Micro segment analysis of supercritical methane thermal-hydraulic performance and pseudo-boiling in a PCHE straight channel

The printed circuit heat exchanger(PCHE) is receiving wide attention as a new kind of compact heat exchanger and is considered as a promising vaporizer in the LNG process. In this paper, a PCHE straight channel in the length of 500 mm is established, with a semicircular cross section in a diameter of 1.2 mm.Numerical simulation is employed to investigate the flow and heat transfer performance of supercritical methane in the channel. The pseudo-boiling theory is adopted and the liquid-like, two-phase-like, and vapor-like regimes are divided for supercritical methane to analyze the heat transfer and flow features.The results are presented in micro segment to show the local convective heat transfer coefficient and pressure drop. It shows that the convective heat transfer coefficient in segments along the channel has a significant peak feature near the pseudo-critical point and a heat transfer deterioration when the average fluid temperature in the segment is higher than the pseudo-critical point. The reason is explained with the generation of vapor-like film near the channel wall that the peak feature related to a nucleateboiling-like state and heat transfer deterioration related to a film-boiling-like state. The effects of parameters, including mass flow rate, pressure, and wall heat flux on flow and heat transfer were analyzed.In calculating of the averaged heat transfer coefficient of the whole channel, the traditional method shows significant deviation and the micro segment weighted average method is adopted. The pressure drop can mainly be affected by the mass flux and pressure and little affected by the wall heat flux. The peak of the convective heat transfer coefficient can only form at high mass flux, low wall heat flux, and near critical pressure, in which condition the nucleate-boiling-like state is easier to appear. Moreover,heat transfer deterioration will always appear, since the supercritical flow will finally develop into a filmboiling-like state. So heat transfer deterioration should be taken seriously in the design and safe operation of vaporizer PCHE. The study of this work clarified the local heat transfer and flow feature of supercritical methane in microchannel and contributed to the deep understanding of supercritical methane flow of the vaporization process in PCHE.

FibroScan-aspartate transaminase:A superior non-invasive model for diagnosing high-risk metabolic dysfunction-associated steatohepatitis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4.

An Interpretable Light Attention-Convolution-Gate Recurrent Unit Architecture for the Highly Accurate Modeling of Actual Chemical Dynamic Processes

To equip data-driven dynamic chemical process models with strong interpretability,we develop a light attention–convolution–gate recurrent unit(LACG)architecture with three sub-modules—a basic module,a brand-new light attention module,and a residue module—that are specially designed to learn the general dynamic behavior,transient disturbances,and other input factors of chemical processes,respectively.Combined with a hyperparameter optimization framework,Optuna,the effectiveness of the proposed LACG is tested by distributed control system data-driven modeling experiments on the discharge flowrate of an actual deethanization process.The LACG model provides significant advantages in prediction accuracy and model generalization compared with other models,including the feedforward neural network,convolution neural network,long short-term memory(LSTM),and attention-LSTM.Moreover,compared with the simulation results of a deethanization model built using Aspen Plus Dynamics V12.1,the LACG parameters are demonstrated to be interpretable,and more details on the variable interactions can be observed from the model parameters in comparison with the traditional interpretable model attention-LSTM.This contribution enriches interpretable machine learning knowledge and provides a reliable method with high accuracy for actual chemical process modeling,paving a route to intelligent manufacturing.

Ultrathin Zincophilic Interphase Regulated Electric Double Layer Enabling Highly Stable Aqueous Zinc‑Ion Batteries

The practical application of aqueous zinc-ion batteries for large-grid scale systems is still hindered by uncontrolled zinc dendrite and side reactions.Regulating the elec-trical double layer via the electrode/electrolyte interface layer is an effective strategy to improve the stability of Zn anodes.Herein,we report an ultrathin zincophilic ZnS layer as a model regu-lator.At a given cycling current,the cell with Zn@ZnS electrode displays a lower potential drop over the Helmholtz layer(stern layer)and a suppressed diffuse layer,indicating the regulated charge distribution and decreased electric double layer repulsion force.Boosted zinc adsorption sites are also expected as proved by the enhanced electric double-layer capacitance.Consequently,the symmetric cell with the ZnS protection layer can stably cycle for around 3,000 h at 1 mA cm^(-2) with a lower overpotential of 25 mV.When coupled with an I2/AC cathode,the cell demonstrates a high rate performance of 160 mAh g^(-1) at 0.1 A g^(-1) and long cycling stability of over 10,000 cycles at 10 A g^(-1).The Zn||MnO_(2) also sustains both high capacity and long cycling stability of 130 mAh g^(-1) after 1,200 cycles at 0.5 A g^(-1).

