0.05);the successful rate was 92.9 %.Conclusion Favorable results after 12~18 months of clinical service indicate that the DT light-post system can be an effective alternative to conventional cast post-and-core systems in the treatment of anterior esthetic prosthodontics.

Cross-leg flaps are a useful reconstructive option for complex lower limb defects when free flaps cannot be performed owing to vessel damage. We describe the use of the extended distally based sural artery flap in a cross-leg fashion for lower extremity coverage in three patients. To maximise the viability of these extended flaps, a delay was performed by raising them in a bipedicled fashion before gradual division of the tip over 5 to 7 days for cross-leg transfer. Rigid coupling of the lower limbs with external fixators was critical in preventing flap avulsion and to promote neovascular takeover. The pedicle was gradually divided over the ensuing 7 to 14 days before full flap inset and removal of the external fixators. In all three patients, the flaps survived with no complications and successful coverage of the critical defect was achieved. One patient developed a grade 2 pressure injury on his heel that resolved with conservative dressings. The donor sites and external fixator pin wounds healed well, with no functional morbidity. The cross-leg extended distally based sural artery flap is a reliable reconstructive option in challenging scenarios. Adequate flap delay, manoeuvres to reduce congestion, and postoperative rigid immobilization are key to a successful outcome.
Arteries ; Bandages ; Estrogens, Conjugated (USP) ; External Fixators ; Free Tissue Flaps ; Heel ; Humans ; Immobilization ; Leg Injuries ; Lower Extremity ; Perforator Flap ; Sural Nerve ; Surgical Flaps ; Tissue Donors ; Wounds and Injuries

Objective: To explore the influence of birthweight and delivery mode on overweight/obesity and abdominal obesity in primary school students, and to provide evidence for childhood obesity prevention. Methods: After physical examination, questionnaire survey was conducted among 3 361 students and their parents from 3 primary schools in Guangzhou selected through stratified clustering sampling. Information about birthweight and delivery mode was collected. Logistic regression model was used to analyze the association of birthweight and delivery mode with overweight/obesity and abdominal obesity. The multiplicative interaction term and the Delta method was used to explore the potential interaction. Results: The prevalence rate of overweight and obesity for primary school students was 21.33%, and the rate of abdominal obesity was 12.08%. Multivariate Logistic regression analysis showed that delivery by cesarean section was associated with 44% increased risk of overweight/obesity(OR=1.44, 95%CI=1.16-1.80), as compared to vaginal delivery. Higher birthweight was linked to increased risk of overweight/obesity(OR=1.62, 95%CI=1.09-2.42). There was no significant association of birth weight and delivery mode with abdominal obesity in multivariate analysis(P>0.05). Additionally, a positive additive interaction was seen between delivery mode and parental obesity for students risk of overweight/obesity(RERI=0.33, 95%CI=0.02-0.65), as well as for the risk of abdominal obesity(RERI=0.39, 95%CI=0.12-0.65). Conclusion Cesarean section delivery and higher birthweight are linked to increased risk of overweight and obesity in primary school students. The synergistic effect of cesarean section and parental obesity may increase the risk of childhood obesity.

: To investigate the current status of milk and dairy product intake of primary and middle school students in Guangzhou and to explore the influencing factors, to provide the basis for promoting the consumption of milk and dairy products for students. Methods: Questionnaire survey was conducted among 7 948 students selected from 3 primary schools and 3 middle schools in Guangzhou. The contents included general information, average amount of the intake of milk and dairy products (including pure milk, yoghurt, milk powder, cheese and other dairy products). Using χ2 test and multivariate Logistic regression to analyze the influencing factors of students’ milk and dairy product intake. Results: About 76.12% of all participants reported milk and dairy products intake<7 times/week, 78.88% reported milk and dairy products intake<300 g/d and the median of milk and dairy products was 178.57 g/d. In the multiple Logistic regression model, girls and high school students were more likely to consume milk and dairy products insufficiently, with the OR of 1.42 (95%CI=1.26-1.60), 1.86 (95%CI=1.51-2.28) respectively. The students with father’s education level being college degree or above (OR= 0.75, 95%CI=0.59-0.94), mother’s education level being high school or above (high school:OR=0.75, 95%CI=0.61-0.93, college degree or above:OR=0.58, 95%CI=0.46-0.72) and annual household income ≥200 000 (OR=0.77,95%CI=0.64-0.92) were more likely to consume sufficient milk and dairy products. Conclusion Consumption of milk and dairy products among primary and middle school students in Guangzhou was high but not meet the recommended amount,should be strengthened. Health and nutritional education for students and their parents,especially girls and senior students,should be strengthened to promote the milk and dairy products consumption.

