BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during or...BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.展开更多
The popularity of the Internet of Things(IoT)has enabled a large number of vulnerable devices to connect to the Internet,bringing huge security risks.As a network-level security authentication method,device fingerprin...The popularity of the Internet of Things(IoT)has enabled a large number of vulnerable devices to connect to the Internet,bringing huge security risks.As a network-level security authentication method,device fingerprint based on machine learning has attracted considerable attention because it can detect vulnerable devices in complex and heterogeneous access phases.However,flexible and diversified IoT devices with limited resources increase dif-ficulty of the device fingerprint authentication method executed in IoT,because it needs to retrain the model network to deal with incremental features or types.To address this problem,a device fingerprinting mechanism based on a Broad Learning System(BLS)is proposed in this paper.The mechanism firstly characterizes IoT devices by traffic analysis based on the identifiable differences of the traffic data of IoT devices,and extracts feature parameters of the traffic packets.A hierarchical hybrid sampling method is designed at the preprocessing phase to improve the imbalanced data distribution and reconstruct the fingerprint dataset.The complexity of the dataset is reduced using Principal Component Analysis(PCA)and the device type is identified by training weights using BLS.The experimental results show that the proposed method can achieve state-of-the-art accuracy and spend less training time than other existing methods.展开更多
Extensive numerical simulations and scaling analysis are performed to investigate competitive growth between the linear and nonlinear stochastic dynamic growth systems, which belong to the Edwards–Wilkinson(EW) and K...Extensive numerical simulations and scaling analysis are performed to investigate competitive growth between the linear and nonlinear stochastic dynamic growth systems, which belong to the Edwards–Wilkinson(EW) and Kardar–Parisi–Zhang(KPZ) universality classes, respectively. The linear growth systems include the EW equation and the model of random deposition with surface relaxation(RDSR), the nonlinear growth systems involve the KPZ equation and typical discrete models including ballistic deposition(BD), etching, and restricted solid on solid(RSOS). The scaling exponents are obtained in both the(1 + 1)-and(2 + 1)-dimensional competitive growth with the nonlinear growth probability p and the linear proportion 1-p. Our results show that, when p changes from 0 to 1, there exist non-trivial crossover effects from EW to KPZ universality classes based on different competitive growth rules. Furthermore, the growth rate and the porosity are also estimated within various linear and nonlinear growths of cooperation and competition.展开更多
This study analyzed the difference between using a downward breaststroke kick and a horizontal breaststroke kick in a sample of world class elite swimmers.We compared average muscle activity of the gluteus maximus,qua...This study analyzed the difference between using a downward breaststroke kick and a horizontal breaststroke kick in a sample of world class elite swimmers.We compared average muscle activity of the gluteus maximus,quadriceps femoris(vastus medialis and rectus femoris),hamstring/long head of the biceps femoris,gastrocnemius medialis,rectus abdominal,and erector spinae when using the downward breaststroke kick technique.We find that when this sample of swimmers utilized the downward breaststroke kick,max speed and velocity per stroke increased,measured by 12,788 EMG samples,where the results are highly correlated to duration of the aerodynamic buoyant force in breaststroke kick technique.The increases in performance observed from measuring the world class elite swimmers is highly correlated to the duration of the kick aerodynamic buoyant force.Among this sample of elite swimmers,the longer a swimmer demonstrates a buoyant force breaststroke kick,the lower the time in a 100 breaststroke.展开更多
BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lip...BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.展开更多
As an online course-teaching mode,Massive Open Online Course(MOOC)has drawn great attention from both teachers and students.It is necessary to give full play to the advantages of MOOC resources and to enhance teachers...As an online course-teaching mode,Massive Open Online Course(MOOC)has drawn great attention from both teachers and students.It is necessary to give full play to the advantages of MOOC resources and to enhance teachers’consciousness of“identity remodeling”in the process of Integrated Business English flipping classroom teaching.Combining the advantages of MOOC and flipped classroom teaching during before-,during-,and after-class will greatly help promote the overall quality of business English teaching in universities.展开更多
