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.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

Objective To evaluate the stability and aesthetic effect of a xenogeneic collagen matrix(mucograft)on achieving an adequate keratinized mucosa width(KMW)around implants and to provide a reference basis for the clini-cal application of xenogeneic collagen matrix materials.Methods The hospital ethics committee approved the study protocol,and the patients provided informed consent.Twenty patients with a KMW＜2 mm at the buccal implant site who were treated in Binzhou Medical University Affiliated Yantai Stomatological Hospital from July 2020 to September 2022 were included,and a total of 36 implants were included.The mean age of the patients was(52.0±10.4)years,of which 18 were females and 2 were males.They were divided into a free gingival graft group(FGG,control group)and a xenogeneic collagen matrix group(test group)according to different graft materials.The incremental effect of the KMW on the buccal side of the implant and the mucosal shrinkage rate was measured at 1 month and 3 months after the opera-tion.The mucosal scar index(MSI)was evaluated after the operation.Results At 3 months postoperatively,the KMW was(3.67±1.06)mm in the control group and(2.96±0.98)mm in the test group,and the difference was statistically significant(t=2.076,P＜0.05).The KMW shrinkage rate was(33.34±16.30)％in the test group and(22.05± 15.47)％in the control group at 1 month postoperatively and(51.95±12.60)％in the test group and(37.44±16.30)％in the control group at 3 months postoperatively,with statistically significant differences between the two groups at the same time points(P＜0.05).Three months after surgery,the test group showed significantly better outcomes than the control group in terms of the five scar indicators(scar width,scar convexity,scar color,scar trace,and overall appear-ance),and the difference was statistically significant(P＜0.05).Conclusion Xenogeneic collagen matrix can increase the peri-implant KMW and achieve a more natural and coordinated soft tissue aesthetic effect but with a higher shrink-age rate.

OBJECTIVE To establish the drug-induced liver injury （DILI） surveillance and assessment system （DILI-SAS）， and to improve the diagnostic efficiency of clinical DILI. METHODS The DILI-SAS was constructed by using natural language processing technology to mine and utilize all inpatient medical record data， and combined with Roussel Uclaf causality assessment method （RUCAM）. The medical records of 19 445 hospitalized patients from August 2022 to January 2023 were detected to verify the performance of the system and manually analyze the basic data of patients with DILI and the distribution of the first suspected drugs. RESULTS The overall accuracy rate of the DILI-SAS system was 91.95%， and the recall rate was 93.20%. Seventy-five DILI cases were detected， and the DILI incidence rate was 385.70/100 000 people. The efficiency of DILI monitoring by human- computer coupling was increased by about 60 times of manual monitoring； males （61.33%） and patients over 60 years old （56.00%） were the most common in the 75 cases of DILI. The clinical type of liver injury was hepatocyte injury （69.33%）， the incubation period was mainly 5-90 days after treatment （62.67%）， and the RUCAM score between 3 and 5 was the most common （66.67%）； pharmacological distribution of the first suspected drugs was mainly dihydropyridines， HMG CoA reductase inhibitors， proton pump inhibitors， etc. The specific drugs were atorvastatin， omeprazole， ceftriaxone， metronidazole and other drugs. CONCLUSIONS The establishment of DILI-SAS can improve the evaluation efficiency on the basis of ensuring the accuracy degree， and provide a solution for the early identification， diagnosis and evaluation of clinical DILI.

