Peri-implant keratinized mucosa (PIKM) augmentation refers to surgical procedures aimed at increasing the width of PIKM. Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health. Currently, several surgical techniques have been validated for their effectiveness in increasing PIKM. However, the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques, variations in clinical scenarios, and anatomical differences. Therefore, clear guidelines and considerations for PIKM augmentation are needed. This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery. It aims to establish a standardized framework for assessing, planning, and executing PIKM augmentation procedures, with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
Humans ; Consensus ; Dental Implants ; Mouth Mucosa/surgery* ; Keratins

BACKGROUND:In the follow-up after unicompartmental knee arthroplasty,some patients have knee pain,among which postmenopausal obese women are the most common. As an important index to measure the degree of body obesity,whether body mass index is related to the curative effect after unicompartmental knee arthroplasty and whether obesity will affect the function of knee joint after operation are worthy of further study.OBJECTIVE:To evaluate the clinical efficacy of postmenopausal obese women undergoing medial unicompartmental knee arthroplasty,and to determine the influence of body mass index on the quality of life after unicompartmental knee arthroplasty.METHODS:Female postmenopausal patients who underwent medial unicompartmental knee arthroplasty for the first time due to medial knee pain from January 2017 to January 2019 in the Fourth Clinical Medical College of Xinjiang Medical University were enrolled. A total of 270 cases were included according to inclusion and exclusion criteria,and were divided into 4 groups according to preoperative body mass index:There were 42 cases in normal group (body mass index 18.5-22.9 kg/m2),58 cases in overweight group (body mass index 23.0-24.9 kg/m2),122 cases in obese group (body mass index 25.0-29.9 kg/m2),and 48 cases in severely obese group (body mass index ≥30 kg/m2). Hospital for Special Surgery score,Western Ontario and McMaster Universities Osteoarthritis Index score,knee range of motion,visual analog scale score,and hip-knee-ankle angle were compared before,after and at the last time in each group. Patients were followed up to record the time of use of prostheses after surgery and reasons for failure or revision. The effective utilization rate of prostheses was calculated and compared in each group. Survival curve was used for statistical analysis of the effective utilization rate of prostheses.RESULTS AND CONCLUSION:(1) There was no significant difference in postoperative follow-up time,knee joint range of motion,visual analog scale score,and hip-knee-ankle angle between the groups (P>0.05). (2) The Hospital for Special Surgery score and Western Ontario and McMaster Universities Osteoarthritis Index score of each group in final follow-up were significantly improved compared with those before surgery (P<0.05),and the postoperative effect was obvious in each group (P<0.05). Regarding Hospital for Special Surgery score,the improvement effect was worse in the severely obese group. (3) The comparison of hip-knee-ankle angle between all groups immediately after surgery and the last follow-up showed that there were significant differences between the other groups at two time points (P<0.05) except the normal group (P>0.05). (4) The effective utilization rate of prosthesis in normal,overweight,obesity,and severely obese groups was 100％,95％,94％,and 94％,respectively,and there was no significant difference between the groups (x2=2.532,P=0.469). (5) It is indicated that body mass index of postmenopausal obese women had no significant effect on the effective utilization rate of medial unicompartmental prosthesis. Obesity is an important factor affecting the postoperative knee function score and the effective utilization rate of prosthesis.Weight should be properly controlled before and after unicompartmental knee arthroplasty. At the same time,female body mass index ≥ 30 kg/m2 is not the best indication for unicompartmental knee arthroplasty. It is suggested that female patients undergoing unicompartmental knee arthroplasty should controlbody mass index below 30 kg/m2.

To the testing requirements of space product before its delivery to the spacecraft,it is necessary to carry out desktop tests on these products to verify whether their full performance,functions and interfaces are normal.A test system for multi-interface products is proposed to simulate the external environment,providing consistent electrical interfaces and information with the spacecraft,including power supply interfaces,telemetry data downlink,command uplink and other functions.The build test system adopts a B/S architecture with a web server as the computing center and a desktop browser for login,and uses a server operation mode with a separated interface machine,which is flexible and efficient.It is shown that the build system is simple to operate,efficient and reliable,and easy to maintain.It has been stably applied in the testing of relevant equipment on spacecraft.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

