531.26(222.06, 998.40) μg/g) and the decreased value of FC at week 52 and week 0 after treatment of patients achieved clinical remission was more than that of patients did not achieve clinical remission (443.34 (82.25, 788.95) μg/g vs. 269.91 (-79.20, 522.54) μg/g), and the differences were statistically significant ( U=1 078.00, 2 677.00; P<0.001, =0.018). At week 52 after treatment, the FC level of patients achieved endoscopic remission was lower than that of patients did not achieve endoscopic remission (52.80(31.93, 83.47) μg/g vs. 506.18(217.44, 778.02) μg/g), and the decreased value of FC at week 52 and week 0 after treatment of patients achieved endoscopic remission was more than that of patients did not achieve endoscopic remission (428.85(140.20, 863.60) μg/g vs. 309.61(-62.37, 683.82) μg/g), and the differences were statistically significant ( U=500.00, 2 812.00; P<0.001, =0.025). The FC level at week 14 of treatment could predict the clinical and endoscopic remission at week 52 after treatment (area under the curve (AUC) =0.663, 0.773; 95% confidence interval (95% CI): 0.566 to 0.760, 0.694 to 0.852; P=0.006, <0.001). The optimal cutoff value of FC at week 14 of treatment for predicting endoscopic remission at week 52 after treatment was 246.13 μg/g, with a sensitivity of 0.741 and a specificity of 0.671. The results of multivariate logistic regression analysis revealed that FC ≤ 246.13 μg/g at week 14 of treatment ( OR=4.576, 95% CI: 2.021 to 10.363, P<0.001), baseline albumin ( OR=1.093, 95% CI: 1.006 to 1.188, P=0.035), and baseline platelet-to-lymphocyte ratio (PLR) ( OR=0.995, 95% CI: 0.990 to 1.000, P=0.046) were independent influencing factors of endoscopic remission at week 52 after treatment. A predictive model for endoscopic remission at week 52 after IFX treatment was established based on FC ≤ 246.13 μg/g at week 14 of treatment, baseline albumin and PLR. The results of ROC analysis showed that this model had good discriminative ability, with an AUC of 0.780 (95% CI: 0.700 to 0.878) in the validation set, with a sensitivity of 0.812 and a specificity of 0.760. The results of calibration curve analysis demonstrated that the average absolute error of the prediction model in the validation set was 0.038, and the consistency between the predicted probability and the actual probability was good. Conclusion:FC ≤ 246.13 g/g at week 14 of IFX treatment has good predictive value for endoscopic remission at week 52 after treatment in CD patients.

Objective:To explore the prognostic value of assessing plasma thrombin-antithrombin complex (TAT) and D-dimer (D-D) in patients with acute ischemic stroke (AIS).Methods:This prospective cohort study enrolled 538 AIS patients admitted to the General Hospital of Tianjin Medical University from July 2021 to May 2024, including 306 males and 232 females, with an average age of (69.5±11.5) years. Among them, there were 147 cases of lacunar infarction, 166 cases of large artery atherosclerosis type, 122 cases of cardioembolic type, and 103 cases of cancer-related type. Follow-up observations were conducted on enrolled patients, data within 30 days after the initiation of acute phase treatment for one week were collected, thrombus-related cerebral ischemic events recurrence served as the endpoint event, starting from August 5, 2021, to June 19, 2024. During the follow-up period, 68 patients experienced endpoint events, including 14 cases of large artery atherosclerosis type, 23 cases of cardioembolic type, and 31 cases of cancer-related type. The plasma levels of TAT and D-D were determined by chemiluminescence method and enzyme-linked immunofluorescence assay respectively. The receiver operating characteristic (ROC) curve was used to analyze the prediction performance of TAT and D-dimer for recurrent ischemic events in AIS patients during the 30-day follow-up period, and the Kaplan-Meier curve was used for survival analysis.Results:Statistically differences were observed in the plasma TAT and D-D levels among patients with different types of AIS ( P<0.05), with cancer-related type had higher levels than cardioembolic type ( P<0.05), and cardioembolic type had higher levels than large artery atherosclerosis type ( P<0.05). In the non-recurrent ischemic event group, the plasma TAT and D-D levels of patients with large artery atherosclerosis type, cardioembolic type and cancer-related type were lower in post-treatment than pre-treatment ( P<0.05). In the recurrent ischemic event group, the plasma D-D levels were higher in post-treatment than pre-treatment in the patients with large artery atherosclerosis type ( P<0.05); there was no statistically difference between the post-treatment and pre-treatment in plasma TAT and D-D levels in patients with cardioembolic type ( P>0.05); in patients with cancer-related type, the TAT and D-D levels were lower in post-treatment than pre-treatment ( P<0.05), but higher than those in the non-recurrence group ( P<0.05). The ROC curve showed that the area under the curve for predicting the risk of ischemic event recurrence within 30 days in AIS patients by plasma TAT combined with D-D on day 7 after treatment was all >0.9 (0.950 for large artery atherosclerosis type, 0.965 for cardioembolic type, and 0.907 for cancer-related types). Survival analysis indicated that various patients with both indicators above the critical value had an increased cumulative risk probability of adverse events (log-rank χ 2=93.667, 109.266, and 58.433, respectively, with all P<0.001). Conclusion:The changes of plasma TAT and D-D levels in AIS patients are associated with stroke type and coagulation activation, and dynamic monitoring of these two indicators could help evaluate the treatment effect and predict the risk of recurrent ischemic events.