BACKGROUND: Soft-start is a newly photoactivation mode, which has certain effect on composite resin. However, previous study mainly concentrated on the conventional resin-based composites, the reports regarding soft-start on packable resin-based composites is poorly understood. OBJECTIVE: It is assumed that soft-start photoactivation had effect on packable resin-based composites, in addition, to investigate its effect on the hardness of packable resin-based composites. DESIGN, TIME AND SETTING: A double factors design. The experiment was performed at the Department of Stomatology, First Affiliated Hospital, Sun Yat-sen University and Chemical Mine Metal Material Test Laboratory, Guangdong Inspection and Quarantine Technology Center in October 2007. MATERIALS: Three packable resin-based composites were Ecusphere-Carat (EC, DMG Company, Germany), Filtek P60 (P60, 3M EPSE Company, USA), Tetric Ceram HB (HB, Ivoclar Vivadent Company, Liechtenstein) and a conventional composite FiltekZ250 (Z250, 3M EPSE Company, USA). The color of composites was A3. METHODS: Three packable resin-based composites and a conventional composite were filling in a cylindrical container (7 mm diameter, 4 mm depth), to obtain 80 samples, and then were divided into different groups according to the composite and photoactivation mode (n=10). In the soft-start photoactivation, samples were irradiated by 300 mW/cm~2 for 10 s, and then 600 mW/cm~2 for 30 s. Standard photoactivation was irradiated with 600 mW/cm~2 for 40 s.MAIN OUTCOME MEASURES: The microhardness of the top and bottom of the specimens was determined by Vickers microhardness tester. RESULTS: Three packable composites had higher hardness values than conventional composite. Though soft-start photoactivation could decrease the hardness of packable composites, the difference had no significant difference to standard mode (P > 0.05). There was significant difference on the top hardness and on the bottom hardness of conventional composite between two photoactivation modes (P < 0.05). CONCLUSION: The soft-start mode and resin-based composites should be selected carefully according to different filing areas.

BACKGROUND: The use of resin-based composites is increasing in clinical practice. The success and longevity of composite-resin restorations highly depends on adequate polymerization and small polymerization shrinkage, which are closely related with light-curing modes.OBJECTIVE: To investigate the effects of two different light-curing methods on marginal adaptation and microhardness of packable posterior composite restorations. METHODS: Specimens were made from these moulds with 3 types of packable resin-based composites: Ecusphere-Carat, 3M Filtek P60 and Tetric Ceram HB, and 2 curing modes: standard and soft-start curing mode with halogen light. The marginal adaptation was evaluated by measuring the width of margin gap between the mold and specimens with scanning electron microscope. Vickers microhardness was tested on the top and bottom surfaces of the specimens.RESULTS AND CONCLUSION: For Filtek P60 and Tetric Ceram HB, soft-start curing mode showed lower values of the widths of marginal gap than that of standard mode (t=5.78, P < 0.05; t=5.64, P < 0.05), but there was no significant difference with Ecusphere-Carat (t=1.62, P > 0.05). The top surface demonstrated higher microhardness values than the bottom surface in all experimental conditions (P < 0.05). The soft-start curing mode showed lower values of top surface hardness for the three resins than that of standard mode (P < 0.05). But no significant differences were found on the bottom surface hardness of the three resins between these two curing modes (P > 0.05). Compared with routine light-cured mode, the soft-start curing mode can reduce the polymerization shrinkage and surface hardness of packable resin-based composites.

Objective:To evaluate lower facial profile in females in different skeletal patterns.Methods:Investigation pictures of three females with beautiful lower facial profiles from Department of Orthodontics, Henan Stomatological Hospital were collected. The skeletal patterns of these females were classified as average, low and high angle, respectively.Upper lip process point (UL) was moved backwards horizontally to reach towards the E line and go even further gradually in above pictures. The distance changed according to E line was defined as DE value. If UL was in front of E line,DE value was denoted as positive, or else negative. Collectively, we obtained 30 pictures (10 pictures in each skeletal facial type) with different DE values (-5, -4, -3, -2, -1, 0, 1, 2, 3, 4 mm), which were divided into average, low and high angle group according to the skeletal facial type. The pictures were evaluated by 144 randomly-selected adult orthodontic patients [66 males, 78 females, aged (29.4±7.7) years] who visited Department of Orthodontics, Henan Stomatological Hospital from June to September, 2019 and 138 orthodontists (including qualified orthodontists and postgraduate orthodontic students [60 males, 78 females, aged (32.2±7.1) years] who participated orthodontics conferences in Henan Stomatological Hospital in June, 2019. The acceptance rate was calculated and rate above 60% was deemed as acceptable DE range. Evaluators were also asked to choose the most esthetic profiles for the best DE value in each skeletal facial type.Data discrepancy was analyzed using Kruskal-Wallis analysis and chi-square test. Results:Most accepted DE was -2 mm among total investigators including orthodonticpatients and orthodontists. There was no difference in total acceptance rate between orthodontists and patients ( P>0.05). There was statistic difference in total acceptance rate in different skeletal patterns between orthodontic patients and orthodontists ( P<0.05). In total investigators, total acceptance rate was 62.1% (1 752/2 820) in average angle group, 55.4%(1 563/2 820) in high angle group and 33.5%(946/2 820) in low angle group, respectively. Acceptable DE range in three facial types was -4~2 mm (average angle), -2~2 mm (high angle) and -2~-1 mm (low angle), respectively. Conclusions:According to the evaluation of both orthodontic patients and orthodontists, the best DE was-2 mm.Total acceptance rate and acceptable DE range ranked first in average angle group, second in high angle group and third in low angle group.

