BackgroundInfluenza is an acute infectious respiratory disease causing substantial public health and economic burdens. Multiple clinical studies have investigated traditional Chinese medicine (TCM) for influenza prevention.ObjectiveTo assess the effectiveness and safety of TCM preventive interventions against influenza through direct comparisons.MethodsWe systematically searched PubMed, EMbase, CENTRAL, Web of Science, CNKI, WanFang, CQVIP, and Sinomed up to August 14, 2025. A two-stage screening process (title/abstract screening followed by full-text screening) was implemented. Data extraction utilized predefined templates, followed by methodological quality assessment, statistical analysis, and GRADE assessment. All procedures were independently conducted by two investigators with cross-verification, with discrepancies resolved by a third party.Results19 studies involving 55,183 healthy participants were included, comprising special populations of 600 pregnant women, 226 children, and 31,889 school populations, 3,238 community residents, and 210 military residents. Compared with no intervention, TCM demonstrated potential reduction in influenza incidence (RR = 0.23, 95% CI 0.12–0.43, P <0.00001, I2 = 94%, 13 studies, 38,463 participants) and influenza-like illness (RR = 0.38, 95% CI 0.23–0.63, 6 studies, 10,754 participants), with no statistically significant difference in adverse event rates (RR = 5.00, 95% CI 0.59–42.37, P = 0.14, I2 = 0%, 6 studies, 7,486 participants).ConclusionTCM interventions may exhibit potential efficacy for influenza prevention, though the confidence in this conclusion is limited by the methodological limitations of included studies involving healthy populations. Very low certainty of the evidence suggests that TCM might reduce influenza and influenza-like illness incidence with potential safety profiles. We did not identify high certainty of the evidence regarding the effectiveness and safety of any preventive measures. Future research should employ rigorous methodologies, standardized influenza diagnostic criteria, and core outcome measures specific to influenza prevention.Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/view/CRD42024506941], identifier [CRD42024506941]

STUDY DESIGN:Bibliometric analysis. OBJECTIVE:To optimize pain management and identify future research trends through bibliometric analysis. SUMMARY OF BACKGROUND DATA:Postoperative lumbar spine pain is multifactorial and often persists despite successful surgery, reducing patients' quality of life, increasing healthcare use, and increasing the risks of opioid dependence and psychological distress. METHODS:Data from eligible studies were extracted through a comprehensive search and various analyses, including descriptive bibliometrics, citations, keywords, and thematic analyses. Group comparisons were made between Asian and non-Asian groups to assess differences and trends between the two regions. RESULTS:Between 1984 and 2025, 197 studies were published, with an average annual increase of 1.70%. At least 10 studies were contributed by the USA, Turkey, Iran, China, and Korea. Studies from the USA had the highest annual citations, whereas those from Spain had the highest citations per article. The focus of most studies (96.45%) was on pharmacological interventions, including anesthetics, opioids, nonsteroidal anti-inflammatory drugs, antipyretic-analgesic drugs, corticosteroids, serotonin-norepinephrine reuptake inhibitors, nonopioid centrally acting analgesics, and nondepolarizing neuromuscular blockers. Among these, intravenous administration was used in 48.22% of the studies, and 58.38% employed a placebo as the control. Additionally, 77.16% of the studies used the Visual Analog Scale to assess pain. Overall, the field has shifted from basic pain management to more personalized and multifaceted perioperative strategies, especially for patients undergoing complex spinal surgeries. Significant differences were observed between the Asian and non-Asian groups regarding publication year and age. CONCLUSIONS:The number of randomized controlled trials on lumbar postoperative pain has increased, with the USA, Turkey, Iran, and Korea dominating the research. China's lower citation ranking was lower on citation-based indicators; limited international visibility is proposed as a hypothesis for this pattern rather than an established explanation. Driven by the opioid crisis, the field has evolved from opioid-sparing strategies to multimodal, personalized care.

OBJECTIVES:The phosphoinositide 3 kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) signaling pathway is a key therapeutic target for oral diseases. This study uses bibliometric analysis to identify research trends, knowledge gaps, and the development of PI3K/AKT/mTOR-targeted therapies. METHODS:A systematic literature search was conducted in March 2025 using the keywords "PI3K/AKT/mTOR" and "dental OR oral." Publication trends, highly cited studies, research hotspots, and emerging trends were analyzed. Comparative analyses of publication year, study design, and disease categories were performed between Asian and non-Asian cohorts. RESULTS:From 2008 to 2025, 119 studies were identified, with China, India, and Japan leading in publications and citations. Germany had the highest average citations. Keyword analysis showed a shift from basic to clinical research. Of these studies, 91 were from Asia, covering a broader range of oral conditions, while 28 were from non-Asian regions, with no significant differences in study design or disease categories. CONCLUSION:This bibliometric analysis shows rising global interest in PI3K/AKT/mTOR research in oral science, led by Asia. Research has shifted from basic signaling to disease-focused studies, with future efforts focusing on underexplored oral pathologies and translational applications, particularly in targeted therapy and regenerative medicine.

