ObjectiveTo support intelligent clinical decision-making in traditional Chinese medicine（TCM）， this study utilized ontology and knowledge graph construction techniques to achieve the IT application of clinical practice guidelines. MethodBased on the principles of findability， accessibility， interoperability， and reusability （FAIR principles）， this study employed ontology techniques to construct an ontology for TCM clinical practice guidelines and built a knowledge graph using coronary heart disease as an example. Based on the Checklist for Reporting Practice Guidelines in Traditional Chinese Medicine and Recommendation Grading in TCM Clinical Guidelines/Consensus （T/CAS 530—2021），the ontology of TCM clinical practice guidelines was constructed using the seven-step ontology construction method. On this basis，the TCM diagnosis and treatment data from the Guidelines for the Diagnosis and Treatment of Stable Angina Pectoris in Coronary Heart Disease were stored in Neo4j in the form of triples through knowledge extraction，integration，and storage. ResultThe information in the clinical practice guidelines was divided into three categories： onset and prevention information， diagnosis information， and treatment information， and the TCM clinical practice guideline ontology was constructed. A total of 27 concepts related to TCM clinical diagnosis and treatment and 14 data attributes were obtained， and 12 conceptual relationships including hierarchical relationships and object attributes were established. By taking coronary heart disease as an example and the TCM clinical practice guideline ontology as the model layer， the knowledge map of TCM diagnosis and treatment guidelines for stable angina pectoris in coronary heart disease with 276 nodes and 336 relationships was constructed， realizing the visual display and query of the guideline content. ConclusionThe ontology of TCM clinical practice guidelines and the knowledge graph of stable angina pectoris in coronary heart disease constructed by combining the seven-step ontology construction method and Neo4j graph database technology are efficient and flexible，providing an intelligent TCM diagnosis and treatment scheme and promoting the standardization and objectification of TCM diagnosis and treatment.

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a special type of primary liver cancer, which is characterized by dual phenotypic differentiation of hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Due to the lack of specific diagnostic markers and therapeutic targets, the preoperative diagnosis is difficult, the treatment is not easy, and the prognosis is poor. Routine serology, imaging examination and histological biopsy are the main methods of preliminary screening and diagnosis of cHCC-CC. Patients with resectable cHCC-CC should be treated with surgical treatment if possible, but whether they should receive liver transplantation remains a careful choice. There is still no unified standard for local treatment and systemic treatment for advanced patients, and its efficacy is still controversial. Systemic treatment including platinum drugs can benefit some patients. The potential value of targeted therapy and immunotherapy in the treatment of advanced cHCC-CC patients has been highlighted. The introduction of multidisciplinary diagnosis and treatment model has provided a strong guarantee for the comprehensive treatment of patients, and the development of xenogenetic model and multi-omics technology has provided a considerable prospect for the realization of individualized treatment for patients. The present situation and progress of diagnosis and treatment of cHCC-CC are discussed in order to provide reference for clinical practice.

