BACKGROUND:The application of miniscrew in adolescents is increasing day by day,but at present,there are few studies on bone mass in the external oblique line of the mandible in adolescents at home and abroad,and there is no systematic study on bone mass in the external oblique line of the mandible in adolescents in different growth and development periods. OBJECTIVE:To measure the bone mass in the external oblique line of the mandible in adolescents with different cervical vertebral bone ages using a cone-beam CT and to investigate the difference of bone mass in the external oblique line of the mandible in adolescents with different cervical vertebral bone ages and the correlation between bone mass in this area and the cervical vertebral bone age. METHODS:The cone-beam CT data of 105 adolescent patients before orthodontic treatment were collected and divided into CS3 group(n=24),CS4 group(n=26),CS5 group(n=29)and CS6 group(n=26)using the cervical vertebral maturation method.The adolescent mandibular buccal shelf was reconstructed by Mimics Medical 21.0 software.The width of buccal bone at 6 and 11 mm under the cemento-enamel junction and the bone height at 4 and 5 mm buccal to the cemento-enamel junction of right mandibular first and second molars were measured.The measured data were statistically analyzed.The measurement was made on four planes:plane 1 is the plane where the proximal mesial root of the mandibular right first molar is located;plane 2 is the plane where the distal mesial root of the mandibular right first molar is located;plane 3 is the plane where the proximal mesial root of the mandibular right second molar is located;and plane 4 is the plane where the distal mesial root of the mandibular right second molar is located. RESULTS AND CONCLUSION:In each group,the bone width on the buccal side of the external oblique line increased gradually from the first molar proximally to the second molar distally in adolescents,and the width of buccal bone at 6 and 11 mm under the cemento-enamel junction showed significant difference among different layers(P<0.05).The bone width of buccal bone at 11 mm under the cemento-enamel junction was greater than that at 6 mm.The bone height on the buccal side of the external oblique line increased gradually from the first molar proximally to the second molar distally in all four groups,and the bone height at 4 and 5 mm buccal to the cemento-enamel junction showed significant differences at different layers(P<0.05).The bone height at 4 mm buccal to the cemento-enamel junction was greater than that at 5 mm.On the fourth plane,the bone width at 11 mm buccal to the cemento-enamel junction was smaller in the CS3,CS4,and CS5 groups than in the CS6 group(P<0.05).On the third plane,the bone heights at 4 mm and 5 mm buccal to the cemento-enamel junction were smaller in the CS3 and CS4 groups than in the CS6 group(P<0.05).On the fourth plane,the bone height at 5 mm buccal to the cemento-enamel junction was smaller in the CS3 and CS4 groups than in the CS6 group(P<0.05).On the fourth plane,the bone height at 4 mm buccal to the cemento-enamel junction was smaller in the CS3 group than in the CS6 group(P<0.05).Spearman correlation analysis showed that there was no correlation between bone mass and the cervical vertebral bone age,except that there was a weak correlation between bone mass at some measurement sites and cervical vertebral bone age.To conclude,the bone mass in the external oblique area of the mandible in adolescents does not change significantly with the increase of cervical vertebral bone age.The buccal side of the mesial root and distal root of the mandibular second molar in the external oblique area of CS3-CS6 adolescents meets the requirement of bone mass for miniscrew implantation,which is a site available for miniscrew implantation.

