Objective To investigate the effect of uterine distension fluid temperature on the body tem-perature and pain degree of the patients with abnormal uterine bleeding caused by endometrial polyps during hysteroscopy diagnosis and treatment.Methods A total of 114 patients who visited the hysteroscopic clinic of this hospital from April 2022 to April 2024 were enrolled as the study subjects.The patients were randomly divided into two groups by using the simple random allocation method.The group A(n=51)used the warm 0.9％sodium chloride solution at 36-37 ℃ as the uterine distention solution,while the group B(n=63)used a room temperature 0.9％sodium chloride solution at 22-23 ℃ as the uterine distention solution.During the diagnosis and treatment process,thevisual analog scale(VAS)was used to assess the degree of pain.The VAS scores before surgery(T0),entering the vagina(T1),passing through the cervical internal opening(T2),ente-ring the uterine cavity(T3),during operation(T4),at the end of surgery(T5),and at 30 min after surgery end(T6)were compasred between the two groups;the body temperatures at T0,T5 and T6 were compared be-tween the two groups.Results There was no statistically significant difference in the body temperature at T0 time point between the two groups(P＞0.05).The body temperature at T5 and T6 time points in the group A was higher than that in the group B,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the VAS scores at T0 and T6 time points between the two groups(P＞0.05).The VAS scores at T1,T2,T3,T4 and T5 time points in the group A were lower than those in the group B,and the differences were statistically significant(P＜0.05).Conclusion The application of warm uterine distention solution in hysteroscopy diagnosis and treatment could maintain the stable body temperature of the patients,reduce the severity of pain,thus increases the patient comfort level.

Mandibular reconstruction refers to the restoration of the continuity of the mandible through techniques such as autologous bone grafting,thereby restoring the patient's basic appearance,reconstructing the occlusal relationship,and restoring functions such as opening the mouth,chewing,and swallowing,in order to achieve a unity of oral and maxillofacial forms and functions.Due to the fact that mastication necessitates the coordinated efforts of the masticatory muscles,mandible,dental arch,and tongue,the recovery of masticatory function not only serves as a robust indicator for the success of surgery but also enhances the patients'quality of life,facilitating an early return to normal life.Currently,for the rehabilitation of oral function in patients after mandibular reconstruction surgery,standardized tools have been established in the fields of swallowing,occlusion,and speech assessment,and targeted training has been implemented,yielding significant therapeutic outcomes.However,research related to masticatory function faces two major challenges.First,existing assessment tools primarily focus on a single dimension,such as masticatory efficiency or subjective perception,and an integrated assessment system that encompasses multiple dimensions,including bite force distribution and oral sensory perception,has not yet been established.Second,although individual studies have explored factors affecting postoperative masticatory function,a systematic consensus has not been veached,leading to a lack of precision and individualization in clinical interventions,which significantly prolongs the patients'rehabilitation period.This paper reviews the scope and limitations of existing assessment tools for masticatory function in patients after mandibular reconstruction and systematically analyzes the key factors affecting postoperative masticatory function,aiming to promote a shift in clinical practice from"structural reconstruction"to a"function-perception collaborative rehabilitation"approach,and to provide a theoretical framework for constructing evidence-based,personalized masticatory rehabilitation programs.

Mandibular reconstruction refers to the restoration of the continuity of the mandible through techniques such as autologous bone grafting,thereby restoring the patient's basic appearance,reconstructing the occlusal relationship,and restoring functions such as opening the mouth,chewing,and swallowing,in order to achieve a unity of oral and maxillofacial forms and functions.Due to the fact that mastication necessitates the coordinated efforts of the masticatory muscles,mandible,dental arch,and tongue,the recovery of masticatory function not only serves as a robust indicator for the success of surgery but also enhances the patients'quality of life,facilitating an early return to normal life.Currently,for the rehabilitation of oral function in patients after mandibular reconstruction surgery,standardized tools have been established in the fields of swallowing,occlusion,and speech assessment,and targeted training has been implemented,yielding significant therapeutic outcomes.However,research related to masticatory function faces two major challenges.First,existing assessment tools primarily focus on a single dimension,such as masticatory efficiency or subjective perception,and an integrated assessment system that encompasses multiple dimensions,including bite force distribution and oral sensory perception,has not yet been established.Second,although individual studies have explored factors affecting postoperative masticatory function,a systematic consensus has not been veached,leading to a lack of precision and individualization in clinical interventions,which significantly prolongs the patients'rehabilitation period.This paper reviews the scope and limitations of existing assessment tools for masticatory function in patients after mandibular reconstruction and systematically analyzes the key factors affecting postoperative masticatory function,aiming to promote a shift in clinical practice from"structural reconstruction"to a"function-perception collaborative rehabilitation"approach,and to provide a theoretical framework for constructing evidence-based,personalized masticatory rehabilitation programs.

