As the state vigorously promotes the high-quality development of hospitals and improves people's medical ex-perience,the patient-centered hospital should make full use of technological resources such as the Internet,5 G and artificial in-telligence,vigorously develop mobile medical services and artificial intelligence services,transform and optimize the diagnosis and treatment process,and streamline all links before,during and after diagnosis so as to provide better data services to the pa-tient to ensure that they can get things done with greater ease.The patients'medical experience and hospital management effi-ciency can be greatly improved.In this study,specific measures to create a new diagnosis and treatment model through the con-struction of smart hospital platform were expounded in order to provide references for related research and policy formulation of other Chinese medical institutions.

Objective In this study,we compared the masticatory efficiency,occlusal functional indexes,and satisfaction of lingual-ized occlusion(LO)vs.anatomic occlusion(AO)and discussed the difference between these occlusions.Methods Twenty edentulous patients were included in this clinical trial during 2021 April to December.They were divided into 2 groups according to their denture occlusion.Masticatory efficiency was tested by chewing the same amount of peanuts(by weight)and then the absorption of the solution was compared under a spectrophotometer after wearing dentures for 1 month.The TeeTester occlusion analysis system was used to test masticatory function,and satisfaction research was conducted for the edentulous patients at this time point as well.Finally,statistical analyses were conducted to compare the difference in masticatory efficiency between AO and LO by SPSS 20.0.Results The indexes of LO were worse than AO in masticatory efficiency,masticatory function and most of satisfaction research,while LO was better than AO in speech recovery.The difference was only statistically significant in COF-y of masticatory function(P＜0.05).Conclusion LO is similar with AO in terms of masticatory efficiency,satisfaction and denture stability;LO has good performance in denture's fit and use for patients.

Objective:To systematically search and evaluate risk prediction models for ventilator-associated pneumonia (VAP) of ICU in order to provide references for developing higher-quality VAP risk prediction models.Methods:Relevant literature was retrieved from databases including China Biology Medicine disc, WanFang data, China National Knowledge Infrastructure, Embase, PubMed, CINAHL, Web of Science, and Cochrane Library. The search timeframe was from the establishment of the databases to September 30, 2023, limited to English and Chinese languages. Two researchers independently screened the literature and extracted data, and the PROBAST tool was used to evaluate the risk of bias and applicability of the included studies.Results:A total of 15 studies on VAP risk prediction models were included. The area under the receiver operating characteristic curve for the 15 models ranged from 0.722 to 0.982. The most frequently involved predictors were age, duration of mechanical ventilation, ICU length of stay, and comorbid chronic obstructive pulmonary disease. The overall adaptability was good, but the risk of bias was high. The main sources of bias included insufficient sample size, inappropriate data sources, lack of model performance evaluation, and inadequate attention to missing data.Conclusions:The risk of bias in studies on VAP risk prediction models is high, indicating that the field is still developing. Future research should focus on the effectiveness of different risk assessment methods to construct models with low bias, excellent predictive performance, and suitability for clinical practice in China.

Objective: To explore the effect of ultrasound on dentin smear layer's surface and bonding strength of the universal resin adhesive under self-etching mode. Methods: Forty mandibular third molars without caries were randomly divided into two groups; one was polished with silicon carbide sandpaper; the other was polished with silicon carbide sandpaper followed by ultrasonic treatment. Scanning electron microscope (SEM) was used to observe surface of the dentin. Treated teeth were bonded with two universal resin adhesives, Clearfil Universal Bond (pH=2.3) and All-Bond Universal (pH=3.1), and the penetration of the bonding interface was observed with a confocal laser scanning microscope (CLSM) after Rhodamine B staining. Finally, the micro tensile bond strength test was conducted to test the adhesion. Results: The SEM showed that after polishing with silicon carbide sandpaper, the smear layer of the dentin surface was scratched, and dentin tubules were almost completely blocked, with no obvious dentin tubules exposed. After ultrasonic treatment, the scratches were reduced, and a large number of dentin tubules were exposed. CLSM showed that both adhesives could penetrate the dentin along the dentin tubules more deeply after ultrasound treatment. Micro tensile bond strength tests showed that ultrasonic treatment could enhance the bonding strength of two universal resin adhesives. However, there was no statistical difference in bonding strength between these two universal resin adhesives under the same treatment. . Conclusion Ultrasound can partially remove the smear layer on dentin's surface, expose dentin tubules, and increase universal resin adhesives' penetration depth and bonding strength under self-etching mode

