Objective:To compare the difference between virtual surgical planning(VSP)position and postoperative real position of maxilla and condyle,and to explore the degree of intraoperative realization of VSP after orthognathic surgery.Methods:In this study,36 patients with mandibular protrusion de-formity from January 2022 to December 2022 were included.All the patients had been done bilateral sagittal split ramus osteotomy(SSRO)combined with Le Fort Ⅰ osteotomy under guidance of VSP.The VSP data(T0)and 1-week postoperative CT(T1)were collected,the 3D model of postoperative CT was established and segmented into upper and lower jaws in CCMF Plan software.At the same time,accor-ding to the morphology of palatal folds,the virtual design was registered with the postoperative model,and the unclear maxillary dentition in the postoperative model was replaced.Then the postoperative model was matched with VSP model by registration of upper skull anatomy that was not affected by the opera-tion.The three-dimensional reference plane and coordinate system were established.Selecting anatomical landmarks and their connections of condyle and maxilla for the measurement,we compared the coordinate changes of marker points in three directions,and the angle changes between the line connecting the marker points and the reference plane to analyze the positional deviation and the angle deviation of the postoperative condyle and maxilla compared to VSP.Results:The postoperative real position of the maxilla deviates from the VSP by nearly 1 mm in the horizontal and vertical directions,and the anteropos-terior deviation was about 1.5 mm.In addition,most patients had a certain degree of counterclockwise rotation of the maxilla after surgery.Most of the bilateral condyle moved forward,outward and downward(the average distance deviation was 0.15 mm,1.54 mm,2.19 mm,respectively),and rotated forward,outward and upward(the average degree deviation was 4.32°,1.02°,0.86°,respectively)compared with the VSP.Conclusion:VSP can be mostly achieved by assistance of 3D printed occlusal plates,but there are certain deviations in the postoperative real position of maxilla and condyle compared with VSP,which may be related to the rotation axis of the mandible in the VSP.It is necessary to use patient personalized condylar rotation axis for VSP,and apply condylar positioning device to further improve surgical accuracy.

Objective:To investigate the factors influencing phytohemagglutinin (PHA) response in the detection of Mycobacterium tuberculosis infection by gamma interferon release assay (IGRA). Methods:A retrospective case-control study was conducted on 360 hospitalized patients who received IGRA in West China Hospital of Sichuan University from January 2019 to December 2021. According to PHA response (IFN-γ level), they were divided into three groups: negative mitogen response group (IFN-γ<2 pg/ml), weak positive mitogen response group (IFN-γ: 2-100 pg/ml), and normal mitogen response group (IFN-γ>400 pg/ml).Results:Immune diseases were independently associated with negative (OR=0.34, 95%CI: 0.17-0.72, P=0.004) and weak positive mitogen responses (OR=0.29, 95%CI: 0.16-0.55, P<0.001). Infections caused by pathogens other than Mycobacterium tuberculosis was independently associated with negative mitogen response (OR=0.266, 95%CI: 0.09-0.83, P=0.023), while immunodeficiency was independently associated with weak positive mitogen response (OR=0.280, 95%CI: 0.12-0.63, P=0.002). Mitogen response was significantly correlated with the levels of albumin and hemoglobin in serum and the counts of neutrophils and lymphocytes ( P<0.001). Conclusions:Immune diseases and immunodeficiency can affect mitogen response. Therefore, clinicians should give attention to mitogen response in the interpretation of IGRA test results to prevent misdiagnosis and underdiagnosis. Besides, to a certain extent, mitogen response can reflect the infection status of hospitalized patients.

