北京大学学报（医学版）最新文献

{"title":"[Cross-cultural adaptation and reliability validation of a Chinese version of the Clinician-reported Submental Fat Rating Scale].","authors":"Xiangxi Wang, Yexian Li, Changqing Zhou, Qianxi Li, Jinyu Xia, Qi Zhao, Yu Feng, Yunying Wu, Li Yang, Hanjie Zhu, Na Li, Yan Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To translate and culturally adapt the original English version of the Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) into a Chinese version and to systematically evaluate its reliability for assessing submental fat severity in a Chinese population.</p><p><strong>Methods: </strong>In this single-center, prospective, observational study, a total of 123 Chinese participants were enrolled. Standardized head and neck photographs, including frontal, left 45° oblique, and left 90° lateral views, were obtained to establish an image library. The original English version of the CR-SMFRS was translated to create a preliminary Chinese description. A panel comprising one plastic surgeon and two dermatologists then selected a set of representative photographs from the image library to serve as an atlas corresponding to the Chinese description, thereby finalizing the Chinese version of the scale. The inter-rater reliability among the three experts was assessed during this scale development phase. In the validation phase, after excluding 23 photographs with confounding factors such as post-acne erythema, submental skin laxity, skin scars, or hyperpigmentation, 100 standardized photographs were retained in the library. These images were processed to blind subject identity and were randomly ordered. Six dermatologists (one associate chief physician, one attending physician, and four resident physicians), who were not involved in the scale formation, then indepen dently rated the photographs. This rating procedure was conducted in two separate sessions held 14 days apart. Before the second session, all photographs were re-blinded and their order was re-randomized. Test-retest reliability, representing intra-rater agreement, was evaluated using Cohen's kappa coefficient for each rater. Inter-rater reliability was assessed to calculate the intraclass correlation coefficient (ICC) and its 95% confidence interval (<i>CI</i>) using a two-way random-effects model.</p><p><strong>Results: </strong>The mean age of participants was (30.70±8.62) years, and the mean body mass index (BMI) was (24.30±4.74) kg/m<sup>2</sup>. Correlation analysis between the Chinese CR-SMFRS grades and demographic data showed that submental fat grade was correlated with age, BMI, and gender, with BMI showing a positive correlation as submental fat grade increased. Inter-rater reliability among the three experts during scale development was excellent, with an ICC value of 0.900 (95%<i>CI</i>: 0.864-0.927).The test-retest reliability was good, as demonstrated by Cohen's kappa values ranging from 0.667 to 0.796 across all the six raters. Inter-rater reliability was excellent. The ICC value was 0.890 (95%<i>CI</i>: 0.854-0.919) for the first assessment round and 0.919 (95%<i>CI</i>: 0.893-0.941) for the second assessment round.</p><p><strong>Conclusion: </strong>The Chinese version of the CR-SMFRS demonstrates good test-retest reliability and inter-rater reliab","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1056-1064"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Seronegative rheumatoid arthritis combined with elbow pigmented villonodular synovitis: A case report].","authors":"Ruohan Yu, Jing Xu, Qian Guo, Shengguang Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report a case of elbow pigmented villonodular synovitis (PVNS) combined with seronegative rheumatoid arthritis (SNRA) and review relevant literature to summarize the characteristics, treatment, and outcomes of this comorbidity. The patient was a 72-year-old female. She developed swelling and pain of the right elbow in 2002, and underwent surgical treatment. Postoperative histopathology confirmed PVNS. In 2007, she developed swelling and pain in the left elbow and underwent synovectomy, and synovectomy again yielded pathology consistent with PVNS. From 2021 onwards, she experienced recurrent bilateral knee pain and swelling. In June 2023, laboratory tests revealed markedly elevated inflammatory markers: C-reactive protein (CRP) 175.3 mg/L, erythrocyte sedimentation rate (ESR) 116 mm/h, hemoglobin 83 g/L, and platelet count 537×10<sup>9</sup>/L. Rheumatoid factor, anti-cyclic citrullinated peptideantibody, anti-keratin antibody, and anti-perinuclear factor were all negative. Right knee magnetic resonance imaging (MRI) showed severe degenerative changes, suprapatellar bursitis with large effusion, and ligamentous injuries. Given her prior PVNS history and knee MRI findings, right knee replacement was performed; however, intraoperatively