OBJECTIVE: To establish a similarity measurement model for patients with dentofacial deformity based on 3D craniofacial features and to validate the similarity results with quantifying subjective expert scoring. METHODS: In the study, 52 cases of patients with skeletal Class Ⅲ malocclusions who underwent bimaxillary surgery and preoperative orthodontic treatment at Peking University School and Hospital of Stomatology from January 2020 to December 2022, including 26 males and 26 females, were selected and divided into 2 groups by sex. One patient in each group was randomly selected as a reference sample, and the others were set as test samples. Three senior surgeons rated the similarity scores between the test samples and the reference sample. Similarity scores ranged from 1 to 10, where 1 was completely different, and 10 was exactly the same. Scores larger than 7.5 was considered as clinically similar. Preoperative cone beam computed tomography (CBCT) and 3D facial images of the patients were collected. The three-dimensional hard and soft tissue features, including distances, angles and 3D point cloud features were extracted. The similarity measurement model was then established to fit with the experts' similarity scoring by feature selection algorithm and linear regression model. To verify the reliability of the model, 14 new patients were selected and input to similarity measurement model for finding similar cases. The similarity scoring of these similar cases were rated by experts, and used to evaluate the reliability of the model. RESULTS: The similarity metric models indicated that the features of the middle and lower craniofacial features were the main features to influence the craniofacial similarity. The main features that were related to the expert' s similarity scoring included distance of anterior nasal spine-menton (ANS-Me), distance of right upper canion point-Frankfurt horizontal plane (U3RH), distance of left superior point of the condyle-left gonion (CoL-GoL), distance of left gonion-menton (CoL-Me), distance of pogonion-midsagittal plane (Pog-MSP), distance of right alar base-left alar base (AlR-AlL), angle of pronasale-soft tissue pogonion-labrale inferius (Pn-Pog' -Li), distance of trichion-right tragus (Tri-TraR), distance of left exocanthion-left alar base (ExL-AlL), lower 1/3 of skeletal face, middle and lower 2/3 of skeletal face and upper lip region of soft tissue. Fourteen new patients were chosen to evaluate the model. The similar cases selected by the model had an average experts' similarity scoring of 7.627± 0.711, which was not significantly different with 7.5. CONCLUSION The similarity measurement model established by this model could find the similar cases which highly matched experts' subjective similarity scoring. The study could be further used for similar cases retrieval in skeletal Ⅲ malocclusion patients.
Humans ; Male ; Female ; Imaging, Three-Dimensional/methods* ; Cone-Beam Computed Tomography ; Malocclusion, Angle Class III/surgery* ; Orthognathic Surgical Procedures/methods* ; Face/anatomy & histology* ; Cephalometry/methods* ; Adult ; Adolescent ; Dentofacial Deformities/surgery* ; Young Adult