INTRODUCTION:KOA is a prevalent joint disorder significantly impacting patients' quality of life. Tuina and manual interventions are prioritized in clinical practice within the Chinese healthcare context. Current qualitative studies mostly focus on symptom management and basic disease perceptions, overlooking patient-centered treatment expectations, therapeutic process perceptions, and doctor-patient interaction impacts during manual therapy. This study aims to address these gaps by exploring Chinese KOA patients' experiences, perceptions, and expectations of manual therapy, emphasizing contextual factors affecting therapeutic outcomes and interactions. METHODS:Participants with KOA were sampled using a simple sampling method from a randomized controlled trial of Tuina treatment versus manual physical therapy (MPT). The interviews were conducted by two researchers who have extensive experience interviewing KOA patients, and data were gathered through face-to-face, semi-structured interviews to ensure a high level of information power. Three experienced researchers subsequently analyzed employing thematic analysis to assess patient experiences and outcomes from both treatment modalities. RESULT:The study interviewed a total of 61 participants, thematic saturation was reached when interviewing 42 participants, and seven codes along with 5 sub-themes were utilized to depict potential doctor-patient interactions and influencing factors. This process led to the formation of three themes: Understanding and Impact, Treatment Expectations and Satisfaction, and Treatment Goals and Outcomes, which helped in constructing a model to understand the underlying influences among these themes. CONCLUSION:Our study generated three themes-Understanding and Impact, Treatment Expectations and Satisfaction, and Treatment Goals and Outcomes, and developed a manual therapy model based on these themes. The generated model shows the important factors of doctor-patient interaction in KOA manual therapy management. Future research should expand to multidisciplinary and cross-cultural models to align standardized protocols with individualized patient needs.

Tuina therapy (Tuina) is commonly utilized for managing knee osteoarthritis (KOA), yet the available evidence is limited. This study aimed to evaluate the effectiveness of Tuina compared to widely accepted manual physical therapy (mPT) for patients with KOA. Between Oct 2019 and Oct 2021, patients with KOA (Kellgren-Lawrence score II or III) were randomly assigned in a 1:1 ratio to receive Tuina or mPT, with eight 20-min sessions over 3 weeks. Assessments were performed at baseline, week 4, 8, and 16. The primary outcome was the change of total Western Ontario and McMaster University Osteoarthritis Index (WOMAC) from baseline to week 4. Secondary outcomes included WOMAC subscales, knee pain measures, performance-based tests, quality-of-life measures, and safety assessments. Patients, evaluators, and statisticians were blinded to treatment group assignment. All main analyses were by intention-to-treat. Of the 140 patients allocated to Tuina or mPT, 127 completed the treatment. There was significant intervention × time interaction observed in the WOMAC-total (F(2, 266) = 3.87, P = 0.02), there was no statistically significant between groups at week 4 (between-group difference: −1.00, 95

BackgroundThe gag reflex is a common challenge in dental practice, often causing discomfort and leading to treatment avoidance, especially during procedures like taking dental impressions. Although both pharmacological and non-pharmacological treatments are utilized to manage the gag reflex, current evidence supporting the routine use of these interventions is limited, highlighting the need for further research. To optimize gag reflex management and identify future research trends through a bibliometric analysis.MethodsData from eligible studies were extracted through a comprehensive search and various analyses, including descriptive bibliometric, citation, keyword, and thematic analyses. Group comparisons were made between Asian and non-Asian groups to assess the differences and trends between the two regions.ResultsBetween 2000 and 2025, 47 studies were published, with an average annual increase of 4.68%. Japan, Iran, India, the USA, and Turkey each contributed at least 10 studies, and studies from Lebanon had the highest citation frequency. The majority of studies were randomized controlled trials (46.81%), followed by case reports (46.81%) and case series (6.38%). Most studies (80.85%) focused on adults undergoing extractions (38.30%), restorations (31.91%), and dental impressions (14.89%). Interventions primarily targeted nausea and vomiting (74.47%) using pharmacological treatments such as lidocaine, propofol, and midazolam and non-pharmacological methods such as acupuncture, acupressure, and Transcutaneous Electrical Nerve Stimulation. Significant differences were observed between Asian and non-Asian groups in publication years, study designs, demographics, treatments, and clinical outcomes.ConclusionsGag reflex management has advanced with pharmacological treatments for immediate relief and increased use of non-pharmacological methods such as acupuncture and laser stimulation, particularly in Japan, Turkey, and the USA. However, challenges such as small-scale studies, limited follow-ups, and underrepresentation of children and adolescents highlight the need for larger studies, standardized tools, and inclusive approaches for diverse patient groups.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420250650382, identifier (CRD420250650382).

