Jaws and alveolar defects present significant challenges in reconstructive surgery and implant restoration.Calcium phos-phate(CaP)bioceramics are commonly used as bone substitute and play a crucial role in repairing bone defects.Recent studies have shown that T cells play an important regulatory role in bone regeneration.The studies on CaP bioceramics and T cells,including their subpopulations,in bone regeneration,and the mechanisms through which CaP bioceramics regulate the behavior of T cells has been re-viewed.

Objective:To investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.

Objective To explore the efficacy and the impact on the periodontal microenvironment of photodynamic therapy(PDT)combined with subgingival glycine powder air polishing(SubGPAP)for patients with stage Ⅲ periodontitis on residual periodontal pockets.Methods Forty patients who visited the Department of Periodontology at our hospital with stage Ⅲ periodontitis were selected.After 4-6 weeks of initial treatment,the residual periodontal pockets of＞4 mm depth with bleeding on probing,or ≥6 mm depth were randomly assigned in a split-mouth design,to receive subgingival scaling and root planning(SRP)(control group)or PDT+SubGPAP+SRP(test group).Indicators including probing depth(PD),clinical attachment loss(CAL),bleeding index(BI),plaque index(PLI),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)at baseline,6 weeks and 3 months after treatment were measured and compared.Results The clinical indicators showed significant reductions in both groups at 6 weeks and 3 months compared with those at baseline(P＜0.05).The TNF-α in test group showed no significant differ-ence at 3 months compared with 6 weeks(P＞0.05),while the other indicators in both groups showed significant reductions at 3 months compared with those at 6 weeks(P＜0.05).The PD,CAL,BI,TNF-α,IL-6 and IL-1β in test group showed a significant reduction than those in the control group at 6 weeks and 3 months(P＜0.05).The PLI in test group showed a significant reduction at 6 weeks(P＜0.05).Conclusion PDT combined with SubGPAP assisted SRP for patients with stage Ⅲ periodontitis on residual periodontal pockets is conducive to enhancing the clinical efficacy and improving the microenvironment.

Objective To explore the efficacy and the impact on the periodontal microenvironment of photodynamic therapy(PDT)combined with subgingival glycine powder air polishing(SubGPAP)for patients with stage Ⅲ periodontitis on residual periodontal pockets.Methods Forty patients who visited the Department of Periodontology at our hospital with stage Ⅲ periodontitis were selected.After 4-6 weeks of initial treatment,the residual periodontal pockets of＞4 mm depth with bleeding on probing,or ≥6 mm depth were randomly assigned in a split-mouth design,to receive subgingival scaling and root planning(SRP)(control group)or PDT+SubGPAP+SRP(test group).Indicators including probing depth(PD),clinical attachment loss(CAL),bleeding index(BI),plaque index(PLI),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and interleukin-1β(IL-1β)at baseline,6 weeks and 3 months after treatment were measured and compared.Results The clinical indicators showed significant reductions in both groups at 6 weeks and 3 months compared with those at baseline(P＜0.05).The TNF-α in test group showed no significant differ-ence at 3 months compared with 6 weeks(P＞0.05),while the other indicators in both groups showed significant reductions at 3 months compared with those at 6 weeks(P＜0.05).The PD,CAL,BI,TNF-α,IL-6 and IL-1β in test group showed a significant reduction than those in the control group at 6 weeks and 3 months(P＜0.05).The PLI in test group showed a significant reduction at 6 weeks(P＜0.05).Conclusion PDT combined with SubGPAP assisted SRP for patients with stage Ⅲ periodontitis on residual periodontal pockets is conducive to enhancing the clinical efficacy and improving the microenvironment.

Jaws and alveolar defects present significant challenges in reconstructive surgery and implant restoration.Calcium phos-phate(CaP)bioceramics are commonly used as bone substitute and play a crucial role in repairing bone defects.Recent studies have shown that T cells play an important regulatory role in bone regeneration.The studies on CaP bioceramics and T cells,including their subpopulations,in bone regeneration,and the mechanisms through which CaP bioceramics regulate the behavior of T cells has been re-viewed.

