Comparison of three different types of splints and templates for maxilla repositioning in bimaxillary orthognathic surgery: a randomized controlled trial

The selection and implementation of a plan for maxillary surgery is of the utmost importance in achieving the desired outcome for the patient undergoing two-jaw orthognathic surgery. Some splint-based and splintless methods, accompanied by computer-assisted techniques, are helpful in improving surgical plan implementation. However, randomized controlled trials focused on this procedure are lacking. This study included 61 patients who underwent bimaxillary surgeries. The patients were randomly assigned to a conventional resin occlusal splint (CROS) group, a digital occlusal splint (DOS) group, or a digital templates (DT) group, in a 1:1:1 ratio. The mean linear distance between the planned and actual postoperative positions of eight selected points on the surfaces of the maxillary teeth was selected as the outcome measure. The distance was significantly smaller in the DT group (1.17 ± 0.66 mm) when compared to both the CROS group (2.55 ± 0.95 mm, P < 0.05) and DOS group (2.15 ± 1.12 mm, P < 0.05). However, the difference between the CROS group and DOS group was not statistically significant. These findings indicate that using digital templates results in the best performance in transferring the surgical plan to the operation environment as compared to the other two types of splints. This suggests that the application of digital templates could provide a reliable treatment option.     

老年综合评估及干预策略影响老年慢性阻塞性肺疾病患者肺康复及预后的研究进展

老年综合评估(comprehensive Geriatric Assessment,CGA)是医务人员通过多维度、多学科的方法,对老年患者的共病状态、心理状态、衰弱状态等进行全面评估的诊断程序[1],其重要意义在于通过对多器官功能的综合评估,及时发现老年患者潜在的功能缺陷,及早制定个体化诊疗方案及康复措施并评估预后。     

Mechanisms of vascular dysfunction in the interleukin-10–deficient murine model of preeclampsia indicate nitric oxide dysregulation

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Time-varying association of second primary malignancy and long-term survival outcomes in patients with head and neck cancer

A high risk of developing second primary malignancy (SPM) has been reported among head and neck cancer patients. Here, we aimed to statistically quantify the impact of SPM development on the survival of head and neck cancer patients. Our study was conducted using the Surveillance, Epidemiology and End Results database to collect the data of 48 316 patients who received curative surgical resection for initial primary head and neck squamous cell carcinoma (IP-HNSCC) in 1975 to 2019. SPM diagnosis was treated as a time-varying covariate and multivariable Cox regression analysis was conducted to estimate the association between SPM development and survival, overall or by the subsite of IP-HNSCC. Of the included patients, 11 238 patients (23.3%) developed SPM during the follow-up period. A significant reduction in survival was observed among patients with SPM (hazard ratio [HR] for overall survival, 3.30; 95% confidence interval [CI]: 3.20-3.41). The impact of SPM development on reduced survival was more significant in patients with localized IP-HNSCC vs regional IP-HNSCC (HR_OS, 3.41; 95% CI: 3.24-3.6 vs HR_OS, 3.18; 95% CI: 3.05-3.31; P for interaction <.001). The survival impact of SPM development was more evident in younger patients than in older patients. SPM in lung and bronchus was associated with the most pronounced reduction in survival, overall and across all subsites of HNSCC. Our results indicated that SPM development led to a significant reduction in survival. A greater survival benefit may be achieved through intensive surveillance for SPM in lung and bronchus targeting younger patients and those with localized HNSCC.     

主动脉夹层患者术前决策现状及影响因素分析

目的 了解主动脉夹层患者术前决策现状并分析其影响因素，为决策辅助方案构建提供参考。方法 在患者知情同意的基础上，采用一般资料调查表、决策参与量表、决策冲突量表对110例主动脉夹层患者进行调查。结果 主动脉夹层患者术前决策过程中，59例(53.64%)倾向于与医生共享决策，但实际参与过程中60例(54.54%)为被动决策。患者决策冲突得分45.91±9.30。多元逐步回归结果显示，并存疾病数量、婚姻状况、家庭月收入、以往就医体验、实际参与角色是主动脉夹层患者决策冲突的主要影响因素(P<0.05,P<0.01)。结论 主动脉夹层患者术前决策期望与实际参与存在差异，决策冲突处于高水平，且受多因素影响。医务人员应加强与患者的沟通，尊重患者决策偏好，以信息支持为基础构建决策辅助工具，为患者提供适当决策支持，降低决策冲突。     

卒中后认知障碍与软脑膜侧支循环的代偿程度及静脉溶栓治疗的相关性分析

目的：比较急性缺血性卒中患者卒中后认知障碍的发生与软脑膜侧支循环的代偿程度及是否接受静脉溶栓治疗的相关性。方法：前瞻性收集2019年1月至2021年3月在石河子市人民医院住院的急性前循环脑梗死患者161例，获取患者入院时人口学资料，包括是否溶栓、性别、合并症等；通过蒙特利尔认知评估量表（Montreal cognitive assessment,MoCA）评分、简易精神状态检查量表（mini mental state examination,MMSE）评分评估患者认知功能；入院时美国国立卫生院卒中量表（National Institute of Health Stroke Scale,NIHSS）评分获取患者神经功能缺损症状；通过Blessed行为量表（Blessed behavior scale,BBS）评分评估患者的日常生活能力；通过区域软脑膜评分（regional leptomeningeal collateral score,rLMC）获取患者软脑膜侧支循环；根据卒中后6个月是否合并认知障碍分为认知障碍组和非认知障碍组，采用logistic多因素回归方法进行统计比较，分析2组患...     

1972—2016年江苏省启东市胃癌死亡流行特征分析

目的分析江苏省启东市1972—2016年胃癌死亡流行特征。方法收集启东市1972—2016年恶性肿瘤死亡登记数据库及历年人口资料, 计算死亡率、中国人口标化率(中标率)、世界人口标化率(世标率)、35～64岁截缩率、0～74岁累积死亡率、累积死亡风险、变化百分比、死亡率年均变化百分比。结果 1972—2016年启东市胃癌死亡例数为15 863例, 占全部恶性肿瘤死亡例数的16.04%, 胃癌死亡率为31.37/10万, 中标率为12.97/10万, 世标率为21.39/10万, 35～64岁截缩死亡率为28.86/10万, 0～74岁累积死亡率为2.54%, 胃癌死亡累积风险为2.51%。男性死亡10 114例, 男性死亡率、中标率、世标率分别为40.53/10万、17.98/10万和30.13/10万;女性死亡5 749例, 女性死亡率、中标率、世标率分别为22.45/10万、8.52/10万和13.92/10万。25岁以下各年龄组的死亡率<1/10万, 死亡率随年龄的增长而升高, 50～岁组达到并超过人群的平均死亡率水平, 80～岁组达到死亡高峰。1972—2016年间胃癌死...