Sufficient bone tissue is required to ensure the long-term stability of implants. Based on the principles of guided bone regeneration, Dr. Istvan Urban proposed the “sausage technique”. Research indicates that the horizontal bone augmentation observed with the sausage technique averages (5.3 ± 2.3) mm and the vertical bone augmentation averages (4.2 ± 1.9) mm, which is significantly greater than the outcomes achieved with traditional guided bone regeneration techniques. The sausage technique is reliable because the biological membrane has sufficient elasticity and toughness with the application of membrane screws, which stabilizes the mixture of autologous bone and bone graft materials in the bone grafting area and prevents the grafting materials from being displaced. Using substitute materials for autologous bone graft balances the osteogenic activity and the low graft absorption rate. A ball drill is used to prepare nourishing holes in the cortical bone of the recipient area, providing a pathway for mesenchymal stem cells and bone progenitor cells to migrate to the bone regeneration area. Furthermore, this method accelerates the early angiogenesis of wound healing, fully reduces tension during suturing, and ensures that excessive pressure is not applied to the healing area during suturing. Thus, the sausage technique is consistent and reliable. Despite the good outcomes demonstrated by the sausage technique in clinical applications, its potential complications related to soft and hard tissue have attracted widespread attention. These complications negatively affect the patient’s recovery process and influence the final results of the surgery. Therefore, a complete understanding of the complications associated with the sausage technique and their underlying causes is necessary to enhance the clinical safety and effectiveness of the sausage technique. This article summarizes the application principles, clinical effects, barrier membrane applications, selection of bone transplant materials, and related complications of the sausage technique, aiming to provide a reference for clinical application.

Objective To investigate the virulence and drug resistance characteristics of diarrheagenic Escherichia coli isolated from patients with infectious diarrhea in our hospital.Methods The preliminary identification of microbes was carried out by the VITEK-MS microbial mass spectrometry detection system and virulence genes were detected by the multiplex real-time PCR.Five types of diarrhea-genic Escherichia coli(DEC)clinically isolated from patients with infectious diarrhea in our hospital were identified.The drug resist-ance characteristics of DEC strains were detected by the microbroth dilution and E-test.The drug-resistant molecular characteristics were analyzed by the next-generation sequencing and bioinformatics.The Fisher exact probability method was used for statistical analy-sis.Results The detection rate of DEC in our hospital was 11.9%,with enteroaggregative E.coli(EAEC)accounting for 37.5%,a-typical enteropathogenic Escherichia coli(EPEC)accounting for 34.38%,enterotoxigenic E.coli(ETEC)accounting for 25.0%,and enteroinvasive E.coli(EIEC)accounting for 3.12%.None of enterohemorrhagic E.coli(EHEC)strain was detected.The resistance rates of 32 DEC strains to ampicillin,tetracycline,and trimethoprim/sulfamethoxazole were 53.12%,43.75%,and 37.5%,respec-tively.ESBLs(+)strains accounted for 18.75%,and the detection rate of multidrug-resistant strains was 83.83%,significantly higher than that of ESBLs(-)strains(P=0.042).A total of 25 ST genotypes were obtained from 32 DEC strains.The dominant genotypes were ST10(4 strains,12.5%),followed by ST28(2 strains,6.25%),ST31(2 strains,6.25%),ST3153(2 strains,6.25%),and the other 21 genotypes(1 strain,3.13%).One carbapenem resistant strain carrying the blaNDM-1 gene was detected in EAEC.Conclu-sion Four virulence genes such as aggR,pic,astA,and eae,are more common in the DEC of patients with infectious diarrhea in our hospital,with EAEC and EPEC as the main subtypes.The genotypes are highly polymorphic,and multidrug-resistant strains have been detected.

