Objective To analyze the clinical efficacy of valve surgeries for infective endocarditis and the affecting factors, and compare the early- and long-term postoperative outcomes of different surgery approaches. Methods The patients with infective endocarditis who underwent valve replacement/valvuloplasty in our hospital from 2010 to 2022 were retrospectively collected. The clinical data of the patients were analyzed. Results A total of 343 patients were enrolled, including 197 patients with mechanical valve replacement, 62 patients with bioprosthetic valve replacement, and 84 patients with valvuloplasty. There were 238 males and 105 females with an average age of (44.2±14.8) years. Single-valve endocarditis was present in 200 (58.3%) patients, and multivalve involvement was present in 143 (41.7%) patients. Sixty (17.5%) patients had suffered thrombosis before surgery, including cerebral embolisms in 32 patients. The mean follow-up time was (60.6±43.8) months. Early mortality within one month after the surgery occurred in 17 (5.0%) patients, while later mortality occurred in 19 (5.5%) patients. Eight (2.3%) patients underwent postoperative dialysis, 13 (3.8%) patients suffered postoperative stroke, 6 patients underwent reoperation, and 3 patients suffered recurrence of infective endocarditis. Smoking (P=0.002), preoperative embolisms (P=0.001), duration of surgery (P=0.001), and postoperative dialysis (P=0.001) were risk factors for early mortality, and left ventricular ejection fraction ≥60% (P=0.022) was protective factor for early mortality. New York Heart Association classification Ⅲ-Ⅳ (P=0.010) and ≥3 valve procedures (P=0.028) were risk factors for late mortality. The rate of composite endpoint events was significantly lower in the valvuloplasty group than that in the valve replacement group. Conclusion For patients with infective endocarditis, smoking and preoperative embolisms are associated with high postoperative mortality, multiple-valve surgery is associated with a poorer prognosis, and valvuloplasty has advantages over valve replacement and should be attempted in the surgical management of patients with infective endocarditis.

Objective:To assess the prevalence of dentinal hypersensitivity (DH) and related factors in urban adults in China.Methods:The study was designed as an observational, cross-sectional epidemiological study carried out in adults aged 18-69 years old in seven cities (Beijing, Shanghai, Wuhan, Chengdu, Xi′an, Guangzhou, and Harbin) of China. The study was conducted from March 2021 to May 2023. Patients were required to complete a questionnaire regarding the subjects′ socio-economic factors, dietary behavior, oral health behavior and personal antecedent factors. DH was clinically diagnosed by judging whether the tooth cold air stimulation provoked DH or not, and recorded by investigator pain rating Schiff score. Compare the findings of six cities (Harbin excluded) with a similar study conducted in 2008.Results:In total, 11 622 subjects from seven cities in China participated the study. Fifty two point two percent (6 072/11 622) of subjects reported DH in questionnaire, 36.7% (4 266/11 622) of subjects reported experiencing DH in response to cold air stimulation for at least one study tooth. Risk factors including age, sex, city, toothbrush method and acid reflux showed marked associations with DH ( P<0.05). The prevalence of DH of urban residents in six cities (Harbin excluded) was 33.7% (3 335/9 882), higher than that in 2008 [29.7%(2 354/7 939)]. Conclusions:Overall, DH was common among urban adults in China and the prevalence increased in recent years. Better understanding of DH and its associated factors should be considered in its prevention and management by dental professionals.

Objective To explore the accuracy and clinical application value of artificial intelligence(AI)-based coronary computed tomography angiography(CCTA)in the evaluation of coronary artery stenosis in patients with acute coronary syndrome(ACS).Methods Fifty-four patients with suspected ACS who underwent CCTA examination and invasive coronary angiography(ICA)within 72 h were retrospectively selected.The CCTA images of all patients were processed by AI(AI group)and manual post-pro-cessing(manual group),respectively.The image quality,work efficiency and detection rate of coronary artery stenosis were compared between AI group and manual group.With ICA results as the gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of AI in the diagnosis of ACS patients with coronary artery stenosis(≥50％)in CCTA were analyzed,and the consistency of AI and ICA examination results was tested.Results The image quality of CCTA in AI group(grade Ⅰ 27.8％)was better than that in manual group(grade Ⅰ 14.8％),but there was no statistical difference between the two groups(X2=2.707,P＞0.05).The average diagnosis time of AI group(89.67 s±33.21 s)was significantlyshorter than that of manual group(813.33 s±301.84 s)and the difference was statistically significant(t=-17.512,P＜0.001),and the average time gain rate was 88.97％.There was no statistical difference in the detection rate of coronary artery stenosis(≥50％)between AI group and manual group(x2=0.003,P＞0.05).The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of AI in diagnosis of ACS were 87.60％,96.44％,80.30％,97.92％,and 95.19％,respectively,which were significantly consistent with the results of ICA examina-tion(Kappa=0.810,P＜0.05).Conclusion AI-assisted diagnosis can correctly identify the coronary artery tree with better image,significantly shorten the diagnosis time of CCTA in ACS patients with high accuracy,and can provide a strong basis for the early treat-ment of patients with acute chest pain.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

