Immediate implant placement in the aesthetic zone has become increasingly widespread and has gradually evolved into a conventional techniques for implant procedures in the aesthetic region. To achieve favorable aesthetic and long-term outcomes, clinicians must possess extensive clinical experience as well as proficient surgical and restorative skills. This study summarizes the key factors influencing the long-term success of immediate implants in the aesthetic zone: strict adherence to the indications for immediate implant placement; thorough preoperative assessment of the patient’s systemic and local conditions, along with comprehensive evaluation of aesthetic risks; minimally invasive tooth extraction while preserving the integrity of the labial bone plate; selection of appropriately designed implants and their placement in an ideal three-dimensional position based on the implant’s characteristics; utilization of suitable bone and soft tissue augmentation techniques according to the patient’s specific hard and soft tissue anatomy, extent of bone defects, and periodontal phenotype; dynamic shaping of soft tissues through continuous adjustments in the emergence profile of provisional restorations; design of definitive restorations from the perspectives of health, function, and aesthetics; and implementation of regular follow-up and maintenance protocols after implant treatment, with increased emphasis on peri-implant care for patients who smoke, have diabetes, or undergo anti-osteoporosis therapy. This study proposes a decision-making framework to achieve long-term stable clinical outcomes with immediate implants in the aesthetic zone, providing a reference for clinicians in their clinical decision-making and treatment planning: ① for patients assessed as low aesthetic risk (e.g., thick gingival biotype, absence of hard and soft tissue defects, intact labial bone plate with thickness >1 mm, no acute infection), immediate implant placement after minimally invasive extraction is recommended, with the implant positioned in an ideal three-dimensional location, along with bone grafting in the gap between the implant and the labial bone plate and consideration of connective tissue grafting when required; ② for patients assessed as moderate aesthetic risk (e.g., thin gingival biotype, absence of soft tissue defects, intact labial bone plate but with thickness <1 mm or mild to moderate bone defects involving less than 50% height loss, chronic infection present), immediate implant placement with optimal three-dimensional positioning is feasible, accompanied by bone grafting in the implant-labial bone gap or external bone grafting on the labial aspect, with simultaneous or staged connective tissue grafting, or alternatively, use of the socket shield technique for immediate implant placement; ③ for patients assessed as high aesthetic risk (e.g., thin gingival biotype, presence of soft tissue defects, vertical bone deficiency, severe labial bone loss involving >50% height loss, acute infection present), ridge preservation followed by delayed implant placement is advised. By adhering to these treatment principles, immediate implant placement in the aesthetic zone can achieve reliable success rates and excellent aesthetic outcomes.

To promote the construction of a wound repair and regeneration system with Chinese characteristics, it is necessary to follow the principle of combining traditional Chinese and Western medicine, and integrate theory, clinical practice, and teaching. Traditional Chinese medicine emphasizes a holistic concept and the principle of dialectical treatment, while Western medicine focuses on etiological analysis and local treatment. The combination of Chinese and Western medicine can complement each other's advantages and improve treatment effectiveness. The key technological innovations in repairing and regenerating systems cover areas such as drug therapy, physical therapy, and the application of biomaterials. This article discusses the development potential and challenges of combining traditional Chinese and Western medicine in the field of wound repair and regeneration, providing new ideas and methods for the development of wound repair and regeneration. It is expected to bring better medical services and treatment effects to patients undergoing repair and regeneration.

