Abstract:Hepatocellular carcinoma (HCC) is one of the most common cancers,with rising morbidity and mortality in recent years.With the rapid development of tumor immunology,immunotherapy based on immune checkpoint inhibitors (ICIs) has brought a new dawn for the treatment of HCC.ICIs targeting immune checkpoint molecules such as programmed cell death protein 1 have shown good efficacy and safety in clinical trials of HCC-related therapies.However,different treatment regimens also have their own limitations.This review introduces the current research progress of ICIs in the treatment of HCC and outlines the challenges in the clinical treatment.

Abstract:Objective To investigate the effect and mechanism of oridonin (Ori) on the healing of bone fracture with seawater immersion (BFSI).Methods A total of 72 male C57BL/6 mice (6-8 weeks old) were used to construct BFSI model mice,and then they were randomly divided into bone fracture (BF) group,BF+Ori group,BFSI group,and BFSI+Ori group,with 18 mice in each group.X-ray of femur was taken 14 d after operation and femur mechanical strength test was performed to observe the phenotypic changes of Ori on fracture healing 21 d after operation.The callus tissues of mice were harvested 14 d after operation.The expression levels of the M1 macrophage marker (inducible nitric oxide synthase[iNOS]),M2 macrophage marker CD206,inflammatory factors (cyclooxygenase 2[COX2]and interleukin[IL]-1β),pro-apoptotic factors (cleaved cysteine aspartic acid specific protease[caspase 3]and Bcl-2-associated X protein[Bax]) and anti-apoptotic factor (B-cell lymphoma 2[Bcl-2]) were detected by quantitative polymerase chain reaction (qPCR) and Western blotting.The activation of osteoclasts was observed by tartrate-resistant acid phosphatase (TRAP) staining 7 d after operation.Results The results of X-ray and femur mechanical strength test showed that the fracture healing was significantly weakened in the BFSI group,while Ori significantly improved the healing of BFSI and increased the torsion force of the femur (all P<0.01).The results of qPCR and Western blotting showed that the mRNA and protein expression of iNOS,COX2,IL-1β,cleaved caspase 3 and Bax in the callus tissues of mice was significantly decreased,while the mRNA and protein expression of CD206 and Bcl-2 was significantly increased in the BFSI+Ori group compared with the BFSI group (P<0.05,P<0.01).The results of TRAP staining showed that the number of osteoclasts in the vicinity of the cartilage bone boundary was significantly decreased in the BFSI+Ori group compared with the BFSI group (P<0.01).Conclusion Oridonin can alleviate the inflammatory responses after fracture,reduce cell apoptosis,and inhibit the overactivation of osteoclasts,so as to promote the healing of BFSI by enhancing the polarization of anti-inflammatory M2 macrophages and inhibiting the polarization of pro-inflammatory M1 macrophages.

Abstract:Objective To investigate the effects of salidroside (SAL) on myocardial inflammatory cytokines and Hippo signaling pathway-related proteins in diabetes mellitus (DM) rats.Methods Four weeks old male SD rats were randomly divided into 3 groups:blank control group,DM model group (streptozotocin[STZ]group),and SAL intervention group (SAL group),with 5 rats in each group.Rat DM model was induced by intraperitoneal injection of STZ,and SAL was used to treat DM rats.Pathological changes of rat myocardium were observed by hematoxylin-eosin staining and Masson staining,and apoptosis of cardiomyocytes was analyzed by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining.The expression of tumor necrosis factor α(TNF-α),interleukin (IL)-1β and IL-6 in myocardial tissues and peripheral blood was evaluated by enzyme-linked immunosorbent assay (ELISA).The expression of Hippo signaling pathway-related proteins was detected by Western blotting,and Yes-associated protein (Yap) mRNA was detected by real-time polymerase chain reaction.Results Compared with the blank control group,the arrangement of cardiomyocytes in the STZ group was disordered,myocardial fibrosis and apoptosis rate (P<0.01) were increased,the expression levels of TNF-α,IL-1β and IL-6 were significantly increased (all P<0.01),the expression of Hippo signaling pathway-related proteins mammalian sterile-20 like protein kinase 1/2(Mst1/2),large tumor suppressor 1/2(Lats1/2) and Yap was increased (P<0.05,P<0.01),the expression of phosphorylated (p)-Mst1/2,p-Lats1/2 and p-Yap was decreased (all P<0.01),Yap/p-Yap ratio was increased (P<0.01),and the expression level of Yap mRNA was also increased (P<0.01).After SAL intervention,myocardial fibrosis and the rate of apoptosis (P<0.01) were decreased,the expression levels of TNF-α and IL-6 were decreased (P<0.05,P<0.01),and the ratio of Yap/p-Yap and the expression of Yap mRNA were decreased (both P<0.01).Conclusion SAL can improve the cardiomyocyte function in DM rats,and the mechanism may be associated with inhibiting inflammatory reaction,reducing cardiomyocytes apoptosis and regulating Yap/p-Yap ratio.

