Abstract:Biosafety is one of the cornerstones for national security. This review summarizes the major administrative laws and criminal laws related to the prevention and control of biosafety threats, such as infectious diseases, invasion of alien species, laboratory biosafety, bioterrorism, misuse of biotechnology, loss of special biological resource, and biosafety emergencies. The authors also analyzed the existing problems and shortcomings in the current the legislation of biosafety. Based on the above analysis, we proposed suggestions to improve the legislation of biosafety, which include enhancing the propaganda for popular science and relevant laws, reinforcing the implementation of the existing laws and regulations, promoting the connection between administrative laws and criminal laws, as well as building up a comprehensive biosafety law and regulation system.

Abstract:Objective To explore the dual effects of strontium ranelate (SrR) on primary osteoblasts and osteoclasts using an osteogenesis imperfecta (OI) model oim mouse. Methods The osteoblasts were obtained by digesting the calvaria of one-week-old homozygote oim/oim mice and wild type (wt/wt) mice with typeⅠcollagenase. The osteoclasts were obtained by inducing the bone marrow mononuclear cells derived from the long bone of oim/oim mice and wt/wt mice aged between five and seven weeks old. SrR with different concentrations (1 mmol/L and 10 mmol/L) was used to stimulate the cells. Quantitative real-time PCR (qRT-PCR) and Western blotting were used to quantify the expression of osteoblast differentiation-related genes (Runt-related transcription factor 2[Runx2], alkaline phosphatase[ALP] and osteocalcin[OCN]), osteoclast differentiation-related genes (calcitonin receptor[Calcr], tartrate-resistant acid phosphatase[Trap] and cathepsin K[CTSK]), and osteoclast differentiation-related transcription factors (cellular oncogene fos[c-fos] and nuclear factor of activated T-cell c1[NFATc1]). The osteoblast differentiation and mineralization were evaluated by ALP staining and alizarin red S staining. The osteoclastogenesis and resorption activity of the osteoclasts were evaluated by Trap staining and pit formation assay. The effect of SrR on cell viability of osteoblasts and osteoclasts was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results qRT-PCR and Western blotting showed that the expression levels of Runx2, ALP, and OCN in oim/oim mice were significantly increased at mRNA and protein levels after stimulation with SrR in a dose-dependent manner (all P<0.05). In comparison, SrR caused significant decreases in Calcr, Trap, CTSK, c-fos, and NFATc1 expression (all P<0.05). ALP staining and alizarin red S staining demonstrated that SrR stimulation significantly increased osteoblast differentiation and mineralization of oim/oim mice (all P<0.05). Trap staining and pit formation assay showed that SrR significantly decreased the formation number of osteoclasts and inhibited the resorption activity of osteoclasts in oim/oim mice (all P<0.05). MTT assay showed that 1 mmol/L and 10 mmol/L SrR had no cell cytotoxicity on osteoblasts or osteoclasts of oim/oim mice. Conclusion SrR can improve the imbalance of bone metabolism in OI model oim mouse, which might involve the increases in osteoblast differentiation and mineralization and decreases in formation and resorption of the osteoclasts.