BACKGROUND:Traditional lateral cephalometric radiographs always suffer from some problems,such as magnification distortion,left and right overlap inconsistency and so on,while the cone-beam CT can truly display the three-dimensional structure of the craniofacial region.Performing three-dimensional reconstruction of cone-beam CT and then transforming the cone-beam CT in the selected area into the two-dimensional image can make the overlap between the left and right sides consistent and reduce the influence of surrounding tissue structures. OBJECTIVE:To explore the consistency of quantitative analysis of cervical vertebral bone age between two kinds of cone-beam CT transformed two-dimensional images with different integrated thicknesses and traditional lateral cephalometric radiographs. METHODS:The cone-beam CT and lateral cephalometric radiograph data of 118 adolescent orthodontic patients were collected.Firstly,the cone-beam CT image was reconstructed in 3D imaging software.After reconstruction,two types of cone-beam CT images with different integrated thicknesses were selected in the sagittal interface and transformed into two-dimensional images,which were named ICB-1 and ICB-2,respectively.The Zhibeiyun system was used to measure and calculate the angle between the concave base of the second cervical vertebra and the lower edge of the vertebral body(@2),the ratio of the third cervical spine to the posterior height(AH3/PH3),the ratio of height to width of the fourth cervical spine(H4/W4)in lateral cephalometric radiograph,ICB-1,ICB-2 and the cervical vertebral bone age.After an interval of two weeks,20 adolescents were randomly selected to repeat the above measurements.The intraclass correlation coefficient(ICC)method was used to evaluate the repeatability of the three images in measuring cervical bone age.Paired t-test was used to analyze the consistency of cervical bone age measurements between the three images.The Kappa test was used to analyze the consistency of cervical vertebral bone age staging assessment between the three images. RESULTS AND CONCLUSION:(1)ICC of AH3/PH3 in the lateral cephalometric radiograph group was<0.9,and the ICC of other measurement items in each group was>0.9.(2)Paired t-test results showed that there were statistical differences in AH3/PH3 and H4/W4 between the ICB-1 group and lateral cephalometric radiograph group and between the ICB-1 group and ICB-2 group(P<0.05),and there were no statistically significant differences in the other items between the three groups(P>0.05).(3)The Kappa test results showed that the Kappa coefficients of the two groups were all more than 0.8 according to the staging of cervical vertebral bone age in three groups(P<0.001).(4)It is indicated that the repeatability of ICB-1 and ICB-2 in the measurement of cervical vertebral bone age is better than that of lateral cephalometric radiographs.Lateral cephalometric radiographs,ICB-1 and ICB-2 have good consistency in the measurement of cervical vertebral bone age,but considering the integrity of cervical vertebra structure,ICB-2 is more suitable for quantitative analysis of cervical vertebral bone age than ICB-1.

Alzheimer's disease(AD)is the most common cognitive disorder in the elderly and manifests primarily as progressive cognitive function decline, neuropsychiatric symptoms and multiple functional impairments.Obstructive sleep apnea(OSA)is a common type of respiratory disorder.Studies have found that AD and OSA are connected in many ways, including the risk of developing these diseases, biomarkers and neuroimaging features.These connections may result from a variety of mechanisms, such as neuropathological protein deposition, exacerbated immune-mediated inflammation, oxidative stress abnormalities, impaired mitochondrial function, and disturbed neurotransmitter systems, among others.This article reviewed the relationship between AD and OSA, the mechanisms linking them and their treatment.

Objective:To compare esketamine versus dexmedetomidine in improving the adverse mood after cesarean section.Methods:One hundred and fourteen pregnant women undergoing elective cesarean section, aged 20-45 yr, with body mass index≤33 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, were divided into 3 groups ( n=38 each) by the random number table method: esketamine group (group S), dexmedetomidine group (group D) and control group (group C). After delivery, esketamine was intravenously injected as a bolus of 0.3 mg/kg, followed by an infusion of 0.3 mg·kg -1·h -1 throughout the surgery in group S, dexmedetomidine was intravenously injected as a bolus of 0.6 μg/kg, followed by an infusion of 0.6 μg·kg -1·h -1 throughout the surgery in group D, while the equal volume of normal saline was given instead, followed by an infusion of 14 ml/h throughout the surgery in group C. Patient-controlled intravenous analgesia was performed after the end of surgery. Esketamine 50 mg, sufentanil 50 μg and ondansetron 8 mg were given in group S, dexmedetomidine 200 μg, sufentanil 50 μg and ondansetron 8 mg were given in group D, while sufentanil 50 μg and ondansetron 8 mg were given in group C. When the visual analog scale score ≥4 within 48 h after operation, flurbiprofen axidate was intravenously injected as a rescue analgesic. Self-rating Anxiety Scale (SAS) scores and Edinburgh Postnatal Depression Scale (EPDS) scores were assessed at 1 day before surgery and 2 and 7 days after surgery. Serum levels of brain-derived neurotrophic factor (BDNF) were measured by enzyme-linked immunosorbent assay at 1 day before surgery and 2 days after surgery. The effective pressing times of patient-controlled analgesia (PCA) and requirement for rescue analgesia after operation were recorded. The occurrence of adverse reactions during operation and within 48 h after operation was also recorded. Results:Compared with group C, SAS scores and EPDS scores were significantly decreased at 2 and 7 days after surgery, serum BDNF concentrations were increased at 2 days after surgery, the effective pressing times of PCA were reduced, the requirement for rescue analgesia was decreased, and the incidence of intraoperative nausea and vomiting was reduced in S and D groups ( P<0.05). Compared with group D, SAS scores and EPDS scores were significantly decreased at 7 days after surgery, the effective pressing times of PCA were reduced ( P<0.05), and no significant change was found in serum BDNF concentrations at 2 days after surgery and requirement for rescue analgesia in group S ( P>0.05). The incidence of dreaminess was significantly higher in group S than in group C and group D ( P<0.05). Conclusions:Esketamine is better than dexmedetomidine in improving the adverse mood after cesarean section.