Abstract:Objective To investigate whether microRNA (miRNA)-144 inhibitor can attenuate the injury of esophageal mucosa in rats with reflux esophagitis (RE) and its possible mechanism.Methods Eighteen male SD rats were randomly divided into sham group,RE group,and miRNA-144 inhibitor group,with 6 rats in each group.Rats in the RE group and miRNA-144 inhibitor group were recruited to establish RE animal models by tying the proximal stomach and constricting proximal pylorus.Rats in the miRNA-144 inhibitor group were administered with miRNA-144 antagomir to inhibit the expression of miRNA-144 in vivo by tail vein injection.The efficacy of miRNA-144 inhibitor and the mRNA expression of Toll-like receptor 4(TLR4),nuclear factor κB (NF-κB) and inhibitor of nuclear factor κB α(IκBα) in esophageal tissues in each group were detected by quantitative polymerase chain reaction (qPCR).The contents of interleukin (IL)-6,IL-8 and tumor necrosis factor α(TNF-α) in rat esophageal tissues were determined by enzyme-linked immunosorbent assay (ELISA).The protein expression of claudin 3(CLDN3) was detected by Western blotting,the protein expression of cleaved cysteine aspartic acid specific protease (caspase 3) and Ki-67 was detected by immunohistochemistry staining,and the apoptosis of esophageal mucosal cells was examined by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) assay.Results Compared with the sham group,the mRNA expression levels of TLR4,NF-κB and IκBα in esophageal tissues of rats in the RE group were significantly increased (P< 0.05,P<0.01),the contents of inflammatory factors (IL-6,IL-8 and TNF-α) and the expression of cleaved caspase 3(an apoptosis-related protein) were significantly increased (all P<0.05 in the former ones and P<0.01 in the latter one),the apoptosis of esophageal mucosal cells was increased (P<0.01),and the expression of CLDN3 protein (an index of esophageal mucosal barrier) was decreased (P<0.01).Compared with the RE group,inhibition of miRNA-144 significantly reduced the mRNA expression levels of TLR4,NF-κB and IκBα(all P<0.05) and the contents of inflammatory factors (IL-6,IL-8 and TNF-α)(all P<0.05),and then inhibited the apoptosis of mucosal cells in the esophagus of the RE rats (P<0.05) and elevated the expression of CLDN3 protein (P<0.01).Whereas,there was no impact on the proliferation of esophageal mucosal cells by inhibiting the expression of miRNA-144,and there was no significant difference in the number of Ki-67 positive cells between the miRNA-144 inhibitor group and RE group (P>0.05).Conclusion miRNA-144 inhibitor can attenuate the injury of esophageal mucosa in RE rats,and the effect may be mainly through TLR4/NF-κB signal pathway.

Abstract:Objective To explore the differentially expressed genes (DEGs) related to ankylosing spondylitis (AS) through bioinformatics strategies,and to find new diagnostic markers for the disease.Methods The microarray data related to AS were downloaded from the Gene Expression Omnibus (GEO) database of the National Center of Biotechnology Information,and the DEGs between the AS patients and healthy population in the peripheral blood were analyzed and screened.The Database for Annovation,Visualization,and Integrated Discovery (DAVID) was used to complete the Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway analyses of the DEGs,and then the online database String was used to construct a protein-protein interaction (PPI) network,and the Cytoscape 3.7.1 software was used to screen the significant protein modules in the PPI network to obtain hub genes.The area under curve (AUC) values of the receiver operating characteristic (ROC) curves were calculated to evaluate the diagnostic efficacy of hub genes for AS.Results A total of 187 DEGs were screened out,including 96 up-regulated genes and 91 down-regulated genes.The results of GO function analysis showed that the DEGs were mainly involved in ribonucleoside monophosphate metabolism process,nucleoside monophosphate metabolism process and purine ribonucleoside monophosphate metabolism process.And the results of KEGG signaling pathway analysis showed that DEGs mainly participated in non-alcoholic fatty liver disease,Huntington's disease and oxidative phosphorylation.Five hub genes (adenosine triphosphate synthase,H⁺ transporting,mitochondrial F0 complex,subunit F6[ATP5J],NADH:ubiquinone oxidoreductase subunit B3[NDUFB3],ubiquinol-cytochrome c reductase binding protein[UQCRB],cytochrome c oxidase subunit 7A2[COX7A2],and ubiquinol-cytochrome c reductase hinge protein[UQCRH]) were screened out based on the results of PPI network analysis,showing significant diagnostic efficacy for AS (AUC values were 0.859,0.852,0.840,0.820,and 0.805,respectively).Conclusion ATP5J,NDUFB3,UQCRB,COX7A2 and UQCRH may be used as new diagnostic markers related to AS in peripheral blood.