OBJECTIVE: To compare the aesthetic effects of anterior maxilla clockwise rotation combined with segmental Le Fort Ⅰ osteotomy and whole maxilla clockwise rotation on improving paranasal concavity in patients with Class Ⅲ maxillofacial deformity. METHODS: A non-randomized controlled trial was designed, and 21 patients diagnosed with skeletal Class Ⅲ maxillofacial deformity were included. In the study, 11 patients in the test group were treated by segmental Le Fort Ⅰ osteotomy combined with anterior maxilla clockwise rotation, and 10 patients in the control group were treated by whole maxilla clockwise rotation. The CBCT and 3D photography of preoperative (T0), 2 weeks postoperative (T1), and 6 months postoperative (T2) were collected respectively, and the three-dimensional cephalometry was carried out. The differences of specific parameters between the two groups were compared by independent sample t-test, including saggital displacement of the cheek mass point (CK) and subalare point (SA), nasolabial angle, occlusal plane angle and labial inclination angle of the upper incisor. RESULTS: There were no significant differences of the parameters on T0 between the two groups. The average sagittal displacement of the upper incisors of the test group was (-0.71±1.67) mm and smaller than that of control group [(2.26±1.68) mm], t=-4.052, P < 0.05. The average angle of the occlusal plane clockwise rotation of the test group was 1.46°±2.38° and smaller than that of the control group (4.31°±1.83°), t=-3.047, P < 0.05. The angle of anterior maxilla clockwise rotation was 11.73°±2.81° during the surgery. The average saggital displacement of the paranasal soft tissue landmarks of the test group from T0 to T2 was larger than that of the control group [CK point, (4.96±1.18) mm vs. (2.01± 1.50) mm, P < 0.05;SA point, (5.19±1.17) mm vs. (2.69±1.45) mm, P < 0.05]. The labial inclination angle of the upper incisor of the test group was 112.15°±5.40° in T2 and significantly smaller than that of the control group (122.38°±8.83°), t=-3.237, P < 0.05. The nasolabial angle of the test group was 106.54°±12.82° in T2 and significantly larger than that of the control group (93.90°±12.46°), t=2.288, P < 0.05. CONCLUSION Compared with whole maxilla clockwise rotation, anterior maxilla clockwise rotation combined with segmental Le Fort Ⅰ osteotomy can increase the saggital displacement of the paranasal soft tissue, correct labial inclination of the upper incisors and the acute naso-labial angle and better improve the paranasal aesthetic defects in patients with Class Ⅲ maxillofacial deformity with less changing on the saggital orientation of the upper incisors and the occlusal plane angle.
Humans ; Maxilla/surgery* ; Female ; Male ; Osteotomy, Le Fort/methods* ; Malocclusion, Angle Class III/surgery* ; Adult ; Cephalometry ; Young Adult ; Rotation ; Adolescent

Developing and identifying effective medications and targets for treating hepatic fibrosis is an urgent priority. Our previous research demonstrated the efficacy of artesunate (ART) in alleviating liver fibrosis by eliminating activated hepatic stellate cells (HSCs). However, the underlying mechanism remains unclear despite these findings. Notably, endocytic adaptor protein (NUMB) has significant implications for treating hepatic diseases, but current research primarily focuses on liver regeneration and hepatocellular carcinoma. The precise function of NUMB in liver fibrosis, particularly its ability to regulate HSCs, requires further investigation. This study aims to elucidate the role of NUMB in the anti-hepatic fibrosis action of ART in HSCs. We observed that the expression level of NUMB significantly decreased in activated HSCs compared to quiescent HSCs, exhibiting a negative correlation with the progression of liver fibrosis. Additionally, ART induced senescence in activated HSCs through the NUMB/P53 tumor suppressor (P53) axis. We identified NUMB as a crucial regulator of senescence in activated HSCs and as a mediator of ART in determining cell fate. This research examines the specific target of ART in eliminating activated HSCs, providing both theoretical and experimental evidence for the treatment of liver fibrosis.
Hepatic Stellate Cells/cytology* ; Liver Cirrhosis/genetics* ; Artesunate/pharmacology* ; Cellular Senescence/drug effects* ; Membrane Proteins/genetics* ; Animals ; Humans ; Nerve Tissue Proteins/genetics* ; Tumor Suppressor Protein p53/genetics* ; Male ; Mice