Objective: To investigate the effect of maternal passive smoking during pregnancy and girls’ overweight /obesity on the age at menarche(AAM), and to provide a reference for improving healthy development of children and adolescents. Methods: Based on the school entrance physical examination in 2016, a cross-section study was conducted by convenient sampling method, in a total of 2 722 students of 7th grade, from 26 middle schools in urban areas of Guangzhou. Multivariate logistic regression model was used to investigate the relationship between maternal passive smoking during pregnancy and girls’ overweight /obesity and AAM. A four-way decomposition method was used to explore the mediated effect of girls’ overweight/obesity on the relationship between maternal passive smoking during pregnancy and AAM. Results: The proportion of girls who had menstruate was 90.82%(2 472/2 722). The median AAM was 12.00 years old, with an early menarche rate of 34.91%(863/2 472). Compared with girls whose mother hadn’t passive smoking during pregnancy, the risk of early AAM in girls with mother passive smoking during pregnancy≤3 days/week increased by 32%(OR=1.32, 95%CI=1.06-1.65), the risk in girls with maternal passive smoking during pregnancy>3 days/week increased by 58%(OR=1.58, 95%CI=1.21-2.07). Multivariate Logistic regression analysis showed that, overweight or obesity girls had a 77% higher risk of early AAM than non-overweight/obesity girls(OR=1.77, 95%CI=1.36-2.31). The four-way decomposition analysis showed 79.60% of early AAM risk could be accounted by maternal passive smoking during pregnancy(P<0.01). Conclusion Girls’ overweight/obesity and maternal passive smoking during pregnancy were associated with early menarche. The effect on daughters’ age at menarche is mainly in a direct effect manner of maternal passive smoking during pregnancy.

Objective:To investigate the distribution features of anti-neutrophil cytoplasmic antibody (ANCA) in patients with cardiovascular and cerebrovascular diseases and the clinical characteristics of the patients.Methods:Clinical data of 6 759 patients who were treated in Baoding No.1 Central Hospital for cardiovascular and cerebrovascular diseases during January 2015 to July 2019 were collected and analyzed. ANCA was detected by indirect immunofluorescence (IIF). Antibodies against myeloperoxidase (MPO) and protease 3 (PR3) were detected by enzyme-linked immunosorbent assay (ELISA).Results:IIF showed that 558 out of the 6 759 cases tested positive for ANCA with a positive rate of 8.26%. Among them, 382 (68.46%) were positive for perinuclear ANCA (p-ANCA) and 176 (31.54%) were positive for cytoplasmic ANCA (c-ANCA). Anti-MPO and anti-PR3 antibodies were detected in 69 ANCA-positive cases, while the antibodies against other target antigens were detected in 489 cases. The ratio between the two groups was 1∶7.09. The incidence of recurrent respiratory tract infection and pulmonary interstitial lesions in ANCA-positive cases was 69.35% (387/558) and 64.52% (360/558), respectively, which was significantly higher than that in ANCA-negative patients [40.51% (2 512/6 201) and 33.17% (2 057/6 201)].Conclusions:Anti-MPO and anti-PR3 antibody detection could not replace IIF to detect total ANCA for a high rate of missed diagnosis would be caused. Early detection of ANCA would be of great significance to patients with chronic cardiovascular and cerebrovascular diseases.

