Endo-periodontal lesions(EPLs)involve both the periodontium and pulp tissue and have complicated etiologies and pathogenic mechanisms,including unique anatomical and microbiological characteristics and multiple contributing factors.This etiological complexity leads to difficulties in determining patient prognosis,posing great challenges in clinical practice.Furthermore,EPL-affected teeth require multidisciplinary therapy,including periodontal therapy,endodontic therapy and others,but there is still much debate about the appropriate timing of periodontal therapy and root canal therapy.By compiling the most recent findings on the etiology,pathogenesis,clinical characteristics,diagnosis,therapy,and prognosis of EPL-affected teeth,this consensus sought to support clinicians in making the best possible treatment decisions based on both biological and clinical evidence.

Objective:To explore the application value of automated machine learning (autoML) model in predicting the risk of preeclampsia in the first trimester.Methods:From January 2017 to October 2020, 2 180 singleton pregnant women who were registered in Jinan Second Maternal and Child Health Hospital and underwent pregnancy examination at 12 weeks of gestation were selected. The pregnant women were divided into preeclampsia group (103 cases) and control group (2 077 cases) according to the occurrence of preeclampsia. The differences in clinical data and hematological indexes in the two groups were compared, and the correlation between each index and the risk of preeclampsia was analyzed too. All the pregnant women were randomly divided into training set and test set according to the ratio of 7∶3, and the autogluon autoML algorithm was used to build a variety of machine learning models, and training and cross-validation were performed in the training set to compare the accuracy of the different models. The importance of each index in the autoML model was analyzed, and the autoML model and the logistic regression model were used to predict the risk of preeclampsia in pregnant women in the test set respectively, and the receiver operating characteristic (ROC) curve was used to evaluate the prediction performance of the autoML and the logistic regression model.Results:The age, pre-pregnancy body mass index, body mass index at 12 weeks of gestation, waist circumference at 12 weeks of gestation, proportion of drinking history, high-sensitivity C-reactive protein (hs-CRP), triglyceride, low-density lipoprotein cholesterol (LDL-C), aspartate aminotransferase (AST), platelet distribution width (PDW), mean platelet volume, thyroid stimulating hormone (TSH) and β-human chorionic gonadotropin were all significantly higher than those in the control group (all P<0.05), and the free tri-iodothyronine (free T3), free thyroxine (free T4), placental growth factor (PIGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and pregnancy-associated plasma protein-A (PAPP-A) were all significantly lower than those in the control group (all P<0.05). Correlation analysis showed that the correlation between pre-pregnancy body mass index, body mass index at 12 weeks gestation, waist circumference at 12 weeks gestation, hs-CRP, triacylglycerol, AST, TSH, free T3, free T4, β-HCG, PIGF, sFlt-1, PAPP-A and preeclampsia risk were obviously higher; but the correlation between each index were lower. A total of 18 models in 8 categories were constructed with the autoML model algorithm, and the neural network _L2 based on FastAI had the highest accuracy in the training set (0.963) and the validation set (0.971). The TSH, LDL-C, PDW, waist circumference at 12 weeks of gestation, sFlt-1, AST were more important in the model, while the free T4, total cholesterol, pregnancy times, drinking history, parity and family history of hypertension were less important indicators. The area under the ROC curve of the autoML model for predicting the risk of preeclampsia in the first trimester was significantly higher than that of the logistic regression model (0.984 vs 0.765, P=0.002), while there was no statistical difference in the prediction accuracy of the two prediction models in the training set ( P>0.05). The prediction accuracy and sensitivity of the autoML model in the test set were both significantly higher than those of the logistic regression model (99.54% vs 98.32%, 93.75% vs 75.00%, both P<0.05). Conclusions:Factors such as TSH, LDL-C, PDW, waist circumference, sFlt-1 and AST in the first trimester of pregnancy have a certain correlation with the risk of preeclampsia. The autoML model based on the indicators of the first trimester has a high predictive value for the risk of preeclampsia.

Objective:To evaluate the clinical efficacy of hydrotherapy in the treatment of children with spastic cerebral palsy (CP).Methods:The China National Knowledge Infrastructure, Wanfang databases, CQVIP databases, PubMed and the Cochrane library were electronically searched for reports published before November 2018 of randomized and controlled trials (RCTs) of hydrotherapy for treating children with spastic CP. Two researchers screened the literature independently, extracted data and assessed the risk of bias in the included studies. The meta-analysis was performed using version 5.3 of the RevMan software.Results:A total of 6 RCTs were included, covering 464 patients. It was found that hydrotherapy combined with conventional rehabilitation was significantly more effective than conventional rehabilitation alone.Conclusions:It has been proved that hydrotherapy can improve the symptoms of children with spastic CP, relieve their spasticity and promote better motor function.

