Objective:This study aimed to provide some biomechanical references for the clinical use and improvement of Herbst appliance. Methods: The three-dimensional model of the ′Temporomandibular joint mandible Herbst appliance system′was set up by SUPER SAP software (version 9.3). On this model, the passive tensile in the masticatory muscles and ligaments were analyzed under various bit reconstruction designed according to specified advanced displacement and vertical bite opening. Results: When Herbst appliance drove the mandible forward, there was not any tensile in the medial, lateral pterygoid and the collateral ligament, while the temporalis, the deep paret of masseter, the stylomandibular ligament, and the sphenomandibular ligament were passively drawn. Under various bite reconstruction, the passive tensile in the medial temporalis, the posterior temporalis, the stylomandibular ligament and the sphenomandibular ligament increased with the amount of the advancement of the mandible; The passive tensilein the posterior temporalis and the deep part of masseter increased with the amount of vertical bite opening of the mandible. Conclusion: The StL, SpL, PT and AT played an important role in functional reconstruction of mandible by Herbst. All five group of bite reconstruction (3～7mm advancement, 4～2mm vertical bite opening of the mandible) designed by this study can be selected in clinic according to the patient′s capa- bility of adaptation, the extent of malocclusion and the potential and direction of growth.

Objective:To establish a scientific, sensitive and practical sensitive index system for nutritional screening and nursing quality evaluation of maintenance hemodialysis patients, so as to provide reference for objective evaluation of nutritional screening and nursing quality evaluation of MHD patients.Methods:Based on Donabedian three-dimensional quality structure theory of "structure-process-result", the first draft of the index system was constructed through literature review and semi-structured interview. From September to October 2022, a total of 20 clinical nursing and nursing management experts from the field of hemodialysis in 12 Class Ⅲ Grade A hospitals were selected for two rounds of expert letter consultation to revise and confirm the indicator system.Results:The positive coefficient of the two rounds of expert correspondence were 95.00% and 100.00%, the expert authority coefficient were 0.813 and 0.818, the Kendall's harmony coefficients were 0.121-0.257 (all P<0.05), and the coefficient of variation of each index was less than 0.30. After 2 rounds of expert letter consultation, the sensitive index system for nutritional screening and evaluation of nursing quality for maintenance hemodialysis patients was finally constructed, including 1 structural index, 7 process index and 2 outcome index. Conclusions:In this study, a sensitive index system of nutritional screening and evaluation of nursing quality for maintenance hemodialysis patients with 10 indicators is established, which was scientific, practical and specialized and could be used to standardize the nutritional screening and evaluation nursing work in blood purification centers and promote the continuous improvement of nursing quality.

Metaverse technology, which fully combines virtual reality, augmented reality, digital twins, blockchain, Internet of Things and other technologies, enjoys promising prospects and advantages in medical care. This article reviews the types of Metaverse key technologies and their application status in medical care, proposes to develop "Metaverse + nursing" in the future, and looks forward to it, in order to promote the integration of Metaverse and nursing theory and practice and lay the foundation for subsequent research.

Objective To study the influence of foot progression angle on tibial shock during running. Methods The normal, toe-in and toe-out gait of fifteen healthy adults was tested during running trials on a treadmill. The differences in tibial shock (impact peak, average loading rate, instantaneous loading rate and maximum tibia acceleration) for runners at different foot progression angles were analyzed to explore the influence of foot progression angle on tibial shock. The changes in sagittal plane trunk angle, strike pattern, stride frequency and step width of runners under three gaits were also compared to explore its possible causes. Results Compared with normal gait, the maximum tibial acceleration of toe-in and toe-out gait was increased by 19.3% and 24.5%, impact peak was increased by 7.6%, average loading rate was increased by 7.9% and 9.5%, instantaneous loading rate was increased by 3.9% and 10-.9%, with significant statistic differences. No significant changes were found in sagittal plane trunk angle, strike pattern, stride frequency and step width. Conclusions Foot progression angle might be an another gait parameter which affected tibial shock during running in addition to other related known gait parameters such as sagittal plane trunk angle, strike pattern, stride frequency and step width，which would provide an important reference for prevention of tibial stress fracture.

