Objective To explore the long-term efficacy of percutaneous pulmonary valve implantation(PPVI)and the durability of the domestic self-expanding Venus P valve.Methods A total of 8 patients with post-surgical right ventricular outflow tract(RVOT)dysfunction,who were admitted to hospital from October 2014 to July 2016 and deemed anatomically suitable for PPVI with self-expanding valve,were included prospectively.Clinical,imaging,procedural and follow-up data were analyzed.The survival rates,perioperative and long-term complication rates,long-term efficacy of PPVI,and long-term function of Venus P in 8 patients were evaluated.The immediate procedural results were evaluated by clinical implant success rate,which is defined as successful valve implantation with echocardiography-assessed pulmonary regurgitation＜moderate and peak trans-pulmonary pressure gradient＜40 mmHg.Results A total of 8 patients were included,with 7 females,aged 14 to 36 years.The initial diagnosis included post-surgical Tetralogy of Fallot(5 cases),post-surgical Trilogy of Fallot(1 case),post-surgical Quadricuspid pulmonary valve stenosis(1 case)and post-surgical Double-Outlet Right Ventricle(1 case).The indications of PPVI included RVOT-pulmonary obstruction and regurgitation(1 case)and isolated regurgitation(7 cases).Clinical implant success was achieved in all of the 8 patients with firmly fixed valve,and there were no such complications as valve detachment,displacement or stent fracture.All patients experienced significant symptom relief after the procedure.The right ventricular end-diastolic volume index(RVEDVi)measured by CMR 6 months after PPVI showed a significant decrease compared to preprocedural values[(89.99±13.85)ml/m2 vs.(144.93±11.28)ml/m2,P=0.001].Postoperative pulmonary regurgitation were significantly improved or disappeared in all patients,and there was no statistically significant difference in the average peak pressure gradient measured by echocardiogram between preoperative and the latest follow-up[(23.25±8.39)mmHg vs.(18.75±6.28)mmHg,P=0.210].Over an average follow-up period of(9.25±0.71)years,1 case of infective endocarditis occurred 5 years after PPVI.During the follow-up,no death,deterioration of heart failure,malignant arrhythmia or other serious complications were observed.All patients completed 8-year follow-up,and 3 completed 10-year follow-up.All patients were graded as NYHA functional class one at the latest follow-up.Conclusions PPVI using the domestically produced self-expanding Venus P is safe and feasible for the treatment of patients with post-surgical RVOT dysfunction and suitable anatomy.Our study confirms the long-term efficacy and durability of Venus P from multiple perspectives,and no severe stent fracture occurred without pre-stent implantation in the native RVOT.

Objective To conduct preoperative simulations of three different osteotomy line design schemes under centric occlusion based on two distinct material assignment methods,evaluate biomechanical properties of the models,and explore which osteotomy line design schemes are more suitable for different types of mandibles.Methods Three types of mandibles were selected,and CT images were obtained for three-dimensional(3D)reconstruction.Material assignment was completed using the cortical/cancellous bone assignment method and the gray value assignment method.Osteotomy was simulated according to the three osteotomy line design schemes,followed by finite element analysis.Results In all simulation results of the mandibles,the maximum stress was 81.10 MPa,the maximum strain was 0.035 52,and the maximum displacement was 432.4 μm.The stress distributions obtained by the cortical/cancellous bone assignment method showed a larger stress distribution range than that that by the gray value assignment methods,but the maximum stress,strain,and displacement were generally lower.For the outflare type and common type mandibles,Scheme 1 showed lower maximum stress,strain,and displacement under both material assignment methods,but no clearly suitable scheme was found for the retracted type.Conclusions The outflare type and common type mandibles are more suitable for adopting the osteotomy line design scheme of Scheme 1.For the retracted type,other mandibular angle osteotomy plastic surgery methods may be considered to ensure better biomechanical characteristics.Whether choosing the osteotomy line design scheme or the modeling material assignment method,it is necessary to make the final decision based on the specific analysis objective and resource conditions.