Objective To investigate the correlation between serum homeodomain interacting protein ki-nase 2(HIPK2),annexin A5(ANXA5)and coronary stenosis and prognosis in patients with acute myocardial infarction(AMI).Methods A total of 277 AMI patients who received interventional treatment in this hospi-tal from January 2021 to July 2023 were selected as the AMI group,and another 140 cases with normal or very mild stenosis in coronary angiography during the same period were selected as the control group.According to the degree of coronary artery stenosis(Gensini score),the AMI patients were divided into mild coronary arter-y stenosis group(86 cases),moderate coronary artery disease group(111 cases)and severe coronary artery disease group(80 cases).According to the prognosis,they were divided into poor prognosis group(80 cases)and good prognosis group(197 cases).Enzyme-linked immunosorbent assay was used to detect the serum HIPK2 and ANXA5 levels.Spearman correlation analysis was used to analyze the correlation between serum HIPK2 and ANXA5 levels and Gensini score in patients with AMI.Multivariate unconditional Logistic regres-sion was used to determine the relationship between serum HIPK2 and ANXA5 levels and prognosis of AMI patients.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of serum HIPK2 and ANXA5 levels on prognosis of AMI patients.Results Compared with the control group,the ser-um HIPK2 level in the AMI group increased and the ANXA5 level decreased,and the differences were statisti-cally significant(P＜0.05).The serum HIPK2 levels in the mild coronary artery stenosis group,moderate coronary artery stenosis group and severe coronary artery stenosis group increased successively,while the ANXA5 levels decreased successively,and the differences were statistically significant(P＜0.05).Gensini score was positively correlated with serum HIPK2 level and negatively correlated with serum ANXA5 level in AMI patients(P＜0.05).The Gensini score of AMI patients was positively correlated with the serum HIPK2 level(r=0.785,P＜0.05),and negatively correlated with the serum ANXA5 level(r=-0.798,P＜0.05).Compared with the good prognosis group,the serum HIPK2 level in the poor prognosis group increased(P＜0.05),and the ANXA5 level decreased(P＜0.05).After adjusting for confounding factors,high HIPK2 was an independent risk factor for poor prognosis in AMI patients(P＜0.05),and high ANXA5 was an independ-ent protective factor(P＜0.05).The area under the curve of the combined prediction of serum HIPK2 and ANXA5 levels for the prognosis of AMI patients was 0.875,which was greater than 0.778 and 0.784 predic-ted by serum HIPK2 and ANXA5 levels alone(P＜0.05).Conclusion The serum HIPK2 level is increased and the ANXA5 level is decreased in patients with AMI,which is related to the aggravation of coronary steno-sis and the poor prognosis.The combination of serum HIPK2 and ANXA5 levels is more effective in predic-ting the prognosis of patients with AMI.

Objective:To investigate the epidemic status of drinking-tea type endemic fluorosis (fluorosis for short) in Inner Mongolia Autonomous Region (Inner Mongolia for short), and to provide theoretical basis and basic data for formulation and evaluation of prevention and control measures.Methods:From May to October 2022, a cross-sectional survey was conducted in key areas (168 administrative villages in 6 leagues or cities) identified in the 2019 regional census with tea drinking habits, daily per capita intake of tea fluoride > 3.5 mg, and patients with skeletal fluorosis. The drinking condition of brick tea in 10 households of each administrative village was investigated, and the brick tea samples were collected to detect fluoride level. The prevalence of dental fluorosis in children aged 8 - 12 and skeletal fluorosis in adults aged 16 and older was investigated, and urine samples of patients with skeletal fluorosis were collected to detect urinary fluoride levels.Results:Totally 98.40% (1 657/1 684) of the households in the surveyed areas had a habit of drinking brick tea, with an annual per capita consumption of brick tea and a daily per capita intake of tea fluoride of 5.07 kg and 5.38 mg, respectively. The qualified rate of fluoride level in brick tea samples was 55.64% (922/1 657), the average fluoride level of all other brick tea varieties exceeded the national standard limit (300 mg/kg) except for black brick tea (291.08 mg/kg). Totally 2 747 children aged 8 to 12 were examined, with a detection rate of 13.91% (382/2 747) for dental fluorosis. The disease was mainly mild. There was no statistically significant difference in the detection rate of dental fluorosis among different age groups (χ 2 = 5.53, P = 0.238). Totally 71 708 adults aged 16 and older were examined, and the detection rate of skeletal fluorosis was 1.02% (734/71 708). Patients were mainly aged between 50 and 70 years old, and the condition in each age group was mainly mild. Totally 715 urine samples of skeletal fluorosis patients were collected and tested, and 55.24% (395/715) of the urine samples had fluoride levels higher than 1.6 mg/L. Conclusions:In Inner Mongolia, the proportion of high fluoride brick tea in endemic areas of drinking-tea type fluorosis is high. The detection rates of dental fluorosis in children and skeletal fluorosis in adults are relatively high. The prevention and control situation of drinking-tea type fluorosis is still serious.

