ObjectiveTo investigate the efficacy of ovarian tissue cryopreservation and autologous transplantation in preserving fertility and ovarian endocrine function in patients with cervical cancer. MethodsA 26-year-old patient with stage ⅡA1 cervical cancer underwent ovarian tissue harvesting and cryopreservation during cancer surgery. Following complete remission of the cancer， autologous ovarian tissue transplantation was performed. Follow-up monitoring included assessment of menopausal symptoms， hormone levels， and follicular development. ResultsSix months after transplantation， follicle-stimulating hormone levels decreased to 6.60 U/L， and estradiol levels increased from ＜10.00 ng/L to 89.00 ng/L. At 10 months after transplantation， ultrasound monitoring confirmed follicular development and physiological ovulation in the transplanted ovarian tissue. By 15 months after transplantation， follicle-stimulating hormone levels remained stable at 7.24 U/L， and estradiol levels further increased to 368.00 ng/L. Over 2 years after transplantation， the patient successfully gave birth to a healthy baby through assisted reproductive technology. ConclusionThe restoration of endocrine and ovulation functions in the transplanted cryopreserved ovarian tissue， followed by successful pregnancy， demonstrates the clinical success of ovarian tissue transplantation.

BACKGROUND:The utilization of miniscrews for assisting in molar distalization with clear aligners is a commonly adopted clinical approach.However,treatment outcomes may be influenced by the implantation position of miniscrew and the hooks in various tooth location.OBJECTIVE:To analyze the biomechanical effects of hooks at different tooth positions and the assistance of buccal and palatal miniscrews in distalizing molars with clear aligners by using the finite element method.METHODS:By integrating volunteer cone beam CT and Itero intraoral scan data,high-precision finite element models were constructed to simulate the combined use of miniscrews and hooks to assist in the distalization of the maxillary first and second molars with clear aligners,aiming for a designed distalization magnitude of 0.2 mm.Four conditions were established based on the placement of buccal or palatal miniscrews,as well as the located of hooks at the canine or first premolar.The buccal anchorage screw was used in combination with hooks on the buccal side of the canine;the buccal anchorage screw was used in combination with hooks on the buccal side of the first premolar;the palatal anchorage screw was used in combination with hooks on the lingual side of the canine,and the palatal anchorage screw was used in combination with hooks on the lingual side of the first premolar.Analysis using ANSYS software was conducted to evaluate the three-dimensional displacement trends of maxillary teeth and the maximum equivalent stress on the periodontal ligament under each condition.RESULTS AND CONCLUSION:(1)Regardless of whether hooks were placed on canines or first premolars,palatal miniscrews had been shown to enhance the distal movement of maxillary molars and reduce the mesial movement of premolars as well as the labial tipping tendency of anterior teeth,compared to buccal miniscrews.The maximum equivalent stress in the periodontal ligament of molars was increased,while that of anterior teeth was decreased.(2)Regardless of whether the miniscrews were located on the buccal or palatal side,compared with hooks at the first premolar,when hooks were done at the canine,the labial inclination trend of the anterior teeth was reduced,the distal movement of the molars was reduced,the mesial movement of the premolars was increased,and the maximum equivalent stress of the molar and the periodontal membrane of the anterior teeth was reduced.(3)Regardless of whether miniscrews were located on the buccal or palatal side,and the hooks were located on the canine or the first premolar,the molar could not achieve overall movement.(4)The results show that clear aligner combined with palatal miniscrews and hooks at the first premolar are more conducive to improving the efficiency of maxillary molar distalization,but attention should be paid to protecting the anterior tooth miniscrews and molar torque control;clear aligner combined with palatal miniscrews and hooks at the canine is more conducive to reducing the labial tipping tendency of anterior teeth,but the efficiency of molar distalization will be relatively reduced.

