OBJECTIVE: To evaluate the clinical outcomes and define the indications for a one-stage mandibular reconstruction technique that combines iliac bone flaps with immediate implant-based dentures, and to assess both the accuracy of surgical planning and the long-term success of the procedure. METHODS: A total of ten patients underwent the procedure at Peking University Hospital of Stomatology between June 2020 and August 2023. The preoperative biopsy pathology of all the patients confirmed a benign tumor. In this technique, iliac bone flaps were used for mandibular reconstruction, and immediate implant-based dentures were placed during the same surgical session. Various outcome measures were evaluated, including the accuracy of the surgical reconstruction, implant placement deviations (entry point, apical point, depth, and angle), and long-term outcomes, such as cervical bone resorption, implant survival, and the cumulative survival rate. RESULTS: Thirty-eight implants were successfully inserted into the iliac flaps of the ten patients. The median follow-up duration was 23.5 months, and no significant complications occurred during the follow-up period, such as infections, titanium plate exposure, implant loosening, or damage to the implants and dentures. The accuracy of preoperative virtual surgical planning (VSP) was highly reliable. The repeatability of the VSP model compared to the postoperative reconstructed mandible was as follows: 67.82% ±10.16% within 1 mm, 82.14% ±6.58% within 2 mm, and 90.61% ±4.62% within 3 mm. The average maximum deviation from the plan was (6.10±0.89) mm, with an average overall deviation of (1.14±0.31) mm. For the implants, deviations in critical parameters were as follows: entry point deviation was (2.02±0.58) mm, apical point deviation was (2.25± 0.66) mm, depth deviation was (1.26±0.51) mm, and angular deviation was 1.84°±1.10°. The implant survival rate remained 100% during the follow-up, with a cumulative survival rate of 97.37% from 1 to 4 years. Average cervical bone resorption was 0.94 mm. CONCLUSION The combination of iliac bone flaps with immediate implant-based dentures for one-stage mandibular reconstruction demonstrated pro-mising clinical outcomes, including high implant survival and minimal complications. This technique proved to be safe and reliable for mandibular reconstruction. However, further studies with larger sample sizes and longer follow-up periods are necessary to confirm the long-term efficacy and optimal indications for this procedure.
Humans ; Mandibular Reconstruction/methods* ; Male ; Ilium/surgery* ; Female ; Middle Aged ; Surgical Flaps ; Adult ; Mandible/surgery* ; Aged ; Dental Implantation, Endosseous/methods* ; Immediate Dental Implant Loading/methods* ; Bone Transplantation/methods* ; Dental Implants

Objective To observe the effects of wheat grain moxibustion for"Huantiao"on sciatic nerve function,pathological morphology of sciatic nerve stem and expressions of TLR4/MyD88/NF-κB signaling pathway expression in spinal cord tissue of rats with sciatic nerve injury(SNI);To explore the possible mechanism of wheat grain moxibustion for the treatment of SNI.Methods Totally 24 SD male rats were randomly divided into blank group,sham-operation group,model group and wheat grain moxibustion group,with 6 rats in each group.The model group and the wheat grain moxibustion group used a rat model with sciatic nerve clamping injury.From the 7th day after modeling,the rats were treated with moxibustion on the affected side of"Huantiao"for 6 strokes each time,once a day,for consecutive 10 days.The sciatic nerve function index(SFI)of rats on the 7th day after modeling and after intervention were observed,mechanical withdraw threshold(MWT)in rats were measured using a fiber optic pain gauge,ELISA was used to detect NO and iNOS content in spinal cord tissue,HE staining was used to observe the morphology of sciatic nerve stem,the expression of TLR4,NF-κBp65,p-NF-κBp65,MyD88,IκBα and p-IκBα in spinal cord tissue were detected by Western blot.Results Compared with the sham-operation group,the SFI and MWT of the rats in the model group significantly decreased(P<0.01),the arrangement of nerve fibers in sciatic nerve stem was disordered,with a significant increase in the number of Schwann cells and a large number of vacuolar degeneration,the content of NO,iNOS and the expression of TLR4,p-NF-κBp65,MyD88,p-IκBα protein in spinal cord tissue significantly increased(P<0.01).Compared with the model group,the SFI and MWT of the rats in the wheat grain moxibustion group increased significantly(P<0.01),the damage of sciatic nerve stem was reduced,with orderly cell arrangement,a decrease in the number of Schwann cells,and a decrease in axonal demyelination and cellular vacuolar degeneration,the content of NO,iNOS and the expression of TLR4,p-NF-κBp65,MyD88,p-IκBα in spinal cord tissue significantly decreased(P<0.05).Conclusion Wheat grain moxibustion for"Huantiao"can down-regulate TLR4,p-NF-κBp65,MyD88 and p-IκBα protein expressions in spinal cord tissue of SNI rats,reduce the secretion of NO and iNOS,thereby relieve pain and damaged nerve tissue inflammation response.

