Objective To obtain the acceptable range for posed smile characteristic index,in order to supply diagnostic and therapeutic basis for orthodontic treatment.Methods The 200 subjects included in the study consisted of 100 experienced orthodontists and 100 laypersons.Both two frontal posed smile photographs of man and woman were changed by several smile characteristic indexes,including the amount of incisor exposure,amount of gingival display,smile arc,buccal corridor fill,horizontal inclination of maxillary occlusal plate and distance from lower lip to maxillary incisor.All the subjects were desired to evaluate each images according to their own aesthetic standard.Results Each acceptable range for the amount of incisor exposure,amount of gingival display,smile arc,buccal corridor fill,horizontal inclination of maxillary occlusal plate and distance from lower lip to maxillary incisor,was 75 ％-100 ％ (male and female),0-2 mm (male) and 0-3 mm (female) ; 50 ％-100 ％(male and female) ; 0 ％-15 ％ (male) and 0 ％-20 ％ (female) ; 0-6° (male and female) ; 0 mm (male and female)(P＜0.05),respectively.And there was perception difference between the orthodontists and the laypersons on smile evaluation (P＜0.05).Conclusions Posed smile analysis should be an im portant aspect of orthodontic diagnosis and treatment planning.Orthodontists should not disturb con sonant smiles but create them with proper bracket positioning.

Objective To investigate the current status of iodine deficiency disorders in Lianyungang,Jiangsu Province,and to evaluate the effectiveness of prevention and control measures.Methods Using population probability proportional to size sampling method (PPS),in Lianyungang City,30 townships (towns) were selected,one primary school was selected in each township (town),fifty 8-10 years old students (half male and half female,uniformly distributed in age groups) were selected in each school,and goiter was examined; one random urine sample was collected to survey the urinary iodine content; household salt sample was collected to survey the salt iodine content.At the same time,30 students from Grade 5 in each school were selected,and health education questionnaire survey was conducted.In the village where the primary school located,5 housewives were selected and a questionnaire survey was conducted; salt samples were collected and salt iodine level was tested by semi quantitative detection on site; 2-5 drinking water samples were collected and the water iodine level was determined in the village.One random urine sample from twenty pregnant women and 10 lactating women in the township (town)was selected and urinary iodine was determined.The goiter was examined by palpation; urinary iodine was detected by arsenic cerium catalytic spectrophotometry (WS/T 107-2006); salt iodine was detected by direct titration,Sichuan salt and other fortified edible salt were tested by arbitration law (GB/T 13025.7-2012); water iodine was detected by the method suitable for iodine deficiency and high iodine areas (recommended method of reference laboratory of national iodine deficiency disorders).Results One thousand and five hundred children aged 8-10 years old were examined by palpation,18 children had goiter,and the goiter rate was 1.20％ (18/1 500).One thousand and five hundred urine samples of children aged 8-10 years old were tested,and the median of urinary iodine was 239.62 μg/L.A total of 1 500 salt samples were tested; the coverage rate of iodized salt was 96.73％ (1 451/1 500); the rate of qualified iodized salt was 93.53％ (1 403/1 500); and the non-iodized salt rate was 3.27％ (49/1 500).The number of question of the questionnaire survey of health education about iodine deficiency disorders among students and housewives was 2 697,450; the number of correct answer was 2 542,410; the pass rates were 94.25％ and 91.11％,respectively.Sixty-six drinking water samples were collected,water iodine median was 13.5 μg/L.Six hundred and one,two hundred and ninety-eight urine samples of pregnant women and lactating women were monitored,and the median of urinary iodine was 176.12 and 150.03 μg/L,respectively.Conclusion The status of iodine nutrition among residents in Lianyungang City has improved,the control effect of iodine deficiency disorders is significant,and the achievements are stable.

Objective To investigate the relationship between HBV polymerase gene mutations and HBV genotypes in chronic hepatitis B (CHB) patients resistant to adefovir dipivoxil (ADV).Methods Blood samples were collected from 114 ADV-resistant CHB patients during February 2010 and May 2012.The HBV polymerase regions from serum samples were amplified with real-time PCR,and the PCR products were sequenced.Normal distribution data were presented as x ± s,and non-normal distribution data were presented as M (P25-P75) ; for homogeneous data analysis of variance and LSD-t test were performed.Results There were 8 types of HBV polymerase gene mutations in 114 CHB patients; single point mutation was detected in 102 patients (89.47％) and double or triple points mutations were detected in 12 patients (10.53％).rtA181V/T/S (57.89％),rtN236T (14.91％) and rtA181V/T/S + N236T (9.65％) were the predominant mutations.For 21 patients (18.42％) with HBV genotype B,rtN236T mutation was prevalent (47.62％,10/21) ; while for those with HBV genotype C (93,81.58％),rtA181V/T/S mutation was the predominant (65.59％,61/93).The differences of rtA181V/T/S (x2 =12.269,P ＜0.01) and rtN236T (x2 =18.658,P ＜0.01) mutation rates between B and C genotypes were statistically significant.Conclusion rtA181V/T/S,rtN236T and rtA181V/T/S + rtN236T are the major HBV polymerase gene mutation types in ADV resistant CHB patients,and mutation types are related with HBV genotypes.

