Clinicopathologic characteristics of liver inflammation and fibrosis in 310 patients with chronic hepatitis B / 中南大学学报(医学版)

OBJECTIVES@#Long-term hepatitis B virus (HBV) infection can cause recurrent inflammation in the liver, and then develop into liver fibrosis, cirrhosis, and liver cancer. The hepatic pathological change is one of the important criteria for guiding antiviral therapy in patients with chronic hepatitis B (CHB). Due to the limitations of liver biopsy, it is necessary to find valuable non-invasive indicators to evaluate the hepatic pathological changes in CHB patients and guide the antiviral therapy. This study aims to analyze the clinical characteristics of different pathological changes in CHB patients, and to explore the factors influnencing the degree of liver inflammation and fibrosis in CHB patients with normal alanine aminotransferase (ALT).@*METHODS@#This retrospective study was conducted on 310 CHB patients. Liver biopsy was performed in all these patients. The clinical data of the patients were collected. The liver biopsy pathological results were used as the gold standard to analyze the relationship between clinical indicators and liver pathological changes. Then CHB patients with normal ALT were screened, and the independent factors influencing the degree of liver inflammation and fibrosis were explored.@*RESULTS@#Among the 310 patients with CHB, there were 249 (80.3%) patients with significant liver inflammation [liver inflammation grade (G) ≥2] and 119 (38.4%) patients with significant liver fibrosis [liver fibrosis stage (S) ≥2]. The results of univariate analysis of total samples showed that the ALT, γ-glutamyl transferase, alkaline phosphatase, and HBV DNA were related to the significant liver pathological changes. Among the 132 CHB patients with normal ALT, the patients with liver pathology G/S≥2, G≥2, and S≥2 were 80.3% (106/132), 68.2% (90/132), and 43.2% (57/132), respectively. The results showed that the independent influencing factor of significant liver inflammation was HBV DNA>2 000 U/mL (OR=3.592, 95% CI 1.534 to 8.409), and the independent influencing factors of significant liver fibrosis were elevated alkaline phosphatase level (OR=1.022, 95% CI 1.002 to 1.043), decreased platelet count (OR=0.990, 95% CI 0.982 to 0.998), and positive in hepatitis B e antigen (HBeAg) (OR=14.845, 95% CI 4.898 to 44.995). According to the multivariate analysis, a diagnostic model for significant liver fibrosis in CHB patients with normal ALT was established, and the area under the receiver operating characteristic curve was 0.844 (95% CI 0.779 to 0.910).@*CONCLUSIONS@#The liver pathological changes should be evaluated in combination with different clinical indicators. A considerable number of CHB patients with normal ALT still have significant liver pathological changes, which need to be identified and treated with antiviral therapy in time. Among them, HBV DNA>2 000 U/mL suggests the significant liver inflammation, and the diagnostic model for significant liver fibrosis based on alkaline phosphatase, platelet count, and HBeAg can help to evaluate the degree of liver fibrosis.

Effects of neutrophil DNA methylation on periodontitis and research progress in bioinformatics / 国际生物医学工程杂志

Periodontitis is a chronic infectious disease leading to periodontal connective tissue destruction and alveolar bone resorption, which is widely prevalent and seriously endangers the oral and systemic health of a wide range of patients. The host immune inflammatory response plays a major role in the tissue destruction of periodontitis. Polymorphonuclear neutrophils (PMNs), as one of the important immune cell components in periodontal tissues, can trigger the host immune inflammatory response through the release of pro-inflammatory factors, which in turn leads to periodontitis. DNA methylation can influence the function of immune cells by regulating gene expression. Bioinformatics technology can provide new ideas for the treatment of periodontitis by analyzing the gene expression profiles and DNA methylation data of periodontal tissues from public databases of periodontitis patients and healthy populations, uncovering key DNA methylation genes of PMNs, and elucidating the influence of these genes on the pathological progression of periodontitis.

