Objective: To investigate the effect of a free pit and fissure sealing program for caries prevention on first permanent molars (six-year molars) in Haizhu District, Guangzhou, three years after its implementation in 2019. The study aims to provide a reference for the future development of pit and fissure sealing programs for children’s first permanent molars and the effective prevention and treatment of permanent tooth caries in children. Methods: A random sampling method was used. In 2022 October, 270 sixth-grade primary-school students in Haizhu District, Guangzhou, who had participated in the free pit and fissure sealing program for their first permanent molars in 2019, were placed in the sealant group. Another 223 age-matched students from the same schools who met the criteria for the pit and fissure sealing but did not participate in the program were placed in the control group. The first permanent molars of students in both groups were examined. The retention status of the sealant and the caries status of the first permanent molars were recorded for the sealant group, and the caries status of the first permanent molars was recorded for the control group. The 2022 results were compared with the results of a prior pit and fissure sealing program implemented in Haizhu District in 2011, three years after its implementation. Results: Compared with the control group, the caries rate in the sealant group decreased (15.56% vs. 21.52%, P>0.05), the caries detection rate was significantly lower (6.12% vs. 9.00%, P<0.001), and the mean number of decayed teeth was significantly reduced (0.19 vs. 0.37, P<0.001). Compared with the results of the pit and fissure sealing program in Haizhu District in 2011 (in 2014, the retention rate of the first permanent molar sealant was 65.56%, the intact rate was 42.25%, and the protection rate was 38.34%), the results of the pit and fissure sealing program in Haizhu District in 2019 [in 2022, the retention rate of the first permanent molar sealant was 86.09% (P<0.001), the intact rate was 47.00% (P<0.001), and the protection rate was 51.97%] were improved. Conclusion The quality of the pit and fissure sealing program for the first permanent molars in Haizhu District, Guangzhou in 2019 was good. It reduced the caries detection rate, and the retention rate of the sealant was maintained at a high level. However, the intact rate was less than 50%; therefore, it is necessary to vigorously promote oral-health education and examinations in all age groups, and to be attentive to the re-examination and re-sealing of fissure sealants.

[Objective] To investigate the clinical features and treatment of renal cell carcinoma unclassified with medullary phenotype (RCCU-MP), so as to improve the clinical understanding of this disease. [Methods] The clinical data of 2 patients with pathological diagnosis of renal medullary carcinoma (RMC) in Zhujiang Hospital during 2019 and 2023 were retrospectively analyzed, and relevant literature was reviewed. [Results] Both patients had symptoms of backache, and imaging examination indicated renal space-occupying lesions.Case 1 was diagnosed as RMC by renal biopsy, and case 2 was pathologically diagnosed as RMC after surgery.Both cases lacked evidence of sickle cell trait or sickle cell disease, and were finally diagnosed as RCCU-MP.Case 1 did not receive antineoplastic therapy and died 5 months after diagnosis.Case 2 underwent laparoscopic nephrectomy, and then received gemcitabine + paclitaxel chemotherapy + immunotherapy.The patient's tumor progressed gradually after first-line treatment was abandoned due to concurrent hematologic infection, and he eventually died 7 months after surgery. [Conclusion] The clinical features of RCCU-MP are partially similar to those of RMC.The diagnosis of RCCU-MP requires pathological examinations and should exclude sickle cell trait or sickle cell disease.Due to the aggressive nature of the tumor, the prognosis of patients is poor.

Objective: To investigate the clinical effects of sinus elevation surgery and implant restorationdue to insufficient bone massafter tooth extraction in patients with odontogenic maxillary sinusitis (OMS) and to provide a reference for use in clinical practice. Methods: This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Forty-five teeth were extracted from patients with OMS in the maxillary posterior area (the study group). Sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction in the study group. Forty-eight teeth were extracted from patients without "OMS" in the maxillary posterior area (the control group), and sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction inthe control group. In the study group, 13 cases of discontinuous maxillary sinus floor bone and residual alveolar bone height of the maxillary sinus floor less than 4 mm were addressed with lateral wall sinus elevation, and the other 32 cases were addressed with crest-approach sinus elevation. In the control group, 8 cases of residual alveolar bone height less than 4 mm in the maxillary sinus floor were addressed with lateral wall sinus,and the other 40 cases were addressed with crest approach sinus elevation. Restorations were placed 6 to 8 months after surgery. The patients were followed up 21 days, 3 months, and 8 months after implantation and every 6 months after the placement of the restorations. The sinus bone gain (SBG), apical bone height (ABL) and marginal bone loss (MBL) were statistically analyzed 24 months after the restoration. Results: The average preoperative mucosal thickness in the 45 patients in the study group was (1.556 ± 0.693) mm, which was significantly larger than that in the control group (1.229 ± 0.425) mm (P<0.001). There were no perforations in either group. Twenty-four months after restoration, there was no significant difference in the SBG, ABH or MBL between the two groups (P>0.05). Conclusion After the extraction of teeth from patients with OMS, the inflammation of the maxillary sinus decreased, and the bone height and density in the edentulous area were restored to a certain degree. The effects of sinus floor lifting surgery and implant restoration do not differ between patients with and without OMS.