Objective: To evaluate the clinical efficacy of tube moxibustion plus point-toward-point needling method for refractory facial paralysis. Methods: A total of 100 patients with refractory facial paralysis who met the inclusion criteria were randomized into an observation group and a control group, with 50 cases in each group. Both groups were treated with acupuncture by point-toward-point needling method, mainly in the affected eye, cheek and mouth areas. The observation group was given additional tube moxibustion after receiving the point-toward-point needling method, which inserted a tube moxibustion device into the external acoustic meatus 1 cm on the affected side for 20 min. Both groups were treated once a day, 6 times a week, for 4 consecutive weeks. The House-Brackmann scale was scored before and after treatment, and the facial nerve electromyogram data were collected. Results: The total effective rate of the observation group was 93.6％, which was higher than 64.6％ of the control group, and the difference between the two groups was statistically significant (P<0.05). The proportion of new-onset facial paralysis complications (facial synkinesis, facial spasm, facial paralysis perversion, and crocodile tears) in the observation group was 6.4％, which was lower than 35.4％ in the control group. The difference between the two groups was statistically significant (P<0.05). In the observation group, the numbers of cases after treatment with the ratio of action potential amplitude between the affected side and the healthy side increased by 10％-30％ and over 30％ were more than those in the control group. And the difference between the two groups was statistically significant (P<0.05). Conclusion: Tube moxibustion plus point-toward-point needling method has a better effect in improving symptoms of refractory facial paralysis, decreasing the incidence of sequelae, and increasing clinical efficacy than the point-toward- point needling method alone.

Genome packaging is a fundamental process in a viral life cycle and a prime target of antiviral drugs. Herpesviruses use an ATP-driven packaging motor/terminase complex to translocate and cleave concatemeric dsDNA into procapsids but its molecular architecture and mechanism are unknown. We report atomic structures of a herpesvirus hexameric terminase complex in both the apo and ADP•BeF3-bound states. Each subunit of the hexameric ring comprises three components-the ATPase/terminase pUL15 and two regulator/fixer proteins, pUL28 and pUL33-unlike bacteriophage terminases. Distal to the nuclease domains, six ATPase domains form a central channel with conserved basic-patches conducive to DNA binding and trans-acting arginine fingers are essential to ATP hydrolysis and sequential DNA translocation. Rearrangement of the nuclease domains mediated by regulatory domains converts DNA translocation mode to cleavage mode. Our structures favor a sequential revolution model for DNA translocation and suggest mechanisms for concerted domain rearrangements leading to DNA cleavage.

Objective:To evaluate long-term clinical outcome of implant-supported fixed prosthesis with the guidance of computer-aided design/computer-aided manufacturing (CAD/CAM) surgical template in old patients.Methods:Fifteen 50-67(58.6±5.3) year-old patients (11 males and 4 females) who received the digital implant surgery with the guidance of CAD/CAM surgical template and implant-supported fixed prosthesis in Department of Oral Implantology, Yantai Stomatological Hospital Affiliated to Binzhou Medical College from August, 2013 to Janurary, 2016 were included. There are 15 edentulous maxillas, 8 edentulous mandibles on which 145 implants were placed in total. After the placement of implant, the accuracy of CAD/CAM surgical template was assessed by comparing the post-operative 3-dimensional location of implant with the pre-operative design. The 5-year survival rate of implant and prosthesis was recorded, and marginal bone loss around implants and the development of complication were evaluated by radiological and clinical examination respectively.Results:The result on accuracy of CAD/CAM surgical template showed that deviations in neck and apex of implants were (0.78±0.59) and (1.38±0.63) mm respectively, depth deviation was (0.65±0.35) mm and angle deviation was 4.12°±2.77°. The 5-year cumulative survival rate of implants was 98.6%(143/145). In all 145 implants, the prevalence of implant-related biological complication was 4.1%(6/145). The prosthesis-related mechanical complication rate was 57%(13/23). After 5-year function, mean peri-implant bone loss was (0.69±0.35) mm.Conclusions:This 5-year follow-up retrospective study showed that implant-supported fixed prosthesis with the guidance of CAD/CAM surgical template in middle aged and elderly patients could achieve good long-term clinical outcome and patient satisfaction.

