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Objective To explore the "clinical normal reference range" of pulpal blood flow (PBF) in the physiological state in an effort to provide a reference for clinical diagnosis and treatment. Methods According to the working principle and operational considerations of laser Doppler flowmetry (LDF), the PBF blood flow value of the first molars of the upper and lower mandibles of normal adults was detected by LDF, and the clinical reference value range under physiological conditions was analyzed and calculated. The differences in PBF values by sex, dental position and location (left and right side, upper and lower jaw) were analyzed. Results A total of 200 normal adult participants with an average age of (22.76 ± 3.26) years were included. The cohort included 95 males and 105 females, with a total of 800 first molars. Neither the PBF values of the left and right first molars nor the PBF values of the upper and lower first molars in males or females significantly differed (P>0.05). The PBF value for females was higher than that of males. Specifically, the clinical reference PBF values for males and females were (8.56 ± 3.25) PU and (9.51 ± 3.47) PU, respectively. Conclusion The PBF values of normal adult first molars in healthy subjects were higher in females than in males, and in the PBF values of first molars of the same sex did not significantly differ between the left side and right side or upper and lower jaw; these values could be used as a reference for the selection of control teeth.

Objective Method Result Conclusion The principles of limb reconstruction are crucial for treatment success, but there is no unified standard for complex limb deformities. The aim of this study was to analyze the characteristics of the cases of post‐traumatic lower limb deformity and explore the new principle of limb reconstruction.A retrospective analysis was conducted of 148 patients with post‐traumatic lower limb deformity who underwent surgery from May 1978 to December 2023; 85 were males (57.4%) and 63 were females (42.6%); 65 cases of left side (43.9%), 79 cases of right side(53.4%), and 4 cases were on both sides (2.7%), the average age was 24.64 years (5–69). There were 4 cases suffering hip deformities, 40 cases of femoral deformities, 18 cases from knee, 40 cases from tibiofibular, 93 cases of foot and ankle deformities, and some patients also had two or more types. All patients underwent surgical intervention in an average of 40.5 months (12–96) after injury. According to the evaluation of limb deformities, deformity correction and functional reconstruction with external fixation were implemented, following the principle of “one walking, two lines, and three balances.” The clinical evaluation adopts the criteria of Qinsihe lower limb deformity correction and functional reconstruction.148 patients with post‐traumatic lower limb deformities were followed up for 40.9 (12–356) months. The main surgical procedures implemented were tendon lengthening and soft tissue release (84 cases), osteotomy (93 cases), joint fusion (30 cases), and tendon transposition (16 cases); there were multiple surgical procedures in some patients. Among them, 124 cases used external fixators for stress control and 27 cases used internal fixation, while 3 cases used plaster or brace. There were 5 wire reactions postoperatively, which improved after dressing change and oral antibiotics. There were 2 pin infections, which improved by pin removing. No surgical related deep infections occurred, and no surgical related neurovascular damage occurred. At the last follow‐up, all limb deformities were corrected, limb function improved, and the results of treatment was very satisfactory. According to Qinsihe evaluation criteria for lower limb deformities, 74 cases were excellent, 56 cases good, and 18 cases fair, with an excellent and good rate of 87.84%.Stress control with external fixation is effective, safe, and controllable in correcting and reconstructing post‐traumatic lower limb deformities. The principle of “one walking, two lines, and three balances” plays an important role in the entire process of stress control limb reconstruction. [ABSTRACT FROM AUTHOR]

Background: Machine learning (ML) is increasingly used to predict the prognosis of numerous diseases. This retrospective analysis aimed to develop a prediction model using ML algorithms and to identify predictors associated with the recurrence of hallux valgus (HV) following surgery. Methods: A total of 198 symptomatic feet that underwent chevron osteotomy combined with a distal soft tissue procedure were enrolled and analyzed from 2 independent medical centers. The feet were grouped according to nonrecurrence or recurrence based on 1-year follow-up outcomes. Preoperative weightbearing radiographs and immediate postoperative nonweightbearing radiographs were obtained for each HV foot. Radiographic measurements (eg, HV angle and intermetatarsal angle) were acquired and used for ML model training. A total of 9 commonly used ML models were trained on the data obtained from one institute (108 feet), and tested on the other data set from another independent institute (90 feet) for external validation. Optimal feature sets for each model were identified based on a 2000-resample bootstrap-based internal validation via an exhaustive search. The performance of each model was then tested on the external validation set. The area under the curve (AUC), classification accuracy, sensitivity, and specificity of each model were calculated to evaluate the performance of each model. Results: The support vector machine (SVM) model showed the highest predictive accuracy compared to other methods, with an AUC of 0.88 and an accuracy of 75.6%. Preoperative hallux valgus angle, tibial sesamoid position, postoperative intermetatarsal angle, and postoperative tibial sesamoid position were identified as the most selected features by several ML models. Conclusion: ML classifiers such as SVM could predict the recurrence of HV (an HVA >20 degrees) at a 1-year follow-up while identifying associated predictors in a multivariate manner. This study holds the potential for foot and ankle surgeons to effectively identify individuals at higher risk of HV recurrence postsurgery. [ABSTRACT FROM AUTHOR]

