Objective:To establish and assess the precision of pre-surgical condyle position planning using mandibular movement trajectory data for orthognathic surgery.Methods:Skull data from large-field cone beam computed tomography(CBCT)and dental oral scan data were imported into IVSPlan 1.0.25 software for 3D reconstruction and fusion,creating 3D models of the maxilla and mandible.Trajectory da-ta of mandibular movement were collected using a mandibular motion recorder,and the data were inte-grated with the jaw models within the software.Subsequently,three-dimensional trajectories of the con-dyle were obtained through matrix transformations,rendering them visually accessible.A senior oral and maxillofacial surgeon with experience in both diagnosis and treatment of temporomandibular joint disease and orthognathic surgery selected the appropriate condyle position using the condyle movement trajectory interface.During surgical design,the mobile mandibular proximal segment was positioned accordingly.Routine orthognathic surgical planning was completed by determining the location of the mandibular distal segment,which was based on occlusal relationships with maxilla and facial aesthetics.A virtual mandible model was created by integrating data from the proximal and distal segment bone.Subsequently,a solid model was generated through rapid prototyping.The titanium plate was pre-shaped on the mandibular model,and the screw hole positions were determined to design a condylar positioning guide device.In accordance with the surgical plan,orthognathic surgery was performed,involving mandibular bilateral sagittal split ramus osteotomy(SSRO).The distal segment of the mandible was correctly aligned inter-maxillary,while the proximal bone segment was positioned using the condylar positioning guide device and the pre-shaped titanium plate.The accuracy of this procedure was assessed in a study involving 10 patients with skeletal class Ⅱ malocclusion.Preoperative condyle location planning and intraoperative po-sitioning were executed using the aforementioned techniques.CBCT data were collected both before the surgery and 2 weeks after the procedure,and the root mean square(RMS)distance between the preope-rative design position and the actual postoperative condyle position was analyzed.Results:The RMS of the condyle surface distance measured was(1.59±0.36)mm(95％CI:1.35-1.70 mm).This value was found to be significantly less than 2 mm threshold recommended by the expert consensus(P＜0.05).Conclusion:The mandibular trajectory may play a guiding role in determining the position of the mandibular proximal segment including the condyle in the orthognathic surgery.Through the use of a con-dylar positioning guide device and pre-shaped titanium plates,the condyle positioning can be personalized and customized with clinically acceptable accuracy.

Objective:To investigate the distribution of physical and chemical water improvement areas of drinking water-borne endemic fluorosis in Inner Mongolia Autonomous Region, as well as the use of household water purifiers.Methods:From April to October 2021, a survey was conducted in a drinking water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region where physical and chemical water improvement was carried out. The survey included the basic situation of the affected villages (number of permanent households, number of permanent residents, historical water fluoride content) and the use of residential water purifiers. Household peripheral water samples were collected to test the water fluoride content. Water purifier installation rate, normal usage rate, qualified water fluoride rate in normal usage, and the proportion of households covered by filter replacement departments were calculated.Results:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis were distributed in 2 735 villages in 11 leagues (cities) throughout the region, with 192 950 permanent households and 540 216 permanent residents. The average historical water fluoride content in all leagues (cities) was 2.18 mg/L, and the current average water fluoride content was 0.40 mg/L. A total of 134 763 water purifiers were installed, with an installation rate of 69.84% (134 763/192 950). A total of 10 773 households were surveyed, with 10 396 households using water purifiers normally and a normal usage rate of 96.50% (10 396/10 773). Among them, 10 158 households had qualified water fluoride of normal usage, with a qualified water fluoride rate of 97.71% (10 158/10 396). Of the 10 396 households using water purifiers normally, 3 974 households (38.23%) had filter cartridges used within one year, and 3 961 households had qualified water fluoride, with a qualified rate of water fluoride of 99.67% (3 961/3 974). Six thousand four hundred and twenty-two households (61.77%) had filter cartridges used for more than one year, with 6 197 households had qualified water fluoride and a qualified rate of water fluoride of 96.50% (6 197/6 422). There was a statistically significant difference in the qualified rate of water fluoride between purifiers with different filter cartridge usage times (χ 2 = 110.73, P < 0.001). Among the 10 773 surveyed households, the filter cartridges replacement department covered 10 470 households, accounting for 97.19% (10 470/10 773). Conclusions:In Inner Mongolia Autonomous Region, the physical and chemical water improvement areas of drinking water-borne endemic fluorosis are widely distributed, and the normal usage rate of household water purifiers is relatively high. The qualified rate of water fluoride in household water purifiers with filter cartridges used for more than one year is low.

