Objective This study aimed to analyze the use of various virtual surgical planning and 3D printing templates in mandibular angle ostectomy.Methods Twelve patients with mandibular angle prominence were selected from the Affiliated Stomatological Hospital of Guizhou Medical University between January 2022 and January 2023.Preoperative craniofacial CT scans were used to create three-dimensional models.Two types of virtual surgical planning and templates were designed:ascend-ing branch-fixed templates on the ramus(Group Ⅰ)and inferior border-fixed templates on the excised mandibular angle(GroupⅡ).Patients were divided into two groups based on the template used during surgery.The changes in the mandibular angle be-fore and two weeks after surgery were compared between the groups,and deviations between the surgical plans and postopera-tive results were measured.Results All patients healed successfully with satisfactory cosmetic outcomes.Lateral mandibular angles were observed in all patients of Group Ⅰ.In Group Ⅱ,one patient presented with a lateral angle,while the others showed medial angles.An increase in the mandibular angle(P＜0.01)was noted with no significant difference between the bilateral an-gles(P＞0.05).The deviation from the surgical planning was also not significantly different between the groups(P＞0.05).Conclusion Virtual surgical planning and 3D printed templates in mandibular angle ostectomy result in high accuracy and favor-able cosmetic outcomes.Ramus-fixed template is suitable for lateral mandibular angle type,while lower edge-fixed template is better for medial mandibular angle type.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Objective To evaluate the effects of low pneumoperitoneum pressure under deep muscle relaxation on inflammatory factors,oxidative stress and morphology of distal greater omental capillary endothelial cells in patients undergoing laparoscopic radical gastrectomy(LAG)for gastric cancer.Methods Sixty patients with LAG were selected from January to June 2022,45 males and 15 females,aged 40-75 years,BMI 18-30 kg/m2,ASA physical status Ⅰ or Ⅱ.Patients were randomly divided into two groups:low pneumoperitoneum pressure group(group PL)and the control group(group PH),30 patients in each group.Both groups were treated with deep muscle relaxation condition(PTC=1 or 2),and the pneumo-peritoneum pressure was set at 10 mmHg in group PL,and 14 mmHg in group PH.The duration of pneumo-peritoneum maintenance,surgical time,anesthesia time,extubation time,PACU stay time,postoperative hospitalization time,the number of effective PCIA compressions and total PCIA compressions within 48 hours after surgery,and number of relief analgesia were recorded.The plasma concentrations of interleukin-1 β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α),contents of malondialdehyde(MDA),superoxide dismutase(SOD),and reduced glutathione(GSH)were recorded 5 minutes before induction,5 minutes before abdominal closure,and 24 hours after surgery.The morphology of capillary en-dothelial cells in the omental membrane was observed 5 minutes after opening abdomen and 5 minutes before abdominal closure.Results Compared with group PH,the number of effective PCIA compressions and total PCIA compressions in group PL were significantly reduced within 48 hours after surgery(P＜0.05),the concentration of IL-6 was significantly decreased in group PL 5 minutes before abdominal closure and 24 hours after surgery(P＜0.05),the content of MDA was significantly decreased in group PL 5 minutes be-fore abdominal closure(P＜0.05).The endothelial cell of the greater omental capillaries was slightly edematous and unevenly thick,while the nuclear contractile function was slightly weakened and the vascular lumen was moderately narrowed in group PL 5 minutes before abdominal closure.By contrast,the group PH showed obvious swelling of the endothelial cells with significant intracellular fluid accumulation and severe edema,while the vascular lumen turned to be extremely narrow and the nucleus became severe swelling.Conclusion The use of deep muscle relaxation with low abdominal pressure at 10 mmHg in laparoscopic surgery for gastric cancer can diminish inflammation and oxidative stress,alleviating postoperative pain,re-duce the pneumoperitoneum pressure-induced damage on capillary endothelial cells,and leading to better early postoperative recovery.

The purpose of this study was to clone and characterize the ZFP36L1 (zinc finger protein 36-like 1) gene, clarify its expression characteristics, and elucidate its expression patterns in different tissues of goats. Samples of 15 tissues from Jianzhou big-eared goats, including heart, liver, spleen, lung and kidney were collected. Goat ZFP36L1 gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR), then the gene and protein sequence were analyzed by online tools. Quantitative real-time polymerase chain reaction (qPCR) was used to detect the expression level of ZFP36L1 in intramuscular preadipocytes in different tissues and adipocytes of goat at different differentiation stages. The results showed that the length of ZFR36L1 gene was 1 224 bp, and the coding sequence (CDS) region was 1 017 bp, encoding 338 amino acids, which was a non-secretory unstable protein mainly located in nucleus and cytoplasm. Tissue expression profile showed that ZFP36L1 gene was expressed in all selected tissues. In visceral tissues, the small intestine showed the highest expression level (P < 0.01). In muscle tissue, the highest expression level was presented in longissimus dorsi muscle (P < 0.01), whereas the expression level in subcutaneous adipose tissue was significantly higher than that in other tissues (P < 0.01). The results of induced differentiation showed that the expression of this gene was up-regulated during adipogenic differentiation of intramuscular precursor adipocytes (P < 0.01). These data may help to clarify the biological function of the ZFP36L1 gene in goat.
Animals ; Goats/genetics* ; Amino Acid Sequence ; Liver ; Cloning, Molecular

Three cases of vibrio vulnificus-associated necrotizing fasciitis are presented. All patients showed a rapidly progressing, swelling, redness in the limb after eating seafood. Additionally, they presented with multiple organ dysfunction syndromes affecting the heart, lung, liver, kidney, coagulation, and blood. Vibrio vulnificus related necrotizing fasciitis is a fatal soft-tissue infection with high mortality. These are essential to improve survival by early clinical suspicion and immediate surgical intervention.