Evidence-based expert consensus on clinical management of safety of Bruton’s tyrosine kinase inhibitors(2024)

Bruton’s tyrosine kinase inhibitors(BTKis)have revolutionized the treatment of B-cell lymphomas.However,safety issues related to the use of BTKis may hinder treatment continuity and further affect clinical efficacy.A comprehensive and systematic expert consensus from a pharmacological perspective is lacking for safety issues associated with BTKi treatment.A multidisciplinary consensus working group was established,comprising 35 members from the fields of hematology,cardiovascular disease,cardio-oncology,clinical pharmacy,and evidencebased medicine.This evidence-based expert consensus was formulated using an evidence-based approach and the Delphi method.The Joanna Briggs Institute Critical Appraisal(JBI)tool and Grading of Recommendations Assessment,Development,and Evaluation(GRADE)approach were used to rate the quality of evidence and grade the strength of recommendations,respectively.This consensus provides practical recommendations for BTKis medication based on nine aspects within three domains,including the management of common adverse drug events such as bleeding,cardiovascular events,and hematological toxicity,as well as the management of drug-drug interactions and guidance for special populations.This multidisciplinary expert consensus could contribute to promoting a multi-dimensional,comprehensive and standardized management of BTKis.

Effects of the kinetic pattern of dietary glucose release on nitrogen utilization, the portal amino acid profile, and nutrient transporter expression in intestinal enterocytes in piglets

Background Promoting the synchronization of glucose and amino acid release in the digestive tract of pigs could effectively improve dietary nitrogen utilization.The rational allocation of dietary starch sources and the exploration of appropriate dietary glucose release kinetics may promote the dynamic balance of dietary glucose and amino acid supplies.However,research on the effects of diets with different glucose release kinetic profiles on amino acid absorption and portal amino acid appearance in piglets is limited.This study aimed to investigate the effects of the kinetic pattern of dietary glucose release on nitrogen utilization,the portal amino acid profile,and nutrient transporter expression in intestinal enterocytes in piglets.Methods Sixty-four barrows(15.00±1.12 kg)were randomly allotted to 4 groups and fed diets formulated with starch from corn,corn/barley,corn/sorghum,or corn/cassava combinations(diets were coded A,B,C,or D respectively).Protein retention,the concentrations of portal amino acid and glucose,and the relative expression of amino acid and glucose transporter m RNAs were investigated.In vitro digestion was used to compare the dietary glucose release profiles.Results Four piglet diets with different glucose release kinetics were constructed by adjusting starch sources.The in vivo appearance dynamics of portal glucose were consistent with those of in vitro dietary glucose release kinetics.Total nitrogen excretion was reduced in the piglets in group B,while apparent nitrogen digestibility and nitrogen retention increased(P<0.05).Regardless of the time(2 h or 4 h after morning feeding),the portal total free amino acids content and contents of some individual amino acids(Thr,Glu,Gly,Ala,and Ile)of the piglets in group B were significantly higher than those in groups A,C,and D(P<0.05).Cluster analysis showed that different glucose release kinetic patterns resulted in different portal amino acid patterns in piglets,which decreased gradually with the extension of feeding time.The portal His/Phe,Pro/Glu,Leu/Val,Lys/Met,Tyr/Ile and Ala/Gly appeared higher similarity among the diet treatments.In the anterior jejunum,the glucose transporter SGLT1 was significantly positively correlated with the amino acid transporters B0AT1,EAAC1,and CAT1.Conclusions Rational allocation of starch resources could regulate dietary glucose release kinetics.In the present study,group B(corn/barley)diet exhibited a better glucose release kinetic pattern than the other groups,which could affect the portal amino acid contents and patterns by regulating the expression of amino acid transporters in the small intestine,thereby promoting nitrogen deposition in the body,and improving the utilization efficiency of dietary nitrogen.

