Objective: To investigate the changes in oropharyngeal airway parameters and hyoid position in skeletal ClassⅡ adult female patients with different vertical skeletal types who were treated with maxillary anterior teeth retraction with maximum anchorage, and to provide a reference for orthodontic clinical diagnosis and treatment. Methods: This study was reviewed and approved by the Medical Ethics Committee, and informed consent was obtained from patients. Sixty adult female patients with skeletal ClassⅡ were selected and divided into a skeletal ClassⅡ normodivergent group and a skeletal ClassⅡ hyperdivergent group based on the patients’ mandibular plane angle. In both groups, the bilateral maxillary first premolars were extracted and the maxillary anterior teeth were retracted with maximum anchorage. Cone beam CT(CBCT) images were collected before and after treatment, and three-dimensional measurement software was used to analyze oropharyngeal airway-related parameters. Results: After retraction of the maxillary anterior teeth with maximum anchorage, the 10 parameters related to the oropharyngeal airway did not exhibit statistically significant differences in the normodivergent group (P>0.05), but the perpendicular distance from the highest point of the hyoid bone to the vertical line passing through the sella (H-X) value decreased (P<0.001). In the hyperdivergent group, the oropharyngeal area at the level of the epiglottis tip (OPA-E), anterior-posterior diameters of the oropharynx at the level of the epiglottis tip (E-AP), most constricted axial area of the oropharynx (OPA-MCA), and anterior-posterior diameters of MCA area of the oropharynx (MCA-AP) decreased after treatment (P<0.001). In addition, the oropharyngeal volume (OPV) decreased after treatment (P<0.05), and the perpendicular distance from the highest point of the hyoid bone to the horizontal line passing through the sella (H-Y) and the highest point of the hyoid bone to the epiglottis base (H-Eb) values increased after treatment (P<0.05). Conclusion After retraction of the maxillary anterior teeth with maximum anchorage, there is no change in the oropharyngeal airway in skeletal ClassⅡ normodivergent female adult patients, while skeletal ClassⅡhyperdivergent female adult patients have a risk of reduction in the oropharyngeal airway after maximuim anchorage retraction of the maxillary anterior teeth.

ObjectiveTo explore the regulation of hypothalamic-pituitary-gonadal （HPG） axis by modified Erxian decoction in rats with perimenopausal syndrome （PMS） and to further analyze the expression of proteins related to the silent information regulator 1 （SIRT1）/hypothalamic kisspeptin （Kisspeptin）/gonadotropin-releasing hormone （GnRH） signaling pathway in the arcuate nucleus region （ARC） of the hypothalamus， so as to reveal the potential target of action and molecular biological mechanism of modified Erxian decoction for the treatment of perimenopausal syndrome. MethodsAn animal model was established via the incomplete castration method， with successful modeling confirmed by the exfoliated cervical cell smear method. The 48 rats were divided into six groups based on the randomization principle after successful modeling， including a sham operation group， a model group， an estradiol valerate group （0.09 mg∙kg^-1∙d^-1）， high-， medium-， and low-dose modified Erxian decoction groups （7.614， 3.807，1.903 5 g∙kg^-1∙d^-1）， with 8 rats in each group. The estradiol valerate group and the high-， medium- and low-dose modified Erxian decoction groups were continuously administered by gavage for 28 days， and the indicators were detected 24 hours after the last administration. Body weights and uterine indices were measured. The pathological changes of the uterus were observed by hematoxylin-eosin （HE） staining. Enzyme-linked immunosorbent assay （ELISA） was performed to measure the levels of estradiol （E₂）， follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， and gonadotropin-releasing hormone （GnRH）. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to determine the expression levels of SIRT1， Kisspeptin， kisspeptin receptor （GPR54）， and GnRH in the ARC region of the hypothalamus and gonadotropin-releasing hormone receptor （GnRH-R） in pituitary. ResultsCompared with the sham operation group， rats in the model group had a significantly increased body weight （P0.01）， reduced wet weight and index of uterus （P0.01）， endometrial thinning or atrophy， glandular atrophy， and a decreasing number of glands. Additionally， serum levels of E₂ and the expression of SIRT1 in the ARC region of the hypothalamus significantly decreased （P0.01）. Serum levels of FSH， LH， and GnRH， the expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus， and GnRH-R in pituitary significantly increased （P0.01）. Compared with the model group， the estradiol valerate group and the high-， medium-dose modified Erxian decoction groups had significantly reduced body weight， serum levels of FSH， LH， and GnRH， and expression of Kisspeptin， GPR54， and GnRH in the ARC region of the hypothalamus and GnRH-R in pituitary （P0.05， P0.01） and significantly increased wet weight and index of uterus， serum level of E₂， and expression of SIRT1 in the ARC region of the hypothalamus （P0.05， P0.01）. In addition， they showed thickened endometrium， increased number of endometrial glands， and improved glandular atrophy. ConclusionModified Erxian decoction regulates the function of the HPG axis through multi-targets， and its mechanism of action may be related to the up-regulation of the expression of SIRT1 in the ARC region of the hypothalamus， the inhibition of the over-activation of the Kisspeptin/GnRH signaling pathway， the regulation of the expression of GnRH-R in the pituitary， the restoration of secretion balance of gonadotropins， and the elevation of the estrogen level. This study provides an experimental basis for the interpretation of the scientific connotation of modified Erxian decoction in the treatment of perimenopausal syndrome and a theoretical reference for the development of a novel therapeutic strategy based on the SIRT1/Kisspeptin/GnRH pathway.

