Objective:To evaluate the influence of midface (nasal base and zygomatic bone) morphological changes on the overall perception of lip prominence from different perspectives.Methods:From February to March 2024, 212 volunteers were recruited in Fujian Province as study subjects and divided into three groups: orthodontists [65 participants, 28 males and 37 females, aged (31.3±6.9) years], orthodontic patients [72 participants, 24 males and 48 females, aged (27.6±5.7) years], and healthy adults [75 participants, 37 males and 38 females, aged (25.6±4.4) years]. Three-dimensional facial modeling software was used to generate facial models, which were sculpted using three-dimensional model sculpting software to simulate different nasal base, zygomatic bone, and upper lip prominence conditions. A total of 15 facial models were generated, divided into five groups (three models per group): Group A (normal nasolabial angle, normal nasal base, normal upper lip); Group B (increased nasolabial angle, normal nasal base, flattened upper lip); Group C (decreased nasolabial angle, normal nasal base, protruded upper lip); Group D (increased nasolabial angle, protruded nasal base, normal upper lip); Group E (decreased nasolabial angle, recessed nasal base, normal upper lip). Models 1, 2, and 3 in each group had normal, protruded, and flattened zygomatic bones, respectively (with Model 1 in Group A as the initial model). Forty-five-degree and ninety-degree profile images of the models were captured (30 images in total) and compiled into a questionnaire. Participants in the three study groups were selected as the most attractive and least attractive facial appearances based on the questionnaire and ratings of the lip prominence of the 45° and 90° profile images (0-10 points, where 0=very flat, 5=normal, and 10=very prominent). A one-sample t-test was used to compare the difference between model ratings and the median score of 5. Results:Among the 30 images, the proportion of lip prominence ratings deviating from the median score of 5 was the highest among orthodontists [83% (25/30)], followed by orthodontic patients [67% (20/30)], and lowest among healthy adults [53% (16/30)]. At the 90° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.07±0.79, 5.00±1.03, and 4.95±1.07, respectively) showed no statistically significant difference from 5 ( t=0.65, P=0.521; t=0.00, P=1.000; t=-0.42, P=0.673). At the 45° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.42±0.98, 5.40±1.15, and 5.35±1.45, respectively) were significantly higher than 5 ( t=3.30, P=0.002; t=2.98, P=0.004; t=2.11, P=0.038). At both 90° and 45° profile views, orthodontists, orthodontic patients, and healthy adults all rated the lip prominence of Model 1 in Group E (nasal base recession) significantly higher than 5 (all P<0.05). In Group E (nasal base recession model), changes in zygomatic prominence led to alterations in the overall lip prominence ratings by orthodontists and orthodontic patients, with significant differences among Models 1, 2, and 3 (all P<0.05). In the most attractive facial appearance evaluation, Model 1 of Group D had the highest frequency percentage in both the 90° profile and 45° profile views [90°: 19.8% (42/212); 45°: 22.6% (48/212)]. Conclusions:Orthodontists had the highest sensitivity to changes in lip prominence. The observation angle influenced the perception of lip prominence changes, and variations in zygomatic and nasal base prominence could shift lip prominence evaluations. A slightly larger nasolabial angle, protruded nasal base, and normal zygomatic bone configuration were perceived as the most attractive.