Lipid-lowering effects of gefarnate in statin-treated patients with residual hypertriglyceridemia:a randomized controlled study

BACKGROUND The prevention of coronary artery disease(CAD)faces dual challenges:the aspirin-induced gastrointestinal injury,and the residual cardiovascular risk after statin treatment.Geraniol acetate(Gefarnate)is an anti-ulcer drug.It was reported that geraniol might participate in lipid metabolism through a variety of pathways.The aim of this study was to assess the lipid-lowering effects of gefarnate in statin-treated CAD patients with residual hypertriglyceridemia.METHODS In this prospective,open-label,randomized,controlled trial,69 statin-treated CAD patients with residual hypertriglyceridemia were randomly assigned to gefarnate group and control group,received gefarnate(100 mg/3 times a day)combined with statin and statin alone,respectively.At baseline and after one-month treatment,the levels of plasma triglyceride,high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C)and total cholesterol were tested.RESULTS After one-month gefarnate treatment,triglyceride level was significantly lowered from 2.64 mmol/L to 2.12 mmol/L(P=0.0018),LDL-C level lowered from 2.7 mmol/L to 2.37 mmol/L(P=0.0004),HDL-C level increased from 0.97 mmol/L to 1.17mmol/L(P=0.0228).Based on statin therapy,gefarnate could significantly reduce the plasma triglyceride level(P=0.0148)and increase the plasma HDL-C level(P=0.0307).Although the LDL-C and total cholesterol levels tended to decrease,there was no statistically significant difference.CONCLUSIONS The addition of gefarnate to statin reduced triglyceride level and increased HDL-C level to a significant extent compared to statin alone in CAD patients with residual hypertriglyceridemia.This suggested that gefarnate might provide the dual benefits of preventing gastrointestinal injury and lipid lowering in CAD patients.

Application of Automation and Intellectualization Technology in Steelmaking Plant

Steelmaking plant of Fujian San Gang min Guang Co.,Ltd.is keeping pace with the trend of the times.Under the new situation that the labor cost is rising day by day.Constantly introducing intelligent technology to improve the level of automation operation and reducing labor intensity of staff and workers.Especially under the support of MES information system.Advanced and practical technology is adopted in converter,refining and continuous casting process.In recent years,production management and control,energy management and control,material tracking,cost control and equipment operation and maintenance and reducing personnel to new achieve-ments in reducing personnel.

Recent Advances in Glycemic Management for Hospitalized Diabetic Patients

With the increase in the number of diabetic patients,hospitalized diabetes management has become very important.During hospitalization,diabetic patients are prone to high or low blood glucose levels,which pose significant risks and challenges for treatment and recovery.Therefore,glycemic management of diabetic patients during hospitalization is critical.This article reviews the latest research progress in glycemic management of hospitalized diabetic patients from several aspects,develops individualized treatment plans,and uses various methods to manage and control blood glucose in hospitalized diabetic patients.

新疆高粱种质资源萌发期抗旱性综合评价

为研究新疆本土高粱(Sorghum)种质资源的抗旱性并筛选萌发期有效抗旱指标,以来源于不同地区的207份高粱种质资源为研究对象,采用PEG-6000溶液模拟干旱胁迫条件,对高粱萌发相关的10个指标进行分析,在主成分分析基础上采用隶属函数法对各高粱品种的抗旱性进行综合评价。结果表明:在干旱胁迫下,高粱的各萌发指标均受到影响。其中,相对发芽势与萌发抗旱指数相关性最强,前3个主成分累计贡献率为78.328%,分别反映高粱在干旱胁迫下的生长、萌发及发育情况。根据综合得分将207份种质划分为5类,即高度抗旱种质12份、抗旱种质28份、中等抗旱种质87份、干旱敏感种质64份和高度敏感种质16份。筛选出高粱萌发期抗旱性鉴定的重要指标为相对芽鲜重、萌发抗旱指数、相对干物质转运率,建立了可准确评估高粱萌发期抗旱性的回归方程,为高粱萌发期抗旱性种质筛选提供理论依据。