no nodular or mass-like synovial proliferation was observed. Postoperative synovial pathology demonstrated massive chronic inflammatory cell infiltration, small vessel proliferation, and fibrinoid necrosis-findings typical of rheumatoid arthritis rather than PVNS. After surgery, the left knee continued to experience recurring pain and swelling. In April 2024, she developed swelling and pain in both wrists and right ankle joints. Ultrasound examinations showed synovial proliferation in the wrists, knees, ankles, and metatarsophalangeal joints, with abundant blood flow signals and bone erosion. The patient was diagnosed as SNRA combined with PVNS. Treatment with tocilizumab 400 mg intravenously monthly plus methotrexate 10 mg weekly was initiated. After three months, CRP decreased to 0.73 mg/L, ESR to 6 mm/h. A literature review using Wanfang, CNKI, and PubMed databases with keywords \"rheumatoid arthritis\" and \"pigmented villonodular synovitis\" identified only four previously reported cases of RA combined with PVNS. Including the present case, there were 5 cases (4 females, 1 male), the median age of PVNS onset was 45 (32.5-58.0) years. The knee was the most commonly affected joint (4/5 cases), followed by the elbow. PVNS preceded RA in two cases (by 3 and 12 years), rheumatoid arthritis (RA) preceded PVNS in two cases (by 3 and 15 years), and one case had simultaneous onset. Four of the five patients were seropositive for rheunatoid factor/anti-cyclic citrullinated peptide antibody (RF/anti-CCP); only the index case was seronegative. All five patients underwent synovial resection; two (40%) experienced postoperative recurrence. In conclusion, the coexistence of PVNS and SNRA is extremely rare and poses diagno","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1076-1080"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk prediction of pneumonia in maintenance hemodialysis patients after severe acute respiratory syndrome coronavirus 2 infection].","authors":"Zhenbin Jiang, Yuejuan Pan, Jinrong Zhu, Shuhong Bi, Lian He, Junbao Shi, Xinkui Tian, Qian Xie, Wenling Yang, Chunyan Su, Song Wang, Yue Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the risk factors for pneumonia after severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in maintenance hemodialysis patients from a single center in China, and to establish a multivariate model to predict the risk of pneumonia.</p><p><strong>Methods: </strong>A retrospective analysis was performed on maintenance hemodialysis patients with positive SARS-CoV-2 antigen or nucleic acid tests treated at Peking University Third Hospital from December 1, 2022 to January 31, 2023. Demographic data, comorbidities, dialysis-related parameters, and laboratory test results were collected. Multivariate Logistic regression and receiver operating characteristic (ROC) curve were adopted to explore risk factors of pneumonia, and a multivariate model was established to predict the risk of pneumonia occurrence.</p><p><strong>Results: </strong>A total of 209 hemodialysis patients with SARS-CoV-2 infection were enrolled, including 80 patients (38.3%) with pneumonia and 129 patients (61.7%) without pneumonia. Compared with the non-pneumonia group, the pneumonia group presented a significantly higher mean age [(65.8±13.7) years <i>vs.</i> (58.9±12.6) years, <i>P</i> < 0.001] and elevated C-reactive protein levels [4.58(1.62, 9.99) mg/L <i>vs.</i> 2.35(0.95, 6.50) mg/L, <i>P</i>=0.007]. In contrast, the pneumonia group had markedly lower hemoglobin [(109±15) g/L <i>vs.</i> (116±11) g/L, <i>P</i>=0.001], serum phosphorus [(1.60±0.52) mmol/L <i>vs.</i> (1.78±0.53) mmol/L, <i>P</i>=0.022], serum albumin [(35.9±4.1) g/L <i>vs.</i> (38.6±2.5) g/L, <i>P</i> < 0.001], arteriovenous fistula utilization rate (81.3% <i>vs.</i> 96.9%, <i>P</i> < 0.001), and single dialysis session duration [(232±14) min <i>vs.</i> (236±11) min, <i>P</i>=0.046]. Multivariate Logistic analysis revealed that advanced age (<i>OR</i>=1.030, 95%<i>CI</i>: 1.002-1.059, <i>P</i>=0.036), lower hemoglobin (<i>OR</i>=0.968, 95%<i>CI</i>: 0.942-0.995, <i>P</i>=0.019), lower albumin (<i>OR</i>=0.834, 95%<i>CI</i>: 0.738-0.943, <i>P</i>=0.004) were independent risk factors for pneumonia. Patients over 65 years old, with hemoglobin < 115 g/L or serum albumin < 36.8 g/L had elevated risk of pneumonia. A combined predictive factor Q composed of these three indicators was developed for risk prediction of pneumonia. We drew the ROC curve with the predictive factor Q [area under the curve (AUC) =0.756, 95%<i>CI</i>: 0.687-0.825, <i>P</i> < 0.001]. Taking the cut-off value of 0.575, the sensitivity and specificity of predictive factor Q for predicting pneumonia were 44.0% and 94.5%, respectively.