In the realm of oral implantology, currently, there is no unanimous consensus or authoritative guideline regarding how to conduct implant restoration for cases involving oroantral communication or oroantral fistula. In these cases, the bony plate of the maxillary sinus floor is discontinuous, the oro-sinus mucosa is in communication, and a vertical alveolar bone defect exists. This paper presents a case of a patient with two oroantral communications who successfully underwent implant restoration via simple staged surgeries. Following a 2-year clinical follow-up, the implant remains in good condition, and the patient expresses satisfaction. The objective of this paper is to offer a simple, safe, and readily-promotable new approach for such cases.
Humans ; Dental Implantation, Endosseous/methods* ; Dental Implants ; Maxillary Sinus/surgery* ; Oroantral Fistula/surgery*

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective:To construct and validate a depression risk prediction model for middle-aged and elderly patients with diabetes.Methods:Data were extracted from the fifth wave (2020) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 900 diabetic patients were identified, and after excluding those with missing data or invalid questionnaires, 769 patients were included in the analysis. Patients were randomly divided into a training set and a validation set in a 7∶3 ratio. Univariate analysis and logistic regression analysis were performed to screen the optimal predictors of depression in diabetic patients, and a nomogram model was developed. The predictive performance of the model was assessed by the area under the receiver operating characteristic curve ( AUC). Model calibration and accuracy were evaluated using bootstrap resampling, calibration plots, and the Hosmer-Lemeshow test. The clinical utility was further assessed by decision curve analysis (DCA) and clinical impact curves (CIC) . Results:Among the 769 patients, 366 (47.59%) had depression. Logistic regression analysis showed that place of residence, pain, difficulty in toileting, difficulty in bathing, sleep duration, physical exercise, life satisfaction, and children's satisfaction were independent predictors of depression in diabetic patients. A nomogram was constructed based on these variables, yielding an AUC of 0.775. At the optimal cutoff value of 0.557, the model demonstrated a sensitivity of 59.1% and a specificity of 84.8%, indicating good discriminative ability. The Hosmer-Lemeshow test showed (χ 2=15.821, P=0.105), suggesting good agreement between predicted and observed outcomes. In the validation set, the AUC was 0.778, with Hosmer-Lemeshow (χ 2=8.557, P=0.575). DCA and CIC indicated favorable clinical applicability of the model. Conclusions:The depression risk prediction model constructed in this study demonstrated good predictive performance. It can assist clinicians in early identification of high-risk individuals with diabetes and provide a theoretical basis for targeted interventions.

Objective To investigate the distribution and antibiotic resistance profiles of the bacterial strains isolated from urine samples in a tertiary Traditional Chinese Medicine hospital in Shanghai in the 12-year period from 2010 through 2021 for better empirical antibiotic use in clinical practice.Methods The clinical data of patients with urinary tract infection,including the species and antibiotic resistance of the bacterial strains isolated from urine samples from January 2010 to December 2021 were retrospectively analyzed.Results A total of 5 231 nondupliate bacterial strains were isolated,among which E.coli was the most common(52.8％),followed by Enterococcus spp(19.1％)and Klebsiella spp(11.1％).Most of the urinary isolates(76.0％)were isolated from the elderly aged 60-89,and only 3.1％of the strains were isolated from the young people aged under 44.Most of the bacterial strains were isolated from female patients(75.8％),however,more P.aeruginosa and A.baumannii were isolated from male patients compared to female patients(55.3％vs 44.7％and 67.7％vs 32.3％).About 13.7％of the strains were collected from the Department of Nephrology,more than the strains from any other clincial department.In intensive care unit(ICU),the proportion of E.coli was the lowest,while the proportion of Enterococcus spp was the highest.Enterobacterales showed lower resistance raets to carbapenems,cephamycin,amikacin,cefepime,and β-lactam/β-lactamase inhibitor combinations.P.aeruginosa showed higher susceptibility rates to carbapenems,aminoglycosides and β-lactam/β-lactamase inhibitor combinations compared to A.baumannii(≥54.6％vs≤39.8％).Gram-positive cocci were highly sensitive to glycopeptide antibiotics.No SS.aureus or E.faecalis isolates were found resistant to vancomycin.About 2.7％of the E.faecium isolates were resistant to vancomycin.The prevalence of drug-resistant bacteria was the highest in elderly patients,and in the strains isolated from ICU and emergency department.Conclusions Compared with general hospitals,a high proportion of elderly patients were treated in this hospital.It should be more cautious in the treatment of patients with urinary tract infection.The major bacterial species isolated from urine were E.coli,Enterococcus,and K.pneumoniae.Empirical treatment should be prescribed considering patient age and gender as well as the species and distribution of pathogenic bacteria.Urine culture and antibiotic susceptibility testing should be performed proactively.Appropriate antimicrobial agents should be selected according to the results of antimicrobial susceptibility testing.Antimicrobial ressitance surveillance should also be strengthened.

