OBJECTIVES: To investigate the clinical application of the digital-assisted reconstruction of the mandible and tumors with free fibula transplantation and immediate implantation via the intraoral approach. METHODS: Twelve patients with benign mandibular tumors were collected. Three-dimensional mandibular reconstruction was performed digitally before surgery to simulate mandibular tumor resection, fibula resection and reconstruction, and implant implantation. The intraoperative resection of the mandibular tumor was conducted through the intraoral approach under the guidance of a guide plate, and fibula resection, molding, reconstruction, and oral fixation were immediately performed. Implant implantation was performed during the second phase of implant surgery and denture restoration was performed 1-2 months after surgery. RESULTS: The types of mandibular defects were BrownⅠ (one case), Ⅰc (four cases), Ⅱ (one case), Ⅱc(three cases), and Ⅲ (three cases). The length of the fibular bone was 12-22 cm. The number of fibular molding amputations was as follows: two cases in two segments, six cases in three segments, three cases in four segments, and one case in five segments. All of these cases underwent folding fibular reconstruction of mandibular and alveolar bone defects. A total of 44 implants were implanted, and none failed after operation. CONCLUSIONS The intraoral approach is a reliable method for the resection of mandibular benign tumors, with few postoperative complications and the ability to position and fix accurately the reconstructed folded fibula under digital design. The immediate implantation of the transplanted fibula does not affect the blood supply and has a high success rate. It is an effective and reliable method for the resection and reconstruction of mandibular benign tumors.
Humans ; Fibula/transplantation* ; Mandibular Neoplasms/surgery* ; Mandibular Reconstruction/methods* ; Bone Transplantation/methods* ; Male ; Middle Aged ; Female ; Mandible/surgery* ; Adult ; Free Tissue Flaps ; Surgery, Computer-Assisted

Objective: To understand the oral health status and associated factors of preschool children with disabilities in Bengbu City, so as to provide evidence for preventing dental caries in children with disabilities. Methods: From September 2021 to March 2022, a total of 405 preschool children with disabilities from two rehabilitation institutions in Bengbu were randomly selected for oral health examination, questionnaire survey and physical examination. The caries prevalence rate among disabled children was analyzed. After grouping based on childrens BMI, the correlation between body mass index (BMI) and dental caries among children was explored. Multivariate binary Logistic regression analysis was employed to investigate the factors associated with dental caries occurrence in children. Results: The prevalence of dental caries in preschool children with disabilities was 74.07%, with rates of 71.01% for boys and 77.27% for girls. There was a significant difference in caries prevalence between boys and girls aged 5（66.67%，88.24%） (χ2=7.53, P<0.05). There were significant differences in the dmft index among different BMI groups (underweight: 240, normal weight: 606, overweight:30,obese:60,H=35.66,P<0.05). BMI was negatively correlated with dmft（r=-0.50，P＜0.01）. Frequent tooth brushing (2-3 times daily), the use of fluoride toothpaste, limited intake of sugary foods (< 2 times/d) in the past six months, and exclusively breastfeeding within first six months were negatively correlated with the occurrence of dental caries in disabled children (OR=0.09，0.41，0.24, P＜0.05). Sleep forward to eat，parental education level of junior high school or lower, and parental education of vocational school or high school were positively correlated with dental caries (OR=3.18，5.95，3.99，66.95，7.75，P＜0.05). Conclusions The caries prevalence rate of disabled children in Bengbu City is high and is influenced by multiple factors. It is time to strengthen the oral health training for parents and teachers in educational institutions, pay attention to childrens oral health care, and help disabled children improve their quality of life.