Lithiophilicity: The key to efficient lithium metal anodes for lithium batteries

Lithium metal anode of lithium batteries,including lithium-ion batteries,has been considered the anode for next-generation batteries with desired high energy densities due to its high theoretical specific capacity(3860 mA h g^(-1))and low standards electrode potential(-3.04 V vs.SHE).However,the highly reactive nature of metallic lithium and its direct contact with the electrolyte could lead to severe chemical reactions,leading to the continuous consumption of the electrolyte and a reduction in the cycle life and Coulombic efficiency.In addition,the solid electrolyte interface formed during battery cycling is mainly inorganic,which is too fragile to withstand the extreme volume change during the plating and stripping of lithium.The uneven flux of lithium ions could lead to excessive lithium deposition at local points,resulting in needle-like lithium dendrites,which could pierce the separator and cause short circuits,battery failure,and safety issues.In the last five years,tremendous efforts have been dedicated to addressing these issues,and the most successful improvements have been related to lithiophilicity optimizations.Thus,this paper comprehensively reviewed the lithiophilicity regulation in lithium metal anode modifications and highlighted the vital effect of lithiophilicity.The remaining challenges faced by the lithiophilicity optimization for lithium metal anodes are discussed with the proposed research directions for overcoming the technical challenges in this subject.

纳米材料中的界面现象

在课程教学中融入科学前沿实例不仅可以阐明所学基本原理的实际意义,还可以为基本原理的灵活应用提供范例,启发学生独立思考能力。界面化学是物理化学课程中的重要学习内容,但由于在常规尺度的多相体系中界面现象并不显著,学生对该部分知识常有忽视。近年来纳米材料已成为国内外研究的热点。纳米材料由于其高界面分子比例而表现出更为显著的界面现象。将界面化学的基本原理应用于纳米材料的研究中,已取得了一系列令人瞩目的成果。本文首先对附加压力、接触角等相关界面现象的基本原理进行梳理,然后分别介绍根据这些基本原理所发展出的分子马达、光控微流控器件、液体门控技术以及超疏水表面四项科技突破。

Nicotinic acetylcholine signaling is required for motor learning but not for rehabilitation from spinal cord injury

Therapeutic intervention for spinal cord injury is limited,with many approaches relying on strengthening the remaining substrate and driving recovery through rehabilitative training.As compared with learning novel compensatory strategies,rehabilitation focuses on resto ring movements lost to injury.Whether rehabilitation of previously learned movements after spinal cord injury requires the molecular mechanisms of motor learning,or if it engages previously trained motor circuits without requiring novel learning remains an open question.In this study,mice we re randomly assigned to receive intrape ritoneal injection with the pan-nicotinic,non-competitive antagonist mecamylamine and the nicotinicα7 subunit selective antagonist methyllycaconitine citrate salt or vehicle(normal saline)prior to motor learning assays,then randomly reassigned after motor learning for rehabilitation study post-injury.Ce rvical spinal co rd dorsal column lesion was used as a model of in complete injury.Results of this study showed that nicotinic acetylcholine signaling was required for motor learning of the single pellet-reaching task but it was dispensable for the rehabilitation of the same task after injury.Our findings indicate that critical diffe rences exist between the molecular mechanisms supporting compensatory motor learning strategies and the restoration of behavior lost to spinal cord injury.

黄河流域城市能源综合效率时空分异与影响因素研究

经济发展和环境保护的双重压力下,能源效率成为反映一国经济发展质量的关键指标,不断提升能源效率是必然的趋势。本文使用非参数的super-SBM模型、地理信息系统空间分析法、面板Tobit回归和地理加权回归(GWR)模型对黄河流域2007—2018年城市能源综合效率的时空格局和影响因素进行分析。结果表明:①研究期内,城市能源综合效率基本保持平稳,但有下降趋势。效率分布的区域差异有所缩小,且呈现出明显的连片分布特征,具体来说上游城市多处于低效、中低效率区间,中下游城市多位于中低和中高效率区间;②影响因素的Tobit回归结果表明,经济发展水平和绿色创新对城市能源综合效率具有显著正向影响,碳排放水平、产业结构和环境规制对城市能源综合效率具有显著的负向影响,区域异质性回归结果也基本保持不变;③地理加权回归结果表明,各影响因素作用的空间异质性存在并且具有一定分布规律。研究结论为促进黄河流域城市能源综合效率提供思路。

Fast capture and stabilization of Li‐ions via physicochemical dual effects for an ultra‐stable self‐supporting Li metal anode

