Objective:This study aimed to explore the serum levels of soluble programmed cell death protein 1 (sPD-1) and soluble programmed cell death-ligand 1 (sPD-L1) in patients with spontaneous intracerebral hemorrhage (ICH) and their clinical value in the prognostic analysis.Methods:This prospective cohort study included patients aged ≥18 years admitted to the department of critical care medicine at the Affiliated Hospital of Zunyi Medical University between January 2022 and October 2024 with a first episode of ICH presenting within 24 hours of onset. Patients with hemorrhage caused by other causes (e.g., tumor, medication and trauma) or incomplete data were excluded. Based on 28-day all-cause mortality, patients were divided into survival group and non-survival group. According to the 60-day neurological outcome, patients were divided into good neurological outcome group and poor neurological outcome group. Clinical and imaging data were collected, along with venous blood samples obtained within 24 hours of admission to measure serum levels of sPD-1 and sPD-L1. Predictive indicators were identified using LASSO-Logistic regression analysis was used to identify predictive indicators, and a nomogram was constructed to visualize the prediction model. Model performances were evaluated using receiver operating characteristic curves, decision curve analysis, calibration curves, and the Hosmer-Lemeshow test.Results:A total of 155 patients were included: 101 in the survival group and 54 in the death group; 56 in the favorable neurological outcome group and 99 in the poor neurological outcome group. Serum sPD-1 concentrations were significantly lower in the death group and poor neurological outcome group compared to the survival group and favorable neurological outcome group, respectively. Conversely, serum sPD-L1 concentrations were significantly higher in the death group and poor neurological outcome group compared to the survival group and favorable neurological outcome group (all P < 0.05). Serum sPD-1 and sPD-L1 were identified as predictors of 28-day mortality risk. A nomogram incorporating seven indicators—brainstem hemorrhage, hemorrhage volume, obstructive hydrocephalus, surgical intervention, admission NIHSS score, and admission serum sPD-1 and sPD-L1 levels—demonstrated superior predictive performance [AUC=0.984 (95% CI: 0.968-1.000)] compared to sPD-1 alone (AUC=0.712) or sPD-L1 alone (AUC=0.753). Serum sPD-1 was a predictor of poor 60-day neurological outcome. A nomogram incorporating obstructive hydrocephalus, admission NIHSS score, and admission serum sPD-1 level [AUC=0.818 (95% CI: 0.754-0.882)] outperformed sPD-1 alone (AUC=0.637) or sPD-L1 alone (AUC=0.602). Conclusions:Serum levels of sPD-1 were significantly lower in the non-survivors and the patients with poor neurological outcomes compared to the survivors and the patients with good neurological outcomes. However, serum levels of sPD-L1 were significantly higher in the non-survivors and the patients with poor neurological outcome. Serum sPD-1 was an independent predictor of 28-day mortality risk and 60-day poor neurological outcome; serum sPD-L1 was an independent predictor of 28-day mortality risk. A nomogram prediction model incorporating sPD-1 and sPD-L1 demonstrated good predictive performance for mortality risk and poor neurological outcome.

Objective:To study the mechanism of free bone graft survival in calvarial defects.Methods:We simulated the bone autograft reconstruction through transplanting green fluorescent protein (GFP) mice＇ cranium to the nude mice＇ calvarial bone defects. Then gross and histological evaluation were performed to calculate BTA (%) and GFP (%) in graft bone.Results:The results showed that the green fluorescence was getting disappeared from 4 to 24 weeks＇ post-operation. However, a small amount of green fluorescence remained at 24 weeks＇ post-operation (6.69% of the positive control group). In addition, the gross and histological evaluation indicated that the grafted bone survived well at different time points.Conclusions:The survival mechanism of free bone graft in cranium mainly relies on creeping substitution assisted with bony regeneration.

Objective To investigate the contouring plastic effect of the digital navigation techniques assisted mandibular angle osteotomy,thereby providing surgical reference and evaluation basis for improving the accuracy,efficacy and safety of surgery.Methods From March 2015 to March 2017,15 female cases of the digital navigation aided intral-oral mandibular angle osteotomy in the past 2 years were collected and compared to the pre-operational image and digital design.Results The postoperative effect of navigation-assisted mandibular angle osteotomy was well matched to that of preoperative design.The mandibular angle was smooth and bilateral symmetrical with no obvious complication occurred.Conclusions Navigation-assisted techniques can solve the problem of limited exposure of intra-oral approach and significantly improve the accuracy,effectiveness and safety in mandibular angle osteotomy.