Abstract:Objective To investigate the effect of calcitonin (CT) on promoting collagen synthesis and osteogenesis of human periodontal ligament stem cells (hPDLSCs). Methods Fifty adult participants were divided into chronic periodontitis (CP) group (n=25) and control group (n=25). In the CP group, the anterior maxilla with probing depth ≥ 5 mm and the sites with imaging evidence of bone loss were selected. The gingival crevicular fluid (GCF) samples were collected from 6 maxillary sites in each patient. In the control group, multiple sites without inflammation (10 to 12 per subject) were sampled to ensure that a sufficient amount of GCF was collected. The expression of CT, transforming growth factor β1 (TGF-β1) and bone morphogenetic protein (BMP) 2/4/7 in GCF was detected by enzyme linked immunosorbent assay (ELISA), and the correlation between CT expression and clinical parameters such as periodontal pocket probing depth (PD), clinical attachment loss (CAL) and gingival index (GI), and the above-mentioned indicators was investigated with Spearman correlation analysis. hPDLSCs were infected with the adenoviruses carrying CT gene (Ad.CT) and the expression of mRNA and protein of TGF-β1, BMP2/4/7, alkaline phosphatase (ALP), osteocalcin (OCN) and collagen type Ⅰ/Ⅲ (ColⅠ/Ⅲ) were detected by quantitative real-time PCR and Western blotting. Results The expression level of CT in GCF of the CP group was significantly higher than that of the control group ([32.62±1.46] ng/mL vs[17.70±0.76] ng/mL, P<0.01). The expression of CT was positively correlated with clinical parameters such as PD, CAL and GI (P<0.01, P<0.05). The expression levels of BMP2/4/7 and TGF-β1 in GCF of the CP group were significantly higher than those of the control group (BMP2:[138.67±4.04] ng/mL vs[103.96±2.78] ng/mL, BMP4:[155.53±3.55] ng/mL vs[133.15±2.92] ng/mL; BMP7:[106.59±2.85] ng/mL vs[90.22±1.56] ng/mL; TGF-β1:[105.92±3.40] ng/mL vs[89.85±2.42] ng/mL; all P<0.01). The expression of BMP2/4/7 and TGF-β1 was negatively correlated with CT expression (P<0.01, P<0.05). The overexpression of CT significantly increased the expression of TGF-β1, ColⅠ/Ⅲ and osteoblast markers BMP2/4, ALP and OCN in GCF (all P<0.01). Compared with the cells co-infected with Ad.CT and Ad.Null, the cells co-infected with Ad.CT and small interfering RNA specifically blocking TGF-β1 (Ad.TGF-β1 siRNA) had significantly lower collagen expression (ColⅠ:0.16±0.02 vs 0.22±0.03; ColⅢ:0.11±0.01 vs 0.15±0.02; both P<0.01). Compared with Ad.CT infected cells, the protein expression levels of ALP and OCN were significantly decreased in Ad.CT and noggin co-treated cells (ALP:0.19±0.02 vs 0.25±0.03; OCN:0.13±0.01 vs 0.19±0.02; both P<0.01). Conclusion CT can promote collagen synthesis and osteogenesis in hPDLSCs through TGF-β1 and BMP signaling transduction pathways.

Abstract:Objective To investigate the relationship between celastrol inhibition against multiple myeloma cell growth and unfolded protein response (UPR) and the related molecular mechanism, so as to provide new drug targets for multiple myeloma treatment. Methods Four multiple myeloma cell lines RPMI 8226, U266, SKO and KMS-11 were treated with different concentrations (proliferation:0.0-10.0 μmol/L; apoptosis:0.0-4.0 μmol/L; cell cycle:0.0-1.5 μmol/L) of celastrol for different periods (proliferation:1-3 d; apoptosis:1 d; cell cycle:1 d), and cell proliferation, apoptosis and cell cycle were examined. Western blotting analysis was used to detect the main molecules in the inositol-requiring enzyme 1 (IRE1), PRKR-like endoplasmic reticulum kinase (PERK), and activating transcription factor 6 (ATF6) signaling pathways of UPR, which included glucose-regulated protein 78 (GRP78), ATF6, PERK, eukaryotic initiation factor 2α (eIF2α), phosphorylated-eIF2α (p-eIF2α), C/EBP homologous protein (CHOP), IRE1 and phosphorylated-IRE1 (p-IRE1). After the lentivirus vector containing short hairpin RNA (shRNA) was used to interfere with eIF2α expression in RPMI 8226 cells, the effects of celastrol were detected on signaling molecule expression, apoptosis and cell cycle. Results Celastrol inhibited the proliferation of 4 multiple myeloma cells, induced apoptosis, and arrested the cell cycle at G₀/G₁ phase in dose- and time-dependent manners. RPMI 8226 cells were most sensitive to celastrol. For RPMI 8226 cells, when 0.5-2.0 μmol/L of celastrol was used for 30 min to 24 h, the p-eIF2α levels in the PERK signaling pathway of UPR were significantly increased (P<0.05 or P<0.01), and the downstream CHOP expression was risen correspondingly (P<0.05 or P<0.01), but the other two pathways ATF6 and IRE1 were not affected obviously. After interference of eIF2α expression with lentivirus vector containing shRNA, the effects of celastrol to increase CHOP expression, induce apoptosis and arrest cell cycle were significantly attenuated or disappeared. Conclusion Celastrol can inhibit the growth of a variety of multiple myeloma cells, and the activated eIF2α molecule in the UPR PERK signaling pathway may be one of the mechanisms.

