Objective To study the possibility of using cone-beam computed tomography(CBCT)with CTAn software to analyze bone resistance during mandibular third molar extraction surgery.Methods Fifty-three patients who underwent CBCT scans for third molars at the Department of Stomatology from January 1st 2021 to July 31th 2023 were induded,involving a total of 91 mandibular third mo-lars.CTAn software was used to analyze the buccal and lingual bone volume regions around mandibular third molars in CBCT images,assessing three-dimensional bone microstructural parameters.Results Significant differences(P＜0.05)in tissue volume,trabecular bone volume/tissue volume,bone surface/trabecular bone volume,bone surface/tissue volume,and bone mineral density between the buccal and lingual bone volume areas were observed in both the total sample and in stratified analyses based on themesially inclined/verticalmandibular third molar impactionand gender.In high/mid-level mesially inclined and vertical impactions,females showed more significant differences in microstructural parameters of the buccal and lingual bone volume compared to males.Conclusion The inte-gration of CBCT with CTAn software offers a viable method for assessing bone resistance during mandibular third molar extractions.Lin-gual bone exhibits greater bone tissue content,denser trabeculae with smaller tissue volume compared to buccal bone.During mandibu-lar third molar extraction,compressing the buccal alveolar bone helps create trabecular compression space more easily.Additionally,the buccal alveolar bone is more amenable to grinding than the lingual side,thereby achieving a reasonable buccal dislocation of root.For female patients with high/mid-level mesially inclined and vertical impactions of the mandibular third molars,a buccal approach is more advisable to be followed.The evaluation of bone microstructural parameters and accurate determination of bone resistance offer valuable insights for the minimally invasive removal of impacted teeth.

Objective To investigate the correlation between atherogenic index of plasma (AIP) and the severity of hypertriglyceridemic acute pancreatitis (HTG-AP) and the value of AIP combined with Bedside Index for Severity in Acute Pancreatitis (BISAP) score in the early prediction of severe HTG-AP (sHTG-AP). Methods A retrospective analysis was performed for the clinical data of 170 patients with HTG-AP who were hospitalized in The General Hospital of Central Theater Command from January 2017 to December 2021, and according to related guidelines, they were divided into the sHTG-AP group with 28 patients and non-sHTG-AP group with 142 patients. Peripheral blood samples were collected from all patients within 24 hours after admission, and the two groups were compared in terms of sex, age, laboratory test results, AIP, BISAP score, and modified CT severity index (MCTSI) score. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups; the Mann-Whitney U test was used for comparison of continuous data between groups. The Spearman rank correlation test was used to investigate the correlation between each factor and the severity of HTG-AP, and the binary logistic regression analysis were used to investigate the independent risk factors for sHTG-AP. The receiver operating characteristic (ROC) curve was plotted to assess the predictive efficacy of each indicator. Results There were significant differences between the two groups in the medical history of diabetes, lymphocyte count, albumin, Ca 2+ , triglyceride, high-density lipoprotein cholesterol, AIP, BISAP score, MCTSI score, length of hospital stay, and hospital costs (all P < 0.05). The sHTG-AP group had a longer length of hospital stay, higher hospital costs, and a higher AIP value. AIP (odds ratio [ OR ]=1.244, 95% confidence interval [ CI ]: 1.062-1.458, P =0.007), BISAP score ( OR =5.525, 95% CI : 1.646-18.543, P =0.006), and MCTSI score ( OR =2.029, 95% CI : 1.245-3.305, P =0.004) were risk factors for sHTG-AP. AIP, BISAP score, and MCTSI score were positively correlated with the severity of HTG-AP ( r =0.291, 0.631, and 0.649, all P < 0.001), and AIP was positively correlated with BISAP score and MCTSI score ( r =0.190 and 0.215, both P < 0.05). AIP had an optimal cut-off value of 1.095 in predicting sHTG-AP, and AIP, BISAP score, and AIP combined with BISAP score had an area under the ROC curve of 0.759, 0.887, 0.925, respectively, a sensitivity of 0.821, 0.857, and 0.786, respectively, and a specificity of 0.627, 0.817, and 0.937, respectively (all P < 0.001). Conclusion AIP is a risk factor for sHTG-AP and is correlated with disease severity, and AIP combined with BISAP score has a relatively high value in the early prediction of sHTG-AP.