Application of platelet-rich fibrin in the treatment of periodontitis / 国际生物医学工程杂志

Objective:To explore the effects of platelet-rich fibrin (PRF) on the periodontal soft tissue and bone tissue during the treatment of periodontitis.Methods:Twenty patients with three-wall bone defect of periodontitis requiring periodontal surgery in the Department of Stomatology of the Tianjin First Central Hospital from December 2018 to August 2019 were selected and randomly divided into the experimental group ( n=10) and the control group ( n=10) using the random number table method. For the experimental group, the PRF membrane was covered with Bio-Oss bone. For the control group, only Bio-Oss bone powder was implanted. The image measurement values of probing depth (PD), periodontal attachment level (AL), bleeding index (BI) and bone defect (IBD) were recorded before and 6 months after the operation, and statistical analysis was performed. Results:The measured values of PD, AL and IBD of the two groups after the operation were better than those before the operation (all P<0.05), which indicated that the operation was effective. At 6 months after the operation, the PD and AL of the experimental group were better than those of the control group (all P<0.05). However, BI and IBD had no statistical significance between the two groups (all P>0.05). Conclusions:The combined use of PRF membrane during periodontal bone grafting can effectively reduce PD and obtain more new clinical attachments.

Long-term outcomes of survivors of mechanical ventilation in intensive care unit (ICU) and their views on ICU rehabilitation clinics / 中华危重病急救医学

Objective:To describe the long-term outcomes of intensive care unit (ICU) survivors of mechanical ventilation, and investigate the views of survivors on ICU rehabilitation clinics.Methods:A single-center cross-sectional descriptive study was designed. ICU survivors of mechanical ventilation admitted to the First Affiliated Hospital of Guangzhou Medical University from January to December 2016 were enrolled. Data were collected from August 2017 to March 2018. The general information questionnaire, Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and ICU rehabilitation clinics questionnaire were used to evaluate ICU survivors social-demographic factors, social and economic outcomes, clinical data, quality of life and the views on ICU rehabilitation clinics.Results:A total of 248 ICU survivors of mechanical ventilation were included in the study, 130 (52.4%) of them were followed up successfully. The mean time from ICU discharge to follow-up day was (19.64±3.20) months. The average age of the survivors was (60.09±15.42) years old, and 55.4% of them were over 60 years old. Among 130 ICU survivors, severe pneumonia was the dominant ICU admission diagnosis (23.1%), followed by surgical operations (cardiac surgery 16.9%, other surgical operations 20.8%), lung transplantation (13.1%), and acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 12.3%), etc. The first APACHEⅡ score after ICU admission was 16.88±7.37, the mechanical ventilation time was (12.52±12.34) days, and the length of ICU stay was (16.71±15.11) days. In terms of social and economic outcomes, the proportion of having full-time or part-time jobs decreased from 32.3% (42/130) before ICU admission to 25.4% (33/130) by the date of follow-up, while the unemployed rate increased from 6.9% (9/130) to 18.5% (24/130). Only 45.1% (23/51) of the ICU survivors returned to the post before ICU admission. 36.2% (47/130) of the ICU survivors reported that they needed care from others, and 86.9% (113/130) reported that their treatment experiences in ICU had an impact on their lives. In terms of quality of life, physiological function dimension, which was 34.62±33.15, scored the lowest and suffered the most. The physical pain dimension and mental health dimension suffered the least, and the scores were 90.19±16.98 and 75.28±15.15, respectively. Furthermore, physical component summary (PCS) score was 61.12±17.09, and mental component summary (MCS) score was 65.97±21.85. In terms of the views of ICU rehabilitation clinics, 68.5% (89/130) of the subjects believed that the establishment of ICU rehabilitation clinics was very helpful or helpful.Conclusions:The long-term outcomes of ICU survivors of mechanical ventilation are not optimistic. Their quality of life is lower than that of general people. It is necessary to set up ICU rehabilitation clinics.

Effect of low-level laser therapy on cytokines in gingival crevicular fluid of patients with severe periodontitis / 国际生物医学工程杂志

