Objective: To investigate the diagnostic value of MRI-measured symptomatic condylar movement angle in assessing limited mouth opening among temporomandibular disorder (TMD) patients. Methods: A retrospective cross-sectional study was conducted. Patients with unilateral TMD who underwent their first temporomandibular joint (TMJ) MRI examination at the TMJ specialty clinic of Beijing Friendship Hospital, Capital Medical University, between July 2017 and June 2024 were enrolled. All patients were categorized based on maximum pain-free opening (MMO) as limited opening (MMO<38 mm) or unrestricted opening (MMO≥38 mm). Age-based groups included adults (≥18 years) and minors (<18 years). The same patient's TMJ were further classified as symptomatic or asymptomatic sides. Bilateral condylar angles were measured on sagittal MRI images of the condyles in the open-mouth position. The angular difference and mean values were calculated. Diagnostic performance for limited mouth opening was evaluated using area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, and specificity for each condylar angle metric. Differences in cut-off values between adult and minor groups were explored. Results: A total of 130 TMD patients aged [M(Q1, Q3)] 18.0 (15.0, 31.5) years were included, with 27 males (20.8%) and 103 females (79.2%). There were 59 cases (45.4%) who had limited mouth opening, while 71 cases (54.6%) did not have this symptom; 63 cases (48.5%) were minors, and 67 cases (51.5%) were adults. Among all patients, the AUC for diagnosing limited mouth opening using the symptomatic side condylar angle (0.880, 95%CI: 0.822-0.938) was higher than that using the asymptomatic side condylar angle (0.768, 95%CI: 0.687-0.848) and the bilateral condylar angle difference (0.727, 95%CI: 0.639-0.814) (both P<0.05). The condylar angle on the symptomatic side demonstrated a cut-off value of 89.0° for diagnosing limited mouth opening in the adult group, with a sensitivity of 96.7% and specificity of 83.8%; in the minor group, the cut-off value was 80.5°, with a sensitivity of 75.9% and specificity of 70.6%. The AUC for diagnosing limited mouth opening using the condylar angle on the symptomatic side in the adult group (0.968, 95%CI: 0.933-1.000) was significantly different from that in the minor group (0.779, 95%CI: 0.667-0.892) (P=0.002). Conclusions: The symptomatic condylar angle demonstrates high diagnostic efficacy for limited mouth opening in TMD patients. The cut-off value of the condylar angle differs between adult and minor patients.
Influenza is a common acute respiratory infectious disease in China, characterized by pronounced seasonality, rapid transmission, and a high risk of severe illness among high-risk populations. These features pose a substantial threat to public health. Historically, recommendations for influenza treatment and prophylaxis have largely relied on expert consensus in China, with a lack of systematic, evidence-based guidelines. In recent years, accumulating evidence on traditional antiviral agents such as neuraminidase inhibitors, as well as emerging agents targeting RNA polymerase, has expanded therapeutic options for influenza, underscoring the need to systematically update and refine existing treatment recommendations. Accordingly, a multidisciplinary panel of Chinese experts developed the"Clinical practice guidelines for the treatment and prophylaxis of influenza in China (2025 edition)"following established guideline methodology. This guideline focuses on antiviral therapy, adjunctive treatment, and prophylaxis, systematically summarizing and updating treatment indications, drug selection, dosing regimens, duration, and safety management across different populations. Specific recommendations are provided for key groups such as children and pregnant women. The guideline culminates in a series of evidence-based recommendations, providing structured and actionable guidance for the clinical management and prevention of influenza in China.
WHO published the WHO position paper on herpes zoster vaccines-July 2025 (hereinafter referred to as the position paper). This position paper was led by the Strategic Advisory Group of Experts on Immunization (SAGE) of the WHO. In March 2025, SAGE convened a meeting in Geneva, Switzerland. Eleven working groups from different fields of expertise participated in drafting the paper, with core members coming from China, France, Australia and the United States. The position paper recommends for the first time that countries where herpes zoster (HZ) is a significant public health problem incorporate zoster vaccination for older adults into their immunization programs, prioritizing recombinant zoster vaccine (RZV). Compared with the 2014 version, this version of the position paper provides the relevant data of RZV, and puts forward guiding opinions on target populations, immunization schedules, booster vaccinations, combined vaccinations, economic evaluations, HZ monitoring and future research directions. This paper analyzes the position paper's implications for HZ control and prevention in China: (1) clarifying target populations and vaccination strategies; (2) accelerating the research and development of HZ vaccines along multiple technical routes; (3) optimizing the adult vaccination service system; (4) strengthen HZ monitoring and post-marketing evaluation of vaccines; (5) strengthening the training of professionals and public health education; (6) promoting multi-departmental collaboration and policy support.