In recent years,endovascular intervention therapy has gained popularity due to its advantages of minimal trauma and quick recovery,and become an essential method for treating cerebrovascular diseases.As a crucial surgical instrument in interventional therapy,catheters often require precise control of their tips to navigate through tortuous positions.Traditional catheters have shortages of fixed tip shapes,limited proximal torque transmission,and difficulty of manipulation,increasing the risk of complications during interventional procedures and prolonging surgical exposure time.With the rapid development of materials science and engineering,steerable catheter systems have become the spotlight of interventional physicians,making precise"bend control"possible.This article systematically explained the classification of steerable catheter systems,focusing on their application in neurointerventional therapy,and provided an outlook on the future development of steerable catheters.

Objective:To analyze the detection strategy and basic detection situation of markers of infectious diseases transmitted by transfusion in blood testing laboratories of blood stations in China.Methods:Based on the data of practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021, the data on the testing strategies and the basic detection information of the markers for the transmission of infectious diseases through transfusion in the member laboratories of the practice comparison working party of Blood Stations in Mainland of China from 2017 to 2021 were collected, and the situation of the selection for testing markers, testing strategy and the testing method and other relevant aspects were sorted out and analyzed by charts.Results:The selection of the testing markers was consistent, but HTLV testing item was added in some member laboratories. The detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously was adopted in 47 member blood stations; 3) NAT method was dominated by mini pool-NAT in member laboratories. The number of members adopting mini-pools of 8 (MP8)-NAT decreased from 17 in 2017 to 14 in 2021, while the number of members adopting mini-pools of 6 (MP6)-NAT increased from 13 in 2017 to 22 in 2021; Roche NAT system accounted for the largest proportion.Conclusions:In order to ensure blood safety and avoid missing detection, the blood stations still adopt the detection strategy of using two ELISA reagents and one nucleic acid testing (NAT) reagent simultaneously; Meanwhile, in order to increase the NAT positive rate, the proportion of mini pool-NAT mainly decreased year by year despite its dominating role, while the proportion of individual donation-NAT increased year by year; NAT method is transiting from mini-pools of 8 (MP8) to mini-pools of 6 (MP6); The proportion of imported NAT system used in NAT laboratory is relatively large.

Objective:To explore the risk factors of short-term prognosis of severe Budd-Chiari syndrome (BCS) patients,established and verified the nomogram prediction model for these BCS patients and evaluated its clinical application value.Methods:This study is a retrospective cohort study. The clinical data of 171 patients with severe BCS diagnosed were retrospectively analyzed in the Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Zhengzhou University from January 2018 to December 2023. There were 105 males and 66 females, aged (52.1±12.8) years (range: 18 to 79 years). The patients were divided into two groups based on whether they died within 28 days: the death group ( n=38) and the survival group ( n=133). The risk factors for short-term death of patients were analyzed,and independent risk factors were screened by univariate and multivariate analysis. Furthermore,these factors were used to establish the nomogram prediction model. The area under the curve(AUC),the Bootstrap Resampling,the Hosmer-Lemeshow test and the Decision Curve Analysis(DCA) were used to verify the model′s differentiation,internal verification,calibration degree and clinical effectiveness,respectively. Results:Univariate and multivariate Logistics regression analysis showed that the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time were independent risk factors ( P<0.05). The above factors were used to successfully establish the prediction model with 0.908 of AUC and 0.895 of the internal verification of AUC,indicating that the predictive model was valuable. The 0.663 P-values in the Hosmer-Lemeshow test indicated the high calibration degree of the model. The clinical effectiveness of the model was proved by the 18% clinical benefit population using the DCA curve with the 17% probability threshold. Conclusions:The independent risk factors are the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time. An adequate basis was acquired by establishing a nomogram prediction model of the short-term prognosis of severe BCS,which was helpful for early clinical screening and identification of high-risk patients with severe BCS who could die in the short term and timely providing timely intervention measures for improving the prognosis.