Proline-rich transmembrane protein 2 (PRRT2) is the leading cause of paroxysmal kinesigenic dyskinesia (PKD), benign familial infantile epilepsy (BFIE), and infantile convulsions with choreoathetosis (ICCA). Reduced penetrance of PRRT2 has been observed in previous studies, whereas the exact penetrance has not been evaluated well. The objective of this study was to estimate the penetrance of PRRT2 and determine its influencing factors. We screened 222 PKD index patients and their available relatives, identified 39 families with pathogenic or likely pathogenic (P/LP) PRRT2 variants via Sanger sequencing, and obtained 184 PKD/BFIE/ICCA families with P/LP PRRT2 variants from the literature. Penetrance was estimated as the proportion of affected variant carriers. PRRT2 penetrance estimate was 77.6% (95% confidence interval (CI) 74.5%-80.7%) in relatives and 74.5% (95% CI 70.2%-78.8%) in obligate carriers. In addition, we first observed that penetrance was higher in truncated than in non-truncated variants (75.8% versus 50.0%, P = 0.01), higher in Asian than in Caucasian carriers (81.5% versus 68.5%, P = 0.004), and exhibited no difference in gender or parental transmission. Our results are meaningful for genetic counseling, implying that approximately three-quarters of PRRT2 variant carriers will develop PRRT2-related disorders, with patients from Asia or carrying truncated variants at a higher risk.
Dystonia ; Epilepsy, Benign Neonatal/genetics* ; Humans ; Membrane Proteins/genetics* ; Mutation ; Nerve Tissue Proteins/genetics* ; Pedigree ; Penetrance ; Seizures/genetics*

Objective:To explore the feasibility of bedside ultrasound in monitoring gastric residual volume and predicting feeding intolerance during enteral nutrition in critically ill patients in intensive care unit.Methods:The data of critically ill patients admitted to emergency intensive care unit of the Second Affiliated Hospital of Zhejiang University School of Medicine from April 2018 to September 2018 were retrospectively analyzed. The following patients were finally included in this study: (1) abdominal computed tomography during the stay of emergency intensive care unit was performed due to the requirement of disease evaluation and management; (2) bedside ultrasound was performed to measure the gastric antrum cross-sectional area at 30 min prior to or after abdominal computed tomography. The outline of stomach wall in the imaging of abdominal computed tomography was traced with the help of VOLUME-Work Flow medical imaging software to calculate the value of gastric residual volume. The relationship between gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions and gastric residual volume was evaluated by Pearson correlation analysis. The difference of gastric antrum cross-sectional area between those critically ill patients with or without feeding intolerance was compared by independent-sample t test. The predictive value of gastric antrum cross-sectional area under different body positions on feeding intolerance during enteral nutrition was analyzed by ROC curve. Results:Totally, forty-two patients were enrolled and analyzed in this study, in which the mean age was (53±13) y, mean body mass index was (21.5±2.8) kg/m 2 and mean acute physiology and chronic health evaluation was 17.0±6.9. The value of gastric residual volume was (314.5±126.6) mL, and the values of gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions were (7.11±4.13) cm 2, (4.22±2.66) cm 2, (8.36±4.58) cm 2, respectively. The correlation analysis indicated that gastric residual volume was positively associated with gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions ( r=0.543, 0.604 and 0.618, respectively; all P<0.001). During enteral nutrition, 15 patients experienced feeding intolerance while 27 patients hadn’t feeding intolerance, in which the gastric antrum cross-sectional areas under semi-sitting, horizontal and right-lateral positions were significantly increased in those patients with feeding intolerance than those patients without feeding intolerance [semi-sitting: (8.53±4.07) cm 2vs (4.60±2.76) cm 2; horizontal position: (5.15±2.75) cm 2vs (2.61±1.32) cm 2; right-lateral position: (10.32±4.06) cm 2vs (4.95±3.20) cm 2, all P<0.005] . ROC curve analysis showed that the area under ROC curves of gastric antrum cross-sectional area under semi-sitting, horizontal and right-lateral positions for predicting feeding intolerance during enteral nutrition were 0.815, 0.833 and 0.849, respectively; when its values≥3.917 cm 2, 3.395 cm 2 and 4.402 cm 2 were used as the cut-off points, the sensitivities were 92.0%, 69.6% and 92.3%, and the corresponding specificities were 69.2%, 92.3% and 71.4%, respectively. Conclusions:Bedside gastric ultrasound could accurately evaluate the status of gastric residual volume in critically ill patients, and effectively predict their occurrence of feeding intolerance during enteral nutrition.

