Nonalcoholic fatty liver disease （NAFLD） has become the most common chronic liver disease in the world， and it is also one of the main causes of liver cirrhosis and hepatocellular carcinoma， so it is particularly important to curb the development and progression of NAFLD in a timely manner. However， due to its complex pathogeneses， there are currently no effective methods for radical treatment. As a new generation of probiotics， Akkermansia muciniphila （Akk bacteria） can improve metabolic disorders of the body， and more and more studies have shown that Akk bacteria have a potential therapeutic effect on metabolic diseases， especially NAFLD. Therefore， this article briefly reviews the mechanism of action of Akk bacteria in NAFLD， in order to provide new ideas for improving the treatment of NAFLD and creating new therapies.

Objective To analyze the influencing factors of coronary artery lesions in patients with Ka-wasaki disease(KD)in Xinjiang.Methods A total of 1 500 KD patients who were treated in the First Affilia-ted Hospital of Xinjiang Medical University from December 2020 to December 2022 were selected as the re-search objects.According to whether coronary artery disease occurred,they were divided into two groups.886 patients with coronary artery lesions were included in the experimental group,and 614 patients without coro-nary artery lesions were included in the control group.Univariate and multivariate logistic regression analysis was used to analyze the risk factors of coronary artery lesions.Results The results of logistic regression anal-ysis showed that the duration of fever(＞10 d),high Gensini score,high level of N-terminal pro-brain natri-uretic peptide(NT-proBNP),C-reactive protein(CRP),total cholesterol(TC),low-density lipoprotein cho-lesterol(LDL-C)and triglycerides(TG)may be risk factors for coronary artery lesions(P＜0.05).Conclusion In clinical diagnosis and treatment,targeted intervention should be given as early as possible to prevent the occurrence of coronary artery lesions.

Objective:To explore the factors influencing the supportive communication ability of medical undergraduates, and to propose strategies to improve supportive communication.Methods:By cluster sampling, we selected 388 medical undergraduates of grades 2017 and 2018 from Harbin Medical University for a questionnaire survey on supportive communication, general self-efficacy, and health education abilities. SPSS 22.0 was used for descriptive statistical analysis. AMOS 22.0 was used to construct a structural equation model to verify the relationship between the three variables. Mediating effects were also tested.Results:The students showed good supportive communication ability, with a total score of (74.28±10.84) points. The general self-efficacy score was (27.81±5.58) points, and the total score of health education ability was (25.50±4.76) points. General self-efficacy had direct positive effects on supportive communication and health education abilities ( β=0.75, 0.31, both P<0.001). Health education ability had a direct positive effect on supportive communication ability ( β=0.14, P<0.001). Health education ability played a significant mediating role in the influence of general self-efficacy on supportive communication ability (standardized mediating effect value=0.042, P<0.01), with the mediating effect accounting for 5.1%. Conclusions:The health education competency of medical undergraduates can mediate the effect of general self-efficacy on supportive communication ability. By strengthening medical humanities education to increase general self-efficacy and also emphasizing the cultivation of health education competency, the supportive communication ability of students can be improved.

In fixed prosthodontics, clear exposure of the preparation margin is the prerequisite for obtaining accurate digital impressions and improving the marginal fit of restorations. To resolve the issues associated with the cord retraction technique, such as pain, acute injury, and prolonged procedural time, this study proposes a new technology for intraoral digital impression taking with pneumatic gingival retraction. The new scanning head blows a high-speed airflow that instantaneously separates the free gingiva, locally exposing the subgingival preparation margin. Combined with the farthest point preservation stitching algorithm based on the distance from the normal vector and high-speed laser scanning photography, it achieves global preparation edge data and gingival reconstruction, realizing painless, non-invasive, and efficient precise acquisition of the preparation margin. Using this new technique, a patient with a full porcelain crown restoration on a posterior tooth was treated. The digital impression revealed a clear margin of the preparation, and the crown made from this data has a good marginal fit.