Objective:To investigate the management of cancer pain and the clinical practices of hospice care across 11 cities in Zhejiang Province.Methods:From May 22 to 29, 2023, the Zhejiang Provincial Health Commission conducted a survey to assess the current status of hospice care practitioners regarding cancer pain management, the practices employed by medical staff in managing cancer pain, and the understanding of medical personnel concerning self-controlled analgesia for cancer pain treatment in Zhejiang Province.Results:A total of 505 questionnaires were collected from 198 hospitals across 11 cities in the province.Among the medical staff in secondary and tertiary medical institutions, 85.71%(198 out of 231)participated in the management of cancer pain in patients.Oral analgesics emerged as the most commonly used treatment for pain outbreaks, accounting for 38.53%(89 out of 231)of cases.Additionally, 37.66%(87 out of 231)of medical personnel were involved in the development of self-controlled analgesia devices within their institutions.Conclusions:In the management of cancer pain within hospice care, it is essential to enhance the theoretical training of medical staff, ensure the availability of basic analgesic medications, and establish standardized management protocols for the entire process as promptly as possible.

Objective To investigate the value of minimum apparent diffusion coefficient(ADCmin)and delta apparent diffusion coefficient(dADC)of quantitative parameters of MR diffusion weighted imaging(DWI)in differentiating benign from stage Ⅰ malignant ovarian epithelial tumors.Methods A total of 112 patients with primary ovarian epithelial tumors confirmed by operation and pathology(43 benign tumors and 69 stage Ⅰ malignant tumors)were retrospectively selected.All patients underwent routine MRI and DWI before operation.The ADCmin and dADC of solid portion were measured and compared between the two groups.Logistic regression anal-ysis and receiver operating characteristic(ROC)curve were used to evaluate diagnostic performance of each parameter alone and in combination in differentiating ovarian epithelial benign and stage Ⅰ malignant tumors.Results The ADCmin was greater in benign tumors than that in stage Ⅰ malignant tumors,while dADC was smaller in benign tumors than that in stage Ⅰ malignant tumors(P＜0.05).Logis-tic regression analysis showed that ADCmin and dADC were independent risk factors for stage Ⅰ malignant tumors.With threshold of 1.183 × 10-3 mm2/s for ADCmin and 0.579 × 10-3 mm2/s for dADC,the area under the curve(AUC)was 0.802 and 0.857,sensitivity and specificity of 0.885,0.808,0.714,0.857,respectively.According to regression equation logit(P)=7.154+0.267 × dADC-1.016 X ADCmin,the AUC(0.951)was greater than that of single parameter,the sensitivity was 0.890,the specificity was 0.995.Conclusion ADCmin and dADC are useful for differentiating ovarian epithelial benign from stage Ⅰ malignant tumors,and ADCmin combined with dADC can improve the diagnose accuracy before operation.

Objective To discuss the clinical value of echocardiographic indicators in assessing the short-term efficacy of transcatheter aortic valve replacement(TAVR)and surgical aortic valve replacement(SAVR)in treating patients with severe aortic valve stenosis(AS).Methods The clinical data of 70 patients with severe AS,who received treatment at the Daping Hospital of Army Military Medical University of China between June 2019 and September 2022 were retrospectively analyzed.The patients were divided into SAVR group(n=40)and TAVR group(n=30).The preoperative one-week and postoperative one-month echocardiographic indicators were compared between the two groups.Results In both groups,the postoperative one-month peak aortic valve velocity(Vmax),aortic valve mean transvalvular pressure gradient(mPG),relative thickness of chamber wall(RWT),and left ventricular mass index(LVMI)were decreased when compared with preoperative values(all P＜0.05);in TAVR group the left ventricular ejection fraction(LVEF),LVMI and incidence of perivalvular leakage were remarkably higher than those in SAVR group,while the Vmax and mPG were obviously lower than those in SAVR group(all P＜0.05).In TAVR group,the mitral regurgitation decreased from preoperative 12 patients(40％)to postoperative 2 patients(6.7％)and the over-moderate tricuspid regurgitation decreased from preoperative 7 patients(23.3％)to postoperative one patient(3.3％)(all P＜0.05).In SAVR group,the mitral regurgitation decreased from preoperative 15 patients(37.5％)to postoperative 2 patients(5.0％)and the over-moderate tricuspid regurgitation decreased from preoperative 9 patients(22.5％)to postoperative one patient(2.5％)(all P＜0.05).The pulmonary artery hypertension in TAVR group decreased from preoperative 17 patients(56.7％)to postoperative 4 patients(13.3％),which in SAVR group decreased from preoperative 22 patients(55.0％)to postoperative 5 patients(12.5％)(P＜0.05),but the differences in the above indexes between the two groups were not statistically significant(all P＞0.05).Conclusion TAVR and SAVR have similar efficacy in improving secondary valve regurgitation and pulmonary artery hypertension caused by severe AS.TAVR is superior to SAVR in improving postoperative ventricular reverse remodeling and hemodynamics,although the incidence of paravalvular leakage in TAVR is higher than that in SAVR.(J Intervent Radiol,2024,33:479-482)

