BACKGROUND: Video-assisted thoracoscopic surgery (VATS) lobectomy is the primary surgical treatment for lung cancer. A significant factor affecting postoperative recovery is prolonged air leak (PAL). Despite numerous clinical strategies could prevent and manage postoperative PAL, its incidence remains high. Phrenic nerve cryotherapy (PNC) temporarily inhibits phrenic nerve function, causing diaphragm elevation, which reduces thoracic cavity volume, enhances pleural apposition, and mitigates air leakage. This study investigates the efficacy of PNC in preventing postoperative PAL during VATS lobectomy. METHODS: A total of 108 eligible lung cancer patients who underwent surgery at the Department of Thoracic Surgery, The Affiliated Hospital of Inner Mongolia Medical University, from June 2023 to January 2025, were enrolled and randomly assigned to the control group (n=54) and the experimental group (n=54). The patients in both the two groups received VATS lobectomy and systematic lymph node dissection, with the experimental group also undergoing PNC during the operation. The baseline characteristics, intraoperative, postoperative indicators and dynamic changes in air leakage between the two groups were compared. RESULTS: The baseline clinical characteristics were comparable between the two groups (P>0.05). The incidence of pulmonary air leakage at 24 h after surgery (31.5% vs 29.6%) and the incidence of postoperative PAL (20.4% vs 14.8%) showed no significant differences between the two groups (P>0.05). The intraoperative air leak test to 24 hours after surgery revealed that air leakage ceased in 8 cases (32.0%) in the control group, compared to 14 cases (46.7%) in the experimental group. Moreover, during the progression from air leakage at 24 hours post-surgery to postoperative PAL, air leakage ceased in 6 cases (35.3%) in the control group and 8 cases (50.0%) in the experimental group, with a statistically significant difference (P<0.001). Compared to the control group, the patients in the experimental group exhibited more pronounced postoperative diaphragmatic elevation that recovered to a slightly higher than preoperative level by 3 mon after surgery. CONCLUSIONS The combination of PNC and active lung repair can serve as an important intervention for patients at high risk of intraoperative air leakage, reducing the occurrence of postoperative PAL.
Humans ; Thoracic Surgery, Video-Assisted/adverse effects* ; Male ; Female ; Middle Aged ; Lung Neoplasms/surgery* ; Aged ; Phrenic Nerve/physiopathology* ; Cryotherapy ; Pneumonectomy/adverse effects* ; Postoperative Complications/etiology* ; Adult

Dental treatments for children and adolescents have unique clinical characteristics that differ from dental care for adults in terms of children's physiology, psychology, and behavior. These differences impose specific requirements on the application of local anesthesia in pediatric dental procedures. This article presents expert consensus on the principles of local anesthesia techniques in pediatric dental therapies, including the use of common anesthetic drugs and dosage control, safety and efficacy evaluation, and prevention and management of complications. The aim is to improve the safety and quality of pediatric dental treatments and offer guidance for clinical application by dentists.
Humans ; Child ; Anesthesia, Local/methods* ; Consensus ; Anesthesia, Dental/methods* ; Adolescent ; Anesthetics, Local/administration & dosage* ; Dental Care for Children

