Objective To evaluate the application of modified chairside case-based learning(CBL)in the teaching of dental residents in the prosthodontic clinic.Methods Dental residents in Peking Union Medical College Hospital from September 2022 to September 2024 were enrolled.Traditional CBL was conducted in control group.Modified chairside CBL was conducted in test group.The scores of department rotation examination and questionnaire results were analyzed with t-test statistical analysis.Results The score of"patient reception"in test group was significantly higher than control group(P＜0.05).24 valid questionnaires were collected in two groups each.The rate of approval in test group was significantly higher than control group in the following items of questionnaire,including"reduce learning pressure or burden""improve the capacity of doctor-patient communication""improve the capacity of literature review""improve the capacity of group cooperation"(P＜0.05).Conclusions Modified chairside CBL has showed good teaching effects in improving the capacity of patient reception,doctor-patient communication,literature review,group cooperation,and meanwhile reduced learning pressure or burden.

Objective To explore the need and evaluate the effectiveness for head-simulator in the teaching of sto-matology within the eight-year program of clinical medicine.Methods Questionnaire survey was conducted among the students from 2017 cohort of the eight-year program of clinical medicine at Peking Union Medical College.The survey results were statistically analyzed and described.Results Totally 87.9％of the students believed that incor-porating head-simulator into the clinical practice course of stomatology were necessary,and 93.9％expressed will-ingness to join the training.Most students preferred to practice peri-odontal scaling and cavity preparation for caries during the simulated training sessions.The majority of students considered two or four class hours of simulated head teaching to be reasonable.The pilot head simulation training was successfully implemented;75.0％of the students acknowledged clear teaching and convincible demonstrations.All the trainees agreed that the head simulation course helped them better understand stomatology knowledge,stimulated their interest in learning and expressed a desire for increased head simulation sessions during clinical practice course of stomatology.Additionally,87.5％of the students preferred head simulation training course to be applied in classic clinical clerkships.Conclusions There is strong demand among students of eight-year program of clinical medicine for incorporating head-simulator into the education of stomatology.The pilot simulation training received positive evaluations.Further exploration is needed to optimize specific scheduling and content arrangement.

Objective:To evaluate the detection rate and distribution characteristics of lesions in patients with biochemical recurrence (BCR) after radical prostatectomy for prostate cancer by 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT. Methods:From January 2020 to March 2024, 68Ga-PSMA-11 PET/CT examination results of 172 patients (age (69.4±6.5) years) with BCR after radical prostatectomy in Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The relationship between prostate specific antigen (PSA) levels and 68Ga-PSMA-11 PET/CT detection rate was explored. The location and quantity of lesions detected by 68Ga-PSMA-11 PET/CT were analyzed in BCR patients with clear location after local treatment, and data were analyzed by Fisher exact test. Results:The detection rate of 68Ga-PSMA-11 PET/CT in patients with BCR was 70.35%(121/172). The positive detection rate increased with the increase of PSA level, with detection rates of 0.2 μg/L≤PSA<0.5 μg/L, 0.5 μg/L≤PSA<1.0 μg/L, 1.0 μg/L≤PSA<1.5 μg/L and PSA≥1.5 μg/L groups of 49.12%(28/57), 67.24%(39/58), 15/16 and 95.12%(39/41), respectively. After local treatment, 64 cases were diagnosed with 95 recurrent and metastatic lesions. Among them, 22(34.38%) had simple prostate bed recurrence, 23(35.94%) had simple lymph node metastasis, 7(10.94%) had simple bone metastasis, and 12(18.75%) had multi regional metastasis. The proportion of bone metastasis (18.75%, 12/64) was significantly lower than that of prostate bed recurrence and lymph node metastasis (both 50.00%(32/64); both P=0.002). Conclusions:68Ga-PSMA-11 PET/CT has a high detection rate in patients with BCR after radical prostatectomy, especially in patients with high PSA levels. The lesions are mainly distributed in the prostate bed and lymph nodes, while bone metastases are relatively rare, which provide a theoretical basis for the selection of more accurate treatment plans for BCR patients in the future.

