ObjectiveTo compare the clinical features of patients with hepatitis B virus （HBV）-related early-onset liver cancer and those with late-onset liver cancer， to assess the severity of the disease， and to provide a theoretical basis for the early diagnosis and treatment of liver cancer. MethodsA retrospective analysis was performed for 695 patients who were diagnosed with HBV-related liver cancer for the first time in Guangzhou Eighth People’s Hospital， Guangzhou Medical University， from January 2019 to August 2023， among whom 93 had early-onset liver cancer （defined as an age of50 years for female patients and40 years for male patients） and 602 had late-onset liver cancer （defined as an age of ≥50 years for female patients and ≥40 years for male patients）. Related clinical data were collected， including demographic data， clinical symptoms at initial diagnosis， comorbidities， smoking history， drinking history， family history， routine blood test results， biochemical parameters of liver function， serum alpha-fetoprotein（AFP）， virological indicators， coagulation function， and imaging findings. The pan-inflammatory indices neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， and lymphocyte-to-monocyte ratio （LMR） were calculated， as well as FIB-4 index， aspartate aminotransferase-to-platelet ratio index （APRI）， S index， Model for End-Stage Liver Disease （MELD） score， Child-Turcotte-Pugh （CTP） score， albumin-bilirubin （AIBL） grade， and Barcelona Clinic Liver Cancer （BCLC） stage. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or Fisher’s exact test were used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in the proportion of male patients and the incidence rates of diabetes， hypertension， and fatty liver disease （χ²=6.357， 15.230， 11.467， and 14.204， all P0.05）， and compared with the late-onset liver cancer group， the early-onset liver cancer group had a significantly higher proportion of patients progressing to liver cancer without underlying cirrhosis （χ²=24.657， P0.001） and a significantly higher proportion of patients with advanced BCLC stage （χ²=6.172， P=0.046）. For the overall population， the most common clinical symptoms included abdominal distension， abdominal pain， poor appetite， weakness， a reduction in body weight， edema of both lower limbs， jaundice， yellow urine， and nausea， and 55 patients （7.9%） had no obvious symptoms at the time of diagnosis and were found to have liver cancer by routine reexamination， physical examination suggesting an increase in AFP， or radiological examination indicating hepatic space-occupying lesion； compared with the late-onset liver cancer group， the patients in the early-onset liver cancer group were more likely to have the symptoms of abdominal distension， abdominal pain， and jaundice （all P0.05）. Compared with the late-onset liver cancer group， the early-onset liver cancer group had a significantly larger tumor diameter （Z=2.845， P=0.034）， with higher prevalence rates of multiple tumors and intrahepatic， perihepatic， or distant metastasis （χ²=5.889 and 4.079， both P0.05）， and there were significant differences between the two groups in tumor location and size （χ²=3.948 and 11.317， both P0.05）. Compared with the late-onset liver cancer group， the early-onset liver cancer group had significantly lower FIB-4 index， proportion of patients with HBsAg ≤1 500 IU/mL， and levels of LMR and Cr （all P0.05）， as well as significantly higher positive rate of HBeAg and levels of log₁₀ HBV DNA， AFP， WBC， Hb， PLT， NLR， PLR， TBil， ALT， Alb， and TC （all P0.05）. ConclusionCompared with late-onset liver cancer， patients with early-onset liver cancer tend to develop liver cancer without liver cirrhosis and have multiple tumors， obvious clinical symptoms， and advanced BCLC stage， which indicates a poor prognosis.

Patients with periodontal disease often require combined periodontal-orthodontic interventions to restore periodontal health, function, and aesthetics, ensuring both patient satisfaction and long-term stability. Managing these patients involving orthodontic tooth movement can be particularly challenging due to compromised periodontal soft and hard tissues, especially in severe cases. Therefore, close collaboration between orthodontists and periodontists for comprehensive diagnosis and sequential treatment, along with diligent patient compliance throughout the entire process, is crucial for achieving favorable treatment outcomes. Moreover, long-term orthodontic retention and periodontal follow-up are essential to sustain treatment success. This expert consensus, informed by the latest clinical research and practical experience, addresses clinical considerations for orthodontic treatment of periodontal patients, delineating indications, objectives, procedures, and principles with the aim of providing clear and practical guidance for clinical practitioners.
Humans ; Consensus ; Orthodontics, Corrective/standards* ; Periodontal Diseases/complications* ; Tooth Movement Techniques/methods* ; Practice Guidelines as Topic