BackgroundChildhood and adolescence are critical stages in psychological development. During the public health emergencies， children and adolescents exhibit weaker psychological coping ability， making them more vulnerable to mental health issues. ObjectiveTo investigate trends in the distribution of hospitalized children and adolescents patients at mental health centers of a general hospital during public health emergencies， so as to provide references for future research and intervention for adolescent under similar contexts. MethodsA retrospective cohort study was conducted on 6 613 children and adolescent patients hospitalized and discharged from the Mental Health Center of West China Hospital， Sichuan University， from January 1， 2018 to December 31， 2022. Patients were included if their primary diagnosis was schizophrenia， schizotypal disorder and delusional disorder， depressive disorder， bipolar disorder， anxiety disorder or post-traumatic stress disorder in International Classification of Diseases， tenth edition （ICD-10）. Patients were divided into two groups based on their admission period： pre-COVID-19 pandemic period （from January 1， 2018 to December 31， 2019） and during the COVID-19 pandemic （from January 1， 2020 to December 31， 2022）. Trends in diagnostic distributions were analyzed using the trend chi-square test. ResultsSignificant differences were observed between pre-pandemic and pandemic periods in age， length of hospital stay and sex（t=10.743， 4.082， χ²=29.092， P<0.01）. During the COVID-19 pandemic， the proportions of depressive disorder， bipolar disorder and anxiety disorder among hospitalized children and adolescents patients increased （χ²_trend=11.058， 67.333， 17.276， P<0.01）， while the proportions of schizophrenia， schizotypal disorder and delusional disorder decreased （χ²_trend=219.924， P<0.01）. Among patients aged 6~14 years， the proportion of bipolar disorder increased （χ²_trend=18.207， P<0.01）. Among patients aged 15~19 years， the proportion of bipolar disorder and anxiety disorder also increased （χ²_trend=57.339， 19.011， P<0.01）. In male patients， the proportions of depressive disorder and bipolar disorder increased （χ²_trend=21.729， 11.380， P<0.01）， while in female patients， the proportion of bipolar disorder and anxiety disorder increased （χ²_trend=54.830， 14.377， P<0.01）. ConclusionCompared with the pre-pandemic period， during the COVID-19 pandemic， among hospitalized children and adolescents patients， there are more female patients than male patients， with a tendency for patients to be younger and have shorter lengths of hospital stay. The proportions of depressive disorder， bipolar disorder and anxiety disorder have all increased.

Objective:To compare the aortic remodeling of the Fabulous stent system and standard thoracic aortic endovascular repair (TEVAR) on distal aorta type B aortic dissection (TBAD). Methods:The prospective data collected between Dec 2017 and Oct 2019 from 134 patients with type B aortic dissection (TBAD) who underwent treatment with the "Fabulous" stent system, and retrospective data from 159 TBAD patients receiving standard TEVAR from corresponding multicenter. By using propensity score matching analysis, we compared the prognosis and aortic remodeling outcomes in patients undergoing Fabulous and standard TEVAR treatments during a 1-year postoperative follow-up.Results:In this study, 62 patients in Fabulous group and 62 patients in standard TEVAR were included.There were no significant statistical differences in baseline characteristics between the two groups. In terms of aortic remodeling in bare stent region, Fabulous group had better change trends of diameter of true lumen [10.6 (4.4, 14.5) mm vs. 4.7 (0.9, 10.7) mm, P=0.001] and false lumen [-24.2 (-30.5, -4.9) mm vs. 0.7 (-11.8, 2.3) mm, P<0.001] than those in the standard TEVAR group. The rate of complete false lumen thrombosis was also higher in the Fabulous group (62.9% vs. 37.1%, P=0.042). Conclusion:The Fabulous stent system, when compared to standard TEVAR surgery, demonstrates good aortic remodeling outcomes in the distal aorta.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Humans ; Asthma/drug therapy* ; Biological Therapy

ObjectiveTo explore the effects of after-school tutoring for school-age children on their emotions and behaviors， and to provide a basis for developing after-school tutoring and psychological support strategies for school-age children. MethodsFour elementary schools in a district of Shanghai were selected by simple random sampling method. Whole group sampling was conducted by class， and parents of students were surveyed by general questionnaire and the scale of strengths and difficulties. Information was collected on the basic conditions of children and families and the results were compared and analyzed. ResultsThis study showed that 88.26% of children attended extracurricular classes， of which 26.16% attended 3 or more classes， 42.5% attended cultural classes， 28.3% attended sports classes， and 59.8% attended art classes. Children who did not attend classes had higher pro-social scores. Children who attended reading class had lower scores for emotional problems that was a protective factor for emotional problems. Children who chose extracurricular programs in sports and reading also had lower overall scores for difficulties. Excessive use of electronic devices by school-age children on weekdays or weekends had a negative effect on emotional and conduct problem scores regardless of whether they chose extracurricular programs. It appeared that the choice of cultural programs， art programs and different levels of exercise intensity had no effect on children's emotions and behaviors. ConclusionFor children with low pro-social level， extracurricular classes should be carefully selected. For extracurricular classes， more reading and sports-related courses can be considered， which have positive effects on school-age children’s emotions and behaviors. Regardless of the choice of extracurricular classes， try to avoid excessive online classes.

