Objective To investigate the role of a transcription factor p 53 in dengue virus infec-tion.Methods A plasmid expressing siRNA specific for p 53 gene was constructed and then used to prepare HepG2 cell line with a suppressed expression of p 53 protein.The expression of p53 protein was detected by Western blot assay .A wild type control group and a siRNA group were set up by infecting wildtype HepG 2 cells and p53 low expressing HepG2 cells with type 2 dengue viruses,respectively.The virus titers in two dif-ferent cells were determined by plaque forming assay using Vero cells .Indirect immunofluorescence assay was performed to detect virus multiplication .The apoptosis of virus infected cells were analyzed by flow cytome-try.ELISA was performed to analyze the levels of IFN-βsecreted by infected cells from two groups .Results Compared with wildtype control group ,the cells in siRNA group showed a suppressed expression of p 53 pro-tein,suggesting that the HepG2 cell line with low p53 protein expression was successfully established .The vi-rus titer in supernatants of the cells from siRNA group was about 100-fold higher than that of wildtype control group at 24 hours after viral infection .Fluorescence activated cell sorting analysis showed that the numbers of green fluorescence labeled cells were remarkably increased in siRNA group .We speculated that p53 protein might play a role in the inhibition of dengue virus infection as indicated by the observed results .The numbers of apoptotic cells showed no significant difference between two groups .However,the level of IFN-βsecreted by wildtype HepG2 cells was six times higher than that of the cells in siRNA group .Conclusion p53 pro-tein might inhibit dengue virus infection through the activation of type Ⅰ interferon signaling pathway rather than enhance cell apoptosis .

Objective:To analyze the stress and displacement distribution of mandibular reconstruction with fibular flap by fixation based on mortise and tenon joint structure with three-dimensional finite element analysis.Methods:A 66-year-old male patient with no fracture or deformity of the mandible was admitted to the Department of Oral and Maxillofacial Head and Neck Oncology of the Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine in August 2020. The imaging data of the mandible and fibula of the patients were obtained with CT scan. Three-dimensional reconstruction and reverse reconstruction were performed with software Mimics 17.0 and GeomagicWrap 2017 to obtain the three-dimensional models of the mandible and fibula. The model of mandibular reconstruction with fibular flap was obtained by software Solidworks 2017 and Geomagic Design X 64. The cortical bone and cancellous bone were segmented by Boolean operation. The vertical occlusal state was simulated (the loading condition was 125 N downward along the axis of the central incisor and 250 N downward along the axis of the second and third molars). Three dimensional finite element analysis was used to compare and analyze the stress and displacement distribution characteristics of the mandible and internal fixation before and after bone healing with the mortise and tenon joint structure combined with lag screws and traditional titanium plates. After optimized the boundary conditions of the mandible based on the mortise and tenon joint structure, the stress and displacement distribution of the internal fixation and mandible were measured.Results:In terms of stress distribution, under the condition of bone non-union, the stress peak of the internal fixator fixed by mortise and tenon structure was distributed at the junction of bone section and internal fixator, which was 304.07 MPa. The peak stress of the titanium plate fixation was 345.39 MPa at the broken end of the posterior bone. After bone healing, the stress peak distributions of the internal fixator fixed by mortise and tenon structure remained unchanged, which was 58.47 MPa. The stress of the internal fixator was concentrated to the contact point between the titanium nail and the titanium plate, which was 92.06 MPa.In addition, after the boundary conditions were optimized, the stress distribution of the bones was uniform, and the peak stress of internal fixation was 88.56 MPa, which was significantly lower than the maximum yield strength of titanium (860 MPa). In terms of displacement, under the condition of bone non-union, the displacement peaks of the two fixation methods were both located in the right mental foramen in the middle of the lower margin of the mandible and involved the anterior osteotomy surface. The peak value of mandible displacement in tenon and mortise fixation was 1.307 mm, which was slightly lower than that in titanium plate fixation, 1.447 mm.After bone healing, the main displacements of the two fixation methods were located close to the middle of the lower margin of the mandible and did not involve the osteotomy surface. The displacement peak value of titanium plate fixed mode was 0.518 mm, which was less than that of tenon and mortise fixed mode. Under the condition of bone non-union, the peak displacement of the mandible was 0.212 mm after the boundary of the tenon and mortise fixation model was optimized.Conclusions:The tenon and mortise design combined with lag screw fixation is a safe and effective method for the mandible reconstruction with a fibular flap.

