Objective To study the oral health status of officers and soldiers in a certain unit,so as to provide a basis for the formulation and implementation of oral health support plans.Methods A total of 437 officers and soldiers in a certain unit were enrolled to assess their oral health status through questionnaire survey and clinical examination.Results The prevalences of dental caries and periodontal diseases were 87.6%(383/437)and 90.4%(395/437),respectively;the detection rates of impacted third molars,recurrent aphthous stomatitis,other mucosal diseases,and temporomandibular joint disorders were 12.6%(55/437),54.2%(237/437),29.5%(129/437),and 19.2%(84/437),respectively.In terms of oral medical needs,23.3%(102/437)patients did not need treatment,66.1%(289/437)required elective treatment,9.2%(40/437)required early treatment,and 1.4%(6/437)required urgent treatment.Conclusion Officers and soldiers in this study have a variety of oral diseases,with periodontal diseases having the highest prevalence.Supportting plans should be formulated based on the characteristics of the prevalence of oral diseases among them,and regular oral diagnosis and treatment should be carried out to prevent the development and progression of oral diseases.

Objectives:To evaluate the outcomes of cochlear implantation in prelingually deafened late-implanted patients with regular cochlear implant use and to analyze the influencing factors of rehabilitation effects.Methods:This before-after self-controlled study design included 60 subjects, comprising 36 males and 24 females, who had received cochlear implantation at Chinese PLA General Hospital. Post-implantation, all patients demonstrated continuous and regular use of cochlear implants (≥8 hours daily). Rehabilitation outcomes were evaluated by using the Categories of Auditory Performance scale (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility of Rating scale (SIR), Meaningful Use of Speech Scale (MUSS) and speech recognition score (SRS) in 2018 and 2023. 9 potential risk factors were analyzed by univariate analysis with SPSS 25.0. The influencing factors associated with outcomes were evaluated through multivariate logistic regression.Results:Longitudinal data of 60 participants followed-up in 2018 and 2023 were analyzed. The average duration of cochlear implant use for all patients was (11.3±3.0) years. The mean score of CAP, SIR and MUSS improved significantly over time. The mean CAP score before surgery was (1.0±0.9). From 2018 to 2023, the mean CAP score improved from (5.1±1.4) to (5.9±1.6), with a statistical significance ( P<0.01); the mean SIR score before surgery was (1.3±0.5), and the mean SIR score improved from (2.7±1.1) to (3.2±1.3), with a statistical significance ( P<0.01); the mean MUSS score increased from (16.8±9.7) to (21.1±10.9) between the two follow-ups, with a statistical significance ( P<0.01); the MAIS was only initiated in the 2023 follow-up, with a mean score of (31.0±10.2). The speech recognition score for monosyllabic words increased from (23.9±16.0)% to (25.2±13.0)%, with no statistically significant difference ( P=0.66). Preoperative residual hearing significantly predicted rehabilitation outcomes at univariate analysis ( P<0.05), but the statistical significance was lost at multivariate analysis ( P>0.05). Age at implantation was identified as an independent predictive factor by both univariate and multivariate analysis (Hazard Ratio, 0.88; 95% Confidence Interval 0.79-0.97; P=0.014). The cut-off point for predicting further rehabilitation effects was 19.2 years old. In the correlation analysis of different scales, the CAP score was positively correlated with the total score of MAIS. So were the SIR score and the total score of MUSS. Conclusions:For prelingually deafened late-implanted patients with regular CI use, there was still potential for further improvement of auditory and speech abilities even after 10 years post-implantation. Age at implantation was an independent predictive factor and the cut-off point was 19.2 years old.