Objective:To explore the risk factors of short-term prognosis of severe Budd-Chiari syndrome (BCS) patients,established and verified the nomogram prediction model for these BCS patients and evaluated its clinical application value.Methods:This study is a retrospective cohort study. The clinical data of 171 patients with severe BCS diagnosed were retrospectively analyzed in the Department of Hepatopancreatobiliary Surgery First Affiliated Hospital of Zhengzhou University from January 2018 to December 2023. There were 105 males and 66 females, aged (52.1±12.8) years (range: 18 to 79 years). The patients were divided into two groups based on whether they died within 28 days: the death group ( n=38) and the survival group ( n=133). The risk factors for short-term death of patients were analyzed,and independent risk factors were screened by univariate and multivariate analysis. Furthermore,these factors were used to establish the nomogram prediction model. The area under the curve(AUC),the Bootstrap Resampling,the Hosmer-Lemeshow test and the Decision Curve Analysis(DCA) were used to verify the model′s differentiation,internal verification,calibration degree and clinical effectiveness,respectively. Results:Univariate and multivariate Logistics regression analysis showed that the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time were independent risk factors ( P<0.05). The above factors were used to successfully establish the prediction model with 0.908 of AUC and 0.895 of the internal verification of AUC,indicating that the predictive model was valuable. The 0.663 P-values in the Hosmer-Lemeshow test indicated the high calibration degree of the model. The clinical effectiveness of the model was proved by the 18% clinical benefit population using the DCA curve with the 17% probability threshold. Conclusions:The independent risk factors are the history of hepatic encephalopathy,white blood cell,glomerular filtration rate and prothrombin time. An adequate basis was acquired by establishing a nomogram prediction model of the short-term prognosis of severe BCS,which was helpful for early clinical screening and identification of high-risk patients with severe BCS who could die in the short term and timely providing timely intervention measures for improving the prognosis.

A total of 115 patients with type 2 diabetes recruited from Quanzijie Township Health Service Center were divided into integrated management group (n=54) and specialist management group (n=61). Patients in integrated management group were managed by specialists, general practitioners (GPs) and community nurses jointly; while patients in specialist management group were managed by specialists only. Subjects were followed up every 4 weeks for 24 weeks. Total 366 person/time diabetes education courses were given to subjects in integrated management group during the intervention. After intervention, the fasting glucose, 2 h postprandial glucose and glycosylated hemoglobin were decreased significantly in both groups (P<0.05), while the triglyceride level in the integrated management group was significantly lower than that in the specialist management group (P<0.05). In conclusion, patients with type 2 diabetes managed by integrated mode can achieve similar glucose control effect as specialist management mode in primary care settings and their triglyceride level can be also significantly decreased.

Objective: To explore the effect of "diabetes specialists-community general practitioners-community nurse co-management mode" and "diabetes specialist management mode" on diabetic nephropathy (DN) in primary medical institutions. Methods: Patients with type 2 diabetes admitted to Quanzijie Health Clinic of Jimusar County of Xinjiang Uygur Autonomous Region from October 2017 to March 2018 were enrolled. The Patients were divided into co-management group or specialist management group according to their administrative villages. The treatment plans of the two groups were formulated with reference to the current guidelines. The subjects of the co-management group were jointly managed by a fixed team composed of diabetes specialists from Jimusar Traditional Chinese Medicine Hospital, community general practitioners and community nurses from Quanzijie Health Clinic, and required to attend diabetes education courses every month. The diabetes specialist of Jimusar Traditional Chinese Medicine Hospital was responsible for the formulation and management of the treatment plan of the research object. Follow-up was fulfilled once every 4 weeks for 24 weeks in two groups. Before and after intervention, blood glucose, blood pressure, urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) as well as the utilization rate of angiotensin converting enzyme inhibitors/angiotensin Ⅱ receptor blocker (ACEI/ARB) were collected. Results: A total of 115 patients accomplished this study with 54 patients in co-management group and 61 patients in specialist management group. After 24 weeks of intervention, fasting glucose level, postprandial glucose level 2 hours after breakfast, glycosylated hemoglobin (HbA1c), Log UACR in co-management group and specialists management group were significantly decreased compared with baseline [fasting glucose level (mmol/L): 8.06±1.92 vs. 9.16±2.83, 8.21±2.10 vs. 9.06±1.89; postprandial glucose level 2 hours after breakfast (mmol/L): 12.26±3.78 vs. 14.11±5.28, 12.47±3.63 vs. 14.00±3.88; HbA1c: 0.074±0.014 vs. 0.082±0.023, 0.076±0.014 vs. 0.081±0.016; Log UACR (mg/g): 1.63±1.56 vs. 2.25±1.44, 1.84±1.65 vs. 2.43±1.56, all P < 0.05], but there was no statistical significance between the two groups [fasting glucose level (mmol/L): -1.10±0.47 vs. -0.85±0.36, postprandial glucose level 2 hours after breakfast (mmol/L): -1.85±0.88 vs. -1.53±0.68, HbA1c: -0.008±0.004 vs. -0.006±0.003, Log UACR (mg/g): -0.61±0.29 vs. -0.59±0.29, all P < 0.05]. There were no significant changes in blood pressure, serum creatinine and eGFR in the two groups before and after intervention. There were 18 and 24 patients with hypertension in co-management group and specialist management group, respectively. The utilization rates of ACEI/ARB in both groups after intervention were significantly higher than those before intervention [88.9% (16/18) vs. 22.2% (4/18), 95.8% (23/24) vs. 29.2% (7/24), both P < 0.01]. At the end of the study, the utilization rate of ACEI/ARB was similar between the two groups [88.9% (16/18) vs. 95.8% (23/24), P > 0.05]. Conclusion Both "diabetes specialists-community general practitioners-community nurse co-management mode" and "diabetes specialist management mode" can effectively decrease glucose levels and UACR levels of patients with type 2 diabetes as well as the standard use of antihypertensive agents, which has positive effects on the prevention and treatment on DN.