Objective:To investigate the effect of "simulated Chinese medicine nursing clinic" teaching on syndrome differentiation ability among nursing students and the teaching effect of this method.Methods:A total of 325 students were randomly divided into conventional teaching group with 163 students (receiving conventional nursing teaching) and real situational teaching group with 162 students (receiving "simulated Chinese medicine nursing nursing clinic" teaching at the same time). A self-made questionnaire for syndrome differentiation-based nursing ability, assessment scores of traditional Chinese medicine nursing theories and skills, and a teaching satisfaction questionnaire were used for evaluation.Results:After intervention, the real situational teaching group (the treatment group and the experience group) had significantly higher socres of syndrome differentiation-based nursing ability (mastery of four diagnostic methods, diagnosis of syndromes, analysis of syndromes, determination of nursing principles, and development of nursing regimens) than the conventional teaching group (the treatment group and the conventional teaching group: 8.97±1.00/8.47±1.20/8.33±1.06/8.30±1.26/7.89±1.13 and 7.96±1.14/7.29±1.36/7.14±1.18/7.39±1.30/7.26±1.18, P<0.05; the experience group and the conventional teaching group: 8.39±1.10/8.17±1.15/8.07±1.06/7.97±1.26/7.73±1.38 and 7.96±1.14/7.29±1.36/7.14±1.18/7.39±1.30/7.26±1.18, P<0.05). The real situational teaching group had a significantly higher overall degree of satisfaction with teaching than the conventional teaching group [160 (97.6%) and 150 (92.0%), P<0.05]. Conclusions:The "simulated Chinese medicine nursing clinic" teaching program effectively enhances the thinking of syndrome differientiation and related abilities for nursing, improves the learning effect of traditional Chinese medicine nursing theories and skills, and increases the learning interest in traditional Chinese medicine nursing among nursing students.

Objective To compare the outcomes of transvaginal natural orifice transluminal endoscopic surgery(vNOTES)and laparoendoscopic single-site surgery(LESS)for total uterine excision in obese patients with benign uterine lesions,and to investigate the utility of vNOTES in this patient population.Methods A total of 100 obese patients(BMI>28.0 kg/m2)diagnosed with benign uterine lesions requiring total uterine and bilateral salpingectomy between January 2022 and January 2023 were included in this study.They were randomly assigned to two groups:the LESS group(n=51)and the vNOTES group(n=49).Patient demographics,surgical duration,intraoperative blood loss,changes in hemoglobin levels,pain scores,time to first flatus postoperatively,length of hospital stay,pelvic floor function,sexual quality of life,and postoperative complications were compared between the two groups.Results The two groups did not show any statistically significant differences in terms of blood loss,pre-and postoperative hemoglobin changes,pelvic floor function,sexual quality of life,or postoperative complications(P>0.05).However,the vNOTES group exhibited shorter surgical durations,time to first flatus postoperatively,and length of hospital stay compared to the LESS group(P<0.05).Additionally,the vNOTES group demonstrated lower intraoperative pain scores than the LESS group.(P<0.05).Conclusions In obese patients with benign uterine lesions,vNOTES total uterine excision surgery demonstrated shorter surgical durations and postoperative hospital stays,lower postoperative pain scores,and better adherence to the principles of en-hanced recovery after surgery(ERAS),indicating its potential for broader application.