Abstract:Objective To investigate the safety and effectiveness of the ProGlide-based post-closure technique in awake veno-arterial extracorporeal membrane oxygenation (VA-ECMO) decannulation.Methods The clinical outcomes of patients who received awake VA-ECMO treatment and removed from the machine in our hospital from Jan.2017 to Jun.2021 were retrospectively analyzed.The patients were divided into ProGlide-based post-closure technique group (ProGlide group) and surgical repair group according to the vascular closure method used.All-cause in-hospital mortality,procedure time of arterial closure decannulation,bleeding-related events,and vascular-related complications within 30 d were analyzed.Results A total of 35 patients were eventually enrolled,including 21(60.0%) with ProGlide-based post-closure technique and 14(40.0%) with surgical repair technique.There were 21 males (60.0%) and 14 females (40.0%) with a mean age of (49.20±10.52) years old.The median time of VA-ECMO support was 10.0(8.0,12.0) d,and the all-cause in-hospital mortality was 11.4%(4/35).Multivariate logistic regression analysis showed that after adjusting for age and gender,there was no significant difference in all-cause in-hospital mortality between the 2 groups (odds ratio[OR]=0.78,95% confidence interval[CI]0.09-6.89,P=0.826) at the primary end point.The secondary end point showed the ProGlide group had less procedure time (β=14.14,95%CI 7.22-21.05,P<0.01) and shorter intensive care unit (ICU) length of stay after decannulation (β=2.11,95% CI 0.20-4.02,P=0.032).There were no major bleeding events or major vascular-related complications within 30 d between the 2 groups.The ProGlide group had lower incidence of minor bleeding events or minor vascular-related complications within 30 d than the surgical repair group (OR=0.13,95%CI 0.02-0.88,P=0.036;OR=0.05,95%CI 0.00-0.59,P=0.018).The critical care pain observation tool (CPOT) score of the patients in the ProGlide group was significantly lower than that in the surgical repair group (β=1.26,95%CI 0.37-2.14,P=0.007).The need for remifentanil for arterial suturing was significantly increased in the surgical repair group (OR=0.06,95%CI 0.01-0.36,P=0.002).Conclusion ProGlide-based post-closure technique is safe and effective in the process of awake VA-ECMO decannulation.Compared with surgical repair technique,it has the advantages of shorter procedure time,less bleeding and vascular-related complications,and less pain for patients,and it has a certain role in promoting rapid recovery of patients.

Abstract:Objective To explore the classification of 4 common pulmonary ultrasound signs based on deep residual network ResNet152.Methods We prospectively collected ultrasound images of A lines,B lines,pleural effusion and lung consolidation (1 500 at each site) from Jun.to Sep.2020 in Shanghai Pulmonary Hospital of Tongji University.Images that were clear,uncomplicated and not obscured by bones were selected.Finally,1 388 images of A lines,1 375 images of B lines,1 384 images of pleural effusion,and 1 398 images of lung consolidation were included.Deep residual network ResNet152 was used to train and verify the classification model,and the generalization ability of the model was tested on the test set completely independent of the training set and the validation set.Accuracy rate,precision rate,specificity rate,recall rate and F1-score were used as the evaluation criteria for classification,and the classification results were visualized by the confusion matrix.Results The accuracy rates of the classification model based on the deep residual network to classify the 4 signs of A lines,B lines,pleural effusion and lung consolidation were 97.51%,87.31%,85.42% and 93.70%,respectively,and the recall rates were 90.38%,86.97%,94.25% and 91.18%,respectively.The overall classification accuracy rate of the 4 lung signs was 90.99%,the precision rate was 90.70%,the specificity rate was 96.85%,and the F1-score was 90.50%,showing excellent classification characteristics.Conclusion The pulmonary ultrasound classification model based on deep residual network shows high classification characteristics,and has potential to assist ultrasound diagnosis.