Objective:To establish and assess the precision of pre-surgical condyle position planning using mandibular movement trajectory data for orthognathic surgery.Methods:Skull data from large-field cone beam computed tomography(CBCT)and dental oral scan data were imported into IVSPlan 1.0.25 software for 3D reconstruction and fusion,creating 3D models of the maxilla and mandible.Trajectory da-ta of mandibular movement were collected using a mandibular motion recorder,and the data were inte-grated with the jaw models within the software.Subsequently,three-dimensional trajectories of the con-dyle were obtained through matrix transformations,rendering them visually accessible.A senior oral and maxillofacial surgeon with experience in both diagnosis and treatment of temporomandibular joint disease and orthognathic surgery selected the appropriate condyle position using the condyle movement trajectory interface.During surgical design,the mobile mandibular proximal segment was positioned accordingly.Routine orthognathic surgical planning was completed by determining the location of the mandibular distal segment,which was based on occlusal relationships with maxilla and facial aesthetics.A virtual mandible model was created by integrating data from the proximal and distal segment bone.Subsequently,a solid model was generated through rapid prototyping.The titanium plate was pre-shaped on the mandibular model,and the screw hole positions were determined to design a condylar positioning guide device.In accordance with the surgical plan,orthognathic surgery was performed,involving mandibular bilateral sagittal split ramus osteotomy(SSRO).The distal segment of the mandible was correctly aligned inter-maxillary,while the proximal bone segment was positioned using the condylar positioning guide device and the pre-shaped titanium plate.The accuracy of this procedure was assessed in a study involving 10 patients with skeletal class Ⅱ malocclusion.Preoperative condyle location planning and intraoperative po-sitioning were executed using the aforementioned techniques.CBCT data were collected both before the surgery and 2 weeks after the procedure,and the root mean square(RMS)distance between the preope-rative design position and the actual postoperative condyle position was analyzed.Results:The RMS of the condyle surface distance measured was(1.59±0.36)mm(95％CI:1.35-1.70 mm).This value was found to be significantly less than 2 mm threshold recommended by the expert consensus(P＜0.05).Conclusion:The mandibular trajectory may play a guiding role in determining the position of the mandibular proximal segment including the condyle in the orthognathic surgery.Through the use of a con-dylar positioning guide device and pre-shaped titanium plates,the condyle positioning can be personalized and customized with clinically acceptable accuracy.

Objective:To investigate the distribution of physical and chemical water improvement areas of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region, as well as the use of household water purifiers.Methods:From April to October 2021, a survey was conducted in a drinking water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region where physical and chemical water improvement was carried out. The survey included the basic situation of the affected villages (number of permanent households, number of permanent residents, historical water fluoride content) and the use of residential water purifiers. Household peripheral water samples were collected to test the water fluoride content. Water purifier installation rate, normal usage rate, qualified water fluoride rate in normal usage, and the proportion of households covered by filter replacement departments were calculated.Results:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis were distributed in 2 735 villages in 11 leagues (cities) throughout the region, with 192 950 permanent households and 540 216 permanent residents. The average historical water fluoride content in all leagues (cities) was 2.18 mg/L, and the current average water fluoride content was 0.40 mg/L. A total of 134 763 water purifiers were installed, with an installation rate of 69.84% (134 763/192 950). A total of 10 773 households were surveyed, with 10 396 households using water purifiers normally and a normal usage rate of 96.50% (10 396/10 773). Among them, 10 158 households had qualified water fluoride of normal usage, with a qualified water fluoride rate of 97.71% (10 158/10 396). Of the 10 396 households using water purifiers normally, 3 974 households (38.23%) had filter cartridges used within one year, and 3 961 households had qualified water fluoride, with a qualified rate of water fluoride of 99.67% (3 961/3 974). Six thousand four hundred and twenty-two households (61.77%) had filter cartridges used for more than one year, with 6 197 households had qualified water fluoride and a qualified rate of water fluoride of 96.50% (6 197/6 422). There was a statistically significant difference in the qualified rate of water fluoride between purifiers with different filter cartridge usage times (χ 2 = 110.73, P < 0.001). Among the 10 773 surveyed households, the filter cartridges replacement department covered 10 470 households, accounting for 97.19% (10 470/10 773). Conclusions:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis are widely distributed, and the normal usage rate of household water purifiers is relatively high. The qualified rate of water fluoride in household water purifiers with filter cartridges used for more than one year is low.