Establishment of vaginal immune defenses at the mucosal interface layer through gene vaccines promise to prevent infectious diseases among females. Mucosal barriers composed of a flowing mucus hydrogel and tightly conjugated epithelial cells (ECs), which represent the main technical difficulties for vaccine development, reside in the harsh, acidic human vaginal environment. Different from frequently employed viral vectors, two types of nonviral nanocarriers were designed to concurrently overcome the barriers and induce immune responses. Differing design concepts include the charge-reversal property (DRLS) to mimic a virus that uses any cells as factories, as well as the addition of a hyaluronic acid coating (HA/RLS) to directly target dendritic cells (DCs). With a suitable size and electrostatic neutrality, these two nanoparticles penetrate a mucus hydrogel with similar diffusivity. The DRLS system expressed a higher level of the carried human papillomavirus type 16 L1 gene compared to HA/RLS in vivo. Therefore it induced more robust mucosal, cellular, and humoral immune responses. Moreover, the DLRS applied to intravaginal immunization induced high IgA levels compared with intramuscularly injected DNA (naked), indicating timely protection against pathogens at the mucus layer. These findings also offer important approaches for the design and fabrication of nonviral gene vaccines in other mucosal systems.

OBJECTIVE:To observe the clinical efficacy and safety of intravitreal injection of ranibizumab combined with argon laser therapy in the treatment of ischemic neovascular glaucoma. METHODS:A total of 166 patients with neovascular glaucoma selected from our hospital during Mar. 2014-Mar. 2016 were divided into control group and observation group according to random number table,with 88 cases in each group(there were 117 and 125 eyes respectively). Both groups received argon laser photocoagulation therapy twice a week for 1 month. Observation group was additionally given intravitreal injection of Ranibizumab injection(0.5 mg)once a week,for 1 month. Clinical efficacies of 2 groups were observed,and the intraocular pressure and visual acuity of 2 groups were observed before treatment,1 week and 1 month after treatment. The occurrence of ADR was recorded. RESULTS:After 1 month of treatment,total response rate was 95.20％ in observation group,which was significantly higher than 76.92％ in control group,with statistical significance (P<0.05). After 1 week of treatment,intraocular pressures of observation group were lower than before treatment and control group at the same time,while visual acuity was better than before treatment and control group at the same time,with statistical significance (P<0.05). After 1 month of treatment,intraocular pressures of 2 groups were decreased significantly and visual acuity was significantly improved;intraocular pressure was decreased and visual acuity was improved more significantly in observation group than control group,with statistical significance(P<0.05 or P<0.01). The incidences of ADR of 2 groups were 3.41％ and 2.27％,without statistical significance (P>0.05). CONCLUSIONS:The ischemic intravitreal injection of ranibizumab combined with argon laser therapy is better than argon laser therapy alone in the treatment of ischemic neovascular glaucoma,and can significantly reduce intraocular pressure and improve visual acuity with good safety.

Objective To discuss the clinical effect of Penumbra aspiration system combined with Trevo thrombectomy device in treating acute intracranial main artery infarction.Methods The clinical data of a total of 5 patients with acute intracranial main artery infarction,who were treated with ACETM thrombectomy device combined with Trevo visible thrombectomy stent,were retrospectively analyzed.The lesions included anterior circulation infarction (n=2) and posterior circulation infarction (n=3).The mean age of patients was (60.4±11.6) years old.The operation time spent for thrombectomy,the recanalization time of occluded vessels,and the recovery of neural function were assessed.Results The puncture-recanalization intervals in the 5 patients were 29 min,32 min,35 min,33 min and 30 min respectively,with a mean time of (31.8±2.4) min.After intraoperative cerebral infarction thrombolysis treatment,the cerebral blood flow grading reached level 3.NIHSS score was remarkably improved from preoperative (11.0±7.4) points to 24 hpostoperative(4.2±1.1) points,to 7 days-postoperative(1.8±1.3) points,and to 30 days-postoperative (0.9±0.6) points (P＜0.05).Modified Rankin scale (mRS) score was 0-2 points in all patients.No intracranial hemorrhage transformation occurred.Conclusion In treating acute intracranial main artery infarction,ACETM thrombectomy device combined with Trevo visible thrombectomy stent can achieve the best recanalization effect with less times of thrombectomy procedure and short operation time.The clinical prognosis is satisfactory.