Objective:To investigate the epidemic status of drinking-tea type endemic fluorosis (fluorosis for short) in Inner Mongolia Autonomous Region (Inner Mongolia for short), and to provide theoretical basis and basic data for formulation and evaluation of prevention and control measures.Methods:From May to October 2022, a cross-sectional survey was conducted in key areas (168 administrative villages in 6 leagues or cities) identified in the 2019 regional census with tea drinking habits, daily per capita intake of tea fluoride > 3.5 mg, and patients with skeletal fluorosis. The drinking condition of brick tea in 10 households of each administrative village was investigated, and the brick tea samples were collected to detect fluoride level. The prevalence of dental fluorosis in children aged 8 - 12 and skeletal fluorosis in adults aged 16 and older was investigated, and urine samples of patients with skeletal fluorosis were collected to detect urinary fluoride levels.Results:Totally 98.40% (1 657/1 684) of the households in the surveyed areas had a habit of drinking brick tea, with an annual per capita consumption of brick tea and a daily per capita intake of tea fluoride of 5.07 kg and 5.38 mg, respectively. The qualified rate of fluoride level in brick tea samples was 55.64% (922/1 657), the average fluoride level of all other brick tea varieties exceeded the national standard limit (300 mg/kg) except for black brick tea (291.08 mg/kg). Totally 2 747 children aged 8 to 12 were examined, with a detection rate of 13.91% (382/2 747) for dental fluorosis. The disease was mainly mild. There was no statistically significant difference in the detection rate of dental fluorosis among different age groups (χ 2 = 5.53, P = 0.238). Totally 71 708 adults aged 16 and older were examined, and the detection rate of skeletal fluorosis was 1.02% (734/71 708). Patients were mainly aged between 50 and 70 years old, and the condition in each age group was mainly mild. Totally 715 urine samples of skeletal fluorosis patients were collected and tested, and 55.24% (395/715) of the urine samples had fluoride levels higher than 1.6 mg/L. Conclusions:In Inner Mongolia, the proportion of high fluoride brick tea in endemic areas of drinking-tea type fluorosis is high. The detection rates of dental fluorosis in children and skeletal fluorosis in adults are relatively high. The prevention and control situation of drinking-tea type fluorosis is still serious.

Clinical data of 3 pregnant women with primary hyperparathyroidism admitted in Jinan Maternal and Child Health Hospital from 2013 to 2021 were retrospectively reviewed. Hyperparathyroidism was diagnosed during pregnancy in all 3 cases. The clinical manifestations were non-specific, such as nausea, vomiting, anorexia, and fatigue. Patients also had gallbladder stones (1 case), gallbladder polyps (1 case), and renal parenchyma changes (2 cases). The hypercalcemia crisis occurred in all 3 cases, the blood Ca 2+ levels were 4.11 mmol/L, 2.92-3.82 mmol/L and 3.49-4.10 mmol/L, respectively; and preeclampsia developed in 2 cases. Sudden death occurred in case 1 who did not receive effective treatment during pregnancy; blood calcium was well controlled during pregnancy in case 2, and her neonate had hypocalcemia with good prognosis; case 3 underwent surgical treatment in early pregnancy, and then had missed abortion. Pathological examination revealed parathyroid tumors in all 3 cases.

BACKGROUND: Microsatellite instability (MSI) is a key biomarker for cancer immunotherapy and prognosis. Integration of MSI testing into a next-generation-sequencing (NGS) panel could save tissue sample, reduce turn-around time and cost, and provide MSI status and comprehensive genomic profiling in single test. We aimed to develop an MSI calling model to detect MSI status along with the NGS panel-based profiling test using tumor-only samples. METHODS: From January 2019 to December 2020, a total of 174 colorectal cancer (CRC) patients were enrolled, including 31 MSI-high (MSI-H) and 143 microsatellite stability (MSS) cases. Among them, 56 paired tumor and normal samples (10 MSI-H and 46 MSS) were used for modeling, and another 118 tumor-only samples were used for validation. MSI polymerase chain reaction (MSI-PCR) was performed as the gold standard. A baseline was built for the selected microsatellite loci using the NGS data of 56 normal blood samples. An MSI detection model was constructed by analyzing the NGS data of tissue samples. The performance of the model was compared with the results of MSI-PCR. RESULTS: We first intersected the target genomic regions of the NGS panels used in this study to select common microsatellite loci. A total of 42 loci including 23 mononucleotide repeat sites and 19 longer repeat sites were candidates for modeling. As mononucleotide repeat sites are more sensitive and specific for detecting MSI status than sites with longer length motif and the mononucleotide repeat sites performed even better than the total sites, a model containing 23 mononucleotide repeat sites was constructed and named Colorectal Cancer Microsatellite Instability test (CRC-MSI). The model achieved 100% sensitivity and 100% specificity when compared with MSI-PCR in both training and validation sets. Furthermore, the CRC-MSI model was robust with the tumor content as low as 6%. In addition, 8 out of 10 MSI-H samples showed alternations in the four mismatch repair genes ( MLH1 , MSH2 , MSH6 , and PMS2 ). CONCLUSION MSI status can be accurately determined along the targeted NGS panels using only tumor samples. The performance of mononucleotide repeat sites surpasses loci with longer repeat motif in MSI calling.
Humans ; Microsatellite Instability ; Colorectal Neoplasms/diagnosis* ; Microsatellite Repeats/genetics* ; DNA Mismatch Repair

