Objective:To explore the clinical application pathway of the CT generative adversarial networks (CTGANs) algorithm in mandibular reconstruction surgery, aiming to provide a valuable reference for this procedure.Methods:A clinical exploratory study was conducted, 27 patients who visited the Department of Oral and Maxillofacial Surgery, Xiangya Hospital of Central South University between January 2022 and January 2024 and required mandibular reconstruction were selected. The cohort included 16 males and 11 females, with the age of (46.6±11.5) years; among them, 7 cases involved mandibular defects crossing the midline. The CTGANs generator produced 100 images, and the mean squared error (MSE) was calculated for differences between any two generated images. Preoperative cone-beam CT data from 5 patients were used to construct a labeled test database, divided into groups: normal maxilla, normal mandible, diseased mandible, and noise (each group containing 70 cross-sectional images). The CTGANs discriminator was used to evaluate the loss values for each group, and one-way ANOVA and intergroup comparisons were performed. Using the self-developed KuYe multioutcome-option-network generation system (KMG) software, the three-dimensional (3D) completion area of the mandible under cone-beam CT was defined for the 27 patients. The CTGANs algorithm was applied to obtain a reference model for the mandible. Virtual surgery was then performed, utilizing the fibular segment to reconstruct the mandible and design the surgical expectation model. The second-generation combined bone-cutting and prebent reconstruction plate positioning method was used to design and 3D print surgical guides, which were subsequently applied in mandibular reconstruction surgery for the 27 patients. Postoperative cone-beam CT was used to compare the morphology of the reconstructed mandible with the surgical expectation model and the mandibular reference model to assess the three-dimensional deviation.Results:The MSE for the CTGANs generator was 2 411.9±833.6 (95% CI: 2 388.7-2 435.1). No significant difference in loss values was found between the normal mandible and diseased mandible groups ( P>0.05), while both groups demonstrated significantly lower loss values than the maxilla and noise groups ( P<0.001). All 27 patients successfully obtained mandibular reference models and surgical expectation models. In total, 14 162 negative deviation points and 15 346 positive deviation points were observed when comparing the reconstructed mandible morphology with the surgical expectation model, with mean deviations of -1.32 mm (95% CI:-1.33- -1.31 mm) and 1.90 mm (95% CI: 1.04-1.06 mm), respectively. Conclusions:The CTGANs algorithm is capable of generating diverse mandibular reference models that reflect the natural anatomical characteristics of the mandible and closely match individual patient morphology, thereby facilitating the design of surgical expectation models. This method shows promise for application in patients with mandibular defects crossing the midline.

Background There is a lack of research evidence on the association between sugar-sweetened beverage (SSB) consumption and gestational diabetes mellitus (GDM) in China. Objective To explore the association between frequency of SSB consumption before pregnancy and risk of GDM in pregnant women in Shaanxi Province, and to provide a scientific basis for targeted interventions to control maternal blood glucose. Methods The recruitment to the China Birth Cohort study started in October 2020. Pregnant women at 6-16 weeks who had their first prenatal examination at five hospitals in Shaanxi Province were recruited. A maternal health questionnaire was used to collect basic information about pregnant women. A semi-quantitative food frequency questionnaire was used to collect the consumption of carbonated beverages, fruit and vegetable juice beverages, coffee beverages, and milk tea beverages in one year before pregnancy, which were summed to obtain the SSB consumption. Pregnant women were divided into three groups according to SSB consumption, namely <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹. GDM was confirmed by oral glucose tolerance test (OGTT) between 24-28 weeks of gestation. A binary logistic regression model was applied to explore the association between SSB consumption and risk of GDM. Multiple linear regression was applied to investigate the associations between SSB consumption (per 1-serving·d⁻¹ increase) and OGTT fasting plasma glucose, 1-hour glucose, and 2-hour glucose. Results A total of 3811 pregnant women were finally enrolled in this study, of which 752 developed GDM, with an incidence rate of 19.7%. The incidence rates of GDM in pregnant women with SSB consumption frequency of <1 serving·week⁻¹, 1-4 servings·week⁻¹, and ≥5 servings·week⁻¹ were 18.0%, 21.1%, and 26.8%, respectively. After adjusting for maternal age, pre-pregnancy body mass index (BMI), education, number of children born, family history of diabetes, smoking, alcohol consumption, physical activity level, and total energy intake, the risk of GDM increased by 26% (OR=1.26, 95%CI: 1.05, 1.50) in the 1-4 servings·week⁻¹ group and by 76% (OR=1.76, 95%CI: 1.31, 2.38) in the ≥5 servings·week⁻¹ group compared to the <1 serving·week⁻¹ SSB consumption group, respectively. Further stratified analysis revealed no interaction effect (P_interaction>0.05) between SSB consumption and maternal age, pre-pregnancy BMI, or first labor or not. For each additional SSB consumption per day, the risk of GDM increased by 94% (OR=1.94, 95%CI: 1.37, 2.75); and the maternal OGTT 1-hour glucose and 2-hour glucose increased by 0.33 mmol·L⁻¹ and 0.18 mmol·L⁻¹, respectively (P<0.05), and no significant increase in fasting plasma glucose was found (P>0.05). Conclusion Higher SSB consumption before pregnancy increases the risk of GDM in pregnant women.