Objective:To analyze the stress and displacement distribution of mandibular reconstruction with fibular flap by fixation based on mortise and tenon joint structure with three-dimensional finite element analysis.Methods:A 66-year-old male patient with no fracture or deformity of the mandible was admitted to the Department of Oral and Maxillofacial Head and Neck Oncology of the Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine in August 2020. The imaging data of the mandible and fibula of the patients were obtained with CT scan. Three-dimensional reconstruction and reverse reconstruction were performed with software Mimics 17.0 and GeomagicWrap 2017 to obtain the three-dimensional models of the mandible and fibula. The model of mandibular reconstruction with fibular flap was obtained by software Solidworks 2017 and Geomagic Design X 64. The cortical bone and cancellous bone were segmented by Boolean operation. The vertical occlusal state was simulated (the loading condition was 125 N downward along the axis of the central incisor and 250 N downward along the axis of the second and third molars). Three dimensional finite element analysis was used to compare and analyze the stress and displacement distribution characteristics of the mandible and internal fixation before and after bone healing with the mortise and tenon joint structure combined with lag screws and traditional titanium plates. After optimized the boundary conditions of the mandible based on the mortise and tenon joint structure, the stress and displacement distribution of the internal fixation and mandible were measured.Results:In terms of stress distribution, under the condition of bone non-union, the stress peak of the internal fixator fixed by mortise and tenon structure was distributed at the junction of bone section and internal fixator, which was 304.07 MPa. The peak stress of the titanium plate fixation was 345.39 MPa at the broken end of the posterior bone. After bone healing, the stress peak distributions of the internal fixator fixed by mortise and tenon structure remained unchanged, which was 58.47 MPa. The stress of the internal fixator was concentrated to the contact point between the titanium nail and the titanium plate, which was 92.06 MPa.In addition, after the boundary conditions were optimized, the stress distribution of the bones was uniform, and the peak stress of internal fixation was 88.56 MPa, which was significantly lower than the maximum yield strength of titanium (860 MPa). In terms of displacement, under the condition of bone non-union, the displacement peaks of the two fixation methods were both located in the right mental foramen in the middle of the lower margin of the mandible and involved the anterior osteotomy surface. The peak value of mandible displacement in tenon and mortise fixation was 1.307 mm, which was slightly lower than that in titanium plate fixation, 1.447 mm.After bone healing, the main displacements of the two fixation methods were located close to the middle of the lower margin of the mandible and did not involve the osteotomy surface. The displacement peak value of titanium plate fixed mode was 0.518 mm, which was less than that of tenon and mortise fixed mode. Under the condition of bone non-union, the peak displacement of the mandible was 0.212 mm after the boundary of the tenon and mortise fixation model was optimized.Conclusions:The tenon and mortise design combined with lag screw fixation is a safe and effective method for the mandible reconstruction with a fibular flap.

Background and purpose:As one of the most fatal malignant tumors in China, the morbidity and mortality of lung cancer remain high. Early diagnosis and normative treatment is the key to improve the prognosis of lung cancer. The aim of this study was to explore the practice of early lung cancer screening with low-dose spiral computed tomography (CT) based on the current situation in community health service, with integration of superior resources of med-ical institutions at all levels in Shanghai.Methods:From Aug. 2013 to Aug. 2014, we screened high-risk population in selected communities of Minhang District, Shanghai, for early diagnosis of lung cancer with low-dose spiral CT combined with multidisciplinary comprehensive treatment models including minimally invasive surgery, exploring the medical service network covering prevention, diagnosis, treatment, rehabilitation and follow-up.Results:Screening population is 11 332 (male 7 144, female 4 188); Twenty-nine cases with pathological diagnosis of malignant tumor, including 27 cases of pri-mary lung cancer, 1 case of lung metastasis, 1 case of breast cancer. The morbidity of primary lung cancer is 238.26×10-5. There were 22 cases of Stage 0-Ⅰ lung cancer accounting for 81.48% of all diagnosed primary lung cancer.Conclusion:Based on community health service, screening with low-dose spiral CT could improve the early diagnosis rate of lung can-cer with feasibility and validity, which could be applicable in qualified eligible medical center and community in China.