Nowadays,with the introduction of the concept of minimally invasive surgery,laparoscopic surgery which occupied the mainstream operation method,vaginal surgery,and abdominal surgery were three main ways of gynecological surgery.Hysterectomy operation method as the routine operation of gynecology was changed as well.Laparoscopic hysterectomy has replaced transvaginal hysterectomy and transabdominal hysterectomy gradually.Historical development,operation indication,and advantages and disadvantages of hysterectomy are summarized in this article.

Objective To report a pedigree with X?linked dominant protoporphyria(XLDPP), and to detect 5?aminolevulinic acid synthetase 2(ALAS2)gene mutations in this pedigree. Methods A clinical investigation was performed in a pedigree with XLDPP, and relevant data were collected from family members. A next?generation sequencing method was applied to screen possible mutation sites, and Sanger sequencing was performed to determine pathogenic gene mutations. Dermoscopy was conducted to observe skin lesions in the patients with XLDPP, and the Fotofinder system and very high frequency (VHF) ultrasound system were utilized to assess the severity of photodamage. Liver and gallbladder ultrasonography as well as blood examination were performed for all the family members. Results A deletion mutation, c.1706?1709ΔAGTG, was detected in the ALAS2 gene on the X chromosomes of all the patients in this family, which led to replacement or loss of 19-20 C?terminal residues through transcriptional frameshifting, and eventually caused an increase in ALAS2 activity. In the patients with XLDPP, skin photodamage was relatively severe;protoporphyrin?induced hepatobiliary damage was observed and aggravated with age;anemia and iron deficiency occurred sometimes. Conclusion The deletion mutation c.1706?1709ΔAGTG of the ALAS2 gene may be the underlying cause of XLDPP in this pedigree.

OBJECTIVETo evaluate the bond strength and durability of a self-adhesive resin cement with a zirconia ceramic pretreated by a zirconia primer.

METHODSZirconia ceramic (Vita Inceram YZ) plates with a thickness of 2.5 mm were fired, polished, and then cleaned. Half of the polished ceramic plates were sandblasted with 50 μm alumina particles at 0.3 MPa for 20 s. The surface compound weight ratios were measured via X-ray fluorescence microscopy. The polished and sandblasted ceramic plates were directly bonded with self-adhesive resin cement (Biscem) or were pretreated by a zirconia primer (Z Primer Plus) before bonding with Biscem. The specimens of each test group were divided into two subgroups (n=10) and subjected to the shear test after 0 and 10,000 thermal cycles. The data were analyzed via three-way ANOVA.

RESULTSAfter air abrasion, 8.27% weight ratio of alumina attached to the zirconia surface. Compared with air abrasion, primer treatment more significantly improved the primary resin bond strength of the zirconia ceramic. The primary resin bond strength of the zirconia ceramic with no primer treatment was not affected by thermocycling (P>0.05). However, the primary resin bond strength of the zirconia ceramic with primer treatment was significantly decreased by thermocycling (P<0.05).

CONCLUSIONPrimer treatment can improve the primary resin bond strengths of zirconia ceramics. However, the bond interface of the primer is not stable and rapidly degraded during thermocycling.

Adhesives ; Aluminum Oxide ; Ceramics ; Dental Bonding ; Dental Porcelain ; Dental Stress Analysis ; Materials Testing ; Resin Cements ; Surface Properties ; Zirconium