In 2016, a national one million general population cohort project was set up in China for the first time in "Precision Medicine Research" Key Project, National Key Research and Development Program of China, which consists of general population cohorts in seven areas in China. As one of the seven major areas in China, northeastern China has unique climate and specific dietary patterns, and population aging is serious in this area. And the burden of chronic and non-communicable diseases ranks tops in China. Therefore, it is of great significance to establish a large general population cohort in northeastern China to explore the area specific exposure factors related to pathogenesis and prognosis of chronic and non-communicable diseases, develop new prevention strategies to reduce the burden of the diseases and improve the population health in northeastern China. In July 2018, the general population cohort study in northeastern China was launched, the study includes questionnaire survey, health examination and blood, urine and stool sample collection and detection in recruited participants. By now, the cohort has covered all age groups, and the baseline data of 115 414 persons have been collected. This paper summarizes the design and practice of the general population cohort study in northeastern China to provide reference for related research in China.

Objective:To investigate the thyroid volume of adults in Lanzhou City, and analyze its influencing factors.Methods:In June 2016, according to the principle of multi-stage stratified cluster sampling, Han residents aged 18 and above in Chengguan, Xigu and Qilihe districts of Lanzhou City who had lived there for more than 5 years were selected as research subjects, and a portable B-ultrasound machine was used for thyroid examination. Morning urine samples of the subjects were collected to test urinary iodine; fasting venous blood samples of the subjects were collected to test serum thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TgAb), blood lipids [triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL)] and blood uric acid (Ua) levels. At the same time, body indexes systolic blood pressure (SP), diastolic blood pressure (DP), waist circumference, height and weight were measured, and the body mass index (BMI) was calculated. Multiple linear regression was used to analyze the influencing factors of thyroid volume.Results:A total of 1 009 subjects were included, aged (43.50 ± 15.16) years, and the thyroid volume was (8.74 ± 3.39) ml. Among them, 534 males had a thyroid volume of (9.46 ± 3.43) ml; 475 females had a thyroid volume of (7.93 ± 3.15) ml, the thyroid volume of males was larger than that of females ( t = 7.36, P < 0.01). Thyroid volume was positively correlated with age, height, weight, BMI, SP, waist circumference, LDL, Ua and TgAb ( r = 0.07, 0.23, 0.33, 0.27, 0.10, 0.27, 0.10, 0.08, 0.07, P < 0.05), and it was negatively correlated with thyroid nodules, TPOAb, TSH and urinary iodine ( r = - 0.16, - 0.07, - 0.10, - 0.08, P < 0.05). After multiple linear regression analysis, TSH, TPOAb, TgAb and thyroid nodules were included in the regression equation, and the standardized B values were - 0.135, - 0.065, 0.123 and - 0.197, respectively. Conclusions:The thyroid volume of males is larger than that of females in Lanzhou City. TSH, TPOAb, TgAb and thyroid nodules are influencing factors of thyroid volume.