Objective:To explore the correlation between frailty and carotid plaque stability in patients with ischemic stroke.Methods:This study was a cross-sectional study. From May to December 2023, convenience sampling was used to select 360 patients with ischemic stroke in the Department of Neurology of Affiliated Hospital of Jining Medical University and underwent carotid artery color Doppler ultrasound examination as the study subject. Patients were surveyed using the General Information Questionnaire, Barthel Index and the Edmonton Frail Scale. Carotid artery color Doppler ultrasound was used to evaluate the stability of carotid plaques in patients. Multivariate Logistic regression was used to explore the correlation between frailty and carotid plaque stability.Results:A total of 360 questionnaires were distributed, and 352 valid questionnaires were collected, with a valid response rate of 97.78%. The incidence of frailty in 352 ischemic stroke patients was 44.89% (158/352). Multivariate analysis showed that compared to stable plaques, unstable carotid plaques were an independent risk factor for frailty in patients with ischemic stroke ( OR=2.127, 95% confidence interval: 1.247-3.626) . Conclusions:Compared to stable plaques, unstable carotid plaques increase the risk of frailty in patients with ischemic stroke. Strengthening the assessment of carotid plaques in patients with ischemic stroke by nursing staff can early identify high-risk individuals for frailty, and timely carry out personalized interventions, thereby reducing the occurrence of adverse health events in patients.

Objective:To compare the clinical effects of mortice and tenon joint and end-to-end bone contact of zygomatic arch in reduction malarplasty, and to explore the clinical application value of mortice and tenon joint.Methods:The clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital and West China Hospital of Stomatology, Sichuan University from January 2013 to June 2020 were analyzed retrospectively. All patients were treated with classical or modified L-shaped zygomatic arch osteotomy. According to the bone connection mode of the zygomatic arch, the patients were divided into Group Ⅰ and Group Ⅱ. The patients in Group Ⅰ were treated with mortice and tenon joint (from June 2017 to June 2020), and the ones in Group Ⅱ were treated with end-to-end contact (from January 2013 to May 2017). The movement between zygomatic body and zygomatic arch were measured 6-24 months after surgeries. The postoperative satisfaction rate was investigated, and the incidence of complications within 2 years after operation was recorded. The data were statistically analyzed by SPSS 20.0 software. The measurement data were expressed by Mean±SD, and the counting data were expressed by cases (%). T-test was used to compare the age difference, zygomatic body and zygomatic arch movement distance between the two groups. Chi-square test was used to compare the sex composition ratio, postoperative satisfaction rate (sum of very satisfied and satisfied cases/sum of cases in respective group) and incidence of complications between the two groups. P<0.05 was considered statistically significant. Results:A total of 380 patients presenting with zygomatic protrusion were included in this retrospective study. One hundred and ninety patients were included in Group Ⅰ[22 men and 168 women; aged(26.8 ±8.6) years)] and 190 patients in Group Ⅱ [16 men and 174 women; aged (25.2 ±8.8) years)]. There was no significant difference in sex constituent ratio and age between the two groups ( P>0.05). After the operation, the width of the face was narrowed, and the contour of the face was significantly improved. The medial movement distance of zygomatic body in Group Ⅰ and Group Ⅱ was (2.65±0.76) mm versus (2.51±0.78) mm, and the movement distance of zygomatic arch in Group Ⅰ and Group Ⅱ was (4.58 ±0.44) mm versus (2.60±0.28) mm. There was no significant difference in movement distance of zygomatic body between Group Ⅰ and Group Ⅱ ( t=1.77, P=0.077), but there was significant difference in the zygomatic arch ( t=52.33, P<0.001). The satisfaction rate of patients in Group Ⅰ was 75.8% (144/190), which was higher than that in Group Ⅱ (55.3%, 105/190) ( χ2=17.72, P<0.001). There was no significant difference in the incidence of postoperative infection, temporary paresthesia, and hematoma between the two groups ( P>0.05). The incidence of facial asymmetry, sagging cheek, bone suture and nonunion in Group Ⅱ was significantly higher than that in Group Ⅰ ( P<0.05). Conclusion:Compared with end-to-end bone contact in reduction malarplasty, the mortice and tenon joint of the zygomatic arch achieved better facial narrowing effect and long-term stability, higher patient satisfaction rate and less postoperative complications.