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective:To evaluate the efficacy and safety of telitacicept in the treatment of systemic lupus erythematosus (SLE) .Methods:The clinical data of 25 SLE patients who received standard therapy combined with telitacicept at the Department of Dermatology, Xiangya Second Hospital, Central South University, from 2021 to 2024 were retrospectively collected. Baseline demographic and clinical characteristics were analyzed. Changes in skin lesions, joint pain symptoms, complete blood count, and biochemical parameters at 4, 12, and 24 weeks of treatment were compared with baseline (week 0). The Wilcoxon signed-rank test was used to compare complement C3 and C4 levels before and after treatment, and univariate logistic regression analysis was performed to explore factors influencing the efficacy of telitacicept.Results:Among the 25 SLE patients, 3 were male (12.0%) and 22 were female (88.0%). Based on the SLE Disease Activity Index (SLEDAI) -2000 scores, 8 patients were mild, 13 were moderate, and 4 were severe. Of the 11 SLE patients with rashes before treatment, 6 achieved complete remission at 12 weeks. Among the 7 patients with joint pain before treatment, 4 experienced symptom resolution at 24 weeks. The proportion of patients with leukopenia at baseline and at 4, 12, and 24 weeks was 10/25 (40.0%), 0/24 (0), 1/22 (4.5%), and 2/19 (10.5%), respectively. The proportion of patients with thrombocytopenia was 6/25 (24.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively, and the proportion of patients with anemia was 7/25 (28.0%), 3/24 (12.5%), 1/22 (4.5%), and 1/19 (5.3%), respectively. At baseline, 11 out of 25 patients (44.0%) had proteinuria. At 12 weeks, the urinary protein quantification level (0.4 [0, 0.6] g/L) was significantly lower than at baseline (0.9 [0.8, 1.2] g/L). The SLE responder index-4 (SRI4) response rates at 4, 12, and 24 weeks were 14/18, 15/17, and 12/14, respectively. Complement C3 and C4 levels were significantly higher at 4, 12, and 24 weeks compared to baseline (all P < 0.001). Univariate logistic regression analysis showed that age, disease duration, glucocorticoid dosage, baseline complement C4 levels, antinuclear antibody titer, and SLEDAI-2K score did not significantly affect the efficacy of telitacicept (SRI4 response rate at 12 weeks) (all P > 0.05). No serious adverse reactions related to telitacicept were observed in patients. Conclusions:Telitacicept improved skin lesions, complement C3 and C4 levels, and anti-double-stranded DNA antibody levels in SLE patients. No association was found between the efficacy of telitacicept and baseline SLEDAI-2K scores, antinuclear antibody titers, or complement C4 levels, suggesting that telitacicept is an effective and safe treatment for SLE patients.

Objective:Comparative efficacy and safety profiles of tenofovir disoproxil fumarate (TDF) versus tenofovir alafenamide fumarate (TAF) in chronic hepatitis B (CHB) patients with high viral load.Methods:CHB patients with high viral load (hepatitis B virus (HBV) DNA>7 lg IU/mL) receiving TDF ( n=155) or TAF ( n=157) monotherapy were included between December 1st, 2022 and December 1st, 2023, to compare the rates of undetectable HBV DNA (<20 IU/mL), the alanine transaminase (ALT) normalization rate, hepatitis B e antigen (HBeAg) seroconversion rate, renal function and lipid profiles at 48 weeks of treatment. The statistical analysis was performed by the two independent samples t test, Mann-Whitney U test, chi-square test or Fisher′s exact probability test. Results:At week 48 of treatment, the TDF group achieved significantly higher HBV DNA undetectability rates (49.03%(76/155) vs 29.30%(46/157)) and greater mean reduction ((6.05±0.81) lg IU/mL vs (5.57±1.02) lg IU/mL) than the TAF group ( χ2=12.75, t=-4.65, both P<0.001). The ALT normalization rate of patients in the TDF and TAF groups were 77.19%(88/114) and 72.50%(87/120), and HBeAg seroconversion rates were 4.00%(6/150) and 2.67%(4/150), respectively, with no statistically significant differences between the two groups (all P>0.05). The differences in the changes and abnormal rates of serum creatinine and estimated glomerular filtration rate between the two groups of patients were not statistically significant (both P>0.05). The magnitude of decrease (0.15(-0.02, 0.38) mmol/L vs 0.06(-0.06, 0.20) mmol/L) and abnormal rate (27.73%(33/119) vs 16.39%(20/122)) in high-density lipoprotein cholesterol in the TDF group was higher than those in the TAF group, while the increases in low-density lipoprotein cholesterol (-0.09(-0.39, 0.25) mmol/L vs 0.05(-0.31, 0.42) mmol/L), total cholesterol (TC) (-0.23(-0.75, 0.23) mmol/L vs 0.08(-0.35, 0.57) mmol/L), and triglyceride (-0.12(-0.40, 0.06) mmol/L vs 0.00(-0.19, 0.24) mmol/L), as well as the abnormal rate of TC (4.31%(5/116) vs 15.75%(20/127)), in the TDF group were lower than those in the TAF group ( Z=-3.19, χ2=4.51, Z=2.17, Z=4.09, Z=3.71, χ2=8.59, all P<0.05). Conclusion:TDF demonstrated superior efficacy and better safety profiles compared to TAF in high viral load CHB patients.

Perivascular spaces (PVS) are fluid-filled spaces surrounding the cerebral vessels,which are one of the important imaging markers of cerebral small vessel disease (CSVD). The severity of magnetic resonance imaging-visible PVS is associated with the disease burden of multiple neurological diseases. Visual Rating Scale is widely used to evaluate PVS severity. With the development of imaging and computer technology, computational methods based on threshold segmentation, morphological filtering and machine learning have been developed allowing automatically quantifying the number, morphology, and spatial distribution of PVS. The quantitative methods of PVS and the clinical applications were reviewed in this article.