This paper discusses the feasibility of thin-shell wormholes in spacetimes of embedding class one admitting a one-parameter group of conformal motions. It is shown that the surface energy density σis positive, while ...This paper discusses the feasibility of thin-shell wormholes in spacetimes of embedding class one admitting a one-parameter group of conformal motions. It is shown that the surface energy density σis positive, while the surface pressure is negative, resulting in , thereby signaling a violation of the null energy condition, a necessary condition for holding a wormhole open. For a Morris-Thorne wormhole, matter that violates the null energy condition is referred to as “exotic”. For the thin-shell wormholes in this paper, however, the violation has a physical explanation since it is a direct consequence of the embedding theory in conjunction with the assumption of conformal symmetry. These properties avoid the need to hypothesize the existence of the highly problematical exotic matter.展开更多
The professional and moral education of high school mathematics teachers will make classroom management work better,but their work pressure will also lead to classroom management problems.To do a good job in high scho...The professional and moral education of high school mathematics teachers will make classroom management work better,but their work pressure will also lead to classroom management problems.To do a good job in high school class teacher management and organically integrate it with mathematics teaching,we need to start from two aspects:mathematics teaching class teachers and class teacher work teaching,and penetrate mathematical thinking into daily classroom management,moral education,and classroom culture construction.Based on the attributes of the subject,we guide high school students to reflect after class to stimulate their self-management initiative through the cultivation of qualified class representatives.In addition,it is necessary to skillfully resolve classroom generative problems,change the roles of teachers and students,and integrate classroom management with mathematics teaching.展开更多
Based on Bloom’s“effective teaching theory,”this paper proposes pre-class activities to improve students’enthusiasm and autonomy in English learning.These include sentence construction,situational dubbing,famous q...Based on Bloom’s“effective teaching theory,”this paper proposes pre-class activities to improve students’enthusiasm and autonomy in English learning.These include sentence construction,situational dubbing,famous quotes,English songs,English games,Chinese stories,regional cultures,and theme debates,which combine life,interest,and inspiration as the main characteristics.The activities can enhance the sense of participation and achievement of all students to achieve the purpose of effective teaching.展开更多
One-class classification problem has become a popular problem in many fields, with a wide range of applications in anomaly detection, fault diagnosis, and face recognition. We investigate the one-class classification ...One-class classification problem has become a popular problem in many fields, with a wide range of applications in anomaly detection, fault diagnosis, and face recognition. We investigate the one-class classification problem for second-order tensor data. Traditional vector-based one-class classification methods such as one-class support vector machine (OCSVM) and least squares one-class support vector machine (LSOCSVM) have limitations when tensor is used as input data, so we propose a new tensor one-class classification method, LSOCSTM, which directly uses tensor as input data. On one hand, using tensor as input data not only enables to classify tensor data, but also for vector data, classifying it after high dimensionalizing it into tensor still improves the classification accuracy and overcomes the over-fitting problem. On the other hand, different from one-class support tensor machine (OCSTM), we use squared loss instead of the original loss function so that we solve a series of linear equations instead of quadratic programming problems. Therefore, we use the distance to the hyperplane as a metric for classification, and the proposed method is more accurate and faster compared to existing methods. The experimental results show the high efficiency of the proposed method compared with several state-of-the-art methods.展开更多
Precise quantifi cation of climate-growth relationships can make a major contribution to scientifi c forest management.However,whether diff erences in the response of growth to climate at diff erent altitudes remains ...Precise quantifi cation of climate-growth relationships can make a major contribution to scientifi c forest management.However,whether diff erences in the response of growth to climate at diff erent altitudes remains unclear.To answer this,264 trees of Larix kaempferi from 88 plots,representing diff erent altitudinal ranges(1000-2100 m)and tree classes were sampled and used to develop tree-ring chronologies.Tree-ring growth(TRG)was either positively(dominant)or negatively(intermediate and suppressed)correlated with climate in diff erent tree classes at diff erent altitudes.TRG was strongly correlated with growing season at low altitudes,but was less sensitive to climate at middle altitudes.It was mainly limited by precipitation and was highly sensitive to climate at low altitudes.Climate-growth relationships at high altitudes were opposite compared to those at low altitudes.TRG of dominant trees was more sensitive to climate change compared to intermediate and suppressed trees.Climate factors(annual temperatures;moisture,the number of frost-free days)had diff erent eff ects on tree-ring growth of diff erent tree classes along altitudinal gradients.It was concluded that the increase in summer temperatures decreased water availability,resulting in a signifi cant decline in growth rates after 2005 at lower altitudes.L.kaempferi is suitable for planting in middle altitudes and dominant trees were the best sampling choice for accurately assessing climate-growth relationships.展开更多
BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatmen...BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.展开更多
Background:Due to the high heterogeneity among hepatocellular carcinoma(HCC)patients receiving transarterial chemoembolization(TACE),the prognosis of patients varies significantly.The decisionmaking on the initiation ...Background:Due to the high heterogeneity among hepatocellular carcinoma(HCC)patients receiving transarterial chemoembolization(TACE),the prognosis of patients varies significantly.The decisionmaking on the initiation and/or repetition of TACE under different liver functions is a matter of concern in clinical practice.Thus,we aimed to develop a prediction model for TACE candidates using risk stratification based on varied liver function.Methods:A total of 222 unresectable HCC patients who underwent TACE as their only treatment were included in this study.Cox proportional hazards regression was performed to select the independent risk factors and establish a predictive model for the overall survival(OS).The model was validated in patients with different Child-Pugh class and compared to previous TACE scoring systems.Results:The five independent risk factors,including alpha-fetoprotein(AFP)level,maximal tumor size,the increase of albumin-bilirubin(ALBI)grade score,tumor response,and the increase of aspartate aminotransferase(AST),were used to build a prognostic model(ASARA).In the training and validation cohorts,the OS of patients with ASARA score≤2 was significantly higher than that of patients with ASARA score>2(P<0.001,P=0.006,respectively).The ASARA model and its modified version“AS(ARA)”can effectively distinguish the OS(P<0.001,P=0.004)between patients with Child-Pugh class A and B,and the C-index was 0.687 and 0.706,respectively.For repeated TACE,the ASARA model was superior to Assessment for Retreatment with TACE(ART)and ALBI grade,maximal tumor size,AFP,and tumor response(ASAR)among Child-Pugh class A patients.For the first TACE,the performance of AS(ARA)was better than that of modified hepatoma arterial-embolization prognostic(mHAP),mHAP3,and ASA(R)models among Child-Pugh class B patients.Conclusions:The ASARA scoring system is valuable in the decision-making of TACE repetition for HCC patients,especially Child-Pugh class A patients.The modified AS(ARA)can be used to screen the ideal candidate for TACE initiation in Child-Pugh class B patients with poor liver function.展开更多
基金Natural Science Foundation of Jiangsu Province, No. SBK2021021787the Major Project of the Health Commission ofJiangsu Province, No. ZD2022025and the Key Project of the Nanjing Health Commission, No. ZKX20048.
文摘BACKGROUND The relation between orthodontic treatment and temporomandibular disorders(TMDs)is under debate;the management of TMD during orthodontic treatment has always been a challenge.If TMD symptoms occur during orthodontic treatment,an immediate pause of orthodontic adjustments is recommended;the treatment can resume when the symptoms are managed and stabilized.CASE SUMMARY This case report presents a patient(26-year-old,female)with angle class I,skeletal class II and TMDs.The treatment was a hybrid of clear aligners,fixed appliances and temporary anchorage devices(TADs).After 3 mo resting and treatment on her TMD,the patient’s TMD symptom alleviated,but her anterior occlusion displayed deep overbite.Therefore,the fixed appliances with TAD were used to correct the anterior deep-bite and level maxillary and mandibular deep curves.After the levelling,the patient showed dual bite with centric relation and maximum intercuspation discrepancy on her occlusion.After careful examination of temporomandibular joints(TMJ)position,the stable bite splint and Invisible Mandibular Advancement appliance were used to reconstruct her occlusion.Eventually,the improved facial appearance and relatively stable occlusion were achieved.The 1-year follow-up records showed there was no obvious change in TMJ morphology,and her occlusion was stable.CONCLUSION TMD screening and monitoring is of great clinical importance in the TMD susceptible patients.Hybrid treatment with clear aligners and fixed appliances and TADs is an effective treatment modality for the complex cases.
基金supported by National Key R&D Program of China(2019YFB2102303)National Natural Science Foundation of China(NSFC61971014,NSFC11675199)Young Backbone Teacher Training Program of Henan Colleges and Universities(2021GGJS170).