Abstract:Objective To use ultrasound elastography for observing the natural recovery of rabbit muscle elasticity after skeletal muscle injury induced by microwave ablation of different powers. Methods Forty New Zealand white rabbits were randomly divided into 30 W group and 50 W group, with 20 in each group. Another 4 rabbits served as normal controls (normal group). Rabbit models of skeletal muscle injury were established by microwave thermocoagulation with different powers (30 W and 50 W) for the right medial femoral muscle for 3 min using the KY-2100 microwave ablation instrument (2 450 MHz). One hour, and 1, 2, 7 and 28 d after microwave ablation, ultrasound elastography feature strain ratio (SR) values in ablation areas were calculated. At each time point, the thermocoagulated muscle tissue of the right medial femoral muscle in the 30 W and 50 W groups and the muscle tissue of the same area on the same side in the normal group were harvested for pathological observation. Results The ablation areas extracted from ultrasound elastography were mainly blue in the 30 W and 50 W groups, while green area appeared in those areas 7 d after microwave ablation. More blue areas were seen in 50 W group compared with 30 W group 28 d after microwave ablation. Compared with the normal group, the SR values in the 30 W and 50 W groups were significantly increased 1 h, 1 d, and 2 d after microwave ablation (P<0.05, P<0.01). At 7 d and 28 d after microwave ablation, the SR values gradually decreased in the 30 W and 50 W groups; but SR values in the two groups were still significantly higher than that in the normal group 7 d after microwave ablation (P<0.05, P<0.01); while 28 d after microwave ablation, SR value of 50 W group was significantly different compared with the normal group (P<0.01), SR value in the 30 W group was similar to that in the control group (P>0.05). H-E staining showed different degrees of tissue damage, carbonization, and coagulation necrosis of peripheral muscle fibers. Inflammatory cell infiltration was seen at the injured junction 1-2 d after microwave ablation, and the macrophages in the 50 W group was more than that in the 30 W group. A large number of neovascularization, fibroblasts and scar formation were observed at the junction 7-28 d after microwave ablation, and inflammation and turbidity swelling were alleviated in the 30 W and 50 W groups. Masson staining showed less fiber contents and no obvious fiber proliferation 1 h after microwave ablation in the 30 W and 50 W groups. At 1-2 d after microwave ablation, different degrees of new collagen fibers and muscle interstitial fiber proliferation were observed in the 30 W and 50 W groups. At 7-28 d after microwave ablation, a large number of newborn collagen fibers were observed in the 30 W and 50 W groups, accompanied by a significant increase in peripheral fibers of vascular wall. Sirius red staining showed that a large number of newborn collagen gradually appeared in the 30 W and 50 W groups. Immediately and 1 d after microwave ablation, there were mainly typeⅠcollagen fibers, and typeⅡcollagen fibers were found 2 d after microwave ablation. At 7 d and 28 d after microwave ablation, there were more typeⅡcollagen fibers reticulated in the 30 W and 50 W groups. Conclusion Microwave ablation with different powers can cause acute muscle injury in rabbits, the injury intensifies during 1-2 d after microwave ablation, and begin to repair 7-28 d after microwave ablation; the repair of 50 W group is later than the 30 W group. The dynamic changes of ultrasound elastography are consistent with the pathological findings. Ultrasound elastography can noninvasively evaluate the dynamic changes of skeletal muscle tissue repair after muscle injury, and it is a complement to the conventional ultrasound examination.