Objective? To summarize the nursing experience for extracorporeal membrane oxygenation therapy (ECMO) waiting for lung transplantation. Methods? Totally 4 patients waiting for lung transplantation who received ECMO in Shanghai Lung Hospital from May 2017 to June 2018. Nursing management strategies included: building a multidisciplinary medical and nursing team, using "awake" ECMO strategies in early stages, employing high flow nasal cannulae oxygen therapy to improve oxygenation, monitoring coagulation and anticoagulation, and careful in-hospital transfer process management. Results? After careful therapy and nursing care, 3 patients were safely transferred to the operation room for lung transplantation, and 1 died. Conclusions? Careful nursing management during ECMO can improve the survival rate of critical patients and guarantee successful lung transplantation and better prognosis.

Objective: To investigate the correlation between takeaway food consumption and poor sleep status of college students in Jiangxi Province, to provide a theoretical basis for poor sleep prevention and intervention among college students. Methods: A total of 2 610 college students were selected from a university in Shangrao City, Jiangxi Province by cluster stratified random sampling in May of 2018. The frequency and type of takeaway food consumption, sleep quality and drowsiness were investigated. Results: The detection rate of takeaway food consumption behavior(≥4 times in a week) for college students was 74.8%. The detection rates of poor sleep quality and drowsiness were 17.0% and 18.3%, respectively. The difference of sleep quality was statistically significant with sex, college, different self rated family conditions, study burden, physical activity level, depression and daily smoking ( χ 2=4.33，8.67，23.14，39.03，12.89，313.37，15.23， P <0.05). There were statistically significant differences between drowsiness and college, grade, learning burden, physical activity and depression ( χ 2=12.81，6.57，20.61，8.42，228.06， P <0.05). Logistic regression analysis showed that takeaway consumption (≥4 times in a week) had statistical significance with poor sleep quality and drowsiness ( P <0.05). Conclusion College students takeaway consumption (≥4 times in a week) of rice noodles, malatang, fragrant pot hot pot increase the risk of poor sleep. It is suggested that schools should strengthen nutrition and health education for college students.

OBJECTIVES: Safe and effective anticoagulation is essential for hemodialysis patients who are at high risk of bleeding. The purpose of this trial is to evaluate the effectiveness and safety of two-stage regional citrate anticoagulation (RCA) combined with sequential anticoagulation and standard calcium-containing dialysate in intermittent hemodialysis (IHD) treatment. METHODS: Patients at high risk of bleeding who underwent IHD from September 2019 to May 2021 were prospectively enrolled in 13 blood purification centers of nephrology departments, and were randomly divided into RCA group and saline flushing group. In the RCA group, 0.04 g/mL sodium citrate was infused from the start of the dialysis line during blood draining and at the venous expansion chamber. The sodium citrate was stopped after 3 h of dialysis, which was changed to sequential dialysis without anticoagulant. The hazard ratios for coagulation were according to baseline. RESULTS: A total of 159 patients and 208 sessions were enrolled, including RCA group (80 patients, 110 sessions) and saline flushing group (79 patients, 98 sessions). The incidence of severe coagulation events of extracorporeal circulation in the RCA group was significantly lower than that in the saline flushing group (3.64% vs. 20.41%, P<0.001). The survival time of the filter pipeline in the RCA group was significantly longer than that in the saline flushing group ((238.34±9.33) min vs. (221.73±34.10) min, P<0.001). The urea clearance index (Kt/V) in the RCA group was similar to that in the saline flushing group with no statistically significant difference (1.12±0.34 vs. 1.08±0.34, P=0.41). CONCLUSIONS Compared with saline flushing, the two-stage RCA combined with a sequential anticoagulation strategy significantly reduced extracorporeal circulation clotting events and prolonged the dialysis time without serious adverse events.
Humans ; Citric Acid/adverse effects* ; Prospective Studies ; Sodium Citrate ; Hemorrhage/chemically induced* ; Citrates/adverse effects* ; Anticoagulants/adverse effects* ; Renal Dialysis/adverse effects*