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

Schistosomiasis was once hyper-endemic in Yunnan Province. Following concerted efforts for over 70 years, remarkable achievements have been made for schistosomiasis control in the province. In 2004, the Mid- and Long-term Plan for Schistosomiasis Prevention and Control in Yunnan Province was initiated in Yunnan Province, and the target for transmission control of schistosomiasis was achieved in the province in 2009. Following the subsequent implementation of the Outline for Key Projects in Integrated Schistosomiasis Control Program (2009—2015) and the 13th Five - year Plan for Schistosomiasis Control in Yunnan Province, no acute schistosomiasis had been identified in Yunnan Province for successive 12 years, and no local Schistosoma japonicum infections had been detected in humans, animals or Oncomelania hupensis snails for successive 6 years in the province by the end of 2020. The transmission of schistosomiasis was interrupted in Yunnan Province in 2020. This review summarizes the history of schistosomiasis, changes in schistosomiasis prevalence and progress of schistosomiasis control in Yunnan Province, and proposes the future priorities for schistosomiasis control in the province.

Objective To predict the potential geographic distribution of Oncomelania hupensis in Yunnan Province using random forest (RF) and maximum entropy (MaxEnt) models, so as to provide insights into O. hupensis surveillance and control in Yunnan Province. Methods The O. hupensis snail survey data in Yunnan Province from 2015 to 2016 were collected and converted into O. hupensis snail distribution site data. Data of 22 environmental variables in Yunnan Province were collected, including twelve climate variables (annual potential evapotranspiration, annual mean ground surface temperature, annual precipitation, annual mean air pressure, annual mean relative humidity, annual sunshine duration, annual mean air temperature, annual mean wind speed, ≥ 0 ℃ annual accumulated temperature, ≥ 10 ℃ annual accumulated temperature, aridity and index of moisture), eight geographical variables (normalized difference vegetation index, landform type, land use type, altitude, soil type, soil textureclay content, soil texture-sand content and soil texture-silt content) and two population and economic variables (gross domestic product and population). Variables were screened with Pearson correlation test and variance inflation factor (VIF) test. The RF and MaxEnt models and the ensemble model were created using the biomod2 package of the software R 4.2.1, and the potential distribution of O. hupensis snails after 2016 was predicted in Yunnan Province. The predictive effects of models were evaluated through cross-validation and independent tests, and the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS) and Kappa statistics were used for model evaluation. In addition, the importance of environmental variables was analyzed, the contribution of environmental variables output by the models with AUC values of > 0.950 and TSS values of > 0.850 were selected for normalization processing, and the importance percentage of environmental variables was obtained to analyze the importance of environmental variables. Results Data of 148 O. hupensis snail distribution sites and 15 environmental variables were included in training sets of RF and MaxEnt models, and both RF and MaxEnt models had high predictive performance, with both mean AUC values of > 0.900 and all mean TSS values and Kappa values of > 0.800, and significant differences in the AUC (t = 19.862, P < 0.05), TSS (t = 10.140, P < 0.05) and Kappa values (t = 10.237, P < 0.05) between two models. The AUC, TSS and Kappa values of the ensemble model were 0.996, 0.954 and 0.920, respectively. Independent data verification showed that the AUC, TSS and Kappa values of the RF model and the ensemble model were all 1, which still showed high performance in unknown data modeling, and the MaxEnt model showed poor performance, with TSS and Kappa values of 0 for 24%(24/100) of the modeling results. The modeling results of 79 RF models, 38 MaxEnt models and their ensemble models with AUC values of > 0.950 and TSS values of > 0.850 were included in the evaluation of importance of environmental variables. The importance of annual sunshine duration (SSD) was 32.989%, 37.847% and 46.315% in the RF model, the MaxEnt model and their ensemble model, while the importance of annual mean relative humidity (RHU) was 30.947%, 15.921% and 28.121%, respectively. Important environment variables were concentrated in modeling results of the RF model, dispersed in modeling results of the MaxEnt model, and most concentrated in modeling results of the ensemble model. The potential distribution of O. hupensis snails after 2016 was predicted to be relatively concentrated in Yunnan Province by the RF model and relatively large by the MaxEnt model, and the distribution of O. hupensis snails predicted by the ensemble model was mostly the joint distribution of O. hupensis snails predicted by RF and MaxEnt models. Conclusions Both RF and MaxEnt models are effective to predict the potential distribution of O. hupensis snails in Yunnan Province, which facilitates targeted O. hupensis snail control.