BACKGROUND:In the follow-up after unicompartmental knee arthroplasty,some patients have knee pain,among which postmenopausal obese women are the most common. As an important index to measure the degree of body obesity,whether body mass index is related to the curative effect after unicompartmental knee arthroplasty and whether obesity will affect the function of knee joint after operation are worthy of further study.OBJECTIVE:To evaluate the clinical efficacy of postmenopausal obese women undergoing medial unicompartmental knee arthroplasty,and to determine the influence of body mass index on the quality of life after unicompartmental knee arthroplasty.METHODS:Female postmenopausal patients who underwent medial unicompartmental knee arthroplasty for the first time due to medial knee pain from January 2017 to January 2019 in the Fourth Clinical Medical College of Xinjiang Medical University were enrolled. A total of 270 cases were included according to inclusion and exclusion criteria,and were divided into 4 groups according to preoperative body mass index:There were 42 cases in normal group (body mass index 18.5-22.9 kg/m2),58 cases in overweight group (body mass index 23.0-24.9 kg/m2),122 cases in obese group (body mass index 25.0-29.9 kg/m2),and 48 cases in severely obese group (body mass index ≥30 kg/m2). Hospital for Special Surgery score,Western Ontario and McMaster Universities Osteoarthritis Index score,knee range of motion,visual analog scale score,and hip-knee-ankle angle were compared before,after and at the last time in each group. Patients were followed up to record the time of use of prostheses after surgery and reasons for failure or revision. The effective utilization rate of prostheses was calculated and compared in each group. Survival curve was used for statistical analysis of the effective utilization rate of prostheses.RESULTS AND CONCLUSION:(1) There was no significant difference in postoperative follow-up time,knee joint range of motion,visual analog scale score,and hip-knee-ankle angle between the groups (P>0.05). (2) The Hospital for Special Surgery score and Western Ontario and McMaster Universities Osteoarthritis Index score of each group in final follow-up were significantly improved compared with those before surgery (P<0.05),and the postoperative effect was obvious in each group (P<0.05). Regarding Hospital for Special Surgery score,the improvement effect was worse in the severely obese group. (3) The comparison of hip-knee-ankle angle between all groups immediately after surgery and the last follow-up showed that there were significant differences between the other groups at two time points (P<0.05) except the normal group (P>0.05). (4) The effective utilization rate of prosthesis in normal,overweight,obesity,and severely obese groups was 100％,95％,94％,and 94％,respectively,and there was no significant difference between the groups (x2=2.532,P=0.469). (5) It is indicated that body mass index of postmenopausal obese women had no significant effect on the effective utilization rate of medial unicompartmental prosthesis. Obesity is an important factor affecting the postoperative knee function score and the effective utilization rate of prosthesis.Weight should be properly controlled before and after unicompartmental knee arthroplasty. At the same time,female body mass index ≥ 30 kg/m2 is not the best indication for unicompartmental knee arthroplasty. It is suggested that female patients undergoing unicompartmental knee arthroplasty should controlbody mass index below 30 kg/m2.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To elucidate the etiological and epidemiological characteristics and epidemiological patterns of viral acute respiratory infections (ARI) in Shanghai during 2023, with the aim of providing robust laboratory evidence for effective prevention and control strategies against related respiratory diseases and facilitating risk assessment.Methods:Respiratory pathogens were detected in the clinical surveillance specimens submitted by sentinel hospitals through multiplex PCR, as part of the multi-pathogen surveillance of acute respiratory infections in Shanghai during 2023. The obtained detection result were statistically analyzed in conjunction with sample information.Results:The positive detection rate of viral pathogens in 2023 was 21.17% (984/4 648), with rates of 33.53% (504/1 503) observed in ILI cases and 15.62% (480/3 145) in SARI cases. Influenza A virus (FluA) was the predominant virus detected, accounting for 13.7% (637/4 648). Other viruses identified in the surveillance samples included influenza B virus (Flu B), human rhinovirus/enterovirus (HRV/HEV), respiratory syncytial virus (RSV), human metapneumovirus (HMPV), parainfluenza virus (PIV), adenovirus (ADV) and human bocavirus (HBoV). Regarding temporal distribution, HRV/HEV and RSV exhibited the highest detection rates during the second quarter at 2.27% each (28/1 236). PIV had its peak during the third quarter at a rate of 2.49% (35/1 405), and HMPV showed prevalence mainly during the third and fourth quarters, with detection rates of 2.63% (37/1 405) and 2.35% (32/1 360), respectively.Conclusions:In acute respiratory infection surveillance cases in Shanghai in 2023, Flu A emerged as the predominant respiratory pathogen. The detection rate of HMPV ranked second only to Flu A, while other respiratory viruses such as HRV/HEV, RSV, and PIV were detected during different seasons and co-circulated. The prevalence of various respiratory viruses varied among different infected populations and over times.