ObjectiveTo investigate the relationship between serum 25(OH)D and gestational diabetes mellitus in the second trimester (GDM), to analyze the interaction effect of key risk factors, so as to provide a basis for clinical personalized vitamin D supplementation. MethodsA total of 266 pregnant women who registered and took regular obstetric check-ups in Shanghai Pudong New Area Health Care Hospital for Women and Children from June to December 2022, were selected as the research subjects. According to the results of oral glucose tolerance test (OGTT), the subjects were divided into the GDM group (131) and control group (135). The level of serum 25(OH)D at the time of OGTT were detected and other clinical indicators were followed up. ResultsThe age, systolic blood pressure in early pregnancy, pre-pregnancy BMI, FPG, OGTT 1-hour and 2-hour glucose, GHb, HOMA-IR, TG, AST, Cr, D-D, FDP and SF at 35 weeks’ gestation of the pregnant women were higher in the GDM group than that of the pregnant women in the normal group, while gestational weight gain and serum 25(OH)D level were significantly lower than that of the pregnant women in the normal group. Serum 25(OH)D was negatively correlated with HOMA-IR and WBS’s, but positively correlated with TG and ALT. Serum 25(OH)D was non-linearly correlated with the risk of GDM in an inverted J-shape, and there was an interaction effect of advanced age, pre-pregnancy obesity and vitamin D deficiency on the risk of GDM. ConclusionVitamin D is non-linearly associated with the risk of GDM. The risk of GDM is significantly reduced when serum 25(OH)D level ≥30 ng∙mL^-1.

Objective To investigate the influencing factors of Mismatch ratio in computed tomography perfusion(CTP)and dif-fusion weighted imaging(DWI)to assess the lesion outcome after treatment in patients with acute ischemic stroke(AIS).Methods Whether there were any differences in clinical and imaging data of AIS patients were analyzed retrospectively between the Mismatch ratio＞1.2 group and the Mismatch ratio≤1.2 group,and between the hemorrhagic transformation group and the non-hemorrhagic transformation group.Results The age of onset and National Institutes of Health Stroke Scale(NIHSS)score of AIS patients in the group with Mismatch ratio＞1.2 were greater than those in the group with Mismatch ratio≤1.2.The Mismatch ratio＞1.2 group had lower incidence of hyperlipidemia,new infarct foci,and higher hypercoagulability,cerebral hemorrhage,as well as large cerebral infarction.The NIHSS score was higher in the hemorrhagic transformation group than the non-hemorrhagic transformation group,and the incidence of large cerebral infarction and digital subtraction angiography(DSA)thrombectomy was higher in the former than in the latter.Multifactorial logistic analysis showed that age,NIHSS score,and hyperlipidemia were independent risk factors for AIS patients with Mismatch ratio＞1.2 and large cerebral infarction was an independent risk factor for hemorrhagic transformation.Conclusion The Mismatch ratio in CTP is correlated with age,NIHSS score,and hyperlipidemia in patients with AIS and large cerebral infarction is correlated with hemorrhagic transformation.

Patients with traumatic brain injury (TBI) may develop neurological complications such as Alzheimer′s disease, stroke and epilepsy, which severely affect their quality of life. Currently, neurological complications after TBI are poorly understood and there are no comprehensive treatments or definitive interventions for them. Complex pathophysiological changes in the brain, systemic immunological responses, and gastrointestinal dysfunction after TBI all severely affect the biodiversity of the intestinal microbiota and related metabolites, which leads to intestinal dysbiosis and metabolic disorders and exert continued effects on the nervous system. Intestinal microbial probiotic flora that colonize in living organisms are a category of active microorganisms beneficial to the host and supplementation of intestinal probiotics can have a modulatory effect on the nervous system directly or indirectly. The targeted therapeutic effects of intestinal microbial probiotic flora on neurological complications after TBI and the intrinsic mechanism of the effects have not been comprehensively summarized currently. For this purpose, the authors reviewed the research progress on the effects of regulating intestinal microbial probiotic flora on post-TBI neurological complications so as to provide a reference for the clinical prevention and treatment of post-TBI neurological complications.