Objective:To analyze the association between zygomatic change and bone setback or resection and propose a quantitative guidance for L-shaped reduction malarplasty by linear regression analysis based on computed tomographic (CT) scan images.Methods:A retrospective observational study was conducted on patients who underwent L-shaped reduction malarplasty with mortice and tenon joint at the zygomatic arch in Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2017 to September 2022. Bone setback and resection were performed in cases required a classical L-shaped osteoectomy with oblique bone resection (Group Ⅰ). Bone setback was performed in cases required a modified L-shaped osteotomy without bone resection (Group Ⅱ). Wound healing and the occurrence of complications were followed up after operation. The amount of bone setback and resection were calculated by using preoperative and postoperative CT scan images. The unilateral width changes of the anterior, middle, and posterior zygomatic regions(ΔZBP-MFP, ΔZMP-MFP, ΔZAP-MFP, respectively) as well as zygomatic protrusion change(Δzygomatic protrusion) were also evaluated. SPSS 20.0 software was used for statistical analysis. The measurement data was expressed as Mean±SD. Zygomatic width and protrusion change of the two groups was compared by independent t-test. Comparison of complication rates between the two groups was performed using the χ2 test. Correlation analysis using Pearson correlation coefficients was performed between bone resection or setback and zygomatic width or protrusion change. Linear regression analysis was also performed. Results:A total of 80 patients were enrolled. Group Ⅰ consisted of 40 patients [6 males and 34 females; aged (25.2±3.8) years, ranging from 19 to 33 years] who underwent a classical L-shaped osteotomy with both bone setback and resection, while Group Ⅱ consisted of 40 patients [10 males and 30 females; aged (26.0±3.0) years, ranging from 20 to 35 years] who underwent a modified L-shaped osteotomy with bone setback but without bone resection. All patients healed uneventfully during the follow-up period[(12.5±3.3) months, ranging from 5 to 20 months]. There was no significant difference in the incidence of complications such as infection, transient paresthesia, severe swelling and hematoma between the two groups ( P>0.05). No severe complications, such as facial asymmetry, sagging cheek, bone nonunion, were observed. All patients significantly improved facial contours. There was a statistically significant difference (all P<0.01) in ΔZBP-MFP [ (2.52±0.76) mm vs. (1.85±0.40) mm], ΔZMP-MFP [ (3.30±0.54) mm vs. (2.94±0.51) mm] and Δzygomatic protrusion [ (4.42±1.20) mm vs. (3.59±0.84) mm] between Group Ⅰ and Group Ⅱ. No statistical difference was found in ΔZAP-MFP ( P>0.05). Significant correlation was observed between the bone setback or resection and the changes of anterior, middle zygomatic width as well as protrusion in both the two groups ( r=0.60-0.92, all P<0.01), and the linear regression equation was established. The correlation between bone setback or resection and the posterior zygomatic width change was not significant ( P>0.05). Conclusion:There are linear correlations between the unilateral anterior, middle zygomatic width change, zygomatic protrusion change and the unilateral bone setback or resection. The linear regression equations can be used as a quantitative guidance for preoperative surgical planning.