ObjectiveTo analyze the characteristics of HIV-1 molecular network and pretreatment drug resistance genes in the middle-aged and elderly people aged ≥50 years in Huzhou City, Zhejiang Province, and to provide an evidence for the prevention and control of AIDS epidemic. MethodsA total of 332 samples from the newly reported and untreated AIDS patients aged ≥50 years in Huzhou City from January 2020 to December 2023 were collected, pol genes were amplified by reverse transcription polymerase chain reaction (RT-PCR) and nested polymerase chain reaction (nest⁃PCR). Phylogenetic trees analyzing the subtypes were constructed, and a molecular network with a gene distance threshold of 1.0% were constructed at the same time. Mutation sites of drug resistance-related genes were identified through the Data Analysis and Detection System of HIV-1 Resistance Gene Detection of Stanford University, USA. ResultsSequence samples of 308 patients were obtained, and9 genotypes were identified, including CRF07_BC in 172 cases (55.8%), CRF01_AE in 61 cases (19.8%), CRF08_BC in 43 cases (14.0%), CRF85_BC in 9 cases (2.9%), and CRF55_01B in 8 cases (2.6%), subtype B in 5 cases (1.6%), subtype C in 4 cases (1.3%), CRF67_01B in3 cases (1.0%), and unique recombination URF01_AE/07_BC in 3 cases (1.0%). When the gene distance threshold was 1.0%, 28 molecular clusters were formed, and 139 cases were connected to the network, with an access rate of 45.0%. The largest transmission cluster C1 contained 44 cases infected with CRF07_BC subtype, all of whom were heterosexually transmitted, and predominantly by males. A total of 30 patients were found to have low-grade or higher drug resistance mutations, and the pretreatment drug resistance rate was 9.7% (30/308). Among them, there were 5 cases (16.7%) of protease inhibitor (PI) related drug resistance mutations, and 26 cases (86.7%) of non-nucleoside reverse transcriptase inhibitors (NNRTI) related drug resistance mutations. ConclusionCRF07_BC is the subtype with the most clusters among the middle-aged and elderly infected patients aged ≥50 years in Huzhou City. Middle-aged and elderly transmission clusters are formed within the three counties of WX, NX and CX through related activities. Molecular network monitoring on newly reported cases aged ≥50 years in Huzhou City should be strengthened so that the new characteristics of epidemic changes can be detected in time, providing a scientific basis for adjusting AIDS prevention and control measures for the elderly.

Objective:To analyze the epidemiological characteristics of respiratory virus infections in Sichuan from 2017 to 2023, and investigate the changes in detection rates of various viruses in different periods and age groups.Methods:The study included 41 516 patients with acute respiratory infections. Clinical laboratory results of these patients were retrospectively collected to calculate the detection rates of various viruses. The epidemiological characteristics of respiratory virus infections before, during, and after the COVID-19 pandemic, the prevalence of mixed infections, and the detection rates in different seasons and age groups were analyzed.Results:The overall detection rate of respiratory viruses was 23.35% (9 696/41 516), with influenza A virus (8.47%, 3 515/41 516), rhinovirus (7.13%, 2 961/41 516), and influenza B virus (2.04%, 846/41 516) being the most prevalent. The highest detection rate was observed in children aged 0-14 years (48.62%, 1 429/2 939), while the detection rates in young, middle-aged, and elderly individuals were similar [21.00% (1 482/7 057), 22.06% (3 828/17 350), 20.33% (2 685/13 205)]. The detection rate of influenza A virus dropped to 1.35% (253/18 717) during the COVID-19 pandemic, and rebounded to 13.05% (1 560/11 953) after the pandemic. A similar pattern was observed in other viruses such as human metapneumovirus, influenza B virus, coronavirus, and respiratory syncytial virus, with significant reductions during the COVID-19 pandemic and subsequent increases that even exceeded pre-pandemic levels. The detection rates of adenovirus, bocavirus, and rhinovirus gradually decreased over time, while the prevalence of parainfluenza virus remained stable, indicating a less significant impact of COVID-19 on these viruses. Higher detection rates were observed in autumn (28.90%, 2 324/8 041) and winter (26.52%, 4 093/15 433) as compared to that in spring (17.61%, 1 848/10 494) and summer (18.96%, 1 431/7 548), suggesting significant seasonal impacts on virus detection rates ( P<0.001). This study identified 8 666 cases of single-virus infections, 948 double infections, 77 triple infections, and five quadruple infections. Co-infection of bocavirus and rhinovirus was the most common type of double infections (17.41%, 165/948), and 59.60% (565/948) of double infections involved rhinovirus. Conclusions:The overall detection rate of respiratory viruses is higher in autumn and winter than in spring and summer. The prevalence of some respiratory viruses such as influenza viruses decreases during the COVID-19 pandemic. People of different ages can develop multiple infections with rhinovirus being the most common in double infections.

