Objective:To explore the application value of cone-beam computed tomography(CBCT)measurement in morphological change of alveolar bone of patients with malocclusion of osseous class Ⅲ after orthodontic treatment.Methods:A total of 50 patients with malocclusion of osseous class Ⅲ after received orthodontic treatment in Wuxi Stomatology Hospital from January 2020 to December 20203 were selected,and they were included in the treatment group,and 50 patients with same condition who did not receive orthodontic treatment in the same period were included in the control group.The height,width and density of alveolar bone of two groups,as well as the bone density surrounding the tooth root,the tooth inclination,the movement distance of tooth,and the CBCT images between before and after treatment,were compared.Results:The heights of long to medium(5.89±0.25)mm,near to medium(5.48±0.11)mm,cheek side(6.37±0.31)mm and tongue side(6.12±0.28)mm of treatment group were all higher than those[(5.23±0.12)mm,(5.11±0.08)mm,(6.01±0.17)mm and(5.79±0.15)mm]of control group,and the differences of them between two groups were significant(t=16.829,19.235,7.200,7.346,P<0.05),respectively.The widths of alveolar bones of tooth root and nasal base of treatment group were all higher than those of control group,and the differences of them between two groups were significant(t=23.566,26.785,P<0.05),respectively.The alveolar bone density and the density surrounding tooth root of treatment group were all higher than those of control group,and the differences of them between two groups were significant(t=6.470,6.042,P<0.05),respectively.The inclinations of upper and lower incisors of treatment group were all higher than those of control group,and the differences of them between two groups were significant(t=3.710,160.815,P<0.05),respectively.The horizontal movement,vertical movement,internal and external movement,and rotational distance of the teeth of treatment group were all larger than those of control group,and the differences of them were significant(t=62.757,115.000,75.000,5.728,P<0.05),respectively.Conclusion:CBCT measurement is of great significance and function during orthodontic treatment,which can realize careful observation and accurate quantitative analysis of alveolar bone morphology changes.

Objective:To observe and analyze the pathogenic genes and clinical phenotype characteristics of retinitis pigmentosa sinepigmento(RPSP).Methods:A retrospective clinical study. Two patients (proband) and five family members from two RPSP families admitted to Xiamen Eye Center of Xiamen University in December 2022 and Shenzhen Eye Hospital in July 2023 were included in the study. Two families have no blood relationship and were both Han Chinese. Detailed ocular and systemic medical history and specialized examinations were performed for all members, including color fundus photography, fundus autofluorescence (FAF), and full field electroretinogram (ff-ERG) examination. The peripheral venous blood of all members was collected, and genomic DNA was extracted. Pathogenic genes and their loci were screened using whole exome high-throughput sequencing technology. Sanger sequencing was used to verify the pathogenic genes in the two pedigrees. The pathogenicity of candidate variants was evaluated according to the American Society for American College of Medical Genetics and Genomics (ACMG) classification criteria and guidelines for genetic variants.Results:The two probands were male, aged 9 and 7 years, respectively. The main complaint was poor binocular vision for 6 and 3 years and poor treatment effect of amblyopia. The proband (Ⅱ2) in family 1 had a pale red color on the optic disc, with leopard-like changes in the posterior pole and thinner retinal arteries. FAF showed mottled fluorescence attenuation outside the macular vascular arch. There was no significant waveform in both bright and dark visual responses of ff-ERG. He also had 6-toed deformity of both feet, renal cysts, and a slightly overweight body. The clinical diagnosis was non-pigmentary retinitis pigmentosa. The proband of family 2 (Ⅱ1) had poor binocular vision in a dark environment and had atrophy lesions on the nasal side of the optic disc and leopard print like changes in the fundus. FAF showed uneven enhancement in the fovea. ff-ERG showed severe abnormalities in dark and light response, with significant decrease and delay in b-wave amplitude and latency. He had no other systemic abnormalities. The clinical diagnosis was binocular RPSP. There were no abnormal ocular and systemic manifestations in the two family members. Gene sequencing revealed a homozygous mutation (c.534+1G>T) of BBS2 gene, which was inherited from the mother and father respectively. Based on clinical manifestations and genetic testing results, the final diagnosis was Bardet Biedl syndrome. The genetic sequencing results confirmed a novel compound heterozygous mutation (c.950T>G: p. Leu317Arg missense mutation and c.849+1G>C splicing mutation) of BBS7 gene. His father (Ⅰ1) and mother (Ⅰ2) carried M1 heterozygous variants. Combined with the clinical manifestations and genetic testing results, the final diagnosis was Bardet-Biedl syndrome (BBS). Family 2 proband (Ⅱ1) carried the BBS7 gene C.950T>G (p.Leu317Arg) (M2) missense variation and C.849 +1G>C (M3) splice site variation. His father (Ⅰ1) and mother (Ⅰ2) carried M3 shear site variation and M2 missense variation, respectively. The two families all fit the autosomal recessive inheritance pattern, and the genotype and clinical phenotype were coseparated. According to ACMG guidelines, M1, M2 and M3 were all identified as possible pathogenic variants. Conclusions:BBS2 gene M1 homozygous variation and BBS7 gene M2, M3 complex heterozygous variation are the possible pathogenic genes in family 1 and family 2, respectively. Two families are affected by BBS and RPSP, respectively.