Objective:To analyze the risk factors for herpes zoster complicated by kidney dysfunction and construct a prediction model.Methods:A retrospective analysis was conducted on the clinical data of 150 patients with herpes zoster who were admitted to Hangzhou Third People's Hospital from January 2022 to December 2023. The patients were divided into two groups based on the presence of kidney dysfunction: kidney dysfunction group ( n = 30, with kidney dysfunction) and control group ( n = 120, without kidney dysfunction). The risk factors for herpes zoster complicated by kidney dysfunction were analyzed. The logistic prediction model was constructed. The effectiveness of this prediction model in predicting herpes zoster complicated by kidney dysfunction was assessed using the receiver operating characteristic curve. Results:The differences in gender, body mass index, comorbidities (hypertension and hyperlipidemia), and sites of onset between the two patient groups were not statistically significant (all P > 0.05). The average age of the kidney dysfunction group was (67.74 ± 6.71) years, which was significantly older than that in the control group [(62.32 ± 5.58) years, t = 4.56, P < 0.001]. In the kidney dysfunction group, the proportions of patients with comorbid diabetes, severe pain, large lesion area, high-dose antiviral medication use, and hemoglobin levels < 120 g/L were 46.67% (14/30), 63.33% (19/30), 56.67% (17/30), 46.67% (14/30), and 40.00% (12/30), respectively. These values were all significantly greater than those in the control group [14.17% (17/120), 34.17% (41/120), 31.67% (36/120), 19.17% (23/120), and 10.00% (12/120), χ2 = 15.46, 2.60, 2.10, 9.76, 16.07, P < 0.001, 0.002, 0.035, 0.002, < 0.001). Logistic regression analysis revealed that older age ( OR = 3.023), comorbid diabetes ( OR = 4.315), severe pain ( OR = 3.623), large lesion area ( OR = 3.481), high-dose antiviral medication use ( OR = 4.030), and hemoglobin levels < 120 g/L ( OR = 0.151) were all significant risk factors for herpes zoster complicated by kidney dysfunction (all P < 0.05). Based on these risk factors, the following logistic prediction model was developed: Logit( P) = -8.753 + 1.106 × age + 1.462 × diabetes + 1.287 × pain severity + 1.247 × lesion area + 1.394 × high-dose antiviral medication use + (-1.889) × hemoglobin. The receiver operating characteristic curve analysis indicated that the area under the curve for predicting herpes zoster complicated by kidney dysfunction was 0.904 (95% CI: 0.859-0.937), with a sensitivity of 84.62% and a specificity of 89.04%. Conclusions:The risk factors for herpes zoster complicated by kidney dysfunction include older age, comorbid diabetes, severe pain, large lesion area, high-dose antiviral medication use, and hemoglobin levels < 120 g/L. Based on these factors, the construction of a logistic prediction model can provide a reliable basis for clinical prediction of the occurrence of kidney dysfunction.

Objective:To evaluate the influence of midface (nasal base and zygomatic bone) morphological changes on the overall perception of lip prominence from different perspectives.Methods:From February to March 2024, 212 volunteers were recruited in Fujian Province as study subjects and divided into three groups: orthodontists [65 participants, 28 males and 37 females, aged (31.3±6.9) years], orthodontic patients [72 participants, 24 males and 48 females, aged (27.6±5.7) years], and healthy adults [75 participants, 37 males and 38 females, aged (25.6±4.4) years]. Three-dimensional facial modeling software was used to generate facial models, which were sculpted using three-dimensional model sculpting software to simulate different nasal base, zygomatic bone, and upper lip prominence conditions. A total of 15 facial models were generated, divided into five groups (three models per group): Group A (normal nasolabial angle, normal nasal base, normal upper lip); Group B (increased nasolabial angle, normal nasal base, flattened upper lip); Group C (decreased nasolabial angle, normal nasal base, protruded upper lip); Group D (increased nasolabial angle, protruded nasal base, normal upper lip); Group E (decreased nasolabial angle, recessed nasal base, normal upper lip). Models 1, 2, and 3 in each group had normal, protruded, and flattened zygomatic bones, respectively (with Model 1 in Group A as the initial model). Forty-five-degree and ninety-degree profile images of the models were captured (30 images in total) and compiled into a questionnaire. Participants in the three study groups were selected as the most attractive and least attractive facial appearances based on the questionnaire and ratings of the lip prominence of the 45° and 90° profile images (0-10 points, where 0=very flat, 5=normal, and 10=very prominent). A one-sample t-test was used to compare the difference between model ratings and the median score of 5. Results:Among the 30 images, the proportion of lip prominence ratings deviating from the median score of 5 was the highest among orthodontists [83% (25/30)], followed by orthodontic patients [67% (20/30)], and lowest among healthy adults [53% (16/30)]. At the 90° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.07±0.79, 5.00±1.03, and 4.95±1.07, respectively) showed no statistically significant difference from 5 ( t=0.65, P=0.521; t=0.00, P=1.000; t=-0.42, P=0.673). At the 45° profile view, the scores given by orthodontists, orthodontic patients, and healthy adults for the initial model (5.42±0.98, 5.40±1.15, and 5.35±1.45, respectively) were significantly higher than 5 ( t=3.30, P=0.002; t=2.98, P=0.004; t=2.11, P=0.038). At both 90° and 45° profile views, orthodontists, orthodontic patients, and healthy adults all rated the lip prominence of Model 1 in Group E (nasal base recession) significantly higher than 5 (all P<0.05). In Group E (nasal base recession model), changes in zygomatic prominence led to alterations in the overall lip prominence ratings by orthodontists and orthodontic patients, with significant differences among Models 1, 2, and 3 (all P<0.05). In the most attractive facial appearance evaluation, Model 1 of Group D had the highest frequency percentage in both the 90° profile and 45° profile views [90°: 19.8% (42/212); 45°: 22.6% (48/212)]. Conclusions:Orthodontists had the highest sensitivity to changes in lip prominence. The observation angle influenced the perception of lip prominence changes, and variations in zygomatic and nasal base prominence could shift lip prominence evaluations. A slightly larger nasolabial angle, protruded nasal base, and normal zygomatic bone configuration were perceived as the most attractive.