Objective:To observe the clinical effect of modified orbital septum fat release in the treatment of lower eyelid relaxation with lacrimal groove deformity.Methods:From January 2019 to August 2023, 52 patients with lower eyelid relaxation and lacrimal groove deformity were treated with the procedures of modified orbital septum fat release in the First People′s Hospital of Jiande, including 5 males and 47 females. The orbicularis oculi muscle supporting ligament was sutured and fixed at the periosteum of the lower edge of the orbit to achieve anatomical reduction. Suture fixation of the free edge of the orbital septum was performed at the edge of the supporting ligament in the modified orbital septum fat release method. Following-up for 6-12 months after surgery, the complications and satisfactory rate of patients were evaluated.Results:All the incision healed well with improved skin effect, and the incision scar were almost invisible. 52 patients were followed up from 6 to 12 months; 49 patients were satisfied and 2 patients were basically satisfied with their appearance, 1 patient was not satisfied with the result. No complications such as lower eyelid ectropion, lower eyelid retraction, or eyelid ball separation occurred.Conclusions:Modified orbital septum fat release is an effective method for correction of lower eyelid relaxation with lacrimal groove deformity.

Objective:To explore the effect of ultraviolet-C (UV-C) combined with Kangfuxin liquid wet compress and oxygen blowing method on the post chemotherapy oral mucositis (OM) in patients with hematological malignancies.Methods:From January 2022 to February 2023, convenience sampling was used to select 120 patients with post chemotherapy OM in the Department of Hematology of the Affiliated Huai'an First People's Hospital of Nanjing Medical University. The patients were randomly divided into a control group and an observation group, with 60 cases in each group. The control group received Kangfuxin liquid wet compress, while the observation group carried out a combination of UV-C irradiation and oxygen oral blowing method on the basis of the control group. This study compared the Visual Analogue Scale (VAS) score before and two days after treatment, the healing status of OM after treatment on the 5th day, and the healing time of OM between the two groups of patients.Results:A total of 108 patients completed the study, with 52 in the control group and 56 in the observation group. After two days of treatment, the VAS scores of both groups of patients were lower than those before treatment, and those of the observation group were lower than those of the control group, with statistically significant differences ( P<0.05). On the 5th day of treatment, the healing rate of OM in the observation group was higher than that in the control group, and the difference was statistically significant (χ 2=5.425, P<0.05). The healing time of OM in the observation group was shorter than that in the control group, and the difference was statistically significant ( t=2.458, P<0.05) . Conclusions:The combination of UV-C, Kangfuxin liquid and oxygen blowing method can alleviate pain, improve the healing rate of OM, and shorten the healing time of post chemotherapy OM in patients with hematological malignancies, which is worthy of clinical promotion.

Glutamate is a major excitatory neurotransmitter in the central nervous system and a potential neurotoxin.During the development of depression,the glutamate concentration increases in the hippocampus.When glutamate accumulates,it causes serious damage to neurons and brain tissue,aggravating the depressive state.Therefore,glutamate accumulation may be a major mechanism of depression development.Astrocytes,glutamate transporters,and glutamate receptors play important regulatory roles in the glutamate concentration.This article reviews the mechanism-of-action of traditional Chinese medicine on depression by regulating astrocytes,glutamate transporters,and glutamate receptors,and provides new ideas to explore treatment of depression by traditional Chinese medicine.

