Objective To investigate the correlation between non-high density lipoprotein cholesterol(non-HDL-C),homocysteine(Hey)levels and cognitive impairment,prognosis in patients with thalamic infarction.Methods Eighty thalamic infarction patients admitted to Puyang People's Hospital from March 2017 to March 2021 were selected as the research sub-jects.According to Montreal cognitive assessment(MoCA)score,the patients were divided into cognitive impairment group(MoCA score＜26,n=35)and cognitive normal group(MoCA score 26-30,n=45).Another 50 healthy individuals who un-derwent physical examinations during the same period were selected as the control group.The serum cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),Hcy levels of all subjects were detected by fully automated biochemical analyzer,and the non-HDL-C levels were calculated.The correlations between non-HDL-C,Hey levels and MoCA scores were analyzed by Pearson correlation analysis,and the diagnostic efficacy of non-HDL-C,Hcy levels for cognitive impairment of patients with tha-lamic infarction was analyzed by receiver operating characteristic curve.According to the modified Rankin scale(mRS)score,the patients with thalamic infarction were divided into good prognosis group(mRS score ≤2,n=50)and poor prognosis group(mRS score 3-6,n=50).The independent risk factors for poor prognosis of patients with thalamic infarction was analyzed by multivariate logistic regression.Results The serum levels of non-HDL-C and Hcy of patients in the cognitive impairment group were significantly higher than those in the cognitive normal group and control group(P＜0.05);there was no significant difference in the serum non-HDL-C,Hcy levels of subjects between the control group and the cognitive normal group(P＞0.05).The non-HDL-C,Hcy levels were negatively correlated with MoCA scores in thalamic infarction patients(P＜0.05).The area under the curve(AUC)of Hcy level in the diagnosis of cognitive impairment was 0.709,the sensitivity was 0.724 and the specificity was 0.630;the AUC of non-HDL-C level in the diagnosis of cognitive impairment was 0.738,the sensitivity was 0.701 and the specificity was 0.870;the AUC of Hey combined with non-HDL-C in the diagnosis of cognitive impairment was 0.769,the sensitivity was 0.758 and the specificity was 0.889.The diagnostic efficacy of Hey combined with non-HDL-C for cognitive impairment was superior to that of non-HDL-C or Hey alone.Atrial fibrillation,elevated levels of non-HDL-C,Hcy and NIHSS score were independent risk factors for poor prognosis of patients with thalamic infarction(P＜0.05).Conclusion The levels of non-HDL-C and Hey are positively correlated with cognitive impairment in patients with thalamic infarction.The levels of non-HDL-C and Hey can be used to diagnose cognitive impairmnent in patients with thalamic infarction,and the combined detection has a better diagnostic effect.Atrial fibrillation,elevated levels of non-HDL-C,Hcy and NIHSS score are independent risk factors for poor prognosis in patients with thalamic infarction.

Objective: To analyze the current status of latent tuberculosis infection (LTBI) among freshmen in boarding middle schools in Longgang District, Shenzhen, so as to provide reference for formulating tuberculosis prevention and control strategies in the next stage. Methods: Data for tuberculosis health examination conducted among primary and secondary school students in Longgang District of Shenzhen in September 2022 to May 2023 were utilized to analyze the latent tuberculosis infection rate, and to explore the differences in latent tuberculosis infection rate among different grades, school nature, school categories and school levels. Results: The latent tuberculosis infection rate among freshmen in boarding secondary schools in Longgang District, Shenzhen in 2022 was 2.45%. The infection rate among full middle school (6.45%) and high school (3.37%) were higher than that in boarding junior high school (0.28%), nine year education school (0) and twelve year education school (1.00%) ( P <0.01). Moreover, the infection rate of high school freshmen (2.68%) was higher than that of bording junior high school (0.33%), and the rate of public schools (2.87%) and municipal schools (3.24%) were higher than those of private schools (1.78%) and distric-level schools (2.13%) respectively, with statistical significance observed for all differences( χ 2=43.58, 25.15, 22.69, P <0.01). Conclusions The latent tuberculosis infection rate among new boarding secondary students is relatively low in Longgang District of Shenzhen. However, the infection rate is higher in high school, public and municipal school. School should fully guarantee sports participation of students, enhance students awareness of tuberculosis through health knowledge lectures, and reduce the incidence of tuberculosis among students.

Objective:In this retrospective study, the accuracy and outcomes of segmental Le Fort I surgery with the aid of 3D-printed surgical templates and occlusal splints and dental model surgery were evaluated.Methods:Clinical data of patients receiving segmental Le Fort I surgery in the Department of Orthognathic and Temporo-Mandibular Joint Surgery of West China Stomatological Hospital of Sichuan University from January 2014 to June 2019 were retrospectively analyzed. The accuracy of virtual surgical planning(VSP) and the difference between VSP and dental model surgery were evaluated by postoperative complications, color distance maps, and quantitative accuracy analysis.The amount of surgical displacement of the maxilla in the three-dimensional direction before and after surgery, the occurrence of postoperative complications and the patients'satisfaction survey were analyzed in both groups. Paired t-tests were used for the linear distance and angle between the preoperative design model and the final virtual surgery model in the digital surgery group. Independent samples t-test was used for each marker point’s preoperative and postoperative displacements in the three-dimensional direction between the digital surgery group and the dental model group. The proportion of postoperative complications in the 2 groups was tested using the Pearson chi-square test, and the difference was considered statistically significant at P<0.05. Results:There were 129 patients in the digital surgery group, 35 males and 94 females, aged (24.5±6.5) years, and 92 patients in the dental model surgery group, 28 males and 64 females, aged (27.7±5.4) years.The overall mean linear difference was 1.23±0.35 mm, and the overall mean angular difference was 2.48°±0.31°. The vertical displacement of U3R, U6L in the digital surgery group was (6.72±1.57)mm and (4.73±2.07)mm. The vertical displacement of U3R, U6L in the group of dental model surgery was (4.07±2.14)mm and (1.62±1.82)mm.The significant deviation difference in U3R-Y and U6L-Y between two groups could be detected. The complications in two groups showed a significant difference. Except for one case of root injury, there was no serious complication recorded in the digital surgery group. However, there were three cases of palatal fistulas, four cases of root injury and two cases of bone dehiscence in the dental model group. 94.5% of patients in the digital surgery group are satisfied with the surgical results, while 89.1% in the dental model group.Conclusion:Compared with dental model surgery, segmental Le Fort I surgery is highly accurate under the guidance of surgical templates and occlusal splint which has better postoperative results and effectively reduces the occurrence of surgical complications.

Objective:To analyze the association between zygomatic change and bone setback or resection and propose a quantitative guidance for L-shaped reduction malarplasty by linear regression analysis based on computed tomographic (CT) scan images.Methods:A retrospective observational study was conducted on patients who underwent L-shaped reduction malarplasty with mortice and tenon joint at the zygomatic arch in Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2017 to September 2022. Bone setback and resection were performed in cases required a classical L-shaped osteoectomy with oblique bone resection (Group Ⅰ). Bone setback was performed in cases required a modified L-shaped osteotomy without bone resection (Group Ⅱ). Wound healing and the occurrence of complications were followed up after operation. The amount of bone setback and resection were calculated by using preoperative and postoperative CT scan images. The unilateral width changes of the anterior, middle, and posterior zygomatic regions(ΔZBP-MFP, ΔZMP-MFP, ΔZAP-MFP, respectively) as well as zygomatic protrusion change(Δzygomatic protrusion) were also evaluated. SPSS 20.0 software was used for statistical analysis. The measurement data was expressed as Mean±SD. Zygomatic width and protrusion change of the two groups was compared by independent t-test. Comparison of complication rates between the two groups was performed using the χ2 test. Correlation analysis using Pearson correlation coefficients was performed between bone resection or setback and zygomatic width or protrusion change. Linear regression analysis was also performed. Results:A total of 80 patients were enrolled. Group Ⅰ consisted of 40 patients [6 males and 34 females; aged (25.2±3.8) years, ranging from 19 to 33 years] who underwent a classical L-shaped osteotomy with both bone setback and resection, while Group Ⅱ consisted of 40 patients [10 males and 30 females; aged (26.0±3.0) years, ranging from 20 to 35 years] who underwent a modified L-shaped osteotomy with bone setback but without bone resection. All patients healed uneventfully during the follow-up period[(12.5±3.3) months, ranging from 5 to 20 months]. There was no significant difference in the incidence of complications such as infection, transient paresthesia, severe swelling and hematoma between the two groups ( P>0.05). No severe complications, such as facial asymmetry, sagging cheek, bone nonunion, were observed. All patients significantly improved facial contours. There was a statistically significant difference (all P<0.01) in ΔZBP-MFP [ (2.52±0.76) mm vs. (1.85±0.40) mm], ΔZMP-MFP [ (3.30±0.54) mm vs. (2.94±0.51) mm] and Δzygomatic protrusion [ (4.42±1.20) mm vs. (3.59±0.84) mm] between Group Ⅰ and Group Ⅱ. No statistical difference was found in ΔZAP-MFP ( P>0.05). Significant correlation was observed between the bone setback or resection and the changes of anterior, middle zygomatic width as well as protrusion in both the two groups ( r=0.60-0.92, all P<0.01), and the linear regression equation was established. The correlation between bone setback or resection and the posterior zygomatic width change was not significant ( P>0.05). Conclusion:There are linear correlations between the unilateral anterior, middle zygomatic width change, zygomatic protrusion change and the unilateral bone setback or resection. The linear regression equations can be used as a quantitative guidance for preoperative surgical planning.

Objective:To retrieve, evaluate, and integrate the best evidence for enteral nutrition management in children with prone position ventilation, providing a basis for constructing clinical nursing practice programs for enteral nutrition management in children with prone position ventilation.Methods:Evidence on the management of enteral nutrition in children with prone position ventilation, including clinical decisions, guidelines, expert consensus, systematic reviews, and original studies, was electronically retrieved on UpToDate, BMJ Best Practice, Joanna Briggs Institute Evidence-Based Health Care Center Database in Australia, Cochrane Library, CINAHL, PubMed, Web of Science, China National Knowledge Infrastructure, WanFang Data, Chinese Medical Journal Full-text Database, China Biology Medicine disc, Medlive, Guidelines International Network, National Institute for Health and Clinical Excellence, European Society for Parenteral and Enteral Nutrition, American Society for Parenteral and Enteral Nutrition and British Dietetic Association. The search period was from the establishment of the database until June 30, 2023. Two researchers independently screened literature, and extracted and summarized evidence from literature that met quality standards.Results:A total of 17 articles were included, including three clinical decisions, 7 guidelines, three expert consensus, two systematic reviews, one cross-sectional study, and one cohort study. Twenty-six pieces of evidence were summarized from 7 themes of preparation before prone position operation, post operation organization, timing of enteral nutrition restart in prone position, management of prone position, selection of feeding methods, management of feeding intolerance, and prevention of aspiration.Conclusions:The best evidence for enteral nutrition management in children with prone position ventilation covers the entire process of enteral nutrition management in prone position children, with strong guidance and operability, which can provide a basis for enteral nutrition management in children with prone position ventilation. Medical and nursing staff should further refine evidence-based nursing practice programs based on the characteristics of children of different age groups, standardize the operation process of enteral nutrition in children with prone position ventilation, ensure the target feeding amount, and reduce the occurrence of complications.

Objective:In this retrospective study, the accuracy and outcomes of segmental Le Fort I surgery with the aid of 3D-printed surgical templates and occlusal splints and dental model surgery were evaluated.Methods:Clinical data of patients receiving segmental Le Fort I surgery in the Department of Orthognathic and Temporo-Mandibular Joint Surgery of West China Stomatological Hospital of Sichuan University from January 2014 to June 2019 were retrospectively analyzed. The accuracy of virtual surgical planning(VSP) and the difference between VSP and dental model surgery were evaluated by postoperative complications, color distance maps, and quantitative accuracy analysis.The amount of surgical displacement of the maxilla in the three-dimensional direction before and after surgery, the occurrence of postoperative complications and the patients'satisfaction survey were analyzed in both groups. Paired t-tests were used for the linear distance and angle between the preoperative design model and the final virtual surgery model in the digital surgery group. Independent samples t-test was used for each marker point’s preoperative and postoperative displacements in the three-dimensional direction between the digital surgery group and the dental model group. The proportion of postoperative complications in the 2 groups was tested using the Pearson chi-square test, and the difference was considered statistically significant at P<0.05. Results:There were 129 patients in the digital surgery group, 35 males and 94 females, aged (24.5±6.5) years, and 92 patients in the dental model surgery group, 28 males and 64 females, aged (27.7±5.4) years.The overall mean linear difference was 1.23±0.35 mm, and the overall mean angular difference was 2.48°±0.31°. The vertical displacement of U3R, U6L in the digital surgery group was (6.72±1.57)mm and (4.73±2.07)mm. The vertical displacement of U3R, U6L in the group of dental model surgery was (4.07±2.14)mm and (1.62±1.82)mm.The significant deviation difference in U3R-Y and U6L-Y between two groups could be detected. The complications in two groups showed a significant difference. Except for one case of root injury, there was no serious complication recorded in the digital surgery group. However, there were three cases of palatal fistulas, four cases of root injury and two cases of bone dehiscence in the dental model group. 94.5% of patients in the digital surgery group are satisfied with the surgical results, while 89.1% in the dental model group.Conclusion:Compared with dental model surgery, segmental Le Fort I surgery is highly accurate under the guidance of surgical templates and occlusal splint which has better postoperative results and effectively reduces the occurrence of surgical complications.

Objective:To analyze the association between zygomatic change and bone setback or resection and propose a quantitative guidance for L-shaped reduction malarplasty by linear regression analysis based on computed tomographic (CT) scan images.Methods:A retrospective observational study was conducted on patients who underwent L-shaped reduction malarplasty with mortice and tenon joint at the zygomatic arch in Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2017 to September 2022. Bone setback and resection were performed in cases required a classical L-shaped osteoectomy with oblique bone resection (Group Ⅰ). Bone setback was performed in cases required a modified L-shaped osteotomy without bone resection (Group Ⅱ). Wound healing and the occurrence of complications were followed up after operation. The amount of bone setback and resection were calculated by using preoperative and postoperative CT scan images. The unilateral width changes of the anterior, middle, and posterior zygomatic regions(ΔZBP-MFP, ΔZMP-MFP, ΔZAP-MFP, respectively) as well as zygomatic protrusion change(Δzygomatic protrusion) were also evaluated. SPSS 20.0 software was used for statistical analysis. The measurement data was expressed as Mean±SD. Zygomatic width and protrusion change of the two groups was compared by independent t-test. Comparison of complication rates between the two groups was performed using the χ2 test. Correlation analysis using Pearson correlation coefficients was performed between bone resection or setback and zygomatic width or protrusion change. Linear regression analysis was also performed. Results:A total of 80 patients were enrolled. Group Ⅰ consisted of 40 patients [6 males and 34 females; aged (25.2±3.8) years, ranging from 19 to 33 years] who underwent a classical L-shaped osteotomy with both bone setback and resection, while Group Ⅱ consisted of 40 patients [10 males and 30 females; aged (26.0±3.0) years, ranging from 20 to 35 years] who underwent a modified L-shaped osteotomy with bone setback but without bone resection. All patients healed uneventfully during the follow-up period[(12.5±3.3) months, ranging from 5 to 20 months]. There was no significant difference in the incidence of complications such as infection, transient paresthesia, severe swelling and hematoma between the two groups ( P>0.05). No severe complications, such as facial asymmetry, sagging cheek, bone nonunion, were observed. All patients significantly improved facial contours. There was a statistically significant difference (all P<0.01) in ΔZBP-MFP [ (2.52±0.76) mm vs. (1.85±0.40) mm], ΔZMP-MFP [ (3.30±0.54) mm vs. (2.94±0.51) mm] and Δzygomatic protrusion [ (4.42±1.20) mm vs. (3.59±0.84) mm] between Group Ⅰ and Group Ⅱ. No statistical difference was found in ΔZAP-MFP ( P>0.05). Significant correlation was observed between the bone setback or resection and the changes of anterior, middle zygomatic width as well as protrusion in both the two groups ( r=0.60-0.92, all P<0.01), and the linear regression equation was established. The correlation between bone setback or resection and the posterior zygomatic width change was not significant ( P>0.05). Conclusion:There are linear correlations between the unilateral anterior, middle zygomatic width change, zygomatic protrusion change and the unilateral bone setback or resection. The linear regression equations can be used as a quantitative guidance for preoperative surgical planning.

Objective:To investigate the effect of N-acetylserotonin (NAS) on the retinal microglia polarization in retinal ischemia-reperfusion injury (RIRI) rats and explore its mechanism via nucleotide-bound oligomeric domain 1 (NOD1)/receptor interacting protein 2 (Rip2) pathway.Methods:Healthy male Sprague Dawley rats were randomly divided into Sham ( n=21), RIRI ( n=21) and NAS (injected intraperitoneally 30 min before and after modeling with NAS, 10 mg/kg, n=18) groups, using random number table. And the right eye was used experimental eye. The RIRI model of rats in RIRI group and NAS group was established by anterior chamber high intraocular pressure method. Rats in NAS group were intraperitoneally injected with 10 mg/kg NAS before and 30 min after modeling, respectively. The retinal morphology and the number of retinal ganglion cell (RGC) in each group were detected by hematoxylin-eosin staining and immunohistochemical staining. The effect of NAS on polarization of retinal microglia was detected by immunofluorescence staining. Transcriptome sequencing technology was used to screen out the differentially expressed genes between Sham and RIRI groups. Western blot and real-time quantitative polymerase chain reaction (RT-PCR) were used to examine the differentially expressed genes. Immunohistochemical staining, Western blot and RT-PCR were used to investigate the effect of NAS on the expression of NOD1 and Rip2 protein and mRNA in retinal tissue and microglia of rats. General linear regression analysis was performed to determine the correlation between the number difference of NOD1 + cells and the number difference of M1 and M2 microglia in retinal tissues of rats in NAS group and RIRI group. Results:A large number of RGC were observed in the retina of rats in Sham group. 24 h after modeling, compared with Sham group, the inner retinal thickness of rats in RIRI group was significantly increased and the number of RGC was significantly decreased. The thickness of inner retina in NAS group was significantly thinner and the number of RGC was significantly increased. Compared with Sham group, the number of retinal microglia of M1 and M2 in RIRI group was significantly increased. Compared with RIRI group, the number of M1 microglia decreased significantly and the number of M2 microglia increased significantly in NAS group. There was statistical significance in the number of M1 and M2 microglia in the retina of the three groups ( P<0.05). Transcriptome sequencing results showed that retinal NOD1 and Rip2 were important differential genes 24 h after modeling. The mRNA and protein relative expressions of NOD1 and Rip2 in retina of RIRI group were significantly higher than those of Sham group, with statistical significance ( P<0.05). The number of NOD1 + and Rip2 + cells and the relative expression of mRNA and protein in retinal microglia in RIRI group were significantly higher than those in Sham group, and NAS group was also significantly higher than that in Sham group, but lower than that in RIRI group, with statistical significance ( P<0.05). The number of Iba-1 +/NOD1 + and Iba-1 +/Rip2 + cells in retinal microglia in RIRI group was significantly increased compared with that in Sham group, and the number of Iba-1 +/Rip2 + cells in NAS group was significantly decreased compared with that in RIRI group, but still significantly higher than that in Sham group, with statistical significance ( P<0.05). Correlation analysis results showed that the difference of retinal NOD1 + and Rip2 + cells in NAS group and RIRI group was positively correlated with that of M1 microglia ( r=0.851, 0.895), and negatively correlated with that of M2 microglia ( r=-0.797, -0.819). The differences were statistically significant ( P<0.05). Conclusion:NAS can regulate the microglial polarization from M1 to M2 phenotype, the mechanism is correlated with the NOD1/Rip2 pathway.

Objective:To analyze and compare the association between different obesity-related indices and vitamin D deficiency in middle-aged and elderly population dwelled in Lanzhou city.Methods:From May, 2011 to September, 2012, middle-aged and elderly individuals with complete baseline data were included via randomly cluster sampling from 3 communities in Lanzhou. The subjects were divided into 4 subgroups by vitamin D levels and various obesity-related indices were compared across subgroups with the same gender. The relationship between the obesity-related indices and the severity of vitamin D deficiency was analyzed using Spearman correlation analysis, and the effects of different obesity-related indices on the severity of vitamin D deficiency was analyzed using multivariate logistic regression analysis.Results:A total of 9 437 residents were included. The overall prevalence of vitamin D deficiency was 97.7%. Compared with the group with lower vitamin D level, participants in the group with higher vitamin D level showed evidently lower body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI) and triglyceride/ high density lipoprotein cholesterol (TG/HDL-C) ratio in the total population and females, while only WC, LAP, VAI and TG/HDL-C in the males (all P<0.05). Spearman correlation analysis showed that BMI, WC, LAP, VAI and TG/HDL-C were positively correlated with the severity of vitamin D deficiency in the total population and the females, while only LAP, VAI and TG/HDL-C in the males (all P<0.05) . Multivariate logistic regression analysis showed that higher levels of these obesity related indices were correlated with more severe vitamin D deficiency in the total population and the females, while only higher LAP, VAI and TG/HDL-C in the males (all P<0.05). The effects of higher LAP was the most prominant in the total population ,the females and the males. Conclusion:Various obesity phenotypes are closely related to vitamin D deficiency in middle-aged and elderly women, while only visceral obesity and abnormal lipid metabolism are related to vitamin D deficiency in middle-aged and elderly men, with LAP being the most important influencing factor.

Objective:To investigate urinary microalbumin to creatinine ratio (ACR) and α1-microglobulin to creatinine ratio (MCR) of people aged 40 years old and above in Shanxi province, and analyze the influencing factors of abnormal ACR and MCR, and to provide evidence for the prevention and control of chronic kidney diseases.Methods:It was a cross-sectional study. The data came from a screening study of chronic kidney diseases conducted by Shanxi Provincial People's Hospital from April to November 2019, involving aged 40 years old and above from 10 counties (Ningwu county, Yu county, Yangqu county, Lin county, Shouyang county, Zezhou county, Huozhou city, Hejin city, Linyi county and Ruicheng county) in Shanxi province. The related data were collected through questionnaire surveys, physical examinations, and blood and urine sample collection. Urinary α1-microglobulin, creatinine, and microalbuminuria were measured. Urinary ACR and MCR were calculated using urinary creatinine correction. ACR abnormality was defined as ≥30 mg/g, and MCR abnormality was defined as >23 mg/g. Covariate analysis was used to control confounding factors, and adjusted urinary ACR and MCR of 10 counties were calculated. Spearman correlation analysis and chi-square test were performed to analyze the factors associated with abnormal urinary ACR and MCR. Logistic regression analysis model was used to identify the influencing factors of abnormal urinary ACR and MCR.Results:A total of 12 285 residents were enrolled in the study, including 5 206 males (42.4%) and 7 079 females (57.6%). The median age was 58.0 (51.0, 66.0) years old. The median urinary ACR was 7.5 (4.5, 15.7) mg/g, and the median urinary MCR was 10.2 (6.4, 16.2) mg/g. A total of 1 572 individuals (12.80%) had urinary ACR abnormality and 1 450 individuals (11.80%) had urinary MCR abnormality. Yangqu county, Yuxian county, and Ningwu county had higher urinary ACR with (35.58±3.04) mg/g, (34.08±4.50) mg/g and (32.09±3.19) mg/g, respectively. The urinary MCR was generally similar among the 10 counties and Yangqu county had higher urinary MCR with (13.86±0.41) mg/g. In addition to Yu county, female individuals had higher urinary ACR compared to males in other counties, whereas female individuals had lower urinary MCR compared to males in 10 counties. Multivariate logistic regression analysis results showed that elevated triglyceride, fasting blood glucose, glycated hemoglobin, systolic blood pressure, diastolic blood pressure, age, body mass index and gender were independent influencing factors of abnormal urinary ACR and MCR (all P<0.05). Elevated blood homocysteine and low educational level were independent influencing factors of urinary MCR abnormality (both P<0.05). Conclusions:There are differences of gender and region in urinary ACR and MCR among individuals aged 40 years old and above in the 10 counties of Shanxi province. Triglyceride, fasting blood glucose, glycated hemoglobin, systolic blood pressure, diastolic blood pressure, age, gender, and body mass index are independent related factors of abnormal urinary ACR and MCR. Blood homocysteine and education level are independent related factors of abnormal urinary MCR.