Objective:To explore the optimal insertion point of reverse sacral alar-iliac screws (RSAIS) in sacroiliac joint fixation for Tile type C pelvic fracture and the effectiveness of its preliminary clinical application.Methods:CT data from 90 patients with no abnormal pelvic structures in the Radiology Department database of Liyang People's Hospital from January 2022 to January 2023 were selected. There were 45 males and 45 females, aged 21-69 years [(45.5±6.4)years]. With CT digital reconstruction technology, the RSAIS fixation was simulated and the anterior insertable area was measured. Five insertion points were at the ilium-acetabular recess in the area superior posterior to the acetabulum (A1), at 1 cm (A2) and 2 cm (A3) posterior transversal to A1, at 1 cm (A4) and 2 cm (A5) inferior longitudinal to A1. With the entry point of S 1 pedicle screw as the exit point, the transverse and sagittal CT scans were conducted on 5 screw trajectories of anterior posterior lines (corresponding to five groups). The anatomical parameters of the screw trajectories, including the length, width and height of the screw trajectories were measured by two observers independently and the intraclass correlation coefficient (ICC) between the observers was analyzed. Tile type C pelvic fracture models were established from 20 3D-printed L 5-pelvis-femur specimens and divided into 5 groups, with 4 specimens in each group. The anterior rings were fixed with cross screws while the posterior rings with one RSAIS in each group using one of the aforementioned 5 screw trajectories. The overall displacement and local displacement of the sacroiliac space under 300 N vertical load in all the groups were measured with a biomechanical machine. The screw trajectory was designed according to the optimal insertion point shown in the above anatomical measurements and mechanical experiments. An RSAIS with a diameter of 7.3 mm was inserted percutaneously to treat a patient with Tile type C1 pelvic fracture. The fluoroscopy time of screw insertion and screw position were recorded as well as bone reunion, numerical rating scale for pain, Oswestry dysfunction index (ODI) and Majeed functional score of pelvic fracture at the last follow-up. Results:The anterior insertable area was (1236.64±12.04)mm 2. The trajectory lengths for the three transversal insertion points gradually decreased from front to back, with A1 being the longest (104.9±10.4)mm, followed by A2 (98.5±9.8)mm and A3 the shortest (92.7±9.7)mm ( P<0.01), while there were no significant differences in the widths or heights ( P>0.05). There were no significant differences in the length, width or height of the screw trajectories of the three longitudinal insertion points (groups A1, A4 and A5) ( P>0.05). Compared with A4 and A5, A1 was farther from the margin of the acetabulum. The range of ICC of the anatomical parameters of the 3 screw trajectories measured by the two observers was 0.88-0.98, 95% CI 0.90, 0.96, and 95% CI 0.95, 0.99, indicating high consistency. After the screws were placed and fixed at the 3 transversal insertion points, the overall displacement and local displacement of the sacroiliac space of groups A1, A2 and A3 gradually increased from front to back. They were (2.93±0.09)mm and (1.49±0.14)mm in group A1, (3.14±0.12)mm and (1.63±0.54)mm in group A2 and (3.23±0.12)mm and (1.67±0.67)mm in group A3 respectively. There was a significant difference in the overall displacement among three groups ( P<0.01), while the local displacement of the sacroiliac space in group A1 was decreased compared with that of group A2 and A3 ( P<0.01). After the screws were placed and fixed at the 3 longitudinal insertion points, there were no significant differences in the overall displacement and local displacement of the sacroiliac space of group A1, A4 and A5 ( P>0.05). The fluoroscopy time of RSAIS inserted from A1 for the treatment of patients with Tile C1 pelvic fracture was 66 seconds, with fine screw position. At the last follow-up, the fracture was healed, with numerical rating scale for pain decreased from 6 points preoperatively to 1, ODI improved from 41 preoperatively to 18, and the Majeed functional score of 81 points. Conclusions:For Tile type C pelvic fracture, the screw trajectory from the iliac-acetabular recess located in the superior anterior part of the insertable area is the longest, with the best stability and relatively good safety of the screw, making it the optimal insertion point for RSAIS. The effect of preliminary clinical application of RSAIS from the optimal insertion point is satisfactory.

Heart rate recovery,a widely used indicator in clinical evaluation of the autonomic nervous system,refers to the difference between maximum heart rate during exercise and the heart rate after 1 or a few minutes of cessation.It possesses advantages of being noninvasive and repeatable.Currently,heart rate recovery is extensively applied in cardiovascular diseases for evaluating disease severity,prognosis,risk of cardiovascular events,and mortality.This article primarily discusses the application value and current research progress of heart rate recovery in cardiovascular diseases.

