Objective:To analyze the association between remnant cholesterol (RC) and the risk of atherosclerotic cardiovascular disease (ASCVD) in community population in Shanghai.Methods:Using baseline and follow-up data from the Shanghai Suburban Adult Cohort and Biobank, individuals with ASCVD (including coronary heart disease, stroke, myocardial infarction, and peripheral artery disease) at baseline were excluded. A Cox proportional hazards regression model was employed to analyze the relationship between RC and ASCVD risk and the association under different LDL-C levels.Results:A total of 57 281 participants were included, with a median follow-up of 5.61 person-years. During the follow-up, 1 436 ASCVD events (2.51%) were recorded. After adjusting for potential confounders, individuals with moderate ( HR=1.18, 95% CI: 1.03-1.36) or high RC levels ( HR=1.32, 95% CI: 1.15-1.51) had an increased risk of ASCVD. The association was stronger in participants younger than 60 years-old (interaction P=0.048). Participants with RC ≥0.97 mmol/L and LDL-C <3.40 mmol/L demonstrated a 19% ( HR=1.19, 95% CI: 1.06-1.35) increased risk of ASCVD. When RC ≥0.97 mmol/L and LDL-C ≥3.40 mmol/L, ASCVD risk increased by 42% ( HR=1.42, 95% CI: 1.21-1.67). Conclusions:Elevated RC increases ASCVD risk, regardless of LDL-C levels. RC can serve as a valuable predictor and intervention target for ASCVD.

OBJECTIVE: To summarize the methods of ankle hinge position design in the correction of clubfoot deformity by Ilizarov method, and to explore its application value in the prevention of ankle dislocation. METHODS: A retrospective study was conducted including 28 patients with rigid clubfoot deformity (34 feet) who met the selection criteria and admitted between September 2021 and December 2024. There were 19 males and 9 females with an average age of 31.8 years (range, 19-47 years). According to Dimeglio classification, there were 21 feet of degree Ⅲ and 13 feet of degree Ⅳ. The causes were traumatic sequelae in 9 cases, congenital foot deformity in 15 cases, spina bifida sequelae in 1 case, peripheral neuropathy in 1 case, and cerebral palsy sequelae in 2 cases. The malformation lasted from 6 to 46 years, with an average of 29.3 years. All patients were treated with Ilizarov circular external fixator, and the hinge position of ankle joint was planned according to the standard lateral X-ray film of foot and ankle and the principle of Ilizarov limb deformity correction center of rotation angulation (CORA) before operation. The 2008 International Clubfoot Study Group (ICFSG) scoring system was used to evaluate the efficacy. RESULTS: The deformity of rigid clubfoot was completely corrected in all patients, and the patients could walk with plantar weight-bearing, and the ankle weight-bearing walking significantly improved when compared with that before operation. There was no complication such as ankle dislocation, talus impact or extrusion, local skin necrosis, needle tract infection, or numbness of extremities during the correction process. All patients were followed up 5-39 months, with an average of 18.1 months. At last follow-up, according to the ICFSG scoring system, 23 feet were excellent, 10 feet were good, and 1 foot was fair, and the excellent and good rate was 97%. CONCLUSION Designing the position of the ankle hinge according to the principle of CORA can effectively avoid ankle dislocation, talus impingement, tibiotalar joint extrusion, and other ankle adverse events in the process of correcting clubfoot deformity, which has good application value in clinical practice.
Humans ; Male ; Female ; Clubfoot/diagnostic imaging* ; Ilizarov Technique/instrumentation* ; Adult ; Retrospective Studies ; External Fixators ; Ankle Joint/diagnostic imaging* ; Middle Aged ; Joint Dislocations/prevention & control* ; Treatment Outcome ; Young Adult

Deep learning(DL)technology has strong ability for acquiring and learning information,which has been widely used in the field of stomatology imaging,such as segmentation of oral and surrounding structures,diagnosis of tooth and dental pulp diseases,perioperative evaluation of implant surgery,localization of craniomaxillofacial markers,evaluation of temporomandibular joint diseases and maxillary sinus diseases,etc.,contributing to accurate and efficient individualized diagnosis and treatment of oral diseases.The research progresses of DL in oral cone beam CT were reviewed in this article.

Objective:To analyze the association between remnant cholesterol (RC) and the risk of atherosclerotic cardiovascular disease (ASCVD) in community population in Shanghai.Methods:Using baseline and follow-up data from the Shanghai Suburban Adult Cohort and Biobank, individuals with ASCVD (including coronary heart disease, stroke, myocardial infarction, and peripheral artery disease) at baseline were excluded. A Cox proportional hazards regression model was employed to analyze the relationship between RC and ASCVD risk and the association under different LDL-C levels.Results:A total of 57 281 participants were included, with a median follow-up of 5.61 person-years. During the follow-up, 1 436 ASCVD events (2.51%) were recorded. After adjusting for potential confounders, individuals with moderate ( HR=1.18, 95% CI: 1.03-1.36) or high RC levels ( HR=1.32, 95% CI: 1.15-1.51) had an increased risk of ASCVD. The association was stronger in participants younger than 60 years-old (interaction P=0.048). Participants with RC ≥0.97 mmol/L and LDL-C <3.40 mmol/L demonstrated a 19% ( HR=1.19, 95% CI: 1.06-1.35) increased risk of ASCVD. When RC ≥0.97 mmol/L and LDL-C ≥3.40 mmol/L, ASCVD risk increased by 42% ( HR=1.42, 95% CI: 1.21-1.67). Conclusions:Elevated RC increases ASCVD risk, regardless of LDL-C levels. RC can serve as a valuable predictor and intervention target for ASCVD.

Deep learning(DL)technology has strong ability for acquiring and learning information,which has been widely used in the field of stomatology imaging,such as segmentation of oral and surrounding structures,diagnosis of tooth and dental pulp diseases,perioperative evaluation of implant surgery,localization of craniomaxillofacial markers,evaluation of temporomandibular joint diseases and maxillary sinus diseases,etc.,contributing to accurate and efficient individualized diagnosis and treatment of oral diseases.The research progresses of DL in oral cone beam CT were reviewed in this article.

Chronic obstructive pulmonary disease(COPD)has become a common chronic disease in the adult in recent years,and more attention has been gradually paid to its prevention and treatment.This paper reviewed the clinical studies about the effect of traditional Chinese medicine(TCM)exercise therapy on COPD,and indicated that TCM exercise therapy can improve the rehabilitation of COPD patients.TCM exercise therapies,such as Tai Chi,Wuqinxi,Baduanjin,and Liuzijue,have been shown to significantly improve lung function,inflammation levels,and exercise capacity in COPD patients in recent studies.Tai Chi significantly improves patient's respiratory problems although lung function indices are not changed.Liuzijue enhances the strength and endurance of respiratory muscles and limbs.Baduanjin helps to improve patient's cognitive and emotional states.Overall,TCM exercise therapy provides an effective rehabilitation option for COPD patients.However,more clinical controlled trials are needed to further confirm their effectiveness and to develop appropriate rehabilitation programs for COPD patients.

OBJECTIVE To compare the efficacy of Danning tablet， taurosodeoxycholic acid and ursodeoxycholic acid in preventing the recurrence of choledocholithiasis after endoscopic retrograde cholangiopancreatography （ERCP）. METHODS The clinical data of 153 patients who underwent ERCP choledocholithotomy from January 2017 to January 2020 in Nantong First People’s Hospital were retrospectively analyzed. According to the different drug treatment received after surgery， patients were divided into three groups， namely， Danning tablet group （group A， 49 cases）， tauroursodeoxycholic acid group （group B， 44 cases） and ursodeoxycholic acid group （group C， 60 cases）. The above groups of drugs are all single-use， starting from 2 weeks after surgery for a course of 180 days. The effects of bile component indicators [total bilirubin （Tbil）， direct bilirubin （Dbil）， alkaline phosphatase （ALP）， glutamyltransferase （GGT）]， lipid metabolism indicators [total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL）， high-density lipoprotein （HDL）]， the occurrence of clinical symptoms （abdominal pain， bloating， nausea， and poor appetite） at 6 months after ERCP， and the recurrence of choledocholithiasis at 6， 12， 18 and 24 months after surgery were compared among 3 groups. RESULTS Compared with before surgery， the serum levels of Tbil， Dbil， ALP， GGT， TC， TG and LDL were significantly reduced （P＜0.05）， while serum HDL levels were significantly increased （P＜0.05） in the three groups at 6 months after surgery. The proportion of patients who experienced abdominal pain， bloating， nausea， and poor appetite at 6 months after surgery was significantly reduced （P＜0.05）. The Tbil levels of groups A and B were significantly lower than those of group C （P＜0.05）， while the Dbil and ALP levels of group A were significantly lower than those of groups B and C （P＜0.05）； however， there was no statistically significant difference in GGT levels among the 3 groups （P＞0.05）. Compared with groups A and C， the levels of four lipid metabolism indicators in group B were significantly improved （P＜0.05）； the proportion of patients with abdominal pain， bloating， and poor appetite in group A was significantly lower than groups B and C （P＜0.05）， but there was no statistically significant difference in the proportion of patients with nausea among the 3 groups （P＞0.05）. At 6，12 and 18 months after surgery， there was no statistically significant difference in the rate of choledocholithiasis recurrence among the 3 groups （P＞0.05）； at 24 months after surgery， the rate of choledocholithiasis recurrence in group A （2.04%） was significantly lower than group B （15.91%） and group C （15.00%） （P＜0.05）. CONCLUSIONS Compared with tauroursodeoxycholic acid and ursodeoxycholic acid， the application of Danning tablet after ERCP is more beneficial to reduce the secretion of bile acid， prevent the recurrence of gallstones， and improve clinical symptoms， but tauroursodeoxycholic acid can significantly accelerate the lipid metabolism of patients compared with the other two drugs.

Background Occupational noise-induced hearing loss (NIHL) is one of the most prevalent occupational diseases in the world. With the development of industry, noise sources in the workplace have become increasingly complex. Objective To apply kurtosis-adjusted cumulative noise exposure (CNE) to assess the occupational hearing loss among furniture manufacturing workers, and to provide a basis for revising noise measurement methods and occupational exposure limits in China. Methods A cross-sectional survey was conducted to select 694 manufacturing workers, including 542 furniture manufacturing workers exposed to non-Gaussian noise, and 152 textile manufacturing workers and paper manufacturing workers exposed to Gaussian noise. The job titles involving non-Gaussian noise were gunning and nailing, and woodworking, while those involving Gaussian noise were weaving, spinning, and pulping. High frequency noise-induced hearing loss (HFNIHL) and noise exposure data were collected for each study subject. Noise energy metrics included eight-hour equivalent continuous A-weighted sound pressure level (L_{Aeq,8 h}) and CNE. Kurtosis was a noise temporal structure metric. Kurtosis-adjusted CNE was a combined indicator of noise energy and temporal structure. Results The age of the study subjects was (35.64±10.35) years, the exposure duration was (6.71±6.44) years, and the proportion of males was 75.50%. The L_{Aeq,8 h} was (89.43±6.01) dB(A). About 81.42% of the study subjects were exposed to noise levels above 85 dB(A), the CNE was (95.85±7.32) dB(A)·year, with a kurtosis of 99.34 ± 139.19, and the prevalence rate of HFNIHL was 35.59%. The mean kurtosis of the non-Gaussian noise group was higher than that of the Gaussian noise group (125.33±147.17 vs. 5.86±1.94, t=−21.04, P<0.05). The results of binary logistic regression analysis showed that kurtosis was an influential factor of workers' HFNIHL after correcting for age, exposure duration, and L_{Aeq,8 h} (OR=1.49, P<0.05). The results of multiple linear regression analysis showed that the effects of age, exposure duration, L_{Aeq,8 h}, and kurtosis on noise-induced permanent threshold shift at frequencies of 3, 4, and 6 kHz of the poor hearing ear were statistically significant (all P<0.05). The results of chi-square trend analysis showed that when CNE ≥ 90 dB(A)·year, the HFNIHL prevalence rate elevated with increasing kurtosis (P<0.05). The mean HFNIHL prevalence rate was higher in the non-Gaussian noise group than in the Gaussian noise group (31.7% vs. 22.0%, P<0.05). After applying kurtosis-adjusted CNE, the linear equation between CNE and HFNIHL prevalence rate for the non-Gaussian noise group almost overlapped with that for the Gaussian noise group, and the mean difference in HFNIHL prevalence rate between the two groups decreased from 9.7% to 1.4% (P<0.05). Conclusion Noise kurtosis is an effective metric for NIHL evaluation. Kurtosis-adjusted CNE can effectively evaluate occupational hearing loss due to non-Gaussian noise exposure in furniture manufacturing workers, and is expected to be a new indicator of non-Gaussian noise measurement and assessment.

Heilongjiang Province has unique geographical environment, which makes the difference in population morbidity. This paper summarizes the physiological and pathological characteristics of stroke in Longjiang area from the regional factors and dietary factors. The paper also summarizes the treatment thoughts of acupuncture and moxibustion doctors in Longjiang area, mainly including five aspects: Knowing all diseases but treating the essence one, combining theory and practice, combining Chinese and western medicine, combining acupuncture and Chinese medicine, preventing diseases through learning and observing tiny clues. This article aims to summarize the experience of Longjiang acupuncture scholars and enriches the medical connotation of Longjiang area.

Objective:To determine the influences of structural changes after valgus impacted femoral neck fracture on hip range of motion (ROM) so as to provide evidence for clinical judgment of whether reduction is necessary or not in the internal fixation of such fractures.Methods:1. 3D reconstructions of the CT hip scans were performed for the 73 patients who had been treated at Department of Orthopaedic Surgery, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University for valgus impacted femoral neck fractures from January 2019 to April 2019.The femoral neck-shaft angle, anteversion angle, femoral offset, axial alpha angle, lateral center edge angle (LCEA), anterior center edge angle (ACEA) and center displacement were measured and compared between the affected and healthy sides to determine the influences of the fracture on the above indexes. 2. Hip motions (flexion and MIR-90°) were simulated on bilateral sides to determine the influences of structural changes after fracture on hip ROM using stepwise regression and Logistic regression. 3. The distribution of femoral-acetabular contact points on the femoral side was observed in simulation of hip flexion to detect the potential area for femoracetabular impingement (FAI) induced by the fracture displacement.Results:1. The valgus impacted femoral neck fractures had significant influences on femoral neck-shaft angle, anteversion angle, femoral offset and axial alpha angle. Compared with the healthy side, on average, the femoral neck-shaft angle increased by 5.1°, anteversion angle decreased by 6.5°, femoral offset decreased by 8.2 mm and axial alpha angle increased by 9.7° on the affected side, showing significant differences ( P<0.05).The displacements of the femoral head center averaged 9.2 mm. There was no significant difference in LCEA or ACEA between the affected and healthy sides ( P>0.05). 2. Compared with the healthy side, on average, the simulated hip flexion decreased significantly by 27.0° and the hip MIR-90° decreased significantly by 20.3° on the affected side after fracture ( P<0.05). Regression analysis showed that femoral anteversion angle, ACEA and displacement of the femoral head center had a significant influence on hip ROM, especially the anteversion angle. When the anteversion angle decreased by more than 7.1°, the hip flexion would decrease by at least 20%. 3. The points of FAI distributed more widely on the fracture side. Compared with the healthy side, the impact points extended outward and upward in hip flexion and extended inwardly in hip MIR-90° on the affected side. Conclusions:After a valgus impacted femoral neck fracture, if the femoral anteversion angle has been decreased by more than 7.1°, the hip ROM can be greatly influenced and the points of FAI can be distributed more widely. Therefore, reduction should be recommended before internal fixation of the fracture.