Objective To construct a distance self-attention(DSA)and long short-term memory(LSTM)model and observe its value for predicting X-ray tube arcing in CT equipment.Methods CT equipment status data of internet of medical things were collected and preprocessed,then DSA-LSTM model based on model attention(MA)module and nonlinear attenuation distance factor was constructed,and its value for predicting X-ray tube arcing in CT equipment was analyzed compared with other models.Results Compared with other models,DSA-LSTM model had better comprehensive efficiency for predicting X-ray tube arcing in CT equipment.MA module and nonlinear attenuation distance factor could improve the predictive efficiency of DSA-LSTM model,and all included features contributed to the performance of DSA-LSTM model in a certain extent.Conclusion DSA-LSTM model could effectively predict X-ray tube arcing in CT equipment.

Objective To analyze the correlation between the number of oil chambers,the proportion of phloem at cross-section of Aucklandiae Radix and the contents of costunolide and dehydrocostuslactone,and the correlation between inulin quantity,vessel quantity and polysaccharide content in powder characteristics,so as to explore the scientific basis for Aucklandiae Radix"identifying the quality based on appearance differentiation".Methods The constant values of the microscopic features of oil chambers,inulin and vessels were determined by cross-sectional permanent slice method,chloral hydrate method and counting analysis method,and the contents of costunolide and dehydrocostuslactone as well as polysaccharide content were determined by the high-performance liquid chromatography(HPLC)and the phenol-sulfuric acid method,respectively,and the correlation in the two groups of data was analyzed by statistical methods.Results There was a significantly positive correlation between the number of oil chambers per unit area in the cross-section of Aucklandiae Radix and the number of oil chambers per unit area in the phloem and the contents of costunolide and dehydrocostuslactone;there was a significantly positive correlation between the quantity of inulin in the powder of Aucklandiae Radix and the polysaccharide content;there was no correlation between the quantity of vessels and the polysaccharide content.Conclusion This study initially established a new method and a new technology for quality evaluation of Chinese herbal medicines based on the determination of microscopic characteristic constants of Aucklandiae Radix,which can provide a new technical method for the quality control of Aucklandiae Radix.

BACKGROUND:The utilization of miniscrews for assisting in molar distalization with clear aligners is a commonly adopted clinical approach.However,treatment outcomes may be influenced by the implantation position of miniscrew and the hooks in various tooth location.OBJECTIVE:To analyze the biomechanical effects of hooks at different tooth positions and the assistance of buccal and palatal miniscrews in distalizing molars with clear aligners by using the finite element method.METHODS:By integrating volunteer cone beam CT and Itero intraoral scan data,high-precision finite element models were constructed to simulate the combined use of miniscrews and hooks to assist in the distalization of the maxillary first and second molars with clear aligners,aiming for a designed distalization magnitude of 0.2 mm.Four conditions were established based on the placement of buccal or palatal miniscrews,as well as the located of hooks at the canine or first premolar.The buccal anchorage screw was used in combination with hooks on the buccal side of the canine;the buccal anchorage screw was used in combination with hooks on the buccal side of the first premolar;the palatal anchorage screw was used in combination with hooks on the lingual side of the canine,and the palatal anchorage screw was used in combination with hooks on the lingual side of the first premolar.Analysis using ANSYS software was conducted to evaluate the three-dimensional displacement trends of maxillary teeth and the maximum equivalent stress on the periodontal ligament under each condition.RESULTS AND CONCLUSION:(1)Regardless of whether hooks were placed on canines or first premolars,palatal miniscrews had been shown to enhance the distal movement of maxillary molars and reduce the mesial movement of premolars as well as the labial tipping tendency of anterior teeth,compared to buccal miniscrews.The maximum equivalent stress in the periodontal ligament of molars was increased,while that of anterior teeth was decreased.(2)Regardless of whether the miniscrews were located on the buccal or palatal side,compared with hooks at the first premolar,when hooks were done at the canine,the labial inclination trend of the anterior teeth was reduced,the distal movement of the molars was reduced,the mesial movement of the premolars was increased,and the maximum equivalent stress of the molar and the periodontal membrane of the anterior teeth was reduced.(3)Regardless of whether miniscrews were located on the buccal or palatal side,and the hooks were located on the canine or the first premolar,the molar could not achieve overall movement.(4)The results show that clear aligner combined with palatal miniscrews and hooks at the first premolar are more conducive to improving the efficiency of maxillary molar distalization,but attention should be paid to protecting the anterior tooth miniscrews and molar torque control;clear aligner combined with palatal miniscrews and hooks at the canine is more conducive to reducing the labial tipping tendency of anterior teeth,but the efficiency of molar distalization will be relatively reduced.