Abstract:Objective To explore the influencing factors of minor amputation in lower limb arteriosclerosis obliterans (LLASO) patients with foot ulcer.Methods The clinical data of 179 LLASO patients with foot ulcer who were admitted to Department of Vascular Surgery,Shanghai Traditional Chinese Medicine-Integrated Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from Jan.1 to Dec.30,2020 were retrospectively analyzed.Univariate and multivariate analyses were used to screen the potential high-risk factors of amputation in LLASO patients with foot ulcer,and Kaplan-Meier survival analysis was used to explore the relationship between high-risk factors and amputation survival.Results In 179 LLASO patients,41 minor amputations occurred during the follow-up period.Multivariate logistic regression analysis showed that low albumin level,high neutrophil to lymphocyte ratio (NLR),lipid-lowering therapy and ulcer site were the influencing factors of amputation in LLASO patients with foot ulcer (all P<0.05).After adjusting for the effects of age,Wagner classification and ulcer area,high NLR and plantar forefoot ulcer were independent influencing factors of amputation in LLASO patients with foot ulcer (odds ratio[OR]=8.211,95% confidence interval[CI]1.774-37.998,P=0.007;OR=2.919,95%CI 1.040-8.484,P=0.031).Kaplan-Meier survival analysis showed that the amputation-free survival time of patients in the high NLR group (NLR ≥ 2.00,n=136) was significantly shorter than that of those in the low NLR group (NLR<2.00,n=43)(8[5,9]months vs 11[7,15]months,P=0.020).Conclusion Low albumin level and high NLR are associated with amputation in LLASO patients with foot ulcer,and high NLR has predictive value for ulcer progression to amputation.

Abstract:Objective To explore the impacts of childhood traumatic experience of depression patients on the brain function and personality characteristics.Methods A matched case-control study design was used to recruit the outpatients of Department of Psychiatry,the First Affiliated Hospital of Chongqing Medical University.Depression patients with or without childhood traumatic experience (observation group or control group,n=25) were matched by age,gender,years of education,and severity of depression.The resting state functional magnetic resonance brain spontaneous amplitude of low-frequency fluctuation (mALFF) signal,functional connectivity (FC) and the neuroticism extraversion openness five-factor inventory (NEO-FFI) were used as observation indexes to compare the differences between the 2 groups.Results Corrected by the Gauss random field (GRF) with voxel level P<0.001 and mass level P<0.05,the mALFF signal values in the left hippocampus/parahippocampal gyrus and in the right precuneus in the observation group were significantly lower than those in the control group.There were no significant differences between the 2 groups in extraversion,openness,agreeableness or responsibility of NEO-FFI (all P>0.05),while the score of neuroticism in the observation group was significantly higher than that in the control group (P<0.01).There were negative correlations between neuroticism score and mALFF signal value in left hippocampus/left parahippocampal gyrus or right precuneus in both groups (r=-0.397,P<0.01;r=-0.401,P<0.01).Compared with the control group,the functional connection between the left hippocampus and the right superior temporal gyrus was increased,and the functional connection between the left hippocampus and the left central posterior gyrus was decreased in the observation group.Conclusion The function of left hippocampus/left parahippocampal gyrus and right precuneus is more greatly impaired in depression patients with childhood traumatic experience,and they have more neurotic personality traits.At the same time,this study suggests that there may be a brain protective neuroimaging mechanism to shield the excessive arousal of traumatic memory.

