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OBJECTIVE: Cone Beam Computed Tomography (CBCT) was used to observe and describe the distribution of canalis sinuosus (CS) in the Chinese population and the location of CS in the maxillary alveolar bone, so as to help oral surgeons evaluate the intraoperative risk and prognosis before maxillary surgery and reduce the complications caused by the injury of this structure in anterior surgery. PATIENTS AND METHODS: CBCT images of 600 patients admitted from 2021 to 2022 were collected to observe the anatomical structure of CS in the maxillary region. The following parameters were recorded: age, sex, number of CS, left and right distribution of CS, CS diameter, and location. Statistical analysis was performed on all of the collected data. RESULTS: The discovery rate of CS in this study was 59.75%, and it is commonly found in the lateral incisor area (64.82%). No significant difference can be found in the presence and number of CS in different gender and age groups (p>0.05). CONCLUSIONS: The use of high-resolution CBCT before implantation is of irreplaceable significance in the diagnosis and analysis of CS, which is conducive to reducing implantation complications and failure rate. The incidence of CS was independent of age or sex, while the location of CS was statistically significant. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to investigate whether pre-existing chronic obstructive pulmonary disease (COPD) was an independent predictor for adverse outcomes in coronavirus disease 2019 (COVID-19) patients. MATERIALS AND METHODS: We searched electronic databases, including PubMed, Web of Science, EMBASE, and Chinese National Knowledge Infrastructure (CNKI) to screen for eligible articles. A quantitative meta-analysis was performed on the basis of adjusted effect estimates. RESULTS: We observed that COPD was significantly associated with an increased risk of adverse outcomes in COVID-19 patients, which is based on 18 studies with 26,075 cases reporting adjusted effect estimates (pooled effect = 1.53, 95% confidence interval (CI): 1.29-1.8; I2 = 35.4%, random-effects model). CONCLUSIONS: We found that pre-existing COPD was an independent risk factor for predicting the adverse outcomes in COVID-19 patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Osteoporosis (OP) has a high incidence and can be found in multiple age groups. The bone marrow mesenchymal stem cells (BMSCs) have the potential for self-renewal and multi-directional differentiation, which are often used for investigating the differentiation function of osteoporosis bone marrow mesenchymal stem cells. γ-glutamyl carboxylase (GGCX) is a carboxylase-related carboxylase and was observed to be abnormally expressed in osteoarthritis. However, the role and related mechanisms of GGCX in OP have not been fully elucidated. This work aimed to evaluate the effect of GGCX on the differentiation function of BMSCs. PATIENTS AND METHODS: Sprague-Dawley rats were randomly divided into the OP group prepared by ovariectomy and sham group. GGCX expression was tested by enzyme-linked immunosorbent assay (ELISA). BMSCs were isolated from OP rats and transfected with pcDNA-GGCX plasmids. BMSC proliferation was detected by tetrazolium salt colorimetry (MTT) assay. The osteogenic and adipogenic differentiation of BMSCs was analyzed by alizarin red staining and oil red O staining. The ALP activity was determined by alkaline phosphatase (ALP) activity colorimetric assay. Real time-PCR was used to test the expressions of osteogenesis-related genes RUNX2 and OPN mRNA. Western blot was adopted to assess the TGFß/smad signaling pathway activity. RESULTS: GGCX expression was significantly decreased in the serum of OP rats compared with the sham group (p < 0.05). The transfection of pcDNA-GGCX plasmid significantly promoted BMSC cell proliferation, increased calcified nodule formation, inhibited adipogenic differentiation, enhanced ALP activity, elevated RUNX2, and OPN mRNA expressions, and upregulated TGFß1, Smad2, and Smad7 expressions (p < 0.05). CONCLUSIONS: GGCX secretion is reduced in osteoporosis. GGCX can regulate osteoporosis via promoting the TGFß/smad signaling pathway, facilitating BMSCs osteogenic differentiation, and inhibiting BMSCs adipogenic differentiation. [ABSTRACT FROM AUTHOR]

