Objective To clarify the risk factors of diaphragmatic dysfunction (DD) after cardiac surgery with extracorporeal circulation. Methods A retrospective analysis was conducted on the data of patients who underwent cardiac surgery with extracorporeal circulation in the Department of Cardiovascular Surgery of Peking University People's Hospital from January 2023 to March 2024. Patients were divided into two groups according to the results of bedside diaphragm ultrasound: a DD group and a control group. The preoperative, intraoperative, and postoperative indicators of the patients were compared and analyzed, and independent risk factors for DD were screened using multivariate logistic regression analysis. Results A total of 281 patients were included, with 32 patients in the DD group, including 23 males and 9 females, with an average age of (64.0±13.5) years. There were 249 patients in the control group, including 189 males and 60 females, with an average age of (58.0±11.2) years. The body mass index of the DD group was lower than that of the control group [(18.4±1.5) kg/m2 vs. (21.9±1.8) kg/m2, P=0.004], and the prevalence of hypertension, chronic obstructive pulmonary disease, heart failure, and renal insufficiency was higher in the DD group (P<0.05). There was no statistical difference in intraoperative indicators (operation method, extracorporeal circulation time, aortic clamping time, and intraoperative nasopharyngeal temperature) between the two groups (P>0.05). In terms of postoperative aspects, the peak postoperative blood glucose in the DD group was significantly higher than that in the control group (P=0.001), and the proportion of patients requiring continuous renal replacement therapy was significantly higher than that in the control group (P=0.001). The postoperative reintubation rate, tracheotomy rate, mechanical ventilation time, and intensive care unit stay time in the DD group were higher or longer than those in the control group (P<0.05). Multivariate logistic regression analysis showed that low body mass index [OR=0.72, 95%CI (0.41, 0.88), P=0.011], preoperative dialysis [OR=2.51, 95%CI (1.89, 4.14), P=0.027], low left ventricular ejection fraction [OR=0.88, 95%CI (0.71, 0.93), P=0.046], and postoperative hyperglycemia [OR=3.27, 95%CI (2.58, 5.32), P=0.009] were independent risk factors for DD. Conclusion The incidence of DD is relatively high after cardiac surgery, and low body mass index, preoperative renal insufficiency requiring dialysis, low left ventricular ejection fraction, and postoperative hyperglycemia are risk factors for DD.

Oral diseases concern almost every individual and are a serious health risk to the popula-tion.The restorative treatment of tooth and jaw defects is an important means to achieve oral function and support the appearance of the contour.Based on the principle of"learning from the nature",Deng Xu-liang's group of Peking University School and Hospital of Stomatology has proposed a new concept of"microstructural biomimetic design and tissue adaptation of tooth/jaw materials"to address the worldwide problems of difficulty in treating dentine hypersensitivity,poor prognosis of restoration of tooth defects,and vertical bone augmentation of alveolar bone after tooth loss.The group has broken through the bottle-neck of multi-stage biomimetic technology from the design of microscopic features to the enhancement of macroscopic effects,and invented key technologies such as crystalline/amorphous multi-level assembly,ion-transportation blocking,and multi-physical properties of the micro-environment reconstruction,etc.The group also pioneered the cationic-hydrogel desensitizer,digital stump and core integrated restora-tions,and developed new crown and bridge restorative materials,gradient functionalisation guided tissue regeneration membrane,and electrically responsive alveolar bone augmentation restorative membranes,etc.These products have established new clinical strategies for tooth/jaw defect repair and achieved inno-vative results.In conclusion,the research results of our group have strongly supported the theoretical im-provement of stomatology,developed the technical system of oral hard tissue restoration,innovated the clinical treatment strategy,and led the progress of the stomatology industry.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

