Intracranial atherosclerotic stenosis (ICAS) is closely associated with cognitive impairment and dementia. This article reviews the manifestations, mechanisms, and interventions of cognitive impairment in patients with ICAS, aiming at increasing attention to ICAS, early identification and intervention, and delaying the occurrence and deterioration of cognitive impairment.

Objective:To establish a three-dimensional finite element model of the nose, simulate and analyze the deformation of nasal tissue caused by different focal points, traction directions, and modes, provide the theoretical basis for the effectiveness of physical traction therapy, and guide the clinical selection of more efficient physical traction therapy methods.Methods:A finite element model of the nose was established by ANSYS Workbench 19.2 software based on image data obtained from CT scans of a 29-year-old male volunteer with normal nasal appearance in Peking University Third Hospital. Two focal points, the nasal tip, and the nasal columella, were selected, and three force directions, parallel to the forward, forward and down 30°, forward and down 60°, were applied. The deformation caused by different traction conditions on the skin, lining, and soft bone parts, as well as the four anatomical landmarks of the nasal tip, nasal root, the midpoint of the nasal columella, and the nasal base, were compared. The deformation produced by 10 minutes of continuous pulling and 10 times 1-minute pulse pulling were compared under the same pulling conditions. The deformations generated by two types of pulling modes within a 24-hour cycle: a single 1-hour cycle and 6 intermittent 10-minute cycles, were compared.Results:All traction conditions resulted in deformation of the nasal model, with the maximum deformation of the nasal tissue obtained by pulling forward and downward at 60° (4.632 9 mm) which was greater than other traction conditions (0.825 0-3.105 0 mm). The maximum deformation value was located near the nasion of the model’s skin layer. The deformation obtained by 10 minutes of continuous pulling (0.176 6 mm) was slightly greater than that obtained by 10 times of 1-minute pulse pulling (0.176 5 mm). Within 24 hours, the final deformation of multiple intermittent pulling modes (0.019 0 mm) was greater than that of a single pulling mode (0.004 3 mm).Conclusion:Physical traction can effectively deform the skin and soft tissue of the nose, and the most efficient operation is to continuously pinch the tip of the nose for a short period and apply tension parallel to the back of the nose downwards, repeating every a few hours.

The contracted nose is a unique entity that follows rhinoplasty in the Asian patient, which is mainly related to infection, graft implant, multiple invasive nasal repair operations, patients’ own inflammatory reaction and basic conditions, and is a complication that seriously affects the nasal aesthetics and functional characteristics of patients. Comprehensive understanding of the causes, mechanisms and repair method of contracture nose is helpful for its prevention and treatment. In view of the causes and mechanisms of capsular contracture, this paper reviews the research progress in improving the aesthetic and functional characteristics of patients from the three levels of nasal mucosa, cartilage scaffold and skin, as well as the adjuvant treatment of skin contracture release.

Objective:To establish a three-dimensional finite element model of the nose, simulate and analyze the deformation of nasal tissue caused by different focal points, traction directions, and modes, provide the theoretical basis for the effectiveness of physical traction therapy, and guide the clinical selection of more efficient physical traction therapy methods.Methods:A finite element model of the nose was established by ANSYS Workbench 19.2 software based on image data obtained from CT scans of a 29-year-old male volunteer with normal nasal appearance in Peking University Third Hospital. Two focal points, the nasal tip, and the nasal columella, were selected, and three force directions, parallel to the forward, forward and down 30°, forward and down 60°, were applied. The deformation caused by different traction conditions on the skin, lining, and soft bone parts, as well as the four anatomical landmarks of the nasal tip, nasal root, the midpoint of the nasal columella, and the nasal base, were compared. The deformation produced by 10 minutes of continuous pulling and 10 times 1-minute pulse pulling were compared under the same pulling conditions. The deformations generated by two types of pulling modes within a 24-hour cycle: a single 1-hour cycle and 6 intermittent 10-minute cycles, were compared.Results:All traction conditions resulted in deformation of the nasal model, with the maximum deformation of the nasal tissue obtained by pulling forward and downward at 60° (4.632 9 mm) which was greater than other traction conditions (0.825 0-3.105 0 mm). The maximum deformation value was located near the nasion of the model’s skin layer. The deformation obtained by 10 minutes of continuous pulling (0.176 6 mm) was slightly greater than that obtained by 10 times of 1-minute pulse pulling (0.176 5 mm). Within 24 hours, the final deformation of multiple intermittent pulling modes (0.019 0 mm) was greater than that of a single pulling mode (0.004 3 mm).Conclusion:Physical traction can effectively deform the skin and soft tissue of the nose, and the most efficient operation is to continuously pinch the tip of the nose for a short period and apply tension parallel to the back of the nose downwards, repeating every a few hours.