ObjectiveTo conduct a meta-analysis of the prevalent characteristics of the injury-related behaviors among adolescents in China based on Chinese literature, so as to inform the prevention and control of injury-related behaviors of this population. MethodsA cross-sectional study on the prevalent characteristics of adolescent injury-related behaviors was conducted with the data collected from CNKI, VIP, Wanfang Data, CBM, PubMed, and Web of Science. The review included publications from the inception of the databases to November 2023. Meta-analysis was performed with Stata 15.1 software. ResultsA total of 40 articles were included in this study, and the meta-analysis results showed that cycling violation rate was 38% (95%CI: 32%‒43%), walking violation rate was 29% (95%CI: 22%‒36%), rate of unsafe swimming was 13% (95%CI: 11%‒14%), suicidal ideation rate was 13% (95%CI: 12%‒15%) and the prevalence of fighting was 19% (95%CI: 17%‒22%). Subgroup analysis showed that the cycling violation rate was (44%) for boys and 34% (95%CI: 28%‒40%) for girls. Adolescents in Northeast, East, and Southwest of China had the highest rate of cycling violation (44%), of which junior high school students had the highest rate of violation [42% (95%CI: 36%‒49%)]. As for the walking violation rate, male students [29% (95%CI: 21%‒37%)] was higher than that of female students [22% (95%CI: 15%‒30%)]. Adolescents in North of China had the highest rate of walking violation [54% (95%CI: 30%‒76%)], of which vocational school students accounted for 38% (95%CI:21%‒56%) of the total violation. In terms of the detection rate of unsafe swimming, male students [18% (95%CI: 14%‒24%)] was higher than that of female students [8% (95%CI: 6%‒10%)]. Adolescents in Central South China had the highest rate of unsafe swimming [15% (95%CI: 12%‒18%)], of which, vocational school students accounted for the highest [15% (95%CI: 10%‒19%)]. When it comes to the prevalence of suicidal ideation, female students [16% (95%CI: 13%‒19%)] was higher than that of male students [13% (95%CI: 11%‒15%)]. Adolescents in Southwest of China had the highest rate of suicidal ideation [17% (95%CI: 10%‒25%)], of which high school students accounted for the highest [15% (95%CI: 12%‒18%)]. Finally, the detection rate of fights was 30% (95%CI: 26%‒34%) for boys and 11% (95%CI: 10%‒14%) for girls. Adolescents from Southwest of China had the highest rate [29% (95%CI: 24%‒34%)] for fights, and junior high school students accounted for the highest [26% (95%CI: 22%‒31%)]. ConclusionThe prevalence of harmful behaviors among adolescents in China is notably high, with statistical differences across gender, region, and school stages. These behaviors pose a risk to adolescent health, underscoring the need for targeted interventions by health and educational authorities.

Objective This clinical study aimed to evaluate the accuracy of a fully digital technique for mea-suring sagittal condylar inclination(SCI),as well as vali-dating whether differences existed between the left and right SCI values of the same participant,to provide a ref-erence for clinical practice.Methods Ten participants with good occlusal relationship and normal temporomandibular joint were recruited.Three methods were used to mea-sure the SCI values of the participants,namely,A(mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration),B(face scan-based virtual facebow and virtual ar-ticulator-based measuring method with digital protrusive interocclusal registration),and C(jaw motion tracking system-based measuring method).With the group subjected to methods A and C as the control,the SCI values obtained by the three methods were statistically analyzed.The left and right SCI values of the same participant were also compared.Re-sults The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°,those by method B were 35.09°±12.49° and 37.63°±12.10°,and those by method C were 39.43°±8.72° and 38.45°±6.91°.No significant dif-ference existed among the SCI values measured by the three methods(P>0.05).Meanwhile,no statistical difference existed between the SCI values on the left and right sides of the same participant(P>0.05).Conclusion The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods.The SCI values on the left and right sides of the same participant were similar.Clinically,an appropriate SCI measurement and setting strategy can be selected based on the actual situations.