Objective To evaluate the clinical efficacy of different acupuncture-related therapies in treating postoperative pain in patients with osteoporotic vertebral compression fractures (OVCFs) after percutaneous kyphoplasty (PKP) or percutaneous vertebroplasty (PVP) using a network meta-analysis. Methods A systematic search was conducted in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database (SinoMed) from their inception to January 15, 2025. Outcome measures included the Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI) score, and overall efficacy rate. Literature screening, data extraction, and risk-of-bias assessment were independently performed by two researchers. Data analysis was conducted using Stata 17.0 software. Results A total of 35 randomized controlled trials involving 2860 patients were included. The data analysis revealed that, in terms of improving VAS and ODI scores, the top three effective therapies were Fu's subcutaneous needling, wrist-ankle acupuncture, and acupotomy. For the overall efficacy rates in pain treatment, the top three therapies were wrist-ankle acupuncture, warm acupuncture and moxibustion, and Fu's subcutaneous needling. Based on the combined results across the three outcome measures, Fu's subcutaneous needling was found to be the most effective in relieving pain and improving lumbar function. Conclusion Fu's subcutaneous needling, wrist-ankle acupuncture, warm acupuncture and moxibustion, and acupotomy were all effective in treating postoperative pain post-PKP/PVP and improving lumbar function. However, further high-quality, large-sample studies are required to confirm these findings.

BACKGROUND:Dental treatments, especially invasive procedures, often induce anxiety and fear, impacting future treatment adherence. Music intervention, a non-pharmacological approach, has shown promise in reducing anxiety and enhancing well-being, but further research is needed to explore its application in dental settings and the influence of factors like music type, duration, and volume. OBJECTIVE:To assess the effects of music interventions on dental anxiety and fear, analyze research trends, and identify knowledge gaps through a bibliometric analysis of randomized controlled trials. METHODS:Data from eligible studies were extracted through a comprehensive search. Descriptive bibliometrics, citation analysis, and keyword analysis were performed to assess research outputs, distribution, hotspots, and trends. Different human development indices (HDI) were used to analyze variations in publication year, sex distribution, and interventions across countries. RESULTS:This study included 46 randomized controlled trials (RCTs) from 2004 to 2024, with a mean annual growth rate of 5.95 %. India, Japan, and Turkey led the research output and citations. Approximately 4112 participants, with 45.68 % males were enrolled. Most RCTs focused on adults (65.22 %) and used passive music interventions (73.91 %). The most common treatment was dental extraction (39.13 %), with classical music being the predominant intervention (60.87 %). The control group were often blank (80.43 %). Various indicators of anxiety and fear have been reported. Significant differences were found in the sex distribution among the different HDI ranks (p < 0.001). CONCLUSIONS:This study outlined the research profile of music interventions for reducing anxiety and fear during dental treatments, with India, Japan, and Turkey leading in terms of output. The most frequently studied intervention is classical music, which is typically used preoperatively. Notable sex distribution differences were observed across HDI groups. Future research trends should include more extensive trials, personalized interventions, standardized guidelines, and enhanced collaboration to optimize patient engagement and emotional regulation.

