Objective To analyze the influence of shaping on the bending strength of bone plates and the influence of different locking nail distributions on plate force to provide biomechanical references for shaping plates and selecting different locking nail distributions.Methods Finite element simulation analysis of the four-point bending strength of a plate was performed according to the YY/T 0342-2020 standard.Theoretical analysis and finite element simulation method were used to analyze the force on prosthesis models with different lock-nail distributions.Results At 30° bending,the 3.7 mm-thick plate had 28%higher equivalent plastic strain than the 2.7 mm-thick plate.The 3.7 and 2.7 mm-thick plates had ultimate bending angles of 55° and 67°,respectively.The crease had little impact on the plate stress.The four-point bending strength and equivalent bending stiffness of the unshapeed structure were 2.64 N·m and 1.12 N·m2,respectively.The four-point bending strength and equivalent bending stiffness with the crease were 2.63 N·m and 1.10 N·m2,respectively.After forward and backward bending,the four-point bending strength of the plate decreased from 2.64 to 2.45 N·m by approximately 7.72%,and the equivalent bending stiffness decreased from 1.12 to 0.98 N·m2 by approximately 12%.The impact was obvious.After implantation of tamponade screws,the four-point bending strength of the single-hole plate improved significantly from 2.64 to 3.15 N·m,by approximately 19.32%and the equivalent bending stiffness increased from 1.12 to 1.14 N·m2,by approximately 2.1%.At least two locking holes were reserved on both sides of the fracture line.Not inserting the locking screw reduced the stress by approximately 50%compared with the full insertion of the locking screw.During 15-week postoperative walking without bone callus formation,the material stress of TC4 reached 852.7 MPa and yielding occurred.Conclusions In a clinical scenario where larger shaping is required,it is not suitable for plates with larger thicknesses and plate fractures are more likely to occur after large-thickness shaping.This can guide the clinical selection of plates with appropriate thickness based on the shaping angle,and tamponade screws can be implanted in extreme cases.Fixing locking screws clinically is recommended;however,a method of fixing the locking screws with full screws is not recommended.The biomechanical effect is best when two locking holes at both ends of the fracture line are maintained without fixing the locking screws.

Objective:To investigate the enrollment scale and distribution of Master's Degree in Pediatrics programs in China, and to provide a reference for promoting pediatric education and disciplinary development.Methods:Data on colleges and universities authorized to award Master's Degree in Pediatrics in 2023 were collected, sorted, and analyzed for the number, structure, distribution, and enrollment scale and direction of these institutions using descriptive statistics.Results:Among the 117 clinical medicine academic master's degree programs in China, 72 enroll pediatric academic master's degree candidates, with an enrollment of 260 students. Among the 120 master's degree programs in clinical medicine, 104 enroll professional master's degree candidates, enrolling 1 195 students. Enrollment is mainly concentrated in East China, "non-double first-class" colleges and universities, medical colleges and universities with subject level B, and enrollment is carried out in the direction of secondary disciplines.Conclusions:The number of colleges and universities authorized to award Master's Degree in Pediatrics was small, and the distribution of these colleges and universities was unbalanced. The enrollment scale was small and the orientation of Professional Master's Degree was not reasonable. Some colleges and universities were authorized to award Master's Degree in Pediatrics, but did not enroll any students. It is suggested to increase the number of colleges and universities authorized to award Master's Degree in Pediatrics and strengthen the staffing of pediatric departments. The aim is to expand the enrollment scale of candidates for Master's Degree in Pediatrics, improving the differential training of candidates for Academic Master's Degree and Professional Master's Degree, and attach importance to the construction of pediatrics.

OBJECTIVES: This study aimed to remove occlusal veneers of varied thicknesses and compositions by Er:Yag laser in vitro and analyze the interfacial microstructure between veneers and tooth that irradiated by laser, by which experimental evidence could be provided to support the non-invasive removal of occlusal veneerby laser. METHODS: Fresh mandibular premolars extracted for orthodontic requirements were collected for tooth preparation. Three kinds of ceramic materials (Vita Suprinity, Vita Mark Ⅱ, and Upcera Hyramic) were selected to fabricate occlusal veneer with different thicknesses (1.0, 1.5, and 2.0 mm). One week later, Er:Yag laser (2.5 W and 3.5 W) was used to irradiate and remove the occlusal veneer and recorded the timespan. After the removal operation, the micro-morphologies of samples were examined by scanning electron microscope. RESULTS: Upcera Hyramic veneer failed to be removed (>20 min); the operation span at 2.5 W, Vita Suprinity (96.0 s±16.0 s) was longer than Vita MarkⅡ(84.5 s±19.5 s) in the 1.0 mm group (P<0.05), and Vita Suprinity (246.5 s±13.5 s) was longer than Vita MarkⅡ(170.0 s±14.0 s) in the 1.5 mm group (P<0.05). At 3.5 W, Vita Suprinity (381.0 s±24.0 s) was longer than Vita MarkⅡ(341.5 s±26.5 s) in the 2.0 mm group. CONCLUSIONS Increasing laser power could shorten the operation span and facilitate the removal of occlusal veneers with the same thickness and composition. The occlusal veneer was sustained when insufficient laser power was applied. With the same laser power and ceramic thickness, laser penetration could interfere with the integral of the ceramic structure when the laser interacted with the bonding layer. With the same ceramic composition and laser power, the operation span and laser power increased with the thickness of the occlusal veneer. However, the laser was incapable of removing occlusal resin veneer directly.
Lasers, Solid-State ; Materials Testing ; Dental Porcelain/chemistry* ; Ceramics/chemistry* ; Bicuspid ; Dental Veneers

Objective:To investigate the efficacy, safety and recurrence rate of oral atenolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:Search on the following public databases from January 1, 2008 to June 13, 2022: Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform; China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Service System(SinoMed), Chinese Science and Technology Journal Database and Wanfang Data. According to inclusion and exclusion criteria, studies on oral atenolol for the treatment of infantile hemangioma were selected. The outcome indicators were efficiency (complete response rate), incidence of adverse effects and recurrence rate. The single-arm meta-analysis was performed using R software version 4.1.2. Egger’s test was employed and funnel plots were drawn to assess publication bias in the literature.Results:A total of 14 studies were included, comprising 5 randomized controlled trials, 5 single-arm studies, 3 non-randomized controlled trials, and 1 case-control study. The oral administration of atenolol for the treatment of infantile hemangiomas resulted in an efficacy rate (complete remission rate) of 62% (95% CI 52%~71%). The incidence rate of adverse reactions related to the digestive system was 18% (95% CI 7%~30%), while that related to β2 receptor blockade was 4% (95% CI 2%~6%), central nervous system-related adverse reactions occurred at a rate of 10% (95% CI 5%~16%), the recurrence rate was 5% (95% CI 2%~9%). Egger’s test indicated that there was no significant publication bias in the efficacy rate, central nervous system-related adverse reaction rate, and gastrointestinal-related adverse reaction rate of oral atenolol treatment for infantile hemangiomas ( P>0.05). The sensitivity analysis for the efficacy rate, adverse reaction rate, and recurrence rate of oral atenolol treatment for infantile hemangiomas suggested that the result were stable and reliable. Conclusion:Oral administration of atenolol for the treatment of infantile hemangiomas demonstrates significant efficacy, fewer adverse reactions, and a low recurrence rate, making it a promising candidate as a reasonable alternative to oral propranolol for treating infantile hemangiomas.

Objective:To investigate the efficacy, safety and recurrence rate of oral atenolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:Search on the following public databases from January 1, 2008 to June 13, 2022: Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform; China National Knowledge Infrastructure(CNKI), Chinese Biomedical Literature Service System(SinoMed), Chinese Science and Technology Journal Database and Wanfang Data. According to inclusion and exclusion criteria, studies on oral atenolol for the treatment of infantile hemangioma were selected. The outcome indicators were efficiency (complete response rate), incidence of adverse effects and recurrence rate. The single-arm meta-analysis was performed using R software version 4.1.2. Egger’s test was employed and funnel plots were drawn to assess publication bias in the literature.Results:A total of 14 studies were included, comprising 5 randomized controlled trials, 5 single-arm studies, 3 non-randomized controlled trials, and 1 case-control study. The oral administration of atenolol for the treatment of infantile hemangiomas resulted in an efficacy rate (complete remission rate) of 62% (95% CI 52%~71%). The incidence rate of adverse reactions related to the digestive system was 18% (95% CI 7%~30%), while that related to β2 receptor blockade was 4% (95% CI 2%~6%), central nervous system-related adverse reactions occurred at a rate of 10% (95% CI 5%~16%), the recurrence rate was 5% (95% CI 2%~9%). Egger’s test indicated that there was no significant publication bias in the efficacy rate, central nervous system-related adverse reaction rate, and gastrointestinal-related adverse reaction rate of oral atenolol treatment for infantile hemangiomas ( P>0.05). The sensitivity analysis for the efficacy rate, adverse reaction rate, and recurrence rate of oral atenolol treatment for infantile hemangiomas suggested that the result were stable and reliable. Conclusion:Oral administration of atenolol for the treatment of infantile hemangiomas demonstrates significant efficacy, fewer adverse reactions, and a low recurrence rate, making it a promising candidate as a reasonable alternative to oral propranolol for treating infantile hemangiomas.

Objective:To explore the difference of the efficacy, safety and recurrence rate of oral atenolol compared with oral propranolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:A comprehensive search was conducted on the English databases Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform (https: //clinicaltrials.gov) and on the Chinese databases CNKI, CBM, VIP, Wanfang Data from January 2008 to June 2021, according to our defined inclusion and exclusion criteria, randomized controlled trials of oral atenolol versus oral propranolol in the treatment of infantile hemangioma were selected for performing meta-analysis, and the outcome indicators were treatment efficiency, incidence of adverse reactions, and recurrence rate. Meta-analysis was performed by using RevMan 5.3 software, and sensitivity analysis of the result was performed, and the main outcome indicators were tested for publication bias (Egger’s test) by using Stata 16 software.Results:Finally, 5 randomized controlled trials references were included. Our meta-analysis showed that there was no significant difference in the effective rate between oral atenolol and oral propranolol in the treatment of infantile hemangioma ( RR=0.93, 95% CI 0.84-1.02, P=0.110). There was a statistically significant difference in the overall incidence of adverse reactions ( RR=0.78, 95% CI 0.61-0.99, P =0.040), bronch-related and central nervous system related to β 2-blockade( RR=0.55, 95% CI 0.40-0.76, P<0.001) adverse reactions, which were lower in the atenolol group than in the propranolol group; there was a statistically significant difference in the recurrence rate ( RR=0.57, 95% CI 0.39-0.84, P=0.005), which was lower in the atenolol group than in the propranolol group. The sensitivity analysis showed that the result after the exclusion of any 1 study were less variable compared with the result of the previous analysis, and the conclusion obtained were unchanged, suggesting that the result of the meta-analysis were stable and reliable. The Egger’s test showed that P=0.502, which suggested that there was no obvious publication bias. Conclusions:In the treatment of infantile hemangioma, oral atenolol has equivalent efficacy compared with oral propranolol, with less overall incidence of adverse reactions (which can reduce the incidence of bronch-related and central nervous system adverse reactions) and lower recurrence rate.

Objective:To explore the difference of the efficacy, safety and recurrence rate of oral atenolol compared with oral propranolol in the treatment of infantile hemangioma, so as to provide evidence-based medicine basis and reference for clinic.Methods:A comprehensive search was conducted on the English databases Web of Science, PubMed, Cochrane Library, Embase, U. S. National Library of Medicine Clinical Trials Registry Platform (https: //clinicaltrials.gov) and on the Chinese databases CNKI, CBM, VIP, Wanfang Data from January 2008 to June 2021, according to our defined inclusion and exclusion criteria, randomized controlled trials of oral atenolol versus oral propranolol in the treatment of infantile hemangioma were selected for performing meta-analysis, and the outcome indicators were treatment efficiency, incidence of adverse reactions, and recurrence rate. Meta-analysis was performed by using RevMan 5.3 software, and sensitivity analysis of the result was performed, and the main outcome indicators were tested for publication bias (Egger’s test) by using Stata 16 software.Results:Finally, 5 randomized controlled trials references were included. Our meta-analysis showed that there was no significant difference in the effective rate between oral atenolol and oral propranolol in the treatment of infantile hemangioma ( RR=0.93, 95% CI 0.84-1.02, P=0.110). There was a statistically significant difference in the overall incidence of adverse reactions ( RR=0.78, 95% CI 0.61-0.99, P =0.040), bronch-related and central nervous system related to β 2-blockade( RR=0.55, 95% CI 0.40-0.76, P<0.001) adverse reactions, which were lower in the atenolol group than in the propranolol group; there was a statistically significant difference in the recurrence rate ( RR=0.57, 95% CI 0.39-0.84, P=0.005), which was lower in the atenolol group than in the propranolol group. The sensitivity analysis showed that the result after the exclusion of any 1 study were less variable compared with the result of the previous analysis, and the conclusion obtained were unchanged, suggesting that the result of the meta-analysis were stable and reliable. The Egger’s test showed that P=0.502, which suggested that there was no obvious publication bias. Conclusions:In the treatment of infantile hemangioma, oral atenolol has equivalent efficacy compared with oral propranolol, with less overall incidence of adverse reactions (which can reduce the incidence of bronch-related and central nervous system adverse reactions) and lower recurrence rate.

Objective:To investigate the clinical features and prognosis of acute necrotizing encephalopathy (ANE) in children.Methods:The clinical data and follow-up information of 41 pediatric patients with ANE treated in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from January 2014 to September 2019 were retrospectively reviewed.Results:The 41 patients included 23 males and 18 females with the onset age of (4.4±3.2) years.The main prodromal symptoms were gastrointestinal (20/41 cases, 48.8%) and respiratory infections (19/41 cases, 46.3%). Acute encephalopathy progressed rapidly following the prodromal infection [29 cases (70.7%) ≤2 days], and patients had clinical manifestations of coma (32/41 cases, 78.0%), convulsion (32/41 cases, 78.0%), multiple organ dysfunction (27/41 cases, 65.9%), shock and disseminated intravascular coagulation were rarely occured, and 28 cases (68.3%) were admitted to intensive care unit for treatment.Brain magnetic resonance imaging (MRI) showed lesion involving thalamus (41/41 cases, 100.0%), periventricular white matter (34/41 cases, 82.9%), brainstem (31/41 cases, 75.6%), basal ganglia (26/41 cases, 63.4%), cerebral cortex and subcortex (20/41 cases, 48.8%) and cerebellum (18/41 cases, 43.9%). The common presentations on the apparent diffusion coefficient mapping of brain MRI were " tricolor pattern" or " bicolor pattern" of the thalamus.During follow-up (≥ 6 months), MRI showed that hemorrhage, cystic degeneration and atrophy changed dynamically with the progression of ANE.All cases were treated with glucocorticoids, 38 cases(92.7%) with intravenous immune globulin.Seven cases (17.1%) were died and the 34 survivors had different degrees of neurological dysfunction.Conclusions:ANE in children is a distinctive type of clinicoradiologic syndrome with rapid progression and various presentations.Brain MRI has typical imaging characteristics and dynamically indicates the progression of this disease.The treatment options are still limited, the prognosis is poor and the survivors are often with neurological dysfunction.

Objective To optimize a method for extracting traditional Chinese medicine composition with insomnia,and to prepare the insomnia granules for quality control.Methods The optimal extraction process was screened by orthogonal test using high-performance liquid chromatography with geniposide as the evaluation index.The particle size,bulk density,angle of repose,moisture,solubility,hygroscopicity and loading difference of the insomnia granule were evaluated,and the difference between the trial test and the pilot test were analyzed to comprehensively monitor the quality of the insomnia granule.Results The best extraction process was to add 10 times of water and cooked it three times for 1.5 hours each time.The average yield rate of dry extract of the pilot test and trial test was 22.10％,15.52％,and the average yield of powder was 84.96％ and 93.12％,respectively.The conversion rate from the pilot test to the trial test is 76.97％.Both the trial test and the pilot test particles met the quality requirements of the 2015 edition of the pharmacopoeia.Conclusions The preparation method of the insomnia granules is simple and the quality is uniform.The results of the pilot scale showed that the conversion rate is high,the quality is controllable,and the technical feasibility of industrial production is obtained.

Objective: To explore the A wave value in neuroelectrophysiological subtype of Guillain-Barré syndrome(GBS)and the clinical severity and short-term prognosis of acute inflammatory demyelinating polyradiculoneuropathy(AIDP). Methods: From March 2014 to March 2017, a total of 56 children with GBS at Department of Neurology of Wuhan Children′s Hospital Affiliated to Tongji Medical College, Huazhong University of Science & Technology were enrolled.The patients were divided into AIDP subtype(40 cases) and axonal GBS subtype(16 cases) according to the results of electrophysiological examination.According to whether there was existence of A wave or not, the GBS children were divided into 2 groups.The first group was the A wave in GBS group(18 cases), and the second group was non-A wave in GBS group(38 cases). In order to explore classification value for GBS with A wave, clinical data including age, gender, history of prodromal infection, cranial nerve dysfunction, autonomic nerve involvement and conduction blocks were analyzed.To explore A wave value in clinical severity and short-term prognosis of AIDP, the age, gender, clinical severity, conduction blocks, short-term prognosis of the 2 groups were analyzed in A wave with AIDP (18 cases) and non-A wave with AIDP(22 cases). Results: Compared with non-A wave GBS patients, A wave GBS patients had more conduction blocks(10 cases vs.2 cases, χ²=18.021, P=0.000). Age, sex, precedent infections, cranial nerve involvement, autonomic nerve involvement were not significantly statistically different(all P>0.05). A wave was only seen in AIDP subtype(18 cases), and the percentage of A wave in AIDP was 45%(18/40 cases). There was no A wave in axonal GBS.Compared with non-A wave in AIDP, A wave in AIDP patients had more conduction blocks(10 cases vs.2 cases, χ²=9.924, P=0.002), poorer clinical motor function[(3.39±1.09) scores vs.(2.50±1.01) scores, t=2.667, P=0.011]and short-term prognosis[(2.06±0.64) scores vs.(1.55±0.60) scores, t=2.607, P=0.013]. Conclusions A wave is correlated with demyelination subtype in children′s Guillain-Barré syndrome and poor short-term prognosis in AIDP.