Objective This clinical study aimed to as-sess the trueness of three intraoral scanners for the recor-ding of the maximal intercuspal position(MIP)to provide a reference for clinical practice.Methods Ten participants with good occlusal relationship and healthy temporomandibular joint were recruited.For the control group,facebow transferring procedures were performed,and bite registrations at the MIP were used to transfer maxillary and mandibular casts to a mechanical articulator,which were then scanned with a laboratory scanner to obtain digital cast data.For the experimental groups,three intraoral scanners(Trios 3,Carestream 3600,and Aoralscan 3)were used to obtain digital casts of the participants at the MIP following the scanning workflows endorsed by the corresponding manufacturers.Sub-sequently,measurement points were marked on the control group's digital casts at the central incisors,canines,and first molars,and corresponding distances between these points on the maxillary and mandibular casts were measured to calcu-late the sum of measured distances(DA).Distances between measurement points in the incisor(DI),canine(DC),and first molar(DM)regions were also calculated.The control group's maxillary and mandibular digital casts with the added mea-surement points were aligned with the experimental group's casts,and DA,DI,DC,and DM values of the aligned control casts were determined.Statistical analysis was performed on DA,DI,DC,and DM obtained from both the control and ex-perimental groups to evaluate the trueness of the three intraoral scanners for the recording of MIP.Results In the con-trol group,DA,DI,DC,and DM values were(39.58±6.40),(13.64±3.58),(14.91±2.85),and(11.03±1.56)mm.The Trios 3 group had values of(38.99±6.60),(13.42±3.66),(14.55±2.87),and(11.03±1.69)mm.The Carestream 3600 group showed values of(38.57±6.36),(13.56±3.68),(14.45±2.85),and(10.55±1.41)mm,while the Aoralscan 3 group had val-ues of(38.16±5.69),(13.03±3.54),(14.23±2.59),and(10.90±1.54)mm.Analysis of variance revealed no statistically sig-nificant differences between the experimental and control groups for overall deviation DA(P=0.96),as well as local devi-ations DI(P=0.98),DC(P=0.96),and DM(P=0.89).Conclusion With standardized scanning protocols,the three intra-oral scanners demonstrated comparable trueness to traditional methods in recording MIP,fulfilling clinical requirements.

Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.

With the development of digital technology， an increasing number of artificial intelligence （AI） technologies are being applied in the field of public health， significantly improving the efficiency of healthcare systems. However， such technological advancement also introduces a series of ethical risks. In this article， we conducted a systematic review by searching nine domestic and international databases and analyzing the ethical issues related to AI in public health， ultimately including 158 articles. Based on the analysis of the included literature， ethical risks were categorized into four aspects： data， algorithms， rights and responsibilities， and social impact. A total of 15 key issues were identified， among which privacy and confidentiality， informed consent， data security， and fairness， justice and inclusion emerged as the most prominent issues. The ethical challenges posed by AI in the field of public health cannot be ignored， and it is necessary to formulate ethical guidelines and practical recommendations for AI in this field， establish sound regulatory and review mechanisms， thereby ensuring the healthy development of AI research in public health.

