In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.

The density and composition of lymphocytes infiltrating colon tumors serve as predictive factors for the clinical outcome of colon cancer.Our previous studies highlighted the potent anti-cancer properties of the principal compounds found in Garcinia yunnanensis(YTE-17),attributing these effects to the regu-lation of multiple signaling pathways.However,knowledge regarding the mechanism and effect of YTE-17 in the prevention of colorectal cancer is limited.In this study,we conducted isobaric tags for relative and absolute quantification(iTRAQ)analysis on intestinal epithelial cells(IECs)exposed YTE-17,both in vitro and in vivo,revealing a significant inhibition of the Wnt family member 5a(Wnt5a)/c-Jun N-terminal kinase(JNK)signaling pathway.Subsequently,we elucidated the influence and mechanism of YTE-17 on the tumor microenvironment(TME),specifically focusing on macrophage-mediated T helper 17(Th17)cell induction in a colitis-associated cancer(CAC)model with Wnt5a deletion.Additionally,we performed the single-cell RNA sequencing(scRNA-seq)on the colonic tissue from the Wnt5a-deleted CAC model to characterize the composition,lineage,and functional status of immune mesenchymal cells during different stages of colorectal cancer(CRC)progression.Remarkably,our findings demon-strate a significant reduction in M2 macrophage polarization and Th17 cell phenotype upon treatment with YTE-17,leading to the restoration of regulatory T(Treg)/Th17 cell balance in azoxymethane(AOM)/dextran sodium sulfate(DSS)model.Furthermore,we also confirmed that YTE-17 effectively inhibited the glycolysis of Th17 cells in both direct and indirect co-culture systems with M2 macrophages.Notably,our study shed light on potential mechanisms linking the non-canonical Wnt5a/JNK signaling pathway and well-established canonical β-catenin oncogenic pathway in vivo.Specifically,we proposed that Wnt5a/JNK signaling activity in IECs promotes the development of cancer stem cells with β-catenin activity within the TME,involving macrophages and T cells.In summary,our study undergoes the po-tential of YTE-17 as a preventive strategy against CRC development by addressing the imbalance with the immune microenvironment,thereby mitigating the risk of malignancies.

Objective To observe the effect of combined opioid-free and loco-regional anesthesia on the quality of recovery after retrolaparoscopic renal surgery.Methods Sixty patients undergoing elective retrolaparoscopic renal surgery were divided into two groups(30 patients per group):the opioid-free anesthesia group(OFA group)and conventional anesthesia group with opioid(OA group)u-sing the random number table method.Both groups underwent ultrasound-guided anterior quadratus lumbar block(QLB)30minutes be-fore induction of anesthesia.In the OFA group,dexmedetomidine was given before induction,and induction was performed with propofol,midazolam,esketamine,and rocuronium,maintained with dexmedetomidine,propofol,sevoflurane anesthesia,and intermittent push of esketamine.In the OA group,propofol,midazolam,sufentanil,and rocuronium were given to induce anesthesia and maintained with remifentanil,propofol,and sevoflurane.Both groups were given intravenous self-administered analgesia after surgery.The mean arterial pressure(MAP)and heart rate(HR)at different time points,and the resting and motor VAS scores at 2,6,12,24 and 48h after sur-gery were recorded.QoR-40 was used to compare the quality of recovery at 24 hours after surgery between the two groups,and adverse effects and recovery of patients were recorded.Results QoR-40 scores were higher in the OFA group than that in the OA group(P＜0.05).Postoperative pain,postoperative opioid consumption,and incidence of nausea and vomiting were reduced in the OFA group(P＜0.05);and time to first ambulation,first exhaustion,and length of hospital stay were all reduced(P＜0.05).Conclusion Opioid-free anesthesia combined with quadratus lumbar block can significantly improve the quality of postoperative recovery,reduce postoperative pain,reduce postoperative opioid drug consumption,and promote postoperative recovery in patients undergoing retrolaparoscopic renal surgery.

Dry eye is a common ophthalmic disease caused by eye maladjustment due to meibomian gland dysfunction (MGD), which is often accompanied by symptoms such as increased tear film osmotic pressure and ocular surface inflammation. In the treatment of dry eye patients, dredging gland obstruction caused by meibomian gland secretion is an effective treatment method. Based on electrothermal effect and hyperelasticity of the silicone, an auxiliary treatment instrument for MGD is designed, which can improve the blood circulation of the glands through heat compress and massage to achieve the purpose of dredging the meibomian glands. The therapy device can display the temperature and pressure during the treatment in real time, so that the surgeon can grasp the progress of the treatment in real time. The therapy device constructs a user-oriented interactive interface based on parametric modeling method, which can be customized by 3D printing according to the user's eyeball geometric parameters. The designed therapeutic device was finally tested on New Zealand white rabbits. The experimental results show that the therapeutic device has significant effectiveness and safety, as well as clinical application prospects.
Animals ; Dry Eye Syndromes/therapy* ; Humans ; Meibomian Gland Dysfunction ; Meibomian Glands ; Rabbits ; Tears ; Treatment Outcome