</p><p><strong>Conclusion: </strong>Advanced age, anemia and hypoalbuminemia are risk factors for pneumonia in maintenance hemodialysis patients following SARS-CoV-2 infection. A predictive marker Q value less than 0.575 indicates low risk of pneumonia, which can be applied for rapid risk stratification among hemodialysis patients with SARS-CoV-2 infection.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"974-979"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correlation between trimethylamine-N-oxide and cardiovascular metabolic markers].","authors":"Hanyu Zhang, Hexiang Peng, Huangda Guo, Tianjiao Hou, Yixin Li, Yi Zheng, Yinxi Tan, Xinyao Ye, Haodong Zhang, Huan Yu, Xueheng Wang, Meng Fan, Yiqun Wu, Xueying Qin, Jing Li, Dafang Chen, Yonghua Hu, Tao Wu, Mengying Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the correlation between serum trimethylamine-N-oxide (TMAO) levels and cardiovascular metabolic biomarkers, so as to provide a basis for clarifying the impact of TMAO on cardiovascular metabolic disease.</p><p><strong>Methods: </strong>Based on baseline data from the Beijing Fangshan Family Cohort collected from 2013 to 2017, totally 500 participants from 173 families were selected from the survey subjects. Serum TMAO concentrations were measured using enzyme-linked immunosorbent assay kits. The correlation between TMAO and cardiovascular and metabolic disease indicators was analyzed by a linear mixed effects model.</p><p><strong>Results: </strong>The mean age of the participants was (56.52±12.52) years, with 54.20% being male. Serum TMAO levels showed significant positive correlations with systolic blood pressure (SBP) and pulse pressure (PP). Each 1 μmol/L increase in TMAO was associated with a 0.74 mmHg increase in SBP (95%<i>CI</i>: 0.19-1.30, <i>P</i>=0.009) and a 0.64 mmHg increase in PP (95%<i>CI</i>: 0.21-1.08, <i>P</i>=0.004). Subgroup analysis showed that for each 1 μmol/l increase in TMAO in men, SBP and PP increased by 0.91 mmHg (95%<i>CI</i>: 0.24-1.57, <i>P</i> < 0.05) and 0.85 mmHg (95%<i>CI</i>: 0.37-1.35, <i>P</i> < 0.05), respectively. No significant correlation was found in women. In the population aged ≥60 years, each 1 μmol/L increase in TMAO was associated with a 1.10 mmHg increase in SBP (95%<i>CI</i>: 0.23-1.96, <i>P</i> < 0.05) and a 0.98 mmHg increase in PP (95%<i>CI</i>: 0.23-1.73, <i>P</i> < 0.05). No significant correlation was found in people aged < 60 years.</p><p><strong>Conclusion: </strong>The current study found that high TMAO level was correlated with the increase of SBP and PP, and TMAO might be an influencing factor of blood pressure level. No statistically significant correlation was found between TMAO and blood glucose and lipid indicators.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"992-999"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Livedoid vasculopathy: A case report].","authors":"Jun Li, Liya Ma, Ziyi Yan, Jing Qiao, Nan Yang, Min Niu, Xichao Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Livedoid vasculopathy (LV) is a painful and thrombotic obliterative vascular disorder characterized by spontaneous thrombus formation within skin capillaries or small veins, ultimately leading to localized hypoxia and the development of skin ulcers. LV is a rare condition predominantly affecting young women, with an incidence rate of approximately 1/100 000. Clinically, it manifests as recurrent reticular green spots and painful ulcers on the distal lower extremities, which subsequently heal, leaving behind white and atrophic scars, termed \"white atrophy\". The skin manifestations of the disease are prominent, often seen in dermatology. Recently, the Department of Rheumatology and Immunology of Honghui Hospital, Xi ' an Jiaotong University, admitted a patient with LV. This young female patient presented with recurrent lower limb skin purpura and ulcers, which had occurred spontaneously during the summer for the past three years. Following a skin biopsy conducted at another hospital, she was diagnosed with LV and subsequently treated with phototherapy, anticoagulation therapy, and topical corticosteroids, yet there was no improvement in her condition. In April of this year, she sought further treatment at our hospital and was admitted for comprehensive care. After completing a thorough battery of relevant examinations, we excluded other potential vascular disorders, abnormal coagulation profiles, and autoimmune diseases, such as cutaneous polyarteritis nodosa (cPAN), leukocyte-cracking vasculitis (LCV), and antiphospholipid syndrome (APS). The patient remained definitively diagnosed with LV. Under our department's care, she received oral glucocorticoids, tacrolimus for immune modulation, and colchicine for anti-inflammatory effects. Subsequently, her symptoms improved, and she was discharged from the hospital. Four months post-discharge, a follow-up examination revealed significant improvement in her symptoms. The therapeutic approaches for LV