Abstract:Objective To establish streptozotocin (STZ)-induced diabetic retinopathy model in mice, and to observe the pathological changes of the retina in early diabetic stages and the expression of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor (VEGFR)1 and VEGFR2 in the mouse model. Methods C57BL/6J mice, aged 6-8 weeks, received intraperitoneal injection of STZ (55 mg/kg) once a day for 5 d. The fasting blood glucose concentration was measured 1 week after injection. The diabetic and control mice were fed for 5 months. Then the morphological changes of retina in diabetic mice were analyzed by H-E staining, Evans blue perfusion angiography and retinal vascular network digestion. The expression of VEGF and its receptors VEGFR1, VEGFR2 in diabetic retinopathy was analyzed by quantitative real-time PCR and Western blotting. Results Compared with the control group, the blood glucose levels of the model group were significanlty increased 1 week, 1 to 5 months after injection (all higher than 16.5 mmol/L, all P<0.01). At 5 months after injection, the whole retina of the model group became thinner; the number of photoreceptor cells, inner and outer nuclear cells were decreased and disorderly arranged; the blood vessels went tortuously with leakage and leakage spots; the number of vascular endothelial cells was increased, with altered morphology; the number of peripheral cells was decreased; and there were no cellular capillaries and lumen occlusion. The expression levels of VEGF, VEGFR1 and VEGFR2 protein and mRNA were significantly increased in the model group compared with the control group (all P<0.01). Conclusion Diabetic retinopathy mouse model has been successfully constructed, with proliferative diabetic retinopathy appearing 5 months after diabetes, and the expression levels of VEGF, VEGFR1 and VEGFR2 are increased in the retina of diabetic mice.

Abstract:Objective To investigate the diagnostic efficiency of γ-glutamyl transpeptidase to platelet ratio (GPR) for detecting liver fibrosis in chronic hepatitis B patients, and to compare its efficiency with those of liver stiffness measurement (LSM) value, asperate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4). Methods We retrospectively included patients with chronic hepatitis B who had undergone surgery or liver biopsy in our hospital from May 2015 to Sep. 2015. All patients had undergone transient elastography to record LSM value and serological examination to calculate GPR, APRI and FIB-4 before surgery or liver biopsy. The diagnostic efficiency of each index was evaluated by receiver operating characteristic (ROC) curve and the area under ROC curve was compared. Results Totally 260 patients were eventually enrolled in the present study, including 213 males and 47 females, with the average age being (53.49±9.78) years and the average BMI being (23.36±3.06) kg/m². GPR, LSM value, APRI and FIB-4 were moderately correlated with S ≥ 2 and S4 liver fibrosis (all P<0.05). The areas under ROC curves of GPR, LSM value, APRI and FIB-4 for S ≥ 2 liver fibrosis were 0.81, 0.82, 0.75 and 0.72, respectively. For predicting S4 liver fibrosis, the areas under ROC curves of GPR, LSM value, APRI and FIB-4 were 0.82, 0.86, 0.79 and 0.75, respectively. The areas under ROC curves of GPR and LSM value were significantly higher than those of FIB-4 for detecting S ≥ 2 and S4 liver fibrosis (all P<0.05). For predicting S4, the area under ROC curve of LSM value was significantly better than APRI (P<0.05). There were no statistical differences in the areas under ROC curves between APRI and FIB-4 for diagnosis of S ≥ 2 and S4 liver fibrosis (P>0.05). Conclusion It has been indicated that GPR, LSM value, APRI and FIB-4 have diagnostic accuracy for S ≥ 2 and S4 liver fibrosis. The diagnostic accuracy of LSM value and GPR for S ≥ 2 and S4 liver fibrosis is better than that of FIB-4, and that of LSM value for S4 liver fibrosis is better than that of APRI. Therefore, GPR and LSM value may serve as the optimal indexes for noninvasively evaluating liver fibrosis in chronic hepatitis B patients.

