Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans ; Denture, Complete ; Computer-Aided Design ; Denture Design/methods* ; Consensus ; Printing, Three-Dimensional

Objective To investigate the clinical efficacy and safety of nivolumab(PD-1 inhibitor)in combination with lenvatinib and FOLFOX regimen[5-fluorouracil(5-FU),oxaliplatin(L-OHP),and calcium folinate(LV)]in the treatment of intermediate and advanced hepatocellular carcinoma(HCC)via hepatic arterial infusion chemotherapy(HAIC).Methods A total of 160 patients with intermediate and advanced HCC admitted to the Second Affiliated Hospital of Guilin Medical University from January 2021 to January 2023 were randomly divided into the control group and the observation group,with 80 patients in each group,using a random number table.The control group received once-daily oral lenvatinib and intravenous carrizumab infusions for 12 weeks as part of transcatheter arterial chemoembolization(TACE)therapy.The observation group was administered with FOLFOX regimen via HAIC chemotherapy,plus intravenous infusion of carrizumab for 12 weeks and once-daily oral lenvatinib.All the patients were followed up regularly.The clinical efficacy was evaluated using the mRECIST criteria.The objective response rate(ORR),disease control rate(DCR),overall survival(OS),progression-free survival(PFS),and incidence of adverse reactions were compared between the two groups.Results There were no significant differences in the objective response rate and incidence of adverse reactions between the groups.The disease control rate,overall survival,and progression-free survival in the observation group were significantly higher than those in the control group(P<0.05).Conclusions The FOLFOX-HAIC regimen in combination with nivolumab and lenvatinib is safe and effective for the treatment of intermediate and advanced HCC,without adverse reactions.It can prolong the overall survival and progression-free survival,and improve the patient's quality of life.

A lightweight residual attention enhanced Unet(LRAE-Unet)is designed for the fully automatic brain tumor segmentation.LRAE-Unet uses lightweight residual module to solve the problems of gradient disappearance and network degradation when the network layers increases,lightweight self-attention module to suppress the irrelevant areas and highlight the significant features of specific local areas,and enhanced average pooling module with a larger field of perception to reduce the space of feature map,save computing resources and avoid over-fitting.The experiment on BraTS 2019 dataset shows that the proposed method has a Dice similarity coefficient of 91.24%,88.64%and 88.32%in the segmentations of the whole tumor,tumor core and enhanced tumor,which proves its feasibility and effectiveness for brain tumor segmentation.

Objective To investigate the distribution and clinical characteristics of TCM syndromes in infertility patients with autoimmune thyroiditis(AIT).Methods By referring to the relevant literature on the distribution of TCM syndromes of AIT and infertility in women of childbearing age,the TCM Syndromes Survey of Infertility Patients with Autoimmune Thyroiditis was formulated.256 cases of infertility patients with AIT who underwent in vitro fertilization-embryo transfer(IVF-ET)at the Reproductive Center of The First Affiliated Hospital of University of Science and Technology of China from June 2019 to December 2020 were retrospectively analyzed.The data of basic information,TCM syndromes,basic thyroid-stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(TG-Ab)were collected.By means of frequency analysis and systematic cluster analysis,the distribution regularity of TCM syndromes in infertility patients with AIT were concluded.Results After analysis,the following 5 common syndrome elements were obtained,namely,qi deficiency,liver depression,spleen deficiency,kidney deficiency and blood stasis.In addition,it was concluded that this disease was more common in complex syndromes.Through systematic clustering analysis,main TCM syndromes of this disease were obtained,which were qi deficiency and liver depression syndrome(69 cases,26.9%),spleen and kidney deficiency syndrome(45 cases,17.6%),spleen qi deficiency syndrome(38 cases,14.8%),qi deficiency and blood stasis syndrome(36 cases,14.1%),kidney deficiency and liver depression syndrome(32 cases,12.5%)and other syndrome types(36 cases,14.1%).The basic TSH level was higher in patients with qi deficiency and liver depression syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome than other syndrome types,with statistical significance(P<0.05).There was no significant difference in TPO-Ab and TG-Ab titers among different syndromes(P>0.05).Conclusion TCM syndromes of infertility patients with AIT can be clustered into qi deficiency and liver depression syndrome,spleen and kidney deficiency syndrome,spleen qi deficiency syndrome,qi deficiency and blood stasis syndrome,kidney deficiency and liver depression syndrome and other syndrome.The main element of syndrome is qi deficiency,and the pathological sites involved spleen,kidney and liver.Stasis blood is a main pathological product.It is required to pay close attention to the thyroid function in AIT patients with qi deficiency.