Objective:To analyze the new value of gastroscopy in the diagnosis of esophageal hiatal hernia(EHH).Methods:From March 7 to September 24 in 2019, 194 patients with gastroesophageal reflux disease who received endoscopy and high resolution esophageal manometry (HREM) at the Department of Gastroesophageal Surgery, the PLA Rocket Force Medical Center were selected. The transverse diameter of esophageal hiatus and the upward length of esophagogastric junction (EGJ) were measured under endoscopy, and the relevant data of reflux esophagitis (RE) and length and pressure of lower esophageal sphincter (LES) were collected. The value of traditional method under endoscopy and esophageal hiatus transverse diameter (EHTD) method under endoscopy in the diagnosis of EHH was compared. Independent sample- t test, rank sum test and chi-square test were used for statistical analysis. Results:The detection rate of EHH by EHTD method under endescopy was higher than that by traditional method under endoscopy and HREM method (60.8%, 118/194 vs. 14.9%, 29/194 and 37.1%, 72/194), and the detection rate of EHH by HREM method was higher than that by traditional method under endoscopy, and the differences were statistically significant ( χ2=86.75, 21.82, and 24.75; all P<0.001). The proportion of RE, the upward length of EGJ and the transverse diameter of esophageal hiatus of EHH patients diagnosed by traditional method under endoscopy and EHTD method under endoscopy were all higher than those of non-EHH patients (79.3%, 23/29 vs. 28.5%, 47/165; 49.2%, 58/118 vs. 15.8%, 12/76; 2.0 (2.0, 3.0) cm vs. 0.4(0, 0.7) cm, 0.7(0, 1.6) cm vs. 0(0, 0.6) cm; (2.60±0.71) cm vs. (1.88±0.44) cm, (2.30±0.45) cm vs. (1.51±0.29) cm); the minimum resting pressure of LES and resting pressure of LES were both lower than those of non-EHH patients(3.7(0.3, 12.1) mmHg (1 mmHg=0.133 kPa) vs. 9.1(3.3, 14.2) mmHg, 6.4(2.2, 12.5) mmHg vs. 10.8 (4.7, 15.5) mmHg; (9.70±7.92) mmHg vs. (14.92±10.30) mmHg, (11.36±7.79) mmHg vs. (18.44±11.78) mmHg); the length of intraperitoneal LES were shorter than that of non-EHH patients (0(0, 1.4) cm vs. 1.1(0, 1.7) cm, 0.3(0, 1.5) cm vs. 1.3(0.4, 1.8) cm); the length of LES of EHH patients diagnosed by EHTD method under endoscopy was shorter than that of non-EHH patients ((2.83±0.63) cm vs. (3.10±0.66) cm), and the differences were statistically significant ( χ2=26.53 and 22.31, Z=-8.26 and-5.04, t=5.26 and 13.67, Z=-2.14 and-2.71, t=-2.59 and-4.63, Z=-2.58 and-3.60, t=-2.96; all P<0.05). There were no significant differences in gender, LES length, intraperitoneal LES length, minimum resting pressure of LES, resting pressure of LES and residual pressure of LES between EHH patients diagnosed by EHTD method and traditional method under endoscopy (all P>0.05). Conclusions:Endoscopy plays a significant role in the diagnosis of EHH. EHTD method under endoscopy is more accurate in the diagnosis of sliding EHH, which is worthy of clinical reference.