Gallbladder carcinoma is a common malignant tumor of the biliary system characterized by poor specificity of early symptoms， a high degree of malignancy， and rapid progression， and it is difficult to make an early diagnosis. Gallstones and gallbladder polyps are considered the most common risk factors for gallbladder carcinoma. Ultrasound is the preferred examination， while CT， MRI， and PET also have their own advantages. There is a lack of radical treatment methods for gallbladder carcinoma， and surgical operation remains the preferred treatment method for gallbladder carcinoma； however， due to the rapid progression of this disease， most patients have lost the opportunity for surgery at the time of diagnosis. A combination of various treatment modalities， such as radiochemotherapy， targeted therapy， and immunotherapy， has improved the prognosis of patients to a certain extent， but with an unsatisfactory long-term therapeutic effect. Therefore， it is of particular importance to give priority to prevention rather than treatment and emphasize early identification and treatment.

Objective: To investigate the clinical effect of concentrated growth factor (CGF) applied in guided bone regeneration (GBR) for severe bone deficiency in the anterior maxilla. Methods : Forty patients with bone defects in the anterior maxilla were chosen to be treated with GBR, 20 patients were treated with CGF applied in GBR as the observation group, and the other 20 patients were treated only with GBR as the control group. The evaluation of wound healing was performed after the operation, and bone augmentation was evaluated half a year after the operation. Results: The first-stage healing rate of soft tissue wounds in the observation group was 100% and 75% in the control group, and the primary healing rate in the observation group was better than that in the control group (P=0.017). The changes in bone width of the observation group were （3.70 ± 0.28） mm, and those of the control group were （2.96 ± 0.16） mm. The bone augmentation in the observation group was higher than that in the control group (P=0.000). Conclusion CGF applied in GBR has a good effect on bone augmentation for severe bone deficiency in the anterior maxilla.

Objective:This study uses two markers of resting-state functional MRI (r-fMRI) to investigate changes in spontaneous neural activity and their correlation with postpartum depression (PPD) severity.Methods:A total of 15 individuals with PPD, who met the diagnostic criteria for DSM-5 unipolar depression, 24-Item Hamilton Depression Scale (HAMD 24) scores greater than 20, Edinburgh Postnatal Depression Scale (EPDS) score≥12, and 16 postpartum healthy mothers (control group) matched with age and education were examined using r-fMRI. Two-sample t-test was used to compare the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values between groups. Pearson correlation analysis was used to determine the correlation between the ALFF and ReHo of the abnormal brain region and the HAMD 24 and EPDS scores. Results:Compared with the healthy control (HC), PPD showed increased ALFF in the right cerebellum anterior lobe culmen and the left dorsolateral prefrontal cortex (DLPFC), and decreased ALFF in the right parietal lobe (individual voxel P<0.005, cluster size >10 voxels, Alphasim correction). PPD had increased ReHo values in the left superior?frontal?gyrus,?orbital?part, inferior?frontal?gyrus,?orbital?part, middle?frontal?gyrus, precuneus, inferior?parietal lobule than HC. Decreased ReHo values were found in the right inferior?occipital?gyrus, inferior?frontal?gyrus, frontal lobule and left cerebellum inferior semi-lunar lobule (individual voxel P<0.005, cluster size>10 voxels, Alphasim correction). The ALFF value of the left DLPFC was positively correlated with the HAMD 24 score in PPD ( r=0.585, P=0.022). Age, body mass index and education years of each subject was included as covariates, partial correlation coefficient was still statistically significant ( r = 0.561, P = 0.046). Conclusion:This r-fMRI study suggested that changes in the spontaneous neural activity of these regions were related to emotional responses. PPD cases with high ALFF values in the left DLPFC had severe depression.

Objective:This study uses two markers of resting-state functional MRI (r-fMRI) to investigate changes in spontaneous neural activity and their correlation with postpartum depression (PPD) severity.Methods:A total of 15 individuals with PPD, who met the diagnostic criteria for DSM-5 unipolar depression, 24-Item Hamilton Depression Scale (HAMD 24) scores greater than 20, Edinburgh Postnatal Depression Scale (EPDS) score≥12, and 16 postpartum healthy mothers (control group) matched with age and education were examined using r-fMRI. Two-sample t-test was used to compare the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) values between groups. Pearson correlation analysis was used to determine the correlation between the ALFF and ReHo of the abnormal brain region and the HAMD 24 and EPDS scores. Results:Compared with the healthy control (HC), PPD showed increased ALFF in the right cerebellum anterior lobe culmen and the left dorsolateral prefrontal cortex (DLPFC), and decreased ALFF in the right parietal lobe (individual voxel P<0.005, cluster size >10 voxels, Alphasim correction). PPD had increased ReHo values in the left superior?frontal?gyrus,?orbital?part, inferior?frontal?gyrus,?orbital?part, middle?frontal?gyrus, precuneus, inferior?parietal lobule than HC. Decreased ReHo values were found in the right inferior?occipital?gyrus, inferior?frontal?gyrus, frontal lobule and left cerebellum inferior semi-lunar lobule (individual voxel P<0.005, cluster size>10 voxels, Alphasim correction). The ALFF value of the left DLPFC was positively correlated with the HAMD 24 score in PPD ( r=0.585, P=0.022). Age, body mass index and education years of each subject was included as covariates, partial correlation coefficient was still statistically significant ( r = 0.561, P = 0.046). Conclusion:This r-fMRI study suggested that changes in the spontaneous neural activity of these regions were related to emotional responses. PPD cases with high ALFF values in the left DLPFC had severe depression.