Objective:To investigate the correlation between thromboelastography (TEG) and portal vein thrombosis in patients with cirrhotic esophagogastric varices.Methods:210 hospitalized patients with cirrhotic esophagogastric varices treated in Zhongshan Hospital Affiliated to Fudan University from December 2016 to December 2017 were retrospectively included. They were divided into portal vein thrombosis group (PVT group) and non portal vein thrombosis group (NPVT group) according to whether they were complicated with portal vein thrombosis. The correlation between the results of TEG coagulation reaction time (R value), coagulation time (K value), αAngle, maximum amplitude (MA) and coagulation composite index (CI) and portal vein thrombosis was analyzed. The characteristics of coagulation status in patients with portal vein thrombosis in cirrhosis were compared.Results:A total of 91 patients (43.3%) were complicated with portal vein thrombosis. The R value in the PVT group was significantly lower than that of NPVT group [5.49(5.22-5.77) vs 5.98(5.76-6.20), P=0.006]. Logistic regression analysis showed that Child Pugh grade ( OR=2.883, 95% CI: 1.630-5.098, P<0.001) and R value ( OR=0.739, 95% CI: 0.575-0.950, P=0.018) were independently associated risk factors of PVT. The R value of patients was significantly correlated with Child Pugh grade ( r=0.147, P=0.034), platelet ( r=-0.358, P<0.001), prothrombin time (PT) ( r=0.334, P<0.001) and international standardized ratio (INR) ( r=0.328, P<0.001). Conclusions:The decrease of TEG-R value is closely related to PVT in liver cirrhosis.

Objective:To compare the effect of middle meningeal artery embolization (MMAE) versus conventional therapy for chronic subdural hematoma (CSDH).Methods:Retrospective analysis of 38 patients with 48 CSDHs treated with MMAE from May 2019 to May 2021 was performed. Comparisons were made with a conventional treatment for 126 patients with 126 CSDHs from January 2016 to May 2021. The MMAE and conventional treatment patients were matched by the propensity score matching method, and a total of 25 pairs of patients (31 pairs of CSDHs) were successfully matched. The CSDH recurrence, rescue treatment, radiographic follow-up outcome, clinical improvement and complication between the two groups were compared by t test, χ 2 test or Fisher exact probability methods. Results:The rescue treatment rate in MMAE group was significantly lower than that in conventional treatment group [0 (0/31) vs 19.4% (6/31), P=0.024] and the complete resolution rate at 6 months follow-up in MMAE group was significantly higher than that in conventional treatment group [96.8 (30/31) vs 74.2% (23/31), P=0.026]. In terms of CSDH recurrence, there was a trend of lower recurrence in the MMAE group [3.2%(1/31) vs 22.6% (7/31), P=0.053]. The complete resolution rate at 3 months follow-up was 61.3% (19/31) in MMAE group and 45.2% (14/31) in conventional treatment, clinical improvement rate was 92.0% (23/25) in MMAE group and 88.0% (22/23) in conventional treatment, good outcome rate (mRS≤2) was 92.0% (23/25) in MMAE group and 84.0% (21/25) in conventional treatment, complication rate was 0(0/25) in MMAE group and 4.0% (1/25) in conventional treatment, and there were no significant differences in all above-mentioned parameters ( P>0.05). Conclusions:The MMAE may be considered as a safe and effective treatment for CSDH, and MMAE for CSDH is associated with lower trend of recurrence, lower rescue treatment rate and better radiographic follow-up outcome than conventional therapy.

Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease caused by abnormal accumulation of fat in the hepatocytes. Its prevalence is rising globally and has become the most common cause of chronic liver disease worldwide. The pathogenesis of NAFLD is multifaceted, involving insulin resistance, genetic and epigenetic factors, chronic systemic inflammation, mitochondrial dysfunction, endoplasmic reticulum stress, diet, gut microbiota, and other significant contributors. This article primarily delves into the mechanisms of mitochondrial dysfunction and endoplasmic reticulum stress in the development of NAFLD, aiming to provide new insights and therapeutic strategies for NAFLD.

Objective? To explore the real experience of newly recruited nurses during standardized training and to provide a basis for improving the means of standardized training. Methods? Totally 11 newly recruited nurses who received standardized training in a Class Ⅲ Grade A hospital were selected and interviewed by purposive sampling. The interview data were read repeatedly, analyzed, encoded, classified and finally refined to the topics using the phenomenological method in qualitative studies. Results? Totally 4 topics were refined in this study, including occupational cognitive imbalance, mental stress caused by workplace stimulus, physiological stress caused by workplace stimulus and thirst for knowledge. Conclusions? Newly recruited nurses have not fully become practitioners from the role of students. Schools and teaching hospitals need to pay attention to specialized training and pre-vocational transition education, provide relevant training and courses, and make the nurses under standardized training adapted to clinical work as soon as possible.

This paper reviewed the research status on the existing perioperative pain control among patients with cataract surgery both here and abroad. The research status included influencing factors, assessment instruments of pain and pain control plan, so as to provide a basis for improving perioperative pain control plan of cataract patients and reducing the incidence of pain.

It introduced the definition of the caregiver and at home and abroad,and also reviewed influencing factors of family caregiver′s burden of the elderly patients. At last, it put forward the essentiality to perfect the nursing intervention and improve caregivers' coping capacity, as well as the transitional care model and the linkage"hospital-community-family",and improve national legislation and policy support in order to structure the social support system at the same time, so as to provide reference for study of reducing the family caregiver′s burden of the elderly patients.

Objective To explore the experience of the family caregivers of the old hip fracture patients with cognition impairment. Methods By using purpose sampling method,11 participants which treating from January to April 2017 were applied semi-structured in-depth interview,and then analysis the material. Results Four themes were analyzed about the caring demands of the family caregivers, including existing heavier caring burden,inadequate knowledge and skills,positive face to the caring task, desire to caregiver support system. Conclusions The family caregivers of the old hip fracture patients with cognition impairment exist heavier caring burden, the medical service institutions should call on national policy support and economic aid for caregivers, care about the mental health of caregivers and improve their coping ability, as well as provide professional knowledge and skills guidance and build a perfect caregiver support system at the same time in order to reduce the burden of caregivers early.

Objective To evaluate the effect of emergent microsurgery in treatment of patients with hematoma-type anterior circulation ruptured aneurysm.Methods The clinical data and therapeutic effect of emergency microsurgery for 32 patients with hematoma-type anterior circulation ruptured aneurysm were analyzed retrospectively.Results Finally 32 patients underwent emergency craniotomy clipping and hematoma removal in 24 h.Among them,15 cases underwent decompressive craniectomy.One week after the operation,CTA revealed that all aneurysms were completely clipped.One patient with communicating hydrocephalus were treated with ventriculoperitoneal shunt,and 6 patients had different degrees of cerebral infarction.After 6 months of follow-up,the Glasgow outcome scale (GOS) showed that there were 5 cases of grade 5 (15.6％),12 cases of grade 4 (37.5 ％),12 cases of grade 3 (37.5％),2 cases of grade 2 (6.3％) and 1 case of grade 1 (6.3％).The prognosis satisfaction rate was 53.1％ (17/32).Conclusion Emergent microsurgery is effective in the treatment of patients with hematoma-type anterior circulation ruptured aneurysm.