Objective To construct a distance self-attention(DSA)and long short-term memory(LSTM)model and observe its value for predicting X-ray tube arcing in CT equipment.Methods CT equipment status data of internet of medical things were collected and preprocessed,then DSA-LSTM model based on model attention(MA)module and nonlinear attenuation distance factor was constructed,and its value for predicting X-ray tube arcing in CT equipment was analyzed compared with other models.Results Compared with other models,DSA-LSTM model had better comprehensive efficiency for predicting X-ray tube arcing in CT equipment.MA module and nonlinear attenuation distance factor could improve the predictive efficiency of DSA-LSTM model,and all included features contributed to the performance of DSA-LSTM model in a certain extent.Conclusion DSA-LSTM model could effectively predict X-ray tube arcing in CT equipment.

Objective:To explore the impact of early and late antibody-mediated rejection (AMR) on treatment options and allograft outcomes after kidney transplantation (KT).Methods:From January 2013 to December 2022, the study retrospectively enrolled 141 KT allograft recipients receiving allograft biopsy and diagnosed as AMR according to the Banff 2019 criteria. Recipients with a diagnosis of AMR within 30 days post-KT were classified into early AMR group (n=19) while the remainders assigned as late AMR group (n=122). The outcome endpoints included recipient survival rate, death-censored graft survival rate, follow-up estimated glomerular filtration rate (eGFR) and immunodominant donor-specific antibody (DSA) intensity. Wilcoxon's test was utilized for assessing the differences in eGFR and DSA intensity while Kaplan-Meier curve and Log-rank test were employed for evaluating graft survival impact. Treatment regimens for AMR were collected and categorized.Results:The median follow-up duration was 2.6(1.2, 5.2) year. No graft failure was noted in early AMR group while 44 recipients in late AMR group experienced graft failure, with 34 cases (77.2%) due to AMR progression. The 5-year death-censored graft survival rate was significantly better in early AMR group than that in late AMR group [100% vs 60.1%(50.5%, 71.6%), P=0.002]. The one-year change in eGFR for early AMR group was significantly superior to that of late AMR group [19.3(-2.6, 38.1) vs -3.3(-14.0, 5.4), P=0.001]. One-year mean fluorescent intensity (MFI) of early AMR group was 1 158(401.5, 3 126.5). It was significantly lower than that when diagnosed with early AMR [3 120.5(2 392.8, 9 340.0)] and one-year MFI of late AMR group [8 094(2 251.5, 13 560.5)] ( P=0.005, P<0.001). Early AMR group primarily received standard treatment (3/19, 15.8%) and regimens centered on rituximab and/or bortezomib (7/19, 43.8%). Late AMR group mainly received standard (16/122, 13.1%) or intensified regimens (9/122, 7.4%) and regimens focused upon rituximab and/or bortezomib (32/122, 26.2%) and MP monotherapy (21/122, 17.2%). Conclusion:The outcome for early AMR is significantly better than that for late AMR. For early AMR, early and robust immunosuppression is recommended. For late AMR, early detection and timely treatment are crucial and individualized strategies should be implemented.