Objective To explore the application value of automatic cytomorphological analyzer in the morphological analysis of white blood cells(WBC)in peripheral blood.Methods A total of 306 venous blood samples from inpatients and outpatients were randomly selected and prepared with automatic cytomorphological analyzer for WBC pre-classification.The differences between automatic cytomorphological analyzer counting,automatic blood cell analyzer counting and manual counting were compared,and the correlation between automatic cytomorphological analyzer and manual counting method was analyzed.Results Compared with the other two methods,the automatic cytomorphologi-cal analyzer was able to detect more types of WBC,especially abnormal cells.There were no signifi-cant differences between automatic cytomorphological analyzer and manual counting method for 6 ma-ture WBC types(band neutrophils,segmented neutrophils,lymphocytes,monocytes,eosinophils,and basophils),immature cells at different stages and atypical lymphocyte counts(P＞0.05).Re-sults of the 6 mature WBC types counted by the automatic cytomorphological analyzer and manual counting had favorable correlations(r＞0.8).Conclusion The automatic cytomorphological analyzer can classify more types of WBC,provide WBC counting results that are highly consistent with manual microscopy,and the counting results of the two methods have a good correlation.

Background Excessive intake of sugar-sweetened beverages (SSBs) is harmful to health. In recent decades, the consumption of SSBs by Chinese residents has increased rapidly, increasing the risk of death and burden of disease. Objective To analyze the knowledge level and influencing factors of SSBs for Chinese residents aged 18-64 years in 2021. Methods A multi-stage cluster random sampling approach was used to conduct a questionnaire survey among residents aged 18-64 years in 302 survey sites across the country in 2021, and 98567 valid questionnaires were obtained. Four questions are about SSBs among the questionnaire's 5 dimensions. Respondents who answered 3 or more questions correctly were considered to have a basic understanding of SSBs. Frequency and weighted proportion were used for description. With individual as level 1 and resident council (village council) as level 2, a two-level logistic regression model was applied to examine the influencing factors. A null model was used to determine whether the two-level logistic regression model was appropriate. Results The knowledge awareness rate of SSBs was 57.0% among the Chinese residents aged 18-64 years in 2021. The knowledge point with the lowest correct rate was "It is best to consume no more than 25 grams of added sugar per day" (22.6%), while the one with the highest correct rate was "Excessive intake of SSBs can increase the risk of obesity and diabetes" (81.1%). The results of the null model showed that SSBs knowledge level had a clustering effect at resident council (village council) level (t=25.00, P<0.0001), so a two-level model fit better than a one-level model. The results of the two-level logistic model revealed that residents who were female (OR=1.14, 95%CI: 1.11, 1.18) or working in medical and health (OR=1.36, 95%CI: 1.27, 1.45) and education institutions (OR=1.16, 95%CI: 1.07, 1.24) had a higher knowledge level compared to males or residents of other occupations. The knowledge level was lower among residents in central (OR=0.87, 95%CI: 0.77, 0.97) and western (OR=0.85, 95%CI: 0.75, 0.94) areas than in eastern areas. Those with chronic diseases (OR=0.81, 95%CI: 0.78, 0.84) and who did not know if they had a chronic disease (OR=0.75, 95%CI: 0.72, 0.78) had a lower knowledge level than those without chronic diseases. Compared with 18-24 years, the knowledge level was higher in ages 35-44 years (OR=1.07, 95%CI: 1.02, 1.12) and lower in ages 55-64 years (OR=0.92, 95%CI: 0.86, 0.97), and not different from the ages 25-34 years and 45-54 years. The knowledge level increased with the level of education, the trend was statistically significant (P＜0.001). Conclusion Only about half of Chinese adults aged 18-64 years had a basic understanding of SSBs in 2021. The awareness rate of added sugar intake was low in particular. The knowledge levels of male, central and western, or less educated populations were even lower. Awareness of the negative health outcomes of SSBs was high among the population.

Objective To explore the application value of automatic cytomorphological analyzer in the morphological analysis of white blood cells(WBC)in peripheral blood.Methods A total of 306 venous blood samples from inpatients and outpatients were randomly selected and prepared with automatic cytomorphological analyzer for WBC pre-classification.The differences between automatic cytomorphological analyzer counting,automatic blood cell analyzer counting and manual counting were compared,and the correlation between automatic cytomorphological analyzer and manual counting method was analyzed.Results Compared with the other two methods,the automatic cytomorphologi-cal analyzer was able to detect more types of WBC,especially abnormal cells.There were no signifi-cant differences between automatic cytomorphological analyzer and manual counting method for 6 ma-ture WBC types(band neutrophils,segmented neutrophils,lymphocytes,monocytes,eosinophils,and basophils),immature cells at different stages and atypical lymphocyte counts(P＞0.05).Re-sults of the 6 mature WBC types counted by the automatic cytomorphological analyzer and manual counting had favorable correlations(r＞0.8).Conclusion The automatic cytomorphological analyzer can classify more types of WBC,provide WBC counting results that are highly consistent with manual microscopy,and the counting results of the two methods have a good correlation.