ObjectiveTo investigate the clinical efficacy of Gandouling tablet （GDL） on abnormal lipid metabolism in Wilson's disease （WD） and the correlation between the prediction model of hepatic steatosis and the related indexes of lipid metabolism in WD. MethodA total of 86 patients with abnormal lipid metabolism in WD were selected. The 24-hour urine copper， alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， serum triglyceride （TG）， total cholesterol （TC）， apolipoprotein B （ApoB）， low density lipoprotein cholesterol （LDL-C）， bile acid （BA）， γ-glutamyl transferase （GGT）， prediction model of hepatic steatosis ［hepatic steatosis index （HSI） and Zhejiang University index （ZJU index）］， ultrasonic attenuation coefficient imaging （ATT）， and traditional Chinese medicine （TCM） syndrome score were statistically analyzed before treatment. Pearson correlation test was used to analyze the correlation between TG， TC， LDL-C， ApoB， ALT， AST， ALT/AST， BA， GGT， TCM syndrome score， ATT， and HIS and ZJU. The patients were divided into an observation group and a control group by random number table method， with 43 cases in each group. The observation group was treated with GDL combined with sodium dimercaptopropane sulfonate （DMPS）， while the control group was only treated with DMPS as a control. After six courses of treatment， 24-hour urine copper， TC， TG， LDL-C， ApoB， HSI， ZJU， ATT， TCM syndrome score， and clinical efficiency before and after treatment were observed and compared between the two groups. The correlation between HSI and ZJU and serum TC， TG， LDL-C， ApoB， ALT， AST， ALT/AST， BA， GGT， TCM syndrome scores， and ATT was analyzed. ResultPearson correlation analysis showed that serum TC （r = 0.811）， TG （r = 0.826）， LDL-C （r = 0.802）， ApoB （r = 0.820）， ALT （r = 0.497）， ALT/AST （r = 0.826）， TCM syndrome score （r = 0.716）， and ATT （r = 0.736） were positively correlated with HSI （P<0.01）， while AST， BA， and GGT had no significant correlation with HSI. TC （r = 0.718）， TG （r = 0.765）， LDL-C （r = 0.667）， ApoB （r = 0.699）， ALT/AST （r = 0.403）， TCM syndrome score （r = 0.666）， and ATT （r = 0.684） were positively correlated with ZJU （P<0.01）. ALT， AST， BA， and GGT had no significant correlation with ZJU. The total effective rate of the observation group was 86.05 （37/43）， and that of the control group was 72.09% （31/43）. The total effective rate of the observation group was higher than that of the control group （Z = -2.301， P<0.05）. After treatment， the 24-hour urine copper of the two groups increased significantly. The levels of TC， TG， LDL-C， and ApoB were significantly decreased， and the HSI， ZJU， and ATT were significantly decreased （P<0.01）. Compared with those in the control group after treatment， the above indexes improved better in the observation group （P<0.05， P<0.01）. ConclusionGDL can effectively improve the level of copper and lipid metabolism in patients with WD， with high clinical safety and good clinical application value. The prediction model of hepatic steatosis can effectively reflect the degree of abnormal lipid metabolism in WD.