The morbidity and mortality rates of head and neck tumors are among the top ten worldwide, among which head and neck squamous cell carcinoma (HNSCC) is the most common type. In recent years, significant breakthroughs have been achieved by immune checkpoint programmed death-1 (PD-1) / programmed death ligand-1 (PD-L1) inhibitors in the treatment of recurrent/metastatic HNSCC, and their potential in the neoadjuvant treatment of locally advanced HNSCC (LA HNSCC) has also garnered widespread attention. Research indicates that neoadjuvant immunotherapy not only significantly improves pathological response rates, but also contributes to better organ function preservation, while maintaining good patient tolerance, offering a new strategy for the treatment of LA HNSCC. In this article, the latest research progress and clinical application prospects of immune checkpoint PD-1/PD-L1 inhibitors in the neoadjuvant treatment of LA HNSCC were reviewed.

In order to cultivate high-level medical talents, introducing information technology into medical teaching, the teaching faculty of the "Medical Functional Experiment" course constructed and explored an online-offline hybrid experimental problem-based learning (PBL) model guided by hypoxia pathophysiology problems. We explore the teaching method, implementation process, assessment, and effect evaluation of the experimental PBL model from the aspects of teaching objects, online teaching platform setting, and offline application, and also discuss its academic innovation points and application value. We hope to provide ideas for integrating the PBL concept into experimental teaching and help cultivate excellent innovative medical talents.

Objective:To explore the application value of cone-beam computed tomography(CBCT)measurement in morphological change of alveolar bone of patients with malocclusion of osseous class Ⅲ after orthodontic treatment.Methods:A total of 50 patients with malocclusion of osseous class Ⅲ after received orthodontic treatment in Wuxi Stomatology Hospital from January 2020 to December 20203 were selected,and they were included in the treatment group,and 50 patients with same condition who did not receive orthodontic treatment in the same period were included in the control group.The height,width and density of alveolar bone of two groups,as well as the bone density surrounding the tooth root,the tooth inclination,the movement distance of tooth,and the CBCT images between before and after treatment,were compared.Results:The heights of long to medium(5.89±0.25)mm,near to medium(5.48±0.11)mm,cheek side(6.37±0.31)mm and tongue side(6.12±0.28)mm of treatment group were all higher than those[(5.23±0.12)mm,(5.11±0.08)mm,(6.01±0.17)mm and(5.79±0.15)mm]of control group,and the differences of them between two groups were significant(t=16.829,19.235,7.200,7.346,P<0.05),respectively.The widths of alveolar bones of tooth root and nasal base of treatment group were all higher than those of control group,and the differences of them between two groups were significant(t=23.566,26.785,P<0.05),respectively.The alveolar bone density and the density surrounding tooth root of treatment group were all higher than those of control group,and the differences of them between two groups were significant(t=6.470,6.042,P<0.05),respectively.The inclinations of upper and lower incisors of treatment group were all higher than those of control group,and the differences of them between two groups were significant(t=3.710,160.815,P<0.05),respectively.The horizontal movement,vertical movement,internal and external movement,and rotational distance of the teeth of treatment group were all larger than those of control group,and the differences of them were significant(t=62.757,115.000,75.000,5.728,P<0.05),respectively.Conclusion:CBCT measurement is of great significance and function during orthodontic treatment,which can realize careful observation and accurate quantitative analysis of alveolar bone morphology changes.