Background:The objective of this study is to analyse the factors affecting late toxicity for nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT).Methods:Seven hundred and eighty-nine consecutive NPC patients treated with IMRT at our centre from January 2003 to February 2008 were retrospectively analysed. Radiotherapy-related complications were categorised using the RTOG Late Radiation Morbidity Scoring Criteria and the Common Terminology Criteria for Adverse Events (Version 3.0). Two hundred and thirty-three patients were treated with IMRT alone (group 1) and 556 patients underwent cisplatin-based chemotherapy (group 2).Results:Median follow-up was 65 months (range, 4-106 months). The 5-year major late toxicity rate was significantly greater in group 2 than group 1 (63.2% vs 42.0%, P<0.001). Multivariate analyses showed that N category, T category and chemotherapy were significant factors. The maximal dose (Dmax) to the temporal lobe was a significant factor affecting temporal lobe injury (TLI), with a hazard ratio of 1.26 (95% confidence interval (CI), 1.18-1.35; P<0.001) per 1-Gy increase. The 5-year TLI rate increased from 0.8% for 284 lobes with Dmax <65.77 Gy to 27.1% for 176 lobes with greater doses (P<0.001). Logistic regression showed that the hazard ratio attributed to the parotid gland mean dose was 1.36 (95% CI, 1.21-1.53; P<0.001) per 1-Gy increase. Chemotherapy was not a significant factor (P=0.211).Conclusion:With the application of IMRT, the incidence of radiation-related complications has been reduced except for TLI. The significant factors affecting the risk of TLI included T category, chemotherapy and Dmax. [ABSTRACT FROM AUTHOR]

Density profiles in the pedestal region (H-mode) are measured in HL-2A and the characteristics of the density pedestal are described. Cold particle deposition by supersonic molecular beam injection (SMBI) within the pedestal is verified. Edge-localized mode (ELM) mitigation by SMBI into the H-mode pedestal is demonstrated and the relevant physics is elucidated. The sensitivity of the effect to SMBI pressure and duration is studied. Following SMBI, the ELM frequency increases and the ELM amplitude decreases for a finite duration. Increases in ELM frequency of fELMSMBI/fELM0 ~ 2-3.5 are achieved. This experiment argues that the ELM mitigation results from an increase in higher frequency fluctuations and transport events in the pedestal, which are caused by SMBI. These inhibit the occurrence of large transport events which span the entire pedestal width. The observed change in the density pedestal profiles and edge particle flux spectrum with and without SMBI supports this interpretation. An analysis of the experiment and a model shows that ELMs can be mitigated by SMBI with shallow particle penetration into the pedestal. [ABSTRACT FROM AUTHOR]

The fourth KSTARcampaign in 2011 concentrated on active edge-localized mode (ELM) control by various methods such as non-axisymmetric magnetic perturbations, supersonic molecular beam injection (SMBI), vertical jogs of the plasma column and edge electron heating. The segmented in-vessel control coil (IVCC) system is capable of applying n ≤ 2 perturbed field with different phasing among top, middle and bottom coils. Application of an n = 1 perturbed field showed a desirable ELM suppression result. Fast vertical jogs of the plasma column achieved ELM pace-making and ELMs locked to 50 Hz vertical jogs were observed with a high probability of phase locking. A newly installed SMBI system was used for ELM control and the state of mitigated ELMs was sustained by the optimized repetitive SMBI pulse for a few tens of ELM periods. A change in ELM behaviour was seen due to edge electron heating although the effect of ECH launch needs supplementary analyses. The ECEI images of suppressed/mitigated ELM states showed apparent differences when compared with natural ELMy states. Further analyses are ongoing to explain the observed ELM control results. [ABSTRACT FROM AUTHOR]