In robot-assisted eye surgery, such as retinal vascular bypass surgery, precise positioning of operating points is required. In this study, a binocular vision-based 3D reconstruction method is proposed to locate the incision points on retinal vessels. Vessels in the image were extracted by CLAHE algorithm to remove the influence of background, then stereo matching was performed. Finally, the retinal vessel image was reconstructed by using the principle of parallax in binocular vision. Experimental results show that this method can accurately locate the incision points on retinal vessels and meet the requirements of ophthalmic surgery.
Algorithms ; Humans ; Imaging, Three-Dimensional ; Ophthalmologic Surgical Procedures ; Retinal Vessels/diagnostic imaging* ; Robotic Surgical Procedures ; Vision, Binocular

Objective: Taking electronic-eye (visual analyzer) technique,based on the powder color of Andrographis Herba,to investigate the applicability of electronic-eye technique and evaluate the quality of Andrographis Herba with different commercial specifications. Method: HPLC was employed to determine contents of andrographolide,dehydroandrographolide,14-deoxyandrographolide,neoandrographolide in 50 batches of Andrographis Herba with different commercial specifications(stems,leaves and aerial parts).Color of these samples were measured by electronic-eye technique.The data were analyzed by principal component analysis(PCA) and Pearson correlation analysis.The ability of electronic-eye to distinguish the different commercial specifications of Andrographis Herba was investigated and the correlation of chroma space system parameters (L^*,a^*,b^*) with active components was investigated. Result: There was remarkable difference in contents of 4 diterpenoids in Andrographis Herba from different parts,their contents in leaves was the highest,followed by the aerial parts(mixture of stems and leaves),and their contents in stems was the lowest.The results of PCA was divided into two classes,namely the stem part,leaf and aerial parts,indicating that electronic-eye could be used to distinguish the quality of Andrographis Herba.The correlation results showed that there were significant negative correlation(P<0.01) between L^*(lightness value) and the contents of andrographolide,dehydroandrographolide,14-deoxyandrographolide,neoandrographolide and the total content of these 4 components.In addition,L^* of samples that did not conform to the lower limit of determination in the 2015 edition of Chinese Pharmacopeia was ≥ 69.5,and the L^* of more than 90% of the samples in accordance with the requirements was <69.5. Conclusion: Electronic-eye technique provides a new method and idea for the quality evaluation of Andrographis Herba.

Background:The evaluation system for predicting prognosis in patients with liver cirrhosis includes Child-Pugh,model for end-stage liver disease (MELD) and its derivative system,which provides important guiding value for evaluating the prognosis.However,its value still needs to be verified by further clinical studies.Aims:To investigate the predictive value of Child-Pugh,MELD,MELD-Na and iMELD score in assessing 3-month and 1-year survival rates in patients with hepatitis B cirrhosis.Methods:A total of 236 patients with hepatitis B cirrhosis from January 2012 to December 2016 at Fukang Hospital were enrolled.The 3-month and 1-year survival rates of patients with hepatitis B cirrhosis were determined,and Child-Pugh,MELD,MELD-Na and iMELD score were calculated.Area under ROC curve (AUC) was used to evaluate the accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month and 1-year survival rates.Results:Of the 236 patients with hepatitis B cirrhosis,43 died within 3 months,and 71 died within 1 year.The causes of death were upper gastrointestinal bleeding,hepatic encephalopathy,hepatorenal syndrome,spontaneous peritonitis and infection.Child-Pugh,MELD,MELD-Na and iMELD score in 3-months and 1-year survival group were significantly decreased than those in death group (P ＜ 0.05 or 0.01).AUC of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month survival were 0.791,0.818,0.853 and 0.897,respectively,and the difference among the four groups was significant (P ＜ 0.05).AUC of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 1-year survival were 0.772,0.832,0.861 and 0.906,respectively,and the difference among the four groups was significant (P ＜ 0.05).The accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for predicting 3-month and 1-year survival were 70.1％,79.8％,86.2％ and 89.3％,respectively.Conclusions:The accuracy of Child-Pugh,MELD,MELD-Na and iMELD score for assessing 3-month and 1-year survival rates of patients with hepatitis B cirrhosis is high,and is worthy to be applied in clinical practice.

