The standardized workflow of computer-aided static guided implant surgery includes preoperative exami-nation,data acquisition,guide design,guide fabrication and surgery.Errors may occur at each step,leading to irrevers-ible cumulative effects and thus impacting the accuracy of implant placement.However,clinicians tend to focus on fac-tors causing errors in surgical operations,ignoring the possibility of irreversible errors in nonstandard guided surgery.Based on the clinical practice of domestic experts and research progress at home and abroad,this paper summarizes the sources of errors in guided implant surgery from the perspectives of preoperative inspection,data collection,guide de-signing and manufacturing and describes strategies to resolve errors so as to gain expert consensus.Consensus recom-mendation:1.Preoperative considerations:the appropriate implant guide type should be selected according to the pa-tient's oral condition before surgery,and a retaining screw-assisted support guide should be selected if necessary.2.Da-ta acquisition should be standardized as much as possible,including beam CT and extraoral scanning.CBCT performed with the patient's head fixed and with a small field of view is recommended.For patients with metal prostheses inside the mouth,a registration marker guide should be used,and the ambient temperature and light of the external oral scan-ner should be reasonably controlled.3.Optimization of computer-aided design:it is recommended to select a handle-guided planting system and a closed metal sleeve and to register images by overlapping markers.Properly designing the retaining screws,extending the support structure of the guide plate and increasing the length of the guide section are methods to feasibly reduce the incidence of surgical errors.4.Improving computer-aided production:it is also crucial to set the best printing parameters according to different printing technologies and to choose the most appropriate postpro-cessing procedures.

Objective:Early identification of ischemic stroke patients with large vessel occlusion can improve referral efficiency and shorten reperfusion time. The purpose of this study was to analyze the characteristics of patients with large vessel occlusion and identify factors that could predict large vessel occlusion.Methods:The clinical data of 432 patients with ischemic stroke treated through emergency green channel were retrospectively analyzed, and the differences between the large vessel occlusion group (LVO group) and the non-large vessel occlusion group (non-LVO group) were compared, and two independent risk factors of the LVO group were screened out by logistics regression analysis: baseline NIHSS score and D-dimer value. The predicted cutoff values of NIHSS score and D-dimer were further determined by the receiver operating characteristic (ROC) curve.Results:A total of 432 patients with ischemic stroke had complete imaging data, with a mean age of 68.5±12.4 years, including 275 (63.7%) males, and 245 (56.7%) in the LVO group and 187 (43.3%) in the non-LVO group. Age, hemorrhagic transformation, thrombolytic therapy, endovascular treatment, atrial fibrillation, baseline NIHSS score [14.0 (6.0-20.0) vs. 3.0 (1.0-6.0), P<0.05], and D-dimer value at admission [0.9(0.4-2.3) mg/L vs. 0.3 (0.2-0.5)mg/L, P<0.05] were statistically significant different between the two groups. Multivariate Logistic regression analysis showed that higher baseline NIHSS score( OR=1.22,95% CI: 1.17-1.27)and higher D-dimer value( OR=3.10,95% CI: 2.14-4.47)were independent risk factors for large vessel occlusion. Baseline NIHSS score combined with D-dimer value was a good predictor of large vessel occlusion(AUC 0.85 [0.81-0.89]). ROC curve suggested that NIHSS score >6.5 and D-dimer >0.57 mg/L were the cutoff values for predicting large vessel occlusion. Conclusions:Higher baseline NIHSS score and D-dimer value are valuable for early prediction of large vessel occlusion, patients with NIHSS score >6.5 points and D-dimer >0.57 mg/L should be promptly transported to an advanced stroke center for treatment.