Experiments to study inward heat transport phenomena have been performed in the Tore Supra tokamak with off-axis electron cyclotron resonance heating (ECRH). Both power balance and perturbation transport analysis have been done for low-frequency (1 Hz) ECRH modulation experiments. Heat diffusivity and heat pinch have been separately determined by fitting the experimental data of the amplitude and phase of the Fourier transform of the modulated temperature with a linear transport model including convection term. Comparison with the critical gradient model has shown that the heat pinch previously obtained could include a pseudo-pinch due to the non-linearity of the diffusivity and an additional non-diffusive heat pinch. The pinch effect is reduced for higher densities. [ABSTRACT FROM AUTHOR]

Lipid peroxidation, protein oxidation and antioxidant status of serum and muscle in juvenile Jian carp ( Cyprinus carpio var. Jian) fed graded levels of methionine hydroxy analogue (MHA: 0, 5.1, 7.6, 10.2, 12.7, 15.3 g kg−1 diet) for 60 days were investigated. Both malondialdehyde and protein carbonyl content in serum and muscle decreased with increasing dietary MHA level up to 5.1-10.2 g kg−1 diet ( P < 0.05). Anti-hydroxyl radical and activities of catalase, glutathione peroxidase and glutathione reductase in muscle and serum, as well as anti-superoxide anion, superoxide dismutase activity and glutathione content in serum, increased with optimal MHA supplement ( P < 0.05). Meanwhile, glutathione- S-transferase activity in serum showed a downward trend with dietary MHA up to 7.6 g kg−1 diet ( P < 0.05). These results indicated that MHA improved antioxidant status and depressed lipid and protein oxidation in serum and muscle. [ABSTRACT FROM AUTHOR]

Image watermarking has become a popular technique for authentication and copyright protection. However, many proposed image watermarking techniques are sensitive to affine transforms, such as rotation, scaling and translation. Here, a local affine transform invariant watermarking is designed and tested against attacks performed by Stirmark using the Krawtchouk moment invariants. Watermark is inserted into the perceptually significant Krawtchouk moment invariants of the original image, and watermarking based on Krawtchouk moment invariants are local, that is, the embedded watermark affects only a selected portion of the original image, the position of which can be decided by the user. This, in effect, permits the watermark to be embedded at the portion of the image which is most significant information-wise. This also means that the watermark is especially robust to cropping. Independent component analysis (ICA) is utilised by detector to extract the perfect watermark blindly. The computational aspects of the proposed watermarking are also discussed in detail. Experimental results have demonstrated that the proposed watermarking technique has a good robustness against other attacks performed by Stirmark including affine transform, cropping, filtering, image compression and random geometric distortions. It is indicated that the proposed watermarking has superior advantages over the existing ones in many aspects. [ABSTRACT FROM AUTHOR]

The propagation dynamics of resonant magnetic perturbation fields in KSTAR H-mode plasmas with injection of small edge perturbations produced by a supersonic molecular beam injection is reported for the first time. The results show that the perturbation field first excites a plasma response on the q=3 magnetic surface and then propagates inward to the q=2 surface with a radially averaged propagation velocity of resonant magnetic perturbations field equal to 32.5 m/s. As a result, the perturbation field brakes the toroidal rotation on the q=3 surface first causing a momentum transport perturbation that propagates both inward and outward. A higher density fluctuation level is observed. The propagation velocity of the resonant magnetic perturbations field is larger than the radial propagation velocity of the perturbation in the toroidal rotation. [ABSTRACT FROM AUTHOR]

We report on model studies of stimulated L → H transitions. These studies use a novel reduced mesoscale model. Studies reveal that L → H transitions can be triggered by particle injection into a subcritical state (i.e., P < PThresh). Particle injection alters the edge mean flow shear via changes of density and temperature gradients. The change of edge mean flow shear is critical to turbulence collapse and the subsequent stimulated transition. For low ambient heating, strong injection is predicted to trigger a transient turbulence collapse. We predict that repetitive injection can maintain the turbulence collapse and so sustain a driven H-mode-like state. The total number of particles required to induce a transition by either injection or gas puffing is estimated. Results indicate that the total number of injected particles required is much smaller than that required for inducing a transition by gas puffing. Thus, we show that internal injection is more efficient than gas puffing of comparable strength. We also observe that zonal flows do not play a critical role in stimulated transitions. [ABSTRACT FROM AUTHOR]

