Objective To compare the effects of different crown materials on the stress distribution of dental implants by finite ele-ment method.Methods A three-dimensional finite element model of implant-supported crown restoration of the right mandibular first molar was established.Four kinds of crown restoration materials were used,including polymer infiltrated ceramic network Vita Enamic,resin nanoceramic Lava Ultimate,zirconia ceramic Cercon,and polyether-ether-ketone breCAM.A displacement load of 0.01 mm or 200 N was applied to the occlusal surface of the right mandibular first molar,and the analysis of reaction force,the maximum variability of shape,the maximum principal stress,the maximum equivalent stress was performed.Results The results of stress analysis under 0.01 mm displacement load showed that the maximum equivalent stress of Cercon was 937.30 MPa,and that of breCAM was 67.09 MPa.The stress concentration of crowns and implants was obvious.The maximum equivalent stress of the surrounding alveolar bone of Cercon was the highest(26.61 MPa),and that of breCAM was the lowest(3.87 MPa),which was about 1/7 of that of maximum group.The stress concentration range of resin-matrix ceramics and polyether-ether-ketone was relatively small,and the distribution was more uniform.When 200 N was applied,the maximum principal stress and the maximum equivalent stress distribution of the four models were similar,and the maximum variability of shape of breCAM was larger at the loading site.Conclusion Under the same displace-ment load,the stress concentration of polyether-ether-ketone and resin-matrix ceramics crown was lower than that of zirconia.There was no significant difference in stress concentration in the implant and surrounding alveolar bone among polyetheretherketone,resin-ceramic composite,and zirconia crown restorations under the same load.Further research on long-term durability of PEEK and resin-matrix ce-ramicsis needed through practical and clinical trials.

Kidney disease affects a large number of people around the world, imposing a significant burden to people's health and life. If early prediction, rapid diagnosis and prognosis prediction of kidney disease can be carried out, the health of patients will be better protected. Machine learning belongs to the category of artificial intelligence, which can be divided into supervised learning, unsupervised learning and reinforcement learning. With the increasing requirements for the processing and analyzing large-scale and high-dimensional data, machine learning is playing an increasingly important role in the medical domain, and the field of kidney disease is no exception. This article presents a comprehensive overview of the application progress of machine learning in kidney disease, aiming to make medical staff's decision-making in kidney disease more early, accurate and rapid, and better escort the life and health of patients.
Humans ; Artificial Intelligence ; Machine Learning ; Kidney ; Kidney Diseases/diagnosis*

Ischemic stroke in young adults has attracted more and more attention due to the diversity of its etiology. Although atherosclerosis is the most common cause of stroke in young adults, other or unknown causes are not uncommon . To improve clinicians′ understanding of the etiological diagnosis of stroke in young adults, this article reports a case of ischemic stroke in the First Affiliated Hospital of Jinan University. The patient was a 22-year-old male with acute onset who was diagnosed with acute ischemic stroke based on clinical presentation, physical examination, and magnetic resonance imaging of the brain. After actively searching for the cause, laboratory and genetic tests revealed that the patient had inherited thrombophilia (protein C and protein S deficiency), and cardiac magnetic resonance imaging examination found that the patient had noncompaction of the ventricular myocardium.

Premature ovarian failure （POF） is a common gynecological endocrine disease ，which can cause follicular development stagnation or premature failure in the ovary ，leading to ovarian function loss ，and seriously affecting women ’s physical and mental health . Traditional Chinese medicine shows less toxicity and side effects but significant effect in the treatment of POF . Chinese herb monomers are the active ingredients of traditional Chinese medicine that exert their effects ，and their chemical structure are determined . From the perspective of Chinese herb monomers ，the author reviewed the mechanism of their effect on improving POF . The results showed that icariin ，quercetin，resveratrol and ginsenoside Rg 1 could improve the ovarian function of POF model animals by activating the phosphatidylinositol 3-kinase/protein kinase B signaling pathway ，inhibiting oxidative stress and apoptosis of granulosa cells ，promoting ovarian autophagy ，and regulating the level of sex hormones ；puerarin and resveratrol can improve the ovarian function of POF model by interfering with Wnt/ β-catenin signaling pathway ，reducing oxidative stress response ，and inhibiting follicular atresia . Although the Chinese herb monomers have certain effect in improving POF，most of them remain in the experimental stage ，and the clinical efficacy in improving POF cannot be objectively evaluated . In the future ，the development of new dosage forms of Chinese herb monomers should be strengthened to lay a foundation for the development of new drugs for treating POF .