Objective:To explore the current status of postoperative delirium in elderly patients with heart valve replacement and to analyze the relationship between preoperative weakness and postoperative delirium.Methods:The convenient sampling method was used to select 156 elderly patients who received heart valve replacement surgery in Department of Cardiovascular Surgery of Guangdong Provincial People's Hospital Zhuhai Hospital (Zhuhai Golden Bay Central Hospital) from August 2018 to August 2021 as the research objects. The general information questionnaire and Frailty Scale were used to investigate the patients before operation, and Confusion Assessment Methods was used to evaluate the patients on the 3rd day after operation. Binomial logistic regression analysis was used to investigate the risk factors of postoperative delirium in elderly patients with heart valve replacement. A total of 156 questionnaires were distributed, 11 invalid questionnaires were excluded and 145 valid questionnaires were finally collected, with an effective recovery rate of 92.95% (145/156) .Results:Among 145 elderly patients with heart valve replacement, 42 cases (28.97%) developed delirium after operation and 103 cases (71.03%) did not develop delirium after operation. 76 cases (52.41%) were frailty before operation, 69 cases (47.59%) were non-frailty before operation. Among which 31 cases (40.79%, 31/76) of preoperative frailty patients developed postoperative delirium and 11 cases (15.94%, 11/69) of preoperative non-frailty patients developed postoperative delirium. Binomial Logistic regression analysis showed that age, preoperative frailty and preoperative cardiac dysfunction were the influencing factors of postoperative delirium in elderly patients undergoing heart valve replacement ( P<0.05) . Conclusions:The incidence of postoperative delirium is high in elderly patients with heart valve replacement. Patients older than 75 years, in a frailty state before surgery and in combination with cardiac insufficiency are prone to postoperative delirium.

Objective:To establish a continuous monitoring system based on nursing sensitivity outcome indexes so as to improve the quality of fall prevention in elderly inpatients.Methods:By adopting the convenient sampling method, the elderly inpatients and their caregivers in 14 wards of the Institute of Geriatrics of Guangdong People's Hospital from April 2016 to January 2017 were selected as the research objects, and the nurses in 14 wards were also included in the research. A total of 14 wards were randomly divided into the control group with 7 wards and the experimental group with 7 wards. In the experimental group, there were 151 patients, 137 caregivers and 68 nurses. In the control group, there were 151 patients, 131 caregivers and 57 nurses. In the control group, the quality of fall prevention was monitored by the conventional three-level monitoring method of quality control department of the nursing department, head nurse of department and head nurse of ward. On this basis, the experimental group applied Fall-related Evaluation Scale for Elderly Inpatients to continuously monitor the quality of fall prevention. Modified Fall Efficacy Scale (MFES) was used to compare the fall performance scores and the incidence of falls during hospitalization between the two groups. Caregivers' Fall Knowledge, Attitude and Practice Scale was used to compare the knowledge, belief, attitude and practice of caregivers in the two groups before and after intervention. The General Self-Efficacy Scale was used to compare the self-efficacy of nurses in the two groups. The Fall-Related Evaluation Scale for Elderly Inpatients was used to compare the quality evaluation results of fall prevention before and after intervention in the experimental group.Results:None of the patients in the experimental group fell during their hospitalization, and 2 patients in the control group fell. There was no statistically significant difference in the incidence of falls between the two groups ( P>0.05) . The fall efficacy score at discharge was (70.77±16.85) in the experimental group and (62.77±18.78) in the control group, and the difference was statistically significant ( t=3.179, P<0.01) . After intervention, the scores of fall knowledge, attitude and practice of caregivers in the experimental group were higher than those in the control group, and the self-efficacy score of nurses was higher than that in the control group, and the differences were statistically significant ( P<0.01) . The quality score of fall prevention in the experimental group after intervention was higher than that before intervention, and the difference was statistically significant ( P<0.05) . Conclusions:The establishment of continuous monitoring system based on the nursing sensitivity outcome index can improve the quality and efficacy of fall prevention in elderly patients and improve the knowledge, attitude and practice of the caregiver and the self-efficacy of the nurses.

Objective? To explore the effects of seamless nursing management model in transition of intensive care unit (ICU) patients. Methods? From February 2017 to January 2018, we selected 128 patients discharged from ICU within one week in the Second Hospital of Harbin Medical University by convenience sampling. All of the patients were divided into control group and observation group with the method of the random number table, 64 cases in each group. Control group carried out routine nursing management model, while observation group implemented seamless nursing management model with assessment before roll-out, family members communication, doctor-nurse handover and goods handover of patients. And then, we investigated the rate of return to ICU of patients discharged from ICU within 72 hours, cases of telephone counseling in departments and patient satisfaction between two groups. Results? After implementing seamless nursing management, the rate of return to ICU and cases of telephone counseling in departments of patients in observation group were 3.13% (2/64) and 6.25% (4/64) respectively lower than those in control group; the patient satisfaction of observation group was 96.88% (62/64) higher than that of control group; the differences were all statistical (χ2=5.89, 18.29, 8.02;P＜0.05). Conclusions? Seamless nursing management model makes transitional care for patients discharged from ICU complete and scientific which improves satisfaction patients discharged from ICU and has a positive effect on improving nursing work efficiency and quality.

