Objective To analyze the predictive value of bispectral index(BIS)dynamic changes for hypotension after laparoscopic surgery in elderly patients with primary liver cancer.Methods 197 elderly patients with primary liver cancer who underwent laparoscopic surgery in the hospital from November 2021 to July 2024 were selected as the research subjects,and all patients received general anesthesia,and their perioperative BIS was monitored.The patients were divided into a hypotension group and a non hypotension group based on the occur-rence of hypotension after laparoscopic surgery.The general information and the BIS at 5 minutes before anesthesia induction(T0),5 minutes after anesthesia induction(T1),30 minutes after the start of surgery(T2)and the end of surgery(T3)in the two groups were compared.The influencing factors of hypotension after laparoscopic surgery in elderly patients with primary liver cancer were analyzed through Logistic regression analysis,and the predictive value of BIS for hypotension after laparoscopic surgery in elderly patients with primary liver cancer were analyzed through receiver operating characteristic(ROC)curve.Results 51 patients were experienced hypotension after laparoscopic surgery among 197 elderly patients with primary lung cancer,and the incidence rate was 25.89％.The proportion of hypertension and operative time in the hypotension group were higher than those in the non hypoten-sion group(P<0.05),while the levels of albumin(ALB)and BIS at T2 and T3 were lower than those in the non hypertension group(P<0.05).logistic regression analysis showed that hypertension,long operative time,low ALB level,low BIS value at T2 and low BIS value at T3 were all risk factors for hypotension after laparoscopic surgery in elderly patients with primary liver cancer(P<0.05).The sensitivity,specificity and area under curve(AUC)of BIS combined prediction of hypotension after laparoscopic surgery in elderly patients with primary liver cancer at T2 and T3 were 92.16％,78.08％and 0.902％respectively,and the sensitivity and AUC were higher than those single prediction(P<0.05),but the specificity was similar to that of single prediction.Conclusion The predictive value of BIS at 30 minutes after the start of surgery and the end of surgery for hypotension after laparoscopic surgery in elderly patients with primary liver cancer are good,and the joint prediction of this two can further enhance the predictive value.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.
Humans ; Dental Cementum/injuries* ; Consensus ; Diagnosis, Differential ; Cone-Beam Computed Tomography ; Tooth Fractures/therapy*

Objective To analyze the predictive value of bispectral index(BIS)dynamic changes for hypotension after laparoscopic surgery in elderly patients with primary liver cancer.Methods 197 elderly patients with primary liver cancer who underwent laparoscopic surgery in the hospital from November 2021 to July 2024 were selected as the research subjects,and all patients received general anesthesia,and their perioperative BIS was monitored.The patients were divided into a hypotension group and a non hypotension group based on the occur-rence of hypotension after laparoscopic surgery.The general information and the BIS at 5 minutes before anesthesia induction(T0),5 minutes after anesthesia induction(T1),30 minutes after the start of surgery(T2)and the end of surgery(T3)in the two groups were compared.The influencing factors of hypotension after laparoscopic surgery in elderly patients with primary liver cancer were analyzed through Logistic regression analysis,and the predictive value of BIS for hypotension after laparoscopic surgery in elderly patients with primary liver cancer were analyzed through receiver operating characteristic(ROC)curve.Results 51 patients were experienced hypotension after laparoscopic surgery among 197 elderly patients with primary lung cancer,and the incidence rate was 25.89％.The proportion of hypertension and operative time in the hypotension group were higher than those in the non hypoten-sion group(P<0.05),while the levels of albumin(ALB)and BIS at T2 and T3 were lower than those in the non hypertension group(P<0.05).logistic regression analysis showed that hypertension,long operative time,low ALB level,low BIS value at T2 and low BIS value at T3 were all risk factors for hypotension after laparoscopic surgery in elderly patients with primary liver cancer(P<0.05).The sensitivity,specificity and area under curve(AUC)of BIS combined prediction of hypotension after laparoscopic surgery in elderly patients with primary liver cancer at T2 and T3 were 92.16％,78.08％and 0.902％respectively,and the sensitivity and AUC were higher than those single prediction(P<0.05),but the specificity was similar to that of single prediction.Conclusion The predictive value of BIS at 30 minutes after the start of surgery and the end of surgery for hypotension after laparoscopic surgery in elderly patients with primary liver cancer are good,and the joint prediction of this two can further enhance the predictive value.