BACKGROUND:Acne is a chronic inflammatory and immune-mediated disease of the pilosebaceous unit (the skin structure consisting of a hair follicle and its associated sebaceous gland). It is characterised by non-inflammatory lesions (open and closed comedones) and inflammatory lesions (papules, pustules, nodules, and cysts). Lesions may be present on the face, thorax, and back, with variable severity. Acne exhibits a global distribution and has a growing prevalence. Acne vulgaris is the most common form. Acne gives rise to complications such as scars and can seriously affect people's mental health, especially those with severe acne. Acne has a huge impact on the quality of life and self-esteem of those affected. OBJECTIVES:To synthesise the existing evidence on the efficacy and safety of non-systemic pharmacological interventions and non-pharmacological interventions (physical therapy and complementary therapies) in the treatment of acne vulgaris and related skin complications. METHODS:We searched the Cochrane Database of Systematic Reviews, Epistemonikos, MEDLINE, and Embase to 2 December 2021, and checked the reference lists of included reviews. At least two authors were responsible for screening, data extraction, and critical appraisal. We excluded reviews with high risk of bias as assessed with the ROBIS tool. We evaluated the overall certainty of the evidence according to GRADE (as carried out by the authors of the included reviews or ourselves). We provide comprehensive evidence from the review data, including summary of findings tables, summary of results tables, and evidence maps. MAIN RESULTS:We retrieved and assessed a total of 733 records; however, only six reviews (five Cochrane reviews and one non-Cochrane review) with low risk of bias met the overview inclusion criteria. The six reviews involved 40,910 people with acne from 275 trials and 1316 people with acne scars from 37 trials. The age of the participants ranged from 10 to 59 years, with an average age range from 18 to 30 years. Four reviews included original trials involving only female participants and three reviews included original trials with only male participants. Main results for clinically important comparisons: Benzoyl peroxide versus placebo or no treatment: In two trials involving 1012 participants over 12 weeks, benzoyl peroxide may reduce the total (mean difference (MD) -16.14, 95% confidence interval (CI) -26.51 to -5.78), inflammatory (MD -6.12, 95% CI -11.02 to -1.22), and non-inflammatory lesion counts (MD -9.69, 95% CI -15.08 to -4.29) when compared to placebo (long-term treatment), but the evidence is very uncertain (very low-certainty evidence). Two trials including 1073 participants (time point: 10 and 12 weeks) suggested benzoyl peroxide may have little to no effect in improving participants' global self-assessment compared to placebo (long-term treatment), but the evidence is very uncertain (risk ratio (RR) 1.44, 95% CI 0.94 to 2.22; very low-certainty evidence). Very low-certainty evidence suggested that benzoyl peroxide may improve investigators' global assessment (RR 1.77, 95% CI 1.37 to 2.28; 6 trials, 4110 participants, long-term treatment (12 weeks)) compared to placebo. Thirteen trials including 4287 participants over 10 to 12 weeks suggested benzoyl peroxide may increase the risk of a less serious adverse event compared to placebo (long-term treatment), but the evidence is very uncertain (RR 1.46, 95% CI 1.01 to 2.11; very low-certainty evidence). Benzoyl peroxide versus topical retinoids: Benzoyl peroxide may increase the percentage change in total lesion count compared to adapalene (long-term treatment), but the evidence is very uncertain (MD 10.8, 95% CI 3.38 to 18.22; 1 trial, 205 participants, 12 weeks; very low-certainty evidence). When compared to adapalene, benzoyl peroxide may have little to no effect on the following outcomes (long-term treatment): percentage change in inflammatory lesion counts (MD -7.7, 95% CI -16.46 to 1.06; 1 trial, 142 participants, 11 weeks; very low-certainty evidence), percentage change in non-inflammatory lesion counts (MD -3.9, 95% CI -13.31 to 5.51; 1 trial, 142 participants, 11 weeks; very low-certainty evidence), participant's global self-assessment (RR 0.96, 95% CI 0.86 to 1.06; 4 trials, 1123 participants, 11 to 12 weeks; low-certainty evidence), investigators' global assessment (RR 1.16, 95% CI 0.98 to 1.37; 3 trials, 1965 participants, 12 weeks; low-certainty evidence), and incidence of a less serious adverse event (RR 0.77, 95% CI 0.48 to 1.25, 1573 participants, 5 trials, 11 to 12 weeks; very low-certainty evidence). Benzoyl peroxide versus topical antibiotics: When compared to clindamycin, benzoyl peroxide may have little to no effect on the following outcomes (long-term treatment): total lesion counts (MD -3.50, 95% CI -7.54 to 0.54; 1 trial, 641 participants, 12 weeks; very low-certainty evidence), inflammatory lesion counts (MD -1.20, 95% CI -2.99 to 0.59; 1 trial, 641 participants, 12 weeks; very low-certainty evidence), non-inflammatory lesion counts (MD -2.4, 95% CI -5.3 to 0.5; 1 trial, 641 participants, 12 weeks; very low-certainty evidence), participant's global self-assessment (RR 0.95, 95% CI 0.68 to 1.34; 1 trial, 240 participants, 10 weeks; low-certainty evidence), investigator's global assessment (RR 1.10, 95% CI 0.83 to 1.45; 2 trials, 2277 participants, 12 weeks; very low-certainty evidence), and incidence of a less serious adverse event (RR 1.27, 95% CI 0.98 to 1.64; 5 trials, 2842 participants, 10 to 12 weeks; low-certainty evidence). For these clinically important comparisons, no review collected data for the following outcomes: frequency of participants experiencing at least one serious adverse event or quality of life. No review collected data for the following comparisons: topical antibiotics versus placebo or no treatment, topical retinoids versus placebo or no treatment, or topical retinoids versus topical antibiotics. AUTHORS' CONCLUSIONS:This overview summarises the evidence for topical therapy, phototherapy, and complementary therapy for acne and acne scars. We found no high-certainty evidence for the effects of any therapy included. Randomised controlled trials and systematic reviews related to acne and acne scars had limitations (low methodological quality). We could not summarise the evidence for topical retinoids and topical antibiotics due to insufficient high-quality systematic reviews. Future research should consider pooled analysis of data on new emerging drugs for acne treatment (e.g. clascoterone) and focus more on acne complications.