Objective:To summarize the incidence of cerebral venous reflux (CVR) in patients with recent small subcortical infarct (RSSI) and explore its correlation with enlarged perivascular spaces (EPVS).Methods:Patients with RSSI in the lenticulostriate artery admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2022 were included. The baseline demographic data, medical history, and laboratory results of the patients were collected. CVR was assessed by time-of-flight magnetic resonance angiography. Patients were stratified into 2 groups based on the presence (CVR group) or absence of CVR (non-CVR group), and baseline characteristics as well as laboratory test results were compared between the 2 groups. The location and number of EPVS were evaluated using a visual grading scale, with EPVS with higher scores defined as high-grade EPVS (HEPVS). Simultaneous evaluation of cerebral white matter hyperintensities and lacunar infarctions was conducted, followed by intergroup comparisons. The relationship between EPVS and CVR was studied using multiple Logistic regression analysis.Results:A total of 571 patients with RSSI in the lentiform artery area were ultimately included, including 180 females (31.5%). Their age was (59.37±12.87) years. Among them, 73 patients (12.8%) exhibited CVR based on imaging findings, so the incidence of CVR was 12.8%. In comparison between the CVR group ( n=73) and the non-CVR group ( n=498), the proportion of females [21.9% (16/73) vs 32.9% (164/498), χ 2=3.578, P=0.059] was lower and the proportion of history of smoking [38.4% (28/73) vs 27.7% (138/498), χ 2=3.499, P=0.061] was higher in the CVR group, but without statistical significance. Additionally, the history of alcohol consumption [34.2% (25/73) vs 21.7% (108/498), χ 2=5.621, P=0.018] and the proportion of patients with concomitant HEPVS in the basal ganglia area [41.1% (30/73) vs 25.3% (126/498), χ 2=7.999, P=0.005] was higher in the CVR group with statistical significance. Multiple Logistic regression analysis showed that HEPVS in the basal ganglia region remained independently associated with CVR ( OR=1.988, 95% CI 1.190-3.320, P=0.009). Conclusion:EPVS in the basal ganglia region is significantly associated with CVR in the RSSI population, suggesting that venous dysfunction may be closely related to the formation of EPVS.

It is believed that children bronchiolitis obliterans （BO） is located at the lung and closely related to the spleen and kidney. Phlegm， stasis， block and deficiency are the main pathogenesis. This article promotes staged differentiation and treatment of BO considering the clinical manifestations and pathogenesis characteristics. The attack stage is dominated by phlegm and stasis blocking the lung， for which the method of dissolving phlegm and dispelling stasis， relieving cough and calming panting should be used； Xiaoqinglong Decoction（小青龙汤） and Sanzi Yangqin Decoction （三子养亲汤） with modifications and selfmade Modified Wuhu Decoction （五虎汤加味） are recommended for cold-phlegm blocking the lung syndrome and phlegm heat blocking the lung syndrome， respectively. In sustained stage， the upper excess and lower deficiency together with phlegm-stasis blocking the lung are the pathogenesis， for which the method of dissolving phlegm and dispelling stasis， reopening the block and supplementing deficiency is suggested， and Xiaoqinglong Decotion （小青龙汤） and Duqi pills （都气丸） with modifications can be used. In convalescent stage， the pathogenesis is lung-spleen-kidney depletion with residual pathogen. It suggested to supplement the deficiency and consolidate the root， as well as clear the residual pathogen， for which Baogen NO.1 Decoction （宝根1号方） with modifications can be used.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective An exploratory study of the mechanisms for achieving successful aging at work of clinicians in public hospitals by applying grounded theory and proposing appropriate management recommendations.Methods 24 medical staff from 5 public hospitals in Hubei and Shandong Provinces were interviewed in semi-structured interviews by using purposive sampling methods from June to August in 2023.The interview records were coded,analyzed and integrated with grounded theory.Results Through open coding,spindle coding and selective coding,204 original concepts,47 categories,16 main categories and 5 core category related to model of the mechanism for achieving successful aging at work of clinicians.Conclusion Successful aging at work of senior clinicians encompasses five main areas:physical and mental health,work adaptation,relationships and legacy,internal and external compensation,and value realization.Organizational support factors,individual job crafting affect successful aging at work of senior clinicians by meeting the psychological needs,achieving effective resource management,and promoting person-job matching;individual characteristic factors play a moderating role;job crafting mediates the effect of organizational support factors on successful aging at work among clinicians.

Objective To observe the value of nomogram obtained with multivariate logistic regression based on ultrasound for predicting residue of benign thyroid nodules after microwave ablation(MWA).Methods Totally 101 patients with 133 benign thyroid nodules who underwent ultrasound-guided MWA were retrospectively enrolled.The nodules were divided into residual group(n=21)and non-residual group(n=112)according to follow-up results of contrast-enhanced ultrasound(CEUS)1 month after MWA.The ultrasonic performances of nodules before MWA were compared between groups,and those being statistically different were included in a multivariate logistic regression model to identify the independent predictors for residue after MWA,and the model was then visualized as a nomogram.The discrimination of the nomogram for predicting residue after MWA was assessed with receiver operating characteristic curve and area under the curve(AUC),and its calibration was assessed with Hosmer-Lemeshow goodness-of-fit test.Results High ablation risk and nodules volume shown with ultrasound were both independent predictors of residue of benign thyroid nodules after MWA(both P＜0.05),indicating that benign thyroid nodules with high ablation risk(OR=17.637[2.528,123.019])and large volume(OR=1.297[1.155,1.457])had relatively higher risk of residue after MWA.AUC of the nomogram was 0.756 for predicting residue of benign thyroid nodules after MWA,while Hosmer-Lemeshow test showed good fit(P=0.401).Conclusion Benign thyroid nodules with high ablation risk and large volume shown with ultrasound had relatively high risk of residue after MWA,which could be predicted conveniently and effectively with the obtained nomogram.