Objective:To analyze the research status, development trend and frontier hotspots of midwifery education in China in recent 20 years.Methods:Based on the topic of "midwifery education" or "midwifery teaching", this paper searched the periodical literatures from 2001 to 2021 on CNKI database, and used CiteSpace5.7R5 software to analyze them visually and generate knowledge map.Results:A total of 548 Chinese papers were included in this study, and the annual number of published papers showed an overall upward trend. The research field of midwifery education in China formed an obvious core team, and there was few cooperation among core author groups. Health Vocational Education, Chinese Nursing Education and Chinese Higher Medical Education were the top three journals. The six topics with the highest frequency were midwifery specialty, midwifery personnel, midwifery education, practice teaching, delivery mode and teaching mode, forming 10 clusters of midwifery education. In recent three years, the research of midwifery education in China has gradually changed into simulation teaching, flipped classroom, postpartum rehabilitation and so on. Conclusion:The research scope of midwifery education in China is wide and has formed an obvious core team, but the correlation is weak and there is less communication and cooperation among the research teams. The research in the field of high-level midwifery education is insufficient. Midwifery educators and researchers should pay enough attention to carry out in-depth research on relevant aspects.

Objective:To study the prevalence of skeletal fluorosis in drinking-water-borne endemic fluorosis areas in Inner Mongolia Autonomous Region (Inner Mongolia), and to provide reference for further prevention and treatment of skeletal fluorosis at this stage.Methods:From March to October 2019, a survey of skeletal fluorosis was carried out in all diseased villages of the eight diseased leagues (cities) in Inner Mongolia, including Alxa, Bayannur, Baotou, Ordos, Hohhot, Hulunbeier, Ulanqab and Xilingol. Permanent residents aged 18 years and above in the diseased villeges were investigated. Face to face questionnaires were used to collect the basic data of age, sex, epidemiological history, etc. of all subjects, and clinical examination of skeletal fluorosis was carried out. Drinking water samples were collected from residents for fluoride content testing.Results:A total of 123 166 residents aged 18 years and above were investigated, 1 781 cases of skeletal fluorosis were detected, and the detection rate was 1.45%. The degree of skeletal fluorosis was mild, accounting for 72.26% (1 287/1 781); the others were moderate and severe, accounting for 20.38% (363/1 781) and 7.36% (131/1 781), respectively. There were statistically significant differences in the detection rates of skeletal fluorosis among people of different water fluoride content, age, gender and regions (χ 2 = 565.96, 671.32, 4.38, 17 283.80, P < 0.05). Among them, the detection rates of skeletal fluorosis in water fluoride content > 4.0 mg/L, ≥56 years old and female population were relatively high, which were 5.21% (49/941), 2.26% (1 428/63 188) and 1.52% (905/59 555), respectively. The detection rates of skeletal fluorosis in Xilingol League and Baotou City were significantly higher, 25.48% (745/2 924) and 24.32% (225/925), respectively. Conclusion:The situation of skeletal fluorosis in drinking-water-borne endemic fluorosis areas in Inner Mongolia has been effectively controlled, but there are still relatively many patients with skeletal fluorosis in some areas, and further targeted prevention and control work is needed.