Objective:To evaluate the morphological and functional changes of the heart during second trimester fetuses with ventricular septal defect (VSD) using fetal heart quantification (fetal HQ) technology.Methods:A prospective study was conducted from July 2022 to January 2024 at Chengdu Women′s and Children′s Central Hospital, collecting 91 singleton fetuses diagnosed with isolated VSD (VSD group) and 91 normal fetuses matched for gestational age (control group). Fetal HQ technology was used to measure the length and width of the four-chamber view of the fetal heart, obtaining the global sphericity index (GSI). Speckle tracking technology was used to track the endocardial motion trajectories of the left and right ventricles during diastole and systole, obtaining parameters such as left and right ventricular global longitudinal strain (LV-GLS and RV-GLS), end-diastolic diameter (EDD), 24-segment sphericity index (SI), 24-segment fraction of shortening (FS), left ventricular ejection fraction (LV-EF), fraction of area change (FAC), left ventricular stroke volume (LV-SV), and left ventricular cardiac output (LV-CO).The differences between groups were compared, and the correlations between the values of VSD and GSI, GLS, and FAC were evaluated.Results:The EDD of the left ventricular segments 20-23 in the VSD group was lower, while the SI value of the right ventricular segments 1-4 in the VSD group was higher than that in the control group (all P<0.05). There was no statistically significant difference in GSI between the two groups ( P>0.05). LV-GLS in the VSD group was lower than that in the control group ( P<0.05). There was no statistically significant difference in RV-GLS ( P>0.05). Values of LV-FAC, LV-EF, LV-SV, and LV-CO in the VSD group were significantly lower than those in the control group (all P<0.05). The FS value of left ventricular segments 1-10 in the VSD group presented lower, but the FS value of right ventricular segments 7-21 higher compared to controls(all P<0.05). LV-GLS and LV-FAC absolute values were negatively correlated with the size of VSD ( r=-0.309, P=0.004; r=-0.264, P=0.015), while GSI, RV-GLS, and RV-FAC showed no significant correlation with the size of VSD (all P>0.05). Conclusions:The overall sphericity index of second trimester VSD fetuses is normal, but there are changes in the shape of the left ventricular apical segments and the right ventricular basal segments, with the left heart chamber tending to be flatter and the right heart chamber more fusiform. The left ventricular systolic function of VSD fetuses is significantly reduced, the local systolic function of right ventricular increases while the global systolic function shows no significant change. The absolute values of LV-GLS and LV-FAC in VSD fetuses are negatively correlated with the size of VSD.

Objective To compare the efficiency of nomogram and different machine learning algo-rithms for constructing the dental caries predictive models for middle-aged and elderly people.Methods The multi-stage stratified random sampling method was used to select 510 middle-aged and elderly people from Nanning City,Guigang City and Chongzuo City as the research subjects for conducting the questionnaire sur-vey and oral cavity examination.The univariate analysis and Lasso regression were used to screen the related variables,and the multivariate logistic regression analysis was used to determine the final independent influen-cing factors.Based on the salient features,the nomogram predictive model was established,and the seven ma-chine learning algorithms,including linear discriminant analysis (LDA),partial least squares (PLS),range Doppler algorithm (RDA),generalized linear models (GLM),random forest (RF),support vector machine (SVM) kernel function (SVM-Radial),and SVM linear kernel function (SVM-Linear),were used to construct the seven kinds of dental caries risk predictive models.The area under the receiver operating characteristic (ROC) curve (AUC) was adopted to evaluate the predictive performance of various models and the predictive performance of models constructed using different variable screening methods.Results The detection rate of dental caries in middle-aged and elderly people was 71.18％.After feature screening,the five predictive factors were ultimately retained,which were the age (OR=0.945,95％CI:0.917-0.973),brushing frequency (OR=0.688,95％CI:0.475-0.997),whether having teeth cleaning in the past one year (OR=0.303,95％CI:0.103-0.890),number of remaining teeth (OR=1.062,95％CI:1.038-1.087) and oral health assess-ment tool (OHAT) score (OR=1.363,95％CI:1.234-1.505).The results of comparison of various models showed that the predictive model constructed by the RF algorithm performed the best,the median of AUC was 0.747,followed by the nomogram,and the median of AUC was 0.733.The median of AUCs in the predic-tion model constructed by single factor+Lasso+multivariate logistic (Lasso+logistic) screening independent variables were higher than those constructed by RF algorithm screening independent variables.ConclusionBased on Lasso+logistic screening variables,RF provide more reliable predictive efficiency in predicting dental caries in middle-aged and elderly people than nomogram and the other machine learning algorithms.