Objective:To study the effect of low-level laser therapy (LLLT) on cytokines in gingival crevicular fluid of patients with severe periodontitis, and to analyze the effect of LLLT on periodontal inflammation control and bone healing.Methods:A total of 43 teeth from 18 patients with severe periodontitis were selected. There were no differences in age, gender, and periodontal status of all patients enrolled. 20 teeth in the control group received basic periodontal treatment, and 23 teeth in the experimental group were received combination of basic periodontal treatment and LLLT. During the LLLT treatment, the gingival pocket was irradiated by low-level laser for 15 s on days 1, 2, and 7. One and four weeks after treatment, the gingival crevicular fluid the patients in the control group and the experimental group was collected, and the interleukin-1β (IL-1β), transforming growth factor-β (TGF), tumor necrosis factor-α (TNF-α), metal matrix protease-8 (MMP-8), soluble intercellular adhesion molecule-1 (sICAM-1) and periosteal protein levels were determined by enzyme-linked immunosorbent assay (ELISA).Results:After treatments, the levels of IL-1β, TNF-α, MMP-8 and sICAM-1 in the control group and the experimental group decreased, and the levels of TGF-β and periosteal protein increased. The basic periodontal treatment combined with LLLT had better therapeutic effect. One week after treatments, the differences in the levels of IL-1β and TNF-α between the two groups were statistically significant (all P<0.05). Four weeks after treatments, the differences in the levels of IL-1β, TNF-α, TGF-β, MMP-8 and sICAM-1 between the two groups were statistically significant (all P<0.05). Conclusions:LLLT treatment can effectively reduce the levels of IL-1β, TNF-α and MMP-8 in the gingival crevicular fluid of patients with severe periodontitis in a short period of time. LLLT has a certain effect on the recovery of periodontal tissue, including controlling periodontal inflammation, reducing the expression of sICAM-1 in gingival crevicular fluid, alleviating the symptoms of gum bleeding, promoting the secretion of TGF-β, increasing the level of periosteal protein, and inhibiting the destruction of periodontal tissue.

Clinical effect of low-level laser on severe periodontitis / 国际生物医学工程杂志

Objective:To evaluate the clinical effect of basic periodontal therapy combined with low-level laser irradiation on patients with severe periodontitis.Methods:18 patients with severe periodontitis (a total of 43 teeth samples) were enrolled from the Dental Department of Tianjin First Central Hospital from June 2018 to May 2019. The patients were averagely divided into the control group (20 teeth) and the experimental group (23 teeth) according to the random number table method. All the teeth were firstly received basic periodontal treatment. In the experimental group, the gingival pouch of the teeth was irradiated with low energy laser for 15 s on the 1st, 2nd, and 7th days after the basic periodontal treatment, in which the output power is 80 mw, the energy density is 4 J/cm 2, and irradiated area is 0.28 cm 2. Before the treatment and 1 week and 4 weeks after the treatment, the periodontal probing depth (PD), clinical attachment level (CAL), gingival sulcus bleeding index (SBI) of the teeth of the control group and the experimental group were detected, and the gingival sulcus of the two groups were collected at the same time. The level of basic fibroblast growth factor (b-FGF) in gingival crevicular fluid was detected by enzyme-linked immunosorbent assay (ELISA), and the level of serum hypersensitive C-reactive protein (hs-CRP) was detected by immunoturbidimetry. Results:Before the treatment, there were no significant differences in the age, PD, CAL, SBI, hs-CRP and b-FGF levels of patients with severe periodontitis between the two groups (all P>0.05). One week after the treatment, there was no statistically significant difference in PD, CAL, hs-CRP and b-FGF levels between the two groups (all P>0.05), and the SBI of the experimental group (2.43±0.97) was lower than that of the control group (4.13±0.78), and the difference was statistically significant ( P<0.05). Four weeks after the treatment, the SBI of the experimental group (2.26±0.96) was lower than that of the control group (3.75±0.72) ( P<0.01), there was no statistical difference between the two groups in PD and CAL (all P>0.05), the b-FGF level of the experimental group [(35.28±5.41) pg/30 s] was higher than that of the control group [(33.45±2.37) pg/30 s] ( P<0.05), and the serum hs-CRP level of the experimental group [(3.23±1.73) mg/L] was significantly lower than that of the control group [(5.79±0.63) mg/L] ( P<0.05). Conclusions:Low-level laser therapy can effectively reduce the SBI of severe periodontitis patients in the short term, but it has little significance for reducing PD and improving CAL. At the same time, low-level laser therapy can reduce the serum hs-CRP level of patients and increase the level of b-FGF in gingival sulcus fluid, which is beneficial to the control of severe periodontal inflammation.

Effect of low le vel laser treatment combined with periodontal initial therapy on IL-8, b-FGF and IL-1βcontent in gingival crevicular fluid on peri-implantitis / 国际生物医学工程杂志