Background/Aims: The shortage of donor liver hinders the development of liver transplantation. This study aimed to clarify the poor outcomes of functionally marginal liver grafts (FMLs) and provide evidence for the improvement of ischemia-free liver transplantation (IFLT) after FML transplantation. Methods: Propensity score matching was used to control for confounding factors. The outcomes of the control group and FML group were compared to demonstrate the negative impact of FMLs on liver transplantation patients. We compared the clinical improvements of the different surgical types. To elucidate the underlying mechanism, we conducted bioinformatic analysis based on transcriptome and single-cell profiles. Results: FMLs had a significantly greater hazard ratio (HR: 1.969, P=0.018) than did other marginal livers. A worse 90-day survival (Mortality: 12.3% vs. 5.0%, P=0.007) was observed in patients who underwent FML transplantation. Patients who received FMLs had a significant improvement in overall survival after IFLT (Mortality: 10.4% vs 31.3%, P=0.006). Pyroptosis and inflammation were inhibited in patients who underwent IFLT. The infiltration of natural killer cells was lower in liver grafts from these patients. Bulk transcriptome profiles revealed a positive relationship between IL-32 and Caspase 1 (R=0.73, P=0.01) and between IL-32 and Gasdermin D (R=0.84, P=0.0012). Conclusions FML is a more important negative prognostic parameter than other marginal liver parameters. IFLT might ameliorate liver injury in FMLs by inhibiting the infiltration of NK cells, consequently leading to the abortion of IL-32, which drives pyroptosis in monocytes and macrophages.

OBJECTIVE: To evaluate effectiveness of proximal femur bionic nail (PFBN) in treatment of intertrochanteric fractures in the elderly compared to the proximal femoral nail antirotation (PFNA). METHODS: A retrospective analysis was made on 48 geriatric patients with intertrochanteric fractures, who met the selection criteria and were admitted between January 2020 and December 2022. Among them, 24 cases were treated with PFBN fixation after fracture reduction (PFBN group), and 24 cases were treated with PFNA fixation (PFNA group). There was no significant difference in baseline data such as age, gender, cause of injury, side and type of fracture, time from injury to operation, and preoperative mobility score, American Society of Anesthesiologists (ASA) score, Alzheimer's disease degree scoring, self-care ability score, osteoporosis degree (T value), and combined medical diseases between the two groups ( P>0.05). The operation time, intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, occurrence of complications, weight-bearing time after operation, and postoperative visual analogue scale (VAS) score, walking ability score, mobility score, self-care ability score were recorded and compared between the two groups. And the radiographic assessment of fracture reduction quality and postoperative stability, and fracture healing time were recorded. RESULTS: The operations in both groups were successfully completed. All patients were followed up 6-15 months with an average time of 9.8 months in PFBN group and 9.6 months in PFNA group. The operation time was significantly longer in PFBN group than in PFNA group ( P<0.05), but there was no significant difference in intraoperative blood loss, number of blood transfusions, transfusion volume, length of hospital stay, change in activity ability score, and change in self-care ability score between the two groups ( P>0.05). The weight-bearing time after operation was significantly shorter in PFBN group than in PFNA group ( P<0.05), and the postoperative VAS score and walking ability score were significantly better in PFBN group than in PFNA group ( P<0.05). Radiographic assessment showed no significant difference in fracture reduction scores and postoperative stability scores between the two groups ( P>0.05). All fractures healed and there was no significant difference in fracture healing time between the two groups ( P>0.05). The incidence of complications was significantly lower in PFBN group (16.7%, 4/24) than in PFNA group (45.8%, 11/24) ( P<0.05). CONCLUSION Compared with PFNA, PFBN in the treatment of elderly intertrochanteric fractures can effectively relieve postoperative pain, shorten bed time, reduce the risk of complications, and facilitate the recovery of patients' hip joint function and walking ability.
Humans ; Aged ; Retrospective Studies ; Fracture Fixation, Intramedullary ; Bionics ; Blood Loss, Surgical ; Treatment Outcome ; Bone Nails ; Hip Fractures/surgery* ; Femur

Objective:In order to cope with the rising risk pressure on the economic operation of public hospitals,it aims to re-search and construct a comprehensive economic operation evaluation index,and improve the comprehensiveness,scientific and dynamic nature of monitoring and analysis of the economic operation of public hospitals.Methods:Literature research,expert consultation and hierarchical analysis were adopted.Results:A comprehensive evaluation model of public hospitals'economic operation covering 5 dimensions and 25 indexes,including structural optimization,controllable risk,efficiency enhancement,smooth operation and sustain-able development,has been constructed;empirical analyses of the overall index,sub-indexes and monthly indexes have been carried out on the data of some of the tertiary hospitals in Shanghai,which have verified the validity of the above index model in enhancing the monitoring,analysis and evaluation of the hospitals'economic operation,and revealed the role of the above index model in the changes of the economic conditions of the hospitals and the factors.Conclusion:Constructing a comprehensive evaluation index can effectively complement management such as comprehensive assessment and evaluation of public hospitals and traditional financial descriptive analysis.