Objective:To explore the structural characteristics of intestinal microflora in children with non-alcoholic fatty liver disease（NAFLD）and the relationship between intestinal microflora and the occurrence as well as development of NAFLD in children.Methods:Fifteen children with NAFLD diagnosed at the First People's Hospital of Yunnan Province from January 2022 to December 2022 were selected as subjects，and 15 healthy children who received routine physical examinations at the outpatient clinic during the same period were randomly selected as healthy control group.The height，weight，waist circumference，blood pressure，blood biochemistry of all children were collected.At the same time，the fresh fecal samples of all children were collected，and the biological information of intestinal flora was analyzed by 16S rRNA sequencing.Results:In the NAFLD group，there were eight males and seven females，with an average age of（11.13±1.77）years.In healthy control group，there were seven males and eight females，with an average age of（9.73±2.25）years.There were no significant differences in sex，age，blood pressure between two groups.Compared with the healthy control group，the levels of body mass index，waist circumference，waist-to-height ratio，alanine aminotransferase，aspartate transaminase，gamma-glutamyl transpeptidase，total bilirubin，direct bilirubin，unconjugated bilirubin，low density lipoprotein cholesterol，uric acid and serum insulin significantly increased and high density lipoprotein cholesterol significantly decreased in NAFLD group（ P<0.05）.The results of species diversity analysis showed that chaol index and observed-species index in NAFLD group were significantly higher than those in healthy control group（ P<0.05）.Species diversity analysis showed that the species with increased abundance in NAFLD group included：Proteobacteria，Gammaproteobacteria，Enterobacteriaceae，Klebsiella，Escherichia-Shigella，Escherichia-Shigella-unclassified.Differential species with increased abundance in the healthy control group included：Bifidobacterium species，Bifidobacterium，Bifidobacteriaceae，Bifidobacteriales，Actinobacteria，Actinobacteriota，Bacteroidia，Bacteroidales，Streptococcus-thermophilus. Conclusion:There are metabolic abnormalities and obvious changes in the structure of intestinal flora in children with NAFLD.Exogenous supplementation of Bifidobacterium，Streptococcus thermophilus and Bacteroides may prevent the occurrence of NAFLD，delay the progression of disease and improve fat deposition in the liver.

Objective To study the influence of implant depth and scanning rod lengths on the accuracy of digital impression for single-tooth implant restoration of the mandibular posterior teeth.Methods Five standard dental cast models with missing right mandibular first molar(46)were prepared with the subgingival implant depths of 0,1,3,5 and 7 mm.ITI RC and ITI RC H11 scanning rods were connected to the replacement body and placed into the seating tract for scanning.The reference data were obtained using a 3D dental scanner,and the experimental data were obtained by 10 scans of each model using a digitized intraoral scanner.Geomagic Wrap 2021 was used to analyze the model data to test the trueness and precision of the models.Results The trueness did not differ significantly among the groups(P>0.05).The implant depth of 1 mm achieved the highest impression precision(66.81±2.45 μm),and the depth of 0 mm resulted in a significantly lower precision(95.60±3.04 μm)than the depth of 1 and 3 mm.Starting from the subgingival depth of 1 mm,the precision of the scan decreased progressively with the increase of the implant depth.At the subgingival implant depth of 5 or 7 mm,the use of an extended rod significantly improved the scan precision.Conclusion For single-tooth implant restoration of the mandibular posterior teeth,the implant depth can substantially affect the accuracy of digital impression,which decreases as the implant depth increases.For a deep implant,the use of a longer scanning rod can improve the scanning accuracy.

Objective To explore and organize the standards of rehabilitation big data. Methods The connotation and extension of rehabilitation big data were discussed based on International Classification of Functioning,Disability and Health(ICF)framework.Referring to the documents of Guidance on the analysis and use of routine health information systems rehabilitation module,Rehabilitation in health systems:guide for action,Rehabilitation indicator menu:a tool accompanying the Framework for Rehabilitation Monitoring and Evaluation(FRAME),and Data quality assurance.Module 1.Framework and metrics,the sources,patterns,clas-sification systems and coding standards were discussed under the ICF theory,and the metadata standards were ex-plored.The application and management of rehabilitation big data standards were discussed according to Nation-al Health Medical Big Data Standards,Security and Service Management Measures(Trial). Results The rehabilitation big data included rehabilitation service data and personal health data,coming from population-based and institution-based data,covering macro,meso and micro levels.The pattern of rehabilitation data flow corresponded to the interaction and source of the entire process of rehabilitation service,to organize and manage rehabilitation big data.The classification system included object classes,object feature classes,participant role classes,relationship classes,and activity and event classes,each of which was further subdivided into subcatego-ries to cover the entities,features,roles,relationships and activities involved in the rehabilitation process.The metadata standards included three levels:core,general and specialized metadata,ensuring standardized manage-ment,sharing and interoperability of rehabilitation data. Conclusion This study delves into the standardization of rehabilitation big data based on the ICF framework,encompass-ing multiple dimensions such as the connotation and extension of rehabilitation big data,data sources,data mod-els,classification systems,coding standards,and metadata standards.The construction of a rehabilitation big data standard system involves standardization efforts in various aspects,including data content,data structure,data coding,and metadata.These standards not only adhere to the norms of data flow,but also take into account the complexity of data composition.This system aligns with health big data standards,ensuring data consistency,ac-curacy,and interoperability,thus providing a foundation for effective exchange and comparison between different data sources.The establishment of a rehabilitation big data standard system not only ensures the standardized pro-cessing of rehabilitation big data,but also lays a solid foundation for effective exchange between rehabilitation big data and other health data,as well as for the widespread application of rehabilitation big data.This provides crucial support for improving the quality and efficiency of rehabilitation services,ensuring that patients receive appropriate care,rehabilitation and support.It holds significant theoretical and practical implications for promot-ing the development of the rehabilitation field.