The nomenclature of congenital auricular malformations is complex and confusing, which brings great inconvenience to clinical work and scientific research. This study comprehensively summarized and sorted out the existing Chinese and English names of congenital auricular malformations, providing reference basis for the scientific classification and clinical treatment of congenital auricular malformations. Sixty-seven papers on the topic of congenital auricle malformations were collected from databases such as CNKI, Wanfang Database, VIP Database, PubMed, Web of Science, and ScienceDirect by using the PRISMA method. The two core issues of morphological and anatomical naming and classification of congenital auricle malformations were sorted and summarized based on these articles. In this study, the existing Chinese and English names of congenital auricular malformations were summarized, and a preliminary classification was made at the morphological and anatomical levels, and the embryological origin of the external auricle and its substructures was elaborated. Based on the result of this study, a comprehensive analysis can be conducted on the malformations of the ear structures and their embryological origins in order to explore the etiology of congenital ear malformations. It is expected that scientific and standardized naming and classification method can be developed, and reasonable and effective standardized treatment can be formulated for congenital auricular malformations based on this study.

The objective of this study was to examine the effects of electroacupuncture on the expression of ATP-binding cassette transporter A1(ABCA1),ATP-binding cassette transporter G1(ABCG1),and class B type Ⅰ scavenger receptor(SR-B Ⅰ)genes and proteins in peritoneal macrophages of atherosclerotic rabbits.The study aimed to explore the mechanism underlying the treatment of atherosclerosis(AS)with electroacupuncture.Methods Twenty-six male New Zealand rabbits were randomly divided into the negative control group(n=7)and the modeling group(n=19)using a random number table method.The negative control group rabbits were fed a regular diet,while the modeling group was induced with a combination of high-fat feed and common carotid artery balloon injury surgery to create an AS model.After successful modeling,the rabbits in the modeling group were further divided into the model group,the electroacupuncture group,and the atorvastatin group,with 6 rabbits in each group.The rabbits in the electroacupuncture group received electroacupuncture at"'Neiguan'(PC6)","'Zusanli'(ST36)",and"'Guanyuan'(ST25)"acupoints,using a density wave,a current of 1 mA,and a frequency of 4 Hz/20 Hz,once a day.The needle was retained for 20 minutes each time,and a total of 4 courses of treatment were conducted,with 6 days per course.The rabbits in the atorvastatin group were administered atorvastatin calcium tablet suspension(1 mg/kg)orally once a day,for 6 days per course,with a total of 4 courses.After the interventions,HE staining was performed to observe the morphological changes in the common carotid artery tissue of the rabbits.Peritoneal macrophages were collected from the rabbits,and the mRNA expression levels of ABCA1,ABCG1,and SR-B Ⅰ were measured using real-time fluorescence PCR.The protein expression levels of ABCA1,ABCG1,and SR-B Ⅰ were detected using Western blotting.Results The negative control group exhibited smooth intima of common carotid artery in rabbits,while the model group displayed damaged intima of common carotid artery,thickened artery walls,and the formation of atherosclerotic plaques.The electroacupuncture group and atorvastatin group showed significant improvements in wall thickening and a reduction in plaque area.Compared with the negative control group,the mRNA and protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in peritoneal macrophages of rabbits in the model group were reduced(P＜0.01).Compared with the model group,the electroacupuncture group and atorvastatin group exhibited increased mRNA and protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in abdominal macrophages of rabbits(P＜0.01).Furthermore,the atorvastatin group demonstrated increased mRNA levels of ABCG1 and SR-B Ⅰ,as well as increased protein expressions of ABCA1,ABCG1,and SR-B Ⅰ in peritoneal macrophages of rabbits,in comparison to the electroacupuncture group(P＜0.01).Conclusion Electroacupuncture can enhance the expressions of ABCA1,ABCG1,and SR-B Ⅰ mRNA and protein in abdominal macrophages of AS rabbits,thereby promoting the process of cholesterol reverse transport.This may be one of the mechanisms underlying the effectiveness of acupuncture in the treatment of AS.