After ischemic stroke,intracranial cells experience stress due to ischemic and hypoxic injury,leading to a series of aseptic immune response processes.The oxidative stress process in microglias triggers the activation of the NLRP3 inflammasome,which promotes the release of inflammatory factors such as IL-1β and IL-18,contributing to the inflammatory reaction caused by isch-emic stroke.In addition,NLRP3 inflammasome is involved in the polarization,pyroptosis and autophagy of microglias,regulating the prognosis of ischemic stroke.This review summarizes the specific mechanisms of NLRP3 inflammasome in regulating microglial status and its involvement in ischemia-reperfusion injury.It also discusses the associated treatment strategies,identifies the current research focus and blanks,and provides some guidance and ideas for future research.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

After ischemic stroke,intracranial cells experience stress due to ischemic and hypoxic injury,leading to a series of aseptic immune response processes.The oxidative stress process in microglias triggers the activation of the NLRP3 inflammasome,which promotes the release of inflammatory factors such as IL-1β and IL-18,contributing to the inflammatory reaction caused by isch-emic stroke.In addition,NLRP3 inflammasome is involved in the polarization,pyroptosis and autophagy of microglias,regulating the prognosis of ischemic stroke.This review summarizes the specific mechanisms of NLRP3 inflammasome in regulating microglial status and its involvement in ischemia-reperfusion injury.It also discusses the associated treatment strategies,identifies the current research focus and blanks,and provides some guidance and ideas for future research.

Objective To explore the long-term efficacy of percutaneous pulmonary valve implantation(PPVI)and the durability of the domestic self-expanding Venus P valve.Methods A total of 8 patients with post-surgical right ventricular outflow tract(RVOT)dysfunction,who were admitted to hospital from October 2014 to July 2016 and deemed anatomically suitable for PPVI with self-expanding valve,were included prospectively.Clinical,imaging,procedural and follow-up data were analyzed.The survival rates,perioperative and long-term complication rates,long-term efficacy of PPVI,and long-term function of Venus P in 8 patients were evaluated.The immediate procedural results were evaluated by clinical implant success rate,which is defined as successful valve implantation with echocardiography-assessed pulmonary regurgitation＜moderate and peak trans-pulmonary pressure gradient＜40 mmHg.Results A total of 8 patients were included,with 7 females,aged 14 to 36 years.The initial diagnosis included post-surgical Tetralogy of Fallot(5 cases),post-surgical Trilogy of Fallot(1 case),post-surgical Quadricuspid pulmonary valve stenosis(1 case)and post-surgical Double-Outlet Right Ventricle(1 case).The indications of PPVI included RVOT-pulmonary obstruction and regurgitation(1 case)and isolated regurgitation(7 cases).Clinical implant success was achieved in all of the 8 patients with firmly fixed valve,and there were no such complications as valve detachment,displacement or stent fracture.All patients experienced significant symptom relief after the procedure.The right ventricular end-diastolic volume index(RVEDVi)measured by CMR 6 months after PPVI showed a significant decrease compared to preprocedural values[(89.99±13.85)ml/m2 vs.(144.93±11.28)ml/m2,P=0.001].Postoperative pulmonary regurgitation were significantly improved or disappeared in all patients,and there was no statistically significant difference in the average peak pressure gradient measured by echocardiogram between preoperative and the latest follow-up[(23.25±8.39)mmHg vs.(18.75±6.28)mmHg,P=0.210].Over an average follow-up period of(9.25±0.71)years,1 case of infective endocarditis occurred 5 years after PPVI.During the follow-up,no death,deterioration of heart failure,malignant arrhythmia or other serious complications were observed.All patients completed 8-year follow-up,and 3 completed 10-year follow-up.All patients were graded as NYHA functional class one at the latest follow-up.Conclusions PPVI using the domestically produced self-expanding Venus P is safe and feasible for the treatment of patients with post-surgical RVOT dysfunction and suitable anatomy.Our study confirms the long-term efficacy and durability of Venus P from multiple perspectives,and no severe stent fracture occurred without pre-stent implantation in the native RVOT.