Objective:To compare the clinical effects of mortice and tenon joint and end-to-end bone contact of zygomatic arch in reduction malarplasty, and to explore the clinical application value of mortice and tenon joint.Methods:The clinical data of patients who underwent reduction malarplasty in Sichuan Friendship Hospital and West China Hospital of Stomatology, Sichuan University from January 2013 to June 2020 were analyzed retrospectively. All patients were treated with classical or modified L-shaped zygomatic arch osteotomy. According to the bone connection mode of the zygomatic arch, the patients were divided into Group Ⅰ and Group Ⅱ. The patients in Group Ⅰ were treated with mortice and tenon joint (from June 2017 to June 2020), and the ones in Group Ⅱ were treated with end-to-end contact (from January 2013 to May 2017). The movement between zygomatic body and zygomatic arch were measured 6-24 months after surgeries. The postoperative satisfaction rate was investigated, and the incidence of complications within 2 years after operation was recorded. The data were statistically analyzed by SPSS 20.0 software. The measurement data were expressed by Mean±SD, and the counting data were expressed by cases (%). T-test was used to compare the age difference, zygomatic body and zygomatic arch movement distance between the two groups. Chi-square test was used to compare the sex composition ratio, postoperative satisfaction rate (sum of very satisfied and satisfied cases/sum of cases in respective group) and incidence of complications between the two groups. P<0.05 was considered statistically significant. Results:A total of 380 patients presenting with zygomatic protrusion were included in this retrospective study. One hundred and ninety patients were included in Group Ⅰ[22 men and 168 women; aged(26.8 ±8.6) years)] and 190 patients in Group Ⅱ [16 men and 174 women; aged (25.2 ±8.8) years)]. There was no significant difference in sex constituent ratio and age between the two groups ( P>0.05). After the operation, the width of the face was narrowed, and the contour of the face was significantly improved. The medial movement distance of zygomatic body in Group Ⅰ and Group Ⅱ was (2.65±0.76) mm versus (2.51±0.78) mm, and the movement distance of zygomatic arch in Group Ⅰ and Group Ⅱ was (4.58 ±0.44) mm versus (2.60±0.28) mm. There was no significant difference in movement distance of zygomatic body between Group Ⅰ and Group Ⅱ ( t=1.77, P=0.077), but there was significant difference in the zygomatic arch ( t=52.33, P<0.001). The satisfaction rate of patients in Group Ⅰ was 75.8% (144/190), which was higher than that in Group Ⅱ (55.3%, 105/190) ( χ2=17.72, P<0.001). There was no significant difference in the incidence of postoperative infection, temporary paresthesia, and hematoma between the two groups ( P>0.05). The incidence of facial asymmetry, sagging cheek, bone suture and nonunion in Group Ⅱ was significantly higher than that in Group Ⅰ ( P<0.05). Conclusion:Compared with end-to-end bone contact in reduction malarplasty, the mortice and tenon joint of the zygomatic arch achieved better facial narrowing effect and long-term stability, higher patient satisfaction rate and less postoperative complications.

Objective:To investigate the feasibility of contracted nursing services for disabled persons.Methods:A qualitative study on the feasibility of contracted nursing services for disabled persons was conducted from August 2020 to October 2020 with the phenomenological method. Community nurses were selected with the purpose of sampling method from Yuetan and Baizhifang Community Health Service Centers in Beijing Xicheng District for semi-constructed interviews, and 12 community nurses were finally interviewed according to the principle of information saturation. The research team took field notes, audio recordings and transcriptions of the interviews, coded to refine the themes, and fed back with the respondents to confirm the accuracy of the themes.Results:All the interviewed nurses thought that the contents of basic medical and public health required by the Guidance manual of contracted services of family doctors for disabled persons (the manual) including basic documentation, appointments, pre-diagnosis and post-diagnosis services, home care, rehabilitation nursing guidance, referral services and extended nursing services for the disabled and their families could be completed. All interviewees said that the manual had a guiding role in contracted services for disabled persons. Eight interviewed nurses believed that the manual involved referral services and rehabilitation care, but the technical guidance content did not meet the actual work needs and it should be supplemented and improved; 9 interviewees pointed out that there was a lack of communication with various types of disabled people in service practice, especially for those with vision, hearing, mental disabilities and disabled children; 7 interviewees said that it the free home care for the disabled was not sustainable. Conclusion:The contracted nursing services for disabled persons are feasible and the manual has a guiding role for the practice,and some contents need to be added in the manual to further improve service capacity for disabled people.