Objective Taking typical cases of Western medicine as an example,this paper explores the connection between Chinese and Western medicine on the understanding of tongue elephants.Methods After collecting the literature with tongue diagram attached to the clinical imaging column published in NEJM magazine,extracting the symptoms,signs and Western medicine disease information recorded in the literature,the tongue diagram was diagnosed from three aspects:tongue quality,tongue moss and sublingual meridians,and whether the symptoms and signs of tongue correspond to a certain diagnosis result,and the results were analyzed.Results A total of 48 articles were included,including 6 literature on abnormal tongue dynamics,which could correspond to abnormal tongue morphology in traditional Chinese medicine.Thirty-four cases of abnormal tongue shape were found.Among them,12 cases could be diagnosed with corresponding TCM tongue diagnosis,including 7 cases of abnormal tongue shape and 5 cases of abnormal coating.The remaining 22 cases were secondary changes in tongue structure.There were 8 articles on abnormal tongue color,including 1 abnormal tongue color,1 abnormal sublingual chord,and 6 abnormal lichen color.Conclusion Starting from the form and function,explore the connection between Chinese medicine and Western medicine in their understanding of tongue diagnosis,and promote the objectification and standardization of Chinese medicine tongue diagnosis.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To investigate the prognostic factors of combined hepatocellular-cholangiocarcinoma (CHC) based on Surveillance, Epidemiology, and End Results (SEER), and to construct and investigate the application value of a nomogram predictive model for CHC.Methods:The retrospective cohort study was conducted. The clinicopathological data of 208 patients with CHC entered into SEER database from January 2004 to December 2019 were analyzed. There were 150 males and 58 females, 121 cases with age ≥60 years, 87 cases with age <60 years. All the 208 patients with CHC were divided into a training set and a validation set in a 7∶3 ratio based on the random table method. The COX proportional hazard model was used to construct the nomogram predictive model, which was validated and compared the predictive performance with the eighth edition of the American Joint Committee on Cancer (AJCC). Observation indicators: (1) survival of patients with CHC; (2) prognostic factors analysis of patients with CHC; (3) construction and perfor-mance evaluation of the nomogram predictive model. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was analyzed using the rank sum test. The COX regression model was used for univariate and multivariate analyses. The Kaplan-Meier method was used to calculate survival rate. The Log-Rank test was used for survival analysis. The prognostic efficacy of the predictive model was evaluated using the consistency index (C-index) and the area under curve (AUC) of receiver operating characteristic (ROC) curve. The calibration curve was used to validate the accuraly of predictive model and decision curve was used to evaluate the clinical utility of predictive model. Results:(1) Survival of patients with CHC. The overall survival time of 145 patients with CHC in the training set was 15.0(range, 1.0-166.0)months, with 1-year survival rate as 52.7%. The overall survival time of 63 patients with CHC in the validation set was 11.5(range, 1.0-176.0)months, with 1-year survival rate as 48.3%. (2) Prognostic factors analysis of patients with CHC. Results of multivariate analysis showed that T staging, surgery, degree of tumor differentiation and chemotherapy were independent factors for prognosis of patients with CHC ( P<0.05). (3) Cons-truction and performance evaluation of the nomogram model. The nomogram predictive model was constructed based on results of multiveriate analysis. The C-index of nomogram predictive model in the training set and the validation set was 0.758 and 0.742, respectively. The C-index of the AJCC predictive model in the training set and the validation set was 0.622 and 0.662, respectively. The AUC of ROC of the nomogram predictive model for 1-, 3-, 5-year overall survival rates was 0.830, 0.861, 0.881 for CHC patients in the training set and 0.798, 0.813, 0.844 for CHC patients in the validation set. The AUS of ROC of AJCC predictive model for 1-, 3-, 5-year overall survival rates was 0.668, 0.699, 0.747 for CHC patients in the training set and 0.719, 0.760, 0.796 for CHC patients in the validation set. Results of calibration curve showed that 1-year overall survival rate calibration curve fitted well with the ideal straight line with a slope of 1, and the predicted results of the two prediction models were highly consistent with the actual results. Results of decision curve showed that nomogram predictive model had a better prediction efficiency than the AJCC predictive model. Conclusion:T staging, surgery, degree of tumor differentiation, chemotherapy are independent factors for prognosis of patients with CHC, and the nomogram constructed based on SEER database can more accurately evaluate the prognosis of CHC patients.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

Hepatocellular carcinoma (HCC) is the most common type of primary hepatocellular carcinoma (PHC). Early diagnosis of HCC remains the key to improve the prognosis. In recent years, with the promotion of the concept of precision medicine and more in-depth analysis of the biological mechanism underlying HCC, new diagnostic methods, including emerging serum markers, liquid biopsies, molecular diagnosis, and advances in imaging (novel contrast agents and radiomics), have emerged one after another. Herein, we reviewed and analyzed scientific advances in the early diagnosis of HCC and discussed their application and shortcomings. This review aimed to provide a reference for scientific research and clinical practice of HCC.
Humans ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/pathology* ; Prognosis ; Early Diagnosis ; Precision Medicine

Tumor chemoprevention and treatment are two approaches aimed at improving the survival of patients with cancers. An ideal anti-tumor drug is that which not only kills tumor cells but also alleviates tumor-causing risk factors, such as precancerous lesions, and prevents tumor recurrence. Chinese herbal monomers are considered to be ideal treatment agents due to their multi-target effects. Astragaloside has been shown to possess tumor chemoprevention, direct anti-tumor, and chemotherapeutic drug sensitization effects. In this paper, we review the effects of astragaloside on tumor prevention and treatment and provide directions for further research.
Humans ; Chemoprevention ; Antineoplastic Agents ; Neoplasms/prevention & control* ; Saponins/pharmacology* ; Triterpenes/pharmacology*

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.