ObjectiveTo compare the difference in adverse reactions after oxaliplatin-containing chemotherapy between colorectal cancer patients with or without spleen-kidney yang deficiency syndrome. MethodsA retrospective study was conducted using the electronic medical records of Beijing Hospital of Traditional Chinese Medicine， Capital Medical University. A total of 483 colorectal cancer patients from January 1， 2009 to December 31， 2022 were selected. Patients were divided into two groups based on their syndrome types， that was spleen-kidney yang deficiency syndrome （SKYDS） group （130 cases） and non-SKYDS group （353 cases）. The incidence of adverse reactions including gastrointestinal reactions， liver damage， bone marrow suppression， and peripheral neurotoxicity after completing 2， 4， 6， and more than 6 cycles of chemotherapy was compared between the two groups. Univariate and multivariate logistic regression analyses were used to analyze the associations of age， gender， alcohol history， primary tumor location， tumor differentiation， tumor staging， chemotherapy courses， and syndrome types with the occurrence of gastrointestinal adverse reactions， liver function damage， bone marrow suppression and peripheral neurotoxicity in colorectal cancer patients who have completed 2， 4， 6 and more than 6 cycles of oxaliplatin-containing chemotherapy. ResultsThere were significant differences in the occurrence of gastrointestinal reactions after completing 2， 4， 6 and more than 6 cycles of chemotherapy between the two groups （P＜0.01）， with much more severe conditions in SKYDS group than non-SKYDS group （P＜0.01）. There was no significant difference in liver function damage and bone marrow suppression between groups （P＞0.05）. There were statistically significant differences in the occurrence of peripheral neurotoxicity after completion of 2 cycles （P=0.044）， 4 cycles （P=0.002） and more than 6 cycles （P＜0.001） of chemothe-rapy， with higher rate in SKYDS group than the non-SKYDS group （P＜0.05）. Univariate analysis showed that female， patients with stage Ⅲ tumors and patients having completed ≥ 6 cycles of chemotherapy had a higher incidence of bone marrow suppression （P＜0.05）， and patients with SKYDS had a higher incidence of gastrointestinal reactions （P＜0.001）. Patients with a history of drinking， stage Ⅳ cancer， and ≥6 cycles of chemotherapy had a higher incidence of liver function injury （P＜0.05）. Patients with stage Ⅲ cancer， ≥6 cycles of chemotherapy， and SKYDS had a higher incidence of peripheral neurotoxicity （P＜0.05）. Multivariate analysis showed that the risk factor for bone marrow suppression was chemotherapy ≥6 cycles （P=0.001）， and SKYDS was the risk factor for gastrointestinal reaction （P＜0.001）. The risk factor for liver function damage was tumor stage Ⅳ （P=0.001） and SKYDS （P=0.039）. All variables had no significant correlation with the occurrence of peripheral neurotoxicity. ConclusionFor colorectal cancer patients， being diagnosed with SKYDS is a risk factor for developing gastrointestinal adverse reactions and peripheral neurotoxicity following chemotherapy with an oxaliplatin-based regimen.

The study utilized spectral correlation analyses combined with bioactivity evaluation to examine the effective components of antidepressants in the Baihe Dihuang decoction. Firstly, the chemical fingerprints for different extraction parts in the Baihe Dihuang decoction were achieved using HPLC and UHPLC-MS technology. Then, in order to evaluate the antidepressant effect of Baihe Dihuang decoction, the animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Hunan University of Chinese Medicine (No. LLBH-202104270001), in compliance with the Institutional Animal Care Guidelines. We recorded the distance of autonomous movement of mice in open field experiment, the immobility time of tail suspension test, and the forced swimming. Additionally, we measured the content of neurotransmitters. Finally, Pearson analysis, grey correlation analysis, and orthogonal partial least squares regression analysis were utilized to establish the correlation between antidepressant efficacy indicators and fingerprinting. The spectrum-effect relationship results were confirmed through the in vitro activity verification. This study demonstrated that regaloside A, B, C, catalpol, and Isoacteoside might be the main antidepressant components in Baihe Dihuang decoction. Furthermore, it was found that using diverse mathematical models and bioactivity evaluation could enhance the accuracy of the spectral correlation analyses results.

To analyze the factors affecting the cost of hospitalization for patients and provide insights using the intrauterine lesion surgery group (DRG code NE19) as an example.

Tumor immunotherapy occupies a pivotal position in the field of hematological malignancies.Chimeric antigen receptor(CAR)T-cell therapy has established a new therapeutic pattern for hematological immunotherapy and achieved satisfactory clinical results in the treatment of B-lineage hematological malignancies.However,CAR T-cell therapy has some limitations in the treatment of T-cell acute lymphoblastic leukemia because of the presence of CAR T-cell fratricide,tumor cell contamination,T-cell aplasia,and other clinically relevant problems.Therefore,the current major challenge is overcoming the existing bottlenecks to optimize CAR-T therapy and improve its efficacy against T-ALL while improving the prognosis of patients.