Tumor-infiltrating lymphocytes (TILs) are a heterogeneous subset of lymphocytes, mainly T cells, present in tumor parenchyma and stroma. After being digested and isolated from tumor tissue and then cultured in vitro for activation and multiplication, it can be infused back into the patient's body to kill tumor cells. TILs have the advantages of high diversity of TCR, excellent ability to infiltrate into tumor sites, and low toxicity and are considered promising for the treatment of malignant solid tumors. At present, TIL therapy has been tested as a second-line treatment in a variety of solid tumors and has achieved preliminary results. Although there is still no clinical cohort report on the application of TILs in biliary tract cancer (BTC), recent clinical reports on multiple cancers have provided information on the efficacy of TIL therapy in a small number of BTC patients, which preliminarily confirmed the safety and efficacy of TIL therapy. However, since BTC is generally considered an immunologically repulsive tumor in which most effector T cells are sequestered at the tumor edge, the antitumor effect of TILs in BTC remains difficult to predict. Combination therapy with different anti-tumor methods and the development of new techniques to modify cells to enhance the anti-tumor ability of TILs are possible directions for breakthrough in the future.

Objective:To investigate the efficacy and safety of comprehensive therapy in the treatment of advanced unresectable hepatocellular carcinoma.Methods:Clinical data of 34 patients with primary liver cancer admitted to Peking Union Medical College Hospital from Nov 2018 to Dec 2020 initially evaluated as unresectable were treated firstly by combined therapy and then underwent reevaluation for further management.Results:A total of 34 patients completed the integrative treatment, and no serious adverse events occurred. Among them, 6 patients were evaluated as partial remission, and underwent successful tumor resection, tumors in 7 patients were stable, and 21 patients suffered from disease progression.Conclusion:After comprehensive therapy, unresectable tumors in some patients could reduce and be rendered resection.

Objective:To evaluate the safety, efficacy and performance of disposable cholangiopancreatoscope in the diagnosis and treatment of bile duct diseases.Methods:A total of 20 subjects were selected and 16 subjects were enrolled in the prospective and exploratory clinical study which were performed in the Digestive Endoscope Center of Hangzhou First People's Hospital Affiliated to Zhejiang University School of Medicine from July 2021 to August 2021. The disposable cholangiopancreatoscope was used to diagnose bile duct diseases in routine endoscopic retrograde cholangiopancreatography. Biopsies were performed in cases where malignancy was considered. The use related indexes and performance indexes of the instruments were analyzed.Results:Among the 16 patients, there were 6 cases of biliary space-occupying lesions, 6 cases of biliary calculi, and 4 cases of benign biliary stricture before operation. The success rate of the disposable insertion was 100.00% (16/16), and the success rate of observation was 100.00% (16/16). Three biliary space-occupying lesions diagnosed as malignant tumor under cholangiopancreatoscope were confirmed by pathology after operation. Diagnosis of other patients was consistent with preoperative diagnose, so no biopsy was conducted. The rate of positive feedback from operators in directional control was 81.25% (13/16), the image failure rate was 18.75% (3/16), and the rate of positive feedback for image clarity was 93.75% (15/16). In terms of clinical performance, the imaging quality of excellence was 93.75% (15/16), the flexible degree of excellence was 81.25% (13/16), and other indexes were all 100.00% excellence. During the period, there were no instrument defects, pancreatitis, perforation, bleeding or other instrument-related adverse events.Conclusion:The effectiveness, safety and performance indexes of domestic disposable cholangiopancreatoscope have reached the standards of clinical application with high pixel, integration, and portability. It's worthy of clinical recommendation.

