OBJECTIVE To investigate the risk factors for biliary tract infection(BTI)after biliary drainage in pa-tients with obstructive jaundice(OJ)based on clinical characteristics and biliary drainage methods,and to con-struct and validate a nomogram model for risk prediction.METHODS A total of 168 patients with OJ treated in the Hepatobiliary Surgery Department of Ningbo Municipal Hospital of TCM from Jan.2020 to Jan.2025 were includ-ed as study subjects.They were divided into a non-infected group(n=97)and an infected group(n=71)based on the occurrence of BTI after biliary drainage.Lasso regression and logistic regression analysis were used to explore the risk factors for BTI after surgery in patients with OJ.The"rms"package in R programming language version 4.2.6 was used to construct the nomogram model,and decision curves,calibration curves and receiver operating characteristic(ROC)curves were plotted to evaluate the model's effectiveness,calibration and discrimination.RESULTS Diabetes history(OR=3.314),drainage method(percutaneous transhepatic cholangial drainage,OR=2.666),preoperative jaundice duration(OR=2.920),alkaline phosphatase(OR=1.064),total bilirubin(OR=1.028),NLR(OR=1.110)and high biliary obstruction(OR=4.770)were identified as risk factors for BTI after surgery in patients with OJ(P＜0.05).The importance of these risk factors,ranked by the feature_importances_function of the logistic regression model,was as follows:high biliary obstruction,drainage method,preoperative jaundice duration,diabetes history,NLR,total bilirubin and alkaline phosphatase.Based on these seven risk fac-tors,a nomogram model for predicting BTI risk after surgery in patients with OJ was constructed.The area under the ROC curve(AUC)of the model was 0.851,with a concordance index of 0.849.The decision curve suggested that the model had good predictive performance within a probability threshold range of 0.050 to 0.920.The calibra-tion curve of the model closely aligned with the ideal curve.CONCLUSIONS The risk factors for BTI after surger-y in patients with OJ include diabetes history,drainage method,preoperative jaundice duration,alkaline phospha-tase,total bilirubin,NLR and high biliary obstruction.The constructed nomogram model for predicting BTI after surgery in patients with OJ demonstrates good predictive performance.

OBJECTIVE To investigate the risk factors for biliary tract infection(BTI)after biliary drainage in pa-tients with obstructive jaundice(OJ)based on clinical characteristics and biliary drainage methods,and to con-struct and validate a nomogram model for risk prediction.METHODS A total of 168 patients with OJ treated in the Hepatobiliary Surgery Department of Ningbo Municipal Hospital of TCM from Jan.2020 to Jan.2025 were includ-ed as study subjects.They were divided into a non-infected group(n=97)and an infected group(n=71)based on the occurrence of BTI after biliary drainage.Lasso regression and logistic regression analysis were used to explore the risk factors for BTI after surgery in patients with OJ.The"rms"package in R programming language version 4.2.6 was used to construct the nomogram model,and decision curves,calibration curves and receiver operating characteristic(ROC)curves were plotted to evaluate the model's effectiveness,calibration and discrimination.RESULTS Diabetes history(OR=3.314),drainage method(percutaneous transhepatic cholangial drainage,OR=2.666),preoperative jaundice duration(OR=2.920),alkaline phosphatase(OR=1.064),total bilirubin(OR=1.028),NLR(OR=1.110)and high biliary obstruction(OR=4.770)were identified as risk factors for BTI after surgery in patients with OJ(P＜0.05).The importance of these risk factors,ranked by the feature_importances_function of the logistic regression model,was as follows:high biliary obstruction,drainage method,preoperative jaundice duration,diabetes history,NLR,total bilirubin and alkaline phosphatase.Based on these seven risk fac-tors,a nomogram model for predicting BTI risk after surgery in patients with OJ was constructed.The area under the ROC curve(AUC)of the model was 0.851,with a concordance index of 0.849.The decision curve suggested that the model had good predictive performance within a probability threshold range of 0.050 to 0.920.The calibra-tion curve of the model closely aligned with the ideal curve.CONCLUSIONS The risk factors for BTI after surger-y in patients with OJ include diabetes history,drainage method,preoperative jaundice duration,alkaline phospha-tase,total bilirubin,NLR and high biliary obstruction.The constructed nomogram model for predicting BTI after surgery in patients with OJ demonstrates good predictive performance.

Objective:To explore the clinical effect of computer-aided design and computer-aided manufacturing (CAD/CAM) polymethyl methacrylate (PMMA) single-retainer resin-bonded fixed dental prosthesis (RBFDP) for single anterior teeth defect.Methods:A total of 14 children between 10-14 years old (male 8, female 6) who visited the Department of Pediatric Dentistry, School of Stomatology, The Fourth Military Medical University from March to December 2022 with single anterior teeth loss were enrolled in this study. The intraoral scanner was used to obtain their digital impressions, and then the data were imported into CAD software. The single-retainer RBFDP was designed by the CAD software and was manufactured by milling equipment using CAD/CAM PMMA disk. The prosthesis was then tried-in and bonded to the abutment teeth with resin cement and evaluated in a 12 month follow-up observation. The marginal discoloration, marginal adaptation, color match, secondary caries, the occurrence of fractures and loose of abutment tooth were examined on the basis of the modified United States Public Health Services evaluation system. The evaluation was divided into three scores, in which score A indicated ideal restoration effect, score B means that the restoration effect was acceptable (evaluation of restoration integrity, loose of abutment teeth and secondary caries excluded), and score C indicates that the restoration effect is not good.Results:All the 14 CAD/CAM PMMA single-retainer RBFDP had good marginal adaptation and color match with no marginal discoloration, no secondary caries, no fracture of restorations and no abnormal loose of the abutment teeth. All of the six criteria achieved score A evaluation after a three month follow-up observation. One restoration was classified as score B for fracture after a six month follow-up observation, while two restoration were classified as score B for marginal discoloration after 12 month follow-up observation.Conclusions:The CAD/CAM PMMA single-retainer RBFDP was clinically effective in restoration of single anterior teeth defect in children.

Objective To explore the effects of thunder-fire moxibustion in improving affected upper limb hypermyotonia of patients after stroke, so as to provide a clinical basis for improving affected upper limb hypermyotonia (spasm) after stroke. Methods From June 2016 to February 2017, we selected 100 stroke patients from Fastern Area of Dongzhimen Hospital, Beijing University of Chinese Medicine. All of the patients were divided into control group and experimental group according to the order of admission, 50 cases in each group. Patients of control group accepted routine rehabilitation training. On that basis, patients of experimental group were also treated with thunder-fire moxibustion. We compared the rehabilitation efficacy of two groups with the activity of daily living (Barthel) and the Modified Ashworth Scale (MAS). Results The scores of MAS of experimental group were (1.83±0.64) and (1.27±0.85) respectively 14 and 28 days after intervention, lower than those of control group [(2.60±0.79), (1.99±0.85)]with significant differences (t=-2.711, -2.808; P<0.01). There was a significant difference in the score of activity of daily living between experimental group (55.44±19.77) and control group (48.85±13.73), (t=2.112, P=0.037). Conclusions The thunder-fire moxibustion combined with rehabilitation could improve the activity of daily living of patients after stroke and reduce the degree of affected upper limb spasm of patients.