Lithium(Li)salts are commonly used as psychotropic medications for the treatment of major depressive disorders.However,long-term use of Li salts poses a high risk of toxicity,necessitating continuous monitoring of Li concentration in patient blood to ensure medication safety,which is crucial for clinical treatment.Laser-induced breakdown spectroscopy(LIBS),as a rapid analytical technique,has been widely applied in the elemental analysis of complex matrices in various practical scenarios.In this study,LIBS technology combined with partial least squares(PLS)was employed for quantitative analysis of Li elements in blood matrix.A total of 45 clinical blood samples were utilized,and the quantitative models for plasma and whole blood matrices were separately investigated.The number of latent variables in the PLS algorithm was optimized using a five-fold cross-validation method.Results revealed that the PLS quantitative model constructed on the basis of plasma matrix achieved a predictive determination coefficient(R2)of 0.992,a predictive root mean square error(RMSEP)of 0.204 μg/mL,and a relative standard error(RSD)of 2.14%.In contrast,for the PLS quantitative model constructed on the basis of whole blood matrix,the R2 was 0.984,the RMSEP was 0.728 μg/mL,and the RSD was 3.45%Consequently,the LIBS model constructed on the basis of plasma calibration values demonstrated superior performance in quantitative analysis of Li element in whole blood,and LIBS technology provided a new possibility for rapid assessment of blood Li levels in clinical practice,with promising prospects for application.

Objective Recombinase-aided polymerase chain reaction(RAP)is a sensitive,single-tube,two-stage nucleic acid amplification method.This study aimed to develop an assay that can be used for the early diagnosis of three types of bacteremia caused by Staphylococcus aureus(SA),Pseudomonas aeruginosa(PA),and Acinetobacter baumannii(AB)in the bloodstream based on recombinant human mannan-binding lectin protein(M1 protein)-conjugated magnetic bead(M1 bead)enrichment of pathogens combined with RAP. Methods Recombinant plasmids were used to evaluate the assay sensitivity.Common blood influenza bacteria were used for the specific detection.Simulated and clinical plasma samples were enriched with M1 beads and then subjected to multiple recombinase-aided PCR(M-RAP)and quantitative PCR(qPCR)assays.Kappa analysis was used to evaluate the consistency between the two assays. Results The M-RAP method had sensitivity rates of 1,10,and 1 copies/μL for the detection of SA,PA,and AB plasmids,respectively,without cross-reaction to other bacterial species.The M-RAP assay obtained results for<10 CFU/mL pathogens in the blood within 4 h,with higher sensitivity than qPCR.M-RAP and qPCR for SA,PA,and AB yielded Kappa values of 0.839,0.815,and 0.856,respectively(P<0.05). Conclusion An M-RAP assay for SA,PA,and AB in blood samples utilizing M1 bead enrichment has been developed and can be potentially used for the early detection of bacteremia.

Objective:In this retrospective study, the accuracy and outcomes of segmental Le Fort I surgery with the aid of 3D-printed surgical templates and occlusal splints and dental model surgery were evaluated.Methods:Clinical data of patients receiving segmental Le Fort I surgery in the Department of Orthognathic and Temporo-Mandibular Joint Surgery of West China Stomatological Hospital of Sichuan University from January 2014 to June 2019 were retrospectively analyzed. The accuracy of virtual surgical planning(VSP) and the difference between VSP and dental model surgery were evaluated by postoperative complications, color distance maps, and quantitative accuracy analysis.The amount of surgical displacement of the maxilla in the three-dimensional direction before and after surgery, the occurrence of postoperative complications and the patients'satisfaction survey were analyzed in both groups. Paired t-tests were used for the linear distance and angle between the preoperative design model and the final virtual surgery model in the digital surgery group. Independent samples t-test was used for each marker point’s preoperative and postoperative displacements in the three-dimensional direction between the digital surgery group and the dental model group. The proportion of postoperative complications in the 2 groups was tested using the Pearson chi-square test, and the difference was considered statistically significant at P<0.05. Results:There were 129 patients in the digital surgery group, 35 males and 94 females, aged (24.5±6.5) years, and 92 patients in the dental model surgery group, 28 males and 64 females, aged (27.7±5.4) years.The overall mean linear difference was 1.23±0.35 mm, and the overall mean angular difference was 2.48°±0.31°. The vertical displacement of U3R, U6L in the digital surgery group was (6.72±1.57)mm and (4.73±2.07)mm. The vertical displacement of U3R, U6L in the group of dental model surgery was (4.07±2.14)mm and (1.62±1.82)mm.The significant deviation difference in U3R-Y and U6L-Y between two groups could be detected. The complications in two groups showed a significant difference. Except for one case of root injury, there was no serious complication recorded in the digital surgery group. However, there were three cases of palatal fistulas, four cases of root injury and two cases of bone dehiscence in the dental model group. 94.5% of patients in the digital surgery group are satisfied with the surgical results, while 89.1% in the dental model group.Conclusion:Compared with dental model surgery, segmental Le Fort I surgery is highly accurate under the guidance of surgical templates and occlusal splint which has better postoperative results and effectively reduces the occurrence of surgical complications.