Objective: To compare the clinical effects of laparoscopic repair and open repair of gastroduodenal ulcer perforation. Methods: Retrospective analysis was performed on 117 patients with perforated gastroduodenal ulcer admitted to Sijing Hospital of Shanghai Songjiang District from October 2005 to February 2018, including 86 males and 31 females. The average age was 35.56 years with a range from 17 to 68 years. Patients were divided into two groups according to different surgical methods: laparoscopic group (n=56) and open group (n=61). Patients in the laparoscopic group were received laparoscopic repair for perforated gastroduodenal ulcer, while patients in the open group received open repair for perforated gastroduodenal ulcer. Comparison of two groups of patients with operation time, intraoperative blood loss, postoperative first anal exhaust time, analgesic utilization rate, length of hospital stay, the body′s inflammatory response [preoperative and 24 h, 72 h, 120 h of postoperative peripheral white blood cell (WBC)], C-reactive protein level (CRP), postoperative complications (postoperative incision infection, incision dehiscence, gastric duodenal fistula, abdominal abscess, adhesion intestinal obstruction and lung infection). Measurement data were expressed as mean±standard deviation (Mean±SD), and t-test was used for comparison between groups; count data were compared by Chi-square test. Results: All the patients in the two groups successfully completed the operation, and there were no cases transferred to laparotomy in the laparoscopic group. Intraoperative blood loss[(15.3±9.5) ml vs (30.5±11.3) ml, P<0.001], time of first anal exhaust[(56.5±9.8) h vs (83.8±15.6) h, P<0.001], analygesic utilization rate (10.71% vs 52.46%, P<0.005), and length of hospital stay [(7.5±1.5) d vs (10.0±3.4) d, P<0.001] of the laparoscopic group were significantly better in the open group, the differences were statistically significant. The WBC and CRP at 24 h, 72 h and 120 h after surgery of the laparoscopic group were also significantly better than in the open group [WBC: 24 h, (14.55±3.44) ×10⁹/L vs (16.02±4.12) ×10⁹/L, P=0.020; 72 h, (10.25±2.32) ×10⁹/L vs (14.22±3.29) ×10⁹/L, P<0.001; 120 h, (8.12±3.11)×10⁹/L vs (11.58±2.33) ×10⁹/L, P<0.001. CRP: 24 h, (50.35±13.73) mg/L vs (80.11±13.56) mg/L, P<0.001; 72 h, (29.37±7.81) mg/L vs (53.57±8.05) mg/L, P<0.001; 120 h, (17.71±7.01) mg/L vs (34.35±7.72) mg/L, P<0.001], the differences were statistically significant. There was no significant difference in operation time and postoperative complications between the two groups (P>0.05). Conclusion Compared with open gastroduodenal ulcer perforation repair, laparoscopic gastroduodenal ulcer perforation repair surgery trauma are smaller, and the body′s inflammatory response are lighter, postoperative complications is no statistical significance, but will look from actual data, the cases of complications is less, is now a better surgical treatment of gastroduodenal ulcer perforation.

Objective To explore nurses' bonus assessment and distribution methods based on the information technology platform and to improve the efficiency of nursing management. Methods We build a hospital informa-tion platform in order to collect nursing work efficiency data by using existing computer information network. We distributed the bonus through the information platform according to evaluate nursing quality and performance effi-ciency. Results After the information flatform used for 2 years,the satisfaction of nurses with different professional titles and different experience showed no significant difference (P>0.05). The time of department management person-nel collecting and distributing data change from [103.75 (180.00,215.00)] min per month to [42.50 (60.00,90.00)] min per month.The difference showed statistical significance(P<0.05). Conclusion The technology platform can im-prove the satisfaction and the nursing management efficiency.

OBJECTIVETo study mRNA expression of receptor activator nuclear factor kappa B ligand (RANKL) and its decoy receptor, osteoprotegerin (OPG) in peri-implant tissue during unloading period.

METHODSAn animal model of dental implant was established in 6 male Beagle dogs of 1-2 years old. Bone remodeling was tested at 3, 7, 15, 30, 60 and 90 days since the placement of implants. RANKL and OPG mRNA expression were quantified by real-time polymerase chain reaction (PCR). Then mandibular bones were taken out and the morphological changes were observed by X-ray, bone tissue was tested by immunohistochemistry stain.

RESULTSThe most prominent period of bone remodeling occurred at 7th day after the placement of implants. The expression of RANKL and OPG increased in a time-dependent manner in both soft and hard tissue. After 7 days they gradually decreased.

CONCLUSIONRANKL and OPG can express in soft tissue, and the changing tendency is consistent with the change of bone remodeling, it indicates that RANKL and OPG play an important role in the bone remodeling.

Animals ; Bone Remodeling ; Bone and Bones ; Carrier Proteins ; Dogs ; Male ; NF-kappa B ; Osteoprotegerin ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B