Objective To conduct preoperative simulations of three different osteotomy line design schemes under centric occlusion based on two distinct material assignment methods,evaluate biomechanical properties of the models,and explore which osteotomy line design schemes are more suitable for different types of mandibles.Methods Three types of mandibles were selected,and CT images were obtained for three-dimensional(3D)reconstruction.Material assignment was completed using the cortical/cancellous bone assignment method and the gray value assignment method.Osteotomy was simulated according to the three osteotomy line design schemes,followed by finite element analysis.Results In all simulation results of the mandibles,the maximum stress was 81.10 MPa,the maximum strain was 0.035 52,and the maximum displacement was 432.4 μm.The stress distributions obtained by the cortical/cancellous bone assignment method showed a larger stress distribution range than that that by the gray value assignment methods,but the maximum stress,strain,and displacement were generally lower.For the outflare type and common type mandibles,Scheme 1 showed lower maximum stress,strain,and displacement under both material assignment methods,but no clearly suitable scheme was found for the retracted type.Conclusions The outflare type and common type mandibles are more suitable for adopting the osteotomy line design scheme of Scheme 1.For the retracted type,other mandibular angle osteotomy plastic surgery methods may be considered to ensure better biomechanical characteristics.Whether choosing the osteotomy line design scheme or the modeling material assignment method,it is necessary to make the final decision based on the specific analysis objective and resource conditions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective:To assess the effectiveness of robot-assisted mandibular angle osteotomy using the FACE-Q questionnaire.Methods:A randomized controlled clinical study was conducted in the Second Affiliated Hospital of Zhengzhou University from January 2022 to June 2023. Patients with mandibular angle hypertrophy aged 18 to 40 years old were recruited as research objects, and a randomization and supply management system (Clinflash IRT 2.0) was used to randomly assign the experimental group and control groups in a 1∶1 ratio. Before surgery, Mimics 21.0 software was used to plan the surgical approach and determine the osteotomy plane based on the head CT data of the two groups. The experimental group underwent robot-assisted mandibular angle osteotomy according to the preoperative osteotomy plan, while the control group underwent traditional manual mandibular angle osteotomy according to the preoperative design. Six months after surgery, patients filled in the FACE-Q craniofacial module scale to evaluate the surgical effect, covering 12 indicators in four aspects: appearance satisfaction (including face, jaw and smile), health-related quality of life (including appearance anxiety, psychology, social interaction and speech), postoperative function (including breathing, diet, face and pronunciation), and adverse reactions. Each indicator was scored from 0 to 100 points, with higher scores indicating better evaluation. SPSS 27.0 software was used to process the data, and the measurement data of normal distribution were expressed by Mean±SD, and t-test was used for comparison between groups. The measurement data of non-normal distribution were expressed by M ( Q1, Q3), and Mann-Whitney U test was used for the comparison between groups. P<0.05 was considered statistically significant. Results:The experimental group included 20 patients, 3 males and 17 females, with an age of (27.6±4.4) years (19 to 38 years); the control group included 20 patients, 4 males and 16 females, with an age of (27.4±3.9) years (19 to 35 years). Six months postoperatively, all patients in both groups had good wound healing, and the mandibular hypertrophy was improved to varying degrees. There were no complications such as facial paralysis, facial deviation, or pain. The FACE-Q questionnaire results showed that in terms of appearance satisfaction, the scores for the three indicators of face, mandible, and smile in the experimental group were (72.2±11.7), 86(77, 92), and (63.2±9.5) points, respectively, all higher than those in the control group, which were (49.2±9.9), 43(35.5, 50), and (48.0±7.7) points, respectively, with statistically significant differences ( P<0.01 for all); in terms of health-related quality of life, except for speech, the scores for the three indicators of appearance anxiety, psychology, and social interaction in the experimental group were higher than those in the control group [(71.0±11.5) points vs.(49.1±10.3) points, (66.7±11.7) points vs.(45.4±10.5) points, (75.0±9.7)points vs.(56.4±8.5) points], with statistically significant differences ( P<0.01 for all); in terms of postoperative function, the score for eating in the experimental group was higher than that in the control group [(83.4±10.7) points vs.(71.0±14.9) points] ( P<0.01), but there were no statistically significant differences in the other three indicators ( P>0.05 for all); in terms of adverse reaction, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:The result of the FACE-Q questionnaire assessment confirmed that robot-assisted mandibular angle osteotomy can significantly improve patients’ postoperative appearance satisfaction, psychological state, social adaptability, and eating function without increasing the incidence of complications.

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.