Objective To understand the serotype,molecular typing and drug sensitivity characteristics of Salmonella isolated from food and stool samples of diarrhea patients in Nan'an District of Chongqing.Methods A total of 71 Salmonella strains isolated from food and stool samples of diarrhea patients in Nan'an District of Chongqing from 2019 to 2022 were serotyped,and the drug resistance of the strains was determined by the micro-broth dilution method.Multilocus sequence typing(MLST)was performed on 2 Salmonella Ken-tucky strains,and whole genome sequencing was performed on 8 Salmonella typhimurium strains and 2 Sal-monella typhimurium variants.Results The 71 strains of Salmonella included 13 serotypes.A total of 48 Sal-monella strains were isolated from stool samples of diarrhea patients,with Salmonella typhimurium(56.25％,27/48)and Salmonella enteritidis(18.75％,9/48)as the main serotypes.A total of 23 Salmonella strains were isolated in food samples,with Salmonella Rissen(26.09％,6/23)as the predominant.The total drug re-sistance rate of 71 strains of Salmonella was 97.18％.The highest drug resistance rate was ampicillin(69.01％),followed by tetracycline(64.79％),compound sulfamethoxazole(43.66％)and chloramphenicol(43.66％).The multidrug resistant strains accounted for 61.97％(44/71),including 60.42％(29/48)of stool samples of diarrhea patients and 65.22％(15/23)of food samples.The two Salmonella Kentucky strains iso-lated from food and diarrhea patients were resistant to 7 and 8 types,respectively,with the largest number of drug resistant types in the corresponding samples.The MLST types of both Salmonella Kentucky strains was ST198 type.The MLST types of 8 Salmonella typhimurium strains selected for sequencing were ST19,and the MLST types of 2 Salmonella typhimurium monophasic variants were ST34.The genetic relationship of Salmo-nella typhimurium with the same ST type was different.Conclusion The serotypes of Salmonella isolated from Nan'an District of Chongqing are diverse and the drug resistance is serious.The detection of ST198 Sal-monella Kentucky is more accurate by using whole genome sequencing than MLST.The surveillance of Sal-monella serotypes,molecular typing and drug resistance should be strengthened.

Based on the principle of "kidney suffers from dryness and can be moistened by pungent drugs", this article discussed the pathogenesis and treatment of chronic kidney disease-associated pruritus (CKD-aP), and believed that this disease begins with deficiency of kidney qi, and dampness, blood stasis, cold, heat, and turbid toxin are the symptoms, which ultimately leads to the kidney's inability to transport fluids, and develops into "dryness of kidney". It suggested that the treatment of CKD-aP should be "using pungent drugs to moisten" as the core, according to the stage of development of the disease and the contradiction of the primary and secondary, respectively, the use of pungency-warm (heat) declination, pungent-cold (cool) declination of the treatment, to help to restore the normal transmission of fluid operation, qi and blood, and promote fluids to reduce dryness, so as to promote the recovery of the disease.

Objective:To assess the reliability,and validity of the Chinese version of a short-form of Health Literacy Dental scale(HeLD-14)in 3-6 years old preschool children's parents.Methods:The study population consisted of those eligible 3-6 years old preschool children's parents in Yanqing Dis-trict,Beijing,China in 2021.A total of 1 479 preschool children's parents were surveyed by question-naire to understand the general situation of parents and oral health literacy related content.SPSS 21.0 and Mplus 7.4 were used for statistical analysis.Through Cronbach's α coefficient,confirmatory factor a-nalysis,Pearson correlation calculation,Student's t test and other methods,the internal consistency reli-ability,structure validity,calibration validity and discrimination validity of the scale were evaluated.Re-sults:The Cronbach's α coefficient of Chinese version HeLD-14 scale was 0.958,and Cronbach's α co-efficient of different constructs ranged from 0.778 to 0.963.The confirmatory factor analysis showed that the factor loadings of each item of the Chinese version HeLD-14 scale were between 0.719 and 0.977(P＜0.001),root-mean-square error of approximation(RMSEA)=0.04,comparative fix index(CFI)=0.992,Tucker-Lewis index(TLI)=0.988,and the model had good goodness of fit.The total score of the Chinese version HeLD-14 scale and the scores of the dimension of concerning,understanding,sup-porting,financial burden,medical treatment,communication,and application were all positively correla-ted with general self-efficacy,and the correlation coefficients were 0.439,0.406,0.370,0.344,0.346,0.367,0.373,0.390,respectively(P all＜0.05).For parents in the high group with the top 27％HeLD-14 score,the average HeLD-14 score was 69.27±1.06,which was higher than the low group with the bottom 27％HeLD-14 score,41.29±11.09(t=48.13,P＜0.01).Conclusion:The Chinese version HeLD-14 scale has good reliability and validity in the 3-6 years old preschool children's parents,and can be used as a tool to assess the oral health literacy of parents of preschool children.