encompassed general therapy, antiplatelet and anticoagulant therapy, glucocorticoid and immunosuppressant therapy, intravenous human immunoglobulin therapy, and hyperbaric oxygen therapy. Additionally, the use of biologics, including tumor necrosis factor inhibitors and small molecule targeted JAK inhibitors, had been reported in LV cases. Further randomized controlled trials are necessary to validate these treatment options. This report presented a case of LV where favorable outcomes were achieved through a combination of anticoagulant and immunosuppressive therapies. Nevertheless, given that the patient has been afflicted with the disease for three years and we have only conducted a four-month follow-up, which is relatively short, continued long-term follow-up of this patient remains imperative.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1081-1083"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[IgG4-related disease presenting with involvement of the eyes, pituitary gland and nervous system: A case report].","authors":"Cheng Hao, Zewang Li, Longyan Qin, Yi Yin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To report a case of IgG4-related disease (IgG4-RD) involving the eyes, pituitary gland, dura mater and temporal region simultaneously. The patient was a 55-year-old middle-aged male with a protracted course of more than 13 years. The main clinical manifestations included swelling of the left eye accompanied by exophthalmos, which gradually worsened, and progressive visual deterioration. Imaging examinations revealed multiple pseudotumorous masses in the bilateral extraconal spaces (superior to the bilateral superior rectus muscles and inferior to the bilateral inferior rectus muscles) and the left optic nerve sheath area, pseudotumorous thickening of the bilateral temporal dura mater, sellar nodules, as well as pseudotumorous thickening of the muscular tissues in the left temporal and maxillofacial regions. Laboratory tests showed elevated serum IgG4 levels. Pathohistological biopsy of the ocular tissue demonstrated lymphoid hyperplasia accompanied by whorled or storiform proliferative fibrous tissue, formation of lymphoid follicles, and plasma cell infiltration. Immunohistochemical staining was positive for IgG4, with the ratio of IgG4-positive plasma cells to total IgG-positive plasma cells exceeding 70%. After treatment with hormones combined with immunosuppressants, the lesions in these areas shrank and some disappeared. Therefore, the comprehensive diagnosis was IgG4-RD.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1090-1094"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Postoperatively function evaluation of bilateral maxillary reconstruction with vascularized free flaps].","authors":"Shen Lin, Leihao Hu, Yao Yu, Wenbo Zhang, Yang Wang, Chuanbin Guo, Chi Mao, Xin Peng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To retrospectively analyze clinical cases of bilateral maxillary defect reconstruction using free flaps, and to evaluate the clinical treatment methods and functional outcomes of free flap reconstruction for bilateral maxillary defects.</p><p><strong>Methods: </strong>This study collected clinical cases between January 2000 and June 2024 at the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology. Data of surgical procedures were collected, including patient age, gender, etiology of the defect, extent and location of the defect, and the type of reconstruction flaps. The defects were categorized according to the Brown classification into vertical and horizontal categories. Postoperative outcomes were evaluated through clinical follow-up visits and telephone interviews, including the condition of dental prosthesis restoration, oral eating status (scored on a scale of 1-4), swallowing function evaluated by water drinking test, and aesthetic outcomes were assessed using the visual analogue scale (VAS). Data were analyzed using SPSS 23.0 software.</p><p><strong>Results: </strong>A total of 67 patients were included, with 38 males (56.7%) and 29 females (43.3%). The average age was (55.1±1.8) years. A total of 77 free flap transplantations were performed, with the fibula flap being the most commonly used, followed by the anterolateral thigh flap, radial forearm flap, and rectus abdominis myocutaneous flap. 4 free flaps (5.2%) were observed failed. 26 patients (38.8%) completed the entire follow-up, and all of them (100.0%) had satisfactory separation between the oral and nasal cavities and were able to eat orally. One patient (3.8%) wore a removable denture prosthesis postoperatively, while four patients (15.3%) received dental implants placement, and three of them completed implant-supported prosthesis restoration. According to the water drinking test, Seven patients (10.4%) developed swallowing dysfunction after surgery. The mean VAS score was 7.5±2.3. Analysis based on flap type (bone tissue flap/soft tissue flap) showed no statistically significant differences in postoperative eating, swallowing and aesthetic outcomes between the groups.