Objective To investigate the effect of low level laser treatment combined with periodontal therapy on interleukin-8 (IL-8), basic fibrobast growth factor (b-FGF) and interleukin-1β (IL-1β) level in gingival crevicular fluid on peri-implantitis , so as to evaluate the curative effect . Methods A total of 38 patients (50 implants) with early peri-implantitis were randomly divided into experimental group and control group, with 19 patients (25 implants) in each group. The patients in the experimental group were underwent level laser treatment combined with periodontal initial, and in the control group were only treated with periodontal initial. The implant gingival crevicular fluid was collected before the treatment (baseline), and 4 weeks and 12 weeks after the treatment. The levels of IL-8, b-FGF and IL-1βwere determined by enzyme-linked immunosorbent assay (ELISA). The SPSS19.0 software was used for the statistically analysis. Results The levels of IL-8, b-FGF and IL-1β of the experimental group and the control group were both improved at 4 weeks and 12 weeks after treatment comparing with that at the baseline, and the differences were statistically significant (all P<0.01). The differences in IL-8 and b-FGF levels in the gingival crevicular fluid were statistically significant at different time points for each group (all P<0.01). For the two groups, the differences in IL-1βwere not statistically significant at 4 weeks and 12 weeks after the treatment (all P>0.05). The levels of IL-8 and IL-1βof the experimental group were lower than those of the control group at 4 weeks after treatment, and the differences were statistically significant (all P<0.05). The level of b-FGF of the experimental group was higher than that of the control group at 12 weeks after the treatment, and the difference was statistically significant (P<0.05). Conclusions Low-energy laser can affect the level of cytokines in the gingival crevicular fluid on peri-implantitis. The combination of low level laser treatment and periodontal initial therapy is effective for treating peri-implantitis.

Anxiety and depression status of coal miners and related influencing factors / 中华劳动卫生职业病杂志

Objective@#To analyze the anxiety and depression status of coal miners and related influencing factors, and to provide justifications for occupational health protection.@*Methods@#From April 2017 to June 2017, a total of 650 coal miners in a mining area in Shanxi, China were enrolled; The coal miners were evaluated for their anxiety and depression status using the Hamilton Anxiety Rating Scale (14 items) and the Hamilton Depression Rating Scale (17 items) , respectively. The related influencing factors for anxiety and depression of the coal miners were analyzed with nonparametric test, chi-square test, and logistic regression.@*Results@#The incidence rates of anxiety and depression were 51.1% and 60.5%, respectively. As suggested by the scores and detection rates of anxiety and depression, males had significantly higher anxiety and depression scores than females (P<0.05) ; subjects in older-age groups and those working in shifts had significantly higher anxiety scores (P<0.05) ; subjects with higher education degrees and smokers had significantly higher depression scores (P<0.05) ; while subjects with longer length of service, those with poor sleep quality, and those working in the underground mines had both significantly higher anxiety and depression scores (P<0.05) . The detection rate of anxiety was significantly higher in subjects with a drinking habit than in those who did not drink (P<0.05) . The detection rate of depression was significantly higher in subjects with hypertension than in those with normal blood pressure (P<0.05) . A multivariate logistic regression analysis showed that work type and length of service were related to anxiety; gender and length of service were related to depression; length of service was positively correlated with both anxiety and depression.@*Conclusion@#The anxiety and depression in coal miners and related influencing factors should be taken seriously. Gender, age, length of service, working in shifts, education degree, smoking, sleep quality, underground working environment, and hypertension may be risk factors for anxiety and depression in coal miners.

Expression profiles of the exosomal miRNAs in the chronic hepatitis B patients with persistently normal ALT / 中南大学学报(医学版)

Objective:To investigate expression profiles of the plasma exosomal miRNAs of the chronic hepatitis B (CHB) patients with persistently normal alamine aminotransferase (PNALT) for the first time and try to find exosomal miRNAs which could reflect liver inflammation better.Methods:Five CHB patients with liver tissue inflammation grade ≥A2 of PNALT and 5 CHB patients with liver tissue inflammation grade ＜A2 of PNALT were enrolled and their blood samples were collected.The exosomes were extracted from these blood samples and measured by electron microscope to determine the extraction effect.The exosomal miRNAs were extracted and sent for high throughput sequencing,and the expression of exosomal miRNAs in the 2 groups of patients was analyzed.Results:Under the electron microscope,exosomes were small membranous vesicles with 30-100 nm in diameter.The peak value of particle size ranged from 10 to 100 nm.High throughput sequencing showed that there were 591 differentially expressed exosomal miRNAs between the 2 groups.Compared with the control group,18 exosomal miRNAs were up-regulated and 6 exosomal miRNAs were down-regulated in PNALT patients with the liver tissue inflammation grade ≥ A2.Conclusion:Exosomal miRNAs in the CHB patients with PNALT who have the different grades of liver inflammation are differently expressed.Some of the differently expressed exosomal miRNAs are expected to be sensitive biomarkers for timely assessment of liver inflammation in the CHB patients with PNALT.

