Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

Objective:To investigate the characteristics of cortical morphology in children with attention defi-cit hyperactivity disorder(ADHD)and those with oppositional defiant disorder(ODD)from both categorical and dimensional analyses.Methods:A total of 72 children were enrolled,including 16 children with ADHD and ODD,20 children with ADHD without ODD,and 36 age-gender-matched normal children.The diagnoses were made ac-cording to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)criteria.The Chi-nese Wechsler Intelligence Scale for Children(C-WISC)was used to access intelligence quotient.All subjects par-ticipated in the magnetic resonance imaging(MRI)scan.The features of cortical morphology were determined using FreeSurfer software.Results:Children with ADHD and ODD[(6 528.1±857.5)mm3 vs.(7 591.2±657.3)]and children with ADHD only[(6 867.2±41.3)mm3 vs.(7 591.2±657.3)mm3]had smaller volume in the left later-al superior temporal gyrus(P＜0.05)than controls.No difference was found between ADHD with ODD group and ADHD without ODD group.There was no correlation between the cortical volume of left lateral superior temporal gyrus and ODD symptoms.Conclusion:The reduced cortical volume of left lateral superior temporal gyrus may be an important indication of the abnormal brain structure of ADHD in children.And comorbid status of ODD dose not change this structural variation.

Affiliated Hospital of Jiangnan University has always adhered to the public welfare orientation,with the starting point of three fusion three innovation,guided by the high-quality development strategy led by party building,strengthened top-level design,solidly implemented grassroots party building quality and efficiency improvement actions based on branch fortresses,deepened the standardization and standardization construction of party branches,adhered to the deep integration of party building business,explored the key path of the affiliated hospital's characteristics,continuously improved the level of refined management,and met the people's medical needs in all aspects,It has conducted effective exploration and practice.

Objective:This study aims to summarize the surgical efficacy of macroglossia reduction combined with radiofrequency ablation of Beckwith-Wiedemann Syndrome (BWS).Methods:A retrospective analysis was conducted on the clinical data of patients with macroglossia who received treatment at the Department of Otolaryngology-Head and Neck Surgery, Xiamen Children’s Hospital between May 2019 and July 2022. All patients with macroglossia underwent either one-stage or staged anterior tongue V-shaped incision massive resection, followed by needle tip low-temperature plasma radiofrequency ablation on the lateral and base of the tongue. The postoperative complications in pediatric patients were monitored, including the incision shape of the tongue body, restoration of tongue body structure and function. MRI scans of the tongue were performed at 3 and 12 months post-operation to evaluate tissue healing, changes in tongue volume, and whether there was successful retraction of the enlarged tongue into the oral cavity for evaluating treatment efficacy (cured or not cured).Results:The study included 70 cases, comprising 31 male and 39 female patients, with an average age of 15.4 months (ranging from 5 months to 4 years old). Among them, 68 cases underwent macroglossia reduction combined with radiofrequency ablation at the same time, and 2 cases underwent macroglossia reduction surgery first in other hospitals, and tongue body radiofrequency ablation was performed one year after the surgery. All children were followed up foran average follow-up time of 18 months (6 to 36 months). There were no serious complications such as massive hemorrhage and tongue hematoma. After the operation, 14 cases of superficial rupture of tongue tip wound were gradually improved after 5-7 days of no oral eating, and recovered after 4-12 weeks of liquid diet. Thirteen cases had suture reactions in the tongue back, which were self-resolving within 2 to 3 weeks with no special treatment. All patients showed significant reduction in tongue size after the surgery, which could be completely inserted into the oral cavity, and the treatment effect was satisfactory.Conclusion:Macroglossia reduction combined with radiofrequency ablation is a feasible and effective method for the treatment of BWS with macroglossia and is recommended for application.

Objective To observe the effectiveness and safety of Regional Citrate Anticoagulation(RCA)in CRRT combined with artificial liver treatment.Methods Clinical data of 54 sessions of CRRT linked with artificial liver treatment using RCA in 21 patients with acute on chronic liver failure(ACLF)combined with acute kidney injury(AKI)admitted to our center from December 2019 to June 2023 were collected..The improvement of liver and kidney function indicators,anticoagulant effect and adverse reactions of citric acid,and patient outcomes were observed and analyzed before and after treatment.Results The 54 cases of liver and renal function indexes were improved,which showed a statistically significant difference(P<0.05);All 54 cases of CRRT linked artificial liver treatment were successfully completed,and no obvious blood clots were found in the extracorporeal circulation tubing,filters,and adsorbers;There was no statistically significant difference(P>0.05)in the total calcium and ionized calcium levels of all patients at each stage of artificial liver treatment compared to before treatment;However,three cases of CRRT combined with PE and one case of CRRT combined with DPMAS+LPE experienced citrate accumulation after treatment,which returned to normal after 24 hours of timely correction and supplemen-tation;The 30-day survival rate of the 21 patients was 13 survivors,5 deaths,and 3 discharged automatically.Conclusion Under strict monitoring and timely adjustment,the application of RCA in CRRT series artificial liver treatment is safe and feasible,and is worthy of clinical promotion.