Objective:In this retrospective study, the accuracy and outcomes of segmental Le Fort I surgery with the aid of 3D-printed surgical templates and occlusal splints and dental model surgery were evaluated.Methods:Clinical data of patients receiving segmental Le Fort I surgery in the Department of Orthognathic and Temporo-Mandibular Joint Surgery of West China Stomatological Hospital of Sichuan University from January 2014 to June 2019 were retrospectively analyzed. The accuracy of virtual surgical planning(VSP) and the difference between VSP and dental model surgery were evaluated by postoperative complications, color distance maps, and quantitative accuracy analysis.The amount of surgical displacement of the maxilla in the three-dimensional direction before and after surgery, the occurrence of postoperative complications and the patients'satisfaction survey were analyzed in both groups. Paired t-tests were used for the linear distance and angle between the preoperative design model and the final virtual surgery model in the digital surgery group. Independent samples t-test was used for each marker point’s preoperative and postoperative displacements in the three-dimensional direction between the digital surgery group and the dental model group. The proportion of postoperative complications in the 2 groups was tested using the Pearson chi-square test, and the difference was considered statistically significant at P<0.05. Results:There were 129 patients in the digital surgery group, 35 males and 94 females, aged (24.5±6.5) years, and 92 patients in the dental model surgery group, 28 males and 64 females, aged (27.7±5.4) years.The overall mean linear difference was 1.23±0.35 mm, and the overall mean angular difference was 2.48°±0.31°. The vertical displacement of U3R, U6L in the digital surgery group was (6.72±1.57)mm and (4.73±2.07)mm. The vertical displacement of U3R, U6L in the group of dental model surgery was (4.07±2.14)mm and (1.62±1.82)mm.The significant deviation difference in U3R-Y and U6L-Y between two groups could be detected. The complications in two groups showed a significant difference. Except for one case of root injury, there was no serious complication recorded in the digital surgery group. However, there were three cases of palatal fistulas, four cases of root injury and two cases of bone dehiscence in the dental model group. 94.5% of patients in the digital surgery group are satisfied with the surgical results, while 89.1% in the dental model group.Conclusion:Compared with dental model surgery, segmental Le Fort I surgery is highly accurate under the guidance of surgical templates and occlusal splint which has better postoperative results and effectively reduces the occurrence of surgical complications.

Objective:In this retrospective study, the accuracy and outcomes of segmental Le Fort I surgery with the aid of 3D-printed surgical templates and occlusal splints and dental model surgery were evaluated.Methods:Clinical data of patients receiving segmental Le Fort I surgery in the Department of Orthognathic and Temporo-Mandibular Joint Surgery of West China Stomatological Hospital of Sichuan University from January 2014 to June 2019 were retrospectively analyzed. The accuracy of virtual surgical planning(VSP) and the difference between VSP and dental model surgery were evaluated by postoperative complications, color distance maps, and quantitative accuracy analysis.The amount of surgical displacement of the maxilla in the three-dimensional direction before and after surgery, the occurrence of postoperative complications and the patients'satisfaction survey were analyzed in both groups. Paired t-tests were used for the linear distance and angle between the preoperative design model and the final virtual surgery model in the digital surgery group. Independent samples t-test was used for each marker point’s preoperative and postoperative displacements in the three-dimensional direction between the digital surgery group and the dental model group. The proportion of postoperative complications in the 2 groups was tested using the Pearson chi-square test, and the difference was considered statistically significant at P<0.05. Results:There were 129 patients in the digital surgery group, 35 males and 94 females, aged (24.5±6.5) years, and 92 patients in the dental model surgery group, 28 males and 64 females, aged (27.7±5.4) years.The overall mean linear difference was 1.23±0.35 mm, and the overall mean angular difference was 2.48°±0.31°. The vertical displacement of U3R, U6L in the digital surgery group was (6.72±1.57)mm and (4.73±2.07)mm. The vertical displacement of U3R, U6L in the group of dental model surgery was (4.07±2.14)mm and (1.62±1.82)mm.The significant deviation difference in U3R-Y and U6L-Y between two groups could be detected. The complications in two groups showed a significant difference. Except for one case of root injury, there was no serious complication recorded in the digital surgery group. However, there were three cases of palatal fistulas, four cases of root injury and two cases of bone dehiscence in the dental model group. 94.5% of patients in the digital surgery group are satisfied with the surgical results, while 89.1% in the dental model group.Conclusion:Compared with dental model surgery, segmental Le Fort I surgery is highly accurate under the guidance of surgical templates and occlusal splint which has better postoperative results and effectively reduces the occurrence of surgical complications.