The contracted nose is a unique entity that follows rhinoplasty in the Asian patient, which is mainly related to infection, graft implant, multiple invasive nasal repair operations, patients’ own inflammatory reaction and basic conditions, and is a complication that seriously affects the nasal aesthetics and functional characteristics of patients. Comprehensive understanding of the causes, mechanisms and repair method of contracture nose is helpful for its prevention and treatment. In view of the causes and mechanisms of capsular contracture, this paper reviews the research progress in improving the aesthetic and functional characteristics of patients from the three levels of nasal mucosa, cartilage scaffold and skin, as well as the adjuvant treatment of skin contracture release.

Objective:To reconstruct the three-dimensional (3D) dose distribution in radiotherapy based on the convolutional neural networks (CNN) through multi-perspective scintillation light processing.Methods:First, fluorescence images were captured from three orthogonal perspectives using a complementary metal-oxide-semiconductor (CMOS) imaging sensor. Then, the images were converted into 3D images, which were input to the trained CNN for dose reconstruction. Finally, the reconstructed doses in different fields were evaluated in terms of gamma pass rate, mean-square error (MSE), percentage depth dose (PDD), and cross beam profile (CBP). Additionally, as the CNN model, 3D-Unet was pre-trained on a virtual dataset.Results:With the 50% maximum dose of as the threshold and 3%/3 mm as the standard, the central-plane and stereo-mean gamma pass rates of all field reconstruction distributions were over 90%, with MSEs remained below 1%. Besides, the PDD and CBP curves showed MSEs below 1‰ and below 1%, respectively.Conclusions:The deep learning-based method for 3D dose reconstruction using scintillation light contributes to enhanced verification of instantaneous 3D relative dose based on plastic scintillation detectors.

Objective: To investigate electronic cigarette (e-cigarette) use and its influencing factors among junior high school students of health promotion schools in Xihu District, Hangzhou City, so as to provide insights into school-based tobacco control. Methods: Grade 1 to 3 junior high school students of health promotion schools in Xihu District were recruited using a multi-stage stratified cluster sampling method from September to December, 2021. The participants' demographic features, e-cigarette use and exposure to tobacco advertising were collected using the Chinese version of the Global Youth Tobacco Survey, and the factors affecting the intention to use e-cigarettes were identified using a multivariable logistic regression model. Results: The 1 677 respondents included 875 boys (52.18%) and 802 girls (47.82%), and grade 1 to 3 junior high school students consisted of 33.93%, 35.00% and 31.07% of all respondents, respectively. There were 1 461 students that had heard of e-cigarettes (87.12%), 101 students with intention to use e-cigarettes (6.02%), and 24 current users (1.43%). Multivariable logistic regression analysis identified living in rural areas (OR=2.364, 95%CI: 1.442-3.875), having close friends that were smokers (OR=5.614, 95%CI: 3.404-9.258), having seen smoking via TV, video or movie in the past 30 days (OR=2.106, 95%CI: 1.259-3.523), having received free tobacco products (OR=3.887, 95%CI: 1.172-12.894), considering e-cigarettes as nicotine-free (OR=208.442, 95%CI: 55.713-779.856), and considering smoking making comfortable at party (OR=4.534, 95%CI: 1.853-11.090) as factors affecting intention to use e-cigarettes. There were 38.04% (638/1 677) of junior high school students with exposure to advertisements for e-cigarettes and related products, and stores, supermarkets, convenience stores, grocery, e-cigarette experience stores or offline retail stores were the primary places to contact e-cigarettes and related products. Conclusions The percentage of intention to use e-cigarettes was low among junior high school students of health promotion schools in Xihu District in 2021, and their intention to use e-cigarettes was mainly affected by close friends' smoking status and personal recognition.