The 2021 version of the Baveno Ⅶ consensus on portal hypertension and the 2023 guidelines from the European Association for the Study of the Liver define recompensated cirrhosis as the restoration and stabilization of liver function, improvement of liver fibrosis, and absence of decompensated cirrhosis for a long time following effective treatment of the underlying etiology of cirrhosis. Recompensated cirrhosis has become an important research direction in the field with the gradually increasing number of these patients. Temporary recompensation, stable recompensation, and long-term recompensation are the three stages into which patients with cirrhosis are divided, based on varying recompensation stages. Clinical characteristics and prognosis are significantly different among different stages. Patients in the temporary compensation stage have significant fluctuations in their condition and poor stability, with a high risk of recurrent complications. The prognosis of patients in the stable recompensation stage is significantly affected by the cause and the type of initial decompensation event, while the condition of patients in the long-term recompensation stage is more stable, and the long-term prognosis is close to that of compensated cirrhosis. This article aims to summarize and explore the recompensation rates at different stages of liver cirrhosis, the occurrence risk of various complications and liver cancer, and long-term management and treatment following recompensation, providing new directions for future research in this field.

Objective To investigate the clinical efficacy of placing a covered esophageal stent by blind pushing method under endoscopic distance measurement in the treatment of advanced esophageal cancer.Method Clinical data of 182 patients with advanced esophageal cancer who were treated by the above method from January 2014 to December 2023 were retrospectively analyzed,and the situations of operation time,patient comfort,accuracy of stent placement,postoperative bleeding,and postoperative chest pain were observed.Result All 182 patients with advanced esophageal cancer were successfully implanted with the covered esophageal stent by the blind pushing method under endoscopic distance measurement.The average placement time was(11.0±4.0)min,and the position of the stent was within 0.5 cm of the expected position.The patients could eat semi-liquid food within 6 h after the operation.No obvious symptoms such as nausea,vomiting and choking cough occurred during the implantation process.Postoperative bleeding was observed in 25 patients(13.7%).No intravenous anesthesia was required,no perforation occurred after the operation,the incidence of postoperative chest pain was documented at 82.4%.The dysphagia problem of the patients was significantly alleviated.Conclusion The endoscopic distance measurement and blind push insertion demonstrate advantages of procedural simplicity,accurate positioning,reducing procedure-related complications,and minimal patient discomfort in patients with advanced esophageal carcinoma and obstruction,establishing its clinical applicability as a novel approach for esophageal stent placement.

Objective To investigate whether Dauricine(Dau)can ameliorate acute kidney injury induced by renal ischemia-reperfusion(IR)in mice.Methods C57BL/6 mice were randomly assigned to three experimental groups:sham operation,ischemia-reperfusion injury(IRI),and IRI treated with daunorubicin(IRI+Dau),with 12 animals in each group.Following oral administration of Dau(15 mg/kg),renal ischemia-reperfusion was induced,and blood and kidney tissue samples were collected 24 hours post-surgery.Histopathological changes were assessed using hematoxylin and eosin(HE)staining.Renal function was evaluated by measuring serum creatinine and blood urea nitrogen(BUN)levels.Protein expression related to lipid peroxidation was analyzed using western blotting and immunofluorescence.Inflammatory gene expression was determined via quantitative polymerase chain reaction(qPCR).Nuclear translocation of nuclear factor κB(NF-κB),a key inflammatory marker,was assessed using immu-nofluorescence.Statistical comparisons between groups were performed using t-tests.Results The administration of Dau significantly ameliorated IR-induced acute kidney injury compared to the Sham group.Serum creatinine(P<0.001)and urea nitrogen(P<0.000 1)levels were markedly decreased in Dau-treated mice relative to those in the IRI group.Furthermore,Dau significantly suppressed lipid peroxide production in renal tissues(P<0.001),without significantly affecting the expression levels of Gpx4(P=0.919)and Acsl4(P=0.086),two key proteins involved in lipid peroxidation.In addition,Dau effectively inhibited IR-induced nuclear translocation of NF-κB(P<0.001)and reduced apoptosis in kidney cells(P=0.004).Conclusion Dau mitigates IR-induced kidney damage by reducing the accumulation of lipid peroxides and inhibiting the nuclear translocation of NF-κB,thereby attenuating inflammation and renal cell apoptosis.

Objective To analyze the current status and research frontiers of Huanglian Jiedu decoction based on bibliometrics.Methods By retrieving Chinese and English literature related to Huanglian Jiedu decoction in multiple databases from January 12000 to December 31 2024.A total of 1237 and 102 Chinese and English literature were included respectively,and the literature were analyzed by bibliometrics analysis.Results The keyword analysis showed that metabolomics,network pharmacology,mechanism pathway and autophagy regulation were the research hotspots of Huanglian Jiedu decoction.Conclusion The research field of Huanglian Jiedu decoction should integrate clinical and basic advantages,expand experimental protocols,strengthen long-term efficacy and safety evaluation,and explore multi-target and multi-disease synergistic effects and drug interactions.