Objective:To study the actual effect of the use of personal protective equipment of the examined individuals, and provide reference and basis for the correct use of personal protective equipment and the radiological health administrative law enforcement.Methods:From February to June 2022, the imaging department of Qingdao Municipal Hospital selected 170 patients who underwent X-ray imaging examination (oral panoramic, dental radiography, DR photography, CT scanning), including 25 with oral panoramic and dental radiography, 60 with CT scanning and 60 with DR imaging. The thermoluminescent dosimeter was used to detect the ambient dose equivalent at the point of concern for 170 examined individuals who have used personal protective equipment to cover their sensitive parts, and to analyze the data detected at the same point as above when routinely using the same equipment.Results:There was a statistically significant difference in the dose equivalent at the same points inside and outside the lead neckband ( t=-2.23, P<0.05). There was no statistically significant difference in the dose equivalent at the same point inside and outside the lead collar during dental radiography ( P>0.05). During DR photography (chest PA, lateral and lumbar AP), the examined individuals were wearing lead aprons. Among them, there was a statistically significant difference in the dose equivalent at the same points inside and outside the lead aprons of children′s chest PA and adults′ chest PA ( U=10.00, 19.00, P<0.05). There was no statistically significant difference in the dose equivalent at the same points inside and outside the lead aprons of adult′s chest PA and lumbar AP ( P>0.05). When performing CT scan (chest or upper abdomen), there was a statistically significant difference in the dose equivalent at the same points of wrapped lead aprons( U=878.50, 11.00, P<0.05). Conclusions:The correct use of personal protective equipment is a complex technical problem. It is very important to fully and accurately understand the optimization principle of radiation protection and correctly use personal protective equipment for the examined individuals. The administrative punishment of radiation health on the use of personal protective equipment of the examined individuals should be cautious.

Long noncoding RNAs (lncRNAs) are expressed in different species and different tissues, and perform different functions, but little is known about their involvement in the synthesis or secretion of follicle-stimulating hormone (FSH). In general, we have revealed lncRNA‍‒‍microRNA (miRNA)‍‒‍‍messenger RNA (mRNA) interactions that may play important roles in rat primary pituitary cells. In this study, a new lncRNA was identified for the first time. First, we analyzed the gene expression of lncRNA-m18as1 in different tissues and different stages by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and observed the localization of lncRNA-m18as1 with fluorescence in situ hybridization, which indicated that this lncRNA was distributed mainly in the cytoplasm. Next, we used RT-qPCR and enzyme-linked immunosorbent assay (ELISA) to analyze the regulation of FSH synthesis and secretion after overexpression or knockdown of lncRNA-m18as1 and found that lncRNA-m18as1 was positively correlated with FSH synthesis and secretion. In addition, mothers against decapentaplegic homolog 2 (Smad2) was highly expressed in our sequencing results. We also screened miR-18a-5p from our sequencing results as a miRNA that may bind to lncRNA-m18as1 and Smad2. We used RNA immunoprecipitation-qPCR (RIP-qPCR) and/or dual luciferase assays to confirm that lncRNA-m18as1 interacted with miR-18a-5p and miR-18a-5p interacted with Smad2. Fluorescence in situ hybridization (FISH) showed that lncRNA-m18as1 and miR-18a-5p were localized mainly in the cytoplasm. Finally, we determined the relationship among lncRNA-m18as1, miR-18a-5p, and the Smad2/3 pathway. Overall, we found that lncRNA-m18as1 acts as a molecular sponge of miR-18a-5p to regulate the synthesis and secretion of FSH through the Smad2/3 pathway.
Animals ; Cell Line, Tumor ; Cell Proliferation ; Follicle Stimulating Hormone/metabolism* ; Gene Expression Regulation, Neoplastic ; In Situ Hybridization, Fluorescence ; MicroRNAs/metabolism* ; RNA, Long Noncoding/metabolism* ; Rats