Abstract:Objective To compare the efficacy and safety between humidified high flow nasal cannula (HHFNC) and noninvasive positive pressure ventilation (NPPV) in patients with chronic obstructive pulmonary disease (COPD) complicated with type 2 respiratory failure after extubation. Methods Seventy-two patients with COPD complicated with type 2 respiratory failure were enrolled after extubation and were randomized into HHFNC group and NPPV group at 1:1 ratio, with 36 patients in each group. The blood gas analysis index, respiratory rate, heart rate, mean arterial pressure, reintubation rate, incidence of tracheotomy, intensive care unit stay, incidence of adverse events and mortality were compared between the two groups before treatment and 2, 12, 24 h after treatment. Results The pH at 24 h, partial pressure of oxygen in artery (PaO₂) at 2 h and 12 h, and oxygenation index (PaO₂/FiO₂) at 2 h and 12 h after treatment were significantly higher in the HHFNC group compared with the NPPV group (all P<0.05), while partial pressure of carbon dioxide in artery (PaCO2) at 12 h, respiratory rate at 2 h, 12 h and 24 h, and heart rate at 12 h and 24 h after treatment were significantly lower in the HHFNC group compared with the NPPV group (all P<0.05). There were no significant differences in reintubation rate, incidence of tracheotomy or intensive care unit stay between the two groups (all P>0.05), while the overall incidence of adverse events, intolerance rate, flatulence rate and aspiration rate were significantly lower in the HHFNC group than those in the NPPV group (all P<0.05). The mortality rates were not significantly different between the two groups (P>0.05). Conclusion The short-time efficacy and safety of HHFNC are better than NPPV in treatment of COPD complicated with type 2 respiratory failure.

Abstract:Objective To establish a quantitative analysis model for online monitoring of the blending uniformity of hydroxychloroquine sulfate raw and auxiliary materials, so as to accurately and quickly determine the blending endpoint. Methods A mixture of excipients and hydroxychloroquine sulfate raw material was prepared with a labeling percentage of 70%-130%. The near-infrared spectrum was collected; and the standard normal variate transformation and first derivative by Norris smoothing were used for spectra pretreating, with 8 372-9 045 cm^-1, 5 616-6 058 cm^-1 used as the spectral bands. A quantitative analysis model was developed using partial least squares regression. The quantitative analysis model was used to predict the labeling percentage of hydroxychloroquine sulfate in the blending process of raw and auxiliary materials, and the blending endpoint was verified by high-performance liquid chromatography (HPLC) analysis. Results Five primary factors were used to establish the model. The root mean square error of calibration was 0.96 and the correlation coefficient of calibration set (R_c) was 0.998. The root mean square error of prediction was 0.97 and the correlation coefficient of validation set (R_p) was 0.998. The root mean square error of cross-validation was 1.56 and the correlation coefficient of cross-validation (R_cv) was 0.995. The prediction results of the near-infrared model was consistent with the results of HPLC verification. Conclusion The near-infrared model in this study can be used for online quantitative analysis of the blending uniformity of hydroxychloroquine sulfate, and it can accurately and quickly determine the blending endpoint.

Abstract:Objective To explore the disease targets of breast cancer related to age at diagnosis and tumor stage by weighted gene co-expression network analysis (WGCNA) from public database The Cancer Genome Atlas (TCGA). Methods We obtained the breast cancer gene chip expression data and corresponding clinical data of 53 Asians and 126 Africans from TCGA database. R software WGCNA package was used to construct the co-expression network of the two populations, and the significant modules related to age at diagnosis and cancer stage were obtained. Online website DAVID was used for function enrichment and online website UALCAN for survival analysis. Results WGCNA yielded 11 modules significantly related to cancer stage and age at diagnosis. Forty-two candidate genes were obtained after 11 modules were intersected. Gene ontology (GO) enrichment analysis was carried out using online website DAVID and these genes were mainly involved in protein binding function. Nine of the 42 candidate genes were identified as hub genes by WGCNA, the 9 genes were used in UALCAN for differential analysis and survival analysis, and 2 candidate biomarkers (ERLIN2 and ASH2L) were screened out. The expression of the 2 genes in normal tissues and breast cancer tissues was significantly different (P<0.01), and the expression level significantly influenced the survival of breast cancer patients (P<0.05). Conclusion Data mining from public databases for biomarkers or therapeutic targets is a cost-effective research method. In this study ERLIN2 and ASH2L have been found to be candidate biomarkers for breast cancer through data mining, which needs large sample study and mechanism exploration.