The deep integration of artificial intelligence (AI) is driving a profound transformation in the research paradigm of sports medicine. This article systematically reviewed the primary models of AI-sports medicine integration, including intelligent early warning for sports injury risks, intelligent diagnosis of musculoskeletal health issues, intelligent assistance of surgeries, and intelligent prediction of patient prognosis. It further analyzed the key challenges hindering deep integration, covering technical bottlenecks and data barriers, patient privacy and health equity risks, as well as the lack of regulatory and health insurance mechanisms. On this basis, systematic pathways for promoting high-quality development were proposed, including strengthening a clinical value-oriented technology research and development and transformation system, building a full-cycle data security and ethical governance framework for technologies, and improving value-based payment mechanisms and policy support environments. Through multi-dimensional and coordinated advancement, the potential of AI-sports medicine integration could be fully unleashed, achieving a leap from technological empowerment to health value creation, thereby providing robust support for the implementation of the"Healthy China 2030"strategy.
A retrospective analysis was conducted on the clinical data of patients with giant refractory gastric bezoars treated at Zhongda Hospital of Southeast University between January 2019 and May 2025. All patients underwent modified endoscopic holmium laser-yellow zebra guidewire loop combined lithotripsy. Follow-up gastroscopy was performed 4 weeks postoperatively to analyze the efficacy of this combined technique in treating giant refractory gastric bezoars. A total of 38 patients were included, including 14 males and 24 females, aged (66±12) years (44-88 years). Thirty-five patients successfully achieved bezoar removal after a single treatment session, with a single-session success rate of 92.1% (35/38). Postoperative complications, such as nausea, vomiting, gastric mucosal injury, or pain, occurred in 4 patients (10.5%). At the 4-week follow-up gastroscopy, the complete ulcer healing rate was 87.0% (20/23). The modified endoscopic holmium laser-yellow zebra guidewire loop combined lithotripsy is a safe and effective treatment for giant refractory gastric bezoars.
The incidence of osteoporosis increases significantly with age. When elderly patients require internal fixation due to degenerative changes or trauma in the thoracolumbar spine, concomitant osteoporosis considerably elevates surgical difficulty and risk. Common complications include screw loosening, internal fixation failure, and nonunion of bone grafts, posing substantial challenges to spine surgeons. Currently, there is a lack of relevant clinical standards or guidelines for the application of thoracolumbar internal fixation in elderly patients with osteoporosis. To address this gap, based on the principles of evidence-based medicine, integrating scientific rigor with practicality, conducting a systematic review and analysis of relevant literature, the Innovation and Transformation Group of the Chinese Orthopaedic Association and the Spine Trauma Group of the Chinese Association of Orthopaedic Surgeons and the Orthopedic Minimally Invasive Injury Professional Committee of Shaanxi Province Association of Orthopedic Surgeons jointly led an expert initiative leading to the development of this guideline. Recommendations are proposed primarily covering preoperative education, surgical strategies, intraoperative considerations, and postoperative rehabilitation, aiming to standardize the clinical application of this technique.
More and more studies have confirmed that robotic-assisted total knee arthroplasty (RATKA) can improve surgical accuracy and has a user-friendly learning curve. However, most current studies evaluating the learning curve use operative time as the standard of assessment, although proficiency does not equate to complete mastery of RATKA surgical techniques. This article will summarize experience from two perspectives: surgical technical pitfalls and non-surgical technical adverse events in RATKA. Regarding surgical techniques, it is essential to fully understand the differences in workflow and principles between RATKA and traditional total knee arthroplasty to avoid the occurrence of"unsatisfactory cases". At the non-surgical technical level, a comprehensive understanding of the various new complications that may arise during RATKA is necessary in order to consciously prevent adverse events. Ultimately, the robot will become a powerful tool for surgeons.
Objective: To quantitatively evaluate the efficacy, precision, and reproducibility of the surgical navigation module of a novel robotic-assisted anterior cruciate ligament reconstruction (ACLR) system during bone tunnel drilling using in vitro models. Methods: Thirty 3D-printed knee models were randomized into a robotic group (n=15) and a conventional group (n=15) using a random number table. Both groups utilized the same individualized surgical plans generated by the system's preoperative planning module. In the robotic group, bone tunnel drilling was guided by the system's mechanical arm; in the conventional group, drilling was performed manually by senior sports medicine surgeons using traditional instrumentation. Operative time was recorded. Postoperative bone tunnel lengths and tunnel exit positions in both groups were compared with the preoperative planning values among the three groups. Results: The total operative time was significantly longer in the robotic group [(25.83±2.20) vs (15.55±1.96) min, P<0.001], whereas the robotic group achieved a significantly shorter duration for the core bone tunnel drilling phase [6.08 (5.72, 6.75) vs 7.60 (6.80, 8.52) min, P=0.003]. There were no statistically significant differences among the three groups regarding the numerical values of the three length indicators (femoral and tibial tunnel lengths, intra-articular distance) or the four tunnel exit position dimensions (deep-shallow, high-low, anterior-posterior, medial-lateral) within the Bernard quadrant (all P>0.05). However, the variance in all positioning dimensions was significantly lower in the robotic group compared to the conventional group (all P<0.05), particularly in the femoral high-low and tibial anterior-posterior directions (both P<0.001), indicating superior consistency in robot-assisted operation. Conclusions: Robot-assisted ACLR technology improves efficiency during the critical drilling phase and significantly minimizes manual operational variability. These findings provide experimental evidence supporting the application of high-precision surgical navigation in ACLR.
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