Objective:To analyze the risk factors for herpes zoster complicated by kidney dysfunction and construct a prediction model.Methods:A retrospective analysis was conducted on the clinical data of 150 patients with herpes zoster who were admitted to Hangzhou Third People's Hospital from January 2022 to December 2023. The patients were divided into two groups based on the presence of kidney dysfunction: kidney dysfunction group ( n = 30, with kidney dysfunction) and control group ( n = 120, without kidney dysfunction). The risk factors for herpes zoster complicated by kidney dysfunction were analyzed. The logistic prediction model was constructed. The effectiveness of this prediction model in predicting herpes zoster complicated by kidney dysfunction was assessed using the receiver operating characteristic curve. Results:The differences in gender, body mass index, comorbidities (hypertension and hyperlipidemia), and sites of onset between the two patient groups were not statistically significant (all P > 0.05). The average age of the kidney dysfunction group was (67.74 ± 6.71) years, which was significantly older than that in the control group [(62.32 ± 5.58) years, t = 4.56, P < 0.001]. In the kidney dysfunction group, the proportions of patients with comorbid diabetes, severe pain, large lesion area, high-dose antiviral medication use, and hemoglobin levels < 120 g/L were 46.67% (14/30), 63.33% (19/30), 56.67% (17/30), 46.67% (14/30), and 40.00% (12/30), respectively. These values were all significantly greater than those in the control group [14.17% (17/120), 34.17% (41/120), 31.67% (36/120), 19.17% (23/120), and 10.00% (12/120), χ2 = 15.46, 2.60, 2.10, 9.76, 16.07, P < 0.001, 0.002, 0.035, 0.002, < 0.001). Logistic regression analysis revealed that older age ( OR = 3.023), comorbid diabetes ( OR = 4.315), severe pain ( OR = 3.623), large lesion area ( OR = 3.481), high-dose antiviral medication use ( OR = 4.030), and hemoglobin levels < 120 g/L ( OR = 0.151) were all significant risk factors for herpes zoster complicated by kidney dysfunction (all P < 0.05). Based on these risk factors, the following logistic prediction model was developed: Logit( P) = -8.753 + 1.106 × age + 1.462 × diabetes + 1.287 × pain severity + 1.247 × lesion area + 1.394 × high-dose antiviral medication use + (-1.889) × hemoglobin. The receiver operating characteristic curve analysis indicated that the area under the curve for predicting herpes zoster complicated by kidney dysfunction was 0.904 (95% CI: 0.859-0.937), with a sensitivity of 84.62% and a specificity of 89.04%. Conclusions:The risk factors for herpes zoster complicated by kidney dysfunction include older age, comorbid diabetes, severe pain, large lesion area, high-dose antiviral medication use, and hemoglobin levels < 120 g/L. Based on these factors, the construction of a logistic prediction model can provide a reliable basis for clinical prediction of the occurrence of kidney dysfunction.

Objective:To investigate the long-term efficacy and complications of augmentation uretero-enterocystoplasty (AUEC).Methods:The clinical data of 262 patients with lower urinary tract dysfunction who underwent AUEC at our center from January 2003 to June 2022 were analyzed retrospectively. There were 193 males and 69 females, the median age was 24 (4, 67) years, the median disease duration was 12.0 (0.2, 56.0) years and the preoperative creatinine was 91.5 (68.1, 140.0) μmol/L. 320 ureters had high-grade UUTD, 216 ureters had VUR, 14 of which had low-pressure reflux.The number of low-grade VUR ureter was 22 (10.2%) and the number of high-grade VUR ureter was 194 (89.8%). Video-urodynamics showed that the maximum bladder capacity was 102 (47, 209) ml, the maximum detrusor pressure was 33.0 (15.5, 50.5) cmH 2O, and the bladder compliance was 6.4 (3.0, 12.3) ml/cmH 2O. All patients underwent AUEC. The surgical method is to cut a segment of sigmoid colon, open the sigmoid colon along the mesenteric margin, fold and suture it into " U" or " S" shaped intestinal mesh according to the principle of " detubulization" . At the same time, perform ureteroplasty and replanting, and then anastomosis the intestinal mesh with the opened bladder flap to form an expanded new bladder. Follow-up was performed via outpatient clinic or telephone. The creatinine, maximum bladder capacity, maximum detrusor pressure, bladder compliance, ureteral reflux and upper urinary tract dilatation were compared preoperatively and postoperatively. The postoperative complications were also evaluated. Results:The median follow-up time was 57.4 (4, 151) months after surgery. At 1-3 months after surgery, the maximum bladder capacity and bladder compliance increased to 303.9% and 189.9% of the preoperative level, and the maximum detrusor pressure decreased to 63.6% of the preoperative level. At 6-10 years after surgery, the maximum bladder capacity and bladder compliance increased to 490.2% and 627.9% and the maximum detrusor pressure decreased to 25.8% of the preoperative level. The UUTD of the patients was significantly reduced after surgery. The number of the high grade UUTD decreased to 116 (116/398, 29.2%) at 1-3 months and 51 (51/274, 18.6%) at 4-6 months. At 6-10 years, the number of the high-grade UUTD decreased to 4 (4/76, 5.3%) ( P<0.001), which was significantly lower than that before operation. The VUR was significantly relieved after operation, and 393 ureters had no VUR at 1-3 months, accounting for 97.8% (393/402) of the total ureters. Sustained remission of VUR was observed during follow-up. 73 ureters had no VUR at 6-10 years, accounting for 96.1% (73/76) of total ureters ( P<0.001). Patients' creatinine decreased to 79.0 (65.0-128.2) μmol/L at 1-3 months postoperatively, with a downward trend but no statistical difference, and creatinine levels were not significantly elevated at any postoperative time point compared with preoperative levels ( P>0.05). Postoperative complications included metabolic acidosis in 26 cases (9.9%), vesicoureteral anastomosis stenosis in 15 cases (5.7%), recurrent urinary tract infection in 16 cases (6.1%), and urinary calculi in 20 cases (7.6%), and intestinal obstruction requiring laparotomy in 8 cases (3.1%), all of them could be improved after treatments. Conclusions:AUEC is a safe and effective method for treating high-grade VUR or VUR with impaired anti-reflux mechanism, high-grade UUTD or UUTD with ureteral or vesicoureteral junction obstruction, and all of the complications can be improved after treatment. This technique can increase the bladder capacity and compliance, reconstruct the anti-reflux mechanism, and release upper urinary tract obstruction. It may play an important role in stabilizing and protecting the residual renal function from further deterioration.

Objective: To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. Methods: This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed. The primary endpoint was the composite of cardiac death, recurrent myocardial infarction and target lesion revascularization. Results: (1)The age was (63.3±10.3) years. There were 68.4%(52/76) acute coronary syndrome patients, prevalence of type 2 diabetes was 36.8%(28/76), and 64.5%(49/76)patients with at least one high bleeding risk. (2)The lesion length was (17.4±7.6)mm, and the stenosis was (88.1±8.2)%.The reference vessel diameter≥2.75 mm accounted for 51.2% (41/80), and bifurcation stenosis accounted for 67.5%(54/80). (3)53.7%(43/80) lesions were pretreated with scoring balloon to optimize plaque modification. The paclitaxel-eluting balloon length and diameter were (22.3±5.5)mm and (2.74±0.52)mm.The residual stenosis was (12.3±10.3)%. Procedural success was 88.8%(71/80).Bail-out stenting rate was 5.0%(4/80). (4)The median follow-up duration was 12(6, 25) months. Primary endpoint occurred in 3 cases (3.9%), including 2 cardiac deaths(1 patient died of recurrent myocardial infarction, and 1 patient died of acute heart failure induced by severe mitral insufficiency), and one patient receivedtarget lesion revascularization. Conclusion In case of no more than 30% residual stenosis and no blood flow limited dissection after lesion pretreatment,it is safe and feasible to treat de novo coronary lesionsusing paclitaxel-eluting balloon.

[Objective]To investigate the molecular mechanism of abnormal platelet activation induced by platelet O2 ·- and H2O2 levels in type 2 diabetes mellitus.[Methods]The platelet parameters in patients with type 2 diabetic patients and normal controls were measured;Immunofluorescence technique was used to observe the platelet morphology changing;Flow cytometry was used to detect platelet intracellular O2 ·- and H2O2 content in two groups,then with platelets in normal controls treated with NADH/PMS system and H2O2 respectively,platelet activation positive percentage was observed. Standard Western blot analysis protocols were used to detect expression difference of Catalase and type 2 super-oxide dismutase(Mn-SOD)in platelets.[Results]The MPV in the group of type 2 diabetic patients was significantly higher than in the normal control group(P < 0.001),but there was no statisticdifference in PLT,PDW,PCT between two groups. Immunofluorescence results showed that morphology of platelets in type 2 diabetic patients changed contrast to normal group. Through flowcytometry detection,the content of mitochondrial O2·-and H2O2 of platelet in type 2 diabetic patients were obviously higher than in normal group(P<0.05),whereas no significant difference in cytoplasmic O2·-. We adopted NADH/PMS system and H2O2 to treat platelets of normal group,heightened activated positive percentage were observed which described O2 ·- and H2O2 can significantly promote platelet activation(P<0.01). Western blot results showed that expression of Catalase in platelet of type 2diabetes patients decreased,while the expression and activity of Mn-SOD had no difference.[Conclusion]It is diabetic platelet Catalase expression decreased that may lead to Diabetic platelet mitochondrial O 2 ·- and H2O2 level increased ,thus regulating aberrant activation of diabetic platelet.

BACKGROUND:With the development of three-dimensional (3D) printing technology, 3D printed porous titanium scaffolds as bone substitutes have become a research hotspot. OBJECTIVE:To introduce and discuss the effects of each parameter of 3D printed porous titanium scaffolds on bone ingrowth, and to sum out the optimal parameters for bone ingrowth. METHODS:The first author retrieved PubMed, Springerlink and Medline databases with“three-dimensional (3D) printing, scaffold, titanium, bone ingrowth”as keywords for relevant articles published from 2006 to 2016. 125 articles were retrieved initial y, and final y 42 eligible articles were included for analysis. RESULTS AND CONCLUSION:Pore size, porosity, pore structures and surface modifications of 3D printed porous titanium scaffolds al make effects on bone ingrowth or osteoblasts in scaffolds. Scaffolds with appropriate pore size and porosity can promote the vascularization and provide adequate nutrition and oxygen supplement, to ensure high cel viability. Regulations of cel performances, such as cel attachment, proliferation and differentiation, are also affected by pore structures and nano-scale surface modification. Herein, a detailed combination of the parameters, as mentioned above, can create a better porous scaffold for better bone ingrowth. Hence, the high-stability interface between bone and scaffolds may be obtained through the parameter adjustment.

BACKGROUNDThoracic endovascular aortic repair (TEVAR) is an emerging treatment modality, which has been rapidly embraced by clinicians treating thoracic aortic disease. However, the clinical manifestations of systemic inflammatory response after TEVAR as post-implantation syndrome (PIS) resemble the perioperative infection. This study aimed to evaluate changes and diagnostic value of procalcitonin (PCT) and other traditional inflammatory markers for infections after TEVAR.

METHODSWe conducted a prospective clinical study that enrolled 162 consecutive aortic dissection cases, who underwent TEVAR in our institution between July 2011 and November 2012. The PCT, C-response protein (CRP), erythrocyte sedimentation rate (ESR) and blood routine examination were monitored before the operation and on days 1, 2, 3 and 5 after the operation. The diagnosis of infection was confirmed by the infection control committee with reference to Hospital Acquired Infection Diagnostic Criteria Assessment, released by the Ministry of Health of the People's Republic of China.

RESULTSPost endovascular repair of thoracic aorta, PCT changes significantly at different time points (χ(2) = 13.225, P = 0.021), without significant difference between the PIS group and the control group (0.24 ± 0.04 vs.0.26 ± 0.10, P = 0.804). PCT values were significantly higher in the first day after TEVAR than the preoperative levels (0.18 ± 0.03 vs. 0.11 ± 0.02, P < 0.001). Compared with PIS patients, the level of PCT, CRP, White blood cell (WBC) and neutrophil (NEU) in the infection patients elevated significantly (relatively χ(2) = 6.062, P = 0.048; χ(2) = 6.081, P = 0.048; χ(2) = 11.030, P = 0.004; χ(2) = 14.632, P = 0.001). According to the ROC analysis, the PCT levels in the first day after TEVAR (AUC = 0.785, P = 0.012) had better predictive values of infection than WBC, NEU CRP and ESR (AUC = 0.720, P = 0.040; AUC = 0.715, P = 0.045; AUC = 0.663, P = 0.274; AUC = 0.502, P = 0.991). The best predictive index was the changes of PCT between preoperative and postoperative (PCT), which possess AUC as 0.803 (P = 0.014). And PCT = 0.055 could be considered as an infection diagnosis cutoff value with a sensitivity of 83.3% and specificity 69.0%.

CONCLUSIONSPCT provides better diagnostic value of infection compared with other inflammatory markers. The potential applications of PCT in differential diagnosis of PIS and infection after percutaneous TEVAR deserve further studies.

Adult ; Aged ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Calcitonin ; metabolism ; Calcitonin Gene-Related Peptide ; Diagnosis, Differential ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Protein Precursors ; metabolism ; Vascular Surgical Procedures

Objective To investigate the rs501120 and rs17465637 gene polymorphisms,and their relationship with the risk of coronary heart disease(CHD)in Chinese Han population.Methods 775 CHD without treatment and 775 age and gender matched controls were selected for this study,the genotypes of two single nucleotide polymorphisms(SNP)rs501120 and rs17465637 were tested with TaqMan-MGB probes.Results There was no significant difference in the frequency of genotypes of the 2 SNPs between CHD group and control group(P ＞0.05).Stratified analysis showed that SNP rs501120 had significant protection with CHD in people younger than 60 years old(OR 0.4,95% CI 0.2-0.9,P ＜ 0.05)or people with diabetes(OR0.3,95%CI0.1-0.7,P ＜0.05).Conclusions The results suggested that rs501120 was tightly associated with CHD in people younger than 60 years or had diabetes.