Abstract:Objective To explore the sleep quality and its influencing factors of naval officers and soldiers in different job positions during voyage.Methods The officers and soldiers were selected from a naval fleet by random cluster sampling method,and 501 valid questionnaires of officers and soldiers during voyage and 460 valid questionnaires of officers and soldiers before voyage were obtained.The 501 officers and soldiers during voyage were divided into logistics group,shipping group,nautical group,electromechanical group,communication group,and weapon group according to the staffing and work nature.The Pittsburgh sleep quality index (PSQI) scale,Epworth sleepiness scale (ESS),self-rating anxiety scale (SAS) and self-compiled sleep disorder cause questionnaire were used to investigate the sleep quality of officers and soldiers and identify the influencing factors of sleep quality.The point biserial correlation analysis was used to analyze the correlations between the sleep influencing factors and sleep quality of officers and soldiers in different job positions.Results The total PSQI score of the officers and soldiers during voyage was 9.22±4.13,which was higher than that of the officers and soldiers before voyage (6.75±3.54;t=2.37,P<0.01).The main factors influencing the sleep quality of officers and soldiers during voyage were anxiety (75.25%,377/501),noise (62.67%,314/501),and physical pain (59.08%,296/501).There were differences in the sleep quality of officers and soldiers in different job positions,and the main influencing factors were also different.The sleep quality of officers and soldiers of the logistics group and the nautical group was mainly affected by anxiety,the sleep quality of officers and soldiers of the electromechanical group and the communication group was mainly affected by the shift system,the sleep quality of officers and soldiers of the weapon group was mainly affected by physical pain,and the officers and soldiers of the shipping group were mainly affected by noise.Noise was mainly correlated with the subjective sleep quality,sleep disorder and daytime dysfunction of officers and soldiers of the shipping group;the shift system was mainly correlated with the subjective sleep quality,sleep time,sleep disorder and daytime sleep disorder of officers and soldiers of the electromechanical group and the communication group;body pain was mainly correlated with the subjective sleep quality,sleep time,sleep disorder and daytime dysfunction of officers and soldiers of the weapon group;and anxiety was mainly correlated with the sleep efficiency and daytime dysfunction of officers and soldiers of the logistics group and nautical group (all P<0.05).Conclusion The sleep quality of naval officers and soldiers is worse during voyage than when they are in port,and there are close relationships between the behavior during voyage,job positions on warship and sleep quality.

Abstract:Fatigue is a subjective discomfort,often manifested in a variety of physical and mental complaints.It can not only develop into an independent disease,but also is a symptom of a variety of diseases,seriously reducing people's quality of life.The pathogenesis of fatigue is complex.In recent years,the changes of central and peripheral neurotransmitter levels and abnormal energy metabolism are considered to be the main causes.Purine substances such as adenosine triphosphate (ATP) are mainly involved in the process of somatic energy demand in cells,and as important signal molecules,they participate in effective neurotransmission,neuron-glial interaction,immune response and control outside cells.They have attracted extensive attention in fatigue research.Extracellular ATP metabolism further activates P1 and P2 receptors in a concentration dependent manner,while ecto-nucleotidases control the concentration of purine substances by releasing receptor ligands to terminate or promote purine signaling pathway.This paper summarizes the synergistic effects of purinergic signaling and ecto-nucleotidases on the perception and development of fatigue,so as to provide a basis for further research on the pathogenesis and effective treatment of fatigue.

Abstract:Atrial fibrillation (AF) is one of the most common arrhythmias in clinical scenario and its symptoms can lead to a decline in the quality of life and increase the risk of ischemic stroke and heart failure in patients.Catheter ablation can effectively relieve the symptoms of AF patients,but there is no enough evidence that it reduces the incidence of stroke.Left atrial appendage closure is an effective method for the prevention of stroke caused by AF.The one-stop operation of catheter ablation combined with left atrial appendage closure is suitable for nonvalvular AF patients with high risk of stroke and bleeding.This article reviews the safety,effectiveness and influencing factors of the efficacy of catheter ablation combined with left atrial appendage closure for clinical reference.

Abstract:At present,oxidative stress plays an increasingly prominent role in the pathogenesis of osteoporosis.It has been found that the accumulation of high levels of reactive oxygen species and related oxidation products can break the balance of bone metabolism and lead to osteoporosis.In recent years,researches of Chinese materia medica and its chemical constituents in preventing and treating osteoporosis by alleviating oxidative stress are growing,and some achievements have been obtained.In this paper,the pathogenesis of osteoporosis mediated by oxidative stress was briefly reviewed by referring to relevant literatures,the researches and applications of Chinese materia medica and its antioxidant chemicals,such as flavonoids,polyphenols and saponins on osteoporosis were also introduced,and it may provide reference for the clinical application and research and development of new drug.