Objective:To analyze the screening test results of people infected with human immunodeficiency virus (HIV) in the window period confirmed to be "negative" by Western blotting, with a view to finding a way to identify people infected with HIV during the window period as soon as possible.Methods:In the serum (plasma) samples of HIV-positive people screened by the fourth-generation chemiluminescent immunoassay in medical institutions at all levels in Pudong New District, Shanghai from 2014 to 2021, a total of 100 people (200 samples) were confirmed as "negative" and the fourth-generation enzyme-linked immunosorbent assay was screened positive. According to the follow-up results, it was divided into the early infection group (24 cases) and the uninfected group (76 people), and the fourth-generation rapid diagnostic test (RDT) was performed. The compliance rates of positive results of screening and follow-up were compared, and the epidemiological data of early HIV infections were analyzed. The chi-square test was used for statistical analysis.Results:Of the 200 samples, 48(24.00%) were early infected. A total of 106 samples antigens and (or) antibodies were positive by the fourth-generation RDT screening, and the compliance rate with the follow-up results was 45.28%(48/106), of which those of the fourth-generation RDT screening antigen positive and follow-up results were 100.00%(36/36), which was higher than the antibody positive results (24.68%(19/77)). The difference was statistically significant ( χ2=57.49, P<0.001). Of the 24 cases of early HIV infections, 19(79.2%) had acute symptoms. Only one out of six people≥50 years old had asked about the partner about his HIV status before engaging high-risk sex, and 13 out of 18 people <50 years old had asked the partners about their HIV status or to detect HIV before engaging high-risk sex. The difference was statistically significant ( χ2=5.71, P=0.017). Out of the six people ≥50 years old, only one actively tested HIV, and 12 out of 18 people <50 years old actively tested HIV, and the difference was statistically significant ( χ2=4.53, P=0.033). Conclusions:The Western blotting confirmed "negative" samples may be false negative. The comprehensive evaluation which combined with the fourth-generation screening test could help to screen out HIV window infection. In addition, the publicity, education and monitoring of high-risk population need to be further strengthened.

Objective To construct a scientific and practical core literacy training system for nurses working in bleeding centers so as to provide reference for the training and curriculum design of nurses working in bleeding centers.Methods A computerized retrieval of academic papers concerning the core literacy training system for nurses working in bleeding centers from the databases of PubMed,Web of Science,China Biomedical Literature Service(CBM),China Knowledge Network(CNKI),Wanfang and other databases was conducted.Combined with the results of interviews with patients,family members and medical staff,and through organizing the group discussion,a training system for nurses working in bleeding centers was preliminary formulated.Finally,the Delphi method was used to make two rounds of inquiries to 21 experts from 12 provinces,and a three-level index system was determined.Results The first round of expert inquiry questionnaires effectively collected 21/21 consultation letters,and the second round of expert inquiry questionnaires effectively collected 19/21 consultation letters.The expert consultation and judgment coefficient of the core literacy training system for nurses working in bleeding centers was 0.99,the authority coefficient was 0.89;the Miller pyramid theory expert consultation and judgment coefficient was 0.72,the authority coefficient is 0.85,and the familiarity level was 0.80.Finally,the training system for bleeding center nurses covered four levels,including theory,application,skills and practical performance ability,and consisted of three parts,including training content,training management,and exam assessment.The training content included 22 first-level indicators,96 second-level indicators and 78 third-level indicators;the training management included 4 first-level indicators,8 second-level indicators and 12 third-level indicators;and the exam assessment included 5 first-level indicators and 16 second-level indicators.Conclusion The Miller pyramid theory-based core literacy training system for nurses working in hemorrhage centers fully adopts the expert opinions and suggestions,and it carries a high degree of credibility,therefore,it can provide reference for the training of the nurses working in bleeding centers.(J Intervent Radiol,2024,33:664-673)

Objective To explore the effect of multiparameter electroencephalogram(EEG)-guided anesthesia management on EEG burst suppression(BS)and postoperative delirium(POD)in elderly patients undergoing lower abdominal laparoscopic surgery.Methods A total of 100 elderly patients,48 males and 52 females,aged 65-85 years,BMI 18.5-28.0 kg/m2,and ASA physical status Ⅱ or Ⅲ,were enrolled for lower abdominal surgery under general anesthesia.Patients were randomly divided into two groups:multiparameter group and single parameter group,50 patients in each group.In multiparameter group,multiparameter EEG monitoring with patient statu index(PSI),spectral edge frequency(SEF),burst suppression ratio(BSR)and density spectral array(DSA)were used to guide the depth management of anesthesia.In single parameter group,single parameter PSI was used to guide the depth management of anesthesia.The total area under the hypotensive threshold of MAP(AUTMAP)was calculated,and the amount of anesthetic used during the operation and the use of vasoactive drugs,duration of anesthesia,extu-bation time,duration of PACU stay,and postoperative hospitalisation days were recorded.HR,MAP,PSI,and SEF were recorded before the induction of anesthesia,5 minutes after induction of anesthesia,5,30,and 60 minutes after incision,and at the end of surgery.The incidence,duration,and maximum BSR of in-traoperative BS,as well as the incidence of POD 1,2,and 3 days after surgery were recorded.Results There was no significant difference in AUTMAP values between the two groups.Compared with single parame-ter group,intraoperative propofol and remifentanil dosage were significantly decreased(P＜0.05),awak-ening time,PACU stay,and postoperative hospitalization time were significantly shorter in multiparameter group(P＜0.05),the PSI was significantly increased 5,30,and 60 minutes after incision and at the end of surgery,and the SEF was significantly increased 5 minutes after induction of anesthesia,5,30,and 60 minutes after induction and the end of surgery(P＜0.05).Compared with single parameter group,inci-dence of intraoperative BS was significantly decreased,duration of BS was significantly shorter,smaller maximum BSR was significantly decreased,and incidence of POD on 1 day after surgery in multiparameter group(P＜0.05).Conclusion Anesthesia management guided by multiparameter EEG can inhibit the oc-currence of BS,mitigate the degree of BS,and reduce the incidence of POD in elderly patients undergoing abdominal surgery.