Now the visiting physicians are usually trained without effective supervision and guidance mechanism.Since 2017,the Emergency Department of Peking University Third Hospital has adopted the training model under tutor system for visiting physicians.Tutors and visiting physicians are matched 1∶1.Personalized training program is made by tutors and visiting physicians depending on the level of the hospital where visiting physicians practice in,educational background,clinical experience,length and the goal of study.The training plan is refined according to the timeline in order to facilitate the tutor and training physician's own precise management.Since implementation of this training model,the visiting physicians say they are more efficient to complete the training program and learned more than before.The teaching ability of tutors has further been enhanced.

Objectives To investigate whether the presence of metabolic syndrome (MS) modifies overall survival and cardiovascular (CV) outcomes among patients undergoing long-term peritoneal dialysis (PD) and to explore suitable diagnostic criterion for PD patients.Methods A total of 258 patients on PD in Peking University Third Hospital between October 2008 and March 2009 were enrolled and followed until June 2017.According to the diagnostic criteria of WHO,IDF and ATP Ⅲ,the patients were divided into MS group and non-MS group.The median following time was 51.9 (26.8,97.9) months.Overall survival and cardiovascular death were analyzed by the Kaplan-Meier method.The analyses were also done among non-diabetic PD patients.The influence of MS and its components on outcomes was analyzed by Cox regression models.Results Among 258 PD patients,106(41.1％) fulfilled the WHO criteria,121(46.9％) the IDF criteria,and 167(64.7％) the ATP criteria.139 cases were dead,among which 50(36.0％) cases were caused by CV diseases.The patients with MS had worse outcomes than those without MS by WHO and IDF criteria (cumulative survival rates of WHO criteria:21.3％ vs 44.8％,P ＜ 0.01;cumulative surviva rats of IDF criteria:23.3％ vs 45.7％,P ＜ 0.01).It was the same even in non-diabetic PD patients.The patients with MS had more CV death than those without MS by WHO and IDF criteria (both P ＜ 0.05).Among non-diabetic PD patients,the results remained the same only by IDF criteria (P ＜ 0.05).By ATP criteria,above analyses showed no difference.By multivariate Cox regression analysis,MS and serum albumin (all P ＜ 0.01) were independently associated with increased risk for overall and cardiovascular survival.Among MS components,waist girth,low-density lipoprotein cholesterol (LDL-C) levels and blood sugar (all P ＜ 0.01) were significant risk factors for adverse survival outcomes.Conclusions In patients undergoing PD,both overall survival and cardiovascular survival were worse in patients with MS than those without MS.Waist girth,blood sugar and serum LDL-C were the main risk factors.For PD patients the IDF criterion for MS was recommended.

Mitochondrial diseases are maternally inherited heterogeneous disorders that are primarily caused by mitochondrial DNA (mtDNA) mutations. Depending on the ratio of mutant to wild-type mtDNA, known as heteroplasmy, mitochondrial defects can result in a wide spectrum of clinical manifestations. Mitochondria-targeted endonucleases provide an alternative avenue for treating mitochondrial disorders via targeted destruction of the mutant mtDNA and induction of heteroplasmic shifting. Here, we generated mitochondrial disease patient-specific induced pluripotent stem cells (MiPSCs) that harbored a high proportion of m.3243A>G mtDNA mutations and caused mitochondrial encephalomyopathy and stroke-like episodes (MELAS). We engineered mitochondrial-targeted transcription activator-like effector nucleases (mitoTALENs) and successfully eliminated the m.3243A>G mutation in MiPSCs. Off-target mutagenesis was not detected in the targeted MiPSC clones. Utilizing a dual fluorescence iPSC reporter cell line expressing a 3243G mutant mtDNA sequence in the nuclear genome, mitoTALENs displayed a significantly limited ability to target the nuclear genome compared with nuclear-localized TALENs. Moreover, genetically rescued MiPSCs displayed normal mitochondrial respiration and energy production. Moreover, neuronal progenitor cells differentiated from the rescued MiPSCs also demonstrated normal metabolic profiles. Furthermore, we successfully achieved reduction in the human m.3243A>G mtDNA mutation in porcine oocytes via injection of mitoTALEN mRNA. Our study shows the great potential for using mitoTALENs for specific targeting of mutant mtDNA both in iPSCs and mammalian oocytes, which not only provides a new avenue for studying mitochondrial biology and disease but also suggests a potential therapeutic approach for the treatment of mitochondrial disease, as well as the prevention of germline transmission of mutant mtDNA.
Animals ; DNA, Mitochondrial ; genetics ; Humans ; Induced Pluripotent Stem Cells ; cytology ; metabolism ; MELAS Syndrome ; genetics ; Male ; Mice ; Microsatellite Repeats ; genetics ; Mitochondria ; genetics ; metabolism ; Mutation ; genetics