Objective:To study the influence of the choice of main diagnosis on diagnosis-related groups(DRG) grouping and weight change, by taking cerebral infarction as the entry point.Methods:From January 1, 2019 to March 31, 2019, 331 patients in three DRG groups(BR25, BR23, BR21) with cerebral infarction were selected. The original group was used as the control group; the main diagnosis was exchanged with the first other diagnosis, then DRG group was used as the experimental group. The difference of the number of cases and weight between the two groups was analyzed.Results:41.4%(137/331) of the patients in the experimental group were enrolled in BZ11 with other neurological disorders associated with important comorbidities and comorbidities, and 82.5%(273/331) patients′ weight increased after diagnostic conversion.Conclusions:Choosing other diagnosis as the main diagnosis may change the weight of the disease and affect the corresponding disease benefit. In order to prevent downcoding, DRG grouping should be detailed, and DRG payment should consider how to reflect the value of difficult cases; for upcoding behavior, medical insurance center and relevant medical institutions should check the correctness of coding, and monitor in place.

Objective:To investigate the clinicopathological features and prognosis of pleomorphic giant cell adenocarcinoma (PGCA) of the prostate, and to strengthen the understanding of this rare variant.Methods:From January 2009 to December 2019, 383 pathological samples of prostate adenocarcinoma with Gleason scores of 8-10 were selected from the First Affiliated Hospital, Army Medical University. PGCA was screened by reviewing the histomorphology of hematoxylin and eosin stained sections. Then the expression of prostate specific markers and mismatch repair (MMR) proteins of PGCA were detected by immunohistochemistry (IHC), and microsatellite instability (MSI) status was detected through polymerase chain reaction (PCR)-capillary electrophoresis. Meanwhile, the clinicopathological characteristics, diagnosis, treatment and prognosis of PGCA were summarized and analyzed along with those reported in the literature.Results:Three patients with PGCA of the prostate were 68, 63 and 71 years old respectively, and case 1 had a history of transurethral resection of the prostate and oral bicalutamide 3 months before surgery. All 3 patients underwent radical prostatectomy and received endocrine therapy, radiotherapy and/or chemotherapy, and died at 18, 23, and 10 months after surgery, respectively. Histologically, both the usual prostate adenocarcinoma with Gleason score of 9-10 and the pleomorphic giant cell component with anaplastic characteristics were observed in 3 tumors, and the latter accounted for 90%, 10%, and 20%, respectively. Immunohistochemical staining showed that both components expressed epithelial markers (CK, CK8/18) and prostate-specific markers (NKX3.1, PSA, P504S) to varying degrees, and the expression of MMR proteins (MSH2, MSH6, MLH1 and PMS2) were not defective. MSI was not detected in the usual prostate adenocarcinoma and pleomorphic giant cell components obtained by microdissection in 3 cases. Combined with 10 cases reported in the literature, there were totally 13 cases of PGCA for reviewing. The patients were 45-81 years old, the average age was 66 years old, and the median age was 66 years old. During the follow-up period of 3-36 months, 7 cases relapsed/metastasized, 6 cases died within 23 months after diagnosis, and 4 of which died within 1 year.Conclusions:PGCA is a newly recognized rare variant of prostate adenocarcinoma. At present, all cases are accompanied with high-grade usual prostate adenocarcinoma with Gleason score of 9-10, but it is different from the latter in pathological morphology and clinical manifestations, by presenting high invasiveness and poor prognosis. PGCA is not sensitive to conventional endocrine therapy, radiotherapy or chemotherapy. Accurate diagnosis of PGCA is helpful to judge the prognosis of patients and guide the treatment.

Objective:To analyze the epidemiological characteristics of pneumoconiosis in Hunan Province.Methods:In November 2018, we collected the type of work, pneumoconiosis type, pneumoconiosis stage, length of service, age of onset and complications of pneumoconiosis cases diagnosed by Hunan occupational disease prevention and control hospital from January 2017 to October 2018. A total of 3 325 cases of pneumoconiosis were collected, including 651 cases (19.58%) of occupational pneumoconiosis and 2674 cases (80.42%) of clinically diagnosed pneumoconiosis. The measurement data were expressed by ± s. The comparison between groups was performed by independent sample t test and one-way ANOVA. Results:The age of 651 patients with occupational pneumoconiosis was 35.59-85.15 years old, the average age of onset was (54.27±8.29) years, and the average exposure to dust was (14.74±8.60) years. 2 674 cases of clinically diagnosed pneumoconiosis were 26.85~87.02 years old. The average age of onset was (55.26±7.38) years, and the average exposure time was (18.83±9.35) years. Compared with silicosis patients, coal workers' pneumoconiosis patients had longer exposure time, the difference was statistically significant ( P<0.05) , and the difference was statistically significant ( F=3.678, P<0.05) . There were no complications in 651 cases of occupational pneumoconiosis. Among 2 674 cases of clinically diagnosed pneumoconiosis, 710 cases (26.55%) had complications. Conclusion:Further attention should be paid to the clinical diagnosis of pneumoconiosis in Hunan Province.