BACKGROUND:Socket-shield technique can effectively maintain labial soft and hard tissues,but the incidence of postoperative complications such as exposure and displacement of root shield is relatively high.It is speculated that the root shield may be exposed and displaced due to excessive load after long-term function of dental implants. OBJECTIVE:Through three-dimensional finite element analysis,we aim to study the influence of varying root shield thicknesses on the stress distribution,equivalent stress peaks,and displacement in the root shield,periodontal ligaments,implant,and surrounding alveolar bone under normal occlusal loading.We also attempt to analyze the correlation between the thickness of the root shield and occurrence of mechanical events such as root shield exposure,displacement,and fracture. METHODS:Cone-beam CT data of a patient who met the indication standard of socket-shield technique for maxillary central incisor were retrieved from database.Reverse engineering techniques were used to build models of the maxillary bone and root shield,while forward engineering was used to create models for the implant components based on their parameters.Models depicting various root shield thicknesses(0.5,1.0,1.5,and 2.0 mm)were created using Solidworks 2022 software.ANSYS Workbench 2021 software was then used to simulate and analyze the effects of varying root shield thicknesses on stress distribution,equivalent stress peaks,and displacement of the root shields,periodontal ligaments,implants,and surrounding alveolar bone under normal occlusion. RESULTS AND CONCLUSION:(1)In all root shield models,the stress was concentrated on the palatal cervical side,both sides of the edges and the lower edge of the labial side.As the thickness of the root shield increased,the equivalent stress peak and displacement showed a decreasing trend.The 0.5 mm thickness model produced a stress concentration of 176.20 MPa,which exceeded the yield strength(150 MPa)of tooth tissue.(2)The periodontal ligament stress in each group was concentrated in the neck margin and upper region.With the increase of root shield thickness,the equivalent stress peak and displacement of periodontal ligament showed a decreasing trend.(3)Implant stress in all models was concentrated in the neck of the implant and the joint of the implant-repair abutment,and the labial side was more concentrated than the palatal side.With the increase of root shield thickness,the equivalent stress peak of the implant in the model showed an increasing trend.(4)In each group of models,stress of cortical bone concentrated around the neck of the implant and the periphery of the root shield,and the labial side was more concentrated than the palatal side.With the increase of the thickness of the root shield,the equivalent stress peak around the root shield decreased;the peak value of the equivalent stress of the bone around the neck of the implant showed an increasing trend.In the model,the stress of cancellous bone was mainly concentrated around the neck of the lip of the implant,the top of the thread,the root tip and the lower margin of the root shield,and the labial side was more concentrated than the palatal side.With the increase of the thickness of the root shield,the peak value of the equivalent stress of the bone around the root shield in the model showed a decreasing trend.The minimum principal stress of cortical bone in each group of models was concentrated around the neck of the implant,exhibiting a fan-shaped distribution.As the thickness of the root shield increased,the minimum principal stress of cortical bone showed an increasing trend.(5)These results indicate that different thicknesses of the root shield have different biomechanical effects.The root shield with a thickness of 0.5 mm is easy to fracture.For patients with sufficient bone width,the root shield with a thickness of 2.0 mm is an option to reduce the risk of complications such as root shield exposure,fracture,and displacement.Meanwhile,it should be taken into account to protect the periodontal ligament in the preparation process,and rounding treatments ought to be carried out on both sides and the lower edge of the root shield.