Effect of low energy laser therapy on peri-implantitis in clinical patients / 国际生物医学工程杂志

Objective To study the effectiveness of basic therapy combined with low energy laser irradiation therapy to the patients with peri-implantitis, and to clarify the effect of laser irradiation in the treatment process. Methods A total of 38 patients (50 implants) who were diagnosed with early peri-implantitis from September 2017 to March 2018 in the Department of Stomatology, Tianjin First Central Hospital were randomly divided into the laser treatment group (n=25) and the conventional treatment group (n=25). The control group received basic treatment, and the laser treatment group received basic treatment combined with low energy laser irradiation (808 nm GaAlAs semiconductor continuous laser, average output power 80 mw, energy density 4 J/cm2, facula area 0.28 cm2, 15 seconds irradiation for each implant bag). The GIgingival index (GI), plaque index (PLI), sulcus bleeding index (SBI) and probe depth (PD) were examined before and 2 weeks and 8 weeks after the treatment. Results At 2 weeks and 8 weeks after the treatments, the indexes of the two groups were both improved compared with the baseline, and the differences were statistically significant (all P<0.05). Compared with the control group, the GI was significantly decreased (P=0.018) at 2 weeks after the treatment, and the GI, PD, and SBI were significantly decreased at 8 weeks after the treatment (P<0.001, P=0.018, and P<0.001, respectively). Conclusions At an energy density of 4 J/cm2, low energy laser irradiation at a wavelength of 808 nm can accelerate tissue healing of peri-implant inflammation after basic treatments.

Clinical observation of preservation of inclined fractured permanent molars by transverse fixation with screw post / 天津医药

Objective To explore the effect of preservation of inclined fractured permanent molars by transverse fixation with screw post,and provide a practical method for reserving the inclined fractured permanent molars.Methods Clinical data of 50 patients with inclined fractured permanent molars by transverse fixation with screw post in the Department of Stomatology of Tianjin First Central Hospital between January 2010 to December 2011 were reviewed retrospectively.After fixing the crown with steel-wire binding and root canal treatment,the molars were drilled a hole buccolingually and placed screw post.The flowable light-curing composite resin was used to seal the crack and bond screw post to prevent the relative movement.All treated molars were restored with full crown.All patients were followed up for 10-60 months.The therapeutic effects were observed.Results After 5 year-follow-up,41 cases were cured completely,6 cases were cured clinically,and 3 cases failed treatment.Conclusion The transverse fixation with screw post and bonding technique can preserve the inclined fractured molars to gain chewing function and avoid or reduce the extraction of affected teeth,which provides a better restoration effect.

MicroRNA-30a inhibits proliferation of hepatocellular carcinoma cells via targeted regulation of forkhead-box protein A1 / 中华肝脏病杂志

Objective@#To investigate the expression of microRNA-30a (miR-30a) in hepatocellular carcinoma (HCC) and related molecular mechanisms in regulating HCC cell proliferation.@*Methods@#A total of 30 pairs of HCC and adjacent tissue samples were collected, and quantitative real-time PCR and Western blot were used to measure the mRNA and protein expression of forkhead-box protein A1 (FOXA1). Methyl thiazolyl tetrazolium (MTT) assay was used to evaluate the proliferation of HCC cells, luciferase reporter gene assay was performed to verify the target relationship between miR-30a and FOXA1, and MTT assay and Western blot were used to measure the proliferation of HepG2 cells and the protein expression of FOXA1 after miR-30a transfection. The t-test was used for comparison of data between two groups, and a one-way analysis of variance was used for comparison of data between multiple groups. P < 0.05 was considered statistically significant.@*Results@#HCC tissue had significantly lower relative expression of miR-30a than adjacent tissue (1.049 ± 0.380 vs 1.982 ± 1.013, t = 3.985, P < 0.001). At 72 hours after miR-30a overexpression, there was a significant difference in the proliferative capacity of HepG2 cells between the blank control group, the miR-30a-NC group, and the miR-30a group (0.821 ± 0.006 vs 0.816 ± 0.013 vs 0.546 ± 0.020, F = 3.396, P < 0.05), suggesting that miR-30a overexpression significantly inhibited the proliferation of HepG2 cells. FOXA1 was a target gene of miR-30a and its protein expression was negatively regulated by miR-30a, and there was a significant difference in luciferase activity between wild-type and mutant FOXA1-3’UTR vectors (1.221 ± 0.024 vs 2.658 ± 0.031, F = 6.737, P < 0.05). In HepG2 cells, miR-30a overexpression significantly inhibited the protein expression of FOXA1, and there was a significant difference in the relative expression of FOXA1 between the blank control group, the miR-30a-NC group, and the miR-30a group (1.019 ± 0.016 vs 1.022 ± 0.017 vs 0.227 ± 0.021, F = 45.43, P < 0.05). Upregulating the protein expression of FOXA1 reversed the inhibitory effect of miR-30a on the proliferation of HepG2 cells, and there was a significant difference in the proliferative capacity of HepG2 cells between the miR-30a group and the miR-30a+FOXA1 group (0.524 ± 0.023 vs 0.843 ± 0.019, t = 2.507, P < 0.05).@*Conclusion@#MiR-30a exerts its inhibitory effect on the proliferation of HCC cells by negatively regulating the expression of FOXA1.

