ObjectiveTo observe the clinical efficacy and safety of Tangning Tongluo tablets in the treatment of nonproliferative diabetic retinopathy （DR）. MethodsFourteen research centers participated in this study， which spanned a time interval from September 2021 to May 2023. A total of 240 patients with nonproliferative DR were included and randomly assigned into an observation group （120 cases） and a control group （120 cases）. The observation group was treated with Tangning Tongluo tablets， and the control group with calcium dobesilate capsules. Both groups were treated for 24 consecutive weeks. The vision， DR progression rate， retinal microhemangioma， hemorrhage area， exudation area， glycosylated hemoglobin （HbA1c） level， and TCM syndrome score were assessed before and after treatment， and the safety was observed. ResultsThe vision changed in both groups after treatment （P<0.05）， and the observation group showed higher best corrected visual acuity （BCVA） than the control group （P<0.05）. The DR progression was slow with similar rates in the two groups. The fundus hemorrhage area and exudation area did not change significantly after treatment in both groups， while the observation group outperformed the control group in reducing the fundus hemorrhage area and exudation area. There was no significant difference in the number of microhemangiomas between the two groups before treatment. After treatment， the number of microhemangiomas decreased in both the observation group （Z=-1.437， P<0.05） and the control group （Z=-2.238， P<0.05）， and it showed no significant difference between the two groups. As the treatment time prolonged， the number of microhemangiomas gradually decreased in both groups. There was no significant difference in the HbA1c level between the two groups before treatment. After treatment， the decline in the HbA1c level showed no significant difference between the two groups. The TCM syndrome score did not have a statistically significant difference between the two groups before treatment. After treatment， neither the TCM syndrome score nor the response rate had significant difference between the two groups. With the extension of the treatment time， both groups showed amelioration of TCM syndrome compared with the baseline. ConclusionTangning Tongluo tablets are safe and effective in the treatment of nonproliferative DR， being capable of improving vision and reducing hemorrhage and exudation in the fundus.

Objective To explore the application value of microwave ablation under ultrasound-magnetic resonance imaging(US-MRI)in the treatment of small liver cancer.Methods A total of 94 patients with small liver cancer were selected and randomly divided into observation group and control group using a random number table method,with 47 patients in each group.The observation group underwent microwave ablation under US-MRI,while the control group received surgical resection.The tumor control rate,periopera-tive indicators,liver function indicators[total bilirubin(TBIL),albumin(ALB),aspartate aminotransferase(AST),and alanine amin-otransferase(ALT)],postoperative complications,and 6-month follow-up status were compared between the two groups.Results There was no significant difference in tumor control rate between the two groups(P>0.05).In the observation group,the proportion of patients with smaller intraoperative blood loss,shorter operative time and postoperative performance status(PS)score of 0-1 was higher than those in the control group(P<0.05).After treatment,the levels of TBIL,AST and ALT were lower and the level of ALB was higher,and the incidence of complications was lower in the observation group(P<0.05).There were no significant differences between the two groups in residual lesion and recurrence(P>0.05).Conclusion The short-term efficacy of microwave ablation under US-MRI in the treatment of small liver cancer is similar to that of surgical treatment,and the microwave ablation under US-MRI can also reduce liver function injury,reduce intraoperative blood loss and shorten operation time.

Objective To analyze the willingness and influencing factors of doctors in Beijing public hospitals to set up clinics in the community,and to provide scientific basis for promoting quality health technicians to go down to the grassroots and realize hierarchical diagnosis and treatment.Methods Doctors from 6 specialized hospita ls and 3 general hospitals in Beijing were selected as subjects for questionnaire survey.By stratified sampling,a questionnaire survey was conducted on 518 doctors from 9 public hospitals in Beijing through stratified sampling method.Descriptive analysis,rank sum test and ordered logistic regression were used to explore doctors'willingness to open clinics and its influencing factors.Results In all survey respondents,212(40.93%)physicians were very or somewhat willing to open a clinic in the community,physicians with higher benefit perception,and greater willingness to publicize relevant policies were more willing to set up clinics.Conclusion Opening of clinics by doctors in public hospitals is affected by perceived benefits and willingness to advocate policies.It is suggested to further improve relevant systems and policies,reduce the risk of doctors opening clinics,and promote doctors in public hospitals to open clinics in communities,so as to realize the sinking of high-quality health human resources to the grassroots.