Objective:To analyze the association between zygomatic change and bone setback or resection and propose a quantitative guidance for L-shaped reduction malarplasty by linear regression analysis based on computed tomographic (CT) scan images.Methods:A retrospective observational study was conducted on patients who underwent L-shaped reduction malarplasty with mortice and tenon joint at the zygomatic arch in Department of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University from January 2017 to September 2022. Bone setback and resection were performed in cases required a classical L-shaped osteoectomy with oblique bone resection (Group Ⅰ). Bone setback was performed in cases required a modified L-shaped osteotomy without bone resection (Group Ⅱ). Wound healing and the occurrence of complications were followed up after operation. The amount of bone setback and resection were calculated by using preoperative and postoperative CT scan images. The unilateral width changes of the anterior, middle, and posterior zygomatic regions(ΔZBP-MFP, ΔZMP-MFP, ΔZAP-MFP, respectively) as well as zygomatic protrusion change(Δzygomatic protrusion) were also evaluated. SPSS 20.0 software was used for statistical analysis. The measurement data was expressed as Mean±SD. Zygomatic width and protrusion change of the two groups was compared by independent t-test. Comparison of complication rates between the two groups was performed using the χ2 test. Correlation analysis using Pearson correlation coefficients was performed between bone resection or setback and zygomatic width or protrusion change. Linear regression analysis was also performed. Results:A total of 80 patients were enrolled. Group Ⅰ consisted of 40 patients [6 males and 34 females; aged (25.2±3.8) years, ranging from 19 to 33 years] who underwent a classical L-shaped osteotomy with both bone setback and resection, while Group Ⅱ consisted of 40 patients [10 males and 30 females; aged (26.0±3.0) years, ranging from 20 to 35 years] who underwent a modified L-shaped osteotomy with bone setback but without bone resection. All patients healed uneventfully during the follow-up period[(12.5±3.3) months, ranging from 5 to 20 months]. There was no significant difference in the incidence of complications such as infection, transient paresthesia, severe swelling and hematoma between the two groups ( P>0.05). No severe complications, such as facial asymmetry, sagging cheek, bone nonunion, were observed. All patients significantly improved facial contours. There was a statistically significant difference (all P<0.01) in ΔZBP-MFP [ (2.52±0.76) mm vs. (1.85±0.40) mm], ΔZMP-MFP [ (3.30±0.54) mm vs. (2.94±0.51) mm] and Δzygomatic protrusion [ (4.42±1.20) mm vs. (3.59±0.84) mm] between Group Ⅰ and Group Ⅱ. No statistical difference was found in ΔZAP-MFP ( P>0.05). Significant correlation was observed between the bone setback or resection and the changes of anterior, middle zygomatic width as well as protrusion in both the two groups ( r=0.60-0.92, all P<0.01), and the linear regression equation was established. The correlation between bone setback or resection and the posterior zygomatic width change was not significant ( P>0.05). Conclusion:There are linear correlations between the unilateral anterior, middle zygomatic width change, zygomatic protrusion change and the unilateral bone setback or resection. The linear regression equations can be used as a quantitative guidance for preoperative surgical planning.