The facile and efficient synthetic route for Ag dendritic nanostructures on Indium tin oxide ( ITO) via electrodeposition was reported. The results showed that the Raman intensities of rhodamine 6G ( R6G) decreased with decreasing the loading concentration, and even at a low concentration of 10-10 mol/L, the signatures of R6G in Raman spectrum were still clearly observed. It indicated that the Ag dendritic nanostructures exhibited high surface-enhanced Raman scattering ( SERS) sensitivity. Moreover, the relative standard deviation ( RSD ) of band at 610 cm-1 was calculated to be 12 . 1%, 12 . 0%, 11 . 7%, 10 . 9%, 13. 2% and 14. 3%, respectively, corresponding with the concentration of R6G from 10-5 mol/L to 10-10 mol/L, which revealed that the Ag dendritic nanostructures could provide abundant hot spots and exhibited excellent reproducibility. In addition, the SERS spectrum of 3-mercaptopropionic acid (3MPA) also could be detected when its concentration was 10-5 mol/L. This method offers an easy and low-cost way to prepare Ag dendritic substrates and makes SERS detection more practicable.

Objective To investigate the efficacy and accuracy of 3D printing individualized navigation templates used in shoulder hemi-arthroplasty (HA).Methods We collected 9 adult cadaveric specimens of 18 shoulders with no obvious deformities or defects.After CT scanning was conducted on bilateral shoulders,the raw CT data in DICOM format were imported into software Mimics 10.01 and Imageware 12.0 to reconstruct 3D shoulder models.The retroversion angles and heights of bilateral humeral heads were measured to design individualized navigational templates using software Geomagic Studio 12.0.Rapid prototyping (RP) technique was used to manufacture the individualized navigation templates which were then used to assist shoulder HA in cadaveric specimens.CT scanning was performed postoperatively to measure the retroversion angle and height of the prosthesis implanted for comparison with the preoperative measurements.Results Before shoulder replacement in the 9 cadaveric specimens,respectively,the heights of left and right humeral heads averaged 300.0 ± 11.6 mm and 300.0 ± 11.4 mm,and the retroversion angles 15.6°±4.9° and 15.9°± 4.9°.After the replacement,the heights of left and right humeral heads averaged 300.0 ± 11.3 mm and 300.0 ± 11.7 mm,respectively,and the retroversion angles 15.7° ± 4.9° and 15.8° ± 5.2°,respectively.There were no significant differences between the left and right sides in the pre-or post-operative heights or retroversion angles of the humeral head (P ＞ 0.05).There were no significant differences either between preand post-operation in the heights or retroversion angles of the left and right humeral heads (P ＞ 0.05).The mean errors for the preoperative and postoperative heights and retroversion angles of the humeral heads were 1.44 ± 0.96 mm and 0.25° ± 0.15°,respectively.Conclusion Individualized navigation templates 3D printed can be used to assist effective and accurate shoulder HA because they are designed and manufactured according to accurate measurements of retroversion angles and heights of the humeral heads which are acquired by computer preoperatively.