Background Oral traditional Chinese medicine(TCM)has been widely used in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD),but the outcome measures of relevant clinical trials have not been standardized and regulated.Objective To screen the published randomized controlled trials(RCTs)of oral TCM in the treatment of AECOPD,summarize the literature characteristics and outcome measures,so as to provide reference for the design of clinical trials and the selection of outcome measures for the treatment of AECOPD with TCM.Methods CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,Web of Science,Cochrane Library,Clinical Trials.gov and Chinese Clinical Trial Registry were systematically searched by computer to obtain RCTs and clinical trial registration protocols for the treatment of AECOPD with oral TCM from January 2018 to October 2022.After independent screening of the literature and extraction of data by 2 researchers,qualitative analysis was used to describe the selection of outcome measures in the enrolled studies.Results A total of 578 studies were enrolled,including 574 RCTs with reported trial results and 4 clinical trial registration protocols.A total of 51 508 patients were involved in 574 RCTs.In the inclusion criteria,88 studies limited the classification of disease,and 361 studies limited the TCM syndrome type,6 studies reported the blinding method,and 6 studies mentioned the follow-up.A total of 4 030 outcome measures were covered and the number of outcome measures in a single article ranged from 1 to 24.According to the functional attributes,the outcome measures were classified into 8 measure domains:TCM symptoms/syndromes,symptoms/signs,physical and chemical tests,quality of life,long-term prognosis,economic evaluation,safety evaluation and others.The measure domain with the highest reporting rate was physical and chemical tests,and the top 5 outcome measure items reported in terms of frequency were:response rate(11.5%),forced expiratory volume in 1 s(FEV1)(7.5%),TCM symptom/syndrome score(7.0%),FEV1/Forced Vital Capacity(FVC)(6.8%),FVC(4.6%).Four hundred and forty-five studies reported the composition of response rate,and the top 5 measures with reporting rate were symptoms(423),signs(281),TCM syndrome score(203),laboratory tests(89),and pulmonary function(71).Conclusion The RCTs of oral TCM in the treatment of AECOPD involved a large number and a wide range of outcome measures.The included literature focused on the effects of oral TCM on the symptoms and signs,physical and chemical test indicators,quality of life,long-term prognosis,economic evaluation and safety outcomes of patients with AECOPD in varying degrees.However,the selection of outcome measures remains problematic in multiple ways:unclear prioritization of outcome measures;focusing on clinical endpoints with insufficient attention to clinical endpoints;insufficient attention to health economics indicators;different sources and judgment criterias of reference of response.In the future studies,researchers can design the rational outcome measures by refering to the published core outcome set(COS)to improve the quality of TCM clinical research.