Objectives:To evaluate the outcomes of cochlear implantation in prelingually deafened late-implanted patients with regular cochlear implant use and to analyze the influencing factors of rehabilitation effects.Methods:This before-after self-controlled study design included 60 subjects, comprising 36 males and 24 females, who had received cochlear implantation at Chinese PLA General Hospital. Post-implantation, all patients demonstrated continuous and regular use of cochlear implants (≥8 hours daily). Rehabilitation outcomes were evaluated by using the Categories of Auditory Performance scale (CAP), Meaningful Auditory Integration Scale (MAIS), Speech Intelligibility of Rating scale (SIR), Meaningful Use of Speech Scale (MUSS) and speech recognition score (SRS) in 2018 and 2023. 9 potential risk factors were analyzed by univariate analysis with SPSS 25.0. The influencing factors associated with outcomes were evaluated through multivariate logistic regression.Results:Longitudinal data of 60 participants followed-up in 2018 and 2023 were analyzed. The average duration of cochlear implant use for all patients was (11.3±3.0) years. The mean score of CAP, SIR and MUSS improved significantly over time. The mean CAP score before surgery was (1.0±0.9). From 2018 to 2023, the mean CAP score improved from (5.1±1.4) to (5.9±1.6), with a statistical significance ( P<0.01); the mean SIR score before surgery was (1.3±0.5), and the mean SIR score improved from (2.7±1.1) to (3.2±1.3), with a statistical significance ( P<0.01); the mean MUSS score increased from (16.8±9.7) to (21.1±10.9) between the two follow-ups, with a statistical significance ( P<0.01); the MAIS was only initiated in the 2023 follow-up, with a mean score of (31.0±10.2). The speech recognition score for monosyllabic words increased from (23.9±16.0)% to (25.2±13.0)%, with no statistically significant difference ( P=0.66). Preoperative residual hearing significantly predicted rehabilitation outcomes at univariate analysis ( P<0.05), but the statistical significance was lost at multivariate analysis ( P>0.05). Age at implantation was identified as an independent predictive factor by both univariate and multivariate analysis (Hazard Ratio, 0.88; 95% Confidence Interval 0.79-0.97; P=0.014). The cut-off point for predicting further rehabilitation effects was 19.2 years old. In the correlation analysis of different scales, the CAP score was positively correlated with the total score of MAIS. So were the SIR score and the total score of MUSS. Conclusions:For prelingually deafened late-implanted patients with regular CI use, there was still potential for further improvement of auditory and speech abilities even after 10 years post-implantation. Age at implantation was an independent predictive factor and the cut-off point was 19.2 years old.

Humans ; Diabetic Neuropathies/diagnostic imaging* ; Diabetes Mellitus, Type 2 ; Ultrasonography ; Diabetic Foot/diagnostic imaging*

Cathartic colon （CC） is a common and refractory digestive system disease， with the pathogenesis not fully clarified. The effective therapies other than laxatives and surgery remain to be developed for CC. Therefore， establishing the CC animal models that fit the disease characteristics of western medicine and syndrome characteristics of traditional Chinese medicine （TCM） is an important link to promote the research on this disease. The fitting degree of animal models with the latest Chinese and western medical diagnostic criteria is an indicator to assess the effectiveness of the animal models in simulating the disease characteristics of western medicine and syndrome characteristics of TCM. The literature review showed that the model animals， drugs and their dosage forms， doses， administration methods， and modeling period of CC varied in different studies， and the available CC animal models presented different fitting degrees with the disease characteristics of western medicine and syndrome characteristics of TCM. Rats were the preferred animals for the modeling of CC. Rhei Radix et Rhizoma preparations were commonly used for model inducing， which， however， may cause water electrolyte disorders， decreased immunity， and even death of animals at the late stage of modeling. The animals were modeled by gradually increasing the starting dose， while the starting dose and increasing dose varied. The maintenance dose was determined based on 50% of the animals having loose stools， and the end for a cycle was determined as the time when loose stools disappeared in 80% of animals. The modeling always lasted for 2-3 cycles， approximately 2-4 months. The CC models established with Rhei Radix et Rhizoma granules and rhein had high fitting degrees with the disease and syndrome characteristics. In addition， the CC animal models of TCM syndromes were still in the exploration stage. There were only the animal models of four TCM syndromes： liver depression and spleen deficiency， both Qi and Yin deficiency， Qi stagnation and blood stasis， and spleen and kidney deficiency. Efforts should be made to establish the animal models that meet the characteristics of disease of western medicine and syndromes of TCM， so as to facilitate the research on CC mechanism and drug development.