Study on ultramicrostructure change and keratin1 expression in patients with symmetrical acral keratoderma / 重庆医学

Objective To study the ultramicrostructure change and keartin(KRT1) expression in skin lesion of symmetrical acral keratoderma(SAK) .Methods Thirteen cases of SAK in the First Affiliated Hospital of Fujian Medical University and the outpatient department of the Dongguan Municipal Sixth People′s Hospital were selected as the study subjects .The histopathological samples were taken from the wrist site .The retinoic acid preparation or corticosteroid preparation or Chinese medicine preparation were not externally used within 2 months before taking skin lesion sample .The healthy control skin samples were the normal skin in 12 cases by plastic surgical resection .The ultramicrostructural change were observed by the transmission electron microscopy .The KRT1 expression in skin lesion of 13 cases of SAK and healthy skin tissue of 12 cases were measured by immunohistochemistry method .Results The SAK ultramicrostructures manifested by the interruption of keratinizing envelope continuity in horny layer , and remarkable aggregation of keratin filament in upper stratum spinosum and surrounding nucleus of granular layer .KRT1 was ex-pressed in the cells of SAK skin lesion and basal layer ,spinous layer ,granular layer and horny layer .The cytoplasm and cytomem-brane staining was common .The KRT1 expression in skin lesion was significantly higher than that in normal skin (t=2 .210 ,P=0 .038) .Conclusion The ultramicrostructure features of SAK skin lesion are abnormal differentiation of epidermis keratin fila-ments ,which might be related with overexpression of KRT 1 .

Effect of low 1evel laser treatment on metabolic control and high-sensitivity C-reactive protein of type 2 diabetes mellitus combined chronic peridontitis patients / 国际生物医学工程杂志

Objective To investigate the effect of low 1evel laser treatment (LLLT) on periodontal clinical index,high-sensitivity C-reactive protein (hs-CRP) and metabolic control in patients of type 2 diabetes mellitus combined chronic peridontitis.Methods Nighty patients with type 2 diabetes combined chronic peridontitis were divided into three groups:initial periodontal therapy (group A),initial therapy combined with LLLT (group B) and control group (group C).The periodontal clinical parameters including periodontal probing depth (PD),clinical attachment loss (CAL),sulcus bleeding index (SBI),hs-CRP,HbA1c and fasting blood glucose (FBG) were tested before and at three months after therapy.Results The periodontal clinical parameters (PD,CAL,SBI) and hsCRP in group A and B improved significantly compared with that of group C after therapy (P＜0.05),with group B had more significant difference (P＜0.01).For the levels of HbA1c and FPG,group A and B showed downtrend,and more obvious outcome was detected in group B (P＜0.05).Conclusions LLLT can effectively improve periodontal status,hs-CRP levels and metabolic control of patients with type 2 diabetes combined with chronic peridontitis,and thus to prevent the occurrence of diabetes complications.

MicroRNA-33b inhibits cell proliferation in hepatocellular carcinoma via targeting SALL4 / 中南大学学报(医学版)

OBJECTIVE@#To investigate the expression of miR-33b in hepatocellular carcinoma (HCC) and to explore regulatory mechanism of miR-33b for cell proliferation of HCC.
@*METHODS@#HCC tissues and adjacent non-tumor tissues were collected for this study (n=32 for each). Real-time PCR and Western blot were conducted to examine the mRNA and protein expression, respectively. MTT assay was used to detect the cell proliferation. Luciferase reporter gene assay was performed to verify the target relationship between miR-33b and Sal-like 4 (SALL4).
@*RESULTS@#MiR-33b was significantly downregulated in HCC tissues compared with adjacent non-tumor tissues. Overexpression of miR-33b decreased the proliferation of HCC LH86 cells. SALL4 was identified as a target gene of miR-33b, and its protein expression was negatively regulated by miR-33b. Overexpression of SALL4 reversed the suppressive effect of miR-33b on LH86 cell proliferation. SALL4 was significantly upregulated in HCC tissues compared with adjacent non-tumor tissues.
@*CONCLUSION@#The miR-33b suppresses HCC cell proliferation through down-regulation of SALL4.