Objective To observe the root and root canal morphology of mandibular second molars in Western Guangxi by CBCT, to provide a reference for clinical diagnosis and treatment. Methods In total, 564 patients′ 1 128 mandibular second molars that satisfy the inclusion criteria were analyzed with a planmecaromexis CBCT machine and its own image analysis software. The patients′ gender, age and ethnic differences in the root and canal morphology and the symmetry of the bilateral root and canal were statistically analyzed. Results Among the 1 128 mandibular second molars, 662 were the Zhuang ethnic group and 384 were the Han ethnic group, and 82 were other ethnic groups; the double root type and C-shaped root type accounted for a relatively high proportion: 73.94% and 24.47%, respectively. The detection rates of the double root type were higher in males than in females (P < 0.05); the detection rates of the C-shaped root type were higher in females than in males (P

Background: Fluid management in hemodialysis patients is critical, but there are no optimal care protocols. The aim of this study was to investigate the impact of a home-based care model on the fluid loads in patients undergoing sustained hemodialysis., Methods: This is a single-center, randomized, controlled clinical study. 124 patients who underwent maintenance hemodialysis were randomized into an experimental group (EG) and a control group (CG) (n=62 for each group). The EG underwent a home-based care model, and the CG was cared for using a routine nursing model. They were compared in terms of their blood pressure, BMI, pulse wave velocity (PWV), and N-terminal (NT)-pro hormone BNP (NT-proBNP) levels before the nursing and at 12 months of follow-up., Results: There was no significant difference in the baseline data between the two groups (P>0.05). At 12 months of intervention, the EG had better systolic blood pressure (139±9 mmHg vs. 144±13 mmHg, P=0.04) and NT-proBNP levels (6148 pg/ml vs. 8552 pg/ml, P=0.01) than the CG. There was no significant difference between the two groups in terms of BMI, DBP or PWV or in their adverse event rates., Conclusion: The home-based care model is beneficial for fluid management in hemodialysis patients., Competing Interests: None., (AJTR Copyright © 2021.)

Pulse signal contains a wealth of biological and pathological information. However, it is susceptible to the influence of various factors which results in poor signal quality, and causes the device to generate false alarms. First the pulse signals are processing into discrete symbols, and then compare the test signal with the pulse template by using Dynamic Time Warping (DTW) to get the threshold for which can be used to find the interference segment of the test signal. By analyzing the DTW distance of the pulse signal, we can get the interference degree of the signal, then the quality level of the plus signal can be defined by the relationship between the interference degree and quality of the signal. The 1 055 group pulse signals provided by MIMIC II physiological database are used to train and test the signal quality assessment algorithms, and compared with other existing algorithms. The results show that the algorithms can accurately detect interference segments in pulse signal and reflect the quality of it.

Western blot of synovial fluid has been widely used for osteoarthritis (OA) research and diagnosis, but there is no ideal loading control for this purpose. Although β-actin is extensively used as loading control in western blot, it is not suitable for synovial fluid because it is not required in synovial fluid as a cytoskeletal protein. A good loading control for synovial fluid in OA studies should have unchanged content in synovial fluids from normal and OA groups, because synovial fluid protein content can vary with changes in synovial vascular permeability with OA onset. In this study, we explore the potential of using α1-antitripsin (A1AT) as loading control for OA synovial fluid in western blot. A1AT level is elevated in inflammatory conditions such as rheumatoid arthritis (RA). Unlike RA, OA is a non-inflammation disease, which does not induce A1AT. In this study, we identified A1AT as an abundant component of synovial fluid by Mass Spectrometry and confirmed that the level of A1AT is relative constant between human OA and normal synovial fluid by western blot and ELISA. Hence, we proposed that A1AT may be a good loading control for western blot in human OA synovial fluid studies provided that pathological conditions such as RA or A1AT deficiency associated liver or lung diseases are excluded.