Purpose Metastatic non-small cell lung cancer (mNSCLC) has a high incidence rate, and economic burdens to patients, healthcare systems, and societies. Durvalumab plus tremelimumab and chemotherapy (T+D+CT) is a novel therapeutic strategy for mNSCLC, which demonstrated promising efficacy in a phase-3 randomized clinical trial, but its economic value remains unclear.Methods This economic evaluation used a hypothetical cohort of patients with mNSCLC, with characteristics mirroring those of the participants in the POSEIDON trial. Several partitioned survival models were constructed to estimate 15-year costs and health outcomes associated with the T+D+CT, durvalumab plus chemotherapy (D+CT) and chemotherapy alone (CT) strategies, discounting costs and effectiveness at 3% annually. Costs were in 2023 US dollars. Data were derived from the POSEIDON trial and published literature. Deterministic and probabilistic sensitivity analyses were performed to assess the uncertainty of input parameters and study generalizability. The analysis was designed and conducted from September 2022 to March 2023. To evaluate the cost-effectiveness of T+D+CT, compared with CT and D+CT, for mNSCLC from the perspectives of the US healthcare sector and society.Findings From the healthcare sector's perspective, the T+D+CT yielded an additional 0.09 QALYs at an increased cost of $7,108 compared with CT, which resulted in an ICER of $82,501/QALY. The T+D+CT strategy yielded an additional 0.02 QALYs at an increased cost of $27,779 compared with the D+CT, which resulted in an ICER of $1,243,868/QALY. The economic results of T+D+CT vs. CT were most sensitive to the annual discount rate, subsequent immunotherapy cost, tremelimumab cost, palliative care and death cost, pemetrexed cost, and durvalumab cost. The T+D+CT strategy was considered cost-effective relative to CT in 59%-82% of model iterations against willingness-to-pay. thresholds of $100,000/QALY gained to $150,000/QALY gained. From the societal perspective, the T+D+CT can be considered as cost-effective as compared with CT or D+CT, independent of histology.Implications In this cost-effectiveness analysis, the T+D+CT strategy represented good value compared with CT for patients with mNSCLC from the perspectives of the healthcare sector and the society. This treatment strategy may be prioritized for mNSCLC patients at high risks of disease progression.

Introduction and aims To reveal the evolution of pain management strategies following mandibular third molar (M3M) exodontia, examine the geographic contribution of research, and explore future developments through a bibliometric analysis. Methods A comprehensive search was conducted in various leading databases. Data on bibliometrics, participant demographics, and agent regimens were extracted for eligible studies. Descriptive bibliometrics, citation analysis, and keyword bursts were performed to assess the research outputs, distribution, and emerging hotspots. Results A total of 173 randomized control trials from 2004 to 2024 were included. The number of publications showed a consistent upward trend since 2007. Brazil exhibited the most publications and citations. Germany presented the highest mean citations per publication. Brazil, Spain, and Italy showed the closest collaboration. Appropriately 14,391participants with 14,710 extracted M3M were enrolled. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most extensively studied analgesics, followed by glucocorticoids, opioids, and paracetamol. NSAIDs and paracetamol were predominantly administered orally, whereas glucocorticoids and opioids were primarily applied topically (P < .001). Studies on opioids significantly predated the studies using other agents. Adverse events were found in 50.87% of the included studies, where nausea and vomiting were the most frequently reported. Tramadol and piroxicam have drawn increasing interest in recent years. Conclusions This study revealed information on the research outputs, distribution, and future developments of analgesic agents following M3M exodontia. Brazil exhibited the highest level of productivity and recorded the most citations. NSAIDs generated the largest amount of research and are emerging as a benchmark for comparative studies. Oral administration is the most frequently used approach for agent delivery. Nausea and vomiting are the most commonly reported adverse effects. Clinical relevance The bibliometric analysis offers insights into the field of pain management following mandibular 3rd molar exodontia and how it has evolved. Tramadol and piroxicam have become research hotspots in recent years.

Objective To investigate the characteristics of brainstem auditory evoked potential（BAEP） in children with autism spectrum disorders（ASD）. Methods The BAEP results of 20 children diagnosed with ASD aged 2 ～ 5 years（ASD group） were retrospectively analyzed and compared with the BEAP results of 20 normal children of the same age（control group）.Results BAEP results showed that the latency of wave Ⅰ and wave Ⅲ in the ASD group was not significantly different from that in the control group（P ＞ 0.05）, while the latency of wave Ⅴ was longer than that in the control group（P ＜ 0.05）. Compared with the control group, there was no statistical significance in the interval difference between Ⅰ ～ Ⅲ waves in the ASD group（P ＞ 0.05）, while the interval difference between Ⅲ ～ Ⅴ waves and the interval difference between Ⅰ ～ Ⅴ waves were longer than that in the control group, and the difference was statistically significant（P ＜ 0.05）. Conclusion Compared with normal children, the latent time of the Ⅴ wave in children with ASD is longer, and the interval difference of Ⅲ ～ Ⅴ wave and Ⅰ ～Ⅴ wave is longer, indicating the abnormal brain stem conduction pathway in children with ASD. BAEP is of certain significance in the early diagnosis of children with ASD and may be suitable as an objective indicator for the early diagnosis of children with ASD.