Clinical observation of perioperative continuing aspirin therapy in tooth extraction surgery in patients with coronary heart disease / 中华老年医学杂志

Objective To investigate the influence of perioperative continuing aspirin therapy on tooth extraction surgery in elderly patients with coronary heart disease.Methods A total of 926 patients with coronary heart disease who required tooth extraction were enrolled in this study.Among them,241 patients discontinued aspirin therapy before tooth extraction,685 patients continued aspirin therapy before tooth extraction.The entering rate of operation was evaluated.100 patients continuing aspirin and 100 patients discontinuing aspirin were randomly selected.Systemic pressure,diastolic pressure and heart rate before and after tooth extraction were detected.100 matched healthy elderly patients were selected as normal control group.Multivariate logistic regression analysis was used to estimate the risk for tooth extraction.Results The entering rate of operation was 67.9％ (131 cases) in 193 patients with angina pectoris discontinuing aspirin therapy and 82.1 ％ (312 cases) in 380 patients with angina pectoris continuing aspirin therapy (x2 =14.77,P＜0.01).The entering rate of operation was 41.7％ (20 cases) in 48 patients undergoing coronary revascularization and discontinuing aspirin therapy,and 80.7％ (312 cases) in 305 patients undergoing coronary revascularization and continuing aspirin therapy (x2=33.95,P＜0.01).The changes in systolic blood pressure before versus after dental extraction had a significant difference between the discontinuing aspirin group and control group [(15.9±5.5) mmHg vs.(12.2±4.7)mmHg,P＜0.05,1 mmHg=0.133 kPa],while had no significant difference between the continuing aspirin group and control group [(13.6±4.5) mmHg vs.(12.2±4.7) mmHg,P＞0.05].There were no significant differences in changes in diastolic blood pressure and heart rate in the intraoperative period between the patients and controls (P＞0.05).The bleeding rate in patients continuing aspirin therapy was not significantly different as compared with control group (P＞ 0.05).Multivariate logistic regression analysis revealed that perioperative discontinuing aspirin therapy remained the second significant risk factor for tooth extraction.Conclusions Preoperative administration of aspirin should be continued in dental extraction surgery in elderly patients with coronary heart disease.

In Vitro Study of Four Endodontic Irrigation Protocols on Smear Layer Removal in Curved Canals / 天津医药

Objective To investigate the effective endodontic irrigation protocols on smear layer removal from curved canals. Methods Forty extracted mandibular first molars with curved mesial root canal were selected and decoronat-ed. Mesiobuccal root canal was instrumented to F3 using handed ProTaper system, and randomly divided into four groups ac-cording to final irrigation protocols: syringe irrigation (group A), #30K file agitation (group B), passive ultrasonic irrigation (PUI, group C) and combination of #30K file agitation and PUI (group D). The ultrasonic file was located within 0.5 mm coro-nal from start of the curvature. All root canals were mesio-distally split, snicked at the start of the curvature and 2 mm apical-ly from the start of the curvature, and divided into three sections. They wereⅠ,ⅡandⅢfrom coronal to apical. The smear layer of each section of root canal was examined under scanning electron microscope (SEM). Results Group D presented small amounts of scattered or thin smear layers and obtained the lowest score at each section of root canal wall. At sectionⅠandⅡ, there was no significant difference in smear layer score between group D and group C. The smear layer scores were both significantly lower in group D and group C than those of group A and group B (P<0.05). At sectionⅢ, the smear layer score was significantly lower in group D than that of group A, group B and group C, and which was significantly lower in group B and group C than that of group A (P<0.05). Conclusion When ultrasonic file was located coronal from the start of the curvature, K file, which was the same size as dimension of apical portion preparation to agitate and PUI can remove smear layer from curved canals efficiently.