Objective To compare H_p(3) calibration with a homemade (A) thermoluminescent dosimeter (TLD) and an imported (B) TLD in a standard X-ray RQR radiation field, to explore the different responses of A and B, and to provide foundation for the calibration of H_p(3). Methods A column mode was selected. H_p(3) calibration was performed using A and B in a standard X-ray RQR radiation field in the Secondary Standard Dosimetry Laboratory, National Institute for Radiological Protection, China Center for Disease Control and Prevention. Angle response, energy response, and linear response were calibrated with RQR4 (60 kV), RQR7 (90 kV), and RQR9 (120 kV), respectively. Results In terms of angle response, the calibration results of A were relatively high, while the calibration results of B were relatively low. In terms of energy response, the calibration results showed a similar pattern to angle response. In terms of linear response, the calibration results of both A and B were satisfactory. Conclusion Both A and B can be used for normal calibration of H_p(3) in a standard X-ray RQR radiation field. However, in actual monitoring, attention should be paid to the energy and angle response values of TLDs.

Objective:To investigate the relationship between the duration of the second stage of labor and the amount of postpartum hemorrhage within 2 hours in primiparas using epidural analgesia.Methods:A retrospective study was conducted on the clinical data of pregnant women who delivered vaginally in the obstetrics department of the Affiliated Hospital of Jining Medical University from January 1, 2020, to December 31, 2020. The data included maternal age, pre-pregnancy body mass index (BMI), gravidity, gestational age at delivery, weight gain during pregnancy, common pregnancy complications (such as gestational hypertension, gestational diabetes, hypothyroidism, and pregnancy-related anemia), types of uterotonics, duration of each stage of labor, delivery outcomes, perineal conditions, postpartum hemorrhage within 2 hours, and neonatal birth length and weight. The exposure variable was the duration of the second stage of labor, and the outcome was the amount of postpartum hemorrhage within 2 hours. Potential risk factors were analyzed using univariate analysis. After adjusting for potential confounding factors, a generalized additive model was used for linear regression analysis, smooth curve fitting, and threshold effect analysis to observe the relationship between the duration of the second stage of labor and postpartum hemorrhage within 2 hours.Results:A total of 2 067 primiparas were included in the study. The mean age of the participants was 26.5±3.6 years, the median duration of the second stage of labor was 54 min (range: 35-81 min), and the median amount of postpartum hemorrhage within 2 hours was 230 ml (range: 200-300 ml). After adjusting for factors such as maternal age, pre-pregnancy BMI, gestational age at delivery, vaginal delivery, duration of the first and third stages of labor, perineal conditions, types of uterotonics used within 2 hours postpartum, and neonatal birth length and weight, a positive relationship was found between the duration of the second stage of labor and the amount of postpartum hemorrhage within 2 hours ( ?=0.20, 95% CI: 0.00-0.30, P<0.05). The smooth curve fitting results showed a non-linear relationship between the duration of the second stage of labor and postpartum hemorrhage within 2 hours. Threshold effect analysis indicated that the two-segment regression model (Model Ⅱ) was more suitable for fitting the correlation compared to the univariate linear regression model (Model Ⅰ), with a log-likelihood ratio test P-value of 0.001, and the inflection point was 115 min for the second stage of labor (95% CI: 99-125 min). Conclusions:In primiparas using epidural analgesia, there is a non-linear relationship and threshold effect between the duration of the second stage of labor and the amount of postpartum hemorrhage within 2 hours. When the second stage of labor exceeds 115 min, the extension of the second stage may increase the amount of postpartum hemorrhage within 2 hours.