The clinical and imaging manifestations of the dural arteriovenous fistula(DAVF)located in the great cerebral vein area with progressive bilateral thalamic edema lack specificity and are easily confused with a variety of diseases.The authors reported a case presented with psychiatric and behavioral abnormalities,followed by bilateral thalamic lesions.Initially,the diagnosis was considered as a glioma of the thalamus,encephalitis and straight sinus thrombosis,but the clinical and imaging findings progressively worsened.Through multi-modal imaging examinations,a DAVF in the great cerebral vein territory was finally diagnosed.By reporting the case and reviewing the literature,this paper aimed to explore the clinical manifestations and imaging features of the disease to reduce the incidence of misdiagnosis.

Objective:To construct an intelligent medical emergency information platform for the 19th Hangzhou Asian Games events and evaluate its practical application.Methods:Addressing the medical support demands for Asian Games, based on the " Emergency medical service system for large-scale social activities" developed by Zhejiang Laboratory, a collaborative team comprising Hangzhou Emergency Center, the Second Affiliated Hospital of Zhejiang University,Zhejiang Lab and College of Biomedical Engineering and Instrument Science of ZhejiangUniversity developed an intelligent medical emergency information platform for the Asian Games. This system was implemented during the 19th Hangzhou Asian Games, collecting basic information, initial diagnosis locations, prognoses, severity grading, and occurrences of infectious diseases for all patients treated at support locations from September 16th to October 8th, 2023. The Modified Early Warning Score (MEWS) was employed for assessing patient conditions, and a symptom monitoring system was used to alert the occurrence of infectious diseases. Post-event, a satisfaction evaluation (on a 5-point scale) regarding the system's application was conducted.Results:The successful construction of the intelligent medical emergency information platform comprised a data dashboard display platform, a comprehensive command system on the management center, and a mobile platform covering on-site medical support, ambulances, and designated hospitals. ①A total of 11 068 patients were treated using this system, including 2 979 athletes, 3 429 staff members, 1 421 volunteers,1 051 spectators, and 2 188 others. The proportion of patients seeking treatment due to illnesses was significantly higher than those due to injuries. Among injury-related cases, athletes constituted 41.37%, while staff accounted for 32.5% of illness-related cases. ②The area under the ROC curve for MEWS regarding hospitalization rates was 0.81 for disease patients and 0.60 for injury patients. ③ There were 211 reported cases of infectious diseases during the event, constituting 1.91% of all treated cases.④ Satisfaction ratings: User-friendliness scored 4.47, completeness of functions scored 4.28, data security scored 4.38, and data accuracy scored 4.49. Compared to traditional paper-based reporting methods, 98.11% of users found the system more convenient, 92.45% were satisfied overall, and the recommendation rating was 4.36.Conclusions:The study findings confirm the critical role played by the information platform in enhancing comprehensive, accurate, timely, secure medical support information dissemination for the Asian Games and in early warning and control of infectious diseases.

Objective: To investigate the core information about tuberculosis prevention and control knowledge among residents in Jiangxi Province, so as to provide insights into formulation of health education strategy for tuberculosis prevention and control. Methods: Permanent residents at ages of 15 years and older were sampled from Jiangxi Province using a multi-stage stratified cluster sampling method from January to June 2021. Participants' demographic features and access to health education for tuberculosis prevention and control were collected through questionnaires, and the awareness of core information about tuberculosis prevention and control was investigated according to Key Points for Core Information and Knowledge about Tuberculosis Prevention and Control (2016 version). Results: A total of 1 280 questionnaires were allocated, and 1 217 valid questionnaires were recovered, with an effective recovery rate of 95.08%. The respondents included 605 men (49.71%) and 612 women (50.29%), and had a mean age of (50.05±15.78) years. The overall awareness of core information of tuberculosis prevention and control was 80.46%, and the awareness rates of “Pulmonary tuberculosis is suspected and timely healthcare-seeking is required if you have cough or expectoration for more than 2 weeks”, “Pulmonary tuberculosis is mainly transmitted via respiratory tract, and everyone is likely to be infected”, “No spit anywhere, covering mouth and nose when coughing or sneezing, and wearing a mouth mask may reduce the transmission of pulmonary tuberculosis”, “Pulmonary tuberculosis is a chronic infectious disease that poses a long-term damage to health” and “Most patients may be cured and others are avoided to be infected following standard whole-process treatment” were 90.22%, 86.52%, 85.95%, 80.03% and 59.57%, respectively. There were 491 respondents that were aware of all core information about tuberculosis prevention and control (40.35%), and network was the predominant route for acquiring health education about tuberculosis prevention and control (62.08%, 586/944). Conclusions The overall awareness of core information about tuberculosis prevention and control did not achieve the target set in the 13th Five-year Plan for Tuberculosis Prevention and Control, and the awareness of tuberculosis treatment-related knowledge was low.