There are inconsistencies in treatment outcomes, measurement instruments, and criteria for assessing clinical effectiveness in studies related to distal radius fractures (DRF), resulting in potential biases and failing to provide high-quality clinical evidence. To address these challenges, international researchers have reached a consensus on developing the core outcome indicator set for distal radius fractures(COS-DRF). However, it's important to note that the existing COS-DRF framework could not reflect the unique characteristics of Traditional Chinese Medicine (TCM) treatment. Currently, there are no established standards for treatment outcomes and measurement instruments specific to TCM clinical research, nor has a COS-DRF been established for TCM clinical studies in China. In light of these gaps, our research team aims to construct a core set of treatment outcomes for TCM clinical research on distal radius fractures. This involves compiling a comprehensive list of treatment outcomes and measurement instruments, initially derived from a thorough literature review and expert consensus, which will then undergo further refinement and updates based on real-world clinical experiences, incorporating feedback from 2 to 3 rounds of expert consensus or Delphi questionnaire surveys. Our goal is to establish a COS-DRF or CMS-DRF that aligns with the principles and practices of TCM, and provide high-quality evidence for clinical practice.

膝内侧副韧带复合体急性损伤的核心病机是"不通则痛",治疗时以局部疏通以理筋复位,拔伸推捋调伤处气血为主,结合外敷消肿化瘀散活血化瘀止痛.膝内侧副韧带复合体急性损伤常常与"跌打碰撞"有关,属中医"虎眼里缝伤筋""膝部筋伤"的范畴,刘寿山根据其损伤特点,采用独创的盘膝拔伸推捋的骨伤科推拿手法,结合经验用方消肿化瘀散外敷联合治疗,临床治疗效果显著.本文通过总结刘寿山手法联合方药辨治膝内侧副韧带复合体急性损伤的干预方案,围绕本病病因病机并结合临床进行探讨,为临床诊疗提供些许借鉴.

Objective:To establish a simple and explainable model and provide reference for improving the accuracy of model prediction in similar research.Methods:The data（heart failure grade and related factors） of 200 patients with pulmonary fibrosis complicated with heart failure in a research project supported by the National Natural Science Foundation of China（81673904） were collected.The Lasso regression was employed to screen out the characteristic variables from sex, age, body mass index（BMI）,systolic blood pressure（SBP）,diastolic blood pressure, total cholesterol（TC）,fasting blood glucose, tongue color, tongue coating color, and traditional Chinese medicine（TCM） physique.A regression model was established to explore the relationship between the severity of heart failure and the characteristic variables.Results:After removal of the confounding factors in high-dimensional data, six characteristic variables were selected for the model, including BMI（0.006 357 091）,SBP（0.219 695 622）,TC（0.229 324 833）,red tongue（0.004 216 705）,thin white tongue coating（-0.825 660 057）,and thick yellow tongue coating（0.356 499 153）.The probability of severe heart failure was P=-33.632+0.006×BMI+0.220×SBP+0.229×TC+0.004×red tongue-0.826×thin white tongue coating+0.356×thick yellow tongue coating.Conclusion:The established model can explain the factors associated with severe heart failure and be applied to the prediction in the population.Lasso regression model is suitable for high-dimensional data analysis of TCM clinical research, demonstrating the value for promotion.

Objective To explore the therapeutic effect and mechanism of C225, an EGFR inhibitor, on the brain injury of fetal rats infected during pregnancy. Methods The brain injury model of infected fetal rat during pregnancy was established by intraperitoneal injection of LPS. The pregnant rats were treated with C225（250 nm）. The content of inflammatory factors and oxidative stress markers in brain tissue of fetal rats were detected by the kit. The content of M1 and M2 microglial markers was detected by PCR, The phosphorylation and protein expression of EGFR were detected by Western blot. Results In LPS-induced brain injury of the fetal of pregnant rats, the content of inflammatory factors in the brain tissue of the fetal rats increased, and the level of oxidative stress increased. The content of M1 microglia markers increased, while M2 microglia markers decreased. The level of EGFR phosphorylation and protein expression increased. C225 reduced the content of inflammatory factors and the level of oxidative stress in the brain tissue of LPS-induced fetal rat infected during pregnancy, C225 reduced the content of M1 microglial markers and increased the content of M2 microglial markers. C225 decreased the phosphorylation and protein expression of EGFR in the brain of fetal rats. Conclusion The EGFR inhibitor C225 alleviates LPS-induced brain injury in pregnant infected fetal rats by inhibiting the conversion of M2 microglia to M1.