</p><p><strong>Conclusion: </strong>The fibula flap and the anterolateral thigh flap are currently the most commonly used and reliable free flap options for bilateral maxillary defect functional reconstruction. Predictable clinical outcomes in oronasal closure, eating, swallowing and aesthetic function have been achieved in most patients.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"959-964"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fitting method and characteristics of upper occlusal plane based on three-dimensional fusion imaging].","authors":"Wei Li, Hong Su, Chunxia Ren, Hanqing Zhou, Li Xiao, Zineng Xu, Hailong Bai, Peng Ding, Tianmin Xu","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore a method for accurately fitting the upper occlusal plane, and investigate its morphological and positional characteristics in different skeletal type groups based on the fusion images from cone beam computed tomography (CBCT) and digital dental cast models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Fifteen patients were selected from each of the skeletal Class Ⅰ & normodivergent, Class Ⅱ & hyperdivergent, and Class Ⅲ & hypodivergent. Their CBCT and dental cast models before treatment were integrated and fused, and then the landmarks of the fused models were obtained. Divided into left and right sides, the upper anterior and posterior occlusal planes were fitted separately using buccal landmarks, lingual landmarks, both buccal and lingual landmarks, and clinical crown centers in the median sagittal plane. Indicators reflecting the morphological and positional characteristics of the upper occlusal plane were mea-sured. Analysis of variance (ANOVA) or non-parametric test was employed to compare the differences in the indicators of the upper occlusal planes fitted using the four methods, as well as differences among three different skeletal type samples. Multiple comparisons were also conducted. Pearson's correlation coefficient was used to analyze the relationship between the indicators of the upper occlusal planes and skeletal types.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were statistically significant differences in the intersection angles between the upper posterior occlusal planes and the palatal plane obtained using the four different fitting methods (&lt;i&gt;F&lt;/i&gt;=7.05, &lt;i&gt;P&lt;/i&gt;=0.002), as well as in the intersection angles between the anterior occlusal planes and the palatal plane (&lt;i&gt;F&lt;/i&gt;=85.56, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). There were also statistically significant differences in the intersection angles between the anterior and posterior occlusal planes (&lt;i&gt;F&lt;/i&gt;=40.08, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). Regardless of which of the four methods was used, the intersection angles between the upper anterior and posterior occlusal planes and the palatal plane, respectively, showed statistically significant differences (&lt;i&gt;P&lt;/i&gt; &lt; 0.001), among the three skeletal type samples. Only the intersection angles between the anterior and posterior occlusal planes individually fitted by clinical crown centers, exhibited a statistically significant negative correlation with the ANB (A point-nasion-B point) angle, mandibular plane angle, and palatomandibular plane angle (&lt;i&gt;P&lt;/i&gt; &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;There were significant differences in the intersection angles of the upper anterior and posterior occlusal planes fitted with different landmarks with the palatal plane, respectively, and in the intersection angles between the anterior and posterior occlusal planes. From skeletal class Ⅲ & hypodivergent to Class Ⅰ & normodivergent and then to Class Ⅱ & hyperdivergent, the degree of forward and downward inclination of the upper posterior o","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"932-939"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systemic sclerosis with anti-human neutrophil cytoplasm antibody associated vasculitis: A case report].","authors":"Li Yang, Jinmei Zou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is an autoimmune disease involving microvessels and a wide range of connective tissues. Anti-human neutrophil cytoplasm antibody-associated vasculitis (AAV) is a primary, systemic necrotizing small vasculitis. The coexistence of AAV and SSc is rare. We report a case of SSc combined with AAV complicated with alveolar hemorrhage, gastrointestinal hemorrhage, and cerebral hemorrhage. The patient was a 56-year-old woman with a 20-year history of Raynaud phenomenon, skin sclerosis on the fingertip and