BACKGROUND:Graphene oxide,with its excellent physical and chemical properties and biocompatibility,can promote the differentiation of osteoblasts and inhibit the proliferation of bacteria,which will hopefully improve the success rate of implant restoration.OBJECTIVE:To summarize the research progress of graphene oxide in the field of dental implant restoration.METHODS:The related articles published by CNKI,WanFang Database,ScienceDirect,and PubMed from January 2000 to June 2024 were searched by computer.The keywords were"graphene oxide,dental implantation,biocompatibility,antibacterial mechanism,osteoblasts,mechanical properties,chemical properties"in Chinese and English.By reading the titles and abstracts,we preliminarily screened out the documents irrelevant to the topic of the article.According to the inclusion and exclusion criteria,65 documents were finally included for analysis.RESULTS AND CONCLUSION:Graphene oxide can increase the innate immune protection response of the body through its own antibacterial and drug-loaded antibacterial abilities,thus inhibiting the occurrence and development of periimplant inflammation.Graphene oxide can promote the proliferation and differentiation of bone marrow mesenchymal stem cells,enhance the proliferation of osteoblasts and vascular endothelial cells,inhibit the proliferation of osteoclasts,increase the rate of bone bonding between implants and alveolar bones,and contribute to the formation and stability of bone around implants.Graphene oxide can promote the combination of implant and gingival tissue,and reduce the occurrence of inflammation.Graphene oxide has low toxicity,and its biological safety needs further study.Graphene oxide coating endows the surface of titanium implant with excellent physical and chemical properties,which can greatly reduce the occurrence of complications such as implant fracture and prolong the survival time of implant.

BACKGROUND:Graphene oxide,with its excellent physical and chemical properties and biocompatibility,can promote the differentiation of osteoblasts and inhibit the proliferation of bacteria,which will hopefully improve the success rate of implant restoration.OBJECTIVE:To summarize the research progress of graphene oxide in the field of dental implant restoration.METHODS:The related articles published by CNKI,WanFang Database,ScienceDirect,and PubMed from January 2000 to June 2024 were searched by computer.The keywords were"graphene oxide,dental implantation,biocompatibility,antibacterial mechanism,osteoblasts,mechanical properties,chemical properties"in Chinese and English.By reading the titles and abstracts,we preliminarily screened out the documents irrelevant to the topic of the article.According to the inclusion and exclusion criteria,65 documents were finally included for analysis.RESULTS AND CONCLUSION:Graphene oxide can increase the innate immune protection response of the body through its own antibacterial and drug-loaded antibacterial abilities,thus inhibiting the occurrence and development of periimplant inflammation.Graphene oxide can promote the proliferation and differentiation of bone marrow mesenchymal stem cells,enhance the proliferation of osteoblasts and vascular endothelial cells,inhibit the proliferation of osteoclasts,increase the rate of bone bonding between implants and alveolar bones,and contribute to the formation and stability of bone around implants.Graphene oxide can promote the combination of implant and gingival tissue,and reduce the occurrence of inflammation.Graphene oxide has low toxicity,and its biological safety needs further study.Graphene oxide coating endows the surface of titanium implant with excellent physical and chemical properties,which can greatly reduce the occurrence of complications such as implant fracture and prolong the survival time of implant.

Stress urinary incontinence (SUI) and underactive bladder (UAB) are common types of lower urinary tract dysfunction in women.As the treatment mechanisms of the two conditions are contradictory, the treatment of SUI patients complicated with UAB remains a difficult clinical problem.In order to improve the treatment rate of such patients and promote research, this paper reviews the latest domestic and overseas diagnostic criteria of UAB, summarizes the treatment experience of conventional midurethral sling (tension-free vaginal tape or outside-in transobturator tape) and adjustable sling procedures (transobturator adjustable tape or Remeex system) combined with medication or intermittent catheterization, and the application prospects of cutting-edge technologies such as stem cell injection, cytokine therapy and gene therapy, so as to provide reference for clinicians and researchers.