Objective To study the influence of implant depth and scanning rod lengths on the accuracy of digital impression for single-tooth implant restoration of the mandibular posterior teeth.Methods Five standard dental cast models with missing right mandibular first molar(46)were prepared with the subgingival implant depths of 0,1,3,5 and 7 mm.ITI RC and ITI RC H11 scanning rods were connected to the replacement body and placed into the seating tract for scanning.The reference data were obtained using a 3D dental scanner,and the experimental data were obtained by 10 scans of each model using a digitized intraoral scanner.Geomagic Wrap 2021 was used to analyze the model data to test the trueness and precision of the models.Results The trueness did not differ significantly among the groups(P>0.05).The implant depth of 1 mm achieved the highest impression precision(66.81±2.45 μm),and the depth of 0 mm resulted in a significantly lower precision(95.60±3.04 μm)than the depth of 1 and 3 mm.Starting from the subgingival depth of 1 mm,the precision of the scan decreased progressively with the increase of the implant depth.At the subgingival implant depth of 5 or 7 mm,the use of an extended rod significantly improved the scan precision.Conclusion For single-tooth implant restoration of the mandibular posterior teeth,the implant depth can substantially affect the accuracy of digital impression,which decreases as the implant depth increases.For a deep implant,the use of a longer scanning rod can improve the scanning accuracy.

Objective To analyze the interventional effect of high-flow nasal cannula oxygen (HFNC) therapy in patients with stable chronic obstructive pulmonary disease (COPD) combined with hypercapnia. Methods A total of 45 patients with stable COPD complicating with hypercapnia who require long-term oxygen therapy were selected as study subjects. They were divided into three groups based on different respiratory support modes: long-term home oxygen therapy (LTOT) group, non-invasive ventilation (NIV) group, and HFNC group, with 15 patients in each group. The general condition, blood gas index, lung function index, respiratory status, quality of life, and walking test results of the three groups were compared after discharge. Results During the follow-up period, the number of admission and acute exacerbation in the HFNC group and NIV group was lower than that in the LTOT group (P < 0.05). At 6 and 12 months after discharge, the arterial partial pressure of carbon dioxide [p_a(CO₂)] in the three groups was lower than before discharge, while the arterial partial pressure of oxygen[p_a(O₂)], pulse oxygen saturation (SpO₂), forced vital capacity (FVC), and forced expiratory volume in one second (FEV₁) were higher than before discharge. Moreover, the changes in the above indicators in the HFNC group were greater than those in the NIV group and LTOT group (P < 0.05). At 1-, 3-, 6-, and 12-month after discharge, the scores of dyspnea scale of the modified Medical Research Council (mMRC) and the St. George′s Respiratory Questionnaire (SGRQ) in the three groups gradually decreased, and the 6-minute walking distance (6MWD) gradually increased. Additionally, the changesin the above indicators in the HFNC group were greater than those in the NIV group and LTOT group (P < 0.05). Conclusion HFNC can effectively alleviate dyspnea symptoms, improve lung function, promote the recovery of blood gas indicators, enhance quality of life and exercise tolerance, and reduce re-hospitalization rates in patients with stable COPD combined with hypercapnia.