Objective: This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. Methods: Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. Results: The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. Conclusion PMTS is safe and effective in improving insomnia disorders.

Objective The objective of this study was to investigate the effect of depression on serum levels of C-reactive protein(CRP)and high-sensitivity C-reactive protein(hs-CRP),and prognosis in liver cancer patients. Methods A total of 251 patients with liver cancer undergoing hepatectomy were enrolled. The hospital anxiety and depression scale( HADS-D) and 9-item patients health questionnaire(PHQ9) were assessed for depression before 3 days for surgery. Patients were divided into depression group(n=95)and non-depression group(n=156) according to the scores. Preoperative serum levels of CRP,hs-CRP,ALT and AST were measured and compared between the depression and non-depression groups. Survival analysis Kaplan-Meier method was used to compare the disease-free survival(DFS)and total survival(OS)between the two groups. Results The serum levels of CRP, hs-CRP,ALT and AST in the depression group were significantly higher than those in the non-depression group(P<0. 05). The follow-up of 3. 5-year showed that 164 patients(65 in depression group and 99 in non-depression group)had recurrence or metas-tasis and 47 patients(22 in depression group and 25 in non-depression group) died. The DFS and OS in the depression group were significantly lower than those in the non-depression group(P< 0. 05). Cox multiple regression analysis showed that liver function grading,BCLC staging and depression were independent risk factors for the prognosis of liver cancer. Spearman correlation analysis showed that patients′degree of depression was positively correlated with serum levels of CRP and hs-CRP(P<0. 05),DFS and OS were negatively correlated with serum levels of CRP and hs-CRP(P<0. 05). Conclusion Depression may mediate elevated serum levels of CRP and hs-CRP,maintain inflammatory response in patients,lead to increased liver function damage,elevate levels of ALT and AST,and thus adversely affect the prognosis of patients with liver cancer.

过继细胞疗法（ACT）的飞速发展使其成为肿瘤治疗手段中的一项新热点，其中嵌合抗原受体修饰的T细胞（CAR-T 细胞）在治疗恶性血液肿瘤中取得的成果更是令人振奋，同时也为实体瘤的治疗提供了新策略。但是，目前CAR-T细胞免疫疗法 在肿瘤治疗过程中的局限性也日渐显露。本文旨在针对CAR-T细胞在肿瘤治疗中的研究进展及治疗中的挑战予以简要探讨。

OBJECTIVE: This study aimed to compare the effect of D55 and D65 light sources on the visual colorimetry performance of dental students by using a homemade light-source shelf. METHODS: Two Vitapan 3D-Master shade guides were randomly selected. One set was used as shade guides. Ten commonly used shade tabs of 2L2.5, 2M2, 2R2.5, 3M2, 3R2.5, 3L1.5, 3R1.5, 3L2.5, 4R1.5, and 4L1.5 were selected from the other set with covered value marks and numbered from 1 to 10. After the colorimetric training, 49 undergraduate dental students were randomly divided into two groups. Each student randomly selected two of the 10 shade tabs, and the colors were subsequently matched under D65 and D55 light sources from a distance of approximately 40 cm. The average color difference (ΔE) between the color selected by each participant and the actual color of shade tabs was calculated. Paired t test was used for statistical analysis. RESULTS: The ΔE values between the color selected by each participant and the actual color of the shade tabs under the D55 light source varied from 0 to 6.540. The average value was 2.501. The ΔE values between the color selected by each participant and the actual color of the shade tabs under the D65 light source varied from 0 to 6.610. The average value was 2.530. No statistically significant difference was observed between the results under the two light sources (P=0.921). CONCLUSIONS Both D55 and D65 daylight lamps can be used for daily dental colorimetry. These two different color temperatures showed no significant difference.
Color ; Colorimetry ; Dental Prosthesis Design ; Humans ; Prosthesis Coloring ; Students, Dental

Objective:To learn the cognition and attitudes of psychometric ethics of graduate students whose major was clinical psychology or counseling psychology,and to investigate whether ethics training could influence their cognition and attitude.Methods:Researchers distributed the questionnaire online regarding cognition and attitudes of psychometric ethics among clinical and counseling psychology graduate students.Seventy-six feedbacks were collected (4 students were learning ethics courses,27 students had learned ethics courses,45 students hadnt learned ethics courses).The questionnaire included the Psychometric Cognition Questionnaire (PCQ),Situational Judgement Questionnaire (SJQ) and Psychometric Attitude Questionnaire (PAQ).The first two sets of questionnaires reflected ethics knowledge.The last one showed ethics attitudes and behavioral tendencies.Results:The correct rates in participants who had learned or were learning ethics were 76.5％ and 75.1％ at the first and second set of questionnaires,while were 73.9％ and 74.2％ in other participants.The correct rates of three major clauses in PCQ were 90.3％,67.7％ and 74.2％,significantly higher than participants who never learned ethics,whose correct rates were 88.9％,66.7％,and 44.4％ (Ps ＜ 0.05).There were no significant differences in SJQ between those who had learned or was learning ethics and those who had never learned ethics (Ps ＞0.05).Participants who had learned or were leaning ethics scored in sum in PAQ that had no significant differences with those who had never learned ethics(Ps ＞ 0.05).Conclusion:Clinical and counseling psychology graduate students master considerable level of knowledge on ethics and attitude.Ethics training is essential for acquiring psychometric ethics.