Objective:To investigate the status quo of communication between contracted family doctor team and the disabled.Methods:Using convenience sampling, family doctor team members of 80 community health centers (CHCs) in Beijing were selected to participate in a questionnaire survey from April to June 2022. The questionnaire included the basic information of team members, the choice of communication methods and targets, the acquisition of communication knowledge and skills and so on.Results:A total of 365 team members participated in the survey. The most common type of disability was physical disability (78.08%,285/365). All participants met communication obstacles with disabled people in contracted health service, and hearing and speech disabilities were the most common (70.14%, 256/365). Only 13.42% (49/365) chose to directly communicate with the disabled themselves; 84.93% (310/365) used "increase the volume and slow down" method when communicating with the disabled, and 38.63% (141/365) chose "write and convey multiple messages at the same time". Most of participants (84.38%, 308/365) indicated the need for professional training in communication with persons with disabilities.Conclusion:There are communication obstacles between family doctor team members and the disabled during contracted services. More relevant professional training are urgently needed for contracted family doctor team to improve the abilities to communicate with the disabled.

Objective:To analyze the pulmonary high resolution CT (HRCT) images before and after hematopoietic stem cell transplantation (HSCT) in 6 children with Niemann-Pick disease(NPD) type B, and to investigate the effect of HSCT on lung lesions.Methods:Data of 6 children who were diagnosed with NPD type B and underwent HSCT treatment in Children′s Hospital Affiliated to Capital Institute of Pediatric from March 2019 to June 2021 were retrospectively enrolled, including 5 males and 1 female, with ages ranging from 1 year and 2 months to 5 years, and a median age of 2 years and 1month. The follow-up time of HRCT after HSCT was 7-20.5 months, the median time was 5 months, and the number of follow-up was 2-7 per patients, a total of 27 times. The pulmonary lesions (including interstitial lung disease, airway lesions and alveolar lesions) on aortic arch level, tracheal carina level and right diaphragmatic surface level were evaluated and scored respectively by two experienced pediatric radiologists, and the average score between them would be the final score. The Kruskal-Wallis H test was used to compare the scores of the three kinds of lung lesions before HSCT. The linear regression method was used to analyze the impact of HSCT duration on the degree of different lesions. To control possible confounding factors in the study, a generalized linear mixed model was used to evaluate the effects of HSCT duration, age, gender and whether co-infection on different types of lesions after HSCT. Results:Before HSCT treatment, all of the 6 children had different degree of airway, interstitial and alveolar lesions, with a median score of 3.0, 14.0 and 5.8 points, respectively (χ2=11.95, P=0.003). Interstitial disease was the most extensive and serious lesion among those three pulmonary involvements in pediatric NPD type B. After HSCT treatment, the scores of interstitial and airway lesions in all of the 6 children reduced, in varying degree, with the increase of time after HSCT. Except case 4, the alveolar lesion in 5 patients also showed a decreasing trend over time. The linear regression equation between the score of airway, interstitial, alveolar lesions and the HSCT duration was: airway lesion, Y=1.94-0.15X; interstitial lesion, Y=12.73-0.78X; and alveolar lesion, Y=3.31-0.27X. The results of the generalized linear mixed model showed that the main effect of HSCT duration significantly affected on the three kinds of lung lesions, and the scores of interstitial lesions, airway lesions and alveolar lesions were decreased by 0.688, 0.245, and 0.338 points for each 1 month increase of HSCT duration (all P<0.05). The alveolar lesion score decreased by 1.135 points for each 1 year increase in age at presentation ( P=0.012). The main effects of gender and co-infection were not statistically significant in all of the pulmonary lesions (both P>0.05). Conclusion:HSCT alleviates pulmonary lesions of children with NPD type B significantly and consistently, with interstitial lesions were the most prominent.