Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Tooth extraction is one of the most common procedures in oral surgery.Poor wound healing is a common problem after tooth extraction.Poor wound healing may not only lead to eating difficulties and impaire psychological health,but also increase the difficulty and cost of treatment,prolong the treatment period and lead to osteonecrosis of the jaw in severe cases.Currently,there is a lack of systematic integration and evaluation of domestic and international studies related to post-extraction wound healing.In this study VOSviewer,Bibliometrix and CiteSpace software were used to econometrically analyse the literature on post-extraction wound healing from 2013 to 2023,with the aim of providing a reference for developing more scientific and systematic strategies for post-ex-traction wound management and prevention of the complications.

Tooth extraction is one of the most common procedures in oral surgery.Poor wound healing is a common problem after tooth extraction.Poor wound healing may not only lead to eating difficulties and impaire psychological health,but also increase the difficulty and cost of treatment,prolong the treatment period and lead to osteonecrosis of the jaw in severe cases.Currently,there is a lack of systematic integration and evaluation of domestic and international studies related to post-extraction wound healing.In this study VOSviewer,Bibliometrix and CiteSpace software were used to econometrically analyse the literature on post-extraction wound healing from 2013 to 2023,with the aim of providing a reference for developing more scientific and systematic strategies for post-ex-traction wound management and prevention of the complications.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.

Objective To establish the framework of a prediagnostic risk assessment system for outpatient dental care and to provide references for ensuring patient safety and improving the quality of medical services.Methods A total of 15 medical workers in a tertiary-care stomatology hospital in Sichuan Province were selected for qualitative interviews between October 2019 and December 2019.On the basis of the results of literature analysis and the interviews,an expert consultation form for prediagnostic risk assessment system for outpatient dental care was developed.Then,consultation of 10 experts in the field of oral health care and nursing was conducted between June 2020 and December 2020.Eventually,the framework of prediagnostic risk assessment system for outpatient dental care was formulated.Results Four themes emerged from the qualitative interviews.Firstly,prediagnostic risks of dental outpatients involved mainly syncope,cardiovascular emergencies,and other emergency medical risks.Secondly,medical risks came from three sources,patients,healthcare professionals,and the environment.Thirdly,medical professionals of outpatient dental care had limited awareness of the prediagnostic medical risks of patient.Fourthly,medical professionals of outpatient dental care showed inadequate response to and management of the prediagnostic medical risks of patient.The expert consultation helped finalize the Dental Outpatient Prediagnostic Risk Assessment Questionnaire,which included 3 primary indicators(namely,general information,medical history[including history of allergy],and medication assessment),12 secondary indicators(including patient demographics,patients'status upon admission,oral hygiene habits and special lifestyle habits,sensory disorders,special periods for female patients[ie,menstruation,pregnancy,and breastfeeding],allergy history[history of oral treatment-related allergies],past/present medical history,types of medication,route of medication administration,duration of medication administration,accuracy of medication administration,and adverse drug reactions),and 39 tertiary indicators.The effective recall rate of the expert consultation form was 100%,expert positivity was 100%,and the authority coefficient was 0.83.Kendall's harmony coefficient ranged from 0.808 to 0.839,which was statistically significant(P<0.001).Conclusion The framework of prediagnosis risk assessment system for outpatient dental care is found to be scientific and specific,but its applicability still needs further validation in clinical practice.

Objective:To understand the research progress and quality of lung cancer screening guidelines and consensus in China and abroad, and to provide reference for the formulation of high-quality lung cancer screening guidelines in China.Methods:Databases including PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, SinoMed, VIP and Wanfang Data were searched, websites and important references were also searched by hand retrieval. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guidelines in Healthcare (RIGHT) were used to assess the quality of newly published or updated guidelines and consensus.Results:A total of 9 guidelines and consensus published between 2015 and 2020 were included in this study, with countries including the United States, China, Canada, Saudi Arabia and South Africa. The field of scope and purpose and clarity of presentation scored relatively high but the rigor of development and applicability scored low. Five guidelines were judged to be A-level, all of which were published abroad, and the remaining four were B-level, including three guidelines and consensus issued by China and 1 guideline issued by South Africa. The report rate of RIGHT were higher in basic information and background, lower in review and quality assurance, funding and declaration and management of interests. There were 5 guidelines with a good level and 4 guidelines and consensus with a moderate level. The best overall quality guidelines were those published by the American College of Chest Physicians in 2018 and by the Canadian Task Force on Preventive Health Care in 2016.Conclusions:The number of countries and institutions that issue lung cancer screening guidelines and consensus had been increasing gradually, but the quality in China remained low. It is necessary to develop high-quality lung cancer screening guidelines suitable for China's national conditions in combination with evidence-based methods to guide practice.