Objective To study the clinical, laboratorial, histopathological, imaging features of two cases of hypothyroid myopathy. Method Clinical manifestations, thyroid function, electromyography, muscle MRI, muscle biopsy and follow-up results were collected, and analyzed with the literature. Result These two patients were middle-age to old age and the onset of disease was insidious. Their common clinical manifestations included subacute progressive weakness in the proximal muscles,myalgia after sports and reduction in tendon reflex.The blood test showed an increase in serum concentration of CK and TSH, and a decrease in FT3 and FT4. The electromyography showed suspicious myogenic damage.Muscle histopathological findings were largely nonspecific,such as type I fiber predominance and type 2 atrophy. The MRI revealed extensive muscular dystrophy and fatty filtration in the posterior group of thighs. Treatment of replacement therapy with L-T4 relieved the myopathic symptoms quickly. Conclusion When a patient presents with a subacute progressive weakness in the proximal muscles, the hypothyroidism should be consideration. Muscle histopathological findings may be nonspecific. The muscle MRI have a value of differential diagnosis and lesion assessment.

Objective:To explore clinical significance of sinus heart rate turbulence (HRT) phenomenon in aged pa‐tients with stable angina pectoris (SAP) .Methods :A total of 120 aged SAP patients ,who received 24h DCG in our hospital from Jan 2013 to Oct 2015 ,were selected as SAP group .Meanwhile ,another 144 aged patients ,who re‐ceived 24h DCG examination simultaneously and coronary angiography results were normal ,were regarded as nor‐mal control group .According to coronary lesion severity ,SAP group was further divided into single vessel coronary disease group (single vessel group ,n=35) ,double‐vessel coronary disease group (double‐vessel group ,n=48) and multi‐vessel coronary disease group (multi‐vessel group ,n=37) .The 24h DCG ,HRT indexes ,including turbulence onset (TO) and turbulence slope (TS) ,were measured and compared among all groups .Results:Compared with normal control group ,there was significant rise in TO [(0.77 ± 0.37)% vs .(1.26 ± 0.92)% ] and significant reduc‐tion in TS [(5.45 ± 4.02) ms/RR interval vs .(1.53 ± 0.70) ms/RR interval] ,P<0.01 both ;significant rise in ab‐normal rates of TO (19.44% vs .42.50% ) ,TS (15.97% vs .31.67% ) and TO + TS (11.11% vs .30.83% ) in SAP group ,P<0.01 all .Compared with single vessel group ,there was significant rise in TO [(0.66 ± 0.22)% vs .(1.28 ± 1.11)% vs .(1.46 ± 1.20)% ] and significant reduction in TS [ (2.04 ± 0.82) ms/RR interval vs .(1.66 ± 0.38) ms/RR interval vs .(1.29 ± 0.58) ms/RR interval] in double‐vessel group and multi‐vessel group ,and TO of multi‐vessel group was significantly higher than that of double‐vessel group ,TS of multi‐vessel group was significantly low‐er than that of double‐vessel group , P<0.01 all .Conclusion:Sinus heart rate turbulence can be used as risk predic‐tor for aged patients with stable angina pectoris ,which can provide basis for clinical effective treatment and progno‐sis assessment .

Objective To develop a multiplex touchdown PCR for simultaneous detection of extended-spectrum β-lactamases (ESBLs )-producing Enterobacteriaceae and methicillin-resistant Staphylococcus aureus (MRSA ). Methods Blood culture positive specimens from 102 hospitalized patients were collected between March 2013 and September 2014,four pairs of specific primers were designed based on SHV,TEM,and OXA genes of ESBLs-pro-ducing Enterobacteriaceae and MecA gene of MRSA,drug-resistant genes were amplified with single touchdown PCR and multiplex touchdown PCR, the results were compared with Kirby-Bauer disk diffusion method. Results Each single PCR amplified a specific band,four drug-resistant genes were also detected by multiplex touchdown PCR;the lower detection limits of multiplex touchdown PCR for DNA of MecA,SHV,TEM,and OXA were 4.37 ng,2.19 ng,4.53 ng,and 3.59 ng,respectively.Compared with Kirby-Bauer disk diffusion method, the overall sensitivity and specificity of multiplex touchdown PCR were 100.00% and 88.24% respectively,for ES-BLs were 100.00% and 87.23% respectively,for MRSA were both 100.00%.Conclusion A higher sensitivity and specificity multiple touchdown PCR assay has been developed,and it can be used in the rapid diagnosis and epidemi-ology investigation of bloodstream infection caused by ESBLs-producing Enterobacteriaceae and MRSA,and is help-ful for guiding antimicrobial use in clinic.