Abstract:American military medical security system,with leading concept and level globally,has been tested and reformed in many wars.Especially,in Oct.2013,the American Military Health System (MHS) launched the largest organizational structure adjustment in its history,and the Defense Health Agency was established.Its medical support system is increasingly scientific and its structure is increasingly reasonable.It has established a support system based on the MHS and supplemented by the civil health system.It not only distinguishes between peacetime and wartime medical support,but also emphasize the transformation of peacetime and wartime support systems,with the characteristics of separating construction and management,flexible mode,integration of military and civilian,efficient operation,etc.It plays a positive role in maintaining and improving the combat readiness capability of the American military medical services,improving medical service,and promoting medical treatment capability.At present,the construction of the medical support system of our army has entered a critical period of transformation and development.We can learn some concepts and experience from American medical security system in terms of the determining health service status,transformation of health service systems,and health service support mode,so as to establish a more scientific and efficient health service support system.

Abstract:Objective To observe the preventive effect of Bailongjieyu granule on mental stress of naval officers and soldiers on voyage mission.Methods A total of 209 naval officers and soldiers were enrolled and divided into Bailongjieyu granule group (n=103) and blank group (n=106) by random number table method.The officers and soldiers of the 2 groups were investigated with psychological stress self-evaluation test (PSET) and symptom checklist 90(SCL-90) in their 1^st week of voyage.Only the officers and soldiers in the Bailongjieyu granule group were given Bailongjieyu granule in their 3^rd week of voyage.PSET and SCL-90 were retested respectively in the 2 groups in the 4^th week of voyage,and intergroup analysis was conducted.Results The baseline data of the 2 groups were basically consistent,and there were no significant differences in factor scores of PSET or SCL-90 between the Bailongjieyu granule group and the blank group in the 1^st week of voyage (all P>0.05).The standard score of PSET in the blank group in the 4^th week of voyage was significantly higher than that in the 1^st week of voyage (P<0.05).There was no significant difference in the standard score of PSET in the Bailongjieyu granule group between the 1^st week and the 4^th week of voyage (P>0.05).The standard score of PSET in the Bailongjieyu granule group in the 4^th week of voyage was significantly lower than that in the blank group (P<0.05).The SCL-90 scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,fear,paranoia,psychotic,and other factors in the blank group in the 4^th week of voyage were significantly higher than those in the 1^st week of voyage (all P<0.05).The SCL-90 scores of depression,fear,paranoia and psychotic factors in the Bailongjieyu granule group in the 4^th week of voyage were significantly lower than those in the blank group in the 4^th week of voyage (all P<0.05).Conclusion Bailongjieyu granule can prevent naval officers and soldiers who are in voyage missions from military stress response.

Abstract:Severe traumatic brain injury (sTBI) is the leading cause of death in combat casualties.Although no neurosurgeon was deployed in early medical treatment facilities (MTF) during Operation Iraqi Freedom and Operation Enduring Freedom,early intervention with active and effective treatment strategies resulted in improved the outcomes in soldiers suffering sTBI,even better than civilians in the same period.In this article,the author reviewed the significance,task lists and problems of US military early MTF,so as to provide reference for our military medical service in sTBI.

Abstract:Objective To investigate the effect of low-level laser on periodontal bone remodeling factors during orthodontic retention after tooth movement in rats.Methods A total of 80 Wistar rats were randomly divided into blank control group and 4 model groups (relapse group,retention group,retention+laser group,and relapse+laser group),with 16 rats in each group.In the blank control group,no active force was applied and no measures were taken.The first molar mesial movement model was constructed in the other 4 groups,and the intraoral device was removed after 21 d of active force application.The relapse group was equipped without retention device,the retention group was equipped with retention device,the retention+laser group was equipped with retention device and irradiated with low-level laser every other day,and the relapse+laser group was equipped without retention device but irradiated with low-level laser every other day.The rats were sacrificed on the 2^nd,5^th,10^th and 15^th day of the retention period after 21 d of active force application,and the total RNA of 2-mm tissues around the first molar was extracted.The mRNA expression of bone remodeling factors (Runt-related transcription factor 2[Runx2],alkaline phosphatase[ALP],type Ⅰ collagen[COLⅠ],nuclear factor of activated T cell[NFATc],cathepsin K[CTSK],and matrix metalloproteinase 9[MMP9]) were detected by quantitative polymerase chain reaction (qPCR).Results The mRNA expression of the 6 bone remodeling factors in the 4 model groups was higher than that in the blank control group,and the differences were statistically significant at most time points (all P<0.05);the mRNA expression of the 6 bone remodeling factors in the relapse group was significantly higher than that in the retention group at each time point (all P<0.01).As time went on,the mRNA expression of 6 bone remodeling factors in the retention+laser group was higher than that in the retention group,and the difference was significant from the 5^th day (all P<0.05) and peaked on the 10^th day.Except for the MMP9,the mRNA expression of the other 5 bone remodeling factors in the relapse+laser group was higher than that in the relapse group at most time points (all P<0.05).Conclusion In the retention process of the first molar in rats,the low-level laser can increase the expression of bone remodeling factors and accelerate the remodeling of alveolar bone.

