BACKGROUND:How to effectively promote bone regeneration and bone reconstruction after bone injury has always been a key issue in clinical bone repair research.The use of biological and degradable materials loaded with bioactive factors to treat bone defects has excellent application prospects in bone repair. OBJECTIVE:To investigate the effect of polylactic acid-glycolic acid copolymer(PLGA)composite scaffold modified by lysine-grafted graphene oxide nanoparticles(LGA-g-GO)on osteogenic differentiation and new bone formation. METHODS:PLGA was dissolved in dichloromethane and PLGA scaffold was prepared by solvent evaporation method.PLGA/GO composite scaffolds were prepared by dispersing graphene oxide uniformly in PLGA solution.LGA-g-GO nanoparticles were prepared by chemical grafting method,and the PLGA/LGA-g-GO composite scaffolds were constructed by blending LGA-g-GO nanoparticles at different mass ratios(1%,2%,and 3%)with PLGA.The micromorphology,hydrophilicity,and protein adsorption capacity of scaffolds of five groups were characterized.MC3T3 cells were inoculated on the surface of scaffolds of five groups to detect cell proliferation and osteogenic differentiation. RESULTS AND CONCLUSION:(1)The surface of PLGA scaffolds was smooth and flat under scanning electron microscope,while the surface of the other four scaffolds was rough.The surface roughness of the composite scaffolds increased with the increase of the addition of LGA-g-GO nanoparticles.The water contact angle of PLGA/LGA-g-GO(3%)composite scaffolds was lower than that of the other four groups(P<0.05).The protein adsorption capacity of PLGA/LGA-g-GO(1%,2%,and 3%)composite scaffolds was stronger than PLGA and PLGA/GO scaffolds(P<0.05).(2)CCK-8 assay showed that PLGA/LGA-g-GO(2%,3%)composite scaffold could promote the proliferation of MC3T3 cells.Alkaline phosphatase staining and alizarin red staining showed that the cell alkaline phosphatase activity in PLGA/LGA-g-GO(2%,3%)group was higher than that in the other three groups(P<0.05).The calcium deposition in the PLGA/GO and PLGA/LGA-g-GO(1%,2%,and 3%)groups was higher than that in the PLGA group(P<0.05).(3)In summary,PLGA/LGA-g-GO composite scaffold can promote the proliferation and osteogenic differentiation of osteoblasts,and is conducive to bone regeneration and bone reconstruction after bone injury.

Objective:To explore the value of contrast enhancement T1 fluid-attenuated inversion recovery sequence (CE-T1FLAIR) based on modulated flip angle technique in refocused imaging with extended echo train (MATRIX) in detecting metastases.Methods:One hundred and seventy-six patients with pathologically diagnosed malignant tumors and brain metastases accepted enhanced 3.0T MRI scan in Department of Medical Imaging, He'nan Provincial Cancer Hospital from October 2023 to February 2024 were enrolled. Lianying's intelligent brain metastasis AI-assisted detection system and sequences of MATRIX CE-T1FLAIR, 3D GRE_fsp CE-T1FLAIR and FSE CE-T1FLAIR were used to detect the brain metastasis lesions, respectively. Length of the lesions was measured according to Lianying's intelligent brain metastasis AI-assisted detection system, and all lesions were divided into 3 categories: <3 mm, 3-10 mm, and >10 mm. Differences in detection rate in brain metastases of different lengths and locations among the 3 sequences were compared.Results:Detection rates of MATRIX CE-T1FLAIR, 3D GRE_fsp CE-T1FLAIR, and FSE CE-T1FLAIR in brain metastases were 99.67%, 90.52%, and 71.02%, which were decreased successively, with significant differences ( P<0.05). Detection rates of MATRIX CE-T1FLAIR, 3D GRE_fsp CE-T1FLAIR and FSE CE-T1FLAIR in brain metastases with length<3 mm (99.24%, 79.95% and 46.45%) or length of 3-10 mm (100%, 98.19% and 87.53%) were decreased successively, with significant differences ( P<0.05). Detection rates of MATRIX CE-T1FLAIR (100%, 80.56% and 64.24%), 3D GRE_fsp CE-T1FLAIR (100%, 97.25% and 76.11%), and FSE CE-T1FLAIR (100%, 91.18% and 70.59%) in metastases at the superficial area of the brain convexity, gray-white matter junction area, and cerebellum were decreased successively, with significant differences ( P<0.05). Detection rates of FSE CE-T1FLAIR in brain metastases in the basal ganglia and brainstem (69.33% and 50%) were significantly lower than those of MATRIX CE-T1FLAIR and 3D GRE_fsp CE-T1FLAIR (97.33% and 92.86%; 88% and 78.57%, P<0.05). Conclusion:MATRIX CE-T1FLAIR sequence is better than 3D GRE_fsp CE-T1FLAIR and FSE CE-T1FLAIR sequences in detecting brain metastases, especially for metastases with length<10 mm and metastases located at the superficial area of the brain convexity, gray-white matter junction area and cerebellum.