Objective:To investigate the construction of containing CT imaging features Nomograms model of postoperative intraluminal thromus (ILT) formation in patients with aortic dissective aneurysm (ADA).Methods:One hundred and twenty patients with Stanford type B ADA treated with overlapping stent endoluminal repair and multilayer spiral CT (MSCT) examination in Affiliated Hospital of Jining Medical College from May 2020 to February 2022 were selected. The patients were divided into the modeling population (84 patients) and the validation population (36 patients) according to a 7∶3 ratio. The factors influencing postoperative ILT formation in ADA patients were analyzed by univariate and Logistic multifactor regression models, and the prediction model of postoperative ILT formation was constructed based on the influencing factors.Results:In the modeled population, the rate of ILT formation within 1 month after luminal repair with overlapping stents was 27.38%(23/84), including 5 cases in the aortic arch and 18 cases in the abdominal aorta. In the modeled population, the results of univariate analysis showed that the sex, age, body mass index(BMI), smoking, drinking, hypertension, hyperlipidemia, rupture diameter, rupture distance from left subclavicular artery, involvement of important branches, uneven thickening of aneurysm wall, low density on plain scan and operation timing between the ILT formation group and non-ILT formation group had no statistically significant ( P>0.05). The diabetes mellitus, irregular inner wall, calcified plaque, postoperative anticoagulant therapy, B-type brain natriuretic peptide (BNP), fibrinogen (Fib), D-dimer (D-D) and C-reactive protein (CRP) between the two groups had statistical differences: 43.48%(10/23) vs. 11.48%(7/61), 86.96%(20/23) vs. 57.38%(35/61), 91.30%(21/23) vs. 62.30%(38/61), 21.74%(5/23) vs. 57.38%(35/61), (523.60 ± 128.74) ng/L vs.(271.83 ± 109.65) ng/L, (3.82 ± 0.96) g/L vs. (2.85 ± 0.83) g/L, (601.37 ± 75.62) μg/L vs. (389.20 ± 68.79)μg/L, (0.63 ± 0.19) mg/L vs. (0.48 ± 0.15) mg/L, P<0.05. The results of Logistic multifactor regression analysis showed that diabetes mellitus, irregular inner wall, calcified plaque, postoperative anticoagulant therapy and BNP, Fib, D-D CRP levels were influential factors for postoperative ILT formation in Stanford type B ADA patients ( P<0.05). The C-index of the model was 0.903 and 0.894 for the modeled and validated populations, respectively, which had good discrimination and was good at predicting ILT formation after operation in Stanford type B ADA patients. The model had good clinical utility in predicting postoperative ILT formation in Stanford B ADA patients. Conclusions:The Nomograms model can help to screen and identify patients with high risk of ILT formation at an early clinical stage.

Objective:To investigate the correlation between state-trait anxiety levels and quality of life before and after orthognathic surgery in patients with dentofacial deformities, and explore the feasibility of using the state-trait anxiety inventory(STAI) to screen postoperative patients with low quality of life.Methods:Patients with dentofacial deformities who underwent orthognathic surgery in Peking University Stomatological Hospital from September 2019 to March 2021 were selected as the research objects. STAI [including state anxiety inventory(SAI) and trait anxiety inventory(TAI)] and orthognathic quality of life questionnaire(OQLQ) were used to investigate patients before surgery, 2 weeks after surgery, 3 months after surgery and 6 months after surgery. The total scores of SAI and TAI ranged from 20 to 80 points, with higher scores implying a higher level of state-trait anxiety. The OQLQ includes four dimensions: social function, facial aesthetics, oral function and aesthetic perception, with total scores ranging from 22 to 88, higher scores representing a lower life quality level. SPSS 26.0 software used for statistical analysis, the measurement data was expressed as Mean±SD. Repeated measures ANOVA and the Bonferroni method were used to compare the SAI, TAI and OQLQ scores in different periods. Pearson correlation analysis was used to explore the correlation between patients’ demographic characteristics (gender, age, diagnostic classification, education, number of social contacts) and state-trait anxiety level, and life quality level at different periods, as well as the correlation between the state-trait anxiety level and the life quality level over time. Receiver operator characteristic(ROC) curve analysis was used to explore the feasibility of using the preoperative STAI scale to screen postoperative patients with low quality of life.Results:A total of 96 patients were included in this study, including 26 males and 70 females, aged (26.0±5.8) years. The SAI, TAI, and OQLQ total scores decreased during three postoperative periods compared to preoperative period ( P<0.01), indicating that the patients’ postoperative state-trait anxiety level decreased and their life quality level improved after surgery. Pearson correlation analysis showed a negative correlation between the patient’s social contact number and their SAI and TAI scores at postoperative 2 weeks (SAI: r=-0.30, P=0.003; TAI: r=-0.35, P<0.001). SAI and TAI scores were positively correlated in different periods ( r=0.48-0.84, P<0.01). Preoperative SAI scores and TAI scores were correlated with preoperative social function, aesthetic perception, facial aesthetic scores and total OQLQ scores (SAI: r=0.39-0.52, P<0.01; TAI: r=0.32-0.51, P<0.01). Preoperative SAI scores were positively correlated with social function and aesthetic perception scores and total OQLQ scores at 2 weeks postoperatively and with aesthetic perception, social function at 6 months postoperatively ( r=0.20-0.52, P<0.05 or <0.01). Postoperative SAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 3 months postoperatively, which were not correlated with the same period ( r= 0.24-0.55, P<0.05 or <0.01). Preoperative TAI scores were positively correlated with social function scores at 2 weeks( r=0.36, P<0.001) and 3 months( r=0.21, P=0.041) postoperatively. Postoperative TAI scores were positively correlated with OQLQ scores in all dimensions and total scores except for oral function scores at 2 weeks postoperatively, which were not correlated with oral function scores at the same period ( r=0.21-0.58, P<0.05 or <0.01). ROC curve analysis showed that preoperative SAI scores >34.5 and >33.5 screened people with low life quality level at postoperative 3 months and 6 months, with an area under the curve (AUC) of 0.75 (95% CI: 0.62-0.87, P=0.001) and 0.71 (95% CI: 0.59-0.84, P=0.003), respectively. Preoperative TAI scores >43.5, >42.5 and >33.5 can screen patients with low quality of life at 2 weeks, 3 months and 6 months after surgery, with AUC of 0.64(95% CI: 0.52-0.75, P=0.046), 0.73(95% CI: 0.60-0.85, P=0.001)and 0.67(95% CI: 0.55-0.80, P=0.016)respectively. Conclusion:The preoperative and postoperative state-trait anxiety level of patients with dentofacial deformity is correlated with the overall level of quality of life, social function, aesthetic perception and facial aesthetics. The preoperative application of STAI scale can screen patients with low quality of life after orthognathic surgery.