Objective:To analyze the values of platelet transforming growth factor-β (TGF-β) and SMAD family member 2 (Smad2) in patients′ peripheral platelets for CRC diagnosis and staging.Methods:Retrospective case-control study. Tumor tissues, paratumor tissues and peripheral blood samples were collected from 248 CRC patients (147 males, 101 females; age 21-93 years) diagnosed in the First Hospital of Jilin University from October 10th, 2020, to March 10th, 2025. Peripheral blood samples were also collected from 40 colorectal adenomatous polyp patients (21 males, 19 females; age 22-74 years) and 75 healthy individuals (43 males, 32 females; age 18-81 years) during the same period. Tissue homogenates and platelets were isolated using tissue disruption and gradient centrifugation, respectively. Total RNA was respectively extracted from tissues and platelets, and the expression levels of TGF-β and Smad2 were quantified by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) expressed as relative quantity 2 -ΔΔCt. Differences of TGF-β and Smad2 expression were compared between CRC tissues and adjacent tissues, as well as among CRC patients, polyp patients, and healthy controls. The relationship of platelet TGF-β and Smad2 expression with pathological features includingtumor stage, pathological type, and metastasis were analyzed. The efficiency of platelet TGF-β, Smad2, and their combination in diagnosing CRC was evaluated using receiver operating characteristic (ROC) curves. Results:The expression levels of TGF-β and Smad2 in CRC tumor tissues[1.09 (0.45, 2.00), 2.93 (0.78, 6.73)] were significantly higher than those in adjacent tissues[0.81 (0.27, 1.50), 1.29 (0.40, 2.63)] ( Z TGF-β=4.54, Z Smad2=6.67, both P<0.001). The expression levels of TGF-β and Smad2 in platelets of CRC patients[2.73(1.53, 4.38), 3.16 (1.58, 4.38)] were significantly higher than those in the colorectal polyp group[1.23(0.70, 2.54), 1.16(0.78, 2.27)] and the healthy control group[0.96(0.51, 1.88), 0.92 (0.55, 1.88)] ( H TGF-β=59.71, H Smad2=78.74, both P<0.001). Platelet TGF-β expression increased progressively with tumor stage (stage 1-4) ( P<0.05), while platelet Smad2 levels were higher in metastatic CRC compared with non-metastatic cases ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing CRC when combining platelet TGF-β and Smad2 was 0.81[95%Confidence interval( CI) 0.77—0.86], which was 0.90 (95% CI 0.86—0.93) if adding serum carcinoembryonic antigen (CEA). Conclusion:Platelet TGF-β and Smad2 expression correlates with the diagnosis and staging of CRC, demonstrating potential as liquid biopsy biomarkers for colorectal malignancies.

BHK-21 cells, cytopathic effects (CPE) were detected, and flavivirus primers were amplified as positive. After the complete sequence of the virus was determined and spliced, a 10 840 nucleotide long sequence was obtained, encoding 3 432 amino acids. Phylogenetic analysis based on the whole gene sequence and E gene sequence showed that: The newly isolated SJM23-22 was most closely related to the GⅠa strain (C081) in Cambodia, with 98.5% nucleotide homology and 99.8% amino acid homology, while the homology with other genotypes was below 90% for nucleotides and below 98% for amino acids. The results of site analysis revealed 22 amino acid difference sites on the E gene compared to the live attenuated vaccine strain SA14-14-2, with 7 differences at 8 neurovirulence-related key amino acid sites. The results of important epitopes analysis indicated an exact match in three important epitopes in domain Ⅲ between the Shuangjiang isolates and the live attenuated vaccine strains. The results of secondary structure and tertiary structure prediction showed that the strain was characterized by random curling. Conclusions One strain of GⅠa-type JEV was isolated from Culex tritaeniorhynchus in Shuangjiang County, with no significant changes in the key amino acid sites related to antigenic epitopes. This study enriches the virus-carrying situation of Culex tritaeniorhynchus in Shuangjiang County, Yunnan Province, providing a reference for the prevention and control of the insect-borne epidemic in the province.Objective　To investigate the status and molecular characteristics of Japanese encephalitis virus (JEV) carried by mosquitoes in Shuangjiang County, Lincang City, Yunnan Province. Methods Mosquito specimens were collected from cattle pens using mosquito traps in Shuangjiang County, Lincang City in August 2023. After mosquito species identification, BHK-21 cells and C6/36 cells were used in one group of 25 mosquitoes each. Positive isolates were identified by flavivirus primers. Subsequently, the full-length GⅠ-type JEV was amplified using 15 pairs of primers with RT-PCR, sequenced, and spliced, and sequence analysis was performed using bioinformatics software such as MEGA X, DNAstar, GeneDoc, SOPMA, and SWISS-MODEL. Results A total of 1 300 Culex tritaeniorhynchus were collected and divided into 52 groups for virus isolation, leading to the identification of one positive isolate (SJM23-22). After inoculation with C6/36 and