Abstract:Bone morphogenetic protein 2 (BMP2) is an active protein inducing bone formation, and it can regulate the proliferation of mesenchymal stem cells into osteoblasts. In 2002 BMP2 was approved by the US Food and Drug Administration for single-segment anterior lumbar intervertebral fusion surgery. However, during the clinical application, BMP2 was found to have the following adverse reactions:heterotopic ossification, osteolysis and graft sinking, formation of bone cysts, inflammation-related complications, radiculitis, retrograde ejaculation and carcinogenesis. These adverse reactions may be due to the off-label use of BMP2 and use of off-physiological dose. This review mainly sums up the adverse reactions in the clinical application of BMP2, hoping to provide reference for safer and more effective clinical medication.

Abstract:Insomnia is one of the common sleep disorders. Despite of wide recognition that patients with insomnia subjectively experience impaired daytime functioning, there is little consistent objective evidence of neurobehavioural performance deficits. However, evidences of potential cognitive impairment in insomnia patients have been found in neuroimaging, neurobiochemistry and neuroelectrophysiology. This paper describes the characteristics of cognitive impairment in insomnia patients, then introduces the evidence of potential cognitive impairment found in neuroimaging, neurobiochemistry and neuroelectrophysiology, and finally analyzes the possible causes of this phenomenon.

Abstract:Objective To investigate the effects of submarine environment on the comprehension, memory and job performance of submariners through a comparative study. Methods A cluster sampling method was used to select 141 submarine crew members from a submarine detachment, and 159 off-shore crew members from a submarine base were taken as the controls. The comprehension capability was examined with comprehension testing subscale of Wechsler adult intelligence scale-Chinese revised in the two groups, and the memory capability was examined with picture arrangement subscale of Wechsler memory scale-Chinese revised. The job performance was evaluated by hand coordination tester and finger flexity tester, and the results were compared between the two groups. Results Comprehension test showed that the comprehension ability of submariners with a more than 5 years service experience was significantly lower than that of off-shore counterparts (t=4.67, P<0.01). In hand coordination test, the out track times were significantly more in submariners with a 3-5 and more than 5 years service experience than those in off-shore counterparts (Z=-2.20, P<0.05; Z=-2.21, P<0.05). In finger flexity test, the out track times was significantly more in submariners with a 3-5 and more than 5 years service experience than those in off-shore counterparts (Z=-3.08, P<0.01; Z=-4.52, P<0.01). Conclusion Comprehension ability and job performance of submariners are lower than those of off-shore counterparts. Comprehension ability of submariners with a more than 5 years service experience is worse than that of off-shore counterparts. Job performance of submariners with a 3-5 or more than 5 years service experience is worse than that of off-shore counterpart. The submarine environment has no obvious influence on memory of submariners.

Abstract:Objective To investigate the status quo of first aid knowledge of students from non-medical naval academies, so as to provide references for designing first aid training program for them. Methods Using convenience sampling, we investigated 342 students from 4 non-medical naval universities using anonymous questionnaire from Sep. 2017 to Dec. 2017. Results A total of 342 questionnaires were returned, with a recovery rate of 100%. And there were 327 questionnaires were valid, with a valid rate of 95.61%. The median first aid knowledge score was 9 (7, 10) for the participants when the total score was 18. The median scores of first aid skills (total 5), treatment of common emergencies and traumas (total 6), and management of environmental emergencies (total 7) were 2 (2, 3), 3 (2, 4) and 3 (3, 4), respectively. There was a significant difference in the mastery of first aid knowledge among students from different non-medical academies (P<0.05). Students who had received first aid education had better mastery of first aid knowledge than those who had not (P<0.05). Genders, ages, and length of military service were not influencing factors of the mastery of first aid knowledge (all P>0.05). Totally 83.79% (274/327) of the respondents thought it was necessary to learn first aid knowledge, and 90.21% (295/327) hoped to learn first aid knowledge through face-to-face teaching. Conclusion The first aid knowledge among non-medical naval students is poor, and there is a lack of effective education and a long-term training mechanism needs to be established.

