Objective:This study aimed to propose an innovative modular surgical technique and explore its safety and application value in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy for advanced proximal gastric cancer invading the greater curvature.Methods:A retrospective collection was conducted on 34 patients with proximal gastric cancer invading the greater curvature who underwent laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy in the same center from October 2020 to December 2022. The technical key points, precautions and crucial steps of the modular surgical technique were summarized, and the Clinical indicators were analyzed.Results:All 34 patients successfully completed the operation under laparoscopy without conversion to open surgery. The average operation duration was 151.9±4.1 minutes, and the duration of splenic hilar lymphadenectomy was 12.9±1.5 minutes. The median intraoperative blood loss was 50(20, 50) ml, and the blood loss during splenic hilar lymphadenectomy was 5 (2, 5) ml. The median number of harvested lymph nodes was 32.0 (23.5,39.5), and the number of submitted No.10 lymph nodes was 3 (2, 4). The metastasis rate of No.10 lymph nodes was 20.6% (7/34). No patient had intraoperative complications. During the postoperative hospital stay, one patient had incision infection (Clavien-Dindo I), and one patient had pulmonary infection (Clavien-Dindo II). The time for the first postoperative feeding was 3 (2, 5) days, the time for the first postoperative flatus was 2 (2,3) days, the time for the first postoperative defecation was 3 (3, 4) days, the total postoperative drainage volume was 1047.5 (607.5,1397.5) mL, the time for postoperative drainage tube removal was 7 (6, 9) days, and the length of postoperative hospital stay was 7.0 (6.0, 9.5) days.Conclusions:The application of the innovative modular surgical technique in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy can simplify surgical process and enable safe, precise and comprehensive dissection of splenic hilar lymph nodes.

Geriatric oral health care encounters significant challenges with the increase in the proportion of older individuals. Age-related changes in the dentition, muscles, and joints result in a decline in objective masticatory function, subjective restoration requirements, and acceptability among the elderly population, with individual variations influenced by systemic health. Considering functional requirements, the adaptability of stomatognathic and systemic health conditions, health economics and other factors, the authors believe that it should not be limited to the conventional "one-to-one" strategy for replacing missing teeth in geriatric prosthodontics. There is an urgent need for a precise and adaptable restoration strategy that is more suitable for older individuals. The proposal of a new concept of functional tooth loss updates the minimal restoration standards for elderly patients and establishes the theory of age-friendly functional restoration. Based on the restoration strategy of functional tooth loss, this paper proposes a new concept termed "age-friendly functional restoration of the stomatognathic system", which integrates treatment considerations including endodontics, periodontology, mucosa, muscles, temporomandibular joint, and systemic health. Efforts should be made in four areas as follows. Firstly, the "assessment of accessible function" should be enhanced by considering the interrelationship between stomatognathic and systemic health. Secondly, the "evaluation of appropriate function" is supposed to be optimised in view of subjective needs and objective evaluation of the stomatognathic system. Moreover, the "formulation of treatment plans" needs to be accomplished with the aid of assistive technologies, such as artificial intelligence, to accurately exert appropriate functional restoration. Lastly, the "management and maintenance of health" is likely to be strengthened through follow-ups, propaganda and education, and preventive healthcare, so as to improve quality of life and ultimately achieve healthy ageing among older individuals.
Humans ; Tooth Loss/therapy* ; Aged ; Stomatognathic System ; Oral Health ; Dental Care for Aged ; Dental Restoration, Permanent/methods*

Objective To compare the value of high-field strength MRI half-Fourier single shot turbo spin-echo(HASTE)sequence with high-frequency color Doppler ultrasound for the diagnosis of placenta previa combined with placenta accreta.Methods A total of 116 pregnant women with suspected high-risk placenta previa and placenta accreta who underwent cesarean section at The No.2 Hospital of Baoding from December 2019 to December 2022 were selected as research objects.All parturients took examinations of ultrasound and high-field MRI before surgery.Pathological diagnosis after cesarean section was used as the gold standard for analysis of the consistency between MRI and ultrasound results and pathological results.The value of HASTE sequence and high-frequency ultrasound in diagnosing placenta accreta was compared.Results Pathological results confirmed that 86 patients had high-risk placenta previa and placenta accreta.The positive predictive values of ultrasound,MRI,and ultrasound+MRI in diagnosis of high-risk placenta previa combined with placenta accreta were 93.51%,97.62%,and 98.81%,respectively.The negative predictive values were 64.10%,87.50%,and 90.63%,respectively.The accuracies were 83.62%,94.83%,and 96.55%,respectively.The sensitivities were 83.72%,95.35%,and 96.51%,respectively.The specificities were 83.33%,93.33%,and 96.67%,respectively.The Kappa values for consistency were 0.611,0.868,and 0.912,respectively.The accuracy of MRI in diagnosis of high-risk placenta previa combined with placenta accreta was higher than that of ultrasound(P<0.05).Conclusion 3.0 T MRI HASTE sequence has greater efficacy and higher accuracy in diagnosis of high-risk placenta previa combined with placenta accreta.