文摘The popularity of the Internet of Things(IoT)has enabled a large number of vulnerable devices to connect to the Internet,bringing huge security risks.As a network-level security authentication method,device fingerprint based on machine learning has attracted considerable attention because it can detect vulnerable devices in complex and heterogeneous access phases.However,flexible and diversified IoT devices with limited resources increase dif-ficulty of the device fingerprint authentication method executed in IoT,because it needs to retrain the model network to deal with incremental features or types.To address this problem,a device fingerprinting mechanism based on a Broad Learning System(BLS)is proposed in this paper.The mechanism firstly characterizes IoT devices by traffic analysis based on the identifiable differences of the traffic data of IoT devices,and extracts feature parameters of the traffic packets.A hierarchical hybrid sampling method is designed at the preprocessing phase to improve the imbalanced data distribution and reconstruct the fingerprint dataset.The complexity of the dataset is reduced using Principal Component Analysis(PCA)and the device type is identified by training weights using BLS.The experimental results show that the proposed method can achieve state-of-the-art accuracy and spend less training time than other existing methods.
基金supported by Undergraduate Training Program for Innovation and Entrepreneurship of China University of Mining and Technology (CUMT)(Grant No. 202110290059Z)Fundamental Research Funds for the Central Universities of CUMT (Grant No. 2020ZDPYMS33)。
文摘Extensive numerical simulations and scaling analysis are performed to investigate competitive growth between the linear and nonlinear stochastic dynamic growth systems, which belong to the Edwards–Wilkinson(EW) and Kardar–Parisi–Zhang(KPZ) universality classes, respectively. The linear growth systems include the EW equation and the model of random deposition with surface relaxation(RDSR), the nonlinear growth systems involve the KPZ equation and typical discrete models including ballistic deposition(BD), etching, and restricted solid on solid(RSOS). The scaling exponents are obtained in both the(1 + 1)-and(2 + 1)-dimensional competitive growth with the nonlinear growth probability p and the linear proportion 1-p. Our results show that, when p changes from 0 to 1, there exist non-trivial crossover effects from EW to KPZ universality classes based on different competitive growth rules. Furthermore, the growth rate and the porosity are also estimated within various linear and nonlinear growths of cooperation and competition.
文摘This study analyzed the difference between using a downward breaststroke kick and a horizontal breaststroke kick in a sample of world class elite swimmers.We compared average muscle activity of the gluteus maximus,quadriceps femoris(vastus medialis and rectus femoris),hamstring/long head of the biceps femoris,gastrocnemius medialis,rectus abdominal,and erector spinae when using the downward breaststroke kick technique.We find that when this sample of swimmers utilized the downward breaststroke kick,max speed and velocity per stroke increased,measured by 12,788 EMG samples,where the results are highly correlated to duration of the aerodynamic buoyant force in breaststroke kick technique.The increases in performance observed from measuring the world class elite swimmers is highly correlated to the duration of the kick aerodynamic buoyant force.Among this sample of elite swimmers,the longer a swimmer demonstrates a buoyant force breaststroke kick,the lower the time in a 100 breaststroke.
基金Supported by Medical Science Research Project Plan by Health Commission of the Hebei Province,No.20220063.
文摘BACKGROUND Severe skeletal class II malocclusion is the indication for combined orthodontic and orthognathic treatment.CASE SUMMARY A woman with a chief complaint of a protruding chin and an inability to close her lips requested orthodontic camouflage.The treatment plan consisted of extracting the right upper third molar,right lower third molar,left lower second molar,and left upper third molar and moving the maxillary dentition distally using a convenient method involving microimplant nail anchors,push springs,long arm traction hooks,and elastic traction chains.After 52 months of treatment,her overbite and overjet were normal,and her facial profile was favorable.CONCLUSION This method can be used for distal movement of the maxillary dentition and to correct severe skeletal class II malocclusion in adults.
基金“Provincial Online and Offline Hybrid First-Class Course-Integrated Business English 1-of Zhejiang Province in 2020”.