Objective:To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods.Methods:This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was ( M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results:The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up ( F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score ( r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score ( r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score ( r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion:Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

Objective:This study aims to summarize the surgical efficacy of macroglossia reduction combined with radiofrequency ablation of Beckwith-Wiedemann Syndrome (BWS).Methods:A retrospective analysis was conducted on the clinical data of patients with macroglossia who received treatment at the Department of Otolaryngology-Head and Neck Surgery, Xiamen Children’s Hospital between May 2019 and July 2022. All patients with macroglossia underwent either one-stage or staged anterior tongue V-shaped incision massive resection, followed by needle tip low-temperature plasma radiofrequency ablation on the lateral and base of the tongue. The postoperative complications in pediatric patients were monitored, including the incision shape of the tongue body, restoration of tongue body structure and function. MRI scans of the tongue were performed at 3 and 12 months post-operation to evaluate tissue healing, changes in tongue volume, and whether there was successful retraction of the enlarged tongue into the oral cavity for evaluating treatment efficacy (cured or not cured).Results:The study included 70 cases, comprising 31 male and 39 female patients, with an average age of 15.4 months (ranging from 5 months to 4 years old). Among them, 68 cases underwent macroglossia reduction combined with radiofrequency ablation at the same time, and 2 cases underwent macroglossia reduction surgery first in other hospitals, and tongue body radiofrequency ablation was performed one year after the surgery. All children were followed up foran average follow-up time of 18 months (6 to 36 months). There were no serious complications such as massive hemorrhage and tongue hematoma. After the operation, 14 cases of superficial rupture of tongue tip wound were gradually improved after 5-7 days of no oral eating, and recovered after 4-12 weeks of liquid diet. Thirteen cases had suture reactions in the tongue back, which were self-resolving within 2 to 3 weeks with no special treatment. All patients showed significant reduction in tongue size after the surgery, which could be completely inserted into the oral cavity, and the treatment effect was satisfactory.Conclusion:Macroglossia reduction combined with radiofrequency ablation is a feasible and effective method for the treatment of BWS with macroglossia and is recommended for application.

Objective:To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods.Methods:This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was ( M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results:The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up ( F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score ( r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score ( r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score ( r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion:Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.

Objective:To investigate the efficacy and safety of oral semaglutide in Chinese patients with type 2 diabetes mellitus(T2DM) inadequately controlled by diet and exercise only.Methods:In the randomized, double-blind, multicenter, multinational PIONEER-11 trial, Chinese patients were prospectively randomly assigned to receive oral semaglutide 3, 7, or 14 mg, or placebo. The primary endpoint was the change from baseline in glycated hemoglobin(HbA 1C) at week 26. This is a pre-defined subset analysis to assess the efficacy and safety in Chinese patients. Results:Totally 390 Chinese T2DM patients were enrolled(mean age 51 years), with a T2DM duration of 1.8 years, HbA 1C of 7.9%, and BMI of 26.5 kg/m 2 at baseline. Overall, changes at week 26 from baseline in HbA 1C were -1.1%, -1.6%, -1.6%, and 0.0%, and in bodyweight were -0.7, -1.9, -2.6, and -0.7 kg in oral semaglutide(3, 7, or 14 mg) and placebo groups, respectively. Compared to the placebo group, estimated treatment differences(ETDs) in HbA 1C for the 3, 7, and 14 mg groups were -1.2%(95% CI -1.4, -0.9), -1.7%(95% CI -1.9, -1.4), and -1.6%(95% CI -1.9, -1.4)(all P<0.001), respectively, and in weight loss for the 7 mg and 14 mg groups were -1.2 kg(95% CI -2.1, -0.4; P=0.006) and -1.9 kg(95% CI -2.8, -1.0; P<0.001), respectively. The most frequent gastrointestinal adverse events were diarrhea(oral semaglutide: 3.1%-12.5% vs placebo: 2.0%) and nausea(3.1%-6.3% vs 2.0%), mostly mild in severity and transient. Conclusion:In Chinese patients with T2DM who had insufficient glycemic control with diet and exercise only, oral semaglutide showed better glycemic control at doses of 3, 7, and 14 mg and more weight loss at doses of 7 and 14 mg compared to placebo, with a safety profile consistent with that observed in the global trial population.

Objective:To improve the users’ comfort of steady-state visual evoked potential (SSVEP)-based brain-computer interface (BCI) through high-frequency stimulation and overcome the problem of accuracy decline caused by high frequency by combining dual-frequency encoding.Methods:Two dual-frequency high-frequency 60-instruction paradigms based on left and right visual fields and checkerboard stimuli were designed based on the 25.5 - 39.6 Hz frequency. Thirteen subjects participated in the experiment, and spectrum and spatial characteristics analyses were performed on SSVEP signals. The filter bank parameters were optimized based on the spectrum characteristics. Extended canonical correlation analysis (eCCA), ensemble task-related component analysis (eTRCA), and task-discriminant component analysis (TDCA) were used for SSVEP recognition.Results:Stable SSVEP was successfully induced in both the left and right visual fields and the checkerboard grid paradigm. The left and right visual fields had high signal-to-noise ratios for the fundamental frequency and its harmonics and weak signal-to-noise ratios for intermodulation components, whereas the intermodulation components of the 2 stimulus frequencies of the checkerboard grid, f1 + f2, had significantly higher signal-to-noise ratios than the second harmonic components above 30 Hz, and there was also a f2 ? f1 component and a 2 f1 ? f2 component. Combined with brain topography, it can be seen that the f1 and f2 response components of the left and right visual fields are located on opposite sides of the visual field, while the checkerboard grids are both concentrated in the center of the occipital region. Regarding the lateralization of brain topography amplitude and signal-to-noise ratio, the mean values of the PO3 and PO4 signal-to-noise ratios at the stimulation frequency of the left and right visual fields are consistent with the contralateral response characteristics. The 5 fb ? 1 method is the optimal filter set setting method, and the recognition correctness rate of TDCA for the left and right visual fields is the highest. However, the comparison of the recognition correctness rate of tessellated lattice eTRCA and TDCA is not statistically significant ( P > 0.05). The information transmission rates of the three algorithms all increase and then decrease with the increase in data length. Conclusions:The designed dual-frequency, high-frequency SSVEP-BCI paradigm is able to better balance performance and comfort and provides a basis for practical large instruction set BCI design methods.