Objective:To evaluate the clinical results of miniplates combined with reconstruction plate in treating comminuted posterior wall acetabular fractures.Methods:A retrospective case series study was conducted for 27 patients with comminuted posterior wall acetabular fractures treated in General Hospital of Central Theatre Command of PLA from October 2015 to June 2019. There were 18 males and 9 females, at age of 23-61 years［（45.9±10.9）years］. All patients were treated by using miniplates combined with the reconstruction plate. The operation time, intraoperative blood loss, intraoperative blood transfusion, length of hospital stay and time of fracture healing were recorded. The reduction quality was evaluated according to Matta radiographic standard at 2 days postoperatively. The modified Merle D'Aubigné-Postel score was adopted to evaluate the hip function at 3, 6 months postoperatively and the final follow-up. Postoperative complications were observed, and heterotopic ossification was assessed by Brooker grading standard.Results:All patients were followed up for 12-48 months［36（24, 36）months］. The operation time was 123-242 minutes［（165.4±29.8）minutes］; the intraoperative blood loss was 170-550 ml［（358.3±111.3）ml］; nine patients required intraoperative blood transfusion of 300-500 ml［（377.8±66.7）ml］. The length of hospital stay was 12-29 days［（21.4±4.7）days］. The fracture healing time was 12-24 weeks［（16.3±3.0）weeks］. According to Matta radiographic standard, the reduction quality was excellent in 21 patients, good in 3 and poor in 3 at 2 days postoperatively, with the excellent rate of 89%. The modified Merle D'Aubigné-Postel score was 9-16 points［（13.1±1.9）points］at 3 months postoperatively, was 10-18 points［（15.4±2.0）points］at 6 months postoperatively, and was 12-18 points［（16.9±1.8）points］at last follow-up（ P<0.01）. The modified Merle D'Aubigné-Postel score between 3 months and 6 months was significantly different（ P<0.01）, and the difference between 6 months and the follow-up was statistically significant（ P<0.01）. The modified Merle D'Aubigné-Postel score was graded as excellent in 0 patient, good in 7, fair in 11 and poor in 9 at 3 months postoperatively, with the excellent rate of 26%; graded as excellent in 3 patients, good in 19, fair in 2 and poor in 3 at 6 months postoperatively, with the excellent rate of 81%; graded as excellent in 18 patients, good in 5, fair in 3 and poor in 1 at the last follow-up, with the excellent rate of 85%（ P<0.01）. No iatrogenic sciatic nerve injury, deep vein thrombosis or wound infection occurred after operation. No hardware loosening or loss of reduction occurred during the follow-up. The post-traumatic arthritis was identified in 2 patients. The avascular necrosis of femoral head was observed in 1 patient and thereafter underwent total hip replacement. The heterotopic ossification occurred in 3 patients, among which 2 patients were graded as Brooker class I and 1 as class II, but there was no adverse effect on hip function. Conclusions:Miniplates combined with reconstruction plate in the treatment of comminuted posterior wall acetabular fractures have reliable fixation effect and attain good reduction, high fracture healing rate, less complications and satisfactory functional recovery.

OBJECTIVETo investigate the effect of previous abdominal surgery(PAS) on laparoscopic resection of colorectal cancer.

METHODSThe retrospective cohort study was adopted.Clinical data of consecutive colorectal cancer patients with PAS history (past history of at least one abdominal surgery, exclusion of previous inguinal hernia repair, simple laparoscopic approach, appendectomy of the right lower quadrant and endoscopic therapy) undergoing laparoscopic surgery at the Cancer Hospital of Chinese Academy of Medical Sciences between 2010 and 2015 were collected, meanwhile other colorectal cancer patients without PAS history were selected according to 1 to 1 match in age, sex, body mass index, American Society of Anesthesiologists score, tumor location, type of surgery, and staging of tumor. A total of 464 pairs were successfully matched. Intraoperative and postoperative conditions, perioperative complications and prognosis were compared between the two groups.