Abstract:Objective To investigate the clinical value of intact parathyroid (iPTH) in evaluating the treatment outcome of uremic secondary hyperparathyroidism (SHPT) after ultrasound-guided percutaneous microwave ablation.Methods A retrospective analysis was conducted on 51 cases of uremic SHPT patients who received ultrasound-guided microwave ablation in The Second Affiliated Hospital of Naval Medical University (Second Military Medical University) and Huai'an Tumor Hospital from Jan.2010 to Dec.2018.According to different ablation strategies,patients were divided into complete ablation group (30 cases) and incomplete ablation group (21 cases).Contrast-enhanced ultrasound (CEUS) and isotope localization were performed in 51 patients before ablation.In the incomplete ablation group,the iPTH determination of fine needle aspiration extract was completed for each hyperplast glands before operation.In the complete ablation group,CEUS and isotope examination were performed after operation to confirm whether the hyperplast glands were completely ablated.All patients were followed up for 9 months after surgery to analyze and compare the changes of serum iPTH level in the 2 groups.Results A total of 196 hyperplastic glands in 51 uremic SHPT patients were successfully ablated.The serum iPTH levels at 1 h and 1,3,6,9 months after operation in both groups were significantly lower than those before operation (all P<0.05);at 6 and 9 months after operation,the serum iPTH levels of patients in the incomplete ablation group were significantly higher than those in the complete ablation group (both P<0.001).The serum iPTH levels rebounded in 4 patients in the complete ablation group 6 months after operation,and rebounded in 8 patients in the incomplete ablation group 4 months after operation;the rebound time in the complete ablation group was later than that in the incomplete ablation group,and the rebound amplitude was lower than that in the incomplete ablation group.The percentage of patients whose serum iPTH level rebounded after operation in the complete ablation group was lower than that in the incomplete ablation group (26.7%[8/30]vs 71.4%[15/21],P<0.05).Conclusion There are defects in using iPTH alone as the main indicator of the postoperative efficacy of microwave ablation for uremic SHPT,so a new clinical evaluation system should be established to comprehensively evaluate the effectiveness of this treatment.

Abstract:Objective To explore the risk factors for poor prognosis of neonatal necrotizing enterocolitis (NEC).Methods The clinical data of 83 newborns with NEC (Bell stage>Ⅱ),who were treated in our hospital from Jan.2017 to Dec.2018,were analyzed retrospectively.According to the prognosis of NEC,the newborns were divided into observation group (with poor prognosis,requiring surgery,giving up treatment,or death) and control group (cured).The general data,perinatal factors,feeding before onset,treatment,laboratory auxiliary examination at onset and clinical manifestations of newborns in the 2 groups were analyzed by univariate and multivariate logistic regression analyses.Results Among the 83 NEC newborns,there were 28 cases (33.7%) in the observation group and 55 cases (66.3%) in the control group,with significant differences between the 2 groups in gestational age,birth weight,incidence of patent ductus arteriosus,time of NEC onset,first time of feeding,proportions of antenatal steroid administration,umbilical vein catheters,ibuprofen administration and prophylactic antibiotics administration,as well as white blood cell (WBC) count,platelet count,immature/total neutrophil ratio,procalcitonin level,proportion of positive blood culture and proportion of abdominal distention at onset (all P<0.05).Multivariate logistic regression analysis showed that increased gestational age (odds ratio[OR]=0.68) and WBC count at onset (OR=0.81) were protective factors,and procalcitonin>10 ng/mL at onset (OR=7.32) was a risk factor for poor prognosis of NEC (all P<0.05).Conclusion The increased gestational age and WBC count at onset are protective factors for the poor prognosis of NEC,and procalcitonin >10 ng/mL at onset is a risk factor for the poor prognosis of NEC.

Abstract: