Objectives: To identify any craniofacial morphological changes induced by a mandibular-repositioning oral appliance (MRA) and to explore the possibility of predicting the treatment response to MRA by cephalometric analysis in patients with obstructive sleep apnea (OSA). Methods: Seventy OSA patients [male/female: 63/7; age: (50.5±11.6) years; BMI: (27.6±4.6) kg/m2; AI: (34.9±21.3) episodes/hour; and oxygen saturation nadir: (66.3±16.5) %] were enrolled. MRA was fabricated individually for each patient after the consultation by a dentist. Polysomnographic (PSG) examination was repeated with MRA in place 3 months after the initiation of the MRA therapy. For cephalometric analysis, a pair of cephalograms of each patient was obtained, one with and another without MRA. Results and Conclusions: After 3 months' treatment, AI was (156±19.2) episodes/hour, significantly reduced compared with the pre-treatment average AI (34.9±21.3 episodes/hour,P<0.000 1). Oxygen saturation nadir improved from (66.3±16.5)% (pre-treatment) to (74.1±15.5)% (with MRA) (P<0.001). A reduction of AI≥50% was achieved in 42 patients. Insertion of MRA led to anterior shift of the mandible, increase in upper airway width and area and decrease in upper airway length. Those with evident retrognathia and longer anterior upper facial height were more likely to benefit from the MRA management.

Objective:To prepare for mAb of progesterone receptor. It would provide support for the immunohistochemistry behind. Methods:Target gene connected together with a carrier by seamless cloning method. The target protein that expression by inducing was collected. And with cell fusion method , the monoclonal antibodies were preparation. Then the mAb were detected by IHC. Results: The mAb ( clone 7C7 ) was detected and it found positive for the breast, uterine fibroid tissue, showed negative in colorectal cancer tissue, smooth muscle tissue, the goal of the claim were achieve. Conclusion: Finally, we found the method that prepare for mAb was far beyond our imagination. The result of IHC on different samples about mAb(7C7)obtained compliance with an-ticipation. Study on the difference between the PR-A and PR-B had significance.

ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio ［HR］=2.839, 95%confidence interval ［CI］: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.

Objective:To investigate the role of TRIZ theory in clinical teaching in orthopedic operating room.Methods:A total of 43 interns in the orthopedic operating room of our hospital from October 2019 to July 2020 were selected as control group, and 46 interns in the orthopedic operating room of our hospital from August 2020 to May 2021 were selected as observation group. The interns in the control group received traditional teaching, and those in the observation group received teaching based on TRIZ theory. The two groups were compared in terms of professional assessment results, self-evaluation, satisfaction score, and qualification of aseptic operation in orthopedic operating room. SPSS 22.0 was used to perform the t-test and the chi-square test. Results:Compared with the control group, the observation group had significantly higher theoretical knowledge score, practical skill score, and weighted total score ( t=14.90, 11.82, and 13.23, all P?0.001). Compared with the control group, the observation group also had significantly higher scores of analysis and problem-solving ability, clinical thinking, doctor-patient communication, psychological quality, clinical case analysis, self-study ability, and teaching satisfaction ( t=7.88, 11.78, 15.26, 7.94, 12.93, 9.83, and 13.22, all P?0.001). Compared with the control group, the observation group had significantly higher qualified rates of surgical hand-washing, wearing sterile surgical gowns, non-contact glove wearing; and bacteriological testing ( χ 2=4.22, 6.02, 4.92, and 7.59, P=0.040, 0.014, 0.027, and 0.006). Conclusion:TRIZ theory has a certain value in clinical teaching in orthopedic operating room and can significantly improve the scores of theoretical knowledge and practical skills, strengthen aseptic operation abilities in orthopedic operating room, and enhance the satisfaction with teaching among interns.

Objective To investigate the effect of real-time continuous monitoring system(RT-CGMS)on serum inflammatory factors and prognosis in patients with sepsis.Methods According to the prospective studies,patients were randomly divided into two groups Patients with sepsis were randomly divided into real-time continuous monitoring of blood glucose group and monitoring blood glucose meter group,of which the fasting serum tumor necrosis factor alpha(TNF-α) and interleukin-6(IL-6) and high sensitive C reactive protein (hs-CRP) were detected on the 1st,3rd,7th day.Meanwhile,insulin dosage,incidence of hypoglycemia and mortality rate of 28 days of patients in two groups were recorded,and the above indexes were analyzed.Results TNF-α,IL-6 and hs-CRP in the real-time continuous blood glucose monitoring group were (16.12±2.42)pg/ml、(112.37±17.39)pg/ml and(19.62±2.72)mg/L on the 7th day respectively,while TNF-α,IL-6 and hs-CRP in the blood glucose monitoring group were(23.46±3.12)pg/ml、(140.19±21.48)pg/ml and(25.42±2.54)mg/L on the 7th day,respectively.The decrease of TNF-α,IL-6 and hs-CRP in the continuous blood glucose monitoring group was more significant than that in the blood glucose monitoring group (P＜0.05).Insulin dosage in real-time continuous blood glucose monitoring group was (90.62±15.79)u,hypoglycemia rate was 5.4％,fatality rate was 10.81％ in 28 days of hospitalization,insulin dosage was (130.59±20.65)u,hypoglycemia rate was 22.85％,and fatality rate was 31.42％ in 28 days of hospitalization.There was significant difference between the two groups(P＜0.05).Conclusion For sepsis patients with stress hyperglycemia,a real-time continuous monitoring system combined with insulin therapy can improve the inflammatory response,and control blood glucose effectively as well as reduce mortality.

Objective:To evaluate the diagnostic performance of non-contrast-enhanced Dixon water-fat separation Compressed SENSE (CS-SENSE) whole-heart coronary magnetic resonance angiography (CMRA) at 3.0 T on patients with suspected coronary artery disease (CAD).Method:The study complied with the Declaration of Helsinki. Local ethics committee approved this study and written informed consent was obtained from each patient. In this prospective study, from March 2021 to September 2021, 53 consecutive participants with suspected CAD who were scheduled for X-ray coronary angiography (CAG) were prospectively recruited in Zhongshan Hospital. CMRA was performed with a 3.0 T scanner without contrast agent enhancement during free breathing with Dixon water-fat separation and CS-SENSE methods. The accuracy of CMRA for detecting a ≥ 50% reduction in diameter was determined using CAG as the reference method.Results:Acquisition of whole-heart CMRA images was successfully performed in 46 (86.8%) of 53 patients with an average imaging time of (7.8±1.8) min. The sensitivity, specificity, positive predictive values, negative predictive values, and accuracy of CMRA according to a patient-based analysis were 95.8%(95%CI 78.9%-99.9%), 81.8%(95%CI 59.7%-94.8%), 85.2%(95%CI 66.3%-95.8%), 94.7%(95%CI 74.0%-99.9%), 89.1%(95%CI 76.4%-96.4%), respectively. The areas under the receiver-operator characteristic curve (AUC) from CMRA images according to patient-, vessel-and segment-based analyses were 0.876(95%CI 0.745-0.955), 0.880(95%CI 0.814-0.929), 0.903(95%CI 0.877-0.926), respectively.Conclusion:3.0 T non-contrast-enhanced Dixon water-fat separation CS-SENSE whole-heart CMRA is a promising technique to detect clinically significant coronary stenosis on patients with suspected CAD.

Ewing sarcoma is a member of the Ewing sarcoma family tumor(ESFT), which is commonly from bones and soft tissues, while it is rare for penis. In this thesis, a case of 21-year-old Ewing sarcomas on the left side of the penis was reported. After the penis mass excision, the pathological diagnosis was Ewing sarcoma and positive margin, then he underwent penis total hysterectomy. After the surgery, he received chemotherapy for 14 cycles without radiation. With 8 months’ reexamination and follow-up, there was no local recurrence or metastasis.

Based on the biomechanical simulation curve of OpenSim, an open source software of biomechanical model, a spherical exoskeleton parallel mechanism with two degrees of freedom for hip joint is proposed in this paper for the rehabilitation therapy of patients with impaired leg motor function or elderly people with walking dysfunction. Firstly, the parallel mechanism is modeled and the position inverse solution of the parallel mechanism is obtained using inverse kinematics analysis. The velocity analysis expression of the mechanism is derived by deriving the inverse kinematics solution. The model is imported into the mechanical system dynamics analysis software ADAMS and matrix processing analysis software MATLAB to carry out simulation experiments. The correctness of the velocity analysis is verified by comparing the velocity simulation results of the two methods. Then, three singular types of the mechanism are analyzed according to the obtained Jacobian matrix. According to the inverse solution of the mechanism, the reachable workspace of the mechanism is obtained by programming in MATLAB with given mechanism parameters and restriction conditions. Finally, the prototype platform is built. The experimental results show that the exoskeleton hip joint using this parallel mechanism can satisfy the requirement of rotation angle of human hip joint movement, but also can be good to assist patients with leg flexion-extension movement and adduction-abduction movement, and it is helpful to carry out corresponding rehabilitation training. It also has theoretical significance and application value for the research work of human hip exoskeleton parallel mechanism.
Biomechanical Phenomena ; Exoskeleton Device ; Hip Joint ; physiology ; Humans ; Models, Theoretical ; Movement ; Rehabilitation ; instrumentation ; Rotation ; Walking

Objective:To investigate the effects of continuous renal replacement therapy (CRRT) on plasma concentration, clinical efficacy and safety of colistin sulfate.Methods:Clinical data of patients received with colistin sulfate were retrospectively analyzed from our group's previous clinical registration study, which was a prospective, multicenter observation study on the efficacy and pharmacokinetic characteristics of colistin sulfate in patients with severe infection in intensive care unit (ICU). According to whether patients received blood purification treatment, they were divided into CRRT group and non-CRRT group. Baseline data (gender, age, whether complicated with diabetes, chronic nervous system disease, etc), general data (infection of pathogens and sites, steady-state trough concentration, steady-state peak concentration, clinical efficacy, 28-day all-cause mortality, etc) and adverse event (renal injury, nervous system, skin pigmentation, etc) were collected from the two groups.Results:A total of 90 patients were enrolled, including 22 patients in the CRRT group and 68 patients in the non-CRRT group. ① There was no significant difference in gender, age, basic diseases, liver function, infection of pathogens and sites, colistin sulfate dose between the two groups. Compared with the non-CRRT group, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) were higher in the CRRT group [APACHE Ⅱ: 21.77±8.26 vs. 18.01±6.34, P < 0.05; SOFA: 8.5 (7.8, 11.0) vs. 6.0 (4.0, 9.0), P < 0.01], serum creatinine level was higher [μmol/L: 162.0 (119.5, 210.5) vs. 72.0 (52.0, 117.0), P < 0.01]. ② Plasma concentration: there was no significant difference in steady-state trough concentration between CRRT group and non-CRRT group (mg/L: 0.58±0.30 vs. 0.64±0.25, P = 0.328), nor was there significant difference in steady-state peak concentration (mg/L: 1.02±0.37 vs. 1.18±0.45, P = 0.133). ③ Clinical efficacy: there was no significant difference in clinical response rate between CRRT group and non-CRRT group [68.2% (15/22) vs. 80.9% (55/68), P = 0.213]. ④ Safety: acute kidney injury occurred in 2 patients (2.9%) in the non-CRRT group. No obvious neurological symptoms and skin pigmentation were found in the two groups. Conclusions:CRRT had little effect on the elimination of colistin sulfate. Routine blood concentration monitoring (TDM) is warranted in patients received with CRRT.

In this article, methods of measuring and evaluating treatment adherence, based on whether they are objective and subjective, are reviewed upon literature examination, and the advantages and disadvantages of each method for different population segments are also discussed.It is intended to provide medical professionals and researchers with a general framework about adherence assessment methods.During treatment and research, medical professionals and researchers should select the most appropriate methods for their purposes and provide effective and personalized evaluation methods to ultimately evaluate and improve patients' medication adherence.