Objective　To investigate the level of pertussis antibody in 344 healthy population in Hebei Province in 2023, and to understand the infection status and estimate the potential infection of pertussis. Methods　A total of 344 healthy people of all ages from 7 cities (counties) in Hebei Province in 2023 were stratified by random sampling method. The demographic characteristics, vaccination history and pertussis history of the subjects were collected. Serum IgG antibody against pertussis toxin (PT-IgG) were determined by enzyme-linked immunosorbent assay (ELISA). Results　The geometric mean concentration (GMC) of PT-IgG in 344 healthy people was 5.28 IU/mL, and the antibody positive rate (PT-IgG concentration ≥ 40 IU/mL) was 6.10% (21/344). There was no significant difference in proportion of antibody levels and antibody concentration ≥40 IU/mL between males and females. The top three regions with the highest antibody positive rate were Xinhe County in Xingtai (20.00%), Lianchi District in Baoding (11.43%), and Shijiazhuang (9.37%). There was a significant difference in pertussis antibody levels among different regions (P=0.007), but no significant difference in pertussis antibody concentration ≥40 IU/mL among different regions (P=0.100). The GMC of antibody was the highest in the 1~<3 years old group (11.45 IU/mL), followed by the <1 year old group (8.15 IU/mL). There was a significant difference in the pertussis antibody levels among different age groups (P=0.001). The proportion of antibody concentration ≥40 IU/mL was the highest in the 1~<3 years old group (20.83%), followed by the <1 year old group (12.77%). There was a significant difference in the proportion of antibody concentration ≥40 IU/mL among different age groups (P=0.028). And 303 (88.08%) cases of the 344 healthy people had a history of DTaP , 4.62%, 46.86% and 48.52% of healthy people had completed 1-2 , 3 and 4 doses of DTaP, respectively. Among the healthy people who had completed 1-2 doses of DTaP, there was no significant difference in the level of pertussis antibody among different age groups (P=0.47). Among the healthy people who had completed 3 doses of basic immunization and 4 doses of complete immunization, there was a significant difference in the level of pertussis antibody among different age groups (P=0.04, P=0.01). There was no significant difference in the proportion of PT-IgG concentration ≥40 IU/mL among different age groups and different immunization doses (P=0.72). Conclusion　The overall antibody level and proportion of PT-IgG concentration ≥40 IU/mL in the healthy population of Hebei Province in 2023 were both low, indicating the inadequacy of the protective effect of the current immunization program for children, although vaccinated people could still infect with pertussis disease, we need to further monitoring and optimization of immune strategies indicating.

One case of non-small cell lung adenocarcinoma patient developed severe liver injury(ALT 319.6 U·L-1,AST 103.3 U·L-1,ALP 586.8 U·L-1,DBIL 104.0 μmol·L-1,TBIL 172.3 μmol·L-1,IBIL 68.3 μmol·L-1),after multiple cycles of chemotherapy combined with camrelizumab.Subsequently,fever and jaundice on the face and sclera were noticed.Based on the previous medication,the RUCAM scale and the R value was used to evaluated the symptons,suggested a high likelihood of drug-induced cholestatic liver injury caused by camrelizumab.Clinical pharmacist proposed drug therapy recommendations for liver injury treatment and the selection of protective drugs.The physician adopted some of these therapeutic suggestions,and the patient was treated with methylprednisolone and hepatoprotective drugs.Although there was a temporary improvement in transaminase levels,bilirubin levels continued to rise.Later,the patient asked to discharge and passed away at home.Immune-related cholestatic liver injury caused by camrelizumab is insensitive to glucocorticoid therapy,clinicians should promptly consider adding immunosuppressants to enhance prognosis.Literature studies have shown that dual-molecule plasma adsorption system sequential plasma exchange has a certain therapeutic effect on immune-related cholestatic liver injury.