face. She developed dry cough for 1 year and shortness of breath after activity for 1month. Blood routine test showed moderate anemia, blood biochemistry showed renal function damage, and urine routine test showed positive urine protein and occult blood. Immunological examination showed that anti-topoisomerase Ⅰ (anti-SCL-70) antibody was positive. Lung CT showed interstitial fibrosis in both lower lungs. Systemic sclerosis and chronic renal injury were diagnosed and she was treated with low-dose prednisone and nifedipine. During the treatment, the patient developed rapidly progressive renal insufficiency, immunological indicator showed positive anti-myeloperoxidase antibody (MPO), and renal pathology suggested crescentic glomerulonephritis. The renal damage was considered to be caused by vasculitis, and the diagnosis was modified as systemic sclerosis complicated with AAV, with crescentic nephritis and interstitial lung disease. She was treated with methylprednisolone 500 mg. One day later, the patient developed hemoptysis, alveolar hemorrhage was considered, and treatment was adjusted to methylprednisolone 1 g for 3 days, plasma exchange and cyclophosphamide. Three days later, she had vomiting coffee-colored gastric contents and melena. Gastrointestinal hemorrhage was considered, and methylprednisolone was reduced to 80 mg. Plasma exchange and cyclophosphamide treatment were continued, supplemented by acid suppression. The patient's condition was finally controlled, improved and discharged. One month later, the patient developed cough and sputum, and lung CT showed pulmonary infection. During anti-infection treatment, the patient developed gastrointestinal hemorrhage again, accompanied by cerebral hemorrhage, and finally died. This case shows that the incidence of SSc combined with AAV is dangerous, mainly with kidney involvement, manifested as crescents glomerulonephritis. When combined with alveolar hemorrhage, cerebral hemorrhage, the mortality rate is high. Clinicians should pay attention to it, early diagnosis and active treatment should be taken seriously.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1084-1089"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Design and implementation of a clinical trial image medical record desensitization system based on artificial intelligence technology].","authors":"Zhili Zhang, Zhiying Fu, Min Jiang, Weiwei Liu, Fanxiu Heng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To designe a clinical trial image medical record desensitization system based on artificial intelligence technology and to conduct preliminary applications, achieving the protection of patient privacy and promoting the safe use of clinical image data in clinical trial projects.</p><p><strong>Methods: </strong>The clinical trial image record desensitization system based on artificial intelligence technology was first performed to preprocess operations, such as cropping and compression on medical images to initialize the image records. Then, it utilized advanced image recognition, natural language processing, and convolutional neural network technologies to automatically classify (labeled, feature extraction, and text recognition) according to the content of medical documents. It automatically identified sensitive information in the image records of clinical trial patients, including personal identity information such as patient name, identification number, medical record number, phone number, and birthplace. Pixel-level masking or blurring was performed on the identified sensitive information points, and an artificial online desensitization system based on canvas technology was assisted to ensure the security and confidentiality of privacy data.</p><p><strong>Results: </strong>The designed clinical trial image record desensitization system exhibited high performance and efficiency in both desensitization effect and processing speed. After desensitizing 100 000 pieces of image record data in this system, a total of 9 000 medical record image samples were randomly selected from the processed medical document types for automated desensitization effect verification. The average accuracy rate of medical document desensitization reached 88.48%, with an accuracy rate of up to 99.40% for serious adverse event medical documents.</p><p><strong>Conclusion: </strong>The clinical trial image record desensitization system based on artificial intelligence technology improves accuracy and efficiency in medical data privacy protection. Combined with the artificial online desensitization auxiliary system, it can be applied in production environments, providing reliable technical support for the safe sharing and effective utilization of clinical trial image records.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 5","pages":"1065-1070"},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}