Objective To explore the effection of four types of surgery for the treatment of adenoid hypertrophy . Methods 148 cases of with adenoid hypertrophy treated in our hospital between April 2012 and April 2015 were chose;they were randomly divided into 4 groups ,each group of 37 people .A group of patients with adenoid hypertrophy were taken traditional ade‐noidectomy curettage;Group B with nasal endoscopic adenoidectomy and cutting aspiration biopsy ;Group C by adenoidectomy shave their + residual endoscopic adenoidectomy bit cut method combined treatment ;Group D with nasal endoscopic adenoidectomy plas‐ma cutting treatment .The curative effect ,operation time ,blood loss were observed ;patients were followed‐up for half a year ,ade‐noidectomy residual rate and complications of each group were compared .Results The total effective rate of B ,C ,D three groups were significantly higher in group A patients (χ2 =7 .731 ,5 .045 ,7 .731 ,P<0 .05) ,the efficient between three groups was not sta‐tistically different (P>0 .05) .B ,C ,D three groups of operation time is significantly higher than A group of patients (t=5 .819 , 5 .829 ,2 .759 ,P<0 .05);B and C group had long operation time than group D (t=3 .555 ,3 .637 ,P<0 .05);But operation time of B and C had no significant difference between the two groups (t=0 .149 ,P>0 .149) .Bleeding of B and C group were significantly higher than group A (t=9 .305 ,4 .126 ,P<0 .05);Group D was significantly lower than A ,B ,C three group (t=8 .054 ,16 .559 , 12 .837 ,P<0 .05);Group C and group B was significantly higher than the bleeding (t=5 .739 ,P<0 .05) .Retention rate of group A is significantly higher than the other three groups (χ2 =31 .308 ,31 .308 ,24 .667 ,P<0 .05) ,the residual rate of B ,C ,B group were lower ,there was no statistically significant difference(P> 0 .05) .Complication rates between the four groups was no statistical difference(P>0 .05) .Conclusion we should choose the right means of surgical treatment according to patients condition and eco‐nomic situation to .

Twenty six patients with fracture of tibial plateau was under arthroscopy assisted reduction, the joint surface of bone graft, and USES the steel plate fixation treatment. Average surgery time was 65 min (70-120 min), average fracture healing time was 15 weeks (12-17 weeks), joint surface anatomical reattachment rate was 92.9%. Using break knee function criteria evaluation of curative effect: 18 cases great 6 cases wed, 2 cases ok, fine rate was 92.3%. No infection, deep venous thrombosis and small leg fascia chamber syndrome and other complications. Conclusion is that treatment of tibial plateau fractures under arthroscope has advantages of small trauma, check intuitively and reset accurately, functional recovery of patients are satisfied, the treatment has certain clinical application value.
Adult ; Arthroscopy ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Tibial Fractures ; surgery ; Treatment Outcome ; Young Adult

Objective To observe the effects of hirudo capsules on degree of platelet activation and blood rheology in patients with cerebral arteriosclerosis. Methods 122 patients with cerebral arteriosclerosis were randomly divided into two groups by the random number table:observation group(61 cases)and control group (61 cases). The two groups received conventional treatment such as antihypertensive and hypoglycemic drugs,and 100 mg of aspirin once a day. In the observation group,additionally hirudo capsules 0.75 g,3 times a day were given. The therapeutic course in both groups was 2 months. Prior to the start of treatment and on the next day after the end of treatment,traditional Chinese medicine(TCM)clinical syndrome integral,platelet membrane glycoproteins caspase 1 (PAC-1),platelet adhesion molecule P selection(CD62P)positive rate,and blood rheology indexes were detected,in addition to the adverse reactions . Results Before treatment,there were no statistical significant differences between the two groups in terms of TCM clinical syndrome integral such as headache,dizziness,head fullness,multiple somnolence amnesia,lip dark purple,sublingual veins purple in color,PAC-1,CD62P positive rate,hemorheology indexes(all P>0.05). After treatment,TCM clinical syndrome integral PAC-1,CD62P,low shear viscosity,high shear viscosity,plasma viscosity and the hematocrit of two groups were significantly lower than those before treatment, the improvement in observation group being more remarkable〔headache:0.75±0.69 vs. 1.23±0.92,dizziness:0.96±0.78 vs. 1.54±1.24,head fullness:0.65±0.59 vs. 1.48±1.17,multiple somnolence amnesia:0.77±0.72 vs. 1.69±1.14,lip dark purple:0.83±0.81 vs. 1.32±0.79,sublingual veins purple:0.84±0.67 vs. 1.20±0.74, PAC-1:(10.31±4.57)%vs.(15.13±6.27)%,CD62P:(11.39±5.24)%vs.(16.40±7.91)%,low shear viscosity (mPa?s):7.52±3.37 vs. 8.97±3.50,high shear viscosity(mPa?s):4.35±1.12 vs. 5.58±1.19,plasma viscosity (mPa?s):1.54±0.35 vs. 1.88±0.42,hematocrit(HCT):0.43±0.09 vs. 0.49±0.10〕. In the patients' follow-up, there were no obvious side effects of hirudo capsules. Conclusion Hirudo capsule is a safe and effective drug for treatment of patients with cerebral arteriosclerosis as it is helpful in reducing platelet activation degree and improving the blood rheology indexes.