After years of development,the advantages of computer-assisted orthognathic surgery have been widely recognized.However,the clinical application of this technology is challenging.Each step may generate errors from data acquisition,computer-assisted diagnosis,and computer-assisted surgical design,causing errors to be transferred from the virtual surgical plan to the operation.The accumulation and amplification of errors will affect the final surgical ef-fect.Currently,digital devices,such as intraoral scanners,are being explored for error control,utilizing automation methods and algorithms,and implementing personalized bone positioning methods.Moreover,there are still many prob-lems that have not been fully resolved,such as precise simulation of postoperative soft tissue,functional assessment of mandibular movement,and absorbable internal fixation materials.Fully understanding computer-assisted orthognathic surgery's limitations could provide direction for optimizing existing methods while helping clinicians avoid risks and maximize its advantages to achieve the best outcome.Many emerging and cutting-edge technologies,such as personal-ized titanium plates,artificial intelligence,and surgical robots,will further promote the development of this discipline.We can expect future optimization of digital orthognathic surgical technology by innovations in automation,intelligence,and personalization.

Objective:To investigate the prognosis and risk factors for children diagnosed with all types of subaortic stenosis(SAS) who developed recurrent left ventricular outflow tract obstruction after surgical treatment.Methods:The study retrospectively included patients aged 0-18 years old who underwent open heart SAS surgery at Fuwai Hospital from 2016-2019. Children with hypertrophic obstructive cardiomyopathy were excluded. Detailed operative notes, medical records and ultrasound information, and follow-ups were extracted. Recurrent SAS was defined as left ventricular outflow tract gradient 30 mmHg(1 mmHg=0.133 kPa) 1 month after SAS surgical treatment.Results:A total of 137 children were included in this study. The medium age of children at the time of SAS surgery was 4.6 years old(3 months-17.8 years old). After a median follow-up of 4.36 years(3.2-5.7 years), a total of 30 patients developed recurrent LVOTO, with a recurrence rate of 21.9%, and 7(5.1%) underwent a second surgery. Compared to the non-recurrent group, children in the recurrent group were younger at the time of surgery( P=0.0443), had a smaller body surface area( P=0.0485), and a longer length of stay( P=0.0380). In Cox analysis, when only considering preoperative variables, the independent risk factor for LVOTO recurrence were a peak left ventricular outflow tract gradient higher than 50 mmHg( HR=5.25, P=0.001), a BSA less than 0.9( HR=2.5, P=0.023), and a length of SAS 5 mm( HR=2.29, P=0.050). When both preoperative and intraoperative variables were considered, preoperative peak left ventricular outflow tract gradient 50 mmHg( HR=4.91, P=0.002) and peeling from the aortic valve( HR=3.23, P=0.010) were independent risk factors for postoperative recurrence. Conclusion:Recurrent LVOTO after SAS surgical repair is common, and regular postoperative follow-up is crucial to evaluate whether a secondary intervention is required. Regular postoperative follow-up is needed for children at high risk.

[Objective] To purify and characterize a novel factor X activator,Fve-1 from Daboia russelli siamensis (Myanmar) venom.[ Methods]F V e-1 was purified by ion-exchange chromatography and gel filtration.The hemostatic activity of F V e-1 was determined based on chromogenic substrates.The fibrinogen-clotting activity of F V e-1 was also determined.Thermal stability, pH stability,enzyme activity,and inhibition of F V e- 1 were determined by its remaining procoagulant activity.N-treminal sequence was determined by the method of automated Edman degradation.[ Results ]F V e-1 was achieved by chromatography with a molecular weight of 13,808 and an isoelectric point of 4.6. The hemostatic activity of 0.5 mg Fve-1 was equal to that of 1.5625 u thrombin or that of 54.93 ng RVV X. F V e-1 primarily activated F X, but did not affect on prothrombin and fibrinogen. The suitable pH and temperature range of F V e-1 was 6.5-7.5 and 25-60 ℃,respectively.The activity of F V e-1 was enhanced by Ca2+ and inhibited by EDTA and DTT.The N-terminal sequence of F V e-1 was NH2-N-L-Y-Q-F-G-E-M-I-N.[Conclusion] F V e-1 is a factor X-activating enzyme,which could activate FX to FX a,but have minimal effect on prothrombin and fibrinogen.

OBJECTIVETo evaluate the reliability and accuracy of arcuate fasciculus (AF) navigation for AF localization and reconstruction.