Objective:To analyze and discuss the application value and teaching effect of simulate patients (SP)-assisted problem-based learning (PBL) combined with team-based learning (TBL) mode in pediatric first aid teaching, in order to provide a new reference for the reform of standardized residency training and teaching mode of pediatrics in the new era in China.Methods:A total of 103 residents who participated in the standardized training in the Department of Pediatrics of Hunan Children's Hospital from January 2018 to December 2020 were selected as the research objects, and they were divided into the control group (50 cases) and the experimental group (53 cases). The control group adopted the previous teaching mode of residents, while the experimental group adopted the SP-assisted PBL combined with TBL mode. In this study, SPSS 22.0 software was used for t test and chi-square test. Results:The examination scores of the experimental group in the theoretical knowledge of pediatric first aid, clinical thinking and skills, and application of pediatric first aid skills were higher than those in the control group [(86.98±3.42), (85.69±5.13), (89.62±4.75)] vs. [(77.23±4.16), (81.16±3.96), (76.54±5.78)], with statistically significant differences between the two groups ( P<0.05). The questionnaire survey showed that the clinical thinking and pediatric emergency skills, doctor-patient communication ability, teamwork ability and other aspects of the experimental group were significantly better than those of the control group ( P<0.05). Conclusion:The SP-assisted PBL combined with TBL mode can produce positive effects in the standardized residency training of pediatrics, which will help residents better master pediatric first aid skills, improve their clinical comprehensive capabilities, and be more conducive to improving the quality of pediatric residency training, which is worth promoting in the new era.

Objective:To analyze the weight score and clinical application of 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) systemic lupus erythematosus (SLE) classification criteria in lupus nephritis patients.Methods:Lupus nephritis patients with renal biopsy results who were admitted in the First Affiliated Hospital of Zhejiang University College of Medicine between January 2014 and December 2018 were enrolled retrospectively. According to whether these patients were treated with glucocorticoids and/or immunosuppressants at the time of renal biopsy, they were divided into untreated group and post-treatment group. The weight scores were compared between the two groups, and the relationship between each weight score and remission after treatment was analyzed. Taking no remission as the end event, Cox regression analysis was used to analyze the influence of each weighted integral on the end event.Results:A total of 153 patients were enrolled, including 131 (85.6%) females. These were 70 (45.8%) patients in the untreated group and 83 (54.2%) patients in the post-treatment group. The patients in the untreated group had higher scores of fever (>38.3℃), blood system involvement, low complement and positive specific antibodies than those in post-treated group (all P<0.05). In a median follow-up of 34 (6-50) months, 99 patients (64.7%) achieved complete remission, 38 patients (24.8%) achieved partial remission and 16 patients (10.5%) had no remission. With no remission as the endpoint event, univariate Cox regression analysis showed that proliferative lupus nephritis (renal score of 10 points vs 8 points) and neuropsychiatric involvement were the risk factors (both P<0.05), while multivariate Cox regression analysis showed that neuropsychiatric involvement ( HR=4.758, 95% CI 1.324-17.101, P=0.017) was an independent risk factor. Conclusion:The weight scores of 2019 EULAR/ACR SLE classification diagnostic criteria have certain predictive value for remission of patients with lupus nephritis.

Objective:To explore the genetic characteristics and evolution of hantavirus carried by rodents in port area of Ningde in Fujian province in the summer of 2020.Methods:Rodents were captured in the port area of Ningde, the RNA was extracted from rodent lung tissues and detected by using specific kit. The positive samples were used for whole-genome sequencing of the virus. Bioinformatics software was used for the analysis on the similarity and genetic variation of the sequences.Results:A total of 112 rodents were captured, including 5 Rattus norvegicus and 2 Rattus flavipectus, the positive rate of hantavirus was 6.25% (7/112). By virus gene sequencing, two hantavirus complete genome sequences were obtained (named as FJ35 and FJ36, GenBank accession numbers: MW449188-MW449193). The genetic analysis results showed that the hantavirus detected in positive samples were SEOV and shared 99% nucleotide similarity with hantavirus strains LZSF21 and JX20140581 isolated from Shandong province. Phylogenetic analysis using the maximum likelihood method showed that the hantavirus detected in positive samples belonged to S3 subtype, sharing the same subtype with hantavirus strains Z37 from Zhejiang province, LZSF21 from Shandong province, and zy27 and Gongzhuling 415 from northeastern China. Compared with FJ372, the amino acid variation of N259S was observed at sites 251-264 of nucleoprotein, which might be related to antigenicity. Another variation of Q81R was observed in glycoprotein compared with SEOV 80-39 segment of coded amino acid of international reference strain, which might also cause the change in antigenicity. Conclusion:The high positive rate of hantavirus in rodents in the port area of Ningde- would increase the risk of natural human infection and epidemic in local area. The hantavirus positive rodents in this focus might be from an endemic area in Shandong. It is necessary to strengthen the imported rodent control in the port area of Ningde. The virus detected in 2 positive samples belonged to SEOV subtype Ⅲ and shared high homologies of nucleotides and amino acid sequences with the hantavirus strains in surrounding area. However, some slight variations occurred in glycoprotein and nucleoprotein amino acid sequences, which might cause changes in its antigeniity.