The nomenclature of congenital auricular malformations is complex and confusing, which brings great inconvenience to clinical work and scientific research. This study comprehensively summarized and sorted out the existing Chinese and English names of congenital auricular malformations, providing reference basis for the scientific classification and clinical treatment of congenital auricular malformations. Sixty-seven papers on the topic of congenital auricle malformations were collected from databases such as CNKI, Wanfang Database, VIP Database, PubMed, Web of Science, and ScienceDirect by using the PRISMA method. The two core issues of morphological and anatomical naming and classification of congenital auricle malformations were sorted and summarized based on these articles. In this study, the existing Chinese and English names of congenital auricular malformations were summarized, and a preliminary classification was made at the morphological and anatomical levels, and the embryological origin of the external auricle and its substructures was elaborated. Based on the result of this study, a comprehensive analysis can be conducted on the malformations of the ear structures and their embryological origins in order to explore the etiology of congenital ear malformations. It is expected that scientific and standardized naming and classification method can be developed, and reasonable and effective standardized treatment can be formulated for congenital auricular malformations based on this study.

Objective:To screen the risk factors for pulmonary embolism in severe burn patients, based on which, a risk prediction model was established and validated.Methods:This study was a retrospective case series study. The clinical data of 267 severe burn patients who met the inclusion criteria and were admitted to the Department of Burns of Wuhan Third Hospital from March 2020 to March 2023 were collected, including 159 males and 108 females, aged 18-82 years. The patients were divided into pulmonary embolism group (26 cases) and non-pulmonary embolism group (241 cases) according to whether they were complicated with pulmonary embolism. The following data of patients in the 2 groups were collected and compared, including gender, age, body mass index, bedtime during treatment, cause of burn, albumin level on admission, combination of chronic obstructive pulmonary disease (COPD), combination of diabetes mellitus, combination of hypertension, combination of inhalation injury, and the abbreviated burn severity index (ABSI) on admission. The indicators with statistically significant differences between the two groups were conducted with univariate and multivariate logistic regression analyses to identify the independent risk factors for pulmonary embolism in 267 severe burn patients. Based on these findings, a nomogram prediction model was established. The performance of the prediction model was evaluated by the receiver operating characteristic (ROC) curve, while its validation was conducted through calibration curve and clinical decision curve analysis.Results:The proportions of beyond 60 years old, bedtime over 7 days during treatment, combination of COPD, and combination of diabetes mellitus (with χ2 values of 7.75, 29.15, 29.86, and 5.94, respectively), and ABSI score on admission ( t=6.01) of patients in pulmonary embolism group were significantly higher than those in non-pulmonary embolism group ( P<0.05). There were no statistically significant differences in the other indicators between the two groups of patients ( P>0.05). The univariate logistic regression analysis showed that age, bedtime during treatment, combination of COPD, combination of diabetes mellitus, and ABSI score on admission were the risk factors for pulmonary embolism in severe burn patients (with odds ratios of 3.40, 14.87, 17.78, 2.80, and 1.88, respectively, 95% confidence intervals of 1.38-8.39, 4.34-50.98, 4.63-68.22, 1.19-6.58, and 1.47-2.41, respectively, P<0.05). The multivariate logistic regression analysis showed that bedtime over 7 days during treatment, combination of COPD, and high ABSI score on admission were the independent risk factors for pulmonary embolism in severe burn patients (with odds ratios of 11.02, 30.82, and 1.86, respectively, 95% confidence intervals of 2.76-43.98, 3.55-267.33, and 1.38-2.50, respectively, P<0.05). Based on the three aforementioned independent risk factors, a nomogram prediction model for the risk of pulmonary embolism in severe burn patients was established. The ROC curve of prediction model showed that the area under the ROC curve was 0.91 (with 95% confidence interval of 0.82-0.99). When the optimal cut-off value of 25% was taken, the sensitivity and specificity of prediction model was 84.6% and 93.4%, respectively. The calibration curve showed that the calibration curve of prediction model was around the ideal curve, with a consistency index of 0.80 in Cox regression (with 95% confidence interval of 0.74-0.87). The clinical decision curve showed that the threshold probability value of the prediction model was in the range of 1% to 98%, with net return rate over 0. Conclusions:The independent risk factors for pulmonary embolism in severe burn patients include bedtime over 7 days during treatment, combination of COPD, and high ABSI score on admission. The nomogram prediction model established based on this has good predictive value for complicated pulmonary embolism in severe burn patients.