METHODSReconstruction of the AF and assessment of the aphasia quotient (AQ) were performed in 43 cases before and after surgical removal of lesions in the language area of the brain. The minimal distance between the AF and the lesion (D(1)), preoperative AQ (AQ(1)), the minimal distance between the AF and the surgical cavity (D(2)), and the postoperative AQ (AQ(2)) were measured. Linear correlation analysis was conducted between D(1) or D(2) and the corresponding AQ(1) or AQ(2) to assess the relationship between the AF and language function. The language function of each patient was evaluated postoperatively.

RESULTSThe AF was successfully reconstructed in all the cases. The tractography results of the identical AF generated by 3 different users showed good congruency. A positive linear correlation was demonstrated between D(1) and AQ(1) (P<0.001) and between D(2) and AQ(2) (P=0.001). Only two patients (4.7%) showed language deficits at postoperative follow-up.

CONCLUSIONAF navigation is a reliable and accurate technique for AF reconstruction and localization and helps to preserve the language function after surgical removal of lesions in the language area of the brain.

Adolescent ; Adult ; Diffusion Tensor Imaging ; Female ; Humans ; Language Disorders ; diagnosis ; Male ; Middle Aged ; Nerve Fibers ; Neuronavigation ; Reproducibility of Results ; Young Adult

Objective To investigate the diagnostic value of telomerase activity and mutatioms of P53 gene in bronchoalveolar lavage fluids (BALF) in lung cancer. Methods Collect BALF from 86 patients with lung cancer and 82 patients with benign bronchial-pulmonar diseases. Telomeric Repeat Amplificaton Protocol (TRAP) and Polymerase Chain Reaction Single Strand Conformational Polymorphism(PCR-SSCP) were used in this study. Meanwhile, conduct fibrobronchoscope brush biopsy and protractor biopsy. Results ①The positive rate of telomerase in experimental group is 82.56% and that of mutatioms of P53 gene is 32.56%, which are both higher than 4.48% and 0% (P0.05) between the mutatioms of P53 and the expression of telomerase activity with respect to pathological classification of lung carcinomas. ③ In central-type lung cancer group, the combining positive rate of telomerase and mutatioms of P53 is 94.34%, the positive rate of routine fibrobronchoscope practice is 86.79%,there were no statistical differences between them. In peripheral lung cancer group, the combining positive rate of telomerase and mutatioms of P53 is 75.76%, which is higher than the positive rate of routine fibrobronchoscope practice that is 45.45%(P

Non-motor symptoms are an important component of the manifestations of Parkinson's disease(PD);they usually include sleep disorder,neuropsychotic symptoms,autonomic dysfunction,pain,and so on.Non-motor symptoms are multifactorial and mainly involve various non-dopaminergic neurotransmitter systems.These symptoms are not only a result of disease progression,but also can appear in the early stage of the disease,and they can have a major impact on the quality of life.The early notice of these symptoms may lead to better therapeutic strategies and subsequently to the improvement of the quality of life in PD patients.

Aim To evaluate the effects of fibrinolytic enzyme FⅡ from agkistrodon acutus venom on an experimental model of kidney thrombus induced by lipopolysaccharide(LPS). Methods The model of microvascular thrombosis in the rabbits kidney was performed by the method of Hermida, which was induced by infusing LPS. Treatments were begun simultaneously with LPS infusion, through the contralateral marginal ear vein. Six different groups were established: NS 10 ml?h~-1 was infused as the negative control group, urokinase ~20 000 IU?kg~-1 ?h~-1 as positive control group, FⅡwas infused with the dosage of 0.1(Low-dose), 0.3 (medium-dose),0.6 (high-dose) mg?kg~-1 ?h~-1 . The further rabbits, which were given neither LPS nor FⅡ, were infused with saline solution through both marginal ear veins. Kinney sections were examined for the presence of fibrin microthrombi. The measurement of FDP concentrations was used to assess the degradation of microvascular thrombosis. Results Intense fibrin deposition was also detected and FDP concentrations were (78.21?4.79)% and (84.27?6.21)% at 2 and 6 hours after LPS administration in LPS-control group. Little fibrin deposition was detected and FDP concentration also increased in urokinase control group. A lot of fibrin deposition was detected in Low-dose FⅡ group,little fibrin deposition was detected in medium-dose FⅡ group, and no fibrin deposition was detected in high-dose FⅡ group. Additional all doses of FⅡ led to a significant increase in FDP concentration as compared with LPS-control group (P