Objective:To evaluate the performance and the accuracy of surgical robot for mandibular reconstruction based on intelligent surgical planning.Methods:115 CT scanning images of normal mandible (57 males, 48 females, 40.3±9.1 years old, from February 2010 to May 2019) and 115 CT scanning images of mandible with tumor (62 males, 53 females, 55.6±7.2 years old, from March 2008 to August 2019) from Shanghai Ninth People’s Hospital were selected. The surgical robot system including work station, UR robot, optical navigation system, 6 dimensional force senor and surgical instrument. A 3D V-Net for mandible preoperational segmentation from CT scans was proposed and used to segment the mandible of a 54-year-old male patient who received mandible reconstruction with fibular flaps. The machine learning algorithm was used to aid surgical planning for maxillo-mandibular defect by detecting landmarks. The accuracy was defined as the distance between corresponding landmarks on the intact mandible. The robot could locate the target according to surgical planning and perform fibula osteotomy through force-motion control. The CT scanning of limb and head from the patient (male, 54 years old) was used for phantom experiments. 30 osteotomies on 5 3D-priented resin phantom were carried out. The pre- and post-operative images were compared to calculate the accuracy. The descriptive results were in the format of Mean±SD.Results:The average accuracy of V-Net for mandible segmentation was 96.581% and the time cost was less than 30 seconds. The average error of feature points on mandible was (2.24±1.74) mm. The residual length error was (1.02±0.45) mm and angle error was (0.96±0.42) degree in robotic-assisted osteotomy according to 3 cases of phantom experiments. The surgical robot could perform osteotomy safely and steadily within 15 min.Conclusions:Intelligent surgical planning can precisely segment the mandible and determine its landmarks. Robot for mandibular reconstruction can perform fibular osteotomy precisely with the pre-operative planning.

Objective:To evaluate the performance and the accuracy of surgical robot for mandibular reconstruction based on intelligent surgical planning.Methods:115 CT scanning images of normal mandible (57 males, 48 females, 40.3±9.1 years old, from February 2010 to May 2019) and 115 CT scanning images of mandible with tumor (62 males, 53 females, 55.6±7.2 years old, from March 2008 to August 2019) from Shanghai Ninth People’s Hospital were selected. The surgical robot system including work station, UR robot, optical navigation system, 6 dimensional force senor and surgical instrument. A 3D V-Net for mandible preoperational segmentation from CT scans was proposed and used to segment the mandible of a 54-year-old male patient who received mandible reconstruction with fibular flaps. The machine learning algorithm was used to aid surgical planning for maxillo-mandibular defect by detecting landmarks. The accuracy was defined as the distance between corresponding landmarks on the intact mandible. The robot could locate the target according to surgical planning and perform fibula osteotomy through force-motion control. The CT scanning of limb and head from the patient (male, 54 years old) was used for phantom experiments. 30 osteotomies on 5 3D-priented resin phantom were carried out. The pre- and post-operative images were compared to calculate the accuracy. The descriptive results were in the format of Mean±SD.Results:The average accuracy of V-Net for mandible segmentation was 96.581% and the time cost was less than 30 seconds. The average error of feature points on mandible was (2.24±1.74) mm. The residual length error was (1.02±0.45) mm and angle error was (0.96±0.42) degree in robotic-assisted osteotomy according to 3 cases of phantom experiments. The surgical robot could perform osteotomy safely and steadily within 15 min.Conclusions:Intelligent surgical planning can precisely segment the mandible and determine its landmarks. Robot for mandibular reconstruction can perform fibular osteotomy precisely with the pre-operative planning.

【Objective】 To achieve supervision and management of the whole business process of blood center, raise productivity and ensure blood quality by enabling blood center managers comprehensively grasp the key business operation situation of the whole process at anytime and anywhere. 【Methods】 A whole business process supervision and management system was established covering background of preparation, business scope, content of position supervision and management, overall framework design, interface design of management and supervision management, physical database design, program development and online debugging, and was integrated with the blood bank management information system. The display and management were through a mobile APP to record key indicators of business process from blood collection to blood supply timely and comprehensively. Statistical analysis was conducted on total collection volume, total preparation volume and total supply volume, as well as discarding rate of test unqualified and of non-test unqualified (lipemic blood excluded) in 2023 and 2022. 【Results】 We established a mobile APP based on a blood bank management information system for business supervision and management of whole process, and achieved management by phones. After its implementation in 2023, the total collection volume, total preparation volume and total supply volume in 2023 were all higher than those in 2022, with growth rates of 5.88% (13 247/225 454 U), 4.73% (24 156/510 698 U), and 6.70% (34 814/519 914 U), respectively. The discarding rate in 2023 was lower than that in 2022 (0.54%, 2 868/534 854 U) vs (0.60%, 3 047/510 698 U) (P<0.01), and the non-test unqualified discarding rate (lipemic blood excluded) in 2023 was significantly lower than that in 2022(0.12%, 649/534 854 U) vs (0.19%, 991/510 698 U)(P<0.01). 【Conclusion】 The construction of supervision and management system of a whole business process based on blood bank management information system can meet the standardized service needs of managers at anytime and anywhere, continuously raise productivity and the standardization and scientific level of blood bank management, thus ensuring blood supply.