Objective To observe the value of whole-tumor apparent diffusion coefficient(ADC)histogram for identifying histopathological grade of alveolar soft part sarcoma(ASPS).Methods Forty-three ASPS patients,including 27 cases of high-grade ASPS(high-grade group)and 16 cases of low-grade ASPS(low-grade group)were retrospectively enrolled.Patients'survival data were collected,MRI manifestations of ASPS were recorded,and the whole-tumor ADC histogram parameters were obtained and compared between groups.The correlations of whole-tumor ADC histogram parameters being different between groups with tumors'histological grading were analyzed,and the efficacy of whole-tumor ADC histogram parameters for identifying high-grade and low-grade ASPS were assessed.Results The 5-year survival rate of ASPS patients in low-grade group was 82.05％,higher than that(51.28％)in high-grade group(P＜0.05).The percentage of distant metastasis,tumor≥5 cm,as well as of tumors with features such as peritumoral edema and intra-tumoral septum in high-grade group were all higher than in low-grade group(all P＜0.05).The 5th,10th,25th,50th,75th,90th and the mean values of ADC in high-grade group were all lower than those in low-grade group(all P＜0.05)and negatively correlated with pathohistological grade of ASPS(from-0.547 to-0.385,all P＜0.05).The aeras under the receiver operating characteristic curves of the above parameters ranged from 0.734 to 0.822,which were fairly good for identifying high-grade and low-grade ASPS.Conclusion Whole-tumor ADC histogram parameters could be used to effectively identify high-grade and low-grade ASPS.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective:To retrospectively analyze the efficacy and safety of dupilumab in the treatment of bullous pemphigoid (BP) .Methods:Clinical data were collected from BP patients who received injections of dupilumab at an initial dose of 600 mg followed by an every-2-week regimen at a dose of 300 mg (the frequency of injections could be increased if necessary) in Department of Dermatology, Peking University First Hospital from October 2020 to October 2021, and their clinical manifestations and changes in laboratory indices were analyzed.Results:A total of 21 BP patients treated with dupilumab were included in this study. Nineteen (90.5%) patients achieved complete or marked disease control after 2-week treatment with dupilumab; 12 patients were followed up for 16 weeks, and all maintained complete disease control at 16 weeks. All patients had a bullous pemphigoid disease area index (BPDAI) score of 122.5 ± 51.1 points at baseline, which decreased to 30.6 ± 27.4 points after 2-week treatment with dupilumab ( t = 8.53, P < 0.001) , and continued to decrease to 12.7 ± 9.1 points after 4-week treatment ( t = 9.73, P < 0.001) . Pruritus was markedly relieved in all the 21 patients within 4-week treatment with dupilumab. Among 10 patients with elevated eosinophil counts at baseline, the eosinophil counts markedly decreased in 9 after treatment. The serum IgE level was elevated in 7 patients at baseline, which markedly decreased in 6 after treatment. Viral conjunctivitis occurred in 1 (4.8%) patient, and no adverse reactions were observed in other patients. Conclusion:Dupilumab is effective in the control of BP and relief of pruritus, with a favorable safety profile.

Objective:To explore the efficacy and safety of urethroplasty combining the reconstruction of urethral plate with the enlargement of urethral cavity in the treatment of short penile urethral atresia or severe stricture.Methods:From January 2017 to September 2020, 10 patients, 22 to 78 years old and the average age 48, with short penile urethral atresia or severe stricture were treated in the Department of Urology, Henan University People’s Hospital, Henan Provincial People’s Hospital. The lengths of the stenotic or atresic segment were 0.2-0.5 cm, with an average length of 0.3 cm. They were all treated with one-stage urethroplasty to reconstructe urethral plate and enlarge urethral cavity with free prepuce skin grafts or pedicled flaps adjacent to the stenosis. By the guidance of urethral dilator, the strictured urethra was incised longitudinally on the ventral side of penis to the distance of 0.5 cm into the normal urethral mucosa at both ends. The stricture or atresic scar tissue of the urethra was removed. The distal and proximal corpus spongiosum were appropriately dissociated, and the urethral mucosa at the both ends of the dorsal side was anastomosed intermittently to reconstruct the urethral plate. Free prepuce skin grafts were used in 4 cases, and pedicled flaps adjacent to the stenosis were used in 6 cases to enlarge the urethral cavity.Results:In this study, the operation time ranged from 75 minutes to 100 minutes, with an average of 85.6 minutes. Intraoperative blood loss ranged from 20 ml to 65 ml, with an average of 45.5 ml. Followed up from 3 months to 3 years postopreatively, all of them did not have painful erection and penile curvature during erection, and felt the same as before in sexual life. Urinary flow rates were significantly improved in 9 cases, and the maximum flow rate was more than 15 ml/s. One recurred patient was cured after urethral dilatation.Conclusions:The one-stage urethroplasty combined the reconstruction of urethral plate with the enlargement of urethral cavity. The urethral plate was reconstructed through urethral resection of narrow segment and the urethral cavity was enlarged with free skin or pedicled flap. This technique has the advantages of a simple and safe operation with a high success rate and a less complication rate. It is an effective procedure to repair short penile urethral atresia or severe stricture.

Objective:To explore the efficacy and safety of urethroplasty combining the reconstruction of urethral plate with the enlargement of urethral cavity in the treatment of short penile urethral atresia or severe stricture.Methods:From January 2017 to September 2020, 10 patients, 22 to 78 years old and the average age 48, with short penile urethral atresia or severe stricture were treated in the Department of Urology, Henan University People’s Hospital, Henan Provincial People’s Hospital. The lengths of the stenotic or atresic segment were 0.2-0.5 cm, with an average length of 0.3 cm. They were all treated with one-stage urethroplasty to reconstructe urethral plate and enlarge urethral cavity with free prepuce skin grafts or pedicled flaps adjacent to the stenosis. By the guidance of urethral dilator, the strictured urethra was incised longitudinally on the ventral side of penis to the distance of 0.5 cm into the normal urethral mucosa at both ends. The stricture or atresic scar tissue of the urethra was removed. The distal and proximal corpus spongiosum were appropriately dissociated, and the urethral mucosa at the both ends of the dorsal side was anastomosed intermittently to reconstruct the urethral plate. Free prepuce skin grafts were used in 4 cases, and pedicled flaps adjacent to the stenosis were used in 6 cases to enlarge the urethral cavity.Results:In this study, the operation time ranged from 75 minutes to 100 minutes, with an average of 85.6 minutes. Intraoperative blood loss ranged from 20 ml to 65 ml, with an average of 45.5 ml. Followed up from 3 months to 3 years postopreatively, all of them did not have painful erection and penile curvature during erection, and felt the same as before in sexual life. Urinary flow rates were significantly improved in 9 cases, and the maximum flow rate was more than 15 ml/s. One recurred patient was cured after urethral dilatation.Conclusions:The one-stage urethroplasty combined the reconstruction of urethral plate with the enlargement of urethral cavity. The urethral plate was reconstructed through urethral resection of narrow segment and the urethral cavity was enlarged with free skin or pedicled flap. This technique has the advantages of a simple and safe operation with a high success rate and a less complication rate. It is an effective procedure to repair short penile urethral atresia or severe stricture.

Objective: To map OTA/AO type B and type C distal radial fractures according to three-dimensional (3D) CT scan data, and to describe the morphological distribution of fracture lines. Methods: A total of 468 cases of distal radius fractures admitted to the Affiliated Hospital of Chengdu University from January 2016 to March 2019 were analyzed and AO classification were performed. AO type B and type C fractures meet the inclusion criteria and then CT data were 3D reconstructed, and morphological description were performed on the fracture lines of each joint surface, including fracture shape angle, fracture area and fracture ratio. At the same time, the articular surface fracture model was superimposed on the standard model, then fracture line and fracture area distribution map were drawn to create the fracture map of intra-articular distal radial fractures. Result: Intra-articular fractures of the distal radius were 209 cases, accounting for 44.7% (209/468) of the distal radius fractures, among which 67 cases of AO type B fracture. In type B fractures, average fracture height were 20.30±11.26 mm, average fracture width were 12.24±6.83 mm, average fracture area were 189.61±101.84 mm², average angle were 57.23°±14.95°, and average area ratio of fracture (fracture zone area/joint surface area ratio) were 32.42%±10.24%. 142 cases were OA type C fracture, the average fracture height were 24.43±11.37 mm, average fracture width were 20.38±7.59 mm, average fracture area were 425.26±314.31 mm², average angle were 51.26°±13.17°, and average area ratio of fracture were 73.81%±26.29%. According to fracture map formed by main fracture lines, five different fracture areas were identified: ① 63 cases in central area; ② 25 cases in Lister's nodule area; ③ 59 cases in scaphoid area; ④ 36 cases in lumbar fossa area; ⑤ 26 cases in lower iliac area. Main fracture lines were concentrated in the area on the dorsal side of the central area and the scaphoid area. The fracture lines of type B fracture mainly concentrated in scaphoid region, which accounted for 29.85% (20/67), and dorsal side and central area accounted for 26.87% (18/67). The fracture lines of type C fracture accounted for 27.46% (39/142) in scaphoid area and 31.69% (45/142) in central area. The fracture line of type C fracture increased in the lumbar fossa region (17.61%, 25/142) and the lower ulnar region (12.68%, 18/142) compared with type B fracture (28.69%). Compared with the type B fracture, the overall distribution of the fracture line of the type C fracture is more central. Conclusion The map of intra-articular fracture of distal radius was drawn and morphological distribution of fracture lines were quantified. Fracture-prone site and shape of fracture line were visually recognized. At the same time, description of articular surface fracture line and fracture area of type B and type C fractures of OA classification were improved, which may help with new classification and diagnosis.

Objective: To investigate the pathogenic characteristics of viral encephalitis in children living in Hebei province. Methods: We randomly collected cerebrospinal fluid specimens from a total of 399 children diagnosed with viral encephalitis in Hebei Children′s Hospital from May to December 2017. Real-time fluorescence quantitative PCR and Sanger sequencing were used to detect viral nucleic acids in cerebrospinal fluid by an automatic laboratory station. Statistical analysis was performed on the experimental data using SPSS 21.0 software and the clinical data were analyzed. Comparison of infection rates of EV encephalitis in different months, using line × column chi-square test. The MRI and EEG positive rates of different viral encephalitis and viral encephalitis patients not infected with the virus were analyzed by Fisher′s exact probability test. The positive rate of infection with different viruses and non-virus agents was analyzed by Fisher′s exact probability test. Results: The result showed that 80 of 399 samples were positive, and the positive rate was 20.05%. It included 22 cases of enterovirus, 4 cases of influenza A virus, 3 cases of mumps virus, 2 cases of herpes simplex virus type 1, 1 case of herpes simplex virus type 2, 4 cases of EB virus, 7 cases of cytomegalovirus, 7 cases of herpes zoster virus, 8 cases of adenovirus, 14 cases of human herpesvirus type 6. Eight cases had combined viral infection. Eight cases had concurrent infections: 3 cases had enterovirus and herpesvirus type 6 concurrent infection, 1 case had enterovirus and Japanese encephalitis virus concurrent infection and 1 case had herpes simplex virus type 2 and adenovirus, 1 case had influenza A virus herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had mumps virus and herpesvirus type 6, 1 case had herpes simplex virus type 1 and herpes zoster virus concurrent infections. Children with EV viral encephalitis in Hebei Province were highly prevalent in May and June (P=0.016). HHV6 virus encephalitis was more susceptible to infection than non-HHV6 virus (P=0.016); The rate of MRI positive findings in patients with different viral encephalitis was not statistically significant (P>0.05). The result of EEG of different viral encephalitis were P>0.05, which was not statistically significant. Conclusions EV was the most common pathogen of children with viral encephalitis in Hebei province. Encephalitis caused by influenza A virus cannot be ignored in clinical practice.

Objective: To establish a real-time fluorescence recombinase acid amplification (RAA) method for the detection of adenovirus type 3(HAdV-3)without extraction nucleic acid. Methods: According to the conserved sequence of adenovirus type 3 gene, a pair of primers and a probe were designed, and a real-time fluorescence RAA without extracting nucleic acid was established and optimizing the condition of DNA-free extraction. The sensitivity of the method was analyzed by a series of dilution and the specificity of the method was evaluated by detecting the original samples of other respiratory viruses. The clinical samples of HAdV-3 were detected and compared with the traditional real-time fluorescence quantitative PCR method for nucleic acid extraction. Results: The sensitivity of the real-time fluorescence RAA method was as high as that of qPCR in the detection of 10 series diluted HAdV-3 strains. The highest corresponding CT value of qPCR was 36.87. The sensitivity of the real-time fluorescence RAA method was similar to that of the real-time fluorescence quantitative PCR method . There was no cross-reaction to other common types of respiratory viruses. The two method were used to detect 56 clinical samples at the same time, and the result were completely consistent. Conclusions We provide the first report of the real-time fluorescent RAA assays for the detection of HAdV-3 without extracting nucleic acid and it has high sensitivity and specificity. Is suitable for rapid detection of HAdV-3 in clinical laboratories and on-site unite.