Objective:To investigate the effect of chest compression synchronized ventilation on cerebral oxygenation in porcine cardiopulmonary resuscitation model.Methods:The porcine ventricular fibrillation model was constructed and randomly(random number)divided into two groups by envelope method. According to the different modes of ventilator during cardiopulmonary resuscitation, they were named intermittent positive pressure ventilation (IPPV) group and chest compression synchronized ventilation (CCSV) group. The arterial blood lactic acid value at 4 and 7 min after resuscitation and 30 min after spontaneous circulation recovery , carotid blood flow (CBF) within 1-8 min during resuscitation, cerebral oxygen saturation at 1 , 2 , 3, and 4 h after resuscitation were recorded. Neurological score was assessed 24 h after resuscitation.Results:The lactic acid value at 3 time points in the CCSV group was significantly lower than that in the IPPV group; during the resuscitation, the CBF of the pig carotid artery in the CCSV group was significantly higher than that in the IPPV group within 1-8 min during resuscitation; cerebral oxygen saturation was also significantly higher in the IPPV group at all time points after resuscitation. The neurological score of the CCSV group decreased significantly 24 h after resuscitation.Conclusions:The choice of CCSV ventilation mode in porcine ventricular fibrillation model can significantly improve cerebral perfusion during cardiac arrest and cerebral oxygenation after resuscitation.

Objective:To investigate the effect of prospective intervention on emergence agitation and postoperative recovery in patients with chronic sinusitis during preoperative visits.Methods:A total of 80 patients with chronic sinusitis who underwent general anesthesia in Dayi County People′s Hospital of Chengdu City from December 2019 to October 2020 were selected and randomly divided into group D and group G, with 40 patients in each group. Group D received preoperative visit with conventional methods and group G received preoperative visit with prospective intervention methods. The hemodynamic changes of patients in the two groups at 30 min before the operation (T 1) and 1 (T 2), 5 (T 3), 10 (T 4) and 30 min (T 5) after tracheal tube extraction were recorded. The anxiety and depression scores of patients before the intervention and 1 d after the operation were compared between the two groups. The incidence of emergence agitation after the operation and complications during anesthesia awakening period were observed in the two groups, sino-nasal outcome test-20 (SNOT-20) was used to assess the postoperative recovery. Results:The incidence of emergence agitation in group G was lower than that in group D: 7.5%(3/40) vs. 25.0%(10/40), the difference was statistically significant ( χ2 = 4.50, P<0.05). There was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate between the two groups at T 1 and T 5 ( P>0.05), but the level of above indicators in group G at T 2, T 3 and T 4 were significantly higher than those in group D ( P<0.05). The scores of State-Trait Anxiety Inventory(S-AI) and Self-Rating Depression Scale (SDS) in group G at the first day after the operation were significantly lower than those in group D: (35.45 ± 5.32) scores vs. (39.35 ± 4.91) scores, (35.42 ± 7.82) scores vs. (38.76 ± 5.21) scores, the differences were statistically significant ( P<0.05). The incidence of complications during anesthesia awakening period in group G was slightly lower than that in group D ( P>0.05). After the operation, the scores of sinusitis symptoms and nasal symptoms in the two groups were significantly decreased compared with those before the operation, and the scores of group G were significantly lower than those in group D ( P<0.05). Conclusions:Prospective intervention before anesthesia in patients with chronic sinusitis surgery can reduce stress response, improve bad mood, reduce the incidence of emergence agitation, and promote the postoperative recovery.

Objective: To compare the biomechanical performance between the single- versus double-threaded cannulated screws in the treatment of femoral neck fractures of Pauwels type Ⅲ. Methods: Models of femoral neck fracture of Pauwels type Ⅲ (70°) were made of the Sawbone synthetic composite femurs. All specimens were divided into 2 groups (n=12). Group A was fixated with single-threaded cannulated screws and group B with double-threaded cannulated screws, both in an inverted triangle configuration. The screws ranged from 90 to 95 mm in length and from 7.3 to 7.5 mm in diameter. All the specimens were subjected to axial stiffness and failure load tests with 7° valgus (simulating normal two-legged weight-bearing stance) and 25° valgus (simulating normal one-legged weight-bearing stance) and torsion test as well. The 2 groups were compared in the torques at axial stiffness angles of 1°, 2°, 3°, 5° and 7°. Results: Group B had significantly greater axial stiffness at 7° valgus and 25° valgus (89±26 N/mm and 128±37 N/mm) and failure load (1,154±368 N) than group A did (36±12 N/mm and 47±16 N/mm; 688±94 N) (P< 0.05). The torques increased with the increase in rotation angle in both groups. However, the torques in group B (3.26±0.96, 4.16±1.23, 4.64±1.13, 5.59±1.26 and 6.53±1.47 N·m) were all significantly larger than in group A (1.44±0.19, 2.03±0.41, 2.33±0.62, 2.74±0.87 and 3.05±1.07 N·m) (P<0.05). Conclusion Double-threaded cannulated screws may provide better biomechanical stability than single-threaded ones, due to their substantial improvement in anti-compression and anti-rotation performance.