Objective To rescue a recombinant oncolytic influenza virus chimeric with IL-21 and evaluate its inhibitory effects and safety against hepatocell ular carcinoma(HCC)both in vitro and in vivo,and to explore the mechanism by which this virus enhances antitumor effects when combined with anti-programmed cell death protein 1(anti-PD-1)antibody.Methods The IL-21 gene fragment was inserted into the nonstructural protein(NS)sequence of the influenza virus PR8 using reverse genetics(RG)technology to rescue the recombinant oncolytic influenza virus rOV-IL-21-NS.The virus titer and virulence were determined using the 50％tissue culture infectious dose(TCID50)and hemagglutination assays.The successful insertion of the exogenous gene into the NS sequence was verified using RT-qPCR,gel electrophoresis,and sequencing analysis.Viral morphology and size were observed with transmission electron microscopy.The impact of the virus on the viability of hepatocellular carcinoma cells was assessed with CCK-8 assay.A subcutaneous tumor model of HCC was established in 45 female C57BL/6 mice(8 weeks old,weighing 16～20 g),and then the mice were randomly assigned into PBS,PR8,anti-PD-1,rOV-IL-21-NS,and the rOV-IL-21-NS+anti-PD-1 treatment groups,with 9 mice in each group,to evaluate the anti-tumor effects of monotherapy versus combination therapy.Flow cytometry was conducted to assess the regulatory effects of monotherapy and combination therapy on the tumor immune microenvironment.Results RG technology successfully rescued the recombinant oncolytic influenza virus rOV-IL-21-NS.Sequencing confirmed the successful insertion of IL-21 into the target sequence,and the obtained virus could be stably propagated,with its sixth passage reaching a hemagglutination titer of 211,and a viral titer of 6 Log10(TCID50/mL).Oncolytic virus rOV-IL-21-NS,at a multiplicity of infection(MOI)of 3,selectively reduced the viability of HCC cells without significantly affecting normal liver cells.Compared to the control group,the combination of rOV-IL-21-NS and anti-PD-1 antibodies significantly inhibited tumor growth(P＜0.001)and increased the proportions of CD4+T and CD8+T cells in the spleen tissue of the mouse model of subcutaneous HCC tumor(P＜0.001).Conclusion The recombinant oncolytic influenza virus rOV-IL-21-NS chimeric with IL-21 can effectively and safely exert targeted killing to HCC cells,enhance T cell activation by synergizing with anti-PD-1 antibodies,and improve the immune microenvironment.

Objective To investigate the clinical features of the spectrum of upper gastrointestinal diseases in children and to provide assistance in the prevention,diagnosis and treatment of upper gastrointestinal diseases in children.Methods Clinical data of 424 children aged 2 months to 14 years who were hospitalised for gastroscopy in the paediatrics department of the First People's Hospital of Yunnan Province from January 2018 to June 2023 were collected,and retrospective analyses were performed for the children's clinical presentation,gastroscopy results,and HP infections.Results The symptoms of vomiting and diarrhea in infants were significantly different from those in preschool and school age groups(P＜0.05).The positive rate of lesions under gastroscopy was 96.46％.The main diseases found were non-atrophic gastritis(222 cases),bile reflux gastritis(42 cases),non-atrophic gastritis with erosion(30 cases),duodenitis(25 cases),reflux esophagitis(15 cases)and others(75 cases).Helicobacter pylori(HP)was detected in 300 of the 424 cases,and 105 cases were HP positive,with a detection rate of 35.00％.Conclusion Abdominal pain was the main symptom of upper gastrointestinal diseases in school-age and pre-school children.Vomiting and diarrhea were the main symptoms of upper gastrointestinal diseases in infants.There was no gender difference in HP infection,but there was a difference in age.