Middle compartment defects,a common subtype of pelvic floor dysfunction(PFD),are primarily characterized by the prolapse of the uterus or vaginal vault.Magnetic resonance imaging(MRI)has emerged as a valuable diagnostic tool for PFD,offering superior soft tissue resolution while eliminating exposure to ionizing radiation.This review comprehensive summarizes current applications of MRI in the diagnosis and treatment of PFD,covering measurement methods,manifestations of three-level structural defects,postoperative efficacy evaluation,vaginal axial assessment,and evaluation of the mesh status.The authors suggest that MRI enables precise preoperative evaluation of three-level defects,thereby facilitating the development of personalized treatment plans.Additionally,MRI provides an accurate postoperative assessment of surgical outcomes and mesh status,offering a new basis for postoperative assessment.MRI demonstrates unique value in the diagnosis and treatment of middle compartment defects.

The anatomical morphology of root canal systems in maxillary second molars (MSMs) is complex and shows diverse variations, which leads to challenging root canal treatments that could end in failure. Therefore, understanding the diverse nature of root canal anatomy is an important prerequisite for the successful treatment of MSMs. The fused root is among the most prevalent root variants of MSMs, exhibiting a distribution rate ranging from 23.9% to 42.25% within the Chinese population. Fused roots are often accompanied by complex root canal fusion, as the incidence of root canal fusion in type VI fused roots of MSMs is 90.5% within the Chinese population. There are several treatment strategies for the root canal variations in MSMs, including the location of the root canal orifice and clearing and filling of the isthmus within the fused root canal. Cone-beam computed tomography, dental operating microscopy, and digital dynamic and static navigation technologies can be employed to accurately identify the root canal variations associated with fused roots. In the treatment of fused root canals, for the cleaning and filling of the isthmus in fused canals, enhanced chemical preparation, timely application of laser-assisted irrigation, photodynamic therapy, and micro-apical surgery significantly improve the success rate of endodontic procedures. The treatment strategies and prevalence of root canal variation of MSMs from a native Chinese population were summarized in this paper to provide guidance and reference for the successful treatment of MSMs.

Objective To provide experimental evidence for selecting acupuncture timing in clinical practice,the optimal time for enhancing the brain effects of electroacupuncture at the Hegu acupoint(LI4)by observing brain imaging data,hemodynamic changes and differences in brain functional connectivity across the twelve traditional Chinese time periods were determined.Methods Thirty-six C57BL/6 mice were randomly divided into 12 groups corresponding to each of the twelve time periods(Zi,Chou,Yin,Mao,Chen,Si,Wu,Wei,Shen,You,Xu,Hai),with 3 mice per group.Each mouse received electroacupuncture stimulation using the same protocol.Brain imaging data and dynamic hemodynamic changes were collected using functional ultrasound imaging(FUS)ultrasound imaging technology every 0.4 s over a total duration of 420 s,covering pre-acupuncture(resting state),during acupuncture(task state),and post-acupuncture(post-task state)phases.The hippocampal region(HIP)was used as the observation point to analyze changes in functional connectivity between HIP and other brain regions before and after acupuncture.Results Compared to other time periods,the Mao group exhibited the largest whole-brain activation area and the highest average activation signal intensity.The hemodynamic signal increase in the hippocampal region was more pronounced,and the post-acupuncture blood flow signal intensity remained significantly higher than the pre-acupuncture resting state.Functional connectivity data revealed that,using 0.2 as the standard value,the Mao group showed the greatest number of altered brain regions before and after acupuncture.Notably,only in the Mao group was there a significant enhancement in connectivity between the bilateral hippocampal regions.Conclusion The immediate effects of electroacupuncture at the Hegu acupoint(LI4)and brain functional connectivity vary significantly across different time periods,aligning with the traditional Chinese medicine theory of meridian qi and blood flow.Mao time is identified as the optimal period.