Objective:To investigate the prevalence of hyperuricemia (HUA) in Bozidun Kirghiz township of Xinjiang Aksu region, and to explore the risk factors for the occurrence of HUA in the local area.Methods:A cross-sectional survey study was conducted by randomly selecting 9 villages in Bozidun Kirgiz Township by the whole-group sampling method and questionnaire were distributed to the households. The questionnaire included: demographic information, history of past illness, personal history, and all subjects were measured for height, weight, blood pressure, abdominal circumference, etc. The diagnostic of HUA if the serum uric acid (SUA) level >420 μmol/L in men or >360 μmol/L in women. The incidences of HUA in different age, sex, food type and life style behavior were analyzed. T test, non-parametric test and Chi-square test were used to analyze the differences among the groups, and logistic regression was used to analyze the risk factors. Results:①A total of 2 138 subjects were surveyed, among which 68 patients were with HUA, the prevalence of HUA in Bozidun Kirghiz township, Aksu region in the general population was 3.18%(68/2 138); the prevalence rate in men was 4.60%(45/978), 45 patients were identified; and the prevalence rate in women was 1.98%(23/1 160), 23 patients were identified. The peak age of HUA in male and female patients was 51~60 years old. ②The prevalence of HUA was lower in those who consumed dairy products ( χ2=6.91, P=0.017), nuts ( χ2=8.43, P=0.038) and eggs ( χ2=7.38, P=0.023), and lower in those who consumed more. Different intake of cereals ( χ2=0.87, P=0.647), meat( χ2=0.82, P=0.662), vegetables and fruits( χ2=5.22, P=0.073) had no effect on the prevalence of HUA.③In terms of different life behaviors, the prevalence of HUA in men who had been smoking was higher than those who had never smoked (57.78%, 28.89%, 13.33%, χ2=8.16, P=0.017). In the relationship between drinking and HUA, the prevalence rates of male always drinking, ever drinking and never drinking were 80.00%, 11.11% and 3.89%, respectively, the difference was statistically significant ( χ2=6.67, P=0.038). ④Multi-factor logistic regression analysis showed that high BMI, old age, high TG, increased Cr and increased WBC were risk factors for the occurrence of HUA [ OR(95% CI)=1.13(1.04, 1.23), 1.03(1.00,1.05),1.39(1.00, 1.93), 1.03(1.02, 1.05), 1.27(1.07, 1.49), all P<0.05]. Conclusion:The prevalence of HUA in Bozidun Kirgiz township in Aksu prefecture of Xinjiang is lower than that in other areas with continental climate. High BMI, old age, high TG, increased Cr and increased WBC count are risk factors for the development of HUA .

Purpose Based on liver lesions,to investigate the feasibility and influencing factors of virtual non-contrast(VNC)replacing true non-contrast(TNC)in tri-phase derived from Revolution CT.Materials and Methods A total of 62 patients who underwent TNC and tri-phase(arterial,venous,and delayed phases)spectral enhanced liver scans were retrospectively enrolled in Zhongda Hospital Affiliated to Southeast University from December 2021 to April 2022.Liver lesions with a diameter of≥5 mm were measured and categorized into Group 1(≤20 Hu)and Group 2(>20 Hu)according to the CT values of TNC,then were respectively further categorized into group a(≤20 Hu across all three phases of enhancement)and group b(>20 Hu in at least one phase of enhancement)based on the degree of enhancement.CT attenuation,maximum diameter and detection rates of lesions were compared between TNC and three-phase VNC groups.Multivariate regression analysis was used to investigate the influencing factors of the density difference between VNC and TNC.Results A statistically significant difference in the attenuation of lesions was observed among the each groups(χ2/F=14.712,18.603,7.334,all P<0.01).Except for VNCV and VNCD in Group-1a which had no significant difference with TNC(both P>0.05),the attenuation of other VNCs were lower than TNC in category-a and greater than TNC in category-b(all P<0.05).Maximal diameter presented strong correlation and no significant difference in VNCA and VNCV compared to TNC in each group(all P>0.05;all r>0.8 and P<0.001).A significant difference in the detection rate of the lesions was observed among the groups(χ2=47.660,P<0.001),VNCV images displayed the higher detection rate than VNCA and VNCD(all P<0.05).The density difference between VNC and TNC was positively correlated with CT values of the corresponding enhancement phase(r2adjusted=0.209,0.142,0.062,P<0.001).Conclusion Based on Revolution CT,VNCV is the optimal phase to replace TNC and can be mitigated by CT value of the lesions in venous-phase.