This report described one patient of giant polycystic liver and polycystic kidney involving iliac fossa. Preoperative computed tomography (CT) revealed a large polycystic kidney occupying partially iliac fossa space. A decompression of lower pole of original kidney was planned for placing transplanted kidney. During total liver resection plus orthotopic liver transplantation, right polycystic kidney could move up on its own and iliac fossa space was released for placing transplanted kidney smoothly. Polycystic kidney shrunk markedly post-operation. It provided references for surgical planning of combined liver-kidney transplantation for this type of disease.

OBJECTIVE To reveal the role of the basal forebrain(BF)GABAergic neurons in the regulation of isoflurane anesthesia and to elucidate the underlying neural pathways.METHODS The activity of BF GABAer-gic neurons was monitored during isoflurane anesthesia using a genetically encoded calcium indicator in Vgat-Cre mice of both sexes.The activity of BF GABAer-gic neurons was manipulated by chemogenetic and opto-genetic approaches.Sensitivity,induction time and emer-gence time of isoflurane anesthesia were estimated by righting reflex.The electroencephalogram(EEG)power and burst-suppression were monitored by EEG recording.The effects of activation of GABAergic BF-thalamic reticu-lar nucleus(TRN)pathway on isoflurane anesthesia were investigated with optogenetics.RESULTS The activity of BF GABAergic neurons was generally inhibited during isoflurane anesthesia,obviously decreased during the induction of anesthesia and gradually restored during the emergence from anesthesia.Activation of BF GABAergic neurons with chemogenetics and optogenetics promoted behavioral emergence from isoflurane anesthesia,with decreased sensitivity to isoflurane,delayed induction and accelerated emergence from isoflurane anesthesia.Optogenetic activation of BF GABAergic neurons prom-oted cortical activity during isoflurane anesthesia,with decreased EEG delta power and burst suppression ratio during 0.8%and 1.4%isoflurane anesthesia,respectively.Similar to the effects of activating BF GABAergic cell bod-ies,photostimulation of BF GABAergic terminals in the TRN also strongly promoted cortical activation and behav-ioral emergence from isoflurane anesthesia.CONCLU-SION The GABAergic neurons in the BF is a key neural substrate for general anesthesia regulation that facilitates behavioral and cortical emergence from general anesthe-sia via the BF-TRN pathway.

Objective:To explore the morbidity features and therapeutic outcomes of rejections in pediatric kidney transplantation (KT) recipients.Methods:Between January 2013 and June 2022, 360 children undergoing KT were recruited.The relevant clinical data were collected for examining the morbidity features and therapeutic outcomes of rejections.The serum levels of creatinine were compared among groups by non-parametric rank test.And Kaplan-Meier and Log-rank methods were employed for examining the incidence of rejection and comparing mortality-censored graft survival rates among patients with different times of rejection.Results:A total of 58 recipients had 82 incidents of rejection with a cumulative incidence of 6.3%, 9.2% and 11.3% at 3/6/12 months respectively.Among 50 incidents of biopsy-proved rejections, the types were T cell-mediated rejection [TCMR, 42.0%(21/50)], antibody-mediated rejection [20.0%(10/50), ABMR] and mixed rejection [38.0%(19/50)].Among 58 incidents of initial rejection, 69% had maintained graft function (MGF) and 31% impaired graft function (IGF) after anti-rejection regimens.Among 80.8%, 85.7% and 75% of recipients with clinical rejection, ABMR or borderline rejection while 36.4% in TCMR patients had MGF.Fifteen kidney allografts lost function in 58 recipients with rejection.Five-year death-censored graft survival was significantly lower in patients with two or more incidents of rejection (30.5%, 95% CI: 12.3%-75.4%) than in those without rejection (92.9%, 95% CI: 89.3%-96.6%) ( P<0.000 1) or with only one rejection (82.9%, 95% CI: 65.9%-100%)( P<0.001). Conclusions:The rejection rate remains high in KT children and it affects graft survival.And TCMR is more likely to cause impaired graft function.Recurrent rejections have a more pronounced impact upon graft survival.