To introduce the repairation procedure of composite distal soft tissue defect of thumb and finger with mini toenail flap. Methods From June, 2015 to June, 2018, 7 cases with composite tissue defect at 7 distal fingers, including 5 thumbs, 1 index finger and 1 middle finger, were reconstructed with mini toenail flap transfer.The flap sizes which were raised during the operation ranged from 4.5 cm×3.0 cm-3.0 cm×1.5 cm.The donor sites were covered by toe phalanx shortening, V-Y advancement flap and local pedicle flap. Microsurgical routine treatment was made after the operation, and followed-up regularly. Results Seven flaps of 7 cases completely sur-vived without any necrosis. All the wounds at the donor sites healed well. All patients were followed-up for 6-36 months. The motive, sensor and cosmetic result were satisfied. In sensory function, the two-point discrimination dis-tance could restore to be 4-6 mm. Conclusion The mini toenail flap transfer is a reliable and suggested method.It can anatomically restored the distal digit sensor function with cosmetic contour, and regain the motive, sensory func-tion and satisfied cosmetic appearance.

Objective To analyze the influencing factors of stunting in children under 5 years old in Jilin province in 2013,with an attempt to further improve the nutrition status among children. Methods Data on stunting in children under 5 years old in Jilin province were extracted from the National Health Services Survey 2013 in Jilin province. The influencing factors of stunting were analyzed by using univariate analysis and Logistic regression analysis.. Results The stunting prevalence in children under 5 years old was 23.8% in 2013. Univariate analysis showed that urban residence (OR=0.38,95% CI=0.25-0.57),high income (OR=0.40,95% CI=0.24-0.66),mother's education level (higher than primary school) (OR=0.50,95% CI=0.32-0.81),safe water coverage (OR=0.41,95% CI=0.22-0.75),and clean toilet coverage (OR=0.36,95% CI=0.24-0.53) are protective factors of stunting. After adjusting other factors,urban residence (OR=0.54,95% CI=0.31-0.94),safe water coverage (OR=0.28,95% CI=0.13-0.60),and clean toilet coverage (OR=0.40,95% CI=0.24-0.67) still showed protective effects. Conclusion The urban-rural disparity and the availability of safe water and clean toilet are the major factors of stunting among children under 5 years old in Jilin province. The major public health service program should be fully implemented to improve the nutrition status among children.

OBJECTIVETo study the morphologic characteristics and prognostic significance of 2 histologic subtypes of papillary renal cell carcinoma (PRCC).

METHODSA series of 48 tumors previously diagnosed as PRCC during the period from 2003 to 2013 were evaluated. All available slides were reviewed and 39 cases were confirmed to be PRCC. The detailed histomorphologic features were evaluated. The tumors were subtyped using the WHO classification and a novel mechanism suggested in recent literature, with prognostic correlation. Type 1 PRCC was assigned for tumors demonstrating simple cuboidal epithelium, irrespective of nuclear grade or other histomorphologic features. Tumors demonstrating cellular pseudostratification and high-grade nuclei were classified as type 2 PRCC.

RESULTSThe novel subtyping mechanism was more practical and correlated with the outcome of patients. The scope of type 1 PRCC was expanded. Type 2 PRCC demonstrated high tumor stage and high nuclear grade, and was more likely to have perinephric/renal sinus fat invasion and sarcomatoid differentiation. Follow-up information was available in 32 patients, including 4 deaths in patients haboring type 2 PRCC. The survival rate of patients with type 2 PRCC was significantly lower than that of type 1 PRCC.

CONCLUSIONSThe novel subtyping mechanism is more practical than WHO classification. Type 1 and type 2 PRCCs share many overlapping histomorphologic features. Type 2 PRCC is notably associated with worse prognosis. Recognizing the histomorphologic diversity of PRCC and classifying subtypes accurately are important in predicting the prognosis of patients with PRCC.