Objective:To establish an index system for frailty risk assessment of maintenance hemodialysis patients, and scientifically evaluate frailty risk status of maintenance hemodialysis patients.Methods:With the biopsychosocial medical model as the theoretical framework, semi-structured interview method and Delphi expert consultation method were used to establish and screen indicators and analytic hierarchy process was used to determine the weight of indicators, and an indicator system for frailty risk assessment of patients with maintenance hemodialysis was constructed.Results:The effective recovery rates of the two rounds of expert consultation questionnaires were respectively 100.00% (22/22) and 95.45% (21/22), the expert authority coefficients were respectively 0.85 and 0.84, the Kendall's harmony coefficients of the importance of expert opinions were respectively 0.149 and 0.201, and the Kendall's harmony coefficients of the feasibility of expert opinions were respectively 0.134 and 0.175. Finally, the frailty risk evaluation system for maintenance hemodialysis patients was established, including 3 primary indexes, 8 secondary indexes and 36 tertiary indexes.Conclusions:The established frailty risk evaluation index system for patients with maintenance hemodialysis is scientific and practical and comprehensive in content, which can better reflect the specialty characteristics and provide a basis for frailty risk assessment for maintenance hemodialysis patients.

ObjectiveTo study the mechanism of Shexiang Tongxin Dripping pills-containing serum （STDP） in ameliorating angiotensinⅡ （AngⅡ）-induced cell phenotype transformation， proliferation， migration， and dysfunction of vascular smooth muscle cells. MethodsAn AngⅡ-induced proliferation and migration model of vascular smooth muscle cells was established. The cells were treated with STDP at 5%， 10%， and 20% for 24 h. The immunofluorescence assay was employed to detect the expression of α smooth muscle actin （α-SMA） and matrix metalloproteinase-2 （MMP-2）. The cell-counting kit-8 （CCK-8） assay and 5-ethynyl-2'-deoxyuridine （EdU） staining were employed to detect the proliferation of vascular smooth muscle cells， and the scratch assay was employed to detect the migration of the cells. Western blot was employed to determine the expression levels of pathway proteins such as angiotensin-converting enzyme 2 （ACE2）， angiotensin Ⅱ type 2 （AT2）， angiotensin Ⅱ type 1 （AT1）， as well as proliferation and migration proteins such as typeⅠ collagen （ColⅠ） and osteopontin （OPN）. ResultsCompared with the model group， STDP increased the expression of α-SMA， reduced the expression of MMP-2， and inhibited the proliferation and migration of vascular smooth muscle cells （P<0.05）. Furthermore， STDP up-regulated the expression levels of ACE2， AT2， and MAS1， while down-regulating the expression level of AT1， PCNA， ColⅠ， MMP-9， Rock1， Rock2， and SRF （P<0.05）. Compared with the STDP group， the ACE2 inhibitor reversed the regulatory effects of STDP. ConclusionSTDP inhibits the phenotype transformation， proliferation， and migration of vascular smooth muscle cells and regulates the expression of cell proliferation and migration-related proteins to ameliorate the dysfunction of vascular smooth muscle cells. It exerts the effects by up-regulating the expression of proteins in the ACE2-AT2/MAS pathway and down-regulating the expression of proteins in the AT1-Rock signaling pathway.

Objective:To establish a standard method to evaluate the scanning accuracy of intraoral scanner (IOS) and to investigate six IOS′s scanning accuracy and the relationship between different scan span.Methods:Five simplified six abutments full arch model were fabricated by high accuracy (5 μm) milling machine with 7075 aluminum alloy. The machining accuracy, which was verified by a coordinate measuring machine with higher accuracy (0.7 μm), was considered as the reference accuracy. The model with the highest machining accuracy was considered as the test model in IOS′s scanning accuracy test, and computer-aided design (CAD) data of the model was used as the reference data. Six IOS scanned the test model 10 times with the same scanning path, obtained 60 test data. CAD data and test data were input into Geomagic Studio 2014. The preparation part above the margin of the abutments of the data was isolated and divided into 4 segments of interest: single crown, three-unit bridge, five-unit bridge, and full arch. The test data were then best-fit aligned to CAD data or each other followed by deviation analysis. Scanning trueness and precision were then calculated.Results:The mid-value of scanning trueness and precision of six IOS in single crown, three-unit bridge, five-unit bridge and full arch were 13.3-29.6 μm and 7.6-20.7 μm, 15.4-30.9 μm and 8.7-26.5 μm, 17.0-66.1 μm and 11.3-44.2 μm, 24.0-107.9 μm and 24.6-150.1 μm respectively.Conclusions:Long-span scanning can affect the accuracy of IOS to a varying extent.