Objective:To integrate the best evidence of non-drug intervention of urinary incontinence in elderly women and to formulate practical recommendations.Methods:In this systematic review study, using “elderly woman”,“urinary incontinence”,“bladder training”,“pelvic floor muscle training”,“enuresis”,“leakage of urine” as the key words, the 6S evidence resource pyramid model was used to search in British Medical Journal best practice, Uptodate, World Health Organization, Guidelines International Network, National Institute for Health and Care Excellence, Chinese Medical Association, Scottish Intercollegiate Guideline Network, Registered Nurses Association of Ontario, Cochrane Library, The Joanna Briggs Institute (JBI), New Zealand Guidelines Group, Polish Society of Gynecologists and Obstetricians, PubMed, Embase, Medline, Web of Science, SinoMed, China National Knowledge Infrastructure, WanFang Data, etc. The evidence retrieved included evidence-based knowledge base resources, clinical practice guidelines, expert consensus, systematic review, etc. Data were retrieved from January 1, 2017 to May 1, 2022, and collated from May 2, 2022 to May 25, 2022. Two researchers independently evaluated the quality of literature and extracted data using the AGREE Ⅱ and JBI evidence-based health care center assessment tools. The JBI evidence-based health care center′s evidence pre-rating system and evidence recommendation rating system were applied to rank the evidence; and under the guidance of the evidence structure of JBI, the strength of evidence recommendation was determined and the best evidence was extracted and summarized in combination with the study group discussion and expert opinion.Results:A total of 9 articles were retrieved, including 7 guidelines and 2 systematic reviews; and 6 guidelines were classified as Grade A and 1 as grade B; both 2 systematic reviews were rated as Grade A; 84% (27/32) of the items were evaluated as “Yes”. Evidence were summarized as 34 pieces of best evidence from 6 dimensions, including “overall recommendation, evaluation of type and degree of urinary incontinence, lifestyle change, behavioral therapy, prevention of precipitating factors, intervention in special population”; the flow chart of screening, evaluation, special symptoms, life style and behavior therapy was combed, and the practical suggestions were formed.Conclusions:The overall quality of the literature on non-drug intervention of urinary incontinence in elderly women is high, and the level of evidence is high. Early identification of urinary incontinence types and assessment of disease severity, lifestyle changes, avoidance of predisposing factors and behavioral therapy are the key to non-drug treatment of urinary incontinence in those patients.

Objective To explore the feasibility of 3D printed individualized applicator for the intracavitary HDR-brachytherapy for nasopharyngeal carcinoma.Methods CT scan was performed in 1 case of recurrent rT1 nasopharyngeal carcinoma and 1 case of T2 residual nasopharyngeal carcinoma and the obtained images were transmitted to 3D image processing software.The geometric contour parameters of the nasopharyngeal cavity were obtained and a pipeline was designed to make it close to the recurrent gross tumor volume (rGTV).Individualized cavity applicators were created by using 3D printer.The applicator was inserted into the patient's nasopharyngeal cavity through oral cavity.The source tube and false source were inserted into the preset pipe of the applicator.CT scan was performed again and the images were transmitted to the 3D brachytherapy planning system.Mter delineating the target volume and organ at risk,treatment plan was optimized.After completing the first treatment,the applicator was removed.Before second treatment in a few days,CT scan was reviewed to confirm whether the position was correct.Results When the applicator was inserted into the nasopharyngeal cavity,it could be fully aligned with the nasopharyngeal wall and self-fixed without additional fixation measures.Comparing the location of false source in multiple reviews of CT scan,the error was ≤ 1 mm.No significant discomfort was reported throughout the treatment.In optimized three-dimensional treatment,100％ prescription dose curve included the full rGTV,maximum dose of the brain stem and spinal cord was＜30％ prescription dose.Recurrent patients were given with a prescription dose of DT 40Gy/8 fractions/4 weeks and patients with residual tumors were given with 12Gy/2 fractions/1 week.No tumor recurrence was observed at postoperative 3 months in two cases.Conclusions The 3D printed individualized nasopharyngeal intracavitary applicator has the advantages of self-fixation,accurate location,good repeatability and good patient tolerance.The short-term outcome is effective,whereas its long-term clinical effect and adverse reactions need to be further observed.

Objective Exploration of the titanium surface nano structure on the cellular bioactivity is of great significance to modifying the pure titanium surface. The unique cluster-like anatase/rutile nanowires (AR@NWs)was prepared and we further examined whether this surface was beneficial for early biological reaction in osteoblast.Methods Unique cluster-like anatase/rutile NWs(AR@NWs)was generated by using a simple hy-drothermal reaction via a three-step synthesis process.The crystal structure of nanowires on titanium surface was de-tected by X-ray diffractometer. The biological activity of nanowires was studied using in vitro cellular experiments. Results The AR@NWs was with a diameter of 200 nm. Three different types of NWs were generated during the production process,displaying different crystal structure and biological characteristics but similar surface topogra-phy and wettability.Compared with sodium titanate NWs(STi@NWs)and H2Ti2O5nanowires(HTi@NWs),AR@NWs surface was conductive to cell attachment. The data indicated that the surface titanium chemical composi-tion and crystal structure played an important role in the cell early response.To some extent,the generation of ana-tase and rutile compensated the cell-repelling properties of NWs. Conclusion Not only the surface physical prop-erties such as surface topography but also the surface chemistry plays an important role in promoting the cell early bioactivity.