Objective:This study aimed to propose an innovative modular surgical technique and explore its safety and application value in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy for advanced proximal gastric cancer invading the greater curvature.Methods:A retrospective collection was conducted on 34 patients with proximal gastric cancer invading the greater curvature who underwent laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy in the same center from October 2020 to December 2022. The technical key points, precautions and crucial steps of the modular surgical technique were summarized, and the Clinical indicators were analyzed.Results:All 34 patients successfully completed the operation under laparoscopy without conversion to open surgery. The average operation duration was 151.9±4.1 minutes, and the duration of splenic hilar lymphadenectomy was 12.9±1.5 minutes. The median intraoperative blood loss was 50(20, 50) ml, and the blood loss during splenic hilar lymphadenectomy was 5 (2, 5) ml. The median number of harvested lymph nodes was 32.0 (23.5,39.5), and the number of submitted No.10 lymph nodes was 3 (2, 4). The metastasis rate of No.10 lymph nodes was 20.6% (7/34). No patient had intraoperative complications. During the postoperative hospital stay, one patient had incision infection (Clavien-Dindo I), and one patient had pulmonary infection (Clavien-Dindo II). The time for the first postoperative feeding was 3 (2, 5) days, the time for the first postoperative flatus was 2 (2,3) days, the time for the first postoperative defecation was 3 (3, 4) days, the total postoperative drainage volume was 1047.5 (607.5,1397.5) mL, the time for postoperative drainage tube removal was 7 (6, 9) days, and the length of postoperative hospital stay was 7.0 (6.0, 9.5) days.Conclusions:The application of the innovative modular surgical technique in laparoscopic total gastrectomy combined with spleen-preserving hilar lymphadenectomy can simplify surgical process and enable safe, precise and comprehensive dissection of splenic hilar lymph nodes.

Objective:Ventricular septal defect(VSD)is a prevalent congenital cardiac anomaly.By enhancing the occluder design and optimizing procedural approaches,the indications for VSD closure can be broadened while minimizing associated complications.The utilization of fully biodegradable occluder holds promising potential in resolving conduction block issues encountered during VSD closure.This study aims to compare the results of the fully biodegradable occluder with the metal occluder in transoesophageal echocardiography-guided VSD closure via lower sternal level minor incision at the interim follow-up,and to find risk factors for the occurrence of electrocardiographic and valvular abnormalities postoperatively. Methods:We reviewed the postoperative and 3-year follow-up data of all patients who underwent the randomized controlled study of VSD closure from January 1 to November 7,2019 in the Second Xiangya Hospital of Central South University.The safety and efficacy of the procedure were assessed and compared between the 2 groups by electrocardiogram and echocardiography results,and the risk factors for the occurrence of postoperative electrocardiogram and valve abnormalities were studied with Logistic regression analysis. Results:Twelve and fifteen patients underwent VSD closure with the metallic occluder and the fully biodegradable occluder,respectively.All patients survived during the follow-up period without major complications such as atrioventricular block,significant residual shunt,too rapid absorption of the occluder,and significant valvular regurgitation.There were no significant differences in the results of electrocardiograph and color Doppler ultrasonography the metal occluder group and the fully biodegradable occluder group 1,2,and 3 years after operation(all P>0.05).The size of the occluder were risk factors for tricuspid regurgitation at 2 and 3 years postoperatively,and the difference between the occluder size and the VSD defect size were risk factors for tricuspid regurgitation at 2 years postoperatively(P<0.05). Conclusion:This study adequately demonstrates the safety and efficacy of fully biodegradable occluders in small VSD closure and shows the same postoperative effects as conventional nitinol occluders.

Objective To compare the accuracy of the original-mirror alignment algorithm and a landmark-indepen-dent method in constructing the midsagittal plane(MSP)of the cone beam computed tomography in patients with facial deformities,so as to provide a theoretical basis for symmetric analysis.Methods The study was approved by the hospi-tal ethics committee.Cone beam computed tomography data of 30 patients with facial deformities were obtained,and the output was saved in DICOM format.The scan data were imported into Mimics 21.0;after segmentation,three-dimension-al(3D)skull models were reconstructed.Furthermore,the 3D scan data of skulls were transformed into mirror skull models using Geomagic Studio 2014 reverse engineering software.The MSP of each skull was generated using both the original-mirror alignment algorithm and the landmark-independent method.Original-mirror alignment algorithm:the original skull model and its mirror model were combined,and the new data to calculate the MSP(S1)of the original data in Geomagic Studio 2014 were obtained.Landmark-independent method:the following anatomical landmarks were deter-mined using Mimics 21.0:nasion(N),crista galli(CG),sella(S),basion(Ba),vomer(V),posterior nasal spine(PNS),in-cisive foramen(IF),and anterior nasal spine(ANS).The MSP(S2)of best fit was then found by minimizing the mean square distance of these eight anatomical landmarks to a plane in Geomagic Studio 2014.The results of the S1 and S2 models constructed using the original-mirror alignment algorithm and the landmark-independent method,respectively,were scored subjectively by five senior maxillofacial surgeons,and a paired t-test was performed for the two groups.The internal consistency analysis was performed based on secondary experiments to verify the repeatability of the expert evaluation method.Results The average scores of the S1 and S2 models were 65.73 and 75.90,respectively.The aver-age score of the model constructed using the landmark-independent method was significantly higher than that of the model constructed using the original-mirror alignment algorithm(P＜0.01).Furthermore,the results of the internal con-sistency analysis showed that the expert evaluation method had good reliability and validity.Conclusion In patients with facial deformities,the MSP constructed using the landmark-independent method is superior to that constructed us-ing the original-mirror alignment algorithm.This study provides a theoretical basis for maxillofacial symmetry analysis in clinical settings and is clinically feasible.