RESULTSIn PAS group, there were 341 males (73.5%) and 123 females (26.5%) with a median age of 62 (24-85) years; 317(68.3%) cases with only one previous abdominal surgery and 147(31.7%) with more than one; 389(83.8%) cases with abdominal midline incisions, 37(8.0%) with transverse incisions, 34(7.3%) with right subcostal incision and 4(0.9%) with left subcostal incision; 146(31.5%) cases undergoing gynecologic surgery, 84(18.1%) cholecystectomy, 52(11.2%) gastroduodenal surgery, 89(19.2%) colorectal surgery, 11(2.4%) small intestine surgery, 23(5.0%) hapatectomy, 16(3.4%) pancreatic surgery, 8(1.7%) urological surgery, 18(3.9%) retroperitoneal tumor resection and 1(0.2%) other surgery. In no PAS group, there were 328 males (70.7%) and 136 females (29.3%) with a median age of 62(24-86) years. No significant differences in baseline data were found between the two groups (all P>0.05). As compared to no PAS group, PAS group had longer mean operative time [(208.0±27.0) minutes vs. (179.0±15.3) minutes, t=4.695, P=0.003] and higher rate of conversion to laparotomy [18.1%(84/464) vs. 11.6%(54/464), χ=7.217, P=0.003]. In the PAS group, conversion to laparotomy was more common due to adhesion reaction [8.8%(41/464) vs. 4.5%(21/464), χ=4.886, P=0.007]. There were no significant differences between the two groups in intraoperative bleeding and transfusion, lymph node dissection, circumferential margin and surgical margin, time to the first diet and postoperative hospital stay(all P>0.05). No significant differences in intraoperative and postoperative morbidity of complication were found between PAS group and no PAS group [3.7%(17/464) vs. 2.8%(13/464), P=0.346; 20.3%(94/464) vs. 18.5%(86/464), P=0.739]. Median follow-up of the whole patients was 32.0(0.5-79.0) months, and there was no significant difference between the two groups [PAS group 31.0(0.5-79.0) months vs. no PAS group 33.0(1.0-75.0) months, P=0.391]. In PAS and no PAS group, the 3-year disease-free survival rate was 68.1%(95%CI: 62.0%-74.2%) and 68.5%(95%CI: 63.0%-74.0%)(P=0.764), and 3-year overall survival rate was 78.5%(95%CI: 72.8%-81.4%) and 80.2%(95%CI:74.3%-86.1%)(P=0.528) respectively, whose differences were not significant.

CONCLUSIONExcept higher risk of conversion to laparotomy due to adhesion reaction, laparoscopic resection of colorectal cancer is safe and feasible in patients with PAS, and the prognosis is not affected by PAS.

Adult ; Aged ; Aged, 80 and over ; Colorectal Neoplasms ; surgery ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objectives: To study an effects on hearing ability and speech performance of the patients with auditory neuropathy (AN) after cochlear implantation (CI). Methods: Thirty-five AN patients (26 males and 9 females) after CI in our center since 2007 were chosen, including 5 postlingual patients (implanted age from 14.3 to 38.6 years old) and 30 prelingual patients (implanted age from 1.1 to 13.7 years old). Hearing sensitivity and speech performance were estimated via following methods: (1) implanted hearing thresholds by sound field audiometry; (2) speech audiometry, including monosyllable, disyllable and sentences recognition test by computer-controlled software and sentence recognition test under noise condition (signal to noise ratio=+ 10dB); (3) Mandarin Early Speech Perception test (MESP), Mandarin Pediatric Speech Intelligibility test (MPSI), MAIS, or IT-MAIS for prelingual AN implantees. Results: The average implanted hearing threshold (250-4 000 Hz) was (41.1±11.7) dBHL in 22 AN implantees, while those prelingual implantees was (39.1±10.9) dBHL, and (44.9±12.3) dBHL in postlingual implantees. Speech audiometry were implemented in four of 5 postlingual AN implantees, the results showed increasing tendency in monosyllable recognition scores, dramatic individual variation in computer-controlled disyllable and sentences recognition test, and poor scores (<30%) in speech recognition test in noise condition. Four of 30 prelingual implantees reconstruct their speech recognition ability within 1-3 years after switch-on, characterized as recognition scores (>60%) in monosyllable, disyllable and sentences. The one of prelingual implantee gained recognition scores of speech in noise within 1 year after switch-on. MAIS or IT-MAIS were implemented in twenty-five prelingual implantees, the average score in these patients was 28.6±11.7. Conclusion Cochlear implant can improve the hearing thresholds of AN patients, however, the improvement in speech performance presented significant variations among the implanted individuals.

Objective To investigate the effect of vascular tortuosity and bending radius on the new type knitting stents (LVIS stent ) releasing on the cavernous sinus segment of internal carotid artery. Methods From December 2015 to January 2016,31 consecutive patients with wide-neckedaneurysm treated with LVIS stents and the proximal end of the stent released in the cavernous segment at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were enrolled. According to whether the stents completely adhered to the walls or not after the first release,they were divided into two groups:a satisfactorily release group (n =23 )or an unsatisfactorily release group (n =8 ). The differences of vascular tortuosity and bending radius of the 2 groups were compared.Results Thevascular tortuosities of the satisfactorily release group and the unsatisfactorily release group were 118° ± 23° and 147° ± 19° respectively. There was significant difference (P=0. 028). The vascular bending radii were 3. 4 ± 0. 7 mm and 2. 8 ± 0. 7 mm respectively. There was significant difference (P=0. 042). The mean vascular tortuosity was larger and the mean vascular bending radius was smaller in the unsatisfactorily release group. Conclusions The greater the vascular tortuosity,the smaller the vascular bending radius may be connected with the unsatisfactorily release in the LVIS stent. The evaluation of vascular tortuosity is conductive to the guidance of the stent release technique before stent implantation.

Objective:To investigate the synergistic killer effect of natural killer cells(NK cells) combined with tamoxifen(TAM) on breast cancer cells(BCC)through the experiment in vitro,and to explore its mechanism.Methods:Three kinds of BCC with different receptor expression levels were selected for the experiment.Blank control group, different concentrations of TAM groups and different time groups were set up.MTT assay was used to detect the inhibitory rates of proliferation of cells,and the final experiment concentration of 5 μmol·L-1 was determined.The cells were divided into natural-release group,largest-release group,TAM group,NK cells group, and combined-experimental group(BCC+NK cells+TAM),and the synergistic killer effect of NK cells combined with TAM in different effector-target ratios were detected with Calcein-AM release assay.In ELISA assay the cells were divided into blank control group (NK cells),NK cells+TAM group, NK cells+BCC group and combined-experimental group,and the levels of IFN-γ and TNF-α in the NK cells in various groups were measured.In flow cytometry detection the cells were divided into blank control group (NK cells),NK cells+TAM group,NK cells+ BCC group, and combined-experimental group,and the expression levels of NKp46,CD158a,CD158b,CD158b2,and CD158e were determined;while the cells were divided into blank control group (BCC),BCC+TAM group,BCC + NK cells group, and combined-experimental group,and the expression levels of the MICA,ULBP1 and ULBP2 were detected.Results: The MTT assay results showed that the inhibitory rates of proliferation of 3 kinds of BCC had obvious time-and concentration-dependence (P<0.05).The Calcein-AM release assay results showed that the killing-rates of BCC in TAM groups were increased with the increase effector-target ratios of compared with NK cells group;and the killing-rate in combined experimental group was obviously higher than those in NK cells and TAM groups(P<0.05).The ELISA assay results showed that the levels of TNF-α and IFN-γ of NK cells in various experimental groups with BCC or not were increased compared with blank control group(P<0.05 or P<0.01);the levels were significantly increased when combined with TAM (P<0.05).The flow cytometry results showed that the NKp46 expression levels in various experimental groups were elevated compared with blank control group(P<0.05);the expression levels of CD158a, CD158b,CD158b2, and CD158e were significantly decreased(P<0.05);the expression levels MICA,ULBP1, and ULBP2 in BCC were significantly increased (P<0.05).Conclusion:The NK cells combined with TAM has the synergistic killer effect on the BCC in vitro.The synergetic mechanism may be as follows: TAM could increase the secretion of TNF-α and IFN-γ of NK cells to enhance their cytotoxicity;TAM also could up-regulate the expression levels of activating receptors and activating ligands,and down-regulate the expression levels of inhibitory receptors to increase the killing ability of NK cells.