Because nanoparticles have particular characteristics, such as small size and surface effects, nano-TiO2 is widely used in air purification, wastewater treatment and self-cleaning. In recent years, TiO2 photocatalysis has thoroughly explored as a new titanium implant surface treatment method. Photocatalytic performance is better for TiO2 nanowires than for nano-TiO2 particles. Hence, these nanowires have received widespread attention with regard for their more specific surface area and surface energy, improved charge carrier transport efficiency, and enhanced charge collection efficiency. Photon-generated carrier transport moves in a one dimensional straight path along a nanowire, and this could decrease photoelectron loss. In this paper, we summarized the principles underlying, factors that influence, and applications involving TiO2 nanowire photocatalysis. Additionally, we describe its method of preparation and toxicity.

Objective To evaluate the clinical outcomes of severely resorbed edentulous mandibles with tilted implants and fixed prostheses. Methods Ten patients with severely resorbed edentulous mandibles were en-rolled. Each patient received 4 implants,two posteriors placed tilted implants. Immediate loading of tilted implants were applied in all cases using a fixed provisional prosthesis. All patients were finalized 3-4 months with fixed pros-theses. Results 40/40 implants with initial torque(>35N.cm)were followed 1-1.5 years presenting 100%surviv-al. Conclusion The method of using tilted implants and fixed prostheses in the cases of severely resorbed edentu-lous mandibles can achieve an ideal short-term and medium-term effects.

Objective: To examine the root position of the maxillary central incisors and to provide clinical reference before the immediate implant placement. Methods: Cone-beam CT (CBCT) data of the maxillary central incisors of 934 patients (934 incisors) was selected and the root position classsified. The sagittal root position in the alveolar bone was classified as buccal, middle, or palatal. The buccally positoined type was further classified into three subtypes of Ⅰ,Ⅱ, and Ⅲ. Results: Most of the maxillary incisor root (95.4% [891/934]) was positioned buccally. Among the buccal-type incisors, the subtypes Ⅰ, Ⅱ and Ⅲ accounted for 47.5% (423/891), 44.2% (394/891), and 8.3% (74/891). In the 4 mm apical to the cemento-enamel junction and the middle of the root, the thickest buccal bone wall was 0.86 and 0.95 mm, the thickest palatal bone wall was 1.65 and 2.37 mm. In the apical location, the thickest buccal bone wall was 1.89 mm, the thickest palatal bone wall was 7.83 mm. Conclusions Most of the maxillary central incisors studied are positioned buccally, and half of these patients have adequate buccal bone and are suitable for immediate implant placement.

Background and objectiveAdenosquamous carcinoma (ASC) is a rare subtype of lung cancer, it is mixed glandular and squamous cell carcinoma with a more aggressive behavior and poor prognosis than the other histologic subtypes. hTe aim of the study was to explore the clinicopathological characteristics and prognostic factors of ASC.Methods A total of 72 patients were enrolled. We investigated clinicalpathological features and prognostic factors retrospectively.Results hTe overall 72 ASC patients’ median age was 34.7 months, 5-year survival rate was 14.9%. hTe inlfuence of tumor size, M stage, and N stage, gene mutation and surgery on the prognosis of patients show statistical signiifcance.Conclusion ASC is charac-terized by both histologic aggressiveness and adverse prognosis. We suggest the comprehensive therapy based on surgery, and given small molecule tyrosine kinase inhibitors (TKIs) treatment may prolong patients’ overall survival.

Objective:To assess the clinical efficacy of two different diameter Osstem MS one-stage implant restoration of small edentu-lous space in the mandibular anterior region.Methods:85 patients were treated by Osstem MS one-stage implant with the diameter of 2.5 mm(n =66)and 3.0 mm(n =66)respectively for the restoration of small edentulous space in mandibular anterior region.The mesi-al and distal marginal bone level and soft tissue were statistically analyzed after 1 2 and 24 months of functional load.The implant survival rate was evaluated according to Wheeler's survival criteria.Results:The survival rate of the implants was 1 00%.The mean changes in marginal bone level(mm)on the mesial side of 2.5 mm and 3.0 mm diameter implants were 0.275 ±0.638 and 0.098 ±0.31 9,distal aspects were 0.360 ±0.588 and 0.1 09 ±0.323 after 1 2 months of functional load;while 0.299 ±0.672 and 0.099 ±0.31 8,0.381 ± 0.581 and 0.1 07 ±0.31 9 after 24 months of functional load.The mesial and distal marginal bone loss of 2.5 mm diameter implant was greater than that of 3.0 mm after 1 2 and 24 months of functional load(P <0.05).No significant change on the marginal bone level was found aomog the same diameter implants from 1 2 to 24 month observation(P >0.05).No relevant complication of peri-implant soft tissue was shown.Conclusion:Favorable clinical effects including function and aesthetics can be achieved by Osstem MS one-stage implant with the diameter of 2.5 mm or 3.0 mm for the restoration of small edentulous space in the mandibular anterior region,however,the mar-ginal bone loss was greater around 2.5 mm diameter implant.