Objective To explore the clinical significance of serum cytokine expression in the hepatitis B surface antigen(HBsAg)sero-clearance in patients with severe hepatitis B.Methods A nested case-control trial was conducted on 14 inpatients with severe hepatitis B admitted in our hospital from 2006 to 2020.Of them,7 patients(aged 36.57±3.15 years)achieved HBsAg sero-clearance within 1 year after the onset of hepatitis B flares(with abrupt rise of ALT level to＞5 times the upper limit of normal during HBV infection)and were assigned into HBsAg clearance group,while the other 7 patients(aged 34.14±2.97 years)only obtained HBsAg decreased less than 1 g within 1 year after the onset(HBsAg non-clearance group).Then,multiplex liquid-chip assay based on Luminex xMAP was used to detect the expression levels of 48 cytokines such as IFN-γ and IL-2 in serum samples of these 14 patients.Results The serum levels IFN-γ,IL-2Ra and SDF-1α were significantly lower in the HBsAg clearance group than the HBsAg non-clearance group(P＜0.05),but no statistical differences were observed in other 39 cytokines between the 2 groups.And there were 5 cytokines having no mutual expression in both groups.The copy number of HBV DNA was positively correlated with serum HGF(r=0.675,P=0.008)and SDF-1α levels(r=0.587,P=0.027),while negatively with IP-10(r=-0.600,P=0.023)and MIG level(r=-0.640,P=0.014).Meanwhile,a positive correlation was found between HBsAg titer and IL12-p70 level(r=0.593,P=0.025),and a negative correlation between HBsAg titer and TNF-α level(r=-0.609,P=0.021).In addition,the serum total bilirubin level was positively correlated with the expression of SCGF-β(r=0.543,P=0.045).Conclusion Three differentially expressed cytokines and some cytokines related to HBV DNA level and HBsAg titer are found,which may provide new insights into the underlying immunological mechanism of HBV virus clearance caused by hepatitis flares.Meanwhile,it also provides potential biomarkers for HBsAg serological clearance in patients with severe hepatitis B.

Objective To explore the effect of targeted silencing wild-type p53-induced phosphatase 1(Wip1)on paclitaxel(PTX)chemosensitivity of ovarian cancer cell line A2780.Methods The ovarian cancer cell lines A2780 served as the research object,the stable cell line Wip1-sgRNA with low expression of Wip1 was constructed by infecting cell line A2780 with lentivirus(Wip1-sgRNA group),while the control cell line was NC-sgRNA(NC-sgRNA group).The cells were treated with PTX at appropriate time and divided into the Wip1-sgRNA+PTX group and NC-sgRNA+PTX group.The CCK8 method was used to detect the cell proliferation ability,the flow cytometry was used to detect the cell apoptosis,and the Transwell invasion assay was used to detect the cell invasion ability.Results Compared with the NC-sgRNA group,the expression lev-els of Wip1 mRNA and protein in the Wip1-sgRNA group were significantly down-regulated(P＜0.001).Un-der the condition of PTX gradient treatment for the same time,the cell survival rate of the Wip1-sgRNA group was significantly lower than that of the NC-sgRNA group(P＜0.001).The half maximal inhibitory concentration(IC50)of PTX in cells of the Wip1-sgRNA group at 48 h was significantly lower than that of the NC-sgRNA group(P＜0.001).Compared with the NC-sgRNA group,the proliferation ability of the Wip1-sgRNA group was significantly weakened(P＜0.001),the rate of cellular apoptosis was significantly in-creased(P＜0.001),and the number of transmenbrane cells was significantly decreased(P＜0.001).After PTX treatment,the proliferation ability was weakened compared with corresponding control groups,the rate of cellular apoptosis was significantly increased,and the number of transmenbrane cells was significantly de-creased;additionally,compared with the NC-sgRNA+PTX group,the cellular proliferation ability of the Wip1-sgRNA+PTX group was significantly weakened(P＜0.001),the rate of cellular apoptosis was signifi-cantly increased(P＜0.001),and the number of transmenbrane cells was significantly decreased(P＜0.001).Conclusion Wip1 gene silencing could increase the chemosensitivity of human ovarian cancer cell lines A2780 to PTX.