Objective To investigate the expression of centromere protein A(CENPA)and granular head like 2(GRHL2)in breast cancer tissues,construct a prognostic model of breast cancer and analyze its clinical application value.Methods The expression of CENPA and GRHL2 in 1 085 breast cancer tissues and 291 con-trol tissues were analyzed using gene expression profiling interactive analysis(GEPIA)database.The relation-ship between CENPA and GRHL2 expression and the survival of breast cancer patients was analyzed using Kaplan-Meier Plotter online website.A total of 84 patients with primary unilateral breast cancer treated in the hospital from January 2018 to June 2020 were selected as the research objects.The expression of CENPA and GRHL2 was detected by immunohistochemistry,and the relationship between CENPA and GRHL2 and clini-copathological characteristics of breast cancer was analyzed.Spearman correlation analysis was used to analyze the correlation between CENPA,GRHL2 and carbohydrate antigen 153(CA153).Receiver operating charac-teristic(ROC)curve was used to analyze the prognostic value of CENPA,GRHL2 and CA153 in breast canc-er.Cox proportional hazards regression model was used to analyze the risk factors of breast cancer prognosis.Results GEPIA database showed that the expression levels of CENPA and GRHL2 in breast cancer tissues were higher than those in normal tissues(P＜0.05).Kaplan-Meier Plotter analysis showed that the expres-sion levels of CENPA and GRHL2 increased,and the survival rate of patients decreased(Log-rank P＜0.001).The expressions of CENPA and GRHL2 were positively correlated with CA153(r=0.410,0.602,P＜0.001).The area under the curve of CENPA,GRHL2 and CA153 in breast cancer diagnosis was 0.878.The expressions of CENPA and GRHL2 were correlated with TNM stage,histological grade,lymph node me-tastasis and epidermal growth factor receptor-2 expression(P＜0.05).Cox regression analysis showed that TNM stage Ⅲ.histological grade Ⅲ,lymph node metastasis and high expression of CENPA and GRHL2 were independent prognostic risk factors of breast cancer(P＜0.05).Conclusion CENPA and GRHL2 are valua-ble biomarkers for the prognosis evaluation of breast cancer.Combined detection of CENPA and GRHL2 with CA153 has a high predictive value for the prognosis of breast cancer.

Objective:To systematically evaluate the effects of "Internet+" nursing intervention mode on negative emotion and pregnancy outcome of infertility patients.Methods:PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, VIP and Chinese Biomedical Literature Database were searched to collect randomized controlled tria related to the effects of "Internet+" nursing interventions on patients with infertility from the inception to August 10th 2023. Two researchers conducted independent quality evaluation, evidence extraction and summary of the literature. Meta-analysis was performed by RevMan 5.4 software.Results:A total of 11 studies were included with a total of 1 596 patients. The Meta-analysis showed that nursing interventions based on "Internet+" significantly improved the anxiety of patients with infertility ( SMD=-1.09, 95% CI-1.76- -0.43, P< 0.01), depression ( SMD=-0.98, 95% CI-1.42- -0.54, P<0.01), biochemical pregnancy rate ( OR=1.67, 95% CI 1.14- 2.44, P<0.01), clinical pregnancy rate ( OR=1.83, 95% CI 1.22- 2.73, P<0.01), but no effect on infertility pressure ( MD=-3.81, 95% CI-15.10- 7.47, P>0.05). Conclusions:The interventions based on "Internet+" can effectively improve anxiety, depression and pregnancy outcome, but there is no adequate evidence of a reduction on infertility stress in patients.