OBJECTIVE: To explore the effect of "diabetes specialists-community general practitioners-community nurse co-management mode" and "diabetes specialist management mode" on diabetic nephropathy (DN) in primary medical institutions. METHODS: Patients with type 2 diabetes admitted to Quanzijie Health Clinic of Jimusar County of Xinjiang Uygur Autonomous Region from October 2017 to March 2018 were enrolled. The Patients were divided into co-management group or specialist management group according to their administrative villages. The treatment plans of the two groups were formulated with reference to the current guidelines. The subjects of the co-management group were jointly managed by a fixed team composed of diabetes specialists from Jimusar Traditional Chinese Medicine Hospital, community general practitioners and community nurses from Quanzijie Health Clinic, and required to attend diabetes education courses every month. The diabetes specialist of Jimusar Traditional Chinese Medicine Hospital was responsible for the formulation and management of the treatment plan of the research object. Follow-up was fulfilled once every 4 weeks for 24 weeks in two groups. Before and after intervention, blood glucose, blood pressure, urinary albumin/creatinine ratio (UACR), estimated glomerular filtration rate (eGFR) as well as the utilization rate of angiotensin converting enzyme inhibitors/angiotensin II receptor blocker (ACEI/ARB) were collected. RESULTS: A total of 115 patients accomplished this study with 54 patients in co-management group and 61 patients in specialist management group. After 24 weeks of intervention, fasting glucose level, postprandial glucose level 2 hours after breakfast, glycosylated hemoglobin (HbA1c), Log UACR in co-management group and specialists management group were significantly decreased compared with baseline [fasting glucose level (mmol/L): 8.06±1.92 vs. 9.16±2.83, 8.21±2.10 vs. 9.06±1.89; postprandial glucose level 2 hours after breakfast (mmol/L): 12.26±3.78 vs. 14.11±5.28, 12.47±3.63 vs. 14.00±3.88; HbA1c: 0.074±0.014 vs. 0.082±0.023, 0.076±0.014 vs. 0.081±0.016; Log UACR (mg/g): 1.63±1.56 vs. 2.25±1.44, 1.84±1.65 vs. 2.43±1.56, all P < 0.05], but there was no statistical significance between the two groups [fasting glucose level (mmol/L): -1.10±0.47 vs. -0.85±0.36, postprandial glucose level 2 hours after breakfast (mmol/L): -1.85±0.88 vs. -1.53±0.68, HbA1c: -0.008±0.004 vs. -0.006±0.003, Log UACR (mg/g): -0.61±0.29 vs. -0.59±0.29, all P < 0.05]. There were no significant changes in blood pressure, serum creatinine and eGFR in the two groups before and after intervention. There were 18 and 24 patients with hypertension in co-management group and specialist management group, respectively. The utilization rates of ACEI/ARB in both groups after intervention were significantly higher than those before intervention [88.9% (16/18) vs. 22.2% (4/18), 95.8% (23/24) vs. 29.2% (7/24), both P < 0.01]. At the end of the study, the utilization rate of ACEI/ARB was similar between the two groups [88.9% (16/18) vs. 95.8% (23/24), P > 0.05]. CONCLUSIONS Both "diabetes specialists-community general practitioners-community nurse co-management mode" and "diabetes specialist management mode" can effectively decrease glucose levels and UACR levels of patients with type 2 diabetes as well as the standard use of antihypertensive agents, which has positive effects on the prevention and treatment on DN.
Blood Glucose ; Creatinine ; Diabetes Mellitus, Type 2 ; Diabetic Nephropathies ; Humans ; Prospective Studies