Objective: To evaluate lower facial profile in females in different skeletal patterns. Methods: Investigation pictures of three females with beautiful lower facial profiles from Department of Orthodontics, Henan Stomatological Hospital were collected. The skeletal patterns of these females were classified as average, low and high angle, respectively.Upper lip process point (UL) was moved backwards horizontally to reach towards the E line and go even further gradually in above pictures. The distance changed according to E line was defined as DE value. If UL was in front of E line,DE value was denoted as positive, or else negative. Collectively, we obtained 30 pictures (10 pictures in each skeletal facial type) with different DE values (-5, -4, -3, -2, -1, 0, 1, 2, 3, 4 mm), which were divided into average, low and high angle group according to the skeletal facial type. The pictures were evaluated by 144 randomly-selected adult orthodontic patients [66 males, 78 females, aged (29.4±7.7) years] who visited Department of Orthodontics, Henan Stomatological Hospital from June to September, 2019 and 138 orthodontists (including qualified orthodontists and postgraduate orthodontic students [60 males, 78 females, aged (32.2±7.1) years] who participated orthodontics conferences in Henan Stomatological Hospital in June, 2019. The acceptance rate was calculated and rate above 60% was deemed as acceptable DE range. Evaluators were also asked to choose the most esthetic profiles for the best DE value in each skeletal facial type.Data discrepancy was analyzed using Kruskal-Wallis analysis and chi -square test. Results: Most accepted DE was -2 mm among total investigators including orthodonticpatients and orthodontists. There was no difference in total acceptance rate between orthodontists and patients ( P> 0.05). There was statistic difference in total acceptance rate in different skeletal patterns between orthodontic patients and orthodontists ( P< 0.05). In total investigators, total acceptance rate was 62.1% (1 752/2 820) in average angle group, 55.4%(1 563/2 820) in high angle group and 33.5%(946/2 820) in low angle group, respectively. Acceptable DE range in three facial types was -4~2 mm (average angle), -2~2 mm (high angle) and -2~-1 mm (low angle), respectively. Conclusions: According to the evaluation of both orthodontic patients and orthodontists, the best DE was-2 mm.Total acceptance rate and acceptable DE range ranked first in average angle group, second in high angle group and third in low angle group.