Objective To explore the effect of transcranial direct current stimulation(tDCS)regulating the motor cortex on the performance of endurance exercise with incremental loading.Methods A randomized,double-blind,parallel control design was adopted.Forty healthy adults were randomly divided into real stimulation(lasting 20 min)or sham stimulation groups(30 s slow-rise and 30 s slow-fall stimulation provided within the 1st 1 min only).The multifocal tDCS was used,with seven small electrodes(3.14 cm2 round electrodes)placed in the primary,premotor,and supplementary motor areas to modulate motor cortex excitability.The injection current of a single electrode did not exceed 1.552 mA,and the total currents did not exceed 3.998 mA.Baseline tests on incrementally loading exercises were performed before and after the intervention,with an interval of 48 hours between the two tests.Two-way ANOVA was used to analyze the effects of this tDCS protocol on duration of cycling,power output,and revolution speed.Results All subjects completed the experiment without unexpected adverse effects.The overall accuracy rate of subjective guess was 37.5%.There was no significant difference in duration of cycling or power output between the two groups(P>0.05),and within-group statistics showed an increase in revolution speed after the real stimulation(P=0.012).Conclusions tDCS that targets and modulates the motor cortex can improve the revolution speed during cycling exercise with incremental loading in healthy adults,suggesting that this stimulation protocol may be a potential means of improving exercise efficiency in endurance sports.

Objective To explore the effect of transcranial direct current stimulation(tDCS)regulating the motor cortex on the performance of endurance exercise with incremental loading.Methods A randomized,double-blind,parallel control design was adopted.Forty healthy adults were randomly divided into real stimulation(lasting 20 min)or sham stimulation groups(30 s slow-rise and 30 s slow-fall stimulation provided within the 1st 1 min only).The multifocal tDCS was used,with seven small electrodes(3.14 cm2 round electrodes)placed in the primary,premotor,and supplementary motor areas to modulate motor cortex excitability.The injection current of a single electrode did not exceed 1.552 mA,and the total currents did not exceed 3.998 mA.Baseline tests on incrementally loading exercises were performed before and after the intervention,with an interval of 48 hours between the two tests.Two-way ANOVA was used to analyze the effects of this tDCS protocol on duration of cycling,power output,and revolution speed.Results All subjects completed the experiment without unexpected adverse effects.The overall accuracy rate of subjective guess was 37.5%.There was no significant difference in duration of cycling or power output between the two groups(P>0.05),and within-group statistics showed an increase in revolution speed after the real stimulation(P=0.012).Conclusions tDCS that targets and modulates the motor cortex can improve the revolution speed during cycling exercise with incremental loading in healthy adults,suggesting that this stimulation protocol may be a potential means of improving exercise efficiency in endurance sports.

This study aims to explore the impact of Rehmannioside D (RD) on ovarian functions of rats with diminished ovarian reserve (DOR) and its underlying mechanisms of action. A single injection of cyclophosphamide was performed to establish a DOR rat model, and fourteen days after the injection, the rats were intragastrically administrated with RD for two weeks. Rat estrus cycles were tested using vaginal smears. Ovarian tissues were histologically evaluated, the number of primordial, mature, and atretic follicles was calculated, and the apoptotic rate of granulosa cells. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2 ) levels were determined by ELISA assays. Protein levels of Forkhead Box O1 (FOXO1), KLOTHO, Bcl-2, and Bax were investigated in ovarian tissues of DOR rats. The binding between FOXO1 and KLOTHO was verified by ChIP assay. High-dose administration of RD into DOR rats improved their estrus cycles, increased ovarian index, enhanced the number of primordial and mature follicles, reduced the number of atretic follicle number, and ovarian granulosa cell apoptosis in addition to inhibiting FSH and LH levels and upregulating E2 expression. FOXO1 and KLOTHO were significantly suppressed in DOR rats. FOXO1 knockdown partially suppressed the protective effects of RD on DOR rats, and KLOTHO overexpression could restore RD-induced blockade of DOR development despite knocking down FOXO1. FOXO1 antibody enriched KLOTHO promoter, and the binding between them was reduced in DOR group compared to that in sham group. RD improved ovarian functions in DOR rats and diminished granulosa cell apoptosis via the FOXO1/KLOTHO axis.

Vagus nerve stimulation (VNS) is a neuromodulation technique that achieves therapeutic purpose through intermittent and chronic stimulation of vagus nerve afferent fibers, which has a remarkable effect on functional diseases of the central nervous system, and has been approved by FDA for intractable epilepsy, depression and migraine treatments. Transcutaneous auricular vagus nerve stimulation(taVNS) is a new type of non-invasive nerve regulation therapy based on traditional VNS and vagus nerve anatomy, and has a wide range of central regulation; taVNS can improve the cognitive state by regulating functions of cognition-related cerebral cortex and nerve nuclei, regulating inflammatory response, promoting neurotransmitter transmission, and so on, which has a broad application prospect in cognition-related diseases. This paper mainly summarizes the recent advance in central mechanism of taVNS in improving cognitive function.

Humans ; Nitric Oxide ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Lung Neoplasms ; Lung ; Nitric Oxide Synthase ; Macrophages, Alveolar ; Pulmonary Alveoli

In recent years, a number of policies have been implemented to strengthen the cultivation of general practitioners in China. However, the development of community-level health professionals is still lagging behind, the development is uneven among regions, the overall number of general practitioners is insufficient, and the quality of medical services needs to be improved. Based on the Shanhai (Mountain and Sea) promotion project, with the close cooperation between the Second Affiliated Hospital and the medical consortium unit Suichang County People′s Hospital, a " Joint Cultivation by Dual-Teachers " model has been applied in training general practitioners for Suichang county community since March 2021. In this article we discuss the optimization and integration of medical and health resources through the outreaching assistance of high-quality personnel, management and system of medical service, to comprehensively upgrade the primary care and the quality of grass-roots general practitioners in remote mountainous areas.