Lithium(Li)metal is regarded as one of the most promising anode candidates for next-generation batteries due to its extremely high specific capacity and low redox potential.However,its application is still hindered by the uncontrolled growth of dendritic Li and huge volume fluctuation during cycles.To address these issues,flexible and self-supporting three-dimensional(3D)interlaced Ndoped carbon nanofibers(NCNFs)coated with uniformly distributed 2D ultrathin NiCo_(2)S_(4)nanosheets(denoted CNCS)were designed to eliminate the intrinsic hotspots for Li deposition.Physicochemical dual effects of CNCS arise from limited surface Li diffusivity with a higher Li affinity,leading to uniform Li nucleation and less random accumulation of Li,as confirmed by ab initio molecular dynamics simulations.Due to the unique structure,exchange current density is reduced significantly and metallic Li is further contained within the interspace between the NCNF and NiCo_(2)S_(4)nanosheets,preventing the formation of dendritic Li.The symmetric cell with a Li/CNCS composite anode shows a long-running lifespan for almost 1200 h,with an exceptionally low and stable overpotential under 1mA cm^(-2)/1 mAh cm^(-2).A full cell coupled with a LiFePO4 cathode at a low N/P ratio of 2.45 shows typical voltage profiles but more significantly enhanced performance than that of a LiFePO4 cathode coupled with a bare Li anode.

An Adaptive Parameter-Free Optimal Number of Market Segments Estimation Algorithm Based on a New Internal Validity Index

An appropriate optimal number of market segments(ONS)estimation is essential for an enterprise to achieve successful market segmentation,but at present,there is a serious lack of attention to this issue in market segmentation.In our study,an independent adaptive ONS estimation method BWCON-NSDK-means++is proposed by integrating a newinternal validity index(IVI)Between-Within-Connectivity(BWCON)and a newstable clustering algorithmNatural-SDK-means++(NSDK-means++)in a novel way.First,to complete the evaluation dimensions of the existing IVIs,we designed a connectivity formula based on the neighbor relationship and proposed the BWCON by integrating the connectivity with other two commonly considered measures of compactness and separation.Then,considering the stability,number of parameters and clustering performance,we proposed the NSDK-means++to participate in the integrationwhere the natural neighbor was used to optimize the initial cluster centers(ICCs)determination strategy in the SDK-means++.At last,to ensure the objectivity of the estimatedONS,we designed a BWCON-based ONS estimation framework that does not require the user to set any parameters in advance and integrated the NSDK-means++into this framework forming a practical ONS estimation tool BWCON-NSDK-means++.The final experimental results showthat the proposed BWCONand NSDK-means++are significantlymore suitable than their respective existing models to participate in the integration for determining theONS,and the proposed BWCON-NSDK-means++is demonstrably superior to the BWCON-KMA,BWCONMBK,BWCON-KM++,BWCON-RKM++,BWCON-SDKM++,BWCON-Single linkage,BWCON-Complete linkage,BWCON-Average linkage and BWCON-Ward linkage in terms of the ONS estimation.Moreover,as an independentmarket segmentation tool,the BWCON-NSDK-means++also outperforms the existing models with respect to the inter-market differentiation and sub-market size.

Design and Dynamic Analysis of Pipeline Dredging Devices

In order to improve the efficiency as well the adaptability and operability of traditional devices used to dredge drainage pipelines a new design is presented here,obtained by matching the structural specifications of a drainage pipeline with the working principle of a high-pressure water jet(HPWJ).To effectively improve the water jet nozzle performances,the nozzle’s structural parameters of the proposed device have been analyzed through Computational fluid dynamics(CFD)simulation.The corresponding behavior of the fluids inside and outside the selfrotational nozzle has been numerically simulated.The final design for the nozzle has been optimized taking into account such results.

Study on Quality Standard of Zhuang Medicine Buddlejae Flos

[Objectives]This study was conducted to explore the quality control method and establish the quality standard of Zhuang medicine Buddlejae Flos.[Methods]The microscopic identification method was adopted to identify the characters and microscopic characteristics of dried Buddlejae Flos in combination with traditional experience.The moisture,ash,acid-insoluble components and extracts of Buddlejae Flos were determined with reference to general rules of Chinese Pharmacopoeia(2015 edition).TLC identification was performed.Liquid chromatography-mass spectrometry(LC-MS)was used to determine the contents of linarin and verbascoside in Buddlejae Flos,and gas chromatography-mass spectrometry(GC-MS)was adopted to detect pesticide residues in Buddlejae Flos.Heavy metal elements As,Cd and Pb were detected by inductively coupled plasma mass spectrometry(ICP-MS).[Results]The established method is simple and accurate.Clear spots were observed on the thin layer chromatograms,and the resolution was good.The average value of moisture content was 12.24%;the average value of ash content was 5.1%;the average value of acid-insoluble content was 7.5%;and the average value of extract content was 27.3%.The regression equation of rutin in Buddlejae Flos was y=11.896x-0.0049,R^(2)=0.9996,and the contents of linarin and verbascoside were 5680 and 2080 mg/kg,respectively.No pesticide residues and heavy metals were detected in the medicinal materials of Buddlejae Flos.[Conclusions]This study can provide reference for the quality standard control of Guangxi Zhuang medicine Buddlejae Flos.