Objective:To explore the clinical effect of non-expansion whole framework ear reconstruction for microtia (referred to as the NEWF ear reconstruction).Methods:The clinical data of congenital microtia patients underwent NEWF ear reconstruction at Department of Ear Reconstruction, Plastic Surgery Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. This advanced method used a tissue non-expansion approach, employing a double flap consisting of preauricular skin flap and fascia flaps, to fabricate and elevate the ear framework in the first stage concurrently. In the subsequent stage, residual ear tissues were utilized to reconstruct key elements such as the tragus, crus of the helix, cavum concha, and so on. At 6 months follow-up, the effectiveness of the reconstructed ear was assessed based on its aesthetic outcomes and complications. Aesthetic outcomes evaluation included 4 items: skin color (front of ear, back of ear and skin graft area were evaluated respectively), appearance of reconstructed ear substructure, scar of incision and hair condition. The individual score was 0-2 points, total scores from 0 to 10, with scores of 9-10 signifying excellent, 6-8 good, 3-5 moderate, and 0-2 poor. The data were analyzed by descriptive statistics.Results:Ear reconstruction was performed on 49 unilateral microtia cases, aged 6-33 years, including 37 males and 12 females, 34 right ears and 15 left ears. According to the Nagata classification: 30 cases were lobule-type, 5 cases were conchal-type, and 14 cases were small conchal-type. The follow-up period averaged 10.63 months, ranging from 6 to 13 months. One patient experienced exposure of the framework 1 month after the first stage surgery, then recovered well after surgery. The skin color of the front side of the reconstructed ear was close to normal, the substructure was clear, the skin graft area behind the ear recovered well, and the reconstructed ear was basically symmetrical with the healthy side. 9 cases (18.4%) had scar hyperplasia in the mastoid area behind the ear. 9 cases (18.4%) had hair growth on the front of the reconstructed ears. Aesthetic outcomes showed that excellent in 8 cases (16.3%), good in 36 cases (73.5%), moderate in 4 cases (8.2%), poor in 1 case (2.0%).Conclusion:The NEWF ear reconstruction enhances the stability of the ear framework, reduces the overall duration of treatment, making it a viable option for ear reconstruction for microtia.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the application value of ultrafast pulse wave velocity (ufPWV) technique in the assessment of carotid artery elasticity decline in the patients with simple hypertriglyceridemia (TG).Methods The patients visiting the cardiology outpatient department of Jiangsu Provincial Hospital of Traditional Chinese Medicine/Affiliated Hospital of Nanjing University of Chinese Medicine from January 2020 to March 2022 were selected,the serum lipid satisfied:TG≥1.7 mmol/L,moreover total cholesterol (TC)<5.2 mmol/L,low density lipoprotein cholesterol (LDL-C)<3.4 mmol/L and high density lipoprotein cholesterol (HDL-C)>1.0 mmol/L,they were included into the simple high TG group (n=63).Sixty-eight healthy subjects undergoing physical examination in this hospital were selected as the normal blood lipid group and their blood lipid indicators TG,TC,LDL-C and HDL-C all were within the normal range.The clinical data of all subjects were collected.The ufPWV technique was used to detect the common carotid artery pulse wave velocity of beginning systole (PWV-BS),pulse wave velocity of ending systolic (PWV-ES) and carotid intima-media thickness (cIMT).Results The body mass index (BMI),systolic blood pressure,diastolic blood pres-sure,TG,fasting blood glucose (FBG),cIMT and PWV-ES value had statistical differences between the sim-ple high TG group and normal blood lipid group (P<0.05);PWV-BS,PWV-ES and cIMT were positively correlated with age,and the PWV-ES correlation was the highest (r=0.607,P<0.001),followed by cIMT (r=0.590,P<0.001),and PWV-BS (r=0.325,P<0.001) was the lowest;the Logistic regression analysis showed that PWV-ES could serve as a predictive factor of carotid artery elasticity decline in the population with simple TG,moreover which was independent of the factors such as age,gender,BMI,systolic blood pres-sure,diastolic blood pressure and FBG (OR=1.449,P<0.005).Conclusion The ufPWV technique could e-valuate the decline phenomenon of carotid artery elasticity in the population with simple high TG,and the ele-vated PWV-ES is an independent risk factor for carotid artery elasticity decline in this population.