文摘As an online course-teaching mode,Massive Open Online Course(MOOC)has drawn great attention from both teachers and students.It is necessary to give full play to the advantages of MOOC resources and to enhance teachers’consciousness of“identity remodeling”in the process of Integrated Business English flipping classroom teaching.Combining the advantages of MOOC and flipped classroom teaching during before-,during-,and after-class will greatly help promote the overall quality of business English teaching in universities.
文摘This paper discusses the feasibility of thin-shell wormholes in spacetimes of embedding class one admitting a one-parameter group of conformal motions. It is shown that the surface energy density σis positive, while the surface pressure is negative, resulting in , thereby signaling a violation of the null energy condition, a necessary condition for holding a wormhole open. For a Morris-Thorne wormhole, matter that violates the null energy condition is referred to as “exotic”. For the thin-shell wormholes in this paper, however, the violation has a physical explanation since it is a direct consequence of the embedding theory in conjunction with the assumption of conformal symmetry. These properties avoid the need to hypothesize the existence of the highly problematical exotic matter.
文摘The professional and moral education of high school mathematics teachers will make classroom management work better,but their work pressure will also lead to classroom management problems.To do a good job in high school class teacher management and organically integrate it with mathematics teaching,we need to start from two aspects:mathematics teaching class teachers and class teacher work teaching,and penetrate mathematical thinking into daily classroom management,moral education,and classroom culture construction.Based on the attributes of the subject,we guide high school students to reflect after class to stimulate their self-management initiative through the cultivation of qualified class representatives.In addition,it is necessary to skillfully resolve classroom generative problems,change the roles of teachers and students,and integrate classroom management with mathematics teaching.
文摘Based on Bloom’s“effective teaching theory,”this paper proposes pre-class activities to improve students’enthusiasm and autonomy in English learning.These include sentence construction,situational dubbing,famous quotes,English songs,English games,Chinese stories,regional cultures,and theme debates,which combine life,interest,and inspiration as the main characteristics.The activities can enhance the sense of participation and achievement of all students to achieve the purpose of effective teaching.
文摘One-class classification problem has become a popular problem in many fields, with a wide range of applications in anomaly detection, fault diagnosis, and face recognition. We investigate the one-class classification problem for second-order tensor data. Traditional vector-based one-class classification methods such as one-class support vector machine (OCSVM) and least squares one-class support vector machine (LSOCSVM) have limitations when tensor is used as input data, so we propose a new tensor one-class classification method, LSOCSTM, which directly uses tensor as input data. On one hand, using tensor as input data not only enables to classify tensor data, but also for vector data, classifying it after high dimensionalizing it into tensor still improves the classification accuracy and overcomes the over-fitting problem. On the other hand, different from one-class support tensor machine (OCSTM), we use squared loss instead of the original loss function so that we solve a series of linear equations instead of quadratic programming problems. Therefore, we use the distance to the hyperplane as a metric for classification, and the proposed method is more accurate and faster compared to existing methods. The experimental results show the high efficiency of the proposed method compared with several state-of-the-art methods.
基金funded by Fundamental Research Funds of CAF (CAFYBB2022ZA00103)National Natural Science Foundation of China (General Program)(31971652)+1 种基金National Natural Science Foundation of China (32001308)Fundamental Research Funds of CAF (CAFYBB2022ZC001)
文摘Precise quantifi cation of climate-growth relationships can make a major contribution to scientifi c forest management.However,whether diff erences in the response of growth to climate at diff erent altitudes remains unclear.To answer this,264 trees of Larix kaempferi from 88 plots,representing diff erent altitudinal ranges(1000-2100 m)and tree classes were sampled and used to develop tree-ring chronologies.Tree-ring growth(TRG)was either positively(dominant)or negatively(intermediate and suppressed)correlated with climate in diff erent tree classes at diff erent altitudes.TRG was strongly correlated with growing season at low altitudes,but was less sensitive to climate at middle altitudes.It was mainly limited by precipitation and was highly sensitive to climate at low altitudes.Climate-growth relationships at high altitudes were opposite compared to those at low altitudes.TRG of dominant trees was more sensitive to climate change compared to intermediate and suppressed trees.Climate factors(annual temperatures;moisture,the number of frost-free days)had diff erent eff ects on tree-ring growth of diff erent tree classes along altitudinal gradients.It was concluded that the increase in summer temperatures decreased water availability,resulting in a signifi cant decline in growth rates after 2005 at lower altitudes.L.kaempferi is suitable for planting in middle altitudes and dominant trees were the best sampling choice for accurately assessing climate-growth relationships.
文摘BACKGROUND Patient satisfaction with facial appearance at the end of orthodontic camouflage treatment is very important, especially for skeletal malocclusion. This case report highlights the importance of the treatment plan for a patient initially treated with four-premolar-extraction camouflage, despite indications for orthognathic surgery.CASE SUMMARY A 23-year-old male sought treatment complaining about his unsatisfactory facial appearance. His maxillary first premolars and mandibular second premolars had been extracted, and a fixed appliance had been used to retract his anterior teeth for two years without improvement. He had a convex profile, a gummy smile, lip incompetence, inadequate maxillary incisor inclination, and almost a class I molar relationship. Cephalometric analysis showed severe skeletal class Ⅱ malocclusion(A point-nasion-B point = 11.5°) with a retrognathic mandible(sella-nasion-B point = 75.9°), a protruded maxilla(sella-nasion-A point = 87.4°), and vertical maxillary excess(upper incisor to palatal plane = 33.2 mm). The excessive lingual inclination of the maxillary incisors(upper incisor to nasion-A point line =-5.5°)was due to previous treatment attempts to compensate for the skeletal class Ⅱ malocclusion. The patient was successfully retreated with decompensating orthodontic treatment combined with orthognathic surgery. The maxillary incisors were repositioned and proclined in the alveolar bone, the overjet was increased, and a space was created for orthognathic surgery, including maxillary impaction, anterior maxillary back-setting, and bilateral sagittal split ramus osteotomy to correct his skeletal anteroposterior discrepancy. Gingival display was reduced, and lip competence was restored. In addition, the results remained stable after 2 years. The patient was satisfied with his new profile as well as with the functional malocclusion at the end of treatment.CONCLUSION This case report provides orthodontists a good example of how to treat an adult with severe skeletal class Ⅱ malocclusion with vertical maxillary excess after an unsatisfactory orthodontic camouflage treatment. Orthodontic and orthognathic treatment can significantly correct a patient’s facial appearance.
基金This study was supported by a grant from Tianjin Key Medical Discipline(Specialty)Construction Project.
文摘Background:Due to the high heterogeneity among hepatocellular carcinoma(HCC)patients receiving transarterial chemoembolization(TACE),the prognosis of patients varies significantly.The decisionmaking on the initiation and/or repetition of TACE under different liver functions is a matter of concern in clinical practice.Thus,we aimed to develop a prediction model for TACE candidates using risk stratification based on varied liver function.Methods:A total of 222 unresectable HCC patients who underwent TACE as their only treatment were included in this study.Cox proportional hazards regression was performed to select the independent risk factors and establish a predictive model for the overall survival(OS).The model was validated in patients with different Child-Pugh class and compared to previous TACE scoring systems.Results:The five independent risk factors,including alpha-fetoprotein(AFP)level,maximal tumor size,the increase of albumin-bilirubin(ALBI)grade score,tumor response,and the increase of aspartate aminotransferase(AST),were used to build a prognostic model(ASARA).In the training and validation cohorts,the OS of patients with ASARA score≤2 was significantly higher than that of patients with ASARA score>2(P<0.001,P=0.006,respectively).The ASARA model and its modified version“AS(ARA)”can effectively distinguish the OS(P<0.001,P=0.004)between patients with Child-Pugh class A and B,and the C-index was 0.687 and 0.706,respectively.For repeated TACE,the ASARA model was superior to Assessment for Retreatment with TACE(ART)and ALBI grade,maximal tumor size,AFP,and tumor response(ASAR)among Child-Pugh class A patients.For the first TACE,the performance of AS(ARA)was better than that of modified hepatoma arterial-embolization prognostic(mHAP),mHAP3,and ASA(R)models among Child-Pugh class B patients.Conclusions:The ASARA scoring system is valuable in the decision-making of TACE repetition for HCC patients,especially Child-Pugh class A patients.The modified AS(ARA)can be used to screen the ideal candidate for TACE initiation in Child-Pugh class B patients with poor liver function.