Objective:To investigate the epidemic scope and intensity of drinking water type endemic arsenic poisoning in Inner Mongolia Autonomous Region, as well as the prevalence and influencing factors, in order to provide scientific basis for precise formulation of prevention and control measures.Methods:A sampling survey was conducted on residents' drinking water in all villages and counties in Inner Mongolia Autonomous Region, water samples were selected according to different water supply methods (engineering water supply, physical and chemical water purification, and decentralized water supply), and the arsenic content was detected by atomic fluorescence method. The "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015) was used for diagnosis of arsenic poisoning among all permanent residents who were exposing to or had been exposed to excessively high arsenic water, in order to search all the arsenic poisoning patients. Analyze the distribution of water arsenic in the historical disease areas and high arsenic villages and newly discovered high arsenic villages, and explore the prevalence and influencing factors of arsenic poisoning.Results:There were a total of 1 186 historical disease areas and high arsenic villages in Inner Mongolia Autonomous Region, mainly distributed in 28 banner counties of 8 league cities such as Bayannur, Hohhot and Baotou, with a regional distribution trend of more in the west and less in the east. At present, the water improvement rate in the historical disease areas and high arsenic villages was 98.23% (1 165/1 186), and the qualified rate of arsenic content in the water was 99.83% (1 184/1 186). The arsenic content in the water of historical disease areas and high arsenic villages ranged from 0.000 to 0.093 mg/L. Four newly discovered villages with arsenic exceeding standards had been found, and their arsenic content ranged from 0.074 to 0.142 mg/L. A total of 2 249 patients with arsenic poisoning were detected in the confirmed disease area/high arsenic villages, and the detection rate was 1.67% (2 249/134 645). The number of patients in Bayannur City was the largest with the most severe disease, accounting for 82.70% (1 860/2 249). Patients aged 60 and above accounted for 61.41% of the total cases (1 381/2 249), which was higher than other age groups (χ 2 = 840.52, P < 0.001). The detection rate of arsenic poisoning was higher in males than in females (χ 2 = 132.38, P < 0.001). There are statistically significant differences in the detection rate and severity distribution of arsenic poisoning patients among different water arsenic content groups(χ 2 = 1 557.85, 1 741.05, P < 0.001). Conclusions:After years of prevention and control work, the arsenic content in most historical disease areas and high arsenic villages in Inner Mongolia Autonomous Region is currently qualified, and some areas have water arsenic exceeding standards or newly discovered villages with arsenic exceeding standards. At the same time, there are still a large number of arsenic poisoning patients in Inner Mongolia Autonomous Region. In the future, the prevention and control of endemic arsenic poisoning in Inner Mongolia Autonomous Region cannot be relaxed, and it is necessary to strengthen water quality monitoring and improve water quality in newly discovered villages with arsenic exceeding standards to prevent the occurrence of new cases.