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Objective To explore the application of membranous concept in vestibular schwannoma surgery. Methods A total of 39 patients with vestibular schwannoma who received membranous surgical treatment in The First Affiliated Hospital of Anhui Medical University from May 2020 to June 2021 were enrolled. Through the retrosigmoid approach, the intraoperative electrophysiological monitoring was performed, and the membranous concept was used to separate the brain stem of the tumor and the interface between the tumor and the facial nerve and the cochlear nerve. Facial nerve function was evaluated by the House⁃Brackmann (H⁃B) grade and hearing was evaluated by the American Academy of Otolaryngology⁃Head and Neck Surgery（AAO⁃HNS）scale at one day, one week and one year after surgery. Results Total resection was performed in 31 cases (79.49%) and nearly total resection in 8 cases (20.51%). Facial nerve anatomical preservation was achieved in all patients, and facial nerve function returned to normal or nearly normal (H⁃B grade Ⅰ-Ⅱ) 84.62% (33/39), moderate facial paralysis (H⁃B grade Ⅲ) 10.27% (4/39), moderate and severe facial paralysis (H⁃B grade Ⅳ) 5.13% (2/39) on the first day after surgery. One week after surgery, 71.79% (28/39) of patients with normal or nearly normal facial nerve function, 15.38% (6/39) of moderate facial paralysis, 10.27% (4/39) of moderate and severe facial paralysis, and 2.56% (1/39) of severe facial paralysis (H⁃B grade Ⅴ). One year after surgery, 92.31% (36/39) of patients with facial nerve function returned to normal or nearly normal, 5.13% (2/39) of patients with moderate facial paralysis, and 2.56% (1/39) of patients with moderate and severe facial paralysis. Among the 10 patients (25.64%) who retained effective hearing before surgery (AAO⁃HNS grade≥C), there were 4, 3 and 6 cases at one day, one week and one year after surgery, respectively. Those who did not retain effective hearing before surgery did not recover effective hearing after surgery. According to the comparison of tumor volume and nature, the proportion of patients with normal facial nerve function (H⁃B grade Ⅰ) in the tumor volume≤3 cm group was higher than that in＞3 cm group [12/18 vs. 19.05% (4/21); Fisher's exact probability: P=0.006], the proportion of patients with normal facial nerve function in the solid tumor group was higher than that in cystic group [71.43% (15/21) vs. 1/10; Fisher's exact probability: P=0.010] at one year after surgery. Conclusions The membranous concept in vestibular schwannoma surgery can protect facial nerve function well, and has a positive effect on the protection of cochlear nerve and brain stem.

The progression of atherosclerotic plaque is one of the most important causes of cardiovascular events in patients with atherosclerotic cardiovascular diseases (ASCVD). With the help of intravascular imaging, such as intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS), it is possible to show the details of the plaque morphological characteristics. Current research suggested that lipid-lowering drugs lead to plaque stabilization and regression mainly by reducing low-density lipoprotein cholesterol (LDL-C). This review focuses on the effects of lipid-lowering therapy on coronary atherosclerotic plaque evaluated by intravascular imaging.

The aim of our study is to evaluate the association of rotational atherectomy (RA) operation procedural indices and baseline lipid parameters with the prognosis of the patients with severe coronary calcification who underwent RA. Our study population consists of 287 patients treated with RA in Fuwai Hospital from January 2013 to December 2019. We analyzed the patients' rotation procedural indices including the number of burrs, the size of burrs, approach site, the size of guiding catheter, along with the baseline level of lipoprotein(a) (Lp(a)), low-density lipoprotein-cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP) to examine the association of these measurements with the prognosis of these patients using Cox regression analysis and Kaplan-Meier survival analysis. We find that during the follow-up period of 56.7 months with the median, the use of single burr in the patients who underwent RA was significantly associated with the occurrence of cumulative major adverse cardiac events (MACE) when compared with using non-single burrs [Hazard Ratio (HR) 0.43, 95% confidence interval (95% CI) 0.24-0.77, p = 0.004] from univariate Cox regression analysis; (HR 0.36, 95% CI 0.20-0.66, p = 0.001) from multivariate Cox regression analysis In addition, we find a higher event-free survival rate in the single-burr group after Kaplan-Meier survival analysis (Log rank p = 0.0033). However, there was no significant association of the size of burrs with the occurrence of MACE (HR 0.90, 95% CI 0.47-1.73, p = 0.76). Similarly, we find no significant associations between the approach site and the occurrence of MACE (HR 0.79, 95% CI 0.24-2.53, p = 0.69), the baseline Lp(a) (HR 1.07, 95% CI 0.76-1.49, p = 0.71), the level of LDL-C (HR 0.83, 95% CI 0.55-1.26, p = 0.38) or hs-CRP (HR 0.85, 95% CI 0.45-1.58, p = 0.60). We find that the patients who receive RA with a single burr have better outcomes than those who receive RA with non-single burrs. Moreover,we find that the number of burrs used in RA instead of the size of burrs, approach site, the size of guiding catheter, or baseline levels of Lp(a), LDL-C or hs-CRP had significant association with the prognosis of RA patients. [ABSTRACT FROM AUTHOR]