BACKGROUND:Confirming the reliability and validity of the My jump 2 application for measuring lower limb vertical stiffness may offer the possibility of it as an alternative to the Kistler three-dimensional force platform for measuring lower limb stiffness. OBJECTIVE:To verify the reliability and validity of the My Jump 2 application in measuring lower limb vertical stiffness of college students. METHODS:The drop jump data of the participants were collected through the Kistler three-dimensional force platform and the My Jump 2 application,and the vertical stiffness of the participants'lower limb vertical stiffness was calculated.The intraclass correlation coefficient was used to analyze the data measured by the My Jump 2 application and the Kistler three-dimensional force platform,attempting to verify the reliability of the My Jump 2 application.The bias and average between the two devices were drawn into a Bland-Altman diagram to verify the consistency between the two test methods.Finally,the test-retest reliability of the My Jump 2 applications at 30 cm and 40 cm was analyzed using the Cronbach's alpha(α)and coefficient of variation.Pearson product-moment correlation was used to analyze the correlation of My Jump 2 applications. RESULTS AND CONCLUSION:My Jump 2 application has high reliability and validity when measuring the vertical stiffness of the lower limb.At the same time,due to its advantages of low cost,convenient portability and field testing for large samples,it can be used as an alternative to the Kistler three-dimensional force platform to test the vertical stiffness of the lower limb in college students and similar populations.

Objective Taking typical cases of Western medicine as an example,this paper explores the connection between Chinese and Western medicine on the understanding of tongue elephants.Methods After collecting the literature with tongue diagram attached to the clinical imaging column published in NEJM magazine,extracting the symptoms,signs and Western medicine disease information recorded in the literature,the tongue diagram was diagnosed from three aspects:tongue quality,tongue moss and sublingual meridians,and whether the symptoms and signs of tongue correspond to a certain diagnosis result,and the results were analyzed.Results A total of 48 articles were included,including 6 literature on abnormal tongue dynamics,which could correspond to abnormal tongue morphology in traditional Chinese medicine.Thirty-four cases of abnormal tongue shape were found.Among them,12 cases could be diagnosed with corresponding TCM tongue diagnosis,including 7 cases of abnormal tongue shape and 5 cases of abnormal coating.The remaining 22 cases were secondary changes in tongue structure.There were 8 articles on abnormal tongue color,including 1 abnormal tongue color,1 abnormal sublingual chord,and 6 abnormal lichen color.Conclusion Starting from the form and function,explore the connection between Chinese medicine and Western medicine in their understanding of tongue diagnosis,and promote the objectification and standardization of Chinese medicine tongue diagnosis.

Objective:To explore the relevant risk factors for deep venous thrombosis (DVT) of lower limb occurring 3 months after joint replacement surgery.Methods:A retrospective analysis was conducted on the clinical data of 1,782 patients who underwent joint replacement surgery at Drum Tower Hospital, School of Medicine of Nanjing University, from February 2015 to December 2018. Of these, 1,298 were male and 484 were female, with an average age of 65.4±12.3 years (range, 18-95 years). Fourteen factors associated with DVT occurrence at 3 months were investigated, including age, gender, body mass index (BMI), season of surgery, preoperative coagulation function, type of surgery, selection of minimally invasive approach, occurrence of lower limb venous thrombosis 1 day after surgery, history of previous thrombotic diseases, smoking, tumors, diabetes, hypertension, and heart disease. Independent sample t-tests and chi-square tests were used to analyze the risk factors for DVT occurrence. Indicators with statistically significant differences were included in a binary logistic regression analysis to determine the risk factors for DVT 3 months after surgery. The risk prediction model was established according to the results of logistic regression analysis, and the receiver operating characteristic curve was drawn. The area under the curve of the prediction model was calculated. Results:A total of 1,782 patients were included. The overall incidence of DVT occurring 3 months after joint replacement surgery was 10.5% (187/1,782). The thrombosis group included 5 symptomatic cases and 182 asymptomatic cases, with 13 proximal and 174 distal cases. DVT was found in the iliac vein (1 case), femoral vein (10 cases), popliteal vein (8 cases), peroneal vein (14 cases), and intramuscular vein (168 cases). Single-factor analysis showed that female gender, increasing age, previous thrombotic disease, hypertension, surgery in autumn, and the occurrence of DVT on the first day after surgery were correlated with DVT occurring 3 months after joint replacement surgery ( P<0.05). After excluding the missing data, a total of 1,744 patients were included in the final analysis. DVT occurrence on the first day after surgery [ OR=7.498, 95% CI (5.312, 10.584), P<0.001], surgery in autumn [ OR=1.834, 95% CI (1.215, 2.769), P=0.004], age [ OR=1.024, 95% CI (1.007, 1.042), P=0.009], female gender [ OR=1.863, 95% CI(1.184, 2.931), P=0.007], and history of previous thrombotic diseases [ OR=0.012, 95% CI (1.136, 2.830), P=0.012] were found to be associated with DVT occurrence at 3 months after surgery. The area under the curve (AUC) for predicting DVT three months after hip or knee arthroplasty was 0.803 [95% CI (0.761, 0.844)]. Conclusion:Advanced age, female gender, history of previous thrombotic diseases, occurrence of DVT on the first day after surgery, and surgery in autumn are risk factors for DVT occurring 3 months after joint replacement surgery.

Objective:To investigate the value of three-dimensional (3D) T 1WI structural images using different acceleration methods including parallel acquisition technique, joint compressed sensing (uCS) technique, and artificial intelligence-assisted compressed sensing (ACS) technique for brain region segmentation. Methods:In this cross-sectional study, fifty patients (female: n=25, age range: 13 to 87 years old) at Corning Hospital of Ningbo University from July to September 2023 were prospectively and consecutively collected. All the subjects underwent brain MRI. Six groups of 3D T 1WI structural images were obtained using different acceleration technique and parameters, including 3D T 1WI without acceleration factor (3D-T 1WI group), 3D T 1WI with parallel acquisition technique with acceleration factor 3 (3D-T 1WI-PI-3 group), 3D T 1WI with uCS technique with acceleration factor 4.5 and 6.9 (3D-T 1WI-uCS-4.5 group, 3D-T 1WI-uCS-6.9 group), 3D T 1WI by ACS technique with acceleration factors of 3 and 5 (3D-T 1WI-ACS-3 group, 3D-T 1WI-ACS-5 group). T 2WI fluid-attenuated inversion recovery (FLAIR) images were also acquired. Subjective scores (cerebral grey matter and white matter clarity scores, clarity scores of cerebral white matter degeneration lesions in relation to the surrounding white matter, and Gibbs artifact scores) and objective metrics [signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), cerebrospinal fluid signal homogeneity, peak signal-to-noise ratio (PSNR), structural similarity index (SSIM), and natural image quality evaluator (NIQE)] were used to evaluate image quality in different groups. Totally 109 brain regions were segmented and volumes were measured using the uAI Research Portal image analysis tool. Kappa or intraclass correlation coefficient ( ICC) was used to evaluate the agreement of subjective and objective evaluation indexes between the 3D-T 1WI-PI-3 group, 3D-T 1WI-uCS-4.5 group, 3D-T 1WI-uCS-6.9 group, 3D-T 1WI-ACS-3 group, 3D-T 1WI-ACS-5 group, and 3D-T 1WI group. Kappa or ICC value>0.70 was considered as good agreement. Results:The acquisition time for the 3D-T 1WI group, 3D-T 1WI-PI-3 group, 3D-T 1WI-uCS-4.5 group, 3D-T 1WI-uCS-6.9 group, 3D-T 1WI-ACS-3 group, and 3D-T 1WI-ACS-5 group were 527, 204, 169, 95, 133, 90 s, respectively. Subjective evaluation showed that the 3D-T 1WI-uCS-4.5, 3D-T 1WI-ACS-3, and 3D-T 1WI-ACS-5 groups had excellent agreement with the 3D-T 1WI group in terms of the distribution of cases of cerebral grey matter and white matter clarity scores, respectively (all Kappa value=1.000); The distribution of cases of clarity score of cerebral white matter lesions and surrounding white matter in the 3D-T 1WI-PI-3 group, 3D-T 1WI-uCS-4.5 group, and 3D-T 1WI-ACS-3 group were in good agreement with that of the 3D-T 1WI group ( Kappa values of 0.775, 0.701, and 0.777, respectively); the distribution of the number of cases of the Gibbs artifact score of the 3D-T 1WI-uCS-4.5, 3D-T 1WI-ACS-3, and 3D-T 1WI-ACS-5 groups was in good agreement with the 3D-T 1WI group (all Kappa value=1.000). Objective evaluation showed the CNR of the images in the 3D-T 1WI-PI-3, 3D-T 1WI-uCS-4.5, and 3D-T 1WI-uCS-6.9 groups were in good agreement with those of the 3D-T 1WI group ( ICC of 0.720, 0.759, and 0.752, respectively); PSNR and SSIM were in good agreement among the 3D-T 1WI-PI-3 group, 3D-T 1WI-uCS-4.5 group, 3D-T 1WI-uCS-6.9 group, 3D-T 1WI-ACS-3 group, and 3D-T 1WI-ACS-5 group (PSNR: ICC=0.854; SSIM: ICC=0.851). NIQE of 3D-T 1WI-PI-3 group, 3D-T 1WI-uCS-4.5 group, and 3D-T 1WI-ACS-3 group images were in good agreement with the 3D-T 1WI group ( ICC value of 0.866, 0.727, 0.753, respectively). The ICC values of the volume of each segmented brain region among the 3D-T 1WI-PI-3, 3D-T 1WI-uCS-4.5, 3D-T 1WI-uCS-6.9, 3D-T 1WI-ACS-3, 3D-T 1WI-ACS-5 group and the 3D-T 1WI group images showed decreased in order (all ICC≥0.62). Conclusions:The uCS and ACS techniques used in 3D-T 1WI show high agreement with 3D-T 1WI in terms of brain segmentation. The application of these accelerating techniques can significantly shorten the acquisition time with obtaining images with good image quality, displaying great value.

Objective:To explore the relationship between glycosylated hemoglobin A 1c/high-density lipoprotein cholesterol ratio (HbA 1c/HDL-C) and urinary albumin-creatinine ratio (UACR) in Chinese adults. Methods:In this cross-sectional study, the clinical data of 43 820 community residents (age>40 years) from the Risk Evaluation of Cancers in Chinese Diabetic Individuals (REACTION study; March-December 2012) across eight centers (Liaoning, Guangdong, Shanghai, Gansu, Guangxi, Henan, Hubei, and Sichuan) in China were collected and analyzed. Participants were divided into three groups based on UACR levels:<10 mg/g, 10-30 mg/g, and >30 mg/g. The HbA 1c/HDL-C ratio was divided into four groups according to quartile division of the subjects: 1st quartile (Q1<3.79), 2nd quartile (3.79≤Q2<4.59), 3rd quartile (4.59≤Q3≤5.66), and 4th quartile (Q4>5.66). Multivariate ordinal logistic regression model was used to analyze the relationship between HbA 1c/HDL-C and UACR. Receiver operating characteristic (ROC) analysis was used to explore the predictive value of HbA 1c/HDL-C to UACR. Results:The 43 820 subjects included 13 452 (30.70%) male and 30 378 (69.30%) female patients, with an average age of (58.00±0.05) years. According to results of one-way analysis of variance analysis, the HbA 1c/HDL-C ratio was significantly associated with the risk of increased UACR ( F=495.73, P<0.001). After adjusting for clinically relevant confounding variables in logistic regression model, compared with participants with the lowest HbA 1c/HDL-C ratio (Q1), women with the highest HbA 1c/HDL-C ratio (Q4) had a 1.483-fold (95% CI 1.376-1.598, P<0.001) and men had a 1.161-fold (95% CI 1.019-1.323, P<0.001) increased risk of UACR. The ROC curve analysis showed that the area under the curve of HbA 1c/HDL-C for predicting increased UACR was 0.623 (95% CI 0.597-0.606), with a sensitivity of 60.18% and a specificity of 54.91%. The HbA 1c/HDL-C ratio showed the highest predictive value of all glycemic and lipidemic parameters. In individuals with well-controlled blood glucose (HbA 1c<6.5%) or lipid levels (HDL-C≥1.0 mmol/L), the HbA 1c/HDL-C ratio was still independently associated with the risk of increased UACR after adjusting for confounding variables [ OR(95% CI) of quartile 4: 1.563 (1.210-2.019, P=0.001) in participants with HbA 1c<6.5% and 1.822 (1.687-1.968, P<0.001) in participants with HDL-C≥1.0 mmol/L]. Conclusion:As a novel compound indicator for evaluating glucose homeostasis and dyslipidemia, the HbA 1c/HDL-C ratio was independently associated with increased UACR in the general population aged>40 years in China, which was superior to both glycemic and lipid parameters alone.