In order to cultivate high-level medical talents, introducing information technology into medical teaching, the teaching faculty of the "Medical Functional Experiment" course constructed and explored an online-offline hybrid experimental problem-based learning (PBL) model guided by hypoxia pathophysiology problems. We explore the teaching method, implementation process, assessment, and effect evaluation of the experimental PBL model from the aspects of teaching objects, online teaching platform setting, and offline application, and also discuss its academic innovation points and application value. We hope to provide ideas for integrating the PBL concept into experimental teaching and help cultivate excellent innovative medical talents.

Objective:To observe and analyze the pathogenic genes and clinical phenotype characteristics of retinitis pigmentosa sinepigmento(RPSP).Methods:A retrospective clinical study. Two patients (proband) and five family members from two RPSP families admitted to Xiamen Eye Center of Xiamen University in December 2022 and Shenzhen Eye Hospital in July 2023 were included in the study. Two families have no blood relationship and were both Han Chinese. Detailed ocular and systemic medical history and specialized examinations were performed for all members, including color fundus photography, fundus autofluorescence (FAF), and full field electroretinogram (ff-ERG) examination. The peripheral venous blood of all members was collected, and genomic DNA was extracted. Pathogenic genes and their loci were screened using whole exome high-throughput sequencing technology. Sanger sequencing was used to verify the pathogenic genes in the two pedigrees. The pathogenicity of candidate variants was evaluated according to the American Society for American College of Medical Genetics and Genomics (ACMG) classification criteria and guidelines for genetic variants.Results:The two probands were male, aged 9 and 7 years, respectively. The main complaint was poor binocular vision for 6 and 3 years and poor treatment effect of amblyopia. The proband (Ⅱ2) in family 1 had a pale red color on the optic disc, with leopard-like changes in the posterior pole and thinner retinal arteries. FAF showed mottled fluorescence attenuation outside the macular vascular arch. There was no significant waveform in both bright and dark visual responses of ff-ERG. He also had 6-toed deformity of both feet, renal cysts, and a slightly overweight body. The clinical diagnosis was non-pigmentary retinitis pigmentosa. The proband of family 2 (Ⅱ1) had poor binocular vision in a dark environment and had atrophy lesions on the nasal side of the optic disc and leopard print like changes in the fundus. FAF showed uneven enhancement in the fovea. ff-ERG showed severe abnormalities in dark and light response, with significant decrease and delay in b-wave amplitude and latency. He had no other systemic abnormalities. The clinical diagnosis was binocular RPSP. There were no abnormal ocular and systemic manifestations in the two family members. Gene sequencing revealed a homozygous mutation (c.534+1G>T) of BBS2 gene, which was inherited from the mother and father respectively. Based on clinical manifestations and genetic testing results, the final diagnosis was Bardet Biedl syndrome. The genetic sequencing results confirmed a novel compound heterozygous mutation (c.950T>G: p. Leu317Arg missense mutation and c.849+1G>C splicing mutation) of BBS7 gene. His father (Ⅰ1) and mother (Ⅰ2) carried M1 heterozygous variants. Combined with the clinical manifestations and genetic testing results, the final diagnosis was Bardet-Biedl syndrome (BBS). Family 2 proband (Ⅱ1) carried the BBS7 gene C.950T>G (p.Leu317Arg) (M2) missense variation and C.849 +1G>C (M3) splice site variation. His father (Ⅰ1) and mother (Ⅰ2) carried M3 shear site variation and M2 missense variation, respectively. The two families all fit the autosomal recessive inheritance pattern, and the genotype and clinical phenotype were coseparated. According to ACMG guidelines, M1, M2 and M3 were all identified as possible pathogenic variants. Conclusions:BBS2 gene M1 homozygous variation and BBS7 gene M2, M3 complex heterozygous variation are the possible pathogenic genes in family 1 and family 2, respectively. Two families are affected by BBS and RPSP, respectively.