Objective: To analyze the correlation between the changes of fibrinogen and the treatment effect of all-frequency sudden deafness, and to explore the individualized treatment strategy for the use of Batroxobin. Methods: Patients with all-frequency sudden deafness who were admitted to Department of Otorhinolaryngology, People′s Hospital of Peking University, from January 2010 to September 2016 were selected. All patients were given standard treatment and regular use of Batroxobin. Value of fibrinogen on D1 (before treatment) / D3 / D7 (±1) and D14 (±2) were recorded, at the same time, the correlation between the changes of fibrinogen and prognosis of all-frequency sudden deafness by the audiograms of onset and after-treatment of all patients were analyzed. Independent t-test was used to analyze normal distributed measurement data and chi square linear trend test was used to analyze the curative effect of different fibrinogen groups. Results: A total of 148 patients were included, the outcomes were worst when the patient′s fibrinogen was below 2 g/L or above 4 g/L before treatment, ineffective rate were both 50%. The fibrinogen was lowest when the treatment came to the third day. Normally, the patient′s prognosis was best when this value waved between 0.7 and 0.9 g/L, with a total effective rate between 73.9% and 83.3%. The fibrinogen value of the 7th day was a good indicator of the outcome, and Fib7 value was significant lower in patients of effective group than ineffective ones ((1.25±0.37)g/L vs (1.38±0.35) g/L, t=-0.27, P=0.04). Patients found a best recovery when Fib7 was below 1 g/L, and the higher the Fib7 value, the higher the inefficiency (χ²=7.55, P=0.01). Batroxobin showed safety during the treatment and found no complications. Conclusion The change of fibrinogen in the process of all-frequency sudden deafness is closely related to the curative effect.

Objective:To explore the effectiveness and safety of simvastatin combined ezetimibe in patients with acute coronary syndrome (ACS).Methods:A total of 124 ACS patients complicated low density lipoprotein cholesterol (LDL-C)>100 mg/dl were selected from our hospital from May 2012 to May 2013. They were randomly and equal-ly divided into rosuvastatin group (received rosuvastatin 20mg/d)and combined treatment group (received simvasta-tin 40mg/d plus ezetimibe 10mg/d),both groups were treated for one month.Blood lipid levels and incidence rates of adverse reactions were observed in two groups.Results:Compared with before treatment,after one-month treat-ment there were significant reductions in levels of LDL-C,total cholesterol (TC)and triglyceride (TG)and signifi-cant rise in levels of high density lipoprotein cholesterol (HDL-C)in both groups (P <0.01 all),and there were no significant difference in all above blood lipid levels between two groups (P >0.05).Incidence rate of myalgia in combined treatment group was significantly lower than that of rosuvastatin group (4.8% vs.17.7%,P =0.023), but there were no significant difference in incidence rates of other adverse reactions between two groups (P >0.05 all).Conclusion:It′s effective and safe to use simvastatin combined ezetimibe in patients with acute coronary syn-drome,which is worthy extending.

Purpose To investigate the prognostic significance of NQO1 protein expression in colorectal carcinoma ( CRC) patients. Methods 192 cases of primary CRC, 28 of colonic dysplasia, and 44 of adjacent non-tumor tissues were selected for immunohisto-chemical staining of NQO1 protein. Correlation between NQO1 overexpression and clinicopathologic characteristics, and the survival rates were calculated by the statistical methods. Results The strongly positive rate of NQO1 protein in CRC was significantly higher than that in gastric dysplasia and adjacent non-tumor tissues (P<0. 01, respectively). NQO1 high-expression rate was positively cor-related with differentiation, serosal invasion, lymph node metastasis, and clinical stage (P <0. 05, respectively). Survival curve showed that the disease-free survival and 5-year survival rates of the patients with high NQO1 expression were obviously shorter than those of patients with low NQO1 expression (P<0. 001, respectively). Further analysis showed that, high expression of NQO1 predic-ted the lower disease-free survival and 5-year survival rates in late-stage patients (P<0. 01, respectively). Importantly, NQO1 was an independent risk factor for the prognosis of CRC using Cox proportional hazards regression model ( HR: 1. 398,95%CI: 1. 011 ~1. 934, P=0. 043). Conclusions Detection of NQO1 protein expression in CRC has an important clinical significance, and it is ex-pected to become a new biomarker for CRC.