Objective:To explore the relevant risk factors for deep venous thrombosis (DVT) of lower limb occurring 3 months after joint replacement surgery.Methods:A retrospective analysis was conducted on the clinical data of 1,782 patients who underwent joint replacement surgery at Drum Tower Hospital, School of Medicine of Nanjing University, from February 2015 to December 2018. Of these, 1,298 were male and 484 were female, with an average age of 65.4±12.3 years (range, 18-95 years). Fourteen factors associated with DVT occurrence at 3 months were investigated, including age, gender, body mass index (BMI), season of surgery, preoperative coagulation function, type of surgery, selection of minimally invasive approach, occurrence of lower limb venous thrombosis 1 day after surgery, history of previous thrombotic diseases, smoking, tumors, diabetes, hypertension, and heart disease. Independent sample t-tests and chi-square tests were used to analyze the risk factors for DVT occurrence. Indicators with statistically significant differences were included in a binary logistic regression analysis to determine the risk factors for DVT 3 months after surgery. The risk prediction model was established according to the results of logistic regression analysis, and the receiver operating characteristic curve was drawn. The area under the curve of the prediction model was calculated. Results:A total of 1,782 patients were included. The overall incidence of DVT occurring 3 months after joint replacement surgery was 10.5% (187/1,782). The thrombosis group included 5 symptomatic cases and 182 asymptomatic cases, with 13 proximal and 174 distal cases. DVT was found in the iliac vein (1 case), femoral vein (10 cases), popliteal vein (8 cases), peroneal vein (14 cases), and intramuscular vein (168 cases). Single-factor analysis showed that female gender, increasing age, previous thrombotic disease, hypertension, surgery in autumn, and the occurrence of DVT on the first day after surgery were correlated with DVT occurring 3 months after joint replacement surgery ( P<0.05). After excluding the missing data, a total of 1,744 patients were included in the final analysis. DVT occurrence on the first day after surgery [ OR=7.498, 95% CI (5.312, 10.584), P<0.001], surgery in autumn [ OR=1.834, 95% CI (1.215, 2.769), P=0.004], age [ OR=1.024, 95% CI (1.007, 1.042), P=0.009], female gender [ OR=1.863, 95% CI(1.184, 2.931), P=0.007], and history of previous thrombotic diseases [ OR=0.012, 95% CI (1.136, 2.830), P=0.012] were found to be associated with DVT occurrence at 3 months after surgery. The area under the curve (AUC) for predicting DVT three months after hip or knee arthroplasty was 0.803 [95% CI (0.761, 0.844)]. Conclusion:Advanced age, female gender, history of previous thrombotic diseases, occurrence of DVT on the first day after surgery, and surgery in autumn are risk factors for DVT occurring 3 months after joint replacement surgery.

Objective:To investigate the effect of total anatomical reconstruction (TAR) during robot-assisted radical prostatectomy (RARP) .Methods:The clinical data of 99 patients with RARP performed by a single doctor in our hospital from January 2018 to January 2021 were analyzed retrospectively.There were 38 patients in the TAR+ vesicourethral anastomosis (VUA) group and 61 patients in the VUA group. There were no significant differences between the two groups in the age of patients [ 65.5 (60.8, 71.0) years vs. 66.0 (61.5, 69.0) years], body mass index[ (24.92±2.65) kg/m 2 vs. (25.51±2.80) kg/m 2], prostate volume [28.13 (25.21, 36.53) ml vs. 26.33 (19.75, 47.84) ml], PSA [15.67 (9.02, 31.49) ng/ml vs. 14.58 (9.23, 30.06) ng/ml], neoadjuvant therapy [50.0% (19/38) vs. 63.9% (39/61)], Gleason score (6/7/8/9-10 scores: 8/16/5/9 cases vs. 16/25/9/11 cases) and clinical T stage (T 1/T 2/T 3 stage: 4/29/5 cases vs. 3/53/5 cases)(all P>0.05). The TAR technique was performed as follows. ①The two layers of posterior reconstruction involved the residual Denonvilliers fascia, the striated sphincter and medial dorsal raphe (MDR), and the vesicoprostatic muscle (VPM), the fascia which was 1-2 cm from the cranial side of the bladder neck and MDR. ②The one layer of anterior reconstruction involved detrusor apron, tissues around the urethra and the visceral and parietal layers of the endoplevic fascia. The VUA technique was suturing the bladder neck and urethra consecutively. Perioperative indexes were compared between the two groups. Results:All 99 operations were successfully completed. There were no statistically significant differences between the TAR+ VUA and VUA groups in operation time [ (174.16±47.21) min vs. (188.70±45.39) min], blood loss [ 50 (50, 100) ml vs. 100 (50, 100) ml], incidence of postoperative complications [10.5% (4/38) vs. 14.8% (9/61)], phathological T stage [pT 2/pT 3~4 stage: 25/12 cases vs. 42/19 cases, P=0.895], and the time of indwelling catheter [ 21.0 (19.0, 21.0) d vs. 21.0 (21.0, 21.0) d] (all P>0.05). The difference in postoperative length of stay between the two groups was statistically significant[6.0 (5.0, 6.0) d vs. 7.0 (6.0, 7.5)d, P<0.001]. Follow-up was performed for 1 year after surgery. The recovery rate of urinary continence 3 months after surgery in TAR+ VUA and VUA groups were 86.8% (33/38) vs. 65.6% (40/61), which were statistically significant( P=0.019). There were no significant differences between TAR+ VUA and VUA groups in recovery rate of urinary continence 1 months after surgery [47.4% (18/38) vs. 45.9% (28/61)], 6 months after surgery [94.7% (36/38) vs. 85.2% (52/61)], and 12 months after surgery [94.7% (36/38) vs. 93.4% (57/61)] (all P>0.05). Conclusions:TAR technique has good surgical safety, and can promote recovery of early urinary continence after RARP.