BACKGROUND: Microsatellite instability (MSI) is a key biomarker for cancer immunotherapy and prognosis. Integration of MSI testing into a next-generation-sequencing (NGS) panel could save tissue sample, reduce turn-around time and cost, and provide MSI status and comprehensive genomic profiling in single test. We aimed to develop an MSI calling model to detect MSI status along with the NGS panel-based profiling test using tumor-only samples. METHODS: From January 2019 to December 2020, a total of 174 colorectal cancer (CRC) patients were enrolled, including 31 MSI-high (MSI-H) and 143 microsatellite stability (MSS) cases. Among them, 56 paired tumor and normal samples (10 MSI-H and 46 MSS) were used for modeling, and another 118 tumor-only samples were used for validation. MSI polymerase chain reaction (MSI-PCR) was performed as the gold standard. A baseline was built for the selected microsatellite loci using the NGS data of 56 normal blood samples. An MSI detection model was constructed by analyzing the NGS data of tissue samples. The performance of the model was compared with the results of MSI-PCR. RESULTS: We first intersected the target genomic regions of the NGS panels used in this study to select common microsatellite loci. A total of 42 loci including 23 mononucleotide repeat sites and 19 longer repeat sites were candidates for modeling. As mononucleotide repeat sites are more sensitive and specific for detecting MSI status than sites with longer length motif and the mononucleotide repeat sites performed even better than the total sites, a model containing 23 mononucleotide repeat sites was constructed and named Colorectal Cancer Microsatellite Instability test (CRC-MSI). The model achieved 100% sensitivity and 100% specificity when compared with MSI-PCR in both training and validation sets. Furthermore, the CRC-MSI model was robust with the tumor content as low as 6%. In addition, 8 out of 10 MSI-H samples showed alternations in the four mismatch repair genes ( MLH1 , MSH2 , MSH6 , and PMS2 ). CONCLUSION MSI status can be accurately determined along the targeted NGS panels using only tumor samples. The performance of mononucleotide repeat sites surpasses loci with longer repeat motif in MSI calling.
Humans ; Microsatellite Instability ; Colorectal Neoplasms/diagnosis* ; Microsatellite Repeats/genetics* ; DNA Mismatch Repair

Objective:To analyze the research status, development trend and frontier hotspots of midwifery education in China in recent 20 years.Methods:Based on the topic of "midwifery education" or "midwifery teaching", this paper searched the periodical literatures from 2001 to 2021 on CNKI database, and used CiteSpace5.7R5 software to analyze them visually and generate knowledge map.Results:A total of 548 Chinese papers were included in this study, and the annual number of published papers showed an overall upward trend. The research field of midwifery education in China formed an obvious core team, and there was few cooperation among core author groups. Health Vocational Education, Chinese Nursing Education and Chinese Higher Medical Education were the top three journals. The six topics with the highest frequency were midwifery specialty, midwifery personnel, midwifery education, practice teaching, delivery mode and teaching mode, forming 10 clusters of midwifery education. In recent three years, the research of midwifery education in China has gradually changed into simulation teaching, flipped classroom, postpartum rehabilitation and so on. Conclusion:The research scope of midwifery education in China is wide and has formed an obvious core team, but the correlation is weak and there is less communication and cooperation among the research teams. The research in the field of high-level midwifery education is insufficient. Midwifery educators and researchers should pay enough attention to carry out in-depth research on relevant aspects.

Clinical data of 3 pregnant women with primary hyperparathyroidism admitted in Jinan Maternal and Child Health Hospital from 2013 to 2021 were retrospectively reviewed. Hyperparathyroidism was diagnosed during pregnancy in all 3 cases. The clinical manifestations were non-specific, such as nausea, vomiting, anorexia, and fatigue. Patients also had gallbladder stones (1 case), gallbladder polyps (1 case), and renal parenchyma changes (2 cases). The hypercalcemia crisis occurred in all 3 cases, the blood Ca 2+ levels were 4.11 mmol/L, 2.92-3.82 mmol/L and 3.49-4.10 mmol/L, respectively; and preeclampsia developed in 2 cases. Sudden death occurred in case 1 who did not receive effective treatment during pregnancy; blood calcium was well controlled during pregnancy in case 2, and her neonate had hypocalcemia with good prognosis; case 3 underwent surgical treatment in early pregnancy, and then had missed abortion. Pathological examination revealed parathyroid tumors in all 3 cases.