Objective To evaluatethe detection rate, typing, and therapeutic effect of second mesiobuccal canals(MB2) of first molars under dental operating microscope.Methods 88 maxillary molars with the presence of MB2 through cone beam computed tomography (CBCT) were collected, in which 68 were received root canal treatment and 20 were received root canal retreatment because of the missing canal of MB2 respectively. The type of mesiobuccal root canal in the former 68 maxillary molars were analyzed under CBCT. The 68 maxillary molars were divided into 2 groups, with 34 in each group. The experienment group received treatment under dental operating microscope, while the control group under naked eyes. MB2 detection rate, treatment and retreatment effect between two groups were compared. The latter 20 maxillary molars were also seperated into 2 groups, in which 10 cases were treated under microscope and 10 cases were treated under naked eye. The effect of retreatment was observed.Results The type of mesiobuccal root canal in 68 maxillary molars under CBCT were mainlytypeⅡand typeⅢ, with the proportion of 77.9% (53 cases) and 22.1% (15 cases) respectively. The detection rate of MB2 in the experimental group was 100%, and 91.2% (30 cases) in the control group, a statistical difference can be found between 2 groups (P < 0.05). 97.5% (33 cases) of the experimental group was successfully treated, and 79.4% (27 cases) for the control group (P < 0.05). The success rate of retreatment under microscope was 60% (6 cases), which was significantly higher than that of the naked eye (P < 0.05). In 3-month and 6-month follow-up, the treatment effect in experimental group was significantly better than the control group (P < 0.05).Conclusion Dental microscope can help to increase MB2 detection rate and improve treatment and retreatment effect.

Objective To investigate the anatomical features of alveolar bone in gummy smile patients with cone beam computed tomography (CBCT), and provide the reference for miniscrews implanted in anterior alveolar crest.Methods A total of 63 cases of adults with gummy smile were selected for the study and the CBCT data of jaw bones were obtained. The mesiodistal interradicular distances, buccal-lingual thickness and buccal cortical bone thickness were measured at three different level which included 4 mm,6 mm and 8 mm above the alveolar crest.Results The mesiodistal interradicular distances increased along with distance between measure level and alveolar crest.(P0.05). The buccal cortical bone thickness increased along with distance between measure level and alveolar crest (P

Abstract Background In 2003, Plasmodium vivax malaria has re-emerged in central eastern China including Yongcheng prefecture, Henan Province, where no case has been reported for eleven years. Our goals were to detect the space-time distribution pattern of malaria and to determine significant environmental variables contributing to malaria incidence in Yongcheng from 2006 to 2010, thus providing scientific basis for further optimizing current malaria surveillance and control programs. Methods This study examined the spatial and temporal heterogeneities in the risk of malaria and the influencing factors on malaria incidence using geographical information system (GIS) and time series analysis. Univariate analysis was conducted to estimate the crude correlations between malaria incidence and environmental variables, such as mosquito abundance and climatic factors. Multivariate analysis was implemented to construct predictive models to explore the principal environmental determinants on malaria epidemic using a Generalized Estimating Equation (GEE) approach. Results Annual malaria incidence at town-level decreased from the north to south, and monthly incidence at prefecture-level demonstrated a strong seasonal pattern with a peak from July to November. Yearly malaria incidence had a visual spatial association with yearly average temperature. Moreover, the best-fit temporal model (model 2) (QIC = 16.934, P2 = 0.818) indicated that significant factors contributing to malaria incidence were maximum temperature at one month lag, average humidity at one month lag, and malaria incidence of the previous month. Conclusions Findings supported the effects of environment factors on malaria incidence and indicated that malaria control targets should vary with intensity of malaria incidence, with more public resource allocated to control the source of infections instead of large scale An. sinensis control when malaria incidence was at a low level, which would benefit for optimizing the malaria surveillance project in China and some other countries with unstable or low malaria transmission.

Abstract Background Cost estimation is a central feature of health economic analyses. The aim of this study was to use a micro-costing approach and a societal perspective to estimate aggregated costs associated with cervical cancer screening, diagnosis and treatment in rural China. Methods We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 2008–9. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion. Results Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, self-sampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64,$7.49,$7.95,$3.90 and $5.76, respectively. Screening costs were robust to screening volume ( Conclusions Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower-volume situations, which is a key consideration for the scale-up phase of new programs. The study’s findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China.

Abstract Background The knowledge of mosquito species diversity and the level of anthropophily exhibited by each species in a region are of great importance to the integrated vector control. Culicine species are the primary vectors of Japanese encephalitis (JE) virus and filariasis in China. Anopheles sinensis plays a major role in the maintenance of Plasmodium vivax malaria transmission in China. The goal of this study was to compare the abundance and host-seeking behavior of culicine species and An. sinensis in Yongcheng city, a representative region of P. vivax malaria. Specifically, we wished to determine the relative attractiveness of different animal baits versus human bait to culicine species and An. sinensis. Results Culex tritaeniorhynchus was the most prevalent mosquito species and An. sinensis was the sole potential vector of P. vivax malaria in Yongcheng city. There were significant differences (P < 0.01) in the abundance of both An. sinensis and Cx. tritaeniorhynchus collected in distinct baited traps. The relative attractiveness of animal versus human bait was similar towards both An. sinensis and Cx. tritaeniorhynchus. The ranking derived from the mean number of mosquitoes per bait indicated that pigs, goats and calves frequently attracted more mosquitoes than the other hosts tested (dogs, humans, and chickens). These trends were similar across all capture nights at three distinct villages. The human blood index (HBI) of female An. sinensis was 2.94% when computed with mixed meals while 3.70% computed with only the single meal. 19:00~21:00 was the primary peak of host-seeking female An. sinensis while 4:00~5:00 was the smaller peak at night. There was significant correlation between the density of female An. sinensis and the average relative humidity (P < 0.05) in Wangshanzhuang village. Conclusions Pigs, goats and calves were more attractive to An. sinensis and Cx. tritaeniorhynchus than dogs, humans, and chickens. Female An. sinensis host-seeking activity mainly occurred from 19:00 to 21:00. Thus, we propose that future vector control against An. sinensis and Cx. tritaeniorhynchus in the areas along the Huang-Huai River of central China should target the interface of human activity with domestic animals and adopt before human hosts go to bed at night.