The morbidity and mortality rates of head and neck tumors are among the top ten worldwide, among which head and neck squamous cell carcinoma (HNSCC) is the most common type. In recent years, significant breakthroughs have been achieved by immune checkpoint programmed death-1 (PD-1) / programmed death ligand-1 (PD-L1) inhibitors in the treatment of recurrent/metastatic HNSCC, and their potential in the neoadjuvant treatment of locally advanced HNSCC (LA HNSCC) has also garnered widespread attention. Research indicates that neoadjuvant immunotherapy not only significantly improves pathological response rates, but also contributes to better organ function preservation, while maintaining good patient tolerance, offering a new strategy for the treatment of LA HNSCC. In this article, the latest research progress and clinical application prospects of immune checkpoint PD-1/PD-L1 inhibitors in the neoadjuvant treatment of LA HNSCC were reviewed.

ObjectiveTo explore the relationship between smoking behavior and related factors among the adult residents in Fengxian District,so as to provide an evidence for carrying out tobacco control and other health promotion work. MethodsA multi-stage stratified cluster random sampling method was used to select 2 272 community residents aged between 15 and 69 yeas to carry out the questionnaire survey. ResultsIn 2020, the smoking rate of adult residents in Fengxian District was 23.50%. Smoking behavior was statistically correlated with age, gender, household registration, chronic disease, occupation and educational level. Smoking behavior was inversely correlated with educational level. Smoking rate of male residents was significantly higher than that of female residents, smoking rate of residents with chronic diseases was significantly higher than that of those without suffering from chronic diseases, and smoking rate of permanent registered residents was significantly higher than that of those non-locals. The highest smoking prevalence was among retired and freelancers, followed by staff of government agencies and public institutes, while the lowest was among students, followed by intellectuals. Multivariate logistic regression analysis showed that gender, age and education level were the main factors affecting the smoking prevalence level. ConclusionThe general　smoking rate of adult residents in Fengxian District was higher than the average level in Shanghai but lower than the national level. Male residents aged ≥25 years and with lower education level are the key invention targets for tobacco control.

Objective:To construct the core competence evaluation index system of general practice residents by the Delphi method.Methods:After the literature review of home and abroad and group discussion, the core competence evaluation index system of general practice residents in the outpatient environment was preliminarily developed. On this basis, the index system was determined through two rounds of expert consultation. Excel 2015 and SPSS 26.0 were used for data entry and statistical analysis.Results:The active coefficients of the two rounds of expert consultation were 95.0% (19/20) and 100.0% (19/19) respectively, and the degree of authority of the two rounds of expert consultation was 0.86. An index system consisting of 6 first-level indicators and 28 second-level indicators was determined. The 6 first-level indicators were medical services/patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, interpersonal communication, and communication skills.Conclusion:This study has constructed a complete and highly reliable core competence evaluation index system of general practice residents based on the outpatient environment, which can provide reference for the cultivation of the outpatient reception ability of general practice residents in the future.