骨属中医五体之一,具有支撑形体、保护内脏、储藏骨髓、构成运动基础结构等重要功能.骨骼的功能需要五体的配合,与肾、肝、脾等多个脏腑及经络相关.骨病的治疗应强调多脏同治、内外同治、动静结合.中药治疗骨病注重从肾、肝、脾等脏腑调治,补肾壮骨、养肝柔筋、健脾助运相配合.临床上,根据不同骨病病机,治疗用药的补肾、养肝、健脾各有侧重,同时常可配合补肾调督、清热利湿、解毒散结、活血化瘀等法.骨病的外治法包括针刺、艾灸等,中医外治法治疗骨骼疾病独具优势.骨病患者在静养之余,适当配合运动,可促使五体协调,气血畅通,有利于骨病康复.

Purpose: The aim of this study was to evaluate the cost-effectiveness of a recently approved first-line therapy (adebrelimab plus chemotherapy vs. chemotherapy alone) for patients with extensive-stage small-cell lung cancer (ES-SCLC) in the US and China, and to estimate the reasonable range of adebrelimab price from the decision-makers. Methods: Several partitioned survival models were built to compare the cost and effectiveness of adebrelimab plus chemotherapy vs. chemotherapy alone over a 10-year time horizon. Clinical efficacy and safety data were extracted from the CAPSTONE-1 trial. Costs and utilities were obtained from previously published studies. Sensitivity, scenario and subgroup analyses were performed to explore the uncertainty of the model outcomes. Price simulation was conducted at three thresholds of willingness-to-pay (WTP), including WTP of $100,000 in the US and of $37,422 in China, 0.5WTP of $50,000 in the US and of $18,711 in China, and 1.5WTP of 150,000 in the US and of $56,133 in China. Findings: Base-case analysis at $1382.82/600 mg of adebrelimab price indicated that adebrelimab plus chemotherapy would be cost-effective in the US at the WTP threshold of $100,000, but not in China at the WTP threshold of $37,422. If PAP was taken into account, the regimen would be cost-effective in China at the given WTP. The results of price simulation indicated that adebrelimab plus chemotherapy was completely favored in the US if adebrelimab price was less than $8894.98/600 mg (total quality-adjusted life years [QALYs] were calculated with progression-based utility [PB-utility]) or $8912.51/600 mg (total QALYs were calculated with time-to-death utility [TTD-utility]) at the WTP threshold of $100,000; if adebrelimab price was reduced by at least $202.03/600 mg (total QALYs were calculated with PB-utility) or $103.06/600 mg (total QALYs were calculated with TTD-utility), the regimen was also cost-effective in China without PAP at the WTP threshold of $37,422. The above results were stable in the sensitivity analyses. Subgroup analysis found that the subgroup with better survival benefits tended to have a higher probability of cost-effectiveness, which was also associated with adebrelimab price. Implications: First-line adebrelimab plus chemotherapy represented a dominant treatment strategy comparing with chemotherapy alone in the US and also did in China with PAP at $1382.82/600 mg of adebrelimab price. Decision-makers could benefit from pricing strategy provided by this study in making optimal decisions. More evidences were needed to verify and improve the results.

ObjectivesClear evidence is lacking regarding the outcomes of autogenous tooth trans-plantation (ATT) of third molars with complete root formation. The current review aims to explore the long-term survival and complication rates.MethodsA comprehensive search was performed in December 2022 of the PubMed, Sco-pus, Embase, EBSCO, Ovid, Science Direct, and Web of Science databases. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered at the In-ternational Prospective Register of Systematic Reviews (CRD42022337659). The pooled survival, root resorption, and ankyloses rates were calculated. Subgroup analyses were performed to explore the effects of sample size and 3D tech-niques.ResultsTwelve studies from 5 countries fulfilled the eligibility, with 759 third molars trans-planted in 723 patients. Five studies reported 100% survival at 1-year follow-up. After excluding these 5 studies, the pooled survival rate was 93.62% at 1 year. The survival rate of 1 large sample study was significantly higher than that of small ones at 5 years. The complications of studies using 3D techniques were: root resorption 2.06% (95% CI: 0.22, 7.50) and ankyloses 2.81% (95% CI: 0.16, 12.22), compared to those without 3D techniques: root resorption 10.18% (95% CI: 4.50, 17.80) and ankyloses 6.49% (95% CI: 3.45, 10.96).ConclusionsATT of third molars with complete root formation is a reliable alternative for re-placement of a missing tooth and has a promising survival rate. The use of 3D techniques can reduce complication rates and improve long-term survival.