Objective To explore the application value of microwave ablation under ultrasound-magnetic resonance imaging(US-MRI)in the treatment of small liver cancer.Methods A total of 94 patients with small liver cancer were selected and randomly divided into observation group and control group using a random number table method,with 47 patients in each group.The observation group underwent microwave ablation under US-MRI,while the control group received surgical resection.The tumor control rate,periopera-tive indicators,liver function indicators[total bilirubin(TBIL),albumin(ALB),aspartate aminotransferase(AST),and alanine amin-otransferase(ALT)],postoperative complications,and 6-month follow-up status were compared between the two groups.Results There was no significant difference in tumor control rate between the two groups(P>0.05).In the observation group,the proportion of patients with smaller intraoperative blood loss,shorter operative time and postoperative performance status(PS)score of 0-1 was higher than those in the control group(P<0.05).After treatment,the levels of TBIL,AST and ALT were lower and the level of ALB was higher,and the incidence of complications was lower in the observation group(P<0.05).There were no significant differences between the two groups in residual lesion and recurrence(P>0.05).Conclusion The short-term efficacy of microwave ablation under US-MRI in the treatment of small liver cancer is similar to that of surgical treatment,and the microwave ablation under US-MRI can also reduce liver function injury,reduce intraoperative blood loss and shorten operation time.

Objective To provide experimental evidence for selecting acupuncture timing in clinical practice,the optimal time for enhancing the brain effects of electroacupuncture at the Hegu acupoint(LI4)by observing brain imaging data,hemodynamic changes and differences in brain functional connectivity across the twelve traditional Chinese time periods were determined.Methods Thirty-six C57BL/6 mice were randomly divided into 12 groups corresponding to each of the twelve time periods(Zi,Chou,Yin,Mao,Chen,Si,Wu,Wei,Shen,You,Xu,Hai),with 3 mice per group.Each mouse received electroacupuncture stimulation using the same protocol.Brain imaging data and dynamic hemodynamic changes were collected using functional ultrasound imaging(FUS)ultrasound imaging technology every 0.4 s over a total duration of 420 s,covering pre-acupuncture(resting state),during acupuncture(task state),and post-acupuncture(post-task state)phases.The hippocampal region(HIP)was used as the observation point to analyze changes in functional connectivity between HIP and other brain regions before and after acupuncture.Results Compared to other time periods,the Mao group exhibited the largest whole-brain activation area and the highest average activation signal intensity.The hemodynamic signal increase in the hippocampal region was more pronounced,and the post-acupuncture blood flow signal intensity remained significantly higher than the pre-acupuncture resting state.Functional connectivity data revealed that,using 0.2 as the standard value,the Mao group showed the greatest number of altered brain regions before and after acupuncture.Notably,only in the Mao group was there a significant enhancement in connectivity between the bilateral hippocampal regions.Conclusion The immediate effects of electroacupuncture at the Hegu acupoint(LI4)and brain functional connectivity vary significantly across different time periods,aligning with the traditional Chinese medicine theory of meridian qi and blood flow.Mao time is identified as the optimal period.

Objective To analyze the willingness and influencing factors of doctors in Beijing public hospitals to set up clinics in the community,and to provide scientific basis for promoting quality health technicians to go down to the grassroots and realize hierarchical diagnosis and treatment.Methods Doctors from 6 specialized hospita ls and 3 general hospitals in Beijing were selected as subjects for questionnaire survey.By stratified sampling,a questionnaire survey was conducted on 518 doctors from 9 public hospitals in Beijing through stratified sampling method.Descriptive analysis,rank sum test and ordered logistic regression were used to explore doctors'willingness to open clinics and its influencing factors.Results In all survey respondents,212(40.93%)physicians were very or somewhat willing to open a clinic in the community,physicians with higher benefit perception,and greater willingness to publicize relevant policies were more willing to set up clinics.Conclusion Opening of clinics by doctors in public hospitals is affected by perceived benefits and willingness to advocate policies.It is suggested to further improve relevant systems and policies,reduce the risk of doctors opening clinics,and promote doctors in public hospitals to open clinics in communities,so as to realize the sinking of high-quality health human resources to the grassroots.

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.