OBJECTIVES: This study aimed to evaluate the clinical application value of in-situ crown reattachment technique combined with pulpotomy in the treatment of complicated crown-root fractures in young permanent anterior teeth. METHODS: A prospective study was conducted on 50 children with complicated crown-root fractures in young permanent anterior teeth, who were treated at the Pediatric Dentistry Department, Hospital of Stomatology, Xi'an Jiaotong University from June 2023 to June 2024. All patients underwent in-situ crown reattachment technique combined with pulpotomy. Clinical examinations, radiographic evaluations, and subjective satisfaction surveys (using a Likert scale of 1-10) were conducted at 1, 6, and 12 months postoperatively. Data were analyzed using SPSS 23.0. RESULTS: The loss-to-follow-up rate was 12% (6/50), with 44 cases completing the 12 months of evaluation. The clinical success rate was 93.18% (41/44), and the radiographic success rate was 97.73% (43/44). The subjective satisfaction scores showed a significant improvement in masticatory function from 7.03±0.52 at 1 month to 8.07±0.92 at 12 months postoperatively (P<0.05), whereas the scores for aesthetics, comfort, and quality-of-life impact showed no statistically significant differences (P>0.05). CONCLUSIONS In-situ crown reattachment technique combined with pulpotomy effectively treats complicated crown-root fractures in young permanent anterior teeth, demonstrating a high short-term clinical success rate, significantly improved masticatory function, and minimally invasive preservation of pulp vitality and root development potential. This technique provides an optimized treatment option for dental trauma in children, although its long-term efficacy requires further validation.
Humans ; Pulpotomy ; Tooth Fractures/surgery* ; Child ; Prospective Studies ; Male ; Female ; Tooth Root/injuries* ; Tooth Crown/injuries* ; Treatment Outcome ; Incisor/injuries* ; Child, Preschool

Objective:To analyze the hard tissue thickness in the crown of primary teeth by CBCT.Methods:The CBCT imaging data of 47 children were included,and the hard tissue thickness of primary teeth was measured by MIMICS software.SPSS 22.0 was used for data analysis.Results:The average thickness in the mesial surfaces was the smallest(P＜0.01),except for the libial surface of maxillary central incisor and the distal surface of mandibular first primary molar.In primary anteriors,the thickness in the same sur-face of maxillary teeth was greater than that of mandibular teeth significantly(P＜0.01)except for the libial surface of primary canine.In primary molars,the thickness of hard tissue in the same part of the distal and lingual side of the maxillary teeth was greater than that of the mandibular teeth(P＜0.01),and the thickness in the buccal side of maxillary teeth was lower than that of the mandibular teeth(P＜0.01).Conclusion:The distribution of hard tissue thickness of primary teeth in different position is different.

AIM: To analyze the clinical characteristics of acute acquired concomitant esotropia(AACE)in patients among different age groups.METHODS: Retrospective analysis of clinical data. A total of 112 non-Swan type AACE patients who underwent surgery at Peking University People's Hospital from January 2015 to December 2022 were retrospectively analyzed. Clinical data were collected and the characteristics were compared, including gender, age, diopter, duration of disease, daily time spent on near work, angles of deviation before and after surgery, stereopsis, etc. According to age, patients were divided into three groups: <18 years old group(22 cases), 18-45 years old group(67 cases), and >45 years old group(23 cases). The clinical characteristics of patients were compared in each group.RESULTS: A total of 112 patients were included in the study, comprising 56 males and 56 females, with a median age of 29.50(19.25, 41.75)years old. Among them, 97 patients had myopia(86.6%). There were 93 patients(83.0%)who spent more than 8 h on near work. The age group <18 years old had the shortest duration before surgery, with a median time of 1.00(0.50, 1.00)a, the minimum negative diopter, with a median diopter of -0.75(-3.19, -0.56)D in the right eye and the diopter of -1.25(-2.81, -0.75)D in the left eye, and the maximum preoperative near angle of deviation, with a median angle of 30.00(18.50, 80.00)PD, and the maximum preoperative distant angle of deviation, with a median angle of 35.00(23.75, 80.00)PD. All these differences were statistically significant compared with other two groups(both P<0.05). For the age group from 18 to 45 years old, the median near angle of deviation was 20.00(14.00, 30.00)PD, and the median distant angle of deviation was 25.00(20.00, 35.00)PD, both of which were higher than those in the age group >45 years old(both P<0.05). For the age group >45 years old, the median near angle of deviation after surgery was -4.50(-7.50, 0)PD, and the median distant angle of deviation after surgery was 4.50(0, 9.50)PD, which were smaller than those in other two groups(all P<0.05). The age group >45 years old had the hiughest surgical success rate(100%). The preoperative stereopsis was better in age group >45 years old than the group <18 years old(P<0.05). The postoperative stereopsis of the age group of 18 to 45 years old and the age group >45 years old was better than age group <18 years old(both P<0.05).CONCLUSION: Surgical patients with AACE are mainly in the age group from 18 to 45 years old. The characteristic of angle of deviation is that distant angle of deviation is greater than near angle of deviation. The patients <18 years old have larger preoperative angles of deviation than adults, while their stereoacuity is worse than adults in the early postoperative period. It is recommended that augmented-dose surgery should be performed in AACE patients who are in the age group of 18 to 45 years old(5-10 PD). A conservative surgery should be designed for hyperopia young children without established binocular vision.