Objective:To investigate the diagnostic value of an intelligent assisted grading algorithm for nuclear cataract using anterior segment optical coherence tomography (AS-OCT) images.Methods:A diagnostic test study was conducted.AS-OCT image data were collected from 939 cases of 1 608 eyes of nuclear cataract patients at the Shanghai Tenth People's Hospital of Tongji University from November 2020 to September 2021.The data were obtained from the electronic case system and met the requirements for clinical reading clarity.Among them, there were 398 cases of 664 male eyes and 541 cases of 944 female eyes.The ages of the patients ranged from 18 to 94 years, with a mean age of (65.7±18.6) years.The AS-OCT images were labelled manually from one to six levels according to the Lens Opacities Classification System Ⅲ (LOCS Ⅲ grading system) by three experienced clinicians.This study proposed a global-local cataract grading algorithm based on multi-level ranking, which contains five basic binary classification global local network (GL-Net).Each GL-Net aggregates multi-scale information, including the cataract nucleus region and original image, for nuclear cataract grading.Based on ablation test and model comparison test, the model's performance was evaluated using accuracy, precision, sensitivity, F1 and Kappa, and all results were cross-validated by five-fold.This study adhered to the Declaration of Helsinjki and was approrved by Shanghai Tenth People's Hospital of Tongji University (No.21K216).Results:The model achieved the results with an accuracy of 87.81%, precision of 88.88%, sensitivity of 88.33%, F1 of 88.51%, and Kappa of 85.22% on the cataract dataset.The ablation experiments demonstrated that ResNet18 combining local and global features for multi-level ranking classification improved the accuracy, recall, specificity, F1, and Kappa metrics.Compared with ResNet34, VGG16, Ranking-CNN, MRF-Net models, the performance index of this model were improved.Conclusions:The deep learning-based AS-OCT nuclear cataract image multi-level ranking classification algorithm demonstrates high accuracy in grading cataracts.This algorithm may help ophthalmologists in improving the diagnostic accuracy and efficiency of nuclear cataract.

Heart failure(HF)is the end stage of almost all cardiovascular diseases,including coronary heart disease and structural heart disease.For end-stage HF,medications and cardiac assist devices have limited therapeutic effects,and heart transplantation is associated with donor shortage and immune rejection.Alginate hydrogel has the ability to mechanically support and induce cardiac tissue regeneration and repair.In March 2021,we conducted the world's first transcatheter endocardial alginate-hydrogel implantation in patients with end-stage heart failure,and explored the safety and feasibility of the treatment.Given that patients with heart failure who had undergone cardiac resynchronization therapy defibrillator(CRT-D)were excluded from previous studies,this paper is the first to report a case of transcatheter endocardial alginate-hydrogel implantation in a patient with heart failure who did not respond to CRT-D,with a significant reduction in the number of visits to the doctor and a significant improvement in the quality of life during the post-procedure follow-up,which may expand the indications for the use of this technology.

Objective To evaluate the efficacy of extracorporeal membrane oxygenation(ECMO)in patients with reduced left ventricular ejection fraction(LVEF)undergoing transcatheter aortic valve implantation(TAVR).Methods This was a single-center,retrospective study enrolling a total of 30 patients with reduced LVEF undergoing TAVR from January 2020 to January 2024.Of these,12 patients underwent TAVR with ECMO.Baseline clinical characteristics,preprocedural echocardiographic and computed tomographic(CT)measurements,TAVR procedural details,and follow-up data at 60-day and 6-month were collected.Results Among the 30 patients,there were 20 males with an average age of(67.0±10.4)years,an average STS score of(8.2±1.8)points,and an average LVEF of(21.2±5.3)％.This study included 11 AR patients,all of whom were in the group without ECMO implantation,and the difference between the two groups was statistically significant(P=0.027).During the operation,there were 0 cases of circulatory collapse in the ECMO group,and 5 cases(5/18)of circulatory collapse in the non ECMO group.All 5 patients underwent emergency ECMO placement.There were statistically significant differences(P＜0.05)in the comparison of two groups with circulatory collapse and salvage ECMO implantation.The technical success rate of 30 patients was 76.7％(23/30),and the instrument success rate was 60.0％(18/30).Among them,the technical success rate and instrument success rate of the ECMO group were higher than those of the non ECMO group,but the differences were not statistically significant(both P＞0.05).During a 30 day follow-up,there were 0 all-cause deaths in the ECMO group and 9 all-cause deaths(9/18)in the non ECMO group.Among them,7 cases(7/18)died from cardiovascular causes.The differences in all-cause and cardiovascular cause deaths between the two groups were statistically significant(both P＜0.05).During a 6-month follow-up,one patient with ECMO died due to extensive cerebral infarction.The all-cause mortality rate during the 6-month follow-up was 1/12(8.3％),while the all-cause mortality rate without ECMO was 9/18(5.0％).The difference between the two groups was statistically significant(P=0.024).The incidence of stroke with ECMO was 1/12(8.3％),while without ECMO it was 0.There was no statistically significant difference between the two groups(P=0.978).Conclusions In patients with reduced LVEF undergoing TAVR,periprocedural ECMO support does seem to improve patient outcome.