Abstract:The standardized training for specialists in China has ushered in a new phase of steady development and gradual improvement from the initial stage of slow start-up and making plan. Current researches focus on the training system, training model and competency-based training model. Due to late start, short history, insufficient experience and rational thinking of training for specialists in China, currently we need more in-depth and systematic studies; the studies should be more pertinent and applicable, and the studies on competency-based training need to be further broadened. In this review, the research focuses of standardized specialist training in China are sorted out, and the main problems are analyzed, hoping to provide reference for the development of standardized specialist training in China.

Abstract:Objective To summarize the characteristics and clinical implications of electrocardiogram (ECG) during the perioperative period of transcatheter aortic valve replacement (TAVR). Methods From Dec. 2017 to Dec. 2018, 20 patients with severe aortic valve stenosis or severe aortic valve insufficiency who underwent TAVR were admitted to Department of Cardiovascular Surgery of our hospital. Eight cases had transapical aortic valve implantation with J-Valve self-expandable valves and 12 cases had transfemoral aortic valve implantation with Venus-A self-expandable valves. Arrhythmia incidence was analyzed based on the ECG results during perioperative period. Results All the 20 cases were complicated with severe heart failure (New York Heart Association classification of cardiac function Ⅲ-Ⅳ). The mean age of patients was (77.8±4.9) years. TAVR was successfully performed in all the 20 patients. The mean follow-up period was (8.0±3.1) months. In the Venus-A self-expandable valve group, there were 2 cases of new onset grade Ⅲ atrioventricular block (resolved 7-12 d postoperatively), 6 cases of new onset left bundle branch block (LBBB), and 2 cases of new onset right bundle branch block (RBBB). In J-Valve self-expandable valve group, there were 4 cases of new onset LBBB, 2 cases of new onset RBBB and 3 cases of multifocal ventrical tachycardia plus ventricular premature beat. Conclusion New onset LBBB arrhythmia has a high incidence during the perioperative period of TAVR.

Abstract:Objective To evaluate the safety and efficacy of occlusion therapy for patent ductus arteriosus (PDA) infants in Gansu plateau and sub-plateau of China. Methods A total of 300 PDA infants treated in Gansu Provincial People's Hospital between Jan. 2008 and Jan. 2018, including 123 patients from plateau area and 177 patients from sub-plateau area, were enrolled in this study. Their ages ranged from 6 months to 3 years. Anterior right heart catheter was blocked for measuring pulmonary artery pressure before occlusion during surgery. Different occlusion devices were selected according to the characteristics of PDA during the operation. Occlusion treatment for PDA patients with mild pulmonary hypertension was processed and testing occlusion was given to patients with moderate to severe pulmonary hypertension. After 1, 3, and 6 months follow-up, electrocardiogram, echocardiography and other data were examined, and changes in pulmonary artery pressure were evaluated based on the rate of tricuspid regurgitation. Results A total of 300 patients receiving angiography showed defects, with the defect diameter being 1-10 (4.5±2.8) mm before operation. After occlusion, 293 infants had no residual shunt. Totally 299 patients were successfully operated, and 97 patients with moderate to severe pulmonary hypertension were tested for hyperoxia and 21 infants with oxygen saturation <95% were given testing occlusion operation. And 235 patients were successfully blocked with PDA occlude, 53 micro-arterial catheters were occluded with German PFM Duct-Occlud, and 11 treated with ventricular septal defect occlude. One case aged 3 years old gave up treatment due to elevation of pulmonary artery pressure immediately after occlusion. Pulmonary systolic pressure and mean pulmonary artery pressure decreased in 299 patients 6 months after operation. Conclusion Occlusion therapy is a reliable method for PDA infants in plateau and sub-plateau areas of Gansu Province, China, with definite curative effect and high success rate. Testing occlusion is a reliable method for identifying severe pulmonary hypertension, and choosing an appropriate occlusion device according to the individual conditions can achieve promising clinical outcomes.