Effects of Smear Layer Removal on the Fracture Resistance of Roots Obturated with AH-Plus in Vitro / 天津医药

Objective To evaluate the effects of root canal cleanliness on the fracture resistance of roots filled with AH-Plus. Methods Eighty single canal premolars were instrumented using step-back technique, then were randomly di-vided into four groups (n=20 for each group). Group A was washed with distilled water for 10 min, group B1 was washed with 5%EDTA for 1 min, group B2 was washed with 5%EDTA for 5 min and group B3 was washed with 5%EDTA for 10 min. Ten samples of each group were observed by scanning electron microscope at the coronal, middle and apical thirds to exam-ine smear layer removal. The remaining samples of each group were fixed into a electronic universal testing machine and ver-tically loaded until fracture. Results The difference of coronal and middle thirds was significant between group B3 and group B2 (P<0.05). At the middle third, there was significantly improved efficiency in smear layer removal in group B2 than that of group B1(P<0.05). The mean fracture resistance was significantly higher in group B3 (391.91±12.82)N than that of group B2 (335.54±16.14)N, group B1(296.47±17.82) N and group A (264.77±16.64)N (P<0.05). Group B2 showed a signifi-cantly better fracture resistance than that of group B1 and group A (P<0.05). Conclusion The complete removal of root ca-nal smear layer can significantly improve the fracture resistances of roots filled with AH-Plus.

Study on the effect of low level laser in the treatment of periodontal disease / 国际生物医学工程杂志

Objective The purpose of this study was to explore the efficacy of low level laser treatment (LLLT) combined with initial periodontal therapy in treating chronic periodontits.Methods Eighteen patients with chronic periodontitis were randomly treated in a spit-mouth design with combination of laser (808 nm,80 mW) treatment with scaling and root planing (experimental) or with scaling and root planing alone (contol) after OHI and supragingival cleaning.Clinical parameters of sulcus bleeding index (SBI),periodontal probing depth (PD) and clinical attachment loss (CAL) of both sides were recorded and gingival crevicular fluid samples were collected at baseline and 1,4,12 weeks after the treatment.GCF samples were analyzed for b-FGF,IL-1β,IL-8 level using ELISA assay.Results For the change of SBI and PD,only SBI in the experimental group experienced significant reduction (P＜0.05) at 1 week compared with baseline (P＜0.05),and the reduction in both groups were statistically significant (P＜0.05) at 4 weeks.The same situation occurred while both experimental groups made more significant difference (P＜0.01) at 12 weeks.The reduction of SBI was obvious in both groups when the PD was more than 6 mm.For CAL,the experimental group showed signs of improvement (P＜0.05) at 4 weeks; both groups indicated improvement (P＜0.05),while the experimental was more significant (P＜0.01) at 12 weeks.For the levels of b-FGF,it showed steady rise after treatment in experimental group,while it went up to the baseline after falling in control group.At 12 weeks,there were statistical significance of differences between two groups (P＜0.05).The changes of IL-1β and IL-8,in the experimental group showed better results than that in control group,while the difference between two groups was not significant (P＞0.05).Conclusion LLLI can accelerate the healing of periodontal tissue by reducing the SBI,decreasing the PD,improving the CAL and increasing levels of b-FGF in the GCF of the patients.

Relationship between enhanced CT examination and acute kidney injury in patients with acute pancreatitis / 中国医师进修杂志

ObjectiveTo investigate the relationship between enhanced CT examination and acute kidney injury in patients with acute pancreatitis.MethodsThe clinical data of 162 acute pancreatitis patients were analyzed retrospectively.Acute kidney injury was diagnosed and graded by RIFLE criterion.The patients were divided into two groups according to enhanced CT examination:enhanced CT group and non-enhanced CT group.ResultsEnhanced CT group had 85 cases,and non-enhanced CT group had 77 cases.The increased creatinine level in enhanced CT group was higher than that in non-enhanced CT group [(59 ± 13 ) μ mol/L vs.(38 ± 11 ) μ mol/L],and there was significant difference between two groups (P ＜0.01 ).The incidence of acute kidney injury in enhanced CT group was higher than that in non-enhanced CT group [30.6％ (26/85) vs.15.6％ (12/77)],and there was significant difference between two groups (P ＜0.01 ).Enhanced CT examination increased the risk of acute kidney injury occurrence (OR =1.293,95％ CI1.089-1.443).After adjusted by diabetes and APACHE Ⅱ score,enhanced CT examination was still anindependent risk factor of acute kidney injury (OR =1.282,95％ CI 1.185-1.377 ).ConclusionsEnhanced CT examination is a potential risk factor of acute kidney injury in acute pancreatitis patients.The time of enhanced CT examination is worthy of further study.