Objective:To understand the mental health status of pregnant women in the third trimester of pregnancy, and explore the influencing factors.Methods:The general demographic information and pregnancy information of 575 pregnant women in the Chinese Pregnant Women Cohort Study were collected. The mental health status of pregnant women in the third trimester was investigated by using Edinburgh Postpartum Depression Scale, Self-Rating Anxiety Scale and University of California at Los Angeles. Multivariate unconditional logistic regression was used to analyze the influencing factors for mental health of pregnant women.Results:In the third trimester of pregnancy, the incidence of depression was 16.52%, the incidence of anxiety was 11.13%, and the incidence of feeling loneliness was 26.26%. Logistic regression analysis showed that compared with those with education level of junior high school below, those with education level of college or bachelor's degree ( OR=0.418, 95% CI: 0.184-0.950) and master's degree or above ( OR=0.116, 95% CI: 0.027-0.503) were less likely to feel loneliness. Pregnant women with higher annual family income (10 000 RMB yuan) were less likely to suffer from depression (≥20 vs. <10: OR=0.527, 95% CI: 0.279-0.998), anxiety (10-20 vs. <10: OR=0.363, 95% CI: 0.180-0.731; ≥20 vs. <10: OR=0.271, 95% CI: 0.132-0.554) and feeling loneliness (≥20 vs. <10: OR=0.477, 95% CI: 0.276-0.826). Conclusions:The education level and family income have impacts on the mental health status of pregnant women in the third trimester. Medical staff should give targeted psychological advice to pregnant women to improve their mental health status.

Data standard plays an important role in the process of data collection, Integration and sharing in clinical cohort studies, and more attention have been paid to it. This paper summarizes the 5 international proven data standard model, analyze their characteristics and development status, and match their data modules with the general data set of the clinical cohorts to evaluate the international data standard models' applicability and provide reference for the development and improvement of the data standard model for clinical cohort studies in China.

Objective:To retrospectively analyze the experience of our center in the use of marginal donor heart, and to explore the principle of use and risk control of marginal donor heart.Methods:A total of 31 patients with end-stage heart disease underwent orthotopic heart transplantation in our center from January 2018 to December 2018, including 28 cases of pure heart transplantation, 2 cases of combined heart-lung transplantation, and 1 case of combined heart-kidney transplantation. 26 of the 31 cases were marginal donor hearts. These patients were all anastomosed by a double lumen method.Results:The rates of postoperative use of ECMO, IABP and acute rejection were zero in this study. The time of cardiopulmonary bypass in the marginal donor group was significantly longer compared with the conventional donor group( P<0.05), but there was no significant difference between the two groups in terms of hospitalization time, mechanical ventilation time, ICU stay time, abnormal rate of ECG, LVEF and blood biochemical indexes(all P>0.05). The postoperative follow-up rate was 100% in the two groups. One case of combined heart-lung transplantation in the marginal donor group died of multiple organ failure in the first month after surgery. During the postoperative follow-up period, the incidence of moderate to severe tricuspid regurgitation and the incidence of recurrent heart failure were zero in the two groups. There was no significant difference in the incidence of arrhythmia, LVEF, infection and blood biochemical parameters. Conclusion:The application of marginal donor heart has no significant effect on the short-term survival rate and recovery of patients after heart transplantation, but the long-term effect needs further follow-up.

Objective To understand the status of economic burden of maternal health care of pregnant women in China, and to discuss the equity and accessibility of maternal health care during pregnancy among different regions and populations. Methods A total of 9 193 women during early pregnancy were recruited from the Chinese Pregnant Women Cohort Study between July 25, 2017 and November 26, 2018. Information on general condition and economic burden of maternal health care was surveyed. SPSS 25.0 software was used for statistical analysis. Results The median direct medical cost of maternity check-ups for pregnant women was 400 CNY per visit, and the median cost of lost work was 360 CNY per visit. The analysis of the results showed that the median medical expense was highest in pre-pregnant women with BMI <18.5kg/m² (P=0.008). The median medical expense was higher in urban residents than rural residents (P<0.001). Families with fewer members had higher direct medical expenses (P<0.001, P_trend=0.003). The higher the socioeconomic status was, the higher the direct medical expense was (P<0.001, P_trend=0.003). The cost of lost work was lower in pregnant women with higher socioeconomic status (P=0.025, P_trend=0.017). In addition, the medical expense was highest in women living in the eastern part of China (P<0.001). The direct medical expenses (P=0.002) and lost-time expenses of pregnant women in the North were higher than those in the South (P=0.013). Conclusion The problem of equity and accessibility of maternal health care still existed. It is recommended that relevant departments further improve maternal health care services and build a diversified healthcare service system to ensure maternal and child health and promote eugenics.