Abstract:Objective To compare the antibacterial effect and short-term clinical effect of new triple antibiotic paste (ornidazole, ciprofloxacin and minocycline) used alone and in combination with calcium hydroxide paste against Enterococcus faecalis in root canal retreatment. Methods A total of 149 single rooted teeth with failed endodontic treatment were selected in the present study. The samples were randomly divided into 5 groups:calcium hydroxide paste group (CH group), triple antibiotic paste (metronidazole, ciprofloxacin and minocycline) group (TAP group), new triple antibiotic paste group (NTAP group), the combination group of calcium hydroxide paste and new triple antibiotic paste (CH+NTAP group), and camphor phenol group (CP group). After removal of the root-filling material, the quantities of Enterococcus faecalis in the root canals were determined before and after root canal preparation and 7 d after root dressing. The short-term clinical effects were evaluated 7 d after root dressing in each group. Results After root canal preparation and root dressing of 7 d, the quantities of Enterococcus faecalis in root canals in each group were significantly decreased versus before root canal preparation (all P<0.05). After 7 d root dressing, the quantities of Enterococcus faecalis of each group were significantly lower versus after root canal preparation (all P<0.05). The quantities of Enterococcus faecalis were significantly lower in the CH, TAP, NTAP and CH+NTAP groups than that in the CP group (all P<0.05), those in the NTAP group and CH+NTAP group were significantly lower than those in the CH group and TAP group (all P<0.05), and that in the TAP group was significantly lower than that in the CH group (P<0.05). After 7 d root dressing, the CH, TAP, NTAP and CH+NTAP groups had better clinical effects than the CP group (all P<0.05), and the clinical effects of the TAP group, NTAP group and CH+NTAP group were better than that of the CH group (all P<0.05), while there was no significant difference between the TAP group, NTAP group and CH+NTAP group (P>0.05). Conclusion Calcium hydroxide paste and triple antibiotic paste alone or in combination have better antibacterial effect for root canal disinfection against Enterococcus faecalis in root canal retreatment. They also have better short-term clinical effect, especially the new triple antibiotic paste, which can be considered as an effective alternative intracanal medicament and is worthy of clinical application.

Abstract:Objective To compare the difference between shade guide and spectrophotometer used by evaluating treatment total effective rate after tooth bleaching. Methods 59 maxillary central incisors bleached with 35% hydrogen peroxide. Teeth color measured with Vita classical shade guide and CM-700d spectrophotometer before and after bleaching. Total effective rate calculated by the evaluation standard of curative effect and analyzed for X2 test by SPSS17.0 statistical software. Results The total effective rate of bleaching was statistically difference between shade guide and spectrophotometer, P=0.031. The total effective rate of bleaching with spectrophotometer was higher than shade guide, 97%, 87% respectively. Conclusion The accuracy of color measurement with spectrophotometer is higher than visual colorimetric. And more fully describes the change of teeth color. Thus spectrophotometer should be gave priority to the assessment of bleaching effect.

Abstract:We analyzed the characteristics of Hashimoto’s encephalopathy in child.A child was diagnosed with Hashimoto’s encephalopathy accompanied by arrhythmia starting with epilepsy and high fever. No significant abnormality was found in the cerebrospinal fluid analysis of two lumbar punctures. The antibodies against autoimmune encephalitis in the blood and cerebrospinal fluid were negative. The titers of anti-thyroglobulin antibody and thyroid peroxidase antibody were significantly higher than normal. Brain MR showed diffuse symmetrical swelling of bilateral cerebral cortex. 24h ambulatory electroencephalogram (EEG) showed that δ activity of the head was not a typical spike-slow wave discharge. 24h ambulatory electrocardiogram showed sinus arrhythmia and frequent atrial premature beats. Paroxysmal atrial tachycardia. The patient finally diagnosed as Hashimoto encephalopathy with arrhythmia.After 5 days of methylprednisolone 20 mg/ (kg.d) shock therapy, intravenous human immunoglobulin of 2g/kg, prednisone 2 mg/ (kg.d) maintenance therapy,sotalol 40 mg oral,2 times/ d,Wenxin granule 1.25g, 3 times / d, the children were discharged from hospital.Hashimoto encephalopathy accompanied by arrhythmia in child starting with epilepsy and high fever was rare. Routine screening of thyroid function and thyroid peroxidase antibody can improve prognosis by early diagnosis and treatment.