Objective To explore the correlation between catechol-O-methyltransferase (COMT) gene polymorphism and the occurrence of senile hypertension with depression.Methods Ninety-eight Han inpatients with senile hypertension complicating depression(elderly hypertension complicating depression group) in our hospitals from January 2010 to July 2014 were selected and contemporaneous 100 Han cases of senile hypertension(elderly hypertension group) and 100 healthy Han elderly people(elderly control group) served as the study subjects.PCR-RFLP was employed to detect COMT gene 1947 locus polymorphism distribution frequency for conducting analysis.Results The genotype frequencies of AA and AG at COMT 1947 locus in the elderly hypertension complicating depression group were significantly higher than those in the elderly control group(28.57 ％,51.02 ％ vs.19.00 ％,39.00％,P＜0.01).The A allele frequency in the elderly hypertensive complicating depression group was significantly higher than that in the elderly control group(54.08％ vs.38.50％,P＜0.01).The risk of hypertension complicating depression occurrence in the population carrying A allele was 1.881 times that of carrying G allele(OR =1.881,95 ％ CI:1.261-2.807,P＜0.01).The various genotypes frequencies had no statistical difference between the elderly hypertension group and elderly hypertension complicating depression group(P＞0.05).However,the COMT 1947A/G allele frequencies had statistical difference between the two groups (P＜0.05).The A allele frequencies in the hypertension complicating depression group was 54.08％,which was higher than 42.50％ in the elderly hypertension group (P＜0.01),moreover the risk of depression occurrence in the population carrying A allele was 1.593 times that of carrying G allele(OR=1.593,95％CI:1.071-2.37,P＜0.01).Conclusion COMT gene polymorphism could have correlation with the occurrence of elderly hypertensive complicating depression.Detecting COMT 1947 locus genotype in elderly patients with hypertension can serve as an important indicator for predicting depression occurrence.

Objective To investigate the effect of probiotics on the blood lipid metabolism of elderly patients with coronary artery disease (CHD).Methods The clinical data of 100 elderly CHD patients who were admitted in our hospital from May 2012 ～November 2015 were collected.The enrolled patients were randomly divided into observation group and control group,50 cases in each group.All patients were routinely given medication for secondary prevention of CHD,patients in the observation group were additionally given oral probiotics.Then we observed the changes in the lipid levels of patients before and after 12 weeks treatment.Results The serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) of patients in the observation group were improved more significantly than the control group,the difference was significant (P＜0.05).The serum total High-density lipoprotein cholesterol (HDL-C) was improved more significantly than the control group.Conclusion Probiotics adjuvant therapy can significantly improve the blood lipid indexes in elderly CHD patients.

OBJECTIVE:To establish the fingerprint of Artemisia apiacea to identify common model and evaluate the quality coherence of the commercially available A. apiacea decoration pieces in Chongqing. METHODS:HPLC method was performed on the column of Waters XTerra C18 with the mobile phase consisted of methanol-0.1% phosphoric acid(gradient elution)at the flow rate of 1.0 ml/min. The detection wavelength was 220 nm,column temperature was 30 ℃ and the sample size was 10 μl. The simi-larity of 12 batches of samples was evaluated by TCM Chromatogram Fingerprint Similarity Evaluation System(2004A edition);a common model of fingerprints was identified by principal component analysis(PCA)and cluster analysis(CA). RESULTS:Total-ly 11 batches of samples were screened to establish common model of fingerprints and 16 common peaks were obtained,among which,3 common components were identified;RSDs of precision,stability and reproducibility tests were lower than 2.53%. The similarity of 11 batches of A. apiacea and reference chromatogram was more than 0.990. CONCLUSIONS:The method is stable and easy,and can provide reference for the scientific quality evaluation and control of A. apiacea;the quality of commercially available A. apiacea decoration pieces is generally good,however,there is still a little number of batches with poor quality. The production procedures and supervision of A. apiacea decoration pieces should be strengthened.