Objective:To observe the effect of intravitreal injection of Conbercept with two different doses in the treatment of retinopathy of prematurity (ROP) and explore the clinical feasibility of ROP treatment by lower dose conbercept.Methods:This was a prospective study. The premature infants were enrolled with pre-threshold type 1, threshold and acute aggressive posterior retinopathy of prematurity (AP-ROP) from March 2018 to June 2019, who received fundus screening in neonatal intensive care unit (NICU) of Henan Provincial People's Hospital, Henan Eye Hospital. They were randomly divided into two groups. The group A (lower dose group) were received intravitreal injection of conbercept with 0.15 mg/0.015 ml, and those in group B (control group) were received intravitreal injection of conbercept with 0.25 mg/0.025 ml. We checked and recorded the lesion area, stage, scope (according to the clock range), additional lesion (plus), etc. Fundus examination should be performed with the pediatric wide-field fundus imaging system within 7 days after treatment. It was used to observe the plus disese, ridge, regression of neovascularization on ridge, and development of retinal vessels to serrated edge or scarring. The follow-up period was at least 24 weeks. The effect evaluation was divided into recovery, improvement, recurrence and aggravation.Results:The 43 ROP subjects (84 eyes) were enrolled including 21 cases (40 eyes) in group A and 22 (44 eyes) in group B. There was no significant difference between the two groups in gender ( χ2=1.169), birth age ( t=0.283), birth weight ( t=0.547), hospitalization days in NICU ( t=1.187), first examination time ( t=1.811), first injection time ( t=0.492), follow-up time ( t=0.899) and ROP condition ( χ2=0.854) ( P>0.05). In group A, 21 eyes (52.5%) were cured, 17 eyes (42.5%) were improved, 2 eyes (5.0%) were recurred, and no aggravating cases were found. In group B, 24 eyes (54.5%) were cured, 14 eyes (31.8%) were improved, 6 eyes (13.6%) were recurred, and no aggravating cases were found. There was no significant difference of the cure rate ( χ2=2.210, P>0.05) and effective (recovery and improvement) rate ( χ2=1.814, P=0.269) between two groups after the first injection. Conclusion:Intravitreal injection of conbercept with the two doses should be effective in the treatment of ROP.

Objective To observe the effect ofintravitreal injection ofconbercept in the treatment of retinopathy of premature (ROP) and to analyze the factors related to the therapy.Methods A retrospective study.A total of 57 patients (57 eyes) with pre-threshold type 1 (30 patients,30 eyes),threshold ROP (21 patients,21 eyes) and acute aggressive posterior ROP (APROP,6 patients,6 eyes)) from premature infants by retinal screening in Henan Provincial People's Hospital during October 2017 and June 2018 were enrolled in this study.All children were received routinely intravitreal injected 10 mg/ml conbercept 0.025 ml (0.25 mg) within 24 hours after diagnosis.Fundus examination was performed 7 days after injection.The interval of examination was 1-3 weeks according to fundus conditions.The mean follow-up was 30.1 ± 4.6 weeks.For patients with relapse or no response to treatment,repeated intravitreal injection of conbercept or laser photocoagulation therapy was given.The retinal blood vessels of the affected eyes were observed.Logistic stepwise regression analysis was used for the correlation test of multiple factors.Results Among 57 eyes,49eyes and 8 eyes were treated with 1 or 2 times of intravitreal injection of conbercept.After 24 weeks of treatment,in 57 eyes,26 eyes were cured (45.6％),22 eyes improved (38.6％),8 eyes relapsed (14.0％),and 1 eye aggravated (1.8％).The recurrence time was 12.9± 4.5 weeks after the first injection,and the corrected gestational age was 49.0±6.7 weeks.There were significant differences in initial injection time,lesion range among the cure,improved and recurrence eyes (F=5.124,7.122;P＜0.01,＜ 0.01).Parameters of ROP condition,including ROP diagnosis (pre-threshold type 1,threshold and APROP),zone (zone 1 and 2),stage (stage 2 and 3) and plus lesions,were significant different among the cure,improved and recurrence eyes (x2=l 1.784,14.100,6.896,9.935;P＜0.01,＜0.01,＜0.05,＜0.01).Logistic stepwise regression analysis showed that the recurrence rate was correlated with ROP zone,more likely recurrence at zone 1 than zone 2 (Wald=9.879,OR=27.333,P=0.002).No injection-related complications such as endophthalmitis,cataract and glaucoma were found during treatment and follow-up period.Conclusions Intravitreal injection ofconbercept is effective in the treatment of ROP without obvious adverse reactions.Lesion zoning is associated with recurrence after treatment.