Objective: To compare long-term efficacy between watch and wait (W&W) strategy and total mesorectal excision (TME) in patients who were diagnosed with locally advanced rectal cancer (LARC) and attained clinical complete response (cCR) after neoadjuvant chemoradiotherapy (nCRT). Methods: A retrospective cohort study was carried out. A total of 238 patients with stage II-III LARC exhibiting cCR after nCRT in Sun Yat-sen University Cancer Center from September 16, 2010 to January 9, 2018 were enrolled. Patients who were diagnosed with other malignant tumor within 5 years, did not receive regular follow-up in our center for more than 1 year and had no complete examination items after nCRT were excluded. Of 238 patients, 151 were male and 87 were female with a median age of 57 (27-83) years old. According to TNM stage, 61 cases were cII, 177 cases were cIII. Concurrent chemoradiotherapy (CCRT) was performed in 20 patients. CCRT plus induction/consolidated chemotherapy was performed in 218 patients. Intensity-modulated radiotherapy (IMRT) was applied to radiotherapy. The median radiation dose was 50 Gy/25 Fr for both the primary tumor and clinical target volumes, and the total dose was 45.0 to 50.6 Gy for 227 patients. In 27 patients, single-agent fluorouracil or capecitabine was used as concurrent chemotherapy. But in the other 211 patients, a combined regimen of oxaliplatin and fluorouracil or capecitabine was used. After nCRT, 59 and 179 patients received W&W (W&W group) and TME 6-12 weeks later (TME group), respectively. After the ending of treatment, patient was interviewed one time every 3 months and after 3 years, one time every six months. Overall survival (OS) rate, distant-metastasis-free survival (DMFS) rate, and local-recurrence-free survival (LRFS) rate were compared between two groups. The salvage treatment and sphincter preservation rate were analyzed. The survival curve was drawn with Kaplan-Meier method and evaluated by log-rank method. Results: In the cases treated with TME, the median interval from nCRT to surgery was 59 days. The postoperative pCR rate was 63.1%(113/179). The median follow-up time of the whole cohort was 41.8 (12.0-99.0) months. The 3-year and 5-year OS rates were 98.4% and 96.5%; the 3-year and 5-year LRFS rates were 96.5% and 96.5%; the 3- and 5-year DMFS rates were 91.0% and 87.9%, respectively. The 3-year OS rates in the W&W group and the TME group were 100% and 97.9%; the 5-year OS rates in W&W group and the TME group were 90.6% and 97.9% ( P =0.339); The 3-year local recurrence rate (LRR) in the W&W group was 12.9% (7 cases recurred within 2 years), which was significanthy higher then that in the TME group (0.6%, P =0.003). Salvage surgery was successful in 5/6 cases. After salvage surgery, LRFS rate was not significantly different between the two groups ( P =0.137). The 3-year DMFS rate in the W&W group and the TME group were 88.4% and 81.1%, whose difference was not significant ( P =0.593). Recurrence with simultaneous metastasis was seen in 3/7 cases of the W&W group. The sphincter was preserved in 89.8% (53/59) of patients in the W&W group, which was significantly higher than 73.7% (132/179) in the TME group ( P <0.001). When distance of tumor from the anal verge was ≤ 5 cm, the sphincter preservation rate (SPR) in the W&W group was 88.0% (44/50), which was significantly higher than the 54.4% (56/103) in the TME group ( P <0.001). Conclusions: W&W is safe and feasible for patients with LARC and cCR after nCRT. The results should be verified by further clinical trials.

Therapeutic goal for locally advance rectal cancer (LARC) patients includes long-term survival and function preservation of pelvic organs. During the recent two decades, treatment strategy for LARC is gradually shifing to minimally invasive surgery, even avoiding a major surgery. "Watch and wait (W&W)" strategy is effective in dramatically decreasing surgical trauma and significantly improving preservation of defecation, urination and sexual function. Total neoadjuvant therapy (TNT) shifts all or part of adjuvant chemotherapy to the neoadjuvant phase and has showed obvious advantage in tumor shrinkage and complete clinical response (cCR) achievement. This article will summarize the transition of treatment strategy of LARC towards W&W from standard treatment. After more than ten years of development, both NCCN and ESMO guidelines recommend stratified neoadjuvant treatment considerations based on distinct risk classifications and especially suggest TNT for LARC patients with advanced diseases, which affirms the value of TNT in tumor shrinkage. Although accumulating data show that pelvic control and organ preservation using W&W strategy after cCR is equal or non-inferior to standard surgery, impact on long-term survival still needs prospective randomized controlled study; no consensus has been achieved for the detail of the W&W strategy. Thus W&W strategy is suggested to applied in hospitals specialized in the treatment of rectal cancer within the framework of multiple disciplinary treatment. In view of special medical conditions of our country, we still need to accumulate more experience and data of W&W strategy for rectal cancer patients with appeals for sphincter preservation and actively participate in international researches.