Atherosclerosis is a multifocal, smoldering, immunoinflammatory disease caused by lipid accumulation. Acute cardio-cerebrovascular disease caused by AS is one of the most serious life threats in the world. Endothelial cell injury, vascular inflammatory stimulation, abnormal lipid metabolism and coagulation disorder are the main pathological mechanisms of AS. Thrombomodulin (TM) is a transmembrane glycoprotein mainly expressed on the surface of endothelium. It plays a key role in maintaining the dynamic equilibrium of the vascular system through its functions of anti-coagulation, anti-inflammation and cell protection. Recombinant human soluble thrombomodulin (rhsTM), a soluble form of human TM containing the extracellular domain of TM, might be effective in the treatment of AS. This review summarizes the structure and function of TM and the mechanism of rhsTM in the treatment of AS. Aiming to provide new ideas for the prevention and treatment of AS.

Long-term exposure to risk factors will lead to coronary atherosclerosis, which will lead to the formation and progression of coronary plaque. Early identification of high-risk plaque characteristics will help prevent plaque rupture or erosion, thus avoiding the occurrence of acute cardiovascular events. Biomechanical stress plays an important role in progression and rupture of atherosclerotic plaques. In recent years, non-invasive coronary computed tomography angiography (CCTA) computational fluid dynamics (CFD) modeling has made it possible to acquire the corresponding biomechanical stress parameters. These coronary biomechanical stress parameters, especially wall shear stress (WSS), will aid in the development of a more accurate clinical model for predicting plaque progression and major adverse cardiovascular events ( MACE ). In this review, the biomechanical stress and the role of WSS from CCTA in atherosclerosis were introduced, and the researches on the relationship between biomechanical stress from CCTA and coronary artery diseases were discussed.

Objective:To analyze the hepatitis B vaccine (HepB) vaccination rate and immune level among children aged eight months to 14 years in Dali Bai Autonomous Prefecture, and to evaluate the effect of immune prevention and control.Methods:A stratified and cluster sampling was designed to survey and collect serum samples of the 17 236 cases from 12 counties (cities) in Dali Bai Autonomous Prefecture. The cases were divided into four age groups (eight to 17 months, 18 to 35 months, three to six years, seven to 14 years). Serum levels of hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (anti-HBs) were detected by enzyme linked immunosorbent assay (ELISA). Statistical analysis was conducted by Spearman rank correlation analysis and chi-square test.Results:The overall HepB vaccination rate, timely vaccination rate, and full course vaccination rate among 17 236 children were 98.78%(17 025/17 236), 84.13%(14 500/17 236) and 97.69%(16 838/17 236), respectively. The positive rates of HBsAg and anti-HBs were 0.28%(49/17 236) and 70.57%(12 164/17 236), respectively. From 2013 to 2020, the trend of the vaccination rate, timely vaccination rate, and full vaccination rate of HepB increased year by year. The timely vaccination rate (88.64%(3 989/4 500)) and the positive rate of anti-HBs (92.78%(4 175/4 500)) were the highest at the age of eight to 17 months. Age was negatively correlated with the positive rate of anti-HBs ( rs=-0.427, P<0.001). The vaccination rate, full course vaccination rate, and positive rate of HBsAg in males were higher than those in females ( χ2=4.41, 6.05 and 0.92, respectively, all P<0.05), while the vaccination rate, timely vaccination rate and full course vaccination rate in rural areas were higher than those in urban areas ( χ2=51.75, 4.81 and 33.20, respectively, all P<0.05). The vaccination rate, full course vaccination rate and the positive rate of anti-HBs in minority nationality were higher than those in Han nationality ( χ2=29.44, 11.83 and 5.04, respectively, all P<0.05). The differences were all statistically significant. The positive rates of anti-HBs in individuals with a history of immunization, timely vaccination, and full vaccination of HepB were higher than those in individuals without a history of HepB immunization, timely vaccination, and full vaccination, and the differences were all statistically significant ( χ2=64.67, 65.46 and 13.39, respectively, all P<0.001). Conclusions:The positive rate of anti-HBs in the older age group has decreased significantly. While continuing carrying out routine immunization work, monitoring, strengthening supplementary immunization should be emphasized, and HepB vaccination in older children should be explored to consolidate the immune barrier.

Sunburn is an acute phototoxic reaction caused by excessive exposure of skin to solar ultravilet (UV) or artificial UV light sources. Studies show that sunburn is common in the general population, so that associated financial burden cannot be ignored. Meanwhile, sunburn at any age increases the risk of melanoma. Only by clarifying the influencing factors of sunburn can precise preventive measures be formulated. Although many studies have been conducted on the influencing factors of sunburn worldwide, there are great heterogeneity in reported influencing factors. In this paper, by means of systematic review, factors affecting sunburn were sorted out and summarized from four aspects, including demographic and socioeconomic characteristics, photosensitive phenotypes, UV-related environmental factors, and sun protection knowledge, attitude & behavior. Combined with population characteristics and data availability in China, our review provided reference for subsequent research and development of precise prevention and control strategies.