Objectives:To explore the prognostic significances of geriatric nutrition risk index (GNRI), controlling nutritional status (CONUT), and prognostic nutritional index (PNI) in patients with heart failure.Methods:This was a retrospective study. Patients with heart failure admitted to the Department of Cardiology, the first affiliated hospital of Sun Yat-sen University from September 16, 2013 to December 28, 2017 were enrolled. Clinical data of patients were collected and patients were followed up. GNRI, CONUT and PNI scores of patients were calculated. Cox proportional risk model was used to evaluate the relationship between the above three nutritional status scores and the risk of all-cause death in patients with heart failure, and restricted cubic spline analysis was used to verify the relationship. Subgroup analysis was performed based on left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, number of heart failure comorbidities, systolic blood pressure, creatinine, body mass index, use of angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists, use of β-blockers, and use of spironolactone.Results:A total of 2 016 patients with heart failure aged (67.7±13.0) years old were enrolled, including 1 230 (61.0%) males. All patients were followed up until September 15, 2021. Multivariate Cox proportional hazard models showed that increased GNRI score was significantly associated with reduced risk of all-cause mortality in patients with heart failure ( HR=0.989, 95% CI 0.982-0.996, P=0.001), while CONUT and PNI scores were not associated with all-cause mortality (both P>0.05). Restricted cubic spline analysis showed no U-shaped relationship between the scores and all-cause death. Subgroup analysis suggested that the prognostic value of GNRI score was predominant in patients not using angiotensin-converting enzyme inhibitor/angiotensin receptor blocker ( Pinteraction=0.024), while there was no statistically significant difference between groups in other subgroup analyses ( Pinteraction>0.05). Conclusions:Increased GNRI score is associated with reduced risk of all-cause mortality in patients with heart failure and may serve as an effective tool to assess nutritional status in patients with heart failure.

Objective: To understand the relationship between screen time and dietary behaviors among urban middle school students in Guangzhou, and to provide scientific evidence for improving students’ health. Methods: Based on the regular medical examinations for elementary and middle school students in Guangzhou, a total of 12 357 middle school students (grade 7 and grade 10) were investigated by using a cross-sectional study. The physical indicators and daily routine were collected by physical examination and questionnaire survey. Multiple Logistic regression analysis was used to explore the association between screen time and dietary behaviors among students. Results: The proportion of excessive screen time was 18.80% (2 323). There was no significant difference between boys (18.52%, 1 165/6 292) and girls (19.09%, 1 158/6 065) (χ2=0.67, P>0.05). Logistic regression results showed that excessive screen time was negatively associated with consumption of vegetables and fruits, with the aORs of 0.50 (95%CI=0.42-0.58) and 0.64 (95%CI=0.58-0.70) respectively, and positively associated with consumption of fried food (OR=1.90, 95%CI=1.70-2.09), western fast food (OR=1.90, 95%CI=1.65-2.19), sweets (OR=1.36, 95%CI=1.25-1.49) and sugar-sweetened beverage (OR=1.70, 95%CI=1.57-1.84). Conclusion Excessive screen time was associated with unhealthy dietary behaviors among middle school students in Guangzhou. Intervention should be tailored to screen time as well as dietary behaviors.

Radiation-induced brain injury (RBI) is the most serious complication of head and neck tumor after radiotherapy. The pathogenesis of RBI is complicated, and the clinical course is irreversible, while no effective treatment available. The activation of glial cells is one of the main theories of RBI, and the prevention and treatment of RBI by targeting glial cells is the focus of current research. As a post-transcriptional regulatory factor, microRNA (miRNA) has been confirmed to be involved in regulatingglial cell radiosensitivity, inflammation type transformation, autophagy, exosomatic, long non-coding RNA (lncRNA), circular RNA (circRNA) and other related pathways, thereby mediating the occurrence and development of cascade reaction of inflammatory injury and neurological function repair of central nervous system (CNS) disease. Therefore, the establishment of miRNA - glial regulatory network may provide a new strategy for the prevention and treatment of RBI.

Interventional therapy for hepatic malignant tumours primarily includes cardiovascular system surgery,diges-tive system surgery,and various diagnostic and therapeutic procedures.Referring to the"International Classification of Diseases,Ninth Edition,Clinical Modification,ICD-9-CM-3"(2011 revision),the relevant surgical procedure codes on the front page of the case are contained mainly in the 9th chapter for cardiovascular system surgery,the 11th chapter for digestive system surgery,and the 18th chapter for various diagnostic and therapeutic procedures and other related chapters on diagnostic and therapeutic procedures.It has become a challenge for the history coders to complete the first page of interventional surgery cases by reviewing the surgery records,extracting the surgical steps,and then identifying the appropriate surgery codes and their sequencing.Accord-ing to the current classification of interventional therapy for hepatic malignant tumors,it is suggested to conduct the search and re-trieval using the keywords like"arteriography""embolization""perfusion""implantation""destruction"and"ablation".