Abstract The growth and development of children is related to the future of the country and the nation. In recent years, there have been more and more cohort studies in the field of children s mental health. Bymainly introducing the advantages of cohort studies on children in distress and organizes domestic and foreign cohort studies in the field of mental health of children in distress, this article finds that it is mostly used in depression, anxiety, post traumatic stress disorder, suicidal ideation and attempts, etc, and mainly explores the risk and prevalence of mental health development in children in distress, and identifies long term negative damage. The research aims to promote the long term development and high quality development of such research by analyzing and summarizing the status quo and prospects of cohort research in the field of mental health of children in distress.

To explore the effects of KIAA0196 gene on cardiac development and the establishment of zebrafish strain.
 Methods: Peripheral blood and gDNA from patients were extracted. Copy number variation analysis and target sequencing were conducted to screen candidate genes. The KIAA0196 knockout zebrafish was generated by CRISPR/Cas9 to detect whether KIAA0196 deficiency could affect cardiac development. Finally, the wild-type and mutant zebrafish were anatomized and histologically stained to observe the phenotype of heart defects.
 Results: The KIAA0196 knockout zebrafish strain was successfully constructed using CRISPR/Cas9 technology. After 60 hours fertilization, microscopic examination of KIAA0196 knockout zebrafish (heterozygote + homozygote) showed pericardial effusion, cardiac compression and severely curly tail. Compared with wild-type zebrafish, the hearts of mutant KIAA0196 zebrafish had cardiac defects including smaller atrium and larger ventricle, and the myocardial cells were looser.
 Conclusion: KIAA0196 gene plays an important regulatory role in the development of heart. It might be a candidate gene for congenital heart disease.
Animals ; DNA Copy Number Variations ; Heart ; Heart Defects, Congenital ; genetics ; Humans ; Myocytes, Cardiac ; Phenotype ; Proteins ; Zebrafish ; genetics ; Zebrafish Proteins ; genetics

Objective To compare the rate of intraplaque hemorrhage between symptomatic and asymptom-atic vertebral artery stenosis groups using high-resolution magnetic resonance imaging(HR-MRI).Methods The patients diagnosed with PCI and with vertebral artery stenosis using HR-MRI were enrolled retrospectively. They were divided into symptomatic and asymptomatic groups according to whether they were detected with PCI by the re-sponsible vertebral artery stenosis before examination. All patients underwent 3D time of flight magnetic resonance angiography(3D TOF MRA)to detect the stenosis location of vertebral artery and the stenosis rate at the narrow-est. T1-weighted fat-suppressed images were positioned on the atherosclerotic plaque that the signal 150% higher than the surrounding muscle was confirmed to be intraplaque hemorrhage. Statistical significance was assessed by chi-square test or Student′s unpaired t test.Results A total of 60 patients were included in this study,28 patients in the symptomatic group and 32 patients in the asymptomatic group.The rate of vertebral artery stenosis in asymp-tomatic group was higher than symptomatic group,but there was no statistical significance[(72 ± 33)% vs.(65 ± 28)%,P=0.383];the number of intraplaque hemorrhage in symptomatic group was significantly higher than that in the asymptomatic group(9 vs.2,P=0.024).Conclusions There is a higher rate of intraplaque hemorrhage in symptomatic vertebral artery stenosis group than asymptomatic group.Intraplaque Hemorrhage could be one of risk factor of acute ischemic cerebral disease.

Objective: To study the effects of Simvastatin on the proliferation and osteoblastic differentiation of human periodontal ligament (PDL) cells. Methods: The fourth passage human PDLs were cultured in conditioned mineralization medium with different concentrations of Simvastatin. Proliferation ability was detected by MTT method. Alkaline phosphatase (ALP) activity was measured with 4-nitrophenyl phosphate hexahydrate (PNPP) assay. Results: Proliferation and osteoblastic differentiation of human PDLs were increased in all treatment groups with different concentrations of Simvastatin(10-9, 10-8, 10-7, 10-6 mol/L). Compared with control group, significant statistical difference was found in 10-8 mol/L, 10-7 mol/L and 10-6 mol/L groups(P<0.05). The maximum effect was observed at the concentration of 10-7 mol/L. Conclusion: Optimal concentration of Simvastatin can improve the proliferation and osteoblastic differentiation of human PDLs.