Objective: To evaluate the correlation between bile duct injury after transcatheter arterial chemoembolization and the level of hepatic arterial embolization, and to analyze the clinical prognosis of hepatocellular carcinoma patients. Methods: From January18, 2012 to December18, 2014, 21 patients underwent TACE for HCC were retrospectively reviewed, including patients' clinical and pathological data. The clinical outcome and relevant factors for bile duct injury were analyzed. Results: A total of 21 patients were identified with bile duct injury at our single institution. All patients received 48 TACE treatments, including proper hepatic artery (14), left hepatic artery (3), the right hepatic artery (10), left and right hepatic artery (9) and tumor artery branches (12). Thirty-five bile duct injury occurred in 21 patients: 7 cases was close to the tumor, 2 distant to the tumor, 7 at right liver, 2 left liver, 11 both lobes of liver and 6 hepatic hilar. After medical conservative treatment and biliary tract inside and outside drainage, liver function of 10 cases were improved. In four patients with hepatic bile duct stricture and biloma, the effect of drainage was not obvious, which subsequently caused biliary complications such as infection, gallbladder and common bile duct stones. Three patients with liver cirrhosis at decompensation stage developed complications, and one of them died of hepatic encephalopathy. Four patients experienced tumor recurrence during the follow-up period. Conclusions: The location of bile duct injury after transcatheter arterial chemoembolization is quite consistent with the level of hepatic arterial embolization. There may be some blood vessels mainly involved in blood supply of biliary duct. Complete embolism of these vessels may lead to bile duct injuries. Biliary drainage is ineffective in patients with hilar bile duct stricture, and can lead to complications of biliary tract later on.

Objective: To investigate the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the differential diagnosis and blood perfusion evaluation of benign and malignant hepatic lesions. Methods: A retrospective analysis was performed for 86 patients (96 lesions) with pathologically or clinically confirmed hepatic lesions or hepatic lesions diagnosed based on follow-up results, among whom 48 had malignant lesions (53 lesions) and 38 had benign lesions (43 lesions). The patients underwent conventional magnetic resonance (MR) plain scan, contrast-enhanced scan, and diffusion-weighted imaging (DWI) with different b values (b = 0, 50, 100, 150, 200, 400, 600, 800, 1 000, and 1 200 s/mm 2 ) to determine the parameters of the double exponential model for intravoxel incoherent motion (IVIM): fast diffusion coefficient Dfast, slow diffusion coefficient Dslow, and percentage of fast-diffusion constituent F value. The patients were divided into groups according to the blood supply to lesions on conventional MR plain scan and contrast-enhanced scan, and there were 47 lesions in abundant blood supply group and 49 in poor blood supply group. The data for analysis were Dfast, Dslow, and F values of benign/malignant lesion groups and abundant/poor blood supply groups. The independent samples t-test was used for statistical analysis; the independent samples non-parametric test Mann-Whitney U test was used for the comparison of F value; the receiver operating characteristic (ROC) curve was used to evaluate the value of above parameters in the differentiation of benign and malignant lesions and blood supply evaluation. Results: Compared with the malignant lesion group, the benign lesion group had significantly higher Dslow, and F values ( P < 0.001 or P = 0.001) and a higher Dfast value ( P = 0.053). Compared with the poor blood supply group, the abundant blood supply group had significantly higher Dfast and F values ( P < 0.001 or P = 0.001) and a higher Dslow value ( P = 0.185). According to the ROC curve, the cut-off values of Dslow, Dfast, and F values in the diagnosis of benign/malignant hepatic lesions and evaluation of abundant/poor blood supply were 1.18×10 -3 mm 2 /s, 27.20×10 -3 mm 2 /s, 20.25%, 1.17×10 -3 mm 2 /s, 20.30×10 -3 mm 2 /s, and 17.80%, respectively, with sensitivities, specificities, accuracy, and areas under the ROC curve of 90.69%/92.45%/91.66%/0.938, 46.51%/73.58%/61.45%/0.589, 74.41%/50.94%/62.50%/0.653, 59.57%/57.14%/58.33%/0.559, 55.32%/63.26%/59.37%/0.618, and 93.61%/89.79%/90.62%/0.961, respectively. Conclusion: The parameter of the double exponential model for IVIM, Dslow value, has a certain value in the differential diagnosis of benign and malignant hepatic lesions, and F value can show blood perfusion in benign and malignant hepatic lesions without the need for contrast-enhanced scan, which provides a reference for the qualitative diagnosis of liver tumor.