【Objective:】 The co-word analysis method was used to analyze narrative medical literature studied in China in the past 10 years to explore the research status in this field and lay a foundation for further research. 【Methods:】 Using "narrative medicine" as the theme term, with the limited time interval of 2013—2022 to retrieve for relevant literature in CNKI, Wanfang, and VIP databases, and include literature that meets the research standards. Bicomb2 was used to perform keyword statistics and analysis on the downloaded literature. Ucinet6.0 and Netdraw were used to draw co-occurrence analysis graphs to visualize the co-occurrence relationship between high-frequency keywords. 【Results:】 A total of 565 papers were included and 31 high-frequency keywords were extracted. The co-occurrence relationship diagrams showed that the current research hotspots of narrative medicine in China include traditional Chinese medicine, nursing, general practice, evidence-based medicine, medical ethics, hospice care, chronic diseases, cancer and other popular disciplines and diseases. Most of them were about enhancing the empathy and humanistic caring ability of medical personnel and improving doctor-patient communication to improve the doctor-patient relationship, as well as doing well in medical humanities education and cultivating narrative ability through parallel medical records and reflective writing. The research on gerontology, improving the professional identity of medical staff, integrating literature and medicine, and the impact on patients were relatively few. 【Conclusion:】 At present, narrative medicine in China has achieved many achievements in fields such as nursing, traditional Chinese medicine, general practice medicine, chronic diseases, cancer, medical humanities education, and improving doctor-patient relationships. In the future, in-depth exploration can be conducted from the use of narrative medicine in multi-disciplinary and disease fields, trying different training methods, and synchronous cultivation of teachers and students, so as to build a more comprehensive narrative medicine system.

Objective:To explore any effects of combining virtual reality training with aromatherapy in caring for Alzheimer′s disease patients in a nursing home.Methods:Fifty nursing home residents with Alzheimer′s were divided at random into an observation group and a control group, each of 25. Both groups received routine rehabilitation, while the observation group was additionally given 45 minutes of virtual reality training combined with aromatherapy, 3 times a week for 6 months. Both groups′ cognition was then evaluated using the MMSE and an Alzheimer′s cognition assessment scale (ADAS-cog). Psycho-behavioral symptoms were quantified using the Alzheimer′s disease pathological behavior scale (BEHAVE-AD). Motor functioning was quantified using the timed up and go test (TUGT), the 30-second sit-to-stand test (30sCST), the 30-second arm curl test (30sACT) and the sit-and-reach test (CSRT). Ability in the activities of daily living (ADL) and life quality were quantified using the activity of daily living scale and of the quality of life scale for Alzheimer′s disease (QOL-AD) before and after the intervention.Results:After the intervention the average MMSE, ADAS-cog, BEHAVE-AD and ADL scores of both groups had improved significantly, with the average improvement in the observation group significantly greater than that in the control group. The TUGT, 30sCST, 30sACT and CSRT results of both groups were also significantly better, with those of the observation group again significantly superior, on average, to the control group′s results. The average QOL-AD score in the observation was significantly improved after the intervention, and was then significantly better than the control group′s average.Conclusions:Virtual reality training combined with aromatherapy can significantly improve the cognition, psycho-behavioral symptoms, activity in daily living, motor functioning and life quality of Alzheimer′s patients in a nursing home. It is worthy of promotion and application in nursing homes.

Objective:To observe any effect of virtual reality (VR) training on the cognitive functioning and functional fitness of nursing home residents with subjective cognitive decline (SCD).Methods:Fifty-six of such residents were randomly divided into an observation group and a control group, each of 28. Both groups received health education and routine care, but the observation group was additionally provided with 45 minutes of VR training three times a week for 6 months. The training included Baduanjin, magic, flying bird, supermarket shopping, gravity ball and gym episodes. Both groups′ cognition was evaluated using the subjective cognitive decline questionnaire (SCD-Q), the Montreal cognitive assessment (MoCA), the Rivermead Behavioural Memory Test (second edition) (RBMT-Ⅱ), a digit symbol substitution test (DSST), an animal fluency test (AFT) and trail-making test A-B (TMT A-B). Functional fitness was quantified using the 8-foot up-and-go test (8UGT), a 30-second arm curl test (30sACT), a 30-second chair stand test (30sCST), a back scratching test (BST), the sit-and-reach test (CSRT) and a 2-minute step test (2MST) before and after the 6-month intervention.Results:After the intervention, the average SCD-Q, MoCA, RBMT-Ⅱ, DSST, TMT-A, and TMT-B scores of the observation group were significantly better than before the intervention, and significantly better than the control group′s averages. And except for the back scratching their functional results were also significantly better, on average, than those of the control group.Conclusions:VR training can effectively improve the cognition and functional fitness of nur-sing home residents with SCD. Such training is worthy of promotion and wider application in nursing homes.