Objective:To investigate diagnosis and treatment methods of nontuberculous mycobacteria (NTM) infections related to cosmetic surgery.Methods:This study was a retrospective observational study. From January 2015 to December 2023, 24 patients with NTM infections related to cosmetic surgery meeting the inclusion criteria were admitted to Shenzhen Hospital of Southern Medical University and Northern Theater Command General Hospital, all of whom were female and aged 29-51 years. Among them, 20 cases underwent lipolysis needle injection surgery, 2 cases underwent facial contouring surgery, 1 case underwent foreign body injection, and 1 case underwent wrinkle removal surgery. The clinical manifestations of infections caused by NTM included scattered dark purplish subcutaneous nodules at the infection site with unclear boundaries, thinning of the skin on the surface of the nodules and ulceration, and powdery-white fish meat like tissue and a small amount of light yellow exudation being seen at the ulceration. In order to improve the detection rate of NTM, bacterial culture of wound exudation combined with solid tissue samples, multiple bacterial cultures, and extending culture time were performed. All patients were treated with damage control debridement on the infected site and comprehensive treatment including the use of antibiotics based on the results of drug sensitivity tests. The types of NTM infections, drug sensitivity test results, wound healing time, number of bacterial cultures, and surgical debridement times were recorded. The wound healing was observed during follow-up.Results:The bacterial culture results showed that there were 22 cases of infections with Mycobacterium abscessus and 2 cases with Mycobacterium fortuitum. The drug sensitivity test results showed that the NTM was sensitive to antibiotics such as clarithromycin, amikacin, and doxycycline. The average healing time of the wound was 83.6 days with an average of 2.85 times bacterial cultures on the specimen, and an average of 2.52 times of debridement surgery. Follow up for 6 months to 5 years, all wounds of the patients were healed. Among them, 22 patients had a basically normal appearance with slight scars, while 2 patients had obvious scars and depressions. Conclusions:It is difficult to treat NTM infections related to cosmetic surgery. Damage control debridement for the infected site can ensure wound healing and reduce the damage and postoperative deformities in facial and other cosmetic areas.

Mechanical allodynia (MA), including punctate and dynamic forms, is a common and debilitating symptom suffered by millions of chronic pain patients. Some peripheral injuries result in the development of bilateral MA, while most injuries usually led to unilateral MA. To date, the control of such laterality remains poorly understood. Here, to study the role of microglia in the control of MA laterality, we used genetic strategies to deplete microglia and tested both dynamic and punctate forms of MA in mice. Surprisingly, the depletion of central microglia did not prevent the induction of bilateral dynamic and punctate MA. Moreover, in dorsal root ganglion-dorsal root-sagittal spinal cord slice preparations we recorded the low-threshold Aβ-fiber stimulation-evoked inputs and outputs of superficial dorsal horn neurons. Consistent with behavioral results, microglial depletion did not prevent the opening of bilateral gates for Aβ pathways in the superficial dorsal horn. This study challenges the role of microglia in the control of MA laterality in mice. Future studies are needed to further understand whether the role of microglia in the control of MA laterality is etiology-or species-specific.
Mice ; Animals ; Hyperalgesia/metabolism* ; Microglia/metabolism* ; Disease Models, Animal ; Spinal Cord/metabolism* ; Spinal Cord Dorsal Horn/metabolism* ; Ganglia, Spinal/metabolism*