Objective To understand the current status of death anxiety in patients with primary liver cancer and analyze its influencing factors,so as to provide basis for developing individualized psychological guidance and intervention measures.Methods A convenient sampling method was used to select 302 patients with primary liver cancer who were hospitalized in a tertiary hospital in Jiangsu Province from March to November 2022.The General Demographic Information Questionnaire,the Templer's Death Anxiety Scale(T-DAS),the State-Trait Anxiety Inventory(STAI),the Rosenberg Self-esteem Scale(SES)and the Self-perceived Burden Scale(SPBS)were used to conduct questionnaire survey during hospitalization.Single factor analysis and multiple linear regression analysis were applied to analyze the factors influencing the death anxiety in patients with primary liver cancer.Results A total of 298 patients with primary liver cancer were included in the study.The effective recovery rate was 98.68％.The total score of the F-DAS was(7.10±3.43)points;56.38％of the patients had high death anxiety.Multiple linear regression analysis results showed that the factors influencing the death anxiety in patients with primary liver cancer included gender,China liver cancer staging,duration of diagnosis,self-esteem,trait anxiety and self-perceived burden.A total of 49.00％of the variation in death anxiety was explained.Conclusion The death anxiety of patients with primary liver cancer is at a high level.It is suggested that medical staff should pay more attention to female patients with China liver cancer staging IV,diagnosis time＞3 months and low self-esteem,high levels of trait-anxiety and self-perceived burden,in order to develop personalized intervention measures,carry out psychological counseling and emotional support to relieve patients'death anxiety.

Objective:To explore the effect of mobile health (mHealth) management system on dietary behavior of patients with coronary heart disease (CHD) .Methods:Using the convenient sampling method, CHD patients who were hospitalized in Department of Cardiology of Beijing Anzhen Hospital and Beijing Chaoyang Hospital of Capital Medical University were selected as the research objects from June 2019 to January 2020. The research objects were randomly divided into the intervention group and the control group using SAS software. Finally, 68 cases in the intervention group and 66 cases in the control group completed the study. The intervention group received mhealth management, while the control group received routine management, and they were followed up to 1 month after discharge. The proportion of patients with the low-salt and low-oil diet, the intake of salt, oil, staple food, vegetables, fruits, fish, shrimp, poultry and eggs, BMI and blood pressure were compared between the two groups.Results:At 1 month follow-up, the intervention group was better than the control group in terms of low salt and low oil diet, salt intake, oil intake and vegetable intake compliance, and the differences were statistically significant ( P<0.05) . At 1 month follow-up, there were no statistically significant differences in BMI and blood pressure between two groups ( P>0.05) . Conclusions:The mobile health system can effectively increase the proportion of patients with a low-salt and low-oil diet, and improve the intake compliance of salt, edible oil and vegetables in patients with CHD. In future studies, the intervention time should be extended to further explore the long-term intervention effect of mobile health and give full play to the role of mobile health in continuous behavior management of patients with CHD after discharge.

Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF).Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospec tively.The following clinical data of these patients were analyzed,including gender,age,location of treated vertebral body and surgical approach.The image features of endplate injury,fracture line extended to the endplate,adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI.The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods.Results Totally 127 patients were enrolled in our study,including 179 treated vertebral bodies,358 endplates and 341 adjacent intervertebral discs.The incidence of intradiscal cement leakage was 57.73％ (56/97) in endplate injury sign,60.98％ (25/41) in fracture line extended to endplate sign,35.91％(51/142) in adjacent discs injury sign and 55.56％(20/36) inintravertebral cleft sign.The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P＜0.05).The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67％(16/60) and 42.86％(51/119),respectively,which was significant different (P=0.035).For bone cement volume ≤ 5 ml vertebral bodies,the incidence of intradiscal cement leakage was 31.19 ％ (34/109),lower than bone cement volume ＞ 5 ml vertebral bodies (47.14％ [33/70],P=0.031).There was no statistically significant association between intradiscal cement leakage and age,gender and location of treated vertebral body (P＞0.05).Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA.The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage.

Objective To study the diagnostic value and clinical efficacy of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for mediastinal and abdominal lymphadenopathy. Methods Thirty patients who underwent EUS-FNA for mediastinal or abdominal lymphadenopathy between May 2009 and December 2015 were reviewed. The clinical efficacy of EUS-FNA was evaluated by pathological results and the follow-up. The EUS-FNA effect on clinical decision was also analyzed. Results Lesions were located in the mediastinum in 10 cases and in the abdomen in 20 cases. The total diagnostic accuracy, sensitivity, specificity, positive predictive value ( PPV) and negative predictive value ( NPV) of EUS-FNA were 96. 7%, 94. 7%, 100. 0%, 100. 0% and 91. 7%, respectively. Of all the 30 cases, 20 lymph glands were of unknown origin. The diagnostic accuracy, sensitivity, specificity, PPV and NPV of EUS-FNA in these lesions were 95. 0%, 88. 9%, 100. 0%, 100. 0% and 91. 7%, respectively. The combination of cytological and histological examination had higher accuracy ( 96. 7% VS 73. 3%, P=0. 026) and sensitivity ( 94. 7%VS 57. 8%, P= 0. 019 ) than cytological examination only. Immunohistochemistry stains were performed in 12 neoplastic cases, and 11 ( 91. 7%) were confirmed. The diagnosis by EUS-FNA had positive impact on clinical decisions in 27 patients ( 90. 0%) . Conclusion EUS-FNA is an effective approach for mediastinal and abdominal lymphadenopathy, and the result has a positive impact on clinical decisions. The combination of cytological and histological examination and application of ancillary techniques, such as immunohistochemistry stains, can improve the diagnostic efficacy of EUS-FNA.

Objective:To investigate the adhesion,proliferation and differentiation of the stem cells from human exfoliated deciduous teeth(SHEDs)on 3 different types of hydroxyapatite(HA)composite scaffold materials.Methods:Pulp cells from human exfoliated de-ciduous teeth were harvested from impacted deciduous teeth by enzyme digestion,expanded and cultured.Cells were verified by immuno-histochemical methods and in vitro differentiation test.Then the cells were cultured on HA/beta tricalcium phosphate (HA/TCP),HA/collagen (HA/COL)and HA/poly-ethylene propylene lactide (HA/PLGA)scaffold respectively.Adhesion rate was examined at hour 4,6,8 and 10 of culture,proliferation was observed by MTT assay on day 1,4,7 and 10 of culture,respectively.The osteogenic dif-ferentiation was studied by alkaline phosphatase(ALP)test,Von Kossa staining and calcium content measur.Results:The attachment of SHEDs was significantly lower on the HA/COL than on the other 2 scaffolds(P <0.05).The ALP activity,mineralization and calci-um content were the highest on HA/PLGA,and the last on HA/COL(P <0.05).Conclusion:HA/PLGA scaffold is more effective in the promotion of the proliferation,attachment and differentiation of SHEDs than HA/TCP and HA/COL scaffolds.