A two-stage but time-saving reconstructive scheme to treat severe lower limb length discrepancy:Two case reports

Limb length discrepancy(LLD)is a common orthopedic condition that can result in significant functional impairment,pain,and cosmetic deformities.Current reconstructive techniques for severe LLD are primarily based on callus distraction,which is a time-consuming process that can lead to complications,such as significant infection,joint stiffness,and stress fractures.To reduce the therapeutic time and minimize the risk of complications,we investigated the use of vascularized bone flaps as a technical supplement to callus distraction in the reconstruction of short limbs.We present two cases of severe LLD in the upper and lower legs,in which a twostage reconstruction approach was used.In the first stage,external fixation was applied to the affected limb to correct the soft tissue length and convert the short deformity into a bone defect.In the second stage,the bone defect was reconstructed using bilateral(patient A)or unilateral(patient B)free vascularized fibula bone grafts.Both patients had complete survival of the fibular grafts without stress fractures,and bone consolidation took 8 months(patient A)and 4 months(patient B).Compared to the traditional callus distraction,the two-stage approach was found to be more time-saving and reliable.The entire reconstructive scheme required 18 and 4 months for patients A and B,respectively,whereas the traditional callus distraction required 41 and 17 months,respectively.These findings suggest that the use of vascularized bone flaps as a technical supplement for callus distraction may provide an effective and efficient alternative for the treatment of severe LLD.Further studies are needed to validate these results and assess the long-term outcomes of this approach.

3种口内扫描仪用于咬合关系记录的准确度研究

目的探究3种口内扫描仪用于获取最大牙尖交错位(MIP)咬合关系的准确度,为临床实践提供参考。方法招募10名上下颌牙列完整、咬合关系正常的受试者。对照组采用面弓转移和咬合记录将位于MIP的上下颌石膏模型固定在架上,并使用桌面扫描仪对固定的模型进行扫描以获得数字化模型数据;实验组分别使用Trios 3、Carestream 3600以及Aoralscan 3口内扫描仪对受试者进行口内扫描以获取位于MIP时上下颌口扫模型数据。在对照组数字化模型的上下颌双侧中切牙、尖牙和第一磨牙上设置测量点并测量上下颌对应同名牙上测量点之间的距离,获得测量的距离之和D_(A),同时计算模型中切牙区、尖牙区以及第一磨牙区的测量点间距离之和,分别记为D_(I)、D_(C)、D_(M)。将添加测量点的对照组上下颌模型分别与实验组上下颌口扫模型进行精确匹配,计算匹配后对照组模型的D_(A)、D_(I)、D_(C)和D_(M)。对对照组和实验组获得的D_(A)、D_(I)、D_(C)、D_(M)进行统计学分析,以评估3种口内扫描仪记录咬合关系的准确度。结果对照组D_(A)、D_(I)、D_(C)、D_(M)的值分别为(39.58±6.40)、(13.64±3.58)、(14.91±2.85)、(11.03±1.56)mm,Trios 3组相应的值为(38.99±6.60)、(13.42±3.66)、(14.55±2.87)、(11.03±1.69)mm,Carestream 3600组相应的值为(38.57±6.36)、(13.56±3.68)、(14.45±2.85)、(10.55±1.41)mm,Aoralscan 3组相应的值为(38.16±5.69)、(13.03±3.54)、(14.23±2.59)、(10.90±1.54)mm。方差分析显示无论是整体偏差D_(A)(P=0.96),还是局部偏差D_(I)(P=0.98)、D_(C)(P=0.96)、D_(M)(P=0.89),3种口内扫描仪获取的数字化模型与对照组模型之间差异均无统计学意义。结论在规范的操作流程下,3种口内扫描仪获取的MIP咬合关系与传统方法无差异,满足临床诊疗的需求。