Objective To analyze the expression level of YEATS2 in hepatocellular carcinoma(HCC)about its clinical prognosis and therapeutic value based on biological information from the cancer genome atlas(TCGA)and human protein atlas(HPA)databases.Methods The mRNA expression data and clinical information of HCC were downloaded from the TCGA database,the expression of YEATS2 between HCC tissues and normal tissues was analyzed by using the R software,and the protein expression differences were preliminary verified by the HPA database.The expression differences of YEATS2 between various clinical features of HCC were compared,and their effects on the survival of HCC patients by Kaplan-Meier method and COX regression analysis were then evaluated.Receiver operating characteristic(ROC)curves were plotted to evaluate their diagnostic values.The biological functions of YEATS2 in HCC were analyzed using gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.The relationship between YEATS2 expression and tumor microenvironment(TME)was analyzed by the"ESTIMATE"algorithm,and its relationship with tumor-infiltrating immune cells(TIICs)was assessed by CIBERSORT.Analysis of YEATS2 expression levels to immune checkpoints and drug sensitivity was performed using the R package.Results The expression of YEATS2 was increased in HCC tissues(P=4.96e-21),and its expression level was correlated with age,clinical stage,pathological grade and T stage(all P＜0.05).Overall survival(OS)(P＜0.001)and progression-free survival(FPS)(P=0.016)were decreased in HCC patients with high expression of YEATS2,COX regression results showed that the expression level ofYEATS2 was associated with poor prognosis in HCC patients(OS:HR=2.167,95％CI:1.441～3.261,P=2.06e-04),and it was an independent risk factor for predicting poor prognosis in HCC patients(OS:HR=1.891,95％CI:1.243～2.877,P=0.003).The ROC curve suggested the AUCs for 1,3 and 5 years were 0.677,0.622 and 0.612,respectively,indicating good predictive ability.The TCGA database screened a total of 6 764 differential genes in the YEATS2 high and low expression groups,of which 4 094 genes were up-regulated and 2 670 genes were down-regulated in the YEATS2 high expression group.The results of GO and KEGG enrichment analyses showed that the differentially differentiated genes in the YEATS2 high expression group were mainly enriched in immunoregulation,and cell cycle regulation drug resistance pathway.The results of the TME score showed that the YEATS2 high expression group caused a decrease in immunity score(P＜0.01).The correlation between YEATS2 and TIICs showed that YEATS2 expression was positively correlated with the level of M0-type macrophage infiltration levels(r=0.48,P＜0.001)and 23 immune checkpoint genes(r=0.20～0.46,all P＜0.05),and was negatively correlated with the CD8+T-cells,plasma cells and monocyte(r=-0.26,-0.29,-0.30,P=0.021,0.011,0.008).Drug sensitivity analysis showed that the half maximal inhibitory concentration(IC50)of cabozantinib,lincitinib,doxorubicin,and cyclobenzaprine in patients with high expression of YEATS2 was higher than those in patients with low expression(all P＜0.01).Conclusion YEATS2 was highly expressed in HCC,and the expression level was associated with poor prognosis in HCC patients.YEATS2 can be used as a biomarker for the clinical early diagnosis,prognosis and immunotherapy of HCC,which may provide new ideas for clinical diagnosis and treatment.

Objective:To explore the clinical characteristics of pneumocystis carinii pneumonia (PCP) after kidney transplantation.Methods:From January 2020 to January 2022, clinical data were retrospectively reviewed for 13 renal transplant recipients with pneumocystis pneumonia diagnosed by metagenomics next generation sequencing (mNGS). There were 3 females and 10 males with an age range of (46±10) years.The median time of postoperative onset was 10(2-21) months; The major clinical manifestations included fever ( n=11), cough ( n=7), expectoration ( n=6) and dyspnea ( n=11). Paired t-test was employed for analyzing the laboratory results at admission and discharge. Results:The diagnosis was confirmed by the detection of NGS in alveolar lavage fluid or venous blood.The levels of G test, LDH test, total T lymphocyte absolute count (CD3+ Abs), inhibitory/cytotoxic T lymphocyte count (CD3+ CD8+ Abs) and auxiliary/induced T lymphocyte absolute count (CD3+ CD4+ Abs) were (543.27±440.49) pg/ml, (529.98±222.43)U/L and (191.92±119.42)/μl, (87.33±50.59)/μl and (106.92±87.42)/μl at admission and (69.58±50.21) pg/ml, (285.38±46.62 U/L), (888.58±672.99)/μl, (336.83±305.21)/μl and (520.08±388.76)/μl at discharge.The differences were statistically significant ( P<0.001, P=0.002, 0.006, 0.017, 0.005). All of them received compound sulfamethoxazole and caspofungin.Except for one death due to septic shock after 21-day treatment, 12 cases were cured. Conclusions:mNGS test is one of the important tool for an early diagnosis of PCP.Combined use of compound sulfamethoxazole and caspofungin is an effective anti-infective regimen.And immune function monitoring is vital for adjusting antibiotic and immunosuppressive regimens.

The top-level design and training system of standardized training for residents has been basically completed in China, and now is gradually transiting to connotation construction and quality improvement, with the emphasis on post competency and quality as the core. There are discrepancies in clinical ability among general practice residents of different categories, so the step-up training mode should be adapted for set up and implement of phased training objectives to achieve the overall goal of training qualified general practitioners. The step-up training based on the framework of entrustable professional activities(EPAs)can quantitatively and qualitatively evaluate the competency of general practice residents and continuously track it, so that to ensure the competency of residents. This study has developed assessment item pools of EPAs-based step-up training for general practice residents through literature review and focus group discussion, and proposed implementation plans, and explored the application of EPAs in the step-up training of general practice residents.