OBJECTIVE To explore the auditory outcomes and prognostic factors in ossiculoplasty using autogenous ossicles. METHODS A retrospective review was performed in 126 patients with cholesteatoma or chronic otitis media, who admitted to the Department of Otolaryngology in Jingzhou hospital affiliated to Tongji medical college from January 2014 to July 2016, and underwent canal wall-down tympanoplasty (CWDT) with ossiculoplasty using autogenous ossicles in a single stage. The postoperative complication and hearing thresholds were analyzed after 12 months' follow-up. RESULTS The rate of dry ear was 96.5％. We had not found any extrusion of prosthesis. There was no one with postoperative retraction pocket or recurrence of cholestatoma during the follow-up. Auditory outcomes showed air conduction threshold improved from (52.7±7.4)dB to (39.0±9.1)dB after operation, while the air-bone gaps improved from(27.4±6.9)dB to (20.8±6.2)dB. Postoperative outcomes were considered successful, if the postoperative air-bone gap was <20 dB. The successful hearing was achieved in 88 patients (69.8％). Prognostic factors were analyzed using multivariate analysis with logistic regression. And we found the presence of the stapes and the malleus handle was significantly favorable predictive factors. All the patients recovered well without severe complication. CONCLUSION Autogenous ossicles is very valuable in ossiculoplasty. The present stapes and malleus handle are important factors for the auditory outcomes in ossiculoplasty.

Objective To investigate the effects of low contrast agent concentration and optimal monoenergetic image on myocardial image quality in dual source, dual energy coronary CT angiography (CCTA).Methods Sixty patients,who were clinically suspected of coronary heart disease and referred to perform dual energy CCTA examination,were prospectively collected between January and June 2016 in the first affiliated hospital of Xinjiang Medical University and then randomly divided into two groups with thirty cases in each group.Dual-energy CCTA was performed in both groups with the same parameters expect the iodine contrast agent concentration.The iopamidol concentrations were 370 and 320 mg/ml for groups A and B, respectively. The raw images of the two groups were reconstructed to get conventional mixed energy images and 60,65,70,75,80,85,90 keV single energy images,respectively labeled as group A1 to A8 and group B1 to B8.The CT attenuation,noise,signal-to-noise ratio(SNR)and contrast to noise ratio(CNR)were measured in images from groups A1 to A8 and B1 to B8. And the optimal monoenergetic image set was selected.Rank sum test was used to compare the CT value,noise,SNR and CNR between groups A1 to A8 and B1 to B8.The differences of above-mentioned parameters between A1 and B5 group,A5 group and B5 group were compared by independent sample t test.Results The differences of CT value,noise,SNR and CNR between groups A1 and A8, B1 and B8 were statistically significant (P<0.05). The CNR and SNR of group A5 were significantly higher than that of group A1,and the image noise of group A5 was lower than that of group A1(all P<0.05),and the images of A5 group(75 keV)were the optimal monoenergetic image. The SNR and CNR of the left ventricular lateral wall in group B5 were significantly higher than those in group B1,and the noise was lower than that in group B1(all P<0.05),and the image of B5 group(75 keV) was the optimal monoenergetic image. The difference of image noise between groups A1 and B5 was statistically significant(P<0.05),while the differences of SNR and CNR between these two groups were not significant(all P>0.05).The differences of image noise,SNR and CNR between groups A5 and B5 were not significant(all P>0.05).Conclusions The myocardial CCTA image quality by using iodine contrast agent (320 mg/ml) and optimal monoenergetic imaging (75 keV) is equivalent to that of conventional iodine contrast agent(370 mg/ml)mixed energy image.The strategy can effectively reduce the amount of contrast agent when meeting the needs of the clinical diagnosis.