Objective To evaluate the role of treadmill exercise‐stress echocardiography in the assessment of left ventricular ( LV ) function in patients with slow coronary flow ( SCF ) ,and discuss the possible mechanism of SCF . Methods Forty‐six patients with diagnosis of SCF were enrolled as SCF group . Forty age and sex matched adults were included as control group . All subjects had underwent clinical evaluation and exercise stress echocardiography . LV diastolic and systolic functions were assessed by conventional echocardiography , tissue Doppler imaging and two‐dimensional speckle tracking echocardiography at rest and during exercise . Results ①LV function in patients with SCF at rest :LV peak systolic longitudinal strain ( LS) was lower in patients with SCF than that in controls ( P ＜0 .05) . T here was no difference of LV ejection fraction ( LVEF) between the two group( P＞0 .05) . Early diastolic mitral annulus velocity ( M itral e′) and the ratio between the early mitral inflow velocity and Mitral e′( M itral E/e′) were significantly decreased in SCF group( all P＜0 .01 ) . ②LV function during exercise :LVEF ,LS and M itral e′were significant increased in two groups ( all P ＜0 .05 ) than those at rest ,but there was no significant difference of LVEF ,LS ,M itral e′ and M itral E/e′ between the two groups ( all P ＞ 0 .05 ) . Compared with control group ,ΔLS and ΔM itral e′were significantly higher in SCF group ( all P＜0 .05 ) . Conclusions LV systolic and diastolic function in patients with SCF are impaired at rest . LV systolic and diastolic function recover in patients with SCF during exercise .

Objective? To expLore the effects of network interactive heaLth education on iLLness uncertainty, anxiety and nursing satisfaction of famiLy members of intensive care unit (ICU) patients. Methods? From March 2017 to February 2018, we seLected 166 famiLy members of ICU patients at a CLass ⅢGrade A hospitaL in Daqing City as subjects by convenience sampLing. ALL of the famiLy members were divided into controL group (n=78) and observation group (n=88) according to the admission order of patients to ICU. ControL group impLemented routine heaLth education. On the basis of that in controL group, observation group carried out network interactive heaLth education. The iLLness uncertainty, anxiety and nursing satisfaction of famiLy members were compared between two groups two weeks after intervention. ResuLts? After intervention, the scores of iLLness uncertainty and SeLf-Rating Anxiety ScaLe (SAS) of observation group were (72.10±3.68) and (40.13±4.63) respectiveLy Lower than those of controL group with statisticaL differences (t=5.10, 3.59; P＜0.05);the famiLy members' satisfactions with nursing care of observation group and controL group were 97.7% and 93.6% respectiveLy with no statisticaL difference (P＞ 0.05). ConcLusions? Network interactive heaLth education can reduce the iLLness uncertainty and anxiety of ICU patients' famiLy members which is worthy of cLinicaL generaLization.

Objective To compare the clinical efficacy of aescuven fort and indomethacin in the prevention of heterotopic ossification (HO) after operative treatment of radial head fractures with anterior bundle of medial collateral ligament(AMCL) injury.Methods A total of 41 patients with radial head fracture combined with AMCL injury leading to elbow valgus instability were randomly divided into 21 cases of the observation group(aescuven fort) and the 20 cases of control group(indomethacin),and were treated with aescuven fort of 600rng/d and indomethacin of 75rng/d for 6 weeks respectively.The incidence of adverse reactions of gastrointestinal tract in the two groups was statistically analyzed,and symptomatic treatment was given.Six weeks later,the incidence of HO was recorded by X-ray examination of the elbow joint.The range of motion (ROM) was recorded,and the excellent and good rate of the improved HSS score was calculated.The results were statistically analyzed.Results The incidence rates of gastrointestinal side effects in the observation group and control group were 9.5％ and 35.0％,respectively,and the difference was statistically significant between the two groups(x2 =4.651,P =0.027).The incidence rate of HO in the observation groupwas 14.3％,which in the control group was 15.0％,there was no significant difference between the two groups(x2 =0.206,P =0.948).The ROM and excellent and good rate of the improved HSS score in the observation group and control group were [(119.2 ± 19.7) ° and 86.9％]and [(120.8 ± 16.3) ° and 88.7％],respectively,and the differences were statistically significant(t =2.023,P=0.613;x2 =0.176,P =0.675).Conclusion Aescuven fort can effectively prevent the formation of HO after operative treatment of radial head fracture with AMCL injury,similar with indomethacin.But the incidence rate of gastrointestinal side effects of aescuven fort is significantly lower than indomethacin.