Objective:To analyze the clinical characteristics and gene mutations of 4 patients with the male phenotype of 17α-hydroxylase /17, 20-lyase deficiency(17-OHD), in order to improve the recognition and appropriate management of atypical cases.Methods:A retrospective analysis was performed on the clinical features, biochemical findings, and gene mutations of 4 patients with the male phenotype of 17-OHD treated in our hospital between 2018 and 2023.Results:The social gender of all 4 patients with 17-OHD was male. None of the 4 patients had hypertension or hypokalemia, but all had micropenis and gynecomastia. Two patients had adrenal hyperplasia, while adrenal morphology was normal in the other two. One patient had decreased bone mass. There were typical changes in the steroid synthesis-related hormone spectrum: progesterone was significantly elevated in all 4 patients, 17-hydroxyprogesterone was not markedly abnormal, cortisol, dehydroepiandrosterone sulfate(DHEAS) and estradiol levels were low, and testosterone levels were also low.Conclusion:17-OHD is a rare type of congenital adrenal hyperplasia, with the male phenotype being even rarer. Early symptoms are often atypical, resulting in high rates of misdiagnosis and missed diagnosis. Patients without hypertension and hypokalemia are particularly prone to diagnostic confusion. Male patients with unexplained progesterone elevation, poor secondary sexual development, and gynecomastia should undergo timely steroid hormone profiling and genetic testing to avoid misdiagnosis and missed diagnosis.

One case of non-small cell lung adenocarcinoma patient developed severe liver injury(ALT 319.6 U·L-1,AST 103.3 U·L-1,ALP 586.8 U·L-1,DBIL 104.0 μmol·L-1,TBIL 172.3 μmol·L-1,IBIL 68.3 μmol·L-1),after multiple cycles of chemotherapy combined with camrelizumab.Subsequently,fever and jaundice on the face and sclera were noticed.Based on the previous medication,the RUCAM scale and the R value was used to evaluated the symptons,suggested a high likelihood of drug-induced cholestatic liver injury caused by camrelizumab.Clinical pharmacist proposed drug therapy recommendations for liver injury treatment and the selection of protective drugs.The physician adopted some of these therapeutic suggestions,and the patient was treated with methylprednisolone and hepatoprotective drugs.Although there was a temporary improvement in transaminase levels,bilirubin levels continued to rise.Later,the patient asked to discharge and passed away at home.Immune-related cholestatic liver injury caused by camrelizumab is insensitive to glucocorticoid therapy,clinicians should promptly consider adding immunosuppressants to enhance prognosis.Literature studies have shown that dual-molecule plasma adsorption system sequential plasma exchange has a certain therapeutic effect on immune-related cholestatic liver injury.

Objective:To analyze the clinical characteristics and gene mutations of 4 patients with the male phenotype of 17α-hydroxylase /17, 20-lyase deficiency(17-OHD), in order to improve the recognition and appropriate management of atypical cases.Methods:A retrospective analysis was performed on the clinical features, biochemical findings, and gene mutations of 4 patients with the male phenotype of 17-OHD treated in our hospital between 2018 and 2023.Results:The social gender of all 4 patients with 17-OHD was male. None of the 4 patients had hypertension or hypokalemia, but all had micropenis and gynecomastia. Two patients had adrenal hyperplasia, while adrenal morphology was normal in the other two. One patient had decreased bone mass. There were typical changes in the steroid synthesis-related hormone spectrum: progesterone was significantly elevated in all 4 patients, 17-hydroxyprogesterone was not markedly abnormal, cortisol, dehydroepiandrosterone sulfate(DHEAS) and estradiol levels were low, and testosterone levels were also low.Conclusion:17-OHD is a rare type of congenital adrenal hyperplasia, with the male phenotype being even rarer. Early symptoms are often atypical, resulting in high rates of misdiagnosis and missed diagnosis. Patients without hypertension and hypokalemia are particularly prone to diagnostic confusion. Male patients with unexplained progesterone elevation, poor secondary sexual development, and gynecomastia should undergo timely steroid hormone profiling and genetic testing to avoid misdiagnosis and missed diagnosis.

Objective:To analyze the values of platelet transforming growth factor-β (TGF-β) and SMAD family member 2 (Smad2) in patients′ peripheral platelets for CRC diagnosis and staging.Methods:Retrospective case-control study. Tumor tissues, paratumor tissues and peripheral blood samples were collected from 248 CRC patients (147 males, 101 females; age 21-93 years) diagnosed in the First Hospital of Jilin University from October 10th, 2020, to March 10th, 2025. Peripheral blood samples were also collected from 40 colorectal adenomatous polyp patients (21 males, 19 females; age 22-74 years) and 75 healthy individuals (43 males, 32 females; age 18-81 years) during the same period. Tissue homogenates and platelets were isolated using tissue disruption and gradient centrifugation, respectively. Total RNA was respectively extracted from tissues and platelets, and the expression levels of TGF-β and Smad2 were quantified by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) expressed as relative quantity 2 -ΔΔCt. Differences of TGF-β and Smad2 expression were compared between CRC tissues and adjacent tissues, as well as among CRC patients, polyp patients, and healthy controls. The relationship of platelet TGF-β and Smad2 expression with pathological features includingtumor stage, pathological type, and metastasis were analyzed. The efficiency of platelet TGF-β, Smad2, and their combination in diagnosing CRC was evaluated using receiver operating characteristic (ROC) curves. Results:The expression levels of TGF-β and Smad2 in CRC tumor tissues[1.09 (0.45, 2.00), 2.93 (0.78, 6.73)] were significantly higher than those in adjacent tissues[0.81 (0.27, 1.50), 1.29 (0.40, 2.63)] ( Z TGF-β=4.54, Z Smad2=6.67, both P<0.001). The expression levels of TGF-β and Smad2 in platelets of CRC patients[2.73(1.53, 4.38), 3.16 (1.58, 4.38)] were significantly higher than those in the colorectal polyp group[1.23(0.70, 2.54), 1.16(0.78, 2.27)] and the healthy control group[0.96(0.51, 1.88), 0.92 (0.55, 1.88)] ( H TGF-β=59.71, H Smad2=78.74, both P<0.001). Platelet TGF-β expression increased progressively with tumor stage (stage 1-4) ( P<0.05), while platelet Smad2 levels were higher in metastatic CRC compared with non-metastatic cases ( P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing CRC when combining platelet TGF-β and Smad2 was 0.81[95%Confidence interval( CI) 0.77—0.86], which was 0.90 (95% CI 0.86—0.93) if adding serum carcinoembryonic antigen (CEA). Conclusion:Platelet TGF-β and Smad2 expression correlates with the diagnosis and staging of CRC, demonstrating potential as liquid biopsy biomarkers for colorectal malignancies.

Abstract: Objective To evaluate the impact of meningococcal vaccine immunization on the incidence of meningococcal meningitis, aiming to refine the local immunization strategies and programs. Methods Data on the reported incidence of meningococcal meningitis in Hebei province for 1970-2023 were collected, and interrupted time-series( ITS) analysis was used to quantitatively analyze the levels and slope change of the incidence of meningococcal meningitis before and after vaccine immunization and before and after inclusion in the Expanded Program on Immunization (EPI). Results The annual average reported incidences of meningococcal meningitis in Hebei province before vaccination (1970-1979), before (1980-2007) and after (2008-2023) the inclusion of the vaccine in the EPI were respectively 20.79 per 100 000, 1.66 per 100 000, and 0.018 per 100 000. The interrupted time-series analysis from 1970 to 2023 showed an initial meningitis incidence rate of 24.12 per 100 000 (t=9.86, P<0.05), with an average annual decrease of 1.07 per 100 000 (t=-2.42, P<0.05). After the introduction of the meningococcal vaccine in 1980, the incidence of meningococcal meningitis decreased quickly with an annual average decline of 18.39 per 100 000, showing a significant short-term intervention effect (t=-2.70, P<0.05); however, the rate of decrease slowed over the long term to 0.13 per 100 000, with the long-term intervention effect not being significant (P>0.05). And the incidence was significantly increased due to the outbreak (t=7.80, P<0.05). From 1980 to 2023, the initial level of incidence was 5.13 per 100 000 (t=8.70, P<0.05), and decreased by 0.23/100 000 per year on average (t=-6.42, P<0.05). After the inclusion of the vaccine in the EPI in 2008, the rate of decrease further slowed down to an average of 0.008 per 100,000 per year, with the long-term intervention effect being significant (t=2.50, P<0.05); the impact of epidemic outbreaks on incidence during this period was not statistically significant (P>0.05). Conclusions Meningococcal meningitis vaccination has led to a general downward trend in the incidence of meningitis in Hebei Province, and has flattened the trend of increased incidence caused by outbreaks. Therefore, long-term maintenance in immunization programs on the meningococcal meningitis is necessary. In addition, it is important to strengthen the monitoring of the distribution of epidemic